消化性溃疡患者的情绪障碍和述情障碍

用汉密顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）和多伦多述情障碍量表（TAS）对57例住院的消化性溃疡患进行评定，并与57例正常健康自愿为对照，结果发现消化性溃疡患HAMA、HAMD总分和TAS总分及四个因子分均显高于对照组，说明消化性溃疡患中存在情绪障碍和述情障碍。     

躯体化症状为主抑郁症患者的述情障碍

目的:探讨以躯体化症状为主抑郁症患者和以情绪症状为主抑郁症患者述情障碍的差异。方法:50例以躯体化症状为主抑郁症患者(躯体症状组)、50例以情绪症状为主抑郁症患者(情绪症状组)和50名正常健康者(正常对照组)参加研究,采用90项症状自评量表(SCL-90)、汉密尔顿抑郁量表(HAMD)和多伦多述情障碍量表进行评定。结果:躯体症状组SCL-90总分、躯体化、焦虑、人际敏感、恐怖、偏执因子分及HAMD的焦虑/躯体化因子评分均高于情绪症状组(P<0.01或P<0.05),情绪症状组在强迫、抑郁因子评分及HAMD的认知障碍、阻滞、日夜变化、睡眠障碍及绝望因子分高于躯体症状组(P<0.05或P<0.01)。躯体症状组与情绪症状组仅在述情障碍因子II评分差异有统计学意义(P<0.05),而在述情障碍总分及因子分上均高于正常对照组(P<0.05或P<0.001)。结论:以躯体化症状为主和以情绪症状为主抑郁症患者均存在述情障碍,以前者更缺乏识别情绪和躯体感受能力。     

躯体形式障碍患者的述情障碍

目的：探讨躯体形式障碍患者的心理健康状况,以及与述情障碍的关系.方法：采用症状自评量表（SCL-90）及多伦多述情障碍量表（TAS）对60例躯体形式障碍患者（患者组）和60名健康自愿者（对照组）进行测评,并对躯体形式障碍患者的心理健康状况与述情障碍作相关分析.结果：患者组SCL-90总分及躯体化、人际关系敏感、抑郁、焦虑、偏执、精神病性6个因子评分均显著高于对照组（P＜0.05或P＜0.01）;其TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分亦均显著高于对照组（P＜0.05或P＜0.01）,而因子Ⅲ评分两组间比较,差别则无统计学意义.躯体形式障碍患者的SCL-90总分与TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分均呈显著性正相关;而与因子Ⅲ评分则无显著性相关.结论：躯体形式障碍患者的心理健康状况较差,并与述情障碍有关.     

抑郁症患者的述情障碍特征及情绪调节研究

背景:抑郁症患者表现出明显的述情障碍,而关于其述情障碍的机制尚未明确,也较少有关于抑郁症患者情绪调节能力的研究.目的:探索抑郁症患者的述情障碍特征,以及抑郁症状、述情障碍与个体情绪调节能力的关系.方法:采用汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA)、多伦多述情障碍量表(TAS)和计算机情绪调节实验,对36名抑郁症患者和31名健康志愿者进行评定分析.结果:病例组中述情障碍发生率为66.67%,对照组为3.23%,两组比例差异有显著性(χ2=28.661,p<0.001).病例组的TAS得分显著高于对照组(t=7.378,p<0.001).情绪调节实验中,病例组观看中性图片的评分显著高于对照组(t=2.080,p=0.043);而负性-观看、负性-重评和负性-抑制三种实验条件下,两组评分无显著差异.在病例组中,HAMD-24、HAMA与TAS得分之间存在显著相关,而情绪调节实验得分与HAMD-24、HAMA、TAS之间均未发现相关.结论:抑郁症患者中述情障碍的发生率可能高于一般人群,其抑郁症状与述情障碍之间可能存在相互影响.情绪调节能力可能是一种独立的特质,与抑郁状态无关.     

