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A Review of the Relationships among the Key Determinants Affecting the Mental Health Disorders of the People in Greater Mekong Subregion Countries. 影响大湄公河次区域国家人民精神健康障碍的主要决定因素之间的关系综述
Pub Date : 2017-12-01 DOI: 10.2174/1573400513666170720143417
Manndy Nget, Kasorn Muijeen

Background: ASEAN integration aims to transform the GMS into a single market with free flows of products, services, and skilled labor, as well as investment openness, which will ultimately force regional economic growth. Therefore, this integration is likely to bring about a big change to this area in the new era; it can subsequently cause many problems as well, including mental health issues of the people in this region. The characteristic differences among the GMS member countries in terms of trade and investment, so-cial and cultural values, medical information and technology, and the living and working environment have become major problems affecting mental health disorders, which are usually identified as depression, stress, and substance abuse.

Methods: This review paper is a literature review of the relationship of the determinants affecting GMS mental disorders conducted using the following strategies: 1) collecting data from previous qualitative and quantitative research studies, com-paratively analyzing the literature, articles, published papers, and reports relevant to the existing policies on economic, environmental, and healthcare issues obtained from the GMS; and 2) exchanging information from the institutions involved, including reports and papers regarding the determinants affecting mental health disorders of the people in the GMS, which were used to generate the synthesis of the existing knowledge of the mental health and to provide recommenda-tion programs for the GMS people.

Results: Based on the reviewed literature there are four key factors affecting mental health, especially mental health in GMS populations: 1) the living and work environments; 2) trade and investment; 3) technology and medical information; and 4) social and cultural values. The study found that the increasing number of mental health dis-orders is a big burden for national healthcare spending. Financial issues have become a major key to the wide prevalence of mental disorders in the GMS. Health issues related to mental health disorders are also caused by the environment and other related factors and therefore a stable and a well-balanced environment is an indicator of healthy mental status. In addition, the environment is a way to pursue both physical and mental health because green spaces serve as a mood freshener and can al-leviate anxiety, stress, and depression.

Conclusion: Globalization and urbanization should follow sustainable development instructions and concerns about the population's health, especially regarding mental health. These key determinants affect the people's life, especially in terms of mental health thus leading to mental health disorders.

背景:东盟一体化旨在将大湄公河次区域转变为产品、服务和熟练劳动力自由流动以及投资开放的单一市场,这最终将推动区域经济增长。因此,这种整合很可能在新时代给这一领域带来很大的变化;它随后也会造成许多问题,包括该地区人民的精神健康问题。大湄公河次区域成员国在贸易和投资、社会和文化价值观、医疗信息和技术以及生活和工作环境方面的特点差异已成为影响精神健康障碍的主要问题,这些障碍通常被确定为抑郁、压力和药物滥用。方法:本综述采用以下策略对影响GMS精神障碍的决定因素之间的关系进行文献综述:1)收集以往定性和定量研究的数据,比较分析GMS中与现行经济、环境和医疗问题相关的文献、文章、已发表的论文和报告;2)与相关机构交流信息,包括影响GMS人群心理健康障碍决定因素的报告和论文,用于综合现有的心理健康知识,并为GMS人群提供推荐方案。结果:根据文献综述,影响GMS人群心理健康的主要因素有四个:1)生活和工作环境;2)贸易和投资;3)技术和医疗信息;4)社会和文化价值观。研究发现,越来越多的精神疾病是国家医疗保健支出的一个巨大负担。经济问题已成为大湄公河次区域精神障碍广泛流行的一个主要关键。与精神健康障碍有关的健康问题也是由环境和其他相关因素引起的,因此,稳定和平衡良好的环境是健康精神状态的一个指标。此外,环境是追求身心健康的一种方式,因为绿色空间可以作为一种情绪清新剂,可以减轻焦虑、压力和抑郁。结论:全球化和城市化应遵循可持续发展的指导方针,并关注人口健康,特别是心理健康。这些关键的决定因素影响着人们的生活,特别是在心理健康方面,从而导致心理健康障碍。
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引用次数: 1
Pathogenesis of major depression by stress induced hyperactivity of hypothalmic-pituitary adrenal axis mediated by dysregulations of neurotransmitter, innate immune systems and altered brain micro RNA expressions 神经递质、先天免疫系统失调和脑微小RNA表达改变介导的应激性垂体-肾上腺轴低水平多动导致重度抑郁症的发病机制
Pub Date : 2017-11-22 DOI: 10.2174/1573400513666171122162727
A. Chatterjee
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引用次数: 0
Editorial: Mental Health in Europe and the World, What Avenues? 社论:欧洲和世界的心理健康,有什么出路?
