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Objective To study the, influencing factors of suicide-committing risks among hospitalized depressive patients. Methods Based on qualitative diagnoses, 102 patients were divided into non-suicide and suicide group.The two groups were compared in terms of general information, score by the Beck hopelessness scale (BHS) and the suicide subscale of the Chinese version of mini-international neuropsychiatric interview (MINI). Logistic regression was applied to analyze the related factors of suicide-committing risk in depressive patients. Results Among the 102 patients, 70 cases had tendency to commit suicide, accounting 68.6% , and 32 did not, accounting for 31.4%. Multivariate logistic regression suggested that the score of the suicide subscale of MINI could effectively predict the suicide tendency (P＜0.001). Conclusions The suicide-committing risk is high in the depressive patients. The MINI suicide risk is the influencing factor of suicide-committing risk and can be used to predict suicide tendency in hospitalized depression patients. More attention should be paid to patients at high risk and relevant nursing countermeasures should be taken for effective intervention.
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Objective To investigate the abnormal change of gray matter volume in patients with euthymic bipolar disorder Ⅰ (BD-Ⅰ),and to elucidate the relationship between the use of different mood stabilizers and brain structure variations.Methods Voxel-based morphometry (VBM) was used to analyze the volume of local gray matter in 35 patients with BD-Ⅰ and 30 healthy controls(HC).The patients were divided into BD-Ⅰ with lithium group and BD-Ⅰ with valproate group according to different mood stabilizers.The volume differences of gray matter of the three groups were compared by one-way ANOVA.Results Compared with HC,BD-Ⅰ patients showed significantly reduced gray matter volume in the medial frontal cortex (MNI (x,y,z):2,34,-18),orbital frontal cortex (MNI(x,y,z):-32,22,-4),frontal operculum (MNI(x,y,z):38,18,4) and insula cortex (MNI(x,y,z):-32,22,-4) (P＜0.05).There was no significant difference in thevolume of gray matter between BD-Ⅰ with lithium group and BD-Ⅰ with valproate group(P＞0.05).Conclusion Emotional disturbance in patients with BD-Ⅰ may be associated with reduced gray matter volume in the medial frontal cortex,orbital frontal cortex,frontal operculum and insula cortex.There are not significant difference about the effects of lithium carbonate and valproate on cerebral gray matter volume in patients with BD-Ⅰ.
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Objective To analyze the risk factors of socio-demographic and clinical characteristics related to anxious symptoms in bipolar depression patients(BDP).Methods This was a secondary analysis of data from the Diagnostic Assessment Service for People with Bipolar Depression in China(DASP)from September 1,2010 to February 28,2011.According to the criterion that comorbid anxiety or not, BDP(n=306)were divided into comorbid anxiety group(n =200)(65.4％)and without anxiety group(n =106)(34.6％).Further analysis for risk factors of anxious symptoms in BDP was performed by the multivariate logistic regression analysis.Results BDP with anxiety were younger(35.10± 11.09), younger at illness onset(27.93-± 10.04), ruore male(t =4.603, P＜0.05), more lifetime episodes(3.21 ± 3.77), frequently episodes(t =17.328,P＜0.05),inducement onset(t=14.859,P＜0.05)and more seasonal episodes(t=8.300,P＜0.05)compared with BDP without anxiety.Logistic regression analysis showed that inducement onset(OR=5.023)and episodes frequency(OR=10.852)was significantly associated with anxious symptom(P＜0.05).Conclusion The finding indicates that postpartum onset and depressive episodes frequency may be risk factors of bipolar depression with anxiety.
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Objective To analyze the risk factors of socio-demographic and clinical characteristics related to anxious symptoms in bipolar depression patients(BDP).Methods This was a secondary analysis of data from the Diagnostic Assessment Service for People with Bipolar Depression in China(DASP)from September 1,2010 to February 28,2011.According to the criterion that comorbid anxiety or not, BDP(n=306)were divided into comorbid anxiety group(n =200)(65.4％)and without anxiety group(n =106)(34.6％).Further analysis for risk factors of anxious symptoms in BDP was performed by the multivariate logistic regression analysis.Results BDP with anxiety were younger(35.10± 11.09), younger at illness onset(27.93-± 10.04), ruore male(t =4.603, P＜0.05), more lifetime episodes(3.21 ± 3.77), frequently episodes(t =17.328,P＜0.05),inducement onset(t=14.859,P＜0.05)and more seasonal episodes(t=8.300,P＜0.05)compared with BDP without anxiety.Logistic regression analysis showed that inducement onset(OR=5.023)and episodes frequency(OR=10.852)was significantly associated with anxious symptom(P＜0.05).Conclusion The finding indicates that postpartum onset and depressive episodes frequency may be risk factors of bipolar depression with anxiety.
