BACKGROUND & AIMS: AIM:The First Episode Mood and Anxiety Program (FEMAP) is a community-based early intervention program that has been shown to improve health outcomes for emerging adults (EAs) with mood and anxiety disorders. However, not all EAs who are admitted to the program initiate treatment. Our aim was to identify factors that distinguish those who initiated treatment from those who did not. METHODS:FEMAP administered questionnaires to EAs upon first contact with the program, collecting information on a range of socioeconomic, patient and condition-related factors. We compared EAs who initiated treatment in the program (n = 318, 87.4%) to those who did not (n = 46, 12.6%). To examine factors associated with treatment initiation, we specified a parsimonious logistic regression model, using the method of purposeful selection to choose from a range of candidate variables. RESULTS:Anxiety Sensitivity Index - Revised (ASI-R), binge drinking and cannabis use were included in the final logistic regression model. Each one-point increment in the ASI-R score was associated with a 1% increase in the odds of treatment initiation (OR = 1.014; 95% CI [1.003, 1.026]). No other variable was significantly associated with treatment initiation. CONCLUSIONS:Our study provides insight on the differences between EAs with mood and anxiety disorders who initiated targeted treatment services and those who did not. Anxiety sensitivity was significantly associated with treatment initiation at FEMAP. Our findings suggest that it may be anxiety sensitivity, rather than depression or functional impairment per se that drive treatment initiation among EAs.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Mood disorders are common, disabling and tend to be recurrent. They carry a high risk of suicide. Maintenance treatment, aimed at the prevention of relapse, is therefore of vital importance. Lithium has been used for some years as the mainstay of maintenance treatment in bipolar affective disorder, and to a lesser extent in unipolar disorder. However, the efficacy and effectiveness of prophylactic lithium therapy has been disputed. Low suicide rates in lithium-treated patients have led to claims that lithium has a specific anti-suicidal effect. If so, this is of considerable importance as treatments for mental disorders in general have not been shown convincingly to be effective in suicide prevention. OBJECTIVES:1. To investigate the efficacy of lithium treatment in the prevention of relapse in recurrent mood disorders. 2. To examine the effect of lithium treatment on consumers' general health and social functioning, its acceptability to consumers, and the side-effects of treatment. 3. To investigate the hypothesis that lithium has a specific effect in reducing the incidence of suicide and deliberate self-harm in persons with mood disorders. SEARCH STRATEGY:The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR) and The Cochrane Controlled Clinical Trials Register (CCTR) were searched. Reference lists of relevant papers and major text books of mood disorder were examined. Authors, other experts in the field and pharmaceutical companies were contacted for knowledge of suitable trials, published or unpublished. Specialist journals concerning lithium were hand searched. SELECTION CRITERIA:Randomised controlled trials comparing lithium with placebo, where the stated intent of treatment was maintenance or prophylaxis. Participants were males and females of all ages with diagnoses of mood disorder. Discontinuation studies (in which all participants had been stable on lithium for some time before being randomised to either continued lithium treatment or placebo substitution) were excluded. DATA COLLECTION AND ANALYSIS:Data were extracted from the original reports independently by two reviewers. The main outcomes studied were related to the objectives stated above. Data were analysed for all diagnoses of mood disorder and for bipolar and unipolar disorder separately. Data were analysed using Review Manager version 4.0. MAIN RESULTS:Nine studies were included in the review, reporting on 825 participants randomly allocated to lithium or placebo. Lithium was found to be more effective than placebo in preventing relapse in mood disorder overall, and in bipolar disorder. The most consistent effect was found in bipolar disorder (random effects OR 0.29; 95% CI 0.09 to 0.93 ). In unipolar disorder, the direction of effect was in favour of lithium, but the result (when heterogeneity between studies was allowed for) did not reach statistical significance. Considerable heterogeneity was found between studies in all groups of patients. The direction of effect was the same in all studies; no study found a negative effect for lithium. Heterogeneity may have been due to differences in selection of participants, and to differing exposures to lithium in the pre-study phase resulting in variable influence of a discontinuation effect. There was little reported data on overall health and social functioning of participants under the different treatment conditions, or on the participants' own views of their treatment. Descriptive analysis showed that assessments of general health and social functioning generally favoured lithium. Small absolute numbers of deaths and suicides, and the absence of data on non-fatal suicidal behaviours, made it impossible to draw meaningful conclusions about the place of lithium therapy in suicide prevention. REVIEWER'S CONCLUSIONS:This systematic review indicates that lithium is an efficacious maintenance treatment for bipolar disorder. In unipolar disorder the evidence of efficacy is less robust. This review does not cover the relative efficacy of lithium compared with other maintenance treatments, which is at present unclear. There is no definitive evidence from this review as to whether or not lithium has an anti-suicidal effect. Systematic reviews and large scale randomised studies comparing lithium with other maintenance treatments (e.g. anti-convulsants, antidepressants) are necessary. Outcomes relating to death and suicidal behaviour should be included in all future maintenance studies of mood disorder.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:Research aimed at understanding the temporal characteristics of depressive symptoms and negative mood in an older female population is lacking, despite the relationship between the two factors being well established. The aim of this study was to examine the characteristics of negative mood scores and depressive symptom scores in a longitudinal sample of women transitioning from mid-life to late life. STUDY DESIGN:This study was a longitudinal assessment of variables drawn from an epidemiological prospective study of women's healthy ageing. Scores were analysed using General Linear Mixed Models. MAIN OUTCOME MEASURES:Negative mood scores derived from the Affectometer 2 were assessed at 11 time points spanning 20 years. Depressive symptom scores were assessed using the Centre for Epidemiological Studies Depression Scale (CESD), administered in 2002, 2004 and 2012. RESULTS:Mean negative mood scores reduced significantly between 1992 and 2012, as did mean CESD scores between 2002 and 2012. Mean negative mood scores reduced by 0.007 for each year of increasing age. For depressive symptoms, a reduction in mean score of 0.15 was found for each year of increase in age. CONCLUSION:Depressive symptom scores and negative mood scores decreased significantly over time.

