新冠肺炎疫情下大学生心理健康现状及求助方式调查

目的调查新冠肺炎(COVID-19)疫情下大学生心理健康现状,为对其进行心理干预提供参考。方法采用电子问卷的方式,通过问卷星网络平台,随机对四川省某高校在读大学生进行调查,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)及躯体化症状自评量表(SSS)评估其焦虑、抑郁及躯体化症状情况,同时使用自制问卷调查其求助方式,并分析之间的关系。结果共完成调查551例,其中焦虑症状检出率为4.90%,抑郁为28.68%,躯体化症状为17.97%;城市大学生的躯体化症状检出率高于农村(23.35%vs.13.27%,P<0.05)、非医学生的躯体化症状检出率高于医学生(21.40%vs.13.89%,P<0.05)。女性SSS评分高于男性[(26.51±5.44)分vs.(25.27±5.78)分]、城市大学生SSS评分高于农村大学生[(26.69±5.98)分vs.(25.38±5.12)分]、非医学生的SSS评分高于医学生[(26.65±5.59)分vs.(25.21±5.45)分],差异均有统计学意义(P均<0.05)。偏相关分析显示,大学生SSS评分与SAS评分呈正相关(r=0.110,P=0.010)、与SDS评分呈负相关(r=-0.087,P=0.042)。大学生常见的求助方式前三位依次为自我调节(81.85%)、与家人或朋友倾诉(70.78%)、线下心理咨询(28.31%)。结论COVID-19疫情下,大学生抑郁和躯体化症状检出率较高;女性、城市、非医专业的大学生躯体化症状检出率相较其他人口学特征与专业的大学生更高;自我调节和向家人或朋友倾诉是大学生主要的心理求助方式。     

伴与不伴焦虑症状的难治性抑郁症临床特征的比较

目的 探讨伴焦虑症状的难治性抑郁症的临床特征.方法 将327例难治性抑郁症患者,按照17项汉密尔顿抑郁量表(HAMD17)焦虑/躯体化因子≥7分,分为焦虑组(229例)和无焦虑组(98例),比较2组患者的人口学特征和临床特征;对伴焦虑症状的危险因素进行Logistic回归分析.结果 焦虑组平均年龄、首发年龄、HAMD17总分、汉密尔顿焦虑量表(HAMA)总分高于无焦虑组[(42.58±11.77)岁vs(36.78±11.84)岁,(34.60±11.66)岁vs(30.04±12.60)岁,(27.83±6.93)分vs(23.39±5.59)分,(21.11±6.61)分vs(13.88±4.68)分],差异有统计学意义(P＜0.01).焦虑组和无焦虑组性别(男:女,OR=0.51)、有无强迫症状(OR=3.67)、未成年和成年发病的构成比(OR=0.36)的差异有统计学意义(P＜0.01).年龄(OR=1.05)、HAMD17总分(OR=1.17)、有自杀观念(OR=2.70)和强迫症状(OR=4.59)与难治性抑郁症伴焦虑症状相关(P＜0.05).结论 伴焦虑症状的难治性抑郁症患者具有年龄较大、女性倾向较高、首发年龄较晚、成年发病的倾向较高、抑郁程度更严重、更可能伴强迫症状等特点;年龄、抑郁严重程度、自杀观念和强迫症状可能是难治性抑郁症伴焦虑症状的危险因素.     

不同年龄阶段伴躯体化症状抑郁症患者的临床特征及相关因素

目的 分析不同年龄阶段伴躯体化症状抑郁症患者的临床特征及相关因素。方法 纳入 2014 年 9 月至 2015 年 4 月在全国 11 家医院门诊就诊的 1 503 例抑郁症患者为研究对象,采用患者健 康问卷躯体症状群量表（PHQ-15）和 16 项抑郁症状快速评估量表（QIDS-SR16）评估患者躯体化症状及 抑郁症状的严重程度。PHQ-15 得分＜ 5 分为无躯体症状,≥ 5 分为有躯体化症状。采用 Spearman 相 关分析抑郁症患者躯体化症状与一般人口学资料及疾病相关资料的关系。以18～39岁（青年）、40～64岁 （中年）和≥ 65 岁（老年）进行年龄分层,采用累积比数 Logistic 回归分析不同年龄阶段抑郁症患者躯体化 症状的相关因素。结果 共 748 例（49.8%）抑郁症患者有躯体化症状,其中 82.6%（618/748）的患者躯体 症状是感到疲劳或无精打采。3 个不同年龄阶段患者背痛,胳膊、腿或关节疼痛,痛经或月经期间其他 的问题,性生活中有疼痛或其他问题的条目得分情况比较,差异有统计学意义（P＜ 0.05）。Spearman 相 关分析显示,抑郁症患者躯体化症状与伴躯体疾病、抗抑郁药治疗种类、合并镇静催眠药、QIDS-SR16 得分呈正相关（P＜ 0.05）,与受教育年限、首次发作年龄、合并抗精神病药呈负相关（P＜ 0.05）。以老 年患者为参照,累积比数 Logistic 回归分析显示,抗抑郁药治疗种类（OR=2.12,95%CI=1.38～3.26）;合 并镇静催眠药（OR=1.59,95%CI=1.14～2.22）、合并抗精神病药（OR=0.59,95%CI=0.39～0.90）、存在残留 症状（OR=11.07,95%CI=7.70～15.90）是青年患者躯体化症状的相关因素（P＜ 0.05）。合并镇静催眠药 （OR=1.51,95%CI=1.10～2.08）、合并抗精神病药（OR=0.45,95%CI=0.31～0.66）、存在残留症状（OR=9.59, 95%CI=6.89～13.34）是中年患者躯体化症状的相关因素（P＜ 0.05）。结论 不同年龄段抑郁症患者伴有 的躯体化症状存在区别,识别年龄相关躯体症状对于临床医生细化抑郁症伴随特征、实施个体化综合 干预是重要的。     

