Abstract:Mental health problems have become one of the most important problems affecting the health of residents. This paper discusses the status of mental health， analyzes the development of mental health services in China， and lists the achievement of mental health services. This paper also puts forward some related problems in the research of mental health services in China and the relevant policy suggestions and development directions for the future development of mental health services.

Abstract:Objective To investigate the anti-depressant effects of psoralen and its mechanisms. Methods The anti-depressant effects of psoralen were evaluated by the forced swimming tests in rats and mice and the tail suspension test in mice. The animals were randomly divided into four groups： control group， low dose psoralen group， high dose psoralen group and amitriptyline group. The effects of psoralen on immobility time were measured in the forced swimming test and tail suspension test in rats and mice. Likewise， PC12 cells injury was induced by corticosterone and the effects of psoralen on the cell viability were measured by MTT assay. Results Psoralen significantly decreased the immobility time in the forced swimming tests and tail suspension test in rats and mice， which were significantly different compared with the control group（ P＜0.05）. In addition， psoralen could improve the survival rate of PC12 cells injuried by corticosterone. Conclusions Psoralen has anti-depressant effects and its mechanisms may be involved in the protective effects of neural cells.

Abstract:Objective To investigate the effects of aerobic exercise intervention on depression and social function for patients with depression symptoms in the hospital. Methods A total of 60 patients with depression were selected in Shanghai Mental Health Center， and were divided into 2 groups by random number table， 30 in the research group and 30 in the control group. The control group was treated with antidepressant drugs and conventional nursing service. Besides the same treatment received in the research group， patients in the control group had done aerobic exercise such as rope skipping and jogging for 8 weeks. All patients were scored by HAMD， Nurses' Observation Scale for Inpatient Evaluation（ NOSIE-30）， Social Disability Screen Schedule（ SDSS） before the research and at the 4th， 8th week after intervention. Results Through antidepressant drugs， conventional nursing service and aerobic exercise intervention， the scores of HAMD and SDSS at end of the 8th week of both groups were lower than before， and the result of research group is more significant（ P ＜ 0.01）. After intervention， total positive factors of NOSIE-30 and overall assessment of both groups were higher， especially the research group（ P＜0.01）. The score of total negative factors is lower than that before intervention， especially the research group（ P ＜ 0.01）. Conclusions Aerobic exercise can significantly improve depression symptoms and social function of patients with depression.

Abstract:Objective To understand the situation of medical visit in patients with mental illness in Hebei Province. Methods This study was part of the epidemiological investigation of mental disorders in Hebei Province. The "Structured Clinical Interview for DSM- Ⅳ "（ SCID- Ⅰ /P） was used as a diagnostic tool with the diagnostic criteria of "diagnostic and statistical manual of mental disorders in the United States"（ DSM- Ⅳ）. The self-made questionnaire on mental health services utilization was carried out in patients with mental disorders. Results Among the 1 826 cases of effective questionnaire， there were 233 patients had been with mental health service， with a visiting rate of 12.76%. In general information， rural/urban household registration， age， marital status and employment situation had an impact on the visiting rate（ P＜ 0.01）. The visiting rates of patients with mood disorders， psychiatric schizophrenia and other psychiatric disorders， substance use disorders， anxiety disorders， somatoform disorder and eating disorders were respectively 15.32%（95/620）， 66.18%（90/136），1.75%（7/400），5.72%（37/647）and 17.39%（4/23）. The difference of visiting rate among different diseases was statistically significant（ χ2=425.068，P＜ 0.01）. The top three of the patients who came to the clinic were anxious and depress， insomniac and delusional. For the first visit， only 5.6% of patients came to the mental health facility. Conclusions Most people with mental health service demand failed to get the corresponding mental health services. The current mental health services can only be used by a small group of people， which indicates that the utilization level of mental health services in Hebei is relatively low， and the current situation of mental health services is not optimistic.

