多发性骨髓瘤患者抑郁和焦虑情绪及其相关因素分析

目的评估多发性骨髓瘤（MM）患者伴抑郁、焦虑情绪的发生率,并分析其相关的影响因素。方法对40例MM患者进行了一般情况及医院焦虑抑郁量表（HADS）问卷调查。结果有抑郁情绪的患者28例（70．00％）,有焦虑情绪的患者31例（77．50％）。21例Ⅲ期MM患者中达到抑郁、焦虑症状肯定存在标准的有19例,高达90．48％。logistic多因素回归分析,男性比女性患者更易出现抑郁和焦虑症状（OR值分别为1．04,95％C10．87～1．68;1．16,95％C10．89～1．70）,肾功能差的患者更易出现抑郁和焦虑症状（OR值分别为2．41,95％CI2．01～3．29;2．56,95％CI2．12～4．01）;了解疾病情况的患者更易出现抑郁和焦虑症状（OR值分别为1．24,95％CI0．97～1．55;1．27,95％CI1．01～2．33）。结论MM患者中存在较高的抑郁及焦虑情绪障碍,肾功能受损程度以及对疾病了解情况是其主要影响因素。     

社区空巢老人焦虑 抑郁现状及影响因素分析

目的 调查合肥市某社区空巢老人焦虑、抑郁等负性情绪流行情况及其影响因素。方法 采用自行编制调查表及抑郁自评量表（SDS）、焦虑自评量表（SAS）调查2017年某社区已经建立居民健康档案的65岁及以上的1 540名老年人的空巢情况及空巢老人焦虑、抑郁现状,采用多因素logistic回归分析方法分析空巢老人焦虑、抑郁的影响因素。结果 共收回有效问卷1 491份,其中空巢老人660名,空巢老人焦虑和抑郁情绪检出率分别为3.18%、23.18%;单因素分析结果显示,父母是否健在、不同文化程度、月收入是否够用和是否参加锻炼的空巢老人,其焦虑患病率差异有统计学意义（χ²=61.188、8.639、12.902、8.990,P<0.05）,父母是否健在、不同文化程度、月收入是否够用、是否患有慢性病和是否参加锻炼的空巢老人,抑郁患病率差异有统计学意义（χ²=15.164、10.334、34.235、6.777、27.640,P<0.05）;多因素logistic回归分析显示,父母一方健在或父母双方均健在[OR=15.141（焦虑）、3.294（抑郁）]、月收入不够用[OR=3.426（焦虑）、2.820（抑郁）]和不锻炼[OR=5.337（焦虑）、2.963（抑郁）]是65岁以上空巢老人产生焦虑和抑郁的主要影响因素。结论 合肥某社区65岁以上空巢老年群体焦虑患病率较低,抑郁患病率较高,父母是否健在、月收入不够用和不锻炼是其主要影响因素,应根据目前存在的影响因素开展有针对性的预防干预是当务之急。     

甲卡西酮使用人群中焦虑及抑郁症状特征及危险因素分析

目的 了解甲卡西酮滥用人群的流行病学特征及该人群中焦虑/抑郁症状的特征。方法 对来自山西省某强制隔离戒毒所中主要滥用物质为甲卡西酮的人群进行横断面调查，并对该人群中焦虑及抑郁症状患病率及其影响因素进行分析。本研究分别采用汉密尔顿焦虑量表(HAMA)和BECK抑郁自评量表(BDI)评估调查对象的焦虑及抑郁症状。结果 本次研究共纳入767名研究对象，以已婚、低学历男性为主；12.6%的调查对象有多药滥用经历，且有48.4%的调查对象有甲卡西酮依赖；分别有15.3%和49.2%的甲卡西酮滥用者存在焦虑及抑郁症状。多因素logistic回归分析显示曾使用过2种及以上的合成毒品(aOR=2.13, 95%CI:1.26-3.61)、甲卡西酮依赖(1.77, 1.13～2.78)及抑郁症状(1.67, 1.10-2.54)是焦虑症状的危险因素，而参加过戒毒治疗(0.42, 0.27-0.64)是焦虑症状的保护因素；甲卡西酮的累计使用时间(>24个月)(1.41, 1.01-1.96)及焦虑症状(1.71, 1.14-2.55)是抑郁症状的危险因素。结论 甲卡西酮滥用后可导致焦虑及抑郁等精神症...     

