焦虑症患者自我监控高低与焦虑特质的关系

目的探讨焦虑症患者自我监控的高低与焦虑特质的关系。方法对43例焦虑症患者进行焦虑特质（T-AI）和Snyder自我监控量表（SSMS）调查,按SSMS得分高低划分为高自我监控组和低自我监控组,并比较两组间T-AI得分情况。结果高自我监控焦虑特质得分明显低于低自我监控（t=3.05,P〈0.01）。结论低自我监控更多关注自身内部状态、个人特点和社会态度的信息,易导致神经质倾向、自我与经验的不和谐及刻板性增高,从而导致焦虑特质的增高。提高自我监控水平,更多关注外部现实情景,可能会达到减轻焦虑的目的。     

焦虑障碍患者焦虑素质及临床特征相关性研究

正焦虑谱系障碍包括广泛性焦虑、惊恐障碍、强迫症、恐惧症等多种疾病,因其发病率高,疾病负担重~([1-2]),近年来日益受到重视。国内目前对焦虑素质与焦虑障碍的关系、临床特征、预后及其影响因素的研究较少。焦虑障碍与个性因素关系密切,而其中焦虑素质与焦虑症状最受关注。焦虑素质是相信与焦虑有关的感觉对自身的生理、心理和社会评价有危害,从而产生的对焦虑症状的害怕和担心,是反映个体对自身发生焦虑的恐惧程度的一个相对稳定     

焦虑障碍患者焦虑敏感与特质焦虑的相关研究

目的:探讨焦虑障碍患者焦虑敏感与特质焦虑、临床特征的相关性。方法:68例焦虑障碍患者(焦虑组)根据汉密尔顿焦虑量表(HAMA)评分≥7分为分界值,分为焦虑未缓解组43例和缓解组25例,进行焦虑敏感测定量表(ASI-R)及状态-特质焦虑问卷中特质焦虑量表部份(T-AI)的评定;ASI-R评分结果与70名正常对照(正常对照组)进行比较,分析ASI-R评分与T-AI总分及临床特征的相关性。结果:焦虑组ASI-R总分、对躯体感觉的焦虑因子分、对躯体感觉的恐惧因子分、对认知失控焦虑恐惧因子分、对社会后果焦虑恐惧因子分均高于正常对照组(t分别=8.51,9.00,8.15,8.74,3.24;P均<0.01)。焦虑缓解组ASI-R总分、及对躯体感觉的焦虑因子分、对躯体感觉的恐惧因子分、对认知失控焦虑恐惧因子分均高于正常对照组(t分别=4.41,3.37,4.24,3.76;P均<0.01);未缓解组ASI-R总分及各因子分高于缓解组(t分别=3.30,3.41,2.61,2.78,2.14;P<0.05或P<0.01)。经相关分析,ASI-R总分、及躯体感觉的焦虑因子分、对认知失控的焦虑恐惧因子分与T-AI总分显著相关(r分别=0.33,0.28,0.40;P<0.05或P<0.01);ASI-R总分、对认知失控焦虑恐惧因子分、对社会后果焦虑恐惧因子分与病程显著相关(r分别=0.27,0.26,0.31;P均<0.05)。结论:焦虑障碍患者的焦虑敏感程度高于正常人群;焦虑敏感水平部分与焦虑特质有关。     

综合干预模式对门诊广泛性焦虑障碍患者的疗效

目的:探讨综合干预模式对门诊广泛性焦虑障碍(GAD)患者的疗效。方法:采用随机数字表法将92例GAD门诊患者分为干预组(n=45)和对照组(n=47),两组均给予门诊常规药物治疗,干预组同时合并综合干预(包括团体认知行为治疗及诊室外疾病管理),疗程12周。分别在干预前、干预1个月、干预结束时、干预结束后1个月随访时采用症状自评量表(SCL-90)、总体幸福感量表(GWB)、简易应对方式问卷(SCSQ)、一般自我效能感量表(GSES)对两组患者进行评估。结果:干预1个月时两组SCL-90总分、躯体化、抑郁、焦虑因子分以及GWB中对健康担心维度评分差异有统计学意义(P<0.05或P<0.01);干预完成及随访时两组SCL-90总分、躯体化、抑郁、焦虑因子分以及GWB总分、对健康担心、生活满足、愉快心境维度评分差异有统计学意义(P均<0.01)。重复测量方差分析显示,两组在不同时间点的SCL-90、GWB总分及各维度得分差异有统计学意义(P均<0.01);SCL-90总分及躯体化、焦虑、抑郁因子分的组间效应和交互效应显著(P均<0.01);两组GWB总分及对健康...     

