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Liang Y, Wu M, Zou Y, Wan X, Liu Y, Liu X. Prevalence of suicide ideation, self-harm, and suicide among Chinese patients with schizophrenia: a systematic review and meta-analysis. Front Public Health 2023; 11:1097098. [PMID: 37200989 PMCID: PMC10186199 DOI: 10.3389/fpubh.2023.1097098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 04/04/2023] [Indexed: 05/20/2023] Open
Abstract
Aims Suicide ideation, self-harm, and suicide are common in patients with schizophrenia, but the reported prevalence vary largely across studies. Improved prevalence estimates and identification of moderators of the above self-directed violence are needed to enhance recognition and care, and to guide future management and research. This systematic review aims to estimate the pooled prevalence and identify moderators of suicide ideation, self-harm, and suicide among patients diagnosed with schizophrenia in China. Methods Relevant articles published until September 23, 2021, were searched using PubMed, EBSCO, Web of Science, Embase, Science Direct, CNKI, CBM, VIP, and Wanfang databases. Eligible studies published in English or Chinese which reported the prevalence of suicide ideation, self-harm, or suicide among Chinese patients with schizophrenia were collected. All studies passed a quality evaluation. This systematic review was registered with PROSPERO (registration number CRD42020222338). PRISMA guidelines were used in extracting and reporting data. Random-effects meta-analyses were generated using the meta package in R. Results A total of 40 studies were identified, 20 of which were evaluated as high-quality studies. Based on these studies, the prevalence of lifetime suicide ideation was 19.22% (95% CI: 7.57-34.50%), prevalence of suicide ideation at the time of investigation was 18.06% (95% CI: 6.49-33.67%), prevalence of lifetime self-harm was 15.77% (95% CI: 12.51-19.33%), and prevalence of suicide was 1.49% (95% CI: 0.00-7.95%). Multivariate meta-regression analysis revealed that age (β = - 0.1517, p = 0.0006) and dependency ratio (β = 0.0113, p < 0.0001) were associated with the lifetime prevalence of self-harm. Study assessment score (β = 0.2668, p < 0.0001) and dependency ratio (β = 0.0050, p = 0.0145) were associated with the lifetime prevalence of suicide ideation. Results of the spatial analysis showed that the prevalence of self-directed violence varied greatly across different provinces. Conclusion This systematic review provides estimates of the prevalence of self-directed violence among Chinese patients with schizophrenia and explores its moderators and spatial patterns. Findings also have important implications for allocating prevention and intervention resources to targeted high-risk populations in high prevalence areas.
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Affiliation(s)
- Yiying Liang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Manqi Wu
- Department of Social Medicine and Health Management, School of Public Health, Peking University, Beijing, China
| | - Yanqiu Zou
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaoyan Wan
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiang Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xiang Liu,
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Thematic analysis of the raters' experiences administering scales to assess depression and suicide in Arab schizophrenia patients. BMC Psychiatry 2022; 22:652. [PMID: 36271342 PMCID: PMC9587575 DOI: 10.1186/s12888-022-04313-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 10/16/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This study aimed to enhance the cultural adaptation and training on administering the Arabic versions of the Calgary Depression Scale in Schizophrenia (CDSS) and The International Scale for Suicidal Thinking (ISST) to Arab schizophrenia patients in Doha, Qatar. METHODS We applied the qualitative thematic analysis of the focus group discussions with clinical research coordinators (CRCs). Five CRCs met with the principal investigator for two sessions; we transcribed the conversations and analyzed the content. RESULTS This study revealed one set of themes related to the scales themselves, like the role of the clinician-patient relationship during administration, the semantic variations in Arabic dialects, and the design of scales to assess suicide and differentiate between negative symptoms and depression. The other set of themes is relevant to the sociocultural domains of Muslim Arabs, covering religion, families' roles, and stigma. It also covered the approaches to culturally sensitive issues like suicide, taboos in Islam, and the gender roles in Arab countries and their impact on the patients' reports of their symptoms. CONCLUSIONS Our results highlight several cultural and religious aspects to tackle when approaching schizophrenia patients through in-depth discussions and training to improve the validity of the assessment tools and treatment services.
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Mo PKH, So GYK, Lu Z, Mak WWS. The Mediating Role of Health-Promoting Behaviors on the Association between Symptom Severity and Quality of Life among Chinese Individuals with Mental Illness: A Cross-Sectional Study. Psychopathology 2022; 56:194-205. [PMID: 35901786 DOI: 10.1159/000525495] [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: 06/25/2021] [Accepted: 05/06/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Research has shown that people with mental illnesses (PMI) are found to show poorer lifestyle than the general population. Yet, the effect of their psychiatric symptoms in the association between gender difference, health-promoting behaviors, and quality of life have received little attention. The present study examined the association between symptom severity, health-promoting behaviors, and quality of life among PMI in Hong Kong. Gender difference on the association between these variables was also examined. METHOD A cross-sectional survey was conducted among 591 individuals with DSM-IV-TR Axis 1 diagnosis recruited from the community. RESULTS Results from MANOVA showed that PMI with more severe psychiatric symptoms engaged in a significantly lower level of health-promoting behaviors and reported a lower level of quality of life. Results from structural equation modeling showed that health-promoting behaviors mediated the association between psychiatric symptoms and quality of life. Multigroup analyses showed that the association between psychiatric symptoms and health-promoting behaviors was stronger among female participants, while the association between health-promoting behaviors and quality of life was stronger among male participants. DISCUSSION/CONCLUSION Despite clear evidence suggesting symptom severity to be negatively correlated with quality of life, the underlying mechanism has been less clear. There is a need to promote health-promoting behaviors in order to improve the quality of life of PMI. Gender-specific interventions are warranted.
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Affiliation(s)
- Phoenix K H Mo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Georgina Y K So
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhihui Lu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
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Rekhi G, Tay J, Lee J. Impact of drug-induced Parkinsonism and tardive dyskinesia on health-related quality of life in schizophrenia. J Psychopharmacol 2022; 36:183-190. [PMID: 34979813 DOI: 10.1177/02698811211055812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Both drug-induced Parkinsonism (DIP) and tardive dyskinesia (TD) have been shown to be associated with lower health-related quality of life (HRQOL) in schizophrenia, but few studies have examined their relative impact. AIMS This study aimed to examine and compare the association of DIP and TD with HRQOL in schizophrenia. METHODS In total, 903 patients with schizophrenia were assessed on the Positive and Negative Syndrome Scale (PANSS), Simpson-Angus Scale (SAS), and Abnormal Involuntary Movement Scale (AIMS). EuroQoL five-dimensional (EQ-5D-5L) utility scores were derived from PANSS scores via a previously validated algorithm and used as a measure of HRQOL. RESULTS In total, 160 (17.7%) participants had only DIP, 119 (13.2%) had only TD, and 123 (13.6%) had both DIP and TD. HRQOL was lowest for participants with both DIP and TD, followed by only DIP group, only TD group, and highest in the group with neither condition. HRQOL scores differed significantly between the four groups, F(3, 892) = 13.724, p < 0.001, ηp2 = 0.044). HRQOL of participants having only DIP or both DIP and TD was significantly lower than those having neither condition. There was no significant interaction between the presence of DIP and TD on the association with HRQOL. CONCLUSIONS DIP was the main antipsychotic-induced movement disorder associated with a poorer HRQOL in patients with schizophrenia. Therefore, clinicians should focus on prevention, detection, and effective management of DIP to optimize HRQOL in patients with schizophrenia.
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Affiliation(s)
- Gurpreet Rekhi
- Research Division, Institute of Mental Health, Singapore
| | - Jenny Tay
- Research Division, Institute of Mental Health, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore.,North Region & Department of Psychosis, Institute of Mental Health, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Coentre R, Fonseca A, Mendes T, Rebelo A, Fernandes E, Levy P, Góis C, Figueira ML. Suicidal behaviour after first-episode psychosis: results from a 1-year longitudinal study in Portugal. Ann Gen Psychiatry 2021; 20:35. [PMID: 34229687 PMCID: PMC8262034 DOI: 10.1186/s12991-021-00356-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/30/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Suicide is one of the main causes of excess of premature death in psychotic patients. Published studies found that suicide risk begins in ultra-high risk of psychosis and continues in early years of the disease. Previous studies identifying predictive and risk factors associated with suicidality in first-episode psychosis (FEP) are highly inconsistent. Also, there are relatively few longitudinal studies on suicidal behaviour in FEP. The aim of this study was to examine prevalence, evolution and predictors of suicidal behaviour at baseline and the 12-month follow-up in patients presenting with FEP. METHODS One hundred and eighteen patients presenting with FEP were recruited from two early psychosis units in Portugal. A comprehensive assessment examining socio-demographic and clinical characteristics was administered at baseline and the 12-month follow-up. Odds ratio were calculated using logistic regression analyses. McNemar test was used to evaluate the evolution of suicidal behaviour and depression prevalence from baseline to 12 months of follow-up. RESULTS Follow-up data were available for 60 participants from the 118 recruited. Approximately 25.4% of the patients had suicidal behaviour at the baseline evaluation, with a significant reduction during the follow-up period to 13.3% (p = 0.035). A multivariate binary logistic regression showed that a history of suicidal behaviour and depression at baseline independently predicted suicidal behaviour at baseline, and a history of suicidal behaviour and low levels of total cholesterol predicted suicidal behaviour at the 12-month follow-up. A significant proportion of patients also had depression at the baseline evaluation (43.3%), with the last month of suicidal behaviour at baseline independently predicting depression at this time. CONCLUSIONS The findings of our study indicate that suicidal behaviour was prevalent on the year after FEP. Patients with a history of suicidal behaviour, depression at baseline and low levels of cholesterol should undergo close evaluation, monitoring and possible intervention in order to reduce suicide risk in the early phases of psychosis.
