孕妇心理抑郁焦虑及相关因素调查分析

目的 探讨孕妇抑郁焦虑及相关因素,为做好产前心理咨询提供依据,找出预防干预孕妇心理问题的措施.方法 采用抑郁自评量表(SDS)和焦虑自评量表(SAS),随机抽取在该院孕期保健门诊建立孕妇保健卡的孕妇280例进行调查,给孕妇讲明调查表的填写方法 ,由孕妇本人填写.结果 孕妇抑郁、焦虑高于正常人群(P<0.05),孕妇中有抑郁情绪占48.9%,焦虑情绪占63.8%.单因素分析结果 ,经期反应、孕期食欲影响胎儿健康,性别担心等因素与孕妇抑郁状态相关.结论 孕期应对孕妇进行心理保健、咨询、指导,加强孕产期健康教育,疏导孕妇心理压力,同时加强孕产期保健工作,提高孕妇身心健康.     

高危孕妇焦虑抑郁症状发生率及相关危险因素（英文）

背景:高危孕妇与普通孕妇相比在妊娠期会出现更多的并发症,高危因素作为一种应激因素更易诱发孕妇产生焦虑、抑郁等负面情绪症状。目前国内外对高危孕妇焦虑、抑郁症状的研究相对较少。目标:调查产科高危妊娠孕妇焦虑、抑郁症状发生率及其相关危险因素。方法:对197例孕中期(16-20周)的高危孕妇在妊娠最后4月每月进行综合性医院焦虑/抑郁量表(HAD)评估和风险因素调查。产后3-7天、42天及3月进行爱丁堡产后抑郁量表(EPDS)评估和风险因素调查。结果:入组时高危孕妇HAD焦虑均分:3.69(2.76),抑郁均分:3.42(2.53)。焦虑症状14例(7.18%),抑郁症状10例(5.13%)。多因素分析显示,怀孕有无保胎(OR:8.162,95%CI:1.213-54.914)和乙肝阳性(OR:8.912,95%CI:1.052-75.498)与焦虑症状相关。尿糖阳性(OR:30.529,95%CI:1.312-710.610)和既往出血史(OR:7.122,95%CI:1.015-49.984)与抑郁症状相关。孕期影响高危孕妇焦虑、抑郁症状的因素有:近3月孕妇健康状况、担心胎儿健康、夫妻关系、婆媳关系等。结论:高危妊娠孕妇焦虑、抑郁症状较常见。近3月孕妇健康状况、婆媳关系、夫妻关系、担心胎儿健康是高危孕妇孕期焦虑、抑郁症状的风险因素。     

孕妇的焦虑和抑郁情况的调查

目的调查孕妇孕期焦虑和抑郁情况及其相关因素。方法妊娠满16周者入组，予HAD量表及自制产前因素调查表等填写，追踪至孕38～40周再于一般情况调查表及HAD量表填写。结果孕16周时焦虑发生率10．8％，抑郁发生率6、9％；孕38～40周时焦虑发生率6、6％，抑郁发生率6．9％。孕16周和孕38～40周焦虑和抑郁共同的相关因素为：经济问题、担心分娩安全、孩子喂养、孩子健康；孕16周时焦虑还与年龄、既往不良孕产史、担心产后避孕等相关，而孕38～40周还与胎位、夫妻关系、胎儿性别等密切相关。结论孕期焦虑情绪占主要地位。孩子的健康及照料、经济问题和分娩安全是焦虑和抑郁的核心问题。     

孕妇焦虑抑郁情绪及产后抑郁症易感性人格的调查分析

目的探讨孕妇产前焦虑抑郁情绪及产后抑郁症易感性人格两者的关系。方法采用医院焦虑抑郁量表（HAD）和易感性人格类型量表（VPSQ）对278例孕妇进行测评分析。结果产前存在明显的焦虑、抑郁情绪者分别占10．1％和9．4％;在产后抑郁症易感性人格方面有36例〉120分的临界值。结论产前焦虑抑郁情绪的比例较高,对较严重者应实施心理干预。     

