Psychotic symptoms associated increased CpG methylation of metabotropic glutamate receptor 8 gene in Chinese Han males with schizophrenia and methamphetamine induced psychotic disorder: a longitudinal study.

Methamphetamine use can produce psychotic symptoms almost indistinguishable from schizophrenia (SCZ). Variation in DNA methylation may be closely implicated in the etiology and longitudinal development of psychiatric disorders. However, the relationship between psychotic symptoms, functional disability, and DNA methylation is still unclear. This study consists of three periods: discovery, validation, and follow-up. In the discovery stage, we employed genome-wide DNA methylation profiling (Illumina 450K) in peripheral blood mononuclear cells to test whether DNA methylation associates with psychotic symptoms and function state in representative SCZ and methamphetamine-induced psychotic disorder (MIP) patients. Then, we found seven differentially methylated regions/genes (DMRs, in UBA6, APOL3, KIF17, MLLT3, GRM8, CSNK1E, SETDB1) overlapping with genetic variants reported in previous studies of psychosis. In the validation stage, we compared the above-mentioned seven genes by MethLight qPCR method in Chinese Han males (N = 109 SCZ patients, N = 99 methamphetamine use disorder with MIP patients, N = 150 methamphetamine use disorder without MIP patients, N = 282 normal controls, age range: 18-50 years). GRM8 showed robustly altered methylation, which has passed rigorous filtration in subsequent validation, suggesting a remarkable contribution to SCZ and MIP. In addition, hypermethylation of GRM8 showed a significant association with the total scores of the Positive Negative Syndrome Scale and WHO disability assessment schedule II in both baseline and follow-up periods. Our findings suggest that increased CpG methylation in the promoter of GRM8 is a potential candidate epigenetic biomarker of psychotic symptoms in transdiagnostic samples of SCZ and MIP.

Lower synaptic density and its association with cognitive dysfunction in patients with obsessive-compulsive disorder.

Background: Understanding synaptic alteration in obsessive-compulsive disorder (OCD) is crucial for elucidating its pathological mechanisms, but in vivo research on this topic remains limited. Aims: This study aimed to identify the synaptic density indicators in OCD and explore the relationship between cognitive dysfunction and synaptic density changes in OCD. Methods: This study enrolled 28 drug-naive adults with OCD aged 18-40 years and 16 healthy controls (HCs). Three-dimensional T1-weighted structural magnetic resonance imaging and 18F-SynVesT-1 positron emission tomography were conducted. Cognitive function was assessed using the Wisconsin Cart Sorting Test (WCST) in patients with OCD and HCs. Correlative analysis was performed to examine the association between synaptic density reduction and cognitive dysfunction. Results: Compared with HCs, patients with OCD showed reduced synaptic density in regions of the cortico-striato-thalamo-cortical circuit such as the bilateral putamen, left caudate, left parahippocampal gyrus, left insula, left parahippocampal gyrus and left middle occipital lobe (voxel p<0.001, uncorrected, with cluster level above 50 contiguous voxels). The per cent conceptual-level responses of WCST were positively associated with the synaptic density reduction in the left middle occipital gyrus (R2=0.1690, p=0.030), left parahippocampal gyrus (R2=0.1464, p=0.045) and left putamen (R2=0.1967, p=0.018) in patients with OCD. Conclusions: Adults with OCD demonstrated lower 18F-labelled difluoro analogue of 18F-SynVesT-1 compared with HCs, indicating potentially lower synaptic density. This is the first study to explore the synaptic density in patients with OCD and provides insights into potential biological targets for cognitive dysfunctions in OCD.

Development and validation of a risk score model for predicting autism based on pre- and perinatal factors.

