老年人抑郁症状与情绪调节策略的横断面研究

目的:考察老年人抑郁症状与情绪调节策略的关系及老年人抑郁症状的相关因素,为老年人抑郁症状的干预提供理论指导。方法:选取北京市某社区60~80岁老年人335名,用流调中心用抑郁量表(CES-D,得分≥16分为"有抑郁症状")来评估老年人抑郁症状,用Gross情绪调节问卷(ERQ,包括认知重评和表达抑制两个分量表)来评估老年人认知重评和表达抑制策略的使用情况,用沉思量表(RRS)来测量老年人沉思策略的使用情况,并用logistic回归分析方法对老年人抑郁症状的相关因素进行分析。结果:有抑郁症状的老年人的比例为19.9%(61/306)。CES-D总分与ERQ的认知重评得分呈负相关(r=-0.21,P<0.01),与ERQ的表达抑制得分的相关无统计学意义(r=0.08,P>0.05),与RRS总分呈正相关(r=0.58,P<0.01)。Logistic回归分析表明,男性(OR=0.42,P<0.05)、健康状况好(OR=0.29,P<0.001)、生活方式好(OR=0.09,P<0.01)、经济状况好(OR=0.05~0.23,P<0.01)和ERQ认知重评得分较高(OR=0.93,P<0.05)的老年人,CES-D得分较低;而高龄(OR=1.04,P<0.05)和RRS总分较高(OR=1.19,P<0.01)的老年人,CES-D得分较高。结论:女性、高龄、经济状况差、健康水平低、无子女或子女在外地或国外、越多使用沉思策略和越少使用认知重评策略的老年人,越可能出现抑郁症状。     

青少年抑郁症与行为抑制/激活系统的关系

目的:探讨青少年抑郁症与行为抑制/激活系统的关系.方法:采用行为抑制/激活系统问卷、Beck抑郁问卷和Zung氏抑郁自评问卷测评27名青少年抑郁症、38名抑郁情绪青少年及健康对照组74名青少年,比较3组青少年在行为抑制/激活系统得分上的差异,并做抑郁与行为抑制/激活系统的相关分析.结果:(1)抑郁症组和抑郁情绪组的行为抑制系统得分均高于无抑郁组[(14.6±2.4),(14.5±1.5)vs.(13.3±1.5);P<0.001],而行为激活系统的奖赏反应和驱力得分均低于无抑郁组[奖赏反应:(11.7 ±1.7)、(12.4±1.7)VS.(12.7±2.0),(10.1±1.8)、(10.3±1.9)VS.(11.2±1.9);P<0.05或0.01];(2)抑郁症组抑郁得分与行为抑制/激活系统呈不同程度的相关(r=-0.26-0.84,P<0.05或0.01).结论:行为激活系统功能降低、行为抑制系统功能增强可能是抑郁症的危险因素.     

宜宾震后青少年身心状况

目的:考察宜宾震后青少年创伤后应激障碍、抑郁与情绪调节策略等状况及其在性别、年级上的差异,探讨PTSD、抑郁与情绪调节策略三者之间的关系,为创伤后心理危机干预提供依据。方法:采用创伤后应激障碍量表、抑郁量表、情绪调节策略量表,对宜宾震中长宁县321名青少年进行测量。结果:(1)震后2周,6.50%的青少年有PTSD倾向,46.40%的青少年有抑郁症状,表现出更多的回避性症状(维度得分3.24±0.77)以及警觉性增高症状(维度得分10.24±2.49);(2)从性别看,女生的CES-D量表得分(t=-2.804,P0.01)及发生率(χ~2=7.100,P0.05)均显著高于男生,同时其ERQ量表的认知重评维度得分(t=-2.154,P0.05)亦显著高于男生,而男生的ERQ量表表达抑制维度得分(t=2.650,P0.01)显著高于女生;从年级看,初中生PCL-5得分(t=3.147,P0.05)及发生率(χ~2=15.797,P0.01)均显著高于高中生,同时在认知重评维度(χ~2=5.747,P0.05)上高中生得分显著高于初中生;(3)被试的PCL-5量表得分与CES-D量表得分呈显著正相关(r=0.639,P0.01),与ERQ量表的认知重评维度得分呈显著负相关(r=-0.187,P0.01),与表达抑制维度得分呈显著正相关(r=0.139,P0.05);被试CES-D量表上的得分与ERQ量表的认知重评维度得分呈显著负相关(r=-0.260,P0.01),与表达抑制维度得分呈显著正相关(r=0.120,P0.05);(4)有PTSD倾向的被试在CES-D量表上得分显著高于没有PTSD倾向的被试(t=5.617,P0.01);同时,有PTSD倾向的被试在ERQ量表的认知重评维度得分显著低于没有PTSD倾向的被试(t=-2.870,P0.01),有抑郁症状的被试在PCL-5量表上得分显著高于没有抑郁症状的被试(t=12.194,P0.01);同时,有抑郁症状的被试和没有抑郁症状的被试分别在ERQ量表的两个维度上得分呈显著差异,表现为有抑郁症状的在表达抑制维度上显著高于没有抑郁症状的(t=2.021,P0.05);而认知重评维度上,有抑郁症状的则显著低于没有抑郁症状的(t=-2.780,P0.01)。结论:震后不久的灾区青少年的PTSD倾向和抑郁症状较严重,而性别、年龄的不同有较明显差异;应有重点地关注女生以及年龄偏低的青少年,注重提升他们的情绪调节策略。     

