北京市心理援助热线青少年来电者自杀意念的危险因素

目的:探索心理援助热线青少年来电者自杀意念的危险因素。方法:2018-2021年北京市心理援助热线的青少年来电者(11～18岁)纳入本研究,收集人口学资料,询问来电者在来电前2周内是否有自杀想法来评估自杀意念,并评估自杀相关的危险因素,如抑郁情绪、希望感、痛苦感等。采用logistic回归分析,探索青少年来电者自杀意念的危险因素。结果:本研究共纳入19 341例来电。77.9%(15 072例)青少年来电者报告该次来电前2周内有自杀意念。女性(OR=1.12,95%CI:1.01～1.24)、年纪轻(OR=1.30,95%CI:1.14～1.49)、有急性生活事件(OR=1.34,95%CI:1.23～1.47)、慢性生活事件(OR=1.31,95%CI:1.19～1.44)、既往自杀未遂史(OR=2.61,95%CI:2.35～2.91)、痛苦感高(OR=1.85,95%CI:1.67～2.04)和抑郁程度高(OR=2.71,95%CI:2.43～3.01)是青少年来电者自杀意念的独立危险因素,而高希望感(OR=0.45,95%CI:0.41～0.50)则是青少年来电者自杀意念的保护...     

北京市心理援助热线有精神障碍诊断史求助者的特征

目的:分析北京市心理援助热线有精神障碍诊断来电者的特征,以便有针对性地为他们提供热线心理干预服务。方法:应用北京市心理援助热线电脑咨询操作系统收集的资料进行统计分析。数据为2002年12月-2008年12月间拨打北京市心理援助热线的24 217例来电者,根据来电者自我报告是否有精神机构就医诊断史将其分为有精神障碍诊断史组(n=6516)和无精神障碍诊断史组(n=17 701),比较两组在求助问题类型、人口学特征及自杀相关因素上的差异性。结果:有精神障碍诊断组咨询的前五位问题为精神疾病、精神疾病相关知识、家庭关系、工作问题及家庭外的人际关系,在两组中,精神疾病问题均为首个咨询问题;相比之下,女性、20~29岁和30~44岁两个年龄组、教育年限≥10年和非现职者更多见于有精神障碍诊断组。来电者11个自杀相关因素评估结果显示,有精神障碍诊断史组在来电时的自杀意念或行为、既往自杀未遂史、高抑郁情绪、严重躯体疾病、受虐待史、害怕被攻击、亲友自杀行为史、高无望感的出现率均高于无精神障碍诊断史组(P0.001或0.05)。结论:热线咨询员对有精神障碍诊断的来电者进行热线干预时要特别注意评估来电者的抑郁程度以及其他自杀相关因素;为这些人群提供帮助时,要注意识别和处理他们生活中各种应激事件。     

北京市心理援助热线反复来电者的特征

目的:了解北京市心理援助热线反复来电者的特征。方法:运用北京市心理援助热线电脑咨询操作系统收集2017年1月-2017年12月期间拨打该热线的7526例来电者的资料,在2017年拨打热线次数≥5次作为反复来电组(n=517),其他为非反复来电组(n=7009)。比较两组的人口学特征、求助问题类型及自杀危险因素。结果:反复来电者求助问题的前3位为精神障碍、家庭外人际关系问题、与家人关系问题,63.1%有既往精神科诊断;来电时,反复来电组与非反复来电组的自杀风险程度差异无统计学意义(P>0.05)。多元logistic回归分析显示,反复来电与害怕被攻击感、亲友有自杀行为史和高无望感有关联(AOR=1.38、1.32、1.29)。结论:热线在接听反复来电者时,应关注来电者的害怕被攻击的想法、高无望感及亲友自杀行为史。     

北京市心理援助热线自杀高危来电的特征及干预效果

目的:了解北京市心理援助热线自杀高危来电特征及干预效果。方法:选取2006年1月至2010年8月拨打北京市心理援助热线的来电,符合高危随访条件来电共856例,其中预约随访来电586例。应用适合非精神科医师使用的抑郁症诊断筛选量表,对来电者近两周的抑郁情绪及自杀危险进行评估。对评估出的高危来电者进行24小时、1周及1月三次随访。结果:586例来电中,女性350例,男性236例;平均年龄(29±9)岁;平均受教育年限(12±4)年;已婚133例,未婚354例;学生98例,无业或退休245例,在业243例;既往有明确的精神科诊断者353例,其中抑郁症225例;既往有自杀未遂史者289例;亲友有过自杀行为者234例。来电咨询问题前三位为:精神心理问题,家庭关系问题、恋爱及与朋友同事矛盾问题。即刻及随后三次随访结果显示,来电者的自杀危险程度显著降低,每次干预自杀危险程度均较前次显著降低。结论:心理援助热线可以在一定程度上减低自杀高危者的危险程度,并提示热线应提供后续的干预服务,以保证自杀的干预效果持续有效。     

