Background Evidence indicates that medical students have had high rates of mental health problems,especially during the COVID-19 pandemic,which could be affected by alexithymia—a marked dysfunction in emotional aware...Background Evidence indicates that medical students have had high rates of mental health problems,especially during the COVID-19 pandemic,which could be affected by alexithymia—a marked dysfunction in emotional awareness,social attachment and interpersonal relationships—and stress.However,psychological resilience might relieve alexithymia and stress levels.Aims This study aimed to investigate the role of resilience in alexithymia and stress in medical students.Methods A total of 470 medical students completed online and offline surveys,including the Toronto Alexithymia Scale-20(TAS-20),the Connor-Davidson Resilience Scale(CD-RISC)and the College Student Stress Questionnaire(CSSQ).The data of five participants were excluded because of a lack of integrity.Mann-Whitney U test or Kruskal-Wallis test was used to compare group differences in the CD-RISC scores among categorical variables.Spearman correlation analysis was employed to evaluate the associations between resilience and alexithymia and between resilience and stress.Mediation analysis was used to test the mediating effect of resilience between alexithymia and stress.Results Of the medical students considered in the analysis,382(81.28%)were female and 88(18.72%)were male.There was a significant negative correlation between the TAS-20 scores and the total and subtotal CD-RISC scores(p<0.001).The CSSQ scores also significantly negatively correlated with the total and subtotal CD-RISC scores(p<0.001).Resilience mediated the relationship between alexithymia and stress(total effect=1.0447,p<0.001).The indirect effect of alexithymia significantly impacted stress through resilience(effect=0.1670,95%CI:0.069 to 0.281).Conclusions Our findings suggest that resilience might effectively reduce alexithymia and stress.They also contributed to a better understanding of the mediating effects of resilience on alexithymia and stress during the COVID-19 pandemic.The evidence from these results encourages universities to focus on improving students’resilience.展开更多
Background Depression,one of the most frequent complications after stroke,increases the disease’s burden and physical disability.Poststroke depression(PSD)is a multifactorial disease with genetic,environmental and bi...Background Depression,one of the most frequent complications after stroke,increases the disease’s burden and physical disability.Poststroke depression(PSD)is a multifactorial disease with genetic,environmental and biological factors involved in its occurrence.Genetic studies on PSD to date have mainly focused on the monoamine system and brain-derived neurotrophic factors.However,understanding is still limited about the influence of the single nucleotide polymorphism(SNP)of other neurotrophic factors on PSD.Aims The present study aimed to investigate the relationship between seven vascular endothelial growth factor(VEGF)family gene variants that occur with PSD.Methods A multicentre candidate gene study from five hospitals in Jiangsu Province from June 2013 to December 2014 involved 121 patients with PSD and 131 patients with non-PSD.Demographic characteristics and neuropsychological assessments were collected.Theχ^(2)test was used to evaluate categorical variables,while the independent t-test was applied to continuous variables.SNPs in seven genes(VEGFA,VEGFB,KDR,FLT-1,IGF-1,IGF-1R and PlGF)were genotyped.Single-marker association for PSD was analysed byχ^(2)tests and logistic regression using SPSS and PLINK software.Results Patients with PSD included more women and those with lower education levels,lower body mass indexes,lower Mini-Mental State Examination scores,and higher scores on the 17-item Hamilton Depression Rating Scale than non-PSD patients.Ninety-two SNPs with seven genes were genotyped and passed quality control.The rs7692791 CC genotypes,the C allele of KDR and the rs9282715 T allele of IGF-1R increased the risk for PSD(χ^(2)=7.881,p=0.019;χ^(2)=4.259,p=0.039;χ^(2)=4.222,p=0.040,respectively).In addition,the SNP rs7692791 of KDR was significantly associated with PSD by the logistic regression of an additive model(p=0.015,OR=9.584,95%CI:1.549 to 59.31).Conclusions Patients with rs7692791 C allele carriers or the CC genotype of KDR and the rs9282715 T allele of IGF-1R may have PSD susceptibility.Findings such as these may help clinicians to identify the high-risk population for PSD earlier and,thus,enable them to provide more timely interventions.展开更多
