文拉法辛与帕罗西汀治疗躯体形式障碍对照研究

目的探讨文拉法辛与帕罗西汀治疗躯体形式障碍的临床疗效及安全性。方法将70例躯体形式障碍患者随机分为研究组30例和对照组40例,研究组口服文拉法辛治疗,对照组口服帕罗西汀治疗,在此基础上两组均给予支持性心理治疗及生物反馈治疗,观察8w。于治疗前及治疗1w、2w、4w、8w末采用汉密顿焦虑量表、汉密顿抑郁量表评定临床疗效,副反应量表评定不良反应。结果治疗8w末,研究组与对照组抗焦虑显效率分别为86．7％和70．0％,抗抑郁显效率分别为90．0％和82．0％（χ^2=2．70,0．79,P〉0．05）;汉密顿焦虑量表、汉密顿抑郁量表评分,两组治疗1w末起均较治疗前有显著下降（P〈0．01）,并随治疗时间的延续均呈持续性下降。同期两组间比较均无显著性差异（P〉0．05）,两组不良反应均轻微（P〉0．05）。结论文拉法辛与帕罗西汀治疗躯体形式障碍疗效肯定,不良反应轻微,安全性高,依从性好。     

氟西汀联合奎硫平治疗抑郁症对照研究

目的探讨氟西汀联合小剂量奎硫平治疗女性抑郁症的临床疗效及安全性。方法将58例女性抑郁症患者随机分为研究组28例,对照组30例,研究组口服氟西汀联合奎硫平治疗,对照组单用氟西汀治疗,观察8w。于治疗前及治疗1w、2w、4w、8w末采用汉密顿焦虑量表、汉密顿抑郁量表评定临床疗效,副反应量表评定不良反应。结果治疗8w末,研究组显效率为85．71％,对照组为63．33％,研究组显著高于对照组（χ^2=3．968,P〈0．05）;研究组治疗1w末和对照组治疗2w末后各时段汉密顿焦虑量表、汉密顿抑郁量表评分较治疗前均有显著下降（P〈0．01）,同期研究组均较对照组下降显著（P〈0．05或0．01）;两组不良反应均轻微,但发生率差异有显著性（P〈0．05）。结论氟西汀联合小剂量奎硫平治疗女性抑郁症疗效肯定,优于单用氟西汀治疗,且起效更快,不良反应轻微,安全性高,能显著提高患者的治疗依从性。     

5·12汶川地震前后灾区焦虑抑郁障碍病人症状对比研究

目的探索5.12汶川地震对幸存者焦虑和抑郁情绪的影响。方法通过对德阳市人民医院神经内科2007年5月12日～2009年5月12日的1298名就诊者,进行汉密尔顿焦虑量表和汉密尔顿抑郁量表评估病人的结果比较,以发现地震对幸存者的焦虑、抑郁情绪的影响。结果地震后单纯焦虑障碍发病率明显增加(P0.05),女性焦虑障碍和抑郁障碍的程度明显高于男性,并且地震对幸存者的认知障碍产生了比较大的影响。结论5.12汶川地震对灾区群众的情绪产生了较大影响。     

文拉法辛缓释片治疗广泛性焦虑症对照研究

目的 评价文拉法辛缓释片治疗广泛性焦虑症的临床疗效.方法将60例广泛性焦虑症患者随机分为两组,每组30例;研究组口服文拉法辛缓释片治疗,对照组口服氯硝西泮治疗,观察4周.于治疗前及治疗2周、4周末采用汉密顿焦虑最表评定临床疗效.结果 治疗后两组汉密顿焦虑量表评分均较治疗前显著下降(P<0.01),同期两组间比较差异均无显著性(P>0.05);治疗4周末,研究组总有效率为76.67%,对照组为80.00%,两组差异无显著性(X2=0.43,P>0.05).结论 文拉法辛缓释片治疗广泛性焦虑症疗效显著,与氯硝西泮相当,可作为治疗广泛性焦虑症的一线用药.     

氟伏沙明治疗抑郁症对照研究

目的 探讨氟伏沙明治疗抑郁症的临床疗效和安全性.方法 将80例抑郁症患者随机分为两组,每组40例,研究组口服氟伏沙明治疗,对照组口服阿米替林治疗,观察8周.于治疗前及治疗第1周、2周、4周、8周末采用汉密顿抑郁量表、汉密顿焦虑量表及副反应量表评定临床疗效和不良反应.结果 治疗后两组汉密顿抑郁量表、汉密顿焦虑量表评分均较...     

脑卒中患者个性特征生活方式和负性情绪与疾病的相关性对照研究

目的 探讨脑卒中患者的个性特征、生活方式和负性情绪状况,为临床综合治疗提供依据.方法 将116例脑卒中患者设为研究组,抽取同期正常体检者115名设为对照组.采用自拟一般资料调查表统计一般资料,艾森克个性问卷评定人格特征,自拟生活方式调查表测评生活方式,汉密顿焦虑量表及汉密顿抑郁量表评定焦虑、抑郁状况.结果 研究组艾森克个性问卷的精神质、内外倾、神经质维度分均显著高于对照组(P＜0.01),外向、内向性格和情绪不稳定者检出率均显著高于对照组(P＜0.05或0.01);饮食偏咸,不喝牛奶,喜高脂饮食,睡眠无规律或睡眠差,业余生活单调,很少或不锻炼,嗜酒、嗜烟等不良生活方式显著高于对照组(P＜0.01);汉密顿焦虑量表及汉密顿抑郁量表总分和各因子分均高于对照组(P＜0.01),不同程度的焦虑、抑郁情绪检出率均显著高于对照组(P＜0.01).结论 脑卒中患者存在明显的个性缺陷、不良生活方式和焦虑抑郁负性情绪,在综合防治时,除控制其生物病因外,还应改善不良生活方式,调整情绪,加强心理治疗,以利于患者的全面康复.     

