Suicidal ideation and suicide attempts among students aged 12 to 24 after the lifting of COVID-19 restrictions in China: prevalence and associated factors.

Objective: To investigate the prevalence and associated factors of suicidal ideation and suicide attempts among adolescent and young adults in China from December 14, 2022 to February 28, 2023, when COVID-19 restrictions were lifted. Methods: Students in middle and high schools and colleges and universities in the province of Sichuan, China were asked to complete on-line cross-sectional surveys. Information was collected about sociodemographics, experiences related to the COVID-19 pandemic, suicidal ideation and suicide attempts. Participants also filled out the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 and the Social Support Rate Scale surveys. Factors associated with suicidal ideation or suicide attempts were explored using logistic regression. Results: Of the 82,873 respondents (aged 12 to 24 years), 21,292 (25.7%) reported having thought of suicide at least once in their lifetime, 10,382 (12.5%) reported having thought about suicide within the previous 12 months, and 1,123 (1.4%) reported having attempted it within the previous 12 months. Risk of lifetime suicidal ideation was higher among middle school students than among older students. Risk of suicidal ideation and risk of suicide attempts correlated directly with severity of symptoms of depression and anxiety, and inversely with level of social support. Greater risk of suicidal ideation and suicidal attempts was associated with: being female, living in an urban environment, attending a boarding school, currently being in love, having parents who divorced or remarried, having parents who exhibit non-authoritative parenting behavior, having higher family income, having been COVID-19 infected, having been quarantined for a long time, and being dissatisfied with one's education. Conclusions: Suicidal ideation and suicide attempts remain prevalent among young people in China. The potential associated factors identified in our study may be useful for targeting appropriate psychosocial interventions and developing mental health policies.

Functions of nonsuicidal self-injury and repeated nonsuicidal self-injury among adolescents: A moderating role of addictive features.

OBJECTIVE: The high prevalence and addictive features of nonsuicidal self-injury (NSSI) in adolescents have been documented, but the role of addictive features in the process from NSSI functions to behaviour remains unclear. The major aim of this study was to investigate the effect of addictive features on NSSI functions and the severity of repeated NSSI. METHODS: A total of 10,781 students from primary and middle schools in Chengdu and Karamay were invited to participate in the online cross-sectional survey, and 10,501 completed the survey. Two self-report questionnaires, the Ottawa Self-Injury Inventory (OSI) and the Adolescent Self-Harm Scale (ASHS), were used to collect data from all participants. RESULTS: Among the students, 23.45% and 6.64% reported having engaged in NSSI at least once or at least five times in the past year. Being a girl, being an only child, and being in a single-parent family were significantly associated with more severe NSSI. Addictive features have high value for predicting repeated NSSI. In addition to their significant independent/direct additive effects, addictive features mediated and moderated the relationship between NSSI functions and increased severity of NSSI in adolescents. DISCUSSION AND CONCLUSIONS: The findings suggest that addictive features play a critical role in the development of repeated NSSI in adolescents, which indicates that addiction models may partially explain the mechanism underlying increased severity of NSSI. This may enhance understanding of the reasons for repeated NSSI and inform interventions for repeated NSSI among adolescents.

Mediating role of anxiety and impulsivity in the association between child maltreatment and lifetime non-suicidal self-injury with and without suicidal self-injury.

BACKGROUND: Child maltreatment can increase the risk of lifetime non-suicidal self-injury (NSSI) and suicidal self-injury (SSI), but there is limited knowledge regarding the differences of potentially psychological mechanisms between NSSI with and without SSI. METHODS: Participants, 3918 community-based Chinese young men aged 18-34 years in Chengdu, were included in this study. We investigated the association between depression, anxiety, psychosis, child maltreatment, adulthood traumatic events, impulsivity, alcohol dependence, drug abuse, and lifetime of NSSI among participants with and without SSI. Parallel mediation analysis was utilized to explore the mediators for the relation between child maltreatment and NSSI. RESULTS: The prevalence of lifetime NSSI was 6.1 % (95 % CI: 5.4 %-6.9 %) among young men. Anxiety and impulsivity partially mediated the effect of child maltreatment on NSSI either with (indirect effect: 51.2 %) or without SSI (indirect effect: 34.3 %). Depression was independently and significantly associated with only NSSI but not with NSSI+SSI. Alcohol dependence and psychosis were independently and significantly associated with NSSI+SSI and mediated the effect of child maltreatment on NSSI+SSI. LIMITATIONS: The cross-sectional survey data limits the robustness of the proof to the causal relationships. CONCLUSIONS: Anxiety and impulsivity are associated with NSSI either with or without SSI and partially mediate the effect of child maltreatment on NSSI. Depression is associated with only NSSI, while alcohol dependence and psychosis are only associated with NSSI+SSI. It could be crucial to improve treatment and recovery of alcohol dependence and psychosis for preventing young men engaged in NSSI from attempting SSI.

