腹膜透析病人的焦虑和抑郁水平与其病情变化的相关分析

目的:探讨腹膜透析病人情绪障碍,即焦虑症状和抑郁症状的发生情况,以及与透析相关因素的关系.方法:88例腹膜透析病人,使用Hamilton焦虑量表和Hamilton抑郁量表评估其情绪状况,同时测定其营养状况、残余肾功能和透析充分性、以及炎症水平,记录心脑血管事件发生情况等.结果:本组腹膜透析病人焦虑症状的发生率为44.3%,抑郁症状的发生率为56.8%.具有糖尿病和心脑血管病史者的Hamilton焦虑评分和抑郁评分高于无此类病史者(P<0.05).SGA评分较高的病人Hamilton焦虑评分和抑郁评分也较高;焦虑评分和抑郁评分较高的病人,其血清白蛋白水平、蛋白质摄入水平、体重指数、上臂中段肌肉面积和脂肪面积均较低(r=0.22～0.60,P<0.05或P<0.01).结论:腹膜透析病人焦虑症状和抑郁症状的发生率较高,焦虑症状和抑郁症状与心脑血管系统疾病和糖尿病相关,并可能与营养不良的发生存在一定的关系.     

持续的躯体形式疼痛障碍患者抑郁症状的特征及治疗

目的：了解躯体形式疼痛障碍患者伴发的抑郁症状的特征，明确氟西汀对抑郁及焦虑症状的作用特点。方法：选取62例符合ICD－10中持续的躯体形式疼痛障碍诊断标准的患者，于治疗前及治疗第2，4，6周末评定HAMD，HAMA。疗效评定以减分率及有效率为评定指标。结果：氟西汀治疗第六周末，有效率为79．03％，治疗前及治疗第6周末的HAMD各项目分均有显著性差异（P值均＜0．01）；氟西汀治疗六周后，HAMD三个因子减分率分别为：迟滞（75．8％），焦虑／躯体性(焦虑（69．4％），体重（45．2％）；HAMA二个因子减分率分别为：精神性焦虑（70．97％），躯体性焦虑（72．58％）。结论：氟西汀对躯体形式疼痛障碍患者的抑郁及焦虑症状均有缓解作用。氟西汀对躯体疼痛障碍患者的动力缺乏亦有较好疗效。     

Actions of theβ-carboline ZK 93426 in an animal test of anxiety and the holeboard: Interactions with Ro 15-1788

Summary The effects of the-carboline ZK 93426, a putative benzodiazepine receptor antagonist, were investigated in the social interaction test of anxiety and in the holeboard. Like the receptor antagonist Ro 15-1788, ZK 93426 (2.5–10 mg/kg) caused a specific reduction in social interaction (interpreted as an anxiogenic effect) and caused a significant elevation in exploratory head-dipping (5 mg/kg). When low (ineffective) doses of both compounds (1 mg/kg ZK 93426; 4 mg/kg Ro 15-1788) were administered together they significantly reduced social interaction. No further reductions in social interaction were observed when effective doses of both compounds (5 mg/kg ZK 93426; 10 mg/kg Ro 15-1788) were tested in combination; it is likely that this is due to almost total benzodiazepine receptor occupancy at effective doses of either compound. When doses of each compound (5 mg/kg ZK 93426; 10 mg/kg Ro 15-1788) that resulted in stimulation of head-dipping were examined in combination, the elevation in exploration was no longer observed. Since at higher doses of both compounds there is an attenuation of the elevation in head-dipping, it is again likely that the effects of the two compounds are additive.     

Symptom patterns and causes of somatization in men: I. Differentiation of two discrete disorders

Two distinct patterns of somatization were identified in 807 Swedish adopted men, using comprehensive lifetime psychiatric and sick-leave records. "Diversiform" somatizers had a high frequency of brief sickness occasions for a wide diversity of complaints, particularly pain in the head, joints, and abdomen. "Asthenic" somatizers had a lower frequency and diversity of complaints. They recuperate more slowly, however, and were more often disabled by fatigue, weakness, and minor illnesses such as upper respiratory infections. Both types of somatizers had associated psychosocial maladjustment, but they had discrete clinical patterns, with infrequent overlap. Diversiform somatizers had a higher risk of alcohol abuse, psychiatric hospitalization, and substandard income than either asthenic somatizers or non-somatizers. Asthenic somatizers had a higher risk of divorce than either diversiform somatizers or non-somatizers. Men with prominent somatization had an excess of psychiatric treatment for alcoholism or anxiety disorders, but, unlike female somatizers, no excess of criminality. These clinical differences suggest that the psychiatric processes associated with somatization may be qualitatively different in men and women. The method used here is generally applicable in genetic epidemiology to identify natural clinical subtypes within a heterogeneous phenotype.     

