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Somatic symptom disorder are common in childhood, and associated with high-risk adult psychiatric disorders and more unexplained hospitalization.They are one of the factors that seriously hinder health sound growth of children.In this article, domestic and foreign studies on somatic symptom disorders were reviewed to discuss their concept change, etiology and pathogenesis, clinical manifestation, diagnosis, evaluation and treatment, in order to facilitate early identification and treatment of somatic symptom disorders in childhood.
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BackgroundDepression is a kind of disease with relatively high suicide risk， which seriously affects the quality of life of patients and their families， and brings a great burden to society. Antidepressants in western medicine are effective， but the improvement of depressive symptoms is relatively limited by single use， and the combination of two antidepressants may increase the risk of adverse reactions in patients. The rational use of Chinese patent medicine and western medicine may play a complementary role， and the safety of Chinese patent medicine is high. ObjectiveTo explore the early clinical efficacy of fluoxetine combined with Shugan Jieyu capsule in the treatment of depression， and to compare the differences in efficacy， safety and influence on heart rate variability between fluoxetine combined with Shugan Jieyu capsule and fluoxetine alone， so as to provide references for clinical medication of depression patients. MethodsFrom December 2015 to June 2016， 64 patients who met the diagnostic criteria of depression in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） who were hospitalized in the Second Affiliated Hospital of Xinxiang Medical University were selected as the research objects， and were randomly divided into the combined medication group and the fluoxetine group with 32 patients in each group. Patients in both groups were treated with fluoxetine， while patients in the combined medication group were treated with Shugan Jieyu capsule on this basis. Patients in both groups were assessed with Hamilton Depression Scale-24 item （HAMD-24）， Hamilton Anxiety Scale （HAMA） and Heart Rate Variability （HRV） before treatment， and were assessed with HAMD-24 and Treatment Emergent Symptom Scale （TESS） at the end of the 2nd， 4th and 6th week of treatment， and HRV was analyzed again at the end of the 6th week of treatment. ResultsThe study ultimately included 60 patients with depression， with 30 cases in the combination therapy group and 30 cases in the fluoxetine group. At the end of the 2nd， 4th and 6th week of treatment， the HAMD-24 score of the combined drug group was lower than that of the fluoxetine group （t=-2.677， -3.960， -4.432， P<0.05 or 0.01）. Compared with before treatment， the 24-hour mean standard deviation of normal RR intervals （SDNN）， normal low frequency （nLF） and normal high frequency （nHF） in the combined treatment group were higher at the end of the 6th week （t=-73.970， -31.878， -38.721， P<0.01）， but significant lower in LF/HF （t=3.525， P<0.01）. At the end of the 6th week of treatment， the total effective rate of the combined treatment group was higher than that of fluoxetine group， and the difference was statistically significant （86.67% vs. 70.00%， χ2=18.764， P<0.01）. At the 2nd， 4th and 6th week of treatment， there was no significant difference in the number of adverse reactions between the two groups （P>0.05）. ConclusionCompared with fluoxetine alone， Shugan Jieyu capsule combined with fluoxetine may be better in clinical efficacy and improvement of heart rate variability in patients with depression， without increasing adverse reactions.
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Depressive disorder is one of the common mental disorders, and its occurrence is usually attributed to the combined effects of multiple factors.The single genetic factor can't fully explain the cause of depressive disorder.Family factors have an important impact on the occurrence of depressive disorder, however, the impact of family factors on depressive disorder and its treatment has not been paid enough attention to.This paper reviewed the recent researches on family factors affecting depressive disorder and family therapy for depressive disorder.The results showed that family factors had an impact on depression patients of any age, and adverse family factors were risk factors for the occurrence, sustainable development and recurrence of depressive disorder.Most of the previous studies were horizontal, but few were longitudinal research.Family therapy plays a positive role in the treatment of depressive disorder and has a significant effect on the acute phase of depression except for major depressive disorder (MDD). Family therapy can quickly relieve the symptoms of depression.Further studies on family-based treatment intervention strategies for MDD are needed in the future, and more longitudinal studies are needed to further analysis of the influence of family factors on depressive disorder.
