Objective:To investigate resting-state regional homogeneity in patients with bipolar disorder in different mood states and the potential trait imaging markers of bipolar disorder.Methods:This is a cross-sectional study involving 169 patients who met the diagnosis criteria of bipolar disorder in DSM-Ⅳ-TR (including 68 patients with bipolar depression, 29 patients with bipolar (hypo)mania, 72 patients with bipolar euthymia) and 113 controls matched by age and gender. The severity of depression, mania, and the positive and negative affects were assessed by the Hamilton Depression Scale (HAMD 17), Young Mania Rating Scale (YMRS), and Positive and Negative Affect Schedule (PANAS). Resting-state fMRI data were obtained. After fMRI data processing, 64 patients with bipolar depression, 28 patients with bipolar (hypo)mania, 66 patients with bipolar euthymia, and 112 controls were included in the final analysis. The regional homogeneity (ReHo) values were computed, and analysis of covariance was performed on ReHo values among the four groups. Post hoc analysis was conducted based on the ReHo values extracted from the brain regions with significant differences. The relationship between the ReHo values and clinical scores was examined. Results:Significant ReHo differences were observed in the bilateral posterior cerebellum ( F=11.41 for left, F=10.45 for right), bilateral calcarine cortex ( F=10.60 for left, F=9.59 for right), and right superior temporal gyrus ( F=10.58). Compared to controls, bipolar patients in all mood states demonstrated decreased ReHo in the left posterior cerebellum ( P<0.01 for all) and increased ReHo in the right posterior cerebellum ( P<0.05 for all), bilateral calcarine cortex and right superior temporal gyrus ( P<0.01 for all). The clinical score of negative affects was negatively correlated with the ReHo values in the right calcarine cortex ( r=-0.17, P=0.04, uncorrected). Conclusions:Bipolar disorder is characterized by regional homogeneity changes in the bilateral posterior cerebellum, bilateral calcarine cortex and right superior temporal gyrus across different mood states. The functional abnormalities in the cerebellum, visual network and sensorimotor network could comprise a trait biomarker for bipolar disorder.

Objective To examine the sex differences in prescribing patterns of psychotropic drugs and drug-induced side effects in schizophrenia patients in China. Methods Using the same design and a standardized protocol as in 2002 and 2006, the cross-sectional survey was conducted from July to August, 2012 in 45 psychiatric hospitals/centers in 10 provinces and municipalities in China. Inpatients and outpatients with schizophrenia were consecutively screened for eligibility for this study. Sociodemographic characteristics and prescription pattern were collected by using a modified questionnaire for the study. Data comparisons between male and female were performed with univariate analysis. Multiple logistic regression analysis was employed to determine the gender differences in prescription pattern and drug-induced side effects. Results The sample consisted of 2 260 male and 1 979 female patients. Univariate analyses showed that male patients were younger than female patients(t=5.398), having an earlier age at onset(t=5.662), higher percentage of being employed(χ2=31.597), and more negative symptoms(χ2=10.814)and aggressive behavior (χ2=5.816), more likely to receive clozapine (23.9%(472/1 979) vs. 28.5%(645/2 260),χ2=11.955), higher antipsychotic doses(476 mg vs. 514 mg,F=14.003), less use of antidepressants (7.9%(156/1 979) vs. 6.0%(136/2 260),χ2=5.722)and benzodiazepines(23.9%(472/1 979)vs. 20.0%(451/2 260),χ2=9.396), more frequent tardive dyskinesia(1.3%(25/1 979)vs. 2.1%(47/2 260),χ2=4.212)and less weight gain(11.0%(218/1 979)vs. 7.7%(173/2 260),χ2=14.233)and prolactin elevation(3.2%(63/1 979)vs. 1.7%(39/2 260),χ2=9.548;all P<0.05). In multivariate analyses, greater rate of clozapine use (OR=1.268,P=0.001), less rate of benzodiazepines use(OR=0.841,P=0.025) and antidepressants(OR=0.78,P=0.045),higher rate of tardive dyskinesia(OR=1.879,P=0.014)and less weight gain (OR=0.669,P=0.001) and prolactin elevation (OR=0.527,P=0.003) were independently associated with the male sex. Conclusion Gender is one of the independent contributors to psychotropic prescription pattern and side effects of antipsychotics in Chinese schizophrenia patients. Gender differences should be given more attention in research and clinical practice.