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Kwok CPC, Kwok JOT, Yan RWK, Lee KKW, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW, Lee ATC. Dementia and risk of visual impairment in Chinese older adults. Sci Rep 2022; 12:18033. [PMID: 36302807 PMCID: PMC9613925 DOI: 10.1038/s41598-022-22785-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/19/2022] [Indexed: 01/24/2023] Open
Abstract
We had previously identified visual impairment increasing risk of incident dementia. While a bi-directional vision-cognition association has subsequently been proposed, no study has specifically examined the longitudinal association between dementia and incidence of clinically defined visual impairment. In this territory-wide community cohort study of 10,806 visually unimpaired older adults, we examined their visual acuity annually for 6 years and tested if dementia at baseline was independently associated with higher risk of incident visual impairment (LogMAR ≥ 0.50 in the better eye despite best correction, which is equivalent to moderate visual impairment according to the World Health Organization definition). By the end of Year 6, a total of 3151 (29.2%) participants developed visual impairment. However, we did not find baseline dementia associating with higher risk of incident visual impairment, after controlling for baseline visual acuity, cataract, glaucoma, diabetes, hypertension, hypercholesterolemia, heart diseases, stroke, Parkinson's disease, depression, hearing and physical impairments, physical, intellectual and social activities, diet, smoking, age, sex, educational level, and socioeconomic status. Among different covariables, baseline visual acuity appears to be more important than dementia in contributing to the development of visual impairment. Our present findings highlight the need for re-evaluating whether dementia is indeed a risk factor for visual impairment.
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Affiliation(s)
- Charlotte P C Kwok
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jessie O T Kwok
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Rachel W K Yan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kaspar K W Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Wai C Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong SAR, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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2
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Li W, Zhang Q, Tang Y, Park SC, Park Y, Yang SY, Chen LY, Lin SK, Najoan E, Kallivayalil RA, Viboonma K, Jamaluddin R, Javed A, Thi Quynh Hoa D, Iida H, Sim K, Swe T, He YL, Ahmed HU, De Alwis A, Chiu HFK, Sartorius N, Tan CH, Chong MY, Shinfuku N, Avasthi A, Grover S, Ungvari GS, Ng CH, Xiang YT. Network analysis of psychiatric symptoms in schizophrenia: Findings from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP). Asian J Psychiatr 2022; 75:103200. [PMID: 35850062 DOI: 10.1016/j.ajp.2022.103200] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/22/2022] [Accepted: 07/01/2022] [Indexed: 11/02/2022]
Abstract
AIMS Schizophrenia is a major mental disorder with a wide range of psychiatric symptoms. This study explored the structure of psychiatric symptoms of schizophrenia using network analysis in a large representative Asian sample based on a survey of clinical features and treatment used in schizophrenia patients across 15 countries/territories in Asia. METHODS Data on the demographic characteristics and psychiatric symptoms in schizophrenia patients were extracted from the dataset of the fourth Research on Asia Psychotropic Prescription for Antipsychotics (REAP-AP) project. The presence of the following psychiatric symptoms including delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms, social/occupational dysfunction, verbal aggression, physical aggression, and affective symptoms were analyzed. RESULTS A total of 3681 patients were included. The network analysis revealed that verbal aggression, hallucinations, and social/occupational dysfunction were the most central symptoms, while the connections between social/occupational dysfunction and verbal aggression, and between hallucinations and disorganized speech were the two strongest edges. There were significant gender differences in the network structure based on the network structure invariance test (M=0.74, P = 0.03) and invariant edge strength test. The positive correlation between verbal aggression and hallucinations was significantly stronger in the female network than that in the male network (P = 0.03), while a negative correlation between affective symptoms and negative symptoms was found in the female, but not the male network (P < 0.01). CONCLUSION Central symptoms including verbal aggression, hallucinations, and socio-occupational dysfunction should be addressed in developing targeted treatment strategy for schizophrenia patients.
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Affiliation(s)
- Wen Li
- Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, China, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yilang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA; Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Seon-Cheol Park
- Department of Psychiatry, Hanyang University College of Medicine, Seoul, the Republic of Korea
| | - Yongchon Park
- Department of Psychiatry, Hanyang University, Seoul, the Republic of Korea
| | - Shu-Yu Yang
- Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
| | - Lian-Yu Chen
- Kunming Prevention and Control Center, Taipei City Hospital; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taiwan
| | - Shih-Ku Lin
- Kunming Prevention and Control Center, Taipei City Hospital; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | | | | | | | - Ruzita Jamaluddin
- Department of Psychiatry & Mental Health, Hospital Tuanku Fauziah, Kangar, Perlis, Malaysia
| | - Afzal Javed
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | | | - Hitoshi Iida
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kang Sim
- Institute of Mental Health, Buangkok Green Medical Park, Singapore
| | - Thiha Swe
- Department of Mental Health, University of Medicine, Magway, Myanmar
| | - Yan-Ling He
- Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, China
| | | | | | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programs, Geneva, Switzerland
| | - Chay-Hoon Tan
- Department of Pharmacology, National University of Singapore, Singapore
| | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung & Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Naotaka Shinfuku
- International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao; Centre for Cognitive and Brain Sciences, University of Macau, Macao; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao.
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Lee ATC, Fung AWT, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW. Late-life longitudinal blood pressure trajectories as predictor of dementia. Sci Rep 2022; 12:1630. [PMID: 35102219 PMCID: PMC8803958 DOI: 10.1038/s41598-022-05680-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/15/2021] [Indexed: 11/08/2022] Open
Abstract
While hypertension is widely recognized as a risk factor for dementia, few observational studies and clinical trials fully accounted for the effect of age on blood pressure (BP) changes prior to dementia onset. In this territory-wide population-based longitudinal study of 16,591 community-living dementia-free older adults, we followed their BP and cognitive status and tested if loss of longitudinal increase in BP in late life was associated with higher dementia risk in 6 years, with consideration of the confounding effects of hypertension, hypotension, BP variability, and other health problems and behaviours and, in the data analysis, exclusion of individuals who developed dementia within 3 years after baseline to minimize risk of reverse causality. Over 72,997 person-years of follow-up, 1429 participants developed dementia. We found that loss of longitudinal increase in systolic BP (defined as SBP increased by either < 10 mmHg or 10%) from baseline to Year 3 was independently associated with higher risk of incident dementia at Years 4 to 6 (adjusted OR 1.22, 95% CI 1.02-1.45, p = 0.03; adjusted OR 1.24, 95% CI 1.03-1.50, p = 0.02; respectively). Our findings suggest that late-life SBP trajectory changes might independently predict dementia onset and highlight the importance of including longitudinal BP monitoring in dementia risk assessment.
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Affiliation(s)
- Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ada W T Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Wai C Chan
- Department of Psychiatry, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong SAR, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Lee ATC, Fung AWT, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW. Risk of incident dementia varies with different onset and courses of depression. J Affect Disord 2021; 282:915-920. [PMID: 33601735 DOI: 10.1016/j.jad.2020.12.195] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/25/2020] [Accepted: 12/26/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study aims to examine if risk of dementia differs between adult- and late-onset depression. METHODS 16,608 community-living dementia-free older adults were followed for 6 years to the outcome of incident dementia. Depression was diagnosed according to international diagnostic guidelines. Depression in adulthood or late life was categorized using age 65 as cutoff. Hazard ratio for dementia was estimated using Cox regression analysis. RESULTS People with depression in adulthood only did not have higher dementia incidence, suggesting those in remission from adult-onset depression are not at greater risk of dementia. Conversely, having depression in both adulthood and late life was associated with higher dementia risk, and improvement in depression in late life was associated with lower risk, suggesting persistent or recurrent lifetime depression is a risk factor for dementia. Those with depression in late life only were not associated with higher dementia risk after controlling for the longitudinal changes in depressive symptoms, consistent with late-onset depression being a prodrome of dementia. LIMITATIONS Reverse causation is a potential limitation. This was minimized by careful ascertainment of depression and dementia cases, exclusion of individuals with suspected dementia at baseline and those who developed dementia within 3 years after baseline, and controlling for various important confounders. CONCLUSIONS Risk of incident dementia varies with presence and resolution of depression at different ages. Further studies are needed to test whether treating adult-onset depression may prevent dementia. Older adults with a history of depression present for an extended time should be monitored for cognitive decline.
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Affiliation(s)
- Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ada W T Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Wai C Chan
- Department of Psychiatry, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong SAR, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Lee ATC, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW. Higher Dementia Incidence in Older Adults with Poor Visual Acuity. J Gerontol A Biol Sci Med Sci 2021; 75:2162-2168. [PMID: 32043518 PMCID: PMC7566398 DOI: 10.1093/gerona/glaa036] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Indexed: 11/13/2022] Open
Abstract
Background Longitudinal evidence of poor visual acuity associating with higher risk of incident dementia is mixed. This study aimed to examine if poor visual acuity was associated with higher dementia incidence in a large community cohort of older adults, independent of the possible biases relating to misclassification error, reverse causality, and confounding effects due to health problems and behaviors. Methods A total of 15,576 community-living older adults without dementia at baseline were followed for 6 years to the outcome of incident dementia, which was diagnosed according to the ICD-10 or a Clinical Dementia Rating of 1 to 3. Visual acuity was assessed using the Snellen’s chart at baseline and follow-up. Important variables including demographics (age, sex, education, and socioeconomic status), physical and psychiatric comorbidities (cardiovascular risks, ophthalmological conditions, hearing impairment, poor mobility, and depression), and lifestyle behaviors (smoking, diet, physical, intellectual, and social activities) were also assessed. Results Over 68,904 person-years of follow-up, 1,349 participants developed dementia. Poorer visual acuity at baseline was associated with higher dementia incidence in 6 years, even after adjusting for demographics, health problems, and lifestyle behaviors, and excluding those who developed dementia within 3 years after baseline. Compared with normal vision, the hazard ratio of dementia was 1.19 (p = .31), 2.09 (p < .001), and 8.66 (p < .001) for mild, moderate, and severe visual impairment, respectively. Conclusions Moderate-to-severe visual impairment could be a potential predictor and possibly a risk factor for dementia. From a clinical perspective, older adults with poor visual acuity might warrant further risk assessment for dementia.
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Affiliation(s)
- Allen T C Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Wai C Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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6
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Lee ATC, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW. Higher dementia incidence in older adults with type 2 diabetes and large reduction in HbA1c. Age Ageing 2019; 48:838-844. [PMID: 31574142 DOI: 10.1093/ageing/afz108] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/14/2019] [Accepted: 07/29/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND although type 2 diabetes increases risk of dementia by 2-fold, whether optimizing glycemic level in late life can reduce risk of dementia remains uncertain. We examined if achieving the glycemic goal recommended by the American Diabetes Association (ADA) within a year was associated with lower risk of dementia in 6 years. METHODS in this population-based observational study, we examined 2246 community-living dementia-free Chinese older adults with type 2 diabetes who attended the Elderly Health Centres in Hong Kong at baseline and followed their HbA1c level and cognitive status for 6 years. In line with the ADA recommendation, we defined the glycemic goal as HbA1c < 7.5%. The study outcome was incident dementia in 6 years, diagnosed according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) or Clinical Dementia Rating of 1-3. RESULTS those with HbA1c ≥ 7.5% at baseline and HbA1c < 7.5% in 1 year were associated with higher rather than lower incidence of dementia, independent of severe hypoglycemia, glycemic variability and other health factors. Sensitivity analyses showed that a relative reduction of ≥10%, but not 5-10%, in HbA1c within a year was associated with higher incidence of dementia in those with high (≥8%) and moderate (6.5-7.9%) HbA1c at baseline. CONCLUSION a large reduction in HbA1c could be a potential predictor and possibly a risk factor for dementia in older adults with type 2 diabetes. Our findings suggest that optimizing or intensifying glycemic control in this population requires caution.
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Affiliation(s)
- Allen T C Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Wai C Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruby S Y Lee
- Department of Health, Elderly Health Service, The Government of Hong Kong SAR, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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7
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Zhang W, Zhu Y, Sun M, Guo R, Wu G, Wang Z, Xue Z, Shi J, Ouyang X, Pu W, Liu Z, Chiu HFK, Rosenheck R. Longitudinal Trajectories of Psychotic-Like Experiences and Their Relationship to Emergent Mental Disorders Among Adolescents: A 3-Year Cohort Study. J Clin Psychiatry 2019; 80. [PMID: 31347795 DOI: 10.4088/jcp.18m12437] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 02/21/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) may be important antecedents of psychosis and other mental disorders. OBJECTIVE To investigate distinct longitudinal trajectories of the frequency of PLEs and their relationship to subsequent development of mental disorders. METHODS A longitudinal study of self-reported PLEs and concurrent traumatic experiences was conducted among 6,198 adolescents through annual classroom assessments over 3 years (2014-2016) using the Community Assessment of Psychic Experiences and the Trauma History Questionnaire. Diagnoses of mental disorders were based on the Mini-International Neuropsychiatric Interview in the final year. Growth mixture modeling was used to identify distinct growth trajectories in the frequency of PLEs. Logistic regression was then used to explore relationships between different PLE trajectories and emergence of psychiatric disorders, taking account of sociodemographic characteristics and childhood antecedents. RESULTS Two different PLE trajectories were identified, one characterized by stable low levels of PLE frequency and the other by progressively increasing PLE frequency. Transition to mental disorder occurred in 3.39% of the increasing-frequency group and 1.28% of the stable low-level group. The increasing-frequency group had a significantly higher risk of transition to any psychiatric disorder (OR = 2.7; 95% CI, 1.56-4.66), to a psychotic disorder (OR = 22.14; 95% CI, 2.30-213.25), and to a nonpsychotic psychiatric disorder (OR = 2.28; 95% CI, 1.27-4.10). Besides increasing PLEs (OR = 3.33; 95% CI, 1.55-7.19), other risk factors for any psychiatric disorder included childhood trauma (OR = 1.17; 95% CI, 1.01-1.36), family divorce (OR = 2.86; 95% CI, 1.24-6.61), and minority ethnicity (OR = 2.91; 95% CI, 1.18-7.20). CONCLUSIONS The pattern of increasing PLEs predominates in predicting emergent mental disorder, particularly psychosis, along with minority status, trauma, and family divorce, suggesting potential targets for preventive intervention.
