瘀热型慢性前列腺炎与心理性因素及性功能的相关性

目的 分析瘀热型慢性前列腺炎(CP)临床症状与心理性因素及性功能的相关性.方法 收集2020年6月至2021年6月在南京市江宁中医院泌尿外科门诊诊治的91例瘀热型CP患者的临床资料进行回顾性分析,使用美国国立卫生研究院慢性前列腺炎症状指数评分表(NIH-CPSI)、中医证候量表、7项广泛性焦虑障碍量表(GAD-7)、抑...     

Anxiety in Response to Sustaining Spinal Cord Injuries and Disorders: When Should Clinicians Be Concerned?

ObjectiveTo recommend a cut-off score for the brief 2-item Generalized Anxiety Disorder (GAD-2) measure for persons with spinal cord injuries/disorders (PwSCI/D) and to estimate anxiety occurrence within this population using the full 7-item Generalized Anxiety Disorder (GAD-7).DesignMulticenter retrospective analyses.SettingOne inpatient rehabilitation center and 2 community sites for PwSCI/D.ParticipantsPwSCI/D 18 years or older (N=909) were included for analysis using retrospectively collected GAD-2 and GAD-7 data.InterventionsNot applicable.Main Outcome Measure(s)Occurrence of anxiety symptoms were compared using cut-off scores of ≥8 and ≥10 on the GAD-7. A cut-off score recommendation for the GAD-2 was determined using ROC curve, and sensitivity and specificity analyses.ResultsOccurrence of anxiety symptoms was 21% using a GAD-7 cut-off of ≥8 and 15% using a cut-off of ≥10. Analyses indicated optimal sensitivity for a GAD-2 score of ≥2 when a GAD-7 cut-off of ≥8 was used.ConclusionsAnxiety occurrence is elevated among PwSCI/D compared with the general population. For PwSCI/D, it is recommended that a cut-off score of ≥2 is used for the GAD-2 to maximize sensitivity and that a threshold of ≥8 is used for the GAD-7 to ensure the maximum number of individuals presenting with symptoms of anxiety are recognized for diagnostic interview. Study limitations are discussed.     

基于正念注意-接纳理论的情绪管理方案在孕妇心理干预中的应用效果研究

目的:分析基于正念注意-接纳理论的情绪管理方案对孕妇焦虑、抑郁及情绪调节的作用。方法:于2018年5月至2019年2月采用目的抽样法选取124例孕妇,随机分为实验组与对照组各62例。对照组接受孕期健康教育和由心理咨询师提供的不涉及正念相关教育和练习的情绪管理课程,实验组接受孕期健康教育和聚焦于正念注意、接纳要素的线上情绪管理训练。干预前后比较两组广泛性焦虑量表(GeneralizedAnxiety Disorder,GAD-7)、病人健康问卷(PatientHealthQuestionnaire,PHQ-9)、情绪调节自我效能量表(RegulatoryEmotionalSelf-Efficacy,RESE)得分差异,通过访谈了解实验组干预过程中感受、体验及正念技能掌握情况。结果:实验组干预后GAD-7、PHQ-9得分降低,RESE得分升高,基本可以掌握正念技能,但在干预过程中仍存在一定的阻碍因素。结论:基于正念注意-接纳理论的情绪管理训练可有效缓解孕妇的焦虑、抑郁情绪,提高其调节负性情绪的能力和信心。     

Psychosomatische Aspekte des chronischen Unterbauchschmerzsyndroms

Background

Chronic pelvic pain syndrome (CPPS) presents as a multicausal disorder. Complex interactions of psychological factors with somatic dysfunctions are crucial to the development and maintenance of CPPS.

Aim

This study characterized the patient cohort from a psychosomatic perspective.

