团体心理治疗对康复期抑郁症患者的影响

目的探讨团体心理治疗对康复期抑郁症患者的影响。方法将58例患者分为研究组和对照组各29例,对照组做常规治疗,研究组除常规治疗外,另进行团体心理治疗8周。以汉密顿抑郁量表（HAMD）和汉密顿焦虑量表（HAMA）及护士用住院观察量表（NOSIE）为量化指标,对2组患者的康复效果做对比分析。结果实施团体心理治疗后,2组间HAMD、HAMA指标（t=-1.96,-2.75;P〈0.05）和NOS IE指标（t=3.79,2.93,9.1,-3.56;P〈0.01）差异有统计学意义。结论团体心理治疗可明显改善康复期抑郁症患者的情绪和认知,从而提高疗效。     

Source imaging of P300 auditory evoked potentials and clinical correlations in patients with posttraumatic stress disorder

Objective

Posttraumatic stress disorder (PTSD) is associated with abnormal information processing. The P300 component of event-related potentials (ERPs) is known to be a useful marker of information processing. The purposes of this study were to determine the P300 current source density in PTSD patients, and its relationship with symptom severity.

Methods

ERPs were recorded in 30 PTSD patients and 33 healthy controls while participants were performing the auditory oddball task. We compared P300 current source density data - obtained by standardized low-resolution brain electromagnetic tomography (sLORETA) - between the two groups. The correlation between P300 current source density and clinical symptoms (as evaluated using the Korean version of the Structured Interview for PTSD — K-SIPS and Davidson Trauma Scale — K-DTS) was conducted.

Results

In PTSD patients, the current source density of P300 is significantly reduced in the inferior frontal gyrus, precentral gyrus, insula, and anterior cingulate compared to healthy controls. Total K-DTS scores were correlated with the P300 current source density in the posterior cingulate gyrus. The K-SIP B items (re-experiencing) and K-SIB D items (increased arousal) were positively correlated with P300 current source densities in several brain regions located in the frontal, parietal, and temporal lobe (p < 0.05). Conversely, the K-SIP C items (avoidance and numbing) were negatively correlated with P300 current source densities in the superior and middle frontal gyri in the frontal lobes (p < 0.05).

Conclusion

The P300 current source densities reflected the pathophysiology of PTSD patients. PTSD symptoms were related to different neural activities, depending on their symptom characteristics.     

Error-related negativity abnormalities in generalized anxiety disorder and obsessive-compulsive disorder

Enhanced error-related negativity (ERN) has been associated with anxiety among both non-clinical and clinical populations. However, whether it is abnormal among adult patients with generalized anxiety disorder (GAD) is still unknown. The present study investigated it across GAD and obsessive-compulsive disorder (OCD). Event related brain potentials (ERPs) were recorded from a group of 27 GAD patients, 25 OCD patients and 27 healthy control participants during a modified Erikson Flankers task. ERP difference waveforms were obtained by subtracting ERP to correct response (CRN) from ERP to error response (ERN). The Ne component of ERPs at medial frontal electrodes were analyzed and reported. The Ne component of ERP difference waveform was enhanced only in OCD patients, but not in GAD patients, as compared to the healthy controls. An exploratory analysis also revealed higher Ne amplitude of error trial waveforms in both GAD and OCD patients than in healthy controls, and an insignificant group difference in Ne component of correct trial waveforms. The Ne amplitude of error trial waveforms also correlated with Hamilton Anxiety Rating Scale (HAMA) scores and with Hamilton Depression Rating Scale (HAMD) scores across the three subject groups. The main findings of the present study suggest that error processing is altered in OCD but not in GAD, and that ERN abnormalities in GAD are possibly associated with an overactive response checking process or excessive response monitoring.     

Coping and quality of life of patients with Parkinson disease who have undergone deep brain stimulation of the subthalamic nucleus

Background

Although the positive effect of DBS of the STN on motor signs and mobility in PD is indisputable, the effect on mental health (depression and anxiety) as well as on QoL is subject to more debate. Some works have already shown that coping strategies have an impact on QoL, depression, and anxiety. To date, no studies have examined the coping strategies used by patients with PD who undergo STN stimulation. We decided to investigate the coping strategies of patients with PD who have undergone an STN DBS and their relationship with QoL while taking depression and anxiety into account.

