慢性乙肝患者的心理健康情况调查分析

目的:本文针对乙肝患者存在的心理障碍,提出相应的干预方法,为提高乙肝患者的心理健康水平及治疗效果提供理论依据。方法:选取2011年1月-2012年11月在我院接受治疗的慢性乙型肝炎患者80例作为研究组,另选取80位同期在我院接受体检的健康人群为对照组。针对两组对象的焦虑、抑郁、偏执等心理问题设计问卷调查,统计并分析调查结果。结果:观察组患者的焦虑及抑郁评分明显高于对照组,差异具有统计学意义(P0.05);观察组中,病情重的患者焦虑及抑郁评分高于病情轻、中度的患者,差异具有统计学意义(P0.05)。结论:慢性乙型肝炎患者的心理压力对治疗有影响,医护人员应积极的对乙肝患者进行心理疏导,帮助其树立自信、摆脱心理障碍,以积极的心态配合治疗,从而获得良好的疗效。     

心理干预对高血压合并脑梗塞患者负性情绪及生活质量的影响

目的:探讨心理干预措施对高血压合并脑梗塞患者负性情绪及生活质量的影响。方法:本次选择的研究对象共92例,均为住院的高血压合并脑梗塞患者,采用简单随机分组方法,分为干预组和对照组,每组46例。对照组给予常规治疗及护理,干预组在对照组的基础上给予心理干预。在入组时、入组后1个月采用抑郁自评量表(SDS)、焦虑自评量表(SAS)、症状自评量表(SCL一90)作为测评工具,测评两组患者干预前后负性情绪和生活质量情况。结果:入组时两组患者的SDS评分、SAS评分及SCL-90各项分值比较差异无统计学意义(P0.05);干预治疗1个月后干预组较对照组患者的SDS评分、SAS评分及SCL-90各项分值均降低,差异有统计学意义(P0.05)。结论:心理干预不仅能缓解患者抑郁焦虑等负性情绪,而且有利于患者生活质量的提高。     

Association between prehypertension and psychological distress among adults in Saudi Arabia: A population-based survey

BackgroundPrehypertension is a precursor to hypertension status. Psychological distress has been identified earlier among hypertensives; however, there is little evidence for the presumptive relationship between prehypertension and psychological distress.ObjectiveThe study aimed to assess the psychological wellbeing of the Al-Kharj, Saudi Arabia population, using the General Health Questionnaire (GHQ-12) and correlating it with prehypertensive patients in the same population.MethodsA cross-sectional analysis of the population of Al-Kharj, Saudi Arabia, was carried out between January and June of 2016. With an 85 percent response rate, a total of 1016 participants participated in the study. A multiple linear regression analysis was performed to assess the relationship between prehypertension and psychological distress.ResultsThe findings of the adjusted analysis demonstrated that, on average prehypertensive patients were more distressed psychologically than non-hypertensive patients (unstandardized Beta regression coefficient = 3.600; P-value 0.025). Similarly, on average women were found to be more psychologically distressed than men (unstandardized Beta = 1.511, P-value 0.002). Civil workers and unemployed individuals were more psychologically distressed than employed individuals (unstandardized Beta = 1.326, P-value 0.041) while adjusting for the sociodemographic and other variables such as BMI, diabetes status, cholesterol, and smoking status.ConclusionThe current study shows that as compared to normotensive patients, self-rated mental wellbeing and psychological wellbeing are all considerably poorer among prehypertensive patients. To prevent individuals from having negative psychological outcomes and their long-term complications, the Government of Saudi Arabia needs to concentrate on prehypertensive, female, and unemployed individuals. Well-designed longitudinal studies, primarily in Saudi Arabia, are needed in the future to research the cause and impact of poor mental health and prehypertension.     

团体心理咨询对甲减患者焦虑抑郁情绪的影响

目的:探讨团体心理咨询对甲减患者焦虑、抑郁情绪的影响,为改善甲减患者心理健康状况提供参考依据。方法:选择2014年1月至2016年1月在我院确诊为甲减后焦虑、抑郁的60例患者,按照随机数字表法分为对照组(n=30)和研究组(n=30)。对照组给予常规药物治疗,研究组在对照组基础上给予6周的团体心理咨询治疗。治疗后6周、3个月测量两组患者的甲状腺功能情况,并对比治疗前、治疗后6周及治疗后3个月两组的汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分,另外治疗后3个月比较两组患者的满意度。结果:治疗后6周对照组甲状腺功能正常24例,异常6例,研究组正常25例,异常5例;治疗3个月两组甲状腺功能正常均为30例,两组患者治疗后6周、3个月的甲状腺功能情况比较无统计学差异(P0.05)。治疗后6周、3个月两组HAMA、HAMD评分较治疗前降低,且研究组较对照组的评分更低(P0.05)。治疗后3个月研究组患者满意度为96.67%(29/30),明显高于对照组的66.67%(20/30)(P0.05)。结论:团体心理咨询在甲减后焦虑、抑郁患者的治疗中的作用明显,可显著改善患者的心理健康状况,提高患者的满意度。     

