海洛因依赖者注意转换过程中持续性注意功能

目的探究海洛因依赖对依赖者注意转换过程的影响。方法采用任务转换范式对36例戒断维持治疗的海洛因依赖者(男33例,女3例)和36名正常对照(男32名,女4名)的持续性注意和转换性注意功能进行评估,分别记录持续性试次和转换性试次的反应时和正确率。结果海洛因依赖组在持续性注意和转换性注意条件下的反应时、正确率均无统计学差异(P0.05),无转换代价不明显。对照组在持续性注意条件下的反应时短于转换性注意条件[(695.3±95.9)ms vs.(780.3±93.3)ms,P0.05],且正确率较高[(98.0%±2.2%)vs.(93.8%±5.0%),P0.05],反应时和正确率均存在明显转换代价。对照组转换代价值高于海洛因依赖组[反应时:(85.1±92.4)ms vs.(19.7±66.8),P0.05;正确率:(4.2%±4.6%)vs.(1.1%±4.4%),P0.05]。在持续性注意条件下,海洛因依赖组的反应时长于对照组[(791.6±74.3)ms vs.(695.3±95.9)ms,P0.05],正确率低于对照组[(92.5%±8.4%)vs.(98.0%±2.2%),P0.05]。结论海洛因依赖者未表现出对照组存在的转换代价,可能与海洛因依赖者的持续性注意功能受损有关。     

左侧颞叶癫痫患者执行功能损害与钩束弥散张量成像参数的相关性

目的 应用神经心理学方法和磁共振弥散张量成像(diffusion tensor imaging,DTI)技术研究左侧颞叶癫痫(temporal lobe epilepsy,TLE)患者执行功能损害的特点及与其双侧钩束(uncinate fasciculus,UF)DTI参数的关系.方法 对14例成人左侧TLE患者(患者组)和15名健康对照者(对照组)进行执行功能的神经心理检查(包括stroop、数字广度、数字符号、连线试验及词语流畅性)评分,并对两组受试者均进行DTI扫描.结果 患者组stroop错误数[(7.20±3.60)vs.(1.60±0.60)]高于对照组(P＜0.05),数字广度[(12.30±6.20)vs.(17.60±2.10)]、数字符号[(50.33±16.10)vs.(66.04±10.12)]及词语流畅性[(12.05±5.36) vs.(19.33±2.55)]均低于对照组(P＜0.05),stroop反应时[(23.86±10.91)vs.(16.36±6.13)]及连线试验的时间[(56.11±20.12)vs.(40.43±15.07)]均长于对照组(P＜0.05).与对照组相比,患者组左侧钩束各向异性(Fractional Anisotrophy,FA)值降低[(0.332±0.043)vs.(0.379±0.014)],差异具有统计学意义(P＜0.05).相关分析示,患者组左侧钩束FA值与词语流畅性(r=0.56,P=0.025)及数字广度(r=0.58,P=0.028)呈正相关.结论 左侧TLE患者存在广泛的执行功能损害,部分执行功能的损害与左侧钩束的损害相关,左侧钩束的损害可能是部分执行功能损害的病理生理基础.     

女性海洛因依赖者空间定位功能损伤与年龄关系研究

目的研究女性海洛因依赖者空间定位功能的损伤情况,及其与海洛因使用时长和年龄的关系。方法采用空间方位实验任务评估20例女性海洛因依赖者和19名女性健康对照的空间定位功能,记录被试判断足拇趾朝向的正确率与反应时。结果依赖组判断拇趾向左图片比对照组慢[(586.6±115.5)ms vs.(531.7±56.4)ms,P0.05],而两组判断正确率及判断拇趾向右的反应时无统计学差异(P0.05)。偏相关分析发现,依赖组判断拇趾向左(r=-0.49,P=0.03)和拇趾向右(r=-0.65,P0.01)图片时的正确率与年龄负相关,判断拇趾向右图片时的反应时(r=0.45,P=0.02)与年龄正相关;依赖组判断的准确性和反应速度与海洛因使用时长均无统计学相关性(P0.05)。结论女性海洛因依赖者的空间定位功能受损,其方位判断速度变慢、准确性下降可能与女性吸毒者年龄相关,未发现与海洛因使用时长相关。     

