抑郁症患者家属的社会支持及家庭功能研究

目的:探讨抑郁症患者家属感知的的社会支持和家庭功能特征。方法:采用社会支持量表(MSPSS)和家庭功能量表(FAD)对50例抑郁症患者的家属(抑郁症患者家属组)及50名正常人(对照组)进行调查。结果:①抑郁症患者家属组MSPSS评分中的社会支持总分(45.1±11.8)分明显高于正常对照组(25.5±9.7)分,两组间比较,差异有显著性(P<0.05);②抑郁症患者家属组的FAD评定除情感卷入维度外,其他5个维度(问题解决、交流、角色、情感反应、行为控制)和总体功能均在不健康家庭功能范围之内;并与社会支持均呈正相关[问题解决(r=0.228,P<0.05),交流(r=0.250,P<0.05),角色(r=0.209,P<0.05),情感反应(r=0.291,P<0.01),行为控制(r=0.289,P<0.01)和总体功能(r=0.217,P<0.05)]。结论:抑郁症患者家属体验到社会支持程度较低,家庭功能有缺陷;社会支持可能影响到家庭功能。     

首发与复发抑郁症患者社会功能状况及影响因素分析

目的:探讨首发与复发抑郁症患者社会功能差异及其影响因素。方法:对首发抑郁症患者(首发组,57例)及复发抑郁症患者(复发组,60例)进行简明国际神经精神访谈(MINI)、汉密尔顿抑郁量表17项版本(HAMD-17)、Sheehan残疾评定量表(SDS)、家庭功能量表(FAD)、领悟社会支持评定量表(PSSS)评估,比较两组社会功能,分析影响社会功能的因素。结果:首发组与复发组SDS评分差异无统计学意义;SDS总分与患者年龄呈负相关(r=-0.205,P=0.026),与HAMD-17总分呈正相关(r=0.623,P0.01),与FAD中各维度评分呈正相关(r=0.187~0.400,P0.05或P0.01);多元线性回归分析显示HAMD-17评分及FAD的情感反应维度进入方程。结论:首发与复发抑郁症患者均有社会功能损害;患者抑郁程度以及其家庭成员间情感反应情况是其社会功能损害的重要因素。     

抑郁障碍患者家庭功能的跨文化研究

目的:探讨中国和美国抑郁障碍患者的家庭功能特征.方法:采用家庭功能量表(FAD)对92例中国抑郁障碍患者(中国组)及92例美国抑郁障碍患者(美国组)进行评估及比较.结果:两组FAD各维度均分均高于健康的家庭功能临界值,为不健康的家庭功能.中国组FAD中的情感反应维度评分及行为控制维度评分明显高于美国组;中国男性组情感反...     

社区2型糖尿病患者生活质量状况及影响因素分析

目的调查社区2型糖尿病患者的生活质量状况并探讨其影响因素。方法采用单纯随机抽样法从上海市杨浦区三个社区抽取210名糖尿病患者(研究组),采用健康状况量表(SF-36)、社会支持评定量表(SSRS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、家庭功能评定量表(FAD)对患者进行评定,并与210例健康人群(对照组)进行对照。结果研究组SF-36的躯体健康所致的角色限制(RP)、总体健康感(GH)、社交功能(SF)、心理健康(MH)及生活质量总评分(SF-36)与对照组比较差异有统计学意义(P0.05或0.01);多因素逐步回归分析显示影响患者生活质量的主要因素依次为SAS、SDS、有无并发症、FAD(P0.01)。结论社区2型糖尿病患者的生活质量较差,焦虑抑郁等负性情绪、并发症的发生、家庭功能障碍是影响患者生活质量的重要因素,在社区康复过程中应予以重视。     

