1
|
Liu Q, Teng CC, Sun I, Muñoz RF, Garza M, Liu NH, Barakat S, Leykin Y. Suicide attempts in the absence of depression: Differences between broad cultural groups. J Affect Disord 2024; 356:722-727. [PMID: 38657769 DOI: 10.1016/j.jad.2024.04.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 04/10/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
Suicide is one of the leading causes of death worldwide (WHO, 2021). Depression is a common precursor to suicide and suicidality; however, individuals' experience of depression and the meaning of suicide differs depending on one's cultural background (Colucci, 2013; Goodmann et al., 2021; Kleinman, 2004). The current study explores the relationship between suicide and depression among six broad cultural groups in a large sample (N = 17,015) of adults representing six broad cultural groups (Latin America, South Asia, former Soviet Bloc, Western English-speakers, Chinese, and Arab World). Participants were recruited to a multilingual depression and suicide screening study via Google Ads (Leykin et al., 2012; Gross et al., 2014). As expected, the presence of depression was associated with suicide attempts. However, cultural group moderated this association, with Chinese participants being most likely to report suicide attempts while screening negative for depression. Although depression remains an important predictor of suicidality, it appears that certain cultural groups may be at higher risk even when depression is not present. Clinicians should consider using culturally adapted assessments for depression and suicidality.
Collapse
Affiliation(s)
| | | | | | - Ricardo F Muñoz
- Palo Alto University; University of California, San Francisco, United States of America; Institute for International Internet Interventions for Health, United States of America
| | - Monica Garza
- Legacy Community Health, United States of America
| | - Nancy H Liu
- University of California, Berkeley, United States of America
| | - Suzanne Barakat
- University of California, San Francisco, United States of America
| | - Yan Leykin
- Palo Alto University; University of California, San Francisco, United States of America; Institute for International Internet Interventions for Health, United States of America.
| |
Collapse
|
2
|
Dong H, Wang Y, Jiang F, Yang F, Li J, Xiao Q, Ou J, Shen Y. Incidence and correlates of suicide attempts in adolescents with major depressive versus bipolar disorders: A cross-sectional study. J Affect Disord 2024; 354:247-252. [PMID: 38461897 DOI: 10.1016/j.jad.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/02/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Major depressive disorders (MDD) and bipolar disorders (BD) are the most common psychiatric diagnoses of suicide attempts (SA) in adolescents. However, little is known regarding the differences in incidence and clinical-related features of SA between these two disorders. The study aims to examine the SA incidence and related factors in adolescents with MDD versus BD. METHOD A retrospective survey was conducted in outpatients. SA incidence, demographic characteristics and substance use history were collected. Symptom Checklist-90 was used to measure the severity of symptoms. The Revised Chinese internet addiction scale and Barratt Impulsiveness Scale-11 were utilized to assess the presence of internet addiction and impulsiveness. The Childhood Trauma Questionnaire was used to measure childhood maltreatment subtypes. RESULTS 295 MDD and 205 BD adolescents were recruited. The incidence of SA for MDD and BD were 52.5 % and 56.4 %, respectively. BD adolescents who attempted suicide showed worse symptoms, higher rates of nicotine and alcohol use, higher motor and non-planning impulsivity, and a more childhood physical abuse proportion than MDD adolescents with SA. Physical abuse in childhood was found to be associated with SA in both disorders (OR = 1.998 for MDD; OR = 2.275 for BD), while higher anxiety (OR = 1.705), and alcohol use (OR = 2.094) were only associated with SA in MDD. LIMITATIONS Retrospective, cross-sectional design cannot draw causality, and biases in self-report measurements cannot be ignored. CONCLUSIONS The findings revealed some difference between BD and MDD for adolescents with SA, and it emphasize significance of prompt identification and exact distinction between BD and MDD in adolescents.
Collapse
Affiliation(s)
- Huixi Dong
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ying Wang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Furong Jiang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fangru Yang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jianling Li
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qian Xiao
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jianjun Ou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yidong Shen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
| |
Collapse
|
3
|
Vodička T, Bozděch M, Vespalec T, Piler P, Paludo AC. Association between muscle strength and depression in a cohort of young adults. PLoS One 2024; 19:e0303925. [PMID: 38820320 PMCID: PMC11142448 DOI: 10.1371/journal.pone.0303925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/02/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The study investigated the association between knee joint muscle strength and the prevalence of depression in a cohort of young adults. METHODS The observational, population-based study was performed with 909 participants (29.02 ± 2.03 years; 48.73% male) from the Central European Longitudinal Studies of Parents and Children: Young Adults (CELSPAC: YA), who were retained to analysis. Quadriceps and hamstring knee muscle strength were assessed by isokinetic dynamometry, and depression by Beck's Depression Inventory (BDI-II). Statistical comparisons (Mann-Whitney and Chi-squared test) and effect size analyses (Eta-Squared, and Odds Ratio) were conducted. RESULTS The main findings revealed an inverse association between knee joint muscle strength and depression, with individuals who had low muscle strength having 3.15 (95% CI = 2.74-3.62) times higher odds of experiencing depression. Specifically, participants with low extensor strength had 4.63 (95% CI = 2.20-9.74) times higher odds, and those with low flexor strength had 2.68 (95% CI = 1.47-4.89) times higher odds of experiencing depression compared to those individuals with high muscle strength. Furthermore, gender-specific analyses revealed that males with low muscle strength had 2.51 (95% CI = 1.53-4.14) times higher odds, while females had 3.46 (95% CI = 2.93-4.08) times higher odds of experiencing depression compared to individuals with high muscle strength. CONCLUSIONS Strong knee muscles seems to be a key factor in preventing depression, specially in female young adults. The results support the importance of promoting an increase in muscle strength through physical activity as a preventive strategy against depression in this population.
Collapse
Affiliation(s)
- Tomáš Vodička
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Michal Bozděch
- Department of Physical Education and Social Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Tomáš Vespalec
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Pavel Piler
- Faculty of Science, RECETOX, Masaryk University, Brno, Czech Republic
| | - Ana Carolina Paludo
- Department of Sport Performance and Exercise Testing, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| |
Collapse
|
4
|
Shang Z, Lang X, Wang J, Zhang X. Prevalence and risk factors of suicide attempts in young, first-episode and drug-naïve Chinese Han outpatients with psychotic major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01698-4. [PMID: 37878033 DOI: 10.1007/s00406-023-01698-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023]
Abstract
This study investigates the relationship between psychotic symptoms and suicide attempts in young first-episode, drug-naive Chinese Han outpatients diagnosed with Major Depressive Disorder (MDD). The prevalence of Psychotic Major Depressive Disorder (PMD) was found to be 8.3% among the enrolled MDD patients. The study assessed 1289 participants using various scales to evaluate the severity of clinical symptoms, including the CGI-S, the HAMD, the HAMA, and the PANSS positive subscale. Additionally, thyroid hormone and glucolipid metabolism indicators were examined. The findings indicate that among patients with PMD, 41.12% had recent suicide attempts, while 6.54% had previous suicide attempts. Patients who recently attempted suicide exhibited higher scores on the HAMA and CGI scales, along with elevated serum levels of Thyroid-Stimulating Hormone (TSH) and total cholesterol (TC), as well as higher systolic and diastolic blood pressure. Notably, TSH levels independently correlated with recent suicide attempts in PMD patients, with an impressive area under the receiver operating characteristic curve (AUROC) of 0.923. Furthermore, the subgroup of patients with previous suicide attempts displayed longer illness duration and higher HAMD scores. Duration of illness and HAMD were found to be independently associated with previous suicide attempts among PMD patients, with a combined predictive effect showing a robust AUROC of 0.910. In conclusion, this study highlights the significant prevalence of recent and previous suicide attempts among young Chinese Han outpatients with PMD. The identification of risk factors, especially the link between TSH levels and recent suicide attempts, offers valuable insights for clinicians to develop targeted interventions and preventive strategies for this vulnerable patient population.
Collapse
Affiliation(s)
- ZhaoXuan Shang
- Department of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - XiaoE Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jikun Wang
- Department of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
| | - XiangYang Zhang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, Beijing, China.
| |
Collapse
|
5
|
Ye G, Yuan Y, Li Z, Yue Y, Wu Y, Yang R, Wang H, Wu S, Zhou Y, Zhao X, Lv X, Yuan N, Li R, Zhang G, Du X, Zhang X. Sex-differential association of suicide attempts with thyroid dysfunction in first-episode and drug-naïve young major depressive disorder patients with comorbid anxiety. Sci Rep 2023; 13:13715. [PMID: 37608074 PMCID: PMC10444780 DOI: 10.1038/s41598-023-40948-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/18/2023] [Indexed: 08/24/2023] Open
Abstract
This study aimed to explore sex differences in the relationship between thyroid function indicators and suicide attempts in first-episode and drug-naïve young major depressive disorder (MDD) patients with comorbid anxiety (MDA). A total of 917 MDD patients (aged 18-35 years) were recruited. The Hamilton depression rating scale (HAMD-17), Hamilton anxiety rating scale (HAMA), positive and negative syndrome scale (PANSS) positive subscale and clinical global impression of severity scale (CGI-S) were used. 467 patients were classified as MDA. The prevalence of suicide attempts was 31.3% in MDA patients, which was significantly higher than that (7.3%) in MDD patients without anxiety. Compared with MDA patients without suicide attempts, MDA patients with suicide attempts were older, had a later age of onset, higher HAMD-17, HAMA, and PANSS positive symptom subscale scores, as well as higher TSH, TgAb and TPOAb levels. For male patients, TSH and TPOAb levels were independently associated with suicide attempts. For female patients, HAMA, PANSS positive symptom scores, CGI-S score and TPOAb levels were independently associated with suicide attempts. Our results suggest that the indicators of thyroid function which can predict suicide attempts in male and female MDA patients have sex differences.
Collapse
Affiliation(s)
- Gang Ye
- Suzhou Medical College of Soochow University, Suzhou, People's Republic of China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Ying Yuan
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Yan Yue
- Suzhou Medical College of Soochow University, Suzhou, People's Republic of China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Yuxuan Wu
- Suzhou Medical College of Soochow University, Suzhou, People's Republic of China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Ruchang Yang
- Suzhou Medical College of Soochow University, Suzhou, People's Republic of China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Haitao Wang
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Siqi Wu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Yue Zhou
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
- Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Xueli Zhao
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Xiaoli Lv
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Nian Yuan
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Ronghua Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Guangya Zhang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, Suzhou, 215137, Jiangsu Province, People's Republic of China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China.
| |
Collapse
|
6
|
Freedland AS, Sundaram K, Liu NH, Barakat S, Muñoz RF, Leykin Y. Self-harm behaviors and their intentions: a cross-cultural analysis. J Ment Health 2023:1-9. [PMID: 37577971 DOI: 10.1080/09638237.2023.2245887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Self-harm behaviors (performed with either lethal and non-lethal intentions) are common, especially among individuals suffering from mood disorders, and the reasons individuals self-harm vary both by person and by the type of behavior. Understanding these variations may help clinicians determine levels of risk more accurately. AIMS To understand whether culture and gender are associated with the likelihood of engaging in specific self-harm behaviors and whether the intention (lethal, ambivalent, non-lethal) of these behaviors vary with culture and gender. METHODS 2826 individuals took part in an international multilingual online depression/suicidality screening study and reported at least one instance of self-harm in the past year. Participants were grouped into six broad cultural categories (Latin America, South Asia, Russian, Western English, Chinese, Arab). RESULTS 3-way (culture x gender x intent) interactions were observed for several self-harm behaviors (overdosing, self-burning, asphyxiating, poisoning, and jumping from heights), suggesting that individuals engage in each of these behaviors with different intentions depending on gender and culture. Cultures and genders likewise differed in the likelihood of engaging in several self-harm behaviors. CONCLUSIONS Clinicians should consider culture and gender when assessing for suicide risk, as similar self-harming behaviors may reflect different intentions depending on an individual's culture and gender.
