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ObjectiveTo investigate the willingness of middle school students to engage in medicine and its influencing factors during COVID-19 pandemic in Lanzhou， so as to provide references for the early career planning education on middle school students. MethodsConvenient sampling method was used to choose 1 795 middle school students from 5 schools in Lanzhou from July 21 to July 31， 2022 for this study where an online questionnaire survey was distributed to collect data. A self-compiled questionnaire was used to gather the general information， assess the willingness to engage in medicine and seek the underlying reasons. The psychological resilience level of students was assessed using Resilience Scale for Adolescents. Then multivariate Logistic regression analysis was conducted to screen the factors associated with the willingness of middle school students to engage in medicine. ResultsAfter the local outbreak of COVID-19 in Lanzhou， 835 （46.52%） middle school students demonstrated their willingness to engage in medicine， and the top three reasons for their willingness were being affected by medical staff during the pandemic （75.69%）， having interests in medical sciences （67.31%）， and the potential increase of attention to national medical development after the epidemic （43.23%）. Logistical regression analysis showed that female gender （OR=1.438， P<0.01）， family members engaged in the medical and health industry （OR=1.574， P<0.01） and having a high psychological resilience score （OR=1.011， P<0.01） were related to the clear willingness to engage in medicine， while studying in senior middle school （OR=0.473， P<0.01） and excessive exposure （≥50%） to negative information during the epidemic （OR=0.797， P<0.05） were related to declining willingness to engage in medicine. ConclusionAfter the COVID-19 outbreak in Lanzhou， a large proportion of local middle school students show their willingness to engage in medicine， especially among those of female gender， having family members engaged in the medical and health industry and having high level of psychological resilience. Whereas students studying in senior middle school and with excessive exposure to negative information during the outbreak indicate low willingness to engage in medicine.
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Treatment resistant depression is a common and severe mental disorder associated with significant burden of disease .Most individuals receiving conventional pharmacotheraphy fail to achieve and sustain remission.So this is still one of the difficult challenges for the psychiatrist .Much of the research pro-vided indications that the efficacy of treatment for the disease was not optimistic, but the treatment was still made great progress .The common treatments for this disease included pharmacotherapy,psychotherapy,elec-troconvulsive therapy(ECT),transcranial magnetic stimulation (TMS),magnetic resonance guided focused ultrasound surgery( MRgFUS) ,deep brain stimulation ( DBS) ,aerobic exercise,light therapy and so on.Each therapeutic strategy has its own features, and could be suitable or unsuitable in some situations.The high rates of non-remission with first-line treatment strategies make the combination of antidepressant and non-drug treatments to be the new trend of the treatments for treatment resistant depression in the future.
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Objective To investigate the psychological situation on people who experienced after earthquake in yushu ,the rela-tives far away from the earthquake ,rescue workers ,the general population far away from the earthquake zone .From investigation to provide powerful evidence for the crisis intervention .Methods PTSD Checklist (PCL-C) ,Self-Rating Anxiety Scale(SAS) ,Self-Rating Depression Scale (SDS) ,Symptom Checklist 90(SCL-90)were used on the victims to survey different groups of people in different stages .Results The detection rate of PTSD ,anxiety ,depression about different groups of people in different stages were different ,The detection rate of PTSD ,anxiety ,depression and SCL-90 factor scores in the same crowd as the time went on showed a downward trend .The detection rate of PTSD ,anxiety ,depression and SCL-90 factor scores in different people showed a downward trend with the increase of distance from the hypocenter .Conclusion There are different degrees of psychological problems to differ-ent groups of people in different stages ,we should strengthen psychological intervention efforts to improve the ability to stress e-vents .
