四川省某少数民族地区医务人员心理健康状况调查

目的了解少数民族地区医务人员的心理健康状况。方法采用抑郁自评量表(SDS)、焦虑自评量表(SAS)对四川省某少数民族地区某县医院全体医务人员共130名进行问卷调查。结果少数民族地区医务人员焦虑和抑郁症状检出率分别为26.15%、36.92%。SAS评分在不同性别、职业、学历间差异无统计学意义(P0.05);女性组SDS评分高于男性组(P0.05),护士组SDS评分高于医生组(P0.05),中专组与大专组、大专组与本科组SDS评分差异无统计学意义(P0.05),中专组SDS评分高于本科组(P0.05)。结论少数民族地区医务人员存在抑郁、焦虑症状,该地区医院应关注医务人员的心理健康问题,采取积极有效的措施,减少心理问题的发生。     

大学生网络成瘾的性别差异

目的探索大学生网络成瘾的性别差异及其相关因素,为大学生网络成瘾的预防干预提供参考。方法采用分层整群随机抽样法在某综合性大学和某医科大学共2所大学抽取659名被试,使用自编网络行为偏好调查问卷、中文网络成瘾量表(CIAS)、交往焦虑量表(IAS)、流调中心用抑郁量表(CES-D)和社会支持评定量表(SSRS)进行调査。结果男性大学生CIAS总评分、时间管理、网络成瘾戒断症状、强迫性上网评分均高于女性大学生,差异均有统计学意义(t=2.94~7.51,P均0.01)。男性大学生每周上网总时间多于女性大学生(t=4.64,P0.01),男性大学生更多使用网络游戏进行娱乐(t=5.77,P0.01);女性大学生CES-D总评分、SSRS总评分高于男性(t=-5.11、-2.39,P均0.05)。结论大学生网络行为偏好、抑郁、社会支持存在性别差异,可能是男性大学生网络成瘾倾向高于女性的相关影响因素。     

帕金森病患者运动和非运动症状的性别差异

目的探讨帕金森病(PD)患者运动和非运动症状的性别差异。方法应用统一PD评分量表(UPDRS)第Ⅲ部分和修订的Hoehn-Yahr(H-Y)分期评定586例PD患者的运动症状。应用PDNMS筛查问卷(NMSQ)评定PD患者及102名正常对照者的非运动症状,并进行比较。结果 PD组男性受教育年限显著长于女性及正常对照组男性(均P0.05)。PD组男性僵直评分显著高于女性(P0.05),UPDRS-Ⅲ总分、震颤、运动迟缓、姿势不稳评分及HY分期差异无统计学意义。PD组女性情绪/情感淡漠、其他症状评分及失眠、情绪低落抑郁、焦虑害怕或恐慌、不明原因的疼痛和腿肿胀、增粗的比率显著高于男性(均P0.05);胃肠道症状、排尿障碍评分及流涎、夜尿增多的比率显著降低(均P0.05)。正常对照组女性生动梦境、丧失兴趣的比率较正常对照组男性高(均P0.05)。PD组男性除错觉、恶心或呕吐、大便失禁外,其余各项评分及比率均高于正常对照组男性(均P0.05);PD组女性除头晕、幻视或幻听、错觉外,其余各项评分及比率均高于正常对照组女性(均P0.05)。PD组除头晕、大便失禁外,其他评分和各分项的比率均显著高于正常对照组(均P0.05)。结论 PD患者的运动和非运动症状具有性别差异。     

