Prevalence and Correlates of Insomnia Symptoms in Older Chinese Adults During the COVID-19 Outbreak: A Classification Tree Analysis.

OBJECTIVE: To examine prevalence and correlates of insomnia symptoms in older Chinese adults (OCAs) during the COVID-19 outbreak. BACKGROUND: During the COVID-19 pandemic, insomnia is a major health concern of elderly individuals, but its subtypes have not been investigated. METHODS: Altogether, 590 OCAs (50+ years) were recruited via snowball sampling during the COVID-19 outbreak. Standardized self-report questions were used to assess the presence of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA). Classification tree analysis (CTA) was used to identify correlates of insomnia. RESULTS: The one-month prevalence (95% confidence interval) of any subtype of insomnia symptoms was 23.4% (20.0-26.8%), with DIS, DMS, and EMA being 15.4% (12.5-18.3%), 17.1% (14.1-20.2%), and 11.2% (8.64-13.7%), respectively. Worry about being infected with COVID-19 emerged as the most salient correlate of insomnia (P < .001); compared to participants who were not worried about being infected, those who were worried and very worried were 3.2-fold (24.3% vs 7.5%) and 5.5-fold (24.3% vs 7.5%) more likely to have insomnia, respectively. Among participants in the "very worried" branch, those residing in Wuhan were 1.8-fold more likely to have insomnia than those residing in other places (50.0% vs 27.5%, P = .011). Among participants in the "worried" branch, unemployed persons were 2.0-fold more likely to have insomnia than employed persons (37.0% vs 18.1%, P < .001). CONCLUSIONS: Insomnia symptoms were prevalent among OCAs during the COVID-19 outbreak. Selective intervention programs targeting elderly individuals who are worried about being infected, living in the epicenter of COVID-19, and unemployed might be effective.

Sense of Alienation and Its Associations With Depressive Symptoms and Poor Sleep Quality in Older Adults Who Experienced the Lockdown in Wuhan, China, During the COVID-19 Pandemic.

OBJECTIVE: To examine the epidemiology of sense of alienation (SoA) and its associations with depressive symptoms and poor sleep quality (PSQ) in Chinese older adults who experienced lockdown during the COVID-19 pandemic. BACKGROUND: There is a dearth of data on SoA in older adults during the COVID-19 pandemic. METHODS: Altogether, 543 community-dwelling older adults (50+ years) were recruited via the three-tier mental health network in Wuhan, China, and completed an online questionnaire in April 2020, the first month after the reopening of Wuhan. SoA, depressive symptoms, and sleep quality were measured by using the General Social Alienation Scale, Depression Anxiety and Stress Scale, and a single standardized question, respectively. RESULTS: The prevalence of SoA was 52.3% (95% confidence interval: 48.1-56.5%). Factors associated with higher levels of SoA were religious belief (ß = 1.960, P = .024), monthly family income<4000 RMB (ß = 1.405, P = .022), unemployment (ß = 1.217, P = .039), fair or poor physical health (ß = 2.202, P = .002), never and sometimes receiving community support (ß = 2.297, P < .001 and ß = 3.417, P < .001), perceiving a low possibility of a cure for COVID-19 (ß = 2.379, P < .001), and affirmative and unsure fear of COVID-19 patients (ß = 2.025, P = .007 and ß = 1.101, P = .027). After adjusting for sociodemographic and pandemic-related variables, a one-SD increment in the SoA score was significantly associated with depressive symptoms (Odd Ratio [OR] = 5.59, P < .001) and poor sleep quality (Odd Ratio = 2.00, P < .001). CONCLUSION: Over half of the older adults who experienced lockdown felt alienated, and SoA was independently associated with their depressive symptoms and PSQ. Efforts are warranted to address SoA in older adults who experienced lockdown during the pandemic.

Suicidal Ideation and Mental Health Help-Seeking Behaviors Among Older Chinese Adults During the COVID-19 Pandemic.