双相障碍抑郁发作患者血清谷氨酸系统代谢紊乱特征及相关因素

目的探讨双相障碍抑郁发作患者外周血清中谷氨酸系统各指标变化的特点及其相关因素。方法选取50例双相障碍抑郁发作患者及48名正常对照,以汉密尔顿抑郁量表(Hamilton depression scale-17,HAMD-17)和汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评估患者抑郁和焦虑症状,以酶联免疫吸附法测定被试血清谷胺酰胺(glutamine,Gln)、谷氨酸(glutamate,Glu)、γ-氨基丁酸(γ-aminobutyric acid,GABA)及谷氨酸脱羧酶(glutamic acid dehydrogenase,GAD)水平,计算Glu/GABA比值。结果双相障碍抑郁发作组较之对照组,血清Glu水平[(35.80±6.34)mg/L vs.(28.69±5.73)mg/L,t=4.68,P0.01]及Glu/GABA[(6.18±1.40)vs.(5.06±1.29),t=3.44,P0.01]增高,血清GABA水平[(5.09±0.71)μmol/L vs.(5.83±1.17)μmol/L,t=3.10,P=0.01]、GAD水平[(28.72±5.39)U/L vs.(35.78±7.22)U/L,t=4.46,P0.01]降低。双相障碍抑郁发作组血清Glu水平与HAMD总分呈正相关(r=0.52,P=0.03),血清GABA水平与HAMD睡眠障碍因子分呈负相关(r=-0.38,P=0.04)。结论双相障碍抑郁发作患者存在Glu能神经元活性增强,GABA能神经元活性降低,兴奋性神经元与抑制性神经元功能失平衡。     

医务人员职业倦怠与工作满意度现状调查

目的调查医务人员职业倦怠与工作满意度情况。方法采用随机数字表法选取佛山市公立医院医务人员1 620名,采用职业生活质量量表(Pro QOL)、明尼苏达工作满意度问卷短式量表(MSQ)、主观幸福感量表(SHS)进行评定。结果共收集有效问卷1 423份;30≤年龄40岁的医务人员职业倦怠评分高于20≤年龄30岁者[(28.29±5.38)分vs.(27.27±5.20)分,t=-1.02,P=0.014],医生职业倦怠评分高于护士[(28.34±5.29)分vs.(27.34±5.16)分,t=-1.00,P=0.009],中级职称医务人员职业倦怠评分高于初级职称者[(28.28±5.16)分vs.(27.36±5.25)分,t=0.92,P=0.020],硕士学历者职业倦怠评分高于专科学历者[(28.49±4.96)分vs.(27.08±5.30)分,t=1.42,P=0.043],精神专科医院及口腔医院的医务人员职业倦怠评分低于其他医院医务人员[(25.39±5.00)分vs.(26.03±4.22)分,F=11.62,P0.01],而工作满意度评分[(72.98±9.52)分vs.(71.18±8.07)分,F=7.31,P0.01]和主观幸福感评分[(20.02±3.94)分vs.(20.33±3.67)分,F=5.65,P0.01)]均高于其他医院。结论 30≤年龄40岁、医生、中级职称、硕士学历的医务人员职业倦怠水平较高,精神专科医院及口腔医院医务人员职业倦怠水平较低且工作满意度和主观幸福感较高。     

