超重或肥胖者执行功能研究的可视化分析

目的 了解超重或肥胖与执行功能的研究现状与发展趋势,把握当前该领域研究热点。方法 以Web of Science核心合集数据库收录的、发表于2010年-2021年的1 321篇以“超重或肥胖与执行功能”为主题的文献为分析对象,采用CiteSpace与VOSviewer绘制知识图谱,通过发文量、研究国家和地区、研究机构以及关键词的共现、聚类和突现进行可视化分析。结果 ①发文量增长趋势方面,2010年-2021年,超重或肥胖与执行功能研究的发文状况分为三个阶段,2010年-2014年、2017年-2021年这两个阶段发文量快速增长,2014年-2017年发文量增长较平缓;②参与研究的国家和地区方面,共有64个国家和地区参与该领域的研究,其中美国的发文量最多,与其他国家和地区的合作交流最频繁、影响力最大,居该研究领域核心地位;③研究机构方面,共有1 627所机构参与该领域的研究,其中伊利诺伊大学（Illinois University）发文量最多且与多所高产机构合作紧密,形成了具有一定规模的研究团体;④关键词分析方面,研究内容主要涉及饮食行为研究、预防与干预研究、风险因素评估以及不同群体特征分析。结论 超重或肥胖与执行功能研究整体呈快速发展态势,国际关注度高且研究范围广泛。     

基于CiteSpace的近五年国内外创伤后应激障碍研究可视化分析

目的 了解近五年国内外创伤后应激障碍（PTSD）的研究现状,了解该领域研究的前沿和热点。方法 检索Web of Science和中国知网（CNKI）数据库,检索时限为2017年1月1日-2021年12月31日。运用Excel和CiteSpace对纳入的8 505篇文献的数量、作者、国家、机构和关键词等进行可视化分析。结果 (1)近五年,国内外PTSD相关文献发文量均呈增长趋势;(2)国外文献中,发文数量排名前5位的国家分别为美国、英国、中国、澳大利亚和加拿大,其中加拿大中心性最高（0.18）;(3)国内外研究机构均以高校为主;(4)国外文献发文量前三位的学者是Bryant RA、Ressler KJ、Greenberg N,国内前三位分别为伍新春、李越峰、严兴科和张桂青（二者并列）,与国外作者相比,我国学者发文量总体较少;(5)研究关键词方面,国内外关注均较多的是PTSD和抑郁。结论 近五年,PTSD一直是国内外研究的热点,国内外研究均关注PTSD与抑郁症。加强国际交流,有助于推动PTSD相关研究的进步。     

基于CNKI数据库的青少年心理弹性研究可视化分析

目的 梳理和分析青少年心理弹性的研究进展,把握该领域的研究热点与前沿。方法 运用CiteSpace对中国知网（CNKI）数据库2012年1月1日-2021年12月31日收录的青少年心理弹性相关文献进行发文量、作者、研究机构以及关键词的共现、聚类和突现词的可视化分析。结果 ①近十年,青少年心理弹性相关研究发文状况可分为缓慢增长阶段（2012年-2018年）和快速增长阶段（2018年-2021年）。②作者之间合作较紧密,且多为中小型合作团体,科研机构方面,各机构合作较少,多为师范类院校之间的合作。③关键词共现分析方面,热点关键词大致分为三类：心理健康状况、影响因素以及预防与干预研究。④相关高频关键词共生成十个聚类,包括学业情绪、学习倦怠、青少年、流动儿童、精神卫生、内化问题、社会支持、应对方式、自尊和幸福感。⑤突现强度较高的关键词为应对方式、心理健康、中介作用、回归分析、社会工作、精神卫生和焦虑。结论 关于青少年心理弹性的研究,未来可加强研究机构之间的合作,促进研究质量提升。此外,心理弹性相关的干预研究或将成为该领域未来研究热点。     