脑外伤患者心理推理能力缺陷的认知性和技巧性干预:一项12周随机单盲对照试验

目的:比较认知干预和技巧干预对脑外伤患者的心理推理能力和社会功能缺陷的疗效。方法:选取外伤后6个月以上的稳定期脑外伤患者90名,随机分成认知干预组(n=30)、技巧干预组(n=30)和对照组(n=30)。认知干预组采用针对患者现实生活表现的认知取向的生活事件讨论、情境扮演、家庭作业的方法进行康复训练,技巧干预组采用针对测试技巧的心理推理能力故事理解、图片理解的方法进行康复训练,对照组进行一般的门诊随诊服务。三组干预均为每周1次,共12周。干预前、干预后、干预结束后3个月采用心理推理能力经典任务、脑外伤患者心理推理能力他评量表、社会功能缺陷筛选量表(SDSS)评定三组患者的心理推理能力和社会功能。结果:干预前,三组患者各项得分差异无统计学意义(P0.05)。干预后,认知干预组与技巧干预组的心理推理能力经典任务总分[(14.7±1.3),(15.2±1.7)vs.(12.5±1.6)]、脑外伤患者心理推理能力他评量表得分[(128.7±17.8),(126.8±17.9)vs.(109.5±16.5)]高于对照组(均P0.05),SDSS得分低于对照组[(9.4±1.1),(10.0±1.0)vs.(12.1±1.3),P0.05],认知干预组和技巧干预组间差异无统计学意义(P0.05)。干预结束后3个月,认知干预组与技巧干预组的心理推理能力经典任务总分[(16.5±1.4),(15.9±1.2)vs.(13.3±1.5)]、脑外伤患者心理推理能力他评量表得分[(146.6±15.7),(134.5±14.6)vs.(115.8±21.2)]高于对照组(均P0.05),SDSS得分低于对照组[(7.1±1.2),(8.0±0.9)vs.(11.4±0.8),P0.05],认知干预组的他评量表得分高于技巧干预组[(146.6±15.7)vs.(134.5±14.6),P0.05],SDSS得分低于技巧干预组[(7.1±1.2)vs.(8.0±0.9),P0.05]。结论:认知干预和技巧干预均能提高脑外伤患者的心理推理能力,并提高患者的社会功能,认知干预方法的疗效可能优于技巧干预。     

小组心理咨询干预服刑人员希望水平的准实验研究

目的:探究小组心理咨询对服刑人员希望水平的干预作用。方法:采取准实验设计,选取低希望水平[成人素质希望量表(ADHS)得分低于总体平均数1个标准差]的服刑人员24人进行人员匹配,12人参加小组心理咨询(干预组),12人为对照组。对干预组开展提升希望水平的小组心理咨询(每周1次,每次90 min,共8次);对照组处于常态。使用ADHS(包含动力思维和路径思维2个维度)、焦虑自评量表(SAS)、自评抑郁量表(SDS)在干预前、干预后、(4周)干预后对两组进行评估。采用配对样本t检验比较组内差异,采用共变数分析和詹森-内曼法比较组间差异。结果:组内差异检验结果显示,干预组在(4周)干预后ADHS总分及2个维度得分均高于干预前,SAS得分低于干预前(P0.01或P0.001)。组间差异检验结果显示,干预组在(4周)干预后ADHS总分及2个维度得分均高于对照组,SAS得分低于对照组[(48.0±5.7)vs.(39.2±5.6),(23.1±3.4)vs.(19.0±3.2),(24.9±3.0)vs.(20.2±3.4),(36.4±7.6)vs.(41.2±6.5)均P0.01或P0.001]。干预组干预前ADHS总分在8~37分的被试,其干预后ADHS总分高于对照组[(48.8±4.9)vs.(35.7±4.9),P0.05]。结论:本研究结果显示,小组心理咨询可以提升服刑人员的希望水平。     