Background: The use of pre- and perinatal risk factors as predictive factors may lower the age limit for reliable autism prediction. The objective of this study was to develop a clinical model based on these risk factors to predict autism. Methods: A stepwise logistic regression analysis was conducted to explore the relationships between 28 candidate risk factors and autism risk among 615 Han Chinese children with autism and 615 unrelated typically developing children. The significant factors were subsequently used to create a clinical risk score model. A chi-square automatic interaction detector (CHAID) decision tree was used to validate the selected predictors included in the model. The predictive performance of the model was evaluated by an independent cohort. Results: Five factors (pregnancy influenza-like illness, pregnancy stressors, maternal allergic/autoimmune disease, cesarean section, and hypoxia) were found to be significantly associated with autism risk. A receiver operating characteristic (ROC) curve indicated that the risk score model had good discrimination ability for autism, with an area under the curve (AUC) of 0.711 (95% CI=0.679-0.744); in the external validation cohort, the model showed slightly worse but overall similar predictive performance. Further subgroup analysis indicated that a higher risk score was associated with more behavioral problems. The risk score also exhibited robustness in a subgroup analysis of patients with mild autism. Conclusion: This risk score model could lower the age limit for autism prediction with good discrimination performance, and it has unique advantages in clinical application.

Incidence and correlates of suicide attempts in adolescents with major depressive versus bipolar disorders: A cross-sectional study.

BACKGROUND: Major depressive disorders (MDD) and bipolar disorders (BD) are the most common psychiatric diagnoses of suicide attempts (SA) in adolescents. However, little is known regarding the differences in incidence and clinical-related features of SA between these two disorders. The study aims to examine the SA incidence and related factors in adolescents with MDD versus BD. METHOD: A retrospective survey was conducted in outpatients. SA incidence, demographic characteristics and substance use history were collected. Symptom Checklist-90 was used to measure the severity of symptoms. The Revised Chinese internet addiction scale and Barratt Impulsiveness Scale-11 were utilized to assess the presence of internet addiction and impulsiveness. The Childhood Trauma Questionnaire was used to measure childhood maltreatment subtypes. RESULTS: 295 MDD and 205 BD adolescents were recruited. The incidence of SA for MDD and BD were 52.5 % and 56.4 %, respectively. BD adolescents who attempted suicide showed worse symptoms, higher rates of nicotine and alcohol use, higher motor and non-planning impulsivity, and a more childhood physical abuse proportion than MDD adolescents with SA. Physical abuse in childhood was found to be associated with SA in both disorders (OR = 1.998 for MDD; OR = 2.275 for BD), while higher anxiety (OR = 1.705), and alcohol use (OR = 2.094) were only associated with SA in MDD. LIMITATIONS: Retrospective, cross-sectional design cannot draw causality, and biases in self-report measurements cannot be ignored. CONCLUSIONS: The findings revealed some difference between BD and MDD for adolescents with SA, and it emphasize significance of prompt identification and exact distinction between BD and MDD in adolescents.

Identifying clinical risk factors correlated with addictive features of non-suicidal self-injury among a consecutive psychiatric outpatient sample of adolescents and young adults.

Non-suicidal self-injury (NSSI) is an issue primarily of concern in adolescents and young adults. Recent literature suggests that persistent, repetitive, and uncontrollable NSSI can be conceptualized as a behavioral addiction. The study aimed to examine the prevalence of NSSI with addictive features and the association of this prevalence with demographic and clinical variables using a cross-sectional and case-control design. A total of 548 outpatients (12 to 22 years old) meeting the criteria for NSSI disorder of DSM-5 were enrolled and completed clinical interviews by 4 psychiatrists. NSSI with addictive features were determined by using a single-factor structure of addictive features items in the Ottawa self-injury inventory (OSI). Current suicidality, psychiatric diagnosis, the OSI, the revised Chinese Internet Addiction Scale, the Childhood Trauma Questionnaire, and the 20-item Toronto Alexithymia Scale were collected. Binary logistic regression analyses were used to explore associations between risk factors and NSSI with addictive features. This study was conducted from April 2021 to May 2022. The mean age of participants was 15.93 (SD = 2.56) years with 418 females (76.3%), and the prevalence of addictive NSSI was 57.5% (n = 315). Subjects with addictive NSSI had a higher lifetime prevalence of nicotine and alcohol use, a higher prevalence of current internet addiction, suicidality, and alexithymia, and were more likely to have physical abuse/neglect, emotional abuse, and sexual abuse than NSSI subjects without addictive features. Among participants with NSSI, the strongest predictors of addictive features of NSSI were female (OR = 2.405, 95% CI 1.512-3.824, p < 0.0001), alcohol use (OR = 2.179, 95% CI 1.378-3.446, p = 0.001), current suicidality (OR = 3.790, 95% CI 2.351-6.109, p < 0.0001), and psysical abuse in childhood (OR = 2.470, 95% CI 1.653-3.690, p < 0.0001). Nearly 3 out of 5 patients (12-22 years old) with NSSI met the criteria of NSSI with addictive features in this psychiatric outpatients sample. Our study demonstrated the importance of the necessity to regularly assess suicide risk, and alcohol use, as well as focus more on females and subjects who had physical abuse in childhood to prevent addictive NSSI.