伴自伤行为的女性青少年抑郁障碍患者家庭功能与童年创伤经历的相关性

目的探索伴自伤行为的女性青少年抑郁障碍患者所感知的家庭功能健康状况与其童年创伤经历的关系,为对其进行有针对性的家庭心理干预提供参考。方法纳入符合《国际疾病分类(第10版)》(ICD-10)抑郁障碍诊断标准且伴有自伤行为的青少年女生为研究组(n=50),选取年龄和家庭结构与研究组相匹配的正常青少年女生为对照组(n=42)。采用贝克抑郁自评量表第2版(BDI-II)、家庭功能评定量表(FAD)、童年创伤问卷(CTQ)评定两组抑郁程度、家庭功能和童年创伤经历。结果除行为控制维度外,研究组FAD其余各分量表评分均高于对照组(P均0.01),CTQ总评分及各因子评分均高于对照组(P0.05或0.01)。研究组FAD中问题解决、沟通、角色、情感反应、情感介入、行为控制、总体功能评分与CTQ中躯体忽视、情感虐待、情感忽视评分均呈正相关(r=0.285～0.677,P0.05或0.01);FAD中问题解决、沟通、角色、行为控制、总体功能评分与CTQ中躯体虐待、性虐待评分均呈正相关(r=0.232～0.470,P0.05或0.01)。多重回归分析显示,情感忽视评分与家庭总体功能正向关联(β=0.318,P0.05)。结论伴自伤行为的女性青少年抑郁障碍患者所感知的家庭功能健康状况较差,可能与其童年创伤经历有关,尤其与情感忽视有关。     

双相障碍患者家庭功能对照研究

目的:探讨双相障碍(BD)患者的家庭功能。方法:使用家庭亲密度与适应性问卷(FACES)及家庭功能问卷(FAD)对67例BD患者(BD组)及101名正常对照者(NC组)进行比较。结果:两组FACES评分差异无统计学意义;BD组FAD中情感卷入维度评分[(2.35±0.46)分]明显高于NC组[(2.20±0.42)分,P0.05]。结论:BD患者的家庭功能缺陷体现在情感卷入上。     

重性抑郁障碍临床痊愈患者心理社会功能特征研究

目的:研究重性抑郁障碍患者在达到临床痊愈标准后心理社会功能的特点。方法:采用生活质量综合评定问卷(GQOLI-74)的躯体、心理、社会功能分量表、17项汉密顿抑郁量表(HAMD)、社会支持评定量表(SSS)和生活事件量表(LES),对32例经住院治疗后达到临床痊愈的重性抑郁障碍患者和32名正常人进行调查分析。结果:协变量方差分析显示,以客观社会支持或负性生活事件为协变量时;研究组躯体功能维度(F=5.75,P<0.05)及躯体不适感因子得分(F=5.51,P<0.05)显著低于对照组;研究组心理功能维度中的正性情感因子得分(F=4.75,P<0.05)显著高于对照组;研究组社会功能维度中的工作学习(t=-3.80,P<0.01)和婚姻家庭因子得分(t=-3.30,P<0.01)显著低于对照组,该维度中的社会支持因子(F=4.94,P<0.05)和业余娱乐生活因子得分(F=9.30,P<0.01)显著高于对照组;研究组总体生活质量因子得分(F=4.14,P<0.05)显著低于对照组。结论:临床痊愈的重性抑郁障碍患者心理功能可能已恢复至正常水平,躯体、社会功能可能尚未完全恢复。     

复发缓解型多发性硬化患者的抑郁症状与疲劳及生活质量的相关性

目的:探讨复发缓解型多发性硬化患者抑郁症状与疲劳及生活质量的相关性。方法:选取复发缓解型多发性硬化患者共80例,采用自编问卷收集患者人口学资料与疾病相关信息;采用贝克抑郁量表第2版中文版(BDI-Ⅱ)评估抑郁症状;采用疲劳影响量表修订版(MFIS)评估疲劳症状;采用健康状况调查问卷(SF-36)评估生活质量。结果:复发缓解型多发性硬化患者BDI-Ⅱ分为(10.43±6.74)分,其中,轻度抑郁11.3%(9/80),中度抑郁11.3%(9/80),重度抑郁1.3%(1/80)。多因素线性回归分析结果显示,BDI-Ⅱ评分与年龄(β=0.17,95%CI:0.01～0.33)和MFIS分(β=0.14,95%CI:0.06～0.22)正相关,与情感角色(β=-0.05,95%CI:-0.08～-0.01)和精神健康(β=-0.59,95%CI:-0.20～-0.04)负相关(P<0.05或P<0.01)。结论:复发缓解型多发性硬化患者抑郁症状的发生率较高,需要重点关注高龄、疲劳程度重及生活质量较差的患者。     

