1
|
Yuan MD, Liu JF, Zhong BL. Prevalence of prolonged grief disorder and its symptoms among bereaved individuals in China: a systematic review and meta-analysis. Gen Psychiatr 2024; 37:e101216. [PMID: 38455380 PMCID: PMC10916091 DOI: 10.1136/gpsych-2023-101216] [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: 07/09/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Background The prevalence of prolonged grief disorder (PGD) and its symptoms among the bereaved population in China vary considerably. Aims This meta-analysis aims to estimate the prevalence of PGD and its symptoms among bereaved individuals in China. Methods We conducted a literature search in major Chinese and English databases from their inception to 4 October 2023, for cross-sectional studies on the prevalence of PGD or its symptoms in bereaved Chinese individuals. The risk of bias of the included studies and certainty of the evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data ('JBI checklist') and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE), respectively. The 'metaprop' package in R V.4.1.2 was used to synthesise the prevalence. Results A total of 28 studies involving 10 994 bereaved individuals were included in the analysis, with JBI checklist scores between 3 and 7. The combined prevalence (95% confidence interval) of PGD and its symptoms was 8.9% (4.2% to 17.6%) and 32.4% (18.2% to 50.8%), respectively. PGD and its symptoms were most prevalent among those who had lost their only child (22.7%) and those bereaved by earthquakes (80.4%), respectively. The GRADE system assigned a very low certainty level to the evidence for the pooled prevalence of PGD and its symptoms. Conclusions The pooled prevalence of PGD and its symptoms indicate a potential high need for grief counselling services among bereaved individuals in China. This need is particularly pronounced in those who have lost their only child and those bereaved due to earthquakes. Further methodologically rigorous studies are needed to provide more accurate prevalence estimates. PROSPERO registration number CRD42023432553.
Collapse
Affiliation(s)
- Meng-Di Yuan
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, Hubei, China
| | - Jun-Fa Liu
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, Hubei, China
| | - Bao-Liang Zhong
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, Hubei, China
- Department of Psychiatry, Wuhan Mental Health Centre, Wuhan, Hubei, China
| |
Collapse
|
2
|
Chung S, Song K, Günlü A. The Effect of Psychological Inflexibility on Social-Distancing Phobia Mediated by Preoccupation With Sleep and Intolerance of Uncertainty in the Elderly Population During the COVID-19 Pandemic. Psychiatry Investig 2024; 21:151-158. [PMID: 38321888 PMCID: PMC10910166 DOI: 10.30773/pi.2023.0326] [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: 09/21/2023] [Revised: 11/03/2023] [Accepted: 11/15/2023] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVE The aim of this study was to explore whether psychological inflexibility in the elderly population is related to social-distancing phobia, and examine whether their viral anxiety, preoccupation with sleep, or intolerance of uncertainty may mediate the relationship. METHODS Among the elderly population aged ≥65 in Korea, we conducted an anonymous online survey during January and February 2023. We collected the responses of 300 participants, collected demographic information, and symptoms using rating scales such as the Social-Distancing Phobia scale, Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Intolerance of Uncertainty Scale-12 (IUS-12), Acceptance and Action Questionnaire-II (AAQ-II), and Glasgow Sleep Effort Scale (GSES). RESULTS Social-distancing phobia was expected by the SAVE-6 (β=0.34, p<0.001), IUS-12 (β=0.18, p=0.003), and GSES (β=0.18, p= 0.001) in the linear regression analysis. In the mediation analysis, psychological inflexibility did not directly influence social-distancing phobia. However, viral anxiety, intolerance of uncertainty, or preoccupation with sleep completely mediated the influence of psychological inflexibility on social-distancing phobia among elderly population. CONCLUSION The management of psychological inflexibility, intolerance of uncertainty, or preoccupation with sleep needs to be considered when designing interventions to address social-distancing phobia in elderly populations in future pandemics.
