微课在新冠肺炎疫情期间内科住院患者心理健康教育中的应用

目的 探讨新冠肺炎疫情期间微课在内科住院患者心理健康教育中的应用效果。方法 选择2020年1月26日-2月10日在绵阳市第三人民医院内科病区住院治疗的患者为研究对象,通过微信公众号和微信群,制作并向患者推送微课视频以实施心理健康教育。在实施前和实施两周后采用广泛性焦虑量表（GAD-7）和患者健康问卷抑郁量表（PHQ-9）评定患者的焦虑和抑郁状态。结果 微课实施前,患者GAD-7和PHQ-9评分分别为（13.03±4.32）分、（14.07±3.13）分;实施后,患者GAD-7和PHQ-9评分分别为（8.58±2.84）分、（12.11±3.27）分。微课实施前后,中度及以上的焦虑和抑郁检出率比较差异均有统计学意义（P均<0.01）。结论 新冠肺炎疫情期间运用微课实施心理健康教育可能有助于缓解内科住院患者的焦虑抑郁情绪。     

南宁市初三学生焦虑抑郁状况调查

目的 了解南宁市初三学生焦虑、抑郁水平及其与考试焦虑的关系,为对学生进行有针对性的心理干预提供参考。方法 于2021年5月-6月,采用简单随机抽样方法,在南宁市每个区/县内随机抽取一个初中学校,以每个学校初三年级中3个班级的学生为调查对象。采用考试焦虑量表（TAS）、焦虑自评量表（SAS）和抑郁自评量表（SDS）进行调查,采用Pearson相关分析考察各量表评分的相关性。结果 共2 080名学生参与此次调查,回收有效问卷1 826份（87.79%）。其中,999名（54.71%）初三学生感受到考试带来的不适感,检出存在焦虑和抑郁情绪者分别有577人（31.60%）、830人（45.45%）。女生TAS评分高于男生［（16.75±6.78）分vs.（15.08±6.97）分,t=-5.136,P<0.01］,女生SAS评分高于男生［（46.05±10.43）分vs.（44.16±10.87）分,t=-3.769,P<0.01］,女生SDS评分高于男生［（52.34±12.44）分vs.（49.98±12.17）分,t=-4.039,P<0.01］。相关分析显示,初三学生SAS、SDS评分与TAS评分均呈正相关（r=0.574、0.531,P均<0.01）,控制年龄和性别后,相关性仍存在（r=0.570、0.526,P均<0.01）。结论 南宁市初三学生的焦虑和抑郁症状检出率较高,且与考试焦虑均呈正相关。另外,女生的焦虑和抑郁水平均高于男生。     

家庭干预辅助碳酸锂治疗康复期双相情感障碍的效果

目的 探讨家庭干预辅助碳酸锂治疗康复期双相情感障碍的效果,为提高治疗效果提供参考。 方法 选取2018年1月-12月在佛山市第三人民医院住院治疗出院后2个月、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）双相情感障碍诊断标准、病情稳定且持续服用碳酸锂治疗的患者68例,采用随机数字表法分为研究组和对照组各34例,两组均接受碳酸锂治疗,研究组采用家庭干预辅助碳酸锂治疗,两组均治疗4个月,其中家庭干预每两周一次。于干预前后采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评定患者的焦虑和抑郁症状,干预后采用世界卫生组织生存质量测定简表（WHOQOL-BREF）评定患者的生活质量。 结果 干预后研究组SAS、SDS总评分低于对照组[（47.21±2.79）分vs.（52.79±2.42）分,（53.32±2.43）分vs.（56.41±3.49）分,t=8.813、4.231,P均<0.01]。研究组WHOQOL-BREF的生理、心理、社会关系领域评分以及总评分均高于对照组,差异有统计学意义[（5.62±0.63）分vs.（4.29±0.35）分,（12.42±4.24）分vs.（5.38±1.34）分,（3.46±0.34）分vs.（1.38±0.53）分,（39.14±11.21）分vs.（29.19±4.42）分,t=4.815~19.260,P均<0.01]。 结论 家庭干预辅助碳酸锂治疗康复期双相情感障碍患者的效果可能优于单用碳酸锂治疗,其生活质量更高。     

