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Jiang X, Chen X, Su J, Liu N. Prevalence of autism spectrum disorder in mainland china over the past 6 years: a systematic review and meta-analysis. BMC Psychiatry 2024; 24:404. [PMID: 38811881 PMCID: PMC11137880 DOI: 10.1186/s12888-024-05729-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 03/28/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Coupled with its rising prevalence, Autism spectrum disorder (ASD) has become a globally recognized public health concern. Nevertheless, large-scale, multicenter studies that analyze the epidemiology of ASD in China are relatively scarce. METHODS Literature searches were conducted in PubMed/Medline, Embase, the Cochrane Library, Wanfang Data Knowledge Service Platform, China Biology Medicine database (CBM), China Science and Technology Journal Database (CSTJ), and China National Knowledge Infrastructure (CNKI) to retrieve studies published before April 8, 2023, related to ASD prevalence among children aged 0 to 14 years in mainland China. Meta-analysis was conducted using RevMan 5.2 and Stata 14.0. RESULTS Twenty-one articles were included. The ASD prevalence among children in mainland China has been 0.7% (95% confidence interval(CI): 0.006-0.008) since 2017. The prevalence of ASD among boys was 1.0% (95% CI: 0.008-0.011), which was significantly higher than that among girls at 0.2% (95% CI: 0.002-0.003), with a statistically significant difference (OR = 3.198, 95% CI: 2.489-4.109, P = 0.000). Among the included studies, 18 reported an ASD prevalence of 0.8% (95% CI: 0.007-0.010), while 3 studies reported an autistic disorder (AD) prevalence of 0.7% (95% CI: 0.006-0.008). The prevalence of autism among urban children was 23.9% (95% CI: 0.149-0.328), and in rural areas, it was 0.7% (95% CI: 0.002-0.013), with no statistically significant difference (OR = 1.342, 95% CI: 0.258-6.975, P = 0.727). Regression analysis showed that factors such as region (P = 0.000), age (P = 0.000), study period (P = 0.000), sample size (P = 0.000), sampling method (P = 0.002), population source (P = 0.000), disease type (P = 0.000), quality score of the study (P = 0.000), and diagnostic criteria (P = 0.000) might have contributed to the heterogeneity in ASD prevalence. CONCLUSION The prevalence of ASD in China from 2017 to 2023 was 7/1000, showing an upward trend compared to that before 2017 (26.50/10,000). The male-to-female prevalence ratio was 5:1.The overall prevalence remained significantly lower than that reported in foreign countries.
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Affiliation(s)
- Xinhong Jiang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China
| | - Xianrui Chen
- Department of Pediatric Rehabilitation, Xiamen Rehabilitation Hospital, Xiamen, 361003, Fujian, China
| | - Jingying Su
- Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, 361003, Fujian, China.
| | - Nan Liu
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China.
- Fujian Institute of Cerebrovascular Disease, Fuzhou, 350001, Fujian, China.
- Key Laboratory of Brain Aging and Neurodegenerative Diseases, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, 350001, Fujian, China.
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian, China.
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程 蓉, 赵 众, 侯 文, 周 刚, 廖 昊, 张 雪, 李 晶. [Machine learning algorithms for identifying autism spectrum disorder through eye-tracking in different intention videos]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:151-157. [PMID: 38436312 PMCID: PMC10921872 DOI: 10.7499/j.issn.1008-8830.2309073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/25/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVES To investigate the differences in visual perception between children with autism spectrum disorder (ASD) and typically developing (TD) children when watching different intention videos, and to explore the feasibility of machine learning algorithms in objectively distinguishing between ASD children and TD children. METHODS A total of 58 children with ASD and 50 TD children were enrolled and were asked to watch the videos containing joint intention and non-joint intention, and the gaze duration and frequency in different areas of interest were used as original indicators to construct classifier-based models. The models were evaluated in terms of the indicators such as accuracy, sensitivity, and specificity. RESULTS When using eight common classifiers, including support vector machine, linear discriminant analysis, decision tree, random forest, and K-nearest neighbors (with K values of 1, 3, 5, and 7), based on the original feature indicators, the highest classification accuracy achieved was 81.90%. A feature reconstruction approach with a decision tree classifier was used to further improve the accuracy of classification, and then the model showed the accuracy of 91.43%, the specificity of 89.80%, and the sensitivity of 92.86%, with an area under the receiver operating characteristic curve of 0.909 (P<0.001). CONCLUSIONS The machine learning model based on eye-tracking data can accurately distinguish ASD children from TD children, which provides a scientific basis for developing rapid and objective ASD screening tools.
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Affiliation(s)
- 蓉 程
- 中国科学院大学心理学系北京100049
- 深圳大学机电与控制工程学院,广东深圳518010
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Manojlovic M, Roklicer R, Trivic T, Milic R, Maksimović N, Tabakov R, Sekulic D, Bianco A, Drid P. Effects of school-based physical activity interventions on physical fitness and cardiometabolic health in children and adolescents with disabilities: a systematic review. Front Physiol 2023; 14:1180639. [PMID: 37362446 PMCID: PMC10289231 DOI: 10.3389/fphys.2023.1180639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
Background: This study aimed to examine the influence of school-based physical exercise programs on physical fitness and cardiometabolic health in children and adolescents with disabilities. Methods: Web of Science, Scopus, and PubMed were thoroughly searched to identify relevant investigations. To be included in the systematic review, studies needed to fulfill the following inclusion criteria: 1) performed school-based physical exercise interventions; 2) parameters evaluated referred to health-related physical fitness (HRPF), skill-related physical fitness (SRPF), and cardiometabolic health; 3) a sample of participants consisted of children and adolescents with disabilities; 4) the mean age of respondents was less than 18 years; and 5) were written in the English language. Results: After searching the databases, a total of 474 studies have been identified, 18 of them met the eligibility criteria, and their outcomes were presented. Relating to the respondents' characteristics, the investigations involved 681 children and adolescents with disabilities, out of which 440 were male and 241 female. Regarding types of physical exercise interventions, the most commonly implemented were combined aerobic and resistance training, aerobic exercise, sports games, adapted high-intensity interval training, as well as sprint interval training. The obtained results unambiguously demonstrated that applied exercise interventions improved HRPF components such as cardiorespiratory fitness, muscular fitness, and flexibility. In terms of the SRPF, agility, balance, coordination, and power were considerably enhanced following the school-based exercise. On the other hand, the influence on indices of body composition and cardiometabolic health is quite controversial. The majority of the available studies did not find favorable effects. Additionally, no adverse events were reported in 7 of 8 research, and adherence to exercise was approximately 92%. Conclusion: School-based physical exercise programs were very efficient in improving HRPF and SRPF in children and adolescents with disabilities, while the evidence concerning the variables of body composition and cardiometabolic health is inconclusive and warrants further investigations.
