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Role of biological rhythm dysfunction in the development and management of bipolar disorders: a review

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General Psychiatry 2020年第1期33卷 8-19页

作者： Yiming Chen Wu Hong Yiru Fang Clinical Research Center&Division of Mood Disorders Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina Shanghai Key Laboratory of Psychotic Disorders ShanghaiChina CAS Center for Excellence in Brain Science and Intelligence Technology ShanghaiChina

Disturbance of biological rhythms contributes to the onset of bipolar disorders and is an important clinical feature of the condition.To further explore the role of biological rhythms in bipolar disorders,95 English articles published between 1968 and 2019 were retrieved from the PubMed database and analysed.We herein review the outcomes of studies on biological rhythm disturbance in bipolar disorders,including the epidemiology,aetiology,clinical features(eg,sleep,feeding and eating disorders)and treatment of the condition evaluated by patients*selfreport and biological indicators such as melatonin.Our report supports the characterisation of biological rhythm disturbance as a significant clinical feature affecting the onset and development of bipolar disorders and reviews classical and novel treatments,such as chronotherapy,that can be applied in the clinical practice.Our analysis indicates that a more comprehensive study of the pathophysiology,clinical phenomenology and treatment of biological rhythm disturbance is required.

关键词： epidemiology bipolar disturbance

Disturbances of affective cognition in mood disorders

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Science China(Life Sciences) 2021年第6期64卷 938-941页

作者： Jun Chen Zuowei Wang Zezhi Li Daihui Peng Yiru Fang Clinical Research Center&Division of Mood Disorders Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghai 200030China Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence Guangzhou 510515China Hongkou District Mental Health Center of Shanghai Shanghai 200083China Ren Ji Hospital Shanghai Jiao Tong University School of MedicineShanghai 200127China CAS Center for Excellence in Brain Science and Intelligence Technology Shanghai 200031China Shanghai Key Laboratory of Psychotic Disorders Shanghai 201108China

Mood disorders,also known as affective disorders,result in a consistent disturbance in mood.There are two major subtypes of mood disorders,i.e.,major depressive disorder(MDD)and bipolar disorder(BD).Mood disorders affect hundreds of millions of people and are the most common mental disorders.According to China’s national survey in2009(Phillips et al.,2009),the weighted 12-month prevalence of mental disorders was 17.5%and 9.3%,respectively.Mood disorders were among the highest prevalence rate disorders related to disease’s increased burdens.

关键词： disorders prevalence al.

The Risk and Prevention of Novel Coronavirus Pneumonia Infections Among Inpatients in Psychiatric Hospitals

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Neuroscience Bulletin 2020年第3期36卷 299-302页

作者： Yuncheng Zhu Liangliang Chen Haifeng Ji Maomao Xi Yiru Fang Yi Li Shanghai Mental Health Center Shanghai Jiao Tong University School of MedicineShanghai 200030China Shanghai Changning Mental Health Center(Affiliated to East China Normal University) Shanghai 200335China Institute of Burns Tongren Hospital of Wuhan University(Wuhan Third Hospital)Wuhan 430000China Affiliated Wuhan Mental Health Center Tongji Medical College of Huazhong University of Science and TechnologyWuhan 430012China CAS Center for Excellence in Brain Science and Intelligence Technology Shanghai 200031China Shanghai Key Laboratory of Psychotic Disorders Shanghai 201108China

Dear Editor,Since the middle of December 2019,human-to-human transmission of novel coronavirus pneumonia(NCP,also called COVID-19)has occurred among close contacts[1].After the outbreak on January 21,2020,it was swiftly included among the Class B infectious diseases stipulated in the Law of the People’s Republic of China on the Prevention and Control of Infectious Diseases,and measures for prevention and control of Class A infectious diseases were adopted.At 21:27 on February 12,2020,the China News Network updated information to include epidemic data from the National Health Commission and official channels in Hong Kong,Macao,and Taiwan regions:the highest death rate was in Wuhan City(Table 1).Overload of inpatients at hospitals may play a negative role in the overall therapeutic effect and contribute to the death rate.

