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Accessible Summary: What is known on the subject?: Physical restraint is widely used in the elderly at home, and cognitive impairment is an important risk factor. Family caregivers of people with dementia are the main decision makers and implementers of physical restraint at home.Most people with dementia in China receive home care, and family caregivers face enormous care and moral pressures influenced by Confucian culture.Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. There is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. What the paper adds to existing knowledge?: Many family caregivers face approach – avoidance conflict and moral dilemmas when making decisions to restrain, and they make difficult choices in these dilemmas.In China, family caregivers are influenced by many unique factors, including traditional Confucian culture, family affection, and rural home environment.Inadequate laws and policies provide the ground for abuse of physical restraints, and family caregivers rarely consider legal and policy restrictions when using physical restraints. What are the implications for practice?: With limited medical resources, nurse‐led dementia management is the hope to reduce physical restraints in home.Mental health nurses need to assess for the appropriateness of physical restraints associated with psychiatric symptoms in people with dementia.At both organizational and community levels, improving effective communication and relationships between professionals and family caregivers are important to address. Improvements in this context require education and time for staff to develop skills and experience which is necessary to provide family caregivers with ongoing information and psychological support within their communities.Considering Confucian culture will be of value for mental health nurses working in other countries where there are Chinese communities to better understand perceptions of family caregivers. Introduction: The use of physical restraints is a common practice in home care. Family caregivers face care‐related and moral pressures due to the influence of Confucian culture in China. The use of physical restraints in the Chinese cultural environment may differ from the use of such restraints in other cultures. Scientific Rationale: Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. However, there is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. Aim: To explore the perceptions of family caregivers on physical restraints in people diagnosed with dementia receiving home care. Method: A descriptive, qualitative study of Chinese family caregivers of people diagnosed with dementia in home care. Framework method analysis was adopted using the multilevel socio‐ecological model. Results: Beliefs about benefit lead to a dilemma for family caregivers. Cherishing family's affection encourages caregivers to reduce physical restraints, but lack of help from family members, professionals and the community forces them to restrain their loved ones. Discussion: Future research should explore the complex issue of culturally specific physical restraints decisions. Implications for Practice: Mental health nurses must receive education regarding the negative outcomes of the use of physical restraints for family members of people diagnosed with dementia. A more liberal approach to mental health and relevant legislation, which is an emerging global phenomenon that is currently in an early phase of development in China, grants human rights to people diagnosed with dementia. Effective communication and relationships between professionals and family caregivers can contribute to the establishment of a dementia‐friendly community in China. [ABSTRACT FROM AUTHOR]

The present study investigates the role of Taiwanese psychiatrists in turning neurasthenia into a culture-specific disease in the late twentieth century. It first delineates the shift in both explanatory models of psychoneuroses and patient population in post-World War II Taiwan. Neurasthenia became a focus of international attention in the 1970s and 1980s with the advance of cultural psychiatry, and, as China was closed to the outside world, Taiwanese psychiatrists were influential in framing the cultural meaning of neurasthenia. With the rise of post-socialist China, Taiwan lost its status as a key laboratory of Chinese studies. This paper argues that the history of neurasthenia during the period was closely associated with the professional development and national identity of Taiwanese psychiatrists. [ABSTRACT FROM AUTHOR]

The China Mental Health Survey (CMHS) is the first nationally representative community survey on mental disorders and mental health services in China. One-step diagnoses for mood disorders, anxiety disorders and substance use disorders were obtained using the Composite International Diagnostic Interview-3.0 (CIDI-3.0), according to the criteria and definition of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). A two-step procedure was applied for schizophrenia and other psychotic disorders, using psychosis screening section in CIDI-3.0 as a screening instrument and the Structured Clinical Interview for DSM-IV Axis I disorders (SCID) as a diagnostic tool. Dementia was diagnosed by the 10/66 dementia diagnosis package in a two-step design. The main aims of the CMHS were: (1) to investigate the prevalence of mood disorders, anxiety disorders, substance use disorders, schizophrenia and other psychotic disorders, and dementia; (2) to obtain data of service use of individuals with mental disorders in China; and (3) to analyse the social and psychological risk factors or correlates of mental disorders and mental health services. This paper presents a brief review of the background of the CMHS, its aims and measures. [ABSTRACT FROM AUTHOR]

