Abstract:The prevalence of chronic physical disease comorbid depression is increasing year by year. This paper discusses the current situation and influencing factors of chronic medical disease comorbid depression from the perspective of biology， psychology and sociology， involving genetics， immunity， social and family environment. Against the backdrop of rapid development of digital technology， combining medication， physical and psychological therapy to establish an intervention model of liaison consultation is expected to reduce depression in patients with chronic physical diseases and improve their overall level of physical and mental health.

Abstract:Objective To explore the current status and influencing factors of the quality of life of parents of children with epilepsy， so as to provide clinical basis for improving the quality of life of parents of children with epilepsy. Methods From January to December 2022， convenience sampling was used to select 310 parents of children with epilepsy in the Department of Neurology of Xi'an Children's Hospital as participants. A self-designed General Information Questionnaire and the Brief World Health Organization Quality of Life Instrument （WHOQOL-BREF） were used to investigate the current status of quality of life of parents of children with epilepsy. The generalized linear model was used to analyze the influencing factors of the quality of life of parents of children with epilepsy. Results The total score of WHOQOL-BREF for parents of children with epilepsy was （12.64±2.24）， and the scores for physiological， psychological， social， and environmental dimensions were （13.09±2.45）， （12.53±2.58）， （13.12±2.88）， and （11.81±2.55）， respectively， all of which were lower than the domestic norm， and the differences were statistically significant （t=-9.207， -14.517， -9.355， -5.015， -2.305； P＜ 0.05）. Generalized linear model analysis showed that the total WHOQOL-BREF score of parents of children with epilepsy was negatively correlated with the child's current residence in rural areas， comorbidities with epilepsy， lack of outdoor activities or frequency of outdoor activities 2 to 3 times per month， lack of vaccination after onset， and the difference was statistically significant （R2 =3.650，P＜ 0.05）.Conclusions Parents of children with epilepsy have poor quality of life. Parents of children with epilepsy comorbidities need to be given special attention. When appropriate， timely vaccination should be given to children with epilepsy to prevent infectious diseases， increase outdoor activity time， improve living environment， and enhance the level of medical and health care at the grassroots level， which is beneficial for improving the quality of life of parents of epilepsy children.

Abstract:Objective To explore the characteristics of sleep quality and heart rate variability （HRV） in patients with anxiety and depressive disorder. Methods From November 2021 to June 2022， 80 patients with depressive disorder were selected as participants at the Mental Health Center of the First Hospital of Hebei Medical University. Hamilton Anxiety Scale （HAMA） was used to assess the severity of anxiety symptoms in patients. A HAMA score greater than 14 was assigned to depressive disorder group with anxiety （n=50）， while a HAMA score ≤ 14 was assigned to depressive disorder group without anxiety （n=30）. Pittsburgh Sleep Quality Index （PSQI） was used to assess the sleep quality of patients. HRV was measured using an HRV measuring instrument to analyze the low frequency （LF）， high frequency （HF）， low frequency/high frequency （LF/HF）， standard deviation of RR intervals （SDNN）， and root mean square of successive RR interval differences （RMSSD） of two groups of patients. Hamilton Depression Scale （HAMD） was used to assess the severity of depressive symptoms in patients. Independent sample t-test was used to compare the differences in sleep quality and HRV between two groups， and binomial Logistic regression was used to analyze the influencing factors of anxiety in patients with depressive disorder. Results There was no statistically significant difference in age， gender， smoking and drinking history， and body mass index （BMI） between the depressive disorder group with and without anxiety （P＞ 0.05）. The PSQI-Ⅴ and PSQI-Ⅶ factor scores of depressive disorder group with anxiety were （1.3±0.6） and （2.3±0.7）， respectively， which were higher than those of depressive disorder group without anxiety （1.0±0.6） and （1.8±1.0）， and the difference was statistically significant （P＜ 0.05）. The HAMD total score， anxiety somatization factor score， cognitive impairment factor score， delay factor score， and sleep disorder factor score in depressive disorder group with anxiety were （19.6±3.6）， （6.5±2.2）， （5.0±2.1）， （7.3±1.9）， and （3.5±1.8）， which were higher than those in depressive disorder group without anxiety （14.7±4.2）， （5.0±2.1）， （3.7±2.4）， （5.4±2.1）， and （2.6±1.9）， and the difference was statistically significant （P ＜ 0.05）. HRV analysis showed that the LF of depressive disorder group with anxiety was （5.2±1.2） ms， which was higher than that of depressive disorder group without anxiety （4.5±1.4） ms， and the difference was statistically significant （P=0.011）. The HF and RMSSD of depressive disorder group with anxiety were （4.0±1.1） ms and （22.8±10.5） ms， which were lower than those of depressive disorder group without anxiety （5.4±1.2） and （28.3±9.7） ms， and the difference was statistically significant （P＜ 0.05）. Binomial Logistic regression analysis showed that high HAMD total score ［OR=1.439， 95%CI （1.157， 1.789）］ and high LF ［OR=2.640， 95%CI （1.275， 5.467）］ were associated with increased anxiety risk in patients with depressive disorder， while high HF was associated with decreased risk of depressive disorder accompanied by anxiety ［OR=0.286， 95%CI （0.142， 0.577）］. Conclusions Patients with depressive disorder accompanied by anxiety tend to have severe depressive emotions， as well as sleep quality and autonomic nervous system dysfunction.

