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Objective:To investigate the effects of biologics on psychological status and quality of life in patients with inflammatory bowel disease (IBD).Methods:A cross-sectional survey was conducted in 42 hospitals in 22 provinces (autonomous regions and municipalities directly under the central government) from September 2021 to May 2022. General clinical information and the use of biologics were obtained from adult patients diagnosed with IBD who voluntarily participated in the study. Psychological status was evaluated using the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and Inflammatory Bowel Disease Questionnaire (IBDQ) assessment tools. Counts were analyzed via the Chi-square test, and datasets that were not normally distributed were analyzed via nonparametric tests. P<0.05 was considered statistically significant. Results:A total of 2 478 valid questionnaires were collected. The GAD-7 score of the biologics group was significantly lower than that of the non-use group [6 (2, 9) vs. 7 (3, 10), Z=-3.49, P<0.001]. IBDQ scores [183 (158, 204) vs. 178 (152, 198), Z=-4.11, P<0.001], intestinal symptom scores [61 (52, 67) vs. 58 (49, 65), Z=-5.41, P<0.001], systemic symptom scores [28 (24, 32) vs. 27 (23, 31), Z=-2.37, P=0.018], emotional ability scores [69 (58, 77) vs. 67 (56, 75), Z=-3.58, P<0.001] and social ability scores [26 (22, 29) vs. 25 (22, 29), Z=-2.52, P=0.012] in the biologics group were significantly higher than in the non-use group. GAD-7 scores [5 (2, 9) vs. 6 (3, 10), Z=-3.50, P<0.001] and PSQI scores [6 (4, 9) vs. 6 (4, 9), Z=-2.55, P=0.011] were significantly lower in the group using infliximab than in the group not using it. IBDQ scores were significantly higher in patients using vedolizumab than in those not using it [186 (159, 205) vs. 181 (155, 201), Z=-2.32, P=0.021] and were also significantly higher in the group treated with adalimumab than in the group not treated with adalimumab [187 (159, 209) vs. 181 (155, 201), Z=-2.16, P=0.030]. However, ustekinumab had no significant effect on any of the scores. Conclusion:The use of biologics is strongly associated with improvements in anxiety status and quality of life in IBD patients.
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Objective:To investigate the associations of brain white matter integrity deficits, and to explore the association of fractional anisotropy (FA) abnormality with clinical symptoms and cognitive impairments, as well as the prediction effect of the FA alterations on symptoms and cognitive function outcomes in the acute stage of schizophrenia from the whole brain level based on magnetic resonance diffusion tensor imaging (DTI).Methods:From November 2019 to December 2020, thirty-eight patients with first-episode schizophrenia and 38 healthy controls were recruited in this study. Wisconsin card classification test (WCST), digit span test (DST forward/backward), verbal fluency test, Stroop (A/B/C), trail making test (TMT-A/B), as well as positive and negative syndrome scale (PANSS) were utilized to evaluate patients' cognitive function and clinical symptoms both before and after 8 weeks of risperidone monotherapy. T1-weighted images and DTI data of all the subjects were collected . FSL and SPM8 were used to preprocess MRI data and compare the between-group differences of FA. Support vector machine (SVM) analysis was used to evaluate the accuracy of abnormal FA values in differentiating schizophrenic patients from healthy controls. Finally, stepwise multiple regression analysis or generalized linear models were used to explore the associations between white matter integrity and symptoms or cognition.Results:Before treatment, patients' FA values of right medial temporal lobe (mTL), cuneus, anterior cingulate gyrus (ACG) and inferior parietal lobe (IPL) were significantly lower than those in healthy controls ( P<0.01, GRF corrected), and patients' FA values of bilateral middle cingulate gyrus (mCG) were significantly higher than those in the control group ( P<0.01, GRF corrected). SVM analysis showed that four combinations could distinguish the patients from the control with the most accurate rate of 89.47%. Patients' baseline decreased FA values in the right IPL were positively associated with their increased total response time in WCST ( β=0.489, P=0.003, FDR corrected), correct response time