Purpose -- An increasing number of people are migrating within the borders of China. Some migrants have to leave their children behind, and 58,000,000 children are estimated to be living as left-behind children. Earlier studies have found severe mental problems in left-behind children, but different factors could influence their mental health. The purpose of this paper is to investigate the mental health of these left-behind children and to determine possible influencing factors. Design/methodology/approach -- Data for this study were collected in one province of the People's Republic of China with a validated instrument, the Strengths and Difficulties Questionnaire (SDQ), to investigate behavior in 13-to-15-year old children. Findings -- No significant difference was found in total difficulty score and in any subscale score of SDQ when left-behind children were compared with children who were not left behind. A significant difference in emotional difficulty subscale score was found between girls who were left behind and girls who were not. Some socio-economic factors such as poor family economy and living with relatives, friends or grandparents, were identified as risk factors. Originality/value -- When strategies for support of the mental health in left-behind children are developed, they will need to be individualized according to the gender, social and economic situation and focused on emotional and conduct problems. [ABSTRACT FROM AUTHOR]

Background: Returning to social life after the lifting of COVID-19 lockdown may increase risk of social anxiety, which is highly co-morbid with depression. However, few studies have reported the association between them. Aims: To explore the complex relationship between social anxiety and depression symptoms in left-behind children after the lifting of the COVID-19 lockdown. Methods: A cross-sectional survey was conducted 6 months after the lockdown removal. A total of 3,107 left-behind children completed the survey with a mean age of 13.33 and a response rate of 87.77%. Depression and social anxiety severity were assessed by the DSM-5 Patient Health Questionnaire for Adolescents and the DSM-5 Social Anxiety Disorder Questionnaire, respectively. The symptom-level association between the two disorders was examined using network analysis. Results: After the lifting of COVID-19 lockdown, the prevalence of depression and social anxiety in left-behind children was 19.57% and 12.36%, respectively, with a co-morbidity rate of 8.98%. Network analysis showed that "Social tension" and "Social avoidance" had the greatest expected influence; "Humiliation" and "Motor" were bridge symptom nodes in the network. The directed acyclic graph indicated that "Social fright" was at the upstream of all symptoms. Conclusion: Attention should be paid to social anxiety symptoms in left-behind children after the lifting of COVID-19 lockdown. Prevention and intervention measures should be taken promptly to reduce the comorbidity of social anxiety and depression symptoms in the left-behind children after the lifting of lockdown. [ABSTRACT FROM AUTHOR]

Background: Conducting routine mild cognitive impairment (MCI) and dementia screening for older adults in the community is important, which not only can improve our understanding of these diseases but also can increase early detection and treatment. Methods: To analyze the reliability and validity of the informant AD8 and explore the cut‐off values for screening MCI and dementia in the community‐dwelling older adults, this study adopted a multi‐stage cluster sampling method to recruit 327 participants aged 60 and over in communities. The informant AD8 and Clinical Dementia Rating (CDR) scales were used to evaluate cognitive function of the subjects, and the receiver operating characteristic curves (ROC) was conducted to test the screening efficacy. Results: Among the 327 participants, 33.0% of them met the criteria of MCI, and 3.4% of them met the criteria of dementia. The area under the receiver operating characteristic curve (AUC) of the informant AD8 for screening dementia was 0.974, with a screening cut‐off of three, sensitivity of 90.9% and specificity of 89.0%. But it has a poor discriminability in MCI screening [AUC = 0.645, 95% confidence interval (CI): 0.578–0.711]. Conclusions: This study suggests that the informant AD8 is an ideal and useful tool for dementia screening in community‐dwelling older adults. However, it is less capable to distinguish older adults with MCI from those with normal cognitive function. [ABSTRACT FROM AUTHOR]

To evaluate the factor structure, reliability, and validity of the Personality Inventory for DSM-5 (PID-5) in Chinese nonclinical adolescents, a total of 1,442 Chinese middle school youths (M age = 14.85, girls = 52.4%) were recruited in the present study. All the participants completed the full-length 220-item PID-5. Some participants (n = 1,003) were administered adolescents' social adjustment as a criterion measure at the same time and 236 participants took part in longitudinal assessment of the PID-5 and adolescents' social adjustment 6 months later. First, exploratory structural equation modeling analyses supported a six-factor structure of the PID-5 in our present sample. Second, Negative Affectivity, Detachment, Antagonistic, and Disinhibition domains had positive correlations with negative social adjustment, and negative correlations with positive social adjustment concurrently and longitudinally, with the exception of Constraint and Psychoticism. Third, Cronbach's alpha for the PID-5 traits ranged from.57 to.91 in the full sample. The 6-month test–retest reliability by indexes of interclass correlation coefficient showed poor to good stability. As a whole, our findings provided preliminary evidence of the PID-5 as a reliable and valid measure of adolescents' maladaptive personality traits in mainland China. [ABSTRACT FROM AUTHOR]