Abstract:Objective To explore the impact of negative life events and psychological resilience on suicide behavior in adolescents with depressive disorder. Methods From April 2021 to June 2023， convenience sampling was used to select 217 adolescents with depressive disorder at the Mental Health Center of the First Hospital of Hebei Medical University as participants. According to the MINI International Neuropsychiatric Interview （MINI）， individuals with a history of attempted suicide were divided into two groups of attempted suicide group （n=49） and non-attempted suicide group （n=168）. Hamilton Depression Scale （HAMD）， Childhood Trauma Questionnaire-Short Form （CTQ-SF）， Adolescent Self-rating Life Events Check List （ASLEC）， and Connor-Davidson Resilience Scale （CD-RISC） were used to assess the patient's depressive disorder， childhood trauma， life events， and psychological resilience， respectively. Univariate analysis and binomial Logistic regression were used to analyze the influencing factors of suicide behavior in adolescents with depressive disorder. Results Among 217 adolescents with depressive disorder， the incidence of suicide behavior was 22.58% （49/217）. Univariate analysis showed that there were statistically significant differences in the age of onset， school bullying， non-suicidal self-injury， suicidal ideation， HAMD score， CTQ total score， emotional abuse score， interpersonal relationship score， psychological resilience total score， hardiness score， and optimism score between the two groups of patients （all P ＜ 0.05）. Binomial Logistic regression analysis showed that school bullying ［OR=2.473， 95%CI （1.036， 5.902）］， suicidal ideation ［OR=10.206， 95%CI （1.909， 54.557）］， high emotional abuse scores ［OR=1.213， 95%CI （1.076， 1.368）］， and high interpersonal relationship scores ［OR=1.139， 95%CI （1.041， 1.246）］were risk factors for suicide behavior in adolescents with depressive disorder （P ＜ 0.05）， while high optimism scores ［OR=0.845， 95%CI （0.719， 0.993）］were protective factors for suicide behavior， and the differences were statistically significant （P＜ 0.05）. Conclusions The incidence of suicide behavior is higher in adolescents with depressive disorder. School bullying， suicidal ideation， emotional abuse， and poor interpersonal relationships are risk factors for suicide behavior， while good psychological resilience is a protective factor for suicide behavior.