OBJECTIVE: To examine prevalence and correlates of suicidal ideation in older Chinese adults (OCAs) during the COVID-19 pandemic, as well as mental health help-seeking behaviors of suicidal OCAs. BACKGROUND: Few data on suicidal behaviors of older adults during the pandemic are available. METHODS: In this cross-sectional survey, 1159 OCAs completed an online self-administered questionnaire between 23 February and 25 March 2020. A standardized single question and the 12-item General Health Questionnaire were used to assess the presence of suicidal ideation and common mental health problems (CMHPs), respectively. Suicidal ideators were further asked about their perceived need for mental health care and help-seeking from mental health workers. RESULTS: 4.1% of the OCAs experienced suicidal ideation during the past 2 weeks. Among the suicidal OCAs, 31.9% perceived a need for mental health care but only 10.6% had sought help from mental health workers. Factors significantly associated with suicidal ideation were a marital status of "others" (OR=2.39, P = .021), disagreement regarding the successful containment of the pandemic (OR=2.43, P = .022), physical health problems (OR=2.23, P = .012), and CMHPs (OR=4.99, P < .001). CONCLUSIONS: During the COVID-19 pandemic, OCAs constitute a subpopulation that needs mental health services for suicidal problems but tends not to seek mental health help. Mental health services for OCAs may include mental health education, periodic evaluation of risk of suicide, expanded psychosocial support, and, when necessary, psychological crisis intervention and psychiatric treatment.

Feelings of loneliness and mental health needs and services utilization among Chinese residents during the COVID-19 epidemic.

BACKGROUND: Due to the implementation of social distancing and quarantine measures, loneliness has been a major public health concern during the COVID-19 pandemic. However, few studies have examined loneliness in Chinese residents during the COVID-19 epidemic, as well as its associations with mental health needs and services utilization. METHODS: The present study was a cross-sectional survey during the COVID-19 outbreak in China. A total of 7741 adults were invited and completed an online self-administered questionnaire. The Chinese 12-item General Health Questionnaire was used to screen for common mental health problems, loneliness was measured with a single-item self-report question ("How often do you feel lonely in recent days?"), and two standardized questions were used to assess perceived needs for and use of mental health services. RESULTS: In total, 24.2 % of the participants felt lonely in recent days. Age of 16-29 years (OR = 1.36, P = 0.020), marital status of never-married (OR = 1.47, P < 0.001), marital status of "others" (re-married, co-habiting, separated, divorced, and widowed) (OR = 1.72, P < 0.001), having infected family members or close relatives (OR = 1.64, P = 0.026), and having infected colleagues, friends, or classmates (OR = 1.62, P < 0.001) were significant correlates of loneliness. Rates of mental health needs (17.4 % vs. 4.9 %, P < 0.001) and services utilization (2.7 % vs. 1.0 %, P < 0.001) were significantly higher in lonely than not lonely participants. After adjusting for socio-demographic and epidemic characteristics and common mental health problems, loneliness was still significantly associated with mental health needs (OR = 2.50, P < 0.001) and services utilization (OR = 1.62, P = 0.020). CONCLUSIONS: Feelings of loneliness are prevalent among Chinese residents affected by the COVID-19 epidemic and the presence of loneliness is associated with high levels of mental health needs and greater services utilization. Effective measures aiming at preventing or reducing loneliness are potentially beneficial for the mental wellbeing of COVID-19-affected population and reducing the use of the limited mental health service resources during the COVID-19 pandemic.

Migrant workers in China need emergency psychological interventions during the COVID-19 outbreak.

The 2019 novel coronavirus disease (COVID-19) has been found in more than 200 countries worldwide since December, 2019. In China, a major reason for the rapid transmission of the COVID-19 in early stage of the outbreak is the huge numbers of passengers boarding their "last train home" to meet family members during the Spring Festival. Most of these travelers were internal migrant workers. In order to reduce the risk of the COVID-19 transmission, public transportation networks were suspended, and many migrant workers who returned to their hometowns needed to be quarantined for 2 weeks, which led to the delay of returning back to cities to work. Many businesses have temporarily closed because of the risk of COVID-19 transmission, leading to unemployment of many workers. Sudden loss of income and further quarantine enforcement in cities can exacerbate existing mental health problems or trigger new mental disorders among affected migrant workers. However, to date no specific guidelines or strategies about mental health services of migrant workers have been released. Health authorities and professionals should pay more attention to this vulnerable group and provide timely mental health service support for those in need.