北京某综合大学一年级学生自杀意念影响因素分析

目的: 调查大学生自杀意念的风险因素,探讨干预策略.方法: 采用整群抽样法,对北京某综合大学9个院系的所有一年级学生进行现况调查,使用Beck抑郁问卷、Beck焦虑问卷、Beck无望问卷、青年健康危害行为问卷(YRBS)、人格障碍诊断问卷-4(PDQ-4)和自编的一般情况问卷调查大学生自杀意念及相关心理行为问题.采用多因素logistic回归分析对一学年内自杀意念和一周内自杀意念的影响因素进行分析.结果: 共2055人填写了问卷,一学年内自杀意念的报告率8.1%,危险因素按OR值大小排列依次为有物质滥用(OR=4.37,95%CI:2.27-8.41)、一学年内有过明显抑郁情绪(OR=3.21,95%CI:2.20-4.68)、一学年内使用过远程求助(OR=1.78,95%CI:1.13-2.81)、一周内存在明显抑郁情绪(OR=2.14,95%CI:1.36-3.37)、分裂样人格因子分(OR=1.21,95%CI:1.07-1.37)、边缘人格因子分(OR=1.23,95%CI:1.09-1.38);一周内自杀意念的报告率5.5%,危险因素按OR值大小排列依次为一周内存在明显抑郁情绪(OR=4.62,95%CI:2.86-7.46)、阳性精神障碍家族史(OR=2.96,95%CI:1.34-6.56)、一学年内有过明显的抑郁情绪(OR=2.35,95%CI:1.49-3.69)、女性(OR=1.65,95%CI:1.09-2.52)、边缘人格因子分(OR=1.50,95%CI:1.30-1.72)、分裂型人格因子分(OR=1.17,95%CI:1.03-1.34).文科专业显示为一学年内自杀意念的保护因素(OR=0.63,95%CI:0.41-0.95).大一学生一学年内寻求精神卫生服务的比例占12.5%,9.8%使用远程求助方式.在使用当面求助方式上女性多于男性(4.8%/2.9%,x2=4.42,P:0.035);报告有自杀意念者一学年内总体求助、当面求助、远程求助比例均高于无自杀意念者(22.5%/11.3%、7.4%/3.2%、18.2%/8.9%,x2=23.0、10.3、19.7,P＜0.01).结论: 大学生自杀风险的筛查指标除自杀意念外还应考虑纳入抑郁、物质滥用、人格特点、阳性精神障碍家族史.大学生精神卫生服务宜从鼓励求助行为、主动提供延伸式服务、大力发展网络精神卫生服务三方面人手,提高服务质量.     

军人自杀意念的相关因素

目的:探索军人自杀意念现患率及自杀意念的相关因素。方法:通过分层随机抽样方法于2015年5-8月选取军人2071名,使用自编一般人口学情况调查问卷、贝克抑郁问卷(BDI)的条目7进行调查,条目7得分≥1分者纳入自杀意念组。采用多因素logistic回归分析探讨自杀意念的相关因素。结果:2071名军人中,条目7得分≥1分者有382人(占18.4%)。自杀意念的危险因素为家族有自杀史(OR=42.97,95%CI=29.14~63.35)、周围出现过自杀事件(OR=2.46,95%CI=1.75~3.46)、饮酒(OR=1.64,95%CI=1.31~2.07)、受教育程度(OR=1.38,95%CI=1.01~1.90);保护因素为军兵种(OR=0.60,95%CI=0.50~0.72)及现驻地(OR=0.15,95%CI=0.03~0.64)。结论:在军人自杀预防中,应重视有家族自杀史、周围出现过自杀事件、饮酒、受教育程度低、空军、驻地在艰苦边远地区的人群。     

湖南某县农村老年人的自杀行为

目的:探讨农村社区老年人自杀行为发生现况及其相关因素.方法:采用分层、整群、随机抽样方法,抽取衡阳县1040名≥60岁的农村社区老年人,应用自行编制的一般人口学资料调查表、自杀行为调查表、病人健康问卷抑郁量表( PHQ-9)、老年人生活事件量表(LESE)进行调查.结果:样本中最近一年自杀意念发生率为21.5％,自杀计划的发生率为5.5％,自杀准备的发生率为2.2％,自杀未遂的发生率为0.8％;将相关因素纳入非条件logistic回归模型,结果显示与自杀行为相关的因素为自评健康状况差(OR =1.43)、负性生活事件刺激量较大(OR =3.18)、抑郁筛查阳性(OR =20.01).结论:本研究显示衡阳县农村社区老年人自杀行为发生率较高,自评健康状况差、负性生活事件刺激量较大、抑郁筛查阳性可能是农村老年人自杀行为发生的独立危险因素.     