A proof-of-principle study: The potential application of MiniHap biomarkers in ancestry inference based on the QNome nanopore sequencing.

Haplotyped SNPs convey forensic-related information, and microhaplotypes (MHs), as the most representative of this kind of marker, have proved the potential value for human forensics. In recent years, nanopore sequencing technology has developed rapidly, with its outstanding ability to sequence long continuous DNA fragments and obtain phase information, making the detection of longer haplotype marker possible. In this proof-of-principle study, we proposed a new type of forensic marker, MiniHap, based on five or more SNPs within a molecular distance less than 800 bp, and investigated the haplotype data of 56 selected MiniHaps in five Chinese populations using the QNome nanopore sequencing. The sequencing performance, allele (haplotype) frequencies, forensic parameters, effective number of alleles (Ae), and informativeness (In) were subsequently calculated. In addition, we performed principal component analysis (PCA), phylogenetic tree, and structure analysis to investigate the population genetic relationships and ancestry components among the five investigated populations and 26 worldwide populations. MiniHap-04 exhibited remarkable forensic efficacy, with 148 haplotypes reported and the Ae was 66.9268. In addition, the power of discrimination (PD) was 0.9934, the probability of exclusion (PE) was 0.9898, and the In value was 0.7893. Of the 56 loci, 85.71% had PD values above 0.85, 66.07% had PE values above 0.54, 67.86% had Ae values over 7.0%, and 55.36% were with In values above 0.2 across all samples, indicating that most of the MiniHaps are suitable for individual identification, paternity testing, mixture deconvolution, and ancestry inference. Moreover, the results of PCA, phylogenetic tree and structure analysis demonstrated that this MiniHap panel had the competency in continental population ancestry inference, but the differentiation within intracontinental/linguistically restricted subpopulations was not ideal. Such findings suggested that the QNome device for MiniHap detection was feasible and this novel marker has the potential in ancestry inference. Yet, the establishment of a more comprehensive database with sufficient reference population data remains necessary to screen more suitable MiniHaps.

Massively parallel sequencing of 74 microhaplotypes and forensic characteristics in three Chinese Sino-Tibetan populations.

Microhaplotype (MH), as an emerging type of forensic genetic marker in recent years, has the potential to support multiple forensic applications, especially for mixture deconvolution and biogeographic ancestry inference. Herein, we investigated the genotype data of 74 MHs included in a novel MH panel, the Ion AmpliSeq MH-74 Plex Microhaplotype Research Panel, in three Chinese Sino-Tibetan populations (Han, Tibetan, and Yi) using the Ion Torrent semiconductor sequencing. The sequencing performance, allele frequencies, effective number of alleles (Ae), informativeness (In), and forensic parameters were subsequently estimated and calculated. In addition, principal component analysis (PCA) and structure analysis were performed to explore the population relationships among the three populations and the ancestry component distribution. Overall, this novel MH panel is robust and reliable, and has an excellent sequencing performance. The Ae values ranged from 1.0126 to 7.0855 across all samples, and 75.68 % of MHs had Ae values >2.0000. Allele frequencies at some loci varied considerably among the three studied populations, and the mean In value was 0.0195. Moreover, the genetic affinity between Tibetans and Yis was closer than that between Tibetans and Hans. The aforementioned results suggest that the Ion AmpliSeq MH-74 Plex Microhaplotype Research Panel is highly polymorphic in three investigated populations and could be used as an effective tool for human forensics. Although these 74 MHs have demonstrated the competency in continental population stratification, a higher resolution for distinguishing intracontinental subpopulations and a more comprehensive database with sufficient reference population data still remain to be accomplished.