Depressive Symptoms in Elderly Chinese Primary Care Patients: Prevalence and Sociodemographic and Clinical Correlates.

OBJECTIVE: To estimate the prevalence of depressive symptoms (depression thereafter) and to identify the sociodemographic and clinical correlates of depression in a sample of elderly patients treated in the primary care setting in Wuhan, China. BACKGROUND: Primary care is an opportune setting for the management of late-life depression in China, but there have been no representative studies on the clinical epidemiology of depression in elderly Chinese primary care patients. METHODS: In total, 752 elderly patients (≥ 65 years) were consecutively recruited from 13 primary care centers in Wuhan, China, and interviewed with a standardized questionnaire. Depression was assessed with the 15-item Geriatric Depression Scale (GDS-15). RESULTS: Of the elderly Chinese primary care patients, 30.6% had depression (GDS-15 ≥ 5). Correlates of depression were an education level of primary school or less (odds ratio [OR]: 1.94, 95% confidence interval [CI]: 1.36-2.77, P < .001), poor financial status (OR: 2.19, 95% CI: 1.16-4.15, P = .016), lack of an exercise habit (OR: 1.40, 95% CI: 1.06-1.74, P = .023), 2 or more chronic medical conditions (OR: 1.90, 95% CI: 1.34-2.69, P < .001), and loneliness (OR: 3.53, 95% CI: 2.46-5.08, P < .001). CONCLUSIONS: Depression is prevalent among elderly Chinese primary care patients, indicating that elderly patients treated in primary care have a high level of need for mental health services in China. There is an urgent need to integrate mental health services into primary health care.

Development and validation of a new cognitive screening test: The Hong Kong Brief Cognitive Test (HKBC).

OBJECTIVES: To develop and examine the validity of a new brief cognitive test with less educational bias for screening cognitive impairment. METHODS: A new cognitive test, Hong Kong Brief Cognitive Test (HKBC), was developed based on review of the literature, as well as the views of an expert panel. Three groups of subjects aged 65 or above were recruited after written consent: normal older people recruited in elderly centres, people with mild NCD (neurocognitive disorder), and people with major NCD. The brief cognitive test, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA), were administered to the subjects. The performance of HKBC in differentiating subjects with major NCD, mild NCD, and normal older people were compared with the clinical diagnosis, as well as the MMSE and MoCA scores. RESULTS: In total, 359 subjects were recruited, with 99 normal controls, 132 subjects with major NCD, and 128 with mild NCD. The mean MMSE, MoCA, and HKBC scores showed significant differences among the 3 groups of subjects. In the receiving operating characteristic curve analysis of the HKBC in differentiating normal subjects from those with cognitive impairment (mild NCD + major NCD), the area under the curve was 0.955 with an optimal cut-off score of 21/22. The performances of MMSE and MoCA in differentiating normal from cognitively impaired subjects are slightly inferior to the HKBC. CONCLUSIONS: The HKBC is a brief instrument useful for screening cognitive impairment in older adults and is also useful in populations with low educational level.

Mindfulness-based stress reduction for family carers of people with dementia.