背景与目标：

BACKGROUND & AIMS: :In medically ill patients, anxiety symptoms and mood alteration are common. Anxiety or mood alteration may be due to a reaction to the stress of illness, a preexisting psychiatric disorder, a manifestation of the medical condition, or an adverse effect of medication. Psychiatrists are frequently called upon to differentiate among these causes and to recommend treatment. This article reviews anxiety, depression, and mania, which are frequently associated with physical disease, and provides an approach to differential diagnosis and treatment.

背景与目标： : 在医疗疾病患者中，焦虑症状和情绪改变是常见的。焦虑或情绪改变可能是由于对疾病压力的反应，先前存在的精神疾病，医学状况的表现或药物的不良影响。精神科医生经常被要求区分这些原因并建议治疗。本文回顾了经常与身体疾病相关的焦虑，抑郁和躁狂症，并提供了鉴别诊断疾病和治疗的方法。

BACKGROUND & AIMS: BACKGROUND:The U.S. Food and Drug Administration can set standards for cigarettes that could include reducing their nicotine content. Such a standard should improve public health without causing unintended serious consequences for sub-populations. This study evaluates the effect of progressive nicotine reduction in cigarettes on smoking behavior, toxicant exposure, and psychiatric symptoms in smokers with comorbid mood and/or anxiety disorders using a two-site, two-arm, double-blind, parallel group, randomized controlled trial (RCT) in four phases over 34 weeks. METHODS:Adult smokers (N = 200) of 5 or more cigarettes per day will be randomized across two sites (Penn State and Massachusetts General). Participants must have not had a quit attempt in the prior month, nor be planning to quit in the next 6 months, meet criteria for a current or lifetime unipolar mood and/or anxiety disorder based on the structured Mini-International Neuropsychiatric Interview, and must not have an unstable medical or psychiatric condition. After a week of smoking their own cigarettes, participants receive two weeks of Spectrum research cigarettes with usual nicotine content (11.6 mg). After this baseline period, participants will be randomly assigned to continue smoking Spectrum research cigarettes that contain either (a) Usual Nicotine Content (11.6 mg); or (b) Reduced Nicotine Content: the nicotine content per cigarette is progressively reduced from approximately 11.6 mg to 0.2 mg in five steps over 18 weeks. At the end of the randomization phase, participants will be offered the choice to either (a) quit smoking with assistance, (b) continue smoking free research cigarettes, or (c) return to purchasing their own cigarettes, for the final 12 weeks of the study. The primary outcome measure is blood cotinine; key secondary outcomes are: exhaled carbon monoxide, urinary total NNAL- 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and 1-hydroxypyrene, oxidative stress biomarkers including 8-isoprostanes, measures of psychiatric symptoms (e.g., depression, anxiety), smoking behavior and dependence (e.g., cigarette consumption, quit attempts), and health effects (e.g., blood pressure, respiratory symptoms). DISCUSSION:Results from this study will inform FDA on the potential effects of regulating the nicotine content of cigarettes and help determine whether smokers with mood and/or anxiety disorders can safely transition to significantly reduced nicotine content cigarettes. TRIAL REGISTRATION:TRN: NCT01928758 , registered August 21, 2013.

