Practitioner Review: Unguided and guided self-help interventions for common mental health disorders in children and adolescents: a systematic review and meta-analysis

Mental health problems are common in children and adolescents, yet evidence-based treatments are hard to access. Self-help interventions can increase such access. The aim of this paper was to conduct a systematic review and meta-analysis of the use of guided and unguided self-help for children and young people with symptoms of common mental health disorders. In contrast to previous reviews of self-help in children, all types of self-help and multiple mental health disorders were investigated in order to increase power to investigate potential moderators of efficacy. Importantly, studies with control arms as well as those comparing against traditional face-to-face treatments were included. Fifty studies (n = 3396 participants in self-help/guided self-help conditions) met the inclusion criteria. Results demonstrated a moderate positive effect size for guided and unguided self-help interventions when compared against a control group (n = 44; g = 0.49; 95% CI: 0.37 to 0.61, p < .01) and a small but significant negative effect size when compared to other therapies (n = 15; g = −0.17; 95% CI: –0.27 to –0.07, p < .01). Few potential moderators had a significant effect on outcome. Most comparisons resulted in significant heterogeneity and therefore results are interpreted with caution.     

系统性红斑狼疮患者的症状群及其网络分析

目的 描述系统性红斑狼疮患者症状群的构成,并运用网络分析探索群内症状之间的关系,为症状管理提供依据。方法 采取便利抽样原则选取201例系统性红斑狼疮患者为研究对象。采用一般资料调查表、系统性红斑狼疮症状清单对患者进行调查。症状群的提取采用探索性因子分析,以JASP软件绘制网络分析图及各症状中心指标图,分析群内症状之间的关系。结果 系统性红斑狼疮患者疲劳的发生率最高(64.7%),共提取5个症状群：疲劳相关症状群、体质量增加相关症状群、瘙痒-疼痛相关症状群、皮肤改变症状群、身体形象症状群。经过网络分析,对太阳光过敏在所有集群中的强度和紧密度最高,情绪改变的中介度最高。结论 系统性红斑狼疮患者存在症状群,各症状的影响强度不同。临床医护人员需密切关注患者症状,通过改善核心症状来改变群内与之相关的其他症状,进一步提高患者的生活质量。     

Target nursing care on anxiety and depression in patients with gallbladder cancer during perioperative period

Background:This study retrospectively investigated the effects of target nursing care (TNC) on anxiety and depression in patients with gallbladder cancer (GBC) during the perioperative period.Methods:This retrospective study analyzed the data of 80 patients with GBC during perioperative period. These records were divided into an intervention group (n = 40) or a control group (n = 40). All 80 patient records in both groups were administered routine nursing care (RNC). The patients in the intervention group also underwent TNC. The primary outcomes were depression (measured using the Hamilton Depression Scale, HAMD) and anxiety (assessed using the Hamilton Anxiety Scale, HAMA). The secondary outcomes were quality of life (assessed using the 36-Item Short Form Health Survey, SF-36) and adverse events. We collected and analyzed the outcome data before and after treatment.Results:After treatment, patients in the intervention group showed more promising effects on depression (HAMD, P < .01) and anxiety (HAMA, P < .01) than those in the control group did. However, there were no significant differences in the quality of life before and after treatment. No TNC- or RNC-associated adverse events were reported in patient records.Conclusion:This study found that TNC was more effective than RNC in relieving depression and anxiety. Future studies should be conducted to validate the present findings.     

李跃华辨治焦虑症发热1例

焦虑抑郁症发病机制至今尚不明确,存在多种假说,其中以脑神经递质与抑郁症的关系研究最为深入。李跃华教授临床辨治1例发热原因不明的患者。患者自发热伊始,原因不明,间断发热,他院给予退热以及激素等治疗,连续应用5月患者病情未改善。患者情绪低落,紧张不安,生活兴趣丧失,李跃华教授以焦虑抑郁症中医辨证诊治,结合清热利湿,并口服西医对症抗焦虑抑郁药物治疗,患者发热好转。     

基于中医情志理论探讨炎症性肠病患者生存质量及其影响因素

目的:分析炎症性肠病(IBD)患者的生存质量(HRQOL)及其影响因素,基于中医情志学说进行理论探讨。方法:应用一般资料调查表、焦虑自评量表(SAS)、抑郁自评量表(SDS)、一般健康状况问卷(SF-36)和炎症性肠病生存质量问卷(IBDQ),对90例炎症性肠病确诊患者进行问卷调查,分析受试者生存质量的主要影响因素。结果:受试者的平均焦虑、抑郁水平处于正常状态,生理机能、生理职能、精力、一般健康状况、情感职能、躯体疼痛、精神健康、社会功能共8项维度得分均低于常模水平,克罗恩病患者HRQOL优于溃疡性结肠炎患者(P0.05);影响IBD患者生存质量的主要因素是精神心理因素:焦虑和抑郁。结论:临床中医应关注IBD患者的焦虑和抑郁情绪,在中医情志理论的指导下,对不良情绪及早发现和干预,提高其生存质量,从而改善临床预后。     

