The relationship between children's and adolescents' perceptions of parenting style and internal and external symptoms

Background This study examined the relationship between children’s and adolescents’ external (aggression or delinquent behaviour) and internal (depression and anxiety, somatic complaints or regressive behaviour) symptoms and their perceptions of parenting behaviour. Method Participants were 159 children (83 boys and 76 girls) aged 10–17 years and were categorized into five groups. The two experimental groups included clearly defined externalizing (n = 35) and internalizing (n = 46) children. Two sibling groups and one non‐sibling group served as controls. The five groups were compared for subjective perceptions of maternal and paternal rejection, favouritism and overprotection. Results No effects of age or gender were found. The results revealed that compared with non‐symptomatic children from different families and with non‐symptomatic siblings, both internalizing and externalizing children obtained higher scores on the variables examined. Externalizing children obtained the highest scores, while internalizing children obtained intermediate scores. The sibling comparison data revealed a gap between the perceptions of symptomatic children and their siblings: symptomatic children reported negative parenting practices towards both themselves and their siblings, whereas the opposite was true of sibling reports. The reports suggest that while both internalizing and externalizing symptoms are associated with negative perceptions of the parent–child interaction, this may be particularly the case among externalizing children. Conclusions The importance of perceptions of reality, as opposed to objective circumstances, is discussed in the context of treatment.     

系统式集体音乐治疗对社区精神分裂症情绪及 精神症状影响的研究

目的研究系统式集体音乐治疗(systematic group music therapy,SGMT)模式对社区精神分裂症患者的负性心理及阳性阴性精神症状的影响。方法按系统抽样方法抽取160例病例,按1∶1配对,80例为干预组,另80例为对照组。对干预组实施SGMT干预,对照组接受常规社区精神病康复管理。使用三种量表作为评价工具。结果在实施干预后的第18个月,干预组的焦虑、抑郁平均得分均比对照组平均得分降低(P0.05);干预组阳性阴性症状量表总分、分量表平均分得分与对照组比较均降低,且存在差异,具有统计学意义(P0.05)。结论实施SGMT干预,能有效地改善社区分裂症患者焦虑、抑郁症状,且能改善其阳性阴性精神症状。     

阑尾炎的超声声像图分析

[目的]对150例手术病理证实阑尾炎患者与术前超声检查所得结果进行对比分析。[方法]全部患者术前进行超声检查,120例2周内进行手术,30例为保守治疗复发于5年内手术。[结果]150例患者,超声诊断阑尾炎79例,慢性阑尾炎71例。超声诊断阑尾炎119例,超声提示诊断阑尾炎23例,漏诊8例。[结论]超声是检查阑尾炎影像学检查的首选方法,通过多方位,多角度,直接征象和间接征象及鉴别诊断的综合分析,提高超声诊断符合率,有利于临床医师手术适应症和保守治疗的选择。     

Health hazards of unemployment–only a boom phenomenon? A study of young men and women during times of prosperity and times of recession

Background: It has been suggested that high unemployment rates in society may be less harmful to the health of people than low unemployment rates. Therefore, a study was carried out to compare, among young men and women, the relationship between health and long-term unemployment during periods of rapid economic growth ‘boom’ and economic recession.Methods: Two study groups were chosen at age 21 y (5 y after compulsory schooling ended) from an industrial town in northern Sweden. The first group (number 1083) was chosen and surveyed in 1986 (under ‘boom’ conditions); the second (number 898) was chosen in 1994 (under economic recession conditions). The non-response rate was 2% for the boom group and 10% for the recession group. The main outcome measurements examined were somatic and psychological symptoms.Results: Health criteria for general health among long-term unemployed young men and women did not differ between the group surveyed in boom conditions and the group surveyed in recession conditions. The only exception was for psychological symptoms, which scored lower among the men in the recession group. Individual unemployment had a high explanatory power for poor health, in particular, psychological ill health.Conclusions: When comparing periods of boom and recession there was no difference in somatic and psychological symptoms for those who were long-term unemployed. Thus, the trade cycle appeared to have had no impact on their health. Public Health (2000) 114, 25–29.     

