抑郁障碍患者家庭功能的跨文化研究

目的:探讨中国和美国抑郁障碍患者的家庭功能特征.方法:采用家庭功能量表(FAD)对92例中国抑郁障碍患者(中国组)及92例美国抑郁障碍患者(美国组)进行评估及比较.结果:两组FAD各维度均分均高于健康的家庭功能临界值,为不健康的家庭功能.中国组FAD中的情感反应维度评分及行为控制维度评分明显高于美国组;中国男性组情感反...     

帕罗西汀治疗2型糖尿病伴抑郁的研究

目的:探讨帕罗西汀对2型糖尿病伴发抑郁患者生活质量的影响.方法:对45例2型糖尿病伴发抑郁患者给予帕罗西汀治疗.疗程12周.治疗前后分别进行汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)及健康状况调查问卷(SF-36)评定.对照组50例为不伴抑郁的糖尿病患者进行SF-36评定.结果:帕罗西汀能明显改善治疗组抑郁、焦虑症状;治疗前2型糖尿病伴抑郁患者生活质量明显低于对照组.结论:帕罗西汀能明显改善2型糖尿病伴抑郁患者的生活质量及预后.     

抑郁症患者的家庭功能和照料者生活质量研究

目的评价抑郁症患者的家庭功能和直接照料者的生活质量。方法采用家庭关怀度指数问卷（APGAR）和健康状况问卷（SF-36）,对96例符合DSM-Ⅳ标准的抑郁症患者的家庭功能和直接照料者的生活质量进行评定,并与一般家庭作对照,从家庭的角度评价抑郁症的疾病负担。结果抑郁症患者患病后家庭功能存在障碍的家庭均显著多于对照组（P〈0.05）,患病后比患病前家庭功能出现障碍的比例显著升高（P〈0.001）。患病后APGAR总分及各因子分均比患病前显著降低（P〈0.001）。直接照料者生活质量评定,在SF-36的8个因子中,生理职能、一般健康、社会功能、情感职能和精神健康因子评分显著低于对照组（P〈0.001）,其他因子评分差异无统计学意义（P〉0.05）。结论抑郁症对家庭功能和直接照料者生活质量的影响是严重和多层次的,需进行相应干预。     

糖尿病患者生活质量研究

目的:探讨糖尿病患者生活质量及其相关因素。方法:应用健康状况调查问卷(SF-36),社会支持评定量表(SSRS)对61例糖尿病患者进行问卷调查,以50名健康者为对照,测患者空腹血糖(FBG)和餐后2h血糖(2hPG)。结果:糖尿病组SF-36生理功能、生理职能、情感职能、生命活力、精神健康、社会功能、躯体疼痛、总体健康状况8个因子分均显著低于对照组,糖尿病组社会支持总分、利用度因子分有明显下降。相关分析显示,社会支持总分与SF-36的躯体功能(r=0.274,P<0.05),躯体角色功能(r=0.240,P<0.05),以及一般健康状况(r=0.216,P<0.05)均相关。2hPG与SF-36社会因子分之间相关(r=-0.276,P<0.05)。结论:糖尿病患者的生活质量普遍下降,与社会支持呈正相关,与2hPG呈负相关。     

伴有抑郁的脑梗死患者生存质量

目的：探讨急性期脑梗死患者抑郁心理对其特异性生存质量的影响。方法：急性期脑梗死患者142例,经Zung抑郁自评量表（SDS）评分后分为无抑郁组50例,轻度抑郁组36例和中度抑郁组56例。运用脑卒中影响量表（SIS）评定3组患者的生存质量。结果：在SIS的8个维度中,轻度抑郁组在体力,记忆/思维,情绪,日常活动能力,社会参与等维度的评分低于无抑郁组（P〈0.05）。中度抑郁组在体力,记忆/思维,日常活动能力,行动能力,社会参与等维度的评分低于轻度抑郁组（P〈0.05或P〈0.001）。中度抑郁组除手功能外的其他各维度评分明显低于无抑郁组（P〈0.05或P〈0.001）。结论：脑梗死患者抑郁程度与其生存质量密切相关,抑郁程度重者生存质量较差。     