Material and methods

Subjects with CPPS were recruited from an interdisciplinary CPP outpatient clinic. Sociodemographic data, symptoms (National Institutes of Health Chronic Prostatitis Symptom Index, NIH-CPSI) and pain-related factors (Short Form of the McGill Pain Questionnaire, SF-MPQ) as well as depressive symptoms (Patient Health Questionnaire 9, PHQ-9), anxiety [Generalized Anxiety Disorder 7-item (GAD-7) Scale], the severity of somatic symptoms (PHQ-15) and quality of life (Short Form-12, SF-12) were measured. Additional socioeconomic data were obtained.

Results

A total of 50 men and women with a mean disease duration of 5.8 years were included in the study. The disease-related symptom severity and healthcare utilization were high. All psychometric scales showed significantly lower values compared with the general population. A high symptom burden was associated with high psychopathological findings and reduced quality of life.

Conclusion

The psychopathological comorbidities in subjects with CPPS require specific evidence-based diagnostic and treatment methods to reduce psychopathology and improve quality of life.     

新型冠状病毒肺炎疫情防控期间血液肿瘤患者心理状况调查及影响因素分析

目的了解新型冠状病毒肺炎疫情防控期间血液肿瘤患者心理状况,分析相关影响因素。方法采用便利抽样法,选取150例血液肿瘤患者为研究对象,使用广泛性焦虑量表(GAD-7)和健康问卷抑郁症状群量表(PHQ-9)对患者的焦虑、抑郁状态进行调查和评估。结果患者GAD-7评分(10.76±4.89)分,PHQ-9评分(13.82±5.59)分。焦虑检出人数105(70.00%)例,抑郁检出人数95(63.33%)例。患者焦虑的影响因素包括性别、婚姻状况、是否携带中心静脉导管、目前是否住院、是否清楚家庭防护、疫情是否影响睡眠(P<0.05);患者抑郁的影响因素包括性别、年龄、家庭每月收入、是否携带中心静脉导管、目前是否在住院(P<0.05)。结论在新型冠状病毒肺炎疫情防控期间,血液肿瘤患者焦虑、抑郁发生率高,需要医护人员及时给予心理疏导,医疗机构采取有效措施,尽可能保证患者按时治疗。     

临床护理路径模式对直肠癌永久性肠造口患者抑郁和焦虑情绪的影响

目的:探讨临床护理路径模式对直肠癌肠造口患者抑郁和焦虑情绪的影响。方法:选取2017年1月—2018年12月南京医科大学第一附属医院收治的100例直肠癌肠造口患者,采用随机数字表法分为对照组与观察组,各50例,两组患者均接受常规护理,观察组在常规护理的基础上进行临床护理路径模式干预。采用患者健康问卷抑郁量表(PHQ-9)和广泛性焦虑评定量表(GAD-7)评估两组患者干预前后抑郁与焦虑情况。结果:干预前两组患者的PHQ-9评分比较,差异无统计学意义(t=0.116,P=0.908);干预后,干预组的PHQ-9评分低于对照组(t=6.083,P<0.01),且较干预前降低(t=7.676,P<0.01)。干预前两组患者的GAD-7评分比较,差异无统计学意义(t=0.227,P=0.821);干预后,干预组的GAD-7评分低于对照组(t=9.249,P<0.01);两组干预后的GAD-7评分均较干预前降低(P<0.01)。结论:临床护理路径模式的应用可以有效改善直肠癌肠造口患者的抑郁及焦虑情绪。     

心血管疾病患者焦虑和抑郁现状及影响因素分析

目的：运用广泛性焦虑量表（GAD-7）和健康问卷抑郁症状群量表（PHQ-9）调查心内科患者焦虑抑郁情况,并分析其影响因素。方法：采用便利抽样的方法选择138例心血管疾病患者为研究对象,使用 GAD-7和PHQ-9对患者的焦虑、抑郁情绪进行调查和评估。结果：GAD-7评分（7.33±4.78）分,PHQ-9评分为（7.29±4.82）分;焦虑检出率为62.3%,抑郁检出率为58.0%;心内科住院患者的抑郁的影响因素为年龄、月收入、介入治疗次数。焦虑的影响因素为年龄、月收入。结论：心血管疾病住院患者的焦虑抑郁发生率偏高,影响因素为年龄、月收入、介入治疗次数,在住院期间应早期筛查,及时发现,及时干预。     

The impact of resilience on headache disability as measured by the Migraine Disability Assessment (MIDAS)

Objective

Our objectives were to examine cross-sectional correlations of headache disability with measures of resilience, anxiety, and depression, and to determine if resilience modified the association between headache severity/frequency and disability.

