Objective: To describe the prevalence and the association of sleep quality trajectory, social jetlag and comorbid symptoms of anxiety and depression among college students, in order to provide a theoretical basis for improving the comorbid symptoms of anxiety and depression in college students. Methods: A questionnaire survey was conducted among 1 135 college students from two universities in Shangrao, Jiangxi Province and Hefei, Anhui Province from April to May 2019, and were followed up once every one year for a total of three times, with a valid sample size of 1 034 individuals after matching with the baseline survey. A selfassessment questionnaire was used to investigate the social jetlag of college students, the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire 9 (PHQ-9) were used to evaluate anxiety and depression symptoms, respectively, while the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. College students with GAD-7 score ≥5 and PHQ-9 score ≥5 were defined as having comorbid anxiety and depression symptoms. Latent class growth model (LCGM) was employed to analyze the sleep quality trajectory of college students, and binary Logistic regression was used to analyze the relationship between social jetlag, sleep quality trajectory and comorbid symptoms of anxiety and depression. Results: The detection rate of comorbid symptoms of anxiety and depression among college students was 16.9%, and the detection rate of social jetlag ≥2 h was 13.8%. The sleep quality showed an overall improvement trend, and the two trajectories were good sleep quality (81.6%) and poor sleep quality (18.4%). Binary Logistic regression model showed that poor sleep quality and social jetlag ≥2 h were positively correlated with comorbid symptoms of anxiety and depression (OR=5.94, 1.84, P<0.05). Conclusions Poor sleep quality and social jetlag ≥2 h in college students increase the risk of comorbid symptoms of anxiety and depression. Early screening and intervention of sleep quality and reduction of social jetlag are crucial for enhancing the mental health of college students.

Objective:To explore the relation of depressive and anxiety symptoms to defense mechanism in transgender population.Methods:Totally 451 transgender patients in the sexual and psychological outpatient depart-ment of a hospital were selected.They were assessed with the self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)and Defense Mechanism Scale(DSQ).The SDS standard score of ≥53 was classified as having depressive symptoms,and the SAS standard score of ≥50 was classified as having anxiety symptoms.Re-sults:The detection rates of depression and anxiety were 46.8％and 28.8％respectively.Multiple linear regression analysis showed that SDS scores were positively correlated with DSQ scores of projection,conceit,complaint,with-drawal,somatization,control,isolation and identity(β=0.08-0.22),while SDS scores were negatively correlated with DSQ scores of sublimation,depression,omnipotence with incompetence and denial(0=-0.09--0.19).The SAS scores were positively correlated with the DSQ scores of projection,latent manifestation,somatization,control,isolation,identity,and consumption tendency(0=0.09-0.26),while the SAS scores were negatively cor-related with the DSQ scores of sublimation,depression,omnipotence accompanied by incompetence,and denial(β=-0.09--0.15).Conclusion:The proportion of depression and anxiety symptoms detected in the transgender group is higher,which may be related to the use of some defenses.

Objective: To investigate the prevalence of depression and anxiety among transgender populations and the correlation with defense mechanism, so as to provide the evidence for improving mental health among transgender populations. Methods: Transgender populations that visited Psychosexual Outpatient Department of Beijing Huilongguan Hospital for the first time from December 2020 to December 2021 were enrolled. Participants' demographics, depression, anxiety and type of defense mechanisms were collected using self-designed questionnaires, Self-rating Depression Scale, Self-rating Anxiety Scale and Defense Style Questionnaire (DSQ). Factors affecting depression and anxiety were identified using a multivariable logistic regression model. Results: Totally 126 transgender individuals were enrolled, including 95 men (75.40%) with a mean age of (21.53±4.55) years and 31 women (24.60%) with a mean age of (23.58±5.55) years. The prevalence of depression was 46.83% among participants, including 44.07% of participants with mild depression, 30.51% with moderate depression and 25.42% with severe depression, and the prevalence of anxiety was 26.19% among participants, including 60.61% of participants with mild anxiety, 21.21% with moderate anxiety and 18.18% with severe anxiety. The detection of depression was 54.74% among men and 22.58% among women (P<0.05), and the detection of both depression (62.79% vs. 38.55%, P<0.05) and anxiety (41.86% vs. 18.07%, P<0.05) was significantly higher among transgender populations with self-injury or suicide behaviors than among those without. Multivariable logistic regression analysis showed that immature defense mechanisms increased the risk of depression (OR=1.034, 95%CI: 1.018-1.051) and anxiety (OR=1.031, 95%CI: 1.014-1.049) among transgender populations, while mature defense mechanisms reduced the risk of depression (OR=0.887, 95%CI: 0.832-0.946) and anxiety (OR=0.878, 95%CI: 0.821-0.938) among transgender populations. Conclusions The prevalence of depression and anxiety was 46.83% and 26.19% among transgender populations included in this study. Mature defense mechanisms are beneficial to reduce the risk of depression and anxiety among transgender populations. Key words： transgender population depression anxiety defense mechanism

