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Background Internet is gradually reshaping adolescents’ behaviors in China. It is important to identify the prevalence and risk factors to predict Internet addiction among adolescent psychiatric patients. Methods The survey was conducted among inpatient or outpatient adolescent patients with mental disorders. All participants were interviewed face-to-face and completed Young Internet Addiction Test and other relevant assessments. Binary logistic regression analysis was used to exam between-group differences of internet addiction. Result The prevalence for internet addiction (mild to severe) in adolescent psychiatric patients was 80.2%, where the prevalence for “medium and severe internet addiction was 25.5%. Logistic regression analysis identified two independent predictors for “medium and severe internet addiction” including the total score of Adolescent Non-suicidal-self-injury (NSSI) Behavior Function Assessment Scale (ANBFAS) and the diagnosis of generalized anxiety disorder (GAD) (R2 =0.27, p = .02 for total ANBFAS score, p = .01 for GAD) in psychiatric adolescent patients. Conclusion The prevalence of internet addiction is notably high among adolescent psychiatric patients in China. Coping for Internet addiction in adolescent psychiatric patients should conclude the coping of NSSI and GAD.

To examine the prevalence and health correlates of depressive and anxiety symptoms among adults living in Guangdong province of China with a large population and rapid urbanization.The Guangdong Sleep and Psychosomatic Health Survey was conducted from September to November in 2019, which was a population-based study with a representative sample of adults aged 18-85 years. Multistage stratified cluster sampling was used. A total of 13,768 inhabitants were included and face-to-face interviewed using standardized assessment tools. Depressive and anxiety symptoms were evaluated using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), respectively.The weighted prevalence rates of depressive and anxiety symptoms were 8.6% (95% confidence interval [CI]: 8.0%-9.3%) and 6.0% (95%CI, 5.4%-6.5%) respectively. People who have never married, irregular diet rhythm, hardly exercise, poorer sleep, alcohol consumption, chronic diseases and being unemployment and retirement were more likely to suffer depressive and anxiety symptoms. Moreover, the prevalence of depressive symptoms was significantly higher in those suffering from cardiovascular disease (Odds ratio[OR]:3.89, 95%CI: 1.77-8.54), chronic nephrosis (OR:3.89, 95%CI: 1.52-9.94), hyperlipidemia (OR:2.68, 95%CI: 1.57-4.59), anemia (OR:1.96, 95%CI: 1.33-2.89) and arthritis (OR:1.93, 95%CI: 1.17-3.16). The prevalence of anxiety symptoms was evidently greater within patients with cardiovascular disease (OR:3.15, 95%CI: 1.39-7.14), chronic nephrosis (OR: 2.89, 95%CI: 1.22-6.83), hyperlipidemia (OR:2.27, 95%CI: 1.20-4.29) and diabetes (OR:1.99, 95%CI: 1.15-3.44).Depressive and anxiety symptoms are commonly found in patients with chronic diseases. Given these adverse outcomes on health, health professionals should pay more attention to depressive and anxiety problems in health care for high-risk population.

Few studies have examined the clozapine in cohort studies of Chinese patients with schizophrenia in rural primary care. The objective of this two-year cohort study was to describe the usage of clozapine and investigate and identify the demographic, clinical correlations and risk variables which affect the use of clozapine in patients with schizophrenia. A random cluster sampling technique was used, and participants were collected from China National Psychiatric Management System (CNPMS). The variables for clozapine use in individuals with schizophrenia who had undergone a two-year follow-up were determined using the generalized estimating equation (GEE). In this study, 742 patients with schizophrenia were invited, and 491 completed the two-year follow-up study. Being married, more years of education, more waist circumference, using mood stabilizer, using anticholinergic, higher ITAQ (Insight and Treatment Attitude Questionnaire) scores were more significantly related to the use of clozapine. Older age of onset, using second-generation antipsychotics (SGAs) except clozapine predicted a lower prevalence of using clozapine. The usage of clozapine was very common in patients with schizophrenia treated by primary care physicians, and was influenced by a variety of factors, including price of drugs, clinical factors, health regulations, and the characteristics of treatment environment. Further examination of the rationale and appropriateness of clozapine in primary care in China is necessary.

