Low Hemoglobin Level and Elevated Inflammatory Hematological Ratios Associated With Depression and Sleep Disturbance.

BACKGROUND: The relationship between blood cell profiles, including hemoglobin (Hb) levels and inflammatory hematological ratios, and mental health problems currently remains unclear. AIM: This study aimed to investigate the relationship between blood cell profiles and mental health issues, including depressive state and sleep disturbance, while adjusting for potential demographic confounders. METHODOLOGY: This retrospective, cross-sectional, observational study used a population-based medical database from the Tohoku Medical Megabank Project with more than 60,000 volunteers. Data on age, sex, daily tobacco use, body mass index, and self-reported scores on the Kessler Psychological Distress Scale (K6), Athens Insomnia Scale (AIS), and the Center for Epidemiologic Studies Depression Scale (CES-D) were collected. RESULTS: A total of 62,796 volunteers (23,663 males and 39,133 females), aged ≥20 years at the time of the blood test, agreed to participate in this study. Among the evaluated blood cell profiles, Hb, hematocrit, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were significantly correlated with the K6, AIS, and CES-D scores, with strong statistical significance (p<0.0001 for all) in bivariate correlation analyses. A significant adjusted odds ratio (aOR) of the Hb level for elevated CES-D scores (aOR=0.965 [95% CI: 0.949-0.981], p<0.0001) was confirmed after adjusting for demographic data and daily tobacco use using a logistic regression model. Sensitivity analyses revealed that these associations existed in both males and females but were more prominent in the former. In male participants, a low Hb level was significantly associated with an elevated AIS score. The evaluated inflammatory hematological ratios, including NLR, PLR, and monocyte-to-lymphocyte ratio (MLR), also showed significant aORs with the K6, AIS, and CES-D scores after adjusting for demographic background. CONCLUSION: Low Hb levels and elevated inflammatory hematological ratios (NLR, MLR, and PLR) were associated with depressive state and sleep disturbances in the general population.

Relationship between ruminative style and adolescent depression.

BACKGROUND: The role of rumination in depression remains controversial. We aimed to establish the ruminative tendency style theory (RTST), discuss the occurrence of depression in adolescents with rumination as the core, and explore the different associations between adolescent ruminative tendency, ruminative style, and depression. METHODS: This study employed an online questionnaire survey of 1110 Chinese adolescents aged 12-17 years, assessing ruminative tendency, ruminative style, stressful life events, depressive state, depressive trait, the Big Five personality traits, and social support. Conditional process analysis was used to test the chain mediation effect with Ruminative Style as a moderator. After screening for the predictor variables, a logistic regression risk prediction model was established and validated internally. RESULTS: The chain mediation effect of ruminative tendency and depressive trait between stressful life events and depressive state was significant, with the indirect effect accounting for 63.4%. Ruminative Style negatively moderated the relationship between Ruminative Tendency and Depressive Trait (ß=-0.053，P＜0.001). The risk prediction model for depressive state showed good calibration and clinical utility. Area under the curve values for the validation and training sets were 0.926 and 0.927, respectively. CONCLUSION: Different associations may exist between adolescent ruminative tendency, ruminative style, and depression, and the proposal of ruminative style is of great significance for intervention in adolescent depression.

Effect of tuina on sleep quality, psychological state and neurotransmitter level in patients with insomnia: a systematic review and meta-analysis.

