Protective factors for children with autism spectrum disorder during COVID-19-related strict lockdowns: a Shanghai autism early developmental cohort study.

BACKGROUND: COVID-19 lockdowns increased the risk of mental health problems, especially for children with autism spectrum disorder (ASD). However, despite its importance, little is known about the protective factors for ASD children during the lockdowns. METHODS: Based on the Shanghai Autism Early Developmental Cohort, 188 ASD children with two visits before and after the strict Omicron lockdown were included; 85 children were lockdown-free, while 52 and 51 children were under the longer and the shorter durations of strict lockdown, respectively. We tested the association of the lockdown group with the clinical improvement and also the modulation effects of parent/family-related factors on this association by linear regression/mixed-effect models. Within the social brain structures, we examined the voxel-wise interaction between the grey matter volume and the identified modulation effects. RESULTS: Compared with the lockdown-free group, the ASD children experienced the longer duration of strict lockdown had less clinical improvement (ß = 0.49, 95% confidence interval (CI) [0.19-0.79], p = 0.001) and this difference was greatest for social cognition (2.62 [0.94-4.30], p = 0.002). We found that this association was modulated by parental agreeableness in a protective way (-0.11 [-0.17 to -0.05], p = 0.002). This protective effect was enhanced in the ASD children with larger grey matter volumes in the brain's mentalizing network, including the temporal pole, the medial superior frontal gyrus, and the superior temporal gyrus. CONCLUSIONS: This longitudinal neuroimaging cohort study identified that the parental agreeableness interacting with the ASD children's social brain development reduced the negative impact on clinical symptoms during the strict lockdown.

A nomogram to predict the risk of cognitive impairment in patients with depressive disorder.

This study was to describe the cognitive function status in patients with depressive disorder and to construct a nomogram model to predict the risk factors of cognitive impairment in these patients. From October 2019 to February 2021, a total of 141 patients with depressive disorder completed the survey in two hospitals. The Montreal cognitive assessment (MoCA) was used with a cutoff score of 26 to differentiate cognitive impairment. Univariable and multivariable logistic regression analyses were conducted to identify independent risk factors. A nomogram was then constructed based on the results of the multivariable logistic regression analysis. The patients had an average MoCA score of 23.99 ± 3.02. The multivariable logistic regression analysis revealed that age (OR: 1.096, 95% CI: 1.042-1.153, p < 0.001), education (OR: 0.065, 95% CI: 0.016-0.263, p < 0.001), depression severity (OR: 1.878, 95% CI: 1.021-3.456, p = 0.043), and sleep quality (OR: 2.454, 95% CI: 1.400-4.301, p = 0.002) were independent risk factors for cognitive impairment in patients with depressive disorder. The area under receiver operating characteristic (ROC) curves was 0.868 (95% CI: 0.807-0.929), indicating good discriminability of the model. The calibration curve of the model and the Hosmer-Lemeshow test (p = 0.571) demonstrated a well-fitted model with high calibration. Age, education, depression severity, and sleep quality were found to be significant predictors of cognitive function. A nomogram model was developed to predict cognitive impairment in patients with depressive disorder, providing a solid foundation for clinical interventions.

Multicenter randomized controlled trial of bifrontal, bitemporal, and right unilateral electroconvulsive therapy in major depressive disorder.

