The risk of adverse effects in Electroconvulsive Therapy (ECT), such as cognitive impairment, can be high if an excessive stimulus is applied to induce the necessary generalized seizure (GS); Conversely, inadequate stimulus results in failure. Recent efforts to automate this task can facilitate statistical analyses on individual parameters or qualitative predictions. However, this automation still significantly lags behind the requirements in clinical practices. This study addresses this issue by predicting the probability of GS induction under the joint restriction of a patient's EEG (electroencephalogram) and the stimulus parameters, sustained by a two-stage learning model (namely ECTnet): 1) Temporal-Spatial Feature Learning . Channel-wise convolution via multiple convolution kernels first learns the deep features of the EEG, followed by a “ConvLSTM” constructing the temporal-spatial features aided with the enforced convolution operations at the LSTM gates; 2) GS Prediction . The probability of seizure induction is predicted based on the EEG features fused with stimulus parameters, through which the optimal parameter setting(s) may be obtained by minimizing the stimulus charge while ensuring the probability above a threshold. Experiments have been conducted on EEG data from 96 subjects with mental disorders to examine the performance and design of ECTnet. These experiments indicate that ECTnet can effectively automate the selection of optimal stimulus parameters: 1) an AUC of 0.746, F1-score of 0.90, a precision of 89% and a recall of 93% in the prediction of seizure induction have been achieved, outperforming the state-of-the-art counterpart, and 2) inclusion of parameter features increases the F1-score by 0.054.

Objective:Childhood maltreatment is a well-established risk factor for nonsuicidal self-injury (NSSI), particularly in individuals with major depressive disorder (MDD). The psychological mechanisms are complex and not completely understood. Based on the Cognitive-Behavioral Vulnerability Model, this study aimed to investigate whether family functioning and dysfunctional attitudes act as parallel mediators of the relationship between childhood maltreatment and NSSI and anhedonia moderates the association between dysfunctional attitudes and NSSI in depressed college students. Methods:525 college students diagnosed with MDD were recruited from the ESCID project. They completed Childhood Trauma Questionnaire (CTQ), Family Assessment Device (FAD), Dysfunctional Attitude Scale (DAS), Snaith-Hamilton Pleasure Scale (SHAPS), and a measure of NSSI. Data were analyzed using SPSS 26.0 for descriptive statistics and correlations, and Mplus 8.3 for mediation and moderated mediation analyses, employing maximum-likelihood estimation with Monte Carlo integration. Results:Childhood maltreatment showed a positive correlation with dysfunctional attitudes, anhedonia, and NSSI, while family functioning demonstrated no significant association. Mediation analyses revealed that childhood maltreatment had both a direct effect on NSSI (β = 0.125, p < 0.05, 95% CI [0.010, 0.240]) and an indirect effect through dysfunctional attitudes (β = 0.035, p < 0.05, 95% CI [0.008, 0.063]). In contrast, the mediating role of family functioning was not significant (β = -0.060, p > 0.05), as was the total indirect effect. Moderated mediation analyses showed that anhedonia significantly moderated the association between dysfunctional attitudes and NSSI (β = 0.190, p < 0.001, 95% CI [0.092, 0.288]). Simple slope tests indicated that dysfunctional attitudes exhibited a stronger correlation with NSSI in individuals with high levels of anhedonia, while this correlation became nonsignificant at lower levels. Conclusions:Our findings reveal that dysfunctional attitudes significantly mediate the link between childhood maltreatment and NSSI, while family functioning showed no mediating effect. Anhedonia amplified the impact of dysfunctional attitudes on NSSI, suggesting that cognitive and affective vulnerabilities enhance the risk of self-injury. Interventions that target dysfunctional attitudes and enhance hedonic capacity may improve prevention and treatment among maltreated youth with depression.