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Affiliation(s)
- Wen Zhang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Yifan Zhu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Meng Sun
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Rui Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Guowei Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Zheng Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Zhimin Xue
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Jingcheng Shi
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Xuan Ouyang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Weidan Pu
- Department of Psychology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China. .,Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China.,The State Key Laboratory of Medical Genetics, Central South University, Changsha, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Robert Rosenheck
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA
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Dong M, Zeng LN, Zhang Q, Ungvari GS, Ng CH, Chiu HFK, Si TM, Sim K, Avasthi A, Grover S, Chong MY, Chee KY, Kanba S, Lee MS, Yang SY, Udomratn P, Kallivayalil RA, Tanra AJ, Maramis MM, Shen WW, Sartorius N, Mahendran R, Tan CH, Shinfuku N, Xiang YT. Concurrent antipsychotic use in older adults treated with antidepressants in Asia. Psychogeriatrics 2019; 19:333-339. [PMID: 30734411 DOI: 10.1111/psyg.12416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 10/15/2018] [Accepted: 12/24/2018] [Indexed: 12/23/2022]
Abstract
AIM Depressive disorders are common in old age. Antipsychotics (APs) are often used as an adjunctive treatment with antidepressants (ADs) in this population but its patterns of use in Asia are not known. This study explored the rate of combination of APs and ADs in older adult psychiatric patients in Asia. METHODS This is a secondary analysis of the database of a multicentre study which recorded participants' basic demographical and clinical data in standardised format in 10 Asian countries and territories. The data were analysed using univariate and multivariate logistic regression analyses. RESULTS A total of 955 older adult psychiatric in- and outpatients were included in this study. The proportion of concurrent AP and AD use was 32.0%, ranging from 23.3% in Korea to 44.0% in Taiwan. Multivariate logistic regression analysis found that younger age, inpatient status and diagnosis of schizophrenia, anxiety and other mental disorders were significantly related to a higher proportion of concurrent use of APs and ADs. CONCLUSION Around a third of older adult psychiatric patients had concurrent AP and AD use in the Asian countries/regions surveyed. Considering the uncertain effectiveness and questionable safety of the AP and AD combination in this patient population, such should be cautiously used.
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Affiliation(s)
- Min Dong
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Liang-Nan Zeng
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qinge 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
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia.,Division of Psychiatry, School Medicine, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Tian-Mei Si
- Peking University Institute of Mental Health (the sixth Hospital) & National Clinical Research Center for Mental Disorders & the key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Kang Sim
- Institute of Mental Health, Singapore, Singapore
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Mian-Yoon Chong
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi & Chang Gung University, Taoyuan, Taiwan
| | - Kok-Yoon Chee
- Department of Psychiatry & Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - Min-Soo Lee
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea
| | - Shu-Yu Yang
- Department of Pharmacy, Songde Branch, Taipei City Hospital, & College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Roy A Kallivayalil
- Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Thiruvalla, India
| | - Andi J Tanra
- Department of Psychiatry, Hasanuddin University Faculty of Medicine, Makassar, Indonesia
| | - Margarita M Maramis
- Dr. Soetomo Hospital - Faculty of Medicine, Airlangga University, Surabaya, Jawa Timur, Indonesia
| | - Winston W Shen
- Departments of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Chay-Hoon Tan
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
| | - Naotaka Shinfuku
- International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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9
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Zhong XM, Dong M, Wang F, Zhang Q, Ungvari GS, Ng CH, Chiu HFK, Si TM, Sim K, Avasthi A, Grover S, Chong MY, Chee KY, Kanba S, Lee MS, Yang SY, Udomratn P, Kallivayalil RA, Tanra AJ, Maramis MM, Shen WW, Sartorius N, Mahendran R, Tan CH, Shinfuku N, Xiang YT. Physical comorbidities in older adults receiving antidepressants in Asia. Psychogeriatrics 2018; 18:351-356. [PMID: 29989257 DOI: 10.1111/psyg.12327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 11/20/2017] [Accepted: 02/03/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The present study explored the patterns of physical comorbidities and their associated demographic and clinical factors in older psychiatric patients prescribed with antidepressants in Asia. METHODS Demographic and clinical information of 955 older adults were extracted from the database of the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) project. Standardized data collection procedure was used to record demographic and clinical data. RESULTS Proportion of physical comorbidities in this cohort was 44%. Multiple logistic regression analyses showed that older age (OR = 1.7, P < 0.001), higher number of depressive symptoms (OR = 1.09, P = 0.016), being treated in psychiatric hospital (OR = 0.5, P = 0.002), living in high income countries/territories (OR = 2.4, P = 0.002), use of benzodiazepines (OR = 1.4, P = 0.013) and diagnosis of 'other psychiatric disorders' (except mood, anxiety disorders and schizophrenia) (OR = 2.7, P < 0.001) were significantly associated with physical comorbidities. CONCLUSIONS Physical comorbidities in older patients prescribed with antidepressants were common in Asia. Integrating physical care into the treatment of older psychiatric patients should be urgently considered.
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Affiliation(s)
- Xiao-Mei Zhong
- Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Hui Hospital), Guangzhou, China.,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Min Dong
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Fei Wang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia / Graylands Hospital, Perth, Victoria, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Tian-Mei Si
- Peking University Institute of Mental Health (the sixth Hospital) & National Clinical Research Center for Mental Disorders & the key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Kang Sim
- Institute of Mental Health, Buangkok View, Buangkok Green Medical Park, Singapore
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan
| | - Kok-Yoon Chee
- Department of Psychiatry & Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - Min-Soo Lee
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea
| | - Shu-Yu Yang
- Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
| | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Roy A Kallivayalil
- Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Thiruvalla, India
| | - Andi J Tanra
- Department of Psychiatry, Hasanuddin University Faculty of Medicine, Makassar, Sulawesi Selatan, Indonesia
| | - Margarita M Maramis
- Dr. Soetomo Hospital - Faculty of Medicine, Universitas Airlangga, Surabaya, Jawa Timur, Indonesia
| | - Winston W Shen
- Departments of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Rathi Mahendran
- Departments of Psychological Medicine, National University of Singapore, Singapore
| | - Chay-Hoon Tan
- Departments of Pharmacology, National University of Singapore, Singapore
| | - Naotaka Shinfuku
- International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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10
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Chen S, Conwell Y, Cerulli C, Xue J, Chiu HFK. Primary care physicians' perceived barriers on the management of depression in China primary care settings. Asian J Psychiatr 2018; 36:54-59. [PMID: 29966887 PMCID: PMC6173978 DOI: 10.1016/j.ajp.2018.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 05/28/2018] [Accepted: 06/26/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chinese patients with depression have limited access to mental health specialty care because of myriad barriers at different levels. Recently, there has been increased interest in targeting primary care settings for managing depression, because most depressed individuals visit their primary care physicians (PCPs) during the course of their depressive episodes. The present study examined PCPs' perceived barriers on the management of depression. METHODS A total of 295 PCPs completed a 36-item survey by mail. The survey questions included demographics, years in primary care, mental health training experience, and perceived barriers regarding the management of depression in their clinical and current practices. Chi-square and t-test analyses were used to compare the difference of demographic variables between the two districts. For the correlates of PCPs' clinical practices and their perceived barriers, logistic regression models were used. RESULTS At the practice level, lack of access to mental health specialists (37.8%) was the most commonly reported barrier and at patients' level, reluctance toward diagnosis of depression (34.6%) was the high barrier. Results have indicated that most PCPs (69.2%) felt comfortable discussing psychological issues with patients. Mental health training is significantly related to PCPs' clinical practice. When PCPs perceived moderate to high-level practice level barriers, prescription and referral were mostly preferred. CONCLUSION PCPs in China perceived some barriers in the management of depression, but they were open to modifications and enhancement of their skills related to managing depression.
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Affiliation(s)
- Shulin Chen
- Department of Psychology, Zhejiang University, China.
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, USA
| | - Catherine Cerulli
- Department of Psychiatry, University of Rochester Medical Center, USA
| | - Jiang Xue
- Department of Psychology, Zhejiang University, China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, China
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11
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Lee ATC, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW. Association of Daily Intellectual Activities With Lower Risk of Incident Dementia Among Older Chinese Adults. JAMA Psychiatry 2018; 75:697-703. [PMID: 29847678 PMCID: PMC6583858 DOI: 10.1001/jamapsychiatry.2018.0657] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
IMPORTANCE Associations between late-life participation in intellectual activities and decreased odds of developing dementia have been reported. However, reverse causality and confounding effects due to other health behaviors or problems have not been adequately addressed. OBJECTIVE To examine whether late-life participation in intellectual activities is associated with a lower risk of incident dementia years later, independent of other lifestyle and health-related factors. DESIGN, SETTING, AND PARTICIPANTS A longitudinal observational study was conducted at all Elderly Health Centres of the Department of Health of the Government of Hong Kong among 15 582 community-living Chinese individuals age 65 years or older at baseline who were free of dementia, with baseline evaluations performed January 1 to June 30, 2005, and follow-up assessments performed from January 1, 2006, to December 31, 2012. Statistical analysis was performed from January 1, 2015, to December 31, 2016. MAIN OUTCOMES AND MEASURES The main outcome was incident dementia as diagnosed by geriatric psychiatrists in accordance with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, or a Clinical Dementia Rating of 1 to 3. At baseline and follow-up interviews, self-reported information on participation in intellectual activities within 1 month before assessment was collected. Examples of intellectual activities, which were described by a local validated classification system, were reading books, newspapers, or magazines; playing board games, Mahjong, or card games; and betting on horse racing. Other important variables including demographics (age, sex, and educational level), physical and psychiatric comorbidities (cardiovascular risks, depression, visual and hearing impairments, and poor mobility), and lifestyle factors (physical exercise, adequate fruit and vegetable intake, smoking, and recreational and social activities) were also assessed. RESULTS Of the 15 582 individuals in the study, 9950 (63.9%) were women, and the median age at baseline was 74 years (interquartile range, 71-77 years). A total of 1349 individuals (8.7%) developed dementia during a median follow-up period of 5.0 years. Multivariable logistic regression analysis showed that the estimated odds ratio for incident dementia was 0.71 (95% CI, 0.60-0.84; P < .001) for those with intellectual activities at baseline, after excluding those who developed dementia within 3 years after baseline and adjusting for health behaviors, physical and psychiatric comorbidities, and sociodemographic factors. CONCLUSIONS AND RELEVANCE Active participation in intellectual activities, even in late life, might help delay or prevent dementia in older adults.
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Affiliation(s)
- Allen T. C. Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Marcus Richards
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, United Kingdom
| | - Wai C. Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China
| | - Helen F. K. Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruby S. Y. Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong SAR, Hong Kong SAR, China
| | - Linda C. W. Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Chiu HFK, Zhong BL, Leung T, Li SW, Chow P, Tsoh J, Yan C, Xiang YT, Wong M. Development and validation of a new cognitive screening test: The Hong Kong Brief Cognitive Test (HKBC). Int J Geriatr Psychiatry 2018; 33:994-999. [PMID: 29642275 DOI: 10.1002/gps.4883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 01/28/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To develop and examine the validity of a new brief cognitive test with less educational bias for screening cognitive impairment. METHODS A new cognitive test, Hong Kong Brief Cognitive Test (HKBC), was developed based on review of the literature, as well as the views of an expert panel. Three groups of subjects aged 65 or above were recruited after written consent: normal older people recruited in elderly centres, people with mild NCD (neurocognitive disorder), and people with major NCD. The brief cognitive test, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA), were administered to the subjects. The performance of HKBC in differentiating subjects with major NCD, mild NCD, and normal older people were compared with the clinical diagnosis, as well as the MMSE and MoCA scores. RESULTS In total, 359 subjects were recruited, with 99 normal controls, 132 subjects with major NCD, and 128 with mild NCD. The mean MMSE, MoCA, and HKBC scores showed significant differences among the 3 groups of subjects. In the receiving operating characteristic curve analysis of the HKBC in differentiating normal subjects from those with cognitive impairment (mild NCD + major NCD), the area under the curve was 0.955 with an optimal cut-off score of 21/22. The performances of MMSE and MoCA in differentiating normal from cognitively impaired subjects are slightly inferior to the HKBC. CONCLUSIONS The HKBC is a brief instrument useful for screening cognitive impairment in older adults and is also useful in populations with low educational level.
