1.Clinical characteristics, seasonal characteristics and related factors in patients with atypical depression
Ziyao WANG ; Yanping SONG ; Shuang LIU ; Yuhan DENG ; Jiuju WANG ; Wenxiang QUAN ; Wentian DONG ; Baohua LIU
Chinese Journal of Behavioral Medicine and Brain Science 2022;31(3):261-266
Objective:To know the clinical characteristics, seasonal pattern and influencing factors of atypical depression(AD) patients.Methods:A total of 203 depressed outpatients of Peking University Sixth Hospital from January 2021 to August 2021 were included.They were assessed with demographic questionnaire, inventory of depressive symptomatology self-report(IDS-SR30) and seasonal pattern assessment questionnaire(SPAQ). According the score of IDS-SR30, all patients were classified as atypical depression(AD) and non-atypical depression(non-AD). The data were analyzed by t-test, non-parametric test and Logistic regression using SPSS 26.0 software. Results:The prevalence of AD among depressed patients was 36.0% (95% CI=29.3%-42.6%). The IDS-30 score of the AD group was (41.59±10.59), and IDS-30 score of the non-AD group was (36.08±13.17), and the difference between the two groups was statistically significant ( t=3.062, P<0.05). The global seasonal score of the AD group was 6 (3, 9), and 17.8% of the AD group had seasonal pattren.The global seasonal score of the non-AD group was 5 (3, 8), and 14.6% of the non-AD group had seasonal pattern.There was no significant difference in the global seasonal score and the proportion of seasonal pattern between the two groups ( Z=0.389, χ2=0.359, P>0.05). Depression patients who were females ( β=1.08, OR=2.95, 95% CI=1.32-6.59, P<0.05), low self-evaluation ( β=0.82, OR=2.27, 95% CI=1.12-4.59, P<0.05)and psychomotor retardation ( β=0.93, OR=2.54, 95% CI=1.33-4.85, P<0.05) were more likely to be diagnosed as AD, and depression patients having mood variation ( β=-0.94, OR=0.39, 95% CI=0.19-0.81, P<0.05) were more likely to be diagnosed as non-AD. Conclusion:Women, low self-evaluation, psychomotor retardation and unobvious mood variation can predict and help to diagnose atypical depression in depressed patients.
2.The clinical effect of computerized cognitive remediation therapy in schizophrenic patients with different levels of cognitive impairment
Jie ZHANG ; Hongzhen FAN ; Xiaolin ZHU ; Yunhui WANG ; Yunlong TAN ; Fude YANG ; Zhiren WANG ; Yanli ZHAO ; Fengmei FAN ; Junhua GUO ; Zhanjiang LI ; Wenxiang QUAN ; Xiangqun WANG ; Dongfeng ZHOU ; Yizhuang ZOU ; Shuping TAN
Chinese Journal of Psychiatry 2020;53(4):328-334
Objective:To explore the improvement rate of the cognitive function of computerized cognitive remediation therapy (CCRT) on patients with schizophrenia and the clinical effect of CCRT in patients with different levels of cognitive impairment.Methods:A random number table was used to divide 311 patients with schizophrenia into CCRT group ( n=196) and work and amusement therapy (WAT) group ( n=115). The independently developed CCRT and operational music and dance therapy were given for 12 weeks to two treatment groups respectively. All patients were assessed using the MATRICS Consensus Cognitive Battery (MCCB) before and after treatment. According to the total score of MCCB at baseline, the patient′s cognition function was divided into 4 levels: severe cognitive impairment, moderate cognitive impairment, mild cognitive impairment and normal cognitive function. According to the change of MCCB total score, the efficacy of the treatment was divided into 3 levels: no improvement (≤0 points), improvement (0-9.57 points), superior improvement (>9.57 points). The improvement rate of cognitive function between two treatment groups was compared. Results:In the CCRT group, there were 19 cases with superior improvement, 105 cases with improvement, and 46 cases with no improvement. In the WAT group, there were 7 cases with superior improvement, 39 cases with improvement, and 41 cases with no improvement. The improvement of cognitive function of CCRT group was better than that of WAT group, and the difference was statistically significant ( Z=2.978, P=0.003). The patients with serious cognitive impairment in the CCRT group had a higher improvement rate than those in the WAT group ( Z=1.860, P=0.032). The patients with moderate cognitive impairment in the CCRT group had a lower no improvement rate than those in the WAT ( Z=-1.817, P=0.035).The patients with mild cognitive impairment in the CCRT group had a lower no improvement rate ( Z=-3.294, P=0.001) and higher improvement rate and superior improvement rate ( Z=2.084, P=0.019; Z=1.969, P=0.025) than those in the WAT group. There was no statistically significant difference in improvement rate between patients with normal cognitive function in the CCRT group and in the WAT group ( P>0.05).The patients with improvement and superior improvement of cognition were combined as responder, and the two treatment groups were compared. The patients with mild cognitive impairment in the CCRT group had a higher improvement rate than those in the WAT group (77.2%(44/57) vs. 41.4%(12/29),χ2=10.853, P=0.001). However, for patients with serious and moderate cognitive impairment or with normal cognitive function at baseline, rates of improvement after treatment did not differ significantly between CCRT group and WAT group. According to Cohen′s d, the level of effect size in cognition improvement after CCRT treatment in patients with different cognitive dysfunction level was: mild cognitive impairment (0.59)>moderate cognitive impairment (0.48)>normal cognitive function (-0.12)>serious cognitive impairment (-0.24). Conclusions:Schizophrenic patients treated with CCRT had a higher improvement rate of cognitive function than those with WAT, and the improvement rate of cognitive function is higher in patients with mild cognitive impairment after CCRT treatment.
