Prognostic associations of cortical gyrification in minimally medicated schizophrenia in an early intervention setting.

The aberration in cortical gyrification seen in schizophrenia likely originates in the earliest phase of life, as gyrification begins in utero and reaches its peak in infancy. However, emerging observations have indicated a later reduction in gyrification, especially in early adulthood, may also occur in schizophrenia. At present, it is unclear whether the baseline and later gyrification reduction has any prognostic importance in schizophrenia. We address this question in a longitudinal design in patients minimally medicated at inception. About 108 minimally medicated (duration of medication = <14 days of antipsychotics) patients and 106 healthy controls underwent structural magnetic resonance imaging, with 34 patients being selectively re-scanned when clinically stable following antipsychotic treatment. The cortical surface from each structural image was reconstructed, and the local gyrification index and cortical thickness were computed for each vertex on the surface. We found minimally medicated schizophrenia patients during the first episode had a relatively higher gyrification in bilateral supramarginal, left superior temporal, and right posterior cingulate and paracentral regions. However, poor prognostic features were more likely in patients with lower baseline gyrification. Longitudinal reductions in left superior parietal and right precentral gyrification were associated with lower improvements in both positive and negative symptoms over time. The spatial pattern of longitudinal changes in gyrification was distinct from the changes in cortical thickness. These results indicated that schizophrenia is characterized by a relative hypergyrification in parieto-temporal and medial cortical areas at a group level at first presentation, but poor outcomes relate to lower-gyrification elsewhere both at the onset and during the early course. The early post-onset reduction of gyrification is rather limited in space and magnitude, but occurs unrelated to the progressive thinning, representing a distinct, prognostically important structural trajectory.

Aberrant Effective Connectivity of Subregions of Posterior Cingulate Cortex in Depressive Disorder / 中国医学影像学杂志

Purpose To explore the role of posterior cingulate cortex (PCC) dysfunction in the pathogenesis of depression and its relationship with the clinical features of depression by analyzing the effective connection among the inner areas of PCC of patients in depression.Materials and Methods The spectral dynamic causal model (spDCM) was used to analyze the resting state functional magnetic resonance imaging (fMRI) data from the PCC inner areas Brodmann area (BA) 23,BA29,BA30,BA31 in the major depressive disorder group (MDD,n=23) and healthy control group (HC,n=36).Results Compared with HC group,the strength of BA30 self-connection of MDD group existed significant difference (t=2.53,P＜0.05).In MDD group,the connection of BA23 toward BA31 had abnormal activation,and the abnormal inhibition occurred in BA23 toward BA30;compared with HC group and after a＜0.05 Hz correction,there were significant differences in the bi-directional connections for BA23 and BA31,BA39 and BA31,BA30 and BA31,and in the unidirectional connections for BA23 to BA31,BA30 to BA23,BA30 to BA29 in MDD group.Conelusion The effective connection and connective nodes and edges in the inner areas of PCC in the depression disorder patients were abnormal.

A cross-national factor analytic comparison of three models of PANSS symptoms in schizophrenia.

The 30-item Positive and Negative Syndrome Scale (PANSS) is used worldwide in the assessment of symptom severity in schizophrenia. The present study uses confirmatory factor analysis (CFA) to compare three different factorial models and to evaluate the best-fitting representation of schizophrenia symptom structure on the PANSS across four samples of patients diagnosed with schizophrenia from the US (the CATIE schizophrenia trial), São Paulo, Brazil, and from Beijing and Changsha, China. We examine the goodness of fit of several previously proposed models. The traditional trifactorial model for the PANSS and two five-factor models were evaluated using absolute and incremental indices. Single group CFA found that the five-factor model proposed by NIMH researchers based on an extensive literature review demonstrates the best fit in each of the four samples. This model used 20 of the 30 PANSS items grouped into five factors: positive, negative, disorganized, excited, and depressed symptoms. Subgroups defined by age, gender, nationality, hospitalization status, and severity of illness also did not differ in overall symptom structure as assessed by several standard indices. Our findings suggest that the five factor NIMH model showed the best representation among all four samples from different countries and potentially contrasting cultures.