Lower synaptic density associated with gaming disorder: an 18F-SynVesT-1 PET imaging study.

Background: Internet gaming disorder (IGD) is an ideal model to study the mechanisms underlying synaptic deficits in addiction as it eliminates the confounding effects of substance use. Synaptic loss and deficits are hypothesised to underlie the enduring maladaptive behaviours and impaired cognitive function that contribute to IGD. Aims: This study aimed to determine whether subjects with IGD have lower synaptic density than control subjects and the relationship between synaptic density and IGD severity. Methods: Eighteen unmedicated subjects diagnosed with current IGD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria and 16 demographically matched healthy controls (HCs) participated in the study and underwent 18F-labelled difluoro-analogue of UCB-J (18F-SynVesT-1) positron emission tomography scans to assess the density of synaptic vesicle glycoprotein 2A (SV2A). The Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA), Barratt Impulsiveness Scale Version 11 (BIS-11), Stroop Colour-Word Test (SCWT), stop-signal paradigms and N-back tasks were administered to all subjects. Results: Patients with IGD had significantly higher scores on the IGDS9-SF, HAMD, HAMA and BIS-11 than HCs. HCs performed better on the two-back and SCWT tests as well as in terms of stop-signal reaction times (SSRTs) in the stop-signal paradigms than patients with IGD. Lower uptake was found in the bilateral putamen, right pregenual anterior cingulate cortex and Rolandic operculum of patients with IGD compared with HCs. Furthermore, in the IGD group, IGDS9-SF scores and daily gaming hours were negatively correlated with the standardised uptake value ratios of 18F-SynVesT-1 in the bilateral putamen. Longer SSRTs were significantly associated with lower SV2A density in the right pregenual anterior cingulate cortex and right Rolandic operculum. Conclusions: The in vivo results in this study suggest that lower synaptic density contributes to the severity and impairments in inhibitory control of IGD. These findings may provide further incentive to evaluate interventions that restore synaptic transmission and plasticity to treat IGD.

The clinical application of Chinese herbal medication to depression: A narrative review.

Depression severely impairs psychosocial functioning and quality of life, which places a huge burden on patients and their families. However, the physiological mechanism of depression remains unknown. Treatment with existing antidepressant medications is effective in around 50% of patients according to various studies, but is associated with severe side effects including nausea and headaches. Chinese herbal medicine (CHM) has been approved and widely used for depression as an alternative medicine in Chinese culture for decades. It has certain advantages and potential in the prevention and treatment of depression. In this review, we summarize the currently available evidence for the efficacy of CHM for the treatment of depression and physiological diseases comorbid with depression. We further discuss the possible mechanisms of action of CHM and the relationships to our current understanding of depression. The majority of current evidence has suggested that the combined treatment with CHM and mainstream antidepressants improves the response rate and reduces the side effects, while CHM alone could be more effective than placebo. However, the results should be carefully interpreted due to the shortcomings of existing clinical trials and a high risk of bias in meta-analyses. Our review provides a summary of the current applications and understanding of widely used CHMs for depression.

Relationship between RELN signaling pathway genes and language development of autism based on a cluster model. / RELNä¿¡å·é€šè·¯åŸºå› ä¸ŽåŸºäºŽèšç±»åˆ†æžæ¨¡åž‹çš„å­¤ç‹¬ç—‡è¯­è¨€å‘è‚²çš„å ³ç³».

