Objective To investigate the injury characteristics of 33 children of Lushan earthquake victims no more than 14 years old treated in the West China Hospital of Sichuan University, and to put forward the early rehabilitation strategy. Methods A total of 33 earthquake children victims were investigated with the modified barthel index score (MBI) and analyzed in following aspects: age, causes, and injury. Results a) The 33 children victims accounted for 10.28% of the total earthquake victims treated in the hospital, they were all no more than 14 years old, and the average age was 7.24 years old. 17 cases were fractures of trunk and limbs, six were traumatic brain injury, and four were soft tissue injury. b) The main traumatic causes were crush by falling objects and heavy stuffs; and some children rarely suffered from hurt, burn and fall injury when running. c) Most children victims were simple open injuries and fractures, especially the limbs fractures accounted for 51.51% of the total cases, and there was only one case suffered from abdominal organ injuries. d) Among 33 children victims, 30 (90.9%) were from the towns and villages. They mainly got injured by the collapse of house or courtyard walls which were not as ber as the house in the cities, so the incidence of severe injury was lower, the degree of injury was milder, and the injury of major organ was rarer. Conclusion Early rehabilitation treatment is helpful to prevent the complications and early recover the functions. It suggests the early rehabilitation treatment should be carried out for the earthquake children victims in order to promote the fracture healing and functional recovery, as well as to prevent the complications. In addition, attention should also be paid to the psychological problems while concerning rehabilitation training.
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.
Objective To systematically evaluate the effects of psychotherapy for cancer patients with depression. Methods We searched The Cochrane Library, PubMed, EMbase, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, and Chinese Journal Full-text Database up to October 2010 to identify randomized controlled trials (RCTs) comparing psychotherapy plus conventional treatment with conventional treatment alone. The data were analyzed by using RevMan 5.0 software. Results Eleven RCTs involving 1 670 participants were included. The results of meta-analyses showed: (1) A significant difference was found between psychotherapy plus conventional treatment and conventional treatment alone in decrease of depression score (SMD= – 0.40, 95%CI – 0.70 to – 0.11); (2) No difference was observed between the two groups in decrease of anxiety score (SMD= – 0.68, 95%CI – 1.37 to 0.01), but the result was changed when a sensitivity analysis was done (SMD= – 0.30, 95%CI – 0.52 to -0.08). Conclusion Compared with conventional treatment alone, psychotherapy combined with conventional treatment could improve depressive states in cancer patients, but the result still needs to be confirmed by high-quality and large-sample RCTs.
Objective Anorexia nervosa is a disorder of high morbidity and significant mortality. The aim of the present review was to evaluate the evidence from randomized controlled trials for the efficacy of outpatient psychotherapies used in the treatment of older adolescents ( aged ＞16 years) and adults with anorexia nervosa. Methods The search strat egy comprised database searches of Medline, EXTRAMED, EMBASE, PSYCLIT, Current Contents, Cochrane Con trolled Trials Register and the Depression and Anxiety Neurosis Cochrane Group ( CCDAN), the search date was Novem ber 2002. A hand-search of The International Journal of Eating Disorders from its first issue up to March 2003, and the ref erence lists of all papers selected. Personal letters were sent to identified leading researchers published in the area, requesting information on trials that are unpublished. All randomized controlled trials of adult individual outpatient therapy for anorexia nervosa, as defined by the DSM-IV or similar international criterion, were included. Quality ratings were made according to the CCDAN criteria. A range of outcome variables were selected, including physical state, severity of eating disorder attitudes and behefs, interpersonal function, and general psychiatric symptom severity. Continuous outcome data comparisons were planned with the standardized mean difference statistic, and binary outcome comparisons planned with the relative risk statistic. Results Six small trials only, two of which included children or adolescents, were identified from the search and aggregation of data was not possible. Bias was possible due to lack of blinding of outcome assessments. The results in two trials suggested that "treatment as usual" or similar may be less efficacious than a specific psychotherapy. No specific treatment was consistently superior to any other specific approach. Dietary advice as a control arm had a 100% non-completion rate in one trial. Conclusions No specific approach can be recommended from this review. It is unclear why "treatment as usual" performed so poorly, or why dietary advice alone appeared so unacceptable. There is an urgent need for large well-designed trials in this area.