Women with mental illness are 5x more likely to experience an unplanned pregnancy due to lower rates of effective contraception use; they also experience higher rates of adverse pregnancy outcomes. Education about women’s reproductive health and family planning are not routinely offered in inpatient mental health and addiction treatment settings.

Weekly women’s groups on the inpatient psychiatry unit were led by psychiatry residents who were trained and provided a script. Groups focused on structured contraception education followed by an open-discussion format.

Data collected included the percentage of women with history of contraception use, child protective service involvement, unplanned pregnancies, abortions, and percentage of women who found the group helpful. Special care was taken to discuss contraception as a tool for empowering women to make their own decisions about their contraceptive needs.

Thirteen sessions were conducted, and attendance among women on the inpatient unit was 42%. Out of the 32 patients who participated, 100% found the group beneficial and responded they would share information they learned with women outside the group. 26.4% self-identified as using contraception, 50% had unplanned pregnancy, 23.6% have had an abortion, and 26.4% have had child protective services involvement.

Dissemination of contraceptive information in these women’s groups effectively led women to consider options that were available to them and seek contraceptive methods that were appropriate to their situation. Women reported they gained a better understanding of the medical, emotional, and financial implications of unplanned pregnancies. The groups were conducted in an open-discussion format that allowed women to participate in shared experiences; in many cases, the discussions were therapeutic. Feedback from patients and unit staff was positive. Many patients requested further groups to discuss issues women face, such as domestic violence and experiences as a mother.

Conducting women’s groups on the inpatient unit is critical in view of the poor access to healthcare that vulnerable women who seek inpatient psychiatric care experience. The groups on the inpatient unit are unique because it is often the only time these women have an opportunity for crucial, gender-specific preventative healthcare. These groups should further lead to appropriate referral and follow-up with primary care or women’s clinic providers.

Ongoing efforts will be put forth to increase group attendance, to incorporate participation from unit staff, and to build this group into a resident curriculum for group therapy.

No Funding

Newcomers to the workplace in the post-epidemic era are often accompanied by maladaptive symptoms such as anxiety and depression. Due to their varying degrees of severity, a combination of psychosocial and pharmacologic treatments is essential.

In this study, 500 on-the-job new employees of a company were selected as research subjects, and they were randomly divided into the control group and the research group. The control group was treated with medication only, and the research group was treated with a combination of psychological intervention medication. The medication was chosen to be buspirone hydrochloride tablets 10 mg 3 times/d orally, and analyzed with the Hamilton Rating Scale for Anxiety (HAM-A) as a control, and finally analyzed using SPSS 22.0 for statistical analysis.

After 3 months of experimentation in the study, the anxiety scale score of new employees in the control group decreased from 23 to 17, and the anxiety scale score of new employees in the research group decreased from 24 to 12. In the research group, there was a significant difference in the psychological stress of new employees before and after the experiment (P<0.05). The experimental results show that the treatment has a more obvious alleviating effect on the depression and anxiety of new employees in the post-epidemic era, which means combining psychological intervention and medication.

The combination of psychotherapy and drug therapy in this study can significantly alleviate the depression and anxiety of new employees after the epidemic. It can also provide a reference for other company managers and promote the attention to the psychological state of employees.

Humanities and Social Science project of Guangdong University of Science and Technology (No. GKY-2021KYYBW-35).

Stimulant medications and the norepinephrine reuptake inhibitor, atomoxetine, contain warnings regarding potential for slowing of growth (weight and height) in children and recommend monitoring of growth when using these medications for pediatric ADHD. Viloxazine ER (viloxazine extended-release capsules; Qelbree®), is a nonstimulant medication, FDA-approved for ADHD in adults and children (≥6 years of age). Viloxazine ER has pharmacologic differences from other approved ADHD medications and might not affect growth in the same manner as other therapies. A safety analysis was conducted to determine viloxazine ER effects on growth and weight trajectories in pediatric ADHD patients with long-term use.

Data were evaluated from five DBPC, phase 2 and 3 clinical trials and an ongoing long-term, open-label extension (OLE) trial (NCT02736656). Viloxazine ER doses during the trials ranged from 100–400 mg/day (age 6–11 yrs) or 100–600 mg/day (age 12–17 yrs). Height and weight were evaluated pretreatment in both DB and OLE every 3 months during the OLE, and converted into percentile values and corresponding z-scores using Centers for Disease Control (CDC) normal growth curves to evaluate growth trajectories. The incidence of weight- and growth-related adverse events (AEs) terms were also evaluated.

At the time of data cut (31 July 2019), 1097 subjects had received at least one dose of viloxazine ER in the OLE (66% male, mean (SD) age 10.8 (3.06), 59% age 6–11, mean (SD) BMI 18.8 (3.42) kg/m2, height 146.7 (17.46) cm, weight 42.1 (16.01) kg. During the OLE, mean (SE) z-scores for height and weight were between -1 and 1 for all timepoints, indicating growth measures within a normal range compared with expected values. Similar results were observed when weight and height were analyzed by sex and by age categories. Growth data were available for 338 subjects at 12 months. Among these subjects, the mean (SD) change from baseline in weight-for-age z-score was -0.2 (0.5) and height-for-age z-score was -0.14 (1.1). Adverse events relevant to weight and growth in the DB trials (incidence ≥ 1%) included (viloxazine ER [100–600 mg/day] n=1117 vs. placebo n=487): decreased appetite (8.1% vs. 0.8%), nausea (5.1% vs. 2.7%), vomiting (4.7% vs. 1.4%), weight increase (0.4% vs. 1.2%) and weight decrease (1.3% vs. 0.4%), and increased appetite (0.2% vs. 1.2%). During the OLE weight-and growth-related AEs reported for ≥ 1% of subjects were: decreased appetite 5.8%, vomiting 2.7%, nausea 2.4%, weight decreased 2.3%, and weight increased 2.0%.

