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Objective:To investigate the psychology status and quality of life in patients with inflammatory bowel disease(IBD) in China, and to analyze the influencing factors.Methods:From September 2021 to May 2022, 42 hospitals in 22 provinces(autonomous regions and municipalities directly under the central government) in China, the clinical data of 2 478 IBD patients were collected, which included age, gender, weight, first visit or not, disease activity, disease course, main clinical manifestations(diarrhea, abdominal pain, hematochezia, extraintestinal manifestations), complications, treatment medication(5-aminosalicylic acid, glucocorticoids, immunosuppressive agents, and biological agents), and whether to have surgery. Anxiety, depression, sleep quality and quality of life of IBD patients were evaluated by generalized anxiety disorder-7 items, patient health questionnaire-9 items, Pittsburgh sleep quality index and inflammatory bowel disease questionnaire, and the related influencing factors were analyzed. Univariate analysis and multiple linear regression analysis were used for statistical analysis.Results:The average age of 2 478 IBD patients was 37.96 years old, and male counted for 62.43%(1 547/2 478). There were 61.82%(1 532/2 478) of the IBD patients in the active stage of disease, mostly mild or moderate(588 and 734 cases). There were 60.61%(1 502/2 478) of the IBD patients with different degrees of anxiety, 58.35%(1 446/2 478) of the IBD patients with different degrees of depression, and 48.87%(1 211/2 478) of the IBD patients had different degrees of sleep problems. The results of multiple linear regression analysis indicated that female, higher level of disease activity and longer disease course were independent risk factors of anxiety, depression and sleep quality in the IBD patients(unstandardized regression coefficient(95% confidence interval) 1.08(0.65 to 1.50), 0.45(0.23 to 0.68), 0.19(0.02 to 0.36), 0.83(0.33 to 1.32), 0.62(0.36 to 0.88), 0.28(0.08 to 0.47), 0.47(0.16 to 0.77), 0.39(0.23 to 0.55), 0.14(0.02 to 0.26); P<0.001, <0.001, =0.025 , =0.001, <0.001, =0.005, =0.003, <0.001, =0.027). The usage of biological agents was an independent protective factor of anxiety(unstandardized regression coefficient(95% confidence interval) -0.67(-1.17 to -0.17), P=0.008), and older age was an independent risk factor of sleep quality(unstandardized regression coefficient(95% confidence interval) 0.35(0.09 to 0.61), P=0.008). Higher level of disease activity, symptoms of diarrhea, abdominal pain, presence of extraintestinal manifestations, usage of 5-aminosalicylic acid and glucocorticoid, and with surgical treatment were independent risk factors of quality of life(unstandardized regression coefficient(95% confidence interval) -11.00(-12.24 to -9.76), -2.90(-5.26 to -0.55), -3.93(-6.25 to -1.61), -5.79(-9.87 to -1.71), -4.78(-7.79 to -1.76), -7.71(-11.07 to -4.35), -4.37(-8.00 to -0.73); P<0.001, =0.016, =0.001, =0.005 , =0.002, <0.001, =0.019), while the usage of biological agents was an independent protective factor of quality of life (unstandardized regression coefficient(95% confidence interval) 4.72(1.97 to 7.48), P=0.001). Conclusion:IBD patients generally have different degrees of anxiety, depression and sleep problems, which affect the quality of life of patients. Gender, disease activity and disease course are the influencing factors of mental disorders in IBD patients.
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Depression is a common psychiatric symptom in cerebral small vessel disease (CSVD), which has a certain relationship with impairment of cognitive function and can significantly increase the mortality and morbidity of CSVD patients. The occurrence of CVSD-associated depression is less related to psychological stress, but is associated with the impairment of the brain's emotional circuit. This article reviewed the correlation between the imaging features of CVSD and the occurrence and development of depression in recent years, and the neuroimaging mechanism of depression associated with CVSD. Many literatures have shown that deep white matter hyperintensities and asymptomatic lacunar infarction in the basal ganglia are independent risk factors for depression in CSVD, and the reduction of local brain volume is associated with depression. The neuroimaging mechanism of depression associated with CSVD suggests that the occurrence of depressive symptoms is related to the neural circuits in the lobar cortex-subcortical limbic area. These findings provide clues for exploring the neuropathological mechanisms and specific treatment methods of depression associated with CVSD.