Methods

A total of 40 patients stimulated for 12 months and 40 patients under dopatherapy were compared. The 2 groups were matched according to age, sex, age at disease onset, severity of disease, motor scores, daily treatment dosage, and professional status. Semistructured interviews were carried out, after which, their mental and cognitive states were assessed using different scales (MINI, MADRS, EHD, HAMA, FAB). Finally, all subjects completed 3 self-report questionnaires: 2 assessing coping strategies (WCC, CHIP), and 1, QoL the Parkinson Disease Questionnaire (PDQ-39).

Results

Depression and anxiety were not significantly influenced by the type of treatment. Concerning coping strategies, we found a significant effect of the stimulation on instrumental strategies with higher scores for patients under dopatherapy. As for QoL, the only difference concerned communication with a poorer QoL for stimulated patients. We noted no significant correlations between any coping strategies and all of the dimensions of QoL in the stimulated group, whereas we found the opposite result for the dopatherapy group.

Conclusions

These results encourage us to prepare patient candidates for such stimulation by developing interventions focused first on their expectations and second, on their coping strategies.     

度洛西汀与阿普唑仑治疗广泛性焦虑症对照研究

目的 评价度洛西汀与阿普唑仑治疗广泛性焦虑症的临床疗效和安全性.方法 将90例广泛性焦虑症患者随机分为两组,每组45例,研究组口服度洛西汀治疗,对照口服阿普唑仑治疗,观察6周.于治疗前及治疗第1周、2周、4周、6周末采用焦虑自评量表及汉密顿焦虑量表评定临床疗效,副反应量表评定不良反应.结果 治疗后两组焦虑自评量表及汉密顿焦虑量表评分均较治疗前显著下降(P＜0.01),治疗6周末,研究组显效率60.0%、有效率84.4%,对照组分别为55.6%、82.2%,两组比较差异无显著性(P＞0.05).研究组不良反应发生率为28.9%,对照组为40.0%,两组差异无显著性(P＞0.05);两组不良反应均较轻微,多出现在治疗初期,患者均能耐受,随着治疗的延续均可逐渐减轻或缓解.结论 度洛西汀有较强的抗焦虑作用,治疗广泛性焦虑症疗效显著,总体疗效与阿普唑仑相当,安全性高,依从性好,可作为治疗广泛性焦虑症的一线用药.     

强迫症患者人格特征临床调查分析

目的 探讨强迫症患者的人格特征以及不同临床特点对强迫症患者人格的影响.方法 将56例强迫症患者设为研究组,抽取同期52名健康者设为对照组,采用明尼苏达多相人格测验评定两组人格特征,同时采用Yale-Brown强迫量表、汉密顿焦虑量表、汉密顿抑郁量表评定研究组临床特征.结果 研究组明尼苏达多相人格测验评分,除说谎或掩饰、校正因子分与对照组差异无显著性(P＞0.05)外,其他因子分均显著高于对照组(P＜0.01).研究组各亚组间明尼苏达多相人格测验因子分差异均无显著性(P＞0.05),汉密顿焦虑量表总分与明尼苏达多相人格测验的诈分、疑病、抑郁、男性化/女性化和精神衰弱因子分呈显著正相关(P＜0.05或0.01),汉密顿抑郁量表总分与诈分、疑病、抑郁、男性化/女性化、偏执、精神衰弱和精神分裂因子分呈显著正相关(P＜0.05或0.01),Yale-Brown强迫量表总分与明尼苏达多相人格测验各因子分均无显著相关(P＞0.05).结论 强迫症患者具有明显的精神病理性人格特征,明尼苏达多相人格测验可以帮助临床医生更好地了解强迫症患者的临床特征与人格特点,为进一步开展深层心理治疗提供依据.     

