岁末年初,你在焦虑什么? 自我测评一下吧。 元旦三天假期,本该放松自己,收拾心情,迎接新一年的到来,但不少人却患上了“年关焦虑症”:工作积压到最后,手忙脚乱,下一年还有更多的忙乱和不确定性在等待;房子、车子、孩子要操心,岁月又在催人老……专家建议,适度的焦虑可以转换为动力,不妨带着焦虑前行。 焦虑是一种比较普遍的精神体验,长期存在焦虑反应的人易发展为焦虑症。 本量表包含20个项目,分为4级评分。 请您仔细阅读以下内容,根据您最近一周的实际感觉,在相应的数字前点击表示。目前主要的情绪和躯体症状的自评请根据自觉症状的程度选择。所有题目均共用答案,请在A、B、C、D下划“√”,每题限选一个答案。 答案: A:没有或很少时间; B:小部分时间; C:相当多时间; D:绝大部分或全部时间 1. 我觉得并平常容易紧张和着急 A. B. C. D. 2. 我无缘无故地感到害怕 A. B. C. D. 3. 我容易心里烦乱或觉得惊恐 A. B. C. D. 4. 我觉得我可能将要发疯 A. B. C. D. 5. 我觉得一切都很好 A. B. C. D. 6. 我手脚发抖打颤 A. B. C. D. 7. 我因为头痛、头颈痛和背痛而苦恼 A. B. C. D. 8. 我感觉容易衰弱和疲乏 A. B. C. D. 9. 我觉得心平气和,并且容易安静坐着 A. B. C. D. 10. 我觉得心跳得很快 A. B. C. D. 11. 我因为一阵阵头晕而苦恼 A. B. C. D. 12. 我有晕倒发作或觉得要晕倒似的 A. B. C. D. 13. 我吸气呼气都感到很容易 A. B. C. D. 14. 我手脚麻木和刺痛 A. B. C. D. 15. 我因为胃痛和消化不良而苦恼 A. B. C. D. 16. 我常常要小便 A. B. C. D. 17. 我的手常常是潮湿的 A. B. C. D. 18. 我脸红发热 A. B. C. D. 19.我容易入睡并且一夜睡得很好 A. B. C. D. 20. 我作恶梦 A. B. C. D. 计分:正向计分题A、B、C、D按1、2、3、4分计;反向计分题A、B、C、D按4、3、2、1计分,反向计分题号:5、9、13、17、19。20个项目的分数相加得出总分,再乘以1.25取整数,即得标准分。 低于50分者为正常;50-60分者为轻度焦虑;61-70分者为中度焦虑,70分以上为重度焦虑,中度以上焦虑建议精神专科咨询就诊,排除焦虑症。
http://www.gopubmed.org/web/gopubmed/1?WEB0lqehl43c1aruI47I8bI0 anxiety and mental health care and primary care 1,169 documents semantically analyzed top author Katon, W Seattle, USA Senior author (75 last author) URL to this profile Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195. statistics 1 2 Top Years Publications 2009 125 2006 106 2008 102 2007 85 2005 84 2004 69 2003 64 2001 59 2010 49 1999 48 2002 45 2000 43 1997 41 1998 37 1996 37 1995 27 1993 22 1994 17 1992 17 1991 14 1 2 1 2 3 4 Top Countries Publications USA 478 United Kingdom 157 Netherlands 64 Australia 50 Spain 49 Canada 48 Germany 34 France 17 Colombia 16 Italy 16 Sweden 16 Norway 13 Israel 13 Brazil 11 Denmark 9 Finland 9 New Zealand 8 Nigeria 8 Hungary 6 India 6 1 2 3 4 1 2 3 ... 18 Top Cities Publications New York 45 London 44 Seattle 35 Boston 34 Manchester 25 Amsterdam 21 Bethesda 20 Philadelphia 19 Los Angeles 18 Washington 17 Utrecht 16 Sydney 15 Barcelona 14 San Diego 14 Toronto 13 Paris 12 Montreal 11 Madrid 11 Rochester 10 San Francisco 10 1 2 3 ... 18 1 2 3 ... 22 Top Journals Publications Gen Hosp Psychiat 34 Psychol Med 33 Aten Primaria 27 Soc Psychiatry Psychiatr Epidemiol 26 Am J Psychiat 24 Int J Psychiat Med 21 J Clin Psychiat 21 Depress Anxiety 20 Arch Gen Psychiat 18 J Gen Intern Med 17 Med Care 16 Psychiat Serv 16 Int J Geriatr Psychiatry 15 Brit J Gen Pract 15 J Affect Disorders 14 Psychosom Med 14 J Psychosom Res 13 Brit J Psychiat 13 J Fam Practice 12 J Clin Psychiatry 11 1 2 3 ... 22 1 2 3 ... 99 Top Terms Publications Humans 1,094 Anxiety 1,040 Primary Health Care 902 Patients 772 Depression 728 Adult 684 Mental Health 606 Mental Disorders 595 Anxiety Disorders 585 Middle Aged 550 Diagnosis 425 Questionnaires 388 Aged 388 Prevalence 377 Adolescent 347 Depressive Disorder 337 Health Care 297 Physicians, Family 294 Evaluation Studies as Topic 289 Comorbidity 281 1 2 3 ... 99 1 2 3 ... 205 Top Authors Publications Katon W 25 Olfson M 21 Stein M 20 Roy-Byrne P 20 Sherbourne C 19 Weissman M 18 Kroenke K 14 Russo J 14 Craske M 13 Spitzer R 13 Leon A 11 Keller M 10 Simon G 10 Wells K 10 Broadhead W 10 Bystritsky A 9 Wittchen H 9 Kessler R 8 Lecrubier Y 7 Levkoff S 7 1 2 3 ... 