Research advances in the electroencephalographic characteristics and treatment of paradoxical insomnia

Paradoxical insomnia (Para-I), also known as pseudoinsomnia or sleep state misperception, is a condition in which the patient complains of severe insomnia but has no objective evidence of sleep disorder, and daytime functioning may be disrupted disproportionately to the degree of patient-reported sleep loss. Para-I is characterized by overestimation of sleep latency (SL) and underestimation of total sleep time (TST). Incorrect assessment of sleep quality hinders the diagnosis, evaluation of severity, and assessment of clinical efficacy of sleep disorders. The pathogenesis of Para-I remains unclear, but may be related to factors such as depression, anxiety, personality traits, social relationships and specific changes in brain structure and function. Studies on the polysomnography (PSG) of the patients with insomnia have found that changes in non-rapid eye movement (NREM) and rapid eye movement (REM) sleep may be related to the degree of subjective-objective sleep discrepancy. PSG is a valuable diagnostic tool for sleep disorders. It allows for the analysis of sleep structure and related physiological and behavioral changes by monitoring various parameters, including electroencephalogram (EEG), electromyogram (EMG), electrooculogram (EOG), oro-nasal airflow, thoracic and abdominal respiratory motions, oxygen saturation, electrocardiogram (ECG) and snoring. In recent years, studies have increasingly explored the sleep EEG and treatment of Para-I with PSG, resulting in significant progress. This article reviews the latest advances in the electroencephalographic characteristics and treatment of Para-I, providing new ideas for precise treatment

Resting-state functional connectivity changes within the default mode network and the salience network after antipsychotic treatment in early-phase schizophrenia

OBJECTIVE: Abnormal resting-state functional connectivity (FC), particularly in the default mode network (DMN) and the salience network (SN), has been reported in schizophrenia, but little is known about the effects of antipsychotics on these networks. The purpose of this study was to examine the effects of atypical antipsychotics on DMN and SN and the relationship between these effects and symptom improvement in patients with schizophrenia. METHODS: This was a prospective study of 33 patients diagnosed with schizophrenia and treated with antipsychotics at Shanghai Mental Health Center. Thirty-three healthy controls matched for age and gender were recruited. All subjects underwent functional magnetic resonance imaging (fMRI). Healthy controls were scanned only once; patients were scanned before and after 6-8 weeks of treatment. RESULTS: In the DMN, the patients exhibited increased FC after treatment in the right superior temporal gyrus, right medial frontal gyrus, and left superior frontal gyrus and decreased FC in the right posterior cingulate/precuneus (P\u3c0.005). In the SN, the patients exhibited decreased FC in the right cerebellum anterior lobe and left insula (P\u3c0.005). The FC in the right posterior cingulate/precuneus in the DMN negatively correlated with the difference between the Clinical Global Impression (CGI) score pre/post-treatment (r=-0.564, P=0.023) and negative trends with the difference in the Positive and Negative Syndrome Scale (PANSS) total score pre/post-treatment (r=-0.475, P=0.063) and the difference in PANSS-positive symptom scores (r=-0.481, P=0.060). CONCLUSION: These findings suggest that atypical antipsychotics could regulate the FC of certain key brain regions within the DMN in early-phase schizophrenia, which might be related to symptom improvement. However, the effects of atypical antipsychotics on SN are less clear

Interaction of social role functioning and coping in people with recent-onset attenuated psychotic symptoms: a case study of three Chinese women at clinical high risk for psychosis

Clinical high risk of psychosis is defined as the period in which the first signs of psychotic symptoms begin to appear. During this period, there is an increased probability of developing frank psychosis. It is crucial to investigate the interaction between psychotic symptoms and the individual’s personality and life experiences in order to effectively prevent, or delay the development of psychosis. This paper presents case reports of three Chinese female subjects with attenuated positive symptoms, attending their initial outpatient assessment in a mental health service, and their longitudinal clinical outcomes. Information regarding each subject’s symptoms and life stressors was collected at 2-month intervals over a 6-month period. The assessments indicated that these women were suffering from the recent onset of symptoms in different ways. However, all three hid their symptoms from others in their school or workplace, and experienced a decline in performance related to their social roles and in their daily functioning. They were often excluded from the social groups to which they had previously belonged. A decline in social activities may be a risk factor in the development of psychosis and a mediator of functional sequelae in psychosis. Effective treatment strategies may include those that teach individuals to gain insights related to their symptoms and a service that provides a context in which individuals can discuss their psychotic symptoms

