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    Cumulative lifetime violence severity, social determinants and anxiety in a national sample of Canadian men. BMC psychiatry BACKGROUND:Despite anxiety disorders being the ninth leading cause of disability and associated with social inequities, little attention has been given to how intersections among social determinants of health and chronic stressors such as cumulative lifetime violence affect the likelihood of experiencing anxiety disorders. Our purpose was to explore the relationships among cumulative lifetime violence severity as target and perpetrator, social determinants of health and generalized anxiety disorder in Canadian men. METHODS:Using a community sample of 592 Canadian men who self-identified as having experienced violence, we developed and tested an evidence-based model of generalized anxiety disorder including indicators of cumulative lifetime violence, gender, social location, socio-economic disparity, personal resources and other chronic stressors using logistic regression. RESULTS:Most men (76.4%, n = 452) reported experiences as both target and perpetrator. The model accounted for 50.8% of the variance in anxiety severity χ (8) = 264.43, p = .000). The prevalence of probable generalized anxiety disorder was 30.9%, a rate higher than that found among Canadian men in general in the same period. Remarkably, the likelihood of generalized anxiety disorder increased by a factor of 5.30 for each increase of 1 in cumulative lifetime violence severity, and six-fold for feeling overwhelmed by demands of everyday life (aOR = 6.26). Masculine discrepancy stress, having been born in Canada, unemployment, and food insecurity also contributed significantly to increasing the likelihood of generalized anxiety disorder. Both social support and mastery had significant aORs < 1, suggesting possible protective effects. Together these findings delineate characteristics and social determinants that may heighten vulnerability to generalized anxiety disorder and influence its progression among men who have experienced lifetime violence. CONCLUSIONS:These findings are the first evidence that Canadian men with lifetime violence histories are a sub-group disproportionately affected by chronic stressors and socio-economic disparities and that together the presence and/or severity of these factors increases their vulnerability to generalized anxiety disorder. Our results highlight the importance of strengths-based trauma- and violence-informed approaches to care, including practical resources to reduce the stress of everyday life, improve social support, and reinforce personal control and choice. 10.1186/s12888-022-03865-8
    The mediation and moderation effect of social support on the relationship between opioid misuse and suicide attempts among native American youth in New Mexico: 2009-2019 Youth Risk Resiliency Survey (NM-YRRS). BMC psychiatry BACKGROUND:Suicide attempt and opioid misuse continue to be major behavioral health challenges among American Indians and Alaska Natives (AI/AN). The aim of the study is to evaluate the mediating and moderating role that social support (SS) plays in their association among AI/AN high-school students in New Mexico (NM). METHODS:An aggregated NM Youth Resiliency and Risk Survey (NM-YRRS, 2009-2019: odd years) dataset was used. Multivariable logistic regression modeling and mediation analysis were conducted while adjusting for confounding variables. RESULTS:Overall, 12.0 and 14.0% of AI/AN students reported opioid misuse and suicide attempt, respectively. The adjusted odds ratio of suicide attempt in students with high SS relative to low SS who misused opioids was 0.43 (p-value = 0.007). The effect of high SS relative to low SS among males who misused opioids was more pronounced (AOR = 0.24, p-value < 0.0001) compared to females (AOR = 0.43, p-value = 0.007). Relative to low SS, high SS was protective for suicide attempt among AI/AN students who misused opioids and attended school in off-reservation (AOR = 0.42, p-value = 0.012) communities, rural communities (AOR = 0.44, p = 0.040), and in communities that are both rural and off-reservation (AOR = 0.39, p = 0.035). Overall, 23.64, and 41.05% of the association between opioid misuse, and suicide attempt was mediated and moderated by SS, respectively. The mediation effect of SS was lowest for rural, on-reservation schools. CONCLUSION:More resources need to be allocated to rural on-reservation schools to enhance social support. The study highlights key insights into the significant role SS plays in promoting health and mitigating the association between opioid misuse and suicide attempt. 10.1186/s12888-022-03900-8
    From emotional intelligence to suicidality: a mediation analysis in patients with borderline personality disorder. Khosravi Mohsen,Hassani Fahimeh BMC psychiatry BACKGROUND:Borderline personality disorder (BPD) is a serious mental illness with a high suicidality rate between 40 and 85%. However, little is known concerning psychosocial risk and protective factors associated with suicidal behaviors in this clinical group. The main focus of the present study was on examining the relationship of emotional intelligence (EI) with suicidal behaviors and its mediators (e.g., depression, self-esteem, addiction potential, and disorder severity) among patients with BPD. METHODS:In this cross-sectional study, a total of 220 participants (including 110 patients with BPD and 110 healthy controls) in Zahedan, Iran, were examined using clinical interviewing and self-report measures of EI, suicidal behaviors, depression, self-esteem, addiction potential, and BPD symptom severity. The data were analyzed using SPSS v25.0 software at the significance level of p < 0.05. RESULTS:Our preliminary analysis showed higher levels of EI, depression, and self-esteem in the BPD group in comparison to healthy controls (p < 0.001). Furthermore, our findings showed that higher levels of addiction potential, BPD symptom severity, and depression and lower levels of self-esteem and EI were likely to be related to suicidal behaviors of the BPD group. Our results also supported the overall hypothesis that addiction potential, depression, BPD symptom severity, and self-esteem had a mediating role in the impact of EI on suicidal behaviors in the BPD group. CONCLUSIONS:According to these findings, we have come to believe that training EI possibly plays a directly and/or indirectly potential preventive and therapeutic role in suicidal behaviors among patients with BPD. However, further longitudinal studies must be carried out to clarify the cause and effect relationship between EI, depression, self-esteem, addiction potential, BPD symptom severity, and suicidal behaviors. 10.1186/s12888-022-03891-6
    Determinants of never-treated status in rural versus urban contexts for individuals with schizophrenia in a population-based study in China. BMC psychiatry BACKGROUND:A goal of China's 2012 National Mental Health Law is to improve access to services and decrease urban versus rural disparities in services. However, pre-reform data is needed for objective evaluation of these reforms' effectiveness. Accordingly, this study compares the pre-reform utilization of medical services for the treatment of schizophrenia in rural and urban communities in China. METHODS:In a large community-based study in four provinces representing 12% of China's population conducted from 2001 to 2005, we identified 326 individuals with schizophrenia (78 never treated). Comparing those living in urban (n = 86) versus rural (n = 240) contexts, we used adjusted Poisson regression models to assess the relationship of 'never treated' status with family-level factors (marital status, family income, and number of co-resident family members) and illness severity factors (age of onset, symptom severity and functional impairment). RESULTS:Despite similar impairments due to symptoms, rural patients were less likely to have received intensive mental health services (i.e., use psychiatric inpatient services), and appeared more likely to be 'never treated' or to only have received outpatient care. Among rural patients, only having more than four co-resident family members was independently associated with 'never-treated' status (RR = 0.34; 95% CI, 0.12-0.94; p = 0.039). Among urban patients, only older age of onset was independently associated with 'never-treated' status (RR = 1.06; 95% CI 1.02-1.10, p = 0.003). CONCLUSIONS:Identifying differential drivers of service utilization in urban and rural communities is needed before implementing policies to improve the utilization and equity of services and to define metrics of program success. 10.1186/s12888-021-03651-y
