Treatment of Persistent Somatoform Pain Disorder by Floating Needle Therapy and Duloxetine / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder (PSPD).</p><p><b>METHODS</b>Totally 108 PSPD patients were randomly assigned to the floating needle treatment group, the duloxetine treatment group, and the placebo treatment group, 36 in each group. Patients in the floating needle treatment group received floating needle therapy and placebo. Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy. Those in the placebo treatment group received the placebo and simulated floating needle therapy. All treatment lasted for six weeks. Efficacy and adverse reactions were evaluated using Simple McGill pain scale (SF-MPQ) and Treatment Emergent Symptom Scale (TESS) before treatment and immediately after treatment, as well as at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Hamilton Depression Scale (HAMD, 17 items), Hamilton Anxiety Scale (HAMA) were assessed before treatment and at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index (PRI) ≥ 50% after 6 weeks' treatment were involved in the follow-up study.</p><p><b>RESULTS</b>(1) Compared with the same group before treatment, SF-MPQ score, HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st, 2nd, 4th, and 6th week of treatment (P < 0.05, P < 0.01). Besides , each item of SF-MPQ significantly decreased immediately after treatment in the floating needle treatment group (P < 0.01). Compared with the placebo treatment group, SF-MPQ, HAMD, and HAMA total score in the floating needle treatment group significantly decreased after 1, 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). SF-MPQ score, HAMD score and HAMA total score in the duloxetine treatment group also significantly decreased after 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). (2) There were 3 patients (8.3%) who had adverse reactions in the floating needle treatment group, 17 (50.0%) in the duloxetine treatment group, and 7 (21.2%) in the placebo treatment group. Compared with the placebo treatment group, the incidence of adverse reaction increased in the duloxetine treatment group (χ² = 6.04, P < 0.05). Besides, it was higher in the duloxetine treatment group than in the floating needle treatment group (χ² = 14.9, P < 0.05). (3) There were 19 patients in the floating needle treatment group and 17 patients in the duloxetine treatment group involved in the follow-up study. Compared with 6 weeks after treatment, no significant difference was observed at 3 and 6 months after treatment in the score of SF-MPQ, HAMD, and HAMA in the floating needle treatment group and the duloxetine treatment group. No significant difference was observed between the two groups (P > 0.05). There were 5 patients (29.4%) who had adverse reactions in the duloxetine treatment group, and no adverse reactions were observed in the floating needle treatment group. The adverse reaction rate was significantly different between the two groups (χ² = 4.26, P < 0.05).</p><p><b>CONCLUSIONS</b>Floating needle therapy and duloxetine were effective in treatment of patients with PSPD. However, floating needle therapy could relieve pain more rapidly than duloxetine, with obviously less adverse reactions.</p>

Study on the correlation between adolescents' emotional and behavioral problems and life events / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the life events which are correlated with adolescent's emotion and behavior problems, and to provide evidence for clinicians and school staff to develop intervention for those problems.</p><p><b>METHODS</b>Youth's Self Report (YSR) and Adolescent Self-Rating Life Events Check List (ASLEC) were used to assess adolescent's emotional and behavioral problems and life events by 'spot' study. The referred group consisted of 585 patients from 11 to 18 years old in a Mental Health Centre of West China Hospital of Sichuan University from July in 2002 to March in 2004. Level of IQ was above 5th grade of primary school among the study subjects who were willing to fill in the YSR and ASLEC. The non-referred group was selected in a 1280 students cluster-sample from the schools of Chengdu city, whose sex, age and father's career were matched with the referred group. Variance inflation factor (VIF) was used to verify that there was no collinearity to each other in the 6 factors of ASLEC: interpersonal relationship, learning pressure, being punished, losing good adaptation and other. Linear stepwise regression was adopted.</p><p><b>RESULTS</b>The YSR scores in referred group were higher than those in non-referred group, and the referred group had more emotional and behavioral problems than the non-referred one. Partial correlations ranged from 0.124 to 0.418 in referred group, and from 0.104 to 0.388 in non-referred group. Unsatisfied interpersonal relationship, heavy learning pressure, having been punished and poor adaptation were likely to increase the risk of youth's emotional and behavioral problems.</p><p><b>CONCLUSION</b>More attention should be paid to help adolescents in the following areas: solving intrapersonal affairs, relieving pressure from learning, avoiding punishment, and improving ability to fit themselves to their surroundings.</p>

An epidemiological study on mental problems in adolescents in Chengdu, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the mental health problems in the adolescents aged 11-18 years in Chengdu, China.</p><p><b>METHODS</b>Youth Self-Report (YSR) and the General Information Questionnaire were administered to 1802 students who were randomly selected from schools in Chengdu City.</p><p><b>RESULTS</b>The overall rate of mental problems was 15.1% in the adolescents, 15.2% in boys and 14.9% in girls if 90th percentile of total scores and/or 98th percentile of syndromes scores were assigned as the cutpoint of norms. The overall rate of mental problems was 27.2% in the adolescents, 27.6% in boys and 26.8% in girls if 75th percentile of total scores and/or 98th percentile of syndromes scores were assigned as the cutpoint of norms. The rates of mental problems were not significantly different between boys and girls (chi-squared = 0.042, P = 0.838; chi-squared = 0.126, P = 0.723). Mental problems tended to be increasing with age (P = 0.000). There were 29 items that the percentiles were higher than 50% but 5 items were under 10% in all the 101 items of YSR. 3.1% of the adolescents often had suicidal intention, and 6.1% of the adolescents often thought of becoming opposite sex identity.</p><p><b>CONCLUSION</b>The rates of mental problems in adolescents aged 11-18 years in Chengdu, Chana were 27.2% or 15.1% respectively,if 75th or 90th percentile of the total scores were assigned as the cutpoint of total scores. The mental problems in the adolescents tended to be increasing along with age.</p>