Background Despite high relapse rate among methamphetamine (MA) abusers, there still have been little empirical data to date detecting the risk factors related to craving and relapse from the perspective of MA abusers...Background Despite high relapse rate among methamphetamine (MA) abusers, there still have been little empirical data to date detecting the risk factors related to craving and relapse from the perspective of MA abusers. Therefore, the aim of this study was to use qualitative research methods exploring the strengths, weaknesses, opportunities and threat factors that could facilitate or impede individuals' abstinence in a real-life context from the perspectives of MA abusers. Aim To use qualitative research methods exploring the strengths, weaknesses, opportunities and threat factors relating to individuals' abstinence in a real-life context. Method Semistructured interviews were conducted with 32 MA abusers recruited in Shanghai guided by open-ended questions on narrating the real-life catalysts and inhibitors related to craving, initiation, relapse and abstinence. All data were transcribed verbatim and analysed using a strengths, weaknesses, opportunities and threats (SWOT) analysis. Results The results of the SWOT analysis revealed that contextual factors including peer influence, prevalence and availability of MA, familiar venue of MA use, discrimination, sexual behaviours, alcohol, emotional states and their attitudes towards smoking MA were important factors that contribute to reinitiation and relapse. Surveillance systems, antidrug social workers, vocational skills trainings, moving to another city and family responsibility might serve as counter measures targeti叩 those mentioned weaknesses and threats above. Conclusion This SWOT analysis highlights the complex nature of relapse. Comprehensive interventions strengtheni叩 coping skills such as virtual reality techniques are desperately needed to facilitate individuals1 sustained abstinence.展开更多
Background Atypical antipsychotics as first-line drugs have been used in patients with schizophrenia in China and abroad.However,its safety still needs to be evaluated in a large population,especially in Chinese patie...Background Atypical antipsychotics as first-line drugs have been used in patients with schizophrenia in China and abroad.However,its safety still needs to be evaluated in a large population,especially in Chinese patients.Objective The main objective of this study is to evaluate the safety and related factors of long-term atypical antipsychotic use in patients with schizophrenia in China.The secondary objective includes the long-term efficacy of atypical antipsychotics in these patients,as well as pharmacoeconomic evaluation,population pharmacokinetic studies and pharmacogenomics studies.Methods This study has an observational design.The atypical antipsychotics include quetiapine,olanzapine,risperidone,aripiprazole,ziprasidone,paliperidone,amisulpride,perospirone and clozapine.Visits occur at 0,4,8,13,26,52,78,104,130 and 156 weeks.The efficacy evaluations include symptoms,social function,recurrence rate and hospitalisation.The safety measures include physical examination,vital signs,abdominal circumference,laboratory tests(such as blood cell analysis,blood biochemical tests and serum prolactin/thyroxine levels),12-lead ECG,extrapyramidal syndrome assessment,sexual function evaluation,medication and other adverse events.The secondary measures include the Positive and Negative Syndrome Scale,Clinical Global Impression-Severity of Illness Scale,Calgary Depression Scale for Schizophrenia,Personal and Social Performance Scale,relapse rate,drug consolidation,medical-related expenses,income,drug plasma concentration and genetic information.Results This is a large sample,non-interventional and long-term prospective clinical study designed to truly reflect the specific details of clinical practice,fully respect patients’needs,and understand patients’treatment intentions and actual treatment details.Conclusions This research method details the aims,methods,study design,strengths and limitations of the study.展开更多
In recent years,research on meditation as an important alternative therapy has developed rapidly and been widely applied in clinical medicine.Mechanism studies of meditation have also developed progressively,showing t...In recent years,research on meditation as an important alternative therapy has developed rapidly and been widely applied in clinical medicine.Mechanism studies of meditation have also developed progressively,showing that meditation has great impact on brain structure and function,and epigenetic and telomere regulation.In line with this,the application of meditation has gradually been expanded to mental illness,most often applied for major depressive disorders and substance-related and addictive disorders.The focus of this paper is to illustrate the biological mechanisms of meditation and its application in mental disorders.展开更多
Disturbance of biological rhythms contributes to the onset of bipolar disorders and is an important clinical feature of the condition.To further explore the role of biological rhythms in bipolar disorders,95 English a...Disturbance of biological rhythms contributes to the onset of bipolar disorders and is an important clinical feature of the condition.To further explore the role of biological rhythms in bipolar disorders,95 English articles published between 1968 and 2019 were retrieved from the PubMed database and analysed.We herein review the outcomes of studies on biological rhythm disturbance in bipolar disorders,including the epidemiology,aetiology,clinical features(eg,sleep,feeding and eating disorders)and treatment of the condition evaluated by patients*selfreport and biological indicators such as melatonin.Our report supports the characterisation of biological rhythm disturbance as a significant clinical feature affecting the onset and development of bipolar disorders and reviews classical and novel treatments,such as chronotherapy,that can be applied in the clinical practice.Our analysis indicates that a more comprehensive study of the pathophysiology,clinical phenomenology and treatment of biological rhythm disturbance is required.展开更多
INTRODUCTION There are many obstacles to developing,maintaining and strengthening international research collaborations,whether they are posed by geography,culture or,most recently,global economics and politics.It is ...INTRODUCTION There are many obstacles to developing,maintaining and strengthening international research collaborations,whether they are posed by geography,culture or,most recently,global economics and politics.It is critically important to overcome these obstacles,especially when it comes to fostering the types of breakthrough biomedical science that benefit from diverse perspectives,methodologies and data sets.Moreover,the research underlying these breakthroughs unfolds over the course of years,and even decades.For these reasons,and more,the Department of Psychiatry at Massachusetts General Hospital(Mass General)and the Shanghai Mental Health Center(SMHC)are taking the long view:exploring and implementing numerous collaborative research and training projects that are leading to better care and treatments for patients,both in the USA and China,who suffer from a range of psychiatric disorders.展开更多
To the Editor,Non-human primate(NHP)models are advantageous for mimicking human addiction with high behavioural validity.1 However,current NHP drug addiction models(eg,self-administration)often require a comprehensive...To the Editor,Non-human primate(NHP)models are advantageous for mimicking human addiction with high behavioural validity.1 However,current NHP drug addiction models(eg,self-administration)often require a comprehensive behavioural training paradigm,relatively expensive apparatus and invasive surgical procedures.展开更多
S Background Music therapy is a promising complementary intervention for addressing various mental health conditions.Despite evidence of the beneficial effects of music,the acoustic features that make music effective ...S Background Music therapy is a promising complementary intervention for addressing various mental health conditions.Despite evidence of the beneficial effects of music,the acoustic features that make music effective in therapeutic contexts remain elusive.Aims This study aimed to identify and validate distinctive acoustic features of healing music.Methods We constructed a healing music dataset(HMD)based on nominations from related professionals and extracted 370 acoustic features.Healing-distinctive acoustic features were identified as those that were(1)independent from genre within the HMD,(2)significantly different from music pieces in a classical music dataset(CMD)and(3)similar to pieces in a five-element music dataset(FEMD).We validated the identified features by comparing jazz pieces in the HMD with a jazz music dataset(JMD).We also examined the emotional properties of the features in a Chinese affective music system(CAMS).Results The HMD comprised 165 pieces.Among all the acoustic features,74.59%shared commonalities across genres,and 26.22%significantly differed between the HMD classical pieces and the CMD.The equivalence test showed that the HMD and FEMD did not differ significantly in 9.46%of the features.The potential healing-distinctive acoustic features were identified as the standard deviation of the roughness,mean and period entropy of the third coefficient of the mel-frequency cepstral coefficients.In a three-dimensional space defined by these features,HMD's jazz pieces could be distinguished from those of the JMD.These three features could significantly predict both subjective valence and arousal ratings in the CAMS.Conclusions The distinctive acoustic features of healing music that have been identified and validated in this study have implications for the development of artificial intelligence models for identifying therapeutic music,particularly in contexts where access to professional expertise may be limited.This study contributes to the growing body of research exploring the potential of digital technologies for healthcare interventions.展开更多
Background Aripiprazole(ARI)is often prescribed alone or in combination with other second-generation antipsychotics(SGAs)to treat patients with schizophrenia.However,this may increase the potential clinical significan...Background Aripiprazole(ARI)is often prescribed alone or in combination with other second-generation antipsychotics(SGAs)to treat patients with schizophrenia.However,this may increase the potential clinical significance of drug-drug interactions.Therapeutic drug monitoring(TDM)is an important and fundamental tool both when administering ARI alone and in combination with other SGAs to monitor ARI pharmacokinetics,adjust the dosage and thereby achieve more effective and safer treatment.Aims This study retrospectively investigated the effects of four SGA comedications(clozapine,risperidone,quetiapine(QTP)and olanzapine)and other potential factors(sex,age and ARI dose)on the serum concentrations of ARI and dehydroaripiprazole(DARI)in Chinese patients with schizophrenia using TDM data.Methods High-performance liquid chromatography was used to test the serum concentrations of ARI,DARI and ARI+DARI.In addition,steady-state dose-adjusted serum concentrations(ie,concentration-to dose ratios,C:D ratios)of ARI,DARI and ARI+DARI;sex;age;ARI dose and SGA comedication dose between 299 inpatients with schizophrenia who received ARI or SGA comedication were all collected and analysed.Spearman’s correlation and multiple linear regression analysis were used to evaluate bivariate associations between ARI dose and serum ARI and DARI concentrations and describe the effect of independent variables on serum ARI and DARI concentrations,respectively.Results There were significant differences in the C:D ratios of ARI(χ^(2)=−3.21,p=0.001)and ARI+DARI(χ^(2)=−2.50,p=0.01)between the ARI and SGA groups,as well as in the C:D ratios of ARI(χ^(2)=−3.59,p<0.001)and ARI+DARI(χ^(2)=−3.10,p=0.002)between the female patients in the two groups.Of the four SGAs,only QTP had significant effects on the C:D ratios of ARI(Z=−4.12,p<0.001)and ARI+DARI(Z=−3.62,p<0.001)when compared with the ARI group in the whole sample and on the C:D ratios of ARI,DARI and ARI+DARI(Z=−3.96,p<0.001;Z=−2.22,p=0.03;Z=−3.75,p<0.001,respectively)in women when compared with their counterparts in the ARI group.Conclusion Comedication with SGAs resulted in lower C:D ratios of ARI and ARI+DARI compared with ARI monotherapy,and comedication with QTP resulted in lower C:D ratios of ARI and ARI+DARI than ARI monotherapy.Despite this statistical significance of our findings,whether the presently observed effect has clinical significance requires exploration by further research.TDM and dosage regulation of ARI should be performed in Chinese inpatients with schizophrenia who are receiving SGA comedication(especially QTP)to maintain a safe and effective dose-adjusted serum concentration of ARI and DARI.展开更多
Current clinical management of major mental disorders,such as autism spectrum disorder,depression and schizophrenia,is less than optimal.Recent scientific advances have indicated that deficits in oxidative and inflamm...Current clinical management of major mental disorders,such as autism spectrum disorder,depression and schizophrenia,is less than optimal.Recent scientific advances have indicated that deficits in oxidative and inflammation systems are lessthanoptimal.Recentscientific advances have indicated extensively involved in the pathogenesis of these disorders. These findings have led to expanded considerations for treatment.Sulforaphane(SFN)is a dietary phytochemical extracted from cruciferous vegetables.It is an effective activator of the transcription factor nuclear erythroid-2 like factor-2,which can upregulate multiple antioxidants and protect neurons against various oxidative damages.On the other hand,it can also significantly reduce inflammatory response to pathological states and decrease the damage caused by the immune response via the nuclear factor-kB pathway and other pathways.In this review,we introduce the biological mechanisms of SFN and the pilot evidence from its clinical trials of major mental disorders,hoping to promote an increase in psychiatric clinical studies of SFN.展开更多
Background Advancements in research have confirmed that gut microbiota can influence health through the microbiota–gut–brain axis.Meditation,as an inner mental exercise,can positively impact the regulation of an ind...Background Advancements in research have confirmed that gut microbiota can influence health through the microbiota–gut–brain axis.Meditation,as an inner mental exercise,can positively impact the regulation of an individual’s physical and mental health.However,few studies have comprehensively investigated faecal microbiota following long-term(several years)deep meditation.Therefore,we propose that long-term meditation may regulate gut microbiota homeostasis and,in turn,affect physical and mental health.Aims To investigate the effects of long-term deep meditation on the gut microbiome structure.Methods To examine the intestinal flora,16S rRNA gene sequencing was performed on faecal samples of 56 Tibetan Buddhist monks and neighbouring residents.Based on the sequencing data,linear discriminant analysis effect size(LEfSe)was employed to identify differential intestinal microbial communities between the two groups.Phylogenetic Investigation of Communities by Reconstruction of Unobserved States(PICRUSt)analysis was used to predict the function of faecal microbiota.In addition,we evaluated biochemical indices in the plasma.Results Theα-diversity indices of the meditation and control groups differed significantly.At the genus level,Prevotella and Bacteroides were significantly enriched in the meditation group.According to the LEfSe analysis,two beneficial bacterial genera(Megamonas and Faecalibacterium)were significantly enriched in the meditation group.Functional predictive analysis further showed that several pathways—including glycan biosynthesis,metabolism and lipopolysaccharide biosynthesis—were significantly enriched in the meditation group.Moreover,plasma levels of clinical risk factors were significantly decreased in the meditation group,including total cholesterol and apolipoprotein B.Conclusions Long-term traditional Tibetan Buddhist meditation may positively impact physical and mental health.We confirmed that the gut microbiota composition differed between the monks and control subjects.The microbiota enriched in monks was associated with a reduced risk of anxiety,depression and cardiovascular disease and could enhance immune function.Overall,these results suggest that meditation plays a positive role in psychosomatic conditions and well-being.展开更多
Background Patients who suffer comorbidity of major depressive disorder(MDD)and chronic pain(CP)maintain a complex interplay between maladaptive prospective memory(PM)and retrospective memory(RM)with physical pain,and...Background Patients who suffer comorbidity of major depressive disorder(MDD)and chronic pain(CP)maintain a complex interplay between maladaptive prospective memory(PM)and retrospective memory(RM)with physical pain,and their complications are still unknown.Aims We aimed to focus on the full cognitive performance and memory complaints in patients with MDD and CP,patients with depression without CP,and control subjects,considering the possible influence of depressed affect and chronic pain severity.Methods According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the criteria given by the International Association of Pain,a total of 124 participants were included in this cross-sectional cohort study.Among them,82 depressed inpatients and outpatients from Anhui Mental Health centre were divided into two groups:a comorbidity group(patients with MDD and CP)(n=40)and a depression group(patients with depression without CP)(n=42).Meanwhile,42 healthy controls were screened from the hospital’s physical examination centre from January 2019 to January 2022.The Hamilton Depression Rating Scale-24(HAMD-24)and Beck Depression Inventory-II(BDI-II)were used to evaluate the severity of depression.The Pain Intensity Numerical Rating Scale(PI-NRS),Short-Form McGill Pain Questionnaire-2 Chinese version(SF-MPQ-2-CN),Montreal Cognitive Assessment-Basic Section(MoCA-BC),and Prospective and Retrospective Memory Questionnaire(PRMQ)were used to assess pain-related features and the global cognitive functioning of study participants.Results The impairments in PM and RM differed remarkably among the three groups(F=7.221,p<0.001;F=7.408,p<0.001)and were severe in the comorbidity group.Spearman correlation analysis revealed the PM and RM were positively correlated with continuous pain and neuropathic pain(r=0.431,p<0.001;r=0.253,p=0.022 and r=0.415,p<0.001;r=0.247,p=0.025),respectively.Regression analysis indicated a significant positive relationship between affective descriptors and total BDI-II score(β=0.594,t=6.600,p<0.001).Examining the mediator pathways revealed the indirect role of PM and RM in patients with comorbid MDD and CP.Conclusions Patients with comorbid MDD and CP presented more PM and RM impairments than patients with MDD without CP.PM and RM are possibly mediating factors that affect the aetiology of comorbid MDD and CP.展开更多
