惊恐障碍患者患病行为研究

目的探讨惊恐障碍患者的患病行为方式.方法用患病行为问卷对47例惊恐障碍患者及38例正常对照者进行自评.结果惊恐障碍患者的心理取向(P/S)分与对照组相比差异无显著性,而一般疑病(GH)、疾病信念(DC)、情感压抑(AI)、情绪紊乱(AD)、否认心因(D)、易激惹性(I)均显著高于正常对照组.不伴广场恐惧的患者在GH(5.71±1.37)、DC(4.16±1.29)因子上显著低于伴广场恐惧的患者(6.57±1.09,4.93±0.73),余差异无显著性(P ＞0.05).长病程的惊恐障碍患者在AD、AS因子上显著高于短病程患者(P ＜0.05),余差异无显著性.高教育年限组情感压抑(AI)因子分显著高于低教育年限组.以性别、婚姻、家族史等因素对惊恐障碍患者进行分组,组间均差异无显著性.结论我们应根据惊恐障碍患者患病行为特点,采取针对性的治疗措施.     

惊恐障碍患者的述情障碍

目的探讨惊恐障碍患者的述情障碍及其相关因素.方法采用多伦多述情障碍量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表对伴或不伴广场恐怖的47名惊恐障碍患者和37名健康对照者进行评估.结果(1)伴或不伴广场恐怖的惊恐患者TAS因子Ⅱ分[分别为(3.30±0.70)分和(3.13±0.75)分]高于正常对照组[(2.58±0.67)分](均P＜0.05),伴广场恐怖的惊恐患者的TAS总分[(75.4±10.1)分]高于对照组[(66.3±8.9)分](P＜0.01),两患者组的因子Ⅰ、Ⅲ和Ⅳ分与对照组之间的差异无显著性(P＞0.05),两患者组TAS及四个因子之间的差异亦无显著性(P＞0.05);(2)伴与不伴广场恐怖的惊恐患者的HAMA和HAMD得分[HAMA分别为(17.0±6.13)分和(18.6±7.94)分,HAMD分别为(13.0±6.2)分和(15.3±6.96)分]均高于对照组[分别为(0.94±1.22)分和(1.08±0.27)分](P＜0.001);(3)伴或不伴广场恐怖的惊恐障碍的TAS因子Ⅱ得分与病程及HAMA和HAMD的相关关系无显著性(P＞0.05).结论伴与不伴广场恐怖的惊恐障碍患者均存在述情障碍,以认识和区别情绪和躯体感受的能力欠缺明显,与其病程和焦虑抑郁状态无相关;其描述情感、幻想及外向型思维的能力可能未受损害.     

莆田市城区社区老年人患病行为的对照研究

目的探讨社区老年人的患病行为的特点。方法采用对照研究方法,对莆田市城区社区老年人(研究组)和中年人(对照组)各162例进行患病行为问卷调查,并对结果进行比较分析。结果 2组间一般疑病(GH)、疾病信念(DC)、否认心因(D)、情感压抑(AI)因子分分别是(5.02±1.94)分比(3.23±1.75)分、(3.39±1.51)分比(2.20±1.31)分、(3.24±1.18)分比(2.76±1.33)分、(3.20±1.09)分比(2.65±1.24)分,老年组显著高于中年组(P<0.01)。两组间心理取向(P/S)、情感紊乱(AD)、易激惹性(I)因子分分别为(1.67±0.92)分比(1.83±1.01)分、(3.11±1.05)分比(2.91±1.09)分、(1.85±1.18)分比(1.75±1.12)分,老年组与中年组之间的差异无统计学意义(P>0.05)。老年组在GH、DC、D、AD、AI因子上高分值段的分布人数多于中年组(P<0.05)。结论社区老年人存在一定程度的异常患病行为,在防治老年病的同时,应根据老年人患病行为的特点给予有针对性的心理疏导和行为干预。     

