Introduction This study aims to explore the risk factors associated with suicidal behavior and establish predictive models in female patients with mood disorders, specifically using a nomogram of the least absolute shrinkage and selection operator (LASSO) regression. Methods A cross-sectional survey was conducted among 396 female individuals diagnosed with mood disorders (F30-F39) according to the International Classification of Diseases and Related Health Problems 10th Revision (ICD-10). The study utilized the Chi-Squared Test, t -test, and the Wilcoxon Rank-Sum Test to assess differences in demographic information and clinical characteristics between the two groups. Logistic LASSO Regression Analyses were utilized to identify the risk factors associated with suicidal behavior. A nomogram was constructed to develop a prediction model. The accuracy of the prediction model was evaluated using a Receiver Operating Characteristic (ROC) curve. Result The LASSO regression analysis showed that psychotic symptoms at first-episode ( β = 0.27), social dysfunction ( β = 1.82), and somatic disease ( β = 1.03) increased the risk of suicidal behavior. Conversely, BMI ( β = −0.03), age of onset ( β = −0.02), polarity at onset ( β = −1.21), and number of hospitalizations ( β = −0.18) decreased the risk of suicidal behavior. The area under ROC curve (AUC) of the nomogram predicting SB was 0.778 (95%CI: 0.730–0.827, p < 0.001). Conclusion The nomogram based on demographic and clinical characteristics can predict suicidal behavior risk in Chinese female patients with mood disorders.

Objective: To examine whether thyroid function in the normal range is associated with recurrence of depressive or mania in bipolar disorder patients. Methods: 104 patients with bipolar disorder in maintenance therapy phase were assigned randomly to mood stabilizer combined with antidepressant group or mood stabilizer group. There were 52 patients in both groups respectively. Clinical symptoms were assessed at baseline, 3rd month, 6th month, 9th month, and 12th month using HAMD-17 and YMRS. Blood samples were analyzed for thyroid function. Results: There was no statistically significant difference of recurrence rate of depressive episode and mania episode at the end of the 12-months between mood stabilizer combined with antidepressant group and mood stabilizer group. There was significant relation of baseline TT4 (P = 0.020, HR = 0.948), FT3 (P = 0.035, HR = 2.055), and FT4 (P = 0.047, OR=0.769) with the recurrence of depressive episode in mood stabilizer group. The area under curve (AUC) of TT4, FT3, FT4 were 0.685, 0.613, 0.544, respectively. There was significant relation of baseline FT3 (P = 0.044 , HR = 4.493) with the recurrence of mania episode for mood stabilizer combined with antidepressants group. The AUC of FT3 was 0.806. Conclusion: Low level of TT4, FT4 and high level of FT3 within normal-range were related with the recurrence of depressive episode in the maintenance treatment with mood stabilizer of bipolar disorder. High level of FT3 within normal-range were related with recurrence of mania when mood stabilizer combined with antidepressants were used in the maintenance treatment of bipolar disorder.

It is essential to monitor pharmacological treatment for schizophrenic outpatients regularly in clinical practice. Especially in China, the situation of common prescribing patterns remains unclear. The objective of this study is to reveal real-world treatment prescription patterns of antipsychotics for schizophrenia patients in a representative large tertiary hospital in China. This study is a cross-sectional observational analysis of outpatients with schizophrenia in a large tertiary psychiatric hospital in Beijing, China, from May 11th to 24th, 2019. Data on subjects' socio-demographic and clinical characteristics, prescriptions of psychotropic drugs were collected from the electronic medical record (EMR) system with a standardized protocol. A multivariate analysis was performed to explore the potential association between antipsychotics treatments and subjects' characteristics. Of the 1940 patients included in this study, only 1470 (75.77%) patients were prescribed antipsychotic medications. 1228 (83.53%) patients were prescribed second-generation antipsychotics (SGAs), 202 (13.74%) patients were treated only with first-generation antipsychotics (FGAs), 40 (2.72%) were prescribed both SGAs and FGAs. The proportion of single SGAs prescriptions was significantly higher than that of single FGAs antipsychotics in each course of monotherapy group, especially among patients with the course less than 2 years (96.08%). Risperidone was most frequently prescribed antipsychotic medication during the study (29.86%, 439 out of 1470). Intermediate-acting sedative benzodiazepines were the most commonly co-prescribed psychotropic class at 23.66%. Long-acting injectable antipsychotics (LAIs) could be the prescribing trend in clinics. Disease course, self-paying cost and LAI antipsychotic use were independently associated with antipsychotics treatments. Second-generation antipsychotics showed domination in prescriptions. More concerns should be paid with concomitant psychiatric medications in clinics.

