丁螺环酮治疗抑郁症双盲对照研究

对１９９６年４月～１９９７年３月期间，符合ＣＣＭＤ－２－Ｒ抑郁症诊断标准的住院病人２６例，随机均分为两组，分别以丁螺环酮（ｂｕｓｐｉｒｏｎｅ）及多虑平治疗。入组者汉密顿抑郁量表（ＨＡＭＤ）＞１８分，焦虑量表（ＨＡＭＡ）＞１２分；年龄２０～５２岁；无重...     

452例更年期居民焦虑换郁调查

目的：了解社区中更年期居民焦虑、抑郁状况。方法：对４５２例更年期居民使用焦虑自评理表（ＳＡＳ）、流调用抑郁自评量表（ＣＥＳ－Ｄ）,自评显示有焦虑、抑郁感受的１５３例中,随机抽取９２例进行汉密尔顿焦虑量表（ＨＡＭＡ）、汉密尔顿抑郁量表（ＨＡＭＤ）。结果：在完成评定的８１例对象中,ＨＡＭＡ评定〉１４分有焦虑症状者２３例,占评定者的２８．４％。ＨＡＭＤ评定〉８分有抑郁症状者２６例,占评定者的３２．１％。     

复方地西泮与地西泮抗焦虑的多中心双盲对照研究

为比较复方地西泮片与地西泮片的镇静、催眠、抗焦虑效果及安全性，对２０６例病例随机入组，疗程３周。结果：（１）用复方地西泮治疗可明显减少地西泮用量，疗效更好；（２）观察组（复方地西泮片）总有效率５０．４％，显著高于对照组（地西泮片）的２２．８％；（３）汉米尔顿焦虑量表（ＨＡＭＡ）及抑郁量表（ＨＡＭＤ）总分于治疗后均明显减低，观察组的减分幅度显著大于对照组；（４）ＨＡＭＡ和ＨＡＭＤ混合因子分析结果显示，两药均可改善睡眠障碍、焦虑、抑郁心境、植物神经及全身症状，复方地西泮片对前二组症状的疗效显著优于地西泮片；（５）不良反应量表记录两组治疗不良反应均轻微，且发生率低。观察组偶见倦、头痛等，均不影响治疗。提示复方地西泮片是一种安全、有效的抗焦虑新药。     

老年冠心病患者冠状动脉支架置入术后心理状态调查

目的 评价老年冠心病患者冠状动脉内支架置入术后的心理状态及对预后的影响。方法 以汉密顿焦虑量表（HAMA）、汉密顿抑郁量表(HAMD),综合性医院焦虑、抑郁量表（HAD）,对86例老年冠心病患者冠状动脉内支架置入术后进行了心理状态调查,将合并焦虑抑郁的患者作为阳性组,其余为阴性组,比较两组患者的一般情况和冠状动脉支架置入术后心血管事件方面的差异。结果 老年冠心病患者冠状动脉内支架置入术后焦虑抑郁发生率为54.65%,性别、性格、教育程度、经济状况、丧偶是影响焦虑抑郁的主要因素。焦虑抑郁增加了心脏事件的危险。结论 老年冠心病患者冠状动脉内支架置入术后焦虑抑郁发生率高,应及时干预,以降低未来事件发生的危险     

社区老人抑郁症状的5年随访

目的 了解老年人群抑郁症状的动态变化及与痴呆的联系。方法 在５年中对７９７名５５岁以上居民以流调用抑郁自评量表（ＣＥＳ－Ｄ）作两次调查。结果 ５年前后老年人群的抑郁症状群发生率为４．９％￣８．３％及６．８％￣１０．７％，无显著变化；６０例新发生Ａｌｚｈｅｉｍｅｒ病（ＡＤ）者，与正常老人相比，发病前ＣＥＳ－Ｄ总分相近，复访时高于正常组；以血管性痴呆（ＶＤ）为主的其它痴呆３３例，初访和复访的ＣＥＳ－Ｄ     

精神分裂症缓解期的抑郁症状

用双密顿抑郁量表（ＨＡＭＤ）对６９例精神分裂症缓解期病人进行评定，发现２７例ＨＡＭＤ≥１７分。并与４０例原发性抑郁症ＨＡＭＤ总分，各因子分及抑郁症状进行比较，初步认为分裂症缓解期的抑郁症状系患者对心理，社会因素的反应，与抗精神病所致性功能障碍也有一定关系。     

巴金森病伴发抑郁的调查

对上海医科大学华山医院１９９６年７～９月期间由神经内科主任医师确诊为巴金森病的患者进行巴金森病严重程度量表，汉密顿抑郁量表（ＨＡＭＤ）及抑郁自评量表（ＳＤＳ）测试，共３１例，其中男１８例，女１３例。年龄４５～８２岁，平均６４．５±９．１岁。起病年龄３...     

