Chronic Pain,Psychopathology, and DSM-5 Somatic Symptom Disorder

Unlike acute pain that warns us of injury or disease, chronic or persistent pain serves no adaptive purpose. Though there is no agreed on definition of chronic pain, it is commonly referred to as pain that is without biological value, lasting longer than the typical healing time, not responsive to treatments based on specific remedies, and of a duration greater than 6 months. Chronic pain that is severe and intractable has detrimental consequences, including psychological distress, job loss, social isolation, and, not surprisingly, it is highly comorbid with depression and anxiety. Historically, pain without an apparent anatomical or neurophysiological origin was labelled as psychopathological. This approach is damaging to the patient and provider alike. It pollutes the therapeutic relationship by introducing an element of mutual distrust as well as implicit, if not explicit, blame. It is demoralizing to the patient who feels at fault, disbelieved, and alone. Moreover, many medically unexplained pains are now understood to involve an interplay between peripheral and central neurophysiological mechanisms that have gone awry. The new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, somatic symptom disorder overpsychologizes people with chronic pain; it has low sensitivity and specificity, and it contributes to misdiagnosis, as well as unnecessary stigma. Adjustment disorder remains the most appropriate, accurate, and acceptable diagnosis for people who are overly concerned about their pain.     

社会心理因素对哮喘发病和控制作用的研究进展

介绍了社会心理因素对哮喘发病和控制作用的研究进展.详细阐述了社会心理因素诱发哮喘的发病机制及其对免疫功能的影响、对治疗依从性的影响,强调应积极发挥家庭、社会等支持系统的作用,增强健康教育的力度,使病人改进不良的行为方式和生活方式,提高哮喘病人的生活质量.     

虚拟现实康复车的组成及功能

本文主要介绍虚拟现实康复车的组成及功能，目前国内外尚未见有关报道。这种康复车可以使患者根据自己的具体情况来选择适当的训练方式，集心理治疗和康复训练于一体，让患者在轻松愉快的环境中锻炼，进而加快康复进程。     

脑性瘫痪患儿家庭生活质量研究

目的:脑性瘫痪(简称脑瘫)患儿的治疗、教育、智力开发及本身生活质量与其监护人的生活质量关系密切。调查脑瘫患儿家长的生活质量,以便实施正确引导,使之能配合脑瘫患儿的全面干预治疗。方法:用“医院焦虑抑郁量表”对50例脑瘫患儿监护人与50例急性病患儿监护人进行配对衡量对照,并就患儿现状、家庭情况、对孩子患病态度、患病对家庭生活影响以及由此带来的家长对治疗的态度等方面进行流行病学调查研究。结果:脑瘫患儿监护人焦虑抑郁量表总评分(AD):19.1±2.3,其中焦虑评分(A):10.1±2.2,抑郁评分(D):8.9±0.7。对照组监护人焦虑抑郁量表总评分(AD):5.7±1.4,焦虑评分(A):3.4±1.3,抑郁评分(D):2.4±1.0,两组间各项评分差异均有显著性意义(t=35.092,18.529,39.056,P均<0.001)。结论:脑瘫患儿家长普遍存在焦虑抑郁情绪、生活质量下降,应给与适当心理指导。     

The experience of caregiving: the influence of coping strategies on behavioral and psychological symptoms in patients with Alzheimer's disease

Objectives: To determine whether caregiver coping strategies are independently associated with behavioral and psychological symptoms (BPS) in Alzheimer's disease (AD) after accounting for patient characteristics.

Methods: Cross-sectional data analysis of 80 patients with AD and their primary caregivers. The presence of BPS was recorded using the Neuropsychiatric Inventory (NPI). The relationship between caregiver characteristics and BPS was assessed through one-way analysis of variance, two-tailed student t-tests or correlation coefficients. Multivariate linear regression was used to determine the combined effect of all caregiver factors that were significant on bivariate analysis regarding coping and BPS controlling for patient characteristics.

