重症监护病房重症脓毒症患者远期负性情绪发生率及相关因素分析

目的 探讨重症监护病房（ICU）重症脓毒症患者远期负性情绪发生率及相关因素。方法 选取2019年1月—2020年12月南阳市第一人民医院入住ICU的99例重症脓毒症患者作为研究对象,均随访2年。将并发焦虑抑郁的患者作为负性情绪组,未并发焦虑抑郁的患者作为非负性情绪组,分别有30和69例。分析两组患者年龄、性别、种族、体重、入院临床特征（住院时长、ICU时长及血清乳酸、降钙素、C反应蛋白水平）、入院诊断疾病（心血管系统、呼吸系统、传染病、其他）、疾病严重程度[急性生理学和慢性健康评估Ⅱ（APACHEⅡ）评分、脓毒症相关器官衰竭评估（SOFA）评分、感染性休克]、器官支持情况[机械通气、连续性肾脏替代疗法（CRRTn）]、入住ICU前72 h是否使用皮质类固醇及在ICU住院期间咪达唑仑、芬太尼、多巴酚丁胺、去甲肾上腺素和氟哌啶醇的累积剂量等基线特征。结果 两组患者性别构成、年龄、种族、体重、心血管系统疾病、呼吸系统疾病、传染病、其他疾病、APACHEⅡ评分、SOFA评分、机械通气、CRRTn、入住ICU前72 h使用皮质类固醇、咪达唑仑、多巴酚丁胺、去甲肾上腺素的累积剂量比较,差异均无统计...     

Maternal effects in infant and adult phenotypes of 5HT1A and 5HT1B receptor knockout mice

The influence of the pre- and postweaning maternal environment on the offspring's phenotype was examined in 5-HT1A and 5-HT1B receptor knockout mice (KO1A and KO1B, respectively). We have previously shown that, when born to and raised by homozygous dams of the same genotype, adult KO1A are more anxious than wild-type (WT) mice, and adult KO1B are hyperactive and slightly less anxious than WT mice. We extend our studies here to the behavioral results of the offspring's own genotype, when the dam's genotype is constant, and the effects of the dam's genotype when the offspring's genotype is constant. In Experiments 1 and 2, KO1A-/- pups produced less ultrasonic vocalizations (USV) than controls in an isolation test on postnatal Day 7 when born to and reared by KO1A dams, either -/- or +/-. Heterozygous F1 pups reared by KO1A-/- dams produced more USV and were less anxious in the plus-maze at 2 to 3 months of age than F1 pups born to and reared by WT dams (Experiment 3). F1 pups reared by KO1B-/- dams produced less USV and were more anxious in the plus-maze than F1 pups reared by WT dams (Experiment 4). The results support a role for maternal effects that may comprise direct effects such as the dam's behavior and nutritional care of the pup, and possibly more complex indirect effects through the establishment of idiosyncratic dam-pup dyadic interactions. We recommend that breeding techniques that rely on same genotype (mutant-mutant or WT-WT) breeding pairs not be used to generate offspring when the focus of research is the study of gene function, but rather when familial effects need to be studied.     

Differential Fear of Cardiopulmonary Sensations in Emergency Room Noncardiac Chest Pain Patients

Fear of bodily sensations has received extensive attention in relation to panic disorder, and more recently, other types of anxiety pathology and chronic pain problems. Extending this work, the present study examined fear of bodily sensations and its underlying dimensions in emergency room patients with Noncardiac Chest Pain (NCCP; n = 63). We posited a differential specificity hypothesis, expecting that specific cardiopulmonary fears would be more strongly associated with NCCP symptoms relative to other bodily fears. As hypothesized, participants reported cardiopulmonary sensations as significantly more fear-provoking than numbness, dissociation, and gastrointestinal sensations. Additionally, regression analysis indicated that after accounting for theoretically relevant demographic variables and health status, cardiopulmonary fear was the best predictor of a composite index of cardiac complaints intensity, even after removing variance related to the absolute number of cardiac complaints. We discuss these findings in relation to the specific role for the fear of cardiopulmonary sensations in chest pain complaints, with implications for better understanding the underlying psychological processes involved in NCCP.     

Effect of amino acid derivatives of β-carboline-3-carboxylate on behavior in rats

Brain Research Institute, All-Union Mental Health Research Center, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR O. S. Adrianov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 107, No. 5, pp. 586–587, May, 1989.     

Heart-focused anxiety,illness beliefs,and behavioral impairment: Comparing healthy heart-anxious patients with cardiac and surgical inpatients

Psychological features and complaints of persons presenting to medical settings with heart-focused anxiety and noncardiac chest pain are poorly understood. Comparing 20 healthy heart-anxious patients to cardiac and surgical inpatients and nonpatient controls, we found that healthy heart-anxious patients (a) were as afraid of chest pain and heart palpitations as inpatients with heart disease, (b) were as incapacitated by symptoms and using medical services as much as both inpatient groups; and (c) reported higher levels of cardiac disease conviction, heart awareness, and behaviors designed to protect their heart than surgical patients and nonpatients. Compared to all other groups, healthy heart-anxious patients reported more panic and other anxiety disorders, hypochondriacal beliefs, physical symptoms, obsessive-compulsive concerns, and negative affect. Following a hyperventilation test, heart-anxious patients also indicated more distressing symptoms and thoughts, and felt less safe and in control than surgical patients and nonpatients. Results support efforts for a timely recognition, diagnosis, and behavioral treatment of persons with heart-focused anxiety.     

