老年舒张性心力衰竭诊治的思考

舒张性心力衰竭在老年高血压、冠心病患者中发病率较高,但临床症状、体征不特异,不典型,常容易漏诊。因此,临床工作中应注意发现舒张性心力衰竭相关的症状、体征,结合胸片有肺淤血、超声心动图左室射血分数(left ventriculare-jection fraction,LVEF)正常、血浆脑钠肽(brain natriuretic peptide,BNP)增高等,早期诊断及治疗,提高老年患者的生活质量,减少晚期混合型心力衰竭的发病率。     

Comorbidity of drug abuse treatment

Research has suggested that comorbidity, the concurrence of substance abuse disorders with other psychiatric disorders, may have prognostic value and important implications for the treatment of substance abuse. Knowledge of the prevalence of comorbid disorder is important because it will enable treatment services to be appropriately configured and designed for clinical drug treatment populations. The form and duration of comorbidity may be influenced by a variety of factors, which include the class of drug being abused, the duration of drug use, the individual sensitivity to drug effects, and whether the drug effects are acute or due to withdrawal or residual conditions. This paper addresses three important scientific questions: (1) What is the prevalence of comorbid disorders in a drug abuser population? (2) What is the stability of psychiatric diagnoses in a drug abuser population? (3) Does the existence of a comorbid disorder influence the outcome of drug abuse treatment?     

Effect of Favorable Employment Change on Alcohol Abuse: One- and Five-Year Follow-Ups in the National Longitudinal Survey of Youth

Job loss has been linked to adverse outcomes such as alcohol abuse, but improved employment, usually assumed to be beneficial, has seldom been evaluated and may not help with addictive disorders. Using the National Longitudinal Survey of Youth, young adults who were unemployed or underemployed (low income or involuntary part-time) in 1984 were followed up in 1985 and 1989. Controlling for 1984 alcohol abuse, there were no effects of positive employment change on 1985 symptoms, but there were significant restorative effects on 1985 binge drinking among those who were heavy drinkers in 1984. There also appeared to be an indirect link of favorable 1984–1985 employment change to heavy drinking in 1989 via 1989 employment status. Because the effects of underemployment partially resembled those of unemployment, the discussion cautions against the conventional wisdom of promoting any work, including underemployment, as curative for the ills of unemployment.     

Taxonomy of Psychological and Social Disturbances in Survivors of Group Psychological Abuse

The purpose of this study was to delimit the psychological and social disturbances that individuals who have suffered psychological abuse within a social group on an ongoing basis can experience. A comprehensive classification of these disturbances was developed based on a review of the scientific literature. Its content was revised by an international panel of 38 experts on the topic. Experts also judged the frequency and intensity with which each disturbance is commonly experienced by survivors of abusive groups. The taxonomy, which includes 20 components classified into four main categories, showed adequate content validity. The components considered the most frequent and intense were related to emotional difficulties, followed by those associated with relational and social integration difficulties, cognitive difficulties, and, finally, other specific problematic behaviors. Operationalizing and classifying the specific psychological and social disturbances commonly experienced by survivors of abusive groups contributes to a better delimitation of the phenomenon. Likewise, it contributes to the understanding of the long-term effects of psychological abuse, which is useful in both the academic and clinical settings.     

Intimacy and Complicated Grief among Chinese Elders Having Lost their Spouses: Mediating Role of Meaning Making

This study aims to investigate the mediating role of meaning making in the relationship between intimacy and complicated grief among bereaved elders. A sample of 352 bereaved elders in rural China participated in the study. Both the linear and quadratic effects of meaning making illustrated a model that mediated the effect of intimacy on complicated grief. Essentially, findings revealed that only high levels of meaning making predicted low levels of complicated grief. This study thereby supplements existing research about meaning-making theory.