Objective To compare the efficacy and safety of mirtazapine and fluoxetine in the treatment of somatoform disorders.Methods 82 patients were randomly divideded into mirtazapine group and fluoxetine group,all the patients were treated for 6 weeks.The efficacy was evaluated with Hamilton depression rating scale and symptom checklist,the side effects were evaluated with treatment emergent symptom scale.Results The total effective rate of the mirtazapine group was 88％.The total effective rate of the fluoxetine group was 80％.There was no difference between the two groups in efficacy (x2 =0.13,P ＞ 0.05).After the first week of treatment,by Symptom checklist,somatization,anxiety and total score of mirtazapine group were significantly lower than the fluoxetine group (t =2.97,3.01,3.73,all P ＜ 0.05).After the sixth week of treatment,somatization,interpersonal,depression,anxiety,fear and total score of mirtazapine group were significantly lower than the fluoxetine group (t =2.01,2.36,3.25,3.62,2.17,3.84,all P ＜ 0.05).Mirtazapine group had no significant adverse drug reactions.Fluoxetine group had four cases of adverse drug reactions.Conclusion Mirtazapine in the treatment of patients with somatoform disorders has more rapid onset and drug side effects is less than fluoxetine.

0.05). Conclusion: DUP related to short-term prognosis of first-episode schizophrenia patients, the DUP is shorter, the prognosis is better, DUP was related factor of relapse.

Objective: To investigate the prevalence of depression and anxiety among transgender populations and the correlation with defense mechanism, so as to provide the evidence for improving mental health among transgender populations. Methods: Transgender populations that visited Psychosexual Outpatient Department of Beijing Huilongguan Hospital for the first time from December 2020 to December 2021 were enrolled. Participants' demographics, depression, anxiety and type of defense mechanisms were collected using self-designed questionnaires, Self-rating Depression Scale, Self-rating Anxiety Scale and Defense Style Questionnaire (DSQ). Factors affecting depression and anxiety were identified using a multivariable logistic regression model. Results: Totally 126 transgender individuals were enrolled, including 95 men (75.40%) with a mean age of (21.53±4.55) years and 31 women (24.60%) with a mean age of (23.58±5.55) years. The prevalence of depression was 46.83% among participants, including 44.07% of participants with mild depression, 30.51% with moderate depression and 25.42% with severe depression, and the prevalence of anxiety was 26.19% among participants, including 60.61% of participants with mild anxiety, 21.21% with moderate anxiety and 18.18% with severe anxiety. The detection of depression was 54.74% among men and 22.58% among women (P<0.05), and the detection of both depression (62.79% vs. 38.55%, P<0.05) and anxiety (41.86% vs. 18.07%, P<0.05) was significantly higher among transgender populations with self-injury or suicide behaviors than among those without. Multivariable logistic regression analysis showed that immature defense mechanisms increased the risk of depression (OR=1.034, 95%CI: 1.018-1.051) and anxiety (OR=1.031, 95%CI: 1.014-1.049) among transgender populations, while mature defense mechanisms reduced the risk of depression (OR=0.887, 95%CI: 0.832-0.946) and anxiety (OR=0.878, 95%CI: 0.821-0.938) among transgender populations. Conclusions The prevalence of depression and anxiety was 46.83% and 26.19% among transgender populations included in this study. Mature defense mechanisms are beneficial to reduce the risk of depression and anxiety among transgender populations. Key words： transgender population depression anxiety defense mechanism