Collapse
Affiliation(s)
- Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kayoung Song
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea
| | - Aykut Günlü
- Department of Child Care and Youth Services, Pamukkale University, Denizli, Turkey
| |
Collapse
|
3
|
Endomba FT, Tchebegna PY, Chiabi E, Angong Wouna DL, Guillet C, Chauvet-Gélinier JC. Epidemiology of insomnia disorder in older persons according to the Diagnostic and Statistical Manual of Mental Disorders: a systematic review and meta-analysis. Eur Geriatr Med 2023; 14:1261-1272. [PMID: 37725311 DOI: 10.1007/s41999-023-00862-2] [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: 05/09/2023] [Accepted: 08/30/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE There is a scarcity of summarizing data on the epidemiology of insomnia in older persons, especially when diagnosed with international criteria. This study aimed to estimate the prevalence and correlates of insomnia disorder in older persons, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). METHODS Through PubMed/MEDLINE, EMBASE, and Web of Science (WoS), we searched for relevant articles published before June 28, 2023. The risk of bias was weighed using the Joanna Briggs Institute's (JBI's) critical appraisal checklist for studies reporting prevalence data. For our analyses, we used a random-effect model, with subgroup analyses, meta-regression, and sensitivity analyses to explore potential sources of heterogeneity. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. RESULTS We included 18,270 participants across 16 studies. The male/female ratio was 0.89 (12 studies), and the mean age varied from 65.9 to 83.1 years (8 studies). The pooled prevalence of insomnia was 19.6% (95% CI = [12.3%; 28.3%]), with substantial heterogeneity. This prevalence fluctuated according to the sample size, the minimal age for inclusion, and the study quality, considering that the risk of bias was moderate for most of studies. There was a publication bias, with a very low level of certainty. Insomnia disorder was associated with the female gender, depression, anxiety, and somatic illnesses notably cardiovascular, respiratory, and painful ones. CONCLUSION Nearly one in every five old individuals was considered to have insomnia disorder, which was associated with the gender and the existence of mental health and/or somatic conditions. REGISTRATION We registered the protocol in the International Prospective Register of Systematic Reviews (PROSPERO) with registration number: CRD42022344675.
Collapse
Affiliation(s)
- Francky Teddy Endomba
- Research department, Medical Mind Association, Yaoundé, Cameroon.
- Sleep Specialized Transversal Training, Psychiatry Internship Program, University of Burgundy, Dijon, France.
| | | | - Edmond Chiabi
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Clément Guillet
- Centre d'Exploration du Sommeil, Centre Hospitaliser Spécialisé La Chartreuse, Dijon, France
| | - Jean Christophe Chauvet-Gélinier
- Service de Psychiatrie Adultes, Centre Hospitalier Universitaire, Dijon, France
- INSERM LNC UMR1231, University of Burgundy, Dijon, France
| |
Collapse
|
4
|
Zhang HG, Fan F, Zhong BL, Chiu HFK. Relationship between left-behind status and cognitive function in older Chinese adults: a prospective 3-year cohort study. Gen Psychiatr 2023; 36:e101054. [PMID: 37337546 PMCID: PMC10277132 DOI: 10.1136/gpsych-2023-101054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/11/2023] [Indexed: 06/21/2023] Open
Abstract
Background Due to the inaccuracy of the traditional geographical distance-based definition of left-behind status, data on the negative effect of left-behind status on cognitive function among older adults are controversial. Aims This study examined the cross-sectional and longitudinal associations of left-behind status with cognitive function in older Chinese adults. The left-behind status definition was based on the frequency of face-to-face parent-child meetings. Methods Data from a nationally representative sample of 8 682 older adults (60+ years) in 2015 (5 658 left behind and 3 024 non-left behind), of which 6 933 completed the follow-up in 2018, were obtained from the China Health and Retirement Longitudinal Study. Left-behind older adults were broadly defined as those aged 60+ years who had living adult children and saw their children less than once per month. The cognitive function was assessed with a composite cognitive test with higher total scores indicating better cognitive function. Results Left-behind older adults had significantly lower cognitive test scores than non-left-behind older adults in both 2015 (11.1 (6.0) vs 13.2 (5.9), t=15.863, p<0.001) and 2018 (10.0 (6.6) vs 12.4 (6.7), t=14.177, p<0.001). After adjusting for demographic factors, lifestyle factors, chronic medical conditions and the baseline cognitive test score (in the longitudinal analysis only), on average, the cognitive test score of left-behind older adults was 0.628 lower than their non-left-behind counterparts in 2015 (t=5.689, p<0.001). This difference in cognitive test scores attenuated to 0.322 but remained significant in 2018 (t=2.733, p=0.006). Conclusions Left-behind older Chinese adults have a higher risk of poor cognitive function and cognitive decline than their non-left-behind counterparts. Specific efforts targeting left-behind older adults, such as encouraging adult children to visit their parents more regularly, are warranted to maintain or delay the progression of cognitive decline.
