Prevalence and correlates of major depressive disorder among rural-to-urban migrant workers in Shenzhen, China

Effect of pre- and post-migration neighborhood environment on migrants' mental health: the case of Shenzhen, China

Existing mental health studies usually disregard people's neighborhood experiences in the past, which may have long-lasting mental health effects. This may particularly be true for migrants. To assess how the perceived pre- and post-migration neighborhood environment shapes migrants' mental health later on in life, a quasi-longitudinal survey (N = 591) among migrants was conducted in Shenzhen, China. The risk of poor mental health was screened with the General Health Questionnaire (GHQ). Perceptions of the pre- and post-migration neighborhood environment were measured retrospectively and assessed with structural equation models. The results show that the direct pathways linking the perceived post-migration neighborhood physical (NPE) and social environment (NSE) to migrants' mental health are significant. No direct association is found between the pre-migration neighborhood environments and mental health. The indirect path between the pre-migration NPE/NSE and mental health is significantly mediated by the post-migration NPE and NSE. Migrants' SES development and their neighborhood attainment interplay overtime which have long-term impacts on their mental health. Our findings suggest that the pre-migration neighborhood plays a crucial role in migrants' mental health. This confirms a path dependency of migrants' neighborhood environment throughout their migrations. Future mental health studies are advised to incorporate neighborhood characteristics along migrants' residential histories.

Association between chronic conditions, multimorbidity, and dependence levels in Chinese community-dwelling older adults with functional dependence: a cross-sectional study in south-central China

Background

The rising prevalence of multimorbidity and functional dependence in community-dwelling older adults contribute to the demand for home care services. Evidence on how chronic conditions, especially multimorbidity, affect dependence levels among older adults with functional dependence in a socio-cultural context is much needed to inform policy, workforce, aged care service development to meet the care needs of this population.

Objectives

This study aimed to determine the association between chronic conditions, multimorbidity and dependence levels among Chinese community-dwelling older adults with functional dependence.

Methods

A cross-sectional study was conducted with 1,235 community-dwelling older adults with functional dependence in Hunan province, China, from June to October 2018. Data on socio-demographic factors, cognitive function, vision and hearing conditions, activities of daily living (ADLs), and health conditions were collected, and binary logistic regression analyses were used to determine the association between chronic conditions, multimorbidity and dependence levels, with adjustments for relevant covariates.

Results

Among the participants, 62.9% had multimorbidity. Parkinson's disease, stroke, COPD, hypertension, mood and psychotic disorders (Anx/Sch/Dep) were significantly associated with high levels of functional dependence. After adjusting for demographic variables, cognitive function, vision, and hearing conditions, we observed a significant relationship between multimorbidity and higher functional dependence, but this association became insignificant when including certain chronic diseases closely associated with high-level dependence. Study revealed that Parkinson's disease and stroke notably increase dependency risk across seven ADL domains, demonstrating their extensive impact on daily functioning.

Conclusion

The prevalence of multimorbidity among Chinese community-dwelling older adults with functional dependence is very high. The association of multimorbidity with functional dependence is mediated by specific chronic conditions. These findings highlight the necessity of adopting an integrated care model that combines medical and social care, with a particular emphasis on managing multimorbidity and critical chronic conditions that lead to severe functional dependence to preventing and diminish the onset of disabilities.

Guardians Looking From Outside: Gendered Experiences of Labor Migration and Psychosocial Health Among Nepalese Migrant Fathers and Left-Behind Mothers

Nepalese migrant workers are at heightened risk of adverse mental health problems. However, the social mechanisms by which experiences of labor migration create such vulnerabilities are not well understood. Moreover, limited attention has been paid to the experiences of left-behind spouses. This study explores how migrant fathers and left-behind mothers experience labor migration and how migration affects mental health across migrant household members, paying special attention to the role of gender. We conducted 29 in-depth interviews with Nepalese migrant fathers (N = 18) in South Korea and left-behind mothers (N = 11) in Nepal. Labor migration imposes substantial stress on the entire family. Migrant fathers discussed their feelings of guilt and worry regarding their relationships with their children due to physical and emotional distance. Left-behind mothers indicated loneliness and caregiver stress due to additional responsibilities as a single parent. Migrant fathers reported that they felt respected by their communities for their work, while left-behind mothers felt heavily scrutinized. Our findings highlight how labor migration reinforces gender inequalities in domestic responsibilities and norms regarding the expected roles of migrating men and left-behind women. These findings suggest that psychosocial services must be tailored to the unique needs of migrant workers and left-behind families.

Elevated levels of loneliness in migrant children compared to nonmigrant children in urban China: a systematic review and meta-analysis of comparative studies

PURPOSE OF REVIEW

About one in four children in China is a migrant child. This population has a higher risk of experiencing loneliness. However, existing studies present conflicting findings regarding the levels of loneliness among migrant children as compared to local urban children in urban China. This review performs a meta-analysis of studies comparing loneliness levels between these two groups.

RECENT FINDINGS

A literature search of major Chinese- and English-language databases revealed 27 eligible comparative studies. These studies reported the means and standardized deviations of loneliness scores for both migrant and nonmigrant children in urban China. Meta-analysis results showed that migrant children experienced significantly higher levels of loneliness than their urban nonmigrant counterparts [standardized mean difference (SMD) = 0.21, P  < 0.001]. Subgroup analysis revealed that studies enrolling migrant children from migrant children's schools had significantly higher pooled SMDs than those enrolling children from public schools (0.346 vs. 0.120, P  = 0.047).

SUMMARY

Migrant children in urban China experience higher levels of loneliness compared to their local urban peers. Efforts to create a socially inclusive, migrant-friendly environment and reduce social isolation among migrant children are crucial to help alleviate their feelings of loneliness.

Relationship between social interaction and health of the floating elderly population in China: an analysis based on interaction type, mode and frequency

BACKGROUND

Although the health of the floating elderly population is an important part of active and healthy ageing, it is neglected in current Chinese society. Based on the general consensus that social interaction can affect the health of the floating population, this study explored whether the interaction type, mode and frequency influenced the health of the floating elderly population in China and investigated the variability of these influential effects.

METHODS

This study used the China Migrant Population Dynamic Survey Data 2017 and selected 5239 floating elderly individuals over 60 years old. Self-rated health was used to assess the comprehensive health status of respondents. Social interaction was measured by the interaction type, mode and frequency. Descriptive statistical analysis was used to analyse the health and social interaction status. An ordinal probit model was used to estimate the influential effects and differences on health caused by social interaction. The 2SLS model was used to examine the mutual causality relationship between interaction frequency and health, and a robustness test was conducted.

RESULTS

A total of 44.6% interacted with local residents, 14.2% participated in interaction activities based on geographical relations, and only 4.3% and 7% participated in interactions based on business and interest, respectively. Interacting with natives improved individuals' self-rated health by 18.5%; specifically, geographical interaction increased self-rated health by 40.9%, occupational interaction increased it by 25.2%, interest-based interaction increased it by 41.2%, and interaction frequency improved the self-rated health (β = 0.128). In addition, sex, education level, personal income, and floating into the eastern region had a positive effect on individuals' health. However, age, spouse and hukou exerted a negative effect.

CONCLUSIONS

This study demonstrated that interacting with local residents could improve the health of floating elderly population, and revealed that interest-based interaction and their frequency had a positive impact on health. The government should speed up the construction of the voluntary service system and encourage the floating elderly population to realize their personal value in social interaction. In addition, the reform of the hukou system should be further promoted, so as to remove institutional barriers to the social interaction.

Prevalence and patterns of major depressive disorder and subthreshold depressive symptoms in south China

BACKGROUND

Information on major depressive disorder (MDD) and subthreshold depressive symptoms (SDS) is rarely reported in south China. This study examines the prevalence rates and patterns of MDD and SDS of a large representative sample of adult residents in south China.

METHODS

The Guangdong Mental Health Survey was conducted on adults (over 18 years) from September to December 2021. Multistage stratified cluster sampling was used and face-to-face interviews were done with a two-stage design by trained lay interviewers and psychiatrists. A total of 16,377 inhabitants were interviewed using standardized assessment tools. Data were weighted to adjust for differential probabilities of selection and differential response.

RESULTS

The weighted prevalence rates of MDD and SDS were 2.5 % (95%CI: 2.2 %-2.9 %) and 14.7 % (95%CI: 14.0 %-15.5 %), respectively. Multinomial logistic regression analysis revealed that female, younger age, living in urban area, higher education, unmarried, irregular meal pattern, lack of physical exercise, chronic diseases, irregular napping pattern and short sleep were positively associated with SDS. Besides, female, younger age, unmarried, irregular meal pattern, lack of physical exercise, chronic diseases, short sleep and poor mental health were positively associated with MDD.