Objective:To explore the causes of the maintenance of smoking behaviors in male patient with chronic schizophrenia.Methods:Totally 188 male,smoking patients with chronic schizophrenia,meeting with the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-IV),above 5-year course of disease,taken a steady dosage of antipsychotics for 3 months,and 61 healthy smoking men were collected according to the voluntary principles.The psychopathologic symptoms and the dependence of cigarette of all patients were as-
sessed with the Positive and Negative Syndrome Scale (PANSS)and the Fagerstrom Test for Nicotine Dependence (FTND),the Russell's Smoking Motivation Questionnaire (SMQ)was used to investigate the causes for maintai-ning behaviors of smoking in patients and healthy controls respectively.Results:The sedative item scores of SMQ were lower in patient group than in the controls [3 (0,9)vs.6 (0,9),P <0.001],and other scores of subscales had no significant difference compared with control.Heavy dependence happened in patient group slightly less than health controls (2.7%vs.8.2%,P <0.05).The total scores of FTND were positively correlated with the doses of antipsychotics (chlorpromazine equivalent)(r =0.22,P <0.01).The scores of total (β=0.22),automatic (β=0.27)and sedative (β=0.37)items in patient group were less than controls (Ps <0.001)by multi-factors step-wise Linear regression analysis.Conclusion:Compared with general smokers,lower need for sedation,less heavy dependence and motivation in smoking patients might be correlated with the strict management for inpatients smok-ing,social-psychological factors and culture background in China.

Objective:To establish a preliminary diagnostic criteria of pathological internet use for field test in China.Methods:Through searching common "pathological internet use" diagnostic criteria or screen criteria in literature,a diagnostic criteria items pool and a preliminary diagnostic criteria of "pathological internet use" were established .According to the diagnostic criteria,each 2 senior professional psychiatrists in turn interviewed 79 patients and their parents,and then made diagnosis respectively. In addiction,44 high school students were each evaluated by one psychiatrist.The definite diagnosis was made when 2 evaluators make the same diagnosis for one patient.Result:In 123 patients,54 were pathological internet use.For diagnosis,the value of kappa for inter-rater reliability was 0.812( P<0.001).In the 12 criteria items,2 for poor inter-rater reliability and 4 for little contribution to diagnosis were eliminated.In the reserved 6 items,if 4 items(or more)were positive,the diagnostic sensitivity was 78.9% and specificity was 95.3%.Functional impairment criteria were made strictly.In the patients who were made the definite diagnosis,90.7% had duration of illness above 3 months,and 77.7% above 6 months.Conclusion:The preliminary diagnostic criteria of pathological internet use after revised includes 6 symptom criteria,3 functional impairment criteria,duration of illness and exclusive criteria.The criteria proposed is with high consistency on evaluations made by psychiatric raters,and with operational convenience.The criteria,after further revised,may fit the clinical application.

Objective:To assess the possibility of suicide in setting condition among urban and rural residents samples in northern China.Methods:By randomly sampling,1007 persons aged 18 years or older were selected from 10 urban neighborhoods in Beijing and from 10 rural village in Hebei province.The Survey Schedule of Atti-tudes in China in which 24 negative life events were listed,and the possibility of committing suicide was asked to the subjects when they encountered the supposed events.Results:The rates of thinking about committing suicide when encountered the supposed life events were 65.2% of incurable illness,62.0% of burden on other and no future hope,61.2% of drug dependence,57.3% of large debt due to gambling,54.2% of being raped, 51.6% of severe depression,50.7% of being elderly and no family to provide support.Only 14.6% of the ur-ban and rural residents would not consider suicide when encountered any type of supposed problems.Conclusion:There is higher possibility of considering suicide in urban and rural residents when encountered negative life events, so it is important to give support to the residents with one or more life events.

