Network analysis of the relationships between depressive symptoms and social participation activities among Chinese older adults and its implications for nursing

Objective:Network analysis was used to explore the complex inter-relationships between social participation activities and depressive symptoms among the Chinese older population,and the differences in network structures among different genders,age groups,and urban-rural residency would be compared.Methods:Based on the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS),12,043 people aged 65 to 105 were included.The 10-item Center for Epidemiologic Studies Depression(CESD)Scale was used to assess depressive symptoms and 10 types of social participation activities were collected,including housework,tai-chi,square dancing,visiting and interacting with friends,garden work,reading newspapers or books,raising domestic animals,playing cards or mahjong,watching TV or listening to radio,and organized social activities.R 4.2.1 software was used to estimate the network model and calculate strength and bridge strength.Results:21.60%(2,601/12,043)of the participants had depressive symptoms.The total social participation score was negatively associated with depressive symptoms after adjusting for sociodemographic factors.The network of social participation and depressive symptoms showed that“D9(Inability to get going)”and“S9(Watching TV and/or listening to the radio)”had the highest strength within depressive symptoms and social participation communities,respectively,and“S1(Housework)”,“S9(Watching TV and/or listening to the radio)”,and“D5(Hopelessness)”were the most prominent bridging nodes between the two communities.Most edges linking the two communities were negative.“S5(Graden work)-D5(Hopelessness)”and“S6(Reading newspapers/books)-D4(Everything was an effort)”were the top 2 strongest negative edges.Older females had significantly denser network structures than older males.Compared to older people aged 65e80,the age group 81e105 showed higher network global strength.Conclusions:This study provides novel insights into the complex relationships between social participation and depressive symptoms.Except for doing housework,other social participation activities were found to be protective for depression levels.Different nursing strategies should be taken to prevent and alleviate depressive symptoms for different genders and older people of different ages.

Association between the frontoparietal network,clinical symptoms and treatment response in individuals with untreated anorexia nervosa

Background Anorexia nervosa(AN)has been characterised as a psychiatric disorder associated with increased control.Currently,it remains difficult to predict treatment response in patients with AN.Their cognitive abilities are known to be resistant to treatment.It has been established that the frontoparietal control network(FPCN)is the direct counterpart of the executive control network.Therefore,the resting-state brain activity of the FPCN may serve as a biomarker to predict treatment response in AN.Aims The study aimed to investigate the association between resting-state functional connectivity(RSFC)of the FPCN,clinical symptoms and treatment response in patients with AN.Methods In this case-control study,79 female patients with AN and no prior treatment from the Shanghai Mental Health Center and 40 matched healthy controls(HCs)were recruited from January 2015 to March 2022.All participants completed the Questionnaire Versionof the Eating Disorder Examination(version 6.0)to assess the severity of their eating disorder symptoms.Additionally,RSFC data were obtained from all participants at baseline by functional magnetic resonance imaging.Patients with AN underwent routine outpatient treatment at the 4th and 12th week,during which time their clinical symptoms were evaluated using the same measures as at baseline.Results Among the 79 patients,40 completed the 4-week follow-up and 35 completed the 12-week follow-up.The RSFC from the right posterior parietal cortex(PPC)and dorsolateral prefrontal cortex(diPFC)increased in 79 patients with AN vs 40 HCs after controlling for depression and anxiety symptoms.By multiple linear regression,the RSFC of the PPC to the inferior frontal gyrus was found to be a significant factor for self-reported eating disorder symptoms at baseline and the treatment response to cognitive preoccupations about eating and body image,after controlling for age,age of onset and body mass index.The RSFC in the dIPFC to the middle temporal gyrus and the superior frontal gyrus may be significant factors in the treatment response to binge eating and loss of control/overeating in patients with AN.Conclusions Alterations in RSFC in the FPCN appear to affect self-reported eating disorder symptoms and treatment response in patients with AN.Our findings offer new insight into the pathogenesis of AN and could promote early prevention and treatment.