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Affiliation(s)
- Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Bao-Liang Zhong
- Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tony Leung
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - S W Li
- Castle Peak Hospital, Hong Kong
| | | | | | | | - Yu-Tao Xiang
- Faculty of Health Sciences, University of Macau, Macau, China
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13
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Lam Nogueira BOC, Li L, Meng LR, Ungvari GS, Ng CH, Chiu HFK, Kuok KCF, Tran L, Xiang YT. Clinical characteristics and quality of life of older adults with cognitive impairment in Macao. Psychogeriatrics 2018; 18:182-189. [PMID: 29409163 DOI: 10.1111/psyg.12306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 07/22/2017] [Accepted: 10/22/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND Little is known about the characteristics of older adults with cognitive impairment in Macao. This study aimed to determine the prevalence of cognitive impairment and the quality of life (QOL) of older adults living in the community and nursing homes. METHODS A consecutive sample of 413 subjects (199 from the community; 214 from nursing homes) was recruited and interviewed using standardized instruments. Cognition was measured with the Repeatable Battery for the Assessment of Neuropsychological Status and QOL with the brief version of the World Health Organization Quality of Life instrument. RESULTS Altogether 87 subjects (21.0%) had cognitive impairment. On multivariate analyses, advanced age (P < 0.001, OR = 1.06, 95%CI: 1.03-1.1) and depressive symptoms (P = 0.03, OR = 1.07, 95%CI: 0.005-1.1) were positively associated with cognitive impairment. Married marital status (P = 0.01, OR = 0.3, 95%CI: 0.1-0.7) and higher education level (P < 0.001, OR = 0.1, 95%CI: 0.06-0.3) were negatively associated with cognitive impairment. After the confounders were controlled for, cognitive impairment was significantly associated with the lower psychological (F (11,412) = 6.3, P = 0.01) and social relationship domains of QOL (F (11,412) = 4.0, P = 0.04). CONCLUSION Cognitive impairment was found to be common in community-dwelling and nursing home resident older adults in Macao. Given cognitive impairment's negative impact on QOL, appropriate strategies should be implemented to improve access to treatment in this population.
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Affiliation(s)
- Bernice O C Lam Nogueira
- School of Health Sciences, Macao Polytechnic Institute, Macao, China.,Macao Sino-Portuguese Nurses Association, Macao, China
| | - Lu Li
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, China
| | - Li-Rong Meng
- School of Health Sciences, Macao Polytechnic Institute, Macao, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Marian Centre, Perth, Western Australia, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Kenny C F Kuok
- School of Health Sciences, Macao Polytechnic Institute, Macao, China
| | - Linda Tran
- Macao Sino-Portuguese Nurses Association, Macao, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, China
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14
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Abstract
OBJECTIVES This study aimed to examine the reliability and validity of the Six-Item Screener (SIS) in screening cognitive impairment (CI) compared to the Mini-Mental State Examination (MMSE) in primary care settings in China. METHODS Participants (n = 2556, aged 60 years or older) from 30 primary care settings in Hangzhou, China, were recruited and screened using the SIS. They had a mean age of 71.6 ± 8.7 years, 50% were females, and 73% had education fewer than 5 years. A number of 373 screened participants received the MMSE assessment after the screening. RESULTS The correlation coefficients between the six items of the SIS and its total score ranged from 0.17 to 0.78. The correlation between the total score of SIS and MMSE was 0.70. The Cronbach's α coefficient of the SIS was 0.70. The receiver operating characteristic analysis using MMSE as the golden standard had the optimal cut-off score of 3, with sensitivity of 0.86 and specificity of 0.87, and the area under the curve (AUC) was 0.93. CONCLUSION The SIS performs well compared with the MMSE for screening of individuals with CI in primary care settings in China.
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Affiliation(s)
- Jiang Xue
- a Department of Psychology , Zhejiang University , Hangzhou , China
| | - Helen F K Chiu
- b Department of Psychiatry , The Chinese University of Hong Kong , Hong Kong
| | - Jiaming Liang
- a Department of Psychology , Zhejiang University , Hangzhou , China
| | - Tingfei Zhu
- a Department of Psychology , Zhejiang University , Hangzhou , China
| | - Yuxing Jiang
- a Department of Psychology , Zhejiang University , Hangzhou , China
| | - Shulin Chen
- a Department of Psychology , Zhejiang University , Hangzhou , China
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15
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Zheng W, Tong G, Ungvari GS, Ng CH, Chiu HFK, Xiang YQ, Cao XL, Liu ZR, Meng LR, Gazdag G, Xiang YT. Memory Impairment Following Electroconvulsive Therapy in Chinese Patients with Schizophrenia: Meta-Analysis of Randomized Controlled Trials. Perspect Psychiatr Care 2018; 54:107-114. [PMID: 28138965 DOI: 10.1111/ppc.12206] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 11/13/2016] [Accepted: 12/06/2016] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To evaluate memory impairment associated with electroconvulsive therapy (ECT)-antipsychotic (AP) combination in comparison to AP monotherapy in schizophrenia. DESIGN AND METHODS A systematic literature search of randomized controlled trial (RCTs) was performed. FINDINGS Eleven RCTs that compared ECT-AP combination (n = 508) with AP monotherapy (n = 510) were analyzed. ECT-AP combination was associated with greater impairment than AP monotherapy in (1) endpoint memory quotient (MQ) of the Wechsler Memory Scale (WMS)-Revised at the end of the ECT course; and (2) picture recall, counting, recognition, and associative learning of the WMS. However, no group difference was found in MQ at 1 and 2 weeks post-ECT. PRACTICE IMPLICATIONS The ECT-AP combination was associated with greater transient memory impairment compared to AP monotherapy.
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Affiliation(s)
- Wei Zheng
- Resident Psychiatrist, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Guo Tong
- Resident Psychiatrist, The National Clinical Research Center for Mental Disorders and Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- Professor, School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
- The University of Notre Dame Australia/Marian Centre, Perth, Australia
| | - Chee H Ng
- Professor, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Professor, Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ying-Qiang Xiang
- Associate Professor, The National Clinical Research Center for Mental Disorders and Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiao-Lan Cao
- Attending Psychiatrist, Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Key Laboratory for Psychological Healthcare and Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen, China
| | - Zheng-Rong Liu
- Attending Psychiatrist, Mental Hospital of Guangzhou Civil Administration, Guangzhou, China
| | - Li-Rong Meng
- Professor, School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China
| | - Gábor Gazdag
- Honorary Associate Professor, Consultation-Liaison Psychiatric Service, Szent Istvan and Szent Laszlo Hospitals, Budapest, Hungary
| | - Yu-Tao Xiang
- Associate Professor, Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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16
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Xue Y, Xu ZY, Zaroff C, Chi P, Du H, Ungvari GS, Chiu HFK, Yang YP, Xiang YT. Associations of Differentiation of Self and Adult Attachment in Individuals With Anxiety-Related Disorders. Perspect Psychiatr Care 2018; 54:54-63. [PMID: 27925215 DOI: 10.1111/ppc.12200] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 10/01/2016] [Accepted: 11/05/2016] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To examine the levels and associations of differentiation of self based on Bowen's theory and adult attachment in a sample with anxiety-related disorders. DESIGN AND METHODS One hundred fourteen adults with anxiety-related disorders and 117 age- and gender-matched controls were recruited. Levels of differentiation of self, adult attachment, and trait and state anxiety were assessed. FINDINGS Adults with anxiety-related disorders showed significantly lower global levels of differentiation of self after controlling for socio-demographic characteristics. Adults with anxiety-related disorders also displayed significantly higher levels of anxiety and avoidant attachment. PRACTICE IMPLICATIONS These constructs may be appropriate targets for intervention research in the study of anxiety-related disorders.
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Affiliation(s)
- Ying Xue
- Attending Psychiatrist at Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, and China Clinical Research Center for Mental Disorders, Beijing, China.,Center of Depression, Beijing Institute for Brain Disorders, and Department of Psychiatry, Capital Medical University, Beijing, China
| | - Zi-Yan Xu
- Postdoctoral Fellow, Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - Charles Zaroff
- Associate Professor at the Department of Psychology, University of Macau, Macao SAR, China
| | - Peilian Chi
- Associate Professor at the Department of Psychology, University of Macau, Macao SAR, China
| | - Hongfei Du
- Associate Professor at the Department of Psychology, University of Macau, Macao SAR, China
| | - Gabor S Ungvari
- Assistant Professor at the Department of Psychology, University of Macau, Macao SAR, China.,Professor at School of Psychiatry & Clinical Neurosciences, University of Western Australia, and a Professor at University of Notre Dame Australia/Marian Centre, Perth, WA, Australia
| | - Helen F K Chiu
- Assistant Professor at the Department of Psychology, University of Macau, Macao SAR, China.,Professor at Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yun-Ping Yang
- Attending Psychiatrist at Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, and China Clinical Research Center for Mental Disorders, Beijing, China.,Center of Depression, Beijing Institute for Brain Disorders, and Department of Psychiatry, Capital Medical University, Beijing, China.,Professor at Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, and China Clinical Research Center for Mental Disorders, Beijing, China.,Center of Depression, Beijing Institute for Brain Disorders, and Department of Psychiatry, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Assistant Professor at the Department of Psychology, University of Macau, Macao SAR, China.,Associate Professor at the Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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17
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Nogueira BOCL, Li L, Meng LR, Ungvari GS, Forester BP, Chiu HFK, Kuok KCF, Tran L, Liu ZM, Xiang YT. Prevalence of Sleep Disturbances and Their Associations With Demographic and Clinical Characteristics and Quality of Life in Older Adults in Macao. Perspect Psychiatr Care 2018; 54:46-53. [PMID: 27966223 DOI: 10.1111/ppc.12199] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/01/2016] [Accepted: 10/26/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To examine the prevalence of sleep disturbances (difficulty initiating sleep [DIS], difficulty maintaining sleep [DMS], and early morning awakening [EMA]), their socio-demographic and clinical correlates, and quality of life (QOL) in older adults in Macao. DESIGN AND METHODS Four hundred fifty-one subjects were interviewed using standardized instruments. FINDINGS The prevalence of at least one type of sleep disturbance was 38.1%; the figures of DIS, DMS, and EMA were 18.6, 31.3, and 23.9%, respectively. Female sex and depressive symptoms were independently associated with more frequent sleep disturbances. Sleep disturbances were independently associated with lower physical QOL. PRACTICE IMPLICATIONS Sleep disturbances are common in older adults in Macao. Appropriate strategies should be implemented to prevent and treat sleep disturbances and concerted attempts should be made to improve access to treatment.
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Affiliation(s)
- Bernice O C Lam Nogueira
- Associate Professor, School of Health Sciences, Macao Polytechnic Institute.,Macao Sino-Portuguese Nurses Association, Macao SAR, China
| | - Lu Li
- PhD Student, Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Li-Rong Meng
- Professor, School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China
| | - Gabor S Ungvari
- Professor, University of Notre Dame Australia/Marian Centre.,School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Brent P Forester
- Assistant Professor, Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA.,Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Helen F K Chiu
- Professor, Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kenny C F Kuok
- Lecturer, School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China
| | - Linda Tran
- Vice-President, Macao Sino-Portuguese Nurses Association, Macao SAR, China
| | - Zhao-Min Liu
- Professor, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
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18
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Xiang YT, Kato TA, Kishimoto T, Ungvari GS, Chiu HFK, Si TM, Yang SY, Fujii S, Ng CH, Shinfuku N. Comparison of treatment patterns in schizophrenia between China and Japan (2001-2009). Asia Pac Psychiatry 2017; 9. [PMID: 28220613 DOI: 10.1111/appy.12277] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 12/08/2016] [Accepted: 01/19/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION To date no study has compared the treatment patterns for schizophrenia specifically between China and Japan. This study examined the cross-national differences in the use of psychotropic drugs and electroconvulsive therapy (ECT) in schizophrenia. METHOD Data on 3248 schizophrenia inpatients (n = 1524 in China and n = 1724 in Japan) were collected by either chart review or interviews during the designated 3 study periods between 2001 and 2009. Patients' socio-demographic and clinical characteristics, prescriptions of psychotropic drugs, and ECT use were recorded using a standardized protocol and data collection procedure. RESULTS Multivariate analyses revealed that compared to their Japanese counterparts, Chinese inpatients had a shorter length of current hospitalization, were significantly less frequently prescribed second-generation antipsychotics (except clozapine), antipsychotic polypharmacy, benzodiazepines, and mood stabilizers, and more likely to receive clozapine, antidepressants, and ECT. DISCUSSION Substantial variations in inpatient treatment patterns for schizophrenia were found between China and Japan. The common use of ECT and clozapine in Chinese inpatients and the frequent use of antipsychotic polypharmacy and high antipsychotic doses in Japanese inpatients need to be addressed.
