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Objective:To investigate the neurobiochemical metabolites of caudate nucleus and thalamus in patients with obsessive-compulsive disorder and their relationship with obsessive-compulsive symptoms.Methods:From April 2019 to January 2022 in Beijing Anding Hospital, totally 25 untreated patients with obsessive-compulsive disorder were recruited, and 20 healthy controls matched with gender, age and educational background were recruited for the study.The maps of neurobiochemical metabolites of patients and normal controls were collected by hydrogen proton magnetic resonance spectroscopy.With bilateral caudate nucleus and thalamus as brain regions of interest.The relative concentrations of N-acetylaspartic acid (NAA), glutamic acid (Glu) and γ-aminobutyric acid (GABA) were fitted by LCModel software.At the same time, the clinical symptoms of patients were evaluated with Yale-Brown obsessive-compulsive scale (Y-BOCS) and Hamilton anxiety scale (HAMA). SPSS 20.0 software was used for statistical analysis.Independent double sample t-test was used to compare the differences of different nerve biochemical metabolite concentrations between patients with obsessive-compulsive disorders and healthy controls.Pearson correlation analysis was used to explore the correlation between biochemical metabolite concentrations and clinical symptoms. Results:The Glu concentration in the left thalamus of patients with obsessive-compulsive disorder (3.97±0.41) was higher than that of the control group (3.66±0.55)( t=-2.11, P<0.05), while the NAA concentration was (4.87±0.47)lower than that of the control group (5.15±0.44)( t=2.05, P<0.05). The GABA concentrations in the right caudate nucleus (0.50±0.18) and thalamus (0.80±0.19) were lower than those in the control group ((0.63±0.23), (0.96±0.24))( t=2.08, 2.36, both P<0.05). Pearson correlation analysis showed that the Glu concentration in the left caudate nucleus of patients with obsessive-compulsive disorder was positively correlated with the total score of Y-BOCS( r=0.46, P<0.05). Spearman correlation analysis showed that Glu concentration in the right caudate nucleus was positively correlated with the total score of HAMA in patients with obsessive-compulsive disorder ( r=0.46, P<0.05). Conclusion:NAA, Glu and GABA metabolism in caudate nucleus and thalamus are abnormal in patients with obsessive-compulsive disorder, and Glu concentration is positively correlated with the severity of obsessive-compulsive and anxiety symptoms.
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BACKGROUND@#Amygdala plays an important role in the neurobiological basis of panic disorder (PD), and the amygdala contains different subregions, which may play different roles in PD. The aim of the present study was to examine whether there are common or distinct patterns of functional connectivity of the amygdala subregions in PD using resting-state functional magnetic resonance imaging and to explore the relationship between the abnormal spontaneous functional connectivity patterns of the regions of interest (ROIs) and the clinical symptoms of PD patients.@*METHODS@#Fifty-three drug-naïve, non-comorbid PD patients and 70 healthy controls (HCs) were recruited. Seed-based resting-state functional connectivity (rsFC) analyses were conducted using the bilateral amygdalae and its subregions as the ROI seed. Two samples t test was performed for the seed-based Fisher's z -transformed correlation maps. The relationship between the abnormal spontaneous functional connectivity patterns of the ROIs and the clinical symptoms of PD patients was investigated by Pearson correlation analysis.@*RESULTS@#PD patients showed increased rsFC of the bilateral amygdalae and almost all the amygdala subregions with the precuneus/posterior cingulate gyrus compared with the HC group (left amygdala [lAMY]: t = 4.84, P <0.001; right amygdala [rAMY]: t = 4.55, P <0.001; left centromedial amygdala [lCMA]: t = 3.87, P <0.001; right centromedial amygdala [rCMA]: t = 3.82, P = 0.002; left laterobasal amygdala [lBLA]: t = 4.33, P <0.001; right laterobasal amygdala [rBLA]: t = 4.97, P <0.001; left superficial amygdala [lSFA]: t = 3.26, P = 0.006). The rsFC of the lBLA with the left angular gyrus/inferior parietal lobule remarkably increased in the PD group ( t = 3.70, P = 0.003). And most of the altered rsFCs were located in the default mode network (DMN). A significant positive correlation was observed between the severity of anxiety and the rsFC between the lSFA and the left precuneus in PD patients ( r = 0.285, P = 0.039).@*CONCLUSIONS@#Our research suggested that the increased rsFC of amygdala subregions with DMN plays an important role in the pathogenesis of PD. Future studies may further explore whether the rsFC of amygdala subregions, especially with the regions in DMN, can be used as a biological marker of PD.
