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Lin K, Buys N, Jiang Y, Sun J. Urbanization and substance use in left-behind children and adolescents: a systematic review and meta-analysis. Curr Opin Psychiatry 2024:00001504-990000000-00143. [PMID: 39377456 DOI: 10.1097/yco.0000000000000970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/09/2024]
Abstract
PURPOSE OF REVIEW Inequalities in job opportunities between urban and rural regions have driven many parents to move from rural to urban regions with aims to improve household income. Financial and political barriers prevent children from moving with their parents, meaning that their children become left-behind in rural regions. This study aims to meta-analyse the risk of drinking, smoking, illicit drug use and drunk experiences in left behind children (LBC) and non-LBC. RECENT FINDINGS Previous studies have indicated the negative effects of prolonged parental separation on children and adolescent mental health. Parental separation and poor mental health have both been identified as proximal risk factors for substance use in adolescence. SUMMARY The results indicated that LBC were at significantly greater risk of drinking, smoking, using illicit drugs, and having drunk experiences. Positive psychology interventions are required to help provide LBC with positive coping strategies against psychological distress. Policy changes to reduce inequalities in job opportunities between urban and rural regions are required to reduce the prevalence of LBC.
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Affiliation(s)
- Kelly Lin
- Rural Health Research Institute, Charles Sturt University
- School of Medicine and Dentistry, Griffith University
- School of Health Science and Social Work, Griffith University, Gold Coast Campus, Australia
| | - Nicholas Buys
- School of Health Science and Social Work, Griffith University, Gold Coast Campus, Australia
| | - Yannan Jiang
- Rural Health Research Institute, Charles Sturt University
- School of Medicine and Dentistry, Griffith University
| | - Jing Sun
- Rural Health Research Institute, Charles Sturt University
- School of Medicine and Dentistry, Griffith University
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Wang F, Yang H, Li F, Zheng Y, Xu H, Wang R, Li Y, Cui Y. Prevalence and comorbidity of anxiety disorder in school-attending children and adolescents aged 6-16 years in China. BMJ Paediatr Open 2024; 8:e001967. [PMID: 38538104 PMCID: PMC10982779 DOI: 10.1136/bmjpo-2023-001967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/18/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The reported prevalence rate of anxiety disorder in the paediatric population varies widely between different counties. Currently, there is no national epidemiological survey of childhood anxiety disorder in China. This study aims to investigate the national prevalence of anxiety disorder, the distribution profiles of different subtypes and its comorbidity rates among school students. METHODS A nationwide epidemiological survey of mental disorders in school students aged 6-16 years was conducted. Participants were randomly recruited from five provinces in China. The Child Behavior Checklist was used to screen students at high risk for mental disorders. The final diagnosis was made based on the Diagnostic and Statistical Manual-IV. The point prevalence and comorbidity rate of anxiety disorder were calculated, and the difference between age, sex and socioeconomic status groups was also compared. RESULTS Generalised anxiety disorder (GAD) was the most common anxiety disorder in school-attending children and adolescents, with a prevalence rate of 1.3% (95% CI: 1.2 to 1.3). Separation anxiety and specific phobia were more common in children than in adolescents. Girls had a higher prevalence of panic disorder (0.3% vs 0.2%, χ2=14.6, p<0.001) and agoraphobia (0.9% vs 0.8%, χ2=4.3, p=0.03) than that of boys. We found no significant difference between developed and less developed areas. Girls were more likely to have panic disorder and GAD than boys, with ratios of 2.13:1 and 1.01:1, respectively. The co-occurrence of anxiety disorder and attention-deficit and disruptive behaviour disorder was very common, ranging from 40% to 85%. CONCLUSIONS Anxiety disorder was prevalent among school students in China, and comorbidity with attention-deficit and disruptive disorder was very common. The data imply that screening for anxiety disorder is needed in school settings. Policies should be adapted to provide psychological services to children and adolescents. A comprehensive assessment is recommended in clinical practice.
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Affiliation(s)
- Fang Wang
- Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hanxue Yang
- Beijing Language and Culture University, Beijing, China
| | - Fenghua Li
- Chinese Academy of Sciences, Beijing, China
| | - Yi Zheng
- Department of Pediatrics, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Hui Xu
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Rui Wang
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ying Li
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yonghua Cui
- Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 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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Pei S, Wu X, Ye W, Fang L, Zhang H, Zhou F, Du X, Cao X, Ma S, Li Y, Xi S, Xu P. Prevalence of mental disorders among middle school students in Shaoxing, China. Ann Gen Psychiatry 2023; 22:31. [PMID: 37641074 PMCID: PMC10463987 DOI: 10.1186/s12991-023-00463-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND In China, adolescents account for about a quarter of those treated for mental disorders each year, and adolescent mental health issues have become a social hotspot. Although several epidemiological surveys of mental disorders have been conducted in China, no study has yet focused on the prevalence of mental disorders among adolescents in a certain region of Zhejiang. METHODS In the first stage, 8219 middle school students aged 12-18 years in a city of Zhejiang Province (Shaoxing) were screened with the mental health screening checklist. In the second stage, participants who screened positive were tested with the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Then, the prevalence of mental disorders were calculated. RESULTS The overall prevalence in this population was 12.4%, with prevalence rates exceeding 20% in both the 17- and 18-year-old age groups. The most common mental disorders were obsessive-compulsive disorder (OCD) (9.1%) and major depressive disorder (MDD) (8.9%). CONCLUSIONS Mental disorders are common among middle school students, and girls are at higher risk than boys. As the most prevalent mental disorders, OCD and MDD should receive timely attention, especially for upper grade students.
