Complex genetic relationships between neurodegenerative disorders and neuropsychiatric symptoms have been shown, suggesting shared pathogenic mechanisms and emphasizing the potential for developing common therapeutic ...Complex genetic relationships between neurodegenerative disorders and neuropsychiatric symptoms have been shown, suggesting shared pathogenic mechanisms and emphasizing the potential for developing common therapeutic targets. Apolipoprotein E(APOE) genotypes and their corresponding protein(Apo E) isoforms may influence the biophysical properties of the cell membrane lipid bilayer. However, the role of APOE in central nervous system pathophysiology extended beyond its lipid transport function. In the present review article, we analyzed the links existing between APOE genotypes and the neurobiology of neuropsychiatric symptoms in neurodegenerative and vascular diseases. APOE genotypes(APOE ε2, APOE ε3, and APOE ε4) were implicated in common mechanisms underlying a wide spectrum of neurodegenerative diseases, including sporadic Alzheimer's disease, synucleinopathies such as Parkinson's disease and Lewy body disease, stroke, and traumatic brain injury. These shared pathways often involved neuroinflammation, abnormal protein accumulation, or responses to acute detrimental events. Across these conditions, APOE variants are believed to contribute to the modulation of inflammatory responses, the regulation of amyloid and tau pathology, as well as the clearance of proteins such as α-synuclein. The bidirectional interactions among Apo E, amyloid and mitochondrial metabolism, immunomodulatory effects, neuronal repair, and remodeling underscored the complexity of Apo E's role in neuropsychiatric symptoms associated with these conditions since from early phases of cognitive impairment such as mild cognitive impairment and mild behavioral impairment. Besides Apo E-specific isoforms' link to increased neuropsychiatric symptoms in Alzheimer's disease(depression, psychosis, aberrant motor behaviors, and anxiety, not apathy), the APOE ε4 genotype was also considered a significant genetic risk factor for Lewy body disease and its worse cognitive outcomes. Conversely, the APOE ε2 variant has been observed not to exert a protective effect equally in all neurodegenerative diseases. Specifically, in Lewy body disease, this variant may delay disease onset, paralleling its protective role in Alzheimer's disease, although its role in frontotemporal dementia is uncertain. The APOE ε4 genotype has been associated with adverse cognitive outcomes across other various neurodegenerative conditions. In Parkinson's disease, the APOE ε4 allele significantly impacted cognitive performance, increasing the risk of developing dementia, even in cases of pure synucleinopathies with minimal co-pathology from Alzheimer's disease. Similarly, in traumatic brain injury, recovery rates varied, with APOE ε4 carriers demonstrating a greater risk of poor long-term cognitive outcomes and elevated levels of neuropsychiatric symptoms. Furthermore, APOE ε4 influenced the age of onset and severity of stroke, as well as the likelihood of developing stroke-associated dementia, potentially due to its role in compromising endothelial integrity and promoting blood–brain barrier dysfunction.展开更多
Type 2 diabetes mellitus has central complications:Diabetes,a metabolic disorder primarily characterized by hyperglycemia due to insufficient insulin secretion,or impaired insulin signaling,has significant central com...Type 2 diabetes mellitus has central complications:Diabetes,a metabolic disorder primarily characterized by hyperglycemia due to insufficient insulin secretion,or impaired insulin signaling,has significant central complications.Type 2 diabetes mellitus(T2DM),the most prevalent type of diabetes,affects more than 38 million individuals in the United States(approximately 1 in 10)and is defined by chronic hyperglycemia and insulin resistance,which refers to a reduced cellular response to insulin.展开更多
Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depress...Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depressive symptoms are formulated as responses to impaired mentalisation.DIT aims to alleviate depressive symptoms by improving mentalising.Aims This study aimed to examine the effect of DIT on improving mentalising and the mediating effect of mentalising in changes in depressive symptoms.Methods Outpatients received either DIT combined with antidepressant medication treatment(DIT group)or antidepressant medication treatment alone(ADM group)for 16 weeks.The Hamilton Depression Rating Scale(HAMD),Patient Health Questionnaire(PHQ)and Reflective Functioning Questionnaire(RFQ)were used.The intention-to-treat principle,mixed linear models,multiple imputation,Pearson's correlation analysis and mediation analysis were conducted.The per-protocol principle was used as sensitivity analysis.Results The DIT group had significantly lower HAMD(least-squares(LS)mean difference=-3.756,p<0.001),PHQ(LS mean difference=-4.188,p<0.001),uncertainty about mental states in the RFQ(RFQ-U,LS mean difference=-2.116,p<0.001)and higher certainty about mental states in the RFQ(RFQ-C,LS mean difference=2.214,p=0.028)scores than the ADM group at post-treatment.The change in RFQ-C was marginally significantly correlated with the change in HAMD(r=-0.218,poretao=0.090),The change in RFQ-U was significantly correlated with the change in HAMD(r=-0.269,poroco-0.024)and the change in PHQ(r=-0.43,Peoretceo l<e0.001).When using RFQ-U as the mediating variable and PHQ as the dependent variable,a significant mediating effect was found(p=0.043,95% confidence interval 0.024 to 1.453).Conclusions The DIT group yielded better outcomes compared with the ADM group in reducing depressive symptoms and improving mentalising.Improvements in mentalising were associated with reductions in depressive symptoms.These findings support that mentalising may contribute to the therapeutic effects of DIT in MDD.展开更多
Objective Elevated depressive symptoms are well-documented among geriatric adults with cardiovascular disease(CVD);however,few studies have accounted for long-term cumulative depressive symptom exposure.This study det...Objective Elevated depressive symptoms are well-documented among geriatric adults with cardiovascular disease(CVD);however,few studies have accounted for long-term cumulative depressive symptom exposure.This study determined the relationship between cumulative depressive symptoms and CVD.Methods Individual participant data were obtained from the China Health and Retirement Longitudinal Study(CHARLS)and Health and Retirement Study(HRS).Eligible participants had access to assessment information on depressive symptoms and had no history of CVD at baseline.Long-term cumulative depressive symptoms were estimated by calculating the area under the curve based on the Center for Epidemiological Studies Depression Scale.Results Herein,8,861 participants from CHARLS(mean age:58.58 years;male:48.6%)and 7,284 from HRS(60.94 years;35.0%)were enrolled.The median follow-up period was 5 years for the CHARLS and10 years for the HRS.Compared with the first quartile of cumulative depressive symptoms,the HRs(95%CI)in the fourth quartile were 1.73(1.48,2.02)for predicting CVD(P<0.001),1.83(1.52,2.19)for heart disease(P<0.001),1.53(95%CI:1.17,1.99)for stroke(P=0.002)in CHARLS.For HRS,the HRs(95%CI)were 1.41(95%CI:1.27,1.57;P<0.001),1.42(95%CI:1.26,1.59;P<0.001),and 1.30(95%CI:1.06,1.58;P=0.010)respectively.Strong dose-response relationships were observed,with similar results for the two cohorts.Conclusion Long-term cumulative depressive symptoms were significantly associated with incident CVD in middle-aged and older adults,providing insights into controlling long-term depressive symptoms to improve this cohort's health.展开更多
