Abstract:Antidepressant is an important treatment for depression. However， the poor compliance of antidepressants is a common problem in the treatment. This paper reviews the main influencing factors of antidepressant compliance， and focuses on the new research progress of improving the compliance.

Abstract:Objective To investigate the relationship of non-verbal facial expression features and aggression risk of patients with severe mental disorders. Methods This study is a cross-sectional study. The study was carried out in 15 community hospitals in Beijing from September to December in 2019. A total of 30 patients with severe mental disorders who had aggressive behavior and met the International Classification of Diseases-10 diagnostic criteria were included. Modified Overt Aggression Scale（ MOAS）， Patient Health Questionnaire 9-items（ PHQ-9） and Generalized Anxiety Disorder Scales 7-items（ GAD-7） were applied to evaluate aggression risk， depression and anxiety respectively. Openface extracted 5 action units（ AU）： AU4 （brow lowerer），AU5（ upper lid raiser）， AU7（ lid tightener）， AU20（ lip stretcher）， and AU23（ lip tightener）. The intensity and duration of each AU were calculated， and the correlation between AU index and the total score of MOAS was studied using partial correlation analysis. Results Among the duration of AU indexes， AU5 （r=0.395， P=0.037）， AU20（ r=0.414， P=0.029）， AU23（ r=0.407， P=0.032） were positively correlated with the total score of MOAS. The intensity AU indexes showed that AU20（ r=0.557， P=0.002） and AU23（ r=0.466， P=0.013） were positively correlated with the total score of MOAS. Conclusions Facial expression features could be helpful to identify aggression risk of patients with severe mental disorders.

Abstract:Objective To investigate the effect of lithium chloride on amphetamine-induced behavioral sensitization in rats and the possible involvement of the Akt/GSK-3β pathway. Methods A total of 40 male SD rats were randomly divided into control group（ S-S group， n=13）， amphetamine group（ S-A group， n=13） and lithium chloride and amphetamine group（ L-A group， n=14）. S-S rats were pretreated with normal saline （10 ml/kg） and intraperitoneally injected with normal saline（ 10 ml/kg） for 5 consecutive days. S-A rats were pretreated with normal saline（ 10 ml/kg） and intraperitoneally injected with amphetamine（ 1.5 mg/kg） for 5 consecutive days. L-A rats were pretreated with lithium chloride（ 100 mg/kg） and intraperitoneally injected with amphetamine（ 1.5 mg/kg） for 5 consecutive days. All injections came to a stop during the ensuing 6 days. On day 12， randomized 6 rats in each group were injected with a lower dosage of amphetamine. The spontaneous activity of three groups of rats was recorded by video recording system within 150 minutes on the 1st day and the 12th day of treatment， respectively. On day 12， 6 rats that did not receive the behavioral test were selected from each group. Western blot was used to detect the expression of phosphorylated Akt（ p-Akt）/Akt and phosphorylated GSK-3 β（ p-GSK-3 β）/GSK-3 β in prefrontal cortex. Results Compared to S-S［ （1 861.50±612.49） cm］ and L-A［ （7 599.00±4 778.14） cm］rats， a significant increase in spontaneous locomotor activity was observed in S-A rats［ （26 826.50±5 987.96） cm］on the first day， and the differences were statistically significant （P＜ 0.05）. On day 12， S-A rats were associated with a significantly increased spontaneous locomotor activity ［（43 823.83±5 831.88） cm］ relative to S-S［ （14 274.50±4 724.98） cm］and L-A［ （17 823.50±4 313.64） cm］ rats， and the differences were statistically significant（ P＜0.05）. Ratios of p-Akt to Akt and p-GSK-3β to GSK- 3β showed a significant decline in the prefrontal cortex of S-A rats compared to those in the prefrontal cortex of S-S（ P＜0.05） and L-A rats（ P＜0.05）. Conclusions Lithium chloride can inhibit amphetamine-induced behavioral sensitization in rats， and the potential mechanisms may be related to the Akt/GSK-3β pathway.

Abstract:Objective To explore the influencing factors of medication compliance in patients with depression. Methods A total of 158 patients with depression admitted to the outpatient department of Beijing Anding Hospital affiliated to Capital Medical University from November 2016 to October 2019 were recruited as the research subject. Telephone interviews were conducted at the end of the study（ the mean time is 1 year）. According to the total score of Medication Adherence Report Scale（ MARS）， the patients were divided into compliance group（ n=77， MARS total score ≥ 6） and noncompliance group（ n=31， MARS total score ＜ 6）. The differences in general demographic information and clinical characteristics between the two groups were analyzed and compared， to find out the influencing factors of patients' medication compliance. Results At last， 50 patients were lost to follow-up due to incomplete acute treatment and telephone change， and 108 patients entered the result analysis， of which 71.30% had good medication compliance. In the good medication compliance group， 33.77%（ 26/77） are male， 48.05%（ 33/77） are younger than or equal to 25 years old， 58.44%（ 45/77）are with bachelor degree， 23.38%（ 18/77） haved family history of mental illness. There were no statistically significant differences between the two groups in gender， age， education level， family history of mental illness， marriage， type of medical insurance， age of onset， first course of disease， total course of disease， and characteristics of course between the two groups（ P ＞ 0.05）， while the differences between the two groups in terms of the item 7（ work and interest）， item 10（ mental anxiety）， item 14（ sexual symptoms） in HAMD-17 scale were statistically significant（ P＜0.05）. Logistic regression analysis showed that item 10（ mental anxiety） and item14（ sexual symptoms） in HAMD-17 were the main influencing factors for medication compliance （OR=2.721， 95%CI：1.126-6.572； OR=3.560， 95%CI： 1.050-12.072）. Conclusions This study showed that anxiety symptoms and sexual dysfunction may be important factors affecting medication compliance. In the process of clinical practice， targeted and timely guidance and adjustment of treatment should be given， so as to further improve medication compliance of patients with depression.

Abstract:Objective To explore the correlation between the scores of mental assessment techniques of image cognition and 17 items of Hamilton Depression Scale（ HAMD-17） in assessing the severity of depression. Methods A total of 113 patients with depression were retrospectively consecutively enrolled from the outpatient department of Beijing Anding Hospital. HAMD-17 was used to assess the severity of depression， and the patients were instructed to complete mental assessment based on image cognition. Partial correlation analysis and multivariate linear regression analysis were used to evaluate the correlation between image cognition score and disease severity assessed by HAMD-17 scale. The predictive value of image cognitive score on the severity of depression was analyzed by the receiver operating characteristic（ ROC） curve. Results The average score of HAMD-17 was（ 19.31±5.30）， including 18 cases of mild depression， HAMD-17 ranged from 7 to 13， with an average score of（ 11.44±1.46）； 40 cases of moderate depression， HAMD-17 ranged from 14 to 19， with an average score of（ 16.75±1.69）； 55 cases of severe disease and above， HAMD-17 over 20（ including 20）， with an average score of（ 23.78±3.03）. There were significant differences in HAMD-17 scores among patients with different degrees of depression（ F=210.99，P＜0.001）. The average score of image cognition was（ 51.02±23.22）， of which 48.7%（ 55/113） were patients with severe depression and above， and the average score of image cognition was（ 44.87±21.81）； the average score of image cognition was（ 57.06±22.91） and（ 59.35±22.82） in patients with mild and moderate depression. There was significant difference in image cognitive score among patients with different degrees of depression（ F=5.42，P＜0.01）. The image cognitive score of severe and above depression was significantly lower than that of mild and moderate depression（ all P＜0.05）. Partial correlation analysis showed that the image cognitive score was negatively correlated with the total score of HAMD-17 （r=-0.31，P ＜ 0.05）. Linear regression analysis showed that there was a linear correlation between the image cognitive score and the total score of HAMD-17（ t=-3.03，P=0.003）. The results of ROC curve analysis showed that the image cognitive score could effectively distinguish patients with major depression（ area under the curve was 0.677， P=0.001）. When the cut-off value was 52， the sensitivity was 67.2%， and the specificity was 69.1%. Conclusions The image cognitive score and HAMD-17 scale have correlation with the severity of depression， which reflects the trend of depression severity， and has a certain value in evaluating the severity of depression.

Abstract:Objective To explore the characteristics of the suicide and the related factors in children and adolescents with depressive disorder. Methods From January 2018 to December 2019， a total of 389 children and adolescents admitted to Hebei Provincial Sixth People's Hospital with depressive disorder were recruited， with 171 patients in suicide group， and 218 patients in non-suicide group. The general and clinical information were compared between the two groups. Logistic regression was used to analyze the related factors of the suicide in children and adolescents with depressive disorder. Results There were significant differences between the two groups in age（ t=-2.23， P=0.026）， physical diseases（ χ2=5.65， P=0.017）， psychotic symptoms （χ2=4.28， P=0.038）， sleep disorder（ χ2=5.69， P=0.017） and the treatments（ drug treatments： χ2=40.31， P＜ 0.001； pyschological treatments： χ2=5.81， P=0.016）. Logistic regression analysis showed that age（OR=0.59， 95%CI： 0.45-0.78）， psychotic symptoms（OR=2.20，95%CI： 1.02-4.76） and physical diseases（ OR=0.08， 95%CI： 0.04-0.18） were related to suicide. Conclusions Age， psychotic symptoms and physical diseases are the related factors to the suicide in children and adolescents with depressive disorder.

Abstract:Objective To investigate the use of psychiatric drugs in hospitalized patients with depressive disorder， and to provide references for clinical treatment. Methods Using the Beijing-Tianjin- Hebei big data platform， the data of eligible patients with depressive disorder admitted to Beijing Anding Hospital from 2015 to 2019 were retrospectively analyzed， and the use of psychotropic drugs in patients with early-onset or late-onset depressive disorder was compared. Results A total of 6 043 inpatients were enrolled， including 1 820（ 30.12%） patients with early-onset depressive disorder and 4 223（ 69.88%） patients with late-onset depressive disorder. The main classification of antidepressants used in early-onset patients were SSRIs（ 61.54%， n=1 120）， SNRIs（ 21.26%， n=387） and NaSSA（ 7.25%， n=132） respectively， including sertraline（ 25.07%， n=456）， escitalopram（ 21.98%， n=400） and venlafaxine（ 13.68%， n=249）. The use rate of antipsychotics was 68.08%（ n=1 239）， including quetiapine（ 29.67%， n=540）， aripiprazole（ 15.93%， n=290） and olanzapine（ 10.11%， n=184）； the use rate of mood stabilizers was 33.85%（ n=616）， including lithium carbonate（ 18.08%， n=329）， valproate（ 15.44%， n=281） and lamotrigine（ 0.33%， n=6）. The main classification of antidepressants used in late-onset patients were SSRIs（ 61.59%， n=2 601）， SNRIs（ 27.97%， n=1 181） and NaSSA（ 19.37%， n=818）， including escitalopram（ 27.73%， n=1 171）， sertraline（ 9.91%， n=841） and mirtazapine（ 19.37%， n=818）； the use rate of antipsychotics was 59.10%（ n=2 496）， including quetiapine（ 30.59%， n=1 292）， olanzapine（ 12.48%， n=527 cases） and aripiprazole（ 5.23%， n=221）； the use rate of mood stabilizers was 8.69%（ n=367）， including lithium carbonate（ 3.84%， n=162）， valproate（ 4.62%， n=195）， lamotrigine（ 0.21%， n=9）. The proportion of early-onset patients without antidepressants was higher than that of late-onset patients［ 12.03%（ 219/1 820） vs. 3.43%（ 145/4 223）； χ2=166.153， P ＜ 0.001］， and the proportion of combination with antidepressants was lower than that in late-onset patients［ 11.65%（ 212/ 1 820） vs. 20.03%（ 846/4 223）； χ2=61.913， P＜ 0.001］. There were statistically significant differences in the use rates of sertraline， escitalopram， fluvoxamine， fluoxetine， paroxetine， mirtazapine， duloxetine， lithium carbonate， valproate， aripiprazole， amisulpride， clozapine and olanzapine between the two groups（ all P＜0.05）. Patients with early-onset depressive disorder were more likely to use SSRIs， and were more likely combined with antipsychotics and mood stabilizers. Conclusions In the real world， there are great differences between the drugs used for patients with early-onset depressive disorder and those with late-onset depressive disorder， which should be paid more attention to in clinical treatment.

Abstract:Objective To explore the Genome-wide DNA methylation in children and adolescents with bipolar depression and aggressive behavior. Methods A total of 45 pediatric bipolar disorder（ PBD） patients admitted to the Department of Clinical Psychology of People's Hospital of Xinjiang Uygur Autonomous Region from September 2019 to January 2021 were recruited， and divided into aggressive group（ n=16） and non-aggressive group（ n=29）. Five patients with PBD were enrolled from each group. Illumina Infinium HumanMethylation EPIC BeadChip 850K array， was applied to detect DNA methylation status in peripheral blood of these 10 patients. Differential methylation loci were filtrated according to the Diffscore and methylation differences（ Delta-beta score）， together with Genome Studio software. The Database for Annotation， Visualization and Integrated Discovery（ DAVID） online database was used to analyze the functional enrichment of methylated genes. Two genes were verified by pyrosequencing in peripheral blood of the aggressive group and the non-aggressive group. Results There were differences in 172 hypermethylated loci， including 87 hypermethylated genes， between the samples of the attack group and the non-attack group. There were 148 different hypomethylated loci， including 74 hypomethylated genes. Differential methylation sites exist on each chromosome and are mainly distributed in other regions of 5'-Cytosine-phosphoric-guanine-3（' CpG） island. The peak value of methylation β in the aggressive group was about 0.63. The peak values of methylation β in non-aggressive group were about 0.40 and 0.85. Gene Ontology analysis results showed that differential methylated genes were involved in biological functions such as axonal orientation. In pathway analysis， it was involved in mucin-type O-glycan biosynthesis pathway. In pyrosequencing verification， the methylation rates of dihydropyrimidinase like 2（ DPYSL2） gene in the two groups were（ 27.438±17.874）% and（ 27.345±18.832）%， respectively. There wass no statistical significance between the two groups（ P=0.987）. The methylation rates of ABI family member 3 binding protein（ ABI3BP） gene in the two groups were（ 84.188±25.761）% and （78.586±23.567）%， respectively. There is no statistical significance between the two groups（ P=0.113）. Conclusions There were differences in methylation loci and genes between the aggressive group and the non-aggressive group， which provided a basis for identifying the causes of aggressive behavior in children and adolescents with bipolar depression.

Abstract:Objective By constructing the clinical symptom evaluation system of patients with Cavum Septum Pellucidum（ CSP） combined with Cavum Vergae（ CV）， and the changes of cysts volume before and after operation， we want to find out the evaluation indicators that can quantitatively predict the prognosis of patients with CSP combined with CV. Methods Nine patients with CSP combined with CV diagnosed by MRI were recruited. Firstly， the reduction rate of cyst was calculated by preoperative and postoperative MRI data. Secondly， according to the characteristics of clinical symptoms， the clinical symptoms were scored， and the clinical symptom scoring system was established. Finally， the correlation between clinical symptoms and objective imaging quantitative data of cyst shall be find out. Results The clinical symptom scores and cyst volume after operation were significantly lower than those before operation， and the differences were statistically significant（ t' values are 6.36 and 5.06， respectively，P＜ 0.01）. There was no significant correlation between preoperative cyst volume and preoperative clinical symptom scores of children（ r=0.018， P＞0.05）. There was no significant correlation between clinical symptom score and cyst volume（ r=0.520， P＞0.05）. There was a positive correlation between the improvement of clinical symptom score and the reduction rate of cyst volume （r=0.843，P=0.009）. There was a negative correlation between the improvement of clinical symptom score and the volume of cyst（ r=-0.738， P=0.037）. Conclusions As one of the surgical methods of CSP combined with CV， neuroendoscopic surgery can significantly improve the postoperative symptoms. Postoperative cyst reduction rate and postoperative cyst volume can be used as independent quantitative predictors of the postoperative prognosis of patients with symptomatic CSP with CV.

Abstract:Mood disorders are based on mood or emotional changes， often characterized by low or high mood， and most symptoms secondary to mood changes. Such disease attack is usually related to stress events and other factors， easy to relapse， and the economic burden of the disease is heavy. The treatment of mood disorders is mainly drug treatment. After receiving monotherapy， parts of patients' symptoms can be completely relieved， while the efficacy of monotherapy alone is not enough for some patients. Therefore， there is an urgent need for new treatment methods as an adjunctive for mood disorders. As a non-invasive brain stimulation technique， transcranial direct current stimulation（ tDCS） has been widely used in mood disorders for more than ten years， which has the characteristics of easy operation， low cost and high safety. It has been proved that tDCS alone or combined with drug therapy can effectively treat some patients with mood disorders， but there is no recommended best treatment parameters and the specific mechanism remains unclear. The mechanism， parameters， efficacy， limitation and prospect of tDCS in the treatment of mood disorders（ mainly depression and bipolar disorder） will be reviewed in order to provide the basis for the future research and clinical application of transcranial direct current stimulation.

Abstract:Co-morbidity between sleep disorders and psychiatric disorders is common. In recent years， increasing researches focus on the role of sleep disorders in the occurrence and development of psychiatric disorders. In order to explore the role of sleep disorders in the etiology of mental disorders，it is required to achieve accurate assessment of sleep disorders. Sleep disorder assessment mostly comes from self-report and polysomnography（ PSG）. Because of its subjectivity or inability to conduct long-term monitoring， its application in clinical research of mental disorders is limited. Wearable devices have shown promise in complementing the assessment of sleep disorders. This review provides an overview of wearable devices for monitoring sleep and their application in mental disorders research to provide clues for the future.

Abstract:The behavioral and psychological symptoms of dementia（ BPSD） is a common symptom of cognitive impairment throughout the disease， and change with the progression of the disease. The incidence of BPSD is high， and its symptoms are complex and changeable. However， the cognition of it is insufficient and there is no unified standard of diagnosis and treatment. Therefore， this article gathered the key points of the identification and evaluation of BPSD according to the development of diagnosis and treatment of BPSD and the current situation in China， and summarized the intervention strategies of BPSD. Correct identification and effective intervention of BPSD can delay the progression of dementia，improve the quality of life of patients， and reduce the burden of disease， which should be paid attention to in practice.

Abstract:Neuronal autoantibodies are the key to the diagnosis of autoimmune encephalitis. Immunohistochemistry/indirect immunofluorescence， immunocytochemistry of dissociated rodent hippocampal neurons and immunoblotting are the commonly used antibody detection methods. The sensitivity of antibody detection in serum and cerebrospinal fluid samples varies in different subtypes of autoimmune encephalitis. Neuronal autoantibody titers correlate with tumorigenesis， but the correlation with prognosis remains controversial. The pathogenic role of antibodies associated with common autoimmune encephalitis subtypes has been further elucidated in recent years. In this paper， we briefly summarize the classical paraneoplastic syndrome-associated encephalitis， while focusing on the new autoimmune encephalitis， elucidate the advantages and disadvantages of different antibody detection methods and the sensitivity of samples， analyze the correlation between antibody titers and prognosis， and introduce the progress of research on the pathogenic role of antibodies associated with some common types of autoimmune encephalitis， in order to help clinical diagnosis and treatment as well as patient prognosis.

Abstract:Alzheimer disease（ AD） is the most common senile dementia， but the cause of the disease is still unclear， and lack of effective treatment. In recent years， studies have shown that neurometabolic problems may be the root cause of AD， and low glucose metabolism in the brain is an important feature of the early AD， while the ketogenic diet with high fat and low carbohydrate provides the possibility to solve these metabolic problems. Current studies have shown that ketogenic diet intervention in the early stage of AD can improve cognition， and its mechanism may be related to improving energy metabolism， reducing the level of pathological markers and neurotoxicity， and regulating intestinal flora. This paper gives a summary of the related progress