放松训练对广泛性焦虑障碍患者生活质量的影响分析

目的 探讨放松训练对广泛性焦虑障碍患者生活质量的影响.方法 60例广泛性焦虑障碍患者,随机分为对照组和试验组,每组30例.对照组患者给予阿普唑仑、帕罗西汀片及一般康复,试验组在对照组基础上给予放松训练.比较两组患者临床治疗效果,焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分,汉密尔顿焦虑量表(HAMA)评分以及...     

重复经颅磁刺激治疗结合心理干预在广泛性焦虑障碍患者中的应用效果观察

目的 探讨重复经颅磁刺激(rTMS)治疗结合心理干预在广泛性焦虑障碍(GAD)患者中的应用效果.方法 选取GAD患者200例,随机分为观察组(rTMS治疗结合心理干预)和对照组(心理干预),各100例.探讨实施不同干预的效果.结果 干预后,两组HAMD、HAMA评分均明显减低,且观察组的评分低于对照组(P＜0.05);...     

认知行为疗法治疗广泛性焦虑障碍的对照研究

目的 探讨摘要认知行为治疗对广泛性焦虑障碍患者的临床疗效.方法将2009年6月至2010年10月在我院治疗的50例住院患者随机分为研究组和对照组各25例,对照组应用米氮平和常规护理,研究组在对照组基础上给予认知行为治疗.8周末应用HAMA.HAMD对患者进行测评分析.结果 8周末研究组抗焦虑疗效优于对照组.结论认知行为疗法结合药物治疗广泛性焦虑障碍较比单纯应用药物治疗效果差异有统计学意义(P<0.05).     

心理资本干预对广泛性焦虑障碍患者心理状况及其免疫功能的影响

目的探讨结合心理资本的综合性干预对广泛性焦虑障碍患者心理状况及其免疫功能的影响,促进患者心身康复。方法运用一般情况调查表、汉密尔顿焦虑量表(HAMA)、积极心理资本问卷(PPQ)对60例广泛性焦虑症患者心理健康状况进行调查,运用流式细胞术检测患者免疫功能。结果 (1)对照组患者心理资本的乐观维度在干预前后差异无统计学意义,HAMA及心理资本问卷的各维度及总分上,干预组和对照组在干预前后差异都具有统计学意义(P<0.01);(2)干预组患者焦虑情绪(P<0.05)及心理资本(P<0.01)在干预后改善程度均显著大于对照组患者;(3)干预组干预前后CD3~+、CD4~+、CD8~+上差异具有统计学意义(P<0.05),对照组仅在CD3~+上具有统计学意义(P<0.05)。结论广泛性焦虑障碍患者心理健康状况及免疫功能严重受损,采用融合心理资本的综合性心理干预可有效改善患者心理健康状况,其免疫功能抑制状况有所改善。     

重复经颅磁刺激联合心理干预治疗广泛性焦虑的临床研究

目的 探讨心理干预联合重复经颅磁刺激治疗广泛性焦虑的疗效.方法 选择我院住院的焦虑症患者63例,随机分为观察组(重复经颅磁刺激结合心理干预)32例,对照组(重复经颅磁刺激)31例,使用汉密顿焦虑量表(HAMA)、焦虑自评量表(SAS)评分比较两组治疗前、治疗2周、4周临床疗效.结果 治疗第2、4周,观察组HAMA、SA...     

帕罗西汀联合九味镇心颗粒治疗广泛性焦虑障碍疗效观察

摘 要 目的:探讨帕罗西汀联合九味镇心颗粒治疗广泛性焦虑障碍的疗效与安全性。方法：150例广泛性焦虑障碍患者随机分为研究组和对照组各75例。研究组给予帕罗西汀片联合九味镇心颗粒治疗,对照组单用帕罗西汀片治疗,疗程均为6周。比较两组汉密尔顿焦虑量表（HAMA）评分变化和临床疗效、药品不良反应。结果：研究组脱落2例,共73例完成观察,对照组脱落6例,共67例完成观察。研究组治疗1周末起HAMA评分较前明显下降（P＜0.01）,对照组治疗2周末起HAMA评分较前明显下降（P＜0.01）;两组治疗前后各时段HAMA评分比较,差异无统计学意义（P>0.05）。治疗后,两组治愈率、有效率比较,差异均无统计学意义（P>0.05）。两组药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论：帕罗西汀联合九味镇心颗粒治疗广泛性焦虑障碍,起效快、安全性好,值得临床推广。     