Social adversity events commonly occur in our daily lives. However, an individual's perception of social adversity experienced may be more important than actual events in impacting an individual's psychological functioning and reactions. In the current study, we examined how individuals' perception of social adversity events they experienced is associated with their traumatic stress symptoms as well as mood and anxiety symptoms using the Bayesian network model. The findings indicated that individuals with a perception of social adversity events as traumatic and frequent showed an increase in the probability of displaying a high level of posttraumatic stress symptoms. [ABSTRACT FROM AUTHOR]

Objective: The study reported in this paper was aimed at developing understanding of schizophrenia-related knowledge and preferences surrounding professional help, medication, and treatment methods among Chinese living in Shanghai, China. Method: A multi-stage cluster sampling method in which participants were taken from six of the 20 districts in Shanghai was adopted for this study. The 522 Shanghai Chinese participants were presented with a vignette describing an individual with schizophrenia before being asked questions designed to assess both their understanding of schizophrenia and their preferences surrounding professional help, medication, and treatment methods. A comparative approach was adopted to identify similarities and differences between our findings and those of two previous studies on the mental health literacy of Chinese living in Melbourne, Australia and Hong Kong, respectively. Results: A lower percentage of Shanghai Chinese than Hong Kong Chinese and Australian Chinese could correctly identify the condition described in the vignette as a case of acute schizophrenia. Although a far lower percentage of Shanghai Chinese endorsed the use of counselling professionals, a much higher percentage of the same group endorsed Chinese medical doctors and herbal medication. A lower percentage of Shanghai Chinese endorsed ''lifestyle changes'' as a strategy for dealing with schizophrenia than did Chinese subjects living in Australia and Hong Kong. On the other hand, a higher percentage of Shanghai residents endorsed psychiatric treatment and the traditional Chinese practices of ''eating nutritious food/taking supplements'' than among the other two groups of Chinese. Conclusions: This study highlights the need for educating Chinese in Shanghai to improve their schizophrenia literacy. The contents of the education programmes will need to take into consideration the socially and culturally driven beliefs that may have been influencing the knowledge and preferences of Shanghai Chinese concerning professional help, medication, and treatment methods for people suffering from schizophrenia. [ABSTRACT FROM AUTHOR]

The objective of this paper is to develop a brief screening instrument of posttraumatic stress disorder (PTSD) for young victims of natural disasters. Data were derived from flood victims in 1998 and 1999 in Hunan, China. A representative population sample of 6,852 subjects 7-15 years of age was selected. Among them, 6,073 (88.6%) were interviewed. Multistage sampling was used to select the subjects and PTSD was ascertained with Diagnostic and Statistical Manual of Mental Disorders: 4th Edition (DSM-IV). We randomly assigned 80% (4,851) of the study subjects to construct the screening instrument (construct model) and the remaining 20% (1,222) subjects to examine the model (validation model). Logistic regression analysis and receiver operating characteristics curves were utilized to select a subset of symptoms and cutoff point from the pre-structured questionnaires. A seven-symptom instrument for PTSD screening was selected. Scores of 3 or more on this instrument were employed to define positive cases of PTSD with a sensitivity of 96.9%, specificity 99.0%, positive predictive value (PPV) 82.6%, and negative predictive value (NPV) 99.8%. The brief screening instrument developed in this study is highly valid, reliable, and predictable. [ABSTRACT FROM AUTHOR]