    Social support and depressive symptoms: exploring stigma and self-efficacy in a moderated mediation model. BMC psychiatry BACKGROUND:Although some psychological processes, such as stigma and self-efficacy, affect the complicated relationship between social support and depressive symptoms, few studies explored a similar psychological mechanism among individuals with substance use disorders (SUDs). Hence, this research investigates the mediating effects of stigma and the moderating effects of self-efficacy among the psychological mechanism that social support affects depressive symptoms. METHODS:The study included 1040 Chinese participants with SUDs and completed a series of self-report questionnaires. R software was used to organize and clean up data sets and analyze mediation and moderation effects. RESULTS:The result showed that stigma partially mediated depressive symptoms, while self-efficacy moderated this relationship. More specifically, less social support increased depression symptoms by bringing about higher stigma. Besides, subjects with higher self-efficacy are less susceptible to stigma and therefore have mild depressive symptoms. Furthermore, clinical and theoretical implications are discussed in our study. CONCLUSIONS:Chinese SUDs patients' depressive symptoms were indirectly affected by perceived social support via stigma and less affected by stigma with improved self-efficacy. The theoretical and practical implications of these results are discussed. 10.1186/s12888-022-03740-6
    Childhood trauma and current depression among Chinese university students: a moderated mediation model of cognitive emotion regulation strategies and neuroticism. BMC psychiatry BACKGROUND:Childhood trauma (CT) is considered as a highly risk factor for depression. Although the pathway of CT to depression, especially the mediating or moderating effects of cognitive emotion regulation strategies (CERS) or neuroticism, have investigated by several studies, the results were inconsistent and there is a paucity of full models among these interactive factors. This study aims to examine the relationships among CT, adaptive / maladaptive CERS, neuroticism, and current depression symptoms in university students. METHODS:We recruited 3009 freshman of 2019, aged averagely 18.00 (SD = 0.772) years, from universities in Hunan province in 2019. A moderated mediation model was built to examine the relationships among CT, CERS, neuroticism, and current depression using the SPSS PROCESS 3.5 macro. We conducted bootstrapping of regression estimates with 5000 samples and 95% confidence interval. RESULTS:Results revealed that the significant mediating effects of adaptive CERS (β = 0.012; 95% CI: 0.006 to 0.018) and maladaptive CERS (β = 0.028; 95% CI: 0.016 to 0.040) between CT and depression were observed, accounting for 5.69% and 13.52% of the total effect respectively. Then, moderated mediation analyses results showed that neuroticism simultaneously moderated the direct effect of CT on current depression (β = 0.035; 95% CI: 0.001 to 0.009), and the indirect effects of CT on current depression through adaptive CERS (adaptive CERS - current depression: β = - 0.034; 95% CI: - 0.007 to - 0.001) and maladaptive CERS (maladaptive CERS - current depression: β = 0.157; 95% CI: 0.017 to 0.025). However, the moderating effects of neuroticism in the indirect paths from CT to adaptive CERS (β = 0.037; 95% CI: 0.000 to 0.014) and maladaptive CERS (β = - 0.001; 95% CI: - 0.006 to 0.005) were not significant. CONCLUSIONS:This study provides powerful evidences through a large university students sample for the mediating role of adaptive / maladaptive CERS and the moderating role of neuroticism between CT and current depression. This manifests that cognitive emotion regulation may be a vital factor for people who suffered from CT and current depression. Furthermore, the influence of neuroticism in this process cannot be ignored. 10.1186/s12888-021-03673-6
    Socioeconomic differences in psychiatric treatment before and after self-harm: an observational study of 4,280 adolescents and young adults. Pitkänen Joonas,Remes Hanna,Aaltonen Mikko,Martikainen Pekka BMC psychiatry BACKGROUND:Individuals in higher socioeconomic positions tend to utilise more mental health care, especially specialist services, than those in lower positions. Whether these disparities in treatment exist among adolescents and young adults who self-harm is currently unknown. METHODS:The study is based on Finnish administrative register data on all individuals born 1986-1994. Adolescents and young adults with an episode of self-harm treated in specialised healthcare at ages 16-21 in 2002-2015 (n=4280, 64% female) were identified and followed 2 years before and after the episode. Probabilities of specialised psychiatric inpatient admissions and outpatient visits and purchases of psychotropic medication at different time points relative to self-harm were estimated using generalised estimation equations, multinomial models and cumulative averages. Socioeconomic differences were assessed based on parental education, controlling for income. RESULTS:An educational gradient in specialised treatment and prescription medication was observed, with the highest probabilities of treatment among the adolescents and young adults with the highest educated parents and lowest probabilities among those whose parents had basic education. These differences emerged mostly after self-harm. The probability to not receive any treatment, either in specialised healthcare or psychotropic medication, was highest among youth whose parents had a basic level of education (before self-harm 0.39, 95% CI 0.34-0.43, and after 0.29, 95% CI 0.25-0.33 after) and lowest among youth with higher tertiary educated parents (before self-harm: 0.22, 95% CI 0.18-0.26, and after 0.18, 95% CI 0.14-0.22). The largest differences were observed in inpatient care. CONCLUSIONS:The results suggest that specialised psychiatric care and psychotropic medication use are common among youth who self-harm, but a considerable proportion have no prior or subsequent specialised treatment. The children of parents with lower levels of education are likely to benefit from additional support in initiating and adhering to treatment after an episode of self-harm. Further research on the mechanisms underlying the educational gradient in psychiatric treatment is needed. 10.1186/s12888-021-03654-9
    Characteristics of depression, anxiety, impulsivity, and aggression among various types of drug users and factors for developing severe depression: a cross-sectional study. BMC psychiatry BACKGROUND:Mood disorder, impulsivity and aggression are common in drug users compared to healthy controls. However, no study has focused on the difference in various types of drug users. Therefore, the objective of this study was to explore the differences in depression, anxiety, impulsivity, and aggression among methamphetamine, heroin and polysubstance users and to further explore the risk factors for severe depression in the three groups. METHODS:Drug users over 18 years old who met the DSM-V diagnostic criteria for substance -related disorders were included in the study. All participants completed a general questionnaire, the Zung Self-Rating Depression Scale (SDS), the Zung Self-Rating Anxiety Scale (SAS), Barratt impulsiveness Scale Version 11 (BIS-11), and the Buss-Perry Aggression Questionnaire (BPAQ). One-way ANOVAs or Chi-square tests were used to test the differences among the groups, correlation analysis was used to test the relationship between drug use and other parameters, and multiple logistic regression was conducted to assess the risk factors for severe depression. RESULTS:A total of 1,486 participants were included, comprising 86.3% males with a mean age of 38.97 years. There was a significant difference in the percentage of severe depression and SDS scores among the three groups, but no significant difference was found in SAS, BIS-11 and BPAQ scores. Using methamphetamines, hostility and anxiety were risk factors for developing severe depression in all the participants and anxiety remained constant in the other three groups. Moreover, methamphetamine use was 2.16 and 3.35 times more likely to cause severe depression than heroin and polysubstance use, respectively. The initial age of substance use was negatively correlated with BPAQ, SAS, and SDS scores, whereas the drug use duration and addiction duration were positively correlated. CONCLUSIONS:In this study, we found that the highest prevalence of severe depression was in participants using methamphetamines and that using methamphetamines, hostility, and anxiety were risk factors for developing severe depression. This result addressed an important gap in our knowledge of the different characteristics of depression, anxiety, impulsivity and aggression in various types of substance users and provides clinicians and policy-makers with directions for intervention and preventing relapse. 10.1186/s12888-022-03933-z
