一、 缘起上海市精神卫生中心始建于1935年，前身为上海普慈疗养院，院址位于上海市西南郊区（现闵行区），由慈善家陆伯鸿集资建设，属教会管理，是当时远东最大、设备最完善的精神科专科医院之一。医院占地约100亩，建筑面积约3万平方米。二、 发展 几十年的风雨历程，如今上海市精神卫生中心已成为上海市三级甲等精神卫生专科医院，担负着全市精神卫生的医疗、教学、科研、预防、康复、心理咨询/治疗和对外学术交流等任务，是全国规模最大、业务种类最全、领衔学科最多的精神卫生机构。2006年5月，上海市精神卫生中心成为上海交通大学医学院附属医院。上海市精神卫生中心徐汇院区地处宛平南路600号；闵行院区地处沪闵路3210号。总建筑面积约10万平方米。中心同时也是上海市疾病预防控制精神卫生分中心、上海市精神卫生临床质量控制中心、上海市心理咨询培训中心、国家精神药物临床试验机构、WHO/上海精神卫生研究与培训合作中心。三、 医疗 上海市精神卫生中心临床科室齐全、技术力量雄厚，主要诊治精神分裂症、心境障碍、器质性精神障碍、儿童青少年及老年期精神障碍、神经症性障碍等各类精神障碍患者及药物依赖患者。中心设有普通精神科以及老年、康复、临床心理、儿少、传染、自愿戒毒等临床科室。核定床位1878张，目前实际开放床位2141张。位于零陵路604号的上海市心理咨询与治疗中心，主要为各类心理障碍患者及受心理困扰的来询者提供心理咨询服务，并开展多种心理治疗。“上海市心理健康热线（64383562）”，是上海市最早设立的热线电话之一。从2008年12月起，与“上海市公共卫生公益电话（12320上海）”合并为“上海市心理援助热线（上海12320-5）”，继续为上海市民提供心理危机干预和心理健康促进服务。四、 科教 上海市精神卫生研究所成立于1981年3月，设有药物依赖、生化、遗传、神经电生理、脑电影像、心理测量、临床流行病学、儿少行为、心理咨询与治疗、司法精神医学、精神护理、危机干预等14个研究室，主要从事精神医学的临床应用研究。近十余年来，荣获国家级、省部级和局级科研成果奖共23项。目前作为上海市医学重点学科有：上海市精神疾病临床医学中心、老年精神医学、预防精神医学。中心作为上海交通大学医学院附属医院和复旦大学上海医学院、同济大学医学院、上海中医药大学的教学医院，拥有精神病与精神卫生学博士、硕士点、博士后工作站，心理学硕士点。同时也是上海师范大学、华东师范大学的心理学教学研究与实践基地。作为WHO精神卫生研究与培训合作中心之一，与世界各国的精神医学界进行着广泛的学术交流及科研合作。受卫生部委托，中心每年举办全国精神科医师、护理进修班和研修班等继续教育项目，培养了大批精神科医疗、护理骨干。心理咨询与治疗培训中心为全国各地培训高质量的心理咨询师和心理治疗师，已形成独特的品牌。自2009年起，中心成为上海市首批住院医师规范化培训基地，同时，中心也是中华预防医学会精神卫生分会等学术组织的挂靠单位。五、 文化 上海市精神卫生中心以严谨的医疗作风、优质的全面服务和精湛的专业技术赢得国内外人士的一致好评。连续十一届获得上海市文明单位。多次荣获卫生部、卫生局文明单位，以及上海市模范职工之家、上海市厂务公开先进单位、上海市无偿献血先进单位、上海市妇女工作优秀品牌、上海市卫生系统先进集体、上海市卫生局“三八”红旗集体、上海市禁毒工作先进集体、上海市爱国卫生先进单位、全国巾帼文明岗等荣誉。价值团结 奉献 勤奋 创新使命提升临床和公共卫生服务质量与服务水平、提高医疗服务效率、坚持公益性为主的办医方向，切实维护人民群众健康权益。目标国际一流的现代化精神卫生机构，满足大众精神卫生和心理健康需求。
Autonomic dysfunction, marked by changes in heart rate and breathing patterns, is a core symptom of depression. However, the role of autonomic dysfunction during sleep as a marker for depression is not well understood. This study evaluates the utility of polysomnography (PSG)-derived cardiorespiratory signals for depression detection and compares their predictive value to that of sleep electroencephalography (EEG), a widely studied modality in depression research. We examined clinical PSG data and electronic health records at Sir Run Run Shaw Hospital, collected between 2018 and 2023. Depression cases were identified using the International Classification of Diseases, 10th Revision (ICD-10) diagnosis, Hamilton Depression Rating Scale (HAMD) scores of 8 or higher, and/or chief complaints indicative of depression. Age- and sex-matched controls were sourced from the National Sleep Research Resource, selected based on physician diagnoses or validated depression scales. Predictive models were developed using a foundational model approach: electrocardiogram (ECG) and abdominal (ABD) signals were pre-trained to predict other PSG channels and annotations, followed by fine-tuning with logistic regression for depression classification. An EEG-based model was used for comparison. Data were divided into 80% training and 20% testing sets for evaluation. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. The study sample consists of 1863 depression cases (mean age 50.9 ± 15.7 years, 57.5% female) and 2547 controls (mean age 55.2 ± 15.6 years, 57.0% female). The ECG+ABD model achieved an AUROC of 0.960, with a specificity of 0.897 and sensitivity of 0.902. These results were comparable to those of the EEG-based model, which yielded an AUROC of 0.975, with specificity of 0.924 and sensitivity of 0.913. Our findings demonstrate that AI-driven analysis of sleep-derived heartbeat and breathing signals can detect depression with performance comparable to that of the EEG-based model. This strategy holds promise for non-invasive monitoring to facilitate at-home depression screening, paving the way for advancements in precision mental health management. Shanghai Mental Health Center Hospital-Level Project (Grant No. 2021-YJ12/2021-QH-05, Dongbin Lyu)
Objective:To investigate the knowledge, attitudes, and practices (KAP) of caregivers of stroke patients regarding the risk factors and management of post-stroke delirium. Methods:This multicenter, cross-sectional study was conducted among caregivers of stroke patients who visited two tertiary hospitals and three community health service centers between November 2023 and January 2024. In this study, knowledge, attitude, and practice were assessed using structured scoring systems, with knowledge scored from 0-24, attitudes from 7-35, and practices from 9-45. Results:A total of 484 valid questionnaires were included, with 325 (67.1%) females respondents. The median (25th, 75th percentile) KAP scores were 9.00 (2.00, 12.00) (possible range: 0-24), 24.00 (23.00, 26.00) (possible range: 7-35), and 33.00 (27.00, 36.00) (possible range: 9-45), respectively. Multivariate logistic regression analysis showed that knowledge score (OR = 1.11, 95% CI: 1.07, 1.16), attitude