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Objective To investigate the relationship between the severity of insomnia and the curative effect in acute stage in patients with major depressive disorder (MDD). Methods The Insomnia Severity Index (ISI) was used to evaluate and group the severity of insomnia in the 57 patients with MDD. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The 24－item Hamilton Depression Scale (HAMD24) was used to evaluate depressive symptoms, and the effect of acute stage (4～6 weeks) was evaluated with its reduction rate. The difference of curative effect was compared among patients with different insomnia levels. Results There was a significantly different recovery rate in acute stage in 3 groups of patients with mild, moderate and severe insomnia ( X2=22.34,P＜0.01). The severity of insomnia in patients with MDD (PSQI) was negatively correlated with the curative effect of acute stage (r=－0.44,P＜0.01). The total score, anxiety/somatization factor score, retardant factor score and despair factor score were significantly higher in severe insomnia group than in the moderate and mild insomnia groups after acute treatment (P＜0.01). Conclusion The severity of insomnia in patients with MDD can predict the curative effect in acute stage. The depressive patients with severe insomnia have residual anxiety/somatization, retardant, feelings of despair and other symptoms more obvious than mild and moderate insomnia patients after acute treatment.
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Objective To explore the short term effects of five second-generation antipsychotics on the serum pro?lactin levels of first-episode schizophrenia patients. Methods Two hundred fifty first-episode schizophrenia patients were randomly divided into five groups and were then treated with risperidone, olanzapine, paliperidone, quetiapine or ziprasidone, respectively. The serum prolactin were tested at baseline, and every week following initiation of treatment. The positive and negative symptom scale (PANSS) and the treatment emergent symptom scale (TESS) were used to evalu?ate the effect and side effect of treatment. Results Repeated measure ANOVA for serum prolactin showed that the main effects of time, the main effect of group, and the interactive effect of time and group were significant (all P0.05). Conclusion The level of serum prolactin gradually increases in schizophrenia patients receiving treatment of antipsychotics. The short term effects of different second generation antipsy?chotics on serum prolactin vary differently. Risperidol and olanzapine result in the elevation of serum prolactin level in the early period of treatment.
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Objective To test the efficacy of cognitive behavioral self help therapy for chronic insomnia (CBTI-SH) patients with hypnotic long-term use.Methods A total of 60 adults with chronic insomnia and common comorbidities were recruited.Participants were randomly assigned to either intervention group (IG,n =30) if they had used hypnotics more than 6 months,or control group(CG,n =30) if they had never used hypnotics in the past 6 months.All the patients were given CBTI-SH for 4 weeks.The primary outcome was self-report symptom,based on sleep diaries (including Sleep Latency(SL),Wake after Sleep Onset(WASO),Total Sleep Time(TST),Time In Bed(TIB),Sleep Efficiency(SE) which were evaluated on baseline and at the end of the 2nd,4th week treatment.Continuous variables were evaluated by repeated-measures multivariate analyses of variance (MANOVA).At the conclusion of treatment,each participant was asked how many days per week they enacted each of 6 core elements of the CBT regimen.Linear regression models were examined to determine net predictors of CBTI-SH adherence.Results The MANOVA showed a significant treatment group × time interaction,as well as time main effects for SE,TIB and WASO(P＜0.05).The patients in CG made better improvements than those in IG on SE,TIB and WASO((0.19 ±0.08) vs(0.09 ±0.09),(92.48 ± 32.64) vs (78.06 ±60.05),(103.08 ±64.82) vs (64.92 ±56.36),respectively) (P ＜ 0.05).Effect size were 1.14,0.85 and 0.62 respectively.Self-ratings of treatment adherence showed patients in the IG reported less adherence to standard rise time and TIB prescription than those in CG.(P ＜ 0.05).According to the linear regression models,both age and the comorbidity of chronic somatic diseases explained net associations with CBTI-SH adherence (P ＜ 0.05).Conclusion Chronic insomnia patients with hypnotic long-term use show less sleep improvement and less adherence to CBTI-SH compared with those who don' t use these medicines.Both age and the comorbidity of chronic somatic diseases explain net associations with CBTI-SH adherence.
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Objective To explore the magnetic resonance spectroscopy characteristics of prefrontal white matter in bipolar Ⅱ disorder and its relation with executive function.Methods Thirty bipolar Ⅱ disorder patients and twenty healthy controls were evaluated with Multi-Voxel proton magnetic resonance spectroscopy (1H-MRS)scans on prefrontal white matter to assess the N-acetyl-aspartate (NAA),Choline (Cho),Creatine (Cr) and myoinositol (MI),and then the ratios of NAA/Cr,Cho/Cr,MI/Cr,NAA/Cho and NAA/Cho + Cr were calculated.All subjects were assessed for executive function using the Wisconsin Card Sorting Test (WCST).Results NAA/Cr in right prefrontal white matter(1.43 ± 0.26) and NAA/Cr,NAA/Cho,NAA/Cho + Cr in left prefrontal white matter (separatelyl.40 ± 0.29,1.13 (1.53,0.24),0.62 ± 0.12) were lower than healthy controls (separately 1.58 ±0.18,1.59,0.23,1.30 (0.53 ± 0.29),0.71 ± 0.08) (P ＜ 0.05).The correct trials and the number of categories of WCST in Bipolar Ⅱ disorder (separately 26.97 ± 8.97,3(6,3)) were less than in healthy controls(separately 36.35±4.85,5 (3,2)),and perseverative errors and random errors were more in patients (separately 12.77 ±5.73,7 (21,5)) than healthy controls (separately 7.35 ± 3.01,4 (13,2)).NAA/Cho and NAA/Cho + Cr in left prefrontal white matter were positively correlated with correct trials,number of categories,and negatively related with perseverative errors (P＜0.05).Conclusions Bilateral prefrontal white matter fiber damage occurs to bipolar Ⅱ disorder.And left prefrontal white matter fiber damage in bipolar Ⅱ disorder may lead to executive impairment.