北京市海淀区老年人焦虑抑郁状况及其影响因素

目的:探讨北京市海淀区65岁以上老年人焦虑抑郁现况及其影响因素。方法:分层随机抽取北京市海淀区29个社区的2464名老年人采用焦虑自评量表(SAS)、抑郁自评量表(SDS)及一般情况调查表进行调查。结果:1老年人情绪问题的检出率为18.5%;2不同年龄的老年人焦虑情绪(χ2=16.157,P0.01)抑郁情绪(χ2=16.157,P0.01)发生率差异显著;3不同年龄阶段老年人焦虑情绪(F=9.132,P0.001)抑郁情绪(F=13.679,P0.001)得分差异显著,不同养老形势老年人抑郁情绪(F=11.90,P0.001)得分差异显著;4脑卒中、冠心病是老年人焦虑情绪(OR=1.9,OR=1.6)和抑郁情绪(OR=1.8,OR=1.4)的危险因素。结论:北京社区的老年人焦虑抑郁情绪问题比较突出,受年龄、养老形势、慢病等多种因素影响,应重视心理健康指导。     

集体治疗缓解酒依赖患者焦虑抑郁症状的初步评价

目的:初步探讨集体治疗对缓解酒依赖患者焦虑抑郁症状的临床疗效。方法:选取普洱市第二人民医院2014年1月1日-12月31日入院诊断为酒依赖患者,使用焦虑自评量表(SAS)、抑郁自评量表(SDS)及简明精神病量表(BPRS)筛查为伴随焦虑抑郁状态者117例,采用入院先后顺序分为药物联合集体治疗组(干预组,n=89)和单纯药物治疗组(对照组,n=88),两组均给予复方地西泮替代治疗,干预组在此基础上联合集体治疗,观察8周。使用临床疗效总评量表(CGI)评定总体疗效。结果:干预组治疗后SAS、SDS、BPRS、CGI得分均低于治疗前[(21.1±8.3)vs.(65.3±10.2),(35.1±7.5)vs.(73.4±9.2),(20.7±3.5)vs.(51.7±5.6);(4.3±1.0)vs.(5.4±0.6),P0.01或P0.05]。对照组治疗前后各量表得分差异均无统计学意义(均P0.05)。结论:药物治疗基础上的集体治疗在缓解酒依赖患者焦虑抑郁方面优于单纯药物治疗。     

情绪面孔对成人惊跳反射的影响

目的:探讨情绪面孔刺激对成人惊跳反射的影响。方法:通过广告招募并结合状态-特质焦虑问卷、Beck抑郁问卷筛查出36名正常成人受试,采用以面孔图片(愤怒、恐惧、悲伤、快乐、中性)为诱发材料的惊跳探测任务,记录其眼轮匝肌肌电(electromyography,EMG)信号和自我报告的情绪效价、唤醒评价。结果:受试对愤怒与恐惧面孔的惊跳反应幅度均高于中性面孔[(52.07±4.24),(50.92±4.87)vs.(47.41±4.49),Ps0.05]。对不同类型情绪面孔的效价和唤醒评价差异有统计学意义(F1=92.933,F2=16.800,均P0.001)。快乐面孔(6.52±1.11)的效价得分高于其他面孔[愤怒(3.42±0.86),恐惧(3.58±1.02),悲伤(3.61±1.00),中性(4.55±0.82)],中性面孔的效价分高于愤怒、恐惧和悲伤面孔;愤怒(5.03±1.74)和恐惧面孔(5.05±1.55)的唤醒得分高于其他面孔[悲伤(4.57±1.34),快乐(4.23±1.43),中性(3.64±1.41)],中性面孔的唤醒得分低于其他面孔(Ps0.05)。结论:个体的惊跳反应与面孔的情绪效价并非一一对应关系,惊跳调节效应只发生于愤怒与恐惧面孔。     

