体外受精-胚胎移植女性孕期焦虑抑郁情绪与妊娠结局的关系

目的:探讨体外受精-胚胎移植(IVF-ET)女性妊娠不同阶段焦虑、抑郁情绪变化及其与妊娠结局的关系。方法:对IVF-ET女性在孕前(进入周期时)、早孕期、中孕期、晚孕期进行焦虑自评量表(SAS)、抑郁自评量表(SDS)问卷调查,分析随访资料完整的88例(IVF-ET组)和同期行孕前检查并于妊娠后定期产检的妇女88例(对照组)的相关资料,比较两组妊娠4个不同时段SAS及SDS评分的情况,以及IVF-ET组不同妊娠结局(胎膜早破、早产、低出生体质量儿、分娩方式)与4个时段中SAS及SDS评分的关系。结果:IVF-ET组的SAS评分在4个不同时段均高于对照组(P0.05),并且IVF-ET组内孕前、早孕期及晚孕期的SAS评分高于中孕期(P0.05);两组在4个不同时段的SDS评分比较,差异均无统计学意义(P0.05)。IVF-ET组中分娩方式为剖宫产的孕妇其在4个不同时段的SAS评分均显著高于阴道分娩孕妇(P0.05),而早产、胎膜早破组、低出生体质量儿中其SAS、SDS评分比较,差异均无统计学意义(P0.05)。结论:行IVF-ET治疗的女性孕前及孕期焦虑的情绪高于正常女性,且焦虑症状在早孕期和晚孕期仍然明显,孕期焦虑可能会导致剖宫产率升高。IVF-ET女性的抑郁情绪变化不显著。     

产妇心理与分娩方式及分娩过程的关系

目的　观察产妇精神状态 (焦虑及抑郁 )与分娩方式、分娩过程及产后出血的关系。　方法　 92例健康无剖宫产指征的单胎初产妇 ,以焦虑自评量表 (SAS)及抑郁自评量表 (SDS)评定精神状态 ,按均分划分 SAS、SDS高分组及低分组。所有产妇以产科常规进行分娩而不进行干预 ,观察其分娩方式、产程及产后出血情况。　结果　 (1) 92例产妇中顺产 80例 ,其中有 8例发生产后出血。(2 )中学文化程度组较大学文化程度组、顺产组较难产组、无产后出血组较产后出血组的 SAS、SDS评分均要低 ,各组间 SAS评分比较的 t值分别为 3.72、3.75、3.0 8,差异有非常显著性 (P<0 .0 1) ,SDS评分比较的 t值分别为 4.0 6 (P<0 .0 1)、2 .5 (P<0 .0 5 )、2 .6 2 (P<0 .0 5 ) ,差异亦有显著性。而SAS高分组产妇的第一、第二产程均较 SAS低分组要长 ,t值分别为 6 .5 3、5 .41,差异有非常显著性(P<0 .0 1)。同样 ,SDS高分组较 SDS低分组产妇的第一、第二产程也要延长 ,t值分别为 3.6 9、2 .6 8,差异亦有非常显著性 (P<0 .0 1)。　结论　焦虑及抑郁状态可增加难产及产后出血的发生率。故可提供有针对性的心理干预以提高产科质量。     

中晚期妊娠情绪焦虑抑郁情况调查及其相关因素分析

目的：调查中晚期妊娠情绪焦虑抑郁发生率与特点,并进行因素分析,为开展防治工作提供借鉴。方法：对接收的280例孕产妇行问卷调查与焦虑、抑郁自测的,行相关性分析。结果：抑郁发生率10.71%、焦虑发生率15.71%,抑郁兼焦虑发生率5.71%,合计率20.71%;同一因素下,受教育年限、孕周、流产史、生产史不同患者抑郁、焦虑、抑郁焦虑发生率差异具有统计学意义（P＜0.05）,受教育年限≤9年、有流产史、孕周＞37周成为独立危险因素,OR危险比分别为1.13、1.53、1.23,差异具有统计学意义（P＜0.05,OR≥1,B＞0）。结论：低文化水平、有流产史、临产孕产妇,发生抑郁与焦虑发生率较高;应密切注意有以上危险指征者孕产妇,给予适当的心理支持。     

