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综合精神医学（英文）

综合精神医学（英文）

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General Psychiatry（原Shanghai Archives of Psychiatry《上海精神医学》）杂志是我国第一本精神病学专业的学术期刊。自1959年创刊以来，《上海精神医学》在中国精神卫生领域中一直秉着立足临床，求新求精的办刊宗旨，坚持出版学术性强、高质量、重科研、贴临床的科学期刊，服务全国精神医学学界和社会医疗行业。从2012年起变更为全英文期刊(双月刊)，成为我国内地精神专科领域唯一的全英文公开发表期刊，并进行全文中文翻译电子版发行，为国内外精神卫生工作者提供学术交流平台。
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  • 发文量：139
  • 被引量：26
  • H指数：0
  • 开始收录时间：1989,1(1)
  • CNKI综合因子：0.407
  • 维普期刊影响因子： 0.85
  • 万方期刊影响因子：0.67
  • 创刊时间：1959
  • 国内刊号/CN：31-2152/R
    国际刊号/ISSN：2096-5923
  • 发行周期：双月刊
    邮发代号：4-951
  • 主管单位：-
    主办单位：Shanghai Municipal Commission of Health and Family Planning
综合精神医学（英文）-联系信息
  • 主编：徐一峰
  • 电话：021-34773296
  • 邮箱：generalpsychiatry@smhc.org.cn
  • 地址：上海市徐汇区宛平南路600号
  • 邮编：200030
综合精神医学（英文）-获奖情况
  • • 卓越计划期刊
  • • 2016、2017、2018连续三年获得中国国际影响力优秀学术期刊称号
  • • 2013年上海市期刊编校质量优秀奖
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综合精神医学（英文） >2023年第4期

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  • 摘要：INTRODUCTION Machine learning(ML)techniques1 are becoming a major area of study in psychiatry,as ML possesses the theoretical capacity to draw conclusions based on a broad range of data once the system has been taught through a process of trial and error.Specifically,and arguably most importantly,ML can do so more quickly and accurately than clinicians.2 Several studies have demonstrated accuracy through the use of ML in various populations and geographic locations,further perpetuating the perceived need to incorporate ML into ongoing studies.
  • 摘要：INTRODUCTION The COVID-19 pandemic has posed unprecedented health and social challenges.WHO has been working to promote the integration of mental health and psychosocial support into the COVID-19 response effort.1 It is vital that targeted measures are initiated to mitigate the potential mental health consequences of the COVID-19 pandemic and psychiatric patients continue to receive a range of psychiatric services.Countries need to adapt strategies identified by WHO to strengthen mental healthcare delivery.
  • 摘要：Novel zoonosis COVID-19 first emerged in Wuhan,China,but rapidly spread to the other regions in China.The spread of this severe acute respiratory syndrome led to the quarantine of 60 million Chinese citizens.Such isolation measures have been associated with increased depression,stress and emotional disturbance.1-3 However,major traumatic events can amplify both positive and negative aspects of interpersonal relations,leading to competing narratives of both harm and enhancem ent.4 Quarantine can create family dependencies,threaten livelihoods and lead to the stigmatisation of those infected/b School closures and disruption of family care seriously disrupt regular domestic practices.
  • 摘要：Pandemic,being unprecedented,leads to several mental health problems,especially among the front-line healthcare workers(HCW).Front-line HCWs often suffer from anxiety,depression,burnout,insomnia and stress-related disorders.This is mediated to a large extent by the biopsychological vulnerabilities of the individuals;socioenvironmental factors such as the risk of exposure to infection,effective risk communication to HCWs,availability of personal protective equipment,job-related stress,perceived stigma and psychological impact of the isolation/quarantine and interpersonal distancing also play the major roles.Despite the huge magnitude of mental health problems among the frontline HCWs,their psychological health is often overlooked.Some of the potential measures to reduce the mental health problems of the front-line HCWs are effective communication,tangible support from the administration/seniors,mental health problem screening—and interventional—facilities,making quarantine/isolation less restrictive and ensuring interpersonal communication through the various digital platforms,proactively curtailing the misinformation/rumour spread by the media and strict legal measures against violence/ill treatment with the HCWs,and so on.India,along with other countries who lately got affected by the COVID-19,must learn from the experiences of the other countries and also from the previous pandemics as to how to address the mental health needs of their front-line HCWs and ensure HCWs''mental well-being,thereby improving their productivity.Current review attempts to highlight the mental health aspects of the pandemic on the front-line HCWs,discusses some of the contentious issues and provides future directions particularly concerning COVID-19 in the Indian context and other low-resource countries.
