Effects of a Cocktail Supplement of Ginkgo Biloba and Acai Extract on Cognitive Symptoms of Parkinson’s Disease

Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).

Neuropsychiatric Symptoms,Parenting Stress and Social Support in Chinese Mothers of Children with Autism Spectrum Disorder

Although little is known about the current situation regarding autism spectrum disorder(ASD)in main land China,psychiatric disorders are common among Chinese mothers of preschool children with ASD.Previous studies showed ASD child's behavioral symptoms,maternal anxiety,and maternal depressive symptoms were associated with overall parenting stress in northern China.In the present study,we retrospectively analyzed medical records at the hospital related to neuropsychiatric symptoms,parenting stress and social support in mothers of children with ASD from southern China.A total of 80 mothers of children with ASD were screened.Among them,34 mothers were in low-functioning ASD group(L-ASD group)and 46 mothers were in highfunctioning ASD group(H-ASD group).Identification of the ASD cases was confirmed with a Revised Autism Diagnostic Inventory.Neuropsychiatric symptoms,parenting stress and social support were measured by neuropsychiatric inventory(NPI),parenting stress index short form(PSISF),and multi-dimensional scale of perceived social support(MSPSS).Total mean score of the NPI in the L-ASD group was significantly higher than that in the H-ASD group(P<0.01).The subscale scores of NPI,including depression,anxiety,apathy,irritability,agitation,night time behavior disturbances and change in appetite were significantly higher in the L-ASD group than those in the H-ASD group(P<0.01 or P<0.05).Meanwhile,the total PSI-SF scores and the scores of parental distress(PD),parental-child dysfunctional interaction(PCDI)and difficult child(DC)in the L-ASD group were significantly higher than those in the H-ASD group(P<0.01 or P<0.05).The total score of MSPSS was also higher in the L-ASD group than in the H-ASD group(P<0.01).This study goes further to show the neuropsychiatric symptoms and parenting stress are significantly higher in mothers of children with ASD,and more social supports are needed for mothers of children with ASD from southern China,especially for mothers of children with low-functioning ASD.

Psychological impacts of the COVID-19 epidemic on Chinese people: Exposure, post-traumatic stress symptom, and emotion regulation

Objective:To examine the effects of coronavirus disease-2019(COVID-19)exposure,expressive suppression/cognitive reappraisal,and demographic variables on post-traumatic stress symptoms(PTS)among Chinese.Methods:Participants were recruited by social media through We Chat and 6049 Chinese(aged from 17 to 63 years;median=24)from 31 provinces were included in the study.PTS symptoms,expressive suppression,and cognitive reappraisal were assessed after the outbreak of COVID-19.A regression mixture analysis was conducted in Mplus 7.Results:A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID-19 exposures on PTS symptoms:(1)Class 1(mildly PTS symptoms,80.9%),(2)Class 2(moderate PTS symptoms,13.0%),and(3)Class 3(high PTS symptoms,6.1%).The results demonstrated that the young,women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms;and they had more expression inhibition and less cognitive reappraisal in three latent classes.Conclusions:The findings suggest that more attention needs to be paid to vulnerable groups such as the young,women and people with responsibilities and concerns for others.Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.

The Effects of Accumulated Short Bouts of Mobile-Based Physical Activity Programs on Depression,Perceived Stress,and Negative Affectivity among College Students in South Korea:Quasi-Experimental Study