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Objective:To explore the latent categories of child security and analyze domain-specific roles of child neglect on security among children aged 10-13 years.Methods:From October to December 2019, the security questionnaire (SQ), child neglect scale (CNS) and Buss-Perry aggression questionnaire (BPAQ) were used to investigate 577 children aged 10-13 years. Mplus 7.0 software was used for latent profile analysis (LPA) to explore the latent categories of child security. SPSS 22.0 software was used for multinomial Logistic regression to examine the effects of different domains of child neglect on the child security categories.Results:(1) Child security was divided into three categories named "medium-slightly low-security subgroup (48.9%)" , "high-security subgroup (31.8%)" , and "inability control subgroup (19.3%)" (entropy = 0.90, Lo-Mendell-Rubin likelihood, and Bootstrapped likelihood ratio test, all P<0.01). (2) Child security(35.06±6.08, 51.49±4.99, 69.67±6.13, F=1 378.09, P<0.01), neglect(71.09±20.58, 59.96±12.90, 50.76±9.27, F=74.50, P<0.01), and aggression(54.31±15.23, 46.44±12.46, 34.19±12.61, F=90.95, P<0.01) were significantly different among the "medium-slightly low-security subgroup" , "high-security subgroup" , and "inability control subgroup" . (3)Compared with "high-security subgroup" , the proportion of children with poor parental relationship and low paternal education level were higher in the other two subgroups(all P<0.05), while the proportion of children in the fifth grade were lower(all P<0.05). (4)In " inability control subgroup" , safe neglect had no impact on security( B=0.01, OR=1.02, 95% CI=0.91-1.13, P>0.05), while physical neglect ( B=0.13, OR=1.14, 95% CI=1.01-1.28), affection neglect( B=0.14, OR=1.15, 95% CI=1.07-1.23), and communication neglect( B=0.15, OR=1.16, 95% CI=1.03-1.30) predicted the "inability control subgroup" (all P<0.05). Only communication neglect predicted the "medium-slightly low-security subgroup" ( B=0.16, OR=1.17, 95% CI=1.07-1.28, P<0.01). Conclusion:Security is heterogenous with three latent categories among Children aged 10-13 years. Child neglect plays domain-specific roles in different child security categories.
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ObjectiveTo investigate the P300 evoked by Stroop Color Word Task in children with emotional neglect, and to explore their implication for inhibition control. MethodsA cluster sampling was conducted for the first grade students of a middle school in Sanmenxia City, Henan Province. The students from 3 classes were assessed by standard Raven reasoning test and Child Neglect Scale (CNS), and a total of 147 eligible students were screened out. Children were divided into the emotional neglect group (n=40) and the control group (n=40) according to the 27% before and after the score of CNS emotional neglect factor. Both groups completed the Stroop Color word task, and EEG data were collected to compare the response time, accuracy, amplitude and latency of P300 between the two groups. ResultsThe CNS total score and the scores of safety neglect, communication neglect, physical neglect and emotional neglect factors in the emotional neglect group were significantly higher than those in control group (t=15.003, 4.301, 11.495, 4.803, 23.957, P<0.01). The average reaction time in the incongruent task of emotional neglect group was significantly longer than that in the control group [(879.02±101.52) ms vs. (756.93±113.91) ms, t=5.061, P<0.01]. Under incongruent task, the average amplitude of P300 in emotional neglect group was lower than that of the control group [(3.97±1.12) μV vs. (8.71±1.24) μV, t=-17.976, P<0.01]. The average latency of P300 of emotional neglect group was longer than that of the control group [(361.81±39.69) ms vs. (301.35±33.67) ms, t=7.346, P<0.01]. ConclusionUnder incongruent task, children with emotional neglect had longer response time, longer latency and lower amplitude of P300， which suggested that children with affective neglect may have inhibition and control disorder.
