Risk of Adverse Perinatal Outcomes and Antenatal Depression Based on the Zung Self-Rating Depression Scale

Objective:The aim of the study is to investigate the relationship between antenatal depression and adverse perinatal outcomes.Methods:This prospective cohort study enrolled pregnant women between gestational ages of 12-20 weeks to complete the Chinese version of the Zung Self-Rating Depression Scale(SDS)and followed them for delivery from September 2015 to September 2016.Participants were classified into mild,moderate,and severe depression groups according to the SDS scores.Logistic regression was performed to assess the association between antenatal depression and perinatal outcomes including preterm birth(PTB),cesarean section use,hypertension disorders,gestational diabetes,and thyroid diseases during pregnancy.An age-stratified analysis was performed.Results:A total of 4,663 pregnant women were analyzed.As a result,13.8%,1.7%,and 0.2%of women were classified as mild,moderate,and severe depression,respectively.Severely depressed mothers were at higher risk for PTB(adjusted odds ratio[OR]=11.31,95%confidence interval[CI]2.13-60.03),especially spontaneous PTB.Moderate-depressed women were at higher risk for hyperthyroidism during pregnancy(adjusted OR=3.67,95%CI 1.10-12.27),while women with mild depression tended to choose cesarean sections(OR=1.24,95%CI=1.04-1.49).Age-stratified analysis indicated an elevated risk of adverse outcomes associated with depression in women aged<25 years,but the association was not significant.Conclusions:Antenatal depression was associated with PTB,hyperthyroidism,and cesarean use.Studies with large sample sizes should verify the relationship between PTB and antenatal depression to avoid casual events.

Prevalence of Depression in Pre-Dialytic Chronic Kidney Disease Patients Attending at a Tertiary Care Hospital in Bangladesh

Background: Depression is a common and serious medical illness around the world. It occurs more frequently in patients with chronic illness than in the general population. It is a common psychiatric problem in patients with chronic kidney disease (CKD). Objective: To assess the level of depression in pre-dialytic CKD patients attending at a tertiary care hospital in Bangladesh. Methodology: This cross sectional study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2020 to June 2020. A total of 100 pre-dialytic CKD patients were selected by convenience sampling technique and their level of depression was assessed by Zung Self-Rating Depression Scale (ZSDS). Data were collected by existing questionnaire with face to face interview and analyzed by statistical test. Results: The mean age of the participants was 49.70 ± 11.80 years. Among them 64% were male, 95% were muslim, 98% were married, 65% were completed secondary/above higher secondary level education, 65% were unemployed and 55% were lived in urban area. It was observed that 65% participants were economically dependent to their family, only 6% were engaged in regular exercise, 14% had family history of depression, 8% were smoker and 12% were alcohol/drug abuser. According to the Zung Self-Rating Depression Scale (ZSDS) we found 29% participants were mildly depressed, 39% participants were moderately depressed and 18% participants were severely depressed. Prevalence of depression was 86% in pre-dialytic CKD patients. Of them, 7% was in CKD stage-I, 17.4% was in CKD stage-II, 19.8% was in CKD stage-III, 22.1% was in CKD stage-IV and 33.7% was in CKD stage-V. Conclusion: Depression is highly prevalent in pre-dialytic CKD patients and more frequent in the advanced stages of CKD.

Early prediction of major depression in chronic hepatitis C patients during peg-interferon α-2b treatment by assessment of vegetative-depressive symptoms after four weeks

AIM: To study the predictive value of the vegetative- depressive symptoms of the Zung Depression Rating Scale for the occurrence of depression during treatment with peg-interferon α-2b of chronic hepatitis C (CHC) patients. METHODS: The predictive value of vegetative- depressive symptoms at 4 wk of treatment for the occurrence of a subsequent diagnosis of major depressive disorder (MDD) was studied in CHC patients infected after substance use in a prospective, multi- center treatment trial in Belgium. The presence of vegetative-depressive symptoms was assessed using the Zung Scale before and 4 wk after the start of antiviral treatment. RESULTS: Out of 49 eligible patients, 19 (39%) developed MDD. The area under the ROC curve of the vegetative Zung subscale was 0.73, P = 0.004. The sensitivity at a cut-point of > 15/35 was 95% (95% CI: 74-100). The positive predictive value equalled 44% (95% CI: 29-60). CONCLUSION: In this group of Belgian CHC patients infected after substance use, antiviral treatment caused a considerable risk of depression. Seven vegetativedepressive symptoms of the Zung scale at wk 4 of treatment predicted 95% of all emerging depressions, at a price of 56% false positive test results.

