Objective:This study aimed to examine the prevalence of comorbid generalized anxiety disorder (GAD) among adult patients with major depressive disorder (MDD) in China and explore its potential risk factors.Methods:This is a multicenter, cross-sectional study, involving 1 086 patients in 9 clinical settings. The diagnosis of MDD and GAD were confirmed by the MINI. Life events were evaluated by the Life Events Scale (LES), and early life stress was assessed by the Childhood Trauma Questionnaire (CTQ). The severity of depression, social support, coping style and personality traits were assessed by Hamilton Depression Rating Scale-17 item (HAMD 17), Simplified Coping Style Questionnaire (SCSQ), and Eysenck Personality Questionnaire, short scale for China (EPQ-RSC), respectively. Pearson correlation analysis, univariate regression analysis and Logistic regression analysis were used to explore the association of clinical characteristics, life stress, social factors and comorbidity of MDD and GAD. Results:Among 1 086 MDD patients, 276 of them (25.4%) were diagnosed with comorbid GAD. Patients with comorbid GAD were more likely to report adulthood adversity then those without (60.2% （165/276） vs. 39.9%（321/810）, χ2=33.993， P<0.01). However, there was no difference in social support and coping styles between the two groups. Furthermore, patients with comorbid GAD had higher levels of neuroticism, and lower levels of extraversion. After controlling for confounders, logistic regression results showed that adulthood adversity ( OR=1.720, 95% CI 1.262-2.343, P<0.01) and higher neuroticism levels (O R=1.211, 95% CI 1.141-1.286, P<0.01) were significantly associated with comorbid GAD in patients with MDD. Conclusion:Adulthood adversity and high levels of neuroticism were potential risk factors of comorbidity of MDD and GAD. This finding provides empirical evidence for developing targeted interventions for this subgroup population with MDD.

Objective:This study aimed to examine the prevalence of comorbid generalized anxiety disorder (GAD) among adult patients with major depressive disorder (MDD) in China and explore its potential risk factors.Methods:This is a multicenter, cross-sectional study, involving 1 086 patients in 9 clinical settings. The diagnosis of MDD and GAD were confirmed by the MINI. Life events were evaluated by the Life Events Scale (LES), and early life stress was assessed by the Childhood Trauma Questionnaire (CTQ). The severity of depression, social support, coping style and personality traits were assessed by Hamilton Depression Rating Scale-17 item (HAMD 17), Simplified Coping Style Questionnaire (SCSQ), and Eysenck Personality Questionnaire, short scale for China (EPQ-RSC), respectively. Pearson correlation analysis, univariate regression analysis and Logistic regression analysis were used to explore the association of clinical characteristics, life stress, social factors and comorbidity of MDD and GAD. Results:Among 1 086 MDD patients, 276 of them (25.4%) were diagnosed with comorbid GAD. Patients with comorbid GAD were more likely to report adulthood adversity then those without (60.2% （165/276） vs. 39.9%（321/810）, χ2=33.993， P<0.01). However, there was no difference in social support and coping styles between the two groups. Furthermore, patients with comorbid GAD had higher levels of neuroticism, and lower levels of extraversion. After controlling for confounders, logistic regression results showed that adulthood adversity ( OR=1.720, 95% CI 1.262-2.343, P<0.01) and higher neuroticism levels (O R=1.211, 95% CI 1.141-1.286, P<0.01) were significantly associated with comorbid GAD in patients with MDD. Conclusion:Adulthood adversity and high levels of neuroticism were potential risk factors of comorbidity of MDD and GAD. This finding provides empirical evidence for developing targeted interventions for this subgroup population with MDD.

