Neural Substrates of Psychotic Depression: Findings From the Global ECT-MRI Research Collaboration

Psychotic major depression (PMD) is hypothesized to be a distinct clinical entity from nonpsychotic major depression (NPMD). However, neurobiological evidence supporting this notion is scarce. The aim of this study is to identify gray matter volume (GMV) differences between PMD and NPMD and their longitudinal change following electroconvulsive therapy (ECT). Structural magnetic resonance imaging (MRI) data from 8 independent sites in the Global ECT-MRI Research Collaboration (GEMRIC) database (n = 108; 56 PMD and 52 NPMD; mean age 71.7 in PMD and 70.2 in NPMD) were analyzed. All participants underwent MRI before and after ECT. First, cross-sectional whole-brain voxel-wise GMV comparisons between PMD and NPMD were conducted at both time points. Second, in a flexible factorial model, a main effect of time and a group-by-time interaction were examined to identify longitudinal effects of ECT on GMV and longitudinal differential effects of ECT between PMD and NPMD, respectively. Compared with NPMD, PMD showed lower GMV in the prefrontal, temporal and parietal cortex before ECT; PMD showed lower GMV in the medial prefrontal cortex (MPFC) after ECT. Although there was a significant main effect of time on GMV in several brain regions in both PMD and NPMD, there was no significant group-by-time interaction. Lower GMV in the MPFC was consistently identified in PMD, suggesting this may be a trait-like neural substrate of PMD. Longitudinal effect of ECT on GMV may not explain superior ECT response in PMD, and further investigation is needed.     

Comparing the associations of three psychometric scales at baseline with long‐term prognosis of depression over a 10‐year period

ObjectiveThe Depression and Somatic Symptoms Scale (DSSS), a free scale, includes depression (DS) and somatic (SS) subscales. This study aimed to compare the associations of the baseline DSSS, Hamilton Depression Rating Scale (HAMD) and Hospital Anxiety and Depression Scale (HADS) scores with the outcome of depression over a 10‐year follow‐up period.MethodsTwo hundred ninety outpatients with major depressive disorder (MDD) were enrolled and were followed‐up at the 6‐month, 2‐year, and 10‐year points. The three scales were administered at each follow‐up. Multiple linear regressions were used to compare the associations.ResultsIn a comparison of the HAMD, DS, and HADS‐depression, the HAMD and DS scores at baseline were most strongly associated with the HAMD score at two (6‐month and 2‐year) and one (10‐year) follow‐up points, respectively. In a comparison of the HAMD, DS, SS, HADS‐depression, and HADS‐anxiety, the SS and HAMD scores at baseline were most strongly associated with the HAMD score at two (6‐month and 10‐year) and one (2‐year) follow‐up points, respectively.ConclusionsThe DS, SS, and HAMD scores at baseline were significantly associated with the long‐term outcome of depression. Scales or subscales assessing somatic symptoms might be more strongly associated with the outcome of depression.     

Negotiating the Interpretation of Depression Shared Among Kin

ABSTRACT

Kinship processes contribute to the experience and interpretation of depression—generating empathy as well as silencing. We explore intersubjective experiences of depression among kin with the aim of understanding how depression can reveal kinship expectations and evolving concepts of distress. In interviews with 28 low-income rural Appalachian women about their depression, participants articulated depression as a social process that neither starts nor ends in themselves. Yet kinship obligations to recognize family members’ depression limited women’s ability to admit distress, let alone request care. The intersubjective experience of depression among kin can challenge the individual expression of distress.     

产后抑郁症发病机制中生物化学因素的研究进展

产后抑郁症是产褥期发生的抑郁症,是指以往无精神疾病史的患者出现以持续性情感低落为主的精神健康疾患,在发病过程中常常伴随着思维以及行为的改变,是最为常见的一种产褥期精神综合征.产后抑郁不仅对产妇的生活造成巨大影响,对婴儿的正常发育成长也有影响,严重抑制婴儿正常认知的发展.研究产后抑郁症的发病因素对于疾病预防及治疗具有十分重要的意义,该文综合了近几年来研究人员对产后抑郁症发病机制中生物化学因素的研究成果,从激素、神经递质、及其他因子等方面加以综述,为临床治疗提供依据.     