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Affiliation(s)
- Marko Manojlovic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Roberto Roklicer
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
- Faculty of Education, Free University of Bozen-Bolzano, Brixen-Bressanone, Italy
| | - Tatjana Trivic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Rade Milic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Nemanja Maksimović
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Roman Tabakov
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Damir Sekulic
- Faculty of Kinesiology, University of Split, Split, Croatia
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
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Salari N, Rasoulpoor S, Rasoulpoor S, Shohaimi S, Jafarpour S, Abdoli N, Khaledi-Paveh B, Mohammadi M. The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis. Ital J Pediatr 2022; 48:112. [PMID: 35804408 PMCID: PMC9270782 DOI: 10.1186/s13052-022-01310-w] [Citation(s) in RCA: 92] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 06/24/2022] [Indexed: 01/02/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is one of the serious developmental disorders that is usually diagnosed below the age of three years. Although the severity of the disease’s symptoms varies from patient to patient, the ability to communicate with others is affected in all forms of ASD. This study aimed to determine the prevalence of ASD in high-risk groups by continent. Methods The present study was conducted by systematic review and meta-analysis from 2008 to July 2021. Databases such as Science Direct, PubMed, Scopus, SID, Magiran, Web of Science (WoS), and Google Scholar from 2008 to July 2021 were searched to find related studies. Data were analysed using Comprehensive Meta-Analysis software (Version 2). Results A total of 74 studies with 30,212,757 participants were included in this study. The prevalence of ASD in the world was 0.6% (95% confidence interval: 0.4–1%). Subgroup analyses indicated that the prevalence of ASD in Asia, America, Europe, Africa and Australia was 0.4% (95% CI: 0.1–1), 1% (95% CI: 0.8–1.1), 0.5% (95% CI: 0.2–1), 1% (95% CI: 0.3–3.1), 1.7% (95% CI: 0.5–6.1) respectively. Conclusion ASD imposes a heavy health burden on communities around the world. Early detection of ASD can reduce the incidence of developmental disorders and improve patients’ communication skills. Therefore, health policymakers need to be aware of the prevalence and increasing trend of ASD to implement appropriate planning and interventions to reduce its consequences.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shabnam Rasoulpoor
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Shna Rasoulpoor
- Student research committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Sima Jafarpour
- Department of Genetics and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Abdoli
- Department of Psychiatry, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behnam Khaledi-Paveh
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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Luo Y, He P, Wen X, Gong R, Hu X, Zheng X. Otitis Media and Its Association With Hearing Loss in Chinese Adults: A Population Based Study of 4 Provinces in China. Front Public Health 2022; 10:852556. [PMID: 35651868 PMCID: PMC9149286 DOI: 10.3389/fpubh.2022.852556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Otitis media is a recognized cause of significant hearing loss, particularly in developing countries. This study aimed to investigate the relationship between otitis media and hearing loss in Chinese adults aged 18 years and older. Methods The survey was based on WHO Ear and Hearing Disorders Survey Protocol and 36,783 adults at the ages between 18 years and above were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. All participants underwent clinical ENT check-up and otoscopic examination by doctors trained in ENT. Each participant was assigned a single middle ear diagnosis. Diagnoses were assigned as per the WHO classification of ear and hearing disorders. Results Logistic regressions showed that higher prevalence of hearing loss was found in participants with otitis media, with an unadjusted odds ratio of 5.67 (95%CI: 4.66, 6.90). The next two models (Model 2–3) had slight impact on ORs. The interaction of residency and otitis media was statistically significant (OR = 1.70, 95%CI = 1.15, 2.53); otitis media patients in rural areas had higher risk of hearing loss. However, this interaction became not significant in 65 years old and above participants. Conclusions Otitis media was associated with the risk of hearing loss. Compared with urban patients with otitis media, rural patients have the higher risk of hearing loss. Action to reduce the risk of hearing loss in otitis media will require attention to rural-urban disparities.
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Affiliation(s)
- Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Xu Wen
- College of Biochemical Engineering, Beijing Union University, Beijing, China
| | - Rui Gong
- China Rehabilitation Research Center for Deaf Children, Beijing, China
| | - Xiangyang Hu
- China Rehabilitation Research Center for Deaf Children, Beijing, China
| | - Xiaoying Zheng
- Chinese Academy of Medical Sciences/Peking Union Medical College, School of Population Medicine and Public Health, Beijing, China
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Liu Y, Zhou F, Qin J, Lin Y, Li T, Zhu C, Long F, Wang X, Hu X, Zhou H. The intervention dilemma and high burden of children with autism in Guizhou province, Southwest China. Front Psychiatry 2022; 13:929833. [PMID: 36405893 PMCID: PMC9666780 DOI: 10.3389/fpsyt.2022.929833] [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: 04/27/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a highly disabling neurodevelopmental disorder, and the burden is high. Data on the burden of ASD are limited in China, especially in the southwest. Therefore, the aims of this study were to investigate the intervention status and burden of children with ASD in Southwest China. MATERIALS AND METHODS Families of children with ASD were recruited from hospitals, special education schools, and private rehabilitation centers; they participated in the survey and completed the questionnaire. Descriptive analysis was conducted on the questionnaire results, which included basic demographic characteristics, rehabilitation status, and burden. Multivariate analysis was used to analyze the association of basic family demographic characteristics, rehabilitation status, and costs of ASD. RESULTS A total of 231 families of children with ASD participated in this survey, and 78.35% (181/231) of the children with ASD were male. The mean age was 4.34 ± 2.09 years. A total of 55.84% (129/231) of the children with ASD had an intellectual disability. Only 46.32% (107/231) started receiving intervention within 1 month after diagnosis. The institutions for rehabilitation interventions for children with ASD were mainly tertiary hospitals (39.39%), special education schools (29.87%) and private rehabilitation institutions (21.64%). For a total of 42.86% (99/231) of the children with ASD, the duration of the intervention was less than 10 h per week. A total of 74.89% (173/231) of the children with ASD received a rehabilitation intervention at home. A total of 66.67% of the parents were satisfied with the treatment. The monthly cost of medical intervention for the patients of children with autism was 7,225 ± 474 RMB ($1,134 ± 74), and the non-medical intervention cost was 2,133 ± 107 RMB ($334 ± 17). The annual burden of patients with autism was 86,700 ± 5,688 RMB ($13,596 ± 892). The estimated total annual burden of ASD was 5.548 billion RMB ($870 million) in Guizhou province. CONCLUSION The results revealed that rehabilitation resources are limited and that the burden of ASD is high in Guizhou province; therefore, improving the rehabilitation status and easing the burden of children with ASD is urgent in these regions.
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Affiliation(s)
- Ye Liu
- Department of Otolaryngology, Guizhou Provincial People's Hospital, Medical College of Guizhou University, Guiyang, China
| | - Fang Zhou
- Department of Developmental Behavioral Pediatrics, Guizhou Provincial People's Hospital, Medical College of Guizhou University, Guiyang, China
| | - Jixuan Qin
- Department of Pediatric Rehabilitation, Anshun Women's & Children's Hospital, Anshun, China
| | - Yong Lin
- Department of Pediatric Rehabilitation, The First People's Hospital of Zunyi, Zunyi, China
| | - Tonghuan Li
- Department of Pediatric Rehabilitation, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Chengyong Zhu
- Department of Pediatric Rehabilitation, The Third Affiliated Hospital of Guizhou Medical University, Duyun, China
| | - Fang Long
- Department of Healthcare, Liupanshui Women & Children Hospital, Liupanshui, China
| | - Xike Wang
- Department of Developmental Behavioral Pediatrics, Guizhou Provincial People's Hospital, Medical College of Guizhou University, Guiyang, China
| | - Xiao Hu
- Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Hao Zhou
- Department of Developmental Behavioral Pediatrics, Guizhou Provincial People's Hospital, Medical College of Guizhou University, Guiyang, China
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Ali H, Rahman H, Lee LC, Khan NZ, Wu LSF, Mehra S, Mitra M, Labrique AB, West KP, Christian P. Autism spectrum disorder in a rural community in Bangladesh: A mid-childhood assessment. Autism Res 2021; 15:328-339. [PMID: 34874130 DOI: 10.1002/aur.2651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/22/2021] [Accepted: 11/16/2021] [Indexed: 11/07/2022]
Abstract
Population-based studies employing standardized diagnostics are needed to determine the burden of autism spectrum disorder (ASD) in low-resource settings. A community-based study was conducted among 8-11 year old children in rural, northwestern Bangladesh to establish the prevalence of ASD. A standardized screening and diagnosis protocol was adapted and deployed comprising the social communication questionnaire (SCQ), and the autism diagnostic observation schedule 2, (ADOS-2), and the autism diagnostic interview, revised (ADI-R), respectively. A year-long research training was conducted for a clinical psychologist to be certified to administer ADOS-2 and ADI-R. Over 8000 children were visited at home and administered the SCQ leading to some, based on their score, being further evaluated using the ADOS-2 and ADI-R by the clinical psychologist. Based on ADOS-2 applying the diagnoses of autism or autism spectrum, the prevalence was 40 (95% CI: 27, 54) per 10,000. Autistic disorder using ADI-R was found at 12 (95% CI: 5, 20) per 10,000. Boys were at a higher risk than girls with the rates among boys being 46 (95% CI: 25, 67) using ADOS-2 and 19 (95% CI:6, 33) using ADI-R. Among girls the rates were 34 (95% CI:16, 52) and 5 (95% CI:0, 12) per 10,000, respectively. Challenges to undertaking ASD research in a rural South Asian context are discussed. There was a low-to-moderate prevalence of ASD in a rural, child population in Bangladesh. Future research is needed to estimate rates of ASD and its causes and socioeconomic consequences in rural and urban settings of South Asia.