新冠肺炎流行期间安徽省青少年焦虑现状及影响因素

目的 探讨2019年新冠肺炎（COVID-19）流行期间安徽省青少年的焦虑现状及其影响因素,以期为后期进行针对性干预提供参考,保护青少年心理健康。方法 于2020年2月13日-19日,以网上问卷的形式采用自编的一般情况调查表、新冠肺炎相关认知调查表以及儿童焦虑性情绪障碍筛查量表（SCARED）对安徽省青少年进行调查,共收回有效问卷973份。结果 焦虑症状检出率为27.13%,其中男性SCARED中的广泛性焦虑评分较全国常模低［（3.31±3.53）分vs.（3.84±3.24）分］,男性社交恐怖评分较全国常模高［（4.35±3.43）分vs.（3.72±2.94）分］,女性躯体化评分［（4.25±4.59）分vs.（3.52±2.74）分］、社交恐怖评分［（5.52±3.55）分vs.（4.17±3.13）分］、学校恐怖评分［（1.18±1.58）分vs.（0.85±1.11）分］以及总评分［（18.99±13.83）分vs.（16.23±9.53）分］均较全国常模高,差异均有统计学意义（P<0.05或0.01）;单因素分析显示,性别、身体健康状况、第一次了解疫情的途径、负面消息占比以及不实信息占比会对焦虑症状检出率造成影响（P<0.05）;二元Logistic回归分析显示,女性（OR=2.04,P<0.01）、身体状况不佳（OR=2.12,P<0.01）、负面消息占比高（OR=4.28,P<0.01）是青少年焦虑的危险因素。结论 新冠肺炎流行期间,安徽省青少年社交恐怖程度普遍较高,其中女性、目前身体状况不佳以及负面信息占比高是其焦虑症状的危险因素。     

医学生焦虑、抑郁情绪对网络游戏障碍的影响：性别的调节作用

目的 探究焦虑、抑郁情绪对医学生网络游戏障碍的影响以及性别在其中的调节效应，为预防和干预医学生网络游戏障碍提供参考。方法 于2021年11月，选取四川省某医学院校11 771名医学生作为研究对象，通过问卷星网络平台，采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和简式网络游戏障碍量表（IGDS9-SF）进行评定，采用多元分层回归分析性别在焦虑、抑郁情绪和网络游戏障碍关系中的调节作用。结果 ①男生SDS评分低于女生（t=-8.302，P<0.01），IGDS9-SF评分高于女生（t=33.384，P<0.01）。②医学生SAS评分与SDS评分呈正相关（r=0.735，P<0.01），SAS和SDS评分与IGDS9-SF评分均呈正相关（r=0.288、0.238，P均<0.01）。③焦虑、抑郁情绪可以正向预测网络游戏障碍（β=0.245、0.058，t=18.864、4.444，P均<0.01）。④性别在焦虑情绪与网络游戏障碍之间具有调节作用（β=-0.194，t=-4.518，P<0.01）。结论 焦虑、抑郁情绪对医学生网络游戏障碍有正向预测作用。焦虑情绪对医学生网络游戏障碍的影响受到性别的调节，相比于女生，焦虑情绪对男生网络游戏障碍的影响更大。     

中医情志护理对脑卒中患者焦虑、抑郁情绪干预效果的Meta分析

目的 系统评价中医情志护理对脑卒中患者焦虑、抑郁情绪的干预效果,为临床应用提供证据支持。方法 计算机检索中英文数据库CNKI、CBM、万方医学网、PubMed、Embase、Web of Science、Cochrane library关于中医情志护理干预脑卒中患者焦虑、抑郁情绪的随机对照试验,各库检索时间均为建库至2020年5月10日。通过对文献进行筛选、资料提取及质量评价后,利用RevMan 5.3进行Meta分析。结果 最终纳入13篇文献,包括1 210例脑卒中患者,其中干预组605例,对照组605例。Meta分析结果显示,干预结束时,中医情志护理干预组抑郁水平低于对照组,差异有统计学意义：抑郁自评量表（SDS）评分（MD=-7.89,95% CI：-13.14~-2.64,P<0.01）,汉密尔顿抑郁量表（HAMD）评分（MD=-4.70,95% CI：-8.48~-0.92,P<0.05）;而焦虑评分方面,中医情志护理干预组焦虑自评量表（SAS）评分低于对照组（MD=-6.65,95% CI：-9.24~-4.06,P<0.01）,差异有统计学意义,中医情志护理干预组汉密尔顿焦虑量表（HAMA）评分低于对照组（MD=-2.06,95% CI：-4.14~0.02,P=0.05）,差异无统计学意义。结论 中医情志护理可能有助于降低脑卒中患者抑郁水平,但对脑卒中患者焦虑水平的改善效果尚不明确。     

