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Hao S.-Q.,Fudan University | Zhao M.,Shanghai Mental Health Center | Zhang J.-C.,Drug Control Office | Zhang J.,Council of Shanghai Ziqiang Social Services | Feng X.-S.,Fudan University
Addictive Behaviors | Year: 2013

Objective: The aim of the study was to compare the effectiveness of Jitai tablets (JTT) versus methadone in a community drug treatment program. Methods: A cohort study was conducted with 386 eligible subjects from 7 districts to 65 communities in Shanghai. The subjects were placed into the JTT group (n=206) or the methadone group (n=180). The data were collected at 8-, 26- and 52-week follow-ups. Results: The retention rates of the methadone group at the 8-, 26-, and 52-week follow-ups were 97.78%, 91.67%, and 85.00%, respectively. The retention rates of the JTT group at these follow-ups were 90.78%, 83.50%, and 74.27%, respectively. A Chi-square test indicated a significant difference, and the P values were 0.0037, 0.0161, and 0.0095 for each follow-up. The relapse rates for the JTT group were 3.88%, 6.31% and 11.17% for each follow-up, and those for the methadone group were 1.11%, 2.78%, and 7.78% for each follow-up. The Chi-square test indicated no significance, and the P values were 0.1128, 0.1005 and 0.2594. A survival analysis indicated that the relapse survival curve had no significant difference between the two groups (log-rank test, P=0.188). Conclusion: Methadone and JTT combined with psychological intervention and social support provided effective maintenance treatment and relapse prevention in a community drug treatment program. The retention rate in the methadone group was higher, but the JTT group had the same relapse prevention as the methadone group. JTT can be recommended to clinical doctors and drug addicts. © 2013 The Authors.

Zhang W.,Shanghai University | Yan T.-T.,Shanghai University | Du Y.-S.,Shanghai Mental Health Center | Liu X.-H.,Shanghai University
Research in Autism Spectrum Disorders | Year: 2013

This study examined the relationship between coping, rumination and posttraumatic growth in mothers of children with autism spectrum disorders (ASD). One hundred and two mothers of autistic children in China were surveyed using Post-traumatic Growth Inventory, Trait Coping Style Questionnaire, and Event Related Rumination Inventory. Mothers reported mediate level of PTG, mostly on the growth of personal strength. Hierarchal regression analysis indicated that positive coping positively predicted PTG and growth on "relating to others"; deliberate rumination was positively correlated with growth on "appreciation of life"; and intrusive rumination negatively predicted growth on "personal strength", "new possibilities" and "spiritual change". No statistically significant relationship between negative coping and PTG was found. The results may be used to provide mothers with a better understanding of the underlying growth process and assist service providers in facilitating this progress. © 2013 Elsevier Ltd. All rights reserved.

Ding B.,Shanghai JiaoTong University | Ling H.-W.,Shanghai JiaoTong University | Zhang Y.,Applied Science Laboratory | Huang J.,Shanghai JiaoTong University | And 3 more authors.
Clinical Interventions in Aging | Year: 2014

Purpose: A three-dimensional (3D) continuous pulse arterial spin labeling (ASL) technique was used to investigate cerebral blood flow (CBF) changes in patients with Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), and age- and sex-matched healthy controls. Materials and methods: Three groups were recruited for comparison, 24 AD patients, 17 MCI patients, and 21 age- and sex-matched control subjects. Three-dimensional ASL scans covering the entire brain were acquired with a 3.0 T magnetic resonance scanner. Spatial processing was performed with statistical parametric mapping 8. A second-level one-way analysis of variance analysis (threshold at P<0.05) was performed on the preprocessed ASL data. An average whole-brain CBF for each subject was also included as group-level covariates for the perfusion data, to control for individual CBF variations. Results: Significantly increased CBF was detected in bilateral frontal lobes and right temporal subgyral regions in aMCI compared with controls. When comparing AD with aMCI, the major hyperperfusion regions were the right limbic lobe and basal ganglia regions, including the putamen, caudate, lentiform nucleus, and thalamus, and hypoperfusion was found in the left medial frontal lobe, parietal cortex, the right middle temporo-occipital lobe, and particularly, the left anterior cingulate gyrus. We also found decreased CBF in the bilateral temporo-parieto-occipital cortices and left limbic lobe in AD patients, relative to the control group. aMCI subjects showed decreased blood flow in the left occipital lobe, bilateral inferior temporal cortex, and right middle temporal cortex. Conclusion: Our results indicated that ASL provided useful perfusion information in AD disease and may be used as an appealing alternative for further pathologic and neuropsychological studies, especially of compensatory mechanisms for cerebral hypoperfusion. © 2014 Ding et al.