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Affiliation(s)
- Shuangyi Pei
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China.
| | - Xiaoting Wu
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
| | - Weijiang Ye
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
| | - Linqi Fang
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
| | - Haoqiang Zhang
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
| | - Fanghua Zhou
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
| | - Xiaofei Du
- Tangshan Vocational and Technical College, Tangshan, China
| | - Xinyi Cao
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
| | - Shengnan Ma
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
| | - Yuanchu Li
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
| | - Shuwen Xi
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
| | - Pingping Xu
- Zhejiang Rehabilitation Medical Center (Rehabilitation Campus of the Third Affiliated Hospital of Zhejiang Chinese Medical University), Hangzhou, China
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Zhao M, Hu M. A multilevel model of the help-seeking behaviors among adolescents with mental health problems. Front Integr Neurosci 2022; 16:946842. [PMID: 36118118 PMCID: PMC9478167 DOI: 10.3389/fnint.2022.946842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Mental health problems are highly prevalent among adolescents yet the utilization of mental health services among such a population is very low. This study was conducted to examine mental health problems and related help-seeking behaviors among a Chinese sample of adolescents. Methods A total of 3,480 students were recruited from four middle- and high schools in Changsha City, Hunan province, and completed an online questionnaire that assessed their general information, mental health problems including depression, anxiety, self-harm, and suicide ideation, as well as their help-seeking behaviors from both formal (including psychological teachers and mental health professionals) and informal sources (including family, friends, and teachers). Results The participants had a prevalence of 13.7% for depression, 11.5% for anxiety, 9.8% for self-harm, and 9.1% for suicide ideation. Although a high rate of help-seeking behaviors was observed (73.0%), most were concentrated in informal sources (99.3%), while only a small portion of participants resorted to formal sources (13.9%). Being female (OR: 1.45, 95% CI: 1.15-1.83), higher grade (OR: 1.32, 95% CI: 1.01-1.73), school mental health resources not available (OR: 1.39, 95% CI: 1.02-1.88), without suicide ideation (OR: 2.03, 95% CI: 1.42-2.90) were all associated with increased likelihood of formal help-seeking behaviors. On the other hand, complete middle school (OR: 0.36, 95% CI: 0.22-0.59), the middle level of academic ranking (OR: 0.64, 95% CI: 0.42-0.97), and higher father education levels (OR: 0.54-0.56, 95% CI: 0.33-0.90) were all associated with a decreased likelihood of formal help-seeking behaviors. Conclusion Our results showed a higher prevalence of help-seeking behavior for emotional or psychological problems during the past year. Compared to the high rate of informal help-seeking behaviors, students showed a lower propensity to seek formal help for their mental health problems, which may be explained by individual-level, family-level, and school-level factors. Our findings provide important implications for the development and popularization of targeted, needs-based mental health promotion and education programs in the future.
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Affiliation(s)
- Mei Zhao
- School of Medicine, Hunan Polytechnic of Environment and Biology, Hengyang, China
| | - Mi Hu
- Xiangya School of Public Health, Central South University, Changsha, China
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Tang X, Liu Q, Cai F, Tian H, Shi X, Tang S. Prevalence of social anxiety disorder and symptoms among Chinese children, adolescents and young adults: A systematic review and meta-analysis. Front Psychol 2022; 13:792356. [PMID: 36072051 PMCID: PMC9442033 DOI: 10.3389/fpsyg.2022.792356] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 07/28/2022] [Indexed: 11/21/2022] Open
Abstract
The objective of the study is to provide a reliable estimate of the pooled prevalence of social anxiety disorder (SAD) and social anxiety symptoms (SAS) among children, adolescents, and young adults (CAYA) in China. Meta-analysis is used to provide pooled-prevalence rate of SAD and SAS. Literature searches were conducted in both English and Chinese databases from the database's inception to April 2019. Eleven studies were identified for SAD, and 17 were included for SAS. The results revealed a pooled prevalence of SAD of 2.1% (95% CI: 1.2-3.8%) with high between-studies heterogeneity (Q = 1,055.2, I 2 = 99.1%, p < 0.001). The pooled prevalence estimate of SAS was 23.5% (95% CI: 18.6-29.3%), also with significant heterogeneity (Q = 1,019.3, I 2 = 98.4%, p < 0.001). Different diagnostic tools or self-report scales reported significant different prevalence of SAD or SAS. Further analysis stratified by gender, age, sampling methods, economic status, and risk of bias were performed. Limitations include the high level of heterogeneity between studies, inadequate number of the studies, and significant differences in prevalence caused by measurements. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020149591, identifier: PROSPERO CRD42020149591.