青少年睡眠问题与自杀行为关系的meta分析

目的:系统评价青少年睡眠问题与自杀行为的关系。方法:检索PubMed、Web of Science、Ovid PsysINFO、中国知网、万方数据知识服务平台、维普中文科技期刊数据库、中国生物医学文献服务系统数据库中截至2021年2月3日发表的青少年睡眠问题与自杀行为关系的观察性研究。采用Stata 16进行分析，计算合并OR(95%CI)值。结果:从检索的8287篇文献中纳入31篇文献，共包含619 715名研究对象。Meta分析结果显示，在横断面研究中，青少年睡眠问题与自杀意念、自杀计划和自杀未遂呈正关联(合并OR=1.63、1.57、1.89);在队列研究中，青少年睡眠问题可以预测自杀意念、自杀计划和自杀未遂(合并OR=1.35、2.40、1.61)。在队列研究的亚组分析中显示，控制抑郁后青少年睡眠问题与自杀行为仍存在关联，且控制抑郁后睡眠问题预测效应更强(OR=2.30,95%CI:1.09～2.41,P<0.001)。此外，青少年睡眠问题预测自杀未遂的能力受随访时长的变化影响，随访时长≥2年的预测效应更强(合并OR=2.43 vs.1.19,P<0.01)。结论:...     

有无自杀未遂史抑郁症患者自杀意念与风险比较

目的:比较既往有自杀未遂史抑郁症患者与无自杀未遂史抑郁症患者住院治疗期间自杀意念与自杀风险的不同。方法:采用Beck自杀意念量表(BSI-CV)、临床疗效总评量表(CGI),根据既往有无自杀未遂史对照研究195例抑郁症患者自杀意念与自杀风险的变化。结果:(1)女性与受教育年限偏低的抑郁症患者既往有自杀未遂史多(P0.05);(2)既往无论有无自杀未遂史,抑郁症患者自杀意念和自杀风险均降低(P0.05);既往有自杀未遂史抑郁症患者从第一周至第三周自杀意念高于无自杀未遂史患者(t=-7.51~-5.57,P0.05)),只在第一周自杀风险高于无自杀未遂史患者(t=-3.13,P0.05);(3)既往无论有无自杀未遂史,抑郁症患者自杀意念与病情严重程度呈正相关(r=0.44~0.72,P0.05),有自杀未遂史患者相关性高于无自杀未遂患者;既往有自杀未遂史抑郁症患者从第一周至第三周自杀风险与病情严重程度呈正相关(r=0.41~0.49,P0.05),无自杀未遂史患者只在第一周有相关性(r=0.47,P0.05);(4)既往有无自杀未遂史抑郁症患者疗效总评无统计学差异(t=-1.69~1.72,P0.05)。结论:既往有自杀未遂史抑郁症患者在治疗过程中自杀意念、自杀风险,及与疾病严重程度相关性均高于无自杀未遂史患者。     

医学院校大学生心理症状两年随访研究

目的:了解医学院校大学生2年新出现心理症状的检出率及影响因素。方法:选取某医科院校大一全体新生2910人,用大学生人格问卷(UPI)对其中心理症状阴性的大学生(n=2376)进行大三后测,采用自编人口学问卷、抑郁自评量表(SDS)、自杀行为问卷(SBQ-R)、家庭功能量表(APGAR)、心理复原力量表(ERS)、痛苦表露指数(DDI)评估心理症状的相关因素。结果:大三心理症状阳性率为15.3%。Logistic回归结果显示,女性(OR=1.60,95%CI:1.22～2.10)、精神疾病家族史(OR=1.83,95%CI:1.11～3.02)、熟人自杀史(OR=1.52,95%CI:1.01～2.28)心理咨询史(OR=2.63,95%CI:1.50～4.62)及SBQ-R得分越高(OR=1.15,95%CI:1.05～1.25)是医学院校大学生心理症状阴性转阳性的危险因素,而DDI得分越高是其保护因素(OR=0.98,95%CI:0.96～0.99)。结论:医学院校大学生入学2年后超过15%的人新出现心理症状,对有精神疾病家族史、熟人自杀史、心理咨询史、高自杀风险及低自我表露程度的学...     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.