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Objective:To construct an evaluation the index system of entrustable professional activities for resident training doctors in psychiatric department,and to provide reference for formulating training strategies and assessment standards.Entrustable professional activities refers to the ability of trainees to perform and complete spe-cific clinical tasks independently after they have been trusted.Methods:Through documental analysis and semi-structured interviews,the item database of entrustable professional activities for psychiatric resident training physi-cians was established.Delphi consultation was conducted among 63 experts in the field of psychiatry from 7 national resident training bases and 3 medical colleges in China.Indicators were comprehensively screened and sorted out,and indicators at all levels and their weights were determined by the analytic hierarchy process.Results:A hierarchi-cal evaluation index system of entrustable professional activities for psychiatric resident training doctors was con-structed,including 4 first-level indicators,17 second-level indicators and 68 third-level indicators.The weights of the first-level,second-level and third-level indicators were determined.Conclusion:The evaluation index system of en-trustable professional activities is comprehensive and systematic,which is suitable for clinical work and convenient for practical application.It could provide quantitative standards for the assessment of psychiatric residents and pro-mote the improvement of training quality.
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BackgroundPatients with schizophrenia and depressive disorders exhibit abnormalities in perceptual processing. Previous perceptual studies are mainly based on asking participants to fill in a questionnaire, and little research has been undertaken on objective behavior in patients with schizophrenia and depressive disorders. ObjectiveTo explore the behavioral changes in vibrotactile sense among patients with schizophrenia and depressive disorders, so as to enrich relevant findings in objective behavioral research. MethodsFrom March 2021 to September 2023, 33 patients with schizophrenia and 31 patients with depressive disorders in the outpatient and inpatient departments of Beijing Huilongguan Hospital and met the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria were enrolled. And another 34 healthy controls were concurrently recruited at Beihang University and Beijing Huilongguan Hospital. Patients with schizophrenia were assessed using Positive and Negative Symptom Scale (PANSS), and patients with depressive disorders were assessed using Hamilton Depression Scale-17 item (HAMD-17). The vibrotactile sensitivity of the left hand in all participants was tested in a delay match-to-sample procedure, and the correct rate of vibrotactile delayed discrimination task was compared among the three groups. ResultsCompared with healthy controls, a reduction was found in the correct rates at index finger, middle finger and ring finger in patients with schizophrenia (P<0.01), the average correct rate at five fingers in patients with schizophrenia (P=0.001), and the correct rate at thumb in patients with depressive disorders (P=0.026). No statistical difference was reported in correct rate of vibrotactile delayed discrimination task between patients with depression disorders and schizophrenia (P>0.05). The average correct rate of vibrotactile sense in schizophrenia group was not significantly correlated with the duration of disease, age of onset, chlorpromazine equivalent doses and PANSS score (r=0.058、0.045、0.114、-0.194, P>0.05). The average correct rate in depressive group was negatively correlated with age of onset (r=-0.415, P=0.020), but not significantly correlated with the duration of disease and HAMD-17 score (r=-0.044, 0.142, P>0.05). ConclusionPatients with schizophrenia and depressive disorders have impaired vibrotactile sense. The vibrotactile sense is impaired in index, middle and ring fingers among patients with schizophrenia, and in thumbs of patients with depressive disorders. Moreover, the impairment in patients with depressive disorders may be related to the age of onset. [Funded by 2023 Hebei Provincial Graduate Innovation Funding Project (number, CXZZSS2023140)]
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BackgroundThe development of executive function in adolescents is influenced by many environmental factors. Previous studies have found that perceived stress is closely related to executive function, whereas its role in the mediation of executive function remains poorly studied. ObjectiveTo explore the role of negative affect and self-hate in mediating the relationship between perceived stress and executive function in adolescents, so as to assist the improvement of executive function in adolescents. MethodsQuestionnaires were administered to 7 734 adolescents from five junior and five senior high schools in Rizhao city, Shandong province from 1 to 30 May 2022. Data were collected using a self-made questionnaire, and adolescents were assessed using Perceived Stress Scale (PSS), Behavior Rating Inventory of Executive Function-Self Report Version (BRIEF-SR), Patient Health Questionnaire (PHQ-4) and Self-Hate Scale (SHS). Spearman correlation analysis was conducted to examine the correlation between variables. A Bootstrap method was chosen to examine the mediation effect of self-hate and negative affect on the relationship between perceived stress and executive function in adolescents. ResultsA total of 7 012 (90.66%) valid questionnaires were retrieved. BRIEF-SR score was positively correlated with PSS, PHQ-4 and SHS scores (r=0.564, 0.653, 0.597, P<0.01). PSS score was positively correlated with PHQ-4 and SHS scores (r=0.615, 0.531, P<0.01). PHQ-4 score was positively correlated with SHS score (r=0.566, P<0.01). The value of mediation effect of perceived stress on executive function was 0.574 (95% CI: 0.555~0.594). Self-hate (indirect effect value of 0.160, 95% CI: 0.145~0.175) and negative affect (indirect effect value of 0.143, 95% CI: 0.129~0.158), separately from each other, mediated the relationship between perceived stress and executive function, and a chained mediation effect of self-hate and negative affect was also documented (indirect effect value of 0.065, 95% CI: 0.058~0.073), accounting for 27.87%, 24.91% and 11.32% of the total effect, respectively. ConclusionThe perceived stress of adolescents may be a influencing factor of the executive function. Additionally, perceived stress can either directly affect executive function or indirectly through the separate or chained mediation via negative affect and self-hate.
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Objective:To explore the mediating role of self-hating in the influence of adverse childhood experiences on adolescents' negative emotions.Methods:A questionnaire method was used to collect demographic variables, and 7 012 valid questionnaires were obtained from adolescents by applying the revised adverse childhood experiences questionnaire, patient health questionnaire-4, and self-hate scale from May 1 to May 30, 2022, in five high schools(90 classes) and five junior high schools(60 classes) in Rizhao city, Shandong province, China. Data entry and analysis were performed by SPSS 22.0 software.Mann-Whitney U test was used for the comparison between demographic variables and other variables, and the correlations between variables were expressed by Spearman correlation coefficient. AMOS 23.0 software was applied for testing the mediating and moderating effects of variables. Results:(1)There were significant positive correlations between adverse childhood experiences(0(2)) and negative emotion(3(10))( r=0.459, P<0.01), self-hating(2(4))( r=0.427, P<0.01). There were significant positive correlations between self-hating and negative emotion( r=0.566, P<0.01). (2) Self-hating played a mediating role between adverse childhood experience and adolescent negative emotion, and the mediating effect was 0.299, accounted for 61.27% of the total effect.(3) The mediating pathway of self-hated was moderated by gender, with girls' adverse childhood experiences( Bsimple=2.428, t=39.585, P<0.05) predicting self-hating more than boys( Bsimple=1.641, t=25.355, P<0.05). Conclusion:Adverse childhood experiences can predict adolescents' negative emotions, and self-disgusting can also affect adolescents' negative emotions.Gender plays a moderating role in the mediating pathway.
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Objective:To explore the situation of insomnia, fatigue, depression, anxiety and cognitive impairment in adolescents with different characteristics, and the chain mediating effect of fatigue, depression and anxiety on insomnia and cognitive impairment.Methods:The general demographic data of 6 014 adolescents were collected.Insomnia severity index (ISI), the multidimensional fatigue inventory (MFI-20), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and perceived deficits questionnaire-depression(PDQ-D) were used to compare the insomnia, fatigue, depression, anxiety and cognitive impairment of adolescents with different characteristics.Spearman correlation analysis was conducted by SPSS 20.0 software.The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The detection rates of insomnia, fatigue, depression, anxiety and cognitive impairment were different in adolescents with different genders, grades and academic achievements.Cognitive impairment was significantly positively correlated with insomnia ( r=0.654, P<0.01), fatigue ( r=0.476, P<0.01), depression ( r=0.677, P<0.01), anxiety ( r=0.655, P<0.01), which was suitable for mediating effect test.Fatigue, depression and anxiety in adolescents had a chain mediating effect between insomnia and cognitive impairment.Insomnia indirectly affects cognition by affecting fatigue and depressive symptoms.The intermediary effect value was 1.253, the effect amount was 55.60%, and the total effect was 2.254.Insomnia indirectly affects cognition by affecting fatigue and anxiety symptoms.The intermediary effect value was 1.161, the effect amount was 51.50%, and the total effect was 2.254. Conclusion:Insomnia can not only directly affect their cognitive impairment, but also indirectly affect their cognitive impairment through the chain mediation of fatigue, depression and anxiety of adolescents.
