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Chen LC, Tan WY, Xi JY, Xie XH, Lin HC, Wang SB, Wu GH, Liu Y, Gu J, Jia FJ, Du ZC, Hao YT. Violent behavior and the network properties of psychopathological symptoms and real-life functioning in patients with schizophrenia. Front Psychiatry 2024; 14:1324911. [PMID: 38274426 PMCID: PMC10808501 DOI: 10.3389/fpsyt.2023.1324911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
Objective To assess the interplay among psychopathological symptoms and real-life functioning, and to further detect their influence with violent behavior in patient with schizophrenia. Methods A sample of 1,664 patients with post-violence assessments and their propensity score-matched controls without violence from a disease registration report system of community mental health service in Guangdong, China, were studied by network analysis. Ising-Model was used to estimate networks of psychopathological symptoms and real-life functioning. Then, we tested whether network properties indicated the patterns of interaction were different between cases and controls, and calculated centrality indices of each node to identify the central nodes. Sensitivity analysis was conducted to examine the difference of interaction patterns between pre-violence and post-violence assessments in violence cases. Results Some nodes in the same domain were highly positive interrelations, while psychopathological symptoms were negatively related to real-life functioning in all networks. Many symptom-symptom connections and symptom-functioning connections were disconnected after the violence. The network density decreased from 23.53% to 12.42% without statistical significance (p = 0.338). The network structure, the global network strength, and the global clustering coefficient decreased significantly after the violence (p < 0.001, p = 0.019, and p = 0.045, respectively). Real-life functioning had a higher node strength. The strength of sleeping, lack of spontaneity and flow of conversation, and preoccupation were decreased in post-violence network of patients. Conclusion The decreasing connectivity may indicate an increased risk of violence and early warning for detecting violence. Interventions and improving health state based on nodes with high strength might prevent violence in schizophrenia patients.
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Affiliation(s)
- Li-Chang Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wen-Yan Tan
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Jun-Yan Xi
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xin-Hui Xie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hai-Cheng Lin
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Gong-Hua Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yu Liu
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jing Gu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Zhi-Cheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuan-Tao Hao
- Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
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Zhang L, Qi X, Wen L, Hu X, Mao H, Pan X, Zhang X, Fang X. Identifying risk factors to predict violent behaviour in community patients with severe mental disorders: A retrospective study of 5277 patients in China. Asian J Psychiatr 2023; 83:103507. [PMID: 36796125 DOI: 10.1016/j.ajp.2023.103507] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/07/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Patients with Severe Mental Disorders (SMD) have a higher risk of violent behaviour than the general population. The study aimed to investigate the predictive factors for the occurrence of violent behaviour in community SMD patients. METHODS The cases and follow-up data were collected from SMD patient Information Management system in Jiangning District, Jiangsu Province. The incidence of violent behaviours was described and analyzed. Logistic regression model was used to examine the influencing factors for violent behaviours in those patients. RESULTS Among 5277 community patients with SMD in Jiangning District, 42.4% (2236/5277) had violent behaviours. The stepwise logistic regression analysis revealed that the disease-related factors (including disease type, disease course, times of hospitalization, medication adherence, past violent behaviours), the demographic factors (age, male sex, educational level, economic and social living status), and the policy-related factors (like free treatment, annual physical check, disability certificate, family physician services, and community interviews) were significantly related to the violent behaviours in community SMD patients. After gender stratification, we found that male patients with unmarried status and with a longer course of disease were more likely to violent. However, we found that female patients with lower economic status and educational experience were more likely to violent. CONCLUSION Our results suggest that community SMD patients had a high incidence of violent behaviour. The findings may provide valuable information for policymakers and mental health professionals worldwide taking a number of measures to reduce the incidence of violence in community SMD patients and to better maintain social security.