成都市综合医院门诊抑郁和焦虑障碍调查

目的:调查成都市综合医院门诊患者抑郁和焦虑障碍的患病率.方法:对成都市3所综合医院神经内科、消化科、心内科及妇科门诊的1 780例就诊者使用医院焦虑抑郁量表(HADS)进行筛查.HADS评分≥8分者使用国际神经精神科简式访谈问卷(MINI5.0.0)进行诊断评定,最后根据美国精神障碍诊断和统计手册第四版(DSM-IV)...     

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...     

焦虑障碍的治疗

焦虑障碍包括惊恐障碍、强迫性障碍、创伤后应激障碍、社交焦虑障碍和广泛性焦虑障碍等。美国国立精神卫生研究所报告，有1600万年龄介乎18至54岁的美国人患焦虑障碍，焦虑障碍的终生患病率高达14．6％。焦虑障碍虽不少见，但得到治疗的患者的比例却远比抑郁症低。英国医生对焦虑障碍患者10108例进行的面谈调查发现，大多数病人没有得到治疗，得到治疗的比例为：     

焦虑障碍患者健康行为水平调查及干预

目的探讨焦虑障碍患者的健康行为水平和综合干预的效果。方法选取80例符合《精神障碍诊断与统计手册(第5版)》(DSM-5)焦虑障碍诊断标准的门诊患者作为研究组,在社区抽签筛选80例健康成人作为健康对照组,采用健康促进生活方式量表Ⅱ(HPLP-Ⅱ)和世界卫生组织生活质量评定量表简表(WHOQOL-BREF)分别评定两组的健康行为水平和生活质量。采用随机数字表法将研究组患者分为干预组和对照组,对干预组进行随访、运动、阅读、心理治疗等行为干预6个月,对照组仅接受一般性心理治疗。采用HPLP-Ⅱ、WHOQOL-BREF、汉密尔顿焦虑量表(HAMA)进行评定,比较干预前后两组HPLP-Ⅱ、WHOQOL-BREF、HAMA总评分及6个月内的疾病复发率。结果研究组HPLP-Ⅱ总评分和自我实现、运动和锻炼、人际关系、压力处理四个分量表评分及WHOQOL-BREF总评分低于健康对照组(P0.05);干预后干预组的HPLP-Ⅱ总评分及运动和锻炼、人际关系、压力处理3个分量表评分及WHOQOL-BREF总评分均较干预前高(P0.05),HAMA评分低于干预前(P0.05),以上与对照组比较差异有统计学意义(P0.05),干预组疾病复发率低于对照组(P0.05)。结论焦虑障碍患者健康行为和生活质量水平低于健康人群,通过综合行为干预,可提高其健康行为水平和生活质量,改善焦虑症状,减少复发。     

广泛性焦虑障碍患者血清炎性因子水平分析

目的研究广泛性焦虑障碍患者血清炎性因子水平及意义。方法选取我院2016年4月～2017年4月收治的66例广泛性焦虑障碍患者作为作为观察组,另外选择66名体检健康的志愿者作为对照组。两组清晨空腹抽取外周静脉血,检测C-反应蛋白(CRP)、白细胞介素-1α(IL-1α)、白细胞介素-6(IL-6)、白细胞介素-12(IL-12)、干扰素-γ(INF-γ)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)各项指标,另外通过相关性分析广泛性焦虑障碍患者血清炎性因子与广泛性焦虑评分(GAD-7)、状态焦虑评分(SAI)及特质焦虑评分(TAI)的关系。结果观察组CRP、IL-1α、IL-6、IL-12、INF-γ、GM-CSF水平与GAD-7、SAI、TAI评分显著高于对照组,差异有统计学意义(P0.05);广泛性焦虑障碍患者血清炎性因子CRP、IL-1α、IL-6、IL-12、INF-γ、GM-CSF与GAD-7、SAI、TAI呈正相关,r分别为0.259～0.711、0.283～0.533、0.357～0.703,差异有统计学意义(P0.05)。结论广泛性焦虑障碍患者相对于正常人血清炎症因子水平较高,且炎症因子水平上升与焦虑障碍严重程度相关,因此临床诊疗过程中应密切关注患者血清炎性因子水平。     