461例乳腺癌患者抑郁症和焦虑症患病现状及其影响因素

目的 探讨新疆乳腺癌患者抑郁症和焦虑症患病现状及其影响因素。 方法 选取2018年1—12月在新疆医科大学第三附属医院住院的所有乳腺癌患者为研究对象,采用抑郁自评量表和焦虑自评量表开展横断面调查,评价乳腺癌患者合并抑郁症和焦虑症现状,并采用二元logistic回归模型分析乳腺癌患者合并抑郁症或焦虑症的影响因素。 结果 461例乳腺癌患者中抑郁症患者为197例(42.73%),其中轻度、中度和重度抑郁症患者分别为146例(31.67%)、44例(9.54%)、7例(1.52%);焦虑症患者为240例(52.06%),其中轻度、中度和重度焦虑症患者分别为146例(31.67%)、64例(13.88%)、30例(6.51%)。多因素结果显示:未做过化疗(OR=0.355,95%CI:0.165~0.761)、低收入(OR=9.211,95%CI:3.303~25.685)、病程短(OR=7.716,95%CI:1.773~33.577)和每周锻炼≤150 min(OR=2.718,95%CI:1.777~4.155)为乳腺癌合并抑郁症影响因素;农村户籍(OR=1.835,95%CI:1.142~2.957)、病程短(OR=2.208,95%CI:1.377~3.541)和每周锻炼≤150 min(OR=1.939,95%CI:1.303~2.886)为乳腺癌合并焦虑症影响因素。 结论 新疆地区女性乳腺癌患者中抑郁症和焦虑症的患病率较高,应积极采取干预措施,降低患者抑郁、焦虑等负性情绪的发生,提高患者生活质量,改善其预后。     

孤独症谱系障碍儿童情绪行为问题与其母亲焦虑状况关联分析

目的 比较孤独症谱系障碍(ASD)儿童与典型发育(TD)儿童母亲的焦虑状况,探索ASD儿童情绪行为问题与其母亲焦虑水平间的关系。方法 通过临床诊断招募55名6~12岁智商≥70的ASD儿童及74名TD儿童,采用状态-特质焦虑问卷(STAI)评估入组儿童母亲的焦虑情况,采用长处与困难问卷(SDQ)评估两组儿童情绪行为问题及表现。结果 ASD儿童组母亲状态焦虑得分与特质焦虑得分高于TD组母亲(t=5.272、4.484、P<0.05),ASD儿童SDQ困难总分及多动/注意力缺陷、情绪症状、同伴交往问题及品行问题因子得分高于TD组儿童(t=10.791、7.482、4.295、12.925、3.544),亲社会行为因子分(t=5.084)低于TD组儿童,差异均有统计学意义(P<0.01)。校正混杂因素后,ASD组母亲状态、特质焦虑得分与儿童困难总分 [S-AI: β=0.83 (95%CI: 0.19~1.46); T-AI: β=0.60 (95%CI: 0.05~1.14)]、情绪症状 [S-AI: β=2.28 (95%CI:0.72~3.84); T-AI: β=2.04 (95%CI: 0.74~3.33)]存在正相关关系(P<0.05)。TD组母亲状态焦虑得分与儿童困难总分 [β=0.50 (95%CI: 0.03~0.96)]、品行问题 [β=1.74 (95%CI: 0.19~3.30)]存在正相关关系;特质焦虑得分与品行问题 [β=1.54 (95%CI: 0.09~3.00)]存在正相关关系(P<0.05)。结论 ASD儿童母亲比TD儿童母亲更容易出现焦虑。其中ASD儿童母亲的焦虑水平与儿童情绪问题有关,TD儿童母亲的焦虑水平与儿童品行问题有关。     

焦虑在家庭亲密度与发育迟缓儿童自我意识关系间的中介效应分析

目的 调查发育迟缓儿童的自我意识水平,并探讨焦虑在家庭亲密度与自我意识的中介作用。方法 采取便利抽样法,于2019年7月—2021年4月抽取辽宁省某医院儿科门诊就诊和复查的200例发育迟缓儿童作为研究对象。采用一般资料调查问卷、家庭亲密度与适应性量表(FACES-Ⅱ)、儿童焦虑量表与儿童自我意识量表进行调查。结果 200例发育迟缓儿童的自我意识总分为45.87±4.15,FACES-Ⅱ得分与自我意识总分呈负相关 (r＝-0.607,P＜0.01);FACES-Ⅱ得分与儿童焦虑呈正相关(r=0.416,P＜0.001);儿童焦虑与自我意识呈负相关(r＝-0.367,P＜0.01)。中介效应检验结果显示,儿童焦虑在家庭亲密度对自我意识之间存在显著的部分中介效应,95%CI为(-0.257,-0.043)。中介效应值为-0.077,占总效应的9.50%。 结论 发育迟缓儿童自我意识较低,要重点关注对儿童焦虑情绪的疏导,营造良好的家庭氛围和融洽的亲子关系,提高发育迟缓儿童心理健康与自我意识水平。     