Mental health is one of the major causes of disability worldwide,and mental health problems such as depression and anxiety are ranked among the top 25 leading causes of disease burden in the world.This burden is consi...Mental health is one of the major causes of disability worldwide,and mental health problems such as depression and anxiety are ranked among the top 25 leading causes of disease burden in the world.This burden is considerable over the lifetime of both men and women and in various settings and ages.This study aims to compare the mental health status of people in China and Pakistan and to highlight the mental health laws and policies during COVID-19 and afterwards.According to the literature on mental health,before the COVID-19 pandemic,mental health problems increased gradually,but during and after the COVID-19 pandemic,an abrupt surge occurred in mental health problems.To overcome mental health disorders,most(but not all)countries have mental health laws,but some countries ignore mental health disorders.China is one such country that has mental health laws and policies and,during the COVID-19 pandemic,China made beneficial and robust policies and laws,thereby succeeding in defeating the COVID-19 pandemic.The mortality rate and financial loss were also lower than in other countries.While Pakistan has mental health laws and general health policies,the law is only limited to paperwork and books.When it came to COVID-19,Pakistan did not make any specific laws to overcome the virus.Mental health problems are greater in Pakistan than in China,and China’s mental health laws and policies are more robust and more widely implemented than those in Pakistan.We conclude that there are fewer mental health issues in China than in Pakistan both before and since the COVID-19 pandemic.China has strong mental health laws and these are robustly implemented,while the mental health law in Pakistan is not applied in practice.展开更多
Prefrontal dysfunction in patients with attention-deficit/hyperactivity disorder (AD/HD) has been repeatedly detected on a behavioral level, and various brain-imaging studies have elucidated the pathophysiology of AD/...Prefrontal dysfunction in patients with attention-deficit/hyperactivity disorder (AD/HD) has been repeatedly detected on a behavioral level, and various brain-imaging studies have elucidated the pathophysiology of AD/HD. Recent advances in near-infrared spectroscopy (NIRS) have enabled noninvasive investigations of brain function in various mental disorders, especially major depression, schizophrenia, and bipolar disorder. The objective of this preliminary study was to use NIRS to evaluate changes in frontal lobe blood flow in post childhood or adult patients with AD/HD symptoms. The subjects included five patients with a range of mental disorders and AD/HD symptoms, and a matched (age, sex, and dominant hand) control group of five healthy subjects. We compared the changes in cerebral blood flow during verbal fluency tasks between the two groups. The duration of the elevated oxygenated hemoglobin was notably shorter in the AD/HD group than that in the healthy control group. We suggest that the shorter elevation durations of oxygenated hemoglobin concentrations might be a biological indicator for post childhood or adult AD/HD or of impaired executive functioning.展开更多
Psychosomatic medicine is a branch of medicine that studies psychosomatic interactions.It focuses on the aetiology,pathology,diagnosis,treatment and prevention of psychosomatic diseases.Increasing effort is being made...Psychosomatic medicine is a branch of medicine that studies psychosomatic interactions.It focuses on the aetiology,pathology,diagnosis,treatment and prevention of psychosomatic diseases.Increasing effort is being made to improve the understanding of psychosomatic medicine in patients,their families,general hospitals and society.12 In addition,the development of psychosomatic medicine calls for wide collaboration with psychiatry,psychology,behavioural science,sociology,biology,neurochemistry and immunology.3 We initiated this special issue to encourage interdisciplinary studies in psychosomatic medicine.展开更多
Depression is the most disabling disorder world- wide that accounts for the highest proportion of global burden attributable to mental disorders. Major depressive disorder (MDD) is characterized by deep sadness, red...Depression is the most disabling disorder world- wide that accounts for the highest proportion of global burden attributable to mental disorders. Major depressive disorder (MDD) is characterized by deep sadness, reduced energy, vegetative nervous system dysregulation, cognitive dysfunction, and even a high suicidal tendency. Although other treatment choices are available, antidepressant medication is the front-line treatment option for MDD. Regarding clinical efficacy, only - 50% of patients respond to frontline antide pressants, and 〈33% obtain remission. Currently, objective indexes to guide clinical decisions are still lacking. Further- more, knowledge about the neurobiological mechanisms underlying discrepant antidepressant outcomes is still also fragmentary. In the present review, we discuss the current research progress and clinical opinions on MDD in China.展开更多
