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Sleep disturbances and psychomotor retardation in the prediction of cognitive impairments in patients with major depressive disorder
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作者 Mi Wang Wen-Tao Chen +15 位作者 Hao-Ting Wang Bang-Shan Liu Yu-Meng Ju Qiang-Li Dong Xiao-Wen Lu Jin-Rong Sun Liang Zhang Hua Guo Fu-Tao Zhao Wei-Hui Li Li Zhang Ze-Xuan Li Mei Liao Yan Zhang Jin Liu Ling-Jiang Li 《World Journal of Psychiatry》 SCIE 2024年第10期1474-1483,共10页
BACKGROUND Symptoms of depression and comorbid anxiety are known risk factors for cognitive impairment in major depressive disorder(MDD).Understanding their relationships is crucial for developing targeted interventio... BACKGROUND Symptoms of depression and comorbid anxiety are known risk factors for cognitive impairment in major depressive disorder(MDD).Understanding their relationships is crucial for developing targeted interventions to mitigate cognitive impairments in MDD patients.We expect that the severity of sleep disturbances and other depressive symptoms will be positively correlated with the degree of cognitive impairments.We also hypothesize that anxiety symptoms,especially psychic anxiety,is a key factor in predicting cognitive performance in MDD patients and may indirectly contribute to cognitive impairment by affecting sleep disturbances and other potential factors.AIM To determine which dimension of the depressive and anxiety symptoms predicts cognitive impairment during a depressive episode.METHODS A comprehensive neurocognitive test battery assessed executive function,attention,processing speed,and memory in 162 medication-free MDD patients and 142 matched healthy controls.The 24-item Hamilton Depression Rating Scale was used to assess depressive symptoms,and the 14-item Hamilton Anxiety Scale was used to assess anxiety symptoms.Linear regression analyses and mediation analyses were conducted to evaluate the impact of depressive and anxiety symptoms,as well as their interactions,on cognitive impairments.RESULTS Among the depressive symptoms,sleep disturbances were associated with poorer executive function(P=0.004),lower processing speed(P=0.047),and memory impairments(P<0.001),and psychomotor retardation(PR)was associated with lower processing speed in patients with MDD(P=0.019).Notably,PR was found to mediate the impact of sleep disturbances on the processing speed.Regarding anxiety symptoms,psychic anxiety,rather than somatic anxiety,was associated with cognitive impairments in all aspects.Sleep disturbances mediated the effect of psychic anxiety on executive function[β=-0.013,BC CI(-0.027,-0.001)]and memory[β=-0.149,BC CI(-0.237,-0.063)],while PR mediated its effect on processing speed(β=-0.023,BC CI(-0.045,-0.004)].CONCLUSION Sleep disturbances may be a key predictor of poorer executive function,lower processing speed,and memory loss,while PR is crucial for lower processing speed during a depressive episode.Psychic anxiety contributes to all aspects of cognitive impairments,mediated by sleep disturbances and PR. 展开更多
关键词 major depressive disorder Cognitive impairment depressive symptoms Anxiety symptoms Sleep disturbance Psychomotor retardation
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The norepinephrine transporter gene is associated with the retardation symptoms of major depressive disorder in the Han Chinese population 被引量:3
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作者 Xinrong Li Ning Sun +6 位作者 Yong Xu Yanfang Wang Suping Li Qiaorong Du Juyi Peng Jinxiu Luo Kerang Zhang 《Neural Regeneration Research》 SCIE CAS CSCD 2012年第25期1985-1991,共7页
