整合性团体诗歌疗法改善青少年抑郁症的有效性和可行性探索

目的探索整合性团体诗歌疗法对改善抑郁症青少年患者情绪低落、人际隔离和自我否定症状的有效性和可行性。方法在上海市精神卫生中心招募7例轻中度青少年抑郁症患者,对对他们开展6治疗单元的整合性团体诗歌治疗活动。在治疗前和治疗结束后1个月对青少年的情绪水平、人际交往、自我功能进行定量和定性评定。结果整合性团体诗歌疗法改善了抑郁症青少年的情绪低落、人际隔离和自我否定状态,受到青少年欢迎。结论整合性团体诗歌疗法对治疗青少年抑郁症具有一定的疗效,实施具有可行性。     

青少年抑郁症需要服药治疗吗?

正康医生:最近一个朋友正在读高中的孩子被诊断患了抑郁症,医生说不用服药治疗,只做心理治疗就可以了。因为明年就要高考了,怕影响学习,家长较着急病情,想尽快治好。所以想问青少年抑郁症需要服药治疗吗?湖南刘先生刘先生:你好!抑郁症是儿童和青少年中最常见的精神障碍之一。对于这类特殊人群,是否需要应用抗抑郁药     

团体人际心理治疗产后抑郁症的疗效观察

目的:探讨团体人际心理治疗对减轻产后抑郁症患者抑郁症状和改善社会功能的效果。方法:人际心理治疗组38例产后抑郁症患者进行8周的团体人际心理治疗,对照组的35例产后抑郁症患者给予一般治疗。两组患者在治疗前及治疗后3个月采用爱丁堡产后抑郁量表(EPDS)、汉密顿抑郁量表(HAMD)、人际问题问卷(IIP)及社会功能缺陷筛选量表(SDSS)等进行评估。结果:与对照组比较,治疗后3个月末的人际心理治疗组人际能力和社会功能改善更明显(P<0.01),人际心理治疗组抑郁症状的缓解程度明显优于对照组(P<0.01)。结论:团体人际心理治疗能够改善产后抑郁症患者的人际能力和社会功能,对产后抑郁症有较好的疗效。     

老年抑郁症原因分析及护理

目的:观察老年抑郁症患者的治疗及护理.方法:对住院的老年抑郁症患者35例,给予药物、心理治疗和相应护理.结果:疗效佳,治疗护理后抑郁及焦虑显著降低.结论:对抑郁症患者进行药物、心理治疗和护理取得较好效果.     

心理治疗及认知疗法在抑郁症治疗中的应用分析

目的:探讨心理治疗及认知疗法在抑郁症病人治疗中的应用效果。方法:将60例抑郁症患者随机分为对照组30例和观察组30例。对照组患者行常规药物治疗,观察组患者在常规药物治疗的基础上行心理治疗及认知疗法。采用汉密尔顿抑郁量表(HAMD)分别对2组患者治疗前和治疗2周、4周、8周的抑郁症状积分进行评价。结果:治疗后2周、4周、8周,观察组患者的平均HAMD评分均低于对照组(P<0.05)。结论:心理治疗及认知疗法联合药物治疗抑郁症的疗效优于单纯药物治疗,值得临床推广与应用。     

上海地区青少年抑郁症患者非自杀性自伤行为现状及影响因素研究

目的 调查上海地区青少年抑郁症患者伴有非自杀性自伤行为（non-suicidal self-injury,NSSI）的情况,并分析其影响因素。方法 选取2022年1—12月上海市精神卫生中心收治的青少年抑郁症患者,诊断NSSI发生情况,并调查患者的人口学信息、环境信息、抑郁程度、童年家庭功能不全情况等,采用单、多因素方法分析患者NSSI发生的影响因素。结果 795例青少年抑郁症患者中男性275例,平均年龄（14.97±1.72）岁,共有287例（36.10%）伴有NSSI情况。多因素logistic回归分析结果显示,遭受过校园暴力（OR=1.874）、童年家庭功能不全（OR=3.740）、目睹家庭暴力（OR=5.618）、与酗酒或物质滥用的家庭成员共同生活（OR=4.702）、存在冲动感（OR=2.575）、存在负性生活事件（OR=6.080）和童年创伤（OR=8.482）、情感虐待（OR=7.272）均与青少年抑郁症患者发生NSSI有关。结论 上海地区青少年抑郁症患者NSSI发生与个人经历、家庭环境和社会关系等有关,应针对性采取心理治疗和干预措施。     

抑郁症的心理治疗

就抑郁症的治疗而言,综合治疗是提高疗效的有效方法.现有研究显示抑郁症药物治疗对70％的患者有效,临床治愈率在30％～35％左右,伴有躯体生物性特征症状的抑郁症更易成为难治性抑郁症,而心理治疗以及电痉挛治疗、重复经颅磁刺激治疗等物理治疗不仅可以提高抑郁症的疗效,在某些人群中可以达到主要的治疗效果,如轻度抑郁症患者,心理治疗可能是最佳的方法之一.     

