冠心病患者的心理社会因素量表分析

目的研究冠心病患者社会心理因素的特点及影响。方法运用生活事件量表、A型行为量表、多伦多述情障碍量表、抑郁自评量表、焦虑自评量表、应付方式问卷、社会支持问卷,测定48例冠心病患者及50例正常对照组病前遭遇的生活事件、人格特征、应付方式、社会支持、患病后的心身健康状况及其影响因素。结果病例组本次患病前所经历的生活事件频数及紧张值,A型行为评分,消极应付方式评分,抑郁及焦虑分值均显著高于对照组(P<0.01)。积极应付评分,社会支持总分减低(P<0.05和P<0.01)。结论生活事件紧张总值、A型行为和抑郁是冠心病的危险因素,而积极应付方式和社会支持为疾病的保护因子。冠心病患者具有特殊的心理社会特征和心身共病状况,应采取积极的社会心理干预措施。     

接受冠状动脉支架置入治疗者的心理状态分析

目的：探讨冠状动脉粥样硬化性心脏病(简称冠心病)患者接受冠状动脉支架置入前后焦虑、抑郁水平。 方法：汇总文献分析冠心病患者发生抑郁、焦虑情绪障碍机制。临床验证病例选择2008-03/12住院接受冠状动脉内支架置入治疗的冠心病患者61例为研究组,同时期选择与患者相匹配的新乡市某区居民61例为对照组,由经过培训的心理工作人员对研究组于手术前后1周内进行焦虑自评量表、抑郁自评量表调查。 结果：早期的研究提出了抑郁对冠心病可能存在的影响机制,包括行为因素如患者对治疗的依从性差等和生理因素如心律失常等。近期又提出了一些新的生理机制,如心脏自主神经功能改变、炎症过程、血栓形成、内皮功能障碍、遗传因素等。冠心病患者的焦虑情绪障碍发生机制十分复杂,目前认为与遗传、行为类型、环境因素等有关。临床验证结果：研究组手术前焦虑自评量表、抑郁自评量表评分均高于对照组第1次评分(P < 0.01)。研究组手术后焦虑自评量表、抑郁自评量表得分与手术前比较,差异无显著性意义(P > 0.05)。对照组第2次焦虑自评量表、抑郁自评量表得分与第1次比较,差异无显著性意义(P > 0.05)。 结论：冠状动脉支架治疗者焦虑、抑郁情绪明显。在接受支架置入治疗时,还要积极配合心理社会干预,帮助患者改善焦虑、抑郁情绪,以促进其疾病康复,提高生活质量。     

新型冠状病毒肺炎病人康复早期心理应激状态调查及影响因素分析

目的 探讨新型冠状病毒肺炎（COVID-19）病人康复早期心理应激状态及其影响因素。方法 以2020年3月1日至2020年3月14日由专科医院治愈出院并转入我院隔离观察病房的COVID-19康复者126例为研究对象,通过网络问卷调查采集心理学信息,问卷包含创伤后应激障碍自评量表（PTSD-SS）、抑郁自评量表和焦虑自评量表。采用多元线性回归分析检验影响因素。结果 126例PTSD-SS评分平均（45.5±18.9）分,39例（31.0%）存在应激障碍;创伤性再体验评分平均（15.4±6.8）分,52例（41.3%）有反复重现体验症状;回避症状评分平均（11.9±5.7）分,35例（27.8%）存在回避症状;警觉性增高评分平均（11.3±5.0）分,51例（40.5%）警觉性增高。28例（22.2%）有焦虑情绪,48例（38.1%）有抑郁情绪。多因素线性回归分析发现,退休、心理支持与PTSD-SS评分及其三个症状评分呈显著负相关（P<0.05）,女性、焦虑情绪与PTSD-SS评分及其三个症状评分呈显著正相关（P<0.05）,抑郁情绪与警觉性增高评分呈显著正相关（P<0.05）。结论 近1/3的COVID-19病人康复早期存在应激障碍,女性、未退休、缺乏心理支持、存在焦虑抑郁情绪这四大类人群应激障碍症状尤为严重,建议所有康复病人定期接受心理评估     