Regular physical activity(PA)is known to enhance multifaceted health benefits,including both physical and mental health.However,traditional in-person physical activity programs have drawbacks,including time constraints for busy people.Although evidence suggests positive impacts on mental health through mobile-based physical activity,effects of accumulated short bouts of physical activity using mobile devices are unexplored.Thus,this study aims to investigate these effects,focusing on depression,perceived stress,and negative affectivity among South Korean college students.Forty-six healthy college students were divided into the accumulated group(n=23,female=47.8%)and control group(n=23,female=47.6%).The accumulated group engaged in mobile-based physical activity,following guidelines to accumulate a minimum of two times per day and three times a week.Sessions were divided into short bouts,ensuing each bout lasted at least 10 min.The control group did not engage in any specific physical activity.The data analysis involved comparing the scores of the intervention and control groups using several statistical techniques,such as independent sample t-test,paired sample t-tests,and 2(time)×2(group)repeated measures analysis of variance.The demographic characteristics at the pre-test showed no statistically significant differences between the groups.The accumulated group had significant decreases in depression(t_(40)=2.59,p=0.013,Cohen’s D=0.84)and perceived stress(t_(40)=2.06,p=0.046,Cohen’s D=0.56)from the pre-to post-test.The control group exhibited no statistically significant differences in any variables.Furthermore,there were significant effects of time on depression scores(F1,36=4.77,p=0.036,η_(p)^(2)=0.12)while significant interaction effects were also observed for depression(F_(1,36)=6.59,p=0.015,η_(p)^(2)=0.16).This study offers informative insights into the potential advantages of mobile-based physical activity programs with accumulated periods for enhancing mental health,specifically in relation to depression.This study illuminates the current ongoing discussions on efficient approaches to encourage mobile-based physical activity and improve mental well-being,addressing various lifestyles and busy schedules.

Changes in insomnia severity with advanced PAP therapy in patients with posttraumatic stress symptoms and comorbid sleep apnea:A retrospective,nonrandomized controlled study

Background:Sleep disorders frequently occur in posttraumatic stress disorder(PTSD)patients.Chronic insomnia is a common feature of and criteria for the diagnosis of PTSD.Another sleep disorder,obstructive sleep apnea(OSA),also occurs frequently in PTSD,and emerging research indicates OSA fuels chronic insomnia.Scant research has investigated the impact of OSA treatment on insomnia outcomes(Insomnia Severity Index,ISI)in trauma survivors.Methods:OSA patients with moderately severe posttraumatic stress symptoms were studied in a retrospective chart review.Ninety-six patients who failed CPAP therapy due to expiratory pressure intolerance or complex sleep apnea or both underwent manual titration with advanced PAP modes[autobilevel(ABPAP);adaptive servo-ventilation(ASV)],which were subsequently prescribed.PAP use measured by objective data downloads divided the sample into three groups:compliant regular users(C-RU):n=68;subthreshold users(SC-RU):n=12;and noncompliant users(NC-MU):n=16.The average follow-up was 11.89±12.22 months.Baseline and posttreatment ISI scores were analyzed to assess residual insomnia symptoms as well as cure rates.Results:The C-RU group showed significant improvements in insomnia with very large effects compared to those in the NC-MU reference group(P=0.019).Insomnia severity significantly decreased in all three groups with large effects(C-RU,P=0.001;SC-RU,P=0.027;NC-MU,P=0.007).Hours of weekly PAP use and insomnia severity were inversely correlated(P=0.001,r=–0.321).However,residual insomnia symptoms based on established ISI cut-offs were quite common,even among the C-RU group.Post hoc analysis showed that several categories of sedating medications reported at baseline(hypnotics,anti-epileptic,opiates)as well as actual use of any sedating medication(prescription or nonprescription)were associated with smaller insomnia improvements than those in patients not using any sedating agents.Conclusions:In a retrospective,nonrandomized analysis of a select sample of sleep clinic patients with OSA and PTSD symptoms,advanced PAP therapy was associated with significant improvement in insomnia severity for both compliant and partial users.However,residual insomnia symptoms persisted,indicating that PAP therapy provides only limited treatment.RCTs are warranted to assess the effect of ABPAP and ASV modes of therapy on adherence and sleep outcomes,and their potential impact on posttraumatic stress symptoms.Treatment arms that combine PAP with CBT-I would be expected to yield the greatest potency.

The relationship between psychological distress with salivary <i>α</i>-amylase and stress related symptoms among breast cancer survivors

