Abstract:Suicide is a serious social and public health problem in the world. There are many obstacle factors for the emergency patients with suicide attempted to receive mental health services. This paper analyzes the existing obstacle factors from hospital and social aspects， and puts forward corresponding strategies， aiming to provide reference for improving the accessibility of mental health services， and to prevent and reduce patients' suicide.

Abstract:Objective To investigate the perceived coercion of involuntary inpatients with mental disorders in the process of admission and during hospitalization， and to explore its influencing factors. Methods A total of 254 involuntary inpatients with mental disorders were selected from 6 closed wards of Xuhui district branch of Shanghai Mental Health Center affiliated to Shanghai Jiao Tong University School of Medicine， from March to August 2017 according to Article 30 of the "Mental Health Law". During the third week after admission， self-compiled basic information questionnaire， Brief Psychiatric Rating Scale（ BPRS），MacArthur Perceived Coercion Scale（ MPCS）， and Coercion Experience Scale（ CES） were used to investigate the enrolled inpatients. All the patients were divided into two groups according to whether they had solicited their opinions before admission. There were 115 cases in solicitation group and 139 cases in non-solicitation group. SPSS 22.0 software was used for statistical analysis. Independent sample Mann-Whitney test， Kruskal- Wallis test and Chi-square test were used for inter group comparison. Bonferroni method was used to correct the post event pairwise comparison of significance level. Correlation analysis was used to understand the correlation between MPCs， CES and BPRS symptom score， and regression analysis was used to explore the influencing factors of coercion score. Results （1） Compared with the environmental limitations of psychiatric wards， the patients' perception of coercion was more due to the restriction of right to make choice and decision by themselves；（ 2） For patients who had not been asked for their opinions at admission， the total score of MPCS ［4.00（2.00，5.00） vs. 1.00（ 0，2.00），Z=8.592，P＜0.01］， total score of CES［ 52.00（39.00，81.00） vs. 44.00 （34.00，56.00），Z=3.236，P＜0.01］ and dimension score［ limitation of rights 13.00（9.00，27.00） vs. 9.00（9.00， 15.00），Z=3.746，P ＜ 0.01］ were significantly higher than those in the solicitation group at admission；The passive score was 14.00（ 10.00，24.00） vs. 12.00（ 9.00，18.00），Z=2.861，P＜0.01； The negative environment score was 9.00（ 6.00，13.00） vs. 8.00（ 6.00，10.00），Z=2.000，P＜0.05； The score of negative reaction was 4.00 （2.00，6.00） vs. 3.00（2.00，5.00），Z=2.706，P＜ 0.01）， which were all higher than those in the solicitation group. （3） Lack of consent before admission， public security agency delivery， and higher education level were positive influencing factors of MPCS total score（ F=25.076，P＜0.01）. Experienced restraint protection， severe BPRS thinking disorder and high coercion experience at admission were positive influencing factors of CES total score （F=5.135，P ＜ 0.01）. Conclusions Coercion experience is common in patients with mental disorders during admission and hospitalization. This subjective negative experience is related to various factors. More attention should be paid to this experience in clinical practice， and targeted measures should be taken to reduce patients' perception of coercion.

Abstract:Objective To explore the difference of the influence of family function on quality of life between first-episode and relapsing schizophrenia. Methods A total of 46 first-episode and 88 relapsing schizophrenias which met the inclusion and exclusion criteria were recruited by convenience sampling method in the inpatient department of mental health center， West China Hospital， Sichuan University from July 2018 to December 2018. General information， Family Assessment Device（ FAD， including communication， role， problem solving， emotional response， emotional intervention， behavior control and total function）， Family Adaptability and Cohesion Evaluation ScaleⅡ China Version（ FACESⅡ-CV， including intimacy and adaptability） and Schizophrenia Quality of Life Scale（ SQLS， including psychosocial， motivation and energy， symptoms and side effects） were applied to compare between groups. Correlation analysis and multiple stepwise regression analysis were used to analyze the influence of family function on the quality of life of the two groups and to explore the differences. Results There were statistically significant differences in family communication and cohesion between first-episode and relapsing schizophrenia（ t=2.45，-2.14；P＜ 0.05）. SQLS total scores was correlated with all dimensions of FAD and FACES in relapsing schizophrenia（ P＜0.05）， while in first-episode patients， only communication（ r=0.32， P ＜ 0.05） and general function（ r=0.32，P ＜ 0.05） were related to motivation and energy. For first-episode schizophrenias， family communication（ β=0.32，P=0.03） was influencing factor of quality of life， while in relapsing schizophrenias， general functions（ β=0.29， P=0.02） and roles（ β=0.24， P=0.04） affected their quality of life. Conclusions The quality of life of first-episode schizophrenias with poor family communication is lower， while in relapsing schizophrenias， poor family roles and general family function is correlated with lower quality of life.

