稽留流产夫妻双方的心理困扰及其相关因素分析

目的 探讨稽留流产夫妻双方的心理困扰,并分析其相关因素。方法 选取2014年6月至2016年6月于首都医科大学附属北京妇产医院诊治的稽留流产病人及其配偶各110例,收集所有研究对象的人口学资料,采用凯勒斯心理困扰量表(K10)调查心理困扰程度,分析心理困扰程度与人口学特征行的相关性。结果 (1)稽留流产病人心理困扰得分(27.89±5.70)分高于病人配偶(24.41±6.10)分,P＜0.05。稽留流产病人重度心理困扰者所占比例44(40.00%)高于病人配偶28(25.46%),P＜0.05。轻度心理困扰者所占比例亦低于病人配偶,P＜0.05;(2)稽留流产病人各指标分层后比较,仅年龄、文化程度及流产史差异有统计学意义(P＜0.05),即年龄低、文化程度低或流产史的病人心理困扰程度较高;配偶的心理困扰程度在不同年龄、文化程度及个人月收入方面比较,差异有统计学意义(P＜0.05),且年龄越小、文化程度越低、个人收入越低,心理困扰程度越高(P＜0.05);(3)Pearson相关分析发现,年龄、文化程度及流产史是稽留流产病人心理困扰的相关因素(r=0.723、-0.783、0.681,P=0.002、0.000、0.007);年龄和个人月收入是配偶心理困扰的相关因素(r=-0.746、0.729,P=0.000、0.001)。结论 稽留流产夫妻以中度心理困扰多见,且女性困扰程度高于男性;年龄高、文化程度低、有流产史的稽留流产病人或低年龄、个人收入低的配偶可能是发生心理困扰的高危对象。     

Infertility and associated factors in three hospitals in Douala,Cameroon: a cross-sectional study

AimWe determined the prevalence and factors associated with couple infertility in three hospitals in Douala, Cameroon.MethodsWe conducted a cross-sectional study from December 18th 2015 to March 18th 2016 in three public hospitals in Douala. Three hundred and sixty participants were studied prospectively for associated factors using a multivariate logistic regression model and 4732 files were studied retrospectively for the prevalence of infertility. Statistical significance was set at p < 0.05.ResultsThe prevalence of couple infertility was 19.2%. In logistic models, the factors which independently increased the risk of couple infertility were a history of reproductive tract infection/STI, a history of uterine fibroids, a history of dysmenorrhea and abortion for the females while for males it was a history of mumps, erectile dysfunction and exposure to chemicals/toxic substances/pesticides.ConclusionOne in every five couples in this study was infertile. Several factors affect the risks associated with couple infertility. The identification of these factors could help detect subgroups of couples at high risk of infertility. Reproductive health education, screening programmes for STI''s that may lead to infertility should be offered to couples.     

Factors related to anxiety and depression in women with breast cancer and their husbands: role of alexithymia and family functioning

Goals of work The purpose of this study was to explore alexithymia, family functioning, and other factors that might affect anxiety and depression levels in women with breast cancer and in their husbands. Patients and methods A cross-sectional study was undertaken in 46 postsurgical ambulatory women with breast cancer and their husbands. Documented informed consent for the study was obtained from each subject. All subjects completed the Zung self-rating anxiety scale (SAS), the Zung self-rating depression scale (SDS), the 20-item Toronto alexithymia scale (TAS-20), and the family assessment device (FAD). Main results Multiple regression analysis revealed that a high degree of alexithymia in patients correlated with a high degree of patient anxiety. Patient perceptions of inappropriate affective responsiveness among family members correlated with a high degree of depression. Among husbands, a high degree of anxiety was correlated with their own high level of alexithymia or low level of education, and with the occurrence of adjuvant therapy in their wives. Husband perceptions of inappropriate sharing of roles among family members, their own low education level, and a large number of family members correlated with high degrees of depression among them. Conclusions The present study revealed that alexithymia and family functioning are associated with anxiety and depression, respectively, in both women with breast cancer and in their husbands. Individual traits such as alexithymia and family functioning should be taken into account when we intervene to treat anxiety and depression in breast cancer patients and their husbands.     

Enabling behavior in a clinical sample of alcohol-dependent clients and their partners

Substance use disorders affect not only the identified client but significant others as well. Clinical work and some research suggest that partner responses to drinking may either facilitate or hinder treatment acceptance and recovery efforts. Female partners of male alcoholics have received much of this attention, and have been labeled as codependents or enablers. We administered a clinically derived assessment tool, the Behavioral Enabling Scale, to 42 alcoholic clients and their partners enrolled in a couples counseling program to determine the extent of specific partner behaviors that might reasonably be thought to reinforce drinking or hinder recovery. Results indicated that, among other findings, the majority of both clients and partners reported the partner took over chores or duties from the alcoholic client at some point during the relationship, drank or used other drugs with the client, and lied or made excuses to others to cover for the drinker. Moreover, particular relationship beliefs were associated with higher behavioral enabling scores, providing clear direction for cognitive and behavioral interventions. It is argued that efforts to understand and treat alcohol dependence will be more productive if partner behaviors are incorporated into assessment and intervention procedures.     