Forensic biogeographical ancestry inference: recent insights and current trends.

BACKGROUND: As a powerful complement to the paradigmatic DNA profiling strategy, biogeographical ancestry inference (BGAI) plays a significant part in human forensic investigation especially when a database hit or eyewitness testimony are not available. It indicates one's biogeographical profile based on known population-specific genetic variations, and thus is crucial for guiding authority investigations to find unknown individuals. Forensic biogeographical ancestry testing exploits much of the recent advances in the understanding of human genomic variation and improving of molecular biology. OBJECTIVE: In this review, recent development of prospective ancestry informative markers (AIMs) and the statistical approaches of inferring biogeographic ancestry from AIMs are elucidated and discussed. METHODS: We highlight the research progress of three potential AIMs (i.e., single nucleotide polymorphisms, microhaplotypes, and Y or mtDNA uniparental markers) and discuss the prospects and challenges of two methods that are commonly used in BGAI. CONCLUSION: While BGAI for forensic purposes has been thriving in recent years, important challenges, such as ethics and responsibilities, data completeness, and ununified standards for evaluation, remain for the use of biogeographical ancestry information in human forensic investigations. To address these issues and fully realize the value of BGAI in forensic investigation, efforts should be made not only by labs/institutions around the world independently, but also by inter-lab/institution collaborations.

Exploring rare differences in mitochondrial genome between MZ twins using Ion Torrent semiconductor sequencing.

Monozygotic (MZ) twins are considered to be genetically identical in that they have the same genomic DNA sequences in theory, and thus cannot be differentiated using forensic standard STR-based DNA profiling. However, a recent study employed deep sequencing to explore extremely rare mutations in the nuclear genome and reported that the mutation analysis could be applied to differentiate between MZ twins. Compared with the nuclear genome, the mitochondrial DNA (mtDNA) exhibits higher mutation rates due to fewer DNA repair mechanisms in the mitochondrial genome (mtGenome) and the lack of proofreading capability of the mtDNA polymerase. In a previous study, we used Illumina ultra-deep sequencing to describe point heteroplasmy (PHP) and nucleotide variant of the mtGenomes in venous blood samples of MZ twins. In the present study, we characterized minor differences of the mtGenomes in three tissue samples from seven sets of MZ twins using Ion Torrent semiconductor sequencing (Thermo Fisher Ion S5 XL system) and commercialized mtGenome sequencing kit (Precision ID mtDNA Whole Genome Panel). PHP was observed in blood samples from one set of MZ twins and in saliva samples from two sets of twins, but it presented in hair shaft samples from all seven sets of MZ twins. Overall, the coding region of the mtGenome exhibits more PHPs than the control region. The results of this study have further attested the competence of mtGenome sequencing in differentiating between MZ twins, and that among the three kinds of samples tested, hair shaft is more likely to accumulate minor differences in the mtGenomes of MZ twins.

Status of mandatory treatment of mentally ill offenders without criminal responsibility in China: Information from 5,262 mandatory treatment judgments.

