Clinimetric properties of the Chinese version of the Euthymia Scale.

The present study was conducted to primarily evaluate the clinimetric sensitivity of the Chinese version of the Euthymia Scale (ES), testing whether this measure discriminated between different groups of patients. Concurrent validity, a clinimetric property that refers to the assessment of the extent to which the rating scale under examination correlates with another related, previously validated, assessment instrument, was also tested investigating whether the ES significantly and negatively correlated with measures of depression and anxiety. A cross-sectional study was conducted. A total of 295 inpatients were recruited from different medical settings and included in this study. In addition to the ES, participants completed the PHQ-9 for the assessment of depression and the GAD-7 for the evaluation of symptoms of generalized anxiety. The clinimetric sensitivity of the ES was evaluated using the Mann-Whitney test and the Kruskal-Wallis analysis of variance, whereas the concurrent validity was tested via Spearman's correlation coefficients. The ES total score and its subscales of psychological flexibility and well-being discriminated between different groups of inpatients and sensitively differentiated depressed from non-depressed patients. Negative and statistically significant correlations between the ES and measures of depression and anxiety were found. Findings of the present study indicate that the Chinese version of the ES is a valid and sensitive clinimetric index that can be used not only to differentiate depressed from non-depressed patients but also as a screening measure to detect vulnerability to depression in a wide range of medical patients.

Desynchronized Functional Activities Between Brain White and Gray Matter in Major Depression Disorder.

BACKGROUND: Alterations in gray matter (GM) have been recognized as playing an important role in the neurobiological mechanism underlying major depressive disorder (MDD) and antidepressant responses. However, little is known about white matter (WM) connectivity in MDD, leaving an incomplete understanding of the pathophysiology of the disorder. PURPOSE: To examine the functional connectivity (FC) of WM, GM, and WM-GM in MDD patients and explore the relationship between FC and antidepressant response. STUDY TYPE: Longitudinal study. SUBJECTS: In all, 129 MDD patients and 89 healthy controls (HC). FIELD STRENGTH/SEQUENCE: Whole-brain blood oxygen level-dependent (BOLD) single-shot echo planar imaging was acquired at 3.0T. ASSESSMENT: At baseline, all participants received Hamilton depression rating scale (HAMD) assessment and an fMRI scan. After 2- and 8-week antidepressant treatment, patients completed the HAMD again. The HAMD reductive rate of 2- and 8-weeks were calculated. STATISTICAL TESTS: The comparisons of age, education, HAMD scores, and FC values (false discovery rate correction) between patients and controls were calculated with a two-sample t-test. The chi-square test was employed to compare the differences of gender between these two groups. Correlations between FC and HAMD, as well as the reductive rate of HAMD, were analyzed with Pearson or Spearman correlation. Receiver operator curve analysis was performed to predict the antidepressant response. RESULTS: Compared to HC, MDD patients exhibited widespread decreases in FC of WM-GM. Furthermore, 28 GM regions and 11 WM bundles had lower connectivity in MDD patients. At baseline, four FC of WM-GM showed negative correlations with the HAMD scores. Six FC of WM-GM correlated with the 2-week reductive rate of HAMD. Moreover, FC in GM, WM, and WM-GM also exhibited significantly positive correlations with an 8-week reductive rate of HAMD. DATA CONCLUSION: The FC of WM-GM was decreased in MDD and may play a role in its pathophysiology and antidepressant responses. LEVEL OF EVIDENCE: 2. TECHNICAL EFFICACY STAGE: 2.

Acceptance and commitment therapy for chronic pain conditions on functioning: A systematic review protocol.