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Affiliation(s)
- Ricardo Coentre
- Department of Psychiatry, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035, Lisboa, Portugal.
- Psychiatric University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisboa, Portugal.
| | - Alexandra Fonseca
- Department of Psychiatry, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035, Lisboa, Portugal
| | - Tiago Mendes
- Department of Psychiatry, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035, Lisboa, Portugal
- Psychiatric University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisboa, Portugal
| | - Ana Rebelo
- Department of Psychiatry, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035, Lisboa, Portugal
| | - Elisabete Fernandes
- Biomathematics Laboratory, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisboa, Portugal
| | - Pedro Levy
- Department of Psychiatry, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035, Lisboa, Portugal
| | - Carlos Góis
- Department of Psychiatry, Centro Hospitalar Universitário Lisboa Norte, Av Prof. Egas Moniz, 1649-035, Lisboa, Portugal
- Psychiatric University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisboa, Portugal
| | - Maria Luísa Figueira
- Psychiatric University Clinic, Faculdade de Medicina, Universidade de Lisboa, 1649-028, Lisboa, Portugal
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Huang Y, Wu K, Jiang R, Zeng X, Zhou S, Guo W, Feng Y, Zou C, Li H, Li T, Ning Y, Yang M, Wu F. Suicide Attempts, Neurocognitive Dysfunctions and Clinical Correlates in Middle-Aged and Elderly Chinese Schizophrenia Patients. Front Psychiatry 2021; 12:684653. [PMID: 34122196 PMCID: PMC8192965 DOI: 10.3389/fpsyt.2021.684653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/03/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Suicide is a common and complex symptom of schizophrenia that may be related to clinical variables and neurocognitive function. This study aimed to investigate the associated correlates of suicide attempts in Chinese middle-aged and elderly inpatients with schizophrenia, including demographic and clinical characteristics and cognitive level, which has not yet been reported. Methods: A total of 426 schizophrenia inpatients were recruited for this study. Clinical symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). Neurocognitive function was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Results: The prevalence of suicide attempts in middle-aged and elderly Chinese schizophrenia patients was 13.3%. Female patients had a higher suicide rate than male patients. Patients with suicide attempts had significantly higher PANSS-positive subscores, depressive subscores, and RBANS-story recall than non-attempter patients (all p < 0.05). Multiple logistic regression showed that gender, positive subscore, depressive subscore and RBANS-story recall (OR = 1.10-2.19, p < 0.05) were independently associated with suicide attempts in middle-aged and elderly schizophrenia patients. Conclusions: Our study showed that the rate of suicide attempts in Chinese middle-aged and elderly schizophrenia patients is high. Compared to non-attempters, there are less cognitive impairments, more clinical symptoms, and more female patients in the suicide attempters.
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Affiliation(s)
- Yuanyuan Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kai Wu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology (SCUT), Guangzhou, China
| | - Rui Jiang
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | - Xiaoying Zeng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,New Growth of Guangzhou, Guangzhou, China
| | - Sumiao Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weijian Guo
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yangdong Feng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Caimei Zou
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hehua Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ting Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Mingzhe Yang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
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7
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Suicide Behavior and Its Predictors in Patients with Schizophrenia in Ethiopia. SCHIZOPHRENIA RESEARCH AND TREATMENT 2021; 2021:6662765. [PMID: 33868728 PMCID: PMC8032509 DOI: 10.1155/2021/6662765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/12/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND People with schizophrenia (PWS) are at greater risk of suicide. However, suicide behaviors that occur in PWS are often overlooked, inadequately characterized, and not consistently integrated into treatment. Despite this burden and consequences in Ethiopia, there is a dearth of studies concerning suicide behavior in PWS. Therefore, this study is aimed at assessing the magnitude of suicide behavior and its predictors among PWS in Ethiopia. METHODS An institution based cross-sectional study was employed. Data were collected using the structured interviewer-administered questionnaire from a sample of 300 PWS at Amanuel Mental Specialized Hospital (AMSH). The revised version of Suicide Behavior Questionnaire (SBQ-R) was used to assess suicide behavior in PWS. The data was collected from March 1 to 30, 2019. Binary logistic regression was performed to identify independent predictors of suicidal behavior at 95% confidence level. Statistical significance was declared at p value <0.05. RESULT A total of 300 patients with schizophrenia participated in the study. More than two-thirds of 203 (67.7%) of the participants were males, and 116 (38.7%) participants were between the ages of 28 and 37 years. We found that the prevalence of suicide behavior among PWS was 30.3%. Being unemployed (AOR = 3.65, CI = 1.32, 10.05), family history of suicide (AOR = 3.16, CI = 1.38, 7.23), substance use (AOR = 2.51, CI = 1.13, 5.59), current positive psychotic symptoms (hallucination (AOR = 6.39, CI = 2.86, 14.29), and delusion (AOR = 4.15, CI = 1.95, 14.29) and presence of comorbid depression (AOR = 4.81, CI = 1.98, 11.68) were independent significant predictors with suicidal behavior in PWS. CONCLUSION The prevalence of suicidal behavior among PWS was found to be high. Hence, designing strategies for early screening and intervention is the most critical prevention strategy of suicide in PWS.
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Hui L, Hu WM, Zhu ZH, Gao ST, Han M, Fan Y, Tian Q, Yin XY, Yuan Y, Jiang CX, Yin GZ, Jia QF, Zhang XY. Association between dopamine beta-hydroxylase polymorphism and attention function in suicide attempters with chronic schizophrenia. Hum Psychopharmacol 2020; 35:1-8. [PMID: 32896003 DOI: 10.1002/hup.2755] [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: 11/13/2019] [Revised: 07/13/2020] [Accepted: 08/03/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Patients with schizophrenia are at a higher risk for suicide compared with the general population. Dopamine beta-hydroxylase (DβH) plays a key role in the conversion of dopamine to norepinephrine, which is related to suicidal behavior and cognitive regulation. OBJECTIVE To examine whether there is the effect of DβH 5'-insertion/deletion (Ins/Del) polymorphism on cognitive performance in suicide attempters with chronic schizophrenia. METHODS This polymorphism was detected in 114 suicide attempters and 617 non-suicide attempters with chronic schizophrenia. Cognitive performance was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). RESULTS The allelic and genotypic frequencies of this polymorphism between two groups did not differ after controlling for covariates (both, p > .05). There were no differences in RBANS scores between two groups after adjusting for covariates (all, p > .05). However, based on the genotype grouping in suicide attempters and non-attempters, the attention score significantly differed after adjusting for covariates (both, p < .05). Further analysis indicated that this polymorphism was associated with attention score in suicide attempters (p < .05), but not in non-suicide attempters (p > .05). CONCLUSIONS DβH 5'-Ins/Del polymorphism was not a risk locus of suicide attempters, but it was implicated in attention regulation in suicide attempters with chronic schizophrenia.
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Affiliation(s)
- Li Hui
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Wei Ming Hu
- Mental Health Center of Yanqing District, Beijing, China
| | - Zhen Hua Zhu
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | | | - Mei Han
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Yu Fan
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Qing Tian
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xu Yuan Yin
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Ying Yuan
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Cai Xia Jiang
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Guang Zhong Yin
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Qiu Fang Jia
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiang Yang Zhang
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.,Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Chau RMW, Tsui AYY, Wong EYW, Cheung EYY, Chan DYC, Lau PMY, Ng RMK. Effectiveness of a structured physical rehabilitation program on the physical fitness, mental health and pain for Chinese patients with major depressive disorders in Hong Kong - a randomized controlled trial with 9-month follow-up outcomes. Disabil Rehabil 2020; 44:1294-1304. [PMID: 32772583 DOI: 10.1080/09638288.2020.1800833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The long-term and specific impacts on the physical and mental health for Chinese people with major depressive disorders (MDD) are not well-studied. The aim of the study is to investigate both short-and long-term effects of a structured physical rehabilitation program on the physical and mental health and pain for Chinese patients with MDD. METHODS 84 Chinese patients with MDD were randomized to intervention (n = 42) or control group (n = 42). Intervention group received a 12-week physical rehabilitation program and the control group with 12-week waiting period followed the same pathway as the intervention group afterwards for longitudinal analysis. Data were collected at baseline (T1), end of 12-week program (T2) and 9-month follow-up period (T3). RESULTS Significant pre- and post-intervention improvements were noted in cardiopulmonary function, depressive symptoms, pain, body composition, muscle strength and flexibility for the intervention group. Although mild attenuation is noted from T2 to T3, subjects without exercise habit experienced significant decline in cardiopulmonary function, depressive symptoms and pain (p < 0.05) but not in those who developed exercise habit (p > 0.05). CONCLUSION Structured physical rehabilitation program could improve physical and mental fitness and pain for Chinese MDD patients. Its effects could be sustained up to 9 months after cessation of the program provided that people establish their own exercise habit.IMPLICATIONS FOR REHABILITATIONExercise is an effective means of improving physical and mental health and pain for people with major depressive disorders (MDD).People with MDD have multiple reasons, both physically and psychosocially, for physical deconditioning and hurdles for exercise.Structured supervised exercise program can enhance physical and mental health and may likely enhance exercise compliance in this population.