in WCST ( β=0.450, P=0.008, FDR corrected), error response time in WCST ( β=0.435, P=0.008, FDR corrected), TMT-B ( β=0.296, P=0.042, FDR corrected), Stroop-C ( β=0.345, P=0.035, FDR corrected), and PANSS-P ( β=0.321, P=0.042, FDR corrected). Reduced FA values in the right mTL in patient group were significantly negatively related to the total time spent on the TMT-A ( β=-0.425, P=0.009, FDR corrected) and TMT-B ( β=-0.325, P=0.026 with FDR correction). Increased FA values in right mCG in patient group demonstrated positive associations with total response time in the WCST ( β=0.585, P=0.002, FDR corrected), correct response time in WCST ( β=0.524, P=0.003, FDR corrected), error response time in WCST ( β=0.536, P=0.003, FDR corrected) and total time consuming in TMT-B ( β=0.484, P=0.004, FDR corrected), as well as negative associations with DST-forward ( β=-0.319, P=0.042, FDR corrected). After treatment, patients' percentage changes in total response time of WCST ( β=0.715, P<0.001, FDR corrected), correct response time of WCST ( β=0.752, P<0.001, FDR corrected), as well as total time-consuming of TMT-A ( β=1.333, P=0.001, FDR corrected) showed positive correlations with baseline increased FA values in the left mCG. Percentage alteration of Stroop-B was negatively correlated with baseline FA values in the right cuneus ( β=-0.745, P=0.015, FDR corrected). Conclusions:The combination of abnormal FA values in multiple brain regions may be potential biomarkers to distinguish schizophrenic patients from healthy volunteers. There was regional dependence in the associations of the impairment of white matter integrity with the cognitive impairment, the severity of psychopathological symptoms as well as the prognosis of patients in the acute stage.
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In recent years, the role of inflammation in depression has received people's attention.Studies have suggested that immune disorder may play an important role in depression, and patients with depression exhibit characteristic immunophenotypes.Inflammation seems to interact with a variety of pathogenesis of depression.Therefore, immunoregulation is becoming an adjuvant therapy for depression.Clinically, not only antidepressants show anti-inflammatory effects, but also anti-inflammatory drugs show antidepressant effects, and they mainly including non-steroidal anti-inflammatory drugs, statins, and cytokine inhibitors.In addition, some non-drug treatment methods are also given immunomodulatory effects, such as electric shock therapy, vagus nerve stimulation, acupuncture and exercise therapy.However, there are still some problems in immunomodulation therapy, such as immunomodulation therapy may be only effective for some subgroups of patients, and its efficacy and safety need to be evaluated.In the future, looking for more effective biomarkers and identifying immune-inflammation-related subtype of depression, will serve to explore new diagnosis and treatment strategies.
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Abstract Background Mental health disorders are common in China. There is a lack of knowledge and resources of mental health in China. Objectives To assess the levels of psychiatric resources and services in general hospitals in China. Methods Data regarding psychiatric departments, wards and staff were collected from 57 general hospitals in four provinces of China (Hubei, Zhejiang, Heilongjiang and Yunnan) between April 2014 and June 2014. Questionnaires were distributed to 1,200 non-psychiatric clinicians. Results Among the 57 hospitals, 50 provided mental health services, 36 had mental health wards, and seven had neither mental health clinics nor wards. The median number of mental health clinicians was six per hospital. The median number of specialized nurses was 42 per hospital. A total of 1,152 non-psychiatric clinicians with a career duration of 9.4 ± 8.9 years returned completed questionnaires. Only 6.9% reported a good understanding of the manifestation of anxiety and depressive disorders, 4.5% reported a good understanding of the diagnostic criteria, and 3.8% reported a good understanding of the treatment protocols. Discussion There is inadequate awareness of anxiety and depressive disorders among non-psychiatric clinicians in general hospitals in China. This awareness/understanding increased with increasing hospital level.