躯体化障碍患者述情障碍分析

目的：探讨躯体化障碍患者的述情障碍及其与个性的相关性。方法：采用多伦多述情障碍量表（TAS）、艾森克个性问卷（EPQ）测查了42例躯体化障碍患者,并以50名健康者作对照。结果：躯体化障碍患者有述情障碍。多元相关分析发现,躯体化障碍组个性越内倾,描述情感能力越欠缺,情绪越不稳定。结论：躯体化障碍患者存在述情障碍,且与个性特征有密切关系。     

脑梗死患者睡眠障碍和不良情绪、认知障碍的关系

目的 分析脑梗死患者睡眠障碍与焦虑抑郁、认知功能障碍间的关联。方法 将我院于2019年3月～2021年11月收治的60例脑梗死并睡眠障碍患者作为观察组,另选同期住院60例非睡眠障碍的脑梗死患者为对照组,观察两组睡眠质量差异,评价指标包括睡眠质量指数量表（PSQI）;汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评估患者抑郁、焦虑状态;以蒙特利尔认知评估量表（MoCA）中文版评分评估认知情况;并分析睡眠质量与情绪、认知功能间的相关性。结果 观察组HAMD、HAMA评分均高于对照组,PSQI评分低于对照组（P<0.05）。且观察组MoCA总分均显著低于对照组（P<0.05）。Pearson分析显示,睡眠障碍与焦虑抑郁呈明显正相关,与认知功能呈负相关。结论 脑梗死患者睡眠障碍后较大概率出现焦虑抑郁等不良情绪和认知功能损害,且睡眠障碍与焦虑抑郁、认知功能明显相关。     

躯体形式障碍患者述情障碍的相关因素分析

目的 探讨躯体形式障碍（SD）患者述情障碍的影响因素.方法 采用自编的躯体症状报告单、贝克抑郁问卷（BDI）、认知情绪调节问卷（CERQ-C）、多伦多述情量表（TASk0）、儿童期受虐经历问卷（CTQ-SF）对115例SD患者（研究组）进行评定,使用TASk0量表对101名健康志愿者（对照组）进行评定.结果 纳入研究的109例研究组患者TAS-20总分及各因子分均高于对照组（P＜0.01）.躯体症状报告单、CERQ-C、CTQ-SF及BDI多个因素中与TAS-20总分及TAS-20因子Ⅰ、Ⅱ、Ⅲ有相关性（P＜0.05,P＜0.01）.躯体症状报告单总分、躯体忽视、呼吸系统症状和睡眠障碍依次进入TAS-20总分的回归方程;BDI总分、泌尿生殖系统症状、积极重新关注依次进入TAS-20因子Ⅰ的回归方程;躯体症状报告单总分与情感虐待依次进入TAS-20因子Ⅱ的回归方程.结论 SD有明显的述情障碍.SD述情障碍的不同纬度影响因素不同,躯体化症状、抑郁情绪等为SD患者述情障碍的重要影响因素.     

抑郁症患者的述情障碍特征及情绪调节研究（英文）

背景:抑郁症患者表现出明显的述情障碍,而关于其述情障碍的机制尚未明确,也较少有关于抑郁症患者情绪调节能力的研究。目的:探索抑郁症患者的述情障碍特征,以及抑郁症状、述情障碍与个体情绪调节能力的关系。方法:采用汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA)、多伦多述情障碍量表(TAS)和计算机情绪调节实验,对36名抑郁症患者和31名健康志愿者进行评定分析。结果:病例组中述情障碍发生率为66.67%,对照组为3.23%,两组比例差异有显著性(χ~2=28.661,p0.001)。病例组的TAS得分显著高于对照组(t=7.378,p0.001)。情绪调节实验中,病例组观看中性图片的评分显著高于对照组(t=2.080,p=0.043);而负性-观看、负性-重评和负性-抑制三种实验条件下,两组评分无显著差异。在病例组中,HAMD-24、HAMA与TAS得分之间存在显著相关,而情绪调节实验得分与HAMD-24、HAMA、TAS之间均未发现相关。结论:抑郁症患者中述情障碍的发生率可能高于一般人群,其抑郁症状与述情障碍之间可能存在相互影响。情绪调节能力可能是一种独立的特质,与抑郁状态无关。     