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Affiliation(s)
- Lin Zhang
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xin Qi
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Lu Wen
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xiuxiu Hu
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Hongjun Mao
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xinming Pan
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
| | - Xinyu Fang
- Department of Geriatric Psychiatry, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
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李 硕, 杨 先, 王 丹, 范 箬, 田 绍, 王 荣, 向 虎, 张 强, 刘 元, 刘 祥. [Factors Influencing Suicide Deaths in Patients With Schizophrenia Based on Cohort Data: An Empirical Study of a Sample of 170006 Patients in Sichuan Province]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:142-147. [PMID: 36647657 PMCID: PMC10409051 DOI: 10.12182/20230160302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Indexed: 01/18/2023]
Abstract
Objective To prospectively explore the risk factors of suicide in patients with schizophrenia. Methods Data on schizophrenia patients in Sichuan Province between 2006 and 2018 were obtained from the National Severe Mental Disorders Information System, and the Cox proportional hazards regression model was used to explore for risk factors for suicide in schizophrenia patients. Result A total of 170006 patients with schizophrenia were included in the study. At the end of the follow-up period, 160570 patients were alive and 9436 died from various causes, 929 of which being suicide deaths, resulting in a suicide rate of 223.61/100, 000 person-years. The Cox proportional hazards regression model suggested that risk factors for suicide in patients with schizophrenia included poverty ( HR=1.20, 95% CI: 1.02-1.41), higher education level (primary school [ HR=1.32, 95% CI: 1.09-1.60], middle school [ HR=1.40, 95% CI: 1.14-1.73], high school and above [ HR=1.93, 95% CI: 1.49-2.52]) in comparison with illiteracy and semi-literacy, suicide attempts ( HR=2.70, 95% CI: 1.70-4.29), strict medication compliance ( HR=1.91, 95% CI: 1.66-2.20), history of antipsychotic drug therapy ( HR=1.42, 95% CI: 1.06-1.90), younger age group of patients of 46-60 ( HR=1.95, 95% CI: 1.60-2.39), 31-45 ( HR=3.61, 95% CI: 2.92-4.47), and 15-30 ( HR=12.37, 95% CI: 9.69-15.78) compared with the 61-90 age group, and doing agriculture jobs ( HR=1.36, 95% CI: 1.13-1.65). Conclusion Young and middle-aged schizophrenia patients with higher education levels, especially those with a history of suicide attempts, are at high risk for suicide. Focused interventions should be directed at high-risk groups to reduce suicide deaths in patients with schizophrenia.
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Affiliation(s)
- 硕 李
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 先梅 杨
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 丹 王
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 箬馨 范
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 绍丽 田
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 荣科 王
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 虎 向
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 强 张
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 元元 刘
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 祥 刘
- 四川大学华西公共卫生学院/四川大学华西第四医院 (成都 610041)West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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Guo Y, Yang X, Wang D, Fan R, Liang Y, Wang R, Xiang H, Liu Y, Liu X. Prevalence of violence to others among individuals with schizophrenia in China: A systematic review and meta-analysis. Front Psychiatry 2022; 13:939329. [PMID: 35935404 PMCID: PMC9354073 DOI: 10.3389/fpsyt.2022.939329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/04/2022] [Indexed: 01/28/2023] Open
Abstract
Background Violence to others (hereinafter referred to as "violence-TO") is common in individuals with schizophrenia. The reported prevalence of violence-TO among schizophrenics ranges widely in existing studies. Improved prevalence estimates and identification of moderators are needed to guide future management and research. Methods We searched EBSCO, EMBASE, Medline, PubMed, Science Direct, Web of Science, CNKI, VIP, WANFANG data, and CBM for relevant articles published before June 5, 2022. Meanwhile, violence-TO was summarized into four categories: (a) violence-TO on the reviews of official criminal or psychiatric records (type I); (b) less serious forms of violence-TO (type II); (c) physical acts causing demonstrable harm to victims (type III); (d) homicide (type IV). We did meta-analysis for the above types of violence-TO, respectively, and applied subgroup analyses and meta-regression analyses to investigate the source of heterogeneity. Results A total of 56 studies were eligible in this study and 34 of them were high-quality. The prevalence of type I to type IV in individuals with schizophrenia in China was 23.83% (95% CI: 18.38-29.75%), 23.16% (95% CI: 8.04-42.97%), 17.19% (95%CI: 8.52-28.04%), and 0.62% (95% CI: 0.08-1.54%) respectively. The results of the subgroup analysis showed that the prevalence of type I was higher among subjects in the inland than in the coastal non-economic zone, while the prevalence of type III was the highest in the coastal economic zone, followed by the inland region and the lowest in the coastal non-economic zone. The results of multivariate meta-regression analyses showed that: patient source in type I (β = 0.15, P < 0.01), patient source (β = 0.47, P < 0.01), and proportion of male (β = 0.19, P < 0.01) in type II, age (β = 0.25, P < 0.01), and GDP per capita (β = 0.05, P = 0.01) in type III were statistically significant. Conclusion The prevalence of different types of violence-TO and their influencing factors varied. Therefore, the authorities should take different management measures. In addition to individual factors, regional factors may also affect violence-TO, which suggests the need for a multi-sectorial approach to prevention and treatment for subjects in different regions and adopting targeted control strategies. Systematic Review Registration [www.ClinicalTrials.gov], identifier [CRD42021269767].