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Humanos , Trastorno de Pánico , Imagen por Resonancia Magnética/métodos , Amígdala del Cerebelo , Giro del Cíngulo , ComorbilidadRESUMEN
The application of diagnosis and treatment technology based on virtual reality (VR) in obsessive-compulsive disorder (OCD) has attracted more and more attention from researchers around the world. The preliminary exploration shows that it is a promising auxiliary evaluation and treatment method. From the perspective of effectiveness and suitability, this paper systematically reviewed the research status of the application of VR technology in OCD clinical symptom evaluation, cognitive function evaluation and clinical intervention, discussed the similarities and differences, advantages and limitations between traditional evaluation and treatment methods and VR-based diagnosis and treatment technology, and prospected the new trend of the application of VR technology in OCD diagnosis and treatment, and provided a reference for the introduction, development and application of VR technology in China to improve the effect of OCD diagnosis and treatment.
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ObjectiveTo explore the beliefs and attitudes about sleep in patients with comorbid depressive disorder and insomnia， and to explore its influence on sleep quality. MethodsPatients with comorbid depressive disorder and insomnia （n=61） and patients with primary insomnia （n=62） who met criteria specified in the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） in Beijing Anding Hospital Affiliated to Capital Medical University were enrolled， meantime， another 64 healthy controls were recruited. All subjects were assessed using Dysfunctional Beliefs and Attitudes about Sleep （DBAS） and Pittsburgh Sleep Quality Index （PSQI）. Additionally， patients with comorbid depressive disorder and insomnia were evaluated using Hamilton Depression Scale-17 item （HAMD-17）. The PSQI and DBAS scores were compared among three groups using analysis of covariance， and multiple linear regression analysis was used to screen the factors affecting PSQI score in patients with comorbid depressive disorder and insomnia. ResultsCompared with healthy controls， higher scores of PSQI （t=18.932， 18.610， P<0.01） along with lower scores of DBAS （t=-5.561， -5.791， P<0.01） were observed in patients with comorbid depressive disorder and insomnia and patients with primary insomnia. Taking the PSQI score of patients with comorbid depressive disorder and insomnia as the dependent variable， statistically significant equations were generated using multiple linear regression analysis （F=14.095， R2=0.327， P<0.05）， and the predictive and control factors of sleep in DBAS and age were found to be the influencing factors of PSQI score in patients （B=-0.100， -0.279， P<0.05 or 0.01）. ConclusionCompared with the normal，depression patients with insomnia have more dysfunctional beliefs and attitudes towards sleep，and dysfunctional cognition may be the influencing factor of their sleep quality.
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The etiology and pathological mechanism of panic disorder (PD) are still unclear, which hinders the development of clinical diagnosis and treatment. In order to clarify the pathogenesis, biological diagnostic markers, curative effect prediction of PD, and ultimately provide a basis for individualized treatment, this article reviews the magnetic resonance imaging (MRI) research on PD in the past 5 years in conjunction with the hypothesis of the " fear network model" . It is found that the brain function and structural abnormalities of PD patients are not limited to the classic " fear network model" , but also a wider range of brain areas such as the cingulate gyrus, fronto-temporal cortex, insula, striatum, thalamus, sensorimotor related brain regions and cerebellum, together with classic brain regions such as the amygdala, form an expanded fear network. Among them, the amygdala, insula, medial prefrontal lobe, somato-motor network (SMN) and cerebellum are specific brain areas that differentiate PD from other anxiety disorders. The changes in the activity of the frontal lobe-limbic loop included in the fear network model can predict the treatment outcome of different methods for PD. This article improved the fear network hypothesis of PD, and more accurately identifies the biological indicators that can be used for accurate diagnosis and efficacy prediction of PD, which lays the foundation for the ultimate realization of personalized diagnosis and treatment of PD.
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Objective To develop a simple,multi-dimensional self-screening questionnaire for som-atoform symptoms(SQSS). Methods Based on theoretical framework,the study developed the items of the questionnaire. The first draft of the questionnaire was screened through the expert evaluation method. Four groups of 359 subjects were selected to test the reliability and validity of questionnaire. Results The explor-atory factor analysis showed that the four factors(somatic symptoms,negative perception,illness behavior and social function) were extracted and the interpretable percentage of variance was 61. 165%. The correlation between the subscales and the total scales was 0. 740-0. 887,and the correlation coefficient between the sub-scales was 0. 503-0. 625. The Crobanch's α coefficient of the questionnaire was 0. 926,and the Spearman-Brown score of the questionnaire was 0. 868. The retest correlation coefficient of the total scale was 0. 876. A cutoff of 23 points in the SQSS was identified for screening somatoform disorders, and the sensitivity was 0. 880 and the specificity was 0. 606. Conclusion SQSS has good reliability and validity,and can be prelim-inarily used as a self-screening tool for patients with somatoform symptoms or disorders in clinical settings.
