Should we abandon annual physical examination? - A meta-analysis of annual physical examination and all-cause mortality in adults based on observational studies.

Several meta-analyses based on randomized clinical trials data have failed to find an association between the annual physical examination (APE) and reduced mortality; however, no comparable meta-analysis based on observational data exists. We conducted a meta-analysis of observational studies comparing APE versus non-APE in adults for all-cause mortality. English-language searches of four databases (PubMed, CINAHL, EMBASE, and Google Scholar) between the years 2000 to 2019 yielded seven observational studies that investigated APE versus non-APE in healthy adults in relation to all-cause mortality. Random effects models were used to calculate pooled hazard ratios and 95% confidence intervals (CI), and to incorporate variation between studies. During follow-up periods that ranged from two to 25 years, there were 35,055 deaths among 633,957 participants. APE was significantly associated with a 45% lower hazard of all-cause mortality, with pooled hazard ratio of 0.55 (95% CI 0.48 to 0.64, P < 0.01) for all participants. This meta-analysis of seven observational studies in the past 20 years provides evidence of an association between APE and a lower hazard of all-cause mortality, a finding that contrasts with findings based on meta-analyses of randomized clinical trials data. Nonetheless, at present the evidence available about the effectiveness or ineffectiveness of APE on all-cause mortality still needs further study.

Strategy to Enhance the Cycling Stability of the Metallic Lithium Anode in Li-Metal Batteries.

Based on the analysis of systematic research (density functional theory calculations, physical characterizations, and electrochemical performances), here, we report a novel mixture surface modification layer of LiC6&LiF, which can enhance the lithium-ion diffusion and decrease the local current density. This is beneficial to the improvement of cycling stability. As a result, the Li@LiC6&LiF-5/NCM half-cell possesses an excellent capacity retention of 94% after 100 cycles at 0.1C, with a capacity decay of only 0.06% per cycle. For comparison, the capacity retention of a pristine Li/NCM cell is only 9.3% after 100 cycles. Our study confirms that compositing the high ionic conductivity layer (e.g., LiC6&LiF for the first time) is a promising avenue to stabilize lithium-metal anodes. From this perspective, we concisely review recent discoveries in this field and suggest possible new research directions for further development of Li-metal batteries.

Post-COVID-19 Epidemic: Allostatic Load among Medical and Nonmedical Workers in China.

BACKGROUND: As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. OBJECTIVE: During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. METHODS: An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. RESULTS: There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; p = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18-1.31; p < 0.01), depression (OR = 1.23; 95% CI 1.17-1.29; p < 0.01), somatization (OR = 1.20; 95% CI 1.14-1.25; p < 0.01), hostility (OR = 1.24; 95% CI 1.18-1.30; p < 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34-1.66; p < 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78-0.89; p < 0.01), subjective support (OR = 0.84; 95% CI 0.80-0.88; p < 0.01), utilization of support (OR = 0.80; 95% CI 0.72-0.88; p < 0.01), social support (OR = 0.90; 95% CI 0.87-0.93; p < 0.01), and global well-being (OR = 0.30; 95% CI 0.22-0.41; p < 0.01) were negatively associated. CONCLUSIONS: In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.

Effects of short-term mindfulness-based training on executive function: Divergent but promising.

Mindfulness-based training (MBT) has repeatedly been proven effective in improving mental health, as well as in eliciting advantages in executive functions (EFs), as demonstrated by objective measures. However, few studies have discussed the role MBT plays in increasing EFs over short periods of time. This current review, to our knowledge, is the first study to investigate the effect of short-term MBT on EFs. In this case, 14 studies were eventually included after literature screening using PubMed, MEDLINE, Elsevier, Embase, EBSCO and references from retrieved articles. We found that the relationship between short-term MBT and three main components of EFs were found controversial. Some reported that individuals' inhibition, working memory and attention shifting were significantly improved by short-term MBT, whereas others reported no such strong connections between MBT and EFs. These controversial findings result from the use of varied assessment instruments, cognitive tasks and experimental materials. Nonetheless, the findings from this review suggest short-term MBT could be of great value in improving mental health, which might especially enable the enhancement of individuals' inhibition and updating subfunctions of EFs. These practical evidences could have a strong impact on clinical psychology. However, the lack of consistency across the studies in this review indicated that more standardized and profound studies exploring the effects of short-term MBT on EFs are needed in the future.

