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

Adverse Childhood Experiences, Family Support, and Depression: Evidence from Internal Migrants in China

Previous studies have linked poor family support and adverse childhood experiences (ACEs) to increased risk of depression; however, little is known about the interplay between the two when it comes to their effects on depression. Therefore, the current study examined if family support moderated the cumulative effect of ACEs on depression. Based on data from a migrant survey in Shiyan, Hubei Province, in 2019 (N = 1,326), this study used the ordinary least squares method to analyze the effect of ACEs on depression and evaluate whether family support moderated this effect. Higher exposure to ACEs and lower scores of family support were associated with higher depression levels in adulthood. The moderation model indicated that family support significantly moderated the relationship between ACEs and depression. Appropriate interventions to reduce depression should target internal migrants with history of ACEs. Community nurses should consider ACEs as an integral part of psychosocial assessment. Negative effects of ACEs can be reduced through teaching skills that increase effective family interaction and maintain supportive family networks. [Journal of Psychosocial Nursing and Mental Health Services, 61(3), 19-25.].

On-call work and depressive mood: A cross-sectional survey among rural migrant workers in China

Introduction

With the rapid development of China's "gig economy," the on-call work model has grown increasingly prevalent in China and has attracted a large number of rural migrant workers with its low employment threshold. However, this irregular employment mode may negatively impact the mental health of workers.

Methods

This paper uses an ordinal logistic regression model to study the relationship between Chinese rural migrant workers' on-call work and their depression.

Results

The results showed that after controlling for relevant variables, the odds ratio of depressive mood among rural migrant workers engaged in on-call work was 1.22 (95% CI 1.04-1.43) compared with rural migrant workers who did not need to be on call. In further heterogeneity research, we found that on-call work is more likely to aggravate the depression risk of rural migrant workers who are highly dependent on the internet and have low-wage incomes.

Discussion

This research suggests that appropriate measures should be taken to mitigate the negative impact of on-call work on the mental health of rural migrant workers, and more attention needs to be paid to the mental health of lower salaried and gig workers. This paper provides a valuable sample of Chinese rural migrant workers for theoretical research on the relationship between on-call work and mental health and confirms the relationship between the two. These results contribute new ideas to the theory and practice of psychological crisis intervention aimed at Chinese rural migrant workers.

"Embedding" and "pulling back": Spatial transformations and urban assimilation of migrant elderlies following their children

Background

Due to the rapid acceleration of social mobility and the shrinking size of families, China has begun to enter a new form of aging society, with an increasing number of migrant elderlies following their children. How to adapt and assimilate into the new living space profoundly affects those migrant elderlies' mental health. Drawing on the spatial framework proposed by Henry Lefebvre, this paper explores the factors affecting urban assimilation of migrant elderlies following their children in China, and puts forward corresponding strategies to promote the urban assimilation.

Method

Using semi-structured interviews and participatory observation, this study conducted a qualitative study among migrant elderlies following their children who lived in a University Community in Wuhan city, Hubei Province from May 2022 to July 2022. During the survey period, we participated in the gathering activities of the migrant elderly five times a week, and conducted semi-structured interviews with 15 migrant elderlies following their children.

Results

Firstly, this study reveals that family assimilation is the foundation of urban assimilation of migrant elderly following their children; Secondly, we could conclude that the urban life of the migrant elderlies are mostly community-based, so it is especially important for them to reconstruct close neighborhood relations and regain the humanity affection of the traditional acquaintance society. Lastly, the fundamental institutional barrier is a significant factor that influences the ability of these migrant elderlies to live a stable urban life. The Chinese government needs to promote a nationwide unified pension and health insurance system, so that the migrant elderlies can enjoy the same benefits as the local elderly residents in the "inflow" area.

What is the global prevalence of depression among men who have sex with men? A systematic review and meta-analysis

BACKGROUND

Depression due to stigma resulting from their sexual identity, isolation, social exclusion, and insufficient access to care and counseling services has become a health problem among men who have sex with men (MSM).

OBJECTIVES

This study aimed to determine the global prevalence of depression among MSM as a systematic review and meta-analysis.