The norepinephrine transporter plays an important role in the pathophysiology and pharmacological treatment of major depressive disorder. Consequently, the norepinephrine transporter gene is an attractive candidate in... The norepinephrine transporter plays an important role in the pathophysiology and pharmacological treatment of major depressive disorder. Consequently, the norepinephrine transporter gene is an attractive candidate in major depressive disorder research. In the present study, we evaluated the depression symptoms of subjects with major depressive disorder, who were all from the North of China and of Hart Chinese origin, using the Hamilton Depression Scale. We examined the relationship between two single nucleotide polymorphisms in the norepinephrine transporter, rs2242446 and rs5569, and the retardation symptoms of major depressive disorder using quantitative trait testing with the UNPHASED program, rs5569 was associated with depressed mood, and the GG genotype may be a risk factor for this; rs2242446 was associated with work and interest, and the TT genotype may be a risk factor for loss of interest. Our findings suggest that rs2242446 and rs5569 in the norepinephrine transporter gene are associated with the retardation symptoms of depression in the Hart Chinese population. 展开更多
关键词 Norepinephrine transporter major depressive disorder quantitative trait locus gene polymorphism retardation symptoms Hamilton Depression Scale ENDOPHENOTYPE single nucleotidepolymorphism pathogenesis
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Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder 被引量:3
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作者 Pontus Karling Martin Maripuu +2 位作者 Mikael Wikgren Rolf Adolfsson Karl-Fredrik Norrback 《World Journal of Gastroenterology》 SCIE CAS 2016年第38期8540-8548,共9页
AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 year... AIM To study if anxiety, depression and experience of stress are associated with gastrointestinal(GI) symptoms in patients with bipolar disorder.METHODS A total of 136 patients with bipolar disorder(mean age 49.9 years; 61% women) and 136 controls from the general population(mean age 51.0 years; 60% women) were included in the study. GI symptoms were assessed with The Gastrointestinal Symptom Rating Scale-irritable bowel syndrome(GSRS-IBS), level of anxiety and depression with The Hospital Anxiety and Depression Scale(HADS) and stress-proneness with Perceived Stress Questionnaire. Over a ten year period, all visits in primary care were retrospectively recorded in order to identify functional GI disorders.RESULTS In subjects with low total HADS-score, there were no significant differences in GI-symptoms between patients and controls(GSRS-IBS 7.0 vs 6.5, P = 0.513). In the patients with bipolar disorder there were significant correlations between all GSRS and HADS subscores for all symptom clusters except for "constipation" and "reflux". Factors associated to GI symptoms in the patient group were female sex(adjusted OR = 2.37, 95%CI: 1.07-5.24) and high HADS-Depression score(adjusted OR = 3.64, 95%CI: 1.07-12.4). These patients had also significantly more visits for IBS than patients with low HADS-Depression scores(29% vs 8%, P = 0.008). However, there was no significant differences in consulting behaviour for functional GI disorders between patients and controls(25% vs 17%, P = 0.108).CONCLUSION Female patients and patients with high HADS depression score reported significantly more GI symptoms, whereas patients with low HADS scores did not differ from control subjects. 展开更多
关键词 ANXIETY Bipolar disorder Brain-Gut axis DEPRESSION DYSPEPSIA Functional gastrointestinal disorder Gastrointestinal Symptom Rating Scale-irritable bowel syndrome Irritable bowel syndrome Hospital Anxiety and Depression Scale Stress
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Psychotic symptoms in bipolar disorder and their impact on the illness:A systematic review 被引量:1
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作者 Subho Chakrabarti Navdeep Singh 《World Journal of Psychiatry》 SCIE 2022年第9期1204-1232,共29页
BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder(BD)and can have an adverse effect on its course,outcome,and treatment.However,despite a considerable amount of rese... BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder(BD)and can have an adverse effect on its course,outcome,and treatment.However,despite a considerable amount of research,the impact of psychotic symptoms on BD remains unclear,and there are very few systematic reviews on the subject.AIM To examine the extent of psychotic symptoms in BD and their impact on several aspects of the illness.METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed.An electronic literature search of six English-language databases and a manual search was undertaken to identify published articles on psychotic symptoms in BD from January 1940 to December 2021.Combinations of the relevant Medical Subject Headings terms were used to search for these studies.Articles were selected after a screening phase,followed by a review of the full texts of the articles.Assessment of the methodological quality of the studies and the risk of bias was conducted using standard tools.RESULTS This systematic review included 339 studies of patients with BD.Lifetime psychosis was found in more than a half to two-thirds of the patients,while current psychosis was found in a little less than half of them.Delusions were more common than hallucinations in all phases of BD.About a third of the patients reported first-rank symptoms or mood-incongruent psychotic symptoms,particularly during manic episodes.Psychotic symptoms were more frequent in bipolar type I compared to bipolar type II disorder and in mania or mixed episodes compared to bipolar depression.Although psychotic symptoms were not more severe in BD,the severity of the illness in psychotic BD was consistently greater.Psychosis was usually associated with poor insight and a higher frequency of agitation,anxiety,and hostility but not with psychiatric comorbidity.Psychosis was consistently linked with increased rates and the duration of hospitalizations,switching among patients with depression,and poorer outcomes with mood-incongruent symptoms.In contrast,psychosis was less likely to be accompanied by a rapid-cycling course,longer illness duration,and heightened suicidal risk.There was no significant impact of psychosis on the other parameters of course and outcome.CONCLUSION Though psychotic symptoms are very common in BD,they are not always associated with an adverse impact on BD and its course and outcome. 展开更多
关键词 psychotic symptoms Bipolar disorder Extent IMPACT
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Insomnia is associated to depressive symptoms in patients with chronic heart failure 被引量:1
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作者 Peter Johansson Anders Brostrom 《Open Journal of Nursing》 2013年第1期33-41,共9页
Introduction: Insomnia and depressive symptoms are common among patients with chronic heart failure (HF). Aim: The aim was to describe the prevalence of insomnia and depressive symptoms, as well as to examine the asso... Introduction: Insomnia and depressive symptoms are common among patients with chronic heart failure (HF). Aim: The aim was to describe the prevalence of insomnia and depressive symptoms, as well as to examine the association between insomnia and depressive symptoms in patients with HF. Method: A crosssectional descriptive study including 212 patients with HF. All patients responded to questionnaires regarding sleeping difficulties (Uppsala Sleep Inventory-Chronic Heart Failure), daytime sleepiness (Epworth Sleepiness Scale) and depressive symptoms (The Mental Health Scale). Results: Patients with depressive symptoms (34%) had, compared to those without, significantly more major complaints of insomnia as indicated by the sub-types;non-restorative sleep (66% vs. 32%, p < 0.0001), difficulty in maintaining sleep (35% vs. 16%, p = 0.003), difficulty in initiating sleep (29% vs. 14%, p = 0.009) and early morning awakenings (25% vs. 10%, p = 0.004). The odds ratio (OR) to suffer from depressive symptoms;were