Over time, pediatric subjects taking viloxazine ER, on average, maintained normal weight and height relative to the CDC’s child growth charts. However, because Qelbree may affect weight, it is recommended that healthcare providers check patient weight before starting and while using viloxazine ER.

Supernus Pharmaceuticals, Inc.

At present, students’ learning pressure is increasing, and many schools have introduced psychomusical therapy from the perspective of ideological and political courses to relieve students’ mental anxiety.

In this study, 100 students with mental anxiety disorder in a high school were selected as research objects and randomly divided into a control group and a study group. The control group was treated with clomipramine only. The study group was treated with ideological and political curriculum visual threshold psychomusic therapy based on clomipramine therapy and the self-rating Anxiety Scale (SAS) was used for comparative analysis. Finally, Minitab was used for statistical analysis.

After 3 months of the experiment, the anxiety scale score of middle school students in the control group changed from 65 points to 54 points; The anxiety scale scores of middle school students in the study group changed from 64 to 46. In the study group, the psychological pressure of students before and after the experiment was significantly different (P<0.05). The experimental results show that the combination of ideological and political curriculum visual psychomusical therapy with drug therapy can alleviate students’ mental anxiety.

In this study, the introduction of visual psychomusic in ideological and political courses into drug therapy has a positive impact on student’s mental anxiety caused by study pressure, and can also arouse other schools’ attention to mental health, provide new ideas for the popularization of psychological counselling, and promote the development of student’s mental health.

At present, the social economy is in a period of fast-paced change in China, with various modes of production and life evolving and emerging. The transfer of agricultural land is the transformation of the utilization mode of the main factors of production in rural areas, and it is one of the contents of the social and economic reform in rural areas. In 2021, the area of rural land transfer is up to 3.7×1011 m2 in China, an increase of 4.3% over the previous year. 1,239 counties (cities, districts) and 18,731 townships have established agricultural land management rights transfer centers to provide services such as policy consultation, information release, and contract signing for both sides of the transfer. Farmers are the subjects of agricultural land management and transfer. Their behaviors are affected by their psychology to some extent. In the long-term, dynamic, and gradual process of agricultural land transfer, it is particularly important to respect farmers’ wishes, pay attention to farmers’ psychology, and guide farmers’ behavior. However, only a few written contracts were signed. Most are verbal agreements of spontaneous or collective land transfers. The verbal agreements auto-execute to some extent within certain limits. The goals of farmers in farmland transfer are diversified, and their cognition, willingness and psychological identity affect the performance of the contract and the effect of transfer.

The psychological contract of agricultural land transfer can be defined as the transferor and transferee of agricultural land transfer. Through a certain psychological suggestion mode, through the subjective cognition and understanding of the rights and obligations of both parties, rather than the direct explicit expression, a contract relationship of rights and obligations is formed. The party awarding contract and the contractor are the subjects of agricultural land transfer. Therefore, the subjects of the psychological contract of agricultural land transfer include farmers, village collectives and enterprises, all of whom have equal status, forming their own psychological contracts. The forming process of the psychological contract of agricultural land transfer includes four steps. Step one is cognition and judgment. Both parties to the transfer are aware of and judge their own rights and obligations based on external environmental information and their own circumstances. Step two is psychological expectations. Before information is transmitted, both sides of the transmission transform cognition and judgment into psychological expectations. The third step is to convey psychological expectations. Both sides of transfer transmit psychological expectations by means of direct patterns, such as oral form and written form, and implicit ways, such as perception and comprehension. Step four is the formation of the psychological contract. Both sides of transfer reciprocally admit information of psychological expectations transmitted in implicit ways, forming psychological contracts. If they can’t come to an agreement on psychological contracts, a new four-step cycle is entered.

The forming of the psychological contract of agricultural land transfer is shown in Figure 1. First, farmers’ behavior background, such as the experiences of land lease and transfer, the targets of land transfer and education, has an effect on the building of psychological contracts and its type. On the one hand, the farmers who have the experience of land transfer and get high benefits from it are much more motivated than those who don’t have that experience or ever have dissension while transferring. On the other hand, the targets of transfer and the education level of farmers affect the type of psychological contracts. Second, Farmers’ subjective norms, mainly reflected in the difference in folk customs, will form various communication modes and take different measures to deal with breaching contracts while transferring. Third, farmers’ behavior cognition reflects in their comprehension of the capability of executing contracts, including bargaining power, decision-making level and managing modes of the rent. The ability of behavior cognition and control of farmers has a positive influence on their behavior intention and happened.

According to the above results, in order to promote the reposeful transfer and orderly development of agricultural land, the following suggestions are proposed: The first is to improve the agricultural land transfer policy system, establish and improve the institutional environment for agricultural land transfer, create conditions for the establishment of farmers’ behavioral psychological contracts in the process of agricultural land transfers, and guide farmers to establish relationship psychological contracts. The second is to improve the market system, properly cultivate and develop agricultural land transfer intermediaries, reduce transaction costs, and reduce the probability of farmers’ psychological contracts being broken. The third is to guide farmers to establish a positive agricultural land transfer psychology based on their resource endowments such as labor force quality and cultural quality, and encourage farmers to make agricultural land transfer decisions such as subcontracting, leasing, reselling, and interchanging.Figure 1.

