多囊卵巢综合征与健康相关生命质量及心理疾患

多囊卵巢综合征(PCOS)可对健康相关生命质量产生负面影响,对性心理、身体满意度及社交也会产生不利影响,是心理疾患(抑郁及焦虑)的一个主要原因.对PCOS患者进行临床治疗干预会改善其生命质量,对心理疾患、性心理、身体满意度及社交也会有积极影响.测量生命质量的调查量表种类较多,最常用的是简式健康调查量表36(SF-36)...     

Health-related Quality of Life, Depression and Anxiety in Thyroid Cancer Patients

Objectives: We examined the relationships among physical complaints, health-related quality of life (HRQL), anxiety and depression in differentiated thyroid cancer (DTC) patients under short-term hypothyroidism. Methods: We conducted a cross-sectional study in 136 patients hypothyroid on thyroid hormone withdrawal (THW) hospitalized for radioiodine administration. Patients were assessed using Short Form SF-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Beck Depression Inventory (BDI), and physical complaints. Results: Compared to the German general population, hypothyroid patients had significantly impaired HRQL. Surprisingly, the prevalence of anxiety (62.5%), but not depression (17.9%) was much higher in hypothyroid DTC patients than in the general population. In multivariate analysis, depression and age were independently associated with the physical health score (R² = 0.21), but only psychological variables (depression, mood disturbance, and anxiety) were associated with the mental health score (R² = 0.43), on the SF-36 HRQL instrument. Conclusions: HRQL is severely impaired in DTC patients under short-term hypothyroidism. As potential predictors of generic HRQL impairment, depression, anxiety, and mood disturbance could be used to preselect the patients most needing psychiatric care. The high frequency of anxiety should be considered in the aftercare of thyroid cancer patients.     

Depression and retirement in late middle-aged U.S. workers

OBJECTIVE: To determine whether late middle-aged U.S. workers with depression are at an increased risk for retirement. DATA SOURCE: Six biennial waves (1992-2002) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61-year-olds and their spouses started in 1992. STUDY DESIGN: Workers aged 53-58 years in 1994 were followed every 2 years thereafter, through 2002. Depression was coded as lagged time-dependent variables measuring active depression and severity of depression. The main outcome variable was a transition to retirement which was measured using two distinct definitions to capture different stages in the retirement process: (1) Retirement was defined as a transition out of the labor force in the sample of all labor force participants (N=2,853); (2) In addition a transition out of full time work was used as the retirement definition in the subset of labor force participants who were full time workers (N=2,288). PRINCIPAL FINDINGS: In the sample of all labor force participants, the presence of active depression significantly increased the hazard of retirement in both late middle-aged men (adjusted OR: 1.37 [95 percent CI 1.05, 1.80]) and women (adjusted OR: 1.40 [95 percent CI 1.10, 1.78]). For women, subthreshold depression was also a significant predictor of retirement. In the sample of full time workers, the relationship between depression and retirement was considerably weaker for women yet remained strong for men. CONCLUSIONS: Depression and depressive symptoms were significantly associated with retirement in late middle-aged U.S. workers. Policymakers must consider the potentially adverse impact of these labor market outcomes when estimating the cost of untreated depression and evaluating the value of interventions to improve the diagnosis and treatment of depression.     

Goal Disturbance in Relation to Anxiety,Depression, and Health-related Quality of Life After Myocardial Infarction

Aim of this cross-sectional study, was to examine whether the sudden event of hospitalization for Myocardial Infarction (MI) would lead to a disturbance in the attainment of important higher order or life goals, and secondly, whether goal importance as well as goal disturbance would be related to emotional distress and health-related quality of life (HRQL) shortly (two to five weeks) after the MI. Respondents were 160 patients who were hospitalized for MI. Results indicate that patients experience goal disturbance as a result of their cardiac event. Hierarchical regression analyses showed that independently from demographics, medical characteristics and prior lifestyle, disturbance of important higher order goals was a powerful correlate of anxiety, depression as well as HRQL. Furthermore, the extent to which patients valued higher order goals in their life (goal importance) was an independent correlate of depression. Based on self-regulation theory, we suggest that emotional distress and lower levels of HRQL can be explained in terms of threat to goal attainment. Recommendations for further research and practical implications for rehabilitation programs were formulated.     