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Objective To explore cognitive characteristics of sleep and analyze its influencing fac-tors in patients with schizophrenia comorbid insomnia. Methods 61 patients with schizophrenia comorbid with insomnia, 62 patients with primary insomnia and 64 normal sleepers were recruited according to DSM-IV.The subjects in the three groups were measured by Dysfunctional Beliefs and Attitudes about Sleep Scale(DBAS)and Pittsburgh Sleep Quality Index(PSQI).Patients with schizophrenia were also measured by the Positive And Negative Symptom Scale( PANSS) . Results The day function factor of PQSI for the schiz-ophrenic patients(1.72±0.92) was significantly higher than that for the primary insomniacs(1.32±0.99) (P<0.05).The time to fall asleep factor of PQSI for the primary insomniacs (2.45±0.71) was significantly higher than that in the patients with schizophrenia (2.11±0.97). In addition to the false beliefs about improving sleep factor,the total and all factor scores of DBAS for the normal sleepers(79.44±10.53) were higher than that in schizophrenic group(68.26±11.76) and primary insomnia group(67.85±11.39)(all P<0.01).The ex-pectations on sleep factor(β=-0.425,P=0.009) and the attitudes towards sleep medications factor(β=-0.239,P=0.048) were the influencing factors on sleep quality in schizophrenic patients comorbid with in-somnia.The estimation of the consequences of insomnia(β=-0.279,P=0.001),predictive and control of sleep(β=-0.291,P=0.017) as well as age factors(β=0.078,P=0.020) were the influencing factors on in primary insomnia patients. Conclusion Patients with schizophrenia comorbid with insomnia and patients with primary insomnia have more distorted cognitions towards sleep,and their cognitions can greatly affect the quality of sleep.
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The self-compiled obsessive-compulsive cognitive behavioral therapy manual was used for a systematic and standardized cognitive behavioral therapy (CBT) intervention for a study of obsessive-compulsive disorder.Based on the assessment of consultant's compulsive thinking and compulsive behaviors,14 sessions of the systematic and standardized CBT treatments were conducted for maladaptive cognitive and behavioral problems.Yale-Brown Obsessive Compulsive Scale (Y-BOCS),Hamilton Depression Scale (HAMD-17) and Hamiltonian anxiety (HAMA) were used to evaluate the change of the mood and symptoms before and after the cognitive and behavioral therapy.The symptoms of consultant were alleviated effectively and the overall function was significantly improved after 14 CBT treatments.The treatment reached the desired treatment goals.This study suggests that self-compiled cognitive behavior therapy manual is effective for the obsessive-compulsive disorder in practice and it has a guiding significance on the normative treatment of obsessive-compulsive disorder.
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To introduce the cognitive behavioral therapy-orientated case conceptualization and process for social anxiety disorder. Based on the detailed and integrated case conceptualization, 15 sessions of the systematic and standardized CBT treatments were conducted for maladaptive cognitive and behavioral problems. The results showed that the Liebowit Social Anxiety Scale (LSAS) score was reduced from 49 to 26, and the initial treatment goal was achieved. This case report suggests that "cognitive reconstruction combined with exposure" therapy strategy could be used to treat social anxiety disorder.
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Attentional bias towards threat may be a key factor associated with development and maintaining symptoms of obsessive-compulsive disorder (OCD).Through the study of attentional bias feature in OCD would be helpful to understand the obsessive-compulsive symptoms and development.We use emotion Stroop task,dot-probe task and eye-tracking methodology in measure attentional bias of obsessive-compulsive disorder,found that OCD patients may performance attentional bias to the general threat stimulus and obsessive-compulsive symptoms related stimulus,and OCD patients may have attentional bias to those obsessivecompulsive symptoms related stimulus in specialty.At present,difficult to repeat studies and inconsistent results are the main problems,and the differences in experimental materials and samples may be the important factors that lead to those inconsistency results.
