209名驻岛人员心理健康状况调查

目的：研究驻岛人员的心理健康状况。方法：采用症状自评量表(SCL-90)、特质应对方式问卷、匹兹堡睡眠质量指数量表(PSQI)和自行设计调查表调查驻岛人员209名。结果：驻岛人员中有轻度不良反应问题为19．1％～48．8％，存在较明显心理健康问题为3．3％～11．5％。轻度不良反应为强迫、偏执、躯体化、人际敏感、敌对、抑郁和焦虑等；较明显的心理健康问题为人际敏感、抑郁、敌对、强迫、偏执和躯体化等。影响消极应对方式较明显的因素为睡眠质量、个人支出、人际关系。影响积极应对方式的较明显因素为父母关心程度。结论：应根据不同的驻岛时间予以因人而异的心理调整。     

慢性认知功能缺损老人的心理健康状况及影响因素的研究

目的 探讨患有慢性认知功能缺损的老年人心理健康状况及其影响因素。方法 采用SCL-90量表对65例慢性认知功能缺损患(病例组)和130名健康老人(对照组)进行心理测试。用病例对照的研究方法，调查影响心理健康的因素。结果 病例组躯体化、抑郁、焦虑、精神病性症状等因子和阳性项目数明显高于对照组(P＜0．01)。60岁以上人群的躯体化和抑郁等因子要高于50～60岁常模。多因素分析结果表明，经历不良生活事件、身体健康状况和家庭经济状况影响老年人群的心理健康。结论 慢性认知功能缺损人群的心理健康状况较差，主要的影响因素是经历不良的生活事件。     

高龄孕产妇焦虑、抑郁症状分析

目的：探讨高龄孕产妇焦虑、抑郁症状的发生率及相应的危险因素。方法：随机选取两家妇产科医院的孕妇522名，采用综合医院焦虑和抑郁量表（HAD）、爱丁堡产后抑郁量表（EPDS）和自编危险因素问卷，分别评估人组时、孕38周、产后7d、产后42d和产后3个月的焦虑、抑郁症状。结果：522名中有19例高龄孕产妇。高龄孕产妇5个时点的焦虑症状发生率依次为：15.8％、11．1％、21．1％、6．7％和10．0％；孕期HAD评定的抑郁症状发生率为21．1％、11.1％，产后EPDS评定抑郁症状发生率为10.5％、28．6％和20．0％。高龄孕产妇焦虑、抑郁症状的发生率均高于非高龄孕产妇。初潮年龄和担忧孩子喂养与高龄孕产妇人组时的抑郁情绪相关，分娩时紧张状态和产后抢救与产后7d的焦虑情绪相关。结论：高龄孕产妇存在较多的焦虑和抑郁情绪，应针对其危险因素进行预防。     

城市社区更年期居民抑郁、焦虑状况及其影响因素

目的 了解城市社区更年期居民的抑郁，焦虑状况及其影响因素。方法 采用自编调查表（包括抑郁自评量表（ＣＥＳ－Ｄ）焦虑自评量表（ＳＡＳ）按整群抽样法对上海市普陀区槽杨街道２４个居委会的更年期居民４７４６人进行调查。结果 有抑郁症状者５７２人（１２．０５％）有焦虑症状者为２４３人（５．１２％）经多元逐步回归分析，躯体疾病，就业情况，人均收入，性别，性格及饮酒影响ＣＥＳ－Ｄ；躯体疾病，就业情况，性别及饮酒     

Ⅰ类大学新生人格与心理健康的相关分析

目的研究Ⅰ类大学新生的人格特征与心理健康状况的关系。方法在1386名大学新生中采用大学生人格问卷（UPI）筛选出219名Ⅰ类大学新生，分别采用症状自评量表（SCL-90）和卡特尔16种个性因素测验（16PF）进行心理健康和人格的测试。结果卡特尔16种人格特征中的稳定性、有恒性、敢为性、怀疑性、忧虑性、自律性、紧张性与SCL-90中的各因子均有显著相关（P〈0．05）；进一步回归分析发现以上7个因子解释抑郁、焦虑和人际敏感的变异率分别为34．2％、30．8％和37．2％。结论人格是影响Ⅰ类大学新生心理健康的重要因素，人格的培养和完善有利于促进心理健康。     

