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Gaming disorder has become a significant issue in mental healthcare. While gaming is an important form of entertainment, excessive gaming may cause serious consequences for players. At present, there are still controversies in the academic community concerning the public health problems related to gaming disorder. This article attempts to expound the definition, epidemiology, aetiology, diagnosis, treatment and prevention of gaming disorder, in order to contribute to future conceptualization of gaming disorder.

Drug treatment services of varying types have been scaled up in China over the past decade. Yet, barriers to treatment remain among the population of drug users in China. In this paper, we use a person-centered approach to examine external barriers to drug treatment among a sample of Chinese drug users. Specifically, we used a latent class analysis to determine a typology of external barriers to treatment among a sample of 262 drug users. The results of the analyses suggest three-classes of drug users with respect to their perceptions of external barriers to treatment – Major Barriers, Low Barriers, and Systems-level Barriers – indicating that drug users are a heterogeneous population on this matter. Age and types of drugs used were predictors of class membership. In this regard, different tactics must be utilized in order to successfully reach this wide ranging group of individuals.

An effective logic built-in self-test scheme aiming at reducing the area overhead of IC testing and improving the fault average is proposed, which combines strategies of linear feedback shift register (LFSR)-reseeding with test vectors applied by circuit-under-test itself (TVAC). LFSR-reseeding technology is first applied to decrease the size of test set and the number of interior feedback wires, while TVAC technology is applied to decrease the number of stored seeds. An efficient LFSR-reseeding algorithm and a modified quick judgment method for path search are proposed. Experimental results for ISCAS 85 benchmarks demonstrate that the proposed method reduces the number of interior feedback wires more than 50% on average and can achieve full fault coverage with much less groups as well as area overhead compared with previous TVACs.

Provide the details about the characteristics of the hypothetical people in the schizophrenia vignette and the depression vignette in English. (DOCX 12 kb)

Background Smartphones are becoming a daily necessity for most undergraduates in Mainland China. Because the present scenario of problematic smartphone use (PSU) is largely unexplored, in the current study we aimed to estimate the prevalence of PSU and to screen suitable predictors for PSU among Chinese undergraduates in the framework of the stress-coping theory. Methods A sample of 1062 undergraduate smartphone users was recruited by means of the stratified cluster random sampling strategy between April and May 2015. The Problematic Cellular Phone Use Questionnaire was used to identify PSU. We evaluated five candidate risk factors for PSU by using logistic regression analysis while controlling for demographic characteristics and specific features of smartphone use. Results The prevalence of PSU among Chinese undergraduates was estimated to be 21.3%. The risk factors for PSU were majoring in the humanities, high monthly income from the family (≥1500 RMB), serious emotional symptoms, high perceived stress, and perfectionism-related factors (high doubts about actions, high parental expectations). Conclusions PSU among undergraduates appears to be ubiquitous and thus constitutes a public health issue in Mainland China. Although further longitudinal studies are required to test whether PSU is a transient phenomenon or a chronic and progressive condition, our study successfully identified socio-demographic and psychological risk factors for PSU. These results, obtained from a random and thus representative sample of undergraduates, opens up new avenues in terms of prevention and regulation policies. Electronic supplementary material The online version of this article (doi:10.1186/s12888-016-1083-3) contains supplementary material, which is available to authorized users.

Considered the cooperation of the container truck and quayside container crane in the container terminal, this paper constructs the model of the quay cranes operation and trucks scheduling problem in the container terminal. And the hybrid intelligence swarm algorithm combined the particle swarm optimization algorithm(PSO) with artificial fish swarm algorithm (AFSA) was proposed. The hybrid algorithm (PSO-AFSA) adopt the particle swarm optimization algorithm to produce diverse original paths, optimization of the choice nodes set of the problem, use AFSA's preying and chasing behavior improved the ability of PSO to avoid being premature. the proposed algorithm has more effectiveness, quick convergence and feasibility in solving the problem. The results of stimulation show that the scheduling operation efficiency of container terminal is improved and optimized.

bjectives:To evaluate life events, levels of anxiety and depression among doctors and nurses in the emergency department (ED). Design:An anonymous self-reported survey was employed from January 2013 to April 2013 that included Life Event Scale (LES), Zung's Self-Rating Anxiety Scale (SAS), Zung's Self-Rating Depression Scale (SDS) and other Likert-style questions. Participants:A total sample of 412 participants (124 doctors and 288 nurses) from department of emergency in eleven grade-3 and grade-2 general hospitals in Hunan Province, China was involved in this study. Results:Both doctors and nurses from ED experienced more negative life events than positive life events (mean total score: 14.13 VS. 6.41). Among all family, work and social life events, high pressures of work as negative life event was the most frequently reported one. 6.34% (5.65% in doctors and 6.60% in nurses) suggestive anxiety symptoms and 17.73% (14.5% in doctors and 18.8% in nurses) suggestive depression symptoms were reported among them. Negative, but not positive, life events correlated with symptoms of depression and anxiety. Doctors experienced much more work related negative events than nurses did. However, nurses showed higher levels of anxiety and depression that that of doctors. Conclusion:These findings suggest doctors and nurses from emergency department experienced much more negative life events than positive life events, and those negative life events, especially work related negative events, may have harmful impact on their mental health (risk for depression and anxiety). Development of a range of coping strategies for decreasing the harmful effects of those negative life events and minimizing or controlling the occurrence of anxiety and depressive symptoms should be emphasized for doctors and nurses who work in a hospital’s emergency department

