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Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.
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Objective:To explore the correlation between attempted suicide and childhood trauma as well as inflammatory cytokines levels in adolescents with depressive disorder.Methods:From January to December 2021, a total of 164 adolescents with depressive disorder were included and categorized into attempted suicide group ( n=108) and non-attempted suicide group ( n=56) according to whether they accompanied attempted suicide or not. The Chinese version of the suicide module of MINI 5.0, the childhood trauma questionnaire(CTQ), and the center for epidemiological studies depression scale (CES-D) were used to assess suicidal behavior, childhood trauma and depressive symptoms, while the plasma inflammatory cytokines levels were measured by electrochemiluminescence technology. The data were statistically analyzed by SPSS 23.0 software. Logistic regression was applied to analyze the independent influencing factors of attempted suicide and the predictive value of each independent risk factor for attempted suicide was assessed by receiver operating characteristic curve(ROC) curves. Results:The prevalence of attempted suicide was 65.9%(108/164) in adolescents with depressive disorder.The univariate analyses showed that the total CTQ score ((55.19±12.44), (45.50±12.11)) ( t=-4.771, P<0.001), CES-D total score ((40.75±10.26), (32.98±13.39)) ( t=-4.131, P<0.001), IL-6 level(1.87 (1.32, 2.69) pg/mL, 1.56 (1.05, 1.87) pg/mL)( Z=-3.102, P=0.002), IL-10 level (0.53 (0.38, 0.83) pg/mL, 0.47 (0.31, 0.69) pg/mL) ( Z=-2.100, P=0.036) and IL-17A level (2.20 (1.52, 3.65) pg/mL, 1.67 (1.25, 2.97) pg/mL) ( Z=-2.254, P=0.024) in plasma of patients in the attempted suicide group were significantly higher than those in non-attempted suicide group. Logistic stepwise regression analyses showed that CTQ total score, IL-6, IL-10, and IL-17A were risk factors for attempted suicide in adolescents with depressive disorder.The ROC showed that the total score of CTQ combined with IL-6 (AUC=0.782, 95% CI=0.709-0.855, P<0.001), the total score of CTQ combined with IL-10 (AUC=0.765, 95% CI=0.688-0.841, P<0.001), and the total score of CTQ combined with IL-17A (AUC=0.762, 95% CI=0.684-0.840, P<0.001) had a larger area under the curve, indicating better recognition and prediction ability for attempted suicide, with high sensitivity and specificity. Conclusion:The incidence of attempted suicide in adolescents with depressive disorder is high, and which is closely related to childhood trauma and the levels of inflammatory cytokines.
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The prevalence rate of tic disorder in Chinese children and adolescents is relatively high, and tic disorder is often co-occurring with psychiatric disorders such as attention deficit and hyperactive disorder and obsessive compulsive disorder.The cognitive impairments of tic disorder patients with different clinical types, course of disease and comorbidities are different, but all affect the learning and life quality of patients.Exploration of the cognitive function characteristics of tic disorder patients is conducive to further understanding of the disease and its etiological mechanism, and has guiding significance for clinical recognition, diagnosis and treatment.
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Objective@#Excessive daytime sleepiness (EDS) and insomnia symptoms are common in patients with major depressive disorder (MDD), which might lead to a poor prognosis and an increased risk of depression relapse. The current study aimed to investigate the prevalence, and sociodemographic and clinical correlates of EDS and insomnia symptoms among adolescents with MDD. @*Methods@#The sample of this cross-sectional study included 297 adolescents (mean age=15.26 years; range=12–18 years; 218 females) with MDD recruited from three general and four psychiatric hospitals in five cities (Hefei, Bengbu, Fuyang, Suzhou, and Ma’anshan) in Anhui Province, China between January and August, 2021. EDS and insomnia symptoms, and clinical severity of depressive symptoms were assessed using Epworth sleepiness scale, Insomnia Severity Index, and Clinical Global Impression-Severity. @*Results@#The prevalence of EDS and insomnia symptoms in adolescents with MDD was 39.7% and 38.0%, respectively. Binary logistic regression analyses showed that EDS symptoms were significantly associated with higher body mass index (odds ratio [OR]=1.097, 95% confidence interval [CI]=1.027–1.172), more severe depressive symptoms (OR=1.313, 95% CI=1.028–1.679), and selective serotonin reuptake inhibitors use (OR=2.078, 95% CI=1.199–3.601). And insomnia symptoms were positively associated with female sex (OR=1.955, 95% CI=1.052–3.633), suicide attempts (OR=1.765, 95% CI=1.037–3.005), more severe depressive symptoms (OR=2.031, 95% CI=1.523–2.709), and negatively associated with antipsychotics use (OR=0.433, 95% CI=0.196–0.952). @*Conclusion@#EDS and insomnia symptoms are common among adolescents with MDD. Considering their negative effects on the clinical prognosis, regular screening and clinical managements should be developed for this patient population.