AIM: To explore the efficacy of acceptance and commitment therapy (ACT) on chronic pain in terms of functioning; and to identify the most promising modes and patterns for implementing ACT. DESIGN: Systematic review and meta-analysis. METHODS: We will include randomized controlled trials which focus on the efficacy of ACT on chronic pain conditions with functioning as the primary outcome. Seven databases have been searched and grey literature will also be systematically searched for. Eligible studies will be screened. The newly revised Cochrane risk of bias tool will be used to assess the quality of the included studies. Data will be extracted, and meta-analyses will be performed within specific condition groups of chronic pain. Meta-regression and subgroup analyses will be employed to identify the efficacious modes and patterns for implementing the therapy. Grading of Recommendations Assessment, Development, and Evaluation approach will be applied to reach a convincing conclusion. The study has been funded since July 2018. DISCUSSION: This systematic review aims to explore the efficacy of ACT for chronic pain on functioning based on the latest evidence. The most promising manners will be identified for designing and delivering the therapy. An accurate, transparent, and standardized review process is expected by adhering to the instructions of relevant guidelines. IMPACT: Chronic pain is prevalent worldwide and reduced functioning is one of the leading consequences. With the anticipated evidence of high level, this research attempts to examine the role of acceptance and commitment therapy, a promising psychological intervention, in the management of chronic pain for improving individual's functioning status. The systematic review may contribute to a more convincing and targeted conclusion compared with the existing studies of its kind.

Reliability and validity of the Chinese version of the post-traumatic embitterment disorder self-rating scale (PTED-21) among inpatients in general hospital.

Embitterment and in some cases also post-traumatic embitterment disorder (PTED) are relevant problem in the general population and even more so in psychiatric patients. PTED screening should be an essential component of routine mental health management, which can be done by the 21-item Post-traumatic Embitterment Disorder Self-Rating Scale (C-PTED-21), which measures the intensity of reactive stimulus bound embitterment. The PTED-21 German version was translated into Chinese, and 200 nonpsychiatric inpatients, reporting major negative life events, were recruited through convenience sampling to evaluate test performance. Ninety patients were selected for retest 2 weeks later to examine scale reliability. Factor analysis was used to assess construct validity and receiving operating characteristic curve analysis based on the "PTED standardized diagnostic interview" to assess diagnostic utility. Correlations with depression, somatic symptom, and anxiety scales were examined to assess aggregate validity. The C-PTED-21 demonstrated high internal consistency (Cronbach's α = 0.944) and good test-retest reliability (total score r = 0.783, individual item r value range, 0.635-0.889). Factor analysis revealed three common factors consistent with PTED core features. Total C-PTED-21 score was strongly correlated with the score on the nine-item Patient Health Questionnaire depression scale (PHQ-9, r = 0.735). Mean PTED-21 score ≥1.6 points distinguished clinical PTED as defined by diagnostic interview with 97.6% sensitivity and 90.5% specificity (AUC = 0.988, 95%CI: 0.976-0.999). The results show that the C-PTED-21 can assess the severity of PTED with good reliability and validity.

Exercise interventions for improving physical function, daily living activities and quality of life in community-dwelling frail older adults: A systematic review and meta-analysis of randomized controlled trials.

This review reports the most current evidence on the effects of exercise interventions on improving physical function, daily living activities and quality of life in community-dwelling frail older adults. CBMdisc, CNKI, Wanfang, VIP, MEDLINE, Cochrane Central Register of Controlled Trials (Central), Pubmed, Embase, Web of Science and EBSCO were searched from inception to July 2019. Exercise interventions were found to improve knee extension strength and normal speed and were beneficial in lower Time up and go test (TUG) and improving semi-tandem, Berg balance scale (BBS), Short Physical Performance Battery (SPPB), Physical Performance Test (PPT) and Activities of daily living (ADL). Further well-designed studies are needed to explore the most effective intervention type and dose.

Higher serum VGF protein levels discriminate bipolar depression from major depressive disorder.

