抑郁症患者总体幸福感与社会支持和应对方式的相关性

目的调查抑郁症患者的幸福感,探讨其总体幸福感与社会支持和应对方式的相关性。方法于2019年2月-9月在安徽省精神卫生中心焦虑抑郁科门诊及住院患者中选择120例符合《国际疾病分类(第10版)》(ICD-10)抑郁症诊断标准的抑郁症患者作为抑郁症组,同时从社区人员及患者家属中选择122例作为对照组。采用总体幸福感量表(GWB)(中国版)、社会支持评定量表(SSRS)、简易应对方式问卷(SCSQ)进行评定,应用Pearson相关分析及多元线性回归分析比较抑郁症患者GWB、SSRS与SCSQ评分的相关性。结果抑郁症患者GWB评分低于对照组,差异有统计学意义[(62.43±13.48)分vs.(84.97±10.02)分,t=-14.780,P<0.01];抑郁症患者GWB评分与SCSQ总评分和积极应对方式评分均呈正相关(r=0.378、0.460,P均<0.01);抑郁症患者GWB评分与SSRS客观支持、主观支持、对支持的利用度评分及总评分均呈正相关(r=0.354~0.561,P<0.05或0.01);SSRS客观支持、主观支持、对支持的利用度评分及总评分与SCSQ总评分和积极应对方式评分均呈正相关(r=0.234~0.398,P<0.05或0.01)。结论抑郁症患者幸福感较低,且其幸福感水平与社会支持和积极应对方式相关。     

述情障碍在领悟社会支持与产后抑郁间的中介效应

目的探讨分娩前、后产妇述情障碍、领悟社会支持、抑郁变化及三者之间的关系。方法选取安阳市人民医院就诊的孕期≥28周的525名孕妇为研究对象,追踪调查至分娩后一周,采用爱丁堡产后抑郁量表(EPDS)、孕产妇社会支持量表(MSSS)、多伦多述情障碍量表[TAS-20,包括情感识别障碍(DIF)、情感描述障碍(DDF)、外向性思维(EOT)3个分量表]进行测评。结果产妇DIF得分低于分娩前[(19.11±4.67)vs.(18.14±4.46),P0.05]。产后EPDS得分与MSSS得分呈负相关(r=-0.39)、与TAS-20各因子得分呈正相关(r=0.16~0.37,P均0.05)。逐步回归分析显示,EPDS得分与MSSS得分呈负相关(β=-0.42)、与DIF得分呈正相关(β=0.26,P均0.05)。MSSS在TAS-20对EPDS影响中不完全中介效应成立(β=-0.33),χ2/df=0.909、P=0.436、RMSEA=0.009、NFI=0.995、RFI=0.983、IFI=0.991、TLI=0.971、CFI=0.989。结论产妇述情障碍直接或间接通过降低产妇对社会支持的领悟能力而影响产后抑郁。     

精神分裂症的共情缺陷及其影响因素

目的探讨精神分裂症患者共情缺陷特点及其影响因素。方法采用人际反应指针量表(IRI-C)对208例精神分裂症患者和213名正常对照的共情能力进行评估,同时作艾森克人格问卷(EPQ)、罗森伯格自尊量表(SES)、一般自我效能感量表(GSES)、简易应对方式问卷(SCSQ)、社会支持量表(SSRS)、多伦多述情障碍量表(TAS-20)和阳性与阴性症状量表(PANSS)等评估,分析影响患者共情能力的相关因素。结果与对照组相比,患者组IRI-C总分、观点采择、幻想力和同情关心因子分均明显减低(P0.01)。患者EPQ的神经质(N)分(r=-0.22)和精神质(P)分(r=-0.18)、TAS因子III分(r=-0.30)、SCSQ积极应对分(r=0.21)、SSRS主观支持分(r=0.16)及GSES分(r=0.21)均与IRI-C总分相关(P0.05)。以IRI-C总分为因变量的回归分析结果显示,SCSQ积极应对分、EPQ的N分和P分、TAS的因子III得分进入回归模型,标准化回归系数分别为0.28、0.30、-0.18、-0.18。结论精神分裂症患者存在广泛的共情缺陷,患者个性特质及其应对方式对共情能力具有影响。     