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Affiliation(s)
- Hasmot Ali
- JiVitA Maternal and Child Health & Nutrition Research Project, Gaibandha, Bangladesh
| | - Hafizur Rahman
- JiVitA Maternal and Child Health & Nutrition Research Project, Gaibandha, Bangladesh
| | - Li-Ching Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Naila Z Khan
- Clinical Neurosciences Center, Bangladesh Protibondhi Foundation, Dhaka, Bangladesh.,Bangladesh Institute of Child Health, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh
| | - Lee Shu-Fune Wu
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sucheta Mehra
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maithilee Mitra
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,School of Medicine, Institute for Clinical and Translational Research (ICTR), Johns Hopkins University, Baltimore, USA
| | - Alain B Labrique
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Keith P West
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Parul Christian
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Ao D, Guo S, Yun C, Zheng X. Socio-demographic factors impact disabilities caused by perinatal asphyxia among Chinese children. PLoS One 2021; 16:e0248154. [PMID: 33667274 PMCID: PMC7935314 DOI: 10.1371/journal.pone.0248154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 02/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Disabilities caused by perinatal asphyxia will burden child health and well-being. To date, our understanding about the situation and risk factors of perinatal asphyxia-induced disabilities among Chinese children is still limited. Objectives To evaluate the prevalence and socio-demographic risk factors of disabilities caused by perinatal asphyxia among Chinese children in 2006 and compare disability trajectories across different socio-demographic status. Methods Cross-sectional data came from the 2006 China National Survey on Disability which includes a total of 616,940 children aged 0–17 years old was employed in the investigation. Perinatal asphyxia-induced disabilities were identified by following the guidance in consensus manuals. Population-weighted numbers and prevalence rates were investigated, and multivariable logistic regression was performed to evaluate associations between disabilities and socio-demographic factors. Adjusted predictions at representative values were computed to compare the disability trajectories relative to significant socio-demographic variables. Results The prevalence rate of disabilities caused by perinatal asphyxia was 7.70 per 10,000 children (95% CI: 7.01–8.39). Male (OR 1.81, 95% CI: 1.47–2.23) and low family income (OR: 1.73, 95% CI: 1.21–2.49) have higher and the increase of per additional year of age (OR: 0.89, 95% CI: 0.88–0.91) has lower probability of being disabilities caused by perinatal asphyxia. Further disability trajectories showed that differences in probability between gender and family income group were more evident before age 7 and weakened with increasing age. Conclusions Our results showed that both demographic and socioeconomic characteristics are risk factors for disabilities caused by perinatal asphyxia. Of these, gender and family income have much higher impact than other factors on the prevalence rate of disabilities caused by perinatal asphyxia at infants and young children. Multiple society sectors should increase their effort to bring about fundamental social change to prevent disabilities caused by perinatal asphyxia, especially concerning younger children and their families.
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Affiliation(s)
- Deng Ao
- Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, China
- Department of Preschool Education, Teacher’s College of Beijing Union University, Beijing, China
| | - Shuai Guo
- Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, China
| | - Chunfeng Yun
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Xiaoying Zheng
- Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, China
- * E-mail:
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Associations between Prenatal Education, Breastfeeding and Autistic-Like Behaviors in Pre-Schoolers. CHILDREN-BASEL 2021; 8:children8020124. [PMID: 33572414 PMCID: PMC7916179 DOI: 10.3390/children8020124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 12/17/2022]
Abstract
This study aimed to investigate the association between prenatal education and autistic-like behaviors of preschoolers as well as the mediating role of breastfeeding in their associations. A cross-sectional study via a structured questionnaire was conducted with 67,578 preschool children and parents from Longhua District of Shenzhen, China. Hierarchical logistic regression models were performed to explore the associations between maternal participation in prenatal education and autistic-like behaviors in preschoolers, as well as the mediating effect of breastfeeding in the associations. After controlling for potential confounders, logistic regression analysis indicated that maternal participation in prenatal education could significantly increase the prevalence of breastfeeding, and the strength of the association was enhanced with the increase frequency of prenatal education visits (ORs ranging from 1.191 to 1.899). While both maternal participation in prenatal education (ORs ranging from 0.732 to 0.798) and breastfeeding (OR = 0.773) were significantly associated with the lower presence of autistic-like behaviors in preschoolers. The crossover analysis indicated that children with both maternal prenatal education and breastfeeding had the lower risk of presence of autistics-like behaviors (OR = 0.569). Furthermore, mediation analysis illustrated that breastfeeding mediated the association between maternal participation in prenatal education and the presence of autistic-like behaviors in preschoolers, with a mediating effect of approximately 14.3%. Our findings suggest that maternal participation in prenatal education is significantly associated with a decreased risk of autistic-like behaviors in preschool children through increased breastfeeding in the mothers who attended prenatal education.
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Wang Y, Yin J, Wang G, Li P, Bi G, Li S, Xia X, Song J, Pei G, Zheng JC. Responsibility and Sustainability in Brain Science, Technology, and Neuroethics in China-a Culture-Oriented Perspective. Neuron 2019; 101:375-379. [PMID: 30731061 DOI: 10.1016/j.neuron.2019.01.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 12/17/2022]
Abstract
The China Brain Project is in development. Integrating an ethical framework to identify and assess ethical challenges and plan for solutions is a priority. Here Wang et al. discuss ethical questions emerging from brain research in the context of traditional Chinese culture and juxtapose the legacy of Confucianism with contemporary thinking.
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Affiliation(s)
- Yi Wang
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai 200072, China; Collaborative Innovation Center for Brain Science, Tongji University, Shanghai 200092, China
| | - Jie Yin
- School of Philosophy & Center for Biomedical Ethics, Fudan University, Shanghai 200433, China
| | - Guoyu Wang
- School of Philosophy & Center for Biomedical Ethics, Fudan University, Shanghai 200433, China
| | - Pingping Li
- China National Center for Biotechnology Development, Beijing 100039, China
| | - Guoqiang Bi
- Hefei National Laboratory for Physical Sciences at Microscale, CAS Key Laboratory of Brain Function and Disease, CAS Center for Excellence in Brain Research and Intelligent Technology, and School of Life Sciences, University of Science and Technology of China., Hefei, Anhui 230026, China
| | - Suning Li
- China National Center for Biotechnology Development, Beijing 100039, China
| | - Xiaohuan Xia
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai 200072, China; Collaborative Innovation Center for Brain Science, Tongji University, Shanghai 200092, China
| | - Jianren Song
- Collaborative Innovation Center for Brain Science, Tongji University, Shanghai 200092, China; Center of Translational Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Gang Pei
- Collaborative Innovation Center for Brain Science, Tongji University, Shanghai 200092, China; School of Life Science and Technology, Tongji University, Shanghai 200092, China; Key Laboratory of Cell Biology, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai 200031, China.
| | - Jialin C Zheng
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai 200072, China; Collaborative Innovation Center for Brain Science, Tongji University, Shanghai 200092, China; Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198-5930, USA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198-5930, USA.