    The prevalence of subthreshold psychiatric symptoms and associations with alcohol and substance use disorders: from a nationally representative survey of 36,309 adults. BMC psychiatry BACKGROUND:Our aim was to describe a broad number of subthreshold psychiatric symptoms (SPS) in a nationally representative population and evaluate associations with substance use. SPS describe groups of symptoms with significant pathology, but that do not quite meet full psychiatric diagnostic criteria. They have been associated with significant impairment and cost. METHODS:The National Epidemiologic Survey on Alcohol and Related Conditions-III was a multistage, weighted, cross-sectional survey completed in the United States in 2013 comprising 36,309 noninstitutionalized adults. We report lifetime prevalence rates of 14 SPS related to mood, anxiety, trauma, eating, and personality disorders. We then evaluate associations with lifetime alcohol use disorders (AUD) and all substance use disorders (SUD) using logistic regression and adjusted odds ratios. SPS and psychiatric diagnoses were mutually exclusive (could not co-occur). RESULTS:Lifetime prevalence of having at least one of 14 SPS was 57% compared with 37% for the related psychiatric disorders. This was similar for males and females, in contrast to psychiatric disorders in which prevalence was 42% in females and 31% in males. Otherwise, overall SPS and disorders had similar prevalence patterns across sociodemographic characteristics. Subthreshold personality symptoms had the highest prevalence rates (schizotypal 21.3%, antisocial 18.3%, and borderline 17.6%), followed by posttraumatic stress (13.1%). Subthreshold bipolar and depression had lifetime prevalence rates of 2.7 and 8.5%, respectively. Prevalence rates of subthreshold anxiety symptoms ranged from 2.2% (agoraphobia) to 9.8% (specific phobia). Subthreshold eating disorder related symptoms had the lowest prevalence rates (anorexia 1.5% and bulimia 1.7%). Half (seven) of the SPS had significantly increased odds of lifetime AUD. This number increased to 12 for all SUD. Subthreshold antisocial personality symptoms had the highest odds of AUD (2.2; 95% CI 2.00-2.37) and SUD (3.5; 95% CI 3.22-3.81). CONCLUSIONS:We found high lifetime SPS prevalence rates and significant associations with AUD and SUD. To our knowledge, this is the first published study evaluating a broad number of SPS. This indicates possible opportunities for early intervention and prevention but requires additional research and development of infrastructure and guidelines to better understand and manage patients who experience SPS. 10.1186/s12888-022-03834-1
    The reconvictions of mentally disordered offenders-how, when, and where? BMC psychiatry BACKGROUND:Little is known about the recidivism of mentally disordered offenders after discharge from forensic psychiatric services. This is problematic because such knowledge could (i) help professionals who encounter this group to better plan interventions to prevent recidivism, (ii) clarify the rates of recidivism post-discharge from forensic psychiatric care and (iii) further develop instruments for specific risk assessment. The aim of this study was to investigate the new crimes of mentally disordered offenders who had been reconvicted after discharge from forensic psychiatric care. METHODS:Included in this study were all individuals (n = 1142) who had been discharged from forensic psychiatric care in Sweden during 2009-2018, were included in the Swedish National Forensic Psychiatric Register, and had been reconvicted in a criminal court within the follow-up period of 2009-2018 (n = 157, 14% of the population). The follow-up times of the discharged patients within the period varied from 4 to 3644 days, (m = 1697, Md = 1685). Retrospective registry data along with coded data from criminal court judgments (n = 210) were used to create a database. Kaplan-Meier survival analysis and descriptive statistical analysis was performed. RESULTS:75% of included individuals were reconvicted for at least one violent crime, but only 9 individuals were reconvicted for a serious violent crime, which can be compared to the 44 individuals with serious violent index crimes. The most common crime was "Other violent". The most common sentence was probation. The offender's most common relationship to the victim was having no known relationship, followed by the victim being a person of authority. The most common circumstance of the crime leading to the reconviction was that it occurred without apparent provocation; other common circumstances were related to the exercise of public authority. The most common crime scene was a public place. CONCLUSIONS:Even though the reconvictions of this group included many violent crimes, there were very few serious violent crimes. The findings that the victims of the crimes of mentally disordered offenders are most commonly either unknown to the perpetrator or persons of authority, and that the crimes are often perpetrated without apparent provocation or reason, are important information for all professionals who encounter this group and should be taken into consideration to assess risk more accurately. 10.1186/s12888-022-03912-4
    Trajectories of depressive symptoms among community-dwelling Korean older adults: findings from the Korean longitudinal study of aging (2006-2016). BMC psychiatry BACKGROUND:Depression among older adults is an important public health concern associated with increased risk of suicide and decreased physical, cognitive, and social functioning. This study identified trajectories of depressive symptoms and investigated predictive variables of group-based trajectory modeling among Korean community-dwelling older adults. METHODS:Participants comprised 2016 community-dwelling Korean adults over 65 years. Data from the years 2006-2016 of the Korean Longitudinal Study of Aging, a nationally representative panel survey that has been conducted every two years since 2006, were used. We employed a group-based trajectory modeling analysis to identify depressive symptom trajectories. Multinomial logistic regression analysis was conducted to identify predictors of each class of depressive symptoms. RESULTS:Five depressive symptom trajectory groups were identified: Group 1, "None" (28.9%); Group 2, "Slowly worsening" (24.3%); Group 3, "Rapidly worsening" (17.5%); Group 4 "Improving" (12.4%); and Group 5, "Persistently severe" (16.9%). Older adults followed five distinct depressive symptom trajectories over 10 years. Mini-Mental State Examination scores, number of chronic diseases, educational level, and social activity were predictors associated with increasing depressive symptoms. CONCLUSIONS:This study showed that many older adults living in the community have depressive symptoms. To prevent and treat depression and aid successful mental health aging among older adults, the development of interventions should be tailored to target specific needs for each symptom trajectory. It is necessary to develop community-based interventions and strategies to identify and prevent depressive symptom trajectories among older adults. 10.1186/s12888-022-03905-3
    Adolescent anxiety and depression: burden of disease study in 53,894 secondary school pupils in the Netherlands. Klaufus Leonie,Verlinden Eva,van der Wal Marcel,Cuijpers Pim,Chinapaw Mai,Smit Filip BMC psychiatry BACKGROUND:Prevalence rates of anxiety and depression in adolescence are rising markedly in early adolescence. It is important to quantify the non-fatal disease burden of anxiety and depression, such that early interventions can be well targeted, and resources can be allocated in a just and optimal way. This study aimed to estimate the non-fatal disease burden of anxiety and depression with and without suicidal ideation in girls and boys aged 13, 14, and 15 years. METHODS:Participants were 53,894 secondary school pupils who completed health questionnaires between September 2018 and July 2019. A design-based approach was used for complex survey data with post-stratification weights and taking clustering at school-level into account. At individual level, disability weights (DWs) were calculated for each disorder. At population level, DWs were multiplied by the point-prevalence per one thousand population of the respective disorders to compute years lived with disability (YLD). DWs and YLD of anxiety and depression were calculated with and without adjustment for comorbid eating disorders, substance use disorders and somatic illnesses. RESULTS:The unadjusted DW of depression with suicidal ideation (0.30) was greater than without suicidal ideation (0.26), and both were greater than the DW of anxiety (0.24). A similar ranking was obtained after adjusting for comorbidities. At population level, where the prevalence of the disorders come into play, the YLD disease burden was greatest for anxiety, followed by depression with suicidal ideation and depression without suicidal ideation with 17.40, 9.85, and 5.28 YLD per one thousand population, unadjusted for comorbidities. This pattern was the same after adjustment, but then the total YLD of depression with and without suicidal ideation was similar to the YLD of anxiety (12.47 and 12.46, respectively). Girls showed a significantly greater YLD burden of anxiety and depression than boys, but no differences were found between different age groups. CONCLUSIONS:From an individual clinical perspective, depression, especially when accompanied by suicidal ideation, was identified as a major health concern, especially in girls. From a public health perspective, both anxiety and depression, especially when accompanied by suicidal ideation, were identified as major drivers of disease burden, again most notably in girls. 10.1186/s12888-022-03868-5
