医学生网络成瘾障碍内观认知疗法对照研究

目的评价内观认知疗法治疗医学生网络成瘾障碍（IAD）的效果。方法采用自编《网络成瘾调查问卷（QIA）》筛查某医学高等院校在校学生,对得分较高者（〉5分）经临床面诊确定15例IAD患者并组成研究组,将未达到IAD诊断标准的其他25人组成对照组。两组均采用内观认知疗法进行7天治疗,治疗前后采用症状自评量表（SCL-90）、情感平衡量表（ABS）、领悟社会支持量表（PSSS）、自尊量表（SES）,自我和谐量表（SCCS）和容纳他人量表（AOS）进行测评。结果研究组和对照组于治疗前后相比SCL-90、ABS、PSSS、SES、SCCS、AOS多项指标均有明显改善（P〈0.01）,而两组之间的差异不显著。结论内观认知疗法对IAD有效,但不是IAD的特异性治疗方法,预计对青少年心理行为问题普遍具有治疗作用,对青少年具有心理健康促进作用。     

短程内观认知疗法对心理亚健康状态的治疗效果

目的对内观认知疗法进行改进,缩短治疗周期从7天到3天半,提出短程内观认知疗法,评价其对心理亚健康状态的治疗效果。方法采用改进法对1例心理亚健康状态者应用,治疗前确定主要心理问题,治疗前后采用症状自评量表(SCL-90)和主题绘画进行测评。结果治疗后心理亚健康状态者的SCL-90得分显著低于治疗前,主题绘画内容前后对照分析结果呈显著差异,事前设定的心理问题基本得到解决。结论短程内观认知疗法对心理亚健康状态有肯定疗效,由于缩短了疗程,扩大了适应人群,对内观认知疗法的推广普及具有积极意义。     

森田疗法门诊操作规则的专家意见

森田疗法已诞生100余年,住院森田疗法可操作性强、易掌握,通过4期治疗就可改善许多难治神经症,但更多神经症是在门诊治疗,无法使用住院森田疗法,因此门诊操作专家意见的制定尤为重要。本文结合国内外文献,经国内森田疗法专家多次讨论,起草了第1版门诊森田疗法操作的专家意见,制定门诊三阶段的森田疗法操作规则：病因分析阶段,通过森田疗法理论指导,分析发病因素,提高对治疗依从性,降低抵抗;作业阶段,指导患者投入建设性意义行动,实现顺其自然为所当为原则,达到治疗目的;陶冶性格、充实生活阶段,注重正面信息关注,扩大行动范围、内容,提高适应复杂生活的能力,预防因能力不足导致的复发。该规则为国内门诊森田疗法的推广,使更多神经症等心理疾病患者在门诊就可得到森田疗法治疗奠定基础。     

软双相心境障碍建议性诊断标准的建立与评价

目的 评价软双相心境诊断标准的诊断学意义.方法 对410例抑郁发作的病人在应用软双相诊断标准诊断后在随后的12月内与CCMD-3和DSM-IV双相心境障碍诊断标准进行比较,评价相关的诊断学指标.结果 诊断学提示:与CCMD-3比较:敏感性76.5%,特异性83.9%,准确率80.7%,假阳性率23.5%,假阴性率16.1%,阳性预测值78.7%,阴性预测值82.2%.与DSM-IV比较:敏感性78.0%,特异性84.2%,准确率81.5%,假阳性率22.0%,假阴性率15.8%,阳性预测值79.8%,阴性预测值82.8%.结论 软双相心境诊断标准比较理想.     