Abstract:Objective To explore the effects of deep transcranial magnetic stimulation （dTMS） combined with drug therapy on anxiety， depression， and social function in patients with depressive disorder. Methods From September 2022 to December 2023， 149 patients with depressive disorder at the Mental Health Center of the First Hospital of Hebei Medical University were selected as participants. The patients were randomly divided into dTMS combined with drug therapy group （n=70） and drug therapy group （n=79） using a random number table method. Drug therapy group was treated with a single antidepressant， while dTMS combined drug therapy group was treated with dTMS in addition to the drug therapy， five times a week for a total of two weeks. Before treatment and two weeks after treatment， the 17 item Hamilton Depression Scale （HAMD-17）and Hamilton Anxiety Scale （HAMA） were used to evaluate the depression and anxiety symptoms of the two groups of subjects， and the Global Assessment Functioning Scale （GAF） was used to evaluate the social function of the subjects. Statistical methods such as independent sample t-test and chi square test were used to compare the efficacy differences between the two groups. Results The differences in HAMA ［（26.10±8.60） vs （12.87±4.54）， （26.89±6.98） vs （12.34±4.91）］， HAMD-17 ［（26.43±6.40） vs （11.46±4.58）， （26.83±4.62） vs （9.30±5.33）］， and GAF ［（41.00±9.30） vs （52.36±11.31）， （42.23±11.49） vs （58.54±15.31） ］ scores before and after treatment between drug therapy group and dTMS combined with drug therapy group were statistically significant （t=13.95， 17.29， 19.15， 21.77， -11.95， -12.26； all P＜ 0.05）. After two weeks of treatment， there was no statistically significant difference in the HAMA score reduction rate ［（0.46±0.27）vs （0.53±0.19）］ between drug therapy group and dTMS combined with drug therapy group （t=-1.73， P=0.09）. There was a statistically significant difference in the HAMD-17 score reduction rate ［（0.55±0.19） vs （0.64±0.20）］ between the two groups （t=-2.90， P＜ 0.05）. The scoring rate of the GAF scale in the dTMS combined with drug therapy group was higher than that in the drug group ［（0.46±0.25）vs （0.30±0.23）］，and the difference was statistically significant（t=-2.81，P＜ 0.05 ）. Conclusions DTMS combined with drug therapy can rapidly improve anxiety and depression in patients with depressive disorder， and promote the improvement of social function

Abstract:Objective To explore the relationship between spontaneous activity in brain regions and executive function in depressive disorder patients with low sleep quality. Methods A total of 42 patients with depressive disorder in the Mental Health Center of the First Hospital of Hebei Medical University from September 2021 to April 2024 were selected as study group. During the same period， 14 matched age， gender， and education level were recruited from the Health Examination Center of the same hospital as healthy control group. Hamilton Depression Scale-17 item （HAMD-17）， Pittsburgh Sleep Quality Index （PSQI）， and Digital Span Test （DST） were used to assess the subjects' depressive mood， sleep quality， and cognition. 3.0T restingstate functional magnetic resonance imaging （rs-fMRI） scan was used to calculate the fraction amplitude of low frequency fluctuation （fALFF）. According to the PSQI score， patients in study group with a PSQI score ≤ 7 were defined as high sleep quality group （n=14）， and patients with a PSQI score ＞ 7 were defined as low sleep quality group （n=28）. After conducting a variance analysis of fALFF values for three groups of subjects， a backtesting was conducted， and Spearman correlation was used to analyze the correlation between different brain regions and digital span scores. Results There was no statistically significant difference in age， gender， education level， and forward digit span scores among the three groups of subjects （P＞ 0.05）. However， there was a statistically significant difference in the scores of backwards digit span （H=26.56， P=0.03）. Backtesting showed that low sleep quality group had a lower score for backwards digit span compared to healthy control group with a statistical difference （Z=-3.40， P ＜ 0.05）， but there was no statistically significant difference between high sleep quality group and low sleep quality group （Z=-1.34， P=0.18） or healthy control group （Z= -1.35， P=0.18）. There was a statistically significant difference in the fALFF values of the right superior occipital gyrus （MNI： x=0， y=-102， z=-31； k=37）， left middle occipital gyrus （MNI： x=21， y=-102， z=6； k=51）， and left anterior cingulate cortex （MNI： x=-9， y=-78， z=21； k=27） among the three groups （GRF correction， P＜ 0.05）. Compared with high sleep quality group， the fALFF value of the right superior occipital gyrus in low sleep quality group increased， and the difference was statistically significant （Z=-3.02， P＜ 0.05）. Compared with healthy control group， the fALFF value of the left anterior cingulate cortex increased in high sleep quality group （Z=-2.02， P=0.04）， while the fALFF values of the right superior occipital gyrus （Z=-3.47， P＜ 0.05）， left middle occipital gyrus （Z=-3.82， P ＜ 0.05）， and left anterior cingulate cortex （Z=-3.71， P ＜ 0.05） increased in low sleep quality group， and the differences were statistically significant. Correlation analysis showed that there was a negative correlation between the right superior occipital gyrus （r=-0.26， P＜ 0.05） and the left anterior cingulate cortex （r=-0.38， P＜ 0.05） and the score of backwards digit span， and the differences were statistically significant. Conclusions Depressive disorder patients with low sleep quality have increased spontaneous activity of the occipital lobe， and abnormal activity of the occipital lobe may be related to decreased executive function.

Abstract:Objective To explore the effect of deep transcranial magnetic stimulation （dTMS） on spontaneous neural activity of patients with depressive disorder. Methods Seventeen patients with depressive disorder at the Mental Health Center of the First Hospital of Hebei Medical University from September 2022 to January 2024 were selected as research group， and 10 healthy individuals who underwent physical examinations at the Health Examination Center of the First Hospital of Hebei Medical University from September 2021 to August 2023 were selected as control group. Research group underwent the left dorsolateral prefrontal cortex dTMS at a frequency of 18 Hz， with a stimulation intensity of 120% of the resting exercise threshold. The treatment was conducted five times a week for two consecutive weeks， totaling 10 times. General data of the subjects were collected. Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） were used to evaluate the depressive disorder and anxiety of research group patients before and after treatment， and resting state functional magnetic resonance imaging （rs-fMRI） of the subjects' heads were collected. Fraction amplitude of low-frequency fluctuation （fALFF） was used to evaluate the spontaneous neural activity of the research group patients before and after treatment， as well as the research group patients before treatment and control group. T-test or non-parametric test were used to evaluate the spontaneous neural activity in research group before and after treatment， while Pearson correlation was used to analyze the association between clinical symptoms and spontaneous neural activity. Results Research group included 16 cases， and control group included 10 cases. The total HAMA score， HAMD score， and factor scores of research group after treatment were all lower than before treatment， and the difference was statistically significant （P＜0.05）. The fALFF value of right paracentral lobule in the research group before treatment was lower than that in the control group， and the difference was statistically significant （t=5.36， P ＜ 0.05）. After dTMS treatment， the fALFF values of the left middle frontal gyrus and right medial superior frontal gyrus decreased， while the fALFF values of the right lingual gyrus， left lingual gyrus， right occipital gyrus， and right paracentral lobule increased， with statistically significant differences （t=12.36，16.01，-11.07，-10.81，-10.19， -14.14； P＜ 0.05）. Pearson correlation analysis showed that the fALFF value of the left lingual gyrus before treatment was negatively correlated with the total HAMA score （r=-0.89， P=0.017） and anxiety/somatic factor score （r=-0.96， P=0.002）， while the decrease in fAFLL value of the left frontal gyrus after treatment was positively correlated with the decrease in retardation factor score （r=0.88， P=0.021）， and the differences were statistically significant. Conclusions Abnormal spontaneous neural activity is present in the frontal， lingual， and occipital lobes of patients with depressive disorder. The balance of spontaneous neural activity after dTMS treatment is related to the improvement of depressive， anxious， and delayed symptoms.

Abstract:Childhood trauma is associated with the recovery and prognosis of depressive disorder. It is believed that the occurrence of depressive disorder accompanied by childhood trauma is the result of the interaction between genes and environment， and non-homogeneous neurobiological mechanisms are also involved. Gene polymorphism， also known as genetic polymorphism， refers to the simultaneous or frequent presence of two or more discontinuous variations in a population of organisms. Research has found that childhood trauma and depressive disorder may be associated with gene polymorphisms in the neurotransmitter system， hypothalamic-pituitary-adrenal axis， brain-derived neurotrophic factor， and inflammation. This article reviews candidate gene polymorphisms related to depressive disorder， aiming to reveal the potential pathogenesis of depressive disorder patients with childhood trauma and provide theoretical basis for early diagnosis and treatment of depressive disorder.

