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هذه هي الصين : قوة تسير نحو العالم
يركز كتاب \"هذه هي الصين\" على سرد قصص تنمية الصين في العصر الجديد. وقد غير الدكتور تشانغ وي وي طريقته المعروفة بالتوجيه والإرشاد في البرامج الأيديولوجية والنظرية في الماضي، وعبر عنها بلغة شعبية سائغة، وحجج منطقية صارمة، وبيانات حقيقية، وتصادمات صريحة للأفكار، وتقنيات عرض مبتكرة لمساعدة الجمهور على فهم النموذج الصيني والطريق الصيني، وتعزيز ثقتهم بمستقبل الصين.
Book
Correlation analysis and gender differences of cognitive function based on mini-mental state examination (MMSE) and suicidal tendency in patients with schizophrenia
Background
The aim of this study was to investigate the correlation and gender differences between cognition and suicidal tendency in patients with schizophrenia.
Methods
A total of 554 patients with schizophrenia were recruited. The Mini-Mental State Examination (MMSE), Positive and Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index (IRI), Toronto Alexithymia Scale (TAS), and Insomnia Severity Index (ISI) were used to assess clinical symptoms.
Results
In male patients, MMSE score and the incidence of suicidal tendency were correlated (P = 0.04, OR = 1.06, 95%CI: 1.00–1.12). Among patients with cognitive dysfunction, IRI score (P = 0.01, OR = 1.04, 95%CI: 1.01–1.06), and types of antipsychotic drugs (P < 0.01, OR = 3.97, 95%CI: 1.76–8.97) in male patients were associated risk factors for suicidal ideation. Among patients without cognitive dysfunction, PANSS positive subscale score (P = 0.03, OR = 1.06, 95%CI: 1.01–1.11), and PANSS general psychopathology score (P = 0.02, OR = 1.05, 95%CI: 1.01–1.08) were associated risk factors for suicidal ideation in male patients and PANSS positive subscale score (P < 0.01, OR = 1.15, 95%CI: 1.05–1.26) were associated risk factors for suicidal ideation in female patients.
Conclusions
There were significant gender differences in the correlation between cognitive functioning and suicidal ideation in patients with schizophrenia. Cognitive function may play an important mediating role in other factors on suicide.
Journal Article
Gender differences in the prevalence and clinical correlates of thyroid dysfunction in patients with first-episode and drug-naïve major depressive disorder with comorbid suicide attempts: a large cross-sectional study
Background
Gender differences in patients with major depressive disorder (MDD) are commonly reported; however, gender differences in first-episode and drug-naïve (FEDN) MDD patients with comorbid suicide attempts have not been reported. This study aimed to examine potential gender differences in the prevalence and clinical correlates of comorbid abnormal thyroid function (ATF) in FEDN MDD patients with comorbid suicide attempts.
Methods
A cross-sectional study of 1718 FEDN MDD patients was conducted. The demographic and clinical data were collected. The Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA) and Positive and Negative Syndrome Scale (PANSS) were used to assess depression, anxiety and psychotic symptoms, respectively. Thyroid function parameters and blood glucose levels were measured.
Results
There was no gender difference in the prevalence of ATF between male (78.6%, 88/112) and female MDD patients (74.8%, 175/234) with comorbid suicide attempts. In the male and female subgroups, duration of disease, HAMD score, HAMA score, anti-thyroglobulin (TgAb), thyroid peroxidases antibody (TPOAb), diastolic blood pressure (DBP), systolic blood pressure (SBP), glucose level and the rate of psychotic symptoms were higher in patients with ATF than those without ATF in MDD with comorbid suicide attempt (all
P
< 0.05). There was a gender main effect only on SBP (
F
= 7.35,
P
= 0.007). Furthermore, binary logistic regression analysis showed that HAMD score, DBP and glucose levels were independently with ATF in both male and female MDD patients with comorbid suicide attempts. However, anxiety symptoms, psychotic symptoms and TPOAb levels were significantly associated with ATF only in female MDD patients with comorbid suicide attempts.
Conclusion
Our study showed no gender differences in the prevalence of ATF in FEDN MDD patients with comorbid suicide attempts. Depression, DBP and glucose levels were associated with ATF in both male and female MDD patients with comorbid suicide attempts, whereas anxiety, psychotic symptoms and TPOAb level were correlated with ATF only in female MDD patients with suicide attempts.
Journal Article
Predicting individual responses to the electroconvulsive therapy with hippocampal subfield volumes in major depression disorder
Electroconvulsive therapy (ECT) is one of the most effective treatments for major depression disorder (MDD). ECT can induce neurogenesis and synaptogenesis in hippocampus, which contains distinct subfields, e.g., the cornu ammonis (CA) subfields, a granule cell layer (GCL), a molecular layer (ML), and the subiculum. It is unclear which subfields are affected by ECT and whether we predict the future treatment response to ECT by using volumetric information of hippocampal subfields at baseline? In this study, 24 patients with severe MDD received the ECT and their structural brain images were acquired with magnetic resonance imaging before and after ECT. A state-of-the-art hippocampal segmentation algorithm from Freesurfer 6.0 was used. We found that ECT induced volume increases in CA subfields, GCL, ML and subiculum. We applied a machine learning algorithm to the hippocampal subfield volumes at baseline and were able to predict the change in depressive symptoms (r = 0.81; within remitters, r = 0.93). Receiver operating characteristic analysis also showed robust prediction of remission with an area under the curve of 0.90. Our findings provide evidence for particular hippocampal subfields having specific roles in the response to ECT. We also provide an analytic approach for generating predictions about clinical outcomes for ECT in MDD.