BACKGROUND Examining patterns of media consumption and their associations with mental health outcomes in the general population during the coronavirus disease 2019(COVID-19)pandemic has implications for public mental ...BACKGROUND Examining patterns of media consumption and their associations with mental health outcomes in the general population during the coronavirus disease 2019(COVID-19)pandemic has implications for public mental health in future pandemics.AIM To investigate patterns of media consumption and their associations with depressive and anxiety symptoms among adults affected by the COVID-19 pandemic.METHODS A total of 8473 adults were recruited through snowball sampling for an online cross-sectional survey.The participants were asked to report the three media sources from which they most frequently acquired knowledge about COVID-19 from a checklist of nine media sources.Depression and anxiety were assessed with the Patient Health Questionnaire and the Generalized Anxiety Disorder Scale,respectively.A two-step cluster analysis was performed to identify distinct clusters of consumption of media sources.RESULTS Seven clusters were identified.The lowest prevalence of depression and anxiety(29.1%and 22.8%,respectively)was observed in cluster one,which was labeled“television and news portals and clients,minimal social media”.The highest prevalence of depression(43.1%)was observed in cluster three,labeled“WeChat,MicroBlog,and news portals,minimal traditional media”.The greatest prevalence of anxiety(35.8%)was observed in cluster seven,which was labeled“news clients and WeChat,no newspaper,radio,or news portals”.Relative to cluster one,a significantly elevated risk of depression and anxiety was found in clusters three,six(labeled“news portals and clients,WeChat,no newspaper and radio”)and seven(adjusted odds ratio=1.28-1.46,P≤0.011).Multiple logistic regression analyses revealed that the risk of COVID-19 infection and knowledge about COVID-19 partially explained the variations in the prevalence of depression and anxiety across the seven clusters.CONCLUSION Communication policies should be designed to channel crucial pandemic-related information more effectively through traditional and digital media sources.Encouraging the use of these media and implementing regulatory policies to reduce misinformation and rumors on social media,may be effective in mitigating the risk of depression and anxiety among populations affected by the pandemic.展开更多
The predominance of pituitary adenoma in the etiology of sellar masses often leads to the diagnostic fallacy of“availability bias”so that pituitary adenoma is almost always considered the most likely diagnosis of al...The predominance of pituitary adenoma in the etiology of sellar masses often leads to the diagnostic fallacy of“availability bias”so that pituitary adenoma is almost always considered the most likely diagnosis of all sellar masses,even when clinical evidence suggests otherwise.Primary sellar atypical teratoid/rhabdoid tumor(AT/RT)is the most aggressive sellar tumor.Most patients with sellar AT/RT are initially misdiagnosed with pituitary macroadenoma.Early diagnosis of sellar AT/RT is of paramount importance to counsel patients and family on the grave prognosis and to avoid futile surgical procedures.Since there are no discerning imaging features to differentiate AT/RT from other sellar tumors,the acuity of sellar compression symptoms characteristic of AT/RT is the only evidence indicative of the AT/RT diagnosis.Based on the biological and anatomical properties of the sella turcica and its surrounding structures,the nature,order of manifestation,and acuity of the sellar compression symptoms in response to sellar content expansion are mostly predictable.It is concluded that rapidly progressive headache and subsequent similarly rapidly progressive visual symptoms in a female with a large sellar mass are pathognomonic of sellar AT/RT(the“Yu rule”).展开更多
BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affectin...BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.展开更多
BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity va...BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity variables affect MDD.We hypothesize that high-level trait-and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD.AIM To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results.METHODS In this prospective study,281 MDD patients were enrolled from a tertiary care setting.High-level stress-sensitivity factors were classified as trait anxiety,state anxiety,perceived stress,and neuroticism,with a total score in the top quartile of the research cohort.The cumulative effects of stress-sensitivity factors on cognitive dysfunction,disability and functional impairment,suicide risk,and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis.Correlations were investigated further using multiple regression analysis.RESULTS Regarding high-level stress-sensitivity factors,53.40%of patients had at least one at baseline,and 29.61%had two or more.Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline(all P<0.001).Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms(partialη^(2)=0.153;standardizedβ=0.195;P<0.05).The follow-up outcomes were significantly impacted only by the high-level trait-related components,mainly when it came to depressive symptoms and suicide risk,which were predicted by trait anxiety and neuroticism,respectively(partialη^(2)=0.204 and 0.156;standardizedβ=0.247 and 0.392;P<0.05).CONCLUSION To enhance outcomes of MDD and lower the suicide risk,screening for stress-sensitivity factors and considering multifaceted measures,mainly focusing on trait-related ones,should be addressed clinically.展开更多
BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking beh...BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.AIM To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.METHODS A total of 2507 Chinese university students were recruited via snowball sampling.The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China.Sociodemo-graphic characteristics,pandemic-related characteristics,and mental health help-seeking behaviors of students with PTSSs were also collected.RESULTS The prevalence of PTSSs among the participants was 28.0%.Seven significant correlates of PTSSs were identified(odds ratio=1.23-3.65,P≤0.024):Female sex,being 19 years old or older,living with others or alone,a low level of family economic status,fair or poor interpersonal relationships,severe or very severe local pandemic,and having family members diagnosed with COVID-19.However,only 3.28%of the students with PTSSs reported seeking help from mental health specialists.Among the 23 students who sought help from mental health specialists,13 opted for online or telephone-based psychological consultation.CONCLUSION Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic.The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.展开更多
BACKGROUND Post-stroke psychiatric complications,particularly depression and anxiety,significantly impact rehabilitation outcomes and quality of life.Despite their prevalence and clinical significance,these conditions...BACKGROUND Post-stroke psychiatric complications,particularly depression and anxiety,significantly impact rehabilitation outcomes and quality of life.Despite their prevalence and clinical significance,these conditions often remain underrecognized in routine stroke care.Understanding their clinical features and temporal patterns is crucial for improving patient outcomes.AIM To investigate the prevalence,temporal evolution,and clinical correlates of depression and anxiety post-stroke and their impact on functional recovery.METHODS In this prospective observational study,127 patients first-ever ischemic stroke were enrolled between June 2022 and June 2024.Depression and anxiety were assessed using the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale at baseline and follow-up intervals(2 weeks,1 month,3 months,and 6 months).Stroke severity was evaluated using the National Institutes of Health Stroke Scale,and functional outcomes were measured using the modified Rankin Scale.RESULTS Among 120 patients who completed follow-up(94.5%completion rate),37.5%had depression(mild:18.3%,moderate:12.5%,severe:6.7%)and 41.7%had anxiety at baseline.Depression prevalence showed a biphasic pattern,peaking at 2 weeks(37.5%),declining at 3 months(28.3%),and slightly increasing at 6 months(30.8%).Stroke severity significantly correlated with both depression(odds ratio=1.18,95%CI:1.06-1.31,P=0.003)and anxiety(odds ratio=1.15,95%CI:1.04-1.27,P=0.008).Left hemisphere lesions had a stronger association with psychiatric symptoms than right hemisphere lesions(P=0.035).Patients with psychiatric complications demonstrated poorer functional outcomes at 6 months(median modified Rankin Scale 3 vs 2,P=0.015)and longer hospital stays(mean difference:3.2 days,P=0.002).CONCLUSION Identifying the clinical and neuroanatomical correlates of depression and anxiety will enable effective risk stratification and patient management.Integrating routine psychiatric screening and early intervention is essential in stroke care.展开更多
BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with an...BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.展开更多
Breast cancer is the most common cancer in women worldwide.A high percentage of these patients may have depressive symptoms and an early detection is crucial as part of a comprehensive management of the disease.Mao et...Breast cancer is the most common cancer in women worldwide.A high percentage of these patients may have depressive symptoms and an early detection is crucial as part of a comprehensive management of the disease.Mao et al recently conducted a study constructing a depression risk predictive model in young and middle-aged breast cancer patients.Four questionnaires(a general one,Patient Health Questionnaire-9,Perceived Social Support From Family Scale and International Physical Activity Questionnaire)and the Visual Analogue Scale were used to examine the correlation between different variables and depressive symptoms.The constructed predictive model showed strong predictive capability with an area under the receiver operating characteristic curve of 0.852 and high sensitivity and specificity values.However,the screening depression tools and questionnaires to assess social support or physical activity are not originally designed for oncological patients and further investigation to corroborate their applicability in this context is relevant.The cross-sectional design of the study prevents establishing clear causal relationships between the identified risk factors and depression.Besides,the study includes only a sample of Chinese patients and the applicability in a different sociocultural context is uncertain.Further investigation is crucial to corroborate the results in larger samples and different contexts.展开更多