Misdiagnosis between major depressive disorder (MDD) and bipolar depression (BD) is quite common. Our previous study found significantly lower serum VGF (non-acronymic) in MDD patients. However, it is unclear whether same changes occur in BD patients. Therefore, we aimed to investigate the relationship between serum VGF levels in BD and MDD patients. General information, scores of 17-item Hamilton Depression Rating Scale (HDRS), and fasting blood samples of all participants including 30 MDD patients, 20 BD patients, and 30 healthy controls (HC) were collected. Serum VGF levels were measured by Enzyme-linked immunosorbent assay kits. Pearson correlation analysis was used to analyze correlations between serum VGF levels and clinical information. Receiver operating characteristic (ROC) curve and likelihood ratios (LRs) were used to analyze the differential potential of serum VGF. Serum VGF levels were significantly lower in MDD patients but higher in BD patients compared with HC (both PTukey < 0.01). No correlation was found between serum VGF levels and any data of subjects. The optimal cutoff for serum VGF in discriminating BD patients from MDD patients was ≥1093.85 pg/ml (AUC = 0.990, sensitivity of 95%, specificity of 100% and accuracy of 95%). LRs further confirmed the differential efficiency of serum VGF in distinguishing BD and MDD patients with +LR of infinity and -LR of 0. The results suggest that serum VGF level changed significantly in MDD and BD patients and serum VGF may be an indicator for differentiating BD patients from MDD patients.

White Matter Integrity Disruptions Correlate With Cognitive Impairments in Asthma.

BACKGROUND: Cognitive impairments are common in asthma, which is a serious global health problem characterized by chronic airway inflammation. However, the underlying neuromechanism is still unclear. PURPOSE/HYPOTHESIS: To investigate the neuromechanism underlying cognitive impairments of asthma. We hypothesized that asthma patients exhibit altered white matter (WM) microstructures, which may contribute to their cognitive impairments. STUDY TYPE: Case-control study. SUBJECTS: 37 patients with asthma (14 male) and 31 healthy controls (10 male). FIELD STRENGTH/SEQUENCE: Diffusion tensor imaging (DTI) covering the whole brain was acquired on a 3.0T scanner using a single-shot echo planar imaging sequence. ASSESSMENT: A DTI with tract-based spatial statistics (TBSS) approach was used to investigate the whole-brain differences in the WM fractional anisotropy (FA) values. STATISTICAL TESTS: Demographic and neuropsychological data were performed using two independent sample t-test or chi-square test or Mann-Whitney rank test. The relationship between cognitive impairments and WM abnormalities was studied using correlation analyses. RESULTS: Impairments of language ability, executive function, and visual-spatial processing and widespread WM disruptions reflected by FA reduction were found in asthma patients. The executive function was related to left forceps major, cingulum, and right uncinate fasciculus, ILF (inferior longitudinal fasciculus) positively (P < 0.05). FA abnormalities were positively correlated with duration of asthma and asthma control test (ACT) scores. DATA CONCLUSION: Asthma patients display multiple cognitive impairments and universally WM integrity disruptions, among which executive dysfunction closely correlates with WM abnormalities. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018.

Cognitive Deficit-Related Interhemispheric Asynchrony within the Medial Hub of the Default Mode Network Aids in Classifying the Hyperthyroid Patients.

Background and Purpose: Recent studies suggest that abnormal structure and function in the brain network were related to cognitive and emotional impairment in hyperthyroid patients (HPs). The association between altered voxel-mirrored homotopic connectivity (VMHC) and neuropsychological impairment in HPs remains unclear. This study is aimed at investigating the association between the disrupted functional coordination and psychological dysfunction in hyperthyroidism. Method: Thirty-three hyperthyroid patients and thirty-three matched healthy controls (HCs) were recruited, and they received resting-state functional magnetic resonance imaging (fMRI) scans and neuropsychological evaluation. The VMHC value was computed to reveal the functional coordination between homotopic regions in both groups. The neurobehavioral relevancy method was employed to explore the relationship between the altered VMHC and emotional, cognition measures. Further receiver operating characteristic (ROC) curve analysis was adopted to examine the power of changed regional VMHC in classifying the patients with hyperthyroidism. Results: Compared with the HCs, the HPs exhibited significantly declined VMHC values in the bilateral medial frontal gyrus (MeFG). The interhemispheric asynchrony in the MeFG was positively correlated with Z scores of episodic memory. The ROC analysis further determined that abnormal VMHC in the MeFG could efficiently distinguish the HPs from the HCs (area under the curve (AUC) = 0.808, P < 0.001). Conclusion: The altered interhemispheric coordination in the hub of the default mode network may implicated in the modulation of episodic memory in HPs patients and the distinct feature of the interhemispheric asynchrony may be treated as a potential target for the early recognition and intervention for the HPs with cognitive impairments. Clinical Trial Registration: This is a study of the neurological basis for dysfunction of mood and cognition in hyperthyroid patients: a resting-state fMRI study (registration number: ChiCTR-OOC-16008607).