  • 摘要：Major depressive disorder(MDD)is a common,serious,debilitating condition affecting 350 million people worldwide,which remains to be unsatisfactorily treated with 53%of patients still complaining of symptoms after completing their courses with the correct dosage.Ketamine,which was approved by the Food and Drug Administration in 2019,is a potential treatment option for those recalcitrant cases.The mechanism of ketamine is not fully understood,but as type it is classified as an N-methyl-D-aspartate(NMDA)glutamate receptor antagonist,and can be given intravenously,intranasally and orally.It is used to treat treatment-resistant depression,depression associated with suicidal ideation,mood and anxiety disorders and depressions associated with either type of bipolar disorder.Although ketamine is considered relatively safe,several side effects have been reported with the major ones being psychiatric in the form of worsening mood,anxiety and agitation;psychotomimetic in the form of dissociation,perceptual disturbance and abnormal sensations;cardiovascular in the form of increased blood pressure and increased heart rate;and neurological in the form of headache and dizziness.Ketamine is still not approved worldwide for usage in patients with treatment-resistant MDD,but if it is approved sometime in the future with relatively fewer side effects,it is expected to significantly save millions of dollars spent yearly on patients with treatment-resistant depression and that will lift this major burden off the shoulders of healthcare professionals.This study was designed to measure the effects of ketamine,an NMDA receptor antagonist,on patients with treatment-resistant MDD and to analyse the concept that makes it different and relatively safer than other major antidepressants like selective serotonin reuptake inhibitors,monoamine oxidase inhibitors and TCAs(tricyclic antidepressants).
  • 摘要：In studies on psychiatry and neurodegenerative diseases,it is common to have data that are correlated due to the hierarchical structure in data collection or to repeated measures on the subject longitudinally.However,the feedback effect created due to time-dependent covariates in these studies is often overlooked and seldom modelled.This article reviews the methodological development of feedback effects with marginal models for longitudinal data and discusses their implementation.
  • 摘要：West syndrome(WS)is the most common epileptic syndrome in infancy characterised by epileptic spasms,hypsarrhythmia and neurodevelopmental problems.Epileptic spasms remain in many ways a conundrum,and the ideal intervention,as well as how to screen patients to provide optimal care and certainly its genetic cause,remains puzzling.It is important to screen infants for early recognition and intervention to achieve the optimal outcome.We hereby discuss the approach to management of a boy aged 4½years old with WS and behavioural problems and of parental expressed emotions.
  • 摘要：Risperidone is a safe second-generation antipsychotic which is rarely associated with the emergence of a few adverse effects,such as oral lesions and stomatitis.We report the case of a 77-year-old woman affected by a neurocognitive disorder with psychotic features and treated with risperidone 2 mg/day.After 1 week,she showed a burning mouth syndrome with oral lesions and risperidone was discontinued.Antipsychotic-induced oral ulcerations may be caused by the reduction of saliva protection with minor adverse effects related to oral movement disorders or impairment of the bacterial flora of saliva.
  • 摘要：The stigma associated with the disease may be as subtle as avoidance,or dramatic as physical aggression.COVID-19 has begun to cause social disruption by growing disease-related stigma and xenophobia against some cultural,national,racial or religious groups worldwide.1 People of East Asian origin and those with facial features like them,or those with a travel history to areas affected by the outbreak,are especially being subjected to xenophobia in personal contact and online threats.COVID-19 has arisen as an unknown and newly emerged highly contagious infection that has spread rapidly across the globe and is associated with high mortality,leading to fear of encountering those infected.2 Leaders across the world have taken strict measures such as lockdowns and shutdown of various vital services that have caused chaos in people’s lives and increased concerns about the disease.3 Box 1 lists the factors leading to stigmatisation towards those infected with COVID-19.
  • 摘要：Dear Editor,During the early spring of 2020,as the COVID-19(coronavirus disease 2019)pandemic spread across the globe like a viral tsunami,many countries urgently implemented unprecedented mitigation measures to slow it down,following the example of China,where the disease first emerged at the end of 2019.As a result,more than 3 billion unprepared people worldwide had to cope with living under stringent lockdown measures for weeks or months,depending on the country.Together with the deaths of hundreds of thousands of people from this disease,a frightening emotional shock has touched populations everywhere around the planet.Millions have lost their jobs,others have had their personal lives changed drastically;the elderly,for example,have sometimes been isolated from any visits.To our knowledge,no guidelines to prevent psychological trauma have been proposed,even for the most vulnerable individuals.Nonetheless,before this crisis began,several experts had warned about the potential impact of such measures on the populations’mental health.
  • 摘要：Sir Internet-based surveys have steadily gained popularity with researchers because of their myriad advantages such as ability to reach a larger pool of potential participants within a shorter period of time(vis-à-vis face-to-face surveys),study subjects who maybe geographically dispersed or otherwise difficult to access and efficiency of data management and collation.12 This is in addition to obvious reasons such as convenience,relative inexpensiveness and user-friendly features such as comfortable pace and enhanced sense of participant control.