Haemochromatosis is the most common genetic condition among people of European descent,resulting in iron overload and multi-organ dysfunction.Despite early detection and treatment advances,affected individuals experie...Haemochromatosis is the most common genetic condition among people of European descent,resulting in iron overload and multi-organ dysfunction.Despite early detection and treatment advances,affected individuals experience significant morbidity impacting their quality of life(QoL).To scope the literature for QoL issues and rank them in order of relevance by professional bodies.A literature search was conducted using PubMed,EMBASE,and MEDLINE in addition to a grey literature search against the eligibility criteria up to July 2023.Inclusion cri-teria included original articles with data concerning symptoms and QoL in patients with haemochromatosis.Nineteen issues were identified from 47 articles and scored by a haemochromatosis special interest group using a scale of 1 to 10(10=highest importance).Mean scores were then calculated for each issue.Fatigue,joint pain and sexual issues were key factors associated with impaired QoL.The least relevant were weight changes and abdominal pain.Other issues raised were anxiety,the development of diabetes,and concerns about genetics and family.This is the first scoping review examining common symptoms affecting QoL of patients with hereditary haemochromatosis.Further studies,including patient interviews and a randomised controlled trial,will inform a validated QoL questionnaire.展开更多
BACKGROUND Patients with schizophrenia may lack awareness of the importance of posttracheotomy care due to the impact of their condition,often showing resistance or misunderstanding of care measures.When coupled with ...BACKGROUND Patients with schizophrenia may lack awareness of the importance of posttracheotomy care due to the impact of their condition,often showing resistance or misunderstanding of care measures.When coupled with the impact of negative symptoms and the risk of complications after tracheotomy,patients may experience emotional fluctuations,restlessness,anxiety,and hostile behaviors,which pose significant challenges to nursing work.CASE SUMMARY We have reported the case of an 87-year-old male patient who was admitted to the hospital because of negative symptoms of schizophrenia and who underwent tracheotomy for severe pneumonia.In this study,we have summarized the nursing experience of a patient with negative symptoms of schizophrenia who underwent tracheotomy.The key nursing strategies included proper tracheotomy care,the management of psychiatric symptoms,a thorough assessment and implementation of enteral and parenteral nutrition,effective skincare,infection prevention,and comprehensive mental care.Individualized nursing skills helped stabilize the patient’s condition,followed by isolation and observation in a psychiatric hospital.CONCLUSION Effective postoperative tracheostomy care in patients with schizophrenia necessitates a tailored,multidisciplinary approach that addresses their psychiatric,physical,and emotional needs to achieve optimal clinical outcomes.展开更多
BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the corr...BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the correlation between sleep quality and depression symptoms in patients after laparoscopic hysterectomy under general anesthesia and explore factors associated with postoperative sleep disturbances and depression.METHODS This retrospective case-control study included 102 females who underwent laparoscopic hysterectomy under general anesthesia at our hospital between January 2022 and June 2024,excluding those with severe cardiovascular/cerebrovascular disease,liver/kidney dysfunction,or other underlying conditions.Sleep quality and depressive symptoms were evaluated preoperatively and at 1-week,1-month,and 3-months postoperatively using the Pittsburgh Sleep Quality Index(PSQI)and the Hamilton Depression Rating Scale(HAMD).Physiological indicators(heart rate,blood pressure,and oxygen saturation)and laboratory parameters were monitored.Pearson correlation and logistic regression analyses were performed to examine the association between sleep quality and depressive symptoms.RESULTS Mean age of participants was(52.30±8.39)years,with a body mass index of(23.56±2.79)kg/m².Preoperative comorbidities included hypertension(25.49%),diabetes(14.71%),and heart disease(9.80%).Patients with poor preoperative sleep quality(higher PSQI scores)exhibited significantly more severe depressive symptoms(P<0.05).Postoperative PSQI scores improved at 1-week,1-month,and 3-months compared to baseline(P<0.05).HAMD scores decreased at 1-week and 1-month postoperatively but returned to near preoperative levels at 3-months.Physiological indicators remained within normal ranges,and the postoperative complication rate was<5%.Logistic regression showed that poor postoperative sleep quality was an independent predictor of depressive symptoms(odds ratio=1.64,95%CI:1.22-2.20,P<0.05).CONCLUSION Sleep quality was significantly correlated with depressive symptoms after laparoscopic hysterectomy under general anesthesia.Patients with poor postoperative sleep quality were more prone to depression.Early interventions for sleep disturbances are potentially beneficial for mitigating depression and improve mental health.展开更多
BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS ...BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS and their relationships with HRQOL among patients with CKD in Jordan.METHODS A descriptive cross-sectional design was used.A convenience sampling approach was used to recruit the participants.Patients with CKD(n=140)who visited the outpatient clinics in four hospitals in Amman between November 2021 and December 2021 were included.RESULTS The Edmonton Symptom Assessment System was used to measure the severity of the DS while the Short Form-36 tool was used to measure the HRQOL.Participants’mean age was 50.9(SD=15.14).Most of them were males(n=92,65.7%),married(n=95,67.9%),and unemployed(n=93,66.4%).The highest DS were tiredness(mean=4.68,SD=2.98)and worse well-being(mean=3.69,SD=2.43).The highest HRQOL mean score was for the bodily pain scale with a mean score of 68.50 out of 100(SD=32.02)followed by the emotional well-being scale with mean score of 67.60(SD=18.57).CONCLUSION Patients with CKD had suboptimal HRQOL,physically and mentally.They suffer from multiple DS that have a strong association with diminished HRQOL such as tiredness and depression.Therefore,healthcare providers should be equipped with the essential knowledge and skills to promote individualized strategies that focusing on symptom management.展开更多
Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.D...Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.Depressive symptoms,frequently observed in breast cancer patients,significantly influence treatment outcomes and quality of life.Recent years have seen a growing focus on these symptoms,emphasizing early identification and intervention.This editorial comments on the recent study by Mao et al on a risk prediction model for de-pression in young and middle-aged breast cancer patients.Research suggests that factors such as tumor grade,monthly income,pain perception,family support,and physical activity critically influence the onset of depressive symptoms.By developing personalized risk prediction models,it becomes possible to identify high-risk patients early,allowing healthcare professionals to implement pre-ventive strategies proactively.The editorial advocates for increased attention and resources dedicated to psychological health interventions for breast cancer pa-tients,aiming to foster comprehensive care strategies that mitigate the impacts of depression and enhance overall quality of life.展开更多
