肾病综合征急性肾炎患儿及家长心理卫生状况初步研究

目的：探讨肾病综合征(NS),急性肾炎(AGN)患儿及家长个性、心理健康状况与疾病的关系,为NS,AGN的心理干预治疗提供理论依据。方法：采用艾森克个性问卷(EPQ)及症状自评量表(SCL-90)对患儿及家长个性心理进行调查。结果：NS患儿P,E量表得分低于正常儿童对照组(P0.05),患儿家长N 和L量表得分高于正常成人对照组(P0.05)。NS患儿SCL-90评定结果,除强迫、精神病性及附加量表外,余如躯体化症状、人际敏感、抑郁、焦虑、敌意、恐惧、偏执得分均明显高于正常儿童对照组(P0.05),而患儿家长SCL-90各项因子得分均高于正常成人对照组(P<0.05)。结论：本研究提示NS患儿具有内向、情绪不稳定的个性倾向,心理上具有明显的焦虑、抑郁、恐惧、躯体化等多方面症状,AGN患儿个性和心理与正常儿童无差异,NS,AGN患儿家长具有内向、神经质个性倾向,心理上亦具有明显的焦虑、抑郁、恐惧、躯体化等症状。     

儿童期躯体情感虐待经历对大学生心理健康的影响

目的：探讨儿童期躯体情感虐待经历对大学生心理健康的影响。方法：对西安1 200名大学生就儿童期躯体情感虐待经历进行儿童虐待史问卷（Bernstein）（修订后）及症状自评量表 (Symptom Check List-90,SCL-90)进行不记名调查。结果：668名学生（55.7%）16岁前曾经历过羞辱、体罚、挨打或限制活动等躯体情感虐待,其中21.0%有过挨打 (包括用器械打)的经历。儿童期有严重躯体情感虐待经历的学生,其躯体症状、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执等症状因子分≥ 1的检出率明显高于无躯体情感虐待经历的学生。结论：中国儿童期羞辱、体罚等躯体情感虐待问题仍较常见,而且儿童期严重躯体情感虐待经历直接会影响到大学生心理健康,应该重视儿童虐待的干预及研究。［中国当代儿科杂志,2009,11（8）：675-678］     

大中专学生儿童期教师体罚经历回顾性调查研究

目的了解大中专学生儿童期被教师体罚经历,探讨教师体罚学生的影响因素及儿童期教师体罚经历与青少年心理问题的关联。方法对河北1所大学和1所中专的528名在校学生就有关儿童期虐待经历进行回顾性不记名自填式问卷调查。结果57．6％（304／528）的学生报告16岁前受到至少1次下列5项中的1项来自学校教师的体罚：非身体接触体罚53．4％（282／528）、徒手打16．1％（85／528）、用物品打10．2％（54／528）、限制活动0．2％（1／528）,没有学生报告教师曾使其窒息／烧烫／刺伤。与没有教师体罚经历的学生相比,儿童期有2项或2项以上教师体罚经历的学生其SCL-90量表中躯体症状、强迫症状、人际关系敏感、抑郁、焦虑、敌对、偏执、精神病性症状等因子均分和总均分均明显偏高;在过去1年里出现严重忧郁情绪、饮酒醉过、参与或卷入打架斗殴的比例以及目前吸烟等的发生率偏高。结论儿童被教师体罚现象较普遍。儿童期教师体罚经历与青少年心理问题显著相关。急需提高公众对儿童权利的意识,学校要为儿童营造一个友好的学习环境。     

