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1、社会心理健康社会心理健康Psychosocial Health祝墡珠祝墡珠祝墡珠祝墡珠 教授教授教授教授复旦大学医学院全科医学系复旦大学医学院全科医学系复旦大学医学院全科医学系复旦大学医学院全科医学系复旦大学附属中山医院全科医学科复旦大学附属中山医院全科医学科复旦大学附属中山医院全科医学科复旦大学附属中山医院全科医学科ShanzhuShanzhu Zhu M.D. Zhu M.D. General Practice Department of Medical School General Practice Department of Medical School FudanFudan Univ
2、ersity UniversityGeneral Practice Department of General Practice Department of ZhonghshanZhonghshan Hospital Hospital FudanFudan University University什么是社会心理健康 ? What is psychosocial health ?l l这是临床心理学家所关注的一个问题这是临床心理学家所关注的一个问题l l主要是在人们社会相互交往中所表现的心理主要是在人们社会相互交往中所表现的心理l l与所处社会的文化背景、个人品质、对自然与社会的认识、价值心理
3、取向与所处社会的文化背景、个人品质、对自然与社会的认识、价值心理取向有关有关l lA concern of clinical Psychologists.A concern of clinical Psychologists.l lDisplayed in the process of social contact .Displayed in the process of social contact .l lAssociated with a persons cultural background, his character traits, Associated with a person
4、s cultural background, his character traits, understanding of society and of nature, and his value orientation.understanding of society and of nature, and his value orientation.基因基因Genes社会社会Society心理心理Psyche 医疗条件医疗条件Healthcare生活方式生活方式Lifestyle健康和寿命健康和寿命Health & Longevity每个人都在社会中担任某一社会角色 ; 然而, Everyo
5、ne takes a role in society; however, 物质生活物质生活物质生活物质生活Material comfortsMaterial comforts生活水平生活水平生活水平生活水平Standard of livingStandard of living 社会经济的发展和竞争的加剧社会经济的发展和竞争的加剧 Development of social economy Exacerbation of social competition 升学、就业、职位升迁、 婚姻、失业、疾病、 亲人亡故、家庭矛盾、 贫富分化、城乡差距拉大等等Seeking good education
6、, employment and promotion, being unemployed, having poor health, death of a family member, conflicts within a family, polarization of the rich and the poor, widening disparity between urban and rural life, and so on. Factors that can contribute to Factors that can contribute to long-term psychologi
7、cal stresslong-term psychological stressPersons body immunity weakenedPhysiological and psychological responses Symptoms: remember ability decreasing insomnia and dream disturbed sleep low work efficiency hypertension peptic ulcer diseases anxiety and depression 可导致长期心理应激的因素可导致长期心理应激的因素可导致长期心理应激的因素可
8、导致长期心理应激的因素削弱了机体的免疫力削弱了机体的免疫力生理和心理疾病生理和心理疾病症状：记忆力下降症状：记忆力下降 失眠多梦失眠多梦 工作效率低下工作效率低下 高血压高血压 溃疡病溃疡病 抑郁和焦虑等抑郁和焦虑等心理疾病的发病率逐年增高Incidence of psychological diseases has been increasing with each passing yearl l 5050年代发病率为年代发病率为2%2%，20002000年发病率上升至年发病率上升至14%14%。l l大学生、妇女、儿童、老年人为重点发病人群，各大学生、妇女、儿童、老年人为重点发病人群，各种
9、精神、心理障碍人群超过种精神、心理障碍人群超过100100万。万。 l l2% in the fifties , 14% by 2000.2% in the fifties , 14% by 2000.l lUniversity students, women, children and the aged are University students, women, children and the aged are often the most susceptible group and the number of often the most susceptible group and
10、the number of people with psychological diseases or problems is people with psychological diseases or problems is estimated to be over one million. estimated to be over one million. l l我国每年有近我国每年有近3030万人自杀，每万人自杀，每2 2分钟就有分钟就有1 1人自杀，人自杀，8 8人人自杀未遂。自杀已成为我国第五位死因。自杀未遂。自杀已成为我国第五位死因。l l同时由于同时由于99.9%99.9%的心理
11、障碍者是以躯体不适到综合医院的心理障碍者是以躯体不适到综合医院就诊，因而造成卫生资源的过度消耗。就诊，因而造成卫生资源的过度消耗。l lSuicide has become the fifth cause of death in China. Suicide has become the fifth cause of death in China. l lWhile 99.9% people with psychological problems go to While 99.9% people with psychological problems go to hospital for th
12、e complaint of body disorders, which hospital for the complaint of body disorders, which contributes to the excessive use of healthcare resources.contributes to the excessive use of healthcare resources.心理问题的产生心理问题的产生The causes of psychological probleml2005年全国年龄60岁者占总人口的11.03%，年龄65岁者占总人口的7.69%。l11.0
13、3% population of China is over sixty years and 7.69% is over sixty-five in 2005.l l目前有半数以上老人不愿与子女同住，四二一家庭赡养模式，情感目前有半数以上老人不愿与子女同住，四二一家庭赡养模式，情感空巢，缺乏交流等产生心理问题。空巢，缺乏交流等产生心理问题。l l新式小区的增加，邻里之间的陌生，非心理专业人士在劝解引导方新式小区的增加，邻里之间的陌生，非心理专业人士在劝解引导方式上的缺陷。式上的缺陷。l lNow more than one half aged people are unwilling to l
14、ive with Now more than one half aged people are unwilling to live with their sons and daughters . Four-two-one family support model, their sons and daughters . Four-two-one family support model, empty nest feelings, lack of communications, all contributes to empty nest feelings, lack of communicatio
15、ns, all contributes to the development of psychological problems. the development of psychological problems. l lThe increase of modern communications, unknown with each The increase of modern communications, unknown with each other in the neighborhood, imperfection in the advice of other in the neig
16、hborhood, imperfection in the advice of nonprofessional persons.nonprofessional persons. 如何解决这一问题如何解决这一问题? How to solve the problem?l l19971997年年WHOWHO的资料显示全球有约的资料显示全球有约5 5亿人需要精神卫生服务，亿人需要精神卫生服务，其中其中9090以上适于在社区得到处置和服务，社区精神卫生以上适于在社区得到处置和服务，社区精神卫生服务已成世界各国普遍做法。服务已成世界各国普遍做法。l lThe data from WHO in 1997 s
17、howed that there are The data from WHO in 1997 showed that there are five hundred million people need psychological five hundred million people need psychological health care, in which 90% problems were optimum health care, in which 90% problems were optimum to be taken care in the community. to be
18、taken care in the community. 如何解决这一问题如何解决这一问题? How to solve the problem?l l成立由全科医师为主导的社区心理咨询师、社工人员参与的成立由全科医师为主导的社区心理咨询师、社工人员参与的心理健康服务机构。心理健康服务机构。l l因为危机家庭的成员不会主动就诊，及时主动发现和掌握社因为危机家庭的成员不会主动就诊，及时主动发现和掌握社区危机家庭情况，对重点危险人群进行专业辅导。区危机家庭情况，对重点危险人群进行专业辅导。l lAn organization leaded by family physicians and compo
19、sed An organization leaded by family physicians and composed of psychological consultants and social workers should be of psychological consultants and social workers should be set up for psychosocial health services. set up for psychosocial health services. l lMost of the families with crisis are u
20、nwilling to go to the Most of the families with crisis are unwilling to go to the doctors. It is important to discover and understand those doctors. It is important to discover and understand those families, to assist those persons with high risk of having families, to assist those persons with high
21、 risk of having psychological problems.psychological problems.l l通过该机构、媒体、社区宣教等保障民众心理健康。通过该机构、媒体、社区宣教等保障民众心理健康。l l对那些因实发事件，重大灾难后的心理创伤进行早期干预。对那些因实发事件，重大灾难后的心理创伤进行早期干预。l lThe psychosocial health of the general public can be The psychosocial health of the general public can be influenced by such an org
22、anization, the news media, influenced by such an organization, the news media, health education in communities and so on. health education in communities and so on. l lEarly detection and intervention will be the key to Early detection and intervention will be the key to prevention of such problems
23、arising from psychological prevention of such problems arising from psychological traumas caused by nasty incidents or disasters. traumas caused by nasty incidents or disasters. 预防措施预防措施 Preventive measures l l行为和心理治疗行为和心理治疗l l药物治疗药物治疗l l事件的干预事件的干预 l l建立援助体系，提高人们对自然和环境的适应能力建立援助体系，提高人们对自然和环境的适应能力l lB
24、ehavioral and psychological therapyBehavioral and psychological therapyl lMedical therapyMedical therapyl lAssistance in social issues Assistance in social issues l lThe establishment of a support system to promote peoples The establishment of a support system to promote peoples adaptability to natu
25、re and environmentadaptability to nature and environment目标目标 Goalsl l提高人们对精神刺激的耐受能力提高人们对精神刺激的耐受能力l l提高人们的自我控制和调节能力提高人们的自我控制和调节能力l l提高人们的社会交往能力提高人们的社会交往能力 l l提高人们心理创伤后的康复能力提高人们心理创伤后的康复能力l lImproved tolerance to psychological stimulationImproved tolerance to psychological stimulationl lImproved self-control and self-adjustingImproved self-control and self-adjustingl lBetter social communicative ability Better social communicative ability l lBetter rehabilitation from psychological trauma Better rehabilitation from psychological trauma