Collapse
Affiliation(s)
- Hong-Guang Zhang
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
- Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, Hubei, China
| | - Fang Fan
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
- Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, Hubei, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
- Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, Hubei, China
| | - Helen Fung-Kum Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
5
|
Idalino SCC, Canever JB, Cândido LM, Wagner KJP, de Souza Moreira B, Danielewicz AL, de Avelar NCP. Association between sleep problems and multimorbidity patterns in older adults. BMC Public Health 2023; 23:978. [PMID: 37237275 DOI: 10.1186/s12889-023-15965-5] [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: 09/06/2022] [Accepted: 05/23/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Sleep problems are frequent in older adults and are associated with chronic diseases. However, the association with multimorbidity patterns is still unknown. Considering the negative impacts that multimorbidity patterns can have on older adults' life, knowledge of this association can help in the screening and early identification of older adults with sleep problems. The objective was to verify the association between sleep problems and multimorbidity patterns in older Brazilian adults. METHODS This was a cross-sectional study conducted with data from 22,728 community-dwelling older adults from the 2019 National Health Survey. The exposure variable was self-reported sleep problems (yes/no). The study outcomes were: multimorbidity patterns, analyzed by self-report of the coexistence of two or more chronic diseases with similar clinical characteristics: (1) cardiopulmonary; (2) vascular-metabolic; (3) musculoskeletal; (4) coexisting patterns. RESULTS Older adults with sleep problems had 1.34 (95%CI: 1.21; 1.48), 1.62 (95%CI: 1.15; 2.28), 1.64 (95%CI: 1.39; 1.93), and 1.88 (95%CI: 1.52; 2.33) greater odds of presenting vascular-metabolic, cardiopulmonary, musculoskeletal, and coexisting patterns, respectively. CONCLUSIONS These results suggest that public health programs aimed at preventing sleep problems in older adults are essential to reduce possible adverse health outcomes, including multimorbidity patterns and their negative consequences for older adults' health.
Collapse
Affiliation(s)
- Stefany Cristina Claudino Idalino
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil
| | - Jaquelini Betta Canever
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil
- Post-Graduate Program in Neuroscience, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Letícia Martins Cândido
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil
| | - Katia Jakovljevic Pudla Wagner
- Federal University of Santa Catarina (UFSC), Campus Curitibanos, Rod. Ulysses Gaboardi, 300, Curitibanos, 89520-000, Santa Catarina, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Federal University of Minas Gerais (UFMG), Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Ana Lúcia Danielewicz
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil
| | - Núbia Carelli Pereira de Avelar
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil.
| |
Collapse
|
6
|
Zhang C, Zeng S, Xu Y, Liu S, Du S, Fang L, Lv Z, Zhang L, Zhang B. Baseline symptoms of depression and anxiety negatively impact the effectiveness of CBTi in treating acute insomnia among young adults. Gen Psychiatr 2023; 36:e101013. [PMID: 37265474 PMCID: PMC10230965 DOI: 10.1136/gpsych-2023-101013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/17/2023] [Indexed: 06/03/2023] Open
Abstract
Background Cognitive-behavioural therapy for insomnia (CBTi) is the first-line treatment for those with this sleep disorder. However, depressive and anxiety symptoms often co-occur with acute insomnia, which may affect the effectiveness of CBTi treatment. Aims This study aimed to determine the impact of depressive and anxiety symptoms on the efficacy of CBTi in treating acute insomnia. Methods A single-arm clinical trial was conducted among individuals who have acute insomnia. Participants underwent self-guided CBTi for 1-week. Their insomnia, depressive symptoms and anxiety symptoms were evaluated using the Insomnia Severity Index and the Hospital Anxiety and Depression Scale at baseline, post-treatment and 3-month follow-up. Repeated measures analysis of variance was used to assess the effectiveness of CBTi in treating insomnia, depressive symptoms and anxiety symptoms. A multivariate Cox regression model was used to determine the impact of depressive and anxiety symptoms on insomnia. Results The study found significant reductions in insomnia, depressive symptoms and anxiety symptoms at both post-treatment and 3-month follow-up (F=17.45, p<0.001; F=36.37, p=0.001; and F=81.51, p<0.001, respectively). The duration of CBTi treatment had a positive impact on insomnia recovery (hazard ratio (HR)=0.94, p=0.018). However, baseline depressive symptoms (HR=1.83, p=0.004) and baseline anxiety symptoms (HR=1.99, p=0.001) had significant negative effects on insomnia recovery. Conclusions The study showed that a 1-week self-guided CBTi treatment is effective in treating acute insomnia and comorbid depressive and anxiety symptoms. However, baseline depressive and anxiety symptoms negatively impact treatment effectiveness. Therefore, clinicians should assess for depressive and anxiety symptoms before treating acute insomnia with monotherapy CBTi.
