游戏障碍的心理治疗研究进展

近年来随着网络信息技术的发展,因病理性使用网络游戏而导致的各种不良后果受到全世界范围内的广泛关注。2018年,世界卫生组织将游戏障碍纳入了第11版的《国际疾病分类》（ICD-11）中,表明游戏障碍已经是一种正式的精神疾病。本文系统综述了游戏障碍心理治疗的最新成果,以期为行为成瘾领域的研究者和临床工作者提供参考。     

网络成瘾(游戏障碍)及干预策略

本文目的是探讨游戏障碍及干预策略.游戏障碍在中国的患病率5％～10％,相对较高,且危害较大,治疗棘手.文章从成瘾机制、成瘾特征、网络成瘾概念、诊断标准、干预策略五个方面进行了讨论.     

广泛性焦虑障碍药物和心理治疗的研究进展

对广泛性焦虑障碍的各种治疗方法的研究进展进行综述.     

产后抑郁障碍的治疗进展

对产后抑郁障碍的诊断、危险因素及治疗进展作一简要介绍。     

躯体形式障碍治疗的研究进展

<正>躯体形式障碍(SD)是一组以躯体不适体验和涉及多系统症状为主而不具备相应躯体医学疾病的精神疾病。为慢性波动性病程,多数患者未得到有效治疗。躯体形式障碍的治疗方法很多,但结果众说纷纭。本文就近年来国内外研究资料进行分析,对躯体形式障碍治疗进展综述如下。1药物治疗1.1抗抑郁药有研究认为躯体形式障碍的发病机理可能与特定的5-羟色胺(5-HT)基因及其受体变化有关[1],而且感觉域的下降与5-HT水平下降有一     

转换障碍的临床访谈与诊治

咨客是一名18岁高三女生,自幼便秘,恋爱受挫后出现胸口痛、胃部不适、食物难以下咽、呼吸不畅等症状,在压力下表现明显。身体检查无异常,倾诉后可迅速缓解,但因症状反复而休学1年。咨客表现出的所有症状都曾在其奶奶身上出现过。该咨客被诊断为转换障碍,躯体症状是在心理作用及焦虑的驱使下产生的,应采用生物、心理、社会的综合干预。具体做法是鼓励咨客运动并使用药物改善焦虑与躯体症状;运用认知行为疗法(CBT)让咨客改变看待问题的角度,运用正念疗法改善强迫思维;规律作息,避免学业及人际压力。     

网络成瘾（游戏障碍）的诊疗与思考

本文目的是探讨网络成瘾（游戏障碍）及其诊疗与研究热点。游戏障碍本质上属于成瘾行为,受到增加正性情绪、缓解负性情绪驱使。本文从一个复杂的共病临床案例引入成瘾行为及游戏障碍的相关问题,对游戏障碍诊断的争议和未来可能的变化、游戏障碍的治疗、目前存在的主要问题与研究热点等进行了讨论。     

“赌博障碍”的访谈与诊治

咨客是一名26岁大专学历的已婚未育男性,事业单位职员。从初中开始参与小额赌博,逐渐加大赌注,反复戒赌失败,目前欠下巨额赌债,严重影响工作和生活,感到内疚后悔。咨客本次咨询的目的是想了解如何才能彻底戒除赌瘾。该咨客被诊断为赌博障碍,属于物质相关及成瘾障碍,容易复发,应采用生物-心理-社会的综合干预。具体做法是鼓励咨客发展健康的爱好来激活大脑;采用认知行为疗法(CBT)让咨客直面赌博的严重后果,认识到自己作为儿子、丈夫的责任和义务;使用动机面询激发咨客为家人和未来孩子戒赌的决心;鼓励患者认真工作,回归家庭,脱离赌博圈子,按时复诊。     