背景与目标：

BACKGROUND & AIMS: :Transnasal butorphanol is effective in relieving migraine and postoperative pain. The extent to which this drug preparation impacts on cognitive and psychomotor performance, as well as mood, has not been examined. Accordingly, the cognitive and psychomotor, subjective, and physiological effects of two clinically relevant doses of transnasal butorphanol (1 and 2 mg) were compared to that of placebo, and a common analgesic drug combination given for pain relief in ambulatory settings, 600 mg of acetaminophen and 60 mg of codeine, in healthy volunteers (n = 10). The larger transnasal butorphanol dose impaired psychomotor performance for up to 2 h, and produced subjective effects for up to 3 h. The smaller dose had no psychomotor-impairing effects, but had subjective effects (including increased ratings of "sleepy"). All three active drug conditions including miosis. These laboratory results suggest that patients should use caution when using the 1-mg dose of transnasal butorphanol, and should curtail certain activities if they administer the 2-mg dose of transnasal butorphanol for analgesia.

背景与目标： : 经鼻布托啡诺可有效缓解偏头痛和术后疼痛。尚未研究该药物制剂对认知和精神运动表现以及情绪的影响程度。因此，比较了两种临床相关剂量的经鼻布托啡诺 (1和2 mg) 与安慰剂的认知和精神运动，主观和生理作用，以及在门诊环境中用于缓解疼痛的常见镇痛药物组合，对乙酰氨基酚600 mg和可待因60 mg，健康志愿者 (n = 10)。较大的经鼻布托啡诺剂量会损害精神运动能力长达2小时，并产生主观作用长达3小时。较小的剂量没有精神运动损害作用，但具有主观作用 (包括增加 “困倦” 的评分)。所有三种活性药物条件，包括子宫内膜异位症。这些实验室结果表明，患者在使用1-mg剂量的经鼻布托啡诺时应谨慎使用，如果他们使用2-mg剂量的经鼻布托啡诺进行镇痛，则应减少某些活动。

BACKGROUND & AIMS: To differentiate women who experience patterns of depressed mood with respect to their perceptions of menopausal changes and those that were part of everyday life, women (N=347) from the Seattle Midlife Women's Health Study were studied. Women participated in in-depth interviews, kept symptom diaries, and responded to mailed health updates. Data for years 1 and 2 on the Center for Epidemiologic Studies Depression Scale revealed four patterns of depressed moodconsistent depressed mood, emerging depressed mood, resolving depressed mood, and absence of depressed mood. Discriminant function analyses differentiated women with consistent, emerging, and resolving depressed mood from those with absence of depressed mood. Patterns of depressed mood were related to stressful life context, past/present health status, and social learning about midlife. Menopausal status did not differentiate women with patterns of depressed mood from those without depressed mood. Vasomotor symptoms, history of premenstrual syndrome, and postpartum blues helped differentiate women with consistently depressed mood from those recovering from depressed mood.