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Affiliation(s)
| | - Amy Ying Yu Tsui
- Physiotherapy Department, Kowloon Hospital, Hong Kong, Hong Kong SAR
| | - Eva Yee Wah Wong
- Physiotherapy Department, Kowloon Hospital, Hong Kong, Hong Kong SAR
| | | | | | - Polly Mo Yee Lau
- Physiotherapy Department, Kowloon Hospital, Hong Kong, Hong Kong SAR
| | - Roger Man Kin Ng
- Department of Psychiatry, Kowloon Hospital, Hong Kong, Hong Kong SAR
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Zhong Y, Xia L, Zhao TT, Zhang YL, Zhang YL, Li WZ, Hu YQ, Yao XH, Ungvari GS, Balbuena L, Liu HZ, Xiang YT. The Prevalence of Suicide Attempts and Independent Demographic and Clinical Correlates among Chronic Schizophrenia Patients in Agricultural Areas of China. Psychiatr Q 2019; 90:683-691. [PMID: 31102121 DOI: 10.1007/s11126-019-09644-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study investigated the lifetime prevalence of suicide attempts (SA) and independent demographic and clinical correlates in stabilized schizophrenia inpatients. A cross-sectional study was conducted in three psychiatric hospitals in Anhui province, an agricultural province located in east China. Psychopathology and depressive symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and Hamilton Depression Rating Scale (HAMD), respectively. A total of 315 stable schizophrenia inpatients were interviewed prior to discharge. The lifetime prevalence of SA was 22.2%. Multiple logistic regression analysis revealed that female gender (P < 0.001, OR = 3.4, 95%CI: 1.9-6.0), being married (P = 0.02, OR = 2.2, 95%CI: 1.1-4.4) and having more severe depressive symptoms (P = 0.014, OR = 1.2, 95%CI: 1.01-1.3) were independently and significantly associated with higher risk of SA. Lifetime SA is common among hospitalized schizophrenia patients living in agricultural areas of China. For suicide prevention, regular assessments, appropriate interventions and clinical management should be integrated into a community-based psychiatric service model for this population.
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Affiliation(s)
- Yi Zhong
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Tong-Tong Zhao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Yu-Long Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Ye-Lei Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Wen-Zheng Li
- Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China.,Hefei Fourth People's Hospital, Anhui Province, China
| | - Yan-Qiong Hu
- Hefei Fourth People's Hospital, Anhui Province, China
| | - Xian-Hu Yao
- MaAnshan Fourth People's Hospital, Anhui Province, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia / Graylands Hospital, Perth, Australia.,Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| | - Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Huan-Zhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China. .,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau, SAR, China.
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11
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Abstract
AIMS Suicide attempt is an important indicator of suicide and potential future mortality. However, the prevalence of suicide attempts has been inconsistent across studies. This meta-analysis aimed to examine the prevalence of suicide attempts in individuals with schizophrenia and associated correlates. METHODS Relevant publications in Embase, PsycINFO, PubMed, Web of science and Cochrane were systematically searched. Data on the prevalence of suicide attempts in individuals with schizophrenia were pooled using a random-effects model. RESULTS Thirty-five studies with 16 747 individuals with schizophrenia were included. The pooled lifetime prevalence of suicide attempts was 26.8% (95% CI 22.1-31.9%; I2 = 97.0%), while the 1-year prevalence, 1-month prevalence and the prevalence of suicide attempts from illness onset were 3.0% (95% CI 2.3-3.7%; I2 = 95.6%), 2.7% (95% CI 2.1-3.4%; I2 = 78.5%) and 45.9% (95% CI 42.1-49.9%; I2 = 0), respectively. Earlier age of onset (Q = 4.38, p = 0.04), high-income countries (Q = 53.29, p < 0.001), North America and Europe and Central Asia (Q = 32.83, p < 0.001) were significantly associated with a higher prevalence of suicide attempts. CONCLUSIONS Suicide attempts are common in individuals with schizophrenia, especially those with an early age of onset and living in high-income countries and regions. Regular screening and effective preventive measures should be implemented as part of the clinical care.
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Abstract
AIMS Suicide-related behaviours are common in schizophrenia and are significantly associated with premature death. The objective of this meta-analysis study was to estimate the pooled prevalence of suicide-related behaviours in schizophrenia patients in China. METHODS The relevant literature was searched systematically via the relevant electronic databases (PubMed, Embase, PsycINFO, Chinese National Knowledge Infrastructure, Wanfang Databases and Chinese Biological Medical Literature Database) from their inception until 14 September 2016. Only original studies that reported the prevalence of suicide-related behaviours including suicidal ideation (SI), suicide plan, suicide attempt (SA) and completed suicide were selected. RESULTS Nineteen articles met the inclusion criteria and were analysed. The pooled lifetime prevalence of SI and SA were 25.8% (95% CI 14.7-41.1%) and 14.6% (95% CI 9.1-22.8%), respectively. The 1-month prevalence of SI was 22.0% (95% CI 18.2-26.4%). Subgroup analyses of lifetime SI and SA showed that gender, sample size, survey year, study location and source of patients have no significant mediating effects on the results. CONCLUSIONS Suicide-related behaviours are common in Chinese schizophrenia patients. Due to the high mortality risk, regular screening and effective suicide prevention programmes are warranted.
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13
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Lien YJ, Chang HA, Kao YC, Tzeng NS, Yeh CB, Loh CH. Self-Stigma Mediates the Impact of Insight on Current Suicide Ideation in Suicide Attempters with Schizophrenia: Results of a Moderated Mediation Approach. Suicide Life Threat Behav 2018; 48:661-676. [PMID: 28869800 DOI: 10.1111/sltb.12384] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/28/2017] [Indexed: 12/12/2022]
Abstract
This study examined the relationships among insight, self-stigma, self-esteem, hope, quality of life, and suicidal behavior in individuals diagnosed as having schizophrenia. Hypotheses concerning mediating and moderating effects were examined. A total of 170 community-dwelling patients with schizophrenia participated in the study. The results revealed a negative association between insight and suicide ideation, which was partially mediated by self-stigma. Moreover, this indirect link was stronger among patients with suicide attempts than among those without attempts. We discuss the implications of these results for preventing or reducing the considerable risks of suicide in this population.
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Affiliation(s)
- Yin-Ju Lien
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan.,Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan.,Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan.,Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan
| | - Ching-Hui Loh
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
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14
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Quality of Life-a Goal for Schizophrenia's Therapy. CURRENT HEALTH SCIENCES JOURNAL 2018; 44:122-128. [PMID: 30746158 PMCID: PMC6320457 DOI: 10.12865/chsj.44.02.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/27/2018] [Indexed: 12/03/2022]
Abstract
Quality of Life (QOL) assessment represents a good instrument to monitor the evolution of schizophrenia and the treatment’s outcomes. The present study has evaluated the relationship between the level of the QOL and different socio-demographical and clinical factors. Lower QOL for schizophrenic persons was influenced by the severity of symptoms and cognitive deficits, while same low level of QOL could be considered an indicator for suicidal behavior. The correct therapeutically management of individuals with schizophrenia could lead to better outcomes in terms of life satisfaction of patients and response to the treatment’s strategies.
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15
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Balazs J, Miklosi M, Halasz J, Horváth LO, Szentiványi D, Vida P. Suicidal Risk, Psychopathology, and Quality of Life in a Clinical Population of Adolescents. Front Psychiatry 2018; 9:17. [PMID: 29459834 PMCID: PMC5807347 DOI: 10.3389/fpsyt.2018.00017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/18/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND According to literature data, psychopathology is associated with both quality of life (QoL) and suicidal risk in adolescents, but the literature does not fully support a direct association between psychopathology and suicidal thoughts and behaviors. The aim of this study was to investigate the possible mediational role of QoL in the relationship between psychopathology and level of suicidal risk in a clinical sample of adolescents. METHOD The authors examined a clinical population of 134 adolescents, aged 13-18 years. Suicidal risk-having any current suicidal ideations and/or previous suicide attempt-was assessed by the Mini International Neuropsychiatric Interview. QoL was evaluated by the adolescent self-rated versions of "Das Intervertar zur Erfassung der Lebensqualität Kindern und Jugendlichen" (ILK: Measure of Quality of Life for Children and Adolescents) and psychopathology was measured by adolescent self-rated versions of the Strengths and Difficulties Questionnaire (SDQ). A mediational model, in which QoL mediated the relationship between psychopathology and suicidal risk controlling for gender and age, was tested by means of regression analyses. RESULTS Gender and age were both associated with suicidal risk. Self-reported QoL significantly mediated the relationships between emotional problems (=1.846; 95% BCa CI: 0.731-2.577), as well as peer problems (=0.883; 95% BCa CI: 0.055-1.561) and suicidal risk: more emotional and peer problems were associated with lower QoL, which in turn was related to higher level of suicidal risk. CONCLUSION Based on this study, which aims to make further steps in suicidal prevention, our findings suggest that clinicians should routinely screen the QoL of their patients, especially in adolescents with emotional and peer problems. Furthermore, it is important to focus intervention and treatment efforts on improving the QoL of adolescents with emotional and peer problems.