放松训练护理对广泛性焦虑症患者康复的影响效果分析

目的探讨放松训练护理对广泛性焦虑症患者康复的影响效果分析。方法将2015年1月至2018年12月在我院精神科治疗的60例广泛性焦虑症患者随机分为两组,对照组采用常规护理,观察组采用放松训练护理,比较两组患者的临床疗效、HAMA评分变化、CGI-SI评分变化、SAS和SDS评分变化。结果观察组护理有效率为93.33%,明显高于对照组的73.33%(P <0.05);观察组护理2周、4周、6周的HAMA评分明显低于对照组(P <0.05);观察组护理后2周、4周、6周的CGI-SI评分明显低于对照组(P <0.05);观察组护理6周后的SAS评分和SDS评分明显低于对照组(P <0.05)。结论放松训练护理对广泛性焦虑症患者康复的影响效果显著,能有效减轻焦虑状态,改善患者心理障碍,促进心境的自然、健康,具有积极的临床意义。     

文拉法辛缓释剂治疗广泛性焦虑障碍的疗效观察

目的探讨文拉法辛缓释剂治疗不伴有抑郁的广泛性焦虑障碍的临床疗效及安全性。方法共88例不伴有抑郁的广泛性焦虑障碍患者入组，文拉法辛缓释剂治疗46例，观察组42例，使用HAMA判断疗效，并记录不良反应。结果77例完成试验（文拉法辛缓释剂41例，观察组36例），结果显示文拉法辛缓释剂治疗GAD有效率为69％，显著优于观察组36％（P〈0．01）；文拉法辛缓释剂治疗后各随访点HAMA评分与观察组比较差异均有显著性（P〈0．05）。结论文拉法辛缓释剂治疗GAD疗效肯定，显著优于观察组，耐受性好，不良反应少，适合临床应用。     

认知心理干预对双相障碍抑郁患者的疗效

目的 探讨认知心理干预对双相障碍抑郁患者的临床疗效.方法 采用随机数字法将符合《美国精神病学会精神障碍诊断与统计手册(第三版)》制定的诊断标准的82例双相障碍患者分为观察组42例和对照组40例,观察组采用认知心理干预治疗.采用世界卫生组织生存质量测定量表(WHOQOL-BREF)评定临床症状及生存质量、采用汉密尔顿抑郁量法评定临床疗效.结果 干预8周后观察组与对照组总有效率为95.2％和82.5％,差异有统计学意义(P＜0.05).两组干预后WHOQOL-BREF 4个领域评分与干预前比较差异有统计学意义(P＜0.05),两组间比较差异也有统计学意义(P＜0.05).结论 认知心理干预可以对双相障碍抑郁患者产生较好的恢复作用、增强康复效果和提高生存质量.     

An effect-size analysis of pharmacologic treatments for generalized anxiety disorder