Collapse
Affiliation(s)
- Chenxi Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shufei Zeng
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yan Xu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuai Liu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shixu Du
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Leqin Fang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhihong Lv
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lili Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
7
|
Wu KG, Chen SJ, Hu YN, Mei SF, Chen WC, Huang XE, Xu ZF, Li MC, Zhong BL, Liu XJ. The relationship between physical activity and depression among community-dwelling adults in Wuhan, China. Front Psychiatry 2023; 14:1179417. [PMID: 37181905 PMCID: PMC10166792 DOI: 10.3389/fpsyt.2023.1179417] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Background While the association between physical activity (PA) and depression has been established, there is limited research on the effect of PA on the risk of depression among Chinese individuals. Thus, this study aimed to investigate the relationship between PA and depression among Chinese individuals. Methods We used a stratified random sampling approach to recruit participants from five urban districts in Wuhan, China. A total of 5,583 permanent residents aged 18 years or older completed questionnaires, which included the International Physical Activity Questionnaire Short Form (IPAQ-SF) to measure PA, and the 9-item Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. To control for potential confounders, multiple logistic regression was employed to assess the association of PA with depression. Results The depression group had significantly lower weekly PA levels, measured in metabolic equivalent of task-minutes per week (MET-min/w), compared to the non-depression group [1,770 (693-4,200) MET-min/w vs. 2,772 (1,324-4,893) MET-min/w, p < 0.001]. In the fully adjusted model, the moderate and high PA level groups had lower odds ratios (ORs) for depressive symptoms compared to the low PA level group [OR (95% confidence interval (CI)) = 0.670 (0.523-0.858), 0.618 (0.484-0.790), respectively]. Among males, moderate and high levels of PA were associated with lower risk of depression compared to low PA levels [OR (95% CI) = 0.417 (0.268-0.649), 0.381 (0.244-0.593), respectively]. However, this association was not observed in females [OR (95% CI) = 0.827 (0.610-1.121), 0.782 (0.579-1.056), respectively]. The study found a significant interaction between PA levels and gender in relation to depression (P for interaction = 0.019). Conclusion The findings suggest a negative association between PA and risk of depressive symptoms, indicating that moderate to high levels of PA may serve as a protective factor against depressive symptoms.
Collapse
Affiliation(s)
- Kai-Ge Wu
- Institute of Education, China University of Geosciences (Wuhan), Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, China
| | - Si-Jing Chen
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ya-Ni Hu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Shu-Fang Mei
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Wen-Cai Chen
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xian-E Huang
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Zai-Feng Xu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ming-Chao Li
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xiu-Jun Liu
- Institute of Education, China University of Geosciences (Wuhan), Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, China
| |
Collapse
|
8
|
Zheng H, Zhou Q, Yang J, Lu Q, Qiu H, He C, Yan H. Altered functional connectivity of the default mode and frontal control networks in patients with insomnia. CNS Neurosci Ther 2023. [PMID: 36942498 DOI: 10.1111/cns.14183] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 02/20/2023] [Accepted: 03/05/2023] [Indexed: 03/23/2023] Open
Abstract
AIMS The purpose of this study was to investigate the association between spontaneous regional activity and brain functional connectivity, which maybe can distinguish insomnia while being responsive to repetitive transcranial magnetic stimulation (rTMS) treatment effects in insomnia patients. METHODS Using resting-state functional magnetic resonance imaging data from 38 chronic insomnia patients and 36 healthy volunteers, we compared the amplitude of low-frequency fluctuations (ALFF) between the two groups. Of all the patients with insomnia, 20 received rTMS for 4 weeks, while 18 patients received a 4-week pseudo-stimulation intervention. Seed-based resting-state functional connectivity (RSFC) analysis was conducted from regions with significantly different ALFF values, and the association between RSFC value and Pittsburgh Sleep Quality Index score was determined. RESULTS Our results revealed that insomnia patients presented a significantly higher ALFF value in the posterior cingulate cortex (PCC), whereas a significantly lower ALFF value was observed in the superior parietal lobule (SPL). Moreover, significantly reduced RSFC was detected from both PCC to prefrontal cortex connections, as well as from left SPL to frontal pole connections. In addition, RSFC from frontal pole to left SPL negatively predicted sleep quality (PSQI) and treatment response in patients' group. CONCLUSION Our findings suggest that disrupted frontoparietal network connectivity may be a biomarker for insomnia in middle-aged adults, reinforcing the potential of rTMS targeting the frontal lobes. Monitoring pretreatment RSFC could offer greater insight into how rTMS treatments are responded to by insomniacs.