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Objective:To investigate the effectiveness of mindfulness training on the emotional regulation and resilience of college students.Methods:Eighty one college students were recruited and randomly divided into mindfulness training group and control group, of which 74 completed the study (36 in mindfulness training group and 38 in control group). Participants in mindfulness training group received an 8-week mindfulness training, while participants in control group received no intervention. Participants were assessed with the Five Facet Mindfulness Questionnaire (FFMQ, measuring mindfulness level), Profile of Mood State (POMS, measuring emotion) and the Resilience Scale for Chinese Adolescent(RSCA, measuring resilience) before and after intervention (4 and 8 weeks).Results:Before and after the intervention, the interaction effects of total score of five factors mindfulness, scores of observing, actaware, non-judging, total score of resilience, scores of goal planning, help-seeking and the fatigue score were significant(all P<0.05). There were significant differences in mindfulness level, mood state and resilience scores in mindfulness training group before and after intervention(all P<0.05). There were significant differences of scores of FFMQ , POMS and RSCA post-training compared with baseline( P<0.05). The total score of FFMQ was improved significantly after 4 weeks of intervention ((114.92±11.70) vs(110.36±11.24), P<0.05), while the scores of observing((26.19±5.21) vs(24.00±5.34)), describing((23.36±4.82) vs(21.19±4.76)), non-judging((23.75±4.20) vs(22.06±4.99)) and non-reacting((19.72±3.16) vs(18.58±3.61)) were improved significantly after 8 weeks of intervention. There were significant differences of the scores of fatigue, depression-dejection, panic, vigor-activity and total mood disturbance before and after the intervention in mindfulness training group (all P<0.05). The scores of fatigue((12.31±4.08) vs(13.39±5.12)), panic((12.08±3.57) vs(13.67±4.35)) and total mood disturbance((132.94±17.71) vs(145.75±22.68)) were reduced significantly after 8 weeks of intervention (all P<0.05), while the scores of vigor-activity were improved significantly after 8 weeks of intervention ((18.31±4.61) vs (15.39±4.99), P<0.01). The participants in mindfulness training group got significantly higher total score, scores of goal planning, help-seeking, and affect control of RSCA after intervention compared with baseline (all P<0.05). Conclusion:Mindfulness training can enhance the mindfulness level and resilience of college students, decrease negative affect such as fatigue, depression, panic, and increase positive affect such as activity.
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Objective This study aims to investigate the sex difference in the hippocampus and parahippocampus in patients with bipolar disorder. Methods We acquired T1－weighted structural MRI from 133 bipolar type I patients (60 males) and 144 normal controls (81 males). The General Linear Model was used to examine the relationship between sex and brain volumes of the hippocampus and parahippocampus, with age and intracranial volume as covariates. Results Patients showed significantly smaller volumes of the bilateral hippocampus and parahippocampus (P＜0.01). There were sex－by－diagnosis interactions in the left parahippocampus gyrus (F=6.534, P=0.044). Male patients had significant smaller volumes of the left parahippocampus gyrus compared to the male normal controls (P＜0.001) whereas the volumes were not significantly different between female patients and female normal controls (P＞0.05). Conclusion The results suggest sex difference in the left parahippocampus gyrus volume in patients with bipolar type I disorder, which deserves further investigation in the future bipolar imaging researches.
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Objective To estimate brain grey matter volume changes and location of abnormal brain regions cerebrum in early stage of bipolar disorder I (BD),in order to provided objective basis for diagnosing early stages BD.Methods 1 7 cases of BD with duration less than 2 years and 1 7 normal controls were recruited in this study.The volumetric difference of grey matter between two groups were analyzed by using voxel-based morphometry(VBM)software.Statistical threshold was voxel> 100,P <0.001 (uncor-rected).Results Compared to the normal controls,the grey matter volume of BD patients decreased in the left dorcial anterior cingu-late cortex(ACC),left insular,right sub-genu ACC,left superior temporal cortex,bilateral hippocampus-parahippocampus-amydala and left posterior lobe of cerebellum(P <0.001).Conclusion The grey matter volume of early stage BD patients is decreased,main-ly locating in the bilateral limbic system,the superior temporal gyrus and the cerebellar cortex,which probably is the morphological appearance of pathomechanism in early stages of BD.