Generalized anxiety disorder (GAD) is a prevalent and impairing disorder, associated with extensive psychiatric and medical comorbidity and usually characterized by a chronic course. Different drugs have been investigated in GAD; among them are the following: 1) SSRIs: paroxetine, sertraline, fluvoxamine and escitalopram; 2) SNRI1s: venlafaxine; 3) benzodiazepines (BZs): alprazolam, diazepam and lorazepam; 4) azapirones (AZAs): buspirone; 5) antihistamines (AHs): hydroxyzine; 6) pregabalin (PGB); and 7) complementary/alternative medicine (CAM): kava-kava and homeopathic preparation. We conducted an effect size (ES) analysis of 21 double-blind placebo-controlled trials of medications treating DSM-III-R, DSM-IV or ICD-10 GAD using HAM-A change in score from baseline or endpoint score as the main efficacy measure. Literature search was performed using MEDLINE and PsycINFO databases including articles published between 1987 and 2003 and personal communications with investigators and sponsors. comparing all drugs versus placebo, the ES was 0.39. Mean ESs, excluding children, were PGB: 0.50, AH: 0.45, SNRI: 0.42, BZ: 0.38, SSRI: 0.36, AZA: 0.17 and CAM: -0.31. Comparing ES for adults versus children/adolescents (excluding CAM) and conventional drugs versus CAM (excluding children/adolescents) we found significantly higher ES for children/adolescents and for conventional drugs (p < 0.001 and p < 0.01, respectively). No significant differences were found when comparing date of publication, location of site (i.e. US versus other), fixed versus flexible dosing, number of study arms, or number of outcome measures used. Medications varied in the magnitude of their ES, ranging from moderate to poor. Adolescents and children showed a much greater ES compared with adults. Subjects taking CAM had worse outcomes than placebo.     

心理干预措施对子宫肌瘤手术患者焦虑心理及性功能的影响研究

目的 评价心理干预措施对子宫肌瘤手术患者焦虑心理及性功能的影响.方法 将2014年3月至2015年3月本院收治的行子宫肌瘤手术的96例纳入本次研究,按随机数字表法分为两组,对照组48例实施一般护理干预方法,观察组48例在此基础上增加心理干预措施,对两组患者焦虑心理及性功能状况进行对比评价.结果 观察组患者中发生焦虑5例(10.42％),对照组患者中发生焦虑23例(47.92％),观察组明显要比对照组低,两组比较差异有统计学意义(P＜0.05).在性欲、性唤起、性高潮、性心理以及性行为异常五项性功能指标评分上,观察组均明显高于对照组,两组比较差异有统计学意义(P＜0.05).结论 对于子宫肌瘤手术患者,实施心理干预措施效果显著,能够控制患者焦虑心理的发生,并增强患者的性功能;因此,值得采纳应用.     

心理护理对人工髂关节置换术后焦虑及满意度的影响

目的观察心理护理干预对人工髂关节置换术后患者焦虑及满意度的影响。方法将2012年1月～2014年1月住院实行人工关节置换术的98例患者,按照护理方法分为对照组和观察组,对照组49例患者进行常规护理,观察组49例患者在常规护理基础上实行心理护理干预,比较两组患者术后焦虑和满意度。结果观察组焦虑评分（2．39±0．62）、抑郁评分（2．57±0．71）、躯体化症状评分（2．61±0．89）,均显著好于对照组（3．25±0．78）、（2．96±0．54）、（3．25±0．93）,差异有统计学意义（P〈0．05）;观察组患者满意度93．9％,显著好于对照组79．1％（P〈0．05）。结论对人工髂关节置换术的患者进行心理护理干预,有利于术后缓解患者焦虑等情绪,提高患者满意度。     

Treatment of generalized anxiety disorder with citalopram

Serotonin reuptake inhibitors (SSRI), such as venalafaxine and paroxetine, are used in the treatment of generalized anxiety disorder (GAD). Patients with GAD frequently have comorbid psychiatric disorders, such as depression. SSRIs are effective in the treatment of a variety of anxiety disorders and depression. Citalopram, a newer SSRI used in the treatment of depression, has not been studied for GAD. This is the first report of the use of citalopram, the most selective SSRI, for the treatment of GAD in a retrospective case observation study. Thirteen patients diagnosed with GAD were treated with citalopram at an academic outpatient clinic. The main outcome measures were the Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Depression Rating Scale (HAM-D) and Clinical Global Impressions of Severity (CGI-S; at baseline) and Improvement (CGI-I). The mean age of the patients was 38 years. The mean dose of citalopram at endpoint was 33 mg/day (range 10-60 mg/day). After 12 weeks of treatment with citalopram, all 13 patients experienced full or partial improvement in GAD and depressive symptoms leading to meaningful improvement in social and occupational functioning. Mean baseline HAM-A scores (mean+/-SEM) decreased from 22.2+/-1.3 to 6.2+/-0.9 after citalopram treatment. The mean CGI-I score was 1.8+/-0.2 with 11 of the 13 patients responding (CGI-I of 1 or 2). These data suggest that citalopram may be an effective treatment for GAD. Several patients who had failed previous treatment with other SSRIs responded to citalopram, suggesting that a second SSRI, such as citalopram, may be beneficial in this population. A larger placebo-controlled study of citalopram is warranted in GAD.     

