Psychoneurodendocrine correlates of lymphocyte subsets during healthy ageing

Ageing has been associated with increased cortisol levels and absolute counts of T lymphocytes with memory phenotype. Although the mechanisms underlying these changes are still unknown, it has been speculated that this could be related to a dysfunction in FAS/CD95 expression in naive or memory cells. In this study, we investigated the role of psychoneuroendocrine variables in regulating CD95 expression on lymphocyte subsets. Forty-six elderly subjects (65-91 years) and 33 young adults (20-40 years) were recruited accordingly the SENIEUR protocol. The psychological status was measured by structured clinical interviews, salivary cortisol was assessed along the day (9, 12 and 22h) and peripheral blood lymphocytes were immunophenotyped. The elderly were more stressed, depressed and anxious than the young subjects. Cortisol levels were increased in the elderly, indicating an activation of the hypothalamic-pituitary-adrenal (HPA) axis. We observed reduced counts of CD45RA+CD95+ cells in the elderly compared to young adults. The elderly subjects also showed a reduced expression of CD3 and CD62L in contrast to increased CD95 expression in CD45RA+ cells. The emotional state was positively correlated with the lymphocyte markers. Our data suggest the healthy ageing is associated with psychoneuroendocrine alterations that may be implicated in the regulation of CD95 expression on peripheral T cells.     

Association of habitual exercise with adults’ mental health following the Fukushima Daiichi nuclear power plant accident: the Fukushima Health Management Survey

IntroductionThe Great East Japan Earthquake and the Fukushima Daiichi nuclear power plant accident in March 2011 impacted survivors’ mental health. This study examined whether exercise habits and mental health conditions were associated, and whether the degree of the effect varied depending on time.MethodsA self-administered questionnaire was sent annually to former residents (born before April 1, 1998) in registered evacuation areas. Exercise habit was evaluated by participants’ exercise frequency, and responses were categorized into “almost never,” “once a week,” and “twice a week and more.” Data were tracked during three periods: fiscal year (FY) 2011–2012, 2012–2013, and 2013–2014. The association between baseline habitual exercise and new onset of psychological distress was assessed using the Japanese version of the Kessler 6-item Psychological Distress Scale and logistic regression analysis.ResultsA total of 1304 (5.7%) of 22,741, 1060 (4.7%) of 22,709, and 759 (3.6%) of 21,220 respondents had psychological distress in FY 2011–2012, 2012–2013, and 2013–2014, respectively. An association between exercise and psychological distress was observed in men in FY 2011–2012 (P for trend: 0.010) and in women in FY 2013–2014 (P for trend: 0.026). “Almost never” was associated with onset of psychological distress in men in FY 2011–2012 [odds ratio (OR): 1.317, 95% confidence interval (CI): 1.054–1.645] and in women in FY 2013–2014 (OR: 1.296, 95% CI: 1.027–1.636).ConclusionsExercise habit was associated with psychological distress, and its effect in time varied according to sex.     

Coping With Stress Through Texting: An Experimental Study

PurposeTexting is used by many adolescents and has the potential to improve well-being, as youth can reach out for support immediately after experiencing a stressful situation. Many studies have examined whether texting is associated with well-being, but few have used experimental designs, preventing causal claims.MethodsIn this experimental study, 130 adolescents (M_age = 12.41) participated with a same-gender friend whom they texted regularly. Both adolescents completed a task that elicited stress and then engaged in one of the following randomly assigned activities: texting their friend, watching a video on a cellphone (passive-phone condition), or sitting quietly (no activity condition). Participants reported their mood and stress levels after the stress task and again after the activity. Heart rate variability was measured throughout.ResultsParticipants who texted their friend reported higher moods (b = ?.80, standard error [SE] = .24, p < .001, η_p² = .09) and lower stress at the end of the study than those in the no activity condition (b = .51, SE = .25, p = .046, η_p² = .04) and higher moods than adolescents in the passive-phone condition (b = ?.74, SE = .25, p = .004, η_p² = .08). No differences were noted between the passive-phone and no activity conditions. There were no differences in heart rate variability between the three conditions. The effects of texting on mood, self-reported stress, and heart rate variability did not differ by gender.ConclusionsBoth boys and girls may benefit from texting a friend after experiencing a stressful event.     

Transitions Between Frailty States and Its Predictors in a Cohort of Community-Dwelling Spaniards

ObjectivesStudy the frequency and determinants of frailty transitions in a community-dwelling older population.DesignPopulation-based prospective longitudinal study [The Toledo Study of Healthy Ageing (TSHA)].Setting and Participants1748 community-dwelling individuals aged >65 years living in Toledo, a Spanish province.MethodsFrailty was measured with the Fried phenotype. Logistic models were used to assess the associations of sociodemographic, clinical, life-habits, functional, physical performance, and analytical variables with frailty transitions (losing robustness, transitioning from prefrailty to robustness, and from prefrailty to frailty) over a median of 5.2 years.ResultsMean age on enrolment was 75 years, and 55.8% were females. At baseline, 10.3% were frail and 43.1% prefrail. At follow-up, 35.8% of the frail individuals recovered to a prefrail and 15.1% to a robust state. In addition, 43.7% of the prefrail participants became robust, but 14.5% developed frailty. Of those robust at baseline, 32.9% became prefrail and 4.2% frail. In multivariate logistic models, chair-stands had a predictive role in all transitions studied: linearly in keeping robustness and with a floor effect (5 stands) in transitions from prefrailty to robustness and (inversely) from prefrailty to frailty. More depressive symptoms were associated with unfavorable transitions. Not declaring the amount of alcohol drunk and low grip strength were associated with loss of robustness. Hearing and cognitive impairment, low physical activity and smoking with transitioning from prefrailty to frailty. Autonomy for instrumental activities of daily living and uricemia were associated with transitions between robustness and prefrailty in both directions. Increasing body mass index in the range of moderate to severe obesity hampered regaining robustness.Conclusions and ImplicationsSpontaneous improvement of frailty measured with the Fried phenotype is frequent, mainly to prefrailty. Most of the variables associated with transitions are modifiable and suggest research topics and interventions to reduce frailty in clinical and social care settings.     

儿童心理问题的家庭治疗原则与策略

儿童心理问题的常规治疗包括心理治疗和药物治疗,但是两者具有一定的局限性和社会不适性。家庭对儿童的成长具有重大影响,也是儿童出现心理问题的重要源头,所以家庭的介入对于心理问题儿童的治疗非常关键。家庭治疗的主要原则包括培养儿童的独立性、解决儿童与外界之间的冲突以及重视家庭成员间的和谐关系。家庭治疗所采取的策略主要是转变家庭内部态度、重视家庭的整体性、心理治疗和家庭治疗的互相配合以及对医学诊断的重视。在专业医学诊断指导下,通过家庭介入传统的心理治疗,从而更好地改善儿童所面临的心理问题。本文回顾了现有的儿童心理问题的研究成果,强调了家庭对儿童心理问题的影响,总结了儿童心理问题的家庭治疗原则和策略。     

长期家庭氧疗对慢性阻塞性肺疾病患者心理情绪的影响

目的探讨长期家庭氧疗(LTOT)对慢性阻塞性肺疾病(COPD)低氧血症患者心理情绪的影响。方法31例COPD低氧血症患者用医院焦虑和抑郁情绪表(HAD)进行心理情绪评分。然后分为LTOT组17例和对照组14例。LTOT组的氧流量0.5～2.5L/min,每日吸氧时间≥15h(包括睡眠时间);对照组除未进行LTOT外,其余治疗与氧疗组相同。两组年龄、性别、肺功能和动脉血气无明显差别。1年后分别复查HAD评分。结果LTOT组焦虑评分由治疗前的14.35±3.81下降到1年后的9.65±3.83(P<0.01),抑郁评分由治疗前的13.18±4.50下降到1年后的9.06±2.79(P<0.01);对照组焦虑和抑郁评分均无明显变化。1年后LTOT组的焦虑及抑郁评分分别与对照组比较明显改善。1年后LTOT组除动脉血氧分压与对照组有显著差异外,动脉血二氧化碳分压、PH值及肺功能均无显著差异。结论LTOT能改善COPD低氧血症患者的心理情绪。     

儿童牙科畏惧症心理干预的临床疗效观察

目的：探讨心理干预对儿童牙科畏惧症（DA）疗效的影响,方法：采用Corah's牙科畏惧症评分法,筛选出316例DA儿童患者,分为干预组和对照组,干预组在进行常规牙科治疗的同时采用心理干预;对照组则为常规的牙科治疗。结果：干预组DA程度明显降低,与牙科治疗前以及对照组比较都有显著性差异（P＜0．01）,牙科治疗后干预组脉搏减慢例数多于对照组,脉博加快例数少于对照组,差异有显著性（P＜0．05）,心理干预后男性比女性疗效要好（P＜0．05）,结论：心理干预方法治疗儿童DA是有效的。     

住院患儿亲属的心理健康状况及其相关因素的研究

目的 了解住院患儿亲属心理健康状况及其相关因素。方法 应用症状自评量表（SCL－90）及自编的一般情况调查表对儿科住院患儿756名亲属进行测查,按亲属是否陪护住院患儿分成陪护组和隔离组。并测查329名健康儿童亲属作对照。结果 住院患儿亲属的SCL－90各项评价指标均显著高于对照组,差异有极显著性（P＜0．001）。陪护组仅躯体化因子得分高于隔离组,差异有显著性（P＜0．05）。住院患儿亲属心理状况与性别、文化程度、职业、家庭经济状况、居住环境及患儿的性别、病情的轻重相关。结论 住院患儿亲属心理健康水平明显低于正常人。儿科的心理护理不仅应包括患儿还应包括患儿亲属。     

200例更年期综合征妇女精神心理及社会因素现况调查

目的：了解更年期综合征患者精神和心理障碍,探讨社会因素对其的影响,方法：通过问卷式表格填写的方法,对200例更年期综合征妇女进行进行躯体表现、精神和心理障碍,应激反应、性生活、应激事件等现况调查,结果：更年期货征妇女普遍存在精神心理障碍,65％应激反应下降,50％性功能下降,生活中应激事件与更年期的综合征互为影响,结论：提高这一人群的生命质量,激素替代治疗须配合心理支持治疗。     

《内经》对心理、行为医学的贡献

通过对《内经》“神”原分析,可见顺应自然,保持乐观舒达的情志,建立平衡的心理状态,建立健康的行为习惯是摄生长寿的要素。从中显示了中医顺应自然,天人合一观;七情、内因发病观;注重机体反应性的整体观;调神扶正的治疗观等优势理论,及其对临床、心理、行为医学的杰出贡献。