16 Psychiatric Disorder

16 Psychiatric Disorder

2015253 Magnetic resonance spectroscopy in lenticular nucleus of BipolarⅡ disorder and its relation with cognitive function.ZHANG Haiyan（張海燕），et al.Dept General Intern Med，3rd Affil Hosp，Sun Yetsen Univ，Guangzhou 510630.Natl Med J China 2015；95（9）：672-675.

Objective To explore the magnetic resonance spec-troscopy characteristics of lenticular nucleus in Bipolar Ⅱ disorder and its relation with cognitive function. Methods Thirty BipolarⅡ disorder patients in hospital from 2012 September to 2013 April and twenty healthy controls were evaluated with Multi-Voxel1H-MRS scans on lenticular nucleus to assess the NAA，Cho，Cr and MI.All subjects were assessed for attention using the Stroop Test and executive function by Wisconsin card sorting test.Results NAA，Cho，Cr in right lenticular nucleus and Cr in left lenticular nucleus were lower than healthy controls（P＜0.05）.The patients showed significant cognitive impairment in all aspects of Stroop Test and Wisconsin card sorting test（P＜0.05）.NAA in right lenticular nucleus was positively correlated with correct number of Stroop-CW.Conclusion Neural dysfunction in right lenticular nucleus of BipolarⅡdisorder may influence attention function.Cellular energy metabolism rate was reduced in bilateral lenticular nucleus.

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2015254 The degree of the brain structural white matter networks in the first-episode and recurrent depressed patients.CHEN Jianhuai（陳建淮），et al. Dept Depression，Nanjing Brain Hosp，Nanjing Med Univ，Nanjing 210029.Chin J Psychiat 2015；48（2）：70-75.

Objective To explore the differences of the degree indicating the density of the connectivity of nodes between the brain structural white matter networks in the first-episode（FD），recurrent（RD）depressed patients and the healthy control（HC）subjects.Methods The diffusion tensor imaging data were obtained from 29 FD patients，20 RD patients and 57 HC subjects.The whole cerebral cortex was divided into 90 regions by the anatomical label map.Fiber tracking was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using the fiber assignment by continuous tracking algorithm.And then the brain structural networks were constructed using the complex network theory.The nodal degree of the brain networks of FD and RD were compared with that of HC，and then the correlations between the degree of the significant nodes and the clinical features of patients were explored.Results The degree of the nodes in the networks of FD descended significantly in the left putamen（11.83±2.28）when compared with HC（13.95±2.33；t=-4.02；P=0.000 13，survived correction）.That of RD descended significantly（the right dorsolateral superior frontal gyrus（7.80±1.43）；the left putamen（11.75±2.07）when compared with HC（9.70±2.89，13.95±2.33，t= -3.81，-3.73；P=0.000 31，0.000 37，survived correction）.That of RD descended significantly in the right dorsolateral superior frontal gyrus（7.80±1.43）when compared with FD（9.62±1.78；t=-3.80；P= 0.000 42，survived correction）.The distribution of the hub regions in the patient and healthy were similar and the left putamen was the same hub region for both groups.Significant negative correlations were found between the degree of the right dorsolateral superior frontal gyrus and the number of episodes（r=-0.42，P= 0.002 6）and the course of the disease（r=-0.41，P=0.003 7）in the patient.Conclusion The degree of the connectivity between the frontal region and putamen are possibly decreased in the depressed patient.The left putamen is in the importance role in the brain network and the damage of its connected fibers may be the common structural changes in both FD and RD.The damage of the fibers connected to the frontal region is related with the recurrent course of the depressed patients.

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2015255 Clinical significance of endocannabinoid mRNA expression in the blood of patients with depression.TANG Di（唐棣），et al.Dept Psychiat，1st Affil Hosp，Kunming Med Univ，Kunming 650032.Chin J Psychiat 2015；48（2）：81-85.