Quality of Life in Depression: Predictive Models

The purpose of this study was to examine the predictive factors of quality of life for inpatients with depressive disorders. Eighty-three patients (mean age 44; 73% female) with depressive disorders were recruited from the psychosomatic ward of a medical center in the northern part of Taiwan. The predictive models of this study were established by encompassing three constructs: clinical variables, demographics, and perceived competence. The outcome variables of this study included an overall quality of life score and four domains’ scores of the World Health Organization Quality of Life-brief version (WHOQOL-BREF). Stepwise regression analysis was used to identify significant factors related to the outcome variables. The results showed that there were five distinct models for the various domains of the quality of life. The predictive variables of the final model for overall quality of life included: the Beck Anxiety Inventory, the Canadian Occupational Performance Measure-satisfaction, and the Occupational Self Assessment-self. For the physical domain of the quality of life model, the adjusted Beck Depression Inventory-II, the Beck Anxiety Inventory, and the Activity of Daily Living Inventory were the significant predictors. In the psychological domain, the adjusted Beck Depression Inventory-II and age were the predictive factors. The adjusted Beck Depression Inventory-II, the Beck Anxiety Inventory and the Occupational Self Assessment-environment were the predictors for the social domain of quality of life. Finally, the adjusted Beck Depression Inventory-II, age, and the Occupational Self Assessment-environment were the predictors for the environmental domain of quality of life. The significance of the perceived competence variables in the quality of life of patients with depression indicates that occupational therapy intervention is warranted.     

The Associations Between Life Satisfaction and Health-related Quality of Life, Chronic Illness, and Health Behaviors among U.S. Community-dwelling Adults

The primary purpose of this article was to examine the associations between life satisfaction level and health-related quality of life (HRQOL), chronic illness, and adverse health behaviors among adults in the U.S. and its territories. Data were obtained from the 2005 Behavioral Risk Factor Surveillance System, an ongoing, state-based, random-digit telephone survey of the noninstitutionalized U.S. population aged ≥18 years. An estimated 5.6% of U.S. adults (about 12 million) reported that they were dissatisfied/very dissatisfied with their lives. As the level of life satisfaction decreased, the prevalence of fair/poor general health, disability, and infrequent social support increased as did the mean number of days in the past 30 days of physical distress, mental distress, activity limitation, depressive symptoms, anxiety symptoms, sleep insufficiency, and pain. The prevalence of smoking, obesity, physical inactivity, and heavy drinking also increased with decreasing level of life satisfaction. Moreover, adults with chronic illnesses were significantly more likely than those without to report life dissatisfaction. Notably, all of these associations remained significant after adjusting for sociodemographic characteristics. Our findings showed that HRQOL and health risk behaviors varied with level of life satisfaction. As life satisfaction appears to encompass many individual life domains, it may be an important concept for public health research. Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.     

Associations of Functional Status and Depressive Symptoms with Health-related Quality of Life in Cancer Patients

Associations of functional status (as measured with the Karnofsky Index), depressive symptoms (as assessed with the Beck Depression Inventory), and sociodemographic characteristics with health-related quality of life (HrQoL; measured with the EORTC Quality of Life Questionnaire QLQ-C30) were assessed in 170 recently diagnosed cancer patients. A better functional status (p<0.001) and a lower level of depressive symptoms (p<0.001) were associated with better HrQoL. In addition, an interaction effect of functional status with HrQoL was found (p<0.001), indicating that stronger functional impairments were related to lower HrQoL in patients with low and average levels of depressive symptoms, but not in those with high levels of depressive symptoms. Associations of HrQoL with sociodemographic variables were not significant. It is concluded that functional decline does not additionally impair HrQoL when patients already have elevated levels of depressive symptoms.     

