Background: Rapamycin (RAPA) is an inhibitor of the mammalian target of rapamycin (mTOR) that may modulate neuropsychiatric conditions. The global prevalence of psychiatric disorders is increasing due to growing socioeconomic stressors. Despite the promising therapeutic indications of RAPA, the precise molecular mechanisms underlying the effects of RAPA on schizophrenia are unclear. This study investigates anti-schizophrenia mechanisms of RAPA using network pharmacology and molecular docking. Methods: Potential pharmacological targets of RAPA were identified by searching the SwissTargetPrediction, GeneCards, and Similarity Ensemble Approach databases. Schizophrenia- related targets were identified by searching GeneCards and Online Mendelian Inheritance in Man. Bioinformatics analysis (including analyses of protein-protein interaction networks and enrichment analyses) was conducted to identify core targets and signaling pathways. Molecular docking simulations were conducted to assess drug binding affinities to core targets. Results: Cross-referencing 4013 targets linked to schizophrenic pathology with 1954 RAPA-associated targets yielded 749 shared targets. Protein-protein interaction network analysis revealed the following core targets: interleukin-6 (IL-6), interferon-gamma, IL-10, IL-4, IL-2, IL-1 beta (IL-1B), tumor necrosis factor, IL-5, IL-17A, and IL-1A. Functional enrichment assessments revealed that signal transduction, positive regulation of transcription by RNA polymerase II, positive regulation of gene expression, and positive regulation of DNA-templated transcription are critical biological processes involved in RAPA antipsychotic effects. Pathway analysis revealed that the PI3K-AKT signaling cascade is a central mechanism mediating the effects of RAPA. Molecular docking simulations confirmed strong binding affinities between RAPA and the core targets. Conclusion: Rapamycin may modulate cytokine networks and PI3K-AKT/mTOR signaling pathways implicated in schizophrenia. These in-silico findings are hypothesis-generating and require experimental and clinical validation.

The Symptom Checklist-90 (SCL-90) is widely used in Chinese adolescents, but its practical utility is limited by its length and by structural problems in the traditional ten-factor model. To address these issues, this study developed and validated a brief computerized adaptive testing (CAT) system based on a theoretically informed six-factor model. Using a clinical sample of 10,052 adolescent outpatients, confirmatory factor analysis showed the traditional ten-factor model had a substantial identification problem: a non-positive definite matrix from extremely high factor correlations. In contrast, the proposed six-factor model had acceptable fit (CFI = 0.875, RMSEA = 0.061). The CAT system was developed via multidimensional item response theory. In post hoc simulations with a stopping rule (SE < 0.4), average test length was reduced from 90 to 37 items (58.9% reduction), maintaining high agreement with full-scale estimates (≥ 0.89) and acceptable marginal reliability (≥ 0.76). External validation with the SDS, SAS, and Y-BOCS provided preliminary support for external validity. Overall, this study supports a clinically meaningful six-factor representation of the SCL-90 and provides an efficient adaptive assessment framework for Chinese adolescents in clinical settings.

BACKGROUND:The incidence of mental health issues among adolescents, particularly anxiety and depression, is increasing in China. Given the large adolescent population and their increasing prevalence, there is an urgent need for a reliable screening tool. This study aimed to validate the Chinese version of the Patient Health Questionnaire (PHQ-4) among Chinese adolescents. METHODS:From September 2022 to March 2024, a cross-sectional study was conducted at four middle schools in Jiangxi Province and Beijing, China, involving 8778 participants. The sample was split into exploratory factor analysis (EFA) and confirmatory factor analyses (CFA). A subset of 159 participants was used for test-re-test reliability, assessed using the intraclass correlation coefficient (ICC). Receiver operating characteristic (ROC) curve analysis was performed to determine this threshold. RESULTS:The Chinese PHQ-4 showed good overall reliability, with Cronbach's α of 0.84 and McDonald's ω of 0.86. The EFA identified two factors, depression and anxiety, with factor loadings between 0.61 and 0.81. The CFA indicated an excellent model fit. The ICC was 0.87, indicating a strong test-retest reliability. The AUC was 0.940, with a 95 % CI of 0.936-0.945, demonstrating high discriminative ability. The optimal screening threshold was determined as 3. LIMITATION:As a cross-sectional study, causal inferences are limited. CONCLUSION:The Chinese PHQ-4 is a reliable and valid tool for screening anxiety and depression in Chinese adolescents, with a recommended cutoff score of 3.