Background

Resilience is associated with quality of life and functioning among patients with chronic conditions. We investigated whether resilience strongly mitigates headache-related disability as measured by the Migraine Disability Assessment (MIDAS).

Methods

We prospectively recruited 160 patients with primary headache disorders seen in a tertiary headache medicine program between February 20, 2018 and August 2, 2019. Each participant completed the MIDAS, Conner Davidson Resilience Scale (CDRS-25), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and WHO-5 Well-Being Index.

Results

The CDRS-25 score was negatively correlated with the total MIDAS (r = −0.21, p = 0.009), GAD-7 (r = −0.56, p < 0.001), and PHQ-9 scores (r = −0.34, p < 0.001). Well-being inversely correlated with disability (r = −0.37, p < 0.001). Increases in anxiety and depression increased the odds of disability. A 1 point increase in the CDRS-25 score decreased the odds of being severely disabled by 4% (OR = 0.96, 95% CI: 0.94 to 0.99, p = 0.001). However, the CDRS-25 score did not significantly moderate the association between headache days and disability.

Conclusion

Traits associated with resilience decreased the odds of severe disability from headaches, whereas anxiety, depression, and headache frequency were strongly associated with higher disability from headache.     

Validity and reliability testing of the prenatal psychosocial profile

Two studies of low-income pregnant women (N = 179) were done to examine the validity and reliability of the Prenatal Psychosocial Profile (PPP). The PPP, a composite of the Rosenberg Self-Esteem Scale, the Support Behaviors Inventory, and a newly developed measure of stress, is a brief, comprehensive clinical assessment of psychosocial risk during pregnancy. Construct validity of the stress scale was supported by theoretically predicted negative correlations with self-esteem, partner support, and support from others (N = 91). Convergent validity of the stress scale was demonstrated by a correlation of .71 with the Difficult Life Circumstances Scale. Adequate levels of internal consistency were found. Interrelationships between the four sub-scales were consistent with the underlying conceptualization, and there was beginning evidence of the factorial independence of the subscales.     

Reliability and validity of a Swedish language version of the Resilience Scale

The purpose of this study was to test the reliability and validity of the Swedish language version of the Resilience Scale (RS). Participants were 142 adults between 19-85 years of age. Internal consistency reliability, stability over time, and construct validity were evaluated using Cronbach's alpha, principal components analysis with varimax rotation and correlations with scores on the Sense of Coherence Scale (SOC) and the Rosenberg Self-Esteem Scale (RSE). The mean score on the RS was 142 (SD = 15). The possible scores on the RS range from 25 to 175, and scores higher than 146 are considered high. The test-retest correlation was .78. Correlations with the SOC and the RSE were .41 (p < 0.01) and .37 (p < 0.01), respectively. Personal Assurance and Acceptance of Self and Life emerged as components from the principal components analysis. These findings provide evidence for the reliability and validity of the Swedish language version of the RS.     