  • 摘要：The collaborative effort of an international research team from the Early Career Psychiatrists section of the World Psychiatry Association has brought about an easy-to-use,quick and stepwise mental health care toolkit for the identification and appropriate referral of those in need of mental health care during the pandemic.This simple guide can be applied in the general outpatient setting and is catered for all healthcare professionals,regardless of their expertise within the mental health field with minimal training.It is our hope that by incorporating this toolkit into our daily clinical care during the pandemic for high-risk patients and patients with non-specific complaints,we will be able to bridge the mental health gap present in our society.
  • 摘要：Background Erectile dysfunction(ED)has gradually become an important issue that seriously affects the quality of life of Chinese men.In addition to classic oral medications,psychotherapeutic interventions are increasingly being used in the treatment of ED.Aim This study aims to investigate the clinical efficacy of brief psychodynamic psychotherapy(BPP)plus Viagra in the treatment of non-organic ED.Methods We initiated this study via a controlled,prospective experimental design with initial optimal efficiency standard greater than 10%.On the standard,63 patients were enrolled who were assigned to control or treatment group.The control group(including 33 cases)received Viagra treatment for 2 months,and the treatment group(including 30 cases)was cured with BPP plus Viagra.After the treatments,the clinical efficacy was assessed using the International Erectile Function Index(IIEF-5)score,the Self-rating Anxiety Scale(SAS),Sexual Satisfaction(SS)score and Erection Hardness Score(EHS).Results In the comparison of efficacy,pretreatment and post-treatment within each group,the two groups showed improvements in IIEF,SAS scores,SS,and EHS(treatment group:PIIEF<0.001,PSAS<0.001,PSS<0.001,PEHS<0.001;control group:PIIEF<0.001,PSAS<0.001,PSS<0.001,PEHS<0.001).Furthermore,the treatment group presented better performances in IIEF(p=0.040),SAS(p=0.006),SS scores(p=0.045)and EHS(p=0.041)than the control group.Conclusion The combination of BPP with Viagra has positive effect on the treatment of non-organic ED.http://creativecommons.org/licenses/by-nc/4.0/Background Erectile dysfunction(ED)has gradually become an important issue that seriously affects the quality of life of Chinese men.In addition to classic oral medications,psychotherapeutic interventions are increasingly being used in the treatment of ED.Aim This study aims to investigate the clinical efficacy of brief psychodynamic psychotherapy(BPP)plus Viagra in the treatment of non-organic ED.Methods We initiated this study via a controlled,prospective experimental design with initial optimal efficiency standard greater than 10%.On the standard,63 patients were enrolled who were assigned to control or treatment group.The control group(including 33 cases)received Viagra treatment for 2 months,and the treatment group(including 30 cases)was cured with BPP plus Viagra.After the treatments,the clinical efficacy was assessed using the International Erectile Function Index(IIEF-5)score,the Self-rating Anxiety Scale(SAS),Sexual Satisfaction(SS)score and Erection Hardness Score(EHS).Results In the comparison of efficacy,pretreatment and post-treatment within each group,the two groups showed improvements in IIEF,SAS scores,SS,and EHS(treatment group:PIIEF<0.001,PSAS<0.001,PSS<0.001,PEHS<0.001;control group:PIIEF<0.001,PSAS<0.001,PSS<0.001,PEHS<0.001).Furthermore,the treatment group presented better performances in IIEF(p=0.040),SAS(p=0.006),SS scores(p=0.045)and EHS(p=0.041)than the control group.Conclusion The combination of BPP with Viagra has positive effect on the treatment of non-organic ED.