Background Non-suicidal self-injury(NSSI)is a frequent and prominent phenomenon in major depressive disorder(MDD).Even though its prevalence and risk factors are relatively well understood,the potential mechanisms of ...Background Non-suicidal self-injury(NSSI)is a frequent and prominent phenomenon in major depressive disorder(MDD).Even though its prevalence and risk factors are relatively well understood,the potential mechanisms of NSSI in MDD remain elusive.Aims To review present evidence related to the potential mechanisms of NSSI in MDD.Methods According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines,articles for this systematic review were searched on Medline(through PubMed),Embase(through Elsevier),PsycINFO(through OVID)and Web of Science databases for English articles,as well as China National Knowledge Infrastructure(CNKI),SinoMed,Wanfang Data,and the Chongqing VIP Chinese Science and Technology Periodical(VIP)Databases for Chinese articles published from the date of inception to 2 August 2022.Two researchers(BW,HZ)independently screened studies based on inclusion and exclusion criteria and assessed their quality.Results A total of 25157 studies were searched.Only 25 of them were ultimately included,containing 3336 subjects(1535 patients with MDD and NSSI,1403 patients with MDD without NSSI and 398 HCs).Included studies were divided into 6 categories:psychosocial factors(11 studies),neuroimaging(8 studies),stress and hypothalamic-pituitary-adrenal(HPA)axis(2 studies),pain perception(1 study),electroencephalogram(EEG)(2 studies)and epigenetics(1 study).Conclusions This systematic review indicates that patients with MDD and NSSI might have specific psychosocial factors,aberrant brain functions and neurochemical metabolisms,HPA axis dysfunctions,abnormal pain perceptions and epigenetic alterations.展开更多
Background Brain-derived neurotrophic factor(BDNF)is known to prevent methamphetamine(METH)-induced neurotoxicity and plays a role in various stages of METH addiction.However,there is a lack of research with longitudi...Background Brain-derived neurotrophic factor(BDNF)is known to prevent methamphetamine(METH)-induced neurotoxicity and plays a role in various stages of METH addiction.However,there is a lack of research with longitudinal design on changes in plasma BDNF levels in active METH-dependent individuals.Aims The aim of the study was to investigate changes in BDNF levels during METH self-administration in monkeys.Methods This study measured plasma BDNF levels in three male rhesus monkeys with continuous METH exposure and four male control rhesus monkeys without METH exposure.Changes in plasma BDNF levels were then assessed longitudinally during 40 sessions of METH self-administration in the three monkeys.Results Repeated METH exposure decreased plasma BDNF levels.Additionally,plasma BDNF decreased with long-term rather than short-term accumulation of METH during METH self-administration.Conclusions These findings may indicate that the changes in peripheral BDNF may reflect the quantity of accumulative METH intake during a frequent drug use period.展开更多
Introduction Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.In 2018,the World Health Organization(WHO)revised the International Classification of Diseases,11th...Introduction Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.In 2018,the World Health Organization(WHO)revised the International Classification of Diseases,11th Revision(ICD-11)to include chronic pain as an independent disease for the first time(MG30.0).1 At the same time,the ICD-11 also developed new classifications for chronic pain,including chronic primary pain(CPP),chronic cancer-related pain,chronic post-surgical or post-traumatic pain,chronic secondary musculoskeletal pain,chronic secondary visceral pain.展开更多
BACKGROUND Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms.Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 m...BACKGROUND Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms.Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 mg/d.However,post-market surveillance(PMS)with an adequate sample size is required for further validation of the drug’s safety profile and effectiveness.AIM To conduct PMS in real-world clinical settings and evaluate the safety and effectiveness of lurasidone in the Chinese population.METHODS A prospective,multicenter,open-label,12-wk surveillance was conducted in China's Mainland.All patients with schizophrenia from 10 sites who had begun medication with lurasidone between September 2019 and August 2022 were eligible for enrollment.Safety assessments included adverse events(AEs),adverse drug reactions(ADRs),extrapyramidal symptoms(EPS),akathisia,use of EPS drugs,weight gain,and laboratory values as metabolic parameters and the QTc interval.The effectiveness was assessed using the brief psychiatric rating scale(BPRS)from baseline to the end of treatment.RESULTS A total of 965 patients were enrolled in the full analysis set and 894 in the safety set in this interim analysis.The average daily dose was 61.7±19.08 mg(mean±SD)during the treatment.AEs and ADRs were experienced by 101 patients(11.3%)and 78 patients(8.7%),respectively,which were mostly mild.EPS occurred in 25 individuals with a 2.8%incidence,including akathisia in 20 individuals(2.2%).Moreover,59 patients received drugs for treating EPS during the treatment,with an incidence of 6.6%which dropped to 5.4%at the end of the treatment.The average weight change was 0.20±2.36 kg(P=0.01687)with 0.8%of patients showing a weight gain of≥7%at week 12 compared with that at the baseline.The mean values of metabolic parameters and the QTc interval at baseline and week 12 were within normal ranges.The mean changes in total BPRS scores were-8.9±9.76(n=959),-13.5±12.29(n=959),and-16.8±13.97(n=959)after 2/4,6/8,and 12 wk,respectively(P<0.001 for each visit compared with the baseline)using the last-observation-carried-forward method.CONCLUSION The interim analysis of the PMS of adult patients with schizophrenia demonstrate the safety and effectiveness of lurasidone in the Chinese population.No new safety or efficacy concerns were identified.展开更多
BACKGROUND Prior studies have noted great variability in the plasma levels of risperidone(RIS).Plasma concentrations of RIS and its active moiety are highly variable and depend on absorption,metabolism,and other predi...BACKGROUND Prior studies have noted great variability in the plasma levels of risperidone(RIS).Plasma concentrations of RIS and its active moiety are highly variable and depend on absorption,metabolism,and other predictors of metabolic dysregulation;however,these factors are poorly understood and the association between metabolic change and change in psychopathology is uncertain.AIM To ascertain the characteristics of chronic schizophrenic patients treated with RIS,and to assess their relationship with plasma RIS levels.METHODS This was a descriptive cross-sectional study of 50 patients with a diagnosis of schizophrenic psychosis treated with RIS in a psychiatric service.The plasma concentrations of RIS and its metabolite 9-hydroxyrisperidone were determined by high performance liquid chromatography.The patients’demographic and clinical characteristics,and psychopathologies were assessed,and the associations between clinical variables and plasma levels of RIS were explored.RESULTS Male patients received higher doses of RIS than female ones,but plasma concentrations of RIS and risperidone+9-hydroxyrisperidone(active moiety)were higher in female patients.Age and the mean scores of the general psychopathology subscale of the Positive and Negative Syndrome Scale(PANSS)were significantly positively correlated with plasma concentrations of risperidone+9-hydroxyrisperidone adjusted for weight and dose in all 50 subjects.In male subjects,we found a statistically significant positive correlation between the concentrations of risperidone+9-hydroxyrisperidone in plasma/(dose×kg)and age,mean PANSS negative subscale scores,mean PANSS general psychopathology subscale scores,and mean PANSS total scores.CONCLUSION Long-term use of RIS should be closely monitored in older patients and females to minimize the risk of high concentrations which could induce side effects.展开更多
Spinal cord injury is linked to the interruption of neural pathways,which results in irreversible neural dysfunction.Neural repair and neuroregeneration are critical goals and issues for rehabilitation in spinal cord ...Spinal cord injury is linked to the interruption of neural pathways,which results in irreversible neural dysfunction.Neural repair and neuroregeneration are critical goals and issues for rehabilitation in spinal cord injury,which require neural stem cell repair and multimodal neuromodulation techniques involving personalized rehabilitation strategies.Besides the involvement of endogenous stem cells in neurogenesis and neural repair,exogenous neural stem cell transplantation is an emerging effective method for repairing and replacing damaged tissues in central nervous system diseases.However,to ensure that endogenous or exogenous neural stem cells truly participate in neural repair following spinal cord injury,appropriate interventional measures(e.g.,neuromodulation)should be adopted.Neuromodulation techniques,such as noninvasive magnetic stimulation and electrical stimulation,have been safely applied in many neuropsychiatric diseases.There is increasing evidence to suggest that neuromagnetic/electrical modulation promotes neuroregeneration and neural repair by affecting signaling in the nervous system;namely,by exciting,inhibiting,or regulating neuronal and neural network activities to improve motor function and motor learning following spinal cord injury.Several studies have indicated that fine motor skill rehabilitation training makes use of residual nerve fibers for collateral growth,encourages the formation of new synaptic connections to promote neural plasticity,and improves motor function recovery in patients with spinal cord injury.With the development of biomaterial technology and biomechanical engineering,several emerging treatments have been developed,such as robots,brain-computer interfaces,and nanomaterials.These treatments have the potential to help millions of patients suffering from motor dysfunction caused by spinal cord injury.However,large-scale clinical trials need to be conducted to validate their efficacy.This review evaluated the efficacy of neural stem cells and magnetic or electrical stimulation combined with rehabilitation training and intelligent therapies for spinal cord injury according to existing evidence,to build up a multimodal treatment strategy of spinal cord injury to enhance nerve repair and regeneration.展开更多
Background Anxiety symptoms are common in mental diseases and a variety of physical disorders, especially in disorders related to stress. More and more basic studies have indicated that gut microbiota can regulate bra...Background Anxiety symptoms are common in mental diseases and a variety of physical disorders, especially in disorders related to stress. More and more basic studies have indicated that gut microbiota can regulate brain function through the gut-brain axis, and dysbiosis of intestinal microbiota was related to anxiety. However, there is no specific evidence to support treatment of anxiety by regulating intestinal microbiota. Aims To find evidence sup porting improvement of anxiety symptoms by regulation of intestinal microbiota. Methods This systematic review of randomised controlled trials was searched based on the following databases: PubMed, EMBASE, the Cochrane Library, OVID, Web of Knowledge, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP databases and SinoMed. The retrieval time dated back to 25 July 2018. Then we screened research literatures based on established inclusion and exclusion criteria. Quality evaluation for each included study was done using the Cochrane risk of bias and the Jadad scale. Results A total of 3334 articles were retrieved and 21 studies were included which contained 1503 subjects. In the 21 studies, 15 chose probiotics as interventions to regulate intestinal microbiota and six chose non-probiotic ways such as adjusting daily diets. Probiotic supplements in seven studies contained only one kind of probiotic, two studies used a product that contained two kinds of probiotics and the supplements used in the other five studies included at least three kinds of probiotics. In the studies that used treatment as usual plus interventions regulating intestinal flora (IRIF) as interventions (five studies), only non-probiotic ways were effective (two studies), which means 40% of studies were effective;in the studies that used IRIF alone (16 studies, 11 studies used probiotic ways and 5 studies used non-probiotic ways), 56% of studies could improve anxiety symptoms, and 80% of studies that conducted the non-probiotic interventions were effective, while 45% of studies that used probiotic supplementations had positive effects on anxiety symptoms. Overall, 11 studies showed a positive effect on anxiety symptoms by regulating intestinal microbiota, which indicated 52% of the 21 studies were effective, and there were five studies that used probiotic supplements as interventions and six used non-probiotic interventions. In addition, it should be noted that six of seven studies showed that regulation of intestinal microbiota could treat anxiety symptoms, the rate of efficacy was 86%.Conclusions We find that more than half of the studies included showed it was positive to treat anxiety symptoms by regulation of intestinal microbiota. There are two kinds of interventions (probiotic and non-probiotic interventions) to regulate intestinal microbiota, and it should be highlighted that the non-probiotic interventions were more effective than the probiotic interventions. More studies are needed to clarify this conclusion since we still cannot run meta-analysis so far.展开更多
Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cogni...Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population. Aim To provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES. Methods An independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size. Results 56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as 'high quality' according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=-1.60,95% Cl -1.82 to -1.38,厂=67%) and all seven cognitive domains, with the SMD ranging from -0.87 to -1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=-1.90), Trail Making Test (TMT)(SMD=-1.36), Continuous Performance Test-Identical Pairs (SMD=-1.33), Hopkins Verbal Learning Test (SMD=-1.24), Brief Visuospatial Memory Test (SMD=-1.18), Mazes (SMD=-1.16), Category Fluency (SMD=-1.01), Spatial Span (SMD=-0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=-0.38). Conclusions Our meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.展开更多
基金National Key R&D Program of China (2017YFC1310400), National Nature Science Foundation of China (U150222& 81501148)Shanghai Municipal Health and Family Planning Commission (2014ZYJB0002)+3 种基金Shanghai Health and Family Planni叩 Commission Clinical Research Project (20184Y0134)Program of Shanghai Academic Research Leader (17XD1403300)Shanghai Key Laboratory of Psychotic Disorders (13DZ2260500)Qihang Project of Shanghai Mental Health Center (2018-QH-02).
文摘Background Despite high relapse rate among methamphetamine (MA) abusers, there still have been little empirical data to date detecting the risk factors related to craving and relapse from the perspective of MA abusers. Therefore, the aim of this study was to use qualitative research methods exploring the strengths, weaknesses, opportunities and threat factors that could facilitate or impede individuals' abstinence in a real-life context from the perspectives of MA abusers. Aim To use qualitative research methods exploring the strengths, weaknesses, opportunities and threat factors relating to individuals' abstinence in a real-life context. Method Semistructured interviews were conducted with 32 MA abusers recruited in Shanghai guided by open-ended questions on narrating the real-life catalysts and inhibitors related to craving, initiation, relapse and abstinence. All data were transcribed verbatim and analysed using a strengths, weaknesses, opportunities and threats (SWOT) analysis. Results The results of the SWOT analysis revealed that contextual factors including peer influence, prevalence and availability of MA, familiar venue of MA use, discrimination, sexual behaviours, alcohol, emotional states and their attitudes towards smoking MA were important factors that contribute to reinitiation and relapse. Surveillance systems, antidrug social workers, vocational skills trainings, moving to another city and family responsibility might serve as counter measures targeti叩 those mentioned weaknesses and threats above. Conclusion This SWOT analysis highlights the complex nature of relapse. Comprehensive interventions strengtheni叩 coping skills such as virtual reality techniques are desperately needed to facilitate individuals1 sustained abstinence.
基金This study was supported by the Clinical Research Center,Shanghai Jiao Tong University School of Medicine(DLY201620)National Science and Technology Major Project for IND(2018ZX09734-005)+1 种基金Shanghai Clinical Research Center for Mental Health(19MC1911100)Medical Engineering Cross Project of Shanghai Jiao Tong University(YG2017MS42).
文摘Background Atypical antipsychotics as first-line drugs have been used in patients with schizophrenia in China and abroad.However,its safety still needs to be evaluated in a large population,especially in Chinese patients.Objective The main objective of this study is to evaluate the safety and related factors of long-term atypical antipsychotic use in patients with schizophrenia in China.The secondary objective includes the long-term efficacy of atypical antipsychotics in these patients,as well as pharmacoeconomic evaluation,population pharmacokinetic studies and pharmacogenomics studies.Methods This study has an observational design.The atypical antipsychotics include quetiapine,olanzapine,risperidone,aripiprazole,ziprasidone,paliperidone,amisulpride,perospirone and clozapine.Visits occur at 0,4,8,13,26,52,78,104,130 and 156 weeks.The efficacy evaluations include symptoms,social function,recurrence rate and hospitalisation.The safety measures include physical examination,vital signs,abdominal circumference,laboratory tests(such as blood cell analysis,blood biochemical tests and serum prolactin/thyroxine levels),12-lead ECG,extrapyramidal syndrome assessment,sexual function evaluation,medication and other adverse events.The secondary measures include the Positive and Negative Syndrome Scale,Clinical Global Impression-Severity of Illness Scale,Calgary Depression Scale for Schizophrenia,Personal and Social Performance Scale,relapse rate,drug consolidation,medical-related expenses,income,drug plasma concentration and genetic information.Results This is a large sample,non-interventional and long-term prospective clinical study designed to truly reflect the specific details of clinical practice,fully respect patients’needs,and understand patients’treatment intentions and actual treatment details.Conclusions This research method details the aims,methods,study design,strengths and limitations of the study.
基金This study was funded by the following fundings:Shanghai Jiao Tong University Medical and Engineering Joint Grant(YG2016ZD06)Shanghai Jiao Tong University Joint Art and Science Funding(14JCRZ05)+1 种基金National Natural Science Foundation of China(81671336)National Key R&D Program of China(2017YFC0909200)。
文摘In recent years,research on meditation as an important alternative therapy has developed rapidly and been widely applied in clinical medicine.Mechanism studies of meditation have also developed progressively,showing that meditation has great impact on brain structure and function,and epigenetic and telomere regulation.In line with this,the application of meditation has gradually been expanded to mental illness,most often applied for major depressive disorders and substance-related and addictive disorders.The focus of this paper is to illustrate the biological mechanisms of meditation and its application in mental disorders.
文摘Disturbance of biological rhythms contributes to the onset of bipolar disorders and is an important clinical feature of the condition.To further explore the role of biological rhythms in bipolar disorders,95 English articles published between 1968 and 2019 were retrieved from the PubMed database and analysed.We herein review the outcomes of studies on biological rhythm disturbance in bipolar disorders,including the epidemiology,aetiology,clinical features(eg,sleep,feeding and eating disorders)and treatment of the condition evaluated by patients*selfreport and biological indicators such as melatonin.Our report supports the characterisation of biological rhythm disturbance as a significant clinical feature affecting the onset and development of bipolar disorders and reviews classical and novel treatments,such as chronotherapy,that can be applied in the clinical practice.Our analysis indicates that a more comprehensive study of the pathophysiology,clinical phenomenology and treatment of biological rhythm disturbance is required.
文摘INTRODUCTION There are many obstacles to developing,maintaining and strengthening international research collaborations,whether they are posed by geography,culture or,most recently,global economics and politics.It is critically important to overcome these obstacles,especially when it comes to fostering the types of breakthrough biomedical science that benefit from diverse perspectives,methodologies and data sets.Moreover,the research underlying these breakthroughs unfolds over the course of years,and even decades.For these reasons,and more,the Department of Psychiatry at Massachusetts General Hospital(Mass General)and the Shanghai Mental Health Center(SMHC)are taking the long view:exploring and implementing numerous collaborative research and training projects that are leading to better care and treatments for patients,both in the USA and China,who suffer from a range of psychiatric disorders.
基金This study was financially supported by the National Natural Science Foundation of China(81822017,82171493,52003021)the Lingang Laboratory(LG-QS-202203-10)the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(20181715).
文摘To the Editor,Non-human primate(NHP)models are advantageous for mimicking human addiction with high behavioural validity.1 However,current NHP drug addiction models(eg,self-administration)often require a comprehensive behavioural training paradigm,relatively expensive apparatus and invasive surgical procedures.
基金supported by the National Natural Science Foundation of China(62101324)the Shanghai Sailing Program(20YF1442000)+2 种基金the Academic Leader of the Health Discipline of Shanghai Municipal Health Commission(2022XD025)the Qihang Program of Shanghai Mental Health Center(2020-QH-01)the Hospital Program of Shanghai Mental Health Center(2020-YJ01)。
文摘S Background Music therapy is a promising complementary intervention for addressing various mental health conditions.Despite evidence of the beneficial effects of music,the acoustic features that make music effective in therapeutic contexts remain elusive.Aims This study aimed to identify and validate distinctive acoustic features of healing music.Methods We constructed a healing music dataset(HMD)based on nominations from related professionals and extracted 370 acoustic features.Healing-distinctive acoustic features were identified as those that were(1)independent from genre within the HMD,(2)significantly different from music pieces in a classical music dataset(CMD)and(3)similar to pieces in a five-element music dataset(FEMD).We validated the identified features by comparing jazz pieces in the HMD with a jazz music dataset(JMD).We also examined the emotional properties of the features in a Chinese affective music system(CAMS).Results The HMD comprised 165 pieces.Among all the acoustic features,74.59%shared commonalities across genres,and 26.22%significantly differed between the HMD classical pieces and the CMD.The equivalence test showed that the HMD and FEMD did not differ significantly in 9.46%of the features.The potential healing-distinctive acoustic features were identified as the standard deviation of the roughness,mean and period entropy of the third coefficient of the mel-frequency cepstral coefficients.In a three-dimensional space defined by these features,HMD's jazz pieces could be distinguished from those of the JMD.These three features could significantly predict both subjective valence and arousal ratings in the CAMS.Conclusions The distinctive acoustic features of healing music that have been identified and validated in this study have implications for the development of artificial intelligence models for identifying therapeutic music,particularly in contexts where access to professional expertise may be limited.This study contributes to the growing body of research exploring the potential of digital technologies for healthcare interventions.
基金This work was supported by the Shanghai Natural Science Foundation(15ZR1435300)Natural Science and Technology Foundation of Shanghai Jiao Tong University School of Medicine(14XJ10080)+5 种基金Shanghai Key Laboratory of Psychotic Disorders(13dz2260500)Teacher Train and Progress Project of Shanghai Jiao Tong University School of Medicine(JFXM201808)Shanghai Mental Health Center Project(2018-YJ-16)China Hospital Development Research Institute Hospital Management Construction Project of Shanghai Jiao Tong University(CHDI-2018-A-23)Young and Middle-aged Teachers Study Abroad Program of Shanghai Jiao Tong University School of MedicineWang Kuancheng Medical Award Fund Project of Shanghai Jiao Tong University.