心理干预对子宫肌瘤患者术后焦虑情绪的影响

目的:探讨心理干预对子宫肌瘤患者术后焦虑情绪的影响。方法:选择2008年1月至2011年3月入住于江苏省盐城市妇幼保健医院妇产科行手术治疗的356例子宫肌瘤患者为研究对象,采用自编一般情况问卷及焦虑自评量表(SAS)分别于术前和术后3个月对其情绪进行评估。结果:手术前,干预组焦虑得分与未干预组焦虑得分差异无统计学意义(t=0.506,P=0.613);手术后,干预组的得分明显低于未干预组的,两组比较差异有统计学意义(t=-3.195,P=0.002)。结论:心理干预对于子宫肌瘤患者术后焦虑情绪的改善有重要作用。     

心理护理干预对女性血液透析患者焦虑、抑郁的影响

目的探究存在焦虑、抑郁的女性血液透析患者实施心理干预的临床效果。方法本次实验课题研究时间选取2018年10月~2019年6月,研究对象选取为我院进行维持性血液透析的女性患者,按照随机抽取方式将本次实验中的60例患者随机分为两组,一组标为对照组(常规护理),另一组标为实验组(常规干预+心理护理),对所有观察对象干预前与干预后分别进行焦虑自量表(SAS)与抑郁自量表(SDS)进行测试,并进行记录观察。结果干预前实验组SDS和SAS评分与对照组与显著差异(P>0.05);干预后实验组患者优于对照组患者,实验结果评分具有显著差异性(P<0.05)。结论临床心理干预可有效的改善女性血液透析患者的焦虑、抑郁情况,具有较高的应用价值。     

Tourette综合征患儿情绪问题和适应行为及视感知功能研究

目的探讨Tourette综合征(TS)患儿的情绪问题、社会适应能力和视感知功能。 方法采用儿童社交焦虑量表(SAS)、儿童抑郁自评量表(DSRS)、儿童适应行为量表(SAB)和本顿视觉保持测验(BVRT)，对2003年10月至2004年12月武汉市儿童医院收治的48例8~12岁TS患儿的焦虑、抑郁、适应行为和视感知功能进行测试，并与46名正常儿童相比较。 结果TS组的SAS总分和DSRS总分均明显高于对照组儿童(P<0.01)；在SAB测试中，TS组的独立功能因子及社会/自制因子T分明显低于对照组儿童(P<0.01)，而适应行为商和认知功能因子T分与对照组相比差异无显著性意义(P>0.05)；TS组的BVRT测试中所有正确得分及错误得分与对照组相比差异均无显著性意义(P>0.05)。 结论TS患儿存在焦虑、抑郁和社会适应能力低下，其独立生活、社会交往及自制能力差，而视感知功能正常。     

积极心理干预对妊娠期高血压疾病产妇心理弹性和自我效能的影响

目的 探讨积极心理干预对妊娠期高血压疾病产妇心理弹性和自我效能的影响。方法 选取94例妊娠期高血压疾病产妇为研究对象,根据双色球法分为对照组和观察组,每组47例。对照组产妇给予常规护理,观察组产妇在常规护理基础上增加积极心理干预。比较护理前后两组心理弹性水平、自我效能状况、护理满意度及分娩情况。结果 护理前,两组心理弹性得分比较差异无统计学意义（P>0.05）;护理后,观察组心理弹性3个维度评分均高于对照组,差异均有统计学意义（P<0.05）。护理前,两组自我效能得分比较差异无统计学意义（P>0.05）;护理后,观察组自我效能得分高于对照组,差异有统计学意义（P<0.05）。观察组护理满意度为97.87%,高于对照组的82.98%,差异有统计学意义（P<0.05）。观察组自然分娩率高于对照组,差异有统计学意义（P<0.05）。结论 妊娠期高血压疾病产妇给予积极心理干预能够提高产妇的心理弹性和自我效能水平,并提高产妇护理满意度和自然分娩率,值得临床推广与应用。     