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Affiliation(s)
- Xinfeng Tang
- Department of Psychology, Renmin University of China, Beijing, China
| | - Qiwen Liu
- Department of Sociology, Law School, Shenzhen University, Shenzhen, China
| | - Fangtong Cai
- Department of Sociology, Law School, Shenzhen University, Shenzhen, China
| | - Hui Tian
- Department of Sociology, Law School, Shenzhen University, Shenzhen, China
| | - Xincheng Shi
- Department of Sociology, Law School, Shenzhen University, Shenzhen, China
| | - Suqin Tang
- School of Psychology, Shenzhen University, Shenzhen, China
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Yan J, Deng H, Wang Y, Wang X, Fan T, Li S, Wen F, Yu L, Wang F, Liu J, Wu Y, Zheng Y, Cui Y, Li Y. The Prevalence and Comorbidity of Tic Disorders and Obsessive-Compulsive Disorder in Chinese School Students Aged 6-16: A National Survey. Brain Sci 2022; 12:brainsci12050650. [PMID: 35625036 PMCID: PMC9139904 DOI: 10.3390/brainsci12050650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/24/2022] [Accepted: 05/10/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Obsessive-compulsive disorder (OCD) and tic disorders (TDs) are closely related and considered to etiologically overlap. Both disorders are characterized by repetitive behaviors. TD and OCD often co-occur. The high comorbidity between OCD and TD individuals suggests that we also need to pay more attention to the homogeneity and heterogeneity between TS and OCD. To date, there has been no systematic nationwide epidemiological survey of the mental health (including tic disorders and obsessive-compulsive disorder) of children and adolescents in China. Methods: A two-stage epidemiological study of psychiatric point prevalence was conducted. We used the multistage cluster stratified random sampling strategy to assess five provinces of China. The Child Behavior Checklist was used to identify behavioral problems among the enrolled students in the first stage. The results from the Mini-International Neuropsychiatric Interview for Children and Adolescents and evaluations from two psychiatrists based on the Diagnostic and Statistical Manual-IV were used to make a diagnosis. Point weighted prevalence for TD and OCD was estimated. We adjusted prevalence estimates with the product of sampling weights and poststratification weights. Standard error values and 95% confidential intervals were generated with Taylor series linearization. Rao−Scott adjusted chi-square (χ2) tests were employed to compare the prevalence estimates of different age and sex groups. Results: In the first stage, 73,992 participants aged 6−16 years old were selected. The prevalence rates of OCD and TDs were 1.37% (95% CI: 1.28−1.45) and 2.46% (95% CI: 2.35−2.57), respectively. The prevalence of OCD was found to be higher in girls (p < 0.001) and higher in boys with transient tic disorder (TTD) (p < 0.001) and Tourette’s syndrome (TS) (p < 0.001). The most common comorbidity of TS was OCD (40.73%), and for OCD, it was TS (11.36%). Conclusions: Our study is the first nationwide survey on the prevalence of TD (2.46%) and OCD (1.37%) in school students aged 6−16 years old in China. The high comorbidity between OCD and TD individuals suggested overlap based on the prevalence dimensions, which might be influenced by age and sex. This result suggested that we also need to pay more attention to the homogeneity and heterogeneity between TS and OCD.
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Affiliation(s)
- Junjuan Yan
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing 100045, China; (J.Y.); (F.W.); (L.Y.); (F.W.); (J.L.)
| | - Hu Deng
- Department of Innovation and Transformation, Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing 100096, China;
| | - Yongming Wang
- School of Biology & Basic Medical Sciences, Medical College of Soochow University, Suzhou 215123, China;
| | - Xiaolin Wang
- Laboratory of Tumor Immunology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;
| | - Tengteng Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China;
| | - Shijie Li
- Department of Child Health Care, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;
| | - Fang Wen
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing 100045, China; (J.Y.); (F.W.); (L.Y.); (F.W.); (J.L.)
| | - Liping Yu
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing 100045, China; (J.Y.); (F.W.); (L.Y.); (F.W.); (J.L.)
| | - Fang Wang
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing 100045, China; (J.Y.); (F.W.); (L.Y.); (F.W.); (J.L.)
| | - Jingran Liu
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing 100045, China; (J.Y.); (F.W.); (L.Y.); (F.W.); (J.L.)
| | - Yuanzhen Wu
- Beijing Anding Hospital, Capital Medical University, Ankang Hutong, Beijing 100101, China; (Y.W.); (Y.Z.)
| | - Yi Zheng
- Beijing Anding Hospital, Capital Medical University, Ankang Hutong, Beijing 100101, China; (Y.W.); (Y.Z.)
| | - Yonghua Cui
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing 100045, China; (J.Y.); (F.W.); (L.Y.); (F.W.); (J.L.)
- Correspondence: (Y.C.); (Y.L.)
| | - Ying Li
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Centre for Children’s Health, Beijing 100045, China; (J.Y.); (F.W.); (L.Y.); (F.W.); (J.L.)
- Correspondence: (Y.C.); (Y.L.)
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Ma J, Mahat P, Brøndbo PH, Handegård BH, Kvernmo S, Javo AC. Parent reports of children's emotional and behavioral problems in a low- and middle- income country (LMIC): An epidemiological study of Nepali schoolchildren. PLoS One 2021; 16:e0255596. [PMID: 34343215 PMCID: PMC8330921 DOI: 10.1371/journal.pone.0255596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/19/2021] [Indexed: 01/09/2023] Open
Abstract
Background As epidemiological data on child mental health in low- and middle-income countries are limited, a large-scale survey was undertaken to estimate the prevalence and amount of child emotional and behavioral problems (EBP) in Nepal as reported by the parents. Methods 3820 schoolchildren aged 6–18 years were selected from 16 districts of the three geographical regions of Nepal, including rural, semi-urban and urban areas. We used the Nepali version of the Child Behavior Checklist (CBCL)/6-18 years as screening instrument. Comparisons of child problems between genders and between the seven largest castes and ethnic groups were carried out by analysis of variance. Prevalence was computed based on American norms. Results Adjusted prevalence of Total Problems was 18.3% (boys: 19.1%; girls:17.6%). The prevalence of internalizing problems was higher than externalizing problems. The mean scores of Total, Externalizing, and Internalizing problems were 29.7 (SD 25.6), 7.7 (SD 8.0), and 9.1 (SD 8.1), respectively. The Khas Kaami (Dalit) group scored the highest, and the indigenous Tharu group scored the lowest on all scales. In the Mountains and Middle Hills regions, problem scores were higher in the rural areas, whereas in the Tarai region, they were higher in the urban areas. Conclusion The prevalence and magnitude of emotional and behavioral problems in Nepali children were found to be high compared to findings in meta-analyses worldwide. Problem scores varied according to gender, castes /ethnic groups, and living areas. Our findings highlight the need for a stronger focus on child mental problems in a low-and middle-income country like Nepal.