OBJECTIVES: Autism is a neurodevelopment disorder with unclear etiology. High heterogeneity is one of the main issues in the etiological studies. This study explores the relationship between RELN signaling pathway related genes (RELN, VLDLR, LRP8, DAB1, CDK5, FYN) and language development of autism patients based on a cluster analysis model which is established to reduce the heterogeneity. METHODS: Autism children were recruited from 5 different medical/autism training institutes from Hunan, Shandong, and Henan provinces, and were divided into 2 parts according to the recruitment time: The first part was the training sample, which was recruited from October 2006 to May 2011, and the second part was the validation sample, which was recruited from July 2011 to May 2012. A two-step cluster analysis was performed to cluster 374 Chinese Han autism patients into different subgroups based on 2 parameters: Onset age of the first word and interval from the first word to the first phase. A Bayes discriminatory equation was established followed the cluster results. Then we used this equation to divide another 310 autism children into prior defined subgroups. After the genotyping data was screened, a single marker case-control association study was conducted. RESULTS: The cluster analysis clustered 374 samples into 3 subgroups. Onset ages of the first word in the Group A were (11.83±4.37) months and intervals from the first word to the first phase were (24.55±8.67) months; onset ages of the first word in the Group B were (12.17±3.46) months, intervals from the first word to the first phase were (7.07±3.79) months; onset ages of the first word of Group C were (30.94±7.60) months, intervals from the first word to the first phase were (4.73±4.80) months. The established equations based on the cluster analysis were YA=-14.442+0.525X1+0.810X2, YB=-4.964+0.477X1+0.264X2, YC=-19.843+1.175X1+0.241X2. Cross validated analysis showed that the false rate of the equation was 3.8%. A total of 341 single nucleotide polymorphism (SNP) in 6 genes passed the quality control. Before divided subgroups, none of these SNPs reached the significant P value (P>2.44×10-5, Bonferroni adjustment). However the result showed that rs1288502 of LRP8 in Group B was significantly different from the control group (P=6.45×10-6). CONCLUSIONS: Based on the cluster analysis of language development, we could establish a discriminatory equation to reduce heterogeneity of autism sample. The association test indicates that LRP8 genein RELN signaling pathway is related to a particular type of language development of autism patients.

Tuberous sclerosis complex with skin lesions as the initial presentation: A case report and multidisciplinary discussion. / 1例以皮肤损害为首发症状的结节性硬化症并多学科讨论.

We reported a case of tuberous sclerosis complex with facial angiofibroma as the initial presentation and conducted a multidisciplinary discussion. The patient, a young female, was admitted to the Department of Dermatology for cosmetic purpose. After the examination, she was found to have multiple system involvement, including a large renal angiomyolipoma pressing on the liver. She never had any subjective symptom. After consultation by the multidisciplinary team of tuberous sclerosis complex, the patient was treated with everolimus orally and followed up regularly. It is suggested that dermatologists should pay attention to the systemic involvement of patients with tuberous sclerosis complex. Early intervention can prolong the life of patients and improve their life quality. Multidisciplinary collaboration for lifelong disease management is the key to enhance the diagnosis and treatment for tuberous sclerosis complex and enhance the prognosis of patients.

Assessing the mediating role of impulsivity between methamphetamine-induced psychotic disorders and increased gambling severity in methamphetamine-dependent individuals.

Pathological gambling (PG) and methamphetamine-induced psychotic disorders (MIPD) both frequently occurs in methamphetamine-dependent individuals. The current study examined whether impulsivity mediated the relationship between MIPD and gambling severity. The sample consisted of 320 pathological gamblers with methamphetamine dependence (mean age 32.6 years, ranging from 15 to 64 years) voluntarily recruited from three rehabilitation centers in Hunan, China. The semistructured clinical interview of DSM-IV-TR Axis I Disorders Patient Edition was used to diagnosis the presence of MIPD and PG by registered psychiatrists. The severity of gambling symptoms was assessed using the global assessment of functioning scale, and the Barratt Impulsiveness Scale-11 provided a measure of impulsivity. Of the sample, 53.4% of participants (n = 171) met diagnostic criteria for MIPD. Individuals with a dual diagnosis of MIPD were associated with higher levels of impulsivity and greater gambling severity. Notably, support for our hypothesized mediation model was found such that impulsivity mediated the association between MIPD and gambling severity. Our findings imply that impulsivity appears to be a transdiagnostic process, which may be targeted in treatment among pathological gamblers with a dual diagnosis of MIPD to reduce gambling behaviors. Limits and future directions for research are discussed.

Sleep Quality in Medical Staffs During the Outbreak of Coronavirus Disease 2019 in China: A Web-Based Cross-Sectional Study.