Cyberbullying is a public health concern worldwide, including China. Cyberbullying victimization has negative effects on adolescents' health and mental health. This study examined the associations between cyberbullying victimization and several health and mental health problems among adolescents in China. A total of 3,232 adolescents aged 15 to 17 were recruited from 18 high schools in Xi'an, China, using a stratified random sampling method. Self-report data were collected via survey from adolescents in Xi'an, China. In total, 22.2% and 6.3% of the sample reported having experienced cyberbullying victimization in their lifetime and the past year, respectively. Ordinary least squares (OLS) regression revealed that lifetime and preceding-year cyberbullying victimization was, respectively, significantly associated with poorer health (β = −1.58, p <.001; β = −2.22, p <.001), more severe depressive symptoms (β= 3.74, p <.001; β = 4.48, p <.001), and posttraumatic stress disorder (PTSD) symptoms (β = 7.16, p <.001; β = 4.77, p <.001). Binary regression revealed that lifetime and preceding-year cyberbullying victimization was, respectively, significantly related to higher odds of problem drinking (odds ratio [OR] = 1.64, p <.001; OR = 1.84, p <.01), cigarette smoking (OR = 1.69, p <.001; OR = 2.21, p <.001), and gambling engagement (OR = 1.35, p <.05; OR = 1.97, p <.01). Furthermore, greater levels of parent–child attachment were a protective factor against the negative effects of cyberbullying victimization on adolescents' depressive symptoms (p <.001) and PTSD (p <.05). It is critical to develop and implement prevention and early intervention programs that are tailored to address the needs of adolescents in China. Parental involvement needs to be incorporated into interventions for cyberbullying victimization. [ABSTRACT FROM AUTHOR]

• Children with HFA have impairment in emotional prosody recognition. • Intensity increase did not improve children with HFA's overall emotion recognition. • Children with HFA have difficulty discriminating between emotions differing in valence. • Children with HFA have difficulty discriminating between emotions differing in arousal. This paper investigated the ability of Mandarin-speaking children with high-functioning autism (HFA) to recognize the four categories of emotional prosody, namely, happiness , anger , sadness and fear , in moderate- and high-intensity emotional conditions using auditory discrimination tasks. Thirty-four children with HFA between 5 and 7 years of age and 34 typically developing (TD) controls participated in this study. In moderate-intensity conditions, children with HFA scored lower than TD children in the recognition of the four categories of emotional prosody, indicating an overall impairment. With an increase in the intensity of emotion, children with HFA showed improved accuracy for anger, decreased accuracy for happiness, but no change in accuracy for either sadness or fear. An analysis of error patterns demonstrated that unlike TD children, children with HFA were inclined to mistake happiness for anger, with the two categories differing in valence, and this inclination deepened as the intensity increased. In discriminating between sadness and fear, which have a slight arousal difference, both groups showed difficulty in moderate-intensity conditions. In high-intensity conditions, TD children were inclined to perceive stimuli as exhibiting fear, which demonstrates comparatively high arousal; thus, they were more accurate for fear, while HFA children were not sensitive to increases in arousal, showing no noticeable effect. These findings indicated that children with HFA have a mechanism distinct from that of TD children in emotional prosody recognition, exhibiting various degrees of impairment in this regard. [ABSTRACT FROM AUTHOR]

Aim: Long‐term care needs are important for older adults with dementia in the West, but they have not received enough attention from China. This study evaluated the psychometric properties of a long‐term care needs instrument for older Chinese adults with dementia. Methods: A total of 1,212 older adults with dementia were recruited from five Chinese cities to complete a 30‐item long‐term care needs questionnaire. The reliability and validity of the questionnaire was evaluated using multiple assessments, including a content validity assessment, Cronbach's alpha, an item‐to‐total correlation test, and exploratory factor analysis. Results: The questionnaire was divided into four sub‐sections: life care services (eight items), basic and specialist care services (12 items), mental comfort psychological services (four items), and homecare support services (six items). Cronbach's alpha was.93 for the whole questionnaire and ranged from.83 to.92 for the four sub‐questionnaires. The item‐to‐total correlation coefficients for the four sub‐questionnaires were between.68 and.88, and the test–retest correlation coefficient was.88. Conclusion: Our results validated the reliability and validity of a questionnaire designed to measure the quality of long‐term care services for older Chinese adults with dementia. [ABSTRACT FROM AUTHOR]

