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Yuan D, Li Q, Zhan N, Zhang L, Wang J, Liu M, Geng F. Longitudinal associations of menstrual characteristics with mental health problems among Chinese girls. Eur Child Adolesc Psychiatry 2024; 33:2547-2556. [PMID: 38150148 DOI: 10.1007/s00787-023-02345-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/28/2023] [Indexed: 12/28/2023]
Abstract
Cross-sectional studies indicate that menstrual problems are related to poorer mental health; however, longitudinal studies are limited. This longitudinal study aimed to determine whether baseline menstrual characteristics were risk factors for incident and persistent mental health problems. The study was conducted among Chinese adolescent girls. Menstrual characteristics including menarche, menstrual cycle and menstrual pain were assessed at baseline, whereas mental health problems including PTSD, depression, anxiety, ADHD, insomnia, psychotic-like experiences, non-suicidal self-injury, suicide ideation, suicide plan, and suicide attempt were assessed at baseline (n = 1039) and at the 1-year follow-up (n = 946) by self-administered, structured questionnaires. Multiple logistic regressions were performed to examine whether menstrual characteristics were associated with incident (e.g., PTSD at follow-up but not baseline) and persistent (e.g., PTSD at both time points) mental health problems. The results demonstrated that early menarche was related to persistence of psychotic-like experiences; irregular menstruation was associated with higher rates of incident anxiety and insomnia, and persistent depression, anxiety, ADHD, insomnia, non-suicidal self-injury, suicide ideation, and suicide plan; menstrual pain was associated with elevated rates of incident PTSD and depression, and persistent depression, insomnia, psychotic-like experiences, non-suicidal self-injury, suicidal ideation, suicide plan, and suicide attempt. In conclusion, irregular menstruation and menstrual pain specifically contributed to the development of emotional problems and insomnia, and were associated with maintenance of the most mental health problems in early adolescence. The long-term effects of menstrual problems on mental health need further study.
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Affiliation(s)
- Danyan Yuan
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Qiaoqiao Li
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Nalan Zhan
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Lan Zhang
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Jian Wang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Mingfan Liu
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China
| | - Fulei Geng
- School of Psychology, Jiangxi Normal University, 99 Ziyang Ave, Nanchang, 330022, Jiangxi, China.
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Shim J, Han S, Baek J. Factors influencing menstrual regularity among female workers: a cross-sectional analysis study. BMC Womens Health 2024; 24:299. [PMID: 38769497 PMCID: PMC11103980 DOI: 10.1186/s12905-024-03142-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 05/13/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Regularity of menstrual cycles is an important indicator of women's health and fertility, and female workers are exposed to several factors, such as sleep disorders, stress, and shift work, that affect their menstrual regularity. This makes it necessary to comprehensively identify the determinants of menstrual regularity. Therefore, this study identified the factors affecting menstrual regularity among female workers from physiological, psychological, and situational dimensions based on the theory of unpleasant symptoms. METHODS This was a secondary analysis of the 2010-2012 Korea National Health and Nutrition Examination Survey and utilized the data of 2418 female workers. Based on the theory of unpleasant symptoms, physiological factors included age, age at menarche, childbirth experience, body mass index, and sleep duration. Psychological factors included stress level, depressive mood, and suicidal ideation. Situational factors included education level, household income, consumption of alcohol, engagement in smoking, and work schedule. The χ²-test and hierarchical logistic regression analysis were performed, reflecting the complex sample design. RESULTS Age at menarche, childbirth experience, and body mass index among physiological factors and education level and work schedule among situational factors were found to be related to menstrual regularity. A higher risk of menstrual irregularities was found among those who had given birth (versus those who had not), had a high age at menarche (versus those with a low age at menarche), were obese (versus those who had a normal body mass index), had elementary school-level or lesser educational achievements (versus those with college graduate-level or higher educational achievements), and who had a shift work schedule (versus those with a fixed schedule). CONCLUSIONS Intervention is needed for female workers who have these risk factors, and special attention must be paid to female workers who have a shift work schedule. Additionally, since body mass index can be controlled, intervention concerning body mass index is necessary to reduce menstrual irregularity.
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Affiliation(s)
- Joohee Shim
- College of Nursing, Yeungnam University College, Daegu, Republic of Korea
| | - Seungwoo Han
- Department of Nursing, Kwangju Women's University, Gwangju, Republic of Korea
| | - Jihyun Baek
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University; Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Republic of Korea.
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54896, Republic of Korea.
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Liu X, Yang Y, Liu ZZ, Jia CX. Bidirectional associations between sleep problems and suicidal thought/attempt in adolescents: A 3-wave data path analysis. J Affect Disord 2024; 350:983-990. [PMID: 38244795 DOI: 10.1016/j.jad.2024.01.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE This longitudinal data analysis examined the bidirectional relationships between sleep problems and suicidal thought (ST)/attempt (SA) in a large sample of Chinese adolescents. METHODS A total of 6995 adolescents (mean age = 14.86 years and 51.4% males) participated in a 3-wave longitudinal study of behavior and health in Shandong, China. A self-administered questionnaire and standardized scales were used to assess ST, SA, sleep duration, insomnia, daytime sleepiness, and behavioral/emotional problems in 2015 (T1), 1 year later (T2), and 2 years later (T3). Path analyses were performed without and with adjustment for covariates, including gender, grade level, chronic diseases, cigarette smoking, alcohol use, anxiety/depressive symptoms, paternal education, and family economic status. RESULTS The prevalence rates of short sleep (<7 h/night), insomnia symptoms, and daytime sleepiness were 46.9-58.8%, 16.0-19.4%, and 25.1-25.3% at T1, T2, and T3, respectively. The rates of past-year ST and SA were 9.1-12.4% and 1.6-2.4% at T1, T2, and T3, respectively. Path analyses showed that short sleep, insomnia, and daytime sleepiness predicted subsequent ST, and vice versa. Daytime sleepiness and SA predicted each other 1 year later. Sleep problems and ST/SA in the previous year significantly predicted themselves in the follow-up year. STUDY LIMITATION All data were based on self-report. CONCLUSION Short sleep, insomnia, and daytime sleepiness all had bidirectional relationships with ST. Daytime sleepiness and SA were bidirectionally linked. Our findings suggest that interventions should be taken for both night sleep disturbances and daytime sleepiness to prevent suicide. Adverse sleep outcomes in suicidal adolescents should be assessed, which can in turn increase suicide risk.
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Affiliation(s)
- Xianchen Liu
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China; South China Normal University School of Psychology, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun 130024, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China
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Liu X, Yang Y, Liu ZZ, Jia CX. Life stress and suicidality mediated by insomnia and depressive symptoms in adolescents: a three-wave longitudinal study. Sleep 2024; 47:zsad121. [PMID: 37075813 DOI: 10.1093/sleep/zsad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/07/2023] [Indexed: 04/21/2023] Open
Abstract
STUDY OBJECTIVES Little empirical work has investigated the associations between life stress (LS), insomnia, depression, and suicidality in multi-wave longitudinal studies. With three waves of data collection 1-year apart, this longitudinal study with a large sample of adolescents examined the predicting effects of LS on suicidality 1-year later and 2 years later and the mediating roles of insomnia and depression in the LS-suicidality link. METHODS A total of 6995 adolescents (mean age = 14.86 years, 51.4% male) participated in a three-wave longitudinal study of behavior and health in Shandong, China. A self-administered structured questionnaire and standardized scales were used to assess suicidality (including suicidal thought [ST], suicide plan [SP], and suicide attempt [SA]), LS, insomnia, and depression in 2015 (T1), 1-year later (T2), and 2 years later (T3). Mediation effects were examined with path models. RESULTS The overall prevalence rates of past-year suicidality were 13.4% at T1, 10.0% at T2, and 9.5% at T3, respectively. The prevalence rates of suicidality across T1-T3 significantly increased with elevated levels of baseline LS, insomnia, and depression (p < .001). Path models indicated that the relationship between baseline LS and suicidal ideation (i.e., ST/SP) 2 years later was significantly mediated by both insomnia and depression. Depression was also a significant mediator between LS and SA. CONCLUSIONS LS is a significant predictor of suicidality 1-2 years later in adolescents. Depression mediates the association between LS and suicidal ideation and suicide attempt while insomnia appears to be a mediator for suicidal ideation rather than suicide attempt.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Zhen-Zhen Liu
- School of Psychology, Northeast Normal University, Changchun, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan, China
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Ma L, Jiang H, Han T, Shi Y, Wang M, Jiang S, Yang S, Yao L, Jia Q, Shao L. The menstrual cycle regularity and skin: irregular menstrual cycle affects skin physiological properties and skin bacterial microbiome in urban Chinese women. BMC Womens Health 2023; 23:292. [PMID: 37259058 DOI: 10.1186/s12905-023-02395-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/25/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND The regularity of the menstrual cycle directly affects women's health. Many studies have focused on menstrual health; however, menstrual cycle regularity-related variations in skin physiological characteristics and skin microbiota have been seldom investigated. METHODS To investigate the menstrual cycle regularity-related variations in skin physiological characteristics and skin microbiota of 197 cases of Chinese women aged 18-35 years living in shanghai in 2021. Based on a self-evaluation questionnaire, the volunteers were divided into three groups C1 (those with a regular menstrual cycle), C2 (those with a less regular menstrual cycle) and C3 (those with an irregular menstrual cycle). The physiological parameters of facial skin were measured by non-invasive methods and the skin microbiome was analyzed by 16S rRNA high-throughput sequencing. RESULTS In the C3 group, the hydration content was significantly decreased (p < 0.05), the TEWL was significantly increased (p < 0.05), and the sebum content was increased (p > 0.05), indicating that the skin barrier integrity weakened with increased menstrual cycle irregularity. Additionally, the melanin level, L value and b value were significantly decreased (p < 0.05) in the C3 group, but the a value was significantly increased (p < 0.001), which indicated that the skin color became darker. Furthermore, the skin microbiota diversity decreased with increasing cycle irregularity, but the differences were not significant. The skin microbiota composition showed that the proportion of Firmicutes, Acinetobacter, Staphylococcus and Cutibacterium were increased in those with an irregular menstrual cycle, indicating that alterations in the ratio of bacterial phyla and/or genera might disturb skin homeostasis. Spearman correlation analysis revealed strong correlations between the microbiota and skin physiological parameters. Based on the associations among hormones, skin physiological parameters and skin microbiota, it is possible that the skin physiological parameters, as well as the skin microbial diversity and composition, change with hormonal fluctuations during the menstrual cycle. CONCLUSIONS An irregular menstrual cycle can affect skin physiological characteristics and the skin microbiota. Female with an irregular menstrual cycle should strengthen skin care practices and use skin care products with moisturising and soothing effects to protect their skin.
