BACKGROUND & AIMS: :We developed a novel multifaceted psychosocial intervention program which involves screening for psychological distress and comprehensive support including individually tailored psychotherapy and pharmacotherapy provided by mental health professionals. The purpose of the present study was to investigate the feasibility of the intervention program and its preliminary usefulness for reducing clinical psychological distress experienced by patients with recurrent breast cancer. The subjects who participated in the 3 months intervention program completed psychiatric diagnostic interview and several self-reported measures regarding psychological distress, traumatic stress, and quality of life. The assessments were conducted before the intervention (T1), after the intervention (T2), and 3 months after the intervention (T3). A total of 50 patients participated in the study. The rates of participation in and adherence to the intervention program were 85 and 86%, respectively. While the proportion of psychiatric disorders at T2 (11.6%) was not significantly different from that at T1 (22.0%) (p = 0.15), the proportion of that at T3 (7.7%) had significantly decreased compared with that at T1 (p = 0.005). The novel intervention program is feasible, is a promising strategy for reducing clinically manifested psychological distress and further controlled studies are warranted.

背景与目标： : 我们开发了一种新颖的多方面的社会心理干预计划，其中包括筛查心理困扰和全面支持，包括由精神卫生专业人员提供的个性化心理治疗和药物疗法。本研究的目的是研究干预计划的可行性及其对减少复发性乳腺癌患者遭受的临床心理困扰的初步作用。参加3个月干预计划的受试者完成了精神病学诊断访谈，并完成了一些有关心理困扰，创伤压力和生活质量的自我报告措施。评估在干预前 (T1)，干预后 (T2) 和干预后3个月 (T3) 进行。共有50名患者参加了这项研究。参与和遵守干预计划的比率分别为85和86%。尽管T2 (11.6%) 的精神疾病比例与T1 (22.0%) 无显着差异 (p = 0.15)，但与T1 (p = 0.005) 相比，T3 (7.7%) 的精神疾病比例显着降低)。新的干预计划是可行的，是减少临床表现的心理困扰的有前途的策略，需要进一步的对照研究。

BACKGROUND & AIMS: :While the medical aspects of living donor liver transplantation (LDLT) have been investigated to a comparatively large degree, only in recent years have psychosocial aspects like donors' quality of life and attitude towards living donation been dealt with. In the course of a retrospective study, we examined 36 pediatric living liver donors at an average of 4.5 +/- 2.8 years postoperatively. The donation's impact on the family was considered "very high," "high," or "average" by 48% of the donors. The physical impact of the donation was regarded as being higher than the emotional impact. Subjective full recovery was achieved at an average of 4.5 months postoperatively. All patients stated that they would donate again. Donors' quality of life, as assessed with the 36-Item Short-Form Quality of Life Questionnaire (SF-36), was significantly higher than the German normative sample. Anxiety and depression, assessed with the Hospital Anxiety and Depression Scale-German version, were significantly lower compared to healthy controls. However, 14 patients (39%) described persistent, mostly physical, symptoms more than 1 yr postoperatively. In conclusion, the study's findings may enable clinicians to achieve a better understanding of living donors' situations, both pre- and postoperatively, and may help to assess the psychosocial risk of LDLT. Knowledge of possible ongoing problems may facilitate intervention at an early stage and should be included among the information given to potential living liver donors. Prospective studies using more specific instruments with an emphasis on the long-term psychosocial outcome of LDLT are needed for future research.