METHODS

This study was a systematic review and meta-analysis performed in five steps of search strategy, screening and selecting articles, data extraction, evaluation of the risk of bias, and meta-analysis. In this study, the determined keywords were searched in the databases of PubMed, Scopus, Embase, and Web of Science from January 1913 to July 2021 to find the initial articles, from which data were extracted according to the set checklist in the data extraction stage. Finally, the studies were included in the present meta-analysis according to the inclusion and exclusion criteria, to be evaluated using the Newcastle Ottawa scale checklist. I Square and Q Cochrane were also used to assess the degree of heterogeneity. The analyses were performed using the random-effects model in STATA 16.

RESULTS

The results showed the quality score of the majority of cross-sectional studies included in the meta-analysis (62 studies) was equal to six or seven (moderate), and five ones had a high-quality score. After combining these studies, the pooled prevalence of depression among MSM in the world was 35% (95% CI 31%-39%, I square; 98.95%, P-value < 0.001). Population subgroup analysis showed the pooled prevalence of depression among MSM living with HIV was 47% (95% CI 39%-55%, I square; 95.76%, P-value < 0.001). Continent subgroup analysis showed the highest pooled prevalence of depression among Asian MSM at 37% (95% CI 31%-43%, I square; 99.07%, P-value < 0.001). Also, in the subgroup analysis of the sampling method, the pooled prevalence in the studies which used the respondent-driven sampling method was equal to 34% (95% CI 25%-43%, I square; 99.32%, P-value < 0.001). Sensitivity analysis revealed the pooled prevalence of depression in studies included in the meta-analysis was near or around the pooled estimate.

CONCLUSION

The pooled prevalence of depression among MSM was almost three times higher than the general male population. Therefore, particular and therapeutic interventions such as screening, and harm reduction programs for mental disorders, especially depression, are suggested to be considered in service packages.

What are the prevalence of and factors independently associated with depression and anxiety among patients with posttraumatic elbow stiffness? A cross-sectional, multicenter study

BACKGROUND

Joint stiffness is a common complication after articular-related trauma in the elbow, resulting in significant limb disability, psychological stress, and a negative impact on daily life. No previous study has reported the impact of post-traumatic elbow stiffness (PTES) on psychological health. This study aims to (1) investigate the depression and anxiety levels and (2) identify factors independently associated with depression and anxiety symptoms in patients with PTES.

METHODS

A total of 108 patients with PTES presenting to 4 collaborative municipal hospitals were consecutively enrolled from September to December 2020. Sociodemographic and clinical characteristics were collected through questionnaires and medical records. The Depression Anxiety Stress Scale-21 was used to assess depression and anxiety status. Ordinal logistic regression analysis was performed to identify factors independently associated with depression and anxiety symptoms.

RESULTS

The detection rates of mild-to-moderate depression and anxiety are 40.7% and 27.8%, and severe-to-extremely severe levels are 23.1% and 25.9%, respectively. Regression results show that factors independently associated with depression include elbow flexion (odds ratio [OR]_{per 1° loss} = 1.021, 95% confidence interval [CI]: 1.001-1.041, P = .035), elbow pain on movement (OR_{per 1 point increase} = 1.236, 95% CI: 1.029-1.484, P = .023), family relationship (OR_{less close/very close} = 10.059, 95% CI: 2.170-46.633, P = .003), and self-care ability (OR_unable/able = 3.858, 95% CI: 1.244-11.961, P = .019). Factors independently associated with anxiety are elbow flexion (OR_{per 1° loss} = 1.031, 95% CI: 1.009-1.052, P = .005), elbow pain on movement (OR_{per 1 point increase} = 1.212, 95% CI: 1.003-1.465, P = .047), and clinically significant heterotopic ossification around elbow (OR_yes/no = 2.344, 95% CI: 1.048-5.243, P = .038).

CONCLUSION

Patients with PTES exhibit significant depression and anxiety symptoms. Several sociodemographic and clinical characteristics are independently associated with depression and anxiety levels. Identifying and addressing these factors may be of particular benefit during PTES management. Future research might address whether depression and anxiety affect the outcome after stiff elbow surgery.