帕罗西汀对首发抑郁症患者治疗前后性激素水平 变化及与疗效的关系

目的 探索抑郁症患者性激素水平和治疗后的变化与治疗效果的关系.方法 收集抑郁症患者60例作为观察组,健康体检的志愿者60例作为对照组,检测患者治疗前后的血清雌二醇、孕酮及睾酮的水平,用汉密尔顿抑郁量表(HAMD)对抑郁患者进行评分,分析抑郁程度与性激素水平之间的相关性.结果 治疗前观察组男性和女性的血清雌二醇水平均低于对照组,男性的孕酮及睾酮水平低于对照组,差异均有统计学意义(P<0.05),女性的孕酮和睾酮水平与对照组差异无统计学意义(P>0.05);治疗后男性和女性患者的血清雌二醇水平高于治疗前,差异有统计学意义(P<0.05),男性患者的睾酮水平高于治疗前,差异有统计学意义(P<0.05),而男性和女性患者孕酮水平及女性患者的睾酮水平与治疗前的差异无统计学意义(P>0.05);治疗后观察组男性和女性患者的孕酮及睾酮水平与对照组之间的差异均无统计学意义(P>0.05),观察组女性患者的血清雌二醇水平与对照组之间的差异无统计学意义(P>0.05),观察组男性患者血清雌二醇水平低于对照组,差异有统计学意义(P<0.05);HAMD减分率与血清雌二醇水平之间呈正相关(r=0.561,P=0.007);而与血清孕酮及睾酮之间无相关性(P>0.05).结论 抑郁症患者血清雌二醇与抑郁症之间呈负相关,睾酮水平的变化可能仅是男性抑郁症患者的一个危险因素.     

个体化健康教育对老年糖尿病患者情绪状态和生活质量的影响

目的探讨个体化健康教育对老年糖尿病患者抑郁情绪和生活质量的影响。方法选取2014年1月~2015年6月我院收治的老年糖尿病患者108例,随机分成两组,对照组50例实施常规护理,观察组58例进行个体化健康教育,3个月后比较两组患者护理前后生活质量和焦虑、抑郁症状评分和护理满意度。结果 3个月后观察组焦虑自评量表(SAS)和抑郁自评量表(SDS)评分显著低于对照组(P0.05);两组患者护理前生存质量量表(WHOQOL-100)各因子评分比较差异无统计学意义(P0.05);护理后,观察组生理、精神支柱、社会关系、环境、独立性评分明显高于对照组(P0.05);调查发现观察组护理满意度(94.83%)显著高于对照组(82.00%)(P0.05)。结论个体化健康教育能够一定程度上改善老年糖尿病患者的抑郁焦虑情绪,提高自我护理能力和生活质量。     

精神分裂症患者临床特征的性别差异

目的探讨精神分裂症患者临床特征的性别差异。方法连续入组住院治疗的符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者334例,采用阳性和阴性症状量表(PANSS)、自知力与治疗态度问卷(ITAQ)、药物态度清单(DAI)、副反应量表(TESS)及健康状况问卷(SF-36)测评患者治疗前后的临床特征。采用χ2检验、t检验及协方差分析对临床特征进行性别差异比较。结果男性患者发病年龄小于女性(P0.05),女性患者已婚比例高(P0.05),治疗后女性患者ITAQ评分、DAI评分、SF-36评分低于男性(P均0.05),TESS评分、PANSS阳性症状评分及抑郁症状评分高于男性(P均0.05)。结论女性精神分裂症患者与男性相比,发病年龄晚,已婚比例高,抑郁症状重,对药物的副反应敏感。     

综合干预对精神分裂症患者亲属抑郁与焦虑情绪的影响

目的:探讨综合干预对精神分裂症患者亲属抑郁、焦虑情绪的影响。方法:对114位精神分裂症患者家属进行综合干预6个月;干预前、干预3及6个月后分别采用抑郁自评量表(SDS)和焦虑自评量表(SAS)对入组者的抑郁、焦虑情绪进行评估,分析影响其抑郁、焦虑情绪的因素。结果:干预前患者亲属SDS和SAS评分明显高于国内常模(t=12.10,t=10.81;P均0.001);女性亲属SDS和SAS评分明显高于男性亲属(t=3.35,P=0.001;t=2.32,P=0.022);无固定职业的患者亲属SDS和SAS评分明显高于有固定职业的患者亲属(t=2.00,P=0.048;t=2.06,P=0.042);不同教育程度的患者亲属的SDS和SAS评分比较差异有统计学意义(F=3.18,P=0.046;F=3.24,P,0.043);但不同亲属关系的患者亲属间SDS和SAS评分比较差异无统计学意义。干预3个月后及6个月后,患者亲属的SDS和SAS评分较基线有明显下降(P均0.05),但与国内常模相比,差异仍有统计学意义(P均0.05)。结论:精神分裂症患者家属有明显的抑郁、焦虑情绪,并与其性别、受教育程度和职业状况有关。综合干预能有效改善精神分裂症患者家属的焦虑、抑郁情绪。     