BACKGROUND Diabetes mellitus(DM)is a rapidly growing global health emergency of the 21st century.Comorbidities,such as DM and depression,are common,presenting challenges to the healthcare system.AIM To investigate the...BACKGROUND Diabetes mellitus(DM)is a rapidly growing global health emergency of the 21st century.Comorbidities,such as DM and depression,are common,presenting challenges to the healthcare system.AIM To investigate the prevalence of depression and its associated factors in patients with DM and to strengthen the management of depression in this patient group.METHODS Participants were selected from the 2018 China Health and Retirement Longitudinal Study.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale,with a score of 10 or more indicating depression.Group differences were compared using analysis of variance andχ^(2)tests.Binary logistic regression was conducted to explore the odds ratios(ORs)of independent variables.Following Andersen’s behavioral model,predisposing,enabling,health need,and health behavior variables were introduced stepwise into the logistic model.RESULTS Of the 1673 patients with diabetes,41.4%had depressive symptoms.Regarding the predisposing characteristics,patients who were male(OR 0.426,P<0.05),married(OR 0.634,P<0.05),and received a high school education or higher(OR 0.432,P<0.05)reported fewer depressive symptoms.Healthcare needs,including better self-rated health(OR 0.458 for fair and OR 0.247 for good,P<0.05)and more sleep(OR 0.642,P<0.05),were associated with a lower likelihood of depressive symptoms.In contrast,pain(OR 1.440 for mild and OR 2.644 for severe,P<0.05)and impairment in the basic activities of daily living(OR 1.886,P<0.05)were inversely associated.Additionally,patients highly satisfied with healthcare services(OR 0.579,P<0.05)were less likely to have depressive symptoms.CONCLUSION Nearly half of the patients with DM reported depressive symptoms,which were strongly associated with predisposing characteristics and healthcare needs,particularly physical pain and impairment in basic activities of daily living.Our study emphasizes the significance of enhanced screening and intervention for depression in diabetes care along with improved management of functional impairments.展开更多
BACKGROUND The rural elderly in China have a high prevalence of depressive symptoms,which is closely linked to poor sleep quality.This not only poses significant threats to their physical and mental health but also la...BACKGROUND The rural elderly in China have a high prevalence of depressive symptoms,which is closely linked to poor sleep quality.This not only poses significant threats to their physical and mental health but also lacks in-depth exploration of associations specific to different sleep dimensions.We hypothesize that specific sleep dimensions are independently and significantly associated with depressive symptoms in this population.AIM To explore the links between different sleep dimensions and depressive symptoms among rural elderly in China.METHODS This cross-sectional study enrolled 5136 older adults(≥60 years)recruited between April and June 2024.Sleep quality was evaluated using the Pittsburgh Sleep Quality Index,and depressive symptoms were assessed with the Patient Health Questionnaire-9.Binary logistic regression analysis was employed to examine the associations between problems in different sleep dimensions and depressive symptoms among these older adults.RESULTS The prevalence of depressive symptoms was 19.5%,and the overall rate of sleep disorders was 40.13%.Among the rural elderly,six sleep dimensions were found to be statistically significantly associated with depressive symptoms(all P<0.05),with the following odds ratios(ORs)and 95%confidence intervals(CIs):Subjective sleep quality(OR=2.066,95%CI:1.709-2.497),sleep onset latency(OR=2.476,95%CI:2.062-2.972),sleep efficiency(OR=1.686,95%CI:1.369-2.076),sleep disturbances(OR=2.092,95%CI:1.566-2.795),daytime dysfunction(OR=3.378,95%CI:2.882-3.959),and use of hypnotic medications(OR=1.662,95%CI:1.093-2.525).CONCLUSION Poor subjective sleep quality,prolonged sleep onset latency,reduced sleep efficiency,sleep disturbances,daytime dysfunction,and use of hypnotic medications are associated with depressive symptoms in the elderly.Therefore,healthcare professionals should target elderly individuals with sleep disorders and implement effective interventions to alleviate their depressive symptoms.展开更多
BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life...BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life.Multidisciplinary team(MDT)collaborative nursing has emerged as a comprehensive care approach that may address both physical and psychological needs.AIM To explored the impact of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors.METHODS A retrospective analysis was conducted on 364 patients with gastrointestinal tumours admitted to our hospital between January 2022 and December 2024.Based on differing postoperative nursing approaches,two groups were established:the MDT group(n=196)and the control group(n=168).The control group received conventional nursing interventions,while the MDT group received MDT collaborative nursing.The study compared wound healing outcomes,pre-intervention and one-month post-intervention Hospital Anxiety and Depression Scale(HADS)scores,Functional Assessment of Cancer Therapy-General(FACT-G)quality of life scores,and complication rates between the two groups.RESULTS The MDT group demonstrated a Grade A wound healing rate of 88.27%and total treatment compliance of 99.49%,both significantly higher than the control group(75.00%and 95.83%,respectively).The complication incidence rate was 3.06%in the MDT group,lower than the control group(8.93%),with all differences statistically significant(P<0.05).After one month of intervention,patients in the MDT group demonstrated lower Anxiety Self-Rating Scale and Depression Self-Rating Scale scores on the HADS scale compared to the control group.Conversely,their scores on the FACT-G scale for physical,social/family,emotional,and functional domains were higher than those in the control group,with all differences being statistically significant(P<0.05).CONCLUSION MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery,alleviates anxiety and depressive symptoms,enhances treatment adherence and quality of life,and reduces the incidence of complications.展开更多
文摘Complex genetic relationships between neurodegenerative disorders and neuropsychiatric symptoms have been shown, suggesting shared pathogenic mechanisms and emphasizing the potential for developing common therapeutic targets. Apolipoprotein E(APOE) genotypes and their corresponding protein(Apo E) isoforms may influence the biophysical properties of the cell membrane lipid bilayer. However, the role of APOE in central nervous system pathophysiology extended beyond its lipid transport function. In the present review article, we analyzed the links existing between APOE genotypes and the neurobiology of neuropsychiatric symptoms in neurodegenerative and vascular diseases. APOE genotypes(APOE ε2, APOE ε3, and APOE ε4) were implicated in common mechanisms underlying a wide spectrum of neurodegenerative diseases, including sporadic Alzheimer's disease, synucleinopathies such as Parkinson's disease and Lewy body disease, stroke, and traumatic brain injury. These shared pathways often involved neuroinflammation, abnormal protein accumulation, or responses to acute detrimental events. Across these conditions, APOE variants are believed to contribute to the modulation of inflammatory responses, the regulation of amyloid and tau pathology, as well as the clearance of proteins such as α-synuclein. The bidirectional interactions among Apo E, amyloid and mitochondrial metabolism, immunomodulatory effects, neuronal repair, and remodeling underscored the complexity of Apo E's role in neuropsychiatric symptoms associated with these conditions since from early phases of cognitive impairment such as mild cognitive impairment and mild behavioral impairment. Besides Apo E-specific isoforms' link to increased neuropsychiatric symptoms in Alzheimer's disease(depression, psychosis, aberrant motor behaviors, and anxiety, not apathy), the APOE ε4 genotype was also considered a significant genetic risk factor for Lewy body disease and its worse cognitive outcomes. Conversely, the APOE ε2 variant has been observed not to exert a protective effect equally in all neurodegenerative diseases. Specifically, in Lewy body disease, this variant may delay disease onset, paralleling its protective role in Alzheimer's disease, although its role in frontotemporal dementia is uncertain. The APOE ε4 genotype has been associated with adverse cognitive outcomes across other various neurodegenerative conditions. In Parkinson's disease, the APOE ε4 allele significantly impacted cognitive performance, increasing the risk of developing dementia, even in cases of pure synucleinopathies with minimal co-pathology from Alzheimer's disease. Similarly, in traumatic brain injury, recovery rates varied, with APOE ε4 carriers demonstrating a greater risk of poor long-term cognitive outcomes and elevated levels of neuropsychiatric symptoms. Furthermore, APOE ε4 influenced the age of onset and severity of stroke, as well as the likelihood of developing stroke-associated dementia, potentially due to its role in compromising endothelial integrity and promoting blood–brain barrier dysfunction.
