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Yu Y, Zheng X, Xu W, Huang Y, Wang X, Hong W, Wang R, Ye X, Zhang C. The impact of parental overprotection on the emotions and behaviors of pediatric hematologic cancer patients: a multicenter cross-sectional study. Front Psychol 2024; 14:1290608. [PMID: 38298359 PMCID: PMC10828849 DOI: 10.3389/fpsyg.2023.1290608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/30/2023] [Indexed: 02/02/2024] Open
Abstract
Background Parental overprotection may have an impact on children's emotional and behavioral problems (EBPs). As pediatric hematologic cancer patients have compromised immune systems, parents of such children often worry excessively, interfering with their daily lives. Therefore, avoiding overprotection is crucial for the overall physical and mental health of pediatric hematologic cancer patients. Aims The aim of this study was to examine the current status of EBPs in pediatric hematologic cancer patients and analyze their associated risk factors. Design This work was a multicenter cross-sectional observational and correlational study. We collected data anonymously through parental questionnaires from three pediatric hematologic oncology hospitals in China. The Strengths and Difficulties Questionnaire, the Parental Overprotection Measure (POM) scale, and a general information survey designed by the research team were employed to assess children's EBPs, the degree of parental overprotection, as well as basic demographic and disease-related information. Chi-square tests and generalized linear mixed-effects regression analysis were used to analyze the factors influencing EBPs among the pediatric hematologic cancer patients. Setting and participants Using a convenience sampling method, a total of 202 participants' parents were selected. All participants were invited to complete the questionnaire through one-on-one guidance. Results Emotional symptoms accounted for the highest proportion of abnormal EBPs in children (27.72%), followed by peer problems (26.24%), prosocial behavior (25.74%), behavioral problems (14.36%), and total difficulties (13.86%). A minority of children had abnormal hyperactivity scores (4.95%). The results of a generalized linear mixed regression analysis showed that age, duration of illness, and parental overprotection were significant factors influencing abnormal EBPs in children (p < 0.05). A POM score threshold of 37 exhibited good sensitivity (74%) and specificity (90%) in predicting abnormal EBPs in children. Conclusion Pediatric hematologic cancer patients under excessive parental protection are more prone to experiencing EBPs. Healthcare professionals should guide parents to reduce this excessive protection, thus mitigating the occurrence of EBPs in children.
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Affiliation(s)
- Yahui Yu
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaofeng Zheng
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wenjing Xu
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuru Huang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xulu Wang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wanting Hong
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Runping Wang
- Department of Hematology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaojing Ye
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chunmei Zhang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Bao R, Yang Z, Memon AR, Chen S, Wang L, Cai Y. Association between meeting the 24-h movement guidelines and psychosocial health in children: A cross-sectional study. Child Care Health Dev 2024; 50:e13191. [PMID: 37899718 DOI: 10.1111/cch.13191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/19/2023] [Accepted: 10/08/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVE Emerging evidence suggests that meeting the 24-h movement guidelines is associated with optimal mental health. However, there remains some uncertainty regarding this association in children. Therefore, this study aimed to examine the association between meeting the 24-h movement guidelines and psychosocial health in children. METHODS A cross-sectional study design was employed to investigate 2005 children aged 9-12 years from four districts of Shanghai, China. The 24-h movement behaviours were assessed using selected items from the Health Behaviour in School-aged Children (HBSC) survey questionnaire. Children's self-rated psychosocial health was evaluated using the Strengths or Difficulties Questionnaire (SDQ). Generalised Linear Models with the ordinal logistic module were employed to analyse the association between meeting the 24-h movement guidelines and psychosocial health. RESULTS The overall prevalence of meeting all three 24-h movement recommendations was 10.2%. Among children, 7.9% of them exhibited abnormal total difficulties, with a notable difference between sex (boys: 11.2%, girls: 7.0%, p = 0.001). Meeting all three 24-h movement behaviour recommendations was associated with reduced total difficulties, emotional symptoms, conduct problems, hyperactivity and peer problems. Furthermore, a dose-response association was observed, indicating that meeting a greater number of 24-h movement behaviour recommendations was associated with enhanced psychosocial health, particularly in boys. CONCLUSION The findings of this study highlight the positive association between meeting the 24-h movement guidelines and psychosocial health in children. Notably, meeting more of these recommendations was associated with a lower likelihood of experiencing psychosocial problems, with greater benefits observed in boys compared with girls.