Stein D.J.,University of Cape Town | He Y.,Shanghai Mental Health Center | Phillips A.,Canadian Institutes of Health Research | Sahakian B.J.,University of Cambridge | And 2 more authors.
The Lancet Psychiatry | Year: 2015

Global mental health has emerged as an important specialty. It has drawn attention to the burden of mental illness and to the relative gap in mental health research and services around the world. Global mental health has raised the question of whether this gap is a developmental issue, a health issue, a human rights issue, or a combination of these issues-and it has raised awareness of the need to develop new approaches for building capacity, mobilising resources, and closing the research and treatment gap. Translational neuroscience has also advanced. It comprises an important conceptual approach to understanding the neurocircuitry and molecular basis of mental disorders, to rethinking how best to undertake research on the aetiology, assessment, and treatment of these disorders, with the ultimate aim to develop entirely new approaches to prevention and intervention. Some apparent contrasts exist between these fields; global mental health emphasises knowledge translation, moving away from the bedside to a focus on health systems, whereas translational neuroscience emphasises molecular neuroscience, focusing on transitions between the bench and bedside. Meanwhile, important opportunities exist for synergy between the two paradigms, to ensure that present opportunities in mental health research and services are maximised. Here, we review the approaches of global mental health and clinical neuroscience to diagnosis, pathogenesis, and intervention, and make recommendations for facilitating an integration of these two perspectives. © 2015 Elsevier Ltd.

News Article | November 15, 2016
Site: www.scientificamerican.com

Renowned neuroscientist Mu-Ming Poo is playing a key role in China’s contribution to the push by national and regional governments to set up gargantuan neuroscience research endeavors. The China Brain Project has yet to put forward funding specifics. But Poo, who directs the Institute of Neuroscience of the Chinese Academy of Sciences and has held multiple academic posts at U.S. universities, is helping to shape the project’s 15-year timeline. To circumvent the paucity of drugs for neurological illnesses, Poo’s own team wants to focus on finding solid evidence for video games and other behavioral training methods that might produce near-term cognitive benefits for China’s aging population. Poo talked to Scientific American recently about these plans. [An edited transcript of the interview follows.] Can you tell us about the Chinese Brain Project? Its goal is similar to the brain projects that have been launched in other regions but I think we’ve put more emphasis on the brain disease aspect than the U.S. project has. The U.S. project is more concentrated on developing new technologies for observing and manipulating the activity of brain circuits. In China there is a particular urgency to solve problems related to brain diseases because of its large population and an aging society saddled with neurodegenerative diseases. If we don’t find a solution for Alzheimer's by 2050, the entire medical system is going broke. In China there is an estimate that there could be many tens of millions of Alzheimer's or Parkinson’s disease patients by 2050 if no cure is found, given the rate of increasing life expectancy. How will the Chinese project move forward? We cannot wait until we understand how the brain works. It will take 20 years before we figure out even the entire circuitry of the rodent brain and fully understand how it works. For humans, it may be 30, 40 years. That’s too long. Going forward, we've got to first find some way, for instance, to diagnose deficiencies in brain function. The general opinion is that the best hope in dealing with brain diseases is to diagnose early and intervene early, hoping to prevent or delay the onset of the disease. But right now there’s a lot of qualitative symptom-based diagnosis, unlike other systems in the body. In the cardiovascular system you know your blood pressure and cholesterol level quantitatively, but we do not have standard measures of brain function quantitatively. So I think that's clearly a problem we need to address. This can be done with the technology and the expertise we have now. Describe a bit more these diagnostic techniques. At a small scale, we have already started to make a tool kit for brain function measurements. At a larger scale, we plan to make broader measurements: from perception to multisensory integration; working memory—remembering a phone number for long enough to dial, for instance; attention and decision-making; and so on. In most measurements you just interact with a computer or take a simple measurement with an EEG. So imagine measuring 10 brain functions and coming up with a score for each function, and you will have reliable measures of your brain functions for the physician to make a quantitative evidence-based evaluation. In our program we hope to be able to monitor progressive changes of these functions with time over a large population of people, and eventually find parameters that could be predictive for brain diseases. We are also interested in developing intervention approaches to prevent the deterioration of specific brain functions. So in the future neurologists or psychiatrists will look at scores of various brain function tests for an individual. They will then prescribe the medicine that addresses specific functional deficits or prescribe an interventional approach, such as specially designed mental exercises to improve specific functions. They will not classify you as having bipolar disorder or schizophrenia or Alzheimer's diseases. All these labels are very bad for people who are resistant to going to a psychiatrist because they don’t want to be labeled as suffering from these diseases. But if you said your working memory score is getting low and you should do some exercise, there would be less stigma attached to a mental problem. Has any of this started to make its way into clinical practice? We're actually trying to persuade the Shanghai health care organizations to integrate this type of brain function testing into regular health checkups in local hospitals, so people will go through this brain checkup besides a checkup of other systems. Then if we have enough data over a 10- or 15-year period, we can really have reliable early indicators of brain disorders for the physicians to prescribe treatments. What are some of the specific measures that can be implemented now or relatively soon? We’ve started to realize that you can prevent progression of some diseases by training, such as by playing video games. You can do this, for instance, to recover vision for people with amblyopia. Some of these discoveries are relatively recent and haven’t been applied to the general population. The major effort in the U.S. biomedical sciences is still drug development. I think that is actually necessary, but it hasn’t been paying off for brain diseases. It's paying off for other diseases but drug development for brain diseases is largely a failure so far. We are still using psychiatric drugs from the 1950s. There are very few new drugs since then. We are interested in various noninvasive programs that help to improve memory and prevent deterioration of memory. It's basically playing well-designed games that get harder as the player gets better. It's very much like Mike Merzenich's program of Fast ForWord [referring to the well-known neurophysiologist from the University of California, San Francisco] to treat hearing and language deficits in school children. Does China have certain advantages in taking this approach? China has the largest population for any major disease—that's obvious. For instance, Shanghai Mental Health Center kept continuous medical records for about 100,000 mental disease patients. The problem is that a lot of data are out there but not being standardized well. So the China Brain Project's hope is that this large patient population will be of use for developing diagnostic or intervention tools by setting standards for data collection and data handling. If you don’t have uniform and internationally acceptable standards, the large number doesn't make a difference. We are putting together teams to create a comprehensive brain-function tool kit. That involves 10 to 15 principal investigators. They work on that part-time. They spend probably 10 to 20 percent of their time working on designing the most effective five-minute test for a specific cognitive function. They will not get Nobel Prize out of this work but they will get the satisfaction that their contribution has been used by and helped a large population of people. Will you have to build the educational infrastructure for this project? Most areas of biological sciences in China are not very competitive internationally, as compared to other disciplines in China such as physical and material sciences. This is true for neuroscience. There is thus a great need for building the research capacity in neuroscience. There are now about 6,000 members in the Chinese Society for Neuroscience, as compared to about 45,000 in the U.S. Among these 6,000 members, many active scientists are young investigators or graduate students. Actually basic neuroscience is still not formally recognized by Chinese educational systems as an independent academic discipline, and significant research support from the government for basic neuroscience only began 10 to 15 years ago. With this limited research base, what do you do to really make a difference on the international scene? Many of the institutions are now filled with young people who have their small groups that are productive. But most of them are not producing groundbreaking or pioneering work in their fields. What they are doing is mostly a continuation of their postdoctoral work, following the major trend in the field. They can publish a few good papers in the top journals but very few are making real impact. I think the key for Chinese neuroscientists to have a true impact is to form research teams that have a unique combination of expertise, with a goal of addressing major unsolved scientific or technological problems. Has there been some improvement? I think the scientific quality is clearly increasing, partly because there are now many returning Chinese who were trained abroad in the U.S. and Europe. After postdoctoral research it's harder for them to get a good position in the U.S. Even if they have a good position, they still have to spend a lot of time writing grants. A lot of the people returning are of very high quality. If they were still in the U.S., they could be competitive as assistant professors in major research universities. So that's the reason why the publications from China have been improving dramatically in the last 10 years. What's lacking is more senior established scientists who are recognized leaders in the field, who could chart out an approach to doing the pioneering work and know what to do, and can organize large groups of people. That type of senior person is rare and takes time to develop. It will take 10, 15 years for a senior leader to emerge. There is also the cultural aspect. The current funding and evaluation system in Chinese scientific institutions does not encourage risk-taking. New innovation and groundbreaking work often require one to take a risk. Most scientists tend to do safe projects that could ensure good funding. On another topic, can you tell us about primate research in China and how that might have an impact on the brain sciences? The use of nonhuman primates [monkeys in particular] as animal models is increasingly difficult in the U.S. and in Europe. This is a bad sign. Given the importance of nonhuman primates for basic research on higher cognitive functions and for studying pathogenesis and potential therapeutic treatments for human brain diseases, we have to sustain the use of these animal models. In this area I think Chinese neuroscientists may offer an important contribution. There are large monkey resources in the country and many neuroscientists are interested in working with monkeys. Can you give an example? There's a recent breakthrough that occurred in my own institute in generating genetically manipulated macaque monkeys. We published a paper in Nature this January describing monkeys that express a human MECP2 gene in the brain, and these monkeys emulate several behavioral deficits similar to that of autistic patients, including stereotyped motion, higher anxiety and deficits in social interaction with other monkeys. We were also able to obtain a second generation of the monkeys carrying the human MECP2 gene within about two and a half years whereas it normally takes five years for only one generation. We got it down to a shorter time using tricks that speed up sperm maturation by incubating the sperm under the skin of mice. Given the recent rapid development in gene-editing technology in mice (such as deleting a gene or replacing a gene with an edited copy), there is hope that gene-editing technology will become applicable to monkeys in order to develop a gene-edited monkey model for brain diseases that have a strong genetic basis. There is still a serious problem in that the gene-editing technology does not make the desired genetic alterations in all of the different cell populations in a single animal. That problem, known as mosaicism, needs to be solved to produce useful animal models. In mice you can deal with this by breeding. In a few generations you can get mice with the same genetic manipulation in all cells. We cannot use the breeding to solve this problem in monkeys because the reproductive cycles are too long, even using some tricks to speed up sperm maturation. But rapid progress is being made in new gene-editing methods. I believe the problem of mosaicism will be solved for monkeys in the near future, and we will then be able to produce many genetically uniform monkey models that will greatly facilitate scientists who study the pathogenesis and treatment of human brain diseases.

Hu Q.,Qiqihar Mental Health Center | Zhang S.-Y.,Institute of Forensic Science | Liu F.,Tongji University | Zhang Y.-L.,Qiqihar Mental Health Center | And 2 more authors.
Journal of Affective Disorders | Year: 2015

Background Previous evidence has shown that adrenal androgens, dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEAS) have significant functions related to the control of mood, affect, and anxiety. Changes in their expression levels are reportedly related to several psychiatric disorders. The objective of this meta-analysis was to explore the role of DHEAS protein expression in patients with depression.Method Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine (CBM) and China National Knowledge Infrastructure (CNKI) were electronically searched. Only those studies that analyzing DHEAS expression in depression patients were considered eligible for inclusion. Standardized mean differences (SMDs) were pooled with a 95% confidence interval (CI) in accordance with the random-effects model.Results Ten clinical case-control studies, consisting of 4496 subjects (493 patients with depression and 4003 healthy controls) were incorporated for analysis. Results revealed a lower DHEAS protein expression level in patients with depression than in normal controls (SMD=0.17, 95% CI: 0.06-0.27, P=0.002). Ethnicity-stratified analysis indicated that lower levels of DHEAS expression in depression patients were not observed in Caucasians or Asians (both P>0.05).Conclusion Elevated DHEAS protein expression may be correlated with the biological pathophysiology of depression, indicating that checking DHEAS levels and administration of DHEAS could contribute to the effective treatment of depression. © 2014 Published by Elsevier B.V.

Lee S.,Chinese University of Hong Kong | Guo W.J.,Chinese University of Hong Kong | Tsang A.,Chinese University of Hong Kong | He Y.L.,Shanghai Mental Health Center | And 5 more authors.
Psychological Medicine | Year: 2011

Background The prevalence of family childhood adversities (FCAs) and their joint effects on the first onset of subsequent mental disorders throughout the life course are rarely examined, especially in Asian communities.Method Face-to-face household interviews of 5201 people aged 18-70 years in Beijing and Shanghai were conducted by a multi-stage household probability sampling method. The first onsets of four broad groups of mental disorders and six categories of FCAs were assessed using The World Mental Health Composite International Diagnostic Interview (WMH-CIDI). Joint effects of FCAs were analyzed by the best fitting of several competitive multivariate models.Results FCAs were highly prevalent and inter-correlated. Half of them were in a family-dysfunction cluster. The best-fitting model included each of six types of FCA (with family-dysfunction FCAs being the strongest predictors), number of family-dysfunction FCAs, and number of other FCAs. Family-dysfunction FCAs had a significant subadditive association with subsequent disorders. Little specificity was found for the effects of particular FCAs with particular disorders. Predictive effects of FCAs reached the highest in ages 13-24 compared to ages 4-12 and 25. Estimates of population-attributable risk proportions indicated that all FCAs together explained 38.5% of all first-onset disorders.Conclusions Chinese children were exposed to a broad spectrum of inter-related FCAs, as found in Western countries. FCAs related to family dysfunction were especially associated with subsequent mental disorders. Biological and/or environmental factors that mediate these long-term effects should be studied in prospective research on broad groups of FCAs. © 2010 Cambridge University Press.

Kong X.,Eye and ENT Hospital | Kong X.,Shanghai Key Laboratory of Visual Impairment and Restoration | Yan M.,Eye and ENT Hospital | Sun X.,Eye and ENT Hospital | And 3 more authors.
Journal of Glaucoma | Year: 2015

Purpose: The aim of this study was to assess the prevalence of psychological disturbances and personality traits in primary angle closure glaucoma (PACG) and primary open-angle glaucoma (POAG) patients. Methods: A sample of 50 PACG patients, 50 POAG patients, and 50 normal controls were enrolled in this study. All the participants were asked to complete the following questionnaires: Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Eysenck Personality Questionnaire (EPQ), and Defense Style Questionnaire (DSQ). Analysis of variance and t test were used to compare the subscores between the groups. Results: The scores of SAS and SDS were higher in glaucoma patients than in controls, whereas the PACG group had a higher score for both scales (48.44 ± 9.90; 53.64 ± 9.74) than the POAG group (42.62 ± 9.00, P = 0.034; 49.02 ± 11.47, P = 0.131) and control group (37.10 ± 6.08, P = 0.000; 38.86 ± 6.64, P = 0.000). Taking an SAS score of ≥45 and an SDS score of ≥50 as cut-offs, the prevalence of anxiety and depression in the PACG group (66.0%, 56.0%) was significantly higher than in the POAG group (44.0%, P = 0.002; 40.0%, P = 0.033) and control group (16.0%, P = 0.000; 10.0%, P = 0.000). The values of psychoticism and neuroticism in EPQ for the PACG and POAG groups were significantly higher than those for controls (P < 0.05). In DSQ, PACG and POAG patients adopted immature and neurotic defense styles more often than controls (P < 0.05). No significant differences were found between male and female participants in all the questionnaires used (P > 0.05). Conclusions: Significant differences were found between primary glaucoma patients and normal controls in psychiatric questionnaires, whereas the level of anxiety and depression was found to be significantly higher in PACG patients than in POAG patients and controls. Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.

