Parkinson’s disease patients,in addition to typical motor symptoms,often experience various psychological symptoms,including depression,anxiety,cognitive impairment,impulse control disorders,and psychotic symptoms.Th...Parkinson’s disease patients,in addition to typical motor symptoms,often experience various psychological symptoms,including depression,anxiety,cognitive impairment,impulse control disorders,and psychotic symptoms.These symptoms severely affect patients’quality of life and may even cause a greater disease burden than motor symptoms.This review focuses on the application progress of transcranial magnetic stimulation(TMS)as a non-invasive neuromodulation technique in the treatment of psychological symptoms in Parkinson’s disease.Studies have shown that repetitive TMS(rTMS)has significant improvement effects on Parkinson’s disease-related depressive symptoms,with mechanisms possibly related to the regulation of the prefrontal-striatal dopamine pathway and the promotion of neuroplasticity.For anxiety symptoms,continuous theta burst stimulation has shown potential in indirect regulation of the amygdala and hippocampal regions.For cognitive impairment,high-frequency rTMS applied to the dorsolateral prefrontal cortex can improve executive function deficits,while bilateral coordinated stimulation protocols help enhance attention and memory functions.For impulse control disorders in Parkinson’s disease patients,inhibitory stimulation applied to the orbitofrontal cortex can alleviate pathological gambling and compulsive behaviors.In terms of sleep disorders,TMS has also shown potential efficacy in regulating circadian rhythms and improving rapid eye movement sleep behavior disorder.However,current research still has limitations such as small sample sizes,non-standardized stimulation protocols,and insufficient evaluation of long-term efficacy.Future research directions should focus on optimizing stimulation parameters,exploring individualized treatment protocols,integrating multimodal imaging assessments,and conducting large-sample randomized controlled trials to clarify the clinical application value of TMS in the rehabilitation of psychological symptoms in Parkinson’s disease,providing new approaches for the comprehensive management of this common neurodegenerative disease.展开更多
Alzheimer's disease(AD)is the most common cognitive disorder in the elderly.Its main clinical manifestations are cognitive decline(C),behavioral and psychological symptoms(B),and a decline in the activities of dai...Alzheimer's disease(AD)is the most common cognitive disorder in the elderly.Its main clinical manifestations are cognitive decline(C),behavioral and psychological symptoms(B),and a decline in the activities of daily living(A),also known as ABC symptoms.Early identification and evaluation of ABC symptoms are helpful for establishing the accurate diagnosis,comprehensive treatment,and prognosis of AD.To guide Chinese clinical practice for optimization of the comprehensive management of AD,in 2018,The Academy of Cognitive Disorder of China gathered 22 neurologists and gerontologists in China to build a consensus on the comprehensive management of AD.Based on a review of the evidence,the consensus summarizes the pathogenesis,pathological changes,clinical manifestations,evaluation,diagnosis,drug and non-drug treatment,and patient care for AD.Focus group discussion was used to establish a flowchart of comprehensive ABC management for AD patients.The new consensus provides a feasible AD management process for clinicians.展开更多
Over the past three decades, concerns about the high prevalence of antipsychotic use in the nursing homes （NHs） for the management of behavioral and psychological symptoms of dementia continue to be emphasized and i...Over the past three decades, concerns about the high prevalence of antipsychotic use in the nursing homes （NHs） for the management of behavioral and psychological symptoms of dementia continue to be emphasized and intervened by many. However, despite the numerous side effects and the recent blackbox warning by the United States Food and Drug Administration about the increased risks for stroke and sudden death associated with the use of antipsychotics in dementia, the preva-lence of antipsychotic use in NHs remains high. While the use of antipsychotics appeared to have modest effcacy in reducing symptoms of aggression and psychosis in dementia, there is insuffcient evidence to routinely rec-ommend the use of alternative psychopharmacological treatments for these symptoms. Hence, clinicians have to balance the safety warnings against the need to treat these symptoms in order to prevent harm to the resident that may result from his/her dangerous behaviors. Although the use of antipsychotics may be warranted in some cases, organizational, resource and training support should be provided to encourage and equip NH staff to participate in interventions so as to minimize inappropriate use of these medicines in NHs. This review will discuss the place in therapy, the trend and appropriateness of antipsychotic use in NHs, as well as the effectiveness of current and future strategies for reducing antipsychotic use in the NHs.展开更多
