慢性前列腺炎患者心理因素与勃起功能障碍相关性分析

目的:探讨慢性前列腺炎患者心理因素与勃起功能障碍的相关性。方法:收集分析312例慢性前列腺炎患者的临床资料,采用调查问卷形式,评估患者的抑郁、焦虑情况,分析心理因素与勃起功能障碍的相关性。结果:本组发生抑郁220例(70. 5%),发生焦虑223例(71. 4%),发生勃起功能障碍90例(28. 8%)。抑郁、焦虑与勃起功能障碍密切相关(P 0. 05)。结论:慢性前列腺炎患者的心理因素与勃起功能障碍密切相关,需及时进行心理疏导。     

盐酸氟西汀治疗慢性疼痛合并抑郁状态的临床研究

目的:探讨精神、心理因素与慢性非器质性疼痛的关系及盐酸氟西汀(百优解)对慢性疼痛合并抑郁状态的临床疗效。方法:对158例慢性疼痛患者进行汉密尔顿抑郁量表(HAMD)评分筛选出具有抑郁状态者,在疼痛治疗的基础上加用盐酸氟西汀,观察其临床疗效。结果:①HAMD评定17项≥18分者71例,所占比例为44.9%。②71例中进入治疗研究的患者治疗后,盐酸氟西汀组及对照组HAMD评分及视觉模拟评分(VAS)均较治疗前明显降低(P<0.05),但治疗后2,4,6周盐酸氟西汀组HAMD及VAS改善程度均明显优于对照组(P<0.05)。结论:慢性疼痛与精神心理因素相关,对其中具有抑郁情绪的患者使用抗抑郁剂治疗能显著改善精神和躯体两方面症状。     

中年男性失眠症患者述情障碍的临床特征

目的:探讨中年男性失眠症患者述情障碍的特征。方法:分别对50例中年男性失眠症患者(失眠组)及50例健康男性(对照组)采用多伦多述情障碍量表(TAS-20)及明尼苏达多相个性调查问卷(MMPI)进行评估比较。结果:失眠组TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分均高于对照组,其MMPI各临床量表中疑病、抑郁、癔症、男性-女性化、精神衰弱平均T分值均高于对照组,差异均有统计学意义(P0.05)。失眠组TAS因子I与精神衰弱正相关,因子Ⅱ、因子Ⅲ与抑郁正相关,因子Ⅳ与癔症正相关(r分别为0.012、0.045、0.049、0.007,P0.05)。结论:中年男性失眠症患者存在述情障碍,且有一定的人格基础,这两者存在相关性。     

中年男性失眠症患者述情障碍的临床特

目的:探讨中年男性失眠症患者述情障碍的特征。方法:分别对50例中年男性失眠症患者(失眠组)及50例健康男性(对照组)采用多伦多述情障碍量表(TAS-20)及明尼苏达多相个性调查问卷(MMPI)进行评估比较。结果:失眠组TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分均高于对照组,其MMPI各临床量表中疑病、抑郁、癔症、男性-女性化、精神衰弱平均T分值均高于对照组,差异均有统计学意义(P<0.05)。失眠组TAS因子I与精神衰弱正相关,因子Ⅱ、因子Ⅲ与抑郁正相关,因子Ⅳ与癔症正相关(r分别为0.012、0.045、0.049、0.007,P<0.05)。结论:中年男性失眠症患者存在述情障碍,且有一定的人格基础,这两者存在相关性。     

抑郁障碍伴慢性功能性疼痛患者认知特征分析

目的：探讨抑郁障碍伴慢性功能性疼痛患者的认知特征。方法将32名抑郁障碍伴慢性功能性疼痛患者设为研究组,49名非抑郁障碍慢性功能性疼痛患者设为对照组,采用自动思维问卷、功能失调性态度问卷和疼痛应对方式问卷对两组患者的自动思维、功能失调性态度、疼痛应对方式进行测评分析。结果研究组自动思维问卷总均分、功能失调性态度问卷的7个因子分均显著高于对照组（P＜0．01）,认知哲学因子分显著低于对照组（P＜0．01）;疼痛应对方式问卷的灾难化、祈祷因子分均显著高于对照组（P＜0．01）,转移注意力因子分显著低于对照组（P＜0．05）。结论抑郁障碍伴慢性功能性疼痛患者存在显著的负性自动思维和功能失调性态度,对躯体疼痛症状更多地采用消极应对方式。     

