综合医院精神医学问题的认识

综合医院精神医学问题涉及面较广,主要是指除精神病外的各种心理障碍与心理应激相关疾病.患者就诊主诉多样化,就诊医院或专科繁多.提高对综合医院精神医学问题的识别能力对临床各科医务人员非常重要.本文对综合医院常见器质性和功能性精神疾病的临床特点、识别处理作一概述.     

精神卫生--综合医院医护人员的必修课

目前,由于知识结构所限,许多综合医院的医护人员精神卫生知识较为欠缺.他们对当今医学模式的转变的认识仅停留在口头上,对社会心理因素在疾病的发生、转归过程中所起的作用认识不足,直接影响到诊治疾病的思维方式和医疗服务水平的提高.     

从综合医院针灸会诊情况看针灸的优势及研究方向

山东大学齐鲁医院是一所卫生部直属大型综合医院,分科详细,科室齐全,拥有病床1602张。该院其他临床科室请求针灸科会诊的情况,应该基本能够反映,作为传统医学的针灸在综合医疗单位中的作用和地位。从中我们也可以从一个侧面说明针灸的优势及其研究方向：     

综合医院如何识别精神疾患——以双心门诊服务为例

本文以双心门诊服务为例,介绍了在综合医院门诊服务中如何融入心理卫生视角,如何发现和诊治精神障碍,同时鉴别和处理患者的心理问题.重点强调了精神科方法的特殊性——既有常规的因果论说明,也要有目的论的理解.只有将患者的临床表现与行为应对放到个性、生存环境的大背景下加以有意义的理解,才能更好地帮助患者追求健康和应对疾病.文章最后,给出了精神科与内科如何进行临床分工合作的实际做法供参考.     

系统方法对综合医院开放式心理病房的分析

1　开放式精神心理疗法的实施1 1　资料 :来源于 2 0 0 0年 7月～ 2 0 0 2年 4月在广东医学院附属医院心理科住院病人 ,共 6 0 0例。其中男 330例 ,女 2 70例 ,男女比例为 1 2∶1,年龄 11～ 80岁 ,平均 4 5岁 ;住院天数 4～ 5 6天 ,平均 19天。高中文化居多 ;工人、农民、干部居多。1 2　方法 :入院患者需经本科医生筛选 ,有攻击、毁物及高度抗拒行为患者不作为入院对象。病房为开放式 ,在一楼 ,明亮、清洁、安静 ,不设防逃窗及铁门。入院患者留有家人陪护 ,可自由进出病房。对患者不得实施监禁、约束带约束及电休克等强制手段。实行三级查…     

论医学的理性精神

面对守望生命的神圣事业 ,人们开始发出“返回故园”的深切呼喊[1] 。自然 ,精神家园是我们的终极关怀所在 ,是我们最深切最真挚的向往。然而 ,当医学现代化的历史使命感和西方所谓“后现代化”思潮交织而来的时候 ,我们是踏上返乡之路 ,还是走向不归之途 ?这需要我们理智地沉思 ,沉思当前医学应具有的理性精神。1　对医学理性的阐释作为人类所特有的一种能力 ,理性同人类历史一样古老。同时 ,理性又不是一种超历史的先天能力 ,人们的理性只能表现在他们的实际活动和思考之中。所以 ,理性又必然带有历史的、文化的、社会的和个体特点的烙印…     

群体心理现象--一种后现代的公共精神卫生问题

探讨以群体心理为基础的公共精神卫生问题的概念、重要性,以及发生的病理机制.认为当代公共精神卫生问题所具有定性模糊、文化边缘化等后现代的特点都与群体非理性心理的性质有关.     

群体心理现象——一种后现代的公共精神卫生问题

探讨以群体心理为基础的公共精神卫生问题的概念、重要性,以及发生的病理机制。认为当代公共精神卫生问题所具有定性模糊、文化边缘化等后现代的特点都与群体非理性心理的性质有关。     

医学人文精神和医学科学精神的融通

医学人文精神和医学科学精神都是人类医学必不可少的内在组成部分,要达到两者的融通与共建,其前提便是在对医学人文和医学科学的全面理解中塑造当代医学精神,促进医学人文精神与医学科学精神的健康互动与协调发展。     

网络成瘾大学生的心理问题

本研究用编辑合成的问卷对某校约2000名大学生进行了网络成瘾以及有关心理问题的调查,得到988份有效的调查资料,并追踪到603份有效的16种人格因素（16PF）历史资料。结果表明：1．网络成瘾者与非网络成瘾者在社会支持、生活满意度、交往焦虑、自我和谐、抑郁、自尊等方面都存在差异;2．网络成瘾者的负面的心理因素多,积极的心理因素少;3．从历史资料来看,网络成瘾者与非网络成瘾者在16PF测验的多项人格特征上存在差异,这些差异可能是网络成瘾的内因。     

心理健康培训对医护人员心理健康服务的影响

为探讨医护人员心理健康培训现状以及对心理健康服务的影响,采用《医护人员心理健康教育培训问卷》与《心理健康服务行为量表》对664名医护人员进行问卷调查。结果发现,分别有91.6%、65.2%的医护人员学习过心理健康相关课程或接受过相关培训,70.3%通过科普宣传途径学习心理健康知识;心理健康教育和培训正向预测心理健康服务,能够增加8.5%解释变异量。因此,医护人员接受心理健康教育与培训的内容和途径较为单一,对医护人员加强心理健康相关教育培训,可以增加其心理健康服务。     

The Reliability and Validity of a Brief Self-Report Questionnaire to Screen for Mental Health Problems: The Health Dynamics Inventory

Mental health problems are underrecognized in medical settings, leading to inadequate treatment. The present paper describes the development of the Health Dynamics Inventory (HDI), a brief, self-report questionnaire developed to evaluate mental health functioning. The HDI was written to evaluate the three aspects of mental disorders as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM): (1) the experience of emotional or behavioral symptoms; (2) emotional distress; and (3) psychosocial impairment. This study evaluated the psychometric properties and construct validity of its items, scales, and subscales. Results indicated that the items distinguish patients from nonpatients, that the instrument's scales and subscales are reliable, and that the scales and subscales discriminates between persons with mental health concerns or diagnosable problems and those without such concerns or problems. The utility of the instrument for screening mental health problems in primary care settings is discussed.     

