理性情绪疗法对乳腺癌患者抑郁焦虑的影响

目的探讨理性情绪疗法对乳腺癌患者抑郁焦虑的影响。方法将82例乳腺癌患者随机分为对照组40例和观察组42例,采用抑郁量表和焦虑量表对两组患者干预前后抑郁和焦虑状态进行评定。结果两组干预前评分比较差异无统计学意义（P〉0．05）;干预后两组比较,抑郁及焦虑量表得分差异均有统计学意义（P〈0．01）。结论理性情绪疗法对提高乳腺癌患者的心理健康水平,增加其健康行为具有积极作用。     

心肌桥患者焦虑抑郁状态分析

目的:调查心肌桥患者合并焦虑、抑郁状态的情况。方法:对126例心肌桥患者进行医院焦虑抑郁量表(hospital anxie-ty depression scale,HADS)调查。计算心肌桥患者焦虑、抑郁状态的患病率。结果:126例患者中,存在焦虑状态的占42.9%,抑郁状态的占31.0%,焦虑合并抑郁状态的占22.2%。结论:许多心肌桥患者存在焦虑、抑郁状态,有必要对这部分患者进行心理干预治疗。     

117例内科疾病患者并发焦虑和抑郁症状的研究

采用ＨＡＭＡ和ＨＡＭＤ检测１１７例内科疾病患者的心理障碍。结果发现焦虑和抑郁症状的发生率为６５．８％（７７／１１７），焦虑和抑制着癍共存者为３６．８％（４５／１１７）高于仅有焦虑症状者（２７．４％，３２／１１７，Ｐ〈０．００５），这些心理障碍的发生与性别，应激因素的存在与否和病程长短有关。提示：内科疾病患者应当重视心理康复治疗。     

失眠的证候学特征与焦虑、抑郁的相关性研究

目的:探讨失眠症不同证型与焦虑、抑郁评分的关联性。方法:将137例失眠患者辨证分型为肝郁化火、痰热内扰、心脾两虚、心虚胆怯、阴虚火旺5种证候类型,采集一般资料并评定HAMA、HAMD,分析中医证型与焦虑、抑郁之间的相关性。结果:肝郁化火型失眠患者出现频次最多,占38.0%;肝郁化火型及心虚胆怯型患者焦虑、抑郁评分较高;肝郁化火型与心脾两虚型患者之间差异有显著性。结论:失眠症中医证型与焦虑、抑郁具有相关性。     

不稳定性心绞痛患者焦虑抑郁情绪临床干预研究

目的探讨抗焦虑、抑郁药物联合综合心理干预措施对不稳定性心绞痛抑郁患者的影响。方法研究对象选自我院心内科住院治疗的不稳定性心绞痛伴随焦虑抑郁情绪患者102例,随机双盲平均分组,对照组51例予以常规不稳定性心绞痛药物及心理健康护理。治疗组在此基础上予抗焦虑药物联合综合心理护理干预措施进行干预,包括抗焦虑、抑郁药物舒乐安定20mg和百忧解15mg给予治疗,行为干预措施、放松体能训练、心理疏通辅导及生物反馈等。连续服药6周及干预半年后评价治疗效果。结果经相关功能性药物及综合护理干预后,治疗组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分结果显示显著高于对照组(P<0.05),与对照组相比,观察心肌缺血改善效果及心绞痛发作次数有明显优势(P<0.05)。结论焦虑、抑郁情绪可引发心绞痛不稳定性负面躯体化行为障碍,抗焦虑药物及综合心理干预治疗对缓解该症有良好的疗效,提高患者生活质量。     

癫痫患者的生活质量以及与焦虑、抑郁情绪的相关性研究

目的探讨癫痫患者的生活质量以及与焦虑、抑郁情绪的关系。方法应用生活质量综合评定问卷（GQOLI）、Zung焦虑自评量表（SAS）及Zung抑郁自评量表（SDS）对60例癫痫患者（癫痫组）及60名健康自愿者（对照组）进行评定,并对生活质量与焦虑、抑郁作相关分析。结果癫痫患者的生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均明显低于对照组（P〈0．01）,而SAS及SDS评分则均明显高于对照组（P〈0．01）;生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均与SAS及SDS评分呈显著性负相关。结论癫痫患者的生活质量较差,焦虑、抑郁情绪明显,其生活质量与焦虑、抑郁情绪密切相关。     