Psychological contracts of agricultural land transfer forming

Executive function deficits (EFDs) are associated with attention-deficit/hyperactivity disorder (ADHD). Viloxazine ER (viloxazine extended-release capsules; Qelbree®) is a novel, nonstimulant, FDA-approved treatment for ADHD in persons ≥6 years of age. In a Phase 3, double-blind (DB), placebo-controlled trial in adults (NCT04016779), viloxazine ER-treated subjects exhibited significant improvement in both ADHD core symptoms (inattention and hyperactivity/impulsivity) compared to placebo. In addition, improvement in EFDs was observed in subjects using the Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A, Self-report), a 75-item scale that assesses aspects of executive function (Metacognition Index [MI]) and problems with self-regulation (Behavioral Regulation Index [BRI]) and overall functioning (Global Executive Composite [GEC]). At Week 6 in DB trial, a statistically significant greater reduction (improvement) was observed in viloxazine ER-treated subjects compared to placebo in the GEC and MI, but not in the BRI. Here, preliminary results of further BRIEF-A assessments in adults during an ongoing open-label extension (OLE) safety trial (NCT04143217) are presented.

Subjects complete the BRIEF-A at baseline and at Week 6 in the DB trial, and at Week 4 and every 8 weeks thereafter in the OLE trial. Subjects rate each BRIEF-A item on a 3-point scale (1=Never, 2=Sometimes, or 3=Often) based on the last month. Raw scores for GEC, MI, and BRI (sum of 70, 40, and 30 items, respectively) were converted to a T-score (mean=50, standard deviation=10; T-score ≥ 65 considered abnormally elevated) and then to a change from (DB) baseline (CFB) T-score. The mean [±SE] CFB T-score was calculated for the GEC, MI, and BRI by study OLE visit, and the mean last on-study OLE visit was analyzed using a paired t-test.

In the OLE trial, 157 subjects received viloxazine ER (first subject dosed, 24 Jan 2020; data cut, 30 MAR 2021). The mean [±SE (n)] T-score at DB baseline between placebo and viloxazine ER groups was similar for GEC [70.9 ± 0.82 (177) and 71.0 ± 0.77 (173)], MI [73.6 ± 0.86 (178) and 74.0 ± 0.83 (173)], and BRI [63.9 ± 0.85 (177) and 63.6 ± 0.77 (174)]. The CFB T-score decreased across OLE visits in all three measures. At last on-study OLE visit, the mean [±SE (n)] CFB T-score was significantly improved for the GEC [-12.4 ± 1.23 (121); P<0.0001], the MI (-12.6 ± 1.30 (121); P<0.0001], and the BRI [-10.0 ± 1.04 (122); P<0.0001]; median viloxazine ER dose was 400 mg/day.

Following the DB trial, improvement in executive function continued during viloxazine ER treatment in adults throughout the OLE trial, including a significant improvement at subjects’ last on-study visit for overall functioning (GEC) and both indices (MI and BRI). Overall, the results suggest adults with ADHD may show improvement in executive function with viloxazine ER treatment.

Supernus Pharmaceuticals, Inc.

At present, the employment pressure on college students is increasing, and their quality of life is also affected. Many colleges and universities have created innovation and entrepreneurship courses to answer questions and doubts for students in the employment dilemma.

This study selected 60 college students about to graduate from a university as research objects and randomly divided them into a control group and a research group. The control group did not receive training on innovation and entrepreneurship courses, while the research group received regular training on innovation and entrepreneurship courses. The state-trait anxiety (STAI) scale was used for comparative analysis, and finally, SAS was used for statistical analysis.

After a 3-month experiment, the STAI score of the control group increased from 62 points to 61 points; The STAI score of the research group increased from 63 points to 51 points. There was a significant difference in psychological stress among the research group of college students before and after the experiment (P<0.05). The experimental results indicate that carrying out innovation and entrepreneurship in universities can effectively alleviate employment anxiety among college students and improve their quality of life.

The integration of innovation and entrepreneurship into college education has a positive impact on the employment pressure of college students, and can also provide new employment ideas for students and promote the development of the college employment rate.

The development of social science is inseparable from the development of research methods. The traditional research methods such as factor analysis, regression analysis, and classical measurement theory cannot meet the professional development of modern disciplines. Therefore, a new generation of statistical analysis methods came into being, among which the most prominent development is the development and application of structural equation. Structural equation model is a statistical method that represents the theory with a corresponding linear equation system on the basis of the existing theory. It makes up for the shortcomings of traditional statistical methods, deals with the relationship between multiple causes and results, and measures variables that cannot be directly observed. Structural equation model has become an important tool in multivariate data analysis, which is widely used in social science data analysis, especially in the fields of education and psychology.

As a research method based on statistical analysis technology, structural equation model can be used to deal with the exploration and analysis of complex multivariable research data, estimation of latent variables, parameter estimation, and fitting degree estimation of complex independent variables and dependent variables prediction model at the same time. The complete structural equation model includes two parts: measurement model and structural model. The measurement model describes the relationship between latent variables and actual measured variables, while the structural model describes the relationship between latent variables.Figure 1.

