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Objective To evaluate the efficacy of MoodGYM Internet-delivered Cognitive Behavior-al Therapy in the treatment of anxiety and depression among nurses. Methods A total of 180 nurses with anxiety or depression were randomly divided into three groups,60 in each group,and 2 months of intervention with MoodGYM and health education ( once a week,30-45 minutes each time) in MoodGYM group and health education group,respectively. Another group was as a control group. Before and after intervention,De-pression Anxiety Stress Scale 21 ( DASS-21),Minnesota Satisfaction Questionnaire ( MSQ) and Subjective Happiness Scale (SHS) were used to evaluate psychological status. Results Compared with pre-interven-tion,the scores of anxiety in DASS-21 ((16. 76±7. 61) vs (9. 67±5. 78),t=21. 339,P<0. 01) and depres-sion in DASS-21 ((13. 86±7. 60) vs (10. 91±7. 12),t=16. 716,P<0. 01) decreased,meanwhile job satis-faction in MSQ((65. 11±11. 12) vs (67. 97±11. 10),t=-16. 400,P<0. 01) and subjective well-being in SHS((17. 67 ± 4. 59) vs (21. 83 ± 3. 53),t=-20. 221, P<0. 01) increased in post-intervention in the MoodGYM group. The scores of anxiety((15. 81±8. 24) vs (12. 45± 7. 68),t=17. 566,P<0. 01) and de-pression((12. 44± 8. 23) vs ( 12. 09 ± 7. 95), t=3. 934,P<0. 01) decreased, meanwhile job satisfaction ((67. 37±9. 76) vs (68. 91± 9. 67),t=-4. 474,P<0. 01) and subjective well-being(( 17. 93± 3. 80) vs (19. 85±3. 96),t=-14. 897,P<0. 01) increased in post-intervention in the health education group. After in-tervention,the effect of improving anxiety, depression, job satisfaction and subjective well-being in the MoodGYM group was more obvious than that in the health education group (P<0. 01). Conclusion -MoodGYM intervention can relieve anxiety and depression of nurses,improve their job satisfaction and sub-jective well-being.
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To observe the clinical efficacy of dopamine modulator methylphenidate (MPH) of extended-release formulations (MPH-ER) augmentation of ongoing fluvoxamine treatment in refractory obsessive-compulsive disorder (OCD) and its effects on patient's anxiety and sleep quality. Methods: A pilot randomized, placebo-controlled, and double-blind trial was conducted at an outpatient, single-center academic setting. Participants included 44 adults with serotonin reuptake inhibitor treatment-refractory OCD and they received a stable fluvoxamine pharmacotherapy with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores higher than 20. The 44 patients were randomly assigned into a study group and a control group, with 22 patiencs in each group. Fluvoxamine and MPH-ER were given to the study group, while fluvoxamine and placebo were given to the control group, with 8 weeks of the treatment course. Y-BOCS, Hamilton Anxiety Scale (HAMA) were used to assess the efficacy, Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality, and Treatment Emergent Symptom Scale (TESS) was used to evaluate the side effects. Data were analyzed in the intention-to-treat sample. Results: The improvement in the Y-BOCS total score, Y-BOCS obsession subscale score and HAMA score were more prominent in the study group than those in the control group (P<0.001). There was no significant difference in PSQI score and TESS score between the two groups. MPH-ER was well tolerated. Conclusion: Fluvoxamine combined with MPH-ER is effective in the treatment of refractory obsessive-compulsive disorder. It can improve anxiety and has no adverse effect on sleep quality.
