目的 研究传统抗焦虑、抑郁药物治疗结合合理情绪疗法对矿区工人工伤后焦虑、抑郁的缓解效果是否显著,评估其社会、经济效益及临床应用前景.方法 选取2018年3-12月天府总医院(北碚区第二精神卫生中心) 、天府三汇医院、南桐总医院、永荣总医院、松藻总医院门诊及住院治疗患者70例作为研究对象(中途脱落8例) ,采用随机数字表法分为研究组和对照组,每组31例.对照组给予传统抗焦虑、抑郁药物治疗及常规护理,研究组在给予传统抗焦虑、抑郁药物治疗及常规护理基础上加用合理情绪疗法.每周对2组患者进行疗效评价,干预前后进行相关心理量表测定,4周后进行统计分析.结果 2组患者干预后各量表得分均明显降低,且研究组患者较对照组各量表得分降低更明显,差异均有统计学意义(P＜0 .05) ;研究组患者住院时间明显短于对照组,住院费用明显低于对照组,差异均有统计学意义(P＜0 .05) .结论 药物联合合理情绪疗法相较于单纯药物治疗可明显改善煤矿工人工伤后负性情绪,且住院时间更短,住院费用更低.

Objective To evaluate the effect of comprehensive psychological intervention on the medical personnel and patients'satisfaction .Methods A total of 327 medical and nursing staffs in the first-line clinical departments of a general hospital were selected from the whole group .50 people were selected out of those with the SDS and SAS scale scores above the normal value and divided into the intervention group and control group ,and each group consisted of 25 people .The 12-week psychological intervention was given to the intervention objects by the methods of comprehensive psychological intervention including the group psychotherapy ,hypnotic relaxation therapy ,individual psychotherapy ,etc .Then the questionnaire was conducted by using SDS ,SAS and the self-made scale of patients'satisfaction .Results The scores of SAS and SDS in the intervention group were significantly different between before and after intervention (P<0.05) ,while there were no significant differences in the control group (P>0.05) .The patients'satisfaction in the intervention group was improved significantly after intervention (P<0.05) ,while there were no significant improvement in the control group .Conclusion The comprehensive psychological intervention improved medical personnel's mental health and patients'satisfaction .

目的:调查某综合医院临床科室医护人员心理健康水平,为实施心理干预提供依据.方法:采用SCL-90量表对301名临床医护人员进行问卷调查.结果:医护人员SCL-90得分阳性检出101人,阳性检出率为33.55％;医护人员SCL-90除人际关系因子外,各因子分及总均分与中国常模比较差异显著(P＜0.01或P＜0.001);不同性别的医护人员SCL-90各因子分及总均分比较差异显著(P＜0.01或P＜0.001);不同婚姻状态的医护人员SCL-90除精神病性因子外,各因子分及总均分比较差异显著(P＜0.01或P＜0.001).结论:某综合医院临床医护人员心理健康水平较差,需要进一步的心理干预.

目的:探讨艾司西酞普兰改善失眠症患者抑郁和焦虑的效果.方法:94例失眠症患者中选取SAS和SDS都为阳性的患者37人作为研究对象,在原安眠药的剂量不变的情况下加服艾司西酞普兰5-10mg/d,共6周.结果:94例患者中焦虑发生率54.26％,抑郁发生率46.81％.经艾司西酞普兰治疗6周后,失眠症患者SAS和SDS得分明显下降,差异有统计学意义(P＜0.01);匹兹堡睡眠质量指数得分在治疗前后明显下降,差异有统计学意义(P＜0.01).结论:失眠症患者中焦虑和抑郁发生率较高,艾司西酞普兰能明显改善患者的焦虑和抑郁情绪,能改善患者的睡眠质量.

目的 探讨精神分裂症患者抑郁症状的影响因素及与病耻感的关系.方法 采用精神病患者病耻感评估量表、卡尔加里精神分裂症抑郁量表对148例精神分裂症患者进行问卷调查.结果 精神分裂症患者的抑郁发生率为31.08％;不同年龄患者抑郁体验因子得分差异有统计学意义(P＜0.05);不同职业的患者抑郁体验因子得分差异有统计学意义(P＜0.05);不同病程自我评价因子得分差异有统计学意义(P＜0.05).与抑郁总分相关性具有统计学意义的变量包括:病耻感总分(r=0.495,P＜0.01)、社交因子(r=0.409,P＜0.01)、能力因子(r=0.496,P＜0.01).与抑郁体验因子相关性具有统计学意义的变量包括:病耻感总分(r=0.474,P＜0.01)、社交因子(r=0.349,P＜0.01)、能力因子(r=0.491,P＜0.01)、治疗因子(r=0.194,P＜0.05);与自我评价因子相关性具有统计学意义的变量包括:病耻感总分(r=0.419,P＜0.01)、社交因子(r=0.407,P＜0.01)、能力因子(r=0.399,P＜0.01).结论 精神分裂症患者抑郁症状较常见.病耻感越强,精神分裂症患者抑郁症状越严重.