出租汽车司机的心理健康状况调查

目的探讨出租汽车司机的心理健康状况及其影响因素。方法采用SCL-90量表、生活事件调查表、应付方式问卷和EPQ个性问卷调查了115名出租汽车司机的心理健康状况及其影响因素。结果有19．1％的出租汽车司机存在明显的心理症状，主要表现为焦虑、抑郁、躯体化和偏执得分显著高于常模，影响出租汽车司机心理健康水平的因素主要有工作压力、身体状况、自责和幻想的消极性应付方式、情绪不稳定的人格特征等。结论不同驾驶工龄的出租汽车司机其心理健康水平有显著差异。     

丁螺环酮治疗心肌梗死伴发焦虑抑郁临床观察

目的：了解丁螺环酮对心肌梗死患者伴发焦虑抑郁症状的疗效。方法：采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评定症状。对伴发焦虑抑郁症状的心肌梗死患者84例，随机分为两组。丁螺环酮组口服丁螺环酮，对照组口服安慰剂，治疗4周，观察丁螺环酮对室性心律失常发生率的影响。结果：丁螺环酮对心肌梗死患者伴发的焦虑、抑郁有效率分别为87．8％及78．1％，明显高于对照组；严重心律失常发生率明显低于对照组。结论：丁螺环酮对心肌梗死患者伴发焦虑抑郁症状有显著疗效，并能改善患者的生活质量和预后。     

独居老人抑郁症状和抑郁症的调查

目的调查城市独居老人的抑郁症状和抑郁症情况。方法抽查上海市虹口区一个街道、两个居委的12岁以上常住人口共5512名，收集社会人口学资料并应用流调用抑郁量表（CES—D），对于CES—D评分在16分及以上者使用定式临床检查（SCID）进行诊断，分析60岁以上独居者的人口学、抑郁症状及抑郁症情况。结果60岁以上独居老人占调查对象的1．19％，占60岁以上老年人口的4．20％，独居老人的人口学资料和一般情况与非独居老人差异没有统计学意义。60岁以上老人的抑郁症状检出率为8．26％（118／1428），高于60岁以下者的抑郁症状检出率（4．2％）；60岁以上老人中抑郁症状检出率独居者高于非独居者（20．00％vs7．74％，χ^2=2．57，P〈0．01），抑郁症检出率独居者高于非独居者（5．0％vs0．58％,χ^2=14．66，P〈0．01）。结论城市人口老龄化程度高，老年人尤其独居者的抑郁症状及抑郁症检出率较高，应该重视独居老年人心理健康。     

期望值对高考生心理健康的影响

目的了解不同的高考期望值对考生心理健康的影响。方法采用症状自评量表（SCL-90）于高考前4个月集体测试，结果按期望值的高低进行比较；同时以半开放式问卷调查可能影响考生心理健康的因素。结果高期望值组的躯体化、焦虑、恐怖、偏执和精神病性因子分高于低期望值组（P〈0．05）；家长高期望值组的阳性症状均分以及躯体化、强迫、抑郁、焦虑和恐怖因子分高于考生高期望值组（P〈0．05）。因子异常率在高期望值组大多高于低期望值组，焦虑、敌对、恐怖间的差异显著（X^2=4．66-5．12）；家长高期望值组≥3分的强迫的发生率高于考生高期望值组（X^2=7．29）；强迫、人际关系、抑郁以及高期望值组的敌对、焦虑、偏执的异常率均超过30％。阳性症状均分≥3分者高期望值组显著多于低期望值组（X^2=4．57）。结论高期望值对高考生的心理健康有一定的负面影响，家长高期望值的影响更大。     