文摘Background Aripiprazole(ARI)is often prescribed alone or in combination with other second-generation antipsychotics(SGAs)to treat patients with schizophrenia.However,this may increase the potential clinical significance of drug-drug interactions.Therapeutic drug monitoring(TDM)is an important and fundamental tool both when administering ARI alone and in combination with other SGAs to monitor ARI pharmacokinetics,adjust the dosage and thereby achieve more effective and safer treatment.Aims This study retrospectively investigated the effects of four SGA comedications(clozapine,risperidone,quetiapine(QTP)and olanzapine)and other potential factors(sex,age and ARI dose)on the serum concentrations of ARI and dehydroaripiprazole(DARI)in Chinese patients with schizophrenia using TDM data.Methods High-performance liquid chromatography was used to test the serum concentrations of ARI,DARI and ARI+DARI.In addition,steady-state dose-adjusted serum concentrations(ie,concentration-to dose ratios,C:D ratios)of ARI,DARI and ARI+DARI;sex;age;ARI dose and SGA comedication dose between 299 inpatients with schizophrenia who received ARI or SGA comedication were all collected and analysed.Spearman’s correlation and multiple linear regression analysis were used to evaluate bivariate associations between ARI dose and serum ARI and DARI concentrations and describe the effect of independent variables on serum ARI and DARI concentrations,respectively.Results There were significant differences in the C:D ratios of ARI(χ^(2)=−3.21,p=0.001)and ARI+DARI(χ^(2)=−2.50,p=0.01)between the ARI and SGA groups,as well as in the C:D ratios of ARI(χ^(2)=−3.59,p<0.001)and ARI+DARI(χ^(2)=−3.10,p=0.002)between the female patients in the two groups.Of the four SGAs,only QTP had significant effects on the C:D ratios of ARI(Z=−4.12,p<0.001)and ARI+DARI(Z=−3.62,p<0.001)when compared with the ARI group in the whole sample and on the C:D ratios of ARI,DARI and ARI+DARI(Z=−3.96,p<0.001;Z=−2.22,p=0.03;Z=−3.75,p<0.001,respectively)in women when compared with their counterparts in the ARI group.Conclusion Comedication with SGAs resulted in lower C:D ratios of ARI and ARI+DARI compared with ARI monotherapy,and comedication with QTP resulted in lower C:D ratios of ARI and ARI+DARI than ARI monotherapy.Despite this statistical significance of our findings,whether the presently observed effect has clinical significance requires exploration by further research.TDM and dosage regulation of ARI should be performed in Chinese inpatients with schizophrenia who are receiving SGA comedication(especially QTP)to maintain a safe and effective dose-adjusted serum concentration of ARI and DARI.
基金This work is supported by the following:National Natural Science Foundation of China(grants 82151314,81971251,81671329,81871050,82171497,82101582 and 82001406)Clinical Research Center at Shanghai Mental Health Center(grants CRC2018ZD01,CRC2018ZD04,CRC2018YB01,CRC2019ZD02 and 2020-FX-02)+4 种基金Clinical Research Center at Shanghai Jiao Tong University School of Medicine(DLY201817 and 20190102)Shanghai Science and Technology Committee Foundation(19411950800,16ZR1430500,19411969100,19410710800,21ZR1481500,20ZR1448600,21S31903100 and 19ZR14451)Shanghai Clinical Research Center for Mental Health(19MC1911100)Project of the Key Discipline Construction,Shanghai 3-Year Public Health Action Plan(GWV-10.1-XK18)and Shanghai Municipal Science and Technology Major Project(no:2018SHZDZX01 and 2018SHZDZX05).
文摘Current clinical management of major mental disorders,such as autism spectrum disorder,depression and schizophrenia,is less than optimal.Recent scientific advances have indicated that deficits in oxidative and inflammation systems are lessthanoptimal.Recentscientific advances have indicated extensively involved in the pathogenesis of these disorders. These findings have led to expanded considerations for treatment.Sulforaphane(SFN)is a dietary phytochemical extracted from cruciferous vegetables.It is an effective activator of the transcription factor nuclear erythroid-2 like factor-2,which can upregulate multiple antioxidants and protect neurons against various oxidative damages.On the other hand,it can also significantly reduce inflammatory response to pathological states and decrease the damage caused by the immune response via the nuclear factor-kB pathway and other pathways.In this review,we introduce the biological mechanisms of SFN and the pilot evidence from its clinical trials of major mental disorders,hoping to promote an increase in psychiatric clinical studies of SFN.
基金This work was supported by the National Natural Science Foundation of China(grants 81571326(2021-TX-004),81671336,81501153)Chinese‘111 Project’(grant B08020)+4 种基金Shanghai Jiao Tong University art and science Grants(grant 14JCRZ05)Startup funding of Shanghai Mental Health Center(grant 2017-kyqd-01)Personnel Training Program of Shanghai Mental Health Center(grants 2018-FX-02,2021-QH-04)National Key R&D Program of China(grant 2017YFC0909200)Excellence Journal Project in China(grant C-198).
文摘Background Advancements in research have confirmed that gut microbiota can influence health through the microbiota–gut–brain axis.Meditation,as an inner mental exercise,can positively impact the regulation of an individual’s physical and mental health.However,few studies have comprehensively investigated faecal microbiota following long-term(several years)deep meditation.Therefore,we propose that long-term meditation may regulate gut microbiota homeostasis and,in turn,affect physical and mental health.Aims To investigate the effects of long-term deep meditation on the gut microbiome structure.Methods To examine the intestinal flora,16S rRNA gene sequencing was performed on faecal samples of 56 Tibetan Buddhist monks and neighbouring residents.Based on the sequencing data,linear discriminant analysis effect size(LEfSe)was employed to identify differential intestinal microbial communities between the two groups.Phylogenetic Investigation of Communities by Reconstruction of Unobserved States(PICRUSt)analysis was used to predict the function of faecal microbiota.In addition,we evaluated biochemical indices in the plasma.Results Theα-diversity indices of the meditation and control groups differed significantly.At the genus level,Prevotella and Bacteroides were significantly enriched in the meditation group.According to the LEfSe analysis,two beneficial bacterial genera(Megamonas and Faecalibacterium)were significantly enriched in the meditation group.Functional predictive analysis further showed that several pathways—including glycan biosynthesis,metabolism and lipopolysaccharide biosynthesis—were significantly enriched in the meditation group.Moreover,plasma levels of clinical risk factors were significantly decreased in the meditation group,including total cholesterol and apolipoprotein B.Conclusions Long-term traditional Tibetan Buddhist meditation may positively impact physical and mental health.We confirmed that the gut microbiota composition differed between the monks and control subjects.The microbiota enriched in monks was associated with a reduced risk of anxiety,depression and cardiovascular disease and could enhance immune function.Overall,these results suggest that meditation plays a positive role in psychosomatic conditions and well-being.
基金This study was supported by funding of key research and development projects of Anhui Province(grant number:2022e07020002)Applied medicine research project of Anhui Health Committee(grant number:AHWJ2021a036)+4 种基金hospital project of Hefei Fourth People’s Hospital(grant number:HFSY2020YB21)Shanghai Key Laboratory of Psychotic Disorders Open Grant(grant number:13dz2260500 and 21-K04)Natural science research projects in Anhui Universities(grant number:KJ2020A0218)Projects supported by public welfare scientific research institutes(grant number:GY2020G-3)the Applied medicine research project of Hefei Health Committee(grant number:Hwk2020zd0016 and Hwk2021zd011).