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ObjectiveTo investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders. MethodsFrom March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence. ResultsA total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ2=14.015， 7.502， 13.106， P<0.05 or 0.01）. In the questionnaire of influential factors on medication adherence， there were statistically significant differences in the scores of lack of insight， stigma and drug-related factors between the two groups （Z=7.588， 2.379， 2.893， P<0.05 or 0.01）. Outpatient chronic disease reimbursement was a protective factor for medication adherence （OR=2.727， 95% CI： 1.320~5.634， P<0.01）， while rural residence （OR=0.465， 95% CI： 0.221~0.977， P<0.05） and lack of insight （OR=0.398， 95% CI： 0.286~0.553， P<0.01） were risk factors for medication adherence. ConclusionPatients with severe mental disorders in Zhengzhou have a high rate of medication adherence， moreover， the outpatient chronic disease reimbursement， lack of insight and residence may be influencing factors for medication adherence in patients with severe mental disorders.
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Non-suicidal self-injury (NSSI) refers to the behavior that intentionally and directly injures one′s own body organization without suicidal intention, which is not recognized by the society.Children have gradually become a high-risk group of NSSI behavior, which seriously affects children′s physical and mental health.This review aims to summarize the epidemiology, influencing factors, behavior characteristics, treatment and prognosis of children′s NSSI behavior, aiming to identify children′s NSSI behavior and provide interventions as early as possible to prevent the occurrence of repeated NSSI behavior.
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The purpose of this paper is to optimize the course construction and teaching process of psychopharmacology， and analyze the problems in the course of teaching and assessment of psychopharmacology from many aspects. This article is to deeply excavate the space for improvement， and enrich the teaching links by using existing conditions， technology and personnel to enhance the teaching effect and improve the teaching quality， so as to provide references for the reform of similar course teaching.
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ObjectiveTo explore the effect of flipped classroom mode in the clinical probation teaching for undergraduate mental health students， so as to expand the new mode of clinical teaching in psychiatry department. MethodsA total of 85 undergraduate psychiatric students from Xinxiang Medical University in 2016 were selected. All participants were divided into experimental group （n=43） and control group （n=42） according to the random number table method. The flipped classroom clinical teaching mode was adopted to experimental group， and the traditional practice mode for control group. The probation lasted for 12 weeks. Theoretical knowledge of symptomology， psychiatric clinical skills （OSCE）， doctor-patient communication ability（SEGUE） and clinical thinking ability were assessed at the end of probation. ResultsAfter the probation， students in experimental group obtained higher scores in theoretical knowledge， clinical skills， doctor-patient communication ability and clinical thinking ability compared with control group. The differences were statistically significant ［（33.08±1.72） vs. （32.06±2.33）， （51.61±2.12） vs. （48.32±2.86）， （18.14±1.98） vs. （14.62±2.15）， （91.26±14.13） vs. （82.40±10.89）， t=2.307， 6.034， 3.230， 7.846， P<0.05 or 0.01］. ConclusionApplying the flipped classroom mode into the clinical probation teaching for mental health undergraduate students may help to improve students' theoretical knowledge level and clinical operation ability， faciliate doctor-patient communication， and have a positive impact on their clinical thinking ability.
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ObjectiveTo investigate the prevalence rate of mobile phone dependence， and to analyze the mediating role of emotional intelligence between parenting rearing behavior and mobile phone dependence among college students， so as to provide references for relieving the mobile phone dependence among college students. MethodsStratified cluster sampling method was applied to enroll 1 200 students from three colleges in He'nan province， and the selected individuals were assessed using Parental Bonding Instrument （PBI）， Mobile Phone Addiction Index （MPAI） and Emotional Intelligence Scale （EIS）. Then the relationship between parenting rearing behavior and mobile phone dependence was discussed， and the mediating effect of emotional intelligence was explored using AMOS path analysis. ResultsOf the students who completed the survey， 597 out of 1 090 （54.77%） suffered from mobile phone dependence. The scores of care and encouragement of behavioral freedom in PBI were negatively correlated with the total score and each dimension score of MPAI （r=-0.316~-0.197， P<0.01）， the denial of psychological autonomy score in PBI was positively correlated with the total score and each dimension score of MPAI （r=0.206~0.258， P<0.05 or 0.01）. EIS score was negatively correlated with total score and each dimension score of MPAI （r=-0.317~-0.219， P<0.01）. The indirect effect sizes of maternal care， encouragement of behavioral freedom and denial of psychological autonomy on mobile phone dependence through emotional intelligence were 47.98%， 47.00% and 42.93%， respectively. The indirect effect sizes of paternal care， encouragement of behavioral freedom and denial of psychological autonomy on mobile phone dependence through emotional intelligence were 47.99%， 48.71% and 44.70%， respectively. ConclusionEmotional intelligence partially mediates the relationship between parental rearing behavior and mobile phone dependence.