冠心病的社会心理因素分析

目的:研究冠心病患者社会心理因素的特点及影响因素。方法:运用生活事件量表(LES)、A型行为量表(TABPSQ)、多伦多述情障碍量表(TAS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)、应付方式问卷(CS)、社会支持问卷(SSS),测定48例冠心病患者(患者组)病前遭遇的生活事件、人格特征、应付方式、社会支持、患病后的心身健康状况及其影响因素,以50名正常健康者为对照。结果:患者组本次患病前经历的生活事件频数及紧张值:TABPSQ评分,消极应付方式评分:抑郁及焦虑分值均显著高于对照组(P均<0.05)。CS的积极应付评分,社会支持总分减低(P<0.05)。家族史、生活事件紧张总值、A型行为和抑郁为冠心病的危险因素,积极应付方式和社会支持为疾病的保护因子。结论:冠心病患者有特殊的心理社会特征和心身健康状况,应采取积极的社会心理干预措施。     

中青年冠心病患者冠脉介入治疗后心理状态及影响因素

目的分析中青年冠心病患者冠脉介入(PCI)治疗后的心理状态及影响因素。方法以2017年11月～2019年10月为时间段,选择我院收治的200例PCI术治疗的中青年冠心病患者作为研究对象,调查患者术后的心理状态,分析影响因素。结果第一,调查显示,200例患者中,103例(51.5%)有焦虑,41例有抑郁(20.5%)。第二,单因素分析显示,中青年冠心病PCI术后并发焦虑、抑郁与社会人际关系、并发症、医疗费用来源、病程有关。第三,Logistic回归多因素分析显示:社会人际关系、并发症与病程是引起中青年冠心病PCI术后患者焦虑、抑郁的危险因素。结论中青年冠心病PCI术后,伴有明显的情绪问题,且影响因素较多,如并发症和社会人际关系差等,需引起重视。     

老年脑胶质瘤患者术后心理状况及影响因素

目的：观察老年脑胶质瘤患者术后心理状况,分析影响因素。方法选择我院2012‐02—2014‐02收治的75例脑胶质瘤患者,采用焦虑自评量表（SAS）与抑郁自评量表（SDS）交由患者自评,自制焦虑、抑郁因素分析表,对引起患者不良情绪的因素进行汇总、分析。结果多数患者有焦虑、抑郁症状,不良心理情绪影响因素依次为：治疗效果、治疗费用、家庭支持不足、自理能力下降、死亡威胁、医护人员技术水平、生活受影响、社会支持不足及术后不良反应。结论多数老年脑胶质瘤患者术后会出现焦虑、抑郁症状,对治疗效果的担忧表现比例最高,给予针对性心理干预,可以改善不良情绪反应,提高生存质量。     

冠心病患者焦虑抑郁情绪及影响因素分析

目的调查分析冠心病患者焦虑与抑郁患病情况及其相关的影响因素。方法收集心内科确诊的冠心病患者64例,采用一般情况调查表、焦虑自评表、特质应对方式问卷表、抑郁自评量表和社会支持评定量问卷进行测评并对结果进行分析。结果本组64例患者中焦虑患者24例(37.5%),男13例,女11例;抑郁患者40例(62.5%),同时存在焦虑及抑郁患者23例(35.9%),男12例,女11例。男女抑郁与焦虑的患病率差异具有统计学意义。积极应对(P<0.01)与焦虑呈正相关。结论冠心病患者普遍存在焦虑和抑郁情绪,是影响抑郁焦虑情绪的主要因素,积极应对与抑郁焦虑呈正相关。     

咽异感症患者心理状态的临床研究

目的　探讨咽异感症患者的个性特征和临床心理状态。方法　采用艾森克个性问卷、症状自评量表、汉密顿抑郁量表、汉密顿焦虑量表对门诊咽异感症 5 1例 ,健康对照组 3 0例评定比较。结果　发现咽异感症患者个性以情绪不稳定 ,精神质及神经质多见 ,心理状态以焦虑、抑郁、躯体化症状为主 ,伴有强迫、恐怖、敌对、偏执、认识障碍、迟缓、睡眠障碍等。结论　咽异感症有复杂的心理症状 ,提示心理干预对防治有重要意义。     

