Clinical efficacy, onset time and safety of bright light therapy in acute bipolar depression as an adjunctive therapy: A randomized controlled trial.

BACKGROUND: Bright light therapy (BLT) is an effective treatment for seasonal affective disorder and non- seasonal depression. The efficacy of BLT in treating patients with bipolar disorder is still unknown. AIMS: The aim of this study is to examine the efficacy, onset time and clinical safety of BLT in treating patients with acute bipolar depression as an adjunctive therapy (trial registration at ClinicalTrials.gov: NCT02009371). METHODS: This was a multi-center, single blind, randomized clinical trial. Seventy-four participants were randomized in one of two treatment conditions: BLT and control (dim red light therapy, dRLT). Sixty-three participants completed the study (33 BLT, 30 dRLT). Light therapy lasted for two weeks, one hour every morning. All participants were required to complete several scales assessments at baseline, and at the end of weeks 1 and 2. The primary outcome measures were the clinical efficacy of BLT which was assessed by the reduction rate of HAMD-17 scores, and the onset time of BLT which was assessed by the reduction rate of QIDS-SR16 scores. The secondary outcome measures were rates of switch into hypomania or mania and adverse events. RESULTS: 1) Clinical efficacy: BLT showed a greater ameliorative effect on bipolar depression than the control, with response rates of 78.19% vs. 43.33% respectively (p < 0.01). 2) Onset day: Median onset day was 4.33 days in BLT group. 3) BLT-emergent hypomania: No participants experienced symptoms of hypomania. 4) Side effects: No serious adverse events were reported. CONCLUSION: BLT can be considered as an effective and safe adjunctive treatment for patients with acute bipolar depression.

Drug therapy versus electroconvulsive therapy for refractory schizophrenia: report of a case with 14 years of follow-up.

The long-term efficacy and safety of electroconvulsive therapy (ECT) for refractory schizophrenia is rarely reported. We report the case of a 38-year-old female patient with refractory schizophrenia who was treated with ECT for 14 years (from 24 years of age). Case records of clinical treatment and laboratory tests are described and analyzed. During the first 11 years, the patient was treated with ECT as an adjunct to antipsychotic drugs, but the effectiveness was unstable. For the remaining 3 years she was treated with antipsychotic drugs as an adjunct to ECT and her condition stabilized as she gradually recovered social function. We summarize the clinical characteristics, therapy regimen, long-term effectiveness, and safety of this interesting case.

[Recognition of depression and related risk factors among non psychiatric doctors in tertiary general hospital outpatients in Beijing].

OBJECTIVE: To explore the level of identification and related factors of depression in physicians of Beijing tertiary general hospitals. METHODS: A cross-sectional investigation was used to screen the outpatients, and depression was diagnosed according to Mini International Neuropsychiatric Interview (MINI). Identification of depression was defined as referral to psychiatrist or managed with antidepressant or sedative hypnotics. RESULTS: Among 248 cases of depression, 30 (12.1%) were referred to psychiatrists, 28(8.9%) managed with antidepressant or sedative hypnotics. The identification rate of depression by physicians was 21.0%, and the identification rate by neurologist was 40.4%, which is higher than the rate by cardiologist (22.4%), gastrointestinal physician (3.8%) and gynecologist (2.0%) (χ2=61.077, P<0.05). Visiting neurology department, severity of life impairment, with psychotic distress history, had psychological complaints, co-morbidity with anxiety related to the physician's identification of depression. Among the psychological complaints, only mood disorder and insomnia were related to the physician's identification of depression. CONCLUSIONS: The level of depression identification by physician was low, the level of neurologist was higher than that of cardiologist, gastrointestinal physician and gynecologist. The patient with serious life impairment, psychotic distress history, mood disorder and insomnia complaints was easily to be identified.

Relationships of sleep duration with sleep disturbances, basic socio-demographic factors, and BMI in Chinese people.

