The Views of Family Members about Nursing Care of Psychiatric Patients Admitted at a Mental Hospital in Malawi

Family members of a mentally ill person play a crucial role in the recovery of their sick relative. They care for their sick relatives at home and in hospital. Some views of family members indicate that they get satisfaction from participating in nursing care of their sick relative. The aim of this study was to describe the views of family members about nursing care of psychiatric patients admitted at a mental hospital in Malawi. A qualitative study design was used and data were collected from ten participants through in-depth interviews. Ethical approval was granted by relevant authorities. Data were analysed using Colaizzi method. The findings fell into the following four themes that emerged: family participation in nursing care;nurses’ skills and experience in caring;respect for psychiatric patients and interactions and information sharing. This study offers valuable information about the views of families regarding nursing care of psychiatric patients. They are involved in the care of their sick relatives although there is lack of effective cooperation between them and nurses. The lack of collaboration made families receive inadequate information about their sick relative. Therefore, it is imperative that nurses are competent in implementing family involvement in nursing care.

The phenomenology, socio-demographic, and clinical profile of substance abusers admitted to drug de-addiction unit at eradah and mental health hospital, taif, Saudi Arabia

Background:Substance abuse has become an increasingly serious socio-medical issue in recent decades.Human health is affected by the socio-cultural environment,which has a direct impact on his psychophysical development and well-being.However,sociocultural factors such as bad habits influence lifestyle and behavior,leading to significant health and social problems for substance abusers.Objective:The present study is to evaluate the phenomenology and socio-demographic characteristics of abusers and compare some of the characteristics randomly.The main objectives of this study are a.To evaluate the socio-demographic profile.b.To find out the pattern of substance use.c.To evaluate the association of phenomenology.d.To find out about substance-related disorders among the substance abuse patients.Materials and methods:There was an observational study conducted in the drug de-addiction unit at Taif,Eradah,and Mental Health Hospital in Saudi Arabia.This study included all substance abusers admitted to the hospital who met the inclusion and exclusion criteria.The study included patients of both genders admitted to the drug de-addiction unit between April 2021 and October 2022.Based on a descriptive statistical analysis,categorical variables were presented as frequencies and percentages.Results:An observational study was conducted for nearly one and a half years.We interviewed 358 substance abuse patients following a systematic sampling procedure in a peaceful,non-threatening environment.Among the 358 substance users,353(98.60%)were male and 5(1.39%)were female.According to the survey,117(32.68%)of the participants reported abusing substances during their 31-40 years of age,followed by 102(28.49%)during their 25-30 years of age.The predominant level of substance abuse was among the unemployed 163(45.53%),followed by students 105(29.33%).It was found that 58.66%of all respondents had initiated abuse between the ages of 18-24 years of age.Conclusion:In our study,combined substances like amphetamine and cannabis abusers were most prevalent because these are the most popular illicit drugs which are easily available.Islamic culture prohibits alcohol consumption both religiously and legally,making alcohol abuse the least prevalent of all drug addictions.

Correlation of EEG power atlas and P300 with depressive episode severity in adolescents hospitalized for the first time

Objective:To investigate the relationship between the changes of electroencephalogram(EEG)power spectrum,P300 latency and amplitude at different frequency bands and the severity of depressive episode in adolescents who were hospitalized for the first time.Methods:A retrospective study was conducted on 126 adolescent patients with depressive episodes who were hospitalized for the first time in the Department of Children and Adolescents of Yunnan Psychiatric Hospital from January 2022 to August 2023.According to Hamilton Depression Rating Scale(HAMD),the patients were divided into three groups:mild depression group(43 cases),moderate depression group(42 cases)and severe depression group(41 cases).The distribution of the 16-lead power spectrum of α,θ,and δ waves in EEG,as well as the latency and amplitude of P300,were compared among the three groups.The association between adolescent depression and its severity was analyzed.Results:(1)The EEG power distribution of the three groups was different in the frequency bands of α,θ and δ(P<0.05).There were differences in the α,θ,and δ frequency bands between mild and moderate as well as severe depressive episodes,and between moderate and severe depressive episodes in the θ and δ frequency bands.(2)P300,N2 latency and P300 amplitude:There were significant differences among the three groups(P<0.05).(3)δFP1,θF3,θC4,P300 latency and N2 latency were positively correlated with the degree of depression;P300 amplitude andα02 were negatively correlated with the degree of depression.(4)The receiver operating characteristic curve(ROC)area of P300 amplitude was 0.932,and the area under the curve ofα02 was 0.776.Conclusion:The combination of resting EEG power and P300 can be used as a biomarker to assess the severity of a depressive episode in adolescents who are hospitalized for the first time and provide a new strategy for treatment.