Pub Date : 2017-08-31 DOI: 10.2174/157340051303171124150348
J. Pereira
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引用次数: 0
Multi Family Group Analysis-(MFGA) 多家族群分析-(MFGA)
Pub Date : 2017-08-31 DOI: 10.2174/1573400513666170503113353
Isaura Manso Neto
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引用次数: 1
Role of Psychiatrists in the Diagnosis and Management of Alzheimer's Disease “Revisited”: A Review and Clinical Opinion 精神病学家在阿尔茨海默病诊断和治疗中的作用“再谈”:综述和临床观点
Pub Date : 2017-08-31 DOI: 10.2174/1573400513666170921163932
A. El-Shafei, T. Asaad, T. Darwish, M. H. Habil, R. Kongsakon, C. Liu, J. Raskin, G. Salazar, S. Shi, Gang Wang, Liwei Wang, Yen Kuang Yang, J. Yeh, H. J. D. Tentori
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引用次数: 0
Seeing the Person in the Patient: Making the Case for Individualized PROMs in Mental Health Care 在病人身上看到人:在精神卫生保健中提出个体化的prom的理由
Pub Date : 2017-08-31 DOI: 10.2174/1573400513666170505111736
C. Sales
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引用次数: 11
Absence, Memory and Dwelling within the Historiography of the Therapeutic Community 缺席,记忆和居住在治疗社区的史学
Pub Date : 2017-08-31 DOI: 10.2174/1573400513666170615125638
J. Gale
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引用次数: 0
Understanding Borderline Personality Disorder Across Sociocultural Groups: Findings, Issues, and Future Directions 跨社会文化群体理解边缘型人格障碍:发现、问题和未来方向
Pub Date : 2017-08-31 DOI: 10.2174/1573400513666170612122034
Andrada D. Neacsiu, J. W. Eberle, S. Keng, Caitlin M. Fang, M. Rosenthal
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引用次数: 9
Severe Mental Disorders from a Cognitive-Behavioural Perspective: A Comprehensive Review from Conceptualization to Intervention 认知-行为视角下的严重精神障碍:从概念化到干预的综合回顾
Pub Date : 2017-08-31 DOI: 10.2174/1573400513666170502123654
S. Tavares
Research has shown that hallucinations and delusions (characteristic of severe mental disorders) are relatively common. Many people in the general population will experience mild instances of such events at some point in their lives. However, for others, these are very disturbing events. Cognitive-behavioural models argue that these differences result from the interpretation of those same experiences. Therefore, cognitive behavioural therapy seeks to know the factors that contribute to the development (e.g. early traumatic experiences) and maintenance (e.g. selective attention, safety behaviours, disruptive control strategies) of psychotic processes, from the deep and isolated understanding of each patient’s experience of specific symptoms (e.g. paranoid delusions) rather than their syndromal diagnosis (e.g. schizophrenia). The case formulation for each