儿童急性白血病长期持续化疗后智力与心理行为的调查分析

目的了解儿童急性白血病长期持续化疗对智力与心理行为的影响。方法27例急性白血病患儿,经长期化疗,已获得3年以上生存。27例均进行智商测定选用儿童联合型瑞文测试(CRT);心理行为测定:13例12岁以上患儿采用90项自觉症状自评量表(SCL-90),14例12岁以下患儿采用心理健康诊断测试(MHT)。所得结果与我国常模相比较。结果27例患儿平均智商为107,与正常儿童相比较,无显著的统计学差异(P>0·05);13例患儿SCL-90量表总均分为1·58,各因子分均值在1·39~1·79之间,其中人际关系、强迫症状,敌对、偏执得分最高;14例心理健康诊断测试(MHT)无一例患儿全量表标准分≥65,说明白血病患儿总体焦虑程度不高。学习焦虑达(85·71%),说明学习焦虑程度较高。其次是自责倾向(21·43%)、过敏倾向(21·43%)、孤独倾向(7·14%)、身体症状(7·14%)。结论儿童急性白血病长期持续化疗对智力无明显影响,但存在一定程度的心理行为的影响,尤其在人际关系、学习焦虑方面,提示我们需要加强白血病患儿的心理支持。     

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目的探讨支气管哮喘患儿行为特征及其母亲心理健康状况,为临床治疗及早期干预提供依据。方法以2007年10月至2009年2月长治医学院附属和济医院、附属和平医院确诊的4～12岁支气管哮喘患儿96例为支气管哮喘组,采用Achenbach儿童行为评定量表(CBCL)对支气管哮喘组及96名正常儿童(对照组)进行评估。采用症状自评量表(SCL-90)对所有研究对象的母亲进行评估。结果支气管哮喘组患儿社会能力低于对照组,行为问题总检出率为38.5%,明显高于对照组(15.7%),差异有统计学意义(P<0.005);在躯体主诉、抑郁、焦虑、内向性行为、社交退缩、违纪等方面得分高于对照组,差异均有统计学意义(P<0.05)。支气管哮喘组患儿母亲在焦虑、抑郁、敌对、恐怖、精神病性等方面得分均高于对照组儿童母亲,差异有统计学意义(P<0.05)。结论支气管哮喘患儿较正常儿童表现出更多的行为问题,且支气管哮喘患儿母亲较正常儿童的母亲更易出现一些心理问题,故在对支气管哮喘患儿进行规范的药物治疗基础上,应配合适当的心理行为干预。     

癫患儿父母心理健康状况调查分析

目的调查了解癫患儿父母心理健康状况.方法采用临床症状自评量表(SCL-90)对一组癫患儿父母的心理状态进行评定,在父母间进行比较,并与对照组、全国常模进行比较.结果癫患儿父母SCL-90总分以焦虑、抑郁、躯体化、恐怖4个因子分值明显高于常模及对照组(P＜0.01),人际敏感、敌对2个因子分值明显低于全国常模及对照组(P＜0.01),母亲组焦虑、抑郁、躯体化、恐怖因子分值明显高于父亲组(P＜0.01),提示癫患儿父母存在不良的心理状态,母亲尤为严重,临床医生在治疗癫患儿时应重视其家长尤其是母亲心理的帮助与支持.     

应用 SCL－90量表评估骨折患儿父母心理状况的调查研究

目的了解骨折患儿父母心理状况，为临床心理干预提供依据。方法采用症状自评量表（SCL—90）和一般资料问卷，对100例骨折患儿父母心理状况进行调查研究。结果患儿父母的症状自评量表中“躯体化”、“强迫症状”、“人际关系敏感”、“抑郁”、“焦虑”、“敌对”、“恐怖”、“偏执”和“精神病性”自评得分与常模比较有统计学意义（P ＜0．05）。其中“教育程度”、“长期居住地”等因素的不同对患儿父母心理状况产生影响。结论医护人员应综合各相关因素，对此类人群的心理状态予以重视，并给予个性化的护理干预。     

哮喘儿童及家长心理健康状况调查

目的 了解哮喘儿童及其家长的心理健康状况.方法 采用艾森克人格问卷(儿童)、Rutter's儿童行为量表(父母问卷)对36例6～14岁哮喘儿童进行个性、行为心理测试.采用90项症状自评量表(SCL-90)对其家长进行心理卫生状况调查.结果 哮喘儿童E、N值均高于正常对照组(P<0.05),行为问题发生率为33.3%,哮喘家长SCL-90各项因子分均高于对照组,以抑郁、焦虑、躯体诉述及恐怖因子得分最明显(P<0.05).结论 哮喘儿童及家长的心理问题均较健康对照人群高,应引起高度重视,积极进行心理干预.     

