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: Although the pathogenesis of depression remains unclear, C-reactive protein (CRP) levels are commonly elevated in depressed patients. Thus, CRP single-nucleotide polymorphisms (SNPs) that influence CRP levels may be associated with depression. In the present study, we explored whether CRP SNPs are related to depressive symptoms and antidepressants efficacy in Han Chinese patients.METHODS: We analyzed data from 440 patients with first-episode depression. We obtained genome CRP SNPs, scores of the 17-item Hamilton Rating Scale for Depression 17 (HAMD17) and its four-factor at baseline and after 6 weeks. Quantitative trait analysis was performed using UNPHASED software and curative effects were analyzed using SPSS software.RESULTS: Male patients with SNP rs1800947G exhibited lower insomnia scores and rs2794521CC exhibited lower scores of anxiety/ physical symptoms, total HAMD17 score. Female patients with rs2794521TT exhibited higher scores of insomnia and lower antidepressants efficacy.CONCLUSION: CRP SNPs rs1800947 and rs2794521 may be associated with depressive symptoms in patients with depression in a sex-specific fashion. Furthermore, rs2794521 may be a predictor of the efficacy of antidepressants in female patients.
Antidepressive Agents ; Asian Continental Ancestry Group ; C-Reactive Protein ; Depression ; Female ; Genome ; Humans ; Male ; Polymorphism, Single Nucleotide ; Sleep Initiation and Maintenance Disorders

Objective To explore the characteristics of spontaneous neural activity of resting?state brain function in depressive patients who also suffered childhood maltreatment (CM) by comparing low frequency fluctuation amplitude (ALFF). The relationship between the ALFF changes and the clinical depressive symptoms was also explored. Methods Fifty adult patients with depression were separated to CM group (twenty?five depressive patients with CM history) and non?CM group (twenty?five depressive patients without CM history).All of them were given a resting functional magnetic resonance scan of the brain. ALFF values of each subject were calculated to estimate the spontaneous activities of different brain regions. A two?sample t?test was performed on the ALFF values of different brain regions between CM group and non?CM group, corrected by an AlphaSim multiple comparison.A Pearson correlation analysis was performed to explore whether the ALFF values were correlated to the clinical depressive symptoms. Results (1) The patients with CM showed higher ALFF values in the left middle frontal gyrus (t=4.14), the right middle frontal gyrus (t=4.11), and the left inferior parietal gyrus (t=4.12);while the lower ALFF values were found in the right precuneus (t=-3.68) and the right angular gyrus (t=-4.34). (2) The ALFF values of both right angular gyrus(r=-0.47) and the left inferior parietal gyrus (r=0.53) in the CM group were correlated with the HAMD despair coefficient. Conclusions Depressive adult patients with childhood maltreatment may have abnormal rest spontaneous neural activities in the middle frontal gyrus and those default mode network?related brain regions. These abnormalities may be closely correlated with a sense of despair.

Objective To explore the characteristics of spontaneous neural activity of resting?state brain function in depressive patients who also suffered childhood maltreatment (CM) by comparing low frequency fluctuation amplitude (ALFF). The relationship between the ALFF changes and the clinical depressive symptoms was also explored. Methods Fifty adult patients with depression were separated to CM group (twenty?five depressive patients with CM history) and non?CM group (twenty?five depressive patients without CM history).All of them were given a resting functional magnetic resonance scan of the brain. ALFF values of each subject were calculated to estimate the spontaneous activities of different brain regions. A two?sample t?test was performed on the ALFF values of different brain regions between CM group and non?CM group, corrected by an AlphaSim multiple comparison.A Pearson correlation analysis was performed to explore whether the ALFF values were correlated to the clinical depressive symptoms. Results (1) The patients with CM showed higher ALFF values in the left middle frontal gyrus (t=4.14), the right middle frontal gyrus (t=4.11), and the left inferior parietal gyrus (t=4.12);while the lower ALFF values were found in the right precuneus (t=-3.68) and the right angular gyrus (t=-4.34). (2) The ALFF values of both right angular gyrus(r=-0.47) and the left inferior parietal gyrus (r=0.53) in the CM group were correlated with the HAMD despair coefficient. Conclusions Depressive adult patients with childhood maltreatment may have abnormal rest spontaneous neural activities in the middle frontal gyrus and those default mode network?related brain regions. These abnormalities may be closely correlated with a sense of despair.