BACKGROUND The emergency department plays a crucial role in providing acute care to patients.Nursing interventions in this setting are essential for improving the continuity of care,enhancing patients’self-care abili...BACKGROUND The emergency department plays a crucial role in providing acute care to patients.Nursing interventions in this setting are essential for improving the continuity of care,enhancing patients’self-care abilities,and reducing psychological symp-toms.AIM To evaluate the effect of nursing interventions in the emergency department on these indicators in an emergency department.METHODS A retrospective analysis was conducted on 120 patients admitted to the emergency department between January 2022 and May 2023.The patients were divided into two groups:The control group(conventional nursing intervention)and the observation group(conventional nursing intervention+emergency department nursing intervention).The two groups were compared regarding continuity of care,self-care ability,psychological symptoms,and satisfaction with care.RESULTS The emergency department nursing interventions significantly improved the continuity of care,enhanced patients’self-care abilities,and reduced psycho-logical symptoms such as anxiety and depression.CONCLUSION Nursing interventions in the emergency department positively impact continuity of care,self-care,and psychological symptoms.However,it is important to acknowledge the limitations of this study,including the small number of studies,variable methodological quality,and the heterogeneity of the study population.Future research should address these limitations and further explore the effects of different types of nursing interventions in the emergency department.Additionally,efforts should be made to enhance the application and evaluation of these interventions in clinical practice.展开更多
Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed...Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.展开更多
Background:Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia(BPSD)in Alzheimer’s disease(AD).This study aimed to develop and validate a novel genetic-clinic...Background:Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia(BPSD)in Alzheimer’s disease(AD).This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism.Methods:This retrospective study included 165 patients with AD from the Chinese Imaging,Biomarkers,and Lifestyle(CIBL)cohort between June 1,2021,and March 31,2022.Data on demographics,neuropsychological assessments,single-nucleotide polymorphisms of AD risk genes,and regional brain volumes were collected.A multivariate logistic regression model identified BPSD-associated factors,for subsequently constructing a diagnostic nomogram.This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1,2022,and February 1,2023.Area under receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA)were used to assess the discrimination,calibration,and clinical applicability of the nomogram.Results:Factors independently associated with BPSD were:CETP rs1800775(odds ratio[OR]=4.137,95%confidence interval[CI]:1.276-13.415,P=0.018),decreased Mini Nutritional Assessment score(OR=0.187,95%CI:0.086-0.405,P<0.001),increased caregiver burden inventory score(OR=8.993,95%CI:3.830-21.119,P<0.001),and decreased brain stem volume(OR=0.006,95%CI:0.001-0.191,P=0.004).These variables were incorporated into the nomogram.The area under the ROC curve was 0.925(95%CI:0.884-0.967,P<0.001)in the internal validation and 0.791(95%CI:0.686-0.895,P<0.001)in the external validation.The calibration plots showed favorable consistency between the prediction of nomogram and actual observations,and the DCA showed that the model was clinically useful in both validations.Conclusion:A novel nomogram was established and validated based on lipid metabolism-related genes,nutritional status,and brain stem volumes,which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD.Registration:Chictr.org.cn,ChiCTR2100049131.展开更多
