1
|
Zhang L, Zhang W, Tian X. The pleiotropic of GLP-1/GLP-1R axis in central nervous system diseases. Int J Neurosci 2023; 133:473-491. [PMID: 33941038 DOI: 10.1080/00207454.2021.1924707] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Glucagon-like peptide-1(GLP-1) is a multifunctional polypeptide throughout the lifespan via activating Glucagon-like peptide-1 receptor (GLP-1R).GLP-1 can affect food ingestion, enhance the secretion of insulin from pancreatic islets induced by glucose and be utilized to treat type 2 diabetes mellitus(T2DM).But, accumulating evidences from the decades suggest that activation GLP-1R can not only regulate the blood glucose, but also sustain the homeostasis of intracellular environment and protect neuron from various damaged responses such as oxidative stress, inflammation, excitotoxicity, ischemia and so on. And more and more pre-clinical and clinical studies identified that GLP-1 and its analogues may play a significant role in improving multiple central nervous system (CNS) diseases including neurodegenerative diseases, epilepsy, mental disorders, ischemic stroke, hemorrhagic stroke, traumatic brain injury, spinal cord injury, chronic pain, addictive disorders, other diseases neurological complications and so on. In order to better reveal the relationship between GLP-1/GLP-1R axis and the growth, development and survival of neurons, herein, this review is aimed to summarize the multi-function of GLP-1/GLP-1R axis in CNS diseases.
Collapse
Affiliation(s)
- LongQing Zhang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wen Zhang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - XueBi Tian
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
2
|
Pizarro Meléndez GP, Valero-Jara V, Acevedo-Hernández P, Thomas-Valdés S. Impact of polyphenols on stress and anxiety: a systematic review of molecular mechanisms and clinical evidence. Crit Rev Food Sci Nutr 2022; 64:2340-2357. [PMID: 36154755 DOI: 10.1080/10408398.2022.2122925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Mental health is a global public concern that contributes raising disability and premature death. Anxiety undertakes around 3.6% of the global population, while psychological stress is a condition associated to anxiety with a prevalence of 36.5%. Treatment for both mental conditions consist mainly of psychological therapy and pharmacotherapy, but the long-term drugs use can trigger adverse effects. Growing evidence shows the effect of specific food compounds on stress and anxiety treatment. The aim of this systematic review is to describe the molecular mechanisms related to dietary polyphenols administration from food matrix (considering food, juices or herbal/food extracts) and their effects on stress and/or anxiety, as well as review the available clinical evidence. Search was based on PRISMA Guidelines using peer-reviewed journal articles sourced from PubMed and Web of Science. A total of 38 articles were considered as eligible. The major effects for anxiety management were: reduction of oxidative stress and inflammation; HPA axis modulation; and regulation of some serotonergic/adrenergic pathways. There is a very limited evidence to conclude about the real effect of dietary polyphenols on stress. Although pharmacological treatment for mood disorders is essential, alternative therapies are necessary using non-pharmacological compounds to improve the long-term treatment effectiveness.