Relationship Among Sociodemographic Factors,Clinical Conditions,and Health-related Quality of Life: Examining the EQ-5D in the U.S. General Population

Introduction: Health-related quality of life (HRQL) measures are used increasingly in evaluations of clinical and population-based outcomes and in economic analyses. We investigate the influence of demographic, socioeconomic, and chronic disease factors on the HRQL of a representative U.S. sample. Methods: We examined data from 13,646 adults in the 2000 Medical Expenditure Panel Survey, a nationally representative sample of the U.S. general population, who completed a self-administered questionnaire containing the EQ-5D, a preference-based measure. We assessed the relationships between EQ-5D scores and sociodemographic variables, including age, sex, race/ethnicity, income and education, and six common chronic conditions. Results: In fully adjusted models, EQ-5D scores decreased with increasing category of age and were lower for persons with a lower income and educational attainment as well as each of the six conditions. Although the EQ-5D scores were lower for females and Whites compared with Blacks such differences were not of a magnitude considered to be clinically important. Conclusions: In the U.S., sociodemographic factors and clinical conditions are strongly associated with scores on the EQ-5D. Population health studies and risk-adjustment models should account and adjust for these factors when assessing the performance of health programs and clinical care.     

STD门诊焦虑抑郁的调查分析

目的观察性传播性疾病(STD)病期超过1个月的患者发生焦虑、抑郁的情况。方法用Zung氏焦虑自评量表(SAS),Zung氏抑郁自评量表(SDS)对我院性病门诊的144例性病患者进行心理反应测试,经统计学分析,与同期慢性皮肤病比较均有统计学意义。结果144例性病患者中,焦虑发生率65.28%,抑郁发生率59.03%。结论提醒性病防治者在治疗躯体疾病的同时也要注意他们的心理问题。     

A Questionnaire for Rating Health-related Quality of Life

BackgroundTranslations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults.MethodsThe study was of a cross-sectional type, assessing the reliability and validity of a newly developed questionnaire for measuring health-related quality of life (HRQoL) in adults residing in western Balkan states (WB-HRQoL). It was conducted on a sample of 489 adults from Serbia, Croatia, Bosnia & Herzegovina, and Montenegro, with a mean age of 52.2±14.4 years and a male/female ratio of 195/294 (39.9%/60.1%).ResultThe definitive version of the WB-HRQoL scale with 19 items showed very good reliability, with Cronbach’s alpha 0.905. The scale was temporally stable, and satisfactory results were obtained for divergent and convergent validity tests. Exploratory factorial analysis brought to the surface four domains of health-related quality of life, namely the physical, psychical, social, and environmental.ConclusionThe WB-HRQoL scale is a reliable and valid generic instrument for measuring HRQoL that takes into account the cultural specifics of the western Balkan region.     

Job Insecurity and Symptoms of Anxiety and Depression Among U.S. Young Adults During COVID-19

PurposeThis study aimed to estimate the associations between job insecurity and symptoms of anxiety and depression among U.S. young adults amidst the COVID-19 pandemic.MethodsWe analyzed data on young adults aged 18–26 years from June 15 to June 30, 2020, from the weekly, cross-sectional Household Pulse Survey (n = 4,852) conducted by the U.S. Census Bureau. Two job insecurity measures and four anxiety and depression measures were analyzed using multivariable Poisson regression models adjusting for age, sex, race/ethnicity, education, and marital status.ResultsFifty-nine percent of participants experienced direct or household employment loss since the start of the COVID-19 pandemic, and 38% were expected to experience direct or household employment loss in the coming 4 weeks. Recent direct or household employment loss and expected direct or household employment loss, among participants who did not experience recent employment loss, were associated with a greater risk of poor mental health on all four measures.ConclusionsU.S. young adults experience a significant mental health burden as a result of job insecurity amidst the COVID-19 pandemic.     