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ObjectiveTo discuss the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. MethodsA total of 47 patients with depression in remission in Beijing Huilongguan Hospital were enrolled. Insomnia Severity Index (ISI) and the sleep efficiency calculated by the first four items of Pittsburgh Sleep Quality Index (PSQI) were defined as insomnia. Among the selected patients, 22 subjects were classified into insomnia group, and 25 subjects in non-insomnia group. The objective sleep status of all subjects was evaluated by polysomnography (PSG), and the cognitive function was evaluated with the Repeatable Battery for Assessment of Neuropsychological Status (RBANS). A regression model was established to explore the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. ResultsThere was statistically significant difference in immediate memory factor scores of RBANS between depression patients in remission with and without insomnia (t=-2.102, P<0.05). The sleep efficiency (Z=-2.113, P<0.05), the proportion of N3 sleep stage (Z=-3.175, P<0.01) and the duration of N3 sleep stage (Z=-3.196, P<0.01) in insomnia group were all lower than those in non-insomnia group, and the nocturnal awakening (Z=-2.058, P<0.01), the proportion of N1 sleep stage (Z=-2.399, P<0.05) and the duration of N1 sleep stage (Z=-2.463, P<0.05) were higher than those of the insomnia group. Within insomnia group, the increased proportion of REM sleep was correlated with the improvement of attention function (β=0.953, 95% CI: 0.123~2.038, P<0.05), and the increase of nocturnal awakening was correlated with the decline of delayed memory (β=-0.173, 95% CI: -0.325~-0.024, P<0.05). ConclusionObjective sleep is associated with cognitive impairment in remission depression patients with insomnia, the proportion of REM sleep has a positive impact on attention function, and frequent nocturnal awakening at night has a negative impact on delayed memory.
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Objective:To study the effects of LY294002, a phosphatidylinositol 3 kinase(PI3K) inhibitor, on the AKT/GSK3β/CRMP2 signaling pathway, and the effect of pathway alterations on the depression-like behavior and microtubulin proteins of SD rats.Methods:Sixteen adult male SD rats were randomly divided into LY294002 group and solvent DMSO group by blind method, 8 rats in each group.After anesthesia, the rats were subjected to stereotactic tube placement in the hippocampal CA1 area. After 1 week of the tube placement, stereoscopic injection of LY294002 or DMSO was given, and depression-like behaviors were detected. RT-qPCR technology was used to detect hippocampal AKT, GSK3β, CRMP2, and tubulin mRNA expression levels, and Western blot technology was used to detect the expression levels of hippocampal AKT, p-AKT, GSK3β, p-GSK3β, CRMP2, p-CRMP2, and microtubule dynamic-related proteins markers Acet-tubulin, Tyr-tubulin. Analysis and comparison of behavioral and molecular expression differences between the two groups were conducted.Results:The open field experiment showed that the central movement distance of the rats in the LY294002 group were significantly lower than those in the control group((3.64±2.17) cm, (31.51±12.68) cm; t=2.69, P=0.03), and the duration of the central area in the LY294002 group were also significantly lower than those in the control group((0.73±0.46)s, (4.85±2.10)s; t=2.33, P=0.04). The results of the forced swimming test showed that the immobility time of rats in the LY294002 group had upward trend, but the difference was not statistically significant. The sucrose preference results showed no significant difference in sugar water consumption between the two groups ( P>0.05). The RT-qPCR results showed that the expression level of CRMP2 mRNA in the LY294002 group decreased significantly ( P<0.05). Western blot results showed that compared with solvent DMSO group, the expression levels of p-AKT and p-GSK3β in the LY294002 group decreased ( P<0.05), the expression level of CRMP2 was decreased and the expression level of p-CRMP2 was significantly increased. At the same time, the expression level of Tyr-tubulin decreased, while Acet-tubulin level increased significantly, and the differences were statistically significant ( P<0.05). Conclusion:LY294002 affects AKT/GSK3β/CRMP2 signaling pathway, induces impairment of microtubular dynamic, and results in depression-like behavior in rats.