背景与目标： : 虽然对活体供体肝移植 (LDLT) 的医学方面进行了较大程度的研究，但仅在最近几年才处理了社会心理方面，例如捐赠者的生活质量和对活体捐赠的态度。在一项回顾性研究过程中，我们在术后平均4.5/- 2.8年检查了36名儿童活体肝脏供体。48% 捐赠者认为捐赠对家庭的影响 “非常高” 、 “高” 或 “平均”。捐赠的身体影响被认为高于情感影响。术后平均4.5个月，主观完全恢复。所有患者都表示将再次捐赠。通过36项简短的生活质量问卷 (SF-36) 评估，捐助者的生活质量显着高于德国的标准样本。用医院焦虑和抑郁量表 (德语版) 评估的焦虑和抑郁明显低于健康对照组。然而，14名患者 (39%) 描述了术后超过1年的持续症状，主要是身体症状。总之，该研究的发现可能使临床医生在术前和术后更好地了解活体捐赠者的情况，并可能有助于评估LDLT的社会心理风险。对可能存在的问题的了解可能有助于在早期阶段进行干预，应包括在提供给潜在活体肝脏供体的信息中。未来的研究需要使用更具体的工具进行前瞻性研究，重点是LDLT的长期社会心理结果。

BACKGROUND & AIMS: OBJECTIVE:Although the addictive potential of benzodiazepine drugs has been known for a long time, new cases of benzodiazepine addictions keep emerging in clinical practice. The etiology of benzodiazepine addiction seems to be multifactorial. The objective of this study was to investigate and measure psychological and situational factors differentiating benzodiazepine addicts from not addicted users. METHODS:A psychological profile and situational factors of patients with the diagnosis of benzodiazepine addiction and a carefully matched control group of not addicted former benzodiazepine users were defined and investigated. RESULTS:The investigated benzodiazepine addicts differed significantly from the control group in particular psychological dimensions, such as higher neuroticism and introversion, prevalence of emotional rather than task based coping mechanisms. There were also significant correlations between the addiction and situational factors such as BZD - treatment circumstances and adverse life events previous to the treatment. CONCLUSIONS:The results show psychological and situational factors which differentiate benzodiazepine addicts from not addicted benzodiazepine users. This data suggest that benzodiazepine addiction might be associated with higher neuroticism, introversion and less effective coping mechanisms as well as with previous accumulation of adverse life events and/or inadequate BZD treatment. The psychological and situational factors mentioned above might be considered as potential risk factors for benzodiazepine addiction.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation. METHODS:Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact of gender minority status, and substance use behaviors as potential mediators for the relationship between perceived stigma and suicidal ideation. All models were controlled for age, race, education, and homelessness. RESULTS:Suicidal ideation was reported by 33% (N = 30) of the study participants. In multivariable analysis, suicidal ideation was associated with sexual abuse (AOR = 3.17, 95% CI = 1.10-9.30), anxiety (AOR = 1.74, 95% CI = 1.10-2.73), family verbal abuse (AOR = 2.99, 95% CI = 1.10-8.40), stranger verbal abuse (AOR = 3.21, 95% CI = 1.02-10.08), and psychosocial impact of gender minority status (AOR = 3.42, 95% CI = 1.81-6.46). Partner support was found to be the protective factor for suicidal ideation (AOR = 0.34, 95% CI = 0.13-0.90). In the mediation analysis, the psychosocial impact of gender minority status mediated the relationship between perceived stigma and suicidal ideation. The estimated conditional indirect effect was 0.46, (95% CI = 0.12-1.11). CONCLUSION:Interventions that aim to reduce suicidal behaviors among TGW should address stigma, psychosocial impact of gender minority status, and different forms of violence and abuse.

背景与目标：

BACKGROUND & AIMS: :Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness.

背景与目标： : 认识到精神卫生服务中的族裔/种族差异并没有直接导致对文化有反应的心理社会干预措施的发展。仍然需要对与患有严重和持续精神疾病的文化多样性消费者的期望，需求和目标相关的社会文化问题进行评估。作者认为，将社会文化问题的评估纳入社会心理康复实践是设计与文化相关的经验支持实践的一步。它成为从业者可以检查其干预措施与日常实践中遇到的多样性的相关性的基础。本文概述了对文化和临床相关评估实践的需求，并断言通过改善对社会文化问题的评估，可以增强服务提供商的临床能力。作者提供了一个概念框架，用于将社会文化问题的临床评估与消费者的结果联系起来，并引入了一种评估工具，以促进社会心理康复环境中的过程。强调合格的临床评估技能将最终提供一种策略，以解决患有严重和持续性精神疾病的文化多样性消费者的研究不足人群的治疗结果差异。

BACKGROUND & AIMS: BACKGROUND:Although pregnancy was once thought of as a time of emotional wellbeing for many women, conferring 'protection' against psychiatric disorders, a recent meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester to a high of 12.8% in the second trimester. Due to maternal treatment preferences and potential concerns about fetal and infant health outcomes, non-pharmacological treatment options are needed. OBJECTIVES:The primary objective of this review is to assess the effects, on mothers and their families, of psychosocial and psychological interventions compared with usual antepartum care in the treatment of antenatal depression. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2006), the Cochrane Collaboration Depression Anxiety and Neurosis Group's Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (July 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1966 to July 2006), EMBASE (1980 to July 2006) and CINAHL (1982 to July 2006). We also scanned secondary references and contacted experts in the field to identify other published or unpublished trials. SELECTION CRITERIA:All published, unpublished and ongoing randomised controlled trials of preventive psychosocial or psychological interventions in which the primary or secondary aim is to treat antenatal depression. We excluded quasi-randomised trials (for example, those randomised by delivery date, or odd versus even medical record numbers) from the analysis. DATA COLLECTION AND ANALYSIS:All review authors participated in the evaluation of methodological quality and data extraction. Results are presented using relative risk for categorical data and weighted mean difference for continuous data. MAIN RESULTS:One US trial was included in this review, incorporating 38 outpatient antenatal women who met Diagnostic and Statistical Manual for Mental Disorders-IV criteria for major depression. Interpersonal psychotherapy, compared to a parenting education program, was associated with a reduction in the risk of depressive symptomatology immediately post-treatment using the Clinical Global Impression Scale (one trial, n = 38; relative risk (RR) 0.46, 95% confidence interval (CI) 0.26 to 0.83) and the Hamilton Rating Scale for Depression (one trial, n = 38; RR 0.82, 95% CI 0.65 to 1.03). AUTHORS' CONCLUSIONS:The evidence is inconclusive to allow us to make any recommendations for interpersonal psychotherapy for the treatment of antenatal depression. The one trial included was too small, with a non-generalisable sample, to make any recommendations.

背景与目标：

BACKGROUND & AIMS: :Psychosocial interventions (PSI) offer a range of problem-centred activities designed to improve the health and quality of life of clients and their carers. The paper reports the findings of a study on the roles and perspectives of mental health nurse practitioners towards clients with enduring mental illness and their carers following completion of PSI training. Focus groups interviews were conducted with PSI mental health nurse practitioners (n = 8) and data were analysed for thematic content. The results of the study indicated that PSI practitioners developed positive attitudes towards their client following PSI training and this attitudinal change enabled clients to develop more confidence and autonomy in managing the symptoms of their illness in a more empowered way. Focus group participants observed reduced levels of anxiety among clients and their carers. This was attributed to the 'sense of hope' within the caring milieu which was established as a result of collaborative working with the client and family. The findings suggest that there is a need for further exploration of the PSI practitioner role with a particular focus on the centrality of positive attitudes on the development of the therapeutic milieu for clients with severe and enduring mental ill health.

背景与目标： : 社会心理干预 (PSI) 提供了一系列以问题为中心的活动，旨在改善客户及其护理人员的健康和生活质量。本文报告了一项关于精神卫生护士从业人员在完成PSI培训后对患有持久精神疾病的客户及其护理人员的作用和观点的研究结果。对PSI精神卫生护士从业人员 (n = 8) 进行了焦点小组访谈，并分析了主题内容的数据。研究结果表明，PSI从业人员在PSI培训后对客户产生了积极的态度，这种态度的变化使客户在以更有能力的方式管理疾病症状方面发展了更多的信心和自主权。焦点小组参与者观察到客户及其护理人员的焦虑水平降低。这归因于与客户和家人合作建立的关怀环境中的 “希望感”。研究结果表明，有必要进一步探索PSI从业者的角色，特别关注积极态度对患有严重和持久精神疾病的患者的治疗环境发展的中心作用。

BACKGROUND & AIMS: :Ninety women with recently diagnosed stage I or stage II breast cancer who had been admitted to the NIH Clinical Center and were participating in a randomized trial were entered onto this behavioral immunology protocol. Patients were immunologically and psychosocially assessed at baseline (approximately 5 days after surgery) and again at 3 and 15 months post surgery. All of the patients were followed up for a minimum of 5 years, and 60% of the patients were followed for 7 years or longer. Twenty-nine women in the study group reported disease recurrences over the entire follow-up period. Causal path modeling statistical techniques showed that natural killer (NK) cell activity was a strong predictor of disease outcome when the outcome variable was defined as recurrence v nonrecurrence of disease (chi 2 = 6.9, p less than .001). Higher NK cell activity at follow-up predicted disease-free survival over the follow-up period. When the disease outcome variable was operationally defined as time to recurrent disease, the psychosocial factors were more strongly predictive of the rate of disease progression for those who had a recurrence (chi 2 = -4.1, p less than .01), but NK cell activity was seemingly less relevant in this latter case. Overall, these findings suggest that including mood and potentially relevant immunological variables, along with important biological prognostic variables, in multivariate and prospective models such as those examined in this study, potentially contributes more to the explanation of greater outcome variance of early-stage breast cancer than has been believed in the past.

背景与目标： : 90名最近被诊断为I期或II期乳腺癌的妇女已进入NIH临床中心并参加了一项随机试验，并进入了该行为免疫学方案。在基线 (手术后约5天) 和术后3和15个月再次对患者进行免疫和心理评估。所有患者均随访至少5年，60% 患者随访7年或更长时间。研究组中有29名妇女报告了整个随访期间的疾病复发。因果路径建模统计技术表明，当结果变量被定义为疾病的复发v不复发 (chi 2 = 6.9，p小于.001) 时，自然杀伤 (NK) 细胞活性是疾病结果的强预测因子。随访时较高的NK细胞活性可预测随访期间的无病生存期。当将疾病结果变量操作性地定义为复发疾病的时间时，社会心理因素对复发患者的疾病进展速率的预测能力更强 (chi 2 = -4.1，p小于.01)，但在后一种情况下，NK细胞活性似乎不太相关。总体而言，这些发现表明，在多变量和前瞻性模型 (例如本研究中检查的模型) 中，包括情绪和潜在相关的免疫学变量以及重要的生物学预后变量，可能有助于解释早期乳腺癌的更大结果差异比过去认为的要多。

BACKGROUND & AIMS: :The aim of this study is to investigate psychosocial factors related to the diagnosis and treatment of patients with restless legs syndrome. Fifteen patients were interviewed at the Neuro-Sono Outpatient Clinic, Universidade Federal de São Paulo. The results were submitted to a qualitative analysis. We identified four content categories: illness description, illness history, illness experience, and relationships. Lack of control over the body and lack of recognition by professionals produce stigma and lead patients to suffering. The research underscores the relevance of psychosocial factors to the diagnosis and treatment of patients with restless legs syndrome and the importance of having interdisciplinary teams when attending patients with restless legs syndrome.

背景与目标： : 本研究的目的是调查与不宁腿综合征患者的诊断和治疗有关的社会心理因素。在圣保罗联邦大学Neuro-Sono门诊接受了15名患者的采访。结果提交给定性分析。我们确定了四个内容类别: 疾病描述，病史，疾病经历和关系。缺乏对身体的控制和缺乏专业人员的认可会产生污名，并导致患者痛苦。该研究强调了社会心理因素与不宁腿综合征患者的诊断和治疗的相关性，以及在治疗不宁腿综合征患者时建立跨学科团队的重要性。

BACKGROUND & AIMS: :We studied 10 boys, and 15 girls, all below the age of 16, who had been referred to the National Hospital in Norway for evaluation for transplantation of either the heart, or the heart and lungs. These represent the complete cohort of patients being considered for transplantation between 1990 and 1997. Of the 25 children and their families, 24 sets underwent a comprehensive psychosocial assessment, including interviews with both parents and their children. The parents completed the Child Behavior Checklist and the General Health Questionnaire. We had accepted 15 children for transplantation and placed them on the waiting list. The others were rejected for medical reasons, and 3 died whilst waiting for an organ. One was reconsidered for conventional surgery and removed from the list. Transplantation was performed in 11 children, whilst one of the patients we had rejected underwent transplantation abroad, and was included in the study. This left 12 patients in the final sample, with a mean age of 8 years, and with a range from 11 months to 13.9 years. We reassessed their psychosocial and physical functioning two years after transplantation. Of those undergoing transplantation of the heart and lungs, two were severely affected by progressive obliterative bronchiolitis. The others were in good general physical condition. At the assessment prior to transplantation, three already fulfilled the criterions for diagnosis of an overanxious disorder. Two others had symptoms of anxiety and depression, but without fulfilling the accepted criterions. At follow- up, two patients retained this psychiatric diagnosis. Increased levels of stress were uncovered in the parents prior to surgery, but these had normalised at follow-up. The study shows that, in general, physical and psychological conditions improve in children undergoing transplantation, but they and their parents live in a stressful environment, and are in need of psychosocial support both before and after transplantation.

背景与目标： : 我们研究了10个男孩和15个女孩，年龄都在16岁以下，他们被转诊到挪威国家医院进行心脏或心脏和肺部移植的评估。这些代表正在考虑进行移植1990年和1997的患者的完整队列。在25名儿童及其家庭中，有24套接受了全面的社会心理评估，包括对父母及其子女的访谈。父母完成了儿童行为清单和一般健康问卷。我们接受了15名儿童进行移植，并将他们列入了等待名单。其他人因医疗原因被拒绝，其中3人在等待器官时死亡。其中一个被重新考虑进行常规手术，并从列表中删除。在11名儿童中进行了移植，而我们拒绝的其中一名患者在国外进行了移植，并被纳入了研究。最终样本中剩下12名患者，平均年龄为8岁，范围为11个月至13.9岁。移植后两年，我们重新评估了他们的心理和身体功能。在接受心脏和肺部移植的患者中，有两例受到进行性闭塞性细支气管炎的严重影响。其他人的身体状况良好。在移植前的评估中，三个已经满足了过度焦虑障碍的诊断标准。另外两个人有焦虑和抑郁的症状，但没有达到公认的标准。在随访中，两名患者保留了这种精神病诊断。手术前父母发现压力水平增加，但随访时压力已恢复正常。研究表明，总体而言，接受移植的儿童的身体和心理状况有所改善，但他们及其父母生活在压力大的环境中，并且在移植前后都需要社会心理支持。

BACKGROUND & AIMS: :Use of opioid analgesics for management of chronic nonmalignant pain has become common, yet there are presently no well-validated predictors of optimal opioid analgesic efficacy. We examined whether psychosocial factors (eg, depressive symptoms) predicted changes in spontaneous low back pain after administration of opioid analgesics, and whether endogenous opioid (EO) function mediated these relationships. Participants with chronic low back pain but who were not chronic opioid users (N = 89) underwent assessment of low back pain intensity pre- and post-drug in 3 (counterbalanced) conditions: (1) placebo, (2) intravenous naloxone, and (3) intravenous morphine. Comparison of placebo condition changes in back pain intensity to those under naloxone and morphine provided indexes of EO function and opioid analgesic responses, respectively. Results showed that (1) most psychosocial variables were related significantly and positively to morphine analgesic responses for low back pain, (2) depressive symptoms, trait anxiety, pain catastrophizing, and pain disability were related negatively to EO function, and (3) EO function was related negatively to morphine analgesic responses for low back pain. Bootstrapped mediation analyses showed that links between morphine analgesic responses and depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability were partially mediated by EO function. Results suggest that psychosocial factors predict elevated analgesic responses to opioid-based medications, and may serve as markers to identify individuals who benefit most from opioid therapy. Results also suggest that people with greater depressive symptoms, trait anxiety, pain catastrophizing, and perceived disability may have deficits in EO function, which may predict enhanced response to opioid analgesics.

背景与目标： : 使用阿片类镇痛药治疗慢性非恶性疼痛已变得很普遍，但目前尚无有效的最佳阿片类镇痛药疗效预测指标。我们检查了心理社会因素 (例如，抑郁症状) 是否预测了阿片类镇痛药给药后自发性腰痛的变化，以及内源性阿片类药物 (EO) 功能是否介导了这些关系。患有慢性腰痛但不是慢性阿片类药物使用者 (N = 89) 的参与者在3种 (平衡) 条件下接受了药物前后腰痛强度的评估 :( 1) 安慰剂，(2) 静脉注射纳洛酮和 (3) 静脉注射吗啡。与纳洛酮和吗啡下的安慰剂状态背痛强度变化的比较分别提供了EO功能和阿片类镇痛药反应的指标。结果表明 :( 1) 大多数心理社会变量与吗啡对下腰痛的镇痛反应显着正相关，(2) 抑郁症状，特质焦虑，疼痛灾难性和疼痛残疾与EO功能负相关。(3) EO功能与下腰痛的吗啡镇痛反应呈负相关。引导中介分析表明，吗啡镇痛反应与抑郁症状，特质焦虑，疼痛灾难性和感知残疾之间的联系部分由EO功能介导。结果表明，社会心理因素可预测对阿片类药物的镇痛反应升高，并可作为识别从阿片类药物治疗中受益最大的个体的标志物。结果还表明，具有更大的抑郁症状，特质焦虑，疼痛灾难性和感知残疾的人可能具有EO功能缺陷，这可能预示着对阿片类镇痛药的反应增强。

BACKGROUND & AIMS: PURPOSE:We identified and treated young adults with type 1 diabetes who had been lost to follow-up during their transfer from pediatric to adult care, comparing their clinical, psychosocial, and health care utilization outcomes to participants receiving continuous care (CC) throughout the transition to adult care. METHODS:Individuals in their last year of pediatric care (CC group, n = 51) and individuals lost to follow-up in the transfer to adult care ("lapsed care" [LC] group, n = 24) were followed prospectively for 12 months. All participants were provided developmentally tailored diabetes education, case management, and clinical care through a structured transition program. RESULTS:At baseline, LC participants reported lapses in care of 11.6 months. Compared with CC participants, they had higher hemoglobin A1C (A1C; p = .005), depressive symptoms (p = .05), incidence of severe hypoglycemia (p = .005), and emergency department visits (p = .004). At 12-month follow-up, CC and LC participants did not differ on the number of diabetes care visits (p = .23), severe hypoglycemia (no events), or emergency department visits (p = .22). Both groups' A1C improved during the study period (CC: p = .03; LC: p = .02). LC participants' depressive symptoms remained elevated (p = .10), and they reported a decline in life satisfaction (p = .007). There was greater loss to follow-up in the LC group (p = .04). CONCLUSIONS:Our study suggests that, for young adults with a history of lapses in care, a structured transition program is effective in lowering A1C, reducing severe hypoglycemia and emergency department utilization, and improving uptake of routine diabetes care. Loss to follow-up and psychosocial concerns remain significant challenges in this population.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The prevalence of mental health problems in women is 1:3 and such problems tend to be persistent. There is evidence from a range of studies to suggest that a number of factors relating to maternal psychosocial health can have a significant effect on the mother-infant relationship, and that this can have consequences for the psychological health of the child. It is now thought that parenting programmes may have an important role to play in the improvement of maternal psychosocial health. OBJECTIVES:The objective of this review is to address whether group-based parenting programmes are effective in improving maternal psychosocial health including anxiety, depression and self-esteem. SEARCH STRATEGY:A range of biomedical, social science, educational and general reference electronic databases were searched including MEDLINE, EMBASE CINAHL, PsychLIT, ERIC, ASSIA, Sociofile and the Social Science Citation Index. Other sources of information included the Cochrane Library (SPECTR, CENTRAL), and the National Research Register (NRR). SELECTION CRITERIA:Only randomised controlled trials were included in which participants had been randomly allocated to an experimental and a control group, the latter being either a waiting-list, no-treatment or a placebo control group. Studies had to include at least one group-based parenting programme, and one standardised instrument measuring maternal psychosocial health. DATA COLLECTION AND ANALYSIS:A systematic critical appraisal of all included studies was undertaken using the Journal of the American Medical Association (JAMA) published criteria. The data were summarised using effect sizes but were not combined in a meta-analysis due to the small number of studies within each group and the presence of significant heterogeneity. MAIN RESULTS:A total of 22 studies were included in the review but only 17 provided sufficient data to calculate effect sizes. These 17 studies reported on a total of 59 outcomes including depression, anxiety, stress, self-esteem, social competence, social support, guilt, mood, automatic thoughts, dyadic adjustment, psychiatric morbidity, irrationality, anger and aggression, mood, attitude, personality, and beliefs. Approximately 22% of the outcomes measured suggested significant differences favouring the intervention group. A further 40% showed differences favouring the intervention group but which failed to achieve conventional levels of statistical significance, in some cases due to the small numbers that were used. Approximately 38% of outcomes suggested no evidence of effectiveness. REVIEWER'S CONCLUSIONS:It is suggested that parenting programmes can make a significant contribution to the improvement of psychosocial health in mothers. While the critical appraisal suggests some variability in the quality of the included studies, it is concluded that there is sufficient evidence to support their use with diverse groups of parents. However, it is also suggested that some caution should be exercised before the results are generalised to parents irrespective of the level of pathology present, and that further research is still required.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The purpose of this study is to examine psychological health of left-behind children (LBC), social support and rearing behavior towards LBC as well as their correlations in the city of Shaoxing, China. METHODS:By stratified sampling, 401 LBC and 527 non-left-behind children (NLBC) had completed the questionnaires in 2014. Spearman's correlation was performed to clarify the relationship between psychological health, social support and rearing behavior in LBC. Multiple linear regression analytical methods were used to identify the variables that were associated with psychological health. RESULTS:Compared to NLBC, LBC got lower scores in psychological health, general social support, subjective support and emotional warmth, but higher in rejection. Psychological health was positively correlated with social support, and negatively with rearing behavior (rejection, overprotection) in LBC. It was also closely connected with the subjective support, rejection and general health status. CONCLUSION:These data show that LBC suffer significant impairment on psychological health, and receive less social support and worse rearing behavior than NLBC. Psychological health may be affected by subjective support, rejection, and general health status. Urgent government assessment and support from the community, school, mental health systems are warranted.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Mental health problems (MHP) are the leading cause of disability worldwide. The inverse association between socioeconomic position (SEP) and MHP has been well documented. There is prospective evidence that factors from the work environment, including adverse psychosocial work factors, could contribute to the development of MHP including psychological distress. However, the contribution of psychosocial work factors to social inequalities in MHP remains unclear. This study evaluates the contribution of psychosocial work factors from two highly supported models, the Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models to SEP inequalities of psychological distress in men and women from a population-based sample of Quebec workers. METHODS:Data were collected during a survey on working conditions, health and safety at work. SEP was evaluated using education, occupation and household income. Psychosocial work factors and psychological distress were assessed using validated instruments. Mean differences (MD) in the score of psychological distress were estimated separately for men and women. RESULTS:Low education level and low household income were associated with psychological distress among men (MD, 0.56 (95% CI 0.06; 1.05) and 1.26 (95% CI 0.79; 1.73) respectively). In men, the contribution of psychosocial work factors from the DCS and the ERI models to the association between household income and psychological distress ranged from 9% to 24%. No clear inequalities were observed among women. CONCLUSIONS:These results suggest that psychosocial work factors from the DCS and the ERI models contribute to explain a part of social inequalities in psychological distress among men. Psychosocial factors at work are frequent and modifiable. The present study supports the relevance of targeting these factors for the primary prevention of MHP and for health policies aiming to reduce social inequalities in mental health.

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