BACKGROUND ： The pathophysiology of tardive dyskinesia （TD） is not yet fully understood. With the hypothesis of altered dopaminergic neurotransmission, altered activities of dopamine degrading enzymes such as monoa...BACKGROUND ： The pathophysiology of tardive dyskinesia （TD） is not yet fully understood. With the hypothesis of altered dopaminergic neurotransmission, altered activities of dopamine degrading enzymes such as monoamine oxidase A （MAOA） and their coding genes are supposed to be related to the pathophysiology of TD. OBJECTIVE： To investigate possible association between 30 bp variable number tandem repeat （VNTR） polymorphism in the promoter of MAOA gene and susceptibility, severity of neuroleptic induced TD in Chinese Han people in Guandong Province. DESIGN ： Non-randomization-synchronization controlled study.SETTING： Guangdong Mental Health Institute, Guangdong Provincial People＇s Hospital; Guangzhou Psychiatric Hospital; Affiliated Psychiatric Hospital of Guangzhou Municipal Bureau of Civil Administration. PARTICIPANTS： A total of 179 subjects were enrolled in the study. All subjects were sporadic and genetically unrelated Chinese schizophrenic patients who were hospitalizing in Guangzhou Psychiatric Hospital or Affiliated Psychiatric Hospital of Guangzhou Municipal Bureau of Civil Administration during January to April 2005. The diagnosis of schizophrenia was made according to the criteria of Diagnostic and Statistic Manual of Mental Disorder-the third edition-revised （DSM-Ⅲ-R）. Among all patients, 88 were diagnosed as with TD and 91 without TD according to the research diagnostic criteria described by Schooler-Kane. Informed consent was obtained from all subjects or their relatives. METHODS ： ① TD seventy was assessed with the AIMS which was a 5-degree rating scale from 0 to 4 （corresponding to none, minimal, mild, moderate and severe, respectively）. The study was approved by the Ethics Committees of the two hospitals and informed consent was obtained from all subjects or their relatives. ② The polymerase chain reaction （PCR） and polyacrylamide gel electrophoresis （PAGE） techniques were used to detect MAOA gene 30 bp VNTR polymorphism in schizophrenic patients with and without TD. ③ The differences in genotype and allele frequencies between two groups were compared with chi-square test and severity of TD rated by Abnormal Involuntary Movement Scale （AIMS） among TD patients with different genotypes or alleles were compared with one way ANOVA test or independent-samples t test. MAIN OUTCOME MEASURES： Demographic and clinical variables including sex, age, duration of illness, cumulative exposure to neuroleptic drugs, times of hospitalization, of all patients; AIMS scores in TD patients; MAOA gene polymorphic allelic and genotypic frequencies in all subjects. RESULTS： All 179 subjects were involved in the final analysis. No one was dropped out in this study.Only 3- and 4-fold repeat alleles were observed in all subjects. Data was stratified and analyzed by gender because MAOA gene was located on the X chromosome. No significant differences were found in genotypic （X^2=2.437, P 〉 0.05） nor allelic （X^2=2.233, P 〉 0.05） frequencies of MAOA gene between patients with TD and without TD in female subjects, and no significant differences in allelic frequencies between male TD and non-TD patients （X^2 =1.750, P 〉 0.05）. And there were no significant differences in mean AIMS scores among female TD patients with different MAOA genotypes （F=1.190, P 〉 0.05） and between male TD patients carrying different alleles （t =0.378, P〉 0.05）. CONCLUSION ： The results do not support any associations between MAOA gene 30 bp VNTR polymorphism and susceptibility nor severity of TD in schizophrenia in Chinese Han people.展开更多
Bipolar disorder and unipolar depressive disorder（UD） may be different in brain structure. In the present study,we performed voxel-based morphometry（VBM） to quantify the grey matter volumes in 23 patients with bip...Bipolar disorder and unipolar depressive disorder（UD） may be different in brain structure. In the present study,we performed voxel-based morphometry（VBM） to quantify the grey matter volumes in 23 patients with bipolar I depressive disorder（BP1） and 23 patients with UD,and 23 age-,gender-,and educationmatched healthy controls（HCs） using magnetic resonance imaging. We found that compared with the HC and UD groups,the BP1 group showed reduced grey matter volumes in the right inferior frontal gyrus and middle cingulate gyrus,while the UD group showed reduced volume in the right inferior frontal gyrus compared to HCs. In addition,correlation analyses revealed that the grey matter volumes of these regions were negatively correlated with the Hamilton depression rating scores. Taken together,the results of our study suggest that decreased grey matter volume of the right inferior frontal gyrus is a common abnormality in BP1 and UD,and decreasedgrey matter volume in the right middle cingulate gyrus may be specifi c to BP1.展开更多
