Application of psychotherapy in treatment-resistant depression / 中华行为医学与脑科学杂志

Treatment-resistant depression (TRD) is characterized by a high suicide rate and a high recurrence rate. The effect of the medicine on TRD is not ideal with obvious side effects. Psychotherapy is an important method recommended in many guidelines for the treatment of depression. However, previous studies and clinical applications have paid little attention to the application of psychotherapy in TRD. Therefore, based on recent studies, this paper reviews the effects of psychotherapy on the depressive symptoms, suicide risk, and recurrence risk in TRD. Further, the possible therapeutic mechanisms are discussed, including the improvement of interpersonal function by dealing with early trauma in TRD, therefore alleviating symptoms; intervening in the dysfunctional cognitive pattern of TRD to help them cope with negative life events, therefore reducing stress and depression. Combined with the limitations of existing studies, the following directions can be considered in the future: improving the research quality, measuring behavioral and physiological indicators to further clarify the therapeutic mechanism, identifying ways in which psychotherapy can be combined with other treatments, exploring the group and online therapy to increase accessibility of psychotherapy for TRD.

Symptom dimensions and the different impairments of quality of life in patients with obsessive-compulsive disorder / 中华行为医学与脑科学杂志

Objective To investigate the difference of quality of life in patients with different symptom dimensions of obsessive-compulsive disorder(OCD).Methods Collected 54 cases of outpatient and the first inpatient with OCD to be the research group and 54 normal persons were the control group.The quality of life was assessed with SF-36,and compared the scores.An analysis was performed on the major categories of the YBOCS-SC to derive symptom dimension scores.Results Compared to the control group,patients with OCD showed significant impairment in seven domains of quality of life,especially in the mental health(t=12.474,P＜0.01),the roleemotional(t=9.407,P＜0.01),the social functioning(t=8.862,P＜0.01) and the vitality(t=8.057,P＜0.01).The patients with distinct symptom dimensions of ①symmetry/order,contribution rate 21.60％ ; ②contaminate/clean,contribution rate 16.37％; ③ aggression/religion,contribution rate 12.34％; ④ sex/check,contribution rate 10.90％.They showed different severity of the impairments in four domains of quality of life,the role-physical(F=5.199,P=0.004),the bodily pain (F=3.169,P=0.034),the role-emotional (F=9.350,P=0.000),the mental health(F=4.854,P=0.005).The differences mainly found between the ①②③group and the ④group by LSD multiple testing.Conclusion The mental health is severely damaged with OCD patients.There is stability with the structure of the symptom dimensions of OCD.And it maybe showed the heterogeneity of the symptoms for the significant difference of impairments of quality of life in patients with OCD.

A study on visual P300 evoked by facial expression stimulus in social anxiety disorder / 中华行为医学与脑科学杂志

Objective To explore the changing indications of visual P300 evoked by facial expression stimulus in social anxiety disorder (SAD). Methods 30 patients with SAD were consecutively recruited, and matched with 30 normal controls (NC). They were evaluated by self-designed demographic questionnaire and Liebowitz Social Anxiety Scale (LSAS), Meanwhile the examination of the visual P300 evoked by five facial expression stimulus included sad, happy, surprise, angry and disgust was administrated to SAD patients and normal controls. Results Compared with NC group, SAD group had higher target P2 amplitudes ( ( 3.73 ± 3.06 ) μV )and higher target P3 amplitudes( ( 9.43 ± 4.01 ) μV ) evoked by angry facial expression (P＜ 0.05 ) and higher target P3 amplitudes( (9.57 ±4.42) μV) evoked by disgust facial expression (P＜0.05). The scores of LSAS in SAD was positively correlated with target P2 amplitudes (P＜0.05). Conclusion SAD group has abnormal changing indications of visual P300 evoked by facial expression stimulus.

Distribution of Personality Disorder Tendency of Outpatients in Psychological Counseling / 中国心理卫生杂志

Objective：To explore the distribution of personality disorder tendency of outpatients in psychological counseling departments.Methods：Systematic sampling was used to get the sample population from Shanghai Psychological Counseling Center.The Personality Diagnostic Questionnaire(PDQ~(+4))was administered to 1402 clients to screen personality disorders.Results：The subscales for different type of personality disorder(PD)and total score of PDQ~(+4) were higher than normal sample(e.g.total score of PDQ~(+4):client(38.23±17.04)vs.normal sample(22.79±14.10),P<0.001).The score of borderline subscales in female clients were higher than that of males [borderline:female(4.25±2.48)vs.male(3.97±2.41),P<0.05],the score of antisocial,paranoid and schizotypal subscales in male clients were higher than that of females [antisocial:female(1.31)vs.male(1.71),P<0.001;paranoid:female(2.75)vs.male(3.02),P<0.01;schizotypal:female(3.31)vs.male(3.56),P<0.05].Age stratification showed that the subscales for different type of PD of PDQ~(+4) were decreased with age [e.g.,total score of PDQ~(+4):18～24 years(41.73)vs.25～34 years(39.46)vs.35～44 years(33.88)vs.≥ 45 years(30.64),Ps<0.001],the positive rate of PDQ~(+4) subscales of obsessive-compulsive(58.5%)and avoidant PDs(54.0%)were higher than others,followed by borderline PD(44.4%).Factor analysis was used for the score of PDQ~(+4),factor 1 to 3 corresponded to cluster C,B and A personality disorders respectively,and the total variance explained 67%. Conclusion：There are different rates of personality deviation between psychological counseling clients and normal sample in China.Some traits of personality disorders can be improved with the increasing of age.The abstracted factors by factor analysis are very consistent with what originally proposed in the theory of personality disorder.It should be paid attention to PD tendency of clients during psychological counseling.

A prospective study of postpartum depression: biological and psychosocial factors / 中国神经精神疾病杂志

Objective 　The study aimed to measure the prevalence of postpartum depression, as well as their relevant psychosocial and biological factors. Methods　A sample of 299 women were prospectively studied at 3 day postpartum and 117 were reassessed at 42 day postpartum. They completed EPDS, some self-designed demographic and psychological investigation questionnaires. Results　23.08% suffered from postpartum depression. Some psychosocial factors such as support system were signigicantly related to the postnatal depression. Conclusions　Postpartum depression has social and psychological causal factors.