Non-suicidal self-injury in Chinese heroin-dependent patients receiving methadone maintenance treatment: Prevalence and associated factors

Association of Non-Suicidal Self-Injury with Tryptophan Hydroxylase 2 Gene Polymorphism and Negative Life Events Among Adolescents with Depression in Northern China

Objective

To investigate the association between single nucleotide polymorphisms (SNPs) of tryptophan hydroxylase 2 (TPH2) (rs11178997, rs11178998, and rs120074175) and negative life events in adolescent depression with Non-suicidal self-injury (NSSI).

Methods

Genomic DNA was extracted from 197 adolescents with depression (participants group, including NSSI group and non-NSSI group), as well as from 100 healthy controls (control group), in northern China. PCR technology was utilized to amplify DNA fragments and detect genotypes in both groups. The Adolescent Life Event Scale (ASLEC) was employed to conduct a questionnaire survey among the participants and control groups. Differences in allele and genotype frequency distribution between the two groups were analyzed using the X^2 test, while generalized multifactor dimensionality reduction (GMDR) was used to analyze gene-environment interactions.

Results

Significant differences were observed in ASLEC scores between the control group and both the NSSI group and non-NSSI group (P<0.05). Additionally, significant differences were found in the interpersonal relationship factor and punishment factor between the NSSI group and non-NSSI group (P < 0.05). Moreover, a significant difference was identified in SNP genotype of rs11178997 between the depression group (NSSI group + non-NSSI group) and control group (P<0.05). GMDR analysis revealed an interaction among rs11178997, rs11178998, and ASLEC.

Conclusion

Adolescents with depression, particularly females, may exhibit a tendency to employ NSSI as an emotional coping mechanism when confronted with greater family and interpersonal challenges. The AT genotype of TPH2 gene locus rs11178997 is more prevalent among adolescents with depression. Furthermore, the occurrence of NSSI may be associated with an interaction involving polymorphic sites rs11178997 and rs11178998 along with life events.

A randomized clinical trial to assess feasibility, acceptability and preliminary effects of telehealth-delivered cognitive-behavioral therapy for perceived social isolation among individuals with opioid use disorders

BACKGROUND

The purpose of this study was to report on feasibility, acceptability, and initial efficacy data cognitive-behavioral therapy for perceived isolation (CBT-PSI) compared to health education among individuals with opioid use disorders (OUD) reporting elevated loneliness.

METHODS

Participants (n = 125) with OUD reporting elevated loneliness were recruited using online advertising to participate in a telehealth-delivered randomized clinical trial. Participants received either a 6-session CBT-PSI (n = 63) or health education (n = 62). Measures assessing loneliness, quantity of social interactions, perceived social support, substance use, substance use consequences, and treatment engagement among others, were completed at baseline, post-intervention, and 1- and 2-months post-intervention. Participants also reported on treatment acceptability for both conditions.

RESULTS

Target enrollment was met with loneliness, social disconnectedness measures, and substance use reflecting a clinically severe sample. Retention was high (> 80%) for both conditions. Participants rated both Health Education and CBT-PSI as acceptable, helpful, and useful interventions to address loneliness and opioid use. Loneliness was reduced and quantity of social interactions and perceived social support were increased to the same extent for both conditions and across the follow-up assessments. Opioid use and overall substance use were reduced in both conditions; however, the reductions among participants received CBT-PSI were significantly greater compared to Health Education.

CONCLUSIONS

This study supports the feasibility and acceptability of CBT-PSI. CBT-PSI findings related to loneliness, substance use, and other social connectedness outcomes are encouraging. Additional testing of CBT-PSI in a fully-powered trial is warranted.

Adolescents' attitudes toward non-suicidal self-injury (NSSI) and their perspectives of barriers to seeking professional treatment for NSSI

PURPOSE

This study aimed to investigate the attitudes of adolescents toward NSSI, and to explore their perspectives on barriers to seeking professional treatment for NSSI.

METHODS

A qualitative phenomenological design was used to conduct in-depth interviews with 17 adolescents with NSSI in a psychiatric hospital in Beijing, China. Data from the 17 adolescents were analyzed using Colaizzi's 7-step analysis.

