社交焦虑障碍与人格障碍的共病及父母养育方式的影响

目的:探讨社交焦虑障碍与轴Ⅱ人格障碍的共病情况及父母养育方式的影响.方法:采用人格障碍评估手册(PDA)和父母养育方式评价量表分别对50例社交焦虑障碍患者、40例强迫症患者和40例广泛性焦虑障碍患者进行测查.结果:社交焦虑障碍与回避型、强迫型人格障碍共病率较高,社交焦虑障碍组的回避型人格障碍得分和PDA总分明显高于强迫症组和广泛性焦虑症组.社交焦虑障碍患者父母情感温暖理解因子显著低于正常对照组,而父母惩罚严厉、拒绝否认因子显著高于正常对照组.结论:社交焦虑障碍与回避型人格障碍关系密切,父母不良的养育方式与社交焦虑障碍的形成有关.     

焦虑障碍与人格障碍的共病

目的:探讨焦虑障碍患者共病人格障碍的情况。方法:对127例符合DSM-IV轴I焦虑障碍的患者进行了DSM-IV轴II人格障碍的诊断评估,并进行汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、疾病严重程度(CGI-SI)、社会功能缺陷(SDSS)等评定。结果:①焦虑障碍与人格障碍的共病率为73.2%;②共病者焦虑障碍的发病年龄更早(P<0.01),焦虑障碍病程更长(P<0.05),疾病更加严重(P<0.01),其焦虑、抑郁水平更高(P<0.05;P<0.05),社会功能更差(P<0.01)。结论:焦虑障碍与人格障碍有较高的共病率,焦虑障碍与人格障碍共病患者的临床特征更加复杂。     

焦虑和抑郁障碍共病患者的防御机制研究

目的 :探讨焦虑和抑郁障碍共病防御机制的特点以及与焦虑障碍和抑郁障碍防御机制的差别。方法 :对 2 5例焦虑和抑郁障碍共病、 3 0例抑郁症、 2 0例焦虑症患者和 83例正常人分别测评防御方式问卷(DSQ)、汉密尔顿抑郁量表 (HAMD)和汉密尔顿焦虑量表 (HAMA)。结果 :共病组与正常对照组相比 ,较少使用被动攻击、抱怨、期望 ;较多使用退缩、躯体化、解除、否认 ;抑郁组与正常对照组相比 ,较少使用幽默、期望 ;较多使用解除、假性利他、隔离 ;焦虑组与正常对照组相比 ,较少使用抱怨、幽默 ;较多使用解除、同一化。共病组的掩饰因子得分与正常人无差异 ,但抑郁组和焦虑组的掩饰因子得分显著低于正常人。共病组仅HAMD评分与退缩呈显著正相关 ;抑郁组HAMA评分与解除、交往倾向呈显著正相关 ,与隔离呈显著负相关 ;焦虑组HAMD评分与躯体化、否认呈显著正相关 ,HAMA评分与反作用形成、理想化呈显著负相关。结论 :焦虑和抑郁障碍共病具有与单纯焦虑障碍和单纯抑郁障碍不同的防御方式 ,但尚不能肯定它是不同于后两者的第三种疾病     

酒依赖与焦虑障碍的共病研究

目的探讨酒依赖与焦虑障碍之间的共病特征,以发病率为切入点进行深入分析。方法选取某院精神科收治的58例焦虑障碍患者作为本次的研究当中的研究组,另外选取58例具有酒依赖现象的焦虑障碍患者作为对照组,对两组患者的发病率进行对照比较。结果从性别方面来看,女性焦虑障碍患者在酒精使用障碍方面的发病率明显高于男性患者,另外两组患者之间进行对比,治愈难度具有明显的差异。结论酒依赖与焦虑障碍之间的关系较为密切,因此对于焦虑障碍患者的治疗当中应将予以酒依赖现象改善的措施作为治疗的主要方向,进而使得患者恢复至健康的精神状态。     

青少年抑郁障碍自杀未遂患者父母的生活质量及影响因素

目的:探讨自杀未遂的青少年抑郁障碍患者父母的生活质量及影响因素.方法:招募76例自杀未遂的青少年抑郁障碍患者父母作为研究组,招募与研究组年龄、性别、受教育程度、婚姻状况和职业状况相匹配的76例健康志愿者作为对照组.采用SF-36健康调查量表(SF-36)评估两组的生活质量,采用Zarit照料者负担量表(ZBI)和家属疾...     

