The Subjective Experiences of Attention-Deficit/Hyperactivity Disorder of Chinese Families in Hong Kong: Co-Construction of Meanings in Multiple Family Groups.

The subjective experiences of Chinese children in Hong Kong with attention-deficit/hyperactivity disorder (ADHD) are underexplored. This article reports the results of a qualitative study that aims to understand the subjective experiences of children with ADHD in Hong Kong, taken from among a clinical sample of Chinese families with children struggling with ADHD who have participated in cross-disciplinary research of multiple family groups (MFG). The participating children revealed the subjective experiences of their struggle with the disorder in response to their parents' concern at a "press conference," one of the MFG activities, which underscored the importance of developing a new social work model to meet the multiple psychosocial service needs of these families. The article concludes with the discussion of the implications for the new model.

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.

Frequency and risk factors of workplace violence on psychiatric nurses and its impact on their quality of life in China.

This study examined the frequency of violence on nurses in Chinese psychiatric hospitals and explored its risk factors and impact on nurses' quality of life (QOL). A survey was conducted with 387 frontline psychiatric nurses in China. Information about experience of workplace violence in the past 6 months, type of workplace violence, and demographic characteristics was collected by a questionnaire. Altogether 319 (82.4%) of 387 nurses reported having experienced at least one type of violent event in the past 6 months. The prevalence of sexual assault, physical and verbal harassment was 18.6%, 61.5% and 78.6%, respectively. Compared to those with no exposure to violence, nurses who were exposed to violence had lower QOL in both the physical and mental domains. Significant predictors of violence against nurses are male sex, receiving college level or higher education and working on rotating duty were independently associated with high risk of violence. Workplace violence against psychiatric nurses commonly occurs in China. Considering the deleterious effects of violence, comprehensive strategies from the perspective of nursing education and training, organizational policy, patient care and staff support are recommended to promote occupational safety in psychiatric settings in China.

Association of insight with sociodemographic and clinical factors, quality of life, and cognition in Chinese patients with schizophrenia.

PURPOSE: The aims of this study were to assess insight in Chinese patients with schizophrenia and to identify its relationship with sociodemographic and clinical factors, cognition, and quality of life (QOL). METHODS: A cohort of 139 patients with clinically stable schizophrenia was selected by consecutively screening patients who had been diagnosed with schizophrenia and who were attending the outpatient department of a university-affiliated psychiatric hospital in China. Participants' sociodemographic and clinical characteristics, including psychotic and depressive symptoms and insight, as well as their social functioning, QOL, and flexibility of cognition, were assessed with standardized rating instruments. RESULTS: Thirty-three patients (23.7%) had good insight into their illness. In univariate analyses, poor insight was associated with the positive, negative, and general symptom scores of the Positive and Negative Syndrome Scale (PANSS), and with higher scores on the physical and mental components of QOL. In multivariate analysis, poor insight was independently associated with a higher negative symptom score on the PANSS, a shorter length of illness, and with a high score on the physical components of QOL. CONCLUSIONS: Poor insight is common in patients with clinically stable schizophrenia. In this study, insight was not associated with basic sociodemographic characteristics or had it any associations with depression or the flexibility of cognitive processes.

Falls in a psychiatric institution in Beijing, China.

PURPOSE: This study aimed to determine the rate of falls and their relationship with sociodemographic and clinical factors in a psychiatric institution in Beijing, China. DESIGN AND METHODS: The case notes of 7,921 inpatients were scrutinized to identify patients who fell while in the hospital. FINDINGS: The fall rate in this study was 1.2% of all inpatients. Nearly all (89.7%) falls occurred when patients attempted to stand up, get out of bed, or walk. PRACTICE IMPLICATIONS: Effective measures should be provided to prevent falls in psychiatric wards. A prospective study exploring predictors of falls is warranted.

Alcohol-related disorders in Beijing, China: prevalence, socio-demographic correlates, and unmet need for treatment.

BACKGROUND: The study aimed to determine the prevalence of alcohol use, episodic heavy drinking, and alcohol dependence and their socio-demographic correlates in Beijing, China. methods: A total of 5,926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview (CIDI 1.0). Data on basic socio-demographic and current major medical conditions were also collected. RESULTS: The 12-month prevalence of alcohol use and episodic heavy drinking were 32.5 and 13.8%, respectively. The 12-month and lifetime prevalence of alcohol dependence were 1.7 and 4.3%, respectively. Age above 24 years, male sex, being married and employed, low education level (junior high school, primary school or illiterate), rural residence, and having comorbid psychiatric disorders were all significantly associated with a higher likelihood of alcohol-related disorders. Only 2.4% of the subjects with alcohol dependence were receiving treatment, and a mere 1.4% had sought treatment from mental health professionals. CONCLUSIONS: Nationwide surveys are urgently needed to further explore the prevalence of alcohol-related disorders in China.

The prevalence of insomnia, its sociodemographic and clinical correlates, and treatment in rural and urban regions of Beijing, China: a general population-based survey.

STUDY OBJECTIVES: To determine the prevalence of insomnia, its sociodemographic and clinical correlates, and treatment patterns in Chinese people. DESIGN: A total of 5,926 subjects were randomly selected in the urban and rural areas of Beijing and interviewed using standardized assessment tools. Basic sociodemographic and clinical data were also collected. SETTING: Urban and rural regions of Beijing municipality, China. Patients or Participants Adult residents older than 15 years. Interventions N/A. MEASUREMENTS AND RESULTS: The prevalence of at least one type of insomnia was 9.2%; the rates of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 7.0%, 8.0%, and 4.9%, respectively. Increased age (age >44 and 24 years in the urban and rural samples, respectively), female sex, married, divorced, separated, or widowed marital status; having a major medical condition; and suffering from a psychiatric disorder were risk factors for all types of insomnia in both the urban and rural samples. A low level of education (primary school or illiteracy) was significantly associated with a higher likelihood of all types of insomnia in the urban sample. Current smokers and current drinkers were less likely to report any type of insomnia in the rural sample. Unemployment was associated with DMS in the urban sample, while it was associated with DIS and DMS in the rural sample. Only 5.4% of the participants with any type of insomnia reported their symptoms to medical practitioners. In contrast, nearly one-third of the subjects with insomnia reported taking benzodiazepines as sleep-enhancing drugs. CONCLUSIONS: Nationwide epidemiologic surveys are needed to further explore the prevalence of insomnia in China. The low percentage of subjects treated for insomnia indicates a major public health problem that should be addressed. Strict controls on use of benzodiazepines are warranted.

Prevalence and socio-demographic correlates of schizophrenia in Beijing, China.

OBJECTIVE: There has been no large-scale survey of schizophrenia in China involving both rural and urban areas using standardized assessment tools and diagnostic criteria. This study aimed to determine the lifetime prevalence of schizophrenia and its socio-demographic correlates in Beijing, China. METHODS: A total of 5926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview (CIDI 1.0). Basic socio-demographic and clinical data were collected during the interviews. RESULTS: The lifetime prevalence of schizophrenia was 0.49%, and 0.44% and 0.55% for men and women, respectively. Unmarried status, lower monthly income, urban abode and positive family history were associated with an increased risk of schizophrenia; 9.7% of the subjects with lifetime schizophrenia reported a history of suicide attempts. The percentage of subjects with schizophrenia who were receiving treatment and their preference to seek treatment from mental health professionals were 58% and 29%, respectively. CONCLUSIONS: National surveys are urgently needed to further explore the prevalence of schizophrenia in China. The low percentage of subjects treated for schizophrenia is a serious public health issue that should be addressed in the near future.