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Objective To explore the attempted suicide risk factors of socio-demographic and clinical charac-teristics in major depressive disorder patients with atypical features (e.g. increased appetite, weight gain and greater time spent sleeping). Methods This was a secondary analysis of the data from the Diagnostic Assessment Service for People with Bipolar Disorders in China (DASP), which was initiated by the Chinese Society of Psychiatry (CSP) and carried out in 13 major mental health centers in China. Totally 179 patients were diagnosed as atypical major depres-sive disorder patients in all 1172 major depressive disorder patients using Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-Ⅳ) by psychiatrists. Suicide attempters and nonattempters were grouped base on the interview results of suicidality module of the Mini International Neuro-psychiatric Interview (MINI). Multiple logistic regression were used to assess association between independent variables and attempted suicide in major depressive disorder patients with atypical features. Results The rater of attempted snicide was 23.5% (42/179) of atypical major depressive disorder patients reported prior or current attempted suicide. Compared to nonattempters, attempters had higher levels of suicidal ideation, postpartum depressive episodes, and the use of antipsychotic, mood stabilizers and benzodiazepines (P<0.05). Logistic regression analysis showed that number of admissions (OR=1.73, 95% CI: 1.093~2.740) and depressive episodes with suicidal ideation (OR=3.90, 95%CI: 1.506~10.092) were significantly associat-ed with attempted suicide in atypical unipolar depression patients (P<0.05). Conclusions High number of admissions and high levels of suicidal ideation may be considered as potential risk factors to identify atypical unipolar depression patients at risk for future suicidal behavior.
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Objective To investigate the characteristic of regional cerebral blood flow (r-CBF) in patients with major depression disorder (MDD) and bipolar depressed (BPD). Methods The r-CBF imaging was detected by using sin?gle emission computed tomography (SPECT) in 22 treatment naive patients with MDD, 22 treatment naive patients with BPD and 15 healthy controls. The r-CBF was compared between patients and controls. Results Compared to controls, the r-CBF in the bilateral temporal lobe, parietal lobe and basal ganglia significantly decreased in MDD and BPD pa?tients (P<0.001). The r-CBF in the basal ganglia was significantly lower in MDD patients than in BPD patients. Conclu?sion The r-CBF is abnormal in MDD and BPD at the resting state. The r-CBF in the basal ganglia is the main differ?ence between MDD and BPD. The difference might be regarded as a biomarker in distinguishing BPD patients from MDD patients.
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Objective To analyze the risk factors of socio-demographic and clinical characteristics related to sui?cide risk in misdiagnosed bipolar disorderⅡ(BPⅡ) treated for major depressive disorder. Methods A total of l478 con?secutive major depressive disorder patients were interviewed with the Mini International Neuropsychiatric Interview (MINI) in 13 major mental health centers in China. Of the 1478 patients, 190 patients were diagnosed BPⅡ, who were divided into two groups (nonsuicidal risk and suicidal risk) with the suicidality module of MINI. Logistic regression was performed to evaluate significant risk factors associated with suicide risk in misdiagnosed BPⅡtreated for major depres?sive disorder. Results Of the 190 patients, 116 were in the nonsuicidal risk group and 74 were in the suicidal risk group. In comparison to the nonsuicidal risk group, the suicidal risk group had younger age [(34.45 ± 11.18) vs.(37.23 ± 13.22), P=0.008], earlier age at onset [(26.20 ± 9.16) vs. (30.37 ± 11.59), P=0.007], and more suicidal ideation (82.4%vs. 53.4%, P=0.001). Logistic regression analysis showed that age (OR=0.969,95% CI:0.945~0.993) and depressive epi?sodes with suicidal ideation (OR=4.129,95%CI:2.030~8.397) were significantly associated with suicide risk in patients of misdiagnosed BPⅡtreated for major depressive disorder (P<0.05). Conclusions Younger age, severer suicidal ide?ation may be potential independent risk factors to suicide risk in BPⅡwith misdiagnosed with major depressive disor?der.
