Relationship between physical activity and specific working memory indicators of depressive symptoms in university students

BACKGROUND

The detection rate of depression among university students has been increasing in recent years, becoming one of the main psychological diseases that endangers their physical and mental health. According to statistics, self-harm and suicide, for which there is no effective intervention, are the second leading causes of death.

AIM

To explore the relationship between different elements and levels of physical activity and college students' depression-symptom-specific working memory indicators.

METHODS

Of 143 college students were analyzed using the Beck Depression Self-Rating Scale, the Physical Activity Rating Scale, and the Working Memory Task.

RESULTS

There was a significant difference between college students with depressive symptoms and healthy college students in completing verbal and spatial working memory (SWM) tasks correctly (all P < 0.01). Physical Activity Scale-3 scores were significantly and positively correlated with the correct rate of the verbal working memory task (r = 0.166) and the correct rate of the SWM task (r = 0.210) (all P < 0.05). There were significant differences in the correct rates of verbal and SWM tasks according to different exercise intensities (all P < 0.05) and different exercise durations (all P < 0.05), and no significant differences in the correct rates of verbal and SWM tasks by exercise frequency (all P > 0.05).

CONCLUSION

An increase in physical exercise among college students, particularly medium- and high-intensity exercise and exercise of 30 min or more, can improve the correct rate of completing working memory tasks.

Postpartum depression and partner support during the period of lactation: Correlation research and its influencing factors

BACKGROUND

Postpartum depression (PPD) not only affects the psychological and physiological aspects of maternal health but can also affect neonatal growth and development. Partners who are in close contact with parturient women play a key role in communication and emotional support. This study explores the PPD support relationship with partners and its influencing factors, which is believed to establish psychological well-being and improve maternal partner support.

AIM

To explore the correlation between PPD and partner support during breastfeeding and its influencing factors.

METHODS

Convenience sampling was used to select lactating women (200 women) who underwent postpartum examinations at the Huzhou Maternity and Child Health Care Hospital from July 2022 to December 2022. A cross-sectional survey was conducted on the basic information (general information questionnaire), depression level [edinburgh postnatal depression scale (EPDS)], and partner support score [dyadic coping inventory (DCI)] of the selected subjects. Pearson's correlation analysis was used to analyze the correlation between PPD and DCI in lactating women. Factors affecting PPD levels during lactation were analyzed using multiple linear regression.

RESULTS

The total average score of EPDS in 200 lactating women was (9.52 ± 1.53), and the total average score of DCI was (115.78 ± 14.90). Dividing the EPDS, the dimension scores were: emotional loss (1.91 ± 0.52), anxiety (3.84 ± 1.05), and depression (3.76 ± 0.96). Each dimension of the DCI was subdivided into: Pressure communication (26.79±6.71), mutual support (39.76 ± 9.63), negative support (24.97 ± 6.68), agent support (6.87 ± 1.92), and joint support (17.39 ± 4.19). Pearson's correlation analysis demonstrated that the total mean score and individual dimension scores of EPDS during breastfeeding were inversely correlated with the total score of partner support, stress communication, mutual support, and co-support (P < 0.05). The total mean score of the EPDS and its dimensions were positively correlated with negative support (P < 0.05). Multiple linear regression analysis showed that the main factors affecting PPD during breastfeeding were marital harmony, newborn health, stress communication, mutual support, negative support, co-support, and the total score of partner support (P < 0.05).

CONCLUSION

PPD during breastfeeding was associated with marital harmony, newborn health, stress communication, mutual support, negative support, joint support, and the total DCI score.

Performance of the walking trail making test in older adults with white matter hyperintensities

BACKGROUND

Several studies have reported that the walking trail making test (WTMT) completion time is significantly higher in patients with developmental coordination disorders and mild cognitive impairments. We hypothesized that WTMT performance would be altered in older adults with white matter hyperintensities (WMH).

AIM

To explore the performance in the WTMT in older people with WMH.

METHODS

In this single-center, observational study, 25 elderly WMH patients admitted to our hospital from June 2019 to June 2020 served as the WMH group and 20 participants matched for age, gender, and educational level who were undergoing physical examination in our hospital during the same period served as the control group. The participants completed the WTMT-A and WTMT-B to obtain their gait parameters, including WTMT-A completion time, WTMT-B completion time, speed, step length, cadence, and stance phase percent. White matter lesions were scored according to the Fazekas scale. Multiple neuropsychological assessments were carried out to assess cognitive function. The relationships between WTMT performance and cognition and motion in elderly patients with WMH were analyzed by partial Pearson correlation analysis.

RESULTS

Patients with WMH performed significantly worse on the choice reaction test (CRT) (0.51 ± 0.09 s vs 0.44 ± 0.06 s, P = 0.007), verbal fluency test (VFT, 14.2 ± 2.75 vs 16.65 ± 3.54, P = 0.012), and digit symbol substitution test (16.00 ± 2.75 vs 18.40 ± 3.27, P = 0.010) than participants in the control group. The WMH group also required significantly more time to complete the WTMT-A (93.00 ± 10.76 s vs 70.55 ± 11.28 s, P < 0.001) and WTMT-B (109.72 ± 12.26 s vs 82.85 ± 7.90 s, P < 0.001). WTMT-A completion time was positively correlated with CRT time (r = 0.460, P = 0.001), while WTMT-B completion time was negatively correlated with VFT (r = -0.391, P = 0.008). On the WTMT-A, only speed was found to statistically differ between the WMH and control groups (0.803 ± 0.096 vs 0.975 ± 0.050 m/s, P < 0.001), whereas on the WTMT-B, the WMH group exhibited a significantly lower speed (0.778 ± 0.111 vs 0.970 ± 0.053 m/s, P < 0.001) and cadence (82.600 ± 4.140 vs 85.500 ± 5.020 steps/m, P = 0.039), as well as a higher stance phase percentage (65.061 ± 1.813% vs 63.513 ± 2.465%, P = 0.019) relative to controls.

CONCLUSION

Older adults with WMH showed obviously poorer WTMT performance. WTMT could be a potential indicator for cognitive and motor deficits in patients with WMH.

Nutritional epigenetics education improves diet and attitude of parents of children with autism or attention deficit/hyperactivity disorder

BACKGROUND

Unhealthy maternal diet leads to heavy metal exposures from the consumption of ultra-processed foods that may impact gene behavior across generations, creating conditions for the neurodevelopmental disorders known as autism and attention deficit/hyperactivity disorder (ADHD). Children with these disorders have difficulty metabolizing and excreting heavy metals from their bloodstream, and the severity of their symptoms correlates with the heavy metal levels measured in their blood. Psychiatrists may play a key role in helping parents reduce their ultra-processed food and dietary heavy metal intake by providing access to effective nutritional epigenetics education.

AIM

To test the efficacy of nutritional epigenetics instruction in reducing parental ultra-processed food intake.

METHODS

The study utilized a semi-randomized test and control group pretest-posttest pilot study design with participants recruited from parents having a learning-disabled child with autism or ADHD. Twenty-two parents who met the inclusion criteria were randomly selected to serve in the test (n = 11) or control (n = 11) group. The test group participated in the six-week online nutritional epigenetics tutorial, while the control group did not. The efficacy of the nutritional epigenetics instruction was determined by measuring changes in parent diet and attitude using data derived from an online diet survey administered to the participants during the pre and post intervention periods. Diet intake scores were derived for both ultra-processed and whole/organic foods. Paired sample t-tests were conducted to determine any differences in mean diet scores within each group.

RESULTS

There was a significant difference in the diet scores of the test group between the pre- and post-intervention periods. The parents in the test group significantly reduced their intake of ultra-processed foods with a pre-intervention diet score of 70 (mean = 5.385, SD = 2.534) and a post-intervention diet score of 113 (mean = 8.692, SD = 1.750) and the paired t-test analysis showing a significance of P < 0.001. The test group also significantly increased their consumption of whole and/or organic foods with a pre-intervention diet score of 100 (mean = 5.882, SD = 2.472) and post-intervention diet score of 121 (mean = 7.118, SD = 2.390) and the paired t-test analysis showing a significance of P < 0.05.

CONCLUSION

Here we show nutritional epigenetics education can be used to reduce ultra-processed food intake and improve attitude among parents having learning-disabled children with autism or ADHD.

Assessing myocardial indices and inflammatory factors to determine anxiety and depression severity in patients with chronic heart failure

BACKGROUND

Patients with chronic heart failure (CHF) have a progressive disease that is associated with poor quality of life and high mortality. Many patients experience anxiety and depression (A&D) symptoms, which can further accelerate disease progression. We hypothesized that indicators of myocardial function and inflammatory stress may reflect the severity of A&D symptoms in patients with CHF. Changes in these biomarkers could potentially predict whether A&D symptoms will deteriorate further in these individuals.

AIM

To measure changes in cardiac and inflammatory markers in patients with CHF to determine A&D severity and predict outcomes.

METHODS

We retrospectively analyzed 233 patients with CHF treated at the Jingzhou Hospital, Yangtze University between 2018-2022 and grouped them according to Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores. We compared clinical data in the no-A&D, mild-A&D, moderate-A&D, and severe-A&D groups, the SAS and SDS scores with the New York Heart Association (NYHA) functional classification, and cardiac markers and inflammatory factors between the no/mild-A&D and moderate/severe-A&D groups. Regression analysis was performed on the markers with P < 0.05 to determine their ability to predict A&D severity in patients and the area under the receiver operating characteristic curve (AUROC) was used to evaluate their accuracy.

RESULTS

In the inter-group comparison, the following variables had an effect on A&D severity in patients with CHF: NYHA class, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter, N-terminal pro-brain natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (P < 0.05). Other variables did not differ significantly between the A&D groups (P > 0.05). In addition, we found that higher NYHA classes were associated with higher the SAS and SDS scores (P < 0.05). Regression analysis showed that LVEF, NT-proBNP, and IL-6 were independent risk factors for A&D severity (P < 0.05). Among them, NT-proBNP had the best predictive ability as a single indicator (AUROC = 0.781). Furthermore, the combination of these three indicators exhibited a good predictive effect toward discriminating the extent of A&D severity among patients (AUROC = 0.875).

CONCLUSION

Cardiac and inflammatory biomarkers, such as LVEF, NT-proBNP, and IL-6, are correlated with A&D severity in patients with CHF and have predictive value.

Improvement of the nutritional support management system for patients in intensive care units

BACKGROUND

Nutritional support for patients hospitalized in the intensive care unit (ICU) is an important part of clinical treatment and care, but there are significant implementation difficulties.

AIM

To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.

METHODS

The division of functions, personnel training, system construction, development of an intelligent decision-making software system, quality control, and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.

RESULTS

Following the implementation of the whole process management system, the scores of ICU medical staff's knowledge, attitudes/beliefs, and practices regarding nutritional support were comprehensively enhanced. The proportion of hospital bed-days of total enteral nutrition (EN) in ICU patients increased from 5.58% to 11.46%, and the proportion of EN plus parenteral nutrition increased from 42.71% to 47.07%. The rate of EN initiation within 48 h of ICU admission increased from 37.50% to 48.28%, and the EN compliance rate within 72 h elevated from 20.59% to 31.72%. After the implementation of the project, the Self-rating Anxiety Scale score decreased from 61.07 ± 9.91 points to 52.03 ± 9.02 points, the Self-rating Depression Scale score reduced from 62.47 ± 10.50 points to 56.34 ± 9.83 points, and the ICU stay decreased from 5.76 ± 2.77 d to 5.10 ± 2.12 d.

CONCLUSION

The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.

Survey and clinical considerations of gender identity in lower primary school children

BACKGROUND

Gender consciousness directly affects the development of gender identity, which is a continuous and lifelong process. Meanwhile, hospitalization is a part of many children's lives and has an impact on their gender development.

AIM

To investigate the current situation of gender identity in lower primary school children by conducting a survey of 202 hospitalized children in the lower grades and to provide a theoretical basis and foundation for the cultivation of gender identity and medical treatment of children based on the results. This study aims to inspire clinical medical staff to scientifically and reasonably arrange hospital wards for lower primary school children and pay attention to gender protection during the medical treatment process and to help children shape a unified and clear gender identity, which will enable them to better integrate into society and promote their personality development.

METHODS

The gender consciousness scale for elementary and middle school students was used for the survey.

RESULTS

Gender identity was already present in lower primary school children. The children's gender roles and gender equality consciousness were strong, exceeding the critical value, but their gender characteristics, gender identity, and gender ideal consciousness were weak. Children aged 6 had the weakest gender identity, and girls had significantly stronger gender identity than boys.

CONCLUSION

Gender identity is already present in lower primary school children, providing a basis and inspiration for the cultivation of gender identity and medical treatment of lower primary school children. Clinical medical staff should be aware of and understand these results and should scientifically and reasonably arrange hospital wards for lower primary school children.

Embracing different languages and local differences: Co-constructive patient simulation strengthens host countries' clinical training in psychiatry

BACKGROUND

Global education in psychiatry is heavily influenced by knowledge from Western, high-income countries, which obscures local voices and expertise.

AIM

To adapt a human simulation model to psychiatric education in a context that is specific to local languages and cultures.

METHODS

We conducted an observational study consisting of six human simulation sessions with standardized patients from two host countries, speaking their native languages, and following an adaptation of the co-constructive patient simulation (CCPS) model. As local faculty became increasingly familiar with the CCPS approach, they took on the role of facilitators-in their country's native language.

RESULTS

Fifty-three learners participated: 19 child and adolescent psychiatry trainees and 3 faculty members in Türkiye (as a group that met online during 3 consecutive months); and 24 trainees and 7 faculty in Israel (divided into 3 groups, in parallel in-person sessions during a single training day). Each of the six cases reflected local realities and clinical challenges, and was associated with specific learning goals identified by each case-writing trainee.

CONCLUSION

Human simulation has not been fully incorporated into psychiatric education: The creation of immersive clinical experiences and the strengthening of reflective practice are two areas ripe for development. Our adaptations of CCPS can also strengthen local and regional networks and psychiatric communities of practice. Finally, the model can help question and press against hegemonies in psychiatric training that overshadow local expertise.

Haplotype analysis of long-chain non-coding RNA NONHSAT102891 promoter polymorphisms and depression in Chinese individuals: A case-control association study

BACKGROUND

Our previous study reported that the single-nucleotide polymorphism (SNP) rs155979 GC in the promoter region of long-chain non-coding RNA (lncRNA) NONHSAT102891 affects depression susceptibility in a Chinese population.

AIM

To explored associations of two SNPs and haplotypes in the lncRNA NONHSAT102891 promoter region with depression susceptibility in Chinese population.

METHODS

This this case-control association study was approved by the Ethics Committee of Chengdu Medical College (approval number: 201815). Patient diagnosis was based on DSM-IV criteria. We selected a total of 480 patients with depression and 329 healthy controls with no history of psychopathology, and performed genotyping of two SNPs by extracting peripheral venous blood samples from the subjects. The function of the two lncRNA NONHSAT102891 promoter G/C and A/T haplotypes was detected by dual-luciferase reporter assays of human embryonic kidney 293T transfected cells.

RESULTS

Stratified analysis of clinical and genotypic characteristics of our cohort showed that the degree of mild depressive episodes associated with the rs6230 TC/CC genotype increased by 1.59 times [TC/CC vs TT: odds ratio (OR) = 1.59, 95% confidence interval (CI): 1.08-2.35, P = 0.019]. The haploid analysis revealed linkage disequilibrium between rs3792747 and rs6230, and the double SNP CG haplotype was more common in the control group compared to case group, indicating that this haplotype significantly reduced the risk of depression (C/G vs T/A: OR = 0.42, 95%CI: 0.21-0.83, P = 0.01). There was no significant difference in the dual-luciferase reporter activity of the G/C and A/T haplotypes compared with the control group (P > 0.05), indicating that the double SNP haplotype has no transcriptional activity.

CONCLUSION

The rs3792747 and rs6230 CG haplotypes of the lncRNA NONHSA T102891 promoter may be related to a reduced risk of depression in the Han Chinese population.

Effect of cognitive behavior therapy training and psychological nursing on the midwifery process in the delivery room

BACKGROUND

The severe physical and psychological impact of pain on the physical and mental health of women during labor leads to increased risks and complications during childbirth, presenting a major public health concern. Some studies have shown that cognitive behavioral therapy (CBT) has a positive effect on maternal psychology during delivery, reducing stress and shortening labor time. Thus, CBT training for mothers and delivery room staff may be beneficial in minimizing complications and adverse effects during natural birth.

AIM

To investigate the clinical effects of CBT training and psychological care during delivery, and their therapeutic effects on women in labor.

METHODS

This study used a retrospective analysis and included 140 mothers admitted to the maternity ward between January 2021 and January 2023. The study subjects were randomized into two groups: control (n = 70) and observation (n = 70). Routine care, CBT training, and psychological care were provided to mothers in both groups. Psychological status scores, delivery time, and satisfaction with care pre- and post-delivery were compared, and the incidence of complications after receiving care was analyzed between the two groups.

RESULTS

Although the psychological state of both groups improved significantly in the late stages of labor, the psychological state scores of the mothers in the observation group were significantly lower than those of the mothers in the control group (P < 0.05). The duration of labor and incidence of complications in the observation group were significantly lower than those in the control group (P < 0.05). The mothers in the observation group were significantly more satisfied with nursing care during the course of labor than those in the control group (P < 0.05).

CONCLUSION

CBT training and psychological care for mothers in the midwifery process can effectively improve anxiety and depression, shorten labor duration, reduce postnatal complications, and improve nursing satisfaction and nurse-patient relationships. Its clinical application is effective and has popularization value, providing a new way to protect maternal mental health.

Analysis of influencing factors and the construction of predictive models for postpartum depression in older pregnant women

BACKGROUND

Changes in China's fertility policy have led to a significant increase in older pregnant women. At present, there is a lack of analysis of influencing factors and research on predictive models for postpartum depression (PPD) in older pregnant women.

AIM

To analysis the influencing factors and the construction of predictive models for PPD in older pregnant women.

METHODS

By adopting a cross-sectional survey research design, 239 older pregnant women (≥ 35 years old) who underwent obstetric examinations and gave birth at Suzhou Ninth People's Hospital from February 2022 to July 2023 were selected as the research subjects. When postpartum women of advanced maternal age came to the hospital for follow-up 42 d after birth, the Edinburgh PPD Scale (EPDS) was used to assess the presence of PPD symptoms. The women were divided into a PPD group and a no-PPD group. Two sets of data were collected for analysis, and a prediction model was constructed. The performance of the predictive model was evaluated using receiver operating characteristic (ROC) analysis and the Hosmer-Lemeshow goodness-of-fit test.

RESULTS

On the 42nd day after delivery, 51 of 239 older pregnant women were evaluated with the EPDS scale and found to have depressive symptoms. The incidence rate was 21.34% (51/239). There were statistically significant differences between the PPD group and the no-PPD group in terms of education level (P = 0.004), family relationships (P = 0.001), pregnancy complications (P = 0.019), and mother-infant separation after birth (P = 0.002). Multivariate logistic regression analysis showed that a high school education and below, poor family relationships, pregnancy complications, and the separation of the mother and baby after birth were influencing factors for PPD in older pregnant women (P < 0.05). Based on the influencing factors, the following model equation was developed: Logit (P) = 0.729 × education level + 0.942 × family relationship + 1.137 × pregnancy complications + 1.285 × separation of the mother and infant after birth -6.671. The area under the ROC curve of this prediction model was 0.873 (95%CI: 0.821-0.924), the sensitivity was 0.871, and the specificity was 0.815. The deviation between the value predicted by the model and the actual value through the Hosmer-Lemeshow goodness-of-fit test was not statistically significant (χ2 = 2.749, P = 0.638), indicating that the model did not show an overfitting phenomenon.

CONCLUSION

The risk of PPD among older pregnant women is influenced by educational level, family relationships, pregnancy complications, and the separation of the mother and baby after birth. A prediction model based on these factors can effectively predict the risk of PPD in older pregnant women.

Brain-derived neurotrophic factor, sex hormones and cognitive decline in male patients with schizophrenia receiving continuous antipsychotic therapy

BACKGROUND

There are systematic differences in clinical features between women and men with schizophrenia (SCZ). The regulation of sex hormones may play a potential role in abnormal neurodevelopment in SCZ. Brain-derived neurotrophic factor (BDNF) and sex hormones have complex interacting actions that contribute to the etiology of SCZ.

AIM

To investigate the influence of BDNF and sex hormones on cognition and clinical symptomatology in chronic antipsychotic-treated male SCZ patients.

METHODS

The serum levels of follicle-stimulating hormone, luteinizing hormone (LH), estradiol (E2), progesterone, testosterone (T), prolactin (PRL) and BDNF were compared between chronic antipsychotic-treated male (CATM) patients with SCZ (n = 120) and healthy controls (n = 120). The Positive and Negative Syndrome Scale was used to quantify SCZ symptoms, while neuropsychological tests were used to assess cognition. Neuropsychological tests, such as the Digit Cancellation Test (DCT), Semantic Verbal Fluency (SVF), Spatial Span Test (SS), Paced Auditory Serial Addition Test (PASAT), Trail Making Task (TMT-A), and Block Design Test (BDT), were used to assess executive functions (BDT), attention (DCT, TMT-A), memory (SS, PASAT), and verbal proficiency (SVF).

RESULTS

Although E2 levels were significantly lower in the patient group compared to the healthy controls, T, PRL, and LH levels were all significantly higher. Additionally, the analysis revealed that across the entire sample, there were positive correlations between E2 Levels and BDNF levels as well as BDNF levels and the digital cancellation time. In CATM patients with SCZ, a significant correlation between the negative symptoms score and PRL levels was observed.

CONCLUSION

Sex hormones and BDNF levels may also be linked to cognitive function in patients with chronic SCZ.

Efficacy and risk factors for anxiety and depression after mini-incision hip arthroplasty for femoral head osteonecrosis

BACKGROUND

Osteonecrosis of the femoral head (ONFH) is a prevalent orthopedic issue, leading to the collapse and fragmentation of the femoral head in its advanced stages, which can severely impair patients' quality of life. Total hip arthroplasty (THA) is a clinical intervention frequently used to alleviate ONFH symptoms and reinstate hip functionality. The conventional surgical technique is invasive and comes with an extended recuperation period, posing significant challenges for patients. With the progression of medical technology, the use of the mini-incision technique in minimally invasive THA (MITHA) has become more prevalent. However, comparative studies examining the effectiveness of these two surgical procedures in treating ONFH remain scarce. Furthermore, understanding patients' psychological well-being is crucial given its profound influence on postoperative recuperation.

AIM

To evaluate the impact of mini-incision MITHA on ONFH treatment and to identify the risk factors associated with postoperative anxiety and depression.

METHODS

A retrospective study was conducted on 125 patients treated for ONFH at Xi'an Hong Hui Hospital between February 2020 and January 2022, with the term "consecutive" indicating that these patients were treated in an unbroken sequence without any selection. Among these, 60 patients (control group) underwent traditional THA, while 65 patients (observation group) were treated with mini-incision MITHA. Variations in the visual analog scale (VAS) score and the Harris hip score were monitored. Additionally, shifts in pre- and posttreatment Hamilton anxiety (HAMA) and Hamilton depression (HAMD) scale scores were recorded. Patients with both postoperative HAMA and HAMD scores of ≥ 8 were identified as those experiencing negative emotions. Logistic regression was utilized to analyze the determinants influencing these negative emotional outcomes. Comparative analyses of surgical and postoperative metrics between the two groups were also conducted.

RESULTS

Posttreatment results indicated a significantly higher VAS score in the control group than in the observation group, while the Harris score was considerably lower (P < 0.0001). The observation group benefited from a notably shorter operation duration, reduced blood loss, diminished incision size, and a decreased postoperative drainage time (P < 0.0001), accompanied by a reduced hospital stay and lower treatment costs (P < 0.0001). The control group had elevated posttreatment HAMA and HAMD scores in comparison to the observation group (P < 0.0001). Multivariate logistic regression revealed that being female [odds ratio (OR): 4.394, 95%CI: 1.689-11.433, P = 0.002], having a higher postoperative VAS score (OR: 5.533, 95%CI: 2.210-13.848, P < 0.0001), and having higher treatment costs (OR: 7.306, 95%CI: 2.801-19.057, P < 0.0001) were significant independent determinants influencing postoperative mood disturbances.

CONCLUSION

Compared to conventional THA, mini-incision MITHA offers advantages such as reduced operation time, minimal bleeding, and a shorter incision in ONFH patients. Moreover, factors such as sex, postoperative pain (reflected in the VAS score), and treatment costs significantly impact postoperative anxiety and depression.

Efficacy of enhanced extracorporeal counterpulsation combined with atorvastatin in the treatment of cognitive impairment after stroke

BACKGROUND

Cerebral apoplexy patients are prone to cognitive impairment, and it is very important to choose appropriate treatment methods to improve their cognitive impairment after stroke.

AIM

To evaluate the effects of enhanced external counterpulsation (EECP) in conjunction with atorvastatin on cognitive function, neurotransmitter levels, and the repair of brain tissue damage in patients with cognitive impairment due to stroke.

METHODS

In this retrospective study, data from 60 patients with poststroke cognitive impairment due to stroke who were treated in our hospital from February 2021 to July 2022 were analyzed and divided into a treatment group (n = 30) and a control group (n = 30) according to the different nursing methods applied. Patients in the treatment group received EECP in addition to atorvastatin, while those in the control group received atorvastatin alone. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and activities of daily living (ADL) scale scores were compared between the two groups. Additionally, the two groups were compared in terms of serum acetylcholine (ACh), acetylcholinesterase (AChE), nitric oxide (NO), endothelin-1 (ET-1), β2-microglobulin (β2-MG), glial fibrillary acidic protein (GFAP), and visinin-like protein 1 (VILIP-1) in the serum. Blood flow measurements from the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) were compared between the two groups before and after treatment, and the pulsatility index (PI) and resistance index (RI) of each artery were determined.

RESULTS

MMSE, MoCA, and ADL scores all improved in both groups following treatment, with the study group showing more improvement than the control group (P < 0.05). After treatment, there were statistically significant increases in both ACh and NO levels, whereas decreases occurred in AChE, ET-1, β2-MG, VILIP-1, and GFAP, levels and the PI and RI of the left-ACA, right-ACA, left-MCA, right-MCA, left-PCA, and right-PCA. The study group showed greater gains in all metrics than the control group (P < 0.05).

CONCLUSION

EECP combined with atorvastatin is effective in the treatment of cognitive impairment after stroke and can effectively improve the cognitive function, neurotransmitter levels, and brain tissue damage status of patients.

Mediating role of physical activity in the relationship between psychological distress and intimate relationships among stroke patients

BACKGROUND

Stroke patients often experience psychological distress, which can impact their intimate relationships with spouses, subsequently influencing their treatment and recovery. Physical activity is considered a key rehabilitation method for stroke patients. This paper aims to analyze whether psychological distress affects intimate relationship between spouses through physical activity.

AIM

To explore the mediating effect of physical activity between psychological distress and intimate relationship in stroke patients.

METHODS

A total of 256 stroke patients who underwent treatment at the First People's Hospital of Shangqiu between July 2021 and July 2022 were enrolled in this study. The participants completed questionnaires, including the Kessler Psychological Distress Scale (K10), the Quality of Relationship Index (QRI), International Physical Activity Questionnaire, and a general information questionnaire. Data analysis were performed using SPSS 23.0. The Harman test was employed to detect common method deviations, and Spearman correlation was used for correlation analysis. The mediating effect was assessed using Process 3.4.1, with significance testing of the regression coefficients conducted using the bias-corrected percentile Bootstrap method (5000 iterations, 95% confidence interval). Statistical significance was set at P < 0.05.

RESULTS

The results showed that patients scored an average of 21.61 ± 6.44 points on the K10, 32.40 ± 6.19 points on the QRI; the median physical activity level according to the International Physical Activity Questionnaire was 1861 (566, 2846) MET·min/w. The level of physical activity (the physical activity intensity of the patients reflected by the International Physical Activity Questionnaire-Long Form scale) negatively correlated with psychological distress and intimacy (P < 0.05), and positively correlated with each other (P < 0.05), with the correlation stronger at lower physical activity levels compared to higher ones. The mediating effect of physical activity between psychological distress and intimate relationship was calculated to be 40.23%. Bootstrap analysis further validated the results. The mediating effect of psychological distress on intimate relationships through physical activity level was -0.284, with a confidence interval of -0.409 to -0.163, excluding 0, confirming a significant mediating effect of psychological distress on intimate relationships.

CONCLUSION

Physical activity significantly affects relationship between psychological distress and intimate relationships among stroke patients. Addressing the role of physical activity may have implications for improving patient outcomes and rehabilitation strategies.

Relationship between nightmare distress and depressive symptoms in Chinese emergency department nurses: A cross-sectional study

BACKGROUND

Most of the recent research on nightmare distress and depressive symptoms has focused on adolescents and students, with less research on the nurse population. Emergency department nurses are at high risk for nightmare distress and depressive symptoms, but no studies have been conducted to explore the relationship between the two; thus, further investigation is needed.

AIM

To understand the relationship between nightmare distress and depressive symptoms among emergency department nurses in China.

METHODS

A convenience sampling method was used to select 280 emergency department nurses from nine provinces, including Jiangxi, Sichuan, Jiangsu, and Shanxi Provinces. The Chinese version of the Nightmare Distress Questionnaire and the Center for Epidemiological Studies Depression Scale (CES-D) were administered.

RESULTS

Emergency department nurses' nightmare distress scores were positively associated with depressive symptom scores (r = 0.732), depressed affect (r = 0.727), somatic symptoms (r = 0.737), and interpersonal difficulty (r = 0.647). Further multiple linear regression analyses showed that education level, work pressure, self-reported health, and CES-D scores were factors that influenced nightmare distress among Chinese emergency department nurses (P < 0.05).

CONCLUSION

Nightmare distress is closely associated with depressive symptoms in Chinese emergency department nurses, and early intervention is recommended for professionals with this type of sleep disorder to reduce the occurrence of depressive symptoms.

Influence of childhood trauma on adolescent internet addiction: The mediating roles of loneliness and negative coping styles

BACKGROUND

In the information age, the use of the internet and multimedia tools has large effects on the life of middle school students. Improper use of the internet may result in internet addiction (IA). Thus, actively exploring the factors influencing adolescent and the mechanism of addiction as well as promoting adolescent physical and mental health and academic development are priorities that families, schools, and society urgently need to address.

AIM

To explore the effect of childhood trauma on adolescent IA and to consider the roles of loneliness and negative coping styles.

METHODS

A total of 11310 students from six junior high schools in Henan, China, completed the child trauma questionnaire, IA test, loneliness scale, and simple coping style questionnaire. In addition, data were collected from 1044 adolescents with childhood trauma for analysis with IBM SPSS 26.0 and AMOS 28.0; we examined the relationships among childhood trauma, IA, loneliness, and negative coping styles.

RESULTS

We found that childhood trauma not only directly affected adolescents' IA but also affected IA through loneliness and negative coping styles.

CONCLUSION

Therefore, this study has theoretical implications regarding adolescent mental health and may inform interventions for IA.

Diagnostic and prognostic implications of non-high-density lipoprotein cholesterol and homocysteine levels for cognitive impairment in thalamic infarction

BACKGROUND

Patients with thalamic infarction experience abnormal blockages of multinucleated vessels, affecting the body and thereby the thalamus. Most patients with thalamic infarction have an adverse prognosis, which seriously affects their safety. Therefore, it is essential to analyze the independent risk factors that influence the prognosis of patients with thalamic infarction and develop corresponding preventive measures.

AIM

To explore the effect of non-high-density lipoprotein cholesterol (non-HDL-C) and Homocysteine (Hcy) levels in cognitive impairment in thalamic infarction.

METHODS

From March 2019 to March 2022, 80 patients with thalamic infarction were divided into a group with cognitive impairment [Montreal Cognitive Assessment (MoCA) score < 26; 35 patients] and a group with normal cognitive function (MoCA score of 26-30; 45 patients) according to the MoCA score. In addition, 50 healthy people in the same period were selected as the control group. A correlation between the non-HDL-C and Hcy levels and the MoCA score and receiver operating characteristic curve was observed, and the serum non-HDL-C and Hcy levels were analyzed for the diagnosis of cognitive impairment in patients with thalamic infarction. According to the Modified Rankin Scale (MRS) score, 80 patients with thalamic infarction were divided into a good prognosis group (MRS score ≤ 2) and a poor prognosis group (MRS score >2).

RESULTS

The non-HDL-C and Hcy levels were significantly higher in the group with cognitive impairment than in the group with normal cognitive function (P < 0.05). There was no significant difference in the non-HDL-C level between the control group and the group with normal cognitive function (P > 0.05). The MoCA scores of the group with cognitive impairment were significantly lower than those of the group with normal cognitive function and the control group (P < 0.05). There was a significant difference between the control group and the group with normal cognitive function (P < 0.05). The non-HDL-C and Hcy levels were correlated with the MoCA score (P < 0.05), cognitive impairment [areas under the curve (AUC) = 0.709, 95% confidence interval (95%CI): 0.599-0.816], the non-HDL-C level, and could predict cognitive impairment in patients with thalamic infarction (AUC = 0.738, 95%CI: 0.618-0.859). Hcy combined with non-HDL-C levels can predict cognitive impairment in patients with thalamic infarction (AUC = 0.769, 95%CI: 0.721-0.895).There were 50 patients in the good prognosis group and 30 patients in the poor prognosis group. Compared with the good prognosis group, in the poor prognosis group, the National Institutes of Health Stroke Scale (NIHSS) score, non-HDL-C level, Hcy level, large-area cerebral infarction, atrial fibrillation, and activated partial prothrombin time were statistically significant (P < 0.05). The non-HDL-C level, the Hcy level, the NIHSS score, extensive cerebral serum, and atrial fibrillation may all be independent risk factors for poor prognosis in patients with thalamic infarction (P < 0.05).

CONCLUSION

Non-HDL-C and Hcy levels are positively correlated with cognitive impairment in patients with thalamic infarction. Non-HDL-C and Hcy levels can be used in the diagnosis of cognitive impairment in patients with thalamic infarction, and the combined detection effect is better. The main factors affecting the prognosis of patients with thalamic infarction are the non-HDL-C level, the Hcy level, the NIHSS score, large-area cerebral infarction, and atrial fibrillation. Clinically, corresponding preventive measures can be formulated based on the above factors to prevent poor prognosis and reduce mortality.

