父母-子女人格相似性对教养行为与青少年抑郁关系的调节作用

目的:考查父母-子女人格相似性对教养行为与青少年抑郁关系的调节作用。方法:采用中国科学院心理研究所全国青少年心理健康数据库中2009年的横断数据,对其中4474名11岁到22岁的在校学生数据进行分析。父母和子女人格均为自评,教养行为采用父母自评,抑郁由青少年自评。结果:父亲-子女在神经质维度上的相似性与父亲各项教养行为的交互作用均显著;母亲-子女在外向性维度上的相似性与母亲说理的交互作用显著,母亲-子女在神经质维度上的相似性与母亲各项教养行为的交互作用均显著,母亲-子女在精神质维度上的相似性与母亲监控交互作用显著。结论:父母-子女人格相似性对教养行为与青少年抑郁的关系具有显著的调节作用。     

Association of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample

Objectives: To assess outcomes of veterans who participated in mindfulness‐based stress reduction (MBSR). Design: Posttraumatic stress disorder (PTSD) symptoms, depression, functional status, behavioral activation, experiential avoidance, and mindfulness were assessed at baseline, and 2 and 6 months after enrollment. Results: At 6 months, there were significant improvements in PTSD symptoms (standardized effect size, d = ‐0.64, p< 0.001); depression (d = ‐0.70, p<0.001); behavioral activation (d = 0.62, p<0.001); mental component summary score of the Short Form‐8 (d = 0.72, p<0.001); acceptance (d = 0.67, p<0.001); and mindfulness (d = 0.78, p<0.001), and 47.7% of veterans had clinically significant improvements in PTSD symptoms. Conclusions: MBSR shows promise as an intervention for PTSD and warrants further study in randomized controlled trials. © 2011 Wiley Periodicals, Inc. J Clin Psychol 68:1–16, 2012.     

Evidence and consensus based GKJR guidelines for the treatment of juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and adolescents. Immunomodulatory drugs are used frequently in its treatment. Using the nominal group technique (NGT) and Delphi method, we created a multidisciplinary, evidence- and consensus-based treatment guideline for JIA based on a systematic literature analysis and three consensus conferences. Conferences were headed by a professional moderator and were attended by representatives who had been nominated by their scientific societies or organizations. 15 statements regarding drug therapy, symptomatic and surgical management were generated. It is recommended that initially JIA is treated with NSAID followed by local glucocorticoids and/or methotrexate if unresponsive. Complementing literature evidence with long-standing experience of caregivers allows creating guidelines that may potentially improve the quality of care for children and adolescents with JIA.     

Web-based cognitive behavior therapy for depression with and without telephone tracking in a national helpline: secondary outcomes from a randomized controlled trial

Background

An earlier report indicated that callers to a telephone counseling service benefited from the addition of an evidence-based Web intervention for depression. It is not known whether the Web intervention would also lower alcohol use and stigma, or improve quality of life and knowledge of depression and its treatments.

Objective

To report the secondary outcomes of a trial of a Web-based cognitive behavior therapy (CBT) intervention for depression, including hazardous alcohol use, quality of life, stigma, depression literacy, and CBT literacy.

Methods

We recruited a sample of 155 callers to Lifeline, a national telephone counseling service in Australia, who met the criteria for moderate to high psychological distress. Participants were randomly assigned to 1 of 4 conditions: (1) Web CBT plus weekly telephone tracking, (2) Web CBT only, (3) weekly telephone tracking only, and (4) neither Web CBT nor telephone tracking. Participants were assessed at preintervention, postintervention, and 6 and 12 months postintervention.

Results

At postintervention, participants who completed the Web intervention either with or without telephone support had lower levels of hazardous alcohol use (without tracking: P = .008, effect size = 0.23; with tracking: P = .003, effect size = 0.26), improved quality of life (without tracking: P = .001, effect size = 0.81; with tracking: P = .009, effect size = 0.63), and improved CBT literacy (without tracking: P = .01, effect size = 0.71; with tracking: P < .001, effect size = 0.80) compared with those who did not receive the Web intervention or telephone support. Results for quality of life and CBT literacy were maintained at 6- and 12-month’s follow-up, but differences in hazardous alcohol use were not significantly different between conditions at 6 and 12 months. Although omnibus tests for depression literacy and stigma were nonsignificant, contrasts revealed that those in the Web-only condition showed significantly lower levels of stigma than participants in the control condition at postintervention. This was true for participants in the Web-only and Web plus tracking conditions at 6 months. Similarly, those in the Web-only and Web plus tracking conditions had significantly higher depression literacy at postintervention, and this was maintained in the Web-only condition at 6-months’ follow-up. No significant differences were found in depression literacy and stigma between conditions at 12 months.

