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Background Little is known about gender differences in the long-term outcomes of people with schizophrenia living in the community. Aims To explore gender differences in the 14-year outcome of people with schizophrenia in rural China. Method A 14-year follow-up study among a 1994 cohort (n = 510) of participants with schizophrenia was conducted in Xinjin County, Chengdu, China. All participants and their informants were followed up in 2004 and 2008 using the Patients Follow-up Schedule. Results Compared with female participants, male participants were significantly younger, had significantly higher rates of mortality, suicide and homelessness, and poorer family and social support. There was no significant gender difference in Positive and Negative Syndrome Scale scores, previous suicide attempts, those never treated, previous hospital admission or inability to work. Longer duration of illness was associated with functional decline and comparatively poorer family economic status. Conclusions The long-term outcomes of men with schizophrenia is worse than those of women with the disorder in rural China. Higher mortality, suicide and homelessness rates in men may contribute partly to the higher prevalence of schizophrenia in women in China. Policies on social and family support and gender-specific intervention strategies for improving long-term outcomes should be developed for people with this disorder. [ABSTRACT FROM AUTHOR]

Traditionally, death is a taboo subject in Chinese culture. However, very few studies examine the effects of death education program on the psycho-spiritual outcomes among Chinese patients. This article, reports on a quasi-experimental study on Chinese patients with chronic diseases who participated in a psycho-education group on positive death preparation. Findings revealed that participants in the intervention group (n = 81) reported significantly greater reduction in fear of death, death avoidance, greater increase in death acceptance, death preparation, tranquility and spiritual well-being at immediate post-intervention than the control group (n = 79). It is also found that levels of death-related fear and avoidance in the intervention group were significantly lower at 1-month follow-up when compared with baseline. This study challenges the assumption that Chinese people are not receptive to intervention that addresses issues of death and dying. Implications of conducting death education program among a culturally diverse population are discussed. [ABSTRACT FROM AUTHOR]

Background: Patients with schizophrenia are characterized by high prevalence rates and chronicity that often leads to long-term institutionalization. Under the traditional medical model, treatment usually emphasizes the management of psychotic symptoms through medication, even though anti-psychotic drugs are associated with severe side effects, which can diminish patients' physical and psychological well-being. Tai-chi, a mind-body exercise rooted in Eastern health philosophy, emphasizes the motor coordination and relaxation. With these potential benefits, a randomized controlled trial (RCT) is planned to investigate the effects of Tai-chi intervention on the cognitive and motor deficits characteristic of patients with schizophrenia. Methods/design: A 3-arm RCT with waitlist control design will be used in this study. One hundred and fifty three participants will be randomized into (i) Tai-chi, (ii) exercise or (iii) waitlist control groups. Participants in both the Tai-chi and exercise groups will receive 12-weeks of specific intervention, in addition to the standard medication and care received by the waitlist control group. The exercise group will serve as a comparison, to delineate any unique benefits of Tai-chi that are independent of moderate aerobic exercise. All three groups will undergo three assessment phases: (i) at baseline, (ii) at 12 weeks (post-intervention), and (iii) at 24 weeks (maintenance). All participants will be assessed in terms of symptom management, motor coordination, memory, daily living function, and stress levels based on self-perceived responses and a physiological marker. Discussion: Based on a promising pilot study conducted prior to this RCT, subjects in the Tai-chi intervention group are expected to be protected against deterioration of motor coordination and interpersonal functioning. They are also expected to have better symptoms management and lower stress level than the other treatment groups. Trial registration: The trail has been registered in the Clinical Trials Center of the University of Hong Kong (HKCTR-1453). [ABSTRACT FROM AUTHOR]