Background: The aim of this study was to describe the sleep quality and its influencing factors among medical workers of different working statuses and staff types during the coronavirus disease 2019 (COVID-19) epidemic. Methods: Through an online questionnaire survey, all medical staffs in Xiangya Hospital were invited to complete sections on general information, the Self-Rating Scale of Sleep (SRSS), the Depression, Anxiety and Stress Scale (DASS-21), the Social Support Rating Scale (SSRS), and the Simplified Coping Style Questionnaire (CSQ). Results: A total of 4,245 respondents completed the survey. Among them, 38.7% had sleep disturbance. After matching, the SRSS scores in the staffs who were assigned to the intensive care unit (ICU) of Union Hospital in Wuhan and working in the epidemic area of Xiangya Hospital were not significantly different (P > 0.05); the SRSS scores in the battlefront staffs were significantly higher than (P < 0.05) those who were not treating patients infected with COVID-19. The SRSS scores of nurses were significantly higher than those of doctors and hospital administrators (P < 0.01). Anxiety, depression, and coping style were associated with sleep disturbance. Conclusion: The sleep quality of the medical staffs has been impaired during the epidemic period, especially among nurses, doctors, and administrators who are working on the front line. Medical institutions should strengthen psychological services and coping strategies for medical staffs.

Sleep Problems of Children with Autism May Independently Affect Parental Quality of Life.

The current study explored how and to what extent sleep problems in children with autism spectrum disorder (ASD) impacted their parents' quality of life (QOL). A total of 440 ASD children and 344 age-matched typically developing (TD) children were included in the case-control designed study. In the TD group, a linear regression model showed that the Children's Sleep Habits Questionnaire (CSHQ) total scores were negatively associated with maternal mental health summary (MCS) scores in the SF-36v2 (ß = - 2.831), while in the ASD group, the CSHQ total scores were negatively associated with the parental physical health summary (PCS) scores (ß = - 3.030 for mothers, ß = - 3.651 for fathers). Path analysis showed that sleep problems in ASD children had both direct and indirect effects on maternal PCS scores. The results indicated that sleep problems in children with ASD might affect parental QOL differently from TD children, and act as independent impact factors on parental physical health.

Genome-Wide DNA Methylation Analysis in Male Methamphetamine Users With Different Addiction Qualities.

This paper aimed to explore the genome-wide DNA methylation status of methamphetamine (MA) abusers with different qualities to addiction and to identify differentially methylated candidate genes. A total of 207 male MA abusers with an MA abuse frequency of ≥10 times and an MA abuse duration of ≥1 year were assigned to the high MA addiction quality group (HMAQ group; 168 subjects who met the diagnostic criteria for MA dependence according to the DSM-IV) or to the low MA addictive quality group (LMAQ group; 39 subjects who did not meet the criteria for MA dependence). In addition 105 healthy controls were recruited. Eight HMAQ subjects, eight LMAQ subjects, and eight healthy controls underwent genome-wide DNA methylation scans with an Infinium Human Methylation 450 array (Illumina). The differentially methylated region (DMR) data were entered into pathway analysis, and the differentially methylated position (DMP) data were screened for candidate genes and verified by MethyLight qPCR with all samples. Seven specific pathways with an abnormal methylation status were identified, including the circadian entrainment, cholinergic synapse, glutamatergic synapse, retrograde endocannabinoid signaling, GABAergic synapse, morphine addiction and PI3K-Akt signaling pathways. SLC1A6, BHLHB9, LYNX1, CAV2, and PCSK9 showed differences in their methylation levels in the three groups. Only the number of methylated copies of CAV2 was significantly higher in the LMAQ group than in the HMAQ group. Our findings suggest that the circadian entrainment pathway and the caveolin-2 gene may play key roles in MA addiction quality. Further studies on their functions and mechanisms will help us to better understand the pathogenesis of MA addiction and to explore new targets for drug intervention.

Internet Addiction and Related Psychological Factors Among Children and Adolescents in China During the Coronavirus Disease 2019 (COVID-19) Epidemic.