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Affiliation(s)
- Laiji Ma
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, 201418, China
- The Oriental Beauty Valley Research Institute, Shanghai Institute of Technology, Shanghai, 201403, China
| | - Hong Jiang
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, 201418, China
- The Oriental Beauty Valley Research Institute, Shanghai Institute of Technology, Shanghai, 201403, China
| | - Tingting Han
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, 250101, Shandong, China
| | - Yanqin Shi
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, 201418, China
- The Oriental Beauty Valley Research Institute, Shanghai Institute of Technology, Shanghai, 201403, China
| | - Man Wang
- Shanghai Jiaotong University Affiliated Sixth People's Hospital, South Campus, Shanghai, 201499, China
| | - Shanshan Jiang
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, 250101, Shandong, China
| | - Suzhen Yang
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, 250101, Shandong, China
| | - Lingyun Yao
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, 201418, China
| | - Qingwen Jia
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, 250101, Shandong, China.
| | - Li Shao
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, 201418, China.
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Dong QY, Yang XF, Liu BP, Zhang YY, Wan LP, Jia CX. Menstrual pain mediated the association between daytime sleepiness and suicidal risk: A prospective study. J Affect Disord 2023; 328:238-244. [PMID: 36806594 DOI: 10.1016/j.jad.2023.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/05/2023] [Accepted: 02/11/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Adolescents with daytime sleepiness have been demonstrated to have a higher level of suicidal risk than those without. Currently, few studies had examined the pathway from daytime sleepiness to suicidal risk among female adolescents. This study aimed to explore the association among menstrual pain, daytime sleepiness, and suicidal risk among female adolescents in China. METHODS Of 7072 adolescents who participated in the follow-up survey of Shandong Adolescents Behavior & Health Cohort (SABHC), 3001 were female adolescents who had begun to menstruate and included for the analysis. A structured self-administrated questionnaire was used to measure menstrual pain, daytime sleepiness, suicidal risk and demographic characteristics. Participants were first surveyed in November-December 2015 and resurveyed 1 year later. RESULTS Of 3001 participants, 11.43 % had suicidal risk, 79.8 % experienced menstrual pain. Cross-lagged analysis showed that there was cause-and-effect relationship between menstrual pain and daytime sleepiness. Moderate (OR = 1.79, 95%CI: 1.22-2.63) and severe (OR = 2.73, 95%CI: 1.80-4.12) menstrual pain (follow-up) were associated with suicidal risk (follow-up). Daytime sleepiness (baseline: OR = 1.04, 95%CI: 1.02-1.06, follow-up: OR = 1.07, 95%CI: 1.05-1.09) had effects on suicidal risk (follow-up). Mediation analysis showed that menstrual pain played a partially mediating role between daytime sleepiness and suicidal risk, with the indirect effect being 0.002 (95%CI: 0.001-0.004). LIMITATIONS All data were self-reported. CONCLUSIONS Menstrual pain and daytime sleepiness had effects on each other, and they both were the risk factors of suicidal risk. Among female adolescents, the association between daytime sleepiness and suicidal risk could be partially mediated by menstrual pain. Releasing the menstrual pain of female adolescents with daytime sleepiness could reduce their suicidal risk.
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Affiliation(s)
- Qiu-Yue Dong
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Xiao-Fan Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Ying-Ying Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Li-Peng Wan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.
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Maekawa M, Miyamoto A, Ariyoshi H, Miura K. A Survey of the Menstrual Status of Female College Students. Healthcare (Basel) 2023; 11:healthcare11081108. [PMID: 37107942 PMCID: PMC10137779 DOI: 10.3390/healthcare11081108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Education about menstruation is a sensitive topic for young female students; providing appropriate knowledge is essential for maintaining and improving their health. The present study was conducted to collect data corresponding to different factors affecting health among young individuals; the menstrual status, exercise habits, sleep status, and body composition of these individuals as well as the relationships among these factors, were evaluated. Altogether, 200 female students responded to the survey; 129 completed all the physical measurement items. As a case study, face-to-face interviews regarding menstrual symptoms were conducted. Results showed that 49/200 (25%) and 120/200 (60%) participants experienced moderate or severe pain before and during menstruation, respectively. The degree of pain one week before menstruation and during menstruation were significantly positively correlated (r = 0.573, p < 0.01). When analyzed as group data, it was difficult to identify the relationship between menstrual status, exercise habits, and sleep status; these were found to be intricately associated with various factors. The case study analysis confirmed that some individuals experienced physical and psychological symptoms, such as irregular menstrual cycles, premenstrual syndrome, and severe menstrual cramps.
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Affiliation(s)
- Maki Maekawa
- Department of Physical Education, International Pacific University, 721 Kanonji, Seto-cho, Higashi-ku, Okayama 709-0863, Japan
| | - Aya Miyamoto
- Department of Physical Education, International Pacific University, 721 Kanonji, Seto-cho, Higashi-ku, Okayama 709-0863, Japan
| | - Hiromi Ariyoshi
- Ariyoshi Occupational Health Consultant Office, Fukuoka 815-0038, Japan
| | - Koji Miura
- Department of Physical Education, International Pacific University, 721 Kanonji, Seto-cho, Higashi-ku, Okayama 709-0863, Japan
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Shan J, Tian H, Zhou C, Wang H, Ma X, Li R, Yu H, Chen G, Zhu J, Cai Z, Lin C, Cheng L, Xu Y, Liu S, Zhang C, Luo Q, Zhang Y, Jin S, Liu C, Zhang Q, Lv L, Yang L, Chen J, Li Q, Liu W, Yue W, Song X, Zhuo C. Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders. Front Pharmacol 2022; 13:904908. [PMID: 35910343 PMCID: PMC9326357 DOI: 10.3389/fphar.2022.904908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022] Open
Abstract
There has been limited studies examining treatment-induced heavy menstrual bleeding (HMB) in women with severe mental illnesses. The aim of this study was to examine HMB prevalence and HMB-associated factors in young women (18–34 years old) diagnosed with bipolar disorder (BP), major depressive disorder (MDD), or schizophrenia (SCZ) who have full insight and normal intelligence. Eighteen-month menstruation histories were recorded with pictorial blood loss assessment chart assessments of HMB. Multivariate analyses were conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Drug effects on cognition were assessed with the MATRICS Consensus Cognitive Battery (MCCB). HMB prevalence were: BP, 25.85%; MDD, 18.78%; and SCH, 13.7%. High glycosylated hemoglobin (HbA1c) level was a strong risk factor for HMB [BP OR, 19.39 (16.60–23.01); MDD OR, 2.69 (4.59–13.78); and SCZ OR, 9.59 (6.14–12.43)]. Additional risk factors included fasting blood sugar, 2-h postprandial blood glucose, and use of the medication valproate [BP: OR, 16.00 (95%CI 12.74–20.22); MDD: OR, 13.88 (95%CI 11.24–17.03); and SCZ OR, 11.35 (95%CI 8.84–19.20)]. Antipsychotic, antidepressant, and electroconvulsive therapy use were minor risk factors. Pharmacotherapy-induced visual learning impairment was associated with HMB [BP: OR, 9.01 (95%CI 3.15–13.44); MDD: OR, 5.99 (95%CI 3.11–9.00); and SCZ: OR, 7.09 (95%CI 2.99–9.20)]. Lithium emerged as a protective factor against HMB [BP: OR, 0.22 (95%CI 0.14–0.40); MDD: OR, 0.30 (95%CI 0.20–0.62); and SCZ: OR, 0.65 (95%CI 0.33–0.90)]. In SCZ patients, hyperlipidemia and high total cholesterol were HMB-associated factors (ORs, 1.87–2.22). Psychiatrist awareness of HMB risk is concerningly low (12/257, 2.28%). In conclusion, prescription of VPA should be cautioned for women with mental illness, especially BP, and lithium may be protective against HMB.