复方地西泮地西泮抗焦虑的多中心双盲对照研究

为比较复方地西泮片与地西泮片的镇静，催眠，抗焦眠效果安全性，对２０６例病例随机入组，疗程３周。结果；１．用复方地西泮治疗可明显减少地西泮用量，疗效更好；２．观察组总有效率５０．４％，显著高于对照组的２２．８％；３汉米尔顿焦虑量表及抑郁量表部分于治疗后均明显减低，观察组的减分幅度显著大于对照组；４．ＨＡＭＡ和ＨＡＭＤ混合因子分析结果显示，两药均可改善睡眠障碍，焦虑，抑郁心境，植物神经及全身症状，复方     

保留子宫对子宫破裂产妇的精神与性心理的影响

目的：观察子宫破裂保留子宫与产妇精神心理的关系。方法：６８例妊娠子宫破裂的产妇根据病情进行手术治疗，并依据孕产情况分初产妇组、经产妇组；按手术的方式分保留子宫（修补术）组、子宫切除组；并同时采用汉密顿焦虑量表（ＨＡＳ）和抑郁量表（ＨＤＳ）评定产妇手术后的精神状态；对术后性心理状态、性生活情况进行１～２年随访。结果：产妇手术后焦虑发生率４５％，抑郁发生率３５％，焦虑并抑郁发生率２５％。子宫切除组的焦虑评分和抑郁评分明显高于保留子宫（修补术）组（Ｐ＜０．０５），子宫切除组中焦虑评分和抑郁评分初产妇组高于经产妇组（Ｐ＜０．０５）；子宫切除组产妇术后性心理状态及性生活质量均明显低于保留子宫（修补术）组（Ｐ＜０．０５）。结论：子宫切除给子宫破裂产妇的精神性心理带来消极影响。     

脑血管病恢复期抑郁状态观察

对４３例脑血管病恢复期抑郁症状态病人予以汉密顿抑郁量表（ＨＡＭＤ）及抑郁自评量表（ＳＤＳ）评分，并且应用小剂量抗抑郁剂和心理疏导进行治疗后复评，结果显示对脑血管病后抑郁状态行综合治疗是有效的，而恢复期病人抑郁状态是生物－心理－社会因素的共同作用结果。     

老年与非老年抑郁症的临床特征差异

目的:探讨老年期抑郁症的临床特征。方法:以60例老年期抑郁症患者作老年组,选60例非老年期抑郁症患者为非老年组。对两组分别用汉密尔顿抑郁量表和汉密尔顿焦虑量表进行评定。结果:老年组抑郁症状中激越和疑病症状显著高于非老年组(P<0.01),老年组的躯体症状中自主神经系统症状、心血管系统症状和消化系统症状显著高于非老年组(P<0.05或P<0.01);躯体性焦虑和认知障碍、焦虑/躯体化和睡眠障碍的严重程度均显著高于非老年组(P<0.05或P<0.01)。结论:老年期抑郁症激越、疑病、躯体症状、焦虑、睡眠障碍及认知障碍等更加突出。     

抑郁症和冠心病共病患者的临床特征

目的:探讨伴发冠心病的抑郁症患者的临床特征.方法:对50例伴有冠心病的抑郁症患者(共病组)和50例单纯抑郁症患者(抑郁组),使用汉密尔顿抑郁量表24项(HAMD)、汉密尔顿焦虑量表(HAMA)和社会功能缺陷筛选量表(SDSS)评定临床表现和社会功能,使用舍曲林治疗12周后再次评定.结果:人组及治疗12周末,共病组HAM...     

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.     