Network analysis of suicide ideation and depression-anxiety symptoms among Chinese adolescents

Background The co-occurrence of depression and anxiety among adolescents is typically associated with suicide ideation.Aims The study aimed to investigate the symptom-level relationship between suicide ideation and the comorbidity of depression and anxiety.Methods 1501 adolescents aged 12-19 years were assessed using the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder Scale,and 716 adolescents who scored≥5 on both scales were selected as participants.Network analysis was used to identify the network structure of depressive symptoms and anxiety symptoms.Participants were categorised into either the suicide ideation or non-suicide ideation groups based on their scoring on the suicide-related item in PHQ-9.A comparison was made between the depression-anxiety symptom networks of the two groups.Results‘Restlessness’,‘sad mood’and‘trouble relaxing’were the most prominent central symptoms in the depression-anxiety symptom network,and‘restlessness’,‘nervousness’and‘reduced movement’were the bridge symptoms in this network.‘Sad mood’was found to be directly related to‘suicide ideation’with the highest variance.The network structure was significantly different in properties between the suicide ideation group and the non-suicide ideation group,with‘restlessness’and‘sad mood’exhibiting significantly higher influence in the network of the suicide ideation group than that in the non-suicide ideation group.Conclusion Restlessness and sad mood could be targeted for the intervention of depression-anxiety symptoms among adolescents with suicide ideation.

Prevalence of prolonged grief disorder and its symptoms among bereaved individuals in China:a systematic review and meta-analysis

Background The prevalence of prolonged grief disorder(PGD)and its symptoms among the bereaved population in China vary considerably.Aims This meta-analysis aims to estimate the prevalence of PGD and its symptoms among bereaved individuals in China.Methods We conducted a literature search in major Chinese and English databases from their inception to 4 October 2023,for cross-sectional studies on the prevalence of PGD or its symptoms in bereaved Chinese individuals.The risk of bias of the included studies and certainty of the evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data(‘JBI checklist’)and the Grading of Recommendations,Assessment,Development and Evaluations(GRADE),respectively.The‘metaprop’package in R V.4.1.2 was used to synthesise the prevalence.Results A total of 28 studies involving 10994 bereaved individuals were included in the analysis,with JBI checklist scores between 3 and 7.The combined prevalence(95%confidence interval)of PGD and its symptoms was 8.9%(4.2%to 17.6%)and 32.4%(18.2%to 50.8%),respectively.PGD and its symptoms were most prevalent among those who had lost their only child(22.7%)and those bereaved by earthquakes(80.4%),respectively.The GRADE system assigned a very low certainty level to the evidence for the pooled prevalence of PGD and its symptoms.Conclusions The pooled prevalence of PGD and its symptoms indicate a potential high need for grief counselling services among bereaved individuals in China.This need is particularly pronounced in those who have lost their only child and those bereaved due to earthquakes.Further methodologically rigorous studies are needed to provide more accurate prevalence estimates.PROSPERO registration number CRD42023432553.

Trajectories of depressive symptoms and risk of cardiovascular disease,cancer and mortality:a prospective cohort study