广州白云区空巢老人焦虑症状的相关因素调查

目的了解城市空巢老人焦虑症状的发生情况及相关因素。方法采用焦虑自评量表（SAS）及一般情况问卷对广州市白云区的10个社区中符合条件的60岁及以上的空巢老人（研究对象）和非空巢老人（对照）进行人户问卷调查,共调查186例,分析焦虑症状发生率及其相关因素。结果调查的186名老年人中,102名有焦虑症状,患病率为54．83％。其中空巢老人与非空巢老人焦虑症发生率比较,差异有统计学意义（P〈0．01）。经Logistic多元回归分析,影响空巢老人（含独居老人）焦虑症的单因素有躯体疾病（P〈0．01）、锻炼和娱乐活动、子女探望间隔时间（P〈0．05）。结论空巢老人焦虑发生率明显高于非空巢老人,其中躯体疾病、缺乏锻炼和娱乐活动、子女探望间隔时间是引发焦虑症的主要原因。     

城市老年人抑郁情绪的保健需求

目的调查城市老年人中抑郁情绪及其影响因素，提出保健需求。方法采用汉密顿抑郁量表(HAMD)对66例各55岁以上的城市老年人进行了评定。结果有12．37％的老年人有明显的抑郁情绪，抑郁量表的得分情况女性显著高于男性，不同年龄组之间差异不明显。多元回归结果显示：家庭结构、经济保障、日常生活能力与配偶及子女的关系、社会支持、健身活动等是影响城市老年人抑郁情绪的主要因素。结论城市老年人存有抑郁情绪的因素很多，有针对性地加强保健措施是必要的。     

社区老年慢性病患者伴随焦虑抑郁情绪的调查分析

目的：调查分析辖区内老年慢性病患者焦虑抑郁情绪伴随情况,提高慢性病管理的依从性。方法以年龄≥60岁住在源城区上城社区的4390例老年人为调查对象,社区医护人员经专门调查训练后,入户对老人进行调查,记录其慢性病及焦虑抑郁情绪的伴随情况。结果辖区内大部分老人患1种或1种以上的慢性病,患1种、2种或2种以上慢性病患者的抑郁焦虑情绪伴随情况与正常人相比,差异具有统计学意义(P<0.05)。结论老年人患慢性病的同时伴有抑郁焦虑情绪,且随着慢性病种类的增加,抑郁焦虑情绪也增加。     

89例慢性心力衰竭患者焦虑抑郁调查研究

目的了解慢性充血性心力衰竭患者中焦虑及抑郁的发病情况及特点。方法对89例心力衰竭患者焦虑和抑郁发生情况进行调查，收集患者的相关资料，评估与焦虑和忧郁发生的相关因素。结果89例心衰患者中有32．6％的患者存在明显焦虑，有34．8％的患者存在明显抑郁，其中心功能分级、房颤、糖尿病可以影响患者焦虑和抑郁量的病情，焦虑和抑郁程度与高敏C反应蛋白（hsCRP）、左心室射血分数（LVEF）有较强的相关性，没有发现性别、年龄与焦虑和忧郁有相关性。结论心力衰竭患者中存在较高的焦虑和抑郁的发生率，值得临床医师重视。     

二级医院神经内科患者焦虑和抑郁症状的调查分析

目的了解二级医院神经内科患者中焦虑和抑郁症状发生情况。方法选取2011年6月~2015年3月503例神经内科患者作为研究对象,分析焦虑、抑郁症状发生情况。结果 503例神经内科患者存在焦虑症状246例(48.9%),抑郁症状257例(51.1%)。其中男276例(54.9%),女227例(45.1%);年龄26~64岁,平均(46.4±8.6)岁;文化程度为小学或文盲的302例(60.0%),中学164例(32.6%),大专或以上37例(7.4%)。有工作的335例(66.6%),无工作的168例(33.4%)。神经内科焦虑、抑郁症状评分显著高于国内成人常模,差异有统计学意义(P<0.05)。结论神经内科患者焦虑及抑郁症状发生率较高,其严重影响患者心理健康及生活质量。患者文化程度与焦虑、抑郁发生率有密切相关,临床应给予关注并提前给予干预措施。     