Listening to the Shenzhen Primary Healthcare Context to Adapt the mhGAP-IG.v2 for the Assessment of Depression: Qualitative Workshops with Primary Healthcare Leaders

In Shenzhen, despite recent primary and mental healthcare reform, Primary healthcare doctors (PHC) have limited access to diagnostic tools and a significant mental health treatment gap presides. The World Health Organization's (WHO) mental health gap intervention guide (mhGAP-IG.v2) offers a non-specialist and evidence-based guide for the assessment of depression however requires adaptation to the context of use. Bilingual (Mandarin and English) qualitative research was undertaken with 30 PHC leaders from Shenzhen to compare their assessment approach for depression against the mhGAP-IG.v2 in order to identify context-specific modifications for a local guide. Local assessment differentiators included: a need for culturally sensitive translation of depression symptoms; a preference for a broad, non-hierarchical symptom presentation (including somatic, behavioural and anxiety items); national prioritisation of suicide patients; the integration of family into the cycle of care; limited primary care awareness of a depressive episode in Bipolar Disorder; and China's specialist-led diagnostic approach. Contextual modification of mhGAP-IG.v2 is recommended to take account of China's unique cultural and primary health system response to depression. Ongoing mental health training is required to develop professional confidence in the recognition of mental disorders.

Adapting the depression component of WHO Mental Health Gap Intervention Guide (mhGAP-IG.v2) for primary care in Shenzhen, China: a DELPHI study

Background

Primary care doctors in Shenzhen, China are increasingly expected to identify and prevent depressive disorder; however, they have received limited mental health training and community healthcare centres (CHC) do not provide standardised protocols for the diagnosis and care of depressive disorder. The World Health Organization’s mental health gap intervention guide, version 2 (mhGAP-IG.v2) is a decision support tool for non-specialists for the assessment, management and follow-up of mental, neurological and substance use disorders (including depressive disorder). Given that mhGAP-IG.v2 is a generic tool, it requires adaptation to take account of cultural differences in depression presentation and unique characteristics of China’s emergent mental health system.

Methods

A two-round, web-based, Delphi survey was conducted. A panel of primary care doctors from Shenzhen, were invited to score their level of agreement with 199 statements (arranged across 10 domains) proposing changes to the content and structure of mhGAP-IG.v2 for use in Shenzhen. Consensus was predefined as 80% panelists providing a rating of either “somewhat agree/definitely agree”, or “definitely disagree/somewhat disagree” on a five-point scale for agreement.

Results

79% of statements received consensus with a mean score of 4.26 (i.e. “somewhat agree”). Agreed adaptations for mhGAP-IG.v2 included:- an assessment approach which considers a broader spectrum of depression symptoms and reflects the life course of disease; incorporating guidance for screening tool usage; clarifying physicians’ roles and including referral pathways for intersectorial care with strong family involvement; aligning drug treatment with national formularies; stronger emphasis of suicide prevention throughout all sections of the guide; contextualizing health education; reflecting a person-centred approach to care. Panelists chose to maintain diagnostic and treatment advice for bipolar patients experiencing a depressive episode as in the current guide.

Conclusions

An adapted mhGAP-IG.v2 for depression recognises China’s cultural and contextual needs for assessment guidance; unique primary healthcare system organization, priorities and treatment availability; and diverse psychosocial educational needs. An adapted mhGAP-IG.v2 could both inform the future training programs for primary care in Shenzhen and also offer an additional mental health resource for non-specialists in other countries.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13033-022-00523-0.

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

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

Social Network Correlates of Mental Health among Rural-to-Urban Migrants in China

Internal rural-to-urban migrants in China are facing a high risk of mental disorders. Previous research on mental health correlates and predictors among this population focused on individual-level characteristics, neglecting network-level indicators, and migrant–urbanite intergroup relationship. A cross-sectional survey was conducted in Beijing, China from December 2018 to January 2019. A convenience sample of 420 rural-to-urban migrants completed the Chinese 12-item General Health Questionnaire and reported their relationship with urbanites in the past six months. Multivariate linear regression models were used to test the association of the inter-hukou network with migrant mental health. Two indicators of the inter-hukou network were significantly associated with migrant mental health. Migrants were more mentally healthy if their proportion of weak ties in the inter-hukou network was no less than 50%. The more social support migrants received from the inter-hukou network, the better their mental health was. Meanwhile, there was a significant interaction effect between social support and sex, indicating that the same level of social support better protected the mental health of female migrants. Results suggest the importance of social network factors and migrant–urbanite ties for migrant mental health. Future efforts may need to mobilize and facilitate the inter-hukou network to improve migrant mental health.