Abnormal Functional Connectivity of Ventral Anterior Insula in Asthmatic Patients with Depression.

OBJECTIVE: To explore the underlying mechanism of depression in asthmatic patients, the ReHo in the insula and its FC was used to probe the differences between depressed asthmatic (DA) and nondepressed asthmatic (NDA) patients. METHODS: 18 DA patients, 24 NDA patients, and 60 healthy controls (HCs) received resting-state fMRI scan, severity of depression, and asthma control assessment. RESULTS: DA patients showed increased FC between the left ventral anterior insula (vAI) and the left middle temporal gyrus compared with both NDA and HC groups. In addition, compared with HCs, the DA and NDA patients both exhibited increased FC between the left vAI and the right anterior cingulate cortex (ACC), decreased FC between the left vAI and the bilateral parietal lobe, and increased FC between the right vAI and the left putamen and the right caudate, respectively. Furthermore, the increased FC between the left vAI and the right ACC could differentiate HCs from both DA and NDA patients, and the increased FC between the right vAI and both the left putamen and the right caudate could separate NDA patients from HCs. CONCLUSIONS: This study confirmed that abnormal vAI FC may be involved in the neuropathology of depression in asthma. The increased FC between the left vAI and the left MTG could distinguish DA from the NDA and HC groups.

Effects of Nursing Interventions on Depression of Patients With Rheumatoid Arthritis: A Meta-Analysis of Randomized Controlled Trials.

INTRODUCTION: Previous randomized controlled trials have led to conflicting findings regarding the effects of nursing interventions on depression of patients with rheumatoid arthritis (RA). The purpose of this study was to use the meta-analytic approach to resolve these discrepancies. METHODS: We performed a systematic search of publications using MEDLINE, EMBASE, the Cochrane Library, and manual searches without language restrictions. Studies that met the following criteria were included: (1) randomized controlled trials; (2) duration of intervention≥4 weeks; (3) comparative control group; (4) adults with RA; (5) published studies in any language since reception; and (6) psychological symptoms assessed. We extracted relative risks (RRs) and 95% confidence internals (CIs) and pooled them using a random effect model. We carried out sensitivity analysis and assessed heterogeneity and publication bias. RESULTS: A total of 14 studies, including 1803 patients, were eligible for inclusion in the review. Depression symptom was assessed by questionnaires. In the pooled analysis, nursing interventions, including exercise training, medication guide, health education and psychotherapy were associated with the remission of depression (RR: -0.67; 95% CI: -0.89 to -0.46; P<0.01) with significant heterogeneity between studies (P<0.01). CONCLUSION: Nursing interventions may be important adjunctive therapies in the medical management of RA patients.

Childhood abuse influences clinical features of major depressive disorder by modulating the functional network of the right amygdala subregions.

Childhood trauma and the amygdala play essential roles in major depressive disorder (MDD) mechanisms. However, the neurobiological mechanism among them remains unclear. Therefore, we explored the relationship among the amygdala subregion's abnormal functional connectivity (FC), clinical features, and childhood trauma in MDD. We obtained resting-state functional magnetic resonance imaging (fMRI) in 115 MDD patients and 91 well-matched healthy controls (HC). Amygdala subregions were defined according to the Human Brainnetome Atlas. The case vs. control difference in FCs was extracted. After controlling for age, sex, and education years, the mediations between the detected abnormal FCs and clinical features were analyzed, including the onset age of MDD and the Hamilton Depression Scale-24 (HAMD-24) reductive rate. Compared with HC subjects, we found, only the right amygdala subregions, namely the right medial amygdala (mAmyg.R) and the right lateral amygdala (lAmyg.R), showed a significant decrease in whole-brain FCs in MDD patients. Only childhood abuse experiences were significantly associated with amygdala subregion connectivity and clinical features in MDD patients. Additionally, The FCs between the mAmyg.R and extensive frontal, temporal, and subcortical regions mediated between the early life abuses and disease onset or treatment outcome. The findings indicate that the abnormal connectivity of the right amygdala subregions is involved in MDD's pathogenesis and clinical characteristics.