背景与目标： 为了区分在更年期变化和日常生活中经历抑郁情绪模式的女性，对西雅图中年妇女健康研究的女性 (N = 347) 进行了研究。妇女参加了深入访谈，保留了症状日记，并对邮寄的健康更新做出了回应。流行病学研究中心抑郁量表第1年和第2年的数据显示，抑郁情绪一致的抑郁情绪，出现的抑郁情绪，缓解抑郁情绪和缺乏抑郁情绪的四种模式。判别功能分析将具有一致，出现和解决抑郁情绪的女性与没有抑郁情绪的女性区分开来。抑郁情绪的模式与紧张的生活环境，过去/现在的健康状况以及有关中年的社会学习有关。更年期状态并未将情绪低落的女性与情绪低落的女性区分开。血管舒缩症状，经前综合症病史和产后忧郁症有助于将持续抑郁的女性与从抑郁情绪中恢复的女性区分开。

BACKGROUND & AIMS: :Chronic inflammatory liver diseases are often accompanied by behavior alterations including fatigue, mood disorders, cognitive dysfunction and sleep disturbances. These altered behaviors can adversely affect patient quality of life. The communication pathways between the inflamed liver and the brain that mediate changes in central neural activity leading to behavior alterations during liver inflammation are poorly understood. Neural and humoral communication pathways have been most commonly implicated as driving peripheral inflammation to brain signaling. Classically, the cytokines TNFα, IL-1β and IL-6 have received the greatest scientific attention as potential mediators of this communication pathway. In mice with liver inflammation we have identified a novel immune-mediated liver-to-brain communication pathway whereby CCR2(+) monocytes found within the peripheral circulation transmigrate into the brain parenchyma in response to MCP-1/CCL2 expressing activated microglia. Inhibition of cerebral monocyte infiltration in these mice significantly improved liver inflammation associated sickness behaviors. Importantly, in recent work we have found that at an earlier time point, when cerebral monocyte infiltration is not evident in mice with liver inflammation, increased monocyte:cerebral endothelial cell adhesive interactions are observed using intravital microscopy of the brain. These monocyte:cerebral endothelial cell adhesive interactions are P-selectin mediated, and inhibition of these interactions attenuated microglial activation and sickness behavior development. Delineating the pathways that the periphery uses to communicate with the brain during inflammatory liver diseases, and the central neurotransmitter systems that are altered through these communication pathways (e.g., serotonin, corticotrophin releasing hormone) to give rise to liver inflammation-associated sickness behaviors, will allow for the identification of novel therapeutic targets to decrease the burden of debilitating symptoms in these patients.

背景与目标： : 慢性炎症性肝病通常伴随着行为改变，包括乏力，情绪障碍，认知功能障碍和睡眠障碍。这些改变的行为会对患者的生活质量产生不利影响。炎症的肝脏和大脑之间的通讯途径介导了中枢神经活动的变化，导致肝脏炎症过程中的行为改变，目前尚不清楚。神经和体液交流途径最常被认为是驱动周围炎症到大脑信号传导的途径。传统上，细胞因子tnf α，IL-1β 和IL-6作为该通信途径的潜在介质受到了最大的科学关注。在患有肝脏炎症的小鼠中，我们已经确定了一种新的免疫介导的肝-脑通讯途径，其中在外周循环中发现的CCR2 () 单核细胞响应于表达MCP-1/CCL2的活化小胶质细胞而迁移到脑实质中。抑制这些小鼠的脑单核细胞浸润可显着改善与肝脏炎症相关的疾病行为。重要的是，在最近的工作中，我们发现在较早的时间点，当患有肝脏炎症的小鼠脑单核细胞浸润不明显时，单核细胞增加: 使用大脑的活体显微镜观察到脑内皮细胞粘附的相互作用。这些单核细胞: 脑内皮细胞粘附的相互作用是P-选择素介导的，这些相互作用的抑制减弱了小胶质细胞的活化和疾病行为的发展。描绘炎性肝病期间外围用于与大脑通信的途径，以及通过这些通信途径改变的中枢神经递质系统 (例如5-羟色胺，促肾上腺皮质激素释放激素) 引起肝脏炎症相关疾病的行为，将允许确定新的治疗靶点，以减轻这些患者虚弱症状的负担。

