Income gap between male and female psychiatric nurses in China: A national survey.

AIM: To investigate gender differences in the actual and expected income among psychiatric nurses in China. BACKGROUND: Although studies have shown that male nurses earn more than female nurses in other countries, there are no published data regarding gender income differences among psychiatric nurses in China. METHODS: We conducted a cross-sectional study involving 41 representative psychiatric hospitals in China. Demographic, income, and job-related data were analyzed using the inverse probability of treatment weighting (IPTW) based on the propensity score. FINDINGS: The sample included 9256 psychiatric nurses, and nearly four-fifths (79.3%) were female. Males earned slightly higher average monthly incomes than female nurses, while initial analysis showed no significant overall gender income difference (p > 0.05). Notably, most participants (92.5%) desired an income increase of at least 10%, with over half (56.2%) expressing significant dissatisfaction with their current income. After adjustment using propensity score combined with IPTW, females in the junior and mid-level groups had significantly lower income than their male counterparts (all p < 0.01), despite having different night shift patterns. However, there were no significant gender differences in actual or expected income among senior-level psychiatric nurses (p > 0.05). CONCLUSION: A majority of psychiatric nurses in China express dissatisfaction with their current incomes and expect higher incomes. Male nurses earned significantly more than female nurses in the junior and mid-level professional groups, potentially due to their differences in night shifts. IMPLICATIONS FOR NURSING POLICY AND HEALTH POLICY: Policymakers and hospital administrators should optimize the income structures of nurses and develop targeted policies to address the gender income gap. Improving nurse income has the potential to enhance motivation and satisfaction within the profession.

Acanthopanax senticosus Polysaccharide Enhances the Pathogen Resistance of Radiation-Damaged Caenorhabditis elegans through Intestinal p38 MAPK-SKN-1/ATF-7 Pathway and Stress Response.

With the advancement of science and technology, humans are chronically exposed to ionizing radiation. It is crucial to look for efficient and low-toxic anti-radiation agents. Through preliminary screening, we found that Acanthopanax senticosus polysaccharide (ASPS) played a major role in regulating immune damage caused by radiation. The objective of this study was to apply the Caenorhabditis elegans-P. aeruginosa (PA14) infection model to illuminate the mechanism of ASPS increasing the pathogen resistance of radiation-damaged nematodes. Results indicated that ASPS (1 mg/mL) significantly enhanced the pathogen resistance of radiation-damaged nematodes by directly elevating the immune response of nematodes rather than by affecting the bacterial activity. Through further research on the p38 MAPK signaling pathway and related mutants, we found that ASPS functioned by the p38 MAPK pathway in the intestine, and SKN-1, ATF-7 as the downstream targets of PMK-1 participated the regulation of ASPS. In addition, ASPS markedly alleviated the stress status of damaged nematodes by regulating oxidative stress. Collectively, our findings suggest that ASPS enhances the pathogen resistance of radiation-damaged nematodes through the intestinal p38MAPK-SKN-1/ATF-7 pathway and stress response.

Eleutheroside E Enhances the Long-Term Memory of Radiation-Damaged C. elegans through G-Protein-Coupled Receptor and Neuropeptide Signaling Pathways.

Eleutheroside E (EE), a principal active compound of Acanthopanax senticosus, has been shown to have a certain neuromodulation effect. Our previous study indicates that EE protects nerve damage caused by radiation. However, its specific function and underlying mechanism remain unknown. Therefore, the objective of this study is to apply the C. elegans model to illuminate the property and mechanism of EE protecting against nerve damage caused by radiation. Here, we found that EE significantly improved the long-term memory of radiation-damaged C. elegans. Through transcriptome sequencing, the results showed that EE protected radiation-damaged C. elegans mainly through G-protein-coupled receptor and neuropeptide signaling pathways. Further research indicated that EE affected the activity of CREB by cAMP-PKA, Gqα-PLC, and neuropeptide signaling pathways to ultimately improve the long-term memory of radiation-damaged C. elegans. In addition, the activity of Gqα and neuropeptides in AWC neurons and the activity of CREB in AIM neurons might be crucial for EE to function.

The effect of sweet tea polysaccharide on the physicochemical and structural properties of whey protein isolate gels.

In this study, we investigated the effect of sweet tea polysaccharide (STP) on the physicochemical and structural properties of heat-induced whey protein isolate (WPI) gels, and explored the potential mechanism. The results indicated that STP promoted the unfolding and cross-linking of WPI to form a stable three-dimensional network structure, and significantly improved the strength, water-holding capacity and viscoelasticity of WPI gels. However, the addition of STP was limited to 2 %, too much STP would loosen the gel network and affect the gel properties. The results of FTIR and fluorescence spectroscopy suggested that STP affected the secondary and tertiary structures of WPI, promoted the movement of aromatic amino acids to the protein surface and the conversion of α-helix to ß-sheet. In addition, STP reduced the surface hydrophobicity of the gel, increased the free sulfhydryl content, and enhanced the hydrogen bonding, disulfide bonding, and hydrophobic interactions between protein molecules. These findings can provide a reference for the application of STP as a gel modifier in the food industry.

Associations between childhood maltreatment and suicidal ideation in depressed adolescents: The mediating effect of alexithymia and insomnia.

BACKGROUND: People with depression appear to experience higher levels of childhood maltreatment (CM) and suicidal behaviour. However, no studies have discussed the factors through which CM influences suicidal ideation (SI) in adolescents with depression. The present study examined the effects of alexithymia and insomnia on the relationship between CM and SI in a population of Chinese adolescents with depression. METHODS: A total of 262 adolescents with depression (198 females) completed the Childhood Trauma Questionnaire-Short Form, the Toronto Alexithymia Scale-20, the Insomnia Severity Index, and the Positive and Negative Suicide Ideation. RESULTS: With the exception of sexual abuse (SA), four types of CM were associated with SI in depressed individuals. The highest incidence was found for physical neglect (PN) (65.27 %). Alexithymia and insomnia were both positively associated with SI. Externally oriented thinking (EOT) and insomnia had significant mediating effects on the relationship between emotional abuse (EA) and SI. EOT and insomnia also had significant mediating effects on the relationship between physical neglect (PN) and SI. LIMITATIONS: The major limitations of this study include the impacts of cross-sectional studies and recall bias on the results. CONCLUSIONS: Alexithymia and insomnia have an impact on SI in adolescents with depression who have experienced CM. Therefore, we should be aware of the impact of alexithymia and insomnia on depression patients. Rates of suicide among adolescents with depression should be reduced by identifying targeted measures.

Would you choose to be a psychiatrist again? A large-sample nationwide survey of psychiatrists and psychiatry residents in China.

BACKGROUND: The mental health workforce sustainability in China suffers high rates of attrition and the intention to leave. Among current professionals, the intention to choose the same career is an interesting way to gauge their job satisfaction and other factors, and it may affect the career choices of younger generations. We aimed to survey the intention of psychiatrists and psychiatry residents to choose the same career if they could start over and to identify associated factors. METHODS: We conducted an anonymous survey of psychiatrists in 41 tertiary psychiatric hospitals in China. We collected demographic data, work-related information, the sense of professional identity, job satisfaction, and burnout (Maslach Burnout Inventory), and we specifically asked each participant whether they would choose to be a psychiatrist again if they could. RESULTS: Among 3,783 psychiatrists we surveyed, one-quarter responded that they would not choose to be a psychiatrist again if they had a choice, with less than half (47.2%) saying they would. Those who would not choose psychiatry again were more likely to have a negative (relative to positive) professional identity (OR = 7.47, P＜0.001, 95%CI: 4.587-12.164); experience job burnout (OR = 2.945, P＜0.001, 95%CI: 2.356-3.681); be dissatisfied with their job (OR = 2.739, P＜0.001, 95%CI: 2.102-3.569) and excessive regulation (OR = 1.819, P＜0.001, 95%CI: 1.487-2.226); have a heavy workload (OR = 1.749, P＜0.001, 95%CI: 1.423-2.149) or a lower income (OR = 1.748, P＜0.001, 95%CI: 1.415-2.161); be married (relative to single) (OR = 1.604, P = 0.004, 95%CI: 1.165-2.208); be dissatisfied with strained doctor-patient relationship (OR = 1.333, P = 0.005, 95%CI: 1.089-1.632); have more night shifts per month (OR = 1.055, P = 0.021, 95%CI: 1.008-1.104) or work longer hours per week (OR = 1.016, P = 0.001, 95%CI: 1.006-1.025). CONCLUSION: Among psychiatrists in tertiary hospitals in China, those with a heavier workload, poor sense of professional identity, job dissatisfaction, and burnout were less likely to choose psychiatry again. Policymakers and hospital administrators need to take effective measures to improve psychiatrists' sense of professional identity and increase their intention to stay.

