广泛性焦虑障碍的个性心理特征

广泛性焦虑障碍是精神科的常见病,国内外不少研究发现个性心理特征与广泛性焦虑障碍关系密切[1~3],但对其作用机制仍有不同意见[1,3],这可能与评估工具不同有关[1,3]。本研究拟选用国内编制的评定工具评定广泛性焦虑障碍心理特征,并对其作用机制加以探讨。1资料与方法1.1研究对象:为来自2005年6月至2006年3月河南省心理咨询中心及临床心理科的患者。入组标准:①符合美国精神障碍诊断与统计手册第4版(DSM-IV)广泛性焦虑障碍的诊断标准。②贝克焦虑自评量表(BAI)粗分≥45分,汉密尔顿焦虑量表(HAMA)得分≥21分。③年龄在18~60岁之间,汉族…     

焦虑障碍患者焦虑素质及临床特征相关性研究

正焦虑谱系障碍包括广泛性焦虑、惊恐障碍、强迫症、恐惧症等多种疾病,因其发病率高,疾病负担重~([1-2]),近年来日益受到重视。国内目前对焦虑素质与焦虑障碍的关系、临床特征、预后及其影响因素的研究较少。焦虑障碍与个性因素关系密切,而其中焦虑素质与焦虑症状最受关注。焦虑素质是相信与焦虑有关的感觉对自身的生理、心理和社会评价有危害,从而产生的对焦虑症状的害怕和担心,是反映个体对自身发生焦虑的恐惧程度的一个相对稳定     

焦虑障碍儿童的性别、年龄与焦虑症状的关系

目的:研究焦虑障碍儿童的性别和年龄与焦虑症状的关系,了解儿童焦虑症状的性别、年龄特征. 方法:对4 500名6～15岁儿童使用长处和困难问卷、儿童和青少年发育和正常状况评定量表进行筛查和诊断,查出焦虑障碍儿童158例,对焦虑障碍儿童按年龄分组,并进行儿童焦虑障碍自评量表的测量,运用多因素方差分析对性别和年龄与自评量表得分之间的关系进行分析. 结果:方差分析结果显示,性别主效应显著,不同性别间广泛性焦虑(F=4.449,P=0.037)和社交焦虑维度(F =-3.880,P =0.050)差异有统计学意义,女童得分高于男童;不同年龄间在分离焦虑维度上(F=3.911,P=0.010)差异有统计学意义,得分随年龄增加而降低.交互作用分析结果显示,性别和年龄对焦虑症状的影响没有交互作用. 结论:焦虑障碍儿童的焦虑症状存在性别与年龄差异.     

焦虑障碍、抑郁障碍患者的睡眠质量及与焦虑、抑郁症状的相关性

目的 探讨焦虑障碍、抑郁障碍患者的睡眠质量及与焦虑、抑郁症状的相关性.方法 选取2020年8月至2021年8月在深圳市康宁医院焦虑障碍科住院治疗的70例广泛性焦虑障碍、惊恐障碍、抑郁障碍患者,其中抑郁障碍组33例,焦虑障碍组37例.比较两组的汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数...     