心脏移植住院等待者的焦虑抑郁状态及相关因素

背景：心脏移植术逐渐增多,但对等待心脏移植患者的情绪状态却知之甚少.方法：2010年10月至2011年12月,由精神科医生对上海某大型综合性医院心外科住院等待心脏移植的38例患者进行汉密尔顿抑郁量表和汉密尔顿焦虑量表的评估,住院时评定一次,以后每周评估一次,直至手术.结果：共入组男性30例,女性8例,平均年龄44.7（12.9）岁,因为心脏疾病使活动严重受限（即心功能III级）的平均病程为18.5 （24.0）个月.这些患者中存在中度和严重抑郁症状的比例为7.9%（3/38）,中度和严重焦虑症状的比例为47.4%（18/38）,同时存在中重度抑郁和焦虑症状的仅有1人（2.6%）.住院第一周焦虑症状和抑郁症状均轻度加重.逐步logistic回归分析（向后法）显示患者自我报告的焦虑水平与以下因素相关,心功能III级的病程越长,焦虑越轻;既往住重症监护病房者,焦虑程度轻;随年龄增大焦虑加重;既往存在因心脏疾病而接受急诊抢救史者焦虑更明显.多元线性回归分析还发现心功能III级的病程越长、受教育程度越高,患者报告的抑郁症状越少,但是心脏疾病的总病程越长,患者报告的抑郁症状越明显.结论：与国外的研究结果不同,我们发现在上海住院等待心脏移植者的焦虑症状比抑郁症状更为普遍、更为严重.疾病导致严重功能障碍的病程与术前自我报告的焦虑症状和抑郁症状的严重度负相关：心功能III级超过1年者报告的焦虑和抑郁症状要比不足1年者少.     

Symptoms of anxiety in depression: assessment of item performance of the Hamilton Anxiety Rating Scale in patients with depression

Background: Although diagnostically dissociable, anxiety is strongly co‐morbid with depression. To examine further the clinical symptoms of anxiety in major depressive disorder (MDD), a non‐parametric item response analysis on “blinded” data from four pharmaceutical company clinical trials was performed on the Hamilton Anxiety Rating Scale (HAMA) across levels of depressive severity. Methods: The severity of depressive symptoms was assessed using the 17‐item Hamilton Depression Rating Scale (HAMD). HAMA and HAMD measures were supplied for each patient on each of two post‐screen visits (n=1,668 observations). Option characteristic curves were generated for all 14 HAMA items to determine the probability of scoring a particular option on the HAMA in relation to the total HAMD score. Additional analyses were conducted using Pearson's product–moment correlations. Results: Results showed that anxiety‐related symptomatology generally increased as a function of overall depressive severity, though there were clear differences between individual anxiety symptoms in their relationship with depressive severity. In particular, anxious mood, tension, insomnia, difficulties in concentration and memory, and depressed mood were found to discriminate over the full range of HAMD scores, increasing continuously with increases in depressive severity. By contrast, many somatic‐related symptoms, including muscular, sensory, cardiovascular, respiratory, gastro‐intestinal, and genito‐urinary were manifested primarily at higher levels of depression and did not discriminate well at lower HAMD scores. Conclusions: These results demonstrate anxiety as a core feature of depression, and the relationship between anxiety‐related symptoms and depression should be considered in the assessment of depression and evaluation of treatment strategies and outcome. Depression and Anxiety, 2008. © 2008 Wiley‐Liss, Inc.     

社区老年人焦虑、抑郁状况的调查

目的了解社区老人的焦虑、抑郁发生率及其相关因素。方法自制一般情况调查表．采用SAS、SDS、SCL-90、MMSE量表对社区504名老人进行调查研究。结果58名老人(11．51％)有焦虑症状；30名(6％)有抑郁症状；影响老年人心理健康主要因素有年龄、躯体健康、家庭关系、社交活动。结论社区老年人群中焦虑抑郁问题突出．并受多种因素影响，应重视心理健康指导。     

The prevalence of anxiety symptoms and depressive symptoms in patients with somatic disorders in urban China: a multi-center cross-sectional study