    Self-directed passive-aggressive behaviour as an essential component of depression: findings from two cross-sectional observational studies. BMC psychiatry BACKGROUND:The self-control model of depression suggests depressive symptoms to derive from distorted self-monitoring, dysfunctional self-evaluation and reduced self-reward as well as increased self-punishment. Building on this model a relationship between self-directed passive-aggressive behaviour, that is, harmful inactivity, and depression has been assumed. This association has been supported by a recent study in an inpatient sample. However, it remains unclear if patients with depressive disorders report more self-directed passive-aggressive behaviour than patients without depressive disorders and if self-directed passive aggression mediates the associations between distorted self-monitoring and dysfunctional self-evaluation with depressive symptoms. METHODS:Study 1 compared self-directed passive-aggressive behaviour levels between 220 psychotherapy outpatients with (n = 140; 67.9% female; M = 40.0) and without (n = 80; 65.0% female; M = 36.2) depressive disorders. Diagnoses were made based on the Structured Clinical Interview for DSM-IV. Study 2 examined self-directed passive-aggressive behaviour as a mediator of the relationship between distorted self-monitoring and dysfunctional self-evaluation and self-reported depressive symptoms in 200 undergraduate Psychology students. RESULTS:Compared to outpatients without depressive disorders, outpatients with depressive disorder reported significantly more self-directed passive aggression (d = 0.51). Furthermore, Study 2 verified self-directed passive-aggressive behaviour as a partial mediator of the relationship between dysfunctional attitudes (ab = .22, 95%-CI: .14, .31), attributional style (ab = .20, 95%-CI: .13, .27), ruminative response style (ab = .15, 95%-CI: .09, .21) and depressive symptoms. CONCLUSION:Self-directed passive-aggressive behaviour partially mediates the association between distorted self-monitoring and dysfunctional self-evaluation with depressive symptoms. Future longitudinal studies need to examine a potential causal relationship that would form a base to include interventions targeting self-directed passive-aggressive behaviour in prevention and treatment of depression. TRIAL REGISTRATION:Both studies were preregistered at the German Clinical Trials Register ( DRKS00014005 and DRKS00019020 ). 10.1186/s12888-022-03850-1
    Subjective well-being among AIDS orphans in southwest China: the role of school connectedness, peer support, and resilience. BMC psychiatry BACKGROUND:Few studies have explored the health and development of AIDS orphans using the positive youth development (PYD) framework. Grounded in this framework, the main objective of this study is to examine how internal assets (i.e., resilience) and external assets (i.e., school connectedness, peer support) affect subjective well-being among Yi AIDS orphans in the Liangshan Yi Autonomous Prefecture, Sichuan province, China. METHODS:A cross-sectional survey was conducted by interviewing 571 AIDS orphans and 979 non-orphans of Yi ethnic minority from 5th-10th grades. Structural equation models (SEM) were utilized to identify and estimate the direct and indirect effects of internal and external assets on subjective well-being. RESULTS:The average score of subjective well-being was significantly lower for AIDS orphans than for in non-orphans (P < 0.05). Resilience, school connectedness, peer support (number of friends, caring friends), and self-rated physical health had significant and positive direct effects on subjective well-being. In addition, the effects of school connectedness, and peer support on subjective well-being were mediated by resilience. CONCLUSIONS:Positive individual and school-related contextual assets can bolster subjective well-being among AIDS orphans. The design of health intervention programs for AIDS orphans should incorporate these positive development assets. 10.1186/s12888-022-03833-2
    Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics. BMC psychiatry BACKGROUND:The aim of this study was to assess the risk of readmission in patients with severe mental disorders, compare it between patients using different types of antipsychotics and determine risk factors for psychiatric readmission. METHODS:Medical records of a non-concurrent cohort of 625 patients with severe mental disorders (such as psychoses and severe mood disorders) who were first discharged from January to December 2012 (entry into the cohort), with longitudinal follow-up until December 2017 constitute the sample. Descriptive statistical analysis of characteristics of study sample was performed. The risk factors for readmission were assessed using Cox regression. RESULTS:Males represented 51.5% of the cohort, and 75.6% of the patients had no partner. Most patients (89.9%) lived with relatives, and 64.7% did not complete elementary school. Only 17.1% used more than one antipsychotic, 34.2% did not adhere to the treatment, and 13.9% discontinued the medication due to unavailability in public pharmacies. There was a need to change the antipsychotic due to the lack of therapeutic response (11.2% of the patients) and adverse reactions to the antipsychotic (5.3% of the patients). Cox regression showed that the risk of readmission was increased by 25.0% (RR, 1.25; 95% CI, 1.03-1.52) when used typical antipsychotics, compared to those who used atypical ones, and by 92.0% (RR, 1.92; 95% CI, 1.63-2.27) when patients did not adhere to maintenance treatment compared to those who adhered. CONCLUSIONS:Use of atypical antipsychotics and adherence to treatment were associated with a lower risk of psychiatric readmissions. 10.1186/s12888-022-03794-6
    The prevalence and clinical correlates of medical disorders comorbidities in patients with bipolar disorder. Wang Zhonggang,Li Tao,Li Shuhua,Li Kunkun,Jiang Xianfei,Wei Chen,Yang Lei,Cao Haiyan,Li Shen,Li Jie BMC psychiatry OBJECTIVE:Medical disorders in patients with bipolar disorder (BD) have attracted more and more attention. So far, there is still a lack of studies on this issue utilizing large sample sizes in the Chinese sample. Therefore, we conducted this study to explore the clinical characteristics of BD patients comorbid medical disorders in a relatively large Chinese sample. METHODS:This was a cross-sectional study including 1,393 BD patients (882 patients with medical disorders and 511 patients without medical disorders). Their demographic and clinical characteristics were obtained by the Hospital Information System and self-designed questionnaires. RESULTS:The comorbidity rate of medical disorders in BD was 63.32%. The average number of medical disorders for a BD patient was 2.69. The top five comorbid medical disorders in BD patients were circulatory system diseases (19%), nervous system diseases (18%), endocrine and metabolic diseases (17%), digestive system diseases (16%), and respiratory system diseases (8%). BD patients with comorbid medical disorders had an older average age, lower education level, longer illness course, later onset age, lower ratio of psychotic features, more admission numbers, higher ratio of smoking and drinking alcohol, more number of manic episodes (All P < 0.05). Smoking, numbers of depressive episode, onset age, and illness course were independent risk factors of comorbidities in BD patients (All P < 0.05). CONCLUSIONS:Medical disorders in Chinese BD patients are highly prevalent. The smoking, number of depressive episodes, onset age, illness course, are correlated with BD patients comorbid medical disorders. Clinicians should pay attention to the medical disorders comorbidities in BD patients, and take effective measures to improve treatment outcome and reduce the suffering. The integrative approach should be the imperative in clinical practice. 10.1186/s12888-022-03819-0
    Predicting depression among rural and urban disabled elderly in China using a random forest classifier. BMC psychiatry With global aging, the number of elderly with physical disabilities is also increasing. Compared with the ordinary elderly, the elderly who lose their independence are more likely to have the symptoms of depression. Reducing depression may help to alleviate the disability process of those who find themselves in the disabled stages. Therefore, the purpose of this study is to explore the predictive effects of demographic characteristics, health behavior, health status, family relations, social relations, and subjective attitude on depression in rural and urban disabled elderly to improve early depression symptom recognition.A total of 1460 older adults aged 60 and disabled were selected from China Family Panel Studies (CFPS). Depression was assessed according to The Center for Epidemiologic Studies Depression Scale (CES-D). This paper used the random forest classifier to predict the depression of the disabled elderly from six aspects: demographic characteristics, health status, health behavior, family relationship, and social relationship. The prediction model was established based on 70% of the training set and 30% of the test set. The depression rate of rural disabled elderly was 57.67%, and that of urban disabled elderly was 44.59%. The mean values of the 10-k cross-validated results were 0.71 in rural areas and 0.70 in urban areas. AUC:0.71, specificity: 65.3%, sensitivity: 80.6% for rural disabled elderly with depression; AUC:0.78, specificity: 78.1%, sensitivity: 64.2% for urban disabled elderly with depression, respectively. There are apparent differences in the top ten predictors between rural and urban disabled elderly. The common predictors were self-rated health, changing in perceived health, disease or accidence experience within the past 2 weeks, life satisfaction, trusting people, BMI, and having trust in the future. Non-common predictors were chronic diseases, neighborly relations, total medical expenses within 1 year, community emotion, sleep duration, and family per capita income. Using random forest data to predict the depression of the disabled elderly may lead to early detection of depression. 10.1186/s12888-022-03742-4