  • 摘要：Background With the rapid increase in ageing population,China is confronted with the daunting challenge of a growing number of patients with neurocognitive disorders(NCDs).This trend makes the maintenance of self-health and early intervention essential,highlighting the need for a tool that assesses self-efficacy of older adults in maintaining brain health or cognitive function.Aim This study aimed to design the Brain Health Self-Efficacy Scale(BHSES)to measure elderly individuals''attitudes to NCDs,motivations and future plans for controlling risks.The psychometric properties of BHSES have been validated.Methods Based on the current literature and relevant models,a 19-item scale was created during the first stage.A total of 660 older adults in the Yinhang community of Shanghai were included.The statistical approaches of item analysis,exploratory factor analysis(EFA),confirmatory factor analysis(CFA),criterion-related validity and reliability test were used to evaluate the quality of BHSES.In addition,the Geriatric Depression Scale(GDS)and the Self-Rating Anxiety Scale(SAS)were used as criteria to test the criterion-related validity.Results To test item differentiation,the study adopted item analysis and excluded item 8.Selecting a random half of the sample for EFA,the BHSES was refined to 16 items,which were categorised into the following three dimensions:''memory belief efficacy'',''self-care efficacy''and''future planning efficacy''.These were highly consistent with the hypothesis model.Its cumulative variance contribution rate reached 61.14%,with factor loads of all items above 0.5.The three-factor model was confirmed by the remaining data through CFA.All fit indices reached the acceptable level(x2=3.045,Goodness of Fit Index=0.898,adjusted Goodness of Fit Index=0.863,Comparative Fit Index=0.916,Incremental Fit Index=0.917,Tucker-Lewis Index=0.900,root mean square error of approximation=0.079 and root mean residual=0.068).The GDS and SAS scores revealed significant correlations with the BHSES score,indicating a high criterion-related validity.The overall Cronbach''sαcoefficient was 0.793,with theαcoefficients''distribution of subdimensions ranging from 0.748 to 0.883.Conclusions The 16-item,self-compiled BHSES is a reliable and valid measurement.It could help identify older adults with potential risks for developing NCDs or with high suspicion of cognitive impairment onset in recent periods and also offer insight into tracking brain health self-efficacy in association with cognition status.
  • 摘要：Collaborative risk assessment and management have been recommended in health policy for over a decade.We consider the nature and need for collaborative risk assessment and management between patients and clinicians in secure and forensic mental health settings in the context of shared decision making and personalised care in the UK.We examine the extent to which policy and recent initiatives have influenced the embedding of such practice in services through consideration of the evidence provided by research and the Commissioning for Quality and Innovation framework,and conclude that there is a need for further improvement.
  • 摘要：As of 12 March 2020,the WHO upgraded the status of COVID-19 from epidemic to pandemic.1 Globally,as of 20 July 2020,14707451 confirmed cases of COVID-19,including 609985 deaths,have been reported by an interactive web-based dashboard released by Johns Hopkins University.2 Strict provisions and strategies have been implemented to suppress or mitigate the spread of the COVID-19 pandemic,such as government-imposed contact tracing and quarantine,lockdown,social and physical distance measures,and closure of non-essential facilities and services.The global spread of the COVID-19 pandemic and rapid escalation response undoubtedly put enormous stress on patients with confirmed or suspected COVID-19,medical personnel and even the public,increasing the risk of mental health problems.
  • 摘要：Background The Hospital Anxiety and Depression Scale(HADS)is a widely used instrument to measure anxiety and depression symptoms.Aims This study aimed to translate,validate and test the applicability of the Urdu version of the Hospital Anxiety and Depression Scale(HADS/UV)among pregnant women.Methods The original English version of the HADS was translated into Urdu by three bilingual experts and retranslated to English using the forward-backward approach.The questionnaire was administered to a sample of 200 pregnant women availing obstetrics and gynaecology services for routine prenatal checkups of Ayub Teaching Hospital,Abbottabad,Pakistan.Psychometric properties of the instrument,including reliability(internal consistency,test-retest analysis and interitems correlation),were tested.Face and content validity were also assessed.Content Validity Index(CVI)was determined using the average approach and ItemLevel Content Validity Index(I-CVI)and Scale-Level Content Validity Index(S-CVI)were calculated accordingly.Construct validity was examined through exploratory factor analysis.Results Cronbach''s alpha coefficient has been found to be 0.82 for the anxiety subscale and 0.64 for the depression subscale,while overall alpha of the HADS/UV is 0.84.The Urdu version is content valid,and the SCVI of anxiety subscale,depression subscale and HADS/UV are 0.947,948 and 0.947,respectively.Test-retest reliability is 0.884 and 0.934 as measured by Pearson correlation and intraclass correlation,respectively.HADS/UV items correlated positively with the whole scale(p<0.001).Factor analysis with varimax rotation revealed that two factors explained 42.75%of the variance.Items''distribution was quite similar to the original HADS.Conclusion The HADS/UV is a psychometrically sound instrument with satisfactory measurement,including good internal consistency.The instrument shows promise to be a sound tool to assess anxiety and depression in pregnancy.