叙事护理在乳腺癌患者化疗期间焦虑抑郁情绪的应用效果

目的：探讨叙事护理在乳腺癌患者化疗期间焦虑抑郁情绪中的应用效果。方法：将2019年9月至2019年12月收治的40例浸润性乳腺癌患者作为对照组,2020年1月至2020年3月收治的40例浸润性乳腺癌患者作为干预组。对照组进行科室常规的心理护理,干预组会在此基础上进行叙事护理的心理干预,从而比较两组的干预效果。结果：叙事护理干预后乳腺癌患者的焦虑、抑郁负面状态得到了明显改善,干预两周后焦虑自评量表(Self-Rating Anxiety Seale,SAS), 抑郁自评量表(Self-Rating Depression Seale, SDS)评分明显低于干预前,且差异具有统计学意义(P＜0.05)。结论：叙事护理能有效减轻乳腺癌患者化疗期间焦虑抑郁的负性情绪,重新激发患者的自我认同和生命意义重构,提高患者的生活质量,值得临床大力推广。     

Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale

The psychometric properties of the Italian version of the Hospital Anxiety and Depression Scale and its utility as a screening instrument for anxiety and depression in a non-psychiatric setting were evaluated. The questionnaire was administered twice to 197 breast cancer patients randomised in a phase III adjuvant clinical trial: before the start of chemotherapy and at the first follow-up visit. The presence of psychiatric disorders was evaluated at the follow-up visit using the Structured Clinical Interview for DSM-III-R in 132 patients. Factor analyses identified two strictly correlated factors. Crohnbach's alpha for the anxiety and depression scales ranged between 0.80 and 0.85. At follow-up, 50 patients (38%) were assigned a current DSM-III-R diagnosis, in most cases adjustment disorders (24%) or major depressive disorder (10%). Receiver operating characteristics (ROC) analysis was used to test the discriminant validity for both anxiety and depressive disorders. The comparison of the areas under the curve (AUC) between the two scales did not show any difference in identifying either anxiety (P=0.855) or depressive disorders (P=0.357). The 14-item total scale showed a high internal consistency (alpha=0.89 and 0.88) and a high discriminating power for all the psychiatric disorders (AUC=0.89; 95% CI=0.83–0.94). The cut-off point that maximised sensitivity (84%) and specificity (79%) was 10. These results suggest that the total score is a valid measure of emotional distress, so that the Italian version of HADS can be used as a screening questionnaire for psychiatric disorders. The use of the two subscales as a 'case identifier' or as an outcome measure should be considered with caution.     

心脏介入治疗手术后患者焦虑抑郁状态分析

目的：调查心脏介入治疗手术后患者合并焦虑、抑郁状态的患病率。方法：因心脏疾病行介入治疗（包括冠状动脉支架植入术、起搏器植入术、经导管射频消融术、先天性心脏病封堵术）的患者356例,术后1周内进行综合医院焦虑抑郁量表（hospital anxiety depression scale,HADs）评价。计算患者焦虑、抑郁状态的患病率。结果：356例患者中,存在焦虑状态的占18．5％,抑郁状态的占19．7％,焦虑合并抑郁状态的占9．8％。结论：心血管疾病介入治疗手术后部分患者存在焦虑、抑郁状态,有必要对这部分患者进行心理干预治疗。     

The Hospital Anxiety and Depression Scale in Greek cancer patients: psychometric analyses and applicability

Goals of work The aim of the present study was to validate the Greek version of the Hospital Anxiety and Depression Scale (HAD) in a palliative care unit.Patients and methods The scale was translated with the forward-backward procedure to Greek. It was administered twice, with a 1-week interval, to 120 patients with advanced cancer. Together with the HAD scale, the patients also completed the Spielberger State-Anxiety Scale (STAI-S).Main results Factor analyses identified a two-factor solution corresponding to the original two subscales of the HAD, which were found to be correlated. The Greek version of the HAD had Cronbachs alphas for the anxiety and depression scales of 0.887 and 0.703, respectively. Validity as performed using known-group analysis showed good results. Both anxiety and depression subscales discriminated well between subgroups of patients differing in disease severity as defined by ECOG performance status. Correlations between the HAD scale and the STAI-S was 0.681 for the anxiety subscale and 0.485 for the depression subscale.Conclusions These psychometric properties of the Greek version of the HAD scale confirm it as a valid and reliable measure when administered to patients with advanced cancer.     