焦虑障碍、抑郁障碍患者的睡眠质量及与焦虑、抑郁症状的相关性

目的 探讨焦虑障碍、抑郁障碍患者的睡眠质量及与焦虑、抑郁症状的相关性.方法 选取2020年8月至2021年8月在深圳市康宁医院焦虑障碍科住院治疗的70例广泛性焦虑障碍、惊恐障碍、抑郁障碍患者,其中抑郁障碍组33例,焦虑障碍组37例.比较两组的汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数...     

发作期抑郁症患者述情障碍影响因素的多元分析

目的探讨发作期抑郁症患者述情障碍的相关因素。方法采用多伦多述情量表（TAS）中文版、Beck抑郁自评量表（BDI）对80例发作期抑郁症患者进行评定,并与95名健康志愿者（对照组）比较。结果（1）抑郁症组TAS因子Ⅰ、Ⅱ、Ⅲ、总分及BDI评分均显著高于对照组（P〈0．01）。（2）患者住院与他人交流、抑郁总分依次进入TAS因子Ⅰ的回归方程;抑郁总分、工作学习应激、性别依次进入TAS因子Ⅱ的回归方程;受教育年限、住院与他人交流依次进入TAS因子Ⅲ的回归方程;抑郁总分、治疗信心依次进入TAS总分的回归方程。结论抑郁发作患者存在明显的述情障碍。性别、受教育年限、抑郁的严重程度等为发作期抑郁症患者述情障碍的重要影响因素。述情障碍不同因子的影响因素不尽相同。     

The relationship between alexithymia and salivary cortisol levels in somatoform disorders

The purpose of this study was to investigate cortisol levels as a function of the hypothalamic-pituitary-adrenal axis (HPA) in relation to alexithymia in patients with somatoform disorders (SFD). Diurnal salivary cortisol was sampled in 32 patients with SFD who also underwent a psychiatric examination and filled in questionnaires (Toronto Alexithymia Scale, TAS scale; Screening for Somatoform Symptoms, SOMS scale; Hamilton Depression Scale, HAMD). The mean TAS total score in the sample was 55.6+/-9.6, 32% of patients being classified as alexithymic on the basis of their TAS scores. Depression scores were moderate (HAMD=13.2, Beck Depression Inventory, BDI=16.5). The patients' alexithymia scores (TAS scale "Difficulty identifying feelings") correlated significantly positively with their somatization scale scores (Symptom Checklist-90 Revised, SCL-90-R); r=0.3438 (P<0.05) and their scores on the Global Severity Index (GSI) on the SCL-90-R; r=0.781 (P<0.01). Regression analysis was performed with cortisol variables as the dependent variables. Cortisol levels [measured by the area under the curve-ground (AUC-G), area under the curve-increase (AUC-I) and morning cortisol (MCS)] were best predicted in a multiple linear regression model by lower depressive scores (HAMD) and more psychopathological symptoms (SCL-90-R). No significant correlations were found between the patients' alexithymia scores (TAS) and cortisol levels. The healthy control group (n=25) demonstrated significantly higher cortisol levels than did the patients with SFD; in both tests P<0.001 for AUC-G and AUC-I. However, the two groups did not differ in terms of their mean morning cortisol levels (P>0.05). The results suggest that pre-existing hypocortisolism might possibly be associated with SFD.     

