广泛焦虑障碍的心理社会因素、免疫学相关研究

目的：研究广泛焦虑障碍(GAD)患者的心理社会因素、免疫学特点及这二者之间的相互关系。方法：研究组为30例GAD患者，对照组为25例抑郁性神经症(DN)患者及32例健康人。所有样本均用生活事件量表(LES)测评生活事件应激，用简易应对方式问卷(SCSQ)评定应对方式，用艾森克个性问卷(EPQ)评定人格特征，测血清白介素-2(IL-2)浓度，自然杀伤细胞(NK)及CD3 细胞比率测定。比较GAD与DN、正常对照组(NCG)二组的差异，并对GAD内部有关指标进行相关分析。结果：GAD组患者LES评定中，负性事件数及LEU值水平小于DN组，生活事件发生的总件数、负性事件数、负性事件LEU值均大于正常组。应对方式中，积极应对维度少于正常组，消极应对维度多于DN组及正常组。EPQ评定中，无论男女N分均大于正常组，与DN组无显著性差异。IL-2大于DN组及正常组。CD3 及NK比例与其它两组均无显著性差异。IL-2与生活事件总件数、EPQ中L分呈负相关，与NK呈正相关。结论：GAD患者有明显的心理社会应激、消极的应对方式、情绪不稳定，存在着部分免疫功能异常。心理社会因素对免疫学有影响。     

急性心肌梗塞病人心理健康及有关心理社会因素调查

目的：探讨急性心肌梗塞患者的负性情绪及相关吲素。方法：91例急性心肌梗塞（AMI）病人和90例正常人应用SCL-90、SAS、SDS、LES、SSRS等量表进行对照调查。结果：AMI组在焦虑、抑郁、强迫、敌对、人际关系敏感、恐怖、偏执、躯体化等因子均明显高于正常组，存一年内的负性生活事件也明显高于对照组。社会支持度低于对照组（P〈0．01）。结论：负性情绪、负性生活事件发生率，缺乏社会支持可能是急性心肌梗塞发生发展的危险因素。     

急性心肌梗塞患者与正常人生活事件、生活方式和负性情绪的对照研究

目的：探寻生活事件、生活方式、负性情绪与急性心肌梗塞（Acute Myocardial Infarction，简AMI）的病因学联系。方法：对91例AMI病人和90位正常人应用LES、SSRS、HAMD、HAMA等量表和生活方式问卷、一般状况测查表进行对照调查。结果：与正常人对照，AMI组发作前有明显心理刺激因素的有72例（79．12％）；AMI组负性生活事件分更高（P〈0．01）；AMI组的客观支持和主观支持和对支持利用度均明显低于正常组（P〈0．01）；生活方式方面，AMI组在饮食不良习惯、业余生活单调、缺乏锻炼，嗜烟酒，睡眠无规律等均明显高于对照组（P〈0．01）；负性情绪方面，AMI组在焦虑／躯体化、认知障碍、阻滞、绝望、睡眠障碍和焦虑抑郁总分均明显高于对照组（P〈0．01）。结论：负性事件多发，缺乏亲人和社会支持．不良的生活方式和负性情绪可能是AMI的发病危险因素。     

肠易激综合征的心理社会因素研究

本研究以临床心理学问卷对５０例肠易激综合征（ＩＢＳ）患者和５０例正常对照进行自评，结果表明：ＩＢＳ患者具有较多的心理社会因素；多元分析发现ＩＢＳ主要危险因素为：生活事件、负性情绪、抑郁症状，过去类似病史和环境刺激因素等。     

负性生活事件对初中生睡眠质量的影响：有调节的中介作用

目的：探讨负性生活事件对初中生睡眠质量的影响以及抑郁的中介作用和心理韧性的调节作用。方法：采用青少年生活事件量表(ASLEC)、匹兹堡睡眠指数量表(PSQI)、青少年心理韧性量表(RSCA)、儿童抑郁量表(CDI)对随机抽取的1440名初中生进行调查。结果：（1）负性生活事件能够显著负向预测初中生睡眠质量；（2）抑郁部分中介了负性生活事件与初中生睡眠质量之间的关系；（3）抑郁的中介作用受到心理韧性的负向调节，即中介效应对于心理韧性水平低的初中生更大。结论：负性生活事件通过抑郁影响初中生睡眠质量，且抑郁的中介作用受到心理韧性的调节。     