冠心病患者住院期间焦虑抑郁状况调查

目的通过调查了解冠心病患者住院期间焦虑抑郁的状况,探究其影响因素,为临床护理干预提供依据。方法选择2013年8月-2014年1月收治于新疆石河子绿洲医院的冠心病患者150例,采用医院焦虑抑郁量表（HAD）进行调查。结果150例患者中,76例存在焦虑情绪,占50．67％;70例存在抑郁情绪,占46．67％。结论冠心病患者中,焦虑、抑郁是比较普遍的负性情绪,临床护士应注意识别患者心理问题。尽早给予护理干预。     

Relationships of Fear, Anxiety, and Depression With Physical Function in Patients With Knee Osteoarthritis

Scopaz KA, Piva SR, Wisniewski S, Fitzgerald GK. Relationships of fear, anxiety, and depression with physical function in patients with knee osteoarthritis.

Objectives

To explore whether the psychologic variables anxiety, depression, and fear-avoidance beliefs, and interactions between these variables, are associated with physical function in patients with knee osteoarthritis (OA). We hypothesized lower levels of function would be related to higher anxiety, higher depression, and higher fear-avoidance beliefs, and that high levels of 2 of these factors simultaneously might interact to have a greater adverse effect on physical function.

Design

Cross-sectional, correlational design.

Setting

Institutional practice.

Participants

Subjects included patients with knee OA (N=182; age, mean ± SD, 63.9±8.8y; 122 women).

Interventions

Not applicable.

Main Outcome Measures

Self-report measures of function included the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, the Lower Extremity Function Scale (LEFS), and the Knee Outcome Survey-Activity of Daily Living Scale. The Get Up and Go test was used as a physical performance measure of function. Self-report measures for psychologic variables included the Beck Anxiety Inventory, the Center for Epidemiological Studies Depression Scale, and the Fear Avoidance Belief Questionnaire-Physical Activity Scale modified for the knee.

Results

Higher anxiety was related to poorer function on the WOMAC physical function. Both high anxiety and fear-avoidance beliefs were related to poorer function on the LEFS and Knee Outcome Survey-Activity of Daily Living Scale. There was no association between the psychologic variables and the Get Up and Go test. The anxiety × depression interaction was associated with the LEFS.

Conclusions

Anxiety and fear-avoidance beliefs are associated with self-report measures of function in patients with knee OA. Depression may influence scores on the LEFS under conditions of low anxiety.     

An Analysis of the Validity of the Hospital Anxiety and Depression Scale as a Screening Tool in Patients with Advanced Metastatic Cancer

Depression is difficult to diagnose in the terminally ill patient. As a result, it frequently is not treated. This has can have an adverse effect on quality of life and make the palliation of physical symptoms more difficult. In an effort to improve the detection of depression, many palliative care teams are using the Hospital Anxiety and Depression (HAD) scale as a screening tool. The HAD was devised for use in general medical settings and has not been validated for use in palliative care patients. One hundred patients receiving palliative care with an estimated prognosis of 6 months or less were invited to complete the HAD and a semi-structured psychiatric interview, the Present State Examination. The depression and anxiety subscales of the HAD showed poor efficacy for screening when used alone. The optimum threshold was at a combined cut-off of 19, which had a sensitivity of 68% and specificity of 67%. The major construct of the HAD is anhedonia, which may be present at the end of life due to increasing physical illness and may not be pathognomic of a depressive illness in this population. We recommend, therefore, that if the HAD is used as a screening tool in palliative care, it should be as a combined scale, but low sensitivity and specificity may lead to poor efficacy as a screening tool.     

生殖道感染——影响妇女精神状态的主要因素：有无生殖道感染的纳西族妇女的焦虑和抑郁症状的比较

目的：探讨生殖道感染与心理卫生之间的关系、比较四川纳西族妇女中有无生殖道感染人群的精神状态及其影响因素、并从心理卫生角度提出改善纳西族妇女生殖健康状况的建议。方法：本研究采用抑郁自评量表（CES-D）和焦虑自评量表（SAS）于2001年7-8月对四川省泸沽湖地区的280名20岁以上的纳西族已婚育龄妇女进行了评定。结果：四川纳西族地区妇女的精神卫生状况不容乐观。在本研究调查的280名纳西族妇女中，只有74人（26．4％）没有表现出自述抑郁症状、116人（41．4％）没有表现出自述焦虑症状。该研究人群的抑郁症状总均分为20．1、焦虑症状总标准分均值为50．2，均超过被怀疑有症状的底线值。且在有、无生殖道感染两组间有显著性差异。分析表明，生殖道感染是抑郁和焦虑症状的主要危险因素（0R值分别为：16．043和12．954）：同时抑郁和焦虑症状还分别与生育孩子多（≥2个，P=0．0045，OR=3．149，95％可信区间：1．228，8．076），以及初次性生活时的年龄较小（〈17岁，P=0．0213，OR=3．042，95％可信区间：1．895，4．884），多次妊娠（≥3次，P=0．005l，OR=2．728，95％可信区间：1．990，4．173）等因素有关：笔者认为，当务之急是要提高当地医务人员心理卫生知识水平治疗、将心理咨询纳入生殖保健服务之中。     