Objective To study the expression of endocannabinoid mRNA in the blood of untreated patients with firstepisode major depressive disorder and to explore the relationship between the endocannabinoid system and major depressive disorder.Methods Thirty-nine untreated firstepisode major depressive disorder patients diagnosed with DSM-Ⅳand 35 healthy volunteers were included and assessed with the Wisconsin Card Sorting Test and the Stroop Color Word Test.Their blood was collected in the fasting state and analyzed to test the possible differences of mRNA expression of cannabinoid receptor 1（CB1）and fatty acid amide hydrolase（FAAH） between depres-sive subjects and healthy controls.The patients'severity of symptoms was assessed with HAMD17.Results（1）Compared with controls（0.24±0.26），there were significantly lower levels of CB1 receptor mRNA in the blood of patients with major depressive disorder（0.13± 0.22；Z=-1.965，P＜0.05）；the levels of CB1 receptor mRNA exhibited a significant correlation with weight factor score of the HAMD17（r=0.484，P= 0.001）.（2）There was no difference between the expression of FAAH mRNA（0.16±0.24）and controls （0.17±0.24；Z=-1.413，P＞0.05）；Levels of FAAH mRNA exhibited a significant correlation with patients'cognition factor of HAMD17（r=0.345，P= 0.045）.Conclusion The lower endocannabinoid mRNA expression in the blood of patients with depression may be involved in the pathogenesis of major depression.

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2015256 The prevalence of hypertension comorbid of depression and anxiety disorder in Beijing and Jilin：an analysis of risk factors.LIU Cui（劉粹），et al.Peking Univ Mental Health Instit，Key Lab，Health Ministry，Beijing 100191.Chin J Psychiat 2015；48（2）：86-91.

Objective To investigate the prevalence of hypertension comorbid of depression and anxiety disorder，and to explore the related psycho-social factors.Methods A total of 1 806 patients with hypertension were selected from urban and rural areas in Beijing and Jilin Province in 2011.The Chinese version of the Composite International Diagnostic Interview Version 3.0（CIDI-3.0）was used to diagnose depression and anxiety disorder.Four additional questionnaires obtained demographic data，and data on coping style，social support，quality of life and degree of life satisfaction.Logistic regression analysis was used to explore the related factors of hypertension comorbid of depression and anxiety.Results（1）The prevalence rate of depression and anxiety disorder among patients with hypertension in Beijing and Jilin was 6.5%（117/1 806）and 24.2%（437/1 806），respectively.（2）The prevalence of depression among patients with hypertension was significantly higher in female patients and patients without a spouse［7.6%（88/1 162）vs.9.0%（29/324）］than male patients and that with a spouse［4.5%（29/ 644）vs.5.9% （88/1 482）；χ2=6.446，3.983，both P＜0.05］.The prevalence of anxiety among patients with hypertension was significantly higher in patients of female gender，being 60 years of age or younger，living in rural areas，manual labor，having 9 or fewer years of education than in patients of male gender［26.6%（309/ 1 162）vs.19.9%（128/644）］，being 60 years older ［28.7%（255/890）vs.19.9%（182/916）］，living in urban areas［26.9%（242/900）vs.21.5%（195/ 906）］，mental work［25.9%（289/1 114）vs.20.0% （83/416）］and having 9 more years of education ［25.7%（333/1 296）vs.20.4%（104/510）；χ2= 10.190，18.983，7.087，5.907，5.610，all P＜0.05］.（3）Compared with non-depression group，depression group had significantly lower scores on subjective support（24.2±4.7 vs.26.1±4.4，t=-2.508），support availability（6.2±2.1 vs.7.6±2.2，t= -3.951），total social support（39.5±7.5 vs.43.1± 6.7，t=-3.110），positive coping dimension（1.6± 0.7 vs.1.9±0.7，Z=-2.356），Q-LES-Q-SF（47.4± 7.8 vs.61.2±4.3，t=-15.615），and had significantly higher scores on amount of negative events stimulation（38.8±59.3 vs.7.8±16.8，t=5.591），total amount of life events stimulation（47.8±64.2 vs.20.2± 33.0，Z=3.775；all P＜0.05）.Compared with nonanxiety group，anxiety group had significantly lower scores on subjective support（24.0±4.9 vs.25.1±4.6，t=-2.678），total social support（40.0±7.2 vs.41.2± 7.1，t=-2.063），positive coping dimension（1.5± 0.6 vs.1.6±0.7，Z=-1.963），Q-LES-Q-SF（48.0± 5.5 vs.53.9±5.5，t=-12.340），and had significantly higher scores on amount of negative events stimulation （27.2±50.0 vs.10.6±21.5，Z=5.993），average negative coping dimension（1.2±0.6 vs.1.1±0.6，Z=3.775），total amount of life events stimulation （39.5±56.4 vs.23.9±36.0，Z=4.155；all P＜0.05）.（4）Logistic regression analysis showed female gender，negative events had significant positive correlation to concurrent depression and anxiety in patients with hypertension（OR=1.689，1.017，1.431，1.070，all P＜0.05）.High life satisfaction degree had significant negative correlation（OR=0.558，0.797，both P＜0.05）.Conclusion The prevalence of anxiety disorder is higher than that of depression in hypertensiv e patients inBeijing and Jilin.Female gender，negative events are possible risk factors for concurrent depression and anxiety in patients with hypertension，and high life satisfaction degree is possible protective factor.