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11
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Wang J, Hedley D, Bury SM, Barbaro J. A systematic review of screening tools for the detection of autism spectrum disorder in mainland China and surrounding regions. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:285-296. [PMID: 31431046 DOI: 10.1177/1362361319871174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Screening for autism spectrum disorder is the first step toward early detection and diagnosis, thereby impacting the likelihood of children accessing early intervention and, importantly, improving long-term outcomes. This systematic review aimed to (a) establish a clear baseline of autism spectrum disorder screening tools currently used throughout mainland China and surrounding regions, (b) identify the strengths and limitations of these instruments, and (c) develop specific recommendations regarding screening for autism spectrum disorder throughout Chinese-speaking countries. Databases were searched for recent (2015-2018) articles published in Chinese or English languages. Twenty-two studies (13 Chinese, 9 English) met inclusion criteria; two from Taiwan and the remainder from mainland China. Studies varied greatly in the extent of psychometric analyses and reported autism spectrum disorder prevalence. The majority of diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders (4th ed. (DSM-IV) or 5th ed. (DSM-5)) criteria, although a small number of studies utilized gold-standard diagnostic assessment instruments. It is recommended that a systematic, multi-tiered, screening network be established to improve the identification of autism spectrum disorder in China and surrounding regions. Assessment and diagnosis need to be culturally appropriate, and amenable to low-resource settings. In addition, increased public awareness programs to reduce stigma will be important in improving outcomes for children with autism spectrum disorder.
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Affiliation(s)
- Ji Wang
- Yangzhou Maternal and Child Health Hospital, P.R. China.,La Trobe University, Australia.,Harbin Children's Hospital, P.R. China
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12
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Abstract
Autism spectrum disorder (ASD) describes a set of neurodevelopmental disorders. Despite extensive ASD research lasting more than 60 years, its causes are still unknown. Without indicating the etiology, its development cannot be stopped. Over the years, both the definition and diagnostic criteria have developed. The number of ASD incidence is rising. The economical aspect should also be highlighted. This disorder presents particular challenges to affected children, their parents and physicians. The research of ASD, physician activities, policy making and raising the level of awareness must be coordinated. Special attention should be paid to the problem among adults with ASD.
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Affiliation(s)
- Joanna Kałużna-Czaplińska
- Department of Chemistry, Institute of General and Ecological Chemistry, Lodz University of Technology, Żeromskiego 116 Street, 90-924 Lodz, Poland
- CONEM Poland Chemistry and Nutrition Research Group, Lodz, Poland
| | - Ewa Żurawicz
- Department of Chemistry, Institute of General and Ecological Chemistry, Lodz University of Technology, Żeromskiego 116 Street, 90-924 Lodz, Poland
| | - Jagoda Jóźwik-Pruska
- Department of Chemistry, Institute of General and Ecological Chemistry, Lodz University of Technology, Żeromskiego 116 Street, 90-924 Lodz, Poland
- CONEM Poland Chemistry and Nutrition Research Group, Lodz, Poland
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13
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Clark E, Zhou Z, Du L. Autism in China: Progress and challenges in addressing the needs of children and families. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/21683603.2019.1570885] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Elaine Clark
- Department of Educational Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Zheng Zhou
- Department of Psychology, St. John’s University, Jamaica, New York, USA
| | - Lin Du
- Teachers College, Columbia University, New York, New York, USA
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14
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Zhu Z, Fang X, Chen H, Zhu X, Zhang L, Zhai X, Cui Z, Gao Q. Alterations in volumes and MRI features of amygdala in Chinese autistic preschoolers associated with social and behavioral deficits. Brain Imaging Behav 2019; 12:1814-1821. [PMID: 29480438 PMCID: PMC6302052 DOI: 10.1007/s11682-018-9853-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
To examine the amygdala volume in 2–5-year-old preschool children with autism and explore the relationship between amygdala volumes based on MRI findings and clinical features. A total of 39 cases with clinically diagnosed autism were collected. The oblique coronal T1 weighted image (T1WI) sequence was used to measure the volume of amygdala and the MRI signals were measured and analyzed. The data were compared to that of 24 age-matched healthy children and correlated to the clinical manifestations. The autism and the control groups were subject to brain scanning in 1 week after Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) review. The 39 cases, diagnosed with autism, were associated with social and behavioral deficits through clinical observation, physical and neurological examination, and assessments according to DSM IV, and the range of ABC scores in the autism group was 47–124, with an average score of 84.7 ± 24.1. Abnormal MRI signals were found in 19/78 (24.4%) amygdala in the autism group, the amygdala lesions showed punctuate or flaky low signal, slightly low signal, low to iso-signal, slightly high signal, or iso to high-signal intensity on T1 weighted three-dimendional fast low angle shot(T1FL3D) images. The right amygdala volume average was 1.088 ± 0.38 cm3, while that of the left amygdala was 1.04 ± 0.41 cm3, without any statistically significant difference (t = 0.533, p = 0.596) in the autism group. Among the 24 cases in the control group, the right amygdala volume average was 0.754 ± 0.194 cm3, while that of the left amygdala was 0.666 ± 0.252 cm3; the autism group had a significantly larger right and left amygdala volumes as compared to the age-matched typically developing group with a significant positive correlation between age and right amygdala volume (r = 0.406, p = 0.01). The preschool children with autism had significantly larger bilateral amygdala volumes as compared to age-matched typically developing children, the amygdala lesions may show abnormal signal. A relationship between age and right amygdala volume in the preschool children with autism was established.
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Affiliation(s)
- Zongming Zhu
- Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299 Qingyang Road, Nanchang District, Wuxi, 214023, China
| | - Xiangming Fang
- Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299 Qingyang Road, Nanchang District, Wuxi, 214023, China.
| | - Hongwei Chen
- Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299 Qingyang Road, Nanchang District, Wuxi, 214023, China
| | - Xiangwen Zhu
- Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299 Qingyang Road, Nanchang District, Wuxi, 214023, China
| | - Lili Zhang
- Department of Child Care, Wuxi Children's Hospital, Nanjing Medical University, Wuxi, 214023, China
| | - Xiaodong Zhai
- Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299 Qingyang Road, Nanchang District, Wuxi, 214023, China
| | - Zhimin Cui
- Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299 Qingyang Road, Nanchang District, Wuxi, 214023, China
| | - Quansheng Gao
- Laboratory of the Animal Center, Academy of Military Medical Sciences, No. 27 Taiping Road, Haidian District, Beijing, 100850, China.
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15
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Zhu ZW, Jin Y, Wu LL, Liu XL. Current status and challenge in clinical work of autism spectrum disorders in China. World J Pediatr 2018; 14:209-211. [PMID: 29923047 DOI: 10.1007/s12519-018-0166-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/21/2018] [Indexed: 02/07/2023]
Affiliation(s)
- Zhi-Wei Zhu
- Department of Developmental and Behavioral Pediatrics, Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310052, China.
| | - Yan Jin
- Department of Developmental and Behavioral Pediatrics, Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310052, China
| | - Ling-Ling Wu
- Department of Developmental and Behavioral Pediatrics, Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310052, China
| | - Xiao-Lin Liu
- Department of Developmental and Behavioral Pediatrics, Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, Hangzhou, 310052, China
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16
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Wang F, Lu L, Wang SB, Zhang L, Ng CH, Ungvari GS, Cao XL, Lu JP, Hou CL, Jia FJ, Xiang YT. The prevalence of autism spectrum disorders in China: a comprehensive meta-analysis. Int J Biol Sci 2018; 14:717-725. [PMID: 29910682 PMCID: PMC6001678 DOI: 10.7150/ijbs.24063] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/16/2018] [Indexed: 12/22/2022] Open
Abstract
There are conflicting prevalence estimates of autism spectrum disorders (ASDs) in mainland China (China thereafter). This study is a comprehensive meta-analysis of the pooled prevalence of ASDs in the general population in China. Study investigators independently conducted a systematic literature search of the following databases: PubMed, EMBASE, PsycINFO, China National Knowledge Infrastructure, Chinese biomedical literature service system, and Wan Fang. Studies reporting prevalence of ASDs and autism in Chinese population were identified and analysed using the Comprehensive Meta-Analysis program with the random effects model. Forty-four studies were included in the meta-analysis comprising 2,337,321 subjects of whom 46.66 % were females. The mean age of subjects ranged from 1.6 to 8 years. Based on diagnostic criteria the pooled prevalence of ASDs was 39.23 per 10,000 (95% CI: 28.44-50.03 per 10,000, I2=89.2%); specifically, the prevalence of autism was 10.18 per 10,000 (95% CI: 8.46-11.89 per 10,000, I2=92.5%). Subgroup analyses revealed significant difference in the prevalence of ASDs between genders (72.77 per 10,000 in males vs. 16.45 per 10,000 in females). In conclusion, the prevalence of ASDs and autism in China was found generally lower than those reported in other countries. Further studies are needed to clarify the variation in prevalence.