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Objective To compare the difference of clinical symptoms and cognitive function between starting young and middle-aged depression patients with and without attempted suicide behavior.Methods Depressive patients were divided into two groups.One group was composed of patients with attempted suicide behavior (n =62),the other group was composed of patients without attempted suicide behavior(n =61).The cognitive function were measured by WAIS-RC,Wechsler Memorv Scale and Wisconsin Card Sorting test(WCST).The patients were evaluated by symptom checklist 90 (SCL-90).Results There were significant differences in the score of depressive factor between tow groups,such as attempted suicide (2.90 ± 1.00,2.51 ± 0.76).There were significant differences in some nenuropsychological test between tow groups,such as long-term memory (35.28 ± 6.87,41.60 ±4.24),short-term memory (51.32 ± 13.41,118.98 ± 10.95),intelligence quotient(107.41 ± 15.78,118.98 ± 10.95),total quizzes number (73.18 ± 27.02,64.14 ± 28.71),perseverative errors (32.77 ± 17.93,23.73 ± 13.64).Conclusions There are certain characteristics on clinical symptoms of depressive patients with attempted suicide.The low cognitive function levels play an important role in the risk of suicide in depressive patients.
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ObjectiveTo compare with the difference of cognitive function between first episode young and middle-aged depression patients with and without somatization.Methods 61 depression patients with somatization and 58 depression patients without somatization attended in this comparison assessment.The cognitive function were measured by WAIS-RC,Wechsler memory scale and Wisconsin card sorting test (WCST).ResultsThere were significant differences in some neuropsychological test between tow groups,such as vocabulary(9.74± 2.40,10.74 ± 2.91 ) ; pictures fill in the blank (5.54 ± 1.65,6.30 ± 1.91 ) ; recognition ( 7.07 ± 2.35,8.28 ±2.76) ; understanding (6.41 ± 2.57,8.28 ± 2.23 ) ; persistent number of errors ( 69.02 ± 11.49,53.11 ± 12.92 ),ConclusionThe cognitive function of first episode young and middle-aged depression patients with somatization is worse that of depression without somatization.
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Objective To compare the effects of atypical antipsyehoties treatment on PS0 sensory gating in first-episode schizophrenics. Methods The P50 auditory evoked potential was recorded by using conditioning-testing stimulus paradigm and stimulus train paradigm in 36 normal controls and 53 first-episode schizophrenics be-fore and after treatment,and compare the difference of P50 sensory gating after treatment. Results Before treat-ment, compared with control group, the atypical groups both had statistic difference of T-P50 amplitude ((1.01±0.88)μV, (0.68±0.64)μV, (0.58±0.47)μV), P50 suppression ((0.61±0.27), (0.54±0.22, (0. 59± 0.19)) in conditioning-testing stimulus paradigm and P50 amplitude,P50 suppression evoked by high frequency stimuli in stimulus train paradigm(P < 0.05), but no difference among the atypical groups (P > 0.05). After treat-ment,compared with control group, there was no statistic difference in olanzapine and elozapine groups of T-P50 amplitude and P50 suppression in conditioning-testing stimulus paradigm, but the difference in risperidone and que-tiapine groups still obviously(P<0.05). In stimulus train paradigm, there was no statistic difference of P50 ampli-tude, P50 suppression evoked by high frequency stimuli in every groups (P>0.05). Compared within atypical groups, the difference of P50 amplitude and P50 suppression were both obviously(P<0.05). Conclusion Each a-typical antipsychotic has different effect on P50 sensory gating;and the conditioning-testing stimulus paradigm and stimulus train paradigm P50 sensory gating may reflect different central neuron mechanism.
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Objective To compare the effects of typical and atypical antipsychotics treatment on P50 sensory ga-ting in first-episode schizophrenics.Methods Using conditioning-testing stimulus paradigm and stimulus train paradigm to record the P50 auditory evoked potential in 36 normal controls and in 61 first-episode schizophrenics before and after treat-ment.Patients were categorized into two groups:the typical antipsychotic treatment group(typical group)and the atypical antipsychotic treatment group(atypical group).Results Before treatment,both of the typical and atypical groups had low-er levels of S2-P50 amplitude,P50 suppression in conditioning-testing stimulus paradigm and P50 amplitude as well as P50 suppression evoked by high frequency stimuli in stimulus train paradigm in comparison with controls(P<0.05).After treatment,the typical antipsychotic treatment significantly improved the levels of P50 suppression in the stimulus train para-digm but not the levels of S2-P50 amplitude,P50 suppression in the conditioning-testing stimulus paradigm(P<0.05)whereas the atypical antipsychotic treatment improve the levels of P50 amplitude,P50 suppression in both stimulus train paradigm and the conditioning-testing stimulus paradigm(P<0.05). Conclusions The typical antipsychotic treatment can ameliorate the P50 suppression in stimulus train paradigm,but not in the conditioning-testing stimulus paradigm,whereas atypical antipsychotic treatment can ameliorate P50 suppression in both paradigms.