To quantitatively evaluate severity of behavioral and psychological symptoms of dementia(BPSD)for vascular dementia(VD).Changes of 51 patients with VD in BPSD between the first and 24th week were assessed using the Ne...To quantitatively evaluate severity of behavioral and psychological symptoms of dementia(BPSD)for vascular dementia(VD).Changes of 51 patients with VD in BPSD between the first and 24th week were assessed using the Neuropsychiatric Inventory(NPI)and the behavioral pathology in Alzheimer’s disease(BEHAVE-AD)rating scale,in detrended fluctuation analysis(DFA)represented by diurnal activity(DA),evening activity(EA),and nocturnal activity(NA),and the relationships were analyzed.The subscores of activity disturbances,diurnal rhythm disturbances,and anxieties and phobias in the BEHAVE-AD score,and that of agitation,irritability,and sleep disorder in the NPI score were significantly increased compared with the first week,as was for the changes for EA in the DFA value.A linear correlation was observed between the changes of activity disturbances plus anxieties and phobias,and those of DA,and between the development of diurnal rhythm and those of EA,the vehement and autism scores and those of DA,and the difference in sleep disorder scores and those of EA,respectively.Analysis of DA,NA,and EA may reflect the fluctuational degrees of VD-BPSD,can provide a useful assessment of VD-BPSD accompanied by clinical scores for VD.展开更多
Background The first year of attending university induces a stressful experience for many college students. The experience exposes these students to challenging circumstances and raises expectations, which consequentl...Background The first year of attending university induces a stressful experience for many college students. The experience exposes these students to challenging circumstances and raises expectations, which consequently increases the risk of psychiatric disorders and may exacerbate pre-existing problems. This study was designed to explore the risk factors of psychological symptoms among freshmen in China. Methods A three-year follow-up study was designed in a sample of Chinese college freshmen. To set up the baseline interviews, subjects from 25 high schools in Beijing were interviewed during the first year in high school. Three years later, we followed up with the 1547 students from 15 of the previously-selected 25 high schools after they had entered universities. Association between potential risk factors and the occurrence of psychological symptoms measured by the Symptoms Check List-90 was evaluated in unconditional logistic regression models with Wald test. Results Among the 1547 interviewed college freshmen in the study, 120 students （7.8%） manifested at least one psychological symptom. Personality dysfunction （OR=3.655, 95% CI 1.967-6.793）, parental rejection （OR=2.619, 95% CI 1.544-4.442）, age 〉 20 （OR=2.578, 95% CI 1.227-5.418）, disfavored university （OR=2.054, 95% CI 1.376-3.066）, non- first-choice academic major （OR=1.887, 95% CI 1.255-2.837） and no orientation （OR=1.739, 95% CI 1.025-2.951） were determined to be the risk factors of psychological symptoms among the college freshmen in China. Conclusions Psychological symptoms of college freshmen are associated with personality traits, parental rearing behavior and study environment. Therefore, it is important to pay attention to changes in mental health as students enter or decide on colleges and increase education geared towards mental health issues for students in high school and universities in China.展开更多
BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term...BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.展开更多
BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even afte...BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.展开更多
Objective:To explore the impact of common gastrointestinal(GI)symptoms on psychological symptoms,sleep quality,and quality of life in patients with inflammatory bowel disease(IBD).Methods:A unified questionnaire was d...Objective:To explore the impact of common gastrointestinal(GI)symptoms on psychological symptoms,sleep quality,and quality of life in patients with inflammatory bowel disease(IBD).Methods:A unified questionnaire was developed to collect clinical data on the mental psychology and quality of life of IBD patients from 42 hospitals in 22 provinces in P.R.China from September 2021 to May 2022.The general clinical characteristics,psychological symptoms,sleep quality,and quality of life of IBD patients with different numbers of GI symptoms were analyzed by descriptive statistical analysis.Results:A total of 2,478 IBD patients were finally analysed in this study,including 365 without GI symptoms(14.7%),752 with single symptoms(30.4%),841 with double symptoms(33.9%),and 520 with three symptoms(21.0%).Compared with patients without GI symptoms,patients with only simple abdominalgia or diarrhea or hematochezia showed significantly higher levels of anxiety and depression and worse quality of life(all P<0.05).Compared with asymptomatic patients,patients with double symptoms(e.g.abdominalgia plus hematochezia,diarrhea plus hematochezia,abdominalgia plus diarrhea)and patients with three symptoms(abdominalgia,diarrhea,and hematochezia)showed significantly higher levels of anxiety and depression and worse sleep quality and quality of life(all P<0.05).Conclusion:Compared with IBD patients without gastrointestinal symptoms,patients with gastrointestinal symptoms were more likely to experience anxiety,depression,sleep disturbances,and poorer quality of life.展开更多
