Since 2019, COVID-19 began spreading globally and has significantly affected peoples’ daily lifestyles. The public was asked to stay at home for constant quarantine and community containment starting on 23 January 2020. To assess the circadian rhythms and sleep changes and their influential factors during the COVID-19 outbreak, a questionnaire was administered to 451 Chinese participants during 20–31 January 2020. The changes in circadian rhythm, sleep–wake cycle, dining, and exercise of the participants and their correlation with negative emotions were analyzed. Furthermore, the effects of three factors (holiday, quarantine, and concerns regarding the pandemic situation) on these changes were assessed. We found that 34.6% of the participants reported circadian rhythm disturbance. Moreover, 67.2% presented negative emotions (worry, fear, downheartedness, anxiety, depression, and stupefaction) regarding the pandemic situation, among which worry was the most prevalent. Gender and age were significant factors for changes in the circadian phases and emotions. There was a correlation between circadian rhythm alterations and negative emotions. In addition, holiday, quarantine, and concerns regarding the pandemic situation had significant effects on circadian rhythms and sleep in a substantial part of the population. Regression analysis demonstrated reciprocal influences between many of these variables. Our findings suggest that circadian rhythms, sleep, and negative emotions in the normal population need to be considered during the pandemic period and that the adjustment of circadian rhythms could help promote sleep, restore emotions and improve public health.

Objectives: The long-term outcome of childhood-onset schizophrenia (COS) and its influencing factors remain unclear. The current study aimed to assess the long-term outcomes of COS and identify possible outcome predictors. Methods: We retrospectively investigated 276 patients with COS. Diagnosis made according to the ICD-10 criteria for schizophrenia, and the age of the first onset was ≤ 14 years. Follow-up was completed for 170 patients, with a median follow-up period of 5.6 years. Outcome variables included occupational/education status and readmission. Spearman correlation was performed to assess the relationship between predictors and outcome variables. Binary logistic regression was conducted to detect possible predictor variables for outcome variables. Results: At the end of the follow-up, 89 patients (52.3%) were at school, 70 patients (41.2%) were employed, and only 11 patients (6.5%) were dropped out of school or unemployed. The duration to the first admission and depressive symptoms were identified as predictors of occupational/educational status. The length of follow-up and obsessive-compulsive symptoms (OCS) were distinguished as predictors of readmission. Duration to the first admission and length of follow-up were risk factors, and depressive symptoms and OCS were protective factors for the outcomes of COS. Conclusion: We found a favorable long-term outcome on occupational/education status in COS, and depressive symptoms and OCS may be associated with more positive long-term outcomes in COS. Our findings suggest that COS patients may benefit from early intervention and require appropriate treatment.

Objective Insomnia with objective short sleep duration (IOSSD) is associated with an increased risk of cardiovascular morbidity, diabetes, neurocognitive impairment, and mortality. Inflammation is believed to be one of the main links between IOSSD and these diseases. The role of nucleotide-binding domain and leucine-rich repeat protein-3 (NLRP3) inflammasome in inducing activation of inflammatory signaling in IOSSD is not clear. In this study, we investigated the expression of NLRP3 inflammasome in patients with IOSSD to clarify this issue. Methods Thirty-six patients with insomnia and 20 age- and sex-matched healthy controls were sequentially recruited. Subjects were categorized into three groups: IOSSD (sleep duration < 6h, n=20), insomnia with objective normal sleep duration (IONSD, sleep duration ≥ 6h, n=16) and healthy controls (n=20). Objective sleep parameters were measured by overnight polysomnography. Peripheral NLRP3 inflammasome protein levels [NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), caspase l] and cytokines [interleukin (IL)-1β and IL-18] were assessed by Western blotting and ELISA, respectively. Results IOSSD group showed significantly increased protein expressions of ASC and caspase-1 compared to IONSD and healthy controls and significantly increased IL-18 levels compared to healthy controls. On correlation analysis, total sleep time showed an inverse correlation with NLRP3, ASC, IL-18, and IL-1β levels. Wake after sleep onset (WASO) showed a positive correlation with NLRP3, ASC, caspase-1, and IL-1β levels. N3 sleep ratio showed a significant negative correlation with NLRP3, ASC, and IL-18 levels. Conclusion The current study demonstrated upregulation of NLRP3 inflammasome in IOSSD. Short sleep duration, decreased slow wave sleep, and sleep fragmentation may contribute to dysregulation of NLRP3 inflammasome.