Background： Optimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment a...Background： Optimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment are frequently used in major depression, but few studies have investigated trends and patterns of their use over time. This study aimed to examine the prescription patterns ofantipsychotic medications for major depression in China from 2002 to 2012 and their association with treatment satisfaction and quality of life （QOL）. Methods： A total of 3655 subjects with major depression treated in 45 Chinese psychiatric hospitals/centers nationwide were interviewed between 2002 and 2012. Patients＇ socio-demographic and clinical characteristics including psychopathology, medication side effects. satisfaction with treatment and QOL were recorded using a standardized protocol and data collection. Results： The frequency ofantipsychotic use was 24.9% in the whole sample; the corresponding figures were 17.1%, 20.3%, and 32.8% in 2002, 2006, and 2012, respectively （χ^2 = 90.3, df= 2, P 〈 0.001 ）. Multiple logistic regression analyses revealed that patients on concurrent antipsychotics had significantly more delusions or hallucinations, longer illness duration, greater side effects, and more likely to be treated as inpatients and in major hospitals （i.e., Level-Ⅲ hospital）. Antipsychotic use was associated with lower treatment satisfaction while there was no significant difference with respect to physical and mental QOL between the antipsychotic and nonantipsychotic groups. Conclusions： Concurrent antipsychotic use was found in about one in four treated depressed patients in China, which has increased over a 10-year period. Considering the association of drug-induced side effects and the lack of patients＇ and relatives＇ satisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of the use of antipsychotics in depression is needed.展开更多
基金supported from funding to H.H.from the Chinese National Key Clinical Program in Psychiatry to the Guangzhou Brain Hospital,Guangzhou,China(No.201201001)from the Guangzhou Municipal Health Bureau(No.20131A011083)
基金Guangdong Provincial Foundation for Medical Science and Technology Research, No. B2003128
文摘BACKGROUND ： The pathophysiology of tardive dyskinesia （TD） is not yet fully understood. With the hypothesis of altered dopaminergic neurotransmission, altered activities of dopamine degrading enzymes such as monoamine oxidase A （MAOA） and their coding genes are supposed to be related to the pathophysiology of TD. OBJECTIVE： To investigate possible association between 30 bp variable number tandem repeat （VNTR） polymorphism in the promoter of MAOA gene and susceptibility, severity of neuroleptic induced TD in Chinese Han people in Guandong Province. DESIGN ： Non-randomization-synchronization controlled study.SETTING： Guangdong Mental Health Institute, Guangdong Provincial People＇s Hospital; Guangzhou Psychiatric Hospital; Affiliated Psychiatric Hospital of Guangzhou Municipal Bureau of Civil Administration. PARTICIPANTS： A total of 179 subjects were enrolled in the study. All subjects were sporadic and genetically unrelated Chinese schizophrenic patients who were hospitalizing in Guangzhou Psychiatric Hospital or Affiliated Psychiatric Hospital of Guangzhou Municipal Bureau of Civil Administration during January to April 2005. The diagnosis of schizophrenia was made according to the criteria of Diagnostic and Statistic Manual of Mental Disorder-the third edition-revised （DSM-Ⅲ-R）. Among all patients, 88 were diagnosed as with TD and 91 without TD according to the research diagnostic criteria described by Schooler-Kane. Informed consent was obtained from all subjects or their relatives. METHODS ： ① TD seventy was assessed with the AIMS which was a 5-degree rating scale from 0 to 4 （corresponding to none, minimal, mild, moderate and severe, respectively）. The study was approved by the Ethics Committees of the two hospitals and informed consent was obtained from all subjects or their relatives. ② The polymerase chain reaction （PCR） and polyacrylamide gel electrophoresis （PAGE） techniques were used to detect MAOA gene 30 bp VNTR polymorphism in schizophrenic patients