Background: Electroconvulsive therapy (ECT) provides rapid relief of depressive symptoms. However, the relationship between intracranial electric field (E-field) distribution, dosage, and antidepressant outcomes remains underexplored. Methods: Thirty patients with depressive episodes received bifrontal ECT. Clinical symptoms were assessed using the 17-Item Hamilton Rating Scale for Depression at baseline and post-ECT treatment. Magnetic resonance imaging was performed at baseline to calculate E-field strength and intracranial E-field dosage. Results: No significant associations were found between accumulated or average E-field dosage and overall antidepressant outcomes. However, significant associations were observed between antidepressant outcomes and Efield dosage during the initial ECT session in key brain regions, including the amygdala, anterior cingulate cortex, cerebellum, hippocampus, medial para-hippocampal cortex, postcentral gyrus, thalamus, and superior frontal lobe (P all < 0.05). Conclusions: While no significant associations were found between cumulative or average E-field dosage and antidepressant outcomes of ECT, significant associations were observed between E-field dosage in key brain regions and antidepressant outcomes during the initial ECT session. These findings suggest that individualized ECT protocols, tailored to patient-specific neuroanatomy and E-field dosage in specific brain regions, may enhance ECT's therapeutic efficacy. Future research should explore personalized ECT protocols using computer-modeled E-field distribution and ECT parameters.

Introduction:Electroconvulsive therapy (ECT) is one of the main strategies for major depressive disorder (MDD). Recently, the use of esketamine in the treatment of depression due to the rapid antidepressant effects has been highlighted. The present study hypothesizes that 1) adjunctive esketamine during ECT will produce greater improvement in depressive symptoms compared to placebo; 2) the esketamine-ciprofol combination will demonstrate superior antidepressant efficacy and fewer adverse events relative to the esketamine-propofol combination. Methods and analysis:This is a prospective, randomized, double-blind, placebo-controlled, repeated-measures trial with factorial design, planned to be conducted in Renmin Hospital of Wuhan University from 1 May 2024 to 31 May 2025. A total of 168 cases with MDD undergoing scheduled ECT will be randomized in a ratio of 1:1:1:1 to receive propofol or ciprofol sedation with or without esketamine (0.25 mg/kg) treatment. The primary outcome is the changes from baseline to day 28 in HAMD-24. Secondary outcomes include the rates of response (a 50% or greater reduction in HAMD-24 total scores) and remission (a score of 8 or less in the HAMD-24 total scores), along with the rate of reduction in the HAMD-24 total scores from baseline, at the end of the trial. In addition, the incidence of adverse events and the details of ECT will also be recorded. Standard intention-to-treat (ITT) analyses will be performed after handling missing data using multiple imputation methods. The predefined subgroup analysis on primary outcomes will be conducted according to age and sex. The generalized estimating equation (GEE) will be utilized to analyze the outcomes. This study will address two critical questions in ECT practice: whether ECT with adjunctive esketamine achieves clinically superior outcomes to ECT alone, and whether anesthetic choice (ciprofol versus propofol) modulates the antidepressant efficacy of esketamine. The findings from this randomized controlled trial (RCT) will provide novel evidence to optimize sedation regimens during ECT in patients with MDD, specifically addressing the risk-benefit ratio of adjunctive esketamine administration. Ethics and dissemination:This trial was approved by the local Institutional Review Board (No. WDRY2024-K018) and conducted following the guidelines of the Declaration of Helsinki. Results of this trial will be publicly disclosed in a peer-reviewed journal. Clinical Trial Registration:clinicaltrials.gov, identifier ChiCTR2400083664.