抑郁和焦虑与老年认知障碍患者认知水平的相关性分析

目的：探讨老年认知障碍患者抑郁和焦虑评估的临床价值，分析老年认知功能减退的可能影响因素。方法：筛选2019年6月至2021年11月期间在复旦大学附属华山医院老年医学科门诊就诊的可疑认知障碍老年人群，检测其认知水平、抑郁和焦虑评分及相关生化指标。按照认知水平分为3组：非认知障碍组、轻度认知障碍组（MCI）及痴呆组。完成认知水平测试（MMSE+MoCA)及焦虑和抑郁评估（PHQ-9+GAD-7），同时完成甲状腺功能、梅毒/艾滋病血清标志物、血同型半胱氨酸（HCY）、叶酸、维生素B12、自身免疫性脑炎抗体等血液生化学检查及尿液阿尔兹海默相关神经丝蛋白（AD7c-NTP）检测。结果：共入组242例可疑老年认知障碍患者，其中非认知障碍组37例，MCI组62例，痴呆组143例，三组人群抑郁检出人数分别为12例（32.4%）、30例（48.4%）和82例(57.3%)，焦虑检出人数分别为10例(27.0%)、24例（38.7%）和72例（50.3%），非认知障碍组和痴呆组之间具有显著差异；三组人群之间甲状腺功能、梅毒/艾滋病血清标志物、自身免疫性脑炎抗体异常率均无明显差异；三组人群之间HCY、叶酸、AD7c-NTP异常率具有显著性差异，但维生素B12异常率无显著性差异；多元Logistics回归分析显示，与非认知障碍组比较，MCI组与年龄和GAD-7评分呈正相关；痴呆组与年龄、HCY水平、PHQ-9和GAD-7评分等危险因素之间存在正相关；痴呆组与MCI组比较，GAD-7评分明显增高(p＜0.05)，而两组年龄、HCY、叶酸和PHQ-9评分之间无明显差异。结论：老年认知障碍患者易伴抑郁、焦虑等不良情绪，抑郁和焦虑情绪与年龄、认知功能及HCY和叶酸水平之间存在一定相关性。以上研究提示门诊接诊可疑老年认知障碍患者时，有必要对患者进行认知功能评估的同时完善抑郁和焦虑评估。     

县级基层护士职业倦怠状况及影响因素分析

目的 分析某县基层护士的职业倦怠状况及影响因素.方法 选取某县医院护士507人,采用职业倦怠量表通用版(MBI-GS)、患者健康问卷抑郁症状群量表(PHQ-9)、广泛性焦虑量表(GAD-7)、中文版知觉压力量表(CPSS)、一般自我效能感量表(GSES)进行横断面调查;比较不同人口学特征护士的职业倦怠情况,采用多元线性...     

Experienced personal control and quality of life in late-stage cancer patients

This study examined the association of experienced personal control and quality of life for late-stage cancer patients within the context of Rotter's Social Learning Theory and Seligman's Theory of Learned Helplessness. It was hypothesized that in late-stage cancer patients greater control would be associated with a higher quality of life as measured by self-esteem, anxiety, and perceived self-esteem, anxiety, and perceived meaningfulness. The longer the history of the disease, the lower would be the individual's level of experienced personal control and quality of life. Fifty-seven late-stage cancer patients completed four standardized instruments: the Rosenberg Self-Esteem Scale; the Health Locus of Control Scale (HLC); the Lewis, Firsich, and Parsell Attorney Scale; and the Crumbaugh Purpose-in-Life Test. As predicted, the measure of experienced personal control over life significantly correlated with scores on the self-esteem scale (tau = -.33; p = .001), and the anxiety scale (tau = -.30; p = .001). Contrary to prediction, scores on the Health Locus of Control Scale were only significantly associated with scores on the Purpose-In-Life Test (tau = -.18; p = .05). Length of history of disease was significantly related to scores on the HLC Scale (tau = .27; p = .007) and to scores on the anxiety scale (tau = .20; p = .03) but was not significantly associated with scores on the self-esteem scale or the Purpose-In-Life Test.     

The state of measurement of self-esteem of African American women.

This article critically reviews the state of measurement of self-esteem in African American women. The Rosenberg Self-Esteem Scale, the Tennessee Self-Concept Scale, and the Coopersmith Self-Esteem Inventory are three commonly used measures. However, their validity for African American women has not been adequately tested. Given the unique nature of the self-esteem of this group, related to experiences of racism and sexism, the accurate measurement of this construct is important. This review provided support for the internal consistency of each measure with alpha coefficients ranging from .74 to .87. However, the validity of the measures was not fully supported. Suggestions for further research specific to the unique needs of this population are discussed.     

