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Objective@#To explore the prevalence and related factors of suicide attempt among patients with major depressive disorder (MDD) and to provide a scientific theoretical basis for preventing suicide attempts in patients with MDD.@*Methods@#The researchers selected 162 patients with MDD based on the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) diagnostic criteria from some patients presenting in the department of Psychology at the First Affiliated Hospital of China Medical University during the January 2017 to March 2018, using the Structured Clinical Interview for DSM-Ⅳ-TR Patient version (SCID-P) as a screening tool. The self-designed General Information Questionnaire and Hamilton Depression Scale-17 items (HAMD-17) were used to investigate and evaluate the factors that affected suicide attempt.@*Results@#The detection rate of suicide attempt was 17.3% (28/162). Compared with the two groups with or without a history of suicide attempt, the age of the MDD patients (Z=-2.183, P=0.029), the place of residence of the MDD patients (χ2=5.405, P=0.020), and the total score of the HAMD-17 scale (t=-2.132, P=0.035), the score of the depression factor (Z=-3.627, P<0.001), guilt factor score (Z=-3.086, P=0.002), the score of the suicidal ideation factor (Z=-5.088, P<0.001) and sleepiness score (Z=-2.021, P=0.043) were significantly different. Multivariate logistic regression analysis showed that age (OR=0.930, P=0.022) was a protective factor of suicide attempt and the residence in rural areas (OR=3.955, P=0.038), severe depression (OR=3.795, P=0.020) and suicidal ideation (OR=2.496, P=0.002) were independent risk factors for attempted suicide.@*Conclusions@#Residence in rural areas, younger age, suicidal ideation and depression are independent risk factors for suicide attempt of depressive patients. Clinical psychologists in general hospitals should strengthen the evaluation of these factors when inquiring to prevent the occurrence of suicide attempt.
ABSTRACT
Objective To explore the prevalence and related factors of suicide attempt among patients with major depressive disorder (MDD) and to provide a scientific theoretical basis for preventing suicide attempts in patients with MDD.Methods The researchers selected 162 patients with MDD based on the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) diagnostic criteria from some patients presenting in the department of Psychology at the First Affiliated Hospital of China Medical University during the January 2017 to March 2018,using the Structured Clinical Interview for DSM-Ⅳ-TR Patient version (SCID-P) as a screening tool.The self-designed General Information Questionnaire and Hamilton Depression Scale-17 items (HAMD-17) were used to investigate and evaluate the factors that affected suicide attempt.Results The detection rate of suicide attempt was 17.3％ (28/162).Compared with the two groups with or without a history of suicide attempt,the age of the MDD patients (Z =-2.183,P =0.029),the place of residence of the MDD patients (x2 =5.405,P =0.020),and the total score of the HAMD-17 scale (t =-2.132,P =0.035),the score of the depression factor (Z =-3.627,P ＜ 0.001),guilt factor score (Z =-3.086,P =0.002),the score of the suicidal ideation factor (Z =-5.088,P ＜0.001) and sleepiness score (Z =-2.021,P =0.043) were significantly different.Multivariate logistic regression analysis showed that age (OR =0.930,P =0.022) was a protective factor of suicide attempt and the residence in rural areas (OR =3.955,P =0.038),severe depression (OR =3.795,P =0.020) and suicidal ideation (OR =2.496,P =0.002) were independent risk factors for attempted suicide.Conclusions Residence in rural areas,younger age,suicidal ideation and depression are independent risk factors for suicide attempt of depressive patients.Clinical psychologists in general hospitals should strengthen the evaluation of these factors when inquiring to prevent the occurrence of suicide attempt.
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China Medical University was approved to offer psychiatry major for five-year undergraduate in 2016, exploring the cultivating ideas and objectives. The general cultivating target is set to meet the basic requirements of clinician and meanwhile help students acquire the knowledge about psychology, psychiatry and so on. The curriculum system includes a number of characteristic professional courses, such as psychology outlines, clinical psychiatry, clinical psychology, psychiatric foundations, child and adolescent psychiatry. Concerning about the cultivating approach, the university sets up the office of psychiatry department, and establishes the responsibility system of department director, class tutor system, and whole mentor system. Furthermore, the university establishes the evaluation system of students' learning effect, including both the evaluation analysis of teacher and personal growth report. Consequently, the cultivating model has achieved an initial success.