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Objective:To evaluate the effect of job-transfer training for psychiatrists in Henan province in 2018 and to compare them with the results of 2016.Methods:Data of the trainees were collected through questionnaires in 2017 and 2019 respectively. The influencing factors of knowledge and skills were determined by Multiple linear regression analysis; baseline data, training intention, training feedback and the proficiency of knowledge and skills were compared by independent sample t test and chi-square test. Results:The overall satisfaction rate for training was 98.3%, and the overall mastery rate of training knowledge and skills was 59.2% in year 2018. Compared with 2016, the willingness to participate in training, the satisfaction rate, the recognition degree of " 1+ 10+ 1" training mode, the degree of mastery and practical application of training knowledge and skills increased( P<0.05). There were statistically significant differences in the distribution of the primary reasons for participating in the training, factors hindering their participation in the training, and the causes for their failure to fully apply their learning to practice( P<0.01). The results showed that scope of practice, title, intention, and interest in psychiatry was related to the mastery of training knowledge and skills( P<0.05). Conclusions:The effect of training in 2018 is better than 2016, and the degree of mastery and practical application of training knowledge and skills should be increased.
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Objective@#To explore the socioeconomic status and psychological characteristics of the children with oppositional defiant disorder(ODD), and to provide evidence for revealing the pathogenesis of ODD.@*Methods@#General Conditions Questionnaire and Achenbach Children′s Behavior Checklist Scale (CBCL) were used to evaluate 44 cases of ODD children aged 8 to 14 years old who were first referred to the Eighth People′s Hospital of Zhengzhou City from August 2016 to January 2017, and 50 healthy children were randomly selected according to their grades from a primary school in Zhengzhou.Chi-square test and independent sample t test were used to analyze data.@*Results@#The father′s and mother′s education levels and family per capita income in ODD group were lower than those in healthy control group, and their academic achievements in ODD group were worse than those in healthy control group, and the diffe-rences were statistically significant(all P=0.000). The scores of schizoid (2.32±2.73), depression(4.48±6.12), social problems(3.09±3.34), compulsion(4.05±5.60), social withdrawal(2.39±3.20), hyperactivity(4.95±4.37), aggressive behavior(7.59±7.62) and rule-breaking(2.91±3.85) in ODD children were higher than those of the healthy control group(1.04±1.37, 1.48±2.06, 0.68±1.13, 0.78±1.46, 0.60±1.16, 1.70±1.98, 2.48±3.28, 0.62±1.58), and the differences were statistically significant(all P<0.05). The scores of social problems(2.85±3.33), compulsion(3.96±5.11), social withdrawal(2.63±3.16), hyperactivity(5.44±4.50) in male ODD children were higher than those in the male healthy children(0.80±1.05, 1.30±1.92, 0.95±1.50, 2.15±1.56), and the differences were statistically significant(all P<0.05). Compared with the female children(0.83±1.22, 1.10±1.84, 0.60±1.18, 0.43±0.92, 0.53±1.09, 0.37±0.80, 1.40±2.17, 1.87±2.14, 0.30±0.78), the scores of schizoid(2.24±2.64), depression(4.65±4.93), social problems(3.47±3.37), compulsion(4.18±6.38), somatic complaints(2.12±3.65), social withdrawal (2.00±3.26), hyperactivity(4.18±4.12), aggressive behavior (8.24±7.26) and rule-breaking(3.76±4.85) in female ODD children were significantly higher, and the differences were statistically significant(all P<0.05). There was no significant gender difference in the score of CBCL scale in ODD group(all P>0.05).@*Conclusions@#There are significant emotional and behavioral problems in ODD children whose family socioeconomic status is lower, and their psychological characteristics vary with gender differences.