家庭干预对精神分裂症患者生活质量的影响

目的：探讨家庭干预对精神分裂症患者的生活质量及社会功能的作用。方法：对60例生活质量及社会功能明显下降的精神分裂症患者进行为期1年家庭干预。采用生活质量量表（QOL），简明精神病评定量表（BPRS）及社会功能缺陷筛选表（SDSS）进行干预前后评分。结果：1年后BPRS、SDSS、QOL评分大多项目较干预前有改善。结论：家庭干预能提高精神分裂症患者生活质量，改善社会功能，降低复发率。     

帕金森病患者的抑郁症状与生活质量

当前越来越多的学者关注帕金森病(Parkinson's diseas, PD)患者的生活质量.而近年来的研究表明,PD患者除运动障碍外还普遍存在抑郁、焦虑、自主神经功能紊乱、睡眠障碍等一些非运动症状.这些可严重影响着患者的生活质量,其中尤以PD伴发的抑郁或情感淡漠影响明显[1].故本研究对PD合并抑郁患者的生活质量进行直接的评估,进一步评价PD的抑郁症状与生活质量的关系.     

抑郁障碍对帕金森病患者生活质量的影响

分别采用抑郁自评量表和36条简明健康状况调查表评价100例原发性帕金森病患者的抑郁障碍和生活质量,结果显示,除生理职能差异无统计学意义外(P0.05),生理功能(P=0.001)、情感(P=0.000)、社会功能(P=0.007)、躯体疼痛(P=0.000)、精力(P=0.000)、精神健康(P=0.000)、一般健康(P=0.004)和总评分(P=0.000)差异均有统计学意义。提示抑郁障碍可以降低帕金森病患者的生活质量。     

Ⅱ型糖尿病患者抑郁症状与生活事件应付方式的比较研究

本文采用横断面研究方法，随机抽样７０例（门诊及住院各３５例）Ⅱ型糖尿病患者，用Ｚｕｎｇ自评抑郁量表，生活事件量表，应付方式量表进行抑郁症状及抑郁症状与生活事件，应付方式关系的调查。结果发现，抑郁症状发生率为６１．０％，抑郁症状与住院组织生活事件有关，门诊组多采用自责应付方式，住院组多采用自责，幻想的应付方式。     

结构式团体认知行为治疗对轻症抑郁患者社会功能及生活质量的影响

目的:评估结构式团体认知行为治疗对轻症抑郁症患者社会功能及生活质量的影响。方法:采用前后对照设计,对102例轻症抑郁症患者每周1次、每次90 min、共12次的结构式团体认知行为治疗;并于治疗前、治疗第12、24、36和48周末随访时进行汉密尔顿抑郁量表(HAMD-17)、6项生活质量问卷(SF-6)及大体功能评定量表(GAF)评估患者抑郁症状、社会功能和生活质量。结果:共有77例完成24周随访,59例完成36周随访,49例完成48周的随访。与治疗前比较,治疗后第12周HAMD-17评分明显下降,SF-6及GAF评分明显提高(P0.05或P0.01);且这种改变在随访的24、36和48周末仍持续存在。结论:结构式团体认知行为治疗可以有效改善轻症抑郁症患者的抑郁症状、社会功能及生活质量。     

The effect of depression on quality of life of patients with type II diabetes mellitus

