职业女性减压，试试催眠

事业和家庭、工作和孩子，这是困扰职业妇女的两大矛盾和冲突。一提起女性上班族，尤其是已婚并且有孩子的职业妇女，我们脑海里都会马上浮现出一个在职场内外的生活中疲于奔命，在单位、家庭、学校、超市各种场所奔波劳碌的身影。     

Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms

BACKGROUND: Regular physical exercise may improve a variety of physiological and psychological factors in depressive persons. However, there is little experimental evidence to support this assumption for adolescent populations. We conducted a randomized controlled trial to investigate the effect of physical exercise on depressive state, the excretions of stress hormones and physiological fitness variables in adolescent females with depressive symptoms. METHODS: Forty-nine female volunteers (aged 18-20 years; mean 18.8 +/- 0.7 years) with mild-to-moderate depressive symptoms, as measured by the Centre for Epidemiologic Studies Depression (CES-D) scale, were randomly assigned to either an exercise regimen or usual daily activities for 8 weeks. The subjects were then crossed over to the alternate regimen for an additional 8-week period. The exercise program consisted of five 50-min sessions per week of a group jogging training at a mild intensity. The variables measured were CES-D rating scale, urinary cortisol and epinephrine levels, and cardiorespiratory factors at rest and during exercise endurance test. RESULTS: After the sessions of exercise the CES-D total depressive score showed a significant decrease, whereas no effect was observed after the period of usual daily activities (ANOVA). Twenty-four hour excretions of cortisol and epinephrine in urine were reduced due to the exercise regimen. The training group had a significantly reduced resting heart rate and increased peak oxygen uptake and lung capacity. CONCLUSIONS: The findings of this study suggest that a group jogging exercise may be effective in improving depressive state, hormonal response to stress and physiological fitness of adolescent females with depressive symptoms.     

Patients with diabetes and depression may need additional support for exercise

OBJECTIVE: To examine the association between depressive symptoms and exercise-related variables among patients with type 2 diabetes. METHODS: Surveys were completed by 207 primary care patients diagnosed with type 2 diabetes (52% female; 95% white; mean age = 63 years). Multiple linear regression analyses were conducted. RESULTS: Lower use of relapse prevention behavior was significantly associated with higher depression scores in a multivariate model. CONCLUSIONS: Patients with diabetes and depression have barriers to exercise (eg, fewer skills for relapse prevention) and may require additional support for exercise initiation and maintenance.     

Prevalence of stress,anxiety and depression in with Alzheimer caregivers

Background  

Alzheimer's disease presents a social and public health problem affecting millions of Italians. Those affected receive home care from caregivers, subjected to risk of stress.     

Physical exercise, oxidative stress and damage

Physical activities (aerobic, anaerobic and resistance exercises) evoke an increased production of high oxidative substances, depending mainly on the intensity of the muscle actions. Antioxidants in the muscle and blood represent the first line of defense, but an oxidative stress activates the scavenger enzyme systems. If the stress is too high, structural modifications, "damage" of lipids, proteins and nucleic acids is a consequence. Markers of this oxidative damage can be recognized for a few days. Oxidative stress certainly have a role in the physiological adaptation to the physical activity. Moderate intensity (less than 50-60% of the aerobic capacity or of the maximal muscle tension) exercises exert low stress without oxidative damage impulse in the normally nourished subjects. Regular training and "normal" diet results a proper defense against excess oxidative stress. Monitoring of the oxidative stress or/and damage is not jet a tool in the training praxis in spite of the obvious advantages and of the existence of certain noninvasive methods. Data reinforce the necessity of regular exercise with moderate intensity in the primary prevention and in the rehabilitation of metabolic and cardiovascular diseases.     

Occupational stress and depression in Korean employees

PURPOSE: The purpose of this study is to analyze what aspects of occupational stress predict depression among Korean workers, and determine which components of occupational stress or job characteristics is more strongly associated with depression. METHODS: In this cross-sectional study, a total of 8,522 workers (21-65 years of age) from a nationwide sample were recruited. A self-administered questionnaire was used to assess socio-demographics, job characteristics, depressive symptoms measured by the Center for Epidemiologic Studies Depression Scale, and occupational stress assessed by the Korean occupational stress scale (KOSS). RESULTS: Multivariate analyses show that inadequate social support (OR = 1.58, 95% CI = 1.52, 1.66) and discomfort in occupational climate (OR = 1.25, 95% CI = 1.18, 1.32) were more important risk factors for depression than organizational injustice, job demand and job control. Compared to the 'business activities' industries, 'recreational, cultural and sporting activities' (OR = 3.45, 95% CI = 1.80, 6.58), 'hotel and restaurants' (OR = 3.34, 95% CI = 1.92, 5.80), 'real estate and renting and leasing' (OR = 2.24, 95% CI = 1.13, 4.44), 'wholesale and retail' (OR = 1.85, 95% CI = 1.28, 2.67), 'transportation' (OR = 1.85, 95% CI = 1.11, 3.07), and 'financial institute and insurance' (OR = 1.60, 95% CI = 1.04, 2.48) industries had significantly greater risk of depression after controlling for gender, age, marital status, duration of employment and all subscale of KOSS. CONCLUSION: The finding that inadequate social support and discomfort in occupational climate is a better predictor of depressive symptoms than organizational injustice in Korea, indicates that the newly developed KOSS has cultural relevance for assessing occupational stress in Korea. Future studies need to understand factors such as "emotional labor" within certain industries where increased risk for depression is observed.     

