中医对抑郁症的认识、辨证分类及研究进展

本文从古代文献及现代文献入手，针对抑郁症的病名、病机、诊断、治疗等多个方面进行阐述。揭示了中医对抑郁症的病因病机的认识、辨证分型、治疗及研究进展。总结了中医（针灸）治疗抑郁症的现代研究目前尚存在的问题。     

安神饮合益聪浆对失眠患者睡眠质量及焦虑抑郁状态的影响

目的观察安神饮和益聪浆对失眠症患者睡眠质量、焦虑抑郁状态的疗效。方法将符合失眠症诊断的病例随机分为中药组和西药组,中药组服安神饮合益聪浆,西药组服舒乐安定、谷维素、维生素B1,采用PSQI,SAS,SDS量表治疗前及治疗后2,4周评定1次,治疗前后行血流变学检查,两组均4周统计疗效,停药后3个月统计复发率。结果组内治疗前后比较,两组PSQI,SAS,SDS均有显著性差异(P<0.001);治疗4周后与对照组比较:PSQI,SAS,SDS均有显著性差异(P<0.001);血流变学检查:组内治疗前后比较均有显著性差异(P<0.05),治疗4周后与对照组比较,红细胞压积、全血低切还原黏度、全血高切还原黏度、血浆黏度值、全血黏度值均有显著性差异(P<0.05);中药组总有效率91.1%,西药组总有效率83.9%(P<0.05);中药组复发率为20.7%,西药组复发率为43.6%(P<0.005)。结论安神饮合益聪浆治疗失眠症,对睡眠质量、焦虑抑郁状态优于西药组。     

青少年学生网络成瘾与心理健康的关系

目的探讨网络成瘾症（IAD）和网络成瘾倾向（IAT）学生抑郁症、焦虑症状况,分析IAD、IAT与学生心理健康的关系。方法整群分层随机抽取天津市9所学校8 694名学生为研究对象,以自行设计的“青少年学生网络成瘾调查信息测评系统”为工具,对学生网络使用情况和身心健康状况进行调查。结果上网者抑郁症检出率为24.47%,IAD抑郁症检率32.16%,IAT抑郁症检出率26.83%,上网无瘾（Non-IA）抑郁症检出率23.17%。上网者焦虑症检出率为3.32%,IAD焦虑症检率12.13%,IAT焦虑症检出率3.72%,上网无瘾焦虑症检出率2.26%。抑郁等级、焦虑等级均与网络成瘾程度有线性相关关系（P〈0.05）。既有抑郁症又有焦虑症的IAD检出率为8.08%,IAT检出率为2.78%,Non-IA检出率为1.55%。16种身体自觉症状与网络成瘾程度均有正相关关系（P〈0.05）,同时存在〉6个症状的比例IAD（3.71%）〉IAT（0.72%）〉Non-IA（0.34%）。结论随着网络成瘾程度的增加,抑郁症与焦虑症的严重程度相应地增加,网络成瘾与青少年的心理健康关系十分密切,但其因果关系有待进一步研究证实。     

孕中晚期抑郁水平及影响因素的调查

目的:探讨广州市越秀区孕妇抑郁水平及其与生活事件、社会支持、应对方式以及人格的关系,为产前抑郁的干预提供依据。方法:采用自评抑郁量表(SDS)、生活事件量表(LES)、社会支持量表(SSRS)、应对方式问卷(CSQ)及艾森克人格问卷(EPQ),对在越秀区孕妇学校学习的627名孕中晚期妇女进行问卷调查。结果:抑郁发生率为30·79%,其中0·96%为重度抑郁,6·86%为中度抑郁,22·97%为轻度抑郁;负性生活事件是抑郁水平的危险因素,而解决问题和社会总支持则是其保护因素。结论:社会环境因素和个体因素深刻影响孕中晚期抑郁水平,产前抑郁的干预应从多层次多方位进行。     

碳酸锂联合帕罗西汀治疗抑郁症的临床疗效

目的：评价碳酸锂联合帕罗西汀治疗抑郁症的疗效及安全性。方法：105例符合中国精神疾病诊断分类第3版（CC—MD-3）抑郁发作标准的抑郁症病人分为2组，分别给予碳酸锂联合帕罗西汀治疗（治疗组）和单用帕罗西汀治疗（对照组），疗程均为10周。根据汉密尔顿抑郁量表（HAMD）减分率评定疗效，用副反应量表（TESS）评定用药的安全性，在治疗前和治疗后的1，2，4，6，8，10周末分别对2组进行检查评定。结果：治疗组总有效率为76．5％，对照组总有效率为50．0％。2组间，疗效比较差异有统计学意义（P〈0．01），不良反应的发生率无统计学差异（P〉0．05），治疗组的转躁率低于对照组。结论：碳酸锂联合帕罗西汀治疗抑郁症可增强疗效，起效快．安全性好。     