阿立哌唑治疗儿童孤独症的临床观察

目的：研究阿立哌唑治疗儿童孤独症的临床疗效和安全性。方法：用阿立哌唑对35例4~16岁合并有行为问题的孤独症儿童进行治疗,疗程8周,在治疗前和治疗后2、4、8周采用临床疗效总评量表（CGI）和孤独症治疗评估量表（ATEC）评分,并观察不良反应。结果：治疗第2周末CGI中的病情严重程度评分开始下降（P<0.05）,治疗第8周末下降更加显著（P<0.01）,疗效评分则于第8周末有显著性提高（P<0.05）。ATEC总分于治疗第8周末明显低于治疗前（P<0.01）,各项目分中,语言、感知、行为评分较治疗前均有明显下降（P<0.01）,社交评分于治疗前后无明显变化。对自伤自残行为、睡眠障碍、精神病性症状显著改善,对注意缺陷及多动、冲动攻击行为、刻板行为、易激惹也有一定效果。未见严重不良反应。结论：阿立哌唑治疗儿童孤独症有效安全。     

地中海贫血患儿父母心理社会状况调查

目的：了解地中海贫血患儿父母心理社会健康状况。方法：采用晤谈方式,结合自编“地中海贫血患儿父母调查问卷表”和“临床症状自评量表(SCL-90)”对3组地中海贫血患儿父母212例,其中轻型贫血组46对父母,92人;中间型贫血组35对父母,70人;重型贫血组25对父母,50人。进行调查,并将其SCL-90的评定结果与健康儿童父母对照组比较。结果：132例(62.3%)缺乏本病基本知识,对贫血现象存在许多误解;189例(89.2%)担心患病子女的生长发育受影响,甚至会过早夭折;176例(83.0%)对子女患病表示内疚、自责;126例(59.4%)不愿公开病情,害怕受到社会歧视;重型贫血组30例(60.0%)父母工作深受影响,48例(96.0%)缺乏足够经济支持,治疗信心不足。与对照组比较,SCL-90总均分及焦虑和抑郁两因子分值在3组中均明显升高(P<0.05);另外,在重型组除偏执和精神病症因子外,大部分因子分值升高,其中以总均分及躯体化、强迫症状、人际关系、敌对、恐怖等因子明显高于另外两组(P<0.05)。结论：地中海贫血患儿父母存在广泛的心理社会健康问题。     

Combined effect of mothers' and fathers' mental health symptoms on children's behavioral and emotional well-being