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Affiliation(s)
- Jasmine Ma
- Regional Centre for Child and Youth Mental Health and Child Welfare -North, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Child & Adolescent Psychiatry Clinic, Kanti Children’s Hospital, Kathmandu, Nepal
- * E-mail:
| | | | - Per Håkan Brøndbo
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørn H. Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare -North, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Siv Kvernmo
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Cecilie Javo
- Regional Centre for Child and Youth Mental Health and Child Welfare -North, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Sami National Competence Center for Mental Health, Sami Klinihkka, Finnmark Hospital Trust, Karasjok, Norway
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Guan M. Associations between socioprovincial factors and self-reported mental disorders among students from grade 4 to 8 in rural China. ACTA ACUST UNITED AC 2021; 79:57. [PMID: 33892798 PMCID: PMC8067348 DOI: 10.1186/s13690-021-00580-w] [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: 10/27/2020] [Accepted: 04/13/2021] [Indexed: 11/10/2022]
Abstract
Background The focus on child mental health in developing countries was increasing. However, little was known in China. This study aimed to explore the associations between socioprovincial factors and self-reported mental disorders in rural China. Methods Data were from a publicly available survey with 54,498 students from Grade 4 to 8 in rural China. Chi-square test was used for descriptive analysis. Self-reported mental disorders included overall mental disorder, study anxiety, personal anxiety, loneliness, guilt, sensitivity, symptomatic psychosis, phobia, and impulsivity. Multiple logistic regressions and errors-in-variables regression models were employed to explore the associations between socioprovincial factors and mental disorders. Poisson regressions and errors-in-variables regression models were adopted to reveal the associations between socioprovincial factors and number of self-reported mental disorders. Results Descriptive statistics showed that mental health was poor in rural adolescents in China. Logistic regression showed that the odds of overall mental disorder and study anxiety were 189% (AOR = 2.89, 95%CI: 2.76, 3.02) and 92% (OR = 1.92, 95%CI: 1.84, 2.00) in Gansu more than those in Anhui, while the odds of personal anxiety, guilt, sensitivity, symptomatic psychosis, and phobia were 92% (AOR = 0.08, 95%CI: 0.08, 0.09), 71% (AOR = 0.29, 95%CI: 0.27, 0.30), 88% (AOR = 0.12, 95%CI: 0.11, 0.13), 69% (AOR = 0.31, 95%CI: 0.29, 0.32), and 78% (AOR = 0.22, 95%CI: 0.21, 0.23) in Gansu less than those in Anhui. Moreover, Gansu (Poisson regression: IRR =1.45, 95%CI: 1.42–1.47; errors-in-variables regression: Coefficient = 0.26, 95%CI: 0.16, 0.36), Ningxia (Poisson regression: IRR =1.63, 95%CI: 1.60–1.67; errors-in-variables regression: Coefficient = 0.43, 95%CI: 0.32, 0.53), Qinghai (Poisson regression: IRR =1.65, 95%CI: 1.60–1.69; errors-in-variables regression: Coefficient = 0.44, 95%CI: 0.34, 0.55), and Shaanxi (Poisson regression: IRR =1.28, 95%CI: 1.25–1.30; errors-in-variables regression: Coefficient = 0.11, 95%CI: 0.00, 0.21) were significantly associated with the number of self-reported mental disorders. Conclusion Class and provincial disparities in self-reported mental disorders were reported among the students from Grade 4 to 8 in rural China. Mental health care supported by governments and schools could be an effective way to reduce the disparities in mental disorders among the adolescents.
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Affiliation(s)
- Ming Guan
- International Issues Center, Xuchang University, Xuchang, Road Bayi 88, Xuchang, Henan, China. .,Family Issues Center, Xuchang University, Road Bayi 88, Xuchang, Henan, China. .,School of Business, Xuchang University, Road Bayi 88, Xuchang, Henan, China.
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Abstract
OBJECTIVE To investigate the prevalence of mental health problems among preschoolers in rural China and examine the relationship between dietary diversity and mental health. DESIGN A cross-sectional survey analysis was performed. Child mental health was assessed with the Strengths and Difficulties Questionnaire (SDQ). Child dietary diversity was assessed with the dietary diversity score (DDS), which was calculated based on nine food groups using a 24-h recall method. Data were analysed using unadjusted and adjusted logistic regression models. SETTING Two nationally designated poverty counties in Hunan Province of China. PARTICIPANTS Preschoolers (n 1334) aged 3-5 years, preschools (n 26). RESULTS Of 950 preschoolers with data on both dietary diversity and mental health, 663 (70 %) were classified as having at least one kind of mental health problem. The prevalences of emotional symptoms, conduct problems, symptoms of hyperactive/inattention, peer relationship problems and poor prosocial behaviour were 39, 27, 23, 12 and 26 %, respectively. Male preschoolers showed higher risks of having mental health problems than their female counterparts on each SDQ subscale except for conduct problems. Moreover, a higher DDS was significantly associated with a lower likelihood of having symptoms of hyperactivity/inattention, peer relationship problems and prosocial behaviour problems after adjustment for confounders (preschoolers' age, gender, cognitive ability, parental migration status, primary caregiver's education and household socio-economic status). CONCLUSIONS The prevalence of mental health problems was high among preschoolers in rural China. Improving child dietary diversity might be an important strategy to consider in the design of interventions to improve child mental health.
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Zhang J, Liu MW, Yu HJ, Chen QT, Tang BW, Yuan S, He QQ. Associations of health-risk behaviors with mental health among Chinese children. PSYCHOL HEALTH MED 2020; 27:528-536. [PMID: 33297726 DOI: 10.1080/13548506.2020.1859559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The study aimed to investigate the individual and combined association of health-risk behaviors with mental health among Chinese children. A cross-sectional study was conducted in Wuhan, China, from May to June 2018. Participants self-reported the information on physical activity (PA), screen time (ST), fruit and vegetable (FV) intake, and sleep duration. Mental health, including depression, social anxiety and self-esteem, was assessed using standard questionnaires. A total of 1296 children (704 males and 592 females) aged 9.2 ± 0.4 years were included in the present study. The prevalence of low PA, high ST, low FV intake, and inadequate sleep duration was 45.6%, 18.0%, 69.7%, and 64.7%, respectively. Overall, significant associations were found between individual health-risk behavior and increased risks of mental health. Furthermore, children with three or four health-risk behaviors showed significantly increased risks of anxiety (OR: 3.18, 95%CI: 1.63-6.21), depression (OR: 4.55, 95%CI: 2.28-9.09) and low self-esteem (OR: 3.59, 95%CI: 2.20-5.88) compared with those without health-risk behavior. Results of this study revealed a high prevalence of health-risk behaviors among Chinese children. Furthermore, the clustering of health-risk behavior was associated with significantly increased risks of mental health in this population. Considering these findings, it is important to perform early interventions to reduce children's health-risk behavior and prevent mental health problems.
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Affiliation(s)
- Jie Zhang
- School of Health Sciences, Wuhan University, Wuhan, Hubei Province, P.R. China
| | - Ming-Wei Liu
- School of Health Sciences, Wuhan University, Wuhan, Hubei Province, P.R. China
| | - Hong-Jie Yu
- School of Health Sciences, Wuhan University, Wuhan, Hubei Province, P.R. China
| | - Qiu-Tong Chen
- School of Health Sciences, Wuhan University, Wuhan, Hubei Province, P.R. China
| | - Bo-Wen Tang
- School of Health Sciences, Wuhan University, Wuhan, Hubei Province, P.R. China
| | - Shuai Yuan
- School of Health Sciences, Wuhan University, Wuhan, Hubei Province, P.R. China
| | - Qi-Qiang He
- School of Health Sciences, Wuhan University, Wuhan, Hubei Province, P.R. China
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12
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Yang Y, Qi Y, Cui Y, Li B, Zhang Z, Zhou Y, Chen X, Zhu D, He F, Zheng Y. Emotional and behavioral problems, social competence and risk factors in 6-16-year-old students in Beijing, China. PLoS One 2019; 14:e0223970. [PMID: 31647827 PMCID: PMC6812843 DOI: 10.1371/journal.pone.0223970] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/02/2019] [Indexed: 12/23/2022] Open
Abstract
Introduction Child emotional or behavioral problems and insufficient social development has been a heavy burden on family and society. However, currently large-scale studies on emotional and behavioral problems as well as social competence among school children in China are still lacking. This cross-sectional study analyzed the current status and risk factors of behavioral problems and social competences in Beijing students. Method A total of 9,295 students, with ages ranging from 6 to 16 years old, were enrolled in the study. The Child Behavior Checklist (CBCL) was used to screen emotional and behavioral problems, social competences of students. We then assessed significant predictors factors associated with children behavioral problems and social competences. Results The total detection rate of behavioral problems of this cohort was 16.7%. All kinds of social competence scores of boys were lower than girls (P <0.05). The scores of social and learning ability in children with behavioral problems were significantly lower than those without behavior problems (P <0.05). Gender, developmental delay, recent life events, negative relationships and negative child-rearing styles were the shared influencing factors for behavioral problems and social competence. In addition, age, macrosomia, threatened abortion, hospitalization for physical illness, physical illness, poor sleep were independent risk factors for children's emotional and behavioral problems, and non-breastfeeding was an independent risk factor for abnormal social competence. Conclusion The social competence, emotional and behavioral problems are serious among students in Beijing. More attention should be paid to mental health and effective intervention measures should be provided.
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Affiliation(s)
- Yang Yang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yanjie Qi
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yonghua Cui
- National Center for Children’s Health, Beijing, China
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Bin Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhixia Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuming Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xu Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dandi Zhu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fan He
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi Zheng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- * E-mail:
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13
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Guo L, Wang T, Wang W, Huang G, Xu Y, Lu C. Trends in Health-Risk Behaviors among Chinese Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1902. [PMID: 31146454 PMCID: PMC6603688 DOI: 10.3390/ijerph16111902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 12/28/2022]
Abstract
Adolescent health-risk behaviors can have long lasting negative effects throughout an individual's life, and cause a major economic and social burden to society. This study aimed to estimate the prevalence of the health-risk behaviors among Chinese adolescents and to test the trends in health-risk behaviors without and with adjusting for sociodemographic characteristics. Data were drawn from the School-based Chinese Adolescents Health Survey, which is an ongoing school-based study about the health-risk behaviors among Chinese adolescents (7th to 12th grade). During the first wave through the third wave, the prevalence of lifetime, past 12-month, and past 30-day use of opioid decreased by 4.19%, 0.63%, and 0.56%, respectively. Moreover, the prevalence of lifetime, past 12-month, and past 30-day sedative use decreased by 3.03%, 0.65%, and 0.35%, respectively. During the three waves, most trends in the prevalence of health-risk behaviors were downward, with a few exceptions: The prevalence of lifetime smoking, drinking, methamphetamine use, and sleep disturbance increased by 7.15%, 13.08%, 0.48%, and 9.06%, respectively. The prevalence of lifetime 3,4-methylene dioxy methamphetamine use (from 0.49% to 0.48%), lifetime mephedrone use (from 0.30% to 0.24%), or suicide attempts (from 2.41% to 2.46%) remained stable.
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Affiliation(s)
- Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China.
| | - Tian Wang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China.
| | - Wanxin Wang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China.
| | - Guoliang Huang
- Center for ADR monitoring of Guangdong, Guangzhou 510080, China.
| | - Yan Xu
- Center for ADR monitoring of Guangdong, Guangzhou 510080, China.
| | - Ciyong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China.
