A control study on pain characteristics and influencing factors in patients with depressive disorders-based on a 5-year follow-up report from the epidemiological survey of mental disorders in Shandong Province, China.

BACKGROUND: This study extends from the 2015 Shandong Province Epidemiological Survey of Mental Disorders in adults aged 18 and above. Over five years, it investigates pain characteristics and influencing factors in individuals with depressive disorders in Shandong Province. METHODS: The study encompasses 871 individuals who met DSM-IV criteria for depressive disorders in 2015. Using 1:1:1 matching by gender, age, and residence, 825 non-afflicted individuals were selected as high-risk controls, and 825 screening-negative individuals became low-risk controls. A follow-up study in 2020 involved 1848 participants. Survey tools included a general information questionnaire, General Health Questionnaire-12 (GHQ-12), SCID-I/P, Global Pain Scale (GPS), Quality of Life Questionnaire (QLQ), PSQI, MoCA, and clinical data questionnaire. RESULTS: GPS scores in the current depressive group were higher than in non-current depressive group (Z = 14.36, P < 0.01). GPS scores in study group exceeded those in high-risk and low-risk control groups (H = 93.71, P < 0.01). GPS scores in non-remission group were higher than in the remission group (Z = 8.90, P < 0.01). Regression analysis revealed positive correlations between GPS scores and physical illnesses, current depression, incumbency, GHQ-12 total score, and PSQI total score. Negative correlations were observed with QLQ total score and MoCA total score. LIMITATIONS: The study could not assess pain during the 2015 survey, limiting controlled pain analysis before and after five years. CONCLUSION: Depression sufferers may experience prolonged heightened pain, potentially relieved when depression subsides. Individual pain is influenced by depression, physical illnesses, sleep quality, quality of life, cognitive function, gender, residence, and occupation.

Segmental abnormalities of superior longitudinal fasciculus microstructure in patients with schizophrenia, bipolar disorder, and attention-deficit/hyperactivity disorder: An automated fiber quantification tractography study.

Introduction: Superior longitudinal fasciculus (SLF) is a white matter (WM) tract that connects the frontal, parietal and temporal lobes. SLF integrity has been widely assessed in neuroimaging studies of psychiatric disorders, such as schizophrenia (SZ), bipolar disorder (BD), and attention-deficit/hyperactivity disorder (ADHD). However, prior studies have revealed inconsistent findings and comparisons across disorders have not been fully examined. Methods: Here, we obtained data for 113 patients (38 patients with SZ, 40 with BD, 35 with ADHD) and 94 healthy controls from the UCLA Consortium for Neuropsychiatric Phenomic LA5c dataset. We assessed the integrity of 20 major WM tracts with a novel segmentation method by automating fiber tract quantification (AFQ). The AFQ divides each tract into 100 equal parts along the direction of travel, with fractional anisotropy (FA) of each part taken as a characteristic. Differences in FA among the four groups were examined. Results: Compared to healthy controls, patients with SZ showed significantly lower FA in the second half (51-100 parts) of the SLF. No differences were found between BD and healthy controls, nor between ADHD and healthy controls. Results also demonstrated that patients with SZ showed FA reduction in the second half of the SLF relative to patients with BP. Moreover, greater FA in patients in SLF was positively correlated with the manic-hostility score of the Brief Psychiatry Rating scale. Discussion: These findings indicated that differences in focal changes in SLF might be a key neurobiological abnormality contributing to characterization of these psychiatric disorders.

The causal association between empty nest and depressive symptoms with cognitive impairments in China.

BACKGROUND: In the context of rapid aging, "empty nest syndrome" is becoming a major public health concern. The causal effects of empty nest on depressive symptoms have been studied in developed countries, but the mediating mechanism of depressive symptoms in the association between empty nest and cognitive impairments has not been studied. This study estimated the causal association of empty nest with depressive symptoms and cognitive impairments in China, and then estimated how depression mediates the association between empty nest and cognitive impairments. METHODS: Using data of 23,614 urban older adults (65+) obtained from the Shandong Province Aging and Mental Health Survey in 2020, a weighted linear regression model combined with instrumental variable was applied to explore the causal effects of empty nest, and a four-step mediation model was run to test the mediator of depressive symptoms. The Ascertain Dementia 8-item Questionnaire and Patient Health Questionnaire-9 were used to measure cognitive impairments and depressive symptoms. RESULTS: Empty nest was associated with 0.13 (95%CI: 0.04-0.23) and 0.23 (95%CI: 0.14-0.33) increases in the Ascertain Dementia 8-item Questionnaire and the Patient Health Questionnaire-9 scores, respectively. The association between empty nest and the Ascertain Dementia 8-item Questionnaire scores was mediated by the Patient Health Questionnaire-9 scores. CONCLUSIONS: Empty nest affected depression in adulthood with cognitive impairments. A focus on integrative intervention for empty nesters is recommended, taking depression and cognition into account. LIMITATIONS: It is a cross-sectional study and the data is not nationally representative.

Prevalence of depressive disorders and associated demographic characteristics in Shandong: An epidemiological investigation.

BACKGROUND: Depression is characterized by debilitating symptoms and high recurrence rates, and there are relatively few large-scale epidemiological surveys of depressive disorders conducted in Shandong since 2005. Data from the largest Epidemiological Survey of Mental Disorders conducted in 2015 in Shandong were collected to investigate the prevalence of depressive disorders and associated demographic characteristics in general adult population. METHODS: A multi-stage stratified cluster sampling method was adopted to select residents and a two-stage screening and assessment process was used to define the prevalence and characteristics of depressive disorders. Respondents were initially screened using the General Health Questionnaire followed by a structured clinical interview using the DSM-IV criteria. RESULTS: Among 27,489 respondents who completed the survey, 1277 respondents met the diagnostic criteria for depressive disorders. The adjusted prevalence in the last month was 4.86%, among which the prevalence of major depressive disorder, dysthymia, and unspecified depressive disorder were 2.32%, 1.78%, and 0.75%, respectively. 40.35% of depression patients had moderate or severe functional impairment and only 10.65% of patients had visited a psychiatric service. Univariate and multivariate analyses revealed that age, gender, occupation, education, marital status, and urban/rural living were associated with the prevalence. LIMITATIONS: The key limitation is that this is a cross-sectional survey therefore cannot draw any causal relationship between risk factors and disease progression. CONCLUSIONS: Findings from this largest epidemiological study reveal current prevalence of depressive disorders and associated demographic factors and offers opportunities for policy makers and health-care professionals to improve mental health provision in Shandong.

Prevalence of mental disorders in 21st century Shandong Province, China: A ten-year comparative study.

BACKGROUND: Although the 2000s observed enormous changes in China, little is known about the variation in the prevalence of mental disorders. The study compared the prevalence in a Chinese population between 2004 and 2015. METHODS: Multistage stratified random sampling methods were used to identify primary sampling sites for cross-sectional surveys in 2004 and 2015 in Shandong, China. In 2004 and 2015, 22,718 and 28,194 adults, respectively, completed an expanded version of the General Health Questionnaire, then 5,402 and 9,420 adults, respectively, were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual-IV axis I disorders. RESULTS: The adjusted 1-month prevalence of any mental disorders was 18•7% (95% CI: 16•7-20•8) and 17•1% (95% CI:15•9-18•4) in 2004 and 2015, respectively. However, the prevalence of major depressive disorders increased from 1•5% (95% CI: 1•2 -1•8) in 2004 to 2•3% (95% CI: 1•9-2•8) in 2015; meanwhile the prevalence of alcohol abuse disorders were becoming more common among men and urban residents. Although mood and anxiety disorders were more prevalent in women, a much more prevalent alcohol abuse disorders for men contributed to a higher overall prevalence among men than among women. Compared to that in urban residents, the overall prevalence in rural residents declined more, and it was lower in 2015 than in 2004. LIMITATIONS: The results may not apply to the population from other regions. CONCLUSIONS: Despite of the stable overall prevalence, mental disorders beyond psychotic disorders should be focused on, especially alcohol abuse and major depressive disorders.

Sleep quality as a mediator of the association between coping styles and mental health: a population-based ten-year comparative study in a Chinese population.

BACKGROUNDS: Little is known about the variation in sleep quality and its association with coping style and mental health in 21st century China, despite of enormous socioeconomic changes. This study aims to document the variation in sleep quality and its contribution to the association between coping style and mental health in China. METHODS: Pooled cross-sectional data of 46,561 adults was obtained from the 2004 and 2015 mental health surveys conducted in Shandong Province, China. A Simplified Coping Style Questionnaire and the Pittsburgh Sleep Quality Index were assessed, with mental health measured by the General Health Questionnaire (GHQ). A mediation regression model was run to test the mediating effect of sleep quality. RESULTS: Above 10% reported poor sleep quality or median-to-high risk of mental disorders according to GHQ results in year 2015, and a significant but small improvement for sleep quality and mental health came during the studied decade, with the exception of poor sleep quality increasing among males. In 2015, a one-point increase in sleep quality score was associated with an increase of 0.17 (95% CI, 0.16-0.18) and 0.16 (95% CI, 0.14-0.17) points on the GHQ for males and females, respectively. Sleep quality mediated the relationship between negative tendency of coping style and elevated GHQ scores, and the mediating effects grew stronger in 2015 than those in 2004. LIMITATION: The study is a cross-sectional study, and the sample is not nationally representative. CONCLUSION: An integrative intervention of mental health promotion is recommended to account for sleep quality and coping strategies..

Effects of SSRIs on peripheral inflammatory markers in patients with major depressive disorder: A systematic review and meta-analysis.

INTRODUCTION: Peripheral levels of inflammatory markers are elevated in major depressive disorder (MDD). Selective serotonin reuptake inhibitors (SSRIs) affect levels of inflammatory markers in patients with MDD, but studies have reported inconsistent findings. This systematic review and meta-analysis aims to investigate the effects of SSRI treatment on peripheral levels of a range of inflammatory markers in MDD patients. METHODS: Systematic literature search (Pubmed, Web of Science, Embase, Cochrane) for studies published before November 2018. Studies were included if they used SSRI monotherapy and peripheral levels of interleukin (IL)-1ß, IL-2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ were measured before and after treatment in patients with MDD. Meta-analysis was conducted using Comprehensive Meta-analysis (version 2). Effect sizes were calculated using bias-corrected standardized mean difference (Hedges' g) between pre- and post-treatment. Sub-group analyses, meta-regression and publication bias estimates were undertaken; sensitivity analyses were performed using different estimated pre- and post-treatment correlations and after removing poor quality studies. RESULTS: Twenty two eligible studies including 827 MDD patients were included in the meta-analysis: fifteen studies for IL-6; eleven for TNF-α; eight for IL-10; seven for IL-1ß; six for IL-4; five for IL-2; and four for IFN-γ. The pooled effect estimate indicates SSRI treatment decreased levels of pro-inflammatory markers IL-6 (Hedges' g, -0.418; 95%CI, -0.663 to -0.174; I2 = 89.412), TNF-α (Hedges' g, -0.554; 95%CI, -0.990 to -0.118; I2 = 95.438) and IL-1ß (Hedges' g = -0.574; 95%CI, -1.014 to -0.135; I2 = 91.622), and anti-inflammatory marker IL-10 (Hedges' g = -0.615; 95%CI, -0.989 to -0.242; I2 = 90.406). There were no significant treatment effects on levels of IL-2, IL-4, or IFN-γ. There was a high level of heterogeneity between studies. Sensitivity analyses indicated the robustness of the primary analyses. CONCLUSIONS: The current review and meta-analysis indicates moderate immunomodulating effects of SSRI treatment for MDD, which suggests SSRIs may owe some of their therapeutic effect to their anti-inflammatory properties. High heterogeneity across studies may limit interpretation of the findings and larger randomized clinical trials are warranted.

[Association study of brain-derived neurotrophic factor Val66Met polymorphism and clinical characteristics of first episode schizophrenia].

OBJECTIVE: To assess the association between brain-derived neurotrophic factor (BDNF) gene Val66Met polymorphism and clinical characteristics of first episode schizophrenia in a Chinese Han population. METHODS: Genotyping of BDNF Val66Met polymorphism was carried out for 135 schizophrenic patients and 483 healthy controls with TaqMan probe technology. The patients' psychotic symptoms were assessed using the positive and negative syndrome scale (PANSS). RESULTS: A significant difference was found in genotype distribution and allelic frequency of the Val66Met polymorphism between the two groups (P< 0.01). In patients, Met homozygotes had a significantly higher score in anxiety/depression factor, cognitive factor and total score of PANSS than Val carriers. CONCLUSION: BDNF gene Val66Met polymorphism is associated with the pathogenesis of schizophrenia. The Met/Met genotype of BDNF Val66Met variant may be a risk factor for symptoms in first episode schizophrenia patients.

Bed sharing, sleep habits, and sleep problems among Chinese school-aged children.

STUDY OBJECTIVES: This study examined the association between bed sharing, sleep habits, and sleep problems among Chinese school-aged children. DESIGN AND SETTING: A questionnaire survey of school-aged children was undertaken in Jinan city, People's Republic of China, in 2001. PARTICIPANTS: A total of 517 elementary-school children (mean age, 10.5 years; 47.4% boys) participated in the survey. MEASUREMENTS: The parents completed the Chinese version of the Children's Sleep Habits Questionnaire and a number of questions that asked about bed sharing and characteristics of the family and child. RESULTS: The prevalence of regular bed sharing in Chinese school-aged children was as high as 18.2%. The rate of bed sharing did not differ between boys and girls but significantly decreased with age from 55.8% in 7-year-olds to 7.2% in 11- to 13-year-olds. Multivariate logistic regression analysis showed that younger age, poor physical health of the child, and crowded housing were associated with an increased likelihood for the child's bed sharing with parents. Bedtime and total sleep duration did not significantly differ between children who shared beds and those who slept alone. Children who shared beds with their parents were reported to have more sleep anxiety and daytime sleepiness than children who slept alone. Bed sharing was not associated with parasomnias and breathing problems during sleep. CONCLUSIONS: Regular bed sharing in Chinese school-aged children was very common and significantly decreased with age. Crowded housing and poor physical health of the child increased the likelihood for children and parents to share beds. Bed sharing may exert influences on sleep quality rather than sleep quantity.