Diagram of the full structural equation model

As shown in Figure 1, a complete structural equation model, the lambda said the relationship between the observed variables and latent variables, gamma said the relationship between exogenous variables and endogenous potential, beta said the relationship between endogenous latent variable, the delta said exogenous variables to explain the latent variables incomplete measuring residual, epsilon says endogenous variable to explain the latent variables measuring residual incomplete; ζ represents the estimated residuals of endogenous latent variables that cannot be fully explained. Figure 1 shows the relationship between exogenous variables on the left and endogenous variables on the right. the complete structural model is composed of γ and β parameters. The relationship between various variables and parameters involved in Figure 1 can be described by a general linear equation:

The relationship between specific variables and specific parameters in Figure 1 can be described by the following two equations:

From the above overview, it is not difficult to find that if there is no assumption of latent variables in a structural equation model, only the measured variables, then it is no different from the traditional path analysis model. Therefore, in general, the structural equation model can not only deal with the estimation of multiple regression equations at the same time, but also make the processing of variable relations more elastic. Anyhow, structural equation modeling following the general linear model of multivariate analysis to verify model analysis, can put the variance analysis, regression analysis, path analysis, factor analysis of traditional statistical methods, such as included in the model, the structural equation modeling and investigation and experiment analysis can be used, therefore more extensive applicability.

Although structural equation model has obvious advantages over traditional statistical methods, it still has limitations, and it is conditional in psychological research.

First, different theoretical assumptions, if the same variables, can be used to construct multiple models. But the more variables you have, the more models you can combine. This will bring difficulty to the test of model fit. Therefore, the use of structural equation model should pay more attention to theoretical discussion, and should be based on the exact theory or reasonable logical reasoning.

Second, in psychological research, if only data are used to explore the causal relationship between latent variables without special design, no statistical method, including structural equation model, can prove whether there is a causal relationship between variables. Therefore, in order to model causality between variables using structural equations, it is necessary to control the design of longitudinal structural equation patterns to help determine causality.

Third, the introduction of latent variables into structural equation model is originally an advantage of structural equation model, which can solve the shortcomings of univariate measurement in the past. However, whether such measurement truly reflects latent variables or whether indicators can truly represent latent variables is a problem worthy of attention.

Fourth, structural equation modeling analysis of demand is a linear relationship between variables, but in many cases, this requirement is difficult to guarantee, and even sure is a linear relationship between variables, the researchers could not put all the variables and the relationship between the built into the theoretical construction, so the data fitting is its support for the theoretical construction, but it can’t prove the correctness of the theoretical construction.

The analysis process of structural equation model generally includes the following steps:

Step 1: Model construction

The model construction includes specifying: The relationship between observed variables and latent variables; The relationship between the latent variables; In complex models, the value or relationship of parameters such as factor loading or factor correlation coefficient can be limited.

Step 2: Model identification

Identifying the specified model is an important stage in building the structural equation model. Model identification focuses on whether a unique estimate can be obtained from the observed data. If there is a non-identifiable parameter in the model, the model is a non-identifiable model, and the model cannot be estimated. In order to make the model recognizable, it is usually necessary to check two necessary conditions: first, the degree of freedom cannot be negative; The second is that every latent variable in the model must have a measurement scale

Step 3: Model fitting

With a new model, it is required to find the solution of the model, the main is the estimation of the model parameters, this process is model fitting. If the fitting index reaches the standard, the model is well fitted.

Step 4: Model evaluation

If each parameter in the structural equation model is successfully estimated, the overall model can be evaluated. The evaluation of the model is to analyze the fitting of the hypothesized model with the actual observed data through different statistical procedures or the calculation of the fitting index. If the fitting degree of the model is not ideal, it means that the proposed hypothesis model has problems. At this time, it is necessary to adjust the parameter estimation content of the hypothesis model and fit it again until the model fit degree reaches the ideal level.

Structural equation models, as a major development in statistical methods, are being used more and more widely by researchers in the application of psychological research. the following are some common structural equation models.

Confirmatory factor analysis (CFA) models:

(1) The basic concept of confirmatory factor

Confirmatory factor analysis is used to test whether the factor structure defined by the hypothesis or theory can fit the corresponding data. In short, it is to test the hypothesized relationship between measured variables and latent variables, which is the most basic measurement part of structural equation modeling. The theoretical factor structure is considered valid if the hypothesized confirmatory factor analysis model fits the data.

(2) Examples of confirmatory factor analysis

In a structural equation model, it is confirmatory factor analysis if only the test of the measurement model is involved. We take the measurement of subjective well-being as an example to perform confirmatory factor analysis. The SWB measurement scale contains three dimensions, each dimension has three questions, a total of 9 questions. The hypothetical model of the measurement model is shown in Figure 2.Figure 2.

Hypothetical model of the confirmatory factor analysis model

Confirmatory factor analysis is to verify the degree of fit of the hypothesized model. After the analysis using relevant software, the path coefficient is used to measure the degree of influence or effect size between variables. If the fitting indices such as GFI value, RMSEA value and NFI value meet the required fit criteria, the model has a good fit and the quality of the questions is good. If the fit index did not meet the requirements, the model was modified and re-analyzed.

Path analysis:

(1) Basic concepts of path analysis

Path analysis is a technique for analyzing causal models. The main feature of path analysis is that it can estimate all the parameters of the model at the same time by taking advantage of the covariation of the measured variables, and test the fit between the theoretical model and the observed data in conjunction with the proposed specific hypothesis model to find the best model.