男性海洛因与甲基苯丙胺依赖者心理渴求及影响因素分析

目的:探讨男性海洛因和甲基苯丙胺依赖者心理渴求及其影响因素。方法:采用一般状况量表(包含人口学信息和毒品使用情况)、药物渴求问卷对住院戒毒的男性海洛因依赖者(海洛因组,157例)及甲基苯丙胺依赖者(甲基苯丙胺组,140例)进行调查和分析。结果:甲基苯丙胺组戒毒时长明显长于海洛因组[(15.61±6.32)d vs(13.85±6.02)d,P0.05];协方差分析显示,甲基苯丙胺组渴求总分及毒品影响和渴求频率分明显高于海洛因组[(38.96±5.64)vs(36.89±8.03),(19.27±3.98)vs(18.05±5.04),(13.79±3.15)vs(12.55±4.24);P均0.05];多元逐步回归分析结果显示,使用毒品时间、频率、种类及就业状况(β=0.261,0.230,0.190,-0.125)进入方程(P均0.05)。结论:男性甲基苯丙胺依赖者心理渴求水平高于海洛因依赖者;心理渴求程度与使用毒品时间、频率、吸食毒品种类及就业状况等因素有关。     

头发、血浆皮质醇水平变化与抑郁症的相关性研究

目的探讨头发、血浆皮质醇水平在抑郁症发病过程中的特点及抗抑郁治疗前后的变化。方法纳入抑郁症患者47例和正常对照47名。抑郁症组给予选择性5-羟色胺再摄取抑制剂治疗4周,分别于治疗前、治疗4周后检测头发、血浆皮质醇水平,分别采用汉密尔顿抑郁量表17项(Hamilton Depression Rating Scale-17,HAMD-17)和汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评估抑郁症状和焦虑症状的严重程度及疗效。对照组不予干预,于入组时检测头发、血浆皮质醇水平。结果抑郁症组治疗前头发皮质醇水平高于对照组[(17.42±12.40)nmol/L vs.(10.22±8.00)nmol/L,P0.01],血浆皮质醇水平两组间无统计学差异(P0.05)。抑郁症组治疗后HAMD-17总分[(10.60±4.57)vs.(24.00±4.86)]和HAMA总分[(6.30±4.86)vs.(15.78±5.45)]较治疗前均降低(P0.01),治疗后头发皮质醇水平较治疗前增高[(30.53±25.75)nmol/L vs.(16.02±11.77)nmol/L,P0.05],血浆皮质醇水平治疗前后差异无统计学意义(P0.05)。治疗后达到临床痊愈的患者治疗前血浆皮质醇水平高于非临床痊愈的患者[(27.47±14.48)nmol/L vs.(18.30±7.11)nmol/L,P0.05]。抑郁症组治疗前血浆皮质醇水平与HAMD-17中的胃肠道症状因子分呈正相关(r=0.335,P=0.023),与HAMD-17总分及其他因子的相关性均无统计学意义(P0.05)。结论抑郁症患者头发皮质醇水平高于正常对照,经抗抑郁药治疗后头发皮质醇水平较治疗前升高。治疗前血浆皮质醇水平高的患者可能对抗抑郁药治疗更敏感,可获得更好的临床疗效。     

情感气质自评问卷青少年中文版的修订及信效度检验☆

目的根据情感气质自评问卷中文版,修订更适合青少年群体的情感气质自评问卷青少年中文版,并检验其信度及效度。方法基于之前修订的情感气质自评问卷中文版每个条目的因子负荷,并考虑青少年期的心理发展特点、各个因子条目数量以及内容适应性等因素,最后形成60条目的情感气质自评问卷青少年中文版,对822名11~17岁青少年进行问卷调查,评估该问卷内部一致性信度、结构效度,并比较各因子的性别差异。结果抑郁气质、环性气质、情感旺盛气质、易激惹气质以及焦虑气质因子条目的 Cranbach’sα系数分别为0.67、0.78、0.76、0.77及0.83。探索性因子分析显示焦虑气质、易激惹气质、情感旺盛气质因子可有效区分,而抑郁气质与环性气质的条目则混合在一起。女性在抑郁气质[(3.521±2.221)vs.(3.144±2.295)]、环性气质[(4.484±2.922)vs.(3.917±2.823)]、焦虑气质[(5.236±3.719)vs.(4.366±3.658)]因子的得分高于男性(P0.05),而男性情感旺盛气质因子得分则高于女性[(5.407±2.842)vs.(4.852±2.963),P0.01]。抑郁气质与环性气质因子得分呈正相关(r=0.625,P0.001),焦虑气质与易激惹气质因子得分呈正相关(r=0.628,P0.001)。结论情感气质自评问卷青少年中文版具有一定的内部一致性信度及结构效度,适用于中国青少年群体情感气质的测量。     