怡诺思在甲状腺功能亢进合并抑郁障碍患者中的临床研究

目的探讨怡诺思对甲状腺功能亢进合并抑郁障碍患者的临床疗效,评估药物治疗的安全性和生活质量变化。方法选择甲状腺功能亢进合并抑郁障碍患者78例随机分为治疗组(43例)和对照组(35例),治疗组给予常规药物和怡诺思治疗8周,对照组给予常规药物治疗。采用汉密尔顿抑郁量表(HAMD)、生活质量量表(SF-36)、副反应量表(TESS)评估治疗前后抑郁程度、生活质量变化和不良反应;检测血常规、肝、肾功能及心电图评估药物的安全性。结果治疗组在药物治疗8周后HAMD评分明显降低,与对照组相比差异具有统计学意义(P<0.05)。与对照组相比,治疗组的生活质量(躯体功能、躯体疼痛、社会功能、情感角色、心理健康、活力)维度分得到改善,差异具有统计学意义(P<0.01)。无明显不良反应,实验室等辅助检查无异常。结论怡诺思可有效改善甲状腺功能亢进合并抑郁障碍患者的抑郁情绪和生活质量。     

强迫症患者疾病严重程度与家庭功能的相关研究

目的 探讨强迫症患者疾病严重程度与其家庭功能的关系及家庭功能特征.方法 对84例强迫症患者（研究组）和90例健康志愿者（对照组）进行一般情况调查问卷、耶鲁-布朗强迫症状量表（Y-BOCS）、家庭功能评定量表（FAD）评定.结果 研究组Y-BOCS评分与FAD量表中的分量表问题解决（CM）、角色（RL）、情感反应（AR）、情感介入（AI）、行为控制（BC）评分均呈显著正相关（P＜0.01）;研究组FAD量表中解决问题（PS）、沟通（CM）、角色（RL）、总的功能（GF）因子评分显著高于对照组（P＜0.01）.结论 患者的强迫症症状越严重,其家庭功能受损越重;强迫症患者家庭功能受损表现在问题解决、沟通、角色、总的功能等方面.     

帕罗西汀治疗2型糖尿病伴抑郁的研究

目的:探讨帕罗西汀对2型糖尿病伴发抑郁患者生活质量的影响.方法:对45例2型糖尿病伴发抑郁患者给予帕罗西汀治疗.疗程12周.治疗前后分别进行汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)及健康状况调查问卷(SF-36)评定.对照组50例为不伴抑郁的糖尿病患者进行SF-36评定.结果:帕罗西汀能明显改善治疗组抑郁、焦虑症状;治疗前2型糖尿病伴抑郁患者生活质量明显低于对照组.结论:帕罗西汀能明显改善2型糖尿病伴抑郁患者的生活质量及预后.     

Factors associated with control of type I diabetes in Malaysian adolescents and young adults

OBJECTIVES: To examine the association between ethnicity, depression, quality of life, and diabetic control in Malaysian adolescents and young adults with type I diabetes mellitus. METHODS: Fifty-two outpatients with type I diabetes (mean age 15.5 years) who attended a Diabetes Clinic were included. The level of HbA1c was the measure of diabetes control used (better control defined as HbA1c < 10%). Other variables were measured through questionnaires (e.g., depressive symptoms, quality of life), computerized diagnostic interviews (major depression), and medical records (e.g., demographic, family circumstances, compliance with treatment). RESULTS: Ethnic Chinese youth showed better diabetic control than Malays and Indians (mean HbA1c 9.1%, 10.3%, and 11.0% respectively). Young people with better diabetic control (HbA1c < 10%) were more likely to have better quality of life and less likely to live in problematic families. When the cut-off for diabetic control was stricter (HbA1c < or = 8%), the young person's compliance was the main predictor of poor control. Family problems were also associated with poor control but to a lesser extent. The initial association between poorer diabetes control and depression became non-significant when quality of life was taken into account. CONCLUSIONS: There are ethnic differences in juvenile diabetic control in this Malaysian sample which need to be understood further. Previous findings of an association between quality of life and glycemic control were verified but different definitions of good control showed different associations with individual and environmental variables. Clinicians' awareness and early intervention for psychosocial problems (for example, inadequate family support) could improve diabetes control.     