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Adult , Humans , Double-Blind Method , Drug Therapy, Combination , Fluvoxamine , Therapeutic Uses , Methylphenidate , Therapeutic Uses , Obsessive-Compulsive Disorder , Drug Therapy , Psychiatric Status Rating Scales , Treatment OutcomeABSTRACT
Objective To investigate the differences of cognitive functions among ultra high-risk individuals(UHR),first-episode schizophrenia patients and healthy controls.Methods Twenty four participants meeting clinical inclusion criteria for initial prodromal states (IPS) selected from the first degree relatives of schizophrenia,23 first onset schizophrenia patients from the same family with UHR as well as 30 healthy controls were assessed with a comprehensive neuropsychological test battery including Trail Making Test (TMT),Stroop color word test and the Continuous Performance Test (CPT) to test the speed of information processing and sustained attention ability.Results ①The time of the Trail Making Test in UHR ((45.12±14.87) s) was shorter than first-episode schizophrenia patients((60.43± 19.30)s),but longer than healthy controls((27.13±7.74) s).The whole score of the Stroop color word test in UHR (28.46± 7.87) was higher than first-episode schizophrenia patients (18.78± 6.86),and lower than healthy controls (43.40±9.64).The score of the Continuous Performance Test in UHR (1.86 ± ± 1.05) was significanly higher than first-episode schizophrenia patients(1.17±0.67),but lower than healthy controls (2.63±0.67),and all these differences were significant (P＜0.01).②Taking age,years of education,occupation status,marital status and the Positive and Negative Syndrome Scale (PANSS) scores as the covariance,the analysis of covariance showed TMT and Stroop color word test were still statistically significant.Conclusion There are cognitive function changes in individuals at ultra high-risk for psychosis,lying between first-episode schizophrenia cases and healthy controls.
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ObjectiveTo help physicians improve detection rate of depressive and anxiety disorders by exploring the complaints of gastrointestinal(GI) outpatients with these disorders in the general hospitals.Methods A multicenter cross-sectional study was conducted from May to June in 2007.A total of 1995 subjects from 13 general hospitals in China were screened with the hospital anxiety and depression scale ( HADS ) and patient health questionnaire 15-item (PHQ-15).Meanwhile patients'complaints were recorded.Psychiatrists interviewed subjects scored ≥8 on HADS and made diagnoses by using the mini international neuropsychiatric interview(MINI).There were 323 outpatients diagnosed as depressive or anxiety disorders and 1287 outpatients without diagnosis of depressive or anxiety disorders.The complaints and PHQ-15 sores were compared between these two groups.The logistic regression analysis was used to determine the risk of having depressive or anxiety disorders with the number of complaints as an independent variable.ResultsSome symptoms between two groups were statistically significant,including weakness(34.1％ vs 18.8％ ;χ2 =18.04; P=0.000),fatigue(9.6％ vs 5.7％ ;χ2 =6.58,P=0.010)and insomnia( 7.1％ vs 3.4％ ; χ2 =8.87 ; P =0.003 ).Logistic regression analysis showed that with each additional complaint,the odds for an interview-based diagnosis of depressive or anxiety disorders increased,the odds ratio(OR) was 1.12(95％ CI,1.08 ～ 1.17,P=0.000).In comparison to the outpatients without depressive or anxiety disorders,outpatients with these disorders signifycantly had higher PHQ-15 scores (( 11.12 ± 4.92 ) vs (6.68 ± 4.05 ) ; t =16.84,P =0.000).ConclusionThe GI outpatients with depressive and/or anxiety disorders have worse mental heath and more complaints,compared to patients without these disorders.These results may help physicians to better identify depressive disorders and anxiety disorders.
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@#ObjectiveTo analyse the requirement and attitude to mental health knowledge and the influence factors among the psychosis patients, the caregivers and the healthy pepople.MethodsThe questionnaire survey conducted among the psychosis patients, the caregivers and the healthy pepople from 12 communities which served as the stations for the psychosis where 12 prefectures were organized uniformly by Guangdong Provincial Federation of Disabled Persons.Results1080 sheets of questionnaire were provided, and 986 replied to meet the requirements. The caregivers showed significant difference in requirment and attitude to mental health knowledge compared to the psychosis patients and the healthy pepople(P＜0.05-0.001). The main influence factors were cultural education, regional economic, the frequency of inpatient, the anxiety emotion of the caregivers, which were statistical significance(P＜0.05-0.001).ConclusionIt is lack in the requirement and cognition to mental health knowledge among the psychosis patients, the caregivers and the healthy pepople. Cultural education and economic development are the effective measures to improve the level of the mental health knowledge.
