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Chan SKW, Zhou LF, Cai J, Liao Y, Huang Y, Deng ZY, Liu YJ, Chen XC, Gao R, Zhang XF, Tao YQ, Zhou L, Deng XP, Liu B, Ran MS. Risk factors of non-suicidal self-injury of youth students at different developmental stages during COVID-19 pandemic in Jingzhou China. J Affect Disord 2024; 355:57-65. [PMID: 38518855 DOI: 10.1016/j.jad.2024.03.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Sherry Kit Wa Chan
- Department of Psychiatry, School of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Li-Fang Zhou
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Jia Cai
- Mental Health Center, Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yingqi Liao
- Department of Psychiatry, School of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Yi Huang
- Mental Health Center, Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhong-Yue Deng
- Mental Health Center, Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yu-Jun Liu
- Department of Social Work and Social Policy, School of Social and Behavioral Sciences, Nanjing University, Nanjing, Jiangsu 210023, China
| | - Xiao-Chuan Chen
- Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
| | - Ru Gao
- Wenjiang People's Hospital, Chengdu, Sichuan 610037, China
| | - Xin-Feng Zhang
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Yan-Qing Tao
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Lie Zhou
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Xiao-Peng Deng
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Bo Liu
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China.
| | - Mao-Sheng Ran
- Mental Health Center, Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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Lin TF, Zhao ZY, Yuan CZ, Huang YH, Liu D, Li FX, Jiang YW, Li BL, Wei C, Sha F, Yang ZR, Ran MS, Tang JL. Life satisfaction components and all-cause and cause-specific mortality: A large prospective cohort study. J Affect Disord 2024; 350:916-925. [PMID: 38244788 DOI: 10.1016/j.jad.2024.01.148] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Which life satisfaction components could be a target of positive psychological interventions for longevity is largely unknown. We aimed to investigate association of the composite measure of life satisfaction and its individual components with mortality. METHODS This cohort study included UK Biobank participants who responded to questions concerning five components of life satisfaction at baseline. We generated a composite score representing overall life satisfaction, ranging from 0 (lowest) to 5 (highest). The outcomes were all-cause and cause-specific mortality. We used multivariable Cox regression to estimate hazard ratios (HR) for the associations of interest. RESULTS Among 165,842 eligible participants, 12,261 all-cause deaths were observed over a median of 12.9-year follow-up. Overall life satisfaction was inversely associated with all-cause mortality (adjusted HR 0.94 [95% CI: 0.93-0.95] per 1 score increment). Health satisfaction showed the strongest association with all-cause mortality, with a fully adjusted HR of 0.52 (95% CI: 0.49-0.55) for high/extreme satisfaction and 0.63 (95% CI: 0.59-0.66) for moderate satisfaction, compared with unsatisfaction (P-trend<0.001), independent of other satisfaction components, regardless of physical health and sociodemographics. The association for family, friendship, work and financial satisfaction was attenuated when adjusted for other life satisfaction components. Similar findings were observed for cause-specific mortality. LIMITATIONS Observational study with single baseline measurement of life satisfaction precludes the ability to establish causal relationship. CONCLUSIONS Higher overall life satisfaction was associated with lower mortality. As the major contributor to lower mortality regardless of physical health and sociodemographics, health satisfaction could be an important target of positive psychological interventions for longevity.
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Affiliation(s)
- Teng-Fei Lin
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Zi-Yi Zhao
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Chang-Zheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Yu-Hui Huang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Di Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Fu-Xiao Li
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yi-Wen Jiang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Bing-Li Li
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Chang Wei
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Feng Sha
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
| | - Zhi-Rong Yang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China; Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jin-Ling Tang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Chen XC, Xu JJ, Yin XT, Qiu YF, Yang R, Wang ZY, Han YW, Wang QK, Zhai JH, Zhang YS, Ran MS, Hu JM. Mediating role of anxiety and impulsivity in the association between child maltreatment and lifetime non-suicidal self-injury with and without suicidal self-injury. J Affect Disord 2024; 347:57-65. [PMID: 37995923 DOI: 10.1016/j.jad.2023.11.080] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Child maltreatment can increase the risk of lifetime non-suicidal self-injury (NSSI) and suicidal self-injury (SSI), but there is limited knowledge regarding the differences of potentially psychological mechanisms between NSSI with and without SSI. METHODS Participants, 3918 community-based Chinese young men aged 18-34 years in Chengdu, were included in this study. We investigated the association between depression, anxiety, psychosis, child maltreatment, adulthood traumatic events, impulsivity, alcohol dependence, drug abuse, and lifetime of NSSI among participants with and without SSI. Parallel mediation analysis was utilized to explore the mediators for the relation between child maltreatment and NSSI. RESULTS The prevalence of lifetime NSSI was 6.1 % (95 % CI: 5.4 %-6.9 %) among young men. Anxiety and impulsivity partially mediated the effect of child maltreatment on NSSI either with (indirect effect: 51.2 %) or without SSI (indirect effect: 34.3 %). Depression was independently and significantly associated with only NSSI but not with NSSI+SSI. Alcohol dependence and psychosis were independently and significantly associated with NSSI+SSI and mediated the effect of child maltreatment on NSSI+SSI. LIMITATIONS The cross-sectional survey data limits the robustness of the proof to the causal relationships. CONCLUSIONS Anxiety and impulsivity are associated with NSSI either with or without SSI and partially mediate the effect of child maltreatment on NSSI. Depression is associated with only NSSI, while alcohol dependence and psychosis are only associated with NSSI+SSI. It could be crucial to improve treatment and recovery of alcohol dependence and psychosis for preventing young men engaged in NSSI from attempting SSI.
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Affiliation(s)
- Xia-Can Chen
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jia-Jun Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiao-Tong Yin
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yu-Feng Qiu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Rui Yang
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Zi-Ye Wang
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yi-Wei Han
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Qi-Kai Wang
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jin-Hui Zhai
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yu-Shu Zhang
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Jun-Mei Hu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China.
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Ran MS, Wang C, Cai J, Deng ZY, Mu YF, Huang Y, Zhang W, Song HJ, Deng AP, Qiu CJ, Shen WW, Chen Y, Zhang L, Meng XD, Huang XH, Chen T, Meng YJ, Chen J, Liu T, Li B, Long J, Liu B, Gao R, Chen XC, Liu GL. The mutual overlapping impact of stress and infection on mental health problems in adolescents and youths during and after COVID-19 pandemic in China. J Affect Disord 2024; 347:500-508. [PMID: 38065477 DOI: 10.1016/j.jad.2023.12.009] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/26/2023] [Accepted: 12/02/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND It is unclear about the mutual impact of COVID-19 related psychological stress and infection on mental health of adolescent and youth students. This study aimed to explore the mutual impact of COVID-19 related psychological stress and infection on mental health problems among students. METHODS This study was conducted from December 14, 2022 to February 28, 2023 in Sichuan, China. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, PTSD Checklist for DSM-5, Insomnia Severity Index, and Internet Addiction Test were used. Participants were grouped by COVID-19 infection and psychological stress level. The differences among groups were compared, and logistic regression analysis was used to investigate risk factors for depression, anxiety, PTSD and insomnia among groups. RESULTS Of 90,118 participants, 82,873 (92.0 %) finished the questionnaires and were included in the study. Of 82,873 participants, 33,314 (40.2 %) reported to be infected with COVID-19. Participants had depression symptoms (38.1 %), anxiety symptoms (31.8 %), PTSD (33.9 %), insomnia (34.0 %), and internet addiction (60.3 %). Compared with participants uninfected with low psychological stress level, the risk for symptoms of depression, anxiety, PTSD and insomnia increased by 9.6 %, 12.3 %, 6.6 %, and 12.0 % in participants infected with low psychological stress level (p < 0.001), 106.8 %, 125.9 %, 125.2 %, and 95.7 % in participants uninfected with high psychological stress level (p < 0.001), and 147.3 %, 161.1 %, 158.7 %, and 141.0 % in participants infected with high psychological stress level (p < 0.001). LIMITATION This study is a cross-sectional design, and no causal associations should be inferred. Infection status was based on self-report of participants with infectious symptoms. CONCLUSION COVID-19 related psychological stress and infection per se have mutually overlapping impacts on mental health problems among students. Further health policies and psychosocial interventions should be developed to reduce mutually overlapping impact and improve the long-term mental health among students.
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Affiliation(s)
- Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Cong Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jia Cai
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhong-Yue Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yun-Fei Mu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Hong-Jun Song
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Outpatient Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ai-Ping Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Outpatient Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Chang-Jian Qiu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wen-Wu Shen
- West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yan Chen
- West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Lan Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xian-Dong Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xue-Hua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ting Chen
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ya-Jing Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jin Chen
- Department of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ting Liu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Bin Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jiang Long
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China
| | - Ru Gao
- Wenjiang People's Hospital, Chengdu, Sichuan 610037, China
| | - Xiao-Chuan Chen
- Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
| | - Ge-Ling Liu
- West China Health School, Sichuan University, Chengdu, Sichuan 610000, China
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Ran MS, Xiao Y, Rohlof H. Editorial: The impact of COVID-19 on internet addiction, suicidal behavior, and study behavior in adolescents in various cultural contexts. Front Psychiatry 2024; 15:1375244. [PMID: 38380118 PMCID: PMC10877024 DOI: 10.3389/fpsyt.2024.1375244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/22/2024] Open
Affiliation(s)
- Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yunyu Xiao
- Weill Cornell Medicine, Cornell University, New York, NY, United States
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Li XH, Deng SY, Zhang TM, Wang YZ, Wong IYL, Ran MS. Medication non-adherence and its influencing factors in persons with schizophrenia in rural China. J Ment Health 2024; 33:40-47. [PMID: 36322512 DOI: 10.1080/09638237.2022.2140789] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Few studies have been conducted to explore medication non-adherence in persons with schizophrenia (PWS) and its influencing factors in rural China. This study aimed to investigate the medication non-adherence and its influencing factors among PWS in rural China. METHODS A total of 269 PWS and their family caregivers in Xinjin district, Chengdu, China were investigated on medication adherence and related factors. Logistic regression was employed to identify the influencing factors. RESULTS The results showed that 37.6% of PWS had medication non-adherence. PWS living with family caregivers had significantly lower rate of medication non-adherence (34.7%) than those not living with family caregivers (60.0%) (p < 0.01). Family caregivers' affiliate stigma of mental illness, knowledge of mental illness and self-esteem were significantly related to patients' medication non-adherence (p < 0.05). PWS' employment status, living with family caregiver, present mental status and social support were significantly related to medication adherence. CONCLUSION This study shows medication non-adherence is severe among PWS in rural China. Both patient- and family-related factors affect patients' medication adherence seriously. Except improving patients' treatment and mental status, development of family caregiving, social support network and intervention on reducing stigma of mental illness should be crucial for enhancing PWS' medication adherence.
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Affiliation(s)
- Xu-Hong Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
| | - Shu-Yu Deng
- Department of Social Work and Social Administration, University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Yi-Zhou Wang
- Department of Social Work and Social Administration, University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Irene Yin Ling Wong
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
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Deng AP, Wang C, Cai J, Deng ZY, Mu YF, Song HJ, Meng YJ, Meng XD, Huang XH, Zhang L, Huang Y, Zhang W, Chen J, Ran MS. Effects of internet addiction and academic satisfaction on mental health among college students after the lifting of COVID-19 restrictions in China. Front Psychiatry 2023; 14:1243619. [PMID: 37953935 PMCID: PMC10639123 DOI: 10.3389/fpsyt.2023.1243619] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023] Open
Abstract
Background Internet addiction (IA) among students, worsened by Coronavirus disease 2019 (COVID-19) pandemic, has become a social problem with the digitalization of school learning and many aspects of daily life. However, few studies on IA have been conducted among students after the lifting of COVID-19 restrictions in China. Method This large-sample, cross-sectional, online survey was conducted to explore the characteristics of IA and the association among IA, academic satisfaction, and mental health problems from December 14, 2022 to February 28, 2023 in Sichuan, China. All participants (N = 22,605) were students in colleges and universities, recruited via their teachers and professors. Results Of all the participants, 14,921 (66.0%) participants had IA. Participants with IA were more likely to have depression symptom, anxiety symptom, insomnia, and lifetime suicidal ideation. In addition, participants with severe IA had significantly higher rates of mental health problems (e.g., depression, anxiety, insomnia, and suicidal ideation) than those with mild IA. A significant IA-by-academic satisfactory-interaction on mental health was identified: participants with higher level of IA showed particularly severe symptom of depression, anxiety and insomnia when affected by low satisfactory of academy (p < 0.001). Conclusion This study reveals that IA has a significantly negative impact on mental health among college students after the lifting of COVID-19 restrictions in China. IA and academic satisfaction have interactive impacts on mental health problems among students. Further educational and health policies and psychosocial interventions should be developed to reduce IA and enhance academic satisfaction for improving students' mental health.
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Affiliation(s)
- Ai-Ping Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Cong Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jia Cai
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhong-Yue Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yun-Fei Mu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong-Jun Song
- West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Ya-Jing Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xian-Dong Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xue-Hua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lan Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jin Chen
- Department of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Wang YZ, Weng X, Zhang TM, Li M, Luo W, Wong YLI, Yang LH, Thornicroft G, Lu L, Ran MS. Effectiveness of enhancing contact model on reducing family caregiving burden and improving psychological wellbeing among caregivers of persons with schizophrenia in rural China. Psychol Med 2023; 53:5756-5766. [PMID: 36154947 DOI: 10.1017/s0033291722002987] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is unclear whether the enhancing contact model (ECM) intervention is effective in reducing family caregiving burden and improving hope and quality of life (QOL) among family caregivers of persons with schizophrenia (FCPWS). METHODS We conducted a cluster randomized controlled trial in FCPWS in eight rural townships in Xinjin, Chengdu, China. In total, 253 FCPWS were randomly allocated to the ECM, psychoeducational family intervention (PFI), or treatment as usual (TAU) group. FCPWS in three groups were assessed caregiving burden, QOL and state of hope at baseline (T0), post-intervention (T1), 3-month (T2), and 9-month (T3) follow-up, respectively. RESULTS Compared with participants in the TAU group, participants in the ECM group had statistically significantly lower caregiving burden scores both at T1 and T2 (p = 0.0059 and 0.0257, respectively). Compared with participants in the TAU group, participants in the PFI group had statistically significantly higher QOL scores in T1 (p = 0.0406), while participants in the ECM group had statistically significantly higher QOL scores in T3 (p = 0.0240). Participants in both ECM and PFI groups had statistically significantly higher hope scores than those in the TAU group at T1 (p = 0.0160 and 0.0486, respectively). CONCLUSIONS This is the first study to explore the effectiveness of ECM on reducing family caregiving burden and improving hope and QOL in rural China. The results indicate the ECM intervention, a comprehensive and multifaceted intervention, is more effective than the PFI in various aspects of mental wellbeing among FCPWS. Future research needs to confirm ECM's effectiveness in various population.
