新冠肺炎疫情期间急性短暂性精神病性障碍伴自杀1例

本文目的是为急性短暂性精神病性障碍的诊治提供参考。在新冠肺炎爆发期间,患者有疫区旅游史,并出现发热、咳嗽症状,属于新冠肺炎疑似病例,由此而导致患者急起出现幻觉、妄想等精神症状,并伴有自杀行为。经过1周喹硫平联合心理治疗后,患者症状改善,社会功能逐渐恢复。     

新冠肺炎疫情下青少年心理健康研究现状：基于CiteSpace的可视化计量分析

背景新冠肺炎疫情对青少年的学习和生活影响重大,导致部分青少年出现心理健康问题。对此,国内外学者围绕青少年心理健康主题开展了大量研究,但目前尚缺乏对这些研究的系统梳理与回顾。目的 了解国内外新冠肺炎疫情下青少年心理健康的研究现状与发展趋势,把握该领域研究的热点及趋势,为后疫情时代青少年心理健康研究与实践提供参考。方法 于2022年10月30日,检索中国知网（CNKI）和Web of Science数据库,检索时限为2019年12月1日至2022年10月30日。运用Excel和CiteSpace对纳入文献的数量、作者、机构、国家和关键词等进行可视化分析。结果 共纳入文献7 608篇。新冠肺炎疫情下,国内外青少年心理健康相关研究的发文量总体呈先上升后下降的趋势;相较于国外,国内学者、机构之间的联系与合作还不够紧密;英文文献发文量前三位的国家分别为美国、英国和中国,中介中心性前三位的国家分别为突尼斯、喀麦隆和安圭拉;国内外学者均关注疫情下青少年的亲子关系与心理健康等主题;随着时间推移,国内外研究者从仅关注消极因素转向关注积极因素。结论 我国学者或机构之间还需加强更多的国内和国际交流合作。国内外...     

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7...     

新冠肺炎疫情常态化防控下社区居民心理健康状况及相关因素

目的 调查在新冠肺炎疫情常态化防控下社区居民的心理健康状况并分析其相关因素。方法 本研究为横断面调查,采用滚雪球抽样法,于2020年8月28日-9月7日通过问卷星网络平台向居民发放调查问卷。采用患者健康问卷抑郁量表（PHQ-9）、广泛性焦虑量表（GAD-7）、失眠严重程度指数量表（ISI）及中文版知觉压力量表（CPSS）评估居民的心理健康状况。结果 476名居民抑郁、焦虑、失眠及高水平压力症状检出率分别为32.35%、21.22%、24.58%及48.74%。男性高水平压力症状检出率高于女性（χ²=5.269）,未婚、离异或丧偶居民的抑郁及焦虑症状检出率均高于已婚居民（χ²=5.251、8.851）,有心理服务需求的居民抑郁、焦虑、失眠及高水平压力症状检出率均高于无此需求的居民（χ²=46.316、66.934、20.153、21.576）,差异均有统计学意义（P<0.05或0.01）。相关分析显示,社区居民年龄与CPSS评分呈负相关（r=-0.171,P<0.01）,睡眠时间与PHQ-9、GAD-7及ISI评分均呈负相关（r=-0.210、-0.247、-0.297,P均<0.01）,关注疫情信息时长与ISI评分呈负相关（r=-0.097,P<0.05）。结论 在疫情常态化防控下,居民的抑郁、焦虑、失眠及高水平压力症状仍较常见。男性和年轻居民更有可能出现高水平压力症状,睡眠时间短和有心理服务需求的居民更有可能出现抑郁、焦虑及失眠症状,关注疫情信息时长越短越有可能出现失眠症状。     