Background: Abnormal psychological state and neurotransmitter levels are important factors affecting sleep quality. Numerous studies have shown that tuina can improve the symptoms of sleep disorders in patients with insomnia while relieving anxiety and depression and regulating neurotransmitter levels. However, there have been no meta-analyses on the effect of tuina on psychological states and neurotransmitter levels. Objectives: A meta-analysis was performed to systematically evaluate the effects of massage on sleep quality, psychological state, and neurotransmitter levels in patients with insomnia. Methods: A comprehensive literature search was conducted from inception to July 2023 using eight electronic databases to identify randomized controlled trials (RCTs) on tuina therapy for insomnia. Gray literature was also searched. The methodological quality of the included studies was assessed using the Cochrane Handbook. Reviewer Manager 5.4 and Stata 16.0 were employed for statistical analysis. Results: A total of 23 studies were included, including 1780 patients with insomnia, of whom 892 and 888 were in the experimental and control groups, respectively. Meta-analysis indicated that tuina therapy was superior to other therapies for the treatment of insomnia in increasing the total effective rate [OR = 4.12, 95%CI (2.80, 6.06), p < 0.00001] and 5-hydroxytryptamine (5-HT) level [MD = 16.03, 95% CI (13.40, 18.65), p < 0.00001], while reducing the Pittsburgh Sleep Quality Index score [MD = -2.34, 95% CI (-2.94, -1.74), p < 0.00001], Athens Insomnia Scale score [MD = -2.10, 95% CI (-2.67, -1.52), p < 0.00001], self-rating anxiety scale score [MD = -6.77, 95% CI (-8.34, -5.20), p < 0.00001] and self-rating depression scale score [MD = -6.60, 95% CI (-8.82, -4.37), p < 0.00001]. Subgroup analysis showed that tuina alone or in combination with other therapies was superior to drugs or acupuncture alone in improving all outcomes (p < 0.05). Only two studies reported minor adverse events. Conclusion: Tuina for insomnia has certain therapeutic advantages and can significantly improve sleep quality, relieve anxiety-depressive states, and increase 5-HT levels with high safety. Due to the limitations of the quality of the included studies, additional high-quality clinical trials are required for further verification. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=447839, identifier CRD42023447839.

Association of sleep status with depressive state in centenarians: Evidence from Hainan centenarian cohort.

OBJECTIVE: The objective of this study is to analyze the association between sleep quality, sleep duration, sleep patterns, and depressive states among centenarians due to the crucial impact of depression on the well-being of elderly individuals, particularly the oldest. Recognizing easily identifiable manifestations and risk factors is essential since the onset of depressive states tends to be insidious. METHODS: The baseline data from the China Hainan Centenarians Cohort Study (CHCCS) served as the basis for this study. Questionnaire surveys were conducted to obtain research indicators, with depressive states evaluated using the GDS-15 scale and sleep quality evaluated using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was employed to describe the association between sleep status and depressive states. RESULTS: A total of 994 centenarians, with an age range of 100-116 years and a mean age of 102.77 ± 2.75 years, were included in this study. Among these participants, 815 were female, accounting for 82.0 %. After adjustment, the odds ratio (OR) for the association between poor sleep quality and depressive states was 2.07 (95 % CI: 1.54-2.77) compared to those with normal sleep quality. Additionally, there were associations between depressive states and both nighttime sleep duration and total sleep duration. After adjustment, the strongest association between depressive state and sleep patterns was found for those who had >9 h of nighttime sleep and ≥2 h of daytime sleep (OR = 1.80, 95%CI: 1.02-3.16). Moreover, compared to centenarians with 7-9 h of sleep duration and good sleep quality, the highest odds ratio (OR = 3.44, 95%CI: 2.18-5.43) for the association between depressive states and sleep duration ≤7 h and poor sleep quality was observed. CONCLUSION: The findings of this study indicate that there is an association between poor sleep quality and depressive states in centenarians. Furthermore, both sleep quality and long/short total sleep duration are associated with depressive states in this population. Therefore, special attention should be given to the psychological state of elderly individuals with short sleep duration and poor sleep quality in order to prevent depression and minimize its negative impact on their overall health.

Survey of physicians' and patients' understanding, perceptions, and attitudes toward depressive state in atrial fibrillation.

BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia among older people and has a significant impact on quality of life. However, it is not always perceived as a serious mental health risk. This study investigated the understanding, perceptions, and attitudes toward the risk of depressive state associated with older patients with AF. METHODS: We conducted a quantitative survey in April-June 2021 among patients with AF aged ≥65 years (n = 156), and physicians or cardiologists attending at least 10 older patients with AF annually (n = 158). RESULTS: In total, 45% of patients considered AF a cause of a depressive state. In contrast, 16% of physicians reported that they considered AF a cause of a depressive state. Fifty-two percent of the patients had experienced a depressive state. Of these, 98% expressed that a depressive state lowered their quality of life. Two of the three patients reported that they would consult their physicians if they felt depressed. By contrast, 30% of physicians responded that even if they perceived their patients as depressed, they prescribe anti-anxiety medication but do not refer the patient to psychiatrists. Of the physicians, 50% stated that they did not regard the association of AF and depressive state as serious, although both physicians and patients understood that negative anxiety, such as fear of AF attacks, strokes, or heart failure, was the most important contributor to a depressive state. CONCLUSION: Establishing mental healthcare involving physicians together with psychiatrists is necessary to improve the mental and physical health outcomes for older patients with AF. Geriatr Gerontol Int 2023; 23: 543-548.

Effects of low-frequency rTMS combined with antidepressants on depression in patients with post-stroke depression: a systematic review and meta-analysis.

Objective: To evaluate the effect of low-frequency (≤1 Hz) repetitive transcranial magnetic stimulation (low-frequency rTMS) combined with antidepressants on depression and the levels of inflammatory factors IL-6 and TNF-α in patients with post-stroke depression (PSD). Design: PubMed, Embase, Web of Science, Cochrane Library (CBM), China National Knowledge Infrastructure, Technology Periodical Database, and Wanfang Database were searched until October 2022 for randomized controlled trials. Participants: Patients with post-stroke depression (PSD) participated in the study. Results: A total of 16 randomized controlled trials (RCTs) involving 1,463 patients with PSD were included. According to the Physiotherapy Evidence Database (PEDro) quality assessment, three studies received high quality (eight scores) and 13 RCTs received moderate quality (six scores) results. The meta-analysis showed that low-rTMS combined with an antidepressant significantly reduced the Hamilton Depression Scale (HAMD) score and the National Institutes of Health Stroke Scale (NIHSS) score, reduced IL-6 and TNF-α levels, and improved the MMSE score in PSD compared to an antidepressant alone. Conclusion: The results of this meta-analysis evidenced the efficacy and safety of low-rTMS combined with antidepressants in the treatment of depression in PSD patients. The combined therapy could reduce The depression state and the levels of IL-6 and TNF-α, and enhance the cognitive function of patients. In addition, low-rTMS had fewer adverse effects, proving safety. However, there are shortcomings, such as a lack of long-term follow-up, different intervention sites of low-rTMS, and different intervention frequencies (0.5 or 1 Hz). Thus, in the future, RCTs with a larger sample size and longer-term observation are required to verify the efectiveness of low-rTMS combined therapy on PSD. Meantime, a new meta-analysis could be analysized, which intervention sites and frequency are more effective in treating PSD. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022376845.

Music Therapy in the Treatment of Dementia: A Review Article.

The etiology of depression is the degeneration of the brain cells involved in cognitive function before the other brain cells. It is characterized by a neurological condition that causes a reduction in terms of physical, social, and cognitive impairment and has no cure presently. These nonpharmacological approaches, such as music therapy, enhance living outcomes for those dealing with dementia and also reduce behavioral incidence. Among these strategies is music therapy, and individual or gap-time psychological and educational counseling. Many scientists believe in the advantages of music for the brain. The brain is affected by music function and enhances some cognitive abilities, including the mechanism of speech, alteration, memory, and learning. Music can activate the limbic system, subcortical circuits, and emotionally related systems, inducing the sensation of well-being. The music itself is quite effective at increasing cerebral plasticity. Music therapy has powerful stimulation for neuroplastic alterations in the adult and developing brain. Dementia can be cured by music therapy and music-based intervention (nonpharmacological intervention) rather than by medication. This study highlights dementia therapy utilizing the music therapy method.

Risk Factors in Japanese Drug Overdose Patients: Identifying Their Associations With Suicide Risk.

Several suicide attempts presented at the emergency department are due to drug overdose associated with psychiatric disorders. We examined and identified the major risk factors among Japanese drug overdose patients and several close associations of suicide risk. We enrolled 101 patients who attempted suicide by drug overdose between January 2015 and April 2018, assessed their background using the SAD PERSONS scale, and performed association rule analysis to characterize the major risk factors and their associations. We identified three main nodes-depressive state, social support lacking, and no spouse-as considerable risk factors. Furthermore, we identified several close associations of suicide risk and their intensity; in cases with previous suicide attempts and ethanol abuse or substance use, a simultaneous social support lacking is likely. These findings align with previous studies that used conventional statistical analysis on suicide and suicide attempt risk and highlight its importance.

Reduced homovanillic acid, SDF-1α and SCGF-ß levels in cerebrospinal fluid are related to depressive states in systemic lupus erythematosus.

OBJECTIVE: This study aimed to seek a new method of evaluation and surrogate markers for diffuse neuropsychiatric SLE (NPSLE). METHODS: We enrolled 44 patients with SLE between 2017 and 2020 who fulfilled at least one of three specific inclusion criteria: high disease activity, abnormal findings (cerebrospinal fluid [CSF] examination, brain MRI, or electroencephalography), or history of neuropsychiatric illness. Psychiatric symptom rating scales (PSYRATS) were evaluated retrospectively. The primary end point was the PSYRATS positivity rate in SLE patients who had not been diagnosed with diffuse NPSLE. RESULTS: Based on the 1999 ACR classifications, 7 out of the 44 patients evaluated using PSYRATS had been diagnosed with diffuse NPSLE. PSYRATS positivity was seen in 13 out of 37 SLE patients (35.1%) who had not been diagnosed with diffuse NPSLE, and all these patients were positive for Montgomery-Åsberg Depression Rating Scale (MADRS), an indicator of depression state in PSYRATS. Additionally, in the 20 SLE patients exhibiting depression symptoms who were MADRS-positive, CSF concentrations of the neuroinflammatory markers homovanillic acid (HVA; P = 0.0400), stromal cell-derived factor-1α (SDF-1α; P = 0.0431) and stem cell growth factor-ß (SCGF-1ß; P = 0.0061) were significantly reduced compared with the 24 MADRS-negative SLE patients, and the levels of HVA, SDF-1α and SCGF-1ß correlated with one another (P < 0.05). CONCLUSION: Many patients with active SLE have subclinical depression, and MADRS evaluation of neuropsychiatric symptoms is useful for detecting them. Additionally, the decrease in CSF levels of HVA, SDF-1 α and SCGF-1ß reflects the same pathology, and these may serve as surrogate markers.

On brutal gestures: trauma, destruction, and forms of mental illness.

The Bohemian writer Milan Kundera narrates, more than once, an experience from his years of life under an authoritarian regime. It is the memory of a violent fantasy of rape, one in which libido and destruction are mingled. Based on this memory and how he wrote about it, we present two forms of mental illnesses (by activation and by passivation) and relate them to the model proposed by Green to think about depressive states through passivation. The first form of mental illness, by activation, is the result of an overly successful active defense against anxiety. The second form, by passivation, is a paradoxical reaction to agony in the face of deadly psychic states. Arguing that this second form of mental illness is frequently identified in individuals during periods of political change, we consider that the intricacy between the drives of destruction and the libido, even when it generates fantasies or brutal gestures, can reveal itself as an episodic attempt of an active defense amid the predominance of passivation generated by post-traumatic helplessness.

Association between serum oxytocin levels and depressive state in community-dwelling older adults: A cross-sectional study.