Effects of anaerobic exercise and aerobic exercise on biomarkers of oxidative stress

Objectives  In addition to having health-promoting effects, exercise is considered to induce oxidative stress. To clarify whether increased oxygen consumption during exercise induces oxidative stress, we investigated the effects of aerobic exercise and anaerobic exercise on a series of oxidative damage markers. Methods  One group of subjects performed aerobic exercise and another group performed anaerobic exercise with similar workloads, but with different levels of oxygen consumption. Blood and urine samples were collected before, immediately after, and 3, 9, and 24 h after exercise. Serum uric acid (UA) and creatine phosphokinase were evaluated. As markers of oxidative damage to lipids, proteins and DNA, we evaluated serum 4-hydroxy-2-nonenal, urinary F₂-isoprostanes, serum protein carbonyls, and leukocyte 8-hydroxydeoxyguanosine. Results  Oxygen consumption was significantly greater during aerobic exercise. Although UA level increased immediately after aerobic exercise and decreased thereafter, UA level did not change after anaerobic exercise. The two types of exercise had significantly different effects on the change in UA level. After anaerobic exercise, the levels of 8-hydroxydeoxyguanosine and 4-hydroxy-2-nonenal significantly increased at 24 h and 3 h, respectively. The levels of creatine phosphokinase and F₂-isoprostanes decreased after exercise. The two types of exercise caused no apparent significant differences in the levels of these biomarkers. Conclusion  The findings suggest that similar workloads of anaerobic exercise and aerobic exercise induce reactive oxygen species (ROS) differently: aerobic exercise seems to initially generate more ROS, whereas anaerobic exercise may induce prolonged ROS generation. Although more oxygen was consumed during aerobic exercise, the generated ROS did not induce significant oxidative damage. Oxygen consumption per se may not be the major cause of exercise-induced oxidative damage.     

健康教育联合有氧运动对青少年抑郁症的干预效果

目的探讨健康教育联合有氧运动对青少年抑郁症的干预效果,为改善青少年抑郁症状提供参考。方法采用方便抽样法,抽取武汉市精神卫生中心接诊的84例青少年抑郁症患者,根据患者就诊先后顺序分为两组(各42例),对照组进行常规的健康宣教,实验组增加情绪智力团体健康教育,并配合中等强度有氧运动。对比两组患者干预前后的抑郁状态、情绪智力水平及5-羟色胺(serotomin,5-HT)、皮质醇、去甲肾上腺素(norepinephrine,NE)水平。结果干预前,两组的汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、社会功能缺陷筛选量表(Social Disability Screening Schedule,SDSS)评分比较,差异均无统计学意义(t值分别为0.62,1.02,P值均>0.05)。与干预前相比,实验组干预后的HAMD、SDSS评分明显降低(t值分别为9.62,10.05,P值均<0.05),且实验组干预后的HAMD、SDSS评分均低于对照组(t值分别为-6.95,-7.32,P值均<0.05)。实验组干预后的情绪知觉、自我情绪管理、他人管...     

Preferences for exercise as a treatment for depression

Depression is a leading cause of disability worldwide, but most depressed individuals do not receive treatment. There is now significant support for physical exercise as an effective alternative treatment for depression, which may be more accessible than traditional psychiatric treatments. Little is known about preferences for exercise as a depression treatment.MethodA total of 102 individuals (50% female, mean age = 39 (SD = 13.1; range: 18–62), 83% Caucasian) with likely major depression completed an online survey of exercise for depression treatment preferences and barriers to increased exercise. Results are reported by gender due to well established gender differences in exercise preferences.ResultsBoth genders reported a high level of interest in an exercise for depression program. On average, participants preferred an individual walking program that was coached, asked them to engage in one longer bout multiple times per week, and was provided in home. However, there was significant variability within and between genders. Lack of motivation, mood, and fatigue were reported as barriers to exercise by the majority of participants of both genders.ConclusionThe majority of those with depression have interest in an exercise for depression program, but symptoms of depression are seen as significant barriers. Future studies should use these results to design exercise for depression programs. The variability and gender differences in our results suggest that flexible programs may be needed.     