OBJECTIVE: This study aimed at determining the mean total sleep time (TST) and the relationship between sleep duration and basic socio-demographic factors and BMI sleep problems in Chinese subjects. METHOD: A total of 5926 subjects were randomly selected and interviewed using standardized assessment tools. RESULTS: The reported mean TST was 7.76 h. Short sleepers were significantly older than medium and long sleepers. There were more urban residents who were short sleepers than medium and long sleepers. Short sleepers reported more sleep problems than medium and long sleepers. Short and long sleepers reported more psychiatric disorders than medium sleepers in both sexes, and short sleepers also had more major medical conditions in women. Short sleepers had a lower BMI than medium and long sleepers after controlling for the effects of age and psychiatric disorders in women. CONCLUSIONS: Nationwide epidemiologic surveys in China are needed to further explore the relationship between sleep duration and sleep problems.

Generalized anxiety disorder in China: prevalence, sociodemographic correlates, comorbidity, and suicide attempts.

PURPOSE: This study aims to determine the 12-month and lifetime prevalence of generalized anxiety disorder (GAD) and its sociodemographic correlates. DESIGN AND METHODS: A total of 5,926 subjects were randomly selected and interviewed. FINDINGS: The overall 12-month and lifetime prevalence of GAD was 0.8%, and 1.2%, respectively. Being older than 25 years and female, lower education level, unemployed status, and lower (RMB2000/month) monthly income were associated with increased risk of GAD. PRACTICE IMPLICATIONS: The low percentage of subjects treated for GAD indicates a major public health problem that should be addressed.

Alcohol-related disorders in Beijing, China: prevalence, socio-demographic correlates, and unmet need for treatment.

BACKGROUND: The study aimed to determine the prevalence of alcohol use, episodic heavy drinking, and alcohol dependence and their socio-demographic correlates in Beijing, China. methods: A total of 5,926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview (CIDI 1.0). Data on basic socio-demographic and current major medical conditions were also collected. RESULTS: The 12-month prevalence of alcohol use and episodic heavy drinking were 32.5 and 13.8%, respectively. The 12-month and lifetime prevalence of alcohol dependence were 1.7 and 4.3%, respectively. Age above 24 years, male sex, being married and employed, low education level (junior high school, primary school or illiterate), rural residence, and having comorbid psychiatric disorders were all significantly associated with a higher likelihood of alcohol-related disorders. Only 2.4% of the subjects with alcohol dependence were receiving treatment, and a mere 1.4% had sought treatment from mental health professionals. CONCLUSIONS: Nationwide surveys are urgently needed to further explore the prevalence of alcohol-related disorders in China.

Lifetime prevalence of suicidal ideation, suicide plans and attempts in rural and urban regions of Beijing, China.

OBJECTIVE: There has been no large-scale survey of suicide-related behaviours including suicidal ideations, plans and attempts in China involving both rural and urban areas and using standardized assessment tools. The aim of the present study was to determine the lifetime prevalence of suicide-related behaviour and its relationship with sociodemographic factors and psychiatric disorders in the rural and urban regions of Beijing, China. METHODS: A total of 5926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview. Basic sociodemographic and clinical data and data on suicide-related behaviour were also collected. RESULTS: The overall lifetime prevalence estimates of suicidal ideation, plans and attempts were 2.3%, 1.4%, and 1.0%, respectively; the corresponding figures were 2.8%, 1.6%, and 1.3% in the rural sample, and 1.8%, 1.3%, and 0.9% in the urban sample. Age (>25 years), female sex, unmarried status, lower education level, lower (RMB2000 month(-1)) monthly income and presence of major medical disorders were significantly associated with increased risk of suicide-related behaviour. 36.2% of subjects with suicide-related behavior consulted a medical practitioner and 20.7% consulted a psychiatrist. CONCLUSIONS: The prevalence of lifetime suicide-related behaviour in Beijing is lower than in Western countries, but the low percentage of subjects treated for suicide-related behaviour indicates a major public health problem that should be addressed. National surveys are needed to further explore the prevalence of suicide-related behaviour in China.

Prevalence and socio-demographic correlates of major depressive episode in rural and urban areas of Beijing, China.