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Affiliation(s)
- Jianmin Shan
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Hongjun Tian
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Haibo Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Xiaoyan Ma
- MECT Center, Sleep Disorder Center, Tianjin Anding Hospital, Tianjin, China
| | - Ranli Li
- MECT Center, Sleep Disorder Center, Tianjin Anding Hospital, Tianjin, China
| | - Haiping Yu
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Guangdong Chen
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Jingjing Zhu
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Ziyao Cai
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Chongguang Lin
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Langlang Cheng
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Congpei Zhang
- Inpatient Department of Harbin First Psychiatry Hospital, Harbin, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunshu Zhang
- Inpatient Department of Hebei Mental Health Center, Baoding, China
| | - Shili Jin
- Inpatient Department, Shandong Daizhuang Hospital, Jining, China
| | - Chuanxin Liu
- Institute of Psychiatry, Jining Medical University, Jinning, China
| | - Qiuyu Zhang
- Institute of Psychiatry, Jining Medical University, Jinning, China
| | - Luxian Lv
- Department of Psychiatry, Henan Psychiatry Hospital, Xinxiang, China
| | - Lei Yang
- Key Laboratory of Mental Health, Ministry of Health (Peking University) and National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jiayue Chen
- Department of Psychiatry, The First Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Qianchen Li
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Liu
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
| | - Weihua Yue
- Department of Psychiatry, The First Hospital Affiliated to Harbin Medical University, Harbin, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
| | - Chuanjun Zhuo
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Laboratory of Psychiatric-Neuroimaging-Genetic and Cor-morbidity, Tianjin Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
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Yue L, Cui N, Liu Z, Jia C, Liu X. Patterns of sleep problems and internalizing and externalizing problems among Chinese adolescents: A latent class analysis. Sleep Med 2022; 95:47-54. [DOI: 10.1016/j.sleep.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 04/10/2022] [Accepted: 04/17/2022] [Indexed: 10/18/2022]
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Depressive symptoms as a mediator between perceived social support and suicidal ideation among Chinese adolescents. J Affect Disord 2022; 302:234-240. [PMID: 35090945 DOI: 10.1016/j.jad.2022.01.061] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/09/2021] [Accepted: 01/11/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Little is known about the association between perceived social support (PSS) and suicidal ideation in Chinese adolescents. This study was to examine the association of perceived social support and suicidal ideation (SI) and the mediating role of depressive symptoms in a large sample of adolescents in China. METHOD A total of 11,831 adolescents who participated in the baseline Shandong Adolescent Behavior & Health Cohort were included for analysis. Perceived social support, depressive symptoms, and other variables were assessed by a self-administrated questionnaire. Path analysis was used to estimate the association between PSS, depressive symptoms, and suicidal ideation. RESULTS The prevalence rate of SI in the past year was 12.5%. Suicidal ideation and depressive symptoms were significantly associated with low PSS from family, friends, and significant others. Path analysis revealed that depressive symptoms partially mediated the relationship between PSS from family, friends, and significant others and suicidal ideation. After controlling for covariates, the mediation effect proportion of depressive symptoms on the associations between perceived social support from family, friends, and significant others and SI ranged from 19.20% to 62.12%. LIMITATIONS As this is a cross-sectional study, no causal relationship could be made. CONCLUSIONS Depressive symptoms partially mediated the association between perceived social support and suicidal ideation. Longitudinal research is needed to better understand the association between social support and suicidal ideation in adolescents.
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Liu X, Liu ZZ, Liu BP, Jia CX. Nightmare frequency and psychopathological problems in a large sample of Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 2022; 57:805-816. [PMID: 35064282 DOI: 10.1007/s00127-022-02224-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 01/06/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Nightmares are common, especially in pediatric populations and psychiatric patients. Nightmares are associated with daytime distress and negative health outcomes. The data on the prevalence and psychopathological profiles of nightmares in Chinese adolescents are limited. This study examined age and gender differences in nightmare frequency and associated psychopathological problems in a large sample of Chinese adolescents. METHODS A total of 11,831 adolescent students (mean age = 14.9, 12-18 years) participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort. Participants completed a self-administered questionnaire to report their nightmare frequency, trait anger, hopelessness, and multiple domains of behavioral/emotional problems. Univariate and multivariate analyses were performed to examine psychopathological problems in relation to nightmare frequency. RESULTS Of the sample, 45.2% reported having nightmares at least once in the past month and 7.9% at least once/week. Girls reported more frequent nightmares than boys. Nightmare frequency significantly declined with age for both boys and girls. Mean scores on trait anger, hopelessness, attention, internalizing problems, and externalizing problems significantly increased with nightmare frequency. Frequent nightmares (at least once/week) were significantly associated with 2-4-fold increased likelihood of behavioral/emotional problems after adjusting for adolescent and family covariates. CONCLUSION Nightmares are prevalent in Chinese adolescents. Frequent nightmares are associated with multiple domains of psychopathological problems. Assessment and intervention of frequent nightmares should be incorporated into routine clinical practice and mental health services in adolescents.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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12
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Hu L, Liu ZZ, Wang ZY, Jia CX, Liu X. Associations between pain and depressive symptoms: A longitudinal study of Chinese adolescents. J Affect Disord 2022; 299:675-681. [PMID: 34953924 DOI: 10.1016/j.jad.2021.12.095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 11/19/2022]
Abstract
AIMS Pain and depressive symptoms are prevalent in adolescents. Data on the association between pain and depressive symptoms in the general adolescent population are limited. The purpose of this study was to investigate the prospective associations of headache, stomachache, and other nonspecific pain with depressive symptoms in a large sample of Chinese adolescents. METHODS A total of 7072 adolescents who participated in the baseline survey and were followed up 1 year later were included in the prospective analysis. Participants completed a self-administered questionnaire to assess three types of pain (headache, stomachache, and other nonspecific pain) and demographics. Depressive symptoms were assessed by the Center for Epidemiology Studies Depression Scale. Logistic regression models were conducted to evaluate the associations between pain and depressive symptoms. RESULTS The prevalence and incidence rates of depressive symptoms significantly increased with elevated pain frequencies. After adjusting for insomnia symptoms and other adolescent and family covariates, frequent headache (OR=2.39, 95% CI =1.37-4.16) and other nonspecific pain (sometimes pain: OR=1.57, 95% CI =1.14-2.15; frequent pain: OR=2.78, 95% CI =1.33-5.82) were significantly associated with increased risk of depressive symptoms 1 year later. Study limitation: Pain and depressive symptoms were self-reports. CONCLUSIONS The findings suggest that frequent pain is associated with subsequent depressive symptoms. Further research is needed to determine the causal relationship between pain and depressive symptoms in adolescents.
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Affiliation(s)
- Lei Hu
- Shandong Mental Health Center, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; School of Psychology, Northeast Normal University, Changchun, China
| | - Zi-Yang Wang
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, United States.
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Zhuo C, Chen G, Lin C, Ping J, Zhu J, Wang L, Jin S, Liu C, Zhang Q, Yang L, Li Q, Zhou C, Cheng L, Tian H, Song X. Risk-to-befit ratios of consecutive antidepressants for heavy menstrual bleeding in young women with bipolar disorder or major depressive disorder. Front Psychiatry 2022; 13:1012644. [PMID: 36386987 PMCID: PMC9650378 DOI: 10.3389/fpsyt.2022.1012644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/06/2022] [Indexed: 11/24/2022] Open
Abstract
The occurrence of heavy menstrual bleeding (HMB) induced by pharmacological agents has been reported in young adult women. This study aimed to investigate a possible association between the occurrence rates of HMB and different treatment methods such as antidepressant agents alone and in combination with other pharmacological agents. The examined cohort included young women (age 18-35 years, n = 1,949) with bipolar disorder (BP) or major depressive disorder (MDD). Menstruation history for 24 months was recorded and evaluated according to pictorial blood loss assessment charts of HMB. Multivariate analyses were conducted to determine odds ratios (ORs) and 95% confidence intervals. The examined antidepressant agents had varying ORs for patients with BP vs. those with MDD. For example, the ORs of venlafaxine-induced HMB were 5.27 and 4.58 for patients with BP and MDD, respectively; duloxetine-induced HMB, 4.72 and 3.98; mirtazapine-induced HMB, 3.26 and 2.39; fluvoxamine-induced HMB, 3.11 and 2.08; fluoxetine-induced HMB, 2.45 and 1.13; citalopram-induced HMB, 2.03 and 1.25; escitalopram-induced HMB, 1.85 and 1.99; agomelatine-induced HMB, 1.45 and 2.97; paroxetine-induced HMB, 1.19 and 1.75; sertraline-induced HMB, 0.88 and 1.13; reboxetine-induced HMB, 0.45 and 0.45; and bupropion-induced HMB, 0.33 and 0.37, in each case. However, when antidepressant agents were combined with valproate, the OR of HMB greatly increased, with distinct profiles observed for patients with BP vs. those with MDD. For example, the ORs of HMB induced by venlafaxine combined with valproate were 8.48 and 6.70 for patients with BP and MDD, respectively; for duloxetine, 5.40 and 4.40; mirtazapine, 5.67 and 3.73; fluvoxamine, 5.27 and 3.37; fluoxetine, 3.69 and 4.30; citalopram, 5.88 and 3.46; escitalopram, 6.00 and 7.55; agomelatine, 4.26 and 5.65; paroxetine, 5.24 and 3.25; sertraline, 4.97 and 5.11; reboxetine, 3.54 and 2.19; and bupropion, 4.85 and 3.46, in each case. In conclusion, some antidepressant agents exhibited potential risks of inducing HMB. Therefore, a combined prescription of antidepressant agents and valproate should be carefully considered for young women with HMB.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China.,Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China.,Department of Psychiatry, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China.,Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Laboratory of Psychiatric-Neuroimaging-Genetic and Comorbidity, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Guangdong Chen
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chongguang Lin
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jing Ping
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jingjing Zhu
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Lina Wang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Comorbidity, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Shili Jin
- Inpatient Department, Shandong Daizhuang Hospital, Jining, China
| | - Chuanxin Liu
- College of Mental Disorder, Jining Medical University, Jining, China
| | - Qiuyu Zhang
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Lei Yang
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Qianchen Li
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Langlang Cheng
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Hongjun Tian
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Sleep Status and Menstrual Problems among Chinese Young Females. BIOMED RESEARCH INTERNATIONAL 2021; 2021:1549712. [PMID: 34734080 PMCID: PMC8560254 DOI: 10.1155/2021/1549712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/12/2021] [Indexed: 11/18/2022]
Abstract
Background The association between sleep disturbance and the menstruation in the young women population has been scarcely studied. The aim of this study is to assess the association between sleep status and phase of the menstrual cycle in healthy, young, ovulating women. Methods This cross-sectional study used the data collected from healthy young, ovulating Chinese females from September to December 2018. The association was analyzed by using linear regression and binary logistic analyses. Results 2260 women aged 17 to 30 were included in the analysis. The average sleep duration of the respondents was 7.24 hours (SD = 0.92). 61.7% of them admitted that they were accompanied by at least one of sleep symptoms including difficulty initiating sleep, difficulty maintaining sleep, dreaminess, early morning awakening, and somnolence. Sleep quality was significantly associated with dysmenorrhea (OR [95%CI] = 1.74 [1.40-2.17], P < 0.001) and self-awareness menstrual regularity (OR [95%CI] = 1.29 [1.06-1.56], P = 0.011). Conclusion This study found that poor sleep quality is significantly associated with dysmenorrhea and self-awareness menstrual irregularity among healthy, young, ovulating, Chinese females.
