Clonidine Patch for Tourette Syndrome With Attention-Deficit/Hyperactivity Disorder

Objective@#To explore the efficacy and safety of clonidine adhesive patch in Tourette syndrome (TS) patients with comorbid attentiondeficit/hyperactivity disorder (ADHD). @*Methods@#This study was conducted on a sample of children and adolescents with TS who had comorbid ADHD between May 2012 and March 2015. The patients were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, and were randomly assigned to four different dose groups: 1.0 mg/week, 1.5 mg/week, 2.0 mg/week and placebo group, and the symptom was evaluated by Swanson, Nolan, and Pelham Rating Scale, Version IV (SNAP-IV) and Yale Global Tic Severity Scale scales every 2 weeks. The primary outcome was tic disorders (TD) effective rate at week 8. @*Results@#One hundred and twenty-seven TS patients with comorbid ADHD in 2.0 mg/week (n=35), 1.5 mg/week (n=27), 1.0 mg/week (n=36) and placebo groups (n=29) were included in this subgroup analysis. The TD effective rate of the 2.0 mg, 1.5 mg, and 1.0 mg groups at week 8 were significantly better than that in placebo group (85.7%, 81.5%, and 86.1% vs. 20.7%, all p<0.0001). All groups demonstrated significant improvements in SNAP-IV total scale scores compared to baseline (p=0.0004), with treatment groups showing only a trend for better performance compared to placebo group at week 8, without statistical differences (22.1±15.41, 21.3±11.96, and 21.2±12.48 vs. 26.0±13.37, p=0.3385). A total of 9 adverse reactions occurred, all recovered spontaneously without additional medication. @*Conclusion@#Clonidine adhesive patch could safely and effectively reduce the tic symptoms of TS patients with comorbid ADHD, and might be potentially helpful in the ADHD symptoms control.

Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers / 中南大学学报(医学版)

OBJECTIVES@#Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model.@*METHODS@#The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention.@*RESULTS@#The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful.@*CONCLUSIONS@#Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.

PTSD-positive screening and factors influencing the mental state in victims evacuated/ not evacuated from Wenchuan earthquake area within 1 month / 中南大学学报(医学版)

OBJECTIVE@#To explore posttraumatic stress disorder (PTSD) positive screening and factors influencing the mental state in victims who were evacuated/were not evacuated from Wenchuan earthquake area within 1 month.@*METHODS@#The 3 groups included 235 victims who were not evacuated from Shifang territory (the incident scene, Group A), 44 victims who were evacuated to Second Xiangya Hospital (the wounded, Group B) and 36 relatives (the relatives, Group C). The mental state of all subjects was evaluated by Impact of Event Scale-Revised (IES-R) and other tools.@*RESULTS@#(1) One month after the disaster, and the positive rate of PTSD screening in these survivors was 35.56%, the positive rate in women was significantly higher than that in men (chi(2)=16.27,P<0.001). The positive rate of PTSD screening in Group A, Group B and Group C was 39.15%, 31.82%, and 16.67%, respectively, with significant difference (chi(2)(mh)=5.243,P<0.05). Among the three groups which met the diagnosis criterion of PTSD symptoms, the scores for "numbness/avoidance symptom"and "excessive arousing symptom"in Group A were significantly higher than those in Group B and C (P<0.01). (2) The scores for "anxiety"and "depression"and "psychosomatic"symptoms in Group A and Group B were significantly higher than those in Group C (P<0.05). (3) Gender, place of residence and evacuating from the earthquake area or not were factors of PTSD symptoms.@*CONCLUSION@#One month after the earthquake, the victims suffered psychologically. PTSD symptoms, anxiety and depression symptoms were their major mental problems, more attention to especially women victims. The protection factors include dispersing victims to the secure place as soon as possible, expanding and strengthening society support. Early psychological interventions will help victims to raise their psychological endurance and prevent PTSD effectively.

Intellectual and behavioral characteristics and their relations with serum 5 hydroxytryptamine level in children with attention deficit hyperactivity disorder complicated by oppositional defiant disorder / 中国组织工程研究

