心理治疗中的相通心理致病机制

分析了4大主要治疗流派--古典精神分析、行为疗法、当事人中心疗法、理性情绪疗法有关致病机制的论述,总结出以下相通的心理致病机制:当事人对自己情感经验的过分压抑防御,导致人格的僵化、固执,使自我的疆界萎缩; 当事人自主力量缺乏,无力控制自己的局面,造成了人格局部的昏乱、冲突; 人格局部的失调又导致人格整体的失调或人格的整合不良.     

“白癜风”并不可怕

白癜风发病原因比较复杂,精神刺激、免疫系统失调、内分泌失调、遗传等因素都可致病,近年来由于精神因素导致发病的比例有所上升,发病后精神负担过重还可导致白斑扩散,因此,患者调整好自己的心态显得十分必要。     

振动致雷诺现象的致病机制

劳动者长期接触手传振动可发生雷诺现象.有关手传振动致雷诺现象的发病机制还没有完全认识,目前认为其发生的机制主要有:(1)自主神经功能失调和受体异常导致血管舒缩异常;(2)内皮损伤和内皮调节异常造成局部肢端血管功能异 常;(3)血液粘滞度增加和细胞活化造成血液流动异常.阐明振动致雷诺现象的致病机制对局部振动病的预防和治疗有很大意义,本文从多因素角度对当前有关振动致雷诺现象的主要病理生理学机制进行了综述.     

利用复发性尿路感染建立PBC小鼠模型

原发性胆汁性肝硬化（PBC）是慢性进行性淤胆性肝病，发病机制主要为机体免疫失调导致肝内胆管破坏和门脉区炎症，具体致病机制尚未完全明确，其中，尿路感染（UTI）常被认为是诱因之一，但缺乏系统研究。     

神奇的心理疗法

神奇的心理疗法王宪华七情即喜、怒、忧、思、悲、恐、惊七种不同的感情变化，人皆有之，一般属于人体正常的生理范畴。但是，情忘过极，一旦超过人体所能调节的限度，就会引起气血不和、经络不通、阴阳失衡、脏腑功能失调，从而导致多种疾病。这就是中医学“七情致病”的...     

探析风湿病病机——虚邪瘀

目的通过探讨风湿病中医的致病机制,旨在为临床根本治疗风湿病并提高患者生活质量提供理论依据。方法选择2013年1月~2014年1月接受治疗的风湿病患者46例,根据患者的临床资料和病情统计分析风湿病的病机。结果风湿病的发病机制主要是气虚血亏、脏脏虚衰、阴阳失调、气血不通、劳逸失度等有关。结论风湿病病因是虚邪瘀所致,正虚、邪侵、淤血,其中正气与邪气作用并结合气血不通导致风湿病发展加重。     

失调性排尿障碍治疗有方巴氯芬疗效获得证据

上海长征医院泌尿外科徐丹枫等研究发现，由尿道括约肌张驰（TL）失调导致的排尿功能障碍，用巴氯芬治疗有效。该研究论文于5月19日在线发表于BJU Int上。 失调性排尿功能障碍是泌尿外科较常见的一组疾病，其主要特征就是患者主观感到尿急，客观有尿频症状，但在B超、CT和造影等辅助检查中，往往不能发现明显的器质性病变。目前医学上只能笼统冠以膀胱过动综合征或下尿路功能障碍，缺少致病机制研究，也无具体治疗措施。     

女性养生新方唠叨购物蹦迪

日前,一项对大城市中年人的调查显示:60%的人多梦、失眠,57%的人记忆衰退,48%的人脾气暴躁、焦虑。其原因主要是现代高度压力之下出现的许多身心症状,严重者会导致忧郁症和精神疾病。下面几种心理“疗法”,简便易行且可舒缓身心压力和减少疲劳、调节情绪。唠叨疗法向别人倾诉自己内心的痛苦和烦恼,一可减缓精神上的苦闷情绪,二可避免因精神忧郁而导致的神经衰弱、内分泌功能紊乱和月经失调等病症。妇女对此多有偏好。购物疗法心情忧郁时,到商场去买回一件心爱之物,成功和满足的心理体     

失眠难熬 食疗辅治

随着现代生活节奏加快,许多人不同程度地受到失眠的困扰。失眠使人精神不振,情绪不稳,疲乏无力;长期失眠会出现神经功能失调的症状。失眠还损害免疫系统,导致机体抵抗力下降。充足的睡眠对青少年更重要,因为生长激素在夜间睡眠时才分泌。 目前治疗失眠的方法有药物疗法和非药物疗法。药物疗法中的安眠镇静药虽然可以起到催眠镇静作用,但     

药源性消化系统疾病 药源性疾病专题讲座之三

药源性消化系统疾病较为常见,约占药物全部副作用的20～40％。这些疾病的发病机制,大致可分为中毒性机制及过敏机制两类。前者的致病与长期或过量用药有关;后者之致病则与用药剂量无关。药源性消化系统疾病可累及消化系统各部分,导致消化管运动、腺体分泌及其他功能障碍,使食物及各种营养物质     

系统心理治疗对产后抑郁的干预效果分析

目的:探讨系统心理治疗对产后抑郁的干预效果。方法:对24例确诊为产后抑郁的患者开展系统心理治疗,并采用症状自评量表(SCL-90)和艾森克人格问卷(EPQ)方式对其在接受系统心理治疗前后的心理状态进行评估。结果:24例产后抑郁患者在接受系统心理治疗后,SCL-90各因子分数均呈现显著降低,差异有统计学意义;EPQ中N分显著降低,差异有统计学意义(t=4.451,P<0.05)。结论:系统心理治疗可以有效改善产后抑郁患者的不良情绪。     

社区2型糖尿病患者心理干预疗效观察

目的：了解糖尿病患者心理干预药物治疗疗效。方法：我们对深圳社区居民患糖尿病的60例患者进行Zung量表评分问卷调查，对高于40分的42例糖尿患者在原有治疗的基础上选择21例加用心理干预与百优解治疗。结果：可以有效地降低空腹血糖、餐后血糖、HbAlc。结论：对2型糖尿病患者进行心理干预及药物治疗可以明显提高糖尿病治疗效果，使其生活质量大大提高。     

Psychotherapy Utilization,Preferences, and Retention among Women Veterans with Post-traumatic Stress Disorder

BackgroundPsychotherapy is the gold standard treatment for post-traumatic stress disorder (PTSD), yet psychotherapy use and retention among veterans is low. Little is known about the barriers to care and factors associated with women veterans' PTSD psychotherapy use and retention. Using a nationally representative sample of 986 women Veterans Health Administration primary care users with PTSD and a perceived need for mental health care, we examined 1) the proportion of women who used psychotherapy, 2) retention in psychotherapy among women who used any psychotherapy, and 3) individual factors related to psychotherapy use and retention.MethodsWomen completed a survey on their mental health care experiences. Outpatient mental health care use in the year before the survey was obtained from Veterans Health Administration administrative data.ResultsMost women (79.1%) used psychotherapy, and 41.7% of those women had a minimal therapeutic dose of psychotherapy (≥8 visits). Mental health diagnostic comorbidity and being African American/Black or identifying as neither African American/Black nor White were significantly associated with higher psychotherapy use. Mental health diagnostic comorbidity, exposure to military sexual trauma, and receiving treatment aligned with gender-related and group-related preferences were associated with higher psychotherapy retention. Being a parent was associated with lower retention.ConclusionsAlthough a significant proportion of women veterans with PTSD are using psychotherapy, retention is enhanced when women are able to obtain treatment aligned with their preferences. Thus, efforts to promote patient-centered, shared decisions regarding mental health treatment options could increase the efficacy and efficiency of treatment for PTSD among women.     

Professional non‐neutrality: criticising the third party in psychotherapy

Using audio‐recorded data from cognitive‐constructivist psychotherapy, the article shows a particular institutional context in which successful professional action does not adhere to the pattern of affective neutrality which Parsons saw as an inherent component of medicine and psychotherapy. In our data, the professional’s non‐neutrality functions as a tool for achieving institutional goals. The analysis focuses on the psychotherapist’s actions that convey a critical stance towards a third party with whom the patient has experienced problems. The data analysis revealed two practices of this kind of critique: (1) the therapist can confirm the critique that the patient has expressed or (2) return to the critique from which the patient has focused away. These actions are shown to build grounds for the therapist’s further actions that challenge the patient’s dysfunctional beliefs. The article suggests that in the case of psychotherapy, actions that as such might be seen as apparent lapses from the neutral professional role can in their specific context perform the task of the institution at hand.     

Multidimensional telecare strategies for rural residents with brain injury

Rural residents with brain injury have difficulty in accessing care from qualified psychologists for consequent cognitive, emotional and behavioural symptoms. We examined high-quality videoconferencing to enhance care for persons with brain injury in three areas: cognitive assessment, psychotherapy and rural mental health training. The assessment study evaluated 52 outpatients seen for diagnostic visits over videoconferencing, and compared their experiences with those of 52 age- and diagnosis-matched controls seen in person. Persons seen via telemedicine were more likely than controls to want to repeat their experience and more satisfied than were the neuropsychologists who examined them. In the psychotherapy study, neurorehabilitation patients were seen via videoconferencing for therapy related to brain injury or stroke. Persons receiving psychotherapy were less likely than persons receiving assessment services to want to repeat their experience. In the training study, 39 rural mental health providers were trained via videoconferencing, and trainees demonstrated significant improvement on tests of knowledge about brain injury. Trainees formed a network of mental health provider referrals for persons with brain injury in a wide geographic area. Given adequate training and ongoing support, rural clinicians can treat many brain-injury adjustment issues locally, reserving specialist consultation for emergency or complex problems.     

Smoking cessation and exercise promotion counseling in psychologists who practice psychotherapy

PURPOSE: Little is known about health promotion within the context of psychotherapy. The present study assessed a sample of psychologists' attitudes and behavior with their psychotherapy clients regarding smoking cessation and exercise promotion counseling. DESIGN: This is a cross-sectional survey study. SETTING: Surveys were mailed. SUBJECTS: Licensed psychologists (1000) in Massachusetts were randomly selected to receive surveys. Psychologists practicing psychotherapy at least 5 h/wk were invited to participate. Out of 496 responses, 328 completed surveys were analyzed. MEASURES: Two parallel surveys were developed for smoking (N = 154) and exercise (N = 174) assessing health promotion behaviors and attitudes. RESULTS: Approximately 43% of respondents inquire about smoking and 53% inquire about exercise with new clients. Over 45% advise smoking clients to quit and 50% advise sedentary clients to exercise. Over 80% of respondents felt smoking and exercise should be addressed in psychotherapy; however only 41% of smoking and 65% of exercise respondents felt confident in their counseling abilities. Lack of confidence, beliefs about relevance of smoking and exercise to psychological functioning, and beliefs that such personal choices should not be addressed in psychotherapy significantly predicted smoking cessation and exercise promotion behaviors. CONCLUSION: Many respondents are engaging in health promotion with their psychotherapy clients. Exercise promotion is occurring more frequently and is viewed more favorably compared with smoking cessation counseling. Health promotion attitudes are associated with counseling behaviors. Limitations include self-selection bias and small sample size.     

帕金森病患者抑郁情绪的心理干预

目的探讨心理治疗对帕金森病(PD)患者抑郁情绪的干预效果及其对生活质量的影响。方法将86例PD患者随机分为心理治疗组和对照组,评定并比较2组抑郁自评量表(SDS)、SF-36生活质量得分及其临床疗效。结果心理治疗组SDS评分显著低于对照组,其临床疗效评定显著高于对照组(P<0.05或P<0.01)。生活质量除生理功能外,其他指标心理治疗组均优于对照组(P<0.05或P<0.01)。结论心理治疗能显著降低PD患者抑郁情绪的严重程度,并可提高临床疗效、躯体功能及生活质量。     

团体人际心理治疗产后抑郁症的疗效观察

目的:探讨团体人际心理治疗对减轻产后抑郁症患者抑郁症状和改善社会功能的效果。方法:人际心理治疗组38例产后抑郁症患者进行8周的团体人际心理治疗,对照组的35例产后抑郁症患者给予一般治疗。两组患者在治疗前及治疗后3个月采用爱丁堡产后抑郁量表(EPDS)、汉密顿抑郁量表(HAMD)、人际问题问卷(IIP)及社会功能缺陷筛选量表(SDSS)等进行评估。结果:与对照组比较,治疗后3个月末的人际心理治疗组人际能力和社会功能改善更明显(P<0.01),人际心理治疗组抑郁症状的缓解程度明显优于对照组(P<0.01)。结论:团体人际心理治疗能够改善产后抑郁症患者的人际能力和社会功能,对产后抑郁症有较好的疗效。     

Transference and group psychotherapy

This study examines the concept of transference, focusing on its peculiarities in the group context. The nature of the therapeutic situation and the broad freedom given to patients in order to access the unconscious material at their own pace, within a safe environment and with as little censorship as can be managed, transference gradually takes place. Through displacement, the psychotherapist and group members are perceived not as they are, with their real attributes, but as one or more objects that arouse emotions coming from the infant world, more precisely from the collection of deep affective influences. One peculiarity of the group situation when compared to individual psychotherapy is that, in the former, multiple transferences coexist, which group members establish among themselves, enabling a wide range of possible feelings. Both treatment modes share the assumption that unresolved conflicts which stimulated patients to seek for help can be reduced or even abolished through the interpretation and working through of transference, which functions as a process of change throughout the psychotherapy.     

Improving marital relationships: strategies for the family physician.

BACKGROUND: Marital conflict and divorce are prevalent in our society, and patients frequently ask family physicians to assist them with marital difficulties. These difficulties are often associated with a decline in health, resulting in additional stress to the marital unit. METHODS: A MEDLINE search was undertaken using the key words "family medicine," "marital therapy," "marital counseling," "brief psychotherapy," and "short-term psychotherapy." The bibliographies of generated articles were searched for additional references. The authors used the resources of their individual behavioral science libraries, as well as their clinical experiences. RESULTS AND CONCLUSIONS: With adequate training, many family physicians can include marital counseling skills in their clinical repertoires. Family life cycle theory provides a framework for understanding the common stresses of marital life and also guides the family physician in recommending strategies to improve marital satisfaction. The physician's role is twofold: (1) to identify couples in crisis, and (2) to provide preventive strategies geared to assist couples in achieving pre-crisis equilibrium or higher levels of functioning. For physicians whose practices do not include marital counseling, an understanding of the basic techniques can be beneficial in effectively referring appropriate couples for marital therapy.