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Objective:To test the psychometric characteristics of the Chinese Version of the Illness Attitudes Scale(IAS-CV).Methods:Totally 297 patients (with somatoform disorders,major depressive disorder,generalized anxiety disorder,panic disorder,and obsessive-compulsive disorder diagnosed with ICD-10) and 212 normal people were assessed with IAS-CV,Beck Depression Inventory-Ⅱ and Beck Anxiety Inventory.Results:The confirmation factor analysis result of the nine-factor model of IAS-CV was x2/df=1.99,GFI =0.86,RMSEA =0.06.The total score of IAS-CV was correlated with BAI scores (r =0.45,P ＜0.01) and BDI-Ⅱ scores(r =0.42,P ＜0.01).Patients with somatoform disorders (62 ± 17) had higher scores than patients with other disorder,such as depression (43 ± 16),anxiety (46 ± 21),obsessive compulsive disorder (46 ± 15),and normal controls (35 ± 13).The Cronbach's α coefficients were 0.91 for IAS-CV and 0.62-0.91 for each subscale.The test-retest coefficients were 0.95 for the total scale and 0.67-0.93 for each subscale (P ＜ 0.01).Split-half coefficient was 0.94.The cut-off score of IAS-CV for screening somatoform disorders was 44.Conclusion:It suggests that the Chinese Version of the Illness Attitudes Scale(IAS-CV) has good psychometric features and could be used in clinical practice and research in China.
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Objective To evaluate the suitability of cognitive behavioral therapy (CBT) techniques for obsessive-compulsive disorder (OCD),and analyze the domestic application status of CBT techniques for OCD and lay a foundation of standard CBT in China.Methods Delphi method was adopted to evaluate 30 CBT techniques on four dimensions,including operability,frequency,contribution of treatment and acceptability,and calculated the final scores of all techniques on different dimension and their comprehensive rank.Results After two rounds of experts consulting,Kendall coefficients of four dimensions were 0.249,0.269,0.234,0.250 (P＜0.01),coefficient of variation ranged from 0.05 to 0.31 of each technology on different dimension.The operability score of thought stopping,cost-benefit analysis and pie chart belonged to general suitability.The frequency and treatment contribution score of thought stopping and pie chart belonged to occasional use and small.The acceptation score of socratic question,thought stopping,in vivo exposure and behavior prevention belonged to partial acceptation.Weight coefficients of four dimensions were 0.26,0.18,0.27,0.29 and techniques ranking in the top three were information collection and evaluation,therapeutic alliance foundation and psychological education.Conclusion Most CBT techniques for OCD are suitable in China but some techniques still need to be improved.
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Objective To develop the Dissociative Trait Scale(DTS),and examine its reliability and validity. Methods Based on literature and research work,a preliminary questionnaire was designed to measure dissociative trait. 1306 college students completed the DTS and Symptom Checklist 90(SCL-90). Results Exploratory factor analysis extracted eight factors. The percentage of variance explained was 57.69％. The Cronbach α-coefficient of the total scale and the eight subscales ranged from 0. 830 ～ 0. 969, the test-retest reliability ranged from 0.575 ～ 763 (P ＜ 0.01 ). The scores of DTS significantly positively correlated with the scores of SCL-90 (P ＜0.01 ). Conclusion The DTS has acceptable psychometric quality,and can be applied to assess dissociative traits in Chinese college students.
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Objective To explore the effects of attributional styles, coping styles, irrational beliefs on the severity of depression. Mehtods A cohort of 74 major depressed patients was collected on admission and at discharge. The assessment included Beck Depression Inventory ( BDI) , Irrational Beliefs Scale (IBS) , Coping Styles Questionnaire (CSQ) , Attributional Style Questionnaire ( ASQ) was applied to depressed patients and 55 normal controls. For the results of statistical analysis, cognitive model of depression was framed. Results The results of statistical analysis showed that low frustration tolerance global evaluation, problem-solving, stable for the negative e-vents play a significant role, problem-solving and stable for the negative events had a direct effects on depression( β= 0.30, P < 0.01; β = - 0.68, P < 0.01 ). low frustration tolerance has a indirect effects. Conclusion problem-solving and stable for the negative events have a direct effects on depression, low frustration tolerance has a indirect effects.