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Objective To explore the relationships between different marital satisfaction of women with childbearing age and sexual life satisfaction, personality characteristics, coping style and social support. Method-s Three hundred and fifty-one complete cases were randomly obtained by means of ENRICH's marital satisfaction and sexual life satisfaction,EPQ,and etc,and further divided into high marital satisfaction(group A, n=170) and low marital satisfaction(group B, n=181) according to the mean score of the whole sample's macital satisfaction.Then comparisons were carried out between the two groups. Results (1)The means of sexual life satisfaction,Lacores and four indexes of social support in group A were significantly higher than those in group B(P<0.05),but P's and N's scores in group A lower than those in group B (P<0.05). (2) Stepwise multiple regression ana-lyses showed that only sexual life satisfaction (sβ=0.487) and objective social support (sβ=0. 158) entered the equation in whole sample (r=0.290). Conclusion (1) There axe significant differences of sexual life satisfac-tion, personality characteristics and social support among the women with different marital satisfactions. (2)Sexual life satisfaction, personality characteristics and social support are important influencing factors to marital satisfaction among the women.
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Thyroid function [triiodothyronine(T3), thyroxine(T4), free T3(FT3), free T4(FT4),and thyroid stimulating hormone (TSH) ] were tested by radioimmunoassay in 56 depressive patients with attempted suicide, 85 patients without suicide attempt and 40 healthy subjects (controls).The serum levels of T3 and FT3 in the patients with attempted suicide were lower than those in the patients without suicide attempt and the controls ( F = 4.937 and 5.01 1, both P ＜ 0.05 ).The lower serum levels of T3 and FT3might be the risk factor of suicide in depressive patients.
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Objective To explore the characteristics of both clinical symptoms and thyroid function between depressive patients with and without attempted suicide behavior. Methods Depressive patients were divided into two groups. The first group was composed of patients with attempted suicide behavior (n = 56) and the second group without attempted suicide behavior ( n = 85 ). Thyroid function (FT3, FT4 )were determined by radioimmunoassay method. The patients were evaluated by symptom checklist 90 (SCL90). Results The score of depressive factor in the group with attempted suicide [(2. 90 ± 1. 01 ) score]was higher than that of the group without attempted suicide [(2.51±0.77) score] ( ( t =2. 127, P =0. 036). The serum level of FT3 in the group with attempted suicide [(3.92 ±0. 52) pmol/L] was lower than that of the group without attempted suicide[(4.18 ±0.71) pmol/L] ( t =-2.219, P =0.028).Conclusions There were certain characteristics on clinical symptoms of depressive patients with attempted suicide. The low serum levels of FT3 might play an important role in the risk of suicide in depressive patients.
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Background During the past two decades, a number of rating scales were developed to facilitate diagnosis and assessment of subjects with social anxiety disorder. One of the most commonly used scales for the assessment of social anxiety disorder is the Liebowitz social anxiety scale (LSAS). The LSAS is widely used in epidemiologic investigations and clinical researches,and its assessment in the pharmacotherapy efficacy for social anxiety disorder is superior to any other scale. So we designed this study to explore the validity and reliability of the LSAS in Chinese patients with social anxiety disorder and normal control, and to find the difference of the scores between the patients self -report version and clinician-administered version. Methods Fifty five patients meeting the DSM-Ⅳ diagnostic criteria for social anxiety disorder and 168 normal controls who were screened from 222 college students were rated by LSAS, social phobia scale and self-made General Information Forms. Results The Cronbath α of LSAS for the patients and the normal controls was 0.83 and 0.77, respectively. The 4-week test-retest reliability for total scores and its factors scores of LSAS in 31 normal controls were ranging from 0.68 to 0.79. The ROC area under curve value in discriminating the patients from normal controls was 0.87±0.03; the total score of 35 was considered to be the best cut-off score for LSAS, then its sensitivity was 0.77 and its specificity was 0.81; and no significant difference between the self-report version and clinician-administered version. Conclusions The LSAS is good in internal consistency and test-retest reliability, and has high sensitivity and specificity in discriminating the patients and the controls. There is no significant difference in the total score and each factor scores of LSAS between self-report version and clinician-administered version.