新冠肺炎疫情期间农民工焦虑与抑郁状况

目的 调查新冠肺炎（COVID-19）疫情期间农民工焦虑、抑郁状况及其影响因素,为公共卫生事件中农民工心理问题防治提供参考。方法 采用方便抽样法,选择陕西省汉中地区某镇110名农民工为调查对象。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）通过电子版问卷调查农民工群体的焦虑抑郁情况。结果 COVID-19疫情期间,农民工SAS和SDS总评分分别为（44.25±8.77）分、（47.50±10.55）分。焦虑与抑郁症状检出率分别为19.09%、25.45%。焦虑危险因素：未婚（β=-4.152,95% CI：-6.199~-3.352,P<0.01）、月收入低（β=-1.740,95% CI：-2.301~-1.442,P<0.01）、女性（β=5.022,95% CI：3.612~6.256,P=0.034）、低年龄（β=-2.792,95% CI：-3.551~-2.105,P=0.002）、受教育程度初中组SAS总评分低于小学及以下（β=-4.225,95% CI：-2.056~-5.261,P=0.024）,高中组SAS总评分低于小学及以下组（β=-4.612,95% CI：-2.275~5.035,P=0.021）。抑郁危险因素：月收入低（β=-5.406,95% CI：-6.292~-4.520,P<0.01）、女性（β=12.518,95% CI：9.916~15.121,P=0.001）、未开始上班（β=6.192,95% CI：3.695~8.688,P=0.042）、低年龄（β=-3.208,95% CI：-4.324~-2.092,P=0.009）。结论 疫情期间农民工焦虑与抑郁水平较高,农民工焦虑危险因素有未婚、月收入低、女性、低年龄、低受教育程度,抑郁危险因素有月收入低、女性、未开始上班、低年龄。     

新冠肺炎疫情期间公众睡眠状况及影响因素分析

目的:探讨新冠肺炎疫情期间公众睡眠状况及其影响因素。方法:使用一般人口学调查问卷、医院焦虑抑郁量表(HADS)、病人健康问卷抑郁量表(PHQ-9)、社会支持评定量表(SSRS)、匹兹堡睡眠质量指数量表(PSQI)向公众发放问卷进行调查评估;采用χ²检验和多因素Logistic回归方法进行统计分析。结果:共收回有效问卷4 949份;根据PSQI>7分划界,1 093例(22.1%)被调查者有睡眠问题。单因素分析显示,女性、年龄的增长、受教育程度程度高、离异者、子女已成年及有抑郁、焦虑情绪者的睡眠问题发生率显著增高(P<0.05或P<0.01)。多因素Logistics回归分析显示,年龄、受教育程度、焦虑、抑郁和主观支持是影响新冠肺炎疫情期间被试睡眠问题的主要因素,可解释总变异的84.5%。结论:新冠肺炎疫情期间公众的睡眠问题发生率较高,年龄、受教育程度、抑郁、焦虑等情绪是公众睡眠问题的影响因素。     

新冠肺炎疫情复学后高中生心理健康状况调查

目的 了解新冠肺炎疫情复学后高中生的心理健康状况,为其心理干预提供参考。方法 采用分层抽样,以山东省某中学的149名高中生为研究对象,通过症状自评量表（SCL-90）对其进行心理健康状况评估。结果 SCL-90评定结果显示,总评分异常（总评分≥160分）者共57人（38.26%）,阳性项目数异常（阳性项目数≥43项）者共45人（30.20%）。不同性别的高中生SCL-90恐怖因子评分差异有统计学意义（t=-2.139,P=0.034）。不同年级的高中生SCL-90总评分（F=3.262,P=0.041）、焦虑因子（F=4.045,P=0.020）、敌对因子（F=3.598,P=0.030）、精神病性症状因子（F=3.573,P=0.031）评分差异均有统计学意义。两两比较显示,高三年级组与高一年级组SCL-90总评分（t=2.618,P=0.01）、强迫症状因子（t=2.067,P=0.041）、抑郁因子（t=2.513,P=0.013）、焦虑因子（t=2.960,P<0.01）、敌对因子（t=2.910,P<0.01）、精神病性因子（t=2.608,P=0.01）、其他因子（t=2.131,P=0.035）评分差异均有统计学意义。结论 新冠肺炎疫情对高中生的心理健康状况有影响,需要关注女生的恐惧情绪,高年级学生更容易受影响,主要与疫情对学习的影响有关。     

心理卫生工作者参与新冠肺炎疫情现场心理危机干预意愿的质性研究

目的探讨心理卫生工作者参与新冠肺炎疫情现场心理危机干预的意愿,了解其真实感受,提高心理卫生工作者进行疫情心理干预的积极性。方法运用质性研究中现象学分析法,根据半结构式访谈提纲对绵阳市某三级甲等医院的10名心理卫生工作者进行面对面的深度访谈,运用Colaizzi分析法对资料进行整理分析。结果心理卫生工作者参与新冠肺炎疫情现场心理危机干预意愿的主题包括愿意参加危机干预的因素和阻碍参加危机干预的因素。愿意参加疫情心理危机干预的因素可归纳为:具备自我心理调节能力和对他人进行心理干预的专业能力、心理危机干预是专业职责、希望有亲身经历现场危机干预的经验;阻碍因素包括缺少疫情相关的知识和能力、家庭原因及心理恐惧。结论心理卫生工作者参加疫情心理危机干预意愿较高,但需要有针对性地开展疫情防治知识及技能培训、心理督导及建立保障体系。     

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...     