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Affiliation(s)
- Fei Wang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Li Lu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Chee H. Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S. Ungvari
- The University of Notre Dame Australia / Graylands Hospital, Perth, Australia
| | - Xiao-Lan Cao
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Jian-Ping Lu
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Cai-Lan Hou
- 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
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR
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17
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Shang LL, Huang YQ, Liu ZR, Chen HG. A Cross-sectional Survey of Disability Attributed to Mental Disorders and Service Use in China. Chin Med J (Engl) 2018; 130:1441-1445. [PMID: 28584207 PMCID: PMC5463474 DOI: 10.4103/0366-6999.207462] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Mental disorders are strongly associated with disabilities. National survey on disability could provide a reliable basis for policymaking in care and rehabilitation of disabled persons. This study aimed to describe the disability prevalence rates attributed to mental disorders, their distribution by sociodemographic factors, and utilizations of service. Methods: This study is a secondary data analysis of the Second National Sample Survey on Disability in 2006. The disability and severity were assessed using the World Health Organization Disability Assessment Schedule 2.0. Mental disorders were diagnosed according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision Classification of Mental and Behavioral Disorders. Using descriptive and analytic epidemiological methods, prevalence rates of disability attributed to mental disorders and service use were calculated. Results: Data of 2,526,145 respondents were analyzed. The disability prevalence rate attributed to mental disorders in China was 6.3‰, accounting for 9.9% of all disabled people. Regarding disability prevalence attributed to mental disorders, it showed that gender, residential area, marital status, education level, and economic area were related to the prevalence distributions. The proportions of mild disability were highest in the disabled people with onset age of 18–64 years, while the proportion of extremely severe disability was highest in the disabled people with onset age of 65 years and above. Only 58.6% of disabled people attributed to mental disorders used some of the services. Conclusions: There are statistical differences of disability prevalence attributed to mental disorders by people and region in China. Service use in disabled people with mental disorders is insufficient.
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Affiliation(s)
- Li-Li Shang
- Department of Social Psychiatry and Behavioral Medicine, Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China
| | - Yue-Qin Huang
- Department of Social Psychiatry and Behavioral Medicine, Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China
| | - Zhao-Rui Liu
- Department of Social Psychiatry and Behavioral Medicine, Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China
| | - Hong-Guang Chen
- Department of Social Psychiatry and Behavioral Medicine, Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China
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18
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Abstract
Examining sex differences in the brain has been historically contentious but is nonetheless important for advancing mental health for both girls and boys. Unfortunately, females in biomedical research remain underrepresented in most mental health conditions including autism spectrum disorders (ASD), even though equal inclusion of females would improve treatment for girls and yield benefits to boys. This review examines sex differences in the relationship between neuroanatomy and neurogenetics of ASD. Recent findings reveal that girls diagnosed with ASD exhibit more intellectual and behavioral problems compared to their male counterparts, suggesting that girls may be less likely diagnosed in the absence of such problems or that they require a higher mutational load to meet the diagnostic criteria. Thus far, the female biased effect of chromosome 4, 5p15.33, 8p, 9p24.1, 11p12-13, 15q, and Xp22.3 and the male biased effect of 1p31.3, 5q12.3, 7q, 9q33.3, 11q13.4, 13q33.3, 16p11.2, 17q11-21, Xp22.33/Yp11.31, DRD1, NLGN3, MAOA, and SHANK1 deletion have been discovered in ASD. The SNPs of genes such as RYR2, UPP2, and the androgen receptor gene have been shown to have sex-biasing factors in both girls and boys diagnosed with ASD. These sex-related genetic factors may drive sex differences in the neuroanatomy of these girls and boys, including abnormal enlargement in temporal gray and white matter volumes, and atypical reduction in cerebellar gray matter volumes and corpus callosum fibers projecting to the anterior frontal cortex in ASD girls relative to boys. Such factors may also be responsible for the attenuation of brain sexual differentiation in adult men and women with ASD; however, much remains to be uncovered or replicated. Future research should leverage further the association between neuroanatomy and genetics in girls for an integrated and interdisciplinary understanding of ASD.
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19
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He P, Guo C, Wang Z, Chen G, Li N, Zheng X. Socioeconomic status and childhood autism: A population-based study in China. Psychiatry Res 2018; 259:27-31. [PMID: 29028520 DOI: 10.1016/j.psychres.2017.08.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/23/2017] [Accepted: 08/19/2017] [Indexed: 10/19/2022]
Abstract
There is limited evidence on the association between socioeconomic status (SES) and autism in developing nations. The aim of this study was to examine this association among children aged 0-17 years in China. We obtained data from the Second National Sample Survey on Disability, and selected 616,940 children for analysis. Autism was ascertained according to the International Statistical Classification of Diseases, Tenth Revision. Multiple logistic regressions allowing for weights showed that children in middle-income and high-income families were less likely than their low-income peers to have autism, with an odds ratio of 0.60 (95%CI: 0.39, 0.93) and 0.44 (95%CI: 0.27, 0.72), respectively. Children in middle-education families had 63% (95%CI: 41%, 95%) odds of autism relative to their counterparts in low-education families. Stratified analyses found that all observed associations were only in male children, not in female children. In conclusion, children in families with socioeconomic disadvantage, in the form of lower family income and education, had greater risk of childhood autism.
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Affiliation(s)
- Ping He
- Institute of Population Research, Peking University, Beijing, China
| | - Chao Guo
- Institute of Population Research, Peking University, Beijing, China
| | - Zhenjie Wang
- Institute of Population Research, Peking University, Beijing, China
| | - Gong Chen
- Institute of Population Research, Peking University, Beijing, China
| | - Ning Li
- Institute of Population Research, Peking University, Beijing, China
| | - Xiaoying Zheng
- Institute of Population Research, Peking University, Beijing, China; WHO Collaborating Center on Reproductive Health and Population Science, Beijing, China.
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20
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He P, Chen G, Wang Z, Guo C, Zheng X. Children with motor impairment related to cerebral palsy: Prevalence, severity and concurrent impairments in China. J Paediatr Child Health 2017; 53:480-484. [PMID: 28094881 DOI: 10.1111/jpc.13444] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 10/14/2016] [Accepted: 11/02/2016] [Indexed: 11/28/2022]
Abstract
AIM Cerebral palsy (CP) is the most common cause of motor impairment in childhood. This study aimed to examine the prevalence, severity and concurrent impairments of CP-related motor impairment among Chinese children. METHODS Children with CP-related motor impairment aged 0-17 years were identified through a national population-based survey based on World Health Organization International Classification of Functioning, Disability and Health. Logistic regression models allowing for weights were used to examine individual and family factors in relation to CP-related motor impairment. RESULTS The weighted prevalence of CP-related motor impairment was 1.25 per 1000 children (95% confidence interval (CI): 1.16, 1.35) in China. Male children, children in multiples and in families where adults suffered from CP, were more likely to be affected by CP-related motor impairment. For mild, moderate, severe and extremely severe groups of motor impairment, weighted proportions of CP were 14.12% (95%CI: 11.70, 16.95), 20.35% (95%CI: 17.48, 23.56), 27.44% (95%CI: 24.25, 30.87) and 38.09% (95%CI: 34.55, 41.76), respectively; and weighted proportions of concurrent visual, hearing and cognitive impairment were 5.00% (95%CI: 3.59, 6.91), 6.98% (95%CI: 5.34, 9.08) and 71.06% (95%CI: 67.57, 74.31), respectively. CONCLUSIONS Gender, multiple births and family adults with CP were significantly associated with CP-related motor impairment in Chinese children. Proportions of CP and concurrent impairments that increased with severity of motor impairment were observed.