Zung抑郁自评量表在癌症患者护理中的应用

为了反映癌症病人心理护理前后抑郁程度的变化，运用Zung抑郁自评量表作为评定工具，客观地对154例癌症患者心理护理实施前1周的抑郁状态与心理护理实施后1月的抑郁状态进行了对比，检验心理护理工作的效果。结果表明，实施心理护理后，病人的抑郁程度得分由心理护理前1周的（69．11±4．46）降至心理护理后1月的（5828±3．57），下降显著（P<0.001），提示病人的抑郁症状有明显改善。

Narrative nursing for negative emotions in patients with acute pancreatitis:Based on model construction and application

BACKGROUND Acute pancreatitis(AP),as a common acute abdomen disease,has a high incidence rate worldwide and is often accompanied by severe complications.Negative emotions lead to increased secretion of stress hormones,elevated blood sugar levels,and enhanced insulin resistance,which in turn increases the risk of AP and significantly affects the patient's quality of life.Therefore,exploring the intervention effects of narrative nursing programs on the negative emotions of patients with AP is not only helpful in alleviating psychological stress and improving quality of life but also has significant implications for improving disease outcomes and prognosis.AIM To construct a narrative nursing model for negative emotions in patients with AP and verify its efficacy in application.METHODS Through Delphi expert consultation,a narrative nursing model for negative emotions in patients with AP was constructed.A non-randomized quasi-experimental study design was used in this study.A total of 92 patients with AP with negative emotions admitted to a tertiary hospital in Nantong City of Jiangsu Province,China from September 2022 to August 2023 were recruited by convenience sampling,among whom 46 patients admitted from September 2022 to February 2023 were included in the observation group,and 46 patients from March to August 2023 were selected as control group.The observation group received narrative nursing plan,while the control group was given with routine nursing.Self-rating anxiety scale(SAS),self-rating depression scale(SDS),positive and negative affect scale(PANAS),caring behavior scale,patient satisfaction scale and 36-item short form health survey questionnaire(SF-36)were used to evaluate their emotions,satisfaction and caring behaviors in the two groups on the day of discharge,1-and 3-month following discharge.RESULTS According to the inclusion and exclusion criteria,a total of 45 cases in the intervention group and 44 cases in the control group eventually recruited and completed in the study.On the day of discharge,the intervention group showed significantly lower scores of SAS,SDS and negative emotion(28.57±4.52 vs 17.4±4.44,P<0.001),whereas evidently higher outcomes in the positive emotion score,Caring behavior scale score and satisfaction score compared to the control group(P<0.05).Repeated measurement analysis of variance showed that significant between-group differences were found in time effect,inter-group effect and interaction effect of SAS and PANAS scores as well as in time effect and inter-group effect of SF-36 scores(P<0.05);the SF-36 scores of two groups at 3 months after discharge were higher than those at 1 month after discharge(P<0.05).CONCLUSION The application of narrative nursing protocols has demonstrated significant effectiveness in alleviating anxiety,ameliorating negative emotions,and enhancing satisfaction among patients with AP.