2021年恶性肿瘤脑转移研究现状和热点分析——基于CiteSpace可视化文献计量学研究

目的 利用文献计量学方法分析2021年恶性肿瘤脑转移的研究现状和热点。方法 以Web of Science核心合集为数据来源,结合CiteSpace 软件的可视化功能,采用文献计量学方法对2021年恶性肿瘤脑转移相关研究文献的期刊、作者、机构、国家/地区、文献共被引和关键词进行分析。结果 1 153篇文献涉及到的期刊中JOURNAL OF CLINICAL ONCOLOGY共被引频次最高;各作者的发文量没有明显差异;发文量最高的机构是哈佛大学医学院;发文量最多的国家是美国,其次是中国;涉及的研究方向包括：预防性脑照射、免疫治疗、靶向治疗、影像组学、人工智能、循环肿瘤DNA监测、姑息治疗和纳米颗粒。结论 2021年与放疗结合的联合治疗模式是恶性肿瘤脑转移相关研究的热点问题,预防性脑照射中的海马保护和不良反应问题亦受到普遍关注。     

强迫症与立体定向神经外科治疗的全球文献计量分析趋势

目的 分析1991—2022年全球强迫症与立体定向神经外科治疗相关文献，了解强迫症立体定向神经外科治疗的相关科研现状和变化态势，为未来相关领域学术发展提供参考和建议。方法 通过检索Web of Science数据库获得强迫症的立体定向神经外科治疗在1991—2022年发表的相关文献，采用文献计量学的方法对文献的发文量变化情况和高频关键词进行可视化分析。结果 1991—2022年共发表相关论文141篇，且发文量呈增长趋势。在这141篇出版物中，超过半数的出版物为美国发表，远超其他国家。且在该研究中最多产的机构，前3名分别为美国的布朗大学、哈佛大学、佛罗里达大学。该领域研究热点集中在难治性强迫症、深部脑刺激、立体定向外科、囊切开术、抑郁、扣带回毁损术、特发性震颤、丘脑切割术、伏膈核。结论 未来该领域的研究可更多基于强迫症患者的实际需求，在保证治疗效果的同时，加强对治疗副作用及患者康复等方面的协同优化，防止患者因治疗后的人格改变等与社会剥离，帮助强迫症患者回归社会。     

国内外卒中患者照顾者领域研究热点与前沿可视化分析

目的 以文献计量学为基础,应用CiteSpace软件对国内外卒中患者照顾者领域研究现状及热点问题进行分析,为深入开展该领域的研究提供参考。方法 在中国知网和Web of Science数据库中检索从建库至2021年12月31日卒中患者照顾者领域的中英文文献,文献类型包括论著、综述、学位论文、会议论文。去除重复文献后,从发文量、作者、机构、国家、关键词等方面进行文献计量学分析。结果 共纳入1298篇中文文献（中国知网）,1763篇英文文献（Web of Science）。对于卒中患者照顾者的研究,中英文文献发表均整体呈逐年上升趋势,中国知网数据库中,发文量从2002年的4篇增至2021年的164篇;郑州大学张振香是发文量最多（48篇）的作者,郑州大学护理与健康学院（50篇）是该领域发文量最多的机构;除主题词外,“影响因素”“照顾能力”“照顾负担”“抑郁”“焦虑”“自我感受负担”等为高频关键词。在Web of Science数据库中,发文量从2009年的103篇增至2021年的201篇;美国发文量最多（565篇）,约翰霍普金斯医学院的Roth在作者中发文量最多,Univ Toronto(5...     

2008年-2018年广西省某精神专科医院入院人次季节变化及趋势预测

目的 分析广西省某精神专科医院精神障碍患者入院人次的季节性变化,预测2019年-2021年入院人次,为优化医院管理和资源配置提供参考。 方法 统计广西省某三级精神专科医院2008年-2018年各月份的入院人次,利用季节指数法对11年间各月（季度）进行动态分析,并用灰色模型预测2019年-2021年入院人次。 结果 该院2月、3月、4月、5月、10月、12月精神障碍患者入院人次季节指数均大于100%,分别为100.53%、115.86%、106.76%、102.58%、100.93%、100.43%。通过灰色预测模型建模,预测2019年-2021年入院量分别为6 878、7 476、8 125人次。 结论 2012年-2021年该医院精神障碍患者年入院人次呈逐年递增趋势,上半年尤其是春季为入院高峰期。     

