耳针与心理综合干预模式治疗亚健康的临床对照研究

目的 评价耳针与心理综合干预模式治疗亚健康的有效性.方法 采用前瞻性随机对照方法,将120例亚健康者随机分为对照组(常规对症治疗)和干预组(耳针加心理干预),每组60例,观察疗效8周.结果 干预组总有效率为85.5％,对照组总有效率68.3％,两组比较差异有统计学意义(P＜0.05).干预组亚健康积分有显著改善,与对照组比较,差异有统计学意义(P＜0.05).干预组治疗后的SF-36总体健康维度和活力维度得分明显高于对照组治疗后相应得分,差异有统计学意义(P＜0.05或P＜0.01).结论 心理干预与耳针疗法相结合干预亚健康在改善症状和提高总体生活质量方面均优于常规对症治疗.     

安徽省不同性别青少年心理亚健康现状及影响因素研究

目的 分析安徽省不同性别青少年心理亚健康现状及影响因素。方法 选取2020年10月至2021年1月安徽省巢湖、宣城和铜陵3个城市的4个乡镇中学和4个市区中学,在每个学校随机抽取2个班级的学生为研究对象。采用一般资料调查表、社会支持量表(SSRS)和心理亚健康问卷比较不同性别青少年的一般资料、社会支持现状和心理亚健康状态的差异。采用多因素Logistic回归分析不同性别青少年心理亚健康的影响因素。结果 线下共发放问卷900份,回收有效问卷834份,问卷有效回收率为92.67%。834名青少年的心理亚健康检出率为25.78%(215/834),其中女性青少年心理亚健康检出率为28.95%(119/411),高于男性青少年的22.70%(96/423),差异有统计学意义(χ²=4.268,P=0.039)。不同心理健康状态的男性青少年的父母婚姻状况、是否在学校寄宿、是否留守、主观支持维度得分、对支持的利用度维度得分比较,差异均有统计学意义(均P<0.05)。不同心理健康状态的女性青少年是否在学校寄宿、是否留守、客观支持维度得分、主观支持维度得分、对支持的利用度维度...     

突发事件对武警官兵的心理影响及对策

目的分析研究突发事件对武警官兵的心理影响，充分认识心理训练在处突战斗中的意义，探讨各种对策，向心理训练要战斗力。方法分析突发事件的类型及特点．通过对武警官兵SCL-9。阳性项目数和各因子分来判断，突发事件对式警官兵的心理影响。结果式警官兵SCL-90阳性项目数和各因子分均高于地方人群，突发事件极易使极少数武警官兵出现抑郁、焦虑、恐惧等心理障碍。通过多种形式经常性、持久性学习、教育、训练，培养良好的心理素质，提高战斗力。结论各种突发事件是一种强大的心理冲击和特殊心理应激源，异常心理反应明确影响部队战斗力。因人而异，“对症下药”。教育式警官兵以理智、平和的心态应对各种突发事件。     

亚健康状态患者脑电地形图与对照组对比分析

目的通过调查亚健康状态患者的脑电地形图,并与对照组正常人群的脑电地形图进行对比分析,获得诊断学上的证据。方法把280例亚健康状态患者与280例正常人群均进行脑电图及脑电地形图的采样分析。结果脑电地形图中δ、θ、α、β及β频带与健康组比较,亚健康组出现的异常率明显增高（P＜0.05 ）。结论亚健康状态中患者的脑电活动不稳定,具有明显的焦虑趋势。脑电地形图侧重于大脑功能性的诊断,对亚健康人群中失眠者的诊断有诊断价值。     

脑卒中患者情绪变化及心理康复对策

脑卒中后偏瘫、截瘫等，使患者失去自理能力，给病人的心身带来巨大的痛苦，使患者产生不同程度的情绪变化。人的情绪变化与疾病康复有密切关系。因此，在对病人进行康复治疗时。尤应注意病人的心理康复。我们于2002-01～2003-12对收治的110例脑卒中患者，进行情绪变化调查，并针对患者的情绪变化采取相应的心理康复对策，取得了满意的效果，现总结如下。     

98例肺癌患者心理分析及护理对策

目的 调查肺癌患者的焦虑和抑郁状况并提出护理对策.方法 采用医院焦虑抑郁量表对98例肺癌患者入院时与采取心理护理后进行焦虑抑郁状况评估比较.结果 采取心理护理后肺癌患者焦虑抑郁的发生率明显降低.结论 焦虑抑郁是肺癌患者常见的负性情绪,它不仅影响治疗效果,而且降低患者生存期和生命质量,应及时发现焦虑抑郁症状、针对原因采取有效的心理护理措施,提高整体护理质量.     