AIM: Electroconvulsive therapy (ECT) has been shown to be the most effective and rapid treatment for severe depression. Electrode placement is one of the most important factors that affect ECT's efficacy and side-effects profile. Bifrontal, bitemporal, and unilateral are the three most used electrode placements. Very few studies have directly compared the efficacy and cognitive side-effects of the three placements. The aim of this study was to compare the efficacy and cognitive side-effects associated with bifrontal, bitemporal, and unilateral electrode placements. METHODS: This multicenter randomized, blinded, controlled trial included 40 patients in each of the three groups. Most of the patients (94.8%) completed six ECT treatments. We used mixed-model analyses to compare differences in 17-item Hamilton Depression Rating Scale (HAMD-17) and Clinical Global Impression (CGI) scores among the three groups and the five times series (baseline, Week 1, Week 2, Week 3, and Week 4). The cognitive outcome was Mini-Mental State Examination (MMSE) score. RESULTS: HAMD-17 and CGI scores did not differ significantly across the groups (HAMD-17 scores: z = -1.13, P = 0.259; CGI scores: z = -0.35, P = 0.729). MMSE scores at pre- and post-ECT were similar across the three groups (F = 2.06, P = 0.133). However, subgroup analysis using paired t-tests showed that MMSE scores improved in the right unilateral and bifrontal groups (t = 2.745, P = 0.0098; t = 2.464, P = 0.0204), but did not change in the bitemporal group (t = 1.188, P = 0.2461). CONCLUSION: The efficacy of right unilateral and bifrontal ECT placement was similar to that of bitemporal ECT. The physical side-effects were also similar across the three groups. Right unilateral and bifrontal ECT placement were associated with improved cognitive outcomes, but bitemporal ECT placement was not.

The therapeutic effect of quetiapine on cognitive impairment associated with 5-HT1A presynaptic receptor involved schizophrenia.

The cognitive impairment associated with schizophrenia is highly prevalent and affects the overall functioning of subjects. The stimulation of the serotonin 1A receptor is a primary characteristic of some atypical antipsychotic drugs. We measured the levels of cognitive impairment using the Morris water maze test and protein kinase A activity in hippocampal neurons on presynaptic and postsynaptic serotonin 1A receptors to investigate the effect of dizocilpine-induced cognitive impairment associated with atypical antipsychotic drugs in rats treated by quetiapine alone or combined with WAY100635/tandospirone. The results of the Morris water maze test presented evidence that quetiapine alone alleviated the cognitive impairment associated with atypical antipsychotic drugs induced by dizocilpine. However, quetiapine plus WAY100635 induced no improvement of cognitive impairment associated with atypical antipsychotic drugs. The results of protein kinase A assay suggested that neither quetiapine alone nor in combination with tandospirone, but not quetiapine plus WAY100635, raised protein kinase A activity in hippocampus neurons. The present study demonstrated the key role of presynaptic serotonin 1A receptors on the therapeutic effect of quetiapine on cognitive impairment associated with atypical antipsychotic drugs. Moreover, that protein kinase A activity in hippocampal cells is involved in the mechanism of quetiapine's effect on cognitive impairment associated with atypical antipsychotic drugs.

A randomized controlled trial: effects of a prenatal depression intervention on perinatal outcomes among Chinese high-risk pregnant women with medically defined complications.

Prenatal psychosocial health has been linked with health behaviors, maternal health, and birth outcomes. This randomized controlled trial evaluated the effects of a prenatal depression intervention on birth outcomes and maternal physical and psychological status at 42 days postpartum. Three hundred fifty-two high-risk pregnant women exposed to obstetric complications with an Edinburgh Postnatal Depression Scale (EPDS) ≥ 9 or a Postpartum Depression Screening Scale (PDSS) ≥ 60 were randomly assigned to the intervention group (n = 176) and control group (n = 176). The intervention group underwent a six-session couple-separated psycho-educational program; the control group received the usual care. All participants were asked to complete questionnaires at late pregnancy (>28 weeks), 3 days postpartum, and 42 days postpartum. The intervention group had a significantly lower cesarean rate and shorter third stage of labor (p < .05). At 42 days after delivery, only 5.1% of participants were lost to follow-up, and the intervention group had significantly less minor and major depression, more sleep time, more satisfaction with their husband and other family members, less concern about taking care of baby, and less breast milk insufficiency than the control group (p < .05). A prenatal psychological intervention model for high-risk pregnant women holds potential as a preventive program that addresses maternal health and birth outcomes. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR-IOR-15006433), http://www.chictr.org.cn/enIndex.aspx (retrospectively registered).

The Prevalence of Antenatal Depression and its Related Factors in Chinese Pregnant Women who Present with Obstetrical Complications.