    Antipsychotic prescribing patterns in Australia: a retrospective analysis. BMC psychiatry BACKGROUND:To examine real-world patterns of antipsychotic use in patients with schizophrenia Australia. METHODS:This retrospective cohort analysis was conducted using the Australian Commonwealth Department of Human Services Pharmaceutical Benefits Scheme (PBS) 10% sample data. Included data were for patients aged 16-years or older who initiated treatment for the first time with a PBS-reimbursed antipsychotic medication for schizophrenia between July 2013 and September 2017. Patterns of treatment usage were summarised descriptively. Differences in prescribing patterns by age and prescribing year were reported. Treatment persistence was estimated using Kaplan-Meier methods, with differences explored using log-rank tests. Values of p < 0.05 were considered statistically significant. RESULTS:6,740 patients, representing 8,249 non-unique patients, received prescriptions for antipsychotic medications. Patients were aged 16 years to over 85 years (54.5% were < 55 years) and two-thirds of patients were male (61%). The majority of treatment episodes (62%, n = 5,139/8,249) were prescribed an atypical oral antipsychotic. Typical long-acting antipsychotic therapies (LATs) were prescribed 19% of the treatment episodes (n = 1,608/8,249. There was a small increase in prescribing of atypical LAT and typical LAT and a small decrease in atypical oral and clozapine prescribing over the study period. Treatment persistence was greatest in patients treated with clozapine, than in those treated with atypical LATs. CONCLUSIONS:While the majority of patients receive atypical antipsychotic medications, one in five continue to use older typical LAT therapies. Patient age and time on therapy may be associated with choice of therapy. Persistence to atypical LAT therapy is better than for other treatment modalities in this real-world cohort. 10.1186/s12888-022-03755-z
    Associations between daily steps and cognitive function among inpatients with schizophrenia. BMC psychiatry BACKGROUND:Walking is the fundamental component of taking steps and is the main form of physical activity among individuals with schizophrenia; it also offers a range of health benefits. This study aimed to examine the associations between daily steps and cognitive function and further explored how many steps were related to better cognitive function among inpatients with schizophrenia. METHODS:Inpatients with schizophrenia were recruited from long-stay psychiatric wards across two hospitals (n=199 at site 1 and n=195 at site 2). Daily steps were collected with an accelerometer for 7 days. Four cognitive domains (attention, processing speed, reaction time, and motor speed) were tested at site 1, and two cognitive domains (attention and processing speed) were tested at site 2. The associations of daily steps and levels of steps/day with cognitive function were tested using multivariable linear regressions separated by site. Covariates included demographic variables, weight status, metabolic parameters, and clinical state. RESULTS:Participants took an average of 7445 (±3442) steps/day. More steps were related to better attention, processing speed, reaction time, and motor speed after multivariable adjustments. Compared with participants taking <5000 steps/day, those taking ≥5000 steps/day showed significantly better processing speed. Participants taking ≥7500 steps/day were associated with better attention, better reaction time, and better motor speed than those taking <5000 steps/day. CONCLUSION:Daily steps are associated with better cognitive function among inpatients with schizophrenia. The optimal benefit for cognitive function among this clinical population is achieving 7500 steps/day or more. 10.1186/s12888-022-03736-2
    Factors associated with the mental health of back-to-Wuhan university students based on quantile regression model during the COVID-19 period. BMC psychiatry BACKGROUND:The COVID-19 pandemic had brought the increased levels of depression and anxiety on people. Our study investigated the levels of mental health and influencing factors among back-to-Wuhan university students. METHODS:A cross-sectional questionnaire survey was conducted from 31 August 2020, to 14 September 2020 by convenience sampling on the back-to-Wuhan university students, which included the Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), the Insomnia Severity Index-7 (ISI-7), the revised Impact of Event Scale (IES-R) scales, and the basic demographic characteristics. Moreover, quantile regression analysis was used to identify the key factors related to the mental health variables of the back-to-Wuhan university students during the COVID-19 period. RESULTS:The results from 1017 participants suggested that the prevalence rates of the anxiety, depression, insomnia, and distress were 44%, 47.5%, 37.7%, 57.7%, respectively. Quantile regression showed that mental health scores were negatively associated to age, years from graduation, being discriminated against owing to the experience in Wuhan, and the attitude on the future of COVID-19, while was positively related to the education level (P < 0.05). Especially, the education level was highly related with anxiety (25th = 1.64, 50th = 2.54). CONCLUSION:The finding showed that the respondents who were near graduation, discriminated owing to the experience in Wuhan, and worried about the future trend of COVID-19 had a higher risk of negative psychologic status, especially in the bottom and median quantile, and might require more psycho-social interventions or support. 10.1186/s12888-022-03828-z
    Association among calf circumference, physical performance, and depression in the elderly Chinese population: a cross-sectional study. BMC psychiatry BACKGROUND:Depression and sarcopenia are common diseases in the elderly population. However, the association between them is controversial. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database, a cross-sectional study was conducted to explore the relationship of calf circumference and physical performance with depression. METHODS:From the 8th wave of CLHLS conducted in 2018, data on calf circumference, physical performance, depressive symptoms, and demographic, socioeconomic, and health-related characteristics were collected. Multiple logistic regression was conducted to explore the impact of calf circumference, physical performance and their combination on depressive symptoms. RESULTS:We enrolled a total of 12,227 participants aged 83.4 ± 11.0 years, including 5689 (46.5%) men and 6538 (53.5%) women. Patients with depression were more likely to have low calf circumference (2274 [68.2%] vs. 5406 [60.8%], p<0.001) and poor physical performance (3[0, 6] vs. 1[0, 4], p<0.001). A significant multiplicative interaction was found between calf circumference and physical performance in their effect on depression. After adjusting for confounding factors, multiple logistic regression showed that a significant inverse correlation persisted between physical performance and depressive symptoms in normal (odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.15-1.26, p<0.001) and low (OR = 1.14, 95% CI: 1.11-1.18, p<0.001) calf circumference group, while the association between calf circumference and depression disappeared. Participants with low calf circumference and poor physical performance were 2.21 times more likely to have depression than those with normal calf circumference and physical performance. All results were found to be robust in sensitivity analyses. CONCLUSIONS:Physical performance was significantly associated with depression in the elderly Chinese population. Attention should be paid to assess depressive symptoms in patients with poor physical performance. 10.1186/s12888-022-03925-z
    Associations of youth mental health, parental psychological distress, and family relationships during the COVID-19 outbreak in China. BMC psychiatry BACKGROUND:The COVID-19 pandemic has brought significant changes in society and family life, which could be particularly difficult for parents. The present study examines the relationship between youth mental health and parental psychological distress after the first peak of the COVID-19 Outbreak in China. The parent-child and marital relationships were examined as moderators of the above relationship. METHODS:Parents and their children aged 10 to 18 years were recruited for this study. The parents completed the Depression Anxiety Stress Scales-21 (DASS-21), the Strengths and Difficulties Questionnaire (SDQ), and a subset of items from the questionnaire of the COVID-19 Supporting Parents, Adolescents, and Children in Epidemics (Co-SPACE) survey of parental mental health, child's psychological symptoms, parent-child, and marital relationship. Several multiple linear regressions were used to analyze the data. RESULTS:The largest variance in parental mental health was explained by the child's psychological symptoms (effect size beta = 0.27). Parent-child (effect size beta = -0.13) and marital relationship (effect size beta = -0.21) were negatively associated with parental mental health. The relationship between child's psychological symptoms and parental mental health was moderated by marital relationship (effect size beta = -0.07). Both parent-child and marital relationships presented with a significant interaction with impact scores, while only parent-child relationships with burden scores. CONCLUSIONS:Youth mental health problems were significantly associated with parental psychological symptoms during the early phase of the COVID-19 pandemic The parent-child and marital relationship moderated the association between youth psychological symptoms and parental mental health. Interventions for alleviating parenting stress and support services that improve family relationships may be particularly effective in reducing parental psychological distress associated with future COVID-19 or related crises. 10.1186/s12888-022-03938-8
