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Objective:To study the effect of continuous subcutaneous insulin infusion(CSII)on the emotional disorder of children and adolescents with type 1 diabetes mellitus(T1DM)and their parents.Methods:A total of 72 children and adolescents with T1DM were divided into CSII group( n=40)and multiple daily injection(MDI)group( n=32).There were 58 healthy children and adolescents with their parents selected as control group.The emotional condition of children and adolescents in T1DM group and control group was evaluated by Depression Self-rating Scale for Children(DSRS)and the Screen for Child Anxiety Related Emotional Disorders(SCARED)respectively, and Symptom Checklist-90(SCL-90)was used for evaluating the mental health of all parents. Results:The average glycated hemoglobin A1c(HbA1c)of T1DM group was at the optimal level(7.406±1.294)%.The average HbA1c of CSII group was significantly lower than that of MDI group[(7.040±1.082)% vs(7.863±1.404)%, t=2.728, P=0.008].The depression rate of children and adolescents in T1DM group increased significantly than that of control group(31.9% vs 15.5%, χ2 =4.671, P=0.031).There were statistically significant differences among CSII group, MDI group and control group(20.0% vs 46.9% vs 15.5%, χ2 =11.591, P=0.003).The depression rate of children and adolescents in MDI group increased significantly than that of CSII group and control group(all P<0.05).CSII group showed similar results as compared with control group( P>0.05).Concerning the anxiety in children and adolescents, there was no significant difference between T1DM group and control group(19.4% vs 13.8%, χ2=0.730, P=0.393), and there were no significant differences among CSII group, MDI group and control group(15.0% vs 25.0% vs 13.8%, χ2=1.994, P=0.369).The emotional disorder prevalence of parents in T1DM group was remarkably higher than that of the control group(31.9% vs 5.2%, χ2=52.927, P<0.01).The factor scores of obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, paranoia and psychotic symptoms in T1DM group were higher than that of control group( P<0.05).There were statistically significant differences among CSII group, MDI group and control group(17.5% vs 50.0% vs 5.2%, χ2=26.126, P<0.01).The emotional disorder prevalence of parents in MDI group increased significantly than that of CSII group and control group(all P<0.05).But CSII group was same as that of control group( P>0.05). Conclusion:The children and adolescents with T1DM and their parents were high-risk population of emotional disorder.CSII can reduce not only the depression in the children and adolescents with T1DM, but also emotional disorder of their parents, thus CSII can improve the mental health in families suffering from T1DM.
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Wumeiwan are recorded in the Jueyin chapter of Treatise on Cold Damage and Miscellaneous Diseases （《伤寒杂病论》）， and many doctors in the past dynasties believed that they had the effects of calming intestinal ascarid by warming Zang organs. The clinical application was limited. Since KE Qin， a doctor in the Qing dynasty， proposed that Wumeiwan were the primary prescription against Jueyin diseases， Wumeiwan have been valued by doctors， and their clinical application has also been expanded. The syndrome indicated for Wumeiwan is attributed， not only to the ascarid internal harassment， but to the abnormal Qi movement of wind and wood in Jueyin and the dysfunction of Yin and Yang. According to the functions of six meridians based on the theory of "open-close axis" in Huangdi's Internal Classic （《黄帝内经》） and the original texts of Treatise on Cold Damage and Miscellaneous Diseases， Yinshu refers to Jueyin. Wumeiwan， the primary prescription against Jueyin diseases， have the function of connecting Yin and Yang， and they can treat diseases caused by Qi disturbance of Jueyin and cold and heat in complexity. Sharing the same resource， the Secrets for Auxiliary Cultivation Life： The Essential Method of Using Herbal Medicine for the Differential Treatment of the Five Zang Organs （《辅行诀五脏用药法要》） and Treatise on Cold Damage and Miscellaneous Diseases both consult Models of the Classic of Decoction （《汤液经方》）. The formulation rules of tonic/purgative and collapse-saving prescriptions in Secrets for Auxiliary Cultivation Life follow the recorded "Tang Ye Jing Fa Tu" （an image revealing the compatibility principles of Chinese herbal drugs） and are closely related to the five elements theory. By exploring the formulation rules in "Tang Ye Jing Fa Tu" and the five elements of drugs， this study analyzed Wumeiwan and proved that Wumeiwan mainly acted on the liver， spleen， and heart. According to the Five Zang-organs Storing Spirit theory from Huangdi's Internal Classic， the above three organs are closely related to emotional adjustment. Therefore， the treatment of emotional disorders caused by qi disturbance of Jueyin and cold and heat in complexity with Wumeiwan is supported by evidence. At the end of this article， the reports on the treatment of emotional disorders with Wumeiwan in recent years were listed and reviewed. This article provides new ideas for the clinical application of Wumeiwan in the treatment of emotional disorders and expands the application range.