耐药性肺结核患者负性情绪的危险因素分析

目的研究耐药性肺结核患者负性情绪的危险因素。方法纳入90例耐药性肺结核患者作为研究对象,采用医院焦虑抑郁量表(HADS)调查耐药性肺结核患者负性情绪现状,比较负性情绪患者与非负性情绪患者基本资料和病理指标,分析耐药性肺结核患者负性情绪的高危因素。结果 90例耐药性肺结核患者HADS评分为(12.46±6.28)分。有负性情绪者38例,占42.22%,平均(14.39±3.05)分,其中轻中度共35例,占92.11%。Logistic多因素分析显示文化程度、咯血、日常活动能力、社会支持及肺功能是影响耐药性肺结核患者负性情绪的独立因素(P0.05)。结论负性情绪在耐药性肺结核患者中较为常见,以轻中度为主,文化程度、咯血症状、日常生活能力、社会支持状态及肺功能是影响患者负性情绪的独立因素。     

心理社会因素在脑卒中发病中的作用研究现状

现已知心理社会因素是高血压、冠心病的重要危险因素之一,有焦虑、抑郁、紧张和恐惧等情绪障碍、负性生活事件多发和A型行为者,高血压、冠心病发病率较高。近年来研究发现,心理社会因素也是脑卒中发病的危险因素之一。现就心理社会因素对脑卒中发病的影响及其作用机制作一综述。     

Alexithymia in patients with coronary heart disease

OBJECTIVE: The aim of this study was to investigate factors associated with alexithymia in patients (n=153) with coronary heart disease (CHD) verified by coronary angiography. METHOD: Self-rated depression was assessed using 21-item Beck Depression Inventory (BDI) and other psychiatric symptoms with Symptom Check List-90 (SCL-90). Life satisfaction was assessed using a separate scale. The Structured Clinical Interview (SCID I and II) for DSM-III-R was used to identify mental disorders. Assessments took place 1 day before angiography. RESULTS: Twenty-one percent of CHD patients (n=32) were assessed as being alexithymic according to the Toronto Alexithymia Scale (TAS-20). Alexithymics were more often blue-collar workers, incapable of working, dissatisfied with life, and depressed than the other CHD patients. Occurrences of mental disorders were not associated with alexithymia. Logistic regression analysis revealed that factors independently associated with alexithymia were currently or previously being a blue-collar worker (adjusted odds ratio, AOR: 4.8), self-rated depression (AOR: 3.2), and dissatisfaction with life (AOR: 2.9). CONCLUSION: In CHD patients alexithymia was unrelated to cardiovascular risk factors or exercise capacity but was related to self-rated depression and decreased life satisfaction. Alexithymia is associated with the enhanced psychosocial burden of suffering CHD. This patient group may need more individual support and attention than other CHD patients.     

躯体化症状为主抑郁症患者的述情障碍

目的:探讨以躯体化症状为主抑郁症患者和以情绪症状为主抑郁症患者述情障碍的差异。方法:50例以躯体化症状为主抑郁症患者(躯体症状组)、50例以情绪症状为主抑郁症患者(情绪症状组)和50名正常健康者(正常对照组)参加研究,采用90项症状自评量表(SCL-90)、汉密尔顿抑郁量表(HAMD)和多伦多述情障碍量表进行评定。结果:躯体症状组SCL-90总分、躯体化、焦虑、人际敏感、恐怖、偏执因子分及HAMD的焦虑/躯体化因子评分均高于情绪症状组(P<0.01或P<0.05),情绪症状组在强迫、抑郁因子评分及HAMD的认知障碍、阻滞、日夜变化、睡眠障碍及绝望因子分高于躯体症状组(P<0.05或P<0.01)。躯体症状组与情绪症状组仅在述情障碍因子II评分差异有统计学意义(P<0.05),而在述情障碍总分及因子分上均高于正常对照组(P<0.05或P<0.001)。结论:以躯体化症状为主和以情绪症状为主抑郁症患者均存在述情障碍,以前者更缺乏识别情绪和躯体感受能力。     

Emotional responses to psychosocial stress in schizophrenia: the role of individual differences in affective traits and coping