新型冠状病毒肺炎流行期间青少年女性情绪问题及影响因素

目的:探讨新型冠状病毒肺炎(COVID-19)流行期间青少年女性情绪问题及影响因素。方法:采用横断面调查方式,招募11～18岁居家隔离的青少年女性自愿在线完成一般人口学资料及疫情相关调查,应用流调中心抑郁量表(CES-D)、广泛性焦虑量表(GAD-7)评估抑郁、焦虑,分析其发生的影响因素。结果:共有4 805名青少年女性完成调查,1 905名(39.6%)有情绪症状,其中1 651名(34.3%)仅出现抑郁症状;6名(0.1%)仅出现焦虑症状,248名(5.2%)出现抑郁伴焦虑症状。低年龄、处于毕业班、未参与网课、所在省份的确诊病例数1 000、不关注疫情、睡眠时间6 h/d或锻炼时间0.5 h/d的青少年女性更容易出现情绪症状(P0.05或P0.01)。出现抑郁症状的青少年女性中,处于毕业班、父母参与一线抗疫和睡眠时间6 h/d是其伴发焦虑症状的影响因素(P均0.01);关注疫情是不发生焦虑症状的保护因素(P0.05)。结论:COVID-19流行期间,低年龄、处于毕业班、未参与网课、不关注疫情和睡眠锻炼不足的青少年女性出现情绪问题较多;处于毕业班、父母参与一线抗疫情与睡眠不足是其伴发焦虑症状的危险因素,关注疫情则为保护因素。     

Symptoms of anxiety and depression in the course of cognitive decline

BACKGROUND/AIMS: Anxiety and depression are common inpatients with cognitive decline and Alzheimer's disease (AD), and recognition and treatment of these symptoms can improve their quality of life. The present study investigates anxiety and depression in different phases of cognitive decline. METHODS: The sample consisted of five groups of elderly people in different phases of cognitive decline; four from a community-based sample (Longitudinal Aging Study Amsterdam), and one group of elderly people diagnosed with AD. ANOVAs were performed to investigate group differences in the severity and prevalence of anxiety and depression, and comorbid anxiety and depressive symptoms. RESULTS: The prevalence rates of anxiety, comorbid anxiety and depressive symptoms and depressive symptoms follow a pattern of an increasing prevalence as cognitive performance declines and a decrease in the prevalence when cognitive functioning is severely impaired. AD patients report fewest anxiety symptoms. CONCLUSION: We found that the prevalence of anxiety symptoms, depressive symptoms and comorbid anxiety and depressive symptoms seems to increase in the early phase of cognitive decline, and decreases as cognitive functioning further declines. Elderly diagnosed with AD report less anxiety as expected, probably due to lack of insight caused by AD.     

老年冠心病病人焦虑、抑郁症状的调查

目的 了解老年心病伴焦虑、抑郁症状的情况,为临床干预提供客观依据,方法 采用汉密顿焦虑量表（ＨＡＭＭＡ）、汉密顿抑郁量表（ＨＡＭＤ）、综合性医院焦虑、抑郁量表（ＨＡＤ）,对７１例住院老年冠心病人进入调查,并与２０例非老年主病患者进行比较。结果 老年冠心病病人焦滤症状发生率为６９￣７０．４％,抑胡 状发生率为４２．１￣６３．４％,焦虑比抑郁发生率高,有显著差异。与２０例非老年冠心病比较,老年冠心伯焦     

