冠心病的社会心理因素分析

目的:研究冠心病患者社会心理因素的特点及影响因素。方法:运用生活事件量表(LES)、A型行为量表(TABPSQ)、多伦多述情障碍量表(TAS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)、应付方式问卷(CS)、社会支持问卷(SSS),测定48例冠心病患者(患者组)病前遭遇的生活事件、人格特征、应付方式、社会支持、患病后的心身健康状况及其影响因素,以50名正常健康者为对照。结果:患者组本次患病前经历的生活事件频数及紧张值:TABPSQ评分,消极应付方式评分:抑郁及焦虑分值均显著高于对照组(P均<0.05)。CS的积极应付评分,社会支持总分减低(P<0.05)。家族史、生活事件紧张总值、A型行为和抑郁为冠心病的危险因素,积极应付方式和社会支持为疾病的保护因子。结论:冠心病患者有特殊的心理社会特征和心身健康状况,应采取积极的社会心理干预措施。     

产后抑郁症患者的心理社会因素分析

目的研究产后抑郁症患者的人格特征、生活事件及社会支持影响因素。方法对93例产后抑郁症患者及135名正常产妇分别应用艾森克人格问卷、生活事件量表及社会支持评定量表进行评估。结果与正常产妇相比较,产后抑郁症在人格方面具有内倾及神经质倾向,且常经历较多的负性生活事件;产后抑郁症组的社会支持总分及其各分量表得分均显著低于正常组。结论产后抑郁症的发生与人格、生活事件及社会支持等心理社会因素有关。     

冠心病的心理社会因素研究进展

冠心病是一种典型的心身疾病,与多方面的心理社会因素相关,本文就目前相关研究,对冠心病相关的心理社会因素进行综述,探讨心理社会因素对冠心病发病的影响及其可能的生理心理机制。     

社区神经症患者的心理社会因素研究

目的 为神经症的社区预防工作提供有针对性的相关依据。方法 使用ＣＣＭＤ－Ⅱ－Ｒ、ＩＣＤ－１０及神经症社区调查问卷等工具,对３６５例神经患者的性格特征,各类间接或直接的心理社会因素,与性别、年龄等特征相匹配的３６３例正常人予以对照分析。结果神经症患者组中的外向性格明显少于对照组（Ｐ〈０．０５）,慢性内科疾病及家庭婚姻问题、亲人亡故、居丧、人际关系问题等生活事件明显高于对照组（Ｐ〈０．００１）。结论 在社区精神卫生服务中应重点关注心理社会因素对神经症的发生、发展作用。     

产后抑郁症患者的心理社会因素调查

产后抑郁症患者的心理社会因素调查袁浩龙周蓓蓓佘正尧戴永干产后抑郁症（ｐｏｓｔｎａｔａｌｄｅｐｒｅｓｓｉｏｎ）最初由Ｐｅｔ（１９６８）提出，是指在产褥期发生的抑郁，其病程较产后心绪不良（ｍａｔｅｒｎｉｔｙｂｌｕｅｓ）长，但严重度则不及产褥期精神病［１］...     

中学生自杀行为的心理社会因素分析及预防

本从心理因素、社会因素、生物因素三个方面对15例中学生自杀行为进行了系统调查和分析,结果发现,中学生自杀的动机由学习不好、早恋、精神疾病、社会压力和某些性格缺陷而适应环境不良等引起。从而提出了进行干预和预防的三项措施：（1）加强社会宣传,改善中学生身边的学习环境和不良人际关系;（2）加强教育,提高中学生的自我认识能力,培养其积极健康的心理素质;（3）积极开展对中学生的心理健康普查工作并建立心理咨询机构,早期发现,及时进行危机干预。     