Collapse
Affiliation(s)
| | - Viviana Valero-Jara
- Programa de Doctorado en Ciencias e Ingeniería para la Salud, Facultad de Medicina, Universidad de Valparaíso, Valparaiso, Chile
| | - Paula Acevedo-Hernández
- Programa de Doctorado en Ciencias mención Neurociencias, Facultad de Ciencias, Universidad de Valparaíso, Valparaiso, Chile
| | - Samanta Thomas-Valdés
- Escuela de Nutrición y Dietética, Facultad de Farmacia, Universidad de Valparaíso, Valparaiso, Chile
| |
Collapse
|
3
|
Liang F, Xu Q, Jiang M, Feng R, Jiang S, Yuan B, Xu S, Wu T, Wang F, Huang JH. Emotion Induced Monoamine Neuromodulator Release Affects Functional Neurological Disorders. Front Cell Dev Biol 2021; 9:633048. [PMID: 33659255 PMCID: PMC7917220 DOI: 10.3389/fcell.2021.633048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/15/2021] [Indexed: 01/11/2023] Open
Abstract
Functional neurologic disorders (FNDs), also called conversion disorder (previously called hysteria), can show almost all the symptoms of other neurological diseases, including both physical (for example, seizure, weakness, fatigue) and psychological (for instance, depression, anxiety) symptoms. In spite of our general knowledge about emotional processes and developmental defects in the formation of these somatic symptoms, there is still no systemic and comprehensive research on the effects of emotional developmental variables in FND. Recently, both experimental and theoretical emotion studies have been greatly increased, such as prediction error, conceptual act model, basic emotional theory, and monoamine neuromodulator based three primary emotions. In addition, a large amount of evidence has confirmed the role of psychosocial adversity (such as stressful life events, interpersonal difficulties) as an important risk factor for FND. Here, we review recent advances about emotional stress on FND, and pay special attention to the effects of monoamine neuromodulators, such as how norepinephrine and serotonin affect behaviors. Then, we discuss the significance of these changes for FND, which may contribute to clarifying the pathogenesis of FND, and thus provide potential therapeutic drug targets or psychological intervention methods in the future.
Collapse
Affiliation(s)
- Fei Liang
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Qiuyue Xu
- School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Mingchen Jiang
- School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Jiangsu Key Laboratory of Pediatric Respiratory Disease, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Rou Feng
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Shan Jiang
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Bin Yuan
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shijun Xu
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ting Wu
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fushun Wang
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Jason H Huang
- Department of Neurosurgery, Baylor Scott & White Health, Temple, TX, United States.,Department of Surgery, College of Medicine, Texas A&M University, Temple, TX, United States
| |
Collapse
|
4
|
Role of BDNF-mTORC1 Signaling Pathway in Female Depression. Neural Plast 2021; 2021:6619515. [PMID: 33628219 PMCID: PMC7886502 DOI: 10.1155/2021/6619515] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/22/2021] [Indexed: 12/18/2022] Open
Abstract
Depression is a common psychological and mental disorder, characterized by low mood, slow thinking and low will, and even suicidal tendencies in severe cases. It imposes a huge mental and economic burden on patients and their families, and its prevention and treatment have become an urgent public health problem. It is worth noting that there is a significant gender difference in the incidence of depression. Studies have shown that females are far more likely to suffer from depression than males, confirming a close relationship between estrogen and the onset of depression. Moreover, recent studies suggest that the brain-derived neurotrophic factor- (BDNF-) mammalian target of rapamycin complex-1 (mTORC1) signaling pathway is a crucial target pathway for improving depression and mediates the rapid antidepressant-like effects of various antidepressants. However, it is not clear whether the BDNF-mTORC1 signaling pathway mediates the regulation of female depression and how to regulate female depression. Hence, we focused on the modulation of estrogen-BDNF-mTORC1 signaling in depression and its possible mechanisms in recent years.