Abstract:Objective To explore the status of accessing medical service of patients with mental disorders in rural areas and its influencing factors. Methods A sampling survey in rural areas of Hebei Province was carried out based on the DSM- Ⅳ criteria ， using the "DSM- Ⅳ axis Ⅰ disorder in clinical interview check "（ SCID-Ⅰ/P） as a diagnostic tool. A total of 1 581 patients were selected in rural areas to take the self-made questionnaire of mental health services. All of the objects were interviewed with "Questionnaire on Behaviors of Help Seeking of Patients with Mental Disorders"（ self-compiled） by investigators. Results At last， 208（ 13.2%） patients visited hospitals， and the rate of female patients（ 14.9%） was significantly higher than that of male patients（ 11.3%）. The results of Binary Logistic regression showed that the influencing factors of the status of accessing medical service were whether they have participated the new rural cooperative medical care system（ OR=2.116）， age（ OR=1.882）， whether they have received the information of disease（ OR=5.186）， their employment situation（ OR=0.522） and whether they are low-income residents（ OR=2.863）. Conclusions The utilization of mental health services is considerably low among rural patients with mental disorders who lack of the knowledge of mental disease in Hebei. The main factors influencing health services utilization are gender， age， marital status， employment status， disease information propaganda， clinic distance， whether they had participated in the new rural cooperative medical care system and whether they are low-income residents.

Abstract:Objective To investigate mental health visits and related influencing factors in elderly （over 60 years old） mentally ill patients with chronic diseases. Methods "Diagnostic and Statistical Manual of Mental Disorders"（ DSM-Ⅳ） was used as the diagnostic criteria， "DSM-Ⅳ axis Ⅰ disorder with clinical definite examination"（ SCID-Ⅰ/P） as a diagnostic tool. All subjects were asked by the investigators and filled the selfdesigned "Hebei Mental Health Service Utilization Checklist". The mental ill patients over 60 years old with chronic diseases were screened out. Results 8.8%（ 49/556） of the elderly patients with chronic disease sought for medical service after the appearance of psychiatric symptoms. Chi-square test analysis showed that whether the patient is low income residents， self-care ability， action and clinic distance have impacts on the decision of seeing a doctor. Binary Logistic regression analysis showed that whether the patient was low income residents and the action function were the influencing factors（ P＜0.05）. Conclusions The rate of mental health visits for elderly patients with mental disorders with chronic diseases is low， and mental health service systems for the elderly patients with mental disorders need to be further improved.

Abstract:Objective To understand the medical situation and distribution of mental disorders of people with mental disorders and other chronic diseases in Hebei Province， and to explore the relevant factors influencing the treatment of patients with mental disorders accompanied with other chronic diseases. Methods Data came from the second mental health epidemiological survey in Hebei province in 2016. In this survey， a multi-stage stratified cluster sampling method was used to investigate the mental health service utilization of the residents in 10 cities in the province， by using the self-made questionnaire by Hebei Mental Health Center. In this study， patients with mental disorders accompanied with chronic diseases were selected for further analysis of their medical treatment. Results Among the 961 cases， 101 patients chose to have a treatment after they had psychiatric symptoms， with a rate of 10.5%. The attendance rate of female（ 11.9%） was significantly higher than that of male（ 8.7%）， and the attendance rate of rural household（ 12.0%） was significantly higher than that of urban household（ 6.5%）. In addition， the impact of age， distance， marital status， employment situation and family income on the attendance rate were statistically significant. The results of Logistic regression analysis showed that distance， marital status， whether poor households and subsistence allowances were factors affecting the attendance of people with mental disorders accompanied with chronic diseases. Among the 101 patients who had been treated， 29（28.7%） of them had access to the psychiatric institution. Conclusions The mental health service utilization of mental disorders accompanied with chronic diseases in Hebei Province is relatively low， most mental health services needs of patients with mental disorders accompanied by other chronic diseases failed to receive mental health professional services.

Abstract:Objective To analyze the differences in the distance between patients with mental disorders and medical services， so as to provide references for the allocation of mental health resources in Hebei Province. Methods From June to August in 2016， the patients who has been diagnosed with mental disorder in the second epidemiological investigation of mental disorders in Hebei Province were investigated for the distance from medical services and the their method of seeking for medical service by questionnaires. Descriptive analysis of data and χ2 test were performed. Results A total of 2 186 questionnaires were released. The number of recovery questionnaires which met the recovery criteria with full filled information was 1 961： 1 826 cases of mental disorders and 135 cases of mental retardation and dementia. The constituent rate of patients within a distance of 30 km was 67.67%（ 1 327/1 961）. There were 426 cases patients who have not been treated for mental illness. Other patients have taken different methods to seek medical services like mental health institutions， clinics and hospitals， or have taken superstitious and other non-medical methods. The differences between constituent rate of treatment distance and methods of seeking medical service were statistically significant（ P ＜ 0.05）. Conclusions The distance between medical service and patients are different from cities in Hebei Province. The access to mental health service and feeling in patients with different treatment distance are different.