Impact of an emergency department nursing intervention on continuity of care, self-care, and psychological symptoms

BACKGROUND

The emergency department plays a crucial role in providing acute care to patients. Nursing interventions in this setting are essential for improving the continuity of care, enhancing patients' self-care abilities, and reducing psychological symp-toms.

AIM

To evaluate the effect of nursing interventions in the emergency department on these indicators in an emergency department.

METHODS

A retrospective analysis was conducted on 120 patients admitted to the emergency department between January 2022 and May 2023. The patients were divided into two groups: The control group (conventional nursing intervention) and the observation group (conventional nursing intervention + emergency department nursing intervention). The two groups were compared regarding continuity of care, self-care ability, psychological symptoms, and satisfaction with care.

RESULTS

The emergency department nursing interventions significantly improved the continuity of care, enhanced patients' self-care abilities, and reduced psychological symptoms such as anxiety and depression.

CONCLUSION

Nursing interventions in the emergency department positively impact continuity of care, self-care, and psychological symptoms. However, it is important to acknowledge the limitations of this study, including the small number of studies, variable methodological quality, and the heterogeneity of the study population. Future research should address these limitations and further explore the effects of different types of nursing interventions in the emergency department. Additionally, efforts should be made to enhance the application and evaluation of these interventions in clinical practice.

Influence of physical education on anxiety, depression, and self-esteem among college students

BACKGROUND

Physical education is pivotal in our country's education reform. Urban schools have notably enhanced the intensity of physical education in recent years. However, the effects of physical education on students' anxiety, depression, and self-esteem levels, as well as their interrelations, remain unexplored.

AIM

To analyze the influence of physical education on students' anxiety, depression, and self-esteem.

METHODS

This study employed a cross-sectional design. A stratified cluster sampling method was used to select 478 first-year university students. Self-administered questionnaires were used to investigate the physical education status and basic information of college students. We used the Physical Activity Rank Scale-3 (PARS-3), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Self-Esteem Scale (SES) to assess the level of exercise, anxiety, depression, and self-esteem. Multiple Logistic regression was used to analyze the factors influencing anxiety, depression, and low self-esteem. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the predictive ability of PARS-3 scores for anxiety, depression, and low self-esteem. Spearman's correlation was used to analyze the correlations among the PARS-3, SAS, SDS, and SES.

RESULTS

Compared with the domestic norms, SAS and SDS scores were higher, and SES scores were lower (P < 0.05). Among the participants, 210 (43.93%) had PARS-3 scores below 20, 94 (19.67%) had scores of 20-42, and 174 (36.40%) had scores above 42. After adjusting for daily sleep time, gender, being an only child, major, father's educational background, mother's educational background, and family residence, PARS-3 scores were independent influencing factors for anxiety, depression, and low self-esteem (P < 0.05). The AUC of PARS-3 scores predicting anxiety, depression, and low self-esteem were 0.805 (0.760-0.849), 0.799 (0.755-0.843), and 0.831 (0.788-0.874), respectively. The sensitivities were 0.799, 0.801, and 0.748, and the specificities were 0.743, 0.716, and 0.814, respectively. PARS-3 was negatively correlated with SAS and SDS scores (r = -0.566, -0.621, both P < 0.001) and positively correlated with SES scores (r = -0.621, P < 0.001). SES scores were negatively correlated with SAS and SDS scores (r = -0.508, r = -0.518, both P < 0.001).

CONCLUSION

The amount of physical activity is negatively correlated with anxiety and depression degree and positively correlated with self-esteem degree.

Surviving the shift: College student satisfaction with emergency online learning during COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) epidemic disrupted education systems by forcing systems to shift to emergency online leaning. Online learning satisfaction affects academic achievement. Many factors affect online learning satisfaction. However there is little study focused on personal characteristics, mental status, and coping style when college students participated in emergency online courses.

AIM

To assess factors related to satisfaction with emergency online learning among college students in Hebei province during the COVID-19 pandemic.

METHODS

We conducted a cross-sectional survey of 1600 college students. The collected information included demographics, psychological aspects of emergent public health events, and coping style. Single factor, correlation, and multiple linear regression analyses were performed to identify factors that affected online learning satisfaction.

RESULTS

Descriptive findings indicated that 62.9% (994/1580) of students were satisfied with online learning. Factors that had significant positive effects on online learning satisfaction were online learning at scheduled times, strong exercise intensity, good health, regular schedule, focusing on the epidemic less than one hour a day, and maintaining emotional stability. Positive coping styles were protective factors of online learning satisfaction. Risk factors for poor satisfaction were depression, neurasthenia, and negative coping style.

CONCLUSION

College students with different personal characteristics, mental status, and coping style exhibited different degrees of online learning satisfaction. Our findings provide reference for educators, psychologists, and school administrators to conduct health education intervention of college students during emergency online learning.

Value of Chuanjin Qinggan decoction in improving the depressive state of patients with herpes zoster combined with depression

BACKGROUND

Western medicine is beneficial for the recovery of neurological function in patients with depression, but some patients experience side effects such as headaches, dizziness, nausea, gastrointestinal symptoms, insomnia, and cardiac dysfunction. In recent years, integrative medicine has achieved positive results in the treatment of various diseases.

AIM

To study Chuanjin Qinggan decoction combined with selective serotonin reuptake inhibitors (SSRIs) in patients with herpes zoster complicated by depression.

METHODS

Patients with herpes zoster complicated by depression who were treated at the Yantai Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were retrospectively selected as research participants. Among them, 43 patients with herpes zoster complicated by depression who received SSRI treatment between January and December 2021 were assigned to the Western medicine group, while those who received combined treatment of traditional Chinese and Western medicine between January and December 2022 were assigned to the combined group. Both groups were treated for eight weeks. The degree of pain, effect of herpes zoster treatment, degree of improvement in depressive symptoms, serum neurotransmitter levels, sleep quality, and occurrence of adverse reactions were compared between the two groups.

RESULTS

We found that after eight weeks of drug treatment, the two treatment schemes achieved differing efficacy. In further comparison, we found that, compared with patients treated with SSRIs alone, patients treated with Chuanjin Qinggan decoction combined with SSRIs showed more significant improvement in depression and a greater increase in dopamine and 5-hydroxytryptamine levels after treatment (P < 0.05). Patients treated with Chuanjin Qinggan decoction combined with SSRIs also experienced lower pain, better treatment efficacy for herpes zoster, better sleep quality, and a lower incidence of adverse reactions compared to those treated with SSRIs alone (P < 0.05). All minor adverse reactions occurring during treatment were resolved after symptomatic treatment.

CONCLUSION

The treatment scheme of Chuanjin Qinggan decoction combined with SSRIs can improve the psychological state of patients with herpes zoster complicated by depression and alleviate adverse reactions.

Risk factors, preventive interventions, overlapping symptoms, and clinical measures of delirium in elderly patients

Delirium is an acute reversible neuropsychiatric syndrome caused by multiple factors. It is associated with many adverse clinical outcomes including cognitive impairment, functional decline, prolonged hospitalization, and increased nursing service. The prevalence of delirium was high in department of cardiology, geriatric, and intensive care unit of hospital. With the increase in the aged population, further increases in delirium seem likely. However, it remains poorly recognized in the clinical practice. This article comprehensively discusses the latest research perspectives on the epidemiological data, risk factors, preventive interventions, overlapping symptoms, and clinical measures of delirium, including specific measures to manage delirium in clinical real-world situations. This article helps readers improve their knowledge and understanding of delirium and helps clinicians quickly identify and implement timely therapeutic measures to address various delirium subtypes that occur in the clinical settings to ensure patients are treated as aggressively as possible.

Meteorological factors, ambient air pollution, and daily hospital admissions for depressive disorder in Harbin: A time-series study

BACKGROUND

The literature has discussed the relationship between environmental factors and depressive disorders; however, the results are inconsistent in different studies and regions, as are the interaction effects between environmental factors. We hypothesized that meteorological factors and ambient air pollution individually affect and interact to affect depressive disorder morbidity.

AIM

To investigate the effects of meteorological factors and air pollution on depressive disorders, including their lagged effects and interactions.

METHODS

The samples were obtained from a class 3 hospital in Harbin, China. Daily hospital admission data for depressive disorders from January 1, 2015 to December 31, 2022 were obtained. Meteorological and air pollution data were also collected during the same period. Generalized additive models with quasi-Poisson regression were used for time-series modeling to measure the non-linear and delayed effects of environmental factors. We further incorporated each pair of environmental factors into a bivariate response surface model to examine the interaction effects on hospital admissions for depressive disorders.

RESULTS

Data for 2922 d were included in the study, with no missing values. The total number of depressive admissions was 83905. Medium to high correlations existed between environmental factors. Air temperature (AT) and wind speed (WS) significantly affected the number of admissions for depression. An extremely low temperature (-29.0 ℃) at lag 0 caused a 53% [relative risk (RR)= 1.53, 95% confidence interval (CI): 1.23-1.89] increase in daily hospital admissions relative to the median temperature. Extremely low WSs (0.4 m/s) at lag 7 increased the number of admissions by 58% (RR = 1.58, 95%CI: 1.07-2.31). In contrast, atmospheric pressure and relative humidity had smaller effects. Among the six air pollutants considered in the time-series model, nitrogen dioxide (NO2) was the only pollutant that showed significant effects over non-cumulative, cumulative, immediate, and lagged conditions. The cumulative effect of NO2 at lag 7 was 0.47% (RR = 1.0047, 95%CI: 1.0024-1.0071). Interaction effects were found between AT and the five air pollutants, atmospheric temperature and the four air pollutants, WS and sulfur dioxide.

CONCLUSION

Meteorological factors and the air pollutant NO2 affect daily hospital admissions for depressive disorders, and interactions exist between meteorological factors and ambient air pollution.

Analysis of the relationship between blood pressure variability and subtle cognitive decline in older adults

BACKGROUND

Blood pressure variability (BPV) has been shown to be related to mild cognitive impairment and Alzheimer's disease in a number of studies. However, the relationship between BPV and subtle cognitive decline (SCD) has received minimal attention in this field of research to date and has rarely been reported.

AIM

To examine whether SCD is independently associated with changes in BPV in older adults.

METHODS

Participants were selected based on having participated in cognitive function evaluation and ambulatory blood pressure measurement at the Shanghai Sixth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine between June 2020 and August 2022. The participants included 182 individuals with SCD as the experimental group and 237 with normal cognitive function as the control group. The basic data, laboratory examinations, scale tests, and ambulatory blood pressure test results of the two groups were analyzed retrospectively, and the relationship between SCD and BPV was subsequently evaluated.

RESULTS

Significant differences were observed between the two groups of participants (P < 0.05) in terms of age, education level, prevalence rate of diabetes, fasting blood glucose level, 24-h systolic blood pressure standard deviation and coefficient of variation, 24-h diastolic blood pressure standard deviation and coefficient of variation. The scale monitoring results showed significant differences in the scores for memory, attention, and visual space between the experimental and control groups. Logistic regression analysis indicated that age, education level, blood sugar level, and BPV were factors influencing cognitive decline. Linear regression analysis showed that there was an independent correlation between blood pressure variation and SCD, even after adjusting for related factors. Each of the above differences was still significant.

CONCLUSION

This study suggests that increased BPV is associated with SCD.

Effects of combined spinal-epidural anesthesia on anxiety, labor analgesia and motor blocks in women during natural delivery

BACKGROUND

The background of this study was analgesia in natural delivery. The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor, and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases.