初诊帕金森病患者睡眠质量的性别差异及临床特征分析

目的探讨初诊未服药帕金森病(PD)患者睡眠质量的性别差异及临床特征。方法选取初诊未服药的PD患者259例(其中男性127例,女性132例),收集患者基本临床资料并用PD睡眠量表(PDSS)评估睡眠情况,比较不同性别患者的睡眠情况以及不同运动亚型PD患者睡眠情况的性别差异,并将两组的PDSS评分分别与基本临床资料作相关性分析。结果女性患者PDSS中总体夜间睡眠质量、入睡困难、睡眠维持障碍、夜间遭受梦境困扰、夜间睡眠时出现上肢或下肢的肌肉痛性痉挛、清晨早醒并伴有上肢或下肢疼痛评分及PDSS总分显著低于男性患者(均P0.05)。在震颤为主型PD患者(TD-PD组)中,不同性别患者的教育程度、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及PDSS评分差异有统计学意义(均P0.05);在姿势异常步态障碍型PD患者(PIGD-TD组)中,不同性别患者的病程、教育程度、校正蒙特利尔认知评估量表(MoCA)、HAMA评分有显著差异(均P0.05)。TD-PD组男性PDSS中总体夜间睡眠质量、入睡困难、夜尿和清晨早醒并伴有上肢或下肢疼痛评分及总分显著高于女性(均P0.05)。PIGD-PD组男性PDSS中夜间遭受梦境困扰、清晨早醒并伴有上肢或下肢疼痛评分显著高于女性患者(均P0.05)。Spearman相关性分析显示,男性PD患者PDSS评分与年龄、发病年龄、HAMD评分、HAMA评分、PD非运动症状评定量表(PDNMS)评分、改良Hoehn-Yahr(H-Y)分期、统一PD评定量表(UPDRS)第三部分评分呈负相关(均P0.05),与MMSE呈正相关(P0.05);女性PD患者的PDSS评分与HAMD评分、HAMA评分、PDNMS评分、H-Y分期、UPDRS第二部分评分呈负相关(均P0.05)。结论初诊未服药PD患者中女性的睡眠质量较男性更差。     

综合护理干预对辅助生殖技术治疗的不孕症患者焦虑抑郁及妊娠结局的影响

目的探讨综合护理干预对接受不孕症辅助生殖技术治疗的患者焦虑、抑郁情绪及妊娠结局的影响。方法选取2017年4月～2018年4月我院收治的不孕症辅助生殖技术治疗的患者60例,采用随机数字表法分组,观察组开展综合护理干预(n=30)对照组施以常规护理(n=30),比较两组患者的焦虑抑郁负性情绪评分、幸福感评分、临床妊娠率、活产率、护理满意度。结果两组不孕症患者在干预前,焦虑、抑郁负性情绪评分经评估无差异(P0.05),干预后各评分经评测均有下降,观察组下降程度较对照组更为显著(P0.05);观察组幸福感评分高于对照组(P0.05);观察组临床妊娠率高于对照组(P0.05);观察组护理满意度经评定为96.7%,高于对照组70%(P0.05)。结论针对临床收治的不孕症应用辅助生殖技术治疗的患者,重视综合护理干预工作的开展,可有效缓解焦虑、抑郁负性情绪,提高幸福感,提升妊娠率,增强护理满意度。     

