Abstract:Objective To explore the value of heart rate variability indices in distinguishing unipolar depression from bipolar depression. Methods This study adopted a cross-sectional survey. From January 2020 to June 2023， 126 patients with unipolar depression who were currently experiencing depressive episodes at the Shanghai Mental Health Center were selected as the unipolar depression group， and 247 patients with bipolar depression were selected as the bipolar depression group. Clinical Data Questionnaire and heart rate variability indices were used to compare the differences in clinical data and heart rate variability between patients with unipolar depression and bipolar depression. Logistic regression was used to evaluate the discriminative ability of heart rate variability indices in distinguishing unipolar depression from bipolar depression， while controlling for potential confounding variables such as age， gender， and body mass index， and to construct new individual models to predict probability variables. Results The body mass index of patients with bipolar depression was higher than that of patients with unipolar depression， and the difference was statistically significant （t= -2.798， P ＜ 0.05）. There was no statistically significant difference in the dicrotic elasticity index and low frequency/ high frequency between the two groups of patients （P ＞ 0.05）. The heart rate variability indices （SDNN， pNN50， very low frequency， low frequency， high frequency， total power） of patients with bipolar depression were lower than those of patients with unipolar depression， and the cardiovascular characteristic indicators （heart rate， ejection elasticity index， and dicrotic dilation index） were higher than those of patients with unipolar depression， with statistical differences （all P ＜ 0.05）. After controlling age， gender， and body mass index， there was no statistically significant difference in low frequency/high frequency between the two groups of patients （P＞ 0.05）. The other indices of heart rate variability （SDNN， pNN50， very low frequency， low frequency， high frequency， total power） in patients with bipolar depression were lower than those in patients with unipolar depression， and the difference was statistically significant （P＜ 0.001）. Logistic regression showed that except for age， gender， and low frequency/high frequency， all other variable indicators had statistically significant differences in their respective differentiation models （OR=0.959-1.097， 95%CI： 0.937-1.166， P＜ 0.05）， and the difference in body mass index among all differentiation models was statistically significant （OR=1.076-1.097， 95%CI：1.010-1.166， P ＜ 0.05）. Conclusions The heart rate variability index may become a psychophysiological biomarker for distinguishing between unipolar depression and bipolar depression.

Abstract:Objective To explore the influencing factors of suicide behavior attitudes among female adolescents with depressive disorder. Methods From June 2021 to April 2023， convenience sampling was used to select 170 female adolescents with depressive disorder who received outpatient or inpatient treatment at the Fourth People's Hospital of Wuhu as research subjects. The self-designed questionnaire， 17-Item Hamilton Depression Rating Scale （HAMD-17）， Suicide Attitude Questionnaire （QSA）， Adolescent Self-Rating Life Events Checklist （ASLEC）， and the Egna Minnen av Barndoms Uppfostran （EMBU） were used to investigate general information， depressive disorder， suicide behavior attitude， life event experiences， and parenting styles， respectively. Spearman correlation was used to examine the correlation between patient suicide behavior attitudes and various variables， and multiple linear regression was used to analyze the influencing factors of suicide behavior attitudes. Results A total of 156 valid questionnaires were collected， with an effective response rate of 91.76%. There was a statistically significant difference in the QSA-attitude towards suicide behavior scores of patients with different educational backgrounds of fathers and those with suicidal behavior within six months （Z=8.447， -4.455； P ＜ 0.05）. The QSA-attitude towards suicide behavior score of patients was negatively correlated with scores HDMD-17， ASLEC-interpersonal relationship， ASLEC-learning pressure， ASLECpunishment， ASLEC-health adaptation， ASLEC-others， EMBU-father punishment and harshness， EMBUfather overinvolvement， EMBU-father rejection， EMBU-mother punishment and harshness， EMBU-mother overinvolvement， EMBU-mother favoritism （r=-0.425 to -0.183， P ＜ 0.05）， and was positively associated with scores of QSA-attitude towards suicide， QSA-attitude towards euthanasia， EMBU-father emotional warmth and understanding， EMBU-mother emotional warmth and understanding （r=0.180 to 0.459， P ＜ 0.05）， and the differences were statistically significant. HDMD-17， ASLEC-punishment， EMBU-father overinvolvement， QSA-attitude towards suicide， QSA-attitude towards euthanasia， and EMBU-mother emotional warmth scores were factors that affected the suicide behavior attitudes in female adolescents with depressive disorder， and the differences were statistically significant （P＜ 0.05）. Conclusions The severity of depressive disorder， attitude towards suicides， attitude towards euthanasia， punishment， overinvolvement from fathers， and emotional warmth from mothers are the influencing factors on the suicide behavior attitudes in female adolescents with depressive disorder.