Abstract:Objective To explore the moderating effect of childhood abuse on the relationship between emotion reactivity and suicide risk in patients with mood disorders， and to provide scientific guidance for suicide prevention and intervention in patients with mood disorders. Methods A total of 323 patients with mood disorders［ mean age（ 30.01±11.85） years］ enrolled in Beijing Anding Hospital Capital Medical University and Beijing Huilongguan Hospital were investigated by the Emotion Reactivity Scale（ ERS， including emotional sensitivity， emotional intensity， emotional persistence）， the abuse & neglect subscale of the Adverse Childhood Experiences-International Questionnaire（ ACE-IQ）， and the Suicide Behaviors Questionnaire-Revised（ SBQ-R）. Spearman correlation analysis was used to analyze the correlation between emotion reactivity and suicide risk in patients with mood disorder， and then multiple linear regression analysis was used. Stepwise regression method was used to screen variables in the model. The mediating effect of childhood abuse on emotion reactivity and suicide risk was tested by using a mediating model with mediating variables as categorical variables. Hierarchical regression analysis was used to test the moderating role of childhood abuse in the relationship between emotion reactivity and suicide risk. Results The differences in scores of emotional sensitivity， emotional intensity， emotional persistence and scores of SBQ-R between patients with and without childhood abuse were statistically significant［ 13（9，16） vs. 5（4，6）， 10（7，12） vs. 4（3，5）， 5（2，8） vs. 3（1，4），（ 11.33±3.91） vs.（ 4.18±1.43）， all P＜ 0.01）］； The score of SBQ-R was positively correlated with the scores of emotional sensitivity， emotional intensity and emotional persistence（ r=0.714-0.917， all P＜0.01）. Regression analysis showed that emotional sensitivity， emotional intensity and emotional persistence were closely related to suicide risk（ β=0.107-0.650， all P＜0.01）. Childhood abuse moderated the relationship between emotional sensitivity（ β=0.097， P＜0.001）， emotional persistence（ β=0.068，P ＜ 0.05） and suicidal risk. Conclusions Patients who have higher level of emotion reactivity tend to have higher suicide risk. Childhood abuse may have moderating effect on the relationship between emotional sensitivity， emotional persistence， and suicidal risk.

Abstract:Objective To investigate the incidence of suicidal ideation and its influencing factors among freshmen of the three public comprehensive university in Nanjing. Methods Questionnaires were given to 8 811 freshmen of the three public comprehensive university in Nanjing， including general information （age， gender， parental divorce， previous history of psychosis， suicide history， etc.）， Neuroticism component of Eysenck Personality Questionnaire（ EPQ-N）， Adolescent Self-rating Life Events Checklis（t ASLEC）， subjective support and social support availability component of Social Support Rating Scale（ SSRS） and Beck Depression Inventory（BDI）. Logistic regression model was used to analyze the influencing factors of suicidal ideation. Results Among the 8 811 freshmen， 8 770 valid questionnaires were collected， among which 7 754（ 88.4%） had no suicidal thoughts and 1 016（ 11.6%） had suicidal thoughts. Multivariate logistic regression results showed that young age（ OR=0.913， 95%CI： 0.876-0.952）， female（ OR=1.296， 95%CI： 1.093-1.535）， parental divorce （OR=1.366， 95%CI： 1.034-1.804）， previous history of mental illness（ OR=1.957， 95%CI： 1.445-2.652）， previous suicide history（ OR=4.827， 95%CI： 3.195-7.293）， depression（ OR=3.982， 95%CI： 3.384-4.685）， high neuroticism score（ OR=1.172， 95%CI： 1.142-1.202）， low levels of SSRS subjective social support and the utilization of social support（ OR=0.936， 95%CI： 0.916-0.955）， more negative life events（ high ASLEC score， OR=1.020， 95%CI： 1.013-1.027） were independent risk factors of suicidal ideation（ all P ＜ 0.05）. Conclusions The incidence of suicidal ideation among freshmen is high， and the influencing factors are diverse and complex. Therefore， it is necessary to prevent and intervene the suicidal ideation of freshmen from multiple perspectives， such as individual demographic characteristics， family， psychological characteristics and society.