针对性护理措施对脑卒中后焦虑抑郁患者生活能力和神经功能的影响

目的研究脑不同护理措施对脑卒中后焦虑抑郁患者的生活能力和神经功能的影响。方法选取我院从2014年7月至2015年8月收治的脑卒中后焦虑抑郁的患者120例,采用随机数字表法将上述患者分为观察组(60例)和对照组(60例);对照组采取常规护理方法进行护理,观察组采取功能锻炼以及心理护理,观察对比两组患者的护理满意率、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分以及国立卫生研究院卒中量表(NIHSS)评分、日常生活能力量表的Barthel指数。结果两组患者实施相应的护理干预前HAMA评分、HAMD评分以及Barthel指数,组间比较无明显差异(P0.05)。护理干预结束后,两组的上述量表各项指标评分较护理前均有改善(P0.05);且观察组护理满意度为100.00%,对照组91.67%,两组比较差异具有统计学意义(P0.05);观察组的NIHSS评分、Barthel评分均高于对照组,差异具有统计学意义(P0.05);观察组的HAMA评分、HAMD评分均低于对照组,差异具有统计学意义(P0.05)。结论脑卒中后焦虑抑郁患者采取功能锻炼及心理护理,可以更有效地促进患者神经功能的恢复,且减少焦虑抑郁等负性情绪的发生,提高护理满意率,对患者疾病的康复与预后均具有很大的改善,因此值得临床推广。     

Dyadic adjustment,sexuality and psychological distress in older couples

The following study gives results on the association between psychological distress and sexual and marital aspects from the Quebec Health Survey of Older Couples (Enquête sur la santé des aînés au Québec/Volet Couple). In this study, 508 francophone couples (508 women, 508 men), aged 65 years old and over, answered several questionnaires about psychological distress (e.g. Psychological Distress Index) and marital (e.g. Dyadic adjustment scale) and sexual aspects of their life (e.g. Derogatis Sexual Functioning Inventory, International Index of Erectile Function, Female Sexual Function Index). Participants answered general questions at home in the presence of an interviewer and they answered to specific questionnaires about their sexuality and marital life on a computer to ensure confidentiality. Results indicate that dyadic adjustment, sexual satisfaction and gender predict psychological distress and explain 14.2% of the variance of psychological distress among older couples. The same predictor variables were found in men and women considered separately. Moreover, participants with low marital functioning show more than twice as much psychological distress and poorer sexual functioning.     

The relationship between depression and marital maladjustment. A descriptive study

Measures of depression and marital adjustment were completed by patients hospitalized on an inpatient psychiatric unit and their spouses. Therapists also provided ratings of the patients' depression and couples' marital adjustment. Results indicated a significant negative correlation between patient self-reports of depression and marital adjustment, which was supported by the correlation between therapist ratings. These results demonstrate generalization of the previously established depression-marital maladjustment relationship from outpatients to inpatients. Analyses of sex differences indicated that, although there were no differences between depressed men and women in the severity of the depression, depressed men rated their marriages as significantly better adjusted than depressed women. Clinical implications of these findings with respect to depression and marital maladjustment are discussed.     

青年缺血性卒中心理状态

目的 评估青年缺血性卒中后心理状态.方法 入选2008年3月~2011年3月期间两院90例青年缺血性卒中患者,男58例,女32例,年龄21~45岁.使用中国版SCL-90评估心理状态,测量值与常模比较.结果 和常模比较,青年缺血性卒中测量值在抑郁,焦虑,躯体化症状,恐惧,厌恶和精神症状方面差别有统计学意义(P<0.01),而在强迫、敌意和妄想方面的差异无统计学意义(P>0.05).抑郁/焦虑的发生率是43.33%,其中女性占75%,男性占25% (P<0.01).受教育程度差异无统计学意义(P> 0.05).医保患者抑郁/焦虑发生率是29.2%,低于自费患者的发生率(66.7%,P< 0.05).脑损伤部位与抑郁/焦虑发生率有关,双重大脑半球缺血者的发生率是75% (P< 0.05).结论 青年缺血性卒中伴有抑郁、焦虑、躯体化症状、人际关系敏感、恐惧和精神症状,但是强迫、敌意和妄想与常模没有明显的差异.性别、医疗费用和缺血部位影响抑郁/焦虑的发生率.     