BACKGROUND:Oppositional defiant disorder(ODD) often occurs as a comorbid condition of attention deficit hyperactivity disorder(ADHD),characterized by defiant behaviors.ADHD children with ODD have more extensive impairments than those with ADHD alone. Some studies suggest that decreased serum 5 hydroxytryptamine(5 HT) level is related to aggressive behavior in ADHD, but no relevant report is available in China. OBJECTIVE:To investigate the clinical features of ADHD with ODD,and their relations with serum 5 HT. DESIGN:A randomized case controlled study taking the ADHD children with or without ODD as the subjects for study. SETTING:Mental Health Institute of the Second Xiangya Hospital. PARTICIPANTS:Sixty one ADHD children(53 boys and 8 girls) aged 7 to 14 years visiting the Children's Clinic of Mental Health Institute of Central South University from June 2002 to May 2003 were recruited and divided into two groups based on the symptomatic criteria of ODD recommended by the Diagnostic and Statistical Manual of Mental Disorder(DSM Ⅳ ):ADHD group(n=33,without ODD) and ADHD+ ODD group(n=28). INTERVENTIONS:The parents of the enrolled children(n=61) were asked to complete the Achenbach child behavior checklist (CBCL),and the teachers(n=31) completed the teacher's report form (TRF).Two milliliters of fasting venous blood was drawn from these children and the serum separated by centrifugation for quantification of 5 HT using external standard method,and whole blood 5 HT was analyzed by LD 10AD high performance liquid chromatography(HPLC). MAIN OUTCOME MEASURES:Scores of CBCL,TRF and Chinese Wechsler Intelligence Scale for Children(C WISC) and serum 5 HT levels. RESULTS:In the ADHD+ ODD group,the scores of CBCL and TRF for externalizing, aggressive behaviors and total scores for behavioral problems rated by the parents and teachers were significantly higher than those of the ADHD group(t=2.28 to 3.76,P< 0.05 to 0.01);the former group also had significantly higher scores of CBCL for anxiety/depression and internalizing(t=2.27 to 2.35,P< 0.05), but had significantly lower serum 5 HT level[(327.01± 164.84) μ g/L vs (451.11± 250.89) μ g/L](t=2.32,P< 0.05). CONCLUSION:Children with ADHD and comorbid ODD receive poorer ratings on all variables including externalizing and internalizing problems,adjustment variables and attention impairment. Increased aggressive behavior and lowered 5 HT level may be the biological markers of impulsive behavior in ADHD children with ODD.

Internet Overuse and Time Management Disposition of Middle School Students / 中国心理卫生杂志

Objective: To explore the relationship between internet overuse and time management disposition in middle school students. Methods: Using Diagnostic Questionnaire for Internet Addiction (YDQ), Time Management Disposition Scale (TMDS), we investigated 2620 middle-school students.Results:The incidence rate of internet overuse among middle school students was 2.4 %. The difference of time management disposition between internet overuse group and control group was significant(129.7?25.3/150.0?28.5,t=4.27, P

Comorbidity of Anxiety and Depression in a Primary School Sample / 中国心理卫生杂志

s Objective: To investigate the comorbidity of depression and anxiety in primary school students. Methods:565 pupils ranged from 2 to 6 grade in a primary school were tested by The Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-Rating Scale for Children (DSRSC). Results: There were 140 pupils with a total score higher than cut-off point of SCARED; 97 pupils with a total score higher than cut-off point of DSRSC; 43 pupils with total scores higher than cut-off point of both SCARED and DSRSC, and the positive rate of comorbidity of anxiety and depression was 7.61%. 30.71 percent of children with anxiety disorder was considered co-morbiding depression; 44.33 percent of children with depressive disorder was considered comorbiding anxiety. Chil-dren with comorbidities had higher scores in Withdrawn(mean rank 297.7 ) than Anxiety group(220.8) and Depressive group(202.2);Somatic Complaints(268.2)than Anxiety group (232.2 ) and Depressive group(206.2 ) , Anxious/Depressed (277.2 )than Anxiety group (227.7 ) and Depressive group(219.2 )of CBCL(?~2 =16.72～22.71,P

Control Study of Group Psychotherapy on Middle School Students with Internet Overuse / 中国心理卫生杂志

Objective:To investigate the effect of group psychotherapy on middle school students with internet overuse(IOU).Methods:A total of 2620 middle-school students from four middle schools of Changsha City were surveyed using Diagnostic Questionnaire for Internet Addiction (YDQ), According to the YDQ criterion and clinical interview, 64 students who were diagnosed as Internet overuse. 29 middle school students with IOU from one regular middle school and one key middle school received group psychotherapy. 35 middle school students with IOU from the other two schools were taken as control(control group). All the students in both groups were assessed with Diagnostic Questionnaire for Internet Addiction(YDQ), Chen Internet Addiction Scale(CIAS), The Screen for Child Anxiety Related Emotional Disorders(SCARED), Strength and Difficulties Questionnaire(SDQ). Results: The scores 0f SCARD and SDQ subscale of emotional symptoms of experimental group decreased significantly (t=2.11～2.99,P