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OBJECTIVE@#To systematically review the effect of acupuncture on emotional disorder in the patients with migraine and knee osteoarthritis and its effect time limit.@*METHODS@#The randomized controlled trials of acupuncture for migraine or knee osteoarthritis were retrieved from the databases, starting from the time of establishment through to December, 2018, i.e. the Cochrane Library, PubMed, EMbase, CNKI, SinoMed, VIP and Wanfang. The bias risk assessment tool of Cochrane Review Manual 5.1.0 was adopted to evaluate the quality of trials in methodology. RevMan 5.3 software was used for the Meta-analysis.@*RESULTS@#A total of 12 articles were included, with 2450 cases. Regarding the immediate effect, the score of the emotional function subscale of migraine-specific quality-of-life questionnaire (MSQ) in the acupuncture group was higher than the control group (6.38[2.78,9.98], =25%). In view of the emotional function subscale of the short-form of health survey (SF-36/SF-12), and the scores of the mental function and negative mode scale in Spain's index of quality of life (PQLC), there were no significant differences in the scores between the acupuncture group and the control group. In 3 months of treatment, the score of the emotional function subscale of MSQ in the acupuncture group was higher than the control group (9.66 [3.06,16.25], =44%). The difference in the score of the mental health subscale of SF-36 and SF-12 was not significant between the acupuncture group and the control group. In 3 to 6 months of treatment, as well as in over 6 months of treatment, the score of every scale was not different statistically between the acupuncture group and the control group.@*CONCLUSION@#Acupuncture effectively maintains the healthy emotion in the patients with migraine and the effect is sustainable for 3 months after treatment. But the improvement of acupuncture is not remarkable in emotional disorder induced by knee osteoarthritis.
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Humans , Acupuncture Therapy , Chronic Pain , Psychology , Therapeutics , Emotions , Migraine Disorders , Psychology , Therapeutics , Osteoarthritis, Knee , Psychology , Therapeutics , Quality of Life , Treatment OutcomeABSTRACT
Objective To explore the effect of group cognitive behavior intervention on self-rated health of middle school students with emotional disorders. Methods From January 2018 to June 2018,79 middle school students with emotional disorders were randomly divided into intervention group ( 41 cases) and control group (38 cases) according to the single or double number of medical records. The control group only received drug treatment,while the intervention group received group cognitive behavior intervention on the basis of drug treatment. All the students in the two groups completed the self-rated health measurement scale before intervention (T0),after intervention (T1) and 8 weeks after intervention (T2). Results (1) There were no significant differences in total health score and dimension score between the two groups before intervention (both P<0. 05). (2)The repeated measurement variance analysis showed that there was a signif-icant group × time interaction effect on total health score and dimensions(P>0. 05). (3) The group effect of physical health was not significant (P>0. 05). The group effect of total mental health, social health and health score at T1 and T2 time points were significant (all P>0. 05). (4)Compared with before intervention, mental health ((123. 34±9. 33),( 122. 63± 9. 11)),social health ((102. 89 ± 7. 28),( 101. 89± 7. 73)) and total health score ((370. 34±17. 99),(367. 63±17. 89)) of intervention group at T1 and T2 increased ( all P<0. 05),while that of control group increased only at T1 (all P<0. 05). Conclusion Group cognitive behavioral intervention has no obvious effect on physical health of middle school students with emotional dis-orders. And group cognitive behavioral intervention can effectively improve their mental health,social health and overall health level,and the long-term effect is better.
