Owing to reasons of social culture, the principle of informed consent is not fully implemented among psychotics. The author introduced the basis and range of application of informed consent, the capacity of informed consent in psychotics, and how to implement the principles also. As mentioned above, the author pointed out the informed consent of psychotics should be regarded.

Objective To compare the effects of mental stress and physical stress on the anxiety behavior in SD rats.Methods 24 male SD rats were allocated into mental stress group,physiological stress group and control group randomly,and the Communication Box was applied to establish animal model of mental stress,then assessed their anxiety behavior through the Open field test and elevated plus nlaze test.Results In the Open field test.the numbers of squares crossed peripherally and centrally,and the grooming frequency significantly lowered in physiological stress group and in mental stress group compared with that in control group,and were significantly higher in mental stress group than in physiological stress group.The elevated plus maze test demonstrated similar results in the numbers of open arm entries and the time spent in open arms among these three groups.Conclusion In Communication Box model,the anxiety behavior level of physiological stress mats were higher than that in mental stress rats.

Objective: To evaluate the quality of life of schizophrenic patients spouses living in the community. Methods:One hundred schizophrenic patients spouses and 60 control subjects were adminstered the General Quality of Life Inventory (GQOLI). Results: The schizophrenic patients spouses reported significantly lower score on the quality of life than the controls in the domains of physical health, mental health, social function and economic condition. The characteristics of disease played an important role in the quality of life. Conclusion: The quality of life of schizophrenic patients spouses were poorer than that of control subjects.

Objective This study aimed to explore the relationship between the traumatic experience in childhood and onset of obsession in adulthood,and the character of family environment of obsession patients.Methods Using Y-BOCS and CAT and FES-CV to evaluate 41 cases with OCD and 36 normal subjects respectively.Baaed on these scales,an edited interview schema for a semi-structured interview was choosed with both groups for 50 minutes respectively.Results ①Tbe whole score and scores of two subscales on punishment,negative-environment in CAT were all obviously higher in patients with obsession [(50.16± 21.03),(12.03±4.24),(19.77±9.74),for punishment:P<0.05,for others:P<0.01],and there were a significant difference in the two groups[(35.35±14.78),(9.92±2.51),(12.54±8.14)].The negative environment was chosen in regress equation,and could explain 14.67% of outcome of obsession. ②The scores of 4 ubacaies like cohesion,expressiveness,intellectual-cultural orientation,active-recreational orientation [(5.13±2.28),(4.10±2.12),(2.71±1.87),(2.52±2.34)] ,were all obviously lower than the normal control in FES-CV.While the subscore of conflict (5.03±2.21) was higher than the normal control(3.50±2.40),and all these differences were significant.When two factors of active-recreational orientation and cohesion in FES-CV were put into regression equation( R2 =0.2078 ,R2 =0.2784),they contribute 27.84% and the disease,and the active-recreational orientation factor can explain 20.78%.③The result of interview found significant difference between obsession groupand control group in parental personality,own personality,childhood experience,and family environment.Condusion The traumatic experience in childhood and unhealthy family environment do have association with onset and development of obsession,also they have a close relationship with the development of personality after adulthood.

Three key ethical issues in neurotherapeutics research are discussed: the ethical challenges arising from changes in the financial incentive of researchers and their institutions,risk-benefit analysis on testing innovative interventions,and the research for informed consent.

Objective:To understand outcome of heroin addicts after abstinence and analyze the factors related to relapse. Methods:A follow-up of 149 heroin addicts in a correction camp was carried out at 6th months after their discharge. Demographic characteristics, clinical features, addiction severity and psychiatric comorbidity were compared between those who relapsed and those who remained abstinent. Results: 22.8% of the subjects were abstinent, 46.3% relapsed, 29.5% in probation or in treatment,1.3% died. Relapse was related to the presence of drug addiction in family members, lack of abstinence intention, antisocial personality disorder, lack of rehabilitation therapy, intravenous heroin use and ASI scores in heroin abuse, composite family/social and legal factors. Conclusion:The outcome of heroin dependence after correction was poor. Relapse was related to family environment, abstinence intention, the heroin addiction severity,antisocial personality disorder.

Objective To study the characteristic of cognitive function impaired and its relationship with the psychiatric symptoms in patients with first-episode schizophrenia.Methods 43 first-episode male schizophrenia patients diagnosed with DSM-Ⅳ were recruited in the study and received the atypical antipsychotics treatment 8weeks.The total score and sub-scores of Chinese Cognitive Ability Scale (CCAS)were obtained for all the patients pre-and post-treatments,and the patients were also assessed by the Positive and Negative Syndrome Scale (PANSS).Results The differences of the intelligence quotient(IQ) and its cognitive function factors between pre-and post-treatment of the patients were significant(P＜ 0.01).The total IQ score (85.7 ± 11.5),learning ability (17.9± 2.3),reasoning ability (16.1 ± 3.4),processing speed (16.9 ± 2.1),working memory (13.8 ± 2.6),space/calculate (17.5 ± 2.9),verbal IQ (86.8 ± 11.7),performance IQ (83.9 ± 12.4) before treatment and cognitive score (97.6 ± 14.3) as well as cognitive function factor (learning ability (20.1 ± 2.9),reasoning ability (18.9± 3.1),processing speed (19.7 ± 1.8),working memory (15.7 ± 2.5),space/calculate (20.8 ± 2.5),verbal IQ (98.3 ± 13.7),performance IQ (95.8 ± 14.6) after treatment,there were significant differences pre-and posttreatment (P ＜ 0.01).The difference of IQ pre-and post-treatment was significantly correlated with that of total score and positive score of PANSS(r =0.596 or 0.783).Conclusions (1) This finding supports that the cognitive function impairment exists in the early stage of schizophrenia.(2)The typical antipsychotic drugs can improve the cognitive function impairment and psychiatric symptoms of schizophrenia.(3) The cognitive function impairment of schizophrenia has significant relation to the positive symptoms,but no relation to the negative symptoms.

