复员退伍精神分裂症患者的幸福感及相关因素

目的探讨复员退伍精神分裂症患者幸福感的相关因素。方法选取河北省荣军医院180例复员退伍精神分裂症患者,采用一般情况调查表、总体幸福感量表（GwB）、阳性与阴性症状量表（PANSS）、自知力与治疗态度问卷（ITAQ）、不良反应量表（TESS）进行评定,并进行相关性分析。结果不同病程、家族史、婚姻状况、TESS评分的复员退伍精神分裂症患者幸福感差异无统计学意义（P〉0．05）;31～40岁患者的幸福感显著高于51～60岁者（P=0．022）;初中组精力、愉快或-比郁心境因子分高于高中及以上组（P分别为0．012,0．003）,小学组愉快或忧郁心境因子分亦高于高中及以上组（P=0．047）,而小学组松弛与紧张因子分高于高中以上组（P=0．045）;住院时间≥6年组GwB总分低于〈6年组（P=0．037）;不伴躯体疾病者的愉快或忧郁心境分显著高于伴有者（P=0．001）。PANss量表阴性症状因子分与愉快或忧郁心境呈负相关（r=-0．148,P=0．048）;ITAQ评分与精力及愉快或忧郁心境呈正相关（r分别为0．149,0．155;P分别为0．045,0．037）。多因素Logistic回归分析显示长期住院是影响患者幸福感的主要因素（B=-0．031）。结论复员退伍精神分裂症患者幸福感的影响因素是多方面的,提高其幸福感需要给予综合康复措施。     

独立学院学生总体幸福感调查

目的描述独立学院学生总体幸福感的特点。方法采用总体幸福感问卷对中国矿业大学徐海学院学生和中国矿业大学学生总体幸福感进行调查和分析。结果独立学院学生的总体幸福感显著高于全国常模;独立学院男生在健康担心因子上得分低于女生;独立学院城市学生的焦虑因子和总体幸福感总分得分都显著高于农村学生,忧郁愉快因子则低于农村学生;独立学院学生的焦虑因子得分显著高于中国矿业大学学生。结论独立学院学生的总体幸福感与性别、生源地、专业相关。     

抑郁症患者总体幸福感与社会支持和应对方式的相关性

目的调查抑郁症患者的幸福感,探讨其总体幸福感与社会支持和应对方式的相关性。方法于2019年2月-9月在安徽省精神卫生中心焦虑抑郁科门诊及住院患者中选择120例符合《国际疾病分类(第10版)》(ICD-10)抑郁症诊断标准的抑郁症患者作为抑郁症组,同时从社区人员及患者家属中选择122例作为对照组。采用总体幸福感量表(GWB)(中国版)、社会支持评定量表(SSRS)、简易应对方式问卷(SCSQ)进行评定,应用Pearson相关分析及多元线性回归分析比较抑郁症患者GWB、SSRS与SCSQ评分的相关性。结果抑郁症患者GWB评分低于对照组,差异有统计学意义[(62.43±13.48)分vs.(84.97±10.02)分,t=-14.780,P<0.01];抑郁症患者GWB评分与SCSQ总评分和积极应对方式评分均呈正相关(r=0.378、0.460,P均<0.01);抑郁症患者GWB评分与SSRS客观支持、主观支持、对支持的利用度评分及总评分均呈正相关(r=0.354~0.561,P<0.05或0.01);SSRS客观支持、主观支持、对支持的利用度评分及总评分与SCSQ总评分和积极应对方式评分均呈正相关(r=0.234~0.398,P<0.05或0.01)。结论抑郁症患者幸福感较低,且其幸福感水平与社会支持和积极应对方式相关。     