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[Objective] To investigate professor SHAN Zhaowei's experience of diagnosing and treating bile reflux gastritis(BRG). [Method] The experience of Professor SHAN Zhaowei on recognition of etiology and pathogenesis, treatment principle, characteristics of prescription selection and administration of BRG is summarized and studied. Besides his academic ideas and clinical medication experience are shown with typical cases. [Result] In his view, emotional disorder is the most common etiology, and liver-stomach disharmony is the basic pathogenesis. He puts forward that we should pay attention to dispersing the stagnated liver Qi, regulating the stomach to lower the adverse flow of Qi when we treat it, and emphasizes the combination of disease differentiation and syndrome differentiation. Meanwhile, herbs of protecting gastric mucosa are compatibly used to improve the curative effect. And the case in this article has obtained good treatment results. [Conclusion] Pro. SHAN Zhaowei thinks that emotional regulation to patency for patients is very important. The dispersing the stagnated liver Qi, regulating the stomach and protecting gastric mucosa treatment proposed by SHAN Zhaowei is smart, simple and effective, which embodies the characteristic of his healing and MengHe Medicine.
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Objective To investigate the emotional state and its influencing factors in children with nocturnal enuresis,so as to improve clinical attention and give appropriate intervention.Methods Totally 166 nocturnal enuresis patients aged 9 -15 years old were admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from August 2011 to August 2014.Specifically,Screen for Child Anxiety Related Emotional Disorders (SCARED)and Depres-sive Self -Rating Scale for Childhood (DSRSC)were utilized to test the patients′emotional state.The comparison be-tween the general norm data of the healthy children and the psychological test of enuresis children were performed,the lat-ter emotional state and its influence factors were evaluated.Analysis of variance and t -test were performed.Frequency comparison was done by using χ2 test.Influence factors analysis was made by Logistic or multiple regression analysis. Results The incidence of children′s anxiety with enuresis was 39.2%(65 /166 cases).Anxiety overall scores of children with enuresis amounted to 21 .16 ±11 .88 which were significantly higher than the norm(14.40 ±9.41 )(P 0.05).The emotional disorders mainly appeared in patients with primary enuresis,without family history,poor grade and poor relationships with family members and peers.The school performance was an important factor for enuresis patients with anxiety disorders(P <0.05).Conclusions Children with nocturnal enuresis are more likely to have anxiety disorders than normal children.Their emotional states is related to the enuresis type,family history,school performance, family and peer relationship.Therefore,attention should be paid to the emotional state of children with nocturnal enuresis. According to the adverse factors for nocturnal enuresis patients,effective treatment and appropriate psychological interven-tion should be given at the same time.
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Objective:To explore whether there will be attentional bias under the condition of fear,disgust and positive emotional arousal. Methods:Totally 96 college students were selected as participants in this study,inclu-ding 60 males and 36 femalesaged 18-22 years. Affective priming videos were adopted to prime participants'emo-tion (dread,disgust,joviality),and then they named the color of the cognitive words (positive words,negative words,neutral words)as quickly and accurately as possible. Reaction time and correctness were recorded. E-prime was adopted to write the experimental program. The reaction time for neutral words was baseline. Results:The aver-age reaction time (RT)of color-naming tasks of negative words were shorter than that of neutral words after fright-ening affective priming[(648 ±118)ms vs. (743 ±124)ms,P<0. 01]. Furthermore,the average RT of color-na-ming tasks of positive words were also shorter than that of neutral after frightening affective priming[(683 ±123) ms vs. (743 ±124)ms,P<0. 05]. The average RT of color-naming tasks of negative words were shorter than that of neutral words after disgusting affective priming[(579 ±86)ms vs. (720 ±101 )ms;P<0. 01 ]. Moreover,the av-erage RT of color-naming tasks of positive words were shorter than that of neutral words after delighted affective priming[(634 ±122)ms vs. (716 ±141)ms;P<0. 01]. Furthermore,the average RT of disgusting priming group-were shorter than the frightening priming grouptowards negative information[(579 ±86)ms vs. (648 ±118)ms,P<0. 05 ]. Conclusion:It suggests that the youth perform more obvious attentional bias towards negative information after disgusting affective priming than the frightening one. Frightening affective priming could evidently induce the attentional bias on positive information.
