Anticipating Unipolar Depression and Bipolar Depression in young adult with first episode of depression using childhood trauma and personality.

Objective: Relevant research focusing on young adults with Unipolar Depression (UD) and Bipolar Depression (BD) is limited. The current research aims to investigate childhood trauma and personality traits in young adults with UD and BD. Methods: Two hundred and thirty-five patients in a first depressive episode (diagnosed UD and BD), 16-25 years old, were recruited from Second Xiangya Hospital. And 79 healthy controls (HC) were recruited from the community to form the comparison group. Patients' childhood trauma was measured by the Childhood Trauma Questionnaire (CTQ), and personality was measured by Eysenck Personality Inventory (EPI). The Kruskal-Wallis test was used to compare depression, anxiety, CTQ, and EPI scores between the HC (n = 79), UD (n = 131), and BD (n = 104) groups. Factors independently associated with mood disorders and BD were determined using binary logistic regression analyses. Results: Compared with HC, mood disorders had more severe anxiety and depression symptoms, and higher CTQ. Emotional abuse (OR = 1.47; 95% CI = 1.08-2.01), emotional neglect (OR = 1.24; 95% CI = 1.05-1.46), and neuroticism (OR = 1.25; 95% CI = 1.16-1.35) were associated with significantly increased odds of mood disorders. Whereas, higher extraversion scores were a protective factor for mood disorders. Compared with UD, BD had more severe anxiety symptoms, and higher CTQ, than extraversion and neuroticism personality scores. Anxiety (OR = 1.06; 95% CI = 1.02-1.08) and extraversion (OR = 1.05; 95% CI = 1.03-1.09) were associated with significantly increased odds of BD. Conclusion: Interventions to prevent childhood trauma may improve young adults' mental health. Using childhood trauma and personality to anticipate BD and UD creates more accurate treatment for young adults with first depression.

The Association Between Suicide Attempts, Anxiety, and Childhood Maltreatment Among Adolescents and Young Adults With First Depressive Episodes.

Objective: Adolescents and young adults are susceptible to high-risk behaviors such as self-harm and suicide. However, the impact of childhood maltreatment on suicide attempts in adolescents and young adults with first episode of depression remains unclear. This study examined the association between suicide attempts and childhood maltreatment among adolescents and young adults with first depressive episodes. Methods: A total of 181 adolescents and young adults with first depressive episodes were included. The Child Trauma Questionnaire (CTQ), Beck Anxiety Inventory (BAI), and Patient Health Questionnaire-2 (PHQ-2) were used to assess childhood maltreatment and the severity of anxiety and depressive symptoms, respectively. The suicide item in the MINI-International Neuropsychiatric Interview (M.I.N.I.) 5.0 was used to assess the suicide attempts. Logistic regression analyses were used to explore the associated factors of suicide attempts. Results: The prevalence of SA in the total sample was 31.5% (95% CI = 24.9-38.1%). Multivariate logistic regression analyses revealed that the diagnosis of bipolar disorder (OR = 2.18, 95% CI = 1.07-4.40), smoking (OR = 2.64, 95% CI = 1.10-6.37), anxiety symptoms (OR = 1.05, 95% CI = 1.02-1.08), and childhood maltreatment (OR = 1.04, 95% CI = 1.01-1.07) were potential associated factors of SA. In addition, anxiety symptoms had a mediating effect on the relationship between childhood maltreatment and SA. Conclusion: Adolescents and young adults with first depressive episodes and having experiences of childhood maltreatment are at a high risk of suicide. The severity of anxiety symptoms may mediate the relation between childhood maltreatment and suicide attempts in this group of patients.

High Psychiatric Morbidity and Comorbidity Among Female Prisoners in Hunan, China.

BACKGROUND: High prevalence of mental disorders has been found among female prisoners in Western countries, however, little is known about the epidemiology of mental disorders in such populations in China. This study aims to investigate psychiatric morbidity and comorbidity among sentenced prisoners in a female prison in China. METHODS: A cluster sample of 2,703 female adult prisoners from Hunan Provincial Female Prison were interviewed with the Mini International Neuropsychiatric Interview, a semi-structured Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) mental disorder diagnostic tool. The rates of psychotic disorders, affective disorders, anxiety disorders, and substance use disorders were reported. RESULTS: Nearly 2/3 (66.2%, N=1,790) of the sample fulfilled the criteria for at least one lifetime DSM-IV disorder 36.5% had major depression, 22.2% had post-traumatic stress disorder (PTSD), and 16.5% had drug use disorder. Drug use disorders were the major comorbid disorders. 60.8% of people with alcohol use disorder and 37.0% of those with psychotic disorders also had a drug use disorder. More than one-quarter (26.1%) of the population met criteria for a current diagnosis of any mental disorder, of which major depression was the most common (14.7%), followed by PTSD (6.4%) and psychotic disorder (1.8%). CONCLUSION: The high levels of psychiatric morbidity and comorbidity in a representative sample of female prisoners in China indicate unmet needs that require identification and therapeutic intervention in prisons.