基金supported by grants from NIH T32(DK007260,to WC)the Steno North American Fellowship awarded by the Novo Nordisk Foundation(NNF23OC0087108,to WC)+6 种基金STI2030-Major Projects(2021ZD0202700,to HY)the National Natural Science Foundation of China(32241004,to HY)the Natural Science Foundation of Zhejiang Province of China(LR24C090001,to HY)Key R&D Program of Zhejiang Province(2024SSYS0017,to HY)CAMS Innovation Fund for Medical Sciences(2019-12M-5-057,to HY)Fundamental Research Funds for the Central Universities(226-2022-00193,to HY)the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(2023-PT310-01,to HY)。
文摘Type 2 diabetes mellitus has central complications:Diabetes,a metabolic disorder primarily characterized by hyperglycemia due to insufficient insulin secretion,or impaired insulin signaling,has significant central complications.Type 2 diabetes mellitus(T2DM),the most prevalent type of diabetes,affects more than 38 million individuals in the United States(approximately 1 in 10)and is defined by chronic hyperglycemia and insulin resistance,which refers to a reduced cellular response to insulin.
基金funded by Science and Technology Commission of Shanghai Municipality(No.21Y11905400)National Natural ScienceFoundationof China(General Program,No.82371555).
文摘Background Dynamic interpersonal therapy(DIT)is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder(MDD).In DIT,the depressive symptoms are formulated as responses to impaired mentalisation.DIT aims to alleviate depressive symptoms by improving mentalising.Aims This study aimed to examine the effect of DIT on improving mentalising and the mediating effect of mentalising in changes in depressive symptoms.Methods Outpatients received either DIT combined with antidepressant medication treatment(DIT group)or antidepressant medication treatment alone(ADM group)for 16 weeks.The Hamilton Depression Rating Scale(HAMD),Patient Health Questionnaire(PHQ)and Reflective Functioning Questionnaire(RFQ)were used.The intention-to-treat principle,mixed linear models,multiple imputation,Pearson's correlation analysis and mediation analysis were conducted.The per-protocol principle was used as sensitivity analysis.Results The DIT group had significantly lower HAMD(least-squares(LS)mean difference=-3.756,p<0.001),PHQ(LS mean difference=-4.188,p<0.001),uncertainty about mental states in the RFQ(RFQ-U,LS mean difference=-2.116,p<0.001)and higher certainty about mental states in the RFQ(RFQ-C,LS mean difference=2.214,p=0.028)scores than the ADM group at post-treatment.The change in RFQ-C was marginally significantly correlated with the change in HAMD(r=-0.218,poretao=0.090),The change in RFQ-U was significantly correlated with the change in HAMD(r=-0.269,poroco-0.024)and the change in PHQ(r=-0.43,Peoretceo l<e0.001).When using RFQ-U as the mediating variable and PHQ as the dependent variable,a significant mediating effect was found(p=0.043,95% confidence interval 0.024 to 1.453).Conclusions The DIT group yielded better outcomes compared with the ADM group in reducing depressive symptoms and improving mentalising.Improvements in mentalising were associated with reductions in depressive symptoms.These findings support that mentalising may contribute to the therapeutic effects of DIT in MDD.
基金supported by the Guangdong Basic and Applied Basic Research Foundation(2021A1515011629)Construction of High-level University of Guangdong(G623330580and G621331128)Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme(2019)。
文摘Objective Elevated depressive symptoms are well-documented among geriatric adults with cardiovascular disease(CVD);however,few studies have accounted for long-term cumulative depressive symptom exposure.This study determined the relationship between cumulative depressive symptoms and CVD.Methods Individual participant data were obtained from the China Health and Retirement Longitudinal Study(CHARLS)and Health and Retirement Study(HRS).Eligible participants had access to assessment information on depressive symptoms and had no history of CVD at baseline.Long-term cumulative depressive symptoms were estimated by calculating the area under the curve based on the Center for Epidemiological Studies Depression Scale.Results Herein,8,861 participants from CHARLS(mean age:58.58 years;male:48.6%)and 7,284 from HRS(60.94 years;35.0%)were enrolled.The median follow-up period was 5 years for the CHARLS and10 years for the HRS.Compared with the first quartile of cumulative depressive symptoms,the HRs(95%CI)in the fourth quartile were 1.73(1.48,2.02)for predicting CVD(P<0.001),1.83(1.52,2.19)for heart disease(P<0.001),1.53(95%CI:1.17,1.99)for stroke(P=0.002)in CHARLS.For HRS,the HRs(95%CI)were 1.41(95%CI:1.27,1.57;P<0.001),1.42(95%CI:1.26,1.59;P<0.001),and 1.30(95%CI:1.06,1.58;P=0.010)respectively.Strong dose-response relationships were observed,with similar results for the two cohorts.Conclusion Long-term cumulative depressive symptoms were significantly associated with incident CVD in middle-aged and older adults,providing insights into controlling long-term depressive symptoms to improve this cohort's health.
基金Supported by National Natural Science Foundation of China,No.71774060the Young Top Talent Program in Public Health from Health Commission of Hubei Province,No.EWEITONG[2021]74.