贵阳市区类风湿关节炎就诊患者抑郁情况调查分析

【目的】了解贵阳市区类风湿关节炎(RA)患者抑郁情况,评价抑郁与生存质量、疾病活动的相关性。【方法】以贵阳中医学院第二附属医院风湿免疫科就诊的门诊和住院RA患者为研究对象,采用RA临床研究观察表、Zung氏抑郁自评量表(SDS)、生存质量量表进行问卷调查。【结果】258例RA患者中70.16%存在抑郁,其中34.50%为轻度抑郁,27.52%为中度抑郁,8.14%为重度抑郁。不同性别、年龄、病程的RA患者SDS计分差异无显著性意义(P>0.05)。SDS计分与生存质量总计分及生理功能、心理功能、社会功能、健康自我认识各领域计分呈正相关,其相关系数分别为0.630、0.387、0.615、0.504、0.478。SDS计分与RA临床研究观察表中的类风湿关节炎患者病情评价(DAS28)计分、血沉(ESR)、C-反应蛋白(CRP)亦相关,相关系数从大到小依次为DAS28计分>CRP>ESR,但SDS计分与血小板计数无相关性。【结论】贵阳市区RA患者伴抑郁比例高,与患者生存质量尤其是心理功能密切相关,但与患者疾病活动指标的相关性不大。

烧伤患者抑郁情绪障碍发病特点的研究

目的探讨烧伤患者抑郁情绪障碍发生的特点。方法采用Zung抑郁量表调查烧伤患者不同时期、性别、年龄、文化、烧伤部位和程度的抑郁发生的特点。结果烧伤患者抑郁情绪发生率较高,康复期比治疗期发病率高(P<0.01),烧伤越严重发病率越高(P<0.01),女性比男性发病率高(P<0.05),有面部、手足、生殖器烧伤的患者抑郁并发率显著增高(P<0.01)。在年龄及文化程度方面无显著差异(P>0.05)。结论针对不同烧伤人群抑郁发生的趋势,制定早期心理干预,以降低烧伤患者抑郁发病率。

上海市社区女性乳腺癌患者抑郁和生活质量状况研究

背景与目的：乳腺癌是目前上海女性中发病率最高的恶性肿瘤,也是最易发生抑郁的癌症。为此,本研究旨在了解上海市社区女性乳腺癌患者的抑郁和生活质量状况及其影响因素。方法：采用整群抽样的方法从上海肿瘤病例数据库中选取社区中1328名女性乳腺癌患者进行问卷调查并填写自评量表,共回收合格调查表1172例。统计描述其抑郁状况和生活质量水平的流行病学分布,确定患者的抑郁发生和生活质量的主要影响因素及抑郁发生和生活质量的关系。结果：上海市社区女性乳腺癌现患者抑郁发生的比例为22.9%（95% CI：20.0%-25.0%）,平均的生活质量评分为107.62分（95% CI：106.41-108.83）。乳腺癌患者存活期、诊断时期别、治疗状况、体能评分KPS、疼痛VAS评分等因素是影响患者抑郁发生和生活质量的主要因素,抑郁的发生严重影响了患者的生活质量。结论：早期诊断乳腺癌、提高临床治疗效果、提供社区康复指导服务可降低其抑郁的发生比例,提高社区乳腺癌患者的生活质量。

200例普通外科患者手术前后伴发抑郁症状的调查分析

目的 了解普通外科患者手术前后抑郁症状的发生情况 ,并分析其可能的影响因素。方法 运用ZUNG自评量表对 2 0 0例手术患者术前、术后伴发抑郁症状的情况进行调查 ,依据患者的年龄、性别、文化程度、罹患疾病的性质等因素进行分别研究 ,应用SPSS 10 0统计软件进行数据的统计学检验。结果 37%患者术前有不同程度的抑郁症状 ,2 7%患者术后伴发抑郁症状。其中 2 0～ 4 4岁年龄段之间发生率与其他年龄段间差异有显著性意义。女性抑郁症状的发生率与男性间差异有显著性意义。大专以上或文盲伴发率与其他文化程度者间差异有显著性意义。恶性肿瘤患者抑郁症状的发生率与良性疾患间差异有显著性意义。结论 普通外科患者手术前后抑郁症状伴发比例较高 ,年龄、性别、文化程度 。