Mental health literacy (MHL) is rarely reported in the Chinese elderly. This study explored the pattern of MHL in the Chinese elderly in relation to depression, anxiety and poor sleep quality.A cross-sectional study was conducted among older adults in Guangzhou, south China. Participants were investigated face-to-face using the Chinese National Mental Health Literacy Scale, the Patient Health Questionnaire-9 item (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI). Mental Health Literacy Scale contains three dimensions: mental health knowledge, mental health skills (such as social support, cognitive reappraisal and attentional distraction) and mental health awareness. Multivariate logistic regression was used for examining the association between MHL and mental health.A total of 506 older adults were recruited. The percentage of depression, anxiety, and poor sleep quality were 16.6%, 7.9% and 40.9%, respectively. MHL dimensions independently associated with depression included cognitive reappraisal (OR = 1.95, p .001), attentional distraction (OR = 0.61, p = 0.044) and awareness (OR = 0.56, p = 0.027). MHL dimensions independently associated with anxiety symptoms included cognitive reappraisal (OR = 1.90, p = 0.011) and attentional distraction (OR = 0.44, p = 0.016). MHL dimensions independently associated with poor sleep quality included social support (OR = 0.75, p = 0.022), cognitive reappraisal (OR = 1.55, p = 0.003) and attentional distraction (OR = 0.65, p = 0.016).Given the low MHL and its association with poor mental health in the Chinese elderly, policymakers and health professionals should improve the older adults' MHL, which could be conducive to the prevention and control of their mental health problems.

Background Physical inactivity exacerbates poorer sleep quality, but potential underlying mechanisms of this association remain unknown. The present study aims to disentangle the pathways linking psychical activity to sleep quality through the serial mediation effect of anxiety and depression in a Chinese population. Methods Data analyzed were from Guangdong Sleep and Psychosomatic Health Survey, a cross-sectional population-based study with a representative sample of adult inhabitants aged 18-85 years living in Guangdong province, China. A total of 13,768 participants were included with the response rate of 80.4%. Singe and serial mediation analyses were conducted to examine whether anxiety and depression mediated the relationship between physical activity and sleep quality, independently and jointly. Results Both direct and indirect effects of physical activity on sleep quality were found. As predicted, anxiety and depression mediated the relationship between physical activity and sleep quality (B Anxiety = -0.17, 95% bootstrap CI: -0.20 to -0.15; B Depression= -0.25, 95% bootstrap CI: -0.28 to -0.21), respectively. In addition, serial mediation analyses indicated that the association of physical activity and sleep quality is mediated by anxiety and depression in a sequential manner (B = -0.13, 95% bootstrap CI: -0.15 to -0.11). Limitations The primary limitation of the study is the cross-sectional design, which limits the causal inference ability. Conclusions These findings highlight the role of anxiety and depression as serial mediators of the relationship between physical activity and sleep quality. Thus, exercise-based programs focusing on improving sleep could benefit from a multi-faceted approach therapeutically targeting psychiatric disorders.

Purpose As lifestyle behaviors are components of the culture of mental health treatment settings, we examined bridge connection between depression and anxiety symptoms and lifestyles from a network perspective using a population-based study.Methods A provincial representative sample of 13,768 inhabitants from the Guangdong Sleep and Psychosomatic Health Survey was face-to-face interviewed using standardized assessment tools. Expected influence was used to identify central symptoms. The interconnection between depression and anxiety symptoms, and bridge connectivity linking depression-anxiety symptoms and lifestyle factors was evaluated using bridge centrality index. A case dropping bootstrap procedure was employed to network stability and sensibility analyses. Results In depression-anxiety symptoms network,fatigue or little energy has the highest expected influence, followed by uncontrollable worry, trouble relaxing and sad mood. Surrounding nodes of each node explained a mean 57.63% of the variance. In the network integrating depression-anxiety symptoms with lifestyle factors, suicidal thoughts were identified as collective bridging symptoms connecting lifestyle variables. And irritability and guilt also indicated the highest connectivity with lifestyles. All networks had high stability and accuracy. Conclusion These emphasized core and bridge symptoms were latent targets to prevent and intervene comorbid depression and anxiety. Targeting interventions aiming at specific lifestyle behaviors may be crucial to develop efficient and purposeful treatment strategies for clinical practitioners.

Background Depressive patients with atypical symptoms tend to cause greater functional impairment. This study examined the differences of the atypical depressive symptoms between unipolar and bipolar depressive patients (BP I and BP II). Methods We studied 466 depressed patients (262 unipolar and 204 bipolar subjects, in which 122 BP I depression, 82 BP II depression) diagnosed with DSM-IV criteria. Atypical depressive symptoms were also evaluated with DSM-IV criteria for atypical features specifier. Binary logistic regression was used to examine the associations of atypical depressive symptoms with depressive disorders after control of confounding variables. Results The prevalence with any atypical depressive symptoms in unipolar depressive disorder was 32.8 % (86/262), and in bipolar depression was 44.6 % (91/204), X2 = 6.76, P = 0.009. In stepwise binary logistic regression analysis, patients with bipolar depression had more females, more positive psychiatric history, more weight gain or increase in appetite, more interpersonal rejection sensitivity, and more visual values of severest pain. Limitations The participants recruited were both inpatients and outpatients in one major hospital which might influence the generality of the study. The cross-sectional research methods can't work out causality. Conclusions Bipolar depression and major depressive disorder exhibit subtle differences in presentation, which may help guide the early intervention, initial diagnosis and the choice of therapy.

To examine whether insomnia disorder is associated with cognitive impairment in young and middle-aged Chinese adults. A case–control sample of 98 adults aged from 18 to 65 years old from Guangdong province underwent clinical history, physical examination, and cognitive assessments. We examined the trail-making test (TMT), basic symbol coding test (BASC), continuous performance task (CPT), category fluency test (CF), visuospatial memory test (BVMT), and verbal learning test (HVLT). Moreover, we assessed sleep and mood conditions with Pittsburg Sleep Questionnaire Index (PSQI), Epworth Sleepiness score (ESS), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Fatigue Assessment Scale (FAS). We used descriptive statistics, an independent t test, bivariate correlation analysis and analysis of covariance (ANCOVA) to assess the statistics produced. Compared to healthy controls (N = 49), individuals with insomnia disorder (N = 49) showed a decreased level of TMT, BASC, CPT and HVLT, which indicates that the insomniac has processing speed, sustained attention and verbal learning memory deficits. Also, the score of SAS, SDS, FAS, ESS and PSQI had a significant difference between the control group and insomnia group. All the cognitive scores were correlated with the severity of insomnia. Young and middle-aged adult insomnia are associated with deficits in speed of processing, sustained attention and verbal learning memory, which may suggest that before old age, these domains of cognitive function of people with insomnia disorder have begun to change. It may provide a clinical reference for recognizing cognitive function impairment in young and middle-aged patients with insomnia.

Li-Fei Cai,1,2 Shi-Bin Wang,2 Cai-Lan Hou,2 Ze-Bin Li,1 Yi-Jun Liao,1 Fu-Jun Jia1,2 1The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China; 2Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, People’s Republic of ChinaCorrespondence: Fu-Jun Jia, Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, People’s Republic of China, Tel +86-13609049731, Fax +86-02081884713, Email jiafujun@126.comPurpose: By exploring the gut-related microbiota differences of adolescents with non-suicidal self-injury (NSSI) and depression (without NSSI) and healthy volunteers, we provide a theoretical basis for the prevention and control of NSSI in adolescents through intestinal microecological regulation.Patients and Methods: A total of 99 subjects were recruited in Guangdong Province, China, including 51 adolescents with NSSI (KD), 24 healthy adolescents (NOR1), and 24 depression adolescents without NSSI (NOR2). General clinical data and fecal samples were collected from all subjects, who were assessed using the NSSI Behavioral Questionnaire and the 24-item Hamilton Depression Scale. The taxonomic composition of the gut microbiota was determined using the 16S rDNA gene sequencing method.Results: There were significant differences in diversity between the KD and NOR1, and the species uniformity index of the KD according to the Shannon and Simpson indices was significantly reduced compared with that of the NOR1 (4.81 vs 5.21, p< 0.01; 0.02 vs 0.01, p< 0.05). The relative abundances were different among the KD, NOR1 and NOR2, as reflected at the taxonomic levels of class, order, family, genus, and species. Bacteroides were the dominant flora of the KD and NOR2, while Mitsuokella was the dominant flora that distinguished the KD from the NOR2.Conclusion: We found that gut microbiota diversity was decreased in adolescents with NSSI, and the relative abundance was altered at different taxonomic levels. These results enrich the understanding of the relationship between NSSI and depression and the gut microbiota, Supporting that NSSI and depression are not homologous disorders. What is more, it establishes the basis for exploring the mechanisms of flora action in NSSI, providing a possible direction for NSSI to achieve a better prognosis and prevent relapse.Keywords: NSSI, gut microbiota, depression, adolescents