Background Depressive symptoms are established risk factors for various health outcomes.However,previous studies assessed depressive symptoms at a single time point,neglecting individual variations over time.Aims To identify depressive symptoms trajectories through repeated measures and examine their associations with cardiovascular disease(CVD),cancer and mortality.Methods This study included 20634 UK Biobank participants free of CVD and cancer at baseline with two or more assessments of depressive symptoms during 2006-2016.Group-based trajectory modelling identified depressive symptoms trajectories.Incident CVD,cancer and mortality were followed up until 2021 through linked registries.Results Six depressive symptoms trajectories were identified:no symptoms(n=6407),mild-stable(n=11539),moderate-stable(n=2183),severe-decreasing(n=206),moderate-increasing(n=177)and severe-stable(n=122).During a median follow-up of 5.5 years,1471 CVD cases,1275 cancer cases and 503 deaths were documented.Compared with the no symptoms trajectory,the mildstable,moderate-stable and severe-stable trajectories exhibited higher CVD risk,with hazard ratios(HRs)(95%CIs)of 1.19(1.06 to 1.34),1.32(1.08 to 1.34)and 2.99(1.85 to 4.84),respectively.Moderate-increasing and severe-stable trajectories were associated with higher mortality risks,with HRs(95%CIs)of 2.27(1.04 to 4.93)and 3.26(1.55 to 6.88),respectively.However,the severedecreasing trajectory was not associated with higher risks of adverse outcomes.We did not find significant associations between any trajectory and cancer.Conclusions Trajectories related to stable and increasing depressive symptoms,but not the trajectory associated with severe depressive symptoms at the initial assessment but decreasing at the follow-up,were associated with higher risks of CVD and mortality.Alleviating severe depressive symptoms at the initial onset may mitigate CVD and mortality risks.

Improving early diagnosis of multiple endocrine neoplasia type 1 by assessing the gastrointestinal symptoms,hypercalcemia,and elevated serum gastrin

Despite advancements in the field,early diagnosis of multiple endocrine neoplasia type 1(MEN1)remains unachievable.This letter to the editor highlighted the importance of carefully assessing gastrointestinal symptoms,hypercalcemia,and elevated serum gastrin levels,as suggested by Yuan et al in their paper.They focused on a patient with recurrent abdominal pain and diarrhea whose diagnostic path led to establishing a MEN1 diagnosis within a year.This emphasized the need for clinicians to consider MEN1 in patients with similar presentations,particularly when gastrointestinal symptoms persist or recur after discontinuation of proton pump inhibitors,especially knowing that early recognition and intervention are crucial for improving patient outcomes.

Current Insights on Vitamin D Intake, Status and Symptoms of Irritable Bowel Syndrome: A Narrative Review

The association between Vitamin D and IBS has attracted growing interest because of vitamin D’s involvement in immune system function and reduction of inflammation. IBS, a prevalent gastrointestinal condition marked by symptoms such as stomach pain, bloating, and changed bowel habits, implies that sufficient levels of Vitamin D may impact the symptomatology and quality of life associated with IBS. This review aimed to unveil current insights on vitamin D intake, status and symptoms of irritable bowel syndrome. A search was conducted on Embase, Scopus, Medline, and Cochrane Library, as well as a reference list of relevant studies. This paper also examined the current therapeutic practices for using vitamin D in the management of IBS. Although several studies demonstrate a positive association between vitamin D administration and the alleviation of IBS symptoms, the data is not yet definitive. Moreover, the review emphasised the necessity for additional rigorous clinical studies to determine a definitive therapeutic function of vitamin D in IBS based on the literature. The role of vitamin D in the modulation of gut health, particularly in IBS, has garnered significant attention due to its potential impact on both inflammation and the integrity of the gut barrier. Vitamin D, acting as a hormone precursor, is recognised for its crucial involvement in maintaining calcium balance and promoting bone health.

Sleep Quality and Emotional Adaptation among Freshmen in Elite Chinese Universities during Prolonged COVID-19 Lockdown:The Mediating Role of Anxiety Symptoms

Under the effects of COVID-19 and a number of ongoing lockdown tactics,anxiety symptoms and poor sleep quality have become common mental health issues among college freshmen and are intimately related to their emotional adaptation.To explore this connection,this study gathered data from a sample of 256 freshmen enrolled in an elite university in China in September 2022.The association between sleep quality,anxiety symptoms,and emotional adaptation was clarified using correlation analysis.Additionally,the mediating function of anxiety symptoms between sleep quality and emotional adaptation was investigated using a structural equation model.The results reveal that:(1)Chinese elite university freshmen who were subjected to prolonged lockdown had poor sleep quality and mild anxiety symptoms;(2)a significant positive correlation between poor sleep quality and anxiety symptoms was identified;(3)anxiety symptoms were found to have a significant negative impact on emotional adaptation;(4)poor sleep quality had a negative impact on emotional adaptation through anxiety symptoms.This research makes a valuable contribution by offering insights into the intricate relationship between sleep quality and emotional adaptation among freshmen in elite Chinese universities during prolonged lockdown conditions,and it is beneficial for schools and educators to further improve school schedules and psychological health initiatives.

