围产期抑郁、焦虑的现况调查

目的 了解围产期孕产妇伴有焦虑、抑郁症状的状况,为孕产妇的心理保健工作提供科学依据.方法 选取2012年5月～2014年4月到昆明市妇幼保健院产前门诊的就诊孕28周的孕妇共968例作为调查对象,采用爱丁堡产后抑郁量表(EPDS)、焦虑自评量表(SAS)、生活质量评定量表(SF-12)对其孕28周、孕36周及产后1个月的情绪及生活质量进行评估.结果 孕28周、孕36周及产后1月有抑郁症状的孕妇分别为25.4％,24.5％和15.9％,有焦虑症状的孕妇分别为6.6％,7.9％及7.5％,随着时间推移孕妇的生活质量总体呈上升趋势.结论 抑郁、焦虑是孕产妇常见的心理障碍,建议在有条件的产前门诊开展心理健康的筛查,最大限度的保护母婴身心健康.     

重症抑郁障碍的结构性磁共振影像学研究进展

重症抑郁障碍（MDD）是一种以持续情感低落、思维迟缓、意志减退为主要临床特征的精神障碍,通常伴有认知功能障碍和躯体症状。     

重症抑郁障碍的结构性磁共振影像学研究进展

重症抑郁障碍(MDD)是一种以持续情感低落、思维迟缓、意志减退为主要临床特征的精神障碍,通常伴有认知功能障碍和躯体症状。1980年,美国精神障碍诊断与统计手册第3版(DSM-Ⅲ)开始采用"major depressive disorder"作为临床抑郁症的正规命名,以描述该症候群作为一种情感障碍的主要特征;而通用名词"depression"也兼指其他心理性抑郁障碍。重症抑郁障碍在所有精神障碍中的患病率最高,通常在青壮年发病,多为慢性迁延病程,易     

围产期心身障碍相关研究进展

本综述论述了围产期心身障碍的病因及发病机制，围产期心身障碍的防治应更多注意社会因素、心理因素、生物学因素的综合作用，精神药物治疗决不是禁忌。     

保胎孕妇与围产期抑郁症发生的相关性分析

目的调查保胎孕妇与孕期顺利孕妇围产期抑郁症的发病情况,探讨保胎对围产期抑郁症的发病影响。方法回顾分析2011-01—2013-06在我院围保并分娩的800例单胎足月初产妇,按孕期有无保胎分为2组,组1(非保胎),组2(保胎),分析保胎对围产期抑郁症影响,采用爱丁堡产后抑郁量表进行调查问卷,采用统计软件进行分析。结果孕期保胎孕妇产前抑郁发生率与孕期顺利孕妇产前抑郁发生率无明显差异(P0.05)。孕期保胎孕妇产后抑郁发生率明显高于孕期顺利孕妇产后抑郁发生率,差异有统计学意义(P0.01)。结论做好围产期保健工作降低孕期保胎率能有效降低产后抑郁症发生。如孕期已进行保胎,孕期及产褥期注意加强心理监护及进行有效的心理疏导有望降低产后抑郁症的发生。     

围产期心身障碍相关研究进展

本综述论述了围产期心身障碍的病因及发病机制 ,围产期心身障碍的防治应更多注意社会因素、心理因素、生物学因素的综合作用 ,精神药物治疗决不是禁忌。     

老年糖尿病共病抑郁的研究进展

糖尿病是一种慢性疾病,病程长、治疗难度大,易并发多种情绪障碍,特别是抑郁。当糖尿病与抑郁共病时,会使疾病治疗难度增加,致残率升高,特别是对于老年糖尿病患者,共病抑郁的现象非常常见。本文总结了老年糖尿病共病抑郁的现状、潜在机制、临床表现及糖尿病共病抑郁的最佳治疗策略,为老年糖尿病共病抑郁的医疗管理及后续相关研究提供参考。     