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Affiliation(s)
- Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan
| | | | - Gabor S Ungvari
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.,School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Tian-Mei Si
- The National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) & Peking University Institute of Mental Health & The Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Shu-Yu Yang
- Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
| | - Senta Fujii
- Department of Disaster Psychiatry, Fukushima Medical University, Fukushima, Japan
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Naotaka Shinfuku
- International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
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Zheng W, Xiang YQ, Ungvari GS, Chiu HFK, Ning YP, Yu X, Forester BP, Xiang YT. Tai chi for mild cognitive impairment: a systematic review. Psychogeriatrics 2017; 17:514-516. [PMID: 28703397 DOI: 10.1111/psyg.12269] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 02/20/2017] [Accepted: 02/28/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Wei Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Ying-Qiang Xiang
- Department of Psychiatry, The National Clinical Research Center for Mental Disorders (Beijing Anding Hospital), Beijing Institute for Brain Disorders, Capital Medical University and Center of Depression, Beijing, China
| | - Gabor S Ungvari
- Marian Centre, The University of Notre Dame Australia, Perth, Western Australia, Australia.,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of HongKong, Hong Kong, China
| | - Yu-Ping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xin Yu
- Institute of Mental Health, Peking University, Beijing, China
| | - Brent P Forester
- Division of Geriatric Psychiatry, Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts, USA
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau, China
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20
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Wang YY, Xiang YT, Ungvari GS, Ng CH, Chiu HFK, Yim LCL, Si TM, Chee KY, Avasthi A, Grover S, Chong MY, Sim K, Kanba S, He YL, Lee MS, Yang SY, Udomratn P, Kallivayalil RA, Tanra AJ, Maramis MM, Shen WW, Sartorius N, Mahendran R, Teng JY, Tan CH, Shinfuku N. A comparison of clinical characteristics of older adults treated with antidepressants in general and psychiatric hospitals in Asia. Psychogeriatrics 2017; 17:348-355. [PMID: 28429844 DOI: 10.1111/psyg.12243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/03/2016] [Accepted: 11/30/2016] [Indexed: 11/28/2022]
Abstract
AIM This study compared the demographics, clinical characteristics, and antidepressant prescription patterns between Asian patients aged 50 years and older attending psychiatric hospitals and those attending general hospitals. METHODS In total, 955 patients (604 in general hospitals, 351 in psychiatric hospitals) aged 50 years or older treated with antidepressants in 10 Asian countries and territories were examined. Patients' demographics, clinical features, and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. RESULTS Binary logistic regression revealed that high income and diagnosis of schizophrenia were independently associated with psychiatric hospital treatment, whereas outpatient care, diagnosis of anxiety disorders, and multiple major medical conditions were independently associated with general hospital treatment. In addition, tetracyclic and noradrenergic and specific serotonergic antidepressants were more likely to be prescribed in general hospitals. CONCLUSION Older adults treated with antidepressants showed different demographic and clinical features between general hospitals and psychiatric hospitals in Asia.
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Affiliation(s)
- Yuan-Yuan Wang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Taipa, Macau.,Department of Psychiatry, Faculty of Public Health, Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Taipa, Macau
| | - Gabor S Ungvari
- Department of Psychiatry, The University of Notre Dame Australia / Marian Centre, Perth, Western Australia, Australia.,Faculty of Medicine, Dentistry and Health, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong
| | - Larina C L Yim
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong
| | - Tian-Mei Si
- Department of Psychiatry, The Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Institute of Mental Health (The Sixth Hospital), Ministry of Health (Peking University), Beijing, China
| | - Kok-Yoon Chee
- Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kang Sim
- Department of General Psychiatry, Institute of Mental Health, Singapore
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - Yan-Ling He
- Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, China
| | - Min-Soo Lee
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea
| | - Shu-Yu Yang
- Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
| | - Pichet Udomratn
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Roy A Kallivayalil
- Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Thiruvalla, India
| | - Andi J Tanra
- Faculty of Medicine, Department of Psychiatry, Hasanuddin University, Makassar, Indonesia
| | - Margarita M Maramis
- Department of Psychiatry, Faculty of Medicine, Dr Soetomo Hospital, Airlangga University, Surabaya, Indonesia
| | - Winston W Shen
- Department of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Rathi Mahendran
- Department of General Psychiatry, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Jia-Ying Teng
- Department of General Psychiatry, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Chay-Hoon Tan
- Department of Pharmacology, National University of Singapore, Singapore
| | - Naotaka Shinfuku
- International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
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21
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Wang S, Wu Y, Ungvari GS, Ng CH, Forester BP, Gatchel JR, Chiu HFK, Kou C, Fu Y, Qi Y, Yu Y, Li B, Xiang YT. Sleep duration and its association with demographics, lifestyle factors, poor mental health and chronic diseases in older Chinese adults. Psychiatry Res 2017; 257:212-218. [PMID: 28777953 DOI: 10.1016/j.psychres.2017.07.036] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 07/11/2017] [Accepted: 07/19/2017] [Indexed: 11/30/2022]
Abstract
This study investigated the total sleep time (TST) and its associated factors in an older Chinese adult population. Multistage stratified cluster sampling was used in this cross-sectional study. A total of 4,115 older adults aged 60 to 79 years were selected and interviewed. Sleep duration was classified as short (<7h per day), long (>8h per day) and medium sleep (7-8h per day). The total mean sleep time was 6.86±1.75h. Short and long sleepers accounted for 45.2% and 14.8% of the sample, respectively. Multivariate logistic regression analysis revealed that inadequate fruit intake and poor mental health were positively associated with short sleep, and married/cohabitation status and living in rural areas was negatively associated with short sleep. In addition, aged 75-79 years old, inadequate fruit intake, poor mental health and multi-morbidity were positively associated with long sleep. Ischemic heart disease, COPD and chronic gastroenteritis/peptic ulcer were positively associated with short sleep duration, while hyperlipidemia, hypertension, cerebrovascular diseases, and urolithiasis were positively associated with long sleep duration. Given the high frequency of aberrant sleep duration and its negative health impact, health professionals should pay more attention to sleep patterns in older people.
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Affiliation(s)
- Shibin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China; Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yanhua Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Gabor S Ungvari
- University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Brent P Forester
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Jennifer R Gatchel
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yingli Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yue Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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22
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Li L, Wang YY, Wang SB, Li L, Lu L, Ng CH, Ungvari GS, Chiu HFK, Hou CL, Jia FJ, Xiang YT. Sleep Duration and Sleep Patterns in Chinese University Students: A Comprehensive Meta-Analysis. J Clin Sleep Med 2017; 13:1153-1162. [PMID: 28859718 DOI: 10.5664/jcsm.6760] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/06/2017] [Indexed: 01/01/2023]
Abstract
STUDY OBJECTIVES This meta-analysis aimed to determine duration and patterns of sleep in Chinese university students. METHODS English (PubMed, PsycINFO, Embase) and Chinese (SinoMed, Wan Fang Database, and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from their inception until August 16, 2016. Data on sleep duration and sleep patterns of tertiary student population in eligible studies were extracted and pooled using random-effects models. RESULTS A total of 57 studies with 82,055 university students were included in the meta-analysis. Pooled mean sleep duration was 7.08 h/d (95% confidence interval [CI]: 6.84 to 7.32 h/d). The percentage of students with sleep duration shorter than 6 h/d and 7 h/d (short sleep) was 8.4% (95% CI: 5.7% to 12.3%) and 43.9% (95% CI: 36.9% to 51.1%), respectively. In contrast, the percentage of students with sleep duration longer than 8 hours and 9 hours (long sleep) was 18.3% and 5.7%, respectively. The pooled mean bedtime was at 12:51 am. The percentage of university students who fall asleep after midnight was 23.8%. The percentage of students with sleep latency more than 30 minutes was 25.5%. The pooled mean wake-up time was at 8:04 am on weekdays and on weekends. CONCLUSIONS Short sleep duration and unhealthy sleep patterns were found to be common among Chinese university students.
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Affiliation(s)
- Lu Li
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.,The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yuan-Yuan Wang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Lin Li
- Faculty of Life Sciences and Biopharmaceutics, University of Shenyang Pharmaceutical, Shenyang, China.,Liaoning Medical Device Test Institute, Shenyang, China
| | - Li Lu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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23
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Hou CL, Zang Y, Ma XR, Cai MY, Li Y, Jia FJ, Lin YQ, Chiu HFK, Ungvari GS, Ng CH, Zhong BL, Cao XL, Tam MI, Xiang YT. The Relationship Between Sleep Patterns, Quality of Life, and Social and Clinical Characteristics in Chinese Patients With Schizophrenia. Perspect Psychiatr Care 2017; 53:342-349. [PMID: 27629985 DOI: 10.1111/ppc.12186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 07/17/2016] [Accepted: 08/15/2016] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The purpose of the study was to determine the pattern of sleep behavior in schizophrenia patients treated in primary care. DESIGN AND METHODS Altogether 623 schizophrenia patients in 22 primary care services were recruited. Sleep duration and demographic and clinical characteristics were recorded. FINDINGS The mean expected total sleep time was 8.8 hr (SD 1.8) and the mean actual total sleep time was 8.2 hr (SD 2.1). The frequency of short, medium, and long sleepers was 18.1, 38.4, and 43.5%, respectively. Major medical conditions and any type of insomnia were independently associated with short sleep, while long sleep was associated with unemployment and use of second-generation antipsychotics. PRACTICE IMPLICATIONS More attention should be paid to sleep duration in this population group.
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Affiliation(s)
- Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong, China
| | - Yu Zang
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Xin-Rong Ma
- Ningxia Mental Health Center, Ningxia Ning-An Hospital, Yinchuan, China
| | - Mei-Ying Cai
- Guangzhou Yuexiu Center for Disease Control and Prevention, Guangzhou, China
| | - Yan Li
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, and School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Bao-Liang Zhong
- Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Xiao-Lan Cao
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Man-Ian Tam
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
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24
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Sun M, Zhang W, Guo R, Hu A, Li Y, Mwansisya TE, Zhou L, Liu C, Chen X, Tao H, Huang X, Xue Z, Chiu HFK, Liu Z. Psychotic-like experiences and correlation with childhood trauma and other socio-demographic factors: A cross-sectional survey in adolescence and early adulthood in China. Psychiatry Res 2017; 255:272-277. [PMID: 28595150 DOI: 10.1016/j.psychres.2017.03.059] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 03/08/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
Psychotic-like experiences (PLEs) in adolescence are found to be risk factors for later mental disorders. Previous research has also found that childhood trauma has a positive correlation with mental health problems. However, few studies have focused on the relationship between them, especially in adolescence and early adulthood. A total of 9122 students (age between 10 and 23.3) were surveyed and assessed with the positive and depressive subscales of the Community Assessment of Psychic Experiences and the Trauma History Questionnaire. A total of 20.7% students experienced frequent PLEs, 17.5% had frequent delusional experiences, and 7.6% had frequent hallucinatory experiences. Only a small portion of this sample experienced frequent PLEs, associated with more types of PLEs, more distress, and more depressive experiences. Several socio-demographic factors were associated with frequent PLEs in this sample, which could be further examined in future prevention studies. Students with frequent PLEs experienced significantly higher impact from trauma events, both at the time of the events and in the present, indicating a possible reciprocal effect between childhood trauma and PLEs. The impact of childhood trauma played an important role in the relationship between childhood trauma and PLEs.
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Affiliation(s)
- Meng Sun
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Wen Zhang
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Rui Guo
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Aimin Hu
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Yihui Li
- Department of Psychology, Gannan Medical University, Ganzhou, China
| | | | - Li Zhou
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Chang Liu
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Xudong Chen
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Haojuan Tao
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Xiaojun Huang
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Zhimin Xue
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhening Liu
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China.
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25
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Fu YN, Cao XL, Hou CL, Ng CH, Ungvari GS, Chiu HFK, Lin YQ, Wang L, Zheng X, Jia FJ, Xiang YT. Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China. Psychiatry Res 2017; 255:13-16. [PMID: 28505468 DOI: 10.1016/j.psychres.2017.04.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/23/2017] [Accepted: 04/07/2017] [Indexed: 11/28/2022]
Abstract
There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight.
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Affiliation(s)
- Yan-Nan Fu
- Southern Medical University, Guangdong Province, China; Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Xiao-Lan Cao
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Lihui Wang
- Huizhou Veteran Hospital, Huizhou, Guangdong, China
| | | | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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26
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Lee ATC, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW. Lower risk of incident dementia among Chinese older adults having three servings of vegetables and two servings of fruits a day. Age Ageing 2017; 46:773-779. [PMID: 28338708 DOI: 10.1093/ageing/afx018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 01/18/2017] [Indexed: 12/25/2022] Open
Abstract
Background dietary modification can potentially reduce dementia risk, but the importance of fruits and the amount of vegetables and fruits required for cognitive maintenance are uncertain. We examined whether the minimal daily requirement of vegetables and fruits recommended by the World Health Organization (WHO) would independently lower dementia risk. Methods in this population-based observational study, we examined the diet of 17,700 community-living dementia-free Chinese older adults who attended the Elderly Health Centres in Hong Kong at baseline and followed their cognitive status for 6 years. In line with the WHO recommendation, we defined the cutoff for minimal intake of vegetables and fruits as at least three and two servings per day, respectively. The study outcome was incident dementia in 6 years. Dementia was defined by presence of clinical dementia in accordance with the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) or Clinical Dementia Rating of 1-3. Results multivariable logistic regression analysis showed that the estimated odds ratios for incident dementia were 0.88 (95% confidence interval 0.73-1.06; P = 0.17) for those consuming at least three servings of vegetables per day, 0.86 (0.74-0.99; P < 0.05) for those consuming at least two servings of fruits per day and 0.75 (0.60-0.95; P = 0.02) for those consuming at least these amounts of both at baseline, after adjusting for age, gender, education, major chronic diseases, physical exercise and smoking. Conclusion having at least three servings of vegetables and two servings of fruits daily might help prevent dementia in older adults.
