Objective:To investigate the efficacy of Naikan cognitive therapy(NCT)combined with medica-tion in improving depressive symptoms and sleep quality in patients with chronic schizophrenia.Methods:Patients were included if they met the following criteria:diagnosed with schizophrenia based on ICD-10 criteria,a disease course of ≥2 years,stable condition under maintenance antipsychotic medication,presence of depressive symptoms and sleep quality issues,and no use of antidepressants in the past two months.A total of 64 eligible patients were randomly assigned to the NCT group(n=32)or the mental health education(MEC)group(n=32).The interven-tion lasted 6 days,with 2 patients from each group dropping out.The Beck Depression Inventory-Ⅱ(BDI-Ⅱ)and Pittsburgh Sleep Quality Index(PSQI)were used to assess depressive symptoms and sleep quality.Results:After the intervention,the BDI-Ⅱ score difference(post-treatment score minus pre-treatment score)in the NCT group was significantly lower than that in the MEC group(P＜0.001).Similarly,the PSQI total score difference was also lower in the NCT group compared to the MEC group(P＜0.001).Conclusion:Adding Naikan cognitive therapy to routine medication treatment can effectively improve depressive symptoms and sleep quality in patients with chronic schizophrenia.

Objective:To explore the core dimensions of adolescent anxiety and their relationship with parental rearing styles and perceived social support using network analysis.Methods:A total of 3 712 adolescents were in-vestigated.The Screen for Child Anxiety Related Emotional Disorders,the Short-form Egna Minnenav Barndoms Uppfostran for Chinese,and the Perceived Social Support Scale were used to assess the anxiety levels,parental rea-ring styles,and perceived social support.Network analysis and gender network comparison were conducted using R programming language.Results:The network analysis model showed that generalized anxiety and somatization/pan-ic anticipation had the highest Expected Influence of 1.21 and 1.12,which were the two core dimensions of adoles-cent anxiety levels.The affective warmth in parental rearing styles had a Bridge Expected Influence index of 0.34,making it a bridging node in the network.The network comparison result indicated that there were significant struc-tural gender differences in the adolescent anxiety-parenting style-perceived social support network(P＜0.05),but there was no significant gender difference in global strength(P＞0.05).Conclusion:Interventions targeting adoles-cent anxiety should prioritize generalized anxiety and somatization/panic.Emotional warmth in parenting serves as a bridge connecting adolescent anxiety with perceived levels of social support.

Objective To explore the life satisfaction and related factors of general and assistant general standardized training physicians(hereinafter referred to as training physicians),and analyze the effecting path of resilience between stress perception and life satisfaction.Methods From July to October 2024,a self-designed general demographic survey,Satisfaction With Life Scale(SWLS),Connor-Davidson Resilience Scale(CD-RISC),and Chinese Perceived Stress Scale(CPSS)were used to survey 251 training physicians from two hospitals in Xi'an to understand their life satisfaction,stress perception,and resilience in the past month.Model 4 in the Process V3.3 plugin of SPSS 25.0 software and Bootstrap method were used to analyze the effecting path of resilience between stress perception and life satisfaction among the training physicians.Results A total of 251 questionnaires were distributed,and 236 valid questionnaires were collected,with an effective response rate of 94.02％.The stress perception of 236 training physicians(24.12±7.02)was negatively correlated with life satisfaction(23.24±7.45)(r=-0.556,P＜0.01),but negatively correlated with resilience(54.88±11.37)(r=-0 658,P＜0.01).Resilience partially mediated the relationship between stress perception and life satisfaction,with a mediation effect value of-0.320 6,accounting for 54.39％ of the total effect.Conclusion Stress perception has an independent negative impact on the life satisfaction of training physicians,and indirectly affects life satisfaction through resilience.Improving life satisfaction can be achieved by reducing stress perception or enhancing resilience.

Objective To explore the life satisfaction and related factors of general and assistant general standardized training physicians(hereinafter referred to as training physicians),and analyze the effecting path of resilience between stress perception and life satisfaction.Methods From July to October 2024,a self-designed general demographic survey,Satisfaction With Life Scale(SWLS),Connor-Davidson Resilience Scale(CD-RISC),and Chinese Perceived Stress Scale(CPSS)were used to survey 251 training physicians from two hospitals in Xi'an to understand their life satisfaction,stress perception,and resilience in the past month.Model 4 in the Process V3.3 plugin of SPSS 25.0 software and Bootstrap method were used to analyze the effecting path of resilience between stress perception and life satisfaction among the training physicians.Results A total of 251 questionnaires were distributed,and 236 valid questionnaires were collected,with an effective response rate of 94.02％.The stress perception of 236 training physicians(24.12±7.02)was negatively correlated with life satisfaction(23.24±7.45)(r=-0.556,P＜0.01),but negatively correlated with resilience(54.88±11.37)(r=-0 658,P＜0.01).Resilience partially mediated the relationship between stress perception and life satisfaction,with a mediation effect value of-0.320 6,accounting for 54.39％ of the total effect.Conclusion Stress perception has an independent negative impact on the life satisfaction of training physicians,and indirectly affects life satisfaction through resilience.Improving life satisfaction can be achieved by reducing stress perception or enhancing resilience.