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Objective To explore the socioeconomic status and psychological characteristics of the children with oppositional defiant disorder(ODD),and to provide evidence for revealing the pathogenesis of ODD.Methods General Conditions Questionnaire and Achenbach Children's Behavior Checklist Scale (CBCL) were used to evaluate 44 cases of ODD children aged 8 to 14 years old who were first referred to the Eighth People's Hospital of Zhengzhou City from August 2016 to January 2017,and 50 healthy children were randomly selected according to their grades from a primary school in Zhengzhou.Chi-square test and independent sample t test were used to analyze data.Results The father's and mother's education levels and family per capita income in ODD group were lower than those in healthy control group,and their academic achievements in ODD group were worse than those in healthy control group,and the differences were statistically significant(all P =0.000).The scores of schizoid (2.32 ± 2.73),depression(4.48 _± 6.12),social problems (3.09 ± 3.34),compulsion (4.05 ± 5.60),social withdrawal (2.39 ± 3.20),hyperactivity (4.95 ±4.37),aggressive behavior(7.59 ± 7.62) and rule-breaking(2.91 ± 3.85) in ODD children were higher than those of the healthy control group(1.04 ± 1.37,1.48 ± 2.06,0.68 ± 1.13,0.78 ± 1.46,0.60 ± 1.16,1.70 _± 1.98,2.48 ±3.28,0.62 ± 1.58),and the differences were statistically significant (all P ＜ 0.05).The scores of social problems (2.85 ± 3.33),compulsion (3.96 ± 5.11),social withdrawal (2.63 ±3.16),hyperactivity (5.44 _± 4.50) in male ODD children were higher than those in the male healthy children (0.80 ± 1.05,1.30 ± 1.92,0.95 ± 1.50,2.15 ±1.56),and the differences were statistically significant (all P ＜ 0.05).Compared with the female children (0.83 ±1.22,1.10 ±1.84,0.60 ± 1.18,0.43 ±0.92,0.53 ± 1.09,0.37 ±0.80,1.40 ±2.17,1.87 ±2.14,0.30 ±0.78),the scores of schizoid (2.24 _± 2.64),depression (4.65 ± 4.93),social problems (3.47 ± 3.37),compulsion (4.18 ±6.38),somatic complaints (2.12 ± 3.65),social withdrawal (2.00 ± 3.26),hyperactivity (4.18 ± 4.12),aggressive behavior (8.24 ± 7.26) and rule-breaking(3.76 ± 4.85) in female ODD children were significantly higher,and the differences were statistically significant(all P ＜ 0.05).There was no significant gender difference in the score of CBCL scale in ODD group(all P ＞ 0.05).Conclusions There are significant emotional and behavioral problems in ODD children whose family socioeconomic status is lower,and their psychological characteristics vary with gender differences.
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Objective To systematically evaluate the efficacy and compliance of domestic ketogenic diet(KD) for children with refractory epilepsy (RE),in order to provide the basis for further improving the curative effect and compliance by finding out the factors influencing efficacy and compliance. Methods The effect of KD on children with RE was investigated by systematically searching China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(CSTJ),Wanfang Data Knowledge Service Platform and PubMed database from January 1, 1989 to January 17,2018. The relevant literature R3. 0. 2 software was used to combine the retention rate and therapeu-tic effect in different periods,based on the systematic analysis of the therapeutic efficacy and compliance literature. Results A total of 11 eligible documents were included. (1)The methodological index for non - randomized studies (MINORS)scores of included literature were rated from 10 to 18 points. (2)A secondary analysis of 9 literatures on the description of the subject′s composition showed that the proportion of male to female in children with RE ranged from 1. 441. 00 to 2. 731. 00,and that of 9 literatures included a total of 331 samples,there were 212 male and 119 female,the ratio of male to female was 1. 781. 00. (3)The sources of the included literatures were from Beijing, Shanghai,Changsha,Shenzhen,Nanchang,Zhengzhou,Suzhou,Chongqing,Shenyang and Xi′an. (4)The retention rates of 1 month(5 studies),3 months(10 studies),6 months(7 studies)and 12 months (6 studies)were respectively 93％ [95％ confidence interval (CI):88％ - 98％],80％ (95％ CI:71％ - 98％),70％ (95％ CI:61％ - 78％) and 54％ (95％ CI:37％ - 71％). (5)According to the Meta - analysis,the effective rate of 1 month(6 studies), 3 months(10 studies),6 months(7 studies)and 12 months (7 studies)were respectively 57％ (95％ CI:34％ -79％),68％ (95％ CI:57％ - 79％),76％ (95％ CI:62％ - 89％)and 80％ (95％ CI:68％ - 93％). (6)Through analyzing the adverse reactions and the causes of termination,the literature showed that common adverse reactions in-volved digestive system (72 cases),infection (23 cases),urinary calculus (4 cases),and the metabolic disorder. The reason of treatment termination was that the children were not cooperative (26 cases)and the parents had poor comp-liance (24 cases). Conclusion KD is one of the effective methods for treating RE in children. Reducing or relieving adverse reactions in KD to improve the treatment compliance of children with RE and their families is a subject worthy of further study and attention.