Exploring the Role of Blame in Couple Relationships within the Triangular Setting of Couple Psychotherapy

This paper describes the process of couple therapy with two couples that used blame as the currency of exchange in their relationship. Both couples struggled with managing three‐person relationships. The triangular setting of couple psychotherapy provoked and triggered primitive anxieties around exclusion, rejection and abandonment in both cases. I draw upon clinical work with two such couples to illustrate how one repeatedly collapsed the triangular space whereas the other gradually became more able to bear it. I refer to scientific evidence of the brain's ability to continue to change in response to new learning by forming fresh neural connections throughout life. I suggest that the repetitive occurrence of new experiences within couple psychotherapy can generate new neural pathways thereby biologically influencing new ways of how partners might respond to each other. I conclude by highlighting the therapeutic potential of the framework within which couple psychotherapy takes place, a triangular configuration which offers a developmental opportunity for navigating primitive anxieties related to triangular relationships.     

Dance movement psychotherapy for couples (DMP-C): systematic treatment guidelines based on a wide-ranging study

ABSTRACT

A new body of knowledge, growing out of the clinical and research fields, has been developing in recent years in the area of dance-movement psychotherapy for couples (DMP-C). Formulation of an intervention protocol based on a systematic review of theories and research is crucial to scientifically establishing the field and to implementing research findings in clinical practice. The present article reviews the results of a comprehensive qualitative research study in DMP-C, which addresses the following topics: couple intake, expectations of couples seeking therapy, a projective identification mechanism in the couple relationship, desires and expectations in the sexual relationship, synchrony in the non-verbal relationship, somatic mirroring, and kinaesthetic empathy in the couple relationship. Based on the findings of the research, a systematic intervention protocol for couples psychotherapy through movement and dance has been developed; its unique contribution will be examined alongside other interventions in couples therapy.     

夫妻共同感染梅毒螺旋体临床表型及实验室指标差异

目的探讨夫妻共同感染梅毒螺旋体后临床表型及实验室指标差异。方法收集2015年3月至2021年7月于首都医科大学附属北京地坛医院首次诊治且人类免疫缺陷病毒(HIV)阴性的共同感染梅毒螺旋体夫妻32对。根据我国2020年梅毒和神经梅毒最新诊断标准分为症状神经梅毒(NS)-无症状NS夫妻组17对,NS-隐性梅毒夫妻组15对。分别比较两组患者夫妻间年龄、性别、外周血淋巴细胞计数和比值、梅毒血清学指标、脑脊液(CSF)白细胞(WBC)计数、蛋白(Pro)定量和葡萄糖(Glu)浓度、CSF梅毒相关指标等差异,通过条件Logistic回归分析影响夫妻间临床表型差异的因素。结果在症状NS-无症状NS夫妻组中,无症状NS患者T淋巴细胞计数较症状NS患者高(t=-2.184、P=0.047),无症状NS患者CD4^(+)T(t=-2.088、P=0.056)和CD8^(+)T(t=-2.112、P=0.053)淋巴细胞计数高于症状NS患者,但差异无统计学意义;症状NS患者CSF TRUST滴度(Z=-2.124、P=0.034)和CSF Pro定量(Z=-3.006、P=0.003)高于无症状NS患者;条件Logistic回归分析显示,男性患者更易表现为症状NS(OR=14.000、95%CI:1.841~106.465、P=0.011)。NS-隐性梅毒夫妻组中,NS患者淋巴细胞(t=2.322、P=0.040)、T淋巴细胞(t=2.385、P=0.036)和CD8^(+)T淋巴细胞计数(t=2.801、P=0.017),CSF Pro定量(Z=-2.062、P=0.039)及血清TRUST滴度(Z=-3.000、P=0.003)均显著高于隐性梅毒患者;条件Logistic回归分析显示CD8^(+)T淋巴细胞计数高的患者更易表现为NS,但差异无统计学意义(OR=1.008、95%CI:0.998~1.018、P=0.130)。结论当夫妻双方共患NS时,男性表现为症状NS的风险高于女性,夫妻间T淋巴细胞计数,血清和CSF TRUST滴度,CSF Pro等实验室指标差异可能与机体的免疫应答和炎症反应有关。     

Effects of relationship education on maintenance of couple relationship satisfaction

Couple relationship education (RE) is the provision of structured education intended to promote healthy couple relationships, and prevent future relationship distress. There is a well-replicated finding that 9–20 hours of curriculum-based RE produces short-term improvements in couple communication and relationship satisfaction, but that established finding does not test whether RE helps couples maintain high relationship satisfaction. The current paper summarizes 17 published studies evaluating RE that have follow up assessments of at least 1 year, of which 14 studies found RE helped maintenance of relationship satisfaction. Couples with elevations of modifiable risk factors benefit substantially from RE, while benefits for couples with low risk have not yet been reliably demonstrated. Couples with elevations on risk factors not readily modified by current forms of RE are likely to show little or no benefit. Future research needs to clarify the mediators of RE effects, and how those mediators are moderated by couple risk profiles.