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ObjectiveTo investigate the status of sleep insufficiency in children and adolescents with mental disorders and related influencing factors. MethodsA total of 131 children and adolescents who were admitted to the Third People's Hospital of Fuyang from February to June 2021 and met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for schizophrenia， depression or childhood-onset mood disorders were selected as the research subjects. A self-compiled questionnaire was used to collect the general demographic information， sleep status， lifestyle habits， family and school status of the selected individuals. The demographic information was compared between sleep sufficiency group and sleep insufficiency group. Spearman rank correlation was used to screen the influencing factors. Results① Among 131 children and adolescents with mental disorders， 93 cases （71.0%） had sleep insufficiency. There were significant differences between sleep insufficiency group and sleep sufficiency group in terms of disease types （χ2=8.798， P=0.012）， experience of being beaten in recent 6 months （χ2=3.427， P=0.035）， being scolded in recent 6 months （χ2=4.145， P=0.031）， and cyberbullying over the past year （χ2=4.187， P=0.041）. ② Among patients with sleep insufficiency， 77 cases （82.8%） reported difficulty in falling asleep and 69 cases （74.2%） reported nocturnal awakenings. ③ Sleep insufficiency in children and adolescents with mental disorders was positively correlated with the experience of being scolded （r=0.210， P=0.037） or beaten （r=0.145， P=0.023） over the past 6 months and cyberbullying over the past year （r=0.179， P=0.041）. ConclusionChildren and adolescents with mental disorders suffer a high risk of sleep insufficiency， and is closely associated with depressive disorder， experience of being scolded or beaten over the past 6 months， and cyberbullying over the past year.
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Objective@#To explore the relationship between insulin resistance and plasma hypersensitive reactive protein (hs-CRP) in patients with chronic schizophrenia.@*Methods@#A total of 247 inpatients with chronic schizophrenia (patient group) and 166 cases of normal individuals(control group) were enrolled.Their general demographic and clinical data were collected, fasting blood glucose, hs-CRP, c-peptide and insulin indexes were tested, and insulin resistance index (HOMA-IR) was calculated.The insulin resistance level of the patients group and the control group was compared by Mann-Whitney U test, and the relationship between insulin-resistance and hs-CRP in patients group was analyzed using Spearman correlation analysis.@*Results@#(1)The levels of C-peptide (2.53(2.06, 3.23)ng/ml vs 2.24(1.89, 2.87)ng/ml), insulin (7.68(4.66, 11.97)μIU/ml vs 7.02(4.31, 9.59)μIU/ml) and HOMA-IR (1.75(1.09, 3.07) vs 1.57(0.97, 2.22)) in the patient group were significantly higher than those in the control group(all P<0.05). (2) The levels of HOMA-IR( 1.91(1.21, 3.74) vs 1.70(1.02, 2.72)) in patients with high hs-CRP(≥3 mg/L) was higher than those in the patients with low hs-CRP(<3 mg/L)(P<0.05). (3)Spearman correlation analysis showed that HOMA-IR was positively correlated with plasma hs-CRP level in the patient group (r=0.139, P<0.05). (4)After logarithmic transformation of related variables, multivariate linear regression analysis showed that HOMA-IR was linearly correlated with hs-CRP level and boy weight index.@*Conclusion@#The hs-CRP level in chronic schizophrenia has a positive predictive effect on insulin resistance.Detection of hs-CRP level in schizophrenic patients is helpful to assess metabolic risk of insulin.
