Publications by authors named "Weixiong Cai"

8 Publications

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Manic episode, aggressive behavior and poor insight are significantly associated with involuntary admission in patients with bipolar disorders.

PeerJ 2019 19;7:e7339. Epub 2019 Jul 19.

Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Objectives: Serious mental illnesses, such as bipolar disorders and schizophrenia, are closely associated with involuntary admission. Many studies have focused on involuntary admission in people with schizophrenia, but little is known about the factors associated with involuntary admission in Chinese patients with bipolar disorders. This study aimed to investigate socio-demographic and clinical factors associated with involuntary admission in Chinese patients with bipolar disorders.

Methods: In this multi-center cross-sectional survey in China, a total of 155 newly admitted patients with bipolar disorders were consecutively recruited from 16 psychiatric institutions from 15 March to 14 April, 2013. Patients' socio-demographic and clinical data were collected from their medical records. The Modified Overt Aggression Scale and the Insight and Treatment Attitudes Questionnaire were used to measure patients' level of aggression and insight of current psychiatric illness.

Results: The prevalence of involuntary admission was 52% in this sample of Chinese inpatients with bipolar disorders. In multiple logistic regression, a high level of aggression (odds ratio (OR) = 2.48), diagnosis of manic episode (OR = 3.65), poor insight (OR = 7.52), and a low level of education (OR = 3.13) were significantly associated with involuntary admission.

Conclusion: Manic episode, aggressive behavior, and poor insight were the significant contributing factors to involuntary admission in Chinese patients with bipolar disorders.
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http://dx.doi.org/10.7717/peerj.7339DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6644629PMC
July 2019

Increased ratio of high sensitivity C-reactive protein to interleukin-10 as a potential peripheral biomarker of schizophrenia and aggression.

Int J Psychophysiol 2017 04 4;114:9-15. Epub 2017 Feb 4.

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai, China. Electronic address:

Background: Many studies have indicated that immune dysfunction might be involved in the physiopathology of schizophrenia and aggression. This study aimed to investigate the correlation between high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-10 and clinical characteristics, especially aggression, and to explore the potential role of hsCRP and IL-10 as plasma biomarkers of schizophrenia.

Methods: Forty-one patients with schizophrenia and forty healthy individuals were enrolled. Psychopathological severity and aggression were assessed using the Positive and Negative Syndrome Scale (PANSS) and Modified Overt Aggression Scale (MOAS). Plasma concentrations of hsCRP and IL-10 were assessed by enzyme-linked immunosorbent assay (ELISA).

Results: (1) Higher levels of hsCRP (p<0.001), lower levels of logIL-10 (p<0.001) and higher ratio of hsCRP to IL-10 (p<0.001) were observed in the plasma of patients with schizophrenia, compared to healthy controls; (2) ROC (receiver operating characteristic) curve analysis revealed that ratio of hsCRP/IL-10 (predictive value: 0.783, p<0.01; sensitivity: 85.4%; specificity: 67.5%) was more applicable as a biomarker to distinguish patients with schizophrenia from the control group than hsCRP and IL-10 alone (predictive value: 0.718, p<0.01; 0.275, p<0.001, respectively); (3) we found positive correlations between hsCRP and the total score and verbal aggression score of MOAS (r=0.654, p<0.01; r=0.678, p<0.05), and between hsCRP/IL-10 and the total score of MOAS (r=0.636, p<0.01).

Conclusions: Our results suggest the possible function of hsCRP and IL-10 in the pathogenesis of schizophrenia and the possible value of hsCRP/IL-10 as a potential peripheral biomarker of schizophrenia. This finding also suggests a relationship between hsCRP, IL-10 and their ratio with aggression in patients with schizophrenia.
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http://dx.doi.org/10.1016/j.ijpsycho.2017.02.001DOI Listing
April 2017

Plasma levels of Th17-related cytokines and complement C3 correlated with aggressive behavior in patients with schizophrenia.

Psychiatry Res 2016 Dec 2;246:700-706. Epub 2016 Nov 2.

Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:

Increasing evidence indicates that immune inflammatory processes, especially autoimmune reaction, should be considered in the pathophysiology of schizophrenia and aggressive behavior. The present study aimed to explore the correlation between immune factors (C3 and Th17-related cytokines) and aggressive behavior in schizophrenia patients. Forty schizophrenia patients and forty age- and gender-matched healthy controls participated in the study. Blood samples were assessed by ELISA upon enrollment. Positive and negative syndrome scale (PANSS) and modified overt aggression scale (MOAS) were used to estimate the severity and aggressive symptoms of schizophrenia patients. Plasma levels of IL-17, IL-23, and TGF-β1 in schizophrenia patients were significantly higher than those in healthy controls [(37.63±17.82) vs. (29.34±10.38)pg/ml, p=0.02; (101.40±135.26) vs. (13.09±5.94) pg/ml, p=0.01; (2864.57±2163.61) vs. (1839.69±1797.73)pg/ml, p=0.04], whereas C3 levels were significantly lower in schizophrenia patients [( 120,479.67± 65,612.50) vs. ( 208,060.21± 217,008.21)ng/ml, p=0.02]. IL-17, IL-23, and TGF-β1 levels were positively related to total scores of MOAS (p=0.02, p=0.02 and p=0.03, respectively) and PANSS (p=0.04, p=0.04 and p=0.02, respectively), whereas C3 levels were negatively related to total PANSS scores (p=0.03). IL-17 and IL-23 levels were positively correlated with PANSS excited component scores (p=0.04 and p=0.01, respectively). Our findings suggested that the Th17-related cytokine levels were positively related to the severity of schizophrenia and aggressive behavior, whereas C3 levels were negatively related to the severity of schizophrenia. This study demonstrated that elevated levels of Th17-related cytokines and decreased levels of C3 could be potential biomarkers for schizophrenia and aggressive behavior.
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http://dx.doi.org/10.1016/j.psychres.2016.10.061DOI Listing
December 2016

Development and psychometric properties of an informant assessment scale of theory of mind for adults with traumatic brain injury.

Neuropsychol Rehabil 2016 Aug 7;26(4):481-501. Epub 2015 Apr 7.

b Forensic Identification Center , Shaoxing University , Shaoxing , PR. China.

Impairment of theory of mind (ToM) is a common phenomenon following traumatic brain injury (TBI) that has clear effects on patients' social functioning. A growing body of research has focused on this area, and several methods have been developed to assess ToM deficiency. Although an informant assessment scale would be useful for examining individuals with TBI, very few studies have adopted this approach. The purpose of the present study was to develop an informant assessment scale of ToM for adults with traumatic brain injury (IASToM-aTBI) and to test its reliability and validity with 196 adults with TBI and 80 normal adults. A 44-item scale was developed following a literature review, interviews with patient informants, consultations with experts, item analysis, and exploratory factor analysis (EFA). The following three common factors were extracted: social interaction, understanding of beliefs, and understanding of emotions. The psychometric analyses indicate that the scale has good internal consistency reliability, split-half reliability, test-retest reliability, inter-rater reliability, structural validity, discriminate validity and criterion validity. These results provide preliminary evidence that supports the reliability and validity of the IASToM-aTBI as a ToM assessment tool for adults with TBI.
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http://dx.doi.org/10.1080/09602011.2015.1030431DOI Listing
August 2016

Sex differences of uncinate fasciculus structural connectivity in individuals with conduct disorder.

Biomed Res Int 2014 14;2014:673165. Epub 2014 Apr 14.

Medical Psychological Institute, The Second Xiangya Hospital, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China.

Conduct disorder (CD) is one of the most common behavior disorders in adolescents, such as impulsivity, aggression, and running from school. Males are more likely to develop CD than females, and two previous diffusion tensor imaging (DTI) studies have demonstrated abnormal microstructural integrity in the uncinate fasciculus (UF) in boys with CD compared to a healthy control group. However, little is known about changes in the UF in females with CD. In this study, the UF was illustrated by tractography; then, the fractional anisotropy (FA), axial diffusivity, mean diffusion, radial diffusivity (RD), and the length and number of the UF fiber bundles were compared between male and female patients with CD and between female patients with CD and female healthy controls, as well as between males with CD and healthy males. We found that males with CD showed significantly higher FA of the bilateral UF and significantly lower RD of the left UF when comparing with females with CD. Meanwhile, significantly higher FA and lower RD of the bilateral UF were also found in boys with CD relative to the male healthy controls. Our results replicated previous reports that the microstructural integrity of the UF was abnormal in boys with CD. Additionally, our results demonstrated significant gender effects on the UF of patients with CD, which may indicate why boys have higher rates of conduct problems than girls.
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http://dx.doi.org/10.1155/2014/673165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009134PMC
December 2014

The reliability and validity of the rating scale of criminal responsibility for mentally disordered offenders.

Forensic Sci Int 2014 Mar 13;236:146-50. Epub 2014 Jan 13.

Shanghai Key laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai 200063, PR China.

In China, the criminal responsibility of the mentally disordered offenders is divided into three levels, there are the whole responsibility, diminished responsibility and irresponsibility. According to the Criminal Law, "If a mental disordered patient causes harmful consequences at a time when he is unable to recognize or control his own conduct, upon verification and confirmation through legal procedure, he shall not bear criminal responsibility." That means there are two standards of assessing criminal responsibility, namely volitional and cognitive capacity. It is as equal as the Mc'Naughton Rule and the Irresistible Impulse Test. But for a long time, the criminal responsibility was assessed mainly by experience because of lacking of standardized assessment instrument. Recently, we have developed "the rating scale of criminal responsibility for mentally disordered offenders (RSCRs)". The scale includes eighteen items, namely criminal motivation, aura before offense, inducement of crime, time and place and object and tool selectivity of crime, emotion during the crime, shirking responsibility after offense, concealing the truth during inquest, camouflage, understanding the nature of the offense, estimating the consequence of the offense, impairment of life ability, impairment of learning or work, impairment of insight, impairment of reality testing, and impairment of self-control. This scale can be applicable for all cases and easy to use. This scale had been tried out in several forensic psychiatry institutes, the Cronbach α of the scale is 0.93, and all items have high correlation with the total score of the scale (r=0.50-0.89). Two factors were extracted by the factorial analysis, and the cumulative squared loading was 68.62%. The scores of the three levels were 9.66 ± 5.11, 26.54 ± 5.21 and 40.08 ± 7.90 respectively and highly significant differences were observed among groups. By establishing discrimination analysis among three levels, classification results suggested that 88.90% of the original grouped cases were correctly classified, and the discriminant value had high conformity with the experts' opinions. The data showed that the scale would be the best validated instrument for the criminal responsibility in China.
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http://dx.doi.org/10.1016/j.forsciint.2013.12.018DOI Listing
March 2014

Prevalence of mental disorders in the male juvenile detention centers of Hunan and Sichuan.

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2012 Mar;37(3):217-21

Institute of Mental Health, Second Xiangya Hospital, Central South University, Changsha 410011, China.

Objective: To investigate the prevalence of mental health problems in male violent offenders of Hunan and Sichuan Provinces; and to compare the types and severity of problems between the violent and nonviolent offenders.

Methods: Ninety-one violent juvenile offenders and 64 nonviolent juvenile offenders in the juvenile detention centers of Hunan, and 81 violent juvenile offenders in the juvenile detention centers of Sichuan; 39 high school students from a middle school of Hunan Province and 49 from a middle school of Sichuan Province were investigated using the Investigation Screening Inventory for Child Mental Disorder and the Kiddy Schedule for Affective Diseases and Schizophrenia (K-SADS-PL), and classified according to the Diagnostic and Statistical Manual of Mental Disorders.

Results: In the Hunan violent group, 86.6% met the criterion of conduct disorder (CD), 17.6% of substance abuse, 9.9% of substance dependence, while in the Hunan nonviolent group, 75.0% met the criterion of CD, and 11.7% of substance abuse; these were all significantly higher than those of the control group (P<0.05). In the Sichuan violent group, 17.3% met the criterion of attention deficit/hyperactivity disorder (ADHD), 18.5% of oppositional defiant disorder (ODD), 69.1% of CD, and 22.2% of substance abuse; these were all significantly higher than those of the Sichuan control group. Moreover, 63.7% of Hunan-violent, 55.6% of Sichuan-violent, and 45.0% of Hunan-nonviolent offenders had a previous offence records.

Conclusion: Mental and behavioral disorders among delinquent youth is becoming a serious problem, and there is an urgent need to develop and implement effective assessment and treatment approaches for juvenile offenders with the aim of reducing offence and recidivism in this population.
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http://dx.doi.org/10.3969/j.issn.1672-7347.2012.03.001DOI Listing
March 2012

[Study of affecting factors of mentally prisoner's competency to serve a sentence].

Fa Yi Xue Za Zhi 2004 ;20(4):218-20

Institute of Forensic Science, Ministry of Justice, PR China, Shanghai 200063, China.

Objective: Explore the affecting factors of mentally prisoner's competency to serve a sentence (CSS), establish the base of quantitative study of CSS.

Methods: Firstly, the researchers compile a questionnaire named legal-psycho ability of competency to serve a sentence questionnaire, then the researchers scaling the object with RTHD, and ask all object complete the questionnaire. there a hypothesis, that the object who are cured in cured ward is incompetent to serve a sentence (ISS), and the other who are stay in rehabilitated ward is competent to serve a sentence (CSS).

Results: There are 185 object admitted the study, the ISS group the CSS group have significance between psychiatric and legal aspects.

Conclusion: At the influence of psychiatric symptoms, the mentally prisoner's competency to serve a sentence had been impaired, and they should been transferred from prison to hospital.
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April 2006