Patient satisfaction and associated factors among psychiatry outpatients of St Paulo's Hospital,Ethiopia

Background Patient satisfaction with mental healthcare service is recognised as an important integral part of measuring the outcomes and performance of clinical service delivery.It is not well studied in Ethiopia.Therefore,it is essential to improve service in the future.Aims To assess patient satisfaction and associated factors among psychiatry outpatients at St.Paulo's Hospital Millennium Medical College,Addis Ababa,Ethiopia.Methods An institutional-based cross-sectional study was conducted with consecutive sampling technique from May to June 2018.Data were collected using a Client Satisfaction Questionnaire(CSQ-8).Both bivariate and multivariate ordinal logistic regression analyses were used.Variables with p value<0.05 at multivariate analysis were considered statistically significant.Results A total of 589 participants were enrolled with a response rate of 98.2%.In regard to the magnitude of patient satisfaction,50.3%(95% CI 46.0 to 54.2)were highly satisfied,31.0%(95% CI 27.2 to 34.8)were satisfied,and 18.7%(95% CI 15.4 to 22.1)were dissatisfied.Male sex(adjusted OR(A0R)2.30,95%Cl 1.57 to 3.36),inability to read and write(A0R 2.23,95% CI 1.10 to 4.66),being unemployed(AOR 1.69,95% CI 1.15 to 2.47),obtaining services for free(A0R 1.57,95% CI 1.11 to 2.22),and availability of medication(AOR 1.62,95% CI 1.13 to 2.23)were significantly associated with patient satisfaction.Conclusions The study showed that further improvements in patient satisfaction are required.Male sex,inability to read and write,being unemployed,obtaining services free of charge,and availability of medication were significantly associated with patient satisfaction.More than half of the participants were dissatisfied with the waiting time to receive services.The provision of services within a reasonable timeframe and meeting patient expectations are helpful for good health outcomes.

Application of Social Support System in the Rehabilitation of Vagrants and Beggars with Mental Illness

Objective:Analyze the specific role of social support in vagrants and beggars with mental illness.Methods:80 patients with vagrant psychosis admitted into our hospital from April 2020 to April 2021 were randomly selected.The patients were treated for more than 6 months.The patients were randomly divided into two groups by drawing lots,with 40 cases in each group.The control group received routine nursing,and the observation group received routine nursing along with social support.The objective support,subjective support,and the utilization of support,which were combined into total social support of the two groups were compared after different nursing interventions.Results:After different nursing interventions,through the comparison of social support scale,the scores of objective support,subjective support,and utilization of support,and the total social support in the observation group were higher than the control group,and the differences were statistically significant(P<0.05).Conclusion:The application of social support system and while providing routine nursing among vagrants and beggars with psychosis can effectively improve their mental status,make them feel more valued and supported,and help improve their mental health and quality of life.

COVID-19 mental health care toolkit:an international collaborative effort by Early Career Psychiatrists section

The collaborative effort of an international research team from the Early Career Psychiatrists section of the World Psychiatry Association has brought about an easy-to-use,quick and stepwise mental health care toolkit for the identification and appropriate referral of those in need of mental health care during the pandemic.This simple guide can be applied in the general outpatient setting and is catered for all healthcare professionals,regardless of their expertise within the mental health field with minimal training.It is our hope that by incorporating this toolkit into our daily clinical care during the pandemic for high-risk patients and patients with non-specific complaints,we will be able to bridge the mental health gap present in our society.