妇科化学治疗患者自我管理效能感与焦虑抑郁的相关性分析

目的探讨妇科化学治疗（化疗）患者自我管理效能感与焦虑抑郁的关系。方法 2011年10月-2012年1月采用中文版癌症自我管理效能感量表和医院焦虑抑郁量表对110例妇科化疗患者进行问卷调查。结果共收回有效问卷106份。33例（31.70%）患者焦虑阳性,43例（41.30%）抑郁阳性,35例（33.70%）焦虑抑郁均为阳性;自我管理效能感得分为（86.31±27.06）分,并与焦虑呈负相关（r=0.793,P=0.000）,与抑郁呈负相关（r=0.753,P=0.000）。结论妇科化疗患者自我管理效能感与焦虑抑郁密切相关,在以后的护理工作中应该重视妇科肿瘤患者自我管理项目的构建,提高患者的自我效能,从而改善其心理状况。     

Anxiety Sensitivity and Health Anxiety in a Nonclinical Sample: Specificity and Prospective Relations with Clinical Stress

The present study examines the association between anxiety sensitivity (AS) and symptoms of hypochondriasis (a pattern of intense health anxiety) in a nonclinical sample. Findings from study 1 (n = 498) revealed a significant association between AS and health anxiety even after controlling for symptoms of depression and negative affect. However, the association between AS and health anxiety was not moderated by stress levels. Subsequent analysis did reveal a specific association between AS for physical concerns and health anxiety when controlling for other AS dimensions. Contrary to predictions, AS did not significantly predict residual change in symptoms of health anxiety over a 12-week period (n = 195) in Study 2. However, exploratory analyses suggest that some AS dimensions (e.g., physical concerns) may be more predictive of some facets of health anxiety (e.g., body vigilance) than others (e.g., illness severity). Findings from this study are discussed in the context of future research on the role of AS in the development of hypochondriasis.

肠易激综合征患者社会功能与抑郁、焦虑的关系

目的探讨肠易激综合征(IBS)患者的社会功能缺陷与情绪障碍的关系及抗焦虑、抑郁治疗的相关性。方法采用社会功能缺陷筛选量表（SDSS）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）分别对168例IBS患者进行社会功能评估和焦虑、抑郁的测试;把有社会功能缺陷的68例患者随机分成两组,对两组施以内科常规治疗和解释性心理治疗,同时,对研究组患者加用帕罗西汀治疗。2个月后再次用SDSS进行评定。结果IBS患者的社会功能缺陷发生率为40.5%;伴抑郁或/和焦虑者社会功能缺陷发生率较高。治疗后研究组SDSS评分显著低于对照组（P<0.001）。结论治疗IBS患者的情绪障碍能有效改善其社会功能缺陷,提高患者生活质量。     

Association between Type-D Personality and Affective (Anxiety,Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study

Background:Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients.Objective:The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up).Aims:The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients.Methods:145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1.Results:One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of Type-D personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1.Conclusion:Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology.     

Anxiety,depression and quality of life in Chinese women with breast cancer during and after treatment: A comparative evaluation

Purpose of the researchTo compare the psychological health and quality of life (QoL) of women with breast cancer, and to determine the relationship between anxiety, depression and QoL during treatment and one year afterwards.Methods and sampleFor this secondary analysis, 269 women undergoing adjuvant therapy for breast cancer, and 148 women with breast cancer who had completed all treatment within the last year completed a self-report questionnaire covering the Hospital Anxiety and Depression Scale-Cantonese/Chinese version, Functional Assessment of Cancer Therapy-General, and demographic and clinical characteristics.Key resultsThe ongoing-therapy group showed higher levels of anxiety and depression and lower levels of all QoL dimensions than the post-therapy group. Linear regression results showed that both anxiety and depression were significantly related to physical and functional well-being, while depression was associated with social/family well-being in both groups. In the case of emotional well-being, anxiety had a strong significant association in both groups and depression a significant relationship only in the ongoing-therapy group.ConclusionsThe psychological health of women with breast cancer is affected during and after treatment. Psychological distress in these patients, including anxiety and depression, has independent associations with impaired emotional, functional, physical and social well-being. The results highlight the importance of timely detection of anxiety and depression, and their proper management, during the treatment and survivorship phases of the breast cancer trajectory.