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Liu X, Liu ZZ, Jia CX. Repeat self-harm among Chinese adolescents: 1-year incidence and psychosocial predictors. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1979-1992. [PMID: 33861354 DOI: 10.1007/s00127-021-02085-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/07/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE Self-harm in adolescents is prevalent and is the most significant predictor of future self-harm and suicide. Longitudinal data on the incidence and predictors of repeat self-harm in the general population of adolescents are limited. This study investigated 1-year incidence and psychosocial predictors of repeat self-harm in Chinese adolescents. METHODS Shandong Adolescent Behavior and Health Cohort is a longitudinal study of behavior and health in adolescents in Shandong Province, China. Of 7072 participants who were assessed in 2015 and again 1 year later in 2016, 1879 reported a history of self-harm at the baseline survey and were included for this analysis. A self-administered structured questionnaire was used to assess behavioral and emotional problems, sleep, life stress, previous history of self-harm and suicidal thought, and family factors at baseline and self-harm at 1-year follow-up. RESULTS Mean age of the sample was 14.86 (SD 1.36) years and 54.6% were female. At 1-year follow-up, 22.1% participants engaged in repeat self-harm. Multiple logistic regression analyses showed that female gender (OR 1.45, 95% CI 1.11-1.89), alcohol use (OR 1.95, 95% CI 1.48-2.57), frequent nightmares (OR 1.61, 95% CI 1.14-2.28), elevated depression score (OR 1.59, 95% CI 1.05-2.42), and prior suicidal thought (OR 1.79, 95% CI 1.37-2.34) were independently and significantly associated with an increased risk of repeat self-harm. CONCLUSION More than one in five Chinese adolescents who had a history of self-harm engaged in self-harm at 1-year follow-up. Multiple psychosocial factors including female gender, alcohol use, frequent nightmares, depression, and prior suicidal thought appeared to be significant predictors of repeat self-harm. Our findings highlight the importance of comprehensive psychosocial assessment and intervention of repeat self-harm in adolescents.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Psychology, REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Park M, Jung SJ. Association between menstrual cycle irregularity and suicidal ideation among Korean women: Results from the Korea national health and nutrition examination survey (2010-2012). J Affect Disord 2021; 293:279-284. [PMID: 34225207 DOI: 10.1016/j.jad.2021.06.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/18/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND We aimed to evaluate the association between menstrual cycle irregularity and suicidal ideation in Korean women. METHODS Data on 5,606 women from the 2010-2012 Korea National Health and Nutrition Examination Survey, a population-based cross-sectional study, were included. Menstrual cycle irregularity, suicidal ideation, current occupational status, age at menarche, education level, household income, and marital status were assessed through questionnaires with trained interviewers. A multivariate logistic regression analysis was performed after adjusting for age, socioeconomic status, smoking and drinking status, age at menarche, comorbid diseases, and physical activity. RESULTS In the multivariate-adjusted models, we found significant associations between menstrual cycle irregularity and suicidal ideation (odds ratio [OR], 95% confidence interval [CI] = 1.44 [1.14-1.82]). This association was particularly noticeable in women aged 12 to 29 years (OR [95% CI] = 1.45 [1.04-2.03]), in those who had menarche at a relatively early age (aged 8-13 years) (OR [95% CI] = 1.60 [1.15-2.23]), and in those who were currently employed (OR [95% CI] = 1.46 [1.05-2.04]). LIMITATIONS Suicidal ideation was evaluated based on the participants' self-reports, and were therefore subjective in nature. Additionally, due to the cross-sectional design and use of retrospective data, causal relationships could not be drawn. CONCLUSION Women with irregular menstrual cycles were 1.42 times more likely to have suicidal ideation than those with regular cycles. More attention should be paid to menstrual cycle irregularity when attempting to improve levels of suicidal ideation.
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Affiliation(s)
- Minseo Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Sun Jae Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Kim SR, Lee S, Chung JH. Association between early menarche and suicidal behaviors in Korean girl adolescents. Medicine (Baltimore) 2021; 100:e27301. [PMID: 34559144 PMCID: PMC8462556 DOI: 10.1097/md.0000000000027301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/02/2021] [Indexed: 01/05/2023] Open
Abstract
Early menarche can be the socio-psychological problems. We studied the association between early menarche and suicidal risk behaviors among South Korean girl adolescents using national-wide data.Web-based self-report data from 2006 to 2015 the Korea Youth Risk Behavior Web-based Survey data were used in this study. Menarche status was divided into an "early menarche" group (at <12 years of age) versus "not early" menarche group (at ≥12 years of age).Participants with adolescent girls with early menarche group showed a higher prevalence of substance use, higher levels of stress, poorer self-rated health status, unhappier perceiveness, more frequent depressed mood, inter-sexual kissing or petting, inter-sexual intercourse, homosexual kissing or petting, being the victim or the assailant of sexual assaults, sexual transmitted diseases experience, pregnancy, and abortion experience than the not early menarche group. Adolescent girls with early menarche who had suicidal ideation (25.4% vs 22.2%, P < .001), suicidal plans (4.1% vs 2.6%, P < .001), and suicidal attempts (6.8% vs 5.2%, P < .001) were higher than that in the adolescent girls with not early menarche. A multivariate analysis after adjusting revealed that the odds ratios for suicidal ideation, plans, and attempts were 1.07 (95% confidence interval [CI]: 1.05-1.10), 1.35 (95% CI: 1.28-1.41), and 1.13 (95% CI: 1.09-1.18), respectively.Adolescent girl with early menarche was associated with suicidal behaviors.