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Affiliation(s)
- Allen T C Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | | | - Wai C Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, Hong Kong
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
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27
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Li XH, An FR, Ungvari GS, Ng CH, Chiu HFK, Wu PP, Jin X, Xiang YT. Prevalence of smoking in patients with bipolar disorder, major depressive disorder and schizophrenia and their relationships with quality of life. Sci Rep 2017; 7:8430. [PMID: 28814728 PMCID: PMC5559601 DOI: 10.1038/s41598-017-07928-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/05/2017] [Indexed: 12/13/2022] Open
Abstract
Few studies have compared the prevalence of smoking between patients with bipolar disorder, major depressive disorder (MDD) and schizophrenia. This study examined the prevalence of smoking and its relationships with demographic and clinical characteristics, and quality of life (QOL) in patients with these psychiatric disorders. A total of 1,102 inpatients were consecutively screened. Psychopathology and QOL were measured with standardized instruments. The prevalence of current smoking in the whole sample was 16.7%; 17.5% in bipolar disorder, 10.6% in MDD and 18.5% in schizophrenia. The rates of smoking in bipolar disorder (p = 0.004, OR = 2.5, 95%CI: 1.3–4.7) and schizophrenia (p = 0.03, OR = 2.0, 95%CI: 1.06–3.8) were significantly higher than in MDD, while no difference was found between bipolar disorder and schizophrenia. Smokers had a higher mental QOL than non-smokers (p = 0.007) in MDD, but no difference was found in the other two groups. Male gender, living alone, higher personal income, older age of onset, health insurance coverage, and first episode was significantly associated with smoking in one or more diagnostic groups. Smoking appears more common in bipolar disorder and schizophrenia than in MDD in China. The figures in all disorders were lower than that reported in most of other countries.
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Affiliation(s)
- Xiao-Hong Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia.,School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ping-Ping Wu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xin Jin
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China.
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28
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Li Y, Hou CL, Ma XR, Zhong BL, Zang Y, Jia FJ, Lin YQ, Lai KYC, Chiu HFK, Ungvari GS, Hall BJ, Cai MY, Ng CH, Xiang YT. Quality of life in Chinese patients with schizophrenia treated in primary care. Psychiatry Res 2017; 254:80-84. [PMID: 28456026 DOI: 10.1016/j.psychres.2017.04.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/26/2017] [Accepted: 04/23/2017] [Indexed: 11/17/2022]
Abstract
In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. This study examined the quality of life (QOL) in patients with schizophrenia treated in primary care and explored the demographic and clinical characteristics associated with QOL. Altogether, 612 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. QOL, psychotic and depressive symptoms, extra-pyramidal symptoms and insight were assessed using standardized instruments. Data analyses were conducted with the one sample t-test and multiple linear regression analyses. Compared with the normative data for the Chinese general population, significantly lower scores in physical and mental QOL domains were found in the patient group. Older age, being unemployed, major medical conditions, no smoking, more severe depressive and negative symptoms, more frequent insomnia, and suicidality were independently associated with poor physical QOL. Male gender, more severe depressive and anxiety symptoms, more frequent insomnia, and suicidality were independently associated with poor mental QOL. Patients with schizophrenia treated in primary care had lower level of QOL in comparison with general population. Effective measures need to be implemented to improve their QOL.
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Affiliation(s)
- Yan Li
- The National Clinical Research Center for Mental Disorders, China & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Xin-Rong Ma
- Ningxia Mental Health Center, Ningxia Ning-An Hospital, Ningxia Province, China
| | - Bao-Liang Zhong
- The Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Yu Zang
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Kelly Y C Lai
- Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao SAR, China; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mei-Ying Cai
- Guangzhou Yuexiu Center for Disease Control and Prevention, Guangdong Province, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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29
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Lu L, Wang SB, Rao WW, Ungvari GS, Ng CH, Chiu HFK, Zhang J, Kou C, Jia FJ, Xiang YT. Sleep Duration and Patterns in Chinese Older Adults: a Comprehensive Meta-analysis. Int J Biol Sci 2017; 13:682-689. [PMID: 28655994 PMCID: PMC5485624 DOI: 10.7150/ijbs.19695] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/11/2017] [Indexed: 12/30/2022] Open
Abstract
This meta-analysis examined the mean sleep duration and patterns in Chinese older adult population. A literature search was systematically conducted covering major English (PubMed, Embase and PsycINFO) and Chinese (Chinese National Knowledge Infrastructure (CNKI), WanFang and SinoMed) databases. Data in studies with the mean and standard deviation of sleep duration and/or the proportion of short and long sleep durations in Chinese older adults were extracted and pooled using random-effects models. Subgroup analyses were conducted according to gender, region, area, survey time and sample size. A total of 36 studies with 150,616 subjects were included for analyses. The pooled mean sleep duration of 21 studies with available data was 6.82 hours/day (95% CI: 6.59-7.05 hours/day). The estimated proportions of sleep duration <5 hours/day, <6 hours/day, <7 hours/day were 18.8% (95% CI: 1.7%-35.9%), 26.7% (95% CI: 19.7%-33.7%) and 42.3% (95% CI: 34.8%-49.8%), respectively. The pooled proportions for long sleepers were 22.6% (95% CI: 13.9%-31.4%) (>8 hours/day) and 17.6% (95% CI: 12.4%-22.9%) (>9 hours/day). Given the adverse effects of unhealthy sleep patterns, health professionals should pay more attention to sleep patterns in this population in China.
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Affiliation(s)
- Li Lu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Shi-Bin Wang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.,Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Wen-Wang Rao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Gabor S Ungvari
- University of Notre Dame Australia / Marian Centre, Perth, Australia.,School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Juan Zhang
- Faculty of Education, University of Macau, Macao SAR, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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30
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Wang S, Ungvari GS, Forester BP, Chiu HFK, Wu Y, Kou C, Fu Y, Qi Y, Liu Y, Tao Y, Yu Y, Li B, Xiang YT. Gender differences in general mental health, smoking, drinking and chronic diseases in older adults in Jilin province, China. Psychiatry Res 2017; 251:58-62. [PMID: 28189080 DOI: 10.1016/j.psychres.2017.02.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 11/28/2016] [Accepted: 02/03/2017] [Indexed: 11/17/2022]
Abstract
There is little information on gender differences in general mental health, smoking, drinking and chronic diseases in Chinese elderly. We examined the gender differences in general mental health, smoking, drinking and a number of chronic diseases in a large Chinese old population. Multistage stratified cluster sampling was used in this cross-sectional study. A total of 4115 people (2198 women; 1917 men) aged between 60 and 79 years were included and their general mental health, smoking, drinking and chronic diseases were recorded with standardized assessment tools. Multivariate analyses revealed that women were less likely to be current smokers and frequent drinkers, but had higher prevalence of poor mental health compared with their male counterparts. In addition, the prevalence rate of chronic diseases and multi-morbidities were higher in women than that in men (both p values <0.05). Health professionals and policy makers need to pay special attention to the common chronic diseases and poor mental health in older women and higher prevalence of smoking and drinking in men.
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Affiliation(s)
- Shibin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China; Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Gabor S Ungvari
- University of Notre Dame Australia / Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Brent P Forester
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA & Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yanhua Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yingli Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yue Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yawen Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yuchun Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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31
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C F Kuok K, Li L, Xiang YT, Nogueira BOCL, Ungvari GS, Ng CH, Chiu HFK, Tran L, Meng LR. Quality of life and clinical correlates in older adults living in the community and in nursing homes in Macao. Psychogeriatrics 2017; 17:194-199. [PMID: 28093847 DOI: 10.1111/psyg.12214] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/22/2016] [Indexed: 11/29/2022]
Abstract
AIM There have been no previous studies of quality of life (QOL) in older adults in Macao. This study aimed to examine QOL in relation to the sociodemographic and clinical characteristics of adults aged ≥50 years in Macao. METHODS A sample of 451 subjects (203 living in the community, 248 living in nursing homes) was interviewed using standardized instruments. Basic sociodemographic and clinical data including QOL were collected. RESULT There were no significant differences between the community and nursing home groups in any of the QOL domains. Multiple linear regression analyses revealed that poor physical QOL was significantly predicted by severe depressive symptoms, insomnia, major medical conditions, unmarried status, and lower education ( F 11,438 = 26.2, P < 0.001), which accounted for 38.2% of the variance. Poor psychological QOL was significantly predicted by severe depressive symptoms and lower educational level ( F 11,438 = 24.3, P < 0.001), which accounted for 36.4% of the variance. Poor social QOL was significantly predicted by severe depressive symptoms, male gender, and unmarried status ( F 11,438 = 5.6, P < 0.001), which accounted for 12.5% of the variance. Poor environment QOL was significantly predicted by lower educational level, severe depressive symptoms, and younger age ( F 11,438 = 6.6, P < 0.001), which accounted for 12.1% of the variance. CONCLUSION Older Macanese adults had poorer scores on physical and social QOL domains than the general Hong Kong Chinese population. Their QOL was more strongly related to severe depressive symptoms, major medical conditions, and insomnia.
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Affiliation(s)
- Kenny C F Kuok
- School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China
| | - Lu Li
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Bernice O C Lam Nogueira
- School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China.,Macao Sino-Portuguese Nurses Association, , Macao SAR, China
| | - Gabor S Ungvari
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, , Australia.,University of Notre Dame Australia/Marian Centre, , Perth, , Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China,
| | - Linda Tran
- Macao Sino-Portuguese Nurses Association, , Macao SAR, China
| | - Li-Rong Meng
- School of Health Sciences, Macao Polytechnic Institute, Macao SAR, China
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32
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Hou CL, Li Y, Cai MY, Ma XR, Zang Y, Jia FJ, Lin YQ, Ungvari GS, Chiu HFK, Ng CH, Zhong BL, Cao XL, Tam MI, Xiang YT. Prevalence of Insomnia and Clinical and Quality of Life Correlates in Chinese Patients With Schizophrenia Treated in Primary Care. Perspect Psychiatr Care 2017; 53:80-86. [PMID: 26388498 DOI: 10.1111/ppc.12139] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 07/23/2015] [Accepted: 08/11/2015] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To describe the prevalence and clinical correlates of insomnia in schizophrenia patients treated in primary care. DESIGN AND METHODS Six hundred and twenty-three schizophrenia patients from 22 primary care services were recruited. FINDINGS The prevalence of at least one type of insomnia was 28.9% (180/623), while those of difficulty initiating sleep, difficulty maintaining sleep, and early morning wakening were 20.5%, 19.6%, and 17.7%, respectively. Only 53.3% of patients suffering from insomnia received treatment. PRACTICE IMPLICATIONS Insomnia is common in Chinese patients with schizophrenia treated in primary care and the rate of treatment appears low.
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Affiliation(s)
- Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yan Li
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mei-Ying Cai
- Department of Community, Guangzhou Yuexiu Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Xin-Rong Ma
- Ningxia Mental Health Center, Ningxia Ning-An Hospital, Yinchuan, Ningxia Province, China
| | - Yu Zang
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Gabor S Ungvari
- Marian Centre, The University of Notre Dame Australia, Perth, Western Australia, Australia.,School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Bao-Liang Zhong
- Department of Psychiatry, Chinese University of Hong Kong, Guangzhou, Hong Kong 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
| | - Man-Ian Tam
- Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
| | - Yu-Tao Xiang
- Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
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33
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Zhang L, Yu X, Fang YR, Ungvari GS, Ng CH, Chiu HFK, Li HC, Yang HC, Tan QR, Xu XF, Wang G, Xiang YT. Duration of untreated bipolar disorder: a multicenter study. Sci Rep 2017; 7:44811. [PMID: 28327583 PMCID: PMC5361090 DOI: 10.1038/srep44811] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/15/2017] [Indexed: 11/09/2022] Open
Abstract
Little is known about the demographic and clinical differences between short and long duration of untreated bipolar disorder (DUB) in Chinese patients. This study examined the demographic and clinical features of short (≤2 years) and long DUB (>2 years) in China. A consecutively recruited sample of 555 patients with bipolar disorder (BD) was examined in 7 psychiatric hospitals and general hospital psychiatric units across China. Patients' demographic and clinical characteristics were collected using a standardized protocol and data collection procedure. The mean DUB was 3.2 ± 6.0 years; long DUB accounted for 31.0% of the sample. Multivariate analyses revealed that longer duration of illness, diagnosis of BD type II, and earlier misdiagnosis of BD for major depressive disorder or schizophrenia were independently associated with long DUB. The mean DUB in Chinese BD patients was shorter than the reported figures from Western countries. The long-term impact of DUB on the outcome of BD is warranted.