酒依赖和双相障碍共病患者生活质量的调查分析

目的了解酒依赖和双相障碍共病患者的生活质量及情感体验。方法对30例酒依赖和双相障碍共病患者和30例健康者分别应用生活质量综合评定量表(GQOLI-74),焦虑自评量表(SAS)、抑郁自评量表(SDS)进行评定。结果与健康对照组相比,研究组GQOLI-74的20个因子中,生活环境、经济状况、睡眠与精力、躯体不适感、性功能、精神紧张度、负性情绪、正性情绪、认知功能、自尊、社会支持、人际交往能力、工作与学习、业余娱乐活动、婚姻与家庭、生活质量总体评价因子分均低于健康组,差异有统计学意义,而两组在住房、社区服务、进食功能、运动与感觉功能因子分的差异无统计学意义;研究组在躯体功能、心理功能、社会功能维度分及总分低于健康人,差异有统计学意义,两组的物质功能维度分的差异无统计学意义;研究组的SAS、SDS评分明显高与健康组,差异有统计学意义。结论酒依赖和双相障碍共病患者的生活质量显著下降,负性情感明显。     

有受虐经历的广泛焦虑障碍患儿的行为及自我意识特点

目的:调查广泛性焦虑障碍(GAD)患儿的心理虐待及忽视现状,探讨遭受心理虐待、忽视的GAD患儿行为及自我意识的特点.方法:在湖南省六个地区5～17岁中小学生中抽取9 495名儿童,采用二阶段流行病学调查方法,由对照组及符合诊断标准的GAD组儿童填写儿童自我意识量表、儿童心理虐待与忽视量表,两组家长填写Achenbach儿童行为量表,最后收集资料完整共409人(对照组206人,GAD非受虐组99人,GAD受虐组104人).结果:GAD组受虐阳性率、心理虐待与忽视量表六个维度分均显著高于对照组(P=0.000);GAD受虐组儿童的内化性行为、外化性行为得分高于GAD非受虐组(P=0.000),自我意识总分及行为、焦虑、合群、幸福等四个因子分比GAD非受虐组低(P=0.000).结论:心理虐待及忽视在GAD患儿中更普遍、更严重;当心理虐待、忽视与GAD同时存在时,儿童青少年的行为问题更严重,自我意识水平更低.     

山东枣庄市城乡重点中学学生生活质量及其影响因素

目的:调查山东省枣庄市城市、农村中学生生活质量现状及其影响因素.方法:对4所重点中学的1937名初中、高中生(城市1227例,农村710例)应用儿少主观生活质量问卷,中学生心理健康调查表,父母养育方式量表进行调查分析.结果:在1937名中学生中对生活的满意度处于一般水平的为868例(44.8%),满意为542例(28.0%),不满意为527例(27.2%).其中城市中学生感到不满意361例(29.4%)的比例显著高于农村学生的不满意116例(23.4%).影响中学生生活质量的影响因素有:心理健康总分、学习压力、抑郁、强迫、心理不平衡、父母的关心理解、同伴关系、年龄.结论:农村中学生对生活满意度高于城市,其影响因素是多方面的.     

心理社会支持系统对广泛性焦虑障碍患者焦虑症状、睡眠质量的影响

目的:探讨心理社会支持系统对广泛性焦虑障碍(GAD)患者焦虑症状、睡眠质量的影响.方法:选取2016年2月至2019年2月在医院接受治疗的GAD患者100例为研究对象,采用随机数表法分为观察组和对照组 各50例,对照组在常规药物治疗基础上给予传统干预,观察组在此基础上给予心理社会支持系统干预,比较两组干预效果,分析对患...     