OBJECTIVES: The psychological status of Chinese pregnant women who present with obstetrical complications is concerning to Chinese health professionals. This study aimed to investigate the prevalence of antenatal depression and analyzed related risk factors in a population of high-risk Chinese women. DESIGN: A large sample size, cross-sectional study. METHODS: A total of 842 pregnant women with complications completed the Chinese version of the Postpartum Depression Screen Scale (PDSS) in this cross-sectional study. t-Test, ANOVA and Binary logistic regression tests were used in data analysis of antenatal depression and risk factors. RESULTS: The prevalence of major or minor depression in high-risk Chinese pregnant women during antenatal period was 8.3% and 28.9%, respectively. Independent-sample t-test and two-way analysis of variance (ANOVA) indicated significant differences in age, education, occupation and the number of complications (P<0.05). Binary logistic regression analysis indicated a significant negative association between depression and education (P<0.01) with lower educational level (OR: 0.590; 95% CI: 0.424-0.820) associated with a higher risk for depression. A significant positive association was observed between depression and age (P<0.05) with higher age (OR: 1.338; 95% CI: 1.008-1.774) correlated with a higher risk for depression. CONCLUSIONS: Women who experienced obstetric complications presented with higher PDSS depression scores. Screening for antenatal depression in high-risk pregnant women to promote early detection of depression and reduce health risks for universal health promotion is recommended.

Development and psychometric testing of the Chinese Postnatal Risk Factors Questionnaire (CPRFQ) for postpartum depression.

This article describes the development and psychometric assessment of the Chinese Postnatal Risk Factors Questionnaire (CPRFQ). There were four phases in this process: (1) the items were generated using a literature review and a focus group, (2) content validity was evaluated by an expert panel, (3) a pilot study was conducted with 45 postpartum women to refine the scale, and (4) a convenience sample of 256 postpartum women in China was recruited to complete the questionnaire. Construct validity was established by exploratory factor analysis; a four-factor structure of the scale was accepted (social and family, personality and relationship, mother and infant, maternal feelings and 'doing the month'). These factors explained 47.46 % of the variance. Pearson's correlation coefficient was conducted to test convergent validity with the Edinburgh Postnatal Depression Scale (EPDS) (r = 0.54; p < 0.001). The Cronbach's alpha coefficient of the four subscales ranged from 0.58 to 0.71. The final 18-item version of the questionnaire is potentially a valuable tool for assessing postnatal risk factors in Chinese postpartum mothers.

Prenatal restraint stress is associated with demethylation of corticotrophin releasing hormone (CRH) promoter and enhances CRH transcriptional responses to stress in adolescent rats.

Maternal stress can disturb normal fetal neurodevelopmental progress, and lead to negative behavioral and neuroendocrine consequences for the offspring. These effects may be related to alterations in the hypothalamic-pituitary-adrenal (HPA) axis. Early life events disrupting the function of the HPA axis may be associated with epigenetic modification. This study investigated the effect of maternal stress on the methylation rate of the corticotrophin-releasing hormone (CRH) promoter and HPA axis response to acute stress in the adolescent offspring of Sprague-Dawley rats. Pregnant dams were randomly assigned to two groups: restraint stress group and normal control group. Adolescent male and female offspring were used from each group. The results showed that prenatal stress is associated with the demethylation of the CRH promoter, and leads to anxiety-like behaviors in adolescent life stages, as well as hyper-responsiveness of the HPA axis. Together, these results imply that prenatal stress alters the normal HPA function, which may be via the epigenetic mechanism.

Cerebral metabolism in major depressive disorder: a voxel-based meta-analysis of positron emission tomography studies.