Gender differences in psychosocial risk factors for psychological distress among immigrants

The reasons for a greater prevalence of psychological distress among women than men remain unknown. We sought to test two hypotheses that gender operates either as (1) a moderator or (2) a mediator between psychosocial risk factors and experienced distress. A cross-sectional community survey of 1,062 adult Russian-born Jewish immigrants to Israel was conducted. The Demographic Psychosocial Inventory (DPSI) and the Talbieh Brief Distress Inventory (TBDI) were used to measure the parameters of interest. Univariate and multivariate analyses were used to test the moderation versus mediational hypotheses of gender in the stress-distress relationship. The aggregate levels of psychological distress and depression, anxiety, and obsessive symptoms were significantly higher for women than for men. Five sources of distress were more likely to be reported by women: family problems, inappropriate climatic conditions, anxiety about the future, poor health status, and uncertainty in the present life situation. Men scored higher on three stress-protective factors: the number of reasons for immigration, commitment to the host country, and job adequacy. Results of multiple regression and multivariate analysis of variance (MANOVA) supported the mediation hypothesis that gender differences in psychological distress stem from women's greater exposure to specific psychosocial stressors. Our findings demonstrate the validity of gender as an important mediating mechanism underlying the differential perception of risk factors for the development of psychological distress.     

A preliminary study of the psychological differences in infertile couples and their relation to the coping styles

BackgroundStudies from Western countries have observed that couples undergoing infertility treatment suffer various physical and psychological difficulties at a higher frequency than the comparable general population. These relate to treatment challenges and other psychosocial stressors, often influenced by coping style, personality factors and available support systems. There is paucity of studies in non-Western populations.ObjectiveThe aim of this pilot investigation was to evaluate characteristics and gender differences in perceived psychological difficulties reported by infertile Malaysian couples. In particular, depression, anxiety and stress, along with correlated coping styles, were examined between spouses.MethodsDemographic information, including age, ethnicity and duration and causes of infertility, were collected from participants treated within a fertility clinic. The Depression, Anxiety and Stress Scale (DASS) and Coping Inventory for Stressful Situation (CISS) were completed to measure psychological distress and coping styles.ResultsDepression, anxiety and stress-related difficulties were reported at significantly higher frequency by wives than husbands (p < 0.05). There were no significant differences in coping styles between wives and husbands. However, emotional-oriented coping style was associated with significantly higher levels of depression, anxiety and stress (p < 0.05) within the overall sample with odds ratios of 2.5, 3.0 and 1.5, respectively.ConclusionThe study confirms that, as with Western subjects, Malaysian infertile couples demonstrate the vulnerability to psychological distress that occurs more frequently among wives than husbands. As anticipated, emotional coping style was associated with greater distress in both genders.     

Psychosocial adjustment of epilepsy patients in Cyprus

This study investigated aspects of psychosocial adjustment in epilepsy patients in Cyprus. Sixty-three patients under 55years of age with idiopathic or symptomatic epilepsy and 89 neurologically matched healthy volunteers participated. Subjects completed the State and Trait Anxiety Inventory and the Beck Depression Inventory; patients with epilepsy also completed the Epilepsy Foundation Concerns Index. Results showed that patients with symptomatic epilepsy had significantly higher scores on state and trait anxiety and depressive symptoms. Sociodemographic characteristics including gender, marital status, and education levels contributed to differences in trait and state anxiety, depressive symptom scales, autonomy concerns, and fear for seizure recurrence. Variables such as poor seizure control and use of polytherapy were associated with lower adjustment scores and reduced psychosocial outcome. Finally, patients with epilepsy scored significantly higher on depression and anxiety symptoms. The results provide further evidence on challenges patients with epilepsy face and on the need for implementing psychosocial prevention programs.     