RESULTS

Two themes were extracted: (1) attitudes toward NSSI (normal, effective, ignorant, disgraceful); (2) subjective/objective barriers to seeking professional treatment (negative attitudes toward NSSI, fear of being regarded as an attention getter, fear of interfering with personal relationships, fear of aggravating the family burden, fear of being criticized by parents, fear of ongoing hospitalization, fear of the side effects of medication, etc.).

CONCLUSIONS

It is suggested to strengthen the knowledge of NSSI among adolescents, families and society, formulate interventions suitable for Chinese sociocultural backgrounds, and cultivate the specialty literacy of mental health nurses and their abilities to identify the barriers, which are required for eliminating barriers to seeking professional treatment and establishing a system for seeking full coverage of professional treatment.

Non-suicidal self-injury in Chinese population: a scoping review of prevalence, method, risk factors and preventive interventions

Non-suicidal self-injury behavior (NSSI) is a serious public health concern that requires immediate attention. Despite the high prevalence of NSSI among the Chinese population, there is a significant gap in research on the comprehensive picture of this field. Therefore, a scoping review was conducted to investigate the prevalence, methods, risk factors, and preventive intervention programs related to NSSI in China. The review found that the estimated lifetime prevalence of NSSI among Chinese youth population is alarmingly high at 24.7% (N = 1,088,433). Common methods of NSSI include scratching, hitting, and biting. Additionally, the review synthesized 249 risk factors based on the biopsychosocial-ecological framework, highlighting the urgent need for intervention. However, only 12 empirical studies focus on NSSI prevention or intervention programs were included. These findings underscore the necessity for more clinical practices and larger studies to identify effective interventions and ultimately alleviate the burden of NSSI on the Chinese population.

Funding

This review was supported by Humanity and Social Science Youth foundation of Ministry of Education (22YJCZH018), Science and Technology Innovation 2030 (STI2030-Major Projects:2021ZD0200702), National Natural Science Foundation of China (81825009), and Shuimu Tsinghua Scholar. No funding agencies were involved in the data collection, data analysis, and writing of this paper.

Adverse childhood experiences, unhealthy lifestyle, and nonsuicidal self-injury: findings from six universities in Shaanxi province, China

Background

Nonsuicidal self-injury (NSSI) is a serious public health problem. The role of adverse childhood experiences (ACEs) and lifestyle on the risk for NSSI is still underexplored, especially among college students. We aimed to investigate the association of ACEs with the risk of NSSI, and effect modifications by lifestyle among college students.

Methods

A total of 18,723 college students from six universities were recruited through a multistage, random cluster sampling method in Shaanxi province, China. The Adverse Childhood Experiences International Questionnaire was used to assess ACEs for each participant, and the Chinese version of the Ottawa Self-injury Inventory was used to assess the presence or absence of NSSI behaviors. Information about lifestyle was collected by a self-designed questionnaire. The associations of NSSI with ACEs and lifestyle were analyzed using logistic regression models. Furthermore, we constructed a combination score of multiple lifestyles and evaluated whether lifestyle modified the effect of ACEs on the risk of NSSI.

Results

The prevalence of NSSI for the past 1 month, 6 months, and 12 months was 3.8, 5.3, and 6.5%, respectively. 82.6% of participants have reported experiencing at least one type of ACEs, and participants with higher levels of ACEs (≥4) were more likely to have higher odds of developing NSSI during the past 1 month (OR, 4.10; 95%CI, 3.38-4.97), 6 months (OR, 4.76; 95%CI, 4.03-5.62), and 12 months (OR, 5.62; 95%CI, 4.83-6.55), as compared with participants with low levels of ACEs (0-1). There were additive interactions between ACEs and lifestyle. Compared with participants with low levels of ACEs and healthy lifestyle, participants with high levels of ACEs and unhealthy lifestyle had the highest odds of NSSI during the past 1 month (OR, 5.56; 95%CI, 3.80-8.31), 6 months (OR, 6.62; 95%CI, 4.73-9.42), and 12 months (OR, 7.62; 95%CI, 5.59-10.52).