家庭干预对首发精神分裂症患者辅助治疗的随访研究

目的:探讨家庭干预对首发精神分裂症患者预后的影响。方法:将90例首发精神分裂症患者随机分为抗精神病药物合并家庭干预组(干预组,45例)及单用抗精神病药物组(对照组,45例),进行为期1年的随访研究。采用家庭亲密度和适应性量表(FACESⅡ-CV)、家庭功能量表(FAD)、简明精神病评定量表(BPRS)、阳性症状评定量表(SAPS)及阴性症状评定量表(SANS)评估患者家庭状况和精神症状。结果:随访结束后,干预组家庭亲密度和适应性及家庭功能改善明显(P<0.01);干预组FACESⅡ-CV中的实际亲密度、理想亲密度因子评分显著高于对照组[(66.7±12.2)分、(57.7±10.4)分、(68.4±10.6)分、(55.8±9.7)分,P均<0.01],干预组FAD中的沟通、角色、情感反应、情感介入、行为控制及总的功能因子评分显著低于对照组(P均<0.05);两组BPRS、SAPS及SANS评分均较入组时有明显下降(P均<0.01),随访期干预组BPRS和SANS评分显著低于对照组[(19.6±10.7)分、(21.8±12.5)分、(16.7±6.4)分、(18.8±7.2)分,P均<0.01];多元逐步回归分析显示患者精神症状预后与基线期精神症状严重程度呈正相关,与基线期家庭功能及发病年龄呈负相关(t=2.65,-2.49,-2.79,P均<0.05)。结论:对精神分裂症患者进行家庭干预,可增加患者家庭亲密度和适应性,提高家庭功能,改善疾病预后。     

脂肪因子CTRP1与2型糖尿病合并脑梗死患者脂代谢异常的相关性研究

目的 探讨脂肪因子CTRP1与脂肪三酰甘油脂酶(ATGL)、内皮脂肪酶(EL)和脂蛋白相关磷脂酶A2(Lp-PLA2)与2型糖尿病合并脑梗死发病的关系.方法 选取2018-12—2020-10郑州大学第二附属医院确诊的2型糖尿病患者36例、合并脑梗死患者36例及健康体检者34例为研究对象.采用酶联免疫吸附法检测血清CT...     

Cognition in type 2 diabetes: Association with vascular risk factors, complications of diabetes and depression

Background

The role of variables like duration of diabetes, diabetic control and microvascular complications in the causation of cognitive decline in patients with type 2 diabetes is not well studied. The contribution of hypertension to the cognitive decline in nondemented diabetic patients is unclear.

Aims:

We wanted to see if cognition in patients with type 2 diabetes is associated with the duration of diabetes, control of diabetes, complications of diabetes, vascular risk factors, or depression. We also looked at association of noncompliance with cognition, and depression.

Settings and Design:

We recruited ambulant patients with type 2 diabetes who are 55 years or more in age from the weekly diabetic clinic. We excluded patients with past history of stroke.

Methods and Material:

We selected the time taken for the Trial A test, delayed recall on ten-word list from Consortium to Establish a Registry for Alzheimer''s Disease (CERAD), Rowland Universal Dementia Assessment Scale (RUDAS) and Centre for Epidemiologic Studies Depression scale (CES-D) screening instrument to assess these patients.

Statistical Analysis Used:

We utilized mean, standard deviation, Chi-square test and Pearson''s correlation for statistical analysis. We considered P < 0.05 to be significant.

Results:

RUDAS scores inversely correlated (r = −0.360) with CES-D scores (P = 0.002). Scores of the screening instrument for depression, the CES-D was associated with the duration of diabetes mellitus (P = 0.018), fasting blood glucose (P = 0.029) as well as with 2-hour post prandial blood glucose (P = 0.017).

Conclusions:

There is correlation between depression and global cognitive score. Depression seems to be associated with duration of diabetes and control of diabetes.     