LIMITATIONS

The cross-sectional nature of the study limited causal inferences.

CONCLUSIONS

The prevalence of MDD in Guangdong province in 2021 is higher than in mainland China in 2013. Given the higher prevalence of SDS, and high burden of depression, it also offers valuable opportunities for policymakers and health-care professionals to explore the factors affecting mental health in Guangdong province, especially during the COVID-19 epidemic.

The Intellectual Structure of Research on Rural-to-Urban Migrants: A Bibliometric Analysis

As noted in the United Nations' Sustainable Development Goals 2030 agenda, sustainable cities "without leaving anyone behind" should take into consideration migrant groups, which may play only a marginal role but may be at the root of potential social conflicts. This study thereby promotes cross-disciplinary explorations of knowing and understanding the rural-to-urban internal migrants against the background of rapid urbanization. This study conducted a bibliometric analysis based on 2788 English language articles obtained from the Web of Science Core Collection database. As China's unique Hukou system highlights the divide between rural migrants and urban dwellers, migrant studies have extended to a diverse range of interests. We underlined the most productive sources and authors in this area and identified networks of collaboration among countries and institutions. Furthermore, we found trends in research themes and topics and research clusters through keyword-based analysis techniques. The results provide a rich source of information on the intellectual structure of the chosen domain of rural-to-urban migrants.

Prevalence and Unmet Need for Mental Healthcare of Major Depressive Disorder in Community-Dwelling Chinese People Living With Vision Disability

Objective

Mental health services have been recognized as an essential part of the comprehensive eye care services, but data regarding the mental health of people living with vision disability (PLwVD) remain very limited. This study examined the epidemiology of major depressive disorder (MDD) among Chinese PLwVD, as well as their perceived needs for and utilization of mental health services.

Methods

By using stratified cluster sampling method, a total of 1,753 PLwVD were successfully recruited from 73 urban communities and 169 rural villages in Wuhan, China, and interviewed with the Mini-international Neuropsychiatric Interview 5.0. Standardized questions were used to measure perceived mental healthcare needs and use of mental health services of PLwVD with MDD.

Results

The one-month prevalence of MDD was 24.4%. Among the PLwVD with MDD, 26.0% perceived needs for mental healthcare and only 1.2% sought treatment from mental health specialists for their emotional problems. Factors associated with MDD were middle age [vs. young adulthood, odds ratio (OR) = 1.96, P < 0.001], older adulthood (vs. young adulthood, OR = 1.79, P = 0.004), being never-married (vs. married, remarried, and cohabiting, OR = 1.96, P < 0.001), being separated, divorced, and widowed (vs. married, remarried, and cohabiting, OR = 12.30, P < 0.001), a low level of objective social support (vs. high, OR = 1.83, P < 0.001), currently drinking (OR = 1.81, P < 0.001), having childhood-onset eye conditions (OR = 1.89, P = 0.005), and having difficulties in performing daily activities (OR = 2.78, P < 0.001).

Conclusions

Chinese PLwVD are at high risk for MDD and have a high level of unmet need for mental healthcare. Public strategies are warranted to improve the mental health literacy of PLwVD and make the mental health services available, accessible, and affordable for PLwVD.

Prevalence and influencing factors of depressive symptoms among rural-to-urban migrant workers in China: A systematic review and meta-analysis

BACKGROUND

Rural-to-urban migrant workers are a large group in China, and they are often more prone to mental health problems, especially depression. We expected to use meta-analysis to estimate the prevalence of depressive symptoms and the influencing factors of depressive symptoms among rural-to-urban migrant workers in China.

METHODS

PubMed, Web of Science, Embase, Scopus, CINAHL Complete, PsycARTICLES, CNKI, Wan Fang, CBM, and Cochrane were searched on October 16, 2021. The data were analyzed using OR and random effect model in Revman5.3 and STATA 15 Software.

RESULTS

We included 30 studies involving 43,884 rural-to-urban migrant workers. The prevalence of depressive symptoms among rural-to-urban migrant workers in China was 0.28 (95% CI:0.22, 0.34); Results of the meta-analysis showed that working hours, sleep status, self-rated health, financial condition, job satisfaction, marriage, and social support were correlated with depressive symptoms.

LIMITATIONS

The systematic review and meta-analysis included only cross-sectional studies, and more types of original studies on depressive symptoms of rural-to-urban migrant workers in China should be carried out in the future.

CONCLUSION

The prevalence of depressive symptoms among rural-to-urban migrant workers in China is 28%. Government departments can intervene early in the process to promote the mental health of this group based on influencing factors of depressive symptoms among rural-to-urban migrant workers in China.

Negative coping style mediates the relationship between negative mental and suicide risk among migrant workers in China

Suicide is increasingly recognized as a major public health concern among migrant workers in China. Despite negative mental and negative coping styles being core themes found in suicide notes, there is scarce research addressing the theoretical framework of underlying mechanisms between these variables. The study was designed to examine the relationships of negative mental, negative coping styles, and suicide risk among migrant workers. It hypothesized that negative mental would exert a positive effect on suicide risk via increased negative coping. Using a cross-sectional design, the study was conducted using a sample of 3095 migrant workers from Shenzhen, China. Self-made Suicide Risk Scale (SRS), Short-form of the ULCA Loneliness Scale (USL-6), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Scale (GAD-7), Simplified Coping Style Questionnaire (SCSQ) were used to collect data. Structural equation modeling (SEM) was performed to quantitatively explore the path effects between negative mental, negative coping styles and suicide risk. Results showed that negative coping style had a positive association with suicide risk (β = 0.029, P < 0.001). Negative mental had both direct and indirect positive effects on suicide risk through negative coping styles (β = 0.109, β = 0.013, P < 0.001). Therefore, to prevent suicidal behaviors among migrant workers, targeted interventions focusing on improving their mental health and coping strategies are needed.

Disparities in the Outcomes Following Ischemic Stroke Between the Floating Population and Indigenous Population of Shanghai

Background and Purposes: Through this study, we hope to gain more insights into the differences in outcome following an ischemic stroke between the floating population and the indigenous population of Shanghai.

Method: In this retrospective cohort study, we analyzed patients with first-ever acute ischemic stroke who were admitted to a comprehensive stroke center in the Minhang district, Shanghai, from January 1, 2019, to December 31, 2020. All patient's demographic data and medical histories were prospectively collected and they were followed up for at least 3 months. The Indigenous population of Shanghai was defined as patients with an identification number starting with 310. All others were treated as floating population. The primary outcome was defined as an unfavorable prognosis at 3 months, with a modified Rankin Scale (mRS) score above 1. Secondary outcomes included the use of emergency medical service (EMS), 3 h arrival rate, and endovascular therapy in eligible patients. Logistic regression analysis was applied to investigate the differences.

Results: Finally, 698 patients with first-ever acute ischemic stroke were included (with mean age of 65.32 years, 74.6% men). Of these, 302 patients belonged to the floating population group. Indigenous populations with ischemic stroke were older than the floating population (68.26 years vs. 61.47 years, P &lt; 0.001). The floating population was more likely to achieve favorable outcomes at 3 months compared with the indigenous population in multivariable logistic regression analysis [Odds ratio (OR): 0.49, 95% CI: 0.32–0.75, P = 0.001]. The use of EMS, 3 h arrival rate, and the application of endovascular therapy were comparable between the floating population and indigenous population (OR: 0.89, 95% CI: 0.62–1.27, P = 0.519; OR: 0.78, 95% CI: 0.56–1.09, P = 0.14; and OR: 0.82, 95% CI: 0.54–1.26, P = 0.365, respectively).

Conclusion: Compared with the indigenous population, the floating population with the first-ever ischemic stroke was more likely to have a favorable outcome at 3 months.

Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study

BACKGROUND

In China, depressive disorders have been estimated to be the second leading cause of years lived with disability. However, nationally representative epidemiological data for depressive disorders, in particular use of mental health services by adults with these disorders, are unavailable in China. The present study, part of the China Mental Health Survey, 2012-15, aims to describe the socioeconomic characteristics and the use of mental health services in people with depressive disorders in China.