Conclusion

These results suggest that ACEs play an important role in the occurrence of NSSI among college students, especially in those with unhealthy lifestyle. Our findings may help develop targeted intervention strategies for the prevention of NSSI.

A cross-sectional study of non-suicidal self-injury in a Chinese adolescent inpatient cohort

Background

Non-suicidal self-injury (NSSI) is a significant predictor of completed suicide and is increasingly recognized as a serious public health concern. Multiple factors, including social, familial, mental, and genetic factors could influence the occurrence of this behavior. Identifying the early risk factors is important for screening and preventing this behavior.

Methods

Here, we recruited a total of 742 adolescent inpatient participants from a mental health center and conducted a series of diagnostic interviews and questionnaires to assess NSSI behavior and other events. Bivariate analysis was used to detect differences between groups in NSSI and non-NSSI. Then, binary logistic regression was fitted to identify predictors of NSSI as a function of these questionnaire scores.

Results

Of the 742 adolescents examined, a total of 382 (51.5%) participants engaged in NSSI. Bivariate analysis showed that age, gender, depression, anxiety, insomnia, and childhood trauma was significantly associated with NSSI. Logistic regression results suggested that females had 2.43 higher odds of engaging in NSSI when compared to their male counterparts (OR = 3.43, 95%CI = 2.09-5.74, p = 1.70 × 10^-6). Depression was a primary risk predictor for NSSI with each additional increase in symptoms of depression increasing the odds of engaging in NSSI by 18% (OR = 1.18, 95%CI = 1.12-1.25, p = 2.25 × 10^-8).

Conclusion

More than half of the adolescent inpatients with psychiatric disorders have NSSI experience. Depression and gender were the risk factors for NSSI. Age at a specific range had a high prevalence of NSSI.

Prevalence of and Factors Influencing Suicide Ideation, Attempt, and Completion in Heroin Users: A Systematic Review and Meta-Analysis

BACKGROUND

Suicide is considered a fundamental problem in discussions on public and global health. Thus, the current study aimed to review the prevalence of and reasons for successful suicide attempts in heroin users.

METHODS

This study was conducted by systematically searching the electronic databases of PubMed, Scopus, Web of Science, and PsycINFO from 1960/1/1 to 2021/11/1 based on the PRISMA checklist and using MeSH keywords with no temporal or linguistic limitations. The primary and secondary impacts of suicide were identified, and all studies following an observational design (cohort, case-control, and cross-sectional studies) were included in the research. Data analysis was performed using Stata version 13. Finally, 17 studies were included in the work process for systematic review and meta-analysis.

FINDINGS

The results showed the most frequent reasons for suicide among the studied individuals were gender (being female), youngness, heroin overdose, multi-drug abuse, history of repeated suicide attempts, history of psychiatric disorder (especially depression), joblessness, homelessness, distorted family relationships, etc. Moreover, the results of synthesizing the studies revealed the prevalence of suicide attempts equaled the effect size (95% CI=0.3 [0.23-0.37]) among these individuals, and the prevalence of successful suicides approached the effect size (95% CI=0.03 [0.01-0.05]).

CONCLUSION

The results of the present study showed the high prevalence of suicidal thoughts and suicide attempts among the heroin-abusing population. Furthermore, according to the findings, the prevalence of unsuccessful suicide attempts was ten times more than that of successful ones in the target population.

The Characteristics and Influencing Factors of Nonsuicidal Self-Injury of Adolescents With Depressive Disorder in China: A Meta-analysis

ABSTRACT

This study is a systematic review of characteristics and influencing factors of nonsuicidal self-injury behavior among adolescents with depressive disorder in China. PubMed, CNKI, WanFang Database, and VIP were searched for studies. Meta-analysis was performed using RevMan 5.1 software. Nineteen studies involving 707 subjects were included in the meta-analysis. Age, gender, only child or not, and residence were included in the analysis, of which age (I2 = 0%, p = 0.42) and residence (I2 = 0%, p = 0.84) were analyzed by fixed-effects model; gender (I2 = 75%, p = 0.003) and only child or not (I2 = 50%, p = 0.140) were analyzed by random-effects model. The evidence shows that, according to the common self-injury mode and location, the nonsuicidal self-injury behavior of young people with depressive disorder aged 15-18 years is paid attention to and guided, so as to achieve early detection and early diagnosis and treatment, and reduce the occurrence of serious harm.