螺旋藻治疗高脂血症的临床观察

高脂血症是动脉粥样硬化 (ＡＳ)的一个重要因素 ,控制血脂水平是防止和减低ＡＳ ,预防心脑血管疾病的重要环节。降脂药物的正确应用可减少心脏病死亡率 2 4 % ,降低非致死性心脏病发作率19 % [1] 。然而多数能够降低血脂的化学药物 ,都或多或少地存在有毒、副作用或不良反应。因此 ,从食物和天然药物中寻找更安全而有效的理想降脂药物 ,是防治心脑血管疾病的方向。螺旋藻 (ＳＰ)是纯天然的食品 ,其调节血脂的作用已被动物实验及人体实验所证实。一、材料与方法1.螺旋藻胶囊 :藻株为钝顶螺旋藻 ,露天海水养殖 ,机器采收 ,喷雾干燥收集后制成…     

农民工子女中学生自我意识与个性特征的比较研究

目的 比较农民工子女中学生与本地中学生自我意识与个性特征的差异.方法 采用Piers-Harris儿童自我意识量表(PHCSS)与艾森克个性问卷(EPQ)测定在津农民工子女中学生(n=206)和天津本地中学生(n=166)的自我意识与个性特征.结果 1.对自我意识的评定:除行为、智力与学校情况和躯体外貌分量表外,农民工子女中学生焦虑[(9.1±2.6)分]、合群[(7.8±2.0)分]、幸福与满足[(7.5±1.8)分]3个分量表及总分[(55.7±10.1)分]均低于本地中学生,差异有显著性(P＜0.01).女生比较结果与总体比较结果一致;从男生比较来看,农民工子女中学生焦虑[(9.4±2.4)分]、幸福与满足[(7.5±1.9)分]2个分量表及总分[(55.8±9.9)分]低于本地中学生(P＜0.05或P＜0.01),而合群及其他分量表比较差异无显著性.2.个性特征方面,从总体和男、女生分别比较来看,除掩饰维度外,其余3个维度两组比较差异均有显著性或极显著性(P＜0.05或P＜0.01).结论 农民工子女的自我意识水平明显低于本地学生,个性多偏内向、神经质和精神质,建议根据其心理特点和性格特征进行干预.

Abstract：

Objective To investigate the differences of self-concept and personality in middle school students between the migrant workers and local children. Methods Self-concept was assessed by Piers-Harris Children's Self-concept Scale (PHCSS) and personality was assessed by Eysenck personality questionnaire (EPQ ) in the middle school students between the migrant workers ( n = 206) and local children ( n= 166). Results 1. There was no significant difference between two groups in behavior,intellect and school state and physical appearance subscale of PHCSS. The total scores (55. 7 ± 10.1) and other subscale of PHCSS of the migrant workers group were significant lower than those of the local group (P＜0.01). The total scores (55. 8 ±9. 9) and anxiety (9.4 ± 2.4) and happiness satisfaction (7.5 ±1.9) subscale of PHCSS in the male middle school students of the migrant workers group was significant lower than those of the local group(P＜0.05 or P＜ 0.01). The total scores (54.8±10.2),anxiety(9.0±2.2),gregarious (8.2 ±2.0) ,happiness satisfaction (7.4 ±2.0) subscale of PHCSS in the female middle school students of the migrant workers group were significant lower than those of the local group(P ＜ 0. 01) 2. Except Lie ( L) score of EPQ, other three scores were significantly different between two groups. Conclusion self-concept of middle school students of the migrant workers studying in Tianjin is significantly lower than that of the local. Personality in middle school students of the migrant workers is more diffident, neuropathic and more psychotics than that of local.     

社交恐怖障碍患者执行功能与工作记忆能力研究

探讨社交恐怖障碍患者的执行功能、工作记忆能力与正常对照组的差异.方法 采用威斯康星分类卡片测验(Wisconsin Card Sorting Test,WSCT)以及数字广度、空间广度、多图形空间广度测验对42名社交恐怖障碍患者和42名健康对照者的执行功能、工作记忆能力进行评估.结果 在WSCT测验中,社交恐怖障碍患者非持续错误数明显高于对照组[分别为(18.75±6.20)分,(8.89±3.22)分],差异具有统计学意义.社交恐怖障碍患者工作记忆能力测验中数字广度[分别为(7.25±1.35)分,(8.03 ±2.30)分]、空间广度[分别为(6.11±1.85)分,(8.61±2.87)分]以及多图形空间广度[分别为(4.03±1.39)分,(5.18±1.07)分]成绩均低于对照组,差异具有统计学意义.结论 社交恐怖障碍患者存在工作记忆受损,而这可能是社交恐怖障碍患者学业以及社会功能不良的神经心理学机制.