3.The clinical effect of computerized cognitive remediation therapy in schizophrenic patients with different levels of cognitive impairment
Jie ZHANG ; Hongzhen FAN ; Xiaolin ZHU ; Yunhui WANG ; Yunlong TAN ; Fude YANG ; Zhiren WANG ; Yanli ZHAO ; Fengmei FAN ; Junhua GUO ; Zhanjiang LI ; Wenxiang QUAN ; Xiangqun WANG ; Dongfeng ZHOU ; Yizhuang ZOU ; Shuping TAN
Chinese Journal of Psychiatry 2020;53(4):328-334
Objective:To explore the improvement rate of the cognitive function of computerized cognitive remediation therapy (CCRT) on patients with schizophrenia and the clinical effect of CCRT in patients with different levels of cognitive impairment.Methods:A random number table was used to divide 311 patients with schizophrenia into CCRT group ( n=196) and work and amusement therapy (WAT) group ( n=115). The independently developed CCRT and operational music and dance therapy were given for 12 weeks to two treatment groups respectively. All patients were assessed using the MATRICS Consensus Cognitive Battery (MCCB) before and after treatment. According to the total score of MCCB at baseline, the patient′s cognition function was divided into 4 levels: severe cognitive impairment, moderate cognitive impairment, mild cognitive impairment and normal cognitive function. According to the change of MCCB total score, the efficacy of the treatment was divided into 3 levels: no improvement (≤0 points), improvement (0-9.57 points), superior improvement (>9.57 points). The improvement rate of cognitive function between two treatment groups was compared. Results:In the CCRT group, there were 19 cases with superior improvement, 105 cases with improvement, and 46 cases with no improvement. In the WAT group, there were 7 cases with superior improvement, 39 cases with improvement, and 41 cases with no improvement. The improvement of cognitive function of CCRT group was better than that of WAT group, and the difference was statistically significant ( Z=2.978, P=0.003). The patients with serious cognitive impairment in the CCRT group had a higher improvement rate than those in the WAT group ( Z=1.860, P=0.032). The patients with moderate cognitive impairment in the CCRT group had a lower no improvement rate than those in the WAT ( Z=-1.817, P=0.035).The patients with mild cognitive impairment in the CCRT group had a lower no improvement rate ( Z=-3.294, P=0.001) and higher improvement rate and superior improvement rate ( Z=2.084, P=0.019; Z=1.969, P=0.025) than those in the WAT group. There was no statistically significant difference in improvement rate between patients with normal cognitive function in the CCRT group and in the WAT group ( P>0.05).The patients with improvement and superior improvement of cognition were combined as responder, and the two treatment groups were compared. The patients with mild cognitive impairment in the CCRT group had a higher improvement rate than those in the WAT group (77.2%(44/57) vs. 41.4%(12/29),χ2=10.853, P=0.001). However, for patients with serious and moderate cognitive impairment or with normal cognitive function at baseline, rates of improvement after treatment did not differ significantly between CCRT group and WAT group. According to Cohen′s d, the level of effect size in cognition improvement after CCRT treatment in patients with different cognitive dysfunction level was: mild cognitive impairment (0.59)>moderate cognitive impairment (0.48)>normal cognitive function (-0.12)>serious cognitive impairment (-0.24). Conclusions:Schizophrenic patients treated with CCRT had a higher improvement rate of cognitive function than those with WAT, and the improvement rate of cognitive function is higher in patients with mild cognitive impairment after CCRT treatment.