Opioid use disorder and its association with self-reported difficulties participating in social activities

BACKGROUND AND OBJECTIVES

Difficulties participating in social activities are associated with increased mortality and are underemphasized in addressing the opioid epidemic. This study assessed the association of difficulties participating in social activities and opioid use disorder (OUD) and suicidal ideation and suicide attempts and difficulties participating in social activities among individuals with OUD.

METHODS

Data on OUD, difficulties participating in social activities, suicidal ideation, suicide attempts, and other characteristics were assessed in 398,962 respondents from the 2008-2017 National Survey of Drug Use and Health. Logistic regressions examined the association of difficulties participating in social activities and OUD, and then among only respondents with OUD, difficulties participating in social activities and suicidal ideation and suicide attempts.

RESULTS

Respondents with OUD reported higher levels of difficulties participating in social activities compared with respondents without OUD (severe difficulties: odds ratio [OR] = 4.10, 95% confidence interval [CI] = 3.40-4.93). Among those with OUD, difficulties participating in social activities were associated with suicidal ideation (severe difficulties: OR = 2.45, 95% CI = 1.77-3.38), but not attempts.

CONCLUSION AND SCIENTIFIC SIGNIFICANCE

The findings indicate that people with OUD experience difficulties participating in social activities and these difficulties are associated with suicidal ideation. It may be important to address difficulties participating in social activities within the context of OUD treatment, potentially as it relates to suicide prevention. This is the first study utilizing 10 years of nationally representative data to assess difficulties participating in social activities, OUD, and suicidal ideation and suicide attempts. Difficulties participating in social activities represent an under-addressed, potentially important therapeutic target to address OUD.

The properties of MOF-Zn2(EBNB)2(BPY)2·2H2O and its basic study of loading methadone

The ligands of (E)-bis(p-3-nitrobenzoic acid) vinyl (C₁₆H₁₀N₂O₈) were synthesized in three steps, and then the MOF-Zn₂(EBNB)₂(BPY)₂·2H₂O was synthesized by solvothermal method. This structure was characterized by X-ray single crystal diffraction, SEM and TG. The drug loading and in vitro release of Zn₂(EBNB)₂(BPY)₂·2H₂O were also studied with Methadone as model drug. The results show that the highest loading amount of Zn₂(EBNB)₂(BPY)₂·2H₂O to Methadone was 0.256 g/g, and the drug delivery system was a two-phase mode. The results of in vitro cytotoxicity test show that Zn₂(EBNB)₂(BPY)₂·2H₂O has good biocompatibility.

Alcohol Drinking in Chinese Methadone-maintained Clients: A Self-medication for Depression and Anxiety?

Objectives:

Unhealthy alcohol use is associated with negative health outcomes in clients attending methadone maintenance therapy (MMT) programs. However, debates exist regarding the methadone dose of drinkers, and little is known about the health outcomes of drinkers with other types of alcohol use. This study examined the drinking pattern and its association with methadone dose, and depressive and anxiety symptoms in Chinese clients undergoing MMT.

Methods:

A secondary data analysis was conducted with data from a large-scale cross-sectional survey of 549 clients of 3 MMT clinics in Wuhan, China. Depression, anxiety, and alcohol dependence were measured with Zung Self-rating Depression Scale, Zung Self-rating Anxiety Scale, and Alcohol Dependence Scale, respectively. Drinking pattern was assessed using 3 indicators: weekly amount of alcohol consumed, weekly frequency of alcohol consumed, and severity of alcohol dependence.