抑郁障碍急性期单药治疗和联合治疗对患者生活质量的影响

背景 目前,抑郁障碍患者的临床治疗缺乏有针对性的治疗结局评估。生活质量作为一种以患者价值为导向的次要结局,具有较高的评估价值,国内缺少关于评估抑郁障碍急性期不同治疗方案对患者生活质量影响的大样本前瞻性队列研究。目的 探讨抑郁障碍患者急性期单药治疗和联合治疗对其生活质量的影响,以期为抑郁障碍患者优化治疗结局提供参考。方法 采用前瞻性随访队列研究,于2020年8月24日-2021年11月29日,在中国18个城市的22家医院中,纳入符合《精神障碍诊断与统计手册（第5版）》（DSM-5）抑郁发作或复发性抑郁障碍的患者1 330例。根据抑郁障碍急性期治疗方案,将患者分为单药治疗组（n=969）和联合治疗组（n=361）。分别于基线期、治疗半月末以及治疗1、2、3、6、9、12个月末,采用抑郁症状量表（IDS-SR30）、简明幸福与生活质量满意度问卷（Q-LES-Q-SF）、简明健康风险跟踪量表（CHRT）以及席汉残疾量表（SDS）进行评定,于治疗后各访视时间点进行频率、强度及负担自评量表（FIBSER）评定。采用Spearman相关分析考查两组患者生活质量与自杀风险、不良反应以及社会功能损害的相关性。结果 治疗3个月末,单药治疗组Q-LES-Q-SF评分高于联合治疗组,差异有统计学意义（Z=2.008,P<0.05）。两种治疗方案时间效应有统计学意义（F=111.393,P<0.01）。治疗3个月末,单药治疗组和联合治疗组Q-LES-Q-SF评分与CHRT和SDS评分均呈负相关（r=-0.660、-0.712、-0.634、-0.718,P均<0.01）。结论 单药治疗和联合治疗均有助于改善急性期抑郁障碍患者的生活质量,但单药治疗对患者生活质量的改善可能优于联合治疗。     

失眠的认知行为治疗对失眠障碍患者睡眠质量和认知功能的影响

背景 失眠障碍已成为当前社会的一种常见疾病,失眠的认知行为治疗（CBTI）是失眠障碍的非药物治疗方法之一,其对失眠障碍患者睡眠质量和认知功能影响的研究有限。目的 探索CBTI对失眠障碍患者睡眠质量和认知功能的影响,为失眠障碍的非药物治疗提供参考。方法 选取2021年1月-2022年10月在四川省精神卫生中心就诊、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）诊断标准的47例失眠障碍患者为研究对象。患者接受为期6周的CBTI治疗。治疗前,采用汉密尔顿抑郁量表24项（HAMD-24）和汉密尔顿焦虑量表（HAMA）评定患者的抑郁和焦虑症状,在治疗前及治疗6周后采用匹兹堡睡眠质量指数量表（PSQI）和蒙特利尔认知评估量表（MoCA）评定患者的睡眠情况和认知功能。采用Spearman相关分析考查治疗后失眠障碍患者PSQI总评分减分值与MoCA总评分增分值的相关性。结果 治疗6周后,失眠障碍患者PSQI的主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍因子评分及PSQI总评分均低于治疗前,差异均有统计学意义（t=5.569~15.290,P均<0.01）,MoCA的视空间与执行功能、命名、注意力、语言能力、抽象思维、记忆力因子评分及总评分均高于治疗前,差异均有统计学意义（t=-11.273~-4.277,P均<0.01）。Spearman相关分析显示,经6周CBTI治疗后,失眠障碍患者PSQI总评分减分值与MoCA总评分增分值呈正相关（r=0.323,P=0.027）。结论 CBTI可能有助于改善失眠障碍患者的睡眠质量和认知功能。CBTI干预后,失眠障碍患者睡眠质量的提高可能与认知功能的改善存在一定的关联。     

负性生活事件对抑郁障碍青少年自杀意念的影响：母子依恋的中介作用

目的 探究负性生活事件对抑郁障碍青少年自杀意念的影响及母子依恋在其中的作用,为降低抑郁障碍青少年的自杀意念提供参考。方法 纳入2020年5月-2021年4月在重庆医科大学附属第一医院精神科门诊及住院部就诊、符合《国际疾病分类（第10版）》（ICD-10）抑郁障碍诊断标准的青少年145例,采用青少年生活事件量表（ASLEC）、父母与同伴依恋量表（IPPA）中文简版和贝克自杀意念量表中文版（BSI-CV）进行评定。使用Bootstrap方法进行中介效应检验。结果 抑郁障碍青少年BSI-CV评分与ASLEC评分呈正相关（r=0.453,P<0.01）,BSI-CV评分与IPPA母子依恋评分呈负相关（r=-0.165,P<0.01）;母子依恋在负性生活事件与自杀意念间的部分中介效应显著,中介效应值为0.008,占总效应值（0.055）的14.55%。结论 抑郁障碍青少年的自杀意念可能与较多的负性生活事件与较差的母子依恋有关,母子依恋在其负性生活事件与自杀意念间起部分中介作用。     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.     

