A Systematic Review and Meta-Analysis of Metabolic Syndrome Prevalence in Chinese Inpatients with Bipolar Disorder.

The aim of the work was to study the prevalence of metabolic syndrome in Chinese patients with bipolar disorder. We searched Chinese literature related to the study in prevalence of metabolic syndrome in bipolar disorder in Chinese language, among which results such as comments, letters, reviews and case reports were excluded. The prevalence of metabolic syndrome in bipolar disorder was researched and discussed. A total of 1562 subjects were included in 11 studies. The prevalence of MetS in bipolar disorder was 33% (95% CI=0.29-0.37), which was higher significantly than normal control (10.82%), but similar to schizophrenia (31.59%). The 41.41% prevalence of MetS in male patients was higher significantly than that in females (26.83%).The prevalence of MetS in BD treated by AAP was 47.54%, by MS was 19.19%, by MS+AAP was 40%.The prevalence of MetS in BD treated by carbamazepine was 28.21%, by lithium was 30%, by valproate was 21.71%, by clozepine was 51.43%, by olanzapine was 39.84%, by quetiapine was 39.44%, and by risperidone was 35%. The prevalence of MetS in bipolar disorder was 33% (95% CI=0.29-0.37), which was higher significantly than normal control (10.82%), but similar to schizophrenia (31.59%). AAP and MS were the main one risks of MetS in BD.

Restless Back Syndrome: A Case Report and Literature Review.

Restless back syndrome is characterized by uncomfortable pain, burning, ant crawling, or itching sensations in the back. Restless back syndrome is regarded as a back variant of restless legs syndrome. The lack of specific diagnostic criteria makes it difficult to recognize the restless back syndrome, which is usually neglected in clinical practice. Moreover, when a patient was diagnosed with restless back syndrome, the adjustment of medications was the first choice for doctors, which may make the patient's condition unstable. To describe the restless back syndrome and collect and review the related lecture, and the possible mechanism of restless back syndrome was analyzed. A 50-year-old man was diagnosed with schizophrenia 15 years ago. Starting with 25 mg/day aripiprazole, which was switched to amisulpride 0.6 g/day due to no effectiveness, the patient reported symptoms of restless back syndrome in the 2 weeks since the treatment with 0.6 g/day of amisulpride. With the reduction of amisulpride adjustment, restless back syndrome spontaneously remitted. The central dopaminergic dysfunction may play an important role in the development of restless back syndrome. This case suggests that psychiatrists should pay attention to restless back syndrome when using antipsychotics. Moreover, when a patient manifests restless back syndrome, observation or decreasing medication may be one choice.

Is aripiprazole similar to quetiapine for treatment of bipolar depression? Results from meta-analysis of Chinese data.

Objective: To study the similarities and differences in the clinical efficacy of aripiprazole and quetiapine in Chinese patients with bipolar depression through meta-analysis. Additionally, to provide evidence of aripiprazole in treatment for bipolar depression. Methods: We searched Chinese literature related to the study of aripiprazole and quetiapine in treatment for bipolar depression, among which results such as comments, letters, reviews, and case reports were excluded. The clinical efficacy between aripiprazole and quetiapine was synthesized and discussed. Result: A total of 1,546 subjects were included in 17 studies. The random effect model was used to review the data by RevMan 5.2. The results showed that there was no significant difference in the remission rate between patients treated with aripiprazole and quetiapine evidenced by the scale used to evaluate the patients being treated for bipolar depression (221/501 vs. 193/501, Z = 1.12, P = 0.26). But the results also showed that the remission rate of aripiprazole with lithium carbonate was significantly higher than quetiapine with lithium carbonate in the treatment of bipolar depression (111/232 vs. 69/232, Z = 3.92, P < 0.0001). The results showed that the effective rate of aripiprazole was similar to quetiapine (426/572 vs. 386/572, Z = 2.70, P = 0.007). Overall, there was no difference in the Hamilton Rating Scale for Depression (HAMD) score between patients treated with aripiprazole and quetiapine (Z = 1.68, P = 0.09). The results also show that the drop-out rate of aripiprazole was similar to quetiapine in the treatment of patients with bipolar depression (Z = 1.80, P = 0.07). Conclusion: As an atypical antipsychotic, aripiprazole may be similar to quetiapine for treating bipolar depression with similar drop-out and higher remission rates when combined with lithium carbonate. However, the results of this study need to be read with caution given the poor quality of collected/analyzed literature.

A systematic review involving 11,187 participants evaluating the impact of COVID-19 on anxiety and depression in pregnant women.

BACKGROUND: COVID-19 has started to spread within China since the end of December 2019. As a special population, the pregnant and delivery women maybe influenced both in physical and psychological aspects. The meta-analysis was conducted about mental health in pregnant and delivery women. METHODS: We searched both MEDLINE, EMBASE, Cochrane Library in English and CBM, CNKI, WANFANG and CSSCI in Chinese to find literature from December 2019 to 31 July 2020 related to COVID-19 and mental health in patient with pregnancy and delivery, among which results such as comments, letters, reviews and case reports were excluded. The prevalence of anxiety and depression in the population was synthesized and discussed. RESULTS: A total of 11,187 subjects were included in 15 studies. Random effect model is used to account for the data by Revman 5.2. The results showed that the prevalence of depression was 30% (95% CI: 0.23-0.37), the prevalence of anxiety was 34% (95% CI: 0.26-0.43) and prevalence of both anxiety and depression was 18% (95% CI: 0.09-0.29). The prevalence of anxiety (OR = 2.15, 95% CI: 1.39-3.31, Z = 3.47, p=.0005), depression (OR = 1.95, 95% CI: 1.07-3.56, Z = 2.19, p=.03) were higher than that of controls. Significant heterogeneity was detected across studies regarding these prevalence estimates. Subgroup analysis was taken according to assessment tools, and sensitivity analysis was done to explore the sources of heterogeneity. CONCLUSIONS: The higher prevalence of depression, anxiety, both depression and anxiety in women with pregnancy and delivery during COVID-19 pandemic although the significant heterogeneity detected in studies. We must interpret the results with caution and also put attention to this result. As the epidemic is ongoing, it is vital to set up a comprehensive crisis prevention system.