青少年抑郁的社会心理因素及干预效果研究

目的:探讨青少年抑郁的社会心理因素,并对其干预方法进行分析研究。方法:选取2010年1月至2011年8月我院接收的100名青少年抑郁障碍患者,随机分成两组即病例组和病例对照组,另外选取符合条件的12～18岁的100名健康青少年作为健康对照组,利用一般情况调查表收集相关资料,进行心理社会因素评估。采用心理治疗联合药物治疗对病例组进行综合干预,而病例对照组仅给予药物治疗,观察两组的干预效果并进行分析研究。结果:病例组和病例对照组在自我接纳和自我评价因子上分数均低于健康对照组,病例组与病例对照组相比差别有显著统计学意义(P<0.05)。积极的应对和应激呈显著负相关,而消极应对与应激总量呈显著正相关,P<0.05。积极应对和总体感受到的支持呈显著正相关,而消极应对与总体感受到的支持呈显著负相关,P<0.05.结论:青少年抑郁发病与许多社会心理因素密切相关,包括家庭因素,自尊水平以及外部环境应激等等,治疗青少年抑郁症应多研究其致病的社会心理因素,以抗抑郁药物与心理治疗并重为原则。     

中晚期妊娠情绪焦虑抑郁情况调查及其相关因素分析

目的 了解中晚期妊娠妇女的焦虑抑郁状况,探讨其影响因素.方法 连续选取2006年5月16日至5月25日间,在同济大学附属同济医院、东方医院、上海市第十人民医院及第一妇耍保健院共4所医院妇产科就诊符 合条件的177例中晚期妊娠妇女;对其焦虑抑郁状况及影响因素进行问卷调查.孕期焦虑抑郁评定采用综合医院焦虑抑郁量表(HAD).结果 妊娠中晚期焦虑、抑郁情绪的发生率分别为12.43%(22/177)和9.60%(17/177),各种情绪异常[焦虑和(或)抑郁]总发生率为16.38%(29/177).将单因素分析有统计学意义的变量和其他研究报道的相关因素孕妇年龄、孕周、职业、文化程度等共计8个变量,分别引入焦虑和抑郁的多因素Logistic 回归模型.逐步回归分析显示,年龄(≥25岁)(OR=0.282,0R95%CI 0.091～0.870)和既往剖宫产史(OR6.846,OR95%CI 1.431～32.756)为妊娠中晚期焦虑的影响因素,而妊娠抑郁的影响因素则为多次妊娠(≥3次)(OR=8.173,OR95%CI 1.051～63.586).结论 孕期普遍存在焦虑、抑郁情绪.要加强对低龄、多次妊娠及有异常孕产史妇女的孕期健康教育和产前心理指导.     

门诊宫腔镜检查对患者心理弹性的影响因素及针对性护理干预效果

目的 探讨门诊宫腔镜检查患者心理弹性的相关影响因素及针对性护理效果。方法 选择80例行宫腔镜检查患者,所有患者开展心理弹性调查问卷（CD-RISC）、简单应对方式问卷（SCSQ）及领悟社会支持量表（PSSS）,分析其心理弹性的相关影响因素,并根据相关因素制定针对性护理方案,比较护理前后患者焦虑自评量表（SAS）、抑郁自评量表（SDS）及护理满意度。结果 年龄>50岁患者心理弹性、积极应对、消极应对及社会支持评分低于<30岁、30～50岁年龄阶段,差异有统计学意义（P<0.05）。初中学历患者心理弹性、积极应对、消极应对及社会支持评分均低于高中、大学及以上患者,差异具有统计学意义（P<0.05）。居住乡村患者心理弹性、积极应对、消极应对和社会支持评分均低于居住城镇患者,差异具有统计学意义（P<0.05）。护理后患者护理满意度90.0%高于护理前70.0%,差异具有统计学意义（P<0.05）。结论 在门诊宫腔镜检查中,明确影响心理弹性的相关因素,并展开针对性护理措施,可改善患者负面情绪,提高护理满意度,促使其从中受益,值得深入探讨和研究。     

