心理干预在肝癌护理中的作用

目的探讨一般支持性心理治疗和认知疗法在肝癌护理中的作用。方法将58例肝癌患者随机分为两组各29例。两组均接受相应的内科综合治疗及护理措施，研究组同时给予支持性心理治疗和认知疗法。采用症状自评量表，焦虑自评量表，抑郁自评量表评估治疗后两组患者的心理健康状况。结果研究组实施心理干预后症状自评量表，焦虑自评量表，抑郁自评量表评分均比对照组下降显著（P〈0．05或0．01）。结论心理干预能有效改善肝癌患者的身心症状，提高患者治疗效果和生存质量，从而延长患者的寿命。     

集体心理治疗对住院慢性精神分裂症患者的康复效果

目的：探索集体心理治疗对住院慢性精神分裂症患者的疗效。方法：84例慢性精神分裂症患者分为心理组40例和对照组44例，均对症给予精神分裂症药物治疗；心理组并接受集体形式的讲座、讨论、问题解答等心理治疗。治疗前后采用90项症状清单（SCL-90）、阳性和阴性症状量表（PANSS）测评。结果：经过10个月的观察，心理组患者SCL-90和PANSS各因子分与治疗前及对照组比较均有改善，尤以阴性症状较明显。结论：集体心理治疗对住院慢性精神分裂症患者的康复有一定效果。     

Perioperative psychotherapy for persistent post-surgical pain and physical impairment: a meta-analysis of randomised trials

Background

Persistent post-surgical pain affects 10–80% of individuals after common operations, and is more common among patients with psychological factors such as depression, anxiety, or catastrophising.

脑梗死后抑郁症状综合康复治疗的疗效及其对血小板5-羟色胺水平的影响

目的：观察综合康复治疗（抗抑郁药物联合心理干预）对脑梗死后抑郁症状的临床疗效及对血小板5-羟色胺（5-HT）的影响。方法：66例脑梗死后抑郁症状患者随机分为两组，治疗组34例给予药物（帕罗西汀）联合心理干预治疗6周，对照组32例，未接受上述治疗，所有患者在治疗前后均进行Zung量表评分，HAMD评分，ADL评分及血小板5-羟色胺测定。结果：两组Zung量表、HAMD评分治疗后减分明显，ADL评分明显增加且有非常显著性差异（P〈0．01），治疗组ADL评分增加更明显，且有非常显著性差异（P〈0．01）。伴抑郁症状的脑梗死患者血小板5-HT含量较低．应用联合治疗后，脑梗死患者抑郁症状改善的有效率为70％以上，血小板5-HT含量进一步下降。结论：综合康复治疗对脑梗死后抑郁症状有较好的疗效。血小板5-HT含量可作为早期诊断抑郁症状的实验室筛查指标。     

北京市某三甲精神专科医院心理治疗服务的成本与价格

目的:测量北京市三甲精神专科医院心理治疗项目的实际成本,分析成本价格偏离程度,并提出相应的政策建议。方法:在北京市某三甲精神专科医院进行调查,以医疗技术类科室二级分摊后的成本且剔除药品成本和单独收费的卫生材料成本作为医疗服务项目总成本,再采用收入分配系数法计算单个医疗服务项目成本。结果:三甲精神专科医院心理治疗的实际成本远超过现行的价格标准,不同心理治疗项目的实际成本是现行医疗服务价格的5.30～10.54倍。结论:北京市三甲精神专科医院心理治疗价格严重倒挂,加剧了医院的运营困难,也影响了专业人员的积极性,需调整心理治疗价格,落实财政补偿政策,共同推动心理治疗服务的有效开展。     

心理咨询与心理治疗

心理咨询是在协商与帮助患者过程中达到解决问题的目的,心理治疗则是按治疗方法对患者进行调治和矫正,本文阐述适合心理咨询/心理治疗的人群以及主要的心理治疗方法,包括精神分析治疗、行为治疗、认知治疗、咨客中心疗法、家庭治疗和森田治疗。     

引导式心理治疗对锰中毒患者的效果观察

目的探讨引导式心理治疗对职业性慢性锰中毒患者的效果。方法选取2008年6月～2013年5月本院收治的职业性慢性锰中毒患者40例,随机分成观察组和对照组,每组20例,对照组采用常规治疗,观察组在常规治疗基础上采用引导式心理治疗,观察两组患者的治疗效果。结果观察组治疗总有效率明显高于对照组,差异有统计学意义（P〈0．05）;两组患者治疗后MMSE评分明显高于治疗前,PSQI评分明显低于治疗前,且观察组的MMSE和PSQI评分变化明显优于对照组,差异有统计学意义（P〈0．05）。结论在常规治疗基础上采用引导式心理治疗能有效提高锰中毒患者的精神状态和睡眠质量,缓解其临床症状及提高治疗信心,效果显著,值得临床推广。     

Disclosures of self-injurious thoughts and behaviors to parents in the context of adolescent therapy: A qualitative investigation

Self-injurious thoughts and behaviors (SITBs), including suicidal thoughts, suicide attempts, and nonsuicidal self-injury, are highly prevalent among adolescents. Identifying adolescents at risk for SITBs relies on their disclosure, and these disclosures commonly occur in therapy context. Moreover, therapists often breach confidentiality to inform adolescents' parent or guardian when they disclose SITBs. Research has explored rates of and barriers to disclosure among adolescents, yet no studies have examined adolescents' experiences of disclosure in the therapy context. Further, no studies have examined adolescents' experiences when their parents are then informed. In this study, we examined qualitative responses from 1495 adolescents who had experienced a SITB disclosure in the therapy context. Qualitative questions included asking adolescents to describe how the SITB disclosure occurred, how their parents were informed, and their parents' reactions. Using open and axial coding, several themes emerged. Adolescents described therapist breaches of confidentiality as collaborative, noncollaborative, or unclear. Adolescents described their parents' affective responses, communication about SITBs, validating and invalidating responses, treatment-oriented responses, and ways that parents restricted their access to people, places, and activities. Findings have implications for the development of clinical guidelines when adolescents disclose SITBs in therapy and highlight areas for future research in adolescent SITB disclosure.