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14
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Araz Altay M, Bozatlı L, Demirci Şipka B, Görker I. Current Pattern of Psychiatric Comorbidity and Psychotropic Drug Prescription in Child and Adolescent Patients. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E159. [PMID: 31108992 PMCID: PMC6572123 DOI: 10.3390/medicina55050159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/15/2019] [Accepted: 05/15/2019] [Indexed: 11/30/2022]
Abstract
Background: In recent years, patterns of the use of psychotropic drugs vary with increasing rates of psychiatric presentation and diagnosis in children and adolescents. Purpose: In this study, we aimed to investigate distributions of current psychiatric symptoms and diagnosis, patterns of the use of psychotropic drugs, and differences according to age and gender in patients presented to a child and adolescent outpatient clinic. Methods: All patients aged between 0 and 18 years presenting to a child and adolescent psychiatry outpatient clinic between November 1, 2017 and November 1, 2018 were included in the study. Files of all patients were examined in detail, and patients' demographic characteristics, symptoms, psychiatric diagnoses established according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), psychotropic drugs initiated, and side effect profiles were recorded. Psychiatric symptoms and diagnostic features of the patients were determined, and the differences were investigated according to gender. Clinical characteristics were compared between diagnosed and undiagnosed patients, and between patients with and without drug initiation. Results: Of the 2066 patients, 1298 (62.8%) were male and the mean age was 10.14 ± 4.42 years. The most common symptoms were hyperactivity (23.8%) and inattention (21.6%) in males, inattention (15.1%) and irritability (14.2%) in females, and 79% of the patients received one or more psychiatric diagnoses. The most common psychiatric diagnoses in both genders were attention-deficit hyperactivity disorder (ADHD), specific learning disorder (SLD), and conduct disorder, respectively. Of the patients who received a psychiatric diagnosis, 61.8% were using psychotropic drugs, with the majority of them (71.3%) receiving monotherapy. The most frequently initiated drugs included psychostimulants, antipsychotics, and antidepressants, with 28.7% of the drug user patients receiving multiple drug therapy. Conclusion: Our study indicates that rate of presentation to child and adolescent psychiatry outpatient clinics is increasing, and rates of diagnosis and initiation of psychiatry drugs are high among the presented children. The prevalence of ADHD shows an increase in males and females in our country, and psychiatric polypharmacy has reached significant rates.
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Affiliation(s)
- Mengühan Araz Altay
- Department of Child and Adolescent Psychiatry, Trakya University School of Medicine, 22030 Edirne, Turkey.
| | - Leyla Bozatlı
- Department of Child and Adolescent Psychiatry, Trakya University School of Medicine, 22030 Edirne, Turkey.
| | - Begüm Demirci Şipka
- Department of Child and Adolescent Psychiatry, Trakya University School of Medicine, 22030 Edirne, Turkey.
| | - Işık Görker
- Department of Child and Adolescent Psychiatry, Trakya University School of Medicine, 22030 Edirne, Turkey.
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15
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The Prevalence of PTSD Symptoms and Depressive Symptoms and Related Predictors in Children and Adolescents 3 Years After the Ya'an Earthquake. Child Psychiatry Hum Dev 2019; 50:300-307. [PMID: 30302576 DOI: 10.1007/s10578-018-0840-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The objectives of this study were to investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms and depressive symptoms in teenage survivors three years after the Ya'an earthquake to assess the differences between left-behind (LBC) and non-left-behind (non-LBC) children, and to explore predictors for PTSD symptoms and depressive symptoms. The participants were assessed using children's revised impact of event scale (CRIES) and short mood and feelings questionnaire (SMFQ), after which t tests, Chi square tests, and a multivariate logistic regression were conducted to examine the differences in the LBC and identify the associated predictors. It was found that the PTSD and depressive symptom prevalences were 13.10% and 20.75%, with the LBC having a significantly higher prevalence than the non-LBC. The PTSD and depression symptoms tended to be highly comorbid (r = .52, p < .001). Being female, being aged less than 15, having siblings, being an LBC, and having higher exposure were found to be associated with PTSD and depressive symptoms.
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16
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Fellmeth G, Rose-Clarke K, Zhao C, Busert LK, Zheng Y, Massazza A, Sonmez H, Eder B, Blewitt A, Lertgrai W, Orcutt M, Ricci K, Mohamed-Ahmed O, Burns R, Knipe D, Hargreaves S, Hesketh T, Opondo C, Devakumar D. Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. Lancet 2018; 392:2567-2582. [PMID: 30528471 PMCID: PMC6294734 DOI: 10.1016/s0140-6736(18)32558-3] [Citation(s) in RCA: 252] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/14/2018] [Accepted: 10/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Globally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs). METHODS For this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0-19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0-19 years, the mean or median age of participants was more than 19 years, fewer than 50% of parents had migrated for more than 6 months, or the mean or median duration of migration was less than 6 months. We screened studies using systematic review software and extracted summary estimates from published reports independently. The main outcomes were risk and prevalence of health outcomes, including nutrition (stunting, wasting, underweight, overweight and obesity, low birthweight, and anaemia), mental health (depressive disorder, anxiety disorder, conduct disorders, self-harm, and suicide), unintentional injuries, substance use, abuse, and infectious disease. We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs) using random-effects models. This study is registered with PROSPERO, number CRD42017064871. FINDINGS Our search identified 10 284 records, of which 111 studies were included for analysis, including a total of 264 967 children (n=106 167 left-behind children and adolescents; n=158 800 children and adolescents of non-migrant parents). 91 studies were done in China and focused on effects of internal labour migration. Compared with children of non-migrants, left-behind children had increased risk of depression and higher depression scores (RR 1·52 [95% CI 1·27-1·82]; SMD 0·16 [0·10-0·21]), anxiety (RR 1·85 [1·36-2·53]; SMD 0·18 [0·11-0·26]), suicidal ideation (RR 1·70 [1·28-2·26]), conduct disorder (SMD 0·16 [0·04-0·28]), substance use (RR 1·24 [1·00-1·52]), wasting (RR 1·13 [1·02-1·24]) and stunting (RR 1·12 [1·00-1·26]). No differences were identified between left-behind children and children of non-migrants for other nutrition outcomes, unintentional injury, abuse, or diarrhoea. No studies reported outcomes for other infectious diseases, self-harm, unprotected sex, or early pregnancy. Study quality varied across the included studies, with 43% of studies at high or unclear risk of bias across five or more domains. INTERPRETATION Parental migration is detrimental to the health of left-behind children and adolescents, with no evidence of any benefit. Policy makers and health-care professionals need to take action to improve the health of these young people. FUNDING Wellcome Trust.