• The gender disparities in DCM vary among different maltreatment subtypes. • DCM's negative effect was more severe for girls than for boys. • Gender heterogeneity is less evident than gender homogeneity in the risk factors. Currently, gender disparities in domestic child maltreatment (DCM) have become an important and highly controversial issue worldwide. This study aims to provide panoramic evidence from China on this issue. Data were derived from a survey of 4,308 children (M age = 12.13, 48.7% were boys) conducted in seven provinces in rural China from June to December 2019. This study used multistage cluster sampling to select respondents, and modified versions of the JVQ Scale and the DSM-5 Scale (11–17 years old) were adopted. This study reached three significant conclusions. First, the gender disparities in DCM vary among different maltreatment subtypes. Compared with girls, boys are more likely to experience physical abuse. A higher prevalence of neglect is observed among girls than among boys. Second, although DCM significantly increased the likelihood of posttraumatic depression for all children, its negative effect was more severe for girls than for boys. Third, gender heterogeneity is less evident than gender homogeneity in the risk factors for DCM. In rural China, children's problematic behaviours, family structure, parents' experiences of childhood violence and family relationships are common predictors of maltreatment for all children. This paper highlights gender differences in the risk of DCM among children in rural China, reveals the Confucian culture behind DCM and gender, and provides Chinese evidence for building an international dialogue. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable neurodevelopmental disorder. However, no study has examined genetic and environmental influences in the longitudinal developmental course of ADHD symptoms in a non-Western population. This study investigated changes of genetic and environmental influences and their contributions to the stability and change of ADHD symptoms of hyperactivity/impulsivity and inattention in Chinese adolescent twins. A prospective sample of 602 twin pairs (48% male) self-reported both DSM-IV ADHD symptom subscales three times at the approximate age of 12, 13, and 15 years. Longitudinal multivariate genetic analyses through structural equation modelling examined genetic and environmental contributions to the developmental course of ADHD symptoms. From early (time 1 and 2) to middle adolescence (time 3), both symptoms showed modest and non-significant genetic influences that became substantial and significant, whereas shared environmental influences were substantial and significant and became modest and non-significant. The same genetic factors influenced ADHD symptoms throughout adolescence, while shared and non-shared environmental influences largely came from new emerging factors. In early adolescence, genetic factor contributed to the stability of inattention, whereas shared environmental factor contributed to the stability of hyperactivity/impulsivity. Genetic influences of ADHD tended to be smaller, whereas shared environmental influences tended to be larger in Chinese than in Western populations. Genetic factors played a large role in the stability of ADHD throughout adolescence, while shared and non-shared environment primarily contributed to its change. Findings highlight the importance of shared family, neighbourhood, and community experiences on child psychopathology in a collectivistic culture such as the Chinese society. [ABSTRACT FROM AUTHOR]

Background: Insomnia is a major public health problem affecting older people. This study aimed to investigate the prevalence and clinical risk factors of insomnia in a representative sample of Chinese elderly (≥ 60 years) in Chongqing. Methods: A cross‐sectional study based on comprehensive geriatric assessment was conducted from January 2013 to February 2014. A questionnaire on sleep status was provided to each patient and insomnia was assessed according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria. A multivariate logistic regression model was used to illustrate risk factors correlated with insomnia. Results: Of the total 597 participants, 55.4% suffered from insomnia. The prevalence of insomnia in men and women was 48.2% and 63.2%, respectively. Coronary heart disease, dizziness, chronic pain, anorexia, malnutrition, depression and cognitive decline were identified as risk factors associated with insomnia. Hypertension, diabetes, hyperlipidaemia, headache, age and education level were not observed to be significantly associated with insomnia. Conclusions: Insomnia is highly prevalent among the elderly in Chongqing, and shows a positive correlation to coronary heart disease, dizziness, chronic pain, anorexia, malnutrition, depression, cognitive impairment. Moreover, women are more likely to experience insomnia than men. [ABSTRACT FROM AUTHOR]

Internalized stigma is a barrier to mental health care in China, and stigma reduction is expected to promote treatment utilization, especially for mood disorders and schizophrenia. We aimed to identify the most common domains of internalized stigma of mental illness and to test the hypothesis that people with more severe mood disorders evidence more internalized stigma than those with less severe disorders. The Internalized Stigma of Mental Illness (ISMI) was administered to 366 outpatients with various mood disorders in Shanghai. Reliability statistics were calculated and frequently-endorsed items were identified. The magnitude of internalized stigma was compared among diagnostic categories and among sociodemographic groups. Except for stigma resistance, the ISMI and its subscales had good internal consistency. Across subgroups, stereotype endorsement was most commonly reported. Bipolar (versus depressive) disorders, male gender, and less education were associated with more internalized stigma, especially social withdrawal. Contrasting findings in Western countries, those with family history of mental illness trended toward more internalized stigma. We conclude that anti-stigma interventions should focus on reducing social withdrawal and stereotype endorsement, especially for those with more severe mood disorders, males, less educated individuals, and those with family history of mental illness. [ABSTRACT FROM AUTHOR]