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Affiliation(s)
- Yi-Zhou Wang
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
| | - Xue Weng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Ming Li
- Chengdu Xinjin Second People's Hospital, Chengdu, China
| | - Wei Luo
- Chengdu Xinjin Second People's Hospital, Chengdu, China
| | | | - Lawrence H Yang
- Department of Social and Behavioral Sciences, New York University, USA
- Department of Epidemiology, Columbia University, NY, USA
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Song HJ, Mu YF, Wang C, Cai J, Deng ZY, Deng AP, Huang XH, Meng XD, Zhang L, Huang Y, Zhang W, Shen WW, Chen J, Liu B, Gao R, Zhao JS, Ran MS. Academic performance and mental health among Chinese middle and high school students after the lifting of COVID-19 restrictions. Front Psychiatry 2023; 14:1248541. [PMID: 37645634 PMCID: PMC10461048 DOI: 10.3389/fpsyt.2023.1248541] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023] Open
Abstract
Background Although the COVID-19 pandemic has greatly changed the way students studied, it is still unknown about the impact of the COVID-19 pandemic on students' academic performance and mental health. Objective To explore the academic performance and mental health status of middle and high school students after the lifting of COVID-19 restrictions in China. Methods An online survey was conducted in Sichuan province, China from Dec 14, 2022 to Feb 28, 2023. All participants were students in middle and high schools, recruited via their teachers. The general information, COVID-19-related information, and academic performance were collected. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Internet Addiction Test (IAT) were used to assess the mental health problems. Results Of 60,268 participants, 36,247 (60.2%) middle and high school students reported that their studies were affected by the COVID-19 pandemic, and 24,864 (41.2%) reported that their academic performance had worsened. The prevalence of depression and anxiety symptoms was 38.4 and 32.7%, respectively. There was a significant association between academic performance change and mental health problems. The logistic regression analysis showed that improved academic performance was a protective factor for depression, and declined academic performance was a risk factor for depression and anxiety. Being COVID-19 infected, family members being infected, with quarantine experience, and with COVID-19-related stigma were risk factors for depression and anxiety. Conclusion Academic studies and mental health status of middle and high school students in Sichuan, China have been negatively impacted by the COVID-19 pandemic, even after the lifting of COVID-19 restrictions. Students' academic performance, academic concerns, and mental health status should be considered for educational policymakers and institutions to improve students' academic studies and mental well-being.
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Affiliation(s)
- Hong-Jun Song
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yun-Fei Mu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Cong Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jia Cai
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhong-Yue Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ai-Ping Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xue-Hua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xian-Dong Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lan Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wen-Wu Shen
- West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jin Chen
- Department of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei, China
| | - Ru Gao
- Wenjiang People’s Hospital, Chengdu, Sichuan, China
| | - Jun-Shu Zhao
- Ya’an Fourth People’s Hospital, Ya’an, Sichuan, China
| | - Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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10
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Zhang TM, Zhang XF, Meng XD, Huang Y, Zhang W, Gong HH, Chan SKW, Chen XC, Gao R, Lewis-Fernández R, Fan YY, Liu CC, Huang L, Deng XP, Liu B, Ran MS. Comparison of stigmatizing views towards COVID-19 and mental disorders among adolescent and young adult students in China. Front Psychiatry 2023; 14:1170540. [PMID: 37484667 PMCID: PMC10359161 DOI: 10.3389/fpsyt.2023.1170540] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023] Open
Abstract
Objective Infectious diseases including COVID-19 and mental disorders are two of the most common health conditions associated with stigma. However, the comparative stigma of these two conditions has received less attention in research. This study aimed to compare the prevalence of stigmatizing views toward people with COVID-19 and mental disorders and the factors associated with these views, among a large sample of adolescent and young adult students in China. Methods A total of 9,749 adolescents and young adults aged 15-24 years completed a survey on stigmatizing attitudes toward COVID-19 and mental disorders, as well as mental health-related factors, including general mental health status and symptoms of depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD). Multivariable linear regression analyses were conducted to identify factors associated with stigmatizing views. Findings The prevalence of COVID-19 and mental disorders-related stigma was 17.2% and 40.7%, respectively. COVID-19-related stigma scores were significantly higher among male students (β = 0.025, p < 0.05), those without quarantine experience (β = 0.035, p < 0.001), those with lower educational level (p < 0.001), those with lower family income (p < 0.01), and those with higher PTSD symptoms (β = 0.045, p < 0.05). Mental disorder-related stigma scores were significantly higher among individuals with average and lower-than-average levels of family income (p < 0.01), depression symptoms (β = 0.056, p < 0.001), anxiety symptoms (β = 0.051, p < 0.001), and mental health problems (β = 0.027, p < 0.05). Conclusion The stigma of mental disorders is higher in the youth population than the stigma of COVID-19. Factors associated with stigmatizing attitudes toward people with COVID-19 and mental disorders varied across the youth. Stigma-reduction interventions among the youth should be targeted specifically to COVID-19 or mental disorders conditions.
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Affiliation(s)
- Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Xin-Feng Zhang
- Jingzhou Mental Health Center and The Mental Health Institute of Yangtze University, Jingzhou, Hubei, China
| | - Xian-Dong Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hui-Hui Gong
- School of Public Administration, Hunan University, Changsha, Hunan, China
| | - Sherry Kit Wa Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | - Ru Gao
- Wenjiang People‘s Hospital, Chengdu, Sichuan, China
| | | | - Yuan-Yuan Fan
- Jingzhou Mental Health Center and The Mental Health Institute of Yangtze University, Jingzhou, Hubei, China
| | - Chang-Cheng Liu
- Jingzhou Mental Health Center and The Mental Health Institute of Yangtze University, Jingzhou, Hubei, China
| | - Lu Huang
- Jingzhou Mental Health Center and The Mental Health Institute of Yangtze University, Jingzhou, Hubei, China
| | - Xiao-Peng Deng
- Jingzhou Mental Health Center and The Mental Health Institute of Yangtze University, Jingzhou, Hubei, China
| | - Bo Liu
- Jingzhou Mental Health Center and The Mental Health Institute of Yangtze University, Jingzhou, Hubei, China
| | - Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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11
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Wang YZ, Meng XD, Zhang TM, Weng X, Li M, Luo W, Huang Y, Thornicroft G, Ran MS. Affiliate stigma and caregiving burden among family caregivers of persons with schizophrenia in rural China. Int J Soc Psychiatry 2023; 69:1024-1032. [PMID: 36708508 DOI: 10.1177/00207640231152206] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Although stigma and caregiving burden are important in relation to mental health recovery, few studies have been conducted on affiliate stigma and caregiving burden among family caregivers of persons with schizophrenia (FCPWS) in rural China. AIMS This study aimed to examine the severity level of affiliate stigma and caregiving burden, and identify the correlates among FCPWS in rural China. METHODS A mental health survey was conducted (N = 253 FCPWS) in Xinjin county, Sichuan province, China. Affiliate Self-Stigma Scale and Zarit Burden Interview Short Form were used. The regression analysis was performed to explore the correlates of stigma and burden. RESULTS Most FCPWS reported experiencing high and severe level of affiliate stigma (78.66%) and caregiving burden (95.26%). Family caregivers who were middle aged, unemployed, with high caregiving burden and low quality of life (QoL), showed more severe affiliate stigma. Family caregivers who were female, older, with low income, high affiliate stigma and low QoL, experienced greater caregiving burden. CONCLUSIONS The large majority of FCPWS in rural China experienced severe affiliate stigma, caregiving burden and poor QoL. It is crucial to develop culture-specific anti-stigma interventions to reduce caregivers' stigma and caregiving burden, and improve QoL. Specific risk factors of family caregivers' affiliate stigma and caregiving burden should be considered for development of health policy and community-based mental health services.
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Affiliation(s)
- Yi-Zhou Wang
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
| | - Xian-Dong Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Xue Weng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Ming Li
- Chengdu Xinjin Second People's Hospital, China
| | - Wei Luo
- Chengdu Xinjin Second People's Hospital, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, King's College London, UK
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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12
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Deng SY, Wang YZ, Peng MM, Zhang TM, Li M, Luo W, Ran MS. Quality of life among family caregivers of people with schizophrenia in rural China. Qual Life Res 2023; 32:1759-1769. [PMID: 36715814 DOI: 10.1007/s11136-023-03349-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 01/31/2023]
Abstract
PURPOSES To investigate quality of life (QoL) of family caregivers of people with schizophrenia and examine the influencing factors of the QoL in a Chinese rural area. METHODS This study included people with schizophrenia (n = 269) and their family caregivers (n = 269) from Xinjin district, Chengdu, China. Family caregivers' QoL was measured by the World Health Organization Quality of Life-Brief Form and its influencing factors was analyzed by the multivariate regression. RESULTS Family caregivers of people with schizophrenia had very poor QoL across four domains. The regression analysis showed that physical domain of QoL was significantly associated with age, psychiatric symptoms of people with schizophrenia, and caregiving burden of family caregivers (p < 0.05). Psychological domain of QoL was significantly related to family caregivers' affiliate stigma, caregiving burden, and psychiatric symptoms of people with schizophrenia (p < 0.05). Social domain of QoL was significantly associated with age and psychiatric symptoms of people with schizophrenia, and affiliate stigma of family caregivers (p < 0.05). Environmental domain of QoL was significantly related to age and psychiatric symptoms of people with schizophrenia, and family caregivers' caregiving burden (p < 0.05). CONCLUSION Family caregivers of people with schizophrenia had poor QoL in rural China. Family caregivers' QoL is significantly impacted by age and psychiatric symptoms of people with schizophrenia, caregivers' affiliate stigma and caregiving burden. Providing social support and psychosocial interventions for family caregivers of people with schizophrenia might be crucial to improve their QoL and caregiving.
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Affiliation(s)
- Shu-Yu Deng
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Yi-Zhou Wang
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, 519087, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Ming Li
- Chengdu Xinjin Second People's Hospital, Chengdu, China
| | - Wei Luo
- Chengdu Xinjin Second People's Hospital, Chengdu, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China. .,Mental Health Center and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
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13
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Li XH, Deng SY, Zhang TM, Wang YZ, Wei DN, Wong IYL, Chan CLW, Ran MS. Affiliate stigma of mental illness in family caregivers of persons with mental illness in Hong Kong. Int J Soc Psychiatry 2022; 68:1698-1707. [PMID: 34791960 DOI: 10.1177/00207640211057723] [Citation(s) in RCA: 2] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Affiliate stigma of family caregivers may severely influence family caregiving, early treatment, and recovery of people with mental illness (PMI), and it may be impacted by the knowledge of mental illness and contact with PMI. However, little is known about the correlation between affiliate stigma of family caregivers of PMI and contact in Hong Kong. AIMS This study aimed to investigate affiliate stigma and its influencing factors among family caregivers of PMI in Hong Kong. METHODS A total of 106 family caregivers in Hong Kong participated in the study. The measurements included affiliate stigma, contacts (quantity, quality, and level), knowledge, prejudice, and discriminatory behaviors. Multiple regression analyses were employed. RESULTS The mean score of affiliate stigma scale (ASS) in family caregivers was 2.17 (SD = 0.65). In regression analyses, the results showed that contact quantity and contact level were significantly associated with higher affiliate stigma and its cognitive domain, while contact quality (e.g. positive contact) were significantly associated with lower affiliate stigma and its all domains among family caregivers. The positive relationship between prejudicial attitudes and affiliate stigma was also found. CONCLUSIONS Affiliate stigma is severe among family caregivers of PMI in Hong Kong. The results of this study indicate that contact, especially positive contact, contributes to reducing affiliate stigma among family caregivers of PMI. The results of this study are important for development of health policy on reducing stigma in family caregivers of PMI. The effectiveness of Enhancing Contact Model (ECM) should be examined in future anti-stigma interventions.
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Affiliation(s)
- Xu-Hong Li
- Department of Social Work and Social Administration, University of Hong Kong, China
| | - Shu-Yu Deng
- Department of Social Work and Social Administration, University of Hong Kong, China
| | | | - Yi-Zhou Wang
- Department of Social Work and Social Administration, University of Hong Kong, China
| | - Dan-Nuo Wei
- Department of Social Work and Social Administration, University of Hong Kong, China
| | - Irene Yin Ling Wong
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, USA
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, China
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14
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Peng MM, Ma Z, Luo W, Hu SH, Yang X, Liu B, Lai-Wan Chan C, Ran MS. Longitudinal impact of caregiver transition and family caregiving on psychiatric symptoms and psychosocial functioning among persons with schizophrenia in rural China. Fam Process 2022; 61:1663-1680. [PMID: 34921397 DOI: 10.1111/famp.12743] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 10/27/2021] [Accepted: 11/12/2021] [Indexed: 02/05/2023]
Abstract
This study examines the 21-year longitudinal impacts and predictive effects of family caregiver transition and the presence of family caregiving on the clinical status of persons with schizophrenia (PwSs) in a rural area of China. Using panel data derived from the Chengdu Mental Health Project (CMHP), 250 dyads of PwSs and their family caregivers were investigated in 1994 and 2015. The Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) were utilized. The generalized linear model (GLM) approach was used. The results of this study showed that more severe symptoms in PwSs were found to be significantly predicted by older age and nonmarried status at baseline. Compared with "spousal caregiving in two waves," the PANSS score was significantly higher in the "transition into sibling caregiving" group. A higher degree of psychosocial functioning was found to be significantly predicted by marital status, shorter duration of illness, and better mental status. Compared with "spousal caregiving in two waves," the GAF score was significantly lower in the "transition into parental caregiving" group. The presence of family caregiving was not a significant predictor of the severity of symptoms or psychosocial functioning in the PwSs. In conclusion, this study shows the 21-year predictive effects of family caregiver transition on the mental status of PwSs but not the presence of family caregiving. Psychosocial interventions and specific guidance should be provided to family caregivers to enhance their quality of caregiving and improve the prognosis of PwSs during long periods of home care.