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Affiliation(s)
- Gracia Fellmeth
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Kelly Rose-Clarke
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Chenyue Zhao
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Laura K Busert
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Alessandro Massazza
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Hacer Sonmez
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Ben Eder
- Institute for Global Health, University College London, London, UK
| | - Alice Blewitt
- Institute for Global Health, University College London, London, UK
| | - Wachiraya Lertgrai
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Miriam Orcutt
- Institute for Global Health, University College London, London, UK
| | - Katharina Ricci
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
| | | | - Rachel Burns
- Institute for Global Health, University College London, London, UK
| | - Duleeka Knipe
- Department of Population Science, University of Bristol, Bristol, UK
| | - Sally Hargreaves
- Institute for Infection and Immunity, St George's, University of London, London, UK; International Health Unit, Section of Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Therese Hesketh
- Institute for Global Health, University College London, London, UK; Centre for Global Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Charles Opondo
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK.
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17
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Xu DD, Rao WW, Cao XL, Wen SY, Che WI, Ng CH, Ungvari GS, Du Y, Zhang L, Xiang YT. Prevalence of major depressive disorder in children and adolescents in China: A systematic review and meta-analysis. J Affect Disord 2018; 241:592-598. [PMID: 30172211 DOI: 10.1016/j.jad.2018.07.083] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/29/2018] [Accepted: 07/31/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Prevalence figures of major depressive disorder (MDD) in children and adolescents across various epidemiological studies have been inconclusive. This is a systematic review and meta-analysis of the pooled prevalence of MDD and its associated factors in children and adolescents in China. METHOD A systematic review and literature search were conducted covering PubMed, PsycINFO, EMBASE and Chinese databases (China National Knowledge Internet, WANFANG Data and SinoMed) to identify studies reporting the prevalence of MDD in children and adolescents in China. The pooled prevalence estimates and associated factors were examined using the Comprehensive Meta-Analysis program, Version 2. RESULTS Fourteen studies involving 82,592 subjects were included in this meta-analysis. The pooled point prevalence of MDD in Chinese children and adolescents was 1.3% (95% CI: 0.8%-2.0%). Subgroup and meta-regression analyses revealed that diagnostic criteria, age, year of survey and study quality were significantly associated with the prevalence of MDD. CONCLUSIONS The point prevalence of MDD in children and adolescents in China is similar to worldwide figures. Further national epidemiological studies with the view of developing effective intervention strategies should be considered.
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Affiliation(s)
- Dan-Dan Xu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macao SAR, China; Department of Biology, Faculty of Sciences, Harbin University, Harbin, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macao SAR, China
| | - Xiao-Lan Cao
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Si-Ying Wen
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Weng-Ian Che
- Department of Public Health Science, Karolinska Institute, Stockholm, Sweden
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- University of Notre Dame Australia & Graylands Hospital, Perth, Australia; Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| | - Yasong Du
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders, China & Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macao SAR, China.
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18
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The Prevalence of Attention Deficit/Hyperactivity Disorder among Chinese Children and Adolescents. Sci Rep 2018; 8:11169. [PMID: 30115972 PMCID: PMC6095841 DOI: 10.1038/s41598-018-29488-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 07/05/2018] [Indexed: 12/30/2022] Open
Abstract
Updating the worldwide prevalence estimates of attention-deficit hyperactivity disorder (ADHD) has significant applications for the further study of ADHD. However, previous reviews included few samples of Chinese children and adolescents. To conduct a systematic review of ADHD prevalence in Mainland China, Hong Kong, and Taiwan to determine the possible causes of the varied estimates in Chinese samples and to offer a reference for computing the worldwide pooled prevalence. We searched for PubMed, Embase, PsycINFO, Web of Science, China National Knowledge Infrastructure, VIP, WANFANG DATA, and China Science Periodical Database databases with time and language restrictions. A total of 67 studies covering 642,266 Chinese children and adolescents were included. The prevalence estimates of ADHD in Mainland China, Hong Kong, and Taiwan were 6.5%, 6.4%, and 4.2%, respectively, with a pooled estimate of 6.3%. Multivariate meta-regression analyses indicated that the year of data collection, age, and family socioeconomic status of the participants were significantly associated with the prevalence estimates. Our findings suggest that geographic location plays a limited role in the large variability of ADHD prevalence estimates. Instead, the variability may be explained primarily by the years of data collection, and children's socioeconomic backgrounds, and methodological characteristics of studies.
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19
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Shen YM, Chan BSM, Liu JB, Zhou YY, Cui XL, He YQ, Fang YM, Xiang YT, Luo XR. The prevalence of psychiatric disorders among students aged 6~ 16 years old in central Hunan, China. BMC Psychiatry 2018; 18:243. [PMID: 30055590 PMCID: PMC6064142 DOI: 10.1186/s12888-018-1823-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/19/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Though several epidemiological surveys of psychiatric disorders have been carried out in China, only a few of them are concerned about the prevalence of psychiatric disorders in central Hunan and reveal the distribution of common psychiatric disorders and their comorbidities. METHODS Achenbach's Child Behavior Checklist (CBCL), the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) were administered to a stratified sample of 17,071 participants aged 6 to 16 years old from two cities in the central part of Hunan province. Twelve-month prevalence rates were calculated. RESULTS Twelve-month prevalence of the population was 9.74%. The most common psychiatric disorders were attention deficit hyperactivity disorder (ADHD) (4.96%), oppositional defiant disorder (ODD) (2.98%) and generalized anxiety disorder (GAD) (1.77%). Of those with a 12-month prevalence diagnosis, 34.6% had one or more comorbid psychiatric disorders. Most notably, ADHD had comorbidity rates of 25.15% with ODD, 18.18% with CD, 6.38% with GAD, and 3.66% with MDD. CONCLUSIONS Psychiatric disorders are common in Chinese children and adolescents. Being the most prevalent mental disorder, ADHD requires continued focus and support in awareness and education.