(2) Examples of path analysis

Some researchers have pointed out that path analysis is a complex model formed by a series of mediating effects. For example, there are many factors affecting SWB. We take attachment style as the influencing factor X and SWB as the dependent variable Y. There is at least one mediating variable M (loneliness) in the relationship between X and Y, which forms the mediating effect of X M Y. That is, the independent variable X influences the mediating variable M and then the dependent variable Y. As shown in Figure 3.Figure 3.

Mediating effect diagram

Integrated analysis model:

(1) The basic concept of integrated analysis model

Integrated model analysis refers to structural equation model analysis with both measurement model and structural model. Simply speaking, integrated model analysis can be considered as the synthesis of confirmatory factor analysis and path analysis, which takes into account both internal and external aspects and integrates the core concepts of both.

(2) Examples of integrated model analysis

Usually, a unified model analysis contains multiple latent variables, which can be used not only as exogenous and endogenous variables, but also as mediating variables. In the illustrative illustration of path analysis, we propose that the dependent variable X influences the independent variable Y by influencing the mediator variable M. In other words, the level of loneliness will affect the level of subjective well-being, but the level of loneliness will be affected by attachment style. As shown in Figure 4.Figure 4.

Figure of the integrated model of structural equations for individual subjective well-being

After assuming the model, model definition, parameter estimation and analysis should be carried out. After analysis, if all the fitting indices meet the fit criteria, then the model is good. If one item does not meet the fit criteria, the model still needs to be modified.

The wide application of structural equation model reflects the progress of data analysis and statistical methods. This new method of data analysis and statistics lays a methodological foundation for our comprehensive understanding and in-depth study of psychological phenomena. However, we should not blindly use this method, should fully grasp the basic principles of the constitutive equation model, applicable conditions to use this method, in order to give full play to the advantages of this method.

Schizophrenia is a group of chronic diseases with unknown causes. It usually starts slowly or subacute in young adults. In clinical practice, it is often manifested as a syndrome with different symptoms, involving various obstacles in perception, thinking, emotion, and behavior, as well as uncoordinated mental activities. Patients are generally conscious and their intelligence is basically normal, but some patients may suffer from cognitive impairment during the disease process. Schizophrenia has a huge impact on the mental health of vocational college students. The study will strengthen education and management and combine psychotropic drugs to conduct clinical treatment of vocational college students’ schizophrenia and observe its effect, so as to provide a scientific basis for the clinical treatment of vocational college students’ schizophrenia.

60 students suffering from schizophrenia were selected from several vocational schools and divided into two groups: drug treatment group and combined treatment group. The students in the drug treatment group take conventional psychotic drugs for treatment, while the students in the combined treatment group take conventional psychotic drugs for treatment and also receive strengthened education and management. Before and after treatment, Minnesota Multiphasic Personality Inventory (MMPI) was used to evaluate the condition of schizophrenia of the two groups of students, and the evaluation results were statistically analyzed.

The MMPI scores of the two groups of students before treatment were 65.32±3.24 and 65.48±3.21 respectively. The MMPI scores of the two groups of students after treatment decreased compared with those before treatment. The average MMPI score of the drug treatment group after treatment was 57.46±3.18, and the average MMPI score of the combined treatment group was 45.83±2.87, which was statistically significant (P < 0.05) compared with the scores before the experiment. However, the remission effect of the combined treatment group after treatment was more significant than that of the drug treatment group. Table 1 shows the comparison of MMPI scores between the two groups before and after the experiment.Table 1.

Comparison of MMPI scores of patients before and after the experiment

Conventional psychotic drug treatment has a certain effect on the remission of schizophrenia in vocational college students, but the treatment plan of strengthening education management and combining psychotic drugs proposed in the study has a more significant effect on the remission of schizophrenia in vocational college students, providing a scientific basis for the clinical treatment of schizophrenia of vocational college students.

Currently utilized clinician-rated symptom scales for tardive dyskinesia (TD) have not kept up with the expanding spectrum of TD phenomenology. The objective of this study was to develop and test the reliability of a new instrument, the CTI.

A movement disorder neurologist devised the outline of the scale. A steering committee (four neurologists and two psychiatrists) provided revisions until consensus was reached. The resulting instrument assesses frequency of abnormal movements of the eye/eyelid/face, tongue/mouth, jaw, limb/trunk, complex movements (e.g., handwringing, self-caressing), and vocalizations. The CTI rates symptoms from 0–3 with 0 = absent, 1 = infrequent/intermittent or only present with activating maneuvers, 2 = frequent intermittent, brief periods without movements, 3 = constant or nearly constant. Functional impairments including activities of daily living (ADL), social impairment, symptom bother, and harm are rated 0–3 with 0 = patient is unaware or unaffected, 1 = symptoms mildly impact patient, 2 = symptoms moderately impact patient, 3 = symptoms severely impact patient. Following institutional review board approval, the CTI underwent inter-rater and test-retest reliability testing. Videos of patient TD examinations were obtained and reviewed by two movement disorder specialists to confirm the diagnosis of TD by consensus and the adequacy to demonstrate a TD-consistent movement. Vignettes were created to include patients’ symptom descriptions and functional, social, or occupational impairments/limitations. Four clinicians rated each video/vignette. Selected videos/vignettes were also subject to an intra-rater retest. Interrater agreement was analyzed via 2-way random-effects interclass correlation (ICC) and test-retest agreement assessment utilizing Kendall’s tau-b.