complex psychotic symptom results from the initial intake assessment at the start of a prospective intervention. This article reviews the cognitive behavioural conceptualization of psychotic symptoms (i.e. auditory hallucinations, delusions and negative symptoms), as well as the key areas of assessment and therapeutic interventions proposed by these models. Key-words: Cognitive-Behavioural Therapy; Psychosis; Hallucinations; Delusions A growing number of meta-analyses have supported the use of Cognitive Behavioural Therapy (CBT) in the treatment of psychosis [1-14]. Overall, findings suggests that cognitive behaviour therapy for people with psychosis (CBTp) can be beneficial in reducing positive and negative symptoms, hallucinations and delusions, while also improving overall functioning and level of disability, both during post-intervention and follow-up. In one of the most recent studies [1], a systematic review and meta-analysis of 10 controlled trials evaluating low intensity CBT (i.e. fewer than 16 therapy contact hours) dealing with psychosis symptom outcomes, found significant between-group effects on psychosis symptoms during postintervention (d=−0.46) and follow-up (d=−0.40). It showed that low intensity CBTp led to significant post-intervention, between group differences in psychotic symptoms compared to control conditions with a medium effect size. Where follow-up was measured, this effect was maintained, with the follow-up time period ranging from 3 to 18 months. Pfammatter, [2] in a systematic review of findings of all relevant meta-analyses on CBT in the treatment of psychosis, demonstrates considerable differences in controlled efficacy; CBT for psychosis has long-term effects on the persistence of positive and negative symptoms, yet without any effect on acute positive symptoms and with limited benefits as an early intervention. Gould et al. [3] conducted a meta-analysis using all available controlled treatment outcome studies of cognitive therapy (CT) for psychotic symptoms in schizophrenia. The mean effect size for reduction of psychotic symptoms was 0.65. The findings suggest th
研究表明,幻觉和妄想(严重精神障碍的特征)相对常见。一般人群中的许多人在他们生活中的某个时刻都会经历这类事件的轻微实例。然而,对其他人来说,这些是非常令人不安的事件。认知行为模型认为,这些差异源于对相同经历的解释。因此,认知行为疗法试图通过对每个患者特定症状(如偏执妄想)的深刻和孤立的理解,而不是对他们的综合征诊断(如精神分裂症),了解促成精神病过程发展(如早期创伤经历)和维持(如选择性注意、安全行为、破坏性控制策略)的因素。每一种复杂精神病症状的病例形成都来自于前瞻性干预开始时的初始摄入评估。本文综述了精神病症状(即幻听、妄想和阴性症状)的认知行为概念化,以及这些模型提出的评估和治疗干预的关键领域。关键词:认知行为疗法;精神病;幻觉;越来越多的荟萃分析支持认知行为疗法(CBT)在精神病治疗中的应用[1-14]。总体而言,研究结果表明,对精神病患者的认知行为疗法(CBTp)在减少阳性和阴性症状、幻觉和妄想方面是有益的,同时在干预后和随访期间也能改善整体功能和残疾水平。在最近的一项研究[1]中,对10项评估低强度CBT(即少于16个治疗接触小时)治疗精神病症状结果的对照试验进行了系统回顾和荟萃分析,发现干预后(d= - 0.46)和随访(d= - 0.40)对精神病症状有显著的组间影响。