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The role of education level on changes in endorsement of medication treatment and perceived public stigma towards psychosis in Hong Kong: comparison of three population-based surveys between 2009 and 2018. BMC Psychiatry 2022; 22:641. [PMID: 36229867 PMCID: PMC9559020 DOI: 10.1186/s12888-022-04288-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 09/29/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the changes in perceived public stigma (PPS) towards psychosis, and endorsement of medication treatment between 2009 to 2018 in the Hong Kong Chinese population.The role of education level on the changes in PPS and endorsement of medication treatment for psychosis was also examined. METHODS Telephone survey of the general population was conducted in 2009, 2014, and 2018. PPS was assessed using the revised Link's Perceived Discrimination-Devaluation Scale. Endorsement of medication was measured using an item asking if individuals with psychosis requires medication to manage their symptoms. Education level was separated into three categories (primary, secondary, and tertiary) for analysis. Factorial analysis of covariance was used to examine the main effects of survey year, education and endorsement of medication on stigma, and the interaction between survey year and education level, and survey year and endorsement of medication on PPS. RESULTS 1016, 1018, and 1514 respondents completed the surveys in 2009, 2014, and 2018, respectively. PPS was found to be stable across the three public surveys. Endorsement of medication treatment was associated with higher PPS. An interaction effect between survey year and education level onPPS was observed. PPS was significantly lower and fewer respondents endorsed medication treatment in 2018 in the tertiary education group than in previous years. CONCLUSION Current findings suggest that a targeted approach may be required for different education groups when developing anti-stigma public campaigns. Inclusion of other aspects of knowledge about psychosis may also be useful in reduction of PPS.
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Renaming Schizophrenia and Stigma Reduction: A Cross-Sectional Study of Nursing Students in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063563. [PMID: 35329254 PMCID: PMC8954196 DOI: 10.3390/ijerph19063563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/04/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022]
Abstract
Schizophrenia is one of the most stigmatized mental disorders. In 2014, schizophrenia was renamed in Mandarin in Taiwan, from the old name of “mind-splitting disease” to new name “disorder with dysfunction of thought and perception”, in an attempt to reduce the stigmatization of schizophrenia. This cross-sectional study aimed to investigate the effects of renaming schizophrenia on its stigma in nursing students. We examined the public stigma, self-stigma, and social distance associated with schizophrenia and compared them before and after the renaming. Basic demographic data and previous contact experience were collected, and participants completed a modified Attribution Questionnaire, the Perceived Psychiatric Stigma Scale, and modified Social Distance Scale. The final sample comprised 99 participants. Assessment revealed that the renaming significantly reduced public stigma, self-stigma, and social distance. Regarding the old and new names for schizophrenia, the fourth-year nursing students scored significantly higher on public stigma and self-stigma than did the first-year students. Personal exposure to individuals diagnosed with mental disorders reduced public stigma toward schizophrenia. The study findings suggest that the renaming of schizophrenia reduced its associated stigma. Providing accurate information, instruction by qualified tutors, as well as exposure to patients in acute exacerbation in hospital settings and recovered patients in the community are important. Further studies with longitudinal design, participants from diverse backgrounds, and larger sample sizes to investigate the effect of renaming on the stigma toward schizophrenia are warranted.
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Wang M, Wang Y, Xu J, Meng N, Li X, Liu Z, Huang J. Individual-level socioeconomic status and contact or familiarity with people with mental illness: a cross-sectional study in Wuhou District, Chengdu, Southwest China. BMC FAMILY PRACTICE 2021; 22:71. [PMID: 33836653 PMCID: PMC8035729 DOI: 10.1186/s12875-021-01422-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/19/2021] [Indexed: 02/08/2023]
Abstract
Background People with mental illness (PWMI) often suffer from public stigma, which can make them unwilling to seek help and reduce access to early treatment. The aims of this study were to determine attitudes towards PWMI among the general public in a Chinese sample and to explore the relationships with sociodemographic characteristics. Methods A community-based, cross-sectional study was conducted from March to June 2019. The participants’ attitudes towards PWMI were evaluated by the Chinese version of the Social Distance Scale (SDSC). An independent-sample T-test and one-way ANOVA were used to determine the association of categorical variables with the outcome variable. Multiple linear regression and Spearman correlations were computed to explore the correlation between SDSC scores and individual-level socioeconomic status (SES). Results A total of 1437 participants were recruited, and their total SDSC score was 12.53 (SD: 3.11). Univariate analysis results showed that age, education level, educational attainment, and individual-level SES as well as whether they were caregivers/family members of PWMI were correlated with SDSC scores. The results of regression analysis showed a significant effect caused by contact or familiarity with PWMI (B = -1.134, β = -.190, P < 0.001), as well as for individual-level SES (B = -.339, β = -.110, P < 0.001). Spearman correlation results showed that SDSC scores were negatively correlated with individual-level SES (r = -.078, p < 0.01) and contact or familiarity with PWMI (r = -.168, p < 0.001). Conclusion This study reveals that public stigma towards PWMI is common in Southwest China. Individuals who are not a family member or a caregiver of PWMI or have low education level or low individual-level SES need to be provided more anti-stigma interventions. Contacting with PWMI is also a potentially beneficial measure to reduce social distance. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01422-y.