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Affiliation(s)
- Judit Balazs
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Vadaskert Child Psychiatry Hospital, Budapest, Hungary
| | - Monika Miklosi
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Heim Pál Paediatric Hospital, Centre of Mental Health, Budapest, Hungary
| | - Jozsef Halasz
- Vadaskert Child Psychiatry Hospital, Budapest, Hungary.,Alba Regia Technical Faculty, Obuda University, Szekesfehervar, Hungary
| | - Lili Olga Horváth
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Dóra Szentiványi
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Péter Vida
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,School of Ph.D. Studies, Semmelweis University, Budapest, Hungary
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16
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Li Y, Hou CL, Ma XR, Zhong BL, Zang Y, Jia FJ, Lin YQ, Lai KYC, Chiu HFK, Ungvari GS, Hall BJ, Cai MY, Ng CH, Xiang YT. Quality of life in Chinese patients with schizophrenia treated in primary care. Psychiatry Res 2017; 254:80-84. [PMID: 28456026 DOI: 10.1016/j.psychres.2017.04.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/26/2017] [Accepted: 04/23/2017] [Indexed: 11/17/2022]
Abstract
In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. This study examined the quality of life (QOL) in patients with schizophrenia treated in primary care and explored the demographic and clinical characteristics associated with QOL. Altogether, 612 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. QOL, psychotic and depressive symptoms, extra-pyramidal symptoms and insight were assessed using standardized instruments. Data analyses were conducted with the one sample t-test and multiple linear regression analyses. Compared with the normative data for the Chinese general population, significantly lower scores in physical and mental QOL domains were found in the patient group. Older age, being unemployed, major medical conditions, no smoking, more severe depressive and negative symptoms, more frequent insomnia, and suicidality were independently associated with poor physical QOL. Male gender, more severe depressive and anxiety symptoms, more frequent insomnia, and suicidality were independently associated with poor mental QOL. Patients with schizophrenia treated in primary care had lower level of QOL in comparison with general population. Effective measures need to be implemented to improve their QOL.
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Affiliation(s)
- Yan Li
- The National Clinical Research Center for Mental Disorders, China & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Xin-Rong Ma
- Ningxia Mental Health Center, Ningxia Ning-An Hospital, Ningxia Province, China
| | - Bao-Liang Zhong
- The Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Yu Zang
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Kelly Y C Lai
- Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao SAR, China; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mei-Ying Cai
- Guangzhou Yuexiu Center for Disease Control and Prevention, Guangdong Province, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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17
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Cao XL, Fu YN, Jia FJ, Chiu HFK, Ungvari GS, Ng CH, Hou CL, Lin YQ, Zhong XB, Liu XM, Yim LCL, Xiang YT. Comparison of quality of life in homeless and non-homeless Chinese patients with psychiatric disorders. Psychiatry Res 2017; 249:115-119. [PMID: 28092790 DOI: 10.1016/j.psychres.2017.01.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 12/02/2016] [Accepted: 01/06/2017] [Indexed: 11/30/2022]
Abstract
To date, there are no data on quality of life (QOL) and its correlates in homeless Chinese patients with psychiatric disorders. This study aimed to compare QOL between homeless and non-homeless patients with psychiatric disorders in China. A total of 278 homeless and 222 non-homeless patients matched in age and gender were consecutively recruited. Socio-demographic and clinical data were collected from medical records. A clinical interview was conducted using standardized instruments. The physical and mental QOL in both groups were lower than the normative data for Chinese general population, but there was no significant difference in any QOL domain between the two groups. Multivariate analyses of homeless patients revealed that male gender was associated with higher physical QOL, while living in cities and lower education level were associated with higher mental QOL. In non-homeless patients, use of second-generation antipsychotics was associated with lower physical QOL, while having more severe depressive symptoms was associated with lower mental QOL. Longitudinal studies are warranted to clarify the contributing factors of QOL in both homeless and non-homeless patients.
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Affiliation(s)
- Xiao-Lan Cao
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Yan-Nan Fu
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | | | | | - Larina C L Yim
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, China.
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18
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Zhao J, Li L, Shi J, Li Y, Xu X, Li K, Zhang L, Cai S, Feng Y, Zhuo J, Liu W, Lu H. Safety and efficacy of paliperidone palmitate 1-month formulation in Chinese patients with schizophrenia: a 25-week, open-label, multicenter, Phase IV study. Neuropsychiatr Dis Treat 2017; 13:2045-2056. [PMID: 28814873 PMCID: PMC5546821 DOI: 10.2147/ndt.s131224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
RATIONALE Long-acting injectable (LAI) paliperidone palmitate 1-month formulation (PP1M) has demonstrated acceptable tolerability and favorable clinical outcomes in Western and Asian patients with schizophrenia. Hence, analysis of the outcomes of long-term PP1M treatment specifically in Chinese patients is of interest. OBJECTIVE The aim of this study is to evaluate the long-term safety and efficacy of PP1M treatment in Chinese patients with schizophrenia. METHODS In this 25-week, open-label, Phase IV study, patients (18-65 years) diagnosed with schizophrenia and having a baseline Positive and Negative Syndrome Scale (PANSS) total score of 60-120 (inclusive) were enrolled. All patients received injections of PP1M 150 mg eq. (day 1) and 100 mg eq. (day 8), followed by a flexible once-monthly maintenance dosing (75, 100, or 150 mg eq.). RESULTS Of the 353 patients, 234 (66.3%) completed the study treatment (mean age, 31.1 years; 52.7% men). The PANSS total score (primary end point) improved significantly over the 6-month treatment period (mean [standard deviation] change from baseline to end of treatment, -27.2 [18.30]; P<0.0001). The Clinical Global Impressions-Severity and Personal and Social Performance scores (secondary end points) also improved significantly (P<0.0001). At 6 months, PP1M had a positive impact on medication satisfaction, adherence, and increased preference for LAIs. Treatment-emergent adverse events (TEAEs) were reported by 181 (51.3%) patients (TEAEs ≥5%: extrapyramidal disorder [15.3%], akathisia [10.5%], blood prolactin increase [8.8%], insomnia [5.4%]). A total of 8 deaths were reported, including 4 completed suicides. CONCLUSION Long-term treatment with PP1M was efficacious, and no new safety concerns were identified in Chinese patients with schizophrenia. Overall, the results were comparable with observations from previous studies.
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Affiliation(s)
- Jingping Zhao
- Department of Psychiatry, The Mental Health Institute, The Second Xiangya Hospital of Central South University
| | - Lehua Li
- Department of Psychiatry, The Mental Health Institute, The Second Xiangya Hospital of Central South University
| | - Jianguo Shi
- Department of Psychiatry, Mental Health Center of Xi'an City
| | - Yi Li
- Department of Psychiatry, Mental Health Center of Wuhan City
| | - Xiufeng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University
| | - Keqing Li
- Department of Psychiatry, The Sixth People's Hospital of Hebei Province
| | - Lili Zhang
- Department of Medical Affairs, Xi'an Janssen Pharmaceutical Ltd., Beijing, People's Republic of China
| | - Shangli Cai
- Department of Medical Affairs, Xi'an Janssen Pharmaceutical Ltd., Beijing, People's Republic of China
| | - Yu Feng
- Department of Medical Affairs, Xi'an Janssen Pharmaceutical Ltd., Beijing, People's Republic of China
| | - Jianmin Zhuo
- Department of Medical Affairs, Xi'an Janssen Pharmaceutical Ltd., Beijing, People's Republic of China
| | - Weihong Liu
- Department of Medical Affairs, Xi'an Janssen Pharmaceutical Ltd., Beijing, People's Republic of China
| | - Huafei Lu
- Department of Medical Affairs, Xi'an Janssen Pharmaceutical Ltd., Beijing, People's Republic of China
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19
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Oladeji BD, Taiwo B, Mosuro O, Fayemiwo SA, Abiona T, Fought AJ, Robertson K, Ogunniyi A, Adewole IF. Suicidal Behavior and Associations with Quality of Life among HIV-Infected Patients in Ibadan, Nigeria. J Int Assoc Provid AIDS Care 2015; 16:376-382. [PMID: 26586788 DOI: 10.1177/2325957415617829] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Suicidality has rarely been studied in HIV-infected patients in sub-Saharan Africa. This study explored suicidal behavior in a clinic sample of people living with HIV, in Nigeria. METHODS Consecutive patients were interviewed using the Composite International Diagnostic Interview (CIDI-10.0) and the World Health Organization Quality of Life (WHO-QOL-HIV-BREF). Associations of suicidal behavior were explored using logistic regression models. RESULTS In this sample of 828 patients (71% female, mean age 41.3 ± 10 years), prevalence of suicidal behaviors were 15.1%, 5.8%, and 3.9% for suicidal ideation, plans, and attempts, respectively. Women were more likely than men to report suicidal ideation (odds ratio 1.7; 95% confidence interval 1.05-2.64). Depression and/or anxiety disorder was associated with increased odds of all suicidal behaviors. Suicidal behavior was associated with significantly lower overall and domain scores on the WHO-QOL. CONCLUSION Suicidal behaviors were common and significantly associated with the presence of mental disorders and lower quality of life.