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BACKGROUND: In addition to physical disability, stroke may also result in psychological impairments usually manifested by depression and anxiety.Regardless of the primary or secondary onset of anxiety, anti-depressants should be given for treatment of the anxiety and depression besides routine treatment of the primary condition underlying the symptoms.OBJECTIVE: To compare the effect of different treatment protocols with or without anti-depressants and different anti-depressants on poststroke anxiety and depression as well as the neurological functions.DESIGN: Randomized controlled double-blind clinical trial.SETTING: Departments of Psychiatry and Neurology of the Second Hospital Affiliated to Lanzhou University.PARTICIPANTS: Ninety patients aged 41-72 years with post-stroke anxiety and depression, who were admitted in the Departments of Psychiatry and Neurology of the Second Hospital Affiliated to Lanzhou University between July 1999 and December 2002, were enrolled in this study and randomized equally into Paxil group, imipramine group and control group.METHODS: After emergency management for 1-2 weeks in the acute stage, the stroke patients showed clear consciousness and stable life signs without any understanding problems. Patients in the control group received conventional treatment combined with rehabilitative training, while patients in the other two groups were given additional Paxil (20 mg/day) or imipramine (50-150 mg/day) for totally 12 weeks. The neurological deficits and capacity for independent living of the patients were assessed with Hamilton Depression Scale (24 items) and Hamilton Anxiety Scale (14items) at 2, 4, 8, and 12 weeks during the treatment. A reduction of the score for Hamilton anxiety and depression scale by over 75% suggested a cure of depression and anxiety, 50% but ＜ 75% obvious improvement,25% but ＜ 50% improvement, and ＜ 25% non-response. Basically recovered neurological function was indicated by a reduction of neurological deficit score by 90%-100%, remarkable improvement by 46%-89%, improvement by 18%-45%, and non-response or exacerbation by a reduction less than 17%.MAIN OUTCOME MEASURS: ① Neurological function recovery of recovery of the patients after treatment; ② Poststroke anxiety and depression status before and after treatment; ③ Therapeutic effects on depression,neurological functions, severity of neurological deficit, and capacity of independent living. ④ Adverse events and side effects.RESULTS: One patient in Paxil group and 3 in the control group failed to be available for follow-up study, and 3 patients in imipramine group withdrew from the study due to adverse events, so that 83 cases were analyzed.At 2 and 4 weeks in the treatment, the scores for neurological deficits and capacity for independent living exhibited obvious changes (P ＜ 0.01),which gradually stabilized at 8 and 12 weeks (P ＜ 0.05), and significantly greater improvement in the neurological function and capacity for independent living was observed in Paxil group than in the control group (P＜ 0.01), but the differences between imipramine group and the control group and between Paxil group and imipramine group were not statistically significant (P ＞ 0.05). The scores for Hamilton Depression Scale and Hamilton Anxiety Scale were obviously lower in Paxil group and imipramine group at 2, 4, 8 and 12 week than those in the control group (P＜ 0.01-0.001), but similar between the former two groups at 12 weeks (P＞ 0.05). Paxil and imipramine on resulted in curative rates of anxiety and depression of 86.6% and 85.1%, respectively, which were obviously higher than that of the control group (46.6%); the improvement rate ofneurological function in Paxil group, imipramine group and control groupwas 89.6%, 70.3% and 56.6%, respectively, with that of Paxil groupsignificantly higher than that of the control group (P ＜ 0.01), but the difference between imipramine group and control group was not signifi cant (P ＞ 0.05).CONCLUSION: Patients with poststroke anxiety and depression shouldreceive appropriate interventions with anti-depressants in addition to treat ment of neural function impairment. Paxil and imipramine haye similar effect in treating anxiety and depression, but the former can be for its less side effects, better compliance on the part of patients and good effect inpromoting neurological function recovery.