Aim: Identifying peripheral biomarkers related to the prevention or modification of unhealthy mental conditions in older adults would be extremely beneficial. This study aimed to evaluate serum oxytocin levels in older adults living in a rural community and their association with cognitive function, anxiety, depressive state, and well-being. Methods: This survey was conducted between November 2016 and September 2017 in Kurokawa-cho, Imari, Saga Prefecture, Japan, among people aged ≥65 years. Blood samples were collected from the participants for serum oxytocin level analysis, which was performed using peptide enzyme immunoassay. Participants underwent neuropsychological assessments, including the Mini-Mental State Examination, Clinical Dementia Rating, Frontal Assessment Battery, State-Trait Anxiety Inventory, 15-item Geriatric Depression Scale, and 17-item Philadelphia Geriatric Center Morale Scale. We examined the association between serum oxytocin levels and neuropsychological assessment results. Results: Out of 94 participants, 25 were men and 69 were women, with mean ages of 78.24 ± 3.85 years and 78.10 ± 5.43 years, respectively. Serum oxytocin levels were negatively associated with 15-item Geriatric Depression Scale scores. Additionally, nondepressive state/depressive state was classified by the 15-item Geriatric Depression Scale (cut-off 5/6). Logistic regression analysis showed that higher serum oxytocin levels tended to be associated with a less depressive state at that time. Conclusions: Serum oxytocin levels may be associated with depressive state in adults aged ≥65 years.

EEG-based high-performance depression state recognition.

Depression is a global disease that is harmful to people. Traditional identification methods based on various scales are not objective and accurate enough. Electroencephalogram (EEG) contains abundant physiological information, which makes it a new research direction to identify depression state. However, most EEG-based algorithms only extract the original EEG features and ignore the complex spatiotemporal information interactions, which will reduce performance. Thus, a more accurate and objective method for depression identification is urgently needed. In this work, we propose a novel depression identification model: W-GCN-GRU. In our proposed method, we censored six sensitive features based on Spearman's rank correlation coefficient and assigned different weight coefficients to each sensitive feature by AUC for the weighted fusion of sensitive features. In particular, we use the GCN and GRU cascade networks based on weighted sensitive features as depression recognition models. For the GCN, we creatively took the brain function network based on the correlation coefficient matrix as the adjacency matrix input and the weighted fused sensitive features were used as the node feature matrix input. Our proposed model performed well on our self-collected dataset and the MODMA datasets with a accuracy of 94.72%, outperforming other methods. Our findings showed that feature dimensionality reduction, weighted fusion, and EEG spatial information all had great effects on depression recognition.

[Dyspnea: neurobiological and clinical aspects].

An analysis of the results of studies carried out by specialists of the Russian Respiratory Society over the past 15 years is given. The article also includes the main provisions set out in the III Guidelines for dyspnea. A significant part of the manual is devoted to the recent achievements in studying neurophysiological processes in the brain structures during the development of dyspnea. These achievements were driven by image-diagnosis methods. An important aspect of this series of works for the clinical practice was identifying dyspnea domains and developing the instruments to assess severity. Analysis of the data on dyspnea from the clinical practice showed a highly heterogenic clinical picture, which must be taken into account in the management of individual patients. A diagnostic algorithm for long-term follow-up of patients with dyspnea syndrome is also discussed. The attention of doctors is drawn to the features of dyspnea during COVID-19; the disproportion between the sensory perception of respiratory discomfort and the degree of oxygen desaturation is emphasized. It was concluded that in the Russian-speaking environment of patients, doctors should actively use a verbal characteristic of dyspnea the language of dyspnea.

Factors Associated with Caregiver Burden and Depressive States among Family Caregivers of Patients Admitted due to Behavioral and Psychological Symptoms of Dementia.

