康复期精神病病人焦虑情绪和应对方式分析

目的：探讨康复期精神病病人的焦虑情绪和应对方式及相互关系，为临床心理干预提供依据。方法：对80例康复期精神病病人应用焦虑自评量表（SAS）及简易应对方式问卷进行调查。结果：病人SAS均分明显高于国内常模，焦虑发生率48．75％，女性及文化程度较低者发生率高；应对方式多为消极应对，积极应对不足；、积极的应对方式与焦虑程度呈负相关，消极的应对方式与焦虑程度呈正相关，结论：应对方式与焦虑程度之间有显著的相关关系，积极应对能降低虚伪程度，应运用社会认知疗法帮助病人调整认知结构，改善应对方式，以减轻其焦虑程度。     

健康教育对肝硬化重度腹水患者焦虑抑郁和生活质量的影响

目的探讨肝硬化腹水患者焦虑、抑郁情绪和生活质量的影响因素,以制订相应健康教育措施。方法采用焦 虑、抑郁量表(SAS、SDS)进行调查,确定影响肝硬化重度腹水患者焦虑、抑郁情绪发生的主要因素,并针对性进行 健康教育;同时采用诺丁汉健康量表(NHP QOL)了解患者的生活质量。结果肝硬化重度腹水患者因职业、文化 程度、经济条件、社会支持的不同,焦虑、抑郁的发生差异有显著性意义(均P<0.05);健康教育后SDS、SAS及 NHP QOL各项评分较教育前显著降低(P<0.01,P<0.05)。结论多种因素可致肝硬化重度腹水患者发生焦虑、 抑郁情绪,健康教育可有效地缓解患者负性情绪,提高其生活质量。     

腹膜透析患者透析前后焦虑抑郁状态变化的影响因素分析

目的：探讨腹膜透析患者在透析1年后焦虑抑郁状态较透析前的变化,并分析影响其变化的因素。方法：本研究共纳入2002年2月～2007年2月新增腹透患者177名。收集患者透析开始时的人口学资料和生化参数。分别于透析前,透析后1年采用Hamilton焦虑抑郁量表评估出焦虑抑郁积分。根据透析后1年和透析前焦虑积分的差值的百分位数,将患者三等分为焦虑程度改善组,不变组和变差组。结果：患者进入透析时年龄（58.7±14.0）岁,39.5%为男性。透析1年后焦虑积分自（12.1±9.4）分下降至（8.4±6.9）分（P〈0.001）,抑郁积分自（9.8±6.1）分下降至（5.9±4.7）分（P〈0.001）。透析1年后焦虑程度加重组的糖尿病比例,明显高于焦虑程度不变和改善组,分别为47.5%和27.1%（P〈0.01）,其中年收入2万以上所占比例明显低于焦虑程度不变和改善组,分别为22.1%和38.9%（P〈0.05）。结论：总的说来腹透患者透析1年后焦虑抑郁程度有所改善。透析1年后焦虑程度加重者糖尿病和经济收入较低者居多。     

PICU患儿家属焦虑状况与应对方式的相关性分析

目的探讨儿童重症监护病房（PICU）患儿家属在患儿住院期间焦虑状况及其应对方式的关系。方法采用焦虑自评量表和应对方式量表对72名患儿家长进行问卷调查。结果患儿家属的焦虑水平高于国内常模（P〈0．05，P〈0．01）：PICU患儿家属常采用积极应对方式。较少采用消极应对方式（P〈0．01）。父亲积极应对评分高于母亲（P〈0．05）；患儿家属的消极应对方式与焦虑呈正相关（P〈0．01）。结论PICU患儿家属存在焦虑情绪．面对应激事件时常采用积极的应对方式，且积极应对方式可缓解其焦虑情绪。     

心理剧治疗对改善癫痫患者焦虑抑郁情绪及应对方式的作用

目的探讨心理剧治疗对改善癫痫患者焦虑、抑郁情绪及应对方式的作用。方法将60例癫痫患者随机均分为观察组和对照组，对照组按常规予抗癫痫药物治疗及一般健康教育；观察组在此基础上，辅以心理剧治疗，4周为1个疗程。采用抑郁自评量表（SDS）、焦虑自评量表（SAS）及应对方式问卷对患者进行治疗效果评定。结果干预后观察组SAS和SDS评分显著低于对照组（均P〈0．05）；不成熟的应对方式（自责、幻想、退避）的评分显著低于对照组（均P〈0．05）。结论心理剧治疗能使癫痫患者较多地使用成熟的应对方式，能改善癫痫患者的负性情绪，提高心理健康水平，是促进癫痫患者神经功能康复的有效方法。     