BACKGROUND: Few studies have examined the effects on children of maternal mental health symptoms other than depressive symptoms or have examined the joint effects of mothers' and fathers' mental health symptoms. OBJECTIVE: To examine whether the father's mental health symptoms may modify the association between the mother's mental health and the child's behavioral and emotional health. METHODS: Cross-sectional data from a national longitudinal survey of families provided information on 822 children aged 3 to 12 years who were living with both parents. The main child outcomes were the Behavior Problems Index-Externalizing (BPI-EXT) and-Internalizing (BPI-INT) subscales. The mother's and father's mental health were each assessed by self-report using the K10, a new, validated 10-item screen for serious mental illness, including mood or anxiety disorder. Parents with scores in the upper quartile were considered to be in poorer mental health and those with scores in the other 3 quartiles were considered to be in better mental health. RESULTS: Adjusted for covariates, having both parents in poorer mental health was associated with a 1-SD increase in the children's BPI-EXT scores (beta coefficient, 5.2; SE, 0.9; P<.001) compared with neither parent reporting poorer mental health. This effect was substantially weakened if the mother was in poorer mental health but the father was not (beta coefficient, 1.8; SE, 0.5; P<.01). There was no statistically significant effect if only the father was in poorer mental health (beta coefficient, 0.1; SE, 0.6; P =.88). The risk of a child having a high BPI-EXT score (>or=90th percentile for the cohort) was elevated if both parents reported poorer mental health (odds ratio, 9.2; 95% confidence interval [CI], 4.8-17.8), but was less elevated if only the mother reported poorer mental health (odds ratio, 2.3; 95% CI, 1.1-4.9), and was not elevated if only the father reported poorer mental health (odds ratio, 0.6; 95% CI, 0.2-1.9). Similar patterns emerged for children's BPI-INT scores. CONCLUSIONS: A father in better mental health may buffer the influence of a mother's poorer mental health on a child's behavioral and emotional problems, and these problems seem to be most severe for children who have 2 parents with poorer mental health. The form and intensity of pediatric approaches to mothers with poorer mental health may need to consider the mental health of fathers.     

The Quality of Life and Psychological Status of Mothers of Hospitalized Pediatric Oncology Patients

This study compares the quality of life (QoL) and psychological status of mothers of children with cancer with those of mothers of children without cancer. One hundred hospitalized children and their mothers, as primary caregivers, were included in this study. Fifty mothers with healthy children were enrolled as the control group. A children and mother query form was used to obtain demographical data. The disease histories were extracted from patient records. QoL was measured with the Medical Outcomes Study 36-item Short Form Survey (SF-36) and the State-Trait Anxiety Inventory (STAI) in order to assess the psychological symptoms of the mothers in the study and in the control groups. The mean age of the caregivers was 35.93 ± 8.27 years, whereas the mean age of the mothers in the control group was 39.72 ± 6.88 years. The general health, vitality, social functioning, and mental health scores from the SF-36 and the STAI-trait scores were significantly poorer among the mothers of children with cancer as compared with the scores of the mothers of children without cancer (P < .05). Significant negative correlations were found between the age of the children, the age at diagnosis, and the SF-36 subscores for physical functioning, physical role, and pain (P < .05). The mothers of children with cancer, who require hospital care, have poorer QoL and psychological health than the mothers of healthy children. These results suggest that the current system for treating cancer in Turkish children should also include close monitoring of the care-giving mothers’ QoL and psychological health.     

儿童品行障碍心理与家庭综合治疗的疗效观察

目的探讨儿童品行障碍(CD)的心理卫生状况及其心理社会综合干预的临床疗效。方法将符合CCMD3诊断标准的40例CD患儿进行焦点解决短期治疗和家庭治疗的综合干预,疗程为3月,用症状自评量表(SCL90)和CD症状量表评估其心理卫生状况和临床疗效。结果临床治疗显效率和总有效率分别为67.5%(27例)和90.0%(36例)。治疗前CD患儿的SCL90评分与国内常模比较,除躯体化(S)、精神病性(P)及偏执(Pa)因子无显著差异外,其SCL90总分及强迫(Oc)、人际敏感(Is)、抑郁(D)、焦虑(A)、敌对(H)、恐怖(Ph)因子分均明显高于常模值(P<0.05或P<0.01);而治疗后上述计分均较治疗前显著降低(P<0.05或P<0.01)。结论焦点解决短期治疗结合家庭治疗能显著改善儿童强迫、抑郁、焦虑、敌对及恐惧等不良情绪,有效治疗品行障碍。     

Influence of smoke exposure on serum IgE levels of atopic patients

The effect of environmental tobacco smoke on serum total immunogobulin E (IgE) of respiratory allergic patients was evaluated in this study. A total of 558 patients with respiratory allergies (311 boys and 248 girls) aged between 1 and 17 years (mean 6.92 ± 3.81 years) were included. None of the subjects were active smokers. IgE levels were significantly higher in children with smoking parents compared with non-smokers (P < 0.05). Children with smoking mothers were found to have higher levels of IgE than children with smoking fathers. The highest level of IgE was found in children when both parents were smokers (P < 0.005).     