Abstract:Non-suicidal self-injury（NSSI） behavior is a serious threat to the mental and physical health of adolescents， which has become an important public health problem in the world. It is particularly important to intervene actively and effectively. However， there is still a lack of effective evidence for the treatment of adolescent NSSI. In this paper， the current research status of adolescent NSSI psychotherapy， medication and physical therapy is described， to provide the basis for further exploring the treatment of adolescent non-suicidal self-injury.

Abstract:Objective To systematically evaluate the clinical efficacy and late effect of group cognitive behavioral therapy（ GCBT） in the treatment of insomnia. Methods EMbase， Cochrane Library， Medline， CNKI and Wanfang database were searched for randomized controlled trials that met the inclusion criteria. The GCBT group received group cognitive behavior therapy， including sleep health education， cognitive therapy， relaxation training， sleep restriction and stimulation control. The control group received placebo treatment， health education， routine care， waiting for treatment. The questionnaire of sleep latency， wake-up time after sleep， total sleep time and sleep efficiency， sleep severity index and Pittsburgh sleep quality index were extracted from sleep diary， and meta-analysis was conducted by RevMan 5.3 and STATA 15.1 software. Results Finally， 11 articles were included， a total of 814 patients， including 441 cases in GCBT group and 373 cases in control group. The results of meta-analysis showed that： sleep latency（ WMD=-15.06，95%CI： -19.06- -11.05，P＜0.05）， awakening time after sleep（ WMD=-34.95，95%CI：-49.96- -19.93，P＜0.05）， insomnia severity index（ WMD=-6.13，95%CI：-8.04- -4.22，P ＜ 0.05）， Pittsburgh sleep quality index （WMD=-2.49，95%CI：-4.11- -0.87，P ＜ 0.05） of the GCBT group were all lower than those of the control group， while the sleep efficiency of the GCBT group was higher than that of the control group（ WMD=10.46， 95%CI：6.89-14.03，P ＜ 0.05）. There was no significant difference in the total sleep time between the two groups（ P ＞ 0.05）. At early follow-up， the awakening time（ WMD=-32.51， 95%CI：-58.61- -6.41，P ＜ 0.01）， insomnia severity index（ WMD=-6.01，95%CI：-8.40- -3.62，P＜0.05）， Pittsburgh sleep quality index （WMD=-4.33，95%CI：-7.06- -1.59，P ＜ 0.05） were lower in GCBT group than those in control group， and total sleep time（ WMD=0.32， 95%CI：0.10-0.54，P ＜ 0.05）， sleep efficiency（ WMD=10.51， 95%CI：5.99- 15.02，P ＜ 0.05） were higher than those in the control group， and there was no significant difference in the sleep latency between the two groups（ all P＞0.05）. At long-term follow-up， the sleep efficiency of GCBT group was higher than that of control group（ WMD=5.30，95%CI：1.61-8.98，P＜0.05）， and Pittsburgh sleep quality index score was lower than that of control group（ WMD=-2.80，95%CI：-3.82- -1.78，P＜0.05）. There was no significant difference between the two groups in sleep latency， wake-up time and total sleep time（ all P＞0.05）. Conclusions The clinical efficacy of GCBT in patients with insomnia is reliable， and it will continue to be effective in the late follow-up， but its efficacy will decline with time prolongation.