初始沙盘在临床心理中的诊断鉴别作用

目的:探讨患者初始沙盘在临床心理中的诊断鉴别作用。方法:选择4名在临床中被误诊的患者。其中A例患者诊断一般心理问题;B、C、D例患者诊断为精神分裂症;使用沙盘对该4例患者重新进行临床分析与诊断。结果:根据患者初始沙盘中是否给玩具赋予特殊意义、使用玩具的多少、玩具之间是否有联系、使用栅栏情况、沙盘主题以及患者对沙盘的解释等对4名被误诊的患者进行重新诊断;A例患者重新诊断应为精神分裂症;B例患者应为强迫症(强迫思维);C例患者应为边缘型人格障碍;D例患者应为人际关系障碍。结论:在临床心理工作中,患者的初始沙盘可以起到高效、准确的诊断鉴别作用。     

腰椎间盘突出症阶梯式手术治疗方案的临床疗效和患者心理状况调查

目的:探讨阶梯式手术治疗方案对腰椎间盘突出的临床疗效和患者对临床疗效的心理接受情况。方法:回顾性分析2014年至2016年本院骨科确诊为腰椎间盘突出症的50例患者,经椎间孔镜下行髓核摘除微创手术(Percutaneous transforaminal endoscopic discectomy,PTED),术后1天和3个月采用视觉疼痛模拟评分(VAS)和改良Mac Nab疗效评定、术后3个月采用Oswestry功能障碍指数(ODI)评价手术效果,以及相应调查时间点患者对手术效果心理接受程度调查;对于7例微创手术疗效不佳患者进一步采用传统的开窗髓核摘除术(Fenestration discectomy,FD),采用同样方法评价手术效果和调查患者心理接受情况。结果:50例微创术后1天及术后3个月的VAS评分和ODI指数均显著低于术前,差异具有显著性(P均0.05);改良Mac Nab疗效评定:术后1天优良率为84%,术后3个月为86%;患者对术后疗效心理满意度调查:术后1天,满意并接受为84%,不满意但接受为16%,不满意难接受为0;术后3个月,满意并接受为86%,不满意但接受为14%,不满意难接受为0。对于微创术后效果欠佳7例患者行FD手术,术后1天及3个月的VAS评分和ODI指数均显著低于术前,差异具有显著性(P均0.05);改良Mac Nab疗效评定:术后1天优良率为71%,术后3个月为100%;患者对开窗术后疗效心理满意度调查:术后1天,满意并接受为71%,不满意但接受为0,不满意难接受为29%;术后3个月,满意并接受为100%,不满意但接受为0,不满意难接受为0。结论:腰椎间盘突出症阶梯式手术治疗方案临床效果和患者心理接受情况均值得临床推荐。     

5436 例性病门诊患者流行病学调查及心理状况分析

目的:调查本地区5436例性病(STD)门诊患者流行病学特征,并对患者心理状况进行分析。方法:对2012年1月~2014年12月本地区3家医院性病门诊5436例患者(观察组)的5种生殖器疱疹(GH)、生殖道衣原体感染(GCI)、尖锐湿疣(CA)、淋病(GU)、梅毒(SYP)常见性传播疾病的基本情况、流行病学特征进行记录分析。采用自制心理测评量表对其中250例STD患者的心理状况进行评估,并与250例同期门诊治疗的一般感冒患者(对照组)进行比较。结果:2012~2014年门诊5种常见STD患者就诊人数呈上升趋势,以GU下降最为明显,GCI逐渐上升较为明显;STD患者发病主要集中于26~35岁,以司机、低学历及未婚人群居多。心理测评结果显示,STD患者的抑郁、焦虑、回避治疗、性欲障碍等因子分均高于对照组,差异有统计学意义(P0.05);交往障碍、社会攻击等因子分与对照组比较差异无统计学意义(P0.05)。结论:本地区STD患病以性活跃年龄人群、司机、学历低及未婚人群为主,临床上治疗性病的同时,应重视STD患者的心理健康。     

Social Jetlag: Misalignment of Biological and Social Time

Humans show large differences in the preferred timing of their sleep and activity. This so‐called “chronotype” is largely regulated by the circadian clock. Both genetic variations in clock genes and environmental influences contribute to the distribution of chronotypes in a given population, ranging from extreme early types to extreme late types with the majority falling between these extremes. Social (e.g., school and work) schedules interfere considerably with individual sleep preferences in the majority of the population. Late chronotypes show the largest differences in sleep timing between work and free days leading to a considerable sleep debt on work days, for which they compensate on free days. The discrepancy between work and free days, between social and biological time, can be described as ‘social jetlag.’ Here, we explore how sleep quality and psychological wellbeing are associated with individual chronotype and/or social jetlag. A total of 501 volunteers filled out the Munich ChronoType Questionnaire (MCTQ) as well as additional questionnaires on: (i) sleep quality (SF‐A), (ii) current psychological wellbeing (Basler Befindlichkeitsbogen), (iii) retrospective psychological wellbeing over the past week (POMS), and (iv) consumption of stimulants (e.g., caffeine, nicotine, and alcohol). Associations of chronotype, wellbeing, and stimulant consumption are strongest in teenagers and young adults up to age 25 yrs. The most striking correlation exists between chronotype and smoking, which is significantly higher in late chronotypes of all ages (except for those in retirement). We show these correlations are most probably a consequence of social jetlag, i.e., the discrepancies between social and biological timing rather than a simple association to different chronotypes. Our results strongly suggest that work (and school) schedules should be adapted to chronotype whenever possible.     

高校心理咨询工作者枯竭的原因及预防

枯竭会影响高校心理咨询工作者的工作绩效和身心健康,本文针对高校心理咨询工作的现状,从个人特征、当事人特征、工作特征三个方面分析了高校心理咨询工作者枯竭的原因,并提出了一些预防措施。