意外伤害病人的情绪障碍调查及其护理对策

目的探讨意外伤害病人的焦虑、抑郁情绪,为临床护理提供依据.方法应用焦虑自评量表(SAS)、抑郁自评量表(SDS)、应对方式问卷对85例意外伤害病人(观察组)和120例非意外伤害病人(对照组)进行调查.结果观察组病人SAS、SDS均分及焦虑、抑郁症状发生率显著高于对照组(均P＜0.01);积极应对均分显著低于对照组(P＜0.01),消极应对均分显著高于对照组(P＜0.01).结论意外伤害病人存在明显的焦虑和抑郁情绪;应对方式多为消极应对,积极应对不足.应全面评估病人情况、加强健康教育、早期进行心理干预及药物治疗,以缓解意外伤害病人负性情绪,防止消极行为发生.     

长期腹膜透析患者睡眠质量调查

目的：探索长期腹膜透析患者睡眠质量与焦虑、抑郁及各临床指标间的相关性。方法：对25名终末期肾脏疾病腹膜透析患者均使用中文版匹兹堡睡眠质量指数量表（PSQI）、抑郁自评量表（SDS）、汉密尔顿焦虑自评量表（HAMA）进行调查。结果：资料完整的患者共21例,其中PQSI〉5的13例,睡眠质量差的发生率为61.9%;相关分析表明PSQI与焦虑、抑郁得分及年龄正相关,仅焦虑评分与PSQI存在线性回归关系。结论：终末期肾脏疾病腹膜透析患者睡眠质量与焦虑、抑郁及年龄相关,及时抗焦虑、抗抑郁治疗可能有助于改善患者的睡眠质量。     

慢性肾衰竭患者的焦虑、抑郁状态及其相关因素95例分析

目的探讨慢性肾衰竭患者的焦虑、抑郁状态的发生情况及其相关影响因素。方法选择慢性肾衰竭患者95例,分为非透析组（34例）,血液透析12个月以下组（血液透析1组,33例）,血液透析12个月以上组（血液透析2组,28例）,使用焦虑量表（SAS）和抑郁量表（SDS）评估患者的情绪状态。结果性别对于焦虑和抑郁的发生没有影响,相关分析显示抑郁评分和年龄呈正相关。三组的焦虑发生与透析时间之间没有明显相关,血液透析2组与血液透析1组抑郁发生的差异具有统计学意义,同时发现医保患者的抑郁发生率高于自费患者。结论慢性肾衰竭患者的抑郁发生率与医疗费用结构和透析患者的年龄、透析时间有一定程度的相关性。     

综合医院住院患者心理咨询联络护理的实施

目的探讨综合医院住院患者心理咨询联络护理的实施效果。方法将综合医院SAS≥50分或SDS≥53分的65例住院患者按住院时间分为观察组33例和对照组32例。对照组由责任护士给予常规心理护理,观察组由心理咨询联络护士给予心理咨询联络护理,包括宣泄疗法、认知行为疗法、松弛疗法及阳性强化疗法。结果干预后,观察组焦虑、抑郁、消极应对方式得分显著低于对照组,积极应对方式得分显著高于对照组(P0.05,P0.01)。结论综合医院住院患者心理咨询联络护理有利于缓解患者的焦虑、抑郁情绪,增加积极应对策略,减少消极应对策略。     

心理干预对不同妇科疾病患者焦虑抑郁状态的影响

目的探讨心理干预对不同妇科疾病患者焦虑抑郁的影响。方法选取恶性组、切除组、核除组各50例共150例患者，住院期间在常规护理的基础上给予心理支持、松弛训练、内心意象等措施，入院及出院时采用焦虑自评量表（SAS）和抑郁自评量表（SDS）评定患者情绪状态。结果干预后恶性组SAS、SDS较干预前显著降低（P〈0．05，P〈0．01）；切除组、核除组SAS较干预前显著降低（P〈0．05）。结论妇科疾病患者存在明显的焦虑、抑郁状态，针对性心理干预可有效缓解其焦虑、抑郁状态。     

Psychosocial characteristics and coping skills in children maintained on chronic dialysis

Psychosocial character traits and coping skills were examined in 12 children with end-stage renal failure. Six of the children were maintained on in-center hemodialysis and 6 were treated with home peritoneal dialysis. All of the patients felt a lack of ability to control their lives. The incidence of anxiety, depression, and hostility did not appear to vary from a population of healthy adolescents. Personal and social adjustment scores were, on average, on the 20th percentile. Coping skills appeared to be most influenced by the mode of dialysis treatment. Home peritoneal dialysis patients utilized self-reliance as a coping process more often than their counterparts on hemodialysis. We conclude that children maintained on chronic dialysis therapy demonstrate reasonable psychological adjustment with some differences in social and emotional functioning when compared with healthy children, and that the type of treatment chosen may influence the development of certain coping skills.     