冗思反应量表中文版在抑郁障碍患者中的运用结果分析

目的 评价冗思反应量表中文版(RRS-C)在抑郁障碍患者中的信、效度.方法 212例抑郁障碍患者完成了RRS-C和流调中心抑郁量表(CES- D),分析RRS-C的Cronbach'sα系数、条目间平均相关系数、总分和各因子的相关系数,并采用验证性因子分析考察其三因子结构.结果 RRS-C总量表的Cronbach's α系数为0.88,三因子的Cronbach's α系数在0.67～0.84;总量表的条目间平均相关系数为0.26,量表总分和各因子间的相关系数在0.71～0.94,各因子条目间平均相关系数在0.29～0.32;验证性因子分析指标(CFI=0.913;GFI=0.905;x2/v＜2;RSMEA=0.072)均符合测量学要求.结论 RRS-C在抑郁障碍患者中有良好的信、效度,可应用于我国抑郁障碍患者冗思特征的测评.     

强迫症症状分类量表(修订版)中文版的信效度研究

目的:评价中文版强迫症症状分类量表(修订版)(OCI-R)在正常人群和强迫症患者中的信、效度。方法:采用中文版耶鲁-布朗强迫症量表(Y-BOCS)对299例在校大学生及90例强迫症患者进行评定,同时要求每位被试者自行完成OCI-R中文版的评估。其中44名强迫症患者于4周后进行再次测试。结果:OCI-R中文版Cronbach’salpha=0.88,重测信度r=0.690(P<0.05)。OCI-R验证性因素分析结果:χ2=403.07,ν=120,n=299;拟合优度指数(GFI)=0.87;近似误差均方根(RMSEA)=0.086;比较拟合指数(CFI)=0.96;非标准拟合参数(NNFI)=0.95。OCI-R各条目在总量表中的负荷值r=0.450～0.660(P<0.01),各维度在总量中的负荷值r=0.662～0.782(P<0.01)。强迫症患者中OCI-R总分与Y-BOCS总分之间相关系数r=0.422(P<0.01)。结论:OCI-R(修订版)中文译本具有良好的信效度,符合心理测试要求,可适用于中国人群强迫症状的测量。     

临床医生精神疾病态度量表中文版在社区精神卫生工作者中的信度、效度研究

目的:探讨临床医生精神疾病态度量表(MICA)中文版在社区精神卫生工作者中的信度、效度与可接受性。方法:应用MICA中文版对广州市8个区(市)80名社区精神卫生工作者进行间隔1周的两次调查、报告和意向行为量表(RIBS)调查,并附加关于生活中对精神疾病患者态度及对MICA理解度的调查。结果:MICA中文版内部一致性信度(Cronbach’α)为0.720,分半信度为0.685,重测信度为0.764(P0.05);表面效度良好;与RIBS总分及附加条目评分呈负相关(r=-0.516,r=-0.310;P均0.01)。主成份分析产生6个因子,共解释方差65.1%。该量表3 min内可完成。结论:MICA中文版是社区精神卫生工作者对精神疾病态度的有效评估工具。     

歧视与病耻感量表(DISC)中文版在精神障碍患者中的信度和效度研究

目的:评估歧视与病耻感量表(DISC)在中国精神障碍患者中的信度和效度。方法:引进Thornicroft团队研发的DISC,按初译、回译等步骤形成DISC中文版,以242例精神障碍患者作为受访对象,验证量表的信度和效度。结果:DISC的Cronbach'α系数为0.70,分半信度为0.85,总分重测信度为0.83;DISC分量表1总分与精神疾病内在病耻感调查表(ISMI)歧视经历因子分呈正相关(r=0.417,P0.01),分量表2总分与ISMI社会退缩因子分呈正相关(r=0.332,P0.01);分量表2总分与自尊量表(SES)总分呈正相关(r=0.250,P0.01),分量表3总分与SES总分呈负相关(r=-0.187,P0.01);分量表4总分与社会支持评定量表(SSRS)客观支持分以及对支持的利用度分均呈正相关(r=0.177,0.170,P均0.01)。结论:DISC中文版具有较好的信度和效度,可作为评估精神障碍患者歧视与病耻感的临床工具。     

