初发脑梗死患者应对方式与情绪的相关性研究

目的：探讨初发脑梗死患者应对方式与情绪的相关性。方法对80例初发脑梗死患者应用简易应对方式问卷（SCSQ）、医院焦虑抑郁量表（HADS）、美国国立卫生院神经功能缺损评分（NIHSS）、自编患者一般资料调查表进行评估。结果初发脑梗死患者应对方式中排在第1位的是积极应对条目“坚持自己的立场,为自己想得到的斗争”,排在第2位的则是消极应对条目“自己安慰自己”。焦虑发生率33．8％,抑郁发生率31．3％,积极应对与焦虑（rs ＝－0．293）和抑郁（rs ＝－0．486）均呈负相关（P ＜0．05）,但消极应对与焦虑抑郁的相关性没有统计学意义。结论1／3的初发脑梗死患者存在焦虑抑郁情绪,医护人员若能尽早评估初发脑梗死患者的应对方式,鼓励患者采用积极应对方式,并合理利用消极应对方式的缓冲作用,将有利于促进患者的精神健康。     

Chronic Ethanol Potentiates the Effect of Neuropeptide S in the Basolateral Amygdala and Shows Increased Anxiolytic and Anti-Depressive Effects

Alleviating anxiety and depression is pivotal for reducing the risk of relapse in alcoholics. Currently available anxiolytic treatments are limited by side effects, including reduced efficacy in alcoholics, addiction, and sedation. We examined whether the neuropeptide S receptor (NPSR) was effective at controlling ethanol consumption and the anxiety and depression produced by forced abstinence from ethanol. We found that the anxiolytic and anti-depressant effects of NPS are enhanced in acute ethanol abstinent mice. In addition, we found that NPS reduced ethanol consumption and is not in and of itself rewarding. We also provide evidence that ethanol consumption increases the ability of NPS to modulate neuronal activity in the basolateral amygdala. Finally, we found that local injection of NPS in the basolateral amygdala promotes anxiolysis after chronic ethanol consumption, thereby providing insight into the molecular mechanism underlying the changes in behavioral response to NPS. In light of the improved anxiolytic efficacy and benign side effects of NPS in ethanol-withdrawn animals, the NPSR may prove a suitable target for reducing relapse in alcoholism.     

Client Attitudes Toward Alcohol Use Self-Report

Because psychiatric illnesses and problematic alcohol use frequently co-occur and heavy alcohol use can exacerbate depression and anxiety, mental health clinicians should perform alcohol-use screenings. The aim of this study was to determine if psychiatric patients would be accepting of their mental health clinician screening them for heavy alcohol use. Using a written survey, patients rated their levels of agreement with 9 statements regarding opinions about alcohol screening by their mental-health providers. They also completed the Alcohol Use Disorders Identification Test-C (AUDIT-C), a screening instrument for heavy alcohol use. One hundred fifty-four patients were surveyed in 2 psychiatric outpatient clinics. Nearly 40% screened positively for heavy alcohol use on the AUDIT-C. Nearly 8 out of 10 psychiatric patients were in favor of being screened for alcohol use by either self-report or biomarkers, independent of AUDIT-C status and gender. Thus, mental health clinicians should not be deterred from alcohol screening by perceived negative attitudes from patients.     

Coping strategies of alcoholic women

Recent efforts have increased research on alcoholic women. Few studies have examined the coping mechanisms characteristic of alcoholic women relative to their nonalcoholic controls. Conforming to DSM‐IV criteria for alcohol dependence, 159 alcoholic women stratified by race (black and white) and age (20–29, 30–39, and 40–49 years) were compared to 150 nonalcoholic women from a variety of public and private inpatient and outpatient treatment facilities regarding the types of coping strategies used. Alcoholic women were significantly more likely to favor maladaptive styles of coping, while nonalcoholic women employed significantly more problem‐solving and emotion‐based coping strategies. Neither race nor age differences significantly influenced the types of coping utilized by these women. The profile of coping strategies utilized by the alcoholic group is consistent with a poor quality of life and compounding of problems.     

Coping Strategies of Alcoholic Women

Recent efforts have increased research on alcoholic women. Few studies have examined the coping mechanisms characteristic of alcoholic women relative to their nonalcoholic controls. Conforming to DSM-IV criteria for alcohol dependence, 159 alcoholic women stratified by race (black and white) and age (20–29, 30–39, and 40–49 years) were compared to 150 nonalcoholic women from a variety of public and private inpatient and outpatient treatment facilities regarding the types of coping strategies used. Alcoholic women were significantly more likely to favor maladaptive styles of coping, while nonalcoholic women employed significantly more problem-solving and emotion-based coping strategies. Neither race nor age differences significantly influenced the types of coping utilized by these women. The profile of coping strategies utilized by the alcoholic group is consistent with a poor quality of life and compounding of problems.     

酒精依赖患者家属心理状况的研究与分析

目的獉獉:对酒精依赖患者家属的心理状况进行分析研究,以了解酒精依赖患者家属的心理健康状况,为患者家属的心理支持干预提供依据。方法獉獉:60例酒精依赖患者家属作为实验组,对年龄、性别和文化程度匹配后,在医院职工等正常人群中选择59例作为对照组,运用症状自评量表(SCL-90)、抑郁自评量表(SDS)、焦虑自评量表(SAS)三种自评量表对两组人群进行调查及统计分析。结果獉獉:在酒精依赖患者的家属中除人际关系、精神病性与对照组无统计学差异外,躯体化、强迫症状、抑郁、焦虑、敌对、恐怖、偏执因子均高于对照组。抑郁、焦虑阳性检出率也高于对照组,且差异具有统计学意义。结论獉獉:由于患者家属长期与酒依赖患者居住生活在一起,易诱发不同程度的焦虑、抑郁,甚至有些严重者可能会出现精神病性症状。我们在治疗患者的同时,也应关注患者家属的心理健康状况。采用不同的心理干预方式有针对性的进行治疗,以便减轻酒精依赖患者家属的抑郁、焦虑等情况。     

度洛西汀防治慢性偏头痛伴焦虑抑郁障碍的疗效分析

目的 探讨度洛西汀治疗伴焦虑抑郁障碍的慢性偏头痛的临床疗效.方法 选择于河北医科大学第一医院治疗的偏头痛患者117例,对照组予盐酸氟桂利嗪胶囊和洛索洛芬钠治疗,观察组在对照组基础上给予盐酸度洛西汀肠溶胶囊.观察治疗前及疗程完成后第6周末患者头痛发作频率、持续时间(h)及头痛等级.同时评估汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分及激越分量表(BPRS)评分情况.结果 治疗后,观察组HAMD评分为(9.2±3.6)分、HAMA为(6.2±2.1)分、BPRS为(4.5±1.6)分,偏头痛每周发作次数(0.30±0.11)次,每次持续(2.65±1.36)h,与治疗前比较差异有统计学意义(P＜0.05),观察组优于对照组(P＜0.05).治疗前,2组患者发作次数、持续时间比较差异无统计学意义(P＞0.05).2组偏头痛发作频率及每次发作持续时间较治疗前均显著降低(P＜0.05);观察组发作次数少于对照组,持续时间低于对照组,差异有统计学意义(P＜0.05).对照组和观察组头痛分级治疗前差异无统计学意义(P＞0.05);对照组观察组头痛等级为0级的升高至16.4％,比例为Ⅲ的降低至14.5％,差异有统计学意义(P＜0.05);观察组头痛等级为0级的升高至24.2％,比例为Ⅲ的降低至6.5％,差异有统计学意义(P＜0.05).结论 联合盐酸度洛西汀肠溶胶囊用手缓解焦虑抑郁症、降低偏头痛发作频率和减轻偏头痛程度等方面有确切的疗效,能够明显提高患者生活质量.     

艾司西酞普兰的药理及临床评价

艾司西酞普兰为S-西酞普兰,以其较好的疗效及较高的耐受性,在抑郁症及焦虑症等的治疗中得到广泛应用。笔者对其药理作用、药动学特点、临床应用及安全性等方面做一综述。     

A Role for Galanin N-Terminal Fragment (1–15) in Anxiety- and Depression-Related Behaviors in Rats

Background:

Galanin (GAL) plays a role in mood regulation. In this study we analyzed the action of the active N-terminal fragment [GAL(1–15)] in anxiety- and depression-related behavioral tests in rats.