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Affiliation(s)
- Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Zhiying Ma
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, Illinois, USA
| | - Wei Luo
- Chengdu Xinjin Second People's Hospital, Xinjin, Chengdu, Sichuan, China
| | - Shi-Hui Hu
- Chengdu Mental Health Center, Chengdu, China
| | - Xin Yang
- Guangyuan Mental Health Center, Guangyuan, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China.,Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
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15
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Ran MS, Gao R, Lin JX, Zhang TM, Chan SKW, Deng XP, Zhang BZ, Zhang XF, Huang GP, Pu DS, Bai JZ, Xu LX, Liu B. The impacts of COVID-19 outbreak on mental health in general population in different areas in China. Psychol Med 2022; 52:2651-2660. [PMID: 33298220 DOI: 10.1017/s0033291720004717] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study aimed to explore the impacts of COVID-19 outbreak on mental health status in general population in different affected areas in China. METHODS This was a comparative study including two groups of participants: (1) general population in an online survey in Ya'an and Jingzhou cities during the COVID-19 outbreak from 10-20 February 2020; and (2) matching general population selected from the mental health survey in Ya'an in 2019 (from January to May 2019). General Health Questionnaire (GHQ-12), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used. RESULTS There were 1775 participants (Ya'an in 2019 and 2020: 537 respectively; Jingzhou in 2020: 701). Participants in Ya'an had a significantly higher rate of general health problems (GHQ scores ⩾3) in 2020 (14.7%) than in 2019 (5.2%) (p < 0.001). Compared with Ya'an (8.0%), participants in Jingzhou in 2020 had a significantly higher rate of anxiety (SAS scores ⩾50, 24.1%) (p < 0.001). Participants in Ya'an in 2020 had a significantly higher rate of depression (SDS scores ⩾53, 55.3%) than in Jingzhou (16.3%) (p < 0.001). The risk factors of anxiety symptoms included female, number of family members (⩾6 persons), and frequent outdoor activities. The risk factors of depression symptoms included participants in Ya'an and uptake self-protective measures. CONCLUSIONS The prevalence of psychological symptoms has increased sharply in general population during the COVID-19 outbreak. People in COVID-19 severely affected areas may have higher scores of GHQ and anxiety symptoms. Culture-specific and individual-based psychosocial interventions should be developed for those in need during the COVID-19 outbreak.
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Affiliation(s)
- Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Ru Gao
- Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
| | - Jing-Xia Lin
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | | | - Xiao-Peng Deng
- Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China
- Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China
| | - Bing-Zhi Zhang
- Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
| | - Xin-Feng Zhang
- Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China
- Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China
| | - Guo-Ping Huang
- School of Mental Health, North Sichuan Medical College, Sichuan 637000, China
| | - Dao-Shen Pu
- Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
| | - Jing-Zhen Bai
- Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
| | - Liu-Xiu Xu
- Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China
- Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China
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16
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Ran MS, Rohlof H, Li J, Persaud A, Zhang TM, Lewis-Fernández R. Global Call to Reduce the Stigma of Mental Illness and COVID-19 Worldwide. Psychiatry 2022; 86:87-90. [PMID: 36006452 DOI: 10.1080/00332747.2022.2113317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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17
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Withers M, Jahangir T, Kubasova K, Ran MS. Reducing stigma associated with mental health problems among university students in the Asia-Pacific: A video content analysis of student-driven proposals. Int J Soc Psychiatry 2022; 68:827-835. [PMID: 33827300 DOI: 10.1177/00207640211007511] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Studies have demonstrated that mental health problems among university students may be increasing in both prevalence and severity. This study aimed to identify ways to reduce stigma and improve students' utilization of mental health services. METHODS We performed a content analysis on video proposals to address stigma and mental health at universities, submitted by 15 teams from nine Asian-Pacific countries as part of a case competition. We examined five domains: (1) tone; (2) cultural context; (3) mental health issue of focus; (4) prevention versus secondary prevention; and (5) main intervention strategies. RESULTS Five main intervention strategies emerged: (1) educational campaigns; (2) peer interaction and support; (3) counseling; (4) screening; and (5) self-management. The results suggest that mental health literacy is low among students. Educational campaigns and events to increase awareness and reduce stigma were the most commonly incorporated strategy, through film screenings, mental health days, and social media. Building empathy through personal stories from celebrities and other students was also highly recommended. Second, counseling was incorporated in 80% of proposals, with a preference for peers and staff support, and web-based therapy over professional counselors, except in severe cases. Programs to increase social contact were the third most common strategy, suggesting students may feel isolated and disconnected. Creating common spaces for students to interact and pairing of students with and without mental health issues were widely suggested. The use of technology was recommended for self-management of mental health and for mandatory mental health screening, which was generally only recommended for incoming students. CONCLUSIONS Our analysis provides insight into student-generated intervention approaches to prevent and address stigma associated with mental health issues among students. A greater university commitment is needed to provide a range of resources, including education and counseling, to leverage technology, and to foster stronger support networks among students.
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Affiliation(s)
- Mellissa Withers
- Department of Preventive Medicine, University of Southern California, Los Angeles, USA
| | - Tasfia Jahangir
- Department of Preventive Medicine, University of Southern California, Los Angeles, USA
| | - Ksenia Kubasova
- School of Global Studies, Thammasat University, Pathum Thani, Thailand
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, China
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18
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Ran MS, Wang YZ, Lu PY, Weng X, Zhang TM, Deng SY, Li M, Luo W, Wong IYL, Yang LH, Thornicroft G, Lu L. Effectiveness of enhancing contact model on reducing stigma of mental illness among family caregivers of persons with schizophrenia in rural China: A cluster randomized controlled trial. The Lancet Regional Health - Western Pacific 2022; 22:100419. [PMID: 35257121 PMCID: PMC8897707 DOI: 10.1016/j.lanwpc.2022.100419] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Contact-based intervention has been documented and proved effective on reducing stigma of mental illness in high-income countries, but it is still unclear about the effectiveness of the contact-based intervention among family caregivers of persons with schizophrenia (FCPWS) in low- and middle-income countries including rural China. Methods We conducted a cluster randomized controlled trial in FCPWS in eight rural townships in Xinjin district of Chengdu city in Southwest China. The FCPWS in these townships were randomly allocated to the Enhancing Contact Model (ECM), Psychoeducational Family Intervention (PFI), or Treatment as Usual (TAU) group. FCPWS in three groups were provided specific interventions and follow-ups. By using a mixed-effect model, our goal was to examine the differences in affiliate self-stigma scale (ASSS) scores among three groups with the data collected at baseline (T0), post-intervention (T1), 3-month (T2), and 9-month (T3) follow-up timepoints, respectively. This trial is registered with ChiCTR, number ChiCTR2000039133. Findings In April 2019, 253 FCPWS from 8 townships were randomly assigned to receive either ECM (cluster=3, n=90), PFI (cluster=2, n=81), or TAU (cluster=3, n=82). Compared with participants in the TAU group, participants in the ECM group had statistically significantly lower ASSS scores at 9-month follow-up (estimated parameter [EP]= -5.51, 95% CI -10.27 to -0.74, p=0.02). There were no statistically significantly different ASSS scores at 9-month follow up between ECM and PFI groups. Compared with participants in the PFI group, younger (<60 years old), with higher monthly income and other caregiver (e.g., parent, sibling, child) participants in the ECM group had statistically significantly lower ASSS scores in the 3-month follow-up (EP = -5.66, 95% CI -10.13 to -1.19, p<0.01; EP = -7.82, 95% CI -11.87 to -3.78, p<0.001; EP = -6.79, 95% CI -10.69 to -2.90, p<0.001, respectively). Interpretation This first trial in rural China shows that ECM intervention, a new anti-stigma intervention model, is a promising method for reducing affiliate stigma among FCPWS. The ECM intervention is more effective and stable than the PFI on reducing affiliate stigma among FCPWS. Further research needs to explore whether a long-term intervention could produce a more positive anti-stigma outcome trajectory. Funding General Research Fund, University Grants Committee, Hong Kong SAR (GRF, Grant No. 17605618, 2018-2021, PI: Dr. M.S. Ran).
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Affiliation(s)
- Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Corresponding author at: Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China.
| | - Yi-Zhou Wang
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Pei-Yi Lu
- Department of Political Science, Iowa State University, United States
| | - Xue Weng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Shu-Yu Deng
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Ming Li
- Chengdu Xinjin Second People's Hospital, China
| | - Wei Luo
- Chengdu Xinjin Second People's Hospital, China
| | - Irene Yin-Ling Wong
- School of Social Policy and Practice, University of Pennsylvania, United States
| | - Lawrence H. Yang
- Department of Social and Behavioral Sciences, New York University, United States
- Department of Epidemiology, Columbia University, United States
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
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19
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Que JY, Shi L, Yan W, Chen SJ, Wu P, Sun SW, Yuan K, Liu ZC, Zhu Z, Fan JY, Lu Y, Hu B, Xiao H, Liu ZS, Li Y, Wang GH, Wang W, Ran MS, Shi J, Wing YK, Bao YP, Lu L. Nightmares mediate the association between traumatic event exposure and suicidal ideation in frontline medical workers exposed to COVID-19. J Affect Disord 2022; 304:12-19. [PMID: 35176338 PMCID: PMC8843324 DOI: 10.1016/j.jad.2022.02.033] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/04/2021] [Accepted: 02/13/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Trauma experience increases the risk of suicidal ideation, but little is known about potentially psychological mechanisms underlying this relationship. This study aims to examine the relationship between coronavirus disease 2019 (COVID-19)-related traumatic event (CTE) exposure and suicidal ideation among hospital workers, and identify mediating roles of sleep disturbances in this relationship. METHODS Workers in seven designated hospitals in Wuhan, China, were invited to participate in an online survey from May 27, 2020, to July 31, 2020. Participants completed a self-report questionnaire to evaluate demographic characteristics, level of CTE exposures, nightmare frequency, insomnia severity, symptoms of depression and anxiety, and suicidal ideation. A series of correlation analyses were performed, and a mediation model was generated to examine correlations between CTE exposure, sleep disturbances, and suicidal ideation. RESULTS A total of 16,220 hospital workers were included in the final analysis, 13.3% of them reported suicidal ideation in the past month. CTE exposure was significantly associated with insomnia severity, nightmare frequency, and suicidal ideation. After controlling potential confounders, nightmares but not insomnia, depression, or anxiety were shown to be independent risk factors for suicidal ideation. Pathway analyses showed that the relationship between CTE exposure and suicidal ideation was fully mediated by nightmares (proportion mediated 66.4%) after adjusting for demographic characteristics and psychological confounders. LIMITATIONS Cross-sectional design precluded the investigation of causal relationships. CONCLUSIONS CTE exposure increases risk of hospital workers' suicidal ideation that is mediated by nightmares, suggesting nightmares intervention might be considered as a component when developing suicide prevention strategies.
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Affiliation(s)
- Jian-Yu Que
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Le Shi
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Wei Yan
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Si-Jing Chen
- Faculty of Medicine, Department of Psychiatry, Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, 38 Xueyuan Road, Beijing 100191, China
| | - Si-Wei Sun
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Kai Yuan
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Zhong-Chun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhou Zhu
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Jing-Yi Fan
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yu Lu
- Affiliated Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Bo Hu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Han Xiao
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi-Sheng Liu
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Li
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Gao-Hua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, 38 Xueyuan Road, Beijing 100191, China
| | - Yun Kwok Wing
- Faculty of Medicine, Department of Psychiatry, Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, 38 Xueyuan Road, Beijing 100191, China.
| | - Lin Lu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China; National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, 38 Xueyuan Road, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Beijing 100191, China.
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20
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Deng Y, Wang AL, Frasso R, Ran MS, Zhang TM, Kong D, Wong YLI. Mental health-related stigma and attitudes toward patient care among providers of mental health services in a rural Chinese county. Int J Soc Psychiatry 2022; 68:610-618. [PMID: 33554704 PMCID: PMC8668239 DOI: 10.1177/0020764021992807] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS The increasing prevalence of mental illness and low treatment rate presents a pressing public health issue in China. Pervasive stigma is a significant barrier to mental health recovery and community inclusion. In particular, stigmatizing or supportive attitudes held by healthcare providers could either perpetuate or mitigate self-stigma of people with mental illness. Moreover, mental health resources are unevenly distributed in China, with most of them concentrated in urban centers and provincial capitals. This study explores healthcare providers' attitudes toward mental illness and the challenges they faced at work in a rural Chinese county. METHOD Four focus groups were conducted with 36 healthcare providers from a three-tier mental healthcare system in a rural county in southwestern China. Focus group discussions were recorded and transcribed verbatim. The team employed a conventional content analysis approach for data analysis. All transcripts were double-coded by three bilingual team members who are native Chinese speakers. Coding discrepancies were resolved by consensus. RESULTS Healthcare providers recruited from the county, township, and village levels varied in educational background, professional qualification, and experience of working with people with mental illness. Five thematic categories identified across four groups include (1) barriers to mental healthcare delivery, (2) keys to mental health recovery, (3) providers' attitudes toward providing care, (4) providers' perception toward patients and family members, and (5) providers' perception of training needs. CONCLUSIONS This is a unique study that included healthcare providers from a three-tier healthcare system. Findings signal the importance of understanding healthcare practitioners' experiences and views to inform the design of training initiatives in rural or low-resource communities.
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Affiliation(s)
- Yuer Deng
- School of Social Policy & Practice, University of Pennsylvania, USA
| | - An-Li Wang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Rosemary Frasso
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | | | - Dexia Kong
- Rutgers Institute for Health, Health Care Policy and Aging Research, The State University of New Jersey, Rutgers, USA
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21
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Wei DN, Wang YZ, Deng SY, Cohen A, Luo W, Liu B, Ran MS. Physical illness comorbidity and its influencing factors among persons with severe mental illness in Rural China. Asian J Psychiatr 2022; 71:103075. [PMID: 35305451 DOI: 10.1016/j.ajp.2022.103075] [Citation(s) in RCA: 1] [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: 12/07/2021] [Revised: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Comorbid physical illness is a common cause of death in people with severe mental illness (SMI) worldwide. In rural China, the prevalence of physical illness comorbidity among persons with SMI remains unclear. This study aimed to examine non-communicable physical illness comorbidity and its risk factors among people with SMI in a rural area of China. METHODS A mental health survey, using the International Classification of Disease (ICD-10), was conducted in six townships of Xinjin District, Chengdu, China in 2015. RESULTS A total of 724 persons with SMI were included in this study, and 37.8% of them had at least one physical illness. The most common physical illnesses were hypertension (10.5%) and diabetes (5.8%). More physical comorbidity was reported among persons with affective disorders than persons with schizophrenia. Many participants (37.4%) had never received antipsychotic treatment, and of those, 51.6% reported having a physical illness comorbidity. Significant associations were found between physical illness comorbidity and participants' family economic status, family size, age at onset of mental disorder, treatment status, and symptom severity. CONCLUSIONS Our findings indicate the need of an integration of medical and psychiatric care in primary care. It also suggests that poverty and having never received treatment for mental health problems negatively affect the health of persons with SMI, which deserve more attention. Researchers and policymakers can take these findings into account to develop health policies and improve the mental and physical health care in rural China.