牙科畏惧症患者的患病行为分析

摘要目的探讨牙科畏惧症患者的患病行为。方法采用牙科畏惧量表和患病行为问卷对来就诊的329倒牙科患者进行调查，然后进行统计学分析。结果①牙科畏惧症患者的一般疑病（GH）、情感压抑（AI）、情绪紊乱（AD）、否认心因（D）、疑病指数（WI）和情绪状态（AS）因子与正常对照组比较差异有统计学意义。②中青年组否认心因（D）因子、易激惹性（I）因子、情绪紊乱（AD）因子，中年组易激惹性（I）因子、疑病指数（WI）、一般疑病（GH）、情绪状态（AS）因子，老年组疾病信念（DC）因子、否认心因（D）因子、一般疑病（GH）、情绪紊乱（AD）因子、情绪状态（As）因子与正常对照组比较差异有统计学意义。③不同畏惧程度的各组间除心理取向因子外，患病行为问卷的各因子差异均有统计学意义。结论牙科畏惧症患者具有异常患病行为，年龄不同，畏惧的程度不同，异常患病行为的表现不同。     

惊恐障碍患者的述情障碍

目的探讨惊恐障碍患者的述情障碍及其相关因素。方法采用多伦多述情障碍量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表对伴或不伴广场恐怖的47名惊恐障碍患者和37名健康对照者进行评估。结果(1)伴或不伴广场恐怖的惊恐患者TAS因子Ⅱ分[分别为(3.30±0.70)分和(3.13±0.75)分]高于正常对照组[(2.58±0.67)分](均P<0.05),伴广场恐怖的惊恐患者的TAS总分[(75.4±10.1)分]高于对照组[(66.3±8.9)分](P<0.01),两患者组的因子Ⅰ、Ⅲ和Ⅳ分与对照组之间的差异无显著性(P>0.05),两患者组TAS及四个因子之间的差异亦无显著性(P>0.05);(2)伴与不伴广场恐怖的惊恐患者的HAMA和HAMD得分[HAMA分别为(17.0±6.13)分和(18.6±7.94)分,HAMD分别为(13.0±6.2)分和(15.3±6.96)分]均高于对照组[分别为(0.94±1.22)分和(1.08±0.27)分](P<0.001);(3)伴或不伴广场恐怖的惊恐障碍的TAS因子Ⅱ得分与病程及HAMA和HAMD的相关关系无显著性(P>0.05)。结论伴与不伴广场恐怖的惊恐障碍患者均存在述情障碍,以认识和区别情绪和躯体感受的能力欠缺明显,与其病程和焦虑抑郁状态无相关;其描述情感、幻想及外向型思维的能力可能未受损害。     

骨不连伴发惊恐障碍患者行为特点分析

目的 研究骨不连伴发惊恐障碍患者行为特点.方法 采用患病行为问卷(IBQ)对87例骨不连伴发惊恐障碍患者和87例普通骨折对照组进行调查并分析.结果 惊恐障碍患者的一般疑病、疾病信念、情感压抑、情绪紊乱、否认心因及易激惹因子评分均高于对照组(P<0.05).结论 骨不连伴发惊恐障碍患者不良情绪明显,应根据其患病行为特点采取心理干预,帮助其及时恢复心态平衡,采取针对性护理措施给予帮助和支持.     

骨不连伴发惊恐障碍患者行为特点分析

目的 研究骨不连伴发惊恐障碍患者行为特点.方法 采用患病行为问卷(IBQ)对86例骨不连伴发惊恐障碍患者和86例普通骨折对照组进行调查并分析.结果 惊恐障碍患者的一般疑病、疾病信念、情感压抑、情绪紊乱、否认心因及易激惹因子评分均高于对照组(P<0.05).结论 骨不连伴发惊恐障碍患者不良情绪明显,应根据其患病行为特点采取心理干预,帮助其及时恢复心态平衡,采取针对性护理措施给予帮助.     

