抑郁症患者的情绪冲突研究

目的:应用情绪启动范式考察抑郁症患者情绪冲突的异常。方法:对20例抑郁症患者和18名在年龄、受教育程度等方面相匹配的对照组,进行了情绪启动实验,启动刺激为积极词、一般消极词和抑郁相关词,目标刺激为积极和消极人脸,要求判断人脸的情绪类型。还对所有被试进行了贝克抑郁问卷(BDI)和状态-特质焦虑问卷(STAT)的测查。结果:在抑郁组和对照组均发现了显著的一般情绪冲突效应(由一般消极词导致);在抑郁组身上还发现,当目标人脸为积极表情时,由抑郁相关词导致的特殊情绪冲突效应,显著大于一般消极词导致的情绪冲突效应,而这种差异在正常控制组身上却没有发现。回归分析的结果进一步表明,抑郁相关词导致的情绪冲突效应与BDI分数具有线性相关关系。结论:抑郁症患者在情绪冲突上不同于正常人的异常表现,可能跟他们的注意偏向有关。     

神经肽Y系统与应激和抑郁症的相关研究进展

神经肽Y(Neuropeptide Y,NPY)是含量最丰富的神经肽之一,广泛分布于哺乳动物中枢神经系统及外周,与NPY受体共同组成了NPY系统。研究显示NPY系统与应激反应和情感障碍密切相关,本文主要总结了NPY系统与应激和抑郁症的相关研究进展。     

Open-Label Placebo for Major Depressive Disorder: A Pilot Randomized Controlled Trial

No abstract available.     

抑郁症的静息态脑功能磁共振研究

本研究的目的是研究抑郁症患者与健康人静息态脑功能的差别。对符合DSM-IV诊断标准的53例抑郁症患者和38例正常对照进行静息态功能磁共振扫描,采用局部一致性(regional homogeneity,ReHo)的方法分析数据,然后进行基于体素的组间比较,分析其静息态脑功能的差异。结果显示与正常组相比,抑郁组在双侧前扣带皮质(anterior cingulate cortex,ACC)、左侧内侧前额叶皮质、左侧颞中回均有ReHo值降低。ACC位置ReHo值显著降低提示抑郁症患者在前扣带皮质及其相邻部位自发神经活动异常。     

VHL综合征1例报告

Von Hippel-Lindau(VHL)病是一种少见的常染色体遗传性疾病,最早于1904年Von Hippel 及1927年Lindau对此病有相关描述.VHL患者可以并发多脏器肿瘤,以中枢神经系统、视网膜毛细血管瘤,肾、胰腺肿瘤和嗜铬细胞瘤等较为常见.我科收治1例,现报道如下.     

Peripheral Biomarkers in Animal Models of Major Depressive Disorder

Investigations of preclinical biomarkers for major depressive disorder (MDD) encompass the quantification of proteins, peptides, mRNAs, or small molecules in blood or urine of animal models. Most studies aim at characterising the animal model by including the assessment of analytes or hormones affected in depressive patients. The ultimate objective is to validate the model to better understand the neurobiological basis of MDD. Stress hormones or inflammation-related analytes associated with MDD are frequently measured. In contrast, other investigators evaluate peripheral analytes in preclinical models to translate the results in clinical settings afterwards. Large-scale, hypothesis-free studies are performed in MDD models to identify candidate biomarkers. Other studies wish to propose new targets for drug discovery. Animal models endowed with predictive validity are investigated, and the assessment of peripheral analytes, such as stress hormones or immune molecules, is comprised to increase the confidence in the target. Finally, since the mechanism of action of antidepressants is incompletely understood, studies investigating molecular alterations associated with antidepressant treatment may include peripheral analyte levels. In conclusion, preclinical biomarker studies aid the identification of new candidate analytes to be tested in clinical trials. They also increase our understanding of MDD pathophysiology and help to identify new pharmacological targets.     

功能失调性态度、认知偏差与抑郁障碍的关系

目的：探讨随着抑郁严重程度的变化,抑郁障碍患者功能失调性态度和认知偏差的变化情况。方法：采用功能失调性态度问卷（DAS）、认知偏差问卷（CBQ）和汉密尔顿抑郁量表（HRSD）对122例抑郁障碍患者于入组时（基线）、8周末的两个时点进行评定,采用DAS、CBQ和抑郁自评量表（SDS）对51名正常对照进行评定。结果：（1）基线时抑郁障碍组DAS总分（158.2±34.6）和CBQ评分（5.19±3.77）均显著高于对照组（DAS总分：119.3±23.4,CBQ评分：1.69±1.83）（t=8.559、8.208,P均为0.000）;（2）基线、8周末病例组自身比较,HRSD评分降至中位数7.0,DAS总分由158.2±34.6降至143.3±29.3（t=3.611,P=0.000）,CBQ评分由中位数5.0降至3.0（z=4.670,P=0.000）;（3）8周末,抑郁障碍完全恢复组的DAS总分（131.1±25.7）、CBQ评分（中位数为3.0）显著高于正常对照组（t=2.397,P=0.018;z=3.990,P=0.000）。结论：抑郁障碍患者的功能失调性态度和认知偏差既随抑郁症状的变化而变化,又有一定的稳定特质性,具有状态-特质性。     

