This study assessed the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of patients with chronic primary insomnia. Hundred and twenty patients with chronic primary insomnia were randomly assigned to three study groups (n = 40 per group): rTMS, medication, or psychotherapy treatment (both latter as controls). The treatments proceeded for 2 weeks, after which treatment efficacies were assessed in each study group based on changes in polysomnography parameters, Pittsburgh sleep quality index, and indices of HPA and HPT axes (serum cortisol, adrenocorticotropic hormone, highly sensitive thyrotropin, free T3, and free T4). Further, the relapse and recurrence rates within 3 months after respective treatments were also measured. rTMS treatment significantly better (p < 0.05) improved stage III sleep and REM sleep cycle compared with both control groups. Further, rTMS treatment group was more advantageous in improving the indices of HPA and HPT axes (p < 0.05 vs. both control groups). In addition, the relapse and recurrence rates were also the lowest in rTMS treatment group. In conclusion, rTMS treatment is more advantageous than both medication and psychotherapy treatments in improving the sleep architecture. Further, rTMS significantly decreases the body awakening level and provides a better long-term treatment effect.

BackgroundIt has been observed that trait anxiety easily leads to conflict maladaptation under conflict circumstances. However, it remains unclear whether the precise neural mechanisms underlying the effects of high trait anxiety (HTA) on cognitive control are consistent in high trait anxious individuals, with and without anxiety disorders.MethodsThe present study recruited 29 healthy volunteers with low trait anxiety (LTA), 37 healthy volunteers with HTA, and 23 patients with generalized anxiety disorder (GAD). All participants completed demographic information and self-report measures of trait anxiety and depression. Then, they performed the emotional flanker task with event-related potentials (ERPs) recorded.ResultsBehavioral data manifested that, relative to LTA individuals, GAD patients displayed prolonged response times and increased error rates, while HTA individuals showed intact response times and accuracies. Event-related potential (ERP) data revealed that HTA individuals exhibited a trend toward more negative N2 amplitudes for conflict detection. By contrast, both HTA and GAD individuals displayed decreased P3 amplitudes for conflict resolution. ERP results indicated that both HTA and GAD individuals exhibited conflict maladaptation on the N2 amplitude. Correlation analyses also showed that the increased anxiety symptoms were associated with longer reaction times, more error rates, lower P3 amplitudes, and more perturbations in conflict adaptation on reaction times and N2 amplitudes.ConclusionOur results demonstrated a severely impaired cognitive control in GAD patients while a moderately impaired cognitive control in HTA individuals. Trait anxiety can indeed serve as a predominant factor at the onset and in the maintenance of GAD. Therefore, the trait anxiety reducing strategies may provide significant therapeutic gains.

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Background: Increasing studies have found that high trait anxiety is a key susceptibility phenotype that causes depression. Mindfulness-based interventions can target on dealing with depressogenic vulnerability effectively. Evidence indicates that trait anxiety could affect the trajectory of anti-depressive psychotherapy, and play an important role in the relationship between mindfulness and depression. Furthermore, related studies have found that trait anxiety could involve factors beyond anxiety and be a two-factor construct instead of one-dimensional concept. This viewpoint provides a new prospective for exploring the pathways of the two factors of trait anxiety in the complex relationship and further understand the potential mechanism of vulnerable personality mediated the link of mindfulness and depression.Methods: A cross-sectional survey and a preliminary intervention study were conducted. Thousand two hundred and sixty-two subjects completed a set of self-reported questionnaires that evaluated trait anxiety, mindfulness, and depressive symptoms. Twenty-Three eligible participants with depression were recruited to attend mindfulness-based cognitive training for eight weeks. The same questionnaires were completed 1 week before the training and 6 months after the training. Factor analysis was performed on the 1262-subject sample to explore and confirm the factorial structure of trait anxiety. In addition, mediating effect analysis was conducted in the two studies to test whether two factors of trait anxiety were mediators of the relationship between mindfulness and depression.Results: The exploratory factor analysis extracted two dimensions of trait anxiety, namely, trait anxiety-present factor (TA-P) and trait anxiety-absent factor (TA-A). And confirmatory factor analysis showed that the fit of the two-factor model was acceptable. Both TA-P and TA-A were significantly negatively correlated with mindfulness and positively correlated with depression, and they played a mediating role between mindfulness and depression. The two factors of trait anxiety had multiple mediating effects on the relationship between mindfulness and depression, and the mediating effect of the TA-P factor was stronger than that of the TA-A factor.Conclusion: Our results demonstrated a two-factor model of trait anxiety in the Chinese population. TA-P and TA-A played a multiple mediating role in the relationship between mindfulness and depression. The findings provide new perspectives for psychological interventions to treat depression for people with susceptible personalities. Aiming to reduce negative emotional tendencies (TA-P factor) and enhance positive cognition (TA-A factor) may achieve the early prevention and efficient treatment of depression.

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To explore the efficacy of psychological interventions (PI) in patients with breast hyperplasia (BH). In total 120 BH patients who were treated in the Third Affiliated Hospital of the Third Military Medical University were randomly divided into PI group (n = 40; treated with oral XiaoYao Pill and psychological interventions), anti-anxiety/depression medication (AADM) group (n = 40; treated with oral XiaoYao Pill and paroxetine), and control group (n = 40; treated with oral XiaoYao Pill) and the treatment lasted for 1 year. Before the treatment and 4, 8, and 12 months after the initiation of treatment, the changes in the psychological indicators were measured using Toronto Alexithymia Scale (TAS), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Ways of Coping Questionnaire (WCQ), as well as the physiological indicators including estradiol, prolactin, and progesterone were determined. The overall response rates were evaluated at the end of the treatment, and the relapse rates were calculated during the 1-year follow-up. The HAMD and HAMA scores were declined in all three groups. The scores of TAS and WCQ negative coping subscales showed a declining trend after treatment for the AADM and PI groups. Compared to the control and PI groups, the HAMA and HAMD scores were significantly lower in the AADM group 4, 8, and 12 months after the initiation of treatment (P < 0.05). The scores of TAS and WCQ negative coping subscales were significantly lower in AADM group but were significantly higher than those in PI group and lower than the control group 4, 8, and 12 months after the initiation of treatment (P < 0.05). The HAMA and HAMD scores were significantly lower in PI group than in control group 4, 8, and 12 months after the initiation of treatment (P < 0.05). After the initiation of treatment, the estradiol and prolactin levels decreased while the progesterone levels increased in all three groups. Compared with the control group and AADM group, the PI group had significantly higher estradiol and prolactin levels and higher progesterone levels 4, 8, and 12 months after the initiation of treatment (P < 0.05). Compared with the control group, the AADM group had significantly lower levels of estradiol and prolactin and higher progesterone levels 4, 8, and 12 months after the initiation of treatment (P < 0.05). The overall response rate was not significantly different for both PI group and AADM group (P > 0.05), while the relapse rate was significantly lower in the PI group than the control and AADM groups (P < 0.05). However, the relapse rate did not significantly differ between the control group and AADM group (P > 0.05). PI can effectively improve the psychological status of BH patients and restore the disordered endocrine system. The efficacy lasts for long and the relapse rate is lower. Therefore, it could be an effective method for treating BH.