Airways symptoms, immunological response and exposure in powder painting

Objectives: Powder painting is an alternative to solvent-based spray painting. Powder paints may contain organic acid anhydrides (OAAs), which are irritants to the airways and may cause sensitisation. The aim of this study was to determine the prevalence of respiratory symptoms and immunological response among powder painters and to describe the exposure to OAAs. Methods: In all, 205 subjects in 32 enterprises participated: 93 exposed and 26 formerly exposed workers in 25 powder paint shops and 86 unexposed workers. They completed a questionnaire about working conditions and symptoms and took part in a medical examination, which included a lung function test. Urine samples, for determination of two OAAs, and blood samples, for analysis of specific antibodies against the OAAs, were taken. In addition, 33 paint samples were analysed for nine OAAs. Results: The powder painters reported more work-related respiratory symptoms than unexposed subjects did. The prevalence of three or more symptoms was 24% in subjects with low exposure, 44% in highly exposed individuals, 46% in formerly exposed subjects and 19% in unexposed workers. Asthma symptoms were frequent, 7%, 40%, 15% and 2%, respectively. Regression analyses of the lung volumes did not show any influence of exposure. IgG, but not IgE, against the OAAs and metabolites of OAAs was found in some subjects, but no associations with the exposure could be observed. OAAs were found in only small amounts in the paint samples. Conclusions: The exposure to organic acid anhydrides was estimated to be low, and yet, IgG antibodies to OAA were observed in some subjects. The prevalence of work-related symptoms from the eyes and the airways was relatively high among the powder painters, and these symptoms, but not the lung volumes, were clearly related to exposure. The symptoms were probably caused by irritative properties of the powder paint dust.     

无麸质无酪蛋白饮食对孤独症谱系障碍儿童治疗效果的系统评价

目的 系统评价无麸质无酪蛋白(GFCF)饮食对孤独症谱系障碍(ASD)儿童的治疗效果,为临床治疗提供科学依据。方法 通过检索PubMed、EBSCO、Cochrane Library、SpringerLink、维普、万方、中国知网等数据库筛选符合标准的文献,进行文献质量评估,综合评估其治疗结果。结果 共筛选出7篇符合标准的原始文献,包括181例ASD患者,7篇文献均研究了GFCF对ASD核心症状的影响,5篇文献均显示GFCF饮食治疗对ASD核心症状无改善作用;其中2篇同时研究了GFCF饮食对患儿胃肠道的影响,2篇均显示GFCF饮食对胃肠道无明显影响。结论 GFCF饮食疗法对ASD儿童核心症状、胃肠道症状无明显改善作用。     

妊娠早期症状与经前期症状之间的相关性分析

目的通过对妊娠早期症状与经前期症状之间的相关性分析,评估经前期症状对妊娠早期症状的预测价值。方法对2014年9~12月在郑州大学第一附属医院产科就诊的305例妊娠期妇女进行问卷调查,采用配对t检验对经前期症状和妊娠早期症状进行差异性分析,分别采用简单线性回归模型、多重线性回归模型对经前期症状与妊娠早期症状进行相关性分析。结果妊娠早期症状出现的频数及严重程度与经前期症状比较,差异均有统计学意义(t=6.9、t=6.7,P0.001);妊娠早期与经前期各症状平均严重程度之间存在大量的相关性;妊娠早期症状的总体严重程度与经前期症状的总体严重程度呈显著性相关(b=0.4,95%CI=0.3~0.5,P0.001)。结论妊娠早期与经前期具有相似的症状模式,妊娠早期出现的某一精神心理症状可通过经前期症状预测,经前期易怒症状的严重程度是预测妊娠早期症状总体严重程度的最佳指标。     