Results:

The prevalence of current drinking, hazardous drinking, regular drinking, and alcohol abuse/dependence was 29.0%, 10.4%, 14.2%, and 8.7%, respectively. In adjustment analyses, relative to nondrinkers, drinkers had significantly lower weight-based methadone dose (β = −0.136, P = 0.008); hazardous drinkers, irregular drinkers, and drinkers without alcohol abuse/dependence had less severe depression (β = −3.67, P = 0.004; β = −2.37, P = 0.034; β = −3.20, P = 0.001) and anxiety (β = −4.90, P < 0.001; β = −3.24, P = 0.006; β = −4.52, P < 0.001), but drinkers with alcohol abuse/dependence had more severe depression (β = 5.55, P < 0.001) and anxiety (β = 4.31, P = 0.005).

Conclusion:

In Chinese MMT clinics, drinkers may use alcohol to compensate for inadequate MMT and self-medicate negative emotions. Compared with nondrinkers, the severities of depression and anxiety were lower among drinkers without alcohol abuse/dependence, but higher among those with alcohol abuse/dependence.

Loneliness among people with substance use problems: A narrative systematic review

ISSUES

Despite the serious implications of loneliness on health and wellbeing, little is understood about this experience across people with substance use problems. This systematic review aimed to examine: (i) correlates and predictors of loneliness; (ii) theories underpinning loneliness; (iii) methods employed to measure loneliness; and (iv) loneliness interventions for people with substance use problems.

APPROACH

Empirical sources were identified from key databases for all publications preceding February 2019. Overall, 41 studies met the eligibility criteria and were included in the review.

KEY FINDINGS

Findings from this review suggest that loneliness is related to poor physical and mental health, substance use, the quality of relationships, stigma and perception of ill treatment by others. Although cognitive theories have proposed cognitive patterns underlying the onset and maintenance of loneliness, they had not been investigated in relation to measurement or intervention efforts. Just one loneliness measure (UCLA Loneliness Scale) is valid for use with this population. Finally, only a single loneliness intervention had been trialled and was not found to be efficacious in reducing loneliness for people with substance use problems.

IMPLICATIONS

Understanding possible links between loneliness and substance use and how to alleviate loneliness is important for this population in terms of their wellbeing and recovery.

CONCLUSION

Loneliness is prevalent and experienced as problematic among people with substance use problems. Future research should focus on employing longitudinal designs, using validated, multidimensional measures of loneliness and on developing and trialling loneliness interventions that meet the specific needs of people with substance use problems.

Relationship Between Buddhist Belief and Suicide Risk in Chinese Persons Undergoing Methadone Maintenance Therapy for Heroin Dependence

BACKGROUND

In western countries, there is a negative association between religious belief and suicide risk, while in China this association is positive. Nevertheless, few data are available on the association between one specific type of religion and suicide risk, which might be different from the overall positive religion-suicide association in China. This study examined the association between Buddhist belief and suicide risk in Chinese persons receiving methadone maintenance therapy (MMT) for heroin dependence.

METHODS

In total, 61 Buddhist believers and 425 age, gender, and clinic frequency-matched non-religious believers were selected from a sample of patients with heroin dependence treated in three MMT clinics in Wuhan, China. The suicidality module of the Chinese version of the Mini-international Neuropsychiatric Interview 5.0 was used to assess current suicide risk. Patients' demographic and clinical characteristics were also collected. Multiple ordinary logistic regression was used to analyze the association between Buddhist belief and current suicide risk, controlling for the confounding effects of demographic and clinical factors.

RESULTS

In Chinese patients receiving MMT for heroin dependence, Buddhist believers had significantly higher levels of current suicide risk than non-religious believers (low: 45.9% vs. 24.7%, medium: 4.9% vs. 3.5%, high: 19.7% vs. 12.5%, P < 0.001). After adjusting for demographic and clinical covariates (including depressive symptoms), Buddhist belief was still significantly associated with an increase in the level of current suicide risk (OR: 2.98, P < 0.001).

CONCLUSION

Buddhist belief is significantly associated with elevated current suicide risk in Chinese patients receiving MMT for heroin independence. In Chinese MMT clinics, patients with Buddhist belief may have a high current suicide risk and a timely psychiatric assessment and crisis intervention (when necessary) should be provided to these patients.