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。     

新冠肺炎疫情期间封闭管理精神科医护人员焦虑抑郁症状及相关因素调查

目的探讨新冠肺炎疫情期间封闭管理精神科医护人员焦虑抑郁状况及相关因素,为改善其心理健康状况提供参考。方法采用随机数字表法抽取临沂市精神卫生中心接受封闭管理的精神科医护人员124名,应用一般情况调查表、广泛性焦虑量表(GAD-7)、患者健康问卷抑郁量表(PHQ-9)进行测查。结果封闭管理精神科医护人员轻度、中度、重度焦虑症状检出率分别为49.59%、4.96%、4.13%;轻度、中度、中重度、重度抑郁症状检出率分别为30.58%、7.44%、2.48%、2.48%。不同年龄的精神科医护人员GAD-7评分差异有统计学意义(F=3.207,P=0.044),有无子女及不同行为类型的精神科医护人员PHQ-9评分差异有统计学意义(F=3.993,P=0.048;F=6.523,P=0.002)。逐步回归分析显示,影响封闭管理精神科医护人员焦虑的因素为:年龄和存在A型行为(β=0.225、0.183,P均<0.05);影响其抑郁的因素为:A型行为和年龄(β=0.258、0.187,P<0.05或0.01)。结论新冠肺炎疫情期间,封闭管理精神科医护人员普遍出现不同程度的焦虑、抑郁症状,年龄大和存在A型行为类型者是出现焦虑、抑郁症状的高危人群。     

Development of a protocol for videoconferencing-based exposure and response prevention treatment of obsessive-compulsive disorder during the COVID-19 pandemic

BACKGROUND The existing literature indicates that psychotherapeutic treatment, especially exposure and response prevention(ERP) is efficacious in treating obsessivecompulsive disorder(OCD). The coronavirus disease 2019 pandemic adversely impacted many patients with OCD and disrupted their usual treatment. Moreover, the pandemic forced a global switch to telemental health(TMH) services to maintain the standards and continuity of care. Consequently, clinicians are increasingly using TMH-based psyc...     

COVID-19 and OCD: Potential impact of exposure and response prevention therapy

This brief clinical review critically assesses the use of exposure and response prevention therapy (ERP) for patients with obsessive-compulsive disorder (OCD) in light of the COVID-19 pandemic. We discuss the ethical and practical considerations that clinicians employed in past infectious disease outbreaks, as well as general safety measures routinely practiced in the conduct of exposure therapy. During this time, concerns regarding the feasibility of ERP have emerged, especially with strict guidelines on social distancing and on following other preventative behaviors. While ERP may have to be modified to follow public health guidelines, this review outlines a) how ERP has been adapted in the context of other infectious triggers; b) the potential impacts on OCD patients of attenuated ERP, and c) minimizing concerns related to litigation. A case report is provided detailing ERP personalized given COVID-19 related considerations. In all, we advise against modifying therapies in ways that may jeopardize the efficacy of patient care or progress.     

Nervous system involvement after infection with COVID-19 and other coronaviruses

Viral infections have detrimental impacts on neurological functions, and even to cause severe neurological damage. Very recently, coronaviruses (CoV), especially severe acute respiratory syndrome CoV 2 (SARS-CoV-2), exhibit neurotropic properties and may also cause neurological diseases. It is reported that CoV can be found in the brain or cerebrospinal fluid. The pathobiology of these neuroinvasive viruses is still incompletely known, and it is therefore important to explore the impact of CoV infections on the nervous system. Here, we review the research into neurological complications in CoV infections and the possible mechanisms of damage to the nervous system.     