Despite a growing neuroimaging literature on the pathophysiology of major depressive disorder(MDD),repro-ducible findings are lacking,probably reflecting mostly small sample sizes and heterogeneity in analytic approac...Despite a growing neuroimaging literature on the pathophysiology of major depressive disorder(MDD),repro-ducible findings are lacking,probably reflecting mostly small sample sizes and heterogeneity in analytic approaches.To address these issues,the Depression Imaging REsearch ConsorTium(DIRECT)was launched.The REST-meta-MDD project,pooling 2428 functional brain images processed with a standardized pipeline across all participating sites,has been the first effort from DIRECT.In this review,we present an overview of the moti-vations,rationale,and principal findings of the studies so far from the REST-meta-MDD project.Findings from the first round of analyses of the pooled repository have included alterations in functional connectivity within the default mode network,in whole-brain topological properties,in dynamic features,and in functional lat-eralization.These well-powered exploratory observations have also provided the basis for future longitudinal hypothesis-driven research.Following these fruitful explorations,DIRECT has proceeded to its second stage of data sharing that seeks to examine ethnicity in brain alterations in MDD by extending the exclusive Chinese original sample to other ethnic groups through international collaborations.A state-of-the-art,surface-based preprocessing pipeline has also been introduced to improve sensitivity.Functional images from patients with bipolar disorder and schizophrenia will be included to identify shared and unique abnormalities across diag-nosis boundaries.In addition,large-scale longitudinal studies targeting brain network alterations following antidepressant treatment,aggregation of diffusion tensor images,and the development of functional magnetic resonance imaging-guided neuromodulation approaches are underway.Through these endeavours,we hope to accelerate the translation of functional neuroimaging findings to clinical use,such as evaluating longitudinal effects of antidepressant medications and developing individualized neuromodulation targets,while building an open repository for the scientific community.展开更多
Major depressive disorder(MDD) is the most common mental disorder. Over 95 million people in China suffer from MDD(Huang et al.,2019). Currently available antidepressants have delayed onset and a low cure rate(Malhi a...Major depressive disorder(MDD) is the most common mental disorder. Over 95 million people in China suffer from MDD(Huang et al.,2019). Currently available antidepressants have delayed onset and a low cure rate(Malhi and Mann, 2018). Genetic and psychosocial factors, as well as their interactions, play an important role in the response to antidepressants for MDD patients(Uher, 2011;Gonda et al., 2019;Musci et al., 2019). Understanding the underlying associations and mechanisms may help to improve the first-episode cure rate in MDD patients.展开更多
The regional specifi city of hippocampal abnormalities in late-life depression(LLD) has been demonstrated in previous studies. In this study,we sought to examine the functional connectivity(FC) patterns of hippoca...The regional specifi city of hippocampal abnormalities in late-life depression(LLD) has been demonstrated in previous studies. In this study,we sought to examine the functional connectivity(FC) patterns of hippocampal subregions in remitted late-onset depression(r LOD),a special subtype of LLD. Fourteen r LOD patients and 18 healthy controls underwent clinical and cognitive evaluations as well as resting-state functional magnetic resonance imaging scans at baseline and at ~21 months of follow-up. Each hippocampus was divided into three parts,the cornu ammonis(CA),the dentate gyrus,and the subicular complex,and then six seed-based hippocampal subregional networks were established.Longitudinal changes of the six networks over time were directly compared between the rL OD and control groups. From baseline to follow-up,the r LOD group showed a greater decline in connectivity of the left CA to the bilateral posterior cingulate cortex/precuneus(PCC/PCUN),but showed increased connectivity of the right hippocampal subregional networks with the frontal cortex(bilateral medial prefrontal cortex/anterior cingulate cortex and supplementary motor area). Further correlative analyses revealed thatthe longitudinal changes in FC between the left CA and PCC/PCUN were positively correlated with longitudinal changes in the Symbol Digit Modalities Test(r = 0.624,P = 0.017) and the Digit Span Test(r = 0.545,P = 0.044) scores in the r LOD group. These results may provide insights into the neurobiological mechanism underlying the cognitive dysfunction in r LOD patients.展开更多
基金This work was funded by Qing Lan Project of Jiangsu Higher Education Institutions,National Natural Science Foundation of China(grant number 82001426)School-based Youth Project Funding(grant number NZY82001426).