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2015257 Prepulse inhibition of startle reflex in schizophrenics and healthy adults.WU Rongqin（吳榮琴），et al.Dept Psychiat，Shanghai Zhabei Mental Health Center，Shanghai 200436.Natl Med J China 2015；95（11）：823-827.

Objective To evaluate the characteristics of sensory gating inhibition and variation of schizophrenia with both prepulse inhibition（PPI）and P50.Methods The PPI of startle reflex and P50 were tested by an event-related potential（ERP）recorder in 82 first episode schizophrenics （FES）recruited from September 2007 to February 2014 at Shanghai Mental Health Hospital and 78 healthy controls（NC）from hospital staffs and local residents for the same period.All patients fulfilled the evaluation of PPI with strong stimulus alone and strong+weak stimulus paradigm，P50 with conditioning（S1）-testing（S2）paradigm.The psychotic symptoms were assessed with Positive and Negative Syndrome Scale（PANSS）.Results （1）Compared with control group，schizophrenia group had increased PL［NC：（89±14）ms，F(xiàn)ES：（97±17）ms，P＜0.05］and PPL，decreased amplitude［NC：（92±21）ms，（24±14）μV，F(xiàn)SZ：（96±20）ms，（41±29）μV，P＜0.05，0.01］，lower PPI inhibition ratio［NC：（67±32）%，F(xiàn)SZ：（41±37）%，P＜0.05］. （2）Compared with NC group，there were increased S2 amplitude［NC：（3±2）μV vs FES：（5±3）μV，P＜0.05］and ratio of S2/S1 amplitude［（43±22）%vs （82±41）%，P＜0.05］in schizophrenia group.And P50inhibitiondecreasedsignificantly.Conclusion Schizophrenics have both PPI and P50 impairments.And a combination of PPI inhibition ratio and S2/S1（P50）may be a better electrocerebrophysiological index for schizophrenia.

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2015258 A correlation study of metacognition and theory of mind in patients with schizophrenia.WU Weiming（吳偉明），et al.Dept Med Psychol，Anhui Med Univ，Hefei 230022.Chin J Psychiat 2015；48（2）：98-103.

Objective To explore the metacognitive ability of patients with schizophrenia and its relationship with theory of mind.Methods Seventy schizophrenic patients in post-acute phase of illness and 50 patients with anxiety disorder were assessed with the Abbreviated Metacognition Assessment Scale（MAS-A）in order to measure their ability of metacognition，then the two groups of patients and 55 normal people were assessed with Theory of Mind-Picture Sequencing Task（ToM-PST）.The metacognitive function of patients with schizophrenia was compared with that of patients with anxiety disorder.Correlation between metacognition ability and theory of mind in patients with schizophrenia was analyzed using Spearman correlation analysis.Results The MAS-A total score，the subscores ofself-reflectivity，understandingtheothers' mind，decentration and mastery（respectively 8.91± 3.45，3.46±1.11，2.50±1.09，0.46±0.57，2.49± 1.19）were significantly lower in patients with schizophrenia than those in the patients with anxiety disorder （respectively 12.72±3.27，4.79±1.16，3.28± 0.95，1.09±0.70，3.56±1.08；Z=-3.858--5.309，all P＜0.01）.Compared with the normal people，patients with schizophrenia and anxiety disorder had significantly lower total scores in ToM-PST（47.30± 9.19 vs.58.29±1.06；55.58±5.02 vs.58.29± 1.06；Z=-8.344，-2.084；both P＜0.05）.Correlation analysis showed a positive correlation between the total score of MAS-A and that of ToM-PST（r=0.460，P＜0.01）in patients with schizophrenia，and the correlation was persisted when the PANSS total score and illness duration were statistically controlled（r=0.418，P＜0.01）.The total score of MAS-A of patients with schizophrenia was negatively correlated with the total score of PANSS（r=-0.547，P＜0.01）and the subscores of negative symptoms（r=-0.518，P＜0.01）and positive symptoms（r=-0.348，P＜0.01）.Conclusion Patients with schizophrenia may experience metacognitive deficits which are related to the impairments of theory of mind，which suggests that they share the sameneurophysiological basis.