METHODS

The China Mental Health Survey was a cross-sectional epidemiological survey of mental disorders in a multistage clustered-area probability sample of adults of Chinese nationality (≥18 years) from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Trained investigators interviewed the participants with the Composite International Diagnostic Interview 3.0 to ascertain the presence of lifetime and 12-month depressive disorders according to DSM-IV criteria, including major depressive disorder, dysthymic disorder, and depressive disorder not otherwise specified. Participants with 12-month depressive disorders were asked whether they received any treatment for their emotional problems during the past 12 months and, if so, the specific types of treatment providers. The Sheehan Disability Scale (SDS) was used to assess impairments associated with 12-month depressive symptoms. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted according to the age-sex-residence distribution data from China's 2010 census population survey to adjust for differential probabilities of selection and differential response, as well as to post-stratify the sample to match the population distribution.

FINDINGS

28 140 respondents (12 537 [44·6%] men and 15 603 [55·4%] women) completed the survey between July 22, 2013, and March 5, 2015. Ethnicity data (Han or non-Han) were collected for only a subsample. Prevalence of any depressive disorders was higher in women than men (lifetime prevalence odds ratio [OR] 1·44 [95% CI 1·20-1·72] and 12-month prevalence OR 1·41 [1·12-1·78]), in unemployed people than employed people (lifetime OR 2·38 [95% CI 1·68-3·38] and 12-month OR 2·80 [95% CI 1·88-4·18]), and in people who were separated, widowed, or divorced compared with those who were married or cohabiting (lifetime OR 1·87 [95% CI 1·39-2·51] and 12-month OR 1·85 [95% CI 1·40-2·46]). Overall, 574 (weighted % 75·9%) of 744 people with 12-month depressive disorders had role impairment of any SDS domain: 439 (83·6%) of 534 respondents with major depressive disorder, 207 (79·8%) of 254 respondents with dysthymic disorder, and 122 (59·9%) of 189 respondents with depressive disorder not otherwise specified. Only an estimated 84 (weighted % 9·5%) of 1007 participants with 12-month depressive disorders were treated in any treatment sector: 38 (3·6%) in speciality mental health, 20 (1·5%) in general medical, two (0·3%) in human services, and 21 (2·7%) in complementary and alternative medicine. Only 12 (0·5%) of 1007 participants with depressive disorders were treated adequately.

INTERPRETATION

Depressive disorders in China were more prevalent in women than men, unemployed people than employed, and those who were separated, widowed, or divorced than people who were married or cohabiting. Most people with depressive disorders reported social impairment. Treatment rates were very low, and few people received adequate treatment. National programmes are needed to remove barriers to availability, accessibility, and acceptability of care for depression in China.

FUNDING

National Health Commission and Ministry of Science and Technology of People's Republic of China.

TRANSLATION

For the Chinese translation of the abstract see Supplementary Materials section.

The Mental Health and Syndemic Effect on Suicidal Ideation among Migrant Workers in China: A Cross-Sectional Study

Background: Migrant workers are in a socially disadvantaged position and thus suffer from more stress and mental health disorders, resulting in a high risk of suicidal ideation. This study aimed to explore the association between psychosocial problems and suicidal ideation, and the syndemic effect of concurrent psychosocial problems on suicidal ideation among migrant workers. Methods: We conducted a cross-sectional study and recruited 1805 migrant workers in Shenzhen, China. Each participant completed a self-administered questionnaire to report sociodemographic information and mental health status. Univariate and multivariate logistic regression were used to explore the association between psychosocial variables and suicidal ideation, and their syndemic effect on suicidal ideation. Results: The prevalence of suicidal ideation among migrant workers was 7.5%. All selected psychosocial variables were independently associated with suicidal ideation. Multivariate logistic regression analysis showed that three psychosocial variables were associated with suicidal ideation: anxiety (ORm: 1783, 95% CI: 1.089–2.920), entrapment (ORm: 2.064, 95% CI: 1.257–3.388), and defeat (ORm: 2.572, 95% CI: 1.612–4.103). Various mental health issues can exist simultaneously to increase the risk of suicidal ideation (AOR: 5.762, 95% CI: 3.773–8.802). Workers with more psychosocial problems were more likely to have suicidal ideation. Conclusions: The association between poor mental health and suicidal ideation should not be overlooked among migrant workers. The co-occurring or syndemic effect of psychosocial problems may increase the risk of suicidal ideation.

Prevalence of Major Depressive Disorder and Correlates of Thoughts of Death, Suicidal Behaviour, and Death by Suicide in the Geriatric Population-A General Review of Literature

Background: There has been an increase in deaths by suicide in old age in the last decade. Depression and suicide in the elderly, 60 years and above, is a major global public health concern. Determining the prevalence of depression, and correlates of death by suicide in the geriatric population, is an important first step toward addressing this public health concern. This literature review aims to determine the prevalence of major depressive disorders and the correlates of death by suicide in the geriatric population. Methods: This general review of the literature was performed using relevant search terms to determine both the prevalence of depression and the correlates of death by suicide among the geriatric population. Databases such as MEDLINE, PsycINFO, CINAHL, and PubMed were searched. Relevant and current articles were extracted, reviewed, and analyzed. The elderly population was defined as individuals 60 years and above. Only full texts articles in English were reviewed. Findings: The prevalence estimates of major depressive disorder in the elderly ranged from 5.37 to 56%. Adults aged 60 years and older have a high risk of depression that exposes them to suicide. Moreover, elderly women are more likely to experience depression than elderly men, but successful suicide is more common in men. Depression and other mental health conditions (schizophrenia, anxiety disorders) and perceived stress were found to be predictors of suicide in the elderly. Other predictors included physical illnesses such as malignancies, financial constraints, cuckoldry, and sexual dysfunction, and also social factors like living alone triggers depressive symptoms and increases suicidal risk in the elderly. Hanging was found to be the most common method of death by suicide for both sexes. While elderly women preferred poisoning, elderly men in Western countries preferred firearms. Differences in gender, the aging process and social issues were also contributing factors to methods used for suicide. Conclusions: Depression and debilitating physical illnesses were identified as significant contributors to suicide risk in the elderly population, and emphasis should be placed on identifying these factors early and treating them. Recognizing and addressing factors that predict suicide in the elderly will help to improve the mental wellbeing of the elderly.

The Interactive Effect of Social Capital and Duration of Migration on Suicidal Behaviors Among Rural-to-Urban Migrants in China: Evidence from a GIS/GPS-Assisted Probability Sample

Suicide for rural-to-urban migrants in China presents a challenge. Social capital as a modifiable factor is associated with suicidal behaviors at different levels for different populations. This study focuses on the social capital-suicidal behavior relationship among rural migrants with detailed social capital measures and their interaction with migration duration. Data were collected from a rural migrant sample in Wuhan, China. Outcome variable was reported suicidal ideation and attempts in the past 12 months. Social capital was measured using the Personal Social Capital Scale. Year of migration was measured as the number of years a subject migrated to the city. Multivariate logistic regression (coefficients [95%CIs]) was used for data analysis. Time of crossover for interaction was estimated as the year when the effect of social capital on a suicidal behavior revered from negative to positive. Study findings show a negative association between social capital and suicidal ideation (-1.48 [-2.86, -0.10]), but the association was not significant for suicidal attempts (-1.30 [-2.68, 0.08]) after considering the positive interaction between social capital and year of migration (0.11 [0.03, 0.19] for ideation and 0.11 [0.02, 0.19] for attempts). Similar effects were found for detailed social capital measures. The estimated time of crossover ranged from 7.0 to 14.8 years for different social capital measures. The findings of this study confirm the protective relationship between social capital and suicidal behaviors in the early years of migration among rural migrants. These findings inform suicide prevention among rural migrants by considering social capital during the first 7 to 15 years of migration.

Prevalence of depressive symptoms among Chinese university students amid the COVID-19 pandemic: a systematic review and meta-analysis

AIMS

Chinese university students are at high risk for depressive symptoms and the ongoing coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the mental health of university students. However, existing studies on depressive symptoms in Chinese university students during the COVID-19 pandemic reported a wide range of prevalence estimates, making mental health planning for this population difficult. The objective of this study was to conduct a systematic review and meta-analysis of surveys that assessed the prevalence of depressive symptoms in Chinese university students amid the COVID-19 pandemic.