第2代亚健康调查表的项目分析与筛选

目的：结合多种项目分析方法对第2代亚健康调查表各个条目进行分析与筛选，为进一步研制亚健康量表奠定基础。 方法：调查分析于2006-12/2008-05在南方医科大学完成。按整群抽样法抽取广州市某医科大学在读大学生共6 000名。采用现场问卷调查的方式，内容包括躯体症状、心理症状和社会症状和生存质量的总评。发出问卷6 000份，收回有效问卷5 599份。采用离散程度法、相关系数法、因子分析法、区分度分析法及克朗巴赫α系数法等5种方法对83个条目进行分析。 结果：汇总5种方法的提名，将每一个条目选出被提名次数达4次以上者作为最终结果，共有63个条目最终被入选。 结论：筛选出的63个条目均具备有较好的敏感性、代表性、独立性、重要性及内部一致性，为下一步研制亚健康量表提供基础。     

汶川特大地震颅脑创伤临床救治分析

目的 总结汶川特大地震中颅脑外伤的临床类型及特点、救治经验.方法 对5.12汶川特大地震中四川大学华西医院神经外科收治的182例伤员资料、流行病学、致伤原因、分类、伤情、救助时间、合并症、并发症、治疗和预后等进行分析.结果 男102例,女80例,建筑物砸伤是最主要的致伤原因,其次为挤压伤;按GCS评分:轻型129例,占70.9%;中型32例,占17.6%.,重型21例,占11.5%.伤口开放占68.7%;合并叫肢及脊柱骨折占16.5%,伤口感染18例占7.4%,急性肾功衰竭3例(1.2%).手术治疗者40例.出院或转科时GOS评估:5分121例(66.5%),4分38例(20.8%),3分或以下23例(9.7%),死亡5例,死亡率3.3%.结论 重伤伤员院前抢救率低,院内以轻、中型颅脑创伤为主,合并症多,伤口感染率高;多学科联合早期、有序规范救治有重要意义.     

地震灾害应急医疗救援存在的问题与对策

地震灾害在发生时间和发生地点、破坏程度及范围上具有不可预知性.其瞬间可造成大批人员的伤亡和巨大的财产损失.据报道,"5·12"汶川特大地震造成约7万人遇难.1万8千多人失踪,37万余人受伤,近10万人重伤住院治疗:地震还使450万间房屋倒塌,1400多万人无家可归;总受灾人数达4600万人,直接经济损失高达1.2万亿元人民币.因此,对于这样破坏性极大的地震灾害,常规的医疗救援方法很难奏效.     

四川汶川地震灾区伤员和伤员家属心理状况调查研究

目的调查四川汶川地震灾区伤员和伤员家属的心理状况,探讨重大自然灾害事件对人们心理的影响情况。方法采用90项症状自评量表（SCL-90）、汉密尔顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）、自制的灾区伤员一般情况调查表、睡眠情况调查表以及心理应激调查表,对196名四川汶川灾区伤员和伤员家属的心理状况进行调查。结果196名灾区伤员和伤员家属中,SCL-90各因子均分均高于正常人群,差异有显著性（P〈0.05）,其中,躯体化、抑郁、焦虑和恐怖性因子均分与常模相比较,差异有极其显著性（P〈0.01）。HAMA总分〉14分的有23例（11.7%）;HAMD总分〉20分的有29例（14.8%）;睡眠量表总分〉7分的有96例（49%）;应激量表总分〉10分的有74例（37.7%）;具有明显的创伤后综合症并且符合中国精神障碍分类与诊断标准第3版（CCMD-3）中创伤后应激障碍（PTSD）症状学标准的有11例（5.6%）;此外,符合CCMD-3脑器质性精神障碍诊断标准的有1例。结论地震对人们心理的影响是普遍而严重的,对灾区伤员和伤员家属要进行随访,并需要为其提供早期的合适的心理干预。     