高职学生主观幸福感及与自尊的关系

目的探讨高职院校学生主观幸福感的特点及与自尊的关系。方法采取整群随机抽样方法抽取江苏省三所高等职业院校2063名高职生,采用总体幸福感量表(GWB)和自尊量表(SES)调查高职生主观幸福感状况及其与自尊的关系。结果高职女生主观幸福感评分高于男生,差异有统计学意义(t=2.97,P<0.01);母亲是大学文化的高职生主观幸福感评分高于母亲是小学文化的高职生(t=3.88,P<0.01);人文艺术类与理工科类高职生的主观幸福感评分差异有统计学意义(t=3.13,P<0.01);高职生主观幸福感和自尊之间有正相关关系(r=0.17,P<0.01),自尊对主观幸福感有预测作用。结论性别、母亲受教育程度和专业类别对高职生主观幸福感有影响,尤以男生、母亲是小学受教育程度及理工类高职生主观幸福感较低,加强高职生的自尊有助于提高其主观幸福感。     

恶劣心境患者述情障碍与自主神经功能的相关研究

目的:探讨恶劣心境患者的人格特质、述情障碍与自主神经功能心理生理反应的相关机制。方法:采用多伦多述情障碍量表中文版(TAS-20-C)及心理健康测查表(PHI)对42例恶劣心境患者组(DD组)、33例重性抑郁症患者组(MD组)及30例健康对照组(NC组)进行述情障碍和心理健康水平和人格特质测定,并分析短时(5min)心率变异性(HRV),评定自主神经功能。结果:DD组TAS-20-C各因子得分及总分显著高于NC组(P<0.01),因子Ⅰ、因子Ⅱ及总分均明显高于MD组(P<0.01或P<0.05);DD组PHI量表躯体化、焦虑、病态人格及疑心因子分明显高于MD组(P<0.01或P<0.05);DD组HRV频谱指标中SDNN、PNN50及HF较MD及NC组均显著下降(P<0.01或P<0.05),LF∕HF较MD及NC组均明显升高(P<0.05);TAS-20-C总分及因子Ⅰ与躯体化、焦虑、病态人格、疑心均相关(︱r︱=0.25～0.38,0.40～0.44,0.47～0.59,0.43～0.42,P<0.01或P<0.05),因子Ⅱ与焦虑及变态人格相关(︱r︱=0.31,0.31,P<0.05);躯体化及焦虑与SDNN、VLF及LF均相关(︱r︱=0.26～0.27,0.39～0.27;︱r︱=0.36～0.28,P<0.05或P<0.01)。结论:恶劣心境患者存在明显的述情障碍,其人格特质可能导致患者焦虑程度更高,伴自主神经功能紊乱。     

流浪精神分裂症患者自测健康状况及相关因素分析

目的探讨流浪精神分裂症患者自测健康状况及相关影响因素。方法以2013年4月-10月广州市民政局精神病院收治的符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的60名流浪精神分裂症患者(研究组)为研究对象,对照组为40名健康志愿者,由经过统一培训的专业人员采用自测健康状况评定量表(SRHMS)、社会支持评定量表(SSRS)、总体幸福感量表(GWB)对其健康状况、社会支持状况、幸福感进行评定。结果流浪精神分裂症患者SRHMS总评分及因子分低于对照组(P0.05或0.01);社会支持评定量表各因子、幸福感与自测健康各因子显著相关(P0.05或0.01)。结论流浪精神分裂症患者自测健康状况较差,给予社会支持与提高总体幸福感可能有利于改善其健康状况。     