Collapse
Affiliation(s)
- Hui Zheng
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Zhou
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Junjie Yang
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Qian Lu
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Huaide Qiu
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chuan He
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Hailang Yan
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
- Department of Radiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| |
Collapse
|
9
|
Zhong BL, Li HJ, Xu YM, Jiang XF. Clinical insomnia among elderly primary care attenders in Wuhan, China: A multicenter cross-sectional epidemiological study. Front Public Health 2022; 10:1026034. [PMID: 36339226 PMCID: PMC9634545 DOI: 10.3389/fpubh.2022.1026034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/10/2022] [Indexed: 01/28/2023] Open
Abstract
Background and objectives Integrating sleep health into primary care is a promising approach to narrow the treatment gap for insomnia in older adults but data regarding the epidemiological characteristics of insomnia among elderly primary care attenders (EPCAs) are very limited. This study examined the prevalence and correlates of clinical insomnia among Chinese EPCAs. Methods By using two-stage consecutive sampling method, a total of 757 EPCAs were recruited from seven urban and six rural primary care centers in Wuhan, China. The Insomnia Severity Index (ISI) and the Geriatric Depression Scale (15 item version) were administered to assess insomnia severity and depressive symptoms, respectively. Results The two-week prevalence of clinical insomnia (ISI score ≥ 15) was 28.9%. Significant correlates of clinical insomnia were: female sex (vs. male, OR = 2.13, P < 0.001), fair and poor family relationship (vs. good, OR = 1.59, P = 0.028), hypertension (OR = 1.67, P = 0.004), heart disease (OR = 1.73, P = 0.048), arthritis (OR = 2.72, P = 0.001), and depressive symptoms (OR = 4.53, P < 0.001). Conclusion The high prevalence of clinical insomnia among Chinese EPCAs suggests a high level of sleep health need in older patients in China's primary care settings. Considering the many negative outcomes associated with insomnia, it is necessary to integrate sleep health into primary care in China.
Collapse
Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China,Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Hong-Jie Li
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China,Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yan-Min Xu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China,Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Xue-Feng Jiang
- Department of Outpatient and Emergency, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Xue-Feng Jiang
| |
Collapse
|
10
|
Xie Q, Xu YM, Zhong BL. Anxiety symptoms in older Chinese adults in primary care settings: Prevalence and correlates. Front Public Health 2022; 10:1009226. [PMID: 36267994 PMCID: PMC9577322 DOI: 10.3389/fpubh.2022.1009226] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/20/2022] [Indexed: 01/27/2023] Open
Abstract
Background Integrating mental health services into primary care is a potentially cost-effective way to decrease the treatment gap for anxiety in older adults but data on the epidemiology of anxiety symptoms in older Chinese adults in primary care settings have been very limited. This study investigated the prevalence and correlates of anxiety symptoms in Chinese older primary care patients. Methods A total of 753 older primary care patients (≥65 years) were consecutively recruited from 13 primary care clinics in Wuhan, China, and interviewed with the validated Chinese version of the short form of the Geriatric Anxiety Inventory (GAI-SF). Results The prevalence of anxiety symptoms (GAI-SF ≥ 3) in older primary care patients was 21.1%. Statistically significant correlates of anxiety symptoms were female sex (vs. male, OR = 1.85, P = 0.002), poor economic status (vs. good, OR = 2.31, P = 0.013), fair and poor family relationship (vs. good, OR = 1.85, P = 0.006), hypertension (OR = 2.01, P < 0.001), chronic gastric ulcer (OR = 6.82, P < 0.001), and Parkinson's disease (OR = 7.83, P = 0.031). Conclusions Anxiety symptoms are prevalent among older adults attending primary care clinics. Efforts for preventing or reducing anxiety symptoms in older primary care patients may be more useful to target those who are women, have poor financial status, don't have a good family relationship, suffer from hypertension, have chronic gastric ulcer, and suffer from Parkinson's disease.