BACKGROUND: Caring for people with dementia is highly challenging, and family carers are recognised as being at increased risk of physical and mental ill-health. Most current interventions have limited success in reducing stress among carers of people with dementia. Mindfulness-based stress reduction (MBSR) draws on a range of practices and may be a promising approach to helping carers of people with dementia. OBJECTIVES: To assess the effectiveness of MBSR in reducing the stress of family carers of people with dementia. SEARCH METHODS: We searched ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (all years to Issue 9 of 12, 2017), MEDLINE (Ovid SP 1950 to September 2017), Embase (Ovid SP 1974 to Sepetmber 2017), Web of Science (ISI Web of Science 1945 to September 2017), PsycINFO (Ovid SP 1806 to September 2017), CINAHL (all dates to September 2017), LILACS (all dates to September 2017), World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, and Dissertation Abstracts International (DAI) up to 6 September 2017, with no language restrictions. SELECTION CRITERIA: Randomised controlled trials (RCTs) of MBSR for family carers of people with dementia. DATA COLLECTION AND ANALYSIS: Two review authors independently screened references for inclusion criteria, extracted data, assessed the risk of bias of trials with the Cochrane 'Risk of bias' tool, and evaluated the quality of the evidence using the GRADE instrument. We contacted study authors for additional information, then conducted meta-analyses, or reported results narratively in the case of insufficient data. We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We included five RCTs involving 201 carers assessing the effectiveness of MBSR. Controls used in included studies varied in structure and content. Mindfulness-based stress reduction programmes were compared with either active controls (those matched for time and attention with MBSR, i.e. education, social support, or progressive muscle relaxation), or inactive controls (those not matched for time and attention with MBSR, i.e. self help education or respite care). One trial used both active and inactive comparisons with MBSR. All studies were at high risk of bias in terms of blinding of outcome assessment. Most studies provided no information about selective reporting, incomplete outcome data, or allocation concealment.1. Compared with active controls, MBSR may reduce depressive symptoms of carers at the end of the intervention (3 trials, 135 participants; standardised mean difference (SMD) -0.63, 95% confidence interval (CI) -0.98 to -0.28; P<0.001; low-quality evidence). We could not be certain of any effect on clinically significant depressive symptoms (very low-quality evidence).Mindfulness-based stress reduction compared with active control may decrease carer anxiety at the end of the intervention (1 trial, 78 participants; mean difference (MD) -7.50, 95% CI -13.11 to -1.89; P<0.001; low-quality evidence) and may slightly increase carer burden (3 trials, 135 participants; SMD 0.24, 95% CI -0.11 to 0.58; P=0.18; low-quality evidence), although both results were imprecise, and we could not exclude little or no effect. Due to the very low quality of the evidence, we could not be sure of any effect on carers' coping style, nor could we determine whether carers were more or less likely to drop out of treatment.2. Compared with inactive controls, MBSR showed no clear evidence of any effect on depressive symptoms (2 trials, 50 participants; MD -1.97, 95% CI -6.89 to 2.95; P=0.43; low-quality evidence). We could not be certain of any effect on clinically significant depressive symptoms (very low-quality evidence).In this comparison, MBSR may also reduce carer anxiety at the end of the intervention (1 trial, 33 participants; MD -7.27, 95% CI -14.92 to 0.38; P=0.06; low-quality evidence), although we were unable to exclude little or no effect. Due to the very low quality of the evidence, we could not be certain of any effects of MBSR on carer burden, the use of positive coping strategies, or dropout rates.We found no studies that looked at quality of life of carers or care-recipients, or institutionalisation.Only one included study reported on adverse events, noting a single adverse event related to yoga practices at home AUTHORS' CONCLUSIONS: After accounting for non-specific effects of the intervention (i.e. comparing it with an active control), low-quality evidence suggests that MBSR may reduce carers' depressive symptoms and anxiety, at least in the short term.There are significant limitations to the evidence base on MBSR in this population. Our GRADE assessment of the evidence was low to very low quality. We downgraded the quality of the evidence primarily because of high risk of detection or performance bias, and imprecision.In conclusion, MBSR has the potential to meet some important needs of the carer, but more high-quality studies in this field are needed to confirm its efficacy.

Loneliness in Chinese older adults in primary care: prevalence and correlates.