焦虑障碍患者焦虑敏感与特质焦虑的相关研究

目的:探讨焦虑障碍患者焦虑敏感与特质焦虑、临床特征的相关性。方法:68例焦虑障碍患者(焦虑组)根据汉密尔顿焦虑量表(HAMA)评分≥7分为分界值,分为焦虑未缓解组43例和缓解组25例,进行焦虑敏感测定量表(ASI-R)及状态-特质焦虑问卷中特质焦虑量表部份(T-AI)的评定;ASI-R评分结果与70名正常对照(正常对照组)进行比较,分析ASI-R评分与T-AI总分及临床特征的相关性。结果:焦虑组ASI-R总分、对躯体感觉的焦虑因子分、对躯体感觉的恐惧因子分、对认知失控焦虑恐惧因子分、对社会后果焦虑恐惧因子分均高于正常对照组(t分别=8.51,9.00,8.15,8.74,3.24;P均<0.01)。焦虑缓解组ASI-R总分、及对躯体感觉的焦虑因子分、对躯体感觉的恐惧因子分、对认知失控焦虑恐惧因子分均高于正常对照组(t分别=4.41,3.37,4.24,3.76;P均<0.01);未缓解组ASI-R总分及各因子分高于缓解组(t分别=3.30,3.41,2.61,2.78,2.14;P<0.05或P<0.01)。经相关分析,ASI-R总分、及躯体感觉的焦虑因子分、对认知失控的焦虑恐惧因子分与T-AI总分显著相关(r分别=0.33,0.28,0.40;P<0.05或P<0.01);ASI-R总分、对认知失控焦虑恐惧因子分、对社会后果焦虑恐惧因子分与病程显著相关(r分别=0.27,0.26,0.31;P均<0.05)。结论:焦虑障碍患者的焦虑敏感程度高于正常人群;焦虑敏感水平部分与焦虑特质有关。     

抑郁障碍患者与焦虑障碍患者的个性测定比较

目的 探讨抑郁障碍患者与焦虑障碍患者的个性特征差异。方法 使用本土化的人格测量工具《中国人个性测量表2》（CPAI-2）对抑郁障碍患者和焦虑障碍患者进行调查。结果 在一般性格特征上两类人群在新颖性（t=2．39,P〈0．05）、多元思考（t=3．01,P〈0．01）、理智-情感（t=3．09,P〈0．01）、阿Q精神（t=2．26,P〈0．05）、老实-圆滑（t=-1．98,P〈0．05）、人际触觉（t=2．57,P〈0．05）等六个方面存在显著差异,在病态性格特征上两类人群在焦虑紧张（t=2．15,P〈0．05）、抑郁（t=-2．48,P〈0．01）、病态依赖（t=-2．34,P〈0．05）、兴奋性（t=2．42,P〈0．05）等四个方面存在显著差异。结论 抑郁障碍患者和焦虑障碍患者的个性特征存在有共性和个性。     

焦虑障碍的核心特征与治疗

焦虑障碍的代表疾病主要包括广泛性焦虑障碍、惊恐障碍、场所恐怖症、社交焦虑障碍(社交恐怖症)等,该组障碍的共同特征是过度害怕和焦虑的心境,以及相关的行为紊乱。广泛性焦虑障碍表现为对多种主题、事件或任务感到严重的焦虑与担心。惊恐障碍是指在没有预警的情况下反复出现惊恐发作并担心再次发作。场所恐怖症是指个体对某些场合的强烈恐惧、焦虑与回避,患者常担心无法逃离、得不到帮助或健康受到威胁。社交焦虑障碍表现为回避社交环境,过分担心他人的负性评价。焦虑障碍的治疗方法包括药物治疗、心理咨询等。     

门诊焦虑障碍患者的自我分化水平研究

目的 探讨精神科门诊焦虑障碍患者的自我分化水平及其与焦虑特质的关系.方法 对符合简明国际神经精神访谈(MINI)中文版诊断的123名焦虑障碍患者和120名健康对照予以自我分化量表修订版的中文版(DSI-R)、状态-特质焦虑量表(STAI)问卷调查.结果 (1)焦虑障碍组DSI-R总分、情绪反应性(ER)维度和自我位置(IP)维度分值低于健康对照组,差异有显著性(P＜0.01),而情感断绝(EC)维度和与他人融合(FO)维度分值两组差异无显著性;(2)焦虑障碍组年龄与DSI-R总分、ER、IP、EC维度呈正相关(P＜0.05或P＜0.01),与FO维度无相关关系.男性焦虑障碍患者的ER维度分值高于女性焦虑障碍患者(P＜0.05),健康对照组年龄与IP维度正相关(P＜0.01),未婚者的DSI-R总分及ER维度分值高于已婚者(P＜0.01);(3)逐步回归分析表明,情绪反应性(ER)和自我位置(IP)是特质焦虑的重要预测因素,能联合预测特质焦虑的27.2％(焦虑障碍组)、39.9％(健康对照组)的变异量.结论 焦虑障碍患者自我分化水平较健康对照组低,自我分化能预测个体的焦虑特质.     