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ObjectiveTo examine biochemical characteristics of the frontal lobe and hippocampus in unaffected parentsof schizophreniaprohandsusingprotonmagneticresonancespectroscopy(1H-MRS).Method 19 unaffected fathers of schizophrenia probands with matched 19 male healthy control subjects and 24 unaffected mothers of schizophrenia probands with matched 24 female healthy control subjects were included in the study.1 H-MRS was performed in two sides of the hippocampus and frontal lobes regions.The ratios of N-Acetylaspartate ( NAA ),choline (Cho) to creatine (Cr) were measured.One-sample T test and paired-samples t test were used for statistic process.ResultsUnaffected mothers of schizophrenia probands had a higher Cho/Cr ratio ( left ( 1.10 ± 0.13,right ( 1.08 ± 0.12 ) ) in the frontal white matter compared with matched female health control subjects(left( 1.03 ± 0.10),right( 1.02 ± 0.09 )).The NAA/Cr ratio was significantly reduced in the left frontal white matter of female health control subjects compared to right( 1.64 ± 0.12 vs 1.74 ± 0.13 ),but this difference was not observed in unaffected mothers of schizophrenia probands.There were no significant differences in metabolites for frontal lobe and hippocampus regions between unaffected fathers of schizophrenia probands and male healthy control subjects groups( all P＞0.05 ).ConclusionThe results implicate that the metabolic abnormalities and disappeared asymmetry of NAA/Cr might exist in the frontal white matter among unaffected mothers of schizophrenia probands.
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ObjectiveTo identify the metabolic alterations on prefrontal lobes and hippocampus in male patients with the first-episode mania using proton magnetic resonance spectroscopy(H-MRS).Method 18 male patients with the first-episode mania and 27 healthy subjects matched for age,gender,and years of education were included in the study.1 H-MRS was performed in two sides of the hippocampus and frontal lobes regions.The ratios of N-acetylaspartate (NAA),choline (Cho) to creatine (Cr) were measured.One-sample t test and paired-samples t test were used for statistic process.ResultsMale patients with the first-episode mania presented decreased NAA/Cr in left frontal lobe and hippocampus regions when compared to normal controls( left frontal lobe (1.68 ±0.19 vs 1.86 ± 0.19),hippocampus ( 1.32 ± 0.10 vs 1.43 ± 0.16 ),P ＜ 0.01 ),but there were no significant difference in NAA/Cr for right frontal lobe and hippocampus regions between groups ( all P ＞ 0.05 ).Two groups also showcd no significant difference for Cho/Cr in bilateral frontal lobe and hippocampus (P ＞ 0.05 ).Conclusion There is significant difference of manifestation of 1H-MRS between male patients with mania and normal controls,which reflects neuronal dysfunction in the prefrontal lobes and hippocampus.
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Objective To detect the patterns of cognitive impairment between patients with paranoid schizophrenia and patients with bipolar mania by using the Cambridge Neuropsychological Test Automated Battery (CANTAB) ,and to explore research clues for finding of cognitive endophenotype in patients with paranoid schizophrenia or bipolar mania. Methods Six CANTAB subtests and the seven subtests of the Wechsler Abbreviated Scale of Intelligence (WAIS short form) were administered to 35 patients with paranoid schizophrenia and 33 patients with bipolar mania who were drug naive experiencing an acute episode, as well as 30 healthy controls. Results Patients with paranoid schizophrenia and bipolar mania demonstrated impairments in 13 of the 15 cognitive indicators in CANTAB. After controlling IQ, both patient groups remained as significantly different from normal controls in terms of search strategy(36. 8 ±3.56,37.24 ±4. 21,30. 33 ±6.24) ,between-search errors(40. 86 ± 19.97,40.24 ± 18.92,15.4 ±17.22) on the SWM test,the proportion of hits(0.54 ±0. 18,0.56 ±0.15,0.78 ± 0.17) on the RVIP test,total errors(45.26 ±36.36,46.61 ±33.32,14 ± 11.7) and EDS errors (12.43 ±9.96, 13.18 ±8.98,4.97 ±6.09)on the IED test. Between search error in the SWM test was positively correlation with YMRS scores ( r=0.38, P=0.039) in bipolar patients. Conclusion Both patient groups demonstrated a comparable profile of cognitive impairments during active periods of their condition. The cognitive impairment index may be a discreet cognitive endophenotype overlapping the disorders.
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Cultivation of Medical Humanism Spirit has special value in the teaching of psychiatry,but which was ignored in the teaching. This paper explored the way to integrate humanistic spirit education into the teaching process of psychiatry.