Ren J.,Shanghai Mental Health Center
The Cochrane database of systematic reviews | Year: 2013

Dance therapy or dance movement therapy (DMT) is defined as 'the psychotherapeutic use of movement as a process which furthers the emotional, social, cognitive, and physical integration of the individual'. It may be of value for people with developmental, medical, social, physical or psychological impairments. Dance therapy can be practiced in mental health rehabilitation units, nursing homes, day care centres and incorporated into disease prevention and health promotion programmes. To evaluate the effects of dance therapy for people with schizophrenia or schizophrenia-like illnesses compared with standard care and other interventions. We updated the original July 2007 search of the Cochrane Schizophrenia Group' register in July 2012. We also searched Chinese main medical databases. We included one randomised controlled trial (RCT) comparing dance therapy and related approaches with standard care or other psychosocial interventions for people with schizophrenia. We reliably selected, quality assessed and extracted data. For continuous outcomes, we calculated a mean difference (MD); for binary outcomes we calculated a fixed-effect risk ratio (RR) and their 95% confidence intervals (CI). We created a 'Summary of findings' table using the GRADE approach. We included one single blind study (total n = 45) of reasonable quality. It compared dance therapy plus routine care with routine care alone. Most people tolerated the treatment package but nearly 40% were lost in both groups by four months (1 RCT n = 45, RR 0.68 95% CI 0.31 to 1.51, low quality evidence). The Positive and Negative Syndrome Scale (PANSS) average endpoint total scores were similar in both groups (1 RCT n = 43, MD -0.50 95% CI -11.80 to 10.80, moderate quality evidence) as were the positive sub-scores (1 RCT n = 43, MD 2.50 CI -0.67 to 5.67, moderate quality evidence). At the end of treatment, significantly more people in the dance therapy group had a greater than 20% reduction in PANSS negative symptom score (1 RCT n = 45, RR 0.62 CI 0.39 to 0.97, moderate quality evidence), and overall, average negative endpoint scores were lower (1 RCT n = 43, MD -4.40 CI -8.15 to -0.65, moderate quality evidence). There was no difference in satisfaction score (average Client's Assessment of Treatment Scale (CAT) score, 1 RCT n = 42, MD 0.40 CI -0.78 to 1.58, moderate quality evidence) and quality of life data were also equivocal (average Manchester Short Assessment of Quality of life (MANSA) score, 1 RCT n = 39, MD 0.00 CI -0.48 to 0.48, moderate quality evidence).  Based on predominantly moderate quality data, there is no evidence to support - or refute - the use of dance therapy in this group of people. This therapy remains unproven and those with schizophrenia, their carers, trialists and funders of research may wish to encourage future work to increase high quality evidence in this area.

Mei L.,Shanghai Mental Health Center
Zhonghua yi xue za zhi | Year: 2010

To investigate the prevalence of anxiety disorder in internal medical outpatients at general hospital, explore some susceptible factors of anxiety disorder patients and assess the physician diagnosis and treatment of anxiety disorders. According to 10:1 random sampling, the outpatients from cardiac medicine, digestive medicine, endocrinology and hypertension at Shanghai Ruijin Hospital were selected during November 2007 to January 2008. Hospital anxiety and depression scale (HADS) was used to screen the subjects. Those whose anxiety sub-score was higher or equal to 8 were interviewed with M.I.N.I. investigators further. The information of the physician diagnosis and treatment was collected from the history cards. The prevalence of anxiety disorders was 2.51%, panic attack 0.9%, agoraphobia 0.47%, social phobia 0.25%, specific phobia 0.31%, obsessive-compulsive disorder 0.28% and general anxiety disorder 1.47%. Women and widows were more susceptible to anxiety disorders (P < 0.01). And 23% of anxiety disorder patients received treatment. But the physician diagnosis rate of anxiety disorders was only 3.2%. The prevalence of anxiety disorders in internal medical outpatients at general hospital is still high and general anxiety disorders are commonly encountered. Women and widows are more susceptible to anxiety disorders than others. The physician diagnosis rate of anxiety disorders remains low.

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