Adverse childhood experiences and risk of diabetes: A systematic review and meta-analysis.

Background: The association between adverse childhood experiences (ACEs) and diabetes is unclear. This systematic review and meta-analysis aims to quantify the association between the number and types of ACEs and diabetes during adulthood based on available observational studies. Methods: A comprehensive literature search of studies exploring the association between ACEs and diabetes was conducted in PubMed, Medline, and Embase databases until 15 April 2022. A random-effects model was used to pool odds ratios (ORs) and 95% confidence intervals (CIs) for the number and types of ACEs with diabetes. Regarding the association between the number of ACEs and diabetes, we used funnel plots to examine publication bias, subgroup analysis to explore sources of heterogeneity, and sensitivity analysis to explore the robustness of the pooled results. Results: A total of 49 studies were included. Individuals with higher continuous ACEs (per each additional ACE: OR = 1.06, 95% CI = 1.02-1.10), any ACE (OR = 1.22, 95% CI = 1.16-1.28), or ≥4 ACEs (OR = 1.44, 95% CI = 1.27-1.63) were at an increased risk of diabetes in adulthood when compared with individuals without ACEs. Across specific ACE types, childhood economic adversity (OR = 1.11, 95% CI = 1.04-1.19), physical abuse (OR = 1.14, 95% CI = 1.07-1.21), sexual abuse (OR = 1.25, 95% CI = 1.12-1.39), verbal abuse (OR = 1.11, 95% CI = 1.03-1.20), and incarceration (OR = 1.22, 95% CI = 1.03-1.45) were associated with diabetes. However, neglect, emotional abuse, domestic violence, parental divorce or separation, parental death, and living with a family member with substance abuse or mental disorders were not significantly associated with diabetes. Conclusions: Individuals with ACEs may have a cumulative risk for diabetes in adulthood. It is critical to prevent ACEs and build resilience in individuals affected by ACEs.

Prevalence and risk factors of post-traumatic stress disorder among adult survivors six months after the Wenchuan earthquake.

PURPOSE: Exposure to earthquake has been associated with psychological distress, in particular, the development of posttraumatic stress disorder (PTSD). The aims of this study were to estimate the prevalence of PTSD, explore the associated risk factors among adult survivors 6 months after the Wenchuan earthquake in China, and compare the findings in our study to other studies about the Wenchuan earthquake and other earthquakes that occurred in the past. METHODS: Multistage stratified random sampling methods were conducted in three severely affected areas in the Wenchuan earthquake. In this study, 14,798 individuals were identified with simple random selection methods at the sampling sites, 14,207 individuals were screened with the 12-item General Health Questionnaire(GHQ-12), and 3692 individuals were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders (SCID-I/P) by 180 psychiatrists. RESULT: The prevalence of PTSD was 15.57%. The risk factors for PTSD included old age, female gender, living alone, buried in the earthquake, injured in the earthquake, operated on after the earthquake, witnessing someone get injured in the earthquake, witnessing someone get buried in the earthquake, witnessing someone die in the earthquake (P<0.05, 95% CI). CONCLUSION: PTSD is common after a major disaster. Risk factors help people to identify the potential victims after disasters in time. Post-disaster mental health recovery interventions include early identification, sustained psychosocial support, governmental programs that provide social and economic support.

Risk factors of mental illness among adult survivors after the Wenchuan earthquake.

PURPOSE: This study was to analyze the mental health status of the adults from the areas struck by the Wenchuan earthquake, to understand the factors that may have impact on their mental health after they were exposed to the earthquake, to obtain information specifically relevant to further research and future preventive measures. METHODS: We used multistage stratified random sampling methods in three areas that were severely damaged in the Wenchuan earthquake, Sichuan Province, China. For this study, 14,798 individuals were identified with simple random selection methods at the sampling sites, 14,207 were screened with the 12-item General Health Questionnaire (GHQ-12), and 3,692 individuals were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by 180 investigators. RESULTS: The risk factors for post-traumatic stress disorder included old age, female gender, low school education and witness someone die in the earthquake (P < 0.05, 95 % CI). The risk factors for anxiety disorder included old age, female gender, low school education, living alone and witness someone die in the earthquake (P < 0.05, 95 % CI). The risk factors for depression included old age, female gender, low school education and living alone (P < 0.05, 95 % CI). CONCLUSIONS: Given inadequate knowledge and practices concerning the mental health of disaster victims in China, the information provided by this study is useful for directing, strengthening, and evaluating disaster-related mental health needs and interventions after the earthquake.