综合医院门诊多躯体症状患者的躯体疾病和精神心理特点

  目的  了解综合医院门诊多躯体症状患者的躯体疾病和精神心理特点, 并探讨其相关因素。  方法  2012年3月至10月采用方便取样的方法, 对北京协和医院消化内科、中医科和心理医学科门诊候诊患者通过躯体症状严重程度量表(somatic symptom scale of the Patient Health Questionnaire, PHQ-15)进行连续筛查。依据PHQ-15分数≥ 10或 < 10, 将患者分为多躯体症状组(SOM+组)和对照组(SOM-组)。每科各组均纳入25例患者, 共纳入150例患者。所纳入患者均完成7份自评问卷及结构化半定式访谈, 包括过去12个月所患躯体疾病和简明国际神经精神访谈。  结果  SOM+组患者女性(69.3%比53.3%)和低于大学文化程度者(54.8%比43.2%)所占比例较SOM-组更高(P < 0.05)。SOM+组患者并未发现患有更多的可明确诊断的躯体疾病; 而其抑郁发作、广泛性焦虑障碍和疑病症的患病率以及抑郁症状严重程度量表(depression scale of the Patient Health Questionnaire, PHQ-9)、广泛性焦虑量表(Generalized Anxiety Disorder 7-item scale, GAD-7)、健康焦虑量表(Whiteley-7 scale, WI-7)得分均显著高于SOM-组(P均 < 0.05), 其日常生活和就医行为受症状影响更显著(P均 < 0.01)。对多躯体症状预测因素进行Logistic回归分析(P < 0.01, 调整R²=0.53), 发现PHQ-9和WI-7总分高以及没有职业为影响因素。  结论  多躯体症状患者并未发现伴有更多可明确诊断的躯体疾病; 此类患者的焦虑及抑郁程度更高, 生活质量更低, 且其症状对日常生活和就医影响更大; 抑郁和健康焦虑水平高及没有职业是多躯体症状的预测因素。     

中学生的焦虑状况及与自尊和应付方式的关系研究

目的探讨中学生焦虑的状况及与自尊和应付方式之间的关系。方法采用状态-特质焦虑问卷(STAI)、自尊量表(SES)及应付方式问卷,对396名中学生进行测查,所得数据运用SPSS 10.0软件包进行统计处理。结果中学生状态焦虑和特质焦虑分高于全国常模,有显著性差异。中学生状态焦虑、特质焦虑分与自尊呈显著负相关。中学生焦虑水平与自责、幻想、逃避和合理化应付因子呈显著正相关,与问题解决、求助应付因子呈显著负相关。自尊对状态焦虑和特质焦虑有较强预测作用;解决问题、自责对状态焦虑和特质焦虑有很强预测作用,求助对特质焦虑有预测作用。高焦虑的中学生自尊水平低,倾向使用消极的应付方式。结论中学生的焦虑水平较高,自尊和应付方式是影响中学生焦虑的重要的内部心理因素。     

New insights in symptom assessment: the Chinese Versions of the Memorial Symptom Assessment Scale Short Form (MSAS-SF) and the Condensed MSAS (CMSAS)