Despite the well-established association between psychosocial stress and symptom exacerbation in schizophrenia, factors that account for variability in stress reactivity among individuals with this disorder are unknown. This study examined the association between affective traits, coping style, and neurocognitive functioning and subjective emotional responses during putatively stressful social interactions among individuals with schizophrenia. Self-reported mood was assessed in male schizophrenia outpatients (n=36) and matched nonpsychiatric controls (n=15) during a role-play test (RPT) comprised of simulated social encounters requiring assertive or affiliative skills. During the RPT, schizophrenia patients and controls reported similar elevations in negative mood and decreases in positive mood as compared to baseline mood during assertion scenes. Affiliation scenes resulted only in similar decreases in positive mood across groups as compared to baseline mood. Among schizophrenia patients, trait negative affectivity (NA) and maladaptive coping style accounted for one quarter of the variance in negative mood during the assertion RPTs, and these relationships held after controlling for baseline mood, clinical symptoms, and neurocognitive functioning. Results provide preliminary support for the validity of the social RPT as a paradigm for examining psychosocial stress in schizophrenia and suggest that trait negative affectivity and maladaptive coping are associated with individual differences in emotional responses to psychosocial stressors in schizophrenia.     

Illness perceptions in coronary heart disease. Sociodemographic, illness-related, and psychosocial correlates

OBJECTIVES: This study examined illness perceptions (IP) and their correlates in coronary heart disease (CHD). METHODS: The sample of the questionnaire study (n = 3130 at baseline and n = 2745 at 1-year follow-up, aged 45-74 years) was drawn from the drug reimbursement register, which covers persons with various drug-treated conditions. Independent variables were CHD severity and history, vicarious experiences, and psychosocial resources. RESULTS: Men attributed their CHD more often to risk behaviours and internal factors (own attitude/behaviour), while women perceived stress as the cause of their CHD more often. Women also perceived more symptoms associated with CHD but reported less severe consequences. CHD severity was the most important correlate of IP and also predicted change in IP at the follow-up. Stronger perceived competence was related to weaker illness identity, stronger control/cure, and less severe consequences. CONCLUSIONS: Although disease-related factors are powerful correlates of CHD-related illness cognitions, also social and psychosocial factors are related to IP.     

Psychiatric manifestations accompanying interferon therapy for patients with chronic hepatitis C: An overview of cases in Japan

Abstract  Thirty case reports published in Japan that refer to psychiatric symptoms accompanying interferon (IFN) therapy were examined. These papers covered a total of 49 cases. We categorized these 49 cases into 35 cases of mood disorder, 10 of delirium and four of psychotic disorder. The key findings of our study of these cases are as follows: (i) in total, 11 patients had psychiatric past histories: five patients in the mood disorders group were susceptible to the influence of social or psychological factors; (ii) whereas the symptoms of mood disorder or delirium appeared soon after IFN was administered, the symptoms of psychotic disorders appeared later. The patients with delirium displayed many neurological abnormalities, which were reduced by suspending IFN therapy. This suggests the neurological toxicity of IFN; (iii) the outcome of most patients was good; and (iv) we suspect that IFN-induced psychiatric symptoms other than delirium are connected with psychoneuroimmunological functions.     

癫(疒间)患者焦虑抑郁情绪研究

目的:探讨癫(疒间)患者焦虑抑郁情绪的有关因素. 方法:80例成年癫疒间患者,前期诊疗不规范,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估. 结果:癫疒间合并焦虑情绪者25%,合并抑郁情绪者45%.多因素回归分析结果显示,病程越长,发作程度越严重,男性患者更易产生焦虑情绪,而居住在农村的癫疒间患者更易产生抑郁情绪. 结论:癫疒间患者焦虑抑郁情绪明显高于正常人群,性别、病程、发作严重程度和生活居住地是影响癫疒间患者焦虑抑郁情绪的独立危险因素.     

Differences in quality of life domains and psychopathologic and psychosocial factors in psychiatric patients

