Tardive dyskinesia (TD) is a medication-induced hyperkinetic movement disorder, generally manifested as involuntary spasms or choreiform movements of the tongue, lower face and jaw, and limbs (lasting at least several weeks). It occurs after using neuroleptic medication for at least several months, causing irreversible injuries to the nerve system and significantly impacting patients′ daily function. This review summarizes recent research progress regarding TD risk factors, possible pathogenesis, clinical characteristics, assessment and identification, and treatment and management approaches. The goal is to raise awareness of TD to archive early prevention and identification, standardize treatment, and improve patients′ prognosis and quality of life.

Tardive dyskinesia (TD) is a medication-induced hyperkinetic movement disorder, generally manifested as involuntary spasms or choreiform movements of the tongue, lower face and jaw, and limbs (lasting at least several weeks). It occurs after using neuroleptic medication for at least several months, causing irreversible injuries to the nerve system and significantly impacting patients′ daily function. This review summarizes recent research progress regarding TD risk factors, possible pathogenesis, clinical characteristics, assessment and identification, and treatment and management approaches. The goal is to raise awareness of TD to archive early prevention and identification, standardize treatment, and improve patients′ prognosis and quality of life.

Bipolar disorder is one of the most common mood disorders characterized by an early age of onset and high prevalence rate， and patients tent to have poor prognosis due to high misdiagnosis rate and incomplete diagnosis rate. At present， existing pharmacological treatment for bipolar disorder remains highly variable. Therefore， this paper presents a review of indications of the medications， clinical therapeutic effect and adverse drug reactions， thus providing references for the pharmaceutical treatment of bipolar disorder.

To standardize clinical treatment decisions and improve the comprehensive diagnosis and treatment of bipolar disorder in China, the Psychiatric Branch of the Chinese Medical Association initiated the Guidelines for the Prevention and Treatment of Bipolar disorder in China (2025 edition). This protocol summary describes the background and purpose of the guideline, the formulation method, working group members, division of responsibilities, guideline registration, conflicts of interest, collection and selection of clinical issues, the evidence-based foundation of the guideline, writing and external review, as well as publishing, dissemination, and other aspects.

To standardize clinical treatment decisions and improve the comprehensive diagnosis and treatment of bipolar disorder in China, the Psychiatric Branch of the Chinese Medical Association initiated the Guidelines for the Prevention and Treatment of Bipolar disorder in China (2025 edition). This protocol summary describes the background and purpose of the guideline, the formulation method, working group members, division of responsibilities, guideline registration, conflicts of interest, collection and selection of clinical issues, the evidence-based foundation of the guideline, writing and external review, as well as publishing, dissemination, and other aspects.

Objective:To explore the characteristics of theory of mind(TOM) ability of adolescent depressive disorder patients with non-suicidal self-injury (NSSI) behavior, and analyze the relationship between NSSI behavior and TOM, so as to identify patients with NSSI behavioral risk early and give timely intervention.Methods:A total of 54 adolescent patients with depressive disorder who were hospitalized for the first time in Shenzhen Kangning Hospital from May to October 2021 were enrolled.They were divided into NSSI group( n=31)and non-NSSI group( n=23)according to DSM-5.Hamilton anxiety rating scale-14 item (HAMA-14) and Hamilton depression rating scale-17 item(HAMD-17)were used to evaluate the severity of anxiety and depression.Hinting task, Yoni task and reading the mind in the eyes test(RMET) were used to test TOM of the two groups.Binary Logistic regression analysis in SPSS 22.0 was used to explore the influence of TOM ability on NSSI behavior of adolescents with depressive disordor. Results:Compared with patients in non-NSSI group, patients in NSSI had significantly higher scores of HAMA-14(21.48±4.92 vs 16.35±5.61, t=3.57, P<0.05) and HAMD-17(25.61±4.08 vs 21.43±4.64)( t=3.51, P<0.05). The patients in NSSI group had lower scores on the hinting task(16.10±2.84 vs 18.17±1.15, t=-3.68, P<0.05), RMET task (21.61±2.58 vs 23.61±3.07)( t=-2.59, P<0.05), and second-order cognitive TOM((18.90±3.70) vs (20.96±2.72), t=-2.27, P<0.05) and second-order affective TOM(28.84±3.93 vs 31.04±3.04)( t=-2.24, P<0.05) in Yoni task than those in non-NSSI group.Binary Logistic regression analysis showed effective TOM ( β=-0.306, OR=0.736, 95% CI= 0.552-0.982, P=0.037)and cognitive TOM ( β=-0.485, OR=0.616, 95% CI=0.396-0.957, P=0.031) were associated with non-suicidal self-injury in patients with depressive disorder. Conclusion:The increased impairment of the emotional component (decoding component) and cognitive component (reasoning component) of TOM may be risk factors for the occurrence of NSSI behavior in adolescent depressive disorder patients.

