独生子女情感障碍患者人格与父母教养方式的相关性

目的:探讨独生子女情感障碍患者人格与父母教养方式的相关性. 方法:采用艾森克个性问卷(EPQ)、人格诊断问卷(PDQ-4+)、父母教养方式评价量表(EMBU)对情感障碍独生子女患者90例(研究组)和正常独生子女90名(正常对照组)进行测评,其中研究组患者在自知力恢复以后测评.结果:研究组EPQ评分精神质、神经质、内外倾性显著高于正常对照组(t=5.63,6.11,11.13;P均＜0.01).研究组人格障碍的阳性率(44.44％)高于正常对照组(28.89％)(x2=4.69,P＜0.05).研究组EMBU评分父母惩罚、父母拒绝、父亲保护、母亲干涉因子分高于正常对照组(t=3.03 ～8.20,P均＜0.01),而父亲温暖因子低于正常对照组(t=4.46,P＜0.01). 结论:不良的父母教养方式可能造成独生子女人格障碍,人格障碍与情感障碍的发病有关.     

精神分裂症患者的情感体验和表达

背景:精神分裂症存在情感体验和表达障碍.然而,大多数以往研究往往只局限于情感体验(尤其是快感缺乏)或只针对表达.较少有同时研究精神分裂症患者情感体验和表达.目的:本研究旨在考察精神分裂症患者的快感体验和情感表达.尤其是,特别关注精神分裂症患者的情感障碍(包括快感体验和表达)和阴性症状之间的关系.方法:150例患者完成了愉快情绪体验量表(Temporal Experience of Pleasure Scale)和情感表达量表(Emoitonal Expressivity Scale)的评估.结果:精神分裂症患者表现出快感缺乏,但情感表达的能力完整.以阴性症状为主的精神分裂症患者在期待性愉快体验,尤其是抽象性期待愉快体验上的缺损更为明显结论:研究结果表明,精神分裂症患者存在出快感缺乏,但他们表达情感的能力似乎完好无损.快感缺乏尤以阴性症状为主的精神分裂症患者更为突出.     

女大学生生育价值观及抑郁发生状况和影响因素分析

目的 调查女大学生生育价值观、抑郁发生现状,研究其抑郁发生的相关影响因素.方法 采用生育价值观量表、流行病研究中心抑郁量表(center for epidemiologic studies depression scale,CES-D)评估生育价值观和抑郁状况,采用一般资料调查问卷、心理弹性量表(CD-RISC)和压力知觉量表(PSS)测量抑郁影响因素.结果 不同年级女大学生生育价值观除生育价值、生育职责因子得分外,其余因子差异均有统计学意义(P＜0.05).抑郁发生率为8.72％(45/516),Logistic回归分析结果显示,女大学生抑郁的影响因素为:生活满意度(OR:1.925,95％ CI:1.504～2.367)、压力知觉(OR:1.167,95％CI:1.013～1.247)和心理弹性(OR:0.843,95％CI:0.715～0.968).结论 女大学生新政策环境下的生育价值观有所变化,抑郁发生现状值得重视,抑郁影响因素涉及多方面.高校、医院、社会应针对干预,以减少抑郁发生.     

多发性硬化患者情感障碍研究

目的 初步探讨多发性硬化(multiple sclerosis,MS)患者情感障碍的发生频率、特点和发生机制,以及情感障碍对MS患者生活质量的影响.方法 选取37例复发-缓解型MS患者,并均经脑MRI、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床功能障碍评分(EDSS)、生活质量评价[包括基本生活能力(ADL)和操作性生活能力(IADL)]检查.分析MS患者情感障碍发生情况及其与其他临床表现的相关关系,以及各因素对情感障碍的影响.结果 所有MS患者发生抑郁占43.2%(16/37),焦虑占37.8%(14/37),抑郁伴焦虑占35.1%(13/37).患者中有、无抑郁组间比较临床表现差异无统计学意义,焦虑组EDSS和IADL评分高于无焦虑组(P＜0.05),低收入者焦虑发生率较高(P＜0.05).抑郁和焦虑与EDSS、ADL及IADL得分呈正相关,经回归分析发现EDSS评分对抑郁、焦虑的影响有统计学意义.糖皮质激素治疗对患者情感无显著影响.结论 情感障碍对MS患者日常生活功能造成不利影响,在某种程度上可能较运动或感觉障碍更影响患者的工作和社会牛活能力.     