外科医生抑郁症状与职业紧张的关系

目的探讨外科医生抑郁症状与职业紧张的关系。方法采用流行病学调查方法,用抑郁自评量表测评心理健康,使用职业紧张测量工具测量职业紧张因素、紧张缓解因素,调查年龄、性别、文化程度、医院等级、周平均工作时间等资料。数据分别用χ2检验、方差分析、逐步回归模型进行分析。结果肯定有抑郁症状者占49.0%,总平均得分为20.05±7.61,女性肯定有抑郁症状发生率高于男性,51～62岁组抑郁症状发生率高于其他年龄组,差异有统计学意义(P<0.05)。肯定有抑郁症状者紧张因素中工作冲突(包括组间冲突、组内冲突)、技术利用、工作危险、工作前景、工作中角色(包括角色冲突、角色模糊)、物理环境和紧张缓解因素中忍耐性行为方式、工作心理控制源、社会支持(包括上级支持、家庭支持、同事支持)得分明显高于无抑郁症状者和可能有抑郁症状者,差异有统计学意义(P<0.05);提升机会、任务控制、竞争性行为方式、应付策略、自尊感得分明显低于无抑郁症状者和可能有抑郁症状者,差异有统计学意义(P<0.05)。工作角色、工作危险、工作前景、性别、行为方式、社会支持、周工作时间、物理环境、应付策略、工作单调性被引入回归方程。结论外科医生抑郁症状发生较为突出,人口学特征、职业紧张因素和缓解因素影响抑郁症状得分。     

Reducing burnout and stress: the effectiveness of clinical supervision

Health visitors and school nurses have been identified as a particularly vulnerable group to stress given the complex, frontline clinical work that they are involved in. Recent high-profile reviews of safeguarding practices have brought an increased pressure on the profession. This paper provides evidence of the effectiveness of a model of clinical supervision that reduced burnout and stress for health visitor and school nurse Leaders. Commissioned by NHS West Midlands, the project delivered supervision to health visitors and school nurses with a safeguarding leadership responsibility within their organisation.     

运动对慢性应激大鼠不同脑区ERK-CREB表达影响

目的探讨运动对慢性应激大鼠不同脑区磷酸化细胞外信号调节蛋白激酶(p-ERK)-环磷酸腺苷反应元件结合蛋白(p-CREB)信号通路的作用。方法雄性SD大鼠40只随机分为对照组、应激组、运动+应激组及运动组;采用慢性束缚方式建立应激模型;运动方式为无负重游泳;免疫组织化学方法检测海马、额叶皮层、纹状体p-ERK/p-CREB表达变化。结果应激组海马、额叶皮层、纹状体区p-ERK表达分别为(11.25±3.68),(19.26±6.03),(18.22±4.70),p-CREB表达分别为(2.13±0.38),(2.32±0.49),(2.91±0.54),对照组各脑区p-ERK表达分别为(22.53±2.96),(30.64±5.89),(29.46±4.54),p-CREB表达分别为(3.32±0.33),(3.56±0.44),(3.94±0.51),应激组表达低于对照组,差异有统计学意义(P<0.01);运动+应激组海马、额叶皮层p-ERK表达为(17.59±4.30),(25.31±5.57),p-CREB表达为(2.76±0.40),(2.98±0.53),表达高于应激组,差异有统计学意义(P<0.05)。结论运动锻炼作为一种有效的防护和干预手段,可能通过上调ERK-CREB通路提高慢性应激状态下的学习记忆能力。     

Barriers and facilitators to physical activity and exercise among adults with depression: A scoping review

BackgroundExercise is now recommended as a treatment for depression in Canada. What remains less clear is how best to encourage exercise uptake by individuals with mood disorders. The purpose of this scoping review is to identify barriers and facilitators to exercise and physical activity participation among individuals with depression.MethodA scoping review with systematic searches was conducted. Eligible studies required samples >50% diagnosed with depression or a mood disorder, and reported empirical data on barriers and/or facilitators to physical activity using quantitative and/or qualitative methods. Extracted barriers and facilitators were classified into the fourteen domains of the Theoretical Domains Framework (TDF).ResultsThirteen studies were included (seven quantitative, six qualitative). The most common barriers were classified under the TDF domains of Emotion, Environmental Context & Resources, Beliefs about Capabilities, and Intentions. The most common facilitators were classified under the domains of Beliefs about Consequences, Social Influences, Emotion and Behavioural Regulation.ConclusionsMost identified domains are all common determinants of health behaviours in various models and theories applied to physical activity participation. However, the Emotion domain appears to be particularly important to individuals with depression, and yet is not covered by these traditional theories of behaviour change, and may be overlooked when trying to promote physical activity among this population. Future research should investigate the effectiveness of behaviour change interventions that specifically target the Emotion domain, and clearly report the behaviour change techniques employed to do so.     