精神分裂症高危人群的认知功能与焦虑、抑郁及精神病性症状

目的评估精神分裂症高危人群的认知功能与焦虑、抑郁及精神病性症状,为该人群的早期干预提供科学依据.方法收集来源于中国医科大学附属第一医院精神医学科和沈阳市精神卫生中心就诊的门诊和住院的精神分裂症患者健康子女109人作为精神分裂症遗传高危组,通过广告招募的与精神分裂症患者健康子女年龄、性别、受教育年限相匹配的健康人群,共109人作为健康对照组.两组分别完成威斯康星卡片测试(WCST)、认知成套测试(MCCB)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD-17)和简明精神症状量表(BPRS)测试.对两组被试者的一般人口学资料、认知状况及临床特征进行统计分析处理.结果(1)精神分裂症高危组在执行功能WCST卡片测试中的总正确数(Z=-4.54,P<0.01)、正确分类数(Z=-3.78,P<0.01)、总错误数(Z=-4.49,P<0.01)、持续错误数(Z=-3.91,P<0.01)及非持续错误数(Z=-3.38,P<0.01)与健康对照组比较,差异有统计学意义;(2)精神分裂症高危组在MCCB总分(t=11.58,P<0.01)、符号编码(t=11.25,P<0.01)、视觉空间记忆(t=4.59,P=0.04)、持续操作测验(t=6.18,P=0.02)显著低于健康对照组;(3)精神分裂症高危组在HAMA总分(t=2.54,P=0.01)、HAMD-17总分(t=3.03,P<0.01)和抑郁量表中的躯体性焦虑因子(t=2.70,P<0.01)、核心抑郁因子(t=3.04,P<0.01)评分显著高于健康对照组;(4)精神分裂症高危组在BPRS总分(t=3.14,P<0.01)、焦虑和抑郁因子分(t=2.90,P<0.01)亦显著高于健康对照组.结论精神分裂症高危人群不仅存在认知功能损害,而且焦虑、抑郁以及精神病性症状高于健康人群.     

离退休人员焦虑、抑郁症状及相关因素分析

为探讨离退休人员存在的焦虑、抑郁症状，采用焦虑自评量表（ＳＡＳ）、抑郁自评量表（ＳＤＳ）和艾森克个性问卷（ＥＰＱ）对７８０位离退休人员进行了调查。结果发现４６—５０岁和６１—６５岁及内、外向不稳定型性格的离退休人员易发生焦虑、抑都症状。提示，离退休人员是一个特殊的需要关注的群体，应改善其不良的环境条件，给予多方面的干预措施，减少心理冲突与压力。     

急性脑卒中后抑郁焦虑的发生率及相关因素研究

目的 探讨急性脑卒中后抑郁、焦虑症状的发生率及相关因素。方法 采用SDS和SAS对389例急性脑卒中患者进行量表自评。结果 抑郁症状的发生率为39.6％、焦虑症状的发生率为41.6％,分析发现抑郁症状的发生与左侧大脑半球病变、病程>1个月及SAS评分高有关;而焦虑症状的发生则与左侧大脑半球病变、病程≤1个月及SDS评分高有关。结论 急性脑卒中患者存在明显的负性情绪障碍,应及早诊断和处理,以促进病人全面康复。     

正念分娩疗法对孕妇焦虑抑郁情绪的影响

目的 探究正念分娩疗法对孕妇焦虑抑郁情绪的影响,以期为孕妇的心理干预提供参考.方法 选择2018年10月-2019年3月在绵阳市第三人民医院产科就诊、符合《精神障碍诊断与统计手册(第5版)》(DSM-5)轻中度焦虑和抑郁诊断标准的孕妇80例,采用随机数字表法分为对照组和试验组各40例,两组均接受常规的心理健康教育,试验...     