Prevalence of depression disorder in industrial workers: a meta-analysis

Objectives. Depression is known to be associated with a variety of occupational factors. The aim of this study was to meta-analyze the prevalence of depressive disorder in industrial workers. Methods. Three databases indexing abstracts of articles were selected and searched until August 2020: PubMed, Web of Science and Scopus. For each study, the sample size and number of depression events were extracted, and after extracting these data, the random effects method was used to assess the prevalence. I² and χ² values were used to investigate the heterogeneity. Results. The prevalence of depressive disorder in industrial workers is 21%. The prevalence of depressive disorder in men and women industrial workers is 23 and 28%, respectively. The prevalence of depressive disorder in Asia, Europe and America is equal to 22, 18 and 20%, respectively. The result of the heterogeneity test showed that the heterogeneity is high. Conclusion. The prevalence of depression in industrial workers is higher than in the general population. These differences can be due to the working conditions of industrial workers. Therefore, the work environment and the promotion of occupational health can play an important role in preventing depression.

The Influence of the Urban Environment on Mental Health during the COVID-19 Pandemic: Focus on Air Pollution and Migration-A Narrative Review

The coronavirus disease 2019 (COVID-19) pandemic caused a crisis worldwide, due to both its public health impact and socio-economic consequences. Mental health was consistently affected by the pandemic, with the emergence of newly diagnosed psychiatric disorders and the exacerbation of pre-existing ones. Urban areas were particularly affected by the virus spread. In this review, we analyze how the urban environment may influence mental health during the COVID-19 pandemic, considering two factors that profoundly characterize urbanization: air pollution and migration. Air pollution serves as a possibly risk factor for higher viral spread and infection severity in the context of urban areas and it has also been demonstrated to play a role in the development of serious mental illnesses and their relapses. The urban environment also represents a complex social context where minorities such as migrants may live in poor hygienic conditions and lack access to adequate mental health care. A global rethinking of the urban environment is thus required to reduce the impact of these factors on mental health. This should include actions aimed at reducing air pollution and combating climate change, promoting at the same time a more inclusive society in a sustainable development perspective.

Mental health service use and its associated factors among nurses in China: a cross-sectional survey

Background

To facilitate mental health service planning for nurses, data on the patterns of mental health service use (MHSU) among nurses are needed. However, MHSU among Chinese nurses has seldom been studied. Our study aimed to explore the rate of MHSU among Chinese nurses and to identify the factors associated with MHSU.

Methods

A self-designed anonymous questionnaire was used in this study. MHSU was assessed by the question, “Have you ever used any kind of mental health services, such as mental health outpatient services or psychotherapies, when you felt that your health was suffering due to stress, insomnia, or other reasons?” The answer to the question was binary (yes or no). Sleep quality, burnout, and depressive symptoms were assessed using the Chinese version of the Pittsburgh Sleep Quality Index , the Chinese version of the Maslach Burnout Inventory-General Survey and the two-item Patient Health Questionnaire, respectively. Chi-square tests and binary logistic regression were used for univariate and multivariate analyses.

Results

A total of 10.94% (301/2750) of the nurses reported MHSU. 10.25% (282/2750) of the nurses had poor sleep quality, burnout and depressive symptoms, and only 26.95% of these nurses reported MHSU. Very poor sleep quality (OR 9.36, 95% CI [5.38-16.29]), mid-level professional title (OR 1.48, 95% CI [1.13-1.93]) and depressive symptoms (OR 1.66, 95% CI [1.28-2.13]) were independent factors associated with MHSU.

Conclusions

Most of the nurses have experienced burnout, poor sleep quality or depressive symptoms and the MHSU rate among them was low. Interventions to improve the mental health of nurses and to promote the use of mental health services are needed.