AIM

To study the effects of combined spinal-epidural anesthesia on anxiety, labor analgesia, and motor blocks in parturients during natural delivery.

METHODS

A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included; a random number table approach was employed to divide the women into a control group and a joint group, with each group consisting of 60 women. The control group was given epidural anesthesia, while the joint group was given combined spinal-epidural anesthesia. The visual analog scale (VAS) was used to evaluate the degree of maternal pain. Comparisons were made between the two groups’ conditions of childbirth and the duration of labor. Apgar scores were used to evaluate the status of the newborns at birth; Self-rating Anxiety Scale (SAS) and General Self-Efficacy Scale (GSES) scores, umbilical artery blood gas analysis indices and stress indices were compared between the two groups; and the frequencies of motor block and postpartum complications were analyzed.

RESULTS

In comparison to the control group, in the joint group, the VAS scores for the first, second, and third stages of labor were lower (P < 0.05). The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group (P < 0.05). No significant differences were observed in the Apgar score, the duration of the first stage of labor, or the total duration of labor between the two groups (P > 0.05). The second and third stages of labor in the joint group were shorter than those in the control group (P < 0.05). When compared to the control group, the postpartum SAS score of the joint group was lower, while the GSES score was greater (P < 0.05). Between the control group and the joint group, the differences observed in pH, arterial carbon dioxide partial pressure, arterial oxygen partial pressure, or arterial hydrogen ion concentration were not significant (P > 0.05). Nitric oxide, cortisol, and adrenaline levels were lower in the joint group than in the control group (P < 0.05). There were no substantial differences in Bromage grade or rate of complications between the two groups (P > 0.05).

CONCLUSION

For parturients during natural delivery, combined spinal-epidural anesthesia can reduce anxiety, provide labor analgesia, shorten labor time, and reduce postoperative stress levels but did not result in a motor block.

Effectiveness of menstruation hygiene skills training for adolescents with autism

BACKGROUND

Adolescents with autism spectrum disorder (ASD) may encounter many difficulties with their menstrual cycles. Potential challenges that adolescents with ASD may face include understanding physical changes, coping with symptoms, emotional sensitivity, communication, personal care, and hygiene.

AIM

To evaluate the effect of menstrual hygiene skills training given to adolescents with ASD on their menstrual hygiene skills.

METHODS

The study was conducted with 15 adolescents diagnosed with ASD by the single group pre-test and post-test model in three special education centers in Türkiye. Data were collected with the Adolescent and Parent Information Form and the Adolescent-Specific Menstrual Hygiene Skill Registration Form.

RESULTS

While the mean age of adolescents was 16.06 ± 0.88 years, the mean age of individuals responsible for adolescent care was 43.66 ± 5.56 years. While 60.0% of the adolescents noticed the onset of bleeding before training, this rate was 93.3% after training. The Adolescent-Specific Menstrual Hygiene Skill Registration Form showed a statistically significant increase in the application steps after the training. The difference between the menstrual hygiene skill scores of adolescents diagnosed with ASD before and after training was significant.

CONCLUSION

The menstrual hygiene skills training given to adolescents with ASD was beneficial in increasing their menstrual hygiene skills. These individuals must take responsibility during menstruation and independently manage their continuous care activities.

Correlation analysis of mental health conditions and personality of patients with alcohol addiction

BACKGROUND

Alcohol addiction, or alcohol dependence, refers to a psychological state of strong craving for alcohol caused by drinking when both the drinking times and alcohol consumption reach a certain level. Alcohol addiction can cause irreversible damage, leading to mental illness or mental disorders, negative changes in their original personality, and a tendency to safety incidents such as committing suicide or violent attacks on others. Significant attention needs to be given to the mental health of alcohol addicts, which could reflect their abnormal personality traits. However, only a few papers on this issue have been reported in China.

AIM

To investigate the correlation between mental health and personality in patients with alcohol addiction.

METHODS

In this single-center observational study, we selected 80 patients with alcohol addiction as the research subjects, according to the criteria of the K10 scale to evaluate the mental health of patients with alcohol addiction, and divided these patients into four groups based on the evaluation results: Good, average, relatively poor and bad. And then analyzed the correlation between mental health conditions and personality characteristics from these four groups of patients.

RESULTS

The average score of the K10 scale (Kessler 10 Simple Psychological Status Assessment Scale) in 80 patients with alcohol addiction was 25.45 points, the median score was 25 points, the highest score was 50 points, and the lowest score was 11 points. Pearson's analysis showed that the K10 score was positively correlated with the scores of these two subscales, such as the P-subscale and the N-subscale (P < 0.05). In contrast, the K10 score had no significant correlation with the scores from the E-subscale and the L-subscale (P > 0.05).

CONCLUSION

The mental health conditions of patients with alcohol addiction are positively correlated with their personality characteristics.

Independent risk factors for depression in older adult patients receiving peritoneal dialysis for chronic kidney disease

BACKGROUND

According to the trend of global population aging, the proportion of elderly patients with chronic kidney disease (CKD) is expected to increase. However, there are more than 20 million people in China with decompensated kidney function, of which 19.25% are elderly people. Therefore, special attention should be paid to the education years, sleep quality, anxiety status, comorbidities with diabetes, cardiovascular disease (CVD), and anemia as independent risk factors for depression in elderly CKD patients. This study explores the clinical mana-gement of elderly CKD patients that should address these risk factors to prevent depression and improve their prognosis.

AIM

To investigate depression risk factors in older patients receiving peritoneal dialysis, aiding future prevention of depression in these patients.

METHODS

This retrospective study included a primary study population of 170 patients with CKD who received peritoneal dialysis from January 2020 to December 2022. We assessed the patients’ mental status using the Beck Depression Inventory Score-II (BDI-II), Self-Rating Anxiety Scale (SAS), Anxiety Inventory Score, and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was employed to identify depression independent risk factors among these patients.

RESULTS

The non-depressed group had a significantly longer education period than the depressed group (P < 0.05). The depressed group exhibited significantly higher mental status scores than the non-depressed group (P < 0.001). Patients with diabetes mellitus (DM) or CVD had a higher probability of developing dep-ression. Patients with depression had significantly lower hemoglobin and albumin levels than patients without depression (P < 0.05). Spearman correlation analysis of BDI-II scale scores, measuring depression, indicated positive correlations with BDI-II and SAS scores as risk factors for depression in patients with CKD. In contrast, years of education, hemoglobin levels, and peritoneal Kt/V were negatively correlated, serving as protective factors against depression. An analysis of variance for influences with significant differences in the univariate analysis revealed that years of schooling, BDI-II, SAS, PSQI, DM, CVD, and hemoglobin levels independently influenced depression in older patients with CKD.

CONCLUSION

Education, BDI-II, SAS, PSQI, DM, and CVD are independent risk factors for depression in older patients with CKD; therefore, post-treatment psychological monitoring of high-risk patients is crucial to prevent depression.

Anti-infective therapy durations predict psychological stress and laparoscopic surgery quality in pelvic abscess patients

BACKGROUND

The degree of psychological stress and the difficulty and efficacy of laparoscopic surgery differ in patients with pelvic abscesses after different durations of anti-infection treatment.

AIM

To compare and analyse the effects of different durations of anti-infective therapy on patients’ preoperative psychological stress level and the clinical efficacy of laparoscopic surgery in patients with pelvic abscesses to offer a reference for the selection of therapy plans.

METHODS

A total of 100 patients with pelvic abscesses who were admitted to the Department of Gynecology of Suzhou Ninth Hospital affiliated to Soochow University (Suzhou Ninth People's Hospital) from January 2018 to December 2022 were retrospectively enrolled. According to the different durations of anti-infective therapy, they were divided into Group S (50 patients, received anti-infective therapy for 24-48 h) and Group L (50 patients, received anti-infective therapy for 48-96 h). Baseline data, state-trait anxiety score at admission and before surgery, self-rating anxiety scale (SAS) + self-rating depression scale (SDS) score, surgery time, adhesion grading score, intraoperative blood loss, presence or absence of intraoperative intestinal injury, ureteral injury or bladder injury, postoperative body temperature, length of hospital stay, and presence or absence of recurrence within 3 mo after surgery, chronic pelvic pain, incision infection, dysmenorrhea, menstrual disorder or intestinal obstruction were compared between the S group and the L group.

RESULTS

There was no significant difference in the background data between the S group and the L group (P < 0.05). There was no significant difference in the state-trait anxiety score or SAS + SDS score between the S group and the L group on admission (P < 0.05). The state-trait anxiety score and SAS + SDS score of the S group were lower than those of Group L after receiving different durations of anti-infective therapy (P < 0.05). There was no significant difference in the incidence of intestinal, ureteral or bladder injury between the S group and the L group (P < 0.05). The surgery time of Group S was shorter than that of Group L, and the adhesion score and intraoperative blood loss volume were lower than those of Group L (P < 0.05). There was no significant difference in the incidence of incision infection, dysmenorrhea, menstrual disorder or intestinal obstruction between the S group and the L group (P < 0.05). The postoperative body temperature of Group S was lower than that of Group L (P < 0.05), and the hospital stay was shorter than that of Group L (P < 0.05). The incidences of recurrence and chronic pelvic pain within 3 mo after surgery were lower than that of Group L (P < 0.05).

CONCLUSION

Twenty-four to forty-eight hours of anti-infective therapy is better than 48-96 h of anti-infective therapy for patients with pelvic abscesses because the degree of psychological stress is lower, which is more conducive to achieving better outcomes after laparoscopic surgery.

Management of acute carbamazepine poisoning: A narrative review

Standard management protocols are lacking and specific antidotes are unavailable for acute carbamazepine (CBZ) poisoning. The objective of this review is to provide currently available information on acute CBZ poisoning, including its management, by describing and summarizing various therapeutic methods for its treatment according to previously published studies. Several treatment methods for CBZ poisoning will be briefly introduced, their advantages and disadvantages will be analyzed and compared, and suggestions for the clinical treatment of CBZ poisoning will be provided. A literature search was performed in various English and Chinese databases. In addition, the reference lists of identified articles were screened for additional relevant studies, including non-indexed reports. Non-peer-reviewed sources were also included. In the present review, 154 articles met the inclusion criteria including case reports, case series, descriptive cohorts, pharmacokinetic studies, and in vitro studies. Data on 67 patients, including 4 fatalities, were reviewed. Based on the summary of cases reported in the included articles, the cure rate of CBZ poisoning after symptomatic treatment was 82% and the efficiency of hemoperfusion was 58.2%. Based on the literature review, CBZ is moderately dialyzable and the recommendation for CBZ poisoning is supportive management and gastric lavage. In severe cases, extracorporeal treatment is recommended, with hemodialysis as the first choice.

Safety and effectiveness of lurasidone in the treatment of Chinese schizophrenia patients: An interim analysis of post-marketing surveillance

BACKGROUND

Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms. Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 mg/d. However, post-market surveillance (PMS) with an adequate sample size is required for further validation of the drug’s safety profile and effectiveness.

AIM

To conduct PMS in real-world clinical settings and evaluate the safety and effectiveness of lurasidone in the Chinese population.

METHODS

A prospective, multicenter, open-label, 12-wk surveillance was conducted in mainland China. All patients with schizophrenia from 10 sites who had begun medication with lurasidone between September 2019 and August 2022 were eligible for enrollment. Safety assessments included adverse events (AEs), adverse drug reactions (ADRs), extrapyramidal symptoms (EPS), akathisia, use of EPS drugs, weight gain, and laboratory values as metabolic parameters and the QTc interval. The effectiveness was assessed using the brief psychiatric rating scale (BPRS) from baseline to the end of treatment.

