Psychiatric disturbances in radiologically isolated syndrome

BackgroundRadiologically isolated syndrome (RIS) is characterized by incidental lesions suggestive of multiple sclerosis (MS) on MRI without typical symptoms of MS. Clinically isolated syndrome (CIS) is characterized by a first episode of neurologic symptoms caused by demyelination in the central nervous system. To date, psychiatric disorders have not been systematically addressed in RIS subjects. We assessed emotional disturbances, personality features and health-related quality of life (HRQoL) in a cohort of RIS patients as compared with clinically isolated syndrome (CIS).MethodsTwenty-eight RIS patients, 25 clinically isolated syndrome (CIS) patients, and 22 healthy subjects were enrolled in the study. Participants were administered a mood scale (Hamilton Depression Rating Scale), behavioural measures (Personality Assessment Inventory), and fatigue measures (Fatigue Impact Scale for Daily Use). HRQoL was quantified using the EuroQol-5.Results14 (50%) of RIS patients had clinically significant depression, with over one-third of these having moderate depression, scores virtually identical to those observed in CIS patients. 11 of 28 (39.3%) subjects with RIS had anxious depression, a figure three times higher than that found in CIS patients. RIS patients' HAMD-17 total score showed a very strong correlation with severity of fatigue. In addition, RIS patients reported lower HRQoL (p = 0.036) and a significantly higher symptoms load for somatisation compared to both CIS and control groups (p < 0.002).ConclusionRIS patients had high rates of depression, particularly anxious depression and somatization. Future studies are warranted to clarify whether these psychiatric disturbances are causally associated with a distinct white matter psychopathologic process.     

情绪干预对高血压治疗效果的影响

目的:探讨高血压患者的情绪与降压效果的关系。方法:以原发性高血压患者为研究对象。有情绪障碍的93 例患者被分为两组,其中46例给予综合性的心理治疗(B组),47例单纯给予药物治疗(C组),无情绪障碍的43例患者也单纯给予药物治疗(A组)。比较三组的降压效果。心理学量表采用SCL-90。结果:68%的高血压患者存在情绪障碍,主要以焦虑为主,有的患者焦虑、抑郁并存。治疗后,A、B组降压效果明显好于C组(P<0.01)。结论: 无情绪障碍的患者降压效果较好,对有情绪障碍的患者可施加综合性的心理治疗。     

138例血液透析患者抑郁状态与中医虚证的调查

目的：观察138例长期维持性血液透析（maintenance hemodialysis,MHD）患者的抑郁状态与中医虚证分布规律的联系。方法：通过临床观察138例MHD患者的虚证辨证分型及汉密尔顿焦虑量表（hamilton anxiety scale,HAMA）、汉密尔顿抑郁量表（hamilton depression scale,HDMA）、社会支持评定量表（social support rating scale,SSRS）积分,研究其抑郁状态与中医虚证的联系。结果：（1）MHD患者中本虚证以脾肾气虚证最多,占47.1%（65/138）。（2）MHD患者均有不同程度的心理焦虑抑郁,其汉密尔顿焦虑量表、汉密尔顿抑郁量表积分均高于正常,而其中积分最高的以阴阳两虚证为主。（3）社会支持积分各虚证证型间差异无统计学意义;结论：（1）MHD患者均有不同程度的心理焦虑抑郁,而其中严重的辨证以阴阳两虚证为主（P〈0.05）。（2）社会支持并非引起本组MHD患者焦虑抑郁评分变化的主要原因。     

围生期健康教育对孕产妇焦虑、抑郁状况的影响分析

目的:探讨围生期健康教育对孕产妇焦虑、抑郁状况的影响。方法:选择在该院妇产科就诊、住院分娩的孕产妇220例,随机分为为对照组和观察组,每组各110例。对照组未给予围生期健康教育,仅给予常规护理;观察组围生期给予健康教育。采用SAS和SDS量表评价比较两组孕产妇分娩前后焦虑、抑郁情况。结果:分娩前、后观察组的SAS和SDS评分均明显低于对照组(P<0.05);而两组组内比较SAS评分无明显变化(P>0.05),而对照组分娩后SDS评分明显高于分娩前(P<0.05)。结论:围生期健康教育可显著降低孕产妇分娩前后焦虑、抑郁的发生率,改善孕产妇的心理状态。     

Effects of social anxiety on static and dynamic balance task assessment in older women

BackgroundSocial anxiety caused by the presence of an evaluator can impair balance performance in older women. However, it is unknown whether co-performing balance tasks with a partner mitigates this effect.Research questionDoes the presence of a partner mitigate the effect of social anxiety on static and dynamic balance assessment in older women?MethodsTwenty-one older women (mean age 66.5 (SD = 5.2) years) performed nine balance tasks under three conditions: (a) Alone (no evaluator present); (b) Evaluator (male evaluator present); (c) Partner (evaluator + performing tasks in parallel with partner). Participants were split into two groups post-hoc: Affected (n = 10) and Unaffected (n = 11), based on their emotional response to the presence of the evaluator (increased self-reported anxiety and fear).ResultsThe affected group took a longer time to complete tandem walking with eyes open in the Evaluator vs. Alone condition, but not in the Partner condition. Both groups increased anterior-posterior trunk angular velocity during tandem walking with eyes closed in the Evaluator vs. Alone condition, but not in the Partner condition.SignificanceSocial anxiety impairs the balance performance of older women, particularly in those most affected by the evaluator, and during more dynamic modified gait tasks that challenge balance while walking. However, co-performing balance tasks with a partner reduced the effects of social anxiety, suggesting that social support may help to mitigate some of the potential ‘white coat’ effects experienced during clinical balance assessments.     