205 最新医学证据 Roy-Byrne P, Craske MG, Sullivan G, et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA. 2010 May 19;303(19):1921-8. (Original) PMID: 20483968 ReadAbstract ReadComments Clinical Evidence Topics: Generalisedanxietydisorder Post-traumaticstressdisorder Panicdisorder Depressioninadults:psychologicaltreatmentsandcarepathways DISCIPLINE RELEVANCE TO PRACTICE IS THIS NEWS? General Internal Medicine-Primary Care(US) General Practice(GP)/Family Practice(FP) GP/FP/Mental Health * * Psychiatry * * * Ratings pending login to http://plus.mcmaster.ca/evidenceupdates in a few days if interested. Print Save Article Delete Article Email this article to a colleague Abstract CONTEXT: Improving the quality of mental health care requires moving clinical interventions from controlled research settings into real-world practice settings. Although such advances have been made for depression, little work has been performed for anxiety disorders. OBJECTIVE: To determine whether a flexible treatment-delivery model for multiple primary care anxiety disorders (panic, generalized anxiety, social anxiety, and posttraumatic stress disorders) would be better than usual care (UC). Design, Setting, and PATIENTS: A randomized controlled effectiveness trial of Coordinated Anxiety Learning and Management (CALM) compared with UC in 17 primary care clinics in 4 US cities. Between June 2006 and April 2008, 1004 patients with anxiety disorders (with or without major depression), aged 18 to 75 years, English- or Spanish-speaking, were enrolled and subsequently received treatment for 3 to 12 months. Blinded follow-up assessments at 6, 12, and 18 months after baseline were completed in October 2009. INTERVENTION: CALM allowed choice of cognitive behavioral therapy (CBT), medication, or both; included real-time Web-based outcomes monitoring to optimize treatment decisions; and a computer-assisted program to optimize delivery of CBT by nonexpert care managers who also assisted primary care clinicians in promoting adherence and optimizing medications. MAIN OUTCOME MEASURES: Twelve-item Brief Symptom Inventory (BSI-12) anxiety and somatic symptoms score. Secondary outcomes included proportion of responders (/=50% reduction from pretreatment BSI-12 score) and remitters (total BSI-12 score 6). RESULTS: A significantly greater improvement for CALM vs UC in global anxiety symptoms was found (BSI-12 group mean differences of -2.49 , -2.63 , and -1.63 at 6, 12, and 18 months, respectively). At 12 months, response and remission rates (CALM vs UC) were 63.66% (95% CI, 58.95%-68.37%) vs 44.68% (95% CI, 39.76%-49.59%), and 51.49% (95% CI, 46.60%-56.38%) vs 33.28% (95% CI, 28.62%-37.93%), with a number needed to treat of 5.27 (95% CI, 4.18-7.13) for response and 5.50 (95% CI, 4.32-7.55) for remission. CONCLUSION: For patients with anxiety disorders treated in primary care clinics, CALM compared with UC resulted in greater improvement in anxiety symptoms, depression symptoms, functional disability, and quality of care during 18 months of follow-up. Trial Registration clinicaltrials.gov Identifier: NCT00347269. Comments from Clinical Raters General Internal Medicine-Primary Care(US) Seems like a very effective intervention but it takes a significant investment of time and resources on the part of the primary care provider. Psychiatry More studies like this one are needed. It appeared in a recent issue of JAMA devoted to mental health, which was in general of great interest for Primary Care doctors and psychiatrists.