Impact of childhood cancer on the mental health of parents

BACKGROUND: When a child is diagnosed with cancer, the family experiences great stress and disruption to daily life. As part of a national study in New Zealand, we evaluated the mental health of mothers and fathers of children with cancer, making comparisons to parents of children from the general population. PROCEDURE: This was a cross-sectional study. All children diagnosed with cancer at ages 0-14 years in New Zealand during a defined period were ascertained from the national cancer registry and other databases. The population-based comparison children were selected using national birth records. Parents from both groups completed self-administered questionnaires containing the General Health Questionnaire (GHQ-12) and other measures. The analyses included 218 mothers and 179 fathers of children with cancer, and 266 mothers and 224 fathers of children in the comparison group. Multivariate regression was used to adjust for demographic and socioeconomic characteristics, life events, and social support. RESULTS: Mothers and fathers of children with cancer had poorer GHQ-12 and mood rating scores than those of controls. The adjusted difference in the mean total GHQ-12 score (comparing mothers of children with cancer to mothers of controls) was 2.2 (95% confidence interval 1.3-3.2). The 12 items of the GHQ were each scored 0-3, and the total score was the sum, so 2 points is a small difference. For fathers the difference was 1.5 (95% confidence interval 0.6-2.4). Some subgroups of cancer group parents had poorer emotional health scores than others, including those with poor social support and no paid employment and also those who were bereaved. CONCLUSIONS: We found statistically significant but small differences between the mental health of parents of children with cancer and controls. The small differences suggest that as a group the parents of children with cancer are relatively resilient.     

A prospective study of the psychological adjustment of parents and families of children with cancer

This study compared the psychological adjustment of parents and families of children with cancer, with the adjustment of parents and families in the community. In the weeks after their children's diagnoses, the mothers of children with cancer reported significantly more anxiety and insomnia, somatic symptoms and social dysfunction than mothers in the community. These problems had declined by the time of a 1 year follow-up assessment However, at the follow-up assessment the mothers of children with cancer reported significantly more symptoms of depression and somatic symptoms than mothers in the community. A similar pattern of findings was evident among the fathers although the fathers generally reported less distress than was reported by the mothers. The results also suggest that a year after the children's diagnoses, the families in which there was a child with cancer were functioning less effectively than the families in the community.     

Parental information needs in chronic renal failure and diabetes mellitus

The information needs of parents of children with end stage renal failure (ESRF) or with insulin dependent diabetes mellitus (IDDM) were assessed by questionnaires over a 2-year period. Questionnaires were posted on seven occasions at 4-monthly intervals and were sent to both mothers and fathers. Most information needs were reported to be for detailed test results, for new information about the condition and about the child's future social development. Questions responsible for the three highest scores were concerned with the future: the child's fertility; their social, career and marriage prospects; and the hope for a new improved treatment. For the IDDM mothers, scores were significantly different depending on age of the child (P=0.02). Change in treatment mode had no significant effect on the information needs of parents of children with ESRF (P=0.81). Occupation was significantly associated with the mean general information needs scores for parents, with occupations of a lower socioeconomic status associated with higher information needs scores. There were no significant differences between the reported mean general information needs scores of parents of children with ESRF and of parents of children with IDDM (P=0.69) or between mothers and fathers mean general information needs scores (P=0.58). Conclusion Multidisciplinary team members need to tailor information to the needs of the individual families and be sensitive to socioeconomic factors and communication issues. Received: 3 April 2000 / Accepted: 26 July 2000