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Affiliation(s)
| | - Babafemi Taiwo
- 2 Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Olushola Mosuro
- 3 Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - Samuel A Fayemiwo
- 4 Department of Medical Microbiology, College of Medicine, University of Ibadan, Nigeria
| | - Taiwo Abiona
- 5 Department of Community Medicine, University of Ibadan, Nigeria
| | - Angela J Fought
- 6 Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kevin Robertson
- 7 Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Adesola Ogunniyi
- 8 Department of Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Isaac F Adewole
- 9 Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Nigeria
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20
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Chang WC, Chen ESM, Hui CLM, Chan SKW, Lee EHM, Chen EYH. Prevalence and risk factors for suicidal behavior in young people presenting with first-episode psychosis in Hong Kong: a 3-year follow-up study. Soc Psychiatry Psychiatr Epidemiol 2015; 50:219-26. [PMID: 25116203 DOI: 10.1007/s00127-014-0946-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Individuals with first-episode psychosis (FEP) have markedly elevated risk for suicide. Previous research investigating risk factors of suicidal behavior in FEP mainly focused on western populations. This study aimed to examine the prevalence, and pretreatment and early illness predictors of suicidal behavior in Chinese FEP patients. METHOD Seven hundred participants aged 15-25 years consecutively enrolled in a territory-wide treatment program for FEP in Hong Kong from July 2001 to August 2003 were studied. Baseline and 3-year follow-up variables were collected via systematic medical file review. Suicidal behavior evaluated in this study comprised suicide attempt and completed suicide. RESULTS Seventy-four (10.6%) participants attempted suicide before treatment. Ten percent (n = 70) exhibited suicidal behavior and 1% (n = 7) committed suicide during 3-year follow-up. The majority of post-treatment suicidal behaviors (51.4%) occurred in the first year of follow-up. Jumping from a height was the most common method of committing suicide. Multivariate regression analysis indicated that previous suicide attempt, history of substance abuse and poorer baseline functioning were significantly associated with an increased risk for suicidal behavior after treatment initiation. CONCLUSION In a large representative cohort of Chinese young FEP patients, the rates of suicidal behavior before and after treatment and risk factors for post-treatment suicidal behavior were comparable to the findings of previous research on early psychosis conducted in western populations. Close monitoring of high-risk patients with history of attempted suicide or substance abuse, and enhancement of psychosocial functioning may help reduce suicide risk in the early stage of psychotic illness.
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Affiliation(s)
- Wing Chung Chang
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong,
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21
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Zoghbi AW, Al Jurdi RK, Deshmukh PR, Chen DC, Xiu MH, Tan YL, Yang FD, Zhang XY. Cognitive function and suicide risk in Han Chinese inpatients with schizophrenia. Psychiatry Res 2014; 220:188-92. [PMID: 25174852 DOI: 10.1016/j.psychres.2014.07.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 05/28/2014] [Accepted: 07/22/2014] [Indexed: 01/25/2023]
Abstract
The lifetime risk of suicide in patients with schizophrenia is estimated to be 4.9-13%. While there are many known risk factors for suicide in schizophrenia, the relationship between cognitive function and suicide risk is unclear, particularly in non-Caucasian populations. In our cross-sectional study, we administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to 316 Han Chinese chronic inpatients with schizophrenia and compared the performance of those who had attempted suicide (n=25) to non-attempters (n=291). The lifetime suicide attempt data were collected from medical records and interviews with patients and their family members. We found a lifetime suicide attempt rate of 7.9%. Suicide attempters were more likely to be single, but showed no significant differences in other demographic factors such as age, gender, or living arrangements. Contrary to our hypothesis, there was no significant relationship between performance on the RBANS test and lifetime risk of suicide attempts in Han Chinese inpatients with schizophrenia. The literature remains mixed on this topic. Culturally influenced differences in suicidal behavior may have affected the outcome of this study and further investigation of this topic is necessary.
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Affiliation(s)
- Anthony William Zoghbi
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Rayan K Al Jurdi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Poonam R Deshmukh
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Da C Chen
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Chang-Ping District, Beijing 100096, PR China
| | - Mei H Xiu
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Chang-Ping District, Beijing 100096, PR China
| | - Yun L Tan
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Chang-Ping District, Beijing 100096, PR China
| | - Fu D Yang
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Chang-Ping District, Beijing 100096, PR China
| | - Xiang Yang Zhang
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Chang-Ping District, Beijing 100096, PR China; Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA.
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22
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Zhang XY, Al Jurdi RK, Zoghbi AW, Chen DC, Xiu MH, Tan YL, Yang FD, Kosten TR. Prevalence, demographic and clinical correlates of suicide attempts in Chinese medicated chronic inpatients with schizophrenia. J Psychiatr Res 2013; 47:1370-5. [PMID: 23791457 DOI: 10.1016/j.jpsychires.2013.05.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 05/19/2013] [Accepted: 05/23/2013] [Indexed: 01/05/2023]
Abstract
The high prevalence of suicide in schizophrenia may be related to its demographic and clinical characteristics. Because suicide prevalence and its associations with clinical variables are less well characterized in Chinese than European patients with schizophrenia, we assessed the suicide attempts in 520 Chinese inpatients with schizophrenia. The suicide attempt data were collected from medical case notes and interviews with the patients and their family members. Patients were rated on the Positive and Negative Syndrome Scale (PANSS), the Simpson and Angus Extrapyramidal Symptom Rating Scale (SAES), and the Abnormal Involuntary Movement Scale (AIMS). Smoking severity was evaluated using clinician-administered questionnaires and the Fagerstrom Test for Nicotine Dependence (FTND). We found a suicide attempt rate of 9.2% in these schizophrenic inpatients. The attempters were single, had a significantly younger age but more hospitalizations, had higher depressive symptoms, and began smoking at an earlier age, smoked more cigarettes each day and had higher FTND total scores than patients without suicide attempts. The logistic regression analysis also indicated that suicide attempts were associated with the number of hospitalizations, depressive symptoms and FTND total scores. These results suggest that Chinese inpatients with schizophrenia attempt suicide more often than the general population. Further, some demographic and clinical variables are risk factors for suicide attempts in schizophrenia.
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Affiliation(s)
- Xiang Yang Zhang
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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Xiang YT, Buchanan RW, Ungvari GS, Chiu HFK, Lai KYC, Li YH, Si TM, Wang CY, Lee EHM, He YL, Yang SY, Chong MY, Kua EH, Fujii S, Sim K, Yong MKH, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, Tan CH, Shinfuku N. Use of clozapine in older Asian patients with schizophrenia between 2001 and 2009. PLoS One 2013; 8:e66154. [PMID: 23762478 PMCID: PMC3677908 DOI: 10.1371/journal.pone.0066154] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 05/02/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To date there has been no large-scale international study that examined the use of clozapine in older patients with schizophrenia. This study examined the use of clozapine and its demographic and clinical correlates in older patients with schizophrenia in East Asia during the period between 2001 and 2009. METHOD Information on 1,157 hospitalized patients with schizophrenia aged 50 or older in five East Asian countries and territories (China, Hong Kong, Korea, Singapore and Taiwan) was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) project. Socio-demographic and clinical characteristics and prescription of psychotropic medications were recorded. RESULTS Clozapine was prescribed for 20.6% of the pooled sample; 19.0% in 2001, 19.4% in 2004 and 22.9% in 2009. Multiple logistic regression analysis of the whole sample revealed that patients taking clozapine had a longer duration of illness, more negative symptoms and were less likely to receive first generation antipsychotic and anticholinergic drugs, but more likely to report weight gain compared to those not receiving clozapine. Compared to those in other sites, older patients in China were more likely to receive clozapine. CONCLUSIONS The prescription of clozapine for older Asian schizophrenia inpatients has remained at a stable level during the past decade. The appropriateness of use of clozapine in China needs to be further explored.