上海某社区老年高血压病合并2型糖尿病者抑郁状况及相关因素调查

目的：探讨高血压病合并2型糖尿病者的抑郁状况及相关影响因素.方法调查2014年3月~12月上海龙华社区60岁以上高血压病和(或)糖尿病患者1189例,采用病人健康问卷抑郁量表(PHQ－9)筛查有无抑郁症状并运用美国精神疾病诊断与统计手册标准第四版(DSM－Ⅳ)作出诊断,采用 Logistic 分析可能影响抑郁的因素.结果高血压病共病糖尿病者的抑郁障碍发生率为26.4％,阈下抑郁为42．2％,均明显高于高血压病组(20．3％和29．1％)和糖尿病组(18．0％和30．9％),差异有统计学意义(P ＜0．05);有并发症(OR ＝2．715,95％ CI ＝1．802~4．924)、血糖控制不佳(OR ＝2.045,95％ CI ＝1．754~6．378)、血压控制不佳(OR ＝1．704,95％ CI ＝1．537~4．758)、女性(OR ＝1．383,95％ CI ＝0．998~1．916)是高血压病共病糖尿病患者发生抑郁的危险因素(P ＜0．05).结论高血压病共病糖尿病患者具有较高的抑郁发生率,危险因素包括并发症、血糖/血压控制不良及女性.     

抽动秽语综合征患者父母的情感表达及其对患者治疗效果的影响

目的:探讨抽动秽语综合征(TS)患者父母的情感表达(EE)及其对患者治疗效果的影响。方法:对61例TS患者给予阿立哌唑治疗8周,治疗前后进行耶鲁综合抽动严重程度量表(YGTSS)测评,治疗后患者YGTSS减分率≥50%为有效。对TS患者父母进行坎伯威尔家庭问卷(CFI-CV)评估,并据此将患者家庭分为低EE家庭和高EE家庭;分析患者父母EE对TS患者治疗效果的影响。结果:TS患者的父亲和母亲在对患者情感表达上差异有统计学意义。Logistic回归分析显示,中度以下情感表达是TS治疗效果的有利因素,而TS患者父亲的敌对或者拒绝的家庭监护及母亲的敌对是TS治疗效果的不利因素。结论:TS患者父母的情感表达有差异,并且影响治疗效果。     

青少年精神分裂症患者家庭因素的研究

目的:探讨青少年精神分裂症患者的发病和家庭因素的相关性.方法:采用父母养育方式评价量表(EMBU)及家庭环境量表中文版(FES-CV)对60名青少年精神分裂症患者进行测评并与60名健康青少年进行对照及相关分析.结果:青少年精神分裂症患者父母养育方式与正常组对照显示:其父亲惩罚严厉、拒绝否认因子分显著高于对照组,情感温暖、理解因子分显著低于对照组(P＜0.05或P＜0.01);其母亲过分干涉过度保护、偏爱被试因子分显著高于对照组;母亲的情感温暖理解、过度保护、偏爱被试因子分高于父亲(P＜0.05或P＜0.01).家庭环境的亲密度、情感表达、文化性、娱乐性的因子分低于对照组,矛盾性和控制性均高于对照组(P＜0.05或P＜0.01).相关分析显示:父亲过度保护与母亲拒绝否认,及母亲过度保护与父亲拒绝否认因子之间呈负相关(r≥0.8);父亲与母亲EMBU相同因子得分具有相关关系(r≥0.6).结论:不良的家庭环境和父母养育方式对青少年精神分裂症的发病起一定作用,具有相关性.     

拉莫三嗪添加治疗癫(痫)合并抑郁障碍的Meta分析

目的 对拉莫三嗪添加治疗癫(痫)合并抑郁障碍的疗效进行系统评价.方法 以拉莫三嗪(lamotrigine)、癫(痫)(epilepsy)、抑郁(depressive)等中英文词汇,计算机检索1998年1月-2014年6月美国国立医学图书馆生物医学信息检索系统、Cochrane临床对照试验中心注册库、中国知网中国知识基础设施工程、万方数据库等关于拉莫三嗪添加治疗癫(痫)合并抑郁障碍的临床研究,分别以Cochrane系统评价手册5.0.2随机对照试验质量评价标准和RevMan 5.1.1统计软件行文献质量评价和Meta分析.结果 经剔除重复和不符合纳入标准文献,48篇文献中最终仅纳入3项临床试验共668例癫(痫)合并抑郁障碍患者.Meta分析显示:拉莫三嗪组患者Beck抑郁量表第2版(MD =-8.400,95％CI:-10.890 ～-5.920;P=0.000)、康奈尔精神抑郁量表(MD=-8.240,95％CI:-11.180～-5.290;P=0.000)以及简明心境量表(MD=-24.210,95％CI:-30.740 ～-17.680;P=0.000)评分改善程度均优于对照组;POMS量表6项分量表评分中拉莫三嗪组患者紧张-焦虑(MD=-3.360,95％CI:-4.620 ～-2.100;P=0.000)、抑郁-沮丧(MD=-5.490,95 ％CI:-7.420 ～-3.560;P=0.000)、愤怒-敌意(MD=-3.870,95％CI:-5.510-2.230;P=0.000)、疲乏-迟钝(MD =-4.480,95％CI:-5.630～-3.320;P=0.000)、迷惑-混乱(MD =-2.720,95％CI:-3.730～-1.720;P=0.000)评分均低于对照组,而精力-活力评分高于对照组(MD=3.970,95％CI:2.870 ～ 5.070;P=0.000).结论 拉莫三嗪添加治疗癫(痫)合并抑郁障碍疗效良好,主要不良反应为皮疹、中枢神经系统兴奋等.     

