Excessive Daytime Sleepiness and Insomnia Symptoms in Adolescents With Major Depressive Disorder: Prevalence, Clinical Correlates, and the Relationship With Psychiatric Medications Use

Objective@#Excessive daytime sleepiness (EDS) and insomnia symptoms are common in patients with major depressive disorder (MDD), which might lead to a poor prognosis and an increased risk of depression relapse. The current study aimed to investigate the prevalence, and sociodemographic and clinical correlates of EDS and insomnia symptoms among adolescents with MDD. @*Methods@#The sample of this cross-sectional study included 297 adolescents (mean age=15.26 years; range=12–18 years; 218 females) with MDD recruited from three general and four psychiatric hospitals in five cities (Hefei, Bengbu, Fuyang, Suzhou, and Ma’anshan) in Anhui Province, China between January and August, 2021. EDS and insomnia symptoms, and clinical severity of depressive symptoms were assessed using Epworth sleepiness scale, Insomnia Severity Index, and Clinical Global Impression-Severity. @*Results@#The prevalence of EDS and insomnia symptoms in adolescents with MDD was 39.7% and 38.0%, respectively. Binary logistic regression analyses showed that EDS symptoms were significantly associated with higher body mass index (odds ratio [OR]=1.097, 95% confidence interval [CI]=1.027–1.172), more severe depressive symptoms (OR=1.313, 95% CI=1.028–1.679), and selective serotonin reuptake inhibitors use (OR=2.078, 95% CI=1.199–3.601). And insomnia symptoms were positively associated with female sex (OR=1.955, 95% CI=1.052–3.633), suicide attempts (OR=1.765, 95% CI=1.037–3.005), more severe depressive symptoms (OR=2.031, 95% CI=1.523–2.709), and negatively associated with antipsychotics use (OR=0.433, 95% CI=0.196–0.952). @*Conclusion@#EDS and insomnia symptoms are common among adolescents with MDD. Considering their negative effects on the clinical prognosis, regular screening and clinical managements should be developed for this patient population.

Status of sleep insufficiency and related factors in children and adolescents with mental disorders / 四川精神卫生

ObjectiveTo investigate the status of sleep insufficiency in children and adolescents with mental disorders and related influencing factors. MethodsA total of 131 children and adolescents who were admitted to the Third People's Hospital of Fuyang from February to June 2021 and met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for schizophrenia， depression or childhood-onset mood disorders were selected as the research subjects. A self-compiled questionnaire was used to collect the general demographic information， sleep status， lifestyle habits， family and school status of the selected individuals. The demographic information was compared between sleep sufficiency group and sleep insufficiency group. Spearman rank correlation was used to screen the influencing factors. Results① Among 131 children and adolescents with mental disorders， 93 cases （71.0%） had sleep insufficiency. There were significant differences between sleep insufficiency group and sleep sufficiency group in terms of disease types （χ2=8.798， P=0.012）， experience of being beaten in recent 6 months （χ2=3.427， P=0.035）， being scolded in recent 6 months （χ2=4.145， P=0.031）， and cyberbullying over the past year （χ2=4.187， P=0.041）. ② Among patients with sleep insufficiency， 77 cases （82.8%） reported difficulty in falling asleep and 69 cases （74.2%） reported nocturnal awakenings. ③ Sleep insufficiency in children and adolescents with mental disorders was positively correlated with the experience of being scolded （r=0.210， P=0.037） or beaten （r=0.145， P=0.023） over the past 6 months and cyberbullying over the past year （r=0.179， P=0.041）. ConclusionChildren and adolescents with mental disorders suffer a high risk of sleep insufficiency， and is closely associated with depressive disorder， experience of being scolded or beaten over the past 6 months， and cyberbullying over the past year.

The relationship between insulin resistance and plasma hs-CRP in patients with chronic schizophrenia / 中华行为医学与脑科学杂志

Objective@#To explore the relationship between insulin resistance and plasma hypersensitive reactive protein (hs-CRP) in patients with chronic schizophrenia.@*Methods@#A total of 247 inpatients with chronic schizophrenia (patient group) and 166 cases of normal individuals(control group) were enrolled.Their general demographic and clinical data were collected, fasting blood glucose, hs-CRP, c-peptide and insulin indexes were tested, and insulin resistance index (HOMA-IR) was calculated.The insulin resistance level of the patients group and the control group was compared by Mann-Whitney U test, and the relationship between insulin-resistance and hs-CRP in patients group was analyzed using Spearman correlation analysis.@*Results@#(1)The levels of C-peptide (2.53(2.06, 3.23)ng/ml vs 2.24(1.89, 2.87)ng/ml), insulin (7.68(4.66, 11.97)μIU/ml vs 7.02(4.31, 9.59)μIU/ml) and HOMA-IR (1.75(1.09, 3.07) vs 1.57(0.97, 2.22)) in the patient group were significantly higher than those in the control group(all P<0.05). (2) The levels of HOMA-IR( 1.91(1.21, 3.74) vs 1.70(1.02, 2.72)) in patients with high hs-CRP(≥3 mg/L) was higher than those in the patients with low hs-CRP(<3 mg/L)(P<0.05). (3)Spearman correlation analysis showed that HOMA-IR was positively correlated with plasma hs-CRP level in the patient group (r=0.139, P<0.05). (4)After logarithmic transformation of related variables, multivariate linear regression analysis showed that HOMA-IR was linearly correlated with hs-CRP level and boy weight index.@*Conclusion@#The hs-CRP level in chronic schizophrenia has a positive predictive effect on insulin resistance.Detection of hs-CRP level in schizophrenic patients is helpful to assess metabolic risk of insulin.