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Objective The kinetic house tree person test has many advantages compare to traditional psychometrics,but also some limits such as scoring subjectively and ambiguous.This research attempted to develop a reliable scoring system.That can distinguish college students with emotional disorder from normal college students by employing kinetic house tree person (KHTP) drawings.Methods 143 College students were invited to partake in the research KHTP drawings,the Beck Depression Inventory Ⅱ (BDI-Ⅱ),the Beck Anxiety Inventory (BAI) were administered to the subjects.Undergraduates with a BDI score of ≥ 14 or a BAI score of ≥8 were classified as the clinical group,while those with a BDI-Ⅱ and a BAI score are minimal were classified as the controis.The researcher and an expert studied and analyzed the KHTP drawings Manual,filtrate 35 indicators correlate to emotional disorder,and then researcher make standard for evaluation of every indicator.The standard for evaluation were then revised by the researcher and another rater then finalized by the expert.Results The results showed that 35 indicators correlate to emotional disorder were found,and there were significant differences in facial expressions (x2 =19.109,P＜0.01) and actions (x2 =13.341,P＜ 0.01) between clinical group and normal group.The Pearson coefficient of concordance showed that the inter-rater reliability and inner-rater reliability was consistent(r=0.932,r=0.913,P＜0.01).The t-test was employed to verify the discriminant validity between the clinical and control groups.The result showed that a significant discriminant validity was found with the scoring system developed in this research(t=14.890,P＜0.01).Conclusion The scoring system developed from this study has good inter-rater reliability,inner-rater reliability and discriminant validity.
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Objective To investigate the effects of mindfulness behavior training on emotional disorder and immunological function in elderly patients after hip fracture fixation surgery.Methods Sixty elderly patients with fixed hip fracture by operation were randomly divided into a training group and a control group with 30 cases in each group.The training group received mindfulness behavior training in addition to routine rehabilitation training,while the control group only received routine rehabilitation training.The mindfulness behavior training was administered 90 min for once a week,lasting for 5 weeks.The emotional disorder was assessed with the profile of mood states (POMS),and the immune system function were evaluated by the number of CD3 + 、CD4 + 、CD8 + in T cell subgroup before and after 5 weeks of training.Results Before training,there was no significant difference in scores of POMS and the cells number of CD3 +,CD4 +,CD8 + (P ＞ 0.05) between the two groups.After treatment,scores of POMS including tension-anxiety (13.14 ± 3.36 vs 15.90 ± 4.28),depression-dejection (18.10 ± 6.24 vs 20.06 ± 5.42),fatigue-inertia (16.53 ± 3.50 vs 18.98 ± 4.88),vgor-activity (26.68 ± 5.22 vs 22.43 ± 5.20) (P ＜ 0.05),the level of mindfulness practice(58.00 ± 4.78 vs 54.00 ± 4.89) and the cells number of CD3 +,CD4 +,CD8 + (75.75 ± 5.40vs 69.91 ± 4.42 ;39.54 ± 3.29 vs 34.44 ± 4.21 ; 39.82 ± 3.55 vs 36.82 ± 3.55) in experimental group improved more than those in control group (P ＜ 0.05).Conclusion Mindfulness behavior training can improve the patients' mood state and have positive promotion on immunological function.
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Objective To explore the attachment of children with emotional disorder,and provide a theoretical basis for mental intervention.Methods A total of 70 outpatients with emotional disorder and their parents and 140 normal children and their parents were enrolled.All the children and their parents were assessed with Adolescent Attachment Inventory and Experiences in Close Relationships Inventory and General demographic information inventory.Results There were statistical significances in family proximity((12.76 ± 3.69) vs (15.47 ±3.05)),friend proximity ((14.23 ± 3.84) vs (15.82 ± 3.06)) and family negativity ((12.84 ± 3.42) vs (10.46 ± 2.94)) of two groups (all P ＜ 0.05).There were statistical significances in maternal attachment avoidance ((3.60 ± 0.70) vs (3.84 ± 0.63)) and anxiety ((3.23 ± 0.77) vs (3.37 ± 0.79)) of two groups (all P ＜0.05).In emotional disorder group,there was a significantly negative relation (P ＜ 0.01) between parental anxiety dimension and friend dependence factor.Conclusion The attachment of children with emotional disorser is low family and friends proximity,higher family negativity.