METHODS

Major Chinese (CNKI, Wanfang, VIP) and English (PubMed, Embase, PsycInfo) databases and preprint platforms were searched to identify cross-sectional studies containing data on the prevalence of depressive symptoms in Chinese university students during the pandemic. Two authors independently retrieved the literature, evaluated the eligibility of potential studies, assessed the risk of bias (RoB) of included studies, and extracted data. RoB was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

RESULTS

In total, 1177 records were retrieved, and 84 studies involving 1 292 811 Chinese university students during the pandemic were included. None of the included studies were rated as completely low RoB. Statistically significant heterogeneity in the prevalence estimates of included studies was detected (I2 = 99.9%, p < 0.001). The pooled prevalence of depressive symptoms was 26.0% (95%CI: 23.3-28.9%), which was significantly higher in female than in male students (30.8% v. 28.6%, p < 0.001), in postgraduates than in undergraduates (29.3% v. 22.9%, p < 0.001), in students living inside than in those living outside the COVID-19 epicentre (27.5% v. 22.3%, P < 0.001), in students from universities at the epicentre than in those from universities outside the epicentre (26.2% v. 23.1%, p < 0.001), in students who had close contact with COVID-19 than in those who did not (46.0% v. 25.0%, p < 0.001), and in students who had acquaintances or relatives infected with COVID-19 (39.7% v. 24.0%, p < 0.001) than in those who did not. Five sources of heterogeneity were identified from the subgroup analysis: survey period, % of males among the survey sample, scale of depressive symptoms, cutoff score of the scale and level of RoB.

CONCLUSIONS

Over one-fourth of Chinese university students experienced depressive symptoms during the COVID-19 pandemic. Mental health services for this population should include periodic evaluation of depressive symptoms, expanded social support and psychiatric assessment and treatment when necessary. It is also necessary to design depression prevention programmes that target higher-risk cohorts of university students.

Associations between Community Cohesion and Subjective Wellbeing of the Elderly in Guangzhou, China-A Cross-Sectional Study Based on the Structural Equation Model

Population aging has become one of the most prominent population trends in China and worldwide. Given the retirement and physical limitation of the elderly, the neighborhood has gradually become the center of their daily lives and communication. Community cohesion plays an essential role in improving the elderly’s subjective wellbeing. However, most present studies on the concept and relationship between different dimensions of community cohesion are mainly in western countries. Meanwhile, most of the studies on the relationship between community cohesion and subjective wellbeing only focused on one aspect of community cohesion such as community interaction. To address this research gap, this study sampled 20 communities in Guangzhou, conducted a questionnaire survey on 969 elderly people, and explored the relationship between four aspects of community cohesion (community interaction, environmental satisfaction, belonging, and participation) and their associations with subjective wellbeing using the Structural Equation Model (SEM). In addition, we performed multi-group analysis to study the association differences among older individuals in communities with different socioeconomic types. We found that: (1) The conceptual relationship between different aspects of community cohesion among older adults is significant; (2) Community environmental satisfaction, interaction, and belonging associate with the elderly’s subjective wellbeing, whereas there is no significant association between community participation and subjective wellbeing; (3) Mental health is an important mediating factor connecting community cohesion and subjective wellbeing, whereas physical health is not. (4) The association pattern of older adults in communities with different socio-economic status are identical, whereas the association strengths are different. In high Socio-Economic Status Index (SESI) communities (communities where older adults with relatively high socioeconomic attributes gather, such as high income and education level), community belonging and participation are significantly associated with community environmental satisfaction and interaction, respectively. In low SESI communities (communities in which older adults with relatively low socioeconomic attributes gather, such as low income and education level), community interaction, belonging, and participation considerably link to community environmental satisfaction, interaction, and belonging, respectively. Regarding the association between community cohesion and subjective wellbeing, community interaction has stronger linkage with the elderly’s subjective wellbeing of in high-SESI aging community than low-SESI aging community. While community environmental satisfaction has stronger association with the elderly’s subjective wellbeing of the elderly in low-SESI aging community than high-SESI aging community. Therefore, it is sensible for community planning to focus on community environment improvement and vibrant community activities organization.

Associations between Objective and Subjective Housing Status with Individual Mental Health in Guangzhou, China

Housing is an important social determinant of mental health. However, few studies simultaneously measure the objective housing status (i.e., housing tenure, living space, housing conditions, and housing stability) and subjective housing status (i.e., housing satisfaction) as well as examine their effects on people's mental health (i.e., stress, anxiety, and depression). Thus, using a sample size of 1003 participants by two-stage random sampling survey in Guangzhou, China, this study applies multivariate ordinary least square regression models to comprehensively explore and compare the associations between objective and subjective housing status with mental health, and then analyze the moderating effects of subjective housing status on the relationships between objective housing status and mental health. The findings suggest that there are significant differences in people's mental health based on different housing status. The subjective housing status can better explain the variances in mental health than objective housing status. Also, subjective housing status may partly mitigate the adverse impacts of objective housing disadvantages on some aspects of an individual's mental health. Therefore, housing improvement policies and public health initiatives should be designed based on a comprehensive account of objective and subjective housing characteristics as well as their influences on specific aspects of mental health.

Intercepted journeys: Associations between migration and mobility experiences and depressive symptoms among substance using migrants at the Mexico-Guatemala border

Substance use and depressive psychiatric symptoms have been associated with migration and mobility. The Mexico-Guatemala border is a key transit point for internal, regional, and international migration flows. However, there is limited knowledge of the role of substance use, migration, and mobility on mental health among migrants at this border. Our paper explores the association of migration and mobility patterns with possible major depressive symptoms among migrants at this key geographic region. We recruited 392 substance-using migrants using modified time-location sampling. Crude and adjusted logistic regression models were developed. We found that 12% of the sample had possible major depressive symptoms. After adjusting for relevant covariates, including gender, income, and perceived homelessness, we found that recent rural-urban and short-term migrants had higher odds of possible major depressive symptoms, whereas international migrants had lower odds. Findings of this paper suggest that although migrants experience hardship and uncertainty, they may respond with complex and nuanced forms of coping and planning.

Health-related quality of life in Chinese rural-to-urban migrants: Investigating the roles of working conditions and job satisfaction

The existing research aims to explore the relationships between working conditions, job satisfaction and health-related quality of life (HRQL) of Chinese rural-to-urban migrants. Both probability and nonprobability sampling methods were done in four randomly chosen jurisdictions of Nanjing (N = 712). Results reveal that the working environment has the strongest and positive correlation with job satisfaction. In addition, job satisfaction is negatively correlated with the number of working days per week, and affects the physical and psychological health status of Chinese rural-to-urban migrants. This study highlights the importance to improve working conditions for migrants and their HRQL and recommends government policies to provide services to Chinese migrants and protect their human rights, as well as promote awareness of their working conditions and HRQL.

Prevalence, risk factors and clinical correlates of depression in quarantined population during the COVID-19 outbreak

BACKGROUND

The COVID-19 outbreak has brought tremendous psychological pressure to the general population, which may lead to depression. Therefore, this study aim to evaluate the prevalence and clinical correlates of depressive symptoms in the general population quarantined during the COVID-19 outbreak in Shenzhen.

METHODS

2237 quarantined general individuals participated in this cross-sectional study from February 14 to March 4, 2020, during their 14 days quarantine. They completed the Zung's Self-Rating Depression Scale (SDS) for depression, Zung's self-rating anxiety scale (SAS) for anxiety, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the Impact of Events Scale-Revised (IES-R) for post-traumatic stress symptoms (PTSS).

RESULTS

The prevalence of depressive symptom was 6.21% in quarantined individuals. The depressed group were younger, less married and educated, and had higher SAS, PSQI, IES-R total scores (all p<0.05), as well as more avoidance, intrusion and hyperarousal symptoms than the non-depressed group. Correlation analysis showed significant correlations between SDS score and the following parameters: age, marriage, education, SAS, PSQI, IES-R total and its three subscale scores (Bonferroni corrected all p<0.05). Further multiple regression indicated that age, marriage, education, SAS, PSQI, IES-R total score, Avoidance and Hyperarousal factor were independent predictors of depressive symptom.

LIMITATIONS

This study adopted a cross-sectional design and used self-report questionnaires.

CONCLUSIONS

Our results suggest an elevated prevalence of depressive symptom in quarantined general individuals in Shenzhen. Some demographic and clinical variables were associated with depressive symptoms.

Prevalence and correlates of depressive symptoms among Chinese patients with cataracts treated in tertiary general hospitals

Background

Previous studies recruited unrepresentative samples of Chinese patients with cataract and reported a wide range of prevalence of depressive symptoms in this patient population (18.0–89.7%). The present study determined the prevalence and correlates of depressive symptoms among a consecutive sample of Chinese patients with cataract treated in tertiary general hospitals.

Methods

A total of 339 patients with cataract were consecutively selected from ophthalmology departments of two large general hospitals in Wuhan, China. Depressive symptoms were assessed with the Chinese Hospital Anxiety and Depression Scale. Logistic regression was used to identify factors that were associated with depression.

Results

The prevalence of depressive symptoms was 23.9% (95% CI [19.4–28.4]%) among patients with cataract. Correlates for depressive symptoms include an education level of primary school and below (OR = 1.93, P = 0.038), marital status of “others” (OR =3.15, P < 0.001), poor family economic status (OR = 2.26, P = 0.010), nuclear cataract (OR =4.32, P < 0.001), and mixed cataract (OR = 2.76, P = 0.017).

Conclusions

Depressive symptoms are common among Chinese patients with cataract treated in large general hospitals. Patients who are poorly educated, have a marital status other than “married”, have poor family economic status, and suffer from nuclear and mixed cataracts are at greater risk for depressive symptoms.

Depressive Symptoms, Suicidal Ideation, and Mental Health Service Use of Industrial Workers: Evidence from Vietnam

Background: Depressive symptoms and suicidal ideation substantially reduce industrial workers' productivity and performance. This study was performed to examine the prevalence of depressive symptoms and suicidal ideation and identify associated factors among industrial workers in different provinces of Vietnam. Materials and Methods: We performed a cross-sectional study in industrial zones of four provinces of Vietnam. The Patient Health Questionnaire (PHQ-9) was employed to screen depressive symptoms and suicidal ideation. Multivariate logistic regression was performed to determine factors related to depressive symptoms and suicidal ideation. Results: Of 1200 industrial workers, 30.5% and 33.6% industrial workers had positive depressive symptoms and suicidal ideation in the last two weeks, respectively. There were 38.3% ever using mental health services in the last 12 months. High school education (OR = 0.64, 95% CI = 0.44-0.95); living in dormitory (OR = 3.07, 95% CI = 1.51-6.24), living with siblings (OR = 2.98; 95% CI = 1.32-6.75), having two children or more (OR = 1.45, 95% CI = 1.03-2.03), high years of experience (OR = 0.94; 95% CI = 0.89-0.98), suffering from burnout, alcohol use disorder (OR = 2.38; 95% CI = 1.72-3.28), and smoking status (OR = 0.38, 95% CI = 0.23-0.61) were associated with positive depressive symptoms. Living with children, working in mechanical/metallurgy/electronics factories, completely exhausted and often thinking of quitting, and alcohol use disorder were positively related to suicidal ideation. Conclusions: This study found a high prevalence of depressive symptoms and suicidal ideation among industrial workers in Vietnam. Regular screening and detecting high-risk groups, along with interventions to reduce health risk behaviors, burnout and on-site medical service quality improvement, are recommended to alleviate the burden of depression in industrial workers.

Social integration, perceived stress, locus of control, and psychological wellbeing among chinese emerging adult migrants: A conditional process analysis

BACKGROUND

This study investigated the underlying determinants of the relationship between social integration and three dimensions of psychological wellbeing in a nationally representative sample of emerging adult migrants in China.

METHODS

Data on 6,084 migrants aged 18-29 years in the 2014 China Migrants Dynamic Survey were analyzed. A conditional process analysis tested hypotheses regarding the influence of social integration on self-rated health, life satisfaction, and mental illness. Perceived stress was tested as a mediator, and the locus of control was tested as a moderator.

RESULTS

Social integration negatively related to mental illness (β= -0.10, p < 0.001), and it positively related to self-rated health (β = 0.24, p < 0.001) and life satisfaction (β = 0.14, p < 0.001). Perceived stress had significant mediating effects on the influence of social integration on the dimensions of psychological wellbeing. The locus of control not only moderated the influence of social integration on perceived stress (β = -0.02, p < 0.05), it moderated the influence of perceived stress on the mental illness dimension of psychological wellbeing (β = -0.03, p < 0.001).

LIMITATIONS

The cross-sectional design impeded the ability to draw causal inferences.

CONCLUSIONS

Social integration was a key predictor of psychological wellbeing among emerging adult migrants in China. Perceived stress significantly mediated that relationship. The locus of control moderated the indirect effect of social integration on psychological wellbeing by weakening the buffering effect of social integration on perceived stress. Furthermore, the locus of control also buffered the negative effects of perceived stress.

Mental health and self-rated health status of internal migrant workers and the correlated factors analysis in Shanghai, China: a cross-sectional epidemiological study

BACKGROUND

A cross-sectional study was conducted in 2018 to investigate the mental health status of internal migrant workers (IMWs) in Shanghai to understand basic information and the mental health status of IMWs.

METHODS

The total number of IMWs in the study was 4793 and 4648 questionnaires were valid. We used χ2 test, t test, analysis of variance, linear regression and logistic regression to analyse the data.

RESULTS

Mental health, represented by the nine-item Patient Health Questionnaire score (≥10), was significantly correlated with self-rated income-expenditure status, living with family, job type and alcohol use. The total depression prevalence of IMWs in this study was 20.1%. Subjective well-being (SWB) was significantly correlated with marital status, educational attainment, self-reported income-expenditure status, living with family and job type. Those who were female, had a high school education or above, self-reported inadequate income, did not live with family, had poor self-rated health and had moderate or severe depression were more likely to have lower SWB. Promoting the mental health of IMWs also benefited their physical health.

CONCLUSIONS

Chinese migrant workers who were younger, had insufficient self-rated income, had worse self-reported health, used alcohol and were unmarried had a high risk of mental health disorders.

Major depressive disorder in Chinese persons with speech disability: High rates of prevalence and perceived need for mental health care but extremely low rate of use of mental health services

BACKGROUND

In recent years, there has been increasing awareness on the importance of mental health services for persons with disability in China, but data on mental health of persons with speech disability (PwSD) are scarce. This study examined prevalence and correlates of major depressive disorder (MDD) among Chinese PwSD, as well as their perceived need for and utilization of mental health services.

METHODS

A total of 227 community-residing adult PwSD were successfully recruited by using multi-stage sampling approach, and interviewed with the Mini-international Neuropsychiatric Interview 5.0. Depressed PwSD's perceived need for and utilization of mental health services were also measured.

RESULTS

29.5% of the PwSD suffered from MDD during the month before the interview and, of the depressed PwSD, 44.8% perceived a need for mental health care but only 1.5% had sought help from mental health specialists. Factors significantly associated with MDD included female gender (OR=2.42), marital status of "non-married" (OR=2.27), having the disability during childhood (OR=4.60) and adulthood (OR=10.99) (vs. at birth), co-occurring other types of disabilities (OR=2.29), major medical conditions (OR=2.62), and impaired ability of activities of daily living (OR=3.23).

LIMITATIONS

Findings can only be generalized to PwSD who register with the Disabled People's Federation (DPF) in China, because the sampling frame was based on the registration system of DPF.

CONCLUSIONS

There is a large unmet need for mental health services among Chinese PwSD. It is urgently needed to integrate the management of MDD and other common mental disorders into the services system for PwSD in China.

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.

Migrant Workers and Psychological Health: A Systematic Review

Migrant workers show an increase in the incidence of serious, psychotic, anxiety, and post-traumatic disorders due to a series of socio-environmental variables, such as loss of social status, discrimination, and separations from the family. The purpose is to elaborate a systematic review and highlight the prevailing psychological pathologies of these workers and categories most at risk. Our research included articles published from 2009 to 2019 on the major databases (Pub Med, Cochrane Library, and Scopus) using a combination of some keywords. The online search indicated 1.228 references. Using inclusion and exclusion criteria, we analyzed 127 articles, in particular 12 reviews and 115 original articles. Principal emerging disorders from the research are depressive syndrome (poor concentration at work, feeling down, or anger and somatization), anxiety, alcohol or substance abuse, and poor sleep quality. This causes low life conditions, which is also due to marginalization from the social context and strenuous work; in fact, migrant workers may suffer verbal or physical abuse, and they are often employed in dangerous, unhealthy jobs. It is therefore essential to increase the role of occupational medicine and promote wellbeing for this vulnerable job category.

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.

Socioeconomic disparities in psychological health: Testing the Reserve Capacity Model in a population-based sample of Chinese migrants

Based on the Reserve Capacity Model, this study investigated the associations of objective socioeconomic status and subjective social status with psychological health and the underlying psychosocial mechanisms in a population-based sample of Chinese migrants (n = 15,999). Results showed that subjective social status was positively associated with life satisfaction and self-rated health through the mediation of psychological distress and perceived stress. Whereas education showed a very weak association with life satisfaction, income was directly associated with life satisfaction only. The findings suggest that reducing psychosocial vulnerabilities may be a potential impetus to eliminate socioeconomic health disparities among Chinese migrants.

