心理学在灾难急救医学中的作用

灾难作为创伤件的事件,往往与日常的认知结构相冲突,超过了个体的心理应对水平.因此,灾难中的个体常常会并发一系列的心理学反应,并可能继发各种精神疾患,尤其是创伤相关精神障碍,如急性应激障碍和创伤后应激障碍.本文作者从灾难急救医学的视角,对2008年发生在我国的"5·12"汶川地震的两个心理学研究进行了总结.结果 显示,在"5·12"汶川地震发生后超过一半的个体存在焦虑-警觉性增高症状,12.59%的灾区群众在地震发生后一月内发生急性应激障碍.地震后5个月,采用复合性国际诊断问卷(Comprehensive International diagnostic Interview,CIDI)对灾区群众的的调查结果显示,有21.29%的灾区成人和10.21%的青少年学生存在创伤后应激障碍."5.12"汶川地震对灾区群众的心理已造成严重的心理影响,作为灾难急救医学的相关人员应充分认识到灾难急救中的相关心理学问题.同时结果提示,长期的心理卫生服务应该成为四川地震重建规划中重要的内容之一.

Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress dis-order (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, relfective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimu-lation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI +PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological ifndings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identiifed by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review arti-cles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.

术中知晓相关创伤后应激障碍的研究进展

背景术中知晓相关创伤后应激障碍（posttraumatic stress disorder，PTSD）在经历过术中知晓的患者中普遍存在，严重危害患者的身心健康，正逐渐成为医学的热门研究领域之一。目的旨在提高广大医疗工作者对该病的认识。 内容术中知晓相关PTSD的临床特征、影响因素、发生机制、治疗和目前的研究状况。趋向该病的临床流行病学特征、个体化治疗方案和发病机制是未来的研究热点。