文摘BACKGROUND Examining patterns of media consumption and their associations with mental health outcomes in the general population during the coronavirus disease 2019(COVID-19)pandemic has implications for public mental health in future pandemics.AIM To investigate patterns of media consumption and their associations with depressive and anxiety symptoms among adults affected by the COVID-19 pandemic.METHODS A total of 8473 adults were recruited through snowball sampling for an online cross-sectional survey.The participants were asked to report the three media sources from which they most frequently acquired knowledge about COVID-19 from a checklist of nine media sources.Depression and anxiety were assessed with the Patient Health Questionnaire and the Generalized Anxiety Disorder Scale,respectively.A two-step cluster analysis was performed to identify distinct clusters of consumption of media sources.RESULTS Seven clusters were identified.The lowest prevalence of depression and anxiety(29.1%and 22.8%,respectively)was observed in cluster one,which was labeled“television and news portals and clients,minimal social media”.The highest prevalence of depression(43.1%)was observed in cluster three,labeled“WeChat,MicroBlog,and news portals,minimal traditional media”.The greatest prevalence of anxiety(35.8%)was observed in cluster seven,which was labeled“news clients and WeChat,no newspaper,radio,or news portals”.Relative to cluster one,a significantly elevated risk of depression and anxiety was found in clusters three,six(labeled“news portals and clients,WeChat,no newspaper and radio”)and seven(adjusted odds ratio=1.28-1.46,P≤0.011).Multiple logistic regression analyses revealed that the risk of COVID-19 infection and knowledge about COVID-19 partially explained the variations in the prevalence of depression and anxiety across the seven clusters.CONCLUSION Communication policies should be designed to channel crucial pandemic-related information more effectively through traditional and digital media sources.Encouraging the use of these media and implementing regulatory policies to reduce misinformation and rumors on social media,may be effective in mitigating the risk of depression and anxiety among populations affected by the pandemic.
文摘The predominance of pituitary adenoma in the etiology of sellar masses often leads to the diagnostic fallacy of“availability bias”so that pituitary adenoma is almost always considered the most likely diagnosis of all sellar masses,even when clinical evidence suggests otherwise.Primary sellar atypical teratoid/rhabdoid tumor(AT/RT)is the most aggressive sellar tumor.Most patients with sellar AT/RT are initially misdiagnosed with pituitary macroadenoma.Early diagnosis of sellar AT/RT is of paramount importance to counsel patients and family on the grave prognosis and to avoid futile surgical procedures.Since there are no discerning imaging features to differentiate AT/RT from other sellar tumors,the acuity of sellar compression symptoms characteristic of AT/RT is the only evidence indicative of the AT/RT diagnosis.Based on the biological and anatomical properties of the sella turcica and its surrounding structures,the nature,order of manifestation,and acuity of the sellar compression symptoms in response to sellar content expansion are mostly predictable.It is concluded that rapidly progressive headache and subsequent similarly rapidly progressive visual symptoms in a female with a large sellar mass are pathognomonic of sellar AT/RT(the“Yu rule”).
文摘BACKGROUND At present,the influencing factors of social function in patients with residual depressive symptoms are still unclear.Residual depressive symptoms are highly harmful,leading to low mood in patients,affecting work and interpersonal communication,increasing the risk of recurrence,and adding to the burden on families.Studying the influencing factors of their social function is of great significance.AIM To explore the social function score and its influencing factors in patients with residual depressive symptoms.METHODS This observational study surveyed patients with residual depressive symptoms(case group)and healthy patients undergoing physical examinations(control group).Participants were admitted between January 2022 and December 2023.Social functioning was assessed using the Sheehan Disability Scale(SDS),and scores were compared between groups.Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve,and these RESULTS The SDS scores of the 158 patients with depressive symptoms were 11.48±3.26.Compared with the control group,the SDS scores and all items in the case group were higher.SDS scores were higher in patients with relapse,discon-tinuous medication,drug therapy alone,severe somatic symptoms,obvious residual symptoms,and anxiety scores≥8.Disease history,medication compliance,therapy method,and residual symptoms correlated positively with SDS scores(r=0.354,0.414,0.602,and 0.456,respectively).Independent influencing factors included disease history,medication compliance,therapy method,somatic symptoms,residual symptoms,and anxiety scores(P<0.05).The areas under the curve for predicting social functional impairment using these factors were 0.713,0.559,0.684,0.729,0.668,and 0.628,respectively,with sensitivities of 79.2%,61.8%,76.8%,81.7%,63.6%,and 65.5%and specificities of 83.3%,87.5%,82.6%,83.3%,86.7%,and 92.1%,respectively.CONCLUSION The social function scores of patients with residual symptoms of depression are high.They are affected by disease history,medication compliance,therapy method,degree of somatic symptoms,residual symptoms,and anxiety.
基金Supported by Science and Technology Innovation 2030-Major Projects,No.2021ZD0202000National Key Research and Development Program of China,No.2019YFA0706200+2 种基金National Natural Science Foundation of China,No.82371535Science and Technology Innovation Program of Hunan Province,No.2023RC3083Fundamental Research Funds for the Central Universities of Central South University,No.2023ZZTS0838.
文摘BACKGROUND Sensitivity to stress is essential in the onset,clinical symptoms,course,and prognosis of major depressive disorder(MDD).Meanwhile,it was unclear how variously classified but connected stress-sensitivity variables affect MDD.We hypothesize that high-level trait-and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD.AIM To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results.METHODS In this prospective study,281 MDD patients were enrolled from a tertiary care setting.High-level stress-sensitivity factors were classified as trait anxiety,state anxiety,perceived stress,and neuroticism,with a total score in the top quartile of the research cohort.The cumulative effects of stress-sensitivity factors on cognitive dysfunction,disability and functional impairment,suicide risk,and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis.Correlations were investigated further using multiple regression analysis.RESULTS Regarding high-level stress-sensitivity factors,53.40%of patients had at least one at baseline,and 29.61%had two or more.Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline(all P<0.001).Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms(partialη^(2)=0.153;standardizedβ=0.195;P<0.05).The follow-up outcomes were significantly impacted only by the high-level trait-related components,mainly when it came to depressive symptoms and suicide risk,which were predicted by trait anxiety and neuroticism,respectively(partialη^(2)=0.204 and 0.156;standardizedβ=0.247 and 0.392;P<0.05).CONCLUSION To enhance outcomes of MDD and lower the suicide risk,screening for stress-sensitivity factors and considering multifaceted measures,mainly focusing on trait-related ones,should be addressed clinically.
文摘BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.AIM To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.METHODS A total of 2507 Chinese university students were recruited via snowball sampling.The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China.Sociodemo-graphic characteristics,pandemic-related characteristics,and mental health help-seeking behaviors of students with PTSSs were also collected.RESULTS The prevalence of PTSSs among the participants was 28.0%.Seven significant correlates of PTSSs were identified(odds ratio=1.23-3.65,P≤0.024):Female sex,being 19 years old or older,living with others or alone,a low level of family economic status,fair or poor interpersonal relationships,severe or very severe local pandemic,and having family members diagnosed with COVID-19.However,only 3.28%of the students with PTSSs reported seeking help from mental health specialists.Among the 23 students who sought help from mental health specialists,13 opted for online or telephone-based psychological consultation.CONCLUSION Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic.The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.
基金the 2023 Fuyang Municipal Scientific Research Projects in Health and Wellness,No.FY2023-0.