Nonfatal Suicidal Behaviors of Chinese Rural-to-Urban Migrant Workers: Attitude Toward Suicide Matters

OBJECTIVE

To examine the attitude toward suicide (ATS) and its influence on nonfatal suicidal behaviors of Chinese rural-to-urban migrant workers (MWs).

METHOD

Altogether, 3031 MWs completed the positive ATS Scale and structured questions regarding lifetime suicide ideation, plan, and attempt. Mental health help-seeking behaviors of MWs were also investigated.

RESULTS

Overall, MWs held a more negative ATS than the Chinese general population. The lifetime prevalence of suicide ideation, plan, and attempt was 5.5%, 1.3%, and 1.1%, respectively. After controlling for lifetime depressive disorders and other covariates, a negative ATS was still significantly associated with lower risk of lifetime suicide ideation (OR = 0.32), plan (OR = 0.22), and attempt (OR = 0.26). MWs with a negative ATS were more likely to talk to others and seek help by online/telephone consultation for their mental health and suicidal problems (p < .05). A more positive ATS was significantly associated with male gender, low education level, ethnic minority of Miao, low monthly income, and originating from western China.

CONCLUSIONS

The majority of MWs hold a negative ATS, which significantly contributes to their relatively low risk of nonfatal suicidal behaviors. The more help-seeking from others and online/telephone consultation in MWs with a negative ATS may lower their risk of nonfatal suicidal behaviors.

Determinants of the Proactiveness of Female Migrant Workers with Psychological Distress Seeking Allied Health Services

Seeking utilization of allied health services (AHS) has significant implications for psychological distress self-management. However, utilization of AHS by Chinese female migrant workers (FMWs) has not received enough attention. This study, therefore, aims to explore what contributes to FMWs' proactiveness in utilizing AHS. A cross-sectional study was conducted to collect data in terms of socio-demographic characteristics, work-related characteristics and AHS accessibility. A logistic regression model was adopted to examine association of these predictors with proactiveness in seeking AHS. 992 FMWs with psychological distress were interviewed with stratified multiple-stage sampling. The results indicated that Basic Public Health Services (BPHS) is a salient predictor affecting proactiveness in seeking AHS. BPHS includes psychological counseling (Odds Ratio (OR) =2.401, 95% Confidence Interval (CI) =1.284-4.490, p = 0.006), psychotherapy (OR = 2.063, 95% CI = 1.438-2.960, p = 0.000) and health knowledge lectures (OR = 1.613, 95% CI = 1.115-2.333, p = 0.011). Moreover, sampled participants under 25 and those who received education for more than 9 years are more likely to seek AHS compared with other groups. In addition, proactiveness in seeking AHS is clearly associated with working hours per day. The probability is only 31.1% for those working more than 12 h per day to seek AHS actively compared with those working below 8 h (95% CI = 0.119-0.812, p = 0.017). There are no differences between those with 8-12 working hours and those working less than 8 h (OR = 1.100, 95% CI = 0.798-1.518, p = 0.560). The present findings suggest that policies be made to improve the coverage of BPHS and to provide specified AHS to meet the increasing demand of different social groups.

The Disparity in Mental Health Between Two Generations of Internal Migrants (IMs) in China: Evidence from A Nationwide Cross-Sectional Study

Background: Internal migrants (IMs) are a large, vulnerable population in China and are mostly driven by national economic reform. IMs who were born before and after 1980, when the general social and economic reform began to appear in China, are considered to be two separate generations. The generational differences in mental health across IMs remain undocumented. In this study, the intergenerational disparity in IMs’ mental health, using data from a national cross-sectional study, was assessed. Methods: Cross-sectional data from the “National Internal Migrant Dynamic Monitoring Survey 2014” were used. IMs were divided into the “old” or “new” generation, based on their date of birth (before 1980 vs. from 1980 onwards). Mental health includes psychological distress, which was measured using the Kessler Screening Scale for Psychological Distress (K6), and perceived stress, which was measured with the Perceived Stress Scales (PSS-4). Two-level Generalized Linear Mixed Models were performed so as to assess the generation gap and associated factors of each group’s mental health. IM demographics, migration characteristics, and social integration indicators were controlled for when assessing the intergenerational disparity in mental health. Results: A total of 15,999 IMs from eight different cities participated in the survey. New generation migrants accounted for 61.5% (9838/15,999) of the total sample. After controlling for participants’ characteristics, new generation migrants had higher psychological distress scores (β_ad = 0.084, 95% CI: (0.026,0.193) and higher perceived stress scores (β_ad = 0.118, 95% CI: 0.029, 0.207) than the older generation. For both generations, factors associated with good mental health included high levels of social integration, personal autonomy, and life satisfaction, as well as self-rated good physical health. For the new generation, the mental health of urban-to-urban IMs (β_ad = 0.201, 95%CI: 0.009, 0.410) for the K6, β_ad = 0.241, 95% CI: 0.073, 0.409 for the PSS-4), IMs with a longer migration duration (β_ad = 0.002, 95% CI: (0.000, 0.003) for the PSS-4) and IMs with a higher annual income (β_ad = 0.124, 95% CI: (0.029, 0.218) for the K6) was significantly poorer than their counterparts. Conclusions: New-generation migrants’ mental health is worse compared to older IMs. An array of services for addressing these generation-specific needs may facilitate the promotion of mental health among IMs in China.

The Potential Psychological Mechanism of Subjective Well-Being in Migrant Workers: A Structural Equation Models Analysis

Objective: The aim of this study was to identify the potential psychological mechanism of well-being in migrants in Shanghai, China. Methods: A cross-sectional study was conducted in 2018. First, a literature review was conducted to understand the salutogenesis of migrants in China. Then, 2573 random participants were recruited from six workplaces and public places in six districts of Shanghai. The Chinese versions of the Patient Health Questionnaire-9 (PHQ-9), the Personal Wellbeing Index (PWI), and the Sense of Coherence (SOC) Scale were used to evaluate the depression, subjective well-being (SWB), and SOC of migrants. The t-test, ANOVA, and multiple linear regression and structural equation models (SEM) were used to analyze the correlations and paths among generalized resistant resources (GRRs), SOC, PHQ, and SWB. Results: The subjects were aged between 18 and 58 (mean, 28.17; SD, 6.99). SOC showed a positive correlation with SWB (r = 0.46, p < 0.001) and a negative correlation to PHQ (r = -0.53, p < 0.001). After controlling for the demographic characteristics, we found that PHQ, SOC (comprehensibility, manageability, meaningfulness), and GRRs (income ratio, marital status) contributed 33.3% of the variance in SWB, and their linear regression coefficients were: -0.32 (p < 0.001), 0.09 (p < 0.001), 0.09 (p < 0.001), 0.15 (p < 0.001), 0.06 (p < 0.05), and 0.16 (p < 0.05), respectively. These findings not only confirmed the direct association among SOC, PHQ and SWB, but also verified two underlying mechanisms regarding the mediating effect of SOC by using SEM: (1) GRRs (income ratio, marital status) are positively associated with a higher SOC, which further contributes to favorable SWB; and (2) PHQ is negatively associated with poor SWB indirectly via SOC. Conclusion: Migrant workers with low SOC and high PHQ are vulnerable to poor well-being levels. Meanwhile, GRRs (income ratio, marital status) may strengthen the SOC level, and can be regarded as the basis of intervention. Further investigation may be needed to focus on external psychological support factors.

Depressive symptoms in Chinese assembly-line migrant workers: A case study in the shoe-making industry

INTRODUCTION

Assembly-line migrant workers (AMWs), as a major workforce in China, may be at particularly high risk of depression due to their relative low social economic status and particular job characteristics. However, little is known about the frequency and characteristics of depression among Chinese AMWs. This study investigated the prevalence and correlates of depressive symptoms in Chinese AMWs.

METHODS

In this cross-sectional survey, 915 Chinese AMWs from two shoe-making factories completed a standardized questionnaire to report their socio-demographics, physical health, migration, and work. They also reported their depressive symptoms by completing the Beck Depression Inventory-Short Form (BDI-SF). We conducted multiple logistic regression analysis to identify factors related to depression.

RESULTS

We found that 31.7% of AMWs were clinically depressed (BDI-SF ≥ 8). The multiple regression model included age, self-rated physical health, pain, family relationships, having no good friends at the same factory, and working under high pressure.

DISCUSSION

Our findings suggest that depression is common among Chinese AMWs. We argue that there is an urgent need for health care providers and factory managers to work on the early identification of AMWs, who are at high risk for depression. Psychological and psychiatric treatments are necessary in the Chinese labor-intensive industries.