for;non-restorative sleep 5.2 (CI 95%, 2.2 - 12.3), difficulties maintaining sleep 2.5 (CI 95%, 1.2 - 4.9), difficulties in initiating sleep 2.2 (CI 95%, 1.1 - 4.4) and early morning awakenings 2.4 (CI 95%, 1.1 - 5.4). When categorising insomnia into three severity groups, 1) non insomnia, 2) mild insomnia, and 3) severe insomnia, the OR for depressive symptoms for the mild insomnia and severe insomnia group were 2.2 (CI 95%, 1.1 - 4.2) and 7.4 (CI 95%, 2.4 - 22.8) respectively, compared to the non insomnia group. Conclusion: Insomnia is independently associated to depressive symptoms. Assessment of depressive symptoms and insomnia in patients with HF is important since treatment could be targeted to depressive symptoms only and/or to the sleep disturbance. 展开更多
关键词 Congestive Heart Failure Insomnia disorders depressive symptoms
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Generalized Anxiety and Major Depressive Symptoms of General Public in South Korea during the Early COVID-19 Pandemic
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作者 Kye S.Kim Peter M.Kang He Sook N.Kim 《International Journal of Mental Health Promotion》 2021年第3期303-317,共15页
The extent of viral spread and strategies in dealing with the COVID-19 pandemic have been different in each country.There are overall increased mental health concerns in many countries but it is unclear what the gener... The extent of viral spread and strategies in dealing with the COVID-19 pandemic have been different in each country.There are overall increased mental health concerns in many countries but it is unclear what the general public individuals who do not have heighten vulnerability to stressors for existing mental diseases or significant physical illnesses were experiencing during the pandemic.We evaluated the stressors and mental health of general public in South Korea that has a relatively low confirmed cases and deaths.Responses on the on-line survey questions were used to assess the mental and physical symptoms in association with individuals’reported stressors.Individuals with the symptoms of the generalized anxiety disorder(GAD)were reported in 58.9%,and major depression(MD)in 23.2%,mostly in minimal to mild degrees,cut-off scores of 5 and 10,respectively by the validated screening tools,GAD-7 and PHQ-9.Both GAD and MD symptoms were in 21.5%of the respondents.The total number of stress had significant association with the scores of GAD-7,PHQ-9,physical symptoms,sleep difficulties and resilience(p<0.01).GAD scores were also associated with sleep difficulties(p<0.01)and raising young children(p<0.05).MD scores were associated with sleep difficulties,job-dissatisfaction,and educational level(p<0.05).The limitations of the study include small sample size,usage of smartphone or email,potential under-reporting by stigma in the socio-cultural context and evolving nature of pandemic.We conclude that keeping careful watch for mental symptoms,stressors,sleep difficulties and other physical symptoms are important even for the individuals without previous mental illnesses during the pandemic era. 展开更多
关键词 Generalized anxiety disorder symptoms major depression symptoms sleep difficulties physical symptoms pandemic stressors South Korea generalized anxiety disorder-7(GAD-7) patient health questionnaire-9(PHQ-9)
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Depressive Symptoms in Patients with Cancer
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作者 Catarina Possenti Sette Cláudio Garcia Capitão Lucas de Francisco Carvalho 《Open Journal of Medical Psychology》 2016年第1期7-16,共10页