Prevalence and recognition of depressive disorders among Chinese older adults receiving primary care: A multi-center cross-sectional study

BACKGROUND

In recent years, there have been increasing calls for integrating late-life mental health services into primary care in China, but data on the epidemiology of depressive disorders in older adults receiving primary care are very limited. This study examined prevalence, correlates and recognition of depressive disorders among Chinese older adults receiving primary care.

METHODS

A total of 752 older patients (65+ years) were consecutively recruited from 13 primary care clinics in Wuhan, China, and interviewed with the Chinese Mini-international Neuropsychiatric Interview 5.0.

RESULTS

One-fifth (20.3%) of the older adults met DSM-IV criteria for depressive disorders during the month prior to the interview: 10.2% had major depression, 4.8% had dysthymia, and 5.3% had minor depressive disorder. The recognition rate of older patients with depressive disorders was 1.3% only. In multiple logistic regression analysis, factors significantly associated with depressive disorders included female gender (OR = 1.61), an education of primary school and below (OR = 1.69), poor financial status (OR = 2.44), poor or fair family relationship (OR = 1.66), loneliness (OR = 1.77), hypertension (OR = 1.91), heart disease (OR = 2.02), chronic gastric ulcer (OR = 6.01), and arthritis (OR = 3.55).

LIMITATIONS

Older adults from primary care clinics of economically underdeveloped regions of China were not included.

CONCLUSIONS

Depressive disorders are prevalent but poorly recognized in Chinese older adults receiving treatment in primary care clinics. In order to improve the emotional well-being and health of older adults, it is time to integrate the management of common mental disorders into primary healthcare in China.

Depressive Symptoms in Elderly Chinese Primary Care Patients: Prevalence and Sociodemographic and Clinical Correlates

OBJECTIVE

To estimate the prevalence of depressive symptoms (depression thereafter) and to identify the sociodemographic and clinical correlates of depression in a sample of elderly patients treated in the primary care setting in Wuhan, China.

BACKGROUND

Primary care is an opportune setting for the management of late-life depression in China, but there have been no representative studies on the clinical epidemiology of depression in elderly Chinese primary care patients.

METHODS

In total, 752 elderly patients (≥ 65 years) were consecutively recruited from 13 primary care centers in Wuhan, China, and interviewed with a standardized questionnaire. Depression was assessed with the 15-item Geriatric Depression Scale (GDS-15).

RESULTS

Of the elderly Chinese primary care patients, 30.6% had depression (GDS-15 ≥ 5). Correlates of depression were an education level of primary school or less (odds ratio [OR]: 1.94, 95% confidence interval [CI]: 1.36-2.77, P < .001), poor financial status (OR: 2.19, 95% CI: 1.16-4.15, P = .016), lack of an exercise habit (OR: 1.40, 95% CI: 1.06-1.74, P = .023), 2 or more chronic medical conditions (OR: 1.90, 95% CI: 1.34-2.69, P < .001), and loneliness (OR: 3.53, 95% CI: 2.46-5.08, P < .001).

CONCLUSIONS

Depression is prevalent among elderly Chinese primary care patients, indicating that elderly patients treated in primary care have a high level of need for mental health services in China. There is an urgent need to integrate mental health services into primary health care.

Prevalence and correlates of suicide attempt among Chinese individuals receiving methadone maintenance treatment for heroin dependence