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Objective To evaluate the effect of combination treatment by psychological intervention and a new atypical antipsychotic Paliperidone extended-release tablets(paliperidone ER)on first-episode schizophrenic out-patients.Methods All 62 patients diagnosed as first-episode schizophrenia by DSM-Ⅳ were randomly allocated into,combination treatment group and control group,for a 12-month treatment study.The combination treatment group was treated by paliperidone ER once a day and psychological counseling once a month,while the control group was treated only by paliperidone ER.The efficacy and social function were assessed by Positive and Negative Syndrome Scale(PANSS)and Personal and Social Performance Scale(PSP)individually at baseline,and following 1,3,6,9,12 months.The remission rate was calculated at the end of the 3rd,6th,9th month.The safety and tolerability were assessed using Barnes Akathisia Scale(BARS),extrapyramidal side effects scale(SAS)and involuntary movement scale(AIMS).Results Twenty-seven patients of combination treatment group and seventeen patients of the control group completed the trial with the discontinuation rate 12.9% and 45.2%,respectively.The difference between the above two groups was statistically significant(P＜0.05).The mean total score of PANSS and the PSP of the both groups were significantly improved(P＜0.05)after treatment.PANSS total score reduced more than 30% compared with baseline,and PSP total score increased more than 7.The remission rate of combination treatment group was 74.2%,51.6% and 67.7% at the end of 3rd,6th,and 9th month,which was better than the control group(45.2%,38.7% and 38.7%)(P＜0.05).Both incidence and types of adverse events were almost same between the two groups.The major adverse events were extrapyramidal symptoms,tachycardia,gastrointestinal discomfort and akathisia.Conclusion Paliperidone ER treatment combined with psychological intervention on first-episode schizophrenia out-patients can improve their treatment compliance by reducing the discontinuation rate.And this combination treatment can increase the remission rate and improve social functioning of the patients.
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Objective To analyze the family burden of the caregivers of the psychosis patients in community, and the psychosocial factors which influence the family burden.Methods Conducted some questionnaires to survey the requirement and attitude on mental health knowledge,social support,family burden and coping style of the caregivers of the psychosis patients from the twelve communities which served as the stations for the psychosis of the twelve prefectures organized uniformly by Guangdong provincial disabled federation.Results 360 questionnaire was provided,and 308 replied to our questionnaire effectively.The mean score of each single item of the family burden questionnaire was beyond the moderate.The factor score of the economy burden was the highest among the factots of the economy burden(2.33±0.52),the daily activity of the family(2.17±0.53),the recreation activity of the family(2.00±0.58),the family relationship(2.10±0.54),the body health of the family members (2.03±0.65),and the mental health of the family members(2.09±0.68).The bad emotion and experience with the patients aggravated some factors of the family burden(P<0.05～0.01).According to correlation analysis and regression analysis,there were significant relation and impact between family burden with the requirement and attitude on mental health knowledge,subject support,coping style,age,economy,culture and so on(P<0.05～0.01). Conclusion Negative assumption to mental health will aggravate the family burden,transfering the positive message and changing passive coping style will help to reduce the family burden.
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@#ObjectiveTo investigate the negative emoion and the relative factors in the caregivers of the schizophrenia patients in community. Methods212 caregivers from 12 communities psychotic service stations in 12 prefectures in Guangdong were investigated with the Zung Self-rate of Depression, the experience and attitude of the psychosis, the requirement and attitude on mental health knowledge, the social support scale, the family burden scale and the simply coping style questionaire. ResultsThere were 112 caregivers with no depression (52.8%), 57 with mild depression (26.9%), 30 with middle depression (14.2%), 13 with severe depression (6.1%). More than 50% caregivers worry about unsafty, getting into trouble, worse reputation, genetics, felt scare, strained relationship with the patients. There were significant differences in the hopelessness, the strained relaionship, treatment in other cities, superstition, hospitalization longer between the depression and no depression group, as well as in the economy burden, the interference in the family living, the amusement of family, the family relaionship, the body health and the mental health of the other family members, but no significant in the factors of the requirement and attitude on mental healh knowledge. The caregivers with depression reported less social support than the caregivers with no depression, but there was no difference between these groups in utilization of support. ConclusionThe caregivers of the schizophrenia patients experience negative emotion in community, who need mental and material assistance and the education of the knowledge about diseases.