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Objective To study the relationship between suicidal attitude and childhood trauma in bipolar disorders.Methods 67 patients with bipolar disorder and 101 healthy individuals were assessed with the Questionnaire of Suicidal Attitude (QSA) and Childhood Trauma Questionnaire(CTQ).Results There was no statistical difference between the patients group and healthy control group in the results of suicidal attitude (P＞0.05).The scores of emotional neglect (M =10)and physical neglect (M =9) in patients group were significantly higher than those of the healthy control group(M =8,M =6)(P＜0.05).The attitude to suicidal behavior was negative correlation with emotion neglect(r=-0.181,P＜0.05)in patients group.Conclusion Emotional and physical neglect are the main types of trauma in patients with BD,and may increase the risk of suicide.It is important to survey the patients with BD on childhood trauma,and intervention is necessary.
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Objective:To compare the suicidality risk in major depressive disorder (MDD)patients with and without anxious characteristics,and analyze the risk factors of suicidality in MDD patients. Methods:This was a secondary analysis of the data from the Diagnostic Assessment Service for people with Bipolar Disorders in China (DASP),which was initiated by the Chinese Society of Psychiatry (CSP),from September 1,2010 to February 28, 201 1. Based on the anxious module and suicide module of Mini International Neuropsychiatric Interview (M. I. N. I),1 172 MDD patients were classified as suffering from anxious MDD (n=728,62. 1%)and non-anxious MDD(n=444,37. 9%). Logistic regression was employed to examine the risk factors of suicidality in MDD pa-tients. Results:Among the anxious MDD patients,331 (45. 5%)of them had suicidality risk. And 54(12. 2%)of non-anxious MDD patients had suicidality risk. Compare to the non-anxious group,the anxious MDD patients had significantly higher suicidality risk (P<0. 00 1 ). Logistic regression analysis showed that more frequent depressive episodes (OR=2. 07 ),depressive episodes with psychotic symptoms (OR=2. 0 1 ),comorbid with anxious charac-teristics (OR=3. 18)or melancholic characteristics (OR=2. 90)were associated with suicidality risk in patients with MDD. Conclusion:It indicates that the anxious MDD patients may have higher suicidality risk than non-anx-ious MDD patients,and more frequent depressive episodes,depressive episodes with psychotic symptoms,comorbid with anxious characteristics or melancholic characteristics may be risk factors of suicidality in patients with MDD.
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Objective To analyze the risk factors of socio-demographic and clinical characteristics related to sui?cidal attempt in major depressive disorder (MDD) patients with anxious characteristics. Methods Based on the anxious module of Mini International Neuropsychiatric Interview (MINI), a total of 728 anxious MDD patients from 13 major men?tal health centers in China were classified as suicidal and non-suicidal attempt groups. Further analyses regarding risk factors of suicidal attempt in anxious MDD patients were performed by the multivariate logistic regression analysis. Re?sults Among the 728 patients with anxious MDD analyzed, 135 (18.5%) of them had suicidal attempt and 593 (81.5%) had non-suicidal attempt. Compared to the non-suicidal attempt group, patients with suicidal attempt had significantly earlier age onset[(32.3 ± 11.9) vs. (35.3 ± 13.1)], more lifetime depression episodes (median:2 vs. 2), more number of ad?missions (median: 1 vs. 0), more frequent depressive episodes (14.8% vs. 7.4%), more atypical characteristics (25.9%vs.15.0%), more suicidal ideation (78.5%vs. 50.3%) and more antidepressant use (81.5%vs. 71.2%). Logistic regression analysis showed that number of admissions (OR=1.18, 95%CI:1.02~1.37), frequent depressive episodes (OR=2.10, 95%CI:1.14~3.68), depressive episodes with suicidal ideation (OR=3.55, 95%CI:2.28~5.54) were associated with suicidal at?tempt in MDD patients with anxious characteristics (P<0.05). Conclusions More number of admissions, more frequent depressive episodes, comorbid suicidal ideation may be risk factors of suicidal attempt in anxious MDD patients.