BACKGROUND: The Coronavirus disease 2019 (COVID-19) is an infectious disease presenting a major threat to public health. This study aims to assess Internet use characteristics and objectively examine the potential psychological factors associated with Internet addiction (IA) during the COVID-19 epidemic. METHODS: A cross-sectional, anonymized, self-reported survey was conducted among Chinese children and adolescents aged 6 to 18 years old. Participants completed questionnaires containing Young's Internet Addiction Test (IAT) and the Depression, Anxiety, and Stress Scale (DASS-21), and questions regarding demographic information and Internet use characteristics. RESULTS: A total of 2050 participants (mean age:12.34 ± 4.67 years old, female: 48.44%) were enrolled. Fifty-five (2.68%) participants met the criterion for addictive Internet use (IAT≥70), while 684 (33.37%) participants were classified as problematic Internet users (69≥IAT≥40). Internet usage had grown during the COVID-19 epidemic, including the frequency and duration of recreational Internet use, and the frequency of stay-up Internet use. A linear regression analysis showed female gender (ß=-0.091, p<0.001), age (ß=0.066, p=0.001), depression (ß=0.257, p<0.001), and stress (ß=0.323, p<0.001) were significantly correlated with the IAT total scores (R=0.539, R2 = 0.291, p<0.001). CONCLUSIONS: We observed excessive Internet use among Chinese children and adolescents during the outbreak of COVID-19. Age, gender, depression, and stress were the potential key factors affecting IA. Extended family and professional support should be considered for vulnerable individuals during these unprecedented times.

Effects of ketamine use on psychotic disorders and symptoms in male, methamphetamine-dependent subjects.

BACKGROUND: Repeated and extensive methamphetamine or ketamine use may cause psychotic symptoms. Whether the chronic and combined use of these substances has a greater psychotic effect is still unknown. OBJECTIVES: To examine the effect of different levels of ketamine use on psychotic disorders and symptoms in male methamphetamine-dependent subjects. METHODS: A cross-sectional, structured, and clinical interview method was used to examine the differences in DSM-IV-TR Axis I psychotic disorders and symptoms among methamphetamine-dependent subjects in three categories: 205 with no ketamine use, 38 with occasional ketamine use, and 72 with ketamine abuse or dependence from compulsory rehabilitation centers. RESULTS: Both methamphetamine-dependent subjects with occasional ketamine use and those with ketamine abuse or dependence had a higher prevalence of psychotic disorders than those who had not used ketamine (p = 0.021; p < 0.001). Subjects who used ketamine occasionally had a higher prevalence of referential and persecutory delusions (p < 0.001; p = 0.013) and auditory hallucinations (p = 0.030), and those with ketamine abuse or dependence had a higher prevalence of referential and persecutory delusions (p = 0.005; p = 0.021), compared with those who had not used ketamine. There was no significant difference in any psychotic disorders or symptoms between subjects with occasional ketamine use and those with ketamine abuse or dependence. CONCLUSIONS: The combination of methamphetamine and ketamine was associated with greater psychotic effects than methamphetamine alone. Both occasional ketamine use and ketamine abuse or dependence were associated with increased psychotic symptoms and disorders in methamphetamine-dependent males.

Associations among maternal pre-pregnancy body mass index, gestational weight gain and risk of autism in the Han Chinese population.

BACKGROUND: Autism is a neurodevelopmental disorder with an unclear etiology. Pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) have been suggested to play a role in the etiology of autism. The current study explores the associations among maternal pre-pregnancy BMI, GWG and the risk of autism in the Han Chinese population. METHODS: Demographic information, a basic medical history and information regarding maternal pre-pregnancy and pregnancy conditions were collected from the parents of 705 Han Chinese children with autism and 2236 unrelated typically developing children. Binary logistic regressions were conducted to calculate the odds ratio (OR) for the relationship among pre-pregnancy BMI, GWG and the occurrence of autism. The interaction between pre-pregnancy BMI and GWG was analyzed by performing stratification analyses using a logistic model. RESULTS: After adjusting for the children's gender, parental age and family annual income, excessive GWG was associated with autism risk in the entire sample (OR = 1.327, 95% CI: 1.021-1.725), whereas the relationship between maternal pre-pregnancy BMI and autism was not significant. According to the stratification analyses, excessive GWG increased the risk of autism in overweight/obese mothers (OR = 2.468, 95% CI: 1.102-5.526) but not in underweight or normal weight mothers. CONCLUSIONS: The maternal pre-pregnancy BMI might not be independently associated with autism risk. However, excessive GWG might increase the autism risk of offspring of overweight and obese mothers.

