The Relationship Among BDNF Val66Met Polymorphism, Plasma BDNF Level, and Trait Anxiety in Chinese Patients With Panic Disorder.

Background: Brain-derived neurotrophic factor (BDNF) is a candidate for susceptibility locus of Panic disorder (PD). However, the findings about the role of the BDNF Val66Met variant in PD were not consistent. Till now, the relationship between BDNF Val66Met polymorphism and anxiety-related traits in PD patients has been rarely explored. This study aimed to explore the relationship among BDNF Val66Met polymorphism, plasma BDNF level and anxiety-related trait in Chinese PD patients. Method: This multi-center study included 116 PD patients and 99 health controls. We detected single-nucleotide polymorphism (SNP) of BDNF rs6265 (Val66Met) and BDNF plasma level in the two groups. In addition, PD patients were administered the State-Trait Anxiety Inventory (STAI), Panic Disorder Severity Scale-Chinese Version (PDSS-CV) and Hamilton Anxiety Rating Scale (HAMA-14). Quantitative comparison of the differences of BDNF concentration among subjects with different genotypes and association between BDNF Val66Met genotype and trait anxiety were performed. Results: There were no significant differences in the genotype frequency (p = 0.79) or allele frequency (p = 0.88) between PD patients and health controls. BDNF plasma levels of PD patients were significantly lower than those in control group (p = 0.003). BDNF plasma levels of the Met/Met genotype were significantly lower than those of Val/Met genotype in PD patients (p = 0.033). PD patients carried Met/Met genotype showed significantly higher scores in STAI trait compared to those carried Val/Val genotype (p = 0.045) and Val/Met genotype (p = 0.018). STAI trait scores of PD patients with agoraphobia were significantly higher than those of patients without agoraphobia (p < 0.05). The ANCOVA showed that the dependent variable STAI trait score was significantly affected by factor "genotype" (Val/Val, Val/Met, Met/Met, p = 0.029), and covariate "agoraphobia" (p = 0.008). In this model, 11.5% of the variance of the STAI trait score was explained by the BDNF genotype. Contrast analysis showed STAI trait scores of Met/Met subjects were significantly higher than those of Val/Met (p = 0.018) and Val/Val individuals (p = 0.045). Conclusion: We found that anxiety trait was associated with the BDNF polymorphism in PD patients. BDNF Met/Met genotype may decrease plasma BDNF level and increase trait anxiety in panic disorder.

The Prevalence, Risk Factors and Clinical Correlates of QTc Prolongation in Chinese Hospitalized Patients With Chronic Schizophrenia.

Background: The QTc interval may be significantly prolonged in schizophrenia patients taking antipsychotics. Few studies have addressed QTc prolongation (QTP) in Chinese patients. Objectives: This study was designed to evaluate the prevalence of QTP and its clinical correlates in Chinese hospitalized patients with chronic schizophrenia. Methods: A total of 436 inpatients and 291 normal controls matched with age and sex were included. QTc prolongation was defined as 2 standard deviations (SD) above the mean value of normal controls. Positive and Negative Syndrome Scale (PANSS) and its five-factor model were used to evaluate psychopathological symptoms. Results: QTc interval was significantly longer in patients than in normal controls. The prevalence of QTP is 8.26% in Chinese hospitalized patients with chronic schizophrenia. More women than men displayed QTP. Compared with patients without QTP, the patients with QTP had significantly higher concrete/disorganized subscore, lower low density lipoprotein (LDL) and lower total protein (TP). Furthermore, binary logistic regression analysis showed that higher number of hospitalizations, higher concrete/disorganized subscore and lower LDL were risk factors for QTP. Correlation analysis indicated significant association between QTc interval and the following variables: sex, age, duration of illness, the number of hospitalizations, PANSS total score, fasting blood glucose (FPG). Finally, a multiple regression analysis showed that older age, antipsychotic polypharmacy, higher PANSS total score, and lower LDL were risk factors for QTP. Among them, LDL seemed to be a protective factor for QTP. Conclusions: QTc interval was longer in schizophrenia patients than in normal controls. The prevalence of QTP is 8.26% in Chinese hospitalized patients with chronic schizophrenia. Some clinical characteristics were risk factors for QTP. And LDL seemed to be a protective factor for QTP.

Comparison of impulsive and nonimpulsive suicide attempt patients treated in the emergency departments of four general hospitals in Shenyang, China.

OBJECTIVE: The aim of the current study was to compare the sociodemographic and psychological characteristics of impulsive suicide attempters with those of nonimpulsive suicide attempters in the emergency departments of general hospitals in Shenyang, China. METHODS: A total of 239 consecutive suicide attempters, who were treated in the emergency departments of four randomly selected general hospitals from Shenyang city, were evaluated by the following measurements: a detailed structured questionnaire, Beck Suicide Ideation Scale, Hamilton Depression Rating Scale, a quality of life scale and the Structured Clinical Interview for DSM-IV Axis I Disorders. The patients were categorized as "impulsive suicide attempts" (≤ 2 h) and "nonimpulsive suicide attempts" (> 2 h) based on the hours it takes for a patient to consider suicide before acting, and the characteristics of the two groups of patients were compared. RESULTS: One hundred seven (44.8%) patients were categorized as impulsive attempters. Compared to nonimpulsive suicide attempters, the impulsive suicide attempters had significantly more self-rescue ideation, their motive was more likely to threaten or express anger at others, and they scored much lower on the intensity of suicidal ideation and depression but higher on life quality; they also had a lower prevalence of psychiatric diagnosis but a higher rate of substance-related disorders. Multivariate logistic regression analysis identified the following independent predictors of impulsive suicide attempts among suicide attempters: having religious beliefs [odds ratio (OR)=4.435, 95% confidence interval (CI)=1.545-12.736], a lower score on the Suicide Ideation Scale (OR=0.952, 95% CI=0.936-0.969) and a lower score on the Hamilton Depression Rating Scale (OR=0.949, 95% CI=0.911-0.989). CONCLUSIONS: The characteristics of impulsive suicide attempters differed significantly with those of nonimpulsive suicide attempters in emergency departments of urban China. It is important to develop different kinds of interventions for the two types of suicide attempters to prevent more future suicide attempts.

An intervention and follow-up study following a suicide attempt in the emergency departments of four general hospitals in Shenyang, China.

BACKGROUND: Studies on the effects of interventions in patients who have attempted suicide in China have not reported so far. AIMS: To describe the basic situation surrounding the interventions and follow-up of patients who have attempted suicide and to determine whether the interventions would be effective in reducing repeat suicide attempts. METHOD: 239 patients who had attempted suicide were evaluated in the emergency departments of four general hospitals. They were randomized into three groups: cognitive therapy group, telephone intervention group, and control group. Postintervention the participants were evaluated at 3, 6, and 12 months separately by the following measurements: a detailed structured questionnaire, Beck Suicide Ideation Scale (SIS), Hamilton Rating Scale for Depression (HAMD), and a quality-of-life scale. RESULTS: After 12 months, the cumulative dropout rate was 69.5% (n = 57) for the cognitive therapy group, 55.0% (n = 44) for the telephone intervention group, and 64.9% (n = 50) for the control group. One patient (1.2%) in the cognitive therapy group, one patient (1.3%) in the telephone intervention group, and five patients (6.5%) in the control group made at least one subsequent suicide attempt. The rates of repeated attempted suicide among the three groups were not significantly different (χ² = 5.077, p = .08). Five patients (6.1%) received cognitive therapy, and 60 patients (75.0%) received telephone intervention. There were no differences regarding the score of HAMD, a quality-of-life scale, and the rates of subsequent suicide attempt and suicide ideation among the three groups at follow-up. CONCLUSIONS: The dropout rates were higher than those reported in developed countries. Most participants in the cognitive therapy group refused to receive cognitive therapy so that the effect of cognitive therapy for these patients cannot be evaluated. The participants in the telephone intervention group had good compliance, but the effect of telephone intervention could not be confirmed, so that more studies are needed in the future. Consequently, interventions cannot be evaluated accurately in their preventing suicide attempts for patients who have attempted suicide in China at present.

Comparison of patients with and without mental disorders treated for suicide attempts in the emergency departments of four general hospitals in Shenyang, China.

OBJECTIVE: Compare the sociodemographic and psychological characteristics of suicide attempters admitted to emergency departments of general hospitals in China that do and do not meet diagnostic criteria for mental disorders. METHODS: The Structured Clinical Interview for DSM-IV, the Suicide Ideation Scale, the Hamilton Depression Rating Scale and a quality of life measure were administered to 239 consecutive suicide attempters who were treated in the emergency departments of four randomly selected general hospitals in Shenyang. RESULTS: Among the enrolled subjects, 166 (69.5%) met diagnostic criteria for a current mental disorder. Among these 166 subjects, 62.7% had mood disorders, 14.5% had anxiety disorders, 10.8% had psychotic disorders and 3.6% had substance use disorders. The 73 suicide attempters without a mental disorder were younger, had higher levels of impulsiveness and were more likely to have ideas about being rescued. Multivariate logistic regression analysis identified the following independent predictors of having a current psychiatric disorder in the suicide attempters: female gender (OR=3.67, 95% CI=1.23-10.91), more than 6 years of formal education (OR=1.19, 95% CI=1.04-1.36), a higher score on the suicide ideation scale (OR=1.01, 95% CI=1.00-1.03), a higher score on Hamilton depression rating scale (OR=1.26, 95% CI=1.16-1.37) and a lower score on the quality of life scale (OR=0.75, 95% CI=0.63-0.90). CONCLUSION: The prevalence of psychiatric disorders in suicide attempters in emergency departments of urban China is lower than that reported in most western countries. Suicide attempters with and without mental illnesses are distinct on a number of important dimensions. Mental health assessment and appropriate discharge planning for patients treated in emergency departments for suicide attempts are crucial components of comprehensive suicide prevention efforts.