金龙解郁胶囊治疗广泛性焦虑障碍的临床疗效

目的探讨中药制剂金龙解郁胶囊对广泛性焦虑障碍的疗效和不良反应。方法对临床诊断为广泛性焦虑障碍的160名患者口服金龙解郁胶囊4～6粒／d,进行治疗前、治疗后2周、4周、6周焦虑自评量表评估,观察疗效和不良反应。结果金龙解郁胶囊治疗广泛性焦虑障碍疗效：治疗前及治疗2、4、6周的焦虑自评量表评分分别为（60．9±6．5）分、（54．2±5．4）分、（48．3±6．4）分及（34．2±2．6）分。治疗后各时间与治疗前比较,差异有统计学意义（t=10．03、13．46、13．74,均P〈0．01）。治疗2周末（t=10．03）、4周末（t=13．46）、6周末（t=13．74）P均〈0．01;男性患者和女性患者疗效比较,差异无统计学意义（P〉0．05）。结论金龙解郁胶囊治疗广泛性焦虑障碍疗效显著,不良反应少,服药依从性好,价格便宜。     

Psychiatrists' treatment preferences for generalized anxiety disorder

Objective

The objective of this study is to ascertain psychiatrists' treatment preferences for generalized anxiety disorder (GAD) and compare them to the same psychiatrists' treatment preferences in the hypothetical scenario that treatment is to be administered to themselves as patients.

Methods

A questionnaire was completed by 221 psychiatrists from 3 Balkan countries. They were asked to indicate their treatment preferences for patients with GAD and for themselves as patients.

Results

A large majority of psychiatrists chose selective serotonin reuptake inhibitors/serotonin and norepinephrine reuptake inhibitors as preferred treatment option for GAD patients. Fewer psychiatrists selected benzodiazepines and pregabalin and about one third chose psychotherapy. The majority of psychiatrists chose the same treatments for their patients and for themselves, with main differences being in terms of pharmacotherapy (especially benzodiazepines) being less frequently recommended and psychotherapy being more frequently recommended as preferred treatment option for psychiatrists as patients.

Conclusions

Treatment preferences for GAD by psychiatrists in the 3 West Balkan countries were mostly in accordance with treatment guidelines and treatment preferences for patients and for psychiatrists as patients were mostly concordant. However, some psychiatrists were more likely to choose pharmacotherapy for patients and psychotherapy for themselves as patients. These findings have implications for education of psychiatrists and for efforts to improve treatment guidelines and mental health services.     

脑卒中焦虑病人的心理干预

目的:探讨综合性心理干预对脑卒中伴焦虑病人的治疗效果.方法:将116例脑卒中伴焦虑病人随机分为观察组和对照组,每组58例.对照组病人采用常规治疗、护理及健康教育;观察组在对照组治疗的基础上给予综合性心理干预,包括行为干预、支持性心理治疗、放松训练及生物反馈治疗等.结果:干预组治疗后与对照组病人治疗后的焦虑情绪差异有显著性,心理干预组焦虑减分率均明显大于对照组.结论:心理干预能有效改善脑卒中病人伴有的抑郁焦虑症状,亦可促进躯体疾病的康复,提高疗效,改善预后.