Ala Ustyol, Josh M Raitt, C Robert Cloninger, Carol S North
Background: Dissociation is a serious psychological condition that is characterized as a pathological outcome of trauma-related experience. Thus, dissociation could be expected to develop in survivors of disaster trauma and to be associated with trauma exposure and psychopathology.
Methods: A sample of 278 disaster-affected Kenyans was assessed 8 to 10 months after the 1998 terrorist bombing of the US Embassy in Nairobi for a study of trauma-related psychopathology and dissociation in the context of personality and culture. Instruments of assessment were the Diagnostic Interview Schedule, the Dissociative Experiences Scale, and the Temperament and Character Inventory.
Results: Dissociation appeared to represent a largely nonpathological response to the disaster experience that reflected personality variables and a cultural context.
Conclusions: These findings suggest that dissociation encountered in disaster-exposed groups in this cultural setting does not necessarily represent psychopathology, but attention to dissociative responses might help clinicians identify and provide interventions for individuals experiencing distressing intrusive and hyperarousal symptoms.
{"title":"Dissociation and psychopathology in Kenyan survivors of a terrorist bombing.","authors":"Ala Ustyol, Josh M Raitt, C Robert Cloninger, Carol S North","doi":"10.12788/acp.0076","DOIUrl":"https://doi.org/10.12788/acp.0076","url":null,"abstract":"<p><strong>Background: </strong>Dissociation is a serious psychological condition that is characterized as a pathological outcome of trauma-related experience. Thus, dissociation could be expected to develop in survivors of disaster trauma and to be associated with trauma exposure and psychopathology.</p><p><strong>Methods: </strong>A sample of 278 disaster-affected Kenyans was assessed 8 to 10 months after the 1998 terrorist bombing of the US Embassy in Nairobi for a study of trauma-related psychopathology and dissociation in the context of personality and culture. Instruments of assessment were the Diagnostic Interview Schedule, the Dissociative Experiences Scale, and the Temperament and Character Inventory.</p><p><strong>Results: </strong>Dissociation appeared to represent a largely nonpathological response to the disaster experience that reflected personality variables and a cultural context.</p><p><strong>Conclusions: </strong>These findings suggest that dissociation encountered in disaster-exposed groups in this cultural setting does not necessarily represent psychopathology, but attention to dissociative responses might help clinicians identify and provide interventions for individuals experiencing distressing intrusive and hyperarousal symptoms.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"34 3","pages":"183-191"},"PeriodicalIF":1.3,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40626375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lee S Cohen, Sinéad M Rhodes, Lauren D Claypoole, Lina Góez-Mogollón, Alexandra Z Sosinsky, Danna Moustafa, Olivia B Noe, Sara A McElheny, Laura J Cheng, Johanna R Bick, Marlene P Freeman, Charles A Nelson
Background: Systematic data regarding long-term neurobehavioral effects of maternal antidepressant use during pregnancy are sparse. The aim of this study was to evaluate the impact of gestational exposure to antidepressants on later neurodevelopmental function.
Methods: This study describes a cohort of mother-child dyads (44 mothers, 54 children) in which maternal depressive symptoms and medication exposures were prospectively collected across pregnancy and the postpartum period. Children age 6 to 17 were assessed using validated instruments across domains of childhood behavior and executive memory and functioning.
Results: No associations were found between maternal use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy and atypical neurodevelopment of children. Borderline clinical or clinical ranges of internalizing symptoms were associated with exposure to a higher maternal depressive symptom burden during pregnancy compared with those in the normal range. Compared with age- and sex-matched controls, the SSRI-exposed group showed superior performance on executive function tasks; findings did not demonstrate elevated risk for abnormal neurodevelopment in children age 6 to 17 exposed to SSRIs in utero. Deviations from the norm were instead associated with higher in utero exposure to maternal depression burden.
Conclusions: This study highlights the need for rigorous studies of long-term outcomes after fetal antidepressant exposure.
{"title":"Neurobehavioral follow-up of children exposed to selective serotonin reuptake inhibitors in utero.","authors":"Lee S Cohen, Sinéad M Rhodes, Lauren D Claypoole, Lina Góez-Mogollón, Alexandra Z Sosinsky, Danna Moustafa, Olivia B Noe, Sara A McElheny, Laura J Cheng, Johanna R Bick, Marlene P Freeman, Charles A Nelson","doi":"10.12788/acp.0074","DOIUrl":"https://doi.org/10.12788/acp.0074","url":null,"abstract":"<p><strong>Background: </strong>Systematic data regarding long-term neurobehavioral effects of maternal antidepressant use during pregnancy are sparse. The aim of this study was to evaluate the impact of gestational exposure to antidepressants on later neurodevelopmental function.</p><p><strong>Methods: </strong>This study describes a cohort of mother-child dyads (44 mothers, 54 children) in which maternal depressive symptoms and medication exposures were prospectively collected across pregnancy and the postpartum period. Children age 6 to 17 were assessed using validated instruments across domains of childhood behavior and executive memory and functioning.</p><p><strong>Results: </strong>No associations were found between maternal use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy and atypical neurodevelopment of children. Borderline clinical or clinical ranges of internalizing symptoms were associated with exposure to a higher maternal depressive symptom burden during pregnancy compared with those in the normal range. Compared with age- and sex-matched controls, the SSRI-exposed group showed superior performance on executive function tasks; findings did not demonstrate elevated risk for abnormal neurodevelopment in children age 6 to 17 exposed to SSRIs in utero. Deviations from the norm were instead associated with higher in utero exposure to maternal depression burden.</p><p><strong>Conclusions: </strong>This study highlights the need for rigorous studies of long-term outcomes after fetal antidepressant exposure.</p>","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"34 3","pages":"197-206"},"PeriodicalIF":1.3,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40626376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The need to clarify professional terminology in psychiatry.","authors":"Carol S North, Betty Pfefferbaum","doi":"10.12788/acp.0079","DOIUrl":"https://doi.org/10.12788/acp.0079","url":null,"abstract":"","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"34 3","pages":"149-151"},"PeriodicalIF":1.3,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40626379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Repetitive transcranial magnetic stimulation for generalized anxiety and panic disorders: A systematic review and meta-analysis","authors":"J. Cox","doi":"10.12788/acp.0067","DOIUrl":"https://doi.org/10.12788/acp.0067","url":null,"abstract":"","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49010424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND The ways patients with psychosis and depression engage in therapeutic treatment is not well understood. To determine if an intensive outpatient psychotherapy program could benefit patients experiencing psychotic symptoms, it is important to know how these individuals engage with psychotherapeutic treatment. METHODS The present study from the Rhode Island Hospital Methods to Improve Diagnostic Assessment and Services (MIDAS) project compared dropout rates, treatment response, and satisfaction among 219 individuals with psychosis and major depressive disorder (MDD) to 2,545 individuals with MDD at a general, Acceptance and Commitment Therapy-based partial hospital program (PHP). RESULTS Those with psychosis were significantly less likely to complete treatment. Approximately one-fifth of all patients experienced at least a 50% reduction in depressive and anxiety symptoms. The vast majority of patients with psychosis were highly satisfied with treatment. CONCLUSIONS Findings suggest patients with psychosis have a higher risk of premature dropout. Patients with psychosis demonstrated a reduction in symptoms during PHP treatment and self-reported high satisfaction with treatment. This study calls for the implementation of practices to reduce premature dropout for patients with psychosis, and for future research on the effectiveness of general psychiatric treatment for those with psychotic symptoms.
{"title":"Treatment engagement of depressed patients with and without psychosis in a partial hospital program: Dropout, symptom reduction, and satisfaction.","authors":"Madeline Ward, M. Zimmerman","doi":"10.12788/acp.0062","DOIUrl":"https://doi.org/10.12788/acp.0062","url":null,"abstract":"BACKGROUND\u0000The ways patients with psychosis and depression engage in therapeutic treatment is not well understood. To determine if an intensive outpatient psychotherapy program could benefit patients experiencing psychotic symptoms, it is important to know how these individuals engage with psychotherapeutic treatment.\u0000\u0000\u0000METHODS\u0000The present study from the Rhode Island Hospital Methods to Improve Diagnostic Assessment and Services (MIDAS) project compared dropout rates, treatment response, and satisfaction among 219 individuals with psychosis and major depressive disorder (MDD) to 2,545 individuals with MDD at a general, Acceptance and Commitment Therapy-based partial hospital program (PHP).\u0000\u0000\u0000RESULTS\u0000Those with psychosis were significantly less likely to complete treatment. Approximately one-fifth of all patients experienced at least a 50% reduction in depressive and anxiety symptoms. The vast majority of patients with psychosis were highly satisfied with treatment.\u0000\u0000\u0000CONCLUSIONS\u0000Findings suggest patients with psychosis have a higher risk of premature dropout. Patients with psychosis demonstrated a reduction in symptoms during PHP treatment and self-reported high satisfaction with treatment. This study calls for the implementation of practices to reduce premature dropout for patients with psychosis, and for future research on the effectiveness of general psychiatric treatment for those with psychotic symptoms.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"136 1","pages":"106-113"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80433731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sexual tactile hallucinations in a patient with obsessive-compulsive disorder.","authors":"F. Elghazouani, H. Hlal","doi":"10.12788/acp.0064","DOIUrl":"https://doi.org/10.12788/acp.0064","url":null,"abstract":"","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"162 1","pages":"136-137"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86170224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has been associated with the emergence of various psychiatric illnesses, although very little literature has focused on the effect of COVID-19 on psychosis. Preliminary data have shown possible increases in new-onset psychosis. METHODS Using MEDLINE, we performed a review of the current literature to identify the mechanisms by which pandemics may increase psychosis risk and generate evidence-based recommendations to control surges of psychosis. We identified 85 relevant studies, of which 34 were case reports on psychosis during the COVID-19 pandemic. RESULTS Underlying mechanisms of psychosis include "direct viral mechanisms," such as neuroinflammation linked with the coronavirus, and "nonviral mechanisms," such as stress, isolation, and uncertainty. CONCLUSIONS Improvement of our understanding of the pathophysiology of psychosis related to COVID-19 along with implementation of strategies to fight against stress and social isolation in addition to awareness campaigns regarding new-onset psychotic symptoms are much needed to optimize early detection and management of psychosis.
{"title":"Mechanisms of new-onset psychosis during the COVID-19 pandemic: What ignited the fire?","authors":"S. C. Mourani, R. Khoury, E. Ghossoub","doi":"10.12788/acp.0065","DOIUrl":"https://doi.org/10.12788/acp.0065","url":null,"abstract":"BACKGROUND\u0000The coronavirus disease 2019 (COVID-19) pandemic has been associated with the emergence of various psychiatric illnesses, although very little literature has focused on the effect of COVID-19 on psychosis. Preliminary data have shown possible increases in new-onset psychosis.\u0000\u0000\u0000METHODS\u0000Using MEDLINE, we performed a review of the current literature to identify the mechanisms by which pandemics may increase psychosis risk and generate evidence-based recommendations to control surges of psychosis. We identified 85 relevant studies, of which 34 were case reports on psychosis during the COVID-19 pandemic.\u0000\u0000\u0000RESULTS\u0000Underlying mechanisms of psychosis include \"direct viral mechanisms,\" such as neuroinflammation linked with the coronavirus, and \"nonviral mechanisms,\" such as stress, isolation, and uncertainty.\u0000\u0000\u0000CONCLUSIONS\u0000Improvement of our understanding of the pathophysiology of psychosis related to COVID-19 along with implementation of strategies to fight against stress and social isolation in addition to awareness campaigns regarding new-onset psychotic symptoms are much needed to optimize early detection and management of psychosis.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"112 1","pages":"123-135"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79223097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
For most physicians, the phrase “conflict of interest” (COI) usually refers to a financial COI, such as physicians receiving payments from a pharmaceutical company. Financial COI is the most frequently discussed COI, and the one disclosed at the end of articles in professional journals. However, financial COI is not the only COI an individual may have. The recent debate about the origin of the virus that causes COVID-19 and the possibility that it escaped from a laboratory in Wuhan, China, revealed another facet of COI—the impact of ideology and personal belief. Some researchers strongly opposed the lab leak theory and attacked those who proposed it. For many, the fact that President Donald J. Trump proposed the virus originated in China was argument enough to label the lab leak theory as yet another conspiracy theory. Additionally, there is what I call “ideological bias” or “ideological COI,” eg, some of the opponents of the lab leak theory were probably impacted by the fact that their reputation would be ruined if it turned out to be true. Unbelievably, Facebook and Wikipedia initially banned any suggestion that the virus may had leaked from the Wuhan laboratory. Interestingly, with President Trump’s departure from office, more people were willing to entertain the possibility that the virus that causes COVID-19 escaped from the laboratory and were willing to investigate this theory. I believe this tale does not paint a very laudatory picture of many scientists and the state of present-day science. It also raises serious questions about nonfinancial COIs. I believe that compared to financial COIs, nonfinancial COIs have a similar, if not worse, impact on scientific conduct. As a profession, psychiatry has focused on discussing and disclosing financial COIs. Yet, there are numerous nonfinancial pressures and COIs. As Korn wrote, “These pressures ... include the desire for faculty advancement, to compete successfully and repetitively for sponsored research funding, to receive academic accolades from professional peers and win Richard Balon, MD Departments of Psychiatry and Behavioral Neurosciences and Anesthesiology Wayne State University Detroit, Michigan, USA
{"title":"Multiple facets of conflict of interest.","authors":"R. Balon","doi":"10.12788/acp.0070","DOIUrl":"https://doi.org/10.12788/acp.0070","url":null,"abstract":"For most physicians, the phrase “conflict of interest” (COI) usually refers to a financial COI, such as physicians receiving payments from a pharmaceutical company. Financial COI is the most frequently discussed COI, and the one disclosed at the end of articles in professional journals. However, financial COI is not the only COI an individual may have. The recent debate about the origin of the virus that causes COVID-19 and the possibility that it escaped from a laboratory in Wuhan, China, revealed another facet of COI—the impact of ideology and personal belief. Some researchers strongly opposed the lab leak theory and attacked those who proposed it. For many, the fact that President Donald J. Trump proposed the virus originated in China was argument enough to label the lab leak theory as yet another conspiracy theory. Additionally, there is what I call “ideological bias” or “ideological COI,” eg, some of the opponents of the lab leak theory were probably impacted by the fact that their reputation would be ruined if it turned out to be true. Unbelievably, Facebook and Wikipedia initially banned any suggestion that the virus may had leaked from the Wuhan laboratory. Interestingly, with President Trump’s departure from office, more people were willing to entertain the possibility that the virus that causes COVID-19 escaped from the laboratory and were willing to investigate this theory. I believe this tale does not paint a very laudatory picture of many scientists and the state of present-day science. It also raises serious questions about nonfinancial COIs. I believe that compared to financial COIs, nonfinancial COIs have a similar, if not worse, impact on scientific conduct. As a profession, psychiatry has focused on discussing and disclosing financial COIs. Yet, there are numerous nonfinancial pressures and COIs. As Korn wrote, “These pressures ... include the desire for faculty advancement, to compete successfully and repetitively for sponsored research funding, to receive academic accolades from professional peers and win Richard Balon, MD Departments of Psychiatry and Behavioral Neurosciences and Anesthesiology Wayne State University Detroit, Michigan, USA","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"59 1","pages":"73-75"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83963000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charles Ho, Lilian Cole, Kaylee Davis-Bordovsky, A. Eichenberger, Anna Faubion, Matthew Faubion, Colette Kendrick, Neema Khonsari, Joshua Lampley, Adeeb Masood, K. Nuako, Eduardo Rivera Mirabal, Natalie Spiller, Joshua Walther, Bernice N. Yau, M. Yung, J. Raitt, A. Kulikova, C. North, Kimberly Roaten, E. Brown
BACKGROUND Identifying individuals at increased risk of suicide is important, particularly those who present for treatment for nonpsychiatric chief complaints who may go undetected. It has been found that pain symptoms, such as headache, are associated with suicide, although this association requires further characterization. This study examined specific components of suicidality in relation to headache subtypes. METHODS This study retrospectively reviewed 2,832,835 nonpsychiatric adult clinical encounters at a large county hospital, where a standardized suicide risk screening tool, the Columbia-Suicide Severity Rating Scale (C-SSRS), was universally implemented. The C-SSRS assesses specific components of suicidality: wish to be dead and suicidal ideation, method, intent, plan, and action. Multivariate logistic regressions were performed to assess the association between headache, as well as headache subtype (migraine, tension, or cluster), and each component of suicidality. RESULTS There were significant positive associations between presenting with a headache and 2 specific components of suicidality: wish to be dead and suicidal action. Individuals with tension headache may have a lower risk of wishing to be dead compared to those with migraine and cluster headaches. CONCLUSIONS The association of headaches with specific elements of sui-cidality demonstrates the potential yield of identification of suicide risk among individuals with nonpsychiatric presentations.
{"title":"Association between headache and suicidality: An analysis of universal suicide screening data at a large urban county hospital.","authors":"Charles Ho, Lilian Cole, Kaylee Davis-Bordovsky, A. Eichenberger, Anna Faubion, Matthew Faubion, Colette Kendrick, Neema Khonsari, Joshua Lampley, Adeeb Masood, K. Nuako, Eduardo Rivera Mirabal, Natalie Spiller, Joshua Walther, Bernice N. Yau, M. Yung, J. Raitt, A. Kulikova, C. North, Kimberly Roaten, E. Brown","doi":"10.12788/acp.0068","DOIUrl":"https://doi.org/10.12788/acp.0068","url":null,"abstract":"BACKGROUND\u0000Identifying individuals at increased risk of suicide is important, particularly those who present for treatment for nonpsychiatric chief complaints who may go undetected. It has been found that pain symptoms, such as headache, are associated with suicide, although this association requires further characterization. This study examined specific components of suicidality in relation to headache subtypes.\u0000\u0000\u0000METHODS\u0000This study retrospectively reviewed 2,832,835 nonpsychiatric adult clinical encounters at a large county hospital, where a standardized suicide risk screening tool, the Columbia-Suicide Severity Rating Scale (C-SSRS), was universally implemented. The C-SSRS assesses specific components of suicidality: wish to be dead and suicidal ideation, method, intent, plan, and action. Multivariate logistic regressions were performed to assess the association between headache, as well as headache subtype (migraine, tension, or cluster), and each component of suicidality.\u0000\u0000\u0000RESULTS\u0000There were significant positive associations between presenting with a headache and 2 specific components of suicidality: wish to be dead and suicidal action. Individuals with tension headache may have a lower risk of wishing to be dead compared to those with migraine and cluster headaches.\u0000\u0000\u0000CONCLUSIONS\u0000The association of headaches with specific elements of sui-cidality demonstrates the potential yield of identification of suicide risk among individuals with nonpsychiatric presentations.","PeriodicalId":50770,"journal":{"name":"Annals of Clinical Psychiatry","volume":"36 1","pages":"114-122"},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87405013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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