易被忽视的抑郁症

隐匿性抑郁症是指有明显的躯体疾病症状的抑郁症．而且由于躯体疾病症状十分明显．使得患者往往只注意到躯体症状而忽略了情绪问题，以至在求治时只诉说躯体症状而不提及情绪症状．就好像躯体症状掩盖了抑郁情绪或抑郁情绪被隐匿了一样，造成误诊。     

表现另类的抑郁症

隐匿性抑郁症 隐匿性抑郁症是指情绪低落和抑郁症状并不明显,往往以躯体不适为主诉的抑郁症。患者有明显的躯体症状,而且由于躯体症状十分明显,使得患者往往只注意到躯体症状而忽略了情绪问题,以致在求治时只诉说躯体症状而不提及情绪症状,     

老人抑郁别当是感冒

老年抑郁症早期症状通常跟感冒症状很相似,不容易被重视起来,所以很多情况下被人忽略,耽误治疗,所以一定要警惕。老年抑郁多是一种"焦虑+抑郁"的混合状态,同时伴有较多的躯体症状。     

大学生隐匿性抑郁症的诊断和治疗体会

隐匿性抑郁症又称抑郁等位症 ,是抑郁症的一种不典型类别 ,临床表现主要为反复、持续出现的各种躯体不适和植物神经症状 ,抑郁情绪往往被各种躯体症状所掩盖〔1〕。患者往往因躯体不适的某一症状 ,反复、多次求助内科医师 ,但他们常不被诊断为抑郁症。而按内科疾病长期治疗无效 ,有的已严重影响学业。为引起对此类疾病的重视 ,笔者将近年来诊治的大学生中以躯体症状为主要表现的隐匿性抑郁症的临床资料进行整理 ,报道如下。1　一般资料1998～ 2 0 0 0年在神经内科门诊就诊的病人 32例 ,其中男性 2 8例 ,女性 4例 ,年龄 2 0～ 2 7岁 ,平均 2 …     

抑郁症的躯体症状有哪些？

抑郁症在我们日常生活中是一种较为常见的心理疾病,该疾病不仅会让病人产生焦虑、自卑以及过度烦躁等负性心理,同时也会表现在病人的身体等多个方面。基于此,若我们对抑郁症的躯体症状缺乏正确的了解与充分的重视,这就会在一定程度上耽误抑郁症心理疾病的早期治疗。为此,本文章主要叙述了抑郁症病人几种较为常见的躯体症状。     

神经性抑郁症和重型抑郁症的症状聚类和判别分析

为了比较神经性抑郁症和重型抑郁症的临床症状学差异，采用判别分析和聚类分析对30例神经性抑郁症和28例重型抑郁症的症状学进行研究。结果发现，仅根据症状学并不能判别神经性抑郁症和重型抑郁症：聚类分析提示，神经性抑郁症主要以焦虑、躯体不适、睡眠障碍、能力减退感为主要症状群，而重型抑郁症以阻滞、认知障碍、精神病性症状为主要症状群。     

老年期抑郁症与非老年期抑郁症临床对照分析

目的探讨老年期抑郁症的临床特点。方法对本院住院的首次发病于老年期的58例单相抑郁症患者，并与同期住院60例非老年单相抑郁患者进行对照分析。采用HAMD量表评定。结果老年期抑郁症患者，女性多于男性，病前有明显诱因，躯体不适、焦虑激越多见，精神运动迟滞，生物节律症状改变少见，阳性家族史少，治疗预后差。结论老年期抑郁症症状不够典型，有其独特的临床特点。     

普通内科门诊对抑郁症误诊的原因分析

目的分析对抑郁症误诊的原因，减少误诊率。方法对47例被诊断为抑郁症的患者进行后期调查，并用相关的诊断方法及统计方法对其行为进行评分。结果确认有30例被误诊。核对其门诊资料，发现所有患者都有抑郁症临床症状，但是30名患者均被诊断为心脏病，肠胃病，精神紊乱或其他病因。结论抑郁症的临床表现和很多躯体疾病的表现相似，也呈一定程度的影响关系，因此必须通过提高医生对抑郁症的认识，有计划的调整医院门诊模式，加强对抑郁症的宣传，提高社会对抑郁症的认识。这样可以有效降低抑郁症的误诊率。     