米氮平治疗广泛性焦虑症的临床观察

目的探讨米氮平治疗广泛性焦虑症(GAD)的临床疗效及安全性。方法共85例广泛性焦虑症患者入组,米氮平治疗46例,对照观察组39例,共观察8周,使用HAMA判断疗效,并记录不良反应。结果74例完成研究(米氮平41例,对照组33例)。研究终点,米氮平组HAMA减分平均为12.5±5.8,对照组减分平均为7.7±6.5,两组比较差异有统计学意义(t=3.35,P(0.01);米氮平治疗后14天及其后各随访点HAMA减分与观察组比较差异均有统计学意义;米氮平治疗GAD的有效率71%,显著优于观察组(39%)(2χ=7.32,P<0.01);米氮平的主要不良反应为体重增加、食欲增强、嗜睡及头晕。结论米氮平治疗GAD有效,依从性高,不良反应不多见,可作为临床治疗GAD的一种选择。     

惊恐障碍病人药物治疗前后状态-特质焦虑问卷结果分析

目的　探讨氟西汀联用氯硝西泮治疗惊恐障碍前后状态—特质焦虑问卷 (STAI)测查结果变化特点。方法　对 2 8例惊恐障碍病人治疗 6个月 ,分别于疗前、疗后 1、3、6月末以SAI评定焦虑症状 ,以TAI评定焦虑特质 ,以CGI中GI评定临床疗效。结果　药物治疗对焦虑症状有明显疗效 ,疗后各时段与疗前、疗后各时段之间差异均有显著性 (P <0 .0 1) ,而焦虑特质的变化与焦虑症状的变化不同 ,疗后各时段与疗前差异有显著性 (P <0 .0 1) ,但疗后各时段之间基本无变化 (P >0 .0 5 )。GI评定疗后 6月末显效率 85 .7% ,有效率10 0 %。结论　药物治疗对焦虑症状近、远期均有效 ,对焦虑特质近期有效 ,远期基本无效 ,近期效果可能与惊恐情绪所致认知偏差有关 ,故需配合心理治疗     

焦虑症患者的生命质量与焦虑症状的相关性研究

目的 探讨焦虑症患者的生命质量以及与焦虑症状的关系.方法 采用生命质量量表(LQS)及Hamilton焦虑量表(HAMA)对60例焦虑症患者进行了问卷调查,并与60例正常对照者比较.结果 焦虑症患者的生命质量总分及各因子评分均明显低于正常对照者(P＜0.01).焦虑症患者的生命质量总分及各因子评分与HAMA总分及因子分均呈显著性负相关(P＜0.01).结论 焦虑症患者的生命质量较差,且与焦虑症状有关,即焦虑症状越重,其生命质量越差.     

Metacognitive therapy for generalized anxiety disorder: an open trial

Generalized anxiety disorder (GAD) responds only modestly to existing cognitive-behavioural treatments. This study investigated a new treatment based on an empirically supported metacognitive model [Wells, (1995). Metacognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301-320; Wells, (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Chichester, UK: Wiley]. Ten consecutive patients fulfilling DSM-IV criteria for GAD were assessed before and after metacognitive therapy, and at 6, and 12-month follow-up. Patients were significantly improved at post-treatment, with large improvements in worry, anxiety, and depression (ESs ranging from 1.04-2.78). In all but one case these were lasting changes. Recovery rates were 87.5% at post treatment and 75% at 6 and 12 months. The treatment appears promising and controlled evaluation is clearly indicated.     

卒中后焦虑障碍血清炎症标志物的研究进展

卒中后焦虑障碍（PSA）是卒中后常见的精神心理障碍之一,对患者的康复和生活质量具有重要影响。当前研究表明,在PSA的发生和发展过程中,炎症发挥了一定作用。本研究回顾PSA与血清炎症标志物之间关联的相关文献,以期为PSA的干预提供参考。检索中国知网、万方数据库、Web of Science和PubMed,收集国内外关于PSA与血清炎症标志物的相关文献,最终纳入13篇文献。结果显示,PSA与血清炎症标志物存在一定关联,炎症标志物水平的升高可能与PSA的发生和严重程度相关,但具体机制仍需进一步研究。     