There are very few symptom assessment instruments in Chinese. We present the validity and reliability of the Memorial Symptom Assessment Scale Short Form (MSAS-SF) and the Condensed Form MSAS (CMSAS) in Chinese cancer patients. The Chinese version of the 32-item MSAS-SF, a self-report measure for assessing symptom distress and frequency in cancer patients, was administered to 256 Chinese patients with colorectal cancer at a clinical oncology outpatient unit. Highly prevalent symptoms included worrying (59%), dry mouth (54%), lack of energy (54%), feeling sad (48%), feeling irritable (48%), and pain (41%). Both the MSAS-SF and CMSAS demonstrated good validity and reliability. For the MSAS-SF subscales, Cronbach alphas ranged from 0.84 to 0.91, and for CMSAS subscales, from 0.79 to 0.87. Moderate-to-high correlations of MSAS-SF and CMSAS subscales with appropriate European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 subscales (0.42–0.71, Ps < 0.001) indicated acceptable convergent validity. Low correlations with the Rosenberg Self-Esteem and Optimism Scale (0.22, P < 0.001) indicated divergent validity. MSAS subscales varied as expected with other Chinese scales—the Chinese Health Questionnaire (CHQ) and the Life Orientation Scale. Construct validity of both MSAS versions was demonstrated by effective differentiation between clinically distinct patient groups (Karnofsky scores <80% vs. ≥80% [P < 0.001]; no active treatment vs. active treatment [P < 0.002–0.034]; CHQ-12 scores ≤4 vs. CHQ-12 scores >4 [P < 0.001]). The Number of Symptoms subscale correlated appropriately with the EORTC QLQ-C30 function (−0.46 to −0.60, P < 0.001) and symptom scales (0.31–0.64, P < 0.001). The average time to complete the MSAS-SF was six minutes. The Chinese versions of the MSAS-SF and CMSAS are valid and practical measures. Further validation is needed for Chinese patients with other cancer types and with other symptom instruments.     

新冠肺炎疫情对居民睡眠质量的影响分析

目的 调研新冠肺炎疫情期间居民的睡眠质量、焦虑、抑郁情况，并分析其影响因素，探寻居家干预策略。方法 2021年7月30日至8月12日，以南京市江宁区常住居民为抽样调查对象，通过线上或线下形式发放问卷，包括失眠严重指数量表（ISI）、广泛性焦虑障碍量表（GAD-7）、抑郁自评量表（PHQ-9），对居民的睡眠质量、心理状态进行评估，并采用Logistic回归分析影响居民睡眠质量的相关因素。结果 共调查了779名居民，ISI评分为（15.40±5.99）分，中、重度失眠发生率为47.37%（369/779）；GAD-7量表评分为（5.52±5.34）分，中、重度焦虑发生率为36.97%（288/779）；PHQ-9量表评分为（7.97±6.31）分，中、重度抑郁发生率为38.51%（300/779）。Logistic回归分析结果显示，女性、医务人员、黄码人员、中度焦虑、抑郁与失眠的发生呈正相关，是失眠的危险因素；而高文化水平、接种疫苗与失眠的发生呈负相关，是失眠的保护因素。结论 新冠肺炎疫情期间，居民易出现失眠、焦虑、抑郁等问题，应关注相关影响因素，针对涉疫地区居民及时进行线上睡眠健康宣教和心理疏导。     

Diagnostic and Clinical Utility of the GAD-2 for Screening Anxiety Symptoms in Individuals With Multiple Sclerosis

Objective

To assess the diagnostic and clinical utility of the 2-item Generalized Anxiety Disorder Scale (GAD-2) for screening anxiety symptoms in individuals with multiple sclerosis (MS).

The Duke Health Profile. A 17-item measure of health and dysfunction

The Duke Health Profile (DUKE) is a 17-item generic self-report instrument containing six health measures (physical, mental, social, general, perceived health, and self-esteem), and four dysfunction measures (anxiety, depression, pain, and disability). Items were derived from the 63-item Duke-UNC Health Profile, based upon face validity and item-remainder correlations. The study population included 683 primary care adult patients. Reliability was supported by Cronbach's alphas (0.55 to 0.78) and test-retest correlations (0.30 to 0.78). Convergent and discriminant validity were demonstrated by score correlations between the DUKE and the Sickness Impact Profile, the Tennessee Self-Concept Scale, and the Zung Self-Rating Depression Scale. Clinical validity was supported by differences between the health scores of patients with clinically different health problems. Patients with painful physical problems had a DUKE physical health mean score of 58.1, while patients with only health maintenance problems had a mean score of 83.9 (scale: 0.0 = poorest health and 100.0 = best health). Patients with mental health problems had a DUKE mental health mean score of 49.2, in contrast to 75.7 for patients with painful physical problems and 79.2 for those with health maintenance. The DUKE is presented as a brief technique for measuring health as an outcome of medical intervention and health promotion.