Background and Aims: This study examined the stress levels, the stressors and biomarker such as Alpha (α)-Amylase enzyme which is secreted under distress conditions. The aim was to determine the relationship between these three variables. Methods: The study respondents were made up of cancer outpatients from 3 hospitals namely the Hospital Kuala Lumpur, Seberang Jaya and Johor Baru, Pantai Ipoh and Putrajaya. The Personal Stress Inventory (PSI) questionnaire was used to identify stressors, while the Hospital Anxiety and Depression Scale (HADS) were used to determine the psychological distress levels. The Salimentary Oral Swab (SOS) Technique was used to collect the saliva and then the Salivary α-Amylase Assay Kit was used to analyse for α amylase. Results: The majority of respondents were stressed due to their sensitive emotion and nervousness in their daily lives (68.7%), they had poor memory and short attention spans of carrying out job tasks (67.3%) as well as they were emotionally depressed (65.3%). Their poor memory and short attention span (p = 0.037), heavy work load and poor task delivery (p = 0.008) were predictors for distress using HADS. The salivary α-amylase concentration was significantly related to the stress levels (p = 0.002). Conclusion: Breast cancer respondents with musculoskeletal system related symptoms, with heavy work load and poor task delivery, as well as had poor memory and short attention span were at higher risk of experiencing psychological distress. The salivary α-amylase which had significant relationships with psychological distress was therefore, a potential biological indicator for distress, while the musculoskeletal system related symptoms from the PSI questionnaire were predictors for distress.

Acute Stress Symptoms in Families of Patients Admitted to the Intensive Care Unit during the First 24 Hours Following Admission in Japan

Families of patients in the intensive care unit often experience sever stress. Understanding their experience is important for providing family-centered care during this difficult period. Little is known about the experience of families of patients admitted to the intensive care unit (ICU). To evaluate the prevalence and factors associated with acute stress symptoms among families of patients admitted to the ICU, we carried out a cross-sectional study at a teaching and advanced treatment hospital. The mean total Impact of Event Scale-Revised (IES-R) score differed significantly between planned and unplanned ICU admissions (t = 4.03, p < 0.05), indicating a main effect of admission type (F = 18.5, p < 0.05). There was no significant main effect of relationship (F = 0.05, p = 0.82) or interaction effect of admission type and relationship (F = 0.54, p = 0.47). Multiple regression analysis indicated that admission type was significantly associated with acute stress symptoms (B = 18.09, β = 0.47, p < 0.01), and explained 22% of the variance in total IES-R score. Whether a patient had a planned or unplanned admission to the ICU influenced symptoms associated with acute stress symptoms of family members more than did getting support from nurses, being the patient’s spouse, or the severity of illness of the patient.

Evaluation of visual stress symptoms in age-matched dyslexic, Meares-Irlen syndrome and normal adults

AIM： To examine the prevalence of dyslexia and Meares-Irlen syndrome（MIS） among female students and determine their level of visual stress in comparison with normal subjects.·METHODS： A random sample of 450 female medical students of King Saud University Riyadh（age range, 18-30y） responded to a wide range of questions designed to accomplish the aims of this study. The detailed questionnaire consisted of 54 questions with 12 questions enquiring on ocular history and demography of participants while 42 questions were on visual symptoms. Items were categorized into critical and non-critical questions（CQ and NCQ） and were rated on four point Likert scale. Based on the responses obtained, the subjects were grouped into normal（control）, dyslexic with or without MIS（Group 1） and subjects with MIS only（Group 2）. Responses were analysed as averages and mean scores were calculated and compared between groups using one way analysis of variance to evaluate total visual stress score（TVSS =NCQ ＋CQ）, critical and non-critical visual stress scores. The relationship between categorical variables such as age, handedness and condition were assessed with Chi-square test.·RESULTS： The completion rate was 97.6% and majority of the respondents（92%） were normal readers, 2%dyslexic and 6% had MIS. They were age-matched. More than half of the participants had visited an eye care practitioner in the last 2y. About 13% were recommendedeye exercises and one participant experienced pattern glare. Hand preference was not associated with any condition but Group 1 subjects（3/9, 33%） were significantly more likely to be diagnosed of lazy eye than Group 2（2/27, 7%） and control（27/414, 7%） subjects. The mean±SD of TVSS responses were 63±14 and it was 44±9for CQ and 19 ±5 for NCQ. Responses from all three variables were normally distributed but the CQ responses were on the average more positive（82%） in Group 2 and less positive（46%） in Group 1 than control. With NCQ,the responses were equally less positive in Group 1 and2 than control. Group 2 subjects showed significantly higher TVSS（P =0.002）, NCQ（P =0.006） and CQ（P =0.008）visual stress scores than control but no difference between Group 1 and control subjects, was observed for all scores（P 〉0.05, for all comparisons）.·CONCLUSION： The prevalence of dyslexia and MIS among Saudi female students was 2% and 6%,respectively. Critical questions performed best for assessing visual stress symptoms in dyslexic and MIS subjects. Generally, students with MIS were more sensitive to visual stress than normal students but dyslexics were more likely to present with a lazy eye than MIS and normal readers.