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Affiliation(s)
- Dan-Nuo Wei
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR
| | - Yi-Zhou Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR
| | - Shu-Yu Deng
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR
| | - Alex Cohen
- London School of Hygiene & Tropical Medicine, UK
| | - Wei Luo
- Chengdu Xinjin Second People's Hospital, Chengdu, Xinjin 611432, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR; Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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22
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Zhu XM, Yan W, Sun J, Liu L, Zhao YM, Zheng YB, Que JY, Sun SW, Gong YM, Zeng N, Yuan K, Shi L, Sun YK, Guo SH, Lu Y, Ran MS, Wong SYS, Shi J, Jiang ZD, Bao YP, Lu L. Patterns and influencing factors of COVID-19 vaccination willingness among college students in China. Vaccine 2022; 40:3046-3054. [PMID: 35450782 PMCID: PMC8995203 DOI: 10.1016/j.vaccine.2022.04.013] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 03/09/2022] [Accepted: 04/04/2022] [Indexed: 12/28/2022]
Abstract
Background Vaccination is an important preventive measure against the coronavirus disease 19 (COVID-19) pandemic. We aimed to examine the willingness to vaccination and influencing factors among college students in China. Methods From March 18 to April 26, 2021, we conducted a cross-sectional online survey among college students from 30 universities in Wuhan, Hubei Province, China. The survey was composed of the sociodemographic information, psychological status, experience during pandemic, the willingness of vaccination and related information. Students’ attitudes towards vaccination were classified as ‘vaccine acceptance’, ‘vaccine hesitancy’, and ‘vaccine resistance’. Multinomial logistic regression analyses were performed to identify the influencing factors associated with vaccine hesitancy and resistance. Results Among 23,143 students who completed the survey, a total of 22,660 participants were included in the final analysis with an effective rate of 97.9% after excluding invalid questionnaires. A total of 60.6% of participants would be willing to receive COVID-19 vaccine, 33.4% were hesitant to vaccination, and 6.0% were resistant to vaccination. Social media platforms and government agencies were the main sources of information vaccination. Worry about the efficacy and adverse effects of vaccine were the top two common reason of vaccine hesitancy and resistance. Multiple multinomial logistic regression analysis identified that participants who worried about the adverse effects of vaccination were more likely to be vaccine hesitancy (aOR = 2.44, 95% CI = 2.30, 2.58) and resistance (aOR = 2.71, 95% CI = 2.40, 3.05). Conclusion More than half of college students are willing to receive the COVID-19 vaccine, whereas nearly one-third college students are still hesitant or resistant. It is crucial to provide sufficient and scientific information on the efficacy and safety of vaccine through social media and government agencies platforms to promote vaccine progress against COVID-19 and control the pandemic in China.
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Affiliation(s)
- Xi-Mei Zhu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Wei Yan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Jie Sun
- Center for Pain Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Yi-Miao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Yong-Bo Zheng
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China
| | - Jian-Yu Que
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Si-Wei Sun
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Yi-Miao Gong
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Kai Yuan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Le Shi
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Yan-Kun Sun
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Sui-Huai Guo
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Yu Lu
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Zheng-Dong Jiang
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Lin Lu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China; National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China.
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23
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Peng MM, Ma Z, Chen SY, Luo W, Hu SH, Yang X, Liu B, Chan CLW, Ran MS. Predictors of family caregiving burden of persons with schizophrenia with and without transition of primary caregivers from 1994 to 2015 in rural China. BJPsych Open 2022; 8:e78. [PMID: 35362401 PMCID: PMC9059613 DOI: 10.1192/bjo.2022.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 02/01/2022] [Accepted: 02/22/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Little is known about how sociodemographic and clinical factors affect the caregiving burden of persons with schizophrenia (PwSs) with transition in primary caregivers. AIMS This study aimed to examine the predictive effects of sociodemographic and clinical factors on the caregiving burden of PwSs with and without caregiver transition from 1994 to 2015 in rural China. METHOD Using panel data, 206 dyads of PwSs and their primary caregivers were investigated in both 1994 and 2015. The generalised linear model approach was used to examine the predictive effects of sociodemographic factors, severity of symptoms and changes in social functioning on the caregiving burden with and without caregiver transition. RESULTS The percentages of families with and without caregiver transition were 38.8% and 61.2%, respectively. Among families without caregiver transition, a heavier burden was significantly related to a larger family size and more severe symptoms in PwSs. Deteriorated functioning of 'social activities outside the household' and improved functioning of 'activity in the household' were protective factors against a heavy caregiving burden. Among families with caregiver transition, younger age, improved marital functioning, deteriorated self-care functioning, and better functioning of 'social interest or concern' were significant risk factors for caregiving burden. CONCLUSIONS The effects of sociodemographic and clinical correlates on the caregiving burden were different among families with and without caregiver transition. It is crucial to explore the caregiver arrangement of PwSs and the risk factors for burden over time, which will facilitate culture-specific family interventions, community-based mental health services and recovery.
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Affiliation(s)
- Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Zhiying Ma
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, Illinois, USA
| | - She-Ying Chen
- Center for Social Work Study, Institute on Chinese Culture, Health and Public Welfare, Tsinghua University, China
| | - Wei Luo
- Xinjin Second People's Hospital, Xinjin, Chengdu, Sichuan, China
| | - Shi-Hui Hu
- Chengdu Mental Health Center, Chengdu, Sichuan, China
| | - Xin Yang
- Guangyuan Mental Health Center, Guangyuan, Sichuan, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR; and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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24
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Peng MM, Ma Z, Ran MS. Family caregiving and chronic illness management in schizophrenia: positive and negative aspects of caregiving. BMC Psychol 2022; 10:83. [PMID: 35361263 PMCID: PMC8973811 DOI: 10.1186/s40359-022-00794-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 06/17/2021] [Accepted: 03/24/2022] [Indexed: 02/08/2023] Open
Abstract
Background We aimed to explore the long-term caregiving experiences of family caregivers of people with schizophrenia (PwS) in terms of both positive and negative aspects. Method Utilising a purposive sampling method, we conducted in-depth interviews with 20 family caregivers of persons who had suffered from schizophrenia for more than 20 years. We empirically investigated their retrospective experiences of caregiver-patient interactions during a long period of family caregiving. We audio-recorded and transcribed the interviews into text. We thematically coded and analysed the transcribed text using a four-phase method of theme development. Findings Schizophrenia might not only generate a caregiving burden, affect caregivers’ psychological status, and accordingly influence their coping strategies, but also have short- or long-term patient-related consequences. Discussion Family caregivers should develop their stress management skills to cope with relevant life changes and increase their knowledge of the potential psychological consequences for care recipients resulting from negative caregiving strategies during home-based practice. Care recipients with schizophrenia in a relatively stable status should be empowered to take care of themselves. More effective family-based interventions for psychiatric nursing or individualised training for symptom management should be tailored to serve families’ diverse needs.
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Affiliation(s)
- Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, 519087, China.
| | - Zhiying Ma
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, IL, USA
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China. .,Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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25
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Ran MS, Peng MM, Yau YY, Zhang TM, Li XH, Wong IYL, Ng S, Thornicroft G, Chan CLW, Lu L. Knowledge, contact and stigma of mental illness: Comparing three stakeholder groups in Hong Kong. Int J Soc Psychiatry 2022; 68:365-375. [PMID: 33622065 DOI: 10.1177/0020764021997479] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Indexed: 01/02/2023]
Abstract
BACKGROUND It remains unknown what the impacts of multiple dimensions of contact (e.g. level, quantity and quality) are on the stigma of mental illness. AIMS To explore the relationship between the multiple dimensions of contact and stigma of mental illness among family members (FM), mental health workers (MHW) and community residents (CR) in Hong Kong. METHODS The stigma, contact and knowledge were measured in FM, MHW and CR in Hong Kong. Multiple regression analyses were used. RESULTS MHW (n = 141) had higher knowledge, more contact and lower stigma of mental illness than CR (n = 95) or FM (n = 62). Knowledge and contact quality were significantly associated with lower stigma of mental illness in the three groups. However, contact level and contact quantity were not significantly associated with most stigma components. The contact level was positively associated with stigma of mental illness among FM and CR. CONCLUSIONS The results of this study highlight the differences in knowledge, contact and stigma of mental illness among different stakeholder groups. This study suggests that positive contact (e.g. equal, supportive, voluntary and pleasant contact) reduces stigma of mental illness, while negative contact (e.g. unfriendly, unsupportive, unpleasant contact) may increase stigma. The Enhancing Contact Model (ECM) should be tested in future anti-stigma interventions.
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Affiliation(s)
- Mao-Sheng Ran
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong SAR, China
| | - Man-Man Peng
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong SAR, China
| | - Yuen Yum Yau
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong SAR, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Xu-Hong Li
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong SAR, China
| | - Irene Yin Ling Wong
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, USA
| | - Siuman Ng
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong SAR, China
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong SAR, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
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26
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Li H, Yuan K, Sun YK, Zheng YB, Xu YY, Su SZ, Zhang YX, Zhong Y, Wang YJ, Tian SS, Gong YM, Fan TT, Lin X, Gobat N, Wong SYS, Chan EYY, Yan W, Sun SW, Ran MS, Bao YP, Shi J, Lu L. Efficacy and practice of facemask use in general population: a systematic review and meta-analysis. Transl Psychiatry 2022; 12:49. [PMID: 35105851 PMCID: PMC8804079 DOI: 10.1038/s41398-022-01814-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 12/14/2021] [Accepted: 01/18/2022] [Indexed: 11/17/2022] Open
Abstract
In recent decades, respiratory infections, including SARS, HINI and the currently spreading COVID-19, caused by various viruses such as influenza and coronavirus have seriously threatened human health. It has generated inconsistent recommendations on the mandatory use of facemasks across countries on a population level due to insufficient evidence on the efficacy of facemask use among the general population. This meta-analysis aimed to explore (1) the efficacy of facemask use on preventing respiratory infections, and (2) the perceptions, intentions, and practice about facemask use among the general population worldwide. We searched PubMed, MEDLINE, Web of Science, Cochrane, bioRxiv, and medRxiv databases since inception to August 17, 2020. From 21,341 records identified, eight RCTs on facemask in preventing infections and 78 studies on perception, intention, and practice of facemask use among the general population were included in the analysis. The meta-analysis of RCTs found a significant protective effect of facemask intervention (OR = 0.84; 95% CI = 0.71-0.99; I2 = 0%). This protective effect was even more pronounced when the intervention duration was more than two weeks (OR = 0.76; 95% CI = 0.66-0.88; I2 = 0%). The meta-analysis of observational studies on perception, intention, and practice on facemask use showed that 71% of respondents perceived facemasks to be effective for infection prevention, 68% of respondents would wear facemasks, and 54% of respondents wore facemasks for preventing respiratory infections. Differences in perception, intention, and practice behavior of facemask use in different regions may be related to the impact of respiratory infections, regional culture, and policies. The governments and relevant organizations should make effort to reduce the barriers in the use of facemasks.
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Affiliation(s)
- Hui Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yan-Kun Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Ying-Ying Xu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China
- School of Public Health, Peking University, 100191, Beijing, China
| | - Si-Zhen Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yu-Xin Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- School of Public Health, Peking University, 100191, Beijing, China
| | - Yi Zhong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yi-Jie Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Shan-Shan Tian
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Teng-Teng Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Xiao Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Nina Gobat
- Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, School of Public Health and Primary Care, Prince of Wales Hospital, Sha tin, Hong Kong
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Si-Wei Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China.
- School of Public Health, Peking University, 100191, Beijing, China.
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, 100191, Beijing, China.
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.
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27
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Yuan K, Huang XL, Yan W, Zhang YX, Gong YM, Su SZ, Huang YT, Zhong Y, Wang YJ, Yuan Z, Tian SS, Zheng YB, Fan TT, Zhang YJ, Meng SQ, Sun YK, Lin X, Zhang TM, Ran MS, Wong SYS, Rüsch N, Shi L, Bao YP, Lu L. A systematic review and meta-analysis on the prevalence of stigma in infectious diseases, including COVID-19: a call to action. Mol Psychiatry 2022; 27:19-33. [PMID: 34580416 PMCID: PMC8475479 DOI: 10.1038/s41380-021-01295-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/17/2021] [Accepted: 09/08/2021] [Indexed: 02/07/2023]
Abstract
Infectious diseases, including COVID-19, are crucial public health issues and may lead to considerable fear among the general public and stigmatization of, and discrimination against, specific populations. This meta-analysis aimed to estimate the pooled prevalence of stigma in infectious disease epidemics. We systematically searched PubMed, PsycINFO, Embase, MEDLINE, Web of Science, and Cochrane databases since inception to June 08, 2021, and reported the prevalence of stigma towards people with infectious diseases including SARS, H1N1, MERS, Zika, Ebola, and COVID-19. A total of 50 eligible articles were included that contributed 51 estimates of prevalence in 92722 participants. The overall pooled prevalence of stigma across all populations was 34% [95% CI: 28-40%], including enacted stigma (36% [95% CI: 28-44%]) and perceived stigma (31% [95% CI: 22-40%]). The prevalence of stigma in patients, community population, and health care workers, was 38% [95% CI: 12- 65%], 36% [95% CI: 28-45%], and 30% [95% CI: 20-40%], respectively. The prevalence of stigma in participants from low- and middle-income countries was 37% [95% CI: 29-45%], which is higher than that from high-income countries (27% [95% CI: 18-36%]) though this difference was not statistically significant. A similar trend of prevalence of stigma was also observed in individuals with lower education (47% [95% CI: 23-71%]) compared to higher education level (33% [95% CI: 23-4%]). These findings indicate that stigma is a significant public health concern, and effective and comprehensive interventions are needed to counteract the damaging effects of the infodemics during infectious disease epidemics, including COVID-19, and reduce infectious disease-related stigma.