PHQ-9在综合医院住院患者中信效度研究

目的检验病人健康问卷抑郁量表(PHQ-9)在综合医院住院患者中应用的信度和效度,探索PHQ-9在综合医院住院患者中快速筛查抑郁的可行性。方法方便抽取四川大学华西医院569名住院患者,在规定指导语下完成PHQ-9评定,采用随机数字表法随机抽取38名患者在完成初次评定2周后进行PHQ-9重测;以简明国际神经精神访谈(MINI)作为"金标准",评估中文版PHQ-9的效标效度,共139名患者接受MINI中文版访谈。结果 PHQ-9在本研究中的Cronbach'sα系数为0.839,各条目与总评分的相关系数r=0.484~0.724(P0.01),各条目间相关系数r=0.229~0.520(P0.01);两周后重测系数r=0.846(P0.01);因子分析获得3个公因子,分别为自我评价因子、情感因子和躯体化因子;最佳诊断划界分为8分,敏感度为92.6%,特异度为60.6%;PHQ-9的ROC曲线下面积为0.841(95%CI:0.777~0.905)。结论 PHQ-9应用于综合医院住院患者抑郁评估中具有良好的信效度,8分为该量表的最佳划界分。     

工作坊式训练对住院抑郁症患者康复效果的影响

目的探讨工作坊式训练对抑郁症患者自尊水平、应对方式、自我效能及抑郁症状的改善效果。方法选择在某三级精神专科医院住院的82例抑郁症患者为研究对象,均符合《国际疾病分类(第10版)》(ICD-10)抑郁发作诊断标准。采用随机数字表法分为研究组(n=40)和对照组(n=42)。两组患者均接受常规康复训练,研究组在此基础上接受8次工作坊训练。于干预前、干预后第3个月和第6个月采用自尊量表(SES)、简易应对方式问卷(SCSQ)、一般自我效能感量表(GSES)、贝克抑郁量表第2版中文版(BDI-Ⅱ-C)对两组患者进行评定。结果重复测量方差分析显示,干预因素与时间之间存在交互作用(P0. 05)。单独效应分析显示,干预前,研究组和对照组SES、GSES、BDI-II-C、SCSQ各维度评分差异均无统计学意义(P均0. 05);干预3个月后,两组SES、GSES、SCSQ各维度评分差异均有统计学意义(P0. 05或0. 01);干预6个月后,两组SES、GSES、BDI-II-C、SCSQ各维度评分差异均有统计学意义(P0. 05或0. 01)。结论工作坊训练可能有助于提高康复期抑郁症患者的自尊水平和自我效能感,改善应对方式,并有助于预防抑郁症的复发。     

阿尔茨海默病病理行为评分表信度和效度

目的 :评定阿尔茨海默病 (AD)病理行为评分表 (BEHAVE- AD)的信度和效度。　方法 :8名医生对 6例痴呆病人进行联合测定。对 6 3例痴呆病人进行 BEHAVE- AD和简明精神病评定量表 (BPRS)评定 ,48小时后重复 BEHAVE- AD评定。　结果 :同质性信度系数 Cronbach'sα=0 .770 3。联合检测一致性系数 ICC=0 .95 95 ,重测一致性系数 r=0 .96 1,P均 <0 .0 1。与 BPRS评分相比 ,相关系数 r=0 .475 ,P<0 .0 1。根据医生总体评定结果 ,将病人分组 ,各组病人的量表评分有显著差异。　结论 :BEHAVE- AD中译本有较好的信度和效度 ,值得推广应用     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。