RESULTS

A total of 965 patients were enrolled in the full analysis set and 894 in the safety set in this interim analysis. The average daily dose was 61.7 ± 19.08 mg (mean ± SD) during the treatment. AEs and ADRs were experienced by 101 patients (11.3%) and 78 patients (8.7%), respectively, which were mostly mild. EPS occurred in 25 individuals with a 2.8% incidence, including akathisia in 20 individuals (2.2%). Moreover, 59 patients received drugs for treating EPS during the treatment, with an incidence of 6.6% which dropped to 5.4% at the end of the treatment. The average weight change was 0.20 ± 2.36 kg (P = 0.01687) with 0.8% of patients showing a weight gain of ≥ 7% at week 12 compared with that at the baseline. The mean values of metabolic parameters and the QTc interval at baseline and week 12 were within normal ranges. The mean changes in total BPRS scores were -8.9 ± 9.76 (n = 959), -13.5 ± 12.29 (n = 959), and -16.8 ± 13.97 (n = 959) after 2/4, 6/8, and 12 wk, respectively (P < 0.001 for each visit compared with the baseline) using the last-observation-carried-forward method.

CONCLUSION

The interim analysis of the PMS of adult patients with schizophrenia demonstrate the safety and effectiveness of lurasidone in the Chinese population. No new safety or efficacy concerns were identified.

Effect of Internet + continuous midwifery service model on psychological mood and pregnancy outcomes for women with high-risk pregnancies

BACKGROUND

There are many drawbacks to the traditional midwifery service management model, which can no longer meet the needs of the new era. The Internet + continuous midwifery service management model extends maternal management from prenatal to postpartum, in-hospital to out-of-hospital, and offline to online, thereby improving maternal and infant outcomes. Applying the Internet + continuous midwifery service management model to manage women with high-risk pregnancies (HRP) can improve their psycho-emotional opinion and, in turn, minimize the risk of adverse maternal and/or fetal outcomes.

AIM

To explore the effectiveness of a midwife-led Internet + continuous midwifery service model for women with HRP.

METHODS

We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital (affiliated to the Shanghai Jiao Tong University School of Medicine) from April to December 2022. Among them, 239 pregnant women underwent routine obstetric management, and 200 pregnant women underwent Internet + continuous midwifery service mode management. We used the State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.

RESULTS

The data showed that in early pregnancy, the anxiety and depression levels of the two groups were similar; the levels gradually decreased as pregnancy progressed, and the decrease in the continuous group was more significant [31.00 (29.00, 34.00) vs 34.00 (32.00, 37.00), 8.00 (6.00, 9.00) vs 12.00 (10.00, 13.00), P < 0.05]. The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group, and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group [267.50 (242.25, 284.75) vs 256.00 (233.00, 278.00), 74.00 (69.00, 78.00) vs 71.00 (63.00, 78.00), P < 0.05]. The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group, and nursing satisfaction was higher [10.50% vs 18.83%, 8.50% vs 15.90%, 24.00% vs 42.68%, 89.50% vs 76.15%, P < 0.05].

CONCLUSION

The Internet + continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.

Cerebrotendinous xanthomatosis presenting with schizophrenia-like disorder: A case report

BACKGROUND

Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive lipid-storage disorder caused by mutations in CYP27A1. Psychiatric manifestations in CTX are rare and nonspecific, and they often lead to considerable diagnostic and treatment delay.

CASE SUMMARY

A 33-year-old female patient admitted to the psychiatric ward for presentation of delusions, hallucinations, and behavioral disturbance is reported. The patient presented with cholestasis, cataract, Achilles tendon xanthoma, and cerebellar signs in adulthood and with intellectual disability and learning difficulties in childhood. After the characteristic CTX findings on imaging were obtained, a pathological examination of the Achilles tendon xanthoma was refined. Re-placement therapy was then initiated after the diagnosis was clarified by genetic analysis. During hospitalization in the psychiatric ward, the nonspecific psychiatric manifestations of the patient posed difficulty in diagnosis. After the patient’s history of CTX was identified, the patient was diagnosed with organic schizophrenia-like disorder, and psychotic symptoms were controlled by replacement therapy combined with antipsychotic medication.

CONCLUSION

Psychiatrists should be aware of CTX, its psychiatric manifestations, and clinical features and avoid misdiagnosis of CTX for timely intervention.

Clinical application of multidisciplinary team- and evidence-based practice project in gynecological patients with perioperative hypothermia

BACKGROUND

Perioperative hypothermia (PH) negatively affects the physical and mental health of patients to varying degrees. Currently, there is no effective multidisciplinary team (MDT) intervention for gynecological patients with PH.

AIM

To apply the best evidence on the prevention and management of PH in gynecological patients, improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT- and evidence-based practice (EBP) projects on the psychological status and cognitive function of gynecological patients with PH.

METHODS

Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts, the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting. Based on the evidence, the practice plan was developed, and the MDT intervention was carried out in the preoperative ward, the preoperative preparation room, the intraoperative operating room, the postanesthesia care unit, and the 24-hour postoperative gynecological ward through the EBP program. The incidence of hypothermia, the nurses’ awareness, the implementation rate of examination indicators, and the thermal comfort level, psychological status and cognitive function of patients were compared before and after the implementation of the program.

RESULTS

The incidence of PH in gynecological patients decreased from 43.33% to 13.33% after the implementation of the scheme. The implementation rate of examination indicators 6-10, 12, 14, 16-18, 21, and 22 reached 100%, and that of other indicators was above 90%, except for examination indicators 5 and 13, which was 66.67%; the indices were significantly improved compared with the baseline (before evidence application) (P < 0.05). The score of nurses' awareness of PH prevention and management in gynecological patients increased from 60.96 ± 9.70 to 88.08 ± 8.96, and the difference was statistically significant (P < 0.001). The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97 ± 2.04, which was significantly increased compared with the score of 21.27 ± 1.57 observed by researchers at baseline (P < 0.001). The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03 ± 3.16 and 13.93 ± 2.64 to 4.30 ± 1.15 and 3.53 ± 0.78, respectively, with statistically significant differences (P < 0.001). The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17 ± 1.68 to 26.93 ± 1.11, also with statistical significance (P < 0.001).

CONCLUSION

MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations, improve nurses' awareness and behavioral compliance with gynecological hypothermia management, and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’ negative emotions and enhancing their cognitive function.

Research status of internet-delivered cognitive behavioral therapy in cancer patients

The latest global cancer burden data released by the International Agency for Research on Cancer of the World Health Organization in 2020 shows that there were 19.29 million new cancer cases worldwide, with 4.57 million in China, ranking first. The number of cancer survivors is increasing, with a 5-year survival rate exceeding 85%, but there are emotional disorders. Cognitive behavioral therapy (CBT) can improve negative emotions and has significant effects on patients. However, there is a limited number of physicians and high costs, so internet interventions have become a solution. The feasibility of web-based interventions for breast cancer patients has been proven. Research on internet-delivered CBT is also increasing. The purpose of this study was to review the concept of web-based CBT and its application status in cancer survivors, in order to provide relevant intervention for scholars and provide reference and supplement for patients to provide psychological therapy.

Relationship between primary caregivers’ social support function, anxiety, and depression after interventional therapy for acute myocardial infarction patients

BACKGROUND

An acute myocardial infarction (AMI) is often treated with direct coronary intervention and requires home-based rehabilitation. Caregivers of patients with AMI need adequate social support to maintain high-quality care; however, their social support function is low, and relevant indicators for intervention must be identified.

AIM

To analyze the correlation between social support for primary caregivers, their anxiety, and depression, when caring for patients with AMI after interventional therapy.

METHODS

Using convenience sampling, we selected 300 primary caregivers of patients with AMI who had undergone interventional therapy. The Social Support Rating Scale (SSRS), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were used to assess the primary caregivers. A Pearson’s correlation analysis was used to analyze the correlations between the SSRS, SAS, and SDS, and a multiple logistic regression analysis was used to analyze the factors influencing the low social support function of primary caregivers. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the pre-dictive ability of the SAS and SDS for low social support function in primary caregivers.

RESULTS

Considering the norm among Chinese people, AMI caregivers’ objective support, subjective support, support utilization, and SSRS scores were lower, while their SAS and SDS scores were higher. The SSRS scores of female caregivers were higher than those of the male caregivers (t = 2.123, P = 0.035). The Pearson correlation analysis showed that objective support, subjective support, support utilization, and SSRS total scores were significantly correlated with both SAS (r = -0.414, -0.460, -0.416, -0.535) and SDS scores (r = -0.463, -0.379, -0.349, -0.472). Among the 300 AMI caregivers, 56 cases (18.67%) had a low level of support function (SSRS ≤ 22 points). Logistic regression model analysis showed that SAS and SDS were independent risk factors for low social support function of AMI caregivers, regardless of adjustment for other variables (P < 0.05). SAS and SDS predicted that the AUC of AMI caregivers with low support function was 0.84, sensitivity was 67.9 and 71.4, and specificity was 84.0 and 70.9, respectively.

CONCLUSION

The social support function of the primary caregiver of patients with AMI after interventional therapy was lower and negatively correlated with anxiety and depression in the primary caregiver.

Depression and sarcopenia-related traits: A Mendelian randomization study

BACKGROUND

Observational studies have suggested that depression is associated with sarcopenia. However, the causal relationship between depression and sarcopenia remains unclear.

AIM

To investigate the causal relationship between depression and sarcopenia.

METHODS

We performed a Mendelian randomization (MR) analysis to identify the bidirectional relationship between depression and sarcopenia-related traits. Summary-level data and independent variants used as instrumental variables came from large genome-wide association studies of depression (414055 cases and 892299 controls), of appendicular lean mass (ALM, 450243 participants), and of hand grip strength (exposure: 360000 participants; outcome: 334925 participants).

RESULTS

We identified a negative association of depression with lower ALM [odds ratio (OR): 0.932, 95% confidence interval (95%CI): 0.889-0.979, P = 0.005]. In the reverse MR analysis, we also observed an inverse association of hand grip strength with depression (OR: 0.200, 95%CI: 0.108-0.370, P < 0.001). Similar results were obtained in sensitivity analyses.

CONCLUSION

Depression was causally related to decreased muscle mass, and declined muscle strength might lead to a higher risk of depression.

Treatment outcomes and cognitive function following electroconvulsive therapy in patients with severe depression

BACKGROUND

Traditional treatments for major depressive disorder (MDD), including medication and therapy, often fail and have undesirable side effects. Electroconvulsive therapy (ECT) uses electrical currents to induce brief seizures in the brain, resulting in rapid and potent antidepressant effects. However, owing to misconceptions and controversies, ECT is not as widely used as it could and often faces stigmatization.

AIM

To evaluate the efficacy and safety of ECT compared to those of medication and/or therapy in patients with severe MDD.

METHODS

This prospective cohort study included 220 individuals with severe MDD who were divided into the ECT and non-ECT groups. The patients in the ECT group underwent bilateral ECT three times a wk until they either achieved remission or reached a maximum of 12 sessions. The non-ECT group received medication and/or therapy according to clinical guidelines for MDD. The primary outcome was the variation in the hamilton depression rating scale (HDRS) score from treatment/ECT initiation to week 12. In addition, patients’ quality of life, cognitive abilities, and biomarkers were measured throughout the study.