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Humans , Hospitals, General , Mental Disorders , Mental Health Services/supply & distribution , Anxiety Disorders , China , Health Knowledge, Attitudes, Practice , Mental Health/education , Cross-Sectional Studies , Health Personnel/education , Depressive Disorder , Health Resources/supply & distributionABSTRACT
Objective To investigate the therapeutic effect of total saponins of ginseng (GFS)combined with serotonin re-uptake inhibitor(SSRIs)fluoxetine on rats with myocardial infarction(MI)and depression.Methods Left thoracotomy and per-manent ligation of left atrial appendage were performed to establish MI model in SD rats ,and depression model was established by chronic uncontrollable mild stress.SD rats were randomly divided into control group ,MI depression group(MI+ D group) (intragastric perfusion with 2 mL saline) ,fluoxetine group(F group)(intragastric perfusion with 0.2% fluoxetine at 10 mL/kg) and ginseng fruit saponins+ fluoxetine group(GFS+ F group)(intragastric perfusion of 20 mL/kg ginsenoside + 10 mL/kg 0.2% fluoxetine). The depression degree ,survival rate ,cardiac function ,electrophysiological parameters and histological chan-ges were evaluated after 28 days of intervention.Results Compared with the control group ,the consumption of sugar water in MI+D group was significantly decreased ,and the frequency of climbing ,crawling distance and crawling speed were significantly lower than those of the control group.GFS+fluoxetine and fluoxetine significantly increased the consumption of sugar water , increased the frequency of climbing and crawling distance ,but the treatment of GFS+fluoxetine was better than fluoxetine ,and could also improve the crawl speed. There was no significant difference in survival rate between MI +D group ,F group and GFS+F group(P＝0.24).Compared with the control group ,LVEDD ,LVESD and LVWT were significantly increased ,LVEF and FS significantly reduced in the MI+D group.GFS+fluoxetine and fluoxetine significantly reduced LVEDD in MI+D group and increased LVEF ,but GFS+ fluoxetine was superior to fluoxetine ,and also decreased LVESD and LVWT.Compared with the control group ,VERP and APD90 in MI+D group were significantly prolonged and VFT was significantly decreased.GFS+flu-oxetine and fluoxetine significantly improved the VFT of MI+D rats ,and the effect of GFS+fluoxetine was better than that of fluoxetine ,and they could shorten VERP and APD90 in model group. There was no significant difference in myocardial infarct size between MI+ D group ,F group and GFS+ F group(P＝ 0.076).Fluoxetine intervention did not improve the myocardial thickness and collagen content in the myocardial infarction area ,but GFS+ fluoxetine did.Conclusion Fluoxetine and GFS+fluoxetine can improve depression ,cardiac function and electrophysiological parameters of the rats with MI and depression ,but the effect of GFS+fluoxetine is better than that of fluoxetine ,and the myocardial thickness and collagen expression also have been improved by GFS+fluoxetine.
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The glutamate transporter EAAT 2 ( rodent nomencla-ture GLT-1:glutamate transporter 1), which is a predominantly astroglial glutamate transporter in the hippocampus and the pre-frontal cortex , is responsible for the majority of extracellular glu-tamate uptake .The glutamate transporter EAAT 2 can decrease the high levels of glutamate in the synaptic cleft , avoiding gluta-matergic excitotoxicity to damage the glial cells and neurons . Currently, the transporter EAAT2 has become a research hotspot of depression .This article aims to summarize roles of glutamate transporter EAAT2 in the occurrence and treatment of depres-sion.
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Objective To investigate the characteristics of the event related potential(ERP) P300 and analyze brain network connections in patients with first-episode depressions.Methods P300 auditory oddball task were administrated on twenty-nine patients and twenty-five healthy controls.The P300 amplitude and latency of two groups were compared,and the brain network connectivity of the two groups were analyzed using Granger's Causality analysis.Results The P300 amplitude in depression group were significantly different from those in control group (C3 of the central regions(15.77±7.35) μV vs (20.90±7.82)μV;C4 of the central regions(16.98±7.21) μV vs (22.11±7.50) μV;P3 of the parietal regions(15.65±6.92) μV vs (19.49±5.73) μV;P4 of the parietal(16.35± 6.46) μV vs P4(19.72±5.18) μV;P=0.009,P=0.007,P=0.017,P=0.024 respectively).However,the P300 latency had no significant difference comparing to the controls(P＞0.05).The results also showed that patients had more connections in the brain network.Conclusion As an effective evaluation index,ERP P300 can play an important role in clinical diagnosis of depression.Patients suffering from depression have significant cognition function deficit.