心理社会因素对产后抑郁症发生的相关性分析

目的 探讨产后抑郁症发生的心理社会因素。方法 对住我院被诊断为产后抑郁症的45例病人与45例非产后抑郁症和45例正常产妇作对照研究。结果 产后抑郁症在症状学方面与非产后抑郁症差别不大，但它有较多的负性刺激和家庭问题，受到的客观支持也少。结论 产后抑郁症的发生与生活事件等心理社会因素有关。     

行为类型与心理社会干预对冠心病的影响

本文综述了行为类型与冠心病的关系以及心理社会方法干预冠心病的研究进展。     

行为类型与心理社会干预对冠心病的影响

本文综述了行为类型与冠心病的关系以及心理社会方法干预冠心病的研究进展     

心理社会因素在乳腺癌发病中的作用

心理社会因素在乳腺癌的发病中是否起一定的作用以及起多大的作用一直是个有争议的问题 ;对此作者将生活事件、应付方式、情感、个性和社会支持等心理社会因素在乳腺癌发生中的作用作了综述     

Subgroup differences in psychosocial factors relating to coronary heart disease in the UK South Asian population

Objectives

To explore the differences in psychosocial risk factors related to coronary heart disease (CHD) between South Asian subgroups in the UK. South Asian people suffer significantly higher rates of CHD than other ethnic groups, but vulnerability varies between South Asian subgroups, in terms of both CHD rates and risk profiles. Psychosocial factors may contribute to the excess CHD propensity that is observed; however, subgroup heterogeneity in psychosocial disadvantage has not previously been systematically explored.

Methods

With a cross-sectional design, 1065 healthy South Asian and 818 white men and women from West London, UK, completed psychosocial questionnaires. Psychosocial profiles were compared between South Asian religious groups and the white sample, using analyses of covariance and post hoc tests.

Results

Of the South Asian sample, 50.5% was Sikh, 28.0% was Hindu, and 15.8% was Muslim. Muslim participants were more socioeconomically deprived and experienced higher levels of chronic stress, including financial strain, low social cohesion, and racial discrimination, compared with other South Asian religious groups. In terms of health behaviors, Muslim men smoked more than Sikhs and Hindus, and Muslims also reported lower alcohol consumption and were less physically active than other groups.

Conclusion

This study found that Muslims were exposed to more psychosocial and behavioral adversity than Sikhs and Hindus, and highlights the importance of investigating subgroup heterogeneity in South Asian CHD risk.     

冠心病患者焦虑抑郁情绪及影响因素分析

目的调查分析冠心病患者焦虑与抑郁患病情况及其相关的影响因素。方法收集心内科确诊的冠心病患者64例,采用一般情况调查表、焦虑自评表、特质应对方式问卷表、抑郁自评量表和社会支持评定量问卷进行测评并对结果进行分析。结果本组64例患者中焦虑患者24例(37.5%),男13例,女11例;抑郁患者40例(62.5%),同时存在焦虑及抑郁患者23例(35.9%),男12例,女11例。男女抑郁与焦虑的患病率差异具有统计学意义。积极应对(P<0.01)与焦虑呈正相关。结论冠心病患者普遍存在焦虑和抑郁情绪,是影响抑郁焦虑情绪的主要因素,积极应对与抑郁焦虑呈正相关。     

Effectiveness of cognitive behavioral therapy-based interventions on health outcomes in patients with coronary heart disease: A meta-analysis

BACKGROUNDRecently, the efficacy of cognitive behavioral therapy (CBT)-based intervention on health outcomes in patients with coronary heart disease (CHD) has been recognized in randomized controlled trials (RCTs), but no comprehensive systematic review has been conducted. To address this research gap, our study aimed to evaluate whether comprehensive CBT-based interventions positively affect health outcomes in CHD patients. It was hypothesized that CBT-based interventions are effective in: (1) Reducing depression, anxiety, and stress symptoms; (2) Reducing body mass index, blood pressure, and lipid levels; and (3) Improving quality of life, and exercise endurance.AIMTo verify the effectiveness of CBT-based interventions on CHD patients through a meta-analysis of previous publications.METHODSRelevant RCTs published in English were obtained by searching electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, and Proquest, with the retrieval time from inception to August 2020. The primary outcomes were psychological factors (depression, anxiety, and stress symptoms), physiological factors (body mass index, blood pressure, blood lipids). The secondary outcomes included quality of life and exercise endurance. We used Review Manager 5.3 to conduct the meta-analysis and used the Physiotherapy Evidence Database tool to evaluate the quality of studies.RESULTSA total of 22 RCTs comprising 4991 patients with CHD were included in the systematic review and meta-analysis. The main analysis revealed that CBT-based intervention can reduce depression symptoms: -2.00 [95% confidence interval (CI): -2.83 to -1.16, P < 0.001]; anxiety symptoms: -2.07 (95%CI: -3.39 to -0.75, P = 0.002); stress symptoms: -3.33 (95%CI: -4.23 to -2.44, P < 0.001); body mass index: -0.47 (95%CI: -0.81 to -0.13, P = 0.006); and improve physical functioning: 3.36 (95%CI: 1.63 to 5.10, P = 0.000) and mental functioning: 6.91 (95%CI: 4.10 to 9.73, P < 0.001). Moreover, subgroup analysis results showed that CBT-based interventions were more effective for symptoms of depression and anxiety in CHD patients when individual, as opposed to group treatment, and psycho-education, behavioral and cognitive strategies were applied as the core treatment approaches.CONCLUSIONCBT-based interventions are effective treatment strategies for CHD patients, significantly improving their symptoms of depression, anxiety and stress, body mass index, and health-related quality of life.     

Illness perceptions in coronary heart disease. Sociodemographic, illness-related, and psychosocial correlates

OBJECTIVES: This study examined illness perceptions (IP) and their correlates in coronary heart disease (CHD). METHODS: The sample of the questionnaire study (n = 3130 at baseline and n = 2745 at 1-year follow-up, aged 45-74 years) was drawn from the drug reimbursement register, which covers persons with various drug-treated conditions. Independent variables were CHD severity and history, vicarious experiences, and psychosocial resources. RESULTS: Men attributed their CHD more often to risk behaviours and internal factors (own attitude/behaviour), while women perceived stress as the cause of their CHD more often. Women also perceived more symptoms associated with CHD but reported less severe consequences. CHD severity was the most important correlate of IP and also predicted change in IP at the follow-up. Stronger perceived competence was related to weaker illness identity, stronger control/cure, and less severe consequences. CONCLUSIONS: Although disease-related factors are powerful correlates of CHD-related illness cognitions, also social and psychosocial factors are related to IP.     

Hypertension and coronary heart disease risk factor management

The primary goal in the treatment of essential hypertension is to reduce all end organ damage, not simply to reduce blood pressure. Hypertension is associated with an increased risk of cerebrovascular, cardiovascular and renal morbidity and mortality. Pharmacological therapy has reduced some, but not all, of these complications. In order to achieve maximal decrease in morbidity and mortality in hypertensive related diseases the overall impact of antihypertensive drug therapy on the pathogenesis of damage to each end organ must be considered.The pharmacological therapy of mild hypertension has reduced complications of most pressure related (arteriolar) damage such as cerebrovascular accidents, congestive heart failure, and some cases of chronic renal failure, but atherosclerotic complications, coronary heart disease, angina, myocardial infarction and sudden death have not been convincingly reduced.A more pathophysiologic and individualized approach to the treatment of hypertension is recommended in place of the traditional stepped care approach which has primarily emphasized diuretics and beta blockers as initial therapy. This new approach in the subsets of hypertension, which is based on eight parameters: (1) Pathophysiology; (2) Haemodynamics; (3) End organ damage; (4) Concomitant medical diseases and problems; (5) Demographics; (6) Adverse effects of drugs and quality of life; (7) Compliance with medication regimen; (8) Total health care costs: direct and indirect costs.Hypertension is not just a disorder of increased intraarterial pressure, but in fact, a syndrome of commonly associated genetic and/or acquired abnormalities including dyslipidaemia, insulin resistance, impaired glucose tolerance, central obesity, renal abnormalities, structural abnormalities of smooth muscle, and abnormal cellular cation transport or membranopathy. This leads to acceleration of arterial damage, atherosclerosis and a greater incidence of atherosclerotic cardiovascular complications. Recognition of the hypertension syndrome and these concepts will hopefully lead to a more rational and logical approach to the treatment of hypertension and also a reduction in coronary heart disease.     