Abstract:Objective To evaluate the validity and reliability of the Self-screening Questionnaire for Somatoform Symptoms （SQSS） among Chinese residents， and analyze the characteristics of participants with functional somatic symptoms. Methods From February to March 2020， convenience sampling was used to send the General Information Questionnaire， SQSS， Generalized Anxiety Disorder 7-Item Scale （GAD-7），9-item Patient Health Questionnaire （PHQ-9）， and 7-item Whitely Index （WI-7） to Chinese residents through Wenjuanxing. Two weeks later， 100 participants were selected using a random number table method for retesting of SQSS. Item analysis was carried out by correlation analysis between item scores and total scores of the scale and extreme group test. Validity was tested through exploratory factor analysis， confirmatory factor analysis. Reliability was tested by internal consistency Cronbach's α coefficient， split half reliability coefficient， and retest correlation coefficient. Chi square test and t-test were used to compare general and clinical data of participants with and without functional somatic symptoms. Results A total of 1 506 questionnaires were collected， 56 invalid questionnaires were excluded and 1 450 （96.3%） subjects were included. Item analysis of SQSS showed that the scores of each item were positively correlated with the total score of the scale， and the difference was statistically significant （r=0.49 to 0.70， all P＜ 0.001）. The discrimination analysis of each item showed statistically significant differences （t=15.337 to 27.862， all P ＜ 0.001）. Exploratory factor analysis showed that the SQSS scale could be divided into four dimensions. Confirmatory factor analysis showed that the 4-factor structural model of SQSS fitted well， with a chi square/degree of freedom （χ2 /df） of 5.79， a goodnessof-fit index （GFI） of 0.94， root mean square error Approximation （RMSEA） of 0.06， root mean square residual （RMR） of 0.03， comparative fit index （CFI） of 0.93， normed fit index （NFI） of 0.92， non-normed fit index （NNFI） of 0.92， and Tucker Lewis index （TLI） of 0.92. The Cronbach's α coefficient of SQSS was 0.92， and the split half reliability coefficient was 0.90. The total score of SQSS was positively correlated with the scores of WI-7， PHQ-9， and GAD-7， and the differences were statistically significant （r=0.67， 0.68， 0.61； all P＜ 0.01）. The detection rate of functional somatic symptoms among ordinary residents was 10.28% （149/1 450） based on the 29 points of the SQSS scale as the cut-off point. Among the patients with positive functional somatic symptoms， there were more females， those with mental illness， and those with chronic somatic diseases （χ2 =5.12， 29.90， 34.08； all P＜ 0.05）， and the SQSS， GAD-7， PHQ-9， and WI-7 scores of individuals with functional somatic symptoms were higher than those of the negative individuals （Z=20.03，14.51，13.03，15.27； all P＜ 0.001）， and the differences were statistically significant. Conclusions The SQSS has good validity and reliability， and can be used for functional somatic symptom self-screening in the general population. The detection rate of functional somatic symptoms is relatively high among ordinary Chinese residents.

Abstract:Objective To analyze the mediating effect of family resilience and individual resilience between disease stigma and primary caregiver burden in patients with stroke dysphagia. Methods From December 2022 to August 2023， convenience sampling was used to select 235 patients with stroke dysphagia and their primary caregivers in the Department of Rehabilitation of the First Affiliated Hospital of Xinjiang Medical University as research subjects. Stigma Scale for Chronic Illness （SSCI）， 10-item Connor-Davidson Resilience Scale （CD-RISC-10）， Zarit Caregiver Burden Interview （ZBI）， and the Chinese version of the Revised Walsh Family Resilience Questionnaire （WFRQ-R-CHI） were used to investigate the psychological status， individual resilience， and primary caregiver burden and family resilience of patients with stroke dysphagia. Spearman correlation was used to analyze the correlation between patient stigma， individual resilience， primary caregiver burden， and family resilience. Chain mediating model was constructed using Model 6 from the Process V4.1 plugin and Amos software. Results ZBI score of the primary caregiver for patients with stroke dysphagia was 50 （42，59）， which was at a moderate burden level. The patient's SSCI score was 87 （72，95）. Spearman correlation showed that there was a positive correlation between disease stigma and caregiver burden in patients with stroke dysphagia， a negative correlation with family and individual resilience， a negative correlation between caregiver burden and family and individual resilience， and a positive correlation between family and individual resilience， with statistically significant differences （all P ＜ 0.01）. Family resilience and individual resilience played a chain mediating effect in the disease stigma and caregiver burden of patients with stroke dysphagia， accounting for 69.04% of the total effect. Conclusions Reducing the disease stigma of patients can alleviate the burden on caregivers. Intervention programs to reduce the burden on the primary caregivers of patients with stroke dysphagia can also be explored from the perspective of enhancing their family and individual resilience.

Abstract:Objective To explore the relationship between sarcopenia and depressive symptoms in middle-aged and older adults. Methods General data， serum creatinine to cystatin C ratio （CCR）， relative muscle strength （RMS）， and Center for Epidemiological Studies Depression Scale（CESD-10） scores of 5 600 middle-aged and older adults （aged ≥ 45 years） were collected in the 2011 China Health and Retirement Longitudinal Study （CHARLS）. Multivariate Logistic regression was used to analyze the relationship between CCR， RMS， and depressive symptoms. Restricted cubic splines were used to analyze the dose-response relationship between sarcopenia and depressive symptoms in middle-aged and older adults. Results The age of 5 600 middle-aged and older adults was （59.70±9.39） years old， and 48.6% （2 721/5 600） were males， patients with depressive disorder accounted for 26.5% （1 484/5 600）. Multivariate Logistic regression analysis showed that compared with the group with the lowest CCR level （Q1）， the Q4 group had a 39% lower risk of depressive disorder ［OR=0.61， 95%CI （0.51， 0.73）］. The group with the highest RMS level （T4） had a 58% lower risk of depressive symptoms compared to the group with the lowest RMS level （T1） ［OR=0.42， 95%CI （0.35， 0.51）］. Restrictive cubic spline analysis showed a negative correlation between CCR and RMS levels and the risk of depressive symptoms. Conclusions The muscle level of middle-aged and older adults affects depressive symptoms， and sarcopenia is closely related to depressive symptoms in patients with depressive disorder.

Abstract:Objective To explore the correlation between cognitive manipulation impairment and perfectionism in patients with obsessive-compulsive disorder. Methods Using convenience sampling method， 69 patients with obsessive-compulsive disorder who visited the Department of Clinical Psychology of Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2022 to January 2023 were selected as the research group. During the same period， 74 normal subjects were recruited from the public in Chaoyang District， Beijing as the control group. The Chinese version of Frost's Multidimensional Perfectionism Scale （FMPS-C） and working memory cognitive manipulation task were used to measure perfectionism and cognitive manipulation function in two groups of subjects， respectively. Pearson product-moment correlation was used to analyze the correlation. Results Sixty-five patients in the study group and 69 in the control group were included. The total FMPS-C score and non-adaptive dimension score of the research group were higher than those of the control group， while the adaptive dimension score was lower than that of the control group， and the differences were statistically significant （all P＜ 0.01）. When the prompt condition was "opposite"， there was a statistically significant difference in the responses of the two groups to the three words of neutral， positive and negative （F=8.943， P ＜ 0.01）. The pairwise comparison results showed that， the response of the patients in the study group was higher than that in the control group under neutral， positive， and negative stimuli， and the differences were statistically significant （all P ＜ 0.05）. When the cue condition was "opposite"， the response time of negative words in the study group was longer than that of positive and neutral words （all P＜ 0.05）. Under neutral， positive， and negative stimuli， there was a statistically significant difference in the sorting cost values between the two groups （F=24.378， P＜ 0.001）. The pairwise comparison results showed that， the sorting cost values of the study group patients under neutral， positive， and negative stimuli were statistically higher than those of the control group （all P ＜ 0.05）. The sorting cost value of patients in the study group under negative stimuli was higher than that under neutral and positive stimuli， and the difference was statistically significant （all P＜ 0.01）. Under the neutral stimuli， the sorting cost value of the study group patients was positively correlated with the non-adaptive dimension score， and the difference was statistically significant （r=0.18， P ＜ 0.05）. Under the negative stimuli， the sorting cost value of the study group patients was positively correlated with FMPS-C score and non-adaptive dimension score， and the difference was statistically significant （r=0.23， 0.24； P＜ 0.05）. Conclusions Patients with obsessive-compulsive disorder have significant difficulties in cognitive manipulation function， especially in processing negative stimuli， and this cognitive manipulation difficulty is positively correlated with non-adaptive perfectionism.