The uptake and outcomes of Internet-based cognitive behavioural therapy for health anxiety symptoms during the COVID-19 pandemic

BackgroundInternet cognitive behavioural therapy (iCBT) for health anxiety has demonstrated efficacy but has not been evaluated during the COVID-19 pandemic. This study presents the first evaluation of the uptake and outcomes of iCBT for health anxiety during the COVID-19 pandemic.MethodsTHIS WAY UP is an Australian digital mental health service which delivers iCBT interventions to community members. We compared the uptake of THIS WAY UP’s iCBT course for health anxiety in an Australian adult sample who started the course before the pandemic (12th September 2019–11 th March 2020) to during the pandemic (12th March to 11th June 2020). The course was accessible to Australian adults over 18 years old, with no inclusion criteria. Outcomes included course registrations and commencements, lesson and course completion, and self-reported health anxiety (Short Health Anxiety Inventory), depression (Patient Health Questionnaire 9-item) and distress (Kessler-10).ResultsFrom March to June 2020, we observed significant increases in course registrations (N = 238 vs N = 1057); and course commencements (N = 126 vs. N = 778). Large, significant improvements in health anxiety (g = 0.89), and distress (K10: g = 0.91), and medium improvements in depression (g = 0.55) were found. Course completion during COVID was 30.5%.ConclusionsiCBT improved health anxiety during the COVID-19 pandemic, and provides scalable intervention that can address increased demands for mental health services in the community.     

新型冠状病毒肺炎疫情和游戏障碍风险:防控常态化形势下的回顾和思考

我国目前已基本控制住新型冠状病毒肺炎疫情,并处于常态化防控形势下。此时对2020年疫情期间游戏障碍风险的相关问题进行回顾和思考,可为精神卫生工作者防控游戏障碍提供重要参考。本文在澄清疫情期间游戏厂商的不当宣传和媒体的不实报道,回顾人们游戏使用行为大幅上升和游戏市场快速扩张的趋势之后,指出了人们因过度的游戏行为模式而可能增加的健康风险;同时也指出并分析了疫情期间女性游戏使用人群扩大的新趋势,以及游戏与赌博进一步深度复合的动向;最后,本文为精神卫生工作者在疫情常态化防控中和“后疫情时代”应对上升的游戏障碍风险提出了建议。     

Conducting exposure and response prevention treatment for contamination fears during COVID-19: The behavioral immune system impact on clinician approaches to treatment

The coronavirus disease 2019 (COVID-19) pandemic sparked significant anxiety regarding viral rates and means of transmission. Heightened concerns about contamination have prompted new hygienic strategies to vigilantly guard against infection, including hand washing immediately after touching foreign objects or suspected contaminants. This has presented a critical challenge for the delivery of exposure and response prevention (ERP) therapy to individuals with contamination fears due to Obsessive Compulsive Disorder (OCD), as providers must manage not only their clients’ attitudes and reactions but their own as well. In this investigation, self-identified anxiety and OCD treatment specialists (N = 139) provided demographic information, including their anxiety and OCD caseloads, and completed measures related to intolerance of uncertainty (IUS-SF; Carlton et al., 2007), beliefs about exposure therapy (TBES; Deacon et al., 2013), and emotional reactions to physical sensations (The Chills; Maruskin et al., 2012). We tested the hypothesis that intolerance of uncertainty and activation of the behavioral immune system (BIS; Schaller & Park, 2011), a mechanism theoretically activated by the prominent emergence of pathogens to protect against illness would predict attitudes toward exposure. The Chills Scale was used to assess BIS activation, a broad assessment of vasoconstriction responses associated with different emotional reactions, and includes a subscale (coldness) that evaluates vasoconstriction associated with defense against pathogens. Both coldness and OCD caseload, but not anxiety caseload or subscales of intolerance of uncertainty, emerged as significant predictors of clinicians’ beliefs about exposure; increases in OCD caseload were also related to decreases in negative beliefs about exposure. Findings are useful in determining methods for aiding clinicians in developing effective approaches to contamination fears during and post-pandemic that include addressing their own BIS-related concerns and mapping out means for social behavioral norms associated with engaging in exposure treatment.     

新冠肺炎疫情下网络心理危机干预模式在一线医护人员中的建构

本研究目的是探讨网络心理危机干预的平衡模式、认知模式、心理社会转变模式在新冠肺炎(COVID-19)疫情防控一线医护人员中的应用价值和具体实施方法,以期减轻一线医护人员的心理应激反应,提高其心理健康水平,使其积极投入到临床工作中。