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Affiliation(s)
- 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.,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xin Yu
- Peking University Institute of Mental Health (the sixth Hospital) &National Clinical Research Center for Mental Disorders &the key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia.,School of Psychiatry &Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hui-Chun Li
- The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang province, China
| | - Hai-Chen Yang
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen, Guangdong province, China
| | - Qing-Rong Tan
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shannxi province, China
| | - Xiu-Feng Xu
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan province, China
| | - Gang Wang
- 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, Macao SAR, China
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34
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Snowdon J, Phillips J, Zhong B, Yamauchi T, Chiu HFK, Conwell Y. Changes in age patterns of suicide in Australia, the United States, Japan and Hong Kong. J Affect Disord 2017; 211:12-19. [PMID: 28081432 DOI: 10.1016/j.jad.2017.01.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/29/2016] [Accepted: 01/03/2017] [Indexed: 01/09/2023]
Abstract
The patterns of association between age and suicide rate vary by country, subpopulation and gender, and over time. To shed light on factors associated with these differences, we analysed suicide data from four populations, two 'Western' (Australia, the United States [US]) and two Asian (Japan and Hong Kong). We computed suicide rates in five-year age-groups (between 10 and 14 years and 85+ years) for men and women separately, and present graphical representations of the age patterns during selected five-year periods. Rates and age patterns differed markedly, as did gender patterns except in Hong Kong. In 1964-8, male suicide rates in Australia and US were represented by upward-sloping graphs, whereas in Japan the pattern was bimodal. By 1979-83, male patterns in Australia and US were bimodal, but Japan's was trimodal, including a middle-age peak reached in 1994-98. In contrast, female age patterns in the Western countries were shallowly convex or uniform, while in Hong Kong and Japan the upward-sloping graphs became, over time, less steep; by 2009-13, the pattern in Japan was uniform (flat). In recent decades, suicide rates of older men in Australia, US and Japan, and older women in Japan and Hong Kong, have fallen considerably. Suicide rates of men aged 45-64 in Australia and US also fell, though by 2009-13 the US rate had risen again. The suicide rate of Australian men in their twenties halved between 1994-98 and 2009-13, while rates for younger men and women in Japan have risen since 1994-98. In Hong Kong, suicide rates of young men have increased. Age patterns of suicide likely reflect period and cohort effects shaped by socioeconomic stressors, availability of health and welfare services, access to lethal methods of suicide, and other factors. Greater understanding of their impact on age patterns of suicide can result in potential preventive solutions.
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Affiliation(s)
- John Snowdon
- Discipline of Psychiatry, Sydney Medical School, Sydney, Australia.
| | - Julie Phillips
- Department of Sociology, Institute for Health, Health Care Research and Aging Research, Rutgers University, USA
| | - Baoliang Zhong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Takashi Yamauchi
- Research Center for Overwork-related Disorders, National Institute of Occupational Safety and Health, Kawasaki, Japan
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
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35
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Zhong BL, Chan SSM, Liu TB, Jin D, Hu CY, Chiu HFK. Mental health of the old- and new-generation migrant workers in China: who are at greater risk for psychological distress? Oncotarget 2017; 8:59791-59799. [PMID: 28938682 PMCID: PMC5601778 DOI: 10.18632/oncotarget.15985] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/28/2017] [Indexed: 01/25/2023] Open
Abstract
Rural-to-urban migrant workers (MWs) are a large vulnerable population in China and, recently, the new-generation MWs (those born in 1980 or later) have become the majority of this population. Examining difference in the epidemiology of poor mental health between the new- and old-generation (those born before 1980) MWs would facilitate mental health promotion efforts. However, very few related studies are available and they produced conflicting findings. This study investigated intergenerational difference in prevalence and correlates of psychological distress (PD) in MWs. A total of 3031 MWs (691 old- and 2340 new-generation MWs) completed a standardized questionnaire containing socio-demographic, migration-related, and work-related variables and the Chinese 12-item General Health Questionnaire (GHQ-12). A GHQ-12 score of 3 or higher was used to denote PD. PD was more prevalent in the new- than old-generation MWs (36.2% versus 28.2%, P < 0.001). The elevated risk of PD in the new- versus old-generation remained significant after controlling for potential confounders (OR=1.51, P < 0.001). For the new-generation, correlates for PD included low monthly income, recent two-week physical morbidity, migrating alone, poor Mandarin proficiency and long working hours; while for the old-generation, correlates for PD included low education, recent two-week physical morbidity, and having worked in many cities. The new-generation MWs are at higher risk for PD than the old-generation MWs. Mental health services for addressing the generation-specific needs may be an effective way to prevent or reduce PD of MWs.
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Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China.,Affiliated Wuhan Mental Health Center/The Ninth Clinical School, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, PR China
| | - Sandra S M Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Tie-Bang Liu
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong Province, PR China
| | - Dong Jin
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong Province, PR China
| | - Chi-Yi Hu
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong Province, PR China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
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Cao XL, Fu YN, Jia FJ, Chiu HFK, Ungvari GS, Ng CH, Hou CL, Lin YQ, Zhong XB, Liu XM, Yim LCL, Xiang YT. Comparison of quality of life in homeless and non-homeless Chinese patients with psychiatric disorders. Psychiatry Res 2017; 249:115-119. [PMID: 28092790 DOI: 10.1016/j.psychres.2017.01.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 12/02/2016] [Accepted: 01/06/2017] [Indexed: 11/30/2022]
Abstract
To date, there are no data on quality of life (QOL) and its correlates in homeless Chinese patients with psychiatric disorders. This study aimed to compare QOL between homeless and non-homeless patients with psychiatric disorders in China. A total of 278 homeless and 222 non-homeless patients matched in age and gender were consecutively recruited. Socio-demographic and clinical data were collected from medical records. A clinical interview was conducted using standardized instruments. The physical and mental QOL in both groups were lower than the normative data for Chinese general population, but there was no significant difference in any QOL domain between the two groups. Multivariate analyses of homeless patients revealed that male gender was associated with higher physical QOL, while living in cities and lower education level were associated with higher mental QOL. In non-homeless patients, use of second-generation antipsychotics was associated with lower physical QOL, while having more severe depressive symptoms was associated with lower mental QOL. Longitudinal studies are warranted to clarify the contributing factors of QOL in both homeless and non-homeless patients.
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Affiliation(s)
- Xiao-Lan Cao
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Yan-Nan Fu
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | | | | | - Larina C L Yim
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, China.
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37
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Feng Y, Sha S, Hu C, Wang G, Ungvari GS, Chiu HFK, Ng CH, Si TM, Chen DF, Fang YR, Lu Z, Yang HC, Hu J, Chen ZY, Huang Y, Sun J, Wang XP, Li HC, Zhang JB, Xiang YT. Prescribing patterns of psychotropic medications and clinical features in patients with major depressive disorder with and without comorbid dysthymia in China. Asia Pac Psychiatry 2017; 9. [PMID: 27759189 DOI: 10.1111/appy.12261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 09/16/2016] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Little has been reported about the demographic and clinical features of major depressive disorder (MDD) with comorbid dysthymia in Chinese patients. This study examined the frequency of comorbid dysthymia in Chinese MDD patients together with the demographic and clinical correlates and prescribing patterns of psychotropic drugs. METHODS Consecutively collected sample of 1178 patients with MDD were examined in 13 major psychiatric hospitals in China. Patients' demographic and clinical characteristics and psychotropic drugs prescriptions were recorded using a standardized protocol and data collection procedure. The diagnosis of dysthymia was established using the Mini International Neuropsychiatric Interview. Medications ascertained included antidepressants, antipsychotics, benzodiazepines, and mood stabilizers. RESULTS One hundred and three (8.7%) patients fulfilled criteria for dysthymia. In multiple logistic regression analyses, compared to non-dysthymia counterparts, MDD patients with dysthymia had more depressive episodes with atypical features including increased appetite, sleep, and weight gain, more frequent lifetime depressive episodes, and less likelihood of family history of psychiatric disorders. There was no significant difference in the pattern of psychotropic prescription between the 2 groups. CONCLUSIONS There are important differences in the demographic and clinical features of comorbid dysthymia in Chinese MDD patients compared with previous reports. The clinical profile found in this study has implications for treatment decisions.
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Affiliation(s)
- Yuan Feng
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.,China Clinical Research Center for Mental Disorders, Beijing, China.,Center of Depression, Beijing Institute for Brain Disorders, Beijing, China
| | - Sha Sha
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.,China Clinical Research Center for Mental Disorders, Beijing, China.,Center of Depression, Beijing Institute for Brain Disorders, Beijing, China
| | - Chen Hu
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.,China Clinical Research Center for Mental Disorders, Beijing, China.,Center of Depression, Beijing Institute for Brain Disorders, Beijing, China
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.,China Clinical Research Center for Mental Disorders, Beijing, China.,Center of Depression, Beijing Institute for Brain Disorders, Beijing, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia / Marian Centre, Perth, Australia.,School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Tian-Mei Si
- Key Laboratory of Mental Health, Ministry of Mental Health & Peking University Institute of Mental Health, Beijing, China
| | - Da-Fang Chen
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Lu
- Shanghai Tongji Hospital, Tongji University Medical School, Shanghai, China
| | - Hai-Chen Yang
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen, Guangdong Province, China
| | - Jian Hu
- The First Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Zhi-Yu Chen
- Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang Province, China
| | - Yi Huang
- West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jing Sun
- The Affiliated Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Xiao-Ping Wang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Hui-Chun Li
- The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Jin-Bei Zhang
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yu-Tao Xiang
- Faculty of Health Sciences, University of Macau, Macao SAR, China
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38
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Gu X, Zheng W, Guo T, Ungvari GS, Chiu HFK, Cao X, D'Arcy C, Meng X, Ning Y, Xiang Y. Electroconvulsive Therapy for Agitation in Schizophrenia: Metaanalysis of Randomized Controlled Trials. Shanghai Arch Psychiatry 2017; 29:1-14. [PMID: 28769540 PMCID: PMC5518249 DOI: 10.11919/j.issn.1002-0829.217003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Agitation poses a significant challenge in the treatment of schizophrenia. Electroconvulsive therapy (ECT) is a fast, effective and safe treatment for a variety of psychiatric disorders, but no meta-analysis of ECT treatment for agitation in schizophrenia has yet been reported. Aims To systematically evaluate the efficacy and safety of ECT alone or ECT-antipsychotics (APs) combination for agitation in schizophrenia. Methods Systematic literature search of randomized controlled trials (RCTs) was performed. Two independent evaluators selected studies, extracted data about outcomes and safety with available data, conducted quality assessment and data synthesis. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to judge the level of the overall evidence of main outcomes. Results Seven RCTs from China, including ECT alone (4 RCTs with 5 treatment arms, n=240) and ECT-APs combination (3 RCTs, n=240), were identified. Participants in the studies were on average 34.3(4.5) years of age and lasted an average of 4.3(3.1) weeks of treatment duration. All 7 RCTs were non-blinded, and were rated as low quality based on Jadad scale. Meta-analysis of the pooled sample found no significant difference in the improvement of the agitation sub-score of the Positive and Negative Syndrome Scale (PANSS) when ECT alone (weighted mean difference=-0.90, (95% confidence interval (CI): -2.91, 1.11), p=0.38) or ECT-APs combination (WMD=-1.34, (95%CI: -4.07, 1.39), p=0.33) compared with APs monotherapy. However, ECT alone was superior to APs monotherapy regarding PANSS total score (WMD=-7.13, I2=0%, p=0.004) and its excitement sub-score (WMD=-1.97, p<0.0001) as well as the PANSS total score at 14 days (WMD=-7.13, I2=0%, p=0.004) and its excitement sub-score at 7 and 14 days (WMD=-1.97 to -1.92, p=0.002 to 0.0001) after ECT. The ECT-APs combination was superior to APs monotherapy with respect to the PANSS total score at treatment endpoint (WMD=-10.40, p=0.03) and 7 days (WMD=-5.01, p=0.02). Headache (number-needed-to-harm (NNH)=3, 95%CI=2-4) was more frequent in the ECT alone group compared to AP monotherapy. According to the GRADE approach, the evidence levels of main outcomes were rated as ‘‘very low’’ (37.5%) and “low” (50%). Conclusion Pooling of the data based on 7 RCTs from China found no advantage of ECT alone or ECT-APs combination in the treatment of agitation related outcomes in schizophrenia patients. However, ECT alone or ECT-APs combination were associated with significant reduction in the PANSS total score. High-quality RCTs are needed to confirm the current interpretations.
