Background: Major depressive disorder (MDD) patients often have different clinical manifestations at different age of onset. Anxiety symptoms are frequently seen in patients with MDD, and dyslipidemia is also prevalent in these populations. There is limited reporting on the frequency of anxiety symptoms and their associations with clinical factors in patients with abnormal lipid metabolism who have MDD. Methods: Our study included 1718 first-episode untreated MDD outpatients aged 18-60 years, 1408 of whom had dyslipidemia. We collected basic information, clinically relevant data, and biochemical indicators from these patients. Anxiety, depression and psychiatric symptoms were evaluated by Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Positive and Negative Syndrome Scale (PANSS) positive subscale, respectively. Results: Anxiety symptoms were found in 57.8% of depressed outpatients with dyslipidemia, a rate significantly higher than in MDD patients with normal lipid levels. No statistical difference was observed in the prevalence of anxiety symptoms between the early adulthood onset (EAO) group and mid-adulthood onset (MAO) group. Anxiety symptoms were significantly correlated with both HAMD and PANSS scores, regardless of the age of onset. Thyroid-stimulating hormone (TSH), total cholesterol (TC) levels and suicide attempts were independently associated with anxiety symptoms in the EAO group, whereas fasting blood glucose (FBG) was independently related to anxiety symptoms in the MAO group. Conclusions: Our research findings indicated that the age of MDD onset in patients with dyslipidemia did not impact the presence of anxiety symptom. The clinical factors linked to anxiety symptoms varied between the EAO and MAO groups, potentially aiding in the prediction of anxiety symptoms in the specific population.

Title pageMultiple extremely overdose of antipsychotics with minimal side effects: A case report

Objective: The prevalence of smoking and depressive symptoms in patients with schizophrenia (SCZ) is high. However, few studies have examined the relationship between smoking and depressive symptoms in patients with first-episode SCZ. In this study, we investigated the prevalence and risk factors of smoking and its relationship with depressive symptoms in Chinese male patients with first-episode drug-naïve (FEDN) SCZ. Methods: We recruited 164 male patients with FEDN SCZ, including 58 current smokers and 106 nonsmokers. Patients completed a detailed questionnaire about smoking status, age of onset, body mass index (BMI), and other socio-demographic data. We used the Positive and Negative Syndrome Scale (PANSS), the 24-item Hamilton Rating Scale for Depression (HDRS), and the Hamilton Rating Scale for Anxiety (HARS) to assess the clinical symptoms of patients. Results: The current smoking rate of FEDN SCZ patients was 35.36%. Compared to nonsmokers, current smokers were older, had a later age of onset, fewer years of education, and a larger BMI. Smoking patients had higher HDRS score than nonsmoking patients (39.83±12.32 vs. 34.97±11.88, F1,162=6.10, p<0.05). Logistic regression analysis showed that the HDRS score was significantly associated with patients’ smoking status (Wald χ2 =4.01, df=1, p<0.05, OR=1.05; 95%CI: 1.001~1.104). Conclusions: Our results suggest that the prevalence of smoking in patients with FEDN SCZ is similar to that of healthy individuals. Some demographic and clinical variables, especially depressive symptoms, may be strongly associated with smoking status in patients with FEND SCZ.