Abstract:Objective To develop and validate a nomogram by non-invasive method to assess the risk of post-stroke depression （PSD） based on National Health and Nutrition Examination Survey （NHANES）database， to provide a valuable reference for early clinical screening of high-risk individuals. Methods A total of 1 003 stroke survivors surveyed from 2007 to 2018 were selected from the NHANES database for the study. A total of 659 cases from 2007 to 2014 were assigned to development group， and 344 cases from 2015 to 2018 were assigned to validation group. Depressive symptoms in stroke survivors were assessed by the Patient Health Questionnaire-9 （PHQ-9）. Multivariate Logistic regression was applied to analyze the influencing factors of PSD in stroke survivors. Predictive factors with P ＜ 0.10 in multivariate Logistic regression analysis was incorporated into the nomogram. The prediction performance of nomogram was evaluated by area under curve （AUC） of receiver operator characteristic （ROC） curve. The clinical application value of nomograms was analyzed by decision curve. Results Of all the 1 003 patients， there were 190 cases （18.94%） were assessed with depression symptoms （the score of PHQ-9 greater or equal to 10）， with 124 cases in development group （18.82%） and 66 cases in validation group （19.19%）. Multivariate Logistic analysis showed that female （OR=1.671， 95%CI=1.040-2.684）， sleep disorder （OR=2.797， 95%CI=1.740-4.494）， work limitation （OR=2.293， 95%CI=1.362-3.861） and difficulty walking （OR=2.163， 95%CI=1.304-3.588） were independent risk factors for PSD in stroke survivors （P＜ 0.05）， and 60 to 79 years old （OR=0.321， 95%CI=0.121-0.852），≥ 80 years old （OR=0.117， 95%CI=0.032-0.426） were the protective factor for PSD in stroke survivors （P ＜ 0.05）. The nomogram was constructed based on gender， age， history of cardiovascular disease， sleep disorders， work restrictions and walking disorders. The AUC was 0.797 （95%CI=0.756-0.838） in the development group. After 1 000 times internal validation with bootstrap resampling methods， the C-index was 0.782. The AUC was 0.752 （95%CI=0.684-0.820） in the validation group. The calibration curve showed that the predicted probability of PSD by the nomogram was basically consistent with the actual probability of occurrence. The decision curve results showed that when the threshold probability was between 5% and 75%， using this predictive model to screen stroke patients would result in higher net benefits. Conclusions The nomogram of PSD constructed has a good predictive performance， which can be used for early PSD risk screening in stroke patients to help physicians make better treatment decisions.

Abstract:Objective To investigate the effects of serum C-reactive protein （CRP） level and clinical symptoms on aggressive behavior in untreated first-episode schizophrenia patients. Methods A total of 164 untreated patients with first-episode schizophrenia in the department of outpatient and inpatient of Shandong Mental Health Center from January 2020 to November 2022 were selected as research subjects. The modified Overt Aggression Scale （MOAS） were applied to assess patients aggressive behavior. According to the results of MOAS， the patients were divided into the aggressive group （86 cases） and the non-aggressive group （78 cases）. The Positive and Negative Symptom Scale （PANSS） was used to evaluate the clinical symptoms of the patients. Binomial Logistic hierarchical regression analysis was used to analyze the influencing factors of aggressive behavior in untreated first-episode schizophrenia patients. Results The serum CPR level ［2.97 （2.46，3.47）mg/L vs 1.73 （1.36，2.10） mg/L］， total scores of PANSS ［（89.27±9.82） vs （83.47±8.04）］， positive factor scores ［33.90 （33.01， 34.79） vs 30.13 （29.28， 30.98）］， excitement factor scores ［14.12 （13.43， 14.80） vs 7.01 （6.41， 7.61）］， total scores of MOA ［12.85 （11.90，13.80） vs 2.28 （1.36， 3.20）］， verbal aggression scores ［1.28（1.15， 1.41） vs 0.38 （0.27， 0.50）］， aggression against property scores ［1.47 （1.32，1.61） vs 0.28 （0.15，0.41）］ and physical aggression scores ［2.01 （1.85， 2.17） vs 0.14 （0.01，0.27）］ of the aggressive group were all higher than those of the non-aggressive group， and the differences were statistically significant （P ＜ 0.01）. The negative factor scores ［24.63（23.64， 25.62） vs 28.15 （26.90， 29.40）］ and cognitive factor scores ［10.76 （10.24， 11.27） vs 11.60 （10.98， 12.23）］ of the aggressive group were lower than those of the non-aggressive group （P ＜ 0.05）. The results of binomial Logistic hierarchical regression analysis showed that long duration of disease was the independent protective factor of aggressive behavior in untreated first-episode schizophrenia patients （P＜ 0.05）. High score of excitement factor of PANSS and high serum CRP level were independent risk factors of aggressive behavior in untreated first-episode schizophrenia patients （P＜ 0.05）. Conclusions High score of excitement factor of PANSS and high serum CRP level are independent risk factors of aggressive behavior in untreated firstepisode schizophrenia patients. Patients with aggressive behavior have a shorter course of disease than patients without aggressive behavior， which may be due to the fact that aggressive behavior attracts more attention.

