Beta-cell Function and Metabolic Clearance Rate of Glucose in Patients with Major Mental Health Disorders on Antipsychotic Drug Treatment

Background

Insulin resistance and metabolic alteration continue to be essential features of major mental health disorders (MMHD) with poorly understood and multifaceted mechanisms. This study was carried out to provide information on insulin resistance, beta-cell function, metabolic clearance rate of glucose and their possible interplay with duration of antipsychotic use in patients with major mental health disorders.

北京市大学生对心理健康的认知

目的：了解大学生对心理健康的认识状况。方法：采用SCL-90问卷和自编《心理健康知识调查表》，对北京市6所大学共440名大学生的心理健康状况和对心理健康的认知进行了调查。结果：大学生比较关心心理健康和心理健康知识，对于心理健康有一定了解，但是同时也存在着些误区。大学生对于心理健康的认识状况在不同性别、不同年级、不同学校和是否看过心理门诊的大学生之间都存在着一定差异。结论：大学生对于心理健康的认识程度与其心理健康状况之间存在着显著的正相关。     

Mental health diagnosis by nurses using the Global Mental Health Assessment Tool: a validity and feasibility study.

BACKGROUND: The Global Mental Health Assessment Tool-Primary Care Version (GMHAT/PC) has been developed to assist health professionals to make a quick and comprehensive standardised mental health assessment. It has proved to be a reliable and valid tool in a previous study involving GPs. Its use by other health professionals may help in detecting and managing mental disorders in primary care and general health settings. AIM: To assess the feasibility of using a computer-assisted diagnostic interview by nurses and to examine the level of agreement between the GMHAT/PC diagnosis and psychiatrists' clinical diagnosis. DESIGN OF STUDY: Cross-sectional validation study. SETTING: Primary care, general healthcare (cardiac rehabilitation clinic), and community mental healthcare settings. METHOD: A total of 215 patients between the ages of 16 and 75 years were assessed by nurses and psychiatrists in various settings: primary care centre (n = 54), cardiac rehabilitation centre (n = 98), and community mental health clinic (n = 63). The time taken for the interview, and feedback from patients and interviewers were indicators of feasibility, and the kappa coefficient (kappa), sensitivity, and specificity of the GMHAT/PC diagnosis were measures of validity. RESULTS: Mean duration of interview was under 15 minutes. The agreement between nurses' GMHAT/PC interview-based diagnosis and psychiatrists' International Classification of Diseases (ICD)-10 criteria-based clinical diagnosis was 80% (kappa = 0.76, sensitivity = 0.84, specificity = 0.92). CONCLUSION: The GMHAT/PC can assist nurses to make accurate mental health assessment and diagnosis in various healthcare settings and it is acceptable to patients.     

大学新生UPI问卷调查分析

目的了解我校新生心理健康状况．为有效开展心理健康教育、心理咨询和治疗提供参考依据。方法采用UPI对5674名大学新生进行调查。结果新生中12．89％的人可能有较严重的心理问题．26．74％的人可能存在心理健康问题；新生的心理健康状况性别之间没有差异，但女生在躯体、情绪和人际关系方面问题比男生多。结论我校新生的心理健康状况总体良好．但也存在一些具体问题。因此，应针对性开展心理健康教育与咨询活动。     

心理控制感对心理健康水平的影响

目的 :探讨心理控制感对心理健康水平的影响。方法 :采用成人心理内、外控制感量表(ANSLE)及SCL -90和纽芬兰纪念大学幸福度量表 (MUNSH) 2个自评量表对 2 75 1名正常成年人群进行测试及相关分析。结果 :2 75 1名被试在ANSIE量表的均分为 13 2 7± 4 34,中数为 13 ,众数为 12 基本呈正态分布 ,男、女性得分差异无显著性。与心理内控倾向者相比 ,心理倾向于外在控制的人正性情感少 ,负性情感多 ,精神症状多 ,总体心理健康水平低。结论 :不同的心理控制感倾向对心理健康水平会产生重要影响。     

Mental Health Services Outcome Evaluation

There is an urgent need for pertinent outcome information. Relevance for decision makers must take priority over scientific rigor. However, a review of computer-identified outcome evaluation reports from community service settings, during the past 5 years, suggests that much more has been said than has been done. Although relatively heterogeneous in scope, these studies focused on the effects of community support services for adults with persistent and severe mental illness; traditional outpatient services have been neglected. Studies are characterized by multidimensional, standardized outcome assessment, and nonequivalent comparison group and single cohort designs. Randomized designs, with usual services as the control condition, were feasible in some situations. Inadequate sample size and attrition continue to be method problems.     