Course and Chronicity of Unipolar Major Depressive Disorder: Commentary on Joiner

Joiner (this issue) outlines an organizational framework of dysfunctional psychological processes observed in unipolar major depressive disorder (MDD) patients, which he hypothesizes makes substantial contributions to the chronicity of this common and disabling disorder. Rather than concentrating on the clinical characteristics, past history, biological markers, or genetic variables as risk factors for chronicity, Joiner references the scarring effects of repeated episodes and a set of destructive interpersonal processes present in depressed patients that he feels promotes depressive chronicity. This extends observations reported in prior studies on psychosocial disability in depression, which have concentrated primarily on such issues as employment status, estimates of well-being, and so on, whereas Joiner emphasizes psychological disability and disrupted interpersonal relationships.
This commentary introduces a new dimension of chronicity of unipolar MDD that involves the long-term, chronic manifestation of depressive symptomatology, in addition to the frequent major depressive episode relapse. Further, the long-term symptomatic structure of unipolar MDD is described as a dimensional continuum of symptom severity and illness activity and then highlighted as to the relevance of both of these newer concepts to Joiner's proposals. A number of interesting research questions are outlined in by Joiner that need empirical validation but, if answered, could make a contribution to the understanding and reduction of depression chronicity.     

Clinical Significance of the Number of Depressive Symptoms in Major Depressive Disorder: Results from the CRESCEND Study

Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ² test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, P < 0.001), anxiety symptoms (F [4, 765] = 12.890, P < 0.001) and suicidal ideation (F [4, 653] = 6.970, P < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, P < 0.001), and quality of life (F [4, 656] = 11.975, P < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, P < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.     

快速眼动睡眠行为障碍病案

1典型病例 患者陈XX,男,65岁,初中文化程度,职业炒股人.主诉"反复多梦8年,加剧2个月".患者从:1999年开始做梦,自诉贯穿于整个睡眠过程中,伴有异常行为、呓语.梦的内容多涉及暴力、高空跌下等,清晨醒后常见身体多处青紫,通常异常行为与呓语内容相吻合.虽能回忆梦的大致内容,但不记得受伤经过.其妻发现患者多于凌晨2时许开始目光呆滞,呓语.多伴有双手当空挥舞,动作僵硬,甚至打人毁物.经常跌落床下而均浑然不知.若非被唤醒,则上述症状会持续到清晨醒后.病情呈渐进性加重,近2个月来每夜均有发作,其妻不堪其扰而带来就诊.否认神经精神疾患,否认类似的家族遗传病史,无外伤史.已婚已育,妻儿均体健.既往饮酒20余年,日均饮啤酒(3-8)瓶,现已戒10年.吸烟史40余年,日均吸烟30支.习惯于23:00入睡,7:30起床.多导睡眠图(PSG)显示:在REM期出现颏肌紧张度过度增加、肢体肌电图出现大量动作电位,未发现痫样电活动.     

重度抑郁症对负性情绪面孔的注意偏向

目的:探讨重度抑郁症患者对负性情绪面孔的注意偏向.方法:从35名符合中国精神疾病诊断与分类手册第三版(CCMD-3)抑郁症诊断标准的被试中,筛选出符合汉密尔顿抑郁量表( Hamilton Depression Scale,HAMD)及Beck抑郁自评问卷(Beck Depression Inventory,BDI)重度抑郁症诊断标准的重度抑郁症患者(抑郁组)20名.选取在年龄、性别及受教育程度方面与抑郁组相匹配的正常对照20名.采用NimStim情绪面孔图片库中的负性情绪面孔和中性情绪面孔作为刺激材料,应用注意偏向研究中常用的线索-靶子任务进行研究,比较两组被试线索效应、注意施加、注意解除得分.结果:抑郁组对负性情绪面孔线索效应得分大于对中性情绪面孔线索效应得分(21.73 ms vs.3.91 ms,P<0.01);抑郁组注意施加得分大于对照组(17.25 ms vs.1.64 ms,P<0.001);对照组与抑郁组注意解除得分差别无统计学意义(-1.50 ms vs.0.57 ms, P>0.05).结论:抑郁症患者对负性情绪信息加工存在注意偏向,对负性情绪信息缺乏保护性偏向.