Screening a Suspected Malingerer Using the Symptom Checklist-90-Revised and Visual Analogue Pain Scale Questionnaires.

Malingering in healthcare leads to a significant financial burden, so identifying patients who may be more likely to malinger is a critical step in minimizing the ever-growing cost of healthcare in the United States. Malingering is a clinical diagnosis with no well-established diagnostic tests. General guiding principles exist to determine whether or not a patient is malingering, but there is no well-established set of guidelines that can be used in common to identify malingering. Our team cared for a 51-year-old black, female patient who presented to an outpatient clinic due to generalized pain following a motor vehicle accident (MVA). The patient's symptomatology, clinical progression, and imaging results were discordant with one another, which prompted clinical suspicion of malingering. After careful deliberation, the care team suspected that the patient was malingering. Therefore, the clinical management was limited to a conservative pain management regimen and minimal clinical follow-up to avoid unnecessary healthcare expenditures. This article aims to discuss general principles and specific strategies for how a clinician can approach a case of suspected malingering.

Unraveling the distinction between depression and anxiety: A machine learning exploration of causal relationships.

OBJECTIVE: Depression and anxiety, prevalent coexisting mood disorders, pose a clinical challenge in accurate differentiation, hindering effective healthcare interventions. This research addressed this gap by employing a streamlined Symptom Checklist 90 (SCL-90) designed to minimize patient response burden. Utilizing machine learning algorithms, the study sought to construct classification models capable of distinguishing between depression and anxiety. METHODS: The study included 4262 individuals currently experiencing depression alone (n = 2998), anxiety alone (n = 716), or both depression and anxiety (n = 548). Counterfactual diagnosis was used to construct a causal network on the dataset. Employing a causal network, the SCL-90 was simplified. Items that have causality with only depression, only anxiety and both depression and anxiety were selected, and these streamlined items served as input features for four distinct machine learning algorithms, facilitating the creation of classification models for distinguishing depression and anxiety. RESULTS: Cross-validation demonstrated the performance of the classification models with the following metrics: (1) K-nearest neighbors (AUC = 0.924, Acc = 92.81 %); (2) support vector machine (AUC = 0.937, Acc = 94.38 %); (3) random forest (AUC = 0.918, Acc = 94.38 %); and (4) adaptive boosting (AUC = 0.882, Acc = 94.38 %). Notably, the support vector machine excelled, with the highest AUC and superior accuracy. CONCLUSION: Incorporating the simplified SCL-90 and machine learning presents a promising, efficient, and cost-effective tool for the precise identification of depression and anxiety.

Evaluation of the mental health status of community frontline medical workers after the normalized management of COVID-19 in Sichuan, China.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, community medical workers, as the primary enforcers of community control measures, undertook many tasks with high exposure risk, resulting in severe psychological pressure, anxiety, depression and other psychological problems. Gender, type of workers, education, marital status, working years and other demographic factors were affect the mental state of medical workers. Community frontline medical workers gradually returned to normal work and life after the normalized management of COVID-19, but heavy work and high psychological pressure may continue to affect them. Thus, our research team used the same psychological questionnaire to investigate the psychological status of community frontline medical workers after the normalized management of COVID-19 compared with the COVID-19 period. Methods: This was a cross-sectional study of community frontline medical workers in Sichuan, China, from February 6 to 17, 2023. Symptom Checklist-90 (SCL-90) and a self-designed questionnaire of demographic characteristics were provided to the participants point-to-point through a mobile network platform. Multiple logistic regression was used to analyze influencing factors related to community frontline medical workers' psychology. Results: A total of 440 valid questionnaires were statistically analyzed, including 192 (43.64%) from doctors and 248 (56.36%) from nurses. There were 222 (50.45%) participants who were SCL-90 positive. The median total SCL-90 score of medical workers was 105.0 (IQR 95.00-123.75), which was higher than that during the COVID-19 period. The doctor's median SCL-90 score was 108.5 (IQR 96.00-136.25), and the positive item score was 16.5; the nurse's median score was 104.0 (IQR 94.00-119.50), and the positive item score was 12.0. Bachelor's degree education, no fixed contract and working years (10-19 years, 20-29 years, 30-39 years) were independent influencing factors for community frontline medical workers' psychology. Conclusion: After the normalized management of COVID-19, community frontline medical workers still suffered from psychological problems that were even more serious than those during COVID-19. Doctors were more likely to have psychological problems than nurses. In addition, the mental health status of community frontline medical workers was affected by education, type of contract and working years. Managers should pay attention to the mental health of these people.