[Psychological characteristics in different clinical subgroups of insomniacs].

OBJECTIVE: To investigate psychological characteristics in different clinical subgroups of insomniacs, and to provide the basis for the accurate simplification of cognitive behavioral therapy for insomnia.
 Methods: A total of 212 insomniacs from November 2014 to June 2017 in Clinical Psychology Department or Sleep Department of 2 general hospitals in Hunan Province were included in convenient and classified into sleep onset insomnia (SOI), difficulty maintaining insomnia (DMI), early morning awakening insomnia (EMAI), and combined insomnia (CI) subgroups. Ford Insomnia Response to Stress Test (FIRST), Simplified Coping Style Questionnaire (SCSQ), Dysfunctional Beliefs and Attitudes about Sleep Scale 16 version (DBAS-16), Sleep-Related Behavior Questionnaire (SRBQ), Pre-sleep Arousal Scale (PSAS), Center for Epidemiological Studies Depression Scale (CES-D), Beck Anxiety Inventory (BAI) were used to investigate the psychological characteristics.
 Results: SOI and CI insomniacs had a higher frequency in use of sleep-related behavior than those with DMI; CI had a higher frequency in use of sleep-related behavior than those with EMAI (all P<0.05). Both SOI and CI insomniacs had a higher level of pre-sleep cognitive arousal than DMI and EMAI (all P<0.05). CI insomniacs noticed more consequences of insomnia and had more worries on insomnia than DMI, and CI insomniacs had more expectations of sleep than SOI (all P<0.05).
 Conclusion: Insomniacs with different clinical subgroups have different features of psychological characteristics. Both the insomnia subgroups and the psychological characteristics should be taken into account when we simplify cognitive behavioral therapy for insomnia (CBT-I) precisely.

The reliability and validity of the Chinese version of the Metacognitions about Health Questionnaire in college students.

PURPOSE: In order to explain the potential mechanism that might motivate and maintain health anxiety (HA), researchers have developed several measures to assess the level of HA and to identify related cognitions and personality features. However, such instruments typically measure general metacognitions [e.g., the Metacognition Questionnaire-30 (MCQ-30)], thereby compromising the degree of sensitivity and specificity of measurement as applied to HA-related metacognitions. To address that issue, the Metacognitions about Health Questionnaire (MCQ-HA) was designed especially for measuring metacognitive beliefs specific to HA. Because a Chinese version of MCQ-HA may be helpful in improving our understanding of HA in a Chinese population, in the current study we sought to develop a Chinese version of the MCQ-HA (CMCQ-HA). METHODS: We translated the MCQ-HA into Chinese with consideration of cultural diversity. For evaluation of its validity and stability, a sample of 1290 Chinese college students answered the CMCQ-HA, the Short Health Anxiety Inventory, the MCQ-30, and the Neuroticism scale of the Eysenck Personality Questionnaire. 292 students of them answered the CMCQ-HA twice. RESULTS: Good internal consistency (α = 0.81) and test-retest reliability (ICC = 0.70) of the CMCQ-HA was presented. Exploratory and confirmatory factor analyses indicated a three-factor structure: beliefs about biased thinking, beliefs that thoughts can cause illness, and beliefs that thoughts are uncontrollable. Convergent validity, divergent validity, and incremental validity all were acceptable. Measurement invariance across gender was established. CONCLUSIONS: The CMCQ-HA shows promise for the measurement of specific HA-related metacognitions in Chinese populations.