生活事件,社会支持与情感性精神障碍的预后

采用生活事件量表、社会支持评定量表和社会功能缺陷筛选表，评定了１１３例情感性精神障碍患者，出院８年后随访发现社会功能有缺陷患者的负性生活事件刺激强度明显大于无缺陷患者，而社会支持水平则明显低于无缺陷患者。在对社会功能的影响程度上，家庭负性生活事件强于工作学习方面，主观支持强于客观支持。社会功能缺陷的发生，负性生活事件和社会支持之间存在负交互作用。结果提示心理社会因素对情感性精神障碍的预后有着一定的影响     

飞行员生活期望值与心理社会因素的相关性

本文对飞行员生活期望值研究显示，其与个性因素、客观生活状态、主观生态满意度以及主，客观社会支持有显著或高度显著相关性。发现社会功能期望值与强迫、抑郁因素有负性相关。生活期望值对生活事件、疾病并无作用。     

军队离退休干部幸福度及健康自评的影响因素

目的：了解影响军队离退休干部幸福度及健康自评的因素，为改善其生活质量提供依据。方法：应用纽芬兰纪念大学幸福度量表、老年抑郁量表、社会支持量表、日常生活能力量表和健康自我评价，调查驻南方地区军队离退休干部心理状况。结果：（1）调查对象幸福度得分较高，影响因素依次是抑郁情绪、社会支持、健康自评、文化程度和日常生活能力；（2）影响健康自评得分的因素依次是抑郁、正性体验、生活能力、主观社会支持、正性情感、负性情感、负性体验和幸福度。（3）幸福度和健康自评得分与增龄、婚姻状况无显著相关性。结论：军队离退休干部总体上对生活较为满意，今后应重视负性情绪的克服和正性情绪的培养。     

心理护理对艾滋病负性情绪及免疫功能的影响研究

目的探讨心理护理对艾滋病负性情绪及免疫功能的影响。方法随机抽选在我院行抗病毒治疗的43例艾滋病患者,采用随机数字表法分为对照组(n=21例,予以常规护理)和观察组(n=22例,实施个性化心理护理),比较干预6个月后两组患者HAMD、HAMA等负性情绪及CD4+T淋巴细胞免疫变化。结果两组干预前负性情绪指标及CD4+T淋巴细胞计数比较差异无统计学意义(>0.05)。干预6个月后,观察组HAMD、HAMA等负性情绪评分明显低于对照组(<0.05);CD4+T绝对计数明显高于对照组(<0.05)。结论应重视艾滋病患者的心理健康,予以个性化的心理干预,给予更多的社会支持,以减轻他们的负性情绪,有利于心理健康水平及免疫功能的提高。     

银屑病患者的心理社会因素研究

目的研究银屑病患者心理社会因素的特征。方法运用临床心理测定工具(LES,CS,SSS,SAS,SDS)测定30例银屑病患者及30例正常对照组病前遭遇的生活事件、应付方式、社会支持、患病后的心身健康状况及其影响因素。结果银屑病患者本次患病前所经历的生活事件频数及紧张值,消极应付方式评分,抑郁及焦虑分值均显著高于对照组。积极应付评分,社会支持总分减低。发现家族史、生活事件紧张总值和抑郁为银屑病的危险因素,而积极应付方式和社会支持为疾病的有利的保护因素。结论银屑病患者具有一定的心理社会特征,可对病人进行一定的社会心理干预措施。     

银屑病患者的心理社会因素

目的 :探究银屑病患者的心理社会因素特点。方法 :采用临床心理测定工具分别测定了 40例银屑病患者及 3 8例正常对照组的生活事件、人格特征、应付方式、社会支持、患病后的心身健康状况及其影响因素。结果 :病例组本次患病前所经历的生活事件频数及紧张值 ,A型行为评分 ,消极应付方式评分 ,抑郁及焦虑分值均显著高于对照组。积极应付评分 ,社会支持总分减低。发现家族史、生活事件紧张总值、A型行为和抑郁为银屑病的危险因素 ,而积极应付方式和社会支持为疾病的保护因子。结论 :银屑病患者具有特殊的心理社会特征和心身健康状况 ,应采取积极的社会心理干预措施     