Diabetes mellitus (DM) is a frequently encountered metabolic disease with chronic features and involves numerous complications throughout its course, which causes severe restriction and disability in an individual's life. It has been reported that the incidence of depression is higher in diabetic patients and that diabetes is one of the risk factors in the development of depression. It has also been reported that co-morbid psychiatric disorders cause further deterioration in the quality of life in diabetic patients. The aim of this study was to investigate the effects of depression on the quality of life in type II DM patients. Sixty patients (30 females and 30 males) with current major depressive episode diagnosed according to DSM-IV criteria, and 48 type II DM patients (30 females and 18 males) without a major depressive episode (non-depressed group) were included in the study. All patients were evaluated with a semi-structured interview form to assess the clinical features of DM, Hamilton Rating Scale for Anxiety (HRSA), Hamilton Rating Scale for Depression (HRSD), and the Turkish version of The World Health Organization Quality of Life Assessment-Brief (WHOQOL-BREF). The HRSD and HRSA scores in the depressed group were 24.87+/-4.83 and 21.07+/-5.44, respectively, whereas those in the non-depressed group were 7.83+/-3.92 and 6.88+/-3.43, respectively. The physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores were found significantly lower in the depressed group than the non-depressed group. There were significant negative correlations between HRSD and HRSA scores and physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. Furthermore, there were significant negative correlations between the HbA1c level and physical health, social relationship, environmental domain, social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. However, there was a significant positive correlation between the level of education and physical health, psychological health, social relationship, environmental social pressure domain, overall quality of life, and WHOQOL-BREF total scores. There were significant negative correlations between social relationship domain score, and age and duration of illness. Our study demonstrates that the presence of depression in type II DM further deteriorates the quality of life of the patients. Since treating depression would have a beneficial effect on the quality of life, clinicians should carefully assess for depression associated with type II DM.     

抑郁症患者家属生活质量调查

目的：了解抑郁症患者家属的生活质量。方法：应用生活质量综合评定问卷对116名抑郁症患者家属及52名正常对照者进行评定。结果：抑郁症患者家属的总体生活质量及躯体功能、心理功能、社会功能、物质生活较正常对照者差,其中以心理健康和躯体健康对生活质量的影响最大。结论：抑郁症患者家属的生活质量较正常对照者差,并涉及到心身健康的多个方面。     

抑郁症患者防御方式及其家庭生活质量研究

目的:了解抑郁症患者心理防御方式特征和家庭生活质量。方法:使用防御方式量表(DSQ)对75例抑郁症患者防御方式进行评定,采用生活质量综合评定问卷(GQOLI-74)对92名抑郁症患者家属的生活质量进行评定,两组均以80名正常人作为对照。结果:抑郁症组中间型及不成熟型防御机制评分(4.76±0.41)和(4.41±0.60),显著高于对照组(4.31±0.31)和(3.92±0.81)(P均<0.01);而抑郁症组成熟防御机制评分(4.62±0.54)则显著低于对照组(5.20±0.47)(P<0.05)。抑郁症家属生活质量较对照组差,GQOLI总分及躯体、心理、社会功能及物质生活4个维度均较对照组显著为低(P<0.01或P<0.05)。结论:抑郁症患者多采用了中间型和不成熟型的心理防御方式,其家庭生活质量下降。     

Neuropathy is associated with depression independently of health-related quality of life in Japanese patients with diabetes

Objectives:  To identify factors independently associated with depression in Japanese patients with diabetes, after controlling for potential confounding factors.
Methods:  Among 197 outpatients with diabetes, 129 (type 1: 24, type 2: 105) completed a questionnaire concerning socio-demographic and health-related variables. Depression screening was done using Zung's Self-Rating Depression Scale test, followed by diagnostic interviews by experienced psychiatrists employing the Diagnostic Statistical Manual of Mental Disorders, 4th edition (DSM-IV).
Results:  Forty-seven patients (36.4%) had symptomatological depression. A Self-Rating Depression Scale cut-off score of 40 had good sensitivity (100%) and modest specificity (59%) for detecting major depressive episode, in accordance with the DSM-IV. Diabetic patients suffering from depression were more likely to have neuropathy, retinopathy, body pain, a feeling of poor general health, and lack of social support, than the non-depressed patients. However, age, gender, marital status, diabetes type, insulin requirement, duration of diabetes, hemoglobin A1c (HbA1c) and the presence of nephropathy did not differ between the two groups. In multivariate logistic regression analysis, body pain (OR 3.26, 95% CI 1.31–8.08) and the presence of microvascular complications (OR 2.81, 95% CI 1.13–6.98) were independent factors associated with depression. Specifically, diabetic neuropathy (OR 3.10, 95% CI 1.17–8.22) was associated with depression independently of age, gender, marital status, social supports, quality of life, diabetes type, duration of diabetes, HbA1c, and insulin requirement.
Conclusions:  A diabetic complication, specifically neuropathy, was independently associated with depression in patients with diabetes. The present findings indicate the need to find a biological base common to both depression in diabetes and diabetic neuropathy.     