Early distinction of bipolar disorder (BD) from major depressive disorder (MDD) is difficult since no tools are available to estimate the risk of BD. In this study, we aimed to develop and validate a model of oxidative stress injury for predicting BD. Data were collected from 1252 BD and 1359 MDD patients, including 64 MDD patients identified as converting to BD from 2009 through 2018. 30 variables from a randomly-selected subsample of 1827 (70%) patients were used to develop the model, including age, sex, oxidative stress markers (uric acid, bilirubin, albumin, and prealbumin), sex hormones, cytokines, thyroid and liver function, and glycolipid metabolism. Univariate analyses and the Least Absolute Shrinkage and Selection Operator were applied for data dimension reduction and variable selection. Multivariable logistic regression was used to construct a model for predicting bipolar disorder by oxidative stress biomarkers (BIOS) on a nomogram. Internal validation was assessed in the remaining 784 patients (30%), and independent external validation was done with data from 3797 matched patients from five other hospitals in China. 10 predictors, mainly oxidative stress markers, were shown on the nomogram. The BIOS model showed good discrimination in the training sample, with an AUC of 75.1% (95% CI: 72.9%-77.3%), sensitivity of 0.66, and specificity of 0.73. The discrimination was good both in internal validation (AUC 72.1%, 68.6%-75.6%) and external validation (AUC 65.7%, 63.9%-67.5%). In this study, we developed a nomogram centered on oxidative stress injury, which could help in the individualized prediction of BD. For better real-world practice, a set of measurements, especially on oxidative stress markers, should be emphasized using big data in psychiatry.
Biomarkers/metabolism* ; Bipolar Disorder/metabolism* ; Depressive Disorder, Major/diagnosis* ; Early Diagnosis ; Humans ; Oxidative Stress

ObjectiveTo explore the characteristics of impulsivity in adolescent depressive disorder patients with non-suicidal self-injury （NSSI） behavior， analyze the relationship between NSSI behavior and impulsivity， so as to identify patients with NSSI behavior and provide targeted intervention at early stages. MethodsA total of 53 adolescent patients with depressive disorder who were hospitalized for the first hospitalization in Shenzhen Kangning Hospital were enrolled， diagnosed using Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Thereafter， the adolescents were divided into NSSI group （n=30） and non-NSSI group （n=23）. Hamilton Depression Scale-17 item （HAMD-17）， Adolescents Self-Harm Scale and Barratt Impulsivity Scale （BIS-11） were used to evaluate the severity of depression， NSSI and impulsivity. ResultsCompared with the non-NSSI group， the NSSI group scored higher on HAMD-17 ［（25.50±4.10） vs. （21.43±4.64）， t=3.379， P<0.01］， motor impulsiveness of BIS-11 ［（51.67±15.95） vs. （38.70±14.90）， t=3.018， P<0.01］， cognitive impulsiveness ［（52.75±13.22） vs. （43.37±18.40）， t=2.161， P<0.05］， non-planning impulsiveness ［（68.00±15.32） vs. （50.76±21.35）， t=3.424， P<0.01］ and BIS-11 ［（57.42±11.08） vs. （44.27±14.83）， t=3.695， P<0.01］. Within NSSI group， the score of Adolescents Self-Harm Scale was positively correlated with the score of motor impulsiveness in BIS-11 （r=0.691， P<0.01）. Binary Logistic regression analysis showed that HAMD-17 score （β=0.172， OR=1.187， 95% CI： 1.007~1.400） and non-planning impulsiveness of BIS-11 （β=0.044， OR=1.045， 95% CI： 1.002~1.091） were associated with NSSI in adolescent patients with depressive disorder （P<0.05）. ConclusionThe severity of depressive symptoms and non-planning impulsiveness may be risk factors for NSSI behavior in adolescent patients with depressive disorder.

