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Composition of treatment alliance in bipolar disorder: A cross-sectional study of patients' perspectives

World Journal of psychiatry 2022年第6期12卷 814-826页

作者： Rajeet Kumar Subho Chakrabarti Abhishek Ghosh department of psychiatry Postgraduate Institute of Medical Education and ResearchChandigarh 160012India

BACKGROUND Treatment alliance has an impact on several key patient outcomes in all psychiatric disorders,including bipolar disorder(BD).It has been suggested that the construct of treatment alliance is different among patients from routine psychiatric settings compared to psychotherapeutic ***,research on the composition of treatment alliance in psychiatric disorders,such as BD,is relatively *** To determine whether a broader construct of treatment alliance was prevalent among outpatients with *** This is a cross-sectional study,conducted in the psychiatric unit of a multispecialty hospital in north India over 12 mo(September 2018 to September 2019).A consecutive sample of 160 remitted adult outpatients with BD on mood stabilizers for at least a year were *** principal instrument to assess treatment alliance was the Working Alliance Inventory-client version(WAIClient).Other potential constituents of the alliance explored were perceived trust in clinicians assessed by the Trust in Physicians(TRIP)scale,perceived support from clinicians assessed by the Psychosocial Care by Physicians(PCP)scale,and perceived treatment satisfaction assessed by the Patient Satisfaction Questionnaire(PSQ).Associations between scores on all scales were determined by correlational and multiple regression *** factor analysis of combined items of all scales was conducted using a principal components *** Scores on all the three WAI-Client subscales were significantly correlated with each other(r=0.66-0.81;P<0.0001).The total TRIP scores were associated with the total WAI-Client scores(r=0.28;P<0.01).The total TRIP scores and the total PCP scores were also significantly associated with the WAI-Client scores on the Task subscale(r=0.28-0.29;P<0.01).The total TRIP scores were significantly associated with the total PSQ scores(r=0.45;P<0.0001).Factor analysis yielded two independent and coherent factors,which explained 69%of the va

关键词： Treatment alliance Bipolar disorder Composition Factor-analysis

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Clozapine resistant schizophrenia:Newer avenues of management

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World Journal of psychiatry 2021年第8期11卷 429-448页

作者： Subho Chakrabarti department of psychiatry Postgraduate Institute of Medical Education and ResearchChandigarh 160012India

About 40%-70%of the patients with treatment-resistant schizophrenia have a poor response to adequate treatment with *** impact of clozapineresistant schizophrenia(CRS)is even greater than that of treatment resistance in terms of severe and persistent symptoms,relapses and hospitalizations,poorer quality of life,and healthcare *** serious consequences often compel clinicians to try different augmentation strategies to enhance the inadequate clozapine response in ***,a large body of evidence has shown that antipsychotics,antidepressants,mood stabilizers,electroconvulsive therapy,and cognitive-behavioural therapy are mostly ineffective in augmenting clozapine *** beneficial effects of augmentation have been found,they are usually small and of doubtful clinical significance or based on low-quality ***,newer treatment approaches that go beyond the evidence are *** options proposed include developing a clinical consensus about the augmentation strategies that are most likely to be effective and using them sequentially in patients with ***,newer approaches such as augmentation with long-acting antipsychotic injections or multi-component psychosocial interventions could be ***,perhaps the most effective way to deal with CRS would be to optimize clozapine treatment,which might prevent clozapine resistance from *** dosing,adequate treatment durations,management of side effects and non-adherence,collaboration with patients and caregivers,and addressing clinician barriers to clozapine use are the principal ways of ensuring optimal clozapine *** present,these three options could the best way to manage CRS until research provides more firm directions about the effective options for augmenting clozapine response.

