进食障碍的心理干预

进食障碍是一组以进食行为异常为主的精神障碍,主要包括神经性厌食症(Anorexia Nervosa, AN)和神经性贪食症(Bulimia Nervosa, BN)两大综合征.Russell首次提出了对AN和BN的诊断标准[1,2],为DSM-Ⅲ对进食障碍诊断标准的编制奠定了重要基础.目前普遍使用的是DSM-Ⅳ.诊断标准的制定和完善对治疗的发展具有促进作用.17世纪到20世纪前半叶有很多精神科医生和心理学家报告了自己的治疗案例[3],其中有药物治疗取向也有心理治疗取向.     

分裂症患者家属情绪障碍的心理干预

目的：探讨临床心理干预对住院精神分裂症患者家人焦虑情绪的作用。方法：应用个别心理咨询和电话跟踪心理咨询方式对病人家属实施心理干预（干预组）,并与对照组（未干预）比较。采用状态—特质焦虑问卷进行干预前后的测评。结果：干预组病人家属干预后ＳＡＩ均分降低,与干预前相比有显著性差异,而对照组ＳＡＩ前后则无显著性差异。干预效果与年龄、受教育程度、职业、城乡差别有关。结论：临床上对住院精神分裂症患者家属焦虑情绪实施心理干预是一种简便、易行、有效的途径。     

精神分裂症患者及其家属的心理社会干预

精神分裂症患者及其家属的心理社会干预华西医科大学心理卫生研究所李洁向孟泽一、问题的由来自本世纪７０年代始，Ｌｅｆ＆Ｗｉｎｇ（１９７１年）［１］、Ｈｏｇａｒｔｙ等（１９８４年）［２］人发现，精神分裂症患者出院后即使维持服用抗精神病药物仍有３０－４０％...     

浅谈恶性肿瘤患者及其家属的心理护理与干预措施

目的探讨对恶性肿瘤患者及其患者家属采取心理护理干预措施，提高其生存质量的方法。方法与结果分析恶性肿瘤及其家属的心理特征，采取相应的护理干预措施，及时解决患者存在的心理问题，使患者树立战胜疾病的信心，使家属对癌症有比较正确的认识，祛除"癌症不可治"观点，帮助家属树立正确的态度对待患者的疾病，做好陪护工作。结论心理护理干预措施能有效改善患者及其家属的负面心理，提高患者及其家属的生活质量。     

住院临期精神病患者家属心理分析

目的探讨住院临期精神病患者家属的心理需求和心理特征,为做好此期家属的心理指导提供依据。方法采用自制调查问卷,选取来我院住院临期的精神病患者家属145名进行问卷调查。结果经单因素分析发现,影响住院临期精神病患者的家属心理因素与患者的住院次数和病程密切相关,有统计学意义(χ2=5.60～9.83,P<0.05)。结论应当注重住院临期精神病患者家属的心理指导,并且要注意指导的内容和方式。     

心理干预对改善抑郁症患者家属心理状况的效果分析

目的探讨心理干预对改善抑郁症患者家属心理状况的效果。方法采用症状自评量表(SCL-90)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对36名抑郁症患者家属进行调查,与国内常模相比较,并对其进行为期6周的心理干预。结果抑郁症患者家属的SCL-90各因子、SAS和SDS的评分均显著高于全国常模(t=2.10～2.48,P<0.05),心理干预后,患者家属的SCL-90各因子、SAS和SDS的评分较干预前有显著性降低(t=2.11～2.52,P<0.05)。结论抑郁症患者家属的心理问题状况较为严重,而心理干预可有效改善患者家属的心理状况。     

心理干预对改善抑郁症患者家属心理状况的效果分析

目的 探讨心理干预对改善首发住院抑郁症患者家属心理健康状况及应对方式的效果.方法 将80例抑郁症患者家属随机分为干预组和对照组,每组各40例,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和特质应对方式问卷(TCSQ),心理干预前后对两组家属进行测评和对照研究,并与国内常模对比分析.结果 ①干预前两组家属SAS、S...     