文摘BACKGROUND Post-stroke psychiatric complications,particularly depression and anxiety,significantly impact rehabilitation outcomes and quality of life.Despite their prevalence and clinical significance,these conditions often remain underrecognized in routine stroke care.Understanding their clinical features and temporal patterns is crucial for improving patient outcomes.AIM To investigate the prevalence,temporal evolution,and clinical correlates of depression and anxiety post-stroke and their impact on functional recovery.METHODS In this prospective observational study,127 patients first-ever ischemic stroke were enrolled between June 2022 and June 2024.Depression and anxiety were assessed using the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale at baseline and follow-up intervals(2 weeks,1 month,3 months,and 6 months).Stroke severity was evaluated using the National Institutes of Health Stroke Scale,and functional outcomes were measured using the modified Rankin Scale.RESULTS Among 120 patients who completed follow-up(94.5%completion rate),37.5%had depression(mild:18.3%,moderate:12.5%,severe:6.7%)and 41.7%had anxiety at baseline.Depression prevalence showed a biphasic pattern,peaking at 2 weeks(37.5%),declining at 3 months(28.3%),and slightly increasing at 6 months(30.8%).Stroke severity significantly correlated with both depression(odds ratio=1.18,95%CI:1.06-1.31,P=0.003)and anxiety(odds ratio=1.15,95%CI:1.04-1.27,P=0.008).Left hemisphere lesions had a stronger association with psychiatric symptoms than right hemisphere lesions(P=0.035).Patients with psychiatric complications demonstrated poorer functional outcomes at 6 months(median modified Rankin Scale 3 vs 2,P=0.015)and longer hospital stays(mean difference:3.2 days,P=0.002).CONCLUSION Identifying the clinical and neuroanatomical correlates of depression and anxiety will enable effective risk stratification and patient management.Integrating routine psychiatric screening and early intervention is essential in stroke care.
文摘BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.
文摘Breast cancer is the most common cancer in women worldwide.A high percentage of these patients may have depressive symptoms and an early detection is crucial as part of a comprehensive management of the disease.Mao et al recently conducted a study constructing a depression risk predictive model in young and middle-aged breast cancer patients.Four questionnaires(a general one,Patient Health Questionnaire-9,Perceived Social Support From Family Scale and International Physical Activity Questionnaire)and the Visual Analogue Scale were used to examine the correlation between different variables and depressive symptoms.The constructed predictive model showed strong predictive capability with an area under the receiver operating characteristic curve of 0.852 and high sensitivity and specificity values.However,the screening depression tools and questionnaires to assess social support or physical activity are not originally designed for oncological patients and further investigation to corroborate their applicability in this context is relevant.The cross-sectional design of the study prevents establishing clear causal relationships between the identified risk factors and depression.Besides,the study includes only a sample of Chinese patients and the applicability in a different sociocultural context is uncertain.Further investigation is crucial to corroborate the results in larger samples and different contexts.
文摘Haemochromatosis is the most common genetic condition among people of European descent,resulting in iron overload and multi-organ dysfunction.Despite early detection and treatment advances,affected individuals experience significant morbidity impacting their quality of life(QoL).To scope the literature for QoL issues and rank them in order of relevance by professional bodies.A literature search was conducted using PubMed,EMBASE,and MEDLINE in addition to a grey literature search against the eligibility criteria up to July 2023.Inclusion cri-teria included original articles with data concerning symptoms and QoL in patients with haemochromatosis.Nineteen issues were identified from 47 articles and scored by a haemochromatosis special interest group using a scale of 1 to 10(10=highest importance).Mean scores were then calculated for each issue.Fatigue,joint pain and sexual issues were key factors associated with impaired QoL.The least relevant were weight changes and abdominal pain.Other issues raised were anxiety,the development of diabetes,and concerns about genetics and family.This is the first scoping review examining common symptoms affecting QoL of patients with hereditary haemochromatosis.Further studies,including patient interviews and a randomised controlled trial,will inform a validated QoL questionnaire.
基金Supported by Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-033A。
文摘BACKGROUND Patients with schizophrenia may lack awareness of the importance of posttracheotomy care due to the impact of their condition,often showing resistance or misunderstanding of care measures.When coupled with the impact of negative symptoms and the risk of complications after tracheotomy,patients may experience emotional fluctuations,restlessness,anxiety,and hostile behaviors,which pose significant challenges to nursing work.CASE SUMMARY We have reported the case of an 87-year-old male patient who was admitted to the hospital because of negative symptoms of schizophrenia and who underwent tracheotomy for severe pneumonia.In this study,we have summarized the nursing experience of a patient with negative symptoms of schizophrenia who underwent tracheotomy.The key nursing strategies included proper tracheotomy care,the management of psychiatric symptoms,a thorough assessment and implementation of enteral and parenteral nutrition,effective skincare,infection prevention,and comprehensive mental care.Individualized nursing skills helped stabilize the patient’s condition,followed by isolation and observation in a psychiatric hospital.CONCLUSION Effective postoperative tracheostomy care in patients with schizophrenia necessitates a tailored,multidisciplinary approach that addresses their psychiatric,physical,and emotional needs to achieve optimal clinical outcomes.
文摘BACKGROUND Evaluating the relationship between sleep quality and depressive symptoms after laparoscopic hysterectomy under general anesthesia can help improve postoperative depressive symptoms.AIM To evaluate the correlation between sleep quality and depression symptoms in patients after laparoscopic hysterectomy under general anesthesia and explore factors associated with postoperative sleep disturbances and depression.METHODS This retrospective case-control study included 102 females who underwent laparoscopic hysterectomy under general anesthesia at our hospital between January 2022 and June 2024,excluding those with severe cardiovascular/cerebrovascular disease,liver/kidney dysfunction,or other underlying conditions.Sleep quality and depressive symptoms were evaluated preoperatively and at 1-week,1-month,and 3-months postoperatively using the Pittsburgh Sleep Quality Index(PSQI)and the Hamilton Depression Rating Scale(HAMD).Physiological indicators(heart rate,blood pressure,and oxygen saturation)and laboratory parameters were monitored.Pearson correlation and logistic regression analyses were performed to examine the association between sleep quality and depressive symptoms.RESULTS Mean age of participants was(52.30±8.39)years,with a body mass index of(23.56±2.79)kg/m².Preoperative comorbidities included hypertension(25.49%),diabetes(14.71%),and heart disease(9.80%).Patients with poor preoperative sleep quality(higher PSQI scores)exhibited significantly more severe depressive symptoms(P<0.05).Postoperative PSQI scores improved at 1-week,1-month,and 3-months compared to baseline(P<0.05).HAMD scores decreased at 1-week and 1-month postoperatively but returned to near preoperative levels at 3-months.Physiological indicators remained within normal ranges,and the postoperative complication rate was<5%.Logistic regression showed that poor postoperative sleep quality was an independent predictor of depressive symptoms(odds ratio=1.64,95%CI:1.22-2.20,P<0.05).CONCLUSION Sleep quality was significantly correlated with depressive symptoms after laparoscopic hysterectomy under general anesthesia.Patients with poor postoperative sleep quality were more prone to depression.Early interventions for sleep disturbances are potentially beneficial for mitigating depression and improve mental health.