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Good sleep plays a key role in children's physical growth,mental development and personality matu-rity.Sleep disorders are common and most easily neglected problems in children.Early sleep problems of children can sustain from childhood to adulthood,not only have relevance to the children's physical,cognitive and behavioral development,but also to be the high risk factors of the adult obesity,hypertension,depression,anxiety and other chronic diseases.A deep study of sleep disorders in children is very important for the protection of children's physical and men-tal health.This article reviews the etiology,classification,diagnosis and treatment of sleep disorders in children.
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Children impulse control disorder (CICD)is a kind of psychological disorder occurred in childhood. The early recognition and intervention in children with CICD have important significance for the healthy growth of chil-dren. Now,the classification,etiology,epidemiology,clinical features,differential diagnosis and treatment of CICD are reviewed in order to improve the recognition and treatment level of CICD.
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Objective To explore the rapid eye movement (REM) sleep characteristics of different episode types of depression and post-stroke depression (PSD) patients and provide support for clinical diagnosis,treatment and prognosis.Methods Patients with single-episode depression (group A,n =22),patients with recurrent depression (≥ 2 episodes,group B,n=26) and patients with PSD (group C,n=19)were included from Henan Provincial Mental Hospital.20 healthy volunteers were assigned to control group.Participants in the 4 groups were performed polysomnographic recordings (PSG) from 9 PM to 6 AM before treatment.The 3 patients groups were performed the second PSG recordings and HAMD score at the end of 6 week SSRIs treatment.The REM indexes of 4 groups were compared and analyzed.Results First PSG detection showed that REM sleep latencies (RL) were shorter in group A and B (A:(65.57±18.29) min,B:(66.32±15.46) min) than that in group C ((79.17±20.18) min) and control group((87.24±16.55)min);REM activity (RA) (A:(99.82±25.71) u,B:(104.70±28.23) u)and REM density (RD) (A:(81.06± 19.35)％,B:(86.61±23.83) ％) were increased more significantly in group A and B than those in control group ((79.61 ± 18.40) u;(68.11 ± 17.54) ％);REM sleep time (RT) were decreased more signifi-cantly in group C ((51.66±22.26) min) than that in group A((71.43±20.70) min),group B((74.81±17.52) min) and control group ((70.46±16.35) min)(P＜0.05).After treatment,REM sleep latency was prolonged in group A ((65.57±18.29) min vs (81.71±21.62) min),and REM activity was decreased in group A((99.82±25.71) u vs (83.58±27.19) u),the difference was statistically significant (P＜0.05).REMdensity was decreased,but the difference was not statistically significant (P＞0.05).There was no significant difference in the indexes of REM in group C;RT was prolonged ((51.66± 22.26) min vs (68.37 ± 20.16)min) in group C,the difference was statistically significant (P＜0.05).Conclusion Most of depression patients with different episode types have REM disinhibition phenomenon.RD increase may be REM characteristic type of depression patient.Sleep disorders of PSD patients are mainly poor sleep process and sleep continuity and have no characteristics of REM sleep disorder of depression ones.
