Objective:This study aims to explore the clinical features and electrophysiological mechanism of depression through event-related potential analysis.Method:Temporal Experience of Pleasure Scale (TEPS) was used to evaluate anticipatory (TEPS-A) and consummatory (TEPS-C) pleasurable experience among 53 participants (20 patients with major depressive disorder (MDD), 14 patients with bipolar depression Ⅱ (BD) and 19 health controls (HC)). Hamilton Depression Scale (HAMD) and Brief Screening Scale for Dementia (BSSD) were used to evaluate patients’ clinical characteristics. All subjects completed gambling task according to the instructions. Meanwhile, continuous electroencephalogram （EEG) was recorded, and feedback negativity in event-related potential was analyzed.Results:Firstly, compared with HC group, the scores of TEPS, TEPs-A and TEPs-C in MDD and BD groups were decreased ( P<0.01). Secondly, the FN amplitude wave decreased significantly in MDD group ((-0.138±2.562) μV), compared with HC ((-2.569±2.598) μV) and BD group ((-2.251±0.954) μV), P<0.05. Thirdly, in contrast to HC ((10.778±6.967) μV) and BD ((10.284±5.540) μV), the MDD group ((6.069±4.353) μV) displayed blunted responses to gain feedback; For the loss feedback, no significant difference was shown among the three groups. Moreover, correlation analysis showed that, for the MDD group, consummatory anhedonia measured by TEPS-C were associated with reduction in response to gain feedback ( r=-0.501 ，P=0.024). Conclusions:Patients with depressive episode FN in MDD was negatively correlated with the score of consummatory pleasurable experience by having a lack of pleasure, which was manifested as the decrease of both anticipatory pleasurable experience and consummatory pleasurable experience. Patients with MDD showed decreased reward sensitivity and decreased FN amplitude, while patients with BD Ⅱ showed no similar trend. The changes in EEG indicated underpinning mechanism of anhedonia in depression.

Objective:To investigate the clinical characteristics of bipolar disorder patients who present with depressive symptoms at their first episode.Methods:A total of 1 600 bipolar disorder patients with the first episode of depression who participated in the clinical pathway survey of bipolar disorder were included in this study. Demographic data, clinical phenotype, and symptomatic characteristics when they presented with their first mania were described. One-way analysis of variance was applied to compare the clinical characteristics between patients who visited the general hospitals and the ones who visited the mental health centers, and chi-square test was applied to compare symptomatology of patients at the first hypomania/mania episode and their mania relapse.Results:The average time from the first depressive episode to the first hypomanic/manic episode was 3.63 years. It took an average of 1.83 years from the first hypomanic/manic episode to the diagnosis of bipolar mania, and only 45.4% (728 cases) were diagnosed as bipolar disorder when they presented with depression at their first episode; It was an average of 5.45 years from the first depressive episode to the diagnosis of bipolar disorder; There were statistically significant differences in the number of previous depressive episodes ( F=7.119, P=0.008) and the total number of previous episodes ( F=3.980, P=0.046) between bipolar disorder patients seen in the mental health centres and general hospitals. The top three symptoms of the first manic episode were mood elation (83%, 215 cases); increased activity (81.5%, 211 cases); increased speech (79.9%, 207 cases). Compared with recurrent manic episodes, patients at their first manic episode were more likely to report more gregarious (χ2=13.277, P<0.01), eloquent/humorous (χ2=10.665, P=0.001), and less likely to report excessive use of psychoactive substances (χ2=3.990, P=0.046). Conclusions:It takes a long time for the diagnosis of bipolar disorder who presents with the depressive mood in their first episode. The first manic episode is not easy to identify, and the patients treated in general hospitals have more frequent depressive episodes, while the first manic episode shows some different symptoms from the recurrent manic episodes.

