抑郁性认知量表中文版在社区成人中应用的效度和信度

目的:评价抑郁性认知量表(DCS)中文版在社区成年人中应用的效度和信度。方法:在山东省济宁市8个社区选取≥18岁社区居民595人完成DCS中文版评定,采用探索性因子分析检验DCS的结构效度,计算Cronbachα系数评价DCS的内部一致性。选取其中79例对象完成2周后的DCS重测。结果:探索性因子分析提取1个公因子,方差贡献率为64.5%;DCS中文版内部一致性Cronbachα系数为0.91;2周重测信度系数为0.88(P<0.001)。结论:抑郁性认知量表中文版在社区成年人中具有较好的结构效度和信度,但其效标效度尚须进一步研究。

钙调蛋白依赖性激酶Ⅱ/Ⅳ对抑郁性认知功能障碍中突触可塑性的作用研究

抑郁性认知功能障碍与抑郁症本身密切相关的认知症状,是认知症状中最主要的类型,贯穿整个抑郁症的发病前期、急性期直至缓解期,是抑郁症核心症状之一。在抑郁症急性发作期,患者的抑郁性认知比较常见,可独立于情感症状或躯体症状之外,部分患者的抑郁性认知会随着情感症状的缓解而减轻。抑郁性认知功能康复是抑郁症最终治疗的目标。钙调蛋白依赖性激酶在调节突触可塑性,与改善抑郁性认知障碍息息相关。该文就钙调蛋白依赖性激酶Ⅱ/Ⅳ对抑郁性认知障碍的调节作用与机制研究做一综述。

育龄期慢性乙肝病毒感染者歧视测量及抑郁性认知的研究

目的:研究育龄期慢性乙肝病毒感染者歧视及抑郁性认知状况,并调查两者之间的相关性。方法:采用一般资料问卷、慢性乙肝病毒感染者歧视测量量表及抑郁性认知量表对多名育龄期慢性乙肝病毒感染者进行问卷调查。结果:育龄期慢性乙肝病毒感染者歧视总得分为(65.97±9.06)分,条目均分为(2.87±0.79)分;育龄期慢性乙肝病毒感染者抑郁性认知总得分为(20.22±3.10)分,各条目均分在1.7~3.1之间;不同歧视得分组别间的抑郁性认知得分差异具有统计学意义(P<0.01);育龄期慢性乙肝病毒感染者抑郁性认知总分与外在歧视维度得分(r=0.45,P<0.01)、负性自我评价维度得分(r=0.45,P<0.01)、感知的羞辱维度得分(r=0.45,P<0.01)和歧视总分(r=0.48,P<0.01)呈正相关。结论:育龄期慢性乙肝病毒感染者受歧视和抑郁性认知状况处于中等以下水平,医务人员应通过缓解患者的受歧视情况来降低患者的抑郁性认知,为育龄期乙肝感染患者消除歧视和预防抑郁障碍的产生提供依据。

大学生正念水平与自杀风险的关系:认知灵活性和抑郁性认知的链式中介作用

目的探讨大学生认知灵活性和抑郁性认知在正念与自杀风险间的链式中介作用。方法采用自杀行为问卷(SBQ-R)、正念注意觉知量表(MAAS)、认知灵活性问卷(CFI)和抑郁性认知量表(DCS)对2627名广东某医科大学大一学生进行调查研究。结果自杀风险、正念、认知灵活性和抑郁性认知的得分分别为[M(QR)]:4.00(2.00)分,67.00(15.00)分,78.00(13.00)分,5.00(7.00)分。相关分析结果显示:自杀风险与抑郁性认知呈正相关(r=0.280,P<0.01),与正念和认知灵活性均呈负相关(r=-0.253,r=-0.196,P<0.01);正念与认知灵活性呈正相关(r=0.539,P<0.01),与抑郁性认知呈负相关(r=-0.518,P<0.01);认知灵活性与抑郁性认知呈显著负相关(r=-0.584,P<0.01)。中介模型检验表明,正念对于自杀风险的直接效应显著,直接效应值为-0.101,占总效应的34.9%;正念对自杀风险的总间接效应值为-0.188,占总效应的65.1%;认知灵活性在正念和自杀风险之间的效应值为-0.063,占总效应的21.8%;抑郁性认知在正念和自杀风险间的效应值为-0.054,占总效应的18.7%;认知灵活性和抑郁性认知在正念和自杀风险间的链式中介作用显著,效应值为-0.071,占总效应的24.6%。结论正念不仅直接作用于自杀风险,还分别通过认知灵活性、抑郁性认知的中介作用,以及认知灵活性和抑郁性认知的链式中介作用对自杀风险产生影响。