RESULTS

Although both groups showed significant improvements in their HDRS scores over time, the improvement was more pronounced in the ECT group than in the non-ECT group. Additionally, the ECT group exhibited a more substantial improvement in the quality of life and cognitive function than those of the non-ECT group. Compared with the non-ECT group, the ECT group exhibited evi-dently lower variations in the brain-derived neurotrophic factor (BDNF) and cytokine interleukin-6 (IL-6) levels. The side effects were generally mild and comparable between the two groups. ECT is safer and more potent than medication and/or therapy in mitigating depressive symptoms, enhancing well-being, and bolstering cognitive capabilities in individuals with severe MDD. ECT may also affect the levels of BDNF and IL-6, which are indicators of neuroplasticity and inflammation, respectively.

CONCLUSION

ECT has emerged as a potentially advantageous therapeutic approach for patients with MDD who are unresponsive to alternative treatments.

Correlation study between motor rehabilitation level and psychological state in patients with limb movement disorders after stroke

BACKGROUND

The psychological state of patients with post stroke limb movement disorders undergoes a series of changes that affect rehabilitation training and recovery of limb motor function.

AIM

To determine the correlation between motor rehabilitation and the psychological state of patients with limb movement disorders after stroke.

METHODS

Eighty patients with upper and lower limb dysfunction post stroke were retrospectively enrolled in our study. Based on Hospital Anxiety and Depression Scale (HADS) scores measured before rehabilitation, patients with HADS scores ≥ 8 were divided into the psychological group; otherwise, the patients were included in the normal group. Motor function and daily living abilities were compared between the normal and psychological groups. Correlations between the motor function and psychological status of patients, and between daily living ability and psychological status of patients were analyzed.

RESULTS

After 1, 2, and 3 wk of rehabilitation, both the Fugl-Meyer assessment and Barthel index scores improved compared to their respective baseline scores (P < 0.05). A greater degree of improvement was observed in the normal group compared to the psychological group (P < 0.05). There was a negative correlation between negative emotions and limb rehabilitation (-0.592 ≤ r ≤ -0.233, P < 0.05), and between negative emotions and daily living ability (-0.395 ≤ r ≤ -0.199, P < 0.05).

CONCLUSION

There is a strong correlation between motor rehabilitation and the psychological state of patients with post stroke limb movement disorders. The higher the negative emotions, the worse the rehabilitation effect.

Effects of different intervention methods on psychological flexibility, negative emotions and sleep quality in chronic hepatitis B

BACKGROUND

Patients with chronic hepatitis B (CHB) experience various problems, including low psychological flexibility, negative emotions, and poor sleep quality. Therefore, effective nursing interventions are required to reduce adverse events. Acceptance and commitment therapy (ACT) combined with enabling cognitive-behavioral education (ECBE) can improve patients' psychological and sleep. Therefore, we speculate that this may also be effective in patients with CHB.

AIM

To investigate the effects of different intervention methods on psychological flexibility, negative emotions, and sleep quality in patients with CHB.

METHODS

This retrospective study examined clinical and evaluation data of 129 patients with CHB. Intervention methods were divided into a conventional group (routine nursing, n = 69) and a combination group (ACT combined with ECBE, n = 60). We observed changes in psychological flexibility, negative emotions, sleep quality, and self-care ability in both groups. Observation items were evaluated using the Acceptance and Action Questionnaire-2nd Edition (AAQ-II), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), and Exercise of Self-Care Agency Scale (ESCA).

RESULTS

Compared with the conventional group, the AAQ-II score of the combined group was lower (Fbetween-group effect = 8.548; Ftime effects = 25.020; Finteraction effects = 52.930; all P < 0.001), the SAS score (t = 5.445) and SDS score (t = 7.076) were lower (all P < 0.001), as were the PSQI dimensions (tsleep quality = 4.581, tfall sleep time = 2.826, tsleep time = 2.436, tsleep efficiency = 5.787, tsleep disorder = 5.008, thypnotic drugs = 3.786, tdaytime dysfunction = 4.812); all P < 0.05). The ESCA scores for all dimensions were higher (thealth knowledge level = 6.994, tself-concept = 5.902, tself-responsibility = 19.820, tself-care skills = 8.470; all P < 0.001).

CONCLUSION

ACT combined with ECBE in patients with CHB can improve psychological flexibility and sleep quality, alleviate negative emotions, and improve self-care.

Serum neuronal pentraxin 2 is related to cognitive dysfunction and electroencephalogram slow wave/fast wave frequency ratio in epilepsy

BACKGROUND

Cognitive dysfunction in epileptic patients is a high-incidence complication. Its mechanism is related to nervous system damage during seizures, but there is no effective diagnostic biomarker. Neuronal pentraxin 2 (NPTX2) is thought to play a vital role in neurotransmission and the maintenance of synaptic plasticity. This study explored how serum NPTX2 and electroencephalogram (EEG) slow wave/fast wave frequency ratio relate to cognitive dysfunction in patients with epilepsy.

AIM

To determine if serum NPTX2 could serve as a potential biomarker for diagnosing cognitive impairment in epilepsy patients.

METHODS

The participants of this study, conducted from January 2020 to December 2021, comprised 74 epilepsy patients with normal cognitive function (normal group), 37 epilepsy patients with cognitive dysfunction [epilepsy patients with cognitive dysfunction (ECD) group] and 30 healthy people (control group). The mini-mental state examination (MMSE) scale was used to evaluate cognitive function. We determined serum NPTX2 levels using an enzyme-linked immunosorbent kit and calculated the signal value of EEG regions according to the EEG recording. Pearson correlation coefficient was used to analyze the correlation between serum NPTX2 and the MMSE score.

RESULTS

The serum NPTX2 level in the control group, normal group and ECD group were 240.00 ± 35.06 pg/mL, 235.80 ± 38.01 pg/mL and 193.80 ± 42.72 pg/mL, respectively. The MMSE score was lowest in the ECD group among the three, while no significant difference was observed between the control and normal groups. In epilepsy patients with cognitive dysfunction, NPTX2 level had a positive correlation with the MMSE score (r = 0.367, P = 0.0253) and a negative correlation with epilepsy duration (r = -0.443, P = 0.0061) and the EEG slow wave/fast wave frequency ratio value in the temporal region (r = -0.339, P = 0.039).

CONCLUSION

Serum NPTX2 was found to be related to cognitive dysfunction and the EEG slow wave/fast wave frequency ratio in patients with epilepsy. It is thus a potential biomarker for the diagnosis of cognitive impairment in patients with epilepsy.

Clinical value of ankle flexion and extension exercises combined with a psychological intervention in knee osteoarthritis

BACKGROUND

Considering the limited effectiveness of clinical interventions for knee osteoarthritis (KOA), it is necessary to continue to explore appropriate and effective treatment strategies to improve the condition of KOA patients.

AIM

To clarify the influence of ankle flexion and extension exercises combined with a psychological intervention on the psychological status and activities of daily living (ADLs) of patients with KOA.

METHODS

The research participants were 116 KOA patients admitted to The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine between May 2019 and May 2022, including 54 patients receiving routine treatment, care and psychological intervention (control group) and 62 patients additionally treated with ankle flexion and extension exercises (research group). The two groups were comparatively analyzed in terms of psychological status (Self-rating Anxiety/Depression Scale, SDS/SAS), ADLs, knee joint function (Lysholm Knee Scoring Scale), pain (Visual Analog Scale, VAS), fatigue (Multidimensional Fatigue Inventory, MFI), and quality of life (QoL; Short-Form 36 Item Health Survey, SF-36).

RESULTS

After evaluation, it was found that the postinterventional SDS, SAS, VAS, and MFI scores in the research group were significantly reduced compared with the baseline (before the intervention) values and those of the control group, while the postinterventional Lysholm, ADL and SF-36 scores were markedly elevated.

CONCLUSION

Therefore, ankle flexion and extension exercises are highly effective in easing negative psychological status, enhancing ADLs, daily living ability, knee joint function and QoL, and relieving pain and fatigue in KOA patients, thus warranting clinical promotion.

Analysis of mental health status and related factors in patients with acute cerebral infarction

BACKGROUND

Acute cerebral infarction (ACI) is characterized by a high incidence of morbidity, disability, recurrence, death and heavy economic burden, and has become a disease of concern in global researchers. As ACI has serious effects on patients' physical status, life and economy, often causing anxiety, depression and other psychological problems, these problems can lead to the aggravation of physical symptoms; thus, it is very important to understand the factors affecting the mental health of these patients.

AIM

To understand the elements that affect the mental health of patients who have suffered an ACI.

METHODS

A questionnaire survey was conducted among patients with ACI admitted to three tertiary hospitals (Quanzhou First Hospital, Fuqing City Hospital Affiliated to Fujian Medical University, and the 900 Hospital of the Joint Service Support Force of the People's Liberation Army of China) in Fujian Province from January 2022 to December 2022 using the convenience sampling method. ACI inpatients who met the inclusion criteria were selected. Informed consent was obtained from the patients before the investigation, and a face-to-face questionnaire survey was conducted using a unified scale. The questionnaire included a general situation questionnaire, Zung's self-rating depression scale and Zung's self-rating anxiety scale. All questionnaires were checked by two researchers and then the data were input and sorted using Excel software. The general situation of patients with ACI was analyzed by descriptive statistics, the influence of variables on mental health by the independent sample t test and variance analysis, and the influencing factors on psychological distress were analyzed by multiple stepwise regression.

RESULTS

The average age of the 220 patients with ACI was 68.64 ± 10.74 years, including 142 males and 78 females. Most of the patients were between 60 and 74 years old, the majority had high school or technical secondary school education, most lived with their spouse, and most lived in cities. The majority of patients had a personal income of 3001 to 5000 RMB yuan per month. The new rural cooperative medical insurance system had the largest number of participants. Most stroke patients were cared for by their spouses and of these patients, 52.3% had previously smoked. Univariate analysis showed that gender, age, residence, course of disease, number of previous chronic diseases and smoking history were the main factors affecting the anxiety scores of patients with ACI. Age, living conditions, monthly income, course of disease and knowledge of disease were the primary variables influencing the depression score in patients with ACI. The findings of multivariate analysis revealed that the course of disease and gender were the most important factors influencing patients' anxiety scores, and the course of disease was also the most important factor influencing patients' depression scores.

CONCLUSION

Long disease course and female patients with ACI were more likely to have psychological problems such as a high incidence of emotional disorders. These groups require more attention and counseling.

Sleep disturbances are associated with anxiety, depression, and decreased quality of life in patients with coronary heart disease

BACKGROUND

Studies have shown that sleep disorders are closely related to anxiety and depression, and the quality of life (QoL) of patients with sleep disorders is generally poor.

AIM

To examine the occurrence of sleep disorders in people with coronary heart disease (CHD) and their relationships with QoL, depression, and anxiety.

METHODS

As per the sleep condition, 240 CHD individuals were separated into two groups: non-sleep disorder group (n = 128) and sleep disorder group (n = 112). The self-rating anxiety scale (SAS), self-rating depression scale (SDS), and World Health Organization criteria for the Quality of Life Brief scale (WHOQOL-BREF) scores of the two groups were compared. Logistic regression method was used to analyze the independent risk factors of CHD patients with sleep disorders. Multivariate logistic regression analysis was employed to develop the risk prediction model. The association among the Pittsburgh Sleep Quality Index, SAS, and SDS was examined using Spearman's correlation analysis.

