A Network Model of Positive Resources,Temperament, Childhood Trauma,and Comorbid Symptoms for Patient with Depressive Disorders

ObjectiveTemperament, positive resources, childhood trauma, and other clinical comorbid symptoms are related to depressive symptom severity. Here, we used network analysis to examine the interrelations between these clinical factors in patients with depressive disorders. MethodsPatients with depressive disorders (n=454) completed self-report questionnaires evaluating clinical symptoms, childhood trauma, temperament, and positive resources. To identify network pattern and the most central aspect, we performed network analysis and centrality analyses. First, we analyzed the network pattern in total participants. Second, we established two groups of those with severe depressive symptoms and those with mild depressive symptoms and compared their network patterns. ResultsDeficient optimism and depression were the central factors in the network of total participants. In the group with severe depressive symptoms, lack of social support and childhood emotional trauma showed high centrality. Deficient social support and other positive resources played central roles in the group with mild depressive symptoms. ConclusionNetwork pattern of psychological factors was different between those with mild or severe depression. Lack of positive resources is an important factor in psychological processes in both mild and severe depression. However, childhood emotional trauma may play a relatively important role in patients with severe depressive symptoms.     

产后抑郁症患者的述情障碍与抑郁症状的相关分析

目的探讨产后抑郁症患者的述情障碍与抑郁症状的相关性。方法采用汉密尔顿抑郁量表17项版本(HAMD-17)和多伦多述情障碍量表20项(TAS-20)对60例产后抑郁症患者和60例健康产妇进行评定。结果①产后抑郁症组患者TAS-20总分及3个因子分评分显著高于对照组,差异有统计学意义(t=31.294,21.450,10.006,26.053;P<0.01;);②TAS-20总分及3个因子分与HAMD-17总分、焦虑/躯体化因子(Hf1)、体重因子(Hf2)、认知障碍因子(Hf3)、阻滞因子(Hf4)呈显著正相关(r=0.273～0.638,P<0.01或0.05);睡眠障碍因子(Hf5)与TAS-20总分和3个因子分相关均不显著(r=-0.141～0.030,P>0.05)。结论产后抑郁症患者存在着明显的述情障碍;述情障碍与抑郁症状的严重程度呈显著正相关,产后抑郁症患者的述情障碍与抑郁症状相互影响;有述情障碍的产后抑郁症患者的功能性躯体不适症状更突出。     

青少年抑郁情绪和违纪行为的共存——孰因孰果?

目的:采用交叉滞后模型探讨青少年抑郁情绪和违纪行为共存的机制.方法:886名青春早期(11-13岁)和580名青春中期(14-16岁)的青少年参加了三轮追踪测量,其中男生的比例分别为50％和46.2％.采用流调中心抑郁量表(CES-D)和行为问题问卷(YSR)来测量青少年的抑郁情绪和违纪行为.结果:对于男生来说,在青春发展早期,违纪行为显著预测抑郁情绪的产生,支持失败模型理论;在青春发展中期,抑郁情绪显著预测违纪行为的产生,支持释放模型理论.对于女生来说,违纪行为和抑郁情绪相互影响,不存在发展阶段的差异.结论:抑郁情绪和违纪行为的关系存在性别差异.     

Association analysis of sequence variants of GABA(A) alpha6, beta2, and gamma2 gene cluster and alcohol dependence

Quantitative trait analyses in mice suggest a vulnerability locus for physiological alcohol withdrawal severity on a chromosomal segment that harbors the genes encoding the alpha1, alpha6, beta2, and gamma2 subunits of the gamma-aminobutyric acid type-A receptor (GABR). We tested whether genetic variation at the human GABA(A) alpha6, beta2, and gamma2 gene cluster on chromosome 5q33 confers vulnerability to alcohol dependence. The genotypes of three nucleotide substitution polymorphisms of the GABRA6, GABRB2, and GABRG2 genes were assessed in 349 German alcohol-dependent subjects and in 182 ethnically matched controls. To eliminate some of the genetic variance, three more homogeneous subgroups of alcoholics were formed by: (1) a history of alcohol withdrawal seizure or delirium (n = 106); (2) a history of parental alcoholism (n = 120); and (3) a comorbidity of dissocial personality disorder (n = 57). We found no evidence that any of the investigated allelic variants confers vulnerability to either alcohol dependence or severe physiological alcohol withdrawal symptoms or familial alcoholism (p > 0.05). The frequency of the T allele of the GABRA6 polymorphism was significantly increased in dissocial alcoholics [f(T) = 0.799] compared with the controls [f(T) = 0.658; p = 0.002; OR(T+) = 7.26]. Taking into account the high a priori risk of false-positive association findings due to multiple testing, further replication studies are necessary to examine the tentative phenotype-genotype relationship of GABRA6 gene variants and dissocial alcoholism.     