Intestinal flora and depressive disorders:exploration and prospect of microbial-gut-brain axis

This paper examines the correlation between depressive disorders and intestinal flora.Depression is a common affective disorder characterized by low mood,loss of interest,anhedonia,high incidence,high recurrence rate,high disability rate,and high medical costs.The incidence and harmfulness of depressive disorder are gradually increasing,and its etiology is complex and diverse,among which the abnormal intestinal flora is considered to be one of the causes of depressive disorder.This article reviews the results of several studies that found intestinal flora imbalance in depressed patients,including changes in the type and quantity of flora and changes in metabolic pathways.In addition,antibiotic and probiotic treatments have also been shown to be effective in alleviating depressive symptoms,further indicating the importance of intestinal flora disturbances in the pathogenesis of depression.We also explored the relationship between intestinal flora and the pathogenesis of depressive disorders.Through neuro-immuno-endo-crine-metabolic pathways,intestinal flora can affect the function of the central nervous system,cause changes in the host’s mental behavior,and lead to or aggravate depressive symptoms.Overall,this study not only found differences in the intestinal flora of patients with depressive disorders but also revealed the potential role of intestinal flora in the pathogenesis.Importantly,this provides a new theoretical basis for further clarifying the pathogenesis of depressive disorders and formulating diagnosis and treatment strategies.

The roles of BDNF and ProBDNF in schizophrenia: possibilities for treatment

This review discusses the roles of brain-derived neurotrophic factor(BDNF)and precursor BDNF(proBDNF)in schizophrenia(SCZ).SCZ is asso-ciated with neuronal dysfunction,altered synaptic plas-ticity,and cognitive deficits.BDNF positively promotes neuronal growth,differentiation,and synapse forma-tion,and regulates synaptic transmission and plasticity.ProBDNF negatively affects neuronal survival and syn-aptic remodeling,however,by binding to its neurotroph-in receptor p75(p75NTR).A better understanding of the pathogenesis of SCZ vis-à-vis BDNF and proBDNF may provide new directions and strategies for its treatment.

Research progress on the health status and community management service needs of mobile elderly people

The health status of the floating elderly population and the need of community management ser-vices are complex and important problems.Owing to the change of living environment and the insecure medical care,the mobile elderly people have more health and psy-chological problems compared to the rest of the elderly population.Therefore,the community should take a va-riety of measures to meet their needs and help them to better adapt to the new living environment,and maintain their physical and mental health.This paper aims to sum-marize recent studies on the physical and emotional health problems of mobile elderly people and related community management service needs.

The effects of day rehabilitation training on stable schizophrenia

Objective:To investigate the effects of day rehabilitation exercises on patients with stable schizophrenia.Methods:A total of 80 patients with stable schizophrenia who had been admitted to Yunnan Psychiatric Hospital between July,2022 and December,2022 were randomly selected as the subjects of this study.The selected patients were distributed equally at random between a reference group and an experimental group.The experimental group received day interventions based on a traditional rehabilitation model,and the reference group received traditional rehabilitation measures.Results:Prior to the procedure,the values of the Nucleolus Organizer Regions Scale(NORS)and the Positive and Negative Syndrome Scale(PANSS)were slightly different between the reference and experimental groups,but the difference was not statistically significant(P>0.05).After the intervention,the values of the NORS and PANSS scale were statistically different(P<0.05).Conclusion:The day rehabilitation training improved the NORS and PANSS scores of stable schizophrenia patients compared to traditional rehabilitation methods.

Research progress on the biological effects of BDNF and proBDNFs in post-traumatic stress disorder

Many people were affected psycho-logically and even traumatized by the outbreak of new coronavirus pneumonia in 2020,which has the potential to lead to post-traumatic stress disorder.Many neuropsy-chiatric illnesses are aided by brain-derived neurotrophic factor and its predecessors.Brain-derived neurotrophic factor precursors have the biological impact of triggering neuronal apoptosis and hindering neural regeneration,and brain-derived neurotrophic factor itself can help increase the growth,survival,and differentiation of central and peripheral nerve cells.This article provides an in-depth study of their biological impacts in post-traumatic stress disorder in an attempt to understand the biological effects of brain-derived neurotrophic factor and its precursor proteins.