Association of Perceived Stress and Gastrointestinal Symptoms in College Students: A Systematic Review

Stress and anxiety are common entities in college students, and only a handful of students can handle these stressors appropriately, while others may show physical signs and symptoms. The main purpose of this systematic review was to examine the association between perceived stress and gastrointestinal symptoms. A detailed search was conducted using five databases: PubMed, Research Gate, Science Direct, American Journal of Gastroenterology, and Google scholar. Ten papers were finalized after the application of various inclusion and exclusion criteria. The Newcastle Ottawa scale was used to evaluate the quality of the included articles as all the included articles were cross-sectional studies. The systematic review of these finalized articles found that most studies revealed the prevalence of gastrointestinal symptoms in college students and were linked to perceived stress.

The Single-Item Measure of Stress Symptoms after Myocardial Infarction and Its Association with Fatigue

Surviving a myocardial infarction (MI) can be a stressful event entailing challenges in daily life during the recovery period. Experiencing fatigue symptoms post-MI has been described as bothersome and occurs in nearly half of patients four months and two years after MI. The aetiology of fatigue disorder is unclear, but research has shown that fatigue plays an important role in the relationship between stress and perceived poor health. Previous findings indicate that having access to an easily administered stress measurement is worthwhile both in the clinic and in research. The single-item measure of stress symptoms has not been validated in persons treated for MI. The aim was to validate the single-item measure of stress symptoms and to explore its association with fatigue in a sample of persons treated for MI. Methods: 142 respondents completed the questionnaires of the Multidimensional Fatigue Inventory-20, the single-item measure of stress symptoms and the Perceived Stress Scale-10 (PPS-10) two months post-MI. Correlation analysis and t-tests were used to validate the single-item stress measure and its association with post-MI fatigue. Results: The convergent validity of the single-item measure of stress symptoms was confirmed. In analyses of relations between stress and fatigue, it was found that the single-item stress measure was strongly associated with both the global fatigue score and all four fatigue dimension scores (general, physical and mental fatigue as well as reduced activity). Conclusion: The single-item measure of stress symptoms was found to be a valid measure of post-MI stress. Also, the measure was useful in assessing associations between stress and fatigue and could therefore indicate that post-MI fatigue experiences should be further explored in full using multidimensional fatigue assessment.

Prevalence and related factors of post-traumatic stress disorder among medical staff members exposed to H7N9 patients

Objective: This study aimed to evaluate the prevalence and related factors of post-traumatic stress disorder (PTSD) symptoms among doctors and nurses who were exposed to H7N9 patients during the H7N9 influenza epidemic.To provide scientific basis for promoting the physical and psychological health of these staff members.Method: The 102 medical staff workers who were exposed to H7N9 patients were recruited through convenient sampling between January 2015 and May 2016.We used a self-reported questionnaire,the PTSD Checklist-Civilian Version (PCL-C),to evaluate the PTSD symptoms among doctors and nurses from an intensive care unit (n =61),a respiratory department (n =20),and an emergency department (n =21).We then analyzed the related factors.Results: Around 20.59% of the tested doctors and nurses showed PTSD symptoms.The sample had a mean PCL-C score of 30.00 ± 9.95.The differences in the scores of doctors and nurses with different genders,ages,professional titles,contact frequencies,trainings,and experiences were statistically significant (P < 0.05,P < 0.01).Moreover,t-tests and one-way analysis of variance showed that nurses received higher scores than doctors,female participants received higher scores than male participants,and the participants with low professional title and high contact frequency,aged between 20 years and 30 years,with less than five years of work experience,having not received related training and with no related experience obtained higher PCL-C scores than the others (P < 0.05,P < 0.01).Conclusion: The PTSD level of doctors and nurses after their exposure to H7N9 patients was high,which warrant further research.Health and medical institutions should pay attention to the physical and psychological health of these staff members.

Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder

AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 years; 61% women) and 136 controls from the general population(mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome(GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale(HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTS In subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls(GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for "constipation" and "reflux". Factors associated to GI symptoms in the patient group were female sex(adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score(adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores(29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls(25% vs 17%, P = 0.108).CONCLUSION Female patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects.