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Affiliation(s)
- Yi Guo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xianmei Yang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Dan Wang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Ruoxin Fan
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Yiying Liang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rongke Wang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Hu Xiang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiang Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Tan W, Chen L, Zhang Y, Xi J, Hao Y, Jia F, Hall BJ, Gu J, Wang S, Lin H, Lin X. Regional years of life lost, years lived with disability, and disability-adjusted life-years for severe mental disorders in Guangdong Province, China: a real-world longitudinal study. Glob Health Res Policy 2022; 7:17. [PMID: 35725574 PMCID: PMC9208127 DOI: 10.1186/s41256-022-00253-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To understand the magnitude and spatial-temporal distribution of the regional burden attributable to severe mental disorders is of great essential and high policy relevance. The study aimed to address the burden of severe mental disorders by evaluating the years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) in Guangdong, China. METHODS We undertook a longitudinal study based on a multicenter database established by the Health Commission of Guangdong, involving a total of 21 prefectures and four economic regions in the Guangdong province. A total of 520,731 medical records from patients with severe mental disorders were collected for 2010-2020. Data were analyzed via an integrated evaluation framework by synthesizing prevalence estimates, epidemiological adjustment as well as comorbidity assessment to develop internally consistent estimates of DALY. DALY changes during 2010-2020 were decomposed by population growth and aging and further grouped by Socio-demographic Index (SDI). DALYs were projected to 2030 by the weighted median annualized rate of change in 2010-2020. RESULTS In 2010-2020, the average DALYs for severe mental disorders reached 798,474 (95% uncertainty interval [UI]: 536,280-1,270,465) person-years (52.2% for males, and 47.8% for females). Severe mental disorders led to a great amount of disease burden, especially in Guangzhou, Shenzhen, and Foshan cities. Schizophrenia and mental retardation with mental disorders were the two leading sources of the burden ascribed to severe mental disorders. Population growth and aging could be accountable for the increasing burden of severe mental disorders. Economic regions with higher SDI carried a greater burden but had lower annualized rates of change in DALYs. The overall burden of severe mental disorders is projected to rise modestly over the next decade. CONCLUSIONS The findings urge prioritization of initiatives focused on public mental health, prevention strategies, health resources reallocation, and active involvement of authorities to effectively address the anticipated needs.