Cerebrotendinous xanthomatosis presenting with schizophrenia-like disorder:A case report

BACKGROUND Cerebrotendinous xanthomatosis(CTX)is a rare autosomal recessive lipid-storage disorder caused by mutations in CYP27A1.Psychiatric manifestations in CTX are rare and nonspecific,and they often lead to considerable diagnostic and treatment delay.CASE SUMMARY A 33-year-old female patient admitted to the psychiatric ward for presentation of delusions,hallucinations,and behavioral disturbance is reported.The patient presented with cholestasis,cataract,Achilles tendon xanthoma,and cerebellar signs in adulthood and with intellectual disability and learning difficulties in childhood.After the characteristic CTX findings on imaging were obtained,a pathological examination of the Achilles tendon xanthoma was refined.Replacement therapy was then initiated after the diagnosis was clarified by genetic analysis.During hospitalization in the psychiatric ward,the nonspecific psychiatric manifestations of the patient posed difficulty in diagnosis.After the patient’s history of CTX was identified,the patient was diagnosed with organic schizophrenia-like disorder,and psychotic symptoms were controlled by replacement therapy combined with antipsychotic medication.CONCLUSION Psychiatrists should be aware of CTX,its psychiatric manifestations,and clinical features and avoid misdiagnosis of CTX for timely intervention.

Metabolic syndrome:a psychiatric outlook

A metabolic syndrome is a cluster of clinical signs that are risk factors for the development of type 2 diabetes mellitus,and cardiovascular disease.This cluster includes obesity,elevated blood sugar,high blood pressure,and high cholesterol.Atypical antipsychotics that are associated with a group of signs and symptoms have resulted in an increased focus on this syndrome.This review included accessible literature,such as review articles and original research articles.It provides useful guidelines for psychiatrists and gives them psycho-education so that they can identify and monitor patients who may have the syndrome and properly manage it.

Saponins from Panax japonicus attenuate age-related neuroinflammation via regulation of the mitogen-activated protein kinase and nuclear factor kappa B signaling pathways

Neuroinflammation is recognized as an important pathogenic factor for aging and related cognitive disorders. Mitogen-activated protein kinase and nuclear factor kappa B signaling pathways may mediate neuroinflammation. Saponins from Panax japonicus are the most abundant and bioactive members in rhizomes of Panaxjaponicus, and show anti-inflammatory activity. However, it is not known whether saponin from Panaxjaponicus has an anti-inflammatory effect in the aging brain, and likewise its underlying mechanisms. Sprague-Dawley rats were divided into control groups （3-, 9-, 15-, and 24-month-old groups） and saponins from Panaxjaponicus-treated groups. Saponins from Panaxjaponicus-treated groups were orally administrated saponins from Panaxjaponicus at three doses of 10, 30, and 60 mg/kg once daily for 6 months until the rats were 24 months old. Immunohistochemical staining and western blot assay results demonstrated that many microglia were activated in 24-month-old rats compared with 3- and 9-month-old rats. Expression of interleukin-1β, tumor necrosis factor-a, cyclooxygenase-2, and inducible nitric oxide synthase increased. Each dose of saponins from Panaxjaponicus visibly suppressed microglial activation in the aging rat brain, and inhibited expression levels of the above factors. Each dose of saponins from Panax japonicus markedly diminished levels of nuclear factor kappa B, IKBa, extracellular signal-regulated kinase, c-Jun N-terminal kinase, and p38. These results confirm that saponins from Panaxjaponicus can mitigate neuroinflammation in the aging rat brain by inhibition of the mito- gen-activated protein kinase and nuclear factor kappa B signaling pathways.