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Objective To explore the relationship between insulin resistance and plasma hypersen-sitive reactive protein (hs-CRP) in patients with chronic schizophrenia. Methods A total of 247 inpatients with chronic schizophrenia ( patient group) and 166 cases of normal individuals( control group) were en-rolled. Their general demographic and clinical data were collected,fasting blood glucose,hs-CRP,c-peptide and insulin indexes were tested,and insulin resistance index (HOMA-IR) was calculated. The insulin resist-ance level of the patients group and the control group was compared by Mann-Whitney U test,and the rela-tionship between insulin-resistance and hs-CRP in patients group was analyzed using Spearman correlation a-nalysis. Results (1)The levels of C-peptide (2. 53(2. 06,3. 23)ng/ml vs 2. 24(1. 89,2. 87)ng/ml), in-sulin (7. 68(4. 66,11. 97)μIU/ml vs 7. 02(4. 31,9. 59) μIU/ml) and HOMA-IR (1. 75(1. 09, 3. 07) vs 1. 57(0. 97,2. 22)) in the patient group were significantly higher than those in the control group( all P<0. 05). ( 2) The levels of HOMA-IR( 1. 91( 1. 21,3. 74) vs 1. 70(1. 02,2. 72)) in patients with high hs-CRP(≥3 mg/L) was higher than those in the patients with low hs-CRP (<3 mg/L) (P<0. 05). ( 3) Spearman correlation analysis showed that HOMA-IR was positively correlated with plasma hs-CRP level in the patient group (r=0. 139,P<0. 05). (4)After logarithmic transformation of related variables,multivariate linear regression analysis showed that HOMA-IR was linearly correlated with hs-CRP level and boy weight in-dex. Conclusion The hs-CRP level in chronic schizophrenia has a positive predictive effect on insulin re-sistance. Detection of hs-CRP level in schizophrenic patients is helpful to assess metabolic risk of insulin.
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Objective To explore the medium effect of social support in process of attachment styles and coping styles on criminal juveniles and adolescents with mood disorders.Methods The survey used in the research included Experiences of Close Relationships Inventory (ECR),Social Support Revalued Scale(SSRS) and Coping Style Questionnaire(CSQ) conducted by three groups:177 criminal juveniles,80 adolescents with mood disorders and 163 normal teenagers.Results Firstly,there were significant differences in the avoidant attachment,attachment anxiety,objective support,subjective support,utilization of support,solving problem,rationalization,self-accusation and retreat among three groups (F=7.902,8.047,59.009,19.248,5.304,7.596,10.652,6.699,11.009;P＜0.05).Secondly,attachment avoidance had significant negative correlation with both utilization of support and help seeking behaviors in the group of mood disorders (r =-0.470,-0.350; P＜ 0.01).Similarly,avoidant attachment had significant negative correlation with both subjective support and utilization of support respectively (r=-0.232,-0.235 ; P＜0.01) in the group of criminal juveniles.The subjective support had significant positive correlation with solving problem (r=0.272,P＜0.01) and as well as the utilization of support with both solving problem and help seeking behaviors (r=0.258,0.424; P＜ 0.01).Attachment anxiety had significant negative correlation with objective support and had significant positive correlation with self-accusation respectively (r=-0.253,0.300;P＜0.01).Finally,utilization of support as a medium completely effect on the process of avoidant attachment and help seeking behaviors in the group of mood disorder and criminal juveniles.Moreover,subjective support and utilization of support as medium both affected a part in the process of avoidant attachment and solving problem for the group of criminal juveniles.Conclusion First,both adolescents with mood disorders and criminal juveniles have unsafe attachment mode,which are lacked social support and easy to take negative coping styles.Yet,the level of attachment avoidance and subjective support of criminal juveniles was found different compared to teenagers with mood disorder.Second,the attachment styles for both adolescents with mood disorders and criminal juveniles have impact on coping styles by the means of social support,but there were slightly different way.
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Objective: To study the effect of early intervention on psychosocial development of children in single child family. Method:30 babies were enrolled as intervention group from they were fetus. Another 37 were enrolled as control group. The former received intervention under the Guide of Different Stages from 0 to 6 years old. Achenbach Children Behavior Checklist (CBCL) and Binet Intelligent Test were used to assess the results.Results:The rate of behavior group was 6.7%, significantly lower than that of the control group (13.5%) and Chinese norm (14.2%). The average IQ of the intervention group was significantly higher than control. But there was no significant difference in Social Adaptability between the two groups. Conclusion:Early education and intervention can improve psychosocial development children in single child family.