45 video/vignettes were assessed for interrater reliability, and 16 for test-retest reliability. ICCs for movement frequency were as follows: abnormal eye movement .89; abnormal tongue/mouth movement .91; abnormal jaw movement .89; abnormal limb movement .76; complex movement .87; abnormal vocalization .77; and functional impairments including harm .82; social embarrassment .88; ADLs .83; and symptom bother .92. Retests were conducted on mean (SD) 15 (3) days later with scores ranging from .66–.87.

The CTI is a new instrument with good reliability in assessing TD symptoms and functional impacts. Future validation study is warranted.

Neurocrine Biosciences

With the increase in social pressure, the anxiety symptoms of college students with mental disorders are increasing year by year. This has harmed their living standards and learning outcomes. The current intervention measures largely overlook the impact of ideological and political education in universities.

The study used a randomized controlled trial design. The experimental group (n=60) adopted innovative ideological and political education interventions, including group discussions, role-playing, and theme reports, with an intervention period of 12 months. The control group (n=60) received routine psychological counseling services. All participants were evaluated at the beginning, duration of 6 months, and end of the study. The Hamilton Anxiety Scale (HAM-A) was mainly used for evaluation. Descriptive and inferential statistical analysis was conducted on the data using SPSS 22.0.

After the intervention, compared with the control group, the anxiety symptoms of the experimental group of college students were significantly reduced. After 12 months of intervention, the HAM-A score of the experimental group decreased by an average of 12.1 points, while the average decrease in the HAM-A score of the control group was 3.2 points. The follow-up evaluation also confirmed this result.

This study shows that innovative ideological and political education interventions are significantly superior to conventional psychological counseling services, and effectively reduce anxiety symptoms of college students with mental disorders in clinical practice.

The 2020 Hubei Skilled Talent Training and Research Center Project (No. 20BJN014); 2020 China University Industry, University and Research Innovation Fund - New Generation Information Technology Innovation Project (No. 2020ITA02052).

With the emergence and development of the Internet, the practice of ideological and political education via the Internet for students has gradually become a new trend. However, some students developed anxiety disorders due to changes in activity patterns, increased pressures from society and individual’s particular mentality. The focus of the present study was to explore the impact of online ideological and political education on relieving students’ anxiety disorders.

A total of 200 students with anxiety disorders from different universities were randomly divided into the intervention group (100 students) that underwent online ideological and political education, and the control group (100 students) who received traditional ideological and political education. Pre and post test assessments of anxiety levels were conducted using the Self-rating Anxiety Scale (SAS).

Pre-intervention, both the control and intervention groups showed similar levels of anxiety disorders. However, post-intervention assessments yielded notable results. The anxiety levels in the intervention group who experienced online ideological and political education showed a significant decrease (P<0.05) compared to the control group.

The findings suggest that online ideological and political education can effectively reduce the levels of anxiety disorders among university students. Such intervention can be leveraged as part of the broader strategy to promote psychological health in the student community. Future researchers are encouraged to investigate the specific components of online ideological and political education to have such effect.

The planning research projects of the China Association of Private Education (School Development) No.CANFZG23433; Research on the Construction of the Cultivating System of Private Colleges and Universities under the Prospective of Ideological and political (No.ZD -2023-10); 2022 Liaoning Province First Rate Undergraduate Course; 2023 Shenyang University of Science and Technology Teaching Team Construction (No.13621-2023-03-079).

When the SARS-Cov2 virus hit the New York and New Jersey metropolitan area in Spring 2020, hospitals and hospital workers were hit hard with a new unknown pathogen that either killed people or made them very ill. There were large numbers of severely ill patients that strained resources. Hospital workers had extraordinary stress with multiple additional patients, the need to use personal protective equipment (PPE) in short supply, and faced with a pathogen that had no treatments beyond care and support initially.

We surveyed our hospital workers in late Spring 2020 to identify the main stressors and find out what measures were helpful. An online anonymous survey included questionnaires about sleep, mood, outside stressors, helpful measures, and how they coped generally. All levels of hospital workers were surveyed. Resources were provided to all respondents.

Over 240 individuals responded to the survey; most respondents were women (76%). ‘Workplace stressors’ topped the chart for 98 of our respondents. The worst workplace stressor that was cited was ‘irritable workforce,’ but ‘lack of ‘protocols’ and ‘shortage of PPE’ were also cited as stressors. ‘Other’ (not described) and ‘taking care of an ill relative’ were rated highly. Those who had ‘symptoms everyday:’ Anhedonia (loss of pleasure or interest), 13%; feeling down and hopeless, 12%; sleep disturbance, 41%; low energy, feeling tired, 29%; appetite disturbance, 26%; poor concentration and attention, 15%. Respondents told us what resources they used and what was most helpful; exercise was most frequently cited as helpful.

Various resources for formal and informal mental health support were provided to all respondents at the time of survey. Our hospital mounted its own response with support services, as did our medical school and university. A "warm line" was available through the Department of Psychiatry from late March 2020; tip sheets and online groups were widely circulated; State Department of Health provided resources. There were formal peer support sessions and workers helped each other. Medical students provided child care, shopping, and transport. We learned that extra support for workers and more frequent rest and recharge time are important. A weekly "town hall" was instituted and a weekly update about the hospital and support in healthy activities are widely circulated to employees. Those with active PTSD (some were very disturbed by the number of deceased patients) were referred to professional providers. Hospitals need to be ready to deal with epidemics and pandemics more effectively in order to mitigate stress and support workers. Being prepared, not just with equipment, but with protocols in how to proceed should another pandemic come. We learned that listening to workers is important. Workers also need to know how valued they are.