缺血性卒中恢复期伴失眠的危险因素研究

目的探讨缺血性脑卒中患者恢复期伴失眠的临床及神经心理学危险因素。方法纳入225例急性缺血性脑卒中患者,在卒中后3个月进行失眠及神经心理学评估。失眠的评估采用标准的失眠问卷,抑郁症状评估采用汉密尔顿抑郁量表(HDS),焦虑症状评估采用汉密尔顿焦虑量表(HAS)。比较失眠及非失眠2组间的临床及神经心理学指标,应用Logistic回归分析失眠的影响因素。结果 67例(29.8%)存在失眠。失眠患者入院NIHSS评分及HDS评分较非失眠者更高(P0.05),卒中前失眠更常见(52.2%vs.12.7%,P0.001)。Logistic回归分析显示,卒中前失眠症状(OR=2.729,95%CI=1.550~4.804,P=0.001)及HDS(OR=1.240,95%CI=1.158~1.327,P0.001)均为缺血性卒中患者伴失眠的独立危险因素。结论缺血性卒中恢复期伴失眠十分常见。卒中前存在失眠症状以及卒中后抑郁症状的严重程度是伴失眠的主要影响因素。     

防控新冠肺炎疫情境外输入风险一线医护人员抑郁情绪调查

目的对参加北京市新冠肺炎疫情境外输入风险防控的一线医护人员的抑郁情绪状况进行调查,并分析相关影响因素,为改善一线医护人员心理健康状况提供参考。方法通过问卷星发放电子问卷,使用患者健康问卷抑郁量表(PHQ-9)对支援北京小汤山定点医院参加入境人员新冠肺炎筛查和救治工作的984名一线医护人员进行调查。结果共回收问卷770份,回收率为78.3%,检出344人(44.7%)存在抑郁症状。Logistic回归分析显示,工作内容变化大(OR=2.206,P<0.01)、睡眠减少(OR=2.359,P<0.01)、睡眠不足6小时(OR=2.032,P<0.05)、每天关注疫情信息>1小时(OR=1.095,P<0.05)是抑郁的风险因素,规律的运动习惯(OR=0.473,P<0.01)是减少抑郁的保护因素。结论防控新冠肺炎疫情境外输入风险的一线医护人员抑郁症状检出率较高,采取科学的工作轮换机制、保持足够的睡眠、减少关注疫情的时间以及规律运动可能是维护其身心健康的有效措施。     

新冠肺炎疫情下儿童青少年焦虑症状检出率及影响因素

目的探讨新冠肺炎(COVID-19)疫情期间居家儿童青少年焦虑症状检出率及危险因素,为给予其心理支持提供参考。方法 2020年2月13日-14日,采用电子问卷调查方式,由安徽省7～16岁的中小学生在线填写一般资料和儿童焦虑性情绪障碍筛查表(SCARED)。SCARED评分≥23分为焦虑组,SCARED评分23分为非焦虑组。采用单因素分析、二元Logistic回归分析儿童青少年焦虑症状的危险因素。结果共回收有效问卷5 392份,其中焦虑组1 045人(19. 4%),非焦虑组4 347人(80. 6%);单因素分析显示,焦虑检出率在性别、年龄、所在年级、身体健康状况、第一次了解此次疫情的途径、负面信息占比、不实信息占比上差异均有统计学意义(P均0. 05);二元Logistic回归分析显示,女生(OR=1. 423,P0. 01)、大龄儿童(OR=1. 411,P0. 01)、目前的身体状况不佳(OR=1. 620,P0. 01)、高负面信息占比(OR=1. 240,P0. 01)、高不实信息占比(OR=1. 265,P 0. 01)是儿童青少年存在焦虑症状的独立危险因素。结论新冠肺炎疫情期间居家隔离儿童青少年焦虑检出率未见明显增高,其中女性、大龄儿童、目前身体状况不佳、不良疫情信息是焦虑症状的危险因素。     