Mental Health of Primary and Secondary School Teachers in the Remote Mountain Areas.

Background and objective: Teaching is widely recognized as a highly stressful profession. Job stress leads to emotional exhaustion, which in turn triggers teacher attrition. The cost is estimated as USD 2.2 billion annually for teacher dropouts. It is therefore important to understand the mental state of teachers and the factors that may influence it in order to provide the appropriate early intervention. In the past, more attention has been paid to the mental status of teachers in economically developed cities, but less research has been conducted in remote cities. In this study, we selected primary and secondary school teachers in a typical area to assess their mental health, thereby contributing to the development of effective mental health education programs for teachers in primary and secondary schools. Materials and methods: In this study, 1102 teachers from a typical city in Ningxia Province, characterized by remote mountain areas, minority communities, and a low economic level, participated. The mental status of the teachers was assessed by a Symptom Checklist-90 (SCL-90). The effects of gender, age, level of education, place of work, and marital status on the total SCL-90 score were recorded and compared. The subscale scores of the SCL-90 and the differences among the respondents with various characteristics were analyzed. Results: In total, 1025 data were valid and used for statistical analysis. The effective rate of this study was 93.01%. The analysis showed that 25.17% of the subjects had possible mental problems. There were significant differences in age and marital status (p < 0.001). The score of teachers less than 30 years old was lower than that of other teachers (p = 0.001 vs. 30-39; p < 0.001 vs. 40-49; p < 0.001 vs. ≥50). The no-marriage teachers had the lowest score than the married group or others (p < 0.001 vs. married; p < 0.05 vs. others). Compared to the norm, teachers' mental status was poor, especially in somatization (p < 0.001), obsessive-compulsive symptoms (p < 0.001), depression (p < 0.001), anxiety (p < 0.001), hostility (p < 0.001), phobic anxiety (p < 0.001), and psychosis (p < 0.001). There were gender differences in obsessive-compulsive symptoms (p < 0.05) and depression (p < 0.05). Conclusions: These data indicate that the mental status of these teachers is not optimistic, and married female teachers aged 40-55 years need to be given more attention. Mental health examinations can be incorporated into daily physical examination items to facilitate the timely detection and early intervention of negative emotions.

Prevalence of gastrointestinal symptoms and their association with psychological problems in youths.

BACKGROUND: Gastrointestinal symptoms and psychological problems are common in youths, which can negatively affect their lives on physical, mental, and social levels. This cross-sectional study aimed to determine the prevalence of gastrointestinal symptoms in youths and further explore their association with psychological problems. METHODS: Self-reported data on gastrointestinal symptoms and psychological problems in 692 sophomores who majored in education in a high vocational school and 310 recruits who were undergoing basic training in an army in China were retrospectively collected. The self-reported data included demographics, gastrointestinal symptoms, and Symptom Checklist 90 (SCL-90) used for the assessment of psychological problems. Gastrointestinal symptoms surveyed included nausea, emesis, abdominal pain, acid regurgitation, eructation, heartburn, anorexia, abdominal bloating, diarrhea, constipation, hematemesis, and hematochezia. Logistic regression analysis was performed to identify the independent risk factors associated with gastrointestinal symptoms. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated. RESULTS: The prevalence of gastrointestinal symptoms was 36.7% (n=254) and 15.5% (n=48) in the sophomores and recruits, respectively. Participants with gastrointestinal symptoms had a significantly higher prevalence of total SCL-90 score beyond 160 than those without gastrointestinal symptoms in both sophomores (19.7% vs. 3.2%, P<0.001) and recruits (10.4% vs. 1.1%, P<0.001). Total SCL-90 score beyond 160 was independently associated with gastrointestinal symptoms in both sophomores (OR =5.467; 95% CI: 2.855-10.470; P<0.001) and recruits (OR =6.734; 95% CI: 1.226-36.999; P=0.028). CONCLUSIONS: Gastrointestinal symptoms may be common and strongly associated with psychological problems in youths. Prospective studies should be required to explore the impact of the correction of psychological problems on the improvement of gastrointestinal symptoms.