Objectives: To evaluate life events, anxiety and depression levels among physicians and nurses in emergency department (ED). Design: An anonymous, self-reporting survey was employed between January 2013 and April 2013 that included Life Event Scale (LES), Zung's Self-Rating Anxiety Scale (SAS), Zung's Self-Rating Depression Scale (SDS) and other Likert-style questions. Participants: A total sample of 412 participants (124 physicians and 288 nurses) from the emergency department of eleven grade-3 and grade-2 general hospitals in Hunan Province, China. Results: ED physicians and nurses both experienced more negative life events than positive life events (mean total score: 14.13 VS. 6.41). The high pressure of work as a negative life event was the most frequently reported of all life events. Suggestive anxiety symptoms were reported by 6.34 % (5.65 % in physicians and 6.60 % in nurses) and suggestive depression symptoms were reported by 17.73 % (14.5 % in physicians and 18.8 % in nurses). Negative, but not positive, life events correlated with symptoms of depression and anxiety. Physicians experienced many more work-related negative events than nurses. Nurses showed higher levels of anxiety and depression than physicians. Conclusion: These findings suggest that emergency department physicians and nurses experienced many more negative life events than positive life events, and these negative life events, especially work-related negative events, may harmfully impact their mental health placing them at risk for depression and anxiety. Developing a range of coping strategies for decreasing the harmful effects of these negative life events and minimizing, or controlling, the occurrence of anxiety and depressive symptoms should be emphasized for physicians and nurses who work in a hospital’s emergency department.

N-detect testing suffers from the drawback with its test set size and test application time. A Build-In Self-Test (BIST) N-detect test patterns generation method based on controlled linear shifter is proposed, which embeds test set into the controlled bits stream and provide high defect coverage with low storage area overhead and test application time. In this method, corresponding N test patterns are generated for each fault, by using the bits which are directly stored in ROM to control the first bit of the linear shifter, dynamically generate the complete N-detect test set. Simulation results for benchmark circuits show that the proposed method with power consumption considering provides considerably lower area overhead, shorter test application time and higher transition-fault coverage compared to other recently-published methods.

An understanding of the relationship among life events, anxiety, depression, and heroin abuse may benefit the prevention and early treatment of heroin dependence. The objective of this study was to assess self-reported life events, anxiety, and depression in patients with heroin dependence. In this survey, Chinese heroin-dependent patients (n = 139) were asked to conduct a battery of self-reported questionnaires. A total of 76.26% of heroin-dependent patients reported the occurrence of major lifestyle pattern (dietary and sleep) changes as negative life events. Financial problems from family, unemployment, and poor interpersonal relationships were also frequently reported as negative events. Heroin-dependent patients experienced overwhelmingly more negative life events than positive life events. Those negative life events positively correlated with depression and anxiety. They also exhibited high levels of anxiety (Self-Rating Anxiety Scale, mean 44.42 ± 8.27) and depression (Self-Rating Depression Scale, mean 47.28 ± 8.54). Although preliminary, findings from this study suggest the need for further investigation of life events, anxiety, and depression in a generalized large sample, which may benefit community-based psychosocial intervention and prevention of relapse in heroin-dependent subjects.

Objective This cross-sectional study explored the prevalence of disordered eating attitudes, body shape concerns, and social anxiety and depressive symptoms in male and female medical students in China. Method Four hundred eighty-seven students from Central South University (Hunan Province, Changsha City, China) completed the following self-report measures: Eating Attitudes Test-26, Eating Disorders Assessment Questionnaire, Body Shape Questionnaire, Swansea Muscularity Attitudes Questionnaire, Social Interaction Anxiety Scale, and the Self-Rating Depression Scale. Results A comparatively lower rate of at-risk eating attitudes (2.5%) and eating disorders (0.90%) were found compared to those reported in other studies. Significantly more female (3.2%) than male (1.2%) students had abnormal eating attitudes with 4 female students meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , criteria for bulimia nervosa. Significant relationships were observed between eating attitudes, body shape concern, social anxiety, depression, and body mass index. For females, the most significant correlate of distorted eating attitudes was body shape concern, whereas for male students, social anxiety and concern with muscle size and shape were most strongly correlated with distorted eating attitudes.

Magnetic resonance imaging (MRI) studies showed a link between chronic smoking and structural brain abnormalities. To date, little is known about the long-term effects of smoking on gray matter deficiencies. MRI study was carried for 44 smokers and 44 matched non-smokers to assess gray matter volume differences between the two groups. Decreased gray matter volumes were found in left thalamus, medial frontal cortex and anterior cingulate of smokers in comparison to controls. This voxel-based morphometry study is showing reduction of regional gray matter volume in smokers, which might better guide future research into the pathogenesis of chronic smoking.

Adolescents with early-onset schizophrenia (EOS) provide a unique opportunity to examine regional and disease-specific early abnormal brain development in schizophrenia. There is currently a general agreement that clinical symptoms and cognitive dysfunctions of schizophrenia may arise from a failure of adequate communication between different brain regions. This disturbed connectivity may be related to alterations in the numbers, distribution, and ultrastructural integrity of oligodendrocytes of white matter. Diffusion tensor imaging provides a relatively new approach for quantifying possible connectivity of white matter in vivo. In this study, thirty-eight adolescents with early-onset schizophrenia (EOS; onset of psychotic symptoms by age 18 years) and 38 age- and gender-matched healthy volunteers received diffusion tensor imaging examinations. Fractional anisotropy images were compared between groups in the white matter using a voxelwise analysis after inter-subject registration to standard Montreal Neurological Institute (MNI) space. Adolescents with EOS demonstrated significantly reduced fractional anisotropy in right anterior cingulum compared to healthy volunteers. Increased fractional anisotropy was not observed in any brain region in patients compared to controls. ROI analysis also reported a trend-level negative correlation between mean regional FA in right anterior cingulum and PANSS positive symptom score. These findings indicate that white matter abnormalities in the anterior cingulum are associated with adolescent EOS.