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Affiliation(s)
- Yu-Tao Xiang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- * E-mail: (YTX); (TMS)
| | - Robert W. Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Gabor S. Ungvari
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
- The University of Notre Dame Australia/Marian Centre, Perth, Australia
| | - Helen F. K. Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Kelly Y. C. Lai
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - You-Hong Li
- The Key Laboratory of Mental Health, Ministry of Mental Health & Peking University Institute of Mental Health, Beijing, China
| | - Tian-Mei Si
- The Key Laboratory of Mental Health, Ministry of Mental Health & Peking University Institute of Mental Health, Beijing, China
- * E-mail: (YTX); (TMS)
| | - Chuan-Yue Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Edwin H. M. Lee
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - Yan-Ling He
- Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, China
| | - Shu-Yu Yang
- Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
| | - Mian-Yoon Chong
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University School of Medicine, Kaohsiung, Taiwan
| | - Ee-Heok Kua
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Senta Fujii
- Hyogo Institute for Traumatic Stress (HITS), Kobe, Japan,
| | - Kang Sim
- Department of General Psychiatry, Institute of Mental Health, Buangkok View, Singapore, Singapore
| | - Michael K. H. Yong
- Department of Medicine, Alexandra Hospital/Jurong Health Services, Singapore, Singapore
| | - Jitendra K. Trivedi
- Department of Psychiatry, C.S.M. Medical University UP, Lucknow, Uttar Pradesh, India
| | - Eun-Kee Chung
- Department of Psychiatry, National Seoul Hospital, Seoul, Korea
| | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Kok-Yoon Chee
- Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programs, Geneva, Switzerland
| | - Chay-Hoon Tan
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
| | - Naotaka Shinfuku
- Department of Social Welfare, School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
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Quality of life and marital adjustment in remitted psychiatric illness: an exploratory study in a rural setting. J Nerv Ment Dis 2013; 201:334-8. [PMID: 23538979 DOI: 10.1097/nmd.0b013e318288e298] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
People with mental disorders experience impaired quality of life (QOL). In India, spouses form the most important caregiver for the patient and therefore impact the patients' QOL. However, relatively little is known about marital adjustment, which can definitely influence QOL of patients with mental illness. This study intended to explore marital adjustment and QOL among remitted patients with schizophrenia (SC), depression, and bipolar disorders (BPADs) and to study differences, if any, between the groups. Using a cross-sectional design, consecutive patients (N = 150) with an ICD-10-Diagnostic Criteria for Research diagnosis of SC, depression (recurrent depressive disorder [RDD]), or BPAD, who were currently in remission, were taken up for the study and administered the WHOQOL-BREF for assessing QOL and the Marital Adjustment Inventory for assessing marital adjustment, separately for the husband and the wife. The patients with SC reported poor QOL, whereas a better QOL was seen in those with BPAD and RDD, with significant differences noted between all three groups (p < 0.001). Marital adjustment was perceived to be poor by the patients but not so by the spouses. The greatest marital dissatisfaction was reported by the patients with SC (96%). A positive correlation was observed between the patients' perception of marital adjustment and QOL (p < 0.05). Provision of mental health care should take into consideration patients' possible perception of marital maladjustment and factor these into treatment strategies.
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Suicide attempt and suicidal ideation and their associations with demographic and clinical correlates and quality of life in Chinese schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol 2013; 48:447-54. [PMID: 22847130 DOI: 10.1007/s00127-012-0555-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 07/13/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study aimed to examine the prevalence and correlates of lifetime suicide attempts and current suicidal ideation in community-dwelling schizophrenia patients in China. METHOD A sample of 540 schizophrenia patients was randomly selected in Beijing, China. All subjects were interviewed using standardized assessment instruments and their basic socio-demographic and clinical data including history of suicide attempts were collected. RESULTS The prevalence of lifetime suicide attempts and the point prevalence of suicidal ideation were 12.0%, and 21.1%, respectively. In multiple logistic regression analyses, the presence of lifetime suicide attempt was independently associated with rural residence, having major medical conditions and better social functioning, while higher likelihood of current suicidal ideation was associated with past suicide attempt, the severity of overall psychopathology and depressive symptoms and lower psychological quality of life (QOL). CONCLUSION Among Chinese outpatients with schizophrenia, increased current symptoms and poorer QOL were correlated with current suicidal ideation, while demographic factors and indicators of greater social support were mostly correlated with lifetime suicide attempts. This study may help to identify important subgroups of patients with schizophrenia at particularly high risk of suicidal behavior.
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Wang SM, Chou YC, Yeh MY, Chen CH, Tzeng WC. Factors associated with quality of life after attempted suicide: a cross-sectional study. J Clin Nurs 2013; 22:2150-9. [PMID: 23441824 DOI: 10.1111/jocn.12148] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 12/20/2022]
Affiliation(s)
- Shu-May Wang
- Department of Health; Taoyuan Mental Hospital; Taoyuan Taiwan China
| | - Yu-Ching Chou
- School of Public Health; National Defense Medical Center; Taipei Taiwan China
| | - Mei-Yu Yeh
- Department of Nursing; Chang Gong University of Science and Technology; Taoyuan Taiwan China
| | - Chih-Hao Chen
- Department of Health; Taipei City Government; Taipei Taiwan China
| | - Wen-Chii Tzeng
- Department of Nursing; Tri-Service General Hospital; Taipei Taiwan chaina
- School of Nursing; National Defense Medical Center; Taipei Taiwan Roc
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Bouhlel S, M'solly M, Benhawala S, Jones Y, El-Hechmi Z. [Factors related to suicide attempts in a Tunisian sample of patients with schizophrenia]. Encephale 2012; 39:6-12. [PMID: 23095582 DOI: 10.1016/j.encep.2012.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 03/06/2012] [Indexed: 12/26/2022]
Abstract
INTRODUCTION The mortality rate in schizophrenia is 4.5 times higher than in the general population. Suicide is one of the main causes of premature death in this affection. Life time prevalence of this behavior ranges from 10 to 15%, which represents a risk 20 to 50 times higher than in the general population. In addition, 40 to 93% of patients who committed suicide had attempted suicide previously. Thus, assessment of correlated variables with suicide attempts is a fundamental issue for developing preventive and therapeutic strategies in suicidal behavior. To the best of our knowledge, no systematic study has yet investigated suicide attempts in an Arabic Muslim population with schizophrenia, although many authors have demonstrated cultural differences in socio-demographic and clinical variables related to suicide attempts within many geographic areas around the world. OBJECTIVES The objectives of this study were to assess the frequency and characteristics of lifetime suicide attempts in Tunisian schizophrenic outpatients and to determine the correlated socio-demographic, clinical and therapeutic variables. METHODS A total of 134 patients with a DSM-IV diagnosis of schizophrenia who attended the outpatient department of the university psychiatric hospital of Tunis were included. The main demographic and lifetime clinical variables considered were: gender, marital status, family history of psychiatric disorders and suicide attempts, age at time of recruitment, age at onset of illness, duration of untreated psychosis defined as the interval between the onset of the illness and the first antipsychotic treatment, the type and dose of current treatment, dose of antipsychotic drugs converted to chlorpromazine equivalents, extrapyramidal side effects assessed with the Simpson Angus rating scale, number of hospitalizations, comorbid substance abuse, cigarette smoking, severity of psychopathology measured with the Positive And Negative Syndrome Scale (PANSS), and history of at least one suicide attempt. A suicide attempt was defined as a self-destructive act carried out with at least some intent to end one's life. We also assessed the number, the used methods and the causes of suicide attempts. We subdivided the sample into two sub samples according to the presence or absence of suicidal attempts. We analyzed and compared the demographic, clinical and therapeutic variables. RESULTS Out of the 134 patients, 45 (32%) had attempted suicide at least once. Half of them (49%) had attempted suicide more than once. The number of suicide attempts varied from one to five with an average of 1.8. The most used methods were medication overdose (n=18, 23.4%), followed by organophosphate poisoning (n=11, 14.3%), defenestration (n=9, 11.7%) and hanging or using sharp objects (n=7, 9.1% for each of them). The main reported reasons of suicide attempts were depressive symptoms (n=46, 60%) including depressed mood and hopelessness, stressful life events (bereavement, divorce, separation) (n=35, 46%) and presence of delusions and/or auditory hallucinations (n=25, 32.5%). No differences were found between the two groups regarding the different socio-demographic variables. Significant differences were found with respect to a duration of untreated psychosis equal to or more than one year (P<0.001), smoking in men (P=0.03), positive symptoms score on the PANSS (P<0.001), scores of Simpson-Angus scale (P=0.029) and poor medication compliance (P=0.02). CONCLUSION Demographic variables as suggested by other studies are less valuable predictors of suicide attempts in patients with schizophrenia. Interventions for reducing such behavior should focus on clinical variables and integrate an early diagnosis of the disease, reduce positive psychotic symptoms and tobacco consumption, correct extrapyramidal signs and improve medication compliance.