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Affiliation(s)
- Wenyan Tan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Lichang Chen
- Department of Medical Statistics and Center for Health Information Research and Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Rd, Guangzhou, 510080, Guangdong, China
| | - Yuqin Zhang
- Department of Medical Statistics and Center for Health Information Research and Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Rd, Guangzhou, 510080, Guangdong, China
| | - Junyan Xi
- Department of Medical Statistics and Center for Health Information Research and Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Rd, Guangzhou, 510080, Guangdong, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, 100191, China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Brian J Hall
- Global Public Health, New York University (Shanghai), Shanghai, 200122, China
| | - Jing Gu
- Department of Medical Statistics and Center for Health Information Research and Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Rd, Guangzhou, 510080, Guangdong, China.,Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Shibin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Haicheng Lin
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Xiao Lin
- Department of Medical Statistics and Center for Health Information Research and Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Rd, Guangzhou, 510080, Guangdong, China. .,Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
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Lau JH, Jeyagurunathan A, Shafie S, Chang S, Samari E, Cetty L, Verma S, Tang C, Subramaniam M. The factor structure of the Barratt Impulsiveness Scale (BIS-11) and correlates of impulsivity among outpatients with schizophrenia and other psychotic disorders in Singapore. BMC Psychiatry 2022; 22:226. [PMID: 35361174 PMCID: PMC8968701 DOI: 10.1186/s12888-022-03870-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/21/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Impulsivity has been linked to risky behaviours amongst patients with schizophrenia or other psychotic disorders. However, there is a dearth of studies examining impulsivity amongst this population in Singapore. Moreover, to date, scales to measure impulsivity have not been validated in this population. The present study seeks to examine the underlying factor structure of the Barratt Impulsiveness Scale (BIS-11) and explore sociodemographic and clinical correlates of impulsivity within this group. METHODS Confirmatory factor analyses (CFA) were conducted to test factor structures of the BIS-11 proposed in extant literature. However, due to poor fit statistics, the sample (n = 397) was split into two groups, with Exploratory Factor Analyses (EFA) conducted in the first subgroup (n = 200). The final model of the EFA was then tested within the second subgroup (n = 197) with CFA. Multivariable linear regressions were conducted to examine sociodemographic and clinical correlates of each underlying factor. RESULTS CFA indicated a three-factor structure amongst 16-items of the BIS-11 with acceptable fit: i) Non-planning impulsivity (5-items; α = 0.94), ii) Motor impulsiveness (6-items α = 0.84), and iii) Lack of self-control (5-items, α = 0.85). Lower education was associated with higher non-planning impulsivity. While age, ethnicity, marital status, and general psychiatric symptom severity were significant correlates of motor impulsiveness, problematic alcohol use and general psychiatric symptom severity were related to a greater lack of self-control. CONCLUSION Factor structures of the BIS-11 suggested by extant literature were not applicable, and we propose an alternative factor structure for BIS-11. Significant correlates of impulsivity are highlighted, and avenues for future research are suggested.
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Affiliation(s)
- Jue Hua Lau
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Saleha Shafie
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Sherilyn Chang
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Ellaisha Samari
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Laxman Cetty
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Swapna Verma
- grid.414752.10000 0004 0469 9592Medical Board, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Charmaine Tang
- grid.414752.10000 0004 0469 9592Department of Early Psychosis Intervention, Institute of Mental Health Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
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Liu X, Wang D, Fan R, Wang R, Xiang H, Yang X, Liu Y. Life expectancy and potential years of life lost for schizophrenia in western China. Psychiatry Res 2022; 308:114330. [PMID: 34929521 DOI: 10.1016/j.psychres.2021.114330] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/21/2021] [Accepted: 12/04/2021] [Indexed: 11/17/2022]
Abstract
Excess mortality in people with schizophrenia has been extensively reported. However, little is known about the life expectancy and potential years of life lost (PYLL) in western China. This study aimed to estimated life expectancy and PYLL for people with schizophrenia in western China. A total of 228,572 people with schizophrenia were included from National Information System for Psychosis in one province of western China. Life-expectancy was calculated by using Chiang's method. One-way ANOVA was used to compare the age-sex standardized PYLL for different causes of death among different demographic characteristics groups. Life expectancy for men and women with schizophrenia was 52.8 years and 59.0 years respectively. The overall PYLL of people with schizophrenia was 18.4 years, and suicide had the largest PYLL (31.2 years) among all causes of mortality. The PYLL due to suicide was significantly higher among men, high school and above, non-poverty, non-farmer and divorced people with schizophrenia. The PYLL due to diseases and medical conditions was higher among men, illiteracy, farmer and unmarried people with schizophrenia. Strategies to prevent causes of premature death in schizophrenia are urgently required in western China, particularly in the promotion of physical health and prevention of suicide.
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Affiliation(s)
- Xiang Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Dan Wang
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Ruoxin Fan
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Rongke Wang
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Hu Xiang
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Xianmei Yang
- The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China.