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Objective To study the family environment and the behavior of children with emotional disorder(ED ).Methods Thirty children with ED and 30 healthy children were assessed with family environment scale-Chinese version(FES-CV),and Achenbach CBCL.Results The scores on the items of intimateness,emotion,independence,and entertainment among Children with ED had by FES-CV were lower,but the scores on conflicts and control higher than the health controls(P<0?05).The total scores on social abilities as well as the dimensions were all lower than the healthy controls(P<0?01).The total scores on behaviors as well as the dimensions were higher than the controls(P<0?05).Conclusions Children with ED have more behavior problems,which are associated with their poorer family environment.Therefore,the family members should help and support each other to create a healthy environment for children growth.
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Objective To explore the effect of narrative therapy on family environment and values in adolescents with emotional disorder.Methods 35 adolescents with emotional disorder and their parents from Affiliated Brain Hospital,Nanjing Medical University were enrolled and treated by narrative therapy.Family environment was assessed using Family Environment Scale-Chinese Version (FES-CV)and was compared between pre-and posttherapy.Results 28 adolescents with emotional disorder and their parents completed therapy.The cohesion,independence,intellectual orientation,active-recreation orientation and organization in FES-CV showed higher scores at post-therapy than at pre-therapy ((6.89 ± 2.56) vs.(4.21 ± 3.21) ; (5.54 ± 1.35) vs.(4.68 ± 1.51) ;(4.75±2.07)vs.(3.50±2.12);(4.07±2.65)vs.(2.50±2.32);(3.68±1.77)vs.(2.50±1.62)respectively).The contradict in FES-CV showed lower scores at post-therapy than at pre-therapy ((2.75 ± 2.44) vs (5.25 ± 2.50)).The values of adolescents with emotional disorder and their parents had a positive change after narrative therapy.Conclusion Narrative therapy is effective on the positive change of FES-CV and values of adolescents with emotional disorder and their parents.
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Objective To investigate the family dynamic characteristics of adolescents with emotional disorder.Methods 74 adolescents with emotional disorder from Child Mental Health Research Center of Nanjing Brain Hospital Affiliated to Nanjing Medical University were chosen and compared with 148 gender- and agematched controls from schools in Nanjing.Self-rating scale of systemic family dynamics(SSFD) was used to assess the characteristics of family dynamics,and general demographic information inventory was conducted for all subjects.Results Adolescents with emotional disorder showed higher scores in family atmosphere and systemic logic than control group ( ( 30.54 ± 8.28 ) vs (23.45 ± 7.40),( 17.14 ± 4.26 ) vs ( 15.43 -± 3.86 ),all P ＜ 0.01 ).Logistic regression analysis showed that high individuation ( OR =0.903,95％ CI:0.834 ～ 0.977 ) and high disease thinking( OR =0.853,95％ CI:0.750 ～ 0.970 ) were protective factors for emotional disorder.High family atmosphere ( OR =1.167,95％ CI:1.101 ～ 1.236) was risk factor for emotional disorder.Conclusion Adolescents with emotional disorder demonstrate boring and hostile family atmosphere and Either/or family systemic logic on the family dynamic characteristics.Family atmosphere,disease thinking and individuation are associated with emotional disorder.
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Memory function and learning process are commonly observed impaired among children with Attention Deficit Hyperactive Disorder (ADHD). However, children with Emotional Disorders (ED) too report inability to attend, register and recall the stimuli that eventually result in poor academic performance. The present study aimed to study the nature of impairment in verbal learning and memory function among children with ADHD and ED. The study further aimed to explore the effect of severity of illnesses over the degree of impairment in verbal learning and memory function in both the groups. Twenty children meeting the ICD-10 criteria for ADHD and twenty children meeting the ICD-10 criteria under F-93 for Emotional Disorders (ED) were assessed on the measure of verbal learning & memory and compared with twenty age and education matched normal control group. Children with ADHD and ED performed poorly on the measure of verbal learning and memory in comparison of normal control, but the degree of impairment was observed relatively higher among ADHD children than children with ED. However, severity of illness was not observed a contributory factor for the impairment in verbal learning and memory function in both the groups. Impairment in verbal learning and memory function is not confined only to the children with ADHD but these are now recognizable among children with Emotional Disorders too. Both the groups (Children with ADHD and ED) reflected impaired memory and learning function but in terms of degree of impairment the children with ADHD were always found standing towards higher side than children with emotional disorder.
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We report a case of early resolution of convergence spasms following the addition of antipsychotic medications and present it as a possible alternative to the conventional treatment for convergence spasms. The cessation of atropinization of the eyes and the use of reading glasses was achieved after only 2 months following the initiation of antipsychotic medications for childhood emotional disorder.