Objective To investigate the difference of Wechsler's cognitive test and its influencing factors in first-episode depression patients with and without sleep disorder.Methods 156 patients with de-pression were divided into two groups according to their sleep conditions,including sleep disorder group(n=77)and non-sleep disorder group(n=79).Wechsler Intelligence Scale(WAIS)and Wechsler Memory Scale(WMS)were used to assess the cognitive function,while Hamilton Depression Scale(HAMD-17) were used to assess depressive symptoms.Results (1)Sleep disorders group had lower scores on verbal IQ (95.51±16.45),performance IQ(90.94±13.87),FIQ scores(92.48±15.49)than those in the non-sleep disorder group((105.59±15.20),(96.19±13.62),(101.20±14.70)respectively),the differences were statistically significant(P<0.05).Sleep disorder group had lower scores in immediate memory(10.47 ± 3.88),short-term memory(49.87±14.35)and memory quotient(87.90±18.25)than those in the non-sleep disorder group((11.86±3.47),(56.52±13.03),(97.27±18.76)respectively),the differences were statisti-cally significant(all P<0.05).(2)Multivariate linear regression analysis showed that education and age ex-plained 24% of variance in verbal IQ(F=21.258,P<0.01).Education,sleep disorder factors explained 12.9% of variation in performance IQ(F=9.825,P<0.01).Education,sleep disorder factors explained 22.3% of variance in total IQ(F=22.847,P<0.01).Education,age,sleep disorder factors explained 28.4%of variation in short-term memory(F=23.850,P<0.01).Education and age explained 20.4% of variation in immediate memory(F=18.10,P<0.01).Education and sleep disorder factors explained 21.9% of variation in memory quotient(F=26.162,P<0.01).Conclusion The intelligence and memory impairment in first-epi-sode depression patients with sleep disorders is more serious,and the education,sleep disorder and age are the most important factors.

Objective To investigate the status of depression with anxiety symptoms, and analyze the influencing factors of anxiety symptoms from demographic data and social psychological factors. Methods Hamilton depression rat?ing scale (HAMD), Hamilton anxiety rating scale (HAMA), Eysenck personality questionnaire (EPQ), life event scale (LES), trait coping style questionnaire (TCSQ) and social support scale (SSS) were used to evaluate 729 patients with de?pression. According to HAMA scores, patients were divided into non anxiety symptoms group (HAMA<7) and anxiety symptoms group (HAMA>14). Social psychological factors were compared between two groups, and the influencing fac?tors of anxiety symptoms were analyzed. Results The incidence of anxiety symptoms in depression was 58.85% (429/729), and 119 cases (16.32%) were certainly without anxiety symptoms. Compared with the group without anxiety symp?toms, the anxiety symptoms group had higher scores on neuroticism, psychoticism, negative life events and negative cop?ing style (P<0.001), but lower scores on introversion and extroversion (P=0.010). Degree of depression (OR=9.255, 95%CI:4.726~18.127), neuroticism (OR=1.595, 95%CI:1.197~2.125), negative life events (OR=1.009, 95%CI:1.001~1.017) and negative coping style (OR=1.046, 95%CI:1.013~1.080) were the risk factors of anxiety symptoms (P<0.05). Conclu?sion The incidence of anxiety symptoms in patients with depression is high. Patients with higher degree of depression and typical neurotic personality experiencing more negative life events and those with tendency to adopt negative coping style are more susceptible to anxiety symptoms.

Objective To explore the influence of a polymorphism of protein tyrosine phosphatase receptor type R (PTPRR) gene rs1513105 on abnormal brain activities in resting-state patients with major depressive disorder (MDD) using the gene-imaging technology. Methods 54 MDD and 43 gender-, age-, and education-matched controls received fMRI scans and genotyping to identify the main effect of disease status, genotypes and their interaction in MDD. Results The results of 2 × 2 ANOVA showed increased ReHo in left superior temporal gyrus (t= 4.208 2), right supramarginal gyrus(t= 3.027 1), left superior parietal gyrus (t=3.212 2) were in patients than controls. The carriers with TT genotype showed increased ReHo in left inferior parietal gyrus (t=3.129 0), left postcentral gyrus (t=3.263 3) and reduced ReHo in right caudate nucleus (t=-3.443 4), right inferior frontal gyrus, opercular part (t=-3.444 5), right cerebelum (t=-3.079 3) than G allele carriers(P<0.05). The patients showed increased ReHo in right inferior temporal gyrus (t=3.560 2), right inferior frontal gyrus, triangular part (t=3.296 1) and reduced ReHo in left superior temporal gyrus (t=-4.354 3), left precuneus(t=-4.026 7), left superior frontal gyrus(t=-3.656 0),left inferior occipital gyrus (t=-3.805 4), right supramarginal gyrus (t=-3.433 2) than controls, comparing G allele carriers with TT genotype carriers. Reduced ReHo in left inferior occipital gyrus was positively correlated with cognitive (r=0.323, P= 0.017) and sleep disturbance (r=0.318, P= 0.019), Reduced ReHo in right supramarginal gyrus was positively correlated with cognitive disturbance (r=0.273, P= 0.046). Conclusion The interaction between PTPRR gene polymorphism and MDD may contribute to the change of resting-state function of some depression-related brain region, and might be involved in the pathogenesis of MDD.

