幽默感和主观幸福感、抑郁的关系探讨

目的了解汉语文化背景下大学生幽默感的特点以及其与主观幸福感、抑郁的关系。方法运用幽默风格量表(HSQ)、幽默应对量表(CHS)、总体幸福感量表(GWB)和自评抑郁量表(SDS)调查了245名大学生,并对结果进行统计分析。结果男生在攻击型幽默得分高于女生,幽默应对、附和型幽默得分低于女生,差异均有统计学意义(P<0.05或P<0.01);幽默应对、自强型和附合型幽默感与主观幸福感和抑郁呈正相关(P<0.05),自贬型和攻击型幽默感与主观幸福感、抑郁呈负相关(P<0.05)。除自强型幽默感外,其余幽默均分别进入与主观幸福感、抑郁的回归方程。结论部分幽默感的风格存在性别差异,而不同风格的幽默感对心理健康有不同的影响。     

心理干预对初产妇产后焦虑、抑郁的影响

目的探讨社区产后访视过程中心理干预对初产妇焦虑和抑郁情绪的影响。方法将产后访视的62名初产妇随机分为干预组和对照组。干预组采用常规访视加心理干预，对照组常规访视，比较两组初产妇产后焦虑和抑郁情绪的变化。进行效果评价。结果干预组初产妇焦虑和抑郁显著改善，对照组初产妇焦虑和抑郁改善不显著，比较差异有统计学意义。结论社区产后访视解决了产妇出院后护理支持不足的问题，为产妇提供了连续性的健康服务，而产后抑郁症是孕产妇常见病症之一，属于情感性精神障碍。因此社区护士在提供产后常规访视同时加心理干预对改善初产妇焦虑和抑郁情绪有重要意义，提高了社会效益，强化了基层卫生服务的重要性，同时也体现了护士的价值。     

中风幸存者生活满意度有关问题的研究

目的：为探索中风幸存者的主观生活满意度及其影响因素，该研究采用横断面调查方法对中风后1年内不同病程阶段的幸存者以LSIA、LSIB、改良爱丁堡积分、FAI、SSRS、FACESII－CV、SDS及DIS、SAS、ULS、得克萨斯社会行为问卷（TSBIA及TSBIB）、补充综合问卷等工具进行神经功能缺损、活动能力、社会心理功能及状况的研究。205例中风幸存者及其216例正常对照组的研究结果发现中风幸存者的主观生活满意度明显低于正常对照人群，其主要影响因素为抑郁、对家庭适应性的不满等情况反应，其次为患者的肢体功能、社会家庭活动状况，患者的健康自信与康复欲望对其主观生活满意度有一定关系。因此正确鉴别及处理抑郁等情绪反应、强化家庭及社会支持系统配合正确的肢体康复治疗对全面提高中风幸存者的主观生活满意度及整体生活质量具有重要意义。     

The relationship between posttraumatic and depressive symptoms during virtual reality exposure therapy with a cognitive enhancer

Two studies suggest that reductions in posttraumatic symptoms (Aderka et al., 2013) and cognitions (Zalta et al., 2014) precede reductions in depressive symptoms during prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) in female assault survivors. The present study explored the temporal relationship between posttraumatic and depressive symptoms in a randomized trial of D-Cycloserine (DCS) versus placebo augmented virtual reality exposure (VRE) therapy for chronic World Trade Center-related PTSD following the September 11, 2001 terrorist attacks. Twenty-five male and female participants were randomly assigned to receive either 100 mg DCS (N = 13) or placebo (N = 12) 90 min before 12 weekly VRE sessions. Participants contributed a total of 280 weekly PTSD Checklist (PCL; Weathers et al., 1993) and Beck Depression Inventory-second edition (BDI-II; Beck et al., 1996) symptom scores. Two sets of mediation analyses for longitudinal mixed models assessed the effects of 1) lagged PCL on BDI-II (Model 1), and 2) lagged BDI-II on PCL (Model 2) in the VRE-DCS and VRE-Placebo treatment groups, respectively. Results revealed reciprocal relations between posttraumatic and depressive symptoms during VRE treatment, although reductions in posttraumatic symptoms led to subsequent reductions in depressive symptoms to a greater extent than the converse. These effects were stronger in the DCS-enhanced group. Findings suggest that VRE primarily decreases posttraumatic symptoms, which in turn leads to decreased depressive symptoms, and that DCS may strengthen these effects.     

Effective treatment of depression improves post-myocardial infarction survival

AIM: To examine the contribution of treatment resistant depression(TRD) to mortality in depressed postmyocardial infarction(MI) patients independent of biological and social predictors.METHODS: This secondary analysis study utilizes the Enhancing Recovery in Coronary Heart Disease(ENRICHD) clinical trial data.From 1834 depressed patients in the ENRICHD study,there were 770 depressed post-MI patients who were treated for depression.In this study,TRD is defined as having a less than 50% reduction in Hamilton Depression(HAM-D) score from baseline and a HAM-D score of greater than 10 in 6 mo after depression treatment began.Cox regression analysis was used to examine the independent contributions of TRD to mortality after controlling for the biological and social predictors.RESULTS: TRD occurred in 13.4%(n = 103) of the 770 patients treated for depression.Patients with TRD were significantly younger in age(P = 0.04)(mean = 57.0 years,SD = 11.7) than those without TRD(mean = 59.2 years,SD = 12.0).There was a significantly higher percentage of females with TRD(57.3%) compared to females without TRD(47.4%) [χ2(1) = 4.65,P = 0.031].There were significantly more current smokers with TRD(44.7%) than without TRD(33.0%) [χ2(1) = 7.34,P = 0.007].There were no significant differences in diabetes(P = 0.120),history of heart failure(P = 0.258),prior MI(P = 0.524),and prior stroke(P = 0.180) between patients with TRD and those without TRD.Mortality was 13%(n = 13) in patients with TRD and 7%(n = 49) in patients without TRD,with a mean follow-up of 29 mo(18 mo minimum and maximum of 4.5 years).TRD was a significant independent predictor of mortality(HR =1.995; 95%CI: 1.011-3.938,P = 0.046) after controlling for age(HR = 1.036; 95%CI: 1.011-1.061,P = 0.004),diabetes(HR = 2.912; 95%CI: 1.638-5.180,P < 0.001),heart failure(HR = 2.736; 95%CI: 1.551-4.827,P = 0.001),and smoking(HR = 0.502; 95%CI: 0.228-1.105,P = 0.087).CONCLUSION: The analysis of TRD in the ENRICHD study shows that the effective treatment of depression reduced mortality in depressed post-MI patients.It is important to monitor the effectiveness of depression treatment and change treatments if necessary to reduce depression and improve cardiac outcomes in depressed post-MI patients.