Journal Article
Sex differences in prevalence and clinical correlates of subclinical hypothyroidism in Chinese patients with first-episode untreated major depressive disorder
Background
Previous studies showed sex differences in the prevalences of both major depressive disorder (MDD) and subclinical hypothyroidism (SCH). This study aimed to further compare the prevalence and correlates of moderate-to-severe SCH between male and female Chinese MDD patients.
Methods
A total of 1706 first-episode drug naïve Chinese patients with MDD were recruited. Depressive symptoms were assessed by the 17-item Hamilton Depression Rating Scale, psychotic symptoms by the Positive and Negative Syndrome Scale and anxiety symptoms by the Hamilton Anxiety Rating Scale. Serum thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) concentrations were measured by chemiluminescence immunoassay. Moderate-to-severe SCH was defined as serum TSH > 8 mIU/L with normal fT4.
Results
The prevalence of moderate-to-severe SCH was 10.4% in male patients and 15.1% in female patients (χ2 = 7.22,
p
< 0.01). In female patients, binary logistic regression showed that systolic blood pressure (SBP), suicide attempts and psychotic symptoms (all
p
< 0.001) were associated with moderate-to-severe SCH. In male patients, SBP and psychotic symptoms were associated with moderate-to-severe SCH (both
p
< 0.001), while suicide attempts and severe anxiety were not (
p
> 0.05).
Conclusions
Our findings reveal a higher prevalence rate of moderate-to-severe SCH in female untreated first-episode MDD patients compared with males. Moreover, there is a positive association between suicide attempts and moderate-to-severe SCH only in female MDD patients.
Highlights
1. Moderate-to-severe subclinical hypothyroidism (SCH) occurred more often in female patients.
2. Suicide attempts were associated with moderate-to-severe SCH only in female patients.
3. Psychotic symptoms were associated with moderate-to-severe SCH in both female and male patients.
Journal Article
Sex differences in prevalence and clinical correlates of internet addiction among Chinese adolescents with schizophrenia
Background
Patients with schizophrenia (SCZ) exhibit sex differences in various aspects, and patients with SCZ have a high prevalence of internet addiction (IA). However, sex differences in IA among patients with SCZ mostly remain unstudied, particularly in Chinese adolescent patients with SCZ. This study investigated sex differences in prevalence, risk factors, and clinical correlates of IA among Chinese adolescent patients with SCZ.
Methods
A total of 706 adolescent patients with SCZ were enrolled in this study using a cross-sectional design and a convenience sampling method. Demographics and clinical data of the patients were collected using a standardized clinical assessment form. The Positive and Negative Syndrome Scale (PANSS) and the Young’s Internet Addiction Test were used to evaluate psychopathological symptoms and IA respectively.
Results
Overall, the prevalence of IA among Chinese adolescent patients with SCZ was 26.30% (95% CI: 23.09-29.60%). In Chinese adolescents with SCZ, there was a sex difference in the comorbidity of IA (males: 33.33% vs. females: 21.69%). Binary logistic regression analysis showed that IA was significantly predicted by good socioeconomic status in male and female patients with SCZ. City of living and PANSS total score were associated with IA in male patients with SCZ. In contrast, hospitalization rate and depression score were associated with IA in female patients with SCZ.
Conclusion
Our study suggests sex differences in clinical correlates of IA in Chinese adolescent patients with SCZ. An additional longitudinal study is required to confirm the findings of the present study.
Journal Article
Structural brain changes in the anterior cingulate cortex of major depressive disorder individuals with suicidal ideation: Evidence from the REST-meta-MDD project
Suicidal ideation (SI) is very common in patients with major depressive disorder (MDD). However, its neural mechanisms remain unclear. The anterior cingulate cortex (ACC) region may be associated with SI in MDD patients. This study aimed to elucidate the neural mechanisms of SI in MDD patients by analyzing changes in gray matter volume (GMV) in brain structures in the ACC region, which has not been adequately studied to date.
According to the REST-meta-MDD project, this study subjects consisted of 235 healthy controls and 246 MDD patients, including 123 MDD patients with and 123 without SI, and their structural magnetic resonance imaging data were analyzed. The 17-item Hamilton Depression Rating Scale (HAMD) was used to assess depressive symptoms. Correlation analysis and logistic regression analysis were used to determine whether there was a correlation between GMV of ACC and SI in MDD patients.