循证护理对脑卒中后抑郁患者生活质量的影响

目的探讨循证护理对脑卒中后抑郁（PSD）患者生活质量的影响。方法将80例PSD患者分为试验组和对照组,两组患者均接受神经内科常规治疗和护理,试验组患者在此基础上增加循证护理干预措施,在干预前和干预后25 d对患者的抑郁状态和生活质量进行评分,并进行统计学比较。结果两组患者抑郁状态和生活质量于干预后25 d比较,差异有统计学意义（t=11.82,P〈0.01;t=11.25,P〈0.01）。结论循证护理可以改善PSD患者抑郁状态,提高生活质量,促进疾病的康复。     

Depression and Anxiety in Women During Pregnancy in Slovenia

Objective

The aim of the study was to evaluate the prevalence of elevated depression and anxiety among pregnant women and to examine its correlation with medical complications and socio-demographic characteristics.

Methods

The study is based on a cross-sectional design of a sample of 348 women in three trimesters of pregnancy who received routine obstetrical care at the University Medical Centre Ljubljana, Department of Obstetrics and Gynaecology. The responding women filled out a questionnaire on socio-demographic variables, the Centre for Epidemiologic Studies Depression Scale CES-D and the State Trait Anxiety Inventory STAI.

Results

21.7% of pregnant women were identified as suffering from elevated depression symptomatology, 15.7% reported high state anxiety and 12.5% had high trait anxiety. No significant differences in depression and anxiety across pregnancy trimesters were found. The women who have suffered from health complications during previous pregnancies showed higher state anxiety; those experiencing complications during their current pregnancy reported more intense symptoms of depression and of state and trait anxiety than women free of complications. Less educated, lower income and mothers of many children in the third pregnancy trimester reported more intensive symptoms of depression and trait anxiety.

Conclusions

Elevated depression and anxiety are frequent among pregnant women. The results draw attention to the need for early detection and treatment of depression and anxiety during pregnancy.     

氟西汀治疗高血压合并抑郁症患者的疗效及对患者生活质量的影响

目的:探究氟西汀治疗高血压合并抑郁症患者的疗效及对患者生活质量的影响。方法:择取80例高血压伴抑郁症患者,随机性分成试验组与对照组,各40例。对照组应用硝苯地平控释片进行治疗;试验组在此基础上联合氟西汀加以治疗。结果:试验组总有效率大于对照组,P<0.05;对照组的汉密尔顿抑郁量表(HAMD)评分高于比较组,P<0.05;比较组在生活质量方面得分均高于对照组,P<0.05。结论:高血压合并抑郁症患者应用氟西汀治疗,能够有效改善抑郁情况、降低血压并提高生活质量。     

Prenatal Depression in Latinas in the U.S. and Mexico

Objectives The study aimed to investigate the prevalence of depressive symptoms and their associated risk factors during pregnancy in Latinas in the United States (U.S.) and Mexico. Method The sample included 108 women in the U.S. whose data were obtained from medical chart reviews in a community clinic in Washington, D.C., and 117 women in Mexico who participated in face-to-face interviews in the waiting rooms of primary care community centers in Mexico City. Variables, chosen to match in both countries for comparisons, were: socio-demographics, pregnancy gestation and order, social support, depressive symptoms, personal history of depression, family psychiatric history, and suicidal thoughts. Depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale (CES-D). Results The prevalence of depressive symptoms was 32.4% for pregnant Latinas and 36.8% for Mexicans (CES-D ≥ 16), and 15.7% and 23.9% (CES-D ≥ 24), respectively, with no differences between groups. Separate multiple logistic regression analyses showed that for U.S. Latinas: (1) being more educated predicted depressive symptoms (CES-D ≥ 16), and (2) second trimester, as compared to first, also predicted symptoms (CES-D ≥ 24). (3) History of suicidal thoughts predicted symptoms in Latinas in the U.S. (CES-D ≥ 24) and in Mexico (using both definitions of high symptoms), and (4) living with a partner but not formally married and multi-parous condition predicted symptoms (CES-D ≥ 24) among pregnant Mexicans. Conclusions A high prevalence of depressive symptoms and significant risk factors during pregnancy were found in Latinas in U.S. and Mexico, suggesting increased risk for postpartum major depression. Implications for screening and interventions are discussed.