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Affiliation(s)
- Ping He
- Institute of Population Research, Peking University and WHO Collaborating Center on Reproductive Health and Population Science, Beijing, China
| | - Gong Chen
- Institute of Population Research, Peking University and WHO Collaborating Center on Reproductive Health and Population Science, Beijing, China
| | - Zhenjie Wang
- Institute of Population Research, Peking University and WHO Collaborating Center on Reproductive Health and Population Science, Beijing, China
| | - Chao Guo
- Institute of Population Research, Peking University and WHO Collaborating Center on Reproductive Health and Population Science, Beijing, China
| | - Xiaoying Zheng
- Institute of Population Research, Peking University and WHO Collaborating Center on Reproductive Health and Population Science, Beijing, China
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21
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Zhou H, Zhang L, Luo X, Wu L, Zou X, Xia K, Wang Y, Xu X, Ge X, Jiang YH, Fombonne E, Yan W, Wang Y. Modifying the Autism Spectrum Rating Scale (6-18 years) to a Chinese Context: An Exploratory Factor Analysis. Neurosci Bull 2017; 33:175-182. [PMID: 28238114 PMCID: PMC5360853 DOI: 10.1007/s12264-017-0104-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/22/2017] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to explore the psychometric properties of the Chinese version of the autism spectrum rating scale (ASRS). We recruited 1,625 community-based children and 211 autism spectrum disorder (ASD) cases from 4 sites, and the parents of all participants completed the Chinese version of the ASRS. A robust weighted least squares means and variance adjusted estimator was used for exploratory factor analysis. The 3-factor structure included 59 items suitable for the current sample. The item reliability for the modified Chinese version of the ASRS (MC-ASRS) was excellent. Moreover, with 60 as the cut-off point, receiver operating characteristic analysis showed that the MC-ASRS had excellent discriminate validity, comparable to that of the unmodified Chinese version (UC-ASRS), with area under the curve values of 0.952 (95% CI: 0.936-0.967) and 0.948 (95% CI: 0.930-0.965), respectively. Meanwhile, the confirm factor analysis revealed that MC-ASRS had a better construct validity than UC-ASRS based on the above factor solution in another children sample. In conclusion, the MC-ASRS shows better efficacy in epidemiological screening for ASD in Chinese children.
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Affiliation(s)
- Hao Zhou
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China
- Pediatric Department of Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Lili Zhang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xuerong Luo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410008, China
| | - Lijie Wu
- School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Xiaobing Zou
- Child Development Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Kun Xia
- State Key Laboratory of Medical Genetics, Changsha, 400078, China
| | - Yimin Wang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xiu Xu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xiaoling Ge
- Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yong-Hui Jiang
- Division of Medical Genetics, Department of Pediatrics and Neurobiology, Duke University School of Medicine, Durham, NC, 27710, USA
| | - Eric Fombonne
- Institute on Development and Disability, Oregon Health and Science University, Portland, OR, 97239, USA
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yi Wang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China.
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22
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Baxter AJ, Charlson FJ, Cheng HG, Shidhaye R, Ferrari AJ, Whiteford HA. Prevalence of mental, neurological, and substance use disorders in China and India: a systematic analysis. Lancet Psychiatry 2016; 3:832-41. [PMID: 27528097 DOI: 10.1016/s2215-0366(16)30139-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/03/2016] [Accepted: 06/03/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Population-representative prevalence data for mental, neurological, and substance use disorders are essential for evidence-based decision making. As a background to the China-India Mental Health Alliance Series, we aim to examine the availability of data and report prevalence for the most common mental, neurological, and substance use disorders in China and India from the Global Burden of Disease study 2013 (GBD 2013). METHODS In this systematic analysis, data sources were identified from GBD 2013 for the prevalence of mental, neurological, and substance use disorders in China and India published up to Dec 31, 2013. We calculated the proportion of the population represented by the data with the adjusted population coverage (APC) method adjusting for age, sex, and population size. We developed prevalence models with DisMod-MR 2.0, a Bayesian meta-regression instrument used to pool population-representative epidemiological data as part of GBD 2013. We report estimates and 95% uncertainly intervals (95% UI) for 15 mental, neurological, and substance use disorders for China and India in 1990 and 2013, and benchmark these against those for other BRICS countries (Brazil, Russia, and South Africa) in 2013. FINDINGS Few population-representative data were found for the disorders, with an average coverage of 15% of the population of the Chinese mainland and 1% of the population of India. For men in both China and India, major depressive disorder, anxiety disorders, and alcohol dependence were the most common mental, neurological, and substance use disorders. Prevalence of major depressive disorder was 2·2% (95% UI 1·5-2·8) in Chinese men and 3·5% (2·4-4·6) in Indian men; prevalence of anxiety disorders was 2·0% (1·1-3·2) and 1·9% (1·2-2·3), respectively. For women, anxiety disorders, major depressive disorder, and dysthymia were the most common. Prevalence of major depressive disorder was 3·3% (2·3-4·1) in Chinese women and 4·7% (95% UI 3·3-6·2) in Indian women; prevalence of anxiety disorders was 3·3% (1·6-5·3) and 4·1% (3·3-5·0), respectively. Schizophrenia was more prevalent in China (0·5%, 95% UI 0·4-0·5) than in India (0·2%; 0·2-0·2). INTERPRETATION More data for mental, neurological, and substance use disorders are needed for India and China but the large population and geographic scale of these countries present challenges to population-representative data collection. FUNDING China-India Mental Health Alliance, China Medical Board.
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Affiliation(s)
- Amanda J Baxter
- University of Queensland, School of Public Health, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA.
| | - Fiona J Charlson
- University of Queensland, School of Public Health, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Hui G Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rahul Shidhaye
- Public Health Foundation of India, New Delhi, India; CAPHRI School for Public Health and Primary Care, Maastricht University, Netherlands
| | - Alize J Ferrari
- University of Queensland, School of Public Health, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Harvey A Whiteford
- University of Queensland, School of Public Health, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA
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23
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Frazier TW, Hardan AY. Equivalence of symptom dimensions in females and males with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:749-759. [DOI: 10.1177/1362361316660066] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated equivalence of autism symptom domains in males and females with autism. Symptom data were obtained from 2643 children and adolescents with autism spectrum disorder (352 females, 2291 males; age range = 4–17 years) included in the Simons Simplex Collection. Items from the Social Responsiveness Scale and Autism Diagnostic Interview–Revised were mapped to nine a priori symptom dimensions. Multi-group confirmatory factor models, including measurement equivalence and item response theory analyses, examined whether males and females showed measurement or structural differences in autism symptom constructs. Results indicated mean differences in restricted interests that were not due to measurement bias. No other symptom dimension showed evidence of measurement bias and autism symptom structure was highly similar between males and females. Future studies are needed to carefully estimate any sex differences in the content, frequency, or intensity/severity of restricted interests in females and males.