BACKGROUND: Major depressive disorder (MDD) is a common mental illness with high lifetime prevalence close to 20%. Positron emission tomography (PET) studies have reported decreased prefrontal, insular and limbic cerebral glucose metabolism in depressed patients compared with healthy controls. However, the literature has not always been consistent. To evaluate current evidence from PET studies, we conducted a voxel-based meta-analysis of cerebral metabolism in MDD. METHOD: Data were collected from databases including PubMed and Web of Science, with the last report up to April 2013. Voxel-based meta-analyses were performed using the revised activation likelihood estimation (ALE) software. RESULTS: Ten whole-brain-based FDG-PET studies in MDD were included in the meta-analysis, comprising 188 MDD patients and 169 healthy controls. ALE analyses showed the brain metabolism in bilateral insula, left lentiform nucleus putamen and extra-nuclear, right caudate and cingulate gyrus were significantly decreased. However, the brain activity in right thalamus pulvinar and declive of posterior lobe, left culmen of vermis in anterior lobe were significantly increased in MDD patients. CONCLUSION: Our meta-analysis demonstrates the specific brain regions where possible dysfunctions are more consistently reported in MDD patients. Altered metabolism in insula, limbic system, basal ganglia, thalamus, and cerebellum and thus these regions are likely to play a key role in the pathophysiology of depression.

Prevalence and correlates of major depressive disorder in breast cancer survivors in Shanghai, China.

OBJECTIVE: Our objective is to measure the prevalence and correlates of major depressive disorder (MDD) among Chinese breast cancer patients after surgery, which is essential for analyzing the service needs and allocating mental health resources. METHODS: A total of 505 patients were randomly recruited from 1580 post-surgery breast cancer outpatients from one tertiary hospital in Shanghai, and the Mini International Neuropsychiatric Interview was used to assess 1-month prevalence of MDD according to the Diagnostic and Statistical Manual Fourth Edition (DSM-IV) in a two-phase design. RESULTS: The adjusted 1-month prevalence of MDD was 20.59% (95% CI 17.06-23.82). The risk for depression within the first year was two times as higher as that in more than 1 year. Patients within 1 year after surgery, with lower income, disrupted marriage or being single, recurrent breast cancer and psychiatric history were more likely to have MDD. There was no significant association between depression and disease stage, type of surgery, receptor status and cancer treatment. CONCLUSIONS: Depression is quite common in Chinese breast cancer patients and survivors. A more sensitive and responsive mental health service is recommended for this population.

A comparison of melancholic and nonmelancholic recurrent major depression in Han Chinese women.

BACKGROUND: Although the diagnosis of melancholia has had a long history, the validity of the current DSM-IV definition remains contentious. We report here the first detailed comparison of melancholic and nonmelancholic major depression (MD) in a Chinese population examining in particular whether these two forms of MD differ quantitatively or qualitatively. METHODS: DSM-IV criteria for melancholia were applied to 1,970 Han Chinese women with recurrent MD recruited from 53 provincial mental health centers and psychiatric departments of general medical hospitals in 41 cities. Statistical analyses, utilizing Student's t-tests and Pearson's χ(2) , were calculated using SPSS 13.0. RESULTS: Melancholic patients with MD were distinguished from nonmelancholic by being older, having a later age at onset, more episodes of illness and meeting more A criteria. They also had higher levels of neuroticism and rates of lifetime generalized anxiety disorder, panic disorder, and social and agoraphobia. They had significantly lower rates of childhood sexual abuse but did not differ on other stressful life events or rates of MD in their families. DISCUSSION: Consistent with most prior findings in European and US populations, we find that melancholia is a more clinically severe syndrome than nonmelancholic depression with higher rates of comorbidity. The evidence that it is a more "biological" or qualitatively distinct syndrome, however, is mixed.

Clinical predictors of familial depression in Han Chinese women.

BACKGROUND: A number of clinical features potentially reflect an individual's familial vulnerability to major depression (MD), including early age at onset, recurrence, impairment, episode duration, and the number and pattern of depressive symptoms. However, these results are drawn from studies that have exclusively examined individuals from a European ethnic background. We investigated which clinical features of depressive illness index familial vulnerability in Han Chinese females with MD. METHODS: We used lifetime MD and associated clinical features assessed at personal interview in 1,970 Han Chinese women with DSM-IV MD between 30-60 years of age. Odds Ratios were calculated by logistic regression. RESULTS: Individuals with a high familial risk for MD are characterized by severe episodes of MD without known precipitants (such as stress life events) and are less likely to feel irritable/angry or anxious/nervous. CONCLUSIONS: The association between family history of MD and the lack of a precipitating stressor, traditionally a characteristic of endogenous or biological depression, may reflect the association seen in other samples between recurrent MD and a positive family history. The symptomatic associations we have seen may reflect a familial predisposition to other dimensions of psychopathology, such as externalizing disorders or anxiety states.