Objective To understand the occurrence situation of negative life events in the past year among college students with suicidal ideation and to explore the correlation between negative life events and suicidal ideation. Methods The stratified and cluster sampling method was applied to conduct the questionnaire survey on 12 114 students from 11 universities in Chongqing City. The questionnaire of general demographic information was used to learn sociodemographic characteristics;the perspective on personal life questionnaire was applied to evaluate the suicidal ideation within recent 1 month and the self-designed life event scale was used to investigate the occurrence of negative life events in the past 1 year. Results The report rate of suicidal ideation within 1 month was 9.6%, the occurrence rate of short term suicidal ideation was increased with experiencing more negative life events. The x2 test showed that there was statistically significant difference in the proportion of suicidal ideation occurrence between college students experiencing 1 negative life event and those without experiencing the negative life event (x2 = 37.72,P<0.01) ;besides, the occurrence proportion of recent suicidal ideation had statistical difference between the college students with experiencing two or more negative life events and those without experiencing negative life event (x2 = 65.46,P<0.01). The multivariate Logistic regression analysis showed that the conflict with other family members (OR=0. 295,95%CI 0. 017-0. 571),abuse (OR=7. 295, 95%CI 6. 049-9. 701) were independentrisk factor for the recent suicidal ideation in college students. Conclusion Experiencing more negative life events, conflicting with other family members and abused by others have a correlation with the appearance of short term suicidal ideation in college students.

Objective To analyze the anxiety and depression state in housebound elderly subjects and their influencing factors so as to provide theoretical basis for improving the psychological status of the elderly.Methods Three hundred and fifty elderly patients aged ＞ 60 years suffering from anxiety and depression in two communities of Beijing were clusterly sampled and analyzed.The basic information of housebound elderly subjects with anxiety and depression was recorded during questionnaire survey.The influencing factors for anxiety and depression were explored by using the anxiety self-assessment scale and depression self-rating scale.Results Based on univariable analysis,the factors influencing anxiety and depression of the housebound elderly included ageing,lower cultural level,low income,infrequency of offspring visit and friends meeting,lost spouse,chronic diseases,many medications,and the unsatisfactory living environment(all P ＜ 0.05).However,the participating of entertainment activity and religious beliefs were not influencing factors(all P ＞ 0.05).Logistic multivariate regression showed that women (OR =1.432,95％CI:1.236 1.684,P＜0.05),low income(OR =2.078,95％ CI:1.675 2.412,P＜0.05),the widowed(OR =2.342,95 ％ CI:1.857-2.769,P ＜ 0.05),chronic diseases (OR =2.078,95 ％ CI:1.674-2.531,P＜0.05),medication (OR =3.056,95 ％ CI:2.678 3.756,P ＜ 0.05),less visit by children (OR =2.898,95％CI:2.475 3.425,P＜0.05),less friends visiting(OR=1.965,95％CI:1.685-2.446,P＜0.05) were risk factors for anxiety in the elderly.Meanwhile,women (OR =3.221,95 ％ CI:2.674-3.853,P ＜ 0.05),low income (OR =2.342,95 ％ CI:1.768-2.754,P ＜ 0.05),chronic disease (OR =2.078,95 ％ CI:1.564 2.675,P＜0.05),the widowed(OR=2.223,95％CI:1.789 2.746,P＜0.05),less visit by children (OR=2.987,95％CI:2.463-3.524,P＜0.05),less friends visiting(OR=2.658,95％CI:2.242 3.168,P＜0.05) and poor satisfaction with surrounding environment(OR =1.765,95 ％ CI:1.375 2.371,P＜0.05) were risk factors for depression among the elderly.Conclusions The elderly,especially those with advanced age,low cultural level,low economic income,living alone and poor living environment,are more likely to have anxiety and depression.Therefore,some effective corresponding measures should be taken in order to improve the psychological condition and life quality of old people.