Objective: Previous studies have implicated norepinephrine transporter gene (NET) polymorphisms in the etiology of major depressive disorder (MDD). A functional NET T-182C polymorphism (rs2242446) in the promoter region and a synonymous polymorphisms G1287A in the exon 9 (rs5569) were associated with MDD in different populations. However, few studies have focused on the relationship between these polymorphisms and MDD patients with suicidality. The objective of the present study was to examine whether the two polymorphisms are associated with MDD patients with suicidality in the Han Chinese population. Methods: Two hundred and sixty-three suicidal depressed patients and 241 non-suicidal depressed patients who met DSM-IV criteria for MDD were recruited from our hospital. Three hundred and three unrelated, age- and sex-matched healthy control subjects participated in this case-control study. Suicidality was assessed using Mini International Neuropsychiatric Interview (MINI) and the Hamilton rating scale for depression (HAMD). Genotypes of T-182C polymorphism (rs2242446) and G1287A (rs5569) were screened by polymerase chain reaction. Results: No statistical significant differences between patients and controls were found for any of the analysed polymorphisms, either in the genotype or allele distribution. Conclusions: Our results suggest that the investigated polymorphisms are not major susceptibility factors in the etiology of MDD with suicidality. However, the results must be verified in larger samples and different ethnicities. [ABSTRACT FROM AUTHOR]

The current study investigated the rates of addictions to Internet use, online gaming, and online social networking as well as their associations with depressive symptoms among young adults in China, Singapore, and the United States. A total of 3267 undergraduate students were recruited. Psychological instruments were used to assess various Internet-related addictions and depressive symptoms. Male students were more addicted to Internet and online gaming whereas female students were more addicted to online social networking. Compared with students in the United States, Chinese and Singaporean students were more addicted to Internet use and online social networking but less to online gaming. The odds of depression among students with addiction to various Internet-related addictions were highest in China. Internet-related addiction is a new public health concern of young adults, especially in the Asia-Pacific regions. It is found to associate with depressive symptoms. Strategies should address this phenomenon with attention to specific needs of gender and region while managing mood disturbances. [ABSTRACT FROM AUTHOR]

Two studies were conducted to investigate how high-functioning children with autism use different linguistic cues in sentence comprehension. Two types of linguistic cues were investigated: word order and morphosyntactic cues. The results show that children with autism can use both types of cues in sentence comprehension. However, compared to age-matched typically developing peers, children with autism relied significantly more on word order cues and exhibited significantly more difficulties in interpreting sentences in which there was a conflict between the morphosyntactic cue and the word order cue. We attribute the difficulties exhibited by children with autism to their deficits in executive function. We then discuss the implications of the findings for understanding the nature of the sentence processing mechanism in autism. [ABSTRACT FROM AUTHOR]

Background: China's ageing population will lead to increased neurodegenerative illness and age-related mental health problems. Aims: The Chinese Longitudinal Ageing Study has been developed to better understand the impact of ageing on cognition and mental health. An overview of the sample, major diagnoses and results of the first wave of data collection is presented. Method: One thousand and sixty-eight elderly Chinese (42.2% male), mean age of 72.8 years (SD = 8.5) completed a comprehensive cognitive, psychosocial and mental health assessment. Results: Mean MMSE score was 24.73 (SD = 6.17). Primary generalised anxiety was detected in 0.4% of the sample. Sub-clinical depression and depressive disorder were diagnosed in 1.7% and 2.4% of the sample, respectively. Most (84.5%) reported subjective memory decline, however 66.5% had no cognitive impairment. Mild Cognitive Impairment (MCI) was detected in 25%, Alzheimer's disease (AD) in 4.7%, vascular dementia in 2.5%, and mixed dementia in 1.3%. Cognition was worse in those 85+ years, but affective disorder rates were not. Conclusion: Higher rates of dementia were detected than previously reported in China. Normative data is presented for common cognitive and mental health assessment and screening tasks in a Chinese population. This suggests that the true incidence of dementia has been underestimated, and requires further investigation. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of insomnia and its socio‐demographic correlates in Chinese nurses. Design and Methods: Up to 799 nurses were examined. Demographic data, total sleep time (TST), and insomnia were collected. Findings: The mean expected and actual TST were 8.3 ± 1.5 and 6.1 ± 1.1 hr, respectively. The prevalence of at least one type of reported sleep disturbance was 69.7%; the rates of difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening were 54.6%, 54.7%, and 55.9%, respectively. Practice Implications: There is a large discrepancy of actual and expected sleep duration, and insomnia is common among nurses in China. [ABSTRACT FROM AUTHOR]