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Affiliation(s)
- Ran Bao
- Centre for Active Living and Learning, University of Newcastle, Callaghan, New South Wales, Australia
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, New South Wales, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Zhen Yang
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Aamir Raoof Memon
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Sitong Chen
- Centre for Mental Health, Shenzhen University, Shenzhen, China
| | - Lei Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Yujun Cai
- School of Physical Education, Shanghai University of Sport, Shanghai, China
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van der Eijk Y, Woh J. Is secondhand smoke associated with mental health issues? A narrative review of the evidence and policy implications. Health Policy 2023; 136:104900. [PMID: 37651970 DOI: 10.1016/j.healthpol.2023.104900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/20/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023]
Abstract
Secondhand smoke (SHS) is a well-established cause of lung cancer, respiratory disease, heart disease and developmental issues in children, with an overwhelming evidence base spanning over four decades. In this narrative review, we describe studies which have also linked self-reported or cotinine-assessed SHS exposure in the home, workplace and other settings to mental health disorders including depression, suicide, anxiety, and psychological distress in children and adults, sleeping disorders, Attention Deficit Hyperactivity Disorder and behavioural issues in children, and dementia in older adults. In general, evidence indicates that SHS exposure is associated with these disorders in a dose-response manner, with higher odds reported in people who are exposed to SHS at high levels, frequently, and in the home environment. Most studies so far are cross-sectional albeit in large, nationally representative samples from various countries with a smaller number of longitudinal studies. More research is needed in this area to determine whether SHS is a direct cause of adverse mental health outcomes, and whether creating smokefree environments leads to improved mental wellbeing. In particular, more research is needed on the impact of smokefree home environments, an area which has received relatively little focus in smokefree interventions which generally target public places.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, MD1 Tahir Foundation Building, National University of Singapore, 12 Science Drive 2 #09-01C, 117549, Singapore.
| | - Joanne Woh
- Saw Swee Hock School of Public Health, MD1 Tahir Foundation Building, National University of Singapore, 12 Science Drive 2 #09-01C, 117549, Singapore
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Li L, Xu G, Li J, Wang Y, Bian G. Association between secondhand smoke exposure and negative emotions among 12-15-year-old non-smoking adolescents from 63 low- and middle-income countries. J Affect Disord 2023; 325:297-305. [PMID: 36586618 DOI: 10.1016/j.jad.2022.12.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/14/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Secondhand smoke (SHS) exposure is associated with negative emotions in adolescents, but the association between SHS exposure and negative emotions has been understudied, especially in low- and middle-income countries. Hence, we studied the association between SHS exposure and negative emotions among 12-15-year-old non-smoking adolescents from 63 low- and middle-income countries (LMICs). METHODS We calculated the pooled prevalence of SHS exposure, loneliness, and anxiety in 12-15-year-old non-smoking adolescents. Multivariable logistic regression was used to evaluate country-specific associations between SHS exposure and negative emotions, after adjusting for important confounders. Meta-analyses were performed to evaluate the overall, regional, and country-income level pooled associations. RESULTS Of the adolescents included in the analysis, 34.88 % had less than daily SHS exposure and 13.41 % were exposed to SHS daily. The overall prevalence of loneliness and anxiety in the adolescents was 10.51 % and 8.95 %, respectively. Exposure to SHS in the past 7 days was associated with loneliness and anxiety, with odds ratios (95 % confidence intervals) of 1.15 (1.09-1.21) and 1.24 (1.17-1.31), respectively. These positive associations were observed in girls, but not in boys. In addition, there was a positive dose-response relationship between the day of exposure to SHS and loneliness and anxiety. LIMITATIONS The GSHS data were obtained from a self-report questionnaire and the participants were only adolescents in school. CONCLUSIONS Our study revealed a positive association between SHS exposure and negative emotions among non-smoking adolescents from LMICs.