Background: Non-suicidal self-injury (NSSI), as a major public health issue of high complexity, multifactorial causes and great socioeconomic and family impact, affects China now especially after COVID-19. The aim of this study was to explore the clinical and psychological characteristic in adolescent psychiatric patients with or without NSSI.Methods: Adolescent psychiatric patients were recruited from psychiatric outpatient and inpatient unit in Guangdong mental Health Center between October and December 2020. NSSI was evaluated by the modified version of Adolescents Self-Harm Scale. Childhood trauma was assessed by the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Peer bullying experience was evaluated by The Revised Olweus Bully/Victim Questionnaire（BVQ-R). Depression was assessed by the Montgomery–Asberg Depression Rating Scale (MADRS). Clinical data were collected from electronic medical record system.Results: The sample included 157 adolescent psychiatric patients (72.6% female), aged 13-18 years (M=15.39, SD=0.145). NSSI group experienced more peer bullying (t=4.08,P＜0.001), more likely to get into romantic relationship currently(χ2=5.38, P=0.02), more times of hospitalization (t=0.36, PPP＜0.001), and mood-stabilizer treatment (χ2 =8.53, PConclusions: Adolescent psychiatric patients with NSSI have significantly higher incidences of life event such as peer bulling, childhood trauma experience, and they were more likely to get into a romantic relationship. Meanwhile, patients with NSSI had significantly severe level of depression, being more on benzodiazepine and mood-stabilizer use. This provides a valuable basis for our clinical treatment of adolescent mental patients with NSSI.

Objective To examine the prevalence of sleep disturbances, the socio-demographic and clinical correlates in Chinese older adults with type 2 diabetes (T2DM). Methods A cross-sectional survey of 195 patients with T2DM was conducted using standardized instruments. Results The prevalence of any type of sleep disturbances was 38.5%, the incidence of DIS, DMS, and EMA were 23.6%, 25.6% and 26.2%, respectively. No statistically significant difference was observed in socio-demographic data between participants with and without sleep disturbances except age. Sleep disturbances were associated with more severe depressive symptoms and lower quality of life (QOL). Only 32% of patients suffering sleep disturbance received treatment. Conclusions Sleep disturbance is common in Chinese older patients with T2DM, but the rate of treatment appears low. More aggressive measures should be implemented to improve the assessment and treatment of sleep disturbances in patients with T2DM.

Background Subjective cognitive decline (SCD) may be the early screening signal to distinguish susceptible population with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Subjective cognitive complaints (SCCs) have been proved strongly associated with SCD. This study aimed to explore the association between sleep duration and SCCs in the Chinese elderly. Methods We conducted a cross-sectional study involving 688 participants aged 60 years and older in Guangdong Province, China. SCCs were assessed by the Subjective Cognitive Decline questionnaire 9 (SCD-Q9), which contained 9 items with two dimensions, including the overall memory function and time comparison (OMTC) and daily activity ability (DAA). Restricted cubic splines and generalized additive model (GAM) were used to fit the association between sleep duration and SCD-Q9 score. Results There were significant U-shaped associations between sleep duration and overall score of SCD-Q9 (EDF = 3.842, P EDF = 4.471, P EDF = 3.575, P = 0.004), sleep duration and the OMTC score (EDF = 4.478, P = 0.010) were still found. The daily activity ability (DAA) score was also non-linear associated with sleep duration both in the age- and gender-adjusted GAM (EDF = 2.314, P EDF = 2.080, P = 0.010). Conclusions Both longer sleep duration (> 8 h) and shorter duration (

Background The current study aimed to investigate the sleep quality of patients after valve replacement surgery due to infective endocarditis and identify risk factors for disturbed sleep post hospitalisation. Methods Eighty patients were assessed postoperatively using subjective scale measures, the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale, and an objective measure, actigraphy. Scale measures were assessed approximately 2 weeks and 6 months after surgery. Actigraphy monitoring was performed for 2 consecutive weeks during hospitalisation. Logistic regression was used to identify risk factors for disturbed sleep. Results The study population (n = 80) had an average age of 42.8 ± 14.2 years, and 67.5% were male. The median sleep efficiency was 85.3% in week 1 and 86.8% in week 2. The frequency of awakenings was significantly higher in week 1 (20.0 times vs. 19.3 times, p = 0.017). The scale measures showed significant improvement in sleep by 6 months after surgery compared to that during hospitalisation. Multivariable logistic regression analysis suggested that the possible risk factors for disturbed sleep 6 months after surgery included age (OR = 1.479, 95%CI 1.140–1.920) and a few parameters of early postoperative disturbed sleep quality (PSQI: OR = 2.921, 95%CI 1.431–5.963; sleep efficiency: OR = 0.402, 95%CI 0.206–0.783; and average duration of awakenings: OR = 0.006, 95%CI 0.000–0.827). Conclusions Disturbed sleep quality was witnessed in postoperative patients during hospitalisation and up to 6 months after surgery. Over time, the patients’ sleep quality improved significantly. Age and a few early postoperative sleep quality variables were risk factors for disturbed sleep 6 months after surgery.