Répercussions psychologiques du confinement et de l’épidémie à COVID-19 chez les patients et soignants en hémodialyse en France

IntroductionThe health crisis linked to the COVID-19 epidemic has required lockdown measures in France and changes in practices in dialysis centers. The objective was to assess the depressive and anxiety symptoms during lockdown in hemodialysis patients and their caregivers.MethodsWe sent, during lockdown period, between April and May 2020, self-questionnaires to voluntary subjects (patients and caregivers), treated by hemodialysis or who worked in hemodialysis in one of the 14 participating centers in France. We analyzed their perception of dialysis sessions (beneficial or worrying), their stress level (VAS rated from 0 to 10), their anxiety and depressive symptoms (Hospital anxiety and depression scale). Factors associated with stress, anxiety and depression were analyzed with multiple linear regression models.Results669 patients and 325 caregivers agreed to participate. 70 % of participants found it beneficial to come to dialysis during confinement. The proportions of subjects with a stress level ≥ 6 linked to the epidemic, confinement, fear of contracting COVID-19 and fear of infecting a loved one were respectively 23.9%, 26.2%, 33.4% and 42%. 39.2% presented with certain (13.7%) or doubtful (19.2%) anxious symptoms. 21.2% presented a certain (7.9%) or doubtful (13.3%) depressive symptomatology. Age, gender, history of psychological disorders and perception of dialysis sessions were associated with levels of stress, anxiety and depression.ConclusionDuring the lockdown period, in France, the majority of hemodialysis patients and caregivers found it beneficial to come to dialysis. One in three subjects had anxiety symptoms and one in five subjects had depressive symptoms.     

Serum apelin is associated with affective disorders in peritoneal dialysis patients

Objective: Depression and anxiety are prevalent affective disorders in peritoneal dialysis (PD) patients. Recent research has proposed a potential role of apelinergic system in pathogenesis of depression. The present study aimed to evaluate the frequency of depression and anxiety and their potential relation with serum apelin levels among PD patients.

Methods: A total of 40 PD patients were enrolled into the study. Depressive symptoms and anxiety were assessed with the Beck’s Depression Inventory and the Beck’s Anxiety Inventory. Serum apelin-12 levels were measured by immunoenzymatic assays using commercially available ELISA kit for standard human apelin.

Results: Of the patients, 16 (40%) had depression, 20 (50%) had anxiety. The patients with depression and anxiety had a significantly longer time on dialysis (p?<?0.001 for both), significantly higher serum apelin (p?<?0.001 for both) and C-reactive protein levels (p?<?0.001 for both) than those without depression and anxiety. In multivariate analysis, serum apelin was the only parameter associated independently with depression and anxiety scores.

Conclusions: A substantial number of PD patients had depression and anxiety. Increased levels of serum apelin may constitute a significant independent predictor of development of depression and anxiety in PD patients.     

慢性肾脏病4期以上焦虑和抑郁状态的动态变化

目的分析慢性肾脏病4期、血液透析和腹膜透析患者在1年随访中的焦虑和抑郁状态的变化及原因。方法选择在我科住院并随访的慢性肾脏病4期患者28例（慢性肾脏病4期组）、血液透析患者21例（血液透析组）、腹膜透析患者43例（腹膜透析组）,用Hamilton焦虑和抑郁量表,在0个月（慢性肾脏病4期组在入院时、或血液透析组和腹膜透析组在初始进入透析）、6个月和12个月进行问卷调查。结果选择在我科住院并随访的慢性肾脏病4期患者28例（慢性肾脏病4期组）、血液透析患者21例（血液透析组）、腹膜透析患者43例（腹膜透析组）,用Hamilton焦虑和抑郁量表,在0个月（慢性肾脏病4期组在入院时、或血液透析组和腹膜透析组在初始进入透析）、6个月和12个月进行问卷调查。结果0个月时,Hamilton焦虑和抑郁指数腹膜透析组最高,血液透析组次之,慢性肾脏病4期组患者较轻（P〈0．05）。6个月后,血液透析组的心理问题最重（P〈O．05）,慢性肾脏病4期组和腹膜透析组较轻。12个月后,慢性肾脏病4期组的心理问题较严重,血液透析组次之,腹膜透析组较轻（P〈0．05）。结论慢性肾脏病4期和透析患者焦虑抑郁的发生率较高,其中透析患者更高。随着时间的推移,患者在各时问段的心理状态有一定的变化。     