The purpose of this survey was to investigate depressive symptoms in cancer patients and the differences based on gender, quality of life and social support. Sixty-eight patients diagnosed with cancer participated in ... The purpose of this survey was to investigate depressive symptoms in cancer patients and the differences based on gender, quality of life and social support. Sixty-eight patients diagnosed with cancer participated in the research, with ages varying between 25 and 83 years (A = 55.4;SD = 13.3) and 85.3% were female. The instruments used were Identification Questionnaire, Perceived Social Support Scale—adult version (EPSUS-A), Medical Outcomes Short-Form Health Survey (SF-36) and the Baptista Depression Scale Hospital—clinic version (EBADEP-HOSP-AMB). It was verified that most of the patients reported not having depression diagnosis before the cancer, nor in the current moment, besides not using anti-depressive medication. The scores obtained in the EBADEP-HOSP-AMB suggest light depressive symptoms. It is concluded that the depressive symptoms were mostly presented in women, in patients with worse mental health condition and in those less satisfied with the social support. 展开更多
关键词 depressive symptoms depressive disorder Social Network Social Support Quality of Life
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Predicting South Korea adolescents vulnerable to depressive disorder using Bayesian nomogram:A community-based crosssectional study 被引量:2
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作者 Haewon Byeon 《World Journal of Psychiatry》 SCIE 2022年第7期915-928,共14页
BACKGROUND Although South Korea has developed and carried out evidence-based interventions and prevention programs to prevent depressive disorder in adolescents,the number of adolescents with depressive disorder has i... BACKGROUND Although South Korea has developed and carried out evidence-based interventions and prevention programs to prevent depressive disorder in adolescents,the number of adolescents with depressive disorder has increased every year for the past 10 years.AIM To develop a nomogram based on a naïve Bayesian algorithm by using epidemiological data on adolescents in South Korea and present baseline data for screening depressive disorder in adolescents.METHODS Epidemiological data from 2438 subjects who completed a brief symptom inventory questionnaire were used to develop a model based on a Bayesian nomogram for predicting depressive disorder in adolescents.RESULTS Physical symptoms,aggression,social withdrawal,attention,satisfaction with school life,mean sleeping hours,and conversation time with parents were influential factors on depressive disorder in adolescents.Among them,physical symptoms were the most influential.CONCLUSION Active intervention by periodically checking the emotional state of adolescents and offering individual counseling and in-depth psychological examinations when necessary are required to mitigate depressive disorder in adolescents. 展开更多
关键词 depressive disorder NOMOGRAM Adolescents Risk factor Community-based cross-sectional study Brief symptom inventory
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Legacy of neuropsychiatric symptoms associated with past COVID-19 infection:A cause of concern
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作者 Domenico De Berardis Francesco Di Carlo +1 位作者 Massimo Di Giannantonio Mauro Pettorruso 《World Journal of Psychiatry》 SCIE 2022年第6期773-778,共6页
Although primarily affecting the respiratory system,growing attention is being paid to the neuropsychiatric consequences of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections.Acute and sub-acute neu... Although primarily affecting the respiratory system,growing attention is being paid to the neuropsychiatric consequences of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections.Acute and sub-acute neuropsychiatric manifestations of coronavirus disease 2019(COVID-19)disease and their mechanisms are better studied and understood currently than they had been when the pandemic began;however,many months or years will be necessary to fully comprehend how significant the consequences of such complications will be.In this editorial,we discuss the possible long-term sequelae of the COVID-19 pandemic,deriving our considerations on experiences drawn from past coronaviruses’outbreaks,such as the SARS and the middle east respiratory syndrome,and from the knowledge of the mechanisms of neurotropism and invasiveness of SARS-CoV-2.Acknowledging the global spread of COVID-19 and the vast number of people affected,to date amounting to many millions,the matter of this pandemic’s neuropsychiatric legacy appears concerning.Public health monitoring strategies and early interventions seem to be necessary to manage the possible emergence of a severe wave of neuropsychiatric distress among the survivors. 展开更多
