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.     

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.     

内观认知疗法对大学生心理因素的影响研究:自尊和自我和谐

目的 评价内观认知疗法对大学生自尊和自我和谐的影响,并探讨该疗法引起心理变化的机制.方法 用内观认知疗法对40名大学生实施心理治疗,治疗前后用症状自评量表、自尊量表、自我和谐量表、情感平衡量表、领悟社会支持量表和容纳他人量表进行评定.结果 治疗后大学生的自尊得分[(18.43±4.06)分]显著低于治疗前[(20.70±5.07)分,t=4.294,P<0.01],自我和谐量表总分[(81.28±14.78)分]显著低于治疗前[(89.65±12.32)分,t=4.893,P<0.01].结论 内观认知疗法能显著提高大学生的自尊与自我和谐水平,对维护和促进大学生心身健康水平有积极作用.     

内观认知疗法对医学生心理问题干预效果分析

分析内观认知疗法对医学生心理问题的干预效果及其相关因素,为该疗法在大中学校的推广应用提供依据.方法 将2011-2016年经内观认知疗法干预的天津医科大学325名医学生作为研究对象,评价心理干预效果;采用有序Logistic回归分析评估干预效果的相关因素.结果 医学生内观认知疗法干预的总有效率为82.5%(显效为63.4%,有效为19.1%).有序Logistic回归分析结果显示,女生(OR=0.61,95%CI=0.38 ~0.96)、家庭经济困难(OR=0.34,95%CI=0.12~0.93)、与父母的关系好(OR=0.19,95%CI=0.06~0.59)、父母之间关系好(OR=0.07,95%CI=0.02~0.22)、手册完成情况好(OR=0.01,95%CI=0.00~0.58)、出勤率高(OR=0.03,95%CI=0.00~0.21)的医学生干预效果较好.结论 内观认知疗法能有效解决医学生心理问题,对适应问题、情绪问题、人际关系问题及自我认知失调问题有显著效果.女生、家庭经济困难、与父母的关系好、父母之间关系好、手册完成情况好、出勤率高可能是内观认知疗法的有效因素.     

棕榈酸帕利哌酮注射液治疗老年精神分裂症的有效性及安全性分析

目的:探讨棕榈酸帕利哌酮注射液治疗老年精神分裂症患者的疗效、耐受性、安全性及社会功能的恢复.方法:将天津市安定医院2014年8月-2016年3月老年科收治的80例老年精神分裂症患者随机分为研究组和对照组,每组40例患者.研究组用棕榈酸帕利哌酮注射液治疗,第1日注射75 mg,第8日注射75 mg,此后每隔1个月左右注射50~75 mg;对照组用利培酮片剂治疗,第1日口服0.5 mg,在2周内逐步增量至最佳给药剂量,最大给药剂量不超过2 mg/d,疗程24周.治疗前及治疗后4、8、16和24周采用阳性和阴性症状量表(PANSS)、依从性评定量表(MARS)、副反应量表(TESS)来评估疗效及安全性,用个人和社会功能量表(PSP)来评估社会功能.结果:72例患者完成24周临床治疗,有8例患者脱落.①两组PANSS评分在治疗第4、8、16和24周时均低于基线水平,差异均有统计学意义(P均<0.01);两组间同一时点PANSS评分比较,差异均无统计学意义(P均>0.05).②研究组MARS评分在治疗第4、8、16和24周均高于基线水平,差异均有统计学意义(P均<0.01);对照组MARS评分在治疗第4、8周均有显著统计学意义(P均<0.05);两组间除基线外同一时点MARS评分比较,差异均有统计学意义(P均<0.01).③研究组同一治疗时点PSP评分均高于对照组,且差异均有统计学意义(P均<0.01);对照组PSP评分在治疗第4、8、16和24周均高于基线水平,差异有统计学意义(P均<0.05);两组间除基线外同一时点PSP评分均高于对照组,差异均有统计学意义(P均<0.05).④两组患者均无严重不良反应发生,组间不良反应发生率比较差异无统计学意义(P均>0.05).结论:老年精神分裂症患者采用棕榈酸帕利哌酮注射液治疗疗效与利培酮片剂相当,但服药依从性好,社会功能明显恢复,无明显不良反应.     

内观认知疗法对精神分裂症患者服药依从性的影响

目的 :评价内观认知疗法对精神分裂症患者服药依从性的影响。方法:将稳定期患者随机分成研究组和对照组,研究组在药物治疗同时予以8周内观认知治疗,对照组在药物治疗同时予以8周工娱治疗。两组患者分别在治疗前及治疗后8周、半年时进行PANSS、ITAQ及MARS测试。结果:治疗前研究组与对照组在一般资料、PANSS、ITAQ和MARS评分均无显著性差异（P>0.05）;在治疗8周后及6个月随访时,研究组PANSS、ITAQ和MARS评分改善较对照组差异有统计学意义（P<0.05）。结论:内观认知疗法可以显著提高精神分裂症患者服药依从性。