BackgroundAcute coronary syndrome (ACS) often co-occurs with depression, which adversely affects prognosis and increases medical costs, but effective treatment models are lacking, particularly in low-resource settings. This study aims to determine the effectiveness of an ACS and depression integrative care (IC) model compared to usual care (UC) in improving depression symptoms and other health outcomes among patients discharged for ACS in Chinese rural hospitals.MethodsA multicentre, randomised controlled trial was conducted in sixteen rural county hospitals in China, from October 2014 to March 2017, to recruit consecutively all ACS patients aged 21 years and older after the disease stablised and before discharge. Patients were randomly assigned in a 1:1 ratio to receive either the IC or UC, stratified by hospital and depression severity. Patients allocated to IC received an ACS secondary prevention program and depression care including case screening, group counselling, and individual problem-solving therapy. Patients allocated to UC received usual care. The primary outcome was change in Patient Health Questionnaire-9 (PHQ-9) from baseline to 6 and 12 months. Main secondary outcomes included major adverse events (MAEs) composed of all-cause death, non-fatal myocardial infarction and stroke, and all-cause re-hospitalisation. Participants were followed up till March 2018. All data were collected in person by trained assessors blinded to treatment group and MAEs were adjudicated centrally. This trial is registered with ClinicalTrials.gov, NCT02195193.FindingsAmong 4041 eligible patients (IC: 2051; UC: 1990), the mean age was 61 ± 10 years and 63% were men. The mean PHQ-9 score lowered at both 6 and 12 months in both groups but was not lower in IC compared to UC at 6 months (mean difference (MD): −0.04, 95% confidence interval (CI): −0.20, 0.11) or 12 months (MD: −0.06, 95% CI: −0.21, 0.09). There were no treatment group differences for MAEs or other secondary outcomes except for secondary prevention medications at 12 months (45.2% in IC vs 40.8% in UC; relative risk: 1.21, 95% CI: 1.05–1.40). Pre-specified subgroup analyses showed that IC, compared to UC, may be more effective in lowering PHQ-9 scores in women, older patients, and patients with low social support, but less effective in moderately and severely depressed patients (all p for interaction <0.05).InterpretationThe study found that the cardiology nurse-led ACS- and depression-integrated care, compared to usual care, did not improve depression symptoms in all patients discharged with ACS. Greater benefits in certain subgroups warrants further studies.FundingR01MH100332 National Institute of Mental Health.

Purpose To evaluate the reliability and validity of a newly developed computerized Automated Battery of Cognitive Tests in healthy individuals without cognitive impairments or psychiatric disorders. Methods From April 20 to July 1, 2023, 142 healthy individuals in Beijing and Tangshan, China were assessed using the Automated Battery of Cognitive Tests. After a 3-week interval, 36 participants were randomly selected for retesting. The assessment also included administration of the Repeatable Battery for the Assessment of Neuropsychological Status and the Automated Battery of Cognitive Tests to 59 participants. Results The Automated Battery of Cognitive Tests consists of 16 subtests. Internal consistency reliability was 0.75. The test-retest reliability for each factor ranged from 0.337 to 0.850 (p < 0.05). The criterion-related validity, as measured by correlation with the total Repeatable Battery for the Assessment of Neuropsychological Status score, was 0.748 (p < 0.001). The cumulative variance contribution rate is 70.109%. The results of the confirmatory factor analysis indicated a good model fit. Conclusions The computerized Automated Battery of Cognitive Tests is a cognitive self-assessment tool with good reliability and validity. It can evaluate multiple aspects of cognitive performance in healthy individuals and is suitable for self-administration through remote access via Internet.