Objective:To explore the core dimensions of adolescent anxiety and their relationship with parental rearing styles and perceived social support using network analysis.Methods:A total of 3 712 adolescents were in-vestigated.The Screen for Child Anxiety Related Emotional Disorders,the Short-form Egna Minnenav Barndoms Uppfostran for Chinese,and the Perceived Social Support Scale were used to assess the anxiety levels,parental rea-ring styles,and perceived social support.Network analysis and gender network comparison were conducted using R programming language.Results:The network analysis model showed that generalized anxiety and somatization/pan-ic anticipation had the highest Expected Influence of 1.21 and 1.12,which were the two core dimensions of adoles-cent anxiety levels.The affective warmth in parental rearing styles had a Bridge Expected Influence index of 0.34,making it a bridging node in the network.The network comparison result indicated that there were significant struc-tural gender differences in the adolescent anxiety-parenting style-perceived social support network(P＜0.05),but there was no significant gender difference in global strength(P＞0.05).Conclusion:Interventions targeting adoles-cent anxiety should prioritize generalized anxiety and somatization/panic.Emotional warmth in parenting serves as a bridge connecting adolescent anxiety with perceived levels of social support.

Objective:To investigate the efficacy of Naikan cognitive therapy(NCT)combined with medica-tion in improving depressive symptoms and sleep quality in patients with chronic schizophrenia.Methods:Patients were included if they met the following criteria:diagnosed with schizophrenia based on ICD-10 criteria,a disease course of ≥2 years,stable condition under maintenance antipsychotic medication,presence of depressive symptoms and sleep quality issues,and no use of antidepressants in the past two months.A total of 64 eligible patients were randomly assigned to the NCT group(n=32)or the mental health education(MEC)group(n=32).The interven-tion lasted 6 days,with 2 patients from each group dropping out.The Beck Depression Inventory-Ⅱ(BDI-Ⅱ)and Pittsburgh Sleep Quality Index(PSQI)were used to assess depressive symptoms and sleep quality.Results:After the intervention,the BDI-Ⅱ score difference(post-treatment score minus pre-treatment score)in the NCT group was significantly lower than that in the MEC group(P＜0.001).Similarly,the PSQI total score difference was also lower in the NCT group compared to the MEC group(P＜0.001).Conclusion:Adding Naikan cognitive therapy to routine medication treatment can effectively improve depressive symptoms and sleep quality in patients with chronic schizophrenia.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Background::Although existing mycological tests (bronchoalveolar lavage [BAL] galactomannan [GM], serum GM, serum (1,3)-β-D-glucan [BDG], and fungal culture) are widely used for diagnosing invasive pulmonary aspergillosis (IPA) in non-hematological patients with respiratory diseases, their clinical utility in this large population is actually unclear. We aimed to resolve this clinical uncertainty by evaluating the diagnostic accuracy and utility of existing tests and explore the efficacy of novel sputum-based Aspergillus assays. Methods::Existing tests were assessed in a prospective and consecutive cohort of patients with respiratory diseases in West China Hospital between 2016 and 2019 while novel sputum assays (especially sputum GM and Aspergillus-specific lateral-flow device [LFD]) in a case-controlled subcohort. IPA was defined according to the modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity and specificity were computed for each test and receiver operating characteristic (ROC) curve analysis was performed. Results::The entire cohort included 3530 admissions (proven/probable IPA = 66, no IPA = 3464) and the subcohort included 127 admissions (proven/probable IPA = 38, no IPA = 89). Sensitivity of BAL GM (≥1.0 optical density index [ODI]: 86% [24/28]) was substantially higher than that of serum GM (≥0.5 ODI: 38% [39/102]) ( χ2 = 19.83, P < 0.001), serum BDG (≥70 pg/mL: 33% [31/95]) ( χ2 = 24.65, P < 0.001), and fungal culture (33% [84/253]) ( χ2 = 29.38, P < 0.001). Specificity varied between BAL GM (≥1.0 ODI: 94% [377/402]), serum GM (≥0.5 ODI: 95% [2130/2248]), BDG (89% [1878/2106]), and culture (98% [4936/5055]). Sputum GM (≥2.0 ODI) had similar sensitivity (84% [32/38]) (Fisher’s exact P = 1.000) to and slightly lower specificity (87% [77/89]) ( χ2 = 5.52, P = 0.019) than BAL GM (≥1.0 ODI). Area under the ROC curve values were comparable between sputum GM (0.883 [0.812-0.953]) and BAL GM (0.901 [0.824-0.977]) ( P = 0.734). Sputum LFD had similar specificity (91% [81/89]) ( χ2 = 0.89, P = 0.345) to and lower sensitivity (63% [24/38]) ( χ2 = 4.14, P = 0.042) than BAL GM (≥1.0 ODI), but significantly higher sensitivity than serum GM (≥0.5 ODI) ( χ2 = 6.95, P = 0.008), BDG ( χ2 = 10.43, P = 0.001), and fungal culture ( χ2 = 12.70, P < 0.001). Conclusions::Serum GM, serum BDG, and fungal culture lack sufficient sensitivity for diagnosing IPA in respiratory patients. Sputum GM and LFD assays hold promise as rapid, sensitive, and non-invasive alternatives to the BAL GM test.