青少年首发双相情感障碍精神病性症状特点及对诊断的影响

目的：探讨青少年双相情感障碍患者首次发作时症状特点、精神病性症状的特征及诊断情况,为青少年双相情感障碍的及时诊断提供依据.方法本研究为回顾性研究,对2010年1月1日~2015年10月31日于第四军医大学西京医院心身科住院,年龄13~17岁,诊断为首次发作双相情感障碍的119例患者的临床特征及精神病性症状的特点进行总结分析.结果首次就诊误诊86例,占72.26％;其中,躁狂发作误诊14例,出现精神病性症状的为12例,误诊8例(66．67％);抑郁发作误诊71例,伴精神病性症状的为26例,误诊24例(92．31％).混合发作误诊1例,且伴精神病性症状.在首次发作的双相障碍的患者中,精神病性症状出现最频繁的为关系妄想(27例),其次为幻觉(10例).结论精神病性症状对于首次为抑郁发作的青少年患者来说对确诊双相情感障碍的意义更大.青少年双相请障碍患者出现精神病性症状的形式、内容广泛.重视精神病性症状在青少年双相障碍中的诊断作用,对提高双相障碍的识别率、诊断率有重大意义.     

脑卒中患者情感障碍及生活质量研究

目的探讨脑卒中患者情感障碍的发生率,脑卒中部位与情感障碍的关系,以及对患者生活质量的影响。方法运用抑郁自评量表(SDS)、焦虑自评量表(SAS)、神经功能缺损量表(NFDS)和诺丁汉健康问卷(NHP)对191例脑卒中患者进行现状调查。结果191例患者中发生情感障碍85例(44.5%),55例(65.90%)同时出现抑郁和焦虑。情感障碍的发生与额叶、左侧大脑半球、基底节病灶有关;脑卒中伴情感障碍患者NFDS和NHP评分高。结论脑卒中后情感障碍发生率较高,与脑卒中部位相关,对患者的神经功能及生活质量有明显的影响,不利于脑卒中患者的康复。     

Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression

The differences in affective status between patients who restrain their negative emotion and those who express negative emotion after being given their breast cancer diagnosis were studied using the Profile of Mood States (POMS) at two sessions: (i) at the first visit to the outpatient surgery clinic, and (ii) immediately after being given the diagnosis of breast cancer. Eighty-seven patients completed the POMS and the Courtauld Emotional Control Scale (CECS) at the first visit to the outpatient surgery clinic at Shiga University of Medical Science Hospital. They also completed the POMS immediately after being given the diagnosis of breast cancer. Breast cancer patients who restrain their negative emotion (n = 8) were highly anxious, depressed and confused after being given the diagnosis compared to breast cancer patients who express negative emotion (n = 8). Emotional distress in benign breast tumor patients was reduced after being given the diagnosis regardless of the trend of emotional inhibition. That is, emotional distress in patients who restrain their emotions was considerably increased compared with that of patients who expressed their emotions when they were faced with a life-threatening disease. These results suggest that it may be therapeutic to advise breast cancer patients to express their negative emotion.     

Right-sided facial asymmetry in infant emotional expression

In normal adults, emotional expressions tend to be more intense on the left side of the face, while in preschool-age children, no significant bias in facial asymmetry has been found. We examined facial asymmetries during smiling and distress in 59 infants studied longitudinally at 6.5, 10 and 13.5 months of age. In these infants, asymmetric expressions showed a bias toward greater intensity on the right side of the face. The study of infant facial expression may provide clues to the maturation of the cortical control of emotional responses.     