This study aimed to explore the knowledge, attitude and practice (KAP) of fibromyalgia patients toward fibromyalgia. This web-based cross-sectional study was conducted in China between February and March 2023 among fibromyalgia patients using a self-administered questionnaire. A total of 401 valid questionnaires were enrolled, including 326 (81.30

BACKGROUND:Generalized pain is the core symptom of fibromyalgia (FM). Few studies have described FM's different pain characteristics under various conditions. OBJECTIVE:To explore the pain characteristics of patients with FM of different gender and emotional states. STUDY DESIGN:A cross-sectional study. SETTING:A medical center in Beijing, People's Republic of China. METHODS:A total of 197 patients with FM were recruited from an outpatient clinic. Three distinct instruments were used to assess their pain characteristics: the Numeric Rating Scale (NRS-11) to assess pain severity, the Widespread Pain Index (WPI) to assess the number of pain regions, and the Short Form-McGill Pain Questionnaire-2 (SF-MPQ-2) to assess pain qualities. The Zung Self-Rating Anxiety Scale and Zung Self-Rating Depression Scale were used to assess patients' emotional states. An independent 2-sample t test, chi-squared test, and Mann-Whitney U test were used to analyze gender pain characteristics differences and different emotional states (with/without anxiety, with/without depression). RESULTS:Pain severity on the NRS-11 was 7 (5-8), the number of pain regions determined by WPI was 13 (10-16), and the total score of different pain qualities from the SF-MPQ-2 was 2.36 (1.68-3.73) in all patients with FM. The most frequently reported regions of pain were the right shoulder girdle (89.34%), left shoulder girdle (88.32%), upper back (85.28%), and neck (81.73%). The most frequently reported pain qualities were tiredness/exhaustion (97.46%), aching pain (94.42%), numbness (78.68%), cold/freezing pain (75.63%), and tenderness (75.13%). Women patients reported more severe pain and numbness, less frequent chest pain, and shooting pain than men patients did. Patients with FM and anxiety experienced more frequent and more severe feelings of punishing/cruel thoughts, fearfulness, sickening, and tenderness; more frequent jaw pain and cold-freezing pain; more severe pain caused by light touch and tiredness/exhaustion; less frequent lower leg pain than those without anxiety did. Patients with FM and depression reported more frequent and more severe pain caused by light touch; more frequent tenderness; more severe feelings of tiredness/exhaustion, sickening,fearfulness, and punishing/cruel thoughts; and less frequent and less severe piercing pain than those without depression did. LIMITATIONS:The limitations of this study are its single-center design and lack of objective pain indicators. CONCLUSION:Gender significantly affected pain severity, chest pain, numbness, and shooting pain. Jaw pain, lower leg pain, cold/freezing pain, tenderness, pain caused by light touch, piercing pain, and pain-affective descriptors are closely related to emotional states in FM. A comprehensive understanding of pain characteristics in patients with FM would be helpful for disease education, diagnosis, and treatment.

Individuals suffering from schizophrenia demonstrate deficits in recognizing emotion based on voice. The present study aimed to develop a vocal emotion recognition test with good psychometric properties and use it for evaluation in schizophrenia. Data from 82 healthy participants and 161 stable inpatients diagnosed with schizophrenia were collected. The internal consistency and test-retest reliability of the vocal emotion recognition test (VER-42) were acceptable. Patients were less accurate than the healthy group in identifying emotion based on the VER-42 total score and were less accurate than healthy individuals across all emotions. The VER-42 total score correlated with cognitive functions and social cognition or function; and was associated negatively with negative symptoms of patients suffering from schizophrenia. The VER-42 was shown to be a valid and reliable instrument for evaluating vocal emotion recognition ability and could thus contribute to the screening of patients in the future.

