不孕症妇女心理状态分析

[目的]探讨心理因素与不孕症之间的关系。[方法]采用抑郁自评量表和焦虑自评量表评定68例不孕症妇女心理状态,同时选择正常生育妇女50例作为对照。按既往有无妊娠史,分原发不孕与继发不孕;按不孕病程长短分A组(不孕2~年)、B组(不孕3~年)、C组(不孕4年及以上),比较分析心理因素与不孕之间的关系。[结果]68例不孕妇女抑郁发生率为47.06%,焦虑发生率为66.18%,明显高于对照组的6.00%和4.00%。不孕症妇女的抑郁与焦虑评分明显高于正常生育妇女(P<0.005),原发不孕组的抑郁焦虑评分明显高于继发不孕组(P<0.005)。随着不孕病程的延长,抑郁与焦虑评分也增高。[结论]心理因素可能是引起不孕症的原因之一,其在减轻或加剧不孕症的病程方面有很重要的意义。社会和家人应给予不孕妇女更多的关爱和支持,以避免或减少她们不良心理状态的产生。     

不孕症女性心理状态调查

目的:了解不孕症女性患者的心理健康状况。方法:运用汉密顿抑郁量表、汉密顿焦虑量表、生活事件量表等心理问卷,对105例不孕症患者和110例正常育龄妇女心理状态、生活事件进行调查。结果:①不孕症妇女抑郁评分、焦虑评分、负性事件值比正常育龄妇女均明显增高(P<0.001);②原发不孕组和继发不孕组在抑郁评分、负性事件值两方面存在显著差异(P<0.05),焦虑评分和生活事件总值无显著差异;③随着不孕症患者病程的延长、年龄的增大抑郁评分、焦虑评分、负性事件值日趋升高。结论:①女性不孕症患者的心理健康水平显著低于正常人,抑郁和焦虑是不孕症患者心理应激最常见的反应,社会生活事件可作为社会心理因素对不孕症患者产生影响;②抑郁和焦虑的心理状态和不良的负性生活事件是引起不孕症的危险因素;③心理因素与不孕常同时存在,提示在临床诊治不孕症的过程中应充分重视心理因素在本病中的重要作用。     

不孕症妇女焦虑抑郁心理状态调查

目的:分析不孕症妇女焦虑/抑郁心理状态,为其提供更为有益的治疗措施。方法:用综合医院焦虑/抑郁情绪测定表(HADS)对213例不孕症妇女问卷调查,并选择健康育龄妇女180例作为对照,探讨焦虑/抑郁评分与不孕病程、教育程度、经济状况及患者年龄的相关性。结果:不孕症妇女焦虑评分为6.02±3.47,抑郁评分为5.27±3.37,显著高于对照组(P<0.05);随不孕病程延长,焦虑/抑郁评分升高,但无统计学意义(P>0.05);焦虑与教育程度呈负相关,与患者年龄和经济状况相关性无统计学意义;抑郁与教育程度、经济状况呈负相关,与患者年龄无显著相关性。结论:不孕症妇女焦虑/抑郁水平高于对照组,提示该人群需心理帮助或支持。     

深圳市高龄不孕女性焦虑和抑郁症状及相关因素分析

目的:了解深圳地区高龄不孕女性人群焦虑和抑郁情况,探索影响焦虑和抑郁症状的相关因素。方法:2016年1月—12月对深圳市人民医院不孕不育门诊就诊的年龄35~45岁女性不孕症患者210例开展横断面研究,通过医院焦虑抑郁量表调查研究对象焦虑和抑郁症状,并用SPSS软件分析相关的影响因素。结果:调查对象中有焦虑症状81例(38.6%),抑郁症状83例(39.5%)。多因素分析显示,已有子女(OR=0.67,95%CI0.53~0.93),家庭月收入8000元(OR=0.72,95%CI0.58~0.94)是焦虑的保护因素;对于抑郁的形成,原发性不孕(OR=1.89,95%CI1.19~2.72)是危险因素,高中及以上文化程度(OR=0.54,95%CI0.32~0.91)、家庭的支持(OR=0.42,95%CI0.29~0.61)是保护性因素。结论:深圳市35岁以上不孕女性焦虑和抑郁症状发生率较高,应该引起关注,对于不孕女性应进行常规心理健康问题的筛查,早期给予社会支持和心理关怀。     

女性不孕症患者抑郁现状及影响因素分析

目的 调查分析女性不孕症患者抑郁现状及其影响因素,为其获取更为有益的治疗措施提供依据.方法 选择2012年12月至2013年12月确诊的182例女性不孕症患者为研究对象（不孕组）,另选择174例女性健康体检者为对照组,对所有入选者采用自评抑郁量表（SDS）及汉密尔顿抑郁量表（HAMD）评定后进行比较分析.结果 HAMD评定结果：不孕组轻度、中度、重度抑郁发生率均高于对照组[13.7％（25/182）比4.6％（8/174）,14.8％ （27/182）比4.0％ （7/174）,16.5％（30/182）比2.9％（5/174）],差异有统计学意义（P＜0.01）.SDS评定结果：不孕组轻度、中度、重度抑郁发生率均高于对照组[13.2％（24/182）比4.0％ （7/174）,15.4％ （28/182）比4.6％ （8/174）,17.0％（31/182）比2.9％（5/174）],差异有统计学意义（P＜0.01）;相关性分析显示,患者年龄（r=0.18,P=0.012）与抑郁的发生呈正相关,教育程度（r=-0.26,P=0.000）、经济状况（r=-0.20,P=0.004）与抑郁的发生呈负相关.结论 女性不孕症患者抑郁的发生率高于正常人群,提示需对女性不孕症患者提供心理支持.     

不孕症夫妇心理状况及相关因素分析

[目的]调查不孕症夫妇心理健康状况以及进行相关因素分析,探讨不孕症"生物-心理-社会"的医学模式. [方法]采用90项症状自评量表(SCL-90)及问卷方法对不孕症夫妇进行调查.SCL-90每个项目按1～5分的五级评分,参照全国成人常模标准.数据采用SPSS15.0软件进行统计处理. [结果]调查不孕症夫妇69对(138人),SCL-90总分>160分者占13.8%,抑郁因子均分>2分31.9%,焦虑因子均分>2分者16.7%;白评总分、总均分、阳性项目数、抑郁、焦虑、人际关系敏感、敌对、躯体化等因子分均高于全国常模(P<0.05);不孕症夫妇之间,女方总分、总均分、阳性项目数均高于男方(P<0.01);不孕症夫妇年龄越大、结婚年限越长、治疗时间越长,因子得分相应也高;夫妇双方在总分、总均分、抑郁和焦虑因子得分均呈高度相关性(r>0.7,P<0.01);文化程度越低、个人收入越少,因子得分越高;城乡户籍也是影响因子得分的因素,乡村不孕症夫妇承受的心理压力及心理紊乱的发生率明显高于城镇夫妇. [结论]不孕症对夫妇心理健康影响较大,以抑郁、焦虑、人际关系敏感等负性情绪为主要表现;不孕妇女心理压力高于丈夫,并且夫妇之间负性情感相互影响;年龄、结婚年限、治疗时间、文化程度和收入等因素能够影响心理紊乱的发生和严重程度.     

不孕症妇女心理状况及心理干预效果

[目的]了解不孕症妇女抑郁、焦虑状况,探讨心理干预对不孕症妇女排卵的影响. [方法]应用焦虑自评量表(SAS)和抑郁自身量表(SDS)对40名排卵障碍的不孕症妇女进行心理评估;对其中20例在促排卵时及排卵期进行心理干预即支持性心理干预、家庭疗法、小组治疗和放松训练,对照组不采用心理干预措施.观察两组治疗前后抑郁、焦虑情绪变化的异同,并进行3个月促排卵周期的排卵率的比较. [结果]不孕症妇女均存在不同程度抑郁、焦虑(48.2±9.4,47.9±10.3),心理干预能明显改善其不良情绪(40.8±10.0,36.9±10.0),差异有统计学意义(t=4.2,t=5.9,P＜0.01),干预组与对照组比较3个促排卵周期排卵率高于对照组(分别为89%,67%),差异有统计学意义(X2=7.82,P＜0.01). [结论]妇科医生应重视不孕妇女的心理,并进行必要的心理干预,改善其不良情绪,提高排卵率,增加妊娠机会.     

继发性不孕症妇女心理状态调查

目的：探讨继发性不孕症妇女的心理状态及相关影响因素,为继发性不孕症的针对性治疗与护理提供有价值的信息。方法对2012年6月一2013年6月在本中心行IVF-ET的290例女性因素继发性不孕症进行调查,分析继发性不孕症患者常见心理问题。结果患者焦虑心理、抑郁心理、仇恨心理、感到悲观、内疚感、孤独感和无所谓者分别占70.7％、55.5％、45.9％、33.5％、32.1％、24.8％和8.6％;不同年限、家庭关系、性伴侣数目对患者SDS和SAS有影响。结论对继发性不孕症妇女针对心理特征有的放矢行个性化心理干预,可减轻患者焦虑、抑郁情绪,增加受孕机会。     

接受辅助生殖技术治疗的不孕女性的心理特点及相关因素分析

目的探讨接受辅助生殖技术(ART)治疗的不孕症女性的心理特点及其影响因素。方法选取2014年1月—2017年1月在本院接受ART治疗的女性不孕症患者279例作为研究对象,按照年龄进行1:1匹配,选取同时期在本院体检的已婚女性279例作为对照组。分别采用自制一般问卷、症状自评量表(SCL-90)、焦虑自评量表(SAS)及抑郁自评量表(SDS)对研究对象的一般情况、症状及焦虑抑郁发生情况进行调查,分析影响不孕症女性焦虑、抑郁的相关因素。结果 SCL-90评分结果显示,接受ART治疗的不孕症女性的抑郁、焦虑、敌对、精神病性及人际关系敏感性5个因子的得分均明显高于同年龄段已婚女性;进一步采用SAS、SDS量表对患者进行评定,结果显示,32.2%的不孕症患者存在焦虑症状,24.4%的不育症女性存在抑郁症状。单因素分析结果显示,焦虑症状的发生在年龄、不孕时间、经济收入、既往治疗费用、传统生育观念及对ART治疗了解程度方面的差异均有统计学意义,抑郁症状的发生在教育程度、不孕时间、夫妻关系、既往治疗费用、传统生育观念、社会交往方面的差异有统计学意义。多因素Logistic回归分析结果显示,年龄、不孕时间、经济收入、既往治疗费用及对ART治疗相关知识了解程度是焦虑症状的主要影响因素,文化程度、不孕时间、夫妻关系、社会交往是抑郁症状的主要影响因素。结论接受ART治疗的不孕症女性焦虑、抑郁症状的发生风险较高,临床上应加以重视,并根据其高危因素采取相应干预措施,提高患者心理健康水平。     

不孕症患者的心理状态调查及其护理对策

目的:调查不孕症患者的心理状态并探讨相应的护理对策。方法:采用Zung焦虑自评量表(SAS)及抑郁自评量表(SDS)和自行设计的相关因素调查表,对2004年5月~2005年8月在我院不育不孕门诊就诊的130名符合不孕症诊断标准的患者进行问卷调查。结果:不孕症患者焦虑抑郁发生率明显高于对照组。其相关因素有年龄、既往有无妊娠史、病程、是否有多个性伴侣、婚前性行为、患者对疾病相关知识的了解程度以及来自家庭、社会的压力等。结论:在对不孕症患者疾病治疗过程中应当重视心理健康问题,并采取相应的心理护理措施。     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.     

Stress in police officers: a study of the origins,prevalence and severity of stress-related symptoms within a county police force

BACKGROUND: High levels of stress-related illness are causing concern across industry. Against a background of impending legislative moves to try to improve this situation, there is a need to identify key work-related stressors. Police work tends to be regarded as inherently stressful because of the personal risk of exposure to confrontation and violence and the day-to-day involvement in a variety of traumatic incidents. As a result, high levels of stress-related symptoms might be expected in this population. OBJECTIVE: To examine the sources of stress-related symptoms within police officers and measure the prevalence of significant associated mental ill-health. METHOD: A cross-sectional questionnaire survey of a population of 1206 police officers was performed to assess levels of strain associated with a series of potential home and work related stressors. Participants were then split into low and high scoring groups on the basis of a General Health Questionnaire (GHQ) threshold score in order to identify those stressors most associated with mental ill-health effects. RESULTS: Occupational stressors ranking most highly within the population were not specific to policing, but to organizational issues such as the demands of work impinging upon home life, lack of consultation and communication, lack of control over workload, inadequate support and excess workload in general. The high scoring group constituted 41% of the population and differed significantly from those with low scores in perception of all stressors, ranking both personal and occupational stressors more highly, and from personality constraints appeared significantly more 'stress-prone'. A significant association between gender and mental ill-health was found, with females more likely to score more highly on the GHQ than males. CONCLUSION: This study confirms previous findings of organizational culture and workload as the key issues in officer stress. Given that the degree of symptomatology appears to be worsening, management action is required. Further research is indicated within the police population into a possible increased susceptibility in female officers.