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@#ObjectiveTo investigate the negative emoion and the relative factors in the caregivers of the schizophrenia patients in community. Methods212 caregivers from 12 communities psychotic service stations in 12 prefectures in Guangdong were investigated with the Zung Self-rate of Depression, the experience and attitude of the psychosis, the requirement and attitude on mental health knowledge, the social support scale, the family burden scale and the simply coping style questionaire. ResultsThere were 112 caregivers with no depression (52.8%), 57 with mild depression (26.9%), 30 with middle depression (14.2%), 13 with severe depression (6.1%). More than 50% caregivers worry about unsafty, getting into trouble, worse reputation, genetics, felt scare, strained relationship with the patients. There were significant differences in the hopelessness, the strained relaionship, treatment in other cities, superstition, hospitalization longer between the depression and no depression group, as well as in the economy burden, the interference in the family living, the amusement of family, the family relaionship, the body health and the mental health of the other family members, but no significant in the factors of the requirement and attitude on mental healh knowledge. The caregivers with depression reported less social support than the caregivers with no depression, but there was no difference between these groups in utilization of support. ConclusionThe caregivers of the schizophrenia patients experience negative emotion in community, who need mental and material assistance and the education of the knowledge about diseases.
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or physicians and specialists other than psychiatric professionals in general hospitals should be enhanced together with psychiatric consultation.
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BACKGROUND: As indicated by experiments on animal, cytokine has regulatory effects on sleep. Clinical research has found abnormal level of cytokine in patients with depression. Sleep rhythm disorder is a common symptom of depression; however, the relationship between cytokine and sleep has hardly been conducted at home and abroad.OBJECTIVE: To explore the relationship between abnormal level of cytokine and clinical characteristics of sleep disorder so as to provide theoretical basis for early intervention and functional detection of sleep disorder in patients with depression.DESIGN: A case-controlled study using the patients with depression as the subjects and normal persons as the controls.SETTING: Two wards of the Department of Psychiatry of a university hospital.PARTICIPANTS: The study was completed in the Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical College. The subjects in this study were divided into depression group and control group. The patients in depression group were hospitalized in the Second Affiliated Hospital of Xinxiang Medical College from September 2001 to December 2001. Inclusion International Classification of Diseases(10th edition) and Chinese Classifiliver function, electrocardiography and kidney function examination were quilizer or lithium salt were used in the past year; had the history of alcohol Had endocrine, heart, liver and kidney diseases and other serious somatic diseases. The 35 patients who met the above criteria were 14 males and 21females aged from 18 to 60 years with the average age of(36 ± 12) years in the depression group. In the control group there were 13 males and 17 females aged from 19 to 60 years with the average age of(34 ± 10)years.METHODS: The levels of plasma interleukin-2(IL-2) and solute interleukin-2 receptor(sIL-2R) were detected with enzyme-linked immunoadsorbent assay.disorder in patients with depression.RESULTS: The level of plasma IL-2 in the depression group(77.92± 36.85) pg/L was lower than that of the normal control group (98.98± 30. 72 ) pg/L( t = 2. 446, P ＜ 0.05). Moreover, IL-2 level was positively correlated to depth of sleep level( r = 0. 364, P ＜ 0. 05) . No significant difference in sIL-2R level was found between the two groups( P ＞ 0.05).CONCLUSION: The development of sleep disorder in patients with depression may be related with the level of cytokine, and the decrease of IL-2level can be the neurobiological basis of sleep level in depression.
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0.05), but each gene expression level was higher in schizophrenic or siblings than in normal controls(P0.05), and the correlation between the gene expression levels of IL-1? and TNF-? were significant in all groups(r=0.847 or 0.942, P
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Three key ethical issues in neurotherapeutics research are discussed: the ethical challenges arising from changes in the financial incentive of researchers and their institutions,risk-benefit analysis on testing innovative interventions,and the research for informed consent.
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0.05), but each gene expression level was higher in schizophrenic or siblings than in normal controls (P
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Objective:To explore the quality of life in patients with primary insomnia.Methods:Comprising 85 patients diagnosed as primary insomnia and 57 healthy controls,the study analyzed and compared the differences in quality of life between the two groups.Results:(1)Compared with healthy controls,the patients with primary in- somnia decreased in quality of life.total score,Physical functions,psychological function and social function in pri- mary insomnia group were significantly lower than those in control group in score of generic quality of life inventory (score:254.9?26.4/287.1?30.4,t=-5.15,P