HICL: Hashtag-Driven In-Context Learning for Social Media Natural Language Understanding.

Natural language understanding (NLU) is integral to various social media applications. However, the existing NLU models rely heavily on context for semantic learning, resulting in compromised performance when faced with short and noisy social media content. To address this issue, we leverage in-context learning (ICL), wherein language models learn to make inferences by conditioning on a handful of demonstrations to enrich the context and propose a novel hashtag-driven ICL (HICL) framework. Concretely, we pretrain a model, which employs #hashtags (user-annotated topic labels) to drive BERT-based pretraining through contrastive learning. Our objective here is to enable to gain the ability to incorporate topic-related semantic information, which allows it to retrieve topic-related posts to enrich contexts and enhance social media NLU with noisy contexts. To further integrate the retrieved context with the source text, we employ a gradient-based method to identify trigger terms useful in fusing information from both sources. For empirical studies, we collected 45 M tweets to set up an in-context NLU benchmark, and the experimental results on seven downstream tasks show that HICL substantially advances the previous state-of-the-art results. Furthermore, we conducted an extensive analysis and found that the following hold: 1) combining source input with a top-retrieved post from is more effective than using semantically similar posts and 2) trigger words can largely benefit in merging context from the source and retrieved posts.

Resilience mediates the association between alexithymia and stress in Chinese medical students during the COVID-19 pandemic.

Background: Evidence indicates that medical students have had high rates of mental health problems, especially during the COVID-19 pandemic, which could be affected by alexithymia-a marked dysfunction in emotional awareness, social attachment and interpersonal relationships-and stress. However, psychological resilience might relieve alexithymia and stress levels. Aims: This study aimed to investigate the role of resilience in alexithymia and stress in medical students. Methods: A total of 470 medical students completed online and offline surveys, including the Toronto Alexithymia Scale-20 (TAS-20), the Connor-Davidson Resilience Scale (CD-RISC) and the College Student Stress Questionnaire (CSSQ). The data of five participants were excluded because of a lack of integrity. Mann-Whitney U test or Kruskal-Wallis test was used to compare group differences in the CD-RISC scores among categorical variables. Spearman correlation analysis was employed to evaluate the associations between resilience and alexithymia and between resilience and stress. Mediation analysis was used to test the mediating effect of resilience between alexithymia and stress. Results: Of the medical students considered in the analysis, 382 (81.28%) were female and 88 (18.72%) were male. There was a significant negative correlation between the TAS-20 scores and the total and subtotal CD-RISC scores (p<0.001). The CSSQ scores also significantly negatively correlated with the total and subtotal CD-RISC scores (p<0.001). Resilience mediated the relationship between alexithymia and stress (total effect=1.044 7, p<0.001). The indirect effect of alexithymia significantly impacted stress through resilience (effect=0.167 0, 95% CI: 0.069 to 0.281). Conclusions: Our findings suggest that resilience might effectively reduce alexithymia and stress. They also contributed to a better understanding of the mediating effects of resilience on alexithymia and stress during the COVID-19 pandemic. The evidence from these results encourages universities to focus on improving students' resilience.

Incorporating evidence-based practice education in nursing research curriculum of undergraduate nursing students: A quasi-experimental study.

AIM: To examine the effect of incorporating evidence-based practice (EBP) in Nursing Research curriculum on undergraduate nursing students. BACKGROUND: The competence of EBP is essential for nurses and it is an essential task for educators to implement EBP education in nursing students. DESIGN: A quasi-experimental study. METHODS: Based on Astin's Input-Environment-Outcome model, the study was conducted among 258 third-grade students of a four-year nursing bachelor's program between September through December 2022. The students were divided into two groups. Students in the intervention group received innovative teaching where EBP elements were incorporated in Nursing Research course in a natural, gradual and spiral way, while students in the control group attended conventional teaching. Effect of EBP teaching was examined in terms of students' EBP competence, learning experience and satisfaction and score of team-based research protocol assignment. RESULTS: Compared with conventional teaching, the innovative teaching characterized by EBP improved students' EBP competence in terms of attitudes and skills and enhanced student's comprehensive ability in nursing research. Students' learning experience and satisfaction were similarly favorable between the two groups. CONCLUSIONS: For undergraduate nursing students, the teaching strategy characterized by EBP is an appropriate and effective way to improve their EBP competence of attitudes and skills, as well as their nursing research ability.

