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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. 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. 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). 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. 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. • It is unclear about the mutual impact of COVID-19 infection and psychological stress on individuals' mental health • This study supports the mutual overlapping theory (MOT) of COVID-19 infection and psychological stress • The overlap of COVID-19 infection and psychological stress may cause more severe mental health problems • Health policies and interventions should be developed for reducing the impact of infection and psychological stress [ABSTRACT FROM AUTHOR]

Gender differences in mental health emerge in adolescence. The timing coincides with the development of premenstrual disorders (PMDs). Here, we examine the association between PMDs and adolescent mental health in the context of gender differences. A cross-sectional analysis comprising 21,239[10,563 (49.7 %) girls] individuals aged 10–19 years from the Santai Youth Mental Health Promotion Cohort in China. Possible PMDs, major depression disorder (MDD), general anxiety disorder (GAD), history of self-injury, and high suicide-risk status were surveyed using standard questionnaires. We used logistic regression to contrast the prevalence of outcomes between girls with and without PMDs, and boys. The prevalence rates of possible MDD and GAD were comparable between girls without PMDs and boys [OR1.03 (0.96–1.11) and 0.99 (0.92–1.07)], whereas a higher burden was observed in girls with PMDs [OR4.76(4.31–5.26) and 3.86(3.50–4.27), respectively]. Moreover, MDD/GAD prevalence among premenarchal girls was comparable to their peer boys. Greater gender differences in self-injury and high suicide-risk status were also found for girls with PMDs [OR 4.70 (4.22–5.24) and 7.49 (6.6–8.5)] than that for girls without PMDs [OR1.45(1.33–1.59) and 1.81 (1.62–2.03)]. Girls with PMDs may have overreported depressive and/or anxiety symptoms due to the overlap of symptomology. The greater gender differences in adolescent mental ill-health among girls with PMDs lend support to the hypothesis that PMDs play an important role in the gender disparities in adolescent mental health, particularly in depression and anxiety. • The gender differences in mental health are well-documented in adolescence; yet the determinants are poorly understood. • The development of premenstrual disorders (PMDs) highly coincides the emergence of gender differences in depression/anxiety in adolescence. • PMDs may play an important role in the well-known gender disparities in adolescent mental health. • If confirmed in prospective data, prevention strategies for PMDs should be developed to reduce the gender disparity in mental health. [ABSTRACT FROM AUTHOR]

Background: Optimal strategies for prevention and treatment for post-stroke depression (PSD) remain unclear and a greater understanding of effect of resilience on PSD is promising. The aim was to examine the association between baseline resilience and depression at 1, 3, and 6 months after discharge, which contributes to early detection and management of PSD.Methods: A total of 217 ischemic stroke survivors were recruited in two tertiary hospitals in Shanghai, China from February 2017 to January 2018. The Chinese version of Connor-Davidson Resilience Scale (CD-RISC) was used to assess resilience at acute hospitalization. Hospital Anxiety and Depression Scale (HADS) was employed to ascertain baseline anxiety, baseline depression, and post-discharge depression. Social-demographic and disease-related information were obtained from participants' self-report and medical records. Logistic regression analysis was used to determine which factors were independently associated with PSD.Results: The prevalence of depression at baseline was 21.2% and at 1, 3, and 6 months after discharge was 34.4%, 33.2%, and 29.2%, respectively. Logistics regression analyses indicated that resilience may independently predict PSD at 1 month (OR: 0.22, 95%CI: 0.097, 0.518), 3 months (OR:0.302, 95%CI: 0.151, 0.607), and 6 months (OR: 0.03, 95%CI: 0.006, 0.153) after controlling for social-demographics, disease-related characteristics, baseline anxiety, and baseline depression.Limitations: Non-multicenter survey and mild stroke severity may affect the generalization of these findings. Moreover, response bias should be acknowledged because some participants were read questionnaires out aloud.Conclusion: Resilience is independently associated with PSD at different timepoints. Our findings reveal the important role of resilience as a protective factor against PSD. [ABSTRACT FROM AUTHOR]