INTRODUCTION: Among those caring for people with dementia (PwD) at home, more than 60% feel a caregiver burden (CB), and one in three are depressed. Reducing feelings of burden and depressive states in caregiving families will improve the living environment for PwD. However, very few studies have focused on effective methods and reducing feelings of burden and depressive states of caregivers. Thus, using data from a previous study, we aimed to determine the factors associated with perceived CB and depressive states experienced by caregivers for PwD with behavioral and psychological symptoms of dementia (BPSD) at home. METHODS: We performed single regression analysis on 285 participants' data to determine the association between each item and the Zarit Caregiver Burden Interview and Center for Epidemiologic Studies-Depression Scale scores. We performed multiple regression analysis with variables considered in the single regression analysis as independent variables. RESULTS: Severity of BPSD, caregivers' subjective health status (SHS), time of caregiving, and depressive states were related to CB, and caregivers' SHS and CB were related to depressive states. CONCLUSIONS: Similar to previous studies, we identified an association between family caregivers' perceived CB and BPSD in PwD. Additionally, we found that caregivers' SHS is commonly associated with both perceived CB and depressive states. This is a new finding. Our results suggest that interventions focusing on family caregivers' health status can help not only to reduce family caregivers' CB and depressive states but also stabilize patients' symptoms and provide home-based care for a longer time.

A Young Japanese Patient with Spinocerebellar Ataxia Type 3 Presenting Depressive State with Cenesthopathy and Delusion: a Case Report.

Depressive state is a common complication of spinocerebellar ataxia type 3 (SCA3). To the best of our knowledge, cases of SCA3 presenting with cenesthopathy have not been described. Here, we present a case of a severe depressive state with cenesthopathy and delusion in a young Japanese man with SCA3. A 43-year-old Japanese man with SCA3 developed a severe depressive state with associated cenesthopathy and delusion. He was treated with escitalopram (10 mg/day) and olanzapine (2.5 mg/day). Computed tomography showed atrophy of the cerebellum, bilateral superior cerebellar peduncle, and tegmentum of the pons. Single-photon emission computed tomography demonstrated reduced blood flow in the cerebellum, vermis, and brainstem. After 8 weeks, his depressive state and delusion improved; however, his cenesthopathy persisted. We encountered a case of a severe depressive state with cenesthopathy and delusion in a young Japanese man with SCA3. This case supports previous studies that the cerebellum could have a role beyond motor functions.

Mechanism of Traditional Chinese Medicine in Treating Depressive-related Syndromes Based on Intestinal Flora： A Review / 中国实验方剂学杂志

The depressive state， as an emotional disorder， has common symptoms of lack of interest， self-denial， unresponsiveness， unwillingness to communicate， and even extreme misanthropy or suicidal tendency. The depressive state involves a variety of diseases， such as depression， post-stroke depression， postpartum depression， irritable bowel syndrome， major depression， and schizophrenia， which affects the treatment effect and prognosis of the disease， seriously reduces the quality of life and increases the economic burden of patients. At present， the mechanism of depressive state is complex， and the pathophysiological mechanism is unclear. The mechanism of depressive state may be related to abnormal expression of monoamine neurotransmitters， neuronal damage， changes in transduction pathways， hyperactivity of the hypothalamic-pituitary-adrenal （HPA） axis， release of inflammatory cytokines， etc. An increasing number of studies in recent years have confirmed that the occurrence of depression is closely related to intestinal flora disorder， and they interact with each other. Traditional Chinese medicine （TCM） is effective in preventing and treating depressive state with few adverse reactions and a low recurrence rate. TCM also has the effect of regulating the homeostasis of intestinal flora. At the same time， intestinal flora affects the absorption and efficacy of active components of Chinese medicine through metabolic transformation. With the development of microecology， in-depth studies are conducted on the effect of intestinal flora on the occurrence and development of depressive state and brain-gut axis. Intestinal flora has become another potential target for the study of TCM treating depressive state. Starting from the theory and clinical practice of TCM， this paper summarized the mechanism of TCM in treating depressive state by Chinese medicine monomers， compound prescriptions， and acupuncture based on the theory of intestinal flora in recent years. This paper provided information for the profound study of the pathogenesis of depressive state and the scientific connotation of TCM in treating depressive state and ideas for the systematic exploration of the microbiological basis of symptom changes.