4.Application of convolutional neural networks in the diagnosis of schizophrenia
Jin LIU ; Yong HE ; Jiuju WANG ; Wenxiang QUAN ; Ju TIAN ; Chaonan FENG ; Haokui YU ; Cai NAN ; Jun JI
Chinese Journal of Behavioral Medicine and Brain Science 2019;28(7):622-626
Objective To explore the program of convolutional neural networks for the diagnosis of schizophrenia and evaluate its effects. Methods Using the convolutional neural network,the training model was trained in the lead data of 138 normal people and 183 schizophrenic patients,and the model was valida-ted by 20-fold cross-validation. Results The true positive rate of schizophrenia prediction using the convolu-tional neural network training model was 0. 749, the false positive rate was 0. 275, and the accuracy was 0. 738. Conclusion This model can achieve a strong diagnostic ability for patients with schizophrenia. Therefore,convolutional neural network for the diagnosis of schizophrenia will become an important research direction in the future.
5.Study of the sensitivity and specificity on near-infrared spectroscopy in diagnosis of depression
Ju TIAN ; Wenxiang QUAN ; Jiuju WANG ; Pengfei WANG ; Jin LIU ; Wentian DONG
Chinese Journal of Behavioral Medicine and Brain Science 2017;26(2):149-152
Objective To explore the sensitivity and specificity of near-infrared spectroscopy ( NIRS) in the diagnosis of depression. Methods From March 2013 to August 2013,62 patients with de-pression and 70 normal controls were collected from Peking University Sixth Hospital. Optical Tomography System (52 channels) was used to collect the NIRS data during the Verbal Fluency Test (VFT),and the number of words produced during VFT task was recorded. The wave analysis was performed by a professional psychiatrist. Results There was statistical difference in the number of words produced during VFT task be-tween the patients with depression (8.65±0.49)and control group(10.19±0.43) ( t=2.385, P<0.05). Through the wave analysis of NIRS to test patients with depression,the results demonstrated that the sensitivi-ty was 66.1% and the specificity was 91.4%. Conclusion The results of NIRS test display high specificity in the diagnosis of depression,which can be used as an objective index for clinical auxiliary diagnosis.
6.A preliminary analysis of effect of onset age on prefrontal activation during working memory task in patients with bipolar disorder
Yue ZHU ; Wenxiang QUAN ; Yantao MA ; Ju TIAN ; Wentian DONG ; Xin YU
Chinese Journal of Psychiatry 2017;50(2):114-118
Objectives To assess the effect of onset age on prefrontal activation during a working memory task in patients with bipolar disorder using a 52 multichannel functional near-infrared spectroscopy (NIRS).Methods Sixteen patients with early-onset (EO,onset age≤24 years old) and 14 with non-early-onset (NEO,onset age>24 years old) bipolar Ⅰ disorder were consecutively recruited from wards of Peking University Sixth hospital between October 2013 and May 2014,also including 16 healthy controls (HC) from community.Three groups of participants were diagnosed using MINI,then accepted a cross-sectional comparison of the relative changes in oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) during 1-back working memory task.Results Results from single factor analyses suggested that EO group showed a significantly reduced activation in deoxy-Hb in the right inferior prefrontal gyrus region than HC (CH34:-0.091 vs.0.009,Z=-2.542,P=0.033),while a significant increase of deoxy-Hb changes in the right dorsolateral prefrontal cortex (CH13:0.145 vs.-0.025,Z=2.412,P=0.048) and right frontopolar cortex (CH15:0.053 vs.-0.032,Z=2.890,P=0.012) regions than NEO group.There were no significant differences in the oxy-Hb changes among three groups in any channel during task.After being adjusted by multiple factor analyses,no significant difference in prefrontal activation among three groups was observed in any channel.Conclusions Similar pattern of prefrontal activity during 1-back working memory task exits between EO and NEO group,indicating that onset age may have no effect on NIRS prefrontal activation under low memory load in patients with bipolar disorder,which provides a reference for further NIRS studies in bipolar disorder.