牙源性疾病患者患病行为调查分析

①目的 了解牙源性疾病患者的患病行为状况,以指导临床,取得更好的治疗效果.②方法 选择牙源性疼痛的患者101例为观察组,选择健康人群109例为对照组,两组均使用<患病行为问卷>进行测评和比较分析.③结果 牙源性疾病患者与量表中10个DC、P/S、AI、D、I、WI、GH、AD、AS、DA因子的相关性有统计学意义(P<0.05);P/S、GH 、AS因子得分各年龄段之间差异有统计学意义;I因子、AS因子性别之间有统计学意义,并且都以女性得分最高.④结论 牙源性疼痛与异常患病行为显著相关,且"病感"明显,在治疗牙源性疼痛患者时,需考虑精神心理因素所起的作用.     

骨不连伴发惊恐障碍患者行为特点及其与心理控制源的关系

目的研究骨不连伴发惊恐障碍患者行为特点并分析与心理控制源的相关性。方法采用患病行为问卷(IBQ)对87例骨不连伴发惊恐障碍患者和87例普通骨折对照组进行调查并分析,再利用多维度健康状况心理控制源量表(MHLC)对87例骨不连伴发惊恐障碍患者进行调查分析。结果惊恐障碍患者的一般疑病、疾病信念、情感压抑、情绪紊乱、否认心因及易激惹因子评分均高于对照组(P0.05)。并与心理控制源的部分因子存在显著性相关(P0.05)。结论骨不连伴发惊恐障碍患者不良情绪明显,应根据其患病行为特点采取心理干预,帮助其及时恢复心态平衡。要重视健康心理控制源对骨不连伴发惊恐障碍患者不良情绪的影响,采取针对性护理措施给予帮助和支持。     

Alzheimer病与血管性痴呆认知及精神行为症状的比较

目的比较Alzheimer病（AD）与血管性痴呆（VaD）的认知障碍及精神行为症状（Psychological and behavioral symptoms of dementia,BPSD）特点。方法通过详细收集临床资料,对符合入组条件的29例AD与35例VaD患者采用简易精神状态检查量表（MMSE）和AD病理行为评分量表（BEHAVE-AD）进行比较分析。结果AD组认知功能损害程度最重,范围最广,AD组仅在图形描画稍优于VaD组,在时间定向、短程记忆、注意和计算、阅读理解显著低于VaD组;两组间在情感障碍、幻觉、焦虑和恐惧的发生率与严重程度上无显差异,VaD组行为紊乱、偏执与妄想观念的发生率显著低于AD组,严重程度却高于AD组,VaD组日夜节律紊乱、攻击行为的发生率及严重程度上均高于AD组,均有显著性差异。结论AD与VaD患者的认知功能障碍及BPSD可有不同特点,这对痴呆的诊断与鉴别诊断均具有重要参考价值。     

Hypochondriasis and somatization

Between 60% and 80% of healthy individuals experience somatic symptoms in any one week. About 10% to 20% of a random sample of people worry intermittently about illness. A substantial proportion of patients present physicians with somatic complaints for which no organic cause can be found. Patients who are hypochondriacal do not understand the benign nature of functional somatic symptoms and interpret these as evidence of disease. Hypochondriacal concerns range from common short-lived worries to persistent and distressing fears or convictions of having a disease. Hypochondriasis can be secondary to other psychiatric disorders (eg, melancholia or panic disorder), and hypochondriacal attitudes remit when the primary disorder is successfully treated. Patients with primary hypochondriasis are also anxious or depressed, but the fear of disease, or the false belief of having a disease, persists and is the most important feature of their psychopathology. There are substantial differences among hypochondriacal patients in their personalities and psychopathologies. Psychotherapy as well as psychotropic drugs are effective in the treatment of functional somatic symptoms. There are no adequate controlled studies on the value of psychotherapy in hypochondriasis; the recommended guidelines are based on uncontrolled studies of hypochondriasis and on controlled studies of the psychotherapy in similar disorders. The prognosis of functional somatic symptoms as well as that of hypochondriasis is good in a substantial proportion of patients.     