社区老年人心理健康及相关因素分析

目的：探讨社区老人心理健康水平及影响因素。方法：随机选取杭州市居民区60岁以及以上老人440名，采用纽芬兰主观幸福度量表，SCL－90及生活事件评价调查表，进行问卷调查，了解社区老年人主观幸福感及心理健康水平，并分析影响老年人幸福感及心理健康水平的相关因素，结果：杭州市社区老人自觉幸福，心理健康水平较高，老人的年龄，性别及受教育程度与主观幸福度无关，而社会支持和对生活事件的评价是影响老人心理健康的重要因素。结论：社会支持和对生活事件的评价是影响老人心理健康水平的主要因素。     

Ultrastructural Changes in Erythrocytes in Patients with Mental Disorders

Transmission electron microscopy of peripheral blood erythrocytes from patients with paranoid and residual schizophrenia, mental retardation, and neurotic disturbances revealed nonspecific ultrastructural changes in the membrane and matrix of red blood cells.     

巫术所致精神障碍与癔症性精神障碍的对照分析

目的 :研究巫术所致精神障碍和癔症性精神障碍的临床特征。方法 :将 2 7例巫术所致精神障碍与 3 0例癔症性精神障碍作一临床对照分析。结果 :研究组和对照组的平均发病年龄、病前性格、精神病阳性家族史、起病形式、临床特征、疾病缓解后 2年内的复发率均有明显差别。结论 :两者为不同类型的精神障碍 ,支持CCMD -3。     

老年糖尿病患者心理健康状况的临床研究

目的 :探讨老年糖尿病患者心理健康状况。方法 :本文对 81例老年 型糖尿病患者及其 3 0名健康老年人进行了心理健康状况的评定 (SCL- 90、Zung氏焦虑、抑郁量表及 MMES)。在 81例糖尿病患者中 ,18例接受胰岛素治疗、 3 5例口服药物治疗及 2 8例饮食控制治疗。结果 :胰岛素治疗组和口服药物治疗组的患者心理健康状况明显低于正常对照组 ,饮食控制组心理健康状况良好。简明精神症状检查结果提示 :胰岛素注射和口服药物治疗组的患者存在认知功能障碍。     

The Mental Health of Homeless Children

The literature addressing the mental health of homeless children is critically reviewed. Higher rates of behavioral, emotional, and cognitive problems have been reported for this population, but research results are qualified by significant methodological problems. Minimal attention has been given to the development and evaluation of specific intervention and prevention strategies. Recommendations are made for conducting research that will overcome previous methodological problems and focus more directly on identifying risk and protective mechanisms within the population of children exposed to homelessness.     

管理人员心理健康现状调查

本研究采用症状自评量表（ＳＣＬ－９０），对石家庄几个企业、学校的７３名管理人员进行调查，结果表明，各分量表的同质性信度值均大于０．６０，说明本研究的测量是比较可靠的。在各因子上管理人员与全国成人常模无显著差异，不同性别和不同文化程度的管理人员在各因子上的得分无显著差异，不同年龄组在Ｆ３（人际敏感）、Ｆ５（焦虑）、Ｆ７（恐怖）、Ｆ８（偏执）、Ｆ９（精神病性）因子上，２组（４０≤年龄〈５０）与３组（年龄≥５０）之间存在显著差异，在Ｆ８（偏执）、Ｆ９（精神病性）因子上，１组（年龄〈４０）与３组（年龄≥５０）之间存在显著差异，其它各因子三个年龄组之间均无显著差异。     