Ketamine abuse has been shown to have a deleterious impact on brain function. However, the precise mechanisms of ketamine dependence-induced pathological change remain poorly understood. Although there is evidence for white matter changes in drug abuse, the presence of white matter abnormalities in chronic ketamine users has not been studied. White matter volumes were measured using in vivo diffusion tensor magnetic resonance imaging data in 41 ketamine-dependent subjects and 44 drug-free healthy volunteers. White matter changes associated with chronic ketamine use were found in bilateral frontal and left temporoparietal cortices. There was also evidence that frontal white matter fractional anisotropy correlated with the severity of drug use (as measured by estimated total ketamine consumption). We provide direct evidence for dose-dependent abnormalities of white matter in bilateral frontal and left temporoparietal regions following chronic ketamine use. The findings suggest a microstructural basis for the changes in cognition and experience observed with prolonged ketamine use. Moreover, the similarities of these changes to those observed in chronic schizophrenia have implications for the glutamate model of this illness.

This study aimed to determine sex differences in socio-demographic and clinical characteristics of Chinese schizophrenia patients. In a multi-center, randomized, controlled, longitudinal study, 404 clinically stable patients with schizophrenia were randomly assigned to a maintenance group (optimal therapeutic doses continued throughout the study), a 26-week group (optimal therapeutic doses continued for 26 weeks, followed by a 50% dose reduction maintained until the end of the study), or a 4-week group (optimal therapeutic doses continued for 4 weeks, followed by a 50% dose reduction maintained until the end of the study). Participants were interviewed regularly using standardized assessment instruments, and followed up for 12-26 months. In the univariate analyses, the following factors were significantly associated with the male sex: not married, smoking, younger age, earlier age at onset, higher body mass index (BMI) at baseline, and more severe negative and hostility-excitement symptoms at baseline. The following factors were independently associated with the male sex in the multivariate analyses: not being married, smoking, a higher BMI at baseline, less deterioration in disorganized thoughts (4-week group) and positive symptoms (26-week group) and less increase in BMI in all three treatment groups over the study period. The majority of the sex differences in schizophrenia patients in this study are in accordance with results of previous studies worldwide suggesting that sex differences seen in schizophrenia are not dependent on cultural differences between geographically separate patients.

This cross-sectional study explored the prevalence of body image dissatisfaction, body dysmorphic disorder, social anxiety and depressive symptoms in first-year medical students in China. A self-report survey design was employed, using the Body Shape Questionnaire, Swansea Muscularity Attitudes Questionnaire, Social Interaction Anxiety Scale, Dysmorphic Concern Questionnaire, Self-Rating Depression Scale and the Body Dysmorphic Disorder Questionnaire. A total of 487 first-year medical students participated. About one-third of participants (32.5%) indicated that they were very concerned about some aspect of their appearance unrelated to weight, with six female participants (1.3%) screening positive for body dysmorphic disorder (BDD). Those who displayed concern with their appearance (including those who did not screen positive for BDD) had higher levels of depressive and social anxiety symptoms than those who had no appearance concerns.

OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS) HAS BEEN SHOWN TO AGGREGATE SIGNIFICANTLY WITHIN FAMILIES.1–3 FAMILY STUDIES HAVE SUGGESTED that the risk of OSAS may be from 2- to 4-fold as great in relatives of patients with OSAS than in controls,4 and that nearly 40% of the variance in the apnea hypopnea index (AHI) of patients with OSAS may be explained by genetic factors.1 It is likely that genetic factors accompanied with craniofacial structure, body fat distribution and neural control of the upper airway muscles interact to produce the OSAS phenotype.5–7 However, the role of specific genes that influence the development of OSAS has not been identified. Although several previous studies had presumed that several susceptible genes, such as angiotensin converting enzyme (ACE), ApoE4, and insulin receptor substrate (IRS) −1 might be involved in the pathogenesis of OSAS,8–10 the genetic markers for this disorder remain elusive. Several lines of pharmacological, neurobehavioral, and therapeutic evidence have implicated that serotonin (5-HT) is involved in the pathogenesis of OSAS.11–13 By regulating the magnitude and duration of serotonergic responses, the serotonin transporter (5-HTT) is central to the fine tuning of brain serotonergic neurotransmission and of the peripheral actions of 5-HT.14 The 5-HTT protein is encoded by a single gene, the solute carrier family 6, member 4, SLC6A4 (i.e., 5-HTT), which locates on chromosome 17q11.1–17q12.15,16 Two common polymorphisms have been described in the gene: a deletion /insertion of 44 bp in the promoter region approximately 1 kb upstream of the transcription site (5-HTTLPR) and a variable number of tandem repeats in intron 2 (STin2.VNTR) containing 9,10, or 12 copies of a 16–17 bp repeat element located in intron 2.16–18 These polymorphisms make the 5-HTT a strong candidate gene for study in sleep disorders. In previous studies, the rat with 5-HTT gene knockout showed disturbed sleep.19 Yilmaz et al. reported that the 12/10 and LL genotypes were overrepresented in 20 male patients with OSAS.20 To further assess whether the 5-HTT gene could be implicated in the vulnerability to OSAS, we performed an independent case-control association study in a Chinese Han population.