score (OR = 1.48, 95% CI: 1.32, 1.67), duration of stroke diagnosis > 2 years (OR = 0.47, 95% CI: 0.26, 0.83), and lack of participation in related education (OR = 0.43, 95% CI: 0.26, 0.72) were independently associated with practices. Structural equation modeling revealed that knowledge directly influenced attitudes (β = -0.39, P < 0.001) and practice (β = 0.30, P < 0.001), while attitudes also directly influenced practices (β = -0.51, P < 0.001). Knowledge indirectly affected practices through its effect on attitudes (β = 0.20, P < 0.001). Conclusion:Caregivers of stroke patients exhibited inadequate knowledge, neutral attitudes and moderate practices regarding risk factors and management of post-stroke delirium. Targeted educational interventions should be implemented for caregivers, emphasizing the importance of recognizing and effectively managing post-stroke delirium.
Objective Cognitive dysfunction is a core symptom of depression and contributes significantly to functional and psychosocial impairment. However, pharmacotherapy has shown limited efficacy in alleviating these cognitive deficits. This study aimed to systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in improving cognitive impairments in patients with depression. Methods A literature search was conducted across PubMed, Embase, Web of Science, PsycINFO, and the Cochrane Library databases up to June 19, 2024. Studies were included if they met the following criteria: (1) participants were exclusively patients with unipolar depression, (2) both active rTMS and sham stimulation were administered in parallel groups, (3) sufficient data were available, and (4) the study design was a randomized controlled trial (RCT). Results A total of 15 studies met the inclusion criteria. The meta-analysis revealed no significant improvement in cognitive impairment with active rTMS compared to sham rTMS across multiple cognitive domains, including global cognitive function, attention, working memory, psychomotor speed, language, visuospatial ability, learning and memory, and executive function. Conclusion Current evidence suggests that rTMS does not demonstrate substantial efficacy in alleviating cognitive dysfunction in patients with depression. Future research should focus on elucidating the underlying mechanisms of rTMS efficacy and optimizing stimulation protocols, including the precise targeting of stimulation sites, as well as refining frequency, intensity, and duration parameters to better address cognitive impairment.
Methamphetamine (METH) use leads to addiction, neurotoxicity, and neuroinflammation. Ibudilast, a toll-like receptor 4 (TLR4) inhibitor, has been shown to reduce METH-induced neuroinflammation and self-administration, but its specific role in neuronal TLR4 signalling and associated behavioural outcomes remains poorly understood. This study examined Ibudilast's effects on METH reward, drug-seeking behaviour, and TLR4 signalling in a rat self-administration model. Ibudilast was found to dose-dependently reduce METH intake and motivation for the drug, as evidenced by a downward shift in the dose-response curve and a decrease in breakpoint. Additionally, Ibudilast suppressed both cue- and METH priming-induced drug-seeking behaviours. Western blot analysis revealed elevated TLR4, p-NF-κB and IL-6 in the prefrontal cortex after 14 days of METH self-administration. These increases were significantly attenuated by Ibudilast treatment. Furthermore, local administration of Ibudilast in the prefrontal cortex led to a reduction in METH intake and motivation, as well as decreased TLR4 expression in this brain region. Immunofluorescence staining was revealed that TLR4 was expressed predominantly in neurons and microglia, with METH-induced upregulation of neuronal TLR4 being linked to apoptosis. Ibudilast restored normal spatial interactions between neurons and microglia, thereby mitigating neuroinflammation and neuronal damage. Furthermore, local injection of Ibudilast in the prefrontal cortex led to a reduction in METH intake and motivation, as well as decreased expression of TLR4 in the brain region. These findings underscore the critical role of neuronal TLR4 in METH addiction and highlight Ibudilast's therapeutic potential in addressing METH-related neuroinflammation and behavioural dysregulation.
INTRODUCTION School refusal behaviour(SRB)has become an increasingly significant global issue.In China,the mental health of children and adolescents has emerged as a major soci-etal concern,prompting the development of related policy initiatives.The Chinese Ministry of Education,in collaboration with 17 other government departments,has issued a series of special action plans to address the mental health problems among Chinese children.