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Zhang JX, Zhang J, Li Y. Liver X receptor-β improves autism symptoms via downregulation of β-amyloid expression in cortical neurons. Ital J Pediatr 2016; 42:46. [PMID: 27154582 PMCID: PMC4859958 DOI: 10.1186/s13052-016-0249-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/03/2016] [Indexed: 11/10/2022] Open
Abstract
Background We study the effect of liver X receptor β (LXRβ) on β-amyloid (Aβ) peptide generation and autism behaviors by conducting an animal experiment. Methods In autistic mice treated with LXRβ agonist T0901317, enzyme linked immunosorbent assay was used to measure Aβ in brain tissue homogenates. Western blot was used to detect Aβ precursors, Aβ degradation and secretase enzymes, and expression of autophagy-related proteins and Ras/Raf/Erkl/2 signaling pathway proteins in brain tissue. Changes in autism spectrum disorder syndromes of the BTBR mice were compared before and after T0901317 treatment. Results Compared with the control group, autistic mice treated with LXRβ agonist T0901317 showed significantly lower Aβ level in brain tissue (P < 0.05), significantly higher Aβ degradation enzyme (NEP, IDE proteins) levels (all P < 0.05), significantly lower Aβ secretase enzyme BACE1 protein level (P < 0.05), and significantly lower Ras, P-C-Raf, C-Raf, P-Mekl/2, P-Erkl/2 protein levels (all P < 0.05). BTBR mice treated with T0901317 showed improvements in repetitive stereotyped behavior, inactivity, wall-facing standing time, self-combing time and center stay time, stayed longer in platform quadrant, and crossed the platform more frequently (all P < 0.05). Conclusions LXRβ could potentially reduce brain Aβ generation by inhibiting Aβ production and promoting Aβ degradation, thereby increasing the expression of autophagy-related proteins, reducing Ras/Raf/Erkl/2 signaling pathway proteins, and improving autism behaviors.
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Affiliation(s)
- Ji-Xiang Zhang
- Department of Clinical Psychology, Linyi People's Hospital, Linyi, 276000, China
| | - Jun Zhang
- Department of Children's Rehabilitation, Linyi People's Hospital, No.27 East Jiefang Road, Linyi, 276000, China.
| | - Ye Li
- Department of Outpatient Operation Room, Linyi People's Hospital, Linyi, 276000, China
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25
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Zhou H, Zhang L, Wu L, Zou X, Luo X, Xia K, Wang Y, Xu X, Ge X, Sun C, Deng H, Fombonne E, Jiang YH, Yan W, Wang Y. Validity and reliability analysis of the Chinese parent version of the Autism Spectrum Rating Scale (6-18 years). Psychiatry Res 2015; 230:255-61. [PMID: 26384573 DOI: 10.1016/j.psychres.2015.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 08/31/2015] [Accepted: 09/03/2015] [Indexed: 12/23/2022]
Abstract
This study aimed to investigate the validity and reliability of the Chinese parent version of the Autism Spectrum Rating Scale (ASRS, 6-18 years) for a general sample of Chinese children. The study involved assessing 1625 community-based subjects aged 6-12 years from four sites (Shanghai, Guangzhou, Changsha, and Harbin city) in China and 211 clinic-based participants aged 6-18 with a confirmed diagnosis of autism spectrum disorders (ASDs). The internal consistency (Cronbach's alpha) ranged from 0.585 to 0.929, and the test-retest reliability (interclass correlations) ranged from 0.542 to 0.749, indicating no significant difference between the two tests at an interval of 2-4 weeks. The construct validity was relatively excellent, and the concurrent validity with the Social Responsiveness Scale (SRS) (Pearson correlations) was 0.732 between the two total scores. Receiver operating characteristics (ROC) analyses showed excellent and comparable discriminant validity of the ASRS with respect to the SRS, with an area under the curve (AUC) of 0.9507 (95% CI: 0.93-0.97) versus 0.9703 (95% CI: 0.96-0.98), respectively. Our data suggested a cutoff ≥60 for the Chinese version of the ASRS, with good accuracy in screening autism symptoms (sensitivity=94.2%, specificity=77%). The Chinese parent version of the ASRS is therefore a reliable and valid tool for screening autistic symptoms in Chinese children in general.
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Affiliation(s)
- Hao Zhou
- No. 399, Wanyuan Road, Minhang District, Division of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Lili Zhang
- No. 399, Wanyuan Road, Minhang District, Division of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Lijie Wu
- School of Public Health, Harbin Medical University, Harbin, China
| | - Xiaobing Zou
- Child Development Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xuerong Luo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Kun Xia
- State Key Laboratory of Medical Genetics, Changsha, China
| | - Yimin Wang
- No. 399, Wanyuan Road, Minhang District, Division of Neurology, Children's Hospital of Fudan University, Shanghai, China
| | - Xiu Xu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaoling Ge
- Children's Hospital of Fudan University, Shanghai, China
| | - Caihong Sun
- School of Public Health, Harbin Medical University, Harbin, China
| | - Hongzhu Deng
- Child Development Center, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Eric Fombonne
- Oregon Health & Science University, Portland, OR, USA
| | - Yong-Hui Jiang
- Division of Medical Genetics, Department of Pediatrics and Neurobiology, Duke University School of Medicine, USA
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China.
| | - Yi Wang
- No. 399, Wanyuan Road, Minhang District, Division of Neurology, Children's Hospital of Fudan University, Shanghai, China.
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26
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Current state and recent developments of child psychiatry in China. Child Adolesc Psychiatry Ment Health 2015; 9:10. [PMID: 25972919 PMCID: PMC4429456 DOI: 10.1186/s13034-015-0040-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 03/16/2015] [Indexed: 11/10/2022] Open
Abstract
China has a population of 1.3 billion, of which 238 million are children under age 15. The rapid economic development and social reforms that have taken place in recent years all had a great influence on child and adolescent mental health. Though a nationwide prevalence study for child and adolescent mental disorders in China is lacking, several regional studies have shown the prevalence of mental disorders in children to be close to the worldwide prevalence of 20%. This article reviews the current status of Chinese child psychiatry, the prevalence of specific disorders in China and the influence of culture on the diagnosis and treatment of child and adolescent mental disorders. Several important social issues are also explored in detail, including the one child policy and left-behind children of migrating workers. Changes in family structures along with the growing competitions in life have weakened the traditional social support system. As a result childhood behavioral problems, mood disorders in young college students, substance abuse and youth suicide are all increasing in China. Many who suffer from mental disorders are not adequately cared for because the scarcity of qualified service providers and pathways to care. This article also lists some challenges and possible solutions, including the multidisciplinary and culture sensitive service model for child mental health. Relevant laws, policies and regulations are also introduced.
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27
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Wang W, An DM, Xiao FL, Zhou D. Epilepsy & behavior: making people with epilepsy the focus. Epilepsy Behav 2014; 40:111-2. [PMID: 25440840 DOI: 10.1016/j.yebeh.2014.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/11/2014] [Indexed: 02/05/2023]
Affiliation(s)
- Wei Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Dong-Mei An
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Feng-Lai Xiao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Sun X, Allison C, Auyeung B, Matthews FE, Zhang Z, Baron-Cohen S, Brayne C. Comparison between a Mandarin Chinese version of the Childhood Autism Spectrum Test and the Clancy Autism Behaviour Scale in mainland China. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1599-1608. [PMID: 24769432 DOI: 10.1016/j.ridd.2014.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 02/09/2014] [Accepted: 02/14/2014] [Indexed: 06/03/2023]
Abstract
A Mandarin Chinese version of the Childhood Autism Spectrum Test (CAST) and Clancy Autism Behaviour Scale (CABS) were applied to 150 children aged 4-11 years old from clinical settings and mainstream schools in Beijing. All the children were further assessed using the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). The validity of two instruments on screening of ASC was examined and compared using receiver operating characteristic (ROC) curve analysis. The validity of CAST (sensitivity: 89%, specificity: 80%, PPV: 70%) was better than the CABS (sensitivity: 58%, specificity: 84%, PPV: 65%). The area under the curve (AUC) of the CAST (AUC=0.90) was significantly higher than the CABS (AUC=0.79, p=0.0002). The Mandarin CAST demonstrated a better validity in distinguishing children with ASC from children without ASC. It is an acceptable candidate as a screening instrument for ASC in large epidemiological study in Chinese population.