儿童焦虑障碍与抑郁障碍的关系

按照儿童精神障碍两维度划分法,儿童焦虑障碍和抑郁障碍同属于内化性(internalizing)障碍,或称情绪障碍。儿童焦虑障碍是一组以过分焦虑、担心、害怕为主要体验的心理障碍,包括儿童分离性焦虑障碍、广泛性焦虑障碍、特定恐怖症、社交恐怖症、惊恐障碍,有些文献将选择性缄默症、     

躯体形式障碍患者的症状特点及性别差异

目的:探讨躯体形式障碍(SD)患者的症状特点及性别之间的差异。方法:采用躯体形式症状筛查量表(SOMS-7)中文版对326例SD患者进行调查和分析。结果:①SOMS-7测评均分最高的5种症状女性患者为:全身乏力或易疲劳、心慌或心里砰砰直跳、头痛、胸闷或心脏周围不适、气短(用力时除外);男性患者为:全身乏力或易疲劳、心慌或心里砰砰直跳、气短(用力时除外)、胸闷或心脏周围不适、呼吸困难或过度换气;②在腹痛或胃痛(t=2.218)、背痛(t=2.164)、关节痛(t=2.399)、经常便秘(t=4.077)、色斑或肤色改变(t=3.650)、性冷淡(t=3.678)条目上,女性患者得分高于男性(P0.05或P0.01);③出现频率最高的5种症状女性患者为:全身乏力或易疲劳、头痛、心慌或心里砰砰直跳、胸闷或心脏周围不适、气短(用力时除外);男性患者为:全身乏力或易疲劳、心慌或心里砰砰直跳、气短(用力时除外)、胸闷或心脏周围不适、口干;④在性交时痛(χ2=6.443)、经常便秘(χ2=7.383)、色斑或肤色改变(χ2=12.262)、性冷淡(χ2=15.832)、味觉或嗅觉丧失(χ2=3.942)条目上,女性患者的症状出现频率较男性为高(P0.05或P0.01);在小便时痛(χ2=5.58)、频繁大便或腹泻(χ2=3.954)、有尿却排不出(χ2=7.094)、肢体僵硬或强直(χ2=8.093)条目上,男性患者的症状出现频率较女性为高(P0.05或P0.01)。结论:SD患者"全身乏力或易疲劳"出现次数最多,程度最重;女性患者更常出现性、胃肠道抑制、外表、外部感觉等问题;男性患者更常出现泌尿道、胃肠道活跃、肌肉紧张等问题。     

常见睡眠疾病性别差异机制的研究进展

随着对两性睡眠疾病研究的深入,越来越多的研究提示两性睡眠疾病存在差异,这些研究成果为进一步揭示两性睡眠疾病奥秘,以及对不同性别患者给予循证、个性化治疗提供更多的理论基础.现就临床几种常见睡眠疾病性别差异及可能的机制展开综述.     

Short-term and long-term influences of family arguments and gender difference on developing psychological well-being in Taiwanese adolescents