Mental Health Problems of Children in Foster Care

We compared the rates of mental health problems in children in foster care across three counties in California. A total of 267 children, ages 0 to 17, were assessed two to four months after entry into foster care using a behavioral screening checklist, a measure of self-concept and, in one county, an adaptive behavior survey. Results confirmed previous research and indicated consistently high rates of mental health problems across the three counties. Behavior problems in the clinical or borderline range of the CBCL were observed at two and a half times the rate expected in a community population. Fewer children fell within the clinical range on the self-concept measure. No significant differences in rates between the three county foster care cohorts were observed, despite the different demographic characteristics of the counties. On the adaptive behavior scale, the mean scores for children in foster care were more than one standard deviation below the norm. Our findings suggest that the most important mental health screening issue with children in foster care is to identify what specific mental health problems need to be addressed so that the most effective treatment services can be provided.     

A Social Perspective on Women's Mental Health Problems

No abstract available for this article.     

A Survey on Driving in Clients With Mental Health Disorders

Few studies have explored driving issues in adult mental health. In this pilot study, 48 drivers were compared to 24 participants who had ceased driving, on their clinical and driving characteristics. Driving-related services offered to them were also documented. Participants who had stopped driving were more likely to be in-patients on antipsychotic or several medications. A third of the participants reported negative effects of their illness and/or medications on driving. Psychiatrists and occupational therapists offered assessments and recommendations related to fitness to drive to 30% of their clients using complementary approaches. This survey indicates that few drivers with mental health disorders receive driving-related services. More evidence-based practice guidelines are needed.     

Mapping Men's Mental Health

The central theme of this paper is that men are at one and the same time both damaged and damage-doing. The process of being damaged through the agency of masculinity predisposes men to exploit, dominate and abuse—not only as boys, as partners and fathers, but as priests, teachers, therapists, lawyers, nurses, psychologists and psychiatrists. Mental health services need to see both aspects of this male equation: a focus on male abuse alone leads to punishment, containment and, very likely, the continuation of abuse; a focus on male damagedness alone preserves the ideology of male unaccountability. However, evidence reviewed here suggests that most traditional psychiatric services fail to acknowledge the impact of inequalities on men's mental health as comprehensively as they fail to acknowledge the impact of these inequalities on the mental health of women. This is a significant problem, and we suggest ways that a gendered analysis of masculinity can be used to help address this deficit. This analysis is used to develop a map of men's mental health that not only accommodates traditional categories of mental health difficulty, but other important consequences of the close association between masculinity and sexuality inequality, especially the use of violence and the capacity to do harm. This analytical framework also invites consideration of the invisibility of male distress, the disallowing and desensitizing of ‘vulnerability, and their submersion in a kind of psychology of entitlement. Finally, we consider the implications of this mapping exercise for mental health services and for working with men.     

Postdeployment Psychological Health and Interpersonal Problems Among Air Force Mental Health Personnel

This study is one of the first to use validated screening measures to examine the rates of self-reported mental health and interpersonal problems following deployment of military mental health personnel (MMHP). Research has examined the impact of deployment on military personnel finding 10.2% to 29.0% screen positive for at least one mental health problem. However, little is known about impacts of deployment among MMHP. Utilizing health data collected three to twelve months post-deployment from a sample of 759 Air Force MMHP, this study examined rates of positive screens for psychological health or interpersonal problems, subsequent confirmation of positive screens by a medical provider upon examination, and the demographic characteristics associated with psychological health or interpersonal problems. The study found 13.9% screened positive for “possible or probable PTSD,” 4.6% for depressive symptoms, 3.9% for alcohol problems, and 12.6% for interpersonal problems. In total, nearly 26% screened positive for one or more psychological or interpersonal problem. Of those who screened positive, 48.5% of depressive problems, 36.0% of PTSD, 20.0% of alcohol problems and 29.7% of interpersonal problems were confirmed upon subsequent examination by a medical provider. Those who screened positive were more likely to be (a) female, (b) separated, widowed, or divorced, (c) a mental health nurse or psychiatric nurse practitioner, and (d) deployed to Iraq or Afghanistan. The significance, limitations, and implications of the results, along with recommendations for future research are discussed.     

关于中国心理健康服务体系建设的若干问题

从我国心理健康服务的基本模式、技术体系、服务主体、教育培训、管理监督等五个方面回顾了我国心理健康服务体系的现状。近二、三十年来,我国心理健康服务体系从无到有,发展迅速,但也存在若干亟待解决的问题:服务的技术体系不完善,心理服务的从业机构和个人良莠不齐、总体水平偏低,从业人员的教育培训、从业人员和机构的资质认证缺乏有效的监督管理机制等。目前我国的心理健康服务体系难以适应社会对心理健康服务的需求。需要立足国情,借鉴外国的成功经验并结合我国传统文化,以扎实的研究和细致的工作来完善我国的心理健康服务体系。