An investigation of the physical and mental health of trainees receiving standardized residency training of anesthesiology in four large teaching hospitals in Wuhan, China / 中华医学教育探索杂志

Objective:To investigate the physical and mental health of trainees receiving standardized residency training of anesthesiology in four large teaching hospitals in Wuhan, China, as well as related risk factors.Methods:The trainees who received standardized residency training of anesthesiology in four large general teaching hospitals in Wuhan were selected as subjects, and Symptom Checklist-90 (SCL-90) and Eysenck Personality Questionnaire were used to investigate mental health and personality state. SPSS 22.0 was used to perform the independent samples t-test, a one-way analysis of variance, and the chi-square test, and Logistic regression was used to analyze the influencing factors for SCL-90. Results:A total of 328 questionnaires were distributed and 326 valid questionnaires were collected, with a recovery rate of 99.39%. Among these trainees, 68 (20.86%) were found to have abnormal mental status (SCL-90 score >160), with a relatively high proportion of the trainees with obsessive-compulsive symptoms or depression. The trainees with abnormal mental status showed the personality characteristics of tendency neuroticism and tendency psychoticism, and compared with the trainees with normal mental status, the trainees with abnormal mental status showed a higher proportion of trainees with abnormal personality characteristics. The univariate analysis showed that the grade of residency training, scientific research pressure, monthly on-duty frequency, and personality characteristics were associated with abnormal mental status, and the multivariate analysis showed that a monthly on-duty frequency of >5 times ( B=0.997, odds ratio [ OR]=2.709, 95%CI: 1.051-6.986, P=0.039), great pressure of scientific research ( B=3.235, OR=25.412, 95%CI: 3.239-199.363, P=0.002), emotional instability ( B=2.015, OR=7.504, 95%CI: 3.529-15.954, P<0.001), and psychosomatic abnormalities ( B=1.640, OR=5.154, 95%CI: 2.510-10.581, P<0.001) were risk factors for psychological abnormality in trainees, while extroversion personality ( B=-2.758, OR=0.063, 95%CI: 0.019-0.215, P<0.001) was a protective factor against abnormal mental status. Conclusions:The positive rate of psychological abnormality is 20.86% among trainees receiving standardized residency training of anesthesiology in four large teaching hospitals in Wuhan, and possible influencing factors include monthly on-duty frequency, scientific research pressure, work pressure, and different personality characteristics.

Postoperative symptoms of patients with plastic surgery: a clinical study based on SCL-90 / 中华医学美学美容杂志

Objective:To investigate the mental health status of plastic surgery patients.Methods:A total of 487 plastic surgery patients [4 males and 475 females, aged 17-66 (30±10) years)] from Jiangsu Provincial Hospital of Chinese Medicine were investigated by symptom checklist 90 (SCL-90).Results:In a sample of 479 cases, 111 were positive for SCL-90, accounting for 23.1%. Among non-reconstructive surgeries, 92 out of 439 cases were positive, representing 21.0%, while in reconstructive surgeries, 19 out of 40 cases were positive, amounting to 47.5%. The positive detection rate of SCL-90 in reconstructive surgeries was significantly higher than that in non-reconstructive surgeries (χ 2=21.20, P<0.05). Compared with the national norm, the overall mental health status of patients with plastic surgery and cosmetic surgery showed that the average scores of obsessive-compulsive state (1.91±0.43), anxiety (1.46±0.31), hostility (1.60±0.36), and terror (1.28±0.24) were statistically significant higher than the norm ( t=10.03, P<0.05; t=3.27, P<0.05; t=5.20, P<0.05; t=2.50, P<0.05). The average score of obsessive-compulsive state (2.11±0.54), interpersonal sensitivity (1.82±0.39), depression (1.68±0.50), hostility (1.74±0.45), terror (1.39±0.28), paranoia (1.49±0.34), and psychotic (1.35±0.28) in patients undergoing reconstructive surgeries were all higher than those without reconstructive surgeries ( t=2.97, P<0.05; t=2.10, P<0.05; t=2.18, P<0.05; t=2.18, P<0.05; t=2.80, P<0.05; t=2.20, P<0.05; t=2.10, P<0.05). Conclusions:The results of SCL-90 show that the mental health level of plastic surgery patients (especially repair surgery patients) is lower than that of the normal population, which suggests that we should pay attention to the psychological evaluation and care about the physical and mental health of these patients.