Abstract:Objective To compare the compliance， efficacy and safety of three different half-lives of paliperidone in the treatment of schizophrenia. Methods A total of 187 schizophrenic patients who were hospitalized or outpatient treated in the Department of Psychology in the First Hospital of Heber Medical University and Department of Psychiatry in Handan Central Hospital from August 2019 to August 2020 were selected as the study subjects by convenience sampling method. All the patients were assigned to paliperidone sustained-release tablets （Pali-ER， n=65）， one-month paliperidone palmitate （PP1M， n=67）， and 3-month paliperidone palmitate （PP3M， n=55） according to wills of patients and physician， and underwent a 12 months' treatment. Patients were assessed with the Positive and Negative Symptom Scale （PANSS） at baseline， 3， 6， 9， and 12 months， and adverse events and duration of treatment. Results During the study， a total of 27 patients in the Pali-ER group withdrew from the study， of which 21 stopped treatment， 4 changed medication， and 2 were hospitalized； 17 patients in the PP1M group withdrew from the study， of which 9 stopped treatment， 4 changed medication， and 4 were hospitalized； 6 patients in the PP3M group withdrew from the study， of which 5 stopped treatment and 1 changed medication. The mean duration of treatment in Pali-ER group was （9.169±0.506） months （95%CI=8.178-10.161）， which was shorter than that of PP1M group ［（10.254±0.425） months， 95%CI=9.421-11.087］ and PP3M group［（11.455±0.219） months， 95%CI=11.024- 11.885］， and the differences among the 3 groups were statistically significant （P ＜ 0.05）. There was no significant difference in PANSS scores among the three groups at different time periods （P＞ 0.05）. There were statistically significant differences in the occurrence of extrapyramidal reactions and adverse reactions among three groups of patients （P ＜ 0.05）. Conclusions Paliperidone with different half-life has the same efficacy. Patients treated with paliperidone with longer half-life have better compliance and higher safety

Abstract:Objective To explore the gender differences in the prevalence and influencing factors of nonalcoholic fatty liver disease （NAFLD） in hospitalized schizophrenia patients. Methods A total of 316 schizophrenic inpatients admitted to Shanghai Jiading District Mental Health Center from 1 July 2020 to 30 June 2021 were recruited. Multivariate Logistic regression analysis were applied to analyze schizophrenia inpatients and influencing factors of NAFLD in patients with different genders. Results The prevalence of NAFLD in hospitalized schizophrenics was 41.1% （130/316）， with a prevalence of 42.1% （82/195） in male patients and 39.7% （48/121） in female patients. Multivariate Logistic regression analysis showed that the influencing factors of NAFLD in hospitalized schizophrenia patients were female （OR=2.345， 95%CI=1.159-4.743）， high body mass index （BMI） （OR=1.445， 95%CI=1.296-1.610）， high triglyceride （TG） （OR=2.715， 95%CI=1.709-4.315）， high alanine aminotransferase （ALT） （OR=1.019， 95%CI=1.002-1.037）， long hospitalized time （OR=1.099， 95%CI=1.040-1.162）， diabetes （OR=2.879， 95%CI=1.225-6.768） （P＜ 0.05）. Multivariate Logistic regression analysis showed that high BMI （OR=1.524， 95%CI=1.324-1.753） and high TG （OR=2.841， 95%CI=1.652- 4.887） were the risk factors of NAFLD in male hospitalized schizophrenia patients （P ＜ 0.05）； high BMI （OR=1.370， 95%CI=1.186-1.582） and high blood glucose （OR=1.982，95%CI=1.218-3.225） were the risk factors of NAFLD in female hospitalized schizophrenia patients （P ＜ 0.05）； elder age of onset （OR=0.939， 95%CI=0.889-0.991） was the protective factor of NAFLD in female hospitalized schizophrenia patients （P ＜ 0.05）. Conclusions The prevalence of NAFLD in hospitalized patients with schizophrenia is high， and significantly associated with gender， BMI， TG， ALT， length of hospitalization time and diabetes， and there are gender differences in influencing factors. Therefore， attention should be paid to the prevention and treatment of NAFLD in hospitalized schizophrenia patients in clinical practice.