Prevalence Rates of Personality Disorder and Its Association With Methamphetamine Dependence in Compulsory Treatment Facilities in China.

Methamphetamine use is popular and rapidly increasing in China, and the co-occurrence of personality disorders has an impact on treatment outcomes and may increase vulnerability of developing dependence. The aim of the present study was to investigate the prevalence rates of personality disorders in methamphetamine users and further explore the association between personality disorders and methamphetamine use status. Five hundred and seventy-seven male methamphetamine users were recruited. The self-developed questionnaire was used for demographics, and a Structural Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (SCID-I/II) was performed covering psychiatric diagnosis. Our study found the prevalence of antisocial personality disorder in male methamphetamine users was 71.4%, followed by borderline (20.2%) and obsessive-compulsive (17.9%) personality disorder. Borderline and antisocial personality disorders were found to be risk factors of methamphetamine dependence (adjusted odds ratio = 2.891, p = 0.007 and adjusted odds ratio = 1.680, p = 0.042). These findings suggested personality disorders were highly prevalent in male methamphetamine users, and the comorbidity of antisocial and borderline personality disorders are especially associated with methamphetamine dependence.

Comparison of demographic characteristics and psychiatric comorbidity among methamphetamine-, heroin- and methamphetamine-heroin co- dependent males in Hunan, China.

BACKGROUND: There is little research of psychiatric comorbidity differences among people with different types of drug dependence in Chinese population. We explored demographic and comorbid psychiatric differences among methamphetamine- dependent males (MDs), heroin-dependent males (HDs) and methamphetamine and heroin co-dependent males (M/HDs) in Hunan province, China. METHODS: A cross-sectional, structured and clinical interview method was used to examine differences in DSM-IV-TR Axis I Disorders among 346 MDs, 698 HDs and 247 M/HDs from three compulsory rehabilitation centers and two voluntary rehabilitation centers in Hunan. RESULTS: MDs and M/HDs were younger, more likely to choose inhalation administration, less likely to have a family history of substance use, less likely to have undergone detoxification treatment, had higher incomes and shorter duration of drug use than HDs. Overall, methamphetamine-dependence related to higher rates of current and lifetime psychotic disorders, lifetime hallucinogen use disorders. Heroin-dependence related to higher rates of current and lifetime substance-induced mood disorders, sedative/hypnotic/anxiolytic and other drug use disorders and current alcohol use disorder. For M/HDs, they were more likely to have any other lifetime substance use disorders than MDs and HDs. CONCLUSIONS: There were substantial differences in epidemiological characteristics and comorbidity among MD, HD and M/HD groups, which highlights the urgent need to develop treatment services and policies for drug-specific users in China.

Prevalence, correlates and treatment status of alcohol use disorders in psychiatric patients in China.

OBJECTIVE: To determine the prevalence, associated factors and treatment status of alcohol use disorders (AUDs) in psychiatric patients in China. METHODS: We asked 24,379 consecutive patients aged ≥18years who presented at the psychiatric departments in eight hospitals in 2013 whether they had consumed alcoholic beverages in the previous month. Of the 2964 (12.2%) patients who answered yes and were then screened with the Alcohol Use Disorders Identification Test (AUDIT), 1304 (5.3%) screened positive (AUDIT≥7) and, based on DSM-IV criteria, were diagnosed with AUDs by psychiatrists. The treatments prescribed for them were also recorded. Logistic regression was used to identify AUDs associated factors. RESULTS: The prevalence of AUDs was 2.4% (95% CI: 2.2-2.6%). None of the patients diagnosed with AUDs had got medical treatment for preventing relapse. The risk factors for AUDs were middle-aged or elderly (OR=1.86, 95% CI: 1.23-2.80), and consuming beverages with high degree of alcohol content (OR=2.92, 95% CI: 2.11-4.06). CONCLUSIONS: The prevalence of AUDs in psychiatric patients in China was not high, but the rate of treatment was dramatically low, indicating the serious neglect of AUDs. Our study suggests an urgent need to improve the situation of unmet need for treatment of psychiatric patients with AUDs.