Depressive Symptoms among Industrial Workers in Vietnam and Correlated Factors: A Multi-Site Survey

Depressive disorders have been found to be a significant health issue among industrial workers, resulting from work-related factors and causing serious burdens for the workers as well as their employers. Literature on mental health problems of Vietnamese industrial workers has been limited, despite the rapid foreign investment-fueled industrialization process of the country. This study aimed to fill the gap in literature by examining the prevalence of depressive disorders and their potential associated factors among a cohort of Vietnamese industrial workers. A cross-sectional study was conducted in 3 industrial areas in Hanoi and Bac Ninh. A total of 289 workers agreed to participate in the study. Generalized linear mixed models were applied to identify associated factors with depression status of respondents. 38.6% of participants reported suffering depression. Factors found to be positively associated with the possibility of having depression and higher PHQ9 score were long working hours, suffering more health problems, and health hazards exposure at work. Meanwhile, being females, having more children, living with parents, engaging in smoking, and being local workers were found to correlate with lower likelihood of being depressed. The findings suggested the importance of regular health screening, work safety assurance, and social support outside of workplace on the mental health of the workers.

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.

Depressive Symptoms and Migrant Worker Wages: Estimation Based on a Nationally-Representative Panel Dataset

In recent years, migrant workers, defined as people who move from Chinese rural areas to cities in other parts of the country to find work, have experienced slowed wage growth. An important question that has emerged is whether depressive symptoms have a significant relationship with migrant worker wages. This paper uses a nationally representative panel dataset to examine the overall association of depressive symptoms and migrant worker wages in China and explores the indirect mechanisms through which these impacts occur. Using the Coarsened Exact Matching method, our results show that depressive symptoms have a significant direct negative relationship with migrant worker wages, and that this relationship is consistent. Furthermore, we also find that depressive symptoms can reduce migrant worker wages indirectly by increasing the frequency of job conversion or by shortening work duration.

Life in company dormitories and a career change are associated with anxiety over lack of privacy among radiation decontamination workers in Fukushima Prefecture, Japan

OBJECTIVES

The purpose of the present study was to obtain knowledge for improvement of the housing and life among radiation decontamination workers by examining the effect of housing type on anxiety over lack of privacy.

METHODS

This cross-sectional study comprised 544 male radiation decontamination workers in Fukushima Prefecture who anonymously answered self-administered questionnaires in 2013, including measurement of privacy anxiety, housing type, career change, social support, and sociodemographics. Chi-square tests and binary logistic regression analysis were used to evaluate the associations between these factors and anxiety over lack of privacy.

RESULTS

The number of workers who had anxiety over lack of privacy was 93 (17.1%), and the number of workers who were living in owner-occupied housing, rental housing, company dormitories, and hotels was 165 (30.3%), 177 (32.5%), 168 (30.9%), and 34 (6.3%), respectively. The presence of anxiety was significantly associated with housing type (p <0.001), a career change (p = 0.005), and the location of the worker's previous residence (p <0.001). Binary logistic regression analysis revealed that life in a company dormitory and a career change were separately associated with anxiety over lack of privacy (p <0.001 and p <0.027, respectively).

CONCLUSIONS

We found that anxiety among radiation decontamination workers over lack of privacy increased if they lived in company dormitories or had changed careers to become a radiation decontamination worker. These findings demonstrate the need to improve occupational mental health management, with an intensive focus on the residential environment.

Common mental health problems in rural-to-urban migrant workers in Shenzhen, China: prevalence and risk factors

AIMS

Rural-to-urban migrant workers are a large marginalised population in urban China. Prevalence estimates of common mental health problems (CMHPs) in previous studies varied widely and very few studies have investigated migration-related factors of CMHPs in migrant workers. The objective of this study was to determine the prevalence and risk factors of CMHPs among Chinese migrant workers.

METHODS

A random sample of 3031 migrant workers of ten manufacturing factories in Shenzhen, China, completed a standardised questionnaire containing socio-demographic and migration-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of three or higher was used to denote the presence of CMHPs.

RESULTS

The prevalence of CMHPs was 34.4% in Chinese migrant workers. In multiple logistic regression, risk factors for CMHPs included being 16-25 years old (odd ratio [OR] 1.65, 95% confidence interval [CI] 1.28, 2.12), being 26-35 years old (OR 1.36, 95% CI: 1.05, 1.75), low monthly income (OR 1.42, 95% CI 1.04, 1.92), poor living condition (OR: 1.76, 95% CI: 1.22, 2.54), physical illness in the past 2 weeks (OR 1.72, 95% CI 1.43, 2.05), having worked in many cities (OR 1.34, 95% CI 1.03, 1.74), infrequently visiting hometown (OR 1.56, 95% CI 1.22, 1.99), poor Mandarin proficiency (OR 1.51, 95%CI 1.13, 2.01), a low level of perceived benefits of migration (OR 1.33, 95% CI 1.14, 1.55) and working more than 8 h/day (OR 1.39, 95% CI 1.14, 1.70).

CONCLUSIONS

CMHPs are very prevalent among Chinese migrant workers. Given the large number of Chinese migrant workers, there is an urgent need to address the mental health burden of China's migrant worker population.

Depressive symptoms in Chinese male inpatients with schizophrenia: Prevalence and clinical correlates

Depression is common in patients with schizophrenia and associated with serious consequences. However, previous studies have mixed findings on characteristics of depression in schizophrenia, partly because of the use of depressive symptom scales that are not specific to schizophrenia. This study examined the prevalence and correlates of depressive symptoms in Chinese patients with schizophrenia. A consecutive sample of 349 male inpatients with schizophrenia was recruited from the largest psychiatric specialty hospital in south-central China. Depressive symptoms and psychopathology of patients were assessed with the Calgary Depression Scale for Schizophrenia and the Positive and Negative Symptom Scale, respectively. Extrapyramidal side effects (EPSs) were assessed with the Simpson Angus Scale, the Barnes Akathisia Rating Scale, and the Abnormal Involuntary Movement Scale. Demographic and other clinical data were also collected. Depressive symptoms were present in 41.8% of male schizophrenia inpatients. Multiple logistic regression analysis revealed that early age at onset (OR [95%CI] = 1.12 [1.01,1.27], p = 0.049), more severe negative symptoms (OR [95%CI] = 1.05 [1.01,1.09], p = 0.034), more severe general psychopathological symptoms (OR [95%CI] = 1.06 [1.01,1.12], p = 0.041), akathisia (OR [95%CI] = 2.87 [1.45,5.69], p = 0.003), and dyskinesia (OR [95%CI] = 3.93 [1.36,11.33], p = 0.011) were significantly associated with depression. Appropriate antipsychotic medication treatment and reducing EPSs of antipsychotics may help prevent or relieve depression of patients with schizophrenia.

Suicidal ideation among Chinese cancer inpatients of general hospitals: prevalence and correlates

Cancer patients are at high risk for suicide, particularly when they are informed about the cancer diagnosis or hospitalized for cancer treatment. Therefore, oncology healthcare settings such as large general hospitals in China, may represent an ideal setting to identify and treat suicidality in cancer patients. However, the clinical epidemiology of suicidality of Chinese cancer patients remains largely unknown. This study examined the prevalence and correlates of suicidal ideation among Chinese cancer inpatients of large general hospitals. A total of 517 cancer inpatients were consecutively recruited from two tertiary general hospitals of a metropolitan city in northern China, and administered with standardized questionnaires to collect data on sociodemographics, mental health, and cancer-related clinical characteristics. Suicidal ideation and mental health were measured with a single self-report question “In the past month, did you think about ending your life?” and Hospital Anxiety and Depression Scale, respectively. The one-month prevalence of suicidal ideation was 15.3% in Chinese cancer inpatients. In multivariable Logistic regression, depression, anxiety, moderate-to-severe pain, metastatic cancer, poor performance status, surgery, and palliative care were significantly associated with suicidal ideation. Cancer inpatients of large Chinese general hospitals have high prevalence of suicidal ideation and therefore potentially at high risk for suicide. Suicide prevention efforts for cancer inpatients should include periodic evaluation of suicidality, effective pain management, psychooncological supports, and, when necessary, psychiatric treatment and crisis intervention.