研究表明,与中等效应的对照组相比,低强度CBTp导致了显著的干预后精神病症状组间差异。在随访中,这种效果得以维持,随访时间从3到18个月不等。在对CBT治疗精神病的所有相关荟萃分析结果的系统回顾中,Pfammatter显示在控制疗效方面存在相当大的差异;CBT治疗精神病对阳性和阴性症状的持续性有长期影响,但对急性阳性症状没有任何影响,作为早期干预的益处有限。Gould等人进行了一项荟萃分析,使用了所有可用的认知疗法(CT)治疗精神分裂症精神病症状的对照治疗结果研究。精神病症状减轻的平均效应值为0.65。研究结果表明,认知疗法是一种有效的治疗精神分裂症患者持续精神病症状。四项研究的随访分析表明,随着时间的推移,接受CT治疗的患者继续获益(ES=0.93)。Philling等人对更大范围的随机对照试验进行了荟萃分析,并比较了标准治疗和其他积极干预措施。与其他荟萃分析一样,CBT对精神状态的显著改善率更高,并且在后续随访中对精神状态的持续测量显示出积极的影响。CBT似乎也与低辍学率有关。Wykes等人在对34项CBTp试验的荟萃分析中发现,CBTp对目标症状的总体有益效果(d = 0.40)以及对阳性症状(32项研究)、阴性症状(23项研究)、功能(15项研究)、情绪(13项研究)和社交焦虑(2项研究)的显著效果,其效果范围为0.35至0.44。Dickerson b[6]在另一项荟萃分析中,回顾了17项CBTp研究,并发现了最有力的证据,证明CBTp对有幻觉、妄想或阴性症状的门诊患者有益。Turner等人对精神病心理干预的比较结果研究进行了荟萃分析。48项结果试验,3295名参与者,比较了精神病的心理干预。结果显示,认知行为疗法在减轻阳性症状方面明显优于其他干预措施(g=0.16)。在另一项荟萃分析中,van der Gaag等人回顾了18项针对CBT的研究,这些研究采用了量身定制的案例配方,旨在减少幻觉和妄想。妄想和幻觉的效应值分别为0.36和0.44。与积极治疗相比,CBT治疗妄想没有统计学意义(0.33),但CBT治疗幻觉的效应量增加(0.33)。 49)。盲法研究降低了妄想的效应大小(0.24),并在一定程度上增加了幻觉的效应大小(0.46)。作者得出结论,CBT对治疗幻听是有效的。CBT对妄想也有效,但结果必须谨慎解释,因为与积极治疗相比,效果大小存在异质性和不显著性。Velthorst等人回顾了所有关于改善阴性症状的因素的现有证据,并确定了可能从针对改善阴性症状的CBT中获益最多的患者亚组。共纳入了1993年至2013年间发表的35篇出版物,涵盖了2312名患者的30项试验。结果显示,在以阴性症状为次要结局的研究中,研究对症状缓解的综合效应很小且不均匀。类似的结果也出现在专注于减少消极症状的研究中。荟萃回归显示,较强的治疗效果与发表年份较早、研究质量较低以及单独提供CBT(与基于组的CBT相比)有关。关于CBTp的作用程度一直存在一些争论。然而,考虑到精神障碍的严重程度和缺乏其他已证实有效的治疗反应,这些发现应该足以支持使用CBTp(作为主要或辅助治疗)来帮助减轻严重精神障碍患者的痛苦。1. 认知行为治疗方法基于两个核心理论假设:(1)思想影响情感、行为和生物学;(2)干扰人们的不是事件本身,而是人们对事件的解释。在处理严重精神障碍时,认知行为模型在试图了解每一种特定症状所涉及的脆弱性因素、激活事件和维持因素时,侧重于具体经历(例如幻听、受迫害妄想、宏伟妄想),而不是全局诊断(例如精神分裂症)。精神病经历的复杂性要求每个人都有独特的表述。认知行为案例公式提供了对生活经历和对事件的反应如何导致患者对声音和奇怪想法的特定解释的见解。这种个人解释使治疗师能够理解患者的反应在他们眼中是如何可以理解和合理的。2. 认知行为模型认为幻听是相对“正常”的体验。事实上,对于非临床人群来说,听到声音b[17]是相对常见的。研究表明,经历幻听的个体倾向于外部归因其内部和私人认知,这表明声音和内心言语之间存在联系[18,19]。根据经验证据,有争议的是,听到声音的人实际上是将自己的想法误解为语言,然后将其归因于外部来源。这种误解似乎更有可能发生在有许多不同听觉刺激的环境中(例如嘈杂的咖啡店)或没有任何外部听觉刺激的情况下。从这个角度来看,比听到声音的经历更重要的是,每个人赋予这些声音的意义以及他们听到这些声音时的反应方式决定了这种经历的令人不安的本质。例如,在亲人的丧亲之痛中,听到死者的声音并不罕见。有些人认为这是相对可以理解和不令人不安的。当人们对幻听做出积极的归因(例如,作为一个人“仍然和我在一起”的标志),或者他们意识到幻听可以被视为与经历生活压力有关时,就会发生这种情况。然而,如果人们将声音归因于他们认为需要保护自己的恶意外部来源,他们的答案将会非常不同。所以这是意义,赋予声音的意义类型也就是说,它们如何威胁到患者心理或生理上的人格完整性(例如;“我要疯了”,“魔鬼在跟我说话”,“如果我不服从声音,它们就会伤害我”),以及由此产生的对这些声音的反应(即采取安全行为),这些反应决定了人与声音的关系。当幻觉被患者解释为代表强大和破坏性的力量时,就会产生问题。我们的认知、情绪和行为反应取决于我们是谁,取决于我们以前的经历,以及声音发生的背景[19,20]。在压力特别大的生活中,可能会出现幻听
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引用次数: 2
Addictive Influences and Stress Propensity in Heavy Internet Users: A Proposition for Information Overload Mediated Neuropsychiatric Dysfunction 重度网际网路使用者的成瘾影响与压力倾向:资讯超载介导的神经精神功能障碍的命题
Pub Date : 2017-07-28 DOI: 10.2174/1573400513666170728155836
M. Faiq, K. Raza
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引用次数: 5
期刊
Current Psychiatry Reviews
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