Objective: To describe the prevalence and association of sleep quality and anxiety-depression co-morbid symptoms among nursing students, in order to provide a reference basis for promoting the development of nursing students mental health. Methods: Using a prospective study design, baseline survey was conducted in January 2019 among a random cluster sample of 1 716 individuals in three medical universities in Hefei, Anhui Province, and a follow-up survey was conducted in October 2019, with a valid number of 1 573 individuals after matching with the baseline survey. The Pittsburgh Sleep Quality Index (PSQI) was used to assess nursing students sleep quality, and the Depression Anxiety Stress Scale (DASS-21) to assess the anxiety-depression comorbid symptoms. Results: The detection rates of anxiety-depression co-morbidities among nursing students at baseline and follow-up survey were 16.9% and 18.2%, respectively, and the detection rates of poor sleep quality among nursing students at baseline and follow-up survey were 10.1% and 10.3%, respectively. The results of the binary Logistic regression model showed that baseline PSQI score were positively associated with the risk of anxiety-depression co-morbid symptoms among nursing students at baseline ( OR=1.49, 95%CI =1.40-1.59) and after nine months of follow-up ( OR=1.22, 95%CI =1.16-1.28). Furthermore, the influence of baseline sleep quality on the risk of anxiety-depression co-morbid symptoms were mainly concentrated in the five dimensions of sleep time, sleep efficiency, sleep disorders, hypnotic drugs and daytime dysfunction, and such effects of sleep time, sleep disorders and daytime dysfunction still existed in the follow-up investigation. Conclusion Poor sleep quality of nursing students can increase the risk of anxiety-depression co-morbidities. Improving sleep quality of nursing students has a positive effect on improving their mental health.

Objective:To explore the effect of attentional bias training on the attentional bias, psychological craving and relapse rate of alcohol dependent patients during rehabilitation.Methods:A randomized controlled trial was used to select 90 alcohol-dependent patients and randomly divide them into an intervention group and a control group. The alcohol cue pictures and neutral pictures were imported into E-Prime software at a ratio of 1∶1.The patients in the two groups were trained for eight times with attentional bias and without attentional bias by point delection paradigm. After each training, the software automatically records the response time and correct rate of the cue pictures and neutral pictures, and before intervention(T0), after 4 interventions(T4), and after 8 interventions(T8), the alcohol craving score was assessed by visual analogue scale and the relapse situation was followed up 1 month after the intervention. SPSS 24.0 software was used for statistical analysis.Repeat measure ANOVA, χ2 test and t-test were used to compare the response time, accuracy and psychological craving of the two groups. Results:Repeated measurement analysis of variance showed that there were interaction between group and time in cue-map response time, line chart accuracy and psychological craving score of the two groups ( F=5.218, 6.939, 147.14, all P<0.01). Simple effect analysis showed that there was no significant difference in cue pictures response time, cue pictures accuracy and psychological craving score between the intervention group and the control group at T0(all P>0.05), but there was significant difference at T4 and T8 (all P<0.05), and there was significant difference in neutral pictures reaction only at T8 ( P<0.05). The comparison between two groups showed that the intervention group showed a downward trend in cue pictures response, T4 and T8 were lower than T0, with statistical difference (both P<0.001), while there was no difference in the control group. In the intervention group, the correct rate of cue pictures increased, T4 and T8 were higher than T0, and there were statistical differences (both P<0.001), while there was no difference in the control group( P>0.05). The psychological craving scores of both the intervention group and the control group showed a downward trend, T4 and T8 were lower than T0, there were statistical differences (both P<0.001), but the difference between T4 and T8 in the control group remained unchanged. One month after the end of the intervention, the difference in the rate of relapse between the intervention group and the control group was marginal (11.10%, 26.70%, P=0.059). The total number of days of abstinence in the intervention group was longer than that in the control group ((28.33±4.99)d, (26.47±6.66)d, P=0.010). Conclusion:Attentional bias training can improve the mental craving and attentional bias of alcohol-dependent patients during the rehabilitation period, and the relapse rate decreased one month after the intervention.