男性酒依赖患者执行功能与事件相关电位P300研究

目的探讨男性酒依赖(alcohol dependence,AD)患者执行功能与事件相关电位P300的关系,为AD执行功能损害提供电生理依据。方法收集31例男性AD患者为酒依赖组,26名健康男性为对照组,对两组进行威斯康星卡片分类测验(Wisconsin card sorting test,WCST)和事件相关电位P300(event-related potential P300,ERP-P300)测定,酒依赖患者WCST和ERP-P300均在戒断症状消除后评估。结果酒依赖组的WCST完成分类数(Cc)[(3.48±2.02)vs.(4.68±1.37)]、概念化水平(Cl%)[(43.24%±23.10%)vs.(63.26%±15.75%)]低于对照组,完成第一个分类所需应答数(Rf)[(43.85±25.66)vs.(29.18±15.16)]、错误应答数(Re)[(57.42±26.51)vs.(30.47±14.64)]、持续错误数(Rpe)[(44.06±18.52)vs.(30.84±13.31)]高于对照组(均P<0.05)。酒依赖组ERP-P300的N1[(4.26±1.97)μv vs.(7.89±3.69)μv]、N2[(3.48±2.22)μv vs.(5.03±2.56)μv]、P3[(3.46±2.31)μv vs.(6.94±3.99)μv]波幅较对照组降低,N2[(256.30±31.62)ms vs.(223.68±31.73)ms]、P3[(355.42±27.81)ms vs.(314.52±21.64)ms]潜伏期延长(均P<0.05)。酒依赖组WCST与ERP-P300相关分析显示,Cc及Cl%与N1、N2、P3波幅呈正相关(P<0.05),与N2、P3潜伏期呈负相关(P<0.05);Rf、Re、Rpe与N1、N2、P3波幅呈负相关(P<0.05),与N2、P3潜伏期呈正相关(P<0.01)。结论 AD患者存在执行功能障碍,表现为抽象概括、认知转移和反应抑制能力下降及ERP-P300家族多成分异常,以波幅改变较为明显,ERP-P300多成分分析可更全面地了解AD执行功能障碍的电生理特征。     

应届与往届考生高考前心理状态对照研究

目的调查参加2014年高考的应届、往届考生考前心理状态,为其心理辅导提供参考依据。方法采用随机数字法选取2014年天水市应届考生及往届高中毕业生各184名为调查对象,采用状态-特质焦虑问卷(STAI)、匹茨堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)对两组考生进行考前测评。结果 1SAI评分应届考生高于往届考生,差异有统计学意义[(58.38±7.88)分vs.(58.38±7.88)分,(P<0.05)];而TAI评分往届考生高于应届考生,差异有统计学意义[(48.97±8.28)分vs.(50.24±6.29)分,(P<0.05)];2PSQI评分往届考生高于应届考生,差异有统计学意义[(12.38±5.37)分vs.(15.08±5.70)分,(P<0.01)];3SAS和HAMA评分往届考生高于应届考生[(53.46±6.48)分vs.(55.18±4.94)分]、[(13.87±1.53)分vs.(1.23±1.62)分](P均<0.01)。结论高考生参加高考前均出现明显的焦虑症状,且往届考生较应届考生更明显、检出率高,同时往届考生睡眠质量明显较应届考生差。     

Two successive phases in the threat‐related attentional response of anxious subjects: neural correlates