女性急性冠状动脉综合征患者焦虑抑郁情绪研究

目的探讨女性急性冠状动脉综合征（ACS）患者焦虑、抑郁情绪发生情况。方法连续入选2011年1月至2012年1月北京安贞医院心内科住院ACS患者386例,采用医院焦虑抑郁评分量表进行心理测评,评价焦虑、抑郁及共病的发生率。结果262例男性ACS患者中,65例（24．8％）存在焦虑情绪,54例（20．6％）存在抑郁情绪,39例（14．9％）存在焦虑抑郁共病;124例女性ACS患者中,66例（53．2％）存在焦虑情绪,48例（38．7％）存在抑郁情绪,33例（26．6％）存在焦虑抑郁共病。女性焦虑、抑郁、焦虑抑郁共病发生率明显高于男性,差异均有统计学意义（均P〈0．01）。报销比例≤40％、月收入〈1000元是女性ACS患者发生抑郁的主要影响因素（OR=6．216、2．672,95％CI：1．229～5．583和1．161～6．150,均P〈0．05）。结论对于并发焦虑抑郁情绪的女性ACS患者,应引起临床医师重视,尽早给予心理干预,改善预后。     

空巢老人下肢骨折后焦虑、抑郁的护理体会

据统计,60岁及以上2个老年人的家庭中,单独生活住户占42%[1],但是空巢老年人的生活质量整体上低于非空巢老人,为此空巢老人的生活质量受到社会关注。其主要表现以焦虑、抑郁为主空巢心理。尚加之骨折后活动能力下降,可严重影响老人的心理情绪,焦虑、抑郁症的发生率更为显著。不仅降低了患者的生活质量,也与躯体症状相互作用,严重影响着     

Cannabis use and suicidal behaviours in high-school students

The aim of the study was to evaluate the relative contributions of cannabis use, depressive and anxious symptoms in the prediction of suicidal behaviors. Participants were 248 high-school students who completed questionnaires assessing cannabis use, suicidal behaviors, depressive and anxious symptoms. Cannabis use was a significant independent predictor of suicidal behaviors after adjustment for depressive and anxious symptoms.     

Tianeptine and paroxetine in major depressive disorder,with a special focus on the anxious component in depression: an international, 6-week double-blind study dagger

Tianeptine (37.5 mg/day) and paroxetine (20 mg/day) were compared in a population of depressive patients without past or current history of co-morbid anxiety and/or important anxiolytic treatment. In a 6-week, double blind trial, the special focus was on anxious symptoms.Both drugs showed good efficacy on depressive symptomatology, assessed with MADRS and HDRS, but no difference was detected between tianeptine and paroxetine, for any assessment criterion. Despite the choice of selected depressive patients, without any co-morbid anxious disorder, anxiety scale scores at inclusion (HAMA and BAS) were appreciable but correlated poorly with depressive scores. Both tianeptine and paroxetine improved the apparent anxious component in depression. Tolerability of both drugs was good, although significantly better with tianeptine.Thus tianeptine and paroxetine are effective and safe treatments for major depression and may also act directly on the anxious component of the psychopathology. Copyright 2001 John Wiley & Sons, Ltd.     

Predictors of alcohol problems in college women: The role of depressive symptoms,disordered eating,and family history of alcoholism

Disordered eating and depressive symptoms are established correlates of alcohol use in college women. Family history of alcoholism (FHA) is also related to problematic alcohol use, but there have been limited studies of how it relates to other established cofactors in women. Predictive associations between disordered eating (i.e., overall levels as well as binge eating), depressive symptoms, and alcohol problems were examined in a sample of 295 female twins. The direct and moderating effects of FHA on the relationships between alcohol problems, disordered eating, and depressive symptoms were investigated. Using hierarchical linear modeling depressive symptoms, but not disordered eating or FHA, significantly predicted alcohol problems. However, there was a significant interaction between disordered eating and FHA; disordered eating was associated with alcohol problems in those with a positive FHA. The implications for high-risk subgroups of college women are discussed.     

Incremental validity of anxiety sensitivity in relation to marijuana withdrawal symptoms

The present investigation examined the relation between anxiety sensitivity (AS) and marijuana withdrawal severity among 84 (47 female) young adult marijuana smokers. As expected, after covarying for the theoretically-relevant variables of frequency of past 30-day marijuana use, number of cigarettes smoked per day, volume of alcohol consumed, and anxious arousal as well as anhedonic depressive symptoms, both the global AS factor and the AS-mental incapacitation concerns factor were significantly related to the severity of retrospectively reported marijuana withdrawal symptoms. Results are discussed in relation to better understanding cognitive-emotional variables related to the marijuana withdrawal.     