Appetite decrease is a common symptom in major depressive disorder (MDD). However, published research discussing the cognitive process to food stimuli in MDD patients with decreased appetite is lacking, as are objective indicators to assess their degree of appetitive loss. The current study evaluated the disparities in food-related cognition between healthy controls and MDD patients, explored the brain regions contributing to these changes, and evaluated the potential of event-related potentials for assessing appetite loss severity. A total of 149 subjects (healthy controls, n = 50; MDD patients with decreased appetite, n = 52; MDD patients without appetite change, n = 47) were included in this study. We used the Dimensional Anhedonia Rating Scale (DARS) to measure the degree of appetite decrease, and assessed their alterations in food-related cognition with the late positive potential (LPP). The standardized low-resolution brain electromagnetic tomography (sLORETA) method was used to explore the source activity of the LPP. We found the two groups of MDD patients did not differ in the disease severity, while those with appetite decrease got the lowest DARS food/drink score. And MDD patients with decreased appetite allocated fewer attentional resources to food stimuli with significantly lower LPP amplitude evoked by food in this group. Within depressed patients, LPP source activations were reduced in lingual gyrus, cuneus, inferior and middle occipital lobe, and inferior occipital gyrus in appetite-decreased patients, indicating altered occipital activity may be associated with attentional processing in MDD patients with decreased appetite. And correlation analysis revealed a moderate, positive correlation between LPP amplitude and DARS food/drink score. This study demonstrates the cognitive differences between MDD patients with appetite decrease and without appetite change, and provides a potential biomarker for evaluating the degree of appetite loss in MDD patients experiencing decreased appetite.

ObjectiveThis study aimed to investigate the independent or synergistic effects of evening chronotype and poor sleep quality on cognitive impairment in patients with major depressive disorder (MDD).MethodsA cross-sectional study was conducted on 249 individuals diagnosed with MDD, recruited from the Mental Health Center of Renmin Hospital of Wuhan University. Chronotype preference was assessed using the reduced Horne and Ostberg Morningness - Eveningness Questionnaire (rMEQ), while sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Cognitive function was evaluated through the Digit Symbol Substitution Test (DSST), defining impairment as a DSST score ≤ 56 (the lowest quartile of the cohort). Univariate analysis and logistic regression models were employed to explore the factors associated with cognitive impairment, focusing on the potential interactive effects of evening chronotype and poor sleep quality.ResultsOf the 249 subjects recruited, about 41% were classified as evening chronotype. These individuals exhibited poorer sleep quality and more severe depressive symptoms compared to non-evening chronotype (p < 0.01). Univariate analysis revealed that first episode status, Hamilton Depression Rating Scale (HAMD-17) scores, evening chronotype, and poor sleep quality were significantly associated with cognitive impairment (p < 0.05). Multivariate logistic regression analysis further demonstrated that the co-existence of evening chronotype and poor sleep quality significantly increased the likelihood of cognitive impairment (adjusted odds ratio [AdjOR] = 2.65, 95% confidence interval [CI] = 1.09–6.45, p < 0.05).ConclusionOur findings suggest that evening chronotype, poor sleep quality, and their interaction are important contributors to cognitive impairment in patients with MDD, alongside the severity of depression and first episode status. These results emphasize the need for integrated approaches targeting circadian rhythm disruptions and sleep disturbances in the treatment of cognitive dysfunction in MDD.

Depression and sleep disturbances are highly prevalent health problems that have been suggested to be associated with vitamin D deficiency. This study investigated whether sleep disturbances affect the association between vitamin D and depressive symptoms. A total of 425 patients with depression were included in this study. Spearman correlation coefficients were chosen to assess the relation between vitamin D concentrations and depressive symptomatology (according to the PHQ-9 and HAMD-17 scores). The GLM Mediation Model in the Medmod module for data analysis in Jamovi 2.2.5 was used to analyze the mediation models for sleep disturbances. Vitamin D concentrations were significantly correlated with PHQ-9 and HAMD-17 scale scores. In addition, item 3 was suggested to have a mediating effect between vitamin D and depressive symptoms in the mediating model of PHQ-9, and item 4 was suggested to have a mediating effect between vitamin D and depressive symptoms in the mediating model of HAMD-17. Sleep disturbances (especially difficulty falling asleep) are mediators between vitamin D and depressive symptoms, suggesting that increasing vitamin D levels at the right time to regulate sleep disturbances may improve depression symptoms, yet further research is necessary.