Background: It is well known that highly anxious individuals are characterized by the allocation of a greater amount of attentional resources to threatening stimulation. However, neural data in relation to the time course of attentional biases in anxiety are still surprisingly scarce and preliminary. The present research explored attentional biases in anxious subjects (grouped according to their scores in trait and state forms of the State–Trait Anxiety Inventory) over time by using event‐related potentials (ERPs) and through the application of source localization methodologies. Methods: Participants (n=27) were asked to perform an indirect visual matching task in a cue‐target paradigm. The targets consisted of three types of emotional pictures: positive arousing, negative arousing, and neutral. ERPs in response to target stimulation were submitted to temporal and spatial principal component analyses. Results: Statistical analyses revealed that negative targets elicited higher amplitudes than positive pictures in P200. Subsequently, greater amplitudes in response to positive than to negative pictures were observed in P500. Source analyses (standardized low resolution brain electro‐magnetic tomography: sLORETA) indicated an involvement of visual association cortical areas (i.e., precuneus and cuneus) both in P200 and P500. Conclusions: The results might be interpreted in line with the orienting‐avoidance hypothesis toward threatening events in anxious subjects. This attentional pattern was only manifested by individuals with high levels of both trait and state anxiety. Further investigation should be done in order to better understand the brain mechanisms underlying the attentional biases in anxiety and to apply this knowledge to the development of cognitive therapies. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Investigation of brain electrophysiological properties among heroin addicts: Quantitative EEG and event‐related potentials

This study aims to introduce a new approach of a comprehensive paradigm to evaluate brain electrophysiological properties among addicts. Electroencephalographic spectral power as well as amplitudes and latencies of mismatch negativity (MMN), P300, and P600 components were evaluated among 19 male heroin addicts and 19 healthy nonsmoker subjects using a paradigm consisting of three subparadigms, namely (1) digit span Wechsler test, (2) auditory oddball, and (3) visual cue‐reactivity oddball paradigms. Task 1 provided auditory P300 and P600 in association with working memory. Task 2 provided auditory P300 as well as small and large deviant MMN event‐related potential (ERPs). Finally, task 3 provided visual cue‐reactivity P300. Results show that beta power was higher among heroin addicts while delta, theta, and alpha powers were decreased compared with healthy subjects. ERP analysis confirmed the decline of brain‐evoked potential amplitudes when compared with healthy subjects, thus indicating a broad neurobiological vulnerability of preattentive and attentional processing including attentional deficits and compromise of discrimination abilities. The prolonged latency of ERPs reflects poor cognitive capacity in the engagement of attention and memory resources. On the other hand, an increase of attention towards the heroin‐related stimuli could be concluded from the increase of P300 in the cue‐reactivity condition among heroin addicts. Findings suggest that applying this paradigm in addiction studies benefits comprehensive evaluation of neuroelectrophysiological activity among addicts, which can promote a better understanding of drugs' effects on the brain as well as define new neuroelectrophysiological characteristics of addiction properties. © 2016 Wiley Periodicals, Inc.     

大学生特质应对方式与抑郁、焦虑的关系

目的探讨大学生特质应对方式与抑郁、焦虑的关系。方法用特质应对方式问卷（TCSQ）、状态-特质焦虑问卷（STAI）、贝克抑郁测验（BDI）对120名大学生施测。结果消极应对与状态焦虑（r=0.296,P〈0.01）、特质焦虑（r=0.447,P〈0.001）及抑郁（r=0.227,P〈0.05）存在显著的正相关;积极应对与特质焦虑（r=-0.360,P〈0.001）及抑郁（r=0.227,P〈0.05）存在显著的负相关;抑郁与状态焦虑（r=0.447,P〈0.001）及特质焦虑（r=0.574,P〈0.001）之间也存在显著的正相关。特质焦虑能预测抑郁（P〈0.001）;抑郁、消极应对、状态焦虑和积极应对能预测特质焦虑（P〈0.001）;特质焦虑和积极应对能预测状态焦虑（P〈0.001）。结论特质应对方式对状态-特质焦虑和抑郁有影响。     

