目的 了解保定市县、市两级综合医院住院患者中抑郁症的检出率、医生的识别率和治疗率现况,为相关部门开展精神卫生工作提供依据.方法 采用随机分层整群抽样方法抽取保定市县、市两级综合医院住院患者共1074例进行抑郁症状量表筛查,对筛查阳性者用简明国际神经精神访谈中文版(Mini International Neuropsychiatric Interview,MINI)诊断,查阅诊断为抑郁症患者的病历资料,并对81名主管医生进行问卷调查.结果 MINI共诊断抑郁症患者116例,市级和县级综合医院住院患者中抑郁症校正检出率分别为12.9％和8.6％.综合医院病历资料中医生对抑郁症的识别和治疗率分别是13.0％和7.8％.其中地市级医院医生对抑郁症的识别和治疗率分别是14.8％和8.6％；县级医院医生对抑郁症的识别和治疗率分别是8.6％和5.7％.不同级别医院医生对抑郁症治疗的态度中“应转诊/会诊治疗”间差异有统计学意义(P=0.032).结论 保定市综合医院抑郁症的检出率偏高,医生对抑郁症的识别和治疗率低,不同级别医院医生对抑郁症治疗态度有所不同.

Objective To compare the classification layer delivery nursing and conventional nursing on patients with depressive disorder rehabilitation effect.Methods Developing a set of applicable to patients with depressive disorder classification layer delivery nursing operation manual.A total of 64 patients were divided into classification layer delivery care group(the treatment group)and routine nursing group(the control group),each of 32 cases,after treatment with 6 weeks,Hamilton Depression Rating Scale was used to assess in two groups before treatment and after treatment 2,4,6 weekend minus score,6 weeks after treatment,6 months follow-up at the time of relapse or combustion rate,and assess the compliance.Results ①Two groups had significant difference after 2 weekend,the extremely significant difference after 6 weekend,2 weekend in two groups the HAMD values were(16.44±3.951)and(14.60±3.286),6 weekend HAMD(9.31±2.768)and(8.33±2.333);②There were statistically differences between two groups after 6 weekend(P<0.01),which controls the cure rate was 37.5%,the effective rate was 87.5%,the treatment group cure rate was 43.7%,the effective rate was 93.8%.③Follow-up 6 months,1 patients had symptoms relapse in psychological group,recurrence rate were 3.1%,while the control group of 7cases of recurrence of symptoms(including 2 cases of reburning),recurrence rate were 21.9%.Conclusion The effect is remarkable of classification layer delivery nursing on depression rehabilitation.

Objective:To study the effect of cognitive behavior therapy on rehabilitation of patients with depression.Methods:64 patients with the international classification of diseases,Tenth Edition of mental and behavioral disorders classification on depressive disorder diagnostic criteria were divided into experimental group and the control group with 32 cases in each group,the two groups tooking Pa Rossi Dean 20 mg,after breakfast service,and was given routine nursing;experimental group increased system cognitive behavior therapy.Treatment for 6 weeks,with Hamilton Depression Scale(HAMD) assessment two groups after 6 weeks of treatment efficacy,and evaluation 6 weeks after the compliance and 6 months follow-up recurrence rate.Results:The sixth weekend of two patients in comparison with statistical significance(P<0.05).The sixth weekend in two groups of patients compliance compared with statistical significance(P<0.05).After 6 months follow-up,the test group of 1 patients symptom relapse,recurrence rate was 3.13%,while the control group 8 cases of symptomatic relapse,recurrence rate of 25.00%,comparison of the two groups was statistically significant(P<0.05).Conclusion: Cognitive behavioral therapy for depressive disorder rehabilitation effect,can be used in clinic.

<正>癔症的患病率为3.55‰～7.65‰[1],令人瞩目。癔症,又称歇斯底里,是指一种有癔症性人格基础,起病多受心理社会因素影响的精神障碍。临床表现为解离症状(部分或完全丧失对自身身份识别和对过去的记忆)、转换症状(在遭遇无法解决的问题和冲突时产生的不快情绪以转化成躯体症状的方式出现)[2]。癔症患者常无器质性病变基础,女性发病率显著高于男性。病因与心理社会因素密切相关,紧张、恐惧是诱发癔症的重要因素。由于癔症所表现的症状往往具有夸张

<正>抑郁障碍是一种常见的情绪障碍。众多研究表明,抑郁的发生是由内因与外因共同作用的结果。如适应障碍中的各类抑郁反应,认为生活事件(外因)是它们的病因性因素。抑郁障碍的发生还要通过内因起作用,所谓内因主要是遗传、个性特征和认知评价这样一些因素。

探讨精神分裂症患者家庭背景因素如遗传因素、人格特征、教养方式等在精神分裂症发病过程中的作用,以期对精神分裂症患者及家属实施有效的心理干预措施,为促进患者社会功能康复、预防疾病复发提供对策。如改进教养方式和防御方式:父母的情感温暖、理解是子女正常发育的重要条件,同情支持、爱护关心和通情达理的父母培养出来的孩子,极少使用具有"破坏性"的防御方式,并善于处理各种冲突和应激,对自己充满信心,亦能够对自己的得失正确认识。反之,在冷淡、受惩罚和缺乏情感温暖环境中成长起来的孩子,通常过度使用中间性和不成熟防御方式。通过改进教养方式和防御方式,可以促进心理健康,提高认知功能,有望减少精神分裂症的发生,促进精神分裂症患者全面康复。

目的:分析精神专科医院护理纠纷的原因、法律责任以及如何采取预防措施避免和减少护理纠纷。方法:对精神专科医院发生护理纠纷的原因、法律责任、预防措施进行全面的探索和总结。结果:了解精神专科医院护理纠纷的原因、法律责任、预防措施有利于促进精神科护理工作者工作态度、技术水平乃至护理质量的提高,从而减少护理纠纷。结论:护理纠纷的最终解决仍需全国《精神卫生法》和相关的护理法律法规的尽快出台和完善,从而使护理纠纷的处理能做到有法可依,妥善解决。