孕产期不同阶段的抑郁、焦虑症状筛查及 相关因素调查

目的 探讨孕产期不同阶段抑郁、焦虑发病状况及其影响因素。方法 采用方便抽样 方法,于2017 年10 月至2018 年1 月在北京市抽取妊娠不同时期孕产妇共620 名作为调查对象,自编 一般资料调查表,9 项患者健康问卷（PHQ-9）、7 项广泛性焦虑障碍量表（GAD-7）,分析孕产期抑郁、焦 虑状况及其影响因素。结果 本研究发现孕产期抑郁症状检出率为11.33%（68/600）,焦虑症状检出率 为23.83%（143/600）,抑郁伴焦虑症状检出率为7.83%（47/600）。孕早、中、晚期抑郁症状的检出率分别 为15.58%（12/77）、10.26%（8/78）、4.00%（3/75）,差异无统计学意义（P＞ 0.05）;产后6 个月以内、6 个月以 上的抑郁症状的检出率为8.75%（14/160）、14.76%（31/210）,差异无统计学意义（P＞ 0.05）。孕期焦虑症 状检出率分别为28.57%（22/77）、23.08%（18/78）、9.33%（7/75）,差异有统计学意义（P ＜ 0.05）;产后分别 为25.63%（41/160）、26.19%（55/210）,差异无统计学意义（P ＞ 0.05）。Logistic 回归分析发现,孕产期抑郁 症状的危险因素为非全职（OR：2.27,95%CI：1.33～3.86,P＜ 0.01）;孕产期焦虑症状的危险因素为月收 入≤ 5 000 元（OR：1.60,95%CI：1.02～2.50,P＜ 0.05）、非全职（OR：1.85,95%CI：1.15～2.97,P＜ 0.05）。 结论 PHQ-9及GAD-7可有效检出孕产期抑郁、焦虑症状。孕期和产后均有一定比例的抑郁、焦虑症状。 孕产期抑郁、焦虑症状的共同危险因素为工作不稳定。     

偏头痛并发焦虑抑郁等精神心理症状的相关因素分析

目的探讨偏头痛并发焦虑、抑郁等精神心理症状的相关危险因素。方法选择我院2010-03—2013-05收治的180例偏头痛患者作为研究对象,对伴焦虑、抑郁等精神心理症状患者进行相关危险因素分析。结果观察组偏头痛伴随焦虑、抑郁和睡眠障碍的发生率分别为42.2%、60.5%,均明显高于对照组(P0.05)。长期慢性发作、头痛程度重、持续时间长、发作频率高、睡眠质量差、生活满意度差等均为偏头痛伴焦虑抑郁患者的相关危险因素,且伴焦、抑郁、睡眠障碍患者的MIDAS分值均明显高于无精神心理症状患者,差异有统计学意义(P0.05)。结论偏头痛患者多伴较高的焦虑、抑郁以及睡眠障碍等,相关危险因素较多,对其生活质量有较大影响。临床医生应考虑患者伴随的相关精神心理状况,及时予以心理疏导,改善患者的睡眠质量,促进患者预后。     

Inflammatory markers in women with postpartum depressive symptoms

Postpartum depression (PPD) is a devastating disorder affecting not only more than 10% of all women giving birth, but also the baby, the family, and the society. Compiling evidence suggests the involvement of the immune system in the pathophysiology of major depression; yet, the immune response in perinatal depression is not as well studied. The aim of this study was to investigate the alterations in peripheral levels of inflammatory biomarkers in 169 Swedish women with and without depressive symptoms according to the Edinburgh postnatal depression scale or the M.I.N.I neuropsychiatric interview at eight weeks postpartum. Among the 70 markers analyzed with multiplex proximity extension assay, five were significantly elevated in women with postpartum depressive symptoms in the adjusted LASSO logistic regression analysis: Tumor necrosis factor ligand superfamily member (TRANCE) (OR-per 1 SD increase = 1.20), Hepatocyte growth factor (HGF) (OR = 1.17) Interleukin (IL)-18 (OR = 1.06), Fibroblast growth factor 23 (FGF-23) (OR = 1.25), and C-X-C motif chemokine 1 (CXCL1) (OR 1.11). These results indicate that women with PPD have elevated levels of some inflammatory biomarkers. It is, therefore, plausible that PPD is associated with a compromised adaptability of the immune system.     

高龄孕产妇焦虑、抑郁症状分析

目的：探讨高龄孕产妇焦虑、抑郁症状的发生率及相应的危险因素。方法：随机选取两家妇产科医院的孕妇522名,采用综合医院焦虑和抑郁量表（HAD）、爱丁堡产后抑郁量表（EPDS）和自编危险因素问卷,分别评估人组时、孕38周、产后7d、产后42d和产后3个月的焦虑、抑郁症状。结果：522名中有19例高龄孕产妇。高龄孕产妇5个时点的焦虑症状发生率依次为：15.8％、11．1％、21．1％、6．7％和10．0％;孕期HAD评定的抑郁症状发生率为21．1％、11.1％,产后EPDS评定抑郁症状发生率为10.5％、28．6％和20．0％。高龄孕产妇焦虑、抑郁症状的发生率均高于非高龄孕产妇。初潮年龄和担忧孩子喂养与高龄孕产妇人组时的抑郁情绪相关,分娩时紧张状态和产后抢救与产后7d的焦虑情绪相关。结论：高龄孕产妇存在较多的焦虑和抑郁情绪,应针对其危险因素进行预防。     