To evaluate the national prevalence depression of Chinese cancer patients and clarify its potential associated factors. Twelve databases were searched from database inception through October 31, 2022 for relevant studies published in English (PubMed MEDLINE, Ovid MEDLINE, Embase, Scopus, PsycINFO, and Cochrane and Web of Science) and Chinese (China National Knowledge Infrastructure, Wanfang, Weipu, Chinese Biomedical Literature Service System, Duxiu) that estimated point or period prevalence of depression, depressive disorder, or suicidal ideation as assessed by self-report scale or structured interview. 201 studies were eligible for inclusion in our meta-analyses. We found the national pooled prevalence rates of depression and suicidal ideation were 44.63 % (95 % CI 42.24 %–47.01 %) and 24.95 % (95 % CI 10.96 %–38.95 %), respectively. The pooled prevalence of depression was associated with study location, cancer type, comorbid chronic disease, and female sex (all P < 0.05). The distribution of the depression prevalence among cancer patients in mainland China was characterized by significant geographical variation and clustering. The highest pooled prevalence of depression was among gynecologic oncology patients. We recommend that more attention and resources be given to mental health problems such as depression and suicidal ideation among Chinese cancer patients, and that prevention programs be developed, especially in areas with a high prevalence of depression. • The pooled prevalence of depression among Chinese cancer patients was estimated. • This meta-analysis included 201 studies covering 27 provinces in mainland China. • Factors affecting the prevalence of depression in cancer patients were analyzed. • ArcGIS software was used to analyze the geographic distribution of depression. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) has received increased attention as a major public health problem among adolescents. However, there is a lack of evidence testing the longitudinal association between cybervictimization and NSSI as well as its underlying mediating and moderating mechanisms. The current study investigated the potential mediator (i.e., anxiety symptoms) and moderator (i.e., self-control) of the relation between cybervictimization and NSSI over a 12-month period.Methods: Three waves of data (called T1, T2 and T3) were collected 6 months apart, between November 2018 and 2019. 1987 Chinese adolescents completed self-report measures in their classrooms. SEM was used to test a moderated mediation model, with gender, age and childhood trauma and baseline measures as covariates.Results: The results found a longitudinal association between cybervictimization and NSSI as well as the mediating role of anxiety symptoms in explaining this association. Moderated mediation analyses revealed that greater cybervictimization contributed to anxiety symptoms, which in turn predicted increased levels of NSSI only among adolescents with lower self-control.Limitations: Measures of study variables were self-reported, and generalizability may be limited by a sample of adolescents from school in China.Conclusions: The present study demonstrated that the indirect effect of anxiety symptoms in the association between cybervictimization and NSSI was conditioned by self-control. These results have implications for preventative interventions aimed toward reducing NSSI for at-risk adolescents. [ABSTRACT FROM AUTHOR]

Background: With the modification of DSM-5 mixed features specifier, a brief scale to screen mixed features in patients with mood disorders is needed in clinical practice. This study aimed to explore the psychometric properties of the Chinese version of the Clinically Useful Depression Outcome Scale supplemented with DSM-5 Mixed subtype (CUDOS-M-C) for the Chinese patients with mood disorders.Methods: Overall, 300 patients with major depressive episode were recruited. All participants were assessed using CUDOS-M-C, Young Mania Rating Scale, Hamilton Anxiety Scale and Montgomery-Asberg Depression Rating Scale. The receiver operating characteristic (ROC) curve analysis was used to calculate the optimal cut-off values of CUDOS-M-C score. The reliability and validity of CUDOS-M-C were examined using Cronbach's alpha, intraclass correlation coefficient (ICC) and principal component analysis (PCA).Results: The results of PCA indicated two-factor structure as the best solution for CUDOS-M-C, which explained 54.82% of cumulative variance. The Cronbach's alpha was 0.892 and the ICC was 0.853. The area under the ROC curve of the CUDOS-M-C for participants with mixed depression was 0.927 (p<0.001) and the suitable cut-off value was 8, with a sensitivity of 91.6% and specificity of 79.9%.Limitations: Most of the patients were recruited from eastern China and further research with larger sample is warranted. And this study did not perform confirmatory factor analysis to identify the generalization of factor structure of CUDOS-M-C. Besides, the study performed the test-retest reliability of CUDOS-M-C and further analysis is needed to ascertain the patient's post-treatment changes.Conclusion: The CUDOS-M-C demonstrated to have satisfactory psychometric properties as a self-report scale, and could be applied to screen patients with mixed depression in clinical practice. [ABSTRACT FROM AUTHOR]