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Lee JL, Ma WF, Yen WJ, Huang XY, Chiang LC. Predicting the likelihood of suicide attempts for rural outpatients with schizophrenia. J Clin Nurs 2012; 21:2896-904. [PMID: 22861353 DOI: 10.1111/j.1365-2702.2012.04206.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore suicide predictors in rural outpatients with schizophrenia. Background. Suicide is a major cause of mortality in patients with schizophrenia. Evidence indicates that patients in rural areas are at high risk for inadequate health care services. However, information is limited on suicide risk in outpatients with schizophrenia in rural areas. DESIGN Cross-sectional survey. METHODS Data were collected on individuals enrolled in the 2007 Taiwan National Health Insurance program as diagnosed with schizophrenia, ≥ 18 years, and living in a rural county. Eligible individuals (n=1655) were assessed by 12 community-based nurses at 12 public health centres. Participants' personal information was retrieved from National Health Insurance records using a personal data sheet, and treatment experiences were obtained by interviewing patients with a 10-item risk-assessment inventory. Data were collected over 18 months (2007-2008) and analysed by descriptive statistics and regression analyses. RESULTS Risk of suicide attempt in the previous year had four significant predictors: number of self-harm incidents during the previous year, violent incidents towards others during the previous year, number of follow-ups by mental health clinics and number of involuntary hospitalisations during the previous year (R(2) = 0.337, adjusted R(2) = 0.334, F=133.19, p=0.000). CONCLUSION Health care providers should assess rural outpatients with schizophrenia for suicidal thoughts by asking simple questions to evaluate for a history of self-harm and violence and by comparing this information with health system data on follow-ups by mental health clinics and involuntary hospitalisations. RELEVANCE TO CLINICAL PRACTICE Community-based health providers may use these results to prioritise assessments when they have a high case load of patients with schizophrenia. Community-based nurses need to be trained to recognise these four predictors to increase their sensitivity to suicidality among patients with schizophrenia.
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Affiliation(s)
- Jwo-Leun Lee
- Department of Senior Citizen Service Management, National Taichung University of Science & Technology, Taichung, Taiwan
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Abstract
The aim of this study was to assess Chinese schizophrenia patients' quality of life (QOL) and identify its demographic and clinical correlates. A random sample of 540 community-dwelling schizophrenia patients was interviewed using standardized assessment instruments. The patients' basic sociodemographic and clinical data and QOL were collected. Compared with the general population, patients had significantly lower scores in the physical and psychological QOL domains. Multivariate analyses showed that better social support independently predicted higher QOL in all domains, whereas more severe positive symptoms predicted worse psychological and environmental domains. Overall psychopathology predicted both worse physical and psychological domains; depressive symptoms and being married predicted worse physical and social QOL, respectively. Our results suggest that therapeutic and psychosocial interventions alleviating positive and depressive symptoms and improving poor social support and marriage-related problems in Chinese patients with schizophrenia might be of considerable benefit in improving their QOL.
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Kao YC, Liu YP, Cheng TH, Chou MK. Subjective quality of life and suicidal behavior among Taiwanese schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol 2012; 47:523-32. [PMID: 21390511 DOI: 10.1007/s00127-011-0361-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 02/21/2011] [Indexed: 12/18/2022]
Abstract
PURPOSE Research of suicidal behavior in individuals with schizophrenia has often suggested that clinical characteristics and symptoms likely influence a patient's suicidal risk. However, there is a lack of research describing the link between patients' subjective quality of life (SQOL) and suicidal behavior in non-Western countries. Therefore, the current study attempts to explore how schizophrenia patients' SQOL and their suicidal behavior are related in a Taiwanese sample. METHODS In this study, 102 schizophrenia outpatients were investigated using the Taiwanese World Health Organization Quality of Life Schedule-Brief Version (WHO-QOL-BREF-TW), several Beck-Related symptom rating scales, and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. These patients were also evaluated for suicidal risk using the critical items of the Scale for Suicide Ideation (SSI) and lifetime suicide attempts. RESULTS Statistical analyses, including independent sample t tests, analysis of covariance (ANCOVA) and logistic stepwise regression models were completed. Compared with the non-suicidal group, suicidal patients had significantly lower scores in SQOL domains. The differences in social domain remained significant after adjusting for depressive symptoms. In multiple logistic regression analyses, level of depressive and psychotic symptoms increased and poor social and psychological SQOL were significant contributors to suicidal behavior. Having removed depressive symptoms from the model, only dissatisfaction with social SQOL was associated with heightened suicidal risk. CONCLUSIONS Schizophrenia is associated with a high suicidal risk, of which depressive and psychotic symptoms are the major correlates. Again, the present study confirms and extends previous research showing that dissatisfied SQOL, particularly dissatisfaction with social relationships, should be considered in the assessment of suicidal risk in outpatients with schizophrenia, even when accounting other possible confounding factor such as depression.
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Affiliation(s)
- Yu-Chen Kao
- Department of Psychiatry, Songshan Armed Forces General Hospital, No. 131, Jiankang RD., Songshan District, Taipei 10581, Taiwan, Republic of China.
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de Abreu LN, Nery FG, Harkavy-Friedman JM, de Almeida KM, Gomes BC, Oquendo MA, Lafer B. Suicide attempts are associated with worse quality of life in patients with bipolar disorder type I. Compr Psychiatry 2012; 53:125-9. [PMID: 21550033 DOI: 10.1016/j.comppsych.2011.03.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Revised: 03/01/2011] [Accepted: 03/12/2011] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The association between suicidal behavior and quality of life (QoL) in bipolar disorder (BD) is poorly understood. Worse QoL has been associated with suicide attempts and suicidal ideation in schizophrenic patients, but this relationship has not been investigated in BD. This study tested whether a history of suicide attempts was associated with poor QoL in a well-characterized sample of patients with BD, as has been observed in other psychiatric disorders and in the general population. METHODS One hundred eight patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BD type I (44 with previous suicide attempts, 64 without previous suicide attempts) were studied. Quality of life was assessed using the World Health Organization's Quality of Life Instrument-Short Version. Depressive and manic symptoms were assessed using the Hamilton Depression Rating Scale-17 items and the Young Mania Rating Scale. RESULTS Patients with BD and previous suicide attempts had significantly lower scores in all the 4 domains of the World Health Organization's Quality of Life Instrument-Short Version scale than did patients with BD but no previous suicide attempts (physical domain P = .001; psychological domain P < .0001; social domain P = .001, and environmental domain P = .039). In the euthymic subgroup (n = 70), patients with previous suicide attempts had significantly lower scores only in the psychological and social domains (P = .020 and P = .004). LIMITATIONS This was a cross-sectional study, and no causal associations can be assumed. CONCLUSIONS Patients with BD and a history of previous suicide attempts seem to have a worse QoL than did patients who never attempted suicide. Poorer QoL might be a marker of poor copying skills and inadequate social support and be a risk factor for suicidal behavior in BD. Alternatively, poorer QoL and suicidal behavior might be different expressions of more severe BD.
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Affiliation(s)
- Lena Nabuco de Abreu
- Bipolar Disorder Research Program, Department of Psychiatry, University Sao Paulo, Medical School, Sao Paulo, Brazil.
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Makara-Studzińska M, Wołyniak M, Kryś K. Influence of anxiety and depression on quality of life of people with schizophrenia in the eastern region of poland. ISRN PSYCHIATRY 2012; 2012:839324. [PMID: 23738212 PMCID: PMC3658571 DOI: 10.5402/2012/839324] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 12/07/2011] [Indexed: 11/23/2022]
Abstract
Schizophrenia is the most severe and most debilitating mental illness, which is one of the first ten causes of disability in youth and elderly people. Regarding many consequences that schizophrenia brings for individual and social functioning of ill people, their assessment of the quality of their lives seems to be interesting. The aim of this study is to evaluate the incidence and severity of anxiety and depression as well as analysis of the impact level of anxiety and depression on life quality of people with schizophrenia. A group of patients with schizophrenia from psychiatric centers was involved in a study. A set of methods, included: author's questionnaire, the quality of life scale WHOQOL-BREF, and the hospital anxiety and depression scale (HADS). Anxiety disorders occurred in more than 78% of respondents, while depressive disorders in more than half of respondents. The more severe anxiety and depressive disorders, the lower values were observed in all tested components of quality of life. The study of quality of life of the mentally ill patients should be conducted on a continuous basis in order to explore the current factors influencing the improvement of their psychophysical welfare. It is necessary to promote prohealthy mental lifestyle.
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Affiliation(s)
- Marta Makara-Studzińska
- Independent Laboratory of Mental Health, Medical University of Lublin, 20-093 Lublin, Poland
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Algorta GP, Youngstrom EA, Frazier TW, Freeman AJ, Youngstrom JK, Findling RL. Suicidality in pediatric bipolar disorder: predictor or outcome of family processes and mixed mood presentation? Bipolar Disord 2011; 13:76-86. [PMID: 21320255 PMCID: PMC3076793 DOI: 10.1111/j.1399-5618.2010.00886.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Pediatric bipolar disorder (PBD) involves a potent combination of mood dysregulation and interpersonal processes, placing these youth at significantly greater risk of suicide. We examined the relationship between suicidal behavior, mood symptom presentation, family functioning, and quality of life (QoL) in youth with PBD. METHODS Participants were 138 youths aged 5-18 years presenting to outpatient clinics with DSM-IV diagnoses of bipolar I disorder (n=27), bipolar II disorder (n=18), cyclothymic disorder (n=48), and bipolar disorder not otherwise specified (n=45). RESULTS Twenty PBD patients had lifetime suicide attempts, 63 had past or current suicide ideation, and 55 were free of suicide ideation and attempts. Attempters were older than nonattempters. Suicide ideation and attempts were linked to higher depressive symptoms, and rates were even higher in youths meeting criteria for the mixed specifier proposed for DSM-5. Both suicide ideation and attempts were associated with lower youth QoL and poorer family functioning. Parent effects (with suicidality treated as outcome) and child effects (where suicide was the predictor of poor family functioning) showed equally strong evidence in regression models, even after adjusting for demographics. CONCLUSIONS These findings underscore the strong association between mixed features and suicidality in PBD, as well as the association between QoL, family functioning, and suicidality. It is possible that youths are not just a passive recipient of family processes, and their illness may play an active role in disrupting family functioning. Replication with longitudinal data and qualitative methods should investigate both child and parent effect models.