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Affiliation(s)
- Kai Yuan
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Xiao-Lin Huang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.410726.60000 0004 1797 8419Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Wei Yan
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Yu-Xin Zhang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yi-Miao Gong
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Si-Zhen Su
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Yue-Tong Huang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Yi Zhong
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yi-Jie Wang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Ze Yuan
- grid.410726.60000 0004 1797 8419Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Shan-Shan Tian
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Yong-Bo Zheng
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Teng-Teng Fan
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Ying-Jian Zhang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Shi-Qiu Meng
- grid.11135.370000 0001 2256 9319National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yan-Kun Sun
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Xiao Lin
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Tian-Ming Zhang
- grid.39436.3b0000 0001 2323 5732Department of Social Work, Shanghai University, Shanghai, China
| | - Mao-Sheng Ran
- grid.194645.b0000000121742757Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Samuel-Yeung-Shan Wong
- grid.10784.3a0000 0004 1937 0482JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Nicolas Rüsch
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China.
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China. .,School of Public Health, Peking University, Beijing, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China. .,Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China. .,National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.
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28
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Fang Q, Zhang TM, Wong YLI, Yau YY, Li XH, Li J, Chui CHK, Tse S, Chan CLW, Chen EYH, Ran MS. The mediating role of knowledge on the contact and stigma of mental illness in Hong Kong. Int J Soc Psychiatry 2021; 67:935-945. [PMID: 33231134 DOI: 10.1177/0020764020975792] [Citation(s) in RCA: 4] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although knowledge is a crucial component in contact theory delineating how prejudice changes toward out-groups with stigmatized conditions, little is known about the mediating role of knowledge on contact, stigmatizing attitudes, and behaviors toward mental illness. AIM This study aimed to examine the mechanism underlie contact and stigma change by knowledge. METHODS A total of 366 participants including family members (FM), mental health providers (MHP), and community residents (CR) recruited across communities in Hong Kong and completed measures of contact level, contact quantity, contact quality, mental health related knowledge, prejudice, and discriminatory behaviors. Structural equation modeling was adopted to test the association among the key variables. RESULTS Higher level of contact was significantly correlated with better knowledge, less prejudice, and less discriminatory behaviors. Knowledge was directly and negatively correlated with prejudicial attitudes but was not significantly related to discriminatory behaviors. Furthermore, lower levels of prejudice were associated with less discriminatory behaviors. CONCLUSION Enhancement of contact may increase understanding toward people with mental illness (PMI) and diminish stigmatizing attitudes and behaviors. Although prejudicial attitudes may be reduced by broadening mental health knowledge, increasing knowledge only might not ameliorate discriminatory behaviors. Future research should test mediators on contact and stigma by using longitudinal data.
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Affiliation(s)
- Qi Fang
- School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Yin Ling Irene Wong
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Yuen Yum Yau
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Xu-Hong Li
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Jie Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Cheryl Hiu Kwan Chui
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Samson Tse
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
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29
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Zhao YM, Liu L, Sun J, Yan W, Yuan K, Zheng YB, Lu ZA, Liu L, Ni SY, Su SZ, Zhu XM, Zeng N, Gong YM, Wu P, Ran MS, Leng Y, Shi J, Shi L, Lu L, Bao YP. Public Willingness and Determinants of COVID-19 Vaccination at the Initial Stage of Mass Vaccination in China. Vaccines (Basel) 2021; 9:vaccines9101172. [PMID: 34696281 PMCID: PMC8538840 DOI: 10.3390/vaccines9101172] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 09/01/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 01/06/2023] Open
Abstract
The present study assessed the willingness of the general population to receive COVID-19 vaccines and identified factors that influence vaccine hesitancy and resistance. A national online survey was conducted from 29 January 2021 to 26 April 2021 in China. Multinomial logistic regression analyses were conducted to identify factors that influence vaccine hesitancy and resistance. Of the 34,041 participants surveyed, 18,810 (55.3%) were willing to get vaccinated, 13,736 (40.3%) were hesitant, and 1495 (4.4%) were resistant. Rates of vaccine acceptance increased over time, with geographical discrepancies in vaccine hesitancy and resistance between provinces in China. Vaccine safety was the greatest concern expressed by most participants (24,461 [71.9%]), and the major reason for participants’ refusing vaccination (974 [65.2%]). Government agencies (23,131 [68.0%]) and social media (20,967 [61.6%]) were the main sources of COVID-19 vaccine information. Compared with vaccination acceptance, female, young and middle-aged, high income, and perceived low-risk of infection were associated with vaccine hesitancy. Histories of allergic reactions to other vaccines and depression symptoms were related to vaccine resistance. Common factors that influenced vaccine hesitancy and resistance were residing in cities and perceiving less protection with vaccines than with other protective measures. The results indicate that the rate of vaccine resistance is relatively low, but vaccine hesitancy is common. Individuals who are female, young and middle-aged, with a high income, and residing in cities are more likely to be hesitant for vaccination and should be the target populations for vaccination campaigns. Specific vaccine messaging from the government and social media could alleviate public concerns about vaccine safety and efficacy.
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Affiliation(s)
- Yi-Miao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
| | - Lin Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Jie Sun
- Pain Medicine Center, Peking University Third Hospital, Beijing 100191, China;
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
| | - Zheng-An Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
| | - Shu-Yu Ni
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
| | - Si-Zhen Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Xi-Mei Zhu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
- Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China;
| | - Yue Leng
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA 94121, USA;
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
- Correspondence: (L.S.); (L.L.); (Y.-P.B.); Tel.: +86-10-8280-2470 (L.S. & Y.-P.B.); +86-10-8280-5308 (L.L.); Fax: +86-10-6203-2624 (L.S., L.L. & Y.-P.B.)
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (L.L.); (W.Y.); (K.Y.); (Y.-B.Z.); (Z.-A.L.); (S.-Z.S.); (X.-M.Z.); (Y.-M.G.)
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China
- Correspondence: (L.S.); (L.L.); (Y.-P.B.); Tel.: +86-10-8280-2470 (L.S. & Y.-P.B.); +86-10-8280-5308 (L.L.); Fax: +86-10-6203-2624 (L.S., L.L. & Y.-P.B.)
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; (Y.-M.Z.); (L.L.); (S.-Y.N.); (N.Z.); (P.W.); (J.S.)
- School of Public Health, Peking University, Beijing 100191, China
- Correspondence: (L.S.); (L.L.); (Y.-P.B.); Tel.: +86-10-8280-2470 (L.S. & Y.-P.B.); +86-10-8280-5308 (L.L.); Fax: +86-10-6203-2624 (L.S., L.L. & Y.-P.B.)
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Li XH, Zhang TM, Yau YY, Wang YZ, Wong YLI, Yang L, Tian XL, Chan CLW, Ran MS. Peer-to-peer contact, social support and self-stigma among people with severe mental illness in Hong Kong. Int J Soc Psychiatry 2021; 67:622-631. [PMID: 33059491 DOI: 10.1177/0020764020966009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Indexed: 12/14/2022]
Abstract
BACKGROUND Self-stigma exerts a range of adversities for persons with severe mental illness (SMI), however, little is known about the association between peer contact, social support and self-stigma. AIMS This study aimed to explore the mediating role of social support on the relationship between peer contact and self-stigma among persons with SMI in Hong Kong. METHODS A total of 159 persons with SMI (schizophrenia and mood disorder) in community service centres participated in the study through completing a survey on self-stigma, social functioning, social support, perception of peer contact and mass media. Logistic regression was utilised to explore the influencing factors of self-stigma among the participants. RESULTS The results showed that 81.1% of participants reported moderate to severe levels of self-stigma. Self-stigma was significantly associated with diverse factors (e.g. social functioning). Importantly, positive peer contact was significantly associated with lower self-stigma of persons with SMI. Social support acted as a mediator between peer contact and self-stigma. CONCLUSION The results of this study suggest that contact-based interventions, such as enhancing positive peer-to-peer contact, should be conducted for reducing self-stigma among persons with SMI.
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Affiliation(s)
- Xu-Hong Li
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Yuen Yum Yau
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Yi-Zhou Wang
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Yin-Ling Irene Wong
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Lawrence Yang
- School of Global Public Health, New York University, New York, NY, USA.,Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Xiao-Li Tian
- Department of Sociology, University of Hong Kong, Hong Kong SAR, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
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Morgan C, Dazzan P, Gureje O, Hanlon C, Jones N, Esponda GM, Malla A, Pathare S, Ran MS, Roberts T, Thara R, Vasquez A. Announcing the Lancet Psychiatry Commission on Psychoses in Global Context. Lancet Psychiatry 2021; 8:743-744. [PMID: 34147155 DOI: 10.1016/s2215-0366(21)00234-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 02/04/2023]
Affiliation(s)
- Craig Morgan
- ESRC Centre for Society and Mental Health, King's College London, London SE5 8AF, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK; National Institute for Health Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
| | - Paola Dazzan
- Department of Psychological Medicine, King's College London, London SE5 8AF, UK; National Institute for Health Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | | | - Charlotte Hanlon
- ESRC Centre for Society and Mental Health, King's College London, London SE5 8AF, UK; Addis Ababa University, Addis Ababa, Ethiopia
| | - Nev Jones
- University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Maharashtra, India
| | | | - Tessa Roberts
- ESRC Centre for Society and Mental Health, King's College London, London SE5 8AF, UK
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Gao R, Chan SKW, Zhang BZ, Lin JX, Peng SR, Yang CG, Tian GJ, Bai JZ, Xu LX, Li YH, Zheng ZJ, Pu DS, Chan CLW, Ran MS. An epidemiological survey of mental disorders 5 years after the Lushan earthquake in Ya'an, China. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1263-1272. [PMID: 33146858 DOI: 10.1007/s00127-020-01974-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/02/2020] [Accepted: 10/24/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to (1) explore the prevalence and relevant influencing factors of different mental disorders 5 years after the Lushan earthquake in Ya'an, China. METHODS An epidemiological mental health survey was conducted to identify the prevalence of mental disorders in general population in Ya'an. A multi-stage, group-matching random sampling method was adopted. Face-to-face interviews were done with a two-stage design by trained interviewers and psychiatrists. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) was used for the diagnosis. RESULTS There were 8876 participants who were interviewed in this study. The total 12-month and lifetime prevalence of all mental disorders were 12.5% and 14.7%, respectively. There was a significant difference between males and females in the prevalence patterns of several mental disorders. Han ethnic group had higher prevalence of anxiety disorders (2.7%), and the Tibetan group had higher prevalence of alcohol-related disorders (5.0%). Logistic regression analysis showed that the areas severely affected by the earthquake had significantly higher prevalence of depressive disorders, and the extremely severe affected areas had significantly higher prevalence of trauma- and stressor-related disorders. CONCLUSION Our findings show that the prevalence of a range of mental disorders 5 years after the earthquake in Ya'an are high, and the prevalence of depressive and trauma- and stressor-related disorders may be influenced differently by the various severity of earthquake impact. This study may be crucial for the health policy-making, cultural-specific mental health services and long-term mental recovery after the earthquake.
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Affiliation(s)
- Ru Gao
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | | | - Bing-Zhi Zhang
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Jing-Xia Lin
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Shu-Rong Peng
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Chuan-Gang Yang
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Guo-Jiao Tian
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Jing-Zhen Bai
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Liu-Xiu Xu
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Yu-Hui Li
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Zai-Jiang Zheng
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Dao-Sheng Pu
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China.
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Zhao X, Yu YH, Peng MM, Luo W, Hu SH, Yang X, Liu B, Zhang T, Gao R, Chan CLW, Ran MS. Change of poverty and outcome of persons with severe mental illness in rural China, 1994-2015. Int J Soc Psychiatry 2021; 67:315-323. [PMID: 32830571 DOI: 10.1177/0020764020951234] [Citation(s) in RCA: 1] [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] [Indexed: 01/20/2023]
Abstract
BACKGROUND It is unknown whether and how poverty influences the long-term outcome of persons with severe mental illness (SMI). AIMS To explore the change of poverty status in persons with SMI from 1994 to 2015 and examine the impact of poverty status on patients' outcome in rural China. METHOD Two mental health surveys using identical methods and International Classification of Disease (ICD-10) were conducted in 1994 and 2015 in the same six townships of Xinjin County, Chengdu, China. RESULTS The annual net income per person was 19.8% and 100.2% higher for the general population than for persons with SMI in 1994 and 2015 respectively. Compared with 1994 (48.2%), persons with SMI in 2015 had significantly higher rates of poor family economic status (<mean) (65.2%) (p < .001). Persons with SMI in poor family economic status were significantly more likely to be male, unmarried, unable to work, with no family caregivers or a smaller number of family members, and in poor mental status in 1994 and 2015 (p < .05). The risk factors significantly associated with patients' poor mental status included poor work ability, younger age of first onset, never-treated status and poor family economic status. CONCLUSIONS Relative poverty of persons with SMI has become more severe during the rapid socioeconomic development in rural China. Relative poverty of household, poor work ability, younger age of onset and never-treated status are risk factors of poor outcome. Culture-specific, community-based interventions and targeted poverty alleviation programs should improve patients' early identification, treatment and recovery.
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Affiliation(s)
- Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China
| | - Yue-Hui Yu
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Man-Man Peng
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Wei Luo
- Xinjin Second People's Hospital, Xinjin, Chengdu, Sichuan, China
| | - Shi-Hui Hu
- Chengdu Mental Health Center, Chengdu, Sichuan, China
| | - Xin Yang
- Guangyuan Mental Health Center, Guangyuan, Sichuan, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei, China
| | - Tin Zhang
- Santai Mental Health Center, Sichuan, China
| | - Ru Gao
- Yaan Fourth People's Hospital, Yaan, Sichuan, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
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Zhang YJ, Yuan K, Chang SH, Yan W, Que JY, Deng JH, Gong YM, Luo JM, Yang SC, An CX, Kang YM, Xu HS, Wang YM, Zhang LF, Zhang WF, Song YL, Xu DW, Liu HZ, Wang WQ, Liu CX, Yang WQ, Zhou L, Zhao JB, Yu MY, Chen JY, Tang H, Peng J, Zhang XJ, Xu Y, Zhang N, Kuang L, Li ZJ, Wang YH, Shi J, Ran MS, Bao YP, Shi L, Lu L. Career choice and influential factors among medical students majoring in psychiatry in China. BMC Med Educ 2021; 21:183. [PMID: 33766012 PMCID: PMC7992123 DOI: 10.1186/s12909-021-02622-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/16/2021] [Indexed: 06/10/2023]
Abstract
BACKGROUND The undergraduate program of psychiatry has been widely established in recent years to improve the education and recruitment of psychiatrists in China. We aim to investigate the career choice of medical students majoring in psychiatry in China and the influential factors. METHOD This multicenter study was conducted in 26 medical schools in China from May to October of 2019. Participants included 4610 medical students majoring in psychiatry and 3857 medical students majoring in clinical medicine. Multivariable logistic regression was used to investigate the influential factors of students' choices of psychiatry at matriculation and as a career. RESULTS 44.08% of psychiatry majored students gave psychiatry as a first choice at matriculation, and 56.67% of them would choose psychiatry as a career, which was in sharp contrast to the proportion of clinical medicine majored students who would choose psychiatry as a career (0.69%). Personal interest (59.61%), suggestions from family members (27.96%), and experiencing mental problems (23.19%) were main reasons for choosing psychiatry major at matriculation. Personal interest (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.87-2.40), experiencing a psychiatry clerkship (OR = 1.99, 95% CI = 1.28-3.08), being female (OR = 1.50, 95% CI = 1.30-1.68), experiencing mental problems (OR = 1.33, 95% CI = 1.28-1.56), and suggestions from family members (OR = 1.25, 95% CI = 1.08-1.46) correlated positively with students' choice of psychiatry as career. Students who lacked psychiatry knowledge (OR = 0.49, 95% CI = 0.29-0.85) or chose psychiatry because of lower admission scores (OR = 0.80, 95% CI = 0.63-0.97) were less likely to choose psychiatry as a career. CONCLUSION More than half of psychiatry majored medical school students planned to choose psychiatry as their career, whereas very few students in the clinic medicine major would make this choice. Increasing students' interest in psychiatry, strengthening psychiatry clerkships, and popularizing psychiatric knowledge are modifiable factors to increase the psychiatry career intention. The extent to which medical students' attitudes toward psychiatry can be changed through medical school education and greater exposure to psychiatry will need further investigation.
