Clozapine is the most effective medication for treatment-refractory schizophrenia but is associated with significant adverse drug reactions, including nocturnal enuresis and urinary incontinence. This side effect can be burdensome and lead to medication nonadherence and psychotic relapse. Evidence to guide treatment of clozapine-induced nocturnal enuresis and urinary incontinence is sparse. We therefore aimed to synthesize the evidence base to guide management for clinicians, patients, and their carers.

We systematically searched PubMed, Embase, PsycInfo, CINAHL, and the Cochrane Trial Registry databases from inception to May 2021 for publications on management of clozapine-induced nocturnal enuresis and urinary incontinence using a PROSPERO preregistered search strategy.

We identified 22 case reports and case series describing 74 patients. Interventions included clozapine dose reduction, nonpharmacological treatment, and pharmacological treatments. Among pharmacological treatments, desmopressin, oxybutynin, trihexyphenidyl, tolterodine, imipramine, amitriptyline, ephedrine, pseudoephedrine, aripiprazole, and verapamil were associated with complete resolution of nocturnal enuresis and urinary incontinence. Balancing evidence for effectiveness against risk of adverse effects, we developed a management framework for clozapine-induced nocturnal enuresis and urinary incontinence.

Following assessment of urological, psychiatric, pharmacological, and common comorbid medical issues, first-line treatments should be nonpharmacological, including bathroom alarms, voiding before bedtime, and nocturnal fluid restriction. If these interventions do not provide adequate relief, aripiprazole should be trialed. Desmopressin may be considered for severe refractory cases, but monitoring for hyponatremia is essential.

Anxiety disorder is one of the common mental health problems in college students, which hurts their study, work, and life. Comprehensive psychological crisis intervention is a complete psychological treatment method expected to be essential in treating anxiety disorders in college students.

One hundred college students with anxiety disorder were selected as research subjects and randomly divided into two groups. The experimental group received comprehensive psychological crisis intervention treatment and comprehensive intervention measures such as psychological assistance, cognitive behavioral therapy, and intimate relationship training. The control group received traditional psychotherapy, including counseling and medication. The Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and other assessment tools were used to carry out psychological measurements of the two groups of patients before, after, and at the follow-up point, respectively. The collected information was statistically analyzed by SPSS23.0 software.

After the comprehensive psychological crisis intervention treatment, the anxiety and depression levels of the experimental group were significantly reduced (P<0.001), and life satisfaction was significantly increased (P<0.001). Compared with the control group, the experimental group showed obvious advantages in curative effect.

Comprehensive psychological crisis intervention has shown remarkable efficacy in college students with anxiety disorders, can effectively reduce anxiety and depression, and improves the life satisfaction of patients. This approach may become an essential option for treating anxiety disorders in college students.

2021 Humanities and Social Sciences Research Project for Basic Research Business Expenses of Provincial Undergraduate Universities in Heilongjiang Province. No. 2021- kyywf-0384.

Schizophrenia is a common mental disease in clinic, which is a mental disorder with slow loss of function and decline. Schizophrenia is usually treated with drugs, such as risperidone. However, with the increase of schizophrenic patients and the enhancement of drug resistance, the effect of drug treatment alone has declined. Cognitive behavior therapy is a widely used psychotherapy method to treat mental disorders, which can be seen as a combination of cognitive therapy and behavior therapy. Cognitive behavior therapy can change individual behavior by adjusting individual cognition, and reconstruct individual irrational cognition through training. Therefore, the study will combine cognitive behavior therapy with risperidone to treat schizophrenia patients for clinical diagnosis and treatment.

In this experiment, 98 schizophrenics in a hospital were selected as the research object. 45 of them were treated with risperidone alone, which was regarded as group A. The other 53 patients were treated with cognitive behavioral therapy on the basis of risperidone, and were regarded as group B. The basic data of the two groups were compared, such as age, sex, etc., to ensure the feasibility of this experiment. At the same time, the cognitive functions of the two groups were compared. Before and after treatment, a cognitive ability test consensus scale was used to quantify the cognitive abilities of patients. SPSS21.0 statistical software was used for statistical analysis. The results were shown in Figure 1.Figure 1.