Posttraumatic stress symptom trajectories of Chinese university students during the first eight months of the COVID-19 pandemic and their association with cognitive reappraisal,expressive suppression,and posttraumatic growth

Objective: To identify the moderating effects of cognitive reappraisal(CR) and expressive suppression(ES) on the relationship between posttraumatic stress(PTS) symptoms and posttraumatic growth(PTG) in university students. Methods: The survey included 1 987 Chinese university students who completed questionnaires on PTS symptoms in February 2020, with three follow-up surveys at two-month intervals until August 2020. We assessed CR and ES at February 2020 and PTG at August 2020. Growth mixture modeling was used to classify the PTS symptom trajectories. Multinomial logistic regression was used to recognize the predictors of class membership. The relationships among PTS symptoms, CR, ES, and PTG were examined using multi-group path analysis.Results: Sex, SARS-Co V-2 infection of a family member or friend, number of siblings, CR, and ES were significantly associated with PTS symptoms. Three latent classes were identified: ‘Increasing PTS’(n=205, 10.0%) who had rapid deterioration of PTS symptoms, ‘Moderate PTS’(n=149, 8.0%) who had a high level of PTS symptoms at the beginning and slightly increasing, and ‘Persistent Minimal PTS’(n=1 633, 82.0%), who had slow resolution of PTS symptoms over time. Male, SARS-Co V-2 infection of a family member or friend, and having a lower CR and a higher ES, were more likely to have ‘Increasing PTS’. PTS at February 2020 predicted PTG only in ‘Increasing PTS’ class, and both CR and ES had moderating effects on the conversion between them.Conclusions: Most students recovered from posttraumatic stress of COVID-19 pandemic, but a small proportion expeienced increasing PTS symptoms, and those with this condition may benefit from emotional regulation intervention.

Dietary Modification of Lower Urinary Tract Symptoms with Fermented Whey Product

After the age of 50, the prostate begins to increase in size. This is known as benign prostatic hypertrophy (BPH). Compression of urethra by enlarged prostate causes dribbling reduced force of the urinary stream, pain and occasional bleeding or infection. This causes difficulty in urinating and requires many men to get up several times during the night to urinate. The aim of our study was to evaluate an influence of new fermented whey based product (FWP) to several biochemical parameters and lower urinary tract symptoms (LUTS). Patients from the outpatient department of Andrology Center were randomized. This study involved the patients with minor to moderate LUTS, International Prostate Symptoms Score (IPSS) range 3 - 19 but not prostatitis (NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) 4 and 2-glass test negative for prostate inflammation and infection). Consumption of the FWP decreased the IPSS score in patients with moderate LUTS/BPH (p 0.001) whereas irritative and obstructive symptoms changed in parallel. There was a correlation between LUTS symptoms change and level of inflammation- and oxidative stress-related indices (blood high-sensitive C-reactive protein, hsCRP;glycated haemoglobin, HbA1c;oxidized low density lipoprotein, oxLDL;interleukine-10, IL-10 and 8-isoprostanes in the urine). Statistically significant changes in mentioned parameters occurred only in study group. Compression of urethra by enlarged prostate explains LUTS in BPH patients. Elevated oxidative stress (OxS) intensifies peroxidation of cell membrane phospholipids. This generates 8-isoprostanes (8-EPI), the prostaglandin-like compounds that can exaggerate LUTS. 8-isoprostanes may cause constriction of bladder and urethra in nanomolar concentrations. Consuming the whey-based product fermented by special lactobacilli strains may improve LUTS as well as OxS and diminish LUTS-related inflammatory response.

Legacy of neuropsychiatric symptoms associated with past COVID-19 infection:A cause of concern

Although primarily affecting the respiratory system,growing attention is being paid to the neuropsychiatric consequences of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections.Acute and sub-acute neuropsychiatric manifestations of coronavirus disease 2019(COVID-19)disease and their mechanisms are better studied and understood currently than they had been when the pandemic began;however,many months or years will be necessary to fully comprehend how significant the consequences of such complications will be.In this editorial,we discuss the possible long-term sequelae of the COVID-19 pandemic,deriving our considerations on experiences drawn from past coronaviruses’outbreaks,such as the SARS and the middle east respiratory syndrome,and from the knowledge of the mechanisms of neurotropism and invasiveness of SARS-CoV-2.Acknowledging the global spread of COVID-19 and the vast number of people affected,to date amounting to many millions,the matter of this pandemic’s neuropsychiatric legacy appears concerning.Public health monitoring strategies and early interventions seem to be necessary to manage the possible emergence of a severe wave of neuropsychiatric distress among the survivors.