RESULTS

The incidence of sleep disorder was 46.67% in 240 patients. The scores of SAS and SDS in the sleep disorder group were higher than those in the non-sleep disorder group, and the WHOQOL-BREF scores were lower than those in the non-sleep disorder group (P < 0.05). The risk prediction model of sleep disturbances in CHD patients was constructed using the outcomes of multivariate logistic regression analysis, P = 1/[1 + e (-2.160 + 0.989 × (female) + 0.001 × (new rural cooperative medical insurance) + 2.219 × (anxiety) + 2.157 × depression)]. The results of a Spearman's correlation study revealed that sleep quality was strongly adversely connected with the physiological field, psychological field, and social relation scores in QoL, and was considerably positively correlated with SAS and SDS (P < 0.05).

CONCLUSION

A multivariate logistic regression model can better predict the occurrence of sleep disorders in CHD patients. Sleep disorders in CHD patients are significantly correlated with QoL, depression, and anxiety.

Construction and validation of a personalized prediction model for postpartum anxiety in pregnant women with preeclampsia

BACKGROUND

Preeclampsia is a pregnancy-specific multi-system disease with multi-factor and multi-mechanism characteristics. The cure for preeclampsia is to terminate the pregnancy and deliver the placenta. However, it will reduce the perinatal survival rate, prolong the pregnancy cycle, and increase the incidence of maternal complications. With relaxation of the birth policy, the number of elderly pregnant women has increased significantly, and the prevalence rate of preeclampsia has increased. Inappropriate treatment can seriously affect the normal postpartum life of pregnant women. Studies have shown that postpartum anxiety in women with preeclampsia can affect physical and mental health, as well as infant growth and development.

AIM

To analyze the factors influencing preeclampsia in pregnant women complicated with postpartum anxiety, and to construct a personalized predictive model.

METHODS

We retrospectively studied 528 pregnant women with preeclampsia who delivered in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine between January 2018 and December 2021. Their basic data were collected, and various physiological and biochemical indicators were obtained by laboratory examination. The self-rating anxiety scale was used to determine whether the women had postpartum anxiety 42 d after delivery. The independent factors influencing postpartum anxiety in early pregnant women with eclampsia were analyzed with multifactor logistic regression and a predictive model was constructed. The Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve were used to evaluate the calibration and discrimination of the predictive model. Eighty pregnant women with preeclampsia admitted to our hospital from January 2022 to May 2022 were retrospectively selected to verify the prediction model.

RESULTS

We excluded 46 of the 528 pregnant women with preeclampsia because of loss to follow-up and adverse outcomes. A total of 482 cases completed the assessment of postpartum anxiety 42 d after delivery, and 126 (26.14%) had postpartum anxiety. Bad marital relationship, gender discrimination in family members, hematocrit (Hct), estradiol (E2) hormone and interleukin (IL)-6 were independent risk factors for postpartum anxiety in pregnant women with preeclampsia (P < 0.05). Prediction model: Logit (P) = 0.880 × marital relationship + 0.870 × gender discrimination of family members + 0.130 × Hct - 0.044 × E2 + 0.286 × IL-6 - 21.420. The area under the ROC curve of the model was 0.943 (95% confidence interval: 0.919-0.966). The threshold of the model was -1.507 according to the maximum Youden index (0.757), the corresponding sensitivity was 84.90%, and the specificity was 90.70%. Hosmer-Lemeshow χ2 = 5.900, P = 0.658. The sensitivity, specificity and accuracy of the model were 81.82%, 84.48% and 83.75%, respectively.

CONCLUSION

Poor marital relationship, family gender discrimination, Hct, IL-6 and E2 are the influencing factors of postpartum anxiety in preeclampsia women. The constructed prediction model has high sensitivity and specificity.

Depression among medical students in Tunisia: Prevalence and associated factors

BACKGROUND

Medical school is known for its lengthy process, which is both physically and emotionally draining. Students' mental balance would shrink as they progress in their medical training. A systematic review and meta-analysis reported that the prevalence of depressive symptoms among medical students remained relatively constant at 27.2%.

AIM

To assess the prevalence of depressive symptoms among Tunisian medical students and evaluate its associated factors.

METHODS

This is a descriptive cross-sectional study that was carried out in the second semester of the academic year 2017/2018, between April 2018 and July 2018 among 1138 medical students. Data were collected using a socio-demographic questionnaire and the Beck Depression Inventory-II (BDI-II).

RESULTS

Sixty-four percent (n = 728) of the participants had depressive symptoms, of which 266 (23.4%) met the criteria for mild, 271 (23.8%) for moderate, and 191 (16.8%) for severe depressive symptoms. Female gender, low socio-economic level, smoking habits and history of mental disorder, performing leisure and physical activities, satisfaction toward a career choice, and happiness perception were the main prognostic factors for depression among medical students. Although academic grades may not be considered a prognostic factor, final-year students appeared to be less depressive than their colleagues.

CONCLUSION

These findings give insight into mental health issues and comorbidities among Tunisian medical students. It is a hopeful request for decision-makers and academic authorities to set serious measures and draw effective interventions to minimize the currency of psychological distress among this subpopulation.

International study of the Complex Stress Reaction Syndrome: Implications for transdiagnostic clinical practice

BACKGROUND

The debate regarding diagnostic classification systems in psychiatry (categorial vs dimensional systems) has essential implications for the diagnosis, prevention and treatment of stress reactions. We previously found a unique pattern of stress reaction in a study executed during the coronavirus disease 2019 pandemic using large representative samples in two countries, and termed it the Complex Stress Reaction Syndrome (CSRS).

AIM

To investigate CSRS, Type A (psychiatric symptoms, spanning anxiety, depression, stress symptoms, and post-traumatic stress disorder (PTSD)), with or without long-coronavirus disease (COVID) residuals (CSRS, Type B, neuropsychiatric symptoms spanning cognitive deficits and fatigue, excluding systemic symptoms). Our two-tailed hypothesis was that CSRS is a condition related to an unrecognized type of stress reaction in daily life in the general population (Type A) or that it is related to the severe acute respiratory syndrome coronavirus 2 infection and its long-COVID residuals (Type B).

METHODS

977 individuals in four continents (North America, Europe, Australia and the Middle East) completed the online study questionnaire in six languages using the Qualtrics platform. The study was managed by six teams in six countries that promoted the study on social media. The questionnaire assessed anxiety, depression, stress symptoms and PTSD (CSRS, Type A), cognitive deficits and fatigue (CSRS, Type B). The data were analyzed using Proportion Analyses, Multivariate Analysis of Co-Variance (MANCOVA), linear regression analyses and validated clinical cutoff points.

RESULTS

The results of the Proportion Analyses showed that the prevalence of 4 symptoms spanning anxiety, depression, stress symptoms, and PTSD was significantly higher than the most prevalent combinations of fewer symptoms across 4 continents, age groups, and gender. This supports the transdiagnostic argument embedded in the CSRS (Type A). The same pattern of results was found in infected/recovered individuals. The prevalence of the 4 psychiatric symptoms combination was significantly greater than that of 5 and 6 symptoms, when adding cognitive deficits and fatigue, respectively. MANCOVA showed a significant three-way interaction (age × gender × continent). Further analyses showed that the sources of this three-way interaction were threefold relating to two sub-populations at-risk: (1) Individuals that self-identified as non-binary gender scored significantly higher on all 4 psychiatric symptoms of the CSRS, Type A at young age groups (< 50 years old) in North America compared to (self-identified) women and men located in the 4 continents studied, and to other ages across the adult life span; and (2) This pattern of results (CSRS, Type A) was found also in women at young ages (< 40 years old) in North America who scored higher compared to men and women in other continents and other ages. Linear regression analyses confirmed the MANCOVA results.

CONCLUSION

These results show a combined mental health risk factor related to stress reactivity, suggesting that the CSRS is sensitive to populations at risk and may be applied to future identification of other vulnerable sub-populations. It also supports the transdiagnostic approach for more accurate prevention and treatment. Time will tell if such transdiagnostic syndromes will be part of the discussions on the next revisions of the traditional classification systems or whether the crisis in psychiatry further evolves.

Correlation between cognitive impairment and metabolic imbalance of gut microbiota in patients with schizophrenia

BACKGROUND

The gut microbiome interacts with the central nervous system through the gut-brain axis, and this interaction involves neuronal, endocrine, and immune mechanisms, among others, which allow the microbiota to influence and respond to a variety of behavioral and mental conditions.

AIM

To explore the correlation between cognitive impairment and gut microbiota imbalance in patients with schizophrenia.

METHODS

A total of 498 untreated patients with schizophrenia admitted to our hospital from July 2020 to July 2022 were selected as the case group, while 498 healthy volunteers who underwent physical examinations at our hospital during the same period were selected as a control group. Fluorescence in situ hybridization was employed to determine the total number of bacteria in the feces of the two groups. The cognitive function test package was used to assess the score of cognitive function in each dimension. Then, the relationship between gut microbiota and cognitive function was analyzed.

RESULTS

There were statistically significant differences in the relative abundance of gut microbiota at both phylum and class levels between the case group and the control group. In addition, the scores of cognitive function, such as atten-tion/alertness and learning ability, were significantly lower in the case group than in the control group (all P < 0.05). The cognitive function was positively correlated with Actinomycetota, Bacteroidota, Euryarchaeota, Fusobacteria, Pseudomonadota, and Saccharibacteria, while negatively correlated with Bacillota, Tenericutes, and Verrucomicrobia at the phylum level. While at the class level, the cognitive function was positively correlated with Class Actinobacteria, Bacteroidia, Betaproteobacteria, Proteobacteria, Blastomycetes, and Gammaproteobacteria, while negatively correlated with Bacilli, Clostridia, Coriobacteriia, and Verrucomicrobiae.

CONCLUSION

There is a relationship between the metabolic results of gut microbiota and cognitive function in patients with schizophrenia. When imbalances occur in the gut microbiota of patients, it leads to more severe cognitive impairment.

Correlation and pathways of behavioral activation systems mediating physical activity level and depressive symptoms among college students

BACKGROUND

Depression is a common mental disorder among college students. The main symptoms include being persistent low mood, sad emotional experiences, lack of pleasure, listlessness, and impaired cognitive function accompanied by tendencies of self-harm and suicide.

AIM

To clarify the pathways and effects of the behavioral activation system between physical activity and depressive symptoms in college students with depressive symptoms.

METHODS

This cross-sectional research screened 3047 college students. Of these, 472 had depressive symptoms, with a depression detection rate of 15.49%. Furthermore, 442 college students with depressive symptoms were analyzed. A one-way analysis of variance and Pearson's correlation, linear regression, and structural equation modeling analyses were used to explore the correlations and pathways of the interactions between the variables.

RESULTS

Depressive symptoms were significantly negatively correlated with physical activity (r = -0.175, P < 0.001), the behavioral activation system (r = -0.197, P < 0.001), and drive (r = -0.113, P = 0.017). Furthermore, it was negatively correlated with fun-seeking (FS) (r = -0.055, P = 0.251); however, it was not significant. Physical activity was significantly positively correlated with reward responsiveness (RR) (r = 0.141, P = 0.003) and drive (r = 0.124, P = 0.009) and not significantly positively correlated with FS (r = 0.090, P = 0.058). The mediating effect of RR between physical activity and depressive symptoms was significant [B = -0.025, 95% confidence interval (95%CI): -0.051 to -0.008, P = 0.001]. The direct and total effects of physical activity on depressive symptoms and were significant (B = -0.150, 95%CI: -0.233 to -0.073, P < 0.001; B = -0.175, 95%CI: -0.260 to -0.099, P < 0.001), respectively.

CONCLUSION

As physical activity levels increased, depression scores among college students decreased. The mediating effect of RR between physical activity and depressive symptoms was significant. Therefore, colleges and universities should encourage college students with depression to increase their physical activity and improve their behavioral activation system. Particular attention should be paid to RR, which may reduce the prevalence of depressive symptoms.