“适应障碍”的访谈与诊治

咨客是一名24岁中专受教育程度的未婚女性,目前无业。她是家中的独生女,从小被忙于生计的父母所忽视,中专毕业走向社会开始出现一系列不适应,事业失败,情感不顺。近两年常有失眠、焦虑、烦躁、胃肠道不适,在压力下感到"心脏缺失了""头很僵",偶有时间感扭曲。被诊断为适应障碍伴焦虑,并出现了躯体化症状,采用生物、心理、社会的综合干预。具体做法是鼓励其进行运动并使用药物改善焦虑与睡眠情况,同时避免加重胃肠道反应;运用认知行为疗法(CBT)让咨客理解病因、调整认知、改善人际关系;学习应对策略,避免工作压力。     

社交焦虑障碍治疗前后脑功能影像学变化研究进展

随着神经影像学的发展,社交焦虑障碍的研究已深入到细胞、分子、神经环路等神经生物学机制方面。文章对近年来国内外社交焦虑障碍的药物治疗、心理治疗前后影像学扫描所观测到的大脑功能变化做出综述。     

卒中后抑郁的非药物治疗研究进展

本文目的是对卒中后抑郁(PSD)的非药物治疗方法及其效果进行综述,以期为PSD患者的综合治疗提供参考。PSD是脑卒中的常见并发症,严重影响患者康复及日常生活,给患者及家庭带来沉重的负担。非药物治疗是改善PSD患者的重要干预手段,故本文对非药物治疗中的心理治疗和物理治疗进行综述。     

青少年抑郁障碍诊疗现状与发展趋势

青少年抑郁障碍是目前备受关注的心理健康问题,其发病率逐年上升,严重影响了青少年的身心健康和社会适应能力。目前青少年抑郁障碍的识别、诊断和治疗等各方面还面临很大的挑战。本文旨在系统梳理和评述近年来青少年抑郁障碍诊断与治疗的研究进展,为进一步探讨青少年抑郁障碍治疗的最佳方案提供支持。     

Targeted psychosocial interventions for bipolar disorder

Pharmacotherapy is the foundation of treatment for bipolar disorder, but research suggests that adjunctive psychosocial interventions that are manualized, reproducible, time-limited, empirically supported, and strategically target a number of critical domains, can efficiently provide additional benefits. Psychoeducation as an adjunct of pharmacotherapy may be beneficial, but questions remain about the utility of this treatment for patients who are already compliant with medication treatment. Family educational interventions have demonstrated encouraging results in relapse prevention, but follow-up data are limited and application to patients who have limited social networks may be problematic. Reports on interpersonal and social rhythm therapy in patients with bipolar disorder are scarce, and what is available shows no differential effect on time to remission or relapse, but a significant impact on subsyndromal symptoms. Follow-up data suggest that patients receiving cognitive behavior therapy have significantly fewer bipolar episodes, shorter episodes, fewer hospitalizations, and less subsyndromal mood symptoms. It is unclear, however, if cognitive behavior therapy is superior to other active psychosocial treatments and whether its mechanism in patients with bipolar disorder is through changing dysfunctional cognitions or simply enhancing early symptom detection. Psychotherapies should be considered early in the course of illness to improve medication compliance and to help patients identify prodromes of relapse in order to take steps for prevention. In addition, some strategies may have a beneficial effect on residual symptoms, particularly symptoms of depression, and thus help move patients toward a more comprehensive functional recovery.     

焦虑障碍虚拟现实暴露治疗的效果研究进展

本文目的是对虚拟现实暴露疗法治疗焦虑障碍各亚型效果的研究进展进行综述,以期为临床应用提供参考。虚拟现实技术的日益普及与发展,为焦虑障碍的治疗提供了新的有效方法。近年来,大量研究表明虚拟现实暴露疗法治疗焦虑障碍有一定的效果。本文探讨了虚拟现实暴露疗法治疗焦虑障碍各亚型的效果以及药物对虚拟现实暴露治疗的增效作用,并总结了虚拟现实暴露疗法的优点及不足。     