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Affiliation(s)
- Xiaojing Gu
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Henan, China
| | - Wei Zheng
- Guangzhou Brain Hospital (Guangzhou Huiai Hospital), Affiliated Hospital of Guangzhou Medical University, Guangzhou China
| | - Tong Guo
- The National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Gabor S Ungvari
- School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia.,The University of Notre Dame Australia / Marian Centre, Perth, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaolan Cao
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.,Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Carl D'Arcy
- Department of Psychiatry & School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Xiangfei Meng
- Department of Psychiatry, McGill University and the Douglas Mental Health University Institute, Montreal, Canada
| | - Yuping Ning
- The Second Affiliated Hospital of Xinxiang Medical University, Henan Mental Hospital, Henan, China
| | - Yutao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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39
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Cao XL, Wang SB, Zhong BL, Zhang L, Ungvari GS, Ng CH, Li L, Chiu HFK, Lok GKI, Lu JP, Jia FJ, Xiang YT. The prevalence of insomnia in the general population in China: A meta-analysis. PLoS One 2017; 12:e0170772. [PMID: 28234940 PMCID: PMC5325204 DOI: 10.1371/journal.pone.0170772] [Citation(s) in RCA: 202] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/10/2017] [Indexed: 11/19/2022] Open
Abstract
This is the first meta-analysis of the pooled prevalence of insomnia in the general population of China. A systematic literature search was conducted via the following databases: PubMed, PsycINFO, EMBASE and Chinese databases (China National Knowledge Interne (CNKI), WanFang Data and SinoMed). Statistical analyses were performed using the Comprehensive Meta-Analysis program. A total of 17 studies with 115,988 participants met the inclusion criteria for the analysis. The pooled prevalence of insomnia in China was 15.0% (95% Confidence interval [CI]: 12.1%-18.5%). No significant difference was found in the prevalence between genders or across time period. The pooled prevalence of insomnia in population with a mean age of 43.7 years and older (11.6%; 95% CI: 7.5%-17.6%) was significantly lower than in those with a mean age younger than 43.7 years (20.4%; 95% CI: 14.2%-28.2%). The prevalence of insomnia was significantly affected by the type of assessment tools (Q = 14.1, P = 0.001). The general population prevalence of insomnia in China is lower than those reported in Western countries but similar to those in Asian countries. Younger Chinese adults appear to suffer from more insomnia than older adults. Trial Registration: CRD 42016043620
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Affiliation(s)
- Xiao-Lan Cao
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
- Faculty of Mental health, Shenzhen University, Guangdong province, China
| | - Shi-Bin Wang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Bao-Liang Zhong
- The Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 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
| | - Gabor S. Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia
- School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H. Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Lu Li
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Helen F. K. Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Grace K. I. Lok
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Kiang Wu Nursing College of Macau, Macao SRA, China
| | - Jian-Ping Lu
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
- * E-mail: (YTX); (FJJ)
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
- * E-mail: (YTX); (FJJ)
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40
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Li Q, Su YA, Xiang YT, Shu L, Yu X, Ungvari GS, Ng CH, Chiu HFK, Ning YP, Wang GH, Zhang KR, Li T, Sun LZ, Shi JG, Chen XS, Mei QY, Li KQ, Si TM. Adjunctive antidepressant use in schizophrenia in China: A national survey (2002-2012). Hum Psychopharmacol 2017; 32. [PMID: 28120487 DOI: 10.1002/hup.2571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 12/12/2016] [Accepted: 12/13/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study examined the pattern of adjunctive antidepressant use in schizophrenia patients and its demographic and clinical correlates in a nationwide survey in China. METHODS Fourteen thousand and thirteen patients in 45 Chinese psychiatric hospitals or centers were interviewed (4,486 in 2002, 5,288 in 2006, and 4,239 in 2012). Patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Chi-square test, independent-samples t test, Mann-Whitney U test, and multiple logistic regression analysis were used in data analyses. RESULTS Antidepressant use was found in 5.2% of the study population with 4.6% in 2002, 4.3% in 2006, and 6.9% in 2012, respectively. A significant increase in use from 2006 to 2012 was found (p < .001). Multiple logistic regression analyses in the whole population revealed that patients receiving adjunctive antidepressants were more likely to be outpatients in tertiary referral centers (level-III hospitals) and who had an earlier age of onset, less severe global illness, but more depressive symptoms. They were less likely to receive first-generation antipsychotics but more likely to receive benzodiazepines (R2 = 0.255, p < .001). CONCLUSIONS Despite an increasing trend, the frequency of antidepressant use in schizophrenia in China was considerably lower than in Western countries. The benefits and risks associated with concomitant use of antidepressants in schizophrenia need to be studied further.
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Affiliation(s)
- Qian Li
- Peking University Sixth Hospital (Institute of Mental Health) and National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Yun-Ai Su
- Peking University Sixth Hospital (Institute of Mental Health) and National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Yu-Tao Xiang
- The National Clinical Research Center for Mental Disorders, China and Center of Depression, Beijing Institute for Brain Disorders and Beijing Anding Hospital, Capital Medical University, Beijing, China.,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Zhuhai, Macao SAR, China
| | - Liang Shu
- Peking University Sixth Hospital (Institute of Mental Health) and National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Xin Yu
- Peking University Sixth Hospital (Institute of Mental Health) and National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, WA, Australia.,School of Psychiatry and Clinical Neuroscience, University of Western Australia, Perth, WA, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yu-Ping Ning
- Guangzhou Psychiatric Hospital, Guangzhou, China
| | - Gao-Hua Wang
- Department of Psychiatry, Renmin Hospital, Wuhan University, Wuhan, China
| | - Ke-Rang Zhang
- The First Hospital of Shanxi Medical University, Taiyuan, Shanxi province, China
| | - Tao Li
- West China Hospital, Sichuan University, Chengdu, China
| | | | | | | | - Qi-Yi Mei
- Suzhou Guangji Hospital, Suzhou, China
| | - Ke-Qing Li
- Hebei Mental Health Center, Hebei, China
| | - Tian-Mei Si
- Peking University Sixth Hospital (Institute of Mental Health) and National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
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41
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Guo HM, Liu M, Xiang YT, Zhao J, Ungvari GS, Correll CU, Ng CH, Chiu HFK, Duan ZP. Insomnia in Adults With Chronic Hepatitis B, Liver Failure, and Cirrhosis: A Case-Control Study. Perspect Psychiatr Care 2017; 53:67-72. [PMID: 26633859 DOI: 10.1111/ppc.12138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 07/26/2015] [Accepted: 08/03/2015] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To determine the frequency and socio-demographic/clinical correlates of insomnia in patients with chronic hepatitis B, hepatitis B virus (HBV)-related liver failure, and cirrhosis. DESIGN AND METHODS Up to 120 patients with HBV-related diseases and 40 matched healthy controls were recruited. Depressive and anxiety symptoms, early, middle, and late insomnia were measured. FINDINGS The frequency of ≥1 type of insomnia was 64.2% in patients and 35.0% in controls; frequencies of early, middle, and late insomnia in patients were 39.2%, 42.5%, and 48.3%, respectively, compared to 22.5%, 10.0%, and 25.0% in controls. Urban residency was independently associated with less insomnia of any type, accounting for 22.6% of the variance. PRACTICE IMPLICATIONS A considerable proportion of patients with HBV-related diseases suffer from insomnia that warrants more attention in clinical practice.
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Affiliation(s)
- Hui-Min Guo
- Artificial Liver Treatment and Training Center, Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Mei Liu
- Artificial Liver Treatment and Training Center, Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Jing Zhao
- Artificial Liver Treatment and Training Center, Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia
| | - Christoph U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, New York, USA
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Zhong-Ping Duan
- Artificial Liver Treatment and Training Center, Beijing YouAn Hospital, Capital Medical University, Beijing, China
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42
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An FR, Zhang L, Zhang QE, Ungvari GS, Ng CH, Chiu HFK, Wu PP, Jin X, Li L, Lok GKI, Xiang YT. Electroconvulsive therapy and its relationships with clinical characteristics and quality of life in Chinese psychiatric patients. Psychiatry Res 2016; 246:246-249. [PMID: 27723522 DOI: 10.1016/j.psychres.2016.09.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/25/2016] [Accepted: 09/25/2016] [Indexed: 12/27/2022]
Abstract
Little is known about the pattern of electroconvulsive therapy (ECT) use in the clinical population in China. This study examined the percentage of ECT use and its association with clinical characteristics and quality of life (QOL) in a psychiatric center in China that caters for a population of 20 million. A total sample of 1364 inpatients was consecutively recruited for the study. Demographic and clinical data including the use of ECT were collected. Psychopathology, activity of daily living and QOL were measured using standardized instruments. The percentage of ECT use was 52.1% in the whole sample; 53.4% in major depression, 57.8% in bipolar disorder, 57.0% in schizophrenia and 32.4% in other diagnoses. There was no significant difference between the ECT and non-ECT groups in any domain of QOL. Multivariate analyses revealed that ECT was independently associated with the diagnoses of major depression, bipolar disorder and schizophrenia, physical restraint, severe aggression, better activity of daily living skills, more frequent use of antipsychotics and less frequent use of benzodiazepines. The percentage of ECT use was much greater in a major psychiatric center in China than those reported from other parts of the world. Use of ECT had no influence on the short-term QOL. Further investigations are warranted to explore the reasons for the high percentage of ECT use.
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Affiliation(s)
- Feng-Rong An
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Ling Zhang
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China; Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Qing-E Zhang
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ping-Ping Wu
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Xin Jin
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Lu Li
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Grace K I Lok
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China; Kiang Wu Nursing College of Macau, Macao SRA, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Zhong BL, Chiu HFK, Conwell Y. Rates and characteristics of elderly suicide in China, 2013-14. J Affect Disord 2016; 206:273-279. [PMID: 27639861 DOI: 10.1016/j.jad.2016.09.003] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/11/2016] [Accepted: 09/08/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The number of older adults (OAs) is growing rapidly and the elderly suicide rate (ESR) is highest among all age-groups in China. Examining the epidemiology of elderly suicide (ES) may facilitate population-specific suicide prevention efforts, however, little is known about the patterns of ES in China. OBJECTIVE To describe the rates and characteristics of ES in China during 2013-14. METHODS Suicide mortality data by gender, quinquennial age-group, residence (urban/rural) and geographic location (east/central/west) were obtained from China's Integrated National Mortality Surveillance System for 2013-14. Crude ESRs of OAs aged 65 years or above were standardized to the 2010 China's Census population and adjusted for under-reporting. RESULTS While OAs comprised 8.9% of the Chinese population, they represented 38.2% of suicide deaths. The average annual ESR in China was 34.5 per 100000 in 2013-14. ESRs varied widely across OA subgroups, with the highest rates in central rural men (67.1) and women (53.1), and the lowest rate in eastern urban women (13.6). Male gender (incident rate ratio [IRR]=1.47), every five-year increase in age (IRR=1.33), rural residence (IRR=1.83), and geographic location of central China (IRR=1.93) were significantly associated with increased number of ESs. LIMITATIONS Information on means of ES are lacking in the data source. CONCLUSIONS ESs disproportionately account for a large portion of China's current total suicides, and ESR, particularly in central rural OAs, is very high in China. Prevention of ES should be given priority as an important public health issue in China. Central rural OAs are key target population for current ES prevention.
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Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China; Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, PR China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China.
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
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Zhong BL, Chiu HFK, Conwell Y. Elderly suicide trends in the context of transforming China, 1987-2014. Sci Rep 2016; 6:37724. [PMID: 27886219 PMCID: PMC5123573 DOI: 10.1038/srep37724] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/31/2016] [Indexed: 11/09/2022] Open
Abstract
In the context of rapid ageing, understanding the time-trend of elderly suicide (ES) could inform China’s efforts on suicide prevention. We examined time-trends in Chinese ES rates (ESRs) from 1987 to 2014, a period of profound social changes. Suicide rates by residence (rural/urban), gender, and 5-year age-group (65+) in 1987–2014 were provided by the Chinese Ministry of Health. Time-trends were analyzed with joinpoint analysis. The time-trend of national ESRs was downward (average annual percent change [AAPC] = −3.7, P < 0.001): 76.6/100000 in 1987 and 30.2/100000 in 2014. However, the time-trend of corresponding percentages of ESs among the total suicides was monotonically increasing (AAPC = 3.4, P < 0.001): 16.9% in 1987 to 41.2% in 2014. The time-trends in ESRs of both rural and urban men and women were decreasing, but only the rural trends were significant (P < 0.001). Rural-urban and male-female differences in ESRs were decreasing over time (slope = −4.2 and −3.0, P ≤ 0.006), but the rural-urban and male-female ESR differences in 2014 remained large (16.3/100000 and 9.8/100000, P < 0.001). While national ESRs decreased significantly during the past three decades, the current ESR remains high in China. Further, the age-pattern of Chinese suicide is transitioning to elderly predominance. ES, particularly rural ES, should be a public health priority in China.