Exploring the Impacts of Housing Condition on Migrants' Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach

Although rapid urbanization and associated rural-to-urban migration has brought in enormous economic benefits in Chinese cities, one of the negative externalities include adverse effects upon the migrant workers’ mental health. The links between housing conditions and mental health are well-established in healthy city and community planning scholarship. Nonetheless, there has thusfar been no Chinese study deciphering the links between housing conditions and mental health accounting for macro-level community environments, and no study has previously examined the nature of the relationships in locals and migrants. To overcome this research gap, we hypothesized that housing conditions may have a direct and indirect effects upon mental which may be mediated by neighbourhood satisfaction. We tested this hypothesis with the help of a household survey of 368 adult participants in Nanxiang Town, Shanghai, employing a structural equation modeling approach. Our results point to the differential pathways via which housing conditions effect mental health in locals and migrants. For locals, housing conditions have direct effects on mental health, while as for migrants, housing conditions have indirect effects on mental health, mediated via neighborhood satisfaction. Our findings have significant policy implications on building an inclusive and harmonious society. Upstream-level community interventions in the form of sustainable planning and designing of migrant neighborhoods can promote sense of community, social capital and support, thereby improving mental health and overall mental capital of Chinese cities.

Should the poor have no medicines to cure? A study on the association between social class and social security among the rural migrant workers in urban China

Background

The rampant urbanization and medical marketization in China have resulted in increased vulnerabilities to health and socioeconomic disparities among the rural migrant workers in urban China. In the Chinese context, the socioeconomic characteristics of rural migrant workers have attracted considerable research attention in the recent past years. However, to date, no previous studies have explored the association between the socioeconomic factors and social security among the rural migrant workers in urban China. This study aims to explore the association between socioeconomic inequity and social security inequity and the subsequent associations with medical inequity and reimbursement rejection.

Methods

Data from a regionally representative sample of 2009 Survey of Migrant Workers in Pearl River Delta in China were used for analyses. Multiple logistic regressions were used to analyze the impacts of socioeconomic factors on the eight dimensions of social security (sick pay, paid leave, maternity pay, medical insurance, pension insurance, occupational injury insurance, unemployment insurance, and maternity insurance) and the impacts of social security on medical reimbursement rejection. The zero-inflated negative binomial regression model (ZINB regression) was adopted to explore the relationship between socioeconomic factors and hospital visits among the rural migrant workers with social security.

Results

The study population consisted of 848 rural migrant workers with high income who were young and middle-aged, low-educated, and covered by social security. Reimbursement rejection and abusive supervision for the rural migrant workers were observed. Logistic regression analysis showed that there were significant associations between socioeconomic factors and social security. ZINB regression showed that there were significant associations between socioeconomic factors and hospital visits among the rural migrant workers. Also, several dimensions of social security had significant associations with reimbursement rejections.

Conclusions

This study showed that social security inequity, medical inequity, and reimbursement inequity happened to the rural migrant workers simultaneously. Future policy should strengthen health justice and enterprises’ medical responsibilities to the employed rural migrant workers.

Electronic supplementary material

The online version of this article (10.1186/s12939-017-0692-x) contains supplementary material, which is available to authorized users.

The epidemiology of current depression in Macau, China: towards a plan for mental health action

PURPOSE

Macau is a Special Administrative Region in China that has experienced tremendous development in its gambling industry during its post-colonial years. To inform mental health planning, this study presents the first population estimates and correlates of the current depression in Macau.

METHODS

A population-representative sample of 1068 Macau Chinese citizens aged 18 or above responded to a household telephone survey in January, 2015. The Patient Health Questionnaire-9 measured the current depression. Logistic regression models assessed the association between depression and potential correlates.

RESULTS

Overall, 8.0% (95% CI 6.3-9.7) of persons reported the current depression. A higher but non-significant proportion of women reported depression than men (9.3 vs. 6.6%) and older women reported higher prevalence (13.4%) than other demographic groups. Persons who were unemployed (OR = 4.9, 2.3-10.5), separated or divorced (OR = 3.1, 1.1-8.9), and reported poor self-rated health (OR = 5.0, 2.8-9.0), low quality of life (OR = 6.2, 3.1-12.7), lower social standing (OR = 2.4, 1.4-4.0), lower community trust (OR = 1.9, 1.2-3.1), lower perceived fairness (OR = 2.3, 1.4-3.8), lower social cohesion (OR = 3.8, 2.3-6.2), and lower social integration (OR = 3.0, 1.9-5.0) had greater odds of depression than their comparison group.

CONCLUSIONS

The current study demonstrated the burden of depression among Macau adults disproportionately affects women during emerging adolescence and old age, and men during middle adulthood. Key strategies to improve mental health services in Macau are discussed.

Depression and its impact on health-related quality of life among Chinese inpatients with lung cancer

Depression is of great concern for patients with cancer. A detailed epidemiological profile of depression in Chinese patients with lung cancer and whether depression impacts patients’ health-related quality of life (HRQOL) remain unknown. This study examined the prevalence and socio-demographic and clinical correlates of depression and its effect on HRQOL in Chinese inpatients with lung cancer of two large general hospitals. A total of 148 inpatients were consecutively recruited, and administered with a standardized questionnaire to collect socio-demographic and clinical data. Depression and HRQOL were assessed with the Hospital Anxiety and Depression Scale and World Health Organization QOL Scale Brief Version, respectively. As high as 43.2% Chinese inpatients with lung cancer had clinically significant depressive symptoms. Multiple logistic regression found that depression was significantly associated with moderate-to-severe pain (OR: 4.43), metastatic cancer (OR: 3.63), a short duration after cancer diagnosis (OR: 1.04), poor performance status (OR: 3.41), and small-cell cancer (OR: 4.52). Depressed patients had significantly poorer HRQOL than not depressed patients in terms of all four domains of HRQOL. After controlling for the potential confounding effects of socio-demographic and clinical factors with analysis of covariance, these group-differences in physical (F = 29.074, P < 0.001), psychological (F = 76.869, P < 0.001), social (F = 21.465, P < 0.001), and environmental (F = 27.685, P < 0.001) HRQOL remained statistically significant. Depression is prevalent in inpatients with lung cancer and independently associated with poor HRQOL. To address this serious issue, effective pain management, psycho-oncology services and, when necessary, psychiatric assessment and treatment, should be routinely provided in oncology departments of Chinese general hospitals.

Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China

There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight.

Mental health of the old- and new-generation migrant workers in China: who are at greater risk for psychological distress?

Rural-to-urban migrant workers (MWs) are a large vulnerable population in China and, recently, the new-generation MWs (those born in 1980 or later) have become the majority of this population. Examining difference in the epidemiology of poor mental health between the new- and old-generation (those born before 1980) MWs would facilitate mental health promotion efforts. However, very few related studies are available and they produced conflicting findings. This study investigated intergenerational difference in prevalence and correlates of psychological distress (PD) in MWs. A total of 3031 MWs (691 old- and 2340 new-generation MWs) completed a standardized questionnaire containing socio-demographic, migration-related, and work-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of 3 or higher was used to denote PD. PD was more prevalent in the new- than old-generation MWs (36.2% versus 28.2%, P < 0.001). The elevated risk of PD in the new- versus old-generation remained significant after controlling for potential confounders (OR=1.51, P < 0.001). For the new-generation, correlates for PD included low monthly income, recent two-week physical morbidity, migrating alone, poor Mandarin proficiency and long working hours; while for the old-generation, correlates for PD included low education, recent two-week physical morbidity, and having worked in many cities. The new-generation MWs are at higher risk for PD than the old-generation MWs. Mental health services for addressing the generation-specific needs may be an effective way to prevent or reduce PD of MWs.

Prevalence of Major Depression and Its Associations With Demographic and Clinical Characteristics and Quality of Life in Chinese Patients With HBV-related Liver Diseases

BACKGROUND

There are no data about the frequency of major depression in patients with liver disease related to Hepatitis B virus (HBV) in China. This study examined the prevalence of major depression and its clinical correlates and association with quality of life (QOL) in patients with HBV-related liver diseases.

METHOD

Altogether 634 patients with HBV-related liver diseases met study entry criteria and completed the survey. The diagnosis of major depression was established with the Mini International Neuropsychiatric Interview (MINI). Socio-demographic and clinical characteristics, Global Assessment of Functioning (GAF) and QOL were measured.

RESULTS

The prevalence of major depression was 6.4%. Multivariable logistic regression analyses revealed that insomnia (P=0.01, OR=5.5, 95%CI=1.4-21.6) and global functioning (P<0.001, OR=0.6, 95% CI=0.5-0.7) were independently associated with major depression. Major depression was associated with both poor physical (F _{(1, 634)}=4.0, P=0.04) and mental QOL (F _{(1, 634)}=26.2, P<0.001).

CONCLUSIONS

Given the negative impact of depression on patients' QOL, more attempts should be made to identify and treat it in HBV-related diseases.