OBJECTIVE: To assess the prevalence of anxiety and depressive symptoms among patients with somatic diseases in urban China. METHOD: A hospital-based cross-sectional study was carried out in four major cities of China from June to August in 2004. There were 2111 eligible subjects with Stroke, Parkinson's Disease, Epilepsy, Irritable Bowel Syndrome, Functional Dyspepsia, and Menopausal Syndrome, and 317 Post-natal women were recruited from general hospitals. Self-completed hospital anxiety and depression scale (HAD) questionnaire was used for screening anxiety and/or depressive symptoms. Subjects with a HAD score of > = 9 were further assessed with Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) by certified psychologists or psychiatrists. RESULTS: The prevalence of "screened" depressive and anxiety symptoms using HAD were 11-19% and 11-22% respectively in patients with above somatic diseases and post-natal women. Assessed by HAMA/HAMD scale, the prevalence of "definite" depressive symptoms was 30%-59% in subjects with "screened" depressive symptoms, and 44%-84% in subjects with "screened" anxiety symptoms. About half of the subjects had co-morbidity depressive and anxiety symptoms. Less than one-fourth of these subjects had ever been diagnosed as depressive/anxiety disorders and been treated prior to the investigation. CONCLUSION: There is a high prevalence and low diagnosis and treatment rate of depressive and anxiety symptoms in patients with these somatic diseases in China.     

Emotional symptoms in acute ischemic stroke

BACKGROUND: Anxiety and depressive symptoms encountered in acute stroke influence the patients' neurological outcome and the psychosocial burden of family members. These emotional changes may be caused by the patients' brain damage per se or by psychological reactions. The aims of the present study were to assess the prevalence of anxiety and depressive symptoms in the acute stage of ischemic stroke, and to identify the factors associated with such problems. METHODS: Anxiety and depressive symptoms were evaluated in 178 patients with acute ischemic stroke using the Hospital Anxiety and Depression Scale (HADS) between day 3 and 7 after admittance to the stroke unit. Factors associated with anxiety and depressive symptoms were identified using logistic regression analyses. RESULTS: 26.4% of the patients suffered from anxiety symptoms, 14.0% from depressive symptoms and 7.9% from both. Anxiety symptoms were associated with single marital state (OR 2.53, 95% CI 1.18-5.41) and a low Mini Mental State Examination (MMSE) score (< 26 points) (OR 0.53, 95% CI 0.31-0.87) whereas depressive symptoms were related to a low Barthel Activities of Daily Living index (BI) (score < 90 points) (OR 0.37, 95% CI 0.15-0.88). CONCLUSION: The present study indicates that anxiety symptoms are more frequent than depressive symptoms in the acute stage of ischemic stroke. It is important to focus on both anxiety and depressive symptoms throughout the rehabilitation phase in order to ease the patients' personal anguish and improve neurological outcome after stroke. Copyright (c) 2006 John Wiley & Sons, Ltd.     

The association of depression and anxiety with medical symptom burden in patients with chronic medical illness

BACKGROUND: Primary care patients with anxiety and depression often describe multiple physical symptoms, but no systematic review has studied the effect of anxiety and depressive comorbidity in patients with chronic medical illnesses. METHODS: MEDLINE databases were searched from 1966 through 2006 using the combined search terms diabetes, coronary artery disease (CAD), congestive heart failure (CHF), asthma, COPD, osteoarthritis (OA), rheumatoid arthritis (RA), with depression, anxiety and symptoms. Cross-sectional and longitudinal studies with >100 patients were included as were all randomized controlled trials that measure the impact of improving anxiety and depressive symptoms on medical symptom outcomes. RESULTS: Thirty-one studies involving 16,922 patients met our inclusion criteria. Patients with chronic medical illness and comorbid depression or anxiety compared to those with chronic medical illness alone reported significantly higher numbers of medical symptoms when controlling for severity of medical disorder. Across the four categories of common medical disorders examined (diabetes, pulmonary disease, heart disease, arthritis), somatic symptoms were at least as strongly associated with depression and anxiety as were objective physiologic measures. Two treatment studies also showed that improvement in depression outcome was associated with decreased somatic symptoms without improvement in physiologic measures. CONCLUSIONS: Accurate diagnosis of comorbid depressive and anxiety disorders in patients with chronic medical illness is essential in understanding the cause and in optimizing the management of somatic symptom burden.     

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.