[Recognition of depression and related risk factors among non psychiatric doctors in tertiary general hospital outpatients in Beijing].

OBJECTIVE: To explore the level of identification and related factors of depression in physicians of Beijing tertiary general hospitals. METHODS: A cross-sectional investigation was used to screen the outpatients, and depression was diagnosed according to Mini International Neuropsychiatric Interview (MINI). Identification of depression was defined as referral to psychiatrist or managed with antidepressant or sedative hypnotics. RESULTS: Among 248 cases of depression, 30 (12.1%) were referred to psychiatrists, 28(8.9%) managed with antidepressant or sedative hypnotics. The identification rate of depression by physicians was 21.0%, and the identification rate by neurologist was 40.4%, which is higher than the rate by cardiologist (22.4%), gastrointestinal physician (3.8%) and gynecologist (2.0%) (χ2=61.077, P<0.05). Visiting neurology department, severity of life impairment, with psychotic distress history, had psychological complaints, co-morbidity with anxiety related to the physician's identification of depression. Among the psychological complaints, only mood disorder and insomnia were related to the physician's identification of depression. CONCLUSIONS: The level of depression identification by physician was low, the level of neurologist was higher than that of cardiologist, gastrointestinal physician and gynecologist. The patient with serious life impairment, psychotic distress history, mood disorder and insomnia complaints was easily to be identified.

[The prevalence of depression and anxiety in gastrointestinal out-patients of tertiary general hospitals in Beijing].

OBJECTIVE: To explore the prevalence and physician's recognition of depression and anxiety disorder in gastrointestinal out-patients of three tertiary general hospitals in Beijing. METHODS: A hospital-based cross-sectional survey was conducted in the gastrointestinal out-patient departments of three tertiary general hospitals in Beijing from May to June 2007. Total 517 subjects were recruited consecutively within a one month period. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using Mini International Neuropsychiatric Interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. RESULTS: Among the 517 cases, 301 had a HADS score of 8 and above and 244 were interviewed by psychiatrists; the response rate was 81.1%. The prevalence according to Diagnostic and Statistical Manual of Mental Disorders Fourth edition of depressive disorders and anxiety disorders in gastrointestinal outpatients were 15.3%, depressive disorders were 12.0%, anxiety disorders were 6.4%, depression combined anxiety disorder was 3.0%. The prevalence of depression, anxiety, depression combined anxiety were not different between genders (chi2=0.874, chi2=1.797, chi2=0.518, P>0.05) and among different age group (18-34, 35-54, >or=55 years old) (chi2=1.084, chi2=2.735, chi2=0.350, P>0.05). Gastritis and gastrointestinal dysfunction were the major diagnoses in patients with depression and/or anxiety disorders, the rates were 30.6% and 26.4% respectively. The rate of identification of depression and anxiety disorder by physicians was 2.8%. CONCLUSION: Gastrointestinal out-patients have a high prevalence of depression and anxiety disorder and the rate of identification by physicians was very low.

[Emotional disorder in patients with acute or stable coronary heart disease].

OBJECTIVE: To compare the incidence of emotional disorder in patients with acute or stable coronary heart disease. METHODS: A total of 298 patients with suspected coronary heart disease (CHD) were designed into three groups based on of coronary angiography results: acute coronary syndrome (ACS, n = 128), stable angina pectoris (SAP, n = 108) and non-CHD (n = 62). All patients were evaluated by Zung Self-rating Depression Scale (SDS), Zung Self-rating Anxiety Scale(SAS) and Hamilton Depression Rating Scale (HRSD) for depression and anxiety before coronary angiography (CAG), 3 days after CAG, and 1 day before discharge. RESULTS: Incidences of depression and anxiety were significantly higher the ACS group (65.6%and 78.9% before CAG; 60.9% and 70.3% 3 days post CAG; 45.3%and 64.8% before discharge) compared patients with SAP (18.5% and 26.9% before CAG; 17.6% and 28.7% 3 days post CAG; 15.7% and 26.9% before discharge, all P < 0.05 vs. ACS) and non-CHD patients (32.3% and 25.8% before CAG; 27.4% and 24.2% 3 days post CAG; 29.0% and 30.6% before discharge, all P < 0.05 vs. ACS) while the depression and anxiety incidences were similar between patients with SAP and non-CHD in this cohort (P > 0.05). CONCLUSION: Emotional disorder is common in patients with suspected heart diseases, especially in patients with ACS. Psychological distress of patients with suspected heart disease should be evaluated and treated.

Effects of Working Memory, Strategy Use, and Single-Step Mental Addition on Multi-Step Mental Addition in Chinese Elementary Students.

The aim of this paper was to examine the roles of working memory, single-step mental addition skills, and strategy use in multi-step mental addition in two independent samples of Chinese elementary students through different approaches to manipulate two dimensions of task characteristics (the primary task). In Study 1, we manipulated strategy types through the dimension of schema automaticity (whether intermediate sums were 10s) and the dimension of working memory load (WML, two steps versus four steps). A hierarchical linear model (HLM) analysis was conducted at case level, strategy level, and individual level. In Study 2, we manipulated task characteristics through schema automaticity (one-time versus two-time regrouping) and the WML (partial versus complete decomposition). A three-level HLM analysis was applied. The general findings of Study 1 and Study 2 suggested that shorter response time on single-step mental addition corresponded to shorter response time on multi-step mental addition. The use of strategies (from easier to more difficult strategies) negatively predicted response time on multi-step mental addition. Easier strategy was associated with shorter response time on multi-step mental addition. Better phonological loop was associated with shorter response time on multi-step mental addition. The findings in both studies highlighted the important role of phonological loop in mental addition in Chinese children, suggesting that the involvement of a specific subcomponent of working memory in mental arithmetic might be subject to linguistic, instructional, and contextual factors.

[An analysis of psychological problems of patients in cardiology clinic].

OBJECTIVE: To explore the current condition of psychological problems of patients in cardiology clinic. METHODS: A total of 347 patients in the cardiology clinic of Prof. HU Da-yi were screened by self-rating depression scale (SDS), Self-rating anxiety scale (SAS), Hamilton rating scale for depression (HRSD) and Hamilton anxiety scale (HAMA). RESULTS: The rates of patients with somatic disease only or with psychological disorder only were 52.4% and 12.7%, the rate of somatic disease accompanied with psychological disorder was 27.7%. For the patients with psychological problems, there were 31 cases with depression (8.9%), 62 cases with anxiety (17.9%), and 28 cases (8.1%) suffering from mixed depression and anxiety the diagnosis of cardiovascular disease, functional disease or digestive disease was always used by doctors for the patients with psychological problems only, as they always did not accept the diagnosis of psychological disorder. CONCLUSIONS: It is very common that patients in cardiology clinic department suffered from psychological problems. The patients with psychological disorder only were easily misdiagnosed as somatic disease especially cardiovascular disease.

Turning Potential Flexibility Into Flexible Performance: Moderating Effect of Self-Efficacy and Use of Flexible Cognition.

This study examined the relationship between two types of mathematical flexibility - potential flexibility, which indicates individuals' knowledge of multiple strategies and strategy efficiency, and practical flexibility, which refers to individuals' flexible performances when solving math problems. Both types of flexibility were assessed in the domain of linear equation solving. Furthermore, two types of beliefs - self-efficacy and use of flexible cognition (UFC) - were investigated as potential moderators between potential and practical flexibility. 121 8th grade students from China took part in this study. Results indicate that potential flexibility positively predicted practical flexibility. Additionally, self-efficacy and UFC might moderate the relationship between these two types of flexibility, suggesting that potential flexibility may lead to different degrees of practical flexibility depending on different levels of beliefs. Implications of these findings for research on mathematical flexibility and for educational practice are discussed.

Serotonin regulates brain-derived neurotrophic factor expression in select brain regions during acute psychological stress.

Previous studies suggest that serotonin (5-HT) might interact with brain-derived neurotrophic factor (BDNF) during the stress response. However, the relationship between 5-HT and BDNF expression under purely psychological stress is unclear. In this study, one hour before psychological stress exposure, the 5-HT1A receptor agonist 8-OH-DPAT or antagonist MDL73005, or the 5-HT2A receptor agonist DOI or antagonist ketanserin were administered to rats exposed to psychological stress. Immunohistochemistry and in situ hybridization revealed that after psychological stress, with the exception of the ventral tegmental area, BDNF protein and mRNA expression levels were higher in the 5-HT1A and the 5-HT2A receptor agonist groups compared with the solvent control no-stress or psychological stress group in the CA1 and CA3 of the hippocampus, prefrontal cortex, central amygdaloid nucleus, dorsomedial hypothalamic nucleus, dentate gyrus, shell of the nucleus accumbens and the midbrain periaqueductal gray. There was no significant difference between the two agonist groups. In contrast, after stress exposure, BDNF protein and mRNA expression levels were lower in the 5-HT1A and 5-HT2A receptor antagonist groups than in the solvent control non-stress group, with the exception of the ventral tegmental area. Our findings suggest that 5-HT regulates BDNF expression in a rat model of acute psychological stress.