心理干预在缓解妇科恶性肿瘤患者负性情绪中的作用

目的探讨心理干预在缓解妇科恶性肿瘤患者负性情绪中的作用。方法在患者入院第1d采用Zung焦虑自评量表(SAS)及抑郁自评量表(SDS)对70例妇科恶性肿瘤患者进行心理状态调查,同时实施心理干预,10d后再进行心理状态的调查。结果心理干预前后妇科恶性肿瘤患者的焦虑、抑郁情绪比较,经统计学分析,均P<0.05,差异具有统计学意义。结论心理干预后,妇科恶性肿瘤患者负性情绪能得到缓解,从而使她们能积极配合治疗护理,促进机体康复,提高了患者的生存质量。

老年反流性食管炎患者固体胃排空状况及其心理因素

目的:老年反流性食管炎患者胃固体排空状况和相关因素分析,为临床诊治实践提供依据.方法:确诊为反流性食管炎的患者33例,采用13C辛酸呼气试验进行胃固体排空测定;1999年烟台会议制定的反流性食管炎分级标准进行内镜下分级;采用0-Ⅲ分法进行症状评分;Zung氏抑郁焦虑自评量表进行心理因素评估.结果:老年反流性食管炎患者胃半排空时间(halfgastricemptyingtime,T1/2)和延迟相时间(lagphasetime,Tlag)与对照组比较有显著性差异(147.5±19.3vs106.4±17.1,t=7.51,P<0.01;60.3±10.3vs34.2±9.2,t=9.42,P<0.01);病例组症状评分>6分组的T1/2和Tlag均高于<6分组(161.6±22.4vs137.6±16.7,t=4.01,P<0.01;71.8±11.8vs52.9±9.2,t=9.42,P<0.01);病例组中内镜分极Ⅰ级的患者其T1/2和Tlag与Ⅱ+Ⅲ组比较无显著差异;病例组抑郁和焦虑评分与对照组比较,有显著性差异(56.8±12.3vs39.6±9.8,P<0.01;53.4±10.9vs37.7±11.5,P<0.01).结论:老年反流性食管炎患者存在胃固体排空延迟,且延迟程度与症状评分有关,与内镜下分级无关;老年反流性食管炎患者普遍存在抑郁和焦虑情绪.

头部电针透刺对脑卒中抑郁症病人治疗前后脑电图变化的影响

目的:观察头部电针透刺配合体针治疗脑卒中抑郁症(PSD)病人前后脑电图的变化。方法:使用汉密尔顿抑郁量表(HAMD)和Zung抑郁自评量表(SDS)进行评定抑郁程度,观察治疗前后脑电图的变化。结果:所有患者经30天治疗后,临床有效率为86.25%。HAMD总分和SDS指数较治疗前比较均明显下降,差异有统计学意义。治疗前后脑电图检查比较,异常率从治疗前40%降低到治疗后15%,且均为轻度异常。治疗前后比较差异有显著性意义(P<0.01)。结论:头部电针透刺配合体针治疗PSD有改善患者脑电图中异常脑电波的作用,该研究为头部电针透穴刺法治疗PSD的临床疗效提供了理论依据。

慢性牙周炎患者抑郁心理的调查分析

目的:针对慢性牙周炎患者抑郁心理进行调查分析。方法:将患者分为慢性牙周炎组和牙周健康组(对照组),通过抑郁体验问卷(DEQ)和Zung抑郁自评量表(SDS),分别对上述2组的每一位研究对象进行问卷测试并计算每份问卷的分值,然后计算各组的依赖性因子(DEQ-A)、自我批评因子(DEQ-I)和SDS的平均分值。应用SPSS13.0软件包对数据进行t检验。结果:SDS平均分值在慢性牙周炎组较对照组显著增高,DEQ-A和DEQ-I的平均分值在慢性牙周炎组明显高于对照组,而且在重度慢性牙周炎人群中DEQ和SDS的平均分值较轻度者都明显增高,差异有显著意义(P<0.05)。结论:抑郁心理与慢性牙周炎有一定关系;重度与轻度慢性牙周炎比较,患者的DEQ-A、DEQ-I和SDS的平均分值均增加;与牙周健康组比较,其情感依附性抑郁因子和内射性抑郁因子的平均分值均增加。