OBJECTIVE: This study aimed to determine the 12-month and lifetime prevalence of major depressive episode (MDE) and their socio-demographic correlates in both the urban and rural areas of Beijing, China. METHODS: A total of 4767 adults were randomly selected and interviewed in Beijing using the Composite International Diagnostic Interview (CIDI 1.0). Basic socio-demographic and clinical data were collected during the interviews. RESULTS: The overall 12-month prevalence of MDE was 3.2%; 2.8% and 3.8% for men and women, respectively. The overall lifetime prevalence of MDE was 5.3%; 4.4% and 6.3% for men and women, respectively. Being older than 25 years of age was independently associated with increased risk of MDE. Sixteen point three percent of the subjects with lifetime MDE attempted suicide while the rate of suicide attempts was only 0.2% in subjects without MDE. The percentage of subjects with MDE who received any type of treatment from medical practitioners was 33.1%; of them, only 5.4% sought help from mental health professionals. CONCLUSIONS: National epidemiologic surveys are needed to further explore the prevalence of MDE in China. The low percentage of subjects treated for MDE constitutes a major public health problem that should be urgently addressed.

Smoking and psychiatric disorders in the rural and urban regions of Beijing, China: a community-based survey.

BACKGROUND: In China, there is limited information on smoking and its socio-demographic correlates in general, and in psychiatric patients in particular. The aim of this study was to determine the prevalence of lifetime, current mild, and heavy smoking, the socio-demographic correlates of current smoking, and its relationship with psychiatric disorders in the Beijing municipality, China. METHODS: A total of 5926 subjects who met the study's entry criteria were randomly selected from the urban and rural areas of Beijing and interviewed using standardized assessment tools, including the collection of basic socio-demographic and clinical data. All subjects fully cooperated in the interviews and readily disclosed all of the information. RESULTS: The prevalence of lifetime smoking was 35.9%; the rates for current mild and heavy smoking were 21.8% and 10.8%, respectively. An age of 24 years or above, male sex, married, divorced, separated or widowed marital status, relatively low level of education (less than college level), being employed, a relatively high monthly income (more than RMB500), rural abode, and having a psychiatric disorder were risk factors of current smoking. Both current mild and heavy smoking were significantly associated with alcohol dependence, and current heavy smoking was also associated with a history of a major depressive episode. CONCLUSIONS: The prevalence of smoking in the rural and urban areas of Beijing is unacceptably high. In addition to certain socio-demographic factors, smoking was associated with common psychiatric disorders. Nationwide surveys are warranted to further explore the prevalence of smoking in China. Effective strategies to reduce the high rate of smoking are also needed.

The prevalence of insomnia, its sociodemographic and clinical correlates, and treatment in rural and urban regions of Beijing, China: a general population-based survey.

STUDY OBJECTIVES: To determine the prevalence of insomnia, its sociodemographic and clinical correlates, and treatment patterns in Chinese people. DESIGN: A total of 5,926 subjects were randomly selected in the urban and rural areas of Beijing and interviewed using standardized assessment tools. Basic sociodemographic and clinical data were also collected. SETTING: Urban and rural regions of Beijing municipality, China. Patients or Participants Adult residents older than 15 years. Interventions N/A. MEASUREMENTS AND RESULTS: The prevalence of at least one type of insomnia was 9.2%; the rates of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 7.0%, 8.0%, and 4.9%, respectively. Increased age (age >44 and 24 years in the urban and rural samples, respectively), female sex, married, divorced, separated, or widowed marital status; having a major medical condition; and suffering from a psychiatric disorder were risk factors for all types of insomnia in both the urban and rural samples. A low level of education (primary school or illiteracy) was significantly associated with a higher likelihood of all types of insomnia in the urban sample. Current smokers and current drinkers were less likely to report any type of insomnia in the rural sample. Unemployment was associated with DMS in the urban sample, while it was associated with DIS and DMS in the rural sample. Only 5.4% of the participants with any type of insomnia reported their symptoms to medical practitioners. In contrast, nearly one-third of the subjects with insomnia reported taking benzodiazepines as sleep-enhancing drugs. CONCLUSIONS: Nationwide epidemiologic surveys are needed to further explore the prevalence of insomnia in China. The low percentage of subjects treated for insomnia indicates a major public health problem that should be addressed. Strict controls on use of benzodiazepines are warranted.