BACKGROUND & AIMS: :This study aimed to investigate the impact of SenseCam, a wearable, automatic camera, on subjective mood and identity in a patient with severe memory impairment due to Korsakoff's syndrome. It was hypothesised that SenseCam would improve Ms A's mood and identity through enhancing recall of autobiographical memories of recent events, therefore supporting a coherent sense of self; the lack of which was contributing to Ms A's mood deterioration. An ABA single case experimental design investigated whether using SenseCam to record regular activities impacted on Ms A's mood and identity. Ms A experienced improved recall for events recorded using SenseCam, and showed improvement on subjective ratings of identity. However, a corresponding improvement in mood was not seen, and the study was ended early at Ms A's request. Qualitative information was gathered to explore Ms A's experience of the study, and investigate psychosocial factors that may have impacted on the use of SenseCam. SenseCam may be of significant use as a compensatory memory aid for people with Korsakoff's syndrome and other types of alcohol-related brain damage (ARBD), but acceptance of memory impairment and consistent support may be among the factors required to support the use of such assistive technologies in a community setting.

背景与目标： : 这项研究旨在调查可穿戴自动摄像头SenseCam对因Korsakoff综合征而导致严重记忆障碍的患者的主观情绪和身份的影响。据推测，SenseCam将通过增强对最近事件的自传记忆的回忆来改善Ms A的情绪和身份，从而支持连贯的自我意识; 缺乏这种感觉会导致Ms a的情绪恶化。ABA单例实验设计调查了是否使用SenseCam记录对Ms A情绪和身份的影响的常规活动。Ms A对使用SenseCam记录的事件的回忆有所改善，并且在身份的主观评分方面有所改善。但是，没有看到相应的情绪改善，因此应Ms a的要求，该研究提前结束。收集了定性信息，以探讨Ms A的研究经验，并调查可能影响SenseCam使用的社会心理因素。对于患有Korsakoff综合症和其他类型的酒精相关脑损伤 (ARBD) 的人，SenseCam可能会用作代偿性记忆辅助工具，但接受记忆障碍和一致的支持可能是支持使用此类辅助技术的因素之一在社区环境中。

BACKGROUND & AIMS: :The results of recent community epidemiological research are reviewed, documenting that major depressive disorder (MDD) is a highly prevalent, persistent, and often seriously impairing disorder, and that bipolar disorder (BPD) is less prevalent but more persistent and more impairing than MDD. The higher persistence and severity of BPD results in a substantial proportion of all seriously impairing depressive episodes being due to threshold or subthreshold BPD rather than to MDD. Although the percentage of people with mood disorders in treatment has increased substantially since the early 1990s, a majority of cases remain either untreated or undertreated. An especially serious concern is the misdiagnosis of depressive episodes due to BPD as due to MDD because the majority of depression treatment involves medication provided by primary care doctors in the absence of psychotherapy. The article closes with a discussion of future directions for research.

背景与目标： : 回顾了最近的社区流行病学研究的结果，记录了重性抑郁症 (MDD) 是一种高度流行，持续且经常严重损害的疾病，双相情感障碍 (BPD) 的患病率较低，但比MDD更持久和更具损害。BPD的较高持久性和严重程度导致所有严重损害抑郁发作的很大一部分是由于阈值或阈值以下的BPD而不是MDD引起的。尽管自20世纪90年代初以来，接受治疗的情绪障碍患者的比例已大大增加，但大多数病例仍未得到治疗或治疗不足。一个特别严重的问题是由于BPD和MDD导致的抑郁发作的误诊，因为大多数抑郁症治疗涉及初级保健医生在没有心理治疗的情况下提供的药物。本文最后讨论了未来的研究方向。

BACKGROUND & AIMS: OBJECTIVE AND METHOD:Mood disorders are the most prevalent psychiatric disorders. Despite new insights and advances on the neurobiological basis and therapeutic approaches for bipolar disorders and recurrent depression, elevated prevalence of recurrence, persistent sub-syndromal symptoms and treatment resistance are challenging aspects and need to be urgently addressed. The objective of this literature review is to evaluate the current concepts of treatment resistance and refractoriness in mood disorders. RESULTS:Genetic factors, misdiagnosis, use of inappropriate pharmacological approaches, non-compliance and biological/psychosocial stressors account for dysfunctions in mood regulation, thus increasing the prevalence of refractory mood disorders. Regarding available treatments, the use of effective doses during an adequate period followed by augmentation with a second and/or third agent, and finally switching to other agent are steps frequently necessary to optimize efficacy. However, in the treatment-resistant paradigm, drugs mimicking standard strategies, which target preferentially the monoaminergic system, can present reduced therapeutic effects. Thus, the search for new effective treatments for mood disorders is critical to decreasing the overall morbidity secondary to treatment resistance. CONCLUSION:Emerging strategies targeting brain plasticity pathways or 'plasticity enhancers', including antiglutamatergic drugs, glucocorticoid receptor antagonists and neuropeptides, have been considered promising therapeutic options for difficult-to-treat mood disorders.