Objective To effectively combine the results of resting state regional homogeneity(ReHo) fMRI studies in depression.Methods Literatures between 2003-2016 on fMRI of depression in PubMed,Web of Knowledge,EBSCO host medline,CNKI,CQVIP and Wanfang Med Online were taken as research objects.Screening the relevant data according to the included and excluded standard,then,software of AES-SDM was employed to do Meta analysis,in addition,the age,gender,duration of disease,the year of education and treatment were also analyzed.Results 23 articles met the standard,including 1 036 cases,of which 507 for the depression group,529 for the control group.Meta analysis showed the significant ReHo abnormalities of Default Mode Network(DMN) which centers on left precuneus,left superior frontal gyrus and right cingulate gyrus,in addition,left lenticular nucleus,left postcentral gyrus,left cerebellum and left fusiform gyrus had significant ReHo differences.In the regression analysis,gender,age,duration of disease,years of education,disease severity were all affected factors.The difference of cingulate gyrus was the most stable,and the duration of the disease significantly affected cingulate gyrus (SDM =2.777).Conclusion The abnormalities of DMN which centers on left precuneus,left,medial superior frontal gyrus and right cingulate gyrus are the most consistent in depression,the DMN is closely related to depression.

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 relevance of brain-derived neurotrophic factor (BDNF) gene polymorphisms and the effects of citalopram antidepressant.Methods The subjects comprised 280 patients according to the diagnostic and statistical manual of mental disorders in the fourth edition (DSM-Ⅳ) criterion for major depressive disorder (MDD).Severity of depression were assessed by 17 Hamilton depression scale (HAMD) at the baseline and 1,2,4,6 weekend.Citalopram were selected for treatment.Polymerase chain reaction (PCR) and DNA sequencing analysis were used to detect the genotype of SNPs rs7124442 and rs6265 of BDNF.SPSS17.0 software was used for statistical analysis.Results (1) There were 280 patients (242 responders and 38 nonresponders;175 remissioners and 105 nonremissioners) accomplished 6 weeks of treatment.No association was found between the polymorphisms and antidepressant drug response or remission (the reduction rate of HAMD score ≥ 50％ was defined as response,conversely,defined as nonresponse;HAMD score more than 7 was named as remission,in contrast,named as nonremission) (P＞0.05).(2) Repeated measures analysis of variance was adopted to compare the change of HAMD scores among the genotypes at different time points.There was a significant difference in rs6265 polymorphism between the GA +AA genotype (the scores of HAMD at 2,4,6 weeks were(9.98±4.97),(8.02±4.50),(5.83±3.49) respectively) and the GG genotype groups (the scores of HAMD at 2,4,6 weeks were(11.90±6.55),(9.34± 4.71),(7.07±4.28) respectively) (P=0.031).Conclusion The results suggest that BDNF rs6265 polymorphisms in part determine the antidepressant response to citalopram.

Objective To explore the relationship of miR-34b/c gene polymorphisms and event-related potential P300 in major depressive disorder.Methods The design of case-control research was used,and 302 major depressive patients and 327 normal controls who were in age and gender matched with patients were measured auditory event-related potential P300 on the day when two groups were collected.Polymerase chain reaction(PCR) and direct DNA sequencing technology were used to detect miR-34b/c gene polymorphisms.Results (1) In the single locus analysis,the rs4938723,rs2187473 and rs28757623 had no significant difference in allele frequency and genotype frequency between depressive patients and controls (P＞ 0.05);Haplotype C-C-C in rs4938723-rs2187473-rs28757623 was statistically significant different in depressive patients and controls(x2 =3.96,P=0.046).The odds ratio (OR) was 1.322(95％CI=1.004-1.740).(2) Compared with normal controls,P300 of the patients with major depressive disorder had longer latency of N2 (P＜0.01),P3a (P＜0.01) and P3b (P＜0.05).(3) The P300 targets of major depressive disorder had statistical difference(P＜0.05)in rs28757623 between the individuals with the G allele genotype and C/C genotype.The latency of N1 ((90.80±28.62) ms),P3a((281.79±37.89) ms),P3b((323.87±41.17) ms) were longer thanC/C genotype ((77.40 ± 20.96) ms,(253.00 ± 34.36) ms,(297.30± 23.70) ms).Conclusion Rs4938723-rs2187473-rs28757623 haplotype CCC in miR-34b/c gene might be risk factor for the onset of depression,miR-34b/c gene rs28757623 polymorphism is associated with the principal component of P300 latency in patients with Major depressive disorder which suggest that genetic factors may have a certain impact on cognitive function in the patients with major depressive disorder.

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.