宁夏地区冠心病病人抑郁调查与分析

目的了解冠心病病人抑郁发生率及其严重程度。方法对宁夏3所城市10家综合性医院心内科的冠心病病人499例,采用Zung氏抑郁自评量表(SDS)进行心理测评。结果 499例冠心病病人SDS总分显著高于国内常模,差异有统计学意义(P<0.01)。抑郁发生率为67.1%,男性62.9%,女性73.1%,性别间抑郁发生率差异有统计学意义(P<0.05)。轻度抑郁为51.7%、中度抑郁34.0%、重度14.3%,男性以轻度抑郁为主,女性以轻、中度为主,性别间抑郁程度分布差异有统计学意义(P<0.01)。非条件Logistic回归模型结果显示:年龄、经济来源、早年丧父或丧母、健康状况是冠心病病人抑郁的危险因素。结论冠心病病人抑郁发生率较高,女性患者抑郁发生率高于男性,且抑郁程度相对较重,年龄越大、无固定经济来源、早年丧父或丧母、健康状况较差的冠心病病人抑郁发生率较高。

博士研究生抑郁状况和毕业要求之间关系的调查

目的了解毕业要求的高低与在读博士研究生抑郁指标高低之间可能的关系。方法采用的量表包括基本信息部分(包括毕业要求等调查)和情绪测试部分(Zung抑郁自评量表),对229名合肥市某全国重点大学的博士研究生(含硕博连读研究生)进行调查。结果总体样本的抑郁自评量表得分标准分显著地低于轻度抑郁判定分数即50分(t=2.78,P=0.006),抑郁症状阳性检出率为41.9%。需要在SCI检索的杂志上发表文章才可以毕业的群体(n=138)标准分与轻度抑郁判定分数没有显著性差异(t=0.88,P=0.38),抑郁症状阳性检出率为46.4%,其中低年级组为35.9%,中高年级组为56.8%;并且抑郁自评分数与毕业所需发表的SCI文章数目发现有弱的正相关(r=0.19,P=0.024)。结论毕业要求过高有可能是造成博士研究生群体朝着抑郁症状方向发展的原因之一。

5.12汶川地震伤员及陪护心理状况评估

目的:评估5.12汶川地震伤员及来自灾区的伤员陪护心理状况及相关因素。方法:采用焦虑自评量表(SAS)、抑郁自评量表(SDS)对我院收治的68名地震伤员及59名伤员陪护进行心理评估并与中国常模比较,且按是否丧亲进行亚组间比较。结果:受试者SAS评分高于正常者41例(32.28%),SDS评分高于正常者45例(35.43%);受试者SAS、SDS评分高于中国常模,有显著性差异(P<0.01);丧亲亚组SAS、SDS评分高于未丧亲亚组,有显著性差异(P<0.01)。结论:地震伤员及陪护存在抑郁、焦虑情绪,采用SAS、SDS量表评估地震灾民的心理状况,筛选有心理障碍的地震伤员及陪护,对心理干预和治疗有重要指导意义。

“舒心Ⅰ号”对普外手术伴发抑郁障碍的治疗观察

目的:了解'舒心Ⅰ号'对普外手术伴发抑郁障碍的疗效.方法:应用ZUNG抑郁自评量表,对300例普外病人进行术前测评,筛选出符合诊断患者107名,应用信封抽签法随机分3组.A组术后服用'舒心Ⅰ号',B组服用安慰剂'外科1号',C组未服任何中药.在术后7～14天再次测评.结果:A组术后抑郁症的伴发率与B组及C组相比差异有显著性意义.B组与C组相比差异无意义.结论:'舒心Ⅰ号'对普外患者伴发抑郁障碍有一定疗效.