目的 探讨缓解期双相障碍患者的社会认知损害情况,并了解对社会功能的影响.方法 纳入符合《美国精神疾病诊断及统计手册》第Ⅳ版双相障碍诊断标准的107例患者(患者组),同时纳入91例健康对照者(正常组).使用自制一般情况调查表、失言识别测验、眼区基本情绪识别任务、爱荷华博弈任务、社会功能缺陷筛选量表等收集研究资料.采用SPSS 13.0统计软件对数据进行统计分析.结果 (1)患者组社会认知功能与正常组相比,其中失言识别测验、爱荷华博弈任务、眼区情绪识别任务中悲、恐、怒、喜面孔的测验成绩差异有统计学意义(P＜0.05);而眼区情绪识别任务中惊、厌面孔的测验成绩相比差异无统计学意义(P＞0.05).(2)失言识别测验成绩(r=-0.278,P＜0.05)与社会功能缺陷筛选量表(SDSS)得分呈负性相关,而爱荷华博弈任务(P＞0.05)、眼区情绪识别任务成绩(P＞0.05)未发现与SDSS得分相关.结论 缓解期双相障碍患者存在社会认知功能缺陷,情绪识别、心理理论能力、决策能力均有受损,提示患者社会信息感知能力与社会问题解决能力下降.社会功能低下与心理理论能力下降有关,心理理论受损可能是影响社会功能的关键因素.

Objective: To explore the relevant factors of perimenopausal symptoms. Method: Community female subjects conforming to perimenopausal criteria were recruited through advertising. Modified Kupperman Index(KI) was used for evaluation of perimenopausal symptoms, Zung Self-Rating Depression Scale (SDS)for depressive symptoms and Zung Self-Rating Anxiety Scale (SAS)for anxiety symptoms. Eysenck Personality Questionnaire(EPQ) is used to evaluate the individual mental characteristics of subjects,including Extraversion(E), Neuroticism (N),Psychoticism(P),and Lie(L). Metacognition Questionnaire-30 (MCQ-30) is used to evaluate the metacognitive levels of subjects in the 5 important factors, including cognitive confidence(F1), positive beliefs about worry(F2), cognitive self-consciousness(f3), negative beliefs about uncontrollability of thoughts and danger(F4), and beliefs about the need to control thoughts (F5). Meanwhile, the levels of plasma gonadal hormones such as diol, testosterone and progesterone, are monitored. Pairwise correlation and linear regression are used to analyze the relevance between perimenopausal symptoms and the aforementioned factors. Results: Among 66 perimenopausal female subjects, 40 (60.4%) showed perimenopausal symptoms, with the most frequent being fatigue, joint and muscle pain , headache, dizziness, hypersensitivity and agitation. N score(β’=0.419，P<0.001), SDS anxiety factor (β’=0.363，P<0.001)and BMI （β’=0.244，P=0.001） are significantly correlated with KI total score. Age（β’=0.482，P<0.001）, SDS anxiety factor（β’=0.276，P=0.006）, SDS core depressive factor（β’=0.287，P=0.010）and SDS anxiety factor（β’=0.287，P=0.010）are significantly correlated with psychological symptoms. SAS standard score (β’=0.277，P=0.029) and SDS (β’=0.254，P=0.045) are significantly correlated with somatic symptoms. Conclusion: Emotional symptoms such as depression and anxiety are apparent. Perimenopausal females with Neuroticism personality, of elder age and higher BMI suffer from perimenopausal symptoms more severely.