In addition, approximately 30 million children and young adolescents are suffering from mood and/or behavioral disorders. Drug and alcohol problems and other psychosocial disorders affecting women, elders and survivors of disasters are also important problems adding to the overall national mental health burden. Research from both China and abroad indicate that mental and behavioral problems will continue to increase in the future. The World Health Organization (WHO) has warned that the financial burden from mental disorders in China will constitute 1/4 of total burden from various diseases in 2020.

ObjectivePrevious studies regarding internet addiction have investigated associated psychological variables such as shyness, loneliness, self-consciousness, anxiety, depression and interpersonal relations. Few studies about the relationship between internet Addiction and impulsivity have been done. This study aimed to assess whether internet addiction is related to impulsivity among Chinese adolescents.MethodThis study was performed in two stages. We screened for the presence of internet Addiction among 2620 high school students(age ranging from 12 years to 18 years) from four high schools of Changsha City using Diagnostic Questionnaire for internet Addiction (YDQ). According to the modified YDQ criteria by Beard, 64 students were diagnosed as internet addiction. Excluding current psychiatric comorbidity, 50 students who were diagnosed as internet Addiction (mean age, 14.8 ± 1.4 years) and 50 normal students in internet usage(mean age, 14.5 ± 1.8 years) were included in a case control study. The two groups were assessed using Barratt Impulsiveness Scale 11 (BIS-11) and behavioral measure of impulsivity (GoStop Impulsivity Paradigm).ResultsSixty-four students met the modified YDQ criteria by Beard, of whom 14 students suffered from comorbid psychiatric disorders, especially comorbid ADHD. The internet Addiction group had significantly higher scores on the BIS-11 subscales of Attentional key, Motor key, and Total scores than the control group (P < 0.05). The internet Addiction group scored higher than the control group on the failure to inhibit responses of GoStop Impulsivity Paradigm (P < 0.05). There was a significant positive correlation between YDQ scores and BIS-11subscales and the number of failure to inhibit responses of GoStop Impulsivity Paradigm.ConclusionThis study suggests that adolescents with internet addiction exhibit more impulsivity than controls and have various comorbid psychiatric disorders, which could be associated with the psychopathology of internet addiction.

C l i n M e d International Library Citation: Long J, Liu T (2015) Maladaptive Perfectionism: A Potential Risk Factor for Smartphone Addiction? Int Arch Addict Res Med 1:013 Received: November 02, 2015: Accepted: December 12, 2015: Published: December 14, 2015 Copyright: © 2015 Long J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Long et al. Int Arch Addict Res Med 2015, 1:3

Two types of ZnO single-sided nanocombs, namely the straight comb and the crescent comb, have been synthesized by simple evaporation of Zn powder in diluted O 2 flow at 440 °C. Both combs have a common teeth growth direction of [0 0 0 1]. The backbone of the straight comb is a [ 2 1 ¯ 1 ¯ 0 ] oriented nanobelt, with combteeth distributed on its broader surface. The backbone of the crescent comb is a [ 0 1 1 ¯ 0 ] oriented nanobelt, with combteeth distributed on its narrower surface, and it is bent into an arc by stress. The crescent comb is interesting as it is not only a hierarchical assembly of one-dimensional nanostructures, but also folded into a secondary structure as well. The structures of our nanocombs are controlled by supersaturation. Taking advantage of our low-temperature synthesis, we studied the growth process by freezing the growth stages. A modified VS growth mechanism was proposed.

Background Illicit drug use/dependence has been recognized as a major problem. Clinical studies demonstrate that poor sleep quality is associated with increased frequency of drug use and relapse. However, few studies have addressed the issue of sleep quality among illicit drug dependent subjects. Methods This cross-sectional study explored sleep quality in drug dependent subjects in China. We studied 2178 illicit drug dependent subjects from drug rehabilitation centres in Changsha and 2236 non-drug-using subjects, all of whom completed the self-report Pittsburgh Sleep Quality Index (PSQI). Results We found that the prevalence of sleep disturbance was much higher in drug users (68.5%, PSQI >5; specifically, 80.24% in heroin users, 54.16% in methamphetamine users and 81.98% in ketamine users with PSQI >5) than non-users (26.4%, PSQI >5). Drug users had approximately twice the sleep latency than nondrug users (37.7 minutes V.S 18.4 minutes). Although drug users and non-users reported similar sleep duration (about 7.4 hours), drug users showed poorer subjective sleep quality and habitual sleep efficiency. They reported more sleep disturbance and need for sleep medications, more daytime dysfunction and poorer subjective sleep quality compared with nondrug users. The total PSQI score positively correlated with the duration of drug use (rp = 0.164, p