Psychometric Properties of the Chinese Version of the Perceived Stress Scale in Policewomen

BACKGROUND: The 10-item Perceived Stress Scale (PSS-10) is one of most widely used instruments to measure a global level of perceived stress in a range of clinical and research settings. This study was conducted to examine the psychometric properties of the Simplified Chinese version of the PSS-10 in policewomen. METHODOLOGY: A total of 240 policewomen were recruited in this study. The Simplified Chinese versions of the PSS-10, the Beck Depression Inventory Revised (BDI-II), and the Beck Anxiety Inventory (BAI) were administered to all participants, and 36 of the participants were re-tested two weeks after the initial testing. PRINCIPAL FINDINGS: The overall Cronbach's alpha was 0.86, and the test-retest reliability coefficient was 0.68. Exploratory Factor Analysis (EFA) yielded 2 factors with eigenvalues of 4.76 and 1.48, accounting for 62.41% of variance. Factor 1 consisted of 6 items representing "negative feelings"; whereas Factor 2 consisted of 4 items representing "positive feelings". The item loadings ranged from 0.72 to 0.83. The Confirmatory factor analysis (CFA) indicated a very good fit of this two-factor model to this sample. The PSS-10 significantly correlated with both BDI-II and BAI, indicating an acceptable concurrent validity. CONCLUSIONS: The Simplified Chinese version of the PSS-10 demonstrated adequate psychometric properties for evaluating stress levels. The results support its use among the Chinese population

Patterns of Childhood Trauma and Psychological Distress among Injecting Heroin Users in China

Background: Childhood trauma has been reported as a possible cause of future substance abuse in some countries. This study reports the prevalence of childhood trauma and examines its association with psychological distress among injecting drug users from mainland China. Methodology: The study was conducted in three government-operated drug rehabilitation facilities in Shanghai, China in 2007. The Early Trauma Inventory Self Report-Short Form (ETISR-SF) was used to evaluate 4 types (general, emotional, physical and sexual) and severity of childhood trauma, and the Symptom Checklist-90-Revised (SCL-90-R) to evaluate psychological distress. Principal Findings: Among 341 injecting drug users who completed the study, about 80 % reported one or more types o

Abnormalities of White Matter Microstructure in Unmedicated Obsessive-Compulsive Disorder and Changes after Medication

BACKGROUND: Abnormalities of myelin integrity have been reported in obsessive-compulsive disorder (OCD) using multi-parameter maps of diffusion tensor imaging (DTI). However, it was still unknown to what degree these abnormalities might be affected by pharmacological treatment. OBJECTIVE: To investigate whether the abnormalities of white matter microstructure including myelin integrity exist in OCD and whether they are affected by medication. METHODOLOGY AND PRINCIPAL FINDINGS: Parameter maps of DTI, including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD), were acquired from 27 unmedicated OCD patients (including 13 drug-naïve individuals) and 23 healthy controls. Voxel-based analysis was then performed to detect regions with significant group difference. We compared the DTI-derived parameters of 15 patients before and after 12-week Selective Serotonin Reuptake Inhibitor (SSRI) therapies. Significant differences of DTI-derived parameters were observed between OCD and healthy groups in multiple structures, mainly within the fronto-striato-thalamo-cortical loop. An increased RD in combination with no change in AD among OCD patients was found in the left medial superior frontal gyrus, temporo-parietal lobe, occipital lobe, striatum, insula and right midbrain. There was no statistical difference in DTI-derived parameters between drug-naive and previously medicated OCD patients. After being medicated, OCD patients showed a reduction in RD of the left striatum and right midbrain, and in MD of the right midbrain. CONCLUSION: Our preliminary findings suggest that abnormalities of white matter microstructure, particularly in terms of myelin integrity, are primarily located within the fronto-striato-thalamo-cortical circuit of individuals with OCD. Some abnormalities may be partly reversed by SSRI treatment