Abstract:Violence and aggression is a common behavior problem of schizophrenia patients. In addition to drug intervention， psychosocial intervention is also an important complementary way， which can play a synergistic role in pharmacological intervention. This paper reviews the psychosocial intervention methods of violence and aggression in schizophrenia， so as to provide reference for the intervention of violence and aggression in schizophrenia.

Abstract:Schizophrenia is a serious disabling mental disorder. Its pathophysiological mechanism is still unclear， and there are individual differences and heterogeneity in treatment， resulting in high social and economic burden. In this paper， we review recent updates on the variations of cytokines in schizophrenia and their therapy from multiple perspective， with the aim of understanding the relationship between schizophrenia and cytokines from the mechanism， and providing new ideas for personalized treatment of schizophrenia patients from a more multidimensional perspective in the future.

Abstract:Objective To explore the correlation between unipolar depression， bipolar depression， schizophrenia and one carbon metabolizing nutrients， so as to provide clues for exploring the mechanism of different diseases and provide evidence for adjuvant therapy. Methods Inpatients in Beijing Anding Hospital Affiliated to Capital Medical University from January 2013 to December 2019 were selected as the research objects. A total of 390 patients with unipolar depression， 390 patients with bipolar depression and 865 patients with schizophrenia were included. General demographic data and one-carbon metabolizing nutrients （folic acid， vitamin B12， homocysteine） were compared among the three groups. Multiple Logistic regression analysis was used to control confounding factors and to clarify the correlation between the three diseases and one carbon metabolizing nutrient. Results Compared with unipolar depression and bipolar depression group， the level of vitamin B12 in schizophrenia patients was lower［438.5 （322.3， 581.3） pg/ml vs 449.9 （345.4， 613.3）pg/ml vs 376.9 （280.3， 505.3）pg/ml］， the level of homocysteine was higher［14.3 （11.5， 18.7） μmol/L vs 14.0 （11.6， 18.3）μmol/L vs 15.4 （12.4， 22.1）μmol/L］， the incidence rate of vitamin B12 deficiency was higher ［6.2% （24/390） vs 4.9%（19/390）vs 9.5%（82/865）］， and hyperhomocysteinemia was higher ［44.9%（175/390） vs 41.8% （163/390） vs 51.9%（449/865）］， and all differences were statistically significant （all P ＜ 0.05）. There was no significant difference in the distribution of folate level and folate deficiency among all groups （P＞0.05）. Multiple Logistic regression analysis showed that vitamin B12 level （OR=0.998， 95%CI=0.998-0.999） was the risk factors of schizophrenia （P＜ 0.05）. There was no significant difference in the levels of one-carbon metabolizing nutrients between unipolar depression and bipolar depression group （P＞ 0.05）. Conclusions Compared with unipolar depression and bipolar depression patients， schizophrenia patients have more obvious one-carbon metabolic nutrient deficiency， lower vitamin B12 level and higher homocysteine level. There was no significant difference in the levels of one-carbon metabolizing nutrients between unipolar depression and bipolar depression patients.