老年抑郁症的心理社会因素研究

目的:探讨老年抑郁症的心理社会因素.方法:按CCMD-3心境障碍抑郁发作诊断标准,收集33例60岁以上首次发作的患者(抑郁组),32名健康老年人(对照组).采用生活事件量表、艾森克问卷、简易智力状态检查表和社会支持评定量表等,进行测评分析.结果:抑郁组与对照组精神疾病家族史(分别为5例/0例,χ2=5.253,P=0.022)、现患躯体疾病(16例/6例,χ2=6.415,P=0.011)、血管危险因素(10例/3例,χ2=4.447,P=0.035)和长期困境(19例/3例,χ2=14.437,P=0.000)的差异有显著性,而抑郁组MMSE总分26.2±2.3低于对照组27.3±0.8(t=2.552,P=0.015).抑郁组负性生活事件分值17.9±15.0低于对照组10.7±7.8(t=2.42,P=0.019);抑郁组社交问题分值3.5±6.9高于对照组1.2±3.8(u=1.982,P=0.047).抑郁组社会支持总分39.5±6.8低于对照组42.9±4.2(t =2.434,P=0.018);抑郁组对支持的利用度5.9±2.7低于对照组8.4±1.6(u=3.844,P=0.000).抑郁组神经质分60.0±8.8高于对照组51.7±4.9(t=4.737,P=0.000);抑郁组与对照组的神经质个性(24例/3例,χ2=26.851,P=0.000)的差异有显著性.结论:慢性应激、高度神经质和认知功能损害严重是老年抑郁症的重要危险因素.     

Prevalence and risk indicators of depression in elderly nursing home patients: the AGED study

BACKGROUND: Depression is a common and disabling psychiatric disorder in later life. Particular frail nursing home patients seem to be at increased risk. Nursing home-based studies on risk indicators of depression are scarce. METHODS: Prevalence and risk indicators of depression were assessed in 333 nursing home patients living on somatic wards of 14 nursing homes in the North West of the Netherlands. Depressive symptoms were measured by means of the Geriatric Depression Scale (GDS). Major and minor depression were diagnosed according to the DSM-IV criteria, sub-clinical depression was defined as a GDS score >10 while not meeting the DSM-V criteria for depression. RESULTS: The prevalence of major depression was assessed to be 8.1% and the prevalence of minor depression was 14.1%, while a further 24% of the patients suffered from sub-clinical depression. For major depression significant risk indicators were found for pain, functional limitations, visual impairment, stroke, loneliness, lack of social support, negative life events and perceived inadequacy of care. For sub-clinical depression the same risk indicators were found, with the exception of lack of social support. LIMITATIONS: Data were collected cross-sectional. CONCLUSIONS: The prevalence of depression in the nursing home population is very high. Whichever way defined, the prevalence rates found were three to four times higher than in the community-dwelling elderly. Age, pain, visual impairment, stroke, functional limitations, negative life events, loneliness, lack of social support and perceived inadequacy of care were found to be risk indicators for depression. Consequently, optimal physical treatment and special attention and focus on psychosocial factors must be major goals in developing care programs for this frail population.     

The importance of psychosocial factors,gender, and severity of depression in distinguishing between adjustment and depressive disorders

BACKGROUND: This study evaluated the severity of depressive symptomatology as it relates to: (a) sociodemographic factors and (b) the occurrence and type of acute and chronic psychosocial triggers or life events before admission. METHODS: In total, 718 psychiatric inpatients were assessed with the AMDP-system by the treating psychiatrist within the first 2 days after admission. RESULTS: In the females, sociodemographic factors (being married, children in the household, higher education and the quality of interactions) but not psychosocial stressors or life events were found to be related to severity of depression on admission. Females showed more severe depressive syndromes than males, however, depression severity in males was independent of sociodemographic factors, life events or psychosocial triggers. LIMITATIONS: Clinical assessment was based on retrospective history taking. The sample consisted of inpatients only, the results require replication using larger and more diverse samples. CONCLUSION: Gender differences and life conditions such as familial distress are related to severity of depression. The present criteria for the differentiation between depressive disorders and adjustment disorders are not independent and should be substituted by a multiaxial assessment.     