Objective To examine the sex differences in prescribing patterns of psychotropic drugs and drug-induced side effects in schizophrenia patients in China. Methods Using the same design and a standardized protocol as in 2002 and 2006, the cross-sectional survey was conducted from July to August, 2012 in 45 psychiatric hospitals/centers in 10 provinces and municipalities in China. Inpatients and outpatients with schizophrenia were consecutively screened for eligibility for this study. Sociodemographic characteristics and prescription pattern were collected by using a modified questionnaire for the study. Data comparisons between male and female were performed with univariate analysis. Multiple logistic regression analysis was employed to determine the gender differences in prescription pattern and drug-induced side effects. Results The sample consisted of 2 260 male and 1 979 female patients. Univariate analyses showed that male patients were younger than female patients(t=5.398), having an earlier age at onset(t=5.662), higher percentage of being employed(χ2=31.597), and more negative symptoms(χ2=10.814)and aggressive behavior (χ2=5.816), more likely to receive clozapine (23.9%(472/1 979) vs. 28.5%(645/2 260),χ2=11.955), higher antipsychotic doses(476 mg vs. 514 mg,F=14.003), less use of antidepressants (7.9%(156/1 979) vs. 6.0%(136/2 260),χ2=5.722)and benzodiazepines(23.9%(472/1 979)vs. 20.0%(451/2 260),χ2=9.396), more frequent tardive dyskinesia(1.3%(25/1 979)vs. 2.1%(47/2 260),χ2=4.212)and less weight gain(11.0%(218/1 979)vs. 7.7%(173/2 260),χ2=14.233)and prolactin elevation(3.2%(63/1 979)vs. 1.7%(39/2 260),χ2=9.548;all P<0.05). In multivariate analyses, greater rate of clozapine use (OR=1.268,P=0.001), less rate of benzodiazepines use(OR=0.841,P=0.025) and antidepressants(OR=0.78,P=0.045),higher rate of tardive dyskinesia(OR=1.879,P=0.014)and less weight gain (OR=0.669,P=0.001) and prolactin elevation (OR=0.527,P=0.003) were independently associated with the male sex. Conclusion Gender is one of the independent contributors to psychotropic prescription pattern and side effects of antipsychotics in Chinese schizophrenia patients. Gender differences should be given more attention in research and clinical practice.

Objective To explore the influence of a polymorphism of protein tyrosine phosphatase receptor type R (PTPRR) gene rs1513105 on abnormal brain activities in resting-state patients with major depressive disorder (MDD) using the gene-imaging technology. Methods 54 MDD and 43 gender-, age-, and education-matched controls received fMRI scans and genotyping to identify the main effect of disease status, genotypes and their interaction in MDD. Results The results of 2 × 2 ANOVA showed increased ReHo in left superior temporal gyrus (t= 4.208 2), right supramarginal gyrus(t= 3.027 1), left superior parietal gyrus (t=3.212 2) were in patients than controls. The carriers with TT genotype showed increased ReHo in left inferior parietal gyrus (t=3.129 0), left postcentral gyrus (t=3.263 3) and reduced ReHo in right caudate nucleus (t=-3.443 4), right inferior frontal gyrus, opercular part (t=-3.444 5), right cerebelum (t=-3.079 3) than G allele carriers(P<0.05). The patients showed increased ReHo in right inferior temporal gyrus (t=3.560 2), right inferior frontal gyrus, triangular part (t=3.296 1) and reduced ReHo in left superior temporal gyrus (t=-4.354 3), left precuneus(t=-4.026 7), left superior frontal gyrus(t=-3.656 0),left inferior occipital gyrus (t=-3.805 4), right supramarginal gyrus (t=-3.433 2) than controls, comparing G allele carriers with TT genotype carriers. Reduced ReHo in left inferior occipital gyrus was positively correlated with cognitive (r=0.323, P= 0.017) and sleep disturbance (r=0.318, P= 0.019), Reduced ReHo in right supramarginal gyrus was positively correlated with cognitive disturbance (r=0.273, P= 0.046). Conclusion The interaction between PTPRR gene polymorphism and MDD may contribute to the change of resting-state function of some depression-related brain region, and might be involved in the pathogenesis of MDD.

