The hospital anxiety and depression scale

A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.  

老年冠心病病人焦虑、抑郁症状的调查

目的 了解老年心病伴焦虑、抑郁症状的情况，为临床干预提供客观依据，方法 采用汉密顿焦虑量表（ＨＡＭＭＡ）、汉密顿抑郁量表（ＨＡＭＤ）、综合性医院焦虑、抑郁量表（ＨＡＤ），对７１例住院老年冠心病人进入调查，并与２０例非老年主病患者进行比较。结果 老年冠心病病人焦滤症状发生率为６９￣７０．４％，抑胡 状发生率为４２．１￣６３．４％，焦虑比抑郁发生率高，有显著差异。与２０例非老年冠心病比较，老年冠心伯焦  

Validation of open:closed arm entries in an elevated plus-maze as a measure of anxiety in the rat

A novel test for the selective identification of anxiolytic and anxiogenic drug effects in the rat is described, using an elevated + -maze consisting of two open arms and two enclosed arms. The use of this test for detecting such drug effects was validated behaviourally, physiologically, and pharmacologically. Rats made significantly fewer entries into the open arms than into the closed arms, and spent significantly less time in open arms. Confinement to the open arms was associated with the observation of significantly more anxiety-related behaviours, and of significantly greater plasma corticosterone concentrations, than confinement to the closed arms. Neither novelty nor illumination was a significant contributor to the behaviour of the rats on the + -maze. A significant increase in the percentage of time spent on the open arms and the number of entries into the open arms was observed only within clinically effective anxiolytics (chlordiazepoxide, diazepam and, less effectively, phenobarbitone). Compounds that cause anxiety in man significantly reduced the percentage of entries into, and time spent on, the open arms (yohimbine, pentylenetetrazole, caffeine, amphetamine). Neither antidepressants nor major tranquilisers had a specific effect. Exposure to a holeboard immediately before placement on the + -maze showed that behaviour on the maze was not clearly correlated either with exploratory head-dipping or spontaneous locomotor activity.  

The validity of the Hospital Anxiety and Depression Scale. An updated literature review

OBJECTIVE: To review the literature of the validity of the Hospital Anxiety and Depression Scale (HADS). METHOD: A review of the 747 identified papers that used HADS was performed to address the following questions: (I) How are the factor structure, discriminant validity and the internal consistency of HADS? (II) How does HADS perform as a case finder for anxiety disorders and depression? (III) How does HADS agree with other self-rating instruments used to rate anxiety and depression? RESULTS: Most factor analyses demonstrated a two-factor solution in good accordance with the HADS subscales for Anxiety (HADS-A) and Depression (HADS-D), respectively. The correlations between the two subscales varied from.40 to.74 (mean.56). Cronbach's alpha for HADS-A varied from.68 to.93 (mean.83) and for HADS-D from.67 to.90 (mean.82). In most studies an optimal balance between sensitivity and specificity was achieved when caseness was defined by a score of 8 or above on both HADS-A and HADS-D. The sensitivity and specificity for both HADS-A and HADS-D of approximately 0.80 were very similar to the sensitivity and specificity achieved by the General Health Questionnaire (GHQ). Correlations between HADS and other commonly used questionnaires were in the range.49 to.83. CONCLUSIONS: HADS was found to perform well in assessing the symptom severity and caseness of anxiety disorders and depression in both somatic, psychiatric and primary care patients and in the general population.  

国产丁螺环酮片与安定治疗广泛性焦虑症的随机双盲对照研究

目的评价国产丁螺环酮片治疗广泛性焦虑症的临床效果和副作用。方法采用与安定的随机双盲对照方法，将符合中国精神疾病分类方案与诊断标准第２版修订本广泛性焦虑症标准的２０６例患者随机分为丁螺环酮组（１０７例）和安定组（９９例），治疗４周。用汉密尔顿焦虑量表、Ｚｕｎｇ焦虑自评量表、临床总体印象量表及临床疗效和治疗药物副作用量表评定疗效和药物的不良反应。结果丁螺环酮与安定的疗效相近。丁螺环酮对精神性焦虑症状的起效时间较安定稍慢，但没有明显的镇静、嗜睡及体重增加作用，对焦虑症状的治疗具有选择性，尤适用于门诊治疗。丁螺环酮主要的不良反应是轻微的口干及头昏和眩晕等，偶可致窦性心律不齐，但不影响治疗。结论丁螺环酮治疗焦虑症有效，副作用轻微。  