  • 摘要：Background People living with HIV/AIDS(PLWHA)must contend with a significant burden of disease.However,current studies of this demographic have yielded wide variations in the incidence of suicidality(defined as suicidal ideation,suicide attempt and suicide deaths).Aims This systematic review and meta-analysis aimed to assess the lifetime incidence and prevalence of suicidality in PLWHA.Methods Publications were identified from PubMed(MEDLINE),SCOPUS,OVID(MEDLINE),Joanna Briggs Institute EBP and Cochrane Library databases(from inception to before 1 February 2020).The search strategy included a combination of Medical Subject Headings associated with suicide and HIV.Researchers independently screened records,extracted outcome measures and assessed study quality.Data were pooled using a random-effects model.Subgroup and meta-regression analyses were conducted to explore the associated risk factors and to identify the sources of heterogeneity.Main outcomes were lifetime incidence of suicide completion and lifetime incidence and prevalence of suicidal ideation and suicide attempt.Results A total of 185199 PLWHA were identified from 40 studies(12 cohorts,27 cross-sectional and 1 nested case-control).The overall incidence of suicide completion in PLWHA was 10.2/1000 persons(95%CI:4.5 to 23.1),translating to 100-fold higher suicide deaths than the global general population rate of 0.11/1000 persons.The lifetime prevalence of suicide attempts was 158.3/1000 persons(95%CI:106.9 to 228.2)and of suicidal ideation was 228.3/1000 persons(95%CI:150.8 to 330.1).Meta-regression revealed that for every 10-percentage point increase in the proportion of people living with HIV with advanced disease(AIDS),the risk of suicide completion increased by 34 per 1000 persons.The quality of evidence by Grading of Recommendations,Assessment,Development and Evaluations for the suicide deaths was graded as‘moderate’quality.Conclusions The risk of suicide death is 100-fold higher in people living with HIV than in the general population.Lifetime incidence of suicidal ideation and attempts are substantially high.Suicide risk assessments should be a priority in PLWHA,especially for those with more advanced disease.
  • 摘要：Background Aripiprazole(ARI)is often prescribed alone or in combination with other second-generation antipsychotics(SGAs)to treat patients with schizophrenia.However,this may increase the potential clinical significance of drug-drug interactions.Therapeutic drug monitoring(TDM)is an important and fundamental tool both when administering ARI alone and in combination with other SGAs to monitor ARI pharmacokinetics,adjust the dosage and thereby achieve more effective and safer treatment.Aims This study retrospectively investigated the effects of four SGA comedications(clozapine,risperidone,quetiapine(QTP)and olanzapine)and other potential factors(sex,age and ARI dose)on the serum concentrations of ARI and dehydroaripiprazole(DARI)in Chinese patients with schizophrenia using TDM data.Methods High-performance liquid chromatography was used to test the serum concentrations of ARI,DARI and ARI+DARI.In addition,steady-state dose-adjusted serum concentrations(ie,concentration-to dose ratios,C:D ratios)of ARI,DARI and ARI+DARI;sex;age;ARI dose and SGA comedication dose between 299 inpatients with schizophrenia who received ARI or SGA comedication were all collected and analysed.Spearman’s correlation and multiple linear regression analysis were used to evaluate bivariate associations between ARI dose and serum ARI and DARI concentrations and describe the effect of independent variables on serum ARI and DARI concentrations,respectively.Results There were significant differences in the C:D ratios of ARI(χ^(2)=−3.21,p=0.001)and ARI+DARI(χ^(2)=−2.50,p=0.01)between the ARI and SGA groups,as well as in the C:D ratios of ARI(χ^(2)=−3.59,p<0.001)and ARI+DARI(χ^(2)=−3.10,p=0.002)between the female patients in the two groups.Of the four SGAs,only QTP had significant effects on the C:D ratios of ARI(Z=−4.12,p<0.001)and ARI+DARI(Z=−3.62,p<0.001)when compared with the ARI group in the whole sample and on the C:D ratios of ARI,DARI and ARI+DARI(Z=−3.96,p<0.001;Z=−2.22,p=0.03;Z=−3.75,p<0.001,respectively)in women when compared with their counterparts in the ARI group.Conclusion Comedication with SGAs resulted in lower C:D ratios of ARI and ARI+DARI compared with ARI monotherapy,and comedication with QTP resulted in lower C:D ratios of ARI and ARI+DARI than ARI monotherapy.Despite this statistical significance of our findings,whether the presently observed effect has clinical significance requires exploration by further research.TDM and dosage regulation of ARI should be performed in Chinese inpatients with schizophrenia who are receiving SGA comedication(especially QTP)to maintain a safe and effective dose-adjusted serum concentration of ARI and DARI.