Objective To examine the sex differences in prescribing patterns of psychotropic drugs and drug-induced side effects in schizophrenia patients in China. Methods Using the same design and a standardized protocol as in 2002 and 2006, the cross-sectional survey was conducted from July to August, 2012 in 45 psychiatric hospitals/centers in 10 provinces and municipalities in China. Inpatients and outpatients with schizophrenia were consecutively screened for eligibility for this study. Sociodemographic characteristics and prescription pattern were collected by using a modified questionnaire for the study. Data comparisons between male and female were performed with univariate analysis. Multiple logistic regression analysis was employed to determine the gender differences in prescription pattern and drug-induced side effects. Results The sample consisted of 2 260 male and 1 979 female patients. Univariate analyses showed that male patients were younger than female patients(t=5.398), having an earlier age at onset(t=5.662), higher percentage of being employed(χ2=31.597), and more negative symptoms(χ2=10.814)and aggressive behavior (χ2=5.816), more likely to receive clozapine (23.9%(472/1 979) vs. 28.5%(645/2 260),χ2=11.955), higher antipsychotic doses(476 mg vs. 514 mg,F=14.003), less use of antidepressants (7.9%(156/1 979) vs. 6.0%(136/2 260),χ2=5.722)and benzodiazepines(23.9%(472/1 979)vs. 20.0%(451/2 260),χ2=9.396), more frequent tardive dyskinesia(1.3%(25/1 979)vs. 2.1%(47/2 260),χ2=4.212)and less weight gain(11.0%(218/1 979)vs. 7.7%(173/2 260),χ2=14.233)and prolactin elevation(3.2%(63/1 979)vs. 1.7%(39/2 260),χ2=9.548;all P<0.05). In multivariate analyses, greater rate of clozapine use (OR=1.268,P=0.001), less rate of benzodiazepines use(OR=0.841,P=0.025) and antidepressants(OR=0.78,P=0.045),higher rate of tardive dyskinesia(OR=1.879,P=0.014)and less weight gain (OR=0.669,P=0.001) and prolactin elevation (OR=0.527,P=0.003) were independently associated with the male sex. Conclusion Gender is one of the independent contributors to psychotropic prescription pattern and side effects of antipsychotics in Chinese schizophrenia patients. Gender differences should be given more attention in research and clinical practice.

Objective To investigate the attention bias characteristics of first-episode depressive patients.Methods Forty two patients in our hospital from June 2011 to May 2014 with first-episode depressive and 42 healthy people for physical examination were selected.The reaction time and error number were recorded.Results The reaction time in observation group was significantly longer than control group.Difference between negative and neutral words of observation group was showed (P ＜ 0.01).Conclusions First-episode depressive patients have obviously attention bias in negative related stimulation.

Objective To explore the characteristics of cognitive impairment and its influence factors in first-epi?sode depression patients with sleep disorder. Methods Three hundred and eighteen patients with first-episode depres?sion and two hundreds and forty-three healthy controls were recruited. The patients were divided into two group accord?ing to the sleeping situation: 202 patients with sleep disorder and 116 patients without. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to evaluated the cognitive function of all subjects, including immediate memory, visual span, speech function, attention and delayed memory. The 17 item Hamilton Depression Scale (HAMD-17) was used to evaluate patients’symptoms. Results The scores of immediate memory, visual span, speech function, delayed memory and the whole scale in the depression patients with sleep disorder were significantly lower than the patients without sleep disorder and the controls (P<0.05). Compared with the controls, the patients without sleep disor?der had lower scores of immediate memory, language function, delayed memory and the whole scale (P<0.05). Multiple linear regression showed that in the depression patients with sleep disorder, the RBANS score was related with the cogni?tive factors in HAMD (β=6.29, P=0.04);immediate memory was related with age (β=-0.24, P=0.04);visual span was re?lated with sleeping factor in HAMD (β=2.33, P=0.01);speech function was related with marriage (β=-5.74, P=0.01) and sleeping factor in HAMD (β=-1.20, P=0.03). In the depression patients with sleep disorder, speech function of RBANS was related with age (β=-0.32, P=0.04);attention was related with retardation factor in HAMD (β=2.52, P=0.01). Con?clusion The first-episode depression patients with sleep disorders have cognitive function damage in many aspects. The depressive symptoms (sleep changes, cognitive disorders, retardation and so on), age and marital status may be the influ?encing factors on cognitive impairment in first-episode depression patients with sleep disorder.