大学新生倦怠与抑郁的相关性

目的:评定倦怠对大学新生抑郁状况的影响,并探讨倦怠和抑郁的关系。方法:于2005-10采用整群抽样法随机抽取河南大学本科新生310人进行问卷调查。倦怠测评采用简式倦怠量表,包含失望、无望、陷入困境、无助、沮丧、无价值感和失眠共7个项目。采用7点记分,倦怠程度的评价指标为总分除以7。简式倦怠量表总分<2.4分为无倦怠症状,2.5～3.4分为有倦怠危险信号,3.5～4.4分为倦怠,4.5～5.4分为倦怠非常严重,总分>5.5分为马上需要专业援助。抑郁测评采用自评抑郁量表,由20个项目构成,采用4级评分,最高分为80,总分除以80可作为抑郁的严重度指数。抑郁的严重度指数<0.5表示无抑郁症状,0.5～0.59表示轻微至轻度抑郁,0.6～0.69表示中度抑郁,抑郁的严重度指数>0.7表示重度抑郁者。分别计算倦怠和抑郁的检出率。观察抑郁和倦怠的重叠发生情况,进行列联表分析、χ2检验、相关分析和分层回归分析。结果:发放问卷310份,收回合格问卷270份,有效率为87.1%。①无倦怠症状者占43.3%(117/270),有倦怠危险信号者占41.1%(111/270),倦怠者占13%(35/270),倦怠非常严重者占2.6%(7/270),无马上需要专业援助者。倦怠检出率为15.6%(42/270)。②无抑郁症状者占69.3%(187/270),轻微至轻度抑郁者占23.3%(63/270),中度抑郁者占7.4%(20/270),无重度抑郁者。抑郁的检出率为30.7%(83/270)。③中度抑郁者中有倦怠症状者11人(55%),其中严重倦怠者4人(20%);轻度抑郁者中有倦怠症状者23人(36.5%),其中严重倦怠者3人(4.8%);无抑郁症状者中只有倦怠症状者8人(4.3%)。χ2检验表明倦怠对抑郁的作用显著(χ2=87.720,P=0.000)。④倦怠各项目失望、无望、陷入困境、无助、沮丧、无价值感、失眠与抑郁均相关,并均达到极显著的水平(r=0.317～0.496,P=0.000)。⑤沮丧、无价值感、失眠对新生抑郁程度的预测作用显著(P<0.001)。结论:大学新生倦怠和抑郁的检出率比较低,其中有抑郁体验的新生更经常地体验到倦怠,倦怠各项目(失望、无望、陷入困境、无助、沮丧、无价值感、失眠)与抑郁的相关均达到了极显著的水平,沮丧、无价值感、失眠对抑郁有显著的预测作用。重视新生的倦怠和抑郁问题,应充分考虑倦怠对抑郁的影响。     

社区精神卫生工作人员抑郁状况调查

目的：了解社区精神卫生工作人员抑郁状况。方法对88名社区精神卫生服务工作人员采用流调中心用抑郁量表进行测评分析。结果本组社区精神卫生工作人员流调中心用抑郁量表评分范围0分—52分,平均(8.74±7.09)分,男性为(10.00±6.80)分,女性为(8.27±7.45)分;可能有抑郁症状检出率为7.9%,抑郁症状检出率为5.7%;各条目为3分检出率由高到低排名前5位的依次为：条目12(71.6%)、条目16(67.0%)、条目8(60.2%)、条目4(42.0%)、条目11(14.8%)。结论社区精神卫生工作人流调中心用抑郁量表评分低于全国城市常模,幸福感、快乐感、未来希望感及睡眠状况较差,应予以有针对性的干预。     

不同群体类型师范大学生抑郁发生率及相关因素分析

目的:探讨师范专业大学生抑郁症状的发生情况及影响因素,为高校开展心理健康教育工作提供依据。方法:于2003-09/10用抑郁自评量表作为测量工具,以班为单位,用匿名的方式对河南省某师范院校的师范专业大学生的抑郁症状及相关因素进行调查。抑郁自评量表标准分<50者为“无抑郁”症状,≥50,但<60者为“轻度抑郁”,≥60,但<70者为“中度抑郁”,≥70者为“重度抑郁”。获回答、规范问卷1351份,其中,1年级498名,2年级441名,3年级412名;男577名,女774名。结果:所获得的1351份问卷的数据均进入结果分析。不同群体间抑郁自评量表均值的比较分析:①性别间的比较:男女学生的评分接近(48.44±11.20,48.85±10.39)。②年级间比较:一、二、三年级学生抑郁自评量表得分接近(48.76±10.39,49.22±11.12,47.99±10.74)。③不同学习成绩学生之间的比较:学习成绩优、良的学生的抑郁自评量表标准分均值比学习成绩中、差的学生低(46.62±10.17,47.71±10.51,49.42±10.83,51.75±10.41)。④不同人际关系学生的比较:人际关系较好的学生,其抑郁自评量表标准分均值显著低于人际关系一般的学生、较差的学生(46.62±11.04,49.34±10.32,54.80±12.42);人际关系一般的学生其抑郁自评量表标准分均值明显低于人际关系较差的学生。抑郁症状检出率分析:①抑郁症状检出率比较分析:师范专业大学生抑郁症状检出率较高,轻度及以上者占45.5%,而且具有2.8%的重度抑郁症患者。②不同群体间抑郁症状检出率比较分析:年级、性别间学生抑郁的不同检出率无差异,而人际关系(F=16.04,P<0.01)、学习成绩(F=5.83,P<0.01)之间差异显著。结论:师范专业大学生抑郁症状检出率高。性别及年级对抑郁发生率无明显影响,而学习成绩、人际关系是影响师范专业大学生心理健康的重要因素。     

汶川大地震后都江堰某镇中学学生心理状况研究

目的了解汶川大地震后都江堰某镇中学学生的心理状况,为进一步开展心理干预提供依据。方法 2008年9月下旬,对极重灾区都江堰某镇中学1500名同学进行了调查,收回有效问卷1498份。采用一般情况调查问卷、儿童事件影响量表(CRIES-13)、儿童焦虑性情绪障碍筛查表(SCARED)、儿童抑郁障碍自评量表(DSRSC)进行集体施测。结果该中学学生灾后4个月创伤后应激障碍(PTSD)症状检出率29.71%(445/1498),抑郁症状检出率23.10%(346/1498),焦虑症状检出率33.11%(496/1498),PTSD症状伴随抑郁症状检出率为13.62%(204/1498),PTSD症状伴随焦虑症状检出率为17.16%(257/1498),PTSD症状同时伴随抑郁、焦虑症状检出率为13.22%(198/1498)。创伤后应激反应指数与抑郁总分、焦虑总分呈显著正相关(r=0.332,r=0.298,P均<0.001)。经非条件逐步Logistic回归,筛选出PTSD、抑郁、焦虑症状的共同影响因素有:绝望感、年龄、性别、是否目睹死亡、家人情况、地震时是否受伤。结论汶川大地震后,应该持续关注学生的心理状况,并持续给予心理干预或治疗。     

上海市残疾人焦虑、抑郁情况及影响因素

目的了解上海市残疾人的焦虑、抑郁水平及相关影响因素。方法 2014年11月~12月,采用抑郁自评量表(SDS)及焦虑自评量表(SAS)对参加健康体检的731名残疾人进行问卷调查,通过多因素Logistic回归分析焦虑、抑郁的影响因素。结果上海市健康体检残疾人焦虑、抑郁检出率分别为9.58%、8.48%。抑郁影响因素有残疾年限(OR=0.967,P0.05)和残疾等级(OR1,P0.05);焦虑影响因素有退休(OR=2.047,P0.05)、独居或住养老院(OR=3.073,P0.01)、残疾年限(OR=0.956,P0.01)。结论上海市健康体检残疾人群抑郁、焦虑症状发生率处于较低水平,但应采取有针对性的心理干预措施。     

四川省农村丧偶老人抑郁症状及其影响因素的调查分析

目的 了解四川省农村丧偶老人抑郁症状发生情况及其影响因素.方法 利用老年精神状况量表,采取整群抽样方法,对抽取的13个村中60岁及以上老人行问卷调查.结果 有偶老人抑郁病例检出率4.8%,亚病例检出率为 7.3%;丧偶独居老人抑郁病例检出率16.9%,亚病例检出率为11.3%;丧偶和子女同住老人抑郁病例检出率3.4 %,亚病例检出率为 4.7%.分析结果显示：女性抑郁病例检出率9.6%,男性抑郁病例检出率4.4%,女性显著高于男性;丧偶独居老人抑郁病例检出率高;经济保障、健身活动、自理能力、患慢性病种数与抑郁病例检出率有关.结论 抑郁症状严重影响丧偶老人特别是丧偶独居老人健康,社区护理人员应针对其影响因素采取相应护理措施,促进丧偶老人身心健康.     

肢体残疾成年人心理健康状况配对研究

本文采用症状评量题表（ＳＣＬ－９０）对１４０例肢体残疾成年人和１４０例非残疾人进行了心理健康状况的配对调查研究。结果表明：肢体残疾成年人在总分和十个因子分均高于非残疾人，说明心理健康水平低于非残疾人。分年龄组比较，发现这种差异随着年龄的增大而减小。按职业、婚姻分组比较可见婚姻和职业对残疾人心理健康有保护作用，可提高心理健康水平，减轻抑郁、恐怖等不良情绪。按人格特征分型比较显示，性格外向、情绪稳定者，心理健康水平高，各种不良症状得分低，对心理健康有促进作用     

北京市肢体残疾人康复需求分析

目的 考察北京市肢体残疾人的康复需求情况.方法 以3006年全国残疾人抽样调查中北京市2390名肢体残疾人为研究对象,调查其康复现状与需求.结果 在康复形式上,54.85%的残疾人需要机构康复.38.20%的残疾人需要社区和家庭康复,6.95%的残疾人需要延伸服务(上门服务);康复内容方面.41.06%的残疾人需要医疗服务,30.70%的残疾人需要康复训练与服务,28.24%的残疾人需要辅助器具.结论 北京市肢体残疾人的康复需求多,需要采取多种措施解决.     

柔性管理对护士职业倦怠和抑郁症状的干预效果分析

目的分析柔性管理对护士职业倦怠和抑郁症状的干预效果,为预防其职业倦怠和抑郁症状提供理论依据。方法选择该院工作1年以上的护士160名作为研究对象,随机分为两组,80名接受柔性管理,80名按原刚性管理进行。对柔性管理组实施柔性管理前、后均采用护士职业倦怠调查量表和抑郁自评量表进行职业倦怠和抑郁症状测评,分析干预效果。结果干预后柔性管理组护士在情感衰竭、去人格化和个人成就感、抑郁症状得分分别为(24.61±3.45)、(4.87±0.55)、(35.19±3.58)、(13.12±2.37)分,刚性管理组分别为(38.77±5.03)、(10.68±0.94)、(18.42±1.92)、(19.50±4.85)分,两组差异均有统计学意义(P0.05);柔性管理组干预前情感衰竭、去人格化和个人成就感、抑郁症状得分分别为(39.80±4.58)、(11.90±1.10)、(16.75±1.63)、(20.55±4.55)分,各项差异均有统计学意义(P0.05)。柔性管理组干预后护士中、重度倦怠检出率和抑郁症状检出率分别为10.00%、3.75%和22.50%,均显著低于干预前和刚性管理组,差异均有统计学意义(P0.05)。结论护士实行柔性管理可以降低护士职业倦怠和抑郁症状发生率,值得医院内推广使用。     

社区持证残疾人康复现状与需求调查分析

目的 通过对社区持证残疾人的普查评估,分析其生存现状、生活质量及康复需求.方法 通过多种调查方式对社区108名持证残疾人进行康复需求评定和焦虑与抑郁自评量表评价.结果 大专以上文化程度12.0%,中等文化程度56.5%,低文化水平者31.5%;具有稳定收入能自给者75%,缺乏稳定收入需他人或社会资助者25%;肢体残疾、视力与听觉语言残疾69%;精神与智力残疾31%.在致残等级评定中,多重残疾占4.6%,一级残疾8.3%,二级残疾31.4%,三级残疾42.6%,四级残疾3.7%.生活自理程度评定中,能够完全自理者55.6%;需要他人帮助者42.6%.焦虑评分结果为(44.26±5.21),高于50分者10%;抑郁评分结果为(43.59±4.65),高于50分者7%.结论 社区的残疾人群存在着受教育水平低,生活贫困,残疾等级重,情绪不稳,康复需求达不到满足等问题.     

Depressive symptoms and mental health service utilization among persons with limb loss: results of a national survey