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2015259 Efficacy of nicergoline combined with hyperbaric oxygen treatment on vascular cognitive impairment.CHEN Guojun（陳國(guó)軍），et al.Dept Neurol，General Hosp，China Pingmei Shenma Med Group，Pingdingshan 467000.Chin J Geriatr 2015；34（4）：359-361.

Objective To investigate the efficacy of nicergoline combined with hyperbaric oxygen treatment on vascular cognitive impairment.Methods 120 patients with vascular cognitive impairment were randomly divided into 3 treatment groups：nicergoline，hyperbaric oxygen，and both treatment（n=40，each）for 8 weeks.Mini-mental state examination（MMSE），Wechsler memory scale （WMS）and activities of daily living scale（ADL）were used as assessing items.The efficacy of treatment in each group was evaluated.Results There were no significant differences in clinical data among the three groups（χ2= 0.324，t=0.265 and 0.861，P=0.764，0.784 and 0.386）.After 8 weeks of intervention，scores of MMSE，WMS and ADL were significantly improved in the combined treatment groups compared with pre-treatment（all P＜0.01），and the improvements were observed in nicergoline group（all P＜0.05），while only MMSE and ADL were improved in hyperbaric oxygen group（both P＜0.05）.There were significant differences in scores of MMSE，WMS and ADL between combination therapy group and nicergoline group，hyperbaric oxygen group after treatment（all P＜0.05）.But only MMSE had significant difference between nicergoline group and hyperbaric oxygen group after treatment.No significant side effects were observed in the three groups.Conclusion Combination treatment of nicergline and hyperbaric oxygen has better efficacy on vascular cognitive impairment.It can markedly improve the activities of daily living and cognitive function without significant side effects，which is worthy of application in clinical medicine.

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2015260 Effect of integrative cognitive training on mild cognitive impairments：a one-year follow-up study.FENG Wei（馮威），et al.Dept Psychiat，Tongji Hosp Tongji Univ，Shanghai 200065.Chin J Geriat 2015；34（4）：355-358.

Objective To evaluate the middle and short-term effects of integrative cognitive training on mild cognitive impairments（MCI）.Methods All the participants with MCI aged over 70 years were selected from one sub-district of Putuo District，Shanghai and divided into cognitive intervention group（n=46）and control group（n= 35）.The integrative cognitive training was conducted in 24 sessions for 12 weeks.All subjects were assessed by Neuropsychological Test Battery for Elderly（NTBE）and by a questionnaire of“Shanghai Health Survey for the Elderly（VER2006）”at baseline，follow-up and oneyear follow-up phases.Results At baseline phase，semantic relations test in NTBE was better（t=2.13，P= 0.037），verbal fluency test（vegetables）in NTBE was worse（t=-2.25，P=0.038）in intervention group than in control group，while there were no significant differences in scores of other neuropsychological tests between intervention group and control group（all P＞0.05）.At follow-up phase，16 subscales in reasoning test of NTBE were improved（t=-2.70，P=0.010）and 2 subscales were declined in cognitive intervention group（all P＜0.05）.9 subscales in semantic relations test of NTBE（t=-2.27，P=0.013）were improved and 5 subscales were declined in control group（all P＜0.05）.Comparison between groups at one year follow-up showed that 5 subscales in reasoning test of NTBE（F= 16.80，P=0.000）were better in intervention group than in control group（all P＜0.05）.General linear model（GLM）with repeated measures at three time points showed that 4 subscales in reasoning test of NTBE had a time-by-group interaction（F=5.16，P=0.01）. Conclusion Integrative cognitive training can improve cognitive function in patients with mild cognitive impairments，and the validity of reasoning ability can sustain one year.

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