Chronic pain affects more than 30% of the general population. The 9-item Central Sensitization Inventory (CSI-9) is a shortened version of the CSI-25, which is a patient-reported instrument used to screen people at risk of central sensitization (CS). The aim of this study was to cross-culturally adapt and validate a Chinese version of the CSI-9. The Chinese CSI-9 was generated by translation of the original English version, back-translation, cultural adaptation, and revision using the Delphi method. The Chinese CSI-9 was administered to 235 patients with chronic pain and 55 healthy controls. Structural validity (confirmatory factor analysis), construct validity (correlations with other scales), test-retest reliability (intraclass correlation coefficient, ICC), and internal consistency (Cronbach's α) were evaluated. Confirmatory factor analysis was performed using one factor. The Chinese CSI-9 score was positively correlated with the Pain Catastrophic Scale (PCS) total score (r = 0.463), PCS subscale scores (r = 0.347-0.463), Brief Pain Inventory (BPI) mean item score (r = 0.524), BPI total score (r = 0.773), and the number of painful sites (r = 0.451). The Chinese CSI-9 had excellent test-retest reliability (ICC = 0.958) and excellent internal consistency (Cronbach's α = 0.902 in the overall sample and 0.828 in the chronic pain population). The optimal cut-off value for the Chinese CSI-9 was 18 points. The Chinese CSI-9 had excellent test-retest reliability and satisfactory structural validity and construct validity. The CSI-9 could potentially be utilized in China as a self-report questionnaire in both clinical practice and research settings.

Objective To develop the HTP drawing test system of depressed mood and suicide risk and examine its efficiency, aiming at providing test tools for people. Methods Based on exiting research results, the drawing feature set and psychological feature set of HTP were determined, and the drawing test system was developed. The reliability and validity of the test system was tested with 1904 subjects. Results The drawing feature set and it’s corresponding psychological feature set of HTP test system were built with 47 features. The retest reliability was 0.803, the rater reliability was 0.859. The detection rate was 75.38

Background: Due to the onset of sudden stress, COVID-19 has greatly impacted the incidence of depression and anxiety. However, challenges still exist in identifying high-risk groups for depression and anxiety during COVID-19. Studies have identified how resilience and social support can be employed as effective predictors of depression and anxiety. This study aims to select the best combination of variables from measures of resilience, social support, and alexithymia for predicting depression and anxiety. Methods: The eXtreme Gradient Boosting (XGBoost1) model was applied to a dataset including data on 29,841 participants that was collected during the COVID-19 pandemic. Discriminant analyses on groups of participants with depression (DE2), anxiety (AN3), comorbid depression and anxiety (DA4), and healthy controls (HC5), were performed. All variables were selected according to their importance for classification. Further, analyses were performed with selected features to determine the best variable combination. Results: The mean accuracies achieved by three classification tasks, DE vs HC, AN vs HC, and DA vs HC, were 0.78, 0.77, and 0.89. Further, the combination of 19 selected features almost exhibited the same performance as all 56 variables (accuracies = 0.75, 0.75, and 0.86). Conclusions: Resilience, social support, and some demographic data can accurately distinguish DE, AN, and DA from HC. The results can be used to inform screening practices for depression and anxiety. Additionally, the model performance of a limited scale including only 19 features indicates that using a simplified scale is feasible.

Background Cognitive performance improves clinical outcomes of patients with major psychiatric disorder (MPD), but is impaired by hyperglycemia. Psychotropic agents often induce metabolism syndrome (MetS). The identification of modifiable metabolic risk factors of cognitive impairment may enable targeted improvements of patient care. Objective To investigate the relationship between MetS and cognitive impairment in young women with MPD, and to explore risk factors. Methods We retrospectively studied women of 18–34 years of age receiving psychotropic medications for first-onset schizophrenia (SCH), bipolar disorder (BP), or major depressive disorder (MDD). Data were obtained at four time points: presentation but before psychotropic medication; 4–8 and 8–12 weeks of psychotropic therapy; and enrollment. MATRICS Consensus Cognitive Battery, (MCCB)—based Global Deficit Scores were used to assess cognitive impairment. Multiple logistic analysis was used to calculate risk factors. Multivariate models were used to investigate factors associated with cognitive impairment. Results We evaluated 2,864 participants. Cognitive impairment was observed in 61.94% of study participants, and was most prevalent among patients with BP (69.38%). HbA1c within the 8–12 week-treatment interval was the most significant risk factor and highest in BP. Factors in SCH included pre-treatment waist circumference and elevated triglycerides during the 8–12 weeks treatment interval. Cumulative dosages of antipsychotics, antidepressants, and valproate were associated with cognitive impairment in all MPD subgroups, although lithium demonstrated a protect effect (all P < 0.001). Conclusions Cognitive impairment was associated with elevated HbA1c and cumulative medication dosages. Pre-treatment waist circumference and triglyceride level at 8–12 weeks were risk factors in SCH. Monitoring these indices may inform treatment revisions to improve clinical outcomes.