伴发冠心病的抑郁症患者临床特征分析

目的：探讨伴发冠心病的抑郁症患者的临床特征。方法：收集伴或不伴冠心病的抑郁症患者资料各50例进行比较。结果：伴有冠心病的抑郁症患者的平均病程、平均发病次数和平均住院日均显著高于不伴有冠心病患者；前者的临床症状亦显著较重，疗效显著较差。结论：伴有冠心病的抑郁症患者临床症状更重，治疗难度大。     

冠心病介入性治疗病人的心理特点及术前焦虑的相关因素分析

目的探讨对冠心病介入性治疗病人的心理特点及术前焦虑的相关因素，旨在为综合性心理干预提供依据。方法采用自编量表、状态特质焦虑量表、简易应对方式问卷、社会支持评定量表及艾森克人格问卷，对121例冠心病病人进行测评，并对相关因素进行分析。结果术前有焦虑情绪者占60．33％，其中特质性焦虑、既往有手术或介入接触史、受同病室手术反应者的影响、术后身体恢复情况估计、神经质病人以及是否了解手术过程是病人焦虑的主要因素，而且消极应对方式高于常模。表明冠心病病人多伴有较重的抑郁情绪；社会支持力度明显高于一般手术者。结论术前及术后进行积极的综合性心理干预，对于缓解此类病人的焦虑及术后的恢复非常重要。     

住院冠心病患者的临床心理特征分析

目的 分析住院冠心病患者心理状况的临床特征。方法 应用汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、A型行为类型问卷(TABP)、艾森克成人个性问卷(EPQ)以及症状自评量表(SCL-90),对综合性医院心血管内科住院的80例冠心病患者进行调查。结果 ①60％的住院冠心病患者同时伴有焦虑抑郁症状,35％的患者单有焦虑症状;②住院冠心病患者的HAMD和HAMA总分受性别、文化程度、病程、住院次数以及A型行为类型等因素的影响;③住院冠心病患者的SCL-90总分及其因子分明显高于中国正常人常模。结论 住院冠心病患者存在一定的心理问题,对其进行心理干预是必要的。     

Childhood adversities experienced by working-aged coronary heart disease patients

OBJECTIVE: The aim of this study is to investigate associations between childhood adversities and coronary heart disease (CHD). METHODS: This was a case-control study based on a postal questionnaire addressed to randomly selected working-aged Finns, and response rate was 39% (N = 15,477). The sample comprised 319 CHD patients. Four age- and gender-matched controls were selected for every patient. The participants were asked in six questions to think about their childhood adversities. RESULTS: Fear of some family member and someone in the family being seriously or chronically ill were more common during childhood among working-aged CHD patients than among controls. Likewise, among female CHD patients, serious conflicts in the family and someone in the family having had alcohol problems and, among male CHD patients, long-lasting financial problems were more common than among controls. Odds ratios (OR) varied between 1.27 and 2.66. Adjustment for education had no influence among women, but it had an influence among men. Upon adjustment for conventional risk factors (smoking, obesity, and hypertension), the association mostly disappeared. A family member having been seriously or chronically ill was statistically significant after full adjustment among both genders. CONCLUSION: Working-aged CHD patients have experienced more dramatic events during their childhood than did the control population. This issue cannot be solved in doctors' offices. Health-promoting social policies are of vital importance.