Analysis of scores of Symptom Checklist 90 (SCL-90) questionnaire of 182 parents of children with spinal muscular atrophy: a cross-sectional study.

Background: Spinal muscular atrophy (SMA) is a hereditary disorder characterized by progressive muscle weakness and atrophy in children. However, less attention is paid to psychiatric symptoms of SMA parents. Attention to the psychiatric symptoms of parents of SMA children can improve the comprehensiveness of family support for SMA children, which is beneficial to the rehabilitation of SMA children. Here, we conducted a survey on the psychiatric symptoms of SMA parents and analyzed its relevant factors, with an attempt to inform the psychological support for SMA parents. Methods: The Symptom Checklist 90 (SCL-90) and a self-designed basic information (such as parent's gender, household area, place of residence, education background, etc.) questionnaire (in electronic questionnaire) were distributed to parents of SMA children aged 0-18 in a charity WeChat group sponsored by the Meier Advocacy & Support Center for SMA during the period from August 1 to August 31, 2021. Parents completed the electronic questionnaires by mobile phone or computer voluntarily. A total of 188 questionnaires were obtained, of which 182 were valid. Comparisons were performed with the SCL-90 adult norms as the standards. The potential correlations between the general data of SMA parents and children and abnormal factors in the SCL-90 for SMA parents were analyzed. Results: The SCL-90 factors somatization (1.56±0.80, P=0.002), depression (1.78±0.98, P<0.001), anxiety (1.58±0.87, P=0.007), fear (1.39±0.74, P=0.003), and sleep and eating problems (1.67±0.87, P=0.014) of SMA parents were significantly higher than the national norms. Place of residence was correlated with sleep and eating problems (r=0.158, P=0.033). Increasing age [odds ratio (OR) =1.012, P=0.014] and continuous home-living status (OR =0.360, P=0.031) of SMA children increased the risk of depression in their parents, and the lack of rehabilitation management in SMA children increased the risk of anxiety of their parents (OR =0.409, P=0.038). Non-urban residence (OR =2.602, P=0.017) and poor physical health (OR =0.163, P=0.031) were the relevant factors for the increased risk of sleep and eating problems in SMA parents. Conclusions: SMA parents have a higher risk of developing psychiatric symptoms problems compared with the general population. Increasing age and the continuous home-living status of SMA children increase the risk of depression in their parents, and the lack of rehabilitation management increase the risk of anxiety in SMA parents.

Mental health status and associated contributing factors among the Hakka elderly in Fujian, China.

Purpose: Little is known about the mental health of the Hakka elderly. This study explores the status of, and factors associated with mental health among Hakka elderly populations from Fujian, China. Methods: This is a cross-sectional, community-based survey study containing a total of 1,262 valid samples. The Chinese version Symptom Checklist-90-R (SCL-90-R) was used to assess the mental health status of the Hakka elderly. We used t-tests to compare the differences for 10 dimensions of SCL-90-R scores between the Chinese national norm and the Hakka elderly. Univariate and multivariate analysis were performed by using linear regression analysis to identify the main socio-demographic factors that were most predictive of the total score of SCL-90-R in the Hakka elderly. Results: The scores of somatization (1.78 ± 0.55 vs. 1.40 ± 0.46, P < 0.001) and phobic anxiety (1.21 ± 0.36 vs. 1.17 ± 0.31, P < 0.001) for the Hakka elderly in Fujian appeared to be significantly higher than the Chinese norm. The higher total scores of SCL-90-R were found among females (ß = 0.030, P = 0.044), widowed persons (ß = 0.053, P = 0.021), those with parent(s) alive (ß = 0.047, P = 0.019), and those with poorer self-rated health status (ß = 0.110, P < 0.001). The lower total scores of SCL-90-R were found among those who were currently living in town, those with lower education level, those with higher average annual household incomes, and those who were living with spouse or children. Conclusion: The worse mental health conditions of the Hakka elderly in somatization and phobic anxiety were detected. The overall mental health status was shown to be worse among females, widowed persons, those who were living in village, those with lower education, and those with father or/and mother alive.

