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Early intervention contributes to improving patient experience and doctor-patient relationship in the case of non-psychiatric outpatients with psychological problems.The authors studied the psychological assessment and hierarchical management for non-psychiatric inpatients at a general hospital. Measures taken include establishing multi-disciplinary and inter-department teams, building an intra-hospital joint-action system, and implementing the psychological assessment and hierarchical management for non-psychiatric inpatients.These efforts explored ways for a general hospital in psychological counseling, offering humanistic service, and transformation of medical pattern.
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OBJECTIVE: Although the pathogenesis of depression remains unclear, C-reactive protein (CRP) levels are commonly elevated in depressed patients. Thus, CRP single-nucleotide polymorphisms (SNPs) that influence CRP levels may be associated with depression. In the present study, we explored whether CRP SNPs are related to depressive symptoms and antidepressants efficacy in Han Chinese patients.METHODS: We analyzed data from 440 patients with first-episode depression. We obtained genome CRP SNPs, scores of the 17-item Hamilton Rating Scale for Depression 17 (HAMD17) and its four-factor at baseline and after 6 weeks. Quantitative trait analysis was performed using UNPHASED software and curative effects were analyzed using SPSS software.RESULTS: Male patients with SNP rs1800947G exhibited lower insomnia scores and rs2794521CC exhibited lower scores of anxiety/ physical symptoms, total HAMD17 score. Female patients with rs2794521TT exhibited higher scores of insomnia and lower antidepressants efficacy.CONCLUSION: CRP SNPs rs1800947 and rs2794521 may be associated with depressive symptoms in patients with depression in a sex-specific fashion. Furthermore, rs2794521 may be a predictor of the efficacy of antidepressants in female patients.
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Female , Humans , Male , Antidepressive Agents , Asian People , C-Reactive Protein , Depression , Genome , Polymorphism, Single Nucleotide , Sleep Initiation and Maintenance DisordersABSTRACT
OBJECTIVE: To study the effects of telmisartan combined with finasteride on blood pressure rhythm (BPR) in non-dipper type hypertension patients with benign prostatic hyperplasia (BPH). METHODS: From Jul. 2015 to Dec. 2016, medical information of 190 patients with non-dipper type hypertension complicated with BPH were retrospectively collected from Halison International Peace Hospital, and then divided into control group (n=82) and observation group (n=108) according to therapy plan. Control group was given telmisartan 40 mg, qd; observation group was additionally given finasteride 5 mg, qd, on the basis of observation group. Both groups were treated for 12 months, and followed up once every 3 months. The changes of blood pressure (24 hSBP, 24 hDBP, 24 hPP, dSBP, dDBP, dPP, nSBP, nDBP, nPP), morning blood pressure surge, prostate volume, nocturia times, the changes of BPR (the rate of non-dipper type blood pressure change) were observed in 2 groups. The occurrence of ADR was observed. RESULTS: Before treatment, there was no statistical significance in blood pressure, morning blood pressure surge, prostate volume or nocturia times between 2 groups (P>0. 05). After treated for 3, 6, 12 months, blood pressure, morning blood pressure surge, prostate volume, nocturia times and the rate of non-dipper type blood pressure change in 2 groups were decreased significantly; the observation group was significantly lower than the control group, with statistical significance (P>0. 05). There was no statistical significance in the incidence of ADR between 2 groups (P>0. 05). CONCLUSIONS: Telmisartan combined with finasteride show significant effects on non-dipper hypertension complicated with BPH, effectively reduce the level of blood pressure, prostate volume, nocturia times and improve BPR with good safety. The effect of two-drug is better than that of telmisartan.
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Objective To investigate the status of depression with anxiety symptoms, and analyze the influencing factors of anxiety symptoms from demographic data and social psychological factors. Methods Hamilton depression rat?ing scale (HAMD), Hamilton anxiety rating scale (HAMA), Eysenck personality questionnaire (EPQ), life event scale (LES), trait coping style questionnaire (TCSQ) and social support scale (SSS) were used to evaluate 729 patients with de?pression. According to HAMA scores, patients were divided into non anxiety symptoms group (HAMA14). Social psychological factors were compared between two groups, and the influencing fac?tors of anxiety symptoms were analyzed. Results The incidence of anxiety symptoms in depression was 58.85% (429/729), and 119 cases (16.32%) were certainly without anxiety symptoms. Compared with the group without anxiety symp?toms, the anxiety symptoms group had higher scores on neuroticism, psychoticism, negative life events and negative cop?ing style (P<0.001), but lower scores on introversion and extroversion (P=0.010). Degree of depression (OR=9.255, 95%CI:4.726~18.127), neuroticism (OR=1.595, 95%CI:1.197~2.125), negative life events (OR=1.009, 95%CI:1.001~1.017) and negative coping style (OR=1.046, 95%CI:1.013~1.080) were the risk factors of anxiety symptoms (P<0.05). Conclu?sion The incidence of anxiety symptoms in patients with depression is high. Patients with higher degree of depression and typical neurotic personality experiencing more negative life events and those with tendency to adopt negative coping style are more susceptible to anxiety symptoms.
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Objective To explore the characteristics of cognitive impairment and its influence factors in first-epi?sode depression patients with sleep disorder. Methods Three hundred and eighteen patients with first-episode depres?sion and two hundreds and forty-three healthy controls were recruited. The patients were divided into two group accord?ing to the sleeping situation: 202 patients with sleep disorder and 116 patients without. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to evaluated the cognitive function of all subjects, including immediate memory, visual span, speech function, attention and delayed memory. The 17 item Hamilton Depression Scale (HAMD-17) was used to evaluate patients’symptoms. Results The scores of immediate memory, visual span, speech function, delayed memory and the whole scale in the depression patients with sleep disorder were significantly lower than the patients without sleep disorder and the controls (P<0.05). Compared with the controls, the patients without sleep disor?der had lower scores of immediate memory, language function, delayed memory and the whole scale (P<0.05). Multiple linear regression showed that in the depression patients with sleep disorder, the RBANS score was related with the cogni?tive factors in HAMD (β=6.29, P=0.04);immediate memory was related with age (β=-0.24, P=0.04);visual span was re?lated with sleeping factor in HAMD (β=2.33, P=0.01);speech function was related with marriage (β=-5.74, P=0.01) and sleeping factor in HAMD (β=-1.20, P=0.03). In the depression patients with sleep disorder, speech function of RBANS was related with age (β=-0.32, P=0.04);attention was related with retardation factor in HAMD (β=2.52, P=0.01). Con?clusion The first-episode depression patients with sleep disorders have cognitive function damage in many aspects. The depressive symptoms (sleep changes, cognitive disorders, retardation and so on), age and marital status may be the influ?encing factors on cognitive impairment in first-episode depression patients with sleep disorder.
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Objective To investigate the changing trend of incidence and the relevant factors in fetal macrosomia. Methods 84 883 newborns during Jan. 1,1970 to Dec. 31,1999 were used to analyze the incidence of fetal macrosomia,the average birth weight,the percentage of superior fetal macrosomia, the distribution of gestational age, the rate of cesarean section and the vaginal delivery, the relevant factors of fetal macrosomia. Results All the cases were divided into 3 groups, one group from 1970 to 1979, the second one from 1980 to 1989, the third one from 1990 to 1999. The incidence of fetal macrosomia for three groups were 2. 6%, 6. 9% and 13 2% ( P