    Associations between alexithymia, parental rearing styles, and frequency of drug use in male methamphetamine dependence patients. BMC psychiatry BACKGROUND:Alexithymia, which is characterized by difficulty identifying and describing feelings, is a stable personality trait and it has been associated with early life experiences. Methamphetamine dependence patients with high level of alexithymia may be particularly vulnerable to engaging in more frequent methamphetamine use. Therefore, we aimed to evaluate whether alexithymia was associated with frequency of methamphetamine use. Additionally, the current study sought to examine early-life factors associated with the development of alexithymia, i.e., parental rearing styles. METHOD:Participants were 108 non-injecting methamphetamine dependent patients from a male compulsory detoxification center. The level of alexithymia was assessed by Toronto Alexithymia Scale-20(TAS-20). In addition, we applied Egna Minneu av. Bardndosnauppforstran (EMBU) to assess the parental rearing styles, including the dimensions of warmth, rejection, punishment/strictness, overinvolvement, overprotection, and favoring. RESULTS:The total score of TAS-20 was positively correlated with frequency of methamphetamine use (r = 0.26, p < 0.01). Specifically, except for externally oriented thinking, difficulty identifying feelings (r = 0.23, p < 0.05) and difficulty describing feelings (r = 0.25, p < 0.05) were positively correlated with frequency of methamphetamine use. Multiple linear regression showed that more maternal rejection (B = 0.59, p = 0.002), or less maternal warmth (B = -0.22, p = 0.004) was associated with higher levels of alexithymia. Ordinal logistic regression showed that for every 1 score increase in the total score of TAS-20, there was a 1.06 times risk of a one level increase in the level of methamphetamine use frequency (OR = 1.06, p = 0.01). CONCLUSIONS:These results have major implications for understanding the role of alexithymia in craving and addiction, while providing a further and explicit entry point for addiction treatment. Moreover, more attention should be focused on parenting in relation to early experiences. 10.1186/s12888-022-03897-0
    Epidemiology of gaming disorder and its effect on anxiety and insomnia in Chinese ethnic minority adolescents. BMC psychiatry BACKGROUND:The growing popularity and frequency of online game use have resulted in a large number of studies reporting various mental problems associated with game abuse in adolescents. In this article, we examined the prevalence of gaming disorder (GD) and explored the associations of GD with anxiety and insomnia symptoms in minority youth in China. METHODS:A total of 1494 students completed the Problematic Online Gaming Questionnaire Short-Form (POGQ-SF), the Generalized Anxiety Disorder 7-item questionnaire (GAD-7), and Athens Insomnia Scale (AIS). Chi-square and binary logistic regression analyses were used to explore the associations between gaming disorder and anxiety/insomnia. RESULTS:A total of 356 (23.83%) respondents reported that they had gaming disorder. Chi-square analysis showed that gender, grade, marital status of parents and exercise situation were significantly associated with GD. Binary logistic regression analysis showed that those who had GD were at significantly higher risk for anxiety and insomnia than those without GD. CONCLUSION:We found a high incidence of GD and a positive association among anxiety, insomnia and GD. Thus, special attention should be paid to those who have suffered from GD. It is worth addressing the adverse effects of GD on anxiety and insomnia. 10.1186/s12888-022-03894-3
    Effectiveness of a community health worker-led case management programme to improve outcomes for people with psychotic disorders in Thailand: a one-year prospective cohort study. BMC psychiatry BACKGROUND:Intensive case management (ICM) programmes for psychotic patients are effective in improving outcomes, but often unfeasible in resource-poor settings, as they typically require extensive human resources and expertise. We developed and evaluated the effectiveness of a less intensive case management program (LICM), led by community health workers, on one-year social functioning and service use. METHODS:A prospective cohort study was conducted on patients aged 18 and above residing in a hospital catchment area. Outcomes were compared between LICM (n = 64) and non-LICM participants (n = 485). A counterfactual framework approach was applied to assess causal effects of the LICM on outcomes. The programme effectiveness was analyzed by augmented-inverse probability of treatment weighting (AIPW) to estimate potential outcome mean (POM) and average treatment effect (ATE). Outcomes were employment status and use of emergency, inpatient and outpatient services. Analyses were stratified by the number of previous psychotic relapse (≤ 1, > 1) to assess heterogeneity of treatment effect on those in an early and later stages of psychotic illness. RESULTS:In the early-stage cohort, the likelihood of being employed at one year post-baseline was significantly greater in LICM participants than non-LICM participants (ATE 0.10, 95%CI 0.05-0.14, p < 0.001), whereas service use of all types, except outpatient, was not significantly different between the two groups. In the later-stage cohort, the likelihoods of employment between the two groups at post-baseline were similar (ATE -0.02, 95%CI -0.19-0.15, p = 0.826), whereas service use of all types was significantly higher in LICM participants. CONCLUSION:LICM in a setting where community mental services are scarce may benefit those at an early stage of psychotic illness, by leading to better social functioning and no higher use of unscheduled services at the end of the programme, possibly through their better prognosis and medication adherence. A more intensive case management model may be appropriate for those in a later stage of the illness. 10.1186/s12888-022-03888-1
    Suicide decline and improved psychiatric treatment status: longitudinal survey of suicides and serious suicide attempters in Tokyo. Otaka Yasushi,Arakawa Ryosuke,Narishige Ryuichiro,Okubo Yoshiro,Tateno Amane BMC psychiatry BACKGROUND:Connecting individuals in need of psychiatric treatment with adequate medical services has been a major strategy for suicide prevention in Japan. By investigating serious suicide attempters admitted to our Critical Care Medical Center (CCM), we aimed to examine longitudinal changes in the psychiatric treatment status of high-risk suicidal individuals, and to explore the association between any improvement in psychiatric treatment status and suicide decline. METHODS:Subjects from two periods, 2006-2011 and 2012-2017, were enrolled. We collected the data of 32,252 suicides in Tokyo from police reports and the data of 942 suicide attempters admitted to CCM from medical records. Data were annually collected by both age and gender for the number of suicide completers, the number of suicide attempters, and the psychiatric treatment rates, respectively. ANOVA and t-test were used to examine whether there were differences in the number of suicides and attempers between the two periods. The difference in psychiatric treatment rate between the two periods was examined by chi-square test. Additionally, we used Pearson's correlation coefficient to analyze any correlation between annual treatment rate and the number of suicide completers in subgroups with altered psychiatric treatment rates. RESULTS:The number of suicide attempters in the 20-39-year age group of decreased together with the number of suicides. Psychiatric treatment rates of male attempters aged 20-59 years improved significantly from 48.7 to 70.6% and this improvement correlated with a decrease in suicides. However, psychiatric treatment rates in the elderly, which have the highest number of suicides in both genders, did not improve and remain low. CONCLUSIONS:The number of suicide attempters, as well as that of suicides, decreased in Tokyo. Improvement of psychiatric treatment status in high-risk suicidal male adults may have contributed to the reduction of suicides in Tokyo. However, the continuing low rate of psychiatric treatment in the elderly is a pressing issue for future suicide prevention. 10.1186/s12888-022-03866-7