新冠肺炎疫情期间农民工焦虑与抑郁状况

目的 调查新冠肺炎（COVID-19）疫情期间农民工焦虑、抑郁状况及其影响因素,为公共卫生事件中农民工心理问题防治提供参考。方法 采用方便抽样法,选择陕西省汉中地区某镇110名农民工为调查对象。采用焦虑自评量表（SAS）和抑郁自评量表（SDS）通过电子版问卷调查农民工群体的焦虑抑郁情况。结果 COVID-19疫情期间,农民工SAS和SDS总评分分别为（44.25±8.77）分、（47.50±10.55）分。焦虑与抑郁症状检出率分别为19.09%、25.45%。焦虑危险因素：未婚（β=-4.152,95% CI：-6.199~-3.352,P<0.01）、月收入低（β=-1.740,95% CI：-2.301~-1.442,P<0.01）、女性（β=5.022,95% CI：3.612~6.256,P=0.034）、低年龄（β=-2.792,95% CI：-3.551~-2.105,P=0.002）、受教育程度初中组SAS总评分低于小学及以下（β=-4.225,95% CI：-2.056~-5.261,P=0.024）,高中组SAS总评分低于小学及以下组（β=-4.612,95% CI：-2.275~5.035,P=0.021）。抑郁危险因素：月收入低（β=-5.406,95% CI：-6.292~-4.520,P<0.01）、女性（β=12.518,95% CI：9.916~15.121,P=0.001）、未开始上班（β=6.192,95% CI：3.695~8.688,P=0.042）、低年龄（β=-3.208,95% CI：-4.324~-2.092,P=0.009）。结论 疫情期间农民工焦虑与抑郁水平较高,农民工焦虑危险因素有未婚、月收入低、女性、低年龄、低受教育程度,抑郁危险因素有月收入低、女性、未开始上班、低年龄。     

新冠肺炎疫情下一线医务人员的情绪特点

目的 了解新冠肺炎疫情下一线医务人员的情绪特点,为制定心理干预方案提供参考。方法 采用横断面研究方法,于2020年1月17日-2月3日向中山大学附属第五医院第一批抗击新冠肺炎的医务人员发放一般状况调查表、状态-特质焦虑自评量表（STAI）、抑郁自评量表（SDS）进行测查,并通过单样本t检验、独立样本t检验、单因素方差分析和协方差分析对其特征进行分析。结果 回收有效问卷248份,有156名医务人员在接触患者或血尿便等标本前进行了测评（未接触组）,92名医务人员在接触过患者或标本后两周内进行了测评（接触组）。结果显示,未接触组的SDS、S-AI、T-AI阳性检出率分别为28.85%、17.95%、5.77%,而接触组分别为18.48%、20.65%、6.52%,两组SDS、S-AI、T-AI阳性检出率差异无统计学意义（P>0.05）。接触组中原感染科医护人员T-AI、SDS评分较未接触组的原感染科医护人员评分低,且差异有统计学意义（P<0.05）。未接触组中女性医务人员S-AI评分为（44.85±11.58）分,接触组中女性医务人员S-AI评分为（45.28±10.97）分,分别与国内正常成人女性常模［（38.97±8.45）分］对比,差异均具有统计学意义（P均<0.01）。结论 面对重大新发传染病时,对原从事传染病防控的感染科专职一线医务人员心理冲击不大,应更关注女性及非感染科一线医务人员的情绪变化。     

安宁疗护精神障碍患者家属的生存质量与需求调查

目的 调查安宁疗护精神障碍患者家属的生存质量与需求状况,旨在为患者创造一个能够更好满足其需求的医疗护理环境。方法 采用方便抽样方法,从德阳市两所精神专科医院连续抽取安宁疗护精神障碍患者的家属共205名。采用世界卫生组织生存质量测定量表简表（WHOQOL-BREF）中文版和重危患者家属需求量表（CCFNI）分别评定患者家属的生存质量和需求情况。结果 患者家属WHOQOL-BREF的生理领域评分为（68.08±9.98）分,心理领域评分为（63.82±9.39）分,社会关系领域评分为（70.73±12.61）分,环境领域评分为（64.24±11.87）分,与国内一般人群相比,除生理领域外,其余领域评分差异均有统计学意义（t=3.066、9.845、16.109,P均<0.01）。CCFNI中,病情保证的需求因子评分为（3.20±0.41）分,信息支持的需求因子评分为（2.86±0.50）分,接近患者的需求因子评分为（2.79±0.46）分,自身舒适的需求因子评分为（2.35±0.47）分,医护人员支持的需求因子评分为（2.60±0.44）分。结论 安宁疗护精神障碍患者家属的生存质量可能高于一般人群,其需求主要集中在病情保证和信息支持两方面。     

磁共振成像液体衰减反转恢复高信号血管征对大脑中动脉急性脑梗死静脉溶栓治疗预后的影响

目的 探讨磁共振成像（MRI）液体衰减反转恢复（FLAIR）高信号血管征（HVS）对大脑中动脉（MCA）急性脑梗死患者静脉溶栓治疗的预后评估。 方法 选取60例静脉溶栓前进行了多模态MRI检查的急性脑梗死患者,回顾性分析其临床和影像学资料。将患者分为A组（HVS阳性,25例）和B组（HVS阴性,35例）。比较两组间临床和影像学特征及其预后情况。 结果 两组间发病至MRI检查时间、MRI检查至静脉溶栓时间及出血转化率的比较差异均无统计学意义（P>0.05）。入院时A组美国国立卫生研究院卒中量表（NIHSS）评分高于B组[（14.14±3.57） 分 vs （10.00±3.43） 分,P<0.001]。A组较B组近端大血管闭塞更多见（84.0% vs 14.3%,P<0.001）。A组溶栓治疗后3个月随访的改良Rankin评分高于B组[（2.80±0.87） 分vs （1.94±0.97） 分,P=0.001]。 结论 HVS阳性的急性脑梗死患者静脉溶栓后3个月预后不佳,近端大血管闭塞与HVS的出现有密切相关性,HSV阳性提示静脉溶栓预后较差。     

Processing of emotional reactivity and emotional memory over sleep

Sleep enhances memories, particularly emotional memories. As such, it has been suggested that sleep deprivation may reduce posttraumatic stress disorder. This presumes that emotional memory consolidation is paralleled by a reduction in emotional reactivity, an association that has not yet been examined. In the present experiment, we used an incidental memory task in humans and obtained valence and arousal ratings during two sessions separated either by 12 h of daytime wake or 12 h including overnight sleep. Recognition accuracy was greater following sleep relative to wake for both negative and neutral pictures. While emotional reactivity to negative pictures was greatly reduced over wake, the negative emotional response was relatively preserved over sleep. Moreover, protection of emotional reactivity was associated with greater time in REM sleep. Recognition accuracy, however, was not associated with REM. Thus, we provide the first evidence that sleep enhances emotional memory while preserving emotional reactivity.     

Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression

The differences in affective status between patients who restrain their negative emotion and those who express negative emotion after being given their breast cancer diagnosis were studied using the Profile of Mood States (POMS) at two sessions: (i) at the first visit to the outpatient surgery clinic, and (ii) immediately after being given the diagnosis of breast cancer. Eighty-seven patients completed the POMS and the Courtauld Emotional Control Scale (CECS) at the first visit to the outpatient surgery clinic at Shiga University of Medical Science Hospital. They also completed the POMS immediately after being given the diagnosis of breast cancer. Breast cancer patients who restrain their negative emotion (n = 8) were highly anxious, depressed and confused after being given the diagnosis compared to breast cancer patients who express negative emotion (n = 8). Emotional distress in benign breast tumor patients was reduced after being given the diagnosis regardless of the trend of emotional inhibition. That is, emotional distress in patients who restrain their emotions was considerably increased compared with that of patients who expressed their emotions when they were faced with a life-threatening disease. These results suggest that it may be therapeutic to advise breast cancer patients to express their negative emotion.     

Feeling emotional: the amygdala links emotional perception and experience

The term ‘emotion’ most commonly denotes a specificphenomenal state, such as the solemn weightiness associatedwith sadness or the lightness of being associated with joy.Human affective neuroscience has begun to pin down the elusiveneuroanatomy of these most experientially prominent of mentalexperiences. One of the brain structures consistently associatedwith emotional functioning is the amygdaloid complex (Phan etal., 2002). Numerous neuroimaging studies have shown the amygdalavaries with emotional experience in both healthy and mood disorderedpopulations, pointing to its central role in emotional phenomenology.One difficulty with this apparent association is that emotionlike cognition is not a     

Schizotypy and emotional memory

Background

Emotional dysfunction is a core feature of psychotic disorders. One expression of such dysfunction is a reduction of the emotion-induced enhancement of memory which is normally found in healthy individuals. Less severe disruption of emotional processing may also be present in individuals prone to ‘unusual’ psychosis-like experiences. In this study we investigate voluntary declarative (i.e. explicit or episodic) emotional memory performance, primarily in relation to positive schizotypy (as measured by the unusual experiences scale of the O-LIFE). The effect of negative schizotypy (introvertive anhedonia scale of the O-LIFE) was also explored. We hypothesized that schizotypal individuals (scoring highly on Unusual Experiences) would show reduced memory enhancement.

Methods

One hundred and two healthy participants viewed a narrated slide-show containing neutral and negative emotional content. They rated the story on a number of affective dimensions and completed a variety of trait measures, including a multi-dimensional measure of schizotypy. Seven days later, a memory test was performed and frequency of involuntary memories related to the slide-show assessed.

Results

The voluntary declarative emotional memory advantage in recall seen in low scorers (25%ile) on unusual experiences was absent in high scorers (75%ile), despite greater subjective fearfulness and emotionality in that group. However, the high scoring group did report experiencing more involuntary memories related to the story. There was no effect of negative schizotypy on declarative emotional memory.

Conclusions

The emotional memory difficulties seen in studies of schizophrenia may extend to those with a vulnerability to positive psychosis-like experiences. This vulnerability may be expressed in both voluntary declarative – as well as involuntary – emotional memory performance.     

父亲情感表达在母亲情感表达与青少年抑郁障碍中的中介作用

目的 探索青少年抑郁障碍父母情感表达的特点.方法 采用一般情况量表、情感表达量表评估35例抑郁障碍青少年和31例健康对照的家庭情况.结果 父亲和母亲情感表达量表(LEE)得分存在共线性(r=0.581,P＜0.001),建立logistics回归模型分析,过高的母亲情感表达(OR:0.950,95％CI:0.920,0.981)或父亲情感表达(OR:0.931,95 ％CI:1.018,1.158)均是青少年抑郁的危险因素,且母亲情感表达可能通过父亲情感表达的完全中介作用对抑郁障碍产生影响.结论 对青少年群体而言,抑郁障碍与父亲及母亲的情感表达有关,母亲情感表达可能通过上调主观感知父亲情感表达增加抑郁风险.     

Hoarding and emotional reactivity: The link between negative emotional reactions and hoarding symptomatology

Hoarding disorder (HD) is characterized by difficulty discarding, clutter, and frequently excessive acquiring. Theories have pointed to intense negative emotional reactions (e.g., sadness) as one factor that may play a critical role in HD's etiology. Preliminary work with an analogue sample indicated that more intense negative emotions following emotional films were linked with greater hoarding symptoms. Symptom provocation imaging studies with HD patients have also found evidence for excessive activation in brain regions implicated in processing emotions. The current study utilized a sample with self-reported serious hoarding difficulties to examine how hoarding symptoms related to both general and hoarding-related emotional reactivity, taking into account the specificity of these relationships. We also examined how two cognitive factors, fear of decision-making and confidence in memory, modified this relationship. 628 participants with self-identified hoarding difficulties completed questionnaires about general emotional reactivity, depression, anxiety, decision-making, and confidence in memory. To assess hoarding-related emotional reactivity, participants reported their emotional reactions when imagining discarding various items. Heightened general emotional reactivity and more intense emotional reactions to imagined discarding were associated with both difficulty discarding and acquisition, but not clutter, controlling for age, gender, and co-occurring mood and anxiety symptoms. Fear of decision-making and confidence in memory interacted with general emotional reactivity to predict hoarding symptoms. These findings provide support for cognitive-behavioral models of hoarding. Experimental research should be conducted to discover whether emotional reactivity increases vulnerability for HD. Future work should also examine whether emotional reactivity should be targeted in interventions for hoarding.