The objective of this study was to assess the clinical evidence for or against mood stabilizers as a treatment for Alzheimer’s disease (AD).We searched 5 databases from their inception to January 2010.Five randomized...The objective of this study was to assess the clinical evidence for or against mood stabilizers as a treatment for Alzheimer’s disease (AD).We searched 5 databases from their inception to January 2010.Five randomized clinical trials of mood stabilizers to treat human patients suffering from AD were included.These trials assessed the effectiveness of mood stabilizers as an adjunct treatment to conventional anti-dementia drugs on behavioral and psychological symptoms, especially on agitation.Methodological quality was assessed using the Jadad score.The results suggested a significant effect in favor of placebo on the Mini-Mental Status Examination [n=270, weight mean difference (WMD), -0.89; 95% confidence intervals (CIs) -1.69 to -0.09, P=0.03] and on the Neuropsychiatric Inventory total (NPI total) (n=51, WMD, 3.71; 95% CIs 0.15 to 7.26, P=0.04).There were no significant differences in change scores on total Brief Psychiatric Rating Scale (BPRS total), NPI/BPRS agitation, Cohen-Mansfield Agitation Inventory total and Physical Self Maintenance Scale between mood stabilizers and placebo.Only one of these studies was free of methodological limittions (Jadad score=5).In conclusion, based on the existing evidence, mood stabilizers are ineffective or even harmful as a treatment for AD.展开更多
Objective:To compare the mental health status among Chinese and Korean male nursing students and further clarify the predictors of the mental health.Methods:Research data was collected from 86 undergraduate male nursi...Objective:To compare the mental health status among Chinese and Korean male nursing students and further clarify the predictors of the mental health.Methods:Research data was collected from 86 undergraduate male nursing students of China and Korea by using the SCL-90-R questionnaire.The collected data was analyzed by using SPSS version 22.0.Results:Findings showed Chinese male nursing students reported higher scores of SCL-90-R than the Chinese norms,and Korean group scored lower than Chinese group and the Korean norms.The key predictors of male nursing students'mental health include having a male role model in the nursing field,receiving positive career guidance from teaching staff and having the support and respect of family and friends.Conclusion:Chinese male nursing students need to improve their mental health level more urgently than Korean male nursing students.Chinese educators need to pay more attention to role model education and spread more excellent male nurse models for male nursing students,and Korean educators need to support male nursing students with enthusiastically and provide more positive guidance for their study and career planning.展开更多
文摘Parkinson’s disease patients,in addition to typical motor symptoms,often experience various psychological symptoms,including depression,anxiety,cognitive impairment,impulse control disorders,and psychotic symptoms.These symptoms severely affect patients’quality of life and may even cause a greater disease burden than motor symptoms.This review focuses on the application progress of transcranial magnetic stimulation(TMS)as a non-invasive neuromodulation technique in the treatment of psychological symptoms in Parkinson’s disease.Studies have shown that repetitive TMS(rTMS)has significant improvement effects on Parkinson’s disease-related depressive symptoms,with mechanisms possibly related to the regulation of the prefrontal-striatal dopamine pathway and the promotion of neuroplasticity.For anxiety symptoms,continuous theta burst stimulation has shown potential in indirect regulation of the amygdala and hippocampal regions.For cognitive impairment,high-frequency rTMS applied to the dorsolateral prefrontal cortex can improve executive function deficits,while bilateral coordinated stimulation protocols help enhance attention and memory functions.For impulse control disorders in Parkinson’s disease patients,inhibitory stimulation applied to the orbitofrontal cortex can alleviate pathological gambling and compulsive behaviors.In terms of sleep disorders,TMS has also shown potential efficacy in regulating circadian rhythms and improving rapid eye movement sleep behavior disorder.However,current research still has limitations such as small sample sizes,non-standardized stimulation protocols,and insufficient evaluation of long-term efficacy.Future research directions should focus on optimizing stimulation parameters,exploring individualized treatment protocols,integrating multimodal imaging assessments,and conducting large-sample randomized controlled trials to clarify the clinical application value of TMS in the rehabilitation of psychological symptoms in Parkinson’s disease,providing new approaches for the comprehensive management of this common neurodegenerative disease.