Objective To analyse differences in sex, age, depression, insomnia, psychological stress, resilience, and perceived social support among patients with medically unexplained symptoms (MUS) in a psychological clinic of a general hospital, and to explore the influencing factors of MUS. Methods This is a cross-sectional study. Seven hundred forty-six first-time patients were assessed with the integrated psychosomatic comprehensive evaluation system (IPS) to evaluate their MUS, depression, insomnia, psychological stress, resilience, and perceived social support. The psychological characteristics were compared with regard to sex and age group (<25 years, low age group; 26–44 years, middle age group; >45 years, high age group). The relationships between age and MUS were explored, and how psychological stress affects MUS was analyzed using the mediator effect model. Results Different age groups had significant differences in sex, MUS, depression, psychological stress, resilience, and perceived social support. In further pairwise comparison, no significant difference existed in depression, psychological stress, resilience and perceived social support in the middle and low age groups, depression and psychological stress were higher than those in the high age group, resilience and perceived social support were lower than those of the high age group. MUS were higher in the middle age group than in the low age group. No significant difference existed between the two groups and the high age group. Age, severity of MUS, and perceived social support were significantly different between the sexes. Differences in MUS between men and women in different age groups were analyzed using two-factor analysis of variance. It revealed no interaction between sex and different age groups on MUS. The main effect analysis showed that the effects of different age groups on MUS were statistically significant. Based on pairwise comparative analysis, the MUS score in the low age group was lower than that in the middle age group. To clarify a nonlinear relationship between age and MUS, threshold effect analysis was conducted. The results indicated that the piecewise linear regression model could better depict the relationship between age and MUS. The inflection point was at the age of 60 years. Before the age of 60 years, MUS increased with age. No significant correlation existed between age and MUS after the age of 60 years. To understand the influencing factors of MUS, the intermediary effect model was analyzed using MUS as the dependent variable, psychological stress as the independent variable, resilience as mediator variable M1, perceived social support as mediator variable M2, and depression as mediator variable M3. Resilience, perceived social support, and depression had significant mediator effects on the effects of psychological stress on MUS with a total indirect effect of 69.81%. Conclusion The middle age group had greater MUS than the low age group. Before the age of 60 years, MUS increased with increasing age. Women had more severe MUS than men. Resilience, perceived social support, and depression had significant mediating effects on the effects of perceived stress on MUS. These findings suggest that clinicians should make more comprehensive and detailed evaluations and timely intervention for middle-aged and female patients. Improving psychological resilience and social support can reduce the impact of psychological stress on MUS. Therefore, psychotherapy and multidisciplinary comprehensive treatment are very important for patients is very important for patients.

目的 探讨新型冠状病毒肺炎疫情期间北京市男性青年群体心理健康状况,为临床心理干预提供依据.方法 2020年2月8日～15日采用随机抽样法对北京市青年男性群体以线上远程自助评估的方式进行流行病学调查,共收集有效问卷28882份.调查问卷包括一般情况调查问卷、9条目患者健康问卷抑郁量表、广泛性焦虑量表、失眠严重指数量表以及心理健康自评问卷,对测评结果进行流行病学分析.结果 北京市男性青年群体抑郁、焦虑、应激反应和失眠总体检出率为5.44％～18.00％,其中多数为轻度抑郁、焦虑情绪和轻度失眠,中-重度抑郁、焦虑情绪及睡眠问题检出率分别为5.76％、2.69％、2.24％.结论 新型冠状病毒肺炎疫情期间北京市青年男性群体总体心理健康状况较好,但部分青年存在一定程度的抑郁、焦虑情绪及睡眠问题,需予以关注.