Various effects of antipsychotics on P50 sensory gating in Chinese schizophrenia patients: a meta-analysis.

BACKGROUND: The aim of this study was to conduct a meta-analysis so we could evaluate the impact of antipsychotics on the P50 ratio in Chinese schizophrenia patients. METHODS: Data were collected from the following databases: PubMed, China Biological Medicine Database, China National Knowledge Infrastructure, Cochrane Library and Elsevier Science Direct, with the latest report up to May 2011. An effect size with a 95% confidence interval (CI) was used to assess the strength of various effects of antipsychotics on P50 ratio in the patients. RESULTS: A total of six studies including 315 and 285 schizophrenia patients at the baseline and endpoint, respectively. Overall, no significant effect of these medicines on the P50 ratio was found (overall effect z=1.03, p=0.30; heterogeneity: Chi2=2.81, df=8, p=0.95, I2=0%). In subgroup analysis by drug, we did not find any significant effects on P50 ratio in either first-generation antipsychotics (effect z=0.92, p=0.36; heterogeneity: Chi2=0.00, df=1, p=0.98, I2=0%) or second-generation antipsychotics (effect z=0.55, p=0.58; heterogeneity: Chi2=2.38, df=5, p=0.79, I2=0%). CONCLUSION: Our meta-analysis suggests that neither the first-generation nor the second-generation antipsychotics had any significant effects on P50 ratio in Chinese patients with schizophrenia.

Relative Safety and Efficacy of Two Doses of Tandospirone Citrate for Generalized Anxiety Disorder: A Multicenter Randomized Controlled Trial.

Purpose: To determine the relative safety and efficacy of different doses of tandospirone in treating generalized anxiety disorder (GAD). Patients and Methods: This parallel randomized controlled trial enrolled patients with GAD from eight centers in China. The patients were randomly assigned to 60 mg/day or 30 mg/day tandospirone groups. The primary endpoint was the overall response rate after receiving 6-week treatment. The secondary endpoints included significant response rate, clinical recovery rate, change in the Hamilton Anxiety Scale (HAMA) total score, HAMA subscale score, Hamilton Depression Scale-17 (HAMD-17), Clinical Global Impression-Severity Scale (CGI-S) score, and Impression-Improvement scale (CGI-I) score. Results: No significant difference was found in the overall response rate between the two groups (65.7% vs 58.4%, p = 0.213). A higher significant response rate and change in the HAMA total score were found in the 60 mg/day group. The reduction in the CGI-S score and percentage of patients with a CGI-I score of ≤2 were higher in 60 mg/day group. The reduction in HAMA somatic anxiety factor, cardiovascular symptom factor, gastrointestinal symptom factor, and HAMD-17 score were more significant in the 60 mg/day group. The incidence of total adverse events was higher in the 60 mg/day group than in the 30 mg/day group. No significant difference was found in the proportion of withdrawal due to adverse events. Conclusion: Both 60 mg/day and 30 mg/day tandospirone show good efficacy in treating patients with GAD. High doses of tandospirone may have advantages in relieving the somatic symptoms but also present disadvantages due to their high level. Trial Registration: The trial registration no. was NCT01614041.

Effectiveness and safety of Jiuwei Zhenxin granules for treating generalized anxiety disorder: A randomized controlled trial.