精神分裂症恢复期患者及家属家庭干预的对照研究

目的：以康复期出院精神分裂症患者和家属为对象，定期复诊进行家庭干预并对照研究。方法：干预组68例，对照组52例，采用BPRS评定；干预组家属74人，对照组家属65人，采用SCL－90评定。结果：6个月后干预组患者BPRS和入组时对照比较均有显著性差异（P＜0．01），说明干预组患者的精神症状，不良情绪及社会功能明显好转，入组时两组家属SCL－90评定与常模对照比较，均有明显差异（P＜0．05或0．01），经干预后干预组与全国常规比较无显著性差异（P＞0．05），说明患者家属普遍存在心理障碍，经干预后家属心理状况明显改善。结论：对康复期病人及家属进行门诊家庭干预，是有效的康复方法，值得推广应用。     

住院抑郁症患者家属的心理健康状况调查及干预

目的：了解住院抑郁症家属的心里健康状况,探讨心里干预对抑郁症患者家属焦虑情绪,抑郁状态的作用。方法选取60例抑郁症患者家属为观察对象,随机分成干预组和对照组,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)测评其干预前后的症状变化。结果心里干预后分值比干预前下降,干预后家属的焦虑、抑郁症状减轻。结论采用恰当的心里干预措施,可以解决家属诸多的心里问题,明显改善家属焦虑、抑郁症状,提高生活质量。     

心理干预对癌症患者家属负性情绪的影响

目的 探讨综合心理干预对癌症晚期患者家属焦虑抑郁情绪的影响.方法 将86例癌症晚期患者家属随机分为两组.对照组不进行干预,干预组进行团体心理治疗,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评定其情绪状况,观察比较家属在综合心理干预8周前后SAS和SDS评分结果.结果 干预组患者家属焦虑情绪得到明显改善,前后比较有显著性差异(t=4.225,P＜0.001);干预组患者家属抑郁情绪得到明显改善,前后比较有显著性差异(t=4.345,P＜0.001).结论 综合心理干预可以改善癌症晚期患者家属的焦虑抑郁情绪.     

51例进食障碍患者的临床特征分析

目的 :了解进食障碍患者的临床特征。方法 :对符合CCMD -2 -R神经性厌食症 (AN)和神经性贪食症 (BN)诊断标准的 5 1例住院进食障碍患者的临床特征进行了回顾性分析。结果 :AN和BN患者的怕胖心理、闭经、采取相似的方式减少食物对于身体的影响等临床相相似 (P >0 0 5 )。但是AN患者较BN患者发病年龄早 (t =2 3 2 0 ,P <0 0 5 ) ,体像障碍比较多见 (χ2 =6 110 ,P <0 0 5 ) ;BN患者的抑郁主诉多 (χ2 =8 612 ,P <0 0 0 1) ,病程长 (t=3 2 17,P <0 0 5 ) ,停工、停学时间长 (t=2 2 16,P <0 0 5 ) ,自知力较好。结论 :进食障碍两大综合征可能是一个疾病进程中的两个不同阶段 ,而贪食症的危害更应引起重视     

Stress among Care Givers: The Impact of Nursing a Relative with Cancer

Aims:

The aim of the present study is to assess the level and areas of stress among care givers nursing their loved ones suffering from cancer.

Setting and Design:

An assessment of care givers’ stress providing care to cancer patients at Cipla Palliative Care Center was conducted. The study involves data collection using a questionnaire and subsequent analysis.

Materials and Methods:

A close-ended questionnaire that had seven sections on different aspects of caregivers’ stress was developed and administered to 137 participants and purpose of conducting the survey was explained to their understanding. Caregivers who were willing to participate were asked to read and/or explained the questions and requested to reply as per the scales given. Data was collected in the questionnaires and was quantitatively analyzed.

Results:

The study results showed that overall stress level among caregivers is 5.18 ± 0.26 (on a scale of 0-10); of the total, nearly 62% of caregivers were ready to ask for professional help from nurses, medical social workers and counselors to cope up with their stress.

Conclusion:

Stress among caregivers ultimately affects quality of care that is being provided to the patient. This is also because they are unprepared to provide care, have inadequate knowledge about care giving along with financial burden, physical and emotional stress. Thus interventions are needed to help caregivers to strengthen their confidence in giving care and come out with better quality of care.     

86例酒精所致精神障碍患者临床分析

目的　探讨酒精所致精神障碍的临床特点。方法　采用半定式表格分别对 86例住我院诊断酒精所致精神障碍的患者资料进行回顾性调查。结果　酒精所致精神障碍以男性 ( 96.5 % )、低文化水平 ( 68.6% )、体力劳动者 ( 77.8% )居多 ;女性( 3 .5 % )饮酒有增多倾向 ,年龄呈低龄化趋势 ( 4 0 .5± 1 3 .7岁 ) ,离婚、分居者 (共 2 3 .3 % )较多 ,社会功能受损明显 ;开始持续饮酒越年轻 ,出现精神障碍时间越短。近期疗效尚好 (近愈 94.2 % )。结论　酒精所致精神障碍多与饮酒时间有关 ,对患者心理、生理和社会功能有不同程度的损害。应大力宣传长期过量饮酒的危害 ,早期干预。     