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Objective To investigate the effects of ceftriaxone on depressive-like behavior and changes of hippocampal glutamate transporter-1 (GLT-1) in C57 mice depression model,and to further explore the molecular mechanism of ceftriaxone on antidepressant action.Methods Thirty male C57 mice were randomly divided into control group(group A,n=10),CUS group(group B,n=10) and CUS+ceftriaxone group(group C,n=10).The mice of the CUS group and the CUS+ceftriaxone group were subjected to chronic unpredictable stress (CUS) for 2 sessions per day for 21 days.Then,the mice of the CUS+ceftriaxone group were given ceftriaxone for 21 days.Behavioral changes were assessed by the sucrose preference test and open field test.The GLT-1 protein levels in the hippocampus were detected by Western blot analysis at the end of the ceftriaxone treatment.Results (1) Compared with the control group,the percentage of sucrose preference,the total traveled distance,the moved velocity,and the frequencies of rearing of the CUS group were significantly decreased(P＜0.05) at the 21 days.However,the percentage of sucrose preference ((78.74 ± 3.54) ％),the total traveled distance ((6818.35 ± 505.14) cm),the moved velocity((12.36±0.89) cm/s),and the frequencies of rearing(58.20±4.05) of the CUS+ceftriaxone group at the end of the ceftriaxone treatment were improved significantly compared with the CUS group ((59.46 ± 2.75) ％,(2931.71±271.89) cm,(5.84±0.42) cm/s,(26.20±2.62),P＜0.05).(2) Western blot analysis indicated significant reductions of the GLT-1 protein levels in the hippocampus of CUS group (versus the control mice:P ＜0.05),and chronic ceftriaxone treatment reversed the CUS-induced decrease in the GLT-1 levels(P＜0.05).Conclusion Ceftriaxone might significantly improve depressive-like behavior in C57 mice depression model.Chronic unpredictable stress (CUS) could down-regulate the GLT-1 protein levels in the hippocampus,which are reversed by ceftriaxone.These results further support the notion enhanced expression of the GLT-1 protcin can be molecular mechanism of ceftriaxone on antidepressant action.
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Objective To investigate the status of the non-psychiatrist' s diagnostic and therapeutic ability of depression/anxiety disorders in 57 General Hospitals.Methods 1 152 non psychiatric clinicians in 57 general hospitals were surveyed.A custom-made questionnaire included the training of mental health-related knowledge which the general hospital physicians received and typical anxiety/depression case analysis.Results Among 1 521 non-psychiatric clinicians,596 (51.74％) clinicians participated the training of psychiatry,562 (48.78％) participated the training of medical psychology and 230(20.97％) clinicians participated the training of Healthy Psychology.In professional setting,59 (5.12％) clinicians participated the training of psychotherapy,255 (22.14％) clinicians had attended related academic symposiums.80(6.94％) clinicians believed that they understand the clinical display of anxiety/depression disorders,52 (4.51％) clinicians expressed the understanding of diagnostic criteria of anxiety/depression disorders and its treatments,while 44(3.82％) clinicians only possessed the knowledge of anxiety/depression disorder treatment.In the typical case analysis,it revealed that 794 (68.89％) clinicians made accurate diagnosis,458(57.68％)clinicians made a choice of medical treatment,764(96.22％) clinicians chose psychotherapy,29 (3.65％) clinicians applied physical therapy,while 438 (55.16％) clinicians combined drug therapy with one or more other therapeutic methods.Binary logistic regression analysis showed that the age(P=-0.093,Exp(B)=0.911)and work experience(P=-0.002,Exp(B) =1.080)significantly contribute to the diagnostic accuracy of non-psychiatrists.Conclusion The non-therapeutic psychiatric clinicians in general hospitals have certain basic knowledge of depression/anxiety disorders with lower level of diagnosis and treatment diagnosis and treatment.And there is bigger difference among different hospitals.