关键词： Clozapine-resistance Augmentation Medications Electroconvulsive therapy Psychosocial treatments Schizophrenia

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Psychological impact of the COVID-19 pandemic on individuals with serious mental disorders: A systematic review of the literature

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World Journal of psychiatry 2021年第12期11卷 1387-1406页

作者： Eva Fleischmann Nina Dalkner Frederike T Fellendorf Eva Z Reininghaus department of psychiatry and Psychotherapeutic Medicine Medical University of GrazGraz 8036Austria

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic is having a great impact on individuals from all over the world,particularly on individuals with mental *** studies found more pronounced psychiatric symptoms,notably symptoms of depression and *** To assess the situation of patients with serious mental illness(SMI:Affective disorders and schizophrenia)regarding their mental health outcome during the *** A systematic search using the databases PubMed and MEDLINE was conducted,employing the key words“COVID-19”,“SARS-CoV-2”,“psychiatric/mental disorder/illness”,“affective/mood disorder”,“bipolar disorder”,“(major)depression”,“schizoaffective disorder”,and“schizophrenia”.Studies that had been published up until January 9,2021 were *** of studies in languages other than English and German was mostly taken from their English *** The literature search concluded in the finding of 36 studies containing relevant clinical data.A general impairment of the mental health of individuals with SMI could be detected,particularly in individuals with affective disorders,as compared to those with *** to healthy controls,symptoms of anxiety,depression,and stress were more pronounced in individuals with *** factors found that impacted their mental health were age,resilience,and socioeconomic environment,especially the shortage of mental health services,lack of social support,and inadequate information about *** In light of these results,mental health services should be reinforced,notably the use of telemental health ***,supplying individuals with SMI with adequate information about the COVID-19 pandemic and increasing their resilience is *** researching the impact of the COVID-19 pandemic on individuals with SMI,standardization as well as follow-up studies are needed to enable better comparability and understanding.

关键词： COVID-19 pandemic Serious mental illness Affective disorders Bipolar disorder Major depressive disorder Schizophrenia

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Rare case report of Van Gogh syndrome in a patient with paranoid schizophrenia

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General psychiatry 2020年第1期33卷 53-55页

作者： Varchasvi Mudgal Pali Rastogi Vijay Niranjan Ramghulam Razdan department of psychiatry MGM Medical CollegeIndoreMadhya PradeshIndia

Self-mutilation is often associated with psychiatric *** describe here a 22-year-old male Indian with decreased sleep,aggressive behaviour,self-muttering,disorganised behaviour,frequent spitting,biting and selfmutilation;he bit off his right ring finger and left thumb(Van Gogh syndrome).Self-harm behaviour was frequently evidenced by family members resulting in various *** patient was diagnosed with paranoid schizophrenia and was treated with anti-psychotics which resulted in a decrease in his behavioural disturbances along with treatment for his self-mutilation *** we discuss Van Gogh syndrome’s presentation of self-mutilation in paranoid schizophrenia and its implications.

关键词： injuries schizophrenia Van

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Interoception mediates the association between social support and sociability in patients with major depressive disorder

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World Journal of psychiatry 2024年第10期14卷 1484-1494页

作者： Wen-Liang Wang Ji-Kang Liu Yi-Fan Sun Xiao-Hong Liu Yu-Hang Ma Xue-Zheng Gao Li-Min Chen Zhen-He Zhou Hong-Liang Zhou department of psychiatry The Affiliated Mental Health Center of Jiangnan UniversityWuxi 214151Jiangsu ProvinceChina department of psychiatry The Affiliated Mental Health Center of Nanjing Medical UniversityWuxi 214151Jiangsu ProvinceChina department of psychology The Affiliated Hospital of Jiangnan UniversityWuxi 214151Jiangsu ProvinceChina

BACKGROUND Interoception dysfunction has an important impact on the onset and development of major depressive disorder(MDD).Social support serves as a protective factor against MDD,and sociability also plays a significant role in this *** interconnected constructs-social support and sociability-play pivotal roles in ***,no research on the mechanisms underlying the associations be-tween social support and sociability,particularly the potential role of interocep-tion,have been ***,social support,and sociability,respectively.A mediation analysis model for the eight dimensions of intero-ception(noticing,not distracting,not worrying,attention regulation,emotional awareness,self-regulation,body listening,and trust),social support,and sociability were established to evaluate the mediating *** A partial correlation analysis of eight dimensions of the MAIA-2,SSRS,and TSBI scores,with demographic data as control variables,revealed pairwise correlations between the SSRS score and both the MAIA-2 score and TSBI *** the major depression(MD)group,the SSRS score had a positive direct effect on the TSBI score,while the scores for body listening,emotional awareness,self-regulation,and trust in the MAIA-2C had indirect effects on the TSBI *** the HC group,the SSRS score had a positive direct effect on the TSBI score,and the scores for attention regulation,emotional awareness,self-regulation,and trust in the MAIA-2C had indirect effects on the TSBI *** proportion of mediators in the MD group was lower than that in the HC *** Interoceptive awareness is a mediating factor in the association between social support and sociability in both HCs and depressed *** in interoceptive awareness might not only help improve emotional regulation in depressed patients but also enhance their social skills and support networks.