Background: To avoid public health risks, all governments ensure monitoring and treatment of mentally ill persons if they offend and assess their level of criminal responsibility. The Criminal Procedure Law of the People's Republic of China (2013) instituted special procedures. However, there are few articles in English which explain the implementation of mandatory treatment procedures in China. Methods: We collected 5,262 qualified documents from 2013 to 2021 from the China Judgments Documents Online. We analyzed social demographic characteristics, trial-related information as well as the mandatory treatment-related content, to investigate the mandatory treatment of China's mentally ill offenders without criminal responsibility, from 2013 to 2021. Simple descriptive statistics and chi-square tests were used to compare differences among several types of documents. Results: There was an overall change trend of the number of documents: increasing year by year from 2013 to 2019 after the implementation of the new law, but with sharp decrease in 2020 and 2021 during covid-19 pandemic. From 2013 to 2021, a total of 3,854 people had applications made for mandatory treatment, of whom 3,747 (97.2%) were given mandatory treatment, 107 (2.8%) had applications rejected. "Schizophrenia and other psychotic disorders" was the most common diagnosis in both groups and all offenders receiving mandatory treatment (3,747, 100.0%) were considered to have no criminal responsibility. A total of 1,294 patients had applications made for relief of mandatory treatment, of whom 827 (63.9%) were subsequently approved for relief, 467 (36.1%) were rejected. A total of 118 patients had applications for relief two or more times, and 56 (47.5%) were finally relieved. Conclusion: Our study presents the Chinese model of a criminal mandatory treatment system to the international community which has been in operation since the implementation of the new law. Legislatory changes and covid-19 pandemic can have effect on the number of mandatory treatment cases. Patients, their close relatives and mandatory treatment institutions have the right to apply for relief from mandatory treatment, but the final decision in China is taken by the court.

An Epidemiologic Survey and Violent Behavior Analysis of Antisocial Personality Disorder in Young Men in Chengdu.

OBJECTIVES: To investigate the epidemiological characteristics of antisocial personality disorder (ASPD) in young men in Chengdu and explore the characteristics and risks of violence. METHODS: Stratified random sampling was used to conduct a self-assessment questionnaire survey in 4 108 males aged from 18 to 34 in Chengdu, including general demographic characteristics, structured clinical interview for the diagnostic and statistical manual of mental disorders-Ⅳ axis Ⅱ disorders (SCID-Ⅱ) personality disorder screen questionnaire, violence questionnaire, psychosis screening questionnaire (PSQ), Alcohol Use Disorders Identification Test (AUDIT) and drug use. χ2 test, univariate and multivariate logistic regression were used for analysis and odds ratio (OR) was calculated. RESULTS: The positive rate of ASPD was 5.91%, which was associated with young age, unmarried, unemployment state, low educational level, violent behavior, psychotic symptoms, alcohol and drug use (P<0.05). Young men with ASPD also had a risk (P<0.05) of violence (OR was 8.51), multiple violence (OR was 16.57), injury (OR was 6.68), intentional violence (OR was 11.41), etc., the risk decreased after controlling for psychotic symptoms and substance abuse, but was still statistically significant. CONCLUSIONS: The risk of violence, severe violence and intentional violence in young men in Chengdu is high, and psychotic symptoms and substance abuse increase the risk of ASPD violence and relate characteristics.

Association Between Anxious Symptom Severity and Olfactory Impairment in Young Adults with Generalized Anxiety Disorder: A Case-Control Study.

OBJECTIVE: The findings of olfaction are inconsistent in anxiety disorders, and few studies have reported on the olfactory performance in generalized anxiety disorder (GAD). Therefore, we aim to investigate the olfactory function of patients with GAD and the association between olfactory function and anxiety symptoms. METHODS: We conducted a case-control study by selecting 107 patients with GAD and 107 healthy controls matched for sex and age, to investigate olfaction deficits in GAD and the association between anxiety severity and olfaction. All patients were treatment-naïve prior to the inclusion. Anxiety severity and olfaction were assessed by the Hamilton anxiety rating scale (HAM-A) and the Sniffin' Sticks test (SST), respectively. Partial correlations were used to analyze the relationship between olfaction and anxiety severity. False discovery rate (FDR) correction was used in multi-correlation analyses. RESULTS: Compared with healthy controls, patients in the GAD group demonstrated odor threshold, discrimination and identification deficits. In the moderate/severe anxiety subgroup, discrimination score was significantly and inversely correlated with the somatic anxiety score (γ=-0.44, q = 0.03), and identification score was significantly and inversely correlated with the HAM-A total score (γ=-0.42, q= 0.04). The TDI score (the sum of threshold, discrimination and identification scores) was significantly and inversely correlated with the somatic (γ=-0.44, q = 0.04) and psychic (γ=-0.45, q = 0.04) anxiety scores in the moderate/severe anxiety subgroup. CONCLUSION: This study demonstrated the olfactory impairment in patients with GAD and that poorer odor discrimination was correlated with greater severity of somatic anxiety.

Posttraumatic stress disorder symptoms among child survivors of the 2008 Wenchuan earthquake: a comparison between Chinese ethnic Han and Hui groups.

BACKGROUND: Relatively few studies have compared posttraumatic stress disorder (PTSD) symptoms following a disaster among children of different ethnicities. We sought to investigate the differences in PTSD symptoms between the ethnic Hui and Han child survivors of the 2008 Wenchuan earthquake in China. METHODS: This study collected data from 1,951 Han and 247 Hui child survivors of the 2008 Wenchuan earthquake in China. The children ranged from 7 to 15 years of age. Earthquake-related exposures were measured using a modified version of the PsySTART Rapid Triage System. PTSD symptoms were evaluated using the University of California, Los Angeles PTSD-Reaction Index (UCLA PTSD-RI). Personality characteristics were assessed using the Junior Eysenck Personality Questionnaire (JEPQ). Multiple linear regression was used to investigate the association between the ethnicity and the severity of PTSD symptoms. Multiple logistic regression was used to investigate the association between the ethnicity and the percentage of screening positive for PTSD symptoms. RESULTS: The average UCLA PTSD-RI total score of the ethnic Hui group (27.01 ± 9.24) was significantly higher than that of the ethnic Han group (25.12 ± 9.17) (t = -3.05, p = 0.002), as were the avoidance/numbness (Hui: 10.02 ± 4.82; Han: 9.04 ± 4.60, t = -3.12, p = 0.002) and arousal scores (Hui: 9.36 ± 3.64; Han: 8.79 ± 3.42, t = -2.44, p = 0.015). The percentage of screening positive for D criteria (arousal symptoms) also differed significantly between the ethnic Han (41.9%, 95% CI [39.7-44.1%]) and Hui (48.6%, 95% CI [42.3-54.9%]) groups (χ2 = 3.97, p = 0.046). Ethnicity was associated with the avoidance/numbness symptom score following adjustments for sex, age, personality traits and earthquake exposure experiences by multiple linear regression (B: 0.61, 95% CI [0.04-1.17], p = 0.035). The initial significant associations between the ethnicity and the arousal symptoms score and the PTSD total score disappeared while adjusting for the subjective earthquake exposure experiences (Model 5: arousal symptoms, B = 0.41, 95% CI [-0.01 to 0.83], p = 0.056; PTSD, B = 1.00, 95% CI [-0.07 to 2.07], p = 0.066). The initial significant association between the ethnicity and the percentage of screening positive for D criteria disappeared while adjusting for the objective earthquake exposure experiences (Model 4: OR = 1.32, 95% CI [1.00-1.75], p = 0.052). CONCLUSION: This study is the first to report the relationship between the ethnicity and PTSD symptoms among child survivors following a disaster. The findings of this study suggest that the trauma-focused cognitive behavior therapy could also be an effective treatment for Chinese ethnic Hui and Han children who are suffering from PTSD. Future research could be designed to examine whether cultural differences in perceptions and interpretations may account for the variations in subjective experiences. More attention should be paid to the ethnic minority children with PTSD in the future.

Profiling the differences of gut microbial structure between schizophrenia patients with and without violent behaviors based on 16S rRNA gene sequencing.

Understanding the violence behaviors in schizophrenia patients has always been the focus of forensic psychiatry. Although many studies show gut microbiota could regulate behavior, to our knowledge, no studies have profiled the gut microbiota structure in schizophrenia patients with violence. We profiled the characteristics of gut microbiota structure in 26 schizophrenia patients with violence (V.SCZ) by comparing with that of 16 schizophrenia patients without violence (NV.SCZ) under the control of confounders, and found the differences of gut microbiota structure between the two groups. Violence was assessed by the MacArthur Community Violence Instrument. Psychiatric symptoms were assessed by the Positive and Negative Syndrome Scale. The 16S rRNA gene sequencing was used to identify and relatively quantify gut microbial composition. Bioinformatics analysis was used to find differential gut microbial composition between the V.SCZ and NV.SCZ groups. Fifty-nine differential microbial taxonomic compositions were found between the two groups. Fifteen gut microbial compositions were the key microbial taxonomic compositions responsible for the differences between the V.SCZ and NV.SCZ groups, including five enriched microbial taxonomic compositions (p_Bacteroidetes, c_Bacteroidia, o_Bacteroidales, f_Prevotellaceae, s_Bacteroides_uniformis), and ten impoverished microbial taxonomic compositions (p_Actinobacteria, c_unidentified_Actinobacteria, o_Bifidobacteriales, f_ Enterococcaceae, f_Veillonellaceae, f_Bifidobacteriaceae, g_Enterococcus, g_Candidatus_Saccharimonas, g_Bifidobacterium, and s_Bifidobacterium_pseudocatenulatum). This study profiled the differences of gut microbiota between schizophrenia patients with violence and without violence. These results could enrich the etiological understanding of violence in schizophrenia and might be helpful to violence management in the future.

Dysregulation of amino acids and lipids metabolism in schizophrenia with violence.

BACKGROUND: Many studies have related biochemical characteristics to violence and have reported schizophrenia could elevated the risk of violent behaviour. However, the metabolic characteristics of schizophrenia patients with violence (V.SC) are unclear. METHODS: To explore the metabolic characteristics of schizophrenia with violence and to identify potential biomarkers, untargeted metabolomics was performed by using gas chromatography time-of-flight mass spectrometry to analyse the plasma metabolites of fifty-three V.SC and twenty-four schizophrenia patients without violence (NV.SC). Multivariate and univariate analyses were performed to identify differential metabolites and biomarkers. Violence was assessed by the MacArthur Violence Assessment Study method. Psychiatric symptoms were assessed by the Positive and Negative Syndrome Scale. RESULTS: Multivariate analysis was unable to distinguish V.SC from NV.SC. Glycerolipid metabolism and phenylalanine, tyrosine and tryptophan biosynthesis were the differential metabolic pathways between V.SC and NV.SC. We confirmed ten metabolites and five metabolites as metabolic biomarkers of V.SC by random forest and support vector machine analysis, respectively. The biomarker panel, including the ratio of L-asparagine to L-aspartic acid, vanillylmandelic acid and glutaric acid, yielded an area under the receiver operating characteristic curve of 0.808. CONCLUSIONS: This study gives a holistic view of the metabolic phenotype of schizophrenia with violence which is characterized by the dysregulation of lipids and amino acids. These results might provide information for the aetiological understanding and management of violence in schizophrenia; however, this is a preliminary metabolomics study about schizophrenia with violence, which needs to be repeated in future studies.

Olfactory impairment in first-episode schizophrenia: a case-control study, and sex dimorphism in the relationship between olfactory impairment and psychotic symptoms.

BACKGROUND: A body of studies has focused on the olfactory impairment among people with schizophrenia. The effect of sex on this relationship has attracted the attention of researchers. These issues have not been studied much in Chinese schizophrenia patients. METHODS: We conducted a case-control study of 110 first-episode antipsychotic medicine naïve schizophrenia patients aged 18-35 years and 110 controls, matched by age and sex. Odour threshold, discrimination and identification were assessed by the "Sniffin' Sticks" test. Psychotic symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). RESULTS: The odour threshold, discrimination and identification scores of patients with schizophrenia were significantly lower than those of the healthy control group. The difference in identification score had statistical significance between male and female patients with schizophrenia (t = - 2.45, P < 0.05). Controlling for confounding factor, in male schizophrenia participants, the negative subscale score was significantly and inversely correlated with the discrimination (γ = - 0.37, p < 0.008), identification (γ = - 0.45, p < 0.008) and TDI (γ = - 0.50, p < 0.008) scores; the general psychopathology subscale score was inversely and significantly correlated with the identification (γ = - 0.47, p < 0.008) and TDI (γ = - 0.41, p < 0.008) scores. For female schizophrenia patients, positive and general psychopathology subscale scores had a significant inverse correlation with the identification score (positive: γ = - 0.47, p < 0.008; general psychopathology: γ = - 0.42, p < 0.008). CONCLUSIONS: Controlling for confounder, negative symptoms were related to impaired odour discrimination and identification in male schizophrenia patients, while positive symptoms were correlated with impaired odour identification in female schizophrenia patients. This sex dimorphism could provide useful information for future studies aiming to finding biomarkers of schizophrenia.

Characteristics of alleged homicide offenders with and without schizophrenia in Sichuan, China.

BACKGROUND: Little is known about the characteristics of people with and without schizophrenia who have been charged with homicide in China. AIMS AND RESEARCH QUESTION: Our research question was what differences are there between alleged homicide offenders with and without psychosis? METHOD: All archival records of alleged homicide cases referred for assessment to the West China Forensic Central Medical Service during 1998-2006 were retrieved. The centre serves a large catchment area in the mainly rural province of Sichuan. A random 20% of cases with schizophrenia and all cases without psychosis were selected for comparison. Demographic, criminological and mental health data were extracted from the records, and violence was rated by using the Violence Risk Scale (Chinese version). RESULTS: The two groups differed significantly in age, education, occupation, marital status and relationships to victim. The estimated risk of reoffending was higher in the schizophrenia group than the non-psychotic group, even after controlling for demographic differences. Despite many individuals reporting long histories of mental illness, about 40% of those with schizophrenia had never had any psychiatric treatment and less than 4% were in treatment at the time of the alleged homicide. CONCLUSIONS: The tendency for homicidal people with schizophrenia to be older, less educated and more socially isolated than their non-psychotic peers is similar to experience in Western countries, but the apparently higher risk scale scores of the Chinese schizophrenia group and their greater tendency to attack strangers are different. The lack of reported previous engagement with mental health services by a clearly ill and risky group of people is a likely explanation. Similar rural problems compared with better served urban areas have been reported in the Chuvash Republic. The case for better rural mental health services seems strong. Copyright © 2017 John Wiley & Sons, Ltd.

The Role of Personality and Subjective Exposure Experiences in Posttraumatic Stress Disorder and Depression Symptoms among Children Following Wenchuan Earthquake.

This study aims to investigate the role of personality traits and subjective exposure experiences in posttraumatic stress disorder and depression symptoms. In Qingchuan, 21,652 children aged 7 to 15 years were assessed using face-to-face interviews one year after the Wenchuan earthquake in China. The Junior Eysenck Personality Questionnaire, a modified earthquake exposure scale, the UCLA Posttraumatic Stress Disorder Reaction Index (adolescent), and the Adolescent Depression Inventory were used to assess personality characteristics, trauma experiences, posttraumatic stress disorder and depression symptoms, respectively. The measurement was completed with 20,749 children. After adjusting for other factors by multinomial logistic regression analysis, neuroticism, having felt unable to escape from the disaster and having been trapped for a longer time were risk factors of posttraumatic stress disorder and depression symptoms. Socialization was a protective factor of them. Having felt extreme panic or fear was a risk factor of posttraumatic stress disorder symptoms. For depression symptoms, introversion and psychoticism were risk factors, and extraversion was a protective factor. This study was conducted with the largest representative sample of child survivors of a natural, devastating disaster in a developing country. These results could be useful for planning psychological intervention strategies for children and for influencing further research.

[Reliability of the Violence Risk Scale of Chinese version].

OBJECTIVE: To introduce and revise the Violence Risk Scale (VRS) for assessing violence risk and risk change, and to examine the reliability of Violence Risk Scale of Chinese version(VRS-C). METHODS: The original English version of the VRS was translated into Chinese according to established translation procedures. To examine the scorer reliability the 14 cases assessed by 3 assessors separately. One hundred and twenty-five patients with mental disorders from 3 different institutions in Sichuan province (Refined Control Ward in Ankang Hospital, Department of Forensic Psychiatry, Institute of Forensic Science and Mental Health Center of West China Hospital) were collected to examine the reliability of VRS-C. RESULTS: The results showed moderately good scale reliability of the VRS-C, with 0.80 of ICC for scorer reliability. All items have significant consistence with Cronbach's alpha coefficient as 0.921, split-half reliability as 0.906 and item total correlation as 0.246-0.849. CONCLUSION: The reliability of the VRS-C version is acceptable.