Reciprocal Association between Psychological Distress and PTSD and Their Relationship with Pre-Displacement Stressors among Displaced Women

It is established in the psychological literature that pre-displacement stressors,PTSD symptoms,and psycholo-gical distress are associated among internally displaced persons.However,existing studies have not demonstrated the mechanism underlying these associations.This study compared two explanatory models;one with PTSD symptoms severity explaining the indirect association between pre-displacement stressors and psychological dis-tress,and the other with psychological distress explaining the indirect relationship between pre-displacement stressors and PTSD symptoms severity.In a cross-sectional design,631 women(Mean age=31.18±8.59)were conveniently and purposely selected from the displaced women harboured in two camps in Borno State,Nigeria,due to the Boko-Haram insurgency.Data were collected utilizing structured questionnaires and subjected to path analyses.Results demonstrated that PTSD symptoms severity and psychological distress indirectly explained their respective and independent association with pre-displacement stressors.However,PTSD symptoms had a statis-tically larger standardized indirect effect size,greater indirect effect percentage,and bigger kappa-squared(k2)effect size than psychological distress.PTSD symptoms and psychological distress may have a reciprocal influence on each other from pre-displacement stressors.However,PTSD symptoms can better explain the association between pre-displacement stressors and psychological distress than the other way around.These outcomes have important implications for the psychological treatment of displaced persons.

创伤暴露1年后创伤后应激障碍的发生率及危险因素

目的 观察创伤暴露1年后创伤后应激障碍(PTSD)发生率的变化,并分析创伤暴露1年后PTSD发展的危险因素。方法 在新型冠状病毒感染疫情暴发初期和暴发后1年分别进行方便取样,被试在线匿名参与调查。调查内容包括2份自填问卷:1份收集个人信息(性别、年龄、受教育程度、职业)和主观睡眠质量;另1份是第5版《精神疾病诊断与统计手册》(DSM-5)的PTSD检查表(PCL-5),在创伤暴露初期和创伤暴露1年后分别回收有效问卷2 091、2 092份。结果 创伤暴露初期PTSD发生率为5.3%(111/2 091),创伤暴露1年后PTSD发生率为19.1%(399/2 092)。多元线性回归分析显示,年龄(P<0.01)、性别(P<0.01)和主观睡眠质量(P<0.01)为PTSD的风险因子。结论 创伤暴露1年后PTSD发生率较创伤暴露初期有所上升。在创伤暴露初期应特别重视年纪轻、女性、睡眠障碍群体,并尽早给予心理干预措施,以防后期发生PTSD。

广泛性焦虑障碍患者氧化应激因子与焦虑症状的相关性分析

目的探讨广泛性焦虑障碍(GAD)患者氧化应激因子与焦虑症状的相关性。方法采用病例对照的研究方法,选取2022年1月至2023年1月在湖州市第三人民医院门诊就诊的GAD患者101例和健康体检者100名(对照组)。采用酶联免疫吸附试验测定静脉血氧化应激因子水平,包括丙二醛(MDA)、超氧化物歧化酶(SOD)、HDL、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)、皮质醇、一氧化氮(NO)和脂质过氧化物(LPO),采用汉密尔顿焦虑量表(HAMA)评估焦虑程度,汉密尔顿抑郁量表(HAMD-17)评估抑郁程度。结果GAD组MDA、皮质醇、LPO水平、HAMA评分和HAMD-17评分均明显高于对照组(均P<0.05);SOD、GSH-Px、CAT水平明显低于对照组(均P<0.05);两组间HDL、NO水平比较差异均无统计学意义(均P>0.05)。GAD组MDA、NO、LPO与HAMA评分均呈正相关(均P<0.01);SOD、GSH-Px与HAMA评分均呈负相关(均P<0.01)。经二元logistic回归分析显示,在控制性别、年龄、BMI和教育年限等因素后,MDA是GAD发生的危险因素(P<0.05)。结论GAD患者存在氧化应激失衡,MDA水平升高是GAD发病的危险因素。