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Child , Female , Humans , Affective Symptoms/drug therapy , Anti-Anxiety Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Diazepam/therapeutic use , Fixation, Ocular , Selective Serotonin Reuptake Inhibitors/therapeutic use , Sertraline/therapeutic use , Treatment Outcome , Visual AcuityABSTRACT
Objective To analyze the nursing effect of emotional disorder in patients with alcohol dependence.Methods From January 2009 to February 2010,81 patients in our hospital with emotional disorder of alcohol dependence were randomly divided into the observation group (41 cases)and the control group (40 cases).The control group was given routine nursing care,and the observation group was given enhanced care for emotional disorders on the basis of routine nursing care,the clinical results of two groups were compared.Results In the observation group,the re-drinking rate and readmission rate were19.5 ％ and 7.3％,significantly lower than 40.0％ and 27.5％ of the control group,the time interval of re-drinking of the observation group was significantly longer than the control group,the anxiety and depression scores were significantly better than the control group.Conclusions To give enhanced care on the basis of routine nursing care for patients with emotional disorders because of alcohol dependence has better clinical effect,it contributes to the patients′ rehabilitation.
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Clinical rehabilitation in patients after a cerebrovascular accident or a head injury is sometimes hampered by the onset of emotional disorders, particularly during the initial period of convalescence. Sodium valproate (VPA) is used not only as an antiepileptic drug but also as a mood stabilizer in clinical psychiatric practice. We used VPA for treating emotional disorders, thereby increasing the effectiveness of rehabilitation in a convalescent setting. We administered VPA to 7 patients with higher brain dysfunction to treat their emotional disorders from August 2006 to April 2007 in the convalescent rehabilitation ward (60 beds) of Yamaguchi Rehabilitation Hospital. We used the Japan Stroke Scale-Emotional Disturbance Scale (JSS-E) to evaluate the patient's mental condition and the Barthel Index (BI) to assess the effect of rehabilitation. The JSS-E scores showed significant improvement after VPA administration. The BI scores also showed improvement. These scores indicate that VPA was effective in treating emotional disturbances and in improving patient's activities of daily living. Thus, we showed that VPA can be useful in treating emotional disorders during convalescent rehabilitation.
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@#Objective To investigate the influence of psychosocial factors to emotional disorder of tumor patients. Methods 76 patients with tumor and other 76 patients with tumor were including. All the patients themselves completed once through the following questionnaires: Symptom Check List (SCL-90),Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Life Event Scale (LES). However, Hamilton Depression rating scale (HAMD) and Hamilton Anxiety rating Scale (HAMA) were measured by the researchers. Results The occurrence rate of depression and anxiety in tumor patients was clearly higher than that of the control group (P<0.01), while the negative life event increased. Conclusion The occurrence rate of the emotional disorder among tumor patients is clearly higher than the control group, which may be related with the negative life event.
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Objective To investigate the relationship between different behavior types with classification of TCM and emotional disturbance in coronary artery disease (CAD) patients. Methods Two hundred and forty-two CAD patients were investigated and grouped to A or B type behavior with type A behavior pattern questionnaire (TABPQ) and symptom check-list 90 (SCL-90). To analysis the emotional disturbance in two groups and investigate their relations with syndrome classification of TCM. Results SCL-90 factor score of anxiety and depression in CAD patients was obviously higher than Chinese norm. Factor score of depression, anxiety, hostility, phobia, paranoid and psychotic state in A-type behavior group was obviously higher than that in B-type group, with statistical significance (P
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Objective To evaluate the effects of occupational therapy and Taoist cognitive psychotherapy on emotional disorder of stroke patients.Methods A total of 136 hemiplegic patients with emotional disorder were randomly divided into a general treatment group,a cognitive psychotherapy group,an occupational therapy group and a combined therapy group(occupational therapy combined Taoist cognitive psychotherapy group).All patients were treated accordingly for 8 weeks and followed up for 6 months.All the patients were evaluated with Fugl-Meyer Assess- ment,COPM and SCL-90.Results It was found that the Fugl-Meyer Assessment and COPM scores were improved gradually in all groups.The combined therapy group scored higher than occupational therapy group(P