职业紧张与高血压发病关系的横切队列研究

目的 :探讨职业紧张与高血压发病之间的关系以及影响因素。方法 :选择不同职业 ,工龄≥ 3年在职男性职工 964名进行横切队列研究 ,应用职业紧张测试表 (OSI)测量职业紧张评分 ,根据职业紧张评分将研究对象分为高、中、低职业紧张暴露组。结果 :( 1)在控制和调整了其它危险因素的情况下 ,职业紧张暴露的危险度增加 (RR =1 7) ,并且随着职业紧张评分增加 ,高血压调整发病密度以及危险性也在增加 ,高、中暴露组高血压的调整发病密度、RR分别为 12 47 千人年、 2 99与 8 81 千人年、 2 11,明显高于内对照组 4 17 千人年 ,差异有显著性 (P <0 0 5 ) ;( 2 )在调整年龄后 ,当工龄 >10年时 ,高、中暴露组高血压发病率明显升高 ,与低暴露组有显著性差异 (P <0 0 1)。结论 :职业紧张与高血压之间存在因果关系 ,职业紧张引起的高血压发病是一种慢性的长期作用结果 ,暴露时间达 10年以上。     

精神障碍患者长期住院多因素分析

目的了解长期住院精神障碍患者的现状,并对有可能造成患者长期住院的多因素进行分析。方法采用自制的长期住院病人调查问卷对我院住院1年以上的72例精神障碍患者进行调查分析。结果长期住院病人中男性比例高于女性,以精神分裂症患者居多,多为反复住院。婚姻状况以单身者（未婚、离异）居多,此类病人病程长,反复发作,预后不理想,缺乏家庭监护和被社会忽略。结论精神病人滞留医院既有自身疾病原因,也有家庭和社会因素。发展以医院为依托的社区和家庭康复治疗既有助于降低医疗成本,又有利于改善康复期精神障碍患者的生活质量。     

北京市大学生心理卫生状况调研

目的：研究分析北京市大学生心理卫生状况。方法：采用精神症状自评量表（SCL－90），通过分层抽样在北京市选取23所高校，测评了有效样本5220个，并进行了比较分析。结果：被试中至少有一个SCL0－90因子的得分大于或等于3分的学生占16．51％，男、女及不同年级学生间比较，均无显著性差异，但这一比例来自农村的学生高于来自城市的学生，且具有显著性差异；总体上，北京市大学生心理卫生水平差于全国常模，但优于国内其他地区大学；女生、二年级学生以及来自县镇和农村学生的心理卫生问题相对较为突出。结论：大学生心理问题不容忽视。     

洛阳地区儿童精神卫生调查

作者根据美国ＤＳＭ－Ⅲ诊断标准和南京神经精神病防治院制订的儿童精神卫生调查表及儿童智力筛选表，随机抽样调查了我区２２所小学，４所幼儿园，２所城市中学１０１４０名儿童（３－６岁１７６０人，７－１２岁７２５５人，１３－１４岁１１２４人）。调查结果：（１）轻微脑功能障碍（ＭＢＤ）５３人，患病率为５．２２％－（３－６岁１人，７－１２岁４７人，１３－１４岁４人），以学龄初期居多。（２）智力发育迟滞１１０人，     

幼儿园儿童心理健康状况干预实验研究

目的：对幼儿园儿童心理问题进行干预研究。方法：通过对山西省某市３所幼儿园中,大班幼儿的心理健康状况进行测查,发现幼儿园儿童在心理健康方面存在一定问题,在基线测查基础上,根据研究目的把３所幼儿园分成干预组和对照组,经统计学检验两组被试的均衡性较好对干预组幼儿的保教人员和家长进行了一学期的干预实验。干预后复测。结果：干预组中班幼儿的心理健康问卷得分明显高于对照组,大班幼儿的得分也有所增高。结论：要促进     