Background:Evidence from functional magnetic resonance imaging (fMRI) studies of schizophrenia suggests that interindividual variation in the stationary striatal functional circuit may be correlated with antipsychotic treatment response. However, little is known about the role of the dynamic striatum-related network in predicting patients' clinical improvement. The spontaneous coactivation pattern (CAP) technique has recently been found to be important for elucidating the non-stationary nature of functional brain networks.Methods:Forty-two drug-naive first-episode schizophrenia patients underwent fMRI and T1W imaging before and after 8 weeks of risperidone monotherapy. The striatum was divided into 3 subregions, including the putamen, pallidum, and caudate. Spontaneous CAPs and CAP states were utilized to measure the dynamic characteristics of brain networks. We used DPARSF and Dynamic Brain Connectome software to analyze each subregion-related CAP and CAP state for each group and then compared the between-group differences in the neural network biomarkers. We used Pearson's correlation analysis to determine the associations between the neuroimaging measurements with between-group differences and the improvement in patients' psychopathological symptoms.Results:In the putamen-related CAPs, patients showed significantly increased intensity in the bilateral thalamus, bilateral supplementary motor areas, bilateral medial, and paracingulate gyrus, left paracentral lobule, left medial superior frontal gyrus, and left anterior cingulate gyrus compared with healthy controls. After treatment, thalamic signals in the putamen-related CAP 1 showed a significant increase, while the signals of the medial and paracingulate gyrus in the putamen-related CAP 3 revealed a significant decrease. The increase in thalamic signal intensity in the putamen-related CAP 1 was significantly and positively correlated with the percentage reduction in PANSS_P.Conclusion:This study is the first to combine striatal CAPs and fMRI to explore treatment response-related biomarkers in the early phase of schizophrenia. Our findings suggest that dynamic changes in CAP states in the putamen-thalamus circuit may be potential biomarkers for predicting patients' variation in the short-term treatment response of positive symptoms.

BackgroundAntipsychotic treatment-related alterations of cortical thickness (CT) and clinical symptoms have been previously corroborated, but less is known about whether the changes are driven by gene expression and epigenetic modifications.MethodsUtilizing a prospective design, we recruited 42 treatment-naive first-episode schizophrenia patients (FESP) and 38 healthy controls. Patients were scanned by TI weighted imaging before and after 8-week risperidone monotherapy. CT estimation was automatically performed with the FreeSurfer software package. Participants' peripheral blood genomic DNA methylation (DNAm) status, quantified by using Infinium® Human Methylation 450K BeadChip, was examined in parallel with T1 scanning. In total, CT measures from 118 subjects and genomic DNAm status from 114 subjects were finally collected. Partial least squares (PLS) regression was used to detect the spatial associations between longitudinal CT variations after treatment and cortical transcriptomic data acquired from the Allen Human Brain Atlas. Canonical correlation analysis (CCA) was then performed to identify multivariate associations between DNAm of PLS1 genes and patients' clinical improvement.ResultsWe detected the significant PLS1 component (2,098 genes) related to longitudinal alterations of CT, and the PLS1 genes were significantly enriched in neurobiological processes, and dopaminergic- and cancer-related pathways. Combining Laplacian score and CCA analysis, we further linked DNAm of 33 representative genes from the 2,098 PLS1 genes with patients' reduction rate of clinical symptoms.ConclusionsThis study firstly revealed that changes of CT and clinical behaviors after treatment may be transcriptionally and epigenetically underlied. We define a “three-step” roadmap which represents a vital step toward the exploration of treatment- and treatment response-related biomarkers on the basis of multiple omics rather than a single omics type as a strategy for advancing precise care.

Early adverse life events (EALs) increase susceptibility to depression and impair cognitive performance, but the physiological mechanisms are still unclear. The target of this article is to clarify the impact of adverse childhood experiences on emotional and cognitive performance from the perspective of the heart–brain axis. We used the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to test cognitive function and the Childhood Trauma Questionnaire (CTQ) to assess adverse childhood experiences. Heart rate variability (HRV) and electroencephalograms (EEG) were acquired at rest. We observed that subjects with depression had experienced more traumatic events during their childhood. Furthermore, they exhibited lower heart rate variability and higher power in the delta, theta, and alpha frequency bands. Moreover, heart rate variability partially mediated the association between childhood trauma exposure and depressive symptoms. Our findings suggested that adverse life events in childhood could influence the development of depression in adulthood, which might be linked to cardiac autonomic dysfunction and altered brain function.