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Affiliation(s)
- Guillermo Pérez Algorta
- Centro Clinico del Sur, Montevideo, Uruguay,University of North Carolina at Chapel Hill, Chapel Hill, NC
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Xiang YT, Weng YZ, Leung CM, Tang WK, Chan SSM, Wang CY, Han B, Ungvari GS. Gender differences in sociodemographic and clinical characteristic and the quality of life of Chinese schizophrenia patients. Aust N Z J Psychiatry 2010; 44:450-5. [PMID: 20397787 DOI: 10.3109/00048670903489858] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the present study was to determine the sociodemographic and clinical correlates of the gender of Chinese schizophrenia outpatients and their impact on patients quality of life (QOL). METHODS Two hundred and fifty-five clinically stable schizophrenia outpatients were randomly selected in Hong Kong. Counterparts matched according to gender, age, age at onset, and length of illness were recruited in Beijing, China. All of the subjects at both sites were interviewed by the same investigator using standardized assessment instruments. RESULTS The combined Beijing-Hong Kong sample contained 251 male and 254 female patients. On univariate analysis more male patients were employed, they had a significantly higher monthly income, and took higher doses of antipsychotic drugs. No difference was found, however, in any of the QOL domains between the genders. On multivariate analysis being employed, taking a higher dose of antipsychotic drugs, having more severe extrapyramidal side-effects, and a higher score on the physical domain of QOL were independently associated with male gender. CONCLUSION Female gender is independently associated with lower scores on the physical aspects of QOL, but there is no difference between the genders in the psychological, social and environmental aspects.
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Affiliation(s)
- Yu-Tao Xiang
- Department of Psychiatry, Chinese University of Hong Kong, Ground Floor, Multicentre Building, Tai Po Hospital, Tai Po, NT, Hong Kong.
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Xiang YT, Wang CY, Wang Y, Chiu HFK, Zhao JP, Chen Q, Chan SSM, Lee EHM, Ungvari GS. Socio-demographic and clinical determinants of quality of life in Chinese patients with schizophrenia: a prospective study. Qual Life Res 2010; 19:317-22. [PMID: 20135234 DOI: 10.1007/s11136-010-9593-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the study was to assess the changes in the quality of life (QOL) of Chinese schizophrenia patients and to identify their predictors over a 1-year follow-up. METHODS A cohort of 116 schizophrenia patients was recruited, and their socio-demographic and clinical characteristics including psychotic and depressive symptoms, drug-induced side effects, social functioning, and QOL were assessed with standardized rating instruments. The patients received standard psychiatric care and were followed up for 1 year. RESULTS The psychotic and depressive symptoms, extrapyramidal side effects, and QOL domains of physical functioning, role limitations due to physical problems, social functioning, and role limitations due to emotional problems all improved significantly. Social functioning was a predictor of baseline QOL and change at 1-year follow-up. CONCLUSIONS Routine clinical management was effective in improving schizophrenia patients' psychopathology and several domains of QOL. QOL was related to the level of social functioning and had only a weak association with socio-demographic factors.
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Affiliation(s)
- Yu-Tao Xiang
- Laboratory of Clinical Psychopharmacology, Beijing Anding Hospital, Capital Medical University, Xicheng District, 100088, Beijing, China.
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Abstract
PURPOSE OF REVIEW Quality of life (QOL) has become a standard outcome measure in psychiatry. The QOL concept is culture-dependent, which means that the results of Western studies may not be applicable to Chinese patients. The aim of this study is to summarize the recent literature on QOL and mental health in Chinese culture. RECENT FINDINGS QOL has increasingly been used as an outcome measure of pharmacotherapeutic or psychosocial interventions in Chinese societies. Recent studies have suggested that socio-cultural factors exert an influence on the QOL of Chinese psychiatric patients. Patients with major psychiatric disorders have a poorer QOL than the general population. Socio-demographic characteristics have no, or only weak, associations with QOL in schizophrenia, whereas novel antipsychotics and antidepressants improve QOL relative to traditional psychotropic medications in the short term. SUMMARY The inclusion of QOL measures in routine clinical practice and research in Chinese societies should be encouraged, and culture-sensitive QOL measures should be developed. Chinese psychiatry should also implement appropriate strategies and effective measures in line with the findings on the relationship between QOL and socio-demographic and clinical factors.
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Brent D, Emslie G, Clarke G, Asarnow JR, Spirito A, Ritz L, Vitiello B, Iyengar S, Birmaher B, Ryan N, Zelazny J, Onorato M, Kennard B, Mayes T, DeBar L, McCracken J, Strober M, Suddath R, Leonard H, Porta G, Keller M. Predictors of spontaneous and systematically assessed suicidal adverse events in the treatment of SSRI-resistant depression in adolescents (TORDIA) study. Am J Psychiatry 2009; 166:418-26. [PMID: 19223438 PMCID: PMC3593721 DOI: 10.1176/appi.ajp.2008.08070976] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to identify predictors of self-harm adverse events in treatment-resistant, depressed adolescents during the first 12 weeks of treatment. METHOD Depressed adolescents (N=334) who had not responded to a previous trial with an SSRI antidepressant were randomized to a switch to either another SSRI or venlafaxine, with or without cognitive behavior therapy. Self-harm events, i.e., suicidal and non-suicidal self-injury adverse events were assessed by spontaneous report for the first 181 participants, and by systematic weekly assessment for the last 153 participants. RESULTS Higher rates of suicidal (20.8% vs. 8.8%) and nonsuicidal self-injury (17.6% vs. 2.2%), but not serious adverse events (8.4% vs. 7.3%) were detected with systematic monitoring. Median time to a suicidal event was 3 weeks, predicted by high baseline suicidal ideation, family conflict, and drug and alcohol use. Median time to nonsuicidal self-injury was 2 weeks, predicted by previous history of nonsuicidal self-injury. While there were no main effects of treatment, venlafaxine treatment was associated with a higher rate of self-harm adverse events in those with higher suicidal ideation. Adjunctive use of benzodiazepines, while in a small number of participants (N=10) was associated with higher rate of both suicidal and nonsuicidal self-injury adverse events. CONCLUSIONS Since predictors of suicidal adverse events also predict poor response to treatment, and many of these events occurred early in treatment, improving the speed of response to depression, by targeting of family conflict, suicidal ideation, and drug use may help to reduce their incidence. The relationship of venlafaxine and of benzodiazepines to self-harm events requires further study and clinical caution.
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Ma X, Xiang YT, Cai ZJ, Li SR, Xiang YQ, Guo HL, Hou YZ, Li ZB, Li ZJ, Tao YF, Dang WM, Wu XM, Deng J, Chan SSM, Ungvari GS, Chiu HFK. Lifetime prevalence of suicidal ideation, suicide plans and attempts in rural and urban regions of Beijing, China. Aust N Z J Psychiatry 2009; 43:158-66. [PMID: 19153924 DOI: 10.1080/00048670802607170] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE There has been no large-scale survey of suicide-related behaviours including suicidal ideations, plans and attempts in China involving both rural and urban areas and using standardized assessment tools. The aim of the present study was to determine the lifetime prevalence of suicide-related behaviour and its relationship with sociodemographic factors and psychiatric disorders in the rural and urban regions of Beijing, China. METHODS A total of 5926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview. Basic sociodemographic and clinical data and data on suicide-related behaviour were also collected. RESULTS The overall lifetime prevalence estimates of suicidal ideation, plans and attempts were 2.3%, 1.4%, and 1.0%, respectively; the corresponding figures were 2.8%, 1.6%, and 1.3% in the rural sample, and 1.8%, 1.3%, and 0.9% in the urban sample. Age (>25 years), female sex, unmarried status, lower education level, lower (<RMB500 month(-1)) or higher (>RMB2000 month(-1)) monthly income and presence of major medical disorders were significantly associated with increased risk of suicide-related behaviour. 36.2% of subjects with suicide-related behavior consulted a medical practitioner and 20.7% consulted a psychiatrist. CONCLUSIONS The prevalence of lifetime suicide-related behaviour in Beijing is lower than in Western countries, but the low percentage of subjects treated for suicide-related behaviour indicates a major public health problem that should be addressed. National surveys are needed to further explore the prevalence of suicide-related behaviour in China.
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Affiliation(s)
- Xin Ma
- Beijing Anding Hospital, Capital Medical University, Beijing, China
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