with and without TD. ③ The differences in genotype and allele frequencies between two groups were compared with chi-square test and severity of TD rated by Abnormal Involuntary Movement Scale （AIMS） among TD patients with different genotypes or alleles were compared with one way ANOVA test or independent-samples t test. MAIN OUTCOME MEASURES： Demographic and clinical variables including sex, age, duration of illness, cumulative exposure to neuroleptic drugs, times of hospitalization, of all patients; AIMS scores in TD patients; MAOA gene polymorphic allelic and genotypic frequencies in all subjects. RESULTS： All 179 subjects were involved in the final analysis. No one was dropped out in this study.Only 3- and 4-fold repeat alleles were observed in all subjects. Data was stratified and analyzed by gender because MAOA gene was located on the X chromosome. No significant differences were found in genotypic （X^2=2.437, P 〉 0.05） nor allelic （X^2=2.233, P 〉 0.05） frequencies of MAOA gene between patients with TD and without TD in female subjects, and no significant differences in allelic frequencies between male TD and non-TD patients （X^2 =1.750, P 〉 0.05）. And there were no significant differences in mean AIMS scores among female TD patients with different MAOA genotypes （F=1.190, P 〉 0.05） and between male TD patients carrying different alleles （t =0.378, P〉 0.05）. CONCLUSION ： The results do not support any associations between MAOA gene 30 bp VNTR polymorphism and susceptibility nor severity of TD in schizophrenia in Chinese Han people.
基金supported by grants from the National Natural Science Foundation of China (81171286 and 91232714)National Basic Research Development Program (973 program) of China (2013CB835100 and 2009CB918303)
文摘Bipolar disorder and unipolar depressive disorder（UD） may be different in brain structure. In the present study,we performed voxel-based morphometry（VBM） to quantify the grey matter volumes in 23 patients with bipolar I depressive disorder（BP1） and 23 patients with UD,and 23 age-,gender-,and educationmatched healthy controls（HCs） using magnetic resonance imaging. We found that compared with the HC and UD groups,the BP1 group showed reduced grey matter volumes in the right inferior frontal gyrus and middle cingulate gyrus,while the UD group showed reduced volume in the right inferior frontal gyrus compared to HCs. In addition,correlation analyses revealed that the grey matter volumes of these regions were negatively correlated with the Hamilton depression rating scores. Taken together,the results of our study suggest that decreased grey matter volume of the right inferior frontal gyrus is a common abnormality in BP1 and UD,and decreasedgrey matter volume in the right middle cingulate gyrus may be specifi c to BP1.
文摘Background： Optimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment are frequently used in major depression, but few studies have investigated trends and patterns of their use over time. This study aimed to examine the prescription patterns ofantipsychotic medications for major depression in China from 2002 to 2012 and their association with treatment satisfaction and quality of life （QOL）. Methods： A total of 3655 subjects with major depression treated in 45 Chinese psychiatric hospitals/centers nationwide were interviewed between 2002 and 2012. Patients＇ socio-demographic and clinical characteristics including psychopathology, medication side effects. satisfaction with treatment and QOL were recorded using a standardized protocol and data collection. Results： The frequency ofantipsychotic use was 24.9% in the whole sample; the corresponding figures were 17.1%, 20.3%, and 32.8% in 2002, 2006, and 2012, respectively （χ^2 = 90.3, df= 2, P 〈 0.001 ）. Multiple logistic regression analyses revealed that patients on concurrent antipsychotics had significantly more delusions or hallucinations, longer illness duration, greater side effects, and more likely to be treated as inpatients and in major hospitals （i.e., Level-Ⅲ hospital）. Antipsychotic use was associated with lower treatment satisfaction while there was no significant difference with respect to physical and mental QOL between the antipsychotic and nonantipsychotic groups. Conclusions： Concurrent antipsychotic use was found in about one in four treated depressed patients in China, which has increased over a 10-year period. Considering the association of drug-induced side effects and the lack of patients＇ and relatives＇ satisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of the use of antipsychotics in depression is needed.