Department of Psychiatry, New Jersey Medical School

Anxiety disorder is a common mental disease, which is characterized by tremors, palpitation, sweating, and other symptoms, and has become one of the main psychological problems of college students. The psychological atmosphere is a relatively stable emotional state, which can promote emotional communication and trigger psychological resonance. Through the creation of a good psychological atmosphere in physical education classroom teaching, this paper explores its intervention effect on anxiety patients.

In a domestic university, 900 college students of different grades were selected by random sampling, and the Self-rating Anxiety Scale (SAS) was filled in anonymously. After statistical results, 126 patients with anxiety disorder were selected. Then they were randomly divided into a control group and an observation group, 68 in each group. The students in the observation group studied in the PE class with a positive psychological atmosphere, while the students in the control group studied in the regular PE class. After one semester of study, the anxiety level was assessed again by the SAS scale.

Table 1 shows the statistical results of SAS scores of the two groups before and after physical education classroom teaching. It can be found that after the experiment, the anxiety score of the students in the observation group decreased significantly and was lower than that of the control group, with a statistically significant difference (P < 0.05).Table 1.

Statistical results of SAS scores of two groups of college students before and after physical education classroom teaching

Anxiety has seriously harmed the physical and mental health of college students. The study created a positive psychological atmosphere in physical education classroom teaching and intervened the anxiety patients. The results show that the optimized creation of a psychological atmosphere in physical education classrooms can improve the anxiety symptoms of college students, and has certain clinical application value.

While the ageing population is increasing, diseases such as senile dementia and hypertension have gradually become important health risks for the elderly. The existing research shows that long-term hypertension will affect the structure and function of cerebral vessels, leading to the decline of cerebrovascular compliance, vascular deformation, cerebral blood flow reduction and other problems. The occurrence of these conditions will lead to the decline of the brain’s self-regulation ability, which will lead to cognitive decline and dementia. The study will analyze the risk factors of mild cognitive impairment (MCI) in hypertensive patients, and determine the regulatory role between adaptation and cognitive function in the treatment of hypertensive patients.

In this study, 180 hypertensive patients were investigated to analyze their cognitive factors and functional status. The investigation was completed by the Montreal Cognitive Assessment (MoCA). After the investigation, SPSS 25.0 software was used to analyze the data and screen the independent risk factors of mild cognitive impairment. The experimental results are shown in Table 1.Table 1.

Each dimension score of MoCA scale for hypertensive patients

As shown in Table 1, 124 of 180 hypertensive patients developed MCI, with a prevalence rate of 68.9%. It can be seen from the table that the total score and scores of each dimension in the MCI group were significantly lower than those in the normal cognitive function group (P < 0.05), with the largest difference being delayed recall and executive function.

In this study, the research center was placed at risk of mild cognitive impairment in hypertensive patients. Through the MoCA scale investigation experiment, it was found that 124 of 180 hypertensive patients had a lower cognitive function in all dimensions than normal. The experiment shows that the problems such as micro hemorrhage caused by hypertension and the increase of cerebrovascular events affect the cognitive function of the elderly, which is obviously reflected in memory and executive ability.

The research is supported by: The Study of the Effect of Health Education Based on Teach-back and PRECEDE Model on Elderly Hypertensive Patients in the Community, supported by Fundamental Research Funds for Universities of Inner Mongolia Autonomous Region; The Construction of Human Care Training Courses for Nursing Students Based on Health Care of Elderly Patients with Chronic Diseases, supported by Higher Education Teaching Reform Project of National Ethnic Affairs Commission, 2021 (No.21083); An Exploration of the Ideological and Political Construction in Human Care Training Courses of Higher Education for Nursing Students in the New Era, supported by a grant from the Education and Science Project of Inner Mongolia Autonomous Region during the 14th Five-Year Plan Period, 2021 (No.NGJGH2021145).

KarXT combines the M1/M4 preferring muscarinic receptor agonist xanomeline and the peripherally restricted anticholinergic trospium. In the phase 2 EMERGENT-1 study, KarXT met the primary endpoint of a significant reduction in Positive and Negative Syndrome Scale (PANSS) total score through week 5 vs placebo, improved other key secondary efficacy measures, and was generally well tolerated.

EMERGENT-2 was a phase 3, randomized, double-blind, placebo-controlled, 5-week trial of KarXT in acutely psychotic patients with schizophrenia in the inpatient setting. Eligible patients were randomized 1:1 to KarXT or matched placebo. Dosing of KarXT (mg xanomeline/mg trospium) started at 50 mg/20 mg BID and increased to a maximum of 125 mg/30 mg BID. The primary efficacy endpoint was change from baseline to week 5 in PANSS total score. Key secondary endpoints included change from baseline to week 5 in PANSS positive subscale, PANSS negative subscale, and PANSS negative Marder factor scores compared with placebo. Efficacy analyses were performed using the modified intent-to-treat population (patients with ≥1 dose of study medication, a baseline PANSS assessment, and ≥1 postbaseline PANSS assessment). All patients receiving ≥1 dose of study drug were included in safety analyses.

