Publications by authors named "Gaohua Wang"

77 Publications

Acute psychological impact of coronavirus disease 2019 outbreak among psychiatric professionals in China: a multicentre, cross-sectional, web-based study.

BMJ Open 2021 05 11;11(5):e047828. Epub 2021 May 11.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China

Objectives: To assess the magnitude of mental health outcomes and associated factors among psychiatric professionals in mental health services during COVID-19 in China.

Design, Setting And Participants: This cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from psychiatric professionals in 34 hospitals between 29 January and 7 February 2020, in China. Hospitals equipped with fever clinics or deployed on wards for patients with COVID-19 were eligible.

Primary Outcome And Measures: The severity of symptoms of depression, anxiety, insomnia and distress were assessed by the Chinese versions of 9-item Patient Health Questionnaire, 7-item Generalised Anxiety Disorder, 7-item Insomnia Severity Index and 22-item Impact of Event Scale-Revised, respectively. Multivariable logistic regression and structural equation modelling was performed to identify factors associated with mental health outcomes.

Results: A total of 610 psychiatric professionals were included. 29.8% were employed in Wuhan, and 22.5% were frontline workers. A considerable proportion of participants reported symptoms of depression (461 (75.6%)), anxiety (282 (46.2%)), insomnia (336 (55.1%)) and mental stress (481 (78.9%)). Psychiatric symptoms were associated with worrying about infection (eg, OR 2.36 (95% CI 1.27 to 4.39) for anxiety), risks of exposure to COVID-19 (eg, having inadequate personal protection equipment, OR 2.43 (1.32 to 4.47) for depression) and self-perceived physical health (eg, OR 3.22 (2.24 to 4.64) for mental stress). Information sources of COVID-19 were also found to be both positively (eg, information from relatives, OR 2.16 (1.46 to 3.21) for mental stress) and negatively (eg, information from TV, OR 0.52 (0.35 to 0.77) for mental stress) associated with mental stress. There is preliminary evidence that mental health might benefit from greater availability of mental healthcare services. The structural equation model analysis indicated that worrying about infection may be the primary mediator via which risk of exposure to COVID-19 pandemic affects the mental health of psychiatric professionals.

Conclusions: The current findings demonstrate several pathways via which the COVID-19 pandemic may have negatively affected the mental health of psychiatric professionals in China.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2020-047828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117468PMC
May 2021

Neurogenic hypothesis of positive psychology in stress-induced depression: Adult hippocampal neurogenesis, neuroinflammation, and stress resilience.

Int Immunopharmacol 2021 Apr 26;97:107653. Epub 2021 Apr 26.

Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No.238, Wuhan 430060, China. Electronic address:

Stress is an important risk factor for depression. Emerging evidence supports the hypothesis that stress-mediated neuroinflammation destroys brain function and leads to anxiety-like and depression-like behaviors. Previous studies of stress-induced depression have mainly focused on pathological damage; however, the rise of positive psychology has attracted the interest of many researchers in environmental enrichment to promote stress resilience. The hippocampus is one of the most severely damaged brain regions in stress-induced depression. In addition, the hippocampus is one of the most unique regions in the brain, as new neurons are produced in the adult hippocampus, a process known as adult hippocampal neurogenesis (AHN). AHN is an important core component of the neurogenic hypothesis and has also become a major innovative breakthrough in positive psychology, in which environmental enrichment mediates stress resilience. Neuroinflammation, by activating microglia and releasing some proinflammatory cytokines, is increasingly shown to be one of the key determinant pathophysiological factors that negatively affects AHNand cognitive reserve. AHN is mainly related to remodeling stress response mechanisms, such as memory clearing, emotional control, and pattern separation, suggesting that a correlation may exist between neuroinflammation and AHN in stress resilience. Therefore, we summarized the previous research results to systematically expound on the relationship between AHN, stress resilience, and neuroinflammation. We hope this neurogenic hypothesis of positive psychology in stress-induced depression will provide a new perspective for the study of depression and antidepressant therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.intimp.2021.107653DOI Listing
April 2021

Neuroinflammation decreased hippocampal microtubule dynamics in the acute behavioral deficits induced by intracerebroventricular injection of lipopolysaccharide in male adult rats.

Neuroreport 2021 May;32(7):603-611

Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang, Wuhan, China.

Neuroinflammation plays a vital role in the pathology of depression. Microtubule dynamics produces an immediate response to stress, but the effect of microtubule dynamics in the rats with acute behavioral deficits following a central immune challenge remains elusive. Adult male Sprague-Dawley rats were subjected to the intracerebroventricular (icv) injection of lipopolysaccharide (. Behavioral tests, including bodyweight, sucrose preference test (SPT), forced swimming test (FST) and open field test (OFT), were performed to evaluate anxiety-like and depressive-like phenotypes at 24 h after injection, and some neuroinflammation biomarkers and microtubule dynamics in the hippocampus were detected. Lipopolysaccharide decreased the bodyweight, sucrose preference in SPT (depressive-like behavior), spontaneous activity in OFT (anxiety-like behavior) and increased the immobility time in FST (depressive-like behavior). Besides, lipopolysaccharide increased the mRNA levels of hippocampal CD11b and ionized calcium binding adaptor molecule (Iba1), which suggest microglial activation, and also upregulated hippocampal NLR Family Pyrin Domain Containing 3 inflammasome/interleukin-18/nuclear factor kappa-B mRNA. Lipopolysaccharide injection(icv) reduced the ratio of Tyr-/Acet-tubulin, an important marker of microtubule dynamics, in the acute behavioral deficit rats. Specifically, a decrease in Tyr-tubulin and an increase in the expression of Acet-tubulin were observed, indicating weakened microtubule dynamics. Pearson correlation analysis further showed that there was a significant negative correlation between hippocampal microtubule dynamics and neuroinflammatory activity. This study confirmed that hippocampal microtubule dynamics was decreased in the rats with acute behavioral deficits following a central immune challenge.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/WNR.0000000000001638DOI Listing
May 2021

Effects of CRMP2 DNA Methylation in the Hippocampus on Depressive-Like Behaviors and Cytoskeletal Proteins in Rats.

Front Cell Neurosci 2021 17;15:644663. Epub 2021 Mar 17.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.

Chronic stress appears to alter DNA methylation and DNA methyltransferases (DNMTs) in brain regions related to emotion. Collapsin response mediator protein-2 (CRMP2) mediates the development of depression by regulating microtubule dynamics. In this study, rats were subjected to chronic unpredictable mild stress (CUMS). At the end of the CUMS procedure, normal saline or fluoxetine was administered to the rats. Moreover, normal saline or the 5-aza-2'-deoxycytidine (5-aza) was administered to the hippocampal CA1 region of the rats. Behavioral tests were performed to evaluate the depressive-like phenotypes. The CRMP2 DNA methylation levels and cytoskeletal microtubular system-related biomarkers were detected by several molecular biology techniques. The results showed that the rat model of depression was successfully established by exposure to CUMS, and fluoxetine treatment exerted an antidepressant-like effect. We observed the upregulation of DNMT1 and DNMT3a in the hippocampus of stressed rats. CUMS induced a decrease in CRMP2 expression and an increase in phosphorylated CRMP2 (pCRMP2) expression in the hippocampus of rats. The rate of DNA methylation in the CpG island of the CRMP2 promoter region in the hippocampus of stressed rats was significantly higher than that in control rats. Moreover, CUMS significantly decreased the interaction between CRMP2 and α-tubulin and decreased the microtubule dynamics. Chronic fluoxetine treatment reversed these changes. Also, hypomethylation induced by 5-aza injection into the hippocampal CA1 region caused antidepressant-like effects and increased CRMP2 expression and microtubule dynamics. These results suggested that CRMP2 DNA methylation may be involved in regulating the cytoskeletal microtubular system and mediating depressive-like behaviors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fncel.2021.644663DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010135PMC
March 2021

Brief postpartum separation from offspring promotes resilience to lipopolysaccharide challenge-induced anxiety and depressive-like behaviors and inhibits neuroinflammation in C57BL/6J dams.

Brain Behav Immun 2021 Jul 23;95:190-202. Epub 2021 Mar 23.

Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No.238, Wuhan 430060, China. Electronic address:

Emerging evidence indicates an important role for neuroinflammation in depression. Brief maternal separation promotes resilience to depression in offspring, but relatively little is known about the effects of different durations of postpartum separation (PS) from offspring on anxiety and depressive-like behaviors in dams following immune challenge. Lactating C57BL/6J mice were subjected to no separation (NPS), brief PS (15 min/day, PS15) or prolonged PS (180 min/day, PS180) from postpartum day (PPD) 1 to PPD21 and then injected with lipopolysaccharide (LPS). Behavioral tests, including the open field test (OFT) and forced swimming test (FST), were carried out at 24 h after the injection. LPSresulted in anxiety and depressive-like behaviors in NPS dams and activated ionized calcium-binding adaptor molecule (Iba1), an important biomarker of microglia, in the hippocampus. However, compared with NPS + LPS dams, PS15 + LPS dams spent significantly more time in the center of the OFT (anxiety-like behavior) and exhibited lower immobility time in the FST (depressive-like behavior), which indicated a phenomenon of resilience. Furthermore, the activation of neuroinflammation was inhibited in PS15 dams. Specifically, levels of the Iba1 mRNA and protein were decreased, while the mRNA expression of NLR family pyrin domain containing 3 (NLRP3) inflammasome/interleukin-18 (IL-18)/nuclear factor kappa-B (NF-κB) was decreased in the hippocampus. Furthermore, positive linear correlations were observed between microglial activation and LPS-induced depressive-like behaviors in dams. Collectively, the findings of this study confirm that brief PS from offspring promotes resilience to LPS immune challenge-induced behavioral deficits and inhibits neuroinflammation in dams separated from their offspring during lactation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bbi.2021.03.016DOI Listing
July 2021

Discrepancies between self-rated depression and observed depression severity: The effects of personality and dysfunctional attitudes.

Gen Hosp Psychiatry 2021 May-Jun;70:25-30. Epub 2020 Dec 2.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China. Electronic address:

Background: Patient self-reports and clinician ratings of depression severity can differ substantially. The aim of the current study was to explore factors associated with discrepancies between depressed patients' Patient Health Questionnaire (PHQ-9) self-reports and clinicians' Hamilton Rating Scale for Depression (HAMD-17) ratings.

Methods: We first computed discrepancy scores defined as the standardized weighted HAMD-17 total score minus the standardized PHQ-9 total score. To assess correlates of inconsistent scores, results of patients with similar standardized scores were removed (i.e., within ½ standard deviation, n = 270). Positive values indicate underreporting (HAMD-17 > PHQ-9), i.e., the underreporting group (n = 200); and negative discrepancy scores indicate overreporting (PHQ-9 > HAMD-17), i.e., the overreporting group (n = 221). We examined the relationship of demographic, dysfunctional attitudes and personality variables to the discrepancies between self and observer rated depression.

Results: There were significant differences in extraversion, psychoticism, neuroticism, dysfunctional attitudes and occupation between the underreporting group and the overreporting group (all p < .05). When controlling for potential confounding variables, being a working professional and having high neuroticism and dysfunctional attitudes were significantly associated with overestimating symptoms of depression (e.g., professional: OR, 2.89; 95% CI, 1.67-5.00; p < .001; high neuroticism: OR, 7.08; 95% CI, 1.47-34.08; p < .001;dysfunctional attitudes: OR, 1.01; 95% CI, 1.00-1.02; p = .030). People with average, or high extraversion tended to underestimate scores (average extraversion: OR, 0.59; 95% CI, 0.37-0.95; high extraversion: OR, 0.48; 95% CI, 0.24-0.98).

Conclusions: This study is the first to use PHQ-9 and HAMD-17 to explore the discrepancies between self and observer rated depression. Discrepancies occurred between the PHQ-9 score and HAMD-17 score, which were related to neuroticism, extraversion, dysfunctional attitudes and being a working professional. Future research should clarify the relationship between these factors and therapeutic effects of treatments, including adverse outcomes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.genhosppsych.2020.11.016DOI Listing
December 2020

Sustained low-dose prophylactic early erythropoietin for improvement of neurological outcomes in preterm infants:A systematic review and meta-analysis.

J Affect Disord 2021 03 12;282:1187-1192. Epub 2021 Jan 12.

Department of Psychiatry, Renmin Hospital of Wuhan University, Hubei Zhang Road (formerly Ziyang Road), Wuchang District No. 99, Jiefang Road 238, Wuhan, Hubei province, China. Electronic address:

The aim of this meta-analysis was conducted to assess the effects of different doses of prophylactic rhEPO on neurodevelopmental outcomes and provide reference for rational drug use. The primary outcome was the number of infants with a Mental Developmental Index (MDI) <70 on the Bayley Scales of Infant Development. Five RCTs, comprising 2282 infants, were included in this meta-analysis. Overall, prophylactic rhEPO administration reduced the incidence of infants with an MDI <70, with an odds ratio (95% confidence interval) of 0.55 (0.38-0.79), P <0.05. The low-dose rhEPO subgroup was superior to the placebo subgroup, with an OR (95% CI) of 0.47 (0.25-0.87), P <0.05. However, high-dose rhEPO subgroup had no significant impact on MDI <70 in infants <28 weeks' gestational age. The definitions of the secondary outcome showed that there was no significant effect of rhEPO on cerebral palsy. For neonatal complications, although four studies showed that there were no differences in the pooled results of BPD and ICH events between rhEPO treatment and placebo, the ICH events were significantly lower in the low-dose rhEPO (OR 0.36; 95% CI 0.23-0.59). In addition, in the pooled results of NEC and ROP events, there were significant differences between the two groups (OR 0.63; 95% CI 0.43-0.93) (OR 0.80; 95% CI 0.65-0.98). And the NEC events were significantly lower in the low-dose rhEPO (OR 0.45; 95% CI 0.27-0.73). Sustained low-dose prophylactic early erythropoietin might be more superior than high-dose for improvement of neurological outcomes and several neonatal complications in preterm infants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jad.2021.01.018DOI Listing
March 2021

Comparative Efficacy of Various Pharmacological Interventions in the Treatment of Functional Dyspepsia: A Network Meta-Analysis.

Dig Dis Sci 2021 Feb 15. Epub 2021 Feb 15.

Department of Psychiatry, Renmin Hospital of Wuhan University, Hubei Zhang Road (Formerly Ziyang Road), Wuchang District No. 99, Jiefang Road 238, Wuhan, Hubei Province, China.

Background And Aim: Patients with functional dyspepsia often select different pharmacological treatments. We aimed to compare and rank the efficacy of different pharmacological interventions in treating functional dyspepsia.

Methods: We searched EMBASE, PubMed, Cochrane, Web of Science and MEDLINE from the date of database inception to March 28, 2019. A random-effects model was selected to conduct traditional meta-analysis to directly examine the efficacy of different pharmacological interventions. The consistency model was selected to conduct a network meta-analysis to evaluate the relative effects and rank probability of different pharmacological interventions.

Results: We included 58 trials (15,629 participants and 21 pharmacological treatments). Network meta-analysis showed that cisapride, domperidone, itopride, and levosulpiride were better than placebo, especially in short term (< 4 weeks). And levosulpiride was significantly more effective than 15 other drugs and placebo (ORs ranging between 0.05 and 0.15). Cisapride was significantly more effective than lansoprazole (OR 0.30, 95% CrI 0.09-0.99) and tegaserod (OR 0.26, 95% CrI 0.07-0.98). The rank probability showed that levosulpiride was most likely to be rank 1 (77%), cinitapride rank 2 (17%), and cisapride rank 3 (23%).

Conclusions: Our study confirmed the effectiveness of several pharmacological treatments for ameliorating functional dyspepsia. Furthermore, levosulpiride relatively ranked the best in managing FD. Physicians should be encouraged to apply promising pharmacological interventions (e.g., levosulpiride and cisapride). However, the results should be interpreted with caution due to small study effects.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10620-021-06846-1DOI Listing
February 2021

Integrated Analysis of Methylomic and Transcriptomic Data to Identify Potential Diagnostic Biomarkers for Major Depressive Disorder.

Genes (Basel) 2021 Jan 27;12(2). Epub 2021 Jan 27.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China.

Major depressive disorder (MDD) is a mental illness with high incidence and complex etiology, that poses a serious threat to human health and increases the socioeconomic burden. Currently, high-accuracy biomarkers for MDD diagnosis are urgently needed. This paper aims to identify novel blood-based diagnostic biomarkers for MDD. Whole blood DNA methylation data and gene expression data from the Gene Expression Omnibus database are downloaded. Then, differentially expressed/methylated genes (DEGs/DMGs) are identified. In addition, we made a systematic analysis of the DNA methylation on 5'-C-phosphate-G-3' (CpGs) in all of the gene regions, as well as different gene regions, and then we defined a "dominant" region. Subsequently, integrated analysis is employed to identify the robust MDD-related blood biomarkers. Finally, a gene expression classifier and a methylation classifier are constructed using the random forest algorithm and the leave-one-out cross-validation method. Our results demonstrate that DEGs are mainly involved in the inflammatory response-associated pathways, while DMGs are primarily concentrated in the neurodevelopment- and neuroplasticity-associated pathways. Our integrated analysis identified 46 hypo-methylated and up-regulated (hypo-up) genes and 71 hyper-methylated and down-regulated (hyper-down) genes. One gene expression classifier and two DNA methylation classifiers, based on the CpGs in all of the regions or in the dominant regions are constructed. The gene expression classifier possessed the best predictive ability, followed by the DNA methylation classifiers, based on the CpGs in both the dominant regions and all of the regions. In summary, the integrated analysis of DNA methylation and gene expression has identified 46 hypo-up genes and 71 hyper-down genes, which could be used as diagnostic biomarkers for MDD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/genes12020178DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912210PMC
January 2021

Prevalence and Characteristics of Obsessive-Compulsive Disorder Among Urban Residents in Wuhan During the Stage of Regular Control of Coronavirus Disease-19 Epidemic.

Front Psychiatry 2020 16;11:594167. Epub 2020 Dec 16.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.

Coronavirus disease-19 (Covid-19) is one of the most devastating epidemics in the 21st century, which has caused considerable damage to the physical and mental health of human beings. Despite a few regions like China having controlled the epidemic trends, most countries are still under siege of COVID-19. As the emphasis on cleaning and hygiene has been increasing, the problems related to obsessive-compulsive disorder (OCD) may appear. This study was designed to investigate the prevalence of OCD in the urban population in Wuhan during the stage of regular epidemic control and prevention. Meanwhile, characteristics and risk factors for OCD were also explored. Five-hundred and seventy residents in urban areas of Wuhan were recruited using the snowball sampling method to complete questionnaires and an online interview from July 9 to July 19, 2020. Collected information encompassed socio-demographics, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores, Social Support Rating Scale (SSRS) scores and Pittsburgh Sleep Quality Index(PSQI) values. Three months after lifting the quarantine in Wuhan, the prevalence of OCD was 17.93%. About 89% of OCD patients had both obsessions and compulsions, while 8% had only obsessions and 3% had only compulsions. Top 3 common dimensions of obsessions were miscellaneous (84.0%), aggressive (76.6%), and contamination (48.9%), and of compulsions were miscellaneous (64%), checking (51.7%), and cleaning/washing/repeating (31.5%). The unmarried were more vulnerable to OCD than the married ( < 0.05, odds ration = 1.836). Students had 2.103 times the risk of developing OCD than health care workers ( < 0.05). Those with positive family history of OCD and other mental disorders ( < 0.05, odds ration = 2.497) and presence of psychiatric comorbidity ( < 0.05, odds ration = 4.213) were also at higher risk. Each level increase in sleep latency increased the risk of OCD to 1.646 times ( < 0.05). In the background of regular epidemic control, the prevalence of OCD was high, and the symptoms were widely distributed. Obsessions often accompanied compulsions. Being single and a student, positive family history of OCD and other mental disorders, presence of psychiatric comorbidity, and longer sleep latency were predictors of OCD. Early recognition and detection of these issues may help to intervene in OCD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyt.2020.594167DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7772465PMC
December 2020

Oridonin ameliorates insulin resistance partially through inhibition of inflammatory response in rats subjected to chronic unpredictable mild stress.

Int Immunopharmacol 2021 Feb 31;91:107298. Epub 2020 Dec 31.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China. Electronic address:

Background: Oridonin (Ori) has multiple biological properties, especially anti-inflammatory. However, its effects on chronic unpredictable mild stress (CUMS)-induced insulin resistance are still unclear. In this study, we explored the regulatory role of Ori in CUMS-triggered insulin resistance, and the underlying molecular mechanisms; Methods: SD rats were subjected to CUMS for 4 weeks, some of which were injected with Ori or fluoxetine (FLX) in durations of CUMS. After CUMS procedure, the behavioral and metabolic tests were performed. Elisa, immunofluorescence and western blotting were used to determine the inflammatory response and NLRP3 inflammasome activation. We investigated the interaction between NLRP3 and NEK7 using immunoprecipitation. Finally, we detected the proinflammatory cytokines in Lipopolysaccharide (LPS)-activated RAW264.7 cells treated with Ori; RESULTS: In this study, we found that chronic stress resulted in depressive-like behavior comorbid with insulin resistance. Ori was discovered to ameliorate insulin resistance as well as insulin signaling disturbance in the hippocampus. In addition, CUMS caused the infiltration of macrophages into the islets. And IL-1β, IL-18 and caspase-1 were elevated in pancreases of CUMS rats, which could also be reversed by Ori treatment via reducing the interaction between NLRP3 and NEK7. Furthermore, Ori dose-dependently inhibited the levels of IL-1β and IL-18 in LPS-activated RAW264.7 cells; CONCLUSIONS: All these results supported our hypothesis that Ori possesses potent anti-insulin resistant actions, which is partially correlated with inhibiting infiltration of macrophages into the islets and NLRP3 activation induced by CUMS. Therefore, our results highlighted the protective role of Ori against CUMS-elicited insulin resistance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.intimp.2020.107298DOI Listing
February 2021

The Psychological Pressures of Breast Cancer Patients During the COVID-19 Outbreak in China-A Comparison With Frontline Female Nurses.

Front Psychiatry 2020 15;11:559701. Epub 2020 Dec 15.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.

During the outbreak of the COVID-19 epidemic in China, breast cancer (BC) patients and healthcare workers faced several challenges, resulting in great psychological stress. We measured the psychological status of BC patients and female nurses and compared the severity within the two groups at the peak time-point of the COVID-19 outbreak. A total of 207 BC patients and 684 female nurses were recruited from Wuhan. They completed an anonymous questionnaire online using the most popular social media software in China, WeChat. The psychological status of BC patients and of female nurses was measured using the Chinese versions of the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), the 7-item Insomnia Severity Index (ISI), and the 22-item Impact of Event Scale-Revised (IES-R) for evaluation of post-traumatic stress disorder (PTSD). The differences between the two groups were analyzed. The scores of BC patients and frontline female nurses for the four scales were significantly higher than those of non-frontline female nurses ( < 0.001). There were similar scores between BC patients and frontline female nurses for PHQ-9, GAD-7, and IES-R ( = 0.789, = 0.101, = 0.158, respectively). Notably, the scores of BC patients for ISI were significantly higher than those of the frontline female nurses ( = 0.016). A considerable proportion of BC patients reported symptoms of depression (106/207, 51.2%), anxiety (130/207, 62.8%), insomnia (106/207, 51.2%), and PTSD (73/207, 35.5%), which was more severe than that of female nurses. BC patients experienced great psychological pressure during the COVID-19 outbreak. The incidents of symptomatic anxiety, depression, sleep disorders, and PTSD were significantly comparable to that of frontline female nurses, and episodes of insomnia among BC participants were more serious than for frontline female nurses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyt.2020.559701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769818PMC
December 2020

Clinical characteristics of familial schizophrenia.

Asia Pac Psychiatry 2021 Jun 14;13(2):e12422. Epub 2020 Oct 14.

Department of Psychiatry, Xijing Hospital, Xi'an, China.

Introduction: A family history of psychiatric disorders is one of the strongest risk factors for schizophrenia. The characteristics of patients with a family history of psychiatric disorders have not been systematically evaluated.

Methods: This multicenter study (26 centers, 2425 cases) was performed in a Chinese population to examine the sociodemographic and clinical characteristics of schizophrenia patients with a family history of psychotic disorders in comparison with those of patients with sporadic schizophrenia.

Results: Nineteen percent of patients had a family history of mental disease. Multiple logistic regression analysis revealed that ≥4 hospitalizations (OR = 1.78, P = .004), tobacco dependence (OR = 1.48, P = .006), alcohol dependence (OR = 1.74, P = .013), and physical illness (OR = 1.89, P = .001) were independently and significantly associated with a family history of mental disease.

Conclusion: Patients with a family history of mental disorders present different demographics and clinical features than patients without a family history of psychiatric disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/appy.12422DOI Listing
June 2021

Acute psychological effects of Coronavirus Disease 2019 outbreak among healthcare workers in China: a cross-sectional study.

Transl Psychiatry 2020 10 13;10(1):348. Epub 2020 Oct 13.

Department of Psychiatry, Renmin Hospital of Wuhan University, 430060, Wuhan, China.

To study the acute psychological effects of Coronavirus Disease 2019 (COVID-19) outbreak among healthcare workers (HCWs) in China, a cross-sectional survey was conducted among HCWs during the early period of COVID-19 outbreak. The acute psychological effects including symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) were assessed using the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder (GAD-7) questionnaire, and the Impact of Event Scale-Revised (IES-R). The prevalence of depression, anxiety, and PTSD was estimated at 15.0%, 27.1%, and 9.8%, respectively. Having an intermediate technical title, working at the frontline, receiving insufficient training for protection, and lacking confidence in protection measures were significantly associated with increased risk for depression and anxiety. Being a nurse, having an intermediate technical title, working at the frontline, and lacking confidence in protection measures were risk factors for PTSD. Meanwhile, not worrying about infection was a protective factor for developing depression, anxiety, and PTSD. Psychological interventions should be implemented among HCWs during the COVID-19 outbreak to reduce acute psychological effects and prevent long-term psychological comorbidities. Meanwhile, HCWs should be well trained and well protected before their frontline exposure.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41398-020-01031-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552583PMC
October 2020

Nurses endured high risks of psychological problems under the epidemic of COVID-19 in a longitudinal study in Wuhan China.

J Psychiatr Res 2020 12 14;131:132-137. Epub 2020 Sep 14.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, PR China. Electronic address:

Background: Health care workers, especially frontline nurses, faced great challenges during the coronavirus disease 2019 (COVID-19) outbreak.

Aims: To assess the magnitude of the psychological status and associated risk factors among nurses in the pandemic center in Wuhan, China.

Methods: In this study, we enrolled nurses from Renmin Hospital of Wuhan University. The questionnaire was designed to obtain basic information of the participants, and included four psychological assessment scales. We issued the questionnaires at two different points of time. We conducted the first survey on January 29 to February 2 (outbreak period) with 709 eligible responses, and the second survey on February 26 to February 28 (stable period) with 621 eligible responses. The nurses from Wuchang Fangcang shelter hospital were also enrolled in the second survey.

Results: During the pandemic, over one-third of nurses suffered from depression, anxiety, and insomnia. In the outbreak period, the nurses showed significantly higher risks for depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms than those in the stable period (P < 0.01). Notably, the nurses from the Fangcang shelter hospitals were more likely to present psychological problems than those from other frontline or non-frontline (all P < 0.001) units, especially for insomnia (38.3% with severe insomnia). The nurses from the frontline, with worse physical condition and uncertain concerns about this pandemic as compared to the others, were more likely to bear psychological problems. Thus, online psychological information and sufficient protection conditions were effective interventions to help mitigate psychological distress. The nurses from Fangcang shelter hospitals suffered a significantly higher risk of psychological problems than those from other units.

Conclusion: The psychological status of nurses needs more attention during the COVID-19 pandemic, especially for those who fought in the frontline during the peak of the outbreak.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpsychires.2020.09.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489269PMC
December 2020

Psychological intervention in Fangcang shelter hospitals for COVID-19 in China.

Psychiatry Clin Neurosci 2020 11 25;74(11):618-619. Epub 2020 Sep 25.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/pcn.13149DOI Listing
November 2020

Organized Resting-state Functional Dysconnectivity of the Prefrontal Cortex in Patients with Schizophrenia.

Neuroscience 2020 10 25;446:14-27. Epub 2020 Aug 25.

CAS Key Laboratory of Behavioral Science & Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of the Chinese Academy of Sciences, Beijing 100049, China. Electronic address:

Schizophrenia has prominent functional dysconnectivity, especially in the prefrontal cortex (PFC). However, it is unclear whether in the same group of patients with schizophrenia, PFC functional dysconnectivity appears in an organized manner or is stochastically located in different subregions. By investigating the resting-state functional connectivity (rsFC) of each PFC subregion from the Brainnetome atlas in 40 schizophrenia patients and 40 healthy subjects, we found 24 altered connections in schizophrenia, and the connections were divided into four categories by a clustering analysis: increased connections within the PFC, increased connections between the inferior PFC and the thalamus/striatum, reduced connections between the PFC and the motor control areas, and reduced connections between the orbital PFC and the emotional perception regions. In addition, the four categories of rsFC showed distinct cognitive engagement patterns. Our findings suggest that PFC subregions have specific functional dysconnectivity patterns in schizophrenia and may reflect heterogeneous symptoms and cognitive deficits in schizophrenia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.neuroscience.2020.08.021DOI Listing
October 2020

Clinical Characteristics of Pregnant Women With Coronavirus Disease 2019 in Wuhan, China.

Open Forum Infect Dis 2020 Aug 11;7(8):ofaa294. Epub 2020 Jul 11.

Department of Psychiatry, Renmin Hospital, Wuhan University, Wuhan, China.

Background: Coronavirus disease 2019 (COVID-19) has become a pandemic. Despite the growing number of patients with COVID-19 infection, data on the clinical characteristics of pregnant patients are still limited.

Methods: We retrospectively included childbearing-age female patients with laboratory-confirmed COVID-19 at Renmin Hospital of Wuhan University from January 15 to February 23, 2020. Demographic, clinical, radiological, laboratory, and treatment data were reviewed. Clinical characteristics of pregnant and nonpregnant patients were compared.

Results: One hundred eleven childbearing-age women with COVID-19 were included, including 16 patients (14.4%) with severe or critical disease. Compared with nonpregnant patients (n = 80), pregnant patients (n = 31) were less likely to have dyspnea (16.1% vs 37.5%), asthenia (3.2% vs 33.8%), and ≥3 symptoms (22.6% vs 45.0%); had a significantly higher neutrophil count (5.2 vs 2.5 ×10/L) and a higher percentage of CD3+ cells (76.7% vs 73.7%) and CD8+ cells (32.3% vs 28.4%); and had a dramatically lower percentage of lymphocytes (18.2% vs 31.8%), a lower CD4+/CD8+ ratio (1.2 vs 1.4), and a lower level of IgG (9.8 vs 11.9 g/L). Of note, pregnant patients had a significantly lower percentage of severe disease (3.2% vs 18.8%) and a substantially higher level of inflammation markers including neutrophil-to-lymphocyte ratio (4.4 vs 1.9) and systematic inflammatory index (812.8 vs 354.7) than nonpregnant patients. Seventeen live births were recorded, and all of these showed negative results of postnatal COVID-19 detection together with a normal Apgar score.

Conclusions: Pregnant patients with COVID-19 had a lower level of severity and an enhanced inflammatory response and cell immunity when compared with nonpregnant patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ofid/ofaa294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395671PMC
August 2020

Targeted long-term mental health services in Wuhan dealing with COVID-19.

Eur Arch Psychiatry Clin Neurosci 2021 Mar 27;271(2):397-399. Epub 2020 Jul 27.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00406-020-01178-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7383651PMC
March 2021

Resilience in the LPS-induced acute depressive-like behaviors: Increase of CRMP2 neuroprotection and microtubule dynamics in hippocampus.

Brain Res Bull 2020 09 6;162:261-270. Epub 2020 Jul 6.

Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No. 238, Wuhan, 430060, China.

Depressive-like behaviors occur at 24 h after lipopolysaccharide (LPS) injection, but whether the animals have resilience has not been reported. This study is to explore the existence of resilience in the LPS-induced acute depressive-like behaviors and its biological changes in the neuroprotection and microtubule dynamics. The behavioral tests of Sprague-Dawley male rats, including body weight (BW), sucrose preference test (SPT), forced swimming test (FST) and open field test (OFT), which are used to explore depressive and anxiety-like behaviors, were detected at 24 h after intraperitoneal injection of LPS. In the LPS-induced depression group, body weight and sucrose preference index in SPT were decreased, the immobility time in FST was increased, total distance, time in central zone and frequency of rearing in OFT were decreased. However, there was not any difference in behavioral phenotypes between the resilient animals and the saline control group. The activity of collapsing response mediator protein 2 (CRMP2), which is related to neuronal plasticity and neuroprotection, was increased in resilient rats. The brain-derived neurotrophic factor (BDNF) mRNA expression was also increased. The ratio of Tyr/Acet-tubulin in hippocampus, which is an important marker of microtubule dynamics, was increased without alpha-tubulin. In addition, the expression of CRMP2 and alpha-tubulin in dentate gyrus (DG) region increased in resilient animals, but not in CA1 and CA3 regions. This study firstly confirms the phenomenon of resilience in the LPS-induced acute depressive-like behaviors animal model. CRMP2 neuroprotection and microtubule dynamics in hippocampus are enhanced in this phenomenon of resilience, which may functionally contribute to resilience but need further research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.brainresbull.2020.06.015DOI Listing
September 2020

Dihydrolipoic acid protects against lipopolysaccharide-induced behavioral deficits and neuroinflammation via regulation of Nrf2/HO-1/NLRP3 signaling in rat.

J Neuroinflammation 2020 May 25;17(1):166. Epub 2020 May 25.

Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road 238#, Wuhan, 430060, Hubei, PR China.

Background: Recently, depression has been identified as a prevalent and severe mental disorder. However, the mechanisms underlying the depression risk remain elusive. The neuroinflammation and NLRP3 inflammasome activation are known to be involved in the pathology of depression. Dihydrolipoic acid (DHLA) has been reported as a strong antioxidant and exhibits anti-inflammatory properties in various diseases, albeit the direct relevance between DHLA and depression is yet unknown. The present study aimed to investigate the preventive effect and potential mechanism of DHLA in the lipopolysaccharide (LPS)-induced sickness behavior in rats.

Methods: Adult male Sprague-Dawley rats were utilized. LPS and DHLA were injected intraperitoneally every 2 days and daily, respectively. Fluoxetine (Flu) was injected intraperitoneally daily. PD98059, an inhibitor of ERK, was injected intraperitoneally 1 h before DHLA injection daily. Small interfering ribonucleic acid (siRNA) for nuclear factor erythroid 2-like (Nrf2) was injected into the bilateral hippocampus 14 days before the DHLA injection. Depression-like behavior tests were performed. Western blot and immunofluorescence staining detected the ERK/Nrf2/HO-1/ROS/NLRP3 pathway-related proteins.

Results: The DHLA and fluoxetine treatment exerted preventive effects in LPS-induced sickness behavior rats. The DHLA treatment increased the expression of ERK, Nrf2, and HO-1 but decreased the ROS generation levels and reduced the expression of NLRP3, caspase-1, and IL-1β in LPS-induced sickness behavior rats. PD98059 abolished the effects of DHLA on preventive effect as well as the levels of Nrf2 and HO-1 proteins. Similarly, Nrf2 siRNA reversed the preventive effect of DHLA administration via the decreased expression of HO-1.

Conclusions: These findings suggested that DHLA exerted a preventive effect via ERK/Nrf2/HO-1/ROS/NLRP3 pathway in LPS-induced sickness behavior rats. Thus, DHLA may serve as a potential therapeutic strategy for depression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12974-020-01836-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249417PMC
May 2020

Long-term maternal separation potentiates depressive-like behaviours and neuroinflammation in adult male C57/BL6J mice.

Pharmacol Biochem Behav 2020 09 22;196:172953. Epub 2020 May 22.

Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No. 238, Wuhan 430060, China.

Early life experience is closely related to depression caused by stress in adulthood. Early life experience, including maternal separation (MS), has been shown to evoke stress sensitivity to depression upon re-exposure to stress in adults. However, MS has also been shown to lead to resilience to stress-induced depression, which is contradictory and rarely studied. To investigate the effects of MS on depression in adults and the related mechanism, male C57/BL6J mouse pups were exposed to different MS procedures from postnatal day (PD)1 to PD21. Body weight (BW) measurements and behavioural tests (the forced swimming test (FST) and open field test (OFT)) were performed on PD41 to explore depressive and anxiety-like behaviours. Then, as adults, the mice were exposed to chronic unpredictable mild stress (CUMS) for 28 days, and then behavioural tasks were recorded. After CUMS exposure, the mice in the MS180 group (which were separated from their mothers for 3 h on PD1-PD21) showed significantly decreased time spent in the centre of the open field and reduced velocity in the OFT, a reduced latency to immobility in the FST, and decreased BW. However, the mice in the MS15 group (which were separated from their mothers for 15 min on PD1-PD21) performed similarly to NSNC mice (which were not separated from their mothers) in the behavioural tests. We further found that the expression of Iba1, a marker of neuroinflammation, was increased in the MS180 group but not in the MS15 group. In addition, our study showed decreased mRNA and protein expression of CRMP2, an important neuroprotective factor, in the MS180 group, but CRMP2 expression was unchanged in the MS15 group. This study confirmed the generation of different behavioural responses to stress exposure in adulthood due to different degrees of MS. Neuroinflammation and neuroprotection are involved, which requires further research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pbb.2020.172953DOI Listing
September 2020

Corrigendum: Correlation Analysis Between Attentional Bias and Somatic Symptoms in Depressive Disorders.

Front Psychiatry 2020 24;11:293. Epub 2020 Apr 24.

Department of Psychiatry, Guangzhou Panyu Central Hospital, Guangzhou, China.

[This corrects the article DOI: 10.3389/fpsyt.2019.00903.].
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyt.2020.00293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193895PMC
April 2020

Differential Regulation of DNA Methylation at the CRMP2 Promoter Region Between the Hippocampus and Prefrontal Cortex in a CUMS Depression Model.

Front Psychiatry 2020 18;11:141. Epub 2020 Mar 18.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.

Current evidence supports the idea that neural plasticity is a potential cause of depression. Abundant studies indicate that CRMP2 has important roles in neural plasticity. Moreover, CRMP2 may contribute to the etiology of depression. However, the regulatory mechanisms underlying the role of CRMP2 remain unclear. DNA methylation alteration is generally acknowledged to be involved in the development of depression. The aim of this study was to explore the relationship between the expression and DNA methylation of CRMP2 in the hippocampus and prefrontal cortex of a rat depression model. Chronic unpredictable mild stress (CUMS) was used to establish a rat depression model, and body weight and behavioral tests were used to evaluate the effects of stress. Real-time PCR and Western blotting were used to test CRMP2 mRNA and protein expression, respectively, in the hippocampus and prefrontal cortex of rats. DNA methylation levels of the CRMP2 promoter were analyzed by bisulfite sequencing PCR (BSP). CUMS caused depressive-like behavior in rats, as evidenced by: decreased body weight and sucrose preference rate; decreases in the total distance traveled, rearing frequency, velocity, and duration in the center in the open field test (OFT); and prolonged immobility in the forced swimming test (FST). CRMP2 mRNA and protein expression in the hippocampus and prefrontal cortex were significantly decreased in the CUMS group compared with the control group. The levels of CRMP2 promoter DNA methylation in the hippocampus of the CUMS group were significantly higher than those of the control group, while these changes were not observed in the prefrontal cortex of CUMS rats. Our data provide evidence that altered expression of CRMP2 in the hippocampus and prefrontal cortex is associated with the pathogenesis of depression. Moreover, the results also suggest regional differences in the regulation of DNA methylation in the CRMP2 promoter between the hippocampus and prefrontal cortex during the development of depression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyt.2020.00141DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093734PMC
March 2020

Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study.

Brain Behav Immun 2020 07 30;87:11-17. Epub 2020 Mar 30.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China. Electronic address:

The severe 2019 outbreak of novel coronavirus disease (COVID-19), which was first reported in Wuhan, would be expected to impact the mental health of local medical and nursing staff and thus lead them to seek help. However, those outcomes have yet to be established using epidemiological data. To explore the mental health status of medical and nursing staff and the efficacy, or lack thereof, of critically connecting psychological needs to receiving psychological care, we conducted a quantitative study. This is the first paper on the mental health of medical and nursing staff in Wuhan. Notably, among 994 medical and nursing staff working in Wuhan, 36.9% had subthreshold mental health disturbances (mean PHQ-9: 2.4), 34.4% had mild disturbances (mean PHQ-9: 5.4), 22.4% had moderate disturbances (mean PHQ-9: 9.0), and 6.2% had severe disturbance (mean PHQ-9: 15.1) in the immediate wake of the viral epidemic. The noted burden fell particularly heavily on young women. Of all participants, 36.3% had accessed psychological materials (such as books on mental health), 50.4% had accessed psychological resources available through media (such as online push messages on mental health self-help coping methods), and 17.5% had participated in counseling or psychotherapy. Trends in levels of psychological distress and factors such as exposure to infected people and psychological assistance were identified. Although staff accessed limited mental healthcare services, distressed staff nonetheless saw these services as important resources to alleviate acute mental health disturbances and improve their physical health perceptions. These findings emphasize the importance of being prepared to support frontline workers through mental health interventions at times of widespread crisis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bbi.2020.03.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118532PMC
July 2020

Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019.

JAMA Netw Open 2020 03 2;3(3):e203976. Epub 2020 Mar 2.

Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Importance: Health care workers exposed to coronavirus disease 2019 (COVID-19) could be psychologically stressed.

Objective: To assess the magnitude of mental health outcomes and associated factors among health care workers treating patients exposed to COVID-19 in China.

Design, Settings, And Participants: This cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from 1257 health care workers in 34 hospitals from January 29, 2020, to February 3, 2020, in China. Health care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 were eligible.

Main Outcomes And Measures: The degree of symptoms of depression, anxiety, insomnia, and distress was assessed by the Chinese versions of the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder scale, the 7-item Insomnia Severity Index, and the 22-item Impact of Event Scale-Revised, respectively. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes.

Results: A total of 1257 of 1830 contacted individuals completed the survey, with a participation rate of 68.7%. A total of 813 (64.7%) were aged 26 to 40 years, and 964 (76.7%) were women. Of all participants, 764 (60.8%) were nurses, and 493 (39.2%) were physicians; 760 (60.5%) worked in hospitals in Wuhan, and 522 (41.5%) were frontline health care workers. A considerable proportion of participants reported symptoms of depression (634 [50.4%]), anxiety (560 [44.6%]), insomnia (427 [34.0%]), and distress (899 [71.5%]). Nurses, women, frontline health care workers, and those working in Wuhan, China, reported more severe degrees of all measurements of mental health symptoms than other health care workers (eg, median [IQR] Patient Health Questionnaire scores among physicians vs nurses: 4.0 [1.0-7.0] vs 5.0 [2.0-8.0]; P = .007; median [interquartile range {IQR}] Generalized Anxiety Disorder scale scores among men vs women: 2.0 [0-6.0] vs 4.0 [1.0-7.0]; P < .001; median [IQR] Insomnia Severity Index scores among frontline vs second-line workers: 6.0 [2.0-11.0] vs 4.0 [1.0-8.0]; P < .001; median [IQR] Impact of Event Scale-Revised scores among those in Wuhan vs those in Hubei outside Wuhan and those outside Hubei: 21.0 [8.5-34.5] vs 18.0 [6.0-28.0] in Hubei outside Wuhan and 15.0 [4.0-26.0] outside Hubei; P < .001). Multivariable logistic regression analysis showed participants from outside Hubei province were associated with lower risk of experiencing symptoms of distress compared with those in Wuhan (odds ratio [OR], 0.62; 95% CI, 0.43-0.88; P = .008). Frontline health care workers engaged in direct diagnosis, treatment, and care of patients with COVID-19 were associated with a higher risk of symptoms of depression (OR, 1.52; 95% CI, 1.11-2.09; P = .01), anxiety (OR, 1.57; 95% CI, 1.22-2.02; P < .001), insomnia (OR, 2.97; 95% CI, 1.92-4.60; P < .001), and distress (OR, 1.60; 95% CI, 1.25-2.04; P < .001).

