OBJECTIVE: To review the current global status of social healthcare systems for mental disorders in children and adolescents, which provide systematic and continuous protection against mental disorders.DATA SOURCES: A computer-based search for relevant English articles in Medline database published between January 1980 and March 2005 was conducted with the key words of "mental disorder, children and adolescents, care". The Chinese full-text periodical database and Wanfang database were also searched for relevant Chinese articles published between January 1990 and March 2005 using equivalent Chinese key words of "mental disorder, children and adolescents, care".STUDY SELECTION: The articles that reviewed the current status of social healthcare system for mental disorders in children and adolescents were included for analysis, and those not categorized as reviews were excluded.DATA EXTRACTION: Totally 58 related articles were collected, among which 13 met the inclusion criteria and 45 were excluded.DATA SYNTHESIS: The current status of social healthcare systems for mental disorders in children and adolescents in Europe, North America,South America, Australia, Asia and Africa were described. The prevention and treatment for mental disorders in Europe and North America were well developed. The training, education and research of mental disease in children in South America were still developing, and the healthcare system in Australia needs further improvement. Lack of professional physicians is the major problem in Asia, whereas a complete protective system has not been well established in Africa and the families assume the role of primary defense against the disorder.CONCLUSION: The comprehensive healthcare services for mental disorders in children and adolescents has been lacking globally. Policy development, cultural understanding in the healthcare, recognition of the important role of nongovernmental organizations, epidemiological research, and professional training can be beneficial efforts to better protect the children and adolescents from mental disorders.

Objective:To research the risk factors of developing Oppositional Defiant Disorder (ODD).Methods:Among 427 students in an elementary school in Changsha, we screened out thirty-four children with ODD by the criteria of DSM-IV. They and other thirty-four normal children from the same school were included in the case-control study. Education levels, jobs and Cartel 16 Personality Factors (16PF) were filled out by their parents. Combined Raven's Test (CRT) was used to evaluate children's intelligence.Results:The prevalence rate of ODD in children increased with the decrease of their father's and mother's education level (for father's education level form advanced education, secondary education to primary, the rate increased from 6.6%,7.2% to 12.0%) and (for mother, 5.3%,7.5%,10.6%). The rate of ODD was highest in children with father and mother doing small business (16.7% and 16.5%, ?~2=12.67～12.68,P

AIM:To explore the preventing effect of citalopram on neuro-cell apoptosis caused by long-term stress in CA1 and CA3 region of hippocampus.METHODS:Forty male Sprague Dawley(SD)rats were randomly divided into five groups including blank group,control group(the control group was filled the stomade by 0.9% saline)and three experimental groups(intragastric administration of citalopram hydrobromide at doses of 8 mg?kg-1?d-1,4 mg?kg-1?d-1,1 mg?kg-1?d-1,respectively).Rat stress model was made by compulsory swimming everyday for 4 weeks.Cell apoptosis in CA1 and CA3 region of hippocampus was observed by HE staining method.Apoptotic cell numbers and integral optical density in CA1 and CA3 region were tested and analyzed by terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling(TUNEL)method and Norton Internet Security BR(NIS BR)software.t-test was applied to compare apoptosis cell numbers and integral optical density.RESULTS:Control rats showed more static time and less struggling times.Conversely,static time was shorter and rats spent more time after exhaustive exercise,and more struggling times in the experimental group.Rats in control group showed more positive cells in CA1 and CA3 regions and higher integral optical density in CA3 region than those in blank group.Rats in experimental groups showed fewer positive cells in CA1 and CA3 regions.Rats in experimental group 1 and group 3 showed higher integral optical density in CA1 and CA3 regions than that in control group.CONCLUSION:Long-term stress might cause neuro-cell apoptosis in CA1 and CA3 region of hippocampus.Citalopram might have prophylactic effect on apoptosis caused by long-term stress in CA1 and CA3 region,and the prophylactic effect might not be influenced by citalopram.Our study suggests that the treatment mechanism of citalopram in neural and mental illness by long-term stress may involve in a major role by antagonizing neuronal apoptosis in both the CA1 and CA3.

OBJECTIVE To study mechanisms of terguride on the treatment of herion dependence. METHODS Adult male SD rats were randomly assigned into 5 groups: normal control group, saline treatment during heroin use period group, terguride treatment during heroin use period group, saline treatment during heroin reinstatement period group, terguride treatment during heroin reinstatement period group, the last 4 groups established heroin intravenous self administration and cue induced reinstatement models, and after interfernce and perfusion to get the following five brain regions [including ventral tegmental area (VTA)]sections. The expression of dopamine D2 receptor protein and mRNA, prodynorphin protein and preprodynorphin mRNA was detected by immunohistochemistry and hybridization in situ. RESULTS The expression of dopamine D2 receptor was downregulated during heroin use period and upregulated during heroin reinstatement period in nucleus accumbens shell (AcbSH) region, the expression of dopamine D2 receptor mRNA was parallelled with the protein expression approximately, terguride could downregulate the high expression of receptor protein during reinstatement. The expression of dopamine D2 receptor protein and mRNA was upregulated during heroin reinstatement period in central nucleus amygdalae (CeA) region, and terguride could downregulate this high expression. The expression of dopamine D2 receptor protein and mRNA was upregulated during heroin use period and downregulated during heroin reinstatement period in CA1 region of hippocampus and prefrontal cortex (PFC), terguride could downregulate the high expression of mRNA during heroin reinstatement period. The expression of dynorphin protein and mRNA was upregulated during heroin reinstatement period, terguride could downregulate this high expression. The expression of dynorphin protein was upregulated during heroin reinstatement period, and terguride could downregulate this high expression. CONCLUSION The activity of mesolimbic dopamine is boosted up during heroin use period and depressed during reinstatement period, terguride can regulate this dysregulation. The activity of dynorphin is boosted up during cue induced reinstatement, and terguride has the downregulation effect. So the preclinic study demonstrated that terguride has the potential benefit in heroin dependence.