关键词： Interoception Social support Sociability Major depression Mediation analysis

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Statistical issues and approaches in endophenotype research

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Chinese Science Bulletin 2011年第32期56卷 3403-3408页

作者： SHAM Pak Chung CHERNY Stacey S HALL Mei-Hua department of psychiatry and The State Key Laboratory of Brain and Cognitive Sciences The University of Hong Kong Hong Kong China psychology Research Laboratory McLean Hospital Harvard Medical School Boston MA 02115-6092 USA

The endophenotype concept was initially proposed to enhance the power of genetic studies of complex disorders. It is closely related to the genetic component in a liability-threshold model; a perfect endophenotype should have a correlation of 1 with the genetic component of the liability to disease. In reality, a putative endophenotype is unlikely to be a perfect representation of the genetic component of disease liability. The magnitude of the correlation between a putative endophenotype and the genetic component of disease liability can be estimated by fitting multivariate genetic models to twin data. A number of statistical methods have been developed for incorporating endophenotypes in genetic linkage and association analyses with the aim of improving statistical power. The most recent of such methods can handle multiple endophenotypes simultaneously for the greatest increase in power. In addition to increasing statistical power, endophenotype research plays an important role in helping to understand the mechanisms which connect the associated genetic variants with disease occurrence. Novel statistical approaches may be required for the analysis of the complex relationships between endophenotypes at different levels and how they converge to cause the occurrence of disease.

关键词：统计问题稳定遗传疾病 COM组件复杂疾病组成部分模型估计统计方法

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Analysis of monocyte chemotactic protein-1 gene polymorphism in patients with spontaneous bacterial peritonitis

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World Journal of Gastroenterology 2009年第44期15卷 5558-5562页

作者： Erwin Gbele Marcus Mhlbauer Hartwig Paulo Monika Johann Christin Meltzer Franz Leidl Norbert Wodarz Reiner Wiest Jrgen Schlmerich Claus Hellerbrand department of Internal Medicine University Medical Center RegensburgD-93042 RegensburgGermany department of psychiatry University Medical Center RegensburgD-93042 RegensburgGermany

AIM:To investigate a genetic polymorphism of the monocyte chemotactic protein-1 (MCP-1 ) gene in patients with spontaneous bacterial peritonitis (SBP).METHODS:MCP-1 genotyping was performed in 23 patients with SBP and 83 cirrhotic control patients with non-infected ***:The frequency of carriers of the G-allele was lower in SBP patients but this difference did not reach statistical significance. However,in the subgroup of patients with alcoholic cirrhosis (n=80),carriers of the G-allele were significantly less frequent in SBP-patients (38.1%) than in cirrhotic controls (67.8%,P=0.021). CONCLUSION:In patients with alcoholic liver cirrhosis,the-2518 MCP-1 genotype AA is a risk factor for the development of SBP.

关键词： Monocyte chemotactic protein-1 Chemokines Spontaneous bacterial peritonitis Polymorphism Livercirrhosis

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Effects of ketamine in electroconvulsive therapy for major depressive disorder:meta-analysis of randomised controlled trials

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General psychiatry 2020年第3期33卷 127-134页

作者： Xiao-Mei Li Zhan-Ming Shi Pei-Jia Wang Hua Hu department of psychiatry The First Affiliated Hospital of Chongqing Medical UniversityChongqingChina department of psychiatry Chongqing Jiangbei Mental Health CenterChongqingChina