Abstract:Objective To investigate the clinical characteristics， auxiliary examination， treatment and prognosis of patients with anti contactin associated protein- related 2（ CASPR2） antibody associated encephalitis. Methods The clinical data of 5 consecutive patients with anti CASPR2 antibody associated encephalitis admitted to the Department of Neurology， the Third People's Hospital of Huai'an from March 2018 to March 2020 were retrospectively analyzed and the literature was reviewed. Results The clinical manifestations were limbic system symptoms in 5 cases（ 3 cases of epilepsy， 1 case of abnormal mental behavior， 1 case of cognitive impairment with abnormal mental behavior）； 1 case had limbic system symptoms complicated with Morvans syndrome； 2 cases had increased peripheral nerve excitability and autonomic nerve dysfunction； 2 cases had obvious MRI abnormalities； 1 case had malignant tumor； All the 5 cases had insomnia. All patients were recieved the immunotherapy . The patients were followed up for 3-14 months（ median follow-up time was 9 months）. The symptoms of 4 cases were improved obviously， except the case with tumor. Conclusions The main manifestations of anti CASPR2 antibody associated encephalitis were limbic system symptoms， increased peripheral nerve excitability， autonomic nerve dysfunction and insomnia. When the above manifestations appear， it is necessary to consider the disease and make early diagnosis through antibody detection and other detection. Immunotherapy and anti epilepsy symptomatic treatment is suggested. Most of the prognosis is good， except case combined with tumor which is not good. Some patients may relapse and may develop new antibodies.

Abstract:Cerebral ischemia injury involves a variety of pathological processes， in which protein acetylation is involved， and protein acetylation can activate autophagy. Histone deacetylase（ HDAC） is a family of enzymes that regulate the level of protein acetylation， among which HDAC 2/6 is the most representative subtype. This article mainly introduces the research progress of HDAC 2/6 and autophagy in cerebral ischemia injury.

Abstract:In the past few decades， the steady increase of clinical and neuroimaging data collected in large-scale observational studies has enabled people to better understand the specificity of social eye contact among autism spectrum disorder（ ASD） patients and explore the specific cognitive process of visual processing. In addition， these large-scale data support the development and wider application of auxiliary diagnosis， curative effect assessment and personalized treatment facilities for ASD， which is of great help to improve the expected clinical progress and prognosis of ASD， and provide an opportunity for the development of personalized precision therapy， which is also an important direction in the future. This paper will review the application of eye tracking technique in diagnosis and treatment of ASD.

Abstract:Attention deficit hyperactivity disorder（ ADHD） affects about 5% of children worldwide. The low compliance， effectiveness， tolerance and availability of the existing treatment（ drug treatment， psychotherapy， etc.） are the problems faced by the treatment of ADHD. Based on the age characteristics of children patients， game therapy is more acceptable. As an alternative to traditional therapy， video game has the potential to improve the symptoms of children with ADHD and make up for the deficiencies of traditional therapy. In 2020， the U.S. Food and Drug Administration（ FDA） approved the first video game， Endeavor Rx （AKL-T01）， as a prescription drug for Children with ADHD between 8 and 12. Video games were officially included in clinical treatment. This article mainly reviews the further details of the application of video game therapy in children with ADHD.

Abstract:Alzheimer disease（ AD） is a neurodegenerative disease with high incidence， which seriously affects people's life quality and brings heavy economic burden. The main pathological features of AD are neurofibrillary tangles caused by abnormal tau phosphorylation and senile plaques formed by abnormal aggregation of amyloid beta protein. Recent studies have found that tau misfolding and aggregation interact with endoplasmic reticulum stress， which plays an important role in the pathological mechanism of AD. Therefore， by reviewing the mechanism of endoplasmic reticulum stress and the pathological mechanism of tau protein in the pathogenesis of AD ， this paper explores the possible relationship between endoplasmic reticulum stress and tau protein， in order to provide new ideas and possibilities for the pathogenesis of AD and the development and treatment of new target drugs.

Abstract:Meniere disease（ MD） and vestibular migraine（ VM） are common in clinical practice. Their clinical manifestations are similar and lack of effective means of differential diagnosis. A large number of studies showed that MD and VM are related in terms of pathogenesis， clinical features and treatment. Therefore， this article is to explore the correlation between these two diseases from the pathogenesis， clinical characteristics， treatment.