文摘BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS and their relationships with HRQOL among patients with CKD in Jordan.METHODS A descriptive cross-sectional design was used.A convenience sampling approach was used to recruit the participants.Patients with CKD(n=140)who visited the outpatient clinics in four hospitals in Amman between November 2021 and December 2021 were included.RESULTS The Edmonton Symptom Assessment System was used to measure the severity of the DS while the Short Form-36 tool was used to measure the HRQOL.Participants’mean age was 50.9(SD=15.14).Most of them were males(n=92,65.7%),married(n=95,67.9%),and unemployed(n=93,66.4%).The highest DS were tiredness(mean=4.68,SD=2.98)and worse well-being(mean=3.69,SD=2.43).The highest HRQOL mean score was for the bodily pain scale with a mean score of 68.50 out of 100(SD=32.02)followed by the emotional well-being scale with mean score of 67.60(SD=18.57).CONCLUSION Patients with CKD had suboptimal HRQOL,physically and mentally.They suffer from multiple DS that have a strong association with diminished HRQOL such as tiredness and depression.Therefore,healthcare providers should be equipped with the essential knowledge and skills to promote individualized strategies that focusing on symptom management.
基金Supported by The 2023 Government-Funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731DNatural Science Foundation of Hebei Province,No.
文摘Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.Depressive symptoms,frequently observed in breast cancer patients,significantly influence treatment outcomes and quality of life.Recent years have seen a growing focus on these symptoms,emphasizing early identification and intervention.This editorial comments on the recent study by Mao et al on a risk prediction model for de-pression in young and middle-aged breast cancer patients.Research suggests that factors such as tumor grade,monthly income,pain perception,family support,and physical activity critically influence the onset of depressive symptoms.By developing personalized risk prediction models,it becomes possible to identify high-risk patients early,allowing healthcare professionals to implement pre-ventive strategies proactively.The editorial advocates for increased attention and resources dedicated to psychological health interventions for breast cancer pa-tients,aiming to foster comprehensive care strategies that mitigate the impacts of depression and enhance overall quality of life.
基金Supported by National Natural Science Foundation of China,No.72104058Open Bidding for Selecting the Best Candidates,Guangzhou University of Chinese MedicineUniversity of Macao Research Funding,No.QRCM-IRG2022-001.
文摘BACKGROUND Diabetes mellitus(DM)is a rapidly growing global health emergency of the 21st century.Comorbidities,such as DM and depression,are common,presenting challenges to the healthcare system.AIM To investigate the prevalence of depression and its associated factors in patients with DM and to strengthen the management of depression in this patient group.METHODS Participants were selected from the 2018 China Health and Retirement Longitudinal Study.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale,with a score of 10 or more indicating depression.Group differences were compared using analysis of variance andχ^(2)tests.Binary logistic regression was conducted to explore the odds ratios(ORs)of independent variables.Following Andersen’s behavioral model,predisposing,enabling,health need,and health behavior variables were introduced stepwise into the logistic model.RESULTS Of the 1673 patients with diabetes,41.4%had depressive symptoms.Regarding the predisposing characteristics,patients who were male(OR 0.426,P<0.05),married(OR 0.634,P<0.05),and received a high school education or higher(OR 0.432,P<0.05)reported fewer depressive symptoms.Healthcare needs,including better self-rated health(OR 0.458 for fair and OR 0.247 for good,P<0.05)and more sleep(OR 0.642,P<0.05),were associated with a lower likelihood of depressive symptoms.In contrast,pain(OR 1.440 for mild and OR 2.644 for severe,P<0.05)and impairment in the basic activities of daily living(OR 1.886,P<0.05)were inversely associated.Additionally,patients highly satisfied with healthcare services(OR 0.579,P<0.05)were less likely to have depressive symptoms.CONCLUSION Nearly half of the patients with DM reported depressive symptoms,which were strongly associated with predisposing characteristics and healthcare needs,particularly physical pain and impairment in basic activities of daily living.Our study emphasizes the significance of enhanced screening and intervention for depression in diabetes care along with improved management of functional impairments.
基金Supported by China Postdoctoral Science Foundation,No.2023M732119Natural Science Foundation of Shandong Province,No.ZR2024QG032。
文摘BACKGROUND The rural elderly in China have a high prevalence of depressive symptoms,which is closely linked to poor sleep quality.This not only poses significant threats to their physical and mental health but also lacks in-depth exploration of associations specific to different sleep dimensions.We hypothesize that specific sleep dimensions are independently and significantly associated with depressive symptoms in this population.AIM To explore the links between different sleep dimensions and depressive symptoms among rural elderly in China.METHODS This cross-sectional study enrolled 5136 older adults(≥60 years)recruited between April and June 2024.Sleep quality was evaluated using the Pittsburgh Sleep Quality Index,and depressive symptoms were assessed with the Patient Health Questionnaire-9.Binary logistic regression analysis was employed to examine the associations between problems in different sleep dimensions and depressive symptoms among these older adults.RESULTS The prevalence of depressive symptoms was 19.5%,and the overall rate of sleep disorders was 40.13%.Among the rural elderly,six sleep dimensions were found to be statistically significantly associated with depressive symptoms(all P<0.05),with the following odds ratios(ORs)and 95%confidence intervals(CIs):Subjective sleep quality(OR=2.066,95%CI:1.709-2.497),sleep onset latency(OR=2.476,95%CI:2.062-2.972),sleep efficiency(OR=1.686,95%CI:1.369-2.076),sleep disturbances(OR=2.092,95%CI:1.566-2.795),daytime dysfunction(OR=3.378,95%CI:2.882-3.959),and use of hypnotic medications(OR=1.662,95%CI:1.093-2.525).CONCLUSION Poor subjective sleep quality,prolonged sleep onset latency,reduced sleep efficiency,sleep disturbances,daytime dysfunction,and use of hypnotic medications are associated with depressive symptoms in the elderly.Therefore,healthcare professionals should target elderly individuals with sleep disorders and implement effective interventions to alleviate their depressive symptoms.
文摘BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life.Multidisciplinary team(MDT)collaborative nursing has emerged as a comprehensive care approach that may address both physical and psychological needs.AIM To explored the impact of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors.METHODS A retrospective analysis was conducted on 364 patients with gastrointestinal tumours admitted to our hospital between January 2022 and December 2024.Based on differing postoperative nursing approaches,two groups were established:the MDT group(n=196)and the control group(n=168).The control group received conventional nursing interventions,while the MDT group received MDT collaborative nursing.The study compared wound healing outcomes,pre-intervention and one-month post-intervention Hospital Anxiety and Depression Scale(HADS)scores,Functional Assessment of Cancer Therapy-General(FACT-G)quality of life scores,and complication rates between the two groups.RESULTS The MDT group demonstrated a Grade A wound healing rate of 88.27%and total treatment compliance of 99.49%,both significantly higher than the control group(75.00%and 95.83%,respectively).The complication incidence rate was 3.06%in the MDT group,lower than the control group(8.93%),with all differences statistically significant(P<0.05).After one month of intervention,patients in the MDT group demonstrated lower Anxiety Self-Rating Scale and Depression Self-Rating Scale scores on the HADS scale compared to the control group.Conversely,their scores on the FACT-G scale for physical,social/family,emotional,and functional domains were higher than those in the control group,with all differences being statistically significant(P<0.05).CONCLUSION MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery,alleviates anxiety and depressive symptoms,enhances treatment adherence and quality of life,and reduces the incidence of complications.