Posttraumatic stress disorder and psychiatric co-morbidity: symptoms in a random sample of female Bosnian refugees.

OBJECTIVES: This study investigated psychological symptoms in Bosnian women 3-4 years after their arrival in Sweden. SUBJECTS AND METHODS: A simple random sample of 163 Bosnian women aged 19-59 was drawn from the Swedish populations register in 1996. The control group consisted of 392 Swedish-born women. Data were collected in face-to-face interviews. The Hopkins Symptom Checklist 25 (HSCL-25) and the Posttraumatic Symptom Scale (PTSS-10) were used to measure psychological symptoms of depression, anxiety, psychological distress, and posttraumatic stress disorder (PTSD). Unconditional logistic regression was used to estimate odds ratios (OR) for psychological symptoms after adjustment for age, country of birth, education, marital status, economic difficulties, social network, and feeling secure. RESULTS: The prevalence of symptoms of PTSD was 28.3% among the Bosnian women. Bosnian women had significantly higher risks of symptoms of depression, anxiety, and psychological distress than Swedish-born women. For depression the odds ratio was 9.50 among Bosnian women. CONCLUSION: Psychiatric community interventions need to target Bosnian refugee women. Awareness among health-care workers who encounter these women in a clinical setting should be improved.     

Psychological status of morbidly obese women before gastric restriction surgery

One hundred and eighteen of 142 morbidly obese women had gastric restriction surgery after completing self-report questionnaire measures of psychosocial adjustment as part of their preoperative psychiatric assessment. Compared with an age-matched normal population, they scored significantly higher on measures of phobic anxiety, somatization, depression, hostility, and marital dissatisfaction, the last being associated mainly with later onset obesity. Factor analysis of questionnaire and weight data showed that weight was largely independent of psychological adjustment, although associations occurred when analysis was restricted to the data on married women, in which marital and self-assertion abnormalities loaded significantly on the same factor.     

Clinical Features in Panic Disorder with Agoraphobia: A Comparison of Men and Women

This study compared 96 women and 58 men suffering from panic disorder with agoraphobia. Participants completed questionnaires assessing various clinical features associated with panic disorder with agoraphobia (PDA), general adjustment, and drug/alcohol use. Results showed that PDA is a more severe condition in women. Women reported more severe agoraphobic avoidance when facing situations or places alone, more catastrophic thoughts, more body sensations, and higher scores on the Fear Survey Schedule. Also, women more often had a comorbid social phobia or posttraumatic stress disorder. The lower agoraphobic avoidance of men was associated with their alcohol use. However, there were no differences between genders in other dimensions, including depression, situational and trait anxiety, stressful life events, social self-esteem, marital adjustment, and drug use.     

Gender differences in psychiatric symptoms related to suicidal ideation in Japanese patients with depression

Recent figures show that more than 30,000 people suicide each year in Japan, and that many of them are considered to suffer from depression. In addition, the suicide rate among Japanese women has been shown to be higher than in other countries. However, it is not clear whether the psychiatric symptoms leading to suicide differ by gender. The authors examined gender differences in psychiatric symptoms related to suicidal ideation (SI) in Japanese patients with depression. Study subjects were 199 new patients (66 men and 133 women) who were diagnosed with a major depressive disorder. SI and psychiatric symptoms were assessed by several psychological tests using questionnaires. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (CI) with an adjustment for all relevant factors simultaneously. The stepwise method was also used for selecting variables. In univariate analysis, several psychosocial factors such as self-reproach, derealization, depressive moods, depersonalization, and anxiety traits were statistically significantly associated with SI in both men and women. However, multivariate analysis using the stepwise method distinguished gender differences. Low social/family support and depersonalization were statistically significantly associated with SI in men, while depressive moods and an anxiety state were significantly associated with SI in women. The relation between derealization and SI was statistically significant in women but not significant in men.