BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few stu...BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few studies have focused on the factors related to SI,and effective predictive models are lacking.AIM To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention.METHODS The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed.Based on whether or not they had SI,they were divided into a SI group(n=91)and a non-SI group(n=59).The general data and laboratory indices of the two groups were compared.Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression,a nomogram prediction model was constructed based on the analysis results,and internal evaluation was performed.Receiver operating characteristic and calibration curves were used to evaluate the model’s efficacy,and the clinical application value was evaluated using decision curve analysis(DCA).RESULTS There were differences in trauma history,triggers,serum ferritin levels(SF),highsensitivity C-reactive protein levels(hs-CRP),and high-density lipoprotein(HDLC)levels between the two groups(P<0.05).Logistic regression analysis showed that trauma history,predisposing factors,SF,hs-CRP,and HDL-C were factors influencing SI in adolescent patients with depression.The area under the curve of the nomogram prediction model was 0.831(95%CI:0.763–0.899),sensitivity was 0.912,and specificity was 0.678.The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043,indicating that the model had a good fit.CONCLUSION The nomogram prediction model based on trauma history,triggers,ferritin,serum hs-CRP,and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.展开更多
To the editor:Insomnia disorder has a serious and widespread detrimental effect on humans with comorbidity with other mental or physical health problems.In recent years,noninvasive brain stimulation(NIBS)techniques,es...To the editor:Insomnia disorder has a serious and widespread detrimental effect on humans with comorbidity with other mental or physical health problems.In recent years,noninvasive brain stimulation(NIBS)techniques,especially transcranial magnetic stimulation(TMS)and transcranial electrical stimulation,have been increasingly used for the treatment of brain diseases,including insomnia disorder.展开更多
BACKGROUND Chronic subdural effusion is very common in the cranial imaging of middle-aged and older people.Herein,we report a patient misdiagnosed with subdural effusion,who was eventually diagnosed with chronic subdu...BACKGROUND Chronic subdural effusion is very common in the cranial imaging of middle-aged and older people.Herein,we report a patient misdiagnosed with subdural effusion,who was eventually diagnosed with chronic subdural empyema(SDE)caused by Streptococcus pneumoniae.CASE SUMMARY A 63-year-old man was brought to our emergency room with a headache,vomiting,and disturbed consciousness.Computed tomography(CT)revealed a bilateral subdural effusion at the top left side of the frontal lobe.Cerebrospinal fluid examination after lumbar puncture indicated suppurative meningitis,which improved after anti-infective therapy.However,the patient then presented with acute cognitive dysfunction and right limb paralysis.Repeat CT showed an increase in left frontoparietal subdural effusion,disappearance of the left lateral ventricle,and a shift of the midline to the right.Urgent burr hole drainage showed SDE that was culture-positive for Streptococcus pneumoniae.His condition improved after adequate drainage and antibiotic treatment.CONCLUSION Patients with unexplained subdural effusion,especially asymmetric subdural effusion with intracranial infection,should be assessed for chronic SDE.Early surgical treatment may be beneficial.展开更多
BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a l...BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.展开更多
BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the bioma...BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the biomarkers that may predict better treatment.AIM To compare genome-wide methylation and gene expression patterns between responsive and non-responsive patients with PD after 4 wk of escitalopram treatment.METHODS Thirty patients with PD were enrolled in this study(responders=13;nonresponders=17).All patients were assessed using the PD Severity Scale-Chinese version before and after treatment.The Illumina Infinium MethylationEPIC(850k)BeadChip for genome-wide methylation screening and mRNA sequencing was used in all patients with PD.RESULTS A total of 701 differentially methylated positions(DMPs)were found between responders and non-responders(|Δβ|≥0.06,q<0.05),and the hyper-and hypomethylated CpG sites were 511(72.9%)and 190(27.1%),respectively.Relative to non-responders,there were 59 differential transcripts,of which 20 were downregulated and 39 were upregulated(q<0.05).However,no differen tially expressed genes were identified by mRNA sequencing after correcting for multiple testing(|log2(FC)|>1,q>0.05).CONCLUSION This preliminary study showed that DMPs might be associated with the treatment response to escitalopram in PD;however,these DMPs need to be verified in large samples.展开更多
Background:Examine the degree of disability in adult ADHD patients in relation to the core symptoms attention deficits and hyperactivity and concomitant minimal cerebral dysfunctions.Methods:Patients from a psychosoma...Background:Examine the degree of disability in adult ADHD patients in relation to the core symptoms attention deficits and hyperactivity and concomitant minimal cerebral dysfunctions.Methods:Patients from a psychosomatic rehabilitation hospital(N=1,453)had answered the“ADHS-SB(attention deficit hyperactivity scale)”,the“MCD-scale(minimal cerebral dysfunction self rating scale)”,the“SCL-90R(Symptom Checklist)”,and reported about impairment at work.Results:Psychological distress and the ability to work are primarily related to problems of orientation,cognitive impairment,vegetative lability,emotional problems,disorders of motor function,but only to a lesser degree to hyperactivity and attention deficit.Conclusion:When dealing with ADHD patients,clinicians should take into account the full variety of MCD symptoms as these are decisive in regard to participation and problems in life.展开更多
This review describes the conceptual and clinical relations between irritable bowel syndrome(IBS),other functional,somatoform,and mental disorders,and points to appropriate future conceptualizations.IBS is considered ...This review describes the conceptual and clinical relations between irritable bowel syndrome(IBS),other functional,somatoform,and mental disorders,and points to appropriate future conceptualizations.IBS is considered to be a functional somatic syndrome(FSS)with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome.IBS patients show an increased prevalence of psychiatric symptoms and disorders,especially depression and anxiety.IBS is largely congruent with the concepts of somatoform and somatic symptom disorders.Roughly 50%of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity.IBS concepts,treatment approaches,as well as health care structures should acknowledge its variability and multidimensionality by:(1)awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS;(2)general and collaborative care rather than specialist and separated care;and(3)implementation of"interface disorders"to abandon thedualistic classification of purely organic or purely mental disorders.展开更多
BACKGROUND Laparoscopic radical gastrectomy is currently the most common surgical approach for gastric cancer.The main difference between totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gas...BACKGROUND Laparoscopic radical gastrectomy is currently the most common surgical approach for gastric cancer.The main difference between totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gastrectomy(LATG)is the route of digestive tract reconstruction.However,TLTG is currently not widespread as the safety and feasibility of intracorporeal esophagojejunostomy is uncertain.AIM To compare the short-term efficacy of TLTG and LATG for radical gastrectomy of gastric cancer,and to determine the safety and feasibility of intracorporeal esophagojejunostomy.METHODS PubMed,EMBASE,and Web of Science databases were searched for all relevant articles regarding TLTG vs LATG for gastric cancer published up to October 1,2019.Inclusion and exclusion criteria were established.All the basic conditions of patients and important clinical data related to surgery were extracted,and a meta-analysis was performed with RevMan 5.3 software.RESULTS Eight studies involving a total of 1883 cases(869 cases in the TLTG group and 1014 cases in the LATG group)were included.Compared with the LATG group,reduced intraoperative blood loss(weighted mean difference=-35.37,95%CI:-61.69--9.06,P=0.008)and a larger number of retrieved lymph nodes(weighted mean difference=3.11,95%CI:-2.60-12.00,P=0.01)were found in the TLTG group.There were no significant differences in operating time,anastomotic time,tumor size,proximal resection margin length,postoperative pain score,time to first flatus,time to first oral intake,postoperative hospital stay,postoperative anastomosis-related complication rate and overall complication rate between the two groups(P>0.05).CONCLUSION Intracorporeal esophagojejunostomy is safe and feasible.TLTG has the advantages of being minimally invasive,reduced intraoperative blood loss and easier access to lymph nodes compared with LATG.Totally laparoscopic gastrectomy is likely to be the surgical trend for gastric cancer in the future.展开更多