Collapse
Affiliation(s)
- Anna S Freedland
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Kalpana Sundaram
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Nancy H Liu
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Suzanne Barakat
- Family and Community Medicine, University of California, San Francisco, CA, USA
| | - Ricardo F Muñoz
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Yan Leykin
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| |
Collapse
|
7
|
Liu J, Yang L, Zheng Y, Kang C, Wang X, Shi J, Qiu S, Zhao Y, Yu J, Zhao N. Rural-urban differences in prevalence and correlates of suicidal ideation in adolescent patients with depression in a large sample of Chinese. J Affect Disord 2023; 322:118-124. [PMID: 36395987 DOI: 10.1016/j.jad.2022.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Suicidal ideation (SI) is severe comorbidity of depression that has been extensively studied in the past. Residence differences between SI have rarely been systematically studied, especially in parental rearing behavior. This large-scale explored the residence differences in the prevalence and correlation of SI adolescent patients with depression. METHODS A total of 1417 patients with depression were recruited, and their demographic data and clinical data were collected. The Children's Depression Inventory (CDI) and the Egna Minnen Beträffande Uppfostran (EMBU) scale were used to assess depression, and parental rearing behavior, respectively. RESULTS The prevalence of suicidal ideation was higher in urban patients than in rural patients (43.7 % vs.37.7 %, P < 0.05). Patients with SI scored higher on total CDI scores, parental punishment, parental rejection, and paternal overprotection compared to their respective patients without SI. In the urban group, patients with SI had lower parental emotional warmth scores and higher parental intervention scores compared to patients without SI. Logistic regression analysis showed that total CDI score, gender, alcohol consumption, father's emotional warmth, father's rejection, and mother's intervention were significantly associated with SI in urban patients (P < 0.05); total CDI score and mother's rejection were significantly associated with SI in rural patients (P < 0.05). LIMITATIONS No causal relationship could be drawn due to the cross-sectional design. CONCLUSIONS The results of this study showed significant residential differences in risk and associated factors for SI among adolescents with depression. Focusing on the parenting styles of adolescent patients can help with the early identification and intervention of SI.
Collapse
Affiliation(s)
- Jiacheng Liu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Liying Yang
- Dalian Seventh People's Hospital (Dalian Mental Health Center), Dalian, Liaoning Province, China
| | - Yue Zheng
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China; National Clinical Research Center for Mental Disorders & NHC Key Laboratory of Mental Health, Peking University, Beijing, China
| | - Chuanyi Kang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Xiaohong Wang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Jingjing Shi
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Siyu Qiu
- Department of Gastroenterology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Ying Zhao
- Department of Laboratory, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Jiahong Yu
- Dalian Seventh People's Hospital (Dalian Mental Health Center), Dalian, Liaoning Province, China
| | - Na Zhao
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
| |
Collapse
|
8
|
Chen Y, Qin X. The Impact of Extreme Temperature Shocks on the Health Status of the Elderly in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15729. [PMID: 36497803 PMCID: PMC9738369 DOI: 10.3390/ijerph192315729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/10/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
With the accelerating process of climate change, long-term exposure to extreme temperatures could threaten individuals' physical health, especially for the vulnerable population. This paper aims to investigate the long-term effects of extreme temperature exposure on the health of the elderly in the context of climate change and aging. Different from most of the existing literature in environmental economics, we define the relative extreme temperature exposure based on the local temperature pattern. By combining a large national household survey and nationwide meteorologic historical data, this study provides empirical evidence that heat exposure days and cold exposure days during the past year both significantly affect the physical health of middle-aged and elderly groups, controlling for city, year, and individual fixed effects. The effect on individual physical health has certain seasonal characteristics and is heterogeneous across populations. Additionally, cooling and heating equipment are effective in alleviating the reverse impact of heat and cold exposure. The estimation is robust and consistent across a variety of temperature measurements and model modifications. Our findings provide evidence of the long-term and accumulative cost of extreme temperature to middle-aged and elderly human capital, contributing to helping the public to better understand the full impact of climate change.
Collapse
Affiliation(s)
- Yanran Chen
- School of Economics, Capital University of Economics and Business, Beijing 100070, China
| | - Xuezheng Qin
- School of Economics, Peking University, Beijing 100871, China
| |
Collapse
|
9
|
Ye G, Li Z, Yue Y, Wu Y, Yang R, Wang H, Wu S, Zhou Y, Zhao X, Lv X, Yuan N, Li R, Zhang G, Ganapathi PB, Wu HE, Du X, Zhang XY. Suicide attempt rate and the risk factors in young, first-episode and drug-naïve Chinese Han patients with major depressive disorder. BMC Psychiatry 2022; 22:612. [PMID: 36114485 PMCID: PMC9479358 DOI: 10.1186/s12888-022-04254-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/06/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND In recent years, the rates of suicide among young people have been increasing, and major depressive disorder (MDD) is regarded to be its main cause. Many factors such as thyroid dysfunction and metabolic abnormalities are thought to mediate this process, but the conclusions are inconsistent. This study investigated the rate of suicide attempts and associated risk factors among young, first-episode and drug-naïve Chinese Han patients with MDD. METHODS A total of 917 patients with MDD (aged 18 ~ 35 years) were recruited. Demographic and clinical data were collected and thyroid function, fasting blood glucose and lipid profiles were measured. The Hamilton Depression Rating Scale-17 items (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), positive symptom subscale of Positive and Negative Syndrome Scale (PANSS) and clinical global impression of severity scale (CGI-S) were adopted to assess depression, anxiety, psychotic symptoms and disease severity respectively. RESULTS The rate of suicide attempts was 19.5% in young MDD patients. There were significant differences in age (p = 0.003), education level (p = 0.001), age of onset (p = 0.004) and disease duration (p = 0.001) between patients with and without suicide attempts. Compared with patients without suicide attempts, patients with suicide attempts had significantly higher scores on the HAMD-17, HAMA, PANSS positive symptom subscale and CGI-S (all p < 0.001). Patients with suicide attempts had significantly higher levels of TSH (p < 0.001), TgAb (p = 0.004), TPOAb (p < 0.001), TG (p = 0.016), TC (p < 0.001), LDL (p < 0.001), and fasting glucose (p < 0.001), but significantly lower levels of HDL (p < 0.001). Logistic regression analysis showed that marital status (OR = 0.515, 95%CI: 0.280-0.950, p = 0.515), disease duration (OR = 1.100, 95%CI: 1.013-1.194, p = 0.024), HAMA score (OR = 1.313, 95%CI: 1.205-1.430, p < 0.001), CGI-S score (OR = 1.875, 95%CI: 1.339-2.624, p < 0.001), levels of FT3(OR = 0.717, 95%CI: 0.536-0.959, p = 0.025), TPOAb (OR = 1.004, 95%CI: 1.002-1.006, p < 0.001), TC (OR = 1.330, 95%CI: 1.011-1.750, p = 0.042) and LDL (OR = 0.736, 95%CI: 0.558-0.971, p = 0.030) were all independently associated with suicide attempts in young MDD patients. CONCLUSIONS In China, the rate of suicide attempts in young patients with MDD is quite high and thyroid dysfunction and metabolic abnormalities may be implicated in its pathogenesis.
Collapse
Affiliation(s)
- Gang Ye
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China
| | - Zhe Li
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China
| | - Yan Yue
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China ,grid.263761.70000 0001 0198 0694Medical College of Soochow University, Suzhou, China
| | - Yuxuan Wu
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China ,grid.263761.70000 0001 0198 0694Medical College of Soochow University, Suzhou, China
| | - Ruchang Yang
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China ,grid.263761.70000 0001 0198 0694Medical College of Soochow University, Suzhou, China
| | - Haitao Wang
- grid.440734.00000 0001 0707 0296School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Siqi Wu
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China ,grid.440734.00000 0001 0707 0296School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Yue Zhou
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China ,grid.417303.20000 0000 9927 0537Xuzhou Medical University, Xuzhou, China
| | - Xueli Zhao
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China
| | - Xiaoli Lv
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China
| | - Nian Yuan
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China
| | - Ronghua Li
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China
| | - Guangya Zhang
- grid.452825.c0000 0004 1764 2974Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137 Suzhou, Jiangsu Province PR China
| | - Pallavi B. Ganapathi
- grid.267308.80000 0000 9206 2401Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX USA
| | - Hanjing Emily Wu
- grid.267308.80000 0000 9206 2401Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX USA
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, No. 11 Guangqian Road, 215137, Suzhou, Jiangsu Province, PR China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
| |
Collapse
|
10
|
Qiao J, Xia T, Fang B, Cai R, Chen L, Qian N, Yu H, Jin S, Wang C, Fu C. The reversing trend in suicide rates in Shanghai, China, from 2002 to 2020. J Affect Disord 2022; 308:147-154. [PMID: 35429532 DOI: 10.1016/j.jad.2022.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/08/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND To explore changing patterns in suicides and provide suggestions for suicide prevention by reviewing all suicide deaths from 2002 to 2020 in Shanghai, China. METHODS Suicide-death data were obtained from the Shanghai Death Surveillance System and analyzed in terms of year, sex, age group, area, suicide method, and depression diagnosis. Joinpoint regression analyses were conducted to examine time trends in suicide rates. RESULTS The age-adjusted suicide rate was 6.15/100,000 in 2002 and 5.10/100,000 in 2020. The change in this rate was U-shaped, with a downward trend before 2009 followed by an upward trend. The rate initially decreased by 6.33% annually (95% confidence interval [95%CI]: 4.25-8.37%) but, after 2009, increased by 2.60% annually (95%CI: 1.49-3.71%). Similar trends were found for men and women, the 0-29y and 30-49y age groups, and residents of central and suburban areas, respectively. In 2020, jumping from a high place was the leading suicide method (39.54%), and 22.54% of suicide victims had a diagnosis of depression. LIMITATIONS Suicides may be misclassified in coding (however, provided misclassification rates remain stable, this should not influence overall trends). Suicides among temporary residents were not included because of inadequate stratified population data. The finding of a higher prevalence of depression may have been impacted by a higher detection rate. CONCLUSIONS The post-2002 decline in Shanghai suicide rates reversed in 2009, and the suicide pattern changed greatly from 2002 to 2020. With the current increasing trend in suicide rates, targeted suicide-prevention strategies featuring multi-departmental cooperation are necessary.
Collapse
Affiliation(s)
- Jiaying Qiao
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Tian Xia
- Institute of Health Information, Shanghai Research Institute of Preventive Medicine, Shanghai, China.
| | - Bo Fang
- Department of Vital Statistics, Shanghai Research Institute of Preventive Medicine, Shanghai, China.
| | - Renzhi Cai
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Lei Chen
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Naisi Qian
- Department of Vital Statistics, Shanghai Research Institute of Preventive Medicine, Shanghai, China.
| | - Huiting Yu
- Department of Vital Statistics, Shanghai Research Institute of Preventive Medicine, Shanghai, China.
| | - Shan Jin
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Chunfang Wang
- Department of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Chen Fu
- Shanghai Municipal Center for Disease Control and Prevention, China.
| |
Collapse
|
11
|
Lam JSH, Links PS, Eynan R, Shera W, Tsang AKT, Law S, Fung WLA, Zhang X, Liu P, Zaheer J. "I thought that I had to be alive to repay my parents": Filial piety as a risk and protective factor for suicidal behavior in a qualitative study of Chinese women. Transcult Psychiatry 2022; 59:13-27. [PMID: 34928737 PMCID: PMC8859686 DOI: 10.1177/13634615211059708] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Filial piety involves the Confucian view that children always have a duty to be obedient and to provide care for their parents. Filial piety has been described as both a risk and a protective factor in depression and suicide. This qualitative study aimed to explore the role of filial piety in the suicidal behavior of Chinese women. Qualitative interviews were conducted with Chinese women with a history of suicidal behavior living in the Beijing area (n = 29). Filial piety data were extracted and analyzed in accordance with constructivist grounded theory. The women described five specific family and filial piety factors and how they influenced their ability to fulfill family role obligations, which was described as a nexus connecting these factors to depression, suicidal behavior, and recovery. The five factors were: 1) rigidity of parental filial expectations, 2) perception of family relationships as positive/supportive or negative/harsh, 3) whether filial piety is of high or low personal value in the woman's life, 4) any experiences of rebellion leading to punitive consequences, and 5) how much filial piety she receives from her children. These factors could inform suicide risk assessments in this population. They can be harnessed as part of recovery and protect against future suicidal behavior.
Collapse
Affiliation(s)
| | | | | | | | | | - Samuel Law
- University of Toronto
- St. Michael's Hospital
| | - Wai Lun Alan Fung
- Mount Sinai Hospital and North York General Hospital
- Tyndale University
| | | | | | | |
Collapse
|
12
|
Wang W, Luo X, Zhang C, Song J, Xu D. Can Land Transfer Alleviate the Poverty of the Elderly? Evidence from Rural China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111288. [PMID: 34769804 PMCID: PMC8582979 DOI: 10.3390/ijerph182111288] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
This study explores the impact of farmland transfer on the multidimensional relative poverty of the elderly in rural areas to provide a reference for the study of rural land transfer in China and improve the welfare system for the elderly. Based on the China Family Panel Studies (CFPS) rural sample data in 2018, this paper uses the AF multidimensional index measurement method to assess multidimensional relative poverty in rural areas. Logit regression estimation examines the single index poverty of rural older adults transferred from rural land and the impact of multidimensional relative poverty, using the propensity score matching method (PSM) to analyze the results' robustness. The transfer of agricultural land has different impacts on the poverty of different rural elderly poverty indicators and negatively affects the comprehensive effect of rural elderly poverty. The transfer of agricultural land significantly alleviates rural elderly poverty. Reasonable and effective transfer of agricultural land, together with improved rural social security and a caring service system for the elderly, will promote the continuous operation of large-scale agricultural operations and alleviate rural elderly poverty.