Integrating functional neuroimaging and serum proteins improves the diagnosis of major depressive disorder.

BACKGROUND: The lack of effective objective diagnostic biomarkers for major depressive disorder (MDD) leads to high misdiagnosis. Compared with healthy controls (HC), abnormal brain functions and protein levels are often observed in MDD. However, it is unclear whether combining these changed multidimensional indicators could help improve the diagnosis of MDD. METHODS: Sixty-three MDD and eighty-one HC subjects underwent resting-state fMRI scans, among whom 37 MDD and 45 HC provided blood samples. Amplitudes of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and serum levels of brain-derived neurotrophic factor (BDNF), cortisol, and multiple cytokines were measured and put into the linear discriminant analysis (LDA) to construct corresponding MDD diagnostic models. The area under the receiver operating characteristic curve (AUC) of 5-fold cross-validation was calculated to evaluate each model's performance. RESULTS: Compared with HC, MDD patients' spontaneous brain activity, serum BDNF, cortisol, interleukin (IL)-4, IL-6, and IL-10 levels changed significantly. The combinations of unidimensional multi-indicator had better diagnostic performance than a single one. The model consisted of multidimensional multi-indicator further exhibited conspicuously superior diagnostic efficiency than those constructed with unidimensional multi-indicator, and its AUC, sensitivity, specificity, and accuracy of 5-fold cross-validation were 0.99, 92.0 %, 100.0 %, and 96.3 %, respectively. LIMITATIONS: This cross-sectional study consists of relatively small samples and should be replicated in larger samples with follow-up data to optimize the diagnostic model. CONCLUSIONS: MDD patients' neuroimaging features and serum protein levels significantly changed. The model revealed by LDA could diagnose MDD with high accuracy, which may serve as an ideal diagnostic biomarker for MDD.

The influence of changes in the Chinese COVID-19 prevention and control policies on mental health of medical staff: A network analysis.

BACKGROUND: Shortly after the first outbreak of COVID-19 in Wuhan, the disease spread rapidly around the world. Previous findings reported an increase in mental health problems among Chinese medical staff, but there was a lack of research following changes in COVID-19 prevention and control policies. METHODS: Medical staff were recruited separately in China from 15 to 16 December 2022 (N = 765, wave 1) and from 5 to 8 January 2023 (N = 690, wave 2). All participants completed the assessments of Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9 and the Euthymia Scale. Network analysis was used to explore the relationships between symptoms both within and across depression, anxiety and euthymia. RESULTS: Medical staff showed worse anxiety, depression and euthymia at wave 2 than at wave 1. Depression, motor, restlessness and uncontrollable worrying showed high centrality (i.e., strength, expected influence, closeness) at wave 1, but higher at peak. Meanwhile, motor symptoms and restlessness showed the strongest connection between different mental disorders at both wave 1 and wave 2. The network structure was stable over time after the relaxation of the infection policy. LIMITATIONS: Our participants were not a random sample and the assessments were based on self-reports. CONCLUSIONS: This study indicated the changes in central and bridging symptoms in medical staff at different stages after lifting of restrictions and the withdrawal of testing requirements, which provided management suggestions for the Chinese government and hospitals, as well as clinical guidance for psychological interventions.

Abnormal spontaneous activity of regions related to mood regulation mediates the effect of childhood emotional neglect on major depressive disorder.

