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AIMS: Suicide attempt is an important indicator of suicide and potential future mortality. However, the prevalence of suicide attempts has been inconsistent across studies. This meta-analysis aimed to examine the prevalence of suicide attempts in individuals with schizophrenia and associated correlates. METHODS: Relevant publications in Embase, PsycINFO, PubMed, Web of science and Cochrane were systematically searched. Data on the prevalence of suicide attempts in individuals with schizophrenia were pooled using a random-effects model. RESULTS: Thirty-five studies with 16 747 individuals with schizophrenia were included. The pooled lifetime prevalence of suicide attempts was 26.8% (95% CI 22.1-31.9%; I2 = 97.0%), while the 1-year prevalence, 1-month prevalence and the prevalence of suicide attempts from illness onset were 3.0% (95% CI 2.3-3.7%; I2 = 95.6%), 2.7% (95% CI 2.1-3.4%; I2 = 78.5%) and 45.9% (95% CI 42.1-49.9%; I2 = 0), respectively. Earlier age of onset (Q = 4.38, p = 0.04), high-income countries (Q = 53.29, p < 0.001), North America and Europe and Central Asia (Q = 32.83, p < 0.001) were significantly associated with a higher prevalence of suicide attempts. CONCLUSIONS: Suicide attempts are common in individuals with schizophrenia, especially those with an early age of onset and living in high-income countries and regions. Regular screening and effective preventive measures should be implemented as part of the clinical care.

BACKGROUND: Hyperprolactinaemia is a common adverse effect of antipsychotics (APs). The results of Peony-Glycyrrhiza decoction (PGD) as a potentially useful adjunctive treatment for hyperprolactinaemia are inconsistent. AIM: This meta-analysis of randomised controlled trials (RCTs) examined the efficacy and safety of adjunctive PGD therapy for AP-induced hyperprolactinaemia. METHODS: English (PubMed, Embase, Cochrane Library, PsycINFO) and Chinese (Chinese National Knowledge Infrastructure, Wanfang Data) databases were systematically searched up to 10 June 2018. The inclusion criteria were based on PICOS-Participants: adult patients with schizophrenia; Intervention: PGD plus APs; Comparison: APs plus placebo or AP monotherapy; Outcomes: efficacy and safety; Study design: RCTs. The weighted mean difference (WMD) and risk ratio (RR) along with their 95% CIs were calculated using Review Manager (RevMan) V.5.3 software. RESULTS: Five RCTs (n=450) were included and analysed. Two RCTs (n=140) were double-blind and four RCTs (n=409) reported 'random' assignment with specific description. The PGD group showed a significantly lower serum prolactin level at endpoint than the control group (n=380, WMD: -32.69 ng/mL (95% CI -41.66 to 23.72), p<0.00001, I 2 =97%). Similarly, the superiority of PGD over the control groups was also found in the improvement of hyperprolactinaemia-related symptoms. No difference was found in the improvement of psychiatric symptoms assessed by the Positive and Negative Syndrome Scale (n=403, WMD: -0.62 (95% CI -2.38 to 1.15), p=0.49, I 2 =0%). There were similar rates of all-cause discontinuation (n=330, RR 0.93 (95% CI 0.63 to 1.37), p=0.71, I 2 =0%) and adverse drug reactions between the two groups. According to the Grading of Recommendations Assessment, Development and Evaluation approach, the level of evidence of primary and secondary outcomes ranged from 'very low' (14.3%), 'low' (42.8%), 'moderate' (14.3%), to 'high' (28.6%). CONCLUSIONS: Cur

BACKGROUND: Electroconvulsive therapy (ECT) has been widely used in treating older adult patients with major depressive disorder. The results of randomized controlled trials (RCT) are mixed. This study systematically examined the efficacy and safety of ECT versus antidepressants (AD) in older adult patients with major depressive disorder. METHODS: A literature search was conducted independently by two reviewers using the PubMed, Embase, PsycINFO, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang, and SinoMed databases from their inceptions until 17 May 2017. The Cochrane risk of bias and Jadad scale were used to assess the quality of RCT included in the systematic review. RESULTS: Five RCT (n = 374; mean age: 66.0-66.4 years; men: 36.4-58.3%) all conducted in China were identified, including three RCT (n = 203) with ECT alone and two RCT (n = 171) with ECT-AD co-treatment. In two of the three RCT, ECT alone was superior to AD monotherapy in improving depressive symptoms as assessed by the Hamilton Depression Scale and by clinical judgement at the conclusion of the course of ECT. Both RCT of AD-ECT co-treatment showed a significant reduction in the Hamilton Depression Scale total score after ECT compared with AD monotherapy. The response rate ranged from 80% to 97.5% in the ECT groups and from 63.4% to 73.3% in the AD groups. Rates of adverse reactions were similar between ECT and AD groups in studies with available data. Only one RCT reported the discontinuation rate without a significant group difference. CONCLUSIONS: This systematic review showed that ECT appears to be an effective and safe treatment for older adult patients with major depressive disorder. Further high-quality studies with extended follow-up are warranted.

Little is known about the association between schizophrenia and violence in women in China. This study aimed to examine the association between schizophrenia and violence in Chinese female offenders. Fifty-two schizophrenia patients were identified from the female offenders who received forensic psychiatric assessments in 2011 in Hunan province, China. Using a propensity score matching method, 104 matched controls without psychiatric disorders were selected from female criminals in Hunan province. Violent offences and homicides were verified and recorded. The percentages of violent offences and homicides were significantly higher in female offenders with schizophrenia than in controls (78.8% vs. 30.8%, P < 0.001; 44.2% vs. 18.3%, P = 0.001, respectively). Multivariate logistic regression analyses revealed that diagnosis of schizophrenia, younger age at first offence, living in rural area and a lower education level were independently and positively associated with violent offences, while having a diagnosis of schizophrenia and lower education level were associated with homicides. There appears to be an independent and positive association between schizophrenia and violent offence in Chinese female offenders. Effective preventive approaches on violence in female schizophrenia patients are warranted.

The surface of an annealed Cu plate was processed by a high pressure surface rolling (HPSR) process. It is found that the deformed surface layer in the Cu plate after HPSR can be as thick as 2 mm and is characterized by a gradient microstructure, with grain sizes varying from the nanoscale in the topmost surface to the microscale in the bulk. The hardness varies from 1.37 GPa at the topmost surface to about 0.6 GPa in the coarse-grained matrix. The results of the investigation demonstrate that the HPSR process shows good potential for the generation of thick gradient microstructures on the surface of bulk metallic materials.

A new collisional-radiative model for atmospheric-pressure low-temperature argon discharges is proposed, which illustrates the significant effect of electron density on the excited atom population distribution. This makes it possible to determine the electron density from the intensity ratio of emission lines of excited atoms. Results of this new method in several types of atmospheric-pressure discharges are found to be in agreement with those of the Stark broadening method and the electric model over a wide electron density range 1011-1016 cm-3.