Collapse
Affiliation(s)
- Wei Wang
- Department of Agriculture and Forestry Economics and Management, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China; (W.W.); (X.L.); (C.Z.)
| | - Xin Luo
- Department of Agriculture and Forestry Economics and Management, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China; (W.W.); (X.L.); (C.Z.)
| | - Chongmei Zhang
- Department of Agriculture and Forestry Economics and Management, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China; (W.W.); (X.L.); (C.Z.)
| | - Jiahao Song
- Department of Rural and Regional Development, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China
- Correspondence: (J.S.); (D.X.); Tel.: +86-189-7227-0055 (J.S.); +86-028-8629-0893 (D.X.)
| | - Dingde Xu
- Sichuan Center for Rural Development Research, College of Management, Sichuan Agricultural University, 211 Huimin Rd, Chengdu 130062, China
- Correspondence: (J.S.); (D.X.); Tel.: +86-189-7227-0055 (J.S.); +86-028-8629-0893 (D.X.)
| |
Collapse
|
13
|
Gender Differences in Depressive Traits among Rural and Urban Chinese Adolescent Students: Secondary Data Analysis of Nationwide Survey CFPS. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179124. [PMID: 34501714 PMCID: PMC8430502 DOI: 10.3390/ijerph18179124] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022]
Abstract
Many previous studies have indicated that urban adolescents show a higher level of mental health in China compared to rural adolescents. Specifically, girls in rural areas represented a high-risk group prior to the 21st century, demonstrating more suicidal behaviour and ideation than those in the urban areas because of the severe gender inequality in rural China. However, because of the urbanisation process and centralised policy to eliminate gender inequality in recent decades, the regional and gender differences in mental health might decrease. This research aimed to probe the gender and regional differences in depressive traits among adolescent students currently in China. We adopted the national survey dataset Chinese Family Panel Studies (CFPS) conducted in 2018. Accordingly, 2173 observations from 10–15-year-old subjects were included. CFPS utilised an eight-item questionnaire to screen individuals’ depressive traits. Two dimensions of depressive traits were confirmed by CFA, namely depressed affect and anhedonia. The measurement invariance tests suggested that the two-factor model was applicable for both males and females and rural and urban students. Based on the extracted values from the CFA model, MANOVA results revealed that, compared to boys, girls experienced more depressed affect. Moreover, rural students demonstrated more anhedonia symptoms. There was no interaction between gender and region. The results suggest that, even though the gender and regional differences are small, being a female and coming from a rural area are still potential risk factors for developing depressive traits among adolescent students in China.
Collapse
|
14
|
Matera E, Margari M, Serra M, Petruzzelli MG, Gabellone A, Piarulli FM, Pugliese A, Tassiello AR, Croce F, Renna C, Margari A. Non-Suicidal Self-Injury: An Observational Study in a Sample of Adolescents and Young Adults. Brain Sci 2021; 11:brainsci11080974. [PMID: 34439593 PMCID: PMC8391479 DOI: 10.3390/brainsci11080974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
Non-Suicidal Self-Injury (NSSI) is the self-inflicted destruction of body tissues without suicidal intent with a prevalence of 1.5% to 6.7% in the youth population. At present, it is not clear which emotional and behavioral components are specifically associated with it. Therefore, we studied NSSI in a clinical sample of youth using the Ottawa Self-injury Inventory and the Barratt Impulsiveness Scale 11. The Mann-Whitney test was used to compare the numerical responses provided to the tests. We found 54 patients with NSSI, with a mean age of 17 years. Scores were analyzed in the total sample and in four subgroups. In the total sample, Internal Emotion and External Emotion Regulation, Craving, Non-Planning and Total Impulsivity were significantly associated with NSSI. There were statistically significant differences in Craving between patients with multiple NSSI episodes, suicide attempts and multiple injury modes and patients of other corresponding subgroups, in Internal Emotion Regulation, Sensation Seeking and Motor Impulsivity between NSSI patients with suicide attempts and no suicide attempts, and in Cognitive Impulsivity between NSSI patients with multiple injury modes and one injury mode. It is necessary to carefully evaluate the components underlying NSSI in order to activate personalized treatment options.
Collapse
Affiliation(s)
- Emilia Matera
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy;
- Correspondence:
| | - Mariella Margari
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Maria Serra
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Maria Giuseppina Petruzzelli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Alessandra Gabellone
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy;
| | - Francesco Maria Piarulli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Assunta Pugliese
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Anna Rita Tassiello
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Federica Croce
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Caterina Renna
- Center for Treatment and Research on Eating Disorders Mental Health Department AL, Via Miglietta 5, 73100 Lecce, Italy;
| | - Anna Margari
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| |
Collapse
|
15
|
Cao J, Zhao F, Ren Z. Association Between Changes in Muscle Strength and Risk of Depressive Symptoms Among Chinese Female College Students: A Prospective Cohort Study. Front Public Health 2021; 9:616750. [PMID: 33898372 PMCID: PMC8060500 DOI: 10.3389/fpubh.2021.616750] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/26/2021] [Indexed: 12/31/2022] Open
Abstract
Muscle strength can be a predictor of depressive symptoms among the elderly. We conducted a prospective study aiming to examine the association between change of handgrip strength and the incidence risk of depressive symptoms among Chinese female college students. Handgrip strength was used as a representative indicator of skeletal muscle strength, and a handheld digital smedley dynamometer was applied to measure handgrip strength. We also used the 20-item Zung self-rating depression scale to evaluate depressive status, and a score of ≥50 indicated moderate-to-severe depressive symptoms. During a 1-year follow-up period, the incidence of depressive symptoms is 10.7%. Multivariate logistic regressions analysis revealed that the multivariable-adjusted ORs (95% CI) of depressive symptoms for the categories of handgrip strength change was 1.00 (reference) for group 1, 0.57 (0.28, 1.19) for group 2, 0.41 (0.19, 0.89) for group 3 and 0.33 (0.11, 0.99) for group 4 (p = 0.018). This study indicated that change of handgrip strength level over one-year period is negatively associated with risk of depressive symptoms among Chinese female college students.
Collapse
Affiliation(s)
- Jianhua Cao
- School of Physical Education and Health, Nanning Normal University, Nanning, China
| | - Fang Zhao
- School of Physical Education and Health, Nanning Normal University, Nanning, China
| | - Zhongyu Ren
- Key Laboratory of Physical Fitness Evaluation and Motor Function Monitoring, College of Physical Education, General Administration of Sport of China, Southwest University, Chongqing, China
| |
Collapse
|
16
|
Björkenstam E, Helgesson M, Amin R, Mittendorfer-Rutz E. Mental disorders, suicide attempt and suicide: differences in the association in refugees compared with Swedish-born individuals. Br J Psychiatry 2020; 217:679-685. [PMID: 31608856 DOI: 10.1192/bjp.2019.215] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Mental disorders are associated with an elevated risk for suicide attempt and suicide. Whether the strength of the associations also holds for refugees is unclear. AIMS To examine the relationship between specific mental disorders and suicide attempt and suicide in refugees and Swedish-born individuals. METHOD This longitudinal cohort study included 5 083 447 individuals aged 16-64 years, residing in Sweden in 2004, where 196 757 were refugees. Mental disorders were defined as having a diagnosis in psychiatric care during 2000-2004. Estimates of risk of suicide attempt and suicide were calculated as hazard ratios with 95% confidence intervals. Adjustments were made for important confounding factors, including history of attempt. The reference group comprised Swedish-born individuals without mental disorders. RESULTS Rates for suicide attempt in individuals with a mental disorder were lower in refugees compared with Swedish-born individuals (480 v. 850 per 100 000 person-years, respectively). This pattern was true for most specific disorders: compared with the reference group, among refugees, multivariable-adjusted hazard ratios for suicide attempt ranged from 3.0 (anxiety) to 7.4 (substance misuse), and among Swedish-born individuals, from 4.9 (stress-related disorder) to 9.3 (substance misuse). For schizophrenia, bipolar disorder and personality disorder, estimates for suicide attempt were comparable between refugees and Swedish-born individuals. Similar patterns were seen for suicide. CONCLUSIONS For most mental disorders, refugees were less likely to be admitted to hospital for suicide attempt or die by suicide compared with Swedish-born individuals. Further research on risk and protective factors for suicide attempt and suicide among refugees with mental disorders is warranted. DECLARATION OF INTEREST None.
Collapse
Affiliation(s)
- Emma Björkenstam
- Assistant Professor, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Magnus Helgesson
- Senior Postdoctoral Research Fellow, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Ridwanul Amin
- Doctoral student, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Ellenor Mittendorfer-Rutz
- Professor of Insurance Medicine, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| |
Collapse
|
17
|
Hassan WAN, Noaman MM, Khalifa H, Abdelrahman AA, Omar SM. A clinical study of suicide in patients admitted in psychiatry unit in Assiut University. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00034-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study was performed for clinical study of suicide including risk factors in psychiatric patients admitted in psychiatric unit of Assiut University Hospital (AUH).
Results
We found that frequency of suicidal attempts is more in MDD (major depressive disorder), bipolar disorders followed by schizophrenia. And frequency of suicidal attempts in patients with multiple previous attempts before this one was higher in patients with mood disorders (53.8%) than psychotic and substance-induced disorders (32.3%, 13.8% respectively), with statistically significant difference in patients with MDD as well as there was significant treatment outcome on suicidal behavior.
Conclusion
The frequency of suicidal attempts is more in MDD (major depressive disorder), bipolar disorders followed by schizophrenia. There was significant severity of suicidal behavior in patients with psychotic disorders in comparison to patients with substance-induced disorder or mood disorders.
Collapse
|
18
|
Tang D, Lin Z, Chen F. Moving beyond living arrangements: the role of family and friendship ties in promoting mental health for urban and rural older adults in China. Aging Ment Health 2020; 24:1523-1532. [PMID: 30977378 DOI: 10.1080/13607863.2019.1602589] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: This study examines the interplay among living arrangements, social networks, and depressive symptoms among Chinese older adults.Methods: Data are derived from the 2014 baseline survey of the China Longitudinal Aging Social Survey (CLASS), which provides a sample of older Chinese who had been married and had children (N = 7,662). This study examines the association between living arrangements and depressive symptoms (measured as CES-D scale, 0-18) of older adults, and addresses the moderating role of social networks (measured as family ties and friendship ties, 0-15) on this perceived association.Results: Our results show that older adults who live both with a spouse and adult children report superior mental health than those living alone (β = 1.240, p < 0.001), but no differences are seen from those living only with a spouse or children. Older adults living alone in rural areas are also more disadvantaged in comparison to those living alone in urban places (β = 0.535, p < 0.05). However, we find that the undesirable consequences associated with depression of older adults living alone can be reduced or even eliminated when older adults have strong friendship ties in rural China (β = -0.145, p < 0.01). We also find that for rural older adults living only with children, their mental health is highly contingent on their family ties, that is, they are extremely disadvantaged when having weak family ties, but benefit most significantly from strong family ties (β = -0.137, p < 0.05).Conclusions: Associations between living arrangements and mental health in later life are contingent on older adults' social networks, and these moderating effects vary between rural and urban China.
Collapse
Affiliation(s)
- Dan Tang
- Population Development Studies Center, Renmin University of China, Beijing, China
| | - Zhiyong Lin
- Department of Sociology and Maryland Population Research Center, University of Maryland, College Park, MD, USA
| | - Feinian Chen
- Department of Sociology and Maryland Population Research Center, University of Maryland, College Park, MD, USA
| |
Collapse
|
19
|
Lam JSH, Links PS, Shera W, Law S, Fung WLA, Tsang AKT, Eynan R, Zhang X, Liu P, Zaheer J. Lessons from a Canada-China cross-national qualitative suicide research collaboration. Glob Public Health 2020; 15:1730-1739. [PMID: 32450777 DOI: 10.1080/17441692.2020.1771394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A cross-national qualitative suicide study was conducted by Tsinghua University and the University of Toronto with two samples of Chinese women in Beijing and Toronto. The aim of this article is to reflect on lessons learned from this collaborative study. A literature review guided the analysis. A focus group was conducted with members of both research teams. A semi-structured interview guide was developed to explore the researchers' experiences of participating in the cross-national study. Focus group transcript data and observations from authors informed the analysis, situated in the existing literature on cross-national qualitative health research and guided by Baistow's cross-national research frame. Our study highlights how cross-national research involves conceptual and practical challenges that require negotiation. Such research also holds many opportunities, including (1) using a different cultural lens to understand differences and clarify similarities cross-culturally; (2) co-constructing knowledge through collaboration; (3) deconstructing one's own assumptions; and (4) engaging in an inspiring and empowering experience in collaboration.
Collapse
Affiliation(s)
- June Sing Hong Lam
- Department of Psychiatry, University of Toronto, Toronto, Canada.,The Centre for Addiction and Mental Health, Toronto, Canada
| | - Paul S Links
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Wes Shera
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Samuel Law
- Department of Psychiatry, University of Toronto, Toronto, Canada.,St. Michael's Hospital, Toronto, Canada
| | - Wai Lun Alan Fung
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Mount Sinai Hospital and North York General Hospital, Toronto, Canada.,Department of Psychology, Tyndale University, Toronto, Canada
| | - A Ka Tat Tsang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Rahel Eynan
- Lawson Health Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Xiaoqian Zhang
- Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, People's Republic of China
| | - Pozi Liu
- Department of Psychiatry, Yuquan Hospital, Tsinghua University, Beijing, People's Republic of China
| | - Juveria Zaheer
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, The Centre for Addiction and Mental Health, Toronto, Canada
| |
Collapse
|
20
|
Dai Q, Wang D, Wang J, Xu H, Andriescue EC, Wu HE, Xiu M, Chen D, Zhang X. Suicide attempts in Chinese Han patients with schizophrenia: cognitive, demographic, and clinical variables. BRAZILIAN JOURNAL OF PSYCHIATRY 2020; 43:29-34. [PMID: 32401875 PMCID: PMC7861187 DOI: 10.1590/1516-4446-2020-0900] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 03/13/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the lifetime suicide attempt rate, clinical characteristics and cognitive function of Chinese patients with chronic schizophrenia who had attempted suicide. METHODS We collected data from 908 schizophrenia inpatients about suicide attempts through interviews with the patients and their families, as well as through medical records. All patients were assessed with the Positive and Negative Syndrome Scale, the Rating Scale for Extrapyramidal Side Effects, the Abnormal Involuntary Movement Scale, and the Repeated Battery for the Assessment of Neuropsychological Status. RESULTS Of this sample, 97 (10.68%) had attempted suicide. Patients who had attempted suicide were younger, had longer illness duration, and more severe general psychopathology and depressive symptoms than those who had not. Logistic regression analysis confirmed that suicide attempts were correlated with age, smoking, and depression. No cognitive performance differences were observed between patients who had and had not attempted suicide. CONCLUSIONS In China, patients with chronic schizophrenia may have a higher prevalence of lifetime suicide attempts than the general population. Some demographic and clinical variables were related to suicide attempts in patients with chronic schizophrenia.
Collapse
Affiliation(s)
- Qilong Dai
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiesi Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huang Xu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Elena C Andriescue
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hanjing E Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Meihong Xiu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dachun Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
21
|
Ren Z, Cao J, Cheng P, Shi D, Cao B, Yang G, Liang S, Du F, Su N, Yu M, Zhang C, Wang Y, Liang R, Guo L, Peng L. Association between Breakfast Consumption and Depressive Symptoms among Chinese College Students: A Cross-Sectional and Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051571. [PMID: 32121348 PMCID: PMC7084814 DOI: 10.3390/ijerph17051571] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 11/16/2022]
Abstract
Skipping breakfast has been suggested to increase the risk of depressive symptoms, but there is no information regarding young adults. We aimed to investigate the relationship between the frequency of breakfast consumption and the risk of depressive symptoms among Chinese college students. We investigated a cross-sectional (n = 1060) and one-year prospective (n = 757) relationship between the frequency of breakfast consumption and the risk of depressive symptoms. The frequency of breakfast consumption was categorized into “≤1 time/week”, “2–5 times/week”, or “≥6 times/week”. Depressive symptoms were assessed using the 20-item Zung self-rating depression scale (SDS) with an SDS score of ≥50 to indicate moderate to severe depressive symptoms. In the cross-sectional analysis, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of depressive symptoms related with the breakfast consumption categories were 1.00 (reference) for ≥6 times/week, 1.761 (95% CI: 1.131, 2.742) for 2–5 times/week, and 3.780 (95% CI: 1.719, 8.311) for ≤1 time/week (p for trend: <0.001) after adjusting for these potential confounders. Similarly, in the one-year prospective analysis, we found that 10.2% of participants was classified as having moderate to severe depressive symptoms. Multivariate logistic regressions analysis revealed a significant negative relationship between the frequency of breakfast consumption and the risk of depressive symptoms. The ORs (95% CI) for depressive symptoms with decreasing breakfast consumption frequency were 1.00 (reference) for ≥6 times/week, 2.045 (1.198, 3.491) for 2–5 times/week, and 2.722 (0.941, 7.872) for ≤1 time/week (p for trend: 0.005). This one-year prospective cohort study showed that skipping breakfast is related to increased risk of depressive symptoms among Chinese college students. Future research using interventional or experimental studies is required to explore the causal relationship between the effects of breakfast consumption and depressive symptoms.
Collapse
Affiliation(s)
- Zhongyu Ren
- College of Physical Education, Key Laboratory of Physical Fitness Evaluation and Motor Function Monitoring, General Administration of Sport of China, Institute of Sports Science, Southwest University, Chongqing 400715, China; (Z.R.); (J.C.); (L.G.)
| | - Jianhua Cao
- College of Physical Education, Key Laboratory of Physical Fitness Evaluation and Motor Function Monitoring, General Administration of Sport of China, Institute of Sports Science, Southwest University, Chongqing 400715, China; (Z.R.); (J.C.); (L.G.)
| | - Peng Cheng
- College of Physical Education, Chongqing Nursing Vocational College, Chongqing 402763, China;
| | - Dongzhe Shi
- Department of Physical Education, Xinhua College of Sun Yat-Sen University, Guangzhou 510520, China;
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, China;
| | - Guang Yang
- School of Physical Education, Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China; (G.Y.); (S.L.); (F.D.); (N.S.); (M.Y.); (C.Z.); (Y.W.); (R.L.)
| | - Siyu Liang
- School of Physical Education, Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China; (G.Y.); (S.L.); (F.D.); (N.S.); (M.Y.); (C.Z.); (Y.W.); (R.L.)
| | - Fang Du
- School of Physical Education, Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China; (G.Y.); (S.L.); (F.D.); (N.S.); (M.Y.); (C.Z.); (Y.W.); (R.L.)
| | - Nan Su
- School of Physical Education, Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China; (G.Y.); (S.L.); (F.D.); (N.S.); (M.Y.); (C.Z.); (Y.W.); (R.L.)
| | - Miao Yu
- School of Physical Education, Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China; (G.Y.); (S.L.); (F.D.); (N.S.); (M.Y.); (C.Z.); (Y.W.); (R.L.)
| | - Chaowei Zhang
- School of Physical Education, Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China; (G.Y.); (S.L.); (F.D.); (N.S.); (M.Y.); (C.Z.); (Y.W.); (R.L.)
| | - Yaru Wang
- School of Physical Education, Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China; (G.Y.); (S.L.); (F.D.); (N.S.); (M.Y.); (C.Z.); (Y.W.); (R.L.)
| | - Rui Liang
- School of Physical Education, Chinese Center of Exercise Epidemiology, Northeast Normal University, Changchun 130024, China; (G.Y.); (S.L.); (F.D.); (N.S.); (M.Y.); (C.Z.); (Y.W.); (R.L.)
| | - Liya Guo
- College of Physical Education, Key Laboratory of Physical Fitness Evaluation and Motor Function Monitoring, General Administration of Sport of China, Institute of Sports Science, Southwest University, Chongqing 400715, China; (Z.R.); (J.C.); (L.G.)
| | - Li Peng
- College of Physical Education, Key Laboratory of Physical Fitness Evaluation and Motor Function Monitoring, General Administration of Sport of China, Institute of Sports Science, Southwest University, Chongqing 400715, China; (Z.R.); (J.C.); (L.G.)
- Correspondence:
| |
Collapse
|
22
|
Swaab DF, Bao AM. Sex differences in stress-related disorders: Major depressive disorder, bipolar disorder, and posttraumatic stress disorder. HANDBOOK OF CLINICAL NEUROLOGY 2020; 175:335-358. [PMID: 33008536 DOI: 10.1016/b978-0-444-64123-6.00023-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Stress-related disorders, such as mood disorders and posttraumatic stress disorder (PTSD), are more common in women than in men. This sex difference is at least partly due to the organizing effect of sex steroids during intrauterine development, while activating or inhibiting effects of circulating sex hormones in the postnatal period and adulthood also play a role. Such effects result in structural and functional changes in neuronal networks, neurotransmitters, and neuropeptides, which make the arousal- and stress-related brain systems more vulnerable to environmental stressful events in women. Certain brainstem nuclei, the amygdala, habenula, prefrontal cortex, and hypothalamus are important hubs in the stress-related neuronal network. Various hypothalamic nuclei play a central role in this sexually dimorphic network. This concerns not only the hypothalamus-pituitary-adrenal axis (HPA-axis), which integrates the neuro-endocrine-immune responses to stress, but also other hypothalamic nuclei and systems that play a key role in the symptoms of mood disorders, such as disordered day-night rhythm, lack of reward feelings, disturbed eating and sex, and disturbed cognitive functions. The present chapter focuses on the structural and functional sex differences that are present in the stress-related brain systems in mood disorders and PTSD, placing the HPA-axis in the center. The individual differences in the vulnerability of the discussed systems, caused by genetic and epigenetic developmental factors warrant further research to develop tailor-made therapeutic strategies.
Collapse
Affiliation(s)
- Dick F Swaab
- Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands; Department of Neurobiology and Department of Neurology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Zhejiang, China.
| | - Ai-Min Bao
- Department of Neurobiology and Department of Neurology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Research and Brain-Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Zhejiang, China; Key Laboratory of Mental Disorder Management, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| |
Collapse
|
23
|
Mental disorders and suicidal behavior in refugees and Swedish-born individuals: is the association affected by work disability? Soc Psychiatry Psychiatr Epidemiol 2020; 55:1061-1071. [PMID: 31897579 PMCID: PMC7395008 DOI: 10.1007/s00127-019-01824-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 12/24/2019] [Indexed: 12/03/2022]
Abstract
BACKGROUND Among potential pathways to suicidal behavior in individuals with mental disorders (MD), work disability (WD) may play an important role. We examined the role of WD in the relationship between MD and suicidal behavior in Swedish-born individuals and refugees. METHODS The study cohort consisted of 4,195,058 individuals aged 16-64, residing in Sweden in 2004-2005, whereof 163,160 refugees were followed during 2006-2013 with respect to suicidal behavior. Risk estimates were calculated as hazard ratios (HR) with 95% confidence intervals (CI). The reference groups comprised individuals with neither MD nor WD. WD factors (sickness absence (SA) and disability pension (DP)) were explored as potential modifiers and mediators. RESULTS In both Swedish-born and refugees, SA and DP were associated with an elevated risk of suicide attempt regardless of MD. In refugees, HRs for suicide attempt in long-term SA ranged from 2.96 (95% CI: 2.14-4.09) (no MD) to 6.23 (95% CI: 3.21-12.08) (MD). Similar associations were observed in Swedish-born. Elevated suicide attempt risks were also observed in DP. In Swedish-born individuals, there was a synergy effect between MD, and SA and DP regarding suicidal behavior. Both SA and DP were found to mediate the studied associations in Swedish-born, but not in refugees. CONCLUSION There is an effect modification and a mediating effect between mental disorders and WD for subsequent suicidal behavior in Swedish-born individuals. Also for refugees without MD, WD is a risk factor for subsequent suicidal behavior. Particularly for Swedish-born individuals with MD, information on WD is vital in a clinical suicide risk assessment.
Collapse
|
24
|
Zhong Y, Xia L, Zhao TT, Zhang YL, Zhang YL, Li WZ, Hu YQ, Yao XH, Ungvari GS, Balbuena L, Liu HZ, Xiang YT. The Prevalence of Suicide Attempts and Independent Demographic and Clinical Correlates among Chronic Schizophrenia Patients in Agricultural Areas of China. Psychiatr Q 2019; 90:683-691. [PMID: 31102121 DOI: 10.1007/s11126-019-09644-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study investigated the lifetime prevalence of suicide attempts (SA) and independent demographic and clinical correlates in stabilized schizophrenia inpatients. A cross-sectional study was conducted in three psychiatric hospitals in Anhui province, an agricultural province located in east China. Psychopathology and depressive symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and Hamilton Depression Rating Scale (HAMD), respectively. A total of 315 stable schizophrenia inpatients were interviewed prior to discharge. The lifetime prevalence of SA was 22.2%. Multiple logistic regression analysis revealed that female gender (P < 0.001, OR = 3.4, 95%CI: 1.9-6.0), being married (P = 0.02, OR = 2.2, 95%CI: 1.1-4.4) and having more severe depressive symptoms (P = 0.014, OR = 1.2, 95%CI: 1.01-1.3) were independently and significantly associated with higher risk of SA. Lifetime SA is common among hospitalized schizophrenia patients living in agricultural areas of China. For suicide prevention, regular assessments, appropriate interventions and clinical management should be integrated into a community-based psychiatric service model for this population.
Collapse
Affiliation(s)
- Yi Zhong
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Tong-Tong Zhao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Yu-Long Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Ye-Lei Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Wen-Zheng Li
- Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China.,Hefei Fourth People's Hospital, Anhui Province, China
| | - Yan-Qiong Hu
- Hefei Fourth People's Hospital, Anhui Province, China
| | - Xian-Hu Yao
- MaAnshan Fourth People's Hospital, Anhui Province, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia / Graylands Hospital, Perth, Australia.,Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| | - Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Huan-Zhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China. .,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau, SAR, China.
| |
Collapse
|
25
|
Abstract
AIMS Suicide-related behaviours are common in schizophrenia and are significantly associated with premature death. The objective of this meta-analysis study was to estimate the pooled prevalence of suicide-related behaviours in schizophrenia patients in China. METHODS The relevant literature was searched systematically via the relevant electronic databases (PubMed, Embase, PsycINFO, Chinese National Knowledge Infrastructure, Wanfang Databases and Chinese Biological Medical Literature Database) from their inception until 14 September 2016. Only original studies that reported the prevalence of suicide-related behaviours including suicidal ideation (SI), suicide plan, suicide attempt (SA) and completed suicide were selected. RESULTS Nineteen articles met the inclusion criteria and were analysed. The pooled lifetime prevalence of SI and SA were 25.8% (95% CI 14.7-41.1%) and 14.6% (95% CI 9.1-22.8%), respectively. The 1-month prevalence of SI was 22.0% (95% CI 18.2-26.4%). Subgroup analyses of lifetime SI and SA showed that gender, sample size, survey year, study location and source of patients have no significant mediating effects on the results. CONCLUSIONS Suicide-related behaviours are common in Chinese schizophrenia patients. Due to the high mortality risk, regular screening and effective suicide prevention programmes are warranted.
Collapse
|
26
|
Li X, Liu H, Hou R, Baldwin DS, Li R, Cui K, Liu C, Sun Q, Wang G, Tan Q, Xu X, Zhao J, Ning Y, Sun X. Prevalence, clinical correlates and IQ of suicidal ideation in drug naïve Chinese Han patients with major depressive disorder. J Affect Disord 2019; 248:59-64. [PMID: 30711870 DOI: 10.1016/j.jad.2018.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 12/03/2018] [Accepted: 12/14/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Suicidal ideation (SI) is a common and serious clinical concern in people with major depressive disorder (MDD). Inconsistent evidence suggests that individuals with SI may have a lower measured intelligence quotient (IQ) than those without SI. The aims of this study were to examine SI prevalence and its associations with demographic, clinical variables and IQ in Chinese drug-naïve MDD patients. METHODS 488 drug-naïve Chinese Han patients (male: 203, 41.6%) meeting a DSM-IV diagnosis of MDD were enrolled in a cross-sectional study involving seven hospitals. All participants were asked to complete a series of questionnaires, which include information on socio-demographic and clinical variables. The Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Brief Psychiatric Rating Scale (BPRS) were also administered. Verbal IQ (VIQ), performance IQ (PIQ) and full-scale IQ (FIQ) scores were measured using the Chinese version of the Wechsler Adult Intelligence Scale-Ⅲ (WAIS-Ⅲ). We categorized patients with SI based on a cut-off score of ≥3 on HAMD item 3. RESULTS An estimated prevalence 32.8% (160/488) of drug-naïve MDD patients experienced SI during the current episode of illness. Patients with SI were more likely to be divorced (x2 = 6.93, p = 0.031), male (x2 = 6.04, p = 0.014), had higher severity of depression and anxiety symptoms (t = -8.14, p < 0.001, t = -3.28, p < 0.001, respectively), comorbid psychotic features (t = -5.71, p < 0.001), and lower FIQ levels (t = -4.21, p < 0.001), when compared to patients without SI. Using logistic regression analysis and adjusting for confounding variables, the following variables were independently associated with SI: divorced marital status compared to married (OR=4.674, 95% CI: 1.676~13.036), severity of depression symptoms (OR=1.312, 95% CI: 1.196~1.440), psychotic features (OR=1.044; 1.012~1.077), and FIQ /PIQ levels which expressed in OR per SD increase in IQ score (OR=0.740, 95% CI: 0.561~0.977; OR=0.744, 95% CI: 0.557~0.994, respectively). LIMITATIONS A cross-sectional study which did not assess the influence of severity of SI. CONCLUSIONS The prevalence of SI in drug-naive Chinese patients with MDD is high, and associated with marital status, severity of depression, psychotic features and measured IQ. Further research is needed to further explore these and other potentially relevant risk factors which might affect clinical outcomes.
Collapse
Affiliation(s)
- Xirong Li
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China; Department of Psychiatry, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Haixia Liu
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
| | - Ruihua Hou
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Renjun Li
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
| | - Kaiyan Cui
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
| | - Chuanxin Liu
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Qian Sun
- Beijing Anding Hospital of Capital University of Medical Sciences, Beijing, China
| | - Gang Wang
- Beijing Anding Hospital of Capital University of Medical Sciences, Beijing, China
| | - Qingrong Tan
- Department of Psychiatry, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
| | - Xiufeng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingping Zhao
- Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuping Ning
- Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xueli Sun
- Department of Psychiatry, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
27
|
Treating Obsessive-Compulsive Disorder in the Postpartum Period: Diagnostic and Cultural Considerations. Harv Rev Psychiatry 2019; 26:82-89. [PMID: 28795979 DOI: 10.1097/hrp.0000000000000146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
28
|
Wang Z, Yu G, Tian X. Exploring Behavior of People with Suicidal Ideation in a Chinese Online Suicidal Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010054. [PMID: 30587805 PMCID: PMC6339245 DOI: 10.3390/ijerph16010054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/23/2018] [Accepted: 12/24/2018] [Indexed: 12/19/2022]
Abstract
People with suicidal ideation (PSI) are increasingly using social media to express suicidal feelings. Researchers have found that their internet-based communication may lead to the spread of suicidal ideation, which presents a set of challenges for suicide prevention. To develop effective prevention and intervention strategies that can be efficiently applied in online communities, we need to understand the behavior of PSI in internet-based communities. However, to date there have been no studies that specifically focus on the behavior of PSI in Chinese online communities. A total of 4489 postings in which users explicitly expressed their suicidal ideation were labeled from 560,000 postings in an internet-based suicidal community on Weibo (one of the biggest social media platforms in China) to explore their behavior. The results reveal that PSI are significantly more active than other users in the community. With the use of social network analysis, we also found that the more frequently users communicate with PSI, the more likely that users would become suicidal. In addition, Chinese women may be more likely to be at risk of suicide than men in the community. This study enriches our knowledge of PSI’s behavior in online communities, which may contribute to detecting and assisting PSI on social media.
Collapse
Affiliation(s)
- Zheng Wang
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| | - Guang Yu
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| | - Xianyun Tian
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| |
Collapse
|
29
|
Tang W, Dai Q. Depressive symptoms among first-year Chinese undergraduates: The roles of socio-demographics, coping style, and social support. Psychiatry Res 2018; 270:89-96. [PMID: 30245381 DOI: 10.1016/j.psychres.2018.09.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 06/15/2018] [Accepted: 09/14/2018] [Indexed: 02/08/2023]
Abstract
The prevalence of depressive symptoms among Chinese university students seems to be increasing. However, little research has been conducted in order to examine whether and how socioeconomic factors, coping style and social support affect depressive symptoms among university freshmen. The present study aimed to explore these effects on a sample of freshmen from single- and multi-child households in urban and rural environments. A total of 2,563 university freshmen (883 women, 1,680 men; mean age, 18.27 yr) from three universities in China completed a demographic questionnaire, Patient Health Questionnaire-9, Social Support Rating Scale, and Coping Style Questionnaire. Pearson correlation coefficients suggested that gender and place of origin affected students' coping styles, social support, and depression. Depression was negatively associated with problem-solving and help-seeking, but positively associated with self-blaming, fantasizing, avoidance, and rationalization. Logistic regression showed that depression was predicted by engaging in self-blame and fantasizing, being female, coming from a rural area, being an only child, lacking subjective and social support, having low skills at problem-solving and help-seeking. These findings may help psychological service providers identify first-year students at risk of depressive symptoms and provide them with systematic, gender-specific interventions that pay specific attention to self-blaming and fantasizing coping style.
Collapse
Affiliation(s)
- Wanjie Tang
- Sichuan University, No.24 South Section 1, Yihuan Road, chengdu, sichuan 610065, China
| | - Qian Dai
- Sichuan University, No.24 South Section 1, Yihuan Road, chengdu, sichuan 610065, China.
| |
Collapse
|
30
|
Lin C, Yen TH, Juang YY, Lee CP, Lee SH. Distinct psychopathology of patients who attempted suicide with rodenticide in Taiwan: a comparative study with patients of suicide with paraquat. Psychol Res Behav Manag 2018; 11:323-328. [PMID: 30214328 PMCID: PMC6120505 DOI: 10.2147/prbm.s167621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective Rodenticide as a means of suicide has been documented for centuries. However, this method is often discussed in conjunction with other pesticides. Thus, we aimed to focus on patients who committed suicide with rodenticide and compared them with those who used paraquat for suicide, another frequently used yet lethal method, to highlight the different psychopathology of patients who choose rodenticide as their means of suicide. Methods A 12-year retrospective chart review was conducted on the medical records of all patients admitted to Chang Gung Memorial Hospital due to attempted suicide by either rodenticide or paraquat. Psychiatric consultation sheets were collected to ascertain the psychiatric comorbidity and the major stressor for suicide, measured by the Social Readjustment Rating Scale. A χ2 test and logistic regression were used for group comparisons. Results Seventeen rodenticide and 157 paraquat suicide attempts were identified. Compared with suicides by paraquat, suicides by rodenticide had a more even distribution in the gender ratio but a lower Social Readjustment Rating Scale score (p<0.001). Depressive disorder was the most common diagnosis in suicides by rodenticide and paraquat. However, schizophrenia and psychotic disorder (29.4%) was the second most common diagnosis and a significant predictor of suicide by rodenticide (odds ratio =9.21, 95% confidence interval =1.2–66.07, p=0.027). Conclusion High comorbidity of psychosis in suicide by rodenticide warrants disease-specific suicide prevention and additional large-scale research to confirm this association.
Collapse
Affiliation(s)
- Chemin Lin
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan,
| | - Tzung-Hai Yen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, .,Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yeong-Yuh Juang
- Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Chin-Pang Lee
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, .,Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan,
| | - Shwu-Hua Lee
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, .,Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan,
| |
Collapse
|
31
|
Li A, Huang X, Zhu T. A systematic analysis of online broadcasts of suicidality in China. Asia Pac Psychiatry 2018; 10:e12302. [PMID: 28976066 DOI: 10.1111/appy.12302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 09/06/2017] [Accepted: 09/12/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study attempts to analyze the epidemiological characteristics of online broadcasts of suicidality in China. METHODS A total of 193 incidents were identified by systematically searching for relevant news reports on the internet. A content analysis on these news reports was conducted to obtain information on the characteristics of each individual incident. RESULTS Of these incidents, the ratio of males to females was 1:1.7 (age: 24.6 ± 6.1 years old). Approximately 45.4% and 70.8% of incidents were located in the region of Eastern China and Southern China, respectively, and 15.7% of incidents were unemployed. The most common suicide method was wrist cutting (57.5%), and the most common suicide location was at home (35.2%). Instant messaging apps (52.8%) were most frequently used for broadcasting suicidal thoughts and actions. Relationship breakup (61.1%) was reported as the leading cause of suicide. Furthermore, of the 193 incidents, 19 indicated that they suffered from a mental disorder, and 12 revealed that they had a history of suicide attempts. There were significant gender, age, regional, and occupational differences across the categories. DISCUSSION This study indicates that in China, suicide prevention programmes need to target internet users.
Collapse
Affiliation(s)
- Ang Li
- Department of Psychology, Beijing Forestry University, Beijing, China.,Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Xiaoxiao Huang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Tingshao Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
32
|
The Role of Stigma and Denormalization in Suicide-Prevention Laws in East Asia: A Sociocultural, Historical, and Ethical Perspective. Harv Rev Psychiatry 2018; 25:229-240. [PMID: 28696950 DOI: 10.1097/hrp.0000000000000160] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In many Western countries, the criminalization and stigmatization of suicide has given way to a biomedical approach aimed at destigmatizing suicide and treating underlying mental illness. By contrast, in many East Asian countries, suicide has never historically been criminalized or stigmatized. High rates of suicide in Japan, South Korea, and Taiwan have recently led policy makers in those countries to pursue innovative suicide-prevention strategies. The intentional denormalization of harmful behaviors has been discussed in the public health and ethics literatures, particularly with regard to smoking cessation, and could represent a novel mechanism for preventing suicides in East Asia. Using examples from the sociocultural, historical, and legal discourses surrounding suicide in Western and East Asian contexts, we suggest that denormalization can be a justified, culturally relevant suicide-prevention strategy, but that care must be taken to avoid shaming or stigmatizing suicidal individuals. Specifically, we propose the term weak denormalization to refer to an ethically permissible strategy at the mildest end of a spectrum of denormalizing approaches-milder than the reintegrative shaming described in the criminal justice literature, and diametrically opposed to outright stigmatization, which is generally considered ethically impermissible. Given the severe stigma of mental illness in East Asia, adopting the dominant Western view of suicide as solely a psychiatric concern would not be justified. Weak denormalization strategies in East Asia should be culturally tailored and rigorously tested on a small scale. They should include social supports, praise for the bravery of those of who seek help, and strategies to reduce shame regarding perceived social failure.
Collapse
|
33
|
Liu BP, Qin P, Jia CX. Behavior Characteristics and Risk Factors for Suicide Among the Elderly in Rural China. J Nerv Ment Dis 2018; 206:195-201. [PMID: 28825926 DOI: 10.1097/nmd.0000000000000728] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We examine the characteristics of suicide behavior and associated risk factors in the elderly in rural China, compared with the nonelderly. Paired case-control design and psychological autopsy were used for subject recruitment and data collection. The included cases were 104 suicides of the elderly aged 60 years or older, 86 suicides of the nonelderly, and sex- and age-paired controls from the same villages. Although the characteristics of suicide behavior were similar between the two age groups of victims, the elderly who died by suicide had a greater tendency to experience negative life events and not live with a spouse. Suicide of the nonelderly was associated with family history of suicide, poor social support, and impulsivity. The influence of negative life events on the risk of suicide was greater in the elderly. Thus, efforts for suicide prevention must be tailored to the needs of specific age groups.
Collapse
|
34
|
Mental disorders and suicide attempt in rural China. Psychiatry Res 2018; 261:190-196. [PMID: 29309959 DOI: 10.1016/j.psychres.2017.12.087] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 12/06/2017] [Accepted: 12/31/2017] [Indexed: 11/22/2022]
Abstract
The prevalence of various mental disorders and their age and gender specific characteristics among suicide attempters remains unclear in rural China. This study using 1:1 paired case-control design included 409 suicide attempters and 409 paired controls matched on age, gender and place of residence. Mental disorders were assessed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. The prevalence of mental disorders was 32.3% for suicide attempters and 4.9% for paired controls. Mental disorder constituted a significant risk factor for suicide attempt with an adjusted odds ratio of 7.16 (95%CI: 3.65-14.04). The prevalence of mental disorders was higher among male than female suicide attempters. Major depressive disorder was most common in female suicide attempters while alcohol use disorder was most common in the males. The prevalence of mental disorders seemed to increase with age. Suicide attempters of higher ages were more prone to have mood disorders, especially a major depression. Suicide attempters with mental disorders differed from those without mental disorders on a number of socio-economic characteristics and suicidal behavior features. These insights should be taken into account in strategies and efforts to improve mental health care and ultimately to reduce suicidal behavior among residents in rural China.
Collapse
|
35
|
Wang Z, Yu G, Tian X, Tang J, Yan X. A Study of Users with Suicidal Ideation on Sina Weibo. Telemed J E Health 2018; 24:702-709. [PMID: 29293069 DOI: 10.1089/tmj.2017.0189] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Suicide is a leading cause of death in China, and so suicide intervention on social media is an important issue in the field of public health. Sina Weibo (Weibo) is an emerging surveillance tool that may provide online assistance for users at the risk of suicide. MATERIALS AND METHODS Keyword-based methods and supervised classifiers were employed to conduct this research. A control group was established to explore the differences between Weibo users with suicidal ideation (USI) and the general population. RESULTS A total of 114 USI were detected from 1 million active Weibo users. By studying the negative postings of these USI, disclosure of the reasons for their bad moods was the most common theme. The emotions of USI tend to be particularly down between 05:00 pm and midnight. Use of the first-person pronoun by Weibo USI is significantly frequent. CONCLUSIONS Our findings may help to identify individuals with suicidal ideation who are not identified by the traditional clinical approach. Consequently, detecting and helping individuals who may be at risk of committing suicide may become more efficient.
Collapse
Affiliation(s)
- Zheng Wang
- School of Management, Harbin Institute of Technology , Harbin, China
| | - Guang Yu
- School of Management, Harbin Institute of Technology , Harbin, China
| | - Xianyun Tian
- School of Management, Harbin Institute of Technology , Harbin, China
| | - Jingyun Tang
- School of Management, Harbin Institute of Technology , Harbin, China
| | - Xiangbin Yan
- School of Management, Harbin Institute of Technology , Harbin, China
| |
Collapse
|
36
|
Serrani Azcurra D. Psychometric validation of the Columbia-Suicide Severity rating scale in Spanish-speaking adolescents. COLOMBIA MEDICA (CALI, COLOMBIA) 2017; 48:174-182. [PMID: 29662259 PMCID: PMC5896724 DOI: 10.25100/cm.v43i4.2294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: Adolescent suicide is a major public health issue, and early and accurate detection is of great concern. There are many reliable instruments for this purpose, such as the Columbia-Suicide severity rating scale (C-SSRS), but no validation exists for Spanish speaking Latin American adolescents. Objetive: To assess psychometric properties and cut-off scores of the C-SSRS in Spanish speaking adolescents. Methods: Exploratory assessment with principal component analysis (PCA) and Varimax rotation, and confirmatory analysis (CFA) were performed on two groups with 782 and 834 participants respectively (N=1616). Mean age was 24.8 years. A Receiver operator analysis was applied to distinguish between control and suicide-risk subgroups adolescents. Results: Promax rotation yielded two 10-items factors, for suicide ideation and behavior respectively. C-SSRS was positively correlated with other suicide risk scales, such as Beck Depression Inventory-II, Suicidal Behaviors Questionnaire-Revised, or PHQ-9. Confirmatory factor analysis yielded a two-factor solution as the best goodness of fit model. C-SSRS showed adequate ability to detect suicide risk group with positive predictive value of 68.3%. ROC analyses showed cutoff scores of ≥ 6 and ≥ 4 for suicide ideation and behavior scales respectively Conclusion: This research offers data supporting psychometric validity and reliability of C-SSRS in nonclinical Spanish-speaking students. Added benefits are flexible scoring and management easiness. This questionnaire yields data on distinct aspects of suicidality, being more parsimonious than separate administration of a bunch of questionnaires.
Collapse
Affiliation(s)
- Daniel Serrani Azcurra
- Neuropsychology and Development Psychology Program from the Department of Interdisciplinary Studies, Biology, Psychology and Culture. Faculty of Psychology. Universidad Nacional de Rosario. Rosario, Argentina
| |
Collapse
|
37
|
Ferenčić A, Šoša I, Cuculic D, Stemberga V, Byard RW. Temporal Trends in Rainwater Tank Suicides in Rijeka, Croatia-A 30-year Study. J Forensic Sci 2017; 63:1168-1170. [PMID: 29105777 DOI: 10.1111/1556-4029.13683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 11/29/2022]
Abstract
Although drowning in rainwater tanks is a generally rare phenomenon, this method for suicide has been observed in parts of Croatia. Review of autopsy records at the University of Rijeka, Croatia, was undertaken from 1987 to 2016 to examine this phenomenon. Of 469 drowning deaths, there were 35 suicides in rainwater tanks (7.5%). Overall drowning deaths showed no temporal trends. In contrast, suicidal drownings in rain water tanks showed a marked decline over the years, with 15 cases in 1987-1991, seven in 1992-1996, six in 1997-2001, six in 2002-2006, one in 2007-2011, and none in 2012-2016. Thus, suicidal drowning cases as a percentage of overall drownings dropped from 18% to zero (p<0.001). This study reports a very unusual method of suicide that may have occurred because of the ready availability of large water reservoirs in homes. The recent fall in numbers may relate to less reliance on domestic reservoirs of water.
Collapse
Affiliation(s)
- Antun Ferenčić
- Faculty of Medicine, Department of Forensic Medicine and Criminalistics, University of Rijeka, Brace Branchetta 20, 51 000, Rijeka, Croatia
| | - Ivan Šoša
- Faculty of Medicine, Department of Forensic Medicine and Criminalistics, University of Rijeka, Brace Branchetta 20, 51 000, Rijeka, Croatia
| | - Drazen Cuculic
- Faculty of Medicine, Department of Forensic Medicine and Criminalistics, University of Rijeka, Brace Branchetta 20, 51 000, Rijeka, Croatia
| | - Valter Stemberga
- Faculty of Medicine, Department of Forensic Medicine and Criminalistics, University of Rijeka, Brace Branchetta 20, 51 000, Rijeka, Croatia
| | - Roger W Byard
- School of Medicine, The University of Adelaide, Frome Rd, Adelaide, SA, 5005, Australia
| |
Collapse
|
38
|
Li H, Luo X, Ke X, Dai Q, Zheng W, Zhang C, Cassidy RM, Soares JC, Zhang X, Ning Y. Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population. PLoS One 2017; 12:e0186143. [PMID: 29016669 PMCID: PMC5634639 DOI: 10.1371/journal.pone.0186143] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 09/26/2017] [Indexed: 12/26/2022] Open
Abstract
Background Somatic complaints are often the presenting symptoms of major depressive disorder (MDD) in the outpatient context, because this may go unrecognized. It is well understood that MDD carries an increased risk of suicide. This study aimed to identify the risk factors and association with both MDD and suicidality among Han Chinese outpatients. Methods A multicenter study was carried out in 5189 outpatient adults (≥18 years old) in four general hospitals in Guangzhou, China. The 1392 patients who had the Patient Health Questionnaire-9 (PHQ-9) score ≥ 5, indicating depressive symptoms were offered an interview with a psychiatrist by the Mini International Neuropsychiatric Interview (MINI); 819 patients consented and completed the MINI interview. MINI module B was used to assess suicidality. Stepwise binary logistic models were used to estimate the relationship between a significant risk factor and suicide or MDD. According to with or without MDD, the secondary analysis was performed using the logistic regression model for the risk of suicidility. Results The current prevalence of MDD and the one month prevalence of suicidality were 3.7% and 2.3% respectively. The odds ratio of suicidality in women was more than twice that in men (OR = 2.62; 95% CI 1.45–4.76). Other risk factors which were significantly associated with suicidality were: living alone, higher education, self-reported depression, getting psychiatric diagnoses (MDD, anxiety disorders, and bipolar disorders). Significant risk factors for MDD were also noticed, such as comorbid anxiety disorders, self-reported anxiety, insomnia, suicidal ideation. Limitation It’s a cross-sectional study in outpatient clinics using self-report questionnaires. Conclusion This study provides valuable data about the risk factors and association of MDD and suicide risk in adult outpatients in Han Chinese. Those factors allow better the employment of preventative measures.
Collapse
Affiliation(s)
- Haiyan Li
- Southern Medical University, Guangzhou, China
- Guangzhou Medical University Affiliated Brain Hospital, Guangzhou Huiai Hospital, Guangzhou, China
- National Clinical Research Center on Mental Disorders, Changsha, China
| | - Xinni Luo
- Guangzhou Medical University Affiliated Brain Hospital, Guangzhou Huiai Hospital, Guangzhou, China
| | - Xiaoyin Ke
- Guangzhou Medical University Affiliated Brain Hospital, Guangzhou Huiai Hospital, Guangzhou, China
| | - Qing Dai
- Guangzhou Medical University Affiliated Brain Hospital, Guangzhou Huiai Hospital, Guangzhou, China
| | - Wei Zheng
- Guangzhou Medical University Affiliated Brain Hospital, Guangzhou Huiai Hospital, Guangzhou, China
| | - Chanjuan Zhang
- Guangzhou Medical University Affiliated Brain Hospital, Guangzhou Huiai Hospital, Guangzhou, China
| | - Ryan M. Cassidy
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - XiangYang Zhang
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Yuping Ning
- Southern Medical University, Guangzhou, China
- Guangzhou Medical University Affiliated Brain Hospital, Guangzhou Huiai Hospital, Guangzhou, China
- National Clinical Research Center on Mental Disorders, Changsha, China
- * E-mail:
| |
Collapse
|
39
|
Abstract
More than 800 000 people die every year from suicide, and about 20 times more attempt suicide. In most countries, suicide risk is highest in older males, and risk of attempted suicide is highest in younger females. The higher lethal level of suicidal acts in males is explained by the preference for more lethal methods, as well as other factors. In the vast majority of cases, suicidal behavior occurs in the context of psychiatric disorders, depression being the most important one. Improving the treatment of depression, restricting access to lethal means, and avoiding the Werther effect (imitation suicide) are central aspects of suicide prevention programs. In several European regions, the four-level intervention concept of the European Alliance Against Depression (www.EAAD.net), simultaneously targeting depression and suicidal behavior, has been found to have preventive effects on suicidal behavior. It has already been implemented in more than 100 regions in Europe.