Clobazam for Treatment of Intractable Epilepsy: A Critical Assessment

Summary: Clobazam (CLB), a 1,5-benzodiazepine, is a remarkably effective add-on drug for individual patients with refractory partial epilepsy. CLB has an excellent safety record. As with all benzodiazepines used for treating epilepsy, sedation and withdrawal effects, together with the development of tolerance, limit its usefulness. Recent efforts to prevent or reverse tolerance with intermittent administration of CLB or periodic injection of a benzodiazepine antagonist, flumazenil, are encouraging and justify further investigations.     

La passion de Torquemada et le terrorisme islamique : quelques points de comparaison

This original research compares the doctrinal, psychopathological and operational standpoints of the 15th century Spanish Inquisition (Torquemada) with those of radical Islamism from 1988 to 2005 (Al-Qaeda). The following are reviewed: (a) the main texts codifying the procedure for conducting the criminal investigation of a Holy Office trial (Directorium inquisitorum); (b) the life and work of the grand inquisitor Tomás de Torquemada (1420–1498); (c) the psychopathological relations between passion (passionate psychoses, passionate idealism, paranoid personality) and fanaticism; (d) “the madmen, the enlightened and the criminals” of Islamic terrorism; (e) the cognitive and emotional motives for engagement in the jihadist radicalization of young people; (f) the common principles of monotheistic fanaticism (Inquisition, Al-Qaeda) and the particular dogmas of Islamic terrorism in our time; (g) the operating modes of the Inquisition and the Jihadist holy war. The author concludes that the rigour and seriousness of the inquisitorial judicial procedure, which was precise, individual and personalized, contrasts with the revolutionary pamphlets of Al-Qaeda, which only provide broad guidelines for the modus operandi of the fight against infidels, who are usually random victims.     

Claustration et collectionnisme : réflexions à propos d’un cas de syndrome de Diogène avec vols kleptomaniaques et vengeurs

Social withdrawal is a pathognomonic behaviour that is consistently associated with mental illnesses. Compulsive hoarding can also be interpreted as a pathological behaviour, even when it does not involve kleptomania. Diogenes syndrome (DS) was first described in 1975, and is characterized by both behaviours - social withdrawal and compulsive hoarding. Even though it is often the manifestation of a psychiatric condition, its aetiology is diverse. The most frequent ones are however: dementia, schizophrenia and mental retardation. In this study, we describe an atypical case presenting with DS. Il consists of a young man, seen in a forensic setting, who had been diagnosed with kleptomania in the past, presents with compulsive hoarding, and whose recent thefts were fuelled by revenge. Finally, to our knowledge, the way social withdrawal is viewed is seldom taken into account. We analyse its implication on social withdrawal.     

Neurological soft signs and schizophrenia: a review of current knowledge

Schizophrenia is a frequent and disabling disorder emerging during adolescence or early adulthood. The identification of underlying processes has been hampered by the complex clinical expression and the probable etiological heterogeneity. The frequency of neurological soft signs (NSS) in patients with schizophrenia and their presence early in life (during the first two years) in high risk subjects support the hypothesis that schizophrenia is a "brain disease" reflecting pre- or perinatal insults during development. The growing interest for NSS has lead to multiple studies that are often difficult to compare. The objective of this review is to summarize the current knowledge on NSS, methodological issues and the future perspectives.     

Lacan, lecteur de Minkowski : l'approche structurale

The notion of structure occupies a predominant place in the theory of Lacan. He indicates that was developed from the work of Minkowski. In fact, through his phenomeno-structural approach, Minkowski does not limit himself to purely observable phenomena, but attempts to determine the underlying structure. He refers to the comprehensive phenomenology and psychopathology, and this method provides him with clinical finesse and another means of determining a diagnosis. Thus Lacan has used this as a basis for his approach to structure to develop a theory regarding the individual. This implies that the structure of the individual is based on his relation to language. From this concept, he then develops the clinical structures of neurosis, psychosis, and perversion. These structural landmarks also have an effect on the course of treatment.