The Effects of Childhood Trauma on College Students’Depressive Symptoms:The Mediation Role of Subjective Well-Being and the Moderation Role of Resilience

Background:The enduring and detrimental impact of childhood trauma on later health and well-being is now well established.However,research on the relationship between childhood trauma and depressive symptoms,along with the potential risk and protective factors,is insufficient in the context of Chinese college student population.Methods:Data on childhood trauma,depressive symptoms,resilience,and subjective well-being were collected through surveys conducted with 367 Chinese university students.The data collected in this study were analyzed using SPSS 26.0 and PROCESS 3.5.Results:The results revealed that subjective well-being mediated the relationship between childhood trauma and depressive symptoms among college students,with direct and indirect effects accounting for 59.46%and 40.54%of the total effect,respectively.The pathway process between subjective well-being and depressive symptoms was moderated by resilience,whereby an increase in resilience levels corresponded to a gradual escalation in the predictive power of subjective well-being on depressive symptoms.Conclusion:The study indicates that childhood trauma significantly and positively predicts depressive symptoms among college students,and it can also directly predict depressive symptoms through the mediating effect of subjective well-being.Elevating levels of psychological resilience and subjective well-being among college students can mitigate depression and promote psychological well-being.From the perspective of positive psychology,the present study provides a new perspective for the prevention and intervention of depressive symptoms among college students.

Relationship between physical activity and specific working memory indicators of depressive symptoms in university students

BACKGROUND The detection rate of depression among university students has been increasing in recent years,becoming one of the main psychological diseases that endangers their physical and mental health.According to statistics,self-harm and suicide,for which there is no effective intervention,are the second leading causes of death.AIM To explore the relationship between different elements and levels of physical activity and college students’depression-symptom-specific working memory indicators.METHODS Of 143 college students were analyzed using the Beck Depression Self-Rating Scale,the Physical Activity Rating Scale,and the Working Memory Task.RESULTS There was a significant difference between college students with depressive symptoms and healthy college students in completing verbal and spatial working memory(SWM)tasks correctly(all P<0.01).Physical Activity Scale-3 scores were significantly and positively correlated with the correct rate of the verbal working memory task(r=0.166)and the correct rate of the SWM task(r=0.210)(all P<0.05).There were significant differences in the correct rates of verbal and SWM tasks according to different exercise intensities(all P<0.05)and different exercise durations(all P<0.05),and no significant differences in the correct rates of verbal and SWM tasks by exercise frequency(all P>0.05).CONCLUSION An increase in physical exercise among college students,particularly medium-and high-intensity exercise and exercise of 30 min or more,can improve the correct rate of completing working memory tasks.

Effects of a Cocktail Supplement of Ginkgo Biloba and Acai Extract on Cognitive Symptoms of Parkinson’s Disease

Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).

Study on the occurrence and influencing factors of gastrointestinal symptoms in hemodialysis patients with uremia