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Objective To investigate gender differences of plasma glial cell line-derived neurotro-phic factor (GDNF) levels in patients with major depressive disorder (MDD). Methods MDD subjects (male 20,female 36) and healthy controls (HCs) (male 35,female 45) were divided into four groups by gender. Plasma levels of GDNF were measured and compared in different gender groups. The clinical symp-tom severity of MDD patients was evaluated by 17-item Hamilton Depression Scale (HAMD-17) and Hamil-ton Anxiety Scale (HAMA-17). Results (1)The plasma GDNF level in male patients with major depres-sive disorder (( 1. 55 ± 0. 43 ) pg/ml ) was significantly lower than that in healthy controls (( 1. 86 ± 0. 50)pg/ml,F=4. 64,P=0. 036). There was no significant difference in GDNF level between female de-pression patients((1.62±0.46)pg/ml)) and female healthy control((1. 64±0. 48)pg/ml,F=0. 18,P=0. 672). In HCs,the GDNF level of male was significantly higher than that of female((1. 86±0. 50)pg/ml, (1. 64±0. 48)pg/ml,F=2. 04,P=0. 045). There was no significant difference in GDNF level between male and female patients(P>0. 05). (2) GDNF level in male patients with major depressive disorder was nega-tively correlated with HAMA score(r=-0. 388,P=0. 034). Conclusion The expression of GDNF is affect-ed by sex factors,which may be related to the different pathogenesis of MDD.
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Objective To research the changes of regional gray matter volumes in first-episode, medication naive females with major depressive disorder. Methods Magnetic resonance imaging and voxel-based mor-phometry were used to compare regional gray matter volumes between 14 medication-naive female participants with a first episode of major depressive disorder ( MDD) ( age( 29. 5 ±6.8) years, number of education years(11.4 ± 2. 7) years, duration of iIIness(5.4 ±5. 2 ) months, H AMD score(27.6 ±5.5)) and 14 female healthy comparison participants (HC) (age(29.5 ±6.9)years,number of education years( 12. 2 ±3. 3)years,HAMD score(2. 1 ± 1.9)). Results Volumes of bilateral anterior cingulate cortex ( ACC) and right amygdala were significantly smaller in the MDD group than those in the HC group. Conclusion These results suggest that volume reductions in ACC and amygdala in females with MDD are present at illness onset.
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Objective To research the effects of tianeptine and lithium on expression of pCREB in hippocampus of chronic stress depression rats. Methods All the experimental rats were divided by random into : Group of depression,Group of tianeptine,Group of lithium and Group of control. The rats of Group of depression, Group of tianeptine and Group of lithium were applied stress for 21 days,and meanwhile Group of control had no stress. The rats of Group of tianeptine were fed with tianeptine (50 mg/kg) , Group of lithium were fed with lithium (60 mg/kg) , while another groups were fed with normal sodium of the same volume. The ethology examination was performed by using method of open-field and experiment of fluid consumption. The expression of pCREB was detected by Western-blotting method. Results After the chronic stress,the horizontal crossing numbers,the erection times,the modification times and the percentage of sacchar-consumption of the rats of Group of depression were 23.2±23.0;8. 1 ±7.2; 3.6 ±3.5 and (55.4 ±11.7)% respectively, which were less than Group of control (46.0±18.9;20.3±11.3;8.4±2.7 and (68.5 ±8.2)% ; P＜0.01). The horizontal crossing numbers(28. 1 ±23.0) ,the erection times(12. 1 ± 9.4) and the modification times(5.5 ±3.2) of Group of tianeptine are less than those of Group of control (P ＜ 0. 05), but no significant difference compared with Group of depression; the percentage of sacchar-consumption(62.7 ± 10.6) % ,Group of tianeptine was more than Group of depression (P＜ 0.05 ) , but no obvious difference with Group of control. The horizontal crossing numbers, the erection times, the modification times and the percentage of sacchar-consumption of Group of lithium were less than those of Group of control (P ＜ 0.05), more than those of Group of depression but no significant difference (P ＞ 0.05). In Westernblotting method,the level of pCREB in the hippocampus of Group of depression was less than that of Group of control (P＜ 0.01); that of Group of tianeptine was more than that of Group of depression (P ＜ 0.01) but no obvious difference with Group of control; that of Group of lithium was less than that of Group of control (P＜0. 01) and more than Group of depression (P＜0.01). Conclusion Tianeptine could reverse the reduction of expression of pCREB in hippocampus of chronic stress depression rats and lithium partly did it.