Targeted psychosocial interventions for bipolar disorder

Abstract:  Pharmacotherapy is the foundation of treatment for bipolar disorder, but research suggests that adjunctive psychosocial interventions that are manualized, reproducible, time-limited, empirically supported, and strategically target a number of critical domains, can efficiently provide additional benefits. Psychoeducation as an adjunct of pharmacotherapy may be beneficial, but questions remain about the utility of this treatment for patients who are already compliant with medication treatment. Family educational interventions have demonstrated encouraging results in relapse prevention, but follow-up data are limited and application to patients who have limited social networks may be problematic. Reports on interpersonal and social rhythm therapy in patients with bipolar disorder are scarce, and what is available shows no differential effect on time to remission or relapse, but a significant impact on subsyndromal symptoms. Follow-up data suggest that patients receiving cognitive behavior therapy have significantly fewer bipolar episodes, shorter episodes, fewer hospitalizations, and less subsyndromal mood symptoms. It is unclear, however, if cognitive behavior therapy is superior to other active psychosocial treatments and whether its mechanism in patients with bipolar disorder is through changing dysfunctional cognitions or simply enhancing early symptom detection. Psychotherapies should be considered early in the course of illness to improve medication compliance and to help patients identify prodromes of relapse in order to take steps for prevention. In addition, some strategies may have a beneficial effect on residual symptoms, particularly symptoms of depression, and thus help move patients toward a more comprehensive functional recovery.     

松弛疗法在失眠障碍中的应用进展

失眠障碍(Insomnia Disorders)是临床上常见的一种病症,也是最常见的睡眠障碍之一,其特征是入睡困难、睡眠维持困难、早醒和(或)睡眠质量差.文献报道,约25%的成人对自己睡眠不满意,其中6%~10%符合失眠障碍的诊断标准,长期失眠、睡眠质量低下可增加心血管疾病及慢性病的发生率,睡眠问题越来越受到重视[1-2].2013年出版的《精神疾病诊断与统计手册第5版》(DSM-5)将过去"原发性失眠"和"继发性失眠"的诊断条目删除,依据病程将失眠分为急性失眠、慢性失眠和其他类型失眠 3部分,不再用因果关系解释失眠与其他疾病共病的现象,更强调失眠障碍本身在临床工作中的重要意义、应根据诊断标准进行独立评估[3].失眠的治疗主要包括药物治疗和非药物治疗,临床上较常使用的催眠药是苯二氮 类,但长期使用可导致认知功能障碍、记忆损害、睡眠结构受损等不良反应[4-5].非药物治疗作为更安全的治疗方法日益受到推崇.其中松弛疗法治疗在临床应用有较多突破,本文主要就近年国内外松弛疗法治疗失眠障碍的研究进展做一简单综述.     

Family therapy interventions in India for persons with gambling disorder

Gambling is a popular pastime in India and the number of problem gamblers is on the rise. Although the impact of gambling disorder on families is grossly under‐researched in India, drawing on international evidence it is only reasonable to assume that this is an important area deserving further clinical and research attention. Of the several types of interventions possible with families of persons with gambling disorder, in our clinical experience, the 5‐step intervention is a feasible and culturally adaptable psychotherapeutic intervention. In this paper we have looked at the theoretical aspects of this intervention and also raise some of the practical challenges of offering psychological interventions to families of persons with gambling disorder in India. Albeit limited, we discuss the evidence base to have emerged from India in this field. Finally, we suggest some intervention measures as the way forward.     

酒精使用障碍共病抑郁障碍机制研究进展

本文对近年来国内外关于酒精使用障碍与抑郁障碍共病的相关机制研究的最新进展进行综述,从遗传基础、神经生化、神经免疫及神经内分泌等方面阐述其共病机制,指出当前研究的不足,并预测未来的研究方向,为酒精使用障碍共病抑郁障碍的临床治疗提供新的思路。