抑郁症躯体症状及其相关因素的研究分析

近年来许多研究已证明抑郁症是高患病率、高慢性发病率、高疾病负担及高自杀死亡率频繁的精神疾病.,但过去常局限于精神病学范畴,习惯强调病人症状,即"三低"症状--情感低落.思维迟缓和意志活动减退,然而,相当一部分的抑郁症病人就诊的主诉并非情感或精神症状,而是躯体方面的症状,对这样的病人近半数以上将会被临床医生漏诊.近年来,我国很多学者提出中国抑郁症状诊断率较国外低的假设之一是躯体症状主诉高于心境障碍的主诉.为比较以情感障碍为主诉的和以躯体不适为主诉的抑郁病人的差异,笔者对62例病人进行了深入访谈评定,以期为临床医生对抑郁症的早期识别及治疗提供帮助.     

2型糖尿病患者伴发抑郁症的认识

2型糖尿病是慢性进行性疾病，随着生物-心理-社会医学模式逐渐被人们接受，心理社会因素与躯体疾病的关系日益被重视，而抑郁症与2型糖尿病的相互影响也逐渐被认识。美国一项历时13年的纵向研究结果证实，重度心理压抑与2型糖尿病有显著性关联，同时也发现，1型和2型糖尿病相关的神经和精神改变都与抑郁症的复发率高、病程长、症状严重等有关。     

农村生源地大学生心理健康状况调查

目的了解农村地区大学生主要存在的心理健康问题,为今后农村地区大学生的心理健康教育工作提供参考。方法运用症状自评量表(SCL-90)对山西医科大学2006级全体新生1 214人进行心理测查,比较城乡大学生心理健康状况。结果在强迫、焦虑、抑郁、人际敏感、偏执各项因子得分上,农村地区大学生普遍高于城市大学生(P<0.05);在抑郁、恐怖、人际敏感、精神病性各因子得高分人数比例上,农村最多,乡镇次之,大中城市最少(P<0.01);农村男大学生躯体症状得分(1.43±0.40)高于女大学生(1.36±0.34);恐怖得分(1.40±0.41)明显低于女大学生(1.56±0.48);农村独生子女大学生躯体(1.62±0.39)、强迫(1.70±0.36)因子得分明显低于非独生子女(P<0.01)。结论农村地区大学生心理健康水平普遍偏低,存在较多心理健康问题。     

Biological risk factors for late life depression

Depression in late life is a recognised public health problem. After establishing socio-demographic and psychological risk factors for depression, epidemiological research has focused on biological factors. This review summarises the evidence on the associations of cerebrovascular pathology, inflammation, and endocrine and nutritional status with depression in the elderly. The most consistent finding in biological psychiatry is the disturbance of the hypothalamic–pituary–adrenal axis in depressed persons. About half of the patients with severe depression have a disturbed glucocorticoid feedback mechanism and many exhibit hypercortisolism. Longitudinal studies show that this endocrine dysfunction increases the risk of relapse. More recently, silent brain infarcts and cerebral white matter lesions on MRI were found to be more frequent in the depressed elderly than in controls. Cerebral small vessel disease has been rediscovered as a potential cause of depression. Furthermore, there is evidence of immune activation in depressed persons. However, it remains unclear as to whether inflammation contributes to the pathological process as longitudinal studies are lacking. Clinical studies have also related many nutrients to psychological symptoms, but the evidence in elderly persons is consistent only for some vitamin deficiencies. In conclusion, despite a substantial body of literature on biological correlates of late life depression, little is known about causal relations. Prospective population-based studies are warranted.     

