Objective To investigate the characteristics of cognitive function and its correlation to neuroendocrine status in patients with refractory depression. Methods A total of 41 patients diagnosed by ICD-10 as depression onset who have been treated with more than two antidepressants drugs, fulfilled the criteria of refractory depression. Another 40 patients diagnosed by ICD-10 as depression onset but who have not been treated, or have been treated with only one antidepressant drug were selected as controls. Patients in both groups were evaluated by WAIS-RC, STROOP, VF, TRAILS A, B, TOH and M-WCST, and the concentrations of CORT, ACTH, T3, FT3, T4, FT4, TSH were also determined. Results A significant difference was found in VF between the refractory depression group and the control group. This showed that the damage to short-term memory, attention and interference rejection capability was much more serious in the refractory depression group. The ACTH concentration in the refractory depression group was significantly different from that of the control group, which indicated that the damage to the Hypothalamic-pituitary-adrenal axis was more serious in the refractory depression group. In particular in relation to memory and attention defect. Conclusion Changes in the levels of CORT, ACTH, TSH, FT3 and T4 may be correlated to cognitive function damage in patients with refractory depression.
目的 了解5.12汶川大地震24个月后震区小学生的心理健康状况，为进行震后长期心理危机干预提供依据。 方法 于2010年5月即汶川大地震发生后24个月，分别使用创伤应激量表儿童版（CRIES-13）、儿童抑郁障碍自评量表（DSRSC）、长处与困难问卷（SDQ）学生版，调查了553名来自于彭州灾区的小学生的心理健康状况及其影响因素。 结果 ① 灾区小学生CRIES-13总分为（22.98 ± 12.29）分，其中大于划界分（30分）者为143人，占总人数的25.9%；女性总分高于男性（Z=?2.031，P=0.042）；震后被转移至安全地点的时间越长（OR=1.025，P=0.012）、家人伤亡越严重（OR=1.141，P=0.021），其CRIES-13总分大于划界分的可能性越高。② 灾区小学生DSRSC总分为（11.07 ± 5.78）分，其中总分大于划界分（15分）者为120人，占总人数的21.7%；女性总分高于男性（Z=?2.508，P=0.012）；灾区小学生的年龄（r=0.098，P=0.021）、震后被转移至安全地点的时间（r=0.117，P=0.004）与DSRSC总分呈正相关。③ 灾区小学生SDQ总困难因子得分为（14.97 ± 5.44）分，62.9%的人报告自身存在主观困难；女性的情绪因子、亲社会因子得分高于男性（Z=?3.123，P=0.002；Z=?2.243，P=0.025）；年龄越大，品行因子（χ2=7.604，P=0.023）、亲社会因子（χ2=8.102；P=0.017）得分增加。 结论 震后灾区小学生的心理健康状况受到性别、年龄、震后被转移至安全地点的时间、家人伤亡程度的影响，震后长期心理危机干预应综合考虑这些相关因素以确定高危人群。
ObjectiveTo explore the family function on patients with depression and its influential factors, in order to provide a basis for family support treatment for the patients. MethodsA total of 122 depressed patients from Mental Health Center of West China Hospital between February 2012 and June 2013, and one of their family members were chosen to be the study subjects. Another 122 non-clinical controls and one of their family members were recruited from a community near Sichuan University were regarded as the controls. All the subjects were asked to finish the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Family Assessment Device (FAD). Additionally, the patients received a diagnostic interview to provide the features of their depression. ResultsThe general average score of Q-LES-Q in families with depressed patients was significantly lower than that in the control families (t=-6.243, P<0.01). The general average score of each dimension in FAD for families with depressed patients was significantly higher than that for control families (t=3.644, 3.872, 2.694, 3.369, 5.369, 4.941, 5.241; P<0.01). According to FAD health division scoring, the unhealthy proportion in terms of communication, emotional reaction, emotional link, behavioral control and general function for families with depressed patients was significantly higher than that for control families (χ2=6.778, 23.698, 26.580, 39.875, 17.123, 10.712; P<0.05). The Q-LES-Q scores and the five FAD dimensional scores (except role and affective involvement) were negatively correlated (r=-0.388, -0.188, -0.200, -0.276, -0.370; P<0.05). The scores of perceived social support for families with depressed patients had significant positive correlations with the scores of all FAD dimensions except affective involvement (r=0.363, 0.345, 0.244, 0.418, 0.328, 0.457; P<0.05). The risk factors for unhealthy family function included: female (OR=1.141, P<0.05), poor education (OR=0.948, P<0.01), first-episode (OR=1.416, P<0.05), suicidal attempt (OR=1.014, P<0.05), incomplete suicide (OR=1.367, P<0.01) and depression episode number (OR=1.035, P<0.05). ConclusionDepression is associated with impaired family function in Chinese families. Female, poor education, first episode of depression, suicidal attempt, incomplete suicide and depression episode number are the influential factors for family function on patients with depression.
目的 调查极重灾区某中学学生的创伤后应激障碍（PTSD）症状检出率及影响因素，为进一步开展灾后心理卫生服务提供依据。 方法 2008年9月下旬，对汶川地震的极重灾区都江堰某镇中学1 500名同学进行调查，获有效问卷1 498份。采用一般情况调查问卷、儿童事件影响量表（CRIES-13）中文版进行集体施测。 结果 某镇中学学生灾后4个月PTSD症状检出率29.71%（445/1 498）。经非条件逐步logistic回归筛选PTSD症状的影响因素有：地震时是否受伤（OR=1.995，P=0.000）、性别（OR=1.785，P=0.000）、绝望感（OR=1.597，P=0.000）、是否目睹死亡（OR=1.344，P=0.000）、年龄（OR=1.308，P=0.000）、是否目睹受伤（OR=1.262，P=0.000）、地震时是否被困（OR=1.209，P=0.011）、震后居住地点（OR=1.182，P=0.000）、是否目睹垮塌（OR=1.176，P=0.000）、家人情况（OR=1.104，P=0.000）、地震后是否住院（OR=0.828，P=0.041）12个因素。 结论 在灾后重建过程中，该中学的学生PTSD症状检出率较高，其与地震时是否受伤、性别、绝望感、是否目睹死亡、年龄、是否目睹受伤、地震时是否被困、震后居住地点、是否目睹垮塌、家人情况、地震后是否住院呈显著相关。