文摘Background Evidence indicates that medical students have had high rates of mental health problems,especially during the COVID-19 pandemic,which could be affected by alexithymia—a marked dysfunction in emotional awareness,social attachment and interpersonal relationships—and stress.However,psychological resilience might relieve alexithymia and stress levels.Aims This study aimed to investigate the role of resilience in alexithymia and stress in medical students.Methods A total of 470 medical students completed online and offline surveys,including the Toronto Alexithymia Scale-20(TAS-20),the Connor-Davidson Resilience Scale(CD-RISC)and the College Student Stress Questionnaire(CSSQ).The data of five participants were excluded because of a lack of integrity.Mann-Whitney U test or Kruskal-Wallis test was used to compare group differences in the CD-RISC scores among categorical variables.Spearman correlation analysis was employed to evaluate the associations between resilience and alexithymia and between resilience and stress.Mediation analysis was used to test the mediating effect of resilience between alexithymia and stress.Results Of the medical students considered in the analysis,382(81.28%)were female and 88(18.72%)were male.There was a significant negative correlation between the TAS-20 scores and the total and subtotal CD-RISC scores(p<0.001).The CSSQ scores also significantly negatively correlated with the total and subtotal CD-RISC scores(p<0.001).Resilience mediated the relationship between alexithymia and stress(total effect=1.0447,p<0.001).The indirect effect of alexithymia significantly impacted stress through resilience(effect=0.1670,95%CI:0.069 to 0.281).Conclusions Our findings suggest that resilience might effectively reduce alexithymia and stress.They also contributed to a better understanding of the mediating effects of resilience on alexithymia and stress during the COVID-19 pandemic.The evidence from these results encourages universities to focus on improving students’resilience.
基金This work was supported by the National Natural Science Foundation of China-Youth Foundation Projects(grant no:81901375)the Natural Science Foundation of Jiangsu Province(grant no:BK20180370).
文摘Background Depression,one of the most frequent complications after stroke,increases the disease’s burden and physical disability.Poststroke depression(PSD)is a multifactorial disease with genetic,environmental and biological factors involved in its occurrence.Genetic studies on PSD to date have mainly focused on the monoamine system and brain-derived neurotrophic factors.However,understanding is still limited about the influence of the single nucleotide polymorphism(SNP)of other neurotrophic factors on PSD.Aims The present study aimed to investigate the relationship between seven vascular endothelial growth factor(VEGF)family gene variants that occur with PSD.Methods A multicentre candidate gene study from five hospitals in Jiangsu Province from June 2013 to December 2014 involved 121 patients with PSD and 131 patients with non-PSD.Demographic characteristics and neuropsychological assessments were collected.Theχ^(2)test was used to evaluate categorical variables,while the independent t-test was applied to continuous variables.SNPs in seven genes(VEGFA,VEGFB,KDR,FLT-1,IGF-1,IGF-1R and PlGF)were genotyped.Single-marker association for PSD was analysed byχ^(2)tests and logistic regression using SPSS and PLINK software.Results Patients with PSD included more women and those with lower education levels,lower body mass indexes,lower Mini-Mental State Examination scores,and higher scores on the 17-item Hamilton Depression Rating Scale than non-PSD patients.Ninety-two SNPs with seven genes were genotyped and passed quality control.The rs7692791 CC genotypes,the C allele of KDR and the rs9282715 T allele of IGF-1R increased the risk for PSD(χ^(2)=7.881,p=0.019;χ^(2)=4.259,p=0.039;χ^(2)=4.222,p=0.040,respectively).In addition,the SNP rs7692791 of KDR was significantly associated with PSD by the logistic regression of an additive model(p=0.015,OR=9.584,95%CI:1.549 to 59.31).Conclusions Patients with rs7692791 C allele carriers or the CC genotype of KDR and the rs9282715 T allele of IGF-1R may have PSD susceptibility.Findings such as these may help clinicians to identify the high-risk population for PSD earlier and,thus,enable them to provide more timely interventions.