关键词： prevention Taiwan measures

Major Depressive Disorder: Advances in Neuroscience Research and Translational Applications

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Neuroscience Bulletin 2021年第6期37卷 863-880页

作者： Zezhi Li Meihua Ruan Jun Chen Yiru Fang Clinical Research Center and Division of Mood Disorders of Shanghai Mental Health Center Shanghai Jiao Tong University School of MedicineShanghai 200030China Department of Neurology Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China Shanghai Institute of Nutrition and Health Shanghai Information Center for Life SciencesChinese Academy of ScienceShanghai 200031China Center for Excellence in Brain Science and Intelligence Technology Chinese Academy of ScienceShanghai 200031China Shanghai Key Laboratory of Psychotic Disorders Shanghai 201108China

Major depressive disorder(MDD),also referred to as depression,is one of the most common psychiatric disorders with a high economic burden.The etiology of depression is still not clear,but it is generally believed that MDD is a multifactorial disease caused by the interaction of social,psychological,and biological aspects.Therefore,there is no exact pathological theory that can independently explain its pathogenesis,involving genetics,neurobiology,and neuroimaging.At present,there are many treatment measures for patients with depression,including drug therapy,psychotherapy,and neuromodulation technology.In recent years,great progress has been made in the development of new antidepressants,some of which have been applied in the clinic.This article mainly reviews the research progress,pathogenesis,and treatment of MDD.

关键词： Major depressive disorder Pathogenesis Treatment Progress

Hypothalamic-Pituitary-End-Organ Axes:Hormone Function in Female Patients with Major Depressive Disorder

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Neuroscience Bulletin 2021年第8期37卷 1176-1187页

作者： Yuncheng Zhu Xiaohui Wu Rubai Zhou Oliver Sie Zhiang Niu fang Wang Yiru Fang Division of Mood Disorders Shanghai Hongkou Mental Health CenterShanghai200083China Clinical Research Center Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghai200030China Shanghai Medical College Fudan UniversityShanghai200032China Shanghai Yangpu Mental Health Center Shanghai200093China CAS Center for Excellence in Brain Science and Intelligence Technology Shanghai200031China Shanghai Key Laboratory of Psychotic Disorders Shanghai201108China

Classic hypothalamic-pituitary-end-organ feedback loops–the hypothalamic-pituitary-adrenal axis(HPAA),hypothalamic-pituitary-thyroidal axis(HPTA),and hypothalamic-pituitary-gonadal axis(HPGA)–are associated with the neuroendocrine and immune systems in major depressive disorder(MDD).Female patients with MDD present with evident neuroendocrine and immunological changes.Glucocorticoid,thyroid hormone,and reproductive steroid levels fluctuate with menstrual cycles,which might lead to glucocorticoid receptor resistance,impairment of triiodothyronine conversion,and sex hormone secretion disorders.In this review,we summarize the independent and interactive functions of these three axes in female MDD patients.The similar molecular structure of steroids implies an interrelationship between the hypothalamic-pituitary-end-organ axes and the competitive inhibitory effects at the receptor level,especially when considering the HPAA and HPGA.

关键词： Major depressive disorder Neurosecretory systems Sex steroid hormones

Perspective on Etiology and Treatment of Bipolar Disorders in China: Clinical Implications and Future Directions

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Neuroscience Bulletin 2019年第4期35卷 608-612页

作者： Zuowei Wang Chen Jun Kerning Gao Haichen Yang Yiru Fang Division of Mood Disorders Hongkou District Mental Health Center Shanghai 200083 China Division of Mood Disorders Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine Shanghai 200030 China Case Western Reserve University School of Medicine Cleveland OH 44106 USA Mood and Anxiety Clinic in the Mood Disorders Program of the Department of Psychiatry University Hospital Cleveland Medical Center Cleveland OH 44106 USA Department of Mood Disorders Shenzhen Mental Health Centre Shenzhen 518003 China CAS Center for Excellence in Brain Science and Intelligence Technology Shanghai 200031 China Shanghai Key Laboratory of Psychotic Disorders Shanghai 201108 China

Bipolar disorder (BD) is a chronic, recurrent, disabling disease, even when given currently-available pharmacological and psychological treatments. Currently, the etiology and pathogenesis of BD remain unclear. As a consequence, patients with BD are frequently unrecognized, misdiagnosed, and inappropriately treated, which often yields a low treatment response and poor outcome.

