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.

Shuganjieyu capsule increases neurotrophic factor expression in a rat model of depression

Shuganjieyu capsule has been approved for clinical treatment by the State Food and Drug Ad-ministration of China since 2008. In the clinic, Shuganjieyu capsule is often used to treat mild to moderate depression. In the rat model of depression established in this study, Shuganjieyu capsule was administered intragastrically daily before stress. Behavioral results conifrmed that depressive symptoms lessened after treatment with high-dose （150 mg/kg） Shuganjieyu capsule. Immunohistochemistry results showed that high-dose Shuganjieyu capsule signiifcantly increased phosphorylation levels of phosphorylation cyclic adenosine monophosphate response element binding protein and brain-derived neurotrophic factor expression in the medial prefrontal cortex and hippocampal CA3 area. Overall, our results suggest that in rats, Shuganjieyu capsule effec-tively reverses depressive-like behaviors by increasing expression levels of neurotrophic factors in the brain.

Gut microbiota-derived short-chain fatty acids and depression:deep insight into biological mechanisms and potential

The gut microbiota is a complex and dynamic ecosystem known as the second brain'.Composing the microbiota-gut-brain axis,the gut microbiota and its metabolites regulate the central nervous system through neural,endocrine and immune pathways to ensure the normal functioning of the organism,tuning individuals'health and disease status.Short-chain fatty acids(SCFAs),the main bioactive metabolites of the gut microbiota,are involved in several neuropsychiatric disorders,including depression.SCFAs have essential effects on each component of the microbiota-gut-brain axis in depression.In the present review,the roles of major SCFAs(acetate,propionate and butyrate)in the pathophysiology of depression are summarised with respect to chronic cerebral hypoperfusion,neuroinflammation,host epigenome and neuroendocrine alterations.Concluding remarks on the biological mechanisms related to gut microbiota will hopefully address the clinical value of microbiota-related treatments for depression.

New hypothesis and treatment targets of depression:an integrated view of key findings

Major depressive disorder（MDD） is a common and devastating psychiatric disorder characterized by persistent low mood,cognitive disorder,and impaired social function. Despite its complex mechanisms,increasing evidence has identified the involvement of neurotrophic factors,inflammatory cytokines,the hypothalamuspituitary-adrenal axis,and glutamate receptors in the pathophysiology of this illness. The present review synthesizes recent research achievements to defi ne the network between different hypotheses of MDD and to understand which part is most pivotal for its pathogenesis. By integrating MDD-related signal pathways,we highlight brain-derived neurotrophic factor（BDNF） dysfunction and increased apoptosis as the fi nal common cascades,and new therapeutic strategies aiming to enhance BDNF function have been shown to exert a rapid and effective antidepressant action.

轻度认知损害:一个有利于痴呆早期诊断与干预的概念(英文)

As life expectancy increases around the globe,dementia has become an increasingly important public health issue that has created new challenges for communities’ social service networks’11.The early detection and prevention of dementia,particularly Alzheimer’s disease (AD),necessitate

Face and object visual working memory deficits in first-episode schizophrenia correlate with multiple neurocognitive performances

Background Working memory(WM)deficit is considered a core feature and cognitive biomarker in patients with schizophrenia.Several studies have reported prominent object WM deficits in patients with schizophrenia,suggesting that visual WM in these patients extends to non-spatial domains.However,whether non-spatial WM is similarly affected remains unclear.Aim This study primarily aimed to identify the processing of visual object WM in patients with first-episode schizophrenia.Methods The study included 36 patients with first-episode schizophrenia and 35 healthy controls.Visual object WM capacity,including face and house WM capacity,was assessed by means of delayed matching-to sample visual WM tasks,in which participants must distribute memory so that they can discriminate a target sample.We specifically examined their anhedonia experience by the Temporal Experience of Pleasure Scale and the Snaith-Hamilton Pleasure Scale.Cognitive performance was measured by the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).Results Both face and house WM capacity was significantly impaired in patients with schizophrenia.For both tasks,the performance of all the subjects was worse under the high-load condition than under the low-load condition.We found that WM capacity was highly positively correlated with the performance on RBANS total scores(r=−0.528,p=0.005),RBANS delayed memory scores(r=−0.470,p=0.013),RBANS attention scores(r=−0.584,p=0.001),RBANS language scores(r=−0.448,p=0.019),Trail-Making Test:Part A raw scores(r=0.465,p=0.015)and simple IQ total scores(r=−0.538,p=0.005),and correlated with scores of the vocabulary test(r=−0.490,p=0.011)and scores of the Block Diagram Test(r=−0.426,p=0.027)in schizophrenia.No significant correlations were observed between WM capacity and Positive and Negative Syndrome Scale symptoms.Conclusions Our research found that visual object WM capacity is dramatically impaired in patients with schizophrenia and is strongly correlated with other measures of cognition,suggesting a mechanism that is critical in explaining a portion of the broad cognitive deficits observed in schizophrenia.