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Affiliation(s)
- Ying-Jian Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Su-Hua Chang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Jian-Yu Que
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Jia-Hui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG, McGovern Institute for Brain Research, Beijing, China
| | - Jia-Ming Luo
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Shi-Chang Yang
- Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Cui-Xia An
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of Hebei Medical University, Brain Ageing and Cognitive Neuroscience Laboratory, Hebei Medical University, Shijiazhuang, China
| | - Yi-Min Kang
- School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot, China
| | - Hua-Shan Xu
- School of Mental Health, Bengbu Medical College, Anhui, China
| | - Yi-Ming Wang
- Department of Psychiatry, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Li-Fang Zhang
- Department of Neurology, Changzhi People's Affiliated Hospital of Changzhi Medical College, Changzhi, Shanxi, China
| | - Wen-Fang Zhang
- Mental Health Department of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Yin-Li Song
- Department of Pathology, Daqing Campus of Harbin Medical University, Daqing, China
| | - Dong-Wu Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huan-Zhong Liu
- Chaohu Hospital of Anhui Medical University, Anhui, China
| | | | | | - Wen-Qiong Yang
- Department of Neurology, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Liang Zhou
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Jiu-Bo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Miao-Yu Yu
- Department of Mental Health, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jun-Yu Chen
- Shenzhi Department, Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Hong Tang
- Department of Psychology, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Juan Peng
- Teaching and Research Section of Psychology, School of Management, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiu-Jun Zhang
- North China University of Science and Technology Tangshan, Hebei, China
| | - Yong Xu
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Ning Zhang
- Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Li Kuang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
- Department of Psychiatry, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhan-Jiang Li
- Department of Clinical Psychology, National Clinical Research Center for Mental Disorders, Beijing, China
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yu-Hua Wang
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, China.
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 51 Huayuan Bei Road, Beijing, 100191, China.
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Yu YH, Luo W, Liu B, Kuang WH, Davidson L, Wan Chan CL, Lu L, Xiang MZ, Ran MS. Poverty transitions in severe mental illness: longitudinal analysis of social drift in China, 1994-2015. Psychol Med 2021; 52:1-9. [PMID: 33618792 DOI: 10.1017/s0033291721000350] [Citation(s) in RCA: 1] [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] [Indexed: 02/05/2023]
Abstract
BACKGROUND Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China. METHODS Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions. RESULTS The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty. CONCLUSIONS This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI.
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Affiliation(s)
- Yue-Hui Yu
- School of Public Administration and Policy, Renmin University of China, Beijing100872, China
| | - Wei Luo
- Chengdu Xinjin Second People's Hospital, Xinjin, Chengdu611432, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei434000, China
| | - Wei-Hong Kuang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu610041, China
| | | | - Cecilia Lai Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Lin Lu
- Peking University Sixth Hospital, Institute of Mental Health, Peking University, Beijing100191, China
| | - Meng-Ze Xiang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu610041, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
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Shi L, Que JY, Lu ZA, Gong YM, Liu L, Wang YH, Ran MS, Ravindran N, Ravindran AV, Fazel S, Bao YP, Shi J, Lu L. Prevalence and correlates of suicidal ideation among the general population in China during the COVID-19 pandemic. Eur Psychiatry 2021; 64:e18. [PMID: 33686933 PMCID: PMC7943957 DOI: 10.1192/j.eurpsy.2021.5] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is a major threat to the public. However, the comprehensive profile of suicidal ideation among the general population has not been systematically investigated in a large sample in the age of COVID-19. METHODS A national online cross-sectional survey was conducted between February 28, 2020 and March 11, 2020 in a representative sample of Chinese adults aged 18 years and older. Suicidal ideation was assessed using item 9 of the Patient Health Questionnaire-9. The prevalence of suicidal ideation and its risk factors was evaluated. RESULTS A total of 56,679 participants (27,149 males and 29,530 females) were included. The overall prevalence of suicidal ideation was 16.4%, including 10.9% seldom, 4.1% often, and 1.4% always suicidal ideation. The prevalence of suicidal ideation was higher in males (19.1%) and individuals aged 18-24 years (24.7%) than in females (14.0%) and those aged 45 years and older (11.9%). Suicidal ideation was more prevalent in individuals with suspected or confirmed infection (63.0%), frontline workers (19.2%), and people with pre-existing mental disorders (41.6%). Experience of quarantine, unemployed, and increased psychological stress during the pandemic were associated with an increased risk of suicidal ideation and its severity. However, paying more attention to and gaining a better understanding of COVID-19-related knowledge, especially information about psychological interventions, could reduce the risk. CONCLUSIONS The estimated prevalence of suicidal ideation among the general population in China during COVID-19 was significant. The findings will be important for improving suicide prevention strategies during COVID-19.
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Affiliation(s)
- Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Jian-Yu Que
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Zheng-An Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Yi-Miao Gong
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
| | - Yun-He Wang
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Nisha Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Arun V Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China.,Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.,National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
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Ran MS, Hall BJ, Su TT, Prawira B, Breth-Petersen M, Li XH, Zhang TM. Stigma of mental illness and cultural factors in Pacific Rim region: a systematic review. BMC Psychiatry 2021; 21:8. [PMID: 33413195 PMCID: PMC7789475 DOI: 10.1186/s12888-020-02991-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/26/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although cultural factors play a crucial role in experience of stigma, there is scant review on the impact and importance of culture on stigma of mental illness across Pacific Rim Region. This study aims to investigate: 1) the cultural factors related to stigmatizing beliefs about mental illness in Pacific Rim region, and 2) culture-specific measures and interventions on stigma of mental illness. METHODS A systematic search of papers was conducted in the MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, Cochrane Library and Google scholar through January 2003 to April 2019. RESULTS Forty-one studies in Pacific Rim region which met the inclusion criteria were included in the study. The rate of stigma of mental illness (e.g., public stigma: from 25.4 to 85.2%) was relatively high in Pacific Rim region. Culture factors (e.g., Collectivism, Confucianism, face concern and familism, religion and supernatural beliefs) contributed to people's stigmatizing behaviors and attitudes toward persons with mental illness, their relatives and mental health professionals. Certain measurements were developed and employed to assess different type of cultural factors related to stigma of mental illness. CONCLUSIONS Cultural factors play an important role in influencing the rate and performance of stigma of mental illness. Further research on stigma of mental illness and culture-specific interventions to reduce the stigma should be conducted in the Pacific Rim region.
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Affiliation(s)
- Mao-Sheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China.
| | - Brian J. Hall
- Department of Psychology, The University of Macau, Macau SAR, China
| | - Tin Tin Su
- grid.440425.3South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Selangor DE, Malaysia
| | - Benny Prawira
- Into The Light Indonesia Suicide Prevention Community for Advocacy, Research and Education, Jakarta, Indonesia
| | - Matilde Breth-Petersen
- grid.1013.30000 0004 1936 834XSydney School of Public Health, University of Sydney, Sydney, Australia
| | - Xu-Hong Li
- grid.194645.b0000000121742757Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Tian-Ming Zhang
- grid.194645.b0000000121742757Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
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38
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Zheng YB, Sun J, Liu L, Zhao YM, Yan W, Yuan K, Su SZ, Lu ZA, Huang YT, Liu L, Zeng N, Zhu XM, Gong YM, Lin X, Meng SQ, Wong SYS, Ran MS, Shi J, Shi L, Kosten T, Bao YP, Lu L. COVID-19 Vaccine-Related Psychological Stress Among General Public in China. Front Psychiatry 2021; 12:774504. [PMID: 34950070 PMCID: PMC8689133 DOI: 10.3389/fpsyt.2021.774504] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic is our generation's greatest global challenge to our public health system. Vaccines are considered one of the most effective tools available for preventing COVID-19 infection and its complications and sequelae. Understanding and addressing the psychological stress related to COVID-19 vaccination may promote acceptance of these vaccines. Methods: We conducted an online survey from January 29 to April 26, 2021 to explore stress levels related to COVID-19 vaccination among the general public in China. Participants were asked to evaluate their psychological stress of considering whether or not to get vaccinated at the beginning period of the COVID-19 mass vaccination, after getting access to the information about the vaccine, as well as after getting vaccinated, using visual analog stress scale. Multiple linear regression analysis was performed to explore factors potentially associated with COVID-19-related psychological stress levels before and after getting vaccinated. Results: A total of 34,041 participants were included in the final analysis. The mean stress score concerning COVID-19 vaccination was 3.90 ± 2.60 among all participants, and significantly decreased over time. In addition, the vaccine-related stress level significantly decreased after accessing information about the COVID-19 vaccine (N = 29,396), as well as after getting vaccinated (N = 5,103). Multivariable regression analysis showed higher stress levels related to COVID-19 vaccination in participants who were younger, having lower education level, having history of chronic diseases, mistrusting vaccine's efficacy, experience of vaccine allergy events, being affected by the COVID-19 epidemic, and having mental illness symptoms. Moreover, mistrust in vaccine efficacy and experience of vaccine allergy events had a long-term impact on psychological stress levels about COVID-19 vaccination even after getting vaccinated. Conclusions: The current findings profiled the COVID-19 vaccine-related psychological stress among the general public in China. Population-specific management and interventions targeting the stress related to COVID-19 vaccination are needed to help governments and policy makers promote individual's willingness to get vaccinations for public well-being during the COVID-19 pandemic.
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Affiliation(s)
- Yong-Bo Zheng
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.,Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Jie Sun
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.,Pain Medicine Center, Peking University Third Hospital, Beijing, China
| | - Lin Liu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Yi-Miao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Wei Yan
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Kai Yuan
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Si-Zhen Su
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Zheng-An Lu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Yue-Tong Huang
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China.,Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xi-Mei Zhu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Yi-Miao Gong
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Xiao Lin
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Shi-Qiu Meng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jie Shi
- Pain Medicine Center, Peking University Third Hospital, Beijing, China
| | - Le Shi
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Thomas Kosten
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States.,Department of Pharmacology, Baylor College of Medicine, Houston, TX, United States.,Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States.,Department of Immunology, Baylor College of Medicine, Houston, TX, United States
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Lin Lu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.,Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.,National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
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39
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Yuan K, Gong YM, Liu L, Sun YK, Tian SS, Wang YJ, Zhong Y, Zhang AY, Su SZ, Liu XX, Zhang YX, Lin X, Shi L, Yan W, Fazel S, Vitiello MV, Bryant RA, Zhou XY, Ran MS, Bao YP, Shi J, Lu L. Prevalence of posttraumatic stress disorder after infectious disease pandemics in the twenty-first century, including COVID-19: a meta-analysis and systematic review. Mol Psychiatry 2021; 26:4982-4998. [PMID: 33542468 PMCID: PMC7861006 DOI: 10.1038/s41380-021-01036-x] [Citation(s) in RCA: 141] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/10/2021] [Accepted: 01/20/2021] [Indexed: 02/06/2023]
Abstract
Pandemics have become more frequent and more complex during the twenty-first century. Posttraumatic stress disorder (PTSD) following pandemics is a significant public health concern. We sought to provide a reliable estimate of the worldwide prevalence of PTSD after large-scale pandemics as well as associated risk factors, by a systematic review and meta-analysis. We systematically searched the MedLine, Embase, PsycINFO, Web of Science, CNKI, WanFang, medRxiv, and bioRxiv databases to identify studies that were published from the inception up to August 23, 2020, and reported the prevalence of PTSD after pandemics including sudden acute respiratory syndrome (SARS), H1N1, Poliomyelitis, Ebola, Zika, Nipah, Middle Eastern respiratory syndrome coronavirus (MERS-CoV), H5N1, and coronavirus disease 2019 (COVID-19). A total of 88 studies were included in the analysis, with 77 having prevalence information and 70 having risk factors information. The overall pooled prevalence of post-pandemic PTSD across all populations was 22.6% (95% confidence interval (CI): 19.9-25.4%, I2: 99.7%). Healthcare workers had the highest prevalence of PTSD (26.9%; 95% CI: 20.3-33.6%), followed by infected cases (23.8%: 16.6-31.0%), and the general public (19.3%: 15.3-23.2%). However, the heterogeneity of study findings indicates that results should be interpreted cautiously. Risk factors including individual, family, and societal factors, pandemic-related factors, and specific factors in healthcare workers and patients for post-pandemic PTSD were summarized and discussed in this systematic review. Long-term monitoring and early interventions should be implemented to improve post-pandemic mental health and long-term recovery.
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Affiliation(s)
- Kai Yuan
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Yi-Miao Gong
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Lin Liu
- grid.11135.370000 0001 2256 9319National Institute on Drug Dependence, Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319School of Public Health, Peking University, Beijing, China
| | - Yan-Kun Sun
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Shan-Shan Tian
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Yi-Jie Wang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Yi Zhong
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - An-Yi Zhang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Si-Zhen Su
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Xiao-Xing Liu
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yu-Xin Zhang
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Xiao Lin
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China ,grid.11135.370000 0001 2256 9319Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Le Shi
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Wei Yan
- grid.11135.370000 0001 2256 9319Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China
| | - Seena Fazel
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - Michael V. Vitiello
- grid.34477.330000000122986657Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | - Richard A. Bryant
- grid.1005.40000 0004 4902 0432School of Psychology, University of New South Wales, Sydney, NSW Australia
| | - Xin-Yu Zhou
- grid.452206.70000 0004 1758 417XDepartment of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China ,grid.203458.80000 0000 8653 0555Institute of Neuroscience and Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Mao-Sheng Ran
- grid.194645.b0000000121742757Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence, Peking University, Beijing, China. .,School of Public Health, Peking University, Beijing, China.