[Establishment of the theory and operation of willing acceptance and commitment therapy].

Mindfulness-based psychotherapy, known as the third-wave cognitive behavior therapy, showed a multi-cultural integration trend. As part of it, willing acceptance and commitment therapy not only took root in the discoveries in the fields of evolutionary psychology and cognitive psychology, but also absorbed the concepts of psychotherapy from Chinese traditional culture. As a result, it regards truth and harmony as the essence of health, proposes a triangle model (health/pain-willing acceptance-striving) to elucidate the mechanism of psychopathology and psychotherapy in theory. Operationally, it contains four principles of psychotherapy, which are as follow: "knowing yourself and others, reaction but adequately, reality as well as harmony, willing acceptance and striving". Furthermore, it proposes eight therapeutic procedures including "understand yourself, recognize suffering, check coping style, keep openness and acceptance, mindfulness and flexibility, live in the moment, clarify the value, and commit action". With these principles and procedures, willing acceptance and commitment therapy aims to fade the neural trace of patients' painful memories, improve their psychological flexibility and rebuild their lifestyles consistent with their values.

[Effect of alexithymia on health anxiety: Mediating role of cognition and meta-cognition].

OBJECTIVE: According to the cognitive behavior theory and meta-cognitive theory of health anxiety, to examine the association between alexithymia, cognition factors or meta-cognition factors and health anxiety.
 Methods: A total of 1 164 medical students were investigated by the Short Health Anxiety Inventory, the Health Cognitions Questionnaire, the Meta-cognitions about Health Questionnaire and the Toronto Alexithymia Scale.
 Results: 1) Correlation analysis showed that alexithymia, dysfunctional beliefs, meta-cognition were significantly positively correlated with health anxiety (r=0.227-0.477, all P<0.01); 2) The results of structural equation model indicated that alexithymia could not exert effects on health anxiety directly (ß=-0.05, 95% CI -0.123 to 0.021). The alexithymia could exert effects on health anxiety indirectly not only through dysfunctional beliefs (ß=0.192, 95% CI 0.156 to 0.235), but also through the chain-mediated effect of dysfunctional beliefs and meta-cognitions (ß=0.103, 95% CI 0.077 to 0.135). Dysfunctional beliefs fully mediated the relation between alexithymia and health anxiety (ß=0.247, 95% CI 0.196 to 0.290).
 Conclusion: Alexithymia can affect health anxiety through the mediating effects of dysfunctional beliefs and meta-cognition.

[Status of subjective well-being for medical staff in a tertiary hospital].

OBJECTIVE: To investigate the status of subjective well-being (SWB) for medical staffs who contact with patients directly in a tertiary hospital.
 METHODS: Staffs from a tertiary hospital in Hunan province were investigated the SWB Scale (SWBS-cc20) from 2012 to 2014.
 RESULTS: The scores of SWB for medical staffs are high (81.67±12.33). Among the 10 sub-dimensions of SWB, medical staffs performed the best in family atmosphere, personal growth, and interpersonal adaptation, while performed the worst in physical health, mental health and material contentment. Title, job nature, education and occupation significantly affected the status of SWB. Staffs who directly connected with patients have less scores of SWB than those who do not (t=-4.80, P<0.001). Moreover, they perform better in contentment (OR=0.079, 95% CI 1.278 to 2.214, P<0.001), but worse in mental health (OR=1.315, 95% CI 1.023 to 1.690, P<0.05) and physical health (OR=1.313, 95% CI 1.029 to 1.677, P<0.05).
 CONCLUSION: Medical staffs have high scores of SWB. Staffs who directly connected with patients have less scores of SWB than those who do not. Moreover, they perform better in contentment, but worse in mental health and physical health.

Microwave-assisted polyol synthesis of gadolinium-doped green luminescent carbon dots as a bimodal nanoprobe.