围绝经期潮热妇女焦虑与抑郁状况的分析

目的:探讨围绝经期前后妇女潮热与焦虑、抑郁之间的关系。方法:将符合条件的1 206名40~60岁妇女分为潮热组、无潮热组,分别完成调查问卷。问卷具体内容包括一般情况、潮热状况、焦虑自评量表(SAS)、抑郁自评量表(SDS)。结果:潮热组妇女SAS和SDS的平均值高于无潮热组妇女(SAS:39.8±7.3 vs 36.0±6.1;SDS:44.1±8.3 vs 40.9±8.9,P均<0.05),潮热组轻度焦虑和抑郁的发生率明显高于无潮热组(焦虑:8.3%vs 3.4%;抑郁:23.3%vs 14.2%,P均<0.05)。潮热妇女焦虑、抑郁的发生风险分别是无潮热妇女的4.1倍(95%CI,1.20~13.74)、2.4倍(95%CI,1.15~4.92)。重度潮热妇女较轻度潮热妇女SAS和SDS得分均高(SAS:46.4±7.9 vs 38.8±6.6;SDS:43.9±6.9 vs 52.7±12.5,P均<0.05)。潮热妇女的月经状况与SAS和SDS得分无关。结论:围绝经期潮热妇女易发生焦虑、抑郁症状,且重度潮热妇女更易发生。对妇女进行潮热治疗时,还应对妇女进行心理疏导。     

注意缺陷多动障碍共患焦虑和抑郁情况及其行为特点的研究

评估注意缺陷多动障碍（ADHD）患儿共患焦虑和抑郁情况,同时探讨共患疾病对其行为的影响特点。方法　2007—2009年在中南大学湘雅二医院儿童精神卫生专科门诊收集105例ADHD患儿,年龄8～14岁,均符合DSM-IV诊断标准,但不存在对立违抗障碍、品行障碍和抽动障碍。于某学校选取66名同年龄段,无ADHD、对立违抗障碍、品行障碍和抽动障碍的学生作对照组。对所有研究对象采用ADHD诊断量表、Achenbach儿童行为量表（CBCL） 、儿童焦虑性情绪障碍筛查表（SCARED）、儿童抑郁障碍自评量表（DSRSC）进行评定,对照组儿童经SCARED、DSRSC评定后选择正常的43名作为正常对照组用于分析。结果　105例ADHD中39例（37.1%）共患焦虑,66名对照组中13例（19.7%）共患焦虑,两者间差异有统计学意义（χ2 = 5.829,P = 0.016）。ADHD共患抑郁者33例31.4%）,对照组10例（15.2%）,差异有统计学意义（χ2 = 5.704,P = 0.017）。ADHD同时共患焦虑与抑郁者16例（15.2%）,对照组中未发现共患焦虑与抑郁者。ADHD患儿CBCL社会能力得分均低于对照组,行为问题得分除躯体主诉外均显著高于正常对照组,差异有统计学意义（分别P = 0.000～0.010、P = 0.000～0.007）。ADHD单纯共患焦虑组CBCL躯体主诉得分显著高于单纯ADHD组,差异有统计学意义（P < 0.05）;ADHD单纯共患抑郁组CBCL焦虑/抑郁得分显著高于单纯ADHD组,差异有统计学意义（P < 0.05）;ADHD同时共患焦虑与抑郁组CBCL退缩、躯体主诉、焦虑/抑郁、思维问题、注意问题和内化性问题均显著高于单纯ADHD组,差异有统计学意义（P < 0.05）。结论　ADHD患儿有较高的抑郁和焦虑共患情况,同时共患抑郁与焦虑的ADHD患儿存在更多的行为问题,需要更多的精神卫生服务。     

Anxiety and depression symptoms in infertile men during their first infertility evaluation visit

Objective: To assess the psychological condition of men at the start of the infertility work-up.

Methods: Men seeking an infertility evaluation for the first time were recruited. Depression and anxiety symptoms and subjective psychological burden were assessed with the Beck Depression Inventory (BDI), the Spielberger State-Trait Anxiety Inventory (STAI), and a visual analog scale (VAS).