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Affiliation(s)
- Lian Li
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Guodong Xu
- Precaution ang Health Care Section, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Jincheng Li
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Yucheng Wang
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
| | - Guolin Bian
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
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Xiao H, Li M, Li A, Amaerjiang N, Zunong J, Vermund SH, Pérez-Escamilla R, Song M, Hu Y, Jiang G. Passive Smoking Exposure Modifies Cardiovascular Structure and Function: Beijing Child Growth and Health Cohort (PROC) Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:14585-14593. [PMID: 36094430 DOI: 10.1021/acs.est.2c00991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Passive smoking exposure in children is prevalent worldwide and exposes children to respiratory and systemic toxins. In this study, we enrolled 568 children to study how secondhand smoke (SHS) might affect children's cardiovascular health in China. The measurement of nicotine and its metabolites in urine showed that 78.9% of children were exposed to SHS. Children exposed to SHS had greater interventricular septum thickness (p = 0.005) and left ventricular mass index (p = 0.008) than nonexposed children. Urinary norcotinine levels were associated with increased ascending aorta diameter (β = 0.10, 95%CI 0.02-0.17) and decreased left ventricular end systolic diameter (β = -0.10, 95%CI -0.19 to -0.01). The effects of SHS exposure on cardiovascular function: norcotinine levels associated with lower left ventricular mass index (β = -0.32, 95%CI -0.59 to -0.05), left ventricular end diastolic volume index (β = -0.43, 95%CI -0.85 to -0.02), and left ventricular end systolic volume index (β = -0.20, 95%CI -0.37 to -0.03). Moreover, there no no significant associations of nicotine, cotinine, and trans-3'-hydroxycotinine with cardiovascular health. Overall, SHS exposure in children remains prevalent in Beijing and may affect children's cardiovascular development, in both structure and function. It suggests that stricter and practical measures are needed toward the elimination of tobacco use in children's environments.
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Affiliation(s)
- Huidi Xiao
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Menglong Li
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Aijing Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Nubiya Amaerjiang
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Jiawulan Zunong
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, Connecticut 06510-3201, United States
| | - Rafael Pérez-Escamilla
- Yale School of Public Health, Yale University, New Haven, Connecticut 06510-3201, United States
| | - Maoyong Song
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
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Association between Environmental Tobacco Smoke Exposure and Adaptive Behavior in Individuals with Autism Spectrum Disorder. TOXICS 2022; 10:toxics10040189. [PMID: 35448450 PMCID: PMC9027185 DOI: 10.3390/toxics10040189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022]
Abstract
The study focuses on current issues of adaptive behavior in individuals with autism spectrum disorder (ASD) and on the possible risk factor of environmental tobacco smoke (ETS). Children examined at the Academic Research Center for Autism (ARCA) in Bratislava were involved in the study. The study sample included 84 children (71 boys) with ASD (average age 5.35 years) and a non-ASD group of 24 children (20 boys; average age 8.10 years). The “ETS Questionnaire” focused on the detection of parental smoking habits and other ETS exposures. The concentrations of cotinine in urine were measured by ELISA kit. A significant delay in adaptive behavior of children with ASD in comparison with the non-ASD group was identified. The significant differences were in adaptive behavior, communication, and everyday skills. Children with ASD were more likely to be exposed to ETS, especially in the household. Good agreement was found between objective and subjective ETS exposure indicators (kappa = 0.613). Self-reported exposure to ETS corresponded significantly with the median levels of urinary cotinine. In addition to evaluation and assessment of the quality of adaptive behavior, an important goal of further research should be to identify, investigate, and eliminate environmental factors that interfere with adaptive behavior.
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Xia CL, Xiao SQ, Wu QJ, Yu XY, Xing LL, Gai L, Xia TH, Feng HL, Zhang XY, Guo Y, Xu YW, Fu TT, Sun XH, Fan L. Association Between Passive Smoking and Health Among Chinese Nurses: A Cross-Sectional Study. Front Public Health 2021; 9:741083. [PMID: 34858923 PMCID: PMC8632033 DOI: 10.3389/fpubh.2021.741083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the association between passive smoking and physical and psychological health in Chinese nurses. Participants of this cross-sectional study comprised 2,484 non-smoking nurses. Passive smoking and demographic information were assessed using a self-administered questionnaire. Physical, psychological, and overall health status of nurses were measured using the Cornell Medical Index (CMI) health questionnaire. Multivariate-adjusted odds ratio (OR) and 95% confidence interval (CI) for nurses' health were estimated by exposure to passive smoking using unconditional logistic regression models. A total of 1,219 nurses (49.07%) were exposed to passive smoking. Of these, 609 (24.52%), 160 (6.44%), and 587 (23.63%) nurses had poorer physical, mental, and overall health, respectively. After adjusting for other confounding factors, compared with the non-passive smoking group, passive smoking was associated with poor physical (OR = 1.51, 95% CI: 1.25–1.83), mental (OR = 1.48, 95% CI: 1.07–2.07), and overall (OR = 1.58, 95% CI: 1.30–1.93) health of nurses, respectively. We also carried out subgroup analyses stratified by age, department, and professional title, which showed that most findings supported the main results. This study demonstrated that exposure to passive smoking was a risk factor for overall decreased physical and mental health status among Chinese nurses.