Background We sought to investigate the clinical features of and risk factors for recurrent major depression (MD) with history of postpartum episodes (PPD) in Han Chinese women and the differences between first-onset postpartum MD (MD that has its first lifetime depressive episode in the postpartum period) and first-onset non-postpartum MD (MD with history of PPD and has its first lifetime depressive episode in a period other than postpartum). Methods Data were derived from the China, Oxford and Virginia Commonwealth University Experimental Research on Genetic Epidemiology (CONVERGE) study (N=6017 cases) and analyzed in two steps. We first examined the clinical features of and risk factors for MD patients with (N=981) or without (N=4410) a history of PPD. We then compared the differences between first-onset postpartum MD (N=583) and first-onset non-postpartum MD (N=398) in those with a history of PPD. Linear, logistic and multinomial logistic models were employed to measure the associations. Results A history of PPD was associated with more guilt feelings, greater psychiatric comorbidity, higher neuroticism, earlier onset and more chronicity (OR 0.2–2.8). Severe premenstrual symptoms (PMS) and more childbirths increased the risk of PPD, as did a family history of MD, childhood sexual abuse, stressful life events and lack of social support (OR 1.1–1.3). In the MD with history of PPD subsample, first-onset postpartum MD was associated with fewer recurrent major depressive episodes, less psychiatric comorbidity, lower neuroticism, less severe PMS and fewer disagreements with their husbands (OR 0.5–0.8), but more childbirths (OR 1.2). Limitations Data were obtained retrospectively through interview and recall bias may have affected the results. Conclusions MD with history of PPD in Han Chinese women is typically chronic and severe, with particular risk factors including severe PMS and more childbirths. First-onset postpartum MD and first-onset non-postpartum MD can be partly differentiated by their clinical features and risk factors, but are not clearly distinctive.

Although evidence exists for distinct barriers to drug abuse treatment (BDATs), investigations of their inter-relationships and the effect of individual characteristics on the barrier factors have been sparse, especially in China. A Multiple Indicators Multiple Causes (MIMIC) model is applied for this target.A sample of 262 drug users were recruited from three drug rehabilitation centers in Hunan Province, China. We applied a MIMIC approach to investigate the effect of gender, age, marital status, education, primary substance use, duration of primary drug use, and drug treatment experience on the internal barrier factors: absence of problem (AP), negative social support (NSS), fear of treatment (FT), and privacy concerns (PC).Drug users of various characteristics were found to report different internal barrier factors. Younger participants were more likely to report NSS (-0.19, p=0.038) and PC (-0.31, p0.001). Compared to other drug users, ice users were more likely to report AP (0.44, p0.001) and NSS (0.25, p=0.010). Drug treatment experiences related to AP (0.20, p=0.012). In addition, differential item functioning (DIF) occurred in three items when participant from groups with different duration of drug use, ice use, or marital status.Individual characteristics had significant effects on internal barriers to drug treatment. On this basis, BDAT perceived by different individuals could be assessed before tactics were utilized to successfully remove perceived barriers to drug treatment.

Subanaesthetic ketamine infusion in healthy volunteers induces experiences redolent of early psychosis, including changes in the experience of one’s own body. It is not clear, however, whether repeated self-administration of ketamine has a sustained effect on body representation that is comparable to that found during acute administration. We sought to establish whether chronic ketamine use resulted in disturbances to sense of body ownership. Following on from our work on the effects of acute ketamine infusion, we used the rubber hand illusion (RHI) to experimentally manipulate the sense of body ownership in chronic ketamine users, compared to healthy controls. Chronic ketamine users experienced the RHI more strongly and reported more body-image aberrations, even though they had not recently taken the drug. These findings suggest that the chronic ketamine model for psychosis models more long-lasting changes in sense of ownership, perhaps more akin to schizophrenia.

Methamphetamine use has emerged in China over the past decade. With the growth in methamphetamine use, it remains uncertain how users in China perceive its association with the HIV epidemic.The authors utilize qualitative and survey data from a mixed-methods study on methamphetamine use and HIV risk in China to assess the extent to which users perceive a risk for HIV transmission as well as how they conceive of the drug's links to HIV.Data indicate that a considerable majority (82.2%) perceived themselves to have zero risk for HIV infection. Qualitative interviews highlight the lack of information about HIV possessed by methamphetamine users given the confusion and disbelief often expressed. Others acknowledged that while there was an intertwining of risk, they were not personally at risk.Given the known association between methamphetamine use and HIV risk, health promotion initiatives in China should target methamphetamine users to build HIV-related knowledge and inhibit self-exempting beliefs. In particular, educational efforts regarding the association of methamphetamine use with HIV may inhibit risk behaviors.

Objective To understand the attitudes among medical students in China toward different medical specialties and to find the factors that influenced their choice of career in psychiatry. Methods A questionnaire was developed and administered to 287 medical students at the Xiangya Medical College, Central South University in Changsha, China. All the students were asked to rate the importance of five possible factors in choosing a specialty as a vocation: the ability to help patients, interesting and challenging work, lifestyle factors, financial reward, and prestige. Results Students reported negative perceptions of psychiatry in regard to all five possible factors that were important in choosing a specialty as a vocation, especially in financial reward and prestige. Conclusions Medical students in China have negative attitudes toward psychiatry as a career. Some negative beliefs about psychiatry seem to be due to erroneous or insufficient knowledge that could be corrected during the course of medical education. Some negative attitudes were unlikely to be completely changed until the mental health system in China improves.

Background Although the Brief Symptom Inventory-18 (BSI-18) has been widely used for mental health screenings in both clinical and non-clinical populations, the validation of its application to Chinese populations has been very limited. The objective of this research is to assess the factorial structure of the BSI-18 within a Chinese drug using population. Methods and results A total sample of 303 drug users recruited via Respondent Driven Sampling (RDS) from Changsha, China was used for the study. Our results show: (1) The BSI-18 item scores are highly skewed; (2) With dichotomous items measures (1 – problem at least moderately caused respondent discomfort during the past week; 0 – otherwise), our findings support the designed 3 – factor solution of the BSI-18 (somatization, depression, and anxiety); (3) The BSI-18 has a hierarchical factorial structure with 3 first-order factors and an underlying second-order factor (general psychological distress); (4) Tentative support should also be given to a single dimension of general psychological distress in Chinese drug using populations. Our study recommends a useful alternative approach for evaluating the factorial structure of the BSI-18 – i.e. CFA with dichotomous item measures. Both the total BSI-18 score and the three subscales (SOM, DEP, and ANX) can be used in applications of the BSI-18. Conclusion Overall, our findings suggest the BSI-18 is useful with Chinese drug users, and shows potential for use with non-Western and substance using populations more generally.