Collapse
|
5
|
Zappella M, Biamonte F, Balzamino BO, Manieri R, Cortes M, Santucci D, Di Stasio E, Rizzuto M, Micera A. Relaxation Response in Stressed Volunteers: Psychometric Tests and Neurotrophin Changes in Biological Fluids. Front Psychiatry 2021; 12:655453. [PMID: 34220571 PMCID: PMC8247444 DOI: 10.3389/fpsyt.2021.655453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: To evaluate the beneficial effects of relaxation response (RR) training in adult stressed subjects by evaluating the psychometric response recorded at relaxation session. Cortisol as well as nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) mediators were quantified in both saliva and tears, and their levels were related to each other and to the psychometric response. Methods: Stressed subjects (n = 23; 10M/13F; age range 21-53 years old) were voluntarily enrolled in the study. RR training sessions were carried out for 2 months, 1 day per week, at the same time (3-5 p.m.). Two different psychological questionnaires, the Perceived Stress Scale-10 (PSS-10) and the Beck Depression Inventory - Short Form (BDI-SF) and Ocular Surface Disease Index (OSDI) tests, were administered before each session. Saliva and tears were sampled for cortisol (EIA), NGF (ELISA), and BDNF (ELISA) quantifications. Questionnaires' data were analyzed and compared to biochemical ones. Results: All subjects reported beneficial effects from training. RR significantly reduced the psychological stress indexes (p = 0.039 for PSS-10 and p = 0.001 for BDI-SF). Specifically, RR training lowered the perception of Perceived Helplessness (items 1, 3, 10; p < 0.05) in PSS-10 and increased the Perceived Self-Efficacy (p < 0.05). OSDI score was in the normal range (0-25). Biochemically, a decrease in cortisol, a trend to a decrease in NGF, and an increase in BDNF levels were observed in saliva samples after RR treatment. Furthermore, a trend to a decrease in NGF and an increase in BDNF were quantified in tear samples. A correlation between PSS-10 total score and saliva NGF variation (%) as well as between BDI-SF total score and BDNF tear levels were also observed. Conclusion: RR training appeared useful to lowering psychological, mental, and physical stress, as supported by both psychological total and single scores. The finding on biochemical levels of BDNF in saliva and tears are sustained by previous studies while those of NGF require further investigation. Overall, these data on a small population highlight the potential use of RR training and potential neurotrophic changes in biological fluids, in stressed volunteers.
Collapse
Affiliation(s)
- Miriam Zappella
- Department of Psychology, Salesian University of Rome, Rome, Italy.,Department of Neuroscience, IRCCS Children's Hospital Bambino Gesù, Rome, Italy
| | - Filippo Biamonte
- Department of Basic Biotechnological Sciences, Intensive and Perioperative Clinics, Catholic University of the Sacred Heart, Rome, Italy
| | - Bijorn Omar Balzamino
- Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences; IRCCS - Fondazione Bietti, Rome, Italy
| | - Rocco Manieri
- Department of Laboratory and Infectivological Sciences, UOC Chemistry, Biochemistry and Molecular Biology Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Magdalena Cortes
- Hebrew Hospital Rome Ophthalmology Department, Rome, Italy.,Prevention and Health Care Department, Campus Bio Medico University, Rome, Italy
| | - Daniela Santucci
- Cellular Biology and Neurosciences, Istituto Superiore di Sanita, Rome, Italy
| | - Enrico Di Stasio
- Department of Basic Biotechnological Sciences, Intensive and Perioperative Clinics, Catholic University of the Sacred Heart, Rome, Italy.,Department of Laboratory and Infectivological Sciences, UOC Chemistry, Biochemistry and Molecular Biology Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maurizio Rizzuto
- Department of Psychology, Salesian University of Rome, Rome, Italy
| | - Alessandra Micera
- Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences; IRCCS - Fondazione Bietti, Rome, Italy
| |
Collapse
|
6
|
Birmann PT, Domingues M, Casaril AM, Smaniotto TÂ, Hartwig D, Jacob RG, Savegnago L. A pyrazole-containing selenium compound modulates neuroendocrine, oxidative stress, and behavioral responses to acute restraint stress in mice. Behav Brain Res 2020; 396:112874. [PMID: 32835778 DOI: 10.1016/j.bbr.2020.112874] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 01/07/2023]
Abstract
The contribution of oxidative stress has been described in numerous studies as one of the main pathways involved in the pathophysiology of anxiety and its comorbidities, such as chronic pain. Therefore, in this study, we investigated the anxiolytic-like, antiallodynic, and anti-hyperalgesic effects of 3,5-dimethyl-1-phenyl-4-(phenylselanyl)-1H-pyrazole (SePy) in response to acute restraint stress (ARS) in mice through the modulation of oxidative stress and neuroendocrine responses. Mice were restrained for 2 h followed by SePy (1 or 10 mg/kg, intragastrically) treatment. Behavioral, and biochemical tests were performed after further 30 min. The treatment with SePy reversed (i) the decreased time spent and the number of entries in the open arms of the elevated plus-maze apparatus, (ii) the decreased time spent in the central zone of the open field test and the increased number of grooming, (iii) the increased number of marbles buried, (iv) the increased response frequency of Von Frey Hair stimulation, and (v) the decreased latency time to nociceptive response in the hot plate test stress induced by ARS. Biochemically, SePy reversed ARS-induced increased levels of plasma corticosterone, and reversed the ARS-induced alterations in the levels of reactive species, lipid peroxidation, and superoxide dismutase and catalase activities in the prefrontal cortices and hippocampi of mice. Moreover, a molecular docking approach suggested that SePy may interact with the active site of the glucocorticoid receptor. Altogether, these results indicate that SePy attenuated anxiolytic-like behavior, hyperalgesia, and mechanical allodynia while modulating oxidative stress and neuroendocrine responses in stressed mice.