背景与目标：

BACKGROUND & AIMS: Testing hypotheses derived from neuropsychological models of mood, as well as the association of mood states and personality characteristics with global-local visual processing, were examined. Fifty-nine men completed measures associated with depression and positive mood, and were administered a brief perceptual judgment task that assessed global-local visual processing biases. Additionally, 19 of these 59 subjects were administered measures of anxiety and optimism-pessimism and completed an expanded judgment task. Affective and personality variables were then correlated with judgment task performances. Consistent with predictions, positive mood and optimism were directly associated with a global bias and inversely related to a local bias. A converse pattern of findings was obtained with depression and trait anxiety. Implications for research concerning other aspects of visual processing are discussed.

背景与目标： 检验了从情绪的神经心理学模型得出的假设，以及情绪状态和人格特征与全局局部视觉处理的关联。59名男性完成了与抑郁和积极情绪相关的措施，并接受了一项简短的感知判断任务，该任务评估了全球局部视觉处理偏差。此外，这59名受试者中有19名接受了焦虑和乐观悲观情绪的测量，并完成了扩展的判断任务。然后将情感和人格变量与判断任务绩效相关。与预测一致，积极的情绪和乐观与全球偏见直接相关，与局部偏见成反比。与抑郁和特质焦虑相反的发现模式。讨论了有关视觉处理其他方面的研究意义。

BACKGROUND & AIMS: :Clinicians have found that fasting was frequently accompanied by an increased level of vigilance and a mood improvement, a subjective feeling of well-being, and sometimes of euphoria. Therapeutic fasting, following an established protocol, is safe and well tolerated. We aim in this article to explore the biological mechanisms activated during fasting that could have an effect on brain function with particular focus on mood (we do not discuss here the mechanisms regulating eating behavior) and to provide a comprehensive review on the potential positive impact of therapeutic fasting on mood. We explored Medline, Web of Science and PsycInfo according to the PRISMA criteria (Preferred Reporting Items for Systematic reviews and Meta-Analysis). The initial research paradigm was: [(fasting OR caloric restriction) AND (mental health OR depressive disorders OR mood OR anxiety)]. Many neurobiological mechanisms have been proposed to explain fasting effects on mood, such as changes in neurotransmitters, quality of sleep, and synthesis of neurotrophic factors. Many clinical observations relate an early (between day 2 and day 7) effect of fasting on depressive symptoms with an improvement in mood, alertness and a sense of tranquility reported by patients. The persistence of mood improvement over time remains to be determined.

背景与目标： : 临床医生发现，禁食经常伴随着警惕性的提高和情绪的改善，主观的幸福感，有时甚至是欣快感。遵循既定方案的治疗性禁食是安全且耐受性良好的。我们在本文中旨在探索禁食期间激活的生物学机制，这些机制可能对大脑功能产生影响，特别关注情绪 (我们在这里不讨论调节饮食行为的机制)，并提供对治疗性禁食对情绪的潜在积极影响的全面综述。我们根据PRISMA标准 (系统评价和荟萃分析的首选报告项目) 探索了Medline，Web of Science和PsycInfo。最初的研究范式是: [(禁食或热量限制) 和 (精神卫生或抑郁症或情绪或焦虑)]。已经提出了许多神经生物学机制来解释禁食对情绪的影响，例如神经递质的变化，睡眠质量和神经营养因子的合成。许多临床观察结果表明，禁食对抑郁症状的早期 (在第2天到第7天之间) 有改善情绪，警觉性和患者的宁静感。随着时间的推移，情绪改善的持久性仍有待确定。