OBJECTIVE: To describe the prevalence of depressive symptoms, risk factors, and mental health service utilization in a national limb-loss sample. DESIGN: Cross-sectional survey. SETTING: Participants were interviewed by telephone. PARTICIPANTS: A stratified sample by etiology of 914 persons with limb loss, derived from people who contacted the Amputee Coalition of America from 1998 to 2000. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Center for Epidemiologic Study Depression Scale (CES-D 10-item), pain bothersomeness, characteristics of the amputation, sociodemographics, and mental health service utilization. RESULTS: Prevalence for significant depressive symptoms (CES-D score, >/=10) was 28.7%. Risk factors included being divorced or separated, living at the near-poverty level, having comorbid conditions, being somewhat bothered or extremely bothered by back pain and phantom limb pain, and having residual limb pain for persons aged 18 to 54. Having higher education was a buffer against depressive symptoms. Almost 22% of the sample and 44.6% of persons with significant depressive symptoms received mental health service in the previous year. For persons with significant depressive symptoms, 32.9% reported needing mental health service but not receiving them, and 67.1% reported not needing mental health service. CONCLUSIONS: Depressive symptoms are prevalent among persons with limb loss. Proper management of pain and medical comorbidity may mitigate depressive symptoms. Education about depressive symptoms and treatment options may improve receipt of mental health service among persons with limb loss reporting significant levels of depressive symptoms.     

上海市长宁区新泾镇肢体残疾人伤害特征及其服务需求研究

目的 探讨肢体残疾人群的伤害特征及服务需求。方法 采用自行编制的《残疾人伤害流行病学调查表》，对上海市长宁区新泾镇持有残疾证的肢体残疾人进行横断面调查。结果 共调查1 204人，有效问卷1 199份，应答率99.58%。调查结果显示，肢体残疾人的伤害发生率为31.61%，不同伤害类型中以跌倒发生率最高（19.43%），其中80岁及以上肢体残疾人群的发生率最高，达到34.07%。下肢残疾的调查对象较非下肢残疾的人群伤害发生率更高（2=6.342，P=0.012），且跌倒发生率更高（2=8.839，P=0.003）。发生伤害次数越多的人更需要加装扶手、拐杖安全性评估、检查视力并配镜以及居家安全环境评估等伤害防制服务。结论 肢体残疾人群伤害发生率较高，以跌倒伤为主，且对伤害防制有较大需求。     

Combined effects of major depression, pain and somatic disorders on general functioning in the general adult population

This study was carried out to assess the prevalence of major depressive disorder (MDD) in persons suffering from pain symptoms in various locations, both with and without comorbid somatic disorders and to analyze the single and combined effects of MDD, pain symptoms and somatic disorders on general functioning in the community. The 12-month prevalence of MDD, somatic disorders and pain symptoms, grouped according to location, were determined among 4181 participants from a community sample. Depression was assessed utilising the Composite International Diagnostic Interview. Pain symptoms were self-reported by participants whereas medical diagnoses were validated by medical examinations. General functioning was evaluated utilising the established MOS-SF-36 scale. The prevalence of MDD was significantly increased for persons with pain in any location. In the absence of a somatic disorder, MDD prevalence was highest in persons with abdominal/chest pain (9.3%) and arm or leg pain (7.9%) and lowest in persons with back pain (6.2%). Mental and physical well-being were lowest for persons with both MDD and a somatic disorder, irrespective of pain locations. Increasing numbers of pain locations impaired mental and physical well-being across all groups, but the effect on mental well-being was most marked in participants with MDD and comorbid somatic disorders. The presence of pain increases risk of associated MDD. The number of pain locations experienced, rather than the specific location of pain, has the greatest impact on general functioning. Not only chronic pain, but pain of any type may be an indicator of MDD and decreased general functioning.     

精神分裂症的抑郁症状

为了探讨精神分裂症抑郁症状发生率及其相关因素,对159例精神分裂症患者在疗前和疗后8周进行了阳性症状量表(SAPS)、阴性症状量表(SANS)和Hamilton抑郁量表(HAMD)评定,并对抑郁症状的相关因素进行了分析。结果显示,精神分裂症患者的抑郁症状发生率为60.38%;抑郁症状与阳性症状(SAPS总分)、住院次数和自杀未遂发生率有显著相关,而与阴性症状(SANS总分)和疗效无明显相关。作者认为抑郁症状是精神分裂症症状的组成部分,一般不需合并抗抑郁剂治疗。     

四川汶川地震伤残人员日常生活活动能力的调查分析

目的 调查汶川地震伤残人员的日常生活活动能力（ADL）,分析影响伤残人员日常生活活动能力的相关因素,为汶川地震伤残人员的社区康复提供依据。方法 利用ADL量表对283名汶川地震伤残人员的日常生活活动能力进行测量。结果 283名伤残人员地震伤残人员ADL平均得分为85.08±14.73,其中20.8%ADL完全正常,71.0%的伤残人员ADL日常生活能力轻度障碍,8.2%ADL中重度障碍；经多因素分析,地震伤残人员ADL的主要影响因素依次是：伤残程度、伤残合并疾病、伤残并发症、是否参与残疾人组织或相关活动（P〈0.05）。结论 伤残人员ADL关键在于残疾程度,避免伤残并发症和二次残疾的发生,控制伤残合并疾病的发生,增加伤残人员的社会参与度,均有利于伤残人员ADL的提高。     