乳腺癌患者的焦虑、抑郁、幸福感指数及社会支持

目的:调查不同治疗阶段乳腺癌患者的焦虑、抑郁、幸福感指数和社会支持情况,分析社会支持与情绪状况的关系.方法:收集术前组、术后组与康复组的乳腺癌患者各105例为病例组,以及年龄与教育年限匹配的健康对照105例,应用汉密顿焦虑量表(HAMA,≥8分为可疑焦虑)、汉密顿抑郁量表(HAMD, ≥8分为可疑抑郁)、幸福感指数量表(Index of Well-being)和领悟社会支持量表(PSSS)进行有关测评.结果:病例组的可疑焦虑、抑郁发生率均高于健康对照(42.9％,61.9％,59.0％ vs.9.5％;33.3％,60.0％,46.7％ vs.5.7％;均P＜0.01),病例组的HAMA、HAMD得分均高于健康对照[(7.2±4.3),(9.4±5.1),(9.2±5.6)vs.(3.9±3.1);(6.2±3.8),(9.2±4.8),(7.9±4.6) vs.(3.1±2.4),均P＜0.01];术前组与术后组的幸福感指数低于健康对照[(10.6±2.3),(10.5±2.6) vs.(11.5±2.2),均P＜0.01].病例组中,有可疑焦虑患者的幸福感指数、PSSS得分均低于无焦虑组[如,术后组PSSS得分(63.0±10.1)vs.(70.4±9.1),P＜0.01];有可疑抑郁患者的幸福感指数、PSSS得分低于无抑郁组[如,康复组PSSS得分(63.8±10.6) vs.(70.1±8.4),P＜0.01].结论:本研究提示,不同治疗阶段的乳腺癌患者的可疑焦虑、抑郁发生率和焦虑、抑郁得分均高于健康人群;有可疑焦虑、抑郁患者的幸福感指数和社会支持相对更低.     

深圳市老年人抑郁与焦虑情绪检出率及相关因素

目的:了解深圳市老年人抑郁与焦虑情绪的检出率并探索其相关因素。方法:抽取深圳市17个街道、51个社区的2112名65岁及以上老年人,进行面对面问卷调查。采用老年抑郁问卷(GDI)和焦虑筛查量表(GAD-7)评估抑郁和焦虑情绪,利用logistic回归分析考查其相关因素。结果:深圳市老年人抑郁、焦虑及抑郁合并焦虑情绪的检出率分别为37.1%、8.4%及7.5%。月收入水平<3000元、自评健康状况为一般或不健康、患有3种及以上慢性病、与家人关系融洽度较差的老年人更易检出抑郁情绪(OR值介于1.59～4.87,均P<0.05)与焦虑情绪(OR值介于1.57～2.75,均P<0.05)。结论:深圳市老年人抑郁与焦虑情绪较为常见,与收入水平、自评健康状况、慢性病、与家人关系融洽度等多种因素相关。     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Intestinal helminthiasis in school children in Haiti in 2002

A survey on intestinal helminths in school children was conducted in Haiti in 2002. This first nationwide study involving the entire country was stratified by department according to urban and rural zones using the cluster method. Focusing on elementary school children (n=5792; age range 3 to 20 years), it involved 26 urban and 49 rural schools randomly selected. Stools were preserved in formalin and examined by the Ritchie technique. Thirty-four per cent of stools (1981/5792) tested positive for intestinal helminths with the following parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis (0.2%). The helminth prevalence was higher in rural (38.4%) compared to urban areas (30%). There was no significant difference in prevalence by sex and age. The importance of geohelminths changed from one department to another with the highest prevalence found in the Southern department of Grande Anse (73.7%) and the lowest prevalence in the Center department (20.6%). Five out of the country's nine departments had a similar prevalence varying from 25.5% to 28.2%. Intestinal helminthic polyparasitism was observed in a percentage of infested school children comprise between 3.4% and 28.6% according in relation to the geographical area. A program to fight against geohelminths in school children should be initiated as a public health priority. Albendazole is the drug of choice. Frequency of drug distribution should be based on the prevalence of geohelminths in each department.     

Experience in adult population in dengue outbreak in Delhi

A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.     

Changes in the hypothalamic nuclei in in experimental allergy

Summary In rabbits subjected to prolonged sensitization and in which the Arthus phenomenon was induced there was a marked reaction of the hypothalamic nuclei. Staining by Gomori's method indicated a cellular swelling, loss of granules, and protoplasmic vacuolization in the supraoptic nucleus. There was a considerable increase in the size of the cross-sectional area of the cells. The same effects were much less well shown in the paraventricular nucleus. These results show that marked signs of increased neurosecretion developed in the animals at the height of the Arthus phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten Éksperimental'noi biologii i Meditsiny, Vol. 55, No. 4, pp. 110–113, April, 1963.     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.Originally presented at ECCP 93.