Modified Electric Convulsive Therapy (MECT) is an efficacious physical therapy in treating mental disorders. The occurrence of epilepsy is a crucial benchmark for evaluating therapeutic effectiveness. However, the medical field still lacks relevant research on automatically detecting epileptic waves in MECT. Therefore, this article proposes a novel automatic detection method of epileptic waves in MECT. In this article, EEG local features (time, frequency, and time-frequency domains) and global features (Pearson correlation coefficient) are combined for epileptic wave detection with SVM (Support Vector Machine). We researched the system with 15 EEG detection channels. The dataset under investigation contains EEG data from 22 patients who received MECT and presented with epileptic seizures. The results revealed that LA (Logarithm of Activity) feature exhibits the best classification significance. When epileptic waves appear, there is a decrease in the power ratio of delta waves and an increase in the power ratio of theta waves. Additionally, the complexity of EEG decreases while the correlation between EEG channels increases. The Cz, F4, and P3 channels exhibit the highest classification significance among all EEG channels. Furthermore, based on the channel classification significance, the EEG detection channels number can be reduced to 8. Similarly, based on the feature classification significance, the local feature number can be reduced from 9 to 3. These conclusions can improve detection efficiency and reduce the cost for MECT. Moreover, the method we proposed can effectively detect epileptic waves in MECT. This work can provide physicians with a reference for evaluating the effectiveness of MECT.

目的 观察经颅直流电刺激疗法(rTMS)联合盐酸舍曲林对老年抑郁症患者认知功能、情绪状态、睡眠情况及血清学相关指标水平的影响.方法 回顾性选择2019年4月1日—2021年4月1日钟祥市人民医院精神科及武汉大学人民医院精神科收治的老年抑郁症患者80例,根据不同治疗方法分为观察组和对照组,其中rTMS联合盐酸舍曲林治疗的患者40例为观察组,假刺激疗法联合盐酸舍曲林治疗的患者40例为对照组,2组患者均治疗4周.比较2组患者临床疗效、治疗前后汉密尔顿抑郁量表17项(HAMD-17)评分、匹兹堡睡眠质量指数量表(PSQI)评分、重复性成套神经心理状态测试(RBANS)评分、生活质量(QOL)评分、去甲肾上腺素(NE)、5-羟色胺(5-HT)、脑源性神经生长因子(BDNF)水平.结果 治疗4周后,观察组患者治疗总有效率为87.50％,高于对照组的67.50％(x2=4.588,P=0.035).治疗4周后,2组患者HAMD-17评分及PSQI评分均低于治疗前,RBANS评分、QOL评分及NE、5-HT、BDNF水平均高于治疗前,且观察组降低/升高幅度大于对照组(P<0.05).结论 rTMS联合盐酸舍曲林可改善老年抑郁症患者的认知功能和血清学指标水平,提高睡眠质量和生活质量,获得较满意的临床疗效,值得在精神科临床推广使用.

针对口吃患者言语感知和运动时机障碍特点,分析了治疗口吃4个关键要素治疗机制,设计了针对性的音乐-运动干预方案,并应用于临床实践中.研究表明:针对口吃患者言语感知和运动时机障碍的音乐-运动干预方法有临床治疗效果;通过改善口吃患者的节奏、呼吸、时间和情感4个关键要素可以达到干预目的,其中,节奏是核心、情绪是动力、"声乐化"干预是音乐-运动干预方法在口吃治疗中的独特优势;研究开发的音乐-运动干预方法为言语治疗师提供了参考和借鉴,具有一定推广价值.