White matter alterations in social anxiety disorder

White matter architecture in patients with social anxiety disorder (SAD) has rarely been investigated, but may yield insights with respect to altered structural brain connectivity. Initial evidence points to alterations in the uncinate fasciculus (UF). We applied diffusion tensor imaging in 25 patients with SAD and 25 matched healthy subjects. Whole-brain fractional anisotropy (FA) maps were used for group comparison and voxel-wise correlation with psychometric and clinical measures. Additionally, a region-of-interest analysis of the UF was performed. Patients with SAD had reduced FA compared to healthy subjects in or near the left UF and the left superior longitudinal fasciculus. There were no regions with increased FA in SAD. In the region-of-interest analysis, a negative correlation between FA and trait anxiety was identified in the left and right UF in patients, but not in healthy subjects. No correlations with social anxiety scores were observed. The present study partially confirms previous results pointing to frontal WM alterations in or near the UF in patients with SAD. SAD-specific dimensional associations of FA with trait anxiety might reflect general pathological and/or compensatory mechanisms as a function of symptom severity in patients. Future studies should disentangle in which way the identified WM alterations match functional alterations.     

Quality of life impairment in generalized anxiety disorder, social phobia, and panic disorder

Interest in the assessment of quality of life in the anxiety disorders is growing. The present study examined quality of life impairments in individuals with generalized anxiety disorder (GAD), social phobia, and panic disorder. Results showed that individuals with these disorders reported less satisfaction with their quality of life than non-anxious adults in the community. However, the degree of quality of life impairment is similar across these three disorders. Additionally, comorbid depression, but not anxiety, was found to negatively impact quality of life in these individuals. Finally, diagnostic symptom severity was not found to influence quality of life, indicating that subjective measures of quality of life offer unique information on the effects of anxiety disorders.     

精神分裂症患者特质焦虑与自我接纳和父母养育方式的相关研究

目的：探讨精神分裂症患者特质焦虑与自我接纳和父母养育方式的相关性。方法：对36例25岁以下精神分裂症的特质焦虑与自我接纳和父母养育方式进行调查评定及相关分析。结果：特质焦虑得分明显高于正常人群，父母养育方式中情感温暖、理解和偏爱、过度保护得分低于正常参考指标。相关分析显示：特质焦虑与母亲Ⅲ、Ⅳ因子呈正相关，与自我接纳因子呈负相关，与年龄无相关性。结论：拒绝、否认、惩罚、严厉等损害自尊，降低自我接纳程度的方式与特质焦虑的产生有关；特质焦虑不会随年龄增加发生改变。     

焦虑症患者的生活质量及相关因素分析

目的 探索焦虑症患者的生活质量及相关因素。方法 对60例符合CCMD-3诊断标准的焦虑症患者进行一般情况调查、汉密顿焦虑量表（HAMA）、汉密顿抑郁量表（HAMD）、健康状况调查问卷（SF-36）评定。结果除生理机能一项外,焦虑症患者SF-36各维度的评分均显著低于常模（P〈0．01）。患者HAMD评分和SF-36各维度评分呈显著负相关（P〈0．05或P〈0．01）。伴有抑郁症状的焦虑症患者,其SF-36的躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康6个维度得分显著低于不伴抑郁症状的患者（P〈0．05或P〈0．01）,其HAMA评分显著高于不伴抑郁症状的患者（P〈0．01）。结论 焦虑症患者的生活质量低于一般正常人群,伴有的抑郁症状的焦虑症患者其生活质量受损更加严重。     

Fearful responding to interoceptive exposure in social anxiety disorder

There is accumulating evidence suggesting that anxiety sensitivity (AS) may play a role in social anxiety disorder (SAD; e.g., Ball, Otto, Pollack, Uccello, & Rosenbaum, 1995). Precedent research has demonstrated the role of AS in panic disorder and posttraumatic stress disorder, and subsequently, treatment techniques aimed at reducing AS (i.e., interoceptive exposure (IE)) have been studied in these populations (Schmidt and Trakowski, 2004, Wald and Taylor, 2008). The purpose of this study was to examine the types of responses elicited during IE exercises among individuals with SAD. This study describes the responses of individuals with SAD (n = 37) and nonclinical control participants (n = 28) to six IE exercises. Significant differences in responses to the IE exercises were found between participants with SAD and nonclinical controls. However, there were no significant differences in responses to the exercises among persons with SAD, depending on whether the exercises were completed in private versus group settings. Similarity to symptoms during naturally occurring anxiety significantly predicted fearful responding across all exercises in persons with SAD. Implications and directions for future research are discussed.