BACKGROUND Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis,and these symptoms seriously affect patients'prognosis.AIM To assess the occurrence and factors influencing gastrointestinal symptoms in patients with uremia undergoing hemodialysis.METHODS We retrospectively selected 98 patients with uremia who underwent regular hemo-dialysis treatment in the blood purification center of our hospital from December 2022 to December 2023.The gastrointestinal symptoms and scores of each dimension were evaluated using the Gastrointestinal Symptom Grading Scale(GSRS).Patients were divided into gastrointestinal symptoms and no gastrointestinal symptom groups according to whether they had gastrointestinal symptoms.The factors that may affect gastrointestinal symptoms were identified by single-factor analysis.Multiple logistic regression analysis was performed to identify independent risk factors for gastrointestinal symptoms.RESULTS Gastrointestinal symptoms included indigestion,constipation,reflux,diarrhea,abdominal pain,and eating disorders,and the total average GSRS score was 1.35±0.47.This study showed that age,number of tablets,dialysis time,glucocorticoid,parathyroid hormone(PTH),combined diabetes mellitus and C-reactive protein(CRP)were independent risk factors for gastrointestinal symptoms in patients with uremia undergoing hemodialysis,whereas body mass index(BMI),hemoglobin(Hb),and urea clearance index were independent protective factors(P<0.05).CONCLUSION Gastrointestinal symptoms are mostly mild in patients with uremia undergoing hemodialysis,most commonly including dyspepsia,eating disorders,and gastroesophageal reflux.The independent influencing factors mainly include the BMI,age,number of pills taken,dialysis time,urea clearance index,Hb,use of glucocorticoids,and thyroid hormone level.PTH,CRP,and diabetes are clinically related factors influencing the occurrence of gastrointestinal symptoms,and targeted prevention can be performed.

Rare and lacking typical clinical symptoms of liver tumors:Four case reports

BACKGROUND Rare liver tumors(RLTs)have an extremely low likelihood of forming,and some have been recorded only in isolated cases.The lack of normal clinical symptoms in RLTs makes preoperative diagnosis extremely challenging,which results in frequent misinterpretation.The present case report helps enhance our ability to recognize and treat uncommon liver tumor disorders.CASE SUMMARY We describe four distinct examples of rare liver tumor diseases.These cases were all true cases with no conventional clinical signs or imaging findings.In all patients,hepatic occupancy was discovered on physical examination,which raised the preoperative suspicion of hepatic cancer.All tumors were surgically removed,and postoperative histology and immunohistochemistry were performed to confirm the diagnosis.The first patient had primary hepatic fibrosarcoma.The second case involved a primary hepatic neuroendocrine tumors.These two patients had malignant liver tumors,and both had extremely satisfactory surgical outcomes.The third case involved focal hepatic steatosis,and the fourth case involved a single necrotic nodule in the liver.These two patients had benign liver tumors,but they had already undergone surgery and did not require any postoperative care.CONCLUSION The number of patients with RLTs is small,and the clinical and imaging results are vague.Preoperative diagnosis is challenging,and patients are sometimes mistakenly diagnosed with liver cancer,which leads to unnecessary surgical therapy in certain individuals.

Socio-Demographic and Clinical Characteristics of Patients Presenting with Lower Urinary Tract Symptoms Secondary to BPH, in a Tertiary Hospital

Background: Benign prostatic hyperplasia (BPH) is the proliferation of the stromal and epithelial cells of the prostate gland, resulting in an increase in its size. This may result in obstruction of the lower urinary tract causing storage and voiding symptoms. Methods: This was a prospective cross-sectional study from August 2020 to July 2021, to evaluate the characteristic of patients presenting to the Tamale Teaching Hospital with lower urinary tract symptoms secondary to BPH. Results: The median age at presentation with LUTS secondary to BPH is 68.88 ± 11.10 years with an average prostate volume of 70 g. The average time of presentation to the hospital is 5 months, mostly with moderate to severe symptoms. Correlation between Prostate volume (PV) and age yielded a positive relationship;however, this was not statistically significant, (r = 0.028, p-value = 0.747). There was a significant positive relationship between PV and the IPSS score, (r = 0.334, p-value Conclusion: Our patients with symptomatic BPH present at age 60 years and above, with nearly all of them presenting with moderate to severe LUTS.