Collapse
Affiliation(s)
- Qin Xie
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yan-Min Xu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| |
Collapse
|
11
|
Yuan MD, Wang ZQ, Fei L, Zhong BL. Prevalence of prolonged grief disorder and its symptoms in Chinese parents who lost their only child: A systematic review and meta-analysis. Front Public Health 2022; 10:1016160. [PMID: 36238241 PMCID: PMC9550932 DOI: 10.3389/fpubh.2022.1016160] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/12/2022] [Indexed: 01/28/2023] Open
Abstract
Background Parents who lost their only child and cannot have a second child ("Shidu") have been a large population in China. Prolonged grief disorder (PGD) in Shidu parents is of clinical and public health concern but the reported PGD prevalence varies widely. To facilitate the planning of grief counseling services, this meta-analysis estimated prevalence of PGD and its symptoms and identified subgroups at elevated risk for PGD. Methods We searched English and Chinese literature databases to identify cross-sectional surveys reporting prevalence of PGD or PGD symptoms in Chinese Shidu parents. The Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data ("JBI") was used to assess risk of bias of included studies. Results Seven studies with a total of 2,794 Shidu parents were included and their JBI scores ranged from five to eight. The pooled prevalence of PGD and PGD symptoms was 20.9% and 75.0%, respectively. Greater risk of PGD was observed in mothers [vs. fathers, OR (odds ratio) = 1.89, P = 0.001] and in parents with religious beliefs (vs. without religious beliefs, OR = 1.65, P = 0.040). More severe PGD symptoms were presented in parents whose only child died from accidents [vs. illness, MD (mean difference) = 3.99, P < 0.001]. Deceased children of PGD parents were older than those of non-PGD parents (MD = 1.64, P = 0.035) and PGD parents had a shorter duration since the loss than non-PGD parents (MD = -3.26, P = 0.013). Conclusions PGD is prevalent among Shidu parents. Grief counseling services for Shidu parents would be more effective if they target those who are mothers and have religious beliefs and those whose children died from accidents, lost children are older, and loss occurs more recently.
Collapse
Affiliation(s)
- Meng-Di Yuan
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, China
| | - Zong-Qin Wang
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Lei Fei
- Department of Ultrasound, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Bao-Liang Zhong
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| |
Collapse
|
12
|
Pujasari H, Chung MH. Sleep Disturbance in the Context of HIV: A Concept Analysis. SAGE Open Nurs 2022; 8:23779608221094541. [PMID: 35493547 PMCID: PMC9039437 DOI: 10.1177/23779608221094541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/24/2022] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Due to the differing definitions of the concept of sleep disturbance among people living with human immunodeficiency virus (HIV), reviewers in this area have not reached any firm conclusions. The study aimed to clarify and provide a stronger foundation for the definition of sleep disturbance in the context of HIV to enhance the concept’s development. Following Beth Rodgers’ concept analysis guidelines, two leading databases were searched, and 73 articles were used for this concept analysis. The attributes, surrogate terms, antecedents, and consequences of sleep disturbance have been identified using thematic analysis. In this analysis, two main attributes of sleep disturbance in the context of HIV were identified: a) subjective measures, including reduced total sleep time, difficulty falling asleep, nighttime and early morning awakenings, feeling sleepy and poorly rested after a night’s sleep, frequent arousals, and irritability, and b) objective measures, including changes in sleep architecture and sleep continuity. Five antecedents of sleep disturbance in the context of HIV were identified. Meanwhile, the consequences of sleep disturbance in HIV are listed based on the frequency the points occur within the reviewed articles. The list is as follows: fatigue and pain; reduced neurocognitive functions; reduced health outcome and quality of life; poor anti-retroviral (ARV) therapy adherence; daytime sleepiness; depression, anxiety, and maladaptive coping; increased disease progression and cardiovascular mortality; and social phobia, living arrangement and sexual dysfunction. An improved understanding of sleep disturbance in the context of HIV will be beneficial in directing analysts to develop research plans. At the same time, the knowledge gaps identified in the analysis provided a solid basis for further study intending to fill in these gaps.