癫抑郁患儿应付方式与父母教养方式的相关性研究

目的了解癫抑郁患儿应付方式与父母教养方式的关系,为临床治疗、护理工作提供相关参考。方法采用应付方式问卷(the way of coping questionnaire,WCQ)及父母教养方式评价量表(egna minnenav barndoms uppfostran,EM-BU)对59例癫抑郁患儿(观察组)进行测评,与从当地某小学抽取的性别及年龄相匹配且无重大急慢性疾病的各年级学生59名(对照组)进行比较。结果在应付方式上:癫抑郁患儿的自责、幻想及退避评分均明显高于对照组(P<0.05或P<0.01),而求助及解决问题评分则明显低于对照组(P<0.01);在教养方式上:癫抑郁患儿父母的情感温暖、理解因子评分低于对照组(均P<0.01),而惩罚及拒绝因子评分高于对照组(P<0.05或P<0.01);在患儿应付方式与父母教养方式方面:癫抑郁患儿的WCQ评分与EMBU评分呈显著性相关,尤其是父母的情感温暖理解、过度干涉保护和母亲的惩罚严厉及拒绝否认关系密切,良好的父母教养方式与患儿积极的应付方式呈正相关,不良的父母教养方式与患儿积极的应付方式呈负相关。结论癫抑郁患儿较正常儿童更多的采用消极不成熟的应付方式,而较少采用积极的应付方式;其在成长过程中,普遍存在着不良的父母教养方式;且患儿的应付方式与父母的不良教养方式有关。     

敬老院老人的精神卫生状况调查

目的 探讨老龄人精神卫生状况。方法 采用SCL—90症状自评量表调查敬老院81例老龄人。结果 81例在院老龄人SCL—90测试总分最高305分,最低94分,平均144.29±42.19,阳性项目数29.71±18.68,各因子分与国内常模比较,忧郁、焦虑、恐怖、躯体化、精神病性症状因子存在显著性差异(P<0.01)。结论 在院老龄人存在比较严重的精神卫生问题。     

专题讨论教学法在精神科量表教学中应用效果的对照研究

目的探讨专题讨论法在精神科临床量表教学中的可行性和有效性。方法在精神科常用量表教学中,40名学生采用专题讨论教学法(研究组),40名学生采用常规教学法(对照组)。由授课教师对精神分裂症标准化患者进行精神状况检查,教师及两组学生对患者进行阳性和阴性综合征量表(PANSS)评定,比较两组评分与带教老师评分一致性的差异,并使用自制的授课满意度调查表调查学生对教学的满意程度。结果研究组PANSS量表的评分与带教老师评分一致性均显著高于对照组(P<0.05),研究组的授课满意度显著高于对照组(P<0.01)。结论专题讨论法可以提高精神卫生专业医学生的学习成绩和学习兴趣,可以在精神科教学活动中进一步推广使用。     

中山市中小学教师精神卫生知识知晓情况调查分析

目的了解中山市中小学教师精神卫生知识知晓情况、态度并探讨其相关影响因素。方法采用分层整群随机抽样的方法,抽取中山市小学、初中及高中共12所学校983名教师,采用一般情况调查表、精神卫生与心理保健知识问卷、儿童青少年常见精神疾病知识问卷及精神疾病态度问卷进行问卷调查。结果精神卫生与心理保健知识问卷总评分(15.92±2.50)分,总体正确率为79.6%;9种儿童青少年常见精神疾病中掌握最好的是抑郁症(38.0%),其次是精神发育迟滞(34.2%)和多动症(33.6%),最差为抽动症(13.4%);精神疾病态度问卷总评分(35.94±5.52)分。组间比较显示:女性教师精神卫生知识与心理保健问卷总评分高于男性教师,中学组教师在儿童青少年常见精神疾病总评分上优于小学教师,差异均有统计学意义(P均0.05)。相关分析显示,教师精神疾病态度问卷总评分与其年龄及工作年限呈负相关(r=-0.07,P均0.05)。被调查的983名教师中,有228名(23.2%)反映在其教学工作中遇见过患有精神疾病的学生,97.2%(955名)的教师认为有必要学习精神卫生知识,在知识获得途径方面,新闻、杂志或网络所占比例最高(70.2%),专业讲座或培训(8.6%)及专业书籍(7.8%)较低。结论中山市中小学教师精神卫生知识知晓情况总体较好,具体病种掌握不均衡,对待精神疾病态度有待改变,可以借助新兴媒体进行有针对性的指导和宣教。     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.