心理干预疗法对围术期食管癌患者康复的影响

目的 评价心理干预对围术期食管癌患者康复的影响。方法选择中山大学附属肿瘤防治中心2008年1月至10月胸外科收治的60例食管癌患者，随机分为干预组（31例）、对照组（29例），采用症状自评量表SCL-90（symptomcheck list-90，SCL-90）对食管癌患者做心理状况评价，同时由经过培训并掌握一定肿瘤相关知识的医学生对于预组患者进行针对性心理干预，包括健康教育、心理支持、应激处理、应对技术与行为训练，分术前、术后第一疗程、术后第二疗程三个阶段进行，同时进行阶段性评价、分析。结果与1986年金华等发表的全国常模比较，手术前干预组和对照组的躯体化、强迫、抑郁、焦虑、偏执、敌对、恐怖7个因子分均较常模高（P〈0．05），两组间差异无统计学意义（P=0．31）。术后第4、24周，干预组的因子积分及其平均分逐渐下降，与对照组比较差异有统计学意义（t4=4．71，P4=0．002；t24=3．82，P24=0．005）。结论心理治疗对患者的心理状态产生积极作用，有利于患者术后康复。     

The dream: a psychodynamically informative instrument.

The dream is a unique psychodynamically informative instrument for evaluating the subjective correlates of brain activity during REM sleep. These include feelings, percepts, memories, wishes, fantasies, impulses, conflicts, and defenses, as well as images of self and others. Dream analysis can be used in a variety of clinical settings to assist in diagnostic assessment, psychodynamic formulation, evaluation of clinical change, and the management of medically ill patients. Dreams may serve as the initial indicators of transference, resistance, impending crisis, acting-out, conflict resolution, and decision-making. A clinically functional categorization of dreams can facilitate an understanding of psychopathology, psychodynamics, personality structure, and various components of the psychotherapeutic process. Examples of different types of dreams are provided to illustrate their relevance and use in various clinical situations.     

学习障碍儿童心理问题及心理辅导效果评价

目的 探讨学习障碍（LD）儿童心理问题及心理辅导对改善LD儿童心理行为的效果评价。方法 分设干预组，LD对照组，学业一般组，学业优秀组。对各组儿童进行厌学情绪，心理健康和生活质量测定，并对干预组儿童进行2年心理辅导干预。结果 LD儿童和学业一般，学业优秀儿童在厌学情绪，对人焦虑，孤独倾向，自责倾向，过敏倾向和心理健康测量总分的差异有显意义（P＜0．05），均分结果显示LD组＞学业一般组＞学业优秀组。心理辅导后，干预组儿童在大学套学情绪，孤独倾向，自责倾向，过敏倾向和心理健康测量的总分均明显下降，亲子关系，同伴关系，师生关系，居住环境，活动机会性，社会心理状况，社会环境状况，生活质量总分则显提高，且心理辅导前后差异有显意义（P＜0．01）；干预组与LD对照组比较，在厌学情绪，心理健康状况，生活质量方面的上述各项指标，两组间差异有显意义（P＜0．05）。结论 LD组儿童存在一定的心理问题，心理辅导有助于改善LD儿童的心理健康状况，提高其生活质量。     

心理干预对干扰素-α治疗慢性乙型病毒性肝炎病人疗效及复发的影响

目的 分析心理干预对慢性乙型病毒性肝炎（CHB）病人重组干扰素-α 2b（rIFN-α 2b）疗效的影响.方法 CHB病人60例随机分为2组,观察组和对照组各30例,观察组除用rIFN-α 2b治疗外加心理干预治疗,对照组单用rIFN-α 2b治疗.rIFN-α 2b治疗前、结束时用症状自评量表（SCL-90）分别进行心理测试,并相互比较.结果 抗病毒前两组病人均存在严重的心身症状,差异无显著性（P＞0.05）;抗病毒结束时观察组阳性总分低于对照组（P＜0.05）;随访期末观察组完全应答率高于对照组（P＜0.05）,而复发率低于对照组（P＜0.05）.结论 CHB病人抗病毒前心理负担大,存在负性情绪;心理干预能减轻心理负担,且能提高干扰素-α治疗的远期疗效,降低复发率.     