The development of multimodal nanoprobes is highly desired in medical imaging because it integrates the advantages of multiple imaging modes. In this study, the gadolinium-doped green luminescent carbon dots (Gd-CDs) were prepared by the simple one-step microwave-assisted polyol method. The obtained Gd-CDs emitted a unique green photoluminescence with a quantum yield of 5.4%. The Gd-CDs exhibited a low cytotoxicity and could optically label the C6 glioma cells. Meanwhile, the r1 relaxivity of Gd-CDs was measured to be 11.356 mM(-1) s(-1). This high r1 value together with the r2/r1 ratio close to 1 nominates Gd-CDs as an excellent T1 contrast agent for magnetic resonance imaging. These Gd-CDs combining two complementary imaging modalities are therefore a promising bimodal nanoprobe in medical imaging for a better diagnosis.

The psychometric properties of positive and negative beliefs about the rumination scale in Chinese undergraduates.

BACKGROUND: Rumination, a transdiagnostic factor in different psychopathological conditions, is believed to be activated and sustained by dysfunctional metacognition. The Positive Beliefs about Rumination Scale (PBRS) and the Negative Beliefs about Rumination Scale (NBRS) have been used to measure the metacognitive beliefs of rumination and have been investigated in many cultural contexts. However, it remains unclear whether these scales can work as well for the Chinese population. Therefore, this study aimed to explore the psychometric properties of the Chinese versions of these scales and to test the metacognitive model of rumination for students with different levels of depression. METHODS: The PBRS and NBRS were forward-backward translated into Mandarin. In total 1,025 college students were recruited to complete a battery of web-based questionnaires. Exploratory factor analysis, confirmatory factor analysis, and correlation analysis were used to test the structure, validity, and reliability of the two scales, as well as their item correlations with rumination. RESULTS: A new two-factor structure of the PBRS (rather than the original one-factor model) and a new three-factor structure of the NBRS (rather than the original two-factor model) were extracted. The goodness-of-fit indices of these two factor models showed they had a good to very good fit with the data. The internal consistency and construct validity of PBRS and NBRS were also affirmed. CONCLUSION: The Chinese versions of the PBRS and the NBRS were generally shown to be reliable and valid, but their newly extracted structures fit the Chinese college students better than their original structures. These new models of PBRS and NBRS are of value to be further explored in Chinese population.

Electric double layer-mediated polarization field for optimizing photogenerated carrier dynamics and thermodynamics.

Photocatalytic hydrogen evolution efficiency is limited due to unfavorable carrier dynamics and thermodynamic performance. Here, we propose to introduce electronegative molecules to build an electric double layer (EDL) to generate a polarization field instead of the traditional built-in electric field to improve carrier dynamics, and optimize the thermodynamics by regulating the chemical coordination of surface atoms. Based on theoretical simulation, we designed CuNi@EDL and applied it as the cocatalyst of semiconductor photocatalysts, finally achieved a hydrogen evolution rate of 249.6 mmol h-1 g-1 and remained stable after storing under environmental conditions for more than 300 days. The high H2 yield is mainly due to the perfect work function, Fermi level and Gibbs free energy of hydrogen adsorption, improved light absorption ability, enhanced electron transfer dynamics, decreased HER overpotential and effective carrier transfer channel arose by EDL. Here, our work opens up new perspectives for the design and optimization of photosystems.

Dihydroartemisinin represses oral squamous cell carcinoma progression through downregulating mitochondrial calcium uniporter.