目的:探讨伴或不伴强迫症的双相障碍患者脑部磁共振成像所示形态学的状况.方法:纳入研究对象,使用简明国际神经精神访谈-中文简体版(M.I.N.I.)为研究工具;对研究对象在中山大学附属第三医院磁共振图像进行分析和记录;统计分析.结果:共病强迫症与皮质型脑萎缩、混合型弥漫性脑萎缩及皮层下白质变性有关.经进一步的回归分析发现双相障碍共病强迫症与皮层下白质变性关系明确.结论:患者的脑结构异常与共病强迫症呈正相关,提示双相共病强迫症时可能两者的受损脑区存在交叉.

OBJECTIVE:Lack of physical activity (PA) is common in patients with chronic insomnia. Studies to increase PA and decrease sedentary behavior in those patients are limited. Therefore, we investigated the efficacy of "PA counseling combined with sleep restriction (SR) therapy (PASR)" vs only SR in the patients with chronic insomnia.METHODS:Seventy-one outpatients were assigned to either PASR (n=35), consisting of four weekly PA counseling sessions based on 5A model (assess, advise, agree, assist, and arrange) + SR, or SR (n=36), consisting of four weekly SR. International Physical Activity Questionnaire (Chinese version) and pedometer-based daily steps were evaluated as the primary endpoints. Insomnia Severity Index, Epworth Sleepiness Scale, Fatigue Scale-14, and Sleep Diary were evaluated as the secondary endpoints.RESULTS:The results showed that the patients in the PASR group gained more benefits than the SR group in terms of PA level and pedometer-based daily steps (all P<0.05). Better improvements of the study group were also shown in Epworth Sleepiness Scale, Fatigue Scale-14, and Sleep efficiency (all P<0.05).CONCLUSION:We conclude that PA counseling based on 5A model combined with SR cannot only effectively increase the PA levels but also improve the sleep quality for patients with chronic insomnia.

OBJECTIVE:To study the relationship between daytime fatigue and hyperarousal in patients with primary insomnia.METHODS:One hundred and sixty eighty patients with primary insomnia as research group and 149 healthy people as control group were recruited during November 2013 to December 2014 in the psychiatry department of the Third Affiliated Hospital, Sun Yat-sen University. The Hyperarousal Scale (HAS), Pre-Sleep Arousal Scale (PSAS), Fatigue scale-14 (FS-14) and a visual analogue scale (VAS) were used to evaluate the symptom of hyperarousal trait, pre-sleep arousal, daytime fatigue and self reported sleep quality respectively.RESULTS:The participants in research group had more severe symptoms of hyperarousal trait [(41.9±9.7) vs (27.6±7.0)], pre-sleep arousal [(42.0±7.3) vs (22.1±4.7)], daytime fatigue [(9.2±3.1) vs (3.0±0.7)] than those in control group. According the multiple linear regressions, the daytime fatigue in research group was positively related not only to sleep quality, but also to hyperarousal trait and pre-sleep arousal.CONCLUSION:Hyperarousal is an important factor which could affect the daytime fatigue in patients with primary insomnia and should be given more attention to.

目的 调查慢性失眠患者的体力活动水平,调查并评价其体力活动咨询经历和质量,为临床工作提供指导.方法 以386例门诊慢性失眠患者及154例健康对照为研究对象.采用国际体力活动问卷调查所有入组者体力活动情况,按照体力活动水平分为不充足和充足.采用5-As模型(评估、建议、达成共识、协助和随访安排)体力活动咨询框架调查并评价两组体力活动咨询经历及质量.结果 失眠组体力活动充足者为22％ (84/386),低于对照组(34％,52/154),差异有统计学意义(x2=8.419,P＜0.01).失眠组体力活动咨询经历调查结果显示,仅有19％(72/386)的患者接受过体力活动咨询,且主要咨询策略为“建议”,其他咨询策略使用少,无随访,属低强度体力活动咨询.结论 慢性失眠患者体力活动水平明显不足,所接受的体力活动咨询内容简单、质量低.