The experience of long-stay patients in a forensic psychiatric hospital in China: a qualitative study.

BACKGROUND: Long stay in forensic psychiatric hospitals is common in patients who are defined as "not criminally responsible on account of mental disorder". However, little is known about how these patients experience and perceive the long stay within these settings. The aim of this study is to explore the perception and needs of long-stay patients in forensic psychiatric hospitals in China. METHODS: In-depth semi-structured interviews were conducted with 21 participants who had lived in the forensic psychiatry hospital for more than 8 years. We used thematic analysis strategies to analyse the qualitative data. RESULTS: Participants' perceptions clustered seven themes: hopelessness, loneliness, worthlessness, low mood, sleep disturbances, lack of freedom, and lack of mental health intervention. CONCLUSIONS: The views and opinions expressed by long-stay patients showed that psychological distress is prevailing in forensic psychiatric hospitals. Adequate and effective care and mental health interventions are recommended to be tailored for their special needs.

Manic episode, aggressive behavior and poor insight are significantly associated with involuntary admission in patients with bipolar disorders.

OBJECTIVES: Serious mental illnesses, such as bipolar disorders and schizophrenia, are closely associated with involuntary admission. Many studies have focused on involuntary admission in people with schizophrenia, but little is known about the factors associated with involuntary admission in Chinese patients with bipolar disorders. This study aimed to investigate socio-demographic and clinical factors associated with involuntary admission in Chinese patients with bipolar disorders. METHODS: In this multi-center cross-sectional survey in China, a total of 155 newly admitted patients with bipolar disorders were consecutively recruited from 16 psychiatric institutions from 15 March to 14 April, 2013. Patients' socio-demographic and clinical data were collected from their medical records. The Modified Overt Aggression Scale and the Insight and Treatment Attitudes Questionnaire were used to measure patients' level of aggression and insight of current psychiatric illness. RESULTS: The prevalence of involuntary admission was 52% in this sample of Chinese inpatients with bipolar disorders. In multiple logistic regression, a high level of aggression (odds ratio (OR) = 2.48), diagnosis of manic episode (OR = 3.65), poor insight (OR = 7.52), and a low level of education (OR = 3.13) were significantly associated with involuntary admission. CONCLUSION: Manic episode, aggressive behavior, and poor insight were the significant contributing factors to involuntary admission in Chinese patients with bipolar disorders.

Mental Health Problems, History of Drug Use, and Violent Offending Are Associated With Increased Suicide Risk in Imprisoned Females.

Background: In western countries, imprisoned females are at high risk for suicide, but the risk in Chinese imprisoned females has not been well established. The aim of this study was to clarify the suicide risk and its correlates among imprisoned females in China. Methods: In this cross-sectional study, subjects were recruited from the Female Prison of Hunan province, China. A standardized questionnaire was used to collect socio-demographic and criminological data. The Suicidality module of the Mini International Neuropsychiatric Interview (MINI) 5.0 and 12-item General Health Questionnaire (GHQ-12) were used to assess suicide risk and mental health problems, respectively. Ordinal logistic regressions were used to identify independent factors associated with increased suicide risk. Results: A total of 2,709 imprisoned females completed the survey questionnaire. Twenty percent were rated as presenting suicide risk. Mental health problems [odds ratio (OR) = 1.21, 95% confidence interval (CI) = 1.00-1.47], self-reported help-seeking for mental health problems (OR = 1.69, 95% CI = 1.11-2.56), violent offending (OR = 1.69, 95% CI = 1.37-2.09), history of drug use (OR = 1.46, 95% CI = 1.15-1.84), family history of mental disorders (OR = 1.57, 95% CI = 1.10-2.23), marital status (OR = 1.29, 95% CI = 1.05-1.58), and low educational level (OR = 1.36, 95% CI = 1.11-1.67) were independently associated with increased suicide risk. Conclusion: One fifth of the imprisoned females are at risk for suicide. This study highlights the importance of assessing mental health status for suicide prevention among female prisoners.