  • 摘要：Background Experiencing a pandemic can be very unsettling and may have a negative impact on the mental health of frontline healthcare workers(HCWs).This may have serious consequences for the overall well-being of HCWs,which in turn may adversely affect patient safety and the productivity of the institution.Aims We designed a study to assess the prevalence of generalised anxiety disorder(GAD),depression and work-related stress experienced by the National Health Service staff in a large tertiary London hospital treating patients with COVID-19 during the current active phase of the COVID-19 era.Methods An anonymous survey was designed with demographic data and three questionnaires.The Generalised Anxiety Disorder-7(GAD-7)and Patient Health Questionnaire-9 were used to assess anxiety and depression,respectively.The Health and Safety Executive Management Standards Indicator Tool was used to assess work-related stress.Staff from multiple specialties embracing cardiothoracic surgery,cardiology,respiratory medicine,endocrinology,oncology,imaging,anaesthesia and intensive care at our hospital were asked to complete the questionnaire between 25 May and 15 June 2020.Results A total of 302 staff members(106 males and 196 females)completed the survey.The overall prevalence of GAD and depression was 41.4%and 42.7%,respectively.The prevalence of GAD and depression was significantly higher in females than in males and was statistically significant.Nurses were four times more likely to report moderate to severe levels of anxiety and depression as compared with doctors.Work-related stress was also observed to be prevalent in our surveyed population with the following standards:relationships,role,control and change showing a need for improvement.Conclusions Our study presents early evidence suggestive of a high prevalence of GAD,depression and work-related stress in HCWs.It is imperative that coherent strategies are implemented to improve the healthcare work environment during this pandemic and mitigate further injury to the mental health status of the healthcare population.
  • 摘要：Background There is an urgent need in clinical practice to measure the stress of parenting.The Caregiver Strain Questionnaire(CGSQ)was found to be useful to measure parenting stress,but it has not been validated among the Chinese population.Aims To assess the reliability and construct validity of the Chinese version of CGSQ among Chinese parents.Methods From 2016 to 2017,266 parents(patient group)with a child having DSM-5-defined attention deficit hyperactivity disorder(ADHD)(n=107)or autism spectrum disorder(ASD)(n=159)and 268 parents of healthy children(control group)were recruited to the present study in Kunming,Yunnan province.All the parents were asked to fill out the Chinese version of CGSQ.We conducted exploratory factor analysis and confirmatory factor analysis(CFA)to verify construct validity of CGSQ in both patient and control groups.Cronbach’s α coefficient as an index of internal consistency was assessed for each subscale.Fourteen days later,23 subjects filled out the scale again.Intra-class correlation coefficient was calculated to evaluate the test-retest reliability.Results(1)Cronbach’s alpha of the global scale was 0.901 for the control group and 0.952 for the patient group.The test-retest reliability for the whole scale was 0.890;(2)CFA indicated that the three-factor model had better fitting indices compared with the two-factor model in both groups.Besides,the fitting indices in the patient group were more favourable than those of the control group,withχ2/df=1.564,Goodness-of Fit Index=0.841,Comparative Fit Index=0.954,and root mean square error of approximation=0.065 for the patient group at three-factor model;(3)The caregiver strain of ASD parents was statistically higher than that of ADHD parents,and caregiver strain of ADHD parents was higher than that of control group.Conclusion These findings provide initial evidence to support the construct validity and reliability of CGSQ as a parenting stress measurement tool for Chinese parents,especially for parents of children with ADHD or ASD.
  • 摘要：Background Inflammation that is mediated by microglia activation plays an important role in the pathogenesis of depression.Microglia activation can lead to an increase in the levels of proinflammatory cytokines,including TNF-α,which leads to neuronal apoptosis in the specific neural circuits of some brain regions,abnormal cognition and treatment-resistant depression(TRD).Protein kinase C(PKC)is a key regulator of the microglia activation process.We assume that the abnormality in PKC might result in abnormal microglia activation,neuronal apoptosis,significant changes in emotional and cognitive neural circuits,and TRD.In the current study,we plan to target at the PKC signal pathway to improve the TRD treatment outcome.Methods and analysis This is a 12-week,ongoing,randomised,placebo-controlled trial.Patients with TRD(N=180)were recruited from Shanghai Mental Health Center,Shanghai Jiao Tong University.Healthy control volunteers(N=60)were recruited by advertisement.Patients with TRD were randomly assigned to‘escitalopram+golimumab(TNF-αinhibitor)’,‘escitalopram+calcium tablet+vitamin D(PKC activator)’or‘escitalopram+placebo’groups.We define the primary outcome as changes in the 17-item Hamilton Depression Rating Scale(HAMD-17).The secondary outcome is defined as changes in anti-inflammatory effects,cognitive function and quality of life.Discussion This study might be the first randomised,placebo-controlled trial to target at the PKC signal pathway in patients with TRD.Our study might help to propose individualised treatment strategies for depression.Trial registration number The trial protocol is registered with ClinicalTrials.gov under protocol ID 81930033 and ClinicalTrials.gov ID NCT04156425.
  • 摘要：Dandy-Walker syndrome(DWS)is a group of brain malformations which sometimes present with psychotic symptoms.We present the case of a patient diagnosed with Dandy-Walker variant who presented with schizophrenia-like psychosis.A man in his 30s was admitted to an acute psychiatric unit presenting with persecutory delusions,auditory hallucinations and violent behaviour.The MRI performed showed the typical alterations of Dandy-Walker variant:vermian hypoplasia and cystic dilatation of the fourth ventricle.He also suffered from mild intellectual disability.After being treated with olanzapine 10 mg/d for a month,his psychotic symptoms greatly improved and he was discharged.In conclusion,DWS may cause psychosis through a dysfunction in the circuit connecting prefrontal,thalamic and cerebellar areas.The association between these two conditions may contribute to the understanding of the aetiopathogenesis of schizophrenia.
  • 摘要：Maladaptive daydreaming(MD)is an immersive fantasy activity that leads to distress and socio-occupational dysfunction.MD has many features suggestive of behavioural addiction,but research exploring the phenomenology of this clinical construct is limited.MD has also been purported to be a maladaptive strategy to cope with distress,but often leads to uncontrollable absorption in fantasy world,social withdrawal and neglected aspects of everyday life.In this paper,we report the case of a 16-year old boy who developed internet gaming disorder and MD after experiencing cyberbullying from his peers.The patient engaged in vivid,fanciful imagery that lasted for hours,leading to social dysfunction and academic deterioration.Baseline assessment revealed a Maladaptive Daydreaming Scale-16 score of 65(cut-off 50)and an Internet Gaming Test-20 score of 86(cut-off 71).The patient was managed primarily with psychological intervention.The therapy focused on behaviour modification and cognitive restructuring.Patients in clinical setting should be questioned about MD when presenting with excessive use of technology or other forms of behavioural addictions.Further studies are necessary to determine the biopsychosocial factors of MD and its correlates.There is also a need to study treatment and management approaches for treating MD.
  • 摘要：Diagnostic tests are usually based on some quantitative biomarkers.Two key parameters used to characterise the quality of a test are test sensitivity and specificity.Predictive values of the disease status based on test results are also of interest in medical research and public health management.In this paper,we study the relations among sensitivity,specificity and predictive values of the test.The core concept is risk function,which is assumed to be an increasing function of the biomarker.Our results show that test sensitivity and specificity change in opposite directions.The positive predictive value and the sensitivity also change in opposite directions.Likewise,the negative predictive value and the specificity change in opposite directions.
  • 摘要：Background Working memory(WM)deficit is considered a core feature and cognitive biomarker in patients with schizophrenia.Several studies have reported prominent object WM deficits in patients with schizophrenia,suggesting that visual WM in these patients extends to non-spatial domains.However,whether non-spatial WM is similarly affected remains unclear.Aim This study primarily aimed to identify the processing of visual object WM in patients with first-episode schizophrenia.Methods The study included 36 patients with first-episode schizophrenia and 35 healthy controls.Visual object WM capacity,including face and house WM capacity,was assessed by means of delayed matching-to sample visual WM tasks,in which participants must distribute memory so that they can discriminate a target sample.We specifically examined their anhedonia experience by the Temporal Experience of Pleasure Scale and the Snaith-Hamilton Pleasure Scale.Cognitive performance was measured by the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).Results Both face and house WM capacity was significantly impaired in patients with schizophrenia.For both tasks,the performance of all the subjects was worse under the high-load condition than under the low-load condition.We found that WM capacity was highly positively correlated with the performance on RBANS total scores(r=−0.528,p=0.005),RBANS delayed memory scores(r=−0.470,p=0.013),RBANS attention scores(r=−0.584,p=0.001),RBANS language scores(r=−0.448,p=0.019),Trail-Making Test:Part A raw scores(r=0.465,p=0.015)and simple IQ total scores(r=−0.538,p=0.005),and correlated with scores of the vocabulary test(r=−0.490,p=0.011)and scores of the Block Diagram Test(r=−0.426,p=0.027)in schizophrenia.No significant correlations were observed between WM capacity and Positive and Negative Syndrome Scale symptoms.Conclusions Our research found that visual object WM capacity is dramatically impaired in patients with schizophrenia and is strongly correlated with other measures of cognition,suggesting a mechanism that is critical in explaining a portion of the broad cognitive deficits observed in schizophrenia.