以头晕为主诉的无症状性脑梗死患者焦虑状态的临床分析

目的:探讨以头晕为主诉的无症状性脑梗死(ACI)患者的情绪状态及临床体验并观察抗焦虑/抑郁治疗的疗效.方法:对98例ACI患者采用汉密尔顿焦虑抑郁量表进行筛查,并根据ICD-10的诊断标准做出诊断后,给予抗焦虑/抑郁药物治疗和支持性心理治疗,以治疗前后的汉密尔顿焦虑量表(HAMA)的减分率和临床症状缓解程度来评定疗效.结果:处于焦虑状态的ACI患者,医检证实均有脑血管系统的轻微病损,头晕史0.5～7年,有心悸、气短、眩晕发作、失眠等自诉躯体症状,67.55%伴有高血压;经帕罗西汀和支持性心理治疗,100%显效,临床症状缓解.结论:以头晕为主诉的ACI患者,若经改善脑血流循环治疗无效者,则应实施抗焦虑/抑郁药物治疗和支持性心理治疗,可望获得良好疗效.     

Premenstrual symptomatology,locus of control,anxiety and depression in women with normal menstrual cycles

Summary The present study was designed to investigate the relationships between premenstrual symptomatology, locus of control, anxiety, and depression in women with normal menstrual cycles. Sixty-nine female participants completed a survey, comprised of the Menstrual Distress Questionnaire (MDQ; Moos, 1968), Levenson's (1981) locus of control scales, the Depression Anxiety Stress Scale (DASS; Lovibond and Lovibond, 1995), and a questionnaire constructed by the researchers based on the DSM-IV criteria for Premenstrual Dysphoric Disorder (PMDD). Both overall and specific subtypes of premenstrual symptomatology were found to correlate with external locus of control, anxiety, and depression. In addition, locus of control was found to moderate the relationship between premenstrual symptomatology, anxiety and depression. Finally, women who were in the premenstrual phase when completing the questionnaire scored significantly lower on the internal scale than those in either the follicular or early luteal phases. It was concluded that an external locus of control may be associated with a susceptibility to depression or anxiety when certain premenstrual or postmenstrual changes are experienced. Received August 10, 2002; accepted January 12, 2003 Published online February 19, 2003 Abbreviations · ANOVA · Analysis of variance · DASS · Depression anxiety stress scale · LOC · Locus of control · MANOVA · Multivariate analysis of variance · MDQ · Menstrual distress questionnaire · PMDD · Premenstrual dysphoric disorder · PMS · Premenstrual syndrome Acknowledgement The authors would like to thank John Reece, Department of Psychology and Disability Studies, RMIT University, Melbourne, Australia, for assistance with data analysis. Correspondence: Dr. Andrew Francis, Department of Psychology and Disability Studies, Faculty of Applied Science, RMIT University, P.O. Box 71, Bundoora, Victoria 3083, Australia; e-mail: andrew.francis@rmit.edu.au     

A twin-family study of self-report symptoms of panic-phobia and somatization

Self-report symptoms of anxiety are widely used in mental health and social science research as an index of current psychiatric state. Previous twin studies have suggested that genetic factors account for a significant proportion of the variance in these symptoms. To replicate and extend these findings, we examined self-report symtoms of panic-phobia and somatization in the “Virginia 30,000” twin-family sample. Model fitting applied to 80 unique relationships in the twin-family pedigree produced the following major results: (i) genetic effects were significant for both symptom factors, accounting for between 25 and 49% of the total variance, with the exception of symptoms of panic-phobia in females, where they accounted for 15–16% of the variance; (ii) familial environmental effects were absent for symptoms of somatization, while for symptoms of panic-phobia they accounted for a very small proportion of variance in males (≤1.2%) and a modest proportion in females (6–17%) (iii) spousal correlations were present for both factors, ranging from +0.05 to +0.20; (iv) genetic factors which influenced symptoms were generally the same in males and females, although their effect was greater in males; (v) heritability estimates were lower in the population-based than in the volunteer sample; and (vi) when test-retest reliability was included in the model, results suggest that genetic factors account for at least half of the stable variance for all symptom factors, except panic-phobia in females. Our results support the validity of previous twin studies of self-report symptoms of anxiety and suggest that genetic factors significantly influence these symptoms but familial-environmental factors play little or no etiologic role.     

Life in the Future Versus Life in the Present

Roemer and Orsillo have provided an integrative perspective for developing more effective therapies for generalized anxiety disorder, based on existing knowledge about the disorder, cognitive behavioral approaches to its treatment, and conceptualizations and treatment methods from the acceptance/mindfulness tradition. The present commentary expands upon the notion of the adaptive value of focused attention on present-moment experience and cognitive perspectives that can facilitate that process.