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No.2018RU006), Peking University, Beijing, China. .,Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.
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40
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Yu YH, Peng MM, Bai X, Luo W, Yang X, Li J, Liu B, Thornicroft G, Chan CLW, Ran MS. Schizophrenia, social support, caregiving burden and household poverty in rural China. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1571-1580. [PMID: 32200431 DOI: 10.1007/s00127-020-01864-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 04/21/2019] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Household poverty associated with schizophrenia has been long described. However, the mechanisms by which schizophrenia may have influenced the economic status of a household in rural communities are still unclear. This study aimed to test an integrated model of schizophrenia, social support and caregiving burden on household poverty in a rural community in China. METHODS A mental health survey using identical methods and ICD-10 was conducted in six townships of Xinjin County (population ≥ 15 years old, n = 152,776), Chengdu, China in 2015. Identified persons with schizophrenia (n = 661) and their caregivers completed a joint questionnaire of sociodemographic information, illness conditions, social support and caregiving burden. Descriptive analysis was applied first to give an overview of the dataset. Then, multivariable regression analyses were conducted to examine the associative factors of social support, caregiving burden and household income. Then, structural equation modeling (SEM) was used to estimate the integrated model of schizophrenia, social support, caregiving burden and household income. RESULTS Households with patient being female, married, able to work and having better social function were better off. Larger household size, higher social support and lower caregiving burden also had salient association with higher household income. The relationship between schizophrenia and household poverty appeared to be mediated by the impacts of schizophrenia on social support and caregiving burden. CONCLUSION There was a strong association between schizophrenia and household poverty, in which social support and caregiving burden may had played significant roles on mediating it. More precise poverty alleviation policies and interventions should focus on supporting recovery for persons with schizophrenia, as well as on increasing social support and on reducing family caregiving burden.
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Affiliation(s)
- Yue-Hui Yu
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Man-Man Peng
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Xue Bai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wei Luo
- Xinjin Second People's Hospital, Xinjin, 611432, Chengdu, China
| | - Xin Yang
- Guangyuan Mental Health Center, Guangyuan, 628000, China
| | - Jun Li
- Sichuan Veteran Hospital, Yuantong, Sichuan, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, 434000, Hubei, China
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Cecilia Lai Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
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41
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Yue JL, Yan W, Sun YK, Yuan K, Su SZ, Han Y, Ravindran AV, Kosten T, Everall I, Davey CG, Bullmore E, Kawakami N, Barbui C, Thornicroft G, Lund C, Lin X, Liu L, Shi L, Shi J, Ran MS, Bao YP, Lu L. Mental health services for infectious disease outbreaks including COVID-19: a rapid systematic review. Psychol Med 2020; 50:2498-2513. [PMID: 33148347 PMCID: PMC7642960 DOI: 10.1017/s0033291720003888] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/05/2020] [Accepted: 09/28/2020] [Indexed: 12/27/2022]
Abstract
The upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Culturally-adapted, cost-effective, and accessible strategies integrated into the public health emergency response and established medical systems at the local and national levels are likely to be an effective option to enhance mental health response capacity for the current and for future infectious disease outbreaks. Tele-mental healthcare services were key central components of stepped care for both infectious disease outbreak management and routine support; however, the usefulness and limitations of remote health delivery should also be recognized.
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Affiliation(s)
- Jing-Li Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yan-Kun Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Si-Zhen Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ying Han
- National Institute on Drug Dependence, Peking University, Beijing, China
| | | | - Thomas Kosten
- Division of Alcohol and Addiction Psychiatry, Baylor College of Medicine, Houston, Texas, USA
| | - Ian Everall
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christopher G Davey
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Edward Bullmore
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Research and Development, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Crick Lund
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Xiao Lin
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Lin Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
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Ran MS, Xiao Y, Fazel S, Lee Y, Luo W, Hu SH, Yang X, Liu B, Brink M, Chan SKW, Chen EYH, Chan CLW. Mortality and suicide in schizophrenia: 21-year follow-up in rural China. BJPsych Open 2020; 6:e121. [PMID: 33054894 PMCID: PMC7576648 DOI: 10.1192/bjo.2020.106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Little is known about the trend and predictors of 21-year mortality and suicide patterns in persons with schizophrenia. AIMS To explore the trend and predictors of 21-year mortality and suicide in persons with schizophrenia in rural China. METHOD This longitudinal follow-up study included 510 persons with schizophrenia who were identified in a mental health survey of individuals (≥15 years old) in 1994 in six townships of Xinjin County, Chengdu, China, and followed up in three waves until 2015. Kaplan-Meier survival analysis and Cox hazard regressions were conducted. RESULTS Of the 510 participants, 196 died (38.4% mortality) between 1994 and 2015; 13.8% of the deaths (n = 27) were due to suicide. Life expectancy was lower for men than for women (50.6 v. 58.5 years). Males consistently showed higher rates of mortality and suicide than females. Older participants had higher mortality (hazard ratio HR = 1.03, 95% CI 1.01-1.05) but lower suicide rates (HR = 0.95, 95% CI 0.93-0.98) than their younger counterparts. Poor family attitudes were associated with all-cause mortality and death due to other causes; no previous hospital admission and a history of suicide attempts independently predicted death by suicide. CONCLUSIONS Our findings suggest there is a high mortality and suicide rate in persons with schizophrenia in rural China, with different predictive factors for mortality and suicide. It is important to develop culture-specific, demographically tailored and community-based mental healthcare and to strengthen family intervention to improve the long-term outcome of persons with schizophrenia.
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Affiliation(s)
- Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, China
| | - Yunyu Xiao
- School of Social Work, Indiana University-Bloomington and IUPUI, Indianapolis, USA
| | - Seena Fazel
- Department of Psychiatry, Warneford Hospital, University of Oxford, UK
| | - Yeonjin Lee
- Department of Social Work and Social Administration, University of Hong Kong, China
| | - Wei Luo
- Xinjin Second People's Hospital, Chengdu, China
| | | | - Xin Yang
- Guangyuan Mental Health Center, China
| | - Bo Liu
- Jingzhou Mental Health Center, China
| | - Maria Brink
- Department of Psychiatry, University of Rochester Medical Center, New York, USA
| | | | | | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, China
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Abstract
BACKGROUND Little is known about poverty trends in people with severe mental illness (SMI) over a long time span, especially under conditions of fast socioeconomic development. AIMS This study aims to unravel changes in household poverty levels among people with SMI in a fast-changing rural community in China. METHOD Two mental health surveys, using ICD-10, were conducted in the same six townships of Xinjin county, Chengdu, China. A total of 711 and 1042 people with SMI identified in 1994 and 2015, respectively, participated in the study. The Foster-Greer-Thorbecke poverty index was adopted to measure the changes in household poverty. These changes were decomposed into effects of growth and equity using a static decomposition method. Factors associated with household poverty in 1994 and 2015 were examined and compared by regression analyses. RESULTS The proportion of poor households, as measured by the headcount ratio, increased significantly from 29.8% in 1994 to 39.5% in 2015. Decomposition showed that poverty in households containing people with SMI had worsened because of a redistribution effect. Factors associated with household poverty had also changed during the study period. The patient's age, ability to work and family size were of paramount significance in 2015. CONCLUSIONS This study shows that the levels of poverty faced by households containing people with SMI has become more pressing with China's fast socioeconomic development. It calls for further integration of mental health recovery and targeted antipoverty interventions for people with SMI as a development priority.
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Affiliation(s)
- Yue-Hui Yu
- School of Public Administration and Policy, Renmin University of China, China
| | - Wei Luo
- Xinjin Second People's Hospital, China
| | | | - Xin Yang
- Guangyuan Mental health Center, China
| | - Bo Liu
- Jingzhou Mental Health Center, China
| | - Yu Guo
- School of Labor and Human Resources, Renmin University of China, China
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Cecilia Lai Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
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Shi L, Lu ZA, Que JY, Huang XL, Liu L, Ran MS, Gong YM, Yuan K, Yan W, Sun YK, Shi J, Bao YP, Lu L. Prevalence of and Risk Factors Associated With Mental Health Symptoms Among the General Population in China During the Coronavirus Disease 2019 Pandemic. JAMA Netw Open 2020; 3:e2014053. [PMID: 32609353 PMCID: PMC7330717 DOI: 10.1001/jamanetworkopen.2020.14053] [Citation(s) in RCA: 477] [Impact Index Per Article: 119.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE People exposed to coronavirus disease 2019 (COVID-19) and a series of imperative containment measures could be psychologically stressed, yet the burden of and factors associated with mental health symptoms remain unclear. OBJECTIVE To investigate the prevalence of and risk factors associated with mental health symptoms in the general population in China during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS This large-sample, cross-sectional, population-based, online survey study was conducted from February 28, 2020, to March 11, 2020. It involved all 34 province-level regions in China and included participants aged 18 years and older. Data analysis was performed from March to May 2020. MAIN OUTCOMES AND MEASURES The prevalence of symptoms of depression, anxiety, insomnia, and acute stress among the general population in China during the COVID-19 pandemic was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Insomnia Severity Index, and Acute Stress Disorder Scale. Logistic regression analyses were used to explore demographic and COVID-19-related risk factors. RESULTS Of 71 227 individuals who clicked on the survey link, 56 932 submitted the questionnaires, for a participation rate of 79.9%. After excluding the invalid questionnaires, 56 679 participants (mean [SD] age, 35.97 [8.22] years; 27 149 men [47.9%]) were included in the study; 39 468 respondents (69.6%) were aged 18 to 39 years. During the COVID-19 pandemic, the rates of mental health symptoms among the survey respondents were 27.9% (95% CI, 27.5%-28.2%) for depression, 31.6% (95% CI, 31.2%-32.0%) for anxiety, 29.2% (95% CI, 28.8%-29.6%) for insomnia, and 24.4% (95% CI, 24.0%-24.7%) for acute stress. Participants with confirmed or suspected COVID-19 and their family members or friends had a high risk for symptoms of depression (adjusted odds ratios [ORs], 3.27 [95% CI, 1.84-5.80] for patients; 1.53 [95% CI, 1.26-1.85] for family or friends), anxiety (adjusted ORs, 2.48 [95% CI, 1.43-4.31] for patients; 1.53 [95% CI, 1.27-1.84] for family or friends), insomnia (adjusted ORs, 3.06 [95% CI, 1.73-5.43] for patients; 1.62 [95% CI, 1.35-1.96] for family or friends), and acute stress (adjusted ORs, 3.50 [95% CI, 2.02-6.07] for patients; 1.77 [95% CI, 1.46-2.15] for family or friends). Moreover, people with occupational exposure risks and residents in Hubei province had increased odds of symptoms of depression (adjusted ORs, 1.96 [95% CI, 1.77-2.17] for occupational exposure; 1.42 [95% CI, 1.19-1.68] for Hubei residence), anxiety (adjusted ORs, 1.93 [95% CI, 1.75-2.13] for occupational exposure; 1.54 [95% CI, 1.30-1.82] for Hubei residence), insomnia (adjusted ORs, 1.60 [95% CI, 1.45-1.77] for occupational exposure; 1.20 [95% CI, 1.01-1.42] for Hubei residence), and acute stress (adjusted ORs, 1.98 [95% CI, 1.79-2.20] for occupational exposure; 1.49 [95% CI, 1.25-1.79] for Hubei residence). Both centralized quarantine (adjusted ORs, 1.33 [95% CI, 1.10-1.61] for depression; 1.46 [95% CI, 1.22-1.75] for anxiety; 1.63 [95% CI, 1.36-1.95] for insomnia; 1.46 [95% CI, 1.21-1.77] for acute stress) and home quarantine (adjusted ORs, 1.30 [95% CI, 1.25-1.36] for depression; 1.28 [95% CI, 1.23-1.34] for anxiety; 1.24 [95% CI, 1.19-1.30] for insomnia; 1.29 [95% CI, 1.24-1.35] for acute stress) were associated with the 4 negative mental health outcomes. Being at work was associated with lower risks of depression (adjusted OR, 0.85 [95% CI, 0.79-0.91]), anxiety (adjusted OR, 0.92 [95% CI, 0.86-0.99]), and insomnia (adjusted OR, 0.87 [95% CI, 0.81-0.94]). CONCLUSIONS AND RELEVANCE The results of this survey indicate that mental health symptoms may have been common during the COVID-19 outbreak among the general population in China, especially among infected individuals, people with suspected infection, and people who might have contact with patients with COVID-19. Some measures, such as quarantine and delays in returning to work, were also associated with mental health among the public. These findings identify populations at risk for mental health problems during the COVID-19 pandemic and may help in implementing mental health intervention policies in other countries and regions.
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Affiliation(s)
- Le Shi
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Zheng-An Lu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Jian-Yu Que
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Xiao-Lin Huang
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Peking University School of Public Health, Peking University, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yi-Miao Gong
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG, McGovern Institute for Brain Research, Beijing, China
| | - Kai Yuan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Wei Yan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Yan-Kun Sun
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Peking University School of Public Health, Peking University, Beijing, China
| | - Lin Lu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG, McGovern Institute for Brain Research, Beijing, China
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Peng MM, Chen HL, Zhang T, Yao YY, Li ZH, Long L, Duan QQ, Lin FR, Zen Y, Chen J, Ng SM, Chan CLW, Ran MS. Disease-related stressors of caregiving burden among different types of family caregivers of persons with schizophrenia in rural China. Int J Soc Psychiatry 2019; 65:603-614. [PMID: 31387428 DOI: 10.1177/0020764019866224] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Little is known about the impacts of schizophrenia on different types of caregiving burden. AIM This study aims to examine how the severity of schizophrenia, social functioning and aggressive behavior are associated with caregiving burden across different kinship types. METHOD The analytic sample included 300 dyads of persons with schizophrenia and their family caregivers in Xinjin, Chengdu, China. The 10th edition of the International Classification of Diseases (ICD-10) was utilized to identify the patients, whose symptom severity, social functioning and aggressive behavior were measured. Caregiving burden was estimated using the Burden Scale for Family Caregivers-short (BSFC-s). RESULTS A higher level of burden was significantly associated with female caregivers, larger family size, lower income, worse symptoms, poorer functional status and more aggressive behaviors. Parent caregivers showed greater burden if the patients had better functioning of social interest and concern or more aggression toward property. Mother caregivers showed greater burden than fathers. Spouses tended to perceive greater burden if the patients had better marital functioning, poorer occupational functioning or more aggressive behaviors toward property. Patients attacking others or a father with schizophrenia was related to a higher burden of child caregivers. A heavier burden of other relatives was correlated with patients' more verbal aggression and self-harm. CONCLUSION This study shows the distinct impacts of disease-related factors on the caregiving burden across different kinship types. Our findings have implications for health-care professionals and practitioners in terms of developing more targeted family-based or individualized intervention to ameliorate burden according to kinship types and deal with behavioral and functional problems in schizophrenia.