焦虑症状在孕妇社会支持与抑郁症状的关系中的中介作用

目的 本研究旨在探究孕妇的焦虑症状是否在社会支持与抑郁症状间发挥中介作用。方法 采用基本情况调查表、患者健康问卷(PHQ - 9)、广泛性焦虑量表(GAD - 7)及社会支持评定量表(SSRS)对1 767名孕妇进行问卷调查,对数据进行描述性分析、偏相关分析以及中介效应检验。结果 偏相关分析结果显示,孕妇社会支持及其各维度与抑郁症状呈负相关(r = - 0.077~ - 0.222,P＜0.001),社会支持及其各维度与焦虑症状呈负相关(r = - 0.183~ - 0.298,P＜0.001),焦虑症状与抑郁症状呈正相关(r = 0.581,P＜0.01)。中介效应分析结果显示,焦虑症状在社会支持、主观支持维度、支持利用维度与抑郁症状之间起部分中介作用,中介效应分别占总效应的71.43%、74.07%、65.02%;在客观支持维度与抑郁症状间起完全中介作用,中介效应占总效应的76.88%。结论 社会支持及其各维度可通过焦虑症状对孕妇抑郁症状产生一定的影响。提高孕妇社会支持水平,将有助于减轻焦虑症状,进而避免抑郁症状的发生。     

Two-three-year stability and interrelations of bulimotypic indicators and depressive and anxious symptoms in middle-aged women

OBJECTIVE: There is a paucity of research examining eating disorder symptoms among middle-aged women. METHOD: This prospective study assessed the stability of bulimic symptoms and 5 associated variables (perfectionism, depressive symptoms, self-esteem, anxiety symptoms, and perceived weight status) in a sample of 150 middle-aged women (mean age = 45.19 years) over a 2.5-year time period. In addition, interrelations among bulimic, anxiety, and depressive symptoms were assessed. RESULTS: Results suggested that all 6 bulimia-related variables remained significantly stable over 2.5 years. In addition, notable relations between Time 1 and Time 2 variables emerged (e.g., anxious symptoms at Time 1 predicted bulimic symptoms at Time 2). CONCLUSION: Thus, the results indicate that bulimic symptoms exist in middle-aged women, and that they remain relatively stable over a 2.5-year time period. Clinical implications for middle-aged women with eating disorder symptoms are discussed.     

中国三城市更年期综合征门诊妇女抑郁和焦虑症状现况调查

目的了解中国大城市妇科门诊不同特征更年期综合征患者中抑郁和/或焦虑可疑症状检出比例。方法采用现况研究方法,于2004年6月1日到9月1日在北京、上海和成都的4家三级医院的妇科门诊对306例更年期综合征妇女进行面对面调查,并使用综合医院焦虑抑郁量表(HADS)、Hamilton焦虑量表和Hamilton抑郁量表进行心理测评。结果更年期综合征门诊妇女中抑郁可疑症状(HADS≥9分)比例为11.1%,焦虑可疑症状的比例为12.4%;抑郁症状(HAMD≥17)的检出比例为6.2%和焦虑症状(HAMA≥14分)的检出比例为9.8%。无医保的对象抑郁和/或焦虑症状的检出率高。结论中国大城市妇科更年期综合征妇女抑郁和/或焦虑症状检出比例高于同类研究结果。应特别关注受教育程度较低、没有医疗保险覆盖的更年期综合征妇女中的抑郁和焦虑问题。     

Objective assessment of ocular and respiratory alterations in employees in a sick building