Objective:This study aims to explore the clinical features and electrophysiological mechanism of depression through event-related potential analysis.Method:Temporal Experience of Pleasure Scale (TEPS) was used to evaluate anticipatory (TEPS-A) and consummatory (TEPS-C) pleasurable experience among 53 participants (20 patients with major depressive disorder (MDD), 14 patients with bipolar depression Ⅱ (BD) and 19 health controls (HC)). Hamilton Depression Scale (HAMD) and Brief Screening Scale for Dementia (BSSD) were used to evaluate patients’ clinical characteristics. All subjects completed gambling task according to the instructions. Meanwhile, continuous electroencephalogram （EEG) was recorded, and feedback negativity in event-related potential was analyzed.Results:Firstly, compared with HC group, the scores of TEPS, TEPs-A and TEPs-C in MDD and BD groups were decreased ( P<0.01). Secondly, the FN amplitude wave decreased significantly in MDD group ((-0.138±2.562) μV), compared with HC ((-2.569±2.598) μV) and BD group ((-2.251±0.954) μV), P<0.05. Thirdly, in contrast to HC ((10.778±6.967) μV) and BD ((10.284±5.540) μV), the MDD group ((6.069±4.353) μV) displayed blunted responses to gain feedback; For the loss feedback, no significant difference was shown among the three groups. Moreover, correlation analysis showed that, for the MDD group, consummatory anhedonia measured by TEPS-C were associated with reduction in response to gain feedback ( r=-0.501 ，P=0.024). Conclusions:Patients with depressive episode FN in MDD was negatively correlated with the score of consummatory pleasurable experience by having a lack of pleasure, which was manifested as the decrease of both anticipatory pleasurable experience and consummatory pleasurable experience. Patients with MDD showed decreased reward sensitivity and decreased FN amplitude, while patients with BD Ⅱ showed no similar trend. The changes in EEG indicated underpinning mechanism of anhedonia in depression.

Objective:To investigate the clinical characteristics of bipolar disorder patients who present with depressive symptoms at their first episode.Methods:A total of 1 600 bipolar disorder patients with the first episode of depression who participated in the clinical pathway survey of bipolar disorder were included in this study. Demographic data, clinical phenotype, and symptomatic characteristics when they presented with their first mania were described. One-way analysis of variance was applied to compare the clinical characteristics between patients who visited the general hospitals and the ones who visited the mental health centers, and chi-square test was applied to compare symptomatology of patients at the first hypomania/mania episode and their mania relapse.Results:The average time from the first depressive episode to the first hypomanic/manic episode was 3.63 years. It took an average of 1.83 years from the first hypomanic/manic episode to the diagnosis of bipolar mania, and only 45.4% (728 cases) were diagnosed as bipolar disorder when they presented with depression at their first episode; It was an average of 5.45 years from the first depressive episode to the diagnosis of bipolar disorder; There were statistically significant differences in the number of previous depressive episodes ( F=7.119, P=0.008) and the total number of previous episodes ( F=3.980, P=0.046) between bipolar disorder patients seen in the mental health centres and general hospitals. The top three symptoms of the first manic episode were mood elation (83%, 215 cases); increased activity (81.5%, 211 cases); increased speech (79.9%, 207 cases). Compared with recurrent manic episodes, patients at their first manic episode were more likely to report more gregarious (χ2=13.277, P<0.01), eloquent/humorous (χ2=10.665, P=0.001), and less likely to report excessive use of psychoactive substances (χ2=3.990, P=0.046). Conclusions:It takes a long time for the diagnosis of bipolar disorder who presents with the depressive mood in their first episode. The first manic episode is not easy to identify, and the patients treated in general hospitals have more frequent depressive episodes, while the first manic episode shows some different symptoms from the recurrent manic episodes.