新冠肺炎疫情影响下长期居家人员的情绪及睡眠质量的调查及危险因素分析

目的:探讨新冠肺炎疫情影响下长期居家人员的情绪及睡眠质量,并分析其影响因素。方法:采取便利抽样的方式,通过网络问卷的形式对国内受新冠肺炎疫情影响的长期居家人员进行心理健康及睡眠质量的调查,分为长期居家组(居家≥4周)与非长期居家组(居家4周),评估长期居家人员的焦虑、抑郁、躯体化症状及睡眠质量,并对危险因素进行分析。结果:长期居家组(n=77)和非长期居家组(n=161)在年龄、性别、婚姻、慢性病等方面差异无统计学意义;在地区、受教育程度、工作状态、职业、躯体疼痛等方面比较差异有统计学意义(P0.05或P0.01);长期居家组人员的广泛性焦虑量表(GAD-7)、患者健康问卷抑郁症状量表(PHQ-9)、患者健康问卷(PHQ-15)、失眠严重指数量(ISI)评分均显著高于非长期居家组人员(P0.05或P0.01);受教育程度高是焦虑的保护因素,躯体疼痛是焦虑、躯体化症状及睡眠质量的危险因素,有慢性病史是抑郁、躯体化症状及睡眠质量的危险因素,已婚是躯体症状的保护因素,处于工作状态是睡眠质量的保护因素(P0.05或P0.01)。结论:疫情影响下,长期居家人员容易出现焦虑抑郁情绪及躯体不适感,睡眠质量较差;在有慢性病史、伴有躯体疼痛的人员中更明显;而在受教育程度高、处于工作状态中及有配偶的人员中相对较轻。     

新冠肺炎疫情下不同群体的认知、情绪和行为反应

目的了解新冠肺炎(COVID-19)疫情下不同群体的认知、情绪和行为状态,以期在今后的工作中进行更有针对性的心理援助。方法通过问卷星发放问卷,共957名社会人士完成量表评定。问卷内容分别从认知(压力和强迫思维)、情绪(抑郁、愤怒和焦虑)及行为(强迫行为和情绪调节困难)层面考察个体面对疫情时的心理反应。结果①医务人员的认知反应水平和行为表现与其他职业人员比较差异均有统计学意义(P0. 05或0. 01);②除抑郁水平外,女性的认知和情绪反应水平与男性比较差异有统计学意义(F=6. 109～14. 020,P0. 05或0. 01);③情绪调节困难量表(DERS)评分与被试的所有症状均呈正相关(r=0. 280～0. 723,P均0. 01)。结论在新冠肺炎疫情下,不同社会群体的认知、情绪和行为反应存在差异。     

深圳某企业外来劳务工抑郁焦虑情绪及自杀风险调查

目的 了解深圳某企业外来劳务工的抑郁、焦虑情绪和自杀风险的现状及与自杀相关的危险因素.方法 本研究采用横断面调查研究方法,以自编的社会人口学基本信息资料表、患者健康问卷抑郁量表、患者健康问卷焦虑量表和简明国际神经精神访谈自杀筛选问卷等量表为工具,对深圳某企业1845名外来劳务工的抑郁和焦虑情绪及自杀风险进行现况调查和多因素logistic回归分析.结果 (1) 1845名外来劳务工中,689例存在轻度及以上抑郁症状,占37.3％,其中中度以上抑郁146例,占7.9％;392例存在轻度及以上焦虑症状,占21.2％,其中中度以上焦虑67例,占3.6％.(2)男性和女性员工的抑郁评分在不同年龄、文化程度、婚姻状况的差异无统计学意义(P均＞0.05);男性和女性员工焦虑评分在未婚组(P=0.02)和高中及以上组(P=0.02)的差异有统计学意义.(3)多因素logistic回归分析显示,中度以上抑郁(OR=6.886,P＜0.01)和中度以上焦虑(OR=2.984,P ＜0.05)是自杀的重要危险因素.结论 深圳某企业部分外来劳务工存在轻度及以上抑郁或焦虑症状,中度以上抑郁和焦虑是自杀的重要危险因素.     