Background: Generalized anxiety disorder (GAD) is a chronic disorder characterized by excessive, pervasive, persistent worrying that is difficult to control. Jiuwei Zhenxin granules may be safer and more effective than non-benzodiazepine anti-anxiety drugs for treating GAD. This study aimed to assess the efficacy and safety of Jiuwei Zhenxin granules alone or in combination with the benzodiazepine alprazolam. Materials and methods: A total of 710 patients were recruited from outpatient clinics and were randomly divided into two groups to receive Jiuwei Zhenxin granules (single drug group) or Jiuwei Zhenxin granules and alprazolam (combination group). The primary outcome was the response rate, which was defined as a ≥ 50% reduction from the baseline total score on the Hamilton Anxiety Scale (HAMA). Secondary outcome measures included mean changes in HAMA total score, psychological and somatic factors, Hamilton Depression Rating Scale total score, and SF-36 health survey score. Results: At 4 weeks after treatment, the single and combination treatment groups showed significant improvement in the HAMA total score and they did not differ significantly in response rate (77.58 vs. 79.17%) or rate of adverse drug reactions (16.22 vs. 16.07%). Conclusion: Jiuwei Zhenxin granules are an effective, safe, and well-tolerated treatment against GAD. Combining them with alprazolam may not significantly improve efficacy. Clinical trial registration: [www.ClinicalTrials.gov], identifier [CHICTR1800020095].

[Influence of estradiol on tryptophan hydroxylase and 5-hydroxytryptamine content in raphe nuclei of rats under forced swimming stress].

OBJECTIVE: To investigate the effect of estradiol (E2) on tryptophan hydroxylase (TPH) and 5-hydroxytryptamine (5-HT) content in raphe nuclei of rats under forced swimming stress and explore the role of estrogen and stress in disease mechanism of depression in women. METHODS: At Week 3 post-ovariectomy, 35 ovariectomized (OVX) female SD rats were randomly divided into 5 groups (n = 7): non-stress group, control group, estradiol (E2) group and fluoxetine (FLX) group and E2 plus FLX group. Animals were administered with different drugs for 2 weeks. At Day 14, animals except those in the non-stress group were subjected to the 15 min forced swimming test (FST). At 2 hours post-FST, all animals including those in the non-stress group were perfused with 4% paraformaldehyde and brains removed for TPH and 5-HT immunofluorescence staining. We compared the content of TPH and 5-HT by observing and calculating the integrated optical density (IOD) of immunofluorescent-positive signals in raphe nuclei. RESULTS: (1) The IOD value of TPH- and 5-HT-positive region in raphe nuclei of rats in the control group was significantly lower than that of the non-stress group (P < 0.01); (2) the IOD value of TPH- and 5-HT-positive region in raphe nuclei of rats in the E2, FLX and E2 plus FLX groups was significantly higher than that in the control group (P < 0.05). CONCLUSION: Forced swimming stress can decrease the TPH and 5-HT content in raphe nuclei. Such changes can be prevented by a pre-administration of estradiol. Similar results are observed with antidepressant fluoxetine. These effects may underlie the role of estradiol and stress in the disease mechanism of depression in women.

[P50 sensory gating studies in schizophrenics: a systematic review].

OBJECTIVE: To conduct a systematic review of P50 sensory gating studies in schizophrenics and the change between before and after treatment. METHODS: Standard search strategy for the Cochrane Review Group was performed by two review authors. Searches were made in PubMed, EMBase, Web of knowledge, PsycINFO, Cochrane Library, CNKI, Wanfang, VIP and CBMDisc databases. STROBE (strengthening the reporting of observational studies in epidemiology) was used to assess the methodological quality of the studies. RevMan 5.0.23 software was employed to conduct a Meta analysis. RESULTS: Seventy-one literatures were reviewed and 7 studies met the inclusion criteria for a Meta analysis. The meta-analysis of random effects showed that S1 amplitude was lower in the schizophrenia group than in the normal control group (P = 0.02). And S2 amplitude was significant higher in schizophrenia group than the normal control group (P = 0.001). There were no statistical significance in S1 and S2 latency between two groups (P = 0.34 and P = 0.19 respectively). P50 Ratio in schizophrenia group was significantly higher than the normal control group. And the difference was statistically significant [Z = 11.46, P < 0.00001, combined SMD = 44.18, 95%CI (36.62, 51.74)]. However the P50 difference showed no significant difference (P = 0.14). An analysis of fixed effects showed that the P50 Ratio difference was not statistically significant in schizophrenics between before and after treatment (P = 0.19). CONCLUSION: The schizophrenics have a sensory gating dysfunction. P50 Ratio is a stable and reliable indicator of sensory gating function. Antipsychotics may partly enhance P50 sensory gating in schizophrenics, but can not completely reverse the defect of P50 suppression.

Connectivity between the anterior insula and dorsolateral prefrontal cortex links early symptom improvement to treatment response.

BACKGROUND: Early improvement (EI) following treatment with antidepressants is a widely reported predictor to the treatment response. This study aimed to identify the resting-state functional connectivity (rs-FC) and its related clinical features that link the treatment response at the time of EI. METHODS: This study included 23 first-episode treatment-naive patients with MDD. After 2 weeks of antidepressant treatment, these patients received 3.0 Tesla resting-state functional magnetic resonance imaging scanning and were subgrouped into an EI group (N = 13) and a non-EI group (N = 10). Using the anterior insula (rAI) as a seed region, this study identified the rs-FC that were associated with both EI and the treatment response at week 12, and further tested the associations of the identified rs-FC with either the clinical features or the early symptom improvement. RESULTS: Rs-FC between rAI and the left dorsolateral prefrontal cortex (dlPFC) was associated with EI (t21 = -6.091, p = 0.022 after FDR correction for multiple comparisons). This rs-FC was also associated with an interaction between EI and the treatment response at the week 12 (t21 = -5.361, p = 6.37e-5). Moreover, among the clinical features, this rs-FC was associated with the early symptom improvement in the insomnia, somatic symptoms, and anxiety symptoms, and these early symptom improvements were associated with the treatment response. CONCLUSION: Rs-FC between the rAI and the left dlPFC played a crucial role in the early antidepressant effect, which linked the treatment response. The early treatment effect relating to rAI may represent an early symptom improvement in self-perceptual anxiety, somatic symptoms and insomnia.

[An association study of brain-derived neurotrophic factor gene polymorphism in bipolar disorders].

OBJECTIVE: To investigate the association between brain-derived neurotrophic factor (BDNF) gene polymorphism and bipolar disorder. METHODS: Single nucleotide polymorphisms rs6265 and rs11030101 in BDNF gene were detected and compared between 228 patients with bipolar disorder and 361 healthy controls. RESULTS: The genotypes, alleles and combinative genotype of BDNF gene single nucleotide polymorphism rs6265 and rs11030101 did not show significant differences between two groups. There were also no significant differences in genotypes and combinative genotypes between diagnostic subtypes, genders and on-set age of bipolar disorder and controls. CONCLUSION: This study did not found that BDNF gene single nucleotide polymorphism rs6265 and rs11030101 are associated with bipolar disorders.

[Effect of maternal antepartum psychological therapy upon early infant temperament].

OBJECTIVE: To find out whether there was any change in early infant temperament after mothers had received group psychological therapy on depression and anxiety during pregnancy period. METHODS: A total of 800 subjects meeting the inclusion criteria, without the exclusion criteria and willing to sign the informed consent were recruited randomly from Shanghai International Peace Maternity & Child Health Hospital in their l6th-20th weeks of pregnancy. They were randomized into the therapy group and the control group by the doll randomization table. Women in the therapy group would have a group psychological therapy for 6 times, 1.5 hours each time, while the control group not. The group psychological therapy included therapist introduction and participatory discussion. The therapy concerned the antepartum and postpartum depression, the risk factors concerned with antepartum and postpartum depression, antepartum and postpartum anxiety, psychological defense theory, reflex training and spouse lesson. Mothers reported their babies' infant temperament by filling the early infant temperament questionnaire (EITQ) within 3 months post-delivery. RESULTS: The percent of easy infant temperament type was 87.9% in the psychological therapy group and 81.7% in the hard group. And there was significant difference between two groups (chi2 = 4.530, upsilon=1, P = 0.033). And there were significant differences in the dimensions of approach-withdrawal and threshold of responsiveness in infant temperament between two groups. CONCLUSION: The maternal antepartum psychological therapy can increase the ratio of easy infant temperament. And it has effects upon the temperament dimensions of approach-withdrawal and threshold of responsiveness.