The Effect of Seated Baduanjin Exercise on Psychological State, Fatigue Symptoms, and Quality of Life in Maintenance Hemodialysis Patients

Objective:To evaluate the intervention effects of seated Baduanjin exercise on patients undergoing maintenance hemodialysis(MHD).Methods:A total of 108 MHD patients admitted between July 2022 and July 2023 were selected.They were randomly assigned into two groups:the experimental group,with 55 patients,who received seated Baduanjin exercise combined with leg exercises during dialysis;and the control group,with 53 patients,who only performed leg exercises during dialysis.The psychological state,fatigue symptoms,quality of life,and sleep quality scores were compared between the two groups,and exercise endurance was recorded.Results:After the intervention,the psychological state scores in the experimental group were lower than those in the control group,the fatigue symptom scores were lower,the quality of life scores were higher,the sleep quality scores were lower,and the exercise endurance was higher(P<0.05).Conclusion:Seated Baduanjin exercise can improve the negative psychological state and fatigue symptoms of MHD patients,enhance their quality of life and sleep quality,and effectively increase their exercise endurance.

Combination of symptoms, syndrome and disease: Treatment of refractory diabetic gastroparesis

AIM: To assess effect of combination of symptoms, syndrome and disease on treatment of diabetic gastroparesis with severe nausea and vomiting.

Conceptualization and treatment of negative symptoms in schizophrenia

Negative symptoms of schizophrenia including social withdrawal, diminished affective response, lack of interest, poor social drive, and decreased sense of purpose or goal directed activity predict poor functional outcomes for patients with schizophrenia. They may develop and be maintained as a result of structural and functional brain abnormalities, particularly associated with dopamine reward pathways and by environmental and psychosocial factors such as self-defeating cognitions and the relief from overstimulation that accompanies withdrawal from social and role functioning. Negative symptoms are more difficult to treat than the positive symptoms of schizophrenia and represent an unmet therapeutic need for large numbers of patients with schizophrenia. While antipsychotic medications to treat the symptoms of schizophrenia have been around for decades, they have done little to address the significant functional impairments in the disorder that are associated with negative symptoms. Negative symptoms and the resulting loss in productivity are responsible for much of the world-wide personal and economic burden of schizophrenia. Pharmacologic treatments may be somewhat successful in treating secondary causes of negative symptoms, such as antipsychotic side effects and depression. However, in the United States there are no currently approved treatments for severe and persistent negative symptoms(PNS) that are not responsive to treatments for secondary causes. Pharmacotherapy and psychosocial treatments are currently being developed and tested with severe and PNS as their primary targets. Academia, clinicians, the pharmaceutical industry, research funders, payers and regulators will need to work together to pursue novel treatments to address this major public health issue.

ACUPUNCTURE TREATMENT OF 40 CASES OF SEVERE HICCUP BASED ON DIFFERENTIATION OF SYMPTOMS AND SIGNS

In the present study, the authors selected points according to differentiation of symptoms and signs and applied filiform needles to treating 40 cases of hiccup who had tried treatment with Western and Chinese drugs but without any effect and achieved satisfactory results. After acupuncture treatment, 34 cases (85 %) were cured, 4 (10 %) improved markedly and 2(5 %) improved, with total effective rate of 100 %.

Gabapentin for the treatment of behavioral and psychological symptoms of dementia

Objective: To examine the efficacy of gabapentin for the treatment of behavioral and psychological symptoms of dementia (BPSD). Design: A retrospective chart review. Settings: Tertiary care geriatric psychiatry inpatient unit. Participants: 230 patients with BPSD. Measurements: The socio-demographic information, type of behaviors, co-morbid psychiatric and medical diagnoses, daily doses of medications and side-effects were recorded. Results: Of the 230 patients, 22 were treated with gabapentin. Twenty of these patients were on a combination of gabapentin and an antipsychotic medication while two patients were treated with gabapentin monotherapy. Eighteen of the 20 patients in the combination group tolerated the treatments with little or no side effects as did the two patients in the monotherapy group. Conclusions: Gabapentin may be a safe option for the treatment of BPSD in combination with antipsychotic medications. Gabapentin may also be effective as monotherapy in certain patients with BPSD.