文摘Mental health is one of the major causes of disability worldwide,and mental health problems such as depression and anxiety are ranked among the top 25 leading causes of disease burden in the world.This burden is considerable over the lifetime of both men and women and in various settings and ages.This study aims to compare the mental health status of people in China and Pakistan and to highlight the mental health laws and policies during COVID-19 and afterwards.According to the literature on mental health,before the COVID-19 pandemic,mental health problems increased gradually,but during and after the COVID-19 pandemic,an abrupt surge occurred in mental health problems.To overcome mental health disorders,most(but not all)countries have mental health laws,but some countries ignore mental health disorders.China is one such country that has mental health laws and policies and,during the COVID-19 pandemic,China made beneficial and robust policies and laws,thereby succeeding in defeating the COVID-19 pandemic.The mortality rate and financial loss were also lower than in other countries.While Pakistan has mental health laws and general health policies,the law is only limited to paperwork and books.When it came to COVID-19,Pakistan did not make any specific laws to overcome the virus.Mental health problems are greater in Pakistan than in China,and China’s mental health laws and policies are more robust and more widely implemented than those in Pakistan.We conclude that there are fewer mental health issues in China than in Pakistan both before and since the COVID-19 pandemic.China has strong mental health laws and these are robustly implemented,while the mental health law in Pakistan is not applied in practice.
文摘Prefrontal dysfunction in patients with attention-deficit/hyperactivity disorder (AD/HD) has been repeatedly detected on a behavioral level, and various brain-imaging studies have elucidated the pathophysiology of AD/HD. Recent advances in near-infrared spectroscopy (NIRS) have enabled noninvasive investigations of brain function in various mental disorders, especially major depression, schizophrenia, and bipolar disorder. The objective of this preliminary study was to use NIRS to evaluate changes in frontal lobe blood flow in post childhood or adult patients with AD/HD symptoms. The subjects included five patients with a range of mental disorders and AD/HD symptoms, and a matched (age, sex, and dominant hand) control group of five healthy subjects. We compared the changes in cerebral blood flow during verbal fluency tasks between the two groups. The duration of the elevated oxygenated hemoglobin was notably shorter in the AD/HD group than that in the healthy control group. We suggest that the shorter elevation durations of oxygenated hemoglobin concentrations might be a biological indicator for post childhood or adult AD/HD or of impaired executive functioning.
文摘Psychosomatic medicine is a branch of medicine that studies psychosomatic interactions.It focuses on the aetiology,pathology,diagnosis,treatment and prevention of psychosomatic diseases.Increasing effort is being made to improve the understanding of psychosomatic medicine in patients,their families,general hospitals and society.12 In addition,the development of psychosomatic medicine calls for wide collaboration with psychiatry,psychology,behavioural science,sociology,biology,neurochemistry and immunology.3 We initiated this special issue to encourage interdisciplinary studies in psychosomatic medicine.
基金supported by the National Natural Science Foundation of China(81371488 and 81571330)
文摘Depression is the most disabling disorder world- wide that accounts for the highest proportion of global burden attributable to mental disorders. Major depressive disorder (MDD) is characterized by deep sadness, reduced energy, vegetative nervous system dysregulation, cognitive dysfunction, and even a high suicidal tendency. Although other treatment choices are available, antidepressant medication is the front-line treatment option for MDD. Regarding clinical efficacy, only - 50% of patients respond to frontline antide pressants, and 〈33% obtain remission. Currently, objective indexes to guide clinical decisions are still lacking. Further- more, knowledge about the neurobiological mechanisms underlying discrepant antidepressant outcomes is still also fragmentary. In the present review, we discuss the current research progress and clinical opinions on MDD in China.
基金funded by the National Key R&D Program of China no.2017YFC1309902the National Natural Science Foundation of China grant numbers 82122035,81671774,and 81630031+3 种基金the 13th Five-year Informatization Plan of Chinese Academy of Sciences grant no.XXH13505the Key Research Program of the Chinese Academy of Sciences no.ZDBS-SSW-JSC006Beijing Nova Program of Science and Technology no.Z191100001119104the China National Postdoctoral Program for Innovative Talents no.BX20200360.