MDD patients with SI had higher HAMD scores and greater GMV in bilateral ACC compared to MDD patients without SI (all p < 0.001). GMV of bilateral ACC was positively correlated with SI in MDD patients and entered the regression equation in the subsequent logistic regression analysis.
Our findings suggest that GMV of ACC may be associated with SI in patients with MDD and is a sensitive biomarker of SI.
Journal Article
Prevalence and clinical profile of abnormal glucose in first-episode and drug-naïve patients with major depressive disorder with comorbid abnormal thyroid function: a large-scale cross-sectional study
Background
The associated factors of abnormal glucose in patients with major depressive disorder (MDD) with comorbid abnormal thyroid function (ATF) remain unclear. To the best of our knowledge, this is the first study with a large sample size that examines the risk factors of abnormal glucose in first-episode drug-naïve (FEDN) MDD patients comorbid with ATF and includes clinical correlates and thyroid hormone levels.
Methods
A total of 1718 FEDN MDD patients were recruited. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale were used to evaluate the symptoms of patients. Fasting blood glucose concentration and thyroid hormone levels were measured.
Results
The prevalence of abnormal glucose in MDD patients with comorbid ATF was 47.3%, which was 4.25 times higher than that in MDD patients without ATF (17.4%). Compared to those ATF patients without abnormal glucose, ATF patients with abnormal glucose scored higher on HAMD, HAMA and PANSS positive subscale, had a higher rate of suicide attempts, severe anxiety and psychotic symptoms, and had higher levels of thyroid-stimulating hormone (TSH), and thyroid peroxidases antibody (TPOAb) which were also correlated with abnormal glucose in MDD patients comorbid ATF (all
P
< 0.05). The combination of HAMD score and TSH could differentiate abnormal glucose from ATF. Further, TSH was independence-related with the concentration of fasting blood glucose in MDD patients with comorbid ATF.
Conclusion
Our results demonstrate a high prevalence of abnormal glucose in MDD patients with comorbid ATF. Some clinical and thyroid function-related variables may be associated with abnormal glucose in MDD patients with comorbid ATF.
Journal Article
Prevalence and clinical correlates of abnormal lipid metabolism in older Chinese patients with first-episode drug-naïve major depressive disorder
Background
Older major depressive disorder (MDD) patients have more complex clinical symptoms and higher abnormal lipid metabolism (ALM) rates. This study aimed to compare clinical differences between those with and without ALM in a sample of older first-episode drug naïve (FEDN) patients.
Methods
We recruited 266 older MDD patients. Socio-demographic variables, clinical data, and lipid parameters were obtained. The Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and the positive subscale of the Positive and Negative Syndrome Scale (PANSS-P) were conducted to evaluate patients’ depression, anxiety and psychotic symptoms, respectively.
Results
In this study, we found that the prevalence of comorbid ALM was 86.1% in older MDD patients. Compared with the non-abnormal lipid metabolism (NALM) group, the ALM group had a higher duration of illness, higher clinical global impression of severity scale (CGI-S) and HAMD scores, higher thyroid stimulating hormone (TSH) and glucose levels. Logistic regression analysis indicated that duration of illness (OR = 1.11,
P
= 0.023, 95%CI = 1.015–1.216) and CGI-S score (OR = 2.28,
P
= 0.014, 95%CI = 1.18–4.39) were associated with ALM in older MDD patients.
Conclusion
The importance of regular lipid assessment in older MDD patients needs to be taken into account.
Journal Article
The association of age of onset on suicide attempts in patients with chronic schizophrenia: a cross-sectional study
Background
There are differences in some clinical symptoms among patients with schizophrenia at different ages of onset. However, the association of age at onset on the prevalence and associated factors of suicide attempts in schizophrenia is still unclear.
Methods
A total of 949 patients with chronic schizophrenia in stable phase were enrolled. The onset of schizophrenia at or before age of 25 years was regarded as youth-onset (YO), and the onset after age of 25 years was regarded as non-youth-onset (NYO). Insomnia Severity Index (ISI), Positive and Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index (IRI), Toronto Alexithymia Scale (TAS), Mini-mental State Examination (MMSE), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to assess insomnia, psychotic symptoms, empathy, narration, and cognitive abilities of the subjects, respectively.
Results
There was no significant difference in the prevalence of suicide attempts between patients with YO and NYO (
P
> 0.05). Among YO patients, those with suicide attempts had significantly higher PANSS total scores, positive factor scores, excitability/hostility factor scores, and depression/anxiety factor scores (all
P
< 0.001), with the positive factor scores (
P
< 0.001, β = 0.18, OR = 1.19, 95%CI:1.10–1.30) and depression/anxiety factor scores (
P
< 0.001, β = 0.23, OR = 1.26, 95%CI:1.13–1.41) being independent risk factors for suicide attempts. However, the risk of suicide attempts in NYO patients was not significantly correlated with these factors.
Conclusions
There was no significant difference in the prevalence of suicide attempts between YO and NYO schizophrenic patients, whereas there was a significant difference in their associated influencing factors.
Journal Article