Altered regional homogeneity in post-traumatic stress disorder: a resting-state functional magnetic resonance imaging study.

OBJECTIVE: Little is known about the brain systems that contribute to vulnerability to post-traumatic stress disorder (PTSD). Comparison of the resting-state patterns of intrinsic functional synchronization, as measured by functional magnetic resonance imaging (fMRI), between groups with and without PTSD following a traumatic event can help identify the neural mechanisms of the disorder and targets for intervention. METHODS: Fifty-four PTSD patients and 72 matched traumatized subjects who experienced the 2008 Sichuan earthquake were imaged with blood oxygen level-dependent (BOLD) fMRI and analyzed using the measure of regional homogeneity (ReHo) during the resting state. RESULTS: PTSD patients presented enhanced ReHo in the left inferior parietal lobule and right superior frontal gyrus, and reduced ReHo in the right middle temporal gyrus and lingual gyrus, relative to traumatized individuals without PTSD. CONCLUSION: Our findings showed that abnormal brain activity exists under resting conditions in PTSD patients who had been exposed to a major earthquake. Alterations in the local functional connectivity of cortical regions are likely to contribute to the neural mechanisms underlying PTSD.

Retrospective analysis of treatment effectiveness among patients in Mianyang Municipality enrolled in the national community management program for schizophrenia.

BACKGROUND: Over the last six years China has developed the largest community-based service network for persons with serious mental illness in the world (the '686 Project') but the effectiveness of this program has not been assessed in detail. AIM: Compare the characteristics of patients with schizophrenia enrolled in the program whose clinical status has improved with the characteristics of patients whose clinical status has not improved. METHODS: The records of 3090 patients with schizophrenia in Mianyang Municipality, Sichuan (a community with 60% rural residents) who participated in the 686 Project at any time during 2011 were extracted from the national electronic registry system for the project and the demographic and treatment characteristics of individuals rated by treating clinicians as 'recovered' or 'improved' at the time of their last evaluation in 2011 (n=1866) were compared to those of patients rated as 'unchanged' or 'worsened' (n=1224). The factors considered included gender, age, ethnicity, occupation, education, family economic status, marital status, family history of mental illness, duration of illness, time of enrolled in the 686 Program, and adherence to medication. RESULTS: In the univariate analysis there were significant differences between the two groups in all variables considered except for gender, ethnicity, and family history of mental illness. The recorded treatment outcome was better in patients who were younger, who had a shorter duration of illness, who were more educated, who came from better-off families, who were more adherent to treatment and who had participated in the program for a shorter period of time. Logistic regression analysis found that patients classified as unchanged or worsened were more likely to be non-adherent to drug treatment, to come from families living below the local poverty line, and to be enrolled in the 686 Program for a longer period of time. CONCLUSION: Poor treatment adherence and poverty seriously limit the effectiveness of the 686 Program. New approaches to improving adherence and for providing basic financial support to families with a mentally ill member will be needed to enhance the efficacy of the program.

Child sexual abuse, coping strategies and lifetime posttraumatic stress disorder among female inmates.

The purpose of the study was to assess the relationship between child sexual abuse (CSA) and posttraumatic stress disorder (PTSD) in female inmates in China. A total of 471 participants were assessed for CSA, personality traits, coping strategies, and frequency of lifetime PTSD. Results demonstrated that CSA and negative coping were predictive factors for lifetime PTSD among female inmates after personality traits were controlled. The findings suggest that CSA is one potential factor contributing to lifetime PTSD among female inmates. The importance of screening for CSA among female inmates was highly emphasized. Early intervention and prevention programmes based on coping skills may be useful to forestall the development of chronic PTSD in female inmates.

A family-based association study of PLP1 and schizophrenia.

Recently, proteolipid protein 1 (PLP1) has been identified as downregulated in schizophrenia by quantitative PCR and other technologies. In this work we attempted to investigate the role of PLP1 in the etiology of schizophrenia using a family based association study in 487 Chinese Han family trios. The TDT for allelic association demonstrated that, in male, a weak association was detected in SNP rs475827 with p=0.0294, suggesting that the genetic polymorphisms within PLP1 in male are likely to confer an increased susceptibility to schizophrenia in the Chinese population.