Clinical study of depression accompanying diabetes mellitus]

The appropriate management of chronic diseases is important to ensure a high quality of life. In particular, depression has been reported to occasionally accompany diabetes mellitus. Here, we investigated depression onset in individuals with diabetes mellitus. Subjects were outpatients with a clinical diagnosis of depression in combination with diabetes mellitus between August 1, 1998 and September 30, 1998 of the psychiatry clinic of Jichi Medical School. Of 34 individuals (20 males, 14 females) included in the preliminary investigation, 22 were interviewed. We investigated the social demographic background, the treatment, family history of depression and diabetes mellitus, and measured the Hamilton's Rating Scale for Depression and the value of HbA1c. The overall male/female ratio was 13/9, indicating that this pattern of disease onset was more common in males than in females. The Hamilton's Rating Scale for Depression correlated closely with the percentage of patients being treated with insulin. Furthermore, the timing of the diagnosis of these two diseases correlated closely with each other. The ratio of males to females suggested that the different gender roles and lifestyles and the biological bases of these differences may play roles in the onset of depression among diabetic patients. Moreover, as more patients with insulin dependence developed depression than patients without insulin, insulin was implicated in the onset of depression. Furthermore, as the onset of the two diseases correlated closely with one another, the onset of one disease may have hastened the onset of the other.     

帕罗西汀对2型糖尿病伴发抑郁患者疗效观察

目的评价帕罗西汀对2型糖尿病伴发抑郁患者抑郁、焦虑症状的疗效及安全性。方法对45例2型糖尿病伴发抑郁患者给予帕罗西汀治疗12周,采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、MOS健康状况调查问卷(SF-36)评定疗效,采用副反应量表(TESS)和相关实验室检查评定安全性。结果帕罗西汀能明显改善2型糖尿病伴发抑郁患者抑郁、焦虑症状,治疗后患者生活质量明显提高；无明显副反应。结论帕罗西汀对2型糖尿病伴发抑郁患者的治疗安全有效。     

2型糖尿病心理社会生物因素相关性研究

目的:探索影响2型糖尿病患者转归的相关心理社会生物因素。方法:自编糖尿病基础知识调查表和一般情况调查表,选用焦虑自评量表(SAS)、抑郁自评量表(SDS)、领悟社会支持量表(PSSS)对70例2型糖尿病患者进行调查评估,检测患者的空腹血糖(FBG)、餐后2h血糖(2PBG)、糖化血红蛋白(HbA1C)、高密度脂蛋白胆固醇(HDLC)、肌酐和尿酸水平。结果:糖尿病患者的SDS总分和SAS总分均显著高于正常人群(P<0.01)。SAS总分与糖尿病病程呈正相关(r=0.43,P<0.01),与SDS总分呈正相关(r=0.333,P<0.01)。SDS总分与PSSS总分呈正相关(r=0.316,P<0.01),与糖尿病知识知晓率呈负相关(r=-0.284,P<0.05)。PSSS总分与HDLC水平呈正相关(r=0.251,P<0.05)。结论:糖尿病患者的焦虑、抑郁情绪症状均显著高于正常人群;病程越长,焦虑症状越严重。糖尿病防治知识知晓率越高,领悟社会支持的主观体验越好,抑郁症状越少,就越有助于糖、脂代谢改善。     

Factors affecting the quality of life in patients with epilepsy in Seoul, South Korea

OBJECTIVES: The level of, and factors affecting the quality of life (QOL) in patients with epilepsy may be different in Korea where social prejudice toward them is still pronounced. However, these issues have not yet been addressed properly. METHODS: We consecutively identified 154 epilepsy patients who visited the outpatient clinic at the Seoul National University Hospital. An interview was performed by two research nurses with the use of a standardized questionnaire, which included data pertaining to seizure characteristics, symptoms of depression/anxiety, social support, family life/social life satisfaction, and the activities of daily living (ADLs). The QOL was assessed with the use of QOL in Epilepsy Inventory (QOLIE-31). RESULTS: Factors affecting the QOL were: age (P<0.01), education in years (P<0.01), employment status (P<0.05), employment type (P<0.05), current economic status (P<0.05), seizure frequency (P<0.01), the number of antiepileptic drugs (P<0.01), family life/social life dissatisfaction (P<0.01, respectively), social support (P<0.01), the symptoms of anxiety and depression (P<0.01, respectively) and ADL dysfunction (P<0.01). In multiple regression analysis, the symptom of anxiety was the most important factor in explaining lower QOL in patients with epilepsy, while depression (P<0.01), social life dissatisfaction (P<0.01), ADL dysfunction (P<0.05) and seizure frequency (P<0.05) were also significant factors. CONCLUSION: Psycho-social factors outweighed the physical factors in determining QOL in Korean epilepsy patients. Recognition of these factors will lead health professionals to develop different strategies to improve the QOL of these patients.