Pregabalin, a structural analog of γ-aminobutyric acid (GABA), has been widely prescribed since its approval in 2004 for treating various neuropathic pain conditions. In Western countries, it is also approved for managing anxiety disorders. However, concerns about its potential for abuse and dependence have led to its reclassification as a second-line treatment in recent years. Although pregabalin addiction has been reported in international studies, there have been no such reports within China. This article presents a case of addiction stemming from pregabalin abuse to manage anxiety symptoms. The patient experienced withdrawal symptoms after discontinuing the drug, which were successfully treated. The development of pregabalin addiction, withdrawal symptoms, and the OD(overdose) pattern of drug abuse in this case should draw the attention of clinicians in China.

Pregabalin, a structural analog of γ-aminobutyric acid (GABA), has been widely prescribed since its approval in 2004 for treating various neuropathic pain conditions. In Western countries, it is also approved for managing anxiety disorders. However, concerns about its potential for abuse and dependence have led to its reclassification as a second-line treatment in recent years. Although pregabalin addiction has been reported in international studies, there have been no such reports within China. This article presents a case of addiction stemming from pregabalin abuse to manage anxiety symptoms. The patient experienced withdrawal symptoms after discontinuing the drug, which were successfully treated. The development of pregabalin addiction, withdrawal symptoms, and the OD(overdose) pattern of drug abuse in this case should draw the attention of clinicians in China.

BackgroundThe etiopathogenesis of major depressive disorder （MDD） is strongly associated with neuroinflammation. MDD is a highly heterogeneous psychiatric disorder， and the disease subtyping is an essential step for the identification of biological markers. The presence of psychomotor retardation seriously affects the prognosis of MDD， whereas the underlying mechanism is not yet completely clear. A potential involvement of granulocyte colony-stimulating factor （G-CSF） and macrophage colony-stimulating factor （M-CSF） in the pathogenesis of MDD with psychomotor retardation has been suggested in previous studies， but little detailed research has been completed. ObjectiveTo analyze the correlation of plasma G-CSF and M-CSF levels with psychomotor retardation in patients with MDD， and to explore the potential biological underpinnings of psychomotor retardation in MDD. MethodsA total of 50 MDD patients who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and attended the outpatient clinics of Shanghai Mental Health Center from April 2018 to April 2019 were included. The severity of symptoms was assessed using the Hamilton Depression Scale-17 item （HAMD-17）. According to the retardation factor in HAMD-17， patients with a score of ≥8 were included in retardation group （n=22）， and those with a score below 8 were included in non-retardation group （n=28）. Another 22 age- and sex-matched healthy controls were concurrently recruited. Plasma G-CSF and M-CSF levels were measured in all subjects using Luminex liquid suspension chip technology. Spearman correlation analysis was adopted to verify the correlation of retardation factor score in HAMD-17 with plasma G-CSF and M-CSF levels in MDD patients. ResultsPlasma G-CSF levels were decreased in MDD patients compared with healthy controls ［57.34（39.24， 83.15）pg/mL vs. 71.47（61.20， 79.99）pg/mL， Z=-2.098， P<0.05］. A statistical difference was found in plasma G-CSF level ［63.92（54.60， 89.43）pg/mL vs. 47.80（33.41， 74.66）pg/mL vs. 71.47（61.20， 79.99）pg/mL， H=8.247， P=0.016］ and plasma M-CSF level ［20.05（16.05， 22.23）pg/mL vs. 13.05（11.43， 17.50）pg/mL vs. 18.95（14.59， 22.88）pg/mL， H=7.620， P=0.022］ among retardation group， non-retardation group and healthy control group. The post hoc pairwise comparisons using Bonferroni correction indicated that plasma G-CSF level was lower in non-retardation group compared with healthy control group （adjusted P<0.05）， and plasma M-CSF level was higher in retardation group compared with non-retardation group （adjusted P<0.05）. The retardation factor score in HAMD-17 was positively correlated with plasma M-CSF level in MDD patients （r=0.348， P<0.05）. ConclusionThe prevalence of psychomotor retardation in MDD patients may be related to abnormally elevated plasma M-CSF level. ［Funded by Shanghai "Science and Technology Innovation Action Plan" Project in Medical Innovation Research Field （number， 21Y11905600）； Shanghai "Science and Technology Innovation Action Plan" Project in Natural Science Field （number， 21ZR1455100）； Shanghai Mental Health Center Scientific Research Project （number， 2021-YJ02）］