  • 摘要：Background Patients with major depressive disorder(MDD)may have an abnormal peripheral body temperature rhythm,but its relationship with suicidal risk and the response to treatment with antidepressants remain unknown.Aims This study aimed to investigate the feature of peripheral body temperature in patients with MDD and its relationship with suicide risk before and after treatment with antidepressants.Methods This is a prospective case-control study.Patients diagnosed as MDD were enrolled into MDD group.Healthy subjects who matched in terms of gender,age and body mass index were enrolled into normal control(NC)group.The 24-hour peripheral body temperatures were monitored by TM’Holter the next day after assessment.Patients with MDD were re-assessed after a 2-week treatment with antidepressants.All temperature data were fitted into cosine curves by Python.Result There were 41 patients with MDD,and 21 NC participants enrolled and completed the baseline assessments before the treatment.Patients with MDD were further divided into subgroup of with suicide risk or without suicide risk.In patients with MDD,the mesor of peripheral body temperature rhythm was higher in both patients with(36.17(0.30))and without suicide risk(36.22(0.27))than the mesor in NC participants before treatment(35.84(0.38),Z=11.82,p=0.003,Kruskal-Wallis test).The phase-delay of temperature before treatment was greater in patients with MDD with suicidal risk(4.71(1.68))in comparison with those without suicidal risk(3.05(2.19))and NC participants(3.19(1.82),Z=9.68,p=0.008,Kruskal-Wallis test).Moreover,phase-delay of temperature was associated with suicide risk in patients with MDD before treatment(OR=1.046,95%CI:1.009 to 1.085,p=0.015,unadjusted;OR=1.080,95%CI:1.020 to 1.144,p=0.009,adjusted by age and sex).Conclusion Patients with MDD might have abnormal peripheral body temperature.The abnormal phase-delay of peripheral body temperature may indicate suicide risk in patients with MDD,depending on validation in large-scale cohorts.
  • 摘要：Background Cognitive behavioural therapy(CBT)is considered to be an effective treatment for schizophrenia.In recent years,researchers have published clinical research results on CBT for schizophrenia.However,there is currently a lack of bibliometric analysis on CBT for schizophrenia.Aims To understand the current situation and research trends of CBT for schizophrenia,and to provide valuable information for researchers in this field.Methods Literature was retrieved from the Web of Science Core Collection database.CiteSpace was used to visually analyse the current status of research on CBT for schizophrenia,as well as trends and points of general interest on this topic.Results A total of 1151 papers were retrieved.The annual number of publications has increased 417.65%from 2000 to 2019.Schizophrenia Research was the most active journal.McGorry enjoys considerable influence.The University of London is deemed to be the most active research institution.England and the USA retain the highest scientific productivity in this field.China and Norway might make more contributions to this field in the future.The most important research topics are randomised controlled trials of CBT for schizophrenia,meta-analysis,scale selection and research on the improvement of quality of life.Results from the following keywords‘psychoeducation’,‘insomnia’,‘individual’,‘mental illness’,‘major depressive disorder’,‘efficacy’,‘internalised stigma’and‘remediation’indicated new research frontiers in this field.Conclusions The field of CBT for schizophrenia is progressing and has great potential.The level and quality of research in this field is high.The proposal of research hotspots and frontiers serves as a direction for researchers in this field.Researchers around the world should strengthen their cooperation and communication to promote further development of this field.
  • 摘要：Background Several studies have shown that afternoon napping promotes cognitive function in the elderly;on the other hand,some studies have shown opposite results.This current study further examined the relationship between afternoon napping and cognitive function in the ageing Chinese population.Methods A total of 2214 elderly were included(napping group:n=1534;non-napping group:n=680).They all received cognitive evaluations by the Beijing version of the Montreal Cognitive Assessment,the Mini-Mental State Examination,and the Chinese version of the Neuropsychological Test Battery.Among all the subjects,739 elderly volunteered to take blood lipid tests.Results Significant differences in cognitive function and blood lipids were observed between the napping and the non-napping groups.Afternoon napping was associated with better cognitive function including orientation,language,and memory in the present study.Subjects with the habit of afternoon napping also showed a higher level of triglyceride than the non-napping subjects.Conclusion The results demonstrated that afternoon napping was related to better cognitive function in the Chinese ageing population.
  • 摘要：Background Suicide is a global public health problem and Nigeria is one of the epicentres of suicide in the world.However,there is a dearth of research exploring the epidemiological aspects of suicide in Nigeria.Aim To examine the demographic information and precipitating events for suicides in Nigeria by analysing the contents of newspaper reports of suicide.Methods We searched,collected,and analysed published news reports about suicide from 10 English newspapers in Nigeria.A total of 350 suicide reports were assessed between January 2010 and December 2019 after screening and sorting.Results The mean(SD)age of the reported cases was 36.33(15.48)years.Majority of the reported cases were male(80.6%),married(51.8%),students(33.6%),living in a semi-urban area(40.3%)and among the age group of 25-34(25.3%).Hanging(48.6%)and poisoning(32.2%)were the most commonly reported methods of suicide.Financial constraints and marital conflicts were most commonly assumed precipitating factors.Conclusion This study suggests that being male,married,or living in semi-urban areas are associated with suicide in Nigeria.Further community-based studies are warranted to generalise the findings and adopt appropriate preventive strategies.

    综合精神医学（英文）的期刊信息

    • 曾用名：上海精神医学
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      Medicine:Psychiatry and Mental Health;Neuroscience:Neurology;

    综合精神医学（英文）的获奖情况

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    综合精神医学（英文）的收录情况

    • • 北大核心期刊（2000版）
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