Conclusions And Relevance: In this survey of heath care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 in Wuhan and other regions in China, participants reported experiencing psychological burden, especially nurses, women, those in Wuhan, and frontline health care workers directly engaged in the diagnosis, treatment, and care for patients with COVID-19.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamanetworkopen.2020.3976DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7090843PMC
March 2020

Edaravone reduces depression severity in patients with symptomatic intracranial stenosis and is associated with the serum expression of sex hormones.

Medicine (Baltimore) 2020 Feb;99(8):e19316

Institute of Neuropsychiatry and Mental Health Center.

Objective: To investigate the effect of edaravone on depression relief in symptomatic patients with intracranial stenosis and its relationship with the expression of sex hormones.

Methods: We recruited 112 patients with symptomatic intracranial arterial stenosis from Renmin Hospital, Wuhan University, between October 2014 and October 2017. All patients were divided into the traditional or experimental (traditional treatment + intravenous infusion of edaravone 30 mg twice a day for 14 days) treatment groups. The general clinical data were collected, and neurological functional recovery using the Modified Rankin Scale (mRS) and National Institute of Health stroke scale (NIHSS) scores were recorded. Symptom Checklist 90 (SCL-90) was used to assess the general psychological changes of the patient, followed by the 24 Hamilton Depression Scale (HAMD) to examine the incidence of post-stroke depression (PSD). This divided the patients into the mild, moderate, and severe depression groups. Next, we measured the serum protein expression of the sex hormones estradiol (E2), testosterone (T), follicle stimulating hormone (FSH), prolactin (PRL), and luteinizing hormone (LH).

Results: The mRS and NIHSS scores were significantly lower in the experimental group than in the control group (P < .05). There was no significant difference in SCL90 score before intervention (P > .05); the scores were significantly lower in the experimental group after intervention (P < .05). There was a significant difference in SCL-90 and HAMD scores between groups before treatment (P < .05), with significantly lower scores in the experimental group post-treatment (P < .05). The incidence of depression was significantly reduced in the experimental group post-treatment. Furthermore, the expression of E2 and FSH was significantly higher (P < .01) and lower (P < .001), respectively, in women than in men in the experimental group post-treatment. Interestingly, the expression of T was significantly lower in men in the experimental group post-treatment (P < .001).

Conclusion: Edaravone significantly improved the clinical efficacy of stent implantation in intracranial artery stenosis treatment by alleviating depression and reducing the incidence of PSD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000019316DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034658PMC
February 2020

Fluoxetine exposure for more than 2 days decreases the neuronal plasticity mediated by CRMP2 in differentiated PC12 cells.

Brain Res Bull 2020 05 15;158:99-107. Epub 2020 Feb 15.

Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No.238, Wuhan, 430060, China. Electronic address:

Background: Recent studies indicate that antidepressants treatment restores neuronal plasticity. In contrast, some researchers claim that serotonergic antidepressants, including fluoxetine (FLU), may exacerbate neuronal plasticity, which is contradictory and rarely studied. Since almost those studies exposed cells with drugs for 1-2 days as treatment models of antidepressants, it is possible that FLU exposure for longer periods would have opposite effects on neuronal plasticity.

Results: In the present study, we examined the effects of FLU exposure (up to 3 days) on the neuronal plasticity in differentiated PC12 cells. The cell viability shown a slight decrease at day 2 (93.5 ± 3.5 %), followed by a highly significant decrease at day 3(71.4 ± 4.4 %). As previously reported, neuronal plasticity was significantly upregulated by FLU exposure at day 1. However, the neurite length, activity-regulated cytoskeleton-associated protein (Arc) and c-Fos mRNA were inhibited with FLU exposure at day 3. Similarly, the expression of tubulin, which play important roles in the neuronal plasticity, was the same result. Furthermore, we found α-tubulin interacted with collapsing response mediator protein 2(CRMP2), which is related to neuronal plasticity, and the regulation of CRMP2 activity influenced the neurite length, Arc, c-Fos and tubulin expression.

Conclusions: The results demonstrated that neuronal plasticity was increased by FLU exposure at day 1, but exposure with FLU for more than 2 days had opposite effect on it. The reduction in neuronal plasticity with FLU exposure for more than 2 days might be involved in some aspects of the therapeutic effect of antidepressant on depression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.brainresbull.2020.02.007DOI Listing
May 2020

GRP Receptor Regulates Depression Behavior Interaction With 5-HT2a Receptor.

Front Psychiatry 2019 28;10:1020. Epub 2020 Jan 28.

Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.

Objective: Accumulating evidences indicate that gastrin-releasing peptide receptor (GRPR) may contribute to the pathophysiology of depression. However, the mechanism of the involvement of GRPR in the progression of depression remains unclear. Here, we showed the extent to which stress and antidepressant treatment impact GRPR expression, and explored the interactions between 5-HT2a receptor (5-HT2aR) and GRPR at the cellular level.

Methods: The rat depression models were created with chronic unpredictable mild stress (CUMS). Then, these rats were treated with fluoxetine for 4 weeks after CUMS. We measured body weight and performed behavioral tests to determine the effects of stress and fluoxetine on depressive-like behaviors. Real-time PCR and western blotting were used to measure the mRNA and protein expression levels of GRPR in the hypothalamus. Then, Flag-tagged protein (pcmv-Flag-5HT2aR) and Myc-tagged protein (pcmv-Myc-GRPR) expression vectors were constructed, identified, and transfected into human embryo kidney 293 (HEK293) cells. The interaction between 5-HT2aR and GRPR was detected by coimmunoprecipitation and double-label immunofluorescence.

Results: The rats subjected to 4 weeks of CUMS showed depressive-like behaviors, including decreased body weight, sucrose preference, and distance traveled, rearing frequency and velocity in the open field test and increased immobility time in the forced swimming test. Fluoxetine treatment reversed CUMS-induced depressive-like behavior. The mRNA and protein expression of GRPR in the hypothalamus was significantly increased after 4 weeks CUMS exposure, and treatment with fluoxetine reversed these changes. Coimmunoprecipitation showed that 5-HT2aR and GRPR combine with each other . Immunofluorescence revealed that the 5-HT2aR and GRPR were colocalization in both the cell membrane and cytoplasm.

Conclusion: Our study enhances the understanding of the involvement of GRPR in depression. This study also provides experimental evidence of the interaction between 5-HT2aR and GRPR, which may play an important role in the pathogenesis of depression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyt.2019.01020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997338PMC
January 2020