Background Sick building syndrome (SBS) is a constellation of diffuse, “irritative” symptoms predominantly involving the eyes and the respiratory tract. To date, the effects of working in a “sick building” have not been adequately assessed using objective measures. We undertook the present study to determine whether objective alterations could be found in the eyes and respiratory tracts of employees working in an office building in which a high rate of SBS had been reported in the preceding year. Methods We studied 163 office workers: 87 workers from a modern, air-conditioned building (the sick building), and 76 employees employed in three traditional-style office buildings (the comparison buildings). After being surveyed for SBS symptoms, all subjects underwent a series of objective tests, including spirometry, a methacholine test, prick tests for aeroallergens, and submitted tear samples. In addition, Schirmer's test and the break-up time test were used to explore for potential ocular effects of sick building exposure. Results Employees in the sick building complained more frequently of ocular symptoms, upper-airway disturbances, and general and respiratory symptoms than did employees in the comparison buildings; prick tests were positive in 20% and 17.4%, respectively. Groups did not differ significantly on spirometry measures. Bronchial hyperreactivity to methacholine (PD15 = 16.348 μmol) was present in 20.5% of the sick building workers and in 16.2% of comparison buildings workers. Methacholine dose-response slope values were similar. Stability of tear film was significantly reduced (P< 0.01) in the employees in the sick building compared with employees in the comparison buildings. Conclusions Our results indicate that (1) atopy does not seem to influence the prevalence of SBS symptoms, and (2) the lower respiratory tract seems unaffected by exposure to a “sick building,” but (3) alterations in tear film stability do exist after such exposure. Am. J. Ind. Med. 34:79–88, 1998. © 1998 Wiley-Liss, Inc.     

肿瘤病人临终关怀护士的职业倦怠及其心理症状

目的探讨肿瘤病人临终关怀护士的职业倦怠、心理症状及其之间的关系,为制定干预措施和提高临终关怀服务质量提供依据。方法采用随机抽样方法,对西安市3所三级甲等医院肿瘤科从事临终关怀工作的178名护士的职业倦怠和心理症状进行测评,并采用皮尔逊相关检验方法分析变量之间的关系。结果护士的职业倦怠程度得分为176.6±7.9,抑郁和焦虑症状得分分别为59.7±5.7和56.3±6.9。职业倦怠和抑郁症状、焦虑症状呈正相关,相关系数(r)分别为0.67、0.65,P0.01。等级线性模型分析结果表明,抑郁症状是导致护士职业倦怠的主要原因(Beta=0.45)。结论肿瘤病人临终关怀护士群体呈现出较高程度的职业倦怠,并伴有明显的抑郁和焦虑症状,抑郁症状是导致其职业倦怠的主要原因。     

A cross-sectional survey of respiratory and general health outcomes among semiconductor industry workers

As part of the Semiconductor Health Study, we performed a cross-sectional survey to assess prevalence of specific nonreproductive health outcomes and their association with occupational exposures. A total of 3,175 persons from eight manufacturing sites across the U.S. completed a health and work questionnaire (78% participation rate). After adjusting for confounders, responses from fabrication room (fab) workers indicated a greater risk than those of nonfab workers for upper respiratory symptoms (relative risk [RR] = 1.08; 95% confidence interval [CI] = 1.03-1.13); a dose-response effect with hours per day spent in fabs was observed. Fab workers also had greater prevalence for persistent wheezing (RR = 1.82; 95% CI = 1.15-2.87), Dermatitis within the past year (RR = 1.19; 95% CI = 1.04-1.35), and alopecia (RR = 1.73; 95% CI = 1.16-2.54). Female sex, a somatization index score, and smoking were important nonoccupational covariates. Increased respiratory symptoms MAy result from occupational exposures in fabs; further research is needed to identify causal agents and develop prevention strategies.     

Work-related respiratory problems in industrial arts teachers

Because of reports of respiratory complaints in Swedish industrial arts (IA) teachers, a cross-sectional study was performed on 130 IA teachers in Stockholm to study the relationship between the work environment and health, and especially the aforementioned complaints. One hundred and twelve other school employees served as control subjects. Sex, age, and smoking habit distribution were similar in the two groups. All subjects answered a questionnaire about their health problems, and the IA teachers answered questions about their work environment. The work environment consisted of many old and neglected workshops (hereafter called shops). Compared to the control subjects, the IA teachers had more complaints in respect of the skin, eyes, nose, throat, and lower airways -including chronic bronchitis (OR 12.4, 95% confidence interval 2.95–110.5). A higher occurrence of symptoms existed in shops with bad ventilation and dust-spreading machines and in shops where dustspreading cleanup methods were used. A suspected interaction between smoking and work environment was noted for some symptoms, especially impaired smell and chronic bronchitis. In conclusion, several factors in the work environment were identified as risk factors for health. Identification of these risk factors should result in a program to reduce the health problems in the work environment.     

