目的:探讨氟西汀联合心理干预治疗心血管疾病患者伴焦虑抑郁症状的临床疗效。方法:选择伴有抑郁、焦虑情绪障碍的85例冠心病患者(心功能Ⅱ、Ⅲ级),并将其随机分成研究组和对照组。观察6w,对照组患者仅给予常规的治疗,研究组患者在常规治疗基础上给予氟西汀联合心理干预治疗。观察治疗前后两组患者采用汉密顿焦虑量表( Hamilton Anxiety Scale,HAMA) 评定焦虑症状,汉密顿抑郁量表( Hamilton Depression Scale,HAMD) 评定抑郁症状;并对治疗后心功能分级(NYHA)恢复到Ⅰ级的例数及左室射血分数进行分析评价。结果:治疗6 周 后,研究组均较对照组的汉密顿焦虑量表及汉密顿抑郁量表评分下降显著( P lt;0.01),研究组抗焦虑显效率为87.16%、抗抑郁显效率为82.26%,对照组分别为43.75%、45.36%,研究组均显著高于对照组( P lt;0.01);研究组患者的左室射血分数显著高于对照组 ( P lt;0.05),心功能分级(NYHA)恢复到Ⅰ级的例数显著高于对照组 ( P lt;0.05)。结论:氟西汀联合心理干预治疗不仅能改善心血管疾病伴焦虑抑郁患者的焦虑、抑郁情绪障碍,还能改善患者的心功能,疗效显著优于单用心血管药物治疗。
Objective To assess the effectiveness of psychological intervention on post-stoke depression. Methods Such databases as the JBI Database of Systematic Review (1980 to June, 2010), The Cochrane Library (1980 to June, 2010), PubMed (1966 to 2010), CINAHL(1982 to May, 2000), CBM (1978 to 2010), and CNKI (1979 to 2010) were searched to collect randomized controlled trials (RCTs). In accordance with the predefined inclusion and exclusion criteria, the quality of included studies was evaluated, and then meta-analyses were performed by using RevMan 5.0 software. Results A total of 33 RCTs were included. The results of meta-analyses showed: (1) Compared with the control group, the short-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analysis showed that the intervention effects at the time of four weeks, six weeks, eight weeks, and 12 weeks were better than those of the control group. (2) The long-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analyses showed that the intervention effects at the interval of eight weeks, 24 weeks, and 48 weeks were better than those of the control group. (3) The combined or single application of either cognitive-behavioral psychotherapy or supportive psychotherapy was more effective in decreasing depression score than the control group. However, there was no significant difference between the general psychological treatment group and the control group. (4) The subgroup analyses showed that the different qualities of the included studies were more effective than those of the control group. Conclusion Various psychological intervention is effective in decreasing the patient’s depression score, and cognitive-behavioral therapy and supportive psychotherapy, especially, can significantly improve the depression state and promote recovery.
Objective To assess the effectiveness of psychotherapy for depression in older patients. Methods We searched the Cochrane Central Register of Controlled Trials (1990 to August 2007), MEDLINE (1966 to August 2007), EMbase (1980 to August 2007), and CMB-disk (1990 to August 2007) to collect randomized controlled trials (RCTs) in which psychotherapy was used to treat depression in older patients. We screened the retrieved studies according to the predefined inclusion and exclusion criteria, evaluated the quality of included studies, and performed meta-analyses by using The Cochrane Collaboration’s RevMan 4.2 software. Results Ten RCTs were included. Compared with placebo, psychotherapy was more effective in decreasing depression score (SMD 0.63, 95%CI – 0.84 to – 0.42). Subgroup analysis showed that cognitive-behavioral therapy, reminiscence therapy, and general psychological therapy were more effective than placebo (SMD – 0.70, 95%CI – 1.12 to – 0.27; SMD – 0.54, 95%CI – 0.81 to – 0.26; SMD – 0.84, 95%CI – 1.34 to – 0.34, respectively). However, psychotherapy as an adjunct treatment could not significantly improve the effectiveness of antidepressant medication (SMD – 0.35, 95%CI – 0.74 to 0.05). There was no significant difference between cognitive-behavioral therapy and reminiscence therapy in improving depression symptoms (SMD 0.13, 95%CI – 0.30 to 0.56). The dropout rate was similar between patients treated with or without psychotherapy (RR 1.03, 95%CI 0.55 to 1.94). Conclusion Various kinds of psychotherapy are effective for depression in older patients. But psychotherapy as an adjunct treatment could not significantly improve the effectiveness of antidepressant medication.