Collapse
Affiliation(s)
| | - Min-Huey Chung
- College of Nursing, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
13
|
Zhong BL, Xiang YT. Challenges to and Recent Research on the Mental Health of Older Adults in China During the COVID-19 Pandemic. J Geriatr Psychiatry Neurol 2022; 35:179-181. [PMID: 35245997 PMCID: PMC8899836 DOI: 10.1177/08919887221078558] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry,
Wuhan
Mental Health Center, Wuhan,
China,Department of Clinical Psychology,
Wuhan Hospital
for Psychotherapy, Wuhan, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of
Public Health and Medicinal Administration, and 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, Faculty of Health Sciences,
University of Macau, Avenida da Universidade, 3/F, Building E12, Taipa, Macau
SAR, China.
| |
Collapse
|
14
|
Shimokihara S, Maruta M, Akasaki Y, Ikeda Y, Han G, Kamasaki T, Tokuda K, Hidaka Y, Akasaki Y, Tabira T. Association between Frequency of Going Out and Psychological Condition among Community-Dwelling Older Adults after the COVID-19 Pandemic in Japan. Healthcare (Basel) 2022; 10:healthcare10030439. [PMID: 35326917 PMCID: PMC8954262 DOI: 10.3390/healthcare10030439] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 01/08/2023] Open
Abstract
Background: The psychological condition and frequency of going out (FGO) of community-dwelling older adults after the spread of COVID-19 will provide insights for supporting the daily lives of community-dwelling older adults. Going out is defined as moving from one’s own home to a place or region beyond one’s own home and is considered to reflect the daily and social life of community-dwelling older adults. This study investigates the relationship between the FGO and current psychological condition after the second wave of COVID-19 in community-dwelling older adults in Japan. Methods: This study adopted a self-administered questionnaire by mail. A total of 493 members of CO-OP Kagoshima were included in the analysis and divided into two groups according to the change in FGO. Multiple logistic regression analysis was conducted after a bivariate analysis to investigate the relationship between the FGO and psychological condition. Results: Significant differences were noted between the groups with decreased FGO and those with increased/unchanged FGO in general and pandemic-related psychological condition. Multiple logistic regression analysis showed a significant relationship between FGO and psychological condition, such as mental fatigue, not smiling as much as before, and anxiousness to go outside. Conclusion: Community-dwelling older adults may have experienced a decrease in the frequency of going out and a detrimental effect on their psychological condition after the COVID-19 pandemic. This finding may inform strategies to identify priorities for psychological approaches altered by COVID-19 to prevent confinement and stress in older adults.
Collapse
Affiliation(s)
- Suguru Shimokihara
- Department of Rehabilitation, Medical Corporation, Nissyokai, Minamikagoshima Sakura Hospital, Kagoshima 890-0069, Japan
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan;
- Correspondence: ; Tel.: +81-99-275-6780
| | - Michio Maruta
- Department of Rehabilitation, Medical Corporation, Sanshukai, Okatsu Hospital, 3-95, Masagohonmachi, Kagoshima 890-0067, Japan; (M.M.); (Y.H.)
- Visiting Researcher, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan;
| | - Yasuaki Akasaki
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan; (Y.A.); (Y.I.); (T.T.)
| | - Yuriko Ikeda
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan; (Y.A.); (Y.I.); (T.T.)
| | - Gwanghee Han
- Visiting Researcher, Faculty of Medicine, Kagoshima University, Kagoshima 890-8544, Japan;
- Department of Neuropsychiatry, Kumamoto University Hospital, 1-1-1 Honjo Chuo-ku, Kumamoto 860-8556, Japan
| | - Taishiro Kamasaki
- Doctoral Program of Clinical Neuropsychiatry, Graduate School of Health Science, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan;
| | - Keiichiro Tokuda
- Department of Rehabilitation, Medical Corporation, Gyokushoukai, Kirameki Terrace Healthcare Hospital, Kagoshima 892-0824, Japan;
| | - Yuma Hidaka
- Department of Rehabilitation, Medical Corporation, Sanshukai, Okatsu Hospital, 3-95, Masagohonmachi, Kagoshima 890-0067, Japan; (M.M.); (Y.H.)
- Master’s Program of Health Sciences, Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan;
| | - Yoshihiko Akasaki
- Master’s Program of Health Sciences, Graduate School of Health Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan;
- Department of Rehabilitation, Tarumizu Chuo Hospital, Kagoshima 891-2124, Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan; (Y.A.); (Y.I.); (T.T.)
| |
Collapse
|