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BACKGROUND: The clinical manifestation of senile depression is not typical. The patients with senile depression seldom visit in general hospital, which is hard for clinical doctors to identify the disease at early time.OBJECTIVE: To research the traits of Coping style and social support in the recovered senile depressive patients.DESIGN: Case-control observation.SETTING: Department of Psychology in North China Coal Medical College.PARTICIPANTS: Ninety-six senile depressive patients at convalescent stage were selected for depressive group in clinic service of Beijing Anding Hospital from November 2004 to October 2005. Inclusion criteria: ①Aged≥60 years old. ② Coded with depression with DSM-Ⅳ. ③ Being the period of recovery, geriatric depression scale(GDS)≤10. ④Informed consent was obtained from each participant. Exclusion criteria: ① Depression resulted from other factors for instance substance abuse and schizophrenia,etc. ②Serious and instable body disease such as cerebrovascular disease,liver and kidney disease, falling sickness, disease of internal secretion. Totally 104 questionnaires were sent out, and 96 were qualified. 37 were male and 59 were female in the depressive group, aged 60-87 years old,with average of (68±6)years. The course of disease was 0.3-11 years, with mean of 2 years. The elderly from ordinary community of Beijing were invited for control group. Inclusion criteria: ①Aged ≥ 60 years old; ② No mental disease. ③ Informed consent was obtained from each participant.Exclusion criteria: The same to the depressive group. There are 100 participants in the control group, 44 were male and 56 were female, aged 60 to 84 years old, with average (67±5) years old. There were no significant differences between depressive group and control group in gender, age, education, living conditions and marriage status.METHODS: 96 senile depressive patients at convalescent stage and 100healthy aged were investigated with self-made questionnaire, Geriatric Depression Scale (GDS), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ).MAIN OUTCOME MEASURES: The scores of the self-made questionnaire, GDS, SSRS and SCSQ answered by participants in each group.RESULTS: All the 196 participants entered the result analysis. There was not disqualified questionnaire. There were significantly lower scores of positive coping style and higher scores of negative coping style in the depressive group than the control group(P ＜ 0.05 ). There was lower score of social support, subjective social support and use of social support in the depressive group than the control group (P ＜ 0.05). The scores of objective social support was not significantly different in each group. There was remarkable positive correlation between active coping style and score of social support, subjective social support and use of social support in recovered senile depressive group (P ＜ 0.01). Passive coping style was negatively correlated with score of social support, subjective social support and use of social support(P ＜ 0.01 ).CONCLUSION: Subjective social support and use of social support and negative coping style are the major risk factor in the onset of senile depression.
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Objective:To examine whether dysfunctional attitudes and cognitive bias change with fluctuations in depressive symptoms. Methods:122 patients with MDD (major depressive disorder) were assessed with DAS (dysfunctional attitude scale),CBQ (cognitive bias questionnaire) ,and HRSD (Hamilton rating scale for depression) before and after the 8-week treatment. 51 normal subjects were assessed with the DAS, CBQ and SDS as controls.Results:(1) Compared with normal controls, at the baseline MDD patients had significantly higher total DAS scores (158.2?34.6 vs. 119.3?23.4,t=8.559, P=0.000) and the score of CBQ (5.19?3.77 vs. 1.69?1.83, t=8.208, P=0.000). (2) After 8 weeks, the HRSD scores of patients reduced to Median 7.0, and the DAS and CBQ scores significantly lower than those in baseline (DAS total score from 158.2?34.6 to 143.3?29.3, t=3.611, P=0.000; the median of CBQ decreased from 5.0 to 3.0;z=4.670, P=0.000). (3) The DAS score (131.1?25.7) and CBQ score (median 3.0) of full recovery patients with full recovery remained higher than those of controls (t=2.397, P=0.018 ;z=3.990, P=0.000).Conclusion:Dysfunctional attitudes and cognitive bias were influenced by fluctuations in stata or demonstrateing stability over time. They were all state-trait features.
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Objective: To develop Attributional Style Questionnaire for Adolescents (ASQA) and explore the correlation between attributional style and mental health in adolescents. Method: ASQA was drawn up through referring to Peterson's method. 534 students were measured by ASQA, SSDA, SAS and MMOCI. Results: The goodness of fit indices of three-factor model in ASQA as follows: x2/df = 511.69/188, GFI = 0.91, AGFI = 0.89, NNFI = 0.91, CFI = 0.92, IFI = 0.92. Cronbach's α coefficient was 0.82. Spearman - Brown split - half reliability was 0.84. Stable and global variables entered the equations of depression, anxiety, obaession and compulsion in multiple linear regression analysis. Conclusion:ASQA had good reliability and construct validity. Adolescents were in low level of mental health when they attributed negative events to stable and global causes.