Photobiomodulation using light in the red or near-infrared region is an innovative treatment strategy for a wide range of neurological and psychological conditions.Photobiomodulation can promote neurogenesis and elici...Photobiomodulation using light in the red or near-infrared region is an innovative treatment strategy for a wide range of neurological and psychological conditions.Photobiomodulation can promote neurogenesis and elicit anti-apoptotic,antiinflammatory and antioxidative responses.Its therapeutic effects have been demonstrated in studies on neurological diseases,peripheral nerve injuries,pain relief and wound healing.We conducted a comprehensive literature review of the application of photobiomodulation in patients with central nervous system diseases in February 2019.The NCBI PubMed database,EMBASE database,Cochrane Library and ScienceDirect database were searched.We reviewed 95 papers and analyzed.Photobiomodulation has wide applicability in the treatment of stroke,traumatic brain injury,Parkinson’s disease,Alzheimer’s disease,major depressive disorder,and other diseases.Our analysis provides preliminary evidence that PBM is an effective therapeutic tool for the treatment of central nervous system diseases.However,additional studies with adequate sample size are needed to optimize treatment parameters.展开更多
AIM: To examine the influences of personality characteristics and coping modes on the anxiety of primary glaucoma patients.METHODS: A total of 200 individuals, including 50 with primary angle-closure glaucoma, 60 with...AIM: To examine the influences of personality characteristics and coping modes on the anxiety of primary glaucoma patients.METHODS: A total of 200 individuals, including 50 with primary angle-closure glaucoma, 60 with primary open angle glaucoma and 90 control participants, filled out the State-Trait Anxiety Inventory, NEO Five-Factor Inventory, and Medical Coping Modes Questionnaire. Sociodemographic information was also collected. Data were analyzed via the Spearman rank correlation test and stepwise regression.RESULTS: The personality and coping variables are predictive and jointly account for a significant amount (45.3%-54.2%) of variance across the two subscales of anxiety measures. Notably, neuroticism seems to be most closely related to anxiety disturbances in glaucoma patients. The level of resignation is positively linked to anxiety scores.CONCLUSION: Some personality factors and coping modes help to predict the process of anxiety disorders in primary glaucoma patients. Recognizing the predictive role of these variables in the patients may further enrich clinical research in glaucoma and help to design more effective interventions involving both ophthalmology and psychiatry.展开更多
Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown...Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown that decreased serum IGF-2 was correlated with the severity of psychopathology in patients with schizophrenia.Here we conducted a prospective observation trial to investigate the effects of atypical antipsychotics on serum IGF-2 level and its relationship with clinical improvements in schizophrenia patients.Thirty-one schizophrenia patients with acute exacerbation and 30 healthy individuals were recruited in this study.Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale(PANSS)and serum IGF-2 levels were determined using ELISA.We found that schizophrenia patients with acute exacerbation had lower serum IGF-2 levels than control individuals at baseline(P<0.05).After 2 months of atypical antipsychotic treatment,a significant improvement in each PANSS subscore and total score was observed in patients(all P<0.01),and the serum IGF-2 levels of patients were significantly increased compared with those at baseline(203.13±64.62 vs.426.99±124.26 ng/mL;t=−5.044,P<0.001).Correlation analysis revealed that the changes of serum IGF-2 levels in patients were significantly correlated with the improvements of negative symptoms(r=−0.522,P=0.006).Collectively,our findings demonstrated changes of serum IGF-2 response to improvements of negative symptoms in schizophrenia patients treated with atypical antipsychotics,suggesting that serum IGF-2 might be a treatment biomarker for schizophrenia.展开更多
Background There is an urgent need in clinical practice to measure the stress of parenting.The Caregiver Strain Questionnaire(CGSQ)was found to be useful to measure parenting stress,but it has not been validated among...Background There is an urgent need in clinical practice to measure the stress of parenting.The Caregiver Strain Questionnaire(CGSQ)was found to be useful to measure parenting stress,but it has not been validated among the Chinese population.Aims To assess the reliability and construct validity of the Chinese version of CGSQ among Chinese parents.Methods From 2016 to 2017,266 parents(patient group)with a child having DSM-5-defined attention deficit hyperactivity disorder(ADHD)(n=107)or autism spectrum disorder(ASD)(n=159)and 268 parents of healthy children(control group)were recruited to the present study in Kunming,Yunnan province.All the parents were asked to fill out the Chinese version of CGSQ.We conducted exploratory factor analysis and confirmatory factor analysis(CFA)to verify construct validity of CGSQ in both patient and control groups.Cronbach’s α coefficient as an index of internal consistency was assessed for each subscale.Fourteen days later,23 subjects filled out the scale again.Intra-class correlation coefficient was calculated to evaluate the test-retest reliability.Results(1)Cronbach’s alpha of the global scale was 0.901 for the control group and 0.952 for the patient group.The test-retest reliability for the whole scale was 0.890;(2)CFA indicated that the three-factor model had better fitting indices compared with the two-factor model in both groups.Besides,the fitting indices in the patient group were more favourable than those of the control group,withχ2/df=1.564,Goodness-of Fit Index=0.841,Comparative Fit Index=0.954,and root mean square error of approximation=0.065 for the patient group at three-factor model;(3)The caregiver strain of ASD parents was statistically higher than that of ADHD parents,and caregiver strain of ADHD parents was higher than that of control group.Conclusion These findings provide initial evidence to support the construct validity and reliability of CGSQ as a parenting stress measurement tool for Chinese parents,especially for parents of children with ADHD or ASD.展开更多
The article“Changes of Serum Insulin-like Growth Factor-2 Response to Negative Symptom Improvements in Schizophrenia Patients Treated with Atypical Antipsychotics”,written by Xue-lin CHAO,Shu-zhen JIANG,Jian-wen XIO...The article“Changes of Serum Insulin-like Growth Factor-2 Response to Negative Symptom Improvements in Schizophrenia Patients Treated with Atypical Antipsychotics”,written by Xue-lin CHAO,Shu-zhen JIANG,Jian-wen XIONG,Jin-qiong ZHAN,Bo WEI,Chun-nuan CHEN,Yuan-jian YANG was originally published electronically on the publisher's internet portal on June 2020 without open access.With the author(s)'decision to opt for Open Choice,the copyright of the article is changed to,The Author(s)2020 and the article is forthwith distributed under a Creative Commons Attribution 4.0 International License(http://creativecommons.org/licenses/by/4.0),which permits use,sharing,adaptation,distribution and reproduction in any medium or format,as long as you give appropriate credit to the original author(s)and the source,provide a link to the Creative Commons license,and indicate if changes were made.展开更多
BACKGROUND Single-nucleotide polymorphisms(SNPs)of the serotonin type 3 receptor subunit(HTR3)genes have been associated with psychosomatic symptoms,but it is not clear whether these associations exist in irritable bo...BACKGROUND Single-nucleotide polymorphisms(SNPs)of the serotonin type 3 receptor subunit(HTR3)genes have been associated with psychosomatic symptoms,but it is not clear whether these associations exist in irritable bowel syndrome(IBS).AIM To assess the association of HTR3 polymorphisms with depressive,anxiety,and somatization symptoms in individuals with IBS.METHODS In this retrospective study,623 participants with IBS were recruited from five specialty centers in Germany,Sweden,the United States,the United Kingdom,and Ireland.Depressive,anxiety,and somatization symptoms and sociodemographic characteristics were collected.Four functional SNPs—HTR3A c.-42C>T,HTR3B c.386A>C,HTR3C c.489C>A,and HTR3E c.*76G>A—were genotyped and analyzed using the dominant and recessive models.We also performed separate analyses for sex and IBS subtypes.SNP scores were calculated as the number of minor alleles of the SNPs above.The impact of HTR3C c.489C>A was tested by radioligand-binding and calcium influx assays.RESULTS Depressive and anxiety symptoms significantly worsened with increasing numbers of minor HTR3C c.489C>A alleles in the dominant model(F_(depressive)=7.475,P_(depressive)=0.006;F_(anxiety)=6.535,P_(anxiety)=0.011).A higher SNP score(range 0-6)was linked to a worsened depressive symptoms score(F=7.710,P-linear trend=0.006)in IBS.The potential relevance of the HTR3C SNP was corroborated,showing changes in the expression level of 5-HT3AC variant receptors.CONCLUSION We have provided the first evidence that HTR3C c.489C>A is involved in depressive and anxiety symptoms in individuals with IBS.The SNP score indicated that an increasing number of minor alleles is linked to the worsening of depressive symptoms in IBS.展开更多
Nausea and/or vomiting are aversive gastrointestinal (GI) symptoms. Nausea and vomiting manifest unconditionally after a nauseogenic experience. However, there is correlative, quasiexperimental and experimental eviden...Nausea and/or vomiting are aversive gastrointestinal (GI) symptoms. Nausea and vomiting manifest unconditionally after a nauseogenic experience. However, there is correlative, quasiexperimental and experimental evidence that nausea and vomiting can also be learned via classical (Pavlovian) conditioning and might occur in anticipation of the nauseogenic event. Classical conditioning of nausea can develop with chemotherapy in cancer patients. Initially, nausea and vomiting occur during and after the administration of cytotoxic drugs (post-treatment nausea and vomiting) as unconditioned responses (UR). In addition, 20%-30% of cancer patients receiving chemotherapy report these side effects, despite antiemetic medication, when being re-exposed to the stimuli that usually signal the chemotherapy session and its drug infusion. These symptoms are called anticipatory nausea (AN) and/or anticipatory vomiting (ANV) and are explained by classical conditioning. Moreover, there is recent evidence for the assumption that post- chemotherapy nausea is at least partly influenced by learning. After summarizing the relevant assumptions of the conditioning model, revealing that a context can become a conditioned stimulus (CS), the present paper summarizes data that nausea and/or vomiting is acquired by classical conditioning and, consequently, may be alleviated by conditioning techniques. Our own research has focussed on two aspects and is emphasized here. First, a conditioned nausea model was established in healthy humans using body rotation as the nausea- inducing treatment. The validity of this motion-sickness model to examine conditioning mechanisms in the acquisition and alleviation of conditioned nausea and associated endocrine and immunological responses issummarized. Results from the rotation-induced motion sickness model showed that gender is an important moderator variable to be considered in further studies. This paper concludes with a review of the application of the demonstrated conditioning principles as interventions to ameliorate distressing AN/ANV in cancer patients undergoing chemotherapy, which is the second focus of our work.展开更多
One fi fth of the population report adverse reactions to food. Reasons for these symptoms are heterogeneous, varying from food allergy, food intolerance, irritable bowel syndrome to somatoform or other mental disorder...One fi fth of the population report adverse reactions to food. Reasons for these symptoms are heterogeneous, varying from food allergy, food intolerance, irritable bowel syndrome to somatoform or other mental disorders. Literature reveals a large discrepancy between truly diagnosed food allergy and reports of food allergy symptoms by care seekers. In most studies currently available the characterization of patient groups is incomplete, because they did not distinguish between immunologic reactions and other kinds of food reactions. In analysing these adverse reactions, a thorough physical and psychological diagnostic approach is important. In our qualitative review, we present those diagnostic measures that are evidenced-based as well as clinically useful, and discuss the various psychological dimensions of adverse reactions to food. It is important to acknowledge the complex interplay between body and mind: Adults and children suffering from food allergy show impaired quality of life and a higher level of stress and anxiety. Pavlovian conditioning of adverse reactions plays an important role in maintaining symptoms. The role of personality, mood, or anxiety in food reactions is debatable. Somatoform disorders ought to be identifi ed early to avoid lengthy and frustrating investigations. A future task will be to improve diagnostic algorithms, to describe psychological aspects in clearly characterised patient subgroups, and to develop strategies for an optimized management of the various types of adverse reactions to food.展开更多
Background:Currently,diagnosis of major depressive disorder(MDD)still relies on symptoms.There are some problems for the diagnostic criteria,like low diagnostic consistency and difficulty in differentiation of MDD and...Background:Currently,diagnosis of major depressive disorder(MDD)still relies on symptoms.There are some problems for the diagnostic criteria,like low diagnostic consistency and difficulty in differentiation of MDD and bipolar depression(BD)in the early stage.In terms of treatment,there are also many problems,such as low overall efficiency,slow onset effect,and large differences between individuals.At present,there are a lot of researches on MDD biomarkers,most focus on genomics,transcriptomics,proteomics and brain imaging both from domestic and foreign counterparts,but the main research focuses are genetics and imaging.This study is mainly combine genetics and imaging to conduct the discussions of MDD diagnosis and efficacy prediction biomarkers.Methods:Proteomics mainly included patients who met the diagnostic criteria.Blood samples were taken from the participants.Serum was collected after centrifugation for serum protein concentration detection.Receiver operation curve(ROC)analysis was used to test the diagnostic and differential powers of the single serum proteins or combined serum proteins.In the imageology groups,the 3.0T cranial magnetic resonance imaging(MRI)scan was performed on the subjects meeting the inclusion criteria,and the methods based on the deep learning of the resting-state fMRI data was used.The biological marker spectrums from molecular levels(genotyping or measuring genetic products)to clinical levels(depicting cognitive and motivational areas or clinical symptoms)to predict the outcome of the treatment.Results:In the diagnosis of MDD,accord to the results of previous animal experiments and clinical studies,we developed a highly accurate MDD diagnostic platform based on the serum levels of proteins in the P11-tPA-BDNF pathway.The sensitivity of the MDD diagnostic platform was 88.1%,specificity was 92.7%,and accuracy was as high as 90.6%.Based on the above findings,we further studied the diagnosis and differential diagnosis efficacy of serum proteins levels in this pathway for five common psychiatric diseases:schizophrenia(SZ),MDD,bipolar mania(BM),BD,and panic disorder(PD).The results suggest that the combination of serum proteins levels(tPA,PAI-1,BDNF,proBDNF,TrkB,p75NTR)in this pathway has a high accuracy not only in the diagnosis and differential diagnosis of MDD,but also in the diagnosis and identification of SZ,BM,BD and PD,which can be used as a diagnostic platform for common mental diseases.After that,we further studied serum VGF and BICC1 proteins upstream or downstream of this pathway.We found that serum VGF levels decreased in MDD while increased in BD patients compared with healthy controls(HC),had a significant ability for identifying MDD and BD,and its sensitivity is 95%,specificity is 100%,and the accuracy is up to 95%.Similarly,BICC1 also has a good diagnostic and differential efficacy in MDD,BM,and BD.We also found that facial expressions also contribute to the diagnosis and severity of MDD.In addition,imaging studies also showed that MDD patients have characteristics of small-world networks that are different from other populations,showing an increase in the characteristic path length(Lp)and a decrease in network efficiency(E),which is beneficial to the diagnosis and differential diagnosis of MDD.In the efficacy of MDD,we found that CMHC differences are existed in the precuneus and infraorbital gyrus between responsive depression(RD)group and non-responding depression(NRD)group,and the precuneus VMHC values of RD group were significantly negatively associated with the baseline scores of Hamilton depression rating scale(HAMD).ROC analysis showed that combining the VMHC values of above-mentioned brain regions can distinguish NRD more effectively.Similarly,imaging studies also found that the left ORBsup node was lower than that of the HC group,while the right ORBinf was increased;right dorsolateral superior frontal gyrus(SFGdor)nodes are lower when compare to NRD that may be the basis for different therapeutic effects.The combined ROC analysis showed that the degree of right SFGdor node and the characteristic path length can predict NRD well.We also found that there are significant correlations between bilateral NAcc network connectivity property and the severity as well as early efficacy of MDD,and the temporal variability between different efficacy MDD groups is different.The bimodal analysis based on CBF+ALFF showed that ALFF values of the bilateral occipital gyrus(MOG),left lentiform nuclear(lentiform),right superior temporal gyrus,and CBF and ALFF of right calcarine gyrus(Calcarine)and left caudate nucleus(Caudate)are significantly correlated with the severity or early efficacy of MDD at baseline.Including CBF of left Caudate and right middle frontal gyrus as well as ALFF of right inferior temporal gyrus can predict NRD better.Conclusion:Both proteomics and imaging have the feasibility of developing an objective tool for the diagnosis and efficacy evaluation of MDD.In the future,larger samples of clinical studies are needed to obtain repeatable,scientific,and reliable specific biomarkers for the differential diagnosis of MDD and BD,and the precise clinical diagnosis and treatment of MDD.展开更多
Somatic symptom disorder(SSD)is a new diagnosis introduced into the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),which is expected to solve the diagnostic difficulties of patients with me...Somatic symptom disorder(SSD)is a new diagnosis introduced into the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),which is expected to solve the diagnostic difficulties of patients with medically unexplained symptoms.Based on the previous work,this review aims to comprehensively synthesise updated evidence related to SSD from recent years in English publications and,more extensively,from data published in Chinese language journals.The scoping review update was based on an earlier scoping review and included Chinese language publication data from China National Knowledge Internet(CNKI),WANFANG and WEIPU between January 2013 and May 2022 and data from PubMed,PsyclNFO,and Cochrane Library between June 2020 and May 2022.Initially,2984 articles were identified,of which 63 full texts were included for analysis.In China,SSD is mainly applied in scientific research,but it also shows good predictive validity and clinical application potential.The mean frequency of SSD was 4.5%in the general population,25.2%in the primary care population and 33.5%in diverse specialised care settings.Biological factors,such as brain region changes and heart rate variability,are associated with the onset of sSD.Psychological impairment related to somatic symptoms is the best predictor of prognosis.While adolescent SSD is significantly associated with family function,SSD overall is associated with an increased dysfunction of cognition and emotion,decreased quality of life,and high comorbidity with anxiety and depressive disorders.Further research is needed on suicide risk and cultural and gender-related issues.Updating the data of Chinese language studies,our research enriches the evidence-based findings related to the topics addressed in the text sections of the SSD chapter of DSM-5.However,research gaps remain about SSD reliability,population-based prevalence,suicide risk,and cultural and gender-related issues.展开更多
Background Insomnia disorder(ID)is one of the most common mental disorders.Research on ID focuses on exploring its mechanism of disease,novel treatments and treatment outcome prediction.An emerging technique in this f...Background Insomnia disorder(ID)is one of the most common mental disorders.Research on ID focuses on exploring its mechanism of disease,novel treatments and treatment outcome prediction.An emerging technique in this field is the use of electroencephalography(EEG)microstates,which offer a new method of EEG feature extraction that incorporates information from both temporal and 6/spatial dimensions.Aims To explore the electrophysiological mechanisms of repetitive transcranial magnetic stimulation(rTMS)for ID treatment and use baseline microstate metrics for the prediction of its efficacy.Methods This study included 60 patients with ID and 40 age-matched and gender-matched good sleep controls(GSC).Their resting-state EEG microstates were analysed,and the Pittsburgh Sleep Quality Index(PSQI)and polysomnography(PSG)were collected to assess sleep quality.The 60 patients with ID were equally divided into active and sham groups to receive rTMS for 20 days to test whether rTMS had a moderating effect on abnormal microstates in patients with ID.Furthermore,in an independent group of 90 patients with ID who received rTMS treatment,patients were divided into optimal and suboptimal groups based on their median PSQI reduction rate.Baseline EEG microstates were used to build a machine-learning predictive model for the effects of rTMS treatment.Results The class D microstate was less frequent and contribute in patients with ID,and these abnormalities were associated with sleep onset latency as measured by PSG.Additinally,the abnormalities were partially reversed to the levels observed in the GSC group following rTMS treatment.The baseline microstate characteristics could predict the therapeutic effect of ID after 20 days of rTMS,with an accuracy of 80.13%.Conclusions Our study highlights the value of EEG microstates as functional biomarkers of ID and provides a new perspective for studying the neurophysiological mechanisms of ID.In addition,we predicted the therapeutic effect of rTMS on ID based on the baseline microstates of patients with ID.This finding carries great practical significance for the selection of therapeutic options for patients with ID.展开更多
文摘BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few studies have focused on the factors related to SI,and effective predictive models are lacking.AIM To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention.METHODS The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed.Based on whether or not they had SI,they were divided into a SI group(n=91)and a non-SI group(n=59).The general data and laboratory indices of the two groups were compared.Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression,a nomogram prediction model was constructed based on the analysis results,and internal evaluation was performed.Receiver operating characteristic and calibration curves were used to evaluate the model’s efficacy,and the clinical application value was evaluated using decision curve analysis(DCA).RESULTS There were differences in trauma history,triggers,serum ferritin levels(SF),highsensitivity C-reactive protein levels(hs-CRP),and high-density lipoprotein(HDLC)levels between the two groups(P<0.05).Logistic regression analysis showed that trauma history,predisposing factors,SF,hs-CRP,and HDL-C were factors influencing SI in adolescent patients with depression.The area under the curve of the nomogram prediction model was 0.831(95%CI:0.763–0.899),sensitivity was 0.912,and specificity was 0.678.The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043,indicating that the model had a good fit.CONCLUSION The nomogram prediction model based on trauma history,triggers,ferritin,serum hs-CRP,and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.
基金the National Natural Science Foundation of China(81871426,81871430,82260359,U22A20303)Hebei Provincial Natural Science Foundation(H2020206263,H2020206625)STI2030-Major Projects Program(2022ZD0214500).
文摘To the editor:Insomnia disorder has a serious and widespread detrimental effect on humans with comorbidity with other mental or physical health problems.In recent years,noninvasive brain stimulation(NIBS)techniques,especially transcranial magnetic stimulation(TMS)and transcranial electrical stimulation,have been increasingly used for the treatment of brain diseases,including insomnia disorder.
基金Supported by Sichuan Provincial Health and Family Planning Commission,China,No.17PJ088.
文摘BACKGROUND Chronic subdural effusion is very common in the cranial imaging of middle-aged and older people.Herein,we report a patient misdiagnosed with subdural effusion,who was eventually diagnosed with chronic subdural empyema(SDE)caused by Streptococcus pneumoniae.CASE SUMMARY A 63-year-old man was brought to our emergency room with a headache,vomiting,and disturbed consciousness.Computed tomography(CT)revealed a bilateral subdural effusion at the top left side of the frontal lobe.Cerebrospinal fluid examination after lumbar puncture indicated suppurative meningitis,which improved after anti-infective therapy.However,the patient then presented with acute cognitive dysfunction and right limb paralysis.Repeat CT showed an increase in left frontoparietal subdural effusion,disappearance of the left lateral ventricle,and a shift of the midline to the right.Urgent burr hole drainage showed SDE that was culture-positive for Streptococcus pneumoniae.His condition improved after adequate drainage and antibiotic treatment.CONCLUSION Patients with unexplained subdural effusion,especially asymmetric subdural effusion with intracranial infection,should be assessed for chronic SDE.Early surgical treatment may be beneficial.
基金The study was approved by the Ethics Committee of Beijing Changping Hospital of Traditional and Western Medicine.
文摘BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.
基金Supported by The Sichuan Provincial People’s Hospital Translational Medicine Fund,No.2021LY02.
文摘BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the biomarkers that may predict better treatment.AIM To compare genome-wide methylation and gene expression patterns between responsive and non-responsive patients with PD after 4 wk of escitalopram treatment.METHODS Thirty patients with PD were enrolled in this study(responders=13;nonresponders=17).All patients were assessed using the PD Severity Scale-Chinese version before and after treatment.The Illumina Infinium MethylationEPIC(850k)BeadChip for genome-wide methylation screening and mRNA sequencing was used in all patients with PD.RESULTS A total of 701 differentially methylated positions(DMPs)were found between responders and non-responders(|Δβ|≥0.06,q<0.05),and the hyper-and hypomethylated CpG sites were 511(72.9%)and 190(27.1%),respectively.Relative to non-responders,there were 59 differential transcripts,of which 20 were downregulated and 39 were upregulated(q<0.05).However,no differen tially expressed genes were identified by mRNA sequencing after correcting for multiple testing(|log2(FC)|>1,q>0.05).CONCLUSION This preliminary study showed that DMPs might be associated with the treatment response to escitalopram in PD;however,these DMPs need to be verified in large samples.
文摘Background:Examine the degree of disability in adult ADHD patients in relation to the core symptoms attention deficits and hyperactivity and concomitant minimal cerebral dysfunctions.Methods:Patients from a psychosomatic rehabilitation hospital(N=1,453)had answered the“ADHS-SB(attention deficit hyperactivity scale)”,the“MCD-scale(minimal cerebral dysfunction self rating scale)”,the“SCL-90R(Symptom Checklist)”,and reported about impairment at work.Results:Psychological distress and the ability to work are primarily related to problems of orientation,cognitive impairment,vegetative lability,emotional problems,disorders of motor function,but only to a lesser degree to hyperactivity and attention deficit.Conclusion:When dealing with ADHD patients,clinicians should take into account the full variety of MCD symptoms as these are decisive in regard to participation and problems in life.
文摘This review describes the conceptual and clinical relations between irritable bowel syndrome(IBS),other functional,somatoform,and mental disorders,and points to appropriate future conceptualizations.IBS is considered to be a functional somatic syndrome(FSS)with a considerable symptom overlap with other FSSs like chronic fatigue syndrome or fibromyalgia syndrome.IBS patients show an increased prevalence of psychiatric symptoms and disorders,especially depression and anxiety.IBS is largely congruent with the concepts of somatoform and somatic symptom disorders.Roughly 50%of IBS patients complain of gastrointestinal symptoms only and have no psychiatric comorbidity.IBS concepts,treatment approaches,as well as health care structures should acknowledge its variability and multidimensionality by:(1)awareness of additional extraintestinal and psychobehavioral symptoms in patients with IBS;(2)general and collaborative care rather than specialist and separated care;and(3)implementation of"interface disorders"to abandon thedualistic classification of purely organic or purely mental disorders.
基金Supported by the Ethics Committee of Chongqing Three Gorges Central Hospitalthe Guiding Project of Science and Technology Plan for Social Development in Wanzhou District Chongqing,No.wzstc-z 201707
文摘BACKGROUND Laparoscopic radical gastrectomy is currently the most common surgical approach for gastric cancer.The main difference between totally laparoscopic total gastrectomy(TLTG)and laparoscopic-assisted total gastrectomy(LATG)is the route of digestive tract reconstruction.However,TLTG is currently not widespread as the safety and feasibility of intracorporeal esophagojejunostomy is uncertain.AIM To compare the short-term efficacy of TLTG and LATG for radical gastrectomy of gastric cancer,and to determine the safety and feasibility of intracorporeal esophagojejunostomy.METHODS PubMed,EMBASE,and Web of Science databases were searched for all relevant articles regarding TLTG vs LATG for gastric cancer published up to October 1,2019.Inclusion and exclusion criteria were established.All the basic conditions of patients and important clinical data related to surgery were extracted,and a meta-analysis was performed with RevMan 5.3 software.RESULTS Eight studies involving a total of 1883 cases(869 cases in the TLTG group and 1014 cases in the LATG group)were included.Compared with the LATG group,reduced intraoperative blood loss(weighted mean difference=-35.37,95%CI:-61.69--9.06,P=0.008)and a larger number of retrieved lymph nodes(weighted mean difference=3.11,95%CI:-2.60-12.00,P=0.01)were found in the TLTG group.There were no significant differences in operating time,anastomotic time,tumor size,proximal resection margin length,postoperative pain score,time to first flatus,time to first oral intake,postoperative hospital stay,postoperative anastomosis-related complication rate and overall complication rate between the two groups(P>0.05).CONCLUSION Intracorporeal esophagojejunostomy is safe and feasible.TLTG has the advantages of being minimally invasive,reduced intraoperative blood loss and easier access to lymph nodes compared with LATG.Totally laparoscopic gastrectomy is likely to be the surgical trend for gastric cancer in the future.
文摘Photobiomodulation using light in the red or near-infrared region is an innovative treatment strategy for a wide range of neurological and psychological conditions.Photobiomodulation can promote neurogenesis and elicit anti-apoptotic,antiinflammatory and antioxidative responses.Its therapeutic effects have been demonstrated in studies on neurological diseases,peripheral nerve injuries,pain relief and wound healing.We conducted a comprehensive literature review of the application of photobiomodulation in patients with central nervous system diseases in February 2019.The NCBI PubMed database,EMBASE database,Cochrane Library and ScienceDirect database were searched.We reviewed 95 papers and analyzed.Photobiomodulation has wide applicability in the treatment of stroke,traumatic brain injury,Parkinson’s disease,Alzheimer’s disease,major depressive disorder,and other diseases.Our analysis provides preliminary evidence that PBM is an effective therapeutic tool for the treatment of central nervous system diseases.However,additional studies with adequate sample size are needed to optimize treatment parameters.
基金Supported by the National Natural Science Foundation of China(No.81870634)
文摘AIM: To examine the influences of personality characteristics and coping modes on the anxiety of primary glaucoma patients.METHODS: A total of 200 individuals, including 50 with primary angle-closure glaucoma, 60 with primary open angle glaucoma and 90 control participants, filled out the State-Trait Anxiety Inventory, NEO Five-Factor Inventory, and Medical Coping Modes Questionnaire. Sociodemographic information was also collected. Data were analyzed via the Spearman rank correlation test and stepwise regression.RESULTS: The personality and coping variables are predictive and jointly account for a significant amount (45.3%-54.2%) of variance across the two subscales of anxiety measures. Notably, neuroticism seems to be most closely related to anxiety disturbances in glaucoma patients. The level of resignation is positively linked to anxiety scores.CONCLUSION: Some personality factors and coping modes help to predict the process of anxiety disorders in primary glaucoma patients. Recognizing the predictive role of these variables in the patients may further enrich clinical research in glaucoma and help to design more effective interventions involving both ophthalmology and psychiatry.
基金This work was supported by grants from the National Natural Science Foundation of China(No.81760254)the Natural Science Foundation of Fujian Province of China(No.2019J01164)the Scientific Foundation of Quanzhou City for High Level Talents(No.2019C075R).
文摘Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown that decreased serum IGF-2 was correlated with the severity of psychopathology in patients with schizophrenia.Here we conducted a prospective observation trial to investigate the effects of atypical antipsychotics on serum IGF-2 level and its relationship with clinical improvements in schizophrenia patients.Thirty-one schizophrenia patients with acute exacerbation and 30 healthy individuals were recruited in this study.Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale(PANSS)and serum IGF-2 levels were determined using ELISA.We found that schizophrenia patients with acute exacerbation had lower serum IGF-2 levels than control individuals at baseline(P<0.05).After 2 months of atypical antipsychotic treatment,a significant improvement in each PANSS subscore and total score was observed in patients(all P<0.01),and the serum IGF-2 levels of patients were significantly increased compared with those at baseline(203.13±64.62 vs.426.99±124.26 ng/mL;t=−5.044,P<0.001).Correlation analysis revealed that the changes of serum IGF-2 levels in patients were significantly correlated with the improvements of negative symptoms(r=−0.522,P=0.006).Collectively,our findings demonstrated changes of serum IGF-2 response to improvements of negative symptoms in schizophrenia patients treated with atypical antipsychotics,suggesting that serum IGF-2 might be a treatment biomarker for schizophrenia.
基金This work was supported by the National Natural Science Foundation of China(Grant No.81460218,30900488)National Key Technology Research and Development Program of the Ministry of Science and Technology of China(Grant No.2015BAI13B01).
文摘Background There is an urgent need in clinical practice to measure the stress of parenting.The Caregiver Strain Questionnaire(CGSQ)was found to be useful to measure parenting stress,but it has not been validated among the Chinese population.Aims To assess the reliability and construct validity of the Chinese version of CGSQ among Chinese parents.Methods From 2016 to 2017,266 parents(patient group)with a child having DSM-5-defined attention deficit hyperactivity disorder(ADHD)(n=107)or autism spectrum disorder(ASD)(n=159)and 268 parents of healthy children(control group)were recruited to the present study in Kunming,Yunnan province.All the parents were asked to fill out the Chinese version of CGSQ.We conducted exploratory factor analysis and confirmatory factor analysis(CFA)to verify construct validity of CGSQ in both patient and control groups.Cronbach’s α coefficient as an index of internal consistency was assessed for each subscale.Fourteen days later,23 subjects filled out the scale again.Intra-class correlation coefficient was calculated to evaluate the test-retest reliability.Results(1)Cronbach’s alpha of the global scale was 0.901 for the control group and 0.952 for the patient group.The test-retest reliability for the whole scale was 0.890;(2)CFA indicated that the three-factor model had better fitting indices compared with the two-factor model in both groups.Besides,the fitting indices in the patient group were more favourable than those of the control group,withχ2/df=1.564,Goodness-of Fit Index=0.841,Comparative Fit Index=0.954,and root mean square error of approximation=0.065 for the patient group at three-factor model;(3)The caregiver strain of ASD parents was statistically higher than that of ADHD parents,and caregiver strain of ADHD parents was higher than that of control group.Conclusion These findings provide initial evidence to support the construct validity and reliability of CGSQ as a parenting stress measurement tool for Chinese parents,especially for parents of children with ADHD or ASD.