The characteristics of complaints among gastrointestinal outpatients with depressive or anxiety disorders in general hospitals / 中华行为医学与脑科学杂志

ObjectiveTo help physicians improve detection rate of depressive and anxiety disorders by exploring the complaints of gastrointestinal(GI) outpatients with these disorders in the general hospitals.Methods A multicenter cross-sectional study was conducted from May to June in 2007.A total of 1995 subjects from 13 general hospitals in China were screened with the hospital anxiety and depression scale ( HADS ) and patient health questionnaire 15-item (PHQ-15).Meanwhile patients'complaints were recorded.Psychiatrists interviewed subjects scored ≥8 on HADS and made diagnoses by using the mini international neuropsychiatric interview(MINI).There were 323 outpatients diagnosed as depressive or anxiety disorders and 1287 outpatients without diagnosis of depressive or anxiety disorders.The complaints and PHQ-15 sores were compared between these two groups.The logistic regression analysis was used to determine the risk of having depressive or anxiety disorders with the number of complaints as an independent variable.ResultsSome symptoms between two groups were statistically significant,including weakness(34.1％ vs 18.8％ ;χ2 =18.04; P=0.000),fatigue(9.6％ vs 5.7％ ;χ2 =6.58,P=0.010)and insomnia( 7.1％ vs 3.4％ ; χ2 =8.87 ; P =0.003 ).Logistic regression analysis showed that with each additional complaint,the odds for an interview-based diagnosis of depressive or anxiety disorders increased,the odds ratio(OR) was 1.12(95％ CI,1.08 ～ 1.17,P=0.000).In comparison to the outpatients without depressive or anxiety disorders,outpatients with these disorders signifycantly had higher PHQ-15 scores (( 11.12 ± 4.92 ) vs (6.68 ± 4.05 ) ; t =16.84,P =0.000).ConclusionThe GI outpatients with depressive and/or anxiety disorders have worse mental heath and more complaints,compared to patients without these disorders.These results may help physicians to better identify depressive disorders and anxiety disorders.

Comparing the PANSS in Chinese and American inpatients: cross-cultural psychiatric analyses of instrument translation and implementation.

This article compares data from the Positive and Negative Syndrome Scale (PANSS) collected from Chinese and American inpatients diagnosed with schizophrenia to show how patterned differences in item ratings may reflect cultural attitudes of the raters. The Chinese sample (N=553) was based on consecutive admissions to four academic hospitals in Changsha, China. Only patients ill for 3 or more years were included in the analysis to match the chronically ill sample represented in the US CATIE sample. A total of 261 PANSS assessments were completed during a month when CATIE subjects had been hospitalized for 15 days or more to optimize equivalence of the US and Chinese samples. Controlling for age and gender, the total PANSS and the three sub-scores were all significantly lower in the Chinese than in the US CATIE sample by 5-8% (all p<.05). However, on 9 items, the Chinese sample scored 10-30% higher than the US sample (all p<.05) and on 5 items they scored over 20% higher (all p<.0001). These items rated increased hostility, poorer attention, lack of judgment and insight, disturbance of volition, and poorer impulse control. We ascribe these differences to cultural variations in the ways individuals relate to others in their social environment within Chinese and American societies.

Effect of brain-derived neurotrophic factor Val66Met polymorphism and environmental factors on antidepressant treatment / 中华行为医学与脑科学杂志

Objective To explore the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism,environmental factor and their interactions on antidepressant treatment.Methods 340 patients of major depressive disorder (MDD) who met the diagnosis criteria of MDD ( DSM-Ⅳ Axis Ⅰ) were recruited.280 patients of them were finished 12 weeks antidepressant treatment.The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS) before and after 12 weeks antidepressant treatment.Childhood Trauma Questionnaire,28-item Short Form (CTQ-SF) and Life Events Scale (LES) were used to evaluate childhood adverse and life stress before onset.Genotyping of BDNF Val66Met polymorphism was detected by Illumina GoldenGate assays.Results Male patients proportion were significantly higher in non-remitters than remitters (P =0.008 ).After adjusting by gender, the frequencies of genotype and allele for the BDNF Val66Met polymorphism were no significant difference between remitters (AA: AG: GG = 28: 79: 40, A:G = 135:159 ) and non-remitters (AA: AG: GG = 29:81:23 ,A: G = 139:127 ) (P ＞0.05 ).There was no significant difference of CTQ scores and LES scores between the two groups (P＞0.05 ).The regression analysis showed that social intercourse problem and age were the risk factor for the severity of depression.The gender, HDRS baseline scores and mental disorder family history were associated with the efficacy of 12 weeks antidepressant.However,there was no significantly relationship between the interaction of BDNF Val66Met polymorphism and environment with the antidepressant treatment.Conclusion The older men with the mental disorder family history, severe depression symptom would be less-response to antidepressant treatment.However, BDNF Val66Met polymorphism, childhood trauma, life events stress and the interaction of BDNF Val66Met polymorphism and environment have no significantly effect on the 12 weeks antidepressant treatment.