Weight concerns in individuals with body dysmorphic disorder

OBJECTIVE: To determine the prevalence of weight concerns in individuals with BDD, and to examine similarities and differences between those with and those without weight concerns. METHOD: We assessed 200 participants with BDD for clinically significant weight concerns and compared those with weight concerns (in addition to other body area concerns) to those without weight concerns on measures of BDD symptoms, other symptom severity, comorbidity, suicidality, functioning, and quality of life. RESULTS: 58 (29.0%) participants had weight concerns. Participants with weight concerns were younger, more likely to be female, and had more body areas of concern; a higher frequency of certain BDD behaviors, suicide attempts, and comorbidity; greater body image disturbance and depression; and poorer social functioning. The two groups were similar on other measures. DISCUSSION: Weight concerns in BDD deserve further study, as they appear relatively common and are associated with greater symptom severity and psychopathology in several domains.     

中老年人抑郁症状及其相关因素分析

目的研究社区中老年人抑郁症状现况及其与家庭功能等因素之间的关系，为社区中老年人抑郁的防治提供依据。方法整群抽取某社区55岁及以上的304名中老年人为调查对象，分别采用Zung抑郁自评量表（SDS）和家庭关怀度指数测评量表（APGAR问卷）评价其抑郁症状和家庭功能。结果社区中老年人抑郁症状检出率为21．4％，按家庭功能、生活赡养方式、年龄、是否慢性病患病情况、有无配偶等因素进行分组，发现中老年人SDS平均得分及抑郁症状检出率组间差异有统计学意义；单因素和多因素Logistic回归分析也显示，上述因素与社区中老年人抑郁症状有关。结论针对上述因素采取改善家庭功能、加强自立能力、防治慢性病等措施有利于社区中老年人抑郁的防治。     

A Pilot Evaluation of Associations Between Displayed Depression References on Facebook and Self-reported Depression Using a Clinical Scale

The objective of this study was to determine associations between displayed depression symptoms on Facebook and self-reported depression symptoms using a clinical screen. Public Facebook profiles of undergraduates from two universities were examined for displayed depression references. Profiles were categorized as depression symptom displayers or non-displayers. Participants completed an online PHQ-9 depression scale. Analyses examined associations between PHQ-9 score and depression symptom displayers versus non-displayers. The mean PHQ-9 score for non-displayers was 4.7 (SD?=?4.0), the mean PHQ-9 score for depression symptom displayers was 6.4 (SD?=?5.1; p?=?0.018). A trend approaching significance was noted that participants who scored into a depression category by their PHQ-9 score were more likely to display depression symptom references. Displayed references to depression symptoms were associated with self-reported depression symptoms.     

中国中老年人抑郁症状现状及影响因素分析

目的 了解中国中老年人抑郁症状现状及其影响因素,为改善中老年人抑郁发生状况提供政策依据。方法 采用中国健康与养老追踪调查2013年数据,利用流调中心抑郁水平评定量表测评中老年人抑郁症状,运用二分类logistic模型、多元线性回归模型进行影响因素分析。结果 我国中老年人31.2%（4 815/15 421）存在抑郁症状,中老年人抑郁量表评分为（7.83±5.78）分。各省份中老年人抑郁症状检出率差异有统计学意义（P<0.001）,北京最低为4.3%（3/69）,青海最高为56.8%（88/155）。多因素回归结果显示,女性、无配偶同居、文化程度较低、农村户口、西部地区、非党员、参与社会活动少、吸烟、不喝酒、慢性病数目多、IADL受损的中老年人抑郁量表评分高,有抑郁症状的几率高（均P<0.05）;随着年龄升高,抑郁状况先加重后减轻,分性别进行回归分析发现,女性有抑郁症状的几率在55.5岁达到高峰,男性在47.9岁达到高峰,女性的抑郁量表评分在57.9岁达到高峰,男性在55.4岁达到高峰。结论 我国中老年人抑郁症状检出率较高,应对高危人群采取针对性预防和干预措施,促进中老年人心理健康公平、均衡发展。     

Cigarette smoking and adherence to antihypertensive medication in patients from primary care

Abstract

Background: There are no great differences in the symptom profiles of depression between the genders in observer rating scales, but women self-report more symptoms. Objective: To compare gender differences in symptom profiles of clinical depression in primary care with a short self-report depression scale and an observer-rated scale for social functioning. Methods: A sample of 436 primary care patients aged 18–64 years were screened using the Depression Scale (DEPS) and interviewed using the Present State Examination (PSE). Level of social functioning was also assessed. Sum scores and single items of DEPS were compared between men and women in the groups of both depressive and non-depressive patients, and the interactions between gender and depression were analysed. Results: Depressive men scored poorer on both instruments. Feeling that everything is an effort and feeling worthless were typical for depressive men. Feeling blue was more typical for non-depressive women than for non-depressive men.