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Affiliation(s)
- Mengmeng Wang
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Ya Wang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Jiajun Xu
- Mental Health Center, West China Hospital, Sichuan University, Guoxuexiang No.37, Chengdu, 610041, Sichuan, China.
| | - Na Meng
- Mental Health Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Xiaolin Li
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Zheng Liu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Junqiang Huang
- Chengdu Dekang Hospital, Sichuan University, Chengdu, 610041, China
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Zhao YJ, Jin Y, Rao WW, Zhang QE, Zhang L, Jackson T, Su ZH, Xiang M, Yuan Z, Xiang YT. Prevalence of Major Depressive Disorder Among Adults in China: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:659470. [PMID: 34168579 PMCID: PMC8219051 DOI: 10.3389/fpsyt.2021.659470] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/29/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Prevalence estimates of major depressive disorder (MDD) among adults in China have varied widely between studies. In this systematic review and meta-analysis, the overall prevalence of MDD in the Chinese population was estimated from published epidemiological studies and potential moderators that account for variability in estimates were assessed. Methods: A systematic literature search was conducted in PubMed, EMBASE, Web of Science, PsycINFO, China National Knowledge Internet (CNKI), and WanFang databases to identify relevant studies. Data analyses were conducted using the Comprehensive Meta-Analysis Version 2.0. Results: Forty studies comprising 1,024,087 subjects were included. The pooled point, 12-month, and lifetime prevalence rates of MDD in China were 1.1% (95% CI: 0.9-1.4%), 1.6% (95% CI: 1.0-2.5%), and 1.8% (95% CI: 1.5-2.2%), respectively. Subgroup and meta-regression analyses revealed gender, marital status, survey year, being published in English language, use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic systems and age as significant moderators of MDD prevalence. Conclusion: The overall prevalence of MDD in the Chinese population appears to be lower than that of most countries, but the rates have been increasing over time and are elevated in particular demographic subgroups. Due to the negative consequences of MDD, effective preventive measures, early identification, and timely treatments are still important and should be offered to those in need.
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Affiliation(s)
- Yan-Jie Zhao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China
| | - Yu Jin
- College of Education for the Future, Beijing Normal University, Zhuhai, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China
| | - Qing-E Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, The Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Todd Jackson
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China
| | - Zhao-Hui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, United States
| | - Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Zhen Yuan
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China
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Oudejans SCC, Spits ME, van Weeghel J. A cross-sectional survey of stigma towards people with a mental illness in the general public. The role of employment, domestic noise disturbance and age. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1547-1554. [PMID: 34272574 PMCID: PMC8429159 DOI: 10.1007/s00127-021-02111-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/31/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Stigmatization impedes the social integration of persons recovering from mental illnesses. Little is known about characteristics of the stigmatized person that lessen or aggravate public stigma. PURPOSE This study investigates which characteristics of persons with mental illnesses (i.e. with a depression or a psychotic disorder) might increase or decrease the likelihood of public stigma. METHODS Over 2,000 adults read one of sixteen vignettes describing a person with a depressive disorder or a psychotic disorder and answered a set of items measuring social distance. RESULTS The person who was employed (vs. unemployed), or whose neighbors did not experience domestic noise disturbance (vs. disturbance) elicited significantly less social distance. Also persons with a depressive disorder elicited less social distance, vs. persons with a psychotic disorder. CONCLUSION Employment and good housing circumstances may destigmatize persons coping with mental illnesses. Mental health and social services should encourage paid employment, quality housing and other paths to community integration.
