艾司西酞普兰单用与合用氨磺必利治疗重性抑郁症的疗效和安全性

目的 探讨氨磺必利合用艾司西酞普兰治疗重性抑郁症的有效性和安全性.方法 80例重性抑郁症患者随机分为艾司西酞普兰组(对照组)和艾司西酞普兰合用氨磺必利组(研究组)各40例,疗程8周.于治疗前和治疗后第1、2、4、8周末采用汉密尔顿抑郁量表(HAMD)评定疗效,采用不良事件和实验室检查评价安全性.结果 两组治疗后第8周末缓解率分别为57.9％和64.9％,差异无统计学意义(x2=0.384,P＞0.05).两组HAMD评分治疗后均较治疗前显著降低,差异有统计学意义(P＜0.05).研究组在治疗后第1、2周末HAMD评分显著低于对照组,差异有统计学意义(t=2.91,2.72;P＜0.05).两组不良反应均轻微,差异无统计学意义(P＞0.05).结论 艾司西酞普兰合用氨磺必利治疗重性抑郁症起效更快.     

抑郁症患者血清脑源性神经营养因子水平及其相关因素

目的 探讨抑郁症患者血清脑源性神经营养因子水平及其相关因素,为防治抑郁症提供重要依据.方法 采用酶联免疫吸附法和汉密尔顿抑郁量表分别测定40例抑郁症患者(患者组)的血清BDNF水平和抑郁严重程度,并与49名正常者(对照组)进行对比分析.结果 患者组治疗前血清BDNF水平明显降低,与对照组比较差异有统计学意义(P＜0.01).患者组治疗8周末血清BDNF水平明显升高,HAMD总分明显降低,与治疗前比较差异有统计学意义(P＜0.05).患者组治疗前后血清BDNF水平与性别及年龄均呈负相关,差异具有统计学意义(P＜0.05),与受教育程度、病程及HAMD总分比较无统计学意义(P＞0.05).结论 抑郁症患者存在血清BDNF水平的下降,抗抑郁治疗可改善抑郁症状,并显著提高血清BDNF水平.     

首发精神分裂症及其父母听觉ERP的研究

目的 印证首发精神分裂症及其父母是否存在认知功能障碍,并探讨事件相关电位是精神分裂症的遗传素质标志还是状态性标志.方法 从2010年1～12月期间在徐州市东方人民医院住院的患者中选取符合CCMD-3精神分裂症诊断标准的首发患者60例,作为患者组;选取精神分裂症患者生物学意义上的父母,共120例作为亲属组;选取无精神疾病家族史的健康志愿者作为对照组,共60例.分别对三组进行ERP检测.所得数据应用SPSS 13.0统计软件包处理分析,采用的主要统计学方法包括卡方检验、单因素方差分析和协方差分析.结果 (1)患者组、亲属组和对照组间N2、P3潜伏期和P3波幅差异均有统计学意义(均为P＜0.01);(2)患者组的N2潜伏期长于对照组(P＜0.05),亲属组和对照组的各潜伏期相比差异无统计学意义(均为P＞0.05);患者组和亲属组的P3波幅均明显低于对照组(均为P＜0.05),而患者组和亲属组P3波幅差异无统计学意义(P＞0.05).结论 (1)首发精神分裂症及其父母可能存在一定程度的认知功能障碍;(2)P3波幅倾向于精神分裂症的遗传素质性标志,N2潜伏期倾向于精神分裂症的状态性标志.     

四川省绵阳市某农村社区某人群的自测健康状况

目的 了解四川省绵阳市某农村社区人群的身心健康状况,为相关工作提供依据和建议.方法 采用自测健康评定量表(SRHMS),在调查员的现场指导下采用集中填写和入户调查相结合的方式对随机抽取的2023名农村社区居民的健康状况进行测查.结果 不同受教育程度组的农村居民生理健康、心理健康、社会健康评分及量表总评分差异有统计学意义(P＜0.05);不同年龄、工作状况组的农村居民生理健康、社会健康评分及量表总评分差异有统计学意义(P＜0.05);不同收入组农村居民在心理健康、社会健康评分及量表总评分之间的差异有统计学意义(P＜0.05);不同宗教、民族组农村居民的社会健康评分之间的差异有统计学意义(P＜0.05);不同性别组农村居民的生理健康评分之间的差异有统计学意义(P＜0.05);不同婚姻状况组农村居民的心理健康评分之间的差异有统计学意义(P＜0.05).结论 农村女性身心健康状况优于男性,老年人、已婚者、少数民族、低收入者、退休者、低学历者身心健康状况均较差.     