Excessive Daytime Sleepiness and Insomnia Symptoms in Adolescents With Major Depressive Disorder: Prevalence, Clinical Correlates, and the Relationship With Psychiatric Medications Use.

OBJECTIVE: Excessive daytime sleepiness (EDS) and insomnia symptoms are common in patients with major depressive disorder (MDD), which might lead to a poor prognosis and an increased risk of depression relapse. The current study aimed to investigate the prevalence, and sociodemographic and clinical correlates of EDS and insomnia symptoms among adolescents with MDD. METHODS: The sample of this cross-sectional study included 297 adolescents (mean age=15.26 years; range=12-18 years; 218 females) with MDD recruited from three general and four psychiatric hospitals in five cities (Hefei, Bengbu, Fuyang, Suzhou, and Ma'anshan) in Anhui Province, China between January and August, 2021. EDS and insomnia symptoms, and clinical severity of depressive symptoms were assessed using Epworth sleepiness scale, Insomnia Severity Index, and Clinical Global Impression-Severity. RESULTS: The prevalence of EDS and insomnia symptoms in adolescents with MDD was 39.7% and 38.0%, respectively. Binary logistic regression analyses showed that EDS symptoms were significantly associated with higher body mass index (odds ratio [OR]=1.097, 95% confidence interval [CI]=1.027-1.172), more severe depressive symptoms (OR=1.313, 95% CI=1.028-1.679), and selective serotonin reuptake inhibitors use (OR=2.078, 95% CI=1.199-3.601). And insomnia symptoms were positively associated with female sex (OR=1.955, 95% CI=1.052-3.633), suicide attempts (OR=1.765, 95% CI=1.037-3.005), more severe depressive symptoms (OR=2.031, 95% CI=1.523-2.709), and negatively associated with antipsychotics use (OR=0.433, 95% CI=0.196-0.952). CONCLUSION: EDS and insomnia symptoms are common among adolescents with MDD. Considering their negative effects on the clinical prognosis, regular screening and clinical managements should be developed for this patient population.

[Stable Isotopes of Precipitation in the Eastern Tarim River Basin and Water Vapor Sources].

The in-situ monitoring of stable hydrogen and oxygen isotopes (δ18O and δ2H) in precipitation is helpful to understand the processes of water phase change, mixing, and transportation. Due to the arid climate in the eastern Tarim River basin, water resources are the key factor affecting the regional sustainable development. However, the understanding of stable hydrogen and oxygen isotopes in precipitation is still limited for this region. Based on the isotope data of 103 precipitation samples collected at four stations in the eastern Tarim River basin from June 2019 to September 2020, the spatial and temporal characteristics of stable hydrogen and oxygen isotopes in precipitation were analyzed, and the connections between stable isotopes and moisture sources were discussed. The findings provide a reference for the application of environmental isotope tracers in arid areas. The results show that, ① the four sampling stations generally presented an increasing trend in precipitation stable isotopic values from north to south, and the isotopic values were higher in summer and lower in winter. The d-excess value in the study region was smaller than the national average, and the slope of the local meteoric water line exhibited a significant arid characteristic. ② There was a positive correlation between precipitation stable isotopes and air temperature in the study region, whereas a weak negative relationship was seen between d-excess and air temperature. The negative correlation occurred between δ18O and relative humidity, and the d-excess value exhibited a positive correlation with relative humidity. ③ The backward trajectory showed that the eastern Tarim River basin is mainly controlled by the westerlies paths. The proportion of air mass that comes from the middle and short distance is relatively large. The concentration weighted trajectory method showed that the farther from the precipitation sampling site, the more stable the d-excess value was. The closer to the sampling site, the more frequently the concentration changed, indicating that the d-excess value was greatly affected by the local water vapor recycling.

