Effects of apolipoprotein E genetic polymorphism on susceptibility of depression and efficacy of antidepressants / 中国医学科学院学报

<p><b>OBJECTIVE</b>To assess the effects of apolipoprotein E (APOE) polymorphism on the susceptibility of depression and the efficacy of antidepressants.</p><p><b>METHODS</b>A total of 275 patients with depression, who met the diagnostic criteria of both CCMD-3 and DSM-4, were randomly assigned into venlafaxine group (n=136)and paroxetine group(n=139). Another 202 healthy subjects were enrolled as the control group. Hamilton Rating Scale for Depression (HAMD)-17 was adopted as the primary rating instrument to evaluate the severity of depression on the baseline and the end of the 1st, 2nd, 4th, 6th week after treatment, respectively. HAMD scores ≤7 was defined as remission, and the reduction of HAMD scores ≥50% was defined as response while <50% was defined as invalid. PCR-restriction fragment length polymorphisms (PCR-RFLP) was applied to detect the genetic polymorphism of the APOE in the case groups and control group.</p><p><b>RESULTS</b>In the venlafaxine group, the remission rate was 52.9%(n=72), the response rate was 26.5%(n=36), and the invalid rate was 20.6%(n=28), whereas the corresponding data in the paroxetine group wee 42.4%(n=59), 31.7%(n=44), and 25.9% (n=36), respectively. There were no significant differences in the efficacy between the two groups(p>0.05). In the venlafaxine group, there were no significant differences in the genotypes and the allele distribution frequency of APOEΕ2/Ε3/Ε4 between the remitters, nonremitters, and healthy controls at the end of the 6th week(p>0.05), but there was significant differences in the allele distribution frequency between the nonremitters and healthy controls(p=0.02). In paroxetine group, there were no significant differences in the genotypes and the allele distribution frequency of APOEΕ2/Ε3/Ε4 among the remitters, nonremitters and healthy controls at the end of the 6th week(p>0.05), but there were significant differences in the allele distribution frequency between the nonremitters and healthy controls (p=0.04); in addition, there were also significant differences in Ε2/Ε3 and Ε4 allele between the two groups (p=0.014).</p><p><b>CONCLUSIONS</b>The APOE gene may not play a major role in the pathogenesis of major depression. The efficacy of venlafaxine is same as paroxetine after treatment for six weeks. The APOE (Ε2+Ε3) allele may be an indicator of the bad efficacy of paroxetine treatment.</p>

A comparative study on mental health among students and adults in the earthquake-hit areas / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand mental health status of the students and adults in the earthquake disaster areas, as to providing guidance on intervention for post-disaster psychological crisis.</p><p><b>METHODS</b>The Self-Reporting Questionnaire (SRQ-20), an appendix of The Ministry of Health of "emergency psychological crisis intervention guiding principles", was used among 1222 victims in Wenchuan earthquake, Sichuan province. This questionnaire survey was conducted in 729 students and 493 adult victims in a randomized method. Of the 734 questionnaires distributed and received in students, 729 were validly responded with efficiency rate of 99.32%; while for adults, 496 questionnaires distributed, 496 received, 493 were valid with efficiency rate of 99.39%.</p><p><b>RESULTS</b>(1) In students victims, 65% responded that they did feel "uneasy, nervous or worried", followed by "easy to be scared", "feel unhappy", "easy fatigue" and "hard to make a decision". For adult victims, 80.5% replied that they felt "uneasy, nervous or worried", followed by "feel unhappy", "easy fatigue", "difficult sleeping", "easy to be scared". (2) The average of the SRQ score of student victims was 6.58 +/- 3.99, and 6.07 +/- 4.02 for males, 7.03 +/- 3.91 for females. The average of the SRQ score of student victims was 7.36 +/- 3.98, male 6.68 +/- 3.82, female 7.99 +/- 4.03. The significant differences (t(women) = 2.985, P < 0.01; t(total) = 3.332, P < 0.01) was observed in women and the total group of students and adults. (3) The SRQ positive screening rate of students group was 46.50%, the adult group was 52.33%, SRQ >or= 7 points and SRQ < 7 sub-group of students and adults of the total score there were significant differences (t(1) = 39.771, P < 0.01; t(2) = 31.961, P < 0.01). SRQ >or= 7 sub-group of students and adult women in between there was a significant difference (t = 23.641, P < 0.01), SRQ < 7 sub-group of students and adults in general and women there were significant differences (t(1) = 3.092, P < 0.01; t(2) = 2.911, P < 0.01). (4) SRQ scores with gender and age had had a positive relation (r(SRQ total-sex) = 0.118, P = 0.000; r(SRQ total-age) = 0.103, P = 0.000).</p><p><b>CONCLUSION</b>The emotional suffering symptoms of students victims and adult victims should be "nervous, unhappy, vulnerable on issues such as fatigue", the adult group had a higher symptom rate than the group of students, the mental health was more serious than that of students, as influenced by some factors including age and gender. Students, being a special population group should be paid more attention to focusing a designated behavior intervention, as a planned manner of intervention.</p>