目的 调查云南省大学新生睡眠质量与抑郁、焦虑的关系.方法 选取云南省845名大学一年级新生,采用匹兹堡睡眠质量指数(PSQI)、患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑量表(GAD-7)评定其睡眠质量以及抑郁、焦虑状况.结果 845名大学新生中,PSQI总分为(5.68±2.42)分,睡眠问题检出率为19.5％.男生PSQI评分低于女生,重点本科院校学生PSQI评分低于普通本科院校学生(P<0.05).大学新生准备入睡的平均时间为(23.76±0.73)时,平均睡眠维持时间为(6.55±0.88)h/d.抑郁和焦虑的检出率分别为13.7％和6.6％.睡眠问题检出组PSQI总分及各因子分,PHQ-9、GAD-7评分,抑郁、焦虑阳性检出率均高于睡眠问题未检出组(P<0.001).PSQI总分及各因子分与PHQ-9、GAD-7评分均呈正相关(P<0.05).睡眠障碍、主观睡眠质量、日间功能障碍均能预测大学生的抑郁、焦虑(P<0.05);抑郁、焦虑同时也预测睡眠质量(P<0.05).结论 云南省大学新生的睡眠模式普遍存在入睡晚、睡眠不足、睡眠问题检出率高,且睡眠质量与抑郁、焦虑相关.

失眠的认知行为治疗(CBT-I)是国内外多个睡眠障碍诊疗指南中推荐的治疗失眠症的一线治疗方案.传统的CBT-I受到时间、地域和治疗师缺乏等诸多因素的影响,临床应用受到极大的限制.随着计算机、网络技术以及人工智能的发展,基于网络的CBT-I逐渐兴起,并发展成为失眠症临床治疗的有效方式.截至目前,在欧美等西方国家网络化CBT-I得到快速发展和推广应用,但其在国内的发展和应用尚处于起步阶段.本文主要综述了国内外基于网络的CBT-I技术在失眠症治疗中的应用,并探讨当前研究中存在的问题和研究及应用前景.

目的:探讨综合训练对恢复期精神分裂症患者述情障碍的影响.方法:将110例恢复期精神分裂症患者按随机数字表分为研究组和对照组各55例,对照组按照精神科疾病护理常规进行护理,研究组在对照组基础上从疾病自我监控技能、认知、自信心、情感表达4个方面进行综合训练;于第12周末采用阳性和阴性综合量表(PANSS)对患者精神症状进行评定,采用多伦多述情障碍量表(TAS-26)对患者情感表达能力进行评定.结果:研究组干预后PANSS评分、TAS-26评分低于干预前和对照组同期(P<0.05).结论:对恢复期精神分裂症患者实施综合训练,能够改善其精神症状,降低述情障碍,提升情感表达能力.

Objective To explore the relationship between cognitive impairment and childhood trauma in children and adolescents with first-episode schizophrenia.Method A total of 37 children and adolescents with first-episode schizophrenia in study group and 23 healthy children and adolescents in control group were selected and assessed with MATRICS Consensus Cognitive Battery (MCCB) for cognitive impairment and Childhood Trauma Questionnaire (CTQ-SF) for childhood trauma.Results The total score and factor scores of symbolic coding,language memory,space span,digit sequence,visual memory,verbal fluency,emotion management,continuous operation of MCCB in study group were all significantly lower than those in control group (P ＜ 0.05) and trail making test score of MCCB in study group was significantly higher than that in control group (P ＜ 0.05).The total score and factor scores of emotional abuse,sexual abuse,physical neglect of CTQ-SF in study group were all significantly higher than those in control group(P ＜0.05).In study group,the total score of MCCB for children and adolescents without childhood trauma was significantly higher than those for children and adolescents with childhood trauma (P ＜ 0.05).In study group,the total score of MCCB was negatively correlated with the total score and all factor scores (except emotional abuse factor) of CTQ-SF(P ＜ 0.05).Conclusion It's serious for the impairment of cognitive function in children and adolescents with first-episode schizophrenia,which is correlated with the childhood trauma level to some extent.

Objective: To investigate the effect of psychological intervention on the prevention of internet addiction in junior high school students of Jinan. Methods: A total number of 888 junior high school students in Jinan City were assessed by Internet Addiction Disorder Diagnostic Scale (IADDS). 57 cases students were diagnosed with internet addiction according to the scores of IADDS, while the rest 831 students were required to fill the self-designed general questionnaire, such as demographic questionnaire and Symptom Checklist 90 (SCL-90) and randomly divided into the intervention and the control groups. The psychological intervention was given in 4 states during two years, one stage in each semester, and there were 4 classes in each stage. Results: In the intervention group, the IADDS and SCL-90 scores were significantly lower compared with those in the control students at different time points of T2 and T3 (all Ps<0.01). In the intervention group, the different factors of SCL-90 were decreased after each intervention (all Ps<0.01). These results showed that the intervention has positive effects on the mental health of students. The positive rate of internet addiction screened by IADDS in the intervention group was considerably lower compared with that in the controls at T2 and T3 time points (all P<0.05). Conclusion: Longitudinal prospective and preventive psychological intervention can effectively improve the mental health of junior middle school students of Jinan city and reduce the incidence of internet addiction.