目的:探讨情绪稳定剂(MSs)和苯二氮艹卓类药(BZs)对无抽搐电休克治疗(MECT)诱导癫痫发作阈值、刺激电量和癫痫发作持续时间的影响.方法:347例接受MECT治疗的精神障碍患者根据用药情况分为MSs组(79例)、BZs组(87例)、合用组(118例)和对照组(63例),采用MECT从低剂量开始滴定刺激电量.记录阈值电量、每次治疗电量和癫痫发作持续时间,并进行组间比较.结果:各组MECT阈值电量、平均刺激电量及诱导的癫痫发作持续时间比较差异有统计学意义(P均<0.01);各组阈值电量依次为合用组>MSs组>BZs组>对照组;平均刺激电量依次为合用组>MSs组>BZs组>对照组;诱导癫痫发作持续时间依次为对照组>BZs组>MSs组>合用组.结论:服用MSs或BZs的精神障碍患者进行MECT治疗时出现癫痫发作时间缩短和刺激电量增加;其中服用MSs对其的影响大于BZs;MSs和BZs合用时对此影响更大.

口吃是一种常见的言语流畅性障碍,也是一种复杂的言语障碍,可分为习得性口吃和获得性(神经源性)口吃两类.习得性口吃受心理因素影响较大,而获得性口吃常伴有脑器质性功能障碍.本文分析1例心境障碍合并习得性口吃及恋物癖患者的临床诊疗过程.

Objective:To investigate the associations of brain white matter integrity deficits, and to explore the association of fractional anisotropy (FA) abnormality with clinical symptoms and cognitive impairments, as well as the prediction effect of the FA alterations on symptoms and cognitive function outcomes in the acute stage of schizophrenia from the whole brain level based on magnetic resonance diffusion tensor imaging (DTI).Methods:From November 2019 to December 2020, thirty-eight patients with first-episode schizophrenia and 38 healthy controls were recruited in this study. Wisconsin card classification test (WCST), digit span test (DST forward/backward), verbal fluency test, Stroop (A/B/C), trail making test (TMT-A/B), as well as positive and negative syndrome scale (PANSS) were utilized to evaluate patients' cognitive function and clinical symptoms both before and after 8 weeks of risperidone monotherapy. T1-weighted images and DTI data of all the subjects were collected . FSL and SPM8 were used to preprocess MRI data and compare the between-group differences of FA. Support vector machine (SVM) analysis was used to evaluate the accuracy of abnormal FA values in differentiating schizophrenic patients from healthy controls. Finally, stepwise multiple regression analysis or generalized linear models were used to explore the associations between white matter integrity and symptoms or cognition.Results:Before treatment, patients' FA values of right medial temporal lobe (mTL), cuneus, anterior cingulate gyrus (ACG) and inferior parietal lobe (IPL) were significantly lower than those in healthy controls ( P<0.01, GRF corrected), and patients' FA values of bilateral middle cingulate gyrus (mCG) were significantly higher than those in the control group ( P<0.01, GRF corrected). SVM analysis showed that four combinations could distinguish the patients from the control with the most accurate rate of 89.47%. Patients' baseline decreased FA values in the right IPL were positively associated with their increased total response time in WCST ( β=0.489, P=0.003, FDR corrected), correct response time in WCST ( β=0.450, P=0.008, FDR corrected), error response time in WCST ( β=0.435, P=0.008, FDR corrected), TMT-B ( β=0.296, P=0.042, FDR corrected), Stroop-C ( β=0.345, P=0.035, FDR corrected), and PANSS-P ( β=0.321, P=0.042, FDR corrected). Reduced FA values in the right mTL in patient group were significantly negatively related to the total time spent on the TMT-A ( β=-0.425, P=0.009, FDR corrected) and TMT-B ( β=-0.325, P=0.026 with FDR correction). Increased FA values in right mCG in patient group demonstrated positive associations with total response time in the WCST ( β=0.585, P=0.002, FDR corrected), correct response time in WCST ( β=0.524, P=0.003, FDR corrected), error response time in WCST ( β=0.536, P=0.003, FDR corrected) and total time consuming in TMT-B ( β=0.484, P=0.004, FDR corrected), as well as negative associations with DST-forward ( β=-0.319, P=0.042, FDR corrected). After treatment, patients' percentage changes in total response time of WCST ( β=0.715, P<0.001, FDR corrected), correct response time of WCST ( β=0.752, P<0.001, FDR corrected), as well as total time-consuming of TMT-A ( β=1.333, P=0.001, FDR corrected) showed positive correlations with baseline increased FA values in the left mCG. Percentage alteration of Stroop-B was negatively correlated with baseline FA values in the right cuneus ( β=-0.745, P=0.015, FDR corrected). Conclusions:The combination of abnormal FA values in multiple brain regions may be potential biomarkers to distinguish schizophrenic patients from healthy volunteers. There was regional dependence in the associations of the impairment of white matter integrity with the cognitive impairment, the severity of psychopathological symptoms as well as the prognosis of patients in the acute stage.