Phantom pain, residual limb pain, and back pain in amputees: results of a national survey

OBJECTIVES: To describe the prevalence of amputation-related pain; to ascertain the intensity and affective quality of phantom pain, residual limb pain, back pain, and nonamputated limb pain; and to identify the role that demographics, amputation-related factors, and depressed mood may contribute to the experience of pain in the amputee. DESIGN: Cross-sectional survey. SETTING: A sample of persons who contacted the Amputee Coalition of America from 1998 to 2000 were interviewed by telephone. PARTICIPANTS: A stratified sample by etiology of 914 persons with limb loss. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Prevalence, intensity, and bothersomeness of residual, phantom, and back pain, depressed mood as measured by the Center for Epidemiologic Study Depression Scale, characteristics of the amputation, prosthetic use, and sociodemographic characteristics of the amputee. RESULTS: Nearly all (95%) amputees surveyed reported experiencing 1 or more types of amputation-related pain in the previous 4 weeks. Phantom pain was reported most often (79.9%), with 67.7% reporting residual limb pain and 62.3% back pain. A large proportion of persons with phantom pain and stump pain reported experiencing severe pain (rating 7-10). Across all pain types, a quarter of those with pain reported their pain to be extremely bothersome. Identifiable risk factors for intensity and bothersomeness of amputation-related pain varied greatly by pain site. However, across all pain types, depressive symptoms were found to be a significant predictor of level of pain intensity and bothersomeness. CONCLUSIONS: Chronic pain is highly prevalent among persons with limb loss, regardless of time since amputation. A common predictor of an increased level of intensity and bothersomeness among all pain sites was the presence of depressive symptoms. Further studies are needed to elucidate the relationship between pain and depressive symptoms among amputees.     

Depression and Subthreshold Depression in Stroke-Related Aphasia

ObjectiveTo investigate the prevalence of depression and subthreshold depression in persons with aphasia. To investigate whether there are linguistic and cognitive differences between those with depression, subthreshold depression, and no depression.DesignSurvey.SettingRehabilitation hospital.ParticipantsParticipants with chronic aphasia due to a single left-hemisphere stroke (N=144).Main Outcome MeasuresCenter for Epidemiologic Studies Depression Scale to assess the prevalence of depression. The Western Aphasia Battery-Revised (WAB-R) to evaluate the type of aphasia; the Aphasia Quotient measured the severity of linguistic deficits.ResultsThe prevalence of depression in our participants was 19.44% while that of subthreshold depression was 22.22%. Depressed persons with aphasia had significantly lower WAB-R reading scores than those without depression.ConclusionsFindings suggest that persons with aphasia who have depressive symptoms may do worse on some linguistic measures than those with no depression. Since subthreshold depression can progress to depression, clinicians should routinely screen for depressive symptoms.     

Common Chronic Pain Conditions in Developed and Developing Countries: Gender and Age Differences and Comorbidity With Depression-Anxiety Disorders

Although there is a growing body of research concerning the prevalence and correlates of chronic pain conditions and their association with mental disorders, cross-national research on age and gender differences is limited. The present study reports the prevalence by age and gender of common chronic pain conditions (headache, back or neck pain, arthritis or joint pain, and other chronic pain) in 10 developed and 7 developing countries and their association with the spectrum of both depressive and anxiety disorders. It draws on data from 18 general adult population surveys using a common survey questionnaire (N = 42,249). Results show that age-standardized prevalence of chronic pain conditions in the previous 12 months was 37.3% in developed countries and 41.1% in developing countries, with back pain and headache being somewhat more common in developing than developed countries. After controlling for comorbid chronic physical diseases, several findings were consistent across developing and developed countries. There was a higher prevalence of chronic pain conditions among females and older persons; and chronic pain was similarly associated with depression-anxiety spectrum disorders in developed and developing countries. However, the large majority of persons reporting chronic pain did not meet criteria for depression or anxiety disorder. We conclude that common pain conditions affect a large percentage of persons in both developed and developing countries.PerspectiveChronic pain conditions are common in both developed and developing countries. Overall, the prevalence of pain is greater among females and among older persons. Although most persons reporting pain do not meet criteria for a depressive or anxiety disorder, depression/anxiety spectrum disorders are associated with pain in both developed and developing countries.