Objective·To compare the clinical features between different subtype bipolar patients with first mania episode, and to contribute to early identification of bipolar disorder. Methods·This study was based on the database named as National Bipolar Mania Pathway Survey (BIPAS). From November 2012 to January 2013, bipolar patients from 26 mental health facilities in China were enrolled in current study. The clinical features were compared between mania patients of different subtypes, including hypomania (groupⅠ), mania without psychotic symptoms (groupⅡ), mania with psychotic symptoms (group Ⅲ) and mixed state (group Ⅳ). Results·There was significant difference in the percentage of clinical symptoms between different subtype bipolar patients with first mania episode, especially the mania and anxiety related symptoms. Group Ⅰ, Ⅲ , Ⅳ were further compared with groupⅡ, which was considered as the typical bipolar disorder. The results showed that the mania related symptoms was significantly higher in group Ⅱ, but anxiety related symptoms was significantly higher in group Ⅰ, Ⅲ, Ⅳ. Moreover, Logistic regression analysis revealed that more eloquent or humor and unusually restless could be in favor of the diagnosis of hypomania; younger and mania or hypomania as first episode might be in favor of the diagnosis of mania with psychotic symptoms; older, national minorities and unusually restless could be in favor of the diagnosis of mixed state. Conclusion·The clinical features between different subtype bipolar patients with first mania episode are various, and analysis of the clinical features can contribute to early identification of bipolar disorder.

Objective This report aimed at exploring the risk factors impact on metabolic co-morbidities of bipolar disorder (BD).Methods An cross-sectional study was conducted on a total of 206 inpatients and outpatients mnet the DSM-Ⅳ-TR criteria for BD,meanwhile matched 167 healthy controls in age,gender and education.Self-made questionnaire was used to collect data such as general demographic data,clinical information,blood lipid and glucose indexes.The criterion of metabolic syndrome (MetS) and hyperlipidemia was referred to the Chinese adult dyslipidemia prevention guideline proposed at 2007,the international physical activity questionnaire was used to assess activity level,then compaed between groups.And the Chi-square test,one-way analysis of variance and binary Logistic regression analysis were used in our statistical analysis.Results The rate of MetS in BD group was higher than control group significantly (25.7％ vs.9.6％,x2=14.90,P＜0.01),and so was the related metabolic components include body mass index (BMI) (F=11.70,P＜0.01),triglyceride (F=12.17,P＜0.01),the ratio of triglyceride/high-density lipoprotein-C (F=16.17,P＜0.01),systolic pressure (F=37.81,P＜0.01),diastolic pressure (F=57.89,P＜ 0.01),but no difference was found in total cholesterol,low density lipoprotein,blood-glucose,glycated hemoglobin and hyperlipidemia.BD group showed significantly more eating food (x2=19.38,P＜0.01),meaty (x2=14.67,P＜0.01) and insomnia (x2=24.12,P＜0.01),but no difference was found in levels of activity.A binary logistic regression analysis showed BMI (OR=1.562,P＜0.01),gender(OR=8.162,P＜0.01)and total duration (OR=1.011,P＜0.01) were major independent risk factors for MetS.Conclusion It indicafed higher risk of comorbid with MetS in BD patients.Gender,BMI,and total medication time may be the main risk factors.

Objective This report aimed at exploring the risk factors impact on metabolic co-morbidities of bipolar disorder (BD).Methods An cross-sectional study was conducted on a total of 206 inpatients and outpatients mnet the DSM-Ⅳ-TR criteria for BD,meanwhile matched 167 healthy controls in age,gender and education.Self-made questionnaire was used to collect data such as general demographic data,clinical information,blood lipid and glucose indexes.The criterion of metabolic syndrome (MetS) and hyperlipidemia was referred to the Chinese adult dyslipidemia prevention guideline proposed at 2007,the international physical activity questionnaire was used to assess activity level,then compaed between groups.And the Chi-square test,one-way analysis of variance and binary Logistic regression analysis were used in our statistical analysis.Results The rate of MetS in BD group was higher than control group significantly (25.7％ vs.9.6％,x2=14.90,P＜0.01),and so was the related metabolic components include body mass index (BMI) (F=11.70,P＜0.01),triglyceride (F=12.17,P＜0.01),the ratio of triglyceride/high-density lipoprotein-C (F=16.17,P＜0.01),systolic pressure (F=37.81,P＜0.01),diastolic pressure (F=57.89,P＜ 0.01),but no difference was found in total cholesterol,low density lipoprotein,blood-glucose,glycated hemoglobin and hyperlipidemia.BD group showed significantly more eating food (x2=19.38,P＜0.01),meaty (x2=14.67,P＜0.01) and insomnia (x2=24.12,P＜0.01),but no difference was found in levels of activity.A binary logistic regression analysis showed BMI (OR=1.562,P＜0.01),gender(OR=8.162,P＜0.01)and total duration (OR=1.011,P＜0.01) were major independent risk factors for MetS.Conclusion It indicafed higher risk of comorbid with MetS in BD patients.Gender,BMI,and total medication time may be the main risk factors.