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Affiliation(s)
- Soo Rim Kim
- Department of Obstetrics and Gynecology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Sujin Lee
- Department of Neurology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
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Liu X, Liu ZZ, Yang Y, Jia CX. Prospective Associations of Frequent Pain Symptoms With Suicidal Behavior in Adolescents. THE JOURNAL OF PAIN 2021; 22:852-863. [PMID: 33636372 DOI: 10.1016/j.jpain.2021.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/07/2021] [Accepted: 02/10/2021] [Indexed: 01/15/2023]
Abstract
Chronic pain and suicidal behavior are prevalent in adolescents. This longitudinal study examined the associations between pain symptoms and suicidal behavior in adolescents. A total of 7,072 adolescents participated in a follow-up study of behavior and health in Shandong, China. A self-administered structured questionnaire was used to assess pain symptoms (headache, stomachache, and other nonspecific pain), insomnia, anxiety/depression, substance use, stressful life events, prior suicidal behavior, and family environment in November-December in 2015. One year later, a follow-up survey was conducted. Mean age of the sample was 14.6 years, and half were female. Of the sample, 44.8% and 8.4% reported having one or more pain symptoms "sometimes" and "often", respectively. A total of 22.4% and 10.6% reported having lifetime suicidal behavior at baseline and subsequent suicidal behavior over the 1-year follow-up, respectively. Frequent pain was significantly associated with increased risk of suicidal behavior at baseline (OR=1.64, 95%CI=1.32-2.03) and during the subsequent year (OR=1.50, 95%CI=1.17-1.93) while adjusting for adolescent individual and family covariates. Among adolescents without a history of prior suicidal behavior, frequent pain was significantly associated with an approximately 70% increased risk of incident suicidal behavior (OR= 1.69, 95%CI=1.14-2.51). In conclusion, frequent pain appears to be predictive of adolescent suicidal behavior one year later. PERSPECTIVE: This article presents the prospective associations of frequent pain symptoms with suicidal behavior in adolescents. Frequent pain was associated with a 50-70% increased risk of suicidal behavior 1 year later. The finding underscores the importance of pain assessment and treatment in comprehensive suicide prevention efforts in adolescents.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Department of Psychology, REACH Institute, Arizona State University, Tempe, Arizona
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Liu X, Yang Y, Liu ZZ, Jia CX. Longitudinal associations of nightmare frequency and nightmare distress with suicidal behavior in adolescents: mediating role of depressive symptoms. Sleep 2021; 44:5866620. [PMID: 32614954 DOI: 10.1093/sleep/zsaa130] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/07/2020] [Indexed: 02/06/2023] Open
Abstract
STUDY OBJECTIVES Nightmares are a significant risk factor of suicidal behavior. This study examined the longitudinal associations of nightmare frequency and distress with suicidal thought (ST), suicide plan (SP), and suicide attempt (SA) and mediating role of depressive symptoms in adolescents. METHODS A total of 6,923 adolescents who participated in the 1-year follow-up of Shandong Adolescent Behavior & Health Cohort were included for the analysis. Participants completed a self-administered questionnaire to assess nightmares, sleep duration, insomnia, depressive symptoms, substance use, prior suicidal behavior, and family demographics in November-December in 2015. One year later, a follow-up survey was conducted to ask participants to report their depressive symptoms and suicidal behaviors. RESULTS Of the sample, 26.2% reported having frequent nightmares (at least twice/month) at baseline, and 10.0%, 3.6%, and 2.7% reported having ST, SP, and SA over 1-year follow-up. The rates of subsequent ST, SP, and SA all significantly increased with baseline nightmare frequency and distress. Path analyses showed that depressive symptoms played a significant mediating role in the associations of frequent nightmares and elevated nightmare distress with ST, SP, and SA before and after adjusting for adolescent and family covariates and prior suicidal behavior. CONCLUSIONS Suicidal risk increased with nightmare frequency and distress among adolescents. The association between nightmares and suicidal behavior was at least partially mediated by depressive symptoms. Assessing and intervening nightmares and depressive symptoms associated with nightmares may have important implications for preventing adolescent suicidal behavior.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL
| | - Zhen-Zhen Liu
- Shandong University School of Public Health, Jinan, China.,REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ
| | - Cun-Xian Jia
- Shandong University School of Public Health, Jinan, China
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Wang L, Liu X, Liu ZZ, Jia CX. Digital media use and subsequent self-harm during a 1-year follow-up of Chinese adolescents. J Affect Disord 2020; 277:279-286. [PMID: 32841829 DOI: 10.1016/j.jad.2020.05.066] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/02/2020] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Excessive digital media use is prevalent and has a negative impact on sleep, daytime functioning, and mental health in adolescents. We examined the prospective associations between digital media use and subsequent suicidal and non-suicidal self-harm. METHODS Shandong Adolescent Behavior & Health Cohort (SABHC) is a longitudinal study of adolescent behavior and health in Shandong, China. Participants included for the analysis were 7,072 SABHC adolescents who were initially assessed in 2015 and were reassessed in 2016. A self-administered structured questionnaire was used to measure digital media use (i.e., television watching, internet use, and mobile phone use) on weekdays and at the weekend, mental health, and self-harm. RESULTS Multivariable logistic regression analyses showed that daily internet use ≥2 h on weekdays (odd ratio (OR) = 1.86, 95% confidence interval(CI) = 1.25-2.76) and ≥3 h at the weekend (OR = 1.46, 95%CI = 1.06-2.00) and daily mobile phone use 2-3 h (OR = 1.46, 95%CI = 1.02-2.10) and ≥4 h (OR = 1.74, 95%CI = 1.20-2.51) at the weekend were significantly associated with increased risk of recurrent self-harm. Daily internet use ≥ 2 h on weekdays (OR = 1.81, 95%CI = 1.20-2.74) and ≥3 h at the weekend (OR = 1.55, 95%CI = 1.12-2.15), daily mobile phone use 1-2 h on weekdays (OR = 1.47, 95%CI = 1.02-2.12) and 2-3 h (OR = 1.49, 95%CI = 1.01-2.19) and ≥4 h (OR = 1.93, 95%CI = 1.31-2.85) at the weekend were significantly associated with increased risk of recurrent non-suicidal self-injury. Daily internet use 1-2 h on weekdays and 2-3 h at the weekend were significantly associated with increased risk of new suicide attempt (OR = 1.80, 95%CI = 1.07- 3.03) and recurrent suicide attempt (OR = 6.26, 95%CI = 1.31-29.88), respectively. LIMITATIONS All data were self-reported. CONCLUSIONS Excessive use of internet or mobile phone appears to be a significant risk factor of self-harm, suggesting that limiting adolescent use of internet and mobile phone may be beneficial to reduce risk of self-harm.
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Affiliation(s)
- Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, 76798, USA
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, 250012, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, 250012, China.
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Considering the Role of the Menstrual Cycle on Increased Suicidality in Adolescent Females. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42399-020-00566-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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22
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Ati NAL, Paraswati MD, Windarwati HD. What are the risk factors and protective factors of suicidal behavior in adolescents? A systematic review. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2020; 34:7-18. [DOI: 10.1111/jcap.12295] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/22/2020] [Accepted: 09/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Niken A. L. Ati
- School of Nursing, Faculty of Medicine Brawijaya University Malang Indonesia
| | - Mareta D. Paraswati
- School of Nursing, Faculty of Medicine Brawijaya University Malang Indonesia
| | - Heni D. Windarwati
- School of Nursing, Faculty of Medicine Brawijaya University Malang Indonesia
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Roberts E, Fraser A, Gunnell D, Joinson C, Mars B. Timing of menarche and self-harm in adolescence and adulthood: a population-based cohort study. Psychol Med 2020; 50:2010-2018. [PMID: 31456538 PMCID: PMC7525770 DOI: 10.1017/s0033291719002095] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/18/2019] [Accepted: 07/25/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous studies of pubertal timing and self-harm are limited by subjective measures of pubertal timing or by the conflation of self-harm with suicide attempts and ideation. The current study investigates the association between an objective measure of pubertal timing - age at menarche - and self-harm with and without suicidal intent in adolescence and adulthood in females. METHOD Birth cohort study based on 4042 females from the Avon Longitudinal Study of Parents and Children (ALSPAC). Age at menarche was assessed prospectively between ages 8 and 17 years. Lifetime history of self-harm was self-reported at ages 16 and 21 years. Associations between age at menarche and self-harm, both with and without suicidal intent, were examined using multivariable logistic regression. RESULTS Later age at menarche was associated with a lower risk of lifetime self-harm at age 16 years (OR per-year increase in age at menarche 0.87; 95% CI 0.80-0.95). Compared with normative timing, early menarche (<11.5 years) was associated with an increased risk of self-harm (OR 1.31, 95% CI 1.04-1.64) and later menarche (>13.8 years) with a reduced risk (OR 0.74, 95% CI 0.58-0.93). The pattern of association was similar at age 21 years (OR per-year increase in age at menarche 0.92, 95% CI 0.85-1.00). There was no strong evidence for a difference in associations with suicidal v. non-suicidal self-harm. CONCLUSIONS Risk of self-harm is higher in females with early menarche onset. Future research is needed to establish whether this association is causal and to identify potential mechanisms.
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Affiliation(s)
- Elystan Roberts
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Abigail Fraser
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Medical Research Council Integrated Epidemiology Unit at the University of Bristol, Bristol, UK
| | - David Gunnell
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Carol Joinson
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Becky Mars
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- Department of Population Health Sciences, University of Bristol, Bristol, UK
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24
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Sleep, premenstrual mood disorder, and women’s health. Curr Opin Psychol 2020; 34:43-49. [DOI: 10.1016/j.copsyc.2019.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/05/2019] [Accepted: 09/05/2019] [Indexed: 01/20/2023]
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25
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Lee D, Ahn IY, Park CS, Kim BJ, Lee CS, Cha B, Lee SJ, Seo JY, Choi JW. Early menarche as a risk factor for suicidal ideation in girls: The Korea youth risk behavior web-based survey. Psychiatry Res 2020; 285:112706. [PMID: 31810746 DOI: 10.1016/j.psychres.2019.112706] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 10/07/2019] [Accepted: 11/24/2019] [Indexed: 10/25/2022]
Abstract
Puberty, at which point girls experience menarche, is a biologically and psychologically unstable period. This study investigated the association between early menarche and suicidal ideation in girls. This study analyzed data from approximately 35,000 girls from the Korea Youth Risk Behavior Web-Based Survey every year from 2011 to 2015. The odds ratios of suicidal ideation were compared between the early and average menarche groups. Generally, the odds ratios of suicidal ideation in girls with early menarche were significantly higher than those with average menarche.
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Affiliation(s)
- Dongyun Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea; Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea.
| | - In-Young Ahn
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Chul-Soo Park
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea; Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Bong-Jo Kim
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea; Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Cheol-Soon Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea; Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea; Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - So-Jin Lee
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea; Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ji-Yeong Seo
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jae-Won Choi
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
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Liu X, Liu ZZ, Liu BP, Sun SH, Jia CX. Associations between sleep problems and ADHD symptoms among adolescents: findings from the Shandong Adolescent Behavior and Health Cohort (SABHC). Sleep 2019; 43:5650389. [DOI: 10.1093/sleep/zsz294] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/17/2019] [Indexed: 12/11/2022] Open
Abstract
Abstract
Study Objectives
Sleep problems and symptoms of attention-deficit hyperactivity disorder (ADHD) in adolescence are common. Little is known about the prospective the prospective associations between sleep and subsequent ADHD symptoms in adolescents. This study examined the prospective associations between sleep problems and subsequent ADHD symptoms in a large sample of adolescents.