TIMBER对意外创伤肢体功能障碍康复期患者创伤后应激症状的影响

目的 探讨基于正念的消退和再巩固创伤干预(trauma interventions using mindfulness based extinction and reconsolidation, TIMBER)对意外创伤肢体功能障碍康复期患者创伤后应激症状的影响。方法 采用方便取样的方法,选取2022年3月至2023年5月陆军军医大学第一附属医院康复医学科收治的创伤康复期患者(impact of event scale-revised, IES-R总分≥33分)46例,采用随机数字表法分为干预组和对照组,干预组接受TIMBER干预,对照组进行心理健康相关知识宣教。在干预前(T1)、干预结束时(T2)和干预结束后1个月(T3)使用事件影响量表修订版(IES-R)、医院焦虑抑郁量表(HADS)、睡眠状况自评量表(SRSS)对所有被试进行测量,比较两组患者创伤后应激症状、焦虑症状、抑郁症状和睡眠的变化。结果 两组患者人口统计学信息及各心理学变量在T1时差异均无统计学意义(P>0.05);干预组在T2和T3时的IES-R总分及各维度评分、焦虑、抑郁和睡眠评分显著低于对照组(P<0.05);干预组在T2和T3时的IES-R总分及各维度评分、焦虑、抑郁和睡眠评分显著低于T1(P<0.01);与T1相比,对照组T2、T3时的回避、闯入2个维度评分及IES-R总分有一定程度降低,差异有统计学意义(P<0.05),而高警觉、焦虑、抑郁和睡眠评分差异无统计学意义(P>0.05)。结论 TIMBER可以显著改善意外创伤肢体功能障碍康复期患者的创伤后应激症状、焦虑抑郁症状及睡眠。

RMUS术治疗混合性尿失禁中尿急症、急迫性尿失禁症状的疗效观察

目的探索经阴道经耻骨后无张力尿道中段吊带(RMUS)术治疗混合性尿失禁(MUI)中尿急症、急迫性尿失禁(UUI)症状的疗效。方法回顾性分析2018年1月—2020年12月上海交通大学医学院附属仁济医院采用RMUS术治疗的44例女性MUI患者的临床资料。44例患者术前压力诱发试验、尿道抬举试验均为阳性。27例患者术前完成国际尿失禁咨询委员会女性下尿路症状长问卷(ICIQ-FLUTS-LF)调查,44例患者接受尿动力学(UDS)检查,其中9例(20.5%)出现逼尿肌过度活动(DO)。所有患者RMUS术中均通过解剖定位调整吊带张力。分析手术治疗效果和患者尿失禁改善情况。结果本研究44例患者平均年龄(58.59±9.08)岁,身体质量指数24.71±2.77。术后2年完成电话随访40例,主观治愈率为85.0%(34/40)。在27例完成ICIQ-FLUTS-LF问卷的患者中,手术前后漏尿发生率[100%(27/27)vs.18.5%(5/27)]、压力性尿失禁(SUI)发生率[100%(27/27)vs.18.5%(5/27)]、UUI发生率[70.4%(19/27)vs.29.6%(8/27)]差异均具有统计学意义(P<0.05);患者手术前后夜尿(≥1次)、尿急症、尿痛、排尿踌躇、排尿费力、排尿中断、遗尿发生率差异无统计学意义(P>0.05)。根据术前UDS检查结果进行的患者亚组分析显示,术后2年DO组和无DO组患者的主观治愈率差异有统计学意义[(55.6%(5/9)vs.93.5%(29/31),P<0.05],且两组患者术后SUI发生率[66.7%(4/6)vs.4.8%(1/21)]和UUI发生率[66.7%(4/6)vs.19.0%(4/21)]差异均有统计学意义(P<0.05),但尿急症发生率[66.7%(4/6)vs.33.3%(7/21)]差异无统计学意义(P>0.05)。结论采用RMUS术治疗压力诱发试验和尿道抬举试验阳性的MUI患者有效,术后可改善患者的SUI和UUI症状,但对于尿急症无明显改善。此外,DO组患者术后2年的主观治愈率劣于无DO组。