公寓老年人中抑郁症候群与自杀意念的关联研究

目的:探讨公寓老年人群中抑郁症候群和自杀意念的关系. 方法:采用老年抑郁量表(GDS)和自编自杀意念调查问卷对哈尔滨市2所老年公寓的221名老年人进行问卷调查.运用Logistic回归和Spearman相关进行数据分析. 结果:抑郁症候群与是否发生自杀意念相关(r=0.437,P＜0.0001),与自杀意念等级也相关(r=0.469,P=0.01).多因素Logistic回归分析表明,影响自杀意念发生的抑郁症状有:放弃了许多活动与兴趣(P=0.01,OR =4.19)、常感到孤立无援(P=0.00,OR =3.17)、觉得未来有希望(P=0.00,OR =0.19)、觉得现在活着很惬意(P=0.03,OR =0.31). 结论:公寓老年人群自杀意念发生和加重与抑郁症候群关系较为密切.     

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     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

广西农村壮族妇女精神分裂症患者生活质量状况调查

目的研究农村壮族妇女精神分裂症患者的生活质量及影响因素。方法前瞻性的队列研究。采用随机分层抽样法分为农村壮族妇女精神分裂症组、农村汉族妇女精神分裂症组、农村正常妇女对照组,应用“世界卫生组织生存质量测定报告”(WHOQOL-100)及PANSS量表调查其生活质量和疾病的严重程度。结果农村壮族妇女精神分裂症患者生活质量明显低于农村汉族妇女精神分裂症患者,影响其生活质量的相关因素是生活环境及精神支柱/个人信仰。结论经济贫困、环境条件、缺乏有效的医疗服务和社会保障是农村壮族妇女精神分裂症患者生活质量低的关键。因此,建立农村壮族社区精神卫生服务网络势在必行。     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

The origins of innervation of the esophagus of the dog

This study defined the origins of extrinsic efferent and afferent innervation of the normal canine esophagus. When all the layers of the wall of the 3 esophageal regions (cervical, thoracic and abdominal) were injected with horseradish peroxidase (HRP), labeled nerve cells were found in the nucleus ambiguus (NA) and parasympathetic nucleus of X (PX) of the brainstem. Most labeled cells in the NA were located in the compact column (retrofacial nucleus) while labeled cells in the PX were located in separate rostral and caudal areas. There was no somatotopic organization in either the NA or PX. Labeled sympathetic postganglionic neurons were found in the cranial cervical, middle cervical, cervicothoracic, thoracic sympathetic trunk and celiacomesenteric ganglia. The HRP injection of the esophageal wall labeled sensory cell bodies in the glossopharyngeal, proximal and distal vagal, and C2-T6 spinal ganglia. There was no discernible pattern of distribution of labeled cells in the autonomic or sensory ganglia. When the HRP injections were confined to the mucosa-submucosa layers of the thoracic esophagus, a small number of labeled cells were identified in the NA; however, no labeled cells were found in the NA when injections were confined to the mucosa-submucosa of either the cervical or abdominal esophageal regions. With these confined injections, the labeled nerve cells appeared in the rostral part of the PX. Thus, it appeared that the internal tunics of the esophagus (i.e., the mucosa and submucosa) were innervated by neurons in the rostral PX while the muscular tunic was innervated by neurons in the caudal PX and the rostral NA. After mucosa-submucosa injections, labeled sympathetic neurons appeared in the same ganglia that were identified after whole wall injections and these had a similar random distribution. These injections also labeled neurons in the glossopharyngeal, proximal vagal, and distal vagal ganglia, but unlike the whole wall injections there was no labeling in the spinal ganglia. This suggested that the labeled cells of the spinal ganglia seen after whole wall injections conveyed impulses from the tunica muscularis and serosa.     

Impact of our understanding of the genetic aetiology of epilepsy

A genetic contribution to aetiology is estimated to be present in up to 40% of patients with epilepsy. It is useful to categorise genetic epilepsies according to the mechanisms of inheritance into Mendelian disorders, non-mendelian or ‘complex’ disorders, and chromosomal disorders. Over 200 Mendelian diseases include epilepsy as part of the phenotype, and the genes for a number of these have been identified recently. These include autosomal recessive progressive myoclonic epilepsies such as Unverricht-Lundborg disease, Lafora disease and the neuronal ceroid lipofuscinoses, and three autosomal dominant idiopathic epilepsies. The last named have been shown to arise from mutations in ion channel genes. Autosomal dominant nocturnal frontal lobe epilepsy is caused by mutations in CHRNA4, benign familial neonatal convulsions by mutations in KCNQ2 and KCNQ3, and generalised epilepsy with febrile seizures plus by mutations in SCN1B. ‘Complex’, familial epilepsies are more difficult to analyse, but evidence has been obtained for loci predisposing to juvenile myoclonic epilepsy on chromosome 6p and 15q. Lastly, the genes underlying several spike-wave epilepsies in mice have been cloned, and three of these encode sub-units of voltage-gated calcium channels. Received: 29 September 1999/Accepted: 7 December 1999