Results: Data from 113 patients were analyzed. The mean age of the patients was 33.3 (range: 23–54) years, whereas the mean duration of infertility was 16.3 (range: 0–96) months. Results from the BDI and STAI were 2.24 (SD: ±3.18) and 33.74 (SD: ±8.04). Mild depressive symptoms were found in 4.5% of patients, whereas anxiety reached an abnormal level in 4.9%. There were significant correlations between the results from the BDI score and the duration of infertility (p?=?.024), whereas the STAI and VAS scores showed no similar connection (p?=?.142 and p?=?.261, respectively). Among patients with infertility longer than 2 years, mild depressive symptoms occurred in 23.1%.

Conclusion: Among men, the levels of depressive and anxiety symptoms were low at the start of the infertility work-up. Depressive symptom levels increased significantly with the duration of infertility, whereas anxiety levels and VAS scores did not demonstrate a similar correlation.     

Assessing depression,anxiety and couple psychological well-being in pregnancy: a preliminary study

Objective: The aim of the study was to evaluate symptoms of depression and anxiety and psychological well-being in men and women in their third trimester of pregnancy, and to compare them with two control groups of men and non-pregnant women, both with children and without children. Background: Perinatal research has largely focused on maternal depression, anxiety and the state of the marital relationship, but few studies exist including partners and comparisons with control groups of men and women both with and without children. Methods: The study was a cross-sectional survey. The total sample was 156 participants. Approximately equal numbers of participants in each group were recruited through a local community health centre in Zaragoza (Spain) and completed questionnaires in the presence of a psychologist. Anxiety, depression and the couple’s self-ratings of their well-being were assessed with the Beck Depression Inventory, the State-Trait Anxiety Inventory, and Psychological Well-being in the couple Scale, respectively. Results: The results show higher levels of depression symptoms in the ‘pregnancy group’; specifically, pregnant women reported higher levels of depression than their male partners. Also, the ‘pregnancy group’ (men and women) show lower scores on psychological well-being in the couple compared with the control groups. No significant differences in anxiety-state between the groups and sex were obtained. Conclusion: These findings are important for both researchers and clinicians in practice, in order to improve the identification of women with antenatal depressive symptoms and offer more psychological support for women and their partners during and after pregnancy.     

Perinatal psychological well-being in women with zero postnatal anxiety-depressive symptoms scores: a retrospective descriptive study

ABSTRACT

Background: A total absence of psychological symptoms during pregnancy or postpartum period is not common. Although there are some considerations on zero scores detected by EPDS, no thorough analysis is currently present in the literature of the eventuality and meaning of a total absence of postpartum symptoms following the compilation of two or more self-report symptom questionnaires.

Methods: In a sample of 960 Italian women, three groups of 31 subjects are defined retrospectively by scores on the EPDS-GHQ12: women with ‘zero’, ‘lower’, and ‘higher’ postnatal symptomatology. The psychological well-being of these groups was compared as detected in pregnancy and after childbirth by PWB questionnaire.

Results: Higher and excessive scores in Environmental mastery dimension connote the profile of women with a total absence of postpartum anxiety-depression symptoms. Positive relations with other dimension were less characterising, but it should be noted as a distinctive trait in the ‘zero’ symptoms postnatal symptomatology group. In the same ‘zero’ group, the scores of the six PWB questionnaire dimensions – except Personal growth – are all higher than the scores obtained by women in the general population.

Conclusion: The atypical self-reported perinatal mood condition present in the ‘zero’ symptoms group have currently unknown clinical significance     

护理干预或者人文关怀对围绝经期妇女焦虑抑郁状态的影响研究

目的:探讨围绝经期妇女抑郁、焦虑状态相关因素及综合护理干预的影响。方法:选取在我院妇科就诊的40～60岁之间的522名妇女进行问卷调查,调查工具选择抑郁自评量表(SDS)及焦虑自评量表(SAS)。对有抑郁、焦虑症的妇女给予综合护理干预,4周后再次进行SDS、SAS评定,比较干预前后评分的差异。结果:522名妇女中抑郁、焦虑的发生率分别为9.39%、7.66%;夫妻关系差、性欲下降及合并躯体疾病者抑郁、焦虑的发生率高(P<0.01或P<0.05);对抑郁、焦虑症妇女给予综合护理干预后,其抑郁、焦虑评分均有显著好转(P<0.01)。结论:围绝经期妇女中抑郁、焦虑症的发生率比较高,除生理因素外,夫妻关系、性生活情况及躯体疾病等均是其相关影响因素。辅以综合护理干预,可以缓解其抑郁、焦虑程度。     