Health-related quality of life and its relationship to cognitive and emotional functioning in multiple sclerosis patients

The existing knowledge about the health-related quality of life (HRQoL) and its relationship to cognitive and/or emotional functioning in multiple sclerosis (MS) is scarce. We assessed differences between subgroups of MS outpatients (n = 209) on one HRQoL instrument: a version of the Functional Assessment of Multiple Sclerosis quality of life instrument; on two cognitive functioning tests: the Mini-Mental State Examination and the clock drawing test; and on two emotional functioning tests: the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety. Three disease-related characteristics were assessed: physical disability, duration of the illness, and clinical course. The results showed that each of these has an effect on at least one dimension of HRQoL and on one mental functioning test. Thus, the more severe, the more progressive, and the longer the illness duration, the lower the HRQoL. Likewise, cognitive mean scores decreased and emotional mean scores increased with greater illness severity and progressive the MS. Furthermore, we also found significant correlations between cognitive and emotional functioning tests and HRQoL dimensions. Thus, the worse cognitive functioning and the higher depressive and anxiety symptoms score the lower the HRQoL.     

Impact of family functioning on quality of life in patients with psychogenic nonepileptic seizures versus epilepsy

Purpose: To evaluate different contributions of aspects of family functioning (FF) on health‐related quality of life (HRQOL) in patients with psychogenic nonepileptic seizures (PNES) versus epileptic seizures (ES). Methods: Forty‐five participants with PNES and 32 with ES completed self‐report measures of FF (Family Assessment Device; FAD), HRQOL (Quality of Life in Epilepsy‐31), and depression (Beck Depression Inventory‐II; BDI‐II). The FAD is a self‐report questionnaire that assesses FF along six dimensions and general functioning. Regression analyses were used to evaluate the contribution of FF to HRQOL above and beyond the effects of disease severity and depression. Key Findings: Mean Family General Functioning fell in the unhealthy range in participants with ES or PNES. On further analysis, male participants in each group endorsed unhealthy levels of FF compared to female participants. Patients with PNES reported poorer HRQOL and greater depressive symptoms compared to ES participants; there were no gender differences in HRQOL. Regression analyses indicated that the FAD Roles subscale predicted reduced HRQOL in patients with PNES after controlling for illness duration, seizure frequency, and depression. After controlling for the same factors, Communication and Affective Involvement subscales scores predicted HRQOL in ES participants. Significance: Family dysfunction was reported in both ES and PNES participants, but greater family dysfunction was experienced by male participants in both groups. Aspects of FF predicted HRQOL in patients with PNES and ES differentially. FF may be an important treatment target to enhance coping in these groups, although the treatments may need to target different aspects of FF in PNES versus ES.     

成年癫痫患者抑郁、焦虑状况及生活质量调查

目的调查成年癫痫患者抑郁、焦虑的患病率及可能的危险因素;评价抑郁及焦虑对癫痫患者生活质量的影响。方法采用Beck抑郁问卷(BDI)、贝克焦虑量表(BAI)及癫痫患者生活质量量表-31(QO-LIE-31中文版),对200例成年癫痫患者的抑郁、焦虑情况及生活质量进行评估。结果在200例癫痫患者中43.5%伴发抑郁,28.5%伴发焦虑,23%伴发抑郁及焦虑。发作频繁、无有薪职业是癫痫患者伴发抑郁的重要危险因素,无有薪职业是癫痫患者伴发焦虑的危险因素。抑郁组及抑郁伴焦虑组的QOLIE-31总分及各项评分均低于非抑郁非焦虑组(P=0.000);焦虑组的QOLIE-31总分(P=0.004)及发作的担忧(P=0.019)、认知功能(P=0.009)方面的得分均低于非抑郁非焦虑组。结论抑郁和焦虑是癫痫患者常见的精神共病,严重影响了癫痫患者的生活质量。积极控制发作、为癫痫患者提供更多的就业机会是改善癫痫患者生活质量的重要因素。