抑郁症首选药物治疗

现今对抑郁症的治疗，主要有药物治疗与心理治疗等方法，药物治疗是治疗抑郁症的第一选择。     

抑郁症药物治疗不能断

有关心理学专家表示,我国心理疾病患者中以抑郁症最为常见。现今对抑郁症的治疗主要有药物治疗与心理治疗等方法,而抗抑郁药治疗是目前治疗抑郁症最主要的方式。     

青少年抑郁症相关社会心理因素探析

目的:对青少年抑郁症患者的社会心理因素进行分析.方法:选取2015年1月-2016年7月50例青少年抑郁症患者作为研究对象,对这50例青少年抑郁症患者的存在社会心理因素进行研究分析,并实施相应的护理干预与治疗措施.结果:青少年抑郁症患者的主要社会心理因素包括:孤独无助心理、对立敌视心理、失败受挫心理、社会适应障碍等.结论:导致青少年出现抑郁症的社会心理因素较多,根据青少年抑郁症患者的社会心理因素,为其实施针对性的治疗措施,以利于患者疾病症状的缓解.     

Psychotherapie der Depression

There are now several well evaluated (psychological) interventions available to treat depressive disorders. A large number of controlled randomized trials have been conducted to establish scientific evidence for treatments' short- and long-term outcome. If the patient meets the diagnostic criteria for depression, a decision has to be made about referral to a psychiatrist or a psychotherapist for specialized treatment. Depending on severity of symptomatology (suicidality) as well as the range of individual problems, supportive counselling or specific psychotherapy is indicated. Specific psychotherapies for depression are in particular cognitive behaviour therapy (CBT) and interpersonal psychotherapy (IPT), to a less extent short-term psychodynamic psychotherapy (STPP) and client centred psychotherapy (CCPT). For these specific psychotherapies, empirical evidence is available about short-term (successful symptom reduction) and long-term (relapse prevention) outcome as monotherapy or in combination with antidepressive medication. Based on available outcome studies, 14 up-to-date treatment recommendations conclude this presentation.     

Interpersonal psychotherapy for anorexia nervosa

OBJECTIVE: This paper outlines the rationale for treating individuals with anorexia nervosa using interpersonal psychotherapy. METHOD: We review theoretical, empirical, and psychotherapy literature relating to interpersonal functioning in anorexia nervosa. RESULTS: Etiological theories emphasize interpersonal and family dysfunction in the development of anorexia nervosa. Research supports the notion that families of individuals with anorexia nervosa have dysfunctional patterns of communication. The history of treatment for anorexia nervosa emphasizes the need for resolution of interpersonal dysfunction, within the traditions of psychodynamic, family therapy, and multidimensional therapies. DISCUSSION: Interpersonal psychotherapy is a time-limited psychotherapy based on the notion that regardless of etiology, interpersonal relationships are intertwined with symptomatology. The goals of the therapy are to improve interpersonal functioning and thereby decrease symptomatology. Factors identified as important in the development of anorexia nervosa are readily conceptualized within the interpersonal psychotherapy problem areas of grief, interpersonal disputes, interpersonal deficits, and role transitions.     

Ministers’ Perceptions of Church-Based Programs to Provide Depression Care for African Americans

African Americans, compared with white Americans, underutilize mental health services for major depressive disorder. Church-based programs are effective in reducing racial disparities in health; however, the literature on church-based programs for depression is limited. The purpose of this study was to explore ministers’ perceptions about depression and the feasibility of utilizing the church to implement evidence-based assessments and psychotherapy for depression. From August 2011 to March 2012, data were collected from three focus groups conducted with adult ministers (n = 21) from a black mega-church in New York City. Using consensual qualitative research to analyze data, eight main domains emerged: definition of depression, identification of depression, causal factors, perceived responsibilities, limitations, assessment, group interpersonal psychotherapy, and stigma. A major finding was that ministers described depression within a context of vast suffering due to socioeconomic inequalities (e.g., financial strain and unstable housing) in many African American communities. Implementing evidence-based assessments and psychotherapy in a church was deemed feasible if principles of community-based participatory research were utilized and safeguards to protect participants’ confidentiality were employed. In conclusion, ministers were enthusiastic about the possibility of implementing church-based programs for depression care and emphasized partnering with academic researchers throughout the implementation process. More research is needed to identify effective, multidisciplinary interventions that address social inequalities which contribute to racial disparities in depression treatment.     

产后抑郁症预防和心理干预研究进展

目前心理干预不仅可以用于预防产后抑郁症的发生,有的干预方法也可作为独立的治疗措施而不是药物的辅助治疗.本文介绍关于产后抑郁症的预防和心理干预研究,包括对孕妇和配偶的心理教育、产前教育课程、人际心理治疗、导乐分娩、产后助产士与产妇讨论分娩过程,助产士在妊娠分娩和产褥期全程护理,产后早期家庭随访等.     