To date, there have been very limited studies regarding the clinical epidemiology of attempted suicide in Chinese individuals with heroin-dependence. The objective of this study was to examine the prevalence and correlates of suicide attempt in Chinese individuals receiving methadone maintenance treatment for heroin dependence. Demographic, clinical, and psychosocial data of 603 methadone-maintained patients with heroin dependence were collected with a standardized self-administered questionnaire. The presence of suicide attempt and antisocial personality disorder was assessed by using a single question and the Mini-International Neuropsychiatric Interview 5.0. The one-month and lifetime prevalence rates of suicide attempt were 9.5% and 34.2%, respectively. In multivariable logistic regression, lifetime suicide attempt was significantly associated with female gender (OR = 2.81), being 20–39 years old (OR = 2.73), an education level of primary school or lower (OR = 2.07), poor economic status (OR = 3.06), injecting heroin before methadone maintenance treatment (OR = 2.92), depressive symptoms (OR = 3.46), anxiety symptoms (OR = 1.88), and antisocial personality disorder (OR = 2.85). Suicide attempt is very prevalent among Chinese individuals receiving methadone maintenance treatment for heroin dependence. Services for patients with heroin dependence in methadone maintenance treatment clinics in China should include psychosocial supports, periodic screening for suicide attempt and other suicidal behaviors and, when needed, psychiatric treatment and crisis intervention.

Meeting the challenges of opioid dependence in China: experience of opioid agonist treatment

PURPOSE OF REVIEW

This article reviews the role of methadone maintenance treatment (MMT) clinics in minimizing the harms caused by opioid dependence, as well as China's current challenges in this area. In addition, we aim to discuss the treatment strategies for opioid dependence within the international community in the current global situation of serious abuse of opioids.

RECENT FINDINGS

Like other countries facing the opioid crisis, China is actively working on revising policy, improving the addiction treatment system and promotion of MMT clinics to cope with the risks of opioid abuse. As they provide one of the most effective opioid agonist treatments for opioid dependence, MMT clinics play an extremely important role in this campaign. The MMT programme in China has had a significant beneficial effect on reduction of opioid use and the prevalence rate of HIV/AIDS.

SUMMARY

The efficacy of MMT for patients with opioid dependence in China is confirmed by the present review. However, several important challenges still need to be resolved. China's treatment experience also provides a reference for other countries facing the danger of opioid dependence.

Quality of life of older Chinese adults receiving primary care in Wuhan, China: a multi-center study

Background

Quality of life (QOL) is an important primary care outcome, but the QOL of older adults treated in primary care is understudied in China. This study examined QOL and its associated factors in older adults treated in Chinese primary care.

Methods

A total of 752 older patients (65+ years) were consecutively recruited from 13 primary care centers in Wuhan, China, and interviewed with a standardized questionnaire, concerning socio-demographics, major medical conditions, loneliness, and depression. QOL and depression were measured with the Chinese six-item QOL questionnaire and the shortened Geriatric Depression Scale, respectively. Multiple linear regression was used to identify factors associated with poor QOL.

Results

The average QOL score of primary care older adults was (20.7 ± 2.5), significantly lower than that of the Chinese general population. Factors significantly associated with poor QOL of Chinese primary care older adults included engaging in manual labor before older adulthood (unstandardized coefficient [β]: −0.702, P < 0.001), no living adult children (β: −1.720, P = 0.001), physical inactivity (β: −0.696, P < 0.001), having ≥ four major medical conditions (β: −1.813, P < 0.001), hearing problem (β: −1.004, P = 0.017), depression (β: −1.153, P < 0.001), and loneliness (β: −1.396, P < 0.001).

Conclusions

Older adults treated in Chinese primary care have poorer QOL than the general population. Addressing psychosocial problems at Chinese primary care settings could be helpful in improving QOL in Chinese older adults.

Cigarette Smoking Is Significantly Linked to Sexual Dissatisfaction in Chinese Heroin-Dependent Patients Receiving Methadone Maintenance Treatment