Study on the Evolution of the Source-Flow-Sink Pattern of China’s Chunyun Population Migration Network: Evidence from Tencent Big Data

We construct a comprehensive analysis framework of population flow in China. To do so, we take prefecture-level administrative regions as the basic research unit of population flow and use source-sink theory and flow space theory. Additionally, we reveal the dynamic differentiation of population flow patterns and the evolution of population source-flow-sink systems. We try to provide a theoretical basis for the formulation of population development policies and regional spatial governance. The results show the following: (1) The Hu Huanyong Line has a strong spatial lock-in effect on population flow. Additionally, provincial capital cities, headed by Hangzhou, Nanjing, and Hefei, have played an increasingly prominent role in population flow. (2) The developed eastern coastal areas have undertaken China’s main population outflow. The net population flow is spatially high in the middle of the region and low on the two sides, exhibiting an “inverted U-shaped” pattern. Furthermore, the borders of the central provinces form a continuous population inflow area. (3) The hierarchical characteristics of the population flow network are obvious. Strong connections occur between developed cities, and the effect of distance attenuation is weakened. The medium connection network is consistent with the traffic skeleton, and population flow exhibits a strong “bypass effect”. (4) The source and sink areas are divided into four regions similar to China’s three major economic belts. The 10 regions can be refined to identify the main population source and sink regions, and the 18 regions can basically reflect China’s level of urbanization. The network of the population flow source-flow-sink system exhibits notable nesting characteristics. As a result, it creates a situation in which the source areas on both sides of the east and the west are convective to the middle. The hierarchical differentiation of the source-flow sink system is related to the differences between the east and the west and between the north and the south, as well as local differences in China

Analysis of Urban Resilience in Water Network Cities Based on Scale-Density-Morphology-Function (SDMF) Framework: A Case Study of Nanchang City, China

In the face of increasing disturbance factors, resilience has become an important criterion for measuring the sustainable development of cities. Quantitatively describing the development process of urban resilience and identifying key areas and important dimensions of urban resilience are of scientific significance for understanding the evolutionary law of urban resilience, guiding regional risk prevention, and building an environment for urban resilience development. For this study, taking Nanchang City as a case study and dividing the natural water network groups, the resilience index system was constructed from scale, density, morphology, and function by drawing on the theory of landscape ecology on the basis of considering the internal relationship between urban development attributes and disturbance factors. On this basis, the study focuses on the evolution process and development differences of resilience in various dimensions from the water network groups and quantitatively describes the coordinated development status and adaptive phase characteristics of urban resilience. This study not only enriches the research scale and perspective of urban resilience but also provides specific spatial guidance for formulating resilient urban planning and promoting sustainable urban development

Analysis of Urban Resilience in Water Network Cities Based on Scale-Density-Morphology-Function (SDMF) Framework: A Case Study of Nanchang City, China

In the face of increasing disturbance factors, resilience has become an important criterion for measuring the sustainable development of cities. Quantitatively describing the development process of urban resilience and identifying key areas and important dimensions of urban resilience are of scientific significance for understanding the evolutionary law of urban resilience, guiding regional risk prevention, and building an environment for urban resilience development. For this study, taking Nanchang City as a case study and dividing the natural water network groups, the resilience index system was constructed from scale, density, morphology, and function by drawing on the theory of landscape ecology on the basis of considering the internal relationship between urban development attributes and disturbance factors. On this basis, the study focuses on the evolution process and development differences of resilience in various dimensions from the water network groups and quantitatively describes the coordinated development status and adaptive phase characteristics of urban resilience. This study not only enriches the research scale and perspective of urban resilience but also provides specific spatial guidance for formulating resilient urban planning and promoting sustainable urban development