文摘Background Patients who suffer comorbidity of major depressive disorder(MDD)and chronic pain(CP)maintain a complex interplay between maladaptive prospective memory(PM)and retrospective memory(RM)with physical pain,and their complications are still unknown.Aims We aimed to focus on the full cognitive performance and memory complaints in patients with MDD and CP,patients with depression without CP,and control subjects,considering the possible influence of depressed affect and chronic pain severity.Methods According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the criteria given by the International Association of Pain,a total of 124 participants were included in this cross-sectional cohort study.Among them,82 depressed inpatients and outpatients from Anhui Mental Health centre were divided into two groups:a comorbidity group(patients with MDD and CP)(n=40)and a depression group(patients with depression without CP)(n=42).Meanwhile,42 healthy controls were screened from the hospital’s physical examination centre from January 2019 to January 2022.The Hamilton Depression Rating Scale-24(HAMD-24)and Beck Depression Inventory-II(BDI-II)were used to evaluate the severity of depression.The Pain Intensity Numerical Rating Scale(PI-NRS),Short-Form McGill Pain Questionnaire-2 Chinese version(SF-MPQ-2-CN),Montreal Cognitive Assessment-Basic Section(MoCA-BC),and Prospective and Retrospective Memory Questionnaire(PRMQ)were used to assess pain-related features and the global cognitive functioning of study participants.Results The impairments in PM and RM differed remarkably among the three groups(F=7.221,p<0.001;F=7.408,p<0.001)and were severe in the comorbidity group.Spearman correlation analysis revealed the PM and RM were positively correlated with continuous pain and neuropathic pain(r=0.431,p<0.001;r=0.253,p=0.022 and r=0.415,p<0.001;r=0.247,p=0.025),respectively.Regression analysis indicated a significant positive relationship between affective descriptors and total BDI-II score(β=0.594,t=6.600,p<0.001).Examining the mediator pathways revealed the indirect role of PM and RM in patients with comorbid MDD and CP.Conclusions Patients with comorbid MDD and CP presented more PM and RM impairments than patients with MDD without CP.PM and RM are possibly mediating factors that affect the aetiology of comorbid MDD and CP.
基金This study was funded by Shanghai Science and Technology Committee(grant no.20ZR1448500,YDZX20213100001003,22YF1439100)the National Natural Science Foundation of China(grant no.82201678).
文摘Background Non-suicidal self-injury(NSSI)is a frequent and prominent phenomenon in major depressive disorder(MDD).Even though its prevalence and risk factors are relatively well understood,the potential mechanisms of NSSI in MDD remain elusive.Aims To review present evidence related to the potential mechanisms of NSSI in MDD.Methods According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines,articles for this systematic review were searched on Medline(through PubMed),Embase(through Elsevier),PsycINFO(through OVID)and Web of Science databases for English articles,as well as China National Knowledge Infrastructure(CNKI),SinoMed,Wanfang Data,and the Chongqing VIP Chinese Science and Technology Periodical(VIP)Databases for Chinese articles published from the date of inception to 2 August 2022.Two researchers(BW,HZ)independently screened studies based on inclusion and exclusion criteria and assessed their quality.Results A total of 25157 studies were searched.Only 25 of them were ultimately included,containing 3336 subjects(1535 patients with MDD and NSSI,1403 patients with MDD without NSSI and 398 HCs).Included studies were divided into 6 categories:psychosocial factors(11 studies),neuroimaging(8 studies),stress and hypothalamic-pituitary-adrenal(HPA)axis(2 studies),pain perception(1 study),electroencephalogram(EEG)(2 studies)and epigenetics(1 study).Conclusions This systematic review indicates that patients with MDD and NSSI might have specific psychosocial factors,aberrant brain functions and neurochemical metabolisms,HPA axis dysfunctions,abnormal pain perceptions and epigenetic alterations.
基金Funding for this study was provided by Brain Science and Brain-Like Intelligence Technology(2021ZD0202105)Shanghai‘the Hospital Garden Star’funding for the training of young medical professionals(20224Z0017)+7 种基金the National Natural Science Foundation of China(82171483),(82130041)Shanghai Municipal Science and Technology Major Project(2018SHZDZX05)Shanghai Municipal Health Commission Talent Project(2022YQ048)Lingang Lab(Grant LG202106-03-01),(Grant LG202106-03-03)these fundings had no further role in study designin the collection,analysis and interpretation of datain the writing of the reportin the decision to submit the paper for publication.
文摘Background Brain-derived neurotrophic factor(BDNF)is known to prevent methamphetamine(METH)-induced neurotoxicity and plays a role in various stages of METH addiction.However,there is a lack of research with longitudinal design on changes in plasma BDNF levels in active METH-dependent individuals.Aims The aim of the study was to investigate changes in BDNF levels during METH self-administration in monkeys.Methods This study measured plasma BDNF levels in three male rhesus monkeys with continuous METH exposure and four male control rhesus monkeys without METH exposure.Changes in plasma BDNF levels were then assessed longitudinally during 40 sessions of METH self-administration in the three monkeys.Results Repeated METH exposure decreased plasma BDNF levels.Additionally,plasma BDNF decreased with long-term rather than short-term accumulation of METH during METH self-administration.Conclusions These findings may indicate that the changes in peripheral BDNF may reflect the quantity of accumulative METH intake during a frequent drug use period.
基金This work was funded by the Project of Shanghai Municipal Science and Technology Commission(21DZ2201000)Shanghai Shenkang Hospital Development Center(SHDC2020CR3045B)+1 种基金Shanghai Clinical Research Center for Mental Health(19MC1911100),Shanghai Engineering Research Center of Intelligent Addiction Treatment and Rehabilitation(19DZ2255200)Shanghai Key Laboratory of Psychotic Disorders(13DZ2260500).
文摘Introduction Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.In 2018,the World Health Organization(WHO)revised the International Classification of Diseases,11th Revision(ICD-11)to include chronic pain as an independent disease for the first time(MG30.0).1 At the same time,the ICD-11 also developed new classifications for chronic pain,including chronic primary pain(CPP),chronic cancer-related pain,chronic post-surgical or post-traumatic pain,chronic secondary musculoskeletal pain,chronic secondary visceral pain.
基金Collaborative Innovation Center Project of Translational Medicine,Shanghai Jiaotong University School of Medicine,No.TM202116PT(2021-2023)Clinical Research Plan of SHDC,No.SHDC2022CRS032and the Sumitomo Pharmaceuticals(Suzhou)Co.,Ltd.
文摘BACKGROUND Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms.Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 mg/d.However,post-market surveillance(PMS)with an adequate sample size is required for further validation of the drug’s safety profile and effectiveness.AIM To conduct PMS in real-world clinical settings and evaluate the safety and effectiveness of lurasidone in the Chinese population.METHODS A prospective,multicenter,open-label,12-wk surveillance was conducted in China's Mainland.All patients with schizophrenia from 10 sites who had begun medication with lurasidone between September 2019 and August 2022 were eligible for enrollment.Safety assessments included adverse events(AEs),adverse drug reactions(ADRs),extrapyramidal symptoms(EPS),akathisia,use of EPS drugs,weight gain,and laboratory values as metabolic parameters and the QTc interval.The effectiveness was assessed using the brief psychiatric rating scale(BPRS)from baseline to the end of treatment.RESULTS A total of 965 patients were enrolled in the full analysis set and 894 in the safety set in this interim analysis.The average daily dose was 61.7±19.08 mg(mean±SD)during the treatment.AEs and ADRs were experienced by 101 patients(11.3%)and 78 patients(8.7%),respectively,which were mostly mild.EPS occurred in 25 individuals with a 2.8%incidence,including akathisia in 20 individuals(2.2%).Moreover,59 patients received drugs for treating EPS during the treatment,with an incidence of 6.6%which dropped to 5.4%at the end of the treatment.The average weight change was 0.20±2.36 kg(P=0.01687)with 0.8%of patients showing a weight gain of≥7%at week 12 compared with that at the baseline.The mean values of metabolic parameters and the QTc interval at baseline and week 12 were within normal ranges.The mean changes in total BPRS scores were-8.9±9.76(n=959),-13.5±12.29(n=959),and-16.8±13.97(n=959)after 2/4,6/8,and 12 wk,respectively(P<0.001 for each visit compared with the baseline)using the last-observation-carried-forward method.CONCLUSION The interim analysis of the PMS of adult patients with schizophrenia demonstrate the safety and effectiveness of lurasidone in the Chinese population.No new safety or efficacy concerns were identified.