伴对立违抗障碍的注意缺陷多动障碍儿童行为特征

目的 了解注意缺陷多动障碍(ADHD)及伴对立违抗障碍(ODD)患儿的行为特点.方法 采用二阶段流行病学调查方法,对湖南省六地区9495名儿童用半定式诊断检查表(K-SADS-PL)和DSMⅣ诊断标准进行临床诊断.凡符合ADHD和ADHD+ODD诊断标准的儿童由父母填写Achenbach儿童行为量表.从筛查阴性者中随机抽取正常对照组儿童.结果 (1)单纯ADHD组、ADHD+ODD组CBCL各行为问题得分高于正常儿童对照组(P<0.01),ADHD+ODD组的违纪问题[(4.10±3.17)分,(2.68±2.63)分]、攻击行为[(8.80±6.34)分,(6.85±5.69)分]、外向性问题[(12.90±9.09)分,(9.54±7.88)分]、行为问题总分[(36.39±25.59),(30.35±24.32)]高于ADHD组.(2)ADHD组各社会能力得分低于正常儿童对照组(P<0.01),ADHD+ODD组学校分及社会能力总分低于正常儿童对照组(P<0.01).结论 ADHD患儿行为问题的发生高于正常儿童,合并ODD的ADHD患儿行为问题更加严重.     

社交焦虑障碍和惊恐障碍对患者生活质量的不同影响

目的比较社交焦虑障碍和惊恐障碍对患者生活质量影响的差异性。方法采用健康状况问卷(SF-36)对无明显其他精神障碍的35例社交焦虑障碍患者和35例惊恐障碍患者的生活质量进行评定。结果与正常常模SF-36比较,社交焦虑障碍组在社会功能和精神健康方面受影响明显(P<0.05);惊恐障碍在生理机能、生理职能和精神健康3个方面受影响明显(P<0.05)。结论未合并其他精神障碍的社交焦虑障碍主要影响社会功能和精神健康方面的生活质量;惊恐障碍在躯体和精神两方面都受到影响。     

Use of medical services and treatment for panic disorder with agoraphobia and for social phobia.

OBJECTIVE: To examine the medical services and treatment for anxiety disorders reported by patients who had either panic disorder with agoraphobia or else social phobia. DESIGN: Archival research of consecutive records of psychiatric interviews conducted between January 1990 and December 1991. The records were examined by a trained research assistant who had had no contact with the patients. PATIENTS: One hundred patients who had panic disorder with agoraphobia and twenty-eight patients who had social phobia. SETTING: An anxiety disorders clinic in a university-affiliated psychiatric institute. OUTCOME MEASURES: Variables related to the use of medical services included history of hospitalization, emergency department visits and referrals to specialists. Variables related to treatment included types of medication received, whether behaviour therapy was received and types of health care professionals seen. RESULTS: Almost 30% of the patients with panic disorder and more than 20% of those with social phobia had a history of a major depressive episode at some time in their lives; 30% and 25% respectively had a current nonpsychiatric medical diagnosis. In the past year nearly one-third of both patient groups had seen three or more different health care professionals and almost one-fifth of those with panic disorder had gone to a general hospital emergency department. Of the patients with panic disorder 9% had previously been assessed by a cardiologist and 17% by a neurologist. At least two-thirds of each group had received benzodiazepines, often for use as needed. Although most of the patients in both groups had been seen by mental health professionals such as psychiatrists, few had received optimal treatment. Of those with panic disorder, only 15% had received the tricyclic antidepressant imipramine, 13% alprazolam and 11% cognitive-behavioural therapy. Only 4% of the patients with social phobia had received cognitive-behavioural therapy. CONCLUSIONS: Both groups of patients, and particularly those with panic disorder, are frequent users of medical services. Although most have had contact with mental health professionals, few have received appropriate treatment. Benzodiazepines appear to be overprescribed, whereas forms of treatment that have been shown to reduce the use of medical services, such as cognitive-behavioural therapy, are infrequently given.     