广州市HIV感染合并抑郁症状者耻辱感、压力与抑郁的结构方程模型

目的  构建广州市艾滋病病毒(human immunodeficiency virus,HIV)感染合并抑郁症状者中耻辱感、压力与抑郁之间的结构方程模型,为改善HIV感染者抑郁症状提供参考依据。 方法  2017年8~12月对广州市第八人民医院门诊部的300名HIV感染合并抑郁症状者进行电子问卷调查,收集感染者的社会人口学特征、耻辱感、压力与抑郁情况等信息。采用结构方程模型对数据进行分析,探讨耻辱感对抑郁的影响机制。 结果  300名HIV感染合并抑郁症状者中,平均年龄28.2岁,92.3%为男性,抑郁量表得分M(P₂₅,P₇₅)为23(19,28)分,提示中度抑郁。对耻辱感与抑郁构建结构方程模型显示,模型拟合良好(Chi-Square/df=1.52,RMSEA=0.04,CFI=0.98,SRMR=0.04)。中介效应结果显示,耻辱感与抑郁之间的直接作用具有统计学意义(β=0.31,P < 0.001),压力在耻辱感与抑郁程度之间的间接作用同样具有统计学意义(β=0.25,P < 0.001)。压力在耻辱感与抑郁程度之间呈部分中介作用。 结论  压力是HIV感染者耻辱感导致抑郁的重要中间环节,今后对HIV合并抑郁症状者的干预可以重点考虑对压力进行干预。     

童年期创伤与知觉压力对青少年焦虑性抑郁障碍的影响

目的 探讨童年期创伤与知觉压力对青少年焦虑性抑郁障碍(ADD)的影响,为青少年ADD的临床心理治疗提供数据支持。方法 2020年1月—2021年1月首发入住杭州市第七人民医院青少年抑郁障碍患者120例,根据汉密尔顿抑郁量表-17(HAMD₁₇)焦虑/躯体化因子得分分为焦虑性抑郁障碍组(ADD组)和非焦虑性抑郁障碍组(nADD组),每组各60例。分别运用HAMD₁₇、童年期创伤问卷(CTQ-SF)、中文版压力知觉量表(CPSS)测量抑郁水平、童年期创伤和知觉压力水平,比较两组之间的差异,并分析ADD组童年期创伤与知觉压力对焦虑性抑郁的影响模式。结果 1)ADD组与nADD组在年龄、性别、是否独生子女、受教育年限及抑郁病程方面的差异无统计学意义(P>0.05);2)ADD组HAMD₁₇总分、情感虐待、情感忽视、躯体虐待、童年期创伤总分、紧张感、失控感及知觉压力总分高于nADD组,差异有统计学意义(t=3.558、11.374、5.333、4.080、7.796、8.829、11.854、13.276,P<0.01);3)ADD组HAMD₁₇总分与童年期创伤总分、紧张感、失控感及知觉压力总分呈正相关(r=0.415~0.590,P<0.01);ADD组童年期创伤总分与紧张感、失控感及知觉压力总分呈正相关(r=0.306~0.390,P<0.01);4)ADD组知觉压力对焦虑性抑郁有直接路径影响效应(β=0.81,P<0.001),童年期创伤通过知觉压力对焦虑性抑郁有间接路径影响效应(β=0.567,P<0.001)。结论 焦虑性抑郁障碍青少年存在较多的童年期创伤经历和较高的知觉压力水平,知觉压力对焦虑性抑郁不仅具有直接影响,而且在童年期创伤对焦虑性抑郁的影响关系中起着完全中介作用。     

Muscle-fiber type and blood oxidative stress after eccentric exercise

Acute strength exercise elicits a transient oxidative stress, but the factors underlying the magnitude of this response remain unknown. The purpose of this investigation was to determine whether muscle-fiber type relates to the magnitude of blood oxidative stress after eccentric muscle activity. Eleven college-age men performed 3 sets of 50 eccentric knee-extensions. Blood samples taken pre-, post-, and 24, 48, 72, and 96 hr postexercise were assayed for comparison of muscle damage and oxidative-stress biomarkers including protein carbonyls (PCs). Vastus lateralis muscle biopsies were assayed for relative percentage of slow- and fast-twitch muscle fibers. There was a mixed fiber composition (Type I = 39.6% ± 4.5%, Type IIa = 35.7% ± 3.5%, Type IIx = 24.8% ± 3.8%; p = .366). PCs were elevated 24, 48, and 72 hr (p = .032) postexercise, with a peak response of 126% (p = .012) above baseline, whereas other oxidative-stress biomarkers were unchanged. There are correlations between Type II muscle-fiber type and postexercise PC. Further study is needed to understand the mechanisms responsible for the observed fast-twitch muscle-fiber oxidative-stress relationship.