Visual attention deficits in Alzheimer's disease: relationship to HMPAO SPECT cortical hypoperfusion

Patients with Alzheimer's disease (AD) display a multiplicity of cognitive deficits in domains such as memory, language, and attention, all of which can be clearly linked to the underlying neuropathological alterations. The typical degenerative changes occur early on in the disease in the temporal-parietal lobes, with other brain regions, such as the frontal cortex, becoming more affected as the disease progresses. In light of the importance of the parietal cortex in mediating visuospatial attentional processing, in the present study, we investigated a deficit in covert orienting of visual attention and its relationship to cortical hypoperfusion in AD. We characterized the visual attentional profile of 21 AD patients, relative to that of 26 matched normal individuals, and then assessed the correspondence between behavior and hypoperfusion, as measured by regional cerebral blood flow using SPECT. Relative to controls, the AD group demonstrated a unilateral attentional deficit, with disproportionate slowing in reorienting attention to targets in the left compared to the right hemispace, especially following an invalid peripheral cue. Furthermore, even in the presence of bilateral pathology typical of AD, there was a positive correlation between this unilateral attentional disorder and the magnitude of the right superior parietal lobe hypoperfusion. The association of the altered attentional processing profile (i.e., greater difficulty disengaging attention from right-sided stimuli) with right-hemisphere-predominant hypoperfusion not only confirms the critical role of the right parietal lobe in covert attentional orienting but, more importantly, identifies a potential locus of the behavioral alterations in visuospatial processing in AD.     

济泰片治疗轻度海洛因依赖者稽延性戒断症状的随机双盲对照研究

目的探讨济泰片治疗轻度海洛因依赖者稽延性戒断症状的有效性和安全性,为降低轻度海洛因依赖者的复吸率提供参考。方法在河南省新乡市第一强制隔离戒毒所选取符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)诊断标准的轻度海洛因依赖者81例,采用随机数字表法分为济泰片组(n=40)和对照组(n=41)。济泰片组接受济泰片治疗,对照组给予济泰模拟片,两组均治疗24周。采用海洛因依赖稽延性戒断症状评定量表(RSPWSHA)评定疗效,采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表17项版(HAMD-17)及海洛因渴求问卷(HCQ)评定焦虑、抑郁症状和心理渴求程度,治疗期间监测药物不良反应、生命体征和实验室检查指标评估安全性。结果济泰片组和对照组RSPWSHA、HAMA、HAMD-17及HCQ总评分随治疗时间延长而降低(P0.05),RSPWSHA总评分减分率随治疗时间延长而增加(P0.05)。治疗8周后两组HCQ评分和治疗24周后两组HAMD-17总评分比较差异有统计学意义(P0.05),其他各治疗时点两组各量表评分比较差异均无统计学意义(P均0.05)。结论济泰片治疗轻度海洛因依赖者稽延性戒断症状可能疗效不明确。     

环境线索对戒断期海洛因依赖者神经电生理的影响

目的 了解戒断期海洛因依赖者暴露在吸毒相关环境线索下神经电生理指标的变化特点.方法 采用自身配对设计,指导382例戒断康复期的海洛因依赖者进行放松训练后,观看吸毒相关视频及展示的海洛因模拟物及吸毒用具,同时采用多导联生物反馈仪记录环境线索暴露前后神经电生理指标,评估暴露前后的心理渴求程度,分析心理渴求程度及神经电生理各指标的变化特点.结果 (1)海洛因相关环境线索暴露后,心理渴求程度较暴露前增加[暴露前:(18±22)mm;暴露后:(29±29)mm],肌电[暴露前:(12±7)μV;暴露后:(14±10)μV]及皮肤导电性[暴露前:(6.8±4.3)μS;暴露后:(7.4±4.3)μS]均增加(P<0.01).(2)线索暴露中的脑电各项指标[δ波、θ波、α波、感觉运动节律(SMR)、低β波和高β波的百分率]均低于诱发前(P<0.01～0.05).(3)心理渴求变化与脑电θ波、α波和SMR呈负相关(相关系数为-0.13、-0.12和-0.12);除肌电、δ波外,上述各电生理指标与皮肤导电性之间呈负相关(Pearson相关系数为-0.18～-0.22);余各项指标间呈正相关.结论 海洛因依赖者暴露在吸毒相关环境时,诱发心理渴求反应增强,并引起多项神经电生理指标的变化.     