Background: Abused women, who suffer from chronic psychological stress, have been shown to have shorter telomeres than never abused women. Telomere shortening is associated with increased risk of cell death, and it is believed that adopting health-promoting behaviors can help to increase the activity of telomerase, an enzyme that counters telomere shortening. Qigong is an ancient Chinese mind-body integration, health-oriented practice designed to enhance the function of qi, an energy that sustains well-being. Therefore, an assessor-blind, randomized, wait-list controlled trial was developed to evaluate the effect of a qigong intervention on telomerase activity (primary objective) and proinflammatory cytokines, perceived stress, perceived coping, and depressive symptoms (secondary objectives) in abused Chinese women. Methods/Design: A total of 240 Chinese women, aged ≥18 years, who have been abused by an intimate partner within the past three years will be recruited from a community setting in Hong Kong and randomized to receive either a qigong intervention or wait-list control condition as follows: the qigong intervention will comprise (i) a 2-hour group qigong training session twice a week for 6 weeks, (ii) a 1-hour follow-up group qigong exercise session once a week for 4 months, and (iii) a 30-minute self-practice qigong exercise session once a day for 5.5 months. The wait-list control group will receive qigong training after the intervention group completes the program. Upon completion of the qigong intervention program, it is expected that abused Chinese women in the intervention group will have higher levels of telomerase activity and perceived coping and lower levels of proinflammatory cytokines, perceived stress, and depressive symptoms than will abused Chinese women in the wait-list control group. Discussion: This study will provide information about the effect of qigong exercise on telomerase activity and chronic psychological stress in abused Chinese women. The findings will inform the design of interventions to relieve the effects of IPV-related psychological stress on health. Also, the concept that health-promoting behaviors could slow down cellular aging might even motivate abused women to change their lifestyles. Trial registration: Current Controlled Trials NCT02060123. Registered February 6, 2014. [ABSTRACT FROM AUTHOR]

Background: Little research has focused on the relationship between health insurance and mental health in the community. The objective of this study is to determine how the basic health insurance system influences depression in Northwest China. Methods: Participants were selected from 32 communities in two northwestern Chinese cities through a three-stage random sampling. Three waves of interviews were completed in April 2006, December 2006, and January 2008. The baseline survey was completed by 4,079 participants. Subsequently, 2,220 participants completed the first follow-up, and 1,888 completed the second follow-up. Depression symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Results: A total of 40.0% of participants had at least one form of health insurance. The percentages of participants with severe depressive symptoms in the three waves were 21.7%, 22.0%, and 17.6%. Depressive symptoms were found to be more severe among participants without health insurance in the follow-up surveys. After adjusting for confounders, participants without health insurance were found to experience a higher risk of developing severe depressive symptoms than participants with health insurance (7 months: OR, 1.40; 95% CI, 1.09-1.82; p = 0.01; 20 months: OR, 1.89; 95% CI, 1.37-2.61; p < 0.001). Conclusion: A lack of basic health insurance can dramatically increase the risk of depression based on northwestern Chinese community samples. [ABSTRACT FROM AUTHOR]

Background: Many people with schizophrenia remain untreated in the community. Long-term mortality and suicidal behaviour among never-treated individuals with schizophrenia in the community are unknown.Aims: To explore 10-year mortality and suicidal behaviour among never-treated individuals with schizophrenia.Method: We used data from a 10-year prospective follow-up study (1994-2004) among people with schizophrenia in Xinjin County, Chengdu, China.Results: The mortality rate for never-treated individuals with schizophrenia was 2761 per 100 000 person-years during follow-up. There were no significant differences of rates of suicide and all-cause mortality between never-treated and treated individuals. The standardised mortality ratio (SMR) for never-treated people was 10.4 (95% CI 7.2-15.2) and for treated individuals 6.5 (95% CI 5.2-8.5). Compared with treated people, never-treated individuals were more likely to be older, poorer, have a longer duration of illness, marked symptoms and fewer family members.Conclusions: The never-treated individuals have similar mortality to and a higher proportion of marked symptoms than treated people, which may reflect the poor outcome of the individuals without treatment. The higher rates of mortality, homelessness and never being treated among people with schizophrenia in low- and middle-income nations might challenge presumed wisdom about schizophrenia outcomes in these countries. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to develop and validate the Chinese Making Sense of Adversity Scale (CMSAS) to measure the cognitive coping strategies that Chinese people adopt to make sense of adversity. Method: A 12-item CMSAS was developed by in-depth interview and item analysis. The scale was validated with a sample of 627 Chinese international students in Australia and Mainland Chinese students in Hong Kong. Results: Exploratory factor analysis identified two factors: making positive sense and making negative sense of adversity. The CMSAS exhibited high internal consistency reliability and good concurrent validity. Conclusion: The CMSAS is a reliable and valid instrument for measuring the coping strategies used by Chinese people to make sense of adversity. However further validation of the scale is needed. [ABSTRACT FROM AUTHOR]

Little is known about the differences in mortality among non-institutionalized geriatric and younger patients with schizophrenia. In this study long-term mortality and suicidal behavior of all the geriatric (age ≥ 65 years), middle-age (age 41-64 years), and young (age 15-40 years) subjects with schizophrenia living in a Chinese rural community were compared. A 10 year follow-up investigation among a 1994 cohort (n = 510) of patients with schizophrenia was conducted in Xinjin County, Chengdu, China. Compared with young subjects, geriatric subjects with schizophrenia were more likely to be female, have more previous physical illness, never accepted treatment, and practice religious (p ≤ 0.01). There were no significant differences of suicide attempts among the three groups. Young subjects had a higher rate of suicide (1,033.8 per 100,000 person-years), and geriatric subjects had a higher rate of deaths due to other causes (accident and natural causes) (4,314.2 per 100,000 person-years). Standardized mortality ratios for both suicide and deaths due to other causes were highest in young subjects and the lowest in geriatric subjects. Patients with schizophrenia in all age groups had a marked increase in mortality and suicide. Specific intervention strategies for decreasing mortality and suicide should be developed for patients with schizophrenia in different age groups. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study was to compare the predictive effects of acculturative stressor and meaning of life on negative affect in the process of acculturation between Chinese international students in Australia and Hong Kong. Method: Four hundred mainland Chinese students studying at six universities in Hong Kong and 227 Chinese international students studying at the University of Melbourne in Australia completed a questionnaire that included measures of acculturative stressor, meaning of life, negative affect and demographic information. Results: The Australian sample was found to have a higher level of acculturative stressor and negative affect than the Hong Kong sample. Acculturative stressor had a positive impact on negative affect in both samples, but the impact of different domains of acculturative stressor on negative affect varied between the two groups. Finally, meaning of life partially mediated the relationship between acculturative stressor and negative affect in the Hong Kong sample, but no such effect was found in the Australia sample. Conclusions: Acculturative stressor is a critical risk factor for negative affect in acculturation for Chinese international students in Australia and Hong Kong. Meaning of life acted as a protective factor that mitigated negative affect for mainland Chinese students in Hong Kong, but not for the Chinese international students in Australia. The theoretical and practical implications for resilience-based and meaning-oriented intervention for Chinese international students are discussed. [ABSTRACT FROM AUTHOR]

Background Long-term mortality and the risk factors for premature death among patients with schizophrenia living in rural communities are unknown. Aims To explore the 10 year mortality and its risk factors among patients with schizophrenia. Method We used data from a 10 year prospective follow-up study (1994-2004) of mortality among people with schizophrenia, and death registration data for Xinjin County, Chengdu, China. Results The mortality rate was 2228 per 100 000 person years during follow-up. Both all-cause mortality and suicide rates were significantly greater in male than in female patients. Age at illness onset (> 45 years), duration of illness (≥ 10 years), age greater than 50 years, physical illness, inability to work, male gender, and never having received treatment were identified as independent predictors of increased mortality. Conclusions Higher mortality rates in male patients may contribute to the higher prevalence of schizophrenia in women compared with men in China. The findings of risk factors for mortality should be taken into account when developing interventions to improve outcomes among people with schizophrenia. [ABSTRACT FROM AUTHOR]

Focuses on a study which examined the characteristics of expressed emotion among relatives of patients with schizophrenia in Chengdu, China. Discussion on the Chinese version of the Camberwell Family Interview; Methodology; Results.

CONTEXT: To summarize and evaluate the available evidence from controlled clinical trials of tai chi (TC) exercise for patients with heart disease. SEARCH METHODS: Fourteen databases were searched up to November 2010 with the terms tai chi, taichi, tai ji, taiji, taijichuan, cardiac, heart, coronary, myocardial, and atrial fibrillation in the title, abstract, or key words. No language restrictions were imposed. The quality and validity of randomized clinical trials (RCTs) were evaluated using the Jadad Scale. The strength of the evidence for all included studies was evaluated using the Oxford Centre for Evidence-based Medicine Levels of Evidence. RESULTS: Nine studies including 5 RCTs and 4 nonrandomized controlled clinical trials met the inclusion criteria. Three studies examined the effectiveness of TC exercise for patients with chronic heart failure (CHF), and 6 studies examined the effectiveness of TC exercise among patients with coronary heart disease (CHD). Overall, these studies demonstrated favorable effects of TC exercise for the patients with heart disease. CONCLUSIONS: The existing evidence suggests that TC exercise is a good option for heart patients with very limited exercise tolerance and can be an adjunct to rehabilitation programs for patients with CHD or CHF. [ABSTRACT FROM AUTHOR]