Multidimensionality and state dependency of alexithymia in recently sober alcoholics

In this study, we a) examined the appropriateness of using a single global score to represent alexithymia and b) constructed a model to examine the relationship between alexithymia and depression in recently sober alcoholics applying for inpatient care. To measure alexithymia, we used the Toronto Alexithymia Scale (TAS); to measure depression, we used the revised Beck Depression Inventory (BDI). Factor analyses identified three alexithymia factors (Feelings, Daydreaming, and External Thinking) and two depression factors (Somatic-Performance and Cognitive-Affective). The three TAS factors were not positively related to each other; the two BDI factors were. We used LISREL software to examine the relationships between the TAS factors and the BDI factors. The only two significant unidirectional coefficients were between the TAS-Feelings factor and the two BDI factors. Our results suggest that in recently sober alcoholics, alexithymia, as measured by the TAS, consists of three independent, unrelated dimensions. Moreover, only the dimension associated with an inability to identify feelings and to distinguish them from bodily sensations is related to depressive symptoms. To determine whether this alexithymia feelings dimension actually is dependent on situational depression and/or anxiety will require confirmation in additional samples, such as primary alexithymics and patients with major depressive disorders.     

The relationship between alexithymia and salivary cortisol levels in somatoform disorders

The purpose of this study was to investigate cortisol levels as a function of the hypothalamic–pituitary–adrenal axis (HPA) in relation to alexithymia in patients with somatoform disorders (SFD). Diurnal salivary cortisol was sampled in 32 patients with SFD who also underwent a psychiatric examination and filled in questionnaires (Toronto Alexithymia Scale, TAS scale; Screening for Somatoform Symptoms, SOMS scale; Hamilton Depression Scale, HAMD). The mean TAS total score in the sample was 55.6±9.6, 32% of patients being classified as alexithymic on the basis of their TAS scores. Depression scores were moderate (HAMD=13.2, Beck Depression Inventory, BDI=16.5). The patients’ alexithymia scores (TAS scale “Difficulty identifying feelings”) correlated significantly positively with their somatization scale scores (Symptom Checklist-90 Revised, SCL-90-R); r=0.3438 (P<0.05) and their scores on the Global Severity Index (GSI) on the SCL-90-R; r=0.781 (P<0.01). Regression analysis was performed with cortisol variables as the dependent variables. Cortisol levels [measured by the area under the curve–ground (AUC-G), area under the curve–increase (AUC-I) and morning cortisol (MCS)] were best predicted in a multiple linear regression model by lower depressive scores (HAMD) and more psychopathological symptoms (SCL-90-R). No significant correlations were found between the patients’ alexithymia scores (TAS) and cortisol levels. The healthy control group (n=25) demonstrated significantly higher cortisol levels than did the patients with SFD; in both tests P<0.001 for AUC-G and AUC-I. However, the two groups did not differ in terms of their mean morning cortisol levels (P>0.05). The results suggest that pre-existing hypocortisolism might possibly be associated with SFD.     

米氮平治疗强迫症对照研究

目的:比较米氮平与氟西汀治疗强迫症的疗效和不良反应.方法:分别用米氮平和氟西汀治疗强迫症各27例,疗程8周.应用Yale-Brown强迫症量表(Y-BOCS)、汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)评定疗效.结果:治疗后米氮平组与氟西汀组Y-BOCS、HAMD、HAMA分值均显著下降,两组间疗效差异无显著性.米氮平组不良反应明显少于氟西汀组.结论:米氮平治疗强迫症疗效与氟西汀相仿,不良反应少,可在临床使用.     

Prevalence of gastrointestinal symptoms in alcoholics and the relationship with alexithymia

Alcohol abuse coincides with a wide variety of clinical, sociological and psychological features and symptoms. Gastrointestinal symptoms are also very common in alcoholics, but the reason is unclear. We aimed to determine the prevalence of alexithymia in alcoholics and furthermore if gastrointestinal symptoms were associated with alexithymia. Out of the 84 alcoholics who completed the alexithymia questionnaire (Toronto Alexithymia Scale, TAS20) and the standard gastrointestinal symptoms questionnaire, 92% reported gastrointestinal symptoms and 54% were alexithymic. Alcoholics above age 43 had more difficulty describing feelings (odds ratio=4.1, confidence interval=1.5-11.4). Almost all measured gastrointestinal symptoms in alcoholics were associated with scores on an alexithymia questionnaire.     