Objective:To explore the effect of positive psychology theory on recovering patients with alcohol dependence.Methods:According to the order of admission, 60 patients with alcohol dependence in convalescence were divided into intervention group and control group, 30 cases each. The control group received only routine treatment for alcohol dependence. In addition to conventional treatment, the intervention group also underwent positive psychological treatment for 5 weeks to evaluate the changes in social support, negative automatic thinking, psychological craving, attention bias and other aspects at pre-baseline, week 1, week 3, and week 5 of treatment.Results:The positive psychology therapy had a good effect on the social support of alcohol-dependent patients. Except for the difference in the degree of support utilization in the intervention group ( P>0.05), the difference in other indicators was statistically significant ( F values were 1.653 - 6.571, P <0.01), while the difference in the subjective support score in the control group was statistically significant ( F value was 5.445, P<0.01). The time factors of repeated measurement anova showed that the total score of social support, objective support, subjective support, utilization of support, total score of automatic thinking and visual desire score were significantly different with the increase of treatment times ( F values were 3.324 - 17.153, P<0.01 or 0.05). The interaction between the total score of social support, subjective support, visual desire and intervention measures was significant ( F values were 9.331 - 17.578, P<0.01). The intergroup factors showed that the intervention measures had positive effects on the total score of social support, objective support, total score of automatic thinking and visual desire between the two groups, with statistically significant differences ( F values were 3.865-12.061, P<0.01 or 0.05). There was no statistically significant difference between the intervention group and the control group in response time of cue words, negative word response time and neutral word response time before intervention ( P> 0.05), and the response time of cue words in the intervention group was lower than that in the control group after intervention ( t value was -3.148, P<0.01). Before intervention in the intervention group and control group in the cue word correctly, negative word correctly, neutral accuracy differences of no statistical significance ( P > 0.05), after intervention intervention group negative word accuracy was higher than the control group, the difference was statistically significant ( t value was 2.298, P<0.05), and after the intervention intervention group neutral accuracy is higher than the control group, difference was statistically significant ( t value was 2.010, P<0.05). Conclusions:Positive psychological therapy can enhance the social support of alcohol-dependent patients, reduce the automatic thinking of patients, reduce the craving, and change the attention bias of alcohol-dependent patients, providing a basis for clinical research.