Abstract：

Objective To explore the executive function and working memory ability of patients with social phobia. Methods The study included 42 social phobia patients whose age, sex, and level of education were matched with those of a healthy control group. Wisconsin Card Sorting Test and Digit Span, Spatial Span, Multiple-Objects-Spatial span were used to study the executive function and working memory. Results Patients with social phobia scored higher than the control group in terms of the number of non perseverative errors on the Wisconsin Card Sorting Test ( 18. 75 ± 6. 20, 8. 89 ± 3. 22 respectively ). No differences were observed in perseverative errors and other scores between the patient and control group. Patients with social phobia scored lower than the control group in terms of Digit Span(7.25 ±1.35,8.03 ±2. 30 respectively) ,Spatial Span(6. 11±1.85,8.61 ±2.87 respectively) and Multiple-Objects-Spatial span(4.03 ± 1. 39 ,5. 18 ± 1.07 respectively). Conclusion Working memory ability in the social phobia patients is impaired, and this may cause the poor performance in patients with the social phobia in academic and social working.     

内观认知疗法治疗精神分裂症康复期患者的临床疗效

目的 探讨内观认知疗法对精神分裂症康复期患者的临床疗效.方法 精神分裂症康复期患者69例,应用随机数字表法,将患者随机分为内观认知治疗组和对照组:内观认知治疗组(n=30)在服用原有药物的基础上,给予连续7d集中内观认知疗法(NaiKan Cognitive Therapy,NCT);对照组(n=32)只给予原有药物治疗,观察1周.在人组时和1周后分别进行阳性与阴性症状量表(PANSS)、护士观察量表(NOSIE).结果 ①NCT组患者治疗后PANSS量表总分、阳性量表分、阴性量表分、复合量表、一般精神病理量表、反应缺乏因子分以及偏执因子的评分显著低于治疗前(t=2.672～7.370,P<0.05),治疗后两组间比较PANSS总分、阴性量表分、复合量表分、反应缺乏因子分、思维障碍因子分均差异有显著性(t'=2.696,P=0.009;t=5.186,P=0.000;t=3.757,P=0.001;t=2.634,P=0.011;t'=2.376,P=0.021);②NCT组患者治疗后NOSIE量表总消极冈素、激惹因子和迟缓因子得分[分别为(10.43±9.24)分,(3.13±0.43)分,(1.07±1.64)分],低于治疗前[分别为(13.87±8.03)分,(8.53±4.98)分,(2.20 ±2.85)分],差异有显著性(t=3.463,P=0.002;t=6.139,P:0.000;t=2.067,P=0.048;).结论 内观认知治疗在一定程度上有助于改善康复期精神分症患者精神症状,特别是阴性症状,但需进一步验证其疗效.