Collapse
Affiliation(s)
- Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University Hospital of Leipzig, Leipzig, Germany
| |
Collapse
|
40
|
Qian Y, Sun L, Zhou C, Ge D, Zhang L. The association between suicidal ideation and sleep quality in elderly individuals: A cross-sectional study in Shandong, China. Psychiatry Res 2017; 256:453-457. [PMID: 28709060 DOI: 10.1016/j.psychres.2017.07.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 06/21/2017] [Accepted: 07/09/2017] [Indexed: 10/19/2022]
Abstract
Previous studies have identified global associations between sleep quality and suicidal ideation. However, little is known regarding the relationship between sleep quality and suicidal ideation among Chinese older adults. We examined the relationship between sleep quality and suicidal ideation in older adults in China. A cross-sectional study was conducted in 3313 seniors in Shandong, China. Suicidal ideation was assessed using the interviewees' answers to the question "Have you ever seriously considered wanting to die?". Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Logistic regression was performed to estimate odds ratios and 95% confidence intervals adjusted for confounders. When controlling for sex, age, living condition, economic status, marital status, education, past occupation, relationship with children, non-communicable diseases, and mental health, the odds of suicidal ideation increased in association with an increase in the total score for sleep quality and its components (subjective sleep quality, sleep duration, habitual sleep efficiency, and daytime dysfunction). Poor sleep quality was associated with increased odds of suicidal ideation in Chinese older adults. Sleep-based interventions should be developed to prevent suicide in older adults in China.
Collapse
Affiliation(s)
- Yangyang Qian
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Long Sun
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
| | - Chengchao Zhou
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
| | - Dandan Ge
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Li Zhang
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| |
Collapse
|
41
|
Yang X, Feldman MW. A reversed gender pattern? A meta-analysis of gender differences in the prevalence of non-suicidal self-injurious behaviour among Chinese adolescents. BMC Public Health 2017; 18:66. [PMID: 28754108 PMCID: PMC5534103 DOI: 10.1186/s12889-017-4614-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 07/19/2017] [Indexed: 11/10/2022] Open
Abstract
Background A reversed gender pattern has been observed in the suicide rate in China compared to elsewhere. Like suicidal behaviour, non-suicidal self-injurious (NSSI) behaviour is a health-risk behaviour. We examined whether a reversed gender pattern existed in the prevalence of NSSI. Methods Online literature databases were searched for English and Chinese articles on NSSI behaviours among the Chinese. A meta-analysis with a random-effects model and a subgroup analysis were used to estimate the odds ratios of gender differences in NSSI prevalence among Chinese adolescents including college students, middle school students, and clinical samples, as well as rural, urban, and Hong Kong middle school students. Results There was a male bias in NSSI prevalence among college students (OR = 1.56, 95% CI = [1.30, 1.87], p < 0.001), and a female bias among middle school students (OR = 0.83, 95% CI = [0.73, 0.94], p < 0.01), but there was no gender difference among clinical samples (OR = 0.88, 95% CI = [0.41, 1.89], p > 0.1). The NSSI prevalence among middle school students had a female bias in the rural (OR = 0.58, 95% CI = [0.47, 0.72], p < 0.001) and Hong Kong areas (OR = 0.91, 95% CI = [0.86, 0.96], p < 0.001), with the gender difference in NSSI prevalence in the Hong Kong areas being greater than in rural areas. No gender difference in NSSI prevalence was found in urban areas (OR = 1.01, 95% CI = [0.84, 1.22], p > 0.1) among middle school students. Conclusions Our analysis indicated the existence of specific gender and age patterns in NSSI prevalence among Chinese adolescents. The sample type, age, and the areas that have different gender norms and culture could partly explain this pattern. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4614-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Xueyan Yang
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, #28 Xianning Xi Road, Xi'an, Shaanxi Province, 710049, People's Republic of China.
| | - Marcus W Feldman
- Morrison Institute for Population and Resource Studies, Stanford University, Stanford, CA, USA.,Postal Address: Gilbert 116, Stanford University, Stanford, CA, 94305, USA
| |
Collapse
|
42
|
Liu BP, Liu X, Jia CX. Characteristics of suicide completers and attempters in rural Chinese population. Compr Psychiatry 2016; 70:134-40. [PMID: 27624433 DOI: 10.1016/j.comppsych.2016.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/20/2016] [Accepted: 07/10/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE This study aimed to compare the similarities and differences between suicide completers and attempters in rural China. METHODS Two paired case-control studies of completed suicide and suicide attempts were conducted in rural Shandong, China. This analysis included 409 suicide attempters (SA) with a mean age of 43.90 (SD=13.31), 117 suicide completers (SC) with a mean age of 50.38 (SD=13.02) and their controls matched by gender, age (within 3years), and residence. Logistic regression models were used to examine risk factors of suicide attempts and completed suicide and the differences between SA and SC. RESULTS Compared to their matched controls, suicide attempters and completers shared the following common risk factors: low levels of education (middle school or under) (OR, 95% CI: 2.79, 1.40-5.55 for SA and 16.98, 1.59-181.60 for SC), negative life events (OR, 95% CI: 7.37, 4.73-11.50 for SA and 21.08, 4.74-93.71 for SC), and mental disorders (OR, 95% CI: 7.52, 3.85-14.69 for SA and 22.39, 2.65-189.60 for SC). Compared to suicide attempts, completed suicide was associated with the following risk factors: male gender (OR, 95% CI: 1.75, 1.06-2.90), advancing age (OR, 95% CI: 1.02, 1.00-1.04), poor family economic status (OR, 95% CI: 6.74, 3.22-14.13), prior suicide attempts (OR, 95% CI: 2.43, 1.18-4.97), family suicide history (OR, 95% CI: 2.59, 1.33-5.06), high suicide intent (OR, 95% CI: 1.15, 1.05-1.27), and highly lethal methods (OR, 95% CI: 13.65, 6.51-28.59). CONCLUSIONS Although suicide completers and attempters share some common risk factors, suicide completers are more likely to have prior suicide attempts, family suicide history, and higher suicidal intent, and to use highly lethal methods in rural Chinese.
Collapse
Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China.
| |
Collapse
|
43
|
Effort-reward Imbalance at Work, Parental Support, and Suicidal Ideation in Adolescents: A Cross-sectional Study from Chinese Dual-earner Families. Saf Health Work 2016; 8:77-83. [PMID: 28344844 PMCID: PMC5355538 DOI: 10.1016/j.shaw.2016.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 07/27/2016] [Accepted: 09/08/2016] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In contemporary China, most parents are dual-earner couples and there is only one child in the family. We aimed to examine the associations of parents' work stress with suicidal ideation among the corresponding adolescent. We further hypothesized that low parental support experienced by adolescents may mediate the associations. METHODS Cross-sectional data from school students and their working parents were used, with 907 families from Kunming City, China. Stress at work was measured by the effort-reward imbalance questionnaire. Perceived parental support was assessed by an item on parental empathy and their willingness to communicate with the adolescent. Suicidal ideation was considered positive if students reported thoughts about suicide every month or more frequently during the previous 6 months. Logistic regression was used to examine the associations. RESULTS We observed that parents' work stress was positively associated with low parental support, which was in turn associated with adolescent suicidal ideation. The odds ratio for parents' work stress and adolescent suicidal ideation was 2.91 (95% confidence interval: 1.53-5.53), and this association was markedly attenuated to 2.24 (95% confidence interval: 1.15-4.36) after additional adjustment for parental support. Notably, mothers' work stress levels exerted stronger effects on children's suicidal ideation than those of fathers. CONCLUSION Parents' work stress (particularly mother's work stress) was strongly associated with adolescent's suicidal ideation, and the association was partially mediated by low parental support. These results need to be replicated and extended in prospective investigations within and beyond China, in order to explore potential causal pathways as a basis of preventive action.
Collapse
|
44
|
Temporal Trends of Suicide Mortality in Mainland China: Results from the Age-Period-Cohort Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080784. [PMID: 27527195 PMCID: PMC4997470 DOI: 10.3390/ijerph13080784] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/27/2016] [Accepted: 08/01/2016] [Indexed: 11/16/2022]
Abstract
The aim of this study is to explore the long-term trends of suicide mortality in China. We implemented the age-period-cohort (APC) framework, using data from the Global Burden of Disease Study 2013. Our results showed that the net drift of suicide mortality was -4.727% (95% CI: -4.821% to -4.634%) per year for men and -6.633% (95% CI: -6.751% to -6.515%) per year for women, and the local drift values were below 0 in all age groups (p < 0.01 for all) for both sexes during the period of 1994-2013. Longitudinal age curves indicated that, in the same birth cohort, suicide death risk increased rapidly to peak at the life stage of 20-24 years old and 15-24 years old for men and women, respectively, and then showed a decelerated decline, followed by a rise thereafter after 54 years old for men and a slight one after 69 years old for women. The estimated period and cohort RRs were found to show similar monotonic downward patterns (significantly with p < 0.01 for all) for both sexes, with more quickly decreasing for women than for men during the whole period. The decreasing trend of suicide was likely to be related to the economic rapid growth, improvements in health care, enhancement on the level of education, and increasing awareness of suicide among the public in China. In addition, fast urbanization and the effective control of pesticides and rodenticides might be the special reasons behind these trends we observed in this study.
Collapse
|
45
|
Feng D, Ji L, Xu L. Effect of subjective economic status on psychological distress among farmers and non-farmers of rural China. Aust J Rural Health 2015; 23:215-20. [DOI: 10.1111/ajr.12187] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Danjun Feng
- School of Nursing; Shandong University; Jinan China
| | - Linqin Ji
- School of Psychology; Shandong Normal University; Jinan China
| | - Lingzhong Xu
- Department of Health Services Management and Maternal and Child Healthcare; Shandong University; Jinan China
| |
Collapse
|
46
|
Li Y, Aggen S, Shi S, Gao J, Li Y, Tao M, Zhang K, Wang X, Gao C, Yang L, Liu Y, Li K, Shi J, Wang G, Liu L, Zhang J, Du B, Jiang G, Shen J, Zhang Z, Liang W, Sun J, Hu J, Liu T, Wang X, Miao G, Meng H, Li Y, Hu C, Li Y, Huang G, Li G, Ha B, Deng H, Mei Q, Zhong H, Gao S, Sang H, Zhang Y, Fang X, Yu F, Yang D, Liu T, Chen Y, Hong X, Wu W, Chen G, Cai M, Song Y, Pan J, Dong J, Pan R, Zhang W, Shen Z, Liu Z, Gu D, Wang X, Liu X, Zhang Q, Flint J, Kendler KS. Subtypes of major depression: latent class analysis in depressed Han Chinese women. Psychol Med 2014; 44:3275-3288. [PMID: 25065911 PMCID: PMC4180813 DOI: 10.1017/s0033291714000749] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Despite substantial research, uncertainty remains about the clinical and etiological heterogeneity of major depression (MD). Can meaningful and valid subtypes be identified and would they be stable cross-culturally? METHOD Symptoms at their lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾ 30 years, with recurrent DSM-IV MD. Latent class analysis (LCA) was performed in Mplus. RESULTS; Using the nine DSM-IV MD symptomatic A criteria, the 14 disaggregated DSM-IV criteria and all independently assessed depressive symptoms (n = 27), the best LCA model identified respectively three, four and six classes. A severe and non-suicidal class was seen in all solutions, as was a mild/moderate subtype. An atypical class emerged once bidirectional neurovegetative symptoms were included. The non-suicidal class demonstrated low levels of worthlessness/guilt and hopelessness. Patterns of co-morbidity, family history, personality, environmental precipitants, recurrence and body mass index (BMI) differed meaningfully across subtypes, with the atypical class standing out as particularly distinct. CONCLUSIONS MD is a clinically complex syndrome with several detectable subtypes with distinct clinical and demographic correlates. Three subtypes were most consistently identified in our analyses: severe, atypical and non-suicidal. Severe and atypical MD have been identified in multiple prior studies in samples of European ethnicity. Our non-suicidal subtype, with low levels of guilt and hopelessness, may represent a pathoplastic variant reflecting Chinese cultural influences.
Collapse
Affiliation(s)
- Y. Li
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - S. Aggen
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - S. Shi
- Shanghai Mental Health Center, P.R.C
- Huashan Hospital of Fudan University, Shanghai, P.R.C
| | - J. Gao
- Chinese Traditional Hospital of Zhejiang, Hangzhou, Zhejiang, P.R.C
| | - Y. Li
- No.1 Hospital of Zhengzhou University, Zhengzhou, Henan, P.R.C
| | - M. Tao
- Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, P.R.C
| | - K. Zhang
- No. 1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, P.R.C
| | - X. Wang
- ShengJing Hospital of China Medical University, Heping District, Shenyang, Liaoning, P.R.C
| | - C. Gao
- No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaanxi, P.R.C
| | - L. Yang
- Jilin Brain Hospital, Siping, Jilin, P.R.C
| | - Y. Liu
- The First Hospital of China Medical University, Heping District, Shenyang, Liaoning, P.R.C
| | - K. Li
- Mental Hospital of Jiangxi Province, Nanchang, Jiangxi, P.R.C
| | - J. Shi
- Xian Mental Health Center, New Qujiang District, Xian, Shaanxi, P.R.C
| | - G. Wang
- Beijing Anding Hospital of Capital University of Medical Sciences, Xicheng District, Beijing, P.R.C
| | - L. Liu
- Shandong Mental Health Center, Jinan, Shandong, P.R.C
| | - J. Zhang
- No. 3 Hospital of Sun Yat-sen University, Tianhe District, Guangzhou, Guangdong, P.R.C
| | - B. Du
- Hebei Mental Health Center, Baoding, Hebei, P.R.C
| | - G. Jiang
- Chongqing Mental Health Center, Jiangbei District, Chongqing, P.R.C
| | - J. Shen
- Tianjin Anding Hospital, Hexi District, Tianjin, P.R.C
| | - Z. Zhang
- No. 4 Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R.C
| | - W. Liang
- Psychiatric Hospital of Henan Province, Xinxiang, Henan, P.R.C
| | - J. Sun
- Nanjing Brain Hospital, Nanjing, Jiangsu, P.R.C
| | - J. Hu
- Harbin Medical University, Nangang District, Haerbin, Heilongjiang, P.R.C
| | - T. Liu
- Shenzhen Kang Ning Hospital, Luohu District, Shenzhen, Guangdong, P.R.C
| | - X. Wang
- First Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R.C
| | - G. Miao
- Guangzhou Brain Hospital (Guangzhou Psychiatric Hospital), Liwan District, Guangzhou, Guangdong, P.R.C
| | - H. Meng
- No. 1 Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong District, Chongqing, P.R.C
| | - Y. Li
- Dalian No. 7 Hospital, Ganjingzi District, Dalian, Liaoning, P.R.C
| | - C. Hu
- No. 3 Hospital of Heilongjiang Province, Beian, Heilongjiang, P.R.C
| | - Y. Li
- Wuhan Mental Health Center, Wuhan, Hubei, P.R.C
| | - G. Huang
- Sichuan Mental Health Center, Mianyang, Sichuan, P.R.C
| | - G. Li
- Mental Health Institute of Jining Medical College, Dai Zhuang, Bei Jiao, Jining, Shandong, P.R.C
| | - B. Ha
- Liaocheng No. 4 Hospital, Liaocheng, Shandong, P.R.C
| | - H. Deng
- Mental Health Center of West China Hospital of Sichuan University, Wuhou District, Chengdu, Sichuan, P.R.C
| | - Q. Mei
- Suzhou Guangji Hospital, Suzhou, Jiangsu, P.R.C
| | - H. Zhong
- Anhui Mental Health Center, Hefei, Anhui, P.R.C
| | - S. Gao
- Ningbo Kang Ning Hospital, Zhenhai District, Ningbo, Zhejiang, P.R.C
| | - H. Sang
- Changchun Mental Hospital, Changchun, Jilin, P.R.C
| | - Y. Zhang
- No. 2 Hospital of Lanzhou University, Lanzhou, Gansu, P.R.C
| | - X. Fang
- Fuzhou Psychiatric Hospital, Cangshan District, Fuzhou, Fujian, P.R.C
| | - F. Yu
- Harbin No. 1 Special Hospital, Haerbin, Heilongjiang, P.R.C
| | - D. Yang
- Jining Psychiatric Hospital, North Dai Zhuang, Rencheng District, Jining, Shandong, P.R.C
| | - T. Liu
- No. 2 Xiangya Hospital of Zhongnan University, Furong District, Changsha, Hunan, P.R.C
| | - Y. Chen
- Xijing Hospital of No. 4 Military Medical University, Xian, Shaanxi, P.R.C
| | - X. Hong
- Mental Health Center of Shantou University, Shantou, Guangdong, P.R.C
| | - W. Wu
- Tongji University Hospital, Shanghai, P.R.C
| | - G. Chen
- Huaian No. 3 Hospital, Huaian, Jiangsu, P.R.C
| | - M. Cai
- Huzhou No. 3 Hospital, Huzhou, Zhejiang, P.R.C
| | - Y. Song
- Mudanjiang Psychiatric Hospital of Heilongjiang Province, Xinglong, Mudanjiang, Heilongjiang, P.R.C
| | - J. Pan
- No. 1 Hospital of Jinan University, Guangzhou, Guangdong, P.R.C
| | - J. Dong
- Qingdao Mental Health Center, Shibei District, Qingdao, Shandong, P.R.C
| | - R. Pan
- Guangxi Longquanshan Hospital, Yufeng District, Liuzhou, P.R.C
| | - W. Zhang
- Daqing No. 3 Hospital of Heilongjiang Province, Ranghulu district, Daqing, Heilongjiang, P.R.C
| | - Z. Shen
- Tangshan No. 5 Hospital, Lunan District, Tangshan, Hebei, P.R.C
| | - Z. Liu
- Anshan Psychiatric Rehabilitation Hospital, Lishan District, Anshan, Liaoning, P.R.C
| | - D. Gu
- Weihai Mental Health Center, ETDZ, Weihai, Shandong, P.R.C
| | - X. Wang
- Renmin Hospital of Wuhan University, Wuchang District, Wuhan, Hubei, P.R.C
| | - X. Liu
- Tianjin First Center Hospital, Xinkai Road, Hedong District, Tianjin, P.R.C
| | - Q. Zhang
- Hainan Anning Hospital, Haikou, Hainan, P.R.C
| | - J. Flint
- Wellcome Trust Centre for Human Genetics, Oxford, UK
| | - K. S. Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
47
|
Abstract
OBJECTIVE This study examined the prevalence and correlates of suicidal ideation among U.S. Chinese older adults. METHOD Guided by the community-participatory research approach, the PINE (Population Study of Chinese Elderly in Chicago) study is a population-based epidemiological study conducted from 2011 to 2013 of 3,159 community-dwelling Chinese adults aged 60 years and above in the Greater Chicago area. RESULTS The 2-week prevalence of suicidal ideation, 12-month prevalence of suicidal ideation, and lifetime suicidal ideation were 3.5%, 4.8%, and 9.4%, respectively. Age, sex, marital status, education, income, living arrangement, country of origin, years in the United States, overall health status, quality of life, and health changes over the past year were significantly correlated with suicidal ideation. DISCUSSION Suicidal ideation was common among U.S. Chinese older adults in the Greater Chicago area. Further longitudinal studies should be conducted to explore the risk and protective factors associated with suicidal ideation.
Collapse
Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Chicago, IL, USA
| | - Ruijia Chen
- Rush Institute for Healthy Aging, Chicago, IL, USA
| | - Esther Wong
- Chinese American Service League, Chicago, IL, USA
| | | |
Collapse
|
48
|
Chung MS, Chiu HJ, Sun WJ, Lin CN, Kuo CC, Huang WC, Chen YS, Cheng HP, Chou P. Association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent. Asia Pac Psychiatry 2014; 6:319-25. [PMID: 24357621 DOI: 10.1111/appy.12112] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 09/29/2013] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The aim of this study is to investigate the association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent. METHODS We recruited 607 students (grades 5-9) to fill out the investigation of basic data and sleep disturbance. Psychiatrists then used the Mini International Neuropsychiatric Interview-Kid to interview these students to assess their suicidal ideation and psychiatric diagnosis. Multiple logistic regression with forward conditionals was used to find the risk factors for multivariate analysis. RESULTS Female, age, depressive disorder, adjustment disorder, and poor sleep all contributed to adolescent suicidal ideation in univariate analysis. However, poor sleep became non-significant under the control of depressive disorder and adjustment disorder. DISCUSSION We found that both depressive disorder and adjustment disorder play important roles in sleep and adolescent suicidal ideation. After controlling both depressive disorder and adjustment disorder, sleep disturbance was no longer a risk of adolescent suicidal ideation. We also confirm the indirect influence of sleep on suicidal ideation in adolescent.
Collapse
Affiliation(s)
- Ming-Shun Chung
- Jianan Mental Hospital, Tainan City, Taiwan; National Yang-Ming University, Taipei City, Taiwan
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Betancourt TS, Yang F, Bolton P, Normand SL. Developing an African youth psychosocial assessment: an application of item response theory. Int J Methods Psychiatr Res 2014; 23:142-60. [PMID: 24478113 PMCID: PMC4098666 DOI: 10.1002/mpr.1420] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 02/12/2013] [Accepted: 02/15/2013] [Indexed: 11/09/2022] Open
Abstract
This study aimed to refine a dimensional scale for measuring psychosocial adjustment in African youth using item response theory (IRT). A 60-item scale derived from qualitative data was administered to 667 war-affected adolescents (55% female). Exploratory factor analysis (EFA) determined the dimensionality of items based on goodness-of-fit indices. Items with loadings less than 0.4 were dropped. Confirmatory factor analysis (CFA) was used to confirm the scale's dimensionality found under the EFA. Item discrimination and difficulty were estimated using a graded response model for each subscale using weighted least squares means and variances. Predictive validity was examined through correlations between IRT scores (θ) for each subscale and ratings of functional impairment. All models were assessed using goodness-of-fit and comparative fit indices. Fisher's Information curves examined item precision at different underlying ranges of each trait. Original scale items were optimized and reconfigured into an empirically-robust 41-item scale, the African Youth Psychosocial Assessment (AYPA). Refined subscales assess internalizing and externalizing problems, prosocial attitudes/behaviors and somatic complaints without medical cause. The AYPA is a refined dimensional assessment of emotional and behavioral problems in African youth with good psychometric properties. Validation studies in other cultures are recommended.
Collapse
Affiliation(s)
- Theresa S Betancourt
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA
| | | | | | | |
Collapse
|
50
|
Simon M, Chang ES, Zeng P, Dong X. Prevalence of suicidal ideation, attempts, and completed suicide rate in Chinese aging populations: a systematic review. Arch Gerontol Geriatr 2013; 57:250-6. [PMID: 23791030 PMCID: PMC3750072 DOI: 10.1016/j.archger.2013.05.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 05/21/2013] [Accepted: 05/24/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND As one of the leading causes of death around the world, suicide is a global public health threat. Due to the paucity of systematic studies, there exist vast variations in suicide ideation, attempts and suicide rates between various regions of Chinese aging communities. OBJECTIVES Our systematic study aims to (1) identify studies describing the epidemiology of suicidal ideation, suicide attempts and behaviors among global Chinese communities; (2) conduct systematic review of suicide prevalence; (3) provide cross-cultural insights on this public health issue in the diverse Chinese elderly in China, Hong Kong, Taiwan, Asian societies and Western countries. DATA SOURCES Using the PRISMA statement, we performed systematic review including studies describing suicidal ideation, attempts, and behavior among Chinese older adults in different communities. Literature searches were conducted by using both medical and social science data bases in English and Chinese. RESULTS Forty-nine studies met inclusion criteria. Whereas suicide in Chinese aging population is a multifaceted issue, culturally appropriate and inter-disciplinary approach to improve the quality of life for the Chinese older adults is critical. CONCLUSIONS Future research is needed to explore the risk and protective factors associated with suicidal thoughts, attempts and behaviors in representative Chinese aging populations.
Collapse
Affiliation(s)
- Melissa Simon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Ping Zeng
- Peking Union Medical College Hospital, Beijing, China
| | - XinQi Dong
- Rush University Medical Center, Chicago, Illinois
| |
Collapse
|