43例被关锁重性精神疾病患者解锁治疗前后对照分析

目的 比较被关锁的重性精神疾病患者解锁前后的症状、社会功能及其家庭经济负担的变化.方法 对43例被关锁的重性精神疾病患者(精神分裂症和双相障碍)于解锁前、解锁后6个月分别采用阳性与阴性症状量表(PANSS)或Bech-Rafaelsen躁狂量表(BRMS)评定临床效果,采用社会功能缺陷量表(SDSS)评定社会功能,采用＜解锁患者信息采集表＞和＜解锁患者家庭经济学指标调查表＞进行患者家庭经济学指标比较.结果 解锁前、解锁治疗6个月时PANSS总分、BRMS总分、SDSS总分、家庭经济学指标评定结果比较,差异有显著性(P＜0.01).结论 解锁治疗显著改善了被关锁重性精神疾病患者的精神症状和社会功能,减轻了患者家庭的经济负担,提高了患者及其家属的生活质量.     

精神分裂症患者子女青少年期心理状况的调查分析

目的 探讨精神分裂症患者子女与健康人群子女的青少年期心理状况及性格特征差异.方法 对上海市嘉定区33例精神分裂症患者子女青少年期（研究组）和33例健康人群子女（对照组）,采用艾森克个性问卷（少年版）（EPQ）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、自尊量表（SES）、一般自我效能感量表（GSES）进行测试,比较两组间的差异.结果 研究组EPQ的精神质、神经质评分显著高于对照组,内外向评分显著低于对照组（P＜0.05）.研究组SAS、SDS显著高于对照组,SES、GSES评分显著低于对照组,差异均有统计学意义（P＜0.01）.结论 精神分裂症患者子女较正常人群子女在青少年期更易出现焦虑、抑郁、自卑等心理问题,精神分裂症患者子女青少年期的心理健康值得关注.     

脑卒中患者家庭康复护理干预及效果观察

目的 探讨脑卒中偏瘫患者家庭康复护理的效果.方法 选择治疗好转出院的80例脑卒中偏瘫患者随机分为干预组和对照组,对照组给予药物治疗和常规健康指导,而干预组则增加了对病人及家属进行家庭康复护理指导和定期随访,干预前后用Fugl-Meyer量表(FMA)评定运动功能,用Barthel指数评定日常生活能力(ADL).结果 6个月后干预组FMA及ADL改善程度与对照组比较差异有统计学意义(P＜0.01),而干预组神经功能缺损程度较对照组显著降低(P＜0.01).结论 家庭康复护理干预可明显改善脑卒中偏瘫患者的运动功能和日常生活能力,降低神经功能缺损程度.     

阿尔茨海默病患者血浆可溶性晚期糖基化终产物受体表达水平

目的 探讨阿尔茨海默病(AD)患者血浆可溶性晚期糖基化终产物受体( sRAGE)水平及其与AD严重程度的关系.方法 选择98例AD患者和100例健康对照者,采用ELISA法测定血浆中sRAGE的含量.结果 AD组血浆sRAGE水平(728±38)pg/ml明显低于健康对照组(1068±42)pg/ml,差异有统计学意义(P＜0.01).不同严重程度AD组间血浆sRAGE水平差异无统计学意义(P＞0.05).结论 AD患者血浆sRAGE水平明显低于正常对照组,且其水平与AD严重程度无明显相关性.     

重症肌无力胸腺切除术免疫功能变化及疗效观察

目的 观察重症肌无力胸腺切除术免疫功能变化及临床疗效.方法 选取84例重症肌无力患者为研究对象,胸腺切除术治疗患者52例为手术组,胸腺未切除患者32例为非手术组,同时选取健康志愿者30例为对照组.观察胸腺切除手术免疫功能的变化及临床疗效.结果 非手术组患者外周血AchRab水平(2.02±0.28) ng/L显著高于对照组(1.58±0.32)ng/L,差异有统计学意义(P＜0.05);手术组患者外周血AchRab水平(1.72±0.28)ng/L高于对照组,同时低于非手术组,差异有统计学意义(P＜0.05);3组免疫球蛋白水平差异无统计学意义(P＞0.05).胸腺切除术患者临床总有效率81.8％,明显高于非手术组的60.7％,差异有统计学意义(P＜0.05).结论 通过手术免疫功能变化观察,重症肌无力与胸腺密切相关,术前MG患者免疫功能处于紊乱状态,手术切除胸腺后免疫功能可得到一定程度恢复和改善.     