Relaxation Response in Stressed Volunteers: Psychometric Tests and Neurotrophin Changes in Biological Fluids

Background: To evaluate the beneficial effects of relaxation response (RR) training in adult stressed subjects by evaluating the psychometric response recorded at relaxation session. Cortisol as well as nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) mediators were quantified in both saliva and tears, and their levels were related to each other and to the psychometric response. Methods: Stressed subjects (n = 23; 10M/13F; age range 21-53 years old) were voluntarily enrolled in the study. RR training sessions were carried out for 2 months, 1 day per week, at the same time (3-5 p.m.). Two different psychological questionnaires, the Perceived Stress Scale-10 (PSS-10) and the Beck Depression Inventory - Short Form (BDI-SF) and Ocular Surface Disease Index (OSDI) tests, were administered before each session. Saliva and tears were sampled for cortisol (EIA), NGF (ELISA), and BDNF (ELISA) quantifications. Questionnaires' data were analyzed and compared to biochemical ones. Results: All subjects reported beneficial effects from training. RR significantly reduced the psychological stress indexes (p = 0.039 for PSS-10 and p = 0.001 for BDI-SF). Specifically, RR training lowered the perception of Perceived Helplessness (items 1, 3, 10; p < 0.05) in PSS-10 and increased the Perceived Self-Efficacy (p < 0.05). OSDI score was in the normal range (0-25). Biochemically, a decrease in cortisol, a trend to a decrease in NGF, and an increase in BDNF levels were observed in saliva samples after RR treatment. Furthermore, a trend to a decrease in NGF and an increase in BDNF were quantified in tear samples. A correlation between PSS-10 total score and saliva NGF variation (%) as well as between BDI-SF total score and BDNF tear levels were also observed. Conclusion: RR training appeared useful to lowering psychological, mental, and physical stress, as supported by both psychological total and single scores. The finding on biochemical levels of BDNF in saliva and tears are sustained by previous studies while those of NGF require further investigation. Overall, these data on a small population highlight the potential use of RR training and potential neurotrophic changes in biological fluids, in stressed volunteers.

Prevalence of depression and its association with quality of life in clinically stable patients with COVID-19

INTRODUCTION

High risk of mental health problems is associated with Coronavirus Disease 2019 (COVID-19). This study explored the prevalence of depressive symptoms (depression hereafter) and its relationship with quality of life (QOL) in clinically stable patients with COVID-19.

METHODS

This was an online survey conducted in COVID-19 patients across five designated isolation hospitals for COVID-19 in Hubei province, China. Depression and QOL were assessed with standardized instruments.

RESULTS

A total of 770 participants were included. The prevalence of depression was 43.1% (95%CI: 39.6%-46.6%). Binary logistic regression analysis found that having a family member infected with COVID-19 (OR=1.51, P = 0.01), suffering from severe COVID-19 infection (OR=1.67, P = 0.03), male gender (OR=0.53, P<0.01), and frequent social media use to obtain COVID-19 related information (OR=0.65, P<0.01) were independently associated with depression. Patients with depression had lower QOL than those without.

CONCLUSION

Depression is highly prevalent in clinically stable patients with COVID-19. Regular screening and appropriate treatment of depression are urgently warranted for this population.

Migrant workers in China need emergency psychological interventions during the COVID-19 outbreak

The 2019 novel coronavirus disease (COVID-19) has been found in more than 200 countries worldwide since December, 2019. In China, a major reason for the rapid transmission of the COVID-19 in early stage of the outbreak is the huge numbers of passengers boarding their “last train home” to meet family members during the Spring Festival. Most of these travelers were internal migrant workers. In order to reduce the risk of the COVID-19 transmission, public transportation networks were suspended, and many migrant workers who returned to their hometowns needed to be quarantined for 2 weeks, which led to the delay of returning back to cities to work. Many businesses have temporarily closed because of the risk of COVID-19 transmission, leading to unemployment of many workers. Sudden loss of income and further quarantine enforcement in cities can exacerbate existing mental health problems or trigger new mental disorders among affected migrant workers. However, to date no specific guidelines or strategies about mental health services of migrant workers have been released. Health authorities and professionals should pay more attention to this vulnerable group and provide timely mental health service support for those in need.

