With the socioeconomic development and the acceleration of the ageing process of the population, the incidence rates of mental disorders and psycho-behavioural problems have become higher and higher worldwide. So far,...With the socioeconomic development and the acceleration of the ageing process of the population, the incidence rates of mental disorders and psycho-behavioural problems have become higher and higher worldwide. So far, the disease burden caused by mental disorders has ranked second in the world.1 In China, the disease burden caused by mental disorders accounts for 13% of all non-communicable diseases burden.2 Hence, mental health has become a major public health problem and social problem. In order to promote mental health, the Chinese government has promulgated a series of policies and regulations, as well as reform measures. Moreover, the upcoming 'China Brain Project' will also focus on some mental disorders such as autism, depression and dementia to improve mental health research in China.展开更多
Background Healthcare workers fighting against the coronavirus disease 2019(COVID-19)pandemic are under tremendous pressure,which puts them at an increased risk of developing psychological problems.Aims This study aim...Background Healthcare workers fighting against the coronavirus disease 2019(COVID-19)pandemic are under tremendous pressure,which puts them at an increased risk of developing psychological problems.Aims This study aimed to investigate the prevalence of psychological problems in different healthcare workers(ie,physicians,medical residents,nurses,technicians and public health professionals)during the COVID-19 pandemic in China and explore factors that are associated with the onset of psychological problems in this population during this public health crisis.Methods A cross-sectional,web-based survey was conducted in February 2020 among healthcare workers during the COVID-19 pandemic.Psychological problems were assessed using the Generalized Anxiety Disorder Scale,Patient Health Questionnaire and Insomnia Severity Index.Logistic regression analyses were used to explore the factors that were associated with psychological problems.Results The prevalence of symptoms of anxiety,depression,insomnia and the overall psychological problems in healthcare workers during the COVID-19 pandemic in China was 46.04%,44.37%,28.75%and 56.59%,respectively.The prevalence of the overall psychological problems in physicians,medical residents,nurses,technicians and public health professionals was 60.35%,50.82%,62.02%,57.54%and 62.40%,respectively.Compared with healthcare workers who did not participate in front-line work,front-line healthcare workers had a higher risk of anxiety,insomnia and overall psychological problems.In addition,attention to negative or neutral information about the pandemic,receiving negative feedback from families and friends who joined front-line work,and unwillingness to join front-line work if given a free choice were three major factors for these psychological problems.Conclusions Psychological problems are pervasive among healthcare workers during the COVID-19 pandemic.Receiving negative information and participating in front-line work appear to be.important risk factors for psychological problems.The psychological health of different healthcare workers should be protected during the COVID-19 pandemic with timely interventions and proper information feedback.展开更多
Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain...Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain disease diagnosis and treatment,neurological rehabilitation,and mental health.However,BCI also raises several challenges and ethical concerns in clinical research.In this article,the authors investigate and discuss three aspects of BCI in medicine and healthcare:the state of international ethical governance,multidimensional ethical challenges pertaining to BCI in clinical research,and suggestive concerns for ethical review.Despite the great potential of frontier BCI research and development in the field of medical care,the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI.To ensure"responsible innovation"in BCI research in healthcare and medicine,the creation of an ethical global governance framework and system,along with special guidelines for cutting-edge BCI research in medicine,is suggested.展开更多
Bipolar disorder is characterised by recurrent and alternating episodes of mania/hypomania and depression.Current breakthroughs in functional MRI techniques have uncovered the functional neuroanatomy of bipolar disord...Bipolar disorder is characterised by recurrent and alternating episodes of mania/hypomania and depression.Current breakthroughs in functional MRI techniques have uncovered the functional neuroanatomy of bipolar disorder.However,the pathophysiology underlying mood instability,mood switching and the development of extreme mood states is less well understood.This reviewpresents a comprehensive overviewof current evidence from functional MRI studies from the perspective of mood states.We first summarise the disrupted brain activation patterns and functional connectivity that have been reported in bipolar disorder,irrespective of the mood state.We next focus on research that solely included patients in a single mood state for a better understanding of the pathophysiology of bipolar disorder and research comparing patients with different mood states to dissect mood state-related effects.Finally,we briefly summarise current theoretical models and conclude this review by proposing potential avenues for future research.A comprehensive understanding of the pathophysiology with consideration of mood states could not only deepen our understanding of how acute mood episodes develop at a neurophysiological level but could also facilitate the identification of biological targets for personalised treatment and the development of new interventions for bipolar disorder.展开更多
There is an increasing heavy disease burden of major depressive disorder(MDD)globally.Both high diagnostic heterogeneity and complicated pathological mechanisms of MDD pose significant challenges.There is much evidenc...There is an increasing heavy disease burden of major depressive disorder(MDD)globally.Both high diagnostic heterogeneity and complicated pathological mechanisms of MDD pose significant challenges.There is much evidence to support anhedonia as a core feature of MDD.In the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition,anhedonia is further emphasised as a key item in the diagnosis of major depression with melancholic features.Anhedonia is a multifaceted symptom that includes deficits in various aspects of reward processing,such as anticipatory anhedonia,consummatory anhedonia,and decision-making anhedonia.Anhedonia is expected to become an important clinicopathological sign for predicting the treatment outcome of MDD and assisting clinical decision making.However,the precise neurobiological mechanisms of anhedonia in MDD are not clearly understood.In this paper,we reviewed(1)the current understanding of the link between anhedonia and MDD;(2)the biological basis of the pathological mechanism of anhedonia in MDD;and(3)challenges in research on the pathological mechanisms of anhedonia in MDD.A more in-depth understanding of anhedonia associated with MDD will improve the diagnosis,prediction,and treatment of patients with MDD in the future.展开更多
Major depressive disorder(MDD)with suicidal ideation or behaviour(MDSI)is associated with an increased risk of future suicide.The timely identification of suicide risk in patients with MDD and the subsequent implement...Major depressive disorder(MDD)with suicidal ideation or behaviour(MDSI)is associated with an increased risk of future suicide.The timely identification of suicide risk in patients with MDD and the subsequent implementation of interventions are crucially important to reduce their suffering and save lives.However,the early diagnosis of MDSI remains challenging across the world,as no objective diagnostic method is currently available.In China,the challenge is greater due to the social stigma associated with mental health problems,leading many patients to avoid reporting their suicidal ideation.Additionally,the neural mechanisms underlying MDSl are stll unclear,which may hamper the development of effective interventions.We thus conducted this narrative review to summarise the existing neuroimaging studies of MDSI in Chinese patients,including those involving structural magnetic resonance imaging(MRI),functional MRl,neuronal electrophysiological source imaging of the brain dynamics with electroencephalography and magnetoencephalography.By synthesising the current research efforts in neuroimaging studies of Chinese patients with MDSl,we identified potential objective neuroimaging biomarkers,which may aid in the early identification of patients with MDSI who are at high suicide-related risk.Our findings also offer insights into the complex neural mechanisms underlying MDSI and suggest promising therapeutic targets.Furthermore,we propose future directions to discover novel imaging signatures,improve patient care,as well as help psychiatrists and clinical investigators plan their future research.展开更多
Background Observational studies highlight the association between gut microbiota(GM)composition and depression;however,evidence for the causal relationship between GM and specific depressive symptoms remains lacking....Background Observational studies highlight the association between gut microbiota(GM)composition and depression;however,evidence for the causal relationship between GM and specific depressive symptoms remains lacking.Aims We aimed to evaluate the causal relationship between GM and specific depressive symptoms as well as the mediating role of body mass index(BMI).Methods We performed a two-sample Mendelian randomisation(MR)analysis using genetic variants associated with GM and specific depressive symptoms from genome-wide association studies.The mediating role of BMI was subsequently explored using mediation analysis via two-step MR.Results MR evidence suggested the Bifidobacterium genus(β=0.03;95%CI-0.05 to-0.02;p<0.001 andβ=0.03;95%CI-0.05 to-0.02;p<0.001)and Actinobacteria phylum(β=-0.04;95%CI-0.06 to-0.02;p<0.001 andβ=-0.03;95%CI-0.05 to-0.03;p=0.001)had protective effects on both anhedonia and depressed mood.The Actinobacteria phylum also had protective effects on appetite changes(β=-0.04;95%CI-0.06 to-0.01;p=0.005),while the FamilyⅪhad an antiprotective effect(β=0.03;95%CI 0.01 to 0.04;p<0.001).The Bifidobacteriaceae family(β=-0.01;95%CI-0.02 to-0.01;p=0.001)and Actinobacteria phylum(β=-0.02;95%CI-0.03 to-0.01;p=0.001)showed protective effects against suicidality.The two-step MR analysis revealed that BMl also acted as a mediating moderator between the Actinobacteria phylum and appetite changes(mediated proportion,34.42%)and that BMI partially mediated the effect of the Bifidobacterium genus(14.14%and 8.05%)and Actinobacteria phylum(13.10%and 8.31%)on both anhedonia and depressed mood.Conclusions These findings suggest a potential therapeutic effect of Actinobacteria and Bifidobacterium on both depression and obesity.Further studies are required to translate these findings into clinical practice.展开更多
Microneedle array(MNA)electrodes are an effective solution to achieve high-quality surface biopotential recording without the coordination of conductive gel and are thus very suitable for long-term wearable applicatio...Microneedle array(MNA)electrodes are an effective solution to achieve high-quality surface biopotential recording without the coordination of conductive gel and are thus very suitable for long-term wearable applications.Existing schemes are limited by flexibility,biosafety,and manufacturing costs,which create large barriers for wider applications.Here,we present a novel flexible MNA electrode that can simultaneously achieve flexibility of the substrate to fit a curved body surface,robustness of microneedles to penetrate the skin without fracture,and a simplified process to allow mass production.The compatibility with wearable wireless systems and the short preparation time of the electrodes significantly improves the comfort and convenience of electrophysiological recording.The normalized electrode–skin contact impedance reaches 0.98 kΩcm^(2)at 1 kHz and 1.50 kΩcm^(2)at 10 Hz,a record low value compared to previous reports and approximately 1/250 of the standard electrodes.The morphology,biosafety,and electrical/mechanical properties are fully characterized,and wearable recordings with a high signal-to-noise ratio and low motion artifacts are realized.The first reported clinical study of microneedle electrodes for surface electrophysiological monitoring was conducted in tens of healthy and sleep-disordered subjects with 44 nights of recording(over 8 h per night),providing substantial evidence that the electrodes can be leveraged to substitute for clinical standard electrodes.展开更多
文摘With the socioeconomic development and the acceleration of the ageing process of the population, the incidence rates of mental disorders and psycho-behavioural problems have become higher and higher worldwide. So far, the disease burden caused by mental disorders has ranked second in the world.1 In China, the disease burden caused by mental disorders accounts for 13% of all non-communicable diseases burden.2 Hence, mental health has become a major public health problem and social problem. In order to promote mental health, the Chinese government has promulgated a series of policies and regulations, as well as reform measures. Moreover, the upcoming 'China Brain Project' will also focus on some mental disorders such as autism, depression and dementia to improve mental health research in China.
基金grants from the Beijing Natural Science Foundation(No.7194336)Special Research Fund of PKUHSC for Prevention and Control of COVID-19(No.BMU2020HKYZX008)the National Natural Science Foundation of China(No.81761128036,81821092 and 31900805).
文摘Background Healthcare workers fighting against the coronavirus disease 2019(COVID-19)pandemic are under tremendous pressure,which puts them at an increased risk of developing psychological problems.Aims This study aimed to investigate the prevalence of psychological problems in different healthcare workers(ie,physicians,medical residents,nurses,technicians and public health professionals)during the COVID-19 pandemic in China and explore factors that are associated with the onset of psychological problems in this population during this public health crisis.Methods A cross-sectional,web-based survey was conducted in February 2020 among healthcare workers during the COVID-19 pandemic.Psychological problems were assessed using the Generalized Anxiety Disorder Scale,Patient Health Questionnaire and Insomnia Severity Index.Logistic regression analyses were used to explore the factors that were associated with psychological problems.Results The prevalence of symptoms of anxiety,depression,insomnia and the overall psychological problems in healthcare workers during the COVID-19 pandemic in China was 46.04%,44.37%,28.75%and 56.59%,respectively.The prevalence of the overall psychological problems in physicians,medical residents,nurses,technicians and public health professionals was 60.35%,50.82%,62.02%,57.54%and 62.40%,respectively.Compared with healthcare workers who did not participate in front-line work,front-line healthcare workers had a higher risk of anxiety,insomnia and overall psychological problems.In addition,attention to negative or neutral information about the pandemic,receiving negative feedback from families and friends who joined front-line work,and unwillingness to join front-line work if given a free choice were three major factors for these psychological problems.Conclusions Psychological problems are pervasive among healthcare workers during the COVID-19 pandemic.Receiving negative information and participating in front-line work appear to be.important risk factors for psychological problems.The psychological health of different healthcare workers should be protected during the COVID-19 pandemic with timely interventions and proper information feedback.
基金supported by the Ministry of Science and Tech-nology of the People's Republic of China(2021ZD0201900),Project 5(2021ZD0201905).
文摘Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain disease diagnosis and treatment,neurological rehabilitation,and mental health.However,BCI also raises several challenges and ethical concerns in clinical research.In this article,the authors investigate and discuss three aspects of BCI in medicine and healthcare:the state of international ethical governance,multidimensional ethical challenges pertaining to BCI in clinical research,and suggestive concerns for ethical review.Despite the great potential of frontier BCI research and development in the field of medical care,the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI.To ensure"responsible innovation"in BCI research in healthcare and medicine,the creation of an ethical global governance framework and system,along with special guidelines for cutting-edge BCI research in medicine,is suggested.
基金the National Key Technology R&D Program(2015BA/13B01)Beijing National Science Foundation(7222236)+1 种基金Capital Health Research and Development of Special Fund(2022-1-4111)National Natural Science Foundation of China(82071528,82171529,82271569,82371530).
文摘Bipolar disorder is characterised by recurrent and alternating episodes of mania/hypomania and depression.Current breakthroughs in functional MRI techniques have uncovered the functional neuroanatomy of bipolar disorder.However,the pathophysiology underlying mood instability,mood switching and the development of extreme mood states is less well understood.This reviewpresents a comprehensive overviewof current evidence from functional MRI studies from the perspective of mood states.We first summarise the disrupted brain activation patterns and functional connectivity that have been reported in bipolar disorder,irrespective of the mood state.We next focus on research that solely included patients in a single mood state for a better understanding of the pathophysiology of bipolar disorder and research comparing patients with different mood states to dissect mood state-related effects.Finally,we briefly summarise current theoretical models and conclude this review by proposing potential avenues for future research.A comprehensive understanding of the pathophysiology with consideration of mood states could not only deepen our understanding of how acute mood episodes develop at a neurophysiological level but could also facilitate the identification of biological targets for personalised treatment and the development of new interventions for bipolar disorder.
基金This study was supported by the National Natural Science Foundation of China(No.81630031)National Key Technology R&D Program(2015BAI13B01).
文摘There is an increasing heavy disease burden of major depressive disorder(MDD)globally.Both high diagnostic heterogeneity and complicated pathological mechanisms of MDD pose significant challenges.There is much evidence to support anhedonia as a core feature of MDD.In the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition,anhedonia is further emphasised as a key item in the diagnosis of major depression with melancholic features.Anhedonia is a multifaceted symptom that includes deficits in various aspects of reward processing,such as anticipatory anhedonia,consummatory anhedonia,and decision-making anhedonia.Anhedonia is expected to become an important clinicopathological sign for predicting the treatment outcome of MDD and assisting clinical decision making.However,the precise neurobiological mechanisms of anhedonia in MDD are not clearly understood.In this paper,we reviewed(1)the current understanding of the link between anhedonia and MDD;(2)the biological basis of the pathological mechanism of anhedonia in MDD;and(3)challenges in research on the pathological mechanisms of anhedonia in MDD.A more in-depth understanding of anhedonia associated with MDD will improve the diagnosis,prediction,and treatment of patients with MDD in the future.