Abstract:Objective To analyze the current situation of mental health visits and the influencing factors for people over 60 in Hebei Province， so as to provide reference for improving the utilization level of mental health services for the elderly. Methods Multistage stratified cluster sampling was carried out throughout the province. Chi-square test was used to analyze the basic demographic data， health condition and mental health service utilization of the elderly patients over 60， and Binary logistic regression was used to analyze the influencing factors. Results Among the 946 elderly patients with the age 60 and above， the number of visits was only 83， the rate of visit was 8.77%. The rate of female visits（ 10.29%） was higher than that of men （6.96%）. Female， participating in Rural Subsistence Security System， participating in NCMS， care demand， having health records were the protective factors of visits. Conclusions The rate of mental health visits for the elderly in Hebei is relatively low. It is necessary to improve the mental health service system for the elderly.

Abstract:Objective To investigate the influencing factors of duration of untreated psychosis（ DUP） in patients with mental disorders. Methods "Diagnostic and Statistical Manual of Mental Disorders"（ DSMIV） was used as the diagnostic criteria， "DSM-Ⅳ axis Ⅰ disorder with clinical definite examination"（ SCID-Ⅰ/P） as a diagnostic tool. The screened psychiatric patients were investigated with a self-designed "Hebei Mental Health Service Utilization Checklist". Results Totally 252 patients have been diagnosed among 1 826 screened psychiatric patients， and DUP was 15（ 4， 30） days. The patients were assigned into short DUP group（ DUP≤ 15 d） and long DUP group（ DUP＞15 d）， with 149 and 103 cases respectively in the two groups. The comparison of the two groups showed that there was significant difference of the nature of the account（ χ2=4.123， P=0.032）， being diagnosed with chronic diseases by doctors in recent 6 months（ χ2=12.091， P＜ 0.01）， the distance from residence place to the nearest mental health organization（ χ2=24.867， P ＜ 0.01）， whether received health education on prevention and treatment of related diseases before the discovery of mental illness（ χ2=4.223， P=0.040）， whether the first visit medical institution was special hospital（ χ2=4.449， P=0.035）， the first intervention taken when symptoms appeared（ χ2=21.431， P ＜ 0.01）. Logistic regression analysis showed that being diagnosed by doctors in recent 6 months was risk factor（ OR=4.950， 95%CI=1.805-9.291）. Another risk factor of DUP was rural household（ OR=2.041， 95%CI=1.021-3.973）. Conclusions The influencing factors of DUP should be considered in different aspects. Among them， chronic diseases and rural household have a great impact on the DUP of patients.

Abstract:Objective To make a comparison of the application value of c-TCD and c-TTE in the diagnosis of migraine with right to left shunt（ RLS） in heart. Methods A total of 110 cases of patients with migraine cured in Neurology Department of Hu'nan Brain Hospital from June 2017 to December 2017 were selected. The positive rates of RLS in these selected patients were examined by c-TTE and c-TCD respectively， with transesophageal contrast echocardiography（ CTEE） as the gold standard. The differences of positive rate of RLS in the two examinations were studied. According to the amount of microbubbles， the c-TCD was divided into 3 levels. The difference of the positive rate of c-TTE in different level of microbubbles were compared. At the same time， the correlation study was carried out between the diameter of Patent Foramen Ovale（ PFO） and the amount of microbubbles. Results RLS detection was higher under c-TCD than that under c-TTE（ 75.45% vs 57.27%， χ2=8.092， P=0.004）. The differences had statistical significance. The c-TTE compared with c-TEE showed： sensitivity 69.66%， specificity 100%， and accuracy 75.40%. The detection of c-TCD in small amounts of microbubbles was significantly higher than that of c-TTE（ χ2=4.082， P=0.043；χ2=4.271，P=0.039）. After Pearson correlation analysis， a moderately positive correlation was presented between the diameter of PFO and the amount of microbubbles（ r=0.525） in 62 patients with positive c-TTE examination. Conclusions The amount of microbubbles increases with the diameter of PFO. C-TCD can be used as the preferred method of screening for migraine patients with or without RLS.