关键词 COVID-19 Neuropsychiatric symptoms Neuropsychiatric sequelae Mental health Post-traumatic stress disorder Depression
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Correlative Factors for Organic Psychotic Symptoms in Pa- tients Following Traumatic Brain Injury
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作者 HANG Rong-hua XU Ya-jun ZHU Xu-yan 《法医学杂志》 CAS CSCD 2014年第1期36-40,共5页
Objective To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury(TBI). Methods In the current study, 391 subjects who had undergone forensic identification of the organi... Objective To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury(TBI). Methods In the current study, 391 subjects who had undergone forensic identification of the organic mental disorders due to TBI were included, both the demographic and post-traumatic information collected. The relevant data were statistically analyzed in those confirmed as organic psychotic syndrome according to Chinese Classification of Mental Disorders 3rd version(CCMD-3). Results Fifty-two subjects(13.3%) were identified as organic psychotic symptoms. The chi-square test showed that the detectable organic psychotic symptoms were associated with the marriage status, damage nature,injury severity and treatment, and the multivariate logistic regression analysis revealed good fitness of treatment and injury severity with the regression model(OR=0.044, 95% CI: 0.017-0.114; OR=2.145,95% CI: 1.201-3.832, respectively). Conclusion The risks of organic psychotic symptoms following TBI can be involved in the alternative of craniotomy for the cases with trauma and moderate brain injury. 展开更多
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文拉法辛联合氟西汀对伴焦虑症状重度抑郁症患者的效果 被引量:2
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作者 林荫 赖珏 +1 位作者 林春燕 李佳 《西北药学杂志》 CAS 2024年第2期200-205,共6页
目的探讨文拉法辛联合氟西汀对伴焦虑症状重度抑郁症(major depressive disorder,MDD)患者躯体症状、睡眠质量及血清5-羟色胺(5-hydroxytryptamine,5-HT)、皮质醇(cortisol,Cor)和脑源性神经营养因子(brain-derived neurotrophic factor... 目的探讨文拉法辛联合氟西汀对伴焦虑症状重度抑郁症(major depressive disorder,MDD)患者躯体症状、睡眠质量及血清5-羟色胺(5-hydroxytryptamine,5-HT)、皮质醇(cortisol,Cor)和脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平的影响。方法将收治的149例MDD伴焦虑症状患者用数字表法随机分为对照组(74例)和研究组(75例)。对照组给予氟西汀治疗,研究组在对照组治疗的基础上给予文拉法辛治疗。比较2组治疗8周后的临床疗效、焦虑、抑郁、躯体症状、睡眠质量和血清5-HT、Cor和BDNF水平以及安全性。结果治疗8周后,研究组的治疗有效率(97.33%)显著高于对照组(87.84%),P<0.05;研究组汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分均显著低于对照组(P<0.01);研究组躯体症状群量表(questionnaire-15,PHQ-15)、临床总体印象量表(clinical global impression-severity of illness,CGI-S)和匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分均显著低于对照组(P<0.01);研究组5-HT、去甲肾上腺素(norepinephrine,NE)均显著高于对照组(P<0.01);研究组Cor显著低于对照组,BDNF显著高于对照组(P<0.01);2组各类不良反应发生率比较差异无统计学意义。结论文拉法辛联合氟西汀治疗伴焦虑症状MDD患者疗效显著,能有效改善患者的焦虑、抑郁症状,躯体症状和睡眠质量;提高血清5-HT和BDNF水平,调节神经递质;抑制Cor的过多分泌,实现对神经细胞功能的有效改善。 展开更多
关键词 文拉法辛 氟西汀 重度抑郁症 躯体症状 睡眠质量 5-羟色胺 皮质醇 脑源性神经营养因子
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精神分裂症、抑郁症、双相障碍患者自杀风险比较及相关因素 被引量:1
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作者 罗传琳 李媛媛 +14 位作者 刘肇瑞 何燕玲 周亮 刘波 章杰 龚元东 刘燕 卢瑾 周艳萍 高长青 董青 蔡德芳 杨润许 张婷婷 黄悦勤 《中国心理卫生杂志》 CSCD 北大核心 2024年第1期1-8,共8页