Comorbid anxiety disorders in depressed elderly patients

OBJECTIVE: Anxiety disorders are common in adults with depressive disorders, but several studies have suggested a relatively low prevalence of anxiety disorders in older individuals with depression. This cross-sectional study measured current and lifetime rates and associated clinical features of anxiety disorders in depressed elderly patients. METHOD: History of anxiety disorders was assessed by using a structured diagnostic instrument in 182 depressed subjects aged 60 and older seen in primary care and psychiatric settings. Associations between comorbid anxiety disorders and baseline characteristics were measured. The modified structured instrument allowed detection of symptoms that met inclusion criteria for generalized anxiety disorder in a depressive episode. RESULTS: Thirty-five percent of older subjects with depressive disorders had at least one lifetime anxiety disorder diagnosis, and 23% had a current diagnosis. The most common current comorbid anxiety disorders were panic disorder (9.3%), specific phobias (8.8%), and social phobia (6.6%). Symptoms that met inclusion criteria for generalized anxiety disorder, measured separately, were present in 27.5% of depressed subjects. Presence of a comorbid anxiety disorder was associated with poorer social function and a higher level of somatic symptoms. Symptoms of generalized anxiety disorder were associated with a higher level of suicidality. CONCLUSIONS: Contrary to previous reports, the present study found a relatively high rate of current and lifetime anxiety disorders in elderly depressed individuals. Comorbid anxiety disorders and symptoms of generalized anxiety disorder were associated with a more severe presentation of depressive illness in elderly subjects.     

Anxiety enhances the detrimental effect of depressive symptoms on health status following percutaneous coronary intervention

OBJECTIVE: We examined whether anxiety has incremental value to depressive symptoms in predicting health status in patients undergoing percutaneous coronary intervention (PCI) treated in the drug-eluting stent era. METHODS: A series of consecutive patients (n=692) undergoing PCI as part of the Rapamycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital registry completed the Hospital Anxiety and Depression Scale at 6 months and the Short-Form Health Survey (SF-36) at 6 and 12 months post-PCI. RESULTS: Of 692 patients, 471 (68.1%) had no symptoms of anxiety nor depression, 62 (9.0%) had anxiety only, 59 (8.5%) had depressive symptoms only, and 100 (14.5%) had co-occurring symptoms. There was an overall significant improvement in health status between 6 and 12 months post-PCI (P<.001); the interaction effect for time by psychological symptoms was also significant (P=.003). Generally, patients with co-occurring symptoms reported significantly poorer health status compared with the other three groups (Ps <.001). Patients with co-occurring symptomatology were also at greater risk of impaired health status on six of the eight subdomains of the SF-36 compared with the other three symptom groups, adjusting for baseline characteristics and health status at 6 months. CONCLUSION: Patients with co-occurring symptoms of anxiety and depression reported poorer health status compared with anxious or depressed-only patients and no-symptom patients, showing that anxiety has incremental value to depressive symptoms in identifying PCI patients at risk for impaired health status treated in the drug-eluting stent era.     

Qualitative differences in psychiatric symptoms between high risk groups assessed on a screening test (GHQ-30)

Summary Scores on five subscales derived from the GHQ-30 have been examined in various groups at risk for psychiatric disorder, to determine whether different patterns of symptoms are found. The subscales are based on a factor analysis of a population sample of over 6,000 adults (Huppert et al. 1989) which identified five robust factors corresponding to symptoms of anxiety, feelings of incompetence, depression, difficulty in coping and social dysfunction. Previous studies have identified certain groups of people who are vulnerable to mental illness and are therefore likely to obtain a high score on the GHQ. These include unemployed men, single women with dependent children, and elderly people in poor health. The results show marked differences in symptom patterns among these three at-risk groups. For example, while scores on anxiety and depression subscales were significantly raised in most at-risk groups, young unemployed men did not show significant anxiety whereas elderly men in poor health did not show significant depressive symptoms. However both these groups showed difficulty in coping, unlike older unemployed men or elderly women in poor health. Single women with dependent children reported the highest rate of psychiatric symptoms, particularly anxiety and depression, but had difficulty in coping only if they were also employed. These findings suggest that this method of analysing data from the GHQ-30 has potential value in yielding qualitative as well as quantitative information about psychiatric symptoms.     

Using an annual over-75 health check to screen for depression: validation of the short Geriatric Depression Scale (GDS15) within general practice.