氟伏沙明治疗伴有焦虑的抑郁症对照研究

目的：比较氟伏沙明与氟西汀治疗伴有焦虑的抑郁症疗效和不良反应。方法：71例伴有焦虑的抑郁症患者随机分为氟伏沙明组36例和氟西汀组35例,分别给予氟伏沙明和氟西汀治疗。疗程8周。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、治疗中出现的症状量表（TESS）评定疗效和不良反应。结果：两组HAMD和HAMA评分治疗后均较治疗前显著下降（P均〈0.01）;以氟伏沙明组在治疗1周起即显著下降（P〈0.01）,而氟西汀组在治疗2周起显著下降（P〈0.01）;两组间比较差异有显著性（P〈0.05或P〈0.01）。两组不良反应相仿。结论：氟伏沙明与氟西汀治疗伴有焦虑的抑郁症均安全有效,但氟伏沙明起效更快。     

Social anxiety and insomnia: the mediating role of depressive symptoms

Anxiety is commonly associated with insomnia. Given that social anxiety disorder is one of the most prevalent anxiety disorders, socially anxious individuals may be particularly vulnerable to insomnia. However, there is currently very little empirical work on this relationship. This study used bivariate correlations to examine whether social anxiety was related to insomnia in an undergraduate sample (n=176) using the Social Interaction Anxiety Scale and the Insomnia Severity Index. Further, we utilized responses from the Beck Depression Inventory to investigate the role of depressive symptoms in the association between social anxiety and insomnia. Hierarchical linear regressions were used to examine the moderational and mediational role of depressive symptoms in the link between social anxiety and insomnia. To increase generalizability to clinical samples, analyses were repeated on a subset of the sample with clinically significant social anxiety symptoms (n=23) compared to a matched control group (n=23). Consistent with expectation, social anxiety was associated with increased insomnia symptoms. Specifically, social anxiety was correlated with sleep dissatisfaction, sleep-related functional impairment, perception of a sleep problem to others, and distress about sleep problems. Importantly, depressive symptoms mediated the relationship between social anxiety and insomnia, thereby at least partially accounting for insomnia among socially anxious individuals. Our data support the contention that social anxiety is associated with insomnia and suggest that depression may play a vital role in this co-occurrence.     

Duloxetine in treatment of anxiety symptoms associated with depression

Most patients with major depressive disorder (MDD) have symptoms of anxiety associated with their depression. Duloxetine, a potent and balanced dual serotonin and norepinephrine reuptake inhibitor, is effective in the treatmentof depression. We investigated its effects in treating the symptoms of anxiety in depressed patients. This investigation includes all the placebo-controlled studies of duloxetine in MDD but focuses on four trials in which duloxetine was superior to placebo on the primary outcome measure of the 17-item Hamilton Depression Rating Scale (HAMD(17)) total score. Studies 1 and 2 included duloxetine at 60 mg/d (the recommended starting and therapeutic dose) and placebo. Study 3 included duloxetine 120 mg/d (administered as 60 mg b.i.d.), fluoxetine 20 mg/d, and placebo. Study 4 included duloxetine 40 mg/d (administered as 20 mg b.i.d.), duloxetine 80 mg/d (administered as 40 mg b.i.d.), paroxetine 20 mg/d, and placebo. Anxiety was assessed in all studies using the HAMD anxiety/somatization subfactor and the anxiety-psychic item (HAMD Item 10). Studies 3 and 4 also included the Hamilton Anxiety Rating Scale (HAMA). Across the four studies, duloxetine at doses of >/=60 mg was compared with placebo on 10 outcomes and with either paroxetine or fluoxetine on 6 outcomes. In 8 comparisons, mean improvement for duloxetine was significantly greater than placebo at the last study visit and/or across all study visits. In 3 comparisons, the mean improvement for duloxetine was significantly greater than paroxetine or fluoxetine. In these studies, duloxetine provided rapid relief of anxiety symptoms associated with depression. Previous reports have summarized duloxetine's efficacy in treating the core emotional symptoms and painful physical symptoms associated with depression. Duloxetine's efficacy in treating a broad spectrum of symptoms associated with depression, including mood, anxiety, and painful physical symptoms, may be attributed to dual reuptake inhibition of both serotonin and norepinephrine. Efficacy in these three key symptom domains may in turn explain the high probabilities of remission (43-57%) observed in these studies.