Methods
Participants included 7072 adolescents from the Shandong Adolescent Behavior and Health Cohort (SABHC) study in Shandong, China. Participants were initially assessed in November–December of 2015 and were reassessed 1-year later in 2016. Sleep duration, sleep problems, and psychosocial information were collected using a structured questionnaire. ADHD symptoms were measured by the Achenbach Child Behavior Checklist-Youth Self-Report.
Results
At baseline, 7.6% participants had clinically relevant ADHD symptoms, which were highly comorbid with sleep problems including insomnia symptoms, poor sleep quality, symptoms of restless legs syndrome (RLS), frequent snoring, and short sleep duration. Of the 6531 participants without clinically relevant ADHD symptoms at baseline, 4.5% reported clinically relevant ADHD symptoms at 1-year follow-up. After adolescent and family covariates were adjusted for, insomnia (OR = 2.09, 95% CI = 1.45–3.02), RLS (OR = 1.47, 95% CI = 1.02–2.11), and frequent snoring (OR = 2.30, 95% CI = 1.36–3.90) were all significantly associated with subsequent ADHD symptoms.
Conclusion
ADHD symptoms and sleep problems are highly comorbid. Insomnia, RLS and frequent snoring appear to be significant predictors of subsequent ADHD symptoms. Our study highlights the importance of assessing and managing sleep problems for prevention and clinical treatment of ADHD symptoms in adolescence.
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Affiliation(s)
- Xianchen Liu
- School of Public Health, Shandong University, Jinan, China
- South China Normal University School of Psychology, Guangzhou, China
- University of Tennessee Health Science Center, Memphis
| | - Zhen-Zhen Liu
- School of Public Health, Shandong University, Jinan, China
| | - Bao-Peng Liu
- School of Public Health, Shandong University, Jinan, China
| | - Shi-Hua Sun
- Karolinska Institutet Psychiatry, Stockholm, Sweden
| | - Cun-Xian Jia
- School of Public Health, Shandong University, Jinan, China
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Xie X, Liu P, Chen T, Wang Y, Liu X, Ye P, Xiang W, Yan Z. Influence of the hypothalamus-pituitary-gonadal axis reactivation and corresponding surging sex hormones on the amplitude of low-frequency oscillations in early pubertal girls: A resting state fMRI study. J Affect Disord 2019; 256:288-294. [PMID: 31200166 DOI: 10.1016/j.jad.2019.05.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 04/11/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND There has been a myriad of neuroimaging studies that have suggested that pubertal stages and sex steroid fluctuations contribute to pubertal brain maturation. Investigations on the influence of hypothalamus-pituitary-gonadal (HPG) axis reactivation and the correlated elevated sex hormones on brain maturation have not unraveled these interactions to date. Here, we aimed to explore the impact of the reactivated HPG axis on spontaneous brain activity changes, by analyzing the amplitude of low-frequency fluctuation (ALFF) in developing girls aged 8-11 years old. METHODS The gonadotropin-releasing hormone (GnRH) stimulation test was used to determine the HPG axis status and categorize subjects into two groups (HPG+ or HPG- group). Intelligence quotient (IQ) and the parent-rated Child Behavior Checklist (CBCL) were used to evaluate cognitive and behavioral performance. Two-sample t-tests were used to compare intergroup differences, the relations between brain areas' activities, age and hormonal levels were conducted by Pearson or Spearman correlation analyses. RESULTS Compared with the HPG- group, the HPG+ group showed decreased ALFF values in the left superior temporal gyrus (STG) but increased ALFF values in the right superior frontal gyrus (SFG). In addition, in the HPG+ group, prolactin (PRL) levels were positively correlated with ALFF values in the right SFG, and there was significant negative correlation between ALFF values in the left STG and CBCL activities scores. LIMITATIONS Due to the cross-sectional design of the present study, further study is needed to determine the relationships between age, reawakening of the HPG axis and related sex hormones and spontaneous brain activity change. CONCLUSIONS These findings suggested that the reactivated HPG axis and elevated PRL level could affect changes in brain activity and this effect may be the neuroendocrine basis of mood, cognition, and social behavior changes in early pubertal girls.
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Affiliation(s)
- Xiaoling Xie
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Peining Liu
- Department of Child Healthcare, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Tao Chen
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Yu Wang
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Xiaozheng Liu
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Peipei Ye
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Wei Xiang
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Zhihan Yan
- Department of Radiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China.
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Prevalence of suicidal behaviour and associated factors in a large sample of Chinese adolescents. Epidemiol Psychiatr Sci 2019; 28:280-289. [PMID: 29022520 PMCID: PMC6998902 DOI: 10.1017/s2045796017000488] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS Suicidal behaviour is prevalent among adolescents and is a significant predictor of future suicide attempts (SAs) and suicide death. Data on the prevalence and epidemiological characteristics of suicidal behaviour in Chinese adolescents are limited. This study was aimed to examine the prevalence, characteristics and risk factors of suicidal behaviour, including suicidal thought (ST), suicide plan (SP) and SA, in a large sample of Chinese adolescents. METHOD This report represents the first wave data of an ongoing longitudinal study, Shandong Adolescent Behavior and Health Cohort. Participants included 11 831 adolescent students from three counties of Shandong, China. The mean age of participants was 15.0 (s.d. = 1.5) and 51% were boys. In November-December 2015, participants completed a structured adolescent health questionnaire, including ST, SP and SA, characteristics of most recent SA, demographics, substance use, hopelessness, impulsivity and internalising and externalising behavioural problems. RESULTS The lifetime and last-year prevalence rates were 17.6 and 10.7% for ST in males, 23.5 and 14.7% for ST in females, 8.9 and 2.9% for SP in males, 10.7 and 3.8% for SP in females, 3.4 and 1.3% for SA in males, and 4.6 and 1.8% for SA in females, respectively. The mean age of first SA was 12-13 years. Stabbing/cutting was the most common method to attempt suicide. Approximately 24% of male attempters and 16% of female attempters were medically treated. More than 70% of attempters had no preparatory action. Female gender, smoking, drinking, internalising and externalising problems, hopelessness, suicidal history of friends and acquaintances, poor family economic status and poor parental relationship were all significantly associated with increased risk of suicidal behaviour. CONCLUSIONS Suicidal behaviour in Chinese adolescents is prevalent but less than that previously reported in Western peers. While females are more likely to attempt suicide, males are more likely to use lethal methods. Multiple child and family factors are associated with suicidal behaviour. These findings highlight the importance of early screening and intervention of suicidal behaviour in Chinese adolescents.
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Liu BP, Wang XT, Liu ZZ, Wang ZY, Liu X, Jia CX. Stressful life events, insomnia and suicidality in a large sample of Chinese adolescents. J Affect Disord 2019; 249:404-409. [PMID: 30822663 DOI: 10.1016/j.jad.2019.02.047] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 12/12/2022]
Abstract
AIMS This study aimed to examine the associations between stressful life events, insomnia, and suicidality including suicidal ideation (SI), suicide plan (SP) and suicide attempt (SA) in a large sample of Chinese adolescents. METHODS A total of 11,831 adolescents who participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort were included for the analysis. Participants were sampled from 8 middle/high schools in 3 counties of Shandong, China. Participants completed a structured behavior and health questionnaire, including suicidality, demographics, depression/anxiety, stressful life events (SLEs), and insomnia in November-December 2015. A series of logistic regression models and mediation analyses were performed to examine the associations between SLEs, insomnia and suicidality. RESULTS The prevalence rates of overall suicidality, SI, SP and SA in the last year were 13.1%, 12.5%, 3.3%, and 1.5%, respectively. SLEs were significantly associated with overall suicidality, SI, and SP. Insomnia was an independent risk factor of suicidality and a mediator of the association between SLEs and suicidality. The total effect of SLEs on overall suicidality was 0.597 (95%CI: 0.534-0.661), including 0.457 (95%CI: 0.391-0.523) for direct effect and 0.158 (95%CI: 0.138-0.178) for indirect effect. Insomnia also mediated the associations of SLEs with SI, SP and SA, respectively. LIMITATIONS Causal relationship could not be concluded because this study is cross-sectional. CONCLUSIONS Stressful life events and insomnia are directly associated with suicidality in adolescents. The association between SLEs and suicidality is partially mediated by insomnia.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Xin-Ting Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Zhen-Zhen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Ze-Ying Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China; School of Psychology, South China Normal University, Shipai, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China; Shandong University Center for Suicide Prevention and Research, No.44, Wenhuaxi Rd, Lixia Dist, Jinan 250012, China.