Composition, formation mechanism, and removal method of off-odor in soymilk products.

Soybean is a protein-rich material for plant-based products, and its application in soymilk products is limited due to its off-odor such as beany. In order to explore a solution to address this issue, composition, formation mechanism, and removal methods of the off-odor produced in the processing of soymilk products are comprehensively described in this paper. The main off-odor compounds in soymilk products include hexanal, hexanol, 1-octene-3-ol, (E,E)-2, 4-decadienal, 2-pentylfuran, (E,E)-2,4-nonadienal, (E)-2-nonenal, (E) -2-hexenal, and so on. These odor compounds are mainly produced by the enzymatic and nonenzymatic oxidation of unsaturated fatty acids. At present, physical methods are used to remove off-odor in the industrial production of soymilk products, of which heat treatment is still the most effective. With the development of no beany soybean breeding technology, the combination of multiple methods will become a technical trend for removing off-odor. Some new research directions are also explored about removal methods, which can provide a theoretical reference for the production and technical research of soymilk products.

Depression and insomnia in COVID-19 survivors: a cross-sectional survey from Chinese rehabilitation centers in Anhui province.

BACKGROUND: Suffering from COVID-19 is a strong psychological stressor to the patients. Even after recovery, patients are prone to a variety of mental health problems. Recently, some studies focus on the psychological situation of patients when they got COVID-19. However, no study focused on the psychological status of recovered COVID-19-infected patients in China. Our study aims to investigate sleep and mood status, and detect the influencing factors of the psychological status of the COVID-19 patients after recovery. METHODS: One hundred and twenty-five COVID-19 patients were enrolled from February to April 2020. The social demographic information of all participants was collected by a self-designed questionnaire. Insomnia and depression symptoms were evaluated through the Insomnia Severity Index (ISI) and the Center for Epidemiology Scale for Depression (CES-D). RESULTS: The rates of insomnia and depression were 26.45% and 9.92% in the COVID-19 patients after recovery. There were significant differences in physical, mental impairment, and the need for psychological assistance between the COVID-19 recovered patients with depression and the patients without depression. In addition, age and health status may be the influencing factors for insomnia, and care about the views of others may be the influencing factor of depression (P < 0.05). CONCLUSIONS: Based on the results, we found that COVID-19 recovered patients had a low rate of depression and a high rate of insomnia. We need to pay more attention to their sleep condition than mood status.

Pro-inflammatory cytokine levels are elevated in female patients with schizophrenia treated with clozapine.

RATIONALE AND OBJECTIVE: In this study, we hypothesized that the chronic use of clozapine affects cytokine expression and has a greater effect on female patients than on male patients. The aims of this study were to detect (1) whether serum cytokine levels were altered in patients with chronic schizophrenia after clozapine treatment compared with age- and sex-matched healthy controls, (2) whether there was a gender difference in serum cytokine levels after clozapine treatment, and (3) whether there was a correlation between serum cytokine levels and clozapine daily dosage in patients with schizophrenia. METHODS: Forty-nine inpatients with schizophrenia treated with clozapine and fifty-three sex- and age-matched healthy controls were recruited. The patients' psychiatric symptoms were measured by the Positive and Negative Syndrome Scale (PANSS). Blood samples from both patients and healthy controls were collected. Serum IL-1ß, IL-2, IL-6, IL-17, IFN-γ, and TNF-α levels were measured in duplicate by sandwich enzyme-linked immunosorbent assay. RESULTS: We found that chronic clozapine treatment in patients with schizophrenia resulted in the abnormal expression of serum cytokines, such as IL-2, IL-6, IL-17, and TNF-α, compared with the healthy controls. In addition, there was a gender difference in the abnormal expression of cytokines between male and female patients with schizophrenia. In the female group, IL-2 serum levels were lower than those in the male group. Interestingly, there was a positive correlation between serum IL-2 levels and the daily clozapine dosage in female patients with schizophrenia. CONCLUSION: Findings from our study have shown clear evidence that clozapine had a greater effect on immune function in female patients with schizophrenia.

Eleutheroside E supplementation prevents radiation-induced cognitive impairment and activates PKA signaling via gut microbiota.

Radiation affects not only cognitive function but also gut microbiota. Eleutheroside E (EE), a principal active compound of Acanthopanax senticosus, has a certain protective effect on the nervous system. Here, we find a four-week EE supplementation to the 60Co-γ ray irradiated mice improves the cognition and spatial memory impairments along with the protection of hippocampal neurons, remodels the gut microbiota, especially changes of Lactobacillus and Helicobacter, and altered the microbial metabolites including neurotransmitters (GABA, NE, ACH, 5-HT) as well as their precursors. Furthermore, the fecal transplantation of EE donors verifies that EE alleviated cognition and spatial memory impairments, and activates the PKA/CREB/BDNF signaling via gut microbiota. Our findings provide insight into the mechanism of EE effect on the gut-brain axis and underpin a proposed therapeutic value of EE in cognitive and memory impairments induced by radiation.

Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China.

Objectives: Evidence suggested that thyroid-stimulating hormone (TSH) and lipid levels were associated with major depressive disorder (MDD). However, its role in suicide attempts in adolescents with MDD was unclear. This investigation was to probe into the relationship between TSH, lipid levels, and attempted suicide in adolescents with MDD. Methods: A total of 179 adolescents with MDD were included from January 2021 to January 2022. Socio-demographic data and clinical data were obtained through self-made questionnaires. TSH and lipid levels were analyzed by a recognized laboratory. The Epidemiological Studies Depression Scale (CES-D) was used to assess the severity of depression. Questions about whether there was a behavior of suicide attempts were completed through conversation interviews. Results: Results showed that the CES-D total score, TSH, and low-density lipoprotein cholesterol (LDL-C) of suicide attempters were significantly higher than those of non-suicide attempters. Ordinary family relationships were more likely to attempt suicide than good family relationships. The CES-D total score, ordinary family relationships, TSH and LDL-C were still significant in binary logistic regression, with an adjusted odds ratio (OR) of 1.04, 3.42, 5.14, and 1.76, respectively. The area under the receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) ranged from 0.60 to 0.74. Conclusion: Suicide attempts are common among adolescents with MDD and were associated with CES-D total score, ordinary family relationships, TSH, and LDL-C. Given the association between suicide attempts and TSH and LDL-C, the dynamic changes in TSH and LDL-C levels should be detected regularly.

Prevalence and Clinical Correlates of Internet Addiction Symptoms and Their Association With Quality of Life in Adolescents With Major Depressive Disorder: A Multicenter Cross-Sectional Study.

Background: Internet addiction (IA) symptoms are common among adolescents and negatively impact their academic performance and development. These symptoms are also associated with lower quality of life (QOL) and increased suicidality. This study aimed to examine the prevalence and the sociodemographic and clinical correlates of IA symptoms in adolescents with major depressive disorder (MDD) and their association with QOL. Methods: This cross-sectional study was conducted in three general and four psychiatric hospitals in Anhui Province, China, from January to July 2021. Sociodemographic and clinical data were collected. The Internet Addiction Test (IAT), Center for Epidemiologic Studies of Depression Symptom Scale (CES-D), and World Health Organization Quality of Life Brief version (WHOQOL-BREF) were utilized to examine IA, depressive symptoms, and QOL, respectively. Results: In a multicenter sample of 278 adolescents with MDD, the prevalence of IA symptoms in adolescents with MDD was 46.8% (95% CI: 40.9-52.7%). Logistic regression analysis showed that patients with more severe depressive symptoms (odds ratio [OR] = 1.05, 95% CI: 1.03-1.08), those living in a rural area (OR = 1.94, 95% CI: 1.15-3.27), and those with poor academic performance (OR = 2.90, 95% CI: 1.42-5.95) were more likely to have IA symptoms. After controlling for confounding factors, patients with IA symptoms had significantly poorer QOL in the physical, psychological, and environmental domains than those without IA symptoms. Conclusion: IA symptoms are common in adolescents with MDD and appear to be associated with clinical symptoms. We could not infer a causal relationship between IA and depression because this was a cross-sectional study. Considering the positive association between IA symptoms and lower QOL, screening for IA symptoms should be conducted, and effective measures should be implemented for adolescents with MDD.

Sleep disorders mediate the link between childhood trauma and depression severity in children and adolescents with depression.

Background: Childhood trauma is closely related to the onset of depression and more severe depressive symptoms; however, the specific mechanisms are unclear. We aimed to examine the relationship between childhood trauma and sleep disorders in children and adolescents with depression and to explore further the role of sleep disorders in the relationship between childhood trauma and depression severity. Methods: A total of 285 children and adolescents with depression completed all scale assessments, including the Childhood Trauma Questionnaire, Self-Reported Insomnia Severity Index and Epworth Sleepiness Scale, and the Center for Epidemiologic Studies Depression Scale. A simple mediation model was used as a theoretical model to examine whether sleep disorders could mediate the relationship between childhood trauma and depression severity. Results: Among children and adolescents with depression, childhood trauma is about 78.9%. Compared with patients without childhood trauma, patients with childhood trauma had a higher incidence of sleep disorders (Z = 17.59, P < 0.001), which were characterized by insomnia (Z = 14.45, P < 0.001), not hypersomnia (Z = 2.77, P = 0.096). Different childhood trauma subtypes significantly affected sleep disorders and insomnia (all P < 0.05). Insomnia partially mediated the relationship between childhood trauma and depression severity, and the mediating effect accounted for 35.90%. Conclusion: This study found a high rate of concurrent childhood trauma and insomnia among children and adolescents with depression. Insomnia, as a mediator between childhood trauma and depression severity, partially mediates the relationship.

The chemical composition of human milk from Inner Mongolia of China.

In Inner Mongolia, China, the chemical composition of 66 breast milk samples at three lactation stages was analysed. Except for total nitrogen content, the contents of total solid, fat, NPN, lactose and ash were not significantly different between colostral, transitional and mature milk. Fatty acids did not vary over the three lactation stages, while unsaturated fatty acids accounted for 59.95-63.22% of the total fatty acids. Relatively low contents of vitamins were in the milk because the volunteer mothers did not take any vitamin supplementation over the entire lactation period. Besides sodium and phosphate, the concentrations of most minerals in the breast milk remained fairly constant across the three lactation stages.

Resources and Workforce in Top-Tier Psychiatric Hospitals in China: A Nationwide Survey.

Objectives: Mental healthcare has gained momentum and significant attention in China over the past three decades. However, many challenges still exist. This survey aimed to investigate mental health resources and the psychiatric workforce in representative top-tier psychiatric hospitals in China. Methods: A total of 41 top-tier psychiatric hospitals from 29 provinces participated, providing data about numbers and types of psychiatric beds, numbers of mental health professionals, outpatient services and hospitalization information covering the past 3 years, as well as teaching and training program affiliation. Results: Significant variations were found among participating hospitals and across different regions. Most of these hospitals were large, with a median number of psychiatric beds of 660 (range, 169-2,141). Child and geriatric beds accounted for 3.3 and 12.6% of all beds, respectively, and many hospitals had no specialized child or geriatric units. The overall ratios of psychiatrists, psychiatric nurses, and psychologists per bed were 0.16, 0.34, and 0.03, respectively. More than 40% of the hospitals had no clinical social workers. Based on the government's staffing guidelines, less than one third (31.7%) of the hospitals reached the lower limit of the psychiatric staff per bed ratio, and 43.9% of them reached the lower limit of the nurse per bed ratio. Conclusion: Although some progress has been made, mental health resources and the psychiatric workforce in China are still relatively insufficient with uneven geographical distribution and an acute shortage of psychiatric beds for children and elderly patients. In the meantime, the staffing composition needs to be optimized and more psychologists and social workers are needed. While addressing these shortages of mental health resources and the workforce is important, diversifying the psychiatric workforce, promoting community mental health care, and decentralizing mental health services may be equally important.

The Prevalence of Depressive and Insomnia Symptoms, and Their Association With Quality of Life Among Older Adults in Rural Areas in China.

Background: There are few studies on the epidemiology of depression, insomnia, and their association with quality of life (QOL) in older adults living in rural China. This study examined the prevalence of depressive and insomnia symptoms, and their association with QOL in community-dwelling older adults in a rural area in Anhui province, China. Methods: This was a cross-sectional study conducted in the rural areas of four cities (Hefei, Huaibei, Anqing, and Xuancheng) in Anhui province between July and October, 2019 using random sampling method. All community-dwelling residents from the selected villages who met the study entry criteria were invited to participate in this study. Depressive and insomnia symptoms and QOL were assessed with the Chinese version of self-reported Center for Epidemiological Survey Depression Scale (CES-D), the Insomnia Severity Index (ISI) and the 26-item World Health Organization Quality of Life Brief version (WHOQOL-BREF), respectively. Results: A total of 871 older adults were included. The prevalence of overall depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms were 34.0% [95% confidence intervals (95% CI): 30.8-37.1%], 45.7% (95% CI: 42.4-49.0%) and 20.3% (95% CI: 17.6-23.0%), respectively. Older adults with depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms had lower scores in QOL compared to those without. Depressive symptoms were positively associated with living with families [Odd Ratio (OR) = 1.82, 95% CI: 1.31-2.54] and negatively associated with current drinking (OR = 0.49, 95% CI: 0.33-0.72). Insomnia symptoms were negatively associated with fair and good financial status (fair: OR = 0.53, 95% CI = 0.38-0.75; good: OR = 0.30, 95% CI = 0.14-0.64) and current drinking (OR = 0.64, 95% CI = 0.45-0.93), and positively associated with more frequent major medical conditions (OR = 1.32, 95% CI = 1.16-1.51). Comorbid depressive and insomnia symptoms were positively associated with living with families (OR = 2.02, 95% CI = 1.36-3.00), and negatively associated with fair and good financial status (fair: OR = 0.61, 95% CI = 0.41-0.89; good: OR = 0.34, 95% CI = 0.12-0.95) and current drinking (OR = 0.57, 95% CI = 0.35-0.92). Conclusion: Depressive and insomnia symptoms were common in older adults living in rural areas in China. Considering the negative health outcomes caused by depressive and insomnia symptoms, regular screening and effective treatments should be developed for this population.

A Case Report of Suicide Attempt Caused by Acute and Transient Psychotic Disorder during the COVID-19 Outbreak.

We reported a case of suicide attempt caused by acute and transient psychotic disorder during the COVID-19 outbreak, which broke out in December 2019 in Wuhan. An epidemic of infectious diseases brought great psychological pressure to the public. During this period, a 20-year-old man went to the hospital repeatedly because he suspected that he was infected, with suspicious auditory hallucinations, self-laughter, primary delusions, victimization delusions, relationship delusions, and suicide attempts. He was diagnosed with Acute Transient Psychotic Disorder. 0.1 g bid Quetiapine was given orally, then gradually increased to 0.4 g per day, supplemented by cognitive therapy. The patient was discharged from hospital in relief of symptoms on February 9th. Conclusion. During the epidemic period, in addition to strengthening the protection work, we should also monitor the mental and psychological state of the population to prevent mental illness caused by coronavirus.

Knowledge and attitudes of medical staff in Chinese psychiatric hospitals regarding COVID-19.

On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus COVID-19 a pandemic. There are patients in psychiatric hospitals in China who have been infected with COVID-19, however, the knowledge and attitudes of psychiatric hospital staff towards infectious diseases and their willingness to work during the COVID-19 outbreak has not yet been investigated. This study was performed to assess the knowledge and attitudes of medical staff in two Chinese mental health centers during the COVID-19 outbreak. We included 141 psychiatrists and 170 psychiatric nurses in the study. We found that during the COVID-19 epidemic, 89.51% of the medical staff of the psychiatric hospitals studied had extensive knowledge of COVID-19, and 64.63% of them received the relevant training in hospitals. Furthermore, about 77.17% of participants expressed a willingness to care for psychiatric patients suffering from COVID-19 virus infection. Independent predictors of willingness to care for patients included advanced training and experience of caring for patients with COVID-19. In conclusion, this study suggests that increased attention should be paid to the knowledge and attitudes of medical staff at psychiatric hospitals during the COVID-19 outbreak.