Adolescent mental health is crucial for social competence and accomplishment in later life. The World Health Organization (WHO) estimates that approximately 20% of adolescents suffer from psychological symptoms. However, improving family risk and school environments can largely promote adolescent mental health. A longitudinal survey was conducted to investigate adolescent psychological well-being (PWB) status and associated factors in adolescents 15–20 years of age. Family and school context variables were interviewed and recorded. A total of 2896 participants were included from high, middle, and less urbanized resident areas in Northern Taiwan with completed interview data. Using multivariate regression analysis, factors associated with adolescent PWB at various stages included quarrelsome parents, quarrels with parents, severed friendships, and cigarette and alcohol use. In all three adolescent stages, females yielded higher psychological symptom scores than did males, and diverse weights of risk factors on PWB were observed between genders. Family arguments and cigarette and alcohol use were found to have more pronounced effects on outcomes among females than males. Whereas males are more sensitive to severed friendships than females, cigarette and alcohol use showed more harmful effects on mental health in earlier adolescence than in later life. Moreover, family arguments and severed friendships in earlier adolescence were found to have lasting effects on PWB in later adolescence. In this study, gender differences were observed in the temporal relationship on adolescent mental health. Variables of family arguments and severed friendships exhibited short-term and long-term effects on adolescent mental health across the early to late developmental stages. The family argument environment and regulating cigarette and alcohol use are worthy of focus to promote adolescent mental health.     

重性抑郁障碍的临床特征及其性别差异

目的了解重性抑郁障碍的临床特征及其性别差异。方法采用多阶段分层整群抽样方法随机抽取18周岁及以上的人群10073名,以改编后的一般健康问卷12项（GHQ-12）为筛选工具,以美国精神障碍诊断与统计手册第四版（DSM-IV）轴I障碍定式临床检查患者版（SCID-I/P）为调查的诊断工具。结果重性抑郁障碍的抑郁心境、失眠、疲倦或精力缺乏、兴趣或愉快感缺乏、思考力降低、体重减轻或食欲下降、无价值感、自己死亡的想法、精神运动性激越的出现频率较高;在抑郁发作类型、季节特征、既往发作缓解程度、目前类型、症状严重程度、首次发作年龄及反复发作间歇期的性别比较均无统计学差异。结论重性抑郁障碍各种临床症状的出现频率不同,性别对重性抑郁障碍临床特征的影响有待进一步研究。     

慢性精神分裂症患者家属心理健康状况性别差异调查

目的分析慢性精神分裂症患者家属心理健康状况的性别差异及相关原因。方法采用症状自评量表（SCL-90）、简易应对方式问卷及社会支持评定量表,对110名慢性精神分裂症患者家属进行调查分析。结果慢性精神分裂症患者不同性别组家属的SCL-90、社会支持评定量表、简易应对方式问卷评分差异具有统计学显著意义（P〈O．01）,社会支持评分、应对方式评分与SCL-90评分间存在相关,相关具有统计学意义（P〈O．01）。结论慢性精神分裂症患者家属心理健康状况存在性别差异,女性家属的心理问题较男性家属严重,心理健康状况与个体应对方式及社会支持度相关。     

儿童焦虑症状与性别、年龄的关系

目的 探讨儿童焦虑症状随性别、年龄的变化趋势及焦虑症状与性别、年龄之间的关系.方法 在小学和初中随机抽取4 200名7～15岁的儿童,进行儿童焦虑障碍自评量表（SCARED）的测量,并按年龄分组,分析性别和年龄与自评量表得分之间的关系.结果 各焦虑维度评分及焦虑总分在性别与年龄之间均有交互作用（P＜0.05）;男、女儿童不同年龄组的各焦虑维度评分及焦虑总分差异均有统计学意义（P＜0.01）;10～11岁年龄组分离性维度（t=-2.591,P=0.010）、社交维度（t=-3.573,P=0.00）、焦虑总分（t=-2.288,P=0.022）,以及14 ～ 15岁年龄组躯体化维度（t=-2.349,P=0.019）、广泛性维度（t=-4.65,P=0.00）、分离性维度（t=-4.513,P=0.00）、社交维度（t=-5.25,P=0.00）、学校维度（t=-2.073,P=0.039）、焦虑总分（t=-5.057,P=0.00）均女生高于男生.结论 性别、年龄对儿童焦虑症状的交互作用明显;男、女儿童焦虑症状均随年龄发生变化,但呈现不同变化趋势,随年龄增长男生的焦虑症状减轻而女生的焦虑症状增多;女生焦虑症状明显于男生,尤其在14～15年龄段.     