抗N-甲基-D-门冬氨酸受体脑炎(NMDAR)是一类中枢神经系统自身免疫性疾病,临床表现复杂多样,常以精神异常、认知功能受损、言语及运动障碍、意识状态改变为主要表现,易出现误诊或者诊断延迟的情况.本文结合案例探讨抗NMDAR脑炎所致精神障碍与功能性精神障碍的区别,以提高该疾病的诊治效率.

目的:探讨团体认知行为疗法对缓解广泛性焦虑障碍(GAD)患者负性情绪和改善社会功能的效果.方法:筛选2016年2月至10月在某三甲医院精神科住院的GAD的患者72例,分为干预组和对照组,各36例.对照组接受药物治疗和一般心理辅导,干预组接受药物治疗联合团体认知行为治疗,并进行8周的观察.于治疗前、后采用汉密尔顿焦虑量表(HAMA)和焦虑自评量表(SAS),评价患者焦虑症状的轻重及变化情况;采用社会功能缺陷筛选量表(SDSS)评估患者社会功能缺陷程度.结果:本研究中2组各脱落4例,共64例完成了本次研究.治疗前,2组的HAMA、SAS和SDSS评分差异无统计学意义(P>0.05).干预后,2组的SAS评分和HAMA评分均低于同组治疗前(P<0.05或P<0.01),且干预组显著低于对照组(P<0.01);干预组的SDSS评分低于同组治疗前(P<0.01),且干预组显著低于对照组(P<0.01).结论:团体认知行为治疗结合药物治疗与单纯的药物治疗相比,能更加有效地缓解GAD患者的焦虑症状并增强其社会功能.

电休克治疗(electroconvulsive therapy, ECT)对抑郁发作有效[1].但ECT的治疗机制不清,一般认为诱发癫痫波是其产生治疗作用的关键[2].刺激电量越大越容易诱发癫痫波,但同时也容易产生认知不良事件, 如何找到针对个体最合适的刺激电量成为ECT治疗的重要考量.

Objective To explore the status of cardiovascular events induced by chronic schizophrenia and the influencing factors.Methods A retrospective analysis of clinical data was carried out in 138 patients with chronic schizophrenia from January 2013 to January 2016,patients were divided into cardiovascular events group (59 cases)and no cardiovascular events group (79 cases) according to whether they had induced cardiovascular events,differences in clinical data in the two groups were analyzed,Logistic regression analysis was carried out.Results Proportion of smoking history,new type antipsychotic drugs in cardiovascular events group were higher than no cardiovascular events group significantly (P＜0.05);BMI,FPG,FINS,TC,TG,LDL-C,HDL-C in observation group were higher than no cardiovascular events group significantly (P＜0.05),apolipoprotein A was significant lower than no cardiovascular events group (P＜0.05);Logistic regression analysis showed that smoking history,BMI,FPG,TC,HDL-C,antipsychotic drugs were closely related to chronic schizophrenia-induced cardiovascular events.Conclusion Smoking history,BMI,FPG,TC,antipsychotic drugs are independent risk factors for chronic schizophrenia-induced cardiovascular events,high HDL-C isa protective factor.