文摘The article“Changes of Serum Insulin-like Growth Factor-2 Response to Negative Symptom Improvements in Schizophrenia Patients Treated with Atypical Antipsychotics”,written by Xue-lin CHAO,Shu-zhen JIANG,Jian-wen XIONG,Jin-qiong ZHAN,Bo WEI,Chun-nuan CHEN,Yuan-jian YANG was originally published electronically on the publisher's internet portal on June 2020 without open access.With the author(s)'decision to opt for Open Choice,the copyright of the article is changed to,The Author(s)2020 and the article is forthwith distributed under a Creative Commons Attribution 4.0 International License(http://creativecommons.org/licenses/by/4.0),which permits use,sharing,adaptation,distribution and reproduction in any medium or format,as long as you give appropriate credit to the original author(s)and the source,provide a link to the Creative Commons license,and indicate if changes were made.
基金results in part from collaboration and network activities promoted under the frame of the international network GENIEUR (Genes in Irritable Bowel Syndrome Research Network Europe),which has been funded by the COST program (BM1106, www.GENIEUR.eu)currently supported by the European Society of Neurogastroenterology and Motility (ESNM, www.ESNM.eu)
文摘BACKGROUND Single-nucleotide polymorphisms(SNPs)of the serotonin type 3 receptor subunit(HTR3)genes have been associated with psychosomatic symptoms,but it is not clear whether these associations exist in irritable bowel syndrome(IBS).AIM To assess the association of HTR3 polymorphisms with depressive,anxiety,and somatization symptoms in individuals with IBS.METHODS In this retrospective study,623 participants with IBS were recruited from five specialty centers in Germany,Sweden,the United States,the United Kingdom,and Ireland.Depressive,anxiety,and somatization symptoms and sociodemographic characteristics were collected.Four functional SNPs—HTR3A c.-42C>T,HTR3B c.386A>C,HTR3C c.489C>A,and HTR3E c.*76G>A—were genotyped and analyzed using the dominant and recessive models.We also performed separate analyses for sex and IBS subtypes.SNP scores were calculated as the number of minor alleles of the SNPs above.The impact of HTR3C c.489C>A was tested by radioligand-binding and calcium influx assays.RESULTS Depressive and anxiety symptoms significantly worsened with increasing numbers of minor HTR3C c.489C>A alleles in the dominant model(F_(depressive)=7.475,P_(depressive)=0.006;F_(anxiety)=6.535,P_(anxiety)=0.011).A higher SNP score(range 0-6)was linked to a worsened depressive symptoms score(F=7.710,P-linear trend=0.006)in IBS.The potential relevance of the HTR3C SNP was corroborated,showing changes in the expression level of 5-HT3AC variant receptors.CONCLUSION We have provided the first evidence that HTR3C c.489C>A is involved in depressive and anxiety symptoms in individuals with IBS.The SNP score indicated that an increasing number of minor alleles is linked to the worsening of depressive symptoms in IBS.
文摘Nausea and/or vomiting are aversive gastrointestinal (GI) symptoms. Nausea and vomiting manifest unconditionally after a nauseogenic experience. However, there is correlative, quasiexperimental and experimental evidence that nausea and vomiting can also be learned via classical (Pavlovian) conditioning and might occur in anticipation of the nauseogenic event. Classical conditioning of nausea can develop with chemotherapy in cancer patients. Initially, nausea and vomiting occur during and after the administration of cytotoxic drugs (post-treatment nausea and vomiting) as unconditioned responses (UR). In addition, 20%-30% of cancer patients receiving chemotherapy report these side effects, despite antiemetic medication, when being re-exposed to the stimuli that usually signal the chemotherapy session and its drug infusion. These symptoms are called anticipatory nausea (AN) and/or anticipatory vomiting (ANV) and are explained by classical conditioning. Moreover, there is recent evidence for the assumption that post- chemotherapy nausea is at least partly influenced by learning. After summarizing the relevant assumptions of the conditioning model, revealing that a context can become a conditioned stimulus (CS), the present paper summarizes data that nausea and/or vomiting is acquired by classical conditioning and, consequently, may be alleviated by conditioning techniques. Our own research has focussed on two aspects and is emphasized here. First, a conditioned nausea model was established in healthy humans using body rotation as the nausea- inducing treatment. The validity of this motion-sickness model to examine conditioning mechanisms in the acquisition and alleviation of conditioned nausea and associated endocrine and immunological responses issummarized. Results from the rotation-induced motion sickness model showed that gender is an important moderator variable to be considered in further studies. This paper concludes with a review of the application of the demonstrated conditioning principles as interventions to ameliorate distressing AN/ANV in cancer patients undergoing chemotherapy, which is the second focus of our work.
文摘One fi fth of the population report adverse reactions to food. Reasons for these symptoms are heterogeneous, varying from food allergy, food intolerance, irritable bowel syndrome to somatoform or other mental disorders. Literature reveals a large discrepancy between truly diagnosed food allergy and reports of food allergy symptoms by care seekers. In most studies currently available the characterization of patient groups is incomplete, because they did not distinguish between immunologic reactions and other kinds of food reactions. In analysing these adverse reactions, a thorough physical and psychological diagnostic approach is important. In our qualitative review, we present those diagnostic measures that are evidenced-based as well as clinically useful, and discuss the various psychological dimensions of adverse reactions to food. It is important to acknowledge the complex interplay between body and mind: Adults and children suffering from food allergy show impaired quality of life and a higher level of stress and anxiety. Pavlovian conditioning of adverse reactions plays an important role in maintaining symptoms. The role of personality, mood, or anxiety in food reactions is debatable. Somatoform disorders ought to be identifi ed early to avoid lengthy and frustrating investigations. A future task will be to improve diagnostic algorithms, to describe psychological aspects in clearly characterised patient subgroups, and to develop strategies for an optimized management of the various types of adverse reactions to food.
文摘Background:Currently,diagnosis of major depressive disorder(MDD)still relies on symptoms.There are some problems for the diagnostic criteria,like low diagnostic consistency and difficulty in differentiation of MDD and bipolar depression(BD)in the early stage.In terms of treatment,there are also many problems,such as low overall efficiency,slow onset effect,and large differences between individuals.At present,there are a lot of researches on MDD biomarkers,most focus on genomics,transcriptomics,proteomics and brain imaging both from domestic and foreign counterparts,but the main research focuses are genetics and imaging.This study is mainly combine genetics and imaging to conduct the discussions of MDD diagnosis and efficacy prediction biomarkers.Methods:Proteomics mainly included patients who met the diagnostic criteria.Blood samples were taken from the participants.Serum was collected after centrifugation for serum protein concentration detection.Receiver operation curve(ROC)analysis was used to test the diagnostic and differential powers of the single serum proteins or combined serum proteins.In the imageology groups,the 3.0T cranial magnetic resonance imaging(MRI)scan was performed on the subjects meeting the inclusion criteria,and the methods based on the deep learning of the resting-state fMRI data was used.The biological marker spectrums from molecular levels(genotyping or measuring genetic products)to clinical levels(depicting cognitive and motivational areas or clinical symptoms)to predict the outcome of the treatment.Results:In the diagnosis of MDD,accord to the results of previous animal experiments and clinical studies,we developed a highly accurate MDD diagnostic platform based on the serum levels of proteins in the P11-tPA-BDNF pathway.The sensitivity of the MDD diagnostic platform was 88.1%,specificity was 92.7%,and accuracy was as high as 90.6%.Based on the above findings,we further studied the diagnosis and differential diagnosis efficacy of serum proteins levels in this pathway for five common psychiatric diseases:schizophrenia(SZ),MDD,bipolar mania(BM),BD,and panic disorder(PD).The results suggest that the combination of serum proteins levels(tPA,PAI-1,BDNF,proBDNF,TrkB,p75NTR)in this pathway has a high accuracy not only in the diagnosis and differential diagnosis of MDD,but also in the diagnosis and identification of SZ,BM,BD and PD,which can be used as a diagnostic platform for common mental diseases.After that,we further studied serum VGF and BICC1 proteins upstream or downstream of this pathway.We found that serum VGF levels decreased in MDD while increased in BD patients compared with healthy controls(HC),had a significant ability for identifying MDD and BD,and its sensitivity is 95%,specificity is 100%,and the accuracy is up to 95%.Similarly,BICC1 also has a good diagnostic and differential efficacy in MDD,BM,and BD.We also found that facial expressions also contribute to the diagnosis and severity of MDD.In addition,imaging studies also showed that MDD patients have characteristics of small-world networks that are different from other populations,showing an increase in the characteristic path length(Lp)and a decrease in network efficiency(E),which is beneficial to the diagnosis and differential diagnosis of MDD.In the efficacy of MDD,we found that CMHC differences are existed in the precuneus and infraorbital gyrus between responsive depression(RD)group and non-responding depression(NRD)group,and the precuneus VMHC values of RD group were significantly negatively associated with the baseline scores of Hamilton depression rating scale(HAMD).ROC analysis showed that combining the VMHC values of above-mentioned brain regions can distinguish NRD more effectively.Similarly,imaging studies also found that the left ORBsup node was lower than that of the HC group,while the right ORBinf was increased;right dorsolateral superior frontal gyrus(SFGdor)nodes are lower when compare to NRD that may be the basis for different therapeutic effects.The combined ROC analysis showed that the degree of right SFGdor node and the characteristic path length can predict NRD well.We also found that there are significant correlations between bilateral NAcc network connectivity property and the severity as well as early efficacy of MDD,and the temporal variability between different efficacy MDD groups is different.The bimodal analysis based on CBF+ALFF showed that ALFF values of the bilateral occipital gyrus(MOG),left lentiform nuclear(lentiform),right superior temporal gyrus,and CBF and ALFF of right calcarine gyrus(Calcarine)and left caudate nucleus(Caudate)are significantly correlated with the severity or early efficacy of MDD at baseline.Including CBF of left Caudate and right middle frontal gyrus as well as ALFF of right inferior temporal gyrus can predict NRD better.Conclusion:Both proteomics and imaging have the feasibility of developing an objective tool for the diagnosis and efficacy evaluation of MDD.In the future,larger samples of clinical studies are needed to obtain repeatable,scientific,and reliable specific biomarkers for the differential diagnosis of MDD and BD,and the precise clinical diagnosis and treatment of MDD.
文摘Somatic symptom disorder(SSD)is a new diagnosis introduced into the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),which is expected to solve the diagnostic difficulties of patients with medically unexplained symptoms.Based on the previous work,this review aims to comprehensively synthesise updated evidence related to SSD from recent years in English publications and,more extensively,from data published in Chinese language journals.The scoping review update was based on an earlier scoping review and included Chinese language publication data from China National Knowledge Internet(CNKI),WANFANG and WEIPU between January 2013 and May 2022 and data from PubMed,PsyclNFO,and Cochrane Library between June 2020 and May 2022.Initially,2984 articles were identified,of which 63 full texts were included for analysis.In China,SSD is mainly applied in scientific research,but it also shows good predictive validity and clinical application potential.The mean frequency of SSD was 4.5%in the general population,25.2%in the primary care population and 33.5%in diverse specialised care settings.Biological factors,such as brain region changes and heart rate variability,are associated with the onset of sSD.Psychological impairment related to somatic symptoms is the best predictor of prognosis.While adolescent SSD is significantly associated with family function,SSD overall is associated with an increased dysfunction of cognition and emotion,decreased quality of life,and high comorbidity with anxiety and depressive disorders.Further research is needed on suicide risk and cultural and gender-related issues.Updating the data of Chinese language studies,our research enriches the evidence-based findings related to the topics addressed in the text sections of the SSD chapter of DSM-5.However,research gaps remain about SSD reliability,population-based prevalence,suicide risk,and cultural and gender-related issues.
基金supported by the National Natural Science Foundation of China(Grant Nos.82371500,82260359,U22A20303)Hebei Provincial Natural Science Foundation(H2020206625,H2020206263)+2 种基金STI2030:2022ZD0214500,National Key Research and Development Program of Hunan Province(2021SK2023)Natural Science Foundation of Inner Mongolia 2021MS08014,2023QN08007,Hunan Provincial Natural Science Foundation of China(Grant No.2023JJ30412)the Fundamental Research Funds for the Central Universities(Grant No.QTZX23094).
文摘Background Insomnia disorder(ID)is one of the most common mental disorders.Research on ID focuses on exploring its mechanism of disease,novel treatments and treatment outcome prediction.An emerging technique in this field is the use of electroencephalography(EEG)microstates,which offer a new method of EEG feature extraction that incorporates information from both temporal and 6/spatial dimensions.Aims To explore the electrophysiological mechanisms of repetitive transcranial magnetic stimulation(rTMS)for ID treatment and use baseline microstate metrics for the prediction of its efficacy.Methods This study included 60 patients with ID and 40 age-matched and gender-matched good sleep controls(GSC).Their resting-state EEG microstates were analysed,and the Pittsburgh Sleep Quality Index(PSQI)and polysomnography(PSG)were collected to assess sleep quality.The 60 patients with ID were equally divided into active and sham groups to receive rTMS for 20 days to test whether rTMS had a moderating effect on abnormal microstates in patients with ID.Furthermore,in an independent group of 90 patients with ID who received rTMS treatment,patients were divided into optimal and suboptimal groups based on their median PSQI reduction rate.Baseline EEG microstates were used to build a machine-learning predictive model for the effects of rTMS treatment.Results The class D microstate was less frequent and contribute in patients with ID,and these abnormalities were associated with sleep onset latency as measured by PSG.Additinally,the abnormalities were partially reversed to the levels observed in the GSC group following rTMS treatment.The baseline microstate characteristics could predict the therapeutic effect of ID after 20 days of rTMS,with an accuracy of 80.13%.Conclusions Our study highlights the value of EEG microstates as functional biomarkers of ID and provides a new perspective for studying the neurophysiological mechanisms of ID.In addition,we predicted the therapeutic effect of rTMS on ID based on the baseline microstates of patients with ID.This finding carries great practical significance for the selection of therapeutic options for patients with ID.