长期住院慢性精神分裂症患者C-反应蛋白与精神症状的相关性

目的 探讨长期住院慢性精神分裂症患者C-反应蛋白水平与精神症状的相关性。方法 检测143例长期住院慢性精神分裂症患者(研究组)与72名健康体检者(对照组)的C-反应蛋白水平,采用阳性与阴性症状量表评定患者的精神症状。比较两组C-反应蛋白水平,并分析研究组C-反应蛋白水平与临床症状的相关性。结果 研究组C-反应蛋白水平显著高于对照组(P<0.01)。研究组C-反应蛋白水平与阳性与阴性症状量表总分及阴性因子、认知因子、焦虑抑郁因子评分呈显著正相关(P<0.05或0.01),与年龄、病程、阳性与阴性症状量表的阳性因子、兴奋因子评分无明显相关性(P>0.05)。结论 长期住院慢性精神分裂症患者存在免疫炎症异常,C-反应蛋白水平与阴性症状、焦虑抑郁症状及认知功能损害密切相关。     

慢性紧张性头疼者的个性研究

目的：探讨慢性紧张性头疼患者与个性的关系，以开拓治疗新的思维。方法：采用明尼苏达个性调查表（MMPI）以及艾森克人格测验（EPQ）量表对22例患者及19例对照作个性测评。结果：与对照组比较个性调查（MMPI），二点编码法13／31、23／32、12／21、17／71、37／73型集中。因子分中有20例患者（90．9％）抑郁、疑病、癔症、神经衰弱的得分高于对照组。艾森克人格得分，神经质得分显著高于对照组。人格类型：外向不稳定型7例，内向不稳定型12例。结论：慢性紧张性头疼的发病与个性特质有关。例如抑郁、疑病、癔症、神经质等。     

功能性消化不良与心理因素的关系及抗抑郁药辅助治疗效应

目的探讨不同病期功能性消化不良(functionaldyspepsia,FD)与精神心理因素的相关性及评价抗抑郁药对FD的辅助治疗作用。方法对符合FD诊断标准且资料完整的129例患者随机分为两组,研究组(n=65)给予抗消化不良治疗法莫替丁20mg,3次/d,多潘立酮(吗丁啉)5mg,3次/d,加服抗抑郁药舍曲林治疗;对照组(n=64)单给予相应的抗消化不良治疗,不加舍曲林;观察8周疗程。于入组时、4周末、8周末分别进行消化不良症状严重程度、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)及临床疗效评定,分析FD与心理因素(量表总分和各因子分)的相关性,并比较两组的疗效及治疗前后消化不良症状及心理因素的变化。结果两组的消化不良症状严重程度与HAMD总分及焦虑/躯体化、认知障碍、阻滞、睡眠障碍等因子分、HAMA总分及精神性焦虑因子分呈显著正相关(r=0.211～0.337,P<0.05～0.01),治疗好转后相关性下降,尤以研究组下降更明显;研究组的疗效(86%)显著高于对照组(52%)(χ2=18.04,P<0.01);研究组的量表分下降幅度更大、显效更早(P<0.05～0.01)。结论FD与心理因素密切相关。抗抑郁药对FD有辅助治疗作用,联合抗抑郁药治疗可以提高疗效。     

盐酸氟西汀治疗慢性疼痛合并抑郁状态的临床研究

目的：探讨精神、心理因素与慢性非器质性疼痛的关系及盐酸氟西汀(百优解)对慢性疼痛合并抑郁状态的临床疗效。方法：对158例慢性疼痛患者进行汉密尔顿抑郁量表(HAMD)评分筛选出具有抑郁状态者，在疼痛治疗的基础上加用盐酸氟西汀，观察其临床疗效。结果：①HAMD评定17项≥18分者71例，所占比例为44．9％。②71例中进入治疗研究的患者治疗后，盐酸氟西汀组及对照组HAMD评分及视觉模拟评分(VAS)均较治疗前明显降低(P&;lt;0．05)，但治疗后2，4，6周盐酸氟西汀组HAMD及VAS改善程度均明显优于对照组(P&;lt;0．05)。结论：慢性疼痛与精神心理因素相关，对其中具有抑郁情绪的患者使用抗抑服剂治疗能显著改善精神和躯体两方面症状。     

慢性下腰痛患者社会心理因素分析

目的探讨慢性下腰痛(CLBP)患者的心理特征.方法对65例慢性下腰痛(CLBP)患者进行了明尼苏达多相人格问卷 (MMPI),症状自评量表(SCL-90)测评,并与对照组比较.统计学处理采用t检验.结果慢性下腰痛患者MMPI测试在疑病症、抑郁症、歇斯底里及精神衰弱量表得分上与对照组有显著性差异 (P<0.01),SCL-90测试在躯体化、人际关系、强迫症、忧郁、焦虑、恐怖及精神病性等因子上与对照组均有显著性差异(P<0.05 ),病例组呈心身症特征.结论慢性下腰痛患者呈"疑病-抑郁癔病"神经三联征民主自由特征,其它尚有焦虑、强迫行为和一般适应障碍增多等.建议临床专科医师或治疗师在CLBP 的处理中应同样重视患者的心理和躯体成份.     