Background: To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences.Methods: A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively.Results: The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys.Limitations: The study only included school students, and the cross-sectional design limited our ability to make causal inferences.Conclusions: The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls. [ABSTRACT FROM AUTHOR]

Background: Despite considerable studies focused on the symptoms of posttraumatic stress disorder (PTSD), little is understood about how symptoms of PTSD change over time. The study aimed to use a network analysis approach to understand the nature of the association between PTSD symptoms at different time points among children and adolescents who experience an earthquake.Methods: A longitudinal study enrolled 1623 youth survivors who completed 3 assessments with the Children's Revised Impact of Event Scale at 2 weeks, 3 months and 6 months after the Lushan earthquake. The epicentre was Baoxing Country that located in the Ya'an city (Sichuan Province in China). A network analysis approach was used to investigate how symptom networks change at different time points.Results: A total of 1623 youth survivors (768 male and 855 female) completed three assessments. Different centrality symptoms existed at different time points. Flashback and upset by reminders were centrality symptoms at 2 weeks, 3 months and 6 months. The overall network connectivity was significantly stronger at 3 months than at 2 weeks (5.663 vs. 5.140, s = 0.523, p = 0.000), and significantly stronger at 6 months than at 2 weeks (6.094 vs. 5.663, s = 0.432, p = 0.020).Limitations: Participants from a specific region might limit the generalizability of our results. A self-report questionnaire was used to assess PTSD symptoms.Conclusions: Re-experience cluster (flashback and upset by reminders) and their interactions might play a key role in PTSD symptom evolution. Over time, the global connectivity becomes stronger, suggesting that youth survivors are more vulnerable in the chronic phases. [ABSTRACT FROM AUTHOR]

Background: Suicidal ideation and attempts are still currently serious problems among adolescents worldwide, and there is evidence that sleep problem may be associated with increased rates of mental disorder. This study aimed to examine the associations between sleep duration and suicidal ideation and attempts among adolescents and to test whether depressive symptoms have moderating effects on the associations.Methods: A 3-stage, stratified cluster, random sampling method was used to collect data from 20,130 high school students in southeast China.Results: The weighted prevalence of short sleep among Chinese adolescents was 5.6% (95% CI, 5.3-6.0%), and the weighted prevalence of long sleep was 2.7% (95% CI, 2.5-3.0%). The final results demonstrated that short sleep was positively associated with suicidal ideation (AOR=2.28, 95% CI=1.96-2.66) and suicidal attempts (AOR=3.20, 95% CI=2.46-4.16), and long sleep was only significantly associated with suicidal attempts (AOR=2.47, 95% CI=1.70-3.58). Stratification analyses conducted separately for students with and without depressive symptoms demonstrated that depressive symptoms may have moderating effects on the associations between sleep duration and suicidality.Limitations: Our study sample only included school students, and causal inference could not be examined due to the cross-sectional design.Conclusions: Sleep duration was associated with suicidal ideation and attempts, and the association between sleep duration and suicidal attempts was U-shaped. These findings support that proper treatments services with the potential to restore adolescent normal sleep would be helpful in preventing suicidality among adolescents. [ABSTRACT FROM AUTHOR]