BACKGROUND: The default mode network (DMN) has been linked to a number of mental disorders including schizophrenia. However, the abnormal connectivity of DMN in early onset schizophrenia (EOS) has been rarely reported. METHODS: Independent component analysis (ICA) was used to investigate functional connectivity (FC) of the DMN in 32 first-episode adolescents with EOS and 32 age and gender-matched healthy controls. RESULTS: Compared to healthy controls, patients with EOS showed increased FC between the medial frontal gyrus and other areas of the DMN. Partial correlation analyses showed that the FC of medial frontal gyrus significantly correlated with PANSS-positive symptoms (partial correlation coefficient = 0.538, Bonferoni corrected P = 0.018). LIMITATIONS: Although the sample size of participants was comparable with most fMRI studies to date, it was still relatively small. Pediatric brains were registered to the MNI adult brain template. However, possible age-specific differences in spatial normalization that arise from registering pediatric brains to the MNI adult brain template may have little effect on fMRI results. CONCLUSION: This study provides evidence for functional abnormalities of DMN in first-episode EOS. These abnormalities could be a source of abnormal introspectively-oriented mental actives.

Background: Eating disorders is a particular problem for university students. However, little is known about this problem among medical students who often have high stress. Aims: The aims of this study were to describe the changes in eating attitudes and eating disorders from 2006 to 2008 in a medical student sample, and to compare the gender differences of eating attitudes and body mass index (BMI, kg/m2) with this sample. Methods: This study was conducted in Changsha city, Mainland China. Self-reported questionnaires, including the Eating Attitudes Test (EAT) and Eating Disorders Assessment Questionnaire (CETCA), were employed to examine the changes in eating attitudes and eating disorders from 2006 to 2008 in a medical student sample (N = 500). Results: Self-reported findings suggest that tentative eating disorders prevalence was 0.90% (anorexia nervosa (AN): 0; bulimia nervosa (BN): 4 females) in 2006 and 1.44% (AN: 1 male; BN: 1 male and 3 females) in 2008 of the full sample. The present data showed that 2.26% (2 males and 9 females) in 2006 and 2.47% (4 males and 6 females) in 2008 of all students obtained scores greater than 20 on the EAT-26 indicative of distorted eating attitudes and behaviour. Male students kept lower distorted eating attitudes and behaviours than female students, while female students kept a lower BMI than male students in both 2006 and 2008. However, there were no statistically significant changes in eating attitudes, distorted eating attitudes and CETCA in either male or female students from 2006 to 2008. Conclusions: The results of this study suggest that there were no statistically significant changes from 2006 to 2008 in eating attitudes, distorted eating attitudes and CETCA. However, females showed significantly higher eating disorders and distorted eating attitudes compared to males in both 2006 and 2008. This study is furthering our understanding of eating disorders in a Chinese cultural context.

Background Few studies have been previously published about the resting state brain activity in young chronic smokers, although many previous fMRI studies have shown that the task-related activity pattern is altered in chronic smokers. Methods In the present study, forty-five healthy smokers (age: 27.9 ± 5.6 year) and forty-four healthy non-smoking control subjects (age: 26.3 ± 5.8 year) have been imaged with functional magnetic resonance imaging (fMRI) and analyzed with the regional homogeneity (ReHo) approach. Results Compared with healthy controls, decreased ReHo was found in smokers in the right inferior frontal cortex and increased ReHo was found in the left superior parietal lobe (P Conclusions Our data suggested that, during resting state, neural function is less synchronized in the right inferior frontal cortex and more synchronized in the left superior parietal lobe in chronic smokers compared to non-smokers. The decreased synchronization in the right inferior frontal cortex may reflect lacking of control over reward-related behavior, and the increased synchronization may reflect smoking urges.

Background Previous neuroimaging studies have documented changes in the brain of heroin addicts. However, few researches have detailed whether such changes can be amended after short-term abstinence. Methods We used magnetic resonance imaging (MRI) to investigate gray matter volume in 20 heroin-dependent patients at 3 days and at 1 month after heroin abstinence; 20 normal subjects were also included as controls. Results Decreased gray matter density in frontal cortex, cingulate and the occipital regions were found in heroin users after three days of abstinence. In contrast, after 1-month abstinence, no significant difference was found in superior frontal gyrus between heroin addicts and controls, but changes in other brain regions, including right middle frontal gyrus, left cingulate gyrus and left inferior occipital gyrus, still remained. Conclusion Our findings illustrate that abnormal gray matter in some brain regions of heroin addicts can return to normal after one-month abstinence.