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Affiliation(s)
- Xiang Sun
- Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Forvie Site, Cambridge Biomedical Campus, Cambridge, CB2 0SR, UK; Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, CB2 2AH, UK; The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong.
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, CB2 2AH, UK
| | - Bonnie Auyeung
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, CB2 2AH, UK; Department of Psychology, University of Edinburgh, EH8 9JZ, UK
| | - Fiona E Matthews
- MRC Biostatistics Unit, Cambridge Institute of Public Health, Forvie Site, Robinson Way, CB2 0SR, UK
| | - Zhixiang Zhang
- Paediatrics Department, Peking University First Hospital, No. 8, Xishiku Avenue, Xicheng District, Beijing 100034, China
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, CB2 2AH, UK
| | - Carol Brayne
- Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Forvie Site, Cambridge Biomedical Campus, Cambridge, CB2 0SR, UK
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29
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Feng L, Li C, Chiu H, Lee TS, Spencer MD, Wong JCM. Autism spectrum disorder in Chinese populations: a brief review. Asia Pac Psychiatry 2013; 5:54-60. [PMID: 23857805 DOI: 10.1111/appy.12079] [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: 08/21/2012] [Accepted: 03/12/2013] [Indexed: 11/26/2022]
Abstract
This review summarizes the published work on the prevalence and incidence rates of autism spectrum disorder (ASD) in Chinese populations. The authors searched MEDLINE, Web of Science and the PsycINFO database and identified seven studies that were published in the English language. In mainland China, Li and colleagues reported an autism prevalence rate of 2.38/10,000 but admitted the possibility of underestimation. A higher prevalence of 11/10,000 was reported by Zhang and Ji based on a survey that was conducted in Tianjin, China. In Taiwan, Chien and colleagues reported that the cumulative prevalence of ASD increased from 1.79 to 28.72/10,000 from 1996 to 2005 and the annual incidence rate increased from 0.91 to 4.41/10,000 per year from 1997 to 2005. Another study based on the Taiwan national health insurance database reported a high prevalence rate of 122.8/10,000 for the year 2007. Two studies based on the Taiwan national disability registry data reported an increasing trend of ASD for the period 2000-2007 and 2004-2010, respectively. In Hong Kong, Wong and colleagues estimated that the incidence of ASD was 5.49/10,000 and the average prevalence over the 1986-2005 period was 16.1/10,000. We identified 12 studies through the searching of Chinese databases. The prevalences among these studies varied from 2.8 to 29.5/10,000. While existing data appear to suggest, it remains unclear whether there is a true rise in the prevalence of ASD in ethnic Chinese population across geographic sites. More collaborative research on this topic should be conducted in the future.
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Affiliation(s)
- Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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30
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Sun X, Allison C, Matthews FE, Sharp SJ, Auyeung B, Baron-Cohen S, Brayne C. Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis. Mol Autism 2013; 4:7. [PMID: 23570419 PMCID: PMC3643868 DOI: 10.1186/2040-2392-4-7] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 03/01/2013] [Indexed: 02/07/2023] Open
Abstract
Background The prevalence of autism spectrum conditions (ASC) is 1% in developed countries, but little data are available from mainland China, Hong Kong and Taiwan. This study synthesizes evidence relating to the prevalence of ASC in these areas and assesses the effects of research methodology on prevalence estimates. Methods Systematic literature searches were conducted in PubMed, Web of Knowledge, China Web of Knowledge and Weipu databases, as well as relevant papers published from 1987 to 2011, reporting prevalence estimates of ASC or childhood autism in mainland China, Hong Kong and Taiwan. Summary estimates of prevalence were calculated with a random effects model. The effects of research methodology on the prevalence estimates were assessed using a meta-regression model. Results There were 25 studies eligible for review, 18 of which were suitable for inclusion in a meta-analysis. Pooled prevalence of childhood autism was 11.8 per 10,000 individuals (95% confidence interval (CI): 8.2, 15.3) in mainland China. Pooled prevalence of ASC was 26.6 per 10,000 (95% CI: 18.5, 34.6) in three areas. Substantial heterogeneity was identified between studies (I2>75%). The prevalence estimate of childhood autism was most strongly associated with the choice of screening instrument. After adjustment for age group, the odds ratio for prevalence estimates when using the Autism Behavior Checklist (ABC) as the screening instrument compared with those using the Clancy Autism Behavior Scale (CABS) was 0.29 (95% CI: 0.12, 0.69), and 1.79 (95% CI: 0.70, 4.55; P= 0.20) when using the Checklist for Autism in Toddlers (CHAT) compared to the CABS. Conclusions The available studies investigating the prevalence of ASC in China, Hong Kong and Taiwan have focused mainly on childhood autism rather than the whole spectrum. The prevalence estimates are lower than estimates from developed countries. Studies using more recently developed screening instruments reported higher prevalence than older ones. However, available studies have methodological weaknesses and therefore these results lack comparability with those from developed countries. Our findings indicate a potential under-diagnosis and under-detection of ASC in mainland China, Hong Kong and Taiwan, and a need to adopt more advanced methods for research of ASC in these areas.
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Affiliation(s)
- Xiang Sun
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
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Wan Y, Hu Q, Li T, Jiang L, Du Y, Feng L, Wong JCM, Li C. Prevalence of autism spectrum disorders among children in China: a systematic review. SHANGHAI ARCHIVES OF PSYCHIATRY 2013; 25:70-80. [PMID: 24991138 PMCID: PMC4054540 DOI: 10.3969/j.issn.1002-0829.2013.02.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND There are no reliable estimates of the prevalences of autism and autism spectrum disorders (ASD) in China. OBJECTIVE Combine results across studies to estimate the prevalences of autism and ASD among Chinese children under the age of 18, and assess variations in the prevalences with respect to gender, ethnicity, and urban versus rural residence. METHODS Based on pre-defined inclusion and exclusion criteria, studies were identified by searching the following databases: Chinese National Knowledge Infrastructure, Chongqing VIP database for Chinese Technical Periodicals, WANFANG DATA, Chinese Biological Medical Literature Database, Pubmed, and Web of Science. Statistical analysis was conducted using R-2.15.2 software. RESULTS The 24 studies meeting inclusion criteria included 5 registry studies from Taiwan and Hong Kong (covering a total of 14570 369 children) and 19 community-based screening and diagnostic studies from mainland China (with a combined sample of 771 413 children). The annually reported prevalence of autism in the registry studies ranged from 1.8 to 424.6 per 10 000. A meta-analysis of 18 of the studies from mainland China (excluding a large nationwide study with the lowest prevalence of autism) with a range in rates from 2.8 to 30.4 per 10 000 generated an estimated pooled prevalence of autism of 12.8 per 10 000 (95%CI, 9.4 to 17.5). The pooled prevalence of ASD estimated from 5 of these studies (which had a range in rates from 7.3 to 75.3 per 10 000) was 24.5 per 10000 (95%CI, 10.4 to 57.4). The reported prevalence of autism varied substantially by gender, location of residence, date of publication, and source of the sample. CONCLUSION The huge difference between the rates for autism reported from registry systems in Hong Kong and Taiwan (a 200-fold difference) and the large differences in rates reported from community-based screening studies in mainland China (a 10- to 15-fold difference) highlight the urgent need for establishing standardized methods for estimating the prevalences of autism and ASD. Until these methodological improvements have been made, it will not be possible to develop evidence-based prevention and treatment strategies for the management of these uncommon but seriously disabling conditions.
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Affiliation(s)
- Yumei Wan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijuan Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yasong Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - John Chee-Meng Wong
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Chunbo Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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