整体护理对冠心病患者冠脉内支架植入术围术期血脂水平的影响

目的观察整体护理对冠心病患者冠状动脉内支架植入术围术期血脂水平的影响。方法选择行经皮冠状动脉内支架植入术治疗的冠心病患者149例,随机分为整体护理组86例与传统护理组63例。对整体护理组实施整体护理干预,传统护理组被给予传统护理干预;分析、比较两组患者3个时间点（人院第2日、手术当日及出院当日）的状态焦虑水平、血脂含量变化以及术后并发症发生情况的差异。结果两组患者状态焦虑水平（分）整体护理组手术当日（51．64±7．78）分、出院当日（38．94±4．37）分与传统护理组（74．42±8．29）分、（59．97±5．76）分比较,差异有统计学意义（P〈0．05）。两组患者血脂水平（mmol／L）整体护理组手术当日、出院当日与传统护理组差异有统计学意义（P〈0．05）。两组患者术后并发症发生率（％）、整体护理组血肿或出血、桡动脉痉挛或闭塞、心律失常、发热以及迷走神经反射等并发症发生率明显低于传统护理组（P〈0．05）。结论整体护理可以降低冠心病患者冠脉内支架植入术围术期血脂水平与状态焦虑水平,减少术后并发症的发生,提高护理质量。     

青光眼与颈椎病的眼部表现特点关系探讨

目的:对一组症状,体征表现极相似于青光眼但非青光眼所致的颈椎病患者进行分析诊断,并作治疗探讨。方法:我院1993/2003-10间一组症状相似的颈椎病患者37例,分析其症状及体征特征,并与青光眼相鉴别。结果:通过此组患者症状体征分析,提醒相关医师掌握这些知识,对此组患者进行正确诊断和治疗。结论:该组患者是一组特殊类型的眼科患者,可暂称其为缺血性视疲劳。     

Anxiety and depression symptoms in infertile men during their first infertility evaluation visit

Objective: To assess the psychological condition of men at the start of the infertility work-up.

Methods: Men seeking an infertility evaluation for the first time were recruited. Depression and anxiety symptoms and subjective psychological burden were assessed with the Beck Depression Inventory (BDI), the Spielberger State-Trait Anxiety Inventory (STAI), and a visual analog scale (VAS).

Results: Data from 113 patients were analyzed. The mean age of the patients was 33.3 (range: 23–54) years, whereas the mean duration of infertility was 16.3 (range: 0–96) months. Results from the BDI and STAI were 2.24 (SD: ±3.18) and 33.74 (SD: ±8.04). Mild depressive symptoms were found in 4.5% of patients, whereas anxiety reached an abnormal level in 4.9%. There were significant correlations between the results from the BDI score and the duration of infertility (p?=?.024), whereas the STAI and VAS scores showed no similar connection (p?=?.142 and p?=?.261, respectively). Among patients with infertility longer than 2 years, mild depressive symptoms occurred in 23.1%.

Conclusion: Among men, the levels of depressive and anxiety symptoms were low at the start of the infertility work-up. Depressive symptom levels increased significantly with the duration of infertility, whereas anxiety levels and VAS scores did not demonstrate a similar correlation.     

Nutritional Status and Related Factors in Patients with Gastric Cancer after Gastrectomy: A Cross-Sectional Study

Patients after gastrectomy for gastric cancer are at risk of malnutrition, and poor nutritional status negatively affects patients’ clinical outcomes. Knowledge of the factors influencing patients’ nutritional status can inform interventions for improving patients’ nutrition. A cross-sectional study was conducted to describe nutritional status and related factors in gastric cancer patients after gastrectomy. A convenience sample of gastric cancer patients with gastrectomy was recruited from general surgery or oncology clinics of a medical center in northern Taiwan. Data were collected with self-reported questionnaires, including the Functional Assessment Cancer Therapy—Gastric Module version 4, the Concerns in Meal Preparation scale, the Center for Epidemiologic Studies Depression Scale, and the Mini Nutrition Assessment. One hundred and one gastric cancer patients participated in the study. There were 81 cases of subtotal gastrectomy and 20 cases of total gastrectomy. Most patients (52.5%) were malnourished or at risk. Linear regression showed that symptom severity (β = −0.43), employment status (β = 0.19), and difficulty in diet preparation (β = −0.21) were significant predictors of nutritional status. Together, these three variables explained 35.8% of the variance in patient nutritional status (F = 20.3, p < 0.001). More than 50% of our participants were malnourished or at risk for malnutrition, indicating a need for continued monitoring and support after discharge from hospitals. Special attention should be given to patients with severe symptoms, unemployment, and difficulties in diet preparation.