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ObjectiveTo investigate the effects of sleep deprivation on expressions of Mir-132,mir-134 in the different regions of rat brain.MethodsAll the male SD rats were divided into control group ( normal sleep group),sleep deprivation (SD).The modified multiple platform method (MMPM) was used to establish sleep deprivation model.Mir-132,mir-134 level was detected by real time PCR.ResultsMir-132 were significantly increased in SD groups in hippocampus compared with the control groups ( 51.87 ± 8.13 vs 67.25 ± 7.59 ) (P ＜0.01 ).Mir-134 were significantly decreased in SD groups compared with the control groups( 1.82 ±0.15 vs 1.45± 0.12 )(P ＜ 0.01 ).There were no statistically significant differences in cortex and thalamus (P ＞ 0.05 ).Cortex mir-132 level in SD group and control group was 1.57 ±0.10,1.48 ±0.11 respectively,and it was 1.37 ±0.09,1.36 ±0.11 in thalamus;Cortex mir-134 level in SD group and control group was 98.26 ± 5.17,100.80 ±4.15respectively,and it was 97.56 ± 6.28,91.01 ± 4.07 in thalamus.ConclusionThe upregulation of mir-132 and downregulation of mir-134 implies that two miRNAs did opposite actions in the processes of sleep deprivation.This findings indicate that hippocampus mir-132,mir-134 levels in the SD rat may reflect associated depressive patho-physiological processes.
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Objective To develop the bipolar depression index scale (BDIS) and test the validity and reliability of BDIS.Methods The original bipolar depression index scale (BDIS) was developed by the clinical features of bipolar depression reported by the studies focused on comparing the bipolar depression (BP) and unipolar depressive disorder (UP).46 patients with bipolar depression and 44 patients with unipolar depression were rated the original BDIS and enrolled consecutively by DSM-IV.Results There were eleven items in the BDIS.The interrater reliability between eleven items and BDIS score ranged from 0.61 to 0.87.The correlation coefficients between eleven items and BDIS score ranged from 0.53 to 0.73.The Cronbach's alpha of BDIS was 0.68.The mean BDIS score of BP(7.26 ± 3.12 ) was significantly higher than that of UP( (4.80 ± 3.08 ), (P ＜ 0.01 ).The BDIS scores were significantly correlated with the scores of Mood Disorder Questionnaire ( coefficient 0.56) and 32-item hypomania checklist ( coefficient 0.45).The BDIS score could discriminate between BP patients and UP patients by the ROG curve analysis and 5 was the best cutoff score ( sensitivity 0.80, specificity 0.64).Conclusions The validity and reliability of BDIS are fit for the requirements of psychometrics.BDIS may use to differentiate between bipolar depression and unipolar depression in the practice.
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Objective To study the relationship of levels of circulating endothelial microparticles (EMP62E, EMP31) and high-sensitivity C-reactive protein (hs-CRP) with severity of chronic left heart failure in elderly patients. Methods According to New York Heart Association (NYHA) class and left ventricular ejection fraction (LVEF), the healthy subjects and the patients were divided into five groups: control group [LVEF: (63.97±4.65)%], classⅠ group [LVEF: (42.67±2.06)%], classⅡ group [LVEF: (34.26±3.17)%], class Ⅲ group [LVEF: (29.05±1.07)%] and class Ⅳ group[ LVEF:(25.17±1.42)%] . The levels of circulating EMP62E, EMP31 and hs-CRP of the patients and healthy subjects were measured by flow cytometry and nephelometry immunoassay, respectively. Results There were significantly differences in EMP62E, EMP31 and hs-CRP between class Ⅳ group and classⅠ group P＜0.01) EMP62E [(1092.7 ± 102.8) counts/μl vs. (291.0±21.9) counts/μl], EMP31 [(1596.1±46.3) counts/μl vs. (477.8±40.3) counts/μl] and hs-CRP [(14.74±0.07) mg/L vs. (4.86 ± 0.09) mg/L]. The levels of circulating EMP62E, EMP31 and hs-CRP were gradually elevated significantly along with the increased severity of chronic left heart failure in elderly. Conclusions The upregulation of circulating EMP31, EMP62E and hs-CRP may contribute to the development of chronic heart failure in elderly.