Abstract:Childhood trauma has a certain correlation with resting blood pressure and resting heart rate， which is an important risk factor for predicting cardiovascular disease. This review summarizes the correlation between childhood trauma and resting blood pressure and resting heart rate and cardiovascular disease， as well as the potential mechanisms of childhood trauma affecting resting blood pressure， resting heart rate and cardiovascular disease， including epigenetics， neuroendocrine， oxidative stress， inflammation， adverse lifestyle， psychological stress etc. The aim is to clarify the potential impact of childhood trauma on the cardiovascular system， and provide a theoretical basis for the prevention and treatment of cardiovascular disease

Abstract:Objective To explore the anxiety and depressive disorder status of patients with chronic pain. Methods From January 2023 to January 2024， 455 chronic pain patients admitted to the Pain Department of the First Affiliated Hospital of China Medical University were selected as participants. Visual Analogue Scale （VAS）， Generalized Anxiety Disorder-7 （GAD-7）， and Patient Health Questionnaire-9 （PHQ-9） were used to assess patients' pain， anxiety， and depressive disorder， respectively. Spearman correlation was used to analyze the correlation between patients' age， VAS， GAD-7， and PHQ-9 scores. Results A total of 455 questionnaires were distributed， and 407 valid questionnaires were collected， with a valid response rate of 89.45%. According to the International Classification of Diseases 11th Revision （ICD-11） chronic pain classification criteria， patients were divided into 38 cases of chronic postsurgical or post traumatic pain （Group Ⅰ）， 127 cases of chronic secondary musculoskeletal pain （Group Ⅱ）， 18 cases of chronic secondary visceral pain （Group Ⅲ）， 39 cases of chronic secondary headache or orofacial pain （Group Ⅳ）， 71 cases of chronic neuropathic pain （Group Ⅴ）， 89 cases of chronic primary pain （Group Ⅵ）， and 25 cases of chronic cancer related pain （Group Ⅶ）. There was no statistically significant difference in gender and PHQ-9 score among 7 groups of patients （P ＞ 0.05）， but there was a statistically significant difference in age， VAS score， GAD- 7 score， and duration of pain （P ＜ 0.05）. Among the 407 patients， anxiety patients accounted for 60.37% （248/407）， and depressive disorder patients accounted for 67.57% （275/407）. Among the 407 patients， there were 164 cases of mild anxiety， 53 cases of moderate anxiety， and 31 cases of severe anxiety， and there were 132 cases of mild depressive disorder， 89 cases of moderate depressive disorder， 46 cases of moderate to severe depressive disorder， and 8 cases of severe depressive disorder. Among the 7 groups of patients， there was a statistically significant difference in the total score of GAD-7 （χ2 =13.596， P=0.034）， but there was no statistically significant difference in the total score of PHQ-9 （χ2 =5.417， P=0.492）. Correlation analysis showed that VAS scores of chronic pain patients were positively correlated with age， GAD-7， and PHQ-9 scores （r=0.105， 0.210， 0.216； P＜ 0.05）， and GAD-7 scores were positively correlated with PHQ-9 scores （r=0.647， P ＜ 0.05）， and the differences were statistically significant. Conclusions Chronic pain patients have a high incidence of anxiety and depressive disorder， and the severity of anxiety is positively correlated with the severity of depressive disorder.

Abstract:Inhaled anaesthetics can replace intravenous anaesthesia in modified electroconvulsive therapy （MECT） for patients with severe mental disorders who refuse intravenous anaesthesia， are too agitated to undergo intravenous anaesthesia， or are unsuitable for intravenous anaesthesia in pregnant women. Sevoflurane and isoflurane can also act independently as an antidepressant for therapeutic purposes. This paper aims to reviews the research progress of inhaled anaesthetics， such as sevoflurane， enflurane and isoflurane in MECT， exploring the application of inhaled anesthetics in psychiatric clinical practice.

Abstract:Mood disorders mainly refer to depression and bipolar disorder， which often occur in early adulthood and are one of the main causes of social dysfunction and disability in young adults， causing a huge economic burden on society. Patients with mood disorders have multiple functional impairments， but their functional impairments are difficult to quantify and may manifest differently at different stages of the disease， potentially affecting their lives and even causing serious adverse consequences such as self-injury and suicide. Eye tracking technology is an objective evaluation method for a series of spontaneous， controlled， and purposeful movements of the eye. It has the advantages of lightweight instruments， relatively simple operation， and non-invasiveness， and is increasingly widely used in the field of psychiatry. This article summarizes the current eye tracking research related to mood disorders， focusing on the eye tracking paradigms that can be used in clinical practice， potential clinical application directions， the potential of multimodal analysis， and the development direction of eye tracking technology. It explores the potential of eye tracking technology as a functional assessment tool for patients with mood disorders， to provide reference for clinical applications.

Abstract: