开放式管理下的精神病患者康复治疗300例临床观察

目的：探讨实行开放式管理对精神病患者康复治疗的影响.方法：回顾性调查分析实行开放式管理的患者300例,病房倾向家庭化、社会化,结合医院的实际重点进行康复治疗.结果：精神科疾病疗效得到显著提高,缩短了患者住院时间,患者社会功能恢复较强.结论：对精神病患者实行开放式病区管理及康复治疗,重视及时转变管理理念、重视患者的心理治疗、重视医疗安全管理、重视医患沟通,是提高患者治疗和康复的有效方式.     

首发精神病病人家庭关系调查及干预

目的 探讨首发精神病病人家庭关系对其病情的影响及护理干预措施。方法 选择首次发病的精神病病人78例,随机分为干预组和对照组,各39例。分别对两组病人的家庭关系进行调查,找出影响因素,然后对干预组家庭实施干预措施,对照组进行一般卫生宣教,于患者出院后半年,对两组病人病情及家庭关系再次进行调查。结果 干预组病人临床痊愈率、遵医服药率等均优先于对照组,且家庭关系更为融洽,病人的生活质量明显高于对照组。结论 对首发精神病病人家庭关系进行干预,可明显改善其家庭关系,改善照料者对患者的照护水平,减少复发,提高生活质量。     

Psychopathy and Human Evil: An Overview

The term “psychopath” usually conjures images of serial killers or acts of genocide. Less frequently considered are those who are intelligent enough to avoid detection by the criminal justice system while hiding in the boardrooms of corporations or lurking in the halls of government institutions. This article provides an overview of psychopathy and human evil by exploring the personality characteristics, organization, and cognitive style of the psychopath, the role of superego pathology, contributions from the field of attachment, and ways in which dissociation plays a role in psychopathy and the potential for confusing this with the dissociative structuring of the mind. The article closes with a brief discussion about “corporate” or “successful psychopaths” and how they have a negative impact on culture and society.     

精神病患者多次无抽搐电休克治疗后的心理护理

目的了解精神病患者多次无抽搐电休克治疗（MECT）后出现的不同的心理问题，探讨心理护理方法。方法80例住院精神病患者，经MECT治疗后出现的不同的心理问题.对治疗的依从性发生改变。结果针对不同的心理问题，采取相应的护理措施，使患者继续治疗，有效地控制精神症状。结论心理护理在提高患者完成MECT治疗的依从性方面有不可替代的作用。     

Revisiting the nursing management of the psychopath

Revisiting the nursing management of the psychopath
There has been a growing concern regarding the treatability of those patients labelled as psychopathically disordered. Notwithstanding this important debate, and the ultimate outcome of it, the nursing management of this categorized legal group continues on a daily basis. This paper contributes a theoretical foundation to the practicalities of nursing this particularly difficult patient group, based upon clinical experience, and offers a nursing perspective to the complexities of the debate.     

影响精神病患者回归社会的因素调查

目的了解影响精神病患者回归家庭和社会的主要因素,明确其需要强化和消减的行为,以便及早干预和矫正,提高他们适应社会生活的能力。方法针对影响精神病患者回归社会的因素自编调查问卷,对精神病患者亲属进行问卷调查。结果影响精神病患者回归社会前几位的因素依次为:工作能力下降、情绪不稳和易激怒、沉浸于幻觉妄想中、懒散、不适当或怪异言语、注意力不集中或不能持久、情绪低落和抑郁、人际关系处理不当和日常生活不能自理等;各行为间存在不同程度的正相关,但与性别、年龄、文化程度、职业等关系无显著性意义(P>0.05)。结论临床上应尽早采用有效干预手段,对影响精神病患者回归社会生活的行为加以矫正,训练和培养其适应性行为,提高社会适应能力。     

健康教育对暴力精神病患者家庭环境和生活质量的影响

目的探讨通过健康教育的模式,改善暴力精神病患者家庭环境,提高其生活质量。方法由医生和护士组成健康教育小组,对120例经在院治疗达到临床痊愈后出院的暴力精神病患者,在家庭随访或门诊复诊时实施健康教育,为期1年。采用家庭环境量表（FES—CV）和生活质量综合评定问卷（GQOLI）于入组和出组时对患者的家庭环境状况和生活质量进行评估。结果实施健康教育前后比较,FES．CV量表在亲密度、情感表达、矛盾性、独立性、成功性、控制性等分量表上得分明显改善,差异有统计学意义（P〈0．01）;其中亲密度、情感表达、独立性在入组时评分分别是（5．58±1．26）分、（5．89±1．62）分、（4．24±1．16）分,而出组时提高到（6．92±1．43）分、（6．54±1．71）分、（5．75±1．64）分,差异具有统计学意义（t分别为5．20,4．13,3．95;P〈0．01）。GQOLI量表客观状态与主观满意度每一项得分均有提高,差异有统计学意义（P〈0．01）,其中客观状态躯体功能入组时得分为（20．63±4．52）分,出组时增加至（25．92±6．43）分,组间比较差异具有统计学意义（t=5．57,P〈0．01）。结论本研究表明,通过健康教育能够改善暴力精神病患者家庭环境,提高患者生活质量,促进社会功能恢复,对稳定暴力行为有积极的作用。     

THE ODYSSEY – A JUNGIAN PERSPECTIVE: INDIVIDUATION AND MEETING WITH THE ARCHETYPES OF THE COLLECTIVE UNCONSCIOUS

Homer's epic tale of the 20-year return of Odysseus from the Trojan War is investigated with particular reference to Jung's theory of individuation. Odysseus' meetings with 'the anima' in the form of goddesses, sirens and female monsters and his visit to Hades demonstrate the confrontation and humanization of aspects of the archetypal level of the psyche, central to Jung's theories of psychic growth and development. Jung's important ideas of the psychoid level and the transcendent function are explored and linked both to his investigations into medieval alchemy and with findings from contemporary neuroscience. The importance of Jung's constructive method of the interpretation of dreams and myths is shown to be central.     

Ned Kelly – Stock Thief,Bank Robber,Murderer – Psychopath

In his boyhood, Edward “Ned” Kelly began “lifting” cattle and horses. His early convictions included assault (1870), “feloniously receiving a horse” (1870) and resisting arrest (1877). On 15 April 1878, a lone police constable who visited the Kelly home to arrest Dan Kelly for horse theft later alleged that Ned Kelly shot and wounded him and that he had been assaulted by Kelly's family members. With a warrant for his arrest on a charge of attempted murder, in October 1878, Kelly and his gang ambushed and shot dead three policemen in remote bushland near Mansfield. On 1 November 1878, as a result of the Felons’ Apprehension Act, the Kelly gang were proclaimed “outlaws” and initially rewards of £200 for each was offered alive or dead. After robbing banks in Euroa and Jerilderie in NSW, and murdering a police informant, Kelly and his gang planned to derail a special train carrying police and black-trackers. The derailment was averted and police laid siege as sixty hostages huddled inside the Glenrowan Hotel. Kelly always claimed that he and his family had been victimised by police and that he had been driven to lawlessness. Many historians and authors have attempted to make connections between the Kelly gang outbreak and social conflicts of the period. However, a close examination of his developmental history and subsequent criminal behaviour reveals that Kelly was a violent and vindictive man who demonstrated prominent psychopathic features including pathological lying, callous lack of empathy for others and a parasitic lifestyle. As Kelly terrorised country Victoria, he showed little concern other than for his own gratification and self-justification. Kelly's own florid diatribes and correspondence further illuminate his grandiose sense of self-worth and his inability to accept responsibility for his criminality.     

应用戴师社会基理论对精神病患者进行心理护理的对照研究

目的:研究应用戴师社会基理论对精神病患者进行心理护理的作用效果。方法:2004年1月10日选取精神病患者100例,随机分为社会基理论组和对照组,每组50例。应用戴师社会基理论的基本方法对患者进行心理护理,应用临床疗效总评量表、住院用护士观察量表、日常生活能力量表、WHO社会功能筛选量表,于治疗前及治疗90天后各评定1次,靶问题或行为于出院6个月再进行评定。结果:两组患者心理护理后住院用护士观察量表、日常生活能力量表、WHO社会功能筛选量表评定结果差异有显著性(P<0.01)。研究组与对照组总显效率、有效率差异有显著性(X2=6.829,P<0.01)。研究组、对照组复发率差异有显著性(X2=5.002,P<0.01)。结论:应用戴师社会基理论进行心理护理能改善精神分裂症患者的心理调节和自我保健等调适方法,避免复发的诱因,降低复发率,提高康复质量和护理质量。