Collapse
Affiliation(s)
- Paloma T Birmann
- Technologic Development Center, Biotechnology Unit, Neurobiotechnology Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Micaela Domingues
- Technologic Development Center, Biotechnology Unit, Neurobiotechnology Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Angela M Casaril
- Technologic Development Center, Biotechnology Unit, Neurobiotechnology Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Thiago  Smaniotto
- Technologic Development Center, Biotechnology Unit, Neurobiotechnology Research Group, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Daniela Hartwig
- Center of Chemical, Pharmaceutical and Food Sciences, Laboratory of Clean Organic Synthesis, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Raquel G Jacob
- Center of Chemical, Pharmaceutical and Food Sciences, Laboratory of Clean Organic Synthesis, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Lucielli Savegnago
- Technologic Development Center, Biotechnology Unit, Neurobiotechnology Research Group, Federal University of Pelotas, Pelotas, RS, Brazil.
| |
Collapse
|
7
|
de Bem GF, Okinga A, Ognibene DT, da Costa CA, Santos IB, Soares RA, Silva DLB, da Rocha APM, Isnardo Fernandes J, Fraga MC, Filgueiras CC, Manhães AC, Soares de Moura R, Resende AC. Anxiolytic and antioxidant effects of Euterpe oleracea Mart. (açaí) seed extract in adult rat offspring submitted to periodic maternal separation. Appl Physiol Nutr Metab 2020; 45:1277-1286. [PMID: 32516542 DOI: 10.1139/apnm-2020-0099] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Many studies suggest a protective role of phenolic compounds in mood disorders. We aimed to assess the effect of Euterpe oleracea (açaí) seed extract (ASE) on anxiety induced by periodic maternal separation (PMS) in adult male rats. Animals were divided into 6 groups: control, ASE, fluoxetine (FLU), PMS, PMS+ASE, and PMS+FLU. For PMS, pups were separated daily from the dam for 3 h between postnatal day (PN) 2 and PN21. ASE (200 mg·kg-1·day-1) and FLU (10 mg·kg-1·day-1) were administered by gavage for 34 days after stress induction, starting at PN76. At PN106 and PN108, the rats were submitted to open field (OF) and forced swim tests, respectively. At PN110, the rats were sacrificed by decapitation. ASE increased time spent in the center area in the OF test, glucocorticoid receptors in the hypothalamus, tropomyosin receptor kinase B (TRKB) levels in the hippocampus, and nitrite levels and antioxidant activity in the brain stem (PMS+ASE group compared with PMS group). ASE also reduced plasma corticotropin-releasing hormone levels, adrenal norepinephrine levels, and oxidative damage in the brain stem in adult male offspring submitted to PMS. In conclusion, ASE treatment has an anti-anxiety effect in rats submitted to PMS by reducing hypothalamic-pituitary-adrenal axis reactivity and increasing the nitric oxide (NO)-brain-derived neurotrophic factor (BDNF)-TRKB pathway and antioxidant defense in the central nervous system. Novelty ASE has anti-anxiety and antioxidant effects in early-life stress. ASE reduces hypothalamic-pituitary-adrenal axis reactivity. The anxiolytic effect of ASE may involve activation of the NO-BDNF-TRKB pathway in the central nervous system.