艾司西酞普兰与氯米帕明对强迫症患者临床疗效及生活质量的影响

目的 探讨艾司西酞普兰与氯米帕明对强迫症患者临床疗效和生活质量的影响.方法 将60例强迫症患者随机分为两组,每组30例,研究组口服艾司西酞普兰治疗,对照组口服氯米帕明治疗.观察8周.于治疗前及治疗8周末采用Yale-Brown强迫症量表、汉密顿抑郁量表、汉密顿焦虑量表评定临床疗效,生活质量综合评定问卷评定生活质量,副反应量表评定不良反应.结果 治疗后两组Yale-Brown强迫症量表、汉密顿抑郁量表、汉密顿焦虑量表评分均较治疗前有显著下降(P＜0.01),同期两组间比较差异均无显著性(P＞0.05);治疗8周末,研究组显效率73.3%、有效率86.7%,对照组分别为70.0%、83.3%,两组比较差异无显著性(P＞0.05).治疗后研究组生活质量综合评定问卷躯体功能、心理功能、社会功能维度评分均显著高于对照组(P＜0.05).结论 艾司西酞普兰与氯米帕明治疗强迫症总体疗效相当,但艾司西酞普兰对提高患者的生活质量显著优于氯米帕明.     

舍曲林联合喹硫平治疗强迫症伴精神病性症状患者对照研究

目的 探讨舍曲林联合喹硫平治疗强迫症伴精神病性症状患者的临床疗效和安全性.方法 将60例强迫症伴精神病性症状患者根据随机数字表法分为两组,每组30例,观察组口服舍曲林联合喹硫平治疗,对照组单用舍曲林治疗,观察8周.于治疗前及治疗8周末采用Yale-Brown强迫量表、汉密顿焦虑量表、汉密顿抑郁量表、简明精神病量表评定临床疗效,副反应量表评定不良反应.结果 治疗8周末,两组Yale-Brown强迫量表、汉密顿焦虑量表、汉密顿抑郁量表、简明精神病量表评分均较治疗前显著下降(P＜0.01),但观察组均较对照组下降更显著(P＜0.05或0.01);观察组显效率、总有效率显著高于对照组(P＜0.05).两组不良反应较轻微,观察组嗜睡发生率显著高于对照组,而失眠发生率显著低于对照组(χ2＝4.71、4.71,P＜0.05).结论 舍曲林联合喹硫平治疗强迫症伴精神病性症状患者效果显著,能显著改善患者的强迫、焦虑、抑郁及精神病性症状,安全性高,依从性好,显著优于单用舍曲林.     

安非他酮与氟西汀治疗抑郁症对照研究

目的 探讨安非他酮与氟西汀治疗抑郁症的临床疗效和安全性.方法 将93例抑郁症患者随机分成两组,研究组46例,口服安非他酮治疗,对照组47例,口服氟西汀治疗,观察6周.于治疗前及治疗第1周、2周、4周、6周末采用汉密顿焦虑量表及汉密顿抑郁量表评定临床疗效,副反应量表评定不良反应.结果 治疗1周末起,两组汉密顿焦虑量表及汉密顿抑郁量表评分均较治疗前有显著下降(P＜0.05或0.01),同期两组间评分差异均无显著性(P＞0.05);治疗6周末,研究组显效率为76.1%、有效率为93.5%,对照组分别为78.7%、93.6%,两组比较差异无显著性(χ2=0.09、0.00,P＞0.05).两组不良反应均轻微,发生率差异无显著性(P＞0.05).结论 安非他酮与氟西汀均能显著改善抑郁症患者的焦虑、抑郁症状,起效快,疗效显著,总体疗效相当,安全性高,依从性好.     

西酞普兰与阿普唑仑治疗广泛性焦虑障碍对照研究

目的 探讨西酞普兰(喜太乐)治疗广泛性焦虑障碍的临床疗效.方法 将64例广泛性焦虑障碍患者分成2组,每组32例.研究组口服西酞普兰治疗,对照组口服阿普唑仑治疗,观察4周,于治疗前及治疗2、4周末采用救密顿焦虑量表(HAMA)评定临床疗效,于治疗4周后用TESS评定不良反应.结果 治疗结束时2组HAMA评分均较治疗前显著下降(P＜0.01),2组间比较差异无统计学意义(P＞0.05).治疗4周后研究组总有效率为75.00％,对照组总有效率为78.12％,2组比较无统计学意义(P＞0.05);治疗4周后研究组较对照组不良反应少于对照组(P＜0.05).结论 西酞普兰治疗广泛性焦虑障碍疗效显著,与阿普唑仑相当,且不良反应较阿普唑仑少,可作为治疗广泛性焦虑障碍的一线用药.