Brain structure in post-traumatic stress disorder A voxel-based morphometry analysis

This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lo- bule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal Iobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group （r = 0.477, P = 0.039）. Our findings indicate that （1） chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, oc- cipital lobe, and parietal lobe, （2） after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and （3） the superior parietal Iobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.

中国阴阳文化背景下的躯体症状障碍1例并文献复习

躯体症状障碍(somatic symptom disorder,SSD)的特征是患者长期对各种躯体症状感到过度的担忧,感到十分痛苦,明显影响其社会功能及个人生活。SSD患者的临床表现与其文化背景存在联系;本例SSD患者在躯体检查时未见任何异常,但受到我国传统阴阳文化的影响其临床表现具有显著的中华文化色彩,以与中华传统阴阳文化联系紧密的性功能障碍和心境障碍为主。笔者采用汉密尔顿焦虑量表、汉密尔顿抑郁量表及国际勃起功能问卷表分别对患者的焦虑情绪、抑郁情绪及性功能进行评价,分值分别为32,33及9。经5周的文拉法辛和米氮平联合用药治疗,临床症状得到显著改善。我国SSD患者的临床表现有时具有明显的中华阴阳文化色彩,在临床工作中很容易被误诊,临床医生应对此提高警惕。此外,文拉法辛和米氮平联合用药对以慢性疼痛及性功能障碍为主要表现的SSD患者可能具有较好的疗效。

A Review of the Functional and Anatomical Default Mode Network in Schizophrenia

Schizophrenia is a severe mental disorder characterized by impaired perception, delusions, thought disorder, abnormal emotion regulation, altered motor function, and impaired drive. The default mode network （DMN）, since it was first proposed in 2001, has become a central research theme in neuropsychiatric disorders, including schizophrenia. In this review, first we define the DMN and describe its functional activity, functional and anatomical connectivity, heritability, and inverse correlation with the task positive network. Second, we review empirical studies of the anatomical and functional DMN, and anti-correlation between DMN and the task positive network in schizophrenia. Finally, we review preliminary evidence about the relationship between antipsychotic medications and regulation of the DMN, review the role of DMN as a treatment biomarker for this disease, and consider the DMN effects of individualized therapies for schizophrenia.

Whole-genome sequencing of monozygotic twins discordant for schizophrenia indicates multiple genetic risk factors for schizophrenia

Schizophrenia is a common disorder with a high heritability, but its genetic architecture is still elusive.We implemented whole-genome sequencing(WGS) analysis of 8 families with monozygotic(MZ) twin pairs discordant for schizophrenia to assess potential association of de novo mutations(DNMs) or inherited variants with susceptibility to schizophrenia. Eight non-synonymous DNMs(including one splicing site) were identified and shared by twins, which were either located in previously reported schizophrenia risk genes(p.V24689 I mutation in TTN, p.S2506 T mutation in GCN1L1, IVS3+1G > T in DOCK1) or had a benign to damaging effect according to in silico prediction analysis. By searching the inherited rare damaging or loss-of-function(LOF) variants and common susceptible alleles from three classes of schizophrenia candidate genes, we were able to distill genetic alterations in several schizophrenia risk genes, including GAD1, PLXNA2, RELN and FEZ1. Four inherited copy number variations(CNVs; including a large deletion at 16p13.11) implicated for schizophrenia were identified in four families, respectively. Most of families carried both missense DNMs and inherited risk variants, which might suggest that DNMs, inherited rare damaging variants and common risk alleles together conferred to schizophrenia susceptibility. Our results support that schizophrenia is caused by a combination of multiple genetic factors, with each DNM/variant showing a relatively small effect size.

Involuntary admission and treatment of patients with mental disorder

Despite the efforts of the World Health Organization to internationally standardize strategies for mental-health care delivery,the rules and regulations for involuntary admission and treatment of patients with mental disorder still differ markedly across countries. This review was undertaken to describe the regulations and mental-health laws from diverse countries and districts of Europe（UK,Austria,Denmark,France,Germany,Italy,Ireland,and Norway）,the Americas（Canada,USA,and Brazil）,Australasia（Australia and New Zealand）,and Asia（Japan and China）. We outline the criteria and procedures for involuntary admission to psychiatric hospitals and to community services,illustrate the key features oflaws related to these issues,and discuss their implications for contemporary psychiatric practice. This review may help to standardize the introduction oflegislation that allows involuntary admission and treatment of patients with mental disorders in the mainland of China,and contribute to improved mental-health care. In this review,involuntary admission or treatment does not include the placement of mentally-ill offenders,or any other aspect of forensic psychiatry.