Depression scores and quality of life of vertiginous patients, suffering from different vestibular disorders.

PURPOSE: To contrast the quality of life (QoL) impairment and depression scores of patients suffering from different vestibular disorders. METHODS: 301 patients were examined due to vertiginous complaints at the Neurotology Centre of the Department of Otolaryngology and Head and Neck Surgery of Semmelweis University. These patients completed the Hungarian version of the Dizziness Handicap Inventory (DHI), the Beck Depression Inventory, and the Symptom Checklist-90-Revised questionnaires. RESULTS: According to neurotological examination, the distribution of the different diagnoses was as follows: Menière's disease (n = 101), central vestibular disorders (n = 67), BPPV (n = 47), vestibular neuritis (n = 39), other unilateral peripheral vestibulopathy (n = 18), PPPD (Persistent Postural-Perceptual Dizziness) (n = 16), vestibular migraine (n = 8), and vestibular Schwannoma (n = 5). The results of the DHI questionnaire have indicated worsened QoL in 86.4%, out of which 33.6% was defined as severe. The Beck scale has shown depressive symptoms in 42.3% of the cases, with severe symptoms in 6.3%. Significantly higher total DHI and Beck scale results were observed in patients with central vestibular disorders, vestibular migraine, PPPD and peripheral vestibulopathy, contrasted to the results of the other four diagnosis groups. The onset of the symptoms did not significantly affect the severity of QoL worsening and depression symptoms. CONCLUSION: In this study, the QoL of vertiginous patients was worse in general, with the occurrence of depression symptoms. A difference was observed in the case of the values of patients with different vestibular disorders, indicating the importance of different factors, e.g., central vestibular compensation, behavioural strategies and psychological factors.

Analysis and Countermeasures of related factors between mental health and physical exercise of Law College Students

The goal of this study is to investigate and test if physical exercise affects the mental health of law students. is study aim. The current study used a quantitative research approach. A questionnaire survey is carried out to collect data from respondents. Furthermore, a planned physical exercise in the experimental and control groups is used. Finally, data analysis is carried out by using a statistical tool. There was no significant difference in the level of SCL-90 between the two groups (P > 0.05). There was no significant difference in mental health between the experimental group and the control group, which met the requirements of the experiment. Through T-analysis of the data before and after the investigation, there were significant differences in somatization, obsessive-compulsive symptoms, and interpersonal sensitivity in the experimental group (P ≤ 0.05), and there were very significant differences in anxiety factors (P ≤ 0.01). Physical exercise intervention can significantly alleviate the bad mood of college students. Physical exercise is conducive to improving college students' intelligence level and reducing the learning pressure. Different sports have different effects on the psychological factors of college students; The overall impact of personal sports on psychological conditions is better than that of collective sports. Collective sports can enhance people's aggressive psychology, but individual sports individual sports cannot replace the advantages of collective sports on interpersonal relationship cannot replace the advantages of collective sports on interpersonal relationship.(AU)

The potency of psychiatric questionnaires to distinguish major mental disorders in Chinese outpatients.

Background: Considering the huge population in China, the available mental health resources are inadequate. Thus, our study aimed to evaluate whether mental questionnaires, serving as auxiliary diagnostic tools, have efficient diagnostic ability in outpatient psychiatric services. Methods: We conducted a retrospective study of Chinese psychiatric outpatients. Altogether 1,182, 5,069, and 4,958 records of Symptom Checklist-90 (SCL-90), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HAM-D), respectively, were collected from March 2021 to July 2022. The Mann-Whitney U test was applied to subscale scores and total scores of SCL-90, HAM-A, and HAM-D between the two sexes (male and female groups), different age groups, and four diagnostic groups (anxiety disorder, depressive disorder, bipolar disorder, and schizophrenia). Kendall's tau coefficient analysis and machine learning were also conducted in the diagnostic groups. Results: We found significant differences in most subscale scores for both age and gender groups. Using the Mann-Whitney U test and Kendall's tau coefficient analysis, we found that there were no statistically significant differences in diseases in total scale scores and nearly all subscale scores. The results of machine learning (ML) showed that for HAM-A, anxiety had a small degree of differentiation with an AUC of 0.56, while other diseases had an AUC close to 0.50. As for HAM-D, bipolar disorder was slightly distinguishable with an AUC of 0.60, while the AUC of other diseases was lower than 0.50. In SCL-90, all diseases had a similar AUC; among them, bipolar disorder had the lowest score, schizophrenia had the highest score, while anxiety and depression both had an AUC of approximately 0.56. Conclusion: This study is the first to conduct wide and comprehensive analyses on the use of these three scales in Chinese outpatient clinics with both traditional statistical approaches and novel machine learning methods. Our results indicated that the univariate subscale scores did not have statistical significance among our four diagnostic groups, which highlights the limit of their practical use by doctors in identifying different mental diseases in Chinese outpatient psychiatric services.