关键词： Perspective Future Directions Bipolar Disorders

The Relationship Between Neuroimmunity and Bipolar Disorder:Mechanism and Translational Application

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Neuroscience Bulletin 2019年第4期35卷 595-607页

作者： Zhiang Niu Lu Yang Xiaohui Wu Yuncheng Zhu Jun Chen Yiru Fang Clinical Research Center Division of Mood Disorders Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine Shanghai 200030 China CAS Center for Excellence in Brain Science and Intelligence Technology Shanghai 200031 China Shanghai Key Laboratory of Psychotic Disorders Shanghai 201108 China

Neuroimmune system may be involved in the pathological process of bipolar disorder(BD),but the essential association is not fully understood.Accumulating evidence has shown that BD involves the activation of immune cells and the release of inflammatory substances in the central nerve system(CNS).Meanwhile,neuroimmune responses also interact with other hypothesis of the etiology of BD that are widely recognized,such as neurotransmitter systems,neuroendocrine systems,neurotrophic factors,and oxidative stress.Simultaneously,related genes and immune changes in peripheral blood vary with it.Overall,neuroimmunity may play an important role in the pathogenesis of BD,and the inflammatory cytokines,especially interleukin-6 and tumor necrosis factor-alpha,have potential value for the clinical diagnosis and prognosis of BD,as well as predicting the therapeutic effects of drugs.Large-scale studies are needed to extend the evidence on neuroimmunity in BD,and to examine its clinical value for applications such as early prediction and treatment.

关键词： Neuroimmunity Inflammation Cytokines Bipolar disorder Translational application

Important clinical features of atypical antipsychotics in acute bipolar depression that inform routine clinical care: a review of pivotal studies with number needed to treat

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Neuroscience Bulletin 2015年第5期31卷 572-588页

作者： Keming Gao Chengmei Yuan Renrong Wu Jun Chen Zuowei Wang Yiru Fang Joseph R.Calabrese Department of Psychiatry Case Western Reserve University School of Medicine and Mood Disorders Program University Hospitals Case Medical Center Division of Mood Disorders Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine Institute of Mental Health of Second Xiangya Hospital of Central South University Mood Disorders Program of Hongkou District Mental Health Center of Shanghai

English-language literature cited in MEDLINE from January,1980 to October 30,2014 was searched by using terms of antipsychotic,generic and brand names of atypical antipsychotics, ＂bipolar depression/bipolar disorder＂, ＂placebo＂,and ＂trial＂.The parameters of response（≥50%improvement on MADRS,Montgomery-Asberg Depression Rating Scale total score）,remission（either ≤12 or 8 on MADRS total score at endpoint）,discontinuation due to adverse events（DAEs）,somnolence,≥7%weight gain,overall extrapyramidal side-effects（EPSs）,and akathisia,were extracted from originally published primary outcome papers.The number needed to treat to benefit（NNT） for response and remission or harm（NNH） for DAEs or other side effects relative to placebo were estimated and presented with the estimate and 95%confidence interval.Olanzapine monotherapy,olanzapine-fluoxetine combination（OFC）,quetiapine-IR monotherapy,quetiapine-XR monotherapy,lurasidone monotherapy,and lurasidone adjunctive therapy were superior to placebo with NNTs for responses of 11-12,4,7-8,4,4-5,and 7,and NNTs for remission of 11-12,4,5-11,7,6-7,and 6,respectively.There was no significant difference between OFC and lamotrigine,and between aripiprazole or ziprasidone and placebo in response and remission.Olanzapine monotherapy,quetiapine-IR,quetiapine-XR,aripiprazole,and ziprasidone 120-160 mg/day had significantly increased risk for DAEs with NNHs of 24,8-14,9,12,and 10,respectively.For somnolence,quetiapine-XR had the smallest NNH of 4.For ≥7%weight gain,olanzapine monotherapy and OFC had the smallest NNHs with both of 5.For akathisia,aripiprazole had the smallest NNH of 5.These findings suggest that among the FDA-approved agents including OFC,quetiapine-IR and-XR,lurasidone monotherapy and adjunctive therapy to a mood stabilizer,the differences in the NNTs for response and remission are small,but the differences in NNHs for DAEs and common side-effects are large.Therefore,the selection of an FDA-approved atypical antipsychotic for bipolar depression should be based upon safety

关键词： bipolar depression atypical antipsychotic number needed to treat efficacy tolerability weight gain somnolence extrapyramidal side-effects akathisia

Are subsyndromal symptomatic depression and major depressive disorder distinct disorders？

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上海精神医学 2012年第5期24卷 286-287页

作者： Zhenghui YI Yiru Fang Division of Mood Disorders Shanghai Mental Health CenterShanghai Jiao Tong University School of Medicine

Depressive conditions that do not meet full symptomatic or duration criteria for a major depressive disorder(MDD) are of considerable interest to both clinicians and researchers.[1-4]The fourth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) provides descriptions of several types of subthreshold depressive states including dysthymia, minor depression and recurrent brief depression

关键词：抑郁症症状综合征疾病精神障碍研究人员临床医生时间标准