Effects of risperidone on affective symptoms in patients with schizophrenia

The effects of risperidone on affective symptoms were determined by an analysis of pooled data from six double-blind trials of risperidone versus haloperidol in 1254 patients with chronic schizophrenia. Symptoms indicating mania were assessed by the Positive and Negative Syndrome Scale (PANSS) excitement and grandiosity items and by the excited cluster (excitement, hostility, uncooperativeness, and poor impulse control); anxious / depressive symptoms were assessed by the PANSS anxious / depressive cluster (somatic concern, anxiety, guilt feelings, and depression). Mean change scores from baseline to endpoint were compared in patients receiving risperidone, haloperidol or placebo by analysis of variance with factors for trial and baseline score included in the model. In all patients, change scores on excitement and grandiosity items and excited and anxious / depressive clusters were significantly greater for risperidone than for haloperidol or placebo. Dropouts due to inefficacy were less frequent with risperidone (5 of 59; 8%) than with haloperidol (7 of 38; 18%) or placebo (8 of 10; 80%). In patients with anxious / depressive symptoms at baseline (anxiety / depression cluster score > or = the median), anxiety / depression scores decreased significantly more with risperidone than with haloperidol, and symptom reduction occurred faster with risperidone. These results are consistent with previous reports and suggest that risperidone is more efficacious than haloperidol for affective symptoms in patients with schizophrenia.     

2010-2015年广州市越秀区肺结核可疑症状者病例来源分析

目的 根据结核病防治机构肺结核可疑症状者病例来源评价区域性结核病防治健康促进效果.方法 查阅本院第一门诊部2010-2015年广州市结核病控制项目初诊患者登记本资料,回顾性分析病例来源,因症就诊、转诊、追踪、因症推荐、接触者检查、健康体检、其它等肺结核可疑症状者的百分构成及其与年龄、性别的相关性.结果 在6 154例肺结核可疑病状者中,按百分构成排列其顺位为转诊、因症就诊、追踪、其它、接触者检查、健康体检和因症推荐,分别占病例总数的54.42％、41.03％、2.18％、1.59％、0.47％、0.24％和0.19％.老年(≥65岁)、中年(45～64岁)、青年(15～44岁)人群中,无论男女,其病例来源构成与总体较为一致.但在＜ 15岁少年组中,男、女的因症就诊病例均显著多于转诊病例,分别为71.43％vs.14.29％、75.00％vs.16.67％.结论 转诊、因症就诊为广州市越秀区结核病防治机构肺结核可疑症状者的主要病例来源,结核病防治健康促进工作有待加强.     

Correlates of Co-Occurring Depressive Symptoms and Alcohol Use in an Older Primary Care Clinic Population

ABSTRACT

Objective: This report describes the prevalence and correlates of co-occurring depressive symptoms and alcohol use in an older Veteran's Affairs primary care clinic population.

Methods: Participants include 8,782 older primary care patients (age 65 +) who responded to a self-report, mailed survey. Patients were classified into six mutually exclusive groups based upon screening indicators for problem drinking (quantity/frequency questions) and depressive symptoms (General Health Questionnaire). Groups included: (a) neither problem drinking nor depressive symptoms (n = 6,415, 73.0%); (b) at-risk alcohol use (n = 761; 8.7%); (c) heavy alcohol use (n = 201; 2.3%); (d) depressive symptoms (n = 1,234, 14.1%); (e) depressive symptoms and at-risk alcohol use (n = 120; 1.4%); and (f) depressive symptoms and heavy alcohol use (n = 51; 0.6%). Chi-square and ANOVA were used to test for equality of demographic and clinical characteristics across groups.

Results: 12.9% of patients reported alcohol use consistent with problem drinking (including 10.0% with at-risk alcohol use and 2.9% with heavy alcohol use) and 16.1% screened positive for possible depressive symptoms (including 2.0% with co-occurring at-risk or heavy alcohol use). The combination of heavy alcohol use and depressive symptoms was associated with the highest rates of death and suicidal ideation; living alone; being divorced, separated, or widowed; and regular cigarette smoking. The presence of depressive symptoms (regardless of amount of alcohol use) was associated with worse perceived health, and perceived lack of social support. Finally, individuals with at-risk alcohol use alone were younger and had better perceived health compared to those with non-problem alcohol use or no alcohol use. However, there were no differences between those with at-risk drinking and depressive symptoms and those with depressive symptoms alone.

Conclusions: Self-reported heavy alcohol use combined with depressive symptoms identifies a subgroup of older primary care patients at especially high risk with respect to suicidal ideation and poor mental and physical well-being. In contrast, older adults with depressive symptoms and self-reported “at-risk” alcohol use were not differentiated from older persons with depressive symptoms reporting non-problematic or nonuse of alcohol.     

Self and partner alcohol-related problems among ACOAs and non-ACOAs: Associations with depressive symptoms and motivations for alcohol use

The present study examined whether drinking motivations and depressive symptoms would have a stronger impact on alcohol-related problems among adult children of alcoholics (ACOAs) and their dating partners as compared to non-ACOAs and their dating partners. Participants were 197 undergraduate (60 ACOAs, 137 non-ACOAs) 18 to 25 year-old female drinkers in dating relationships. Participants completed measures of ACOA screening, depressive symptoms, and drinking motives, as well as alcohol-related problems for themselves and their partner. Although no differences were found between ACOA and non-ACOA women's alcohol-related problems, ACOA women and women with greater depressive symptoms were at a higher risk of having a partner with more alcohol-related problems. In addition, we found that regardless of parental history of alcoholism, higher depressive symptoms coupled with stronger motives for drinking to cope with stressors predicted participants' own alcohol-related problems. These findings demonstrate the need for future research to examine additional factors that may moderate the effects of depressive symptoms and ACOA status on female college student drinking problems. A greater understanding of the unique and interactive effects of these variables on alcohol-related problems in both young women and their dating partners can aid in the development of prevention programs more targeted to the specific vulnerabilities of this population.     

Autonomy (vs. sociotropy) and depressive symptoms in quitting smoking: evidence for trait-congruence and the role of gender

According to Beck's cognitive theory of depression, autonomy (high achievement concerns) and sociotropy (high interpersonal concerns) are vulnerability factors for depression when achievement or interpersonal stressors, respectively, are experienced. This hypothesis was tested among men and women attempting to quit smoking, an achievement stressor that can provoke depressive symptoms. Smokers recruited from the community (N=210) provided information about their quit attempt through mailed questionnaires. For the 48-h period following the quit, relationships among autonomy, sociotropy, coping, depressive symptoms and lapsing were assessed. Structural equation models supported the trait-congruence hypothesis because greater autonomy, but not sociotropy, was associated with elevated depressive symptoms among both men and women smokers. However, results were stronger for men (beta=.47, p=.0001) than for women (beta=.20, p=.05). After accounting for autonomy's relationship with depressive symptoms, greater autonomy was inversely associated with lapsing among men (beta=-.35, p=.01), but not women. Results point to the potential usefulness of a theoretical approach to understanding relationships between depressive symptoms and smoking cessation, and indicate that autonomous personality may be an important factor in smoking cessation in men.     

Multisubstance Use Among Treatment-Seeking Smokers: Synergistic Effects of Coping Motives for Cannabis and Alcohol Use and Social Anxiety/Depressive Symptoms

Objective: This study examined the impact of coping motives for cannabis and alcohol use on the relation between social anxiety/depressive symptoms and severity of substance use for alcohol, tobacco, and cannabis among treatment-seeking smokers who also use cannabis and alcohol. Methods: The sample included 197 daily cigarette smokers (M_Age 34.81 years, SD = 13.43) who reported using cannabis and alcohol. Results: Hierarchical multiple regression analyses were conducted wherein separate models were constructed for each dependent variable. Among individuals with higher social anxiety, alcohol coping motives were associated with heavier drinking, and this was more pronounced among those low in depressive symptoms. Similarly, those at greater risk for nicotine dependence were anxious individuals with lower depressive symptoms who endorse coping-oriented motives for using cannabis. Further, among those with higher social anxiety, cannabis coping motives were associated with marginally greater drinking, particularly for those high in depressive symptoms. Conclusions: The present findings support the perspective that among multisubstance users, the interplay between social anxiety, depressive symptoms, and coping-oriented motives for using one substance (e.g., cannabis or alcohol) may pose difficulties in refraining from other substances (e.g., tobacco). This observation highlights the importance of tailoring multisubstance treatments to specific needs of multiusers for whom single-substance interventions may be less effective. Findings also support previous work exploring the benefits of concurrently treating co-occurring substance use and lend credence to the perspective that motivation to use substances for coping reasons is of central theoretical and clinical relevance.