OBJECTIVE: To validate the short Geriatric Depression Scale (GDS15) as a screening instrument and determine the optimal cutpoint for detecting depression among older people living in the community. DESIGN: Two stage study with the first stage consisting of a health check of people aged 75 years and over by a practice nurse which included the GDS15. A second-stage diagnostic interview including the criterion standard was carried out blind to GDS15 score.SETTING: A large general practice in Melton Mowbray, Leicestershire, UK. PATIENTS: A random sample (stratified according to first-stage GDS15 score) of 257 older people living in the community, without significant cognitive impairment, were selected for the second-stage diagnostic interview. MEASURES: The first-stage GDS15 score was compared with diagnostic status for depression and anxiety disorders (according to ICD-10 criteria) and presence of depressive symptoms at the second-stage clinical interview. RESULTS: Ninety-three per cent of those eligible for the study were successfully screened with the GDS15. A cutpoint of <3/3+ had a sensitivity of 100% and specificity of 72% in detecting cases of depression but fewer than one in five of those testing positive reached a diagnostic threshold. Only 25% of those with a diagnosis of depression had any mention of mental health problems in their medical notes in the year prior to the clinical interview. For detecting depressive symptoms the same cutpoint was 79% sensitive and 78% specific with a positive predictive value of 46%. CONCLUSIONS: Used as part of an annual over-75 health check in primary care, the GDS15 would detect a significant amount of hidden morbidity which would serve the original purpose of the annual elderly health checks in the UK.     

Extent and cost of informal caregiving for older Americans with symptoms of depression

OBJECTIVE: The purpose of this study was to obtain nationally representative estimates of the additional time and cost associated with informal caregiving for older Americans with depressive symptoms. METHOD: Data from the 1993 Asset and Health Dynamics Among the Oldest Old Study, a nationally representative survey of people age 70 years or older (N=6,649), were used to determine the weekly hours and imputed costs of informal caregiving for elderly people with no depressive symptoms in the last week, one to three depressive symptoms in the last week, and four to eight depressive symptoms in the last week. RESULTS: Forty-four percent of survey respondents reported one to three depressive symptoms, and 18% reported four to eight depressive symptoms. In multivariate regression analyses that adjusted for sociodemographics, caregiver network, and coexisting chronic health conditions, respondents with no depressive symptoms received an average of 2.9 hours per week of informal care, compared with 4.3 hours per week for those with one to three symptoms and 6.0 hours per week for those with four to eight symptoms. Caregiving associated with depressive symptoms in elderly Americans represented a yearly cost of about $9 billion. CONCLUSIONS: Depressive symptoms in elderly persons are independently associated with significantly higher levels of informal caregiving, even after the effects of major coexisting chronic conditions are adjusted. The additional hours of care attributable to depressive symptoms represent a significant time commitment for family members and, therefore, a significant societal economic cost. Further research should evaluate the causal pathways by which depressive symptoms lead to high levels of caregiving and should examine whether successful treatment of depression reduces the need for informal care.     

Dysthymia among the community-dwelling elderly.

There are few data on the clinical features of dysthymia among the community-dwelling elderly. Forty elderly individuals with dysthymic disorder were identified following screening in the community with GMS-AGECAT. A detailed clinical history was obtained and DSM-IV checklists and standardized scales were used, at a second interview. Comparisons were made with a group of 630 non-depressed elderly from the same community. Dysthymia was predominately of late onset (93%) and associated with a major stressor in 65% of cases. Comorbid axis 1 disorders were present in 15% of dysthymics and an axis 2 disorder in 10%. The dysthymic group had significantly higher degrees of physical impairment than the non-depressed elderly. The symptom profile demonstrated prominent anxiety and functional features. Eighty-three per cent of the elderly with dysthymia had presented to their GP with anxiety/depressive symptoms at some stage during the dysthymic disorder. The presentation of dysthymia in older people differs from that in earlier life. Late life dysthymia is less associated with axes 1 and 2 comorbidity but is associated with significant degrees of physical impairment. Dysthymia in older people presents to primary care, rather than specialist services, and interventions must be delivered at this level.