Conclusion: In this sample of primary care patients, there were differences in the symptom profiles of depression between men and women. Depressive men more commonly had serious symptoms than depressive women. Clinically, male depression deserves more attention. The psychosocial profile of public primary care patients in Finland warrants further research.     

Geschlechtsspezifische Aspekte bei depressiven Erkrankungen

Depression is one of the most prevalent and debilitating diseases. In recent years there has been increased awareness of sex- and gender-specific issues in depression. This narrative review presents and discusses differences in prevalence, symptom profile, age at onset and course, comorbidity, biological and psychosocial factors, the impact of sexual stereotyping, help-seeking, emotion regulation and doctor–patient communication. Typically, women are diagnosed with depression twice as often as men, and their disease follows a more chronic course. Comorbid anxiety is more prevalent in women, whereas comorbid alcohol abuse is a major concern in men. Sucide rates for men are between three and five times higher compared with women. Although there are different symptom profiles in men and women, it is difficult to define a gender-specific symptom profile. Socially mediated gender roles have a significant impact on psychosocial factors associated with risk, sickness behavior and coping strategies. In general, too little attention has been paid to the definition and handling of depression and the gender-related requirements it makes on the healthcare system.     

围生期抑郁和焦虑症状关联及方向的纵向研究

目的 利用重复测量资料探讨围生期抑郁和焦虑症状的纵向关联及方向。方法 2019年5—9月在马鞍山市妇幼保健院纳入孕早期妇女,分别在孕中、晚期及产后一年内对其进行抑郁、焦虑症状随访评估。对围生期抑郁、焦虑症状进行单因素分析后,在自回归交叉滞后模型中调整单因素分析有统计学意义的因素进行路径分析以阐明围生期抑郁和焦虑症状的关联及可能的预测方向。结果 1 094名妇女纳入分析,围生期抑郁、焦虑症状及其共患的检出率分别为27.3%、44.3%和23.5%。路径分析结果显示,同一时期的抑郁和焦虑症状均存在正相关（相关系数r分别为0.705、0.636、0.547、0.665,P＜0.001）;围生期抑郁、焦虑症状的自回归路径均有统计学意义（回归系数b抑郁分别为0.315、0.462、0.373,b焦虑分别为0.473、0.567、0.589,P＜0.001）;在整个围生期均观察到前一时期焦虑症状与后一时期抑郁症状的正向关联（b分别为0.155、0.234、0.271,P＜0.001）,而只在孕中期抑郁症状对孕晚期焦虑症状中观察到正向关联（b = 0.120,P＜0.05）。敏感性分析显示路径分析结果具有稳健性。结论 围生期抑郁和焦虑症状存在共患,且焦虑症状对随后的抑郁症状有稳定正向预测作用。     

深圳市医师心理健康状况的分析

[目的]了解医师的心理健康状况,以便有针对性地开展心理健康工作。[方法]采用症状自评量表（SCL-90）对深圳市的医师358名进行测试。[结果]医师除人际关系、恐怖因子外,SCL-90总均分及其余各因子分均明显高于常模;女性医师总均分、躯体化、人际关系、抑郁和焦虑因子分高于男性医师;不同年龄医师间总均分、躯体化、强迫、抑郁、焦虑和偏执等因子分差异显著,其中总均分、躯体化、强迫、抑郁和偏执等因子分呈现随年龄增大而增高的趋势;焦虑因子分呈现随年龄增大而减小的趋势;50.6%的医师可能有心理健康问题,医师SCL-90因子分达轻度水平以上的前3位因子,男性为强迫、人际关系敏感和精神病性,女性为抑郁、强迫和人际关系敏感。[结论]医师存在一定的心理健康问题,有必要针对性地对医师开展心理健康促进工作。