Ketamine is a non-competitive anatognist of the N-methyl-D-aspartate (NMDA) receptor commonly used as an anesthetic and analgesic. In sub-anesthetic doses, it can induce temporary psychotic symptoms and has served as a pharmacological model for schizophrenia. While its acute effects on brain and behavior have been studied, the effects of long-term exposure to ketamine on brain activity have been largely unexplored. In this study, we aimed to examine such effects on spontaneous brain dynamics measure using resting-state functional magnetic resonance imaging (fMRI). Forty-one patients with ketamine dependence and forty-four healthy control subjects were imaged with BOLD fMRI using a 3.0-Tesla Siemens scanner at the Magnetic Resonance Center of Hunan Provincial People's Hospital, analyzed with the regional homogeneity (ReHo) method. Compared with healthy controls, decreased ReHo was found in ketamine users in the right anterior cingulate cortex and increased ReHo was found in left precentral frontal gyrus (p

To explore the attitudes of medical students toward psychiatry.A total of 254 fourth-year medical students were investigated with a 29-item questionnaire.Although in general, medical school students showed a positive attitude towards psychiatry, opinions about certain aspects like the reputation of psychiatry and the attitude toward psychiatric therapy were not positive.There are still some misunderstandings for psychiatry among medical school students, some of which are based on false beliefs that should be actively targeted for remediation.

To examine white matter integrity in heroin-dependent patients and matched normal controls with diffusion tensor imaging (DTI).The fractional anisotropy was compared between 15 heroin-dependent patients and 15 controls.We found the fractional anisotropy was significantly decreased in specific brain regions of the heroin-dependent patients (P0.001 uncorrected), including the frontal gyrus, the parietal lobule, the insula, and the corpus callosum.The presence of microstructural abnormality is found in the white matter of several brain regions of heroin-dependent patients.

To explore what brain regions are modulated by heroin addiction and withdrawal.We used functional magnetic resonance imaging to investigate the brain function in 15 heroin-dependent patients 3 days (acute) and 1 month (protracted) after heroin abstinence. Sixteen normal controls were included.The blood oxygen level-dependent signal in the orbitofrontal cortex of the brain of heroin-dependent patients was significantly elevated 3 days after the withdrawal. Hyperfunction of the orbitofrontal cortex declined 1 month after the withdrawal.Heroin-dependent subjects at both 3 days and 1 month abstinence have persistent abnormalities in the brain function. Although some tangible beneficial effects are noted following 1 month of detoxification, possible permanent damage to the brain caused by heroin use is suggested.

Previous neuroimaging studies have documented the structural damage in heroin addicts. However, little research has detailed the white matter microstructural changes in the human brain as a result of chronic heroin use and importantly, whether such changes can be recovered after short-term abstinence. Decreased fractional anisotropy values in frontal cortex were found in heroin users after 3 days of abstinence in comparison with controls. However, no significant difference was found between these heroin addicts and controls after 1-month abstinence. These results might better our understanding of the biological basis of drug addiction and provide insight into addiction treatment.

An understanding of the relationship among life events, anxiety, depression, and heroin abuse may benefit the prevention and early treatment of heroin dependence. The objective of this study was to assess self-reported life events, anxiety, and depression in patients with heroin dependence. In this survey, Chinese heroin-dependent patients (n = 139) were asked to conduct a battery of self-reported questionnaires. A total of 76.26% of heroin-dependent patients reported the occurrence of major lifestyle pattern (dietary and sleep) changes as negative life events. Financial problems from family, unemployment, and poor interpersonal relationships were also frequently reported as negative events. Heroin-dependent patients experienced overwhelmingly more negative life events than positive life events. Those negative life events positively correlated with depression and anxiety. They also exhibited high levels of anxiety (Self-Rating Anxiety Scale, mean 44.42 ± 8.27) and depression (Self-Rating Depression Scale, mean 47.28 ± 8.54). Although preliminary, findings from this study suggest the need for further investigation of life events, anxiety, and depression in a generalized large sample, which may benefit community-based psychosocial intervention and prevention of relapse in heroin-dependent subjects.

Heroin abuse is a major public health problem with high morbidity and mortality. Treatment-seeking heroin-dependent subjects frequently report sleep-related problems that contribute to high relapse rates. Few studies have systematically studied the prevalence of sleep disorders among Chinese heroin-dependent subjects.This study aimed to explore the prevalence of sleep disorders with a battery of self-reported questionnaires in 140 heroin-dependent subjects in China.A self-report survey design was used to gather the data, using the Pittsburgh Sleep Quality Index (PSQI), Zung's Self-Rating Anxiety Scale (SAS), and Zung's Self-Rating Depression Scale (SDS). A total of 140 drug users participated in the survey.PSQI results revealed that poor sleep quality (PSQI ≥ 8) was noted in 130 (96.30%) subjects. Those who displayed depressive symptoms, smoked and drank excessively, and had long-term histories of drug use had poorer sleep quality than those who did not. No correlation was found between anxiety, quantity of drugs, and sleeping disorders.This study found that the majority of heroin-dependent patients reported poor sleep quality. Depression, smoking, drinking, and long-term drug use were associated with poor sleep quality in heroin-dependent individuals.Despite the fact that this study collected data only using self-report measures, focused only on heroin-dependent patients, and did not include long-term follow-up study, given the potential link between poor sleep quality and relapse, factoring in this link is an important consideration as part of a comprehensive heroin-dependent treatment program.