Scores of cognitive abilities before and after treatment

Cognitive dysfunction is an independent core symptom of schizophrenia. From the experimental results, the score of group B before treatment was 42±7.61, which was higher than 41.57±6.25 of group A, but lower than 50.47±7.65 of group A after treatment, which was 47.21±8.45. Among them, the scores of most indicators such as connectivity, visual learning, and social cognition in group B were higher than those in group A before treatment, but all indicators were lower than those in group A after treatment. To sum up, the method of risperidone combined with cognitive behavioral therapy selected in the study has certain effectiveness in alleviating the cognitive disorder of psychiatric patients, and can effectively alleviate the clinical symptoms of schizophrenia patients.

The cognitive impairment of schizophrenic patients has been paid more and more attention. In the actual work process, schizophrenics often show behaviors such as denying illness or refusing to take medicine, which will further aggravate their illness. Therefore, on the basis of the use of risperidone, combined with cognitive behavioral therapy, it can strengthen patients’ self-cognition, overcome their bad mentality, enhance patients’ attention to drug treatment, improve drug compliance, improve negative symptoms, and achieve treatment goals. It has high practicability in clinic.

The aim of this paper is to review evidence on Interpersonal Psychotherapy (IPT) administered via telephone (IPT-T).

We conducted a systematic review of studies published between January 1, 1990 and June 30, 2020, assessing the efficacy of IPT administered by phone, using PubMed.

Originally, we found 60 papers; the final selection led to 13 papers. Six studies were performed using a randomized clinical trial methodology (6/13, 46.2%), three were prospective open-label not randomized studies (3/13, 15.7%), three were pilot studies (3/13, 23.1%), and one was a feasibility/acceptance study (1/13, 7.7%). The number of subjects included in the studies ranged between 14 and 442 (mean: 140.0 ± 124.9), for a total of 1850 patients. The mean age of the enrolled subjects was 47.8 ± 9.3 years (range: 27.4-70.4). Thirty-four different instruments were utilized. Qualitative synthesis was conducted only on randomized controlled trials (RCTs), namely on six studies. RCTs were almost all of good quality (mean score/standard deviation of the RCT-Psychotherapy Quality Rating Scale omnibus rating: 5.6 ± 1.2 points; range: 3-7).

IPT-T showed response rates similar to IPT administered in the usual way. Results are limited by small samples sizes, selection bias of the less severe depressed patients, and the heterogeneity of rating scales.

The neurocognitive disorder is a common neuropsychological disease characterized by impaired cognitive function, attention deficit, and memory loss. With the aging of the population and lifestyle changes, the prevalence of neurocognitive disorders is on the rise, seriously affecting patients’ quality of life. Acupuncture therapy, an essential part of traditional Chinese medicine, has shown potential therapeutic effects in treating neurocognitive disorders.

The outcome based education concept was incorporated into acupuncture therapy to explore its therapeutic effect on neurocognitive disorders. The study included 50 neurocognitive-impaired patients, 25 of whom received acupuncture therapy under the outcome based education concept as an experimental group. The other 25 served as a control group and received traditional Chinese acupuncture treatment. The experiment lasted three months, and the 3-minute Delirium Diagnostic Scale (3D-CAM) was used to measure the level of consciousness, mental clarity, attention, and delirium characteristics.

After receiving acupuncture therapy under the outcome based education concept, most of the patients in the experimental group had a lower risk of delirium, and their attention, thinking, and consciousness levels were significantly improved. Patients in the control group generally had a higher risk of delirium, difficulty concentrating, and memory loss.

The study proposed that the outcome based education concept in acupuncture therapy has a more noticeable effect on treating neurocognitive disorders. At the same time, this study’s results will help reveal the mechanism of acupuncture therapy in treating neurocognitive disorders and provide guidance for clinical practice.

The research is supported by the Key R&D project of Hainan Province (No.zdyf2019191).

Drug-induced movement disorders (DIMDs) form an important subgroup of secondary movement disorders, which despite conferring a significant iatrogenic burden, tend to be under-recognized and inappropriately managed.

We aimed to look into phenomenology, predictors of reversibility, and its impact on the quality of life of DIMD patients.