目的:描述和分析精神分裂症、抑郁症、双相障碍患者的自杀风险。方法:选取符合精神障碍诊断与统计手册第5版诊断标准,来自住院、门诊或社区的精神分裂症患者2016例、抑郁症患者903例和双相障碍患者381例,使用简明国际神经精神访谈诊断... 目的:描述和分析精神分裂症、抑郁症、双相障碍患者的自杀风险。方法:选取符合精神障碍诊断与统计手册第5版诊断标准,来自住院、门诊或社区的精神分裂症患者2016例、抑郁症患者903例和双相障碍患者381例,使用简明国际神经精神访谈诊断精神障碍并评估自杀风险,精神症状维度评定量表(CRDPSS)评估症状,采用多因素logistic回归分析探讨3类精神障碍患者自杀风险的差异及相关因素。结果:37例(1.8%)精神分裂症患者、516例(57.1%)抑郁症患者、102例(26.8%)双相障碍患者近1个月有自杀风险。与精神分裂症患者相比,抑郁症(OR=36.50)和双相障碍患者(OR=20.10)自杀风险增加。女性(OR=1.87)、目前吸烟(OR=1.76)、有自杀家族史(OR=5.09)、CRDPSS幻觉条目得分高(OR=1.80)、CRDPSS抑郁条目得分高(OR=1.54)是患者有自杀风险的危险因素。结论:抑郁症和双相障碍患者的自杀风险高于精神分裂症患者,临床上应定期评估患者的自杀风险,重点关注存在幻觉和抑郁症状的患者。 展开更多
关键词 精神分裂症 抑郁症 双相障碍 自杀 精神病性症状
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小剂量富马酸喹硫平联合丙戊酸镁治疗双相情感障碍伴重度抑郁发作的临床疗效及安全性 被引量:2
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作者 叶湘湘 方政华 +2 位作者 周志强 张婵娟 周剑 《临床合理用药杂志》 2024年第6期18-20,24,共4页
目的观察小剂量富马酸喹硫平联合丙戊酸镁治疗双相情感障碍伴重度抑郁发作的临床疗效及安全性。方法选取2022年1月—2023年6月湖南省脑科医院收治的180例双相情感障碍伴重度抑郁发作患者,采用随机抽签法分为对照组(n=90)和观察组(n=90)... 目的观察小剂量富马酸喹硫平联合丙戊酸镁治疗双相情感障碍伴重度抑郁发作的临床疗效及安全性。方法选取2022年1月—2023年6月湖南省脑科医院收治的180例双相情感障碍伴重度抑郁发作患者,采用随机抽签法分为对照组(n=90)和观察组(n=90)。对照组患者采取丙戊酸镁持续治疗8周,观察组患者在对照组基础上采取小剂量富马酸喹硫平片持续治疗8周。比较2组临床疗效,治疗前及治疗8周后实验室指标[血清催乳素(PRL)、促甲状腺激素(TSH)、游离甲状腺素(FT_(4))和游离三碘甲状腺原氨酸(FT_(3))]、汉密尔顿抑郁量表(HAMD)评分及不良反应。结果观察组治疗总有效率高于对照组(83.33%vs.64.44%,χ^(2)=8.322,P=0.004)。治疗前及治疗8周后,2组血清PRL、TSH、FT_(4)、FT_(3)水平比较无统计学差异(P>0.05);治疗8周后,2组血清PRL、TSH水平高于治疗前,血清FT_(4)、FT_(3)水平低于治疗前(P<0.01)。治疗8周后,2组HAMD评分低于治疗前,且观察组低于对照组(P<0.01)。对照组与观察组治疗期间均发生不良反应,但总发生率比较无统计学差异(8.89%vs.12.22%,χ^(2)=0.530,P=0.467)。结论小剂量富马酸喹硫平联合丙戊酸镁治疗双相情感障碍伴重度抑郁发作可更有效地减轻患者抑郁症状,可更好地控制患者临床症状,对内分泌激素的影响较小,且具有较高的用药安全性。 展开更多
关键词 双相情感障碍 精神病性症状 抑郁发作 富马酸喹硫平 丙戊酸镁
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社区精神分裂症患者负性生活事件与失眠的关系:精神病性症状和抑郁的作用路径
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作者 陈旭姝 刘鑫 +6 位作者 何昌九 熊朝新宇 郭易 魏泸懿 刘元元 张春熙 刘祥 《四川精神卫生》 2024年第5期439-443,共5页
背景失眠是精神分裂症患者的常见症状。患者经历的负性生活事件、精神病性症状以及抑郁均可能影响失眠。但在社区精神分裂症患者中,四者的关系尚需进一步探讨。目的探讨负性生活事件对社区精神分裂症患者失眠的影响以及精神病性症状与... 背景失眠是精神分裂症患者的常见症状。患者经历的负性生活事件、精神病性症状以及抑郁均可能影响失眠。但在社区精神分裂症患者中,四者的关系尚需进一步探讨。目的探讨负性生活事件对社区精神分裂症患者失眠的影响以及精神病性症状与抑郁的作用路径,以期为社区精神分裂症患者失眠的干预提供参考。方法于2023年4月—6月,纳入四川省成都市48个社区卫生服务中心在管的、符合《国际疾病分类(第10版)》(ICD)精神分裂症诊断标准的1105例患者。采用10项负性生活事件(SLEs)、阿斯森失眠量表(AIS)、精神病筛查问卷(PSQ)、患者健康问卷抑郁量表(PHQ-9)进行评定。采用Spearman相关分析考查各量表评分之间的相关性,采用Smart PLS 4.0构建中介模型,采用偏最小二乘法和Bootstrap法检验中介效应。结果检出332例(30.05%)社区精神分裂症患者存在失眠。精神分裂症患者AIS评分与SLEs评分、PSQ评分、PHQ-9评分均呈正相关(r=0.165、0.322、0.554,P均<0.01)。精神病性症状和抑郁可能是社区精神分裂症患者负性生活事件与失眠之间的独立作用路径,间接效应值分别为0.102、0.372,效应量分别为10.46%、38.15%。精神病性症状和抑郁可能是社区精神分裂症患者负性生活事件与失眠之间的链式作用路径,间接效应值为0.190,效应量为19.49%。结论社区精神分裂症患者的负性生活事件可以直接影响失眠,也可以通过精神病性症状和抑郁的独立或链式作用路径影响失眠。 展开更多
关键词 负性生活事件 失眠 精神病性症状 抑郁 精神分裂症
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青年首发抑郁症患者继发精神病性症状的危险因素
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作者 毛俊雄 马琦 +5 位作者 彭朕磊 贾麒钰 徐秋爽 罗晓 张丽丽 伊琦忠 《山西医科大学学报》 CAS 2024年第2期239-245,共7页
目的 探讨青年首发重度抑郁症(major depression disorder, MDD)患者继发精神病性症状的相关危险因素。方法 收集232例首发抑郁症患者首诊时的一般人口学资料、汉密尔顿抑郁量表(Hamilton depression scale, HAMD-17)、汉密尔顿焦虑量表... 目的 探讨青年首发重度抑郁症(major depression disorder, MDD)患者继发精神病性症状的相关危险因素。方法 收集232例首发抑郁症患者首诊时的一般人口学资料、汉密尔顿抑郁量表(Hamilton depression scale, HAMD-17)、汉密尔顿焦虑量表(Hamilton anxiety scale, HAMA)得分,于次日采集肘静脉血并检测患者血糖、血脂、甲状腺功能、泌乳素和25-羟基维生素D[25(OH)D]水平,经过1年随访,根据患者是否继发精神病性症状,分为伴有精神病性症状的重度抑郁症组(PMD组,n=46)和不伴有精神病性症状的重度抑郁症组(MDD组,n=186),比较组间差异并分析各指标与精神病性症状的相关性,并探讨与青年首发PMD发生相关的危险因素。结果 PMD组未婚人数占比高于MDD组(P<0.05);PMD组HAMD-17量表得分高于MDD组(P<0.05);PMD组血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及促甲状腺激素(TSH)水平高于MDD组,高密度脂蛋白胆固醇(HDL-C)及25(OH)D水平低于MDD组(P<0.05)。相关性分析显示HAMD-17评分(r=0.345)、TC(r=0.148)、LDL-C(r=0.162)及TSH水平(r=0.134)与精神病性症状呈正相关(P<0.05),已婚(r=-0.208)、HDL-C(r=-0.258)及25(OH)D水平(r=-0.276)与精神病性症状呈负相关(P<0.05)。多因素Logistic回归分析显示,未婚、HAMD-17量表得分、高TC、低HDL-C及低25(OH)D水平为MDD患者精神病性症状的独立危险因素(P<0.05)。ROC曲线提示由婚姻状况、HAMD-17得分、血清TC、HDL-C及25(OH)D水平组成的联合指标能够较好地预测MDD患者精神病性症状的发生(AUC=0.887)。结论 血清脂代谢及25(OH)D水平可能是预测青年MDD患者继发精神病性症状的的生物标志物。 展开更多
关键词 重度抑郁症 精神病性症状 总胆固醇 高密度脂蛋白胆固醇 25-羟基维生素D 危险因素
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光照治疗在双相障碍抑郁发作患者中应用研究进展
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作者 刘滔 戴旭 +7 位作者 黄贺滨 陈宁宁 田鑫荷 郑文静 卢玮聪 徐贵云 苏国辉 林康广 《中国神经精神疾病杂志》 CAS CSCD 北大核心 2024年第4期252-256,I0001,共6页