目的 探讨糖耐量异常患者的焦虑抑郁状况及其与生活质量的相关性，为糖尿病相关心理问题的早期识别与干预提供参考。 方法 以2010年1月－2012年6月糖耐量异常患者145例为试验组，健康人群147例作为对照组，两组分别填写焦虑自评量表（SAS）和抑郁自评量表（SDS），试验组还需填写世界卫生组织生活质量测定量表简表（WHOQOL-BREF）并对其焦虑、抑郁得分与WHOQOL-BREF的各因子的相关性进行分析。 结果 145例患者中有51例（35.2%）存在抑郁情绪，47例（32.4%）存在焦虑情绪，焦虑合并抑郁情绪者29例（20%）。糖耐量异常患者焦虑、抑郁评分明显高于对照组（P＜0.01），其生活质量多个领域评分低于对照组（P＜0.01），且生活质量与焦虑、抑郁情绪存在负相关（P＜0.05）。 结论 糖耐量异常患者焦虑、抑郁情绪明显高于正常人群，其生活质量偏低，提示了对在该人群进行早期心理干预的必要性。
Objective To compare the effects of cognitive-behavior therapy (CBT) and domestic paroxetine in the treatment of minor depression. Methods A therapeutic technique model for the treatment of minor depression was established. Sixty-four patients with minor depression meeting DSM-IV criteria were divided into CBT and paroxetine groups with 32 patients respectively, and were treated for six weeks. The Hamilton Depression Scale (HAMD) was used to evaluate the clinical efficacy and relapse/recrudescence rate of the two groups. Side effects of paroxetine were also recorded. Results At the end of 2 weeks, no significant difference was noted in the reduction of the HAMD score between the two groups. At the end of 6 weeks, there was little difference in thHAMD score reduction between the two groups (F=8.3,P= 0). No significant difference was found in the curative effects between the two groups (u=316.5,P=0.06).In the paroxetine group, cure rate was 20.7%, significant improvement rate was 48.3%; In the CBT group, cure rate was 10.0%, significant improvement rate was 36.7%.The relapse/recrudescence rate after six in the paroxetine group was higher than in cognitive-behavior therapy group at 6 months’ follow-up (u=106.5,P=0.04).Conclusion The clinical efficacy of cognitive-behavior therapy for minor depression seems to be similar to that of paroxetine. The established model of CBT can be used in clinical practice.
【摘要】 目的 了解全开放管理的急性期精神分裂症患者的抑郁状况，为急性期开放管理提供参考信息。 方法 2009年10-11月，采用卡尔加里精神分裂症抑郁量表（CDSS）对95例精神分裂症患者进行调查。 结果 精神分裂症患者抑郁的发生率为38.95%。且与性别、文化程度、住院次数无关。但与病程密切相关，病程5年以上的患者抑郁状况突出。 结论 精神分裂症患者的抑郁状况明显，需要加强对病情的评估；加强对家属的教育，提高患者的社会支持；早期对患者进行心理干预；以预防自杀的发生。【Abstract】 Objective To find out the depressive situation of patients with schizophrenia in the acute phase under a whole open management, and to provide a scientific basis for the open management. Methods From October to November 2009, 95 patients with schizophrenia were investigated via Calgary depression scale with schizophrenia (CDSS). Results The incidence of depression in patients with schizophrenia was 38.95%, which had no relationship with gender, education level, or frequency of hospitalization. However, the course of the disease was closely related. The depressive symptoms were prominent in patients with the duration more than five years. Conclusion The patients with schizophrenia have obvious depressive symptoms we should. strengthen the evaluation of the disease, improve the family education and the patient′s social support, and implement psychological intervening with patients in the early phase in order to prevent the occurrence of suicide and improve the quality of management.