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Objective To observe the effect of changes in CD34+ cell level on various degrees of chronic heart failure (CHF) in the elderly. Methods The enrolled patients were divided into four CHF groups according to the New York Heare Association(NYHA) functional class: NYHA class I (n=23), Ⅱ (n=27), Ⅲ (n = 20) and IV group (n= 16) , and there were 41 healthy controls over the same period. The levels of peripheral blood CD34+ cells were measured, and the tumor necrosis factor-α (TNF-α). its soluble receptors (sTNFR-1 and sTNFR-2) and vascular endothelial growth factor (VEGF) were also measured. Results The levels of CD34+ cells were elevated in the early CHF and depressed in the advanced CHF in elderly patients. The levels of CD34+ cells were (0. 6± 0.2) 109/L in control group, (2.4±0. 4) 109/L in NYHA class I group, (1.9±0.2)×109/L in NYHA class Ⅱ group, (1.3±0.1)×109/L in NYHA class Ⅲ group and (0.5±0.2)×109/L in NYHA class Ⅳ group, respectively (all P<0.01).And TNF-α, sTNFR-1, sTNFR-2 and VEGF were increased in severe chronic left ventricular failure CNYHA class IV vs. I group:TNF-α: (61.4± 15.7) ng/L vs. (28.4±10.8)ng/L; sTNFR-1: (2820.9±1282.8)ng/L vs. (690.8±62.7) ng/L; sTNFR-2: (4113.1±1102.2) ng/L vs. (740.8± 112.3)ng/L; VEGF: (996.3±487.1)ng/L vs. (423. 3±147. 9)ng/L, all P<0. 013. Conclusions The changes of CD34+ cell level may predict various degrees of chronic heart failure in elderly patients.
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Objective To investigate the validity and reliability of the Chinese version HCL-32(CV-HCL-32) in the patients with bipolar disorder(BP) and the best cut-off between the patients with BP and patients with major depression disorder (unipolar depression disorder, UP). Methods The English version HCL-32 was translated into Chinese version after the agreement of the author of the HCL-32. 300 consecutive patients with BP and 156 consecutive patients with UP in outpatients and inpatients departments diagnostically interviewed with DSM-Ⅳ were rated by CV-HCL-32. The test-retest reliability with interval of eight to fourteen days was investigated in 155 patients (51.7%) with BP in the bipolar patients. Results A two-factor solution was preferred by the factors analysis. The Eigenvalues of the two factors were 6.32, 3.00 respectively. The two factors together accounted for 29.1% of the total variance. The internal consistency( Cronbach's alpha) of the CV-HCL-32 was 0.86.The test-retest reliability of the CV-HCL-32 was 0.62(P＜ 0.01 ). The frequency of positive responses to various items ranged from 11.6% to 89.7%. The mean score of CV-HCL-32 was statistically higher in patients with BP( 16.6 ± 6.2) than that of UP ( 10.9 ± 6.4). A CV-HCL-32 screening score of 14 was chosen as the optimal cutoff between the patients with BP and UP, as it provided good sensitivity (0.74) and specificity (0.66). The positive and negative predictive power for this cut-off was 0.81 and 0.57. Conclusions The study demonstrated the suitable validity and reliability of CV-HCL-32, suggested that the CV-HCL-32 is useful questionnaire for screening bipolar disorder in China.
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Objective: To study depression of patients with Grave's disease and the therapeutic effect of Paroxetine (antidepressant). Method: 82 patients with first onset Grave's disease were collected and 52 of them had depression. The depressive patients were divided into Paroxetine and control group. All cases had the same anti-hyperthyroidism treatment. Result: 63.4% (52/82) patients with first onset Grave's disease had depression before Paroxetine treatment. After 4 weeks and 8 weeks treatment, Paroxetine group had greater decrease in FT3 and FT4, and lower scores of SDS and SAS than control group (p＜0.01). Conclusion: Paroxetine does enhance the therapeutic effect of anti-hyperthyroidism, as well as improving depression of patients with first-onset Grave's disease.
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Objective: To investigate the relation between coping style and personality of patients with Graves disease. Method: Eighty two patients with Graves disease were assessed by Coping Style Questionnaire (CSQ), Eysenck Personality Questionnaire (EPQ) and Type A Behavior Questionnaire (TABQ). Results: The extroversive patients adopted more positive coping style than introversive patients did. Patients with higher EPQ-N score had higher score in negative coping. Those with Type A behavior had higher score in negative coping either. There were positive correlation between score of positive coping and that of EPQ-E, between score of negative coping and score of EPQ-N or score of Type A behavior. Conclusion: The coping style of patients with Graves disease is influenced by their personality.