人际心理治疗48例有儿童期虐待史大学生的焦虑障碍效果分析

目的 研究儿童期创伤焦虑障碍大学生接受人际心理治疗(IPT)的效果。方法 将某高校心理健康咨询中发现的、符合研究标准的48例焦虑障碍大学生用抛币法随机分组,治疗组25例和对照组23例,对治疗组实施IPT,在入组时和治疗结束后分别对患者进行焦虑自评量表(SAS)、功能大体评定量表(GAF)、心理弹性量表(CD-RISC)、不安全感心理自评量表(SRFIS)和抑郁症状清单评估。结果 治疗因素和时间因素分别对焦虑自评分、抑郁清单总分、大体功能分、心理不安全感分和心理弹性分存在主效应作用(F=7.407～295.961,P<0.05),且治疗因素和时间因素存在交互作用(F=5.262～81.958,P<0.05)。相关分析发现,治疗后抑郁清单总分减少值、焦虑自评分减少值、大体功能分增加值分别与治疗后心理不安全感减少值、心理弹性分增加值呈正相关(r=0.456～0.894,P<0.05)。结论 IPT能够改善48名儿童期创伤焦虑障碍患者的焦虑抑郁症状和心理社会功能,病情的改善程度与患者心理不安全感的减轻和心理复原力的增强有关。     

Ghrelin as a Biomarker of Stress: A Systematic Review and Meta-Analysis

Introduction: Ghrelin is an orexigenic hormone which favors food-seeking behavior and has been postulated to be a biomarker of stress. We conducted a systematic review and meta-analysis on the evolution of ghrelin levels following acute stress. Methods: The PubMed, Cochrane Library, Embase, and ScienceDirect databases were searched for studies reporting ghrelin levels before and after acute stress in humans. Results: We included ten studies for a total of 348 patients. Acute stress (intervention) was always in a laboratory. Acute stress was psychological (Trier Social Stress Test), physical, or mixed (cold pressure test). The overall meta-analysis demonstrated an increase in ghrelin after the stress intervention (ES = 0.21, 95CI 0.09 to 0.34) compared with baseline levels. Stratification by time demonstrated an acute increase in ghrelin levels in the five minutes immediately following the initiation of stress (0.29, 0.10 to 0.48) but without any difference after. Obese individuals had a more significant (ES = 0.51, 95CI 0.18 to 0.84) and prolonged increase in ghrelin levels for up to 45 min compared with non-obese individuals who had a significant increase only five minutes after stress. Moreover, the ghrelin levels increased in response to stress with BMI (coefficient 0.028, 0.01 to 0.49; p = 0.013) and decreased with the time after the stress intervention (coefficient -0.007, −0.014 to −0.001; p = 0.025). Conclusion: Ghrelin is a biomarker of stress, with a short-term increase following acute stress. Obese individuals have both a higher and prolonged response, emphasizing the link between obesity and stress.     

Wellbeing of Breastfeeding Women in Australia and New Zealand during the COVID-19 Pandemic: A Cross-Sectional Study

During the COVID-19 pandemic, breastfeeding women have experienced restricted access to support, placing them at increased risk of mental health concerns and limited breastfeeding assistance. This study investigated the effect of the pandemic on feeding choices and maternal wellbeing amongst breastfeeding mothers living in Australian and New Zealand. We conducted a cross-sectional online survey that examined feeding methods, maternal mental wellbeing, worries, challenges, and positive experiences during the pandemic. Most women were exclusively breastfeeding (82%). Partial breastfeeding was associated with perceived low milk supply and longer pregnancy duration during the pandemic. Reduced mental health and wellbeing was associated with lower levels of family functioning, increased perceived stress, and perinatal anxiety. Longer pregnancy duration during the pandemic was associated with lower mental health wellbeing scores, while higher perceived stress scores were reported for regions with higher COVID-19 infection rates and women with perceived low milk supply. Women reported that the pandemic resulted in less pressure and more time for family bonding, while worries about the pandemic, family health, and parenting challenges were also cited. Mental health concerns of breastfeeding women appear to be exacerbated by COVID-19, highlighting a critical need for access to mental health and broader family support during the pandemic.