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Objective To explore the efficacy of group cognitive behavioral therapy for improving depressive symptoms and social functional in patients with major depressive disorder.Methods A total of 160 patients with major depressive disorder were randomly divided into intervention group (n=80) and control group (n=80).Intervention group was treated with conventional antidepressants combined with group cognitive behavioral therapy.Control group was treated with one conventional antidepressants.All participants were assessed with Hamilton Depression Scale (HAMD)and Scale of Social function of Psychosis Inpatients (SSFPI) before and 8 weeks after the treatment.Results After 8 weeks treatment,the scores of HAMD (14.76±9.48) was significantly reduced and the scores of SSFPI(30.09±4.34) were significantly increased in intervention group compared with the baseline ((37.91± 10.58),(12.40±2.56),all P<0.01).The scores of HAMD were significantly lower and the scores of SSFPI were significantly higher in intervention group than that in control group((20.71±7.85),(22.63±3.63),all P<0.01).Conclusion Group cognitive behavioral therapy is effective for major depressive disorder patients by reducing depressive symptom and improving social function.
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Objective To investigate the serum levels of uric acid (UA) in bipolar disorder patients and their clini?cal significance. Methods Serum levels of UA was measured in 126 bipolar disorder patients including 77 mania pa?tients and 49 depression patients, 69 first-episode schizophrenic patients and 126 healthy controls (control group). Bipo?lar disorder patients was assessed by using the Young Mania Rating Scale (YMRS) and the Hamilton Depression Scale (HAMD). Results The serum UA levels were significantly higher in bipolar group [(349.34 ± 107.21) μmol/L] than in schizophrenic group [(319.71±84.48)μmol/L] and in control group [(280.94±71.90)μmol/L] (P0.05). Correlation analysis indicated that the correlation of serum UA levels with YMRS scores and HAMD scores was not significant in bipolar disorder patients (P>0.05). Conclusions Patients with bipolar disorder has elevated serum uric acid levels which may be a biomarkers of bipolar disorder.
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Objective To explore the association between serum levels of homocysteine (Hcy) and relation factors in the patients with manic episodes of bipolar Ⅰ disorder(BD).Methods The case-control study was used for this study.A total of 73 inpatients with manic episodes of BD(patient group) and 39 healthy individuals (control group) were enrolled.Diagnosis was made according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition(DSM-Ⅳ) criteria.Serum levels of Hcy was measured by enzymatic cycling assay.Young Mania Rating Scale(YMRS) were used to assess the severity of clinical symptoms of patients.Results There was a statistical difference in serum Hcy levels between patient group ((16.89± 14.67)μmol/L) and control group ((10.61±6.46) μmol/L) (P<0.01),and serum Hcy levels was higher in men((20.42± 16.52) μmol/L) than that in women((10.87±8.02) μmol/L) in patients group(P<0.05).The prevalence rate of high Hcy was 35.6% in the patient group and 13.5% in the control group(P<0.05).Correlation analysis showed body mass index(BMI) had positive correlation with serum levels of Hcy (r=0.317,P<0.05).Stepwise multiple regression analysis showed male,BMI were associated with serum levels of Hcy among the patients (all P< 0.05).Conclusion Serum Hcy levels in the patients with manic episodes of bipolar Ⅰ disorder increase,and it is associated with gender and BMI.
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Objective: To examine the correlation of symptomatic feature and exploratory eye movements in schizophrenia. Methods: The eye movements of 60 patients with schizophrenia and 30 healthy control subjects were measured by the eye-mark recorder (model IV, Japan) and symptom profiles of patients were assessed using the Positive and Negative Syndrome Scale (PANSS) . Pearson correlation analysis was performed to examine the relationship between five-factor scores of PANSS, positive symptoms, negative symptoms and exploratory eye movements respectively. Results: The differences of all indices of eye movements between schizophrenic groups and normal control group had statistical significance ( P