BACKGROUND Treatment-resistant depression(TRD)has a poor response to clinical treatment.Patients with TRD do not respond adequately to standard antidepressants.Even after receiving a full dose and sufficient duration ...BACKGROUND Treatment-resistant depression(TRD)has a poor response to clinical treatment.Patients with TRD do not respond adequately to standard antidepressants.Even after receiving a full dose and sufficient duration of combined antidepressant therapy,significant improvement is still difficult to achieve.At present,electroconvulsive therapy(ECT)remains a clinically effective method for treating refractory depression.A good anesthesia regimen can enhance its clinical efficacy.Actively exploring high-quality anesthesia regimens has become a current research hotspot.AIM To explore the effect of esketamine and etomidate anesthesia on the clinical efficacy of ECT for TRD.METHODS A total of 120 patients with TRD,treated at the Department of Psychiatry,The Second Affiliated Hospital of Shandong First Medical University,China between April 2020 and April 2024,were selected for the study.The patients were allocated at random into two groups using a random number table:The combination and control groups,with 60 patients in each group.Both groups underwent ECT;the combination group received esketamine and etomidate anesthesia,while the control group received etomidate anesthesia.The following parameters were compared between the two groups:Heart rate(HR);mean arterial pressure(MAP);peripheral capillary oxygen saturation(SpO2);initial and final threshold charges;and serum brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),5-hydroxytryptamine(5-HT),and interleukin-4(IL-4)levels.Neurological functions,basic executive function scores,and adverse reactions were compared during the treatment process.RESULTS During treatment,the maximum and minimum HR and MAP values in the combination group were markedly lower than those in the control group(P<0.05),whereas there was no significant difference in SpO2 between the two groups(P>0.05).During the treatment,there were no significant differences in the initial threshold charge and average duration of seizures during ECT between the two groups(P>0.05).However,the final threshold charge and total charge in the combination group were considerably lower than those in the control group(P<0.05).After treatment,the BDNF,NGF,5-HT,and IL-4 levels were evidently higher in the combination group than in the control group(P<0.05).During treatment,as the number of ECT sessions increased,both BRNAS and Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery(MCCB)scores increased,whereas Hamilton Depression Rating Scale(HAMD)-24 scores decreased in both groups.Starting from the third treatment session,the BRNAS and MCCB scores in the combination group were higher than in the control group,whereas the Hamilton Depression Scale-24 score was lower in the combination group than in the control group(P<0.05).After treatment,the Wisconsin Card Sorting Test scores and Tower of Hanoi test results in the combination group were significantly better than those in the control group(P<0.05).The occurrence of adverse reactions was compared between the two groups(P>0.05).CONCLUSION Esketamine and etomidate anesthesia during ECT for patients with TRD helps maintain stable vital signs during the treatment process,improves depressive symptoms,and enhances neurological and basic executive functions.展开更多
BACKGROUND Physical activity(PA)is a key contributor to the neurocognitive and psychological development of children and adolescents.With the rapid integration of digital technologies in educational and recreational c...BACKGROUND Physical activity(PA)is a key contributor to the neurocognitive and psychological development of children and adolescents.With the rapid integration of digital technologies in educational and recreational contexts,technology-enhanced PA(TEPA)interventions have emerged as promising tools for promoting mental and cognitive health.However,the effectiveness of various TEPA modalities—such as virtual reality(VR),mobile applications,and biofeedback systems—remains unclear.Prior findings are fragmented across systematic reviews with inconsistent methodologies.This umbrella review was conducted to synthesize current evidence and evaluate whether specific TEPA modalities yield differential benefits.We hypothesized that TEPA interventions with immersive and selfregulatory features provide greater enhancements in executive function(EF),cognitive function(CF),and mental health(MH)than passive or minimally interactive formats.AIM To determine the effects of TEPA interventions and modality-specific characteristics on EF,CF,and MH outcomes in children and adolescents.METHODS An umbrella review of systematic reviews and meta-analyses was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.Five databases(PubMed,Web of Science,EMBASE,EBSCOhost,and Cochrane Library)were searched up to March 2025.Eligible reviews included participants aged≤18 years,assessed TEPA interventions,and reported EF,CF,or MH outcomes.Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews 2.Data synthesis was stratified by intervention modality,and heterogeneity was evaluated using the I^(2)statistic.RESULTS A total of 11 systematic reviews and meta-analyses were included.Interventions using VR(2/2),game-based formats(2/2),biofeedback(2/2),and multicomponent programs(1/1)showed consistent evidence of improvements in EF and MH(e.g.,EF:6.92±3.86 vs 3.61±1.67,P<0.001).App-based interventions(3/3)demonstrated mixed or modest effects,while augmented reality-based formats showed limited efficacy.MH outcomes were most frequently improved(9/11 reviews),followed by EF(6/11 reviews)and CF(5/11 reviews).Heterogeneity ranged from moderate to high(I^(2)=42%-78%)across modalities.CONCLUSION TEPA significantly improves MH and selectively enhances executive and CF in youth.Immersive,interactive,and biofeedback-driven modalities are particularly effective.展开更多