ObjectiveTo compare the anxiety, depressive and personality characteristics between diabetes mellitus patients with or without diabetic retinopathy (DR), and look for psychological treatment and corresponding prevention measures. Methods435 diabetic patients were enrolled in this study from April to November 2014 in our hospital, including 178 DR cases (group A) and 257 cases without retinopathy (group B). All the patients completed a questionnaire, the Self-Rating Anxiety (SAS), the Self-Rating Depression Scale (SDS) and the big five personality scale (NEO-FFI), and were scored by eye doctors. According to the score, SAS can be divided into mild anxiety, moderate anxiety, and severe anxiety. SDS is divided into depression, mild depression, moderate depression and major depression. NEO-FFI was scored from emotional stability, outgoing, openness, easy-going and sense of responsibility. Multiple linear regression analysis was used to analyze the DR risk factors in those scores and education level, high blood pressure, age, alcohol consumption, occupation and other factors. ResultsThere were 110 cases of mild anxiety, 57 cases of moderate anxiety, 11 cases of severe anxiety; 74 cases without depression, 53 cases of mild depression, 31 cases of moderate depression, 20 cases with major depression in group A. There were 181 cases of mild anxiety, 53 cases of moderate anxiety, 23 cases of severe anxiety; 177 cases without depression, 44 cases of mild depression, 25 cases of moderate depression, 11 cases with major depression in group B. Group A patients had higher SAS, SDS scores than group B, the difference was statistically significant (P=0.035). Group B patients had higher NEO-FFI score in outgoing, easygoing, responsibility (P=0.022), lower NEO-FFI score in emotional stability (P=0.014) and same NEO-FFI score in openness(P=0.210)compare to Group A patients. Multiple linear regression analysis results showed that education level, high blood pressure, age, weight, drinking, occupation can affect the degree of changes in the retina (P=0.019). ConclusionsCompared with those without retinopathy, DR patients were more prone to anxiety and depression. They also had low score in personality characteristics of outgoing, easygoing, responsibility.
摘要:目的:观察伴有抑郁症状的心力衰竭患者加用黛力新干预的疗效。方法: 65例用Zung抑郁自评量表检测评测诊断为抑郁症并心力衰竭患者,将患者分为黛力新治疗组及对照组,治疗组在常规治疗基础上加用黛力新(2片/d),治疗1个月后再行Zung抑郁自评量表粗分及24项症状统计,同时观察治疗前后患者心功能改善情况。结果: 35例治疗组患者心功能的改善及Zung抑郁自评量表检测粗分及24项症状改善明显优于对照组。〖HTH〗结论〖HTSS〗: 黛力新使心衰患者的抑郁症状很快得到改善,并提高了心力衰竭的疗效。Abstract: Objective: To observe the curative efficacy of deanxit to the patients suffering by heart failure with depression. Methods: Sixtyfive patients who were diagnosed as depression by Zung Selfrating Depression Scale are into deanxit treatment group and control group,and treatment group receive the treatment with two pieces of deanxit everyday besides the conventional therapy.After a month,we count the Zung selfrating depression scale score and study the24 symptoms,at the same time,we observed the change of cardiac function in the patients. Results:The curative efficacy in the treatment group is better than those in the control group with improvement in cardiac function and Zung selfrating depression scale score and the alleviation for 24 symptoms. Conclusion:Deanxit can alleviate symptoms of depression in patients with heart failure soon and increase the efficacy of heart failure.
Objective To explore the effect of motivational interviewing (MI) on anxiety and depression in patients with lung cancer undergoing initial chemotherapy. Methods From May 2015 to April 2016, patients with lung cancer who underwent initial chemotherapy after operation were collected and randomly divided into the control group and the MI group. The patients in the control group received traditional health education, psychological care, and post-discharge follow up; while the patients in the MI group were given routine nursing cares and three motivational interviews and one telephone follow up. At the admission and one month after chemotherapy, all patients were evaluated by the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Distress Thermometer (DT). Results At the admission, the SAS, SDS, and DT scores of patients in the two groups had no significant differences (P>0.05). After one month of chemotherapy, the SAS, SDS, and DT scores in the MI group were much better compared to the admission (P<0.05). The differences in the SAS, SDS, and DT scores between the two groups were significant (P<0.05). Conclusion MI can significantly alleviate anxiety and depression of patients with lung cancer undergoing initial chemotherapy.
ObjectiveTo systematically review the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) in the treatment of Parkinson's disease patients with depression. MethodsThe Cochrane Library (Issue 5, 2014), PubMed, EMbase, CNKI, VIP and WanFang Data databases were searched from inception to May 2014 for randomized controlled trials (RCTs) investigating the efficacy and safety of SSRIs for Parkinson's disease patients with depression. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 12 RCTs were included. The results of meta-analysis showed that the efficacy of SSRIs was better than placebo (RR=2.18, 95%CI 1.60 to 2.97, P<0.000 01) and the dropouts rates of SSRIs were higher than placebo (OR=3.02, 95%CI 1.04 to 8.79, P=0.04). However, the incidence rate of adverse events between the SSRIs group and the placebo group was not statistically different. ConclusionCurrent evidence indicates that SSRIs are effective for the Parkinson's disease patients with depression. Because of the limitation of quantity and quality of included studies, large-scale multi-center RCTs are required to confirm these findings.