Objective:This study aims to examine the incidence and risk factors of violent behaviors in community-dwelling unmedicated patients with severe mental disorders in Shenzhen.Methods:The baseline and follow-up data of unmedicated patients with severe mental disorders were collected from the Information Management System of Mental Health Prevention and Control in Shenzhen. The incidence of violent behaviors in unmedicated patients was described. The influencing factors of violent behaviors were analyzed using logistic regression model.Results:A total of 3 163 patients were included. The incidence of violent behaviors was 9.1% (288/3 163) in 2019. Multivariate logistic regression analysis showed that having an acute illness onset ( OR=1.589, 95 %CI 1.181-2.139) was the risk factor of violent behaviors, while having cohabitants ( OR=0.596, 95 %CI 0.410-0.867), being diagnosed as mental retardation comorbid with psychotic disorders ( OR=0.432, 95 %CI 0.199-0.938), having application for carers allowances ( OR=0.440, 95 %CI 0.319-0.606), and participating in family doctor services ( OR=0.642, 95 %CI 0.492-0.838) and community face-to-face interviews during 2019 ( OR (1-2 times vs. 0 times)=0.633, 95 %CI 0.466-0.861; OR (3-4 times vs. 0 times)=0.546, 95 %CI 0.368-0.811) were the protective factors. Conclusions:The incidence of violent behaviors is high in unmedicated patients with severe mental disorders with acute illness onset. The improvement of comprehensive level of community mental health services and the development of targeted intervention measures would help to reduce the occurrence of violent behaviors among unmedicated patients with severe mental disorders in the community.

Objective:This study aims to examine the incidence and risk factors of violent behaviors in community-dwelling unmedicated patients with severe mental disorders in Shenzhen.Methods:The baseline and follow-up data of unmedicated patients with severe mental disorders were collected from the Information Management System of Mental Health Prevention and Control in Shenzhen. The incidence of violent behaviors in unmedicated patients was described. The influencing factors of violent behaviors were analyzed using logistic regression model.Results:A total of 3 163 patients were included. The incidence of violent behaviors was 9.1% (288/3 163) in 2019. Multivariate logistic regression analysis showed that having an acute illness onset ( OR=1.589, 95 %CI 1.181-2.139) was the risk factor of violent behaviors, while having cohabitants ( OR=0.596, 95 %CI 0.410-0.867), being diagnosed as mental retardation comorbid with psychotic disorders ( OR=0.432, 95 %CI 0.199-0.938), having application for carers allowances ( OR=0.440, 95 %CI 0.319-0.606), and participating in family doctor services ( OR=0.642, 95 %CI 0.492-0.838) and community face-to-face interviews during 2019 ( OR (1-2 times vs. 0 times)=0.633, 95 %CI 0.466-0.861; OR (3-4 times vs. 0 times)=0.546, 95 %CI 0.368-0.811) were the protective factors. Conclusions:The incidence of violent behaviors is high in unmedicated patients with severe mental disorders with acute illness onset. The improvement of comprehensive level of community mental health services and the development of targeted intervention measures would help to reduce the occurrence of violent behaviors among unmedicated patients with severe mental disorders in the community.