癫痫伴抑郁的研究进展

目的抑郁症是最常见的癫痫伴随精神症状,约影响1/3的癫痫患者。长久以来,人们认为抑郁症只是癫痫的潜在伴随症状,然而,近十年来大量研究发现这两种疾病有着相同的神经生物学致病机制。抑郁症被认为是导致癫痫病人生活质量降低最重要的因素之一,甚至超过了癫痫频繁发作和难治性癫痫对病人生活质量的影响。本文将从癫痫伴抑郁的发病机制、病灶部位与治疗等各个方面的最新研究进展进行综述。     

糖尿病抑郁综合征的研究进展

本文就糖尿病抑郁症的共病机制、糖尿病与抑郁症的关系、糖尿病合并抑郁症的药物治疗和心理治疗进行如下综述。     

抑郁症病因的神经内分泌学研究进展

抑郁症病因的神经内分泌学研究进展袁浩龙为探讨抑郁症病因，近十年来的神经内分泌学研究进展迅速，主要研究手段是通过若干神经内分泌试验来检测各种受体功能；当然，抗抑郁剂对激素及神经传递的影响，也是抑郁症病因学研究不可缺少的一部份。为使同道对这一领域内的研究...     

Endocrine factors in the etiology of postpartum depression

This article reviews the literature regarding endocrine factors postulated or presumed to be relevant in postpartum depression (PPD), a condition affecting at least 10% of childbearing women. The phenomenology and epidemiology of PPD are also described. Data suggest that parturition-related endocrine changes are causally implicated in PPD in a vulnerable subgroup of women. More specifically, studies by our group and others suggest a role for changes in estradiol and progesterone in precipitating mood symptoms among women with PPD. The mechanisms underlying such differential sensitivities remain undetermined. Future directions for research are explored.     

Bacterial meningitis as an etiology of perinatal cerebral infarction

Despite significant improvement in mortality rate, survivors of neonatal bacterial meningitis experience a significant incidence of neurodevelopmental sequelae. Neuropathologic studies have demonstrated vasculitis, arachnoiditis, and ventriculitis with secondary edema and encephalomalacia. Areas of cerebral infarction, most commonly thought to be venous in origin, have been reported as well. We performed cranial computed tomographic scans on all eight neonates with bacterial meningitis admitted to our Newborn Special Care Unit within the past 36 months and demonstrated abnormalities in seven. Six of these infants were found to have large areas of infarction related primarily to major arterial vascular distributions. We suggest computed tomographic studies for all neonates with bacterial meningitis and subsequent scans at 4-6 months of age in those with abnormal neonatal scans in order to plan better for early intervention services.     

关于抑郁症自杀风险因素及其评估的研究进展

<正>每年全世界都会有上百万的人发生自杀。自杀行为(Suicidal behavior,SB)并不是一个简单的行为,而是从最轻微的只存在自杀意念到最严重的自杀死亡的一个连续谱。Bruffaerts等[1]在研究中建立了自杀模型,根据访谈结果判断划分为只存在自杀意念、有自杀计划、未计划的自杀尝试和有计划的自杀尝试四个类别。近年来自杀问题虽然受到了社会各界的关注,各部门也在积极努力采取措施预测     

Hypothalamic-pituitary-adrenal axis function during perinatal depression

Abnormal function of the hypothalamic-pituitary-adrenal (HPA) axis is an important pathological finding in pregnant women exhibiting major depressive disorder. They show high levels of cortisol pro-inflammatory cytokines, hypothalamic-pituitary peptide hormones and catecholamines, along with low dehydroepiandrosterone levels in plasma. During pregnancy, the TH2 balance together with the immune system and placental factors play crucial roles in the development of the fetal allograft to full term. These factors, when altered, may generate a persistent dysfunction of the HPA axis that may lead to an overt transfer of cortisol and toxicity to the fetus at the expense of reduced activity of placental 11β-hydroxysteroid dehydrogenase type 2. Epigenetic modifications also may contribute to the dysregulation of the HPA axis. Affective disorders in pregnant women should be taken seriously, and therapies focused on preventing the deleterious effects of stressors should be implemented to promote the welfare of both mother and baby.     