活血疏肝解郁汤联合盐酸氟西汀治疗脑卒中后抑郁40例疗效观察

目的:观察活血疏肝解郁汤联合盐酸氟西汀治疗脑卒中后抑郁的临床疗效。方法:按区组随机化方法将80例本病患者分为治疗组和对照组各40例。对照组予盐酸氟西汀治疗,治疗组予活血疏肝解郁汤联合盐酸氟西汀治疗。两组均进行心理干预,观察12周,分析两组患者治疗各阶段汉密尔顿抑郁量表(HAMD)、ZUNG抑郁自评量表(SDS)评分情况。结果:治疗组第12周末HAMD表总有效率优于对照组,差异有统计学意义(P<0.05);第8、12周末SDS表总有效率均优于对照组,差异有统计学意义(P<0.01或P<0.05)。结论:活血疏肝解郁汤配合盐酸氟西汀片治疗脑卒中后抑郁有较好临床疗效。

Effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma

BACKGROUND The brain is the most complex organ in the human body.Treatment for a glioma always involves a multi-disciplinary team.Nursing care in fast-track surgery or enhanced recovery after surgery is such kind of work implemented by an interdisciplinary team to provide services to patients to improve their outcomes.AIM To explore the effects of nursing care in fast-track surgery on postoperative pain,psychological state,and patient satisfaction with nursing for glioma.METHODS From June 2018 to June 2020,138 patients who underwent operation for glioma at Cancer Hospital Affiliated to Chongqing University were selected.They were categorized into groups according to different nursing care that they received.Of them,69 patients receiving nursing care in fast-track surgery were included in an experimental group,and 69 patients receiving conventional postoperative nursing were included in a control group.Visual analogue scale was used to evaluate postoperative pain in the two groups immediately after the operation and at 3 d after the operation.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the psychological status of patients immediately after operation and on the 3rd postoperative day.A self-made satisfaction scale for patient satisfaction with nursing was used to evaluate and compare patient satisfaction with nursing between the two groups.RESULTS Time to excretion,time to out-of-bed activities,and length of hospital stay were significantly shorter in the observation group than in the control group(P<0.05).There was no significant difference in duration of operative time or intraoperative bleeding between the two groups(P>0.05).There was no significant difference in postoperative pain score between the two groups(P>0.05).The pain score was significantly lower in the observation group than in the control group at 3 d after the operation(P<0.05).There was no significant difference in postoperative SAS or SDS score between the two groups(P>0.05).SAS and SDS scores were significantly lower in the observation group than in the control group at 3 d after operation(P<0.05).The rate of patient satisfaction with nursing was 94.2%in the observation group,which was significantly higher than that(81.2%)of the control group(P<0.05).CONCLUSION Nursing care in fast-track surgery can relieve postoperative pain,anxiety,and depression,and improve patient satisfaction with nursing in patients with glioma,which is worthy of clinical application.

Investigation of the effect of military stress on the prevalence of functional bowel disorders

AIM: To investigate the morbidity of functional bowel disorders (FBD) under military stress conditions in order to lay foundations for the prevention and treatment of this disease. METHODS: Four hundred and fifty-seven soldiers who were assigned to specified services and 471 soldiers who were assigned to routine services were enrolled using cluster sampling, with the latter as a control group. They were surveyed using the Rome Ⅲ FBD standard questionnaire. The FBD symptom question-naire included FBD-related symptoms, severity, dura- tion or attack time, and accompanying symptoms. RESULTS: The morbidity of the military stress group (14.6%) was significantly higher than in the control group (9.98%) ( 2 = 4.585, P < 0.05). The incidence of smoking, abdominal pain and acid regurgitation ( 2 = 4.761, P < 0.05) as well as the ZUNG anxiety/depression scores ( 2 = 7.982, P < 0.01) were also sig- nificantly higher in the military stress group compared with the control group. ZUNG anxiety ( 2 = 11.523, P < 0.01) and depression ( 2 = 5.149, P < 0.05) scores were higher in the FBD group compared with the non-FBD group. The differences in the ZUNG self-rated anxiety and depression scales between the 2 groups were statistically significant ( 2 = 14.482, P < 0.01 and 2 = 6.176, P < 0.05). CONCLUSION: The morbidity of FBD was higher under military stress conditions.