Validity of Chinese Version of the Composite International Diagnostic Interview-3.0 in Psychiatric Settings

Background:

The Composite International Diagnostic Interview-3.0 (CIDI-3.0) is a fully structured lay-administered diagnostic interview for the assessment of mental disorders according to ICD-10 and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The aim of the study was to investigate the concurrent validity of the Chinese CIDI in diagnosing mental disorders in psychiatric settings.

Methods:

We recruited 208 participants, of whom 148 were patients from two psychiatric hospitals and 60 healthy people from communities. These participants were administered with CIDI by six trained lay interviewers and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I, gold standard) by two psychiatrists. Agreement between CIDI and SCID-I was assessed with sensitivity, specificity, positive predictive value and negative predictive value. Individual-level CIDI-SCID diagnostic concordance was evaluated using the area under the receiver operator characteristic curve and Cohen''s K.

Results:

Substantial to excellent CIDI to SCID concordance was found for any substance use disorder (area under the receiver operator characteristic curve [AUC] = 0.926), any anxiety disorder (AUC = 0.807) and any mood disorder (AUC = 0.806). The concordance between the CIDI and the SCID for psychotic and eating disorders is moderate. However, for individual mental disorders, the CIDI-SCID concordance for bipolar disorders (AUC = 0.55) and anorexia nervosa (AUC = 0.50) was insufficient.

Conclusions:

Overall, the Chinese version of CIDI-3.0 has acceptable validity in diagnosing the substance use disorder, anxiety disorder and mood disorder among Chinese adult population. However, we should be cautious when using it for bipolar disorders and anorexia nervosa.     

Temporal resolution in individuals with neurological disorders

OBJECTIVE:

Temporal processing refers to the ability of the central auditory nervous system to encode and detect subtle changes in acoustic signals. This study aims to investigate the temporal resolution ability of individuals with mesial temporal sclerosis and to determine the sensitivity and specificity of the gaps-in-noise test in identifying this type of lesion.

METHOD:

This prospective study investigated differences in temporal resolution between 30 individuals with normal hearing and without neurological lesions (G1) and 16 individuals with both normal hearing and mesial temporal sclerosis (G2). Test performances were compared, and the sensitivity and specificity were calculated.

RESULTS:

There was no difference in gap detection thresholds between the two groups, although G1 revealed better average thresholds than G2 did. The sensitivity and specificity of the gaps-in-noise test for neurological lesions were 68% and 98%, respectively.

CONCLUSIONS:

Temporal resolution ability is compromised in individuals with neurological lesions caused by mesial temporal sclerosis. The gaps-in-noise test was shown to be a sensitive and specific measure of central auditory dysfunction in these patients.     

以凝血功能障碍为首发表现的特发性成人肝内胆管缺失症1例

<正>病例:患者男,24岁。因"反复皮下瘀斑8年,身目黄染3个月"于2012年3月11日收治入院。患者8年前四肢受到轻微碰撞后出现大面积皮下瘀斑伴牙龈出血,外院予止血治疗(具体不详)后瘀斑消退,但该症状常反复。1年前再次因皮下瘀斑至外院就诊,检查显示凝血酶原时间(PT)120 s,活化部分凝血活酶时间(APTT)107.8 s,凝血因子FⅦ、FⅨ下降,ALT 372 U/L,AST 386 U/L,ALP 1 633 U/L,甲状旁腺素173.9 pg/mL,骨扫描未见异常,骨髓穿刺活检提示刺激性骨髓象,予"止血、护肝"等对症治疗,皮下出血症状好转后出院。11个月前,复查ALT 298 U/L,AST 246 U/L,继续     

耳穴贴压合肝豆灵对肝豆状核变性患者抑郁状态的影响

目的 观察耳穴贴压联合肝豆灵治疗肝豆状核变性（hepatolenticular degeneration,HLD）患者抑郁状态的疗效。方法 将82例HLD伴抑郁状态患者随机分成对照组、肝豆灵组、肝豆灵合耳穴贴压组。对照组患者接受常规治疗和常规护理,肝豆灵组患者在对照组疗法基础上接受肝豆灵治疗,肝豆灵合耳穴贴压组患者在肝豆灵组疗法基础上接受耳穴贴压治疗。治疗前和治疗6周后分别采用汉密尔顿抑郁量表(Hamilton depression scale, HAMD)评价患者的抑郁状态。结果 3组患者治疗6周后HAMD总分均较治疗前显著下降（P<0.05）,其中肝豆灵合耳穴贴压组HAMD总分及绝望因子、睡眠障碍因子评分降低程度显著大于肝豆灵组和对照组（P<0.05）。结论 耳穴贴压联合肝豆灵在改善HLD患者抑郁状态方面具有一定疗效。     

首发抑郁症患者肠道菌群与认知情绪调节关系研究

背景　近年来抑郁症和肠道菌群的相关研究大多集中于动物实验,而人体肠道菌群的相关研究相对较少,结合心理特征的研究则更少。目的　了解首发抑郁症患者与健康人群在肠道菌群、认知情绪调节方面的差异,进一步探讨抑郁症、肠道菌群及认知情绪调节之间的关系。方法　选取2017年1-12月就诊于宁夏医科大学总医院心理卫生中心门诊的首发抑郁症患者30例（抑郁症组）,同期选取宁夏“十三五”科技重大项目流调体检健康志愿者31例（对照组）。完成一般情况调查问卷、汉密尔顿抑郁量表、认知情绪调节量表（CERQ）的评定与粪便的收集;采用高通量测序及生物信息学方法分析微生物群落多样性和丰度变化;探讨情绪调节策略、抑郁严重程度与肠道菌群的相关性。结果　抑郁症组和对照组一般情况（年龄、性别、BMI、吸烟、文化程度）比较,差异无统计学意义（P>0.05）。本研究以97%的相似性将所有样本的有效序列聚类为Operational Taxonomic Units（OTUs）,所得稀释曲线趋向平坦,说明测序数据量合理。抑郁症组与对照组肠道菌群多样性指数比较,差异无统计学意义（P>0.05）。与对照组相比,在门水平,抑郁症组厚壁菌门、放线菌门、柔壁菌门丰度降低,拟杆菌门丰度增高（P<0.05）;在属水平,抑郁症组Ruminococcus、Subdoligranulum、Enterobacter、Coprococcus、Bifidobacterium、Lactobacillus菌属减少,而Klebsiella、Flavonifractor、Bacteroides菌属增多（P<0.05）。LEfSe分析显示,抑郁症组肠道菌群中主要以拟杆菌、产碱菌科（Alcaligenaceae）,伯克菌目（Burkholderiales）,Β-变形菌纲、Erysipelotrichaceae、幽门螺杆菌等致病菌为主;对照组以厚壁菌门、双歧杆菌、Subdoligranulum、乳酸杆菌等有益菌为优势菌。抑郁症组自我责难、沉思、灾难化、责难他人分量表得分高于对照组,积极重新评价、理性分析分量表得分低于对照组（P<0.05）。CERQ分量表中自我责难得分与Enterobacter菌属呈正相关,与Odoribacter、Alistipes菌属呈负相关（P<0.05）;沉思分量表得分与Subdoligranulum、Alistipes、Faecalibacterium、Odoribacter菌属呈负相关（P<0.05）;重新关注计划、积极重新评价分量表得分与Weissella菌属呈正相关（P<0.05）;灾难化分量表得分与Dialister菌属呈负相关（P<0.05）。抑郁严重程度与拟杆菌门及Flavonifractor菌属呈正相关（P<0.05）,与Ruminococcus、Subdoligranulum、Coprococcus、Dialister、Odoribacter、Faecalibacterium、Butyricimonas菌属呈负相关（P<0.05）。结论　抑郁症患者与健康对照者在肠道菌群、认知情绪调节策略方面均有较大差异,情绪调节策略自我责难、沉思、灾难化,肠道菌群条件致病菌的增多及丁酸盐产生菌、益生菌的减少与抑郁症密切相关。