抑郁对荷瘤大鼠生存期的影响

目的:探讨抑郁对荷瘤大鼠生存期的影响及可能机制.方法:将36只SD大鼠随机分为3组,每组12只,A组:空白组;B组:肿瘤组,接种肿瘤细胞但不给予应激;C组:肿瘤抑郁组,于接种肿瘤细胞前后采用长期不可预见件中等强度应激造成分养大鼠抑郁症模型.观察各组皮F接种Walker-256肉瘤细胞后的生存期及一般状态,并用MTTr法观察荷瘤鼠血清对刀豆素A(ConA)诱导的正常淋巴细胞转化的抑制作用,放射免疫法检测各组血清皮质醇水平.结果:C组的一般状态最差.A、B、C3组平均牛存期分别为(60.00±0.00)、(47.67±20.52)、(24.83±17.39)d,3组问差异有统计学意义(P<0.05).A、B、C 3组大鼠血清对ConA诱导的正常淋巴细胞转化均有抑制作用,抑制率分别为(11.84±-5.38)%、(25.61±7.14)%、(39.98±8.52)%,组间差异有统计学意义(P<0.01).与A、B组相比,C组血清皮质醇显著升高(P<0.05).结论:抑郁町缩短荷瘤大鼠的生存期,其机制与皮质醇水平升高及其导致的免疫抑制有关.     

Experience of Treatment of Depression by Acupuncture plus Medicine

Depression is a type of psychosomatic disorder that presents with persistent depressed emotion （or mood）, poor concentration and psychomotor inhibition. It is more than a psychological problem. However, with pathological changes of biology, depression can be either a major symptom of one condition or accompanying symptom of other conditions.     

Residential Transience and Depression: Does the Relationship Exist for Men and Women?

Residential transience may contribute to adverse mental health. However, to date, this relationship has not been well-investigated among urban, impoverished populations. In a sample of drug users and their social network members (n = 1,024), we assessed the relationship between transience (frequently moving in the past 6 months) and depressive symptoms, measured by the CES-D, among men and women. Even after adjusting for homelessness, high levels of depressive symptoms were 2.29 [95%CI = 1.29-4.07] times more likely among transient men compared to nontransient men and 3.30 [95% CI = 1.10-9.90] times more common among transient women compared to nontransient women. Stable housing and mental health services need to be available, easily accessible, and designed so that they remain amenable to utilization under transient circumstances.     

南京市浦口地区高血压人群抑郁和焦虑状况的病例对照研究

目的 了解南京市浦口地区高血压患者的抑郁和焦虑状况.方法 采用病例对照研究,抽取35岁以上高血压患者326例,健康对照414人;并使用Zung抑郁自评量表(SDS)和焦虑自评量表(SAS)评定调查对象抑郁和焦虑状况.结果 高血压病例组抑郁和焦虑自评量表的总粗分及标准分均显著高于健康对照组(P＜0.01).高血压病例组的抑郁和焦虑检出率(17.9%,11.5%)均高于对照组(9.5%,4.3%),单因素分析显示抑郁、焦虑均可能是高血压的危险因素(OR=1.677,95%C/:1.013～2.776;OR=2.451,95%CI:1.228～4.894).抑郁和焦虑两者之间存在联合作用(OR=5.238,95%C/:2.356～11.664),但无交互作用.结论 高血压与抑郁和焦虑可能存在一定的关联,在高血压的预防和治疗过程中,应及时关注患者的抑郁和焦虑状况.     

Experiences of Traumatic Events and Associations with PTSD and Depression Development in Urban Health Care-seeking Women

Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs after a traumatic event and has been linked to psychiatric and physical health declines. Rates of PTSD are far higher in individuals with low incomes and who reside in urban areas compared to the general population. In this study, 250 urban health care-seeking women were interviewed for a diagnosis of PTSD, major depressive disorder, and also the experience of traumatic events. Multivariate logistic regressions were used to determine the associations between traumatic events and PTSD development. Survival analysis was used to determine if PTSD developed from assaultive and nonassaultive events differed in symptom duration. Eighty-six percent of women reported at least one traumatic event, 14.8% of women were diagnosed with current PTSD, and 19.6% with past PTSD. More than half of women with PTSD had comorbid depression. Assaultive traumatic events were most predictive of PTSD development. More than two thirds of the women who developed PTSD developed chronic PTSD. Women who developed PTSD from assaultive events experienced PTSD for at least twice the duration of women who developed PTSD from nonassaultive events. In conclusion, PTSD was very prevalent in urban health care-seeking women. Assaultive violence was most predictive of PTSD development and also nonremittance.