Conclusions

Evidence-based Web interventions for depression can be effective not only in reducing depression symptoms but also in improving other health outcomes, including quality of life, hazardous alcohol use, and knowledge about effective strategies for depression self-management.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN): 93903959; http://www.controlled-trials.com/ISRCTN93903959/ (Archived by WebCite at http://www.webcitation.org/65y61nSsH)     

广州市中专生的抑郁状况及影响因素分析

目的了解广州市中专生抑郁情绪的发生情况并探讨可能的影响因素,为其心理健康教育及咨询提供依据。方法应用Zung′s抑郁自评量表（SDS）及自制抑郁相关因素调查表对224名广州市某职业学校学生进行调查。结果 SDS总标准分为（47.92±9.50）,抑郁检出率为42.0%;非条件Logistic回归分析结果为和父母一起居住是抑郁的保护因素（OR=0.259）,学习成绩差、家庭经济困难是抑郁的危险因素（OR=1.783、1.896）;抑郁状况在1周内感到孤独的天数、是否想过离家出走、是否想过自杀等方面的分布差异均有统计学意义（P〈0.05）。结论广州市中专生抑郁较严重,可通过让学生和父母一起居住、改善由学习成绩差及家庭经济困难带来的心理负面影响以降低其抑郁情绪的发生。     

On the relationship between functional hearing and depression

Objective: To establish the effect of self-rated and measured functional hearing on depression, taking age and gender into account. Additionally, the study investigates if hearing-aid usage mitigates the effect, and if other physical health problems and social engagement confound it. Design: Cross-sectional data from the UK Biobank resource, including subjective and behavioural measures of functional hearing and multifactorial measures of depressive episodes and symptoms, were accessed and analysed using multi-regression analyses. Study sample: Over 100 000 community-dwelling, 39–70 year-old volunteers. Results: Irrespective of measurement method, poor functional hearing was significantly (p < 0.001) associated with higher levels of depressive episodes (≤ 0.16 factor scores) and depressive symptoms (≤ 0.30 factor scores) when controlling for age and gender. Associations were stronger for subjective reports, for depressive symptoms, and the younger participants. Females generally reported higher levels of depression. Hearing-aid usage did not show a mitigating effect on the associations. Other physical health problems particularly partially confounded the effects. Conclusion: Data support an association between functional hearing and depression that is stronger in the younger participants (40–49 years old) and for milder depression. The association was not alleviated by hearing-aid usage, but was partially confounded by other physical health problems.     

Internet-Based Treatment for Adults with Depressive Symptoms: Randomized Controlled Trial

Background

Many depressed people do not receive help for their symptoms, and there are various barriers that impede help-seeking. The Internet may offer interesting alternatives for reaching and helping people with depression. Depression can be treated effectively with Internet-based cognitive behavioral therapy (CBT), but a short intervention based on problem solving therapy (PST) could constitute a worthwhile alternative to CBT.

Objective

In this study we evaluated the effectiveness of Internet-based CBT and Internet-based PST in comparison to a waiting list control group (WL), and we determined the differences between the two treatments.

Methods

We conducted a 3-arm randomized controlled trial to compare CBT, PST, and WL. The main inclusion criterion was presence of depressive symptoms (≥ 16 on the Center for Epidemiological Studies Depression scale). CBT and PST consisted of eight and five weekly lessons respectively. Participants were supported by email. Self-report measures of depression, anxiety, and quality of life were completed at pretest and after 5, 8, and 12 weeks.

Results

A total of 263 participants were randomized to the three conditions (CBT: n=88; PST: n=88; WL: n=87). Of the 263 participants, 184 (70%) completed questionnaires after 5 weeks, 173 (66%) after 8 weeks, and 151 (57%) after 12 weeks. Between-group effect sizes for depressive symptoms were 0.54 for CBT after 8 weeks (95% confidence interval (CI): 0.25 - 0.84) and 0.47 for PST after 5 weeks (95% CI: 0.17 - 0.77). These effects were further improved at 12 weeks (CBT: 0.69, 95% CI: 0.41 - 0.98; PST: 0.65, 95% CI: 0.36 - 0.95). For anxiety, effect sizes were also at a medium level. Effect sizes for quality of life were low. The number of participants showing clinically significant change at 12 weeks was significantly higher for CBT (n = 34, 38.6%) and PST (n = 30, 34.1%), compared to WL (n = 0).