目的:分析山东省公立医院住院患者的满意度现状,为进一步提高医疗服务质量提供参考依据.方法:采用分层抽样法抽取全省8个地市60家公立医院的1552例住院患者,用自行设计的调查问卷进行满意度调查研究.结果:住院患者对医院的总体满意度较高,且在各区域间比较差异无统计学意义(P>0.05).对医疗服务、护理服务、等待入院时间等方面的满意度比较差异有统计学意义(P<0.05).影响总体满意度的因素包括对等待入院时间、乘坐电梯便捷、护士态度、医生询问病情态度、住院费用明白合理和总费用可承受等方面的满意度.结论:改良就医环境、改善服务态度、优化住院流程、公开收费标准、合理配置医疗资源等是提高住院患者满意度的重要措施.

目的 探讨氨磺必利治疗合并抑郁症状的精神分裂症患者的临床疗效.方法 将60例合并抑郁症状的精神分裂症患者随机分为观察组和对照组各30例,观察组采用氨磺必利治疗,对照组采用利培酮治疗,采用阳性和阴性综合征量表(PANSS)、汉密尔顿抑郁量表(HAMD)和治疗中需处理的不良反应症状量表(TESS)比较两组的疗效及不良反应.结果 治疗后观察组PANSS阴性症状减分和HAMD减分均大于对照组(P＜0.05);观察组总有效率高于对照组(P＜0.05).观察组总不良反应发生率低于对照组(P＜0.05).结论 氨磺必利能显著缓解精神分裂症患者的阴性症状,同时降低抑郁程度,且不良反应少.

Objective To explore the features of cognitive function impairment in children and adolescents with first-episode schizophrenia.Method A total of 37 children and adolescents with schizophrenia in study group and 23 healthy children and adolescents in control group were selected and assessed with Wechsler Adult Intelligence Scale (WAIS),Wechsler Intelligence Scale for Children (WISC),MATRICS Consensus Cognitive Battery (MCCB),Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) before and after 8 weeks of treatment.Results Before treatment,the total scores of WAIS,WISC and MCCB in study group were all significantly lower than those in control group (P ＜ 0.05).In study group,the picture arrangement subtest score of WAIS and WISC at the 4th weekend of treatment was significantly higher than that before treatment (P ＜ 0.05).In study group,the knowledge,picture arrangement subtest scores of WAIS,WISC and the spatial breadth,verbal fluency,emotional management ability factor scores and total score of MCCB at the 8th weekend of treatment were significantly higher than those before treatment (P ＜ 0.05).Conclusion There is cognitive function impairment in children and adolescents with first-episode schizophrenia which should be improved after treatment.

ObjectiveToexploretheresilienceanditsinfluencingfactorsinnursesinpsychiatrichospital.Methods 185 nurses in a psychiatric hospital were assessed with self-designed mental health questionnaire and Conner-Davidson resilience scale.Results Total score of resilience in psychiatric nurses was significantly lower than domestic norm ( P <0.05 ) . Resilience in these nurses was closely related with marital status, rural or urban origin, professional title, working seniority, as well as night-shift or not (P<0.05).Regression analysis showed that rural or urban origin and whether night-shift or not are influencing factors for resilience in psychiatric nurses ( P <0.05 ).Conclusion The resilience is not good in nurses in psychiatric hospital, and its influencing factors consist of rural or urban origin and night-shift or not.

目的:比较精神分裂症患者服用抗精神病药物前后体重的变化,找出原因并提出相应的护理对策。方法:选择104例单一应用抗精神病药物治疗满8周的精神分裂症患者,分别于治疗后第4周、第8周测量体重。结果:服用抗精神病药物后第4周53.8%的患者出现体重增加,治疗第8周61.5%的患者出现体重增加,第8周体重增加值显著高于第4周体重增加值(P<0.01)。女性患者体重增加值明显大于男性(P<0.05)。多次住院者病程与体重增加呈负相关(r=-0.446,P=0.01)。结论:大多数服用抗精神病药物患者存在肥胖的风险。

目的探讨综合心理护理对改善强迫症患者症状的效果。方法将60例强迫症患者随机分为研究组30例和对照组30例,研究组接受综合心理护理干预合并氟西汀系统治疗,对照组仅接受氟西汀系统治疗。分别在干预前和干预后第12周末用耶鲁布朗强迫症状量表(Y-BOCS)评定效果。结果研究组有效率80.00%,对照组有效率50.00%,两组比较差异有统计学意义(P<0.05)。干预后的研究组和对照组的Y-BOCS评分均显著低于干预前,差异有统计学意义(P<0.05)。干预后研究组的Y-BOCS评分显著低于对照组,差异有统计学意义(P<0.05)。结论综合心理护理可有效改善强迫症患者的强迫症状。

精神科护理工作是一门兼具专业性、技术性及风险性等综合特征的临床工作.仅就精神科护理工作的风险而言,具有高发性、随时性和不可预测性,致使降解风险难度很大.

2005年1月～2006年12月,我们收治癌症晚期伴发情绪障碍患者62例,经精心护理,效果满意.现将护理体会报告如下. 1 资料与方法 1.1 临床资料 本组62例,男34例,女28例,65～76岁.其中肺癌34例,胃癌18例,肝癌10例;伴发抑郁、焦虑者43例,躁闹不安、冲动者19例.