男女海洛因依赖者成瘾严重程度的比较

目的：了解男女海洛因依赖者成瘾严重程度的差异,为针对不同性别海洛因依赖者制定干预措施提供依据。方法：采用自制个案调查表和成瘾行为严重度指数量表（addiction severity index,ASI）对199例男性和239例女性海洛因依赖者进行评估,比较不同性别海洛因依赖者ASI量表中各维度分值的差异。结果：女性依赖者ASI中因子4（药物使用）评分平均为（0.52±0.28）分和因子7（精神健康状况）平均（0.15±0.24）分显著高于男性的（0.43±0.34）分和（0.08±0.19）分（P〈0.05或P〈0.01）;男性依赖者因子5（法律状况）评分平均（0.07±0.13）分高于女性的（0.03±0.10）分（P〈0.01）。将年龄、首次吸毒年龄及吸毒时间与ASI分量表进行偏相关分析发现,年龄（r=-0.182）、吸毒时间（r=0.158）与因子4（药物使用）分数存在显著相关;进一步相关分析发现,年龄与吸毒时间存在显著相关（r=0.364,P〈0.01）。结论：男女海洛因依赖者在成瘾行为严重程度方面存在差异,临床治疗与康复过程中应针对不同性别特征制定个体化的治疗方案以满足不同性别患者的需求。     

Long-term abstinence syndrome in heroin addicts: indices of P300 alterations associated with a short memory task

Attentional deficits have been implicated in the pathophysiology of opioid addicts. The P300 component of event-related potentials (ERPs) is considered as a manifestation of attentional operations. The authors' goal was the comparison of P300 elicited during a short memory test between subjects with prolonged heroin abstinence and current heroin users as well as healthy controls. The P300 component was evaluated during the anticipatory period of a short memory task in 20 patients characterized by a past history of opioid dependence (6 months abstinence), in 18 current heroin users and in 20 healthy comparison subjects, matched for age, sex and educational level. Abstinent heroin addicts exhibited significant reduction of P300 amplitude at central frontal region, relative to the other two groups. The findings are discussed in connection to the aim of identifying psychophysiological indices, addressing issues in opioid use disorders, and suggest that knowledge about cognitive operations, such as those reflected by P300 component, could provide further insight into psychophysiological mechanisms underlying the long-term abstinence state of heroin addicts.     

Separation anxiety in the elderly

Separation anxiety has been studied in children and young adults but little is known about this form of anxiety in older people. This study aimed to examine socio-demographic, psychological and physical health correlates of separation anxiety in the elderly. Eighty-six ambulatory subjects aged 62-87 years were recruited from primary medical care practices to participate in this study. The presence of lifetime DSM-IV affective and anxiety disorders was determined by structured clinical interview. Subjects also completed a battery of self-report questionnaires measuring levels of state and trait anxiety, juvenile and adult separation anxiety. Adult separation anxiety scores were moderately correlated with juvenile separation anxiety scores (r= .52, P < .001), trait anxiety (r = .55, P < .001) and state anxiety scores (r = .66, P < .001), as well as younger age (r = .39, P < .001). Higher adult separation anxiety scores were also associated with a lifetime history of any anxiety disorder (t = 3.74, df = 84, P < .001) or any affective disorder (t = 2.12, df = 84, P < .05). However, adult separation anxiety was not associated with increasing age, being widowed, living alone or poorer physical health. Clinicians working with the elderly need to routinely explore this form of anxiety as it may complicate the pattern of presentation of other anxiety and affective disorders, and require specific forms of intervention.