Author(s): Liao, Yanhui; Tang, Jinsong; Deng, Qijian; Deng, Yongwen; Luo, Tao; Wang, Xuyi; Chen, Hongxian; Liu, Tieqiao; Chen, Xiaogang; Brody, Arthur L; Hao, Wei | Abstract: BackgroundCigarette smoking continues to be the leading cause of preventable morbidity and mortality in China and other countries. Previous studies have demonstrated gray matter loss in chronic smokers. However, only a few studies assessed the changes of white matter integrity in this group. Based on those previous reports of alterations in white matter integrity in smokers, the aim of this study was to examine the alteration of white matter integrity in a large, well-matched sample of chronic smokers and non-smokers.Methodology/principal findingsUsing in vivo diffusion tensor imaging (DTI) to measure the differences of whole-brain white matter integrity between 44 chronic smoking subjects (mean age, 28.0±5.6 years) and 44 healthy age- and sex-matched comparison non-smoking volunteers (mean age, 26.3±5.8 years). DTI was performed on a 3-Tesla Siemens scanner (Allegra; Siemens Medical System). The data revealed that smokers had higher fractional anisotropy (FA) than healthy non-smokers in almost symmetrically bilateral fronto-parietal tracts consisting of a major white matter pathway, the superior longitudinal fasciculus (SLF).Conclusion/significanceWe found the almost symmetrically bilateral fronto-parietal whiter matter changes in a relatively large sample of chronic smokers. These findings support the hypothesis that chronic cigarette smoking involves alterations of bilateral fronto-parietal connectivity.

Use of ketamine as a recreational drug is spreading rapidly among young people all over the world. Epidemiological studies have linked chronic ketamine use with a number of problems, including cognitive impairments, bladder dysfunction, and ketamine-related death. However, little is known about the long-term effects of ketamine use on brain structure and function.We used voxel based morphometry in conjunction with statistical parametric mapping on the structural magnetic resonance images of ketamine-dependent (n = 41) and drug-naive control individuals (n = 44) to assess differences in gray matter volume between the two groups.We observed significant decreases in gray matter volume in bilateral frontal cortex (left superior frontal gyrus and right middle frontal gyrus) of ketamine users in comparison with control subjects (p.05 corrected for multiple comparisons at cluster-level). Duration of ketamine use was negatively correlated with gray matter volume in bilateral frontal cortex, whereas the estimated total lifetime ketamine consumption was negatively correlated with gray matter volume in left superior frontal gyrus.We have demonstrated a reduction in frontal gray matter volume in patients after chronic ketamine use. The link between frontal gray matter attenuation and the duration of ketamine use and cumulative doses of ketamine perhaps suggests a dose-dependent effect of long-term use of the drug. Our results have important connotations for the clinical picture that is likely to emerge with the growing recreational use of ketamine and is also relevant to the status of the drug as a model for schizophrenia.

Aims To identify the prevalence, patterns and trends of illicit drug use in the general population of selected high-prevalence areas in China between 1993 and 2000. Design, setting and participants Cluster sampling was employed and the Epidemiological Inventory for Illicit Drug Use (EIIDU) used as survey instrument. In 1993, 1996 and 2000, 56 792, 67 319 and 53 747 individuals aged 15 or above in community were interviewed, respectively, at the three time-points. Measurements Demographics and drug-related data were collected and the prevalence patterns of illicit drug are described. Findings The life-time prevalences of illicit drug use in the three consecutive surveys in 1993, 1996 and 2000 were 1.08, 1.60 and 1.52%, respectively, and the 1-year prevalence rates were 0.91, 1.17 and 1.17%, respectively. Heroin was the first choice for drug use (51.8% in 1993, 83.4% in 1993 and 95.9% in 2000). The two most frequent routes of drug administration were inhalation (89.2% in 1993, 60.1% in 1996 and 93.5% in 2000) and intravenous injection (27.2% in 1993, 31.0% in 1996 and 25.7% in 2000). Conclusion At least for the time being, illicit drug use may have plateaued in these selected high-prevalence areas.

Objectives: To investigate the psychological status of patients with sleep apnea-hypopnea syndrome (SAHS) and to evaluate the association of SAHS with psychological symptoms, using the Symptom Checklist-90 (SCL-90) scale. Methods: The study comprised 30 SAHS patients (25 men, 5 women) and 30 matched, healthy control subjects. They all completed the SCL-90 and the Epworth Sleep Scale (ESS) and underwent a whole-night polysomnographic (PSG) examination. We used t-tests for group comparisons of nocturnal PSG characteristics, daytime sleepiness, and psychological symptoms. We employed Spearman's rank correlation analysis to indicate the effects of several nocturnal PSG variables (for example, total sleep time, percentage of wake at sleep, Apnea and Hypopnea Index [AHI], and oxygen desaturation) or subjective daytime sleepiness on psychological symptoms in SAHS. Results: SAHS patients suffered from fragmented sleep and decreased arterial oxygen saturations, compared with healthy control subjects. The General Severity Index (GSI) of SCL-90 was significantly higher in SAHS patients than in healthy control subjects, as were measures of somatization, obsession–compulsion, depression, anxiety, and hostility (P < 0.05). The severity of psychological symptoms in SAHS patients was negatively related to total sleep time and percentage of stage 2 nonrapid eye movement (NREM) sleep; it was positively related to percentage of wake time after sleep onset, percentage of stage 1 NREM sleep, and ESS scores. Conclusion: In our study population, SAHS patients had decreased psychological well-being, which could be explained by fragmented sleep or excessive daytime sleepiness.

Previous neuroimaging studies have documented the structural damage in heroin addicts. However, little research has detailed the white matter microstructural changes in the human brain as a result of chronic heroin use and importantly, whether such changes can be recovered after short-term abstinence. Decreased fractional anisotropy values in frontal cortex were found in heroin users after 3 days of abstinence in comparison with controls. However, no significant difference was found between these heroin addicts and controls after 1-month abstinence. These results might better our understanding of the biological basis of drug addiction and provide insight into addiction treatment.