BACKGROUND: Loneliness is a significant public health concern among older adults (OA) given its association with a wide range of adverse health outcomes. Primary care is an opportune setting to manage loneliness. However, the epidemiology of loneliness in Chinese OA treated in primary care remains unclear. The present study investigated the prevalence and correlates of loneliness in OA treated in Chinese primary care. METHODS: A total of 744 OA patients (65+ years) were consecutively recruited from 13 primary care clinics in Wuhan, China, and interviewed with a standardized questionnaire, concerning sociodemographic characteristics, lifestyle, relationships with family and others, physical health, and sensory impairments. Consistent with prior research on the construct, loneliness was measured with a single-item self-report question. Logistic regression was used to identify correlates of loneliness. RESULTS: Of primary care OA patients, 26.2% endorsed loneliness. Factors significantly and independently associated with loneliness included 75+ age group (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.07, 2.44, P: 0.023), being illiterate (OR: 2.07, 95%CI: 1.26, 3.42, P: 0.004), unmarried (OR: 2.30, 95%CI: 1.40, 3.78, P: 0.001), living alone (OR: 4.37, 95%CI: 2.27, 8.41, P < 0.001), having fair and poor family (OR: 2.44, 95%CI: 1.48, 4.00, P < 0.001) and non-family relationships (OR: 1.75, 95%CI: 1.10, 2.78, P: 0.019), and ≥2 chronic medical conditions (OR: 2.91, 95%CI: 1.22, 6.95, P: 0.016). CONCLUSIONS: Loneliness is common in Chinese primary care OA. The high prevalence and many negative health consequences of loneliness for OA highlight the importance of routine screening, assessment, and interventions to reduce loneliness in the primary health-care setting.

Effects of Transient Versus Chronic Loneliness on Cognitive Function in Older Adults: Findings From the Chinese Longitudinal Healthy Longevity Survey.

OBJECTIVES: Loneliness is a risk factor for poor cognitive function in older adults (OAs); to date, however, no studies have explored whether transient and chronic loneliness have differential effects on OAs' cognitive function. The present study evaluates the impacts of transient versus chronic loneliness on cognitive function in OAs. DESIGN: A 6-year follow-up cohort study. SETTING: Rural and urban communities of 22 provinces in China. PARTICIPANTS: 2,995 OAs who were cognitively healthy (the modified Mini-Mental State Examination [mMMSE] ≥ 14) and completed the 2005, 2008, and 2011 waves of the Chinese Longitudinal Healthy Longevity Survey. MEASUREMENTS: Self-report loneliness and mMMSE. RESULTS: Both transient (ß = -0.389, t = -2.191, df = 2994, p = 0.029) and chronic loneliness (ß = -0.640, t = -2.109, df = 2994, p = 0.035) were significantly associated with lower mMMSE scores 6 years later, net of potential confounding effects of baseline covariates. Sensitivity analyses found that regression coefficients of mMMSE scores on transient loneliness were statistically significant and relatively stable across samples with various levels of cognitive function. In contrast, coefficients of mMMSE scores on chronic loneliness were statistically significant only among samples with normal cognitive function and the absolute values of these coefficients increased with the degree of cognitive health of the analytic sample. In the sample with mMMSE greater than or equal to 21, the coefficient of chronic loneliness was 2.59 times as large as that of transient loneliness (-1.017 versus -0.392). CONCLUSIONS: Both transient and chronic loneliness are significant predictors of cognitive decline in OAs. Relative to transient loneliness, chronic loneliness has more pronounced negative effects on the brain health of OAs.

Aripiprazole for Tourette's syndrome: a systematic review and meta-analysis.

OBJECTIVE: To review the efficacy and safety of aripiprazole (ARI) for Tourette's syndrome (TS). METHODS: This review included randomized controlled trials (RCTs) of children and adolescents (6-18 years) with TS comparing ARI monotherapy with another monotherapies in relation to clinical improvement and adverse events. RESULTS: Six RCTs with a total of 528 subjects (ARI treatment group: n = 253; control group: n = 275) met the inclusion criteria. These included two RCTs (n = 255) that compared ARI monotherapy with tiapride (TIA). Tic symptoms control assessed by Yale Global Tic Severity Scale (Standard Mean Difference (SMD) = -0.38 (Confidence Interval (CI) = -1.32 to 0.56); I(2) = 90%, P = 0.42) revealed no significant differences between the two groups. Extrapyramidal symptoms were significantly different when ARI (1.5%) was compared with haloperidol (HAL) (43.5%). No significant group differences were found in the rates of nausea/vomiting, dizziness, and dry mouth between ARI and TIA (RR = 0.57 to 1.00 (95%CI = 0.14-4.20); I(2) = 0% to 69%, P = 0.35 to 1.00). CONCLUSION: This review found that ARI has similar efficacy to TIA and HAL for TS, while extrapyramidal symptoms were significantly less with ARI than with HAL. ARI can be considered as an alternative treatment option for TS.