Results: Caregivers were on average 62 years old, 77% female, and most were the children or the spouse of the patient. Over 50% had significant depression or anxiety. Patients were on average 77 years old and 62% were female, and most had moderate to severe dementia. After adjusting for patient characteristics, patients cared for by more depressed, more burdened, or those using more disengagement coping strategies showed higher NPI mean composite scores.

Conclusion: Coping strategies are associated with BPS regardeless of patient characteristics. Interventions to reduce BPS should focus on which psychological coping strategies caregivers use. Understanding how coping strategies influence BPS may help tailor specific interventions for caregivers.     

The social and mental impact on healthcare workers: A comparative and cross-sectional study during two waves of the COVID-19 pandemic in Taiwan

The coronavirus disease 2019 (COVID-19) pandemic has caused a heavily burden on healthcare workers (HCWs) worldwide. The aim of this study was to compare differences in psychological and social impact between two waves of the pandemic among first- and second-line HCWs in Taiwan. The current study derived data from two cross-sectional surveys conducted in 2020 and 2021. Levels of depression, sleep disturbance, psychological distress, social impact, and demographic variables were collected through self-reported questionnaires. The independent t test was used to compare differences in scores between the first and second wave of the pandemic. Differences between first- and second-line HCWs were also analyzed. A total of 711 HCWs in the first wave and 560 HCWs in the second wave were recruited. For the first- and second-line HCWs, the social impact during the second wave was higher than during the first wave, and they expressed a higher intention to maintain social distancing and were more aware of the pandemic overseas in the second wave. The first-line HCWs had a trend of worse sleep quality during the second wave. In addition, sleep quality was worse in the first-line HCWs than in the second-line HCWs during both waves. The second-line HCWs expressed a greater desire to seek COVID-19-related information than the first-line HCWs during the first wave, and more intended to maintain social distancing during the second wave. Our results show the importance of evaluating the social and mental health burden of HCWs, and especially first-line workers.     

空勤科出院患者满意度调查

目的：开展对出院空勤患者心理满意率调查,对于改进医疗服务质量具有一定的指导意义。方法：2006年1-11月间,每月在所有出院患者中发放问卷调查表,并回收统计分析。结果：患者对医师、护士和医疗质量的满意率最高,对相应配套设施满意率相对较低,但总体满意率呈上升趋势。讨论：医疗服务要求人性化,硬件设施要求舒适化。     

团体心理干预对胃癌患者焦虑、血浆皮质醇和睡眠质量的影响

目的探索团体心理干预对胃癌患者血浆皮质醇、焦虑和睡眠质量的影响。方法采用完全随机对照设计,将已确诊为胃癌且已完成临床治疗的78名患者,分为团体心理干预组（n=39）和空白对照组（n=39）。对干预组进行每周1次,每次90 min,共8周的团体心理干预,同时对照组不接受任何形式的心理干预。采用焦虑自评量表（SAS）、血浆皮质醇浓度和阿森斯（AIS）睡眠自评量表分别对两组患者进行干预前和干预结束当周进行评估。结果8周干预结束时,干预组脱落病号3人,对照组脱落病号5人。干预前两组患者焦虑（SAS）得分无显著性差异（t=1.31,P>0.05）,血浆皮质醇浓度无显著性差异（t=0.65,P>0.05）,两组患者睡眠质量评分（AIS）无显著差异（t=0.84,P>0.05）。经团体心理干预后,干预组患者焦虑（SAS）评分显著低于对照组（t=-2.72,P < 0.01）,血浆皮质醇浓度显著低于对照（t=-2.44,P < 0.05）,AIS评分显著低于对照组（t=-3.00,P < 0.01）。结论对胃癌患者进行团体心理干预能显著改善患者的焦虑程度,降低血浆皮质醇浓度,减少身体不良应激,改善睡眠质量,提高患者的生存质量,值得运用和推广