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Affiliation(s)
- Yan-Mei Shen
- 0000 0004 1803 0208grid.452708.cDepartment of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China ,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, 410011 Hunan China
| | - Bella Siu Man Chan
- 0000 0001 2288 9830grid.17091.3eThe Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, Canada
| | - Jian-Bo Liu
- 0000 0004 1803 0208grid.452708.cDepartment of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China ,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, 410011 Hunan China
| | - Yuan-Yue Zhou
- 0000 0004 1759 700Xgrid.13402.34Mental Health Zhejiang University School of Medicine Hangzhou Seventh People’s Hospital, Hangzhou, 310013 China
| | - Xi-Long Cui
- 0000 0004 1803 0208grid.452708.cDepartment of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China ,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, 410011 Hunan China
| | - Yu-Qiong He
- 0000 0004 1803 0208grid.452708.cDepartment of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China ,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, 410011 Hunan China
| | - Yu-min Fang
- 0000 0004 1803 0208grid.452708.cDepartment of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China ,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, 410011 Hunan China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xue-Rong Luo
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China. .,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, 410011, Hunan, China.
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Liu X, Jiang D, Chen X, Tan A, Hou Y, He M, Lu Y, Mao Z. Mental Health Status and Associated Contributing Factors among Gay Men in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:1065. [PMID: 29795013 PMCID: PMC6025140 DOI: 10.3390/ijerph15061065] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/12/2018] [Accepted: 05/17/2018] [Indexed: 11/17/2022]
Abstract
Chinese gay men are preferentially vulnerable to mental health problems because of deep-rooted, traditional social influence that overemphasizes heterosexual marriage, fertility, and filial piety. A cross-sectional survey was conducted from November to December 2017 using the Chinese version of the Symptom Checklist-90-R (SCL-90-R) to assess the status of, and factors associated with the mental health of Chinese gay men. Unadjusted associations between demographic factors and the total score of SCL-90-R were examined using t/F tests or person correlation analysis. The main factors that were most predictive of the aggregate score of SCL-90-R were identified by multiple linear regressions. A total of 367 gay men participated in this survey with an average score of SCL-90-R of 180.78 ± 79.58. The scores of seven dimensions (OCS, INTS, DEPR, ANX, HOS, PHOA, PARI) for Chinese gay men were found to be significantly higher than the national norm (all p < 0.001). Age (B = -1.088, SE = 0.478, p = 0.023), educational level (B = -14.053, SE = 5.270, p = 0.008), and degree of coming out publicly (B = -23.750, SE = 4.690, p < 0.001) were protective factors for participants' mental health status. A gay man who is the only child in his family was more likely to obtain a higher total score of SCL-90-R in China (B = 59.321, SE = 7.798, p < 0.001). Our study reveals the worrying mental health status of Chinese gay men. Shifts in familial, governmental, and societal normas are suggested to improve the current social acceptance towards sexual minority men, as well as to reduce detrimental health effects.
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Affiliation(s)
- Xiaojun Liu
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Dongdong Jiang
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Xiangfan Chen
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Anran Tan
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
- Global Health Research Center, Duke Kunshan University, 8# Duke Road, Kunshan 215316, China.
| | - Yitan Hou
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Meikun He
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
| | - Yuanan Lu
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
- Department of Public Health Sciences, University of Hawaii at Mānoa, 1960 East-West Road, Honolulu, HI 96822, USA.
| | - Zongfu Mao
- School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
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21
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Sun M, Xue Z, Zhang W, Guo R, Hu A, Li Y, Mwansisya TE, Zhou L, Liu C, Chen X, Huang X, Tao H, Shi J, Liu Z, Rosenheck R. Psychotic-like experiences, trauma and related risk factors among "left-behind" children in China. Schizophr Res 2017; 181:43-48. [PMID: 27670236 DOI: 10.1016/j.schres.2016.09.030] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/20/2016] [Accepted: 09/20/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Large scale migration of workers due to wage differences across regions of China has separated millions of children, called "left-behind children" from their parents. Psychotic-like experiences (PLEs) are thought to be associated with childhood deprivation and may predict later psychotic disorders but have not been studied in this potentially vulnerable population. METHODS Data were collected from representative samples of students in thirteen middle schools in the Xiangxi region and Changsha city of Hunan province (N=6623), of whom 1360 (21.3%) were "left-behind" children. Children were surveyed with the positive frequency subscales of the Community Assessment of Psychic Experiences and the Trauma History Questionnaire child version. RESULTS More "left-behind" children reported experiencing PLEs than others. They also scored higher on the overall frequency of PLEs, severity of childhood trauma, and the subjectively perceived psychological impact of trauma both at the time of the events and at present. Compared with "left-behind" children raised by a parent or by grandparents, those raised by others reported suffering more severe impact both at the time of the events and at present. Among "left-behind" children trauma history was the most important correlate of PLEs followed by Han ethnicity, older age, and not having a stable family income. CONCLUSION "Left-behind" children are at higher risk for PLEs and suffer more traumatic events than other Chinese children. Interventions that reduce trauma risk and improve relationships with caregivers may be helpful, especially for older "left-behind" children.
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Affiliation(s)
- Meng Sun
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Zhimin Xue
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Wen Zhang
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Rui Guo
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Aimin Hu
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Yihui Li
- Department of Psychology, Gannan Medical University, Ganzhou, China
| | | | - Li Zhou
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Chang Liu
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Xudong Chen
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Xiaojun Huang
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Haojuan Tao
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Jingcheng Shi
- School of Public Health, Central South University, Changsha, China
| | - Zhening Liu
- Mental Health Institute of the Second Xianga Hospital, Central South University, The China National Clinical Research Center for Mental Health Disorders, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, 139 Middle Renmin Road, Changsha, Hunan 410011, China.
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