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Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.,Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
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45
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Zheng W, Xiang YT, Xiang YQ, Li XB, Ungvari GS, Chiu HFK, Correll CU. Efficacy and safety of adjunctive topiramate for schizophrenia: a meta-analysis of randomized controlled trials. Acta Psychiatr Scand 2016; 134:385-398. [PMID: 27585549 DOI: 10.1111/acps.12631] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2016] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To systematically examine the randomized controlled trial (RCT) evidence regarding efficacy and tolerability of topiramate cotreatment with antipsychotics in schizophrenia-spectrum disorders. METHODS Random-effects meta-analysis of RCTs of topiramate cotreatment with antipsychotics vs. placebo/ongoing antipsychotic treatment in schizophrenia-spectrum disorders. Standardized or weighted mean difference (SMD/WMD), risk ratio (RR) ±95% confidence intervals (CIs), and number needed to harm (NNH) were calculated. RESULTS Across 16 RCTs (n = 934, duration = 11.8 ± 5.6 weeks), topiramate outperformed the comparator regarding change/endpoint of total (SMD: -0.58, 95% CI: -0.82, -0.35, P < 0.00001), positive (SMD: -0.37, 95% CI: -0.61, -0.14, P = 0.002), negative (SMD: -0.58, 95% CI: -0.87, -0.29, P < 0.0001), and general symptoms (SMD: -0.68, 95% CI: -0.95, -0.40, P < 0.00001). Furthermore, topiramate was superior regarding body weight (WMD: -2.75 kg, 95% CI: -4.03, -1.47, P < 0.0001), body mass index (BMI) (WMD: -1.77, 95% CI: -2.38, -1.15, P < 0.00001), triglycerides (P = 0.006), and insulin levels (P < 0.00001). Superiority regarding psychopathology and body weight/BMI was consistent across Chinese/Asian and Western RCTs, double-blind and open designs, clozapine and non-clozapine cotreatment, augmentation and co-initiation RCTs, and higher and lower quality RCTs. In meta-regression analyses, topiramate's efficacy for total symptoms was moderated by shorter illness duration (P = 0.047), while weight loss was greater in prevention/co-initiation vs. intervention/augmentation RCTs (-4.11 kg, 95% CI: -6.70, -1.52 vs. -1.41 kg, 95% CI: -2.23, -0.59, P < 0.001). All-cause discontinuation was similar between topiramate and comparators (RR: 1.28, 95% CI: 0.91, 1.81, P = 0.16). While topiramate led to more concentration/attention difficulties (P = 0.03, NNH = 8, 95% CI=4-25), psychomotor slowing (P = 0.02, NNH = 7, 95% CI = 4-25), and paresthesia (P = 0.05, NNH = 2, 95% CI = 4-33), it led to less ≥7% weight gain (P = 0.0001, NNH = 2, 95% CI = 2-3) and constipation (P = 0.04, NNH = 9, 95% CI = 5-100) than the comparator. CONCLUSIONS These results indicate that adjunctive topiramate to antipsychotics is an effective and safe treatment choice for symptomatic improvement and weight reduction in patients with schizophrenia-spectrum disorders.
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Affiliation(s)
- W Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
| | - Y-T Xiang
- The National Clinical Research Center for Mental Disorders, China & Beijing Anding Hospital, Capital Medical University, Beijing, China. .,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, China.
| | - Y-Q Xiang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - X-B Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - G S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, WA, Australia.,School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
| | - H F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - C U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA
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An FR, Yang R, Wang ZM, Ungvari GS, Ng CH, Chiu HFK, Wu PP, Jin X, Li L, Lok GKI, Xiang YT. Hyperprolactinemia, prolactin-related side effects and quality of life in Chinese psychiatric patients. Compr Psychiatry 2016; 71:71-76. [PMID: 27639124 DOI: 10.1016/j.comppsych.2016.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 08/13/2016] [Accepted: 08/15/2016] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To examine the frequency of hyperprolactinemia and the socio-demographic, clinical, and quality of life (QOL) correlates. The frequency of prolactin-related side effects and associated subjective experiences were also examined. METHODS A cohort of 1364 psychiatric inpatients were consecutively recruited and evaluated. Basic socio-demographic and clinical data were collected. Psychopathology, prolactin-related side effects were measured using standardized instruments. QOL was assessed using the Medical Outcomes Study Short Form 12. RESULTS The frequency of hyperprolactinemia was 61.3% in the whole sample; 61.6% in female and 60.8% in male patients. There was no significant association between hyperprolactinemia and any QOL domain. In the whole sample, 15.1% of patients reported moderately severe breast symptoms and lactation, and 53.9% reported moderate or severe discomfort. Nearly a third of female patients (30.4%) reported at least moderate menstrual changes and 50.2% moderate or severe discomfort, while 24.2% of male patients reported at least moderate erectile dysfunction and 52.6% moderate or severe discomfort. Multiple logistic regression analysis revealed that patients with hyperprolactinemia were less likely to be married, diagnosed with mood disorders, or treated with clozapine, aripiprazole, or antidepressants but more likely to receive risperidone. CONCLUSIONS Effective measures to lower the frequency of hyperprolactinemia and the related side effects should be considered in Chinese psychiatric facilities.
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Affiliation(s)
- Feng-Rong An
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Rui Yang
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Zhi-Min Wang
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ping-Ping Wu
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Xin Jin
- National Clinical Research Center for Mental Disorders & Beijing Anding Hospital, Capital Medical University, China
| | - Lu Li
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Grace K I Lok
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China; Kiang Wu Nursing College of Macau, Macao, SRA, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China.
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47
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Hou CL, Ma XR, Cai MY, Li Y, Zang Y, Jia FJ, Lin YQ, Chiu HFK, Ungvari GS, Hall BJ, Zhong BL, Cao XL, Xiang YT. Comorbid Moderate-Severe Depressive Symptoms and their Association with Quality of Life in Chinese Patients with Schizophrenia Treated in Primary Care. Community Ment Health J 2016; 52:921-926. [PMID: 27306990 DOI: 10.1007/s10597-016-0023-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 05/27/2016] [Indexed: 11/26/2022]
Abstract
This study described the prevalence and correlates of comorbid moderate-severe depressive symptoms (comorbid depression thereafter) and their association with quality of life (QOL) in schizophrenia patients treated in primary care. 623 schizophrenia patients were enrolled. Patients' socio-demographic and clinical characteristics including comorbid depression [defined as a total score of 18 or above on the Montgomery-Asberg Depression Rating Scale (MADRS)] were recorded. Depressive symptoms (defined as a total score of 9 or above on the MADRS) were present in 54.1 % of patients, while 17.7 % had comorbid depression. Analysis of covariance revealed that comorbid depression was significantly associated with lower mental QOL. Multiple logistic regression analysis revealed that more severe positive and negative symptoms, anxiety symptoms, use of first-generation antipsychotics and antidepressants, were independently associated with comorbid depression. Given the negative association between comorbid depression and QOL, attempts to address comorbid depression in schizophrenia patients treated in primary care should be made.
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Affiliation(s)
- Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Xin-Rong Ma
- Ningxia Mental Health Center, Ningxia Ning-An Hospital, Yinchuan, Ningxia, China
| | - Mei-Ying Cai
- Guangzhou Yuexiu Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Yan Li
- Mood Disorders Centre, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yu Zang
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
- Marian Centre, The University of Notre Dame Australia, Perth, Australia
| | - Brian J Hall
- Department of Psychology, University of Macau, Macao SAR, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong 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
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Avenida da Universidade, 3/F, Building E12, Macau SAR, Taipa, China.
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48
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Li Y, An FR, Zhu H, Chiu HFK, Ungvari GS, H Ng C, Lai KYC, Xiang YT. Knowledge and Attitudes of Patients and Their Relatives Toward Electroconvulsive Therapy in China. Perspect Psychiatr Care 2016; 52:248-253. [PMID: 26033408 DOI: 10.1111/ppc.12124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 03/20/2015] [Accepted: 04/23/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To examine the knowledge and attitudes of patients and their relatives as well as patients' subjective experience with electroconvulsive therapy (ECT) in China. DESIGN AND METHODS Up to 420 responders including patients receiving ECT (n = 210) and their relatives (n = 210) were assessed with self-reported questionnaires. FINDINGS Patients and their relatives did not receive adequate information before ECT, particularly about the mode of its delivery, risks, and adverse effects. The most common adverse effect of ECT reported by patients was memory impairment. Both patients and their relatives had positive attitudes toward ECT and appeared satisfied with its therapeutic effects. PRACTICE IMPLICATIONS Mental health professionals need to address the inadequate information on ECT provided to patients and their relatives prior to the treatment.
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Affiliation(s)
- Yang Li
- Mood Disorders Centre, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Feng-Rong An
- Mood Disorders Centre, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Hui Zhu
- Mood Disorders Centre, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Gabor S Ungvari
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia.,The University of Notre Dame Australia/Marian Centre, Perth, Western Australia, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Kelly Y C Lai
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Yu-Tao Xiang
- Faculty of Health Sciences, University of Macau, Macao, China.
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49
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Feng Y, Huang W, Tian TF, Wang G, Hu C, Chiu HFK, Ungvari GS, Kilbourne AM, Xiang YT. The psychometric properties of the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) and the Patient Health Questionnaire-9 (PHQ-9) in depressed inpatients in China. Psychiatry Res 2016; 243:92-6. [PMID: 27376668 DOI: 10.1016/j.psychres.2016.06.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 06/05/2016] [Accepted: 06/15/2016] [Indexed: 12/30/2022]
Abstract
This study examined the psychometric properties of the 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) and Patient Health Questionnaire-9 (PHQ-9). The study sample comprised 297 depressed inpatients. The severity of depressive symptoms was assessed with the Hamilton Rating Scale for Depression, the QIDS-SR and the PHQ-9 in all subjects at baseline and a random sample of 50 subjects two weeks later. The internal consistency, convergent validity, factor structure and sensitivity to change of these scales were assessed. Internal consistency (Cronbach's alpha) of the PHQ-9 and QIDS-SR were 0.88 and 0.83, respectively at baseline and 0.91 and 0.87, respectively at exit. Item to total score correlations were higher for the PHQ-9 than those for the QIDS-SR at baseline and exit. Three domains at baseline and two at study exit of the QIDS-SR had a correlation less than 0.65; while only two items at baseline and no item at exit were less than 0.65 for the PHQ-9. Both the PHQ-9 and the QIDS-SR showed uni-dimensional measurement properties at baseline; the two instruments were less sensitive than the HAMD to detect changes of depressive symptoms suggesting low convergent validity. The QIDS-SR and the PHQ-9 have similar and acceptable psychometric properties in most domains as tested in depressed inpatients.
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Affiliation(s)
- Yuan Feng
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; China Clinical Research Center for Mental Disorders, China; Center of Depression, Beijing Institute for Brain Disorders, China
| | - Wei Huang
- Department of Psychiatry, Harbin First Specialist Hospital, Heilongjiang province, China
| | - Teng-Fei Tian
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; China Clinical Research Center for Mental Disorders, China; Center of Depression, Beijing Institute for Brain Disorders, China
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; China Clinical Research Center for Mental Disorders, China; Center of Depression, Beijing Institute for Brain Disorders, China.
| | - Chen Hu
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Amy M Kilbourne
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA; Veterans Administration Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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50
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Zheng W, Xiang YQ, Ungvari GS, Ng CH, Chiu HFK, Liu ZR, Cao XL, Guo T, Wang HHX, Seiner SJ, Xiang YT. Electroconvulsive Therapy Alone for Schizophrenia: A Meta-analysis of Randomized, Single-blind, Controlled Trials [RETRACTED]. J ECT 2016; Publish Ahead of Print. [PMID: 27227402 DOI: 10.1097/yct.0000000000000319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Electroconvulsive therapy (ECT) is a common treatment in practice for schizophrenia in most developing countries. This is a meta-analysis of the efficacy and safety of ECT alone versus antipsychotic (AP) monotherapy for schizophrenia using randomized, single-blind, controlled trial (RCT) data. METHODS Two assessors independently extracted data. Standardized and weighted mean difference (SMD/WMD), odds ratios (ORs) ± 95% confidence intervals (CIs), and number needed to harm (NNH) were calculated by Review Manager Version 5.3 and the Comprehensive Meta-Analysis Version 2 software. RESULTS Five RCTs (n = 365; age, 34.1 ± 4.7 years; percentage of male, 52.8 ± 9.5; range on the Jaded scale, 2-3) were identified and analyzed. Electroconvulsive therapy alone was superior to AP monotherapy with chlorpromazine, haloperidol, paliperidone, clozapine, and risperidone, respectively, regarding symptomatic improvement at last-observation end point (SMD, -0.84; P = 0.02; I = 89%). Improvement with ECT separated from AP as early as weeks 1 to 2 (SMD, -1.26; P = 0.01; I = 89%). Meta-analysis of the end point memory quotient of the Wechsler Memory Scale-Revised, Chinese version, revealed that the ECT alone group had poorer memory performance than the AP group (WMD, -9.34; P < 0.00001; I = 0%), but the difference lost its significance within 2 weeks after ECT (WMD, 0.09 to -6.54; P = 0.11-0.97; I = 0%). Compared with AP monotherapy, ECT was associated with more memory impairment (OR, 14.11; P = 0.004; NNH, 6) but with less akathisia (OR, 0.06; P = 0.0009; NNH, 6), tremor (OR, 0.08; P = 0.02; NNH, 7), and tachycardia (OR, 0.06; P = 0.006; NNH, 5). There were no significant differences in other adverse events and all-cause discontinuation. CONCLUSIONS Electroconvulsive therapy alone could be an effective and safe treatment option for schizophrenia, with transient memory impairment and headache being the major side effects.
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Affiliation(s)
- Wei Zheng
- From the *Guangzhou Brain Hospital (Guangzhou Huiai Hospital), Affiliated Hospital of Guangzhou Medical University, Guangzhou; †Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; ‡School of Psychiatry and Clinical Neurosciences, University of Western Australia; §The University of Notre Dame Australia/Marian Centre, Perth; ∥Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia; ¶Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China; **Mental Hospital of Guangzhou Civil Administration, Guangzhou; ††Shenzhen Key Laboratory for Psychological Healthcare and Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen; ‡‡School of Public Health, Sun Yat-Sen University, Guangzhou, China; §§Electroconvulsive Therapy (ECT) Service, McLean Hospital, Belmont; ∥∥Harvard Medical School, Department of Psychiatry, Boston, MA; and ¶¶Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
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