痉挛性发声障碍的康复训练

目的 探讨康复训练治疗痉挛性发声障碍的疗效及意义。方法 采用心理疗法、针灸疗法、呼吸及发声功能训练等综合手段促使患者呼吸器官随意性运动协调，变高位呼吸、逆呼吸为正常的胸腹联合式呼吸，降低患者喉肌张力。结果 36例痉挛性发声障碍患者经过上述综合康复训练后，均取得了满意效果，其中30例患者痊愈，6例患者好转，治愈率达83．3％。结论综合应用心理疗法、针灸疗法、呼吸及发声功能训练等是痉挛性发声障碍患者较理想的康复训练方法。     

圣·约翰草提取物对2型糖尿病伴发抑郁症的疗效

目的：探讨抗抑郁植物药圣·约翰草提取物对伴发抑郁症的2型糖尿病患者的临床疗效及对患者血糖的影响。方法：将152例伴发抑郁症的2型糖尿病患者随机分为药物治疗组（38例）、心理治疗组（39例）、物理治疗组（36例）、对照组（39例），均治疗12周。以汉密尔顿抑郁量表（HAMD）减分率评定疗效，用糖化血红蛋白（HbA1c）水平监测血糖控制情况。结果：①治疗12周后，药物治疗组、心理治疗组、物理治疗组HAMD减分率分别为78．79％、51．28％、55．55％，与对照组相比，均有显著的抗抑郁治疗作用（X^2=39．72，p〈0.01），且药物治疗组优于心理治疗组及物理治疗组（p〈0．05）。②治疗12周后，HbA1C比治疗前明显下降（p〈0．01），药物治疗组HbA1C降低优于心理治疗组及物理治疗组。结论：圣·约翰草提取物能显著改善2型糖尿病患者伴发的抑郁症，且有利于患者的血糖控制。     

老年糖尿病共病抑郁的研究进展

糖尿病是一种慢性疾病,病程长、治疗难度大,易并发多种情绪障碍,特别是抑郁。当糖尿病与抑郁共病时,会使疾病治疗难度增加,致残率升高,特别是对于老年糖尿病患者,共病抑郁的现象非常常见。本文总结了老年糖尿病共病抑郁的现状、潜在机制、临床表现及糖尿病共病抑郁的最佳治疗策略,为老年糖尿病共病抑郁的医疗管理及后续相关研究提供参考。     

Asylum seekers’ mental health and treatment utilization in a three months follow-up study after transfer from a state registration-and reception-center in Germany

Even though asylum seekers show a high prevalence of trauma-related disorders and comorbid psychological stress symptoms, little is known about how their mental health develops during the asylum process and what options of care are provided. We aimed to investigate the mental health and treatment utilization of asylum seekers after they were transferred from a state registration- and reception-center to municipal shelters in Germany. N = 228 asylum seekers with on-going asylum procedure were recruited in the psychosocial walk-in clinic located in a state registration- and reception-center. We firstly captured symptoms of posttraumatic stress, depression, anxiety disorders, quality of life, as well as alcohol or drug abuse. Subsequently we performed a follow-up after three months to evaluate a potential shift in symptoms and determining rates of access to treatment. In the pre-post psychometric assessment, there were statistically significant changes in depression (PHQ-2), panic (PHQ-PD) and psychosocial well-being scores (WHO-5). However, all these scores still remained within a clinical relevant range, respectively. Traumatic stress (PC-PTSD-5) and general anxiety scores (GAD-2) did not change significantly. Although N = 44 (66%) of the interviewed patients had been referred to psychotherapy initially, none (0%) of them had received outpatient psychotherapeutic treatment after three months. Our results emphasize a strong need for low-threshold, cultural adapted psychotherapeutic treatment for asylum seekers.