老年抑郁症和焦虑障碍共病患者的临床特征

目的探讨老年抑郁症和焦虑障碍共病患者的临床特征。方法根据美国精神障碍诊断手册第四版(DSM-IV)的诊断标准,把78例老年抑郁症患者分为两组,单纯抑郁症组(抑郁症组,N=44)及抑郁症和焦虑障碍共病组(共病组N=34)。对所有对象评定一般人口学资料及老年抑郁量表(GDS)、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、简易智能状态评定量表(MMSE)和健康状况调查问卷(SF-36)等,比较两组患者间差异。结果抑郁症组与共病组患者的性别、年龄、病程、居住情况、家族史、民族、发病诱因和受教育年限等方面的差异无统计学意义(均P>0.05)。GDS总分(14.0±1.2/12.1±2.0,t=4.92)、HAMD(38.1±4.0/33.4±4.7,t=4.35)和HAMA总分(22.6±5.5/11.7±2.7,t=10.93)及其因子分、HAMD第3项(自杀)条目分、SF-36躯体功能(79.2±13.6/69.1±13.6,t=3.25)、社交功能(70.0±21.2/50.0±22.5,t=4.02)评分共病组均高于抑郁症组差异有统计学意义(均P<0.05)。结论老年抑郁症和焦虑障碍共病患者较单纯抑郁患者的抑郁和焦虑症状更重、自杀风险大、生活质量更差。     

广西河池地区仫佬族7～15岁正常儿童青少年跟骨超声骨密度及其影响因素

目的:了解仫佬族学生超声骨密度的变化规律及其影响因素.方法:按年龄进行分组,以1岁作为1个年龄段.采用定量超声技术(QUS)测定长居广西河池市罗城县四把镇的956名(男465,女491)7～15岁正常儿童的跟骨QUS参数超声振幅衰减系数(BUA),同时测量受检者身高和体质量.结果:7～15岁仫佬族男、女学生BUA值随年龄的增长而增加.男、女生各年龄段的BUA值差异无统计学意义,同性别相邻的2个年龄组间无统计学意义,同年龄不同性别间亦无统计学意义.7～15岁男、女生BUA与年龄、身高、体质量和BMI均呈正相关(P＜0.01),年龄、身高和体质量是超声骨密度参数的主要决定因素.结论:年龄、身高和体质量是影响儿童青少年骨密度的重要因素;本研究获得仫佬族学生定量超声BUA正常参考值,为仫佬族儿童少年骨质疏松症诊疗提供依据,为指导和改善仫佬族学生钙营养提供依据.     

Distribution of serum IgE in children and adolescents aged 7 to 16 years in Copenhagen, in relation to factors of importance

The distribution of total serum-IgE and factors of importance for the level of IgE was studied in a random sample of 508 children and adolescents, aged 7-16 years, from Copenhagen. A detailed history about asthma, rhinitis, dermatitis and urticaria was obtained, and a physical examination, skin prick test with 9 common allergens, lung function test, bronchial challenge with inhaled histamine and exercise, and measurement of IgE (kU/l) were performed. The distribution of IgE among children and adolescents was found to exhibit a log normal distribution and a positive skin prick test, allergic symptoms, a family history of allergic diseases, age and smoking were found to be significantly related to an increased level of IgE. No relationship was found between increased bronchial responsiveness and IgE. The geometric mean of "normal" values of IgE (*1 SD and *2 SD) of the Danish children and adolescents was 18 kU/l (*4.7, *18.2), suggesting that normal IgE values were within 330 kU/l. Measurement of IgE as the only screening for allergic disease is unreliable, as the predictive value of an elevated IgE in population samples was found to be 50%, whereas misclassification (1-specificity) of asymptomatic subjects as allergic because of an increased IgE was low (4%). In conclusion, total IgE is highly influenced by allergen skin reactivity. Further, this study suggests that normal IgE values were within 330 kU/l, although the range was wide.     

Pulmonary function in normal Japanese children 6 to 16 years of age

We measured pulmonary function on 182 healthy Japanese children 6 to 16 years of age living in the Tokyo area. Static lung volumes, RV/TLC (%), FRC/TLC (%), FVC, FEV1, FEV1/FVC (%), MMFR, MVV, f, VE and VO2 were measured. Multiple regression equations were obtained and the results were compared with those derived from the other equations (Kanagami (1958), Ishida (1955]. The predicted values were about 10 approximately 25% higher with our equations than those obtained from the other equations which were made more than 30 years ago. These differences were attributed to the recent improvement in growth of the Japanese children. For this reason we think it is better now to adopt new equations for the prediction of normal values in Japanese children.     