Abstract:Acute ischemic stroke is a neurological emergency with high mortality and morbidity. Due to limited opportunities to participate in the emergency rescue of stroke， it is often difficult for neurology residents to master the diagnosis of acute ischemic stroke and intravenous thrombolysis therapy in the standardized training. Simulation-based training is an effective teaching method. Based on the clinical practice of cerebrovascular diseases in neurology， the teaching team designed a situational simulation for treatment of acute ischemic stroke according to the teaching objectives. The residents with standardized training conduct the role play in the designed situational simulation. This teaching method integrated treatment skills and simulation-based training for acute ischemic stroke. It is more closely related to clinical practice scenarios， can fully stimulate students' initiative， deepen their understanding of stroke theory knowledge and intuitive understanding of intravenous thrombolysis operations， improve their clinical thinking， communication skills， and team cooperation ability， thereby improving their professional treatment ability for acute ischemic stroke， and providing reference for cultivating qualified stroke emergency physicians.

Abstract:The clinical manifestations of anxiety disorders are complex， and there is currently a lack of neurobiological indicators related to diagnosis and efficacy prediction. Electroencephalogram （EEG） is a non-invasive neurophysiological detection tool with high temporal resolution， which can reflect the temporal progression of cognitive impairment in anxiety disorders. This article reviews the relevant research on the temporal， frequency， and functional connectivity EEG characteristics of anxiety disorders， exploring the cognitive processing abnormalities of anxiety disorders from top-down and bottom-up. The aim of this review was to provide reference for further clarifying the neuropsychological mechanisms of anxiety disorders and exploring objective neurobiological indicators related to the prediction， diagnosis， and prognosis of anxiety disorders.

Abstract:Transient receptor potential vanilloid 1 （TRPV1） is widely distributed in the central nervous system and plays a dual role in oxidative stress， neuroinflammation， neuronal apoptosis， and synaptic damage. Schizophrenia is a group of mental disorders characterized by positive symptoms， negative symptoms， psychomotor disorders， and severe impairment of reality testing ability， and its pathogenesis has not been fully elucidated. Research has found that TRPV1 may play a potential role in schizophrenia. This article summarizes the dual role of TRPV1 in the central nervous system， so as to explain the possible mechanism of TRPV1's involvement in schizophrenia.

Abstract:Pyroptosis is a new type of programmed cell death closely related to inflammasomes， mainly mediated by inflammasomes， caspase， and the gasdermins protein family. Research has shown that pyroptosis is associated with neuronal death in ischemic stroke， and some therapeutic drugs can inhibit the process of neuronal cell pyroptosis by inhibiting inflammasomes， thereby reducing nerve injury after ischemic stroke. This paper reviews the process of pyroptosis after ischemic stroke and summarizes anti-pyroptosis related drugs， so as to provide ideas for the prevention and treatment of ischemic stroke.

Abstract:Anhedonia is one of the core symptoms of depressive disorder， and the dopaminergic system plays a crucial role in the occurrence of anhedonia. Dopaminergic activity is highly complex and regulated by various brain structures， including the ventral subiculum， nucleus accumbens， ventral pallidum， and basolateral amygdala. Basic and clinical studies have shown that dopaminergic system defects in depressive disorder can be attributed to dysregulation of the input circuit. This paper starts with the correlation between depressive disorder and dopaminergic system， and summarizes the upstream pathways of dopaminergic neurons in the ventral tegmental area， including the activation pathway from the ventral subiculum to the nucleus accumbens to the ventral pallidum， and the inhibition pathway from the basolateral amygdala to the ventral pallidum. Moreover， this paper objectively elucidates depressive-like behavior and abnormal input regulation of the midbrain dopaminergic system in depressive disorder through basic experiments and clinical studies， and outlines the correlation between antidepressant treatment and midbrain dopaminergic nervous system， so as to provide directions for the diagnosis， treatment， and mechanism research of depressive disorder.

Abstract:

Abstract: