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To investigate the prevalence of psychotic depression and the differences in sociodemographic and clinical characteristics and prescription patterns of psychotropic medications between patients with psychotic depression (PD) and patients with nonpsychotic depression (NPD) in China.We conducted a cross-sectional study in 13 major psychiatric hospitals or the psychiatric units of general hospitals in China from September 1, 2010, to February 28, 2011. PD was defined according to the psychotic disorder section of the Mini International Neuropsychiatric Interview (MINI). The sociodemographic and clinical characteristics and the prescription patterns of psychotropic medications were compared between the PD and NPD groups. Multivariate logistic regression analysis was used to investigate factors associated with an increased likelihood of PD.Among 1172 MDD patients, the prevalence of psychotic features was 9.2% in the present study. The logistic regression analysis indicated that unmarried (OR = 2.08, p 0.001), frequent depressive episodes (OR = 2.10, p = 0.020), depressive episodes with suicidal ideation and attempts (OR = 1.91, p = 0.004), and patients who were prescribed any antipsychotics (OR = 2.94, p 0.001) were associated with psychotic features in patients with MDD.Cross-sectional design, retrospective recall of some data CONCLUSION: The prevalence of PD is high in China, and there were some differences in demographic and clinical characteristics between patients with PD and patients with NPD. Clinicians should regularly assess psychotic symptoms and consider intensive treatment and close monitoring when treating subjects with PD.

Figure S1. Enrollment IPTASC Study. (PDF 22 kb)

Little has been reported about the demographic and clinical features of major depressive disorder (MDD) with comorbid dysthymia in Chinese patients. This study examined the frequency of comorbid dysthymia in Chinese MDD patients together with the demographic and clinical correlates and prescribing patterns of psychotropic drugs.Consecutively collected sample of 1178 patients with MDD were examined in 13 major psychiatric hospitals in China. Patients' demographic and clinical characteristics and psychotropic drugs prescriptions were recorded using a standardized protocol and data collection procedure. The diagnosis of dysthymia was established using the Mini International Neuropsychiatric Interview. Medications ascertained included antidepressants, antipsychotics, benzodiazepines, and mood stabilizers.One hundred and three (8.7%) patients fulfilled criteria for dysthymia. In multiple logistic regression analyses, compared to non-dysthymia counterparts, MDD patients with dysthymia had more depressive episodes with atypical features including increased appetite, sleep, and weight gain, more frequent lifetime depressive episodes, and less likelihood of family history of psychiatric disorders. There was no significant difference in the pattern of psychotropic prescription between the 2 groups.There are important differences in the demographic and clinical features of comorbid dysthymia in Chinese MDD patients compared with previous reports. The clinical profile found in this study has implications for treatment decisions.

To detect the changes of cortical thickness and cortical surface area in untreated patients of first-episode schizophrenia.Fifty-seven untreated patients of first-episode schizophrenia (SCZ) hospitalized from September 2009 to March 2012 at Department of Psychiatry, Third Affiliated Hospital, SUN Yat-sen University and 57 healthy controls (HC) recruited by advertising during the same period underwent a high resolution three-dimensional magnetic resonance imaging of brain structures. And cortical-surface based technique was used to analyze the cortical thickness and cortical surface area. The general linear model (GLM) was employed to detect the differences of cortical thickness and cortical surface area between two groups.were corrected for multiple comparisons by the Monte Carlo simulation method.As compared with HC, the cortical thickness of left superior frontal, left caudal middle cingulate, left lateral occipital, right superior frontal, right superior temporal and right fusiform regions in SCZ decreased by 6.0%, 7.2%, 8.2%, 5.2%, 7.1% and 6.0% respectively. And the largest reductions occurred in left lateral occipital regions. Cortical surface area of each brain regions in SCZ had no significant difference with HC.Cortical thickness reductions exist in multiple brain regions in schizophrenia. It may be the neuropathological mechanisms of schizophrenia.

To explore the diffusion tensor imaging (DTI) features of white matter in healthy siblings of schizophrenics.Twenty healthy siblings of schizophrenics and 45 healthy controls without a family history of mental disorder. They responded to advertised recruitment during December 2009 and March 2012. All participants underwent diffusion weighted magnetic resonance images with a single-shot echo planar imaging (EPI) sequence aligned to straight axial plane. The fractional anisotropy (FA) images of two groups underwent two-sample t-test with SPM5 software.The healthy siblings of schizophrenics demonstrated a significant decrease of regional white matter FA values in right anterior cingulated (MNI: x = 9, y = 43, z = 4; cluster = 106).Reduced white matter integrity in right anterior cingulated may be a risk actor of schizophrenia.

To explore the roles of diffusion tensor imaging (DTI) of white matter at an early stage of schizophrenia.The participants were 20 first-episode, medication-naïve schizophrenics at an early stage (1 - 6 months) and 20 healthy controls adjusted in gender and age during December 2009 and October 2010. They underwent diffusion weighted magnetic resonance imaging with a single-shot echo planar imaging (EPI) sequence aligned to straight axial plane. The fractional anisotropy (FA) images of two groups underwent two-sample paired t-test with SPM5 software.The schizophrenics at an early stage demonstrated a significant decrease of regional white matter FA values in right anterior cingulated (MNI: x = 12, y = 24, z = -10; cluster = 145) and right middle occipital lobe (MNI: x = 36, y = -76, z = -2; cluster = 135).The altered white matter DTI in right anterior cingulated and middle occipital lobe may contribute to an early detection of schizophrenia.

Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to examine prescribing patterns of antidepressants, antipsychotics and mood stabilizers in BD patients misdiagnosed with MDD in China.A total of 1487 patients originally diagnosed with MDD were consecutively screened for diagnostic revision in 13 psychiatric hospitals or psychiatric units of general hospitals in China nationwide. The patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The Mini International Neuropsychiatric Interview (MINI) was used to establish DSM-IV diagnoses. Data on psychotropic prescriptions were collected by a review of medical records.Three hundred and nine of the 1487 patients (20.8%) fulfilled DSM-IV criteria for BD; 118 (7.9%) for BD-I and 191 (12.8%) for BD-II on the MINI. Of the BD patients (n = 309), 227 (73.5%) received any use of antidepressants, 73 (23.6%) antipsychotics and 33 (10.7%) mood stabilizers. In multiple logistic regression analyses, compared with those with MDD, patients with BD-I were more likely to receive antidepressants (OR 1.7, 95% CI 1.1-2.8, p = 0.02), antipsychotics (OR 1.6, 95% CI 1.04-2.5, p = 0.04) and mood stabilizers (OR 3.9, 95% CI 2.1-7.2, p0.001), whereas patients with BD-II were more likely to receive mood stabilizers (OR 2.4, 95% CI 1.3-4.4, p = 0.003). There was no difference in the use of antidepressants (OR 1.1, 95% CI 0.8-1.5, p = 0.7) and antipsychotics (OR 1.3, 95% CI 0.9-1.9, p = 0.2) between BD-II and MDD. In addition, there was no difference between BD-I and BD-II in any use of antidepressants, antipsychotics and mood stabilizers.The prescription of antidepressants for BD patients misdiagnosed with MDD is very common, and only a very small proportion of patients received guideline-concordant treatment. Considering the potentially hazardous effects of inappropriate pharmacotherapy in this population, continuing education and training addressing the correct diagnosis of BD and rational use of psychotropic medications are needed in China.

To compare the regional white matter integrity of schizophrenics with impulsive behaviors versus those without.Seventeen patients with first-episode-schizophrenia impulsive behaviors and 24 patients with first-episode-schizophrenia non-impulsive behaviors underwent diffusion weighted magnetic resonance imaging with a single-shot echo planar imaging (EPI) sequence aligned to straight axial plane. The fractional anisotropy (FA) images of two groups received two-sample t-test with SPM5 software.The patients with impulsive behaviors demonstrated a significant decrement of white matter FA values in left precentral gyrus (MNI: x = -28.00, y = -28.72, z = -54.71; cluster = 79 voxels), left cerebellum anterior lobe (MNI: x = -22, y = -56, z = -28; cluster = 130 voxels) and left occipital lobe (MNI: x = -6, y = -72, z = 6; cluster = 54 voxels).The altered white matter integrity of left precentral gyrus, cerebellum anterior lobe and occipital lobe may be involved in the neural mechanism of impulsive behaviors in schizophrenia.

To investigate the integrity of white matters in first-episode and chronic schizophrenics.For this study, 39 first-episode and 38 chronic schizophrenics, 69 healthy controls (age, gender and years of received education no significantly different from those of the patients) underwent diffusion weighted images with a single-shot echo planar imaging (EPI) sequence aligned to the straight axial plane. The fractional anisotropy (FA) images of three groups underwent one-way ANOVA with the methods of voxel-based morphometric (VBM) analysis.(1) There were three brain regions where the FA values of white matter were different among three groups: right caudate nucleus (MNI: 20, 12, 14; cluster = 432 voxels; FA value: 0.36 ± 0.18 vs 0.35 ± 0.24 vs 0.38 ± 0.17), left insula (MNI: -32, 18, 2; cluster = 204 voxels; FA value: 0.35 ± 0.31 vs 0.33 ± 0.24 vs 0.36 ± 0.21) and right anterior cingulate (MNI: 16, 36, 12; cluster = 132 voxels; FA value: 0.35 ± 0.29 vs 0.34 ± 0.31 vs 0.37 ± 0.25). (2) The mean FA values of the three brain regions of two patients groups decreased versus those of healthy controls (P0.05). (3) The mean FA values of left insular region in chronic patients decreased versus those of the first-episode patients (P0.05).The reduced integrity of white matter may play an etiological role in schizophrenia and the changes are probably progressive.

Lin, S.-F., Lu, X.-J., Zheng, W.-F. and Zhang, J.-B., 1993. A novel search/match system for X-ray powder diffraction data. Chemometrics and Intelligent Laboratory Systems, 20: 85–91. In this article, a new method for identifying components in crystalline mixtures by X-ray powder diffraction is presented. It is based on the powder diffraction file (PDF) provided by the JCPDS-International Centre for Diffraction Data and implemented on IBM PCs using MS FORTRAN 5.0. Unlike other methods, this method uses the weight factor for each diffraction peak as a criterium, and can not only give a list of possible phases but also the definite components of the unknown sample by a simulation process. Actual samples including organic samples have been tested with high performance.

An efficient algorithm for rapid retrieval of elemental information (EI) and its implementation on IBM PCs by Microsoft FORTRAN 5.0 are presented. Bit mapping and Boolean operations result in compact storage, flexible and rapid EI search. Its applications are discussed.