重性精神疾病社区管理服务背景下湛江地区患者及家属对疾病知晓情况的分析

目的了解社区服务背景下湛江地区重性精神疾病患者及家属对疾病的知晓情况及社区服务效果,以促进人们对疾病的认识,指导社区服务与管理。方法随机选取湛江地区三家医院,整群随机抽取2018年3月-10月新入院并符合《国际疾病分类(第10版)》(ICD-10)诊断标准的重性精神疾病患者481例及对应的家属481例为研究对象,自编严重精神障碍患者暴力行为危险因素调查问卷调查患者及其家属对疾病的知晓程度、主要的知晓途径、知晓率。结果患者及家属精神卫生知识知晓率分别为64. 5%和65. 8%,组间差异无统计学意义(P>0. 05)。患者与家属之间的知晓程度构成差异有统计学意义,家属对疾病的知晓程度更高(P<0. 01)。而对疾病知晓的主要途径方面,患者和家属均以就诊或住院的医院为主,分别占92. 3%和92. 7%。结论现阶段湛江地区患者及家属对重性精神疾病的知晓程度偏低,社区服务未能成为最主要的知晓途径。     

Impact of mental illness in families of mental health professionals

Family burden and coping strategies were investigated in 84 experienced mental health professionals with family members suffering from chronic major mental illnesses. The sample was nationally recruited from ads in professional journals. Personal reactions of respondents involved cognitive and attitudinal changes in conceptions of psychotic disorders and guarded relations with colleagues with respect to self-disclosure and case involvement. Financial and emotional burdens were substantial, with ongoing stressful life events, aversive patient behaviors, and poor treatment histories. In rating family coping strategies, mental health professionals showed a high degree of concordance with nonprofessional family members in assigning priority to education on symptoms, medications, and patient management techniques. Involvement with self-help groups and physical separation from patients were rated higher than individual or family therapy as aids in coping for families of the mentally ill.     

Effects of visual arts instruction on the mental health of adults with mental retardation and mental illness

Single-subject multiple probe designs were employed in two studies with 5 young adults who had a dual diagnosis of mental retardation and mental illness. Our aim was to determine effects of instruction designed to teach visual arts activity skills and promote personal expressiveness on acquisition, maintenance, and generalization of these skills and behaviors associated with these persons' mental health. In Study 1, a 5-second constant time delay procedure was used to teach three chosen art activities. In Study 2, an instructional package was used to promote personally expressive behaviors. After learning the skills in Study 1, participants in Study 2 displayed improvement in occurrence of behaviors associated with mental illness and increases in personally expressive behaviors.     

Farming and mental health problems and mental illness

BACKGROUND: Farmers experience one of the highest rates of suicide of any industry and there is growing evidence that those involved in farming are at higher risk of developing mental health problems. This article provides an overview of the literature examining mental health issues experienced by farming populations in the United Kingdom, Europe, Australia, Canada and the United States and identifies areas for further research. METHOD: A literature review (Medline, Science Direct, Ingenta, Proquest and PsychINFO) was carried out using the words 'farmers', 'agriculture', 'depression', 'mental health', 'mental illness', 'stress', and 'suicide', as well as a review of relevant papers and publications known to the authors. (Papers not written in English and those published prior to 1985 were excluded.) RESULTS: Fifty-two papers were identified with the majority focusing on stress and coping styles in farmers (24). A number of studies also focused on neuropsychological functioning and agricultural chemical use (7), depression (7), suicide (9), general mental health (4) and injury and mental health (1). This body of research studied male farmers, female farmers, farm workers, farming families, and young people living on farms. Research to date indicates that farmers, farm workers and their respective families face an array of stressors related to the physical environment, structure of farming families and the economic difficulties and uncertainties associated with farming which may be detrimental to their mental health. CONCLUSION: Whilst suicide rates in some groups of farmers are higher than the general population, conclusive data do not exist to indicate whether farmers and farming families experience higher rates of mental health problems compared with the non-farming community. It is clear, however, that farming is associated with a unique set of characteristics that is potentially hazardous to mental health and requires further research.