森田疗法联合认知教育治疗躯体化障碍对照研究

目的：探讨森田疗法联合认知教育治疗躯体化障碍的疗效和安全性。方法将63例躯体化障碍患者分为两组。研究组32例,予以森田疗法联合认知教育治疗;对照组31例,口服帕罗西汀治疗。观察12周。于治疗前后采用汉密顿焦虑量表及副反应量表评定临床疗效和安全性。结果治疗12周末,研究组显效率为59．4％、有效率为87．5％,对照组分别为46．4％、82．1％,研究组高于对照组,但差异无显著性（ P＞0．05）。研究组无严重不良反应,对照组出现胃肠道反应终止治疗3例。结论森田疗法联合认知教育治疗躯体化障碍疗效显著,依从性高,治疗前期疗效低于药物治疗,但治疗后期疗效优于药物治疗。     

早期心理干预对急性脑梗死抑郁状态及血清炎性因子水平影响

目的探讨早期心理干预对急性脑梗死抑郁状态及血清炎性因子水平的影响。方法将178例急性脑梗死病人随机分为常规治疗组（88例）及心理干预组（90例）,分别观察两组急性脑梗死第14天后抑郁的发病情况,采用症状自评量表（SCL-90）评估卒中后抑郁心理特征,酶联免疫吸附法检测两组血清超敏C反应蛋白（hsCRP）、白细胞介素-2（IL-2）、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平。结果入院第14天共有65例（36.5%）诊断为卒中后抑郁,其中常规治疗组42例,心理干预组23例,两组卒中后抑郁发生率比较差异有显著性（χ2=9.44,P〈0.01）;心理干预组SCL-90中躯体化、人际关系、抑郁、焦虑及精神病性等方面评分均低于常规治疗组,差异有显著性（t=3.92-4.59,P〈0.01）;心理干预组病人血清hs-CRP、IL-2、IL-6及TNF-α水平均显著低于常规治疗组,差异有显著性（t=2.24-39.95,P〈0.05）。结论早期心理干预能够减少卒中后抑郁的发生,改善抑郁障碍,并降低急性脑梗死病人血清炎性因子水平。     

The production of the psychiatric subject: power, knowledge and Michel Foucault

Abstract   The issue of power has become increasingly important within psychiatry, psychotherapy and mental health nursing generally. This paper will suggest that the work of Michel Foucault, the French philosopher and historian, has much to contribute to the discussion about the nature, existence and exercise of power within contemporary mental health care. As well as examining his original and challenging account of power, Foucault's emphasis on the intimate relationship between power and knowledge will be explored within the context of psychiatry and mental health nursing. This is to say that the paper will investigate Foucault's account of how power and knowledge are central to the process by which human beings are 'made subjects' and therefore how 'psychiatric identities' are produced. In doing so, it will be suggested that Foucault's work can not only make a valuable contribution to contemporary discussions about power and knowledge, but can also provide a significant critique and reconceptualization of the theoretical foundations and associated diagnostic and therapeutic practices of psychiatry and mental health nursing.     

团体心理干预对伽马刀治疗肺癌患者抑郁情绪的影响

目的：探讨团体心理干预对伽玛刀治疗肺癌患者抑郁情绪的影响。方法将66例住院肺癌患者随机分为两组,均接受伽玛刀治疗,研究组联合团体心理干预。观察8周。于干预前和干预8周末采用抑郁自评量表、汉密顿抑郁量表评定治疗效果。结果干预8周末研究组抑郁自评量表、汉密顿抑郁量表评分均较干预前显著降低（P＜0．01）,对照组则无显著变化（P＞0．05）,研究组显著低于对照组（P＜0．01）。结论团体心理干预能缓解伽玛刀治疗肺癌患者出现的抑郁情绪,有利于改善患者的预后。     

神经病理性疼痛治疗的研究进展

神经病理性疼痛是一种常见的由躯体感觉神经系统病变或疾病引起的慢性疼痛,严重影响患者生活质量。当前对神经病理性疼痛的治疗主要是药物治疗和微创介入治疗,并适当辅以心理疗法。其中药物治疗包括三环类抗抑郁药、血清素-去甲肾上腺素再摄取抑制剂、加巴喷丁类药物等,微创介入治疗包括神经阻滞和神经电刺激。本文综述了经典治疗药物和治疗方法以及目前发现的新机制,为神经病理性疼痛的治疗提供新思路。     

自杀者电话咨询1例危机干预分析

电话咨询是一种快捷有效的预防自杀干预方法。该方法如运用得当,可帮助个人渡过自杀危机。本文对1例自杀者电话咨询危机干预的过程进行分析,为进一步了解电话咨询的干预策略及方法提供依据。     

综合性心理干预对临退伍期军人情绪状况及相关因素的影响

目的 研究团体授课与个体心理干预相结合对临退伍期军人焦虑、抑郁情绪障碍、个性特征、应对方式及社会支持的作用,探讨改善临退伍军人情绪状况的有效干预模式,为降低临退伍军人情绪障碍的发生提供理论依据和实践基础.方法 退伍前半年随机整群抽取南京军区服役期军人3000人,分为研究组和对照组,干预期为6个月.研究组采用团体授课与个体干预相结合,对照组无心理干预.在退伍前半年(服役期)和退伍前两周(临退伍期)对其中确定退伍的军人(研究组416人,对照组396人)采用症状自评量表(SCL-90)、简易应对方式问卷、艾森克人格问卷(EPQ)、社会支持评定量表(SSRS)及自编一般状况调查表分别进行测评.结果 干预前,两组SCL-90抑郁、焦虑因子得分比较,差异无统计学意义(P>0.05);与干预前相比,研究组干预后抑郁、焦虑因子得分降低(P<0.01),对照组抑郁、焦虑因子得分升高(P<0.01);干预后,研究组抑郁、焦虑因子得分明显低于对照组(P<0.01).干预后研究组积极应对得分增高(P<0.01),消极应对得分降低(P<0.01);主观支持、客观支持及支持利用度得分较干预前增高(P<0.01);情绪障碍发生率(0.5%)较干预前(2.4%)降低(P<0.05);干预后,对照组临退伍军人情绪障碍发生率(4.8%)高于干预组(0.5%),差异有统计学意义(P<0.01).结论 团体授课与个体干预相结合的心理干预模式,可明显降低临退伍期军人情绪障碍的发生率,且对其应对方式及社会支持有明显的改善作用,值得在临退伍期军人中推广试用.     

A scale for rating suitability for insight-oriented psychotherapy

ABSTRACT– An instrument for rating patients as suitable (I) or not suitable (NI) for insight-oriented psychotherapy, is described. It is based on factors suggested by Dewald, and consists of 24 scales, each with 5 steps. Inter-rater reliability was > 0.60 in 11 of the scales in a study of 25 cases, and four subscales were significantly correlated to suitability for insight-oriented psychotherapy according to the total scale: “influence of environmental factors on the symptoms”, “variability of the symptoms during the last year”, “self-confidence”, and “possibility of psychodynamic formulation with a circumscribed focus”. Construct validity was estimated by comparing 29 pairs of I and NI patients. I patients belonged to a higher social class, scored higher on the personality trait dominance and lower on neuroticism, had a more positive experience of the therapist, had lower symptom intensities, and were given a lower global rating of the disorder. I patients were more improved than NI patients when given unspecific treatments. The differences were, however, small. Predictive validity in 38 patients was low which may be due to the fact that the rater had to consider the research points of view, the global nature of several variables and the coarse criteria for correct allocation.