BACKGROUND & AIMS: :Basic elements of artistic (and other) creativity are the technical-professional skill and knowledge, the special talent and ability and the willingness or motivation; one of which being absent results in partially realised creativity like juvenile, frustrated or abandoned types, respectively. Psychometric scales have been developed to measure everyday and eminent creativity, which show that creativity correlates with higher psychoticism, impulsivity and venturesomeness scores and with lower neuroticism and conformity scores of the personality test employed in a general population. Among the psychological components of creativity are the cognitive processes, mood, motivation, and personality traits. Regarding mood, a theory of "inverted U" has been proposed as elevation of mood facilitates creativity to a certain point after what extreme increase has an adverse effect on achievement. Analysing psychopathology and creativity among various professions, higher rates of psychopathology, especially affective symptoms, have been found in art-related professions. Examples of immortal poets, writers, painters, sculptors and composers, having created invaluable cultural treasures for mankind, illustrate that many of them showed signs of mood alterations (unipolar or bipolar affective disorder spectrum) which were expressed in their artistic products.

背景与目标： : 艺术 (和其他) 创造力的基本要素是技术专业技能和知识，特殊才能和能力以及意愿或动机; 其中之一的缺失会导致部分实现的创造力，例如少年，沮丧或被遗弃的类型。已经开发了心理计量学量表来衡量日常和杰出的创造力，这表明创造力与较高的精神病性，冲动性和冒险性得分以及在一般人群中采用的人格测验的较低的神经质和顺从性得分相关。创造力的心理组成部分包括认知过程，情绪，动机和人格特质。关于情绪，已经提出了一种 “倒U” 理论，因为情绪的升高在极大增加对成就产生不利影响之后，有助于创造力达到一定程度。通过分析各种专业的心理病理学和创造力，在与艺术相关的专业中发现了较高的心理病理学率，尤其是情感症状。不朽的诗人，作家，画家，雕塑家和作曲家的例子为人类创造了宝贵的文化宝藏，这表明他们中的许多人表现出了在其艺术产品中表达的情绪变化 (单极或双相情感障碍谱) 的迹象。

BACKGROUND & AIMS: OBJECTIVE:Addiction comorbidity is an important clinical challenge in mood disorders, but the best way of pharmacologically treating people with mood disorders and addictions remains unclear. The aim of this study was to assess the efficacy of pharmacological treatments for mood and addiction symptoms in people with mood disorders and addiction comorbidity. METHODS:A systematic search of placebo-controlled randomized controlled trials investigating the effects of pharmacological treatments in people with bipolar disorder (BD) or major depressive disorder (MDD), and comorbid addictions was performed. Treatment-related effects on mood and addiction measures were assessed in a meta-analysis, which also estimated risks of participant dropout and adverse effects. RESULTS:A total of 32 studies met systematic review inclusion criteria. Pharmacological therapy was more effective than placebo for improving manic symptoms (standardized mean difference [SMD] = -0.15; 95% confidence interval [95% CI], -0.29 to -0.02; P = 0.03) but not BD depressive symptoms (SMD = -0.09; 95% CI, -0.22 to 0.03; P = 0.15). Quetiapine significantly improved manic symptoms (SMD = -0.23; 95% CI, -0.39 to -0.06; P = 0.008) but not BD depressive symptoms (SMD = -0.07; 95% CI, -0.23 to 0.10; P = 0.42). Pharmacological therapy was more effective than placebo for improving depressive symptoms in MDD (SMD = -0.16; 95% CI, -0.30 to -0.03; P = 0.02). Imipramine improved MDD depressive symptoms (SMD = -0.58; 95% CI, -1.03 to -0.13; P = 0.01) but Selective serotonin reuptake Inhibitors (SSRI)-based treatments had no effect (SMD = -0.06; 95% CI, -0.30 to 0.17; P = 0.60). Pharmacological treatment improved the odds of alcohol abstinence in MDD but had no effects on opiate abstinence. CONCLUSIONS:Pharmacological treatments were significantly better than placebo in improving manic symptoms, MDD depressive symptoms, and alcohol abstinence but were not better for bipolar depression symptoms. Importantly, quetiapine was not more effective than placebo in improving bipolar depression symptoms nor were SSRI's for the treatment of MDD depression. Our findings highlight the need for further high-quality clinical trials of treatments for mood disorders and comorbid addictions.

背景与目标：