汶川地震后绵竹市高中学生心理健康状况及其相关因素研究

目的探讨地震后灾区高中学生心理健康、社会支持状况及相关因素。方法对随机抽样选择的816例绵竹市高中学生分别采用一般情况调查表、事件影响量表修订版（IES—R）、社会支持评定量表（SSRS）、领悟社会支持量表（PSSS）及症状自评量表（SCL-90）进行测量。结果（1）绵竹市高中学生PTSD发生率为13．11％;（2）绵竹市高中学生SCL-90各项指标分值（躯体化及人际关系敏感除外）远远大于常模组（P〈0．05）;（3）绵竹市高中学生SSRS各项指标分值低于常模组（P〈0．05）,而PSSS各项指标中,领悟社会支持总分、家庭支持、其他支持分值高于常模组（P〈0．05）;（4）绵竹市高中学生IES—R分值与地震当时的主观感受（r=0．36,P〈0．05）、亲人的受伤情况（r=0．21,P〈0．05）、朋友及同学的受伤情况（r=0．18．P〈0．05）、家庭财产损失情况（r=0．11,P〈0.05）呈正相关;（5）IES—R分值与SCL-90各项指标（躯体化、人际关系敏感除外）均成正相关（P〈0．05）。（6）IES—R分值与PSSS中领悟社会支持总分（r=-0．09,P〈0．05）、朋友支持（r=-0．09,P〈0．05）、其他支持（r=-0．09,P〈0．05）呈负相关。结论与正常人群比较,绵竹市高中学生地震后的心理健康水取较差;他们较正常人群对社会支持的领悟更敏感;有效的社会支持及对社会支持的感受可降低PTSD发生率。     

Development and initial reliability and validity of four self-report measures used in research on interactions between police officers and individuals with mental illnesses

There currently exists a dearth of reliable and valid instruments to examine key police officer variables of importance in the growing research on their interactions with individuals with mental illnesses. This study tested reliability and validity of four newly designed measures of the constructs of self-efficacy (Self-Efficacy Scale; SES), referral decisions and de-escalation skills (Behavioral Outcomes Scale; BOS), attitudes toward psychiatric treatment (Opinions about Psychiatric Treatment; OPT), and social distance (Adapted Social Distance Scale; ASDS) in a sample of law enforcement officers. Self-administered, anonymous surveys, which included the measures of interest, were completed by 177 officers—68 of whom were undergoing Crisis Intervention Team (CIT) training and 109 of whom were not—at the beginning and end of week-long trainings. Analyses examined the internal consistency reliability, test-retest reliability, and construct validity of the instruments. The four measures of interest were found to be reliable and valid. Specifically, internal consistency coefficients and test-retest reliability correlations were generally acceptable, all four demonstrated sensitivity to change, and validity correlations were significant and in the expected direction. Findings demonstrated the ability to measure key constructs related to attitudes and intended behaviors in law enforcement officers utilizing psychometrically sound instruments. Further testing and the development of additional reliable and valid instruments focused on attitudinal and behavioral domains among officers who have frequent interactions with individuals with mental illnesses would be of great value.     

Acute effects of lithium on catecholamines, serotonin, and their major metabolites in discrete brain regions

The acute effects of lithium on the central catecholamine and serotonin systems were investigated in well-defined cortical areas in the rat: the anterior cingulate cortex (CIN), the piriform-entorhinal region (PiEn), and the primary visual area (VIS) as well as in the hippocampus (HIP), the neostriatum (CPU; caudateputamen), and the olfactory bulbs (OBs). In these microdissected regions, the catecholamines noradrenaline (NA) and dopamine (DA), the indoleamine 5-hydroxytryptamine (5-HT; serotonin), as well as some of their major metabolites (3-methoxy-4-hydroxyphenylglycol; 3,4-dihydroxyphenylacetic acid; homovanillic acid; 3-methoxytyramine; 5-hydroxy-1-tryptophan; and 5-hydroxyindole-3-acetic acid) were assayed by using high-performance liquid chromatography (HPLC) with electrochemical detection. One hour after the administration of lithium chloride (2 and 10 mEq/kg; i.p.) the endogenous NA levels increased in the CIN and PiEn cortices, in the HIP, and in the CPU. The DA contents remained unchanged in the CPU, HIP, OB, and VIS cortex but were increased in the CIN and PiEn regions. These increases in cortical DA levels were accompanied by reductions in HVA and DOPAC. The levels of HVA and DOPAC but not 3-MT were also reduced in the CPU, in spite of a normal DA content. The discrepancies between changes of DA and the levels of its metabolites indicate changes in the turnover rates as well as an action of lithium on DA synthesis and/or storage in the nigrostriatal and mesocortical systems. The 5-HT contents were also increased by lithium throughout all regions, except for the OB.(ABSTRACT TRUNCATED AT 250 WORDS)     