7.A preliminary analysis of effect of onset age on prefrontal activation during working memory task in patients with bipolar disorder
Yue ZHU ; Wenxiang QUAN ; Yantao MA ; Ju TIAN ; Wentian DONG ; Xin YU
Chinese Journal of Psychiatry 2017;50(2):114-118
Objectives To assess the effect of onset age on prefrontal activation during a working memory task in patients with bipolar disorder using a 52 multichannel functional near-infrared spectroscopy (NIRS).Methods Sixteen patients with early-onset (EO,onset age≤24 years old) and 14 with non-early-onset (NEO,onset age>24 years old) bipolar Ⅰ disorder were consecutively recruited from wards of Peking University Sixth hospital between October 2013 and May 2014,also including 16 healthy controls (HC) from community.Three groups of participants were diagnosed using MINI,then accepted a cross-sectional comparison of the relative changes in oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) during 1-back working memory task.Results Results from single factor analyses suggested that EO group showed a significantly reduced activation in deoxy-Hb in the right inferior prefrontal gyrus region than HC (CH34:-0.091 vs.0.009,Z=-2.542,P=0.033),while a significant increase of deoxy-Hb changes in the right dorsolateral prefrontal cortex (CH13:0.145 vs.-0.025,Z=2.412,P=0.048) and right frontopolar cortex (CH15:0.053 vs.-0.032,Z=2.890,P=0.012) regions than NEO group.There were no significant differences in the oxy-Hb changes among three groups in any channel during task.After being adjusted by multiple factor analyses,no significant difference in prefrontal activation among three groups was observed in any channel.Conclusions Similar pattern of prefrontal activity during 1-back working memory task exits between EO and NEO group,indicating that onset age may have no effect on NIRS prefrontal activation under low memory load in patients with bipolar disorder,which provides a reference for further NIRS studies in bipolar disorder.
8.Effects of emotion on cognitive function in depression
Ju TIAN ; Jiuju WANG ; Wenxiang QUAN ; Pengfei WANG ; Jin LIU ; Wentian DONG
Chinese Journal of Behavioral Medicine and Brain Science 2015;24(4):329-331
Objective To explore the effects of emotion on cognitive function in patients with depression.Methods Self-rating anxiety scale(SAS),self-rating depression scale (SDS) and the typical one-back task were done by 397 patients with depression in Peking University Sixth hospital out-patient and hospitalization during 2012 June to 2013 October.Results Both of the SAS standard score (51.81 ± 11.50) and SDS standard score (62.94 ± 13.06) were significantly related (r=0.125,P<0.05.r=0.176,P<0.01) to the reaction time of one-back task ((590.27±213.96)ms),and the correlation between SAS standard score and SDS standard score was significant (r=0.682,P<0.01).The results of regression analysis suggested that,only SDS score could predict the reaction time of one-back task.Conclusion The emotion of anxiety and depression in patients with depression are correlated with cognitive function,and the emotion of depression is the main factor to affect the cognitive function.
9.Clinical application of minimizing picture archiving and communication system
Lixin CHEN ; Weijiang ZHAO ; Qiongying JIN ; Wenxiang GU ; Quan YUAN ;
Chinese Journal of Radiology 2001;0(03):-
Objective To investigate the use of the minimizing picture archiving and communication system (mini PACS) in practical work and to realize the advent of filmless radiology Methods A PC based ethernet was set up The medical imaging equipments including CT, MR, digital fluoroscopy, DSA, and a laser camera were combined with the ethernet, and the digital imaging network (DIN) was integrated with the medical diagnostic imaging system (MDIS) In this way, the radiology information system (RIS) was established Through one of the PC workstations with a double network card, this RIS was connected to the hospital information system (HIS) Results The mini PACS has been repeatedly used for more than 2 years The system in Radiology department has been established and improved With the present digital imaging system, such functions as the acquiring, storing, transmitting, printing, and browsing of digital images have been put into practice, all in accordance with the manners of the digital imaging communication in medicine 3 0 (DICOM 3 0) Digital imaging and diagnostic reports were managed through Microsoft Access database Images may be kept on line in different kinds of equipment for 3-6 months All images have been recorded on CD R disks, so as to be kept off line permanently So far, over 32 700 reports have been stored in the database From mini PACS HIS terminals images and diagnostic information may be acquired on a limited scale Conclusion mini PACS needs only a low cost of investment and operation Its maintenance is simple and its performance is efficient The main functions of the PACS can mostly be achieved There lies a bright prospect for its use in small and medium hospitals

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