Methods:

The effect of GAL(1–15) was analyzed in the forced swimming test, tail suspension test, open field test, and light/dark test. The proximity of GAL₁ and GAL₂ receptors was examined with the proximity ligation assay (PLA). We tested the GAL receptors involved in GAL(1–15) effects with the GAL₂ receptor antagonist M871 and with an in vivo model of siRNA GAL₂ receptor knockdown or siRNA GAL₁ receptor knockdown rats. The effects of GAL(1–15) were also studied in the cell line RN33B.

Results:

GAL(1–15) induced strong depression-like and anxiogenic-like effects in all the tests. These effects were stronger than the ones induced by GAL. The involvement of the GAL₂ receptor was demonstrated with M871 and with the siRNA GAL₂ receptor knockdown rats. The PLA indicated the possible existence of GAL₁ and GAL₂ heteroreceptor complexes in the dorsal hippocampus and especially in the dorsal raphe nucleus. In the siRNA GAL₁ receptor knockdown rats the behavioral actions of GAL(1–15) disappeared, and in the siRNA GAL₂ receptor knockdown rats the reductions of the behavioral actions of GAL(1–15) was linked to a disappearance of PLA. In the cell line RN33B, GAL(1–15) decreased 5-HT immunoreactivity more strongly than GAL.

Conclusions:

Our results indicate that GAL(1–15) exerts strong depression-related and anxiogenic-like effects and may give the basis for the development of drugs targeting GAL₁ and GAL₂ heteroreceptor complexes in the raphe-limbic system for the treatment of depression and anxiety.     

心衰患者长期应用卡维地洛对心理状况的影响

目的了解心衰患者长期应用卡维地洛对患者心理状况的影响方法:100例慢性充血性心衰(CHF)患者,(男79例,女21例)平均53.23±16.42岁,心功能(NYHA分级)Ⅱ-Ⅳ级,抑郁者39例,焦虑者48例。卡维地洛从小剂量开始,逐渐递增,实验中严密检测各项相关指标。结果:随访98周,随访期间猝死1例,治疗后心功能有明显改善[(2.24±0.79)比(3.05±0.65)P<0.05],6分钟步行距离较治疗前亦有明显进步[(312.71±152.39)比(203.67±134.86)P<0.001],超声心动图示LVEF明显增加[(38.9±6.7)比(32.8±4.9)P<0.001],治疗后反映抑郁状态的SDS评分两组均稍有改善,但无统计学意义,显示焦虑状态的SAS评分均有明显改善,其中焦虑组(n=48)为[(41.57±11.73)比(67.48±16.37)P<0.001]非焦虑组(n=51)[(31.12±9.72)比(36.32±7.84)P<0.001].明尼苏达生活质量量表评分也有显著的改善[(23.86±9.64)比(41.63±13.76)P<0.05]。结论:卡维地洛长期治疗心衰患者除了能明显提高患者的活动耐量,改善心功能外,还能改善CHF患者的焦虑状况,但对抑郁状况无明显影响.     

某高职院校医学生抑郁、焦虑现状分析

目的 了解安徽省某高职院校医学大学生的抑郁、焦虑现状及相关因素,为针对性的开展大学生心里保健和咨询工作提供依据.方法 采取分层随机整群抽样的方法,抽取安徽省某高职学校医学生537人,用Zung氏抑郁自评量表（SDS）和汉密顿焦虑量表（HAMA）的量表进行抑郁、焦虑状况筛查.结果 抑郁检出率为30.4%;焦虑检出率为40.2%.对焦虑和抑郁得分及检出率分析表明,各专业、成绩排名和同学关系好坏的学生之间抑郁情况差异有统计学意义;药学专业的学生比其他专业的学生抑郁得分较高,检验和影像专业的学生得分其次,医学营销专业的学生得分最低.抑郁情况随着成绩在班内排名的增加而增加,学习成绩排名下30%的的学生抑郁情况较严重,同学关系一般的学生抑郁得分较高;不同家庭经济情况的学生之间焦虑得分情况差异有统计学意义;家庭经济情况好的学生焦虑状况评分较低.焦虑和抑郁之间存在正相关（rs=0.36,P〈0.05）.结论 某高职院校大学生焦虑、抑郁情况较为严重,根据相关因素及时开展心理健康的分析和相关对策研究是必要的.