文摘Despite a growing neuroimaging literature on the pathophysiology of major depressive disorder(MDD),repro-ducible findings are lacking,probably reflecting mostly small sample sizes and heterogeneity in analytic approaches.To address these issues,the Depression Imaging REsearch ConsorTium(DIRECT)was launched.The REST-meta-MDD project,pooling 2428 functional brain images processed with a standardized pipeline across all participating sites,has been the first effort from DIRECT.In this review,we present an overview of the moti-vations,rationale,and principal findings of the studies so far from the REST-meta-MDD project.Findings from the first round of analyses of the pooled repository have included alterations in functional connectivity within the default mode network,in whole-brain topological properties,in dynamic features,and in functional lat-eralization.These well-powered exploratory observations have also provided the basis for future longitudinal hypothesis-driven research.Following these fruitful explorations,DIRECT has proceeded to its second stage of data sharing that seeks to examine ethnicity in brain alterations in MDD by extending the exclusive Chinese original sample to other ethnic groups through international collaborations.A state-of-the-art,surface-based preprocessing pipeline has also been introduced to improve sensitivity.Functional images from patients with bipolar disorder and schizophrenia will be included to identify shared and unique abnormalities across diag-nosis boundaries.In addition,large-scale longitudinal studies targeting brain network alterations following antidepressant treatment,aggregation of diffusion tensor images,and the development of functional magnetic resonance imaging-guided neuromodulation approaches are underway.Through these endeavours,we hope to accelerate the translation of functional neuroimaging findings to clinical use,such as evaluating longitudinal effects of antidepressant medications and developing individualized neuromodulation targets,while building an open repository for the scientific community.
基金partly supported by the National Key R&D Program of China(2016YFC1306700)the Key Projects of National Natural Science Foundation of China(81830040 and 82130042)+2 种基金the Science and Technology Program of Guangdong,China(2018B030334001)the Program of Excellent Talents in Medical Science of Jiangsu Province,China(JCRCA2016006)the Social Science Foundation of Jiangsu Province,China(19GLB025)。
文摘Major depressive disorder(MDD) is the most common mental disorder. Over 95 million people in China suffer from MDD(Huang et al.,2019). Currently available antidepressants have delayed onset and a low cure rate(Malhi and Mann, 2018). Genetic and psychosocial factors, as well as their interactions, play an important role in the response to antidepressants for MDD patients(Uher, 2011;Gonda et al., 2019;Musci et al., 2019). Understanding the underlying associations and mechanisms may help to improve the first-episode cure rate in MDD patients.
基金supported by the National Natural Science Foundation of China (30825014,81061120529,30970814,81371488,91132727 and 30830046)the Key Program for Clinical Medicine and Science and Technology,Jiangsu Provincial Clinical Medical Research Center,China (BL2013025)
文摘The regional specifi city of hippocampal abnormalities in late-life depression(LLD) has been demonstrated in previous studies. In this study,we sought to examine the functional connectivity(FC) patterns of hippocampal subregions in remitted late-onset depression(r LOD),a special subtype of LLD. Fourteen r LOD patients and 18 healthy controls underwent clinical and cognitive evaluations as well as resting-state functional magnetic resonance imaging scans at baseline and at ~21 months of follow-up. Each hippocampus was divided into three parts,the cornu ammonis(CA),the dentate gyrus,and the subicular complex,and then six seed-based hippocampal subregional networks were established.Longitudinal changes of the six networks over time were directly compared between the rL OD and control groups. From baseline to follow-up,the r LOD group showed a greater decline in connectivity of the left CA to the bilateral posterior cingulate cortex/precuneus(PCC/PCUN),but showed increased connectivity of the right hippocampal subregional networks with the frontal cortex(bilateral medial prefrontal cortex/anterior cingulate cortex and supplementary motor area). Further correlative analyses revealed thatthe longitudinal changes in FC between the left CA and PCC/PCUN were positively correlated with longitudinal changes in the Symbol Digit Modalities Test(r = 0.624,P = 0.017) and the Digit Span Test(r = 0.545,P = 0.044) scores in the r LOD group. These results may provide insights into the neurobiological mechanism underlying the cognitive dysfunction in r LOD patients.