精神分裂症照料者相关社会心理因素

目的研究精神分裂症照料者社会心理因素的特点及影响因素。方法应用生活事件量表、多伦多述情障碍量表、焦虑自评量表、抑郁自评量表、应付方式问卷及社会支持问卷,测定48例精神分裂症照料者遭遇的生活事件及其身心健康状况,了解其采取的应付方式,现有的社会支持及其影响因素,同时选取健康对照组50例相同量表评定。结果精神分裂症照料者所经历的生活事件总频数,负性生活事件频数,精神紧张总值及负性紧张值均显著高于对照组(t=3.978,5.064,6.694,9.282;P0.01),消极应付方式评分,抑郁及焦虑分值均显著高于对照组(t=8.195,9.815,7.174;P0.01)。积极应付评分,社会支持总分减低(t=-2.394,P0.05;t=3.616,P0.01);消极应付方式明显高于对照组(t=8.394,P0.01)。结果显示精神分裂症照料者生活事件频数,生活事件紧张总值,抑郁等因子维度与对照组均存在显著差异,在社会支持及应付方式上研究组与对照组也存在明显差异。结论精神分裂症照料者心理健康状况不容乐观,需要进一步关注,必要时应采取积极的干预措施。     

初一学生抑郁情绪影响因素调查

目的:探讨初一学生抑郁症状及与之相关的心理和环境因素。方法:用自陈问卷调查300名样本的抑郁症状及自尊、生活事件、社会支持、家庭亲密度和矛盾性,分析这些因素与抑郁症状之间以及生活事件各因子与自尊之间的相关性。结果:抑郁症状发生率为11%;逐步回归分析发现,自尊、社会支持与抑郁症状负相关(标化回归系数分别为-0·59和-0·14),生活事件与之正相关(标化回归系数0·26);在生活事件6个因子中,学习压力及相关因子与自尊负相关(标化回归系数分别为-0·14和-0·13)。结论:抑郁症状在初一学生中相当常见;自尊水平低下、缺乏社会支持以及不良生活事件的影响与抑郁症状的发生有关;在各种生活事件中,来自学习过程的压力和挫败对自尊的影响最为突出。     

The influence of adversity and perceived social support on the outcome of major depressive disorder in subjects with different levels of depressive symptoms

BACKGROUND: Adverse life events and social support may influence the outcome of major depressive disorder (MDD). We hypothesized that outcome would depend on the level of depressive symptoms present at the outset, with those in partial remission being particularly vulnerable. METHOD: In the Vantaa Depression Study (VDS), patients with DSM-IV MDD were interviewed at baseline, and at 6 and 18 months. Life events were investigated with the Interview for Recent Life Events (IRLE) and social support with the Interview Measure of Social Relationships (IMSR) and the Perceived Social Support Scale - Revised (PSSS-R). The patients were divided into three subgroups at 6 months, those in full remission (n = 68), partial remission (n = 75) or major depressive episode (MDE) (n = 50). The influence of social support and negative life events during the next 12 months on the level of depressive symptoms, measured by the Hamilton Rating Scale for Depression (HAMD), was investigated at endpoint. RESULTS: The severity of life events and perceived social support influenced the outcome of depression overall, even after adjusting for baseline level of depression and neuroticism. In the full remission subgroup, both severity of life events and subjective social support significantly predicted outcome. However, in the partial remission group, only the severity of events, and in the MDE group, the level of social support were significant predictors. CONCLUSIONS: Adverse life events and/or poor perceived social support influence the medium-term outcome of all psychiatric patients with MDD. These factors appear to have the strongest predictive value in the subgroup of patients currently in full remission.     

产后抑郁症与生活事件及社会支持的关系

产后抑郁症最初由ｐａｔｔ(196 8)提出 ,是指产褥期发生的抑郁[1] 。虽然从ＤＳＭ—Ⅲ及ＩＣＤ— 9开始 ,产后抑郁已不再作为一个独立疾病诊断单元 ,但由于产后抑郁症起病于女性的“特殊时期”及预后良好等特点 ,多年来备受人们的关注。有调查表明[2 ] ,产后抑郁症的患病率达 16 .7% ,产后抑郁症的病因复杂 ,其发生与生活事件及社会支持有关。国内报道较少 ,作者对此进行初步的比较分析 ,现报告如下。1　对象与方法1 1　对象产后抑郁症组 :30例为 1996年 2月至 1999年 3月在我院门诊及住院病人 ,为产后 6周内发病 ,均符合ＣＣＭＤ -Ⅱ -Ｒ抑…