Abstract：

Objective To explore effects of Naikan cognitive therapy on improving clinical symptoms in patients with convalescent schizophrenia. Methods The 69 convalescent schizophrenic patients with convalescent clinical state were consecutively recruited. All the patients were divided into Naikan cognitive therapy ( NCT) group an control group at random and were pretreated with antipsychotic agent therapy. In NCT group,the patients received NCT for successive 7 days. In control group,the patients only received antipsychotic agent therapy. Pre-and post-treatment positive and negative syndrome scale( PANSS) , Nurses'observation scale for inpatient evaluation (NOSIE) were administered to all subjects. Results ① A significant decrease occurred in PANSS total score, negative symptom score, positive symptom score, compound scale score, general psychopathology score, reaction retardation score and paranoid score in NCT group ( t = 2. 672～7. 370, P < 0. 05). In the post-treatment, PANSS total score, negative symptom score, positive symptom score, compound scale score, reaction retardation score and thought disorder score were significantly lower in NCT group than those in control group ( t ' = 2. 696, P = 0. 009; t = 5. 186, P=0.000; t = 3.757, P = 0.001; t = 2.634,P = 0.011; t ' =2.376, P = 0.021). ②A significant decrease occurred in NOSIE total negative score( 10.43 ± 9. 24 vs 13. 87 ± 8. 03, t = 3. 463 , P = 0. 002) , irritation score(3. 13 ±0.43 vs8.53 ±4.98, t = 6. 139, P=0.000) and retardation score(1.07 ± 1.64 vs 2. 20 ±2.85, t = 2.067, P = 0.048) in NCT group. Conclusion NCT can possibly improve part clinical symptoms of patients with convalescent schizophrenia to a certain extent,especially negative symptom,but need to further prove the effect of NaiKan cognitive therapy.     

天津市区单亲中小学生心理健康相关因素分析

目的 了解天津市区单亲中小学生心理健康状况及其影响因素.方法 采用多级分层随机整群抽样方法,抽取天津市1 625名中小学生,采用自编一般情况调查表、心理健康诊断测验(MHT)、父母教养方式评价量表(EMBU)进行调查.结果 天津市区中小学生单亲比率为10.8％,和平区最高,为12.85％,七年级学生单亲比率最高,为12.79％;父母文化程度为本科的学生在学习焦虑、对人焦虑、自责倾向、过敏倾向、恐怖倾向方面的得分低于父母为中专的学生,差异均有统计学意义(P＜0.05);单亲中小学生心理健康问题(总分≥65分)检出率为20％;单亲学生的心理健康状况在总分及各个因子得分均高于双亲学生(P＜0.05);父亲惩罚严厉、拒绝否认的教养方式与单亲学生MHT的8个因子均呈正相关(P＜0.01);母亲过分干涉保护、拒绝否认、惩罚严厉的教养方式与学习焦虑、对人焦虑、孤独倾向、过敏倾向、身体症状、恐怖倾向等均呈正相关(P＜0.05).结论 天津市单亲中小学生存在较多的心理健康问题.     

重度抑郁患者血浆催产素、皮质醇水平与抑郁严重程度关系的初步研究

目的 探讨重度抑郁患者与正常对照者血浆催产素、皮质醇水平差异以及其与抑郁症状严重程度的关系.方法 18 ～45岁重度抑郁患者20人,正常对照26人分别接受血浆催产素、皮质醇水平测量,病例组评定汉密顿抑郁量表.结果 非参数检验显示抑郁患者血浆催产素水平高于正常对照组[(213.60±164.29)pg/ml,(112.27±101.21) pg/ml,z=-2.306,P=0.021];差异具有统计学意义.血浆催产素对数值与抑郁严重程度成正相关( r=0.599,P=0.005).病例组血浆皮质醇水平与正常对照组相比差异不具有统计学意义[ (0.131 ±0.089) pg/ul,(0.107±0.077) pg/ul,z=-0.920,P=0.358],但在抑郁患者中血浆皮质醇对数值与抑郁严重程度正相关( r=0.691,P=0.001).催产素水平对数值与皮质醇对数值成正相关( r=0.743,P＜0.001).多元线性回归模型分析显示重度抑郁患者中,催产素水平是影响抑郁严重程度的因素(校正R2 =0.358,F=11.578,P=0.003).结论 与正常对照组相比,重度抑郁患者存在血浆催产素水平异常,血浆催产素水平可能是影响抑郁症状严重程度的因素,而皮质醇水平与抑郁严重程度的关系尚不能确定.