Abstract:Objective To investigate the detection of anxiety symptoms and its risk factors among medical students. Methods All undergraduate students from freshman to junior year at Hebei Medical University were selected for the study from October 19 to 28， 2021. A general profile questionnaire was used to investigate medical students' grade level， physical activity， personality characteristics， family parenting style， and academic stress， and the Generalized Anxiety Scale （GAD-7） was used to assess medical students' anxiety symptoms. Binomial Logistic regression was applied to analyze the influencing factors of anxiety symptoms in medical students and the predictive effect of the number of risk factors on anxiety symptoms in medical students. Ordered multiclass Logistic regression was applied to analyze the factors influencing the severity of anxiety symptoms in medical students and the predictive effect of the number of risk factors on the severity of anxiety symptoms in medical students. A total of 10 990 questionnaires were distributed in this study， and 9 625 valid questionnaires were collected， with an effective response rate of 87.6%. Results The detection rate of anxiety symptoms in 9 625 medical students was 29.4% （2 826/9 625）， including 83.7% （2 364/2 826） for mild anxiety symptoms， 13.4% （377/2 826） for moderate anxiety symptoms and 3.0% （85/2 826） for severe anxiety symptoms. There is a statistically significant difference in the grade， physical exercise， family rearing style， personality characteristics， and learning pressure of medical students with different anxiety symptoms （P＜0.05）. Correlation analysis shows that physical exercise， family rearing style， personality characteristics are negatively correlated with the severity of anxiety symptoms in medical students （r=-0.064， -0.120， -0.061； P ＜ 0.01）， while learning pressure is positively correlated with the severity of anxiety symptoms （r=0.277， P ＜ 0.01）. Logistic regression analysis shows that physical exercise， personality characteristics， learning pressure， family rearing style， and the number of risk factors are all influencing factors for anxiety symptoms （P＜ 0.01）. Conclusions The anxiety symptoms of medical students in school are predominantly mild，and lack of physical exercise， introversion， learning pressure and non-democratic family would increase the anxiety symptoms of medical students. The risk of anxiety symptoms increases with the number of risk factors

Abstract:Depression is a common mood disorder with a high recurrence rate and a considerable proportion of patients with residual symptoms. It was found that the traumatic symptoms of patients with depression were significantly correlated with their residual symptoms and recurrence. Therefore， the intervention of trauma in patients with depression may be an effective means to improve the symptoms and prognosis of the disease. Eye movement desensitization and reprocessing （EMDR） is a commonly used psychological therapy to intervene in trauma. This article reviews the application of EMDR in depression with traumatic symptoms

Abstract:Much attention has been paid to the "inflammatory hypothesis" in recent years， which suggests that inflammation is involved in the pathogenesis of depression. Activation of microglia， the immune cells of the central nervous system， increases the release of inflammatory cytokines and triggers an inflammatory state in the body， which in turn is involved in the development of depression. Protein kinases have been found to play an important role in regulating microglia activation， and protein kinase C （PKC） is probably the most important kinase in this process. In addition， it was found that changes in both PKC expression levels and activity may be closely related to the pathogenesis of depression. Therefore， we will first provide a brief overview of PKC， and then clarify the relationship between PKC and depression by summarizing evidence from animal and clinical studies. Finally， we will focus on PKC-related signaling pathways involved in the pathogenesis of depression to provide research ideas for the immuno inflammatory hypothesis of depression and provide scientific basis for finding new targets for antidepressant therapy

Abstract:Studies have shown that acute stress is highly related to human physical and mental health. A standardized and effective acute stress induction paradigm under controlled experimental conditions is essential for the research in these fields. However， in recent years， there are various paradigms and different effects of acute stress induction experiments. This paper reviews the progress of various types of acute stress induction paradigms under experimental control， and discusses the stressors， experimental processes， techniques used and their effects， to provide reference for the research in related fields.

Abstract:Pre-sleep cognitive arousal is a key factor in maintaining insomnia. Intrusive thoughts such as rumination and worry are the main forms of pre-sleep cognitive arousal， which are generated and maintained by the interaction of metacognition， sleep beliefs， stress and strain and further influence insomnia. Classical cognitive-behavioral therapy for insomnia and relaxation training have limited effect on pre-sleep cognitive arousal， based on which augmentation programs incorporating mindfulness have more advantages in reducing pre-sleep cognitive arousal. This study reviews the factors influencing pre-sleep cognitive arousal and intervention programs based on the relationship between insomnia and pre-sleep cognitive arousal.

Abstract: