平疏结合法治疗郁证之机理初探

分析郁证的病因病机,总结在多年临床实践中发展出的疏通气机与平肝潜阳相结合的治法,从肝脏的疏泄功能、郁证的临床分型、临床疗效三种角度阐述采用平疏结合治法的机理和作用,就郁证临床七种证型逐一说明平疏结合之利弊,从理论上探讨其可行性,最后通过经验病例加以检验。实践与理论均说明该法具有一定的可取之处,不失为当今中医临床治疗郁证的一种新思路。     

Longitudinal association between neighborhood cohesion and depressive mood in old age: A Japanese prospective study

Despite increasing evidence of the relationship between neighborhood cohesion and depressive mood, little is known about this longitudinal association in old age. This study examined the association between perceived neighborhood cohesion and depressive mood and the stress-buffering effect of perceived neighborhood cohesion on depressive mood among older Japanese people using the 2010 (baseline) and 2012 (follow-up) Hatoyama Cohort Study datasets. We analyzed 655 participants aged 65–84 at baseline. Although perceived neighborhood cohesion at baseline was not associated with depressive mood at follow-up, high neighborhood cohesion partially offset the deleterious effect of anticipated daily stressors on depressive mood. This effect was stronger for long-term residents of the neighborhood. Interventions to strengthen neighborhood cohesion may help reduce the deleterious effect of stressors on older residents’ depressive mood.     

盐酸氨溴索与多索茶碱治疗慢性支气管炎的疗效评价

目的探讨对慢性支气管炎急性发作期患者采用盐酸氨溴索联合多索茶碱治疗的临床疗效。方法选取本院收治的慢性支气管炎急性发作期患者88例为研究对象,收治时间为2018年3月-2019年3月,根据入院时间将患者随机分为两组,对照组(n=44)和观察组(n=44)。观察组患者采用盐酸氨溴索联合多索茶碱治疗,对照组采用多索茶碱治疗,对两组患者治疗后的治疗有效率以及两组患者症状改善情况进行观察比较。结果观察组患者治疗有效率(97.7%)高于对照组(84.1%),P <0.05;观察组患者症状改善情况优于对照组,P <0.05。结论盐酸氨溴索联合多索茶碱治疗慢性支气管炎急性发作期患者,临床疗效较好,改善患者症状情况。     

Associations between child behavior problems,family management,and depressive symptoms for mothers of children with autism spectrum disorder

PurposeThe purpose of the current study was to examine the relationships between child behavior problems and mothers’ depressive symptoms and to determine whether family management mediates this relationship.MethodsWe conducted a cross-sectional survey of parents in a southeastern state. Mothers of children with ASD (n = 234) completed self-reported measures of child behavior problems, depressive symptoms, and family management using ad-hoc questions, CES-D-Boston short form, and family management measure (FaMM), respectively. We used a parallel multiple mediator model to address the study hypotheses.ResultsChildren’s behavior problems were significantly associated with mothers’ depressive symptoms and with all five subscales of the FaMM. However, only the Family Life Difficulty subscale was a significant predictor of parent depressive symptoms, suggesting that Family Life Difficulty was the only mediator of the association between child behavior problems and mothers’ depressive symptoms. After accounting for the mediators, the direct effect of child behavior problems on parent depressive symptoms was non-significant.ConclusionAs the severity of child behavior problems increased, mothers of children with ASD perceived a greater impact of ASD on their family life, which in turn increased the levels of the mothers’ depressive symptoms. Family Life Difficulty assesses parent perceptions of the extent to which their child with ASD influences family relationships and routines, suggesting a need for family-centered services that assist the family in maintaining or adapting to their routines.     

Determinants of Weight Loss Dieting Among Adolescents: A Longitudinal Analysis

PurposeTo prospectively assess characteristics associated with dieting behaviors in adolescence.MethodsWe analyzed 1,640 adolescents evaluated at 13 and 17 years old (EPITeen cohort), Porto, Portugal. Dieting was assessed only at 17 years, as self-reported frequency of dieting to lose weight in the previous 12 months. The association between participants' characteristics and dieting was summarized using multinomial logistic regression for girls and binary logistic regression for boys.ResultsDieting at 17 years old was significantly more prevalent in girls than in boys (respectively 27.6% and 10.5% for occasional dieting and 12.2% and 2.6% for frequent dieting). In both sexes, overweight and obese adolescents were significantly more likely to engage in dieting but body dissatisfaction was the strongest determinant among girls. Furthermore, dieting frequency also increased with depressive symptomatology and among those involved in health compromising behaviors.ConclusionsBesides body mass index, body image concerns and depressive symptomatology predict dieting throughout adolescence.     

Psychotic experiences in the context of depression: The cumulative role of victimization

Previous studies have reported an association between depression and psychotic experiences, but little is known about what drives this co-occurrence. This study tests the hypothesis that exposure to trauma and bullying may strengthen the relation between depression and psychotic experiences. A total of 799 college students completed self-report questionnaires on psychotic experiences, depression, bullying, and sexual trauma. Hierarchical linear regression analyses were conducted to test the direct relationship between depression and psychotic experiences, as well as interactions. Approximately 20% of respondents reported a history of being bullied, and 7% reported exposure to childhood sexual trauma. There was a significant direct relationship between depression and psychotic experiences. The association between depression and psychotic experiences was significantly stronger among respondents who were victims of both bullying and sexual violence compared to those who experienced either exposure alone, or who were not exposed to either form of victimization. These findings suggest that cumulative exposure to trauma and victimization may contribute to the co-occurrence of depression and psychotic experiences. History of victimization should be assessed among individuals with depressive symptoms to improve treatment plans and outcomes.     

Lurasidone adjunctive with lithium or valproate for bipolar depression: A placebo-controlled trial utilizing prospective and retrospective enrolment cohorts

In this study, designed to evaluate the efficacy of lurasidone as adjunctive therapy with lithium or valproate, patients with bipolar I depression were randomized to 6 weeks of double-blind treatment with lurasidone (N = 180) or placebo (N = 176), added to background treatment with lithium or valproate. All patients were treated with lithium or valproate for a minimum of 4 weeks prior to screening. This was confirmed either by prospective treatment after study enrolment (run-in cohort), or retrospectively, with blood levels of lithium and valproate at screening (non-run-in cohort). Primary and key secondary endpoints were change from baseline to week 6 on the Montgomery-Åsberg Depression Rating Scale (MADRS) and depression severity score on the Clinical Global Impressions scale for use in bipolar illness (CGI-BP-S), respectively. Treatment with lurasidone was associated with non-significant improvement at week 6 vs. placebo for the MADRS total score (−11.8 vs −10.4; P = 0.176), and the CGI-BP-S score (−1.36 vs −1.13; P = 0.095). Significant separation from placebo was observed from weeks 2–5 for the MADRS and weeks 3–5 for the CGI-BP-S. Improvement in the placebo-subtracted MADRS total score was notably larger at week 6 for the non-run-in cohort compared to the run-in cohort (LS mean difference in endpoint change scores, −4.6; P = 0.009). Adverse events most frequently reported for lurasidone were akathisia, somnolence, and extrapyramidal side effects. In conclusion, lurasidone adjunctive with lithium or valproate demonstrated significant improvement in depressive symptoms based on the MADRS from weeks 2–5 but not at the primary week 6 endpoint.