Background The use of ketamine in electroconvulsive therapy(ECT)has been examined in the treatment of major depressive disorder(MDD);however,there has been no systematic review and meta-analysis of related randomised controlled trials(RCTs).Aim To examine the efficacy and safety of ketamine augmentation of ECT in MDD *** Two reviewers searched Chinese(China National Knowledge Infrastructure and Wanfang)and English(PubMed,PsycINFO,Embase and Cochrane Library)databases from their inception to 23 July *** included studies'bias risk was evaluated using the Cochrane risk of bias assessment *** primary outcome of this metaanalysis was improved d印ressive symptoms at day 1 after a single ECT treatment *** were pooled to calculate the standardised mean difference and risk ratio with their 95%CIs using RevMan *** used the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach to assess the whole quality of *** Four RCTs(n=239)compared ketamine alone or ketamine plus propofol(n=149)versus propofol alone(n=90)in patients with MDD who underwent a single ECT *** RCTs were considered as unclear risk with respect to random sequence generation using the Cochrane risk of *** with propofol alone,ketamine alone and the combination of ketamine and propofol had greater efficacy in the treatment of depressive symptoms at days 1,3 and 7 after a single ECT ***,compared with propofol alone,ketamine alone and the combination of ketamine and propofol were significantly associated with increased seizure duration and seizure energy *** with propofol,ketamine alone was significantly associated with increased opening-eye *** on the GRADE approach,the evidence level of primary and secondary outcomes ranged from very low(26.7%,4/15)to‘low'(73.3%,11/15).Conclusion Compared with propofol,there were very low or low evidence levels showing that ketamine alone and the combination

关键词： ketamine alone random

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Non-invasive electrical brain stimulation:from acute to late-stage treatment of central nervous system damage

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Neural Regeneration Research 2017年第10期12卷 1590-1594页

作者： Petra Henrich-Noack Elena G.Sergeeva Bernhard A.Sabel Institute of medical psychology Otto-von-Guericke University Magdeburg department of Emergency Medicine Emory University

Non-invasive brain current stimulation（NIBS） is a promising and versatile tool for inducing neuroplasticity,protection and functional rehabilitation of damaged neuronal *** is technically simple,requires no surgery,and has significant beneficial ***,there are various technical approaches for NIBS which influence neuronal networks in significantly different *** direct current stimulation（t DCS）,alternating current stimulation（ACS） and repetitive transcranial magnetic stimulation（r TMS） all have been applied to modulate brain activity in animal experiments under normal and pathological *** clinical trials have shown that t DCS,r TMS and ACS induce significant behavioural effects and can – depending on the parameters chosen – enhance or decrease brain excitability and influence performance and learning as well as rehabilitation and protective *** diverse phaenomena and partially opposing effects of NIBS are not yet fully understood and mechanisms of action need to be explored further in order to select appropriate parameters for a given task,such as current type and strength,timing,distribution of current densities and electrode *** this review,we will discuss the various parameters which need to be considered when designing a NIBS protocol and will put them into context with the envisaged applications in experimental neurobiology and medicine such as vision restoration,motor rehabilitation and cognitive enhancement.

关键词： non-invasive brain stimulation transcranial direct current stimulation transcranial magnetic stimulation transorbital alternating current stimulation stroke trauma neuroprotection restoration of function

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Proton magnetic resonance spectroscopy of the anterior cingulate gyrus and caudate nucleus in schizophrenia patients versus healthy controls

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Neural Regeneration Research 2011年第6期6卷 467-473页

作者： Lutfi Incesu Meral Baydin Kerim Aslan Baris Diren Huseyin Sahin Omer Boke Senol Dane department of Radiology Medical FacultyOndokuz Mayis University department of Radiology Gazi State Hospital department of Radiology Ataturk State Hospital department of Radiology Medicana International Hospital department of psychiatry Medical FacultyOndokuz Mayis University department of Physiology Medical FacultyFatih University

Proton magnetic resonance spectroscopy （^1 H-MRS） permits the assessment of cerebral neurometabolites, such as N-acetylaspartate, choline, and creatine, in vivo and has been used to study schizophrenia. The present study used ^1H-MRS to compare the spectroscopy change of N-acetylaspartate, creatine, and choline metabolite levels in the anterior cingulate and caudate nucleus of both schizophrenia patients and healthy controls, as well as between the left and right cerebral hemispheres in the schizophrenia patients. Results showed that N-acetylaspartate and creatine metabolite levels in the left anterior cingulate gyrus were significantly lower in the schizophrenia patients than in the healthy controls, indicating hypometabolism. In addition, choline concentration in the left caudate nucleus of schizophrenia patients was significantly lower than in the right caudate nucleus, indicating that it is necessary to study the cerebral lateralization of ^1H-MRS in schizophrenia patients.

关键词： schizophrenia magnetic resonance spectroscopy anterior cingulate gyrus caudate nucleus neurocognitive test

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