基金Supported by Shanghai Civil Administration Bureau,No.8-2-50.
文摘BACKGROUND Prior studies have noted great variability in the plasma levels of risperidone(RIS).Plasma concentrations of RIS and its active moiety are highly variable and depend on absorption,metabolism,and other predictors of metabolic dysregulation;however,these factors are poorly understood and the association between metabolic change and change in psychopathology is uncertain.AIM To ascertain the characteristics of chronic schizophrenic patients treated with RIS,and to assess their relationship with plasma RIS levels.METHODS This was a descriptive cross-sectional study of 50 patients with a diagnosis of schizophrenic psychosis treated with RIS in a psychiatric service.The plasma concentrations of RIS and its metabolite 9-hydroxyrisperidone were determined by high performance liquid chromatography.The patients’demographic and clinical characteristics,and psychopathologies were assessed,and the associations between clinical variables and plasma levels of RIS were explored.RESULTS Male patients received higher doses of RIS than female ones,but plasma concentrations of RIS and risperidone+9-hydroxyrisperidone(active moiety)were higher in female patients.Age and the mean scores of the general psychopathology subscale of the Positive and Negative Syndrome Scale(PANSS)were significantly positively correlated with plasma concentrations of risperidone+9-hydroxyrisperidone adjusted for weight and dose in all 50 subjects.In male subjects,we found a statistically significant positive correlation between the concentrations of risperidone+9-hydroxyrisperidone in plasma/(dose×kg)and age,mean PANSS negative subscale scores,mean PANSS general psychopathology subscale scores,and mean PANSS total scores.CONCLUSION Long-term use of RIS should be closely monitored in older patients and females to minimize the risk of high concentrations which could induce side effects.
基金supported by the Major International(Regional)Joint Research Project of the National Natural Science Foundation of China,No.81820108013(to LMC)the General Research Project of the National Natural Science Foundation of China,No.81772453(to DSX)the National Key Research and Development Program of China,No.2016YFA0100800(to LMC)
文摘Spinal cord injury is linked to the interruption of neural pathways,which results in irreversible neural dysfunction.Neural repair and neuroregeneration are critical goals and issues for rehabilitation in spinal cord injury,which require neural stem cell repair and multimodal neuromodulation techniques involving personalized rehabilitation strategies.Besides the involvement of endogenous stem cells in neurogenesis and neural repair,exogenous neural stem cell transplantation is an emerging effective method for repairing and replacing damaged tissues in central nervous system diseases.However,to ensure that endogenous or exogenous neural stem cells truly participate in neural repair following spinal cord injury,appropriate interventional measures(e.g.,neuromodulation)should be adopted.Neuromodulation techniques,such as noninvasive magnetic stimulation and electrical stimulation,have been safely applied in many neuropsychiatric diseases.There is increasing evidence to suggest that neuromagnetic/electrical modulation promotes neuroregeneration and neural repair by affecting signaling in the nervous system;namely,by exciting,inhibiting,or regulating neuronal and neural network activities to improve motor function and motor learning following spinal cord injury.Several studies have indicated that fine motor skill rehabilitation training makes use of residual nerve fibers for collateral growth,encourages the formation of new synaptic connections to promote neural plasticity,and improves motor function recovery in patients with spinal cord injury.With the development of biomaterial technology and biomechanical engineering,several emerging treatments have been developed,such as robots,brain-computer interfaces,and nanomaterials.These treatments have the potential to help millions of patients suffering from motor dysfunction caused by spinal cord injury.However,large-scale clinical trials need to be conducted to validate their efficacy.This review evaluated the efficacy of neural stem cells and magnetic or electrical stimulation combined with rehabilitation training and intelligent therapies for spinal cord injury according to existing evidence,to build up a multimodal treatment strategy of spinal cord injury to enhance nerve repair and regeneration.
基金National Natural Science Foundation of China (81571326,81501153)National Key R&D Program of China (2017YFC0909200).
文摘Background Anxiety symptoms are common in mental diseases and a variety of physical disorders, especially in disorders related to stress. More and more basic studies have indicated that gut microbiota can regulate brain function through the gut-brain axis, and dysbiosis of intestinal microbiota was related to anxiety. However, there is no specific evidence to support treatment of anxiety by regulating intestinal microbiota. Aims To find evidence sup porting improvement of anxiety symptoms by regulation of intestinal microbiota. Methods This systematic review of randomised controlled trials was searched based on the following databases: PubMed, EMBASE, the Cochrane Library, OVID, Web of Knowledge, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP databases and SinoMed. The retrieval time dated back to 25 July 2018. Then we screened research literatures based on established inclusion and exclusion criteria. Quality evaluation for each included study was done using the Cochrane risk of bias and the Jadad scale. Results A total of 3334 articles were retrieved and 21 studies were included which contained 1503 subjects. In the 21 studies, 15 chose probiotics as interventions to regulate intestinal microbiota and six chose non-probiotic ways such as adjusting daily diets. Probiotic supplements in seven studies contained only one kind of probiotic, two studies used a product that contained two kinds of probiotics and the supplements used in the other five studies included at least three kinds of probiotics. In the studies that used treatment as usual plus interventions regulating intestinal flora (IRIF) as interventions (five studies), only non-probiotic ways were effective (two studies), which means 40% of studies were effective;in the studies that used IRIF alone (16 studies, 11 studies used probiotic ways and 5 studies used non-probiotic ways), 56% of studies could improve anxiety symptoms, and 80% of studies that conducted the non-probiotic interventions were effective, while 45% of studies that used probiotic supplementations had positive effects on anxiety symptoms. Overall, 11 studies showed a positive effect on anxiety symptoms by regulating intestinal microbiota, which indicated 52% of the 21 studies were effective, and there were five studies that used probiotic supplements as interventions and six used non-probiotic interventions. In addition, it should be noted that six of seven studies showed that regulation of intestinal microbiota could treat anxiety symptoms, the rate of efficacy was 86%.Conclusions We find that more than half of the studies included showed it was positive to treat anxiety symptoms by regulation of intestinal microbiota. There are two kinds of interventions (probiotic and non-probiotic interventions) to regulate intestinal microbiota, and it should be highlighted that the non-probiotic interventions were more effective than the probiotic interventions. More studies are needed to clarify this conclusion since we still cannot run meta-analysis so far.
文摘Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population. Aim To provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES. Methods An independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size. Results 56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as 'high quality' according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=-1.60,95% Cl -1.82 to -1.38,厂=67%) and all seven cognitive domains, with the SMD ranging from -0.87 to -1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=-1.90), Trail Making Test (TMT)(SMD=-1.36), Continuous Performance Test-Identical Pairs (SMD=-1.33), Hopkins Verbal Learning Test (SMD=-1.24), Brief Visuospatial Memory Test (SMD=-1.18), Mazes (SMD=-1.16), Category Fluency (SMD=-1.01), Spatial Span (SMD=-0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=-0.38). Conclusions Our meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.