心理因素与青春期女性月经异常关系的研究

目的通过对16～18岁在校女生进行心理测试及月经状况的调查,探讨社会心理因素、人格特征对青春期女性月经的影响.方法对2003年1～12月在校高中女生2000人进行随机抽样,抽取200人进行了90项症状自评量表,艾森克性格调查表及月经状况调查表的问卷调查,依月经状况调查表对调查人群进行分组,研究两组人群心理状况间的差异.结果月经病发病组在阳性症状总分、人际关系敏感、焦虑、抑郁和精神病性因子分方面明显高于对照组(P＜0.05).精神质分值、情绪稳定性分值高于对照组(P=0.01,P＜0.01).结论本研究表明,青春期女性在出现月经量过多、经期延长、不规则阴道出血及痛经的同时,心理活动也同样有明显改变,主要表现为焦虑、抑郁、人际关系敏感、性格内向、情绪不稳定等障碍.因此,对青春期月经病患者给予药物治疗的同时,心理治疗也是十分重要的.     

Treatments for late life depression in primary care--a systematic review

BACKGROUND: Depression is common among older people. It is associated with increased mortality and use of health services. We could identify no prior systematic review of treatment for depression in either primary care attenders or population samples of older people. OBJECTIVES: The aim of this study was to carry out a systematic review of trials of treatments for depression of patients over 60 years of age in primary care or population samples. METHODS: We searched Medline, Embase, Cinahl, the Cochrane Library, Psyclit, BIDS--Social Science and BIDS--Science Citation Indices for trials of drug treatment, interpersonal psychotherapy, cognitive behavioural psychotherapy, counselling and social interventions for late life depression in English, French or German published between 1980 and June 1999. RESULTS: Of the studies identified, only two were of patients over 60 years of age and met all inclusion criteria for content and quality. Three further studies that were not restricted to but included patients over the age of 60 years also fulfilled our criteria. We found no studies of psychological therapies for depression in older people. With few exceptions, studies were limited to older people who reached a diagnostic threshold and excluded those with 'subcase level depression'. CONCLUSION: There is little evidence of effectiveness for a variety of treatment approaches for depression in older people in primary care, particularly in those with less severe depression. As older people take more medication, making contra-indications to the use of antidepressant drugs more likely, there is a pressing need for studies of the efficacy of non-pharmacological interventions in primary care settings.     

帕罗西汀联合心理治疗脑卒中后抑郁的临床疗效

目的探讨帕罗西汀联合心理治疗脑卒中后抑郁的治疗效果。方法将106例脑卒中后抑郁患者随机分为治疗组和对照组,对照组给予心理治疗,治疗组给予心理治疗和帕罗西汀治疗。8周后,对两组患者进行HAMD、MESSS、TESS评分,入院后采用汉密尔顿抑郁量表（HAMD）评定抑郁症状;采用放射免疫法测定两组患者血浆Cor含量。结果经过治疗,治疗组的脑卒中后抑郁的显效率为71.7%,神经功能恢复总有效率为90.6%,均显著高于对照组的43.4%和66%（P〈0.05）;治疗后两组的HAMD和MESSS评分均显著下降（P〈0.05）,两组间比较差异有统计学意义（P〈0.05）;TESS评分差异无统计学意义（P〉0.05）。帕罗西汀治疗组血浆Cor含量降低幅度较对照组更明显（P〈0.05）。结论脑卒中后抑郁患者经帕罗西汀联合心理治疗后,抑郁程度明显减轻,生活质量均明显改善,血浆Cor含量降低可能是帕罗西汀治疗脑卒中后抑郁症的一种作用机制。     

心理治疗对忧郁症患者康复的影响

在精神疾病中,忧郁症是一种发病率极高的常见疾病,对患者身心健康、工作和生活影响极大。心理治疗对忧郁症患者的康复有较大作用,本文分析郁忧症症状的表现、心理治疗对忧郁症的治疗方法和作用,找出治疗患者的有效途径,旨在帮助郁忧症患者的快速康复。     

Stepped care treatment of postpartum depression: a primary care-based management model.

BACKGROUND AND PURPOSE: Postpartum depression (PPD), the most prevalent serious postpartum complication, is a devastating illness that negatively impacts not only the mother, but also her infant, other family members, and work performance. There is an extensive body of research addressing systems-based quality improvement efforts for treatment of depression in primary care populations; however, little of this research has been directed toward postpartum populations. This paper presents a health care systems-based quality improvement model for the treatment of PPD derived from research outcomes in general primary care populations. METHODS: OVID/MEDLINE and PsychINFO searches were performed using the following terms: depression, postpartum depression, mass screening, collaborative care, stepped care, psychotherapy, cognitive-behavioral therapy, interpersonal therapy, and education as keywords. MAIN FINDINGS: The PPD management model described herein includes screening and diagnosis, initiation of active treatment, and use of collaborative care, which includes primary care visits, case manager follow-up, and more intensive care, through specialty consultation or referral, for complicated or difficult cases. CONCLUSION: Stepped care, a form of collaborative depression treatment, is proposed as a practical, cost-effective method for improving PPD diagnosis and clinical outcomes.