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Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.
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Objective To explore the changes of whole brain white matter ( WM) structural net-work topological property in patients with schizophrenia (SP) and the associations between WM networks to-pological efficiency and clinical variables in patients. Methods Deterministic tractography was used to con-struct the WM networks of 59 patients with SP ( patients group) and 41 age-, handedness-, and gender-matched healthy controls (HCs),and graph theoretical methods were applied to investigate abnormalities in the global and nodal properties of the WM network in these patients. Partial correlation analysis was used to analyze the relationship between global and nodal properties of the WM network and clinical variables in pa-tients with SP. Results Both the patients with SP and HCs showed small-world organization of the WM net-works. However,compared with HCs,the patients with SP exhibited significant abnormal global topology,in-cluding increased shortest path length ( t=7. 95, P=0. 0001) and decreased global efficiency ( 30. 83 ± 16. 08,8. 25±6. 13,t=-9. 81,P=0. 002),clustering coefficiency (0. 03±0. 01,0. 02±0. 01,t=-4. 48,P=0. 0003),the average clustering coefficiency (t=-8. 28,P=0. 002),the small-worldness (3. 92±0. 79,2. 79 ±0. 56,t=-7. 82,P=0. 001) of their WM structural networks(all P<0. 005,FDR corrected). Further,the patients with SP showed a reduction in nodal efficiency predominately in the cingulate gyrus ( t=-4. 11, P=0. 000),superior occipital gyrus ( t=-6. 05, P=0. 002), superior temporal gyrus ( t=-10. 46, P=0. 001),middle temporal gyrus (t=-10. 38,P=0. 000),thalamus (t=-6. 10,P=0. 000) and putamen ( t=-8. 38,P=0. 000) (P<0. 005,FDR corrected). Partial correlation results showed that there was no signifi-cant correlation between global topological properties,node efficiency and clinical symptoms in patients group (Eglob:r=-0. 14,P=0. 279;Eloc:r=-0. 06,P=0. 628;Lp:r=0. 28,P=0. 031;Cp:r=0. 27,P=0. 043;λ:r=-0. 18,P=0. 166;γ:r=-0. 29,P=0. 026;σ:r=0. 26,P=0. 048;nEglob:r=0. 36,P=0. 005;nEloc:r=0. 02,P=0. 901). Conclusions The patients with SP exhibit the abnormal of whole brain WM structural network topological property and the node efficiencies of cortico-striato-thalamo circuitry are significantly re-duced.
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Objective To investigate the susceptibility related sites to schizophrenia through whole genome analysis combined with bioinformatics analysis method.Methods The research was carried out by two stages.In the first stage,300 cases of schizophrenia and 300 healthy controls were enrolled,and 5ml pe-ripheral venous blood was drawn to extract genome DNA.After quality control and concentration adjustment by ultraviolet spectrophotometer,equal mass of DNA was mixed into DNA pooling for case group and control group respectively.Genome-Wide Human SNP Array 6.0 chips were used to detect the polymorphism of the SNP.Plink software was used to locate the differential SNP to genes.GSEA was used to analyze the gene to pathway.Ten loci with the smallest P value of screened pathway were chosen as investigated subjects.In the second stage,240 schizophrenias and 200 healthy controls were collected to gain the genome DNA to verity the genotype of the 10 loci.Results Many single nucleotide polymorphism loci which P<9.2×10-8were found in GWAS.The GSEA pathway analysis showed that the axon guidance pathway was significantly related to the incidence of schizophrenia.The distribution of rs4632195 genotypes involved the distribution of among 10 loci(χ2=11.484,P=0.003)and alleles(χ2=8.824,P=0.009)were statistically significant,and T al-lele was susceptibility genes of schizophrenia(OR=1.537,95%CI:1.157-2.203).Conclusion rs4632195 of DCC gene in the axon guidance pathway is associated with schizophrenia,and the T allele is associated with susceptibility to schizophrenia.