贫困大学生心理健康教育模式的实证研究

目的：探索高校贫困生心理健康教育模式的实施和效果。方法：将贫困生分为干预组（43名）和对照组（37名）,干预组进行了近一年的心理健康教育,开展心理健康讲座、团体辅导、个别辅导、人际交往训练四种教育活动,干预前后分别用五种心理量表进行测试。结果：心理测试各项指标明显降低,心理健康水平显著提高。结论：心理健康教育对贫困大学生心理健康水平改善是有效的。     

Israeli Mental Health Professionals' Attitudes Towards Dissociative Disorders,Reported Incidence and Alternative Diagnoses Considered

Abstract

Clinical diagnoses of dissociative disorders (DDs), including Dissociative Identity Disorder (DID), are controversial because there are mental health professionals in North America and elsewhere who are skeptical about whether these psychiatric disorders actually exist. This paper explores the attitudes of mental health professionals in Israel toward DDs and DID through a survey of 211 practicing clinicians (return rate of 39.5%). Of the sample, 95.5% scored at or above the point on a 5-point Likert scale measuring belief in the validity of DDs (m = 4.17, SD = 0.78); 84.5% declared at least a moderate belief in the validity of DID (M = 3.5, S.D. = 0.97). The average Israeli clinician surveyed had made 4.8 career-long DD diagnoses (S.D. = 18.06) and carried an average of 1.05 DD patients in his/her caseload (S.D. = 2.86). DID had a career-long diagnosis frequency of 0.14 patients per clinician (S.D. = 0.59) and was currently seen at a frequency of 0.03 cases per clinician (S.D. = 0.20). The five most frequently considered alternative diagnoses to DID in Israel were Borderline Personality Disorder (24%), Psychotic Disorder/Schizophrenia (23%), PTSD/Anxiety Disorder (10%), Malingering (8%) and Depressive Disorder (7%). The findings suggest that attitudes of Israeli clinicians are similar to those of North American clinicians despite the geographical and cultural differences between them.     

Effectiveness of a Blended Web-Based Intervention on Return to Work for Sick-Listed Employees With Common Mental Disorders: Results of a Cluster Randomized Controlled Trial

Background

Common mental disorders are strongly associated with long-term sickness absence, which has negative consequences for the individual employee’s quality of life and leads to substantial costs for society. It is important to focus on return to work (RTW) during treatment of sick-listed employees with common mental disorders. Factors such as self-efficacy and the intention to resume work despite having symptoms are important in the RTW process. We developed “E-health module embedded in Collaborative Occupational health care” (ECO) as a blended Web-based intervention with 2 parts: an eHealth module (Return@Work) for the employee aimed at changing cognitions of the employee regarding RTW and a decision aid via email supporting the occupational physician with advice regarding treatment and referral options based on monitoring the employee’s progress during treatment.

Objective

This study evaluated the effect of a blended eHealth intervention (ECO) versus care as usual on time to RTW of sick-listed employees with common mental disorders.

Methods

The study was a 2-armed cluster randomized controlled trial. Employees sick-listed between 4 and 26 weeks with common mental disorder symptoms were recruited by their occupational health service or employer. The employees were followed up to 12 months. The primary outcome measures were time to first RTW (partial or full) and time to full RTW. Secondary outcomes were response and remission of the common mental disorder symptoms (self-assessed).

Results

A total of 220 employees were included: 131 participants were randomized to the ECO intervention and 89 to care as usual (CAU). The duration until first RTW differed significantly between the groups. The median duration was 77.0 (IQR 29.0-152.3) days in the CAU group and 50.0 (IQR 20.8-99.0) days in the ECO group (hazard ratio [HR] 1.390, 95% CI 1.034-1.870, P=.03). No significant difference was found for duration until full RTW. Treatment response of common mental disorder symptoms did not differ significantly between the groups, but at 9 months after baseline significantly more participants in the ECO group achieved remission than in the CAU group (OR 2.228, 95% CI 1.115-4.453, P=.02).

Conclusions

The results of this study showed that in a group of sick-listed employees with common mental disorders, applying the blended eHealth ECO intervention led to faster first RTW and more remission of common mental disorder symptoms than CAU.

Trial Registration

Netherlands Trial Register NTR2108; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2108. (Archived by WebCite at http://www.webcitation.org/6YBSnNx3P).