We conducted the study in the Department of Neurology at a tertiary-care centre in India. The institutional ethics-committee approved the study. We assessed 55-consecutive DIMD patients at presentation to our movement disorder clinic. Subsequently, they followed up to evaluate improvement in severity-scales (UPDRS, UDRS, BARS, AIMS) and quality of life (EuroQol-5D-5L). Wilcoxan-signed-rank test compared the scales at presentation and follow-up. Binary-logistic-regrerssion revealed the independent predictors of reversibility.

Fourteen patients (25.45%) had acute-subacute DIMD and 41 (74.55%) had tardive DIMD. Tardive-DIMD occurred more commonly in the elderly (age 50.73±16.92 years, p<0.001). Drug-induced-Parkinsonism (DIP) was the most common MD, followed by tardivedyskinesia. Risperidone and levosulpiride were the commonest culprit drugs. Patients in both the groups showed a statistically significant response to drug-dose reduction /withdrawal based on follow-up assessment on clinical-rating-scales and quality of life scores (EQ-5D-5L). DIMD was reversible in 71.42% of acute-subacute DIMD and 24.40% of patients with chronic DIMD (p=0.001). Binary-logistic-regression analysis showed acute-subacute DIMDs and DIP as independent predictors of reversibility.

DIP is the commonest and often reversible drug-induced movement disorder. Levosulpiride is notorious for causing DIMD in the elderly, requiring strict pharmacovigilance.

Attention Deficit Hyperactivity Disorder (ADHD) is a common psychological disorder in childhood, also known as child hyperactivity disorder. Its clinical manifestations mainly include excessive activity, inattention, impulsivity, irritability, etc. If the intervention is not carried out in time, it may lead to serious psychological, behavioral, social, learning, or other issues in children, affecting their normal social life. Although drug treatment can improve the symptoms of some ADHD patients, drug treatment alone may cause persistent residual symptoms, addiction and adverse reactions. Feedforward control nursing is an active intervention mode. It realizes the control purpose by controlling variables, plays the role of preventing problems before they occur and solving problems as early as possible. It can provide efficient and high-quality nursing for children. Therefore, our hospital conducted clinical treatment for children with attention deficit hyperactivity disorders through feedforward control nursing combined with methylphenidate sustained-release tablets, in order to provide reference value for the treatment intervention of children with attention deficit hyperactivity disorder.

120 children with ADHD who were admitted to a psychiatric hospital in the same period were selected as the study subjects. The patients were randomly divided into the experimental group and the control group. The experimental group was given a treatment scheme of feedforward control nursing combined with methylphenidate sustained-release tablets, and the control group was given conventional drug treatment. Before the intervention, both groups were given methylphenidate hydrochloride sustained-release tablets for oral treatment. The initial dose of treatment was 19 mg per day, the maximum dose was 53 mg per day, and the intervention time was 3 months. The children were evaluated once a month with Abbreviated Symptom Questionnaire (ASQ). The lower the score, the better the intervention effect. The experimental data were analyzed by SPSS20.0 software.

After 3-month intervention, the ASQ scores of the two groups were compared. The results were shown in Table 1. After the intervention, the scores of the experimental group at 1 month, 2 months and 3 months after the intervention were significantly lower than those before the intervention (P < 0.05), and the scores of the control group at 2 months and 3 months after the intervention were significantly lower than those before the intervention (P < 0.05). The scores of the two groups were compared. The scores of the two groups before the intervention were not statistically significant, but the scores of the experimental group at 1 month, 2 months and 3 months after the treatment were significantly lower than those of the control group (P < 0.05). Among them, * represents P < 0.05 compared with that before intervention, and # represents P < 0.05 compared between groups.Figure 1.

Comparison of conners scale scores between the two groups before and after experimental group

Drug treatment alone can no longer meet the needs of patients, and the collaborative treatment of multiple therapies has become the current trend and research focus of this disease. In this study, feedforward control nursing combined with methylphenidate sustained-release tablets has a significant intervention effect on children with ADHD, which can improve the children’s sustained attention, effectively improve their behavioral ability and attention, and further improve the satisfaction of the children’s family members with nursing. It is worthy of promotion and application.