Conclusions

Both Internet-based treatments are effective in reducing depressive symptoms, although the effect of PST is realized more quickly.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN): 16823487; http://www.controlled-trials.com/ISRCTN16823487/16823487 (Archived by WebCite at http://www.webcitation.org/5cQsOj7xf).     

Tyrosine kinase B protein expression is reduced in the cerebellum of patients with bipolar disorder

Background

The role of the cerebellum in coordinating mental activity is supported by its connections with cerebral regions involved in cognitive/affective functioning, with decreased activities on functional neuroimaging observed in the cerebellum of schizophrenia patients performing mental tasks. Brain-derived neurotrophic factor (BDNF)-induced activation of tyrosine kinase B (TrkB) is essential to synaptic plasticity. We hypothesized that alterations in BDNF and TrkB expression in the cerebellum were associated with schizophrenia and affective disorders.

Methods

We employed immunohistochemistry and immunoblotting to quantify protein expression of BDNF and TrkB in the cerebellum of patients with schizophrenia, bipolar disorder, and major depression compared to controls (n = 15 each).

Results

While TrkB immunoreactivity in each of the molecular and granule-cell layers was reduced in all 3 disease groups (12-34%) compared to the control (P = 0.018 and 0.038, respectively, ANOVA), only the reduction in bipolar disorder remained statistically significant upon Tukey-Kramer post hoc analyses (P = 0.019 and 0.021, respectively). Apparent decreases in BDNF immunoreactivity in all 3 disease groups (12-30%) compared to the control were not statistically significant. TrkB immunoreactivity was not significantly associated with any of the demographic, clinical, and postmortem variables. Immunoblotting displayed an 85-kDa TrkB-immunoreactive band, consistent with a truncated isoform, in all 60 cases.

Limitations

On immunoblotting, apparent decreases in 85-kDa-TrkB levels in all 3 disease groups compared to the control were not statistically significant.

Conclusions

Our finding of reduced TrkB expression in bipolar disorder suggests that dysregulation of TrkB-mediated neurotrophin signaling in the cerebellum may play a role in the pathophysiology of this disease.     

Association between morningness‐eveningness,sleep duration,weekend catch‐up sleep and depression among Korean high‐school students

The present study aimed to examine the association between morningness‐eveningness preferences, sleep duration, weekend catch‐up sleep duration and depression among Korean high‐school students. A total of 8,655 high‐school students participated from 15 districts in South Korea and completed an online self‐report questionnaire. The following sleep characteristics were assessed: weekday and weekend sleep duration, weekend catch‐up sleep duration, morningness‐eveningness preference, perceived sufficiency of sleep, self‐reported snoring and sleep apnea, daytime sleepiness, and sleep environment. Age, gender, body mass index, number of private classes, proneness to internet addiction, and depressive mood were also evaluated. A logistic regression analysis was conducted to compute odds ratios for the association between depression and sleep characteristics, after controlling for relevant covariates. Eveningness preference was a significant predictor of depressive mood (adjusted OR, 1.71; 95% CI, 1.47–1.99). Weekend CUS durations that were ≥2 hr and enrollment in numerous private classes were associated with a lower risk for depression (0.68, 0.55–0.85; 0.76, 0.60–0.95; respectively). Female gender, underweight and obese body weight, short weekday sleep durations, excessive daytime sleepiness, perceived excessiveness and insufficiency of sleep, self‐reported snoring and sleep apnea, proneness to internet addiction and a non‐optimal sleep environment were associated with an increased risk for depression. Eveningness preference and insufficient weekday sleep duration were associated with an increased risk for depression. Weekend CUS duration ≥2 hr reduced the risk for depression. Diverse aspects, including sleeping habits and sleep‐related environmental factors, should be considered to reduce depressive symptoms in late adolescents.     

穴位埋线配合文拉法辛治疗难治性抑郁症的对照研究

目的观察穴位埋线配合文拉法辛治疗难治性抑郁症的临床疗效。方法将80例抑郁症患者随机分成观察组(穴位埋线+药物)和对照组(药物),共观察6周,于治疗前、治疗后1,2,4,6周末采用汉密顿抑郁量表(HAMD),副反应量表(TESS)评定疗效及毒副反应。结果观察组与对照组治愈率比较,差异有显著性意义(χ2=5.05,P<0.05),两组HAMD评分,不良反应(TESS)评分比较,差异均有显著性意义(P<0.05)。结论埋线配合文拉法辛治疗难治性抑郁症是一种安全有效的方法,值得在临床上推广应用。