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Objective To investigate the effects of different duration of fluoxetine and escitalopram administration on depressive-like behavior and hippocampal BDNF expression in adult rats.Methods Ninety-six SD rats were randomly divided into twelve groups: (1)M 1 group: normal control for one week, (2)M2 group: CUMS +saline for one week, (3)M3 group: CUMS+fluoxetine for one week, (4) M4 group: CUMS+escitalopram for one week, (5) M5 group : normal control for two weeks, (6) M6 group : CUMS+ saline for two weeks, (7) M7 group : CUMS+fluoxetine for two weeks, (8)M8 group: CUMS+escitalopram for two weeks, (9)M9 group: normal control for three weeks,(10) M10 group: CUMS+saline for three weeks, (11)M11 group: CUMS+fluoxetine for three weeks, (12) M8 group: CUMS+escitalopram for three weeks.After CUMS procedures,rats in M2 group,M6 group and M10 group were injected with saline, M3 group, M7 group and M11 group were injected with fluoxetine, and rats in M4 group,M8 group,M12 group were injected with escitalopram.After one week of intervention,the openfield test and 1％ sucrose preference test were performed to evaluate depression-like behaviors in rats of M1 group, M2 group,M3 group and M4 group.After behavior test,rats were sacrificed and the hippocampi were isolated.The expression of BDNFmRNA was detected by using real-time quantitative PCR.After two weeks of intervention, rats in M5 group,M6 group, M7 group and M8 group underwent the same behavioral.After three weeks of intervention, rats in M9 group, M10 group, M11 group and M12 group underwent the same behavioral test.Results In the open-field test,total distance travelled in 10 minutes was significant difference among the following groups: M1 group ((3925.70±322.32) cm) vs M3 group ((1841.85±786.33) cm) ,M6 group ((1820.31±296.00) cm) vs M8 group ((4002.72± 1447.19) cm), M10 ((1961.66±919.16) cm) group vs M11 group ((3741.72± 1064.46)cm) ,M10 group ((1961.66±919.16) cm) vs M12 group ((4280.43±1187.05) cm).In the 1％ sucrose preference test,the difference of sucrose preference consumption was statistically significant (P＜0.05) among the following groups: M2 group ((56.23±7.49)％) vs M4 group ((70.55±4.96)％), M6 group ((60.22±8.81)％) vs M8 group ((75.08±4.15)％) ,M10 group ((60.26±7.20)％) vs M11 group ((73.88±7.73)％) ,M10 group ((60.26 ± ±7.20)％) vs M12 group ((73.52±7.58)％).The expression level of BDNF was significant difference among these groups: M2 group (0.66±0.14) vs M4 group (1.15±0.20) ,M10 group (0.90±0.15) vs M11 group (1.22± 0.09) ,M10 group (0.90±0.15) vs M12 group (1.48±0.20).Conclusion Both of fluoxetine and escitalopram can improve depression-like behaviors in rats and significantly increase the expression of the hippocampal BDNFmRNA.Compared with fluoxetine,escitalopram has a shorter onset time in the treatment of depression.It may be related with a rapid increase of the expression of BDNF mRNA.
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Aim To investigate the effects of fluoxe-tine on the changes of of protein levels of GLT-1 in pre-frontal cortex in rat depression model, and to further explore the molecular mechanism of antidepressant ac-tion of fluoxetine. Methods Sixty male SD rats were randomly assigned into three groups: control group, chronic unpredictable stress ( CUS) group, and CUS+fluoxetine group. The rats of CUS group and CUS+flu-oxetine group were subjected to CUS for 2 sessions per day for 35 days. Then, the rats of the CUS+fluoxetine group were given fluoxetine for 28 days. Behavioral changes were assessed by the sucrose preference and open field tests. The GLT-1 protein levels in the pre-frontal cortex were detected by immunohistochemistry and Western blot analysis at the end of the fluoxetine treatment. Results ( 1 ) Compared with the control group,sucrose preference, total traveling distance, ve-locity and frequencies of rearing were reduced in the CUS group ( P < 0. 01 ) . These behavioral changes could be reversed after 28 day fluoxetine treatment. (2 ) Immunohistochemistry assay indicated weak im-munoreactivity for GLT-1 in the prefrontal cortex of CUS group ( versus the control rats: P <0. 01 ); the immunoreactivity for GLT-1 of the fluoxetine-treated rats was significantly up-regulated compared with the CUS group rats ( P<0. 01 ) . ( 3 ) Western blot analy-sis indicated significant reductions of GLT-1 in the pre-frontal cortex of CUS group ( versus the control rats:P<0. 01 ) , and chronic fluoxetine treatment reversed the CUS-induced decrease in GLT-1 levels ( P <0. 01 ) . Conclusions Chronic unpredictable stress ( CUS ) could down-regulate the GLT-1 protein levels in the prefrontal cortex, which is reversed by fluoxe-tine. These results further support the notion that en-hanced expression of the GLT-1 protein could be mo-lecular mechanism of fluoxetine antidepressant effect.