门诊更年期妇女更年期症状与抑郁焦虑的情况调查

目的调查门诊更年期妇女更年期症状与抑郁焦虑症状的发生情况。方法收集2005年3~5月就诊于本院更年期门诊的130名45~70岁确诊的更年期妇女,满足入选标准后采用一般情况问卷和自评抑郁(SDS)、焦虑量表(SAS)进行调查。结果128例符合入选标准的更年期妇女,抑郁症状的发病率为8.6%,焦虑症状的发病率为11.7%。年龄、文化程度、职业、退休和绝经与否与抑郁、焦虑症状的发生无相关性。更年期症状中,焦躁、心悸和尿频、尿急是更年期抑郁症状的主要危险因素,潮热出汗、眩晕和心悸是更年期焦虑症状的主要危险因素。抑郁症状和焦虑症状之间存在显著相关。结论更年期门诊更年期妇女抑郁、焦虑症状的发生率不高,更年期症状增加了抑郁、焦虑症状的发生危险。抑郁和焦虑症状增加了彼此之间发生的危险性。     

High prevalence of irritable bowel syndrome and upper gastrointestinal symptoms in patients with chronic renal failure

BACKGROUND: Gastrointestinal symptoms and psychiatric disorders are common among patients with chronic renal failure since uremia affects all systems as well as the gastrointestinal tract. Irritable bowel syndrome (IBS) is a frequent functional disorder worldwide. We aimed to evaluate the frequency of IBS and upper gastrointestinal symptoms in patients with chronic renal failure (CRF). The relationships between IBS, sex and additional psychiatric disorders in the same patient group were determined and results were compared with controls. METHODS: Ninety-three hemodialysis (HD) and 35 peritoneal dialysis (PD) patients and 51 healthy volunteers were enrolled in this cross-sectional study. They completed the questionnaires that were later evaluated to determine the frequency of IBS in HD, PD and control groups; the frequency of depression and anxiety in these three groups and their relationship to sex. Symptoms of upper gastrointestinal system and their relation to sex were also investigated in all groups. RESULTS: In this study, we have demonstrated that prevalence of IBS in patients with chronic renal failure on hemodialysis or peritoneal dialysis is higher than the controls though the type of dialysis does not seem to influence the IBS prevalence itself. Epigastric pain was more prevalent in HD patients than PD patients. CONCLUSIONS: The present study suggests that though IBS is common in patients with CRF, it is generally underestimated. Type of dialysis does not seem to change the clinical picture much. Accompanying mood disorders must also be taken into consideration.     

Preoperative depression and mortality in coronary artery bypass surgery: preliminary findings

Background : There is convincing evidence to suggest that depression significantly increases the risk of mortality following myocardial infarction. There are few data concerning depression as a risk factor for mortality following cardiac surgery. The aim of the present observational study was to determine if preoperative depressive symptoms resulted in an increased risk of late mortality following cardiac surgery. Methods : Preoperative assessments of depressive symptoms were performed on 158 patients undergoing coronary artery bypass surgery. Elevated preoperative depression symptoms were defined as a depression anxiety stress scale score of ≥ 10. Results : Twenty‐four of the 158 patients (15.2%) were classified as having elevated preoperative depressive symptoms. Patients were followed for a median of 25 months (range: 4–38 months). Three of the 24 patients (12.5%) with preoperative depressive symptoms died within the follow‐up period, compared with three of the 134 (2.2%) non‐depressed patients (odds ratio: 6.24; 95% CI: 1.18–32.98; P = 0.046). There were no other group differences on variables including population demographics, medical risk factors, surgical parameters, and indices of postoperative morbidity. Conclusions : Elevated depressive symptoms before coronary bypass surgery may be a significant predictor of late death. Prospective studies evaluating the prevalence of depressive symptoms in cardiac surgical patients and their effect on long‐term outcome must be undertaken.     