Collapse
Affiliation(s)
- Graziele Freitas de Bem
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Anicet Okinga
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Dayane Teixeira Ognibene
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Cristiane Aguiar da Costa
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Izabelle Barcellos Santos
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Ricardo Andrade Soares
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Dafne Lopes Beserra Silva
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Ana Paula Machado da Rocha
- Department of Physiology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, MG 36036-900, Brazil
| | - Jemima Isnardo Fernandes
- Department of Physiology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Mabel Carneiro Fraga
- Department of Physiology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Cláudio Carneiro Filgueiras
- Department of Physiology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Alex Christian Manhães
- Department of Physiology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Roberto Soares de Moura
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| | - Angela Castro Resende
- Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil
| |
Collapse
|
8
|
Zhang X, Li H, Sun H, Jiang Y, Wang A, Kong Y, Sun X, Zhu G, Li Q, Du Z, Sun H, Sun L. Effects of BDNF Signaling on Anxiety-Related Behavior and Spatial Memory of Adolescent Rats in Different Length of Maternal Separation. Front Psychiatry 2020; 11:709. [PMID: 32793001 PMCID: PMC7391957 DOI: 10.3389/fpsyt.2020.00709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022] Open
Abstract
As an adverse form of early-life stress (ELS), maternal separation (MS) can interfere with the development of cognition and behaviors of adolescent rodents. Brain-derived neurotrophic factor (BDNF) is involved in the regulation of brain development and function, but the molecular mechanisms by which BDNF regulates brain function and behavior in MS with different stressor strengths remain unclear. This descriptive study characterized the levels of BDNF in the prefrontal cortex (PFC) and plasma corticosterone (CORT) from the offspring of rats exposed to early handling (EH, 15-min separation per day) and prolonged MS (PMS, 180-min separation per day), during postnatal days (PND) 1‑21. The behavioral and biochemical analyses were performed during adolescence (PND 42‑56). PMS resulted in reduced weight and decreased locomotor activity in the open field test and Y-maze task compared to control (CON) group, with EH showing an intermediate phenotype. BDNF protein levels in the PFC were lower in PMS compared to EH and further reduced in CON male rats. Plasma CORT levels were higher in PMS compared to CON with EH again showing intermediate levels. Neither PMS or EH affected spatial learning in the Y-maze task. These findings indicate that longer periods of maternal separation are necessary to increase anxiety-like behavior, elevate CORT levels, and further suppress BDNF levels in the PFC, providing a possible mechanism to explain why more severe forms of ELS lead to more significant psychiatric and medical consequences later in life.
Collapse
Affiliation(s)
- Xianqiang Zhang
- Department of Psychology, Weifang Medical University, Weifang, China
| | - Haonan Li
- Department of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Haoran Sun
- Department of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Yinghong Jiang
- Department of Psychology, Weifang Medical University, Weifang, China
| | - Aihong Wang
- Department of Hematology, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Yujia Kong
- School of Public Health and Management, Weifang Medical University, Weifang, China
| | - Xiue Sun
- Department of Nursing, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Guohui Zhu
- Depression Treatment Center, Weifang Mental Health Center, Weifang, China
| | - Qi Li
- Department of Psychiatry and Centre for Reproduction Growth and Development, University of Hong Kong, Hong Kong, Hong Kong
| | - Zhongde Du
- Department of Neurology, Sunshine Union Hospital, Weifang, China
| | - Hongwei Sun
- Department of Psychology, Weifang Medical University, Weifang, China
| | - Lin Sun
- Department of Psychology, Weifang Medical University, Weifang, China
| |
Collapse
|