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Objective To investigate the feasibility and effectiveness of C57 mice depression model established by chronic unpredictable mild stress (CUMS) and separation.Methods 30 male C57 mice were randomly divided into three groups:CUMS + separation group (group CS),CUMS + separation + fluoxetine group (group CSF),and control group (group C).The mice of group CS and group CSF were fed with chronic unpredictable mild stress (CUMS) and separation for 3 weeks.Then,the mice of group CSF were given fluoxetine.To record the food intake/body weight,liquid consumption and field test of the mice at relevant time point.Results Compared with control group,the food intake/body weight,total route in the field test,and the sucrose solution consumption in liquid consumption test of group CS and group CSF decreased significantly (P＜0.05) at the 21th days.But after giving fluoxetine for 14 days,group CSF had no significant differences with group C except sucrose solution consumption.Although the difference of sucrose solution preferences was significant compared with control group(P＜0.05),it was improved significantly compared with CS group (P＜ 0.05).Conclusion The C57 mice depression model established by CUMS and separation are feasible and effective,and it is the ideal animal model of depression.
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Objective To investigate behavior and hippocampal cytoskeletal alterations following re-exposure to chronic unpredictable mild stress(CUMS) and acute swimming stress,and explore the possible mechanism.Methods 40 Male Sprague-Dawley (SD) rats were divided into five groups,with 8 exposed to 21 consecutive days of chronic unpredicted mild stresses (CUMS) and treated with vehicle,8 exposed to CUMS and treated with fluoxetine,8 exposed to CUMS and treated with fluoxetine and re-exposed to acute swimming stress after washout,8 exposed to CUMS and treated with fluoxetine and re-exposed to CUMS after washout,and 8 as normal controls treated with vehicle.Behavioral changes in these rats were analyzed.The expressions of hippocampal cytoskeletal microtubulin were analyzed using Western Blot.Results ( 1 ) Compared with the control and CUMS group,sucrose preference (43.38 ± 7.84 ) ％,total traveling distance ( 859.21 ± 653.62 ) cm,velocity ( 2.05 ± 0.60 ) cm/s and frequencies of rearing(0.12 ±0.30) were reduced (P＜0.01 ) in the re-exposure to CUMS group.After re-exposed to acute stress,these behaviors did not differ from control rats.(2)Compared with the control and CUMS group,the Acet-Tub expression (244.24 ± 8.90 )％ of re-exposure to CUMS group showed a significant increase (P＜ 0.01 ) in rats submitted to re-exposure to CUMS and Tyr-Tub expression (30.92 ± 11.01 )％ was significantly decreased following re-exposure to CUMS (P＜0.01).At the same time,MAP-2 expression did not change while phospho-MAP-2 expression (24.75 ± 8.83 )％ decreased significantly.After re-exposed to acute stress,these prorein expressions did not differ from control rats.Conclusion These findings provide evidence that rats re-exposed to CUMS showed more impairment of cytoskeletal microtubular dynamic and structural neuronal plasticity,this effect appears to be mediated by the degree of phosphorylation of MAP-2.
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Objective To investigate the effect of chronic infection of Toxoplasma gondii on the spatial learning and memory capability in mice.Methods Toxoplasma tachyzoites(RH strain)were reanimated at 37 ℃ after 15 days' storage at-20 ℃,and injected intraperitoneally to mice of the experimental group each with 7.7?105.Normal saline was given to the control group,0.5 ml per mouse.Two months later,all mice were tested in the Morris Water Maze.Smears of the mice brain homogenate and pathological sections were examined.Results ① The density of cysts in the brain homogenate was 15/HP,and there was no evident pathological change in the hippocampus and adjacent areas of mice in the brain in the experimental mice.② Latency to platform,cumulative distance to the platform,total distance traveled in both experimental and control groups decreased significantly with the increase of training days(P