Identification of Serum Exosomal MicroRNA Expression Profiling in Menopausal Females with Osteoporosis by High-throughput Sequencing

Estrogen deficiency,which mainly occurs in postmenopausal women,is a primary reason for osteoporosis in clinical diagnosis.However,the molecular regulation of osteoporosis in menopausal females is still not adequately explained in the literature,with the diagnosis and treatment for osteoporosis being limited.Herein,exosomal microRNAs(miRNAs)were used to evaluate their diagnosis and prediction effects in menopausal females with osteoporosis.In this study,6 menopausal females without osteoporosis and 12 menopausal females with osteoporosis were enrolled.The serum exosomes were isolated,and the miRNA expression was detected by miRNA high-throughput sequencing.Exosomal miRNA effects were analyzed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses.The miRNA-targeted genes were evaluated by Targetscan 7.2 and the protein-protein interactions(PPI)by STRING.Hub genes were analyzed by the CytoHubba app of Cytoscape.The results showed that 191 aberrant miRNAs were found in the group of menopausal females with osteoporosis,including 72 upregulated miRNAs and 121 downregulated miRNAs.Aberrant miRNAs were involved in many signaling pathways,such as the Wnt,MAPK,and Hippo pathways.Based on PPI network analysis,FBXL3,FBXL13,COPS2,UBE2D3,DCUN1D1,DCUN1D4,CUL3,FBXO22,ASB6,and COMMD2 were the 10 most notable genes in the PPI network.In conclusion,aberrant serum exosomal miRNAs were associated with an altered risk of osteoporosis in menopausal females and may act as potential biomarkers for the prediction of risk of osteoporosis in menopausal females.

Changes of Serum Insulin-like Growth Factor-2 Response to Negative Symptom Improvements in Schizophrenia Patients Treated with Atypical Antipsychotics

Accumulating evidence suggests that a disruption of early brain development,in which insulin-like growth factor-2(IGF-2)has a crucial role,may underlie the pathophysiology of schizophrenia.Our previous study has shown that decreased serum IGF-2 was correlated with the severity of psychopathology in patients with schizophrenia.Here we conducted a prospective observation trial to investigate the effects of atypical antipsychotics on serum IGF-2 level and its relationship with clinical improvements in schizophrenia patients.Thirty-one schizophrenia patients with acute exacerbation and 30 healthy individuals were recruited in this study.Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale(PANSS)and serum IGF-2 levels were determined using ELISA.We found that schizophrenia patients with acute exacerbation had lower serum IGF-2 levels than control individuals at baseline(P<0.05).After 2 months of atypical antipsychotic treatment,a significant improvement in each PANSS subscore and total score was observed in patients(all P<0.01),and the serum IGF-2 levels of patients were significantly increased compared with those at baseline(203.13±64.62 vs.426.99±124.26 ng/mL;t=−5.044,P<0.001).Correlation analysis revealed that the changes of serum IGF-2 levels in patients were significantly correlated with the improvements of negative symptoms(r=−0.522,P=0.006).Collectively,our findings demonstrated changes of serum IGF-2 response to improvements of negative symptoms in schizophrenia patients treated with atypical antipsychotics,suggesting that serum IGF-2 might be a treatment biomarker for schizophrenia.

Erratum to:Changes of Serum Insulin-like Growth Factor-2 Response to Negative Symptom Improvements in Schizophrenia Patients Treated with Atypical Antipsychotics

The article“Changes of Serum Insulin-like Growth Factor-2 Response to Negative Symptom Improvements in Schizophrenia Patients Treated with Atypical Antipsychotics”,written by Xue-lin CHAO,Shu-zhen JIANG,Jian-wen XIONG,Jin-qiong ZHAN,Bo WEI,Chun-nuan CHEN,Yuan-jian YANG was originally published electronically on the publisher's internet portal on June 2020 without open access.With the author(s)'decision to opt for Open Choice,the copyright of the article is changed to,The Author(s)2020 and the article is forthwith distributed under a Creative Commons Attribution 4.0 International License(http://creativecommons.org/licenses/by/4.0),which permits use,sharing,adaptation,distribution and reproduction in any medium or format,as long as you give appropriate credit to the original author(s)and the source,provide a link to the Creative Commons license,and indicate if changes were made.