Patterns of normal personality structure among chronic pain patients.

Fifty-nine chronic pain patients satisfying one of four previously identified pain group classifications were evaluated using the NEO Personality Inventory (NEO-PI), a standardized measure of normal adult personality structure. Minnesota Multiphasic Personality Inventory (MMPI) pain subgroups differed with respect to level of NEO-PI Neuroticism. In particular, emotionally overwhelmed pain patients as defined by multiple MMPI scale elevations had higher NEO-PI Neuroticism scores. Post hoc analyses revealed higher levels of depression, anxiety, vulnerability, and hostility in emotionally overwhelmed subjects. None of the remaining groups differed from each other on NEO-PI Neuroticism. Additionally, none of the other NEO-PI domains discriminated pain subgroups. NEO-PI profiles for pain patients (except for Neuroticism in emotionally overwhelmed patients) yielded t scores in the average range, suggesting that chronic pain patients present with a relatively normal underlying personality structure.     

C臂机引导下选择性神经阻滞治疗老年性腰腿痛的疗效观察

目的:探讨C臂机引导下选择性神经阻滞治疗老年性腰腿痛的临床疗效。方法:老年性腰腿痛患者246例纳入观察组,给予C臂机引导下的选择性神经阻滞;老年性腰腿痛患者200例纳入对照组,给予传统借助解剖标志及异感法进行的神经阻滞。术后随访18个月,观察2组治疗前后视觉模拟评分(VAS)及Mac Nab腰椎痛手术评价的差异。结果:2组治疗后VAS评分均降低,均低于同组治疗前(P0.05),且观察组明显低于对照组(P0.01);观察组总有效率96.7%,对照组总有效率76%,差异有统计学意义(P0.01)。结论:C臂机引导下选择性神经阻滞治疗老年性腰腿痛疗效显著。     

Personality characteristics before and after treatment of different head pain syndromes

In order to examine whether, in patients with different types of headache and craniofacial pain, MMPI and STAI scores are significantly different before and after treatment, 114 patients with tension-type headache (n = 34), atypical facial pain (n = 20), temporomandibular joint dysfunction (n = 36), migraine (n = 16), cluster headache (n = 4), chronic paroxysmal hemicrania (n = 2), trigeminal neuralgia (n = 2) were examined. A pain index was calculated (0–10) which quantified pattern, duration and frequency of pain. The Italian MMPI (356 item abbreviated version) and the STAI tests were administered before and after treatment. A paired t -test was used to assess pre- and post-treatment differences, and multiple regression analysis was employed to examine whether such differences correlated with the improvement in the pain index. In the total group after treatment, there was a significant reduction of certain MMPI scores (Hs, D, Hy, Pa, Pt, Sc, Si) and of STAI 1 and 2 scores. Separate analysis confirmed this among women but not among men. No relation was found between MMPI and STAI changes and the degree of improvement as assessed through the pain index. Clinical improvement leads to normalization of MMPI profiles and STAI scores in women. The psychometric data before treatment were not predictive for treatment outcome.     

Comparing chronic pain from spinal cord injury to chronic pain of other origins

Acknowledged as a serious complaint of spinal cord injured (SCI) patients, chronic pain in this population is neither well studied nor well understood. To assess the quality and intensity of pain, a group of 49 SCI patients seeking treatment for chronic pain was compared to a general group of 95 patients from the Comprehensive Pain Clinic (CPC) on selected demographic variables, the McGill Pain Questionnaire (MPQ) and the Minnesota Multiphasic Personality Inventory (MMPI). The SCI patients were categorized as functionally incomplete SCI (SCI-I) or complete SCI (SCI-C). Multivariate analyses revealed differences among groups on the MPQ for Number of Words Checked, Rank Sum, and the Affective dimension. In all cases the CPC group scored higher than the SCI-C group. The MMPI profiles were elevated and typical for the CPC and SCI-C groups and substantially less elevated for the SCI-I group. We suggest in cases where chronic pain is secondary to a chronic medical catastrophe, aspects of the MPQ and the MMPI assess the person's total medical disability and not just the meaning and impact of pain.     