The relationship between insulin resistance and plasma hs-CRP in patients with chronic schizophrenia / 中华行为医学与脑科学杂志

Objective To explore the relationship between insulin resistance and plasma hypersen-sitive reactive protein (hs-CRP) in patients with chronic schizophrenia. Methods A total of 247 inpatients with chronic schizophrenia ( patient group) and 166 cases of normal individuals( control group) were en-rolled. Their general demographic and clinical data were collected,fasting blood glucose,hs-CRP,c-peptide and insulin indexes were tested,and insulin resistance index (HOMA-IR) was calculated. The insulin resist-ance level of the patients group and the control group was compared by Mann-Whitney U test,and the rela-tionship between insulin-resistance and hs-CRP in patients group was analyzed using Spearman correlation a-nalysis. Results (1)The levels of C-peptide (2. 53(2. 06,3. 23)ng/ml vs 2. 24(1. 89,2. 87)ng/ml), in-sulin (7. 68(4. 66,11. 97)μIU/ml vs 7. 02(4. 31,9. 59) μIU/ml) and HOMA-IR (1. 75(1. 09, 3. 07) vs 1. 57(0. 97,2. 22)) in the patient group were significantly higher than those in the control group( all P<0. 05). ( 2) The levels of HOMA-IR( 1. 91( 1. 21,3. 74) vs 1. 70(1. 02,2. 72)) in patients with high hs-CRP(≥3 mg/L) was higher than those in the patients with low hs-CRP (<3 mg/L) (P<0. 05). ( 3) Spearman correlation analysis showed that HOMA-IR was positively correlated with plasma hs-CRP level in the patient group (r=0. 139,P<0. 05). (4)After logarithmic transformation of related variables,multivariate linear regression analysis showed that HOMA-IR was linearly correlated with hs-CRP level and boy weight in-dex. Conclusion The hs-CRP level in chronic schizophrenia has a positive predictive effect on insulin re-sistance. Detection of hs-CRP level in schizophrenic patients is helpful to assess metabolic risk of insulin.

Effect of social support as medium in the process of attachment styles and coping styles on criminal teenagers and adolescents with mood disorders / 中华行为医学与脑科学杂志

Objective To explore the medium effect of social support in process of attachment styles and coping styles on criminal juveniles and adolescents with mood disorders.Methods The survey used in the research included Experiences of Close Relationships Inventory (ECR),Social Support Revalued Scale(SSRS) and Coping Style Questionnaire(CSQ) conducted by three groups:177 criminal juveniles,80 adolescents with mood disorders and 163 normal teenagers.Results Firstly,there were significant differences in the avoidant attachment,attachment anxiety,objective support,subjective support,utilization of support,solving problem,rationalization,self-accusation and retreat among three groups (F=7.902,8.047,59.009,19.248,5.304,7.596,10.652,6.699,11.009;P＜0.05).Secondly,attachment avoidance had significant negative correlation with both utilization of support and help seeking behaviors in the group of mood disorders (r =-0.470,-0.350; P＜ 0.01).Similarly,avoidant attachment had significant negative correlation with both subjective support and utilization of support respectively (r=-0.232,-0.235 ; P＜0.01) in the group of criminal juveniles.The subjective support had significant positive correlation with solving problem (r=0.272,P＜0.01) and as well as the utilization of support with both solving problem and help seeking behaviors (r=0.258,0.424; P＜ 0.01).Attachment anxiety had significant negative correlation with objective support and had significant positive correlation with self-accusation respectively (r=-0.253,0.300;P＜0.01).Finally,utilization of support as a medium completely effect on the process of avoidant attachment and help seeking behaviors in the group of mood disorder and criminal juveniles.Moreover,subjective support and utilization of support as medium both affected a part in the process of avoidant attachment and solving problem for the group of criminal juveniles.Conclusion First,both adolescents with mood disorders and criminal juveniles have unsafe attachment mode,which are lacked social support and easy to take negative coping styles.Yet,the level of attachment avoidance and subjective support of criminal juveniles was found different compared to teenagers with mood disorder.Second,the attachment styles for both adolescents with mood disorders and criminal juveniles have impact on coping styles by the means of social support,but there were slightly different way.

Early Intervention on Psychosocial Development of Children in Single Child Family / 中国心理卫生杂志

Objective: To study the effect of early intervention on psychosocial development of children in single child family. Method:30 babies were enrolled as intervention group from they were fetus. Another 37 were enrolled as control group. The former received intervention under the Guide of Different Stages from 0 to 6 years old. Achenbach Children Behavior Checklist (CBCL) and Binet Intelligent Test were used to assess the results.Results:The rate of behavior group was 6.7%, significantly lower than that of the control group (13.5%) and Chinese norm (14.2%). The average IQ of the intervention group was significantly higher than control. But there was no significant difference in Social Adaptability between the two groups. Conclusion:Early education and intervention can improve psychosocial development children in single child family.