The detection rate of adolescent depression has shown an increasing trend, which has become a public issue in society. Currently, there are still limited treatment options. ACT is one of the core representatives of the third-generation cognitive behavioral therapy (CBT) , and its application in domestic adolescent populations is relatively limited.
This study aims to explore the intervention effects of ACT combined with Sertraline on depressive mood, suicidal ideation, and sleep quality of adolescents with depression.
Adolescents with depression who visited Chenjiaqiao Hospital in Shapingba District, Chongqing, from October 2023 to April 2024 were selected as the research subjects. A total of 70 patients were initially included and divided into a control group (n=35) and an intervention group (n=35) using a randomized controlled trial. The control group used Sertraline combined with mental health education, while the intervention group used ACT combined with Sertraline. The clinical efficacy of the two groups was compared using the Athens Insomnia Scale (AIS) , Self-rating Depression Scale (SDS) , Self-rating Idea of Suicide Scale (SIOSS) , Acceptance and Action Questionnaire-Ⅱ (AAQ-Ⅱ) , Avoidance and Fusion Questionnaire for Youth (AFQ-Y8) , and sleep monitoring results.
Finally, 30 patients in the control group and 32 in the intervention group completed the study. After 8 weeks of treatment, AIS, SDS, SIOSS, AAQ-Ⅱ, and AFQ-Y8 score of the intervention group was lower than that of the control group (P<0.05) . Total sleep time (TST) and Sleep efficiency (SE) were higher in the intervention group (P<0.05) , and Sleep latency (SL) and Wake after sleep onset (WASO) were lower in the intervention group (P<0.05) .
ACT can increase psychological flexibility, alleviate depressive mood, improve sleep quality, and reduce suicidal ideation levels in adolescents with depression, which is of good clinical application value.
Cognitive impairment is a core symptom in patients with schizophrenia, and compensatory cognitive training has been shown to be an effective intervention. However, most existing studies employ offline modes, with limited research on mobile health APP-based compensatory cognitive training.
This study aimed to evaluate the intervention effects and mechanisms of mobile health APP-based compensatory cognitive training in stable schizophrenia patients.
A total of 58 patients with stable schizophrenia from Ningxia Ning'an Hospital (June to December 2023) were randomized into a control group (n=29) and an intervention group (n=29) . The control group received conventional therapy and regular follow-up, while the intervention group underwent additional mobile health APP-based compensatory cognitive training for 12 weeks. Cognitive function and quality of life were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) and the Schizophrenia Quality of Life Scale (SQLS) , respectively. Pre- and post-intervention scores were compared, and mediation analysis was conducted to explore the relationship between group, BACS, and SQLS scores.
Of the initial cohort, 27 patients in each group completed the study. At 12 weeks, the intervention group demonstrated significantly higher BACS total scores and subscale scores (digit sequence, tower of london, verbal memory, semantic fluency, and word fluency) compared to the control group (P<0.05) . Additionally, SQLS total scores psychosocial and motivational-energetic dimension scores were significantly lower in the intervention group (P<0.05) . Mediation analysis revealed that BACS scores partially mediated the relationship between intervention subgroups and SQLS scores (indirect effect was -0.240, 95%CI ranged from -0.556 to -0.050) .
Implementing mHealth APP-based compensatory cognitive training for stable schizophrenia patients effectively enhances both cognitive functioning and quality of life. Moreover, it contributes to an individual's perception of a higher quality of life by improving overall cognitive functioning.
Psychological health issues are important factors leading to early exposure to tobacco and smoking at a younger age. This study focuses on vocational school students to explore the effects of anxiety and depression on their smoking behavior and explore effective ways to control smoking.
To explore the effects of depression and anxiety on smoking behavior among vocational school students, providing evidence for corresponding control measures.
In October 2021, a random cluster sampling method was used to select 5 074 vocational school students in Shanghai for a questionnaire survey, which included students' basic information, depression and anxiety status, and tobacco use. The depression status was assessed using the Patient Health Questionnaire-2 (PHQ-2) Chinese version, and the anxiety status was assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale. Tobacco use was divided into four categories based on the World Health Organization's "Global Youth Tobacco Survey Questionnaire": "never use" "only use cigarettes" "only use e-cigarettes" and "dual use". A multivariate Logistic regression model was used to explore the influence of depression and anxiety on tobacco use.
A total of 4 890 vocational school students were surveyed and the response rate for the survey was 96.37%. The rates of cigarette use, e-cigarette use and dual use were 11.23% (271/4 890) , 8.40% (133/4 890) and 5.69% (278/4 890) respectively. Among them, 747 (15.28%) , 1 259 (25.75%) and 556 (11.37%) had depression, mild and moderate to severe anxiety respectively. Multiple Logistic regression analysis showed that depression increases the risk of vocational school students using only cigarettes (OR=1.64, 95%CI=1.20-2.25) , electronic cigarettes (OR=1.88, 95%CI=1.24-2.84) and dual use (OR=2.32, 95%CI=1.72-3.12) . Mild anxiety increases the risk of dual use (OR=1.81, 95%CI=1.34-2.44) , while moderate to severe anxiety increases the risk of using only cigarettes (OR=1.61, 95%CI=1.11-2.33) , electronic cigarettes (OR=2.19, 95%CI=1.37-3.50) , and dual use (OR=3.05, 95%CI=2.16-4.31) Risk. After gender stratification, it was found that depression increased the risk of male students using only cigarettes and dual use (P<0.05) , and increased the risk of female students using only e-cigarettes and dual use (P<0.05) . Moderate to severe anxiety increased the risk of male students using three types of tobacco (P<0.05) , and the risk of dual use for female students was higher than that for male students (OR values were 5.24 vs 2.77, P<0.05) .
Depression and anxiety can increase the risk of smoking behavior in vocational school students. Schools and families should strengthen mental health education of adolescents, find and guide adolescents' negative emotions in time, and strengthen the management of e-cigarette tobacco control on the basis of traditional tobacco control, to prevent dual tobacco use behavior and promote the healthy growth of adolescents.