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Affiliation(s)
- Chun-Ling Xia
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shi-Qi Xiao
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin-Ying Yu
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lin-Lin Xing
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Li Gai
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tian-Hui Xia
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hui-Ling Feng
- School of Nursing, China Medical University, Shenyang, China.,School of Nursing, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Xin-Ying Zhang
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ying Guo
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Wei Xu
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tong-Tong Fu
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiang-Hong Sun
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ling Fan
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China.,School of Nursing, China Medical University, Shenyang, China
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Lee E, Kim KY. The Association between Secondhand Smoke and Stress, Depression, and Suicidal Ideation in Adolescents. Healthcare (Basel) 2021; 9:healthcare9010039. [PMID: 33406772 PMCID: PMC7824241 DOI: 10.3390/healthcare9010039] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/26/2020] [Accepted: 12/31/2020] [Indexed: 11/22/2022] Open
Abstract
Background: Secondhand smoke (SHS) is an important risk factor for adolescents’ health. Several studies have reported that SHS is as dangerous as active smoking. Therefore, this study aimed to investigate the association between exposure to SHS and mental health, including stress, depression, and suicidal ideation, in adolescents. Methods: Using raw data from the 2018 14th Korea Youth Risk Behavior Web-Based Survey, we analyzed the effects of sociodemographic characteristics on stress, depression, suicidal ideation in 51,500 students, including 85.8% of all sampled students (n = 60,040), after excluding students with a history of smoking, and then we performed logistic regression analysis to determine the level of exposure to SHS and its impact on stress, depression, and suicidal ideation. Results: The increased level of exposure to SHS was positively associated with stress, depression, and suicidal ideation. Furthermore, stress, depression, and suicidal ideation increased as the level of SHS increased, after adjusting for variables such as age, gender, education level of the father and mother, school achievement, economic status, inhabitation, and drinking. Conclusions: This study demonstrates that SHS is positively associated with risk of mental health problems, including stress, depression, and suicidal ideation, in adolescents. Further research and policy strategies and systems to prevent and manage exposure to SHS in adolescents are required.
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Affiliation(s)
- Eunmi Lee
- Department of Nursing, Research Institute for Basic Science, Hoseo University, Asan 31499, Chungcheongnam-do, Korea;
| | - Ka Young Kim
- Department of Nursing, College of Nursing, Gachon University, Incheon 21936, Korea
- Correspondence:
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Huang A, Wu K, Cai Z, Lin Y, Zhang X, Huang Y. Association between postnatal second-hand smoke exposure and ADHD in children: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:1370-1380. [PMID: 33097989 DOI: 10.1007/s11356-020-11269-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 10/14/2020] [Indexed: 02/05/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which is caused by the interplay of genetic and environmental risk factors such as second-hand smoke (SHS). The association between postnatal exposure to SHS and ADHD risk in children was still inconclusive. We performed a systematic review and meta-analysis to explore the definite association. We searched for relevant studies from PubMed, Embase, Ovid, and Web of Science databases up to January 2020. We used random effect models to calculate pooled odds ratio (OR) with 95% confidence interval (CI). Subgroup analyses and sensitive analyses were also performed to solve the heterogeneity. According to our inclusion criteria, 9 studies including 6 cross-sectional studies, 2 cohort studies, and 1 case-control study were included in the final analysis. Postnatal exposure to SHS increased the risk of ADHD in children (OR: 1.60; 95% CI: 1.37-1.87). Children who exposed to SHS were found a slight risk for conduct problems (OR: 1.33, 95% CI: 1.00-1.77). Among the studies which used cotinine as a biomarker for SHS exposure, a lower pooled OR (OR = 1.16, 95%CI = 1.01, 1.33) was observed between cotinine and ADHD in children. Our meta-analysis results suggested that SHS exposure may be a risk factor for ADHD. We also found that SHS exposure may be associated with some adverse behavioral outcomes. More prospective studies should be conducted to confirm the relationship between SHS exposure and ADHD in children.
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Affiliation(s)
- Anyan Huang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China.
| | - Zemin Cai
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China
| | - Yuhang Lin
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Xuanzhi Zhang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Yanhong Huang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China.
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