电休克治疗用于精神分裂症的激越症状:随机对照试验的meta分析（英文）

背景:躁动在精神分裂症治疗中是一个重大挑战。电休克疗法(ECT)对各种精神疾病是一种快速、有效、和安全的治疗,但ECT对精神分裂症的躁动治疗的相关meta分析还尚未报道。目标:系统地评估单一使用ECT或ECT合并使用其他抗精神病药物(APs)的对精神分裂症的躁动治疗的有效性和安全性。方法:进行随机对照试验(RCT)的系统文献搜索。两名独立评估者筛选研究、提取结果数据与现有数据的安全性、进行质量评估和数据合成。采用建议、评估、开发、和评价的工作组等级(GRADE)来判断主要成果的证据的总体水平。结果:一共确定了中国有七个RCTs,包括ECT单一使用(4个RCTs有5个治疗组,n=240)和ECT-APs合并使用(3个RCTs,n=240)。研究对象平均年龄34.3(4.5)岁,平均治疗时间为4.3(3.1)周。所有7个RCTs非盲法,并且根据Jadad量表7项RCTs均被评为低质量。样本的Meta分析发现与APs单一治疗相比,单一使用ECT或ECT-APs合并使用阳性和阴性症状量表(PANSS)的躁动子因子评分改善均无显著性差异(ECT单一使用:weighted mean difference(WMD)=-0.90,95%confidence interval(CI):(-2.91,1.11),p=0.38;ECT-APs合并使用:WMD=-1.34,(95%CI:-4.07,1.39),p=0.33)。然而,PANSS总分(WMD=-7.13,I^2=0%,p=0.004)和兴奋子因子评分(WMD=-1.97,p<0.0001)、ECT治疗14天后的PANSS总分(WMD=-7.13,I^2=0%,p=0.004)和第7天和第14天的兴奋子因子评分(WMD=-1.97to-1.92,p=0.002 to 0.0001)均显示单一使用ECT优于APs单一治疗。ECT-APs合并治疗结束时(WMD=-10.40,p=0.03)和治疗后7天(WMD=-5.01,p=0.02)的PANSS总分显示均优于APs单药治疗。头痛(p=0.0001,number-needed-to-harm(NNH)=3,95%CI=2-4)是唯一的ECT单一治疗后不良反应,并且ECT单一治疗组比APs单药治疗发生的更频繁。根据GRADE方法,主要结果的证据水平被评为"非常低"(37.5%)和"低"(50%)。结论:基于中国7个RCTs合并的数据发现ECT单一治疗或ECT-APs合并治疗在精神分裂症患者的躁动治疗中并没有优势。然而,ECT单一治疗或ECT-APs合并治疗均与PANSS总分减低显著有关。需要高质量的RCTs验证目前的解释。

海洛因依赖者认知功能状况与一氧化氮等的关系(英文)

目的探讨海洛因依赖者认知功能受损与血清一氧化氮(NO)等的关系。方法运用韦氏记忆量表(WMS)、数字划销测验(NCT)、威斯康星卡片分类测验(WCST)对140例男性海洛因依赖者(MPHD)及75例正常对照进行认知功能评估,用化学比色法检测受试血清NO等氧化应激指标水平。结果(1)MPHD组记忆商(MQ)、注意力及执行功能均差于对照组;(2)血清丙二醛水平高于对照组,总抗氧化能力、维生素C、超氧化物歧化酶水平低于对照组(P<0.05或P<0.01);(3)MPHD血清NO水平与记忆商(MQ)及WCST正确数呈负相关(P<0.05或P<0.01);MDA水平与MQ及NCT总净分均呈显著负相关(P<0.01);VC水平与MQ呈正相关(P<0.05);SOD水平与MQ、NCT总净分、WCST正确数均呈正相关(P<0.01)。结论海洛因依赖者存在明显的认知功能损害与氧化抗氧化反应失衡;血清NO、MDA、SOD、VC可能是与认知功能密切相关的氧化应激指标。