Depressive and anxiety symptoms among housemaids

BACKGROUND: Housemaid, the most common occupation in the female labor force in Brazil, is known to be targeted by a generalized racial and job discrimination, which can generate mental suffering such as depressive and anxiety symptoms. In this cross-sectional study, the association between being a maid and having depressive and anxiety symptoms was evaluated. METHODS: Data for this study was taken from a former survey carried out in a random sample of 470 families living in a poor area of the city of Salvador, capital of the state of Bahia, Northeast Brazil. The study population comprised all women between the ages of 14 and 69, who reported having a paid occupation (n = 335). Data was collected by trained interviewers, using questionnaires. Psychological symptoms were identified using the Questionnaire for Psychiatric Morbidity among Adults, (QMPA), from which only those related to depression and anxiety (QMPA-SAD) were analyzed. RESULTS: Logistic regression showed that being a housemaid was positively associated with "sadness/tiredness" (adjusted prevalence ratio, PR(adj) = 1.64; 95% confidence interval, CI: 1.17-2.28), "poor concentration" (PR(adj) = 1.81; 95% CI: 1.13-2.90), "palpitations" (PR(adj) = 2.22; 95% CI: 1.28-3.84), and "aggressive behavior" (PR(aj) = 1.58; 95% CI: 1.01-2.46). CONCLUSIONS: Although cross-sectional designs are limited by causal inference, these results are in accordance with those obtained in qualitative studies. Advances in the Brazilian labor legislation with respect to domestic service may help to reduce social discrimination and contribute towards minimizing a possible mental burden resulting from this occupation.     

首次住院伴抑郁症状的精神分裂症临床研究

[目的]了解首次住院伴抑郁症状的精神分裂症患者的临床特征。[方法]对94例伴抑郁症状的精神分裂症患者与94例不伴抑郁症状的精神分裂症状患者进行临床对照研究。[结果]伴抑郁症状的精神分裂症患者占首次住院精神分裂症患者的30．13％。抑郁症状以焦虑、疑虑、绝望、兴趣下降多见,自杀行为也较突出,精神症状以幻觉、被害、关系、被洞悉、罪恶、疑病为主,治疗上是否使用抗抑郁剂对疗效关系不大。[结论]抑郁症状是精神分裂症的组成部分,随着精神症状的好转,抑郁症状也有所改善,对首次住院伴抑郁症状的精神分裂症患者需防自杀。     

The Role of the Occupational Therapist in the Management of Neuropsychiatric Symptoms of Dementia in Clinical Settings

Neuropsychiatric symptoms (NPS) of dementia include aggression, agitation, depression, anxiety, delusions, hallucinations, apathy, and disinhibition. NPS affect dementia patients nearly universally across dementia stages and etiologies. They are associated with poor patient and caregiver outcomes, including increased health care utilization, excess morbidity and mortality, and earlier nursing home placement, as well as caregiver stress, depression and reduced employment. There are no FDA-approved medications for NPS, but it is a common clinical practice to use psychotropic medications such as antipsychotics, to control symptoms; however, antipsychotics show only modest efficacy in improving NPS and have significant risks for patients, including side effects and mortality. Nonpharmacologic treatments are considered first-line by multiple medical bodies and expert consensus, as they show evidence for efficacy and have limited potential for adverse effects. Ideally, nonpharmacological management of NPS in clinical settings occurs in multidisciplinary teams, where occupational therapists play an important collaborative role in the care of the person with dementia. Our group has articulated an evidence-informed structured approach to the management of NPS that can be integrated into diverse practice settings and used by providers of various disciplines. The “DICE” (Describe, Investigate, Create, and Evaluate) approach is inherently patient- and caregiver-centered, as patient and caregiver concerns are integral to each step of the process. DICE offers a clinical reasoning approach through which providers can more efficiently and effectively choose optimal treatment plans. The purpose of this paper is to describe the role of the occupational therapy in using the DICE approach for NPS management.