BACKGROUND: Although treatment of severe mental disorders should strive to optimize quality of life (QOL) for the individual patient, little is known about variations in QOL domains and related psychopathologic and psychosocial factors in patients suffering from schizophrenia, schizoaffective disorder, and/or mood disorders. We hypothesized that QOL in severe mental disorder patients would have a more substantial relationship with psychosocial factors than with illness-associated factors. METHOD: A case-control, cross-sectional design was used to examine QOL of 210 inpatients who met DSM-IV criteria for a severe mental disorder and who were consecutively admitted to closed, open, and rehabilitation wards. Following psychiatric examination, 210 inpatients were assessed using standardized self-report measures of QOL, insight, medication side effects, psychological distress, self-esteem, self-efficacy, coping, expressed emotion, and social support. QOL ratings for patients and a matched control group (175 nonpatients) were compared. Regression and factor analyses were used to compare multidimensional variables between patients with schizophrenia and schizoaffective and mood disorders. RESULTS: In all QOL domains, patients were less satisfied than nonpatient controls. Patients with schizophrenia reported less satisfaction with social relationships and medication when compared with patients with schizoaffective and/or mood disorders. Regression analysis established differential clusters of predictors for each group of patients and for various domains of QOL. On the basis of the results of factor analysis, we propose a distress protection model to enhance life satisfaction for severe mental disorder patients. CONCLUSION: Psychosocial factors rather than psychopathologic symptoms affect subjective QOL of hospitalized patients with severe mental disorders. The findings enable better understanding of the combining effects of psychopathology and psychosocial factors on subjective life satisfaction and highlight targets for more effective intervention and rehabilitation.     

Psychosocial functioning and physical symptoms in heart failure patients: a within-individual approach

OBJECTIVE: Heart failure (HF) markedly diminishes an individual's quality of life. However, little is known about how psychosocial functioning is related to heart failure physical symptom expression (e.g., chest pain or heaviness, shortness of breath) on a day-to-day basis. METHODS: Fifty-eight HF patients completed daily diaries that evaluated mood, social support, coping, and physical symptoms for 2 weeks. RESULTS: After being prewhitened for serial dependencies, the data were entered into regression analyses to determine the concurrent and lagged relationships among them. Significant concurrent relationships were obtained between physical symptoms and depression, social conflict, positive and negative mood, and symptom-focused coping. Furthermore, negative mood and distraction coping predicted greater physical symptoms the next day, while action/acceptance coping predicted fewer physical symptoms the next day. CONCLUSION: Our data provide evidence for an association between daily psychosocial functioning and HF physical symptoms. Implications for research and clinical work with HF patients are discussed.     

Clinical presentation of anxiety among patients with epilepsy

Different factors have been related with interictal anxiety, reported in 10%–25% of patients with epilepsy. We determined the frequency of interictal anxiety in 196 patients with active epilepsy in a cross-sectional survey to know which symptoms of anxiety were most frequently reported in patients with epilepsy and to analyze the factors associated with their presence. Patients were assessed with the Beck Depression Inventory (BDI), Montgomery-Asberg Depression Rating Scale (MADRS), and the Hamilton Anxiety Scale (HAMA). Data were analyzed with a logistic regression model. The HAMA ratings revealed that 38.8% experienced significant anxiety symptoms, as defined by a rating above 18 points. Use of primidone, depression, cryptogenic, and posttraumatic etiologies significantly predicted anxiety after logistic regression. Symptoms related to higher scores on HAMA were anxious mood, tension, insomnia, intellectual function, depressed mood, cardiovascular and genitourinary symptoms. Further studies should be performed to define the role of psychosocial factors in the development and evolution of anxiety among these patients.     

Mindfulness-based cognitive therapy for nonremitted patients with bipolar disorder

Introduction: Bipolar disorder is characterized by recurrent episodes of depression and/or mania along with interepisodic mood symptoms that interfere with psychosocial functioning. Despite periods of symptomatic recovery, many individuals with bipolar disorder continue to experience substantial residual mood symptoms that often lead to the recurrence of mood episodes. Aims: This study explored whether a new mindfulness‐based cognitive therapy (MBCT) for bipolar disorder would increase mindfulness, reduce residual mood symptoms, and increase emotion‐regulation abilities, psychological well‐being, positive affect, and psychosocial functioning. Following a baseline clinical assessment, 12 individuals with DSM‐IV bipolar disorder were treated with 12 group sessions of MBCT. Results: At the end of treatment, as well as at the 3 months follow‐up, participants showed increased mindfulness, lower residual depressive mood symptoms, less attentional difficulties, and increased emotion‐regulation abilities, psychological well‐being, positive affect, and psychosocial functioning. Conclusions: These findings suggest that treating residual mood symptoms with MBCT may be another avenue to improving mood, emotion regulation, well‐being, and functioning in individuals with bipolar disorder.