Prevalence of depressive symptoms in primary school students in China: A systematic review and meta-analysis

BACKGROUNDS

Depression in children and adolescents is usually under-recognized. The findings of epidemiological studies on depressive symptoms in primary school students are inconsistent across studies. This study reports a systematic review and meta-analysis on the prevalence of depressive symptoms in primary school students in China.

METHODS

Literature search was performed in both international (PubMed, PsycINFO, EMBASE) and Chinese (China National Knowledge Internet, WANFANG Data and Chinese Biological Medical Literature) databases. The random-effects model was used to analyze data.

RESULTS

Twenty-seven studies involving 42,374 subjects were included. The pooled prevalence of depressive symptoms in Chinese primary school students was 17.2% (95% CI: 14.3%-20.5%). Subgroup analyses found that the prevalence significantly varied between geographic regions, with western China reporting the highest prevalence. Meta-regression analyses found that year of survey and study quality were significantly associated with the prevalence of depressive symptoms.

CONCLUSIONS

Given the high prevalence of depressive symptoms and its negative health outcomes, preventive measures, regular screening and effective treatments need to be implemented for this population.

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

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

Obesity increases the risk of depression in children and adolescents: Results from a systematic review and meta-analysis

BACKGROUND

Clinical depression (including major depression, dysthymia, and unspecified depression) is common in children and adolescents with obesity and overweight. The objective of this systematic review and meta-analysis was to examine prevalence of clinical depression among overweight and obese children.

METHODS

PubMed, EMBASE, Web of Science, Medline, Cochrane library, and PsycINFO databases were systematically and independently searched by three researchers from the inception dates to April 01, 2019. The fixed-effects model was used to perform meta-analysis. Data analyses were performed with STATA Version 12.0.

RESULTS

Eleven studies with 69,893 subjects were included; 5 studies examined major depressive disorder (MDD), while the remaining 6 studies examined other types of clinical depression. In the overweight and obese group, the prevalence of clinical depression ranged from 1.7% to 26.7% in obese subjects and from 4.0% to 16.9% in overweight subjects. In studies on MDD, prevalence ranged from 10.1% to 26.7% in obese subjects and from 9.0% to 16.9% in overweight subjects. The odd ratios (ORs) of clinical depression ranged from 0.92 to 4.39 between obese subjects and healthy controls (i.e., normal-weight controls), and ranged from 0.96 to 1.67 between overweight subjects and controls. Compared to healthy controls, obese (OR = 1.851, 95% CI: 1.410-2.429) but not overweight (OR = 1.068, 95% CI: 0.889-1.283) children and adolescents were more likely to have MDD.

CONCLUSION

Obese children and adolescents had a significantly higher risk for MDD compared with healthy controls. Considering the negative health outcomes of depression, regular screening and effective treatments should be implemented for obese children and adolescents.

Prevalence of psoriasis and associated risk factors in China: protocol of a nationwide, population-based, cross-sectional study

INTRODUCTION

Psoriasis is a chronic inflammatory skin disease which could lead to serious complications and increased risk of cardiovascular diseases. Psoriasis was recognised as a serious non-communicable disease with important public health impact by member states in the World Health Assembly resolution in 2014. However, data on psoriasis epidemiology are scarce worldwide, especially from low-income and middle-income countries. Only a few epidemiological studies on psoriasis have been conducted in parts of China, mostly without appropriate sampling design and data analysis.

AIM

This study aims to obtain the prevalence of psoriasis in China and relevant risk factors through a nationwide, population-based study with adequate statistical design.

METHODS AND ANALYSIS

This is a cross-sectional study to be conducted in 60 sites across China. A multistage, cluster random sampling design is used. Participants should have local household registration or be residing in the survey area for at least 6 months during the past year. The presence of psoriasis is ascertained independently by two certified dermatologists. If any discrepancies in the diagnosis occur, consensus will be met via discussion. All participants will be interviewed with a questionnaire to collect sociodemographic and disease information. The field survey will be implemented from October 2018 to June 2019. All statistical analyses will be conducted using survey procedures in SAS V.9.2 software to adjust for the complex sample design.

ETHICS AND DISSEMINATION

The study has been reviewed and approved by the ethics committee of the Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College (Nanjing, China). A written informed consent will be obtained from all participants before the questionnaire survey. Findings of the study will be disseminated through publications in peer-reviewed journals.