Dysregulation of mitochondrial calcium uniporter (MCU) exerts a carcinogenic effect in several cancers. Nevertheless, the roles of MCU in oral squamous cell carcinoma (OSCC) remain elusive. It has been reported that dihydroartemisinin (DHA) may suppress the progression of OSCC but its associated mechanisms have not been investigated. The purpose of our research was to observe the biological function of MCU on OSCC and its regulatory relationship with DHA. MCU, MICU1, MICU2, N-cadherin, TGF-ß and vimentin expression was detected in OSCC and peritumoral tissues by immunohistochemistry and Western blot. Following DHA treatment, the expression of the aforementioned proteins was detected in CAL-27 cells transfected with shMCU or pcDNA3.1-MCU by Western blot or immunofluorescence. Furthermore, clone formation, mitochondrial membrane potential (MMP), wound healing and transwell assays were presented in CAL-27 cells treated with DHA, shMCU or pcDNA3.1-MCU. Our results showed that the members of MCU complex (MCU, MICU1 and MICU2) were overexpressed in OSCC than peritumoral tissues. Furthermore, TGF-ß and epithelial to mesenchymal transition (EMT) proteins (N-cadherin and vimentin) exhibited higher expression in OSCC. DHA treatment significantly lowered the expression of MCU in CAL-27 cells. MCU overexpression reversed the inhibitory effects of DHA on MICU1, MICU2, N-cadherin, TGF-ß and vimentin. MCU knockdown or DHA suppressed proliferation, MMP and migration of CAL-27 cells. DHA treatment could reverse the effects of MCU overexpression. Collectively, our study demonstrated that MCU was an oncogene of OSCC and DHA exerted a suppressive role on proliferation and migration of OSCC cells by suppressing MCU expression.

The moderating effect of alexithymia on the relationship between stress and cyberchondria.

Objectives: The pandemic has increased the level of perceived stress and provided a fertile soil for Cyberchondria. This study aims to investigate the relationship between stress, cyberchondria, and alexithymia. Methods: This cross-sectional study used convenience sampling to carried out on a total 1,117 college students (female/male:536/581; mean age: 19.95 ± 1.32). Cyberchondria Severity Scale (CSS), Toronto Alexithymia Scale (TAS) and Short Depression Anxiety Stress Scales (DASS-21) were used to assessed the present study variables. Results: Significant differences emerged for CSS scores by gender (t = 3.74, p < 0.01) and had any comorbid disease (t = 2.47, p < 0.05), The Pearson correlation showed Cyberchondria has a significant positive correlation with stress and alexithymia (r = 0.50, p < 0.01, r = 0.36, p < 0.01). Furthermore, the regression analysis described that stress (ß = 0.50, p < 0.01) and alexithymia (ß = 0.36, p < 0.01) were the significant positive predictors of cyberchondria. Moreover, moderation analysis showed that alexithymia significantly strengthened the association between stress and cyberchondria (F = 107.20, p < 0.01). Conclusion: The study will help medical practitioners to understand how stress and alexithymia can cause an increase in cyberchondria. This will help them to elaborate operational indications for prevention and psychological support.

Fluorescein Derivative Immobilized Optical Hydrogels: Fabrication and Its Application for Detection of H2O2.

A novel fluorescein-based probe FLA-Boe was developed for detecting H2O2. Modified by 2-Bromomethylphenylboronic acid pinacol ester, FLA-Boe is a Fluorescein derivative with eminent photostability and remarkable H2O2 sensitivity and selectivity. FLA-Boe was utilized to synthesize hydrogel sensors in the manner of guest-host interaction by taking advantage of its aforementioned features. The hydrogel sensor can be used to detect H2O2 effectively in both flowing and static water environments with satisfactory performance. It is expected that this application may open a new page to develop a neoteric fluorescent property analysis method aiming at H2O2 detection.

Electrolyte Additives for Improving the High-Temperature Storage Performance of Li-Ion Battery NCM523∥Graphite with Overcharge Protection.