Pinealoma often comorbid with obstructive hydrocephalus due to their specific location and type, therefore, patients with pinealoma need to be treated by a combined ventriculoperitoneal shunt (VPS) along with surgical resection. Shunt failure is the most common complication after surgery. In this paper, we report a case of obstructive hydrocephalus caused by shunt obstruction after pineal gland tumor resection combined with ventriculoperitoneal shunt. The patient first showed low mood, decreased interest and energy, and gradually developed into manifestations of less eating, less talking, less movement, repeated psychiatric visits, and showed no improvement after treatment with antidepressants. The purpose of the current study is to increase the knowledge of these diseases and reduce misdiagnosis.

Pinealoma often comorbid with obstructive hydrocephalus due to their specific location and type, therefore, patients with pinealoma need to be treated by a combined ventriculoperitoneal shunt (VPS) along with surgical resection. Shunt failure is the most common complication after surgery. In this paper, we report a case of obstructive hydrocephalus caused by shunt obstruction after pineal gland tumor resection combined with ventriculoperitoneal shunt. The patient first showed low mood, decreased interest and energy, and gradually developed into manifestations of less eating, less talking, less movement, repeated psychiatric visits, and showed no improvement after treatment with antidepressants. The purpose of the current study is to increase the knowledge of these diseases and reduce misdiagnosis.

Anti-contactin-associated protein-like 2 (CASPR2) antibody encephalitis often presents with a mental disorder as the first symptom, which is more common in middle-aged and older men. However, adolescent females suffer from CASPR2 antibody-related encephalitis, while schizophrenia is rarely reported. This article reports a case of CASPR2 antibody-related encephalitis, ovarian cyst, and schizophrenia in a young female. Due to the complexity of clinical symptoms, the particularity of the course of the disease, and the richness of the diagnosis and treatment process, through the detection, diagnosis, and treatment of this disease, The process description of the case is expected to increase doctors′ experience in diagnosis and treatment of such comorbidities, and to increase the attention to adolescents suffering from CASPR2 antibody-related encephalitis.

Anti-contactin-associated protein-like 2 (CASPR2) antibody encephalitis often presents with a mental disorder as the first symptom, which is more common in middle-aged and older men. However, adolescent females suffer from CASPR2 antibody-related encephalitis, while schizophrenia is rarely reported. This article reports a case of CASPR2 antibody-related encephalitis, ovarian cyst, and schizophrenia in a young female. Due to the complexity of clinical symptoms, the particularity of the course of the disease, and the richness of the diagnosis and treatment process, through the detection, diagnosis, and treatment of this disease, The process description of the case is expected to increase doctors′ experience in diagnosis and treatment of such comorbidities, and to increase the attention to adolescents suffering from CASPR2 antibody-related encephalitis.

In the measurement-based care for patients with major depressive disorder, both self-report and clinician rating are commonly used for the assessment of symptoms. Self-report assessment has a significant advantage on time, economic and labor costs over clinician rating measurement, therefore it is worthy to explore if self-report assessment could replace clinician rating measurement for depression assessment. This article discussed literature evidence of the agreement, factors associated with rating difference, and usage suggestions on self-report and clinician rating assessment for depression.

In the measurement-based care for patients with major depressive disorder, both self-report and clinician rating are commonly used for the assessment of symptoms. Self-report assessment has a significant advantage on time, economic and labor costs over clinician rating measurement, therefore it is worthy to explore if self-report assessment could replace clinician rating measurement for depression assessment. This article discussed literature evidence of the agreement, factors associated with rating difference, and usage suggestions on self-report and clinician rating assessment for depression.