ABSTRACT
Objective:To explore the relationship between knowledge of a friend's non-suicidal self-injury (NSSI) behavior and self injury and suicide behaviors of adolescents.Methods:From January 2020 to January 2021, totally 1 683 students from a middle school in Xiamen were randomly selected by cluster sampling.The suicide items of the self-injurious thoughts and behaviors interview(SITBT) were used to assess whether students were aware of their friends' self injurious history and their self injurious behaviors.The suicide items of the mini international neuropsychiatric interview for children and adolescents (MINI-KID) were used to assess students' suicide ideation and behavior.The data were statistically analyzed by SPSS 21.0 software.Logistic regression model was used to analyze the relationship between knowledge of a friend's NSSI and adolescents' own self-reported NSSI and suicidal behaviors.Results:A total of 1 683 junior and senior high school students completed the survey, including 412 (24.4%) who knew their friend's NSSI history and 1 271 (75.6%) who did not know their friend's NSSI history.There were statistically significant differences between the adolescents known and unknown friends' NSSI histories in terms of age, gender, whether they were left-behind children, mental disorders, their own NSSI, suicide attempts, and suicidal ideation (all P<0.05). Knowledge of a friend's NSSI behavior had positive predictive effect on adolescents' own NSSI behavior ( β=0.558, OR=2.01, 95% CI=1.58-3.88), suicidal ideation( β=0.238, OR=3.03, 95% CI=2.08-5.55), and suicide attempts ( β=0.233, OR=2.88, 95% CI=1.55-5.45) (all P<0.05). Conclusion:Knowledge of a friend's NSSI behavior may have an impact on adolescents' own self-injury and suicidal behavior.
ABSTRACT
ObjectiveTo investigate the efficacy and safety of sertraline combined with low-dose aripiprazole in the treatment of obsessive-compulsive disorder in children and adolescents. MethodsA total of 62 cases pediatric patients aged 9~16 years who attended the outpatient clinic of a psychiatric hospital in Xiamen from June 2018 to May 2020 and met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for obsessive-compulsive disorder were enrolled in the study. The selected children were randomly classified into two groups for different treatments. Control group （n=30） received sertraline monotherapy， and study group （n=32） received sertraline combined with low-dose aripiprazole treatment. At the baseline and the end of the 2nd， 4th， 8th and 12th weeks of treatment， children were assessed using Children's Yale-Brown Obsessive Compulsive Scale （CY-BOCS） and Treatment Emergent Symptoms Scale （TESS）. Thereafter， the clinical efficacy and adverse reactions were compared between two groups. ResultsThe compulsive behavior dimensional score of CY-BOCS of study group was lower than that of control group at end of the 2nd and 4th weeks of treatment （t=-2.083， -2.176， P<0.05）. At the end of the 2nd week of treatment， the effective rate was 40.63% in study group， which was significantly higher than 3.33% in control group （χ2=12.317， P<0.01）. By the end of the 12th weeks of treatment， the incidence rate of side effects yielded no statistical difference between two groups （χ2=1.608， P=0.205）. ConclusionCompared with sertraline monotherapy， its combination with low-dose aripiprazole treatment can effectively accelerate the improvement of clinical symptoms in childrenand adolescents with obsessive-compulsive disorder， while the combination therapy and sertraline monotherapy have equivalent safety.
ABSTRACT
Mood disorders/psychosis have been associated with dysfunctions in the default mode network (DMN). However, the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder (PBD) remain unclear. The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients. Twenty-nine psychotic and 26 non-psychotic PBD patients, as well as 19 age- and sex-matched healthy controls underwent a resting-state functional MRI scan and the data were analyzed by independent component analysis. The DMN component from the fMRI data was extracted for each participant. Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements. The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex, bilateral caudate nucleus, bilateral angular gyri, and left middle temporal gyrus, while non-psychotic PBD was not, suggesting further impairment with the development of psychosis. In summary, we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group. These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.