Prevalence and socio-demographic correlates of schizophrenia in Beijing, China.

OBJECTIVE: There has been no large-scale survey of schizophrenia in China involving both rural and urban areas using standardized assessment tools and diagnostic criteria. This study aimed to determine the lifetime prevalence of schizophrenia and its socio-demographic correlates in Beijing, China. METHODS: A total of 5926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview (CIDI 1.0). Basic socio-demographic and clinical data were collected during the interviews. RESULTS: The lifetime prevalence of schizophrenia was 0.49%, and 0.44% and 0.55% for men and women, respectively. Unmarried status, lower monthly income, urban abode and positive family history were associated with an increased risk of schizophrenia; 9.7% of the subjects with lifetime schizophrenia reported a history of suicide attempts. The percentage of subjects with schizophrenia who were receiving treatment and their preference to seek treatment from mental health professionals were 58% and 29%, respectively. CONCLUSIONS: National surveys are urgently needed to further explore the prevalence of schizophrenia in China. The low percentage of subjects treated for schizophrenia is a serious public health issue that should be addressed in the near future.

[Investigation on mental health of residents living in a mineral area in Hubei province].

OBJECTIVE: To study the effect of mining operations on the mental health of residents living in a mining area in Hubei province. METHODS: Villagers (n = 93) living in the mining area were compared with a control group of residents (n = 101) in mental health status, and knowledge of environment and health. The mental health status of villagers was assessed using the Symptom Checklist 90 (SCL-90), State-Trait Anxiety Inventory (STAI); The knowledge of environment and health was evaluated using a self-designed questionnaire. The urine and hair samples were collected from some subjects. The lead, cadmium, arsenic, copper and zinc contents were detected as well as the total protein, NAG, d-ALA in the urine. RESULTS: The occurrence rate of lead, cadmium, arsenic exposure symptoms was significantly higher in the exposed group than in the control group. The urine cadmium, the hair cadmium, the hair arsenic and hair lead were significantly higher in the exposed group than in the control group (P < 0.05). The positive symptom detection rate of SCL-90 in the exposed group was 8.60% compared with 0.99% of the control group. For the SCL-90, the total scale, somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, paranoid ideation, psychoticism, other symptom in the exposed groups were significantly higher than those in the control group (P < 0.05), indicating the status of the psychological hygiene of the exposed group was worse than the control group. The total S-AI (anxiety) score and the sex-specific value in the exposed group were higher than the control group (P < 0.05, P < 0.01), which showed that the anxiety of the exposed group was more evident. The total T-AI score and the sex-specific value in women of the exposed group were significantly higher than the control group (P < 0.01), showing that the anxiety were more significant in the exposed group, especially the women of the exposed group. CONCLUSION: The mental health status of the residents who living in a mining area is affected and they have a higher S-AI and T-AI scale than those living a non-mining area.

[Characteristics of infrasound and its influence on workers in working environment of certain thermoelectricity works and department].