现有抗抑郁治疗方法对双相障碍(bipolar disorder,BD)抑郁发作期患者的疗效不甚理想。多项研究探索了光照治疗BD抑郁发作期患者的疗效,并对光疗的参数、设备和安全性等进行研究。较多meta分析和随机对照研究表明光疗能明显改善BD患者的... 现有抗抑郁治疗方法对双相障碍(bipolar disorder,BD)抑郁发作期患者的疗效不甚理想。多项研究探索了光照治疗BD抑郁发作期患者的疗效,并对光疗的参数、设备和安全性等进行研究。较多meta分析和随机对照研究表明光疗能明显改善BD患者的抑郁症状,无论是低光强还是高光强的白光均有这种效果,蓝光抗抑郁疗效尚不明确。光疗起效快,最好在清晨进行,每次持续30~60 min不等,对患者最有益的光照疗程尚无定论。目前最常用的光疗设备是灯箱,光疗眼镜的安全性有待探索。如选择符合安全标准的光疗灯,BD患者光疗整体安全性较高,转躁狂或轻躁狂风险低。总之,光照治疗BD抑郁发作期患者具有较好前景,未来可开展更多的BD患者光疗研究,以期形成BD患者的光疗处方。 展开更多
关键词 光照治疗 双相障碍 抑郁症状 疗效 参数 光疗设备 安全性
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劳拉西泮辅治对精神分裂症伴睡眠障碍患者睡眠和精神症状效果研究
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作者 郑颖 丛伟东 +4 位作者 林力 李妙绒 陈黄霁葳 郑明坚 陈明 《世界睡眠医学杂志》 2024年第6期1400-1402,共3页
目的:探究劳拉西泮辅治对精神分裂症伴睡眠障碍患者的影响。方法:选取2021年12月至2023年1月福建医科大学附属福州神经精神病医院收治的精神分裂症伴睡眠障碍患者80例作为研究对象,按照是否服用劳拉西泮分为对照组和观察组,每组40例。... 目的:探究劳拉西泮辅治对精神分裂症伴睡眠障碍患者的影响。方法:选取2021年12月至2023年1月福建医科大学附属福州神经精神病医院收治的精神分裂症伴睡眠障碍患者80例作为研究对象,按照是否服用劳拉西泮分为对照组和观察组,每组40例。对照组接受常规治疗,观察组在此基础上接受劳拉西泮治疗,比较2组临床疗效、睡眠状况、精神症状,以及不良反应。结果:治疗后,观察组临床总有效率显著高于对照组,差异有统计学意义(P<0.05),匹兹堡睡眠质量指数(PSQI)评分、阳性和阴性症状量表(PANSS)评分显著低于对照组,差异有统计学意义(P<0.05),2组不良反应比较,差异无统计学意义(P>0.05)。结论:劳拉西泮辅治精神分裂症伴睡眠障碍患者疗效显著,能有效改善睡眠质量,同时改善精神状况,且不增加临床安全性风险。 展开更多
关键词 精神分裂症 睡眠障碍 劳拉西泮 睡眠状况 精神症状 辅助治疗 不良反应 疗效
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情绪任务在情感障碍中的近红外脑功能成像研究进展
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作者 郭灿 杨春霞 孙宁 《中国神经精神疾病杂志》 CAS CSCD 北大核心 2024年第1期54-59,共6页
情绪任务(emotional task)是研究情感障碍(affective disorder)注意偏向和情感功能中的主要手段之一。基于情绪任务下功能性近红外光谱成像(functional near-infrared spectroscopy,fNIRS)的相关研究表明,面部情绪识别任务、情绪stroop... 情绪任务(emotional task)是研究情感障碍(affective disorder)注意偏向和情感功能中的主要手段之一。基于情绪任务下功能性近红外光谱成像(functional near-infrared spectroscopy,fNIRS)的相关研究表明,面部情绪识别任务、情绪stroop任务以及情绪诱导任务结合fNIRS技术在情感障碍诊断、治疗中具有临床价值,情感障碍患者注意功能和情绪处理存在的缺陷与左侧前额叶皮质异常激活有关,特别是脑激活模式的差异与抑郁障碍患者抑郁症状有关。使用fNIRS研究情绪任务的未来方向重点在联合多种神经影像学手段进行大样本纵向队列研究以获得更加客观的诊疗依据,以及对比不同情绪刺激材料所激活区域的差异。 展开更多
关键词 抑郁障碍 双相障碍 情感症状 近红外脑功能成像 额颞叶 氧合血红蛋白 情绪任务
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强迫症患者心理社会功能的多维受损及其影响因素的初步分析
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作者 谢民耀 柳娜 +2 位作者 陈豪诚 宋莎莎 张宁 《临床精神医学杂志》 CAS 2024年第2期136-141,共6页
目的:探索强迫症(OCD)患者心理社会功能的损伤及影响因素。方法:研究纳入2021年4月至2022年6月在南京脑科医院门诊就诊的OCD患者153例,使用耶鲁布朗强迫量表(Y-BOCS)评估强迫症严重程度,强迫症症状分类量表修订版(OCI-R)、贝克焦虑量表(... 目的:探索强迫症(OCD)患者心理社会功能的损伤及影响因素。方法:研究纳入2021年4月至2022年6月在南京脑科医院门诊就诊的OCD患者153例,使用耶鲁布朗强迫量表(Y-BOCS)评估强迫症严重程度,强迫症症状分类量表修订版(OCI-R)、贝克焦虑量表(BAI)、贝克抑郁量表(BDI-Ⅱ)、席汉残疾量表(SDS)、心理社会功能问卷评估强迫维度、情绪状态和心理社会功能;采用独立样本t检验、相关分析、多元回归分析探索心理社会功能的影响因素。结果:强迫症患者Y-BOCS、OCI-R强迫思维维度、BAI、BDI-Ⅱ、SDS与心理社会功能存在正相关(r=0.381、0.276、0.221、0.549、0.417,P均<0.05)。多元回归结果显示心理社会功能总分受强迫行为和BDI-Ⅱ影响显著(β=0.151、0.492,P均<0.05);主观幸福感受BDI-Ⅱ和SDS工作/学习维度影响显著(β=0.365、0.225,P均<0.05);心理认知受BDI-Ⅱ影响显著(β=0.510,P<0.05);社会功能受BDI-Ⅱ影响显著(β=0.478,P<0.05)。结论:不同临床特征下强迫症患者的心理社会功能损害不同,抑郁症状是心理社会功能的重要影响因素。 展开更多
关键词 强迫症 心理社会功能 症状维度 抑郁 焦虑
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透析患者躯体化症状与抑郁焦虑睡眠障碍心身疾病诊断及实验室指标的相关性分析
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作者 胡汇悦 吴爱华 +2 位作者 沐晓蝶 周华 凌佩瑶 《临床心身疾病杂志》 CAS 2024年第4期16-21,共6页
目的 研究透析患者躯体化症状与睡眠障碍、焦虑、抑郁、心身疾病及实验室指标的关系。方法 收集132例透析患者的一般临床资料和实验室指标数据,采用匹兹堡睡眠质量指数量表(PSQI)、广泛性焦虑障碍-7量表(GAD-7)、患者健康问卷-9抑郁量表... 目的 研究透析患者躯体化症状与睡眠障碍、焦虑、抑郁、心身疾病及实验室指标的关系。方法 收集132例透析患者的一般临床资料和实验室指标数据,采用匹兹堡睡眠质量指数量表(PSQI)、广泛性焦虑障碍-7量表(GAD-7)、患者健康问卷-9抑郁量表(PHQ-9)、健康问卷躯体症状群量表(PHQ-15)、心身研究的诊断标准(DCPR)评估患者的睡眠、焦虑、抑郁、躯体化症状、心身状态。根据PHQ-15评分将入组患者分为观察组63例(有躯体化症状)和对照组69例(无躯体化症状)。比较两组患者一般资料、实验室指标数据和各项量表评分;采用Pearson、Spearman相关分析研究躯体化症状与睡眠障碍、焦虑、抑郁、心身疾病以及各项实验室指标的相关性。结果 两组患者白细胞计数、中性粒细胞计数及血红蛋白、白蛋白水平比较,差异均有统计学意义(P<0.05或0.01)。观察组患者PSQI、PHQ-9、GAD-7评分均高于对照组,综合征诊断个数多于对照组(P<0.01)。Pearson相关分析显示,透析患者PHQ-15评分与中性粒细胞计数呈正相关(P<0.05),与白蛋白呈负相关(P<0.05)。Spearman偏相关分析显示,控制PHQ-9评分、GAD-7评分和综合征诊断个数后,PHQ-15评分与PSQI评分呈正相关(P<0.01);控制PHQ-9评分、PSQI评分和综合征诊断个数后,PHQ-15评分与GAD-7评分呈正相关(P<0.01);控制GAD-7评分、PSQI评分和综合征诊断个数后,PHQ-15评分与PHQ-9评分呈正相关(P<0.01);控制GAD-7评分、PSQI评分和PHQ-9评分后,PHQ-15评分与综合征诊断个数呈正相关(P<0.05)。结论 透析患者躯体化症状与睡眠障碍、焦虑、抑郁、心身疾病诊断情况及患者的中性粒细胞计数、白蛋白水平密切相关。 展开更多
关键词 透析 躯体化症状 睡眠障碍 抑郁 焦虑 心身疾病 白蛋白 中性粒细胞计数
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