Diffusion tensor imaging and resting state functional magnetic resonance imaging on young patients with major depressive disorder / 中南大学学报(医学版)

Objective To explore the pathological mechanism of brain function and structure in young patients with major depressive disorder by diffusion tensor imaging(DTI)and resting state functional magnetic resonance imaging(fMRI).Methods Sixteen participants diagnosed with major depression (MD) and 16 healthy age and gender-matched controls(HC) were recruited. Resting state fMRI and DTI brain scans were performed on all participants. A voxel-based method (VBM) was used to analyze the DTI datasets, and regional homogeneity (ReHo) approach was applied to preprocess the fMRI datasets. The value of fractional anisotropy (FA) and ReHo maps were obtained in the whole brain.Results FA values in the MD group were significantly lower than those of the healthy controls in the white matter of the left middle temporal gyrus, right middle frontal gyrus, left medial frontal gyrus, right precentral gyrus, left angular gyrus, left fusiform gyrus, left superior temporal gyrus, right middle temporal gyrus, right sub-gyral, left insula, and left pyramis (P＜0.01). ReHo in the MD group decreased in the left superior frontal gyrus, right superior frontal gyrus, left middle frontal gyrus, right middle frontal gyrus, left medial frontal gyrus, right medial frontal gyrus, left paracentral lobule, right paracentral lobule, right inferior parietal lobule, left postcentral gyrus, right postcentral gyrus, left middle occipital gyrus, left lingual gyrus, right putamen, right cingulate gyrus, right cuneus, left superior temporal gyrus, and right middle temporal gyrus (P＜0.01). Conclusion Abnormality of brain white microstructure and function exist widely in young patients with major depressive disorder. Abnormal connection of structures and function between the brain areas may be the key reason for the depression.

A cross-sectional survey of the prevalence of depressive-anxiety disorders among general hospital outpatients in five cities in China / 中华内科杂志

or physicians and specialists other than psychiatric professionals in general hospitals should be enhanced together with psychiatric consultation.

The effects of recognition of emotional words on ERPs of patients with major depression / 中华物理医学与康复杂志

Objective To investigate the effects of recognition of emotional content words on event-related potentials (ERPs) of patients with major depression. Methods ERPs were recorded in 16 patients with major depression and 18 healthy subjects while they performed a visual Chinese emotional content words recognition task. The study used a word identification task consisting of 20% negative and 20% positive words as well as 60% neutral words. Results The ERPs demonstrated similar waveform (N90,P160,N250,P290,N350,P490,N650) between depression patients and normal group, but its components were different. Amplitudes of many ERPs components in patients group were significantly decreased but N250 were significantly increased in FZ and F4 as compared with those of the normal groups (P

Wisconsin Card Sorting Test and Continue Performance Test in Depression / 中国心理卫生杂志

Objective: To study the executive and attention function of patients with depression. Methods: We used the Wisconsin Card Sorting Test (WCST) and Continue Performance Test (CPT) to study the executive and attention function in 66 patients with schizophrenia, 42 patients suffering from depression, and 50 normal controls. Results: Schizophrenic patients and depressive patients performed worse than the normal controls in WCST (P

Postoperative Psychosis Following Open-Heart Surgery / 中国医师杂志

Objective To study the etiology, pathogenesis, prophylaxis and management measures for psychosis after open-heart surgery.Methods Four thousand one hundred and six cases of patients with open-heart surgery were observed. The patients with psychosis complications were diagnosed and treated by psychiatrist.Results Thirty-eight cases of the patients had psychosis complications,the incidence of which was 0 93%. Most of the patients with postcardiotomy psychosis were adults. The symptoms of postcardiotomy psychosis were manic state, compression state, schizophrenia-like state and neurosis reaction. The prognosis of the patients was good.Conclusion Postcardiotomy psychosis may be viewed as having a multivariant etiology encompassing physiologic factors, environmental factors and psychological factors. Comprehensive prevention measures should be taken.