The characteristics of the comorbidity between social anxiety and separation anxiety disorders in adult patients

Abstract

Objective: In the present study, we compared social anxiety disorder (SAD) patients with (n?=?31) and without childhood and adulthood separation anxiety disorder (SeAD) (n?=?50) with respect to suicidal behavior, avoidant personality disorder (AvPD), other anxiety disorders (ADs), and major depression as well as some sociodemographic variables.

Methods: In assessment of patients, we used Structured Clinical Interview for Separation Anxiety Symptoms, childhood and adulthood Separation Anxiety Symptom Inventories, Liebowitz Social Anxiety Scale, The SCID-II Avoidant Personality Disorder Module, Beck Depression Inventory, and Beck Scale for Suicidal Ideation.

Results: SAD patients with SeAD had higher comorbidity rates of AvPD, other lifetime ADs and panic disorder, and current major depression than those without SeAD. The current scores of SAD, depression, and suicide ideation and the mean number of AvPD symptoms were significantly higher in comorbid group compared to pure SAD subjects. The SAD and SeAD scores had significant associations with current depression, suicide ideations, and AvPD. The mean number of AvPD criteria and the current severity of depression were significantly associated with the comorbidity between SAD and SeAD.

Conclusion: Our findings might indicate that the comorbidity of SeAD with SAD may increase the risk of the severity of AvPD and current depression.     

Normalization of personality characteristics in patients with incapacitating anxiety disorders after capsulotomy

The personality characteristics of 24 consecutive patients undergoing psycho-surgery for incapacitating anxiety disorders were assessed prospectively using a self-report personality inventory. The main findings were: absence of negative personality changes after surgery, significant postoperative changes towards normalization on the majority of the scales, and significant symptomatic relief in 80% of the cases. The changes on scales reflecting anxiety proneness were conspicuous in patients suffering from "pure" anxiety disorders, as compared with those suffering from obsessive-compulsive disorder (OCD). In OCD patients, correlations were obtained between changes in brain metabolism studied with positron emission tomography and changes in personality scores. It is concluded that negative personality changes are not likely to occur after capsulotomy.     

Cognitive flexibility impairments in children with autism spectrum disorders: Links to age,gender and child outcomes

There are still many questions about the cognitive flexibility in autism spectrum disorder (ASD) that remain unanswered. The goal of current study was to evaluate cognitive flexibility patterns and their demographic, clinical and behavioral correlates in large sample of children with ASD. A total of 123 children (94 boys and 29 girls) with ASD aged 7–14 years were assessed on the Wisconsin card sorting test (WCST). Findings showed that gender but not age was associated with the cognitive flexibility performance in ASD. Individuals who had more parent-reported language deficits, lower level of intelligence and education, and showed lower daily sleep time or more engagement in solitary instead of social daily activities were more likely to demonstrate perseveration. Findings provide tentative evidence of a link between cognitive flexibility deficits and sociodemographic or clinical child outcomes in ASD.     

Suicidal ideation among patients with gender identity disorder

In this study, we tried to clarify the prevalence of suicidal ideation and self-mutilation including suicide attempts among patients with gender identity disorder (GID) and the relationship of those behaviors to demographic characteristics. A total of 500 consecutive Japanese GID patients without any other psychiatric comorbidity were evaluated at the outpatient GID Clinic of Okayama University Hospital. The lifetime rate of suicidal ideation was 72.0% of the total sample. There were no significant differences in the prevalence of suicidal ideation among groups divided by sex, age, age at onset or education. The lifetime prevalence of self-mutilation including suicide attempts was 31.8% of the total sample. Low level of education was significantly related to self-mutilation among both male-to-female and female-to-male GID patients. Younger age at onset was a significant factor affecting self-mutilation only among MTF GID patients. A lack of strategies to cope with severe distress among persons with lower education might induce a high frequency of self-mutilation including suicidal attempt. GID patients with a low level education might be at high risk of self-mutilation and should be watched with special attention to self-mutilation.