Seroprevalence of anti-RSV IgG in Thai children aged 6 months to 5 years

Respiratory syncytial virus (RSV) is the single most important cause of lower respiratory tract infection during infancy and early childhood worldwide including Thailand. The magnitude as well as the intensity of both infection and host response to the RSV infection determine the severity of disease. To determine the presence of anti-RSV IgG in children of different age groups, 124 serum samples were randomly collected from healthy children aged 6 months to 5 years. All of them were assayed for anti-RSV IgG using a commercial ELISA kit. The mean prevalence rate was found to be 68.91%. The prevalence increased with age: from 6 to 11 months, 11.76%; from 12 to 17 months, 41.67%; from 18 to 23 months, 60.87%; from 24 to 29 months, 88.24%; from 30 to 35 months, 78.57%; from 36 to 41 months, 94.44% and from 42 to 60 months, 100%. The amount of anti-RSV IgG among the groups was significantly different (p = 0.006). No sexual preponderance was found. RSV infection commonly occurred in children aged 12 to 29 months. All children older than 5 years had experienced a RSV infection.     

Prevalence and predictors of bronchial hyperresponsiveness in children aged 7-16 years

To study the prevalence and possible predictors of bronchial responsiveness we examined a cross-section of 527 children aged 7-16 years from Copenhagen. The method used included an interview with the child and the parents, skin prick test with common allergens and se-IgE. Bronchial responsiveness was measured by a histamine inhalation test. We found that 79 (16%) of the children had bronchial hyperresponsiveness (BH), defined as a 20% fall in FEV1 with a provoking concentration of histamine (PC20) at 8 mg/ml or less. Atopic symptoms defined as asthma, rhinitis or eczema were significantly (P less than 0.001) correlated to BH both in prevalence and degree of BH. None of the children with urticaria had BH. The degree of bronchial responsiveness was also significantly influenced (P less than 0.001) by family disposition to atopy, whereas we found no correlation between BH and "passive" smoking, specific skin test in unselected children, or elevation of IgE in children without atopic symptoms. We conclude that BH is severest in children with asthma, independent of elevated IgE or positive skin prick test. Children with rhinitis, dermatitis, or asymptomatic BH have the same degree of BH; this differed from that in children with asthma.     

Growth performance of Punjabi children aged 6-12 years

The study aims at evaluating the growth performance of primary school children of Patiala (Punjab, India) belonging to lower and lower middle socio-economic groups, with special emphasis on the effects of social class and urbanization. Cross-sectional data on 1380 children (656 boys and 724 girls) ranging in age from 6 to 12 years were collected during 1974. Dimensions measured were height, weight, circumferences of chest and upper arm, triceps, subscapular and suprailiac skinfolds. Standard techniques (Weiner and Lourie 1969) were followed for taking these measurements. The boys are significantly taller and heavier than the girls, whereas the girls possess significantly more amounts of subcutaneous tissue, from 6 to 12 years. The Punjabi children are taller than the combined Indian sample. On average, the children of the present study are smaller in size and lighter in body weight than the British children and fall between the 3rd and 25th centiles of the British standards. Children belonging to lower and lower-middle socio-economic classes are significantly lighter in body weight and smaller in height than their coevals of higher groups. The urban boys are taller and heavier than their rural peers, however, the differences are not as marked and clear as those of socio-economic groups.     

6～13岁儿童先天性髋脱位的手术治疗体会

儿童先天性髋脱位是一种较常见的畸形,治疗方法很多,疗效不一,尤其对较大儿童髋脱位尚无理想方法。我科1998年至2006年采用髋臼加盖成形和股骨粗隆下旋转截骨联合治疗6~13岁的发育性髋脱位共计17例,21个髋关节,随访15例,19个髋关节。现报告如下。1资料与方法1.1临床资料本组17例,21个髋关节,其中男性4例,6个髋关节;女性13例,15个髋关节。左侧9例,右侧4例,双侧4例。随访2~8年,平均4.8年。髋脱位可分为三度:Ⅰ度脱位属半脱位;Ⅱ度脱位,股骨头已脱出髋臼或髋臼上缘;Ⅲ度脱位指股骨头向上移位较高,达髂翼处。本组21例中Ⅰ度3例,Ⅱ7例,Ⅲ度11例。…