Evidence for psychological risk factors on prodromal state of psychosis remained limited and inconsistent. This study aimed to investigate childhood trauma, life events and social support in subjects with high risk for psychosis (HR), first episode psychosis with schizophrenia (FEP) and healthy control (HC). In the study, 56 FEP, 83 HR and 61 HC underwent face-to-face clinical interview and psychological assessment, including Childhood Trauma Questionnaire (CTQ), Life Events Scale (LES) and Perceived Social Support Scale (PSSS). The results showed that in univariate analysis, HR individuals had more childhood trauma, more recent life events and less social support than HC group, and these findings were also supported by ANCOVA analysis except for the results related to social support after taking age, education, marital and employment status as covariates. Logistic regression analysis revealed that HR group was significantly associated with more childhood trauma, poorer overall function and unmarried state than HC group after controlling the interfering factors. HR group was similar with FEP group in these assessments. In conclusion, HR individuals experienced more childhood trauma, life events and social support deficit than HC group, which may be risk factors of conversion to psychosis. Further explorations are warranted to develop optimal psychosocial interventions.

BACKGROUND The aim of this study was to measure sleep quality among patients who underwent infective endocarditis (IE) surgery and identify the risk factors involved in sleep disorders. MATERIAL AND METHODS In this study, we used actigraphy, the Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleep Scale (ESS) to determine the clinical characteristics of sleep disorders in 116 patients with IE who were in rehabilitation after surgery. RESULTS Our results showed that 46 (39.7%) patients had sleep efficiency over 85%, while 70 (60.3%) patients had sleep efficiency below 85%. The correlation analysis showed that sleep efficiency was related to the duration of the disease, with a longer duration leading to lower sleep efficiency (P=0.031). The sleep efficiency of patients with IE following surgery was also affected by alcohol consumption; however, surprisingly, patients with "heavy" alcohol consumption had higher sleep efficiency (P=0.030). We found a significant correlation between sleep efficiency and postoperative interleukin-6 (IL) levels, C-reactive protein (CRP) levels, and preoperative erythrocyte sedimentation rate (P

Background Poor sleep quality exacerbates subjective cognitive decline (SCD). Mental health may play an important role in the relationship, but the potential underlying mechanisms remain unknown. Methods A cross-sectional study was conducted on older adult residents in Guangdong province, south China from November 2020 to March 2021. A total of 717 adults aged 60 years and over were recruited for a face-to-face investigation on a range of socio-demographic factors, lifestyle behaviors, sleep quality, SCD, depressive and anxiety symptoms. Parallel, serial and moderated mediation models were used to examine whether depression and anxiety mediated in the poor sleep quality-SCD linkage. Results Both direct and indirect effects of poor sleep quality on SCD symptoms were found. Anxiety and depressive symptoms mediated the relationship between poor sleep quality and SCD symptoms(βAnxiety = 0.123, 95%CI: 0.079 to 0.173; βDepression=0.274, 95%CI: 0.200 to 0.348), respectively. Serial mediation analyses indicated that depressive and anxiety symptoms co-play a serial mediating role in the association of poor sleep quality and SCD symptoms (βa=0.052, 95% CI: 0.026 to 0.084; βb=0.077, 95% CI: 0.033 to 0.128). Moderated mediation model revealed that the mediation of depressive symptoms on the relationship between poor sleep quality and SCD symptoms was moderated by anxiety symptoms(β=0.318, 95% CI: 0.164 to 0.472). Limitations The study is the cross-sectional design, which limits the causal inference ability. Conclusions These findings provided new insights into possible avenues for prevention and intervention on SCD through sleep-based treatments with a multi-faceted approach on psychiatric disorders.

Background: Sleep is vital for maintaining individual’s physical and mental health. Prior studies have reported close relationships between sleep duration and chronic diseases. However, in China, the prevalence of aberrant sleep duration and the associations between sleep duration and chronic conditions still merit studying in Guangdong province. This study aimed at examining the relationship between sleep duration and multiple dimensions of sociodemographic characteristics, mental health and chronic diseases in Guangdong province in China, with a large population-based data of individuals aged from 18 to 85 years old.Methods: This study aimed at analyzing the sociodemographic and clinical characteristics of the population in Guangdong province. Multistage stratified cluster sampling was applied for this study. 13,768 participants from Guangdong province were interviewed with standardized assessment tools, including Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Basic socio-demographic information, mental health and chronic diseases information were collected. Self-reported sleep duration was classified as three types: short (Results: The mean sleep duration was 6.75±1.11h. Short sleepers had a higher prevalence of chronic diseases, including anemia (6.2%, p=0.024), gout (2.8%, p=0.010), hyperlipidemia (3.9%, p=0.003) and low back pain (5.6%, p=0.020) than other types of sleeper. Multinomial logistic regression analysis revealed that short sleepers were more likely to have low income level, have depressive symptoms, be ex- or current drinkers and be overweight. Anemia, hyperlipidemia and low back pain were all risk factors for short sleep, while malignant tumor was risky for long sleep. Conclusions: Low income level, drinking status, being overweight, and chronic conditions may be associated with aberrant sleep duration in Guangdong province general population. Short sleepers have a higher risk of suffering from anemia, hyperlipidemia, and low back pain, while long sleepers are more likely to have malignant tumor. Health professionals should value the sleep patterns in general health care and attach importance to conduct further epidemiologic surveys to explore the relationship between sleep duration and health.