文摘Alzheimer's disease(AD)is the most common cognitive disorder in the elderly.Its main clinical manifestations are cognitive decline(C),behavioral and psychological symptoms(B),and a decline in the activities of daily living(A),also known as ABC symptoms.Early identification and evaluation of ABC symptoms are helpful for establishing the accurate diagnosis,comprehensive treatment,and prognosis of AD.To guide Chinese clinical practice for optimization of the comprehensive management of AD,in 2018,The Academy of Cognitive Disorder of China gathered 22 neurologists and gerontologists in China to build a consensus on the comprehensive management of AD.Based on a review of the evidence,the consensus summarizes the pathogenesis,pathological changes,clinical manifestations,evaluation,diagnosis,drug and non-drug treatment,and patient care for AD.Focus group discussion was used to establish a flowchart of comprehensive ABC management for AD patients.The new consensus provides a feasible AD management process for clinicians.
文摘Over the past three decades, concerns about the high prevalence of antipsychotic use in the nursing homes （NHs） for the management of behavioral and psychological symptoms of dementia continue to be emphasized and intervened by many. However, despite the numerous side effects and the recent blackbox warning by the United States Food and Drug Administration about the increased risks for stroke and sudden death associated with the use of antipsychotics in dementia, the preva-lence of antipsychotic use in NHs remains high. While the use of antipsychotics appeared to have modest effcacy in reducing symptoms of aggression and psychosis in dementia, there is insuffcient evidence to routinely rec-ommend the use of alternative psychopharmacological treatments for these symptoms. Hence, clinicians have to balance the safety warnings against the need to treat these symptoms in order to prevent harm to the resident that may result from his/her dangerous behaviors. Although the use of antipsychotics may be warranted in some cases, organizational, resource and training support should be provided to encourage and equip NH staff to participate in interventions so as to minimize inappropriate use of these medicines in NHs. This review will discuss the place in therapy, the trend and appropriateness of antipsychotic use in NHs, as well as the effectiveness of current and future strategies for reducing antipsychotic use in the NHs.
基金This study was reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Soochow University.
文摘BACKGROUND The emergency department plays a crucial role in providing acute care to patients.Nursing interventions in this setting are essential for improving the continuity of care,enhancing patients’self-care abilities,and reducing psychological symp-toms.AIM To evaluate the effect of nursing interventions in the emergency department on these indicators in an emergency department.METHODS A retrospective analysis was conducted on 120 patients admitted to the emergency department between January 2022 and May 2023.The patients were divided into two groups:The control group(conventional nursing intervention)and the observation group(conventional nursing intervention+emergency department nursing intervention).The two groups were compared regarding continuity of care,self-care ability,psychological symptoms,and satisfaction with care.RESULTS The emergency department nursing interventions significantly improved the continuity of care,enhanced patients’self-care abilities,and reduced psycho-logical symptoms such as anxiety and depression.CONCLUSION Nursing interventions in the emergency department positively impact continuity of care,self-care,and psychological symptoms.However,it is important to acknowledge the limitations of this study,including the small number of studies,variable methodological quality,and the heterogeneity of the study population.Future research should address these limitations and further explore the effects of different types of nursing interventions in the emergency department.Additionally,efforts should be made to enhance the application and evaluation of these interventions in clinical practice.
文摘Aim: The present study aimed to examine the predictors of comorbid psychological symptoms in social anxiety disorder (SAD) after cognitive-behavioral therapy (CBT). Methods: One hundred fourteen SAD patients completed manualized group CBT. We examined associations between the personality dimensions of NEO Five Factor Index (NEO-FFI) and the subscales of Symptom Checklist-90 Revised (SCL-90-R) in SAD patients after CBT using multiple regression analysis. Results: High levels of conscientiousness at baseline predicted symptom reduction on 4 SCL-90-R scales, including somatization, obsessive-compulsive, anxiety and global severity index in patients with SAD after CBT. And high levels of agreeableness predicted symptom reduction on 2 SCL-90-R scales, including Hostility and Paranoid Ideation. High levels of openness predicted psychoticism. Conclusion: The present study suggested that high levels of three NEO-FFI dimensions (openness, agreeableness, conscientiousness) might predict comorbid psychological symptoms reduction in SAD patients after CBT. For the purpose of improving comorbid psychological symptoms with SAD patients, it might be useful to pay more attention to these dimensions of NEO-FFI at baseline.