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Wang ZY, Liu ZZ, Jia CX, Liu X. Age at menarche, menstrual problems, and daytime sleepiness in Chinese adolescent girls. Sleep 2019; 42:5373063. [DOI: 10.1093/sleep/zsz061] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/10/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ze-Ying Wang
- School of Public Health, Shandong University, Jinan, China
| | - Zhen-Zhen Liu
- School of Public Health, Shandong University, Jinan, China
| | - Cun-Xian Jia
- School of Public Health, Shandong University, Jinan, China
| | - Xianchen Liu
- School of Public Health, Shandong University, Jinan, China
- School of Psychology, South China Normal University, Guangzhou, China
- University of Tennessee Health Science Center, Memphis, TN
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Abstract
AIMS Suicidal behaviours in adolescents are prevalent and multifactorial. This study was conducted to examine the associations between exposure to suicide attempt (ESA) or suicide death (ESD) and suicidal behaviours in a large sample of Chinese adolescents. METHODS Participants included for the analysis were 11 831 adolescent students who participated in the baseline survey of the Shandong Adolescent Behavior and Health Cohort (SABHC). Participants were sampled from five middle and three high schools in three counties of Shandong province, China. A self-administered structured questionnaire was used to collect data on demographics, behavioural and emotional problems, family environment, suicidal behaviours (suicidal thought, plan and attempt), and history of ESA or death of a family member, relative, friend or close acquaintance. Based on the sources of exposure, the participants were divided into four groups: non-exposure, exposure from relatives only, exposure from friends/close acquaintances only (EFO) and exposure from both relatives and friends (ERF). Logistic regressions were used to examine the associations between ESA or ESD and suicidal behaviours. RESULTS Mean age of the participants was 14.97 ± 1.46 years and 50.9% were boys. Of the participants, 9.4% reported having ESA, and 6.6% reported having ESD. The prevalence rates of suicidal behaviours were significantly higher in adolescents who had been exposed to suicide attempt or death than those who had not. Multivariate logistic regressions showed that ESA and ESD were both significantly associated with increased risks of suicidal thought (ESA: OR = 1.96, 95% CI = 1.66-2.31; ESD: OR = 1.59, 95% CI = 1.31-1.94), plan (ESA: OR = 2.37, 95% CI = 1.84-3.05; ESD: OR = 1.62, 95% CI = 1.18-2.23) and attempt (ESA: OR = 2.73, 95% CI = 1.92-3.89; ESD: OR = 1.82, 95% CI = 1.18-2.82), respectively. When participants were exposed to suicide attempt, ERF and EFO groups had significantly higher risks of suicidal thought (ERF: OR = 2.61, 95% CI = 1.28-1.64; EFO: OR = 1.96, 95% CI = 1.64-2.36), plan (ERF: OR = 3.72, 95% CI = 2.04-6.78; EFO: OR = 2.31, 95% CI = 1.74-3.01) and attempt (ERF: OR = 4.83, 95% CI = 2.30-10.17; EFO: OR = 2.57, 95% CI = 1.73-3.81), respectively. CONCLUSIONS ESA or ESD was associated with increased risks of suicidal behaviours in adolescents. Exposure to suicidal behaviours of relatives and friends/close acquaintances appeared to have different influence on adolescent suicidal behaviours. Further research is warranted to examine the biological and psychosocial mechanisms between suicidal exposure and subsequent suicidal behaviours in adolescents.
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Liu X, Liu ZZ, Fan F, Jia CX. Menarche and menstrual problems are associated with non-suicidal self-injury in adolescent girls. Arch Womens Ment Health 2018; 21:649-656. [PMID: 29804155 DOI: 10.1007/s00737-018-0861-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/16/2018] [Indexed: 01/13/2023]
Abstract
Menstrual problems and non-suicidal self-injury (NSSI) are common in adolescent girls. This study examined whether onset of menstruation and menstrual problems were related to NSSI in Chinese female adolescents. A total of 5696 adolescent girls participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort (SABHC) study in Shandong, China. A structured questionnaire was used to ask about participants' lifetime and last-year NSSI, age at menarche, menstrual cycle interval, menstrual flow length, menstrual irregularity, period pain, body weight and height, and demographics. Impulsivity was assessed by the Eysenck I7 impulsiveness scale. Internalizing and externalizing problems were measured by the Youth Self-Report of Child Behavior Checklist. The mean age of the sample was 15.0 years (SD = 1.4). The prevalence of lifetime and last year NSSI were 28.1% and 21.4% in Chinese adolescent girls. After adjusting for adolescent and family covariates (age, body mass index, impulsivity, internalizing and externalizing problems, paternal education, and family economic status), onset of menstruation was significantly associated with increased risk of lifetime NSSI (OR = 1.62, 95%CI = 1.20-2.20) and last year NSSI (OR = 1.92, 95%CI = 1.37-2.67). Among adolescent girls who had menarche, often irregular menstruation and period pain were significantly and independently associated with lifetime NSSI (OR = 1.36, 95%CI = 1.03-1.79; OR = 1.29, 95%CI = 1.05-1.58) and last year NSSI (OR = 1.46, 95%CI = 1.07-1.98; OR = 1.29, 95%CI = 1.03-1.61). Our findings suggest that onset of menarche, irregular periods, and period pain appear to be associated with increased risk of NSSI. These findings highlight the importance of menstruation hygiene education and treatment of menstrual problems to reduce the risk of NSSI among adolescent girls.
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Affiliation(s)
- Xianchen Liu
- Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, No. 44, Wenhuaxi Rd, Lixia Dist, Jinan, 250012, China.
- School of Psychology, South China Normal University, Shipai, Guangzhou, 510631, China.
- The University of Tennessee Health Science Center, Memphis, TN, 38163, USA.
- Kelin Health Research, Montgomery, NJ, 08502, USA.
| | - Zhen-Zhen Liu
- Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, No. 44, Wenhuaxi Rd, Lixia Dist, Jinan, 250012, China
| | - Fang Fan
- School of Psychology, South China Normal University, Shipai, Guangzhou, 510631, China
| | - Cun-Xian Jia
- Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, No. 44, Wenhuaxi Rd, Lixia Dist, Jinan, 250012, China.
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Kim T, Nam GE, Han B, Cho SJ, Kim J, Eum DH, Lee SW, Min SH, Lee W, Han K, Park YG. Associations of mental health and sleep duration with menstrual cycle irregularity: a population-based study. Arch Womens Ment Health 2018; 21:619-626. [PMID: 29909508 DOI: 10.1007/s00737-018-0872-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 06/06/2018] [Indexed: 12/30/2022]
Abstract
This study aimed to examine whether the characteristics of mental health and sleep duration, alone or in combination, are associated with menstrual cycle irregularity. This population-based, cross-sectional study analyzed the data from 4445 women aged 19-49 years, who participated in the Korea National Health and Nutrition Examination Survey 2010-2012. A structured questionnaire was used to assess mental health characteristics, sleep duration, and menstrual cycle irregularity. A multivariable logistic regression analysis was performed. High stress, depressive mood, and suicidal ideation were associated with increased risk of menstrual cycle irregularity after adjusting for confounding variables (odds ratio [95% confidence interval] = 1.33 [1.07-1.65], 1.56 [1.17-2.07], and 1.37 [1.01-1.87], respectively). Short sleep duration (≤ 5 h a day) was significantly associated with higher odds of severe menstrual cycle irregularity with menstrual interval of greater than 3 months (2.67 [1.35-5.27]). Participants with sleep duration of ≤ 5 h a day with psychological stress, depressive mood, or suicidal ideation had higher odds of menstrual cycle irregularity (1.96 [1.26-3.05], 2.86 [1.50-5.44], and 2.25 [1.18-4.29]). This study suggests positive associations of mental health problems and short sleep duration with menstrual cycle irregularity among Korean female adults. Therefore, strategies to deal with psychological stress, depressive mood, and sleep duration are needed for improving the reproductive health of women suffering from menstrual disturbances.
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Affiliation(s)
- Taeryoon Kim
- Department of Family Medicine, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul, 02500, Republic of Korea
| | - Ga Eun Nam
- Department of Family Medicine, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul, 02500, Republic of Korea.