胃脘痛患者的精神心理评价报告

目的：了解不同病程的胃脘痛患者的心理状况。方法：采用汉密尔顿焦虑抑郁量表，对228名胃脘痛患者进行焦虑抑郁和不同病程焦虑抑郁的程度进行测定和比较。结果：胃腕痛患者普遍存在焦虑或抑郁或两者并存，且病程越长，焦虑抑郁症状越多，程度越重。     

Attachment and family functioning in patients with Internet addiction

Objective

Although the Internet is used effectively in many areas of life, some users experience problems because of over-use due to a lack of control. The diagnostic criteria for Internet addiction include disruptions in family relationships, but adequate data on the attachment styles and family functioning associated with this condition are limited. This study aimed to investigate the attachment styles and family functioning of patients with Internet addiction.

Method

The sample included 30 male patients consecutively admitted to the Bak?rköy Mental Health and Research Hospital Internet Addiction Outpatient Clinic, who were diagnosed in clinical interviews as having Internet addiction according to Young’s (1998) criteria. Thirty healthy males who were matched with the experimental group in terms of sociodemographic characteristics were included as control subjects. Both groups provided sociodemographic data and completed the Beck Depression Inventory (BDI), the Experiences in Close Relationships Questionnaire-r (ECR-r) and the Family Assessment Device (FAD).

Results

Patients with Internet addiction had higher BDI scores (P< .001) and higher attachment anxiety subscores on ECR-r (P< .001) compared with those in the control group. Patients with Internet addiction evaluated their family functioning as more negative and reported problems in every aspect addressed by the FAD. Scores on the FAD behaviour control, affective responsiveness, and problem-solving subscales (P< .05) and on the FAD communication, roles, and general functioning subscales (P< .001) were significantly higher in the patient compared with the control group.

Conclusion

Patients with Internet addiction have more anxious attachment styles as well as prominent disruptions in family functioning. Thus, it may be important to evaluate the attachment styles and family functioning of patients with Internet addiction. Indeed, comprehensive treatment approaches including other family members may make important contributions to treatment success.     

Influence of the BDNF Val66Met polymorphism on coping response to stress in patients with advanced gastric cancer

Objective

Coping with cancer is an important determinant of psychological morbidity, quality of life, and treatment adherence in cancer patients. The aim of this study was to elucidate the association between the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism and coping response to stress in patients diagnosed with advanced gastric cancer.

Methods

Ninety-one subjects (60 males, 31 females) recently diagnosed with advanced gastric cancer were recruited. Coping style and distress level were examined using the Mini-Mental Adjustment to Cancer (Mini-MAC) scale and Hospital Anxiety and Depression Scale, and genotyping was evaluated. To examine the temporal stability of the Mini-MAC scores, a 6-week follow-up evaluation was conducted in 72 patients, after completion of two chemotherapy cycles.

Results

Coping style to cancer significantly differed between the Met carriers of BDNF Val66Met and the Val/Val homozygotes. The Met carriers were significantly more anxious than the Val/Val homozygotes.

Conclusion

The present findings suggest that the BDNF Val66Met polymorphism may be involved in individual coping responses to cancer. The Met allele of BDNF Val66Met may be predictive of an anxious coping style in patients with advanced cancer.     

体外受精-胚胎移植产妇剖官产围手术期焦虑状态调查

目的探讨体外受精-胚胎移植（IVF—ET）剖宫产术产妇围术期焦虑心理,以便对其采取积极的护理措施,提高手术室的护理质量。方法选择2011年1月至2012年2月择期行剖宫产术的IVF．ET孕妇40例为观察组,同期因漏斗骨盆、羊水少等原因行择期剖宫产术的正常孕妇40例为对照组,应用状态-特质焦虑问卷对两组产妇在剖宫产术术前1天、术前1h、术后3d的心理状态进行评估。结果观察组产妇术前1d、术前1h、术后3d的S-AI量表评分分别为[（43．05±5．715）,（45．10±5．728）,（38．95±5．387）分],对照组产妇围术期评分分别为[（41．18±3．686）,（42．20±2．875）,（38．10±3．311）分],两组比较,差异有统计学意义（t分别为0．031,2．862,0．85;P〈0．05）。结论体外受精-胚胎移植剖宫产术产妇术前焦虑程度较同期正常受孕择期剖宫产产妇严重,而术后有所缓解。在体外受精-胚胎移植剖宫产术产妇围术期应提供心理支持与帮助,以减轻其焦虑情绪。     

心理护理对腹腔镜胆囊切除术患者术后焦虑的影响

目的：腹腔镜胆囊切除术患者围手术期的焦虑程度进行量化，并观察术前心理护理对它们的影响。方法：采用焦虑自评量表问卷调查。在我院2007年10月～2009年2月的住院患者中，采用选择拟择期腹腔镜胆囊切除术患者100人次，采用随机抽样方法，随机编入实验组（接受研究者制定的心理护理）和时照组（接受术前一般护理），每组50人次，对患者术前1日和手术后48h分别使用焦虑自评量泰问卷测量焦虑值。结果：本研究结果表明，围手术期患者在术前和术后显示出不同的应激反应特点。实验组术后焦虑程度评分低于对照组。结论：对手术患者提供术前心理护理，能明显缓解患者焦虑情绪。