252 US patients were enrolled. KarXT demonstrated a statistically significant and clinically meaningful 9.6-point reduction from baseline to week 5 (effect size=0.61) in PANSS total score vs placebo (p<0.0001); a significant improvement in PANSS total score was demonstrated starting at week 2 (first postbaseline rating) and continued through the study end. KarXT also met key secondary endpoints. Results at week 5 included a 2.9-point reduction in PANSS positive subscale score with KarXT vs placebo (p<0.0001), a 1.8-point reduction in PANSS negative subscale score with KarXT vs placebo (p=0.0055), and a 2.2-point reduction in PANSS negative Marder factor score with KarXT vs placebo (p=0.0022). KarXT was generally well tolerated. Overall discontinuation rates were similar with KarXT (25%) and placebo (21%). The overall treatment-emergent adverse events (TEAEs) rate for KarXT and placebo was 75% and 58%, respectively. Discontinuation rates related to TEAEs were similar between KarXT (7%) and placebo (6%). Rates of serious TEAEs were similar with KarXT and placebo (2%, each group); no serious TEAEs were determined to be drug related. The most common TEAEs (≥5%) with KarXT were all mild to moderate in severity and included constipation, dyspepsia, nausea, vomiting, headache, blood pressure increases, dizziness, gastroesophageal reflux disease, abdominal discomfort, and diarrhea. KarXT was not associated with sedation/somnolence, weight gain, and extrapyramidal symptoms.

KarXT has the potential to be the first in a new class of treatments for patients with schizophrenia and a promising alternative to postsynaptic dopamine D2 receptor antagonists.

Karuna Therapeutics, Inc.

With the advent of health poverty alleviation and rural revitalization policies in China, a significant change in the well-being of rural elderly residents has been noted. However, more research is required to understand the psychological implications of these policies. This study aims to analyze residents’ survival anxiety from a psychological perspective.

This study utilized a quasi-experimental design involving two groups-an intervention group (n=500) experiencing the policies of health poverty alleviation and rural revitalization, and a control group (n=500) unexposed to these policies. Both groups consisted of rural elderly residents aged 60 years or above from 10 villages in rural China. Data was collected through face-to-face interviews using the Survival Anxiety Scale (SAS) pre-and-post intervention. Data analysis involved a combination of descriptive statistics, Chi-square tests, and Binary Logistic Regression, conducted via SPSS v23.

Results showed a significant decrease in the level of survival anxiety in the intervention group post-exposure to the policies (P<0.05) compared to the control group. Specifically, the odds of survival anxiety were 0.61 times lower among those who had experienced the policies, controlling for age, gender, and baseline SAS scores.

This finding indicates that health poverty alleviation and rural revitalization have a favourable effect on reducing survival anxiety among rural elderly residents. This implies a strong correlation between social policy and mental health.

Rural revitalization is one of the important development strategies in China. However, in rural areas, due to backward building design and energy utilization methods, residents have more symptoms of anxiety. It constitutes a certain obstacle to the sustainable development of rural revitalization. Therefore, the purpose of this study is to explore the effect of building energy-saving design optimization combined with psychological treatment on improving rural residents’ anxiety.

This study used a controlled experiment, 100 patients were randomly divided into the intervention group and control group. The intervention group received improved building energy efficiency design, including insulation materials used, rational ventilation design, and efficient energy use facilities in combination with psychotherapy. The control group maintained traditional building design and energy use. The study period was 12 months, and the analysis method was SPSS23.0.

The analysis results showed that the anxiety level of residents in the intervention group decreased significantly during the study period, and the difference was significant compared with the control group. At the same time, the sleep quality of the intervention group improved, and the satisfaction with the living environment also significantly increased. In addition, the energy efficiency of the intervention group was significantly higher than that of the control group.

The anxiety symptoms of rural residents can be effectively alleviated by improving building energy-saving design. Energy-saving design measures can reduce energy consumption, improve the comfort of the living environment and residents’ life quality.

Ulotaront is a trace amine-associated receptor 1 (TAAR1) agonist with serotonin 5-HT1A agonist activity that has received FDA Breakthrough Therapy Designation for the treatment of schizophrenia. Here we summarize ongoing clinical research characterizing the efficacy and safety of ulotaront as a member of the novel trace amine-associated receptor 1 (TAAR1) agonist class.

Summarized are results from a double-blind, placebo-controlled study to evaluate the efficacy and safety of ulotaront (50 mg or 75 mg) in an acute exacerbation of schizophrenia, and a 6-month, open-label follow-up study. Also summarized are post-hoc analyses evaluating negative symptom efficacy, and key safety and adverse event (AE) outcomes.

In the short-term study, treatment with ulotaront was associated with significant (p<0.001) endpoint improvement in the PANSS total score (effect size [ES]: 0.45), the CGI-Severity score (ES: 0.52) and the Brief Negative Symptom Scale total score (ES: 0.48). The incidence of any AE was lower on ulotaront versus placebo (45.8% vs. 50.4%), and the number needed to harm (NNH) for individual AEs on ulotaront were all >40. Ulotaront was associated with lower risk for antipsychotic class-related AEs (extrapyramidal symptoms, akathisia, somnolence, nausea/vomiting, increased weight/metabolic labs, prolactinemia). The 6-month study demonstrated further improvement, with a completion rate (67%) that was higher than reported for current dopamine D2 antipsychotics.

The emerging profile of ulotaront is characterized by significant improvement in positive and negative symptoms of schizophrenia. The safety and tolerability profile of ulotaront is markedly different with respect to antipsychotic class-related AEs. The benefit-risk profile of ulotaront, as a member of a novel TAAR1 agonist class, is distinguished from antipsychotics by lack of AEs related to D2 and serotonin 5-HT2A receptor blockade.

Sunovion Pharmaceuticals, Inc., and Otsuka Pharmaceutical Development & Commercialization, Inc.