MMPI profiles in patients with headache or craniofacial pain: a comparative study

Our purpose was to examine the MMPI profiles of 157 patients with chronic headache or facial pain. The following diagnostic groups were considered: tension-type headache (n = 44); migraine + cluster headache + chronic paroxysmal hemicrania (20); trigeminal neuralgia (7); atypical facial pain (AFP) (33); temporomandibular joint dysfunction (TMJ) (53). There were two control groups: C1 of 27 healthy individuals and C2 of 18 patients with chronic pain located elsewhere. A "Pain Index" was calculated (0-10) which quantified pattern, duration and frequency of pain. The Italian MMPI abbreviated version was administered to all subjects. One-way Anova, the Duncan test and correlation analysis were performed. Of the diagnostic groups, AFP scored highest and TMJ lowest in all except three scales. In the AFP group, all neurotic scales scored above 70. The Pain Index correlated with higher scores on most scales. Chronic pain may lead to personality alterations, but some features of craniofacial pain correlate with specific personality disturbances.     

Does personality at college entry predict number of reported pain conditions at mid-life? A longitudinal study.

The purpose of this study was to evaluate whether personality traits, as assessed by the Minnesota Multiphasic Personality Inventory (MMPI), at time of college entry can predict the number of reported pain conditions at an approximate 30-year follow-up for 2332 subjects, 1834 men and 498 women, who were administered the MMPI on entry to the University of North Carolina (Chapel Hill) between 1964 and 1966. In 1997, a follow-up was conducted in which subjects were administered a self-report questionnaire regarding whether they had experienced 1 or more chronic pain conditions. Analyses of the relationship between the MMPI clinical scales at college entrance and the report of number of chronic pain conditions at follow-up were conducted. Among male participants, elevations of Scales 1 (Hypochondriasis), 3 (Hysteria), and 5 (Masculinity/Femininity) predicted increases in number of chronic pain conditions at follow-up. For female participants, elevations in Scales 1, 3, and 6 (Paranoia) predicted increases in number of chronic pain conditions at follow-up. The current study suggests that a statistically significant relationship exists between MMPI responses at college entry and reports of chronic pain conditions at mid-life. PERSPECTIVE: This study found a small, but significant relationship between elevations on MMPI scales measuring hypochondriasis and hysteria and the report of chronic pain conditions at follow-up. The study is important because it is the first to examine how personality assessed in younger adults relates to the number of chronic pain conditions reported 30 years later.     

健康教育卡用于颈肩腰腿痛患者健康教育的效果观察

目的 探讨健康教育卡用于颈肩腰腿痛患者健康教育的效果.方法 将295例颈肩腰腿痛患者按住院号奇偶数分为观察组180例、对照组115例.对照组按健康教育路径,采用口头宣教、宣传栏方式完成健康教育;观察组在对照组基础上发放健康教育卡.比较两组健康教育知识知晓率、患者对健康教育满意度及疾病复发率.结果 观察组患者健康教育知识...     

腰腿痛疾病误诊原因分析

目的：分析可引起腰腿痛的一些疾病的临床特点，误诊原因，有助于提高临床诊断水平方法：总结了23例因 腿痛而被误诊为腰椎间盘突出症，腰椎管狭窄，或被误诊为其它疾病的病例，列举引起腰腿痛的病因及特点。结果：引起腰腿痛的病因较多，对引起腰腿痛的一些疾病的认识不足，过分依赖影像，查体不细，是导致误诊的主要原因。结论：详细询问病史，仔细体格检查，不要过人依赖影像检查，可大大减少误诊机率。     

Factors for predicting premature termination from a multidisciplinary inpatient chronic pain program

Forty-eight chronic pain patients who were discharged from or left the 21-day inpatient component of a multidisciplinary pain program prior to completion were compared with a randomly selected matched group of program patients who stayed the entire 21 days. The purpose of the study was to determine if pre-admission factors are useful in predicting whether a chronic pain patient will complete an inpatient pain program. The results of pre-admission MMPI, POMS, MPQ, and information obtained from a questionnaire specially created for the program were studied. On the tests, the non-completers admitted to less psychopathology than those who did complete the program. The non-completers also had a higher number of pain-related surgeries and were more likely to be college graduates; limited social support from their families and lower MMPI premature termination scale scores were also found. Implications of these findings for the management of chronic pain patients are discussed.