    Gender differences in outpatients with dementia from a large psychiatric hospital in China. BMC psychiatry BACKGROUND:The sociodemographic characteristics and clinical features of dementia patients in psychiatric hospitals have not been thoroughly studied in China. This study aimed to explore the psychiatric outpatient attendance of dementia patients at a psychiatric hospital in China, with particular emphasis on gender differences. METHODS:This retrospective study examined outpatients with dementia from January 2013 to August 2019 using data in the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) in Beijing Anding Hospital. Age, sex, number of visits, use of drugs and comorbid conditions were extracted from medical records. RESULTS:Nine thousand four patients were recruited from a specific outpatient clinic of a hospital in Beijing, and the mean number of visits was 6.92. There were 3,433 (38.13%) male patients and 5,571 (61.87%) female patients. The most common comorbidities were generalized anxiety disorder, nonorganic insomnia, delusional disorder and depressive disorder. The proportion of patients using antidementia was the highest, with the rate of 68.3%, followed by benzodiazepines (48.83%), antipsychotics (45.43%), antidepressants (22.24%) and nonbenzodiazepines (19.96%). Patients with dementia showed a significant gender difference in average age (t = 6.36, P < 0.0001). Compared to male patients, female patients had a higher number of visits (7.40 ± 12.90 vs 6.15 ± 10.50, t = 4.81, P < 0.0001). There were significant differences in comorbidity composition between male and female patients (t = 23.09, P < 0.0001). CONCLUSIONS:Our present findings suggested significant gender differences in the proportion of age, number of visits and comorbidity composition in outpatients with dementia. 10.1186/s12888-022-03852-z
    The impact of schizotypy on quality of life among adults with autism spectrum disorder. BMC psychiatry BACKGROUND:Autism spectrum disorder (ASD) and schizotypal personality disorder can be difficult to distinguish. Deficits in social relationships and social interaction, present in both conditions, are known to impair quality of life. The aim of the present study was to investigate if schizotypal symptoms affect quality of life among adults diagnosed with autism spectrum disorder and to study the association between schizotypy and autistic traits among them. METHODS:Participants diagnosed with autism spectrum disorder (n = 110) completed questionnaires exploring schizotypy (Schizotypal Personality Questionnaire - Brief Revised (SPQ-BR)), autistic traits (The Ritvo Autism, Asperger Diagnostic Scale-Revised Screen 14 items), anxiety and depression (The Hospital Anxiety and Depression scale) and quality of life (Brunnsviken Brief Quality of Life Scale and the European quality of life index version 5D). RESULTS:Schizotypy was found to be associated with anxiety, depressive and autistic symptoms, and poor quality of life. Although schizotypy was a predictor for impaired quality of life, this relationship was mediated by symptoms of anxiety and depression, plausibly inherent to autism. Autistic traits were positively associated with all higher order constructs of the SPQ-BR, i.e. positive and negative schizotypy, disorganization and social anxiety, as well as with poor quality of life. CONCLUSIONS:There is considerable overlap between schizotypy and autism that needs to be considered in research. Prominent schizotypal traits in people with ASD may constitute an endophenotype coinciding with a particularly poor quality of life. TRIAL REGISTRATION:ClinicalTrials.gov identifier:  NCT03570372 : Internet-based Treatment for Adults with Autism Spectrum Disorder (MILAS). 10.1186/s12888-022-03841-2
    Research on interpersonal violence in schizophrenia: based on different victim types. BMC psychiatry BACKGROUND:Schizophrenia is one of the most common severe mental disorders associated with an increased risk of violence. The present study compares the demographical, clinical, and criminological characteristics of the patients with schizophrenia who committed different types of violence to relatives, acquaintances, or strangers. METHOD:Archives of the violent offenders with schizophrenia referred to forensic psychiatric assessments from January 2015 to December 2019 in the West China Forensic Medicine Assessment Center in China were analyzed. The demographic information, mental illness history, and criminological characteristics of the offenders were collected. The clinical symptoms, previous violent behaviors, and social deficits were also evaluated. One-way ANOVA, Kruskal-Wallis test, Chi-square test, and logistic regression analysis were enrolled to do the statistical analysis. RESULTS:The study enrolled 332 cases: 165 cases (49.7%) in the acquaintance victim group (AV), 96 cases (28.9%) in the relative victim group (RV), and 71 cases (21.4%) in the stranger victim group (SV). The multinomial logistic regression analysis revealed that older patients were less likely to attack relatives (OR = 0.966, 95% CI = 0.944-0.990; p = 0.005), and strangers, (OR = 0.971, 95% CI = 0.944-0.998; p = 0.034). Patients who lived with others were more inclined to attack relatives (OR = 15.057, 95% CI = 3.508-64.628; p < 0.001). Additionally, employed patients were more likely to attack strangers (OR = 2.034, 95% CI = 1.036-3.994; p = 0.039). The regression equation did not include psychiatric symptoms. For RV and AV victims, the risk of death was higher compared to that of SV victims (OR = 13.778, p < 0.001; OR = 2.663, p = 0.014). CONCLUSION:In the interpersonal violence cases committed by schizophrenia patients, the victim type correlates with demographic characteristics of offenders such as living situation, age, and employment status, but not with the psychiatric symptoms. The majority of victims were acquaintances and relatives, and the relative victims having more severe injuries. In order to decrease interpersonal violence, especially violent crimes, more people, especially family members and neighbors, should be educated about symptoms of schizophrenia, the ways to communicate with the patients, and the methods for crisis management. 10.1186/s12888-022-03820-7
    Magnitude of common mental disorders and factors associated among people living in Addis Ababa Ethiopia 2018: community based cross-sectional study. BMC psychiatry BACKGROUND:Common mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms, affecting individuals in different age groups, causes suffering to the individuals, families and community. OBJECTIVE:This study assessed the magnitude of Common mental disorder and associated factors among people living in Addis Ababa, Ethiopia. METHODS:Community based cross sectional study design was conducted from November 1 to 30, 2018 among people living in Addis Ababa, Ethiopia. Multistage sampling technique was used to get a total of 755 samples. Common Mental Disorder was assessed through interview using Self-Reported questionnaire (SRQ-20). The collected data were coded, entered into EPI-Info 7 and analysed by using SPPS version 20. Descriptive, analytical statistical procedure; bivariate and multivariate binary logistic regressions with odds ratios and 95% confidence interval was employed. The statistical significance was accepted at p value < 0.05. RESULT:In this study a total of 723 study subjects were participated, with response rate of 95.7%.The prevalence of common mental disorders was 24.7% with [95%CI; 21.6 - 27.7]. Females (AOR=2.1; 95% CI; 1.39- 3.23), Divorced/widowed (AOR=2.55; 95% CI; 1.16- 5.59), daily labourers (AOR=2.52; 95% CI; 1.3- 4.88, chronic medical illness (AOR=4.5; 95% CI; 2.46- 8.24). are independent predictors of CMD and educational status (primary, secondary and diploma) was positively associated with CMD. in this study. Regarding education (primary, secondary and diploma) (AOR=0.34; 95% CI; 0.17-0.66) and (AOR=0.35; 95% CI; 0.19-0.67) has positively associated with common mental disorders. CONCLUSION:The prevalence of common mental disorders was found high. Female sex, marital status like Divorced/Widowed, daily labour workers and chronic medical illness were found to be independent predictors of CMD and educational status (primary, secondary school and diploma holders) was were found to be protective factors. 10.1186/s12888-022-03783-9
    Symptoms of internet gaming disorder among male college students in Nanchong, China. BMC psychiatry BACKGROUND:This study aimed to evaluate the presence of symptoms of Internet Gaming Disorder (IGD) and examined associations between IGD and depressive symptoms, family and peer support among male college students in Nanchong, China. METHODS:A cross-sectional study was conducted among 2533 male students in three colleges. Background characteristics, depressive symptoms, family and peer support and IGD information were collected. Binary logistic regression was performed to access the relationship between variables and IGD. PROCESS macro was used to examine the mediation analysis of family and peer support on the relationship between depressive symptoms and IGD. RESULTS:The estimated presence of symptoms of IGD was 11.6%. The most commonly endorsed items were escapism, continuation and preoccupation both among total participates and the IGD group. In the binary logistic regression, general expenditure per month, depressive symptoms, and family and peer support revealed their significance in associations with IGD. Adjusted for the significant background variable, depressive symptoms and family and peer support remained significance. Additionally, family and peer support would attenuate the relationship between depressive symptoms and IGD. CONCLUSIONS:This study found that one in ten male college students reported clinically significant IGD symptoms, which indicate that IGD is an important public health problem in Nanchong, China. 10.1186/s12888-022-03778-6