最新研究报道 http://news.xinhuanet.com/english2010/health/2010-04/02/c_13234402.htm LOS ANGELES, April 1 (Xinhua) -- Anxiety may modify depression for better or for worse, indicating a link between the two, U.S. researchers suggest. By using functional Magnetic Resonance Imaging (MRI), researchers at the University of Illinois looked at brain activity in subjects who were depressed and not anxious, anxious but not depressed, or who exhibited varying degrees of depression and one or both types of anxiety. The researchers took into account two types of anxiety: anxious arousal, the fearful vigilance that sometimes turns into panic; and anxious apprehension, better known as worry. http://www.gopubmed.org/web/gopubmed/4?WEB0m67ovw19fuinI3I1I00f01000j100200010 anxiety and depression and Magnetic Resonance Imaging 329 documents semantically analyzed 1 2 Top Years Publications 2008 55 2009 49 2007 36 2006 32 2005 27 2004 23 2003 23 2001 19 2002 18 2010 12 2000 8 1996 5 1999 4 1995 4 1998 3 1993 3 1997 2 1988 2 1994 1 1991 1 1 2 1 2 Top Countries Publications USA 126 United Kingdom 37 Germany 23 Italy 22 Australia 17 Japan 13 Canada 12 France 11 Netherlands 10 Brazil 7 Spain 5 Switzerland 4 Turkey 4 South Korea 3 Israel 3 China 3 Austria 2 Norway 2 Hungary 2 South Africa 2 1 2 1 2 3 ... 7 Top Cities Publications Bethesda 21 New York 14 London 14 Oxford 10 Trieste 9 Boston 8 Melbourne 7 San Antonio 7 Los Angeles 6 Ann Arbor 5 Toronto 5 Pittsburgh 5 Rome 5 Montreal 4 So Paulo 4 Freiburg 4 San Diego 4 Baltimore 4 Amsterdam 4 Grenoble 3 1 2 3 ... 7 1 2 3 ... 9 Top Journals Publications Biol Psychiat 18 Neuroimage 10 Psychiat Res 8 Am J Psychiat 8 Arch Gen Psychiat 8 Biol Psychiatry 7 Neuropsychopharmacol 7 Cns Spectr 6 Encephale 5 Epilepsia 5 Depress Anxiety 5 J Neurol Neurosur Ps 5 J Affect Disord 4 Mol Psychiatry 4 J Neurol 4 Neuropsychologia 3 J Clin Psychiatry 3 J Neurol Neurosurg Psychiatry 3 Arch Gen Psychiatry 3 Zh Nevrol Psikhiatr Im S S Korsakova 3 1 2 3 ... 9 1 2 3 ... 83 Top Terms Publications Magnetic Resonance Imaging 317 Humans 303 Depression 286 Anxiety 277 Patients 207 Adult 197 Magnetic Resonance Spectroscopy 178 Middle Aged 147 Brain 122 Anxiety Disorders 92 Depressive Disorder 79 Evaluation Studies as Topic 75 Diagnosis 73 Neuropsychological Tests 72 Amygdala 69 Adolescent 67 amygdala development 65 Aged 64 Emotions 60 Depressive Disorder, Major 52 1 2 3 ... 83 1 2 3 ... 91 Top Authors Publications Drevets W 10 Charney D 9 Cazzato G 8 Pine D 7 Nugent A 6 Zivadinov R 6 Zorzon M 6 Brammer M 5 Rauch S 5 Bain E 5 Luckenbaugh D 5 Nasuelli D 5 Bratina A 5 Ukmar M 5 Cowen P 4 Wen W 4 Carson R 4 Soares J 4 Hatch J 4 Sachdev P 4 1 2 3 ... 91