Background Sleep is vital for maintaining individual’s physical and mental health. Prior studies have reported close relationships between sleep duration and chronic diseases. However, in China, the prevalence of aberrant sleep duration and the associations between sleep duration and chronic conditions still merit studying in Guangdong province. This study aimed at examining the relationship between sleep duration and multiple dimensions of sociodemographic characteristics, mental health and chronic diseases in Guangdong province in China, with a large population-based data of individuals aged from 18 to 85 years old. Methods This study aimed at analyzing the sociodemographic and clinical characteristics of the population in Guangdong province. Multistage stratified cluster sampling was applied for this study. 13,768 participants from Guangdong province were interviewed with standardized assessment tools, including Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Basic socio-demographic information, mental health and chronic diseases information were collected. Self-reported sleep duration was classified as three types: short ( Results The mean sleep duration was 6.75 ± 1.11 h. Short sleepers had a higher prevalence of chronic diseases, including anemia (6.2%, p = 0.024), gout (2.8%, p = 0.010), hyperlipidemia (3.9%, p = 0.003) and low back pain (5.6%, p = 0.020) than other types of sleeper. Multinomial logistic regression analysis revealed that short sleepers were more likely to have low income level, have depressive symptoms, be ex- or current drinkers and be overweight. Anemia, hyperlipidemia and low back pain were all risk factors for short sleep, while malignant tumor was risky for long sleep. Conclusions Low income level, drinking status, being overweight, and chronic conditions may be associated with aberrant sleep duration in Guangdong province general population. Short sleepers have a higher risk of suffering from anemia, hyperlipidemia, and low back pain, while long sleepers are more likely to have malignant tumor. Health professionals should value the sleep patterns in general health care and attach importance to conduct further epidemiologic surveys to explore the relationship between sleep duration and health.

Background: Insomnia is common during pregnancy but the prevalence and risk factors of insomnia in Chinese women during pregnancy is not well studied. This study aimed to examine the prevalence of insomnia and its risk factors in Chinese women during pregnancy. Methods: In this cross sectional study, 436 Chinese pregnant women with Insomnia Severity Index (ISI) ≥ 8 were clinically assessed using the insomnia criteria based on the combination of DSM-IV (Diagnostic and Statistical Manual-4th Edition) and ICD-10 (International Classification of Dieases, 10th Edition). Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), Pregnancy Pressure Scale (PPS), Perceived physical discomfort level and number, Epworth Sleepiness Scale (ESS), and a general socio-demographic questionnaire were administered. Results: The results showed that about 20% of the pregnant women met the strict diagnosis criteria of insomnia. Independent-samples t-test revealed that several risk factors were correlated with the group with insomnia (N = 84) compared to the group without insomnia (N = 352). Binary Logistic regression analysis found that more significant bed partner influence (OR = 1.92, 95% CI: 1.03–3.60), depressive symptoms (OR = 1.07, 95% CI: 1.00–1.14), daytime sleepiness (OR = 1.07, 95% CI: 1.01–1.14), subjective somatic discomfort (OR = 2.27, 95% CI: 1.11–4.65), kinds of somatic discomfort (OR = 1.14, 95% CI: 1.03–1.27) and later gestation (OR = 1.05, 95% CI: 1.01–1.09) were significantly associated with insomnia. Conclusion: In this cohort of Chinese pregnant women, about a fifth of women suffered from clinically significant insomnia. Measures to prevent the adverse effects of insomnia should be provided to pregnant women with depressive symptoms, Sleep disturbance of the bed partner, excessive daytime sleepiness and somatic discomfort, especially late in gestation. Keywords: Insomnia, Pregnancy, Prevalence, Sleepiness, Somatic discomfort