Objective To analyze the anxiety and depression state in housebound elderly subjects and their influencing factors so as to provide theoretical basis for improving the psychological status of the elderly.Methods Three hundred and fifty elderly patients aged ＞ 60 years suffering from anxiety and depression in two communities of Beijing were clusterly sampled and analyzed.The basic information of housebound elderly subjects with anxiety and depression was recorded during questionnaire survey.The influencing factors for anxiety and depression were explored by using the anxiety self-assessment scale and depression self-rating scale.Results Based on univariable analysis,the factors influencing anxiety and depression of the housebound elderly included ageing,lower cultural level,low income,infrequency of offspring visit and friends meeting,lost spouse,chronic diseases,many medications,and the unsatisfactory living environment(all P ＜ 0.05).However,the participating of entertainment activity and religious beliefs were not influencing factors(all P ＞ 0.05).Logistic multivariate regression showed that women (OR =1.432,95％CI:1.236 1.684,P＜0.05),low income(OR =2.078,95％ CI:1.675 2.412,P＜0.05),the widowed(OR =2.342,95 ％ CI:1.857-2.769,P ＜ 0.05),chronic diseases (OR =2.078,95 ％ CI:1.674-2.531,P＜0.05),medication (OR =3.056,95 ％ CI:2.678 3.756,P ＜ 0.05),less visit by children (OR =2.898,95％CI:2.475 3.425,P＜0.05),less friends visiting(OR=1.965,95％CI:1.685-2.446,P＜0.05) were risk factors for anxiety in the elderly.Meanwhile,women (OR =3.221,95 ％ CI:2.674-3.853,P ＜ 0.05),low income (OR =2.342,95 ％ CI:1.768-2.754,P ＜ 0.05),chronic disease (OR =2.078,95 ％ CI:1.564 2.675,P＜0.05),the widowed(OR=2.223,95％CI:1.789 2.746,P＜0.05),less visit by children (OR=2.987,95％CI:2.463-3.524,P＜0.05),less friends visiting(OR=2.658,95％CI:2.242 3.168,P＜0.05) and poor satisfaction with surrounding environment(OR =1.765,95 ％ CI:1.375 2.371,P＜0.05) were risk factors for depression among the elderly.Conclusions The elderly,especially those with advanced age,low cultural level,low economic income,living alone and poor living environment,are more likely to have anxiety and depression.Therefore,some effective corresponding measures should be taken in order to improve the psychological condition and life quality of old people.

Objective To understand the occurrence situation of negative life events in the past year among college students with suicidal ideation and to explore the correlation between negative life events and suicidal ideation. Methods The stratified and cluster sampling method was applied to conduct the questionnaire survey on 12 114 students from 11 universities in Chongqing City. The questionnaire of general demographic information was used to learn sociodemographic characteristics;the perspective on personal life questionnaire was applied to evaluate the suicidal ideation within recent 1 month and the self-designed life event scale was used to investigate the occurrence of negative life events in the past 1 year. Results The report rate of suicidal ideation within 1 month was 9.6%, the occurrence rate of short term suicidal ideation was increased with experiencing more negative life events. The x2 test showed that there was statistically significant difference in the proportion of suicidal ideation occurrence between college students experiencing 1 negative life event and those without experiencing the negative life event (x2 = 37.72,P<0.01) ;besides, the occurrence proportion of recent suicidal ideation had statistical difference between the college students with experiencing two or more negative life events and those without experiencing negative life event (x2 = 65.46,P<0.01). The multivariate Logistic regression analysis showed that the conflict with other family members (OR=0. 295,95%CI 0. 017-0. 571),abuse (OR=7. 295, 95%CI 6. 049-9. 701) were independentrisk factor for the recent suicidal ideation in college students. Conclusion Experiencing more negative life events, conflicting with other family members and abused by others have a correlation with the appearance of short term suicidal ideation in college students.

Objective To explore the application effect of preoperative interview by collective multidisciplinary education model in patients with breast cancer.Methods 126 patients with breast cancer, having undergone radical surgery from February 2015 to February. 2016, were selected and divided, by random number table method, into observation group and control group, each with 63 cases. Traditional mode of preoperative interview was conducted to patients in the control group, while preoperative interview by collective multidisciplinary education model was conducted to patients in the observation group. Anxiety, depression, stress response and satisfaction toward nursing between patients in the two groups were compared before and after intervention.Results After the interview, scores of anxiety and depression of patients in the observation group were (11.2±1.5) and (15.9±0.8) points, while the scores in the control group were (12.5±1.3) and (22.4±1.4) (t=2.032,5.007;P<0.01). Relief of anxiety and depression in the observation group was significantly better than that in the control group (P<0.05). Inside the operating room, before anesthesia was done, heart rate and systolic pressure of patients in the observation group were (71.5±3.9) time/min and (127.3±10.8) mmHg, all lower than that in the control group, which were (81.2±4.7) time/min and (145.2±12.6) mmHg (t=2.975 and 3.382,P<0.05). Satisfaction toward nursing in the observation group was 96.8%, higher than that in the control group, 82.5% (χ2=6.892,P<0.01).Conclusions Preoperative interview by collective multidisciplinary education model to patients with breast cancer can reduce their anxiety and depression, relieve stress response and improve satisfaction towards nursing.