Objective This preliminary study aimed to investigate relevant factors of the metacognition of peri?menopausal women. Methods Total 66 perimenopausal women voluntarily participated in this study from October 2012 to July 2013. The Metacognitions Questionnaire 30-item version (MCQ-30) was used to assess metacognition from 5 di?mensions including cognitive confidence (F1), positive beliefs (F2), cognitive self-consciousness (F3), uncontrollability and danger (F4), and need to control thoughts (F5). Eysenck Personality Questionnaire was utilized to measure the person?ality characteristics such as the extraversion/introversion (E), neuroticism/stability (N), psychoticism/socialization (P), and lie (L). Depression and its 4 symptom components including core, cognitive, anxiety, and somatic symptoms were deter?mined by Zung Self-rating Depression Scale (SDS). The linear multiple stepwise regression were performed to analyze the relevant factors of each MCQ dimension. Results The education level (β’=-0.229, P=0.035), N score (β’=0.255, P=0.042), and L score (β’=-0.292, P=0.021) were related to F1. The education level (β’=-0.260, P=0.031) and N score (β’=0.248, P=0.039) were predictors of the dependent variable F2. The core depression symptom (β’=-0.251, P=0.037) and anxiety symptom (β’=-0.248, P=0.039) of SDS were negatively related to F3. Predictors of F4 were the body mass in?dex (β’=0.211, P=0.048) and L score (β’=0.511, P<0.0001). Only P score (β’=0.299, P=0.015) was related to F5. Con?clusion The metacognition level of perimenopausal women is affected by a variety of factors such as personality character?istics and education level, and low self-consciousness and lack of confidence to the cognitive process may be involved in the increased susceptibility to depression.

Objective To develop the bipolar depression index scale (BDIS) and test the validity and reliability of BDIS.Methods The original bipolar depression index scale (BDIS) was developed by the clinical features of bipolar depression reported by the studies focused on comparing the bipolar depression (BP) and unipolar depressive disorder (UP).46 patients with bipolar depression and 44 patients with unipolar depression were rated the original BDIS and enrolled consecutively by DSM-IV.Results There were eleven items in the BDIS.The interrater reliability between eleven items and BDIS score ranged from 0.61 to 0.87.The correlation coefficients between eleven items and BDIS score ranged from 0.53 to 0.73.The Cronbach's alpha of BDIS was 0.68.The mean BDIS score of BP(7.26 ± 3.12 ) was significantly higher than that of UP( (4.80 ± 3.08 ), (P ＜ 0.01 ).The BDIS scores were significantly correlated with the scores of Mood Disorder Questionnaire ( coefficient 0.56) and 32-item hypomania checklist ( coefficient 0.45).The BDIS score could discriminate between BP patients and UP patients by the ROG curve analysis and 5 was the best cutoff score ( sensitivity 0.80, specificity 0.64).Conclusions The validity and reliability of BDIS are fit for the requirements of psychometrics.BDIS may use to differentiate between bipolar depression and unipolar depression in the practice.

Objective: To develop a calculation model for normal sagittal diameter (SD) of bulbo-medullary junction with the change of distance above the measurement baseline(the line connecting the anterior lower margin of the C₂ vertebral body and the posterior upper margin of the C₃ vertebral body), and to investigate its calculation error. Methods: All of 164 patients with cervical disc herniation or cervical spinal stenosis who underwent cervical MRI between April 2018 and August 2018 in Beijing Jishuitan Hospital were included in this study. The normal bulbo-medullary junction was divided into two parts from top to bottom, and the dividing line was defined factitiously (the line parallel to the measurement baseline and through the lower margin of cancellous bone of the anterior arch of atlas). On the middle sagittal MRI images of 100 cases of normal bulbo-medullary junction, the change rate of the SD along the distance above the measurement baseline was counted on the upper and lower segments separately. The calculation model for SD of bulbo-medullary junction was established, with the SD of spinal cord at level of the lower margin of axis and the distance above the measurement baseline as independent variables. After setting-up of the calculation model, the actual SD at the lower margin of the C₁ anterior arch and 10 mm above and below it was measured on other 64 cases of normal bulbo-medullary junction. The actual SD and calculation value were compared for calculating the error and error rate. The SD at the dividing line was estimated using the substituted estimation (the actual SD at level of the lower margin of axis) and mean-value estimation (the mean SD of the first 100 cases). Calculation value, substituted estimation and mean-value estimation were compared, and their calculation error and the occurrence rate of significant error (no less than 1 mm) were also compared. Results: Calculation formula for SD of bulbo-medullary junction: (below the dividing line) SD=sagittal diameter at level of the lower margin of axis (SDA)+0.0472×height above the measurement baseline (HAB), (above the dividing line) SD=SDA+0.0472×height of dividing line above the measurement baseline (HDL)+0.298×(HAB-HDL). The error of calculation model increased with the distance above the measurement baseline. The error at the topmost level was 1.06±0.72 mm, and the error rate was 10.52%± 8.26%. Compared with the estimation method using the mean value, the calculation model was accompanied with a significantly lower ratio of significant error (Z=-3.527, P<0.001). Compared with the estimation method using a substitute, the error of the calculation model was significantly smaller (Z=-4.88, P<0.001) and the ratio of significant errors was significantly lower (Chi-Square= 6.015, P=0.024). Conclusion The SD calculation model could accurately estimate the SD of a normal bulbo-medullary junction, and has great significance for the quantitative imaging assessment and decompression strategy in patients with atlantoaxial instability.