Psychological profile of Taiwanese interstitial cystitis patients

Objectives:   The correlation between anxiety and interstitial cystitis has, as best we know, not yet been reported on. The present study investigated the psychological profile, including anxiety and depression, of patients suffering from interstitial cystitis (IC).
Methods:   A total of 47 IC patients, all of whom met National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases (NIDDK) criteria, plus a group of 31 age-matched, asymptomatic women received a structured interview on depression (Hamilton Rating Scale for Depression) and also on anxiety symptoms (Hamilton Rating Scale for Anxiety). IC patients also completed questionnaires relating to IC symptom severity, including urgency and frequency (visual analog scale) and O'Leary Sant index.
Results:   A total of 85% of our IC patients featured significant affective symptoms. The average depression scores were 16.6. Fifteen patients (31.9%) featured mild depressive symptoms, five (10.6%) had mild to moderate and 20 (42.6%) had moderate to severe depression symptoms. The mean anxiety score was 21.0, with 21 (44.7%), nine (19.1%) and 17 (36.2%) patients revealing mild, mild to moderate, and moderate to severe anxiety symptoms, respectively. Further, IC patients reported a significantly greater extent of depression and anxiety than was the case for controls. Pain scale and O'Leary Sant index were significantly correlated to anxiety and depression score.
Conclusions:   Most of our IC patients feature significant depression and anxiety. The extent of affective symptoms would appear to correlate well with IC symptom severity.     

The prevalence of anxiety and depression among end-stage renal disease patients on hemodialysis in Saudi Arabia

Depression commonly overlaps with uremic symptoms, but anxiety is less commonly studied among renal patients. The symptoms of medical illness, along with the psychological and social stresses that often accompany a debilitating chronic disease, are thought to produce deleterious psychological consequences. We sought to determine the prevalence and predictors of anxiety and depression among Saudi dialysis patients in Makkah. A cross-sectional study of anxiety and depression among end-stage renal disease (ESRD) patients in Makkah was conducted in November 2011. The Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depression. Participants’ demographic data, possible stressors and past psychiatric history were obtained. All participants were Saudi ESRD patients on maintenance hemodialysis. According to HADS, 57 (21.1%) patients were probable cases of anxiety and 63 (23.3%) were probable cases of depression. Only 32 (11.3%) were diagnosed with depression or anxiety before ESRD onset. Age was a significant predictor of anxiety and depression diagnoses. Major family problems (p?=?0.001) were also a significant predictor of anxiety. Anxiety and depressive symptoms are prevalent among ESRD patients in Makkah, and anxiety can be predicted by family factors. Early detection, management and family support might improve clinical outcomes.     

Screening for depression in hemodialysis patients: associations with diagnosis, treatment, and outcomes in the DOPPS

BACKGROUND: Depressive symptoms and depression are the most frequent psychologic problems reported by hemodialysis patients. We assessed the prevalence of depressive symptoms and physician-diagnosed depression, their variations by country, and associations with treatment by antidepressants among hemodialysis patients. We also assessed whether depressive symptoms were independently associated with mortality, hospitalization, and dialysis withdrawal. METHODS: The sample was represented by 9382 hemodialysis patients randomly selected from dialysis centers of 12 countries enrolled in the Dialysis Outcomes and Practice Patterns Study (DOPPS II). Depressive symptoms were assessed by the short version of the Center for Epidemiological Studies Depression Screening Index (CES-D), using > or =10 CES-D score as the cut-off value. RESULTS: Overall prevalence of physician-diagnosed depression was 13.9%, and percentage of CES-D score > or =10 43.0%. While the smallest prevalence of physician-diagnosed depression was observed in Japan (2.0%) and France (10.6%), the percentage of CES-D score > or =10 in these counties was similar to the whole sample. Patients on antidepressants also varied by country, 34.9% and 17.3% among those with physician-diagnosed depression and CES-D scores > or =10, respectively. In Cox models adjusted for several comorbidities, CES-D scores > or =10 were associated with significantly higher relative risks (RR) of death (RR = 1.42; 95% CI = 1.29 to 1.57), hospitalization (RR = 1.12; 95% CI = 1.03 to 1.22), and dialysis withdrawal (RR = 1.55; 95% CI = 1.29 to 1.85). CONCLUSION: The data suggest that depression is underdiagnosed and undertreated among hemodialysis patients. CES-D can help identify hemodialysis patients who are at higher risk of death and hospitalization. Interventions should target these patients with the goal to improve survival and reduce hospitalizations.