艾司西酞普兰治疗抑郁症伴焦虑的疗效分析

目的评价国产艾司西酞普兰片治疗抑郁症伴焦虑的疗效及安全性。方法本研究为6周的多中心开放性研究,共入组符合CCMD-3诊断标准的抑郁症(同时HAMD≥17分、HAMA≥14分)患者173例,服用国产艾司西酞普兰片的剂量为10mg-20mg/d,分别在治疗前及第1、2、4、6周末以汉密尔顿抑郁量表17项(HAMD)、汉密尔顿焦虑量表(HAMA)和临床总体印象量表CGI(包括病情严重程度评分CGI-SI、疗效评分CGI-GI)评定疗效,以不良事件记录表、体格检查、实验室检查评估用药安全性。结果共169例患者完成研究,经6周治疗后显示,HAMD、HAMA、CGI-SI评分呈现一致的减分趋势,各时点HAMD-17、HAMA、CGI-SI的总分与治疗前比较,差异均有显著性(P<0.05),总体有效率为81.1%、痊愈率是63.9%。不良反应发生率为10.06%,一般可以耐受。结论国产艾司西酞普兰片治疗抗抑郁及焦虑作用确切,可用于治疗抑郁症伴焦虑障碍。     

抑郁与焦虑共病障碍临床研究

目的:调查抑郁与焦虑共病障碍的发生率,探讨其特点及预后.方法:对150例抑郁障碍患者用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、社会功能缺陷筛选量表(SDSS)和临床疗效总评量表(CGI)评定,3个月后进行随访.结果:45.3%的抑郁障碍患者共病焦虑障碍,共病以广泛焦虑障碍与惊恐障碍为最多(分别为22.0%、13.3%);入组时及3个月末,共病组HAMD、HAMA、CGI及SDSS总分均显著高于抑郁组(P＜0.05),3个月末共病组HAMA减分率显著低于抑郁组(P＜0.05),HAMD减分率两组差异无显著性.结论:抑郁与焦虑共病障碍发生率高,具有抑郁及焦虑症状重、社会功能损害重,焦虑症状不易缓解等特征.     

立体定向术治疗精神障碍11例

目的 探讨立体定向术治疗精神障碍的疗效.方法 回顾性分析经立体定向术治疗的11例精神障碍病人的临床资料,其中难治性强迫症7例,抽动秽语综合征3例,双相情感障碍1例.分析手术前后耶鲁-布朗强迫量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)分值、脑白质纤维束变化及脑葡糖代谢情况.结果 术后6个月病人的各量表分值较术前均明显下降(均P<0.05),无严重并发症.大脑MR/弥散张量成像显示内囊前肢的横行纤维被毁损,大脑18F-FDG PET显示眶额皮质、运动区、运动前区、基底核、丘脑和边缘系统的高代谢区在术后明显降低.结论 立体定向术是治疗难治性精神障碍的有效方法.     

立体定向颅内多靶点毁损术治疗难治性精神障碍疗效分析

目的探讨立体定向选择性多靶点联合毁损治疗难治性精神障碍的靶点组合及疗效。方法回顾性分析2005年5月至2011年6月应用立体定向多靶点毁损手术治疗的1026例难治性精神障碍患者的临床资料,所有病例均在CT引导下行选择性多靶点联合毁损,术前应用CT进行靶点定位,手术前后应用阳性与阴性症状量表(PANSS)、耶鲁-布朗强迫量表(Y-BOCS)、汉密尔顿焦虑量表(HAMD)、汉密尔顿抑郁量表(HAMA)等量表进行疗效评定。结果经过量表术前、术后(三个月、一年、三年)评估,评分差值P0.05。1026例患者中,恢复242例,显著进步514例,进步188例,无效82例,无严重并发症和后遗症发生。结论根据不同的症状设计不同的靶点组合,对提高疗效有较大意义。