长期无病生存白血病儿童情绪、自我意识及个性特征的对照研究

目的 探讨长期无病生存白血病儿童的情绪、自我意识及个性特征.方法 选用儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表、Piers-Harris儿童自我意识量表和儿童版艾森克个性问卷分别对19例长期无病生存白血病、20例初发白血病和40例正常对照儿童进行评定.结果 长期无病生存组患儿在焦虑总分以及躯体化/惊恐、广泛性焦虑和社交恐怖分量表评分[分别为(25.72±14.72)分,(6.11±4.36)分,(5.72±4.56)分和(7.67±4.19)分]高于对照组[分别为(16.11±11.81)分,(3.82±1.69)分,(2.84±1.92)分和(3.95±2.85)分],差异具有显著性(均P＜0.01或P＜0.05).2组白血病患儿自我意识总分[分别为(60.06±8.07)分和(58.25±6.54)分]均低于正常对照组(均P＜0.01或P＜0.05),其中长期无病生存组在焦虑和合群分量表得分明显低于正常对照组(均P＜0.01或P＜0.05),而初发白血病组患儿在行为、智力与学校情况、焦虑分量表得分显著低于正常对照组(均P＜0.01或P＜0.05).长期无病生存组与初发白血病组患儿及正常对照组比较,性格普遍偏于内向.结论 长期无病生存白血病儿童较正常儿童有更多的焦虑情绪、较低的自我意识和内向性格特征.     

血管性痴呆与阿尔茨海默病的精神行为症状分析

目的：对血管性痴呆（VD）和阿尔茨海默病（AD）的精神行为症状进行回顾性分析,以区别其临床表现。方法：回顾性分析我院2007年10月至2009年10月门诊及住院患者122例（AD61例、VD61例）精神行为症状。结果：AD组行为紊乱和攻击行为发生率高于VD组,VD组的情感障碍发生率高于AD组,AD组的行为紊乱和攻击行为EHAVE-AD评分高于VD组,而情感障碍EHAVE-AD评分低于VD组,其余BEHAVE-AD评分差异没有统计学意义。结论：通过本研究对临床医生鉴别AD与VD提供参考依据。     

Diazepam use during pregnancy: a review of the literature

Antianxiety medications such as benzodiazepines (BZDs) are frequently and appropriately used to ameliorate the anxiety symptoms of depression, dysthymic disorder, panic disorder, agoraphobia, obsessive-compulsive disorder, generalized anxiety disorder, eating disorder, and many personality disorders. Pregnancy may be accompanied by anxiety necessitating therapeutic intervention by anxiolytic drugs like BZD. Keeping in view the potential risks of teratogenicity and direct neonatal toxicity, BZDs with established safety records should be used, while avoiding exposure in the first trimester, especially with multidrug regimens, and prescribing the lowest dose for the shortest duration. This literature review highlights information from various sources regarding safety data of exposure of pregnant and lactating mothers to long-acting BZDs, especially diazepam.     

计算机多相个性测量诊断系统在女性烫吸海洛因成瘾者中的应用研究

采用计算机多相个性测量诊断系统对５２例女性烫吸海洛因成瘾者进行测定，结果表明女性成瘾者ＨＳ，Ｄ，Ｈｙ，Ｐｄ，Ｐａ，Ｐｔ，Ｓｃ，Ｍａ均明显高于国内常模。五项研究量表中ＭＡＳ，Ｄｙ，ＣＮ高于国内常模（Ｐ＜０．０１），Ｄｏ，Ｒｅ显著低于国内常模（Ｐ＜０．０１）。剖析图两点编码为４８／８４型。提示女性烫吸海洛因成瘾者存在严重的心理障碍和人格改变。应加强心理治疗及不良人格的矫正，以减少复吸促进康复