Background: Cigarette smoking is associated with sexual dysfunction in the general population. Both smoking and sexual dysfunction are common in heroin-dependent patients (HDPs) receiving methadone maintenance treatment (MMT), but their association in MMT HDPs is rarely studied. This study examined the association between smoking and sexual dissatisfaction in Chinese HDPs receiving MMT. Methods: In total, 480 Chinese HDPs, who had sex with their regular or irregular sex partners within one month prior to the study, were included from three MMT clinics in Wuhan, China. Sexual dissatisfaction was assessed with one single question. Socio-demographic and clinical data and smoking characteristics were collected with a standardized questionnaire. Multiple binary logistic regression was used to analyze the association between smoking and sexual dissatisfaction, as well as the associations between levels of smoking and nicotine dependence and sexual dissatisfaction. Results: The prevalence of current smoking was 95.6% in HDPs receiving MMT. Rates of sexual dissatisfaction were higher in current smokers than non-smokers (32.9% vs. 14.3%) with a borderline significant P value of 0.074. After adjusting potential socio-demographic and clinical confounders, current smoking was significantly linked to sexual dissatisfaction (OR = 1.95, P = 0.026), and heavy smoking and severe nicotine dependence were significantly linked to sexual dissatisfaction (OR = 1.80, P = 0.025; OR = 3.27, P < 0.001). Conclusion: Smoking is significantly associated with sexual dysfunction in HDPs receiving MMT. It deserves further investigation as to whether quitting smoking can improve the sexual function of methadone-maintained patients.

Frequent nightmares in Chinese patients undergoing methadone maintenance therapy: prevalence, correlates, and their association with functional impairment

PURPOSE

Nightmares are associated with many negative health outcomes; however, little is known about the characteristics of nightmares in heroin-dependent patients (HDPs). This study examined the prevalence and correlates of frequent nightmares (FNs) and their association with functional impairment in Chinese patients undergoing methadone maintenance therapy (MMT).

PATIENTS AND METHODS

In total, 603 Chinese HDPs from three MMT clinics in Wuhan, China, completed this survey. FNs were defined as reporting nightmares at least once a week. The Sheehan Disability Scale (ShDS) was used to assess the severity of functional impairment of patients. A standardized questionnaire was used to collect data on socio-demographics, drug use characteristics, physical health, mental health, and insomnia.

RESULTS

The prevalence of FNs in Chinese HDPs receiving MMT was 25.9%. Factors significantly associated with nightmares among MMT HDPs included an educational attainment of senior high school and above (OR=2.73, P<0.001), unemployment (OR=3.16, P<0.001), a history of re-education through forced labor (OR=3.14, P<0.001), injecting heroin before MMT (OR=3.62, P=0.002), a high dose of methadone (>70 mg/day) (OR=2.03, P=0.006), use of hypnotics (OR=1.91, P=0.044), the presence of hepatitis B virus core antibody (OR=4.63, P<0.001), pain (OR=3.20, P<0.001), anxiety (OR=2.06, P=0.039), and insomnia (OR=5.75, P<0.001). After controlling for potential confounders, nightmares were still significantly associated with a higher ShDS score (β=2.718, P=0.006).

CONCLUSION

FNs are prevalent among Chinese HDPs receiving MMT and significantly associated with functional impairment. Nightmares are a clinically relevant phenomenon in Chinese MMT clinics, which deserves more clinical and research attention.

Sexual life satisfaction of methadone-maintained Chinese patients: individuals with pain are dissatisfied with their sex lives

Purpose

Pain is potentially associated with sexual dysfunction. Both sexual dysfunction and pain are common in methadone-maintained patients, but the association of pain with sexual dysfunction in methadone-maintained patients is rarely studied. This study examined the association between pain and sexual life satisfaction (SLS) in Chinese patients receiving methadone maintenance treatment (MMT).

Patients and methods

A total of 477 methadone-maintained patients who recently had sex with their sex partners were recruited from three MMT clinics in Wuhan, China. SLS was assessed with a single question, and the sociodemographic, psychological, and clinical data were collected with standardized questionnaires. Pain intensity was assessed with the 5-point verbal rating scale. Multiple ordinary logistic regression was used to control for potential confounders that may bias the pain–SLS relationship.

Results

The prevalence of self-reported dissatisfaction with one’s sexual life was significantly higher in patients with clinically significant pain (CSP) than those without CSP (41.5% vs 19.4%, χ² =23.567, P<0.001). After controlling for potential sociodemographic, psychological, and clinical confounders, CSP was still significantly and independently associated with an increase in sexual life dissatisfaction (OR =1.89, P=0.011).

Conclusion

Pain is significantly associated with low SLS in methadone-maintained patients. Appropriate pain management might improve SLS of patients receiving MMT.