团体心理治疗对康复期抑郁症患者的影响

目的探讨团体心理治疗对康复期抑郁症患者的影响。方法将58例患者分为研究组和对照组各29例,对照组做常规治疗,研究组除常规治疗外,另进行团体心理治疗8周。以汉密顿抑郁量表（HAMD）和汉密顿焦虑量表（HAMA）及护士用住院观察量表（NOSIE）为量化指标,对2组患者的康复效果做对比分析。结果实施团体心理治疗后,2组间HAMD、HAMA指标（t=-1.96,-2.75;P〈0.05）和NOS IE指标（t=3.79,2.93,9.1,-3.56;P〈0.01）差异有统计学意义。结论团体心理治疗可明显改善康复期抑郁症患者的情绪和认知,从而提高疗效。     

Source imaging of P300 auditory evoked potentials and clinical correlations in patients with posttraumatic stress disorder

Objective

Posttraumatic stress disorder (PTSD) is associated with abnormal information processing. The P300 component of event-related potentials (ERPs) is known to be a useful marker of information processing. The purposes of this study were to determine the P300 current source density in PTSD patients, and its relationship with symptom severity.

Methods

ERPs were recorded in 30 PTSD patients and 33 healthy controls while participants were performing the auditory oddball task. We compared P300 current source density data - obtained by standardized low-resolution brain electromagnetic tomography (sLORETA) - between the two groups. The correlation between P300 current source density and clinical symptoms (as evaluated using the Korean version of the Structured Interview for PTSD — K-SIPS and Davidson Trauma Scale — K-DTS) was conducted.

Results

In PTSD patients, the current source density of P300 is significantly reduced in the inferior frontal gyrus, precentral gyrus, insula, and anterior cingulate compared to healthy controls. Total K-DTS scores were correlated with the P300 current source density in the posterior cingulate gyrus. The K-SIP B items (re-experiencing) and K-SIB D items (increased arousal) were positively correlated with P300 current source densities in several brain regions located in the frontal, parietal, and temporal lobe (p < 0.05). Conversely, the K-SIP C items (avoidance and numbing) were negatively correlated with P300 current source densities in the superior and middle frontal gyri in the frontal lobes (p < 0.05).

Conclusion

The P300 current source densities reflected the pathophysiology of PTSD patients. PTSD symptoms were related to different neural activities, depending on their symptom characteristics.     

Error-related negativity abnormalities in generalized anxiety disorder and obsessive-compulsive disorder

Enhanced error-related negativity (ERN) has been associated with anxiety among both non-clinical and clinical populations. However, whether it is abnormal among adult patients with generalized anxiety disorder (GAD) is still unknown. The present study investigated it across GAD and obsessive-compulsive disorder (OCD). Event related brain potentials (ERPs) were recorded from a group of 27 GAD patients, 25 OCD patients and 27 healthy control participants during a modified Erikson Flankers task. ERP difference waveforms were obtained by subtracting ERP to correct response (CRN) from ERP to error response (ERN). The Ne component of ERPs at medial frontal electrodes were analyzed and reported. The Ne component of ERP difference waveform was enhanced only in OCD patients, but not in GAD patients, as compared to the healthy controls. An exploratory analysis also revealed higher Ne amplitude of error trial waveforms in both GAD and OCD patients than in healthy controls, and an insignificant group difference in Ne component of correct trial waveforms. The Ne amplitude of error trial waveforms also correlated with Hamilton Anxiety Rating Scale (HAMA) scores and with Hamilton Depression Rating Scale (HAMD) scores across the three subject groups. The main findings of the present study suggest that error processing is altered in OCD but not in GAD, and that ERN abnormalities in GAD are possibly associated with an overactive response checking process or excessive response monitoring.     

Coping and quality of life of patients with Parkinson disease who have undergone deep brain stimulation of the subthalamic nucleus

Background

Although the positive effect of DBS of the STN on motor signs and mobility in PD is indisputable, the effect on mental health (depression and anxiety) as well as on QoL is subject to more debate. Some works have already shown that coping strategies have an impact on QoL, depression, and anxiety. To date, no studies have examined the coping strategies used by patients with PD who undergo STN stimulation. We decided to investigate the coping strategies of patients with PD who have undergone an STN DBS and their relationship with QoL while taking depression and anxiety into account.

Methods

A total of 40 patients stimulated for 12 months and 40 patients under dopatherapy were compared. The 2 groups were matched according to age, sex, age at disease onset, severity of disease, motor scores, daily treatment dosage, and professional status. Semistructured interviews were carried out, after which, their mental and cognitive states were assessed using different scales (MINI, MADRS, EHD, HAMA, FAB). Finally, all subjects completed 3 self-report questionnaires: 2 assessing coping strategies (WCC, CHIP), and 1, QoL the Parkinson Disease Questionnaire (PDQ-39).

Results

Depression and anxiety were not significantly influenced by the type of treatment. Concerning coping strategies, we found a significant effect of the stimulation on instrumental strategies with higher scores for patients under dopatherapy. As for QoL, the only difference concerned communication with a poorer QoL for stimulated patients. We noted no significant correlations between any coping strategies and all of the dimensions of QoL in the stimulated group, whereas we found the opposite result for the dopatherapy group.

Conclusions

These results encourage us to prepare patient candidates for such stimulation by developing interventions focused first on their expectations and second, on their coping strategies.