Neurobiological mechanisms and related clinical treatment of addiction: a review

Drug addiction or substance use disorder(SUD),has been conceptualized as a three-stage(i.e.binge/intoxication,withdrawal/negative affect,and preoccupation/anticipation/craving)recurring cycle that involves complex changes in neuroplasticity,reward,motivation,desire,stress,memory,and cognitive control,and other related brain regions and brain circuits.Neuroimaging approaches,including magnetic resonance imaging,have been key to mapping neurobiological changes correlated to complex brain regions of SUD.In this review,we highlight the neurobiological mechanisms of these three stages of addiction.The abnormal activity of the ventral tegmental,nucleus accumbens,and caudate nucleus in the binge/intoxication stage involve the reward circuit of the midbrain limbic system.The changes in the orbitofrontal cortex,dorsolateral prefrontal cortex,amygdala,and hypothalamus emotional system in the withdrawal/negative affect stage involve increases in negative emotional states,dysphoric-like effects,and stress-like responses.The dysregulation of the insula and prefrontal lobes is associated with craving in the anticipation stage.Then,we review the present treatments of SUD based on these neuroimaging findings.Finally,we conclude that SUD is a chronically relapsing disorder with complex neurobiological mechanisms and multimodal stages,of which the craving stage with high relapse rate may be the key element in treatment efficacy of SUD.Precise interventions targeting different stages of SUD and characteristics of individuals might serve as a potential therapeutic strategy for SUD.

Interaction between serum inflammatory cytokines and brain-derived neurotrophic factor in cognitive function among first-episode schizophrenia patients

BACKGROUND The pathogenesis of cognitive impairment in schizophrenia(SCZ)remains unclear.Accumulating studies showed that inflammatory-immune dysregulation and altered brain derived neurotrophic factor(BDNF)levels play a crucial role in the psychopathology of SCZ.However,their association with cognitive dysfunction in first-episode SCZ patients has not been thoroughly investigated.AIM To explore the interaction effects between cognitive function and inflammatory cytokines and BDNF in first-episode SCZ.METHODS The current study is a cross-sectional case-control investigation that recruited 84 patients with first-episode SCZ(SCZ group)and 80 healthy controls(HCs group)at the Huzhou Third Municipal Hospital between August 2021 and September 2023.ELISA was employed to measure the serum levels of interleukin(IL)-1β,IL-4,IL-6,IL-10,and BDNF.The Chinese brief cognitive test(C-BCT)and the positive and negative syndrome scales were measured the severity of cognitive impairment and psychiatric symptoms.RESULTS Compared to the HC group,the SCZ group exhibited elevated IL-1βand IL-6 levels,decreased BDNF levels,and reduced C-BCT scores(all P<0.001).In SCZ,BDNF was negatively correlated with IL-6(r=-0.324,P<0.05).Information processing speed was negatively correlated with IL-6(r=-0.315,P<0.05)and positively with BDNF(r=0.290,P<0.05);attention,working memory,comprehensive ability,and executive function were negatively correlated with IL-1βand IL-6(all P<0.05)and positively with BDNF(all P<0.05).Multiple regression analysis showed IL-6 influenced C-BCT dimensions(β=-0.218 to-0.327,all P<0.05);attention and executive ability were influenced by IL-1β(β=-0.199 to-0.261,all P<0.05);comprehensive executive ability was influenced by BDNF(β=0.209,P<0.05).CONCLUSION Our findings suggested that interrelationships between immune dysfunction and neurotrophic deficiency might underlie the pathological mechanisms of cognitive impairments in first-episode SCZ patients.

An update on research and approaches in biological psychiatry

Many studies have shown that,in terms of global burden,mental disorders have exceeded diseases of the cardiovascular and respiratory systems as well as malignant tumors.Nevertheless,the pathological mental activities caused by the millions of neurons in the human brain are far less clear than diseases of other organs and systems.This is not only due to the limited approaches to exploring the human brain,but also the multiple mechanisms by

Measuring and preventing alcohol use and related harm among young people in Asian countries:a thematic review