基金supported by grants from the National Key Research and Development Program of China(Nos.2021YFC2500100 and 2021YFC2500103)the National Natural Science Foundation of China(Nos.82071187 and 81870821)
文摘Background:Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia(BPSD)in Alzheimer’s disease(AD).This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism.Methods:This retrospective study included 165 patients with AD from the Chinese Imaging,Biomarkers,and Lifestyle(CIBL)cohort between June 1,2021,and March 31,2022.Data on demographics,neuropsychological assessments,single-nucleotide polymorphisms of AD risk genes,and regional brain volumes were collected.A multivariate logistic regression model identified BPSD-associated factors,for subsequently constructing a diagnostic nomogram.This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1,2022,and February 1,2023.Area under receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA)were used to assess the discrimination,calibration,and clinical applicability of the nomogram.Results:Factors independently associated with BPSD were:CETP rs1800775(odds ratio[OR]=4.137,95%confidence interval[CI]:1.276-13.415,P=0.018),decreased Mini Nutritional Assessment score(OR=0.187,95%CI:0.086-0.405,P<0.001),increased caregiver burden inventory score(OR=8.993,95%CI:3.830-21.119,P<0.001),and decreased brain stem volume(OR=0.006,95%CI:0.001-0.191,P=0.004).These variables were incorporated into the nomogram.The area under the ROC curve was 0.925(95%CI:0.884-0.967,P<0.001)in the internal validation and 0.791(95%CI:0.686-0.895,P<0.001)in the external validation.The calibration plots showed favorable consistency between the prediction of nomogram and actual observations,and the DCA showed that the model was clinically useful in both validations.Conclusion:A novel nomogram was established and validated based on lipid metabolism-related genes,nutritional status,and brain stem volumes,which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD.Registration:Chictr.org.cn,ChiCTR2100049131.
基金This study was sponsored by the Shanghai Pujiang Program of the Science and Technology Commission of Shanghai Municipality(09PJ1409300)the Three-Year Developmental Plan Project for Traditional Chinese Medicine(major research)of the Shanghai Municipal Health Bureau(ZYSNXD-CCZDYJ028).
文摘To quantitatively evaluate severity of behavioral and psychological symptoms of dementia(BPSD)for vascular dementia(VD).Changes of 51 patients with VD in BPSD between the first and 24th week were assessed using the Neuropsychiatric Inventory(NPI)and the behavioral pathology in Alzheimer’s disease(BEHAVE-AD)rating scale,in detrended fluctuation analysis(DFA)represented by diurnal activity(DA),evening activity(EA),and nocturnal activity(NA),and the relationships were analyzed.The subscores of activity disturbances,diurnal rhythm disturbances,and anxieties and phobias in the BEHAVE-AD score,and that of agitation,irritability,and sleep disorder in the NPI score were significantly increased compared with the first week,as was for the changes for EA in the DFA value.A linear correlation was observed between the changes of activity disturbances plus anxieties and phobias,and those of DA,and between the development of diurnal rhythm and those of EA,the vehement and autism scores and those of DA,and the difference in sleep disorder scores and those of EA,respectively.Analysis of DA,NA,and EA may reflect the fluctuational degrees of VD-BPSD,can provide a useful assessment of VD-BPSD accompanied by clinical scores for VD.
文摘Background The first year of attending university induces a stressful experience for many college students. The experience exposes these students to challenging circumstances and raises expectations, which consequently increases the risk of psychiatric disorders and may exacerbate pre-existing problems. This study was designed to explore the risk factors of psychological symptoms among freshmen in China. Methods A three-year follow-up study was designed in a sample of Chinese college freshmen. To set up the baseline interviews, subjects from 25 high schools in Beijing were interviewed during the first year in high school. Three years later, we followed up with the 1547 students from 15 of the previously-selected 25 high schools after they had entered universities. Association between potential risk factors and the occurrence of psychological symptoms measured by the Symptoms Check List-90 was evaluated in unconditional logistic regression models with Wald test. Results Among the 1547 interviewed college freshmen in the study, 120 students （7.8%） manifested at least one psychological symptom. Personality dysfunction （OR=3.655, 95% CI 1.967-6.793）, parental rejection （OR=2.619, 95% CI 1.544-4.442）, age 〉 20 （OR=2.578, 95% CI 1.227-5.418）, disfavored university （OR=2.054, 95% CI 1.376-3.066）, non- first-choice academic major （OR=1.887, 95% CI 1.255-2.837） and no orientation （OR=1.739, 95% CI 1.025-2.951） were determined to be the risk factors of psychological symptoms among the college freshmen in China. Conclusions Psychological symptoms of college freshmen are associated with personality traits, parental rearing behavior and study environment. Therefore, it is important to pay attention to changes in mental health as students enter or decide on colleges and increase education geared towards mental health issues for students in high school and universities in China.