This longitudinal study examined the association between parental autonomy support and school-aged children’s adjustment across four major domains of school functioning,as well as the mediating role of children’s ex...This longitudinal study examined the association between parental autonomy support and school-aged children’s adjustment across four major domains of school functioning,as well as the mediating role of children’s executive function.Participants were 476 school-aged children(girl:49.2%,M_(age)=10.49 years,SD=1.32 years),who completed the Psychological Autonomy Support Scale,the Behavior Rating Inventory of Executive Function–2,and the Primary School Students’Psychological Suzhi Scale at baseline and at two subsequent follow-up assessments.Results from unconditional latent growth curve models and structural equation modeling indicated that paternal autonomy support was a significant predictor of children’s adjustment across all four school domains.In contrast,maternal autonomy support was significantly associated only with interpersonal adjustment.Both the intercept(initial level)and slope(rate of change)of children’s executive function significantly predicted their adjustment in all four domains.Notably,the initial level of executive function fully mediated the association between paternal autonomy support and school adjustment,whereas the rate of change in executive function did not serve as a significant mediator.Thesefindings underscore the importance of promoting parental autonomy-supportive behaviors-particularly among fathers-as a means to enhance children’s executive functioning and,consequently,their school adjustment.展开更多
Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to ex...Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.展开更多
采用Meta法评价运动干预对注意缺陷多动障碍(ADHD)儿童执行功能的改善效果.检索Web of Science、PubMed等5大数据库,严格按照纳入与排除标准筛选文献,并运用Stata15.1软件进行分析.最终共纳入22篇文献,包含810例研究对象.Meta研究结果显...采用Meta法评价运动干预对注意缺陷多动障碍(ADHD)儿童执行功能的改善效果.检索Web of Science、PubMed等5大数据库,严格按照纳入与排除标准筛选文献,并运用Stata15.1软件进行分析.最终共纳入22篇文献,包含810例研究对象.Meta研究结果显示,运动干预能有效改善ADHD儿童的抑制控制SMD=-0.52,95%CI(-0.88,-0.17)和注意转换SMD=-0.95,95%CI(-1.43,-0.47)都具有统计学意义,但对记忆刷新的影响偏小且不具有统计学意义,SMD=0.08,95%CI(-0.21,0.36).研究认为,中等强度运动对ADHD儿童抑制控制、注意转换的改善效果优于中高强度;中等强度的综合运动对ADHD儿童抑制控制功能的改善效果尤为显著,可以成为ADHD儿童执行功能改善的优选方案.展开更多
文摘BACKGROUND Treatment-resistant depression(TRD)has a poor response to clinical treatment.Patients with TRD do not respond adequately to standard antidepressants.Even after receiving a full dose and sufficient duration of combined antidepressant therapy,significant improvement is still difficult to achieve.At present,electroconvulsive therapy(ECT)remains a clinically effective method for treating refractory depression.A good anesthesia regimen can enhance its clinical efficacy.Actively exploring high-quality anesthesia regimens has become a current research hotspot.AIM To explore the effect of esketamine and etomidate anesthesia on the clinical efficacy of ECT for TRD.METHODS A total of 120 patients with TRD,treated at the Department of Psychiatry,The Second Affiliated Hospital of Shandong First Medical University,China between April 2020 and April 2024,were selected for the study.The patients were allocated at random into two groups using a random number table:The combination and control groups,with 60 patients in each group.Both groups underwent ECT;the combination group received esketamine and etomidate anesthesia,while the control group received etomidate anesthesia.The following parameters were compared between the two groups:Heart rate(HR);mean arterial pressure(MAP);peripheral capillary oxygen saturation(SpO2);initial and final threshold charges;and serum brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),5-hydroxytryptamine(5-HT),and interleukin-4(IL-4)levels.Neurological functions,basic executive function scores,and adverse reactions were compared during the treatment process.RESULTS During treatment,the maximum and minimum HR and MAP values in the combination group were markedly lower than those in the control group(P<0.05),whereas there was no significant difference in SpO2 between the two groups(P>0.05).During the treatment,there were no significant differences in the initial threshold charge and average duration of seizures during ECT between the two groups(P>0.05).However,the final threshold charge and total charge in the combination group were considerably lower than those in the control group(P<0.05).After treatment,the BDNF,NGF,5-HT,and IL-4 levels were evidently higher in the combination group than in the control group(P<0.05).During treatment,as the number of ECT sessions increased,both BRNAS and Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery(MCCB)scores increased,whereas Hamilton Depression Rating Scale(HAMD)-24 scores decreased in both groups.Starting from the third treatment session,the BRNAS and MCCB scores in the combination group were higher than in the control group,whereas the Hamilton Depression Scale-24 score was lower in the combination group than in the control group(P<0.05).After treatment,the Wisconsin Card Sorting Test scores and Tower of Hanoi test results in the combination group were significantly better than those in the control group(P<0.05).The occurrence of adverse reactions was compared between the two groups(P>0.05).CONCLUSION Esketamine and etomidate anesthesia during ECT for patients with TRD helps maintain stable vital signs during the treatment process,improves depressive symptoms,and enhances neurological and basic executive functions.