Botulinum toxin A improves psychological distress in patients with hemifacial spasm.

OBJECTIVE: This study aimed at assessing mental health in patients with hemifacial spasm (HFS) and determined the effect of botulinum toxin type A (BTX-A) on psychological distress in patients with HFS. METHODS: Ninety-five HFS patients and 95 age- and sex-matched healthy controls were enrolled. Symptom checklist-90 (SCL-90) scores were used to measure psychological distress in HFS patients and healthy controls. The mental health status of HFS patients was also evaluated by SCL-90, before and after the injection of BTX-A. Moreover, for those patients with abnormal mental health, efficacy outcomes after treatment with BTX-A were compared with a propensity score-matched historical cohort without BTX-A treatment. RESULTS: The mean scores for interpersonal sensitivity, phobia, anxiety, depression, and somatization were significantly higher among HFS patients than healthy people (P < 0.05). There was no significant difference between female patients and male patients in HFS group (P > 0.05). There were significant improvements in somatization, interpersonal sensitivity, depression, anxiety, and phobia scores before and after treatment (P < 0.05). At 2 months, more patients experienced an improvement in psychological distress in the BTX-A group (61.29% versus 38.71%; P = 0.03). CONCLUSION: Patients with HFS are often accompanied by somatization, interpersonal sensitivity, depression, anxiety, and phobia. Our findings suggest that BTX-A can improve these symptoms. However, further well-designed prospective studies are warranted to validate our findings.

Evaluation of mental health for national nuclear radiation emergency rescuers / 中华放射医学与防护杂志

Objective:To estimate the mental health status and personality traits of the nuclear radiation emergency rescuers, allowing to provide reference basis for improving their mental health.Methods:Totally 52 nuclear radiation emergency rescuers were selected as the subjects. The symptom checklist 90 (SCL-90) and Cattell′s 16 personality factor scale (16PF) were used to assess their mental health status and personality traits. The results obtained from the survey of these rescuers were compared with those obtained using Students′ t-test, One-Way ANOVA and Pearson correlation analysis. Results:The average scores of multiple factors and positive items of the SCL-90 were significantly lower in the rescuers than in the norm ( t=-4.77 to -2.04, P<0.05), and the positive rate was 21.15%. The symptom checklist 90 subscales such as somatization, obsessive-compulsive and depression were found in the rescuers. Rescuers received high scores in the following components among the 16 factors of Cattell: less intelligent-more intelligent, emotionally stable. Rescuers also received low scores in the following components among the 16 factors of Cattell: tough-minded-tender-minded, trusting-suspicious. Life satisfaction, educational degree and Cattell′s 16 PF were significantly associated with the factors of SCL-90( r=-0.569 to 0.627, P<0.05). Conclusions:The rescuers are better than ordinary Chinese people in psychological health. Mental health-related factors such as literacy, life satisfaction, and personality traits should be taken into account when selecting team members and conducting psychological interventions.

Relationship between the Spectral Power Density of Sleep Electroencephalography and Psychiatric Symptoms in Patients with Breathing-related Sleep Disorder.