文摘BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.
文摘BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.
基金supported by the National Natural Science Foundation of China[grant number 82170549].
文摘Objective:To explore the impact of common gastrointestinal(GI)symptoms on psychological symptoms,sleep quality,and quality of life in patients with inflammatory bowel disease(IBD).Methods:A unified questionnaire was developed to collect clinical data on the mental psychology and quality of life of IBD patients from 42 hospitals in 22 provinces in P.R.China from September 2021 to May 2022.The general clinical characteristics,psychological symptoms,sleep quality,and quality of life of IBD patients with different numbers of GI symptoms were analyzed by descriptive statistical analysis.Results:A total of 2,478 IBD patients were finally analysed in this study,including 365 without GI symptoms(14.7%),752 with single symptoms(30.4%),841 with double symptoms(33.9%),and 520 with three symptoms(21.0%).Compared with patients without GI symptoms,patients with only simple abdominalgia or diarrhea or hematochezia showed significantly higher levels of anxiety and depression and worse quality of life(all P<0.05).Compared with asymptomatic patients,patients with double symptoms(e.g.abdominalgia plus hematochezia,diarrhea plus hematochezia,abdominalgia plus diarrhea)and patients with three symptoms(abdominalgia,diarrhea,and hematochezia)showed significantly higher levels of anxiety and depression and worse sleep quality and quality of life(all P<0.05).Conclusion:Compared with IBD patients without gastrointestinal symptoms,patients with gastrointestinal symptoms were more likely to experience anxiety,depression,sleep disturbances,and poorer quality of life.
基金supported by a grant from the Wuhan Bureau of Science and Technology, Hubei,China (No.200960-323132)
文摘The objective of this study was to assess the clinical evidence for or against mood stabilizers as a treatment for Alzheimer’s disease (AD).We searched 5 databases from their inception to January 2010.Five randomized clinical trials of mood stabilizers to treat human patients suffering from AD were included.These trials assessed the effectiveness of mood stabilizers as an adjunct treatment to conventional anti-dementia drugs on behavioral and psychological symptoms, especially on agitation.Methodological quality was assessed using the Jadad score.The results suggested a significant effect in favor of placebo on the Mini-Mental Status Examination [n=270, weight mean difference (WMD), -0.89; 95% confidence intervals (CIs) -1.69 to -0.09, P=0.03] and on the Neuropsychiatric Inventory total (NPI total) (n=51, WMD, 3.71; 95% CIs 0.15 to 7.26, P=0.04).There were no significant differences in change scores on total Brief Psychiatric Rating Scale (BPRS total), NPI/BPRS agitation, Cohen-Mansfield Agitation Inventory total and Physical Self Maintenance Scale between mood stabilizers and placebo.Only one of these studies was free of methodological limittions (Jadad score=5).In conclusion, based on the existing evidence, mood stabilizers are ineffective or even harmful as a treatment for AD.
文摘Objective:To compare the mental health status among Chinese and Korean male nursing students and further clarify the predictors of the mental health.Methods:Research data was collected from 86 undergraduate male nursing students of China and Korea by using the SCL-90-R questionnaire.The collected data was analyzed by using SPSS version 22.0.Results:Findings showed Chinese male nursing students reported higher scores of SCL-90-R than the Chinese norms,and Korean group scored lower than Chinese group and the Korean norms.The key predictors of male nursing students'mental health include having a male role model in the nursing field,receiving positive career guidance from teaching staff and having the support and respect of family and friends.Conclusion:Chinese male nursing students need to improve their mental health level more urgently than Korean male nursing students.Chinese educators need to pay more attention to role model education and spread more excellent male nurse models for male nursing students,and Korean educators need to support male nursing students with enthusiastically and provide more positive guidance for their study and career planning.