    Association between social phobia and the risk of arrhythmia using the Korean National Sample Cohort: a retrospective cohort study. Kim Hyunkyu,Jeong Wonjeong,Kim Seung Hoon,Seo Jun Ho,Ryu Jin Sun,Kim You-Seok,Seok Jeong-Ho,Jang Sung-In,Park Eun-Cheol BMC psychiatry BACKGROUND:Social phobia shares symptoms with arrhythmias, such as palpitations and chest discomfort. However, it is unclear how social phobia is associated with the actual risk of arrhythmia. This study aimed to investigate whether social phobia is associated with the risk of arrhythmia using a nationally representative sample cohort. METHODS:This retrospective cohort study assessed data from the 2002-2013 Korean National Health Insurance Service National Sample Cohort. Using 1:3 propensity score matching for sex, age, income, and insurance status, 1514 patients with social phobia and 4542 control group patients were included in the study. Social phobia and arrhythmia were defined per the International Classification of Diseases, 10th revision. Using cox proportional hazard regression, hazard ratios (HRs) were calculated to estimate the risk of arrhythmia in patients with social phobia. RESULTS:There were statistically significant associations between social phobia history and elevated risks of arrhythmia. Patients with social phobia had a higher risk of arrhythmia after adjusting with covariates (HR = 1.78, 95%CI = 1.25-2.55). Among different types of arrhythmias, atrial fibrillation and flutter presented the highest risk (HR = 2.20, CI = 1.06-4.57) compared to paroxysmal tachycardia (HR = 1.07, CI = 0.39-2.91) and other cardiac arrhythmias (HR = 1.83, CI = 1.16-2.89). CONCLUSION:This study identified the association between social phobia and the risk of arrhythmia in a South Korean representative cohort. These results suggest that social phobia should be treated properly to reduce arrhythmia risks. 10.1186/s12888-022-03689-6
    Individual and residency program factors related to depression, anxiety and burnout in physician residents - a Brazilian survey. BMC psychiatry BACKGROUND:Psychological distress is common among medical trainees. This study aimed to assess the frequency of depression, anxiety and burnout among physician residents and their association with both individual and residency program-related factors. METHODS:This was a cross-sectional study applying an online survey in a national-wide sample of medical residents from Brazil. Depression, anxiety, burnout and diurnal somnolence were assessed with validated tools (Patient Health Questionnaire-4, 2 items version of Maslach Burnout Inventory, and Epworth Sleepiness Scale). Socio-demographic and residency program-related factors were measured with internally validated instruments. We performed multivariate binary logistic regression analysis for each of the main outcomes. RESULTS:Screening for depression, anxiety and burnout was positive respectively in 46.9%, 56.6% and 37.0% of our sample (n = 1,419). Depression was independently related to female sex, longer duty hours, absence of day off, poor learning perception, poor feeling about the residency program, overall occurrence of psychological abuse, anxiety, diurnal somnolence and burnout (AUROC = .859 [95%CI = .840-.878], p < .001). Anxiety was independently associated with female sex, higher age and duty hours, work-personal life conflicts, few classroom activities, providing assistance without supervision, depression and diurnal somnolence (837 [.816-.857], p < .001). Burnout was related to lower age and leisure time, male sex, longer duty hours, absence of day off, provision of care without supervision, choice of the wrong specialty, poor learning, psychological abuse, depression and diurnal somnolence (.780 [.753-.806], p < .001). CONCLUSION:Frequency of psychological distress in residency training is high and related to both individuals and environmental factors, namely high workloads, occurrence of psychological abuse, poor faculty supervision, poor learning experience and work-personal life conflicts. 10.1186/s12888-022-03916-0
    Adherence to the MIND dietary pattern and sleep quality, sleep related outcomes and mental health in male adults: a cross-sectional study. BMC psychiatry BACKGROUND:A large number of studies have investigated the association of the Mediterranean and DASH diets with psychological health as well as sleep related outcomes. However, only a few number of studies have examined the association of their newly proposed hybrid, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) dietary pattern, with sleep quality and sleep related outcomes. METHODS:This cross-sectional study was conducted on 400 male health professions (mean age 38.67 years). Dietary information was collected using a validated 168-item semi-quantitative food frequency questionnaire. The MIND score was computed based on major dietary components emphasized or minimized in this pattern. The higher the MIND score of a subject, the greater his adherence to the MIND pattern. Mental health was evaluated using the 21-item depression, anxiety, and stress scale (DASS-21). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Sleep-related outcomes (day-time sleepiness and insomnia) were also evaluated using standard questionnaires RESULTS: No significant associations were found between adherence to the MIND diet score and odds of stress, anxiety and depression either in the crude or multivariable-adjusted models (P > 0.05). Nevertheless, participants with the greatest adherence to the MIND diet had lower odds of poor sleep quality (OR for T3 vs. T1: 0.56 (95% CI: 0.34, 0.92), P-trend = 0.023). The results remained significant after full adjustment for confounding variables (P-trend = 0.042). Participants in the highest tertile of MIND diet had a 42% lower odds of daytime sleepiness in the crude and multivariable-adjusted model (P-trend < 0.05). Although no significant association was observed between adherence to the MIND diet and severity of insomnia in the crude model (P-trend = 0.055), the multivariable-adjusted model showed that the highest adherence to the MIND diet was associated with lower odds of insomnia (OR for T3 vs. T1: 0.54 (95% CI: 0.31, 0.93), P-trend = 0.031). CONCLUSION:While no significant associations were found between adherence to the MIND diet and stress, anxiety and depression, greater adherence to the MIND diet were associated with lower odds of poor sleep quality and sleep-related outcomes. 10.1186/s12888-022-03816-3
    Association of cardiovascular metabolic risk factor measurements with psychiatric readmission among in-hospital patients with severe mental illness: a retrospective study. Tan Xiao Wei,Chan Christopher Yi Wen,Lum Alvin Wai Mum,Lee Eng Sing,Mok Yee Ming,Fung Daniel Shuen Sheng,Tor Phern Chern BMC psychiatry BACKGROUND:Patients with severe mental illness (SMI) and comorbid physical conditions were often associated with higher risks of mortality and hospital readmission. In this study, we aim to examine the association of cardiovascular metabolic risk factor measurements with risks of psychiatric readmissions among in-hospital patients with severe mental illness (SMI). METHODS:We collected the longitudinal information of laboratory investigations, blood pressure and body mass index (BMI) among in-hospital patients who had been diagnosed with schizophrenia, major depression disorder or bipolar disorder and with comorbid diagnosis of hypertension, hyperlipidemia or diabetes from Jan 2014 to Jan 2019. The primary outcome was time to first psychiatric readmission. Cox proportional hazard model was utilized to calculate the hazard risks (HR) of cardiovascular metabolic risk factors with psychiatric readmission. RESULTS:A total of 5,256 patients were included in the analysis. Compared to patients with normal blood parameters, patients with aberrant tests of high-density dyslipidemia (HDL) and diastolic blood pressure (DBP) during in-hospitalization period were associated with higher risks to first psychiatric readmission [ HR (Hazard Ratio), 1.37 95% Confidence interval (CI), 1.03-1.83 for HDL and HR, 1.32 (95% CI, 1.04-1.67])for DBP]. Compared to patients with optimal monitoring, patients with suboptimal monitoring of blood lipids and blood pressure during in-hospitalization period or recommended window period of cardiovascular disease (CVD) risk management were associated with higher risks to first psychiatric readmission. CONCLUSIONS:Aberrant cardiovascular metabolic blood test and blood pressure and missing measurements among in-hospital patients with SMI were associated with increased risks of psychiatric readmissions. This calls for more active screening and monitoring of CVD risk factors for those in-hospital patients in need. 10.1186/s12888-022-03704-w