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Objective To investigate the association between the patients with schizophrenia and polymorphism in rs2030324 and rs11030101 of brain derived neurotrophic factor(BDNF).Methods 100 patients with schizophrenia and 100 normal controls were enrolled.The BDNF polymorphism (rs2030324 and rs11030101) and allele frequency were genotyped by sequencing the products of PCR.Genotype and allele frequencies were compared between patients and controls.Symptoms were assessed using the PANSS,and the relationship between the score of PANSS and the polymorphism of rs2030324 and rs11030101 was analyzed.Results There was statistically significance between schizophrenic patients and controls in the distribution of allele frequency in rs2030324(x2 =3.888,P=0.049) and rs11030101 (x2 =5.571,P=0.016).There was statistically significance between schizophrenic patients and controls in the distribution of implicit model in rs11030101 (x2=5.230,P=0.022).The score of PANSS negative symptoms of patients with SNPs rs11030101 different genotypes showed that A/T genotype was the highest(34.60±5.63) and T/T genotype was minimum (28.38±9.96),and the difference had statistical significance (F=4.868,P=0.010).Conclusion The polymorphism in rs2030324 and rs11030101 of BDNF is relate to the patients with schizophrenia among Han Chinese and their allele A increases the risk of illness.The SNP of rs11030101 may be associated with the clinical features of schizophrenia.
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Objective To investigate influence of mirtazapine on polysomnograpy (PSG) of depression dysphylaxia patient and treatment effect.Methods 22 dysphylaxia patients and 22 healthy contrast persons were detected by PSG.The group of dysphylaxia patients were re-detected PSG 6 weeks later after treatment by Mirtazapine.In order to evaluate the patient' symptoms of depression and early awakening,the scale of HAMD was utilized at the time before and after 2 weeks,6 weeks treatment by mirtazapine.To compare changes of PSG index,HAMD scores and dysphylaxia scores before and after treatment.Results Compared with healthy controls,there existed much deviation with dysphylaxia patients on PSG index.6 weeks after mirtazapine treatment,the PSG showed the sleeping latency had shortened to ( 16.9 ± 6.6) min,sleep efficiency had improved ( 85.4 ± 6.7 ) %,awake time had shortened (27.7 ± 10.4)min,sleep maintenance rate had risen (87.9 ±5.3)%,decrease (9.7±4.1 )% of the S1 sleeping stage percentage,S2 had increased ( 148.0 ±30.7)%,REM density had decreased (56.1 ±3.8)%.the difference was significant (P<0.05).The scores of HAMD and early awakening after treatment were significantly lower than before treatment,the difference was significant (P<0.01 ).Correlation analysis showed there was no significant correlation between the HAMD,dysphylaxia reduced rate and changes of PSG all indicators(P > 0.05 ).Conclusion It may be one of the biological markers for dysphylaxi in shortened of REM sleep latency,prolonged of REM sleep time and increased of REM activity and density.There is no correlation between post-treatment changes of PSG.
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Objective The survey of continuing education demand of our city' s rural health service members and their feel of job satisfacrion provides the basis for overall quality of the rural health service members. Methods We adopted the method of multistage sampling to conduct a questionnaire survey and condoct interview on rural health workers in our city, and then utilized software to analyze them. Results The survey comprises the first education qualification and highest qualification of 120 health workers and 228 rural doctors from health clinics in localities asoond our city, and most of them had technical secondary school education. 80.7% of rural health workers and 91.7% of village health workers were willing to enter medical college to further their education through the "University Student in Every Village Project" . 93.3% of rural health workers and 84.2% of village health workers were willing to take non - qualification education. Among the rural health workers, 29.2% were satisfied with their jobs, 44.2% were not satisfied with them. Among the village health workers, 12.3% were satisfied with their jobs, 67.5% were not satisfied with them. Conclusion We should increase fonding towards rural health workers' education to satisfy the demand of continuing education, solve the problem of pensioner' s insurance, and improve levels of job satisfaction.
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Objective: To analyze the influential factors of job burnout among psychiatrists.Methods: Psychiatirsts were evaluated by questionnaires.Results: In general,the job burnout of psychiatrists was very serious.There were significant differences in gender in burnout individual level;the person of 31-35 age was prone to job burnout,and the middle-aged staffs’ job burnout was comparatively in high level;There was significantly correlated show between psychiatrists job burnout level and social support.Besides,there was significantly correlated show between psychiatrists job burnout level and coping way.Conclusion: Psychiatrists Burnout is a high-risk population.To better enhance the stability of their profession,we need concern psychiatrists’mental health from the integrated perspective,and improve their level of social support constantly,and prevent occupational burnout from the perspective of medical education early.