癫痫共病精神障碍住院患者的临床特征分析

目的对我院近两年来住院的癫痫患者进行回顾性研究,为规范治疗方案,改善预后提供循证依据。方法采用一般资料量表对50例患者住院资料进行整理,根据诊断与统计手册第五版(DSM-5).诊断系统对这类患者的病例记录资料进行规范诊断,分析临床特征。结果根据DSM-5诊断标准,癫痫脑病的比例明显下降(χ2=21.93,P0.01),癫痫共病双相情感障碍的比例明显增加(χ2=23.51,P0.01)。癫痫起病年龄越晚,共病双相情感障碍的可能性越大,差异有统计学意义(χ2=9.28,P0.05);难治性癫痫共病双相情感障碍所占比例较非难治性癫痫共病双相情感障碍比例低(χ2=12.78,P0.05);癫痫全面性发作共病双相情感障碍比例与部分性发作共病双相情感障碍比例无明显差异(χ2=11.67,P0.05)。结论临床实践中癫痫脑病诊断过多,癫痫共病双相情感障碍诊断不足。癫痫患者共病双相情感障碍与癫痫的发作特征、发病年龄及抗癫痫治疗的效果有关。     

进食障碍预防的理论模型

进食障碍是与认知、情感及行为等心理障碍有关的表现为体重和进食显著异常的综合症。对进食障碍的预防极其重要。目前关于进食障碍预防理论模型主要有三种:非特异性易感压力模型、社会认知模型和批判性社会观点模型。对进食障碍进行有效的预防必须将三种模型结合起来。     

住院乙型肝炎患者情绪障碍及心理干预

目的 了解乙型肝炎患者的情绪障碍和心理干预的效果。方法 对住院的50例乙型肝炎患者进行心理干预,并在心理干预前及心理干预6周后用焦虑自评量表（SAS）、抑郁自评量表（SDS）对患者进行测查。结果 入院时患者的SAS、SDS评分明显高于对照组,心理干预后患者的SAS、SDS评分明显下降。结论 乙型肝炎患者有明显的焦虑抑郁情绪,心理干预是减轻乙型肝炎患者焦虑抑郁情绪障碍的有效方法。     

进食障碍的病因及治疗

本文综述了进食障碍的病因和治疗的国内外最近进展。从社会文化压力、家庭影响、个体因素和生物学角度阐述了进食障碍的病因;从药物治疗和心理治疗两方面总结分析了治疗进食障碍的具体方法和效果。     

An Exploratory Study of a Meditation-based Intervention for Binge Eating Disorder

The efficacy of a 6-week meditation-based group intervention for Binge Eating Disorder (BED) was evaluated in 18 obese women, using standard and eating-specific mindfulness meditation exercises. A single-group extended baseline design assessed all variables at 3 weeks pre-and post-, and at 1, 3, and 6 weeks; briefer assessment occurred weekly.Binges decreased in frequency, from 4.02/week to 1.57/week (p < .001), and in severity. Scores on the Binge Eating Scale (BES) and on the Beck Depression and Anxiety Inventories decreased significantly; sense of control increased. Time using eatingrelated meditations predicted decreases on the BES (r 5 .66, p < .01). Results suggest that meditation training may be an effective component in treating BED.     

Cost of Care for Inpatients with Community-Acquired Intra-Abdominal Infections

Few studies have assessed the actual costs associated with failure of initial empiric antibiotic therapy administered to patients with community-acquired intra-abdominal infections. The goals of this study were (i) to determine the frequency of unsuccessful initial empiric therapy in a real-world setting and (ii) to determine the associated impact on medical costs. Thus, a retrospective chart review was performed at four acute-care university hospitals in France. A total of 292 patients hospitalized for community-acquired intra-abdominal infection were included. The mean age of the cohort was 51 years, and 42% of the patients were female. The most commonly administered empiric regimens were intravenous amoxicillin/clavulanate alone (69 patients) or in combination with other antibiotics (n=87) and piperacillin/tazobactam alone (n=24) or in combination (n=48). Other regimens included broad-spectrum penicillin, cephalosporins, and fluoroquinolones administered alone or in combination (n=64). Empiric therapy was successful in 189 (65%) patients and unsuccessful in 103 (35%). Among the 292 patients with community-acquired infection, 15 died of the infection, 8 required reoperation and 80 required second-line antibiotic therapy. Patients with unsuccessful initial empiric therapy had significantly more parenteral antibiotic days (10.3 vs. 7.6 days) and a longer length of stay (16.2 vs. 12.8 days) compared to those with successful initial empiric therapy. A better selection of initial empiric antibiotic therapy may significantly influence the medical costs associated with patients who are hospitalized with community-acquired intra-abdominal infections. Electronic Publication