Background:The paper reviews alcohol consumption patterns and alcohol-related social and health issues among 15-29-year old young people in Asian countries,and discusses strategies for preventing and controlling alcohol use and related harms.Methods:We searched Google Scholar,PubMed,and Web of Science for reports,reviews and journal articles published in English between 1st Jan 1990 and 31st August 2016.Results:Forty-one reports,reviews and journal papers were identified and included in the final review.The current drinking levels and prevalence among young people are markedly different between eight included Asian countries,ranging from 4.2%in Malaysia to 49.3%in China.In a majority of the selected Asian countries,over 15%of total deaths among young men and 6%among young women aged 15-29 years are attributable to alcohol use.Alcohol use among young people is associated with a number of harms,including stress,family violence,injuries,suicide,and sexual and other risky behaviours.Alcohol policies,such as controlling sales,social supply and marketing,setting up/raising a legal drinking age,adding health warning labels on alcohol containers,and developing a surveillance system to monitor drinking pattern and risky drinking behaviour,could be potential means to reduce harmful use of alcohol and related harm among young people in Asia.Conclusions:The review reveals that drinking patterns and behaviours vary across eight selected Asian countries due to culture,policies and regional variations.The research evidence holds substantial policy implications for harm reduction on alcohol drinking among young people in Asian countries-especially for China,which has almost no alcohol control policies at present.

Aberrant Resting-State Functional Connectivity in the Default Mode Network in Pediatric Bipolar Disorder Patients with and without Psychotic Symptoms

Mood disorders/psychosis have been associated with dysfunctions in the default mode network(DMN).However,the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder(PBD)remain unclear.The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients.Twenty-nine psychotic and 26 non-psychotic PBD patients,as well as 19 age-and sex-matched healthy controls underwent a restingstate functional MRI scan and the data were analyzed by independent component analysis.The DMN component from the fMRI data was extracted for each participant.Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements.The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex,bilateral caudate nucleus,bilateral angular gyri,and left middle temporal gyrus,while non-psychotic PBD was not,suggesting further impairment with the development of psychosis.In summary,we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group.These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.

DNA methylation in schizophrenia: progress and challenges

Schizophrenia is a heterogeneous psychiatric disorder broadly accepted being caused by genetic and environmental factors. Although conventional genetic studies have identified some candidate genes for schizophrenia, low odds ratios and penetrance, and a lack of reproducibility have limited their explanatory power. Despite the major efforts made toward identifying environmental factors in schizophrenia, methodological limitations and inconsistent findings of epidemiological reports have obstructed attempts to identify exogenous causal factors. Epigenetic mechanisms, mediating between environment and genes, have recently been proposed to play an important role in the pathogenesis of schizophrenia. DNA methylation is the most stable and well-characterized epigenetic modification. In this paper, we briefly introduce DNA methylation mechanisms, genome-wide DNA methylation studies, and identify specific genomic methylation sites in individuals diagnosed with schizophrenia. The outline candidate genes such as Reelin and COMT, are also outlined before paying attention to the conundrum of recent researches.

A Matrilineal Genetic Legacy from the Last Glacial Maximum Confers Susceptibility to Schizophrenia in Han Chinese

Mitochondrial dysfunction has been widely reported in schizophrenia patients. To dissect the matrilineal structure of Han Chinese with or without schizophrenia and to decipher the maternal influence and evolutionary history of schizophrenia, a total of 1212 schizophrenia patients and 1005 matched healthy controls, all of Han Chinese origin, were recruited in Hunan Province, China. We classified haplogroup for each individual based on mitochondrial DNA （mtDNA） sequence variations and compared the haplogroup distribution pattern between cases and controls. Haplogroup B5a presented a higher frequency in cases than in controls （P = 0.02, OR = 1.67, 95% CI = [1.09, 2.56]）, and this result could be confirmed by permutation analysis. Age estimation of haplogroup B5a in cases revealed a much younger age than that of controls, which was coincident with the Northern Hemisphere deglaciation at the end of the Last Glacial Maximum. Analysis of complete mtDNA in five patients belonging to haplogroup B5a showed that this background effect might be caused by haplogroup- defining variants m.8584G〉A and m.10398A〉G. Our results showed that matrilineal risk factor for schizophrenia had an ancient origin and might acquire a predisposing effect on schizophrenia due to the environment change and/or orchestration with other nuclear genetic factors appeared recently in human evolutionary history.

Grey matter volume abnormalities in patients with bipolar I depressive disorder and unipolar depressive disorder:a voxelbased morphometry study

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.

Reduced middle cingulate gyrus volume in late-onset schizophrenia in a Chinese Han population: a voxel-based structural MRI study

Dear Editor：Numerous magnetic resonance imaging（MRI）studies have demonstrated that patients with early-onset schizophrenia（EOS）have widespread structural abnormalities in the cortical gray matter[1],suggesting that neurobiological processes play a central role in the structural abnormalities underlying the pathophysiology of schizophrenia[2].In addition,volumetric abnormalities have been used to identify individuals at risk of mental states of