The emotional burden of miscarriage for women and their partners: trajectories of anxiety and depression over 13 months

Objective  To identify the trajectories of anxiety and depression in women and in their partners over 13 months after miscarriage.
Design  A prospective study with follow up at 6 and 13 months after miscarriage.
Setting  Three Scottish Early Pregnancy Assessment Units.
Sample  Of the 1443 eligible individuals approached, 686 (48.3%) consented to participate (432 women; 254 men). Complete data were obtained from 273 women and 133 men at baseline, 6, and 13 months.
Methods  On completion of the management of the index miscarriage, eligible and consenting women and men underwent an initial assessment comprising a semi-structured interview and a standardised self-report questionnaire. The latter was readministered at the follow-up assessments.
Main outcome measures  The hospital anxiety and depression scale (HADS), a reliable and valid measure of general psychopathology for use in nonpsychiatric samples.
Results  Compared with depression, anxiety was overall the greater clinical burden. Over the 13-month period, women reported higher levels of anxiety and depression than men. Over time, a significantly greater level of adjustment was reported by women particularly with regards to the resolution of anxiety symptoms. The effect of time on HADS scores in either gender was similar between subgroups of socio-demographic and clinical factors.
Conclusions  These findings verify that early pregnancy loss represents a significant emotional burden for women, and to some extent for men, especially with regards to anxiety. For many, the detrimental effects of miscarriage are enduring and display a complex course of resolution. These findings are discussed in terms of their clinical implications for early identification and management.     

The prevalence and related risk factors of anxiety and depression symptoms among Chinese pregnant women in Shanghai

Objective: To investigate the prevalence of anxiety and depression of the pregnant women during the prenatal period, and provide information for further epidemiological study.
Methods: With ethics committee approval, a total of 527 recruited pregnant women from the Department of Obstetrics and Gynecology, Tongji University Medical School were selected at four hospitals that affiliated to the University. By applying a self-designed questionnaire for hospital anxiety and depression (HAD) scale, we evaluated anxious and depressive symptoms in these women.
Results: The prevalence rates of anxiety and depression in these Chinese pregnant women during prenatal period were 6.8% and 4.8%, respectively, whereas the co-prevalence rate of both anxiety and depression was 3.4%, and anxiety and/or depression 15.0%. The relationship between the prevalence rate of anxiety/depression and the age distribution was proven negatively correlated (χ² = 1.478, P  = 0.016) by the trend chi-squared test. Among all three groups, the prevalence rate of anxiety and depression was highest in the group of below 20 years old, lowest in the group of over 30 years old, and in-between in the group of 20 to 30 years old. Logistic regression analysis showed that lower age was a risk factor (odds ratio (OR) = 10.094, 95% confidence interval (CI): 1.418~71.838). Meanwhile, poor educational background (OR = 1.929, 95%CI: 1.101~3.379) was a relevant risk factor as well.
Conclusions: We suggest that introduction of psychological health instruction programs for pregnant women, especially the younger ones, should be strengthened. Besides, the essential intervention measures may be applied if necessary.     

帕罗西汀联合心理治疗对产后抑郁的疗效分析

目的:观察帕罗西汀加心理治疗治疗产后抑郁的效果。方法:采用Zung-抑郁自评量表(SDS)、Zung-焦虑自评量表(SAS),症状自评量表(SCL-90)、自尊量表(SEI)、特质应对量表(TCSQ)调查62例产后抑郁患者治疗前后的心理状态。实验组患者服用帕罗西汀加40分钟的心理治疗;对照组只予以帕罗西汀,为期8周。结果:两组患者的焦虑、抑郁、消极应对水平减少,自尊、积极应对水平提高,实验组与对照组差异有统计学意义(P<0.01)。结论:帕罗西汀加心理治疗治疗产后抑郁的效果显著。