文摘Major depressive disorder(MDD)with suicidal ideation or behaviour(MDSI)is associated with an increased risk of future suicide.The timely identification of suicide risk in patients with MDD and the subsequent implementation of interventions are crucially important to reduce their suffering and save lives.However,the early diagnosis of MDSI remains challenging across the world,as no objective diagnostic method is currently available.In China,the challenge is greater due to the social stigma associated with mental health problems,leading many patients to avoid reporting their suicidal ideation.Additionally,the neural mechanisms underlying MDSl are stll unclear,which may hamper the development of effective interventions.We thus conducted this narrative review to summarise the existing neuroimaging studies of MDSI in Chinese patients,including those involving structural magnetic resonance imaging(MRI),functional MRl,neuronal electrophysiological source imaging of the brain dynamics with electroencephalography and magnetoencephalography.By synthesising the current research efforts in neuroimaging studies of Chinese patients with MDSl,we identified potential objective neuroimaging biomarkers,which may aid in the early identification of patients with MDSI who are at high suicide-related risk.Our findings also offer insights into the complex neural mechanisms underlying MDSI and suggest promising therapeutic targets.Furthermore,we propose future directions to discover novel imaging signatures,improve patient care,as well as help psychiatrists and clinical investigators plan their future research.
基金supported by the National Natural Science Foundation of China(grant number:81801345)Tianjin Key Medical Discipline(Specialty)Construction Project(grant number:TJYXZDXK-033A).
文摘Background Observational studies highlight the association between gut microbiota(GM)composition and depression;however,evidence for the causal relationship between GM and specific depressive symptoms remains lacking.Aims We aimed to evaluate the causal relationship between GM and specific depressive symptoms as well as the mediating role of body mass index(BMI).Methods We performed a two-sample Mendelian randomisation(MR)analysis using genetic variants associated with GM and specific depressive symptoms from genome-wide association studies.The mediating role of BMI was subsequently explored using mediation analysis via two-step MR.Results MR evidence suggested the Bifidobacterium genus(β=0.03;95%CI-0.05 to-0.02;p<0.001 andβ=0.03;95%CI-0.05 to-0.02;p<0.001)and Actinobacteria phylum(β=-0.04;95%CI-0.06 to-0.02;p<0.001 andβ=-0.03;95%CI-0.05 to-0.03;p=0.001)had protective effects on both anhedonia and depressed mood.The Actinobacteria phylum also had protective effects on appetite changes(β=-0.04;95%CI-0.06 to-0.01;p=0.005),while the FamilyⅪhad an antiprotective effect(β=0.03;95%CI 0.01 to 0.04;p<0.001).The Bifidobacteriaceae family(β=-0.01;95%CI-0.02 to-0.01;p=0.001)and Actinobacteria phylum(β=-0.02;95%CI-0.03 to-0.01;p=0.001)showed protective effects against suicidality.The two-step MR analysis revealed that BMl also acted as a mediating moderator between the Actinobacteria phylum and appetite changes(mediated proportion,34.42%)and that BMI partially mediated the effect of the Bifidobacterium genus(14.14%and 8.05%)and Actinobacteria phylum(13.10%and 8.31%)on both anhedonia and depressed mood.Conclusions These findings suggest a potential therapeutic effect of Actinobacteria and Bifidobacterium on both depression and obesity.Further studies are required to translate these findings into clinical practice.
基金supported by the China Capital Health Research and Development of Special (No. 2018-14111)the National Natural Science Foundation of China (grant No. 62004007 and No. 82027805)the China Postdoctoral Science Foundation Grant (No. 2021M700258)
文摘Microneedle array(MNA)electrodes are an effective solution to achieve high-quality surface biopotential recording without the coordination of conductive gel and are thus very suitable for long-term wearable applications.Existing schemes are limited by flexibility,biosafety,and manufacturing costs,which create large barriers for wider applications.Here,we present a novel flexible MNA electrode that can simultaneously achieve flexibility of the substrate to fit a curved body surface,robustness of microneedles to penetrate the skin without fracture,and a simplified process to allow mass production.The compatibility with wearable wireless systems and the short preparation time of the electrodes significantly improves the comfort and convenience of electrophysiological recording.The normalized electrode–skin contact impedance reaches 0.98 kΩcm^(2)at 1 kHz and 1.50 kΩcm^(2)at 10 Hz,a record low value compared to previous reports and approximately 1/250 of the standard electrodes.The morphology,biosafety,and electrical/mechanical properties are fully characterized,and wearable recordings with a high signal-to-noise ratio and low motion artifacts are realized.The first reported clinical study of microneedle electrodes for surface electrophysiological monitoring was conducted in tens of healthy and sleep-disordered subjects with 44 nights of recording(over 8 h per night),providing substantial evidence that the electrodes can be leveraged to substitute for clinical standard electrodes.