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Li Y, Yan LL, Ronsmans C, Wen H, Xu J, Wang D, Yang M. Excess mortality among patients with severe mental disorders and effects of community-based mental healthcare: a community-based prospective study in Sichuan, China. BJPsych Open 2021; 7:e84. [PMID: 33883057 PMCID: PMC8086393 DOI: 10.1192/bjo.2021.46] [Citation(s) in RCA: 3] [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] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND High-quality primary care reduces premature mortality in the general population, but evidence for psychiatric patients in China is scarce. AIMS To confirm excess mortality in patients with severe mental illness (SMI), and to examine the impact of community-based mental healthcare and other risk factors on their mortality. METHOD We included 93 655 patients in 2012 and 100 706 in 2013 from the national mental health surveillance system in Sichuan, China to calculate the standardised mortality ratio (SMR). A total of 112 576 patients were followed up from 2009 to 2014 for model analyses. We used growth models to quantify the patterns of change for community management measures, high-risk behaviour, disease stability and medication adherence of patients over time, and then used multilevel proportional hazard models to examine the association between change patterns of management measures and mortality. RESULTS The SMR was 6.44 (95% CI 4.94-8.26) in 2012 and 7.57 (95% CI 5.98-9.44) in 2013 among patients with SMI aged 15-34 years, and diminished with age. Unfavourable baseline socioeconomic status increased the hazard of death by 38-50%. Positive changes in high-risk behaviour, disease stability and medication adherence had a 54% (95% CI 47-60%), 69% (95% CI 63-73%) and 20% (4-33%) reduction in hazard of death, respectively, versus in those where these were unchanged. CONCLUSIONS High excess mortality was confirmed among younger patients with SMI in Sichuan, China. Our findings on the relationships between community management and socioeconomic factors and mortality can inform community-based mental healthcare policies to reduce excess mortality among patients with SMI.
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Affiliation(s)
- Yaxi Li
- West China School of Public Health, Sichuan University, China; Global Heath Research Center, Duke Kunshan University, China
| | - Lijing L Yan
- Global Heath Research Center, Duke Kunshan University, China; School of Global Health and Development, Peking University, China; The George Institute for Global Health at Peking University Health Science Center, China; and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, USA
| | - Carine Ronsmans
- Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, UK
| | - Hong Wen
- The Third Hospital of Mianyang, China
| | - Jiajun Xu
- West China Hospital, Sichuan University, China
| | - Dan Wang
- The Third Hospital of Mianyang, China
| | - Min Yang
- West China School of Public Health, Sichuan University, China; and Faculty of Health, Art and Design, Swinburne University of Technology, Australia
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Wang H, Yao F, Wang H, Wang C, Guo Z. Medication Adherence and Influencing Factors Among Patients With Severe Mental Disorders in Low-Income Families During COVID-19 Outbreak. Front Psychiatry 2021; 12:799270. [PMID: 35115971 PMCID: PMC8803649 DOI: 10.3389/fpsyt.2021.799270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/28/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The COVID-19 has spread across the globe in a short time and affected people's life, especially patients with severe mental disorders. Poor adherence to antipsychotics was usually associated with an increasing risk of relapse. This study investigated medication adherence status among patients with severe mental disorders in low-income families during COVID-19 outbreak and the influencing factors. METHODS To select patients with severe mental disorders in low-income families in central China's Henan Province, we used multi-stage stratified random sampling method. Trained interviewers and psychiatrists collected questionnaire responses from the patients through face-to-face interviews or video interviews. Logistic regression models were used to examine factors that influence the status of medication adherence. RESULTS A total of 24,763 valid questionnaires were collected between March 10, 2020, and March 31, 2020. The regular medication rate of patients with severe mental disorders in low-income families during the COVID-19 outbreak was 51.46%. Twelve factors were found to influence medication adherence of investigated individuals. Positive factors for regular medication were younger age, higher education level of patients and their guardians, higher medical expenditure, higher level of self-care ability, having subsidies for care and supervision, having disability certificate and personal care, etc. CONCLUSIONS The COVID-19 outbreak affected the medication adherence among patients with severe mental disorders in low-income families. The influencing factors are complicated and diverse, including psychological effects, traffic impact, and economy, etc. The government should pay more efforts on social assistance programs and flexibly deal with difficulties during public health emergencies like the COVID-19.
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Affiliation(s)
- Huiying Wang
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, China.,Henan Key Laboratory of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Fengju Yao
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, China
| | - Hailing Wang
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, China
| | - Changhong Wang
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, China.,Henan Key Laboratory of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Zhengjun Guo
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Xinxiang, China
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