Short psychodynamic supportive psychotherapy, antidepressants, and their combination in the treatment of major depression: a mega-analysis based on three randomized clinical trials

The efficacy of Short Psychodynamic Supportive Psychotherapy (SPSP) has not yet been compared with pharmacotherapy. A mega-analysis based on three original Randomized Clinical Trials (RCTs) was performed. Patients with (mild to moderate) major depressive disorder were randomized in (24 weeks) SPSP (n = 97), pharmacotherapy (n = 45), or their combination (n = 171). Efficacy was assessed by the Hamilton Depression Rating Scale (HDRS), Clinical Global Impression of Severity and of Improvement (CGI-S), the Symptom Checklist (SCL; depression subscale) and the Quality of Life Depression Scale (QLDS). Pearson chi(2) calculations were used to compare success rates. Analyses of covariance (ANCOVAs) were used to test inter-group differences. Success rates indicated that independent observers (HDRS) found no differences in symptom reduction between SPSP and pharmacotherapy (P = 0.214), but therapists (CGI-S, P = 0.026), and patients (SCL, P = 0.036) favored SPSP. Combined therapy was found superior to pharmacotherapy by all three (patients (P = 0.000), therapists (P = 0.024), independent observers (P = 0.024)). Independent observers (P = 0.062) and therapists (P = 0.430) found no differences between combined therapy and SPSP, but patients (P = 0.016) found combined therapy to be superior. As far as quality of life is concerned, success rates indicated that patients (QLDS) found no differences between SPSP and pharmacotherapy (P = 0.073) or between SPSP and combined therapy (P = 0.217). However, they found combined therapy superior to pharmacotherapy (P = 0.015). The results of the mega-analysis suggest that combined therapy is more efficacious than pharmacotherapy. SPSP and pharmacotherapy seem equally efficacious, except for some indications that patients and therapists favor SPSP for symptom reduction. Combined therapy and SPSP also seem equally efficacious, except that patients think that the first is better in symptom reduction.     

A review on the oxidative and nitrosative stress (O&NS) pathways in major depression and their possible contribution to the (neuro)degenerative processes in that illness

This paper reviews the body of evidence that major depression is accompanied by a decreased antioxidant status and by induction of oxidative and nitrosative (IO&;NS) pathways. Major depression is characterized by significantly lower plasma concentrations of a number of key antioxidants, such as vitamin E, zinc and coenzyme Q10, and a lowered total antioxidant status. Lowered antioxidant enzyme activity, e.g. glutathione peroxidase (GPX), is another hallmark of depression. The abovementioned lowered antioxidant capacity may impair protection against reactive oxygen species (ROS), causing damage to fatty acids, proteins and DNA by oxidative and nitrosative stress (O&;NS). Increased ROS in depression is demonstrated by increased levels of plasma peroxides and xanthine oxidase. Damage caused by O&;NS is shown by increased levels of malondialdehyde (MDA), a by-product of polyunsaturated fatty acid peroxidation and arachidonic acid; and increased 8-hydroxy-2-deoxyguanosine, indicating oxidative DNA damage. There is also evidence in major depression, that O&;NS may have changed inactive autoepitopes to neoantigens, which have acquired immunogenicity and serve as triggers to bypass immunological tolerance, causing (auto)immune responses. Thus, depression is accompanied by increased levels of plasma IgG antibodies against oxidized LDL; and increased IgM-mediated immune responses against membrane fatty acids, like phosphatidyl inositol (Pi); oleic, palmitic, and myristic acid; and NO modified amino-acids, e.g. NO-tyrosine, NO-tryptophan and NO-arginine; and NO-albumin. There is a significant association between depression and polymorphisms in O&;NS genes, like manganese superoxide dismutase, catalase, and myeloperoxidase. Animal models of depression very consistently show lowered antioxidant defences and activated O&;NS pathways in the peripheral blood and the brain. In animal models of depression, antidepressants consistently increase lowered antioxidant levels and normalize the damage caused by O&;NS processes. Antioxidants, such as N-acetyl-cysteine, compounds that mimic GPX activity, and zinc exhibit antidepressive effects. This paper reviews the pathways by which lowered antioxidants and O&;NS may contribute to depression, and the (neuro)degenerative processes that accompany that illness. It is concluded that aberrations in O&;NS pathways are - together with the inflammatory processes - key components of depression. All in all, the results suggest that depression belongs to the spectrum of (neuro)degenerative disorders.