电针联合草酸艾司西酞普兰治疗对抑郁障碍患者抑郁状态的影响

目的研究电针治疗对重性抑郁障碍患者的抑郁状态的影响。方法本研究共分为3组,药物组、和药物+电针组及对照组(每组各50例),药物组给予艾司西酞普兰抗抑郁治疗连续6周,药物+电针组在给予艾司西酞普兰抗抑郁治疗的基础上,进行电针治疗6周。比较治疗前后三组的HAMD 24项评分,并对三组的HAMD 24项评分与血清细胞炎症因子IL-1β、IL-2、IL-6、TNF-α水平进行相关性分析。采用多元逐步回归法,分析影响基线药物组和药物+电针组HAMD 24项评分的主要因素。结果与治疗前比较,药物组和药物+电针组患者治疗后HAMD 24项评分均降低,差异有统计学意义(P<0.05或P<0.01),与药物组比较,治疗后药物+电针组HAMD 24项评分较低,差异有统计学意义(P<0.05或P<0.01)。药物组HAMD 24项评分与血清细胞炎症因子IL-6(r=0.335,P<0.001)、TNF-α(r=0.269,P<0.001)、IL-2(r=0.257,P=0.001)和IL-1β(r=0.205,P=0.021)呈正相关。药物+电针组HAMD24项评分与血清细胞炎症因子IL-6(r=0.338,P<0.001)、TNF-α(r=0.271,P<0.001)、IL-2(r=0.255,P=0.015)和IL-1β呈正相关(r=0.208,P=0.026)。影响药物组HAMD24项评分的主要因素有:血清细胞炎症因子IL-6、TNF-α、IL-1β、IL-2、婚姻(已婚)、文化程度(受教育年限少),标准化回归系数分别为0.585、0.516、0.452、0.318、-0.290、0.262(P<0.05或P<0.01)。影响药物+电针组HAMD24项评分的主要因素有:血清细胞炎症因子IL-6、TNF-α、IL-2、IL-1β、婚姻(已婚)、文化程度(受教育年限少),标准化回归系数分别为0.592、0.521、0.448、0.323、-0.295、0.271(P<0.05或P<0.01)。结论药物联合电针治疗能有效改善重性抑郁障碍患者的抑郁状态,细胞炎症因子与HAMD24项评分相关,可影响重性抑郁障碍患者的抑郁状态。

Compound Chai Jin Jie Yu Tablets,Acts as An Antidepressant by Promoting Synaptic Function in the Hippocampal Neurons

Objective To investigate the effectiveness of compound Chai Jin Jie Yu Tablets(CJJYT)in ameliorating cognitive impairment associated with depression and its potential mechanism of action.Methods In vitro experiments,the hippocampus was isolated from the whole brain of the fetal rat and cultured into hippocampal neuron cells.50μM corticosterone(CORT)was added to each group 18 h before the experiment for modeling depression,with the exception of the control group.After modeling,the blank serum group was added with 10%blank serum,the CJJYT group and the venlafaxine group were added with the corresponding 10%drug-containing serum,and the control group and the model group were added with equal volumes of culture medium.The intracellular Ca^2+mean fluorescence intensity,miniature excitatory postsynaptic current(mEPSC)current amplitude,and frequency of different hippocampal neurons were evaluated as indicators of synaptic function in the hippocampal neurons.In addition,the expression of synaptic plasticity related proteins,synaptophysin-α(SYN-α),N-methyl-D-aspartate receptor 2A(NR2A),N-methyl-Daspartate receptor 2B(NR2B),post synaptic density 95 protein(PSD-95),calcium/calmodulin dependent protein kinaseⅡ(CaMKⅡ)and synaptic associated protein(SynGAP)were detected in the hippocampal neurons by immunofluorescence staining and high content analysis(HCA)system.Then,reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the mRNA expression levels of SYN-α,NR2A,NR2B,PSD-95,CaMKⅡand SynGAP.For in vivo experiments,except for those in the blank control group,all rats were treated within a single cage for chronic unpredictable stress-induced depression modeling and subjected to corresponding drug interventions.Behavioral tests were used to detect depressive behavior and determine learning,memory and other cognitive abilities,whereas enzyme-linked immunosorbent assay(ELISA)was used to detect the CORT levels.Golgi-Cox staining was used to observe changes in the synaptic morphology of parahippocampal gyrus CA1 area(CA1)and dentategyrus(DG).Results In vitro,CJJYT treatment reduced the intracellular Ca^2+mean flurorescence intensity in the hippocampal neurons(P<0.05),causing a reduction in the frequency and current amplitude of mEPSC(P<0.05),and thus inhibited the excessive activation of post-synaptic receptors.CJJYT treatment reduced the protein and mRNA expression of SYN-α,NR2A,NR2B and PSD-95 in the hippocampal neurons(P<0.05),increased the mRNA and protein expression of CaMKⅡand SynGAP(P<0.05),and thereby improved the synaptic plasticity of the hippocampal neurons.In vivo,CJJYT intervention improved sucrose preference,voluntary activity,learning and memory ability of Morris water maze test,and suppressed appetite(P<0.05),and increased the despair feeling of forced swimming test(P<0.05).The CORT level was reduced(P<0.05),leading to the repair of synaptic damage in the hippocampal neurons.Conclusions CJJYT can improve the synaptic function of hippocampal neurons and has obvious protective effects on neurons.It can repair the structural damage in the hippocampal neurons,improving the cognitive ability of the depressed model rats.The mechanism of CJJYT improving cognition in depressed rats may be related to the transmission and function of SYN-α/NR and its downstream neurotransmitters.