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Objective To explore the rapid eye movement (REM) sleep characteristics of different episode types of depression and post-stroke depression (PSD) patients and provide support for clinical diagnosis,treatment and prognosis.Methods Patients with single-episode depression (group A,n =22),patients with recurrent depression (≥ 2 episodes,group B,n=26) and patients with PSD (group C,n=19)were included from Henan Provincial Mental Hospital.20 healthy volunteers were assigned to control group.Participants in the 4 groups were performed polysomnographic recordings (PSG) from 9 PM to 6 AM before treatment.The 3 patients groups were performed the second PSG recordings and HAMD score at the end of 6 week SSRIs treatment.The REM indexes of 4 groups were compared and analyzed.Results First PSG detection showed that REM sleep latencies (RL) were shorter in group A and B (A:(65.57±18.29) min,B:(66.32±15.46) min) than that in group C ((79.17±20.18) min) and control group((87.24±16.55)min);REM activity (RA) (A:(99.82±25.71) u,B:(104.70±28.23) u)and REM density (RD) (A:(81.06± 19.35)％,B:(86.61±23.83) ％) were increased more significantly in group A and B than those in control group ((79.61 ± 18.40) u;(68.11 ± 17.54) ％);REM sleep time (RT) were decreased more signifi-cantly in group C ((51.66±22.26) min) than that in group A((71.43±20.70) min),group B((74.81±17.52) min) and control group ((70.46±16.35) min)(P＜0.05).After treatment,REM sleep latency was prolonged in group A ((65.57±18.29) min vs (81.71±21.62) min),and REM activity was decreased in group A((99.82±25.71) u vs (83.58±27.19) u),the difference was statistically significant (P＜0.05).REMdensity was decreased,but the difference was not statistically significant (P＞0.05).There was no significant difference in the indexes of REM in group C;RT was prolonged ((51.66± 22.26) min vs (68.37 ± 20.16)min) in group C,the difference was statistically significant (P＜0.05).Conclusion Most of depression patients with different episode types have REM disinhibition phenomenon.RD increase may be REM characteristic type of depression patient.Sleep disorders of PSD patients are mainly poor sleep process and sleep continuity and have no characteristics of REM sleep disorder of depression ones.
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Objective To explore the relationship between responsibility and social adaptation of the left-behind middle school students and to provide evidence for mental health education of left-behind children.Methods 290 left-behind middle school students were selected by cluster-random-sampling.All of them were assessed by the middle school students' social adaptability scale (SAS-SSS),the inventory of parent and peer attachment (IPPA) and the scale of high school students' responsibility.Results The correlation between responsibility,attachment behavior and social adaptation of left-behind middle school students were significant(r=0.39,r=0.56,P＜0.01).There were significant differences between gender on the responsibility(male(202.64±26.78) vs female(212.67±23.24)).Regression analysis showed that mother attachment,overall responsibility,general responsibility and special fault responsibility could predict the social adaptation(P＜0.05).Responsibility and its factors played a mediating role between attachment and adaptation,taking 52.1％,20.1％,30.8％,9.1％,47.9％,40.7％ proportion of the total effect.Conclusion Responsibility is an important factor affecting the social adaptation of left-behind middle school students.
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Objective To study the status of professional commitment and its effect on self-esteem of non-medical undergraduates in medical colleges. Methods Totally 410 non-medical under-graduates and 403 medical undergraduate were investigated by professional commitment of undergrad-uate scales and self-esteem questionnaire of undergraduates. T test,chi-square test,ANOVA,corre-lation analysis and multiple regression analysis were employed to do statical analysis,with P<0.05 be-ing statistical differences. Results Non-medical undergraduates’scores of professional commitment (85.11 ±11.60)and self-esteem (2.57 ±0.37)were lower than those (93.82 ±11.43)and (2.62 ± 0.35) of medical undergraduates. There were statistical differences in non-medical undergraduates’ professional commitment concerning the variables of professional consistency (t=5.657,P=0.000)and grades (F=8.528,P=0.000). Professional commitment of non-medical undergraduates was positively correlated with self-esteem. There was linear regression relationship between the variables of emotion-al commitment (P=0.005),normative commitment (P=0.006)and self-esteem. Conclusions Non-medical undergraduates' professional commitment and self-esteem levels are lower than those of medical undergraduates. The professional commitment could produce obvious effects on self-esteem.