基金Supported by the 2025 Undergraduate Research Project of the Shandong Society for Innovation and Development in Philosophy and Social Sciences,No.Z-DXS25007。
文摘BACKGROUND Physical activity(PA)is a key contributor to the neurocognitive and psychological development of children and adolescents.With the rapid integration of digital technologies in educational and recreational contexts,technology-enhanced PA(TEPA)interventions have emerged as promising tools for promoting mental and cognitive health.However,the effectiveness of various TEPA modalities—such as virtual reality(VR),mobile applications,and biofeedback systems—remains unclear.Prior findings are fragmented across systematic reviews with inconsistent methodologies.This umbrella review was conducted to synthesize current evidence and evaluate whether specific TEPA modalities yield differential benefits.We hypothesized that TEPA interventions with immersive and selfregulatory features provide greater enhancements in executive function(EF),cognitive function(CF),and mental health(MH)than passive or minimally interactive formats.AIM To determine the effects of TEPA interventions and modality-specific characteristics on EF,CF,and MH outcomes in children and adolescents.METHODS An umbrella review of systematic reviews and meta-analyses was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.Five databases(PubMed,Web of Science,EMBASE,EBSCOhost,and Cochrane Library)were searched up to March 2025.Eligible reviews included participants aged≤18 years,assessed TEPA interventions,and reported EF,CF,or MH outcomes.Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews 2.Data synthesis was stratified by intervention modality,and heterogeneity was evaluated using the I^(2)statistic.RESULTS A total of 11 systematic reviews and meta-analyses were included.Interventions using VR(2/2),game-based formats(2/2),biofeedback(2/2),and multicomponent programs(1/1)showed consistent evidence of improvements in EF and MH(e.g.,EF:6.92±3.86 vs 3.61±1.67,P<0.001).App-based interventions(3/3)demonstrated mixed or modest effects,while augmented reality-based formats showed limited efficacy.MH outcomes were most frequently improved(9/11 reviews),followed by EF(6/11 reviews)and CF(5/11 reviews).Heterogeneity ranged from moderate to high(I^(2)=42%-78%)across modalities.CONCLUSION TEPA significantly improves MH and selectively enhances executive and CF in youth.Immersive,interactive,and biofeedback-driven modalities are particularly effective.
基金supported by the National Natural Science Foundation of China(CN)(Grant No.32071074).
文摘This longitudinal study examined the association between parental autonomy support and school-aged children’s adjustment across four major domains of school functioning,as well as the mediating role of children’s executive function.Participants were 476 school-aged children(girl:49.2%,M_(age)=10.49 years,SD=1.32 years),who completed the Psychological Autonomy Support Scale,the Behavior Rating Inventory of Executive Function–2,and the Primary School Students’Psychological Suzhi Scale at baseline and at two subsequent follow-up assessments.Results from unconditional latent growth curve models and structural equation modeling indicated that paternal autonomy support was a significant predictor of children’s adjustment across all four school domains.In contrast,maternal autonomy support was significantly associated only with interpersonal adjustment.Both the intercept(initial level)and slope(rate of change)of children’s executive function significantly predicted their adjustment in all four domains.Notably,the initial level of executive function fully mediated the association between paternal autonomy support and school adjustment,whereas the rate of change in executive function did not serve as a significant mediator.Thesefindings underscore the importance of promoting parental autonomy-supportive behaviors-particularly among fathers-as a means to enhance children’s executive functioning and,consequently,their school adjustment.
基金supported by the STI 2030-Major Projects(2021ZD0200500).
文摘Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.
文摘采用Meta法评价运动干预对注意缺陷多动障碍(ADHD)儿童执行功能的改善效果.检索Web of Science、PubMed等5大数据库,严格按照纳入与排除标准筛选文献,并运用Stata15.1软件进行分析.最终共纳入22篇文献,包含810例研究对象.Meta研究结果显示,运动干预能有效改善ADHD儿童的抑制控制SMD=-0.52,95%CI(-0.88,-0.17)和注意转换SMD=-0.95,95%CI(-1.43,-0.47)都具有统计学意义,但对记忆刷新的影响偏小且不具有统计学意义,SMD=0.08,95%CI(-0.21,0.36).研究认为,中等强度运动对ADHD儿童抑制控制、注意转换的改善效果优于中高强度;中等强度的综合运动对ADHD儿童抑制控制功能的改善效果尤为显著,可以成为ADHD儿童执行功能改善的优选方案.