As a natural polymer, there are a lot of functional groups on the keratin molecular chains, such as carboxyl, amino and hydroxyl groups. In the present study, we used keratin (K) as a multifunctional crosslinker and prepared smart nanogels. The nanogels had high loading capacity for drug, while low drug leakage. The surface of the DOX@K/SA-NG is negatively charged and the size was determined to be 432 nm. The nanogels had drug loading capacity (DLC) of 65.2% (w/w) and were capable of triggering drug release upon both pH and reductive (glutathione (GSH)) environment while stable under physiological conditions (pH 7.4 + 10 μM GSH). We evaluated its cancer treatment performance through cell uptake and cytotoxicity experiments, it showed that the prepared DOX@K/SA-NG can effectively inhibit the growth of HepG2 cancer cells.

This meta-analysis aimed to determine duration and patterns of sleep in Chinese university students.English (PubMed, PsycINFO, Embase) and Chinese (SinoMed, Wan Fang Database, and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from their inception until August 16, 2016. Data on sleep duration and sleep patterns of tertiary student population in eligible studies were extracted and pooled using random-effects models.A total of 57 studies with 82,055 university students were included in the meta-analysis. Pooled mean sleep duration was 7.08 h/d (95% confidence interval [CI]: 6.84 to 7.32 h/d). The percentage of students with sleep duration shorter than 6 h/d and 7 h/d (short sleep) was 8.4% (95% CI: 5.7% to 12.3%) and 43.9% (95% CI: 36.9% to 51.1%), respectively. In contrast, the percentage of students with sleep duration longer than 8 hours and 9 hours (long sleep) was 18.3% and 5.7%, respectively. The pooled mean bedtime was at 12:51 am. The percentage of university students who fall asleep after midnight was 23.8%. The percentage of students with sleep latency more than 30 minutes was 25.5%. The pooled mean wake-up time was at 8:04 am on weekdays and on weekends.Short sleep duration and unhealthy sleep patterns were found to be common among Chinese university students.

Background To date no study has compared more specifically the psychotropic medication treatment patterns for patients with schizophrenia living in community between rural and urban areas. This study examined the rural-urban differences of the use of psychotropic drugs among community-dwelling individuals with schizophrenia in China. Method Data on 993 community-dwelling patients with schizophrenia (n = 479 in rural area and n = 514 urban area) were collected by interviews during 2013–2014, and 2015–2016 according to the diagnosis of DSM-IV or ICD-10. Data on patients’ socio-demographic and clinical characteristics, prescriptions of psychotropic drugs were collected using a standardized protocol and data acquisition procedure. Results Multivariate analyses revealed that in comparison with the rural counterparts, the patients from the urban area were significantly more frequently prescribed antipsychotic polypharmacy, clozapine, and benzodiazepines, but the patients from the rural area had more frequently prescribed anticholinergics. Conclusions Substantial variations in psychotropic medication treatment patterns for patients with schizophrenia living in community were found between rural and urban areas in China. Common use of antipsychotic polypharmacy, clozapine and benzodiazepines in urban area, and anticholinergics in rural area need to be further addressed.

Background Sexual dysfunction is common in patients with schizophrenia, however it is poorly studied in China, especially in primary health care institutions in rural areas. We investigated the prevalence of sexual dysfunction and its correlates including quality of life (QoL), in schizophrenia patients treated in primary care in a rural area in China. Method By using a random numbers table, 21 small town primary care service centers (from 63 totally) were selected in the study. Data of 720 community-dwelling patients with schizophrenia in rural area with diagnoses according to DSM –IV or ICD-10 were collected by interviews. Data on socio-demographic and clinical characteristics including sexual dysfunction and quality of life (QoL) were collected using a standardized protocol and data collection procedure. Data were analyzed using chi-square tests, t-tests, U-tests, ANCOVA and multiple logistic regression as appropriate by SPSS 21.0.The level of significance was set at 0.05 (two-tailed). Results In this sample, sexual dysfunction was found in 71.3% of the whole sample, 82.7% of female patients and 64.5% of male patients. Multiple logistic regression analysis showed that older age (OR = 1.06, P

PURPOSE The purpose of the study was to determine the pattern of sleep behavior in schizophrenia patients treated in primary care. DESIGN AND METHODS Altogether 623 schizophrenia patients in 22 primary care services were recruited. Sleep duration and demographic and clinical characteristics were recorded. FINDINGS The mean expected total sleep time was 8.8 hr (SD 1.8) and the mean actual total sleep time was 8.2 hr (SD 2.1). The frequency of short, medium, and long sleepers was 18.1, 38.4, and 43.5%, respectively. Major medical conditions and any type of insomnia were independently associated with short sleep, while long sleep was associated with unemployment and use of second-generation antipsychotics. PRACTICE IMPLICATIONS More attention should be paid to sleep duration in this population group.