Non-psychiatric therapeutic medications in the etiology of organic depression

Medication-induced depression is classified by DSM-IIIR as organic mood disorder of the depressed type. Unfortunately, there is little consensus in the psychiatric literature regarding which medications are capable of inducing an organic mood disorder. Nor do estimates exist for the prevalence of organic mood disorders. In fact, the existing literature about medication induced depression consists mostly of case reports. Nevertheless, the etiology of organic depression is an important clinical issue, and one deserving of systematic study. In this paper, some of the methodologic issues related to research in this area are reviewed. Meta-analysis is proposed as a useful strategy for the study of some aspects of organic depression. The application of meta-analysis is illustrated with studies investigating the relationship between propranolol, methyldopa, clonidine and depression.     

Early prediction of neurologic outcome after perinatal depression

Evaluation is presented of whether or not a detailed neuromotor examination at 3 months of age could predict later neurologic abnormalities among term infants with perinatal depression. In a prospective cohort, infants were neurologically evaluated at 3 and 12 months. Infants were scored from 0 to 5 according to a new neuromotor scoring system. The neuromotor score at 3 months (NMS-3) was compared with the NMS at 12 months (NMS-12). Seventy-four infants were enrolled in the study; nine were lost to follow-up, and five died before reaching 1 year. Sixty infants were examined (neurologic abnormalities = 52%, normal = 48% at 1 year). The NMS-3 correlated strongly with the NMS-12 and the results of the 12-month neurologic examination. All infants with a NMS-3 of 5 had neurologic abnormalities at 1 year. Infants with neonatal seizures had a significantly increased risk of developmental abnormalities at 1 year. Eighteen infants exhibited transient abnormalities. Using a simple scoring system, the results of the early neurologic examinations correlated strongly with outcome among term infants with perinatal depression. A subgroup of infants had transient abnormalities. These findings suggest that in term high-risk infants, the 1-year neurologic outcome can be predicted at 3 months of age using these parameters.     

Characteristics of women with different perinatal depression trajectories

Maternal perinatal depression (PND), a common mental disorder with a prevalence of over 10%, is associated with long-term health risks for both mothers and offspring. This study aimed at describing characteristics related to background and lifestyle, pregnancy, delivery, and postpartum of different PND trajectories defined according to the onset of depressive symptoms. Participants were drawn from a large population-based cohort study in Uppsala, Sweden (n = 2,466). Five trajectory groups of depressive symptom onset were created using the Edinburgh Postnatal Depression Scale ≥13 (pregnancy) or ≥12 points (postpartum): (a) healthy (60.6%), (b) pregnancy depression (8.5%), (c) early postpartum onset (10.9%), (d) late postpartum onset (5.4%), and (e) chronic depression (14.6%). In multinomial logistic regressions, the associations between trajectories and the included characteristics were tested using the healthy trajectory as reference. Background characteristics (younger age, lower education, unemployment) were primarily associated with pregnancy depression and chronic depression. Characteristics associated with all PND trajectories were smoking prior to pregnancy, migraine, premenstrual mood symptoms, intimate partner violence, interpersonal trauma, negative delivery expectations, pregnancy nausea, and symphysiolysis. Nulliparity, instrumental delivery, or a negative delivery experience was associated with early postpartum onset. Postpartum factors (e.g., infantile colic, lack of sleep, low partner support, and bonding difficulties) were associated with early and late postpartum onset together with chronic depression. The findings suggest that different PND trajectories have divergent characteristics, which could be used to create individualized treatment options. To find the most predictive characteristics for different PND trajectories, studies with even larger and more diverse samples are warranted.