Objective:To explore the effect of attentional bias training on the attentional bias, psychological craving and relapse rate of alcohol dependent patients during rehabilitation.Methods:A randomized controlled trial was used to select 90 alcohol-dependent patients and randomly divide them into an intervention group and a control group. The alcohol cue pictures and neutral pictures were imported into E-Prime software at a ratio of 1∶1.The patients in the two groups were trained for eight times with attentional bias and without attentional bias by point delection paradigm. After each training, the software automatically records the response time and correct rate of the cue pictures and neutral pictures, and before intervention(T0), after 4 interventions(T4), and after 8 interventions(T8), the alcohol craving score was assessed by visual analogue scale and the relapse situation was followed up 1 month after the intervention. SPSS 24.0 software was used for statistical analysis.Repeat measure ANOVA, χ2 test and t-test were used to compare the response time, accuracy and psychological craving of the two groups. Results:Repeated measurement analysis of variance showed that there were interaction between group and time in cue-map response time, line chart accuracy and psychological craving score of the two groups ( F=5.218, 6.939, 147.14, all P<0.01). Simple effect analysis showed that there was no significant difference in cue pictures response time, cue pictures accuracy and psychological craving score between the intervention group and the control group at T0(all P>0.05), but there was significant difference at T4 and T8 (all P<0.05), and there was significant difference in neutral pictures reaction only at T8 ( P<0.05). The comparison between two groups showed that the intervention group showed a downward trend in cue pictures response, T4 and T8 were lower than T0, with statistical difference (both P<0.001), while there was no difference in the control group. In the intervention group, the correct rate of cue pictures increased, T4 and T8 were higher than T0, and there were statistical differences (both P<0.001), while there was no difference in the control group( P>0.05). The psychological craving scores of both the intervention group and the control group showed a downward trend, T4 and T8 were lower than T0, there were statistical differences (both P<0.001), but the difference between T4 and T8 in the control group remained unchanged. One month after the end of the intervention, the difference in the rate of relapse between the intervention group and the control group was marginal (11.10%, 26.70%, P=0.059). The total number of days of abstinence in the intervention group was longer than that in the control group ((28.33±4.99)d, (26.47±6.66)d, P=0.010). Conclusion:Attentional bias training can improve the mental craving and attentional bias of alcohol-dependent patients during the rehabilitation period, and the relapse rate decreased one month after the intervention.

Objective:To explore the effect of positive psychology theory on recovering patients with alcohol dependence.Methods:According to the order of admission, 60 patients with alcohol dependence in convalescence were divided into intervention group and control group, 30 cases each. The control group received only routine treatment for alcohol dependence. In addition to conventional treatment, the intervention group also underwent positive psychological treatment for 5 weeks to evaluate the changes in social support, negative automatic thinking, psychological craving, attention bias and other aspects at pre-baseline, week 1, week 3, and week 5 of treatment.Results:The positive psychology therapy had a good effect on the social support of alcohol-dependent patients. Except for the difference in the degree of support utilization in the intervention group ( P>0.05), the difference in other indicators was statistically significant ( F values were 1.653 - 6.571, P <0.01), while the difference in the subjective support score in the control group was statistically significant ( F value was 5.445, P<0.01). The time factors of repeated measurement anova showed that the total score of social support, objective support, subjective support, utilization of support, total score of automatic thinking and visual desire score were significantly different with the increase of treatment times ( F values were 3.324 - 17.153, P<0.01 or 0.05). The interaction between the total score of social support, subjective support, visual desire and intervention measures was significant ( F values were 9.331 - 17.578, P<0.01). The intergroup factors showed that the intervention measures had positive effects on the total score of social support, objective support, total score of automatic thinking and visual desire between the two groups, with statistically significant differences ( F values were 3.865-12.061, P<0.01 or 0.05). There was no statistically significant difference between the intervention group and the control group in response time of cue words, negative word response time and neutral word response time before intervention ( P> 0.05), and the response time of cue words in the intervention group was lower than that in the control group after intervention ( t value was -3.148, P<0.01). Before intervention in the intervention group and control group in the cue word correctly, negative word correctly, neutral accuracy differences of no statistical significance ( P > 0.05), after intervention intervention group negative word accuracy was higher than the control group, the difference was statistically significant ( t value was 2.298, P<0.05), and after the intervention intervention group neutral accuracy is higher than the control group, difference was statistically significant ( t value was 2.010, P<0.05). Conclusions:Positive psychological therapy can enhance the social support of alcohol-dependent patients, reduce the automatic thinking of patients, reduce the craving, and change the attention bias of alcohol-dependent patients, providing a basis for clinical research.