Objective:To explore the influence of childhood abuse experience on relapse tendency of compulsory drug abusers, and the intermediary role of resilience and depression between them.Methods:A total of 261 drug abusers were investigated with childhood trauma questionnaire(CTQ), the Connor-Davidson resilience scale (CD-RISC), self-rating depression scale (SDS) and relapse tendency psychological questionnaire.All data processing and analysis were carried out by SPSS 25.0 software.Correlation analysis, Bootstrap analysis and other methods were used to test the mediating effect.Results:The scores of childhood abuse treatment, resilience, depression and relapse tendency were 44.690±18.550, 60.210±22.790, 48.370±12.450, and 15.300±9.833 respectively.Childhood abuse was negatively correlated with resilience( r=-0.396, P<0.01), and positively correlated with depression and relapse tendency( r=0.584, 0.298, P<0.01).Resilience was negatively correlated with depression and relapse tendency( r=-0.558, -0.147, P<0.05).Depression had a significant positive correlation with relapse tendency( r=0.286, P<0.01).Childhood abuse could directly predict the tendency of relapse( β=0.202, P<0.01), and it could also affect the tendency of relapse through the mediation of depression( β=0.082, 95% CI=0.007-0.165) and the chain mediation of resilience and depression( β=0.029, 95% CI=0.002-0.064). Conclusion:The experience of childhood abuse leads to the decrease of resilience of strong abstinence personnel and increases the level of depression, which finally increases the tendency of relapse.

Objective:To evaluate the reliability and validity of Chinese version of Glasgow antipsychotics side-effect scale (GASS).Methods:Totally 200 patients diagnosed as schizophrenia following the criteria of DSM-IV were enrolled in the study.Cronbach’s α was used to investigate the internal consistency of GASS.Exploring factor analysis was used to examine the construct validity.Pearson correlation analysis between GASS and TESS and CGI sub-scale of side effect were conducted to evaluate the criterion validity.Based on clinical criteria, the sensitivity and specificity and ROC curve was calculated so as to establish the cut-off point of the scale and test discrimination validity.Results:For reliability, Cronbach’s α ws 0.926, indicating that GASS had a good internal consistency.Four main factors were extracted by exploratory factor analysis which were extrapyramidal side effect factor, genitourinary side effect factor, anticholinergic side effect factor, over sedation and cardiovascular side effect factor.For validity, exploring analysis demonstrated that nineteen item of the scale has relatively higher factor load on the principal factor (0.531-0.972), suggesting that the scale had a good construct validity.The total score of the GASS was positively correlated with that of TESS and CGI subscale of side effects( r=0.90, P<0.05; r=0.87, P<0.05). The cut-off point of experimental validity of GASS for mild antipsychotics side effects was determined as ≥1.With this cut-off point, GASS had both high sensitivity (96.3%) and high specificity (70.7%), area under curve (AUC) were 0.78.The cut-off point of GASS for moderate antipsychotics side effects was determined as ≥20, with the sensitivity and specificity of GASS were 86.3% and 84.7%, AUC were 0.92.When the cut-off point of GASS for severe antipsychotics side effects was determined as ≥41, GASS had both high sensitivity (92.1 %) and high specificity (96.3 %), AUC were 0.96. Conclusion:GASS has good reliability and validity and can reflect the side effects of antipsychotics, and it can be adopted as a useful instrument to evaluate the severity of side effects of antipsychotics.