Mechanism of Traditional Chinese Medicine in Treating Depressive-related Syndromes Based on Intestinal Flora： A Review / 中国实验方剂学杂志

The depressive state， as an emotional disorder， has common symptoms of lack of interest， self-denial， unresponsiveness， unwillingness to communicate， and even extreme misanthropy or suicidal tendency. The depressive state involves a variety of diseases， such as depression， post-stroke depression， postpartum depression， irritable bowel syndrome， major depression， and schizophrenia， which affects the treatment effect and prognosis of the disease， seriously reduces the quality of life and increases the economic burden of patients. At present， the mechanism of depressive state is complex， and the pathophysiological mechanism is unclear. The mechanism of depressive state may be related to abnormal expression of monoamine neurotransmitters， neuronal damage， changes in transduction pathways， hyperactivity of the hypothalamic-pituitary-adrenal （HPA） axis， release of inflammatory cytokines， etc. An increasing number of studies in recent years have confirmed that the occurrence of depression is closely related to intestinal flora disorder， and they interact with each other. Traditional Chinese medicine （TCM） is effective in preventing and treating depressive state with few adverse reactions and a low recurrence rate. TCM also has the effect of regulating the homeostasis of intestinal flora. At the same time， intestinal flora affects the absorption and efficacy of active components of Chinese medicine through metabolic transformation. With the development of microecology， in-depth studies are conducted on the effect of intestinal flora on the occurrence and development of depressive state and brain-gut axis. Intestinal flora has become another potential target for the study of TCM treating depressive state. Starting from the theory and clinical practice of TCM， this paper summarized the mechanism of TCM in treating depressive state by Chinese medicine monomers， compound prescriptions， and acupuncture based on the theory of intestinal flora in recent years. This paper provided information for the profound study of the pathogenesis of depressive state and the scientific connotation of TCM in treating depressive state and ideas for the systematic exploration of the microbiological basis of symptom changes.

WITHDRAWN: Health risk assessment of rural older population.

Ahead of Print article withdrawn by publisher.

Colchicine-Resistant Familial Mediterranean Fever With Depressive State Successfully Treated With Escitalopram.

Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease associated with the Mediterranean fever (MEFV) gene and is mainly characterized by periodic fever and serositis. Colchicine has been used to prevent FMF episodes and reduce the frequency of attacks. We report the case of a 64-year-old man who presented with depressive symptoms and was resistant to colchicine treatment. Adding escitalopram to the ongoing colchicine regimen dramatically improved his fever, abdominal pain, and depressive symptoms. The change in cytokines, ABCB1 effects, and increased serotonin were related to these mechanisms. This case suggested that adding escitalopram to colchicine is a viable treatment option for colchicine-resistant FMF.

Cariprazine modulates sleep architecture in rats.

BACKGROUND: Cariprazine is a dopamine D3-preferring D3/D2 receptor partial agonist compound recently introduced to treat schizophrenia and bipolar disorder. Although cariprazine is clinically classified as a low-somnolence drug, to date no detailed polysomnographic study is available on its effect on sleep. AIMS: This study examined the acute systemic effects of cariprazine on the rat sleep architecture and electroencephalography spectral power. METHODS: Sprague Dawley rats were recorded during their normal sleep period for four hours, and their sleep stages were classified. RESULTS: Cariprazine (0.3 mg/kg i.p.) reduced the time spent in rapid eye movement (REM) sleep and increased REM latency. This dose of cariprazine decreased the gamma (40-80 Hz) band frequency oscillations and increased the theta (4-9 Hz) and alpha (9-15 Hz) frequencies during the wake periods but not during slow-wave sleep. The 0.03 mg/kg dose of cariprazine only increased the alpha power during the wake periods, while the 0.003 mg/kg dose was without any effect. CONCLUSION: Taken together, the present results suggest that the REM-suppressing effect of cariprazine may be related to its effectiveness in improving depressive symptoms, as various drugs with similar REM-reducing properties effectively treat the depressive state, whereas the gamma power-reducing effect of cariprazine may be indicative of its efficacy in schizophrenia or mania, as similar effects have been observed with other D2 and 5-HT2 receptor antagonist drugs. These data contribute to our understanding of the complex mechanism of action that may stand behind the clinical efficacy of cariprazine.