The overcharge safety performance of lithium-ion batteries has been the major bottleneck in the widespread deployment of this promising technology. Pushing the limitations further may jeopardize cell safety when it is performed at high-temperature storage. On the basis of the lacking systematic research on overcharge protection electrolyte additives with high-temperature storage capacity, we explore the promotion effect of overcharge additives on electrolyte decomposition at 60 °C. Specifically, the addition of tris(trimethylsily) phosphite (TMSP) and lithium difluoro(oxalato)borate (LiDFOB) in the electrolyte can not only form the robust cathode electrolyte interface/solid electrolyte interphase (CEI/SEI) but also improve the thermal stability of the electrolyte. Therefore, we promote the electrolyte system to realize the 18,650 LIB storage at 60 °C for 50 days by optimizing the formula in the electrolyte containing biphenyl (BP) and cyclohexylbenzene (CHB) overcharge protection additives, and the capacity retention rate can reach more than 90% with overcharge safety. Further, the optimized electrolyte system has also been implemented to commercial 18,650 LIBs and demonstrates the widening of the route to the widespread application of the electrolyte under extreme conditions.

Examining impulsivity and risky decision making among school youth in balloon analogue risk task.

BACKGROUND: Impulsivity trait as a risk factor which typically displayed in risk decision among school youth. This study aims to examine behavioral and cognitive problems of risky decision among Chinese young people aged 15-25 years. The balloon analogue risk task (BART) and event-related potential (ERP) were combine used to explore the neural mechanism of risky decision process whether infected by impulsivity trait. METHODS: A total of 31 subjects were included, including 16 experimental subjects with risk behavior (RS), and 15 health control subjects with non-risk behavior (HC). BART were used to measure risk-taking propensity and ERP were to record in real time. RS vs. HC were compared to explain the relationship between impulsivity and risky decision. RESULTS: Behavioral data in BART task shown that the RS subjects tended to make risky decisions. ERP results illustrate that P300 in RS subjects is more significant positive-going than HC that means dysfunction of cognitive control, and FRN in RS subjects is more negative-going than HC in negative feedback condition, which means individual with high impulsive would be more sensitive to unexpected outcome. CONCLUSIONS: Impulsiveness is a risk factor for school adolescent, because RS subjects performed more risky decision than control group, the evidence indicate that individual with high impulsiveness would lead to be less sensitive to harmful consequences and more inclination to immediate rewards. Therefore, the inclination of risk taking can be powerfully informed by different levels of impulsiveness.

'Mindfulness Living with Insomnia': an mHealth intervention for individuals with insomnia in China: a study protocol of a randomised controlled trial.

INTRODUCTION: Insomnia has a remarkably negative effect on the work, quality of life and psychosomatic health of individuals, and imposes a substantial economic burden on society. Mindfulness-based interventions (MBIs) have proven beneficial in the treatment of insomnia. However, the effect of mobile or online-based (mHealth) MBIs requires further verification. This study will evaluate the effectiveness of an mHealth MBI, 'Mindful Living with Insomnia' (MLWI), relative to that of mHealth cognitive behavioural therapy for insomnia (CBT-I). METHODS AND ANALYSIS: The study is an mHealth, randomised controlled trial. Two hundred and fifty participants will be allocated randomly and equally to either the MLWI or CBT-I group. The intervention will involve 12 sessions over a 6-week course, with 2, 30 min sessions per week. The primary outcomes are sleep quality, severity of insomnia symptoms and sleep activity, according to the Pittsburgh Sleep Quality Index, Insomnia Severity Index and sleep tracker Mi Smart Band, respectively. The secondary outcomes are perceived stress, anxiety, depression and mindfulness. Outcomes will be evaluated at the baseline, end of the intervention period and at the 3-month follow-up. Data analyses will include covariance, regression analysis, χ2, t-test and Pearson's correlations. Participants will be recruited from January to June 2022, or until the recruitment process is complete. The follow-up will be completed in December 2022. All trial results should be available by the end of December 2022. ETHICS AND DISSEMINATION: Full approval for this study has been obtained from the Ethics Committee at The Third Xiangya Hospital, Central South University, Changsha, China (21010). Study results will be disseminated via social media and peer-reviewed publications. TRIAL REGISTRATION NUMBER: NCT04806009.

Symptoms of disordered eating, body shape, and mood concerns in male and female Chinese medical students.

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

Body dysmorphic disorder, social anxiety and depressive symptoms in Chinese medical students.

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