Type D personality is associated with delaying patients to medical assessment and poor quality of life among rectal cancer survivors.

OBJECTIVE: The aim of this research was to explore quality of life (QoL), mental health status, type D personality, symptom duration, and emergency admissions of Chinese rectal cancer patients as well as the relationship between these factors. METHODS: Type D personality was measured with the 14-item Type D Personality Scale (DS14). Mental health status was measured with the Hospital Anxiety and Depression Scale (HADS). The QoL outcomes were assessed longitudinally using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 questionnaires at the baseline and 6 months after diagnosis. RESULTS: Of the 852 survivors who responded (94 %), 187 (22 %) had a type D personality. The proportion of patients with duration of symptoms >1 month and being diagnosed after emergency admissions in type D group is significantly higher than that in non-type D group. At both of the time points, type D patients reported statistically significant lower scores on most of the functional scales, global health status/QoL scales, and worse symptom scores compared to patients without a type D personality. At the 6-month time point, a higher percentage of patients in the type D group demonstrated QoL deterioration. Clinically elevated levels of anxiety and depression were more prevalent in type D than in non-type D survivors. CONCLUSIONS: Type D personality was associated with poor QoL and mental health status among survivors of rectal cancer, even after adjustment for confounding background variables. Type D personality might be a general vulnerability factor to screen for subgroups at risk for longer symptom duration and emergency admissions in clinical practice.

Factors associated with delaying medical assessment of patients and impacting the prognosis of rectal cancer.

The aims of this study were (a) to compare the clinical presentations and outcomes of patients referred to the hospital from the emergency department (ED) and those referred from non-ED facilities in a Chinese population and (b) to identify the factors influencing delays in medical assessment and prognosis for patients with rectal cancer (RC). Eligible Chinese patients newly diagnosed with RC, admitted to the hospital from the ED, or referred from non-ED sources between 1 January 2008 and 31 December 2009 were enrolled in this prospective study. Associations between symptoms, symptom duration, tumor stage at diagnosis, and 3-year survival were proposed to identify factors associated with delay in the diagnosis of RC and emergency admission. Compared with patients in the non-ED group, patients in the ED group had a significantly longer hospital stay, greater in-hospital mortality, a higher proportion of advanced stage tumor, lower rate of undergoing potentially curative surgery, and a higher proportion of symptom duration longer than 1 month. There was a statistically significant difference in the 3-year overall survival between the patients who underwent emergency operation within 24 h of admission and the patients presenting as emergency who underwent an operation longer than 24 h from admission to operation. Patients who endured symptoms longer than 1 month had a significantly higher proportion of emergency admissions, higher proportion of advanced stage tumor, and lower rate of undergoing potentially curative surgery compared with patients whose symptom duration was less than 1 month. In conclusion, (a) ED referral patients endured significantly longer symptom duration before diagnosis. (b) Emergency operation within 24 h of admission was an independent prognostic indicator of overall survival in patients with RC. A two-stage approach for the management of patients with RC who presented as emergency could enable patients to be transferred to a specialist department of surgical oncology for a definitive radical oncological operation and improve the prognosis.

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.