Abstract:Objective To investigate the association of the effect of modified electroconvulsive therapy with polymorphism of rs326174 loci in ADCY-2 gene in Chinese patients with bipolar disorder. Methods A total of 100 patients with bipolar disorder（ BPD） were distributed into MECT group and non MECT group by random number table method with 50 cases in each group. The polymorphism of rs326174 loci in ADCY-2 gene was detected by TaqMan genotyping. The efficacy was evaluated by the General Rating Scale（GAS）. The results were statistically analyzed. Results There was no difference in genotype distribution between the two groups. A and C alleles were both detected in two groups. There were three genotypes： AA， AC and CC. At baseline， there was no statistically significant difference in GAS score between the two groups（ P＞0.05）， while GAS score in group MECT were significantly higher than those in non MECT group at the first weekend， the second weekend and the fourth weekend after treatment（ P＜ 0.05）. In the MECT group， there was no statistical difference in the GAS score among the three genotypes of patients before treatment and the fourth weekend after treatment （P＞ 0.05）. At both end of the first and second week， the score of GAS in three genotypes from high to low were AA， AC and CC genotype， and the difference was statistical significant（ P＜0.05）. Conclusions MECT is an effective method for the treatment of bipolar disorder. The polymorphism of ADCY2 gene may be associated with efficacy of MECT.

Abstract:Objective To explore the influence of self-acceptance training on the rehabilitation happiness and self-esteem of schizophrenia patients. Methods From May 2015 to May 2017， a total of 110 cases of schizophrenia patients in the First Affiliated Hospital of Harbin Medical University were selected as the research objects， and were divided by random number table into observation group and control group. The control group（ 55 cases） received conventional nursing service； the observation group（ 55 cases） received the self-acceptance training on the basis of the control group. The Brief Psychiatric Rating Scale（ BPRS） score， Personal and Social Performance Scale（ PSP） score， General Well-Being Schedule（ GWB） score and Self- Esteem Scale（ SES） score before and after 2 months' intervention between the two groups were compared and analyzed. Results The PSP score has a significant increase， while BPRS score decreases in both groups after intervention（ P＜ 0.05）. The PSP score of the observation group is significantly higher than that of the control group， while the BPRS is lower（ P ＜ 0.05）. After intervention， the GWB and SES scores of the observation group are significantly better than those of the control group（ P＜0.01）. Conclusions Self-acceptance training can improve the rehabilitation effect， promote the recovery of social function and improve the self-esteem and rehabilitation happiness of schizophrenic patients.

Abstract:The concept of clinical high risk（ CHR） for psychosis refers to facilitate early detection and intervention and is defined by a cluster of subthreshold psychotic symptoms recently（ in a year）. To enhance the indicated prevention in patients with CHR for psychosis， recent research efforts have been increasingly directed to estimate the risk of developing psychosis on an individual level by using multivariable clinical prediction models.

Abstract:Vascular parkinsonism（ VP） is a common parkinsonism， in which the main clinical manifestation is known as lower-body parkinsonism and vascular lesions from the neuroimaging. With the rapid development of conventional magnetic resonance imaging and functional MRI today， MRI has played a considerable role in the etiology research and diagnosis of VP. The existing techniques of MRI are reviewed in this paper.

Abstract:Alexithymia has many effects on schizophrenia， including emotion， executive function， mental symptoms and coping styles. It will lead to interpersonal communication difficulties and social function decline， and affect the rehabilitation of patients. It has been found that antipsychotics， psychotherapy and rehabilitation training are effective treatments for schizophrenic patients with alexithymia. At present， there are relatively few domestic studies on schizophrenic patients with alexithymia， and some of the results are different because of different control conditions. Research needs to be further improved in the future.

Abstract:With the continuous development of neuroimaging research in schizophrenia， the neurotransmitters related to the etiology of schizophrenia are also deepening. As an important complement to the etiology of schizophrenia， glutamate plays a crucial role in the pathophysiology of schizophrenia. This article mainly introduces the basic principles of magnetic resonance proton spectroscopy and the research progress on analyzing glutamatergic levels in the brain of first-episode schizophrenic patients.

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