This study investigated the mediating factors between childhood emotional neglect (EN) and major depressive disorder (MDD) and whether combining multi-indicator could help diagnose MDD. Regional homogeneity (ReHo) and clinical features were compared between 33 MDD patients and 36 healthy controls (HC). Mediation analysis was employed to explore whether social support or ReHo mediates the association between EN and MDD. The linear discriminant analysis model was constructed with EN, social support, and ReHo, and applied to distinguish MDD from HC in both primary and replication cohorts. We found that MDD patients experienced severer EN and poorer social support, and exhibited lower ReHo in the left middle occipital gyrus and bilateral postcentral gyrus, and higher ReHo in the right cerebellum crus1. EN could affect MDD directly and indirectly through ReHo in these discrepant brain regions and social support. Combining ReHo values of these four distinct brain regions, EN, and objective support could classify MDD patients from HC, and the 10-fold cross-validation accuracy within-study replication and in the independent cohort was 83.78 % ± 1.49 % and 82.72 % ± 2.22 %, respectively. These findings suggested that childhood EN, social support, and emotional-related regions' ReHo were associated with risks of MDD, providing new insights into the pathological mechanisms underlying MDD.

The dynamic changes of psychosomatic symptoms in three waves of COVID-19 outbreak and fatigue caused by enduring pandemic in China.

BACKGROUND: Two years have passed since the 2019 novel coronavirus disease (COVID-19) was first reported. The persistent pandemic might lead to severe psychosomatic problems and fatigue. In addition, the recent rapid rising COVID-19 cases in China have become a trending issue. Therefore, this study aimed to investigate the dynamic changes in psychosomatic problems at the initial and current stages of the pandemic. METHODS: Three waves of cross-sectional online survey were conducted during the initial COVID outbreak in China. The psychosomatic symptom scale (PSSS), perceived stress scale (PSS), and pandemic fatigue scale (PFS) were used to assess the psychosomatic problems, stress, and fatigue. RESULTS: 4317, 1096, and 2172 participants completed the first, second, and third surveys. The prevalence of psychosomatic disorder was 22 %, 28 %, and 39 %, respectively. The network structure of PSSS symptoms has not significantly changed as the pandemic progresses. However, the global strength of the PSSS networks, indicating the overall connectivity, in the third wave was significantly higher than in the first wave (s = 0.54, P = 0.007). The most central symptoms in the first and third wave networks were depressed mood and tiredness. The PFS score was higher in the people concerned with indirect impact than those concerned with health (P < 0.001). PFS has positive relationships with PSSS and PSS score (R = 0.41, P < 0.001 and R = 0.35, P < 0.001, respectively). CONCLUSIONS: The persistence of the pandemic caused critical psychosomatic issues, stress, and indirect burden over time, leading to inevitable fatigue. People endured needing immediate attention to prevent or reduce psychosomatic disorders.

Coupling of spatial and directional functional network connectivity reveals a physiological basis for salience network hubs in asthma.

Research findings have consistently indicated that asthma might be correlated with neural activity in brain circuits, especially the insular and anterior cingulate cortex (ACC), which are primary nodes of the salience network (SN). However, little is known about the relationships between the SN and other brain regions that are affected by asthma. Therefore, we explored the role of the SN to determine whether its neural activity was disrupted by asthma. Forty asthmatic patients and 40 well-matched healthy controls (HCs) underwent functional magnetic resonance imaging scanning and clinical assessments, including the asthma control test and 17-item Hamilton depression scale (HAMD). Altered spatial, network and temporal connections of the SN were investigated. Compared to HCs, patients showed increased functional connectivity (FC) between the dorsal ACC (dACC) and left middle frontal gyrus. In addition, network FC analysis suggested that the SN has increased connections with both the default mode network (DMN) and executive control network (ECN), which are both related to asthma. Asthma decreased the network connections between the DMN and ECN. Furthermore, Granger causality (GC) strengths from both the DMN and ECN to the bilateral anterior insula were increased in asthmatic patients. A positive correlation was found between GC strengths from the left parietal cortex to the right anterior insula and HAMD scores in asthmatic patients (r = 0.434, P = 0.005). The findings from this study suggested that the SN plays an important role in asthma. The aberrant spatial FC of the SN and its directional network connections with the DMN and ECN may contribute to the potential neural underpinnings of asthma.