OBJECTIVE: Patients with breathing-related sleep disorder (BRSD) often complain of psychiatric symptoms such as depression in addition to snoring, excessive sleepiness, and disturbed sleep. However, the relationship between psychiatric symptoms and severity of sleep apnea in BRSD is controversial. We conducted this study to investigate the relationship between psychiatric symptoms and sleep electroencephalography (EEG) findings in BRSD patients using spectral analysis. METHODS: All participants underwent polysomnography and evaluation using Symptom Checklist-90-Revised (SCL-90-R) scale. We analyzed the absolute spectral power density values of standard EEG frequency bands in the participants (n = 169) with BRSD during the non-rapid eye movement (NREM) sleep period. We performed correlation analysis between the domain scores of SCL-90-R scale and the absolute values of the EEG frequency bands. RESULTS: Significant positive correlation was observed between the absolute spectral power density values in the slow oscillation band and the degree of paranoid ideation (r = 0.226, p = 0.028) and depression (r = 0.216, p = 0.044) in SCL-90-R. The multiple linear regression model showed that higher paranoid ideation domain score (B = 0.007, p = 0.020), younger age (B = -0.011, p < 0.001), and female sex (B = 0.213, p = 0.004) were associated with higher slow oscillation power during NREM sleep. CONCLUSION: The results of the present study suggested a relationship between sleep EEG and psychiatric symptoms in patients with BRSD. This relationship needs to be validated with further studies.

Mental health status and quality of life in patients with end-stage renal disease undergoing maintenance hemodialysis.

BACKGROUND: This study aimed to identify the association of factors and poorer mental health status and examinate the correlation between mental health status and quality of life (QOL) in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis. METHODS: A total of 190 patients were included in this observational, cross-sectional study. Psychological states of ESRD patients undergoing maintenance hemodialysis were evaluated by the Chinese version symptom checklist-90 (SCL-90) and QOL was assessed using the Chinese Version Kidney Disease Quality of Life-Short Form (KDQOL-SF). RESULTS: A total of 190 patients with a mean age of 61.68 (13.39) years were included in this study. Multiple stepwise linear regression analyses suggested that when controlling for the confounding variables, prealbumin had the significant influence on average positive factors (Coef., -0.647; 95% CI: -1.314, 0.020; P=0.057), somatization (Coef., -1.334; 95% CI: -2.451, -0.217; P=0.020), obsessive-compulsive (Coef., -1.396; 95% CI: -2.255, -0.537; P=0.002), depression (Coef., -1.241; 95% CI: -2.252, -0.229; P=0.017), phobic anxiety (Coef., -2.576; 95% CI: -3.786, -1.367; P<0.001). In the correlation analysis, the score of average positive factors was significantly correlated with the score of the overall health rating (Coef., -0.343; P<0.001), symptom/problem (Coef., -0.337; P<0.001), effects of kidney disease on daily life (Coef., -0.198; P=0.006), burden of kidney disease (Coef., -0.233; P=0.001), cognitive function (Coef., 0.363; P<0.001), quality of social interaction (Coef., 0.292; P<0.001), social support (Coef., 0.237; P=0.001), physical functioning (Coef., -0.339; P<0.001), pain (Coef., 0.362; P<0.001), general health (Coef., -0.332; P<0.001), mental health (Coef., -0.537; P<0.001), social functioning (Coef., 0.202; P=0.005), vitality (Coef., -0.478; P<0.001), respectively. CONCLUSIONS: In our study, prealbumin, type 2 diabetes mellitus, heart rate, educational level, duration of hemodialysis, coronary artery disease, heart failure, marital status, hemoglobin A1C, hemoglobin were significantly associated with poorer mental health status of ESRD patients undergoing maintenance hemodialysis, and patients with poorer psychological states were more significantly associated with decreased QOL. The results may help clinicians to adopt an effective treatment for early interventions, thus improving the QOL in such population.

Evaluation of the construct reliability and validity of the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Chinese version in maintenance hemodialysis patients.

OBJECTIVE: The study aim was to assess the construct reliability and validity of the internal structure of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Self-Rated Level 1 Cross-Cutting Symptom Measure (CCSM)-Chinese version in maintenance hemodialysis (MHD) patients, and to clarify whether the CCSM is suitable for patients with psychological issues. METHODS: Participants were 190 MHD patients. Structural equation modelling was used to establish a measurement model to confirm the reliability and validity of the internal structure of the CCSM-Chinese version, and to compare it with the Chinese version of the Symptom Checklist-90 (SCL-90). RESULTS: Of the 13 CCSM domains, 8 showed stability and validity in the initial screening of psychological symptoms. Although the Chinese version of the SCL-90 is widely used, the measurement model of the 8-domain CCSM was a better fit than the SCL-90 (CCSM: chi-square = 35.668, chi-square/degrees of freedom [CMIN/df] = 1.877; root mean square error of approximation [RMSEA] = 0.061; adjusted goodness of fit index [AGFI] = 0.931 vs. SCL-90: chi-square = 89.159, CMIN/df = 2.972; RMSEA = 0.084; AGFI = 0.879). CONCLUSION: The Chinese version of the CCSM is a useful rapid screening tool to detect psychological symptom risk in MHD patients.

Effects on quality of life and psychosocial wellbeing in Chinese patients with keloids.

Keloids are defined as raised scar tissue that grows excessively and invasively beyond the original wound borders during abnormal, fibroproliferative wound healing. The effects of these lesions on quality of life (QoL) and psychosocial wellbeing have not been assessed in keloid-endemic environments such as China. The purpose of our study was to investigate the QoL and mental health status of patients with keloids in China. The Dermatology Life Quality Index (DLQI) questionnaire and the Symptom Checklist-90 (SCL-90) were used to explore the effects of keloids on patients' QoL and psychosocial wellbeing. The main scoring elements of the DLQI focused on psychological feelings, QoL, and social activities. In addition, the results of the SCL-90 revealed that scores pertaining to interpersonal relationship sensitivity, depression, and anxiety were higher in the visible scar group than in either the invisible scar group or the normal group (P < 0.05). The depression and anxiety scores in the invisible scar group were higher than those in the normal group (P < 0.05), but there were no statistically significant differences in other indices between the invisible scar group and the normal group (P < 0.05). The mental health of female patients was affected to a greater extent than in male patients (P < 0.05). Our findings suggest that psychological and clinical interventions would be beneficial for patients with keloids to improve their QoL.

Mental health status of Chinese physicians working in intensive care unit.

PURPOSE: Physicians working in intensive care unit (ICU) are prone to suffer from mental health problems, but there are still very limited data of mental health status of ICU physicians in China. Therefore, this study was to investigate their psychological status. MATERIALS AND METHODS: ICU physicians were contacted electronically and asked to complete the Symptom Check-list 90 (SCL-90) for Chinese from December 13 to December 14 in 2018. A total of 1749 valid questionnaires were collected. Fifteen potential relevant factors that could affect the mental health status of ICU physicians were also analyzed by multivariate logistic regression. RESULTS: The total mean score of SCL-90 for surveyed subjects was 175.49 ± 65.79. Near half of the respondents were identified with psychological symptoms. The pooled estimates of all the nine factors, including somatization, obsession-compulsion, interpersonal-sensitivity, depression, anxiety, hostility, phobic anxiety, and paranoid ideation among ICU physicians, were significantly higher than those in the general population (P < 0.001). Multivariate analysis revealed that education, title, working hours per week, frequency of night shift were risk factors for psychological symptoms. CONCLUSIONS: The situation of psychological health of ICU physicians in China is worrying, and it is urgent to take some effective measures to improve their mental health.

The use of the Symptom Checklist 90-R in exploring the factor structure of mental disorders and the neglected fact of comorbidity.

The Symptom Checklist 90-R (SCL-90-R) is a popular instrument, accessing nine different symptom clusters of psychopathology, although its original factor structure is widely questioned. However, most validation studies seem to ignore the possible effect of comorbidity. We aimed at validating the factor structure of the SCL-90-R and to draw additional information about the role of comorbidity in the factor structure of mental disorders. We thus introduced a comorbidity index within the SCL-90-R and validated the Greek version of the SCL-90-R in a sample of 914 participants, consisting of 688 individuals from the general population and 226 psychiatric outpatients. We showed that the original 9-factor model was superior to the second order factor and the bi-factor model. This may reflect lower comorbidity traits in our sample, rather than the accuracy of the original 9-factor structure of the SCL-90-R, which has to be further assessed by concurrent validity for each individual scale on selected samples. In this regard, we showed that the depression subscale was an excellent screening tool in a subgroup of patients with a confirmed major depressive episode.