Antipsychotic polypharmacy and quality of life in patients with schizophrenia treated in primary care in China.

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.

Comorbid Moderate-Severe Depressive Symptoms and their Association with Quality of Life in Chinese Patients with Schizophrenia Treated in Primary Care.

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.

[Sexual satisfaction and its associated factors among individuals with hearing disability].

OBJECTIVE: To investigate sexual satisfaction (SS) and the factors associated with decreased SS among individuals with hearing disability. METHODS: We conducted an investigation on SS among 439 individuals (268 males and 171 females, aged ≥18 yr) with hearing disability using a general information questionnaire, Center for Epidemiologic Studies Depression Scale, Social Support Rating Scale, and a self-report on SS. We identified the factors of decreased SS by multivariate ordinal logistic regression analysis. RESULTS: Totally 76 (17.3%) of the hearing-disability individuals investigated were dissatisfied with their sexual life. SS reduction was significantly correlated with the status of being single (OR=1.72), grade-1 or -2 disability (OR=1.78), physical diseases (OR=2.46), depression (OR=6.61), or inadequate subjective social support (OR=3.28). CONCLUSIONS: SS of hearing-disability persons is relatively low, which can be improved by treating physical diseases, promoting mental health, and providing psycho-social support.

Use of electroconvulsive therapy in older Chinese psychiatric patients.

OBJECTIVE: Little is known about the use of electroconvulsive therapy (ECT) in older Chinese psychiatric patients. This study examined the frequency of ECT and the demographic and clinical correlates in older psychiatric patients hospitalized in a large psychiatric institution in Beijing, China. METHODS: This was a retrospective chart review of 2339 inpatients aged 60 years and older treated over a period of 8 years (2007-2013) in a university-affiliated psychiatric institution in Beijing. Sociodemographic and clinical data were collected from the electronic chart management system for discharged patients. RESULTS: The rate of ECT use was 28.1% in the whole sample; 37.9% in those with bipolar disorders, 43.6% in major depression, 21.2% in schizophrenia, and 10.7% in other diagnoses. ECT ("ECT group") was associated with 60-65-year age group, high risk for suicide and low risk for falls at the time of admission, use of mood stabilizers and antidepressants, lack of health insurance, and having major medical conditions and diagnosis of major depression. The above significant correlates explained 24.9% of the variance of ECT use (p < 0.001). CONCLUSIONS: In a major psychiatric hospital in China, the use of ECT was common among older patients. ECT use in older patients treated in other clinical settings warrants further investigations.

Internal migration, mental health, and suicidal behaviors in young rural Chinese.

PURPOSE: There is a dearth of data on the association of internal migration with mental health in young rural Chinese. This study aims to explore the associations between migrant status, mental health, and suicidal behaviors in young rural Chinese. METHODS: We recruited 1,646 rural subjects aged 16-34 years, of whom 756 were migrant workers and 890 non-migrants, from ten representative villages in rural Sichuan Province, the southwestern part of China. To assess subject's depressive symptoms and general psychological quality of life (psycho-QOL), the study protocol included the Centre for Epidemiological Studies Depression Scale, and psycho-QOL subscale of the World Health Organization's QOL Questionnaire-Brief Version, in addition to structured questions regarding one-year suicidal thoughts and behaviors (serious ideation, plan, and attempt), socio-demographic, social support, and physical health information. RESULTS: After adjustment for confounders, migrant workers had relative to non-migrant rural residents a decreased risk for depression (OR = 0.69, P = 0.026), but comparable risk for poor psycho-QOL (OR = 0.91, P = 0.557) and one-year suicidal behaviors (OR = 0.59-1.10, P = 0.19-0.90). Migrant status only accounted for 0.5, 2.8, 4.7, 9.8, and 12.6% of the total explainable variance for suicide attempt, poor psycho-QOL, suicide plan, depression and serious suicide ideation, respectively. CONCLUSION: Our findings suggested that among young rural Chinese there were no significant associations involving migrant status and poor psycho-QOL or one-year suicidal behaviors, while migrant status significantly correlated with a decreased risk of depression. The unique contribution of migrant status to mental health among young rural Chinese participants in this study was very small.