Posed facial emotional expression in brain-damaged patients

Posed emotional facial expression was examined in brain-damaged adults with right (RBD) or left (LBD) hemisphere cerebrovascular lesions and in matched normal controls (NC). Subjects were videotaped while posing eight facial expressions (positive and negative) under two elicitation conditions (verbal command and visual imitation). Expressions were rated by four na?ve judges for intensity, category accuracy, and valence accuracy. RBDs were significantly more impaired than LBDs or NCs on category and valence accuracy, while LBDs posed expressions with significantly more intensity than RBDs or NCs. These findings held for positive emotions only. The results for category accuracy replicate an earlier report (Borod et al., 1986) which utilized a different rating procedure. Finally, expressions posed to visual imitation were rated as more intense and more accurate than those posed to verbal command.     

Lateral asymmetry in intensity of emotional expression

Subjects rated the intensity of emotional expressiveness of left side, right side and original orientation composite human faces, expressing seven distinct emotions. Left side composites were judged to be more emotionally intense than right side composites. The finding points to hemispheric asymmetry in the control of emotional expression and has implications for the role of emotional expression in communication.     

Posed emotional expression in unilateral brain damaged patients

The facial expressions of six basic emotions were posed by two groups of right (N = 23) and left (N = 34) brain damaged patients and by a control group of normal subjects (N = 28). The posed expressions were examined by means of the Facial Action Coding System (FACS) which provides analytical and objective scoring, as by a subjective scale of appropriateness of expression. Results indicated no difference between controls and patients with a lesion in the right or left hemisphere. These findings are inconsistent with the hypothesis that the right hemisphere plays a specific role in the control of posed facial expression. No relationship was observed between posed emotional expressions and facial paralysis or the presence of oral apraxia.     

Processing emotional expression and facial identity in schizophrenia

Previous studies showed that schizophrenic patients have a deficit in facial information processing. The purpose of the present study was to test the abilities of patients with schizophrenia and normal controls in emotion and identity matching when these two dimensions were varied orthogonally. Subjects (20 schizophrenic patients and 20 controls) had to report if two faces had the same emotion or belonged to the same person. When the task concerned one type of information (i.e. emotion or identity), the other one was either constant (same person or same emotion) or changed (different person or different emotion). Schizophrenic patients performed worse than controls for both kinds of facial information. Their deficit was more important when the secondary factor was changed. In particular, they performed at chance level when they had to match one emotion expressed by two distinct persons. Finally, correlation analysis indicated that performance/deficit in identity and emotion matching co-varied and that in such tasks performance is negatively correlated with the severity of negative symptoms in patients. Schizophrenic patients present a generalised deficit for accessing facial information. A facial emotion and an identity-processing deficit are related to negative symptoms. Implications for face-recognition models are discussed.     

Correspondence of emotional self-rating with facial expression.

Emotional processing abilities are difficult to measure psychometrically. Ultimately their quantification has to rely on 'subjective' judgment thereby leaving open the problem of response biases. Assessments of autonomic arousal similarly provide a mere unspecified measurement of a specific emotion. A standardized mood induction procedure capable of obtaining reliable happy and sad mood changes in healthy subjects was used to demonstrate the effectiveness of this procedure. We performed a two-part experiment using a rater-based analysis of facial expressions. This entailed analyzing the emotion portrayed in the faces. The faces of 24 healthy subjects were videotaped during the mood induction procedure of happiness and sadness, respectively. A group of 20 raters naive to the experimental task and conditions rated the facial expressions on six basic emotions. Results showed that ratings corresponded with the facial expressions, which were reflecting the mood of the task condition. Subjects' facial expressions together with self-ratings demonstrate the successful applicability of this standardized mood induction procedure for eliciting happy and sad mood.     

Emotion dysregulation in schizophrenia: reduced amplification of emotional expression is associated with emotional blunting

A prominent emotional disturbance in schizophrenia is clinically evident in blunted affect, often observed as reduced emotional expressivity alongside the individual's report of normal or heightened emotional experience. It has been suggested that this disjunction between the experience and expression of emotion may reflect problems with the regulation of emotional expression. The present study thus set out to examine the capacity to engage in particular emotion regulatory strategies, and specifically, the ability to amplify the emotional expression of an experienced emotion ('amplification') or suppress the emotional expression of an experienced emotion ('suppression') whilst watching film clips selected to elicit amusement. Twenty nine participants with schizophrenia and 30 demographically matched non-clinical controls were asked to watch three different amusing film clips, whilst engaging in different regulatory strategies. The results indicate that participants with schizophrenia have difficulties with the amplification (but not suppression) of emotion expressive behavior. These difficulties are significantly correlated with total negative symptoms experienced, particularly emotional blunting.