New approach in the treatment of refractory vitiligo: CO2 laser combined with betamethasone and salicylic acid solution

The aim of this study is to evaluate the use of fractional carbon dioxide laser (CO₂) with betamethasone and salicylic acid solution in the treatment of patients with refractory vitiligo in hands. Each hand of the patient was randomly assigned to one of two groups: lesion treated with fractional carbon dioxide laser associated with betamethasone and salicylic acid solution administration or lesion treated only with betamethasone and salicylic acid solution. We conclude that combined treatment with fractional carbon dioxide laser and betamethasone associated with salicylic acid solution could effectively and safely be used in the treatment of refractory vitiligo.     

面部凹陷自体脂肪颗粒填充术的临床分析

目的探讨自体脂肪颗粒注射填充矫正面部凹陷畸形的临床效果。方法首先在患者脂肪丰厚的部位,注射器抽取脂肪颗粒,经清洗液反复冲洗后,将脂肪颗粒分点多层注入皮下。结果本组85例患者,55例注射1次,25例注射2次,5例注射3次。72例随访6~24个月,3例上下睑凹陷出现局部不平整,2例患者出现无菌性炎症,其余效果满意。结论面部凹陷畸形采用自体脂肪颗粒填充矫正,方法简单,安全有效。     

中药足浴配合足底按摩促进剖宫产术后康复的研究

目的探讨中药足浴配合足底按摩对促进剖宫产术后康复的作用。方法将120例产妇随机分为四组各30例。四组产后均接受常规护理，除对D组未实施干预外，其余三组均于产后6h和每日8：00～10：00接受干预，其中A组行中药足浴配合足底按摩，B组行中药足浴，C组行温水足浴加足底按摩。结果四组产后第3天恶露量、宫底高度、首次肛门排气时间存在显著性差异（均P〈0.01）．其中A组产妇恢复最快。干预后A、B、C组抑郁、焦虑评分较干预前显著降低（P〈0.05，P〈0．01），其中A组产妇心理状态最佳。结论中药足浴配合足底按摩对剖宫产产妇术后康复有显著促进作用。     

不同萃取方法对番茄籽油理化性质与脂肪酸含量的影响

分别采用超临界ＣＯ２萃取技术和传统溶剂法从番茄籽中萃取脂肪油，经过甲酯化处理后，用气相色谱法分析出亚油酸等５种脂肪酸占总脂肪酸的９８．５％．同时对油的其它理化指标进行了测定。对测定结果进行了比较分析，说明超临界ＣＯ２萃取所得番茄籽油品质更好。并对番茄籽油的营养学机理作了讨论。     

非气腹腹腔镜胆囊切除术在老年患者中的应用

目的探讨非气腹与低压CO2气腹腹腔镜胆囊切除术在老年患者中的应用价值。方法回顾比较2005年1月～2007年12月年龄〉65岁、因慢性结石性胆囊炎接受气腹手术（n=24）和非气腹手术（n=12）的老年患者的临床资料,包括手术时间、住院时间、并发症及合并症的变化等。气腹组CO2压力为8～10mmHg,非气腹组采用人工肋第4代悬吊右侧肋弓。结果2组均在腔镜下完成手术,无中转开腹。手术时间气腹组及非气腹组分别为（46.2±14.8）及（52.4±18.6）min（t=-1.087,P=0.285）。2组术中生命体征平稳,无急性CO2潴留或心血管急性事件发生。住院时间气腹组为（10.5±6.8）d,非气腹组为（8.9±5.5）d（t=0.706,P=0.485）。2组顺利康复出院。随访6～42个月,无并发症发生。结论老年患者接受非气腹腹腔镜胆囊切除术是安全可行的,效果与低压CO2气腹手术相当。