社区老年人焦虑、抑郁状况的调查

目的了解社区老人的焦虑、抑郁发生率及其相关因素。方法自制一般情况调查表．采用SAS、SDS、SCL-90、MMSE量表对社区504名老人进行调查研究。结果58名老人(11．51％)有焦虑症状；30名(6％)有抑郁症状；影响老年人心理健康主要因素有年龄、躯体健康、家庭关系、社交活动。结论社区老年人群中焦虑抑郁问题突出．并受多种因素影响，应重视心理健康指导。  

Anxiety and affective style: role of prefrontal cortex and amygdala.

This article reviews the modern literature on two key aspects of the central circuitry of emotion: the prefrontal cortex (PFC) and the amygdala. There are several different functional divisions of the PFC, including the dorsolateral, ventromedial, and orbital sectors. Each of these regions plays some role in affective processing that shares the feature of representing affect in the absence of immediate rewards and punishments as well as in different aspects of emotional regulation. The amygdala appears to be crucial for the learning of new stimulus-threat contingencies and also appears to be important in the expression of cue-specific fear. Individual differences in both tonic activation and phasic reactivity in this circuit play an important role in governing different aspects of anxiety. Emphasis is placed on affective chronometry, or the time course of emotional responding, as a key attribute of individual differences in propensity for anxiety that is regulated by this circuitry.  

丁螺环酮治疗广泛性焦虑症临床对照研究

目的：比较丁螺环酮与氯硝西泮治疗广泛性焦滤症的疗效及副反应。方法：符合ＣＣＭＤ－２－Ｒ广泛性焦虑症诊断标准的门诊及住院病人７０例，平分为２组，完成６周治疗观察，于治疗前及治疗后１、３、６周末以密尔顿焦虑症量表（ＨＡＭＡ）和不良反应症状量表（ＴＥＳＳ）评定疗效和副作用。结果：丁螺环酮治疗广泛性焦虑症的疗效与氯硝西泮相似，但副作用比氯硝西泮小。结论：丁螺环酮广泛性焦虑症的疗效确切，不良反应轻。  

综合医院住院患者焦虑与抑郁症状调查

目的：调查综合医院中住院患者焦虑抑郁症状的时点发生比率及在不同科室病种的分布情况。方法：采用综合医院焦虑抑郁量表(HADS)，在2003年4月的同一天对综合医院的14个科室中的320例住院患者进行调查。结果：近1／3的患者出现焦虑或抑郁负性情绪；出现焦虑症状阳性者占被调查群体的35．0％，出现抑郁症状阳性者占32．2％，内科患者无论是焦虑和抑郁分，还是出现的焦虑症状和抑郁症状，均显著高于外科患者。焦虑和抑郁症状的发生与患者的年龄密切相关，即随着年龄的增大，其发生率呈增加趋势。结论：综合医院中住院患者的焦虑、抑郁反应是值得重视的现象，应处理这些负性情绪。  

医院焦虑抑郁量表在综合性医院中的应用

目的 评价医院焦虑和抑郁量表在综合性医院住院病人中应用的信度和效度。方法 应用医院焦虑抑郁量表(HADS)对846名住院病人进行调查,并与焦虑自评量表(SAS)和抑郁自评量表(SDS)做相关分析。结果 (1)通过因素分析得到3个相互关联的因素,抑郁、精神性焦虑、精神运动性激越。(2)不同病种分析,HADS具有较高的内部一致性。(3)相关分析得到该量表与SAS、SDS存在较高的相关。(4)通过与SAS、SDS的比较得到以9分作为HADS的筛选临界值是较可靠的。结论 医院焦虑抑郁量表作为综合性医院焦虑抑郁情绪的筛查工具还是较为可靠的。