OBJECTIVE: To study the characteristics of infrasound and its effects on the workers at power plants. METHODS: The audible noise and infrasound in three thermoelectricity plants were measured and by using Symptom Checklist 90 (SCL-90), the subjective sensation, and the physiological indices were compared between exposed workers and controls. RESULTS: The infrasound levels were different at different measure sites of the three thermoelectricity works ranging from 40 to 98 dB. There was still 40 approximately 80 dB infrasound even when the soot blower stopped running. Different apparatus produced different infrasound levels with the highest ranging from 62 to 115 dB. A single frequency (16 Hz) infrasound was produced in certain department during working hour with sound pressure levels of 110 to 120 dB, but the audible noise sound pressure level was less than 70 dB. There was no significant difference in the indices representing vision fatigue and neurobehaviour function between exposed workers and controls. Workers at certain department experienced evident subjective sensation of neurobehavioral dysfunction, and the scores of somatization, depression, hostility, phobic anxiety, and psychotism in the SCL-90 were significantly higher in the exposed group than in the control and the norm in China (P < 0.05). CONCLUSION: Infrasound is ubiquitous in the working environment, but usually, the noise levels are less than 120 dB. In some special production department, there is persistent infrasound above 110 to 120 dB. No obvious health effects are found among those who are exposed to infrasound below 100 dB. However, the workers who are chronically exposed to infrasound above 110 to 120 dB present notable subjective sensation of autonomic neurobehavioral dysfunction, and their psychological health status is not as good as those in the control and those in the domestic normal pattern.

[Effects of infrasound on activities of 3beta hydroxysteroid dehydrogenase and acid phosphatase of polygonal cells in adrenal cortex zona fasciculate in mice].

OBJECTIVE: To explore the biological effects of infrasound on the polygonal cells in adrenal cortex zona fasciculation in mice. METHODS: The biological effects of infrasound on the activities of 3beta hydroxysteroid dehydrogenase (3-betaHSDH) and acid phosphatase(ACP) of the polygonal cells in adrenal cortex zona fasciculate were observed when exposure to 8 and 16 Hz infrasound at 80, 90, 100, 110, 120 and 130 dB for 1 day, 7 days and 14 days or 14 days after the exposure. RESULTS: When exposure to 8 Hz infrasound, the enzyme activities of 3-betaHSDH increase as the sound pressure levels increase. Only when the sound pressure levels reach 130 dB, the enzyme activities began to decrease exceptionally. When exposure to 16 Hz, 80 dB infrasound, no significant difference between the treatment and control group in the activities of 3-betaHSDH could be observed, but the injury of the polygonal cells had appeared. When exposure to 16 Hz, 100 dB infrasound, the activities of 3-betaHSDH started to increase. The cell injury still existed. When exposed to 16 Hz, 120 dB infrasound, the local tissue damage represented. Fourteen days after the mice exposure to 8 Hz, 90 dB and 130 dB infrasound for 14 days continuously, the local tissue injury of the adrenal cortex zona fasciculation began to recover at certain extent, but the higher the exposure sound pressure level, the poorer the tissue recovery. CONCLUSION: The biological effects of infrasound on the polygonal cells in adrenal cortex zona fasciculation response to the frequency of the infrasound are found at certain action strength range, but this characteristic usually is covered by the severe tissue injury. When exposure to infrasound is stopped for a period of time, the local tissue injury of the adrenal cortex zona fasciculation could recovers at certain extent, but the higher the exposure sound pressure level, the more poorer the tissue recovery.

[Study on the psychosocial status and related factors in three universities during severe acute respiratory syndrome epidemic in Beijing].

OBJECTIVE: To investigate the psychosocial status and related factors among university students during severe acute respiratory syndrome (SARS) epidemic in Beijing. METHODS: By means of stratified cluster sampling, symptom checklist-90 (SCL-90) and questionnaire on general information were applied among 6800 students in three universities in Beijing. RESULTS: There were 6280 valid questionnaires gathered. In order to control and prevent SARS, strict management was conducted in three universities which providing various social supports. Out of the 6280 students, 460 had SCL-90 positive symptoms with a rate of 7.3%. Risk factors of SCL-90 positive symptom were found as follows: major in arts (OR = 2.00), misconception on the control and prevention of SARS (OR = 1.91), considering measures non-effective (OR = 2.25), and do not believe that SARS can be under control (OR = 3.57). Protective factors of SCL-90 positive symptom would include as: being female (OR = 0.77), being graduate students (OR = 0.38), and being not much influenced on study and daily life during the period of strict management (OR = 0.54). CONCLUSION: Psychosocial status of students was influenced by their knowledge and attitude on SARS. Various social supports might keep the university students to having a healthy psychosocial status.