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Affiliation(s)
- Man-Man Peng
- 1 Department of Social Work & Social Administration, University of Hong Kong, Hong Kong
| | - Hong-Lin Chen
- 2 Department of Social Work, Fudan University, Shanghai, China
| | - Tin Zhang
- 3 Santai Mental Health Center, Sichuan, China
| | | | - Zi-Han Li
- 3 Santai Mental Health Center, Sichuan, China
| | - Lan Long
- 4 Sichuan College of Traditional Chinese Medicine, Mianyang, China
| | - Qing-Qing Duan
- 4 Sichuan College of Traditional Chinese Medicine, Mianyang, China
| | - Fu-Rong Lin
- 5 Xinjin Second People's Hospital, Chengdu, China
| | - Ya Zen
- 5 Xinjin Second People's Hospital, Chengdu, China
| | - Jia Chen
- 6 Panzhihua Third People's Hospital, Panzhihua, China
| | - Siu-Man Ng
- 1 Department of Social Work & Social Administration, University of Hong Kong, Hong Kong
| | - Cecilia Lai-Wan Chan
- 1 Department of Social Work & Social Administration, University of Hong Kong, Hong Kong
| | - Mao-Sheng Ran
- 1 Department of Social Work & Social Administration, University of Hong Kong, Hong Kong
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Peng MM, Zhang TM, Liu KZ, Gong K, Huang CH, Dai GZ, Hu SH, Lin FR, Chan SKW, Ng S, Ran MS. Perception of social support and psychotic symptoms among persons with schizophrenia: A strategy to lessen caregiver burden. Int J Soc Psychiatry 2019; 65:548-557. [PMID: 31359844 DOI: 10.1177/0020764019866230] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Improving patients' perception of social support is significant not only for their re-adaptation to life but also for alleviating caregivers' burden. AIM This study aims to examine an integrated model regarding social support, psychotic symptoms and caregiver burden. METHODS Persons with schizophrenia (N1 = 300) and their family caregivers (N2 = 300) in Xinjin County, Chengdu, China, completed the survey to report their demographics, patients' perception of social support (Duke Social Support Index), psychotic symptoms (Positive and Negative Syndrome Scale) and caregiver burden (Burden Scale for Family Caregivers, Short Version). Structural equation modelling was utilised to test the proposed model. RESULTS The degree of caregiver burden differed significantly within subgroups of patients' gender and education, as well as caregivers' gender, education and employment. Caregiver burden was negatively related to patients' age and household income. Social interaction partially mediated the relationship between instrumental and subjective social support (total effect = 0.451, p < .01). Subjective social support fully mediated the impact of social interaction on psychotic symptoms (total effect = -0.099, p < .05). In the final model, instrumental social support was positively associated with social interaction (p < .001) and increased subjective social support (p < .05). Increased subjective social support showed correlation with a lower degree of psychotic symptoms (p < .01), which was related to a lower level of caregiver burden (p < .001). CONCLUSION This study shows the associations of patients' social support with psychotic symptoms and caregiver burden. Culture-specific psychosocial interventions should be provided for both patients and caregivers to enrich external support and reduce psychotic symptoms and caregivers' burden within the health care environment.
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Affiliation(s)
- Man-Man Peng
- 1 Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tian-Ming Zhang
- 1 Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ke-Zhi Liu
- 2 Mental Health Center, Southwest Medical University, Luzhou, China
| | - Ke Gong
- 2 Mental Health Center, Southwest Medical University, Luzhou, China
| | - Chao-Hua Huang
- 2 Mental Health Center, Southwest Medical University, Luzhou, China
| | | | - Shi-Hui Hu
- 3 Chengdu Mental Health Center, Chengdu, China
| | - Fu-Rong Lin
- 4 Xinjin Second People's Hospital, Chengdu, China
| | - Sherry Kit Wa Chan
- 5 Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Siuman Ng
- 1 Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Mao-Sheng Ran
- 1 Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
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Chen HL, Xiao Y, Liu YJ, Zhang TM, Luo W, Zeng Y, Hu SH, Yang HJ, Yang X, Liu B, Xu MJ, Chan CLW, Conwell Y, Ran MS. Treatment Status of Elderly Patients With Severe Mental Disorders in Rural China. J Geriatr Psychiatry Neurol 2019; 32:291-297. [PMID: 31480980 DOI: 10.1177/0891988719862622] [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] [Indexed: 11/17/2022]
Abstract
This study was performed to compare the treatment status between older (≥65 years) and younger adults (18-64 years) with severe mental illness (SMI) and explore factors associated with treatment status in rural China. Persons with SMI were identified in one mental health survey in 2015 in 6 townships of Xinjin County, Chengdu, China. Logistic regressions were conducted to explore factors associated with treatment status. Older adults with SMI, especially major depressive disorder, reported significantly lower rates of treatment than younger group. Older age, longer duration of illness, and poor mental status were risk factors for never-treated status in these patients. Never-treated status (46.3%) and poor treatment status in these older patients are serious issues. Different treatment statuses in these patients had various influencing factors. It is crucial to develop culture-specific, community-based mental health services to improve early identification, diagnosis, treatment, and recovery of older adults with SMI in rural China.
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Affiliation(s)
- Hong-Lin Chen
- 1 Department of Social Work, Fudan University, Shanghai, China
| | - Yunyu Xiao
- 2 Silver School of Social Work, New York University, New York, NY, USA
| | - Yu-Jun Liu
- 3 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Tian-Ming Zhang
- 3 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Wei Luo
- 4 Xinjin Second People's Hospital, Xinjin, Chengdu, China
| | - Ya Zeng
- 4 Xinjin Second People's Hospital, Xinjin, Chengdu, China
| | - Shi-Hui Hu
- 5 Chengdu Mental Health Center, Chengdu, China
| | | | - Xin Yang
- 6 Guangyuan Mental Health Center, Guangyuan, China
| | - Bo Liu
- 7 Jingzhou Mental Health Center, Jingzhou, Hubei, China
| | - Mei-Jun Xu
- 7 Jingzhou Mental Health Center, Jingzhou, Hubei, China
| | - Cecilia Lai-Wan Chan
- 3 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yeates Conwell
- 8 Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Mao-Sheng Ran
- 3 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
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Zhang TM, Wong IYL, Yu YH, Ni SG, He XS, Bacon-Shone J, Gong K, Huang CH, Hu Y, Tang MM, Cao W, Chan CLW, Ran MS. An integrative model of internalized stigma and recovery-related outcomes among people diagnosed with schizophrenia in rural China. Soc Psychiatry Psychiatr Epidemiol 2019; 54:911-918. [PMID: 30569395 DOI: 10.1007/s00127-018-1646-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 04/26/2018] [Accepted: 12/04/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Internalized stigma, an adverse psychological process, severely impedes the lives of people diagnosed with schizophrenia and restricts them from social integration and recovery. The aim of this study was to empirically evaluate an integrative model of relationship between internalized stigma and patients' recovery-related outcomes among people diagnosed with schizophrenia in a rural Chinese community. METHOD A total of 232 people diagnosed with schizophrenia in Xinjin, Chengdu, participated in this study and completed measures of internalized stigma, social interaction, perceived social support, social functioning, and symptoms. The internalized stigma of mental illness scale (ISMI) was used to measure the internalized stigma. Path analysis was used to test the association between internalized stigma and recovery-related outcomes. RESULTS There were no significant differences in mean scores of ISMI by gender, age (18-64 years and ≥ 65 years), education, marital status, or economic capacity. Internalized stigma was negatively associated with perceived social support and social interaction. Furthermore, higher level of internalized stigma was associated with impaired social functioning, and a lower level of social functioning was significantly associated with more severe symptoms. CONCLUSION Internalized stigma is associated with poor social interaction and weakened perceived social support in people diagnosed with schizophrenia, and is linked negatively to outcomes in their recovery. It is essential to tailor interventions related to reducing internalized stigma within a Chinese context and evaluate the effectiveness of anti-stigma intervention on recovery for people diagnosed with schizophrenia.
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Affiliation(s)
- Tian-Ming Zhang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Irene Yin-Ling Wong
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Yue-Hui Yu
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Shi-Guang Ni
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Xue-Song He
- School of Society and Public Administration, East China University of Science and Technology, Shanghai, China
| | - John Bacon-Shone
- Social Sciences Research Centre, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Ke Gong
- Department of Psychiatry, Southwest Medical University, Sichuan, China
| | - Chao-Hua Huang
- Department of Psychiatry, Southwest Medical University, Sichuan, China
| | - Yan Hu
- Sichuan Veterans Hospital, Sichuan, China
| | | | - Wan Cao
- Chongqing Medical University, Chongqing, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
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Ran MS, Weng X, Liu YJ, Zhang TM, Yu YH, Peng MM, Luo W, Hu SH, Yang X, Liu B, Zhang T, Thornicroft G, Chan CLW, Xiang MZ. Changes in treatment status of patients with severe mental illness in rural China, 1994-2015. BJPsych Open 2019; 5:e31. [PMID: 31068242 PMCID: PMC6469230 DOI: 10.1192/bjo.2019.13] [Citation(s) in RCA: 18] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although it is crucial to improve the treatment status of people with severe mental illness (SMI), it is still unknown whether and how socioeconomic development influences their treatment status.AimsTo explore the change in treatment status in people with SMI from 1994 to 2015 in rural China and to examine the factors influencing treatment status in those with SMI. METHOD Two mental health surveys using identical methods and ICD-10 were conducted in 1994 and 2015 (population ≥15 years old, n = 152 776) in the same six townships of Xinjin County, Chengdu, China. RESULTS Compared with 1994, individuals with SMI in 2015 had significantly higher rates of poor family economic status, fewer family caregivers, longer duration of illness, later age at first onset and poor mental status. Participants in 2015 had significantly higher rates of never being treated, taking antipsychotic drugs and ever being admitted to hospital, and lower rates of using traditional Chinese medicine or being treated by traditional/spiritual healers. The factors strongly associated with never being treated included worse mental status (symptoms/social functioning), older age, having no family caregivers and poor family economic status. CONCLUSIONS Socioeconomic development influences the treatment status of people with SMI in contemporary rural China. Relative poverty, having no family caregivers and older age are important factors associated with a worse treatment status. Culture-specific, community-based interventions and targeted poverty-alleviation programmes should be developed to improve the early identification, treatment and recovery of individuals with SMI in rural China.Declaration of interestNone.
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Affiliation(s)
- Mao-Sheng Ran
- Associate Professor,Department of Social Work and Social Administration,University of Hong Kong,China
| | - Xue Weng
- Researcher,Department of Social Work and Social Administration,University of Hong Kong,China
| | - Yu-Jun Liu
- Researcher,Department of Social Work and Social Administration,University of Hong Kong,China
| | - Tian-Ming Zhang
- Researcher,Department of Social Work and Social Administration,University of Hong Kong,China
| | - Yue-Hui Yu
- Researcher,Department of Social Work and Social Administration,University of Hong Kong,China
| | - Man-Man Peng
- Researcher,Department of Social Work and Social Administration,University of Hong Kong,China
| | - Wei Luo
- Doctor,Xinjin Mental Hospital,China
| | - Shi-Hui Hu
- Doctor,Chengdu Mental Health Center,China
| | - Xin Yang
- Doctor,Guangyuan Mental Health Center,China
| | - Bo Liu
- Professor,Jingzhou Mental Health Center,China
| | - Tin Zhang
- Doctor,Santai Mental Health Center,China
| | - Graham Thornicroft
- Professor,Centre for Global Mental Health,Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK
| | - Cecilia Lai-Wan Chan
- Professor,Department of Social Work and Social Administration,University of Hong Kong,China
| | - Meng-Ze Xiang
- Professor,Department of Psychiatry,West China Hospital, Sichuan University,China
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50
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Ran MS, Xiao Y, Chui CHK, Hu XZ, Yu YH, Peng MM, Mao WJ, Liu B, Chen Eric YH, Chan CLW. Duration of untreated psychosis (DUP) and outcome of people with schizophrenia in rural China: 14-year follow-up study. Psychiatry Res 2018; 267:340-345. [PMID: 29957551 DOI: 10.1016/j.psychres.2018.06.043] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 12/12/2017] [Revised: 06/14/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022]
Abstract
This study aims to examine the relationship between the duration of untreated psychosis (DUP) and 14-year outcomes of schizophrenia in a Chinese rural area. Participants with schizophrenia (n = 510) were identified in an epidemiological investigation of 123 572 people aged 15 years and older in 1994 and followed up in 2008 in Xinjin, Chengdu, China. Longer DUP (>6 months) was common in participants (27.3%). In 1994, participants with DUP ≤ 6 months were more likely to have a significantly lower rate of suicide attempts, shorter duration of illness and higher rate of full remission compared with those with DUP > 6 months. No significant differences were found regarding the rates of survival, suicide, death due to other causes and homelessness between individuals with shorter and longer DUP in 2008. Nevertheless, longer DUP (>6 months) of participants in 2008 was significantly associated with higher mean of PANSS total negative and general mental scores, longer duration of illness and higher rate of live alone in the logistic regression model. Earlier identification, treatment and rehabilitation, and family intervention should be addressed when developing mental health policies and delivering community mental health services.
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Affiliation(s)
- Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China.
| | - Yunyu Xiao
- Silver School of Social Work, New York University, New York, United States
| | - Cheryl H K Chui
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
| | - Xian-Zhang Hu
- Institute of Psychiatry and Neuroscience, Xinxiang Medical University, Henan 453002, China
| | - Yue-Hui Yu
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Man-Man Peng
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Wen-Jun Mao
- Chengdu Mental Health Center, Chengdu 610036, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China
| | - Yu-Hai Chen Eric
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China.
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