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Affiliation(s)
- S. C. C. Oudejans
- Mark Bench, Rhôneweg 16, 1043AH Amsterdam, The Netherlands ,Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, Amsterdam, The Netherlands
| | - M. E. Spits
- Mark Bench, Rhôneweg 16, 1043AH Amsterdam, The Netherlands ,Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, Amsterdam, The Netherlands ,Dutch Addiction Association, Amersfoort, The Netherlands
| | - J. van Weeghel
- Phrenos Center of Expertise, Utrecht, The Netherlands ,Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
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Wang Q, Du T. Implementation of the college student mental health education course (CSMHEC) in undergraduate medical curriculum: effects and insights. BMC MEDICAL EDUCATION 2020; 20:505. [PMID: 33308205 PMCID: PMC7731140 DOI: 10.1186/s12909-020-02438-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 12/08/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Extant literature reveals that medical students suffer from various mental health problems in the process of learning medicine. However, there are few studies evaluating the implementation of a mental health education course in medical curriculum. The current study aimed to test the effectiveness of an 8-week intensive mental health education course, the College Student Mental Health Education Course (CSMHEC), and to gain further insights on how the course could be improved from students' feedback. METHODS This is a quasi-experimental study with both quantitative and qualitative analyses. We recruited 374 first year medical students as our subjects with 188 (age = 17.97 ± 0.65 years, 37.2% male) for the experiment group and 186 (age = 18.02 ± 0.63 years, 40.3% male) for the control group. For quantitative analysis, Depression Anxiety Stress Scales-21 (DASS-21), Chinese College Student Academic Burnout Inventory (CCSABI) and Satisfaction With Life Scale (SWLS) were used and a 5-point Likert scale was used to indicate students' overall satisfaction with CSMHEC. For qualitative analysis, a thematic analysis method was adopted to gain insights from the feedback of medical students. RESULTS Medical students in the experiment group saw a significant decline in psychological distress (p < 0.001, d = 0.31) and academic burnout (p < 0.001, d = 1.46), while they experienced a significant increase in life satisfaction levels after the intervention (p < 0.001, d = 0.48). Compared with students in the control group, students in the experiment group had statistically significant lower levels of psychological distress (p < 0.05, d = 0.23) and academic burnout (p < 0.001, d = 0.70), but statistically significant higher levels of life satisfaction in the post-test (p < 0.01, d = 0.31). Most students in the experiment group were satisfied with CSMHEC and themes extracted in the thematic analysis shed light on how the course could be improved. CONCLUSIONS Implementing a mental health education course like CSMHEC in medical curriculum can be effective in helping medical students improve psychological health. More research needs to be conducted on further refinement and better design of such a course to implement in medical education.
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Affiliation(s)
- Qinghua Wang
- English Department, School of Fundamental Sciences, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
| | - Tianjiao Du
- Department of Psychology, School of Humanities and Social Sciences, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province People’s Republic of China
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COVID-19 patients managed in psychiatric inpatient settings due to first-episode mental disorders in Wuhan, China: clinical characteristics, treatments, outcomes, and our experiences. Transl Psychiatry 2020; 10:337. [PMID: 33009366 PMCID: PMC7531059 DOI: 10.1038/s41398-020-01022-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/04/2020] [Indexed: 01/08/2023] Open
Abstract
Data are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder (n = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress (n = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms (n = 18, 72.0%), followed by aggressive behaviors (n = 16, 64.0%), delusion (n = 10, 40.0%), and severe anxiety (n = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.
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Jin Y, Zhang YS, Zhang Q, Rao WW, Zhang LL, Cui LJ, Li JF, Li L, Ungvari GS, Jackson T, Li KQ, Xiang YT. Prevalence and Socio-Demographic Correlates of Poor Mental Health Among Older Adults in Agricultural Areas of China. Front Psychiatry 2020; 11:549148. [PMID: 33250790 PMCID: PMC7674548 DOI: 10.3389/fpsyt.2020.549148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022] Open
Abstract
Objective: Poor mental health is associated with impaired social functioning, lower quality of life, and increased risk of suicide and mortality. This study examined the prevalence of poor general mental health among older adults (aged 65 years and above) and its sociodemographic correlates in Hebei province, which is a predominantly agricultural area of China. Methods: This epidemiological survey was conducted from April to August 2016. General mental health status was assessed using the 12-item General Health Questionnaire (GHQ-12). Results: A total of 3,911 participants were included. The prevalence of poor mental health (defined as GHQ-12 total score ≥ 4) was 9.31% [95% confidence interval (CI): 8.4-10.2%]. Multivariable logistic regression analyses found that female gender [P < 0.001, odds ratio (OR) = 1.63, 95% CI: 1.29-2.07], lower education level (P = 0.048, OR = 1.33, 95% CI: 1.00-1.75), lower annual household income (P = 0.005, OR = 1.72, 95% CI: 1.17-2.51), presence of major medical conditions (P < 0.001, OR = 2.95, 95% CI: 2.19-3.96) and family history of psychiatric disorders (P < 0.001, OR = 3.53, 95% CI: 2.02-6.17) were significantly associated with poor mental health. Conclusion: The prevalence of poor mental health among older adults in a predominantly agricultural area was lower than findings from many other countries and areas in China. However, continued surveillance of mental health status among older adults in China is still needed.
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Affiliation(s)
- Yu Jin
- Faculty of Science, Kunming University of Science and Technology, Kunming, China
| | - Yun-Shu Zhang
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Baoding, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China
| | - Li-Li Zhang
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Baoding, China
| | - Li-Jun Cui
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Baoding, China
| | - Jian-Feng Li
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Baoding, China
| | - Lin Li
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Baoding, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia.,University of Notre Dame, Fremantle, WA, Australia
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao, China
| | - Ke-Qing Li
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Baoding, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, China.,Center for Cognition and Brain Sciences, University of Macau, Macao, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China
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