| | - Byoungduck Han
- Department of Family Medicine, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul, 02500, Republic of Korea
| | - Sung Jung Cho
- Department of Family Medicine, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul, 02500, Republic of Korea
| | - Junghun Kim
- Department of Family Medicine, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul, 02500, Republic of Korea
| | - Do Hyun Eum
- Department of Family Medicine, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul, 02500, Republic of Korea
| | - Sang Woo Lee
- Department of Family Medicine, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul, 02500, Republic of Korea
| | - Soon Hong Min
- Department of Family Medicine, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul, 02500, Republic of Korea
| | - Woohyun Lee
- Department of Family Medicine, Sahmyook Medical Center, 82, Mangu-ro, Dongdaemun-gu, Seoul, 02500, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Liu X, Liu ZZ, Wang ZY, Yang Y, Liu BP, Jia CX. Daytime sleepiness predicts future suicidal behavior: a longitudinal study of adolescents. Sleep 2018; 42:5184576. [DOI: 10.1093/sleep/zsy225] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Indexed: 01/25/2023] Open
Affiliation(s)
- Xianchen Liu
- Shandong University School of Public Health, Jinan, China
- South China Normal University School of Psychology, Guangzhou, China
- The University of Tennessee Health Science Center, Memphis, TN
| | - Zhen-Zhen Liu
- Shandong University School of Public Health, Jinan, China
| | - Ze-Ying Wang
- Shandong University School of Public Health, Jinan, China
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL
| | - Bao-Peng Liu
- Shandong University School of Public Health, Jinan, China
| | - Cun-Xian Jia
- Shandong University School of Public Health, Jinan, China
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Alvarado-Esquivel C. Association Between Suicidal Behavior and Clinical Features of Premenstrual Syndrome and Menstrual History: A Cross Sectional Study. J Clin Med Res 2018; 10:830-837. [PMID: 30344818 PMCID: PMC6188025 DOI: 10.14740/jocmr3571w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 09/17/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The link between suicidal behavior and premenstrual syndrome has been poorly studied. This study aimed to determine the association of suicide attempts, and suicidal ideation and signs and symptoms of premenstrual syndrome and menstrual history in women in Durango City, Mexico. METHODS Using a cross-sectional study design, 437 women were interviewed to obtain clinical data about their premenstrual period, menstrual history and suicidal behavior. Logistic regression was used to assess the association between suicide behavior and clinical features of women. Odds ratio (OR) adjusted by age, presence of mental illness, and residence area, and 95% confidence interval (CI) were obtained. RESULTS Of these women, 29 (6.6%) had a history of suicidal ideation, and 15 (3.4%) had a history of suicide attempts. Logistic regression showed that suicidal ideation was associated with the variables: presence of irregular periods (OR = 2.89; 95% CI: 1.10 - 7.55; P = 0.03), low back pain (OR = 4.57; 95% CI: 1.31 - 15.92; P = 0.01), desire to eat certain food or eat a lot (OR = 2.47; 95% CI: 1.10 - 5.57; P = 0.02), guilty feeling (OR = 2.43; 95% CI: 1.06 - 5.59; P = 0.03), and aggressiveness (OR = 3.19; 95% CI: 1.42 - 7.13; P = 0.005). Whereas logistic regression showed that a history of suicide attempts was associated with the variables: presence of irregular periods (OR = 9.57; 95% CI: 1.23 - 74.44; P = 0.03), and desire to eat certain food or eat a lot (OR = 3.08; 95% CI: 1.04 - 9.15; P =0.04). CONCLUSIONS In this first study on the link of suicide behavior and clinical features of premenstrual syndrome, results suggest that suicidal ideation and suicide attempts are associated to specific signs or symptoms of premenstrual syndrome. Further research to confirm the findings of this study is needed. Results might help for an optimal planning of preventive measures against suicide.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Laboratorio de Investigacion Biomedica, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Dgo, Mexico.
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Zhang L, Yang Y, Liu ZZ, Jia CX, Liu X. Sleep disturbance mediates the association between intrafamily conflict and mental health problems in Chinese adolescents. Sleep Med 2018; 46:74-80. [DOI: 10.1016/j.sleep.2018.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 02/03/2018] [Accepted: 02/05/2018] [Indexed: 11/30/2022]
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Suicidality, posttraumatic stress, and depressive reactions after earthquake and maltreatment: A cross-sectional survey of a random sample of 6132 chinese children and adolescents. J Affect Disord 2018; 232:363-369. [PMID: 29510354 DOI: 10.1016/j.jad.2018.02.081] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 02/07/2018] [Accepted: 02/25/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Surviving an earthquake can greatly increase the risk of suicidality among children and adolescents, especially if they experience physical and emotional neglect or abuse within the family after the earthquake. How various types of childhood adversity affect the vulnerability of adolescents to suicidality after exposure to a natural disaster is not well understood. This study examined the relationships among different types of earthquake exposure, childhood trauma, psychopathology and suicidality. METHODS Suicidality, the level of earthquake exposure, post-traumatic stress disorder (PTSD), depression, and maltreatment, including physical and emotional abuse and neglect, were assessed in 6132 child and adolescent survivors randomly selected from three primary schools, five junior high schools, two senior high schools and one six-year high school in Baoxing, Lushan and Tianquan counties, which were the areas most severely affected by the 2013 Ya'an earthquake. RESULTS The Suicidal Behaviors Questionnaire-Revised (SBQ-R) scores were high, with 27.8% of the participants scoring at or above the cut-off score of 7. Multivariate regression showed that emotional abuse and depression experienced after the earthquake contributed to the suicide risk, whereas emotional neglect and PTSD made somewhat smaller contributions. The mediation analysis suggested that PTSD and depression symptoms partially mediated the association of suicidality with emotional neglect or abuse. The PTSD, depression and suicidality scores were generally higher for females than for males, whereas the depression and suicidality scores were higher for older than younger respondents. CONCLUSIONS Our results highlight the need for the implementation of school-based, adolescent-centered suicide prevention programs in the long-term aftermath of exposure to traumatic events. Interventions may also need to be tailored to gender and developmental stage. Suicidality is independently associated with emotional abuse, neglect, depression and PTSD symptoms in this disaster-exposed young population. Longitudinal studies should explore whether depression and PTSD symptoms mediate the relationship between past emotional abuse or neglect and the current suicide risk.
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Liu ZZ, Chen H, Bo QG, Chen RH, Li FW, Lv L, Jia CX, Liu X. Psychological and behavioral characteristics of suicide attempts and non-suicidal self-injury in Chinese adolescents. J Affect Disord 2018; 226:287-293. [PMID: 29024902 DOI: 10.1016/j.jad.2017.10.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 09/24/2017] [Accepted: 10/01/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Suicide attempts (SA) and non-suicidal self-injury (NSSI) are prevalent in adolescents and important risk factors of suicide death. Both SA and NSSI are associated with multiple psychosocial, behavioral, biological and genetic factors. This study examined similarities and differences in psychological vulnerability and internalizing and externalizing problems between adolescents with SA and NSSI. METHODS Participants consisted of 11,831 students and had a mean age of 14.97 (SD = 1.46) years. Students completed a structured questionnaire to report their demographic information, psychological characteristics, internalizing and externalizing problems, SA and NSSI. Based on the history of NSSI and SA in the last year, the sample was divided into four groups: non-self-harm (NSH), NSSI only, SA only, and NSSI+SA. Multivariate analyses of covariance and post-hoc pairwise comparisons were performed for multiple comparisons. RESULTS Compared with NSH group, adolescents with either NSSI or SA scored significantly higher on trait anger, impulsiveness, hopelessness, internalizing and externalizing problems. NSSI+SA group and SA only group scored significantly higher than NSSI only group but both did not score significantly different on most psychological and behavioral variables. LIMITATIONS Limitations include reliance on self-reported measures and cross-sectional survey. CONCLUSIONS Psychological and behavioral profiles between adolescents with SA and NSSI are similar but are more severe in suicide attempters. The findings highlight the necessity of assessing psychological and behavioral problems for prevention and early intervention of adolescent self-harm.
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Affiliation(s)
- Zhen-Zhen Liu
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China
| | - Hua Chen
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China
| | - Qi-Gui Bo
- Centers for Disease Control and Prevention of Lijin County, Lijin 257400, China
| | - Ren-Hong Chen
- Centers for Disease Control and Prevention of Yanggu County, Yanggu 252300, China
| | - Feng-Wen Li
- Centers for Disease Control and Prevention of Zoucheng City, Zoucheng 273500, China
| | - Lei Lv
- Education bureau of Yanggu County, Yanggu 252300, China
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China.
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China; School of Psychology, South China Normal University, Shipai, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, United States.
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Liu X, Chen H, Liu ZZ, Fan F, Jia CX. Early Menarche and Menstrual Problems Are Associated with Sleep Disturbance in a Large Sample of Chinese Adolescent Girls. Sleep 2017. [PMID: 28645184 DOI: 10.1093/sleep/zsx107] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Study Objectives Little is known about the association between menstruation and sleep disturbance in adolescent girls. This study examined sleep duration, insomnia symptoms, and sleep quality in relation to age at menarche and menstrual problems in a large sample of Chinese adolescent girls. Methods This report represents the baseline data of an ongoing longitudinal study of the Shandong Adolescent Behavior & Health Cohort in Shandong, China. A total of 5800 girls aged 12-18 years (mean age = 15.0, standard deviation = 1.4) participated in the baseline survey. A structured questionnaire was used to assess participants' age at menarche, menstrual cycle interval, menstrual flow length, period irregularity, period pain, body weight and height, and demographics. Internalizing and externalizing problems were measured by the Youth-Self Report of Child Behavioral Checklist. Sleep duration, insomnia symptoms, and sleep quality were assessed by the items adapted from the Pittsburgh Sleep Quality Index. Results After adjusting for age, school, body mass index, internalizing and externalizing problems, and family covariates, irregular periods (odds ratio [OR] = 1.46, 95% confidence interval [CI] = 1.06-2.02), period pain (OR = 1.99, 95% CI = 1.44-2.76), and menstrual flow length ≥7 days (OR = 1.21, 95% CI = 1.00-1.48) were significantly associated with insomnia symptoms. Irregular periods (OR = 1.72, 95% CI = 1.30-2.27) and period pain (OR = 1.78, 95% CI = 1.34-2.37) were significantly associated with poor sleep quality. Age at menarche ≤11 years (OR = 1.62, 95% CI = 1.05-2.50) was significantly associated with insomnia symptoms in 12- to 14-year-old girls. Conclusions Our results suggest that irregular periods and period pain appear to be associated with sleep disturbance and that early menarche may have short-term impact on sleep in adolescent girls.
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Affiliation(s)
- Xianchen Liu
- Shandong University School of Public Health, Jinan, China.,South China Normal University School of Psychology, Guangzhou, China.,University of Tennessee Health Science Center, Memphis, TN
| | - Hua Chen
- Shandong University School of Public Health, Jinan, China
| | - Zhen-Zhen Liu
- Shandong University School of Public Health, Jinan, China
| | - Fang Fan
- South China Normal University School of Psychology, Guangzhou, China
| | - Cun-Xian Jia
- Shandong University School of Public Health, Jinan, China
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