肝癌患者TACE术后的抑郁与生活质量的调查及相关性分析

目的探讨肝癌患者TACE术后的抑郁与生活质量之间的关系,为临床护理工作提供重要参考依据。方法采用问卷调查法对130名TACE术后的肝癌患者展开调查,应用抑郁自评量表(SDS)及肝癌患者生活质量测定量表QOL-LC V2.0对患者的抑郁和生活质量进行测评。结果 TACE术后的肝癌患者53.6%存在抑郁;肝癌患者TACE术后的生活质量总均分为128.21±29.72,抑郁与生活质量总分及各维度呈负相关。结论 TACE术后肝癌患者的抑郁发生率较高;患者的抑郁越严重其生活质量越低;TACE术后肝癌患者的生活质量有待提高。     

Assessment of Anxiety and Depression in Advanced Cancer Patients and their Relationship with Quality of Life

The growing interest in the mental health and quality of life of cancer patients, has been the major reason for conducting this study. The aims were to compare advanced cancer patients’ responses to Hospital Anxiety and Depression (HAD) scale with those to European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version 3.0), as well as the impact of quality of life dimensions (as measured by EORTC QLQ-C30) on the levels of anxiety and depression. The analysis, conducted in 120 advanced cancer patients, showed that the most significant associations were found between emotional functioning and HAD-T (total sum of scores) (r=−0.747; p < 0.0005), HAD-A (anxiety) (r=−0.725; p < 0.0005) and HAD-D (depression) (r=−0.553; p < 0.0005). In the prediction of HAD-T, the contribution of physical, emotional, role, and social functioning along with nausea-vomiting, dyspnea, sleep disturbance and gender is high. For anxiety, the predictor variables were physical, role, cognitive, emotional, and social functioning, followed by dyspnea, sleep disturbance, and appetite loss, while depression was predicted by physical, role, emotional, and social functioning, the symptoms of nausea-vomiting, pain, sleep disturbance, constipation, as well as the variables of age, gender, anticancer treatment and performance status. Concluding, psychological morbidity, in this patient population, was predominantly predicted by the emotional functioning dimension of EORTC QLQ-C30.     

A Survey of Quality of Life and Depression for Police Officers in Kaohsiung, Taiwan

Objective: The enormous job stress of police work may result in depression, which is highly correlated with work disability and poor quality of life. We investigated the quality of life, the probability of depression, and the related risk factors for police officers in Kaohsiung, Taiwan. Methods: We used the 12-item Short-Form Health Survey (SF-12) and the Disaster-Related Psychological Screening Test (DRPST) to assess the quality of life and prevalence of depression for 832 police officers in Kaohsiung. Results: The estimated rate of probable major depression was 21.6% (180/832). Those with an educational level of university or above and nondepressed police officers had higher scores in every subscale for quality of life. Police officers older than 50 had higher scores in the mental aspects of quality of life. Family problems and job stress related to achievement, peer pressure about performance, and heavy workloads were predictive factors for depression. Conclusion: Police officers might have a higher estimated rate of depression than previously thought, and those with depression have a poorer quality of life.     

妊娠妇女的成人依恋与抑郁状况的相关性研究

目的：探讨妊娠妇女的依恋类型、抑郁状况以及两者间的关系。方法：采用关系问卷（RQ）、亲密关系经历量表（ECR）中文版及流调中心用抑郁量表（CES-D）对176例妊娠妇女进行问卷调查。结果：①妊娠妇女依恋类型的分布情况是：安全型57.2%、轻视型21.4%、倾注型15.0%、害怕型6.4%。②安全型、轻视型、倾注型、害怕型妊娠妇女的抑郁水平得分分别为11.58±7.09、18.16±10.85、18.82±7.68和21.65±10.55,差别有统计学意义（F＝12.78,P＜0.01）,安全型者均低于后三者。③妊娠妇女的抑郁水平与依恋回避（r=0.445）及依恋焦虑（r=0.215）均呈正相关（均P＜0.01）。结论：妊娠妇女的依恋类型与抑郁水平有关。