The aim of the present study was to investigate and compare cognitive functioning of first-degree relatives of people with schizophrenia who were also at ultra-high risk (UHR) for psychosis with patients with first-episode (FE) schizophrenia, first degree relatives of patients not fulfilling UHR criteria (FDR), and healthy control (HC) subjects.Forty subjects in each group were included, underwent a face-to-face interview and completed a neurocognitive test battery, including the Trail Making Test-A (TMT-A, psychomotor functions), Stroop Color Word Test (attention), Digit Symbol Coding Test (DST, processing speed and working memory) and Hopkins Verbal Leaning Test-Revised (HVLT-R, verbal memory).Functioning in all the cognitive test domains displayed a gradual decrease from the HC, FDR, UHR to FE groups. After controlling for covariates, there were still significant differences in TMT-A (F(7160)=35.4, P0.001), DST (F(7160)=38.9, P0.001), Stroop Color Word Test (F(7160)=35.0, P0.001), Stroop Word Test (F(7160)=36.2, P0.001), Stroop Color Test (F(7160)=40.9, P0.001) and HVLT-R (F(7160)=62.5, P0.001) between the four groups, indicating that the cognitive functioning in the UHR group was intermediate between the FE and FDR groups, while the FDR group had poorer performance than the HC group, and the FE group had the poorest cognitive functioning across all four examined domains.The results indicate that impairments in processing speed, attention, working memory and verbal memory exist in both UHR and FDR subjects. In order to clarify the associations between cognitive functioning and UHR and schizophrenia, longitudinal studies are warranted.

This study described the prevalence and correlates of comorbid moderate-severe depressive symptoms (comorbid depression thereafter) and their association with quality of life (QOL) in schizophrenia patients treated in primary care. 623 schizophrenia patients were enrolled. Patients' socio-demographic and clinical characteristics including comorbid depression [defined as a total score of 18 or above on the Montgomery-Asberg Depression Rating Scale (MADRS)] were recorded. Depressive symptoms (defined as a total score of 9 or above on the MADRS) were present in 54.1 % of patients, while 17.7 % had comorbid depression. Analysis of covariance revealed that comorbid depression was significantly associated with lower mental QOL. Multiple logistic regression analysis revealed that more severe positive and negative symptoms, anxiety symptoms, use of first-generation antipsychotics and antidepressants, were independently associated with comorbid depression. Given the negative association between comorbid depression and QOL, attempts to address comorbid depression in schizophrenia patients treated in primary care should be made.

Purpose: Sexual dysfunction in schizophrenia patients is common. In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. Illness- or treatment-related sexual dysfunction in this patient population has been never studied. This study describes the prevalence and correlates of sexual dysfunction and its impact on quality of life (QOL) in patients with schizophrenia treated in primary care in China. Method: A total of 607 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. Patients' socio-demographic and clinical characteristics including sexual function and QOL were recorded using a standardized protocol and data collection. Results: Sexual dysfunction was present in 69.9% of all patients; 60.7% in males and 80.6% in females. Multiple logistic regression analysis revealed that female gender, being single, older age and use of first-generation antipsychotics were independently and significantly associated with more sexual dysfunction accounting for 23.5% of its variance (P

Objective In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians, but their prescribing patterns have not been studied. This study examined the frequency as well as demographic and clinical correlates of antipsychotic polypharmacy (APP) and its impact on quality of life (QOL) in patients with schizophrenia treated in primary care in China. Method A total of 623 community-dwelling patients from 18 randomly selected primary care services were interviewed. Patients' socio-demographic and clinical characteristics, including number of hospitalizations, antipsychotic drug-induced side effects, and QOL were recorded using a standardized protocol and data collection procedure. Results The rate of APP prescription was 31% (193/623). Of the patients on APP, 89.6% received 2 antipsychotics, 10.4% received 3 or more antipsychotics. Clozapine (35.6%) was the most commonly prescribed second generation antipsychotic (SGA), while perphenazine (17.8%) was the most commonly prescribed first generation antipsychotic (FGA). Multiple logistic regression analyses revealed that patients on APP were more likely to receive SGAs and anticholinergics, had fewer hospitalizations, younger age of onset, and higher doses of antipsychotics. There were no significant differences between the two groups in any of the QOL domains. Conclusions Approximately a third of Chinese patients with schizophrenia in primary care receive APP. Further examination of the rationale and appropriateness of APP and its alternatives is warranted.