To analyze the clinical and psychological characteristics of fibromyalgia (FM), so as to further understand and improve the capability of identifying FM. The clinical data of 250 FM patients diagnosed in the outpatient clinic of the Department of Rheumatology, the First Medical Center, Chinese PLA General Hospital, from December 2019 to September 2021, were collected and analyzed. The patients aged 40 (31.0, 52.3) years, including 188 female patients (75.2%) and 62 male patients (24.8%). There was a statistically significant difference in age comparison between female [42.5 (33.0,54.0) years] and male patients [32.5 (27.8,43.5) years] (P<0.001). The score of pain degree was 6 (4, 8), and [7 (5, 8)] of female patients was higher than [6 (4, 7)] of the male patients (P=0.040). The widespread pain index (WPI) was 13 (10,15). The regions with high pain incidence were left shoulder girdle (87.2%, 218/250), right shoulder girdle (86.8%, 217/250), upper back (86.4%, 216/250), neck (79.6%, 199/250) and lower back (77.6%, 194/250) and etc. The incidence of chest pain in female patients (55.3%, 104/188) was lower than that in male patients (75.8%, 47/62) (P=0.004). The symptom severity scale (SSS) score was 8 (7-10). 74.6% (185/248) suffered from anxiety and 77.5% (193/249) suffered from depression in 249 patients. Female patients were more common in FM patients than male patients, the median age of female patients was older than that of male patients, and the median score of pain severity of female patients was higher than male patients. Shoulders girdle, upper back, neck and lower back were the most frequently reported pain regions, and the incidence of chest pain in female patients was lower than that in male patients. The incidence of major non-painful symptoms was high and the proportion with anxiety or depression was high. The above clinical features are very helpful for early diagnosis of FM.

BACKGROUND AND AIM:Recently, the availability and usefulness of mobile self-help mental health applications have increased, but few applications deal with COVID-19-related psychological problems. This study explored the intervention efficacy of a mobile application on addressing psychological problems related to COVID-19.METHODS:A longitudinal control trial involving 129 Chinese participants with depression symptoms was conducted through the mobile application "Care for Your Mental Health and Sleep during COVID-19" (CMSC) based on WeChat. Participants were divided into two groups: mobile internet cognitive behavioral therapy (MiCBT) and wait-list. The primary outcome was improvement in depression symptoms. Secondary outcomes included improvement in anxiety and insomnia. The MiCBT group received three self-help CBT intervention sessions in one week via CMSC.RESULTS:The MiCBT group showed significant improvement in depression and insomnia (allP < 0.05) compared with the wait-list group. Although both groups showed significant improvement in anxiety at the intervention's end, compared with the wait-list group, the MiCBT group had no significant advantage. Correlation analysis showed that improvement in depression and anxiety had a significant positive association with education level. Changes in insomnia were significantly negatively correlated with anxiety of COVID-19 at the baseline. CMSC was considered helpful (n=68, 81.9 %) and enjoyable (n=54, 65.9 %) in relieving depression and insomnia during the COVID-19 outbreak.CONCLUSIONS:CMSC is verified to be effective and convenient for improving COVID-19-related depression and insomnia symptoms. A large study with sufficient evidence is required to determine its continuous effect on reducing mental health problems during the pandemic.

At present, the diagnosis of depression in clinical practice mainly relies on the subjective judgment of physicians and patients, and lacks a more objective diagnostic method. Previous studies have proposed that depressed patients have abnormal autonomic nervous system activities and inadequate response under cognitive tasks, which can be objectively assessed using physiological signal features. In this study, Electrocardiographic (ECG) and photoplethysmogram (PPG) signals were collected from 17 depressed patients and 19 healthy controls in resting and task states. Statistical, time-domain, frequency-domain, and non-linear features were extracted. Unlike previous studies, linear fusion and merge fusion were performed on the features of both resting state and task state. LightGBM feature importance was adopted for feature selection, And the LightGBM classification algorithm was used to distinguish depressed patients from healthy controls. The accuracy of the fusion modality for both resting state and task state higher than that of the single modality, such as only rest state, only task state, which can obtain 85.32% accuracy. Conclusions: It is shown that the fusion of resting and task states obtains higher accuracy rate for depression recognition compared with individual resting state and individual task state, that the method of multimodal features based on LightGBM Classifier is effective for depression assessment, and that this study may provide some help in the objective assessment of depression.