Objective To investigate the potential association between zinc finger protein 804A (ZNF804A) rs1344706 polymorphism and bipolar disorder as well as its subtypes.Methods A total of 304 bipolar Ⅰ disorder,442 bipolar Ⅱ disorder and 762 healthy controls subjects were recruited from Division of Mood Disorders,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,from November 2006 to August 2014.Rs1344706 was genotyped by SNaPshot genotyping assay.Results In comparison between the patients with bipolar disorder and controls,there were significant differences in the genotypic (TT:210(28.2％) vs.175(23.0％),TG:378(50.7％) vs.399(52.4％),GG:158 (21.2％) vs.188(24.7％)) and allelic (T:798(53.5％) vs.749(49.1％),G:694(46.5％) vs.775(50.9％)) distributions (x2=6.18,P=0.04,x2=5.68,P=0.017,respectively).The frequency of T allele in patients with bipolar disorder was higher than that in controls (OR=1.19,95％CI 1.03-1.37).After stratified by diagnosed subtypes,there were significant differences in the genotypic and allelic distribution between patients with bipolar Ⅰ disorder and controls (x2=7.57,P=0.02,x2=7.22,P=0.007).The frequency of T allele in patients with bipolar Ⅰ disorder was higher than those in controls (OR=1.30,95％ CI 1.07-1.56).In comparison between patients with bipolar Ⅱ disorder and controls,there was no significant difference in the distributions of genotype and allele.Conclusion There is positive association between rs1344706 polymorphism and bipolar Ⅰ disorder in a Chinese Han population.ZNF804A gene may confer susceptibility to bipolar Ⅰ disorder in Han Chinese.

Objective To investigate the potential association between zinc finger protein 804A (ZNF804A) rs1344706 polymorphism and bipolar disorder as well as its subtypes.Methods A total of 304 bipolar Ⅰ disorder,442 bipolar Ⅱ disorder and 762 healthy controls subjects were recruited from Division of Mood Disorders,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,from November 2006 to August 2014.Rs1344706 was genotyped by SNaPshot genotyping assay.Results In comparison between the patients with bipolar disorder and controls,there were significant differences in the genotypic (TT:210(28.2％) vs.175(23.0％),TG:378(50.7％) vs.399(52.4％),GG:158 (21.2％) vs.188(24.7％)) and allelic (T:798(53.5％) vs.749(49.1％),G:694(46.5％) vs.775(50.9％)) distributions (x2=6.18,P=0.04,x2=5.68,P=0.017,respectively).The frequency of T allele in patients with bipolar disorder was higher than that in controls (OR=1.19,95％CI 1.03-1.37).After stratified by diagnosed subtypes,there were significant differences in the genotypic and allelic distribution between patients with bipolar Ⅰ disorder and controls (x2=7.57,P=0.02,x2=7.22,P=0.007).The frequency of T allele in patients with bipolar Ⅰ disorder was higher than those in controls (OR=1.30,95％ CI 1.07-1.56).In comparison between patients with bipolar Ⅱ disorder and controls,there was no significant difference in the distributions of genotype and allele.Conclusion There is positive association between rs1344706 polymorphism and bipolar Ⅰ disorder in a Chinese Han population.ZNF804A gene may confer susceptibility to bipolar Ⅰ disorder in Han Chinese.

Forty cases of hyperlipidemia were treated by herbal moxa stick moxibustion and compared with 22 cases treated by Oenothera Oil Capsules. The results showed that LipidDecreasing Herbal Moxibustion could decrease the serum cholesterol and triglyceride and elevate high-density lipoprotein and change the ratio of TC-HDL-C/HDL-C in the patients, and its therapeutic effect was better than that of the control group treated by Oenothera Oil Capsules (P ＜ 0.01). Lipid-Decreasing Herbal Moxibustion can also improve the clinical symptoms and reduce the body weight.