Background: Epidemiological data on outbreak-associated depression of Chinese teachers are not available. This study aimed to investigate the prevalence and correlates of depression among teachers during the coronavirus disease 2019 (COVID-19) outbreak in mainland China.Methods: A large cross-sectional online survey was conducted during the COVID-19 outbreak. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). The Connor-Davidson Resilience Scale 25 (CD-RISC 25) and Perceived Stress Scale-10 (PSS-10) were used to measure the mental resilience and stress of participants. The correlative factors of depression were analyzed.Results: In this study, 1,096 teachers were analyzed with a median (range) age of 41 (20–65) years. Of them, 624 (56.9%) suffered from depression (PHQ-9 total score of >4). The multivariate analyses showed that participants with aged ≥41 years (OR = 0.752, 95% CI:0.578–0.979, p = 0.034), participating in epidemic prevention and control (OR = 1.413, 95% CI:1.070–1.867, p = 0.015), thinking prolonged school closure have bad effect (OR = 1.385, 95% CI:1.017–1.885, p = 0.038), sleep duration/day of <6 h (OR = 1.814, 95% CI:1.240–2.655, p < 0.001), physical exercise duration/day of <30 min (OR = 1.619, 95% CI:1.247–2.103, p < 0.001), spending less time with family (OR = 1.729, 95% CI: 1.063–2.655, p = 0.002), being concerned about COVID-19 (OR = 0.609, 95% CI:0.434–0.856, p = 0.004), having poor mental resilience (OR = 6.570, 95% CI:3.533–12.22, p < 0.001) and higher PSS-10 scores (OR = 9.058, 95% CI:3.817–21.50, p < 0.001) were independently associated with depression.Conclusion: During the COVID-19 outbreak, depression was common among teachers. Age, participating in epidemic prevention and control, opinions toward distant teaching and prolonged school closure, sleep duration/day, physical exercise duration, spending time with family, attitude toward COVID-19, mental resilience and stress represented the independent factors for suffering from depression.

目的 旨在调查新型冠状病毒肺炎(COVID-19)疫情期间北京市青少年抑郁焦虑情况及影响因素,为北京市青少年心理健康教育及心理危机干预提供有价值的数据及科学参考.方法 本研究采用在线问卷的调查形式,利用儿童流行病学调查用抑郁评定量表(Center for Epidemiological Studies Depression Scale for Children,CES-DC)评估抑郁程度,广泛性焦虑量表(Generalized Anxiety Disorder 7-Item Scale,GAD-7)评估焦虑程度,在新冠肺炎流行期间收集北京市初高中学生数据并对影响因素进行分析.结果 本研究共有1142名北京市初高中学生纳入分析,年龄11～18岁.其中CES-DC>15分的有465例,占40.7％,GAD-7≥5分的有275例,占24.1％.此外,多因素Logistics回归分析结果提示女性(OR=0.754,P=0.034)、每天睡眠时间<6 h(OR=3.977,P<0.001)、学习效率比疫情发生前低(OR=2.699,P<0.001)、每天体育锻炼时间<30 min(OR=1.712,P<0.001)是抑郁症状的独立因素;高中(OR=0.428,P=0.002)、学习效率比疫情发生前低(OR=2.467,P<0.001)、每天体育锻炼时间<30 min(OR=1.817,P<0.001)是焦虑症状的独立因素.结论 在COVID-19流行期间,北京市儿童青少年群体有抑郁症状和焦虑症状的比例显著增高.应重视引发抑郁焦虑的相关因素,关注青少年精神心理健康,尽早在青少年群体中开展心理危机干预工作.

目的 调查抑郁症患者的药物使用情况及抗抑郁药物联合用药的影响因素.方法 采用横断面调查方法,通过电子病历系统调查2019年9月1日至2019年9月30日北京安定医院门诊诊治的抑郁症患者的药物使用情况,分析抗抑郁药物联合用药的影响因素.结果 本研究共纳入5171例抑郁症患者,其中女3575例(69.1％),男1596例(30.9％);年龄10～91(46.5±20.1)岁,<18岁266例,≥18～65岁3788例,≥65岁1117例;自费患者2079例(40.2％),医疗保险付费患者3092例(59.8％).5171例患者中,选择性5-羟色胺再摄取抑制剂(SSRI)类抗抑郁药物使用比例最高[58.7％(3036/5171)],其次是5-羟色胺(5-HT)和去甲肾上腺素再摄取抑制剂(SNRI)类[17.5％(903/5171)],673例(13.0％)使用去甲肾上腺素和特异性5-HT再摄取抑制剂(NaSSA),194例(3.8％)使用5-HT阻滞和再摄取抑制剂(SARI);抗抑郁药物联合用药患者占12.0％(620/5171).在其他抗精神类药物中,苯二氮类药物使用比例最高[36.4％(1881/5171)],其次是二代抗精神病药物[17.5％(904/5171)].<18岁组患者使用多巴胺和去甲肾上腺素再摄取抑制剂(DNRI)、阿扎哌隆类抗焦虑药物、二代抗精神病药物及心境稳定剂的比例高于≥18～65岁组和≥65岁组(P<0.05);≥18～65岁组患者使用DNRI、二代抗精神病药物及心境稳定剂的比例高于>65岁组(P<0.05);>65岁患者使用NaSSA、三环类、四环类、其他抗抑郁药物、苯二氮类药物、非苯二氮类镇静催眠药物及抗抑郁药物联合用药的比例高于<18岁组和≥18～65岁组(P<0.05);≥18～65岁组患者使用NaSSA、SARI、苯二氮类药物、非苯二氮类镇静催眠药及联合用药的比例高于<18岁组(P<0.05).女性患者使用NaSSA的比例高于男性(P<0.05),女性患者抗抑郁药物联合用药比例低于男性(P<0.05).医疗保险付费的患者使用SSRI类药物、非苯二氮类镇静催眠药的比例显著高于自费患者,使用伏硫西汀、二代抗精神病药物及心境稳定剂的比例显著低于自费患者(P<0.05).单因素回归分析显示,性别、年龄是抗抑郁药物联合用药的影响因素(P<0.05),男性、年龄≥18～65岁及≥65岁与抗抑郁药物联合用药显著相关(P<0.05).多因素回归分析结果显示,年龄、付费方式是抗抑郁药物联合用药的影响因素(P<0.05),≥65岁和医疗保险付费是抗抑郁药物联合用药的独立影响因素(P<0.05).结论 抑郁症患者的治疗药物以新型抗抑郁药物为主,其中SSRI类抗抑郁药物所占比重最大;抗抑郁药物联合用药现象并不罕见,≥65岁和医疗保险付费患者更倾向于抗抑郁药物联合用药.

Objectives To improve the diagnosis and treatment level of bipolar disorder and provide evidence for individualized treatment, we compared the clinical characteristics between first-episode depression and first-episode mania in bipolar disorder patients.Method A total of 456 patients with bipolar disorder who were hospitalizedbetween Jun. 2013 and Dec. 2013 were selected and divided into first-episode depression group and first-episode mania group according to the first-episode type. The descriptive statistics was adopted to analyze the demographic data including gender, age, marriage, education, and clinical symptoms.Result The two groups showed significant differences in age and gender (P<0.05), while did not differ significantly in marriage and education(P>0.05). There were significant differences in diagnosis time, frequencies of mania, frequencies of depression, history of suicide attempts, frequencies of hospitalization between the two groups (P<0.05), while no significant difference was found in disease course, first onset age, visiting age, age at first diagnosis, and total number of attack (P>0.05). Significant differences were observed in rate of misdiagnosing as other diseases, rate of misdiagnosing as unipolar depression, relapse due to medication non-compliance, and relapse due to non-standard treatment between the two groups (P<0.05).Conclusion Patients with first-episode depression showed more adverse clinical features, including higher misdiagnosis rate, recurrence rate, suicide rate, and bad therapeutic compliance. Some predictive suggestions should be given based on the first episode so as to realize the individualized treatment.