Background. Patients with schizophrenia have intact ability to experience emotion, but empirical evidence suggests that they fail to translate emotional salience into effortful behaviour. Previous research in patients with chronic schizophrenia suggests that working memory is important in integrating emotion and behaviour. This study aimed to examine avolition and anhedonia in patients with first-episode schizophrenia and clarify the role of working memory in emotion- behaviour coupling. Method. We recruited 72 participants with first-episode schizophrenia and 61 healthy controls, and used a validated emotion-inducing behavioural paradigm to measure participants' affective experiences and how experienced emotion coupled with behaviour. Participants were given the opportunity to expend effort to increase or decrease their exposure to emotion-inducing photographs. Participants with schizophrenia having poor working memory were compared with those with intact working memory in their liking and emotion-behaviour coupling. Results. Patients with first-episode schizophrenia experienced intact 'in-the-moment' emotion, but their emotion was less predictive of the effort expended, compared with controls. The emotion-behaviour coupling was significantly weaker in patients with schizophrenia with poor working memory than in those with intact working memory. However, compared with controls, patients with intact working also showed substantial emotion-behaviour decoupling. Conclusions. Our findings provide strong evidence for emotion-behaviour decoupling in first-episode schizophrenia. Although working memory deficits contribute to defective translation of liking into effortful behaviour, schizophrenia alone affects emotion-behaviour coupling. Conclusions. Our findings provide strong evidence for emotion-behaviour decoupling in first-episode schizophrenia. Although working memory deficits contribute to defective translation of liking into effortful behaviour, schizophrenia alone affects emotion-behaviour coupling. [ABSTRACT FROM AUTHOR]

Background.Neurological soft signs (NSS) have long been considered potential endophenotypes for schizophrenia. However, few studies have investigated the heritability and familiality of NSS. The present study examined the heritability and familiality of NSS in healthy twins and patient–relative pairs.Method.The abridged version of the Cambridge Neurological Inventory was administered to 267 pairs of monozygotic twins, 124 pairs of dizygotic twins, and 75 pairs of patients with schizophrenia and their non-psychotic first-degree relatives.Results.NSS were found to have moderate but significant heritability in the healthy twin sample. Moreover, patients with schizophrenia correlated closely with their first-degree relatives on NSS.Conclusions.Taken together, the findings provide evidence on the heritability and familiality of NSS in the Han Chinese population. [ABSTRACT FROM PUBLISHER]

BackgroundThe symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome?MethodSymptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples.ResultsThe preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety.ConclusionsMD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome. [ABSTRACT FROM PUBLISHER]

BackgroundPrevious studies support Beck's cognitive model of vulnerability to depression. However, the relationship between his cognitive triad and other clinical features and risk factors among those with major depression (MD) has rarely been systematically studied.MethodThe three key cognitive symptoms of worthlessness, hopelessness and helplessness were assessed during their lifetime worst episode in 1970 Han Chinese women with recurrent MD. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression.ResultsCompared to patients who did not endorse the cognitive trio, those who did had a greater number of DSM-IV A criteria, more individual depressive symptoms, an earlier age at onset, a greater number of episodes, and were more likely to meet diagnostic criteria for melancholia, postnatal depression, dysthymia and anxiety disorders. Hopelessness was highly related to all the suicidal symptomatology, with ORs ranging from 5.92 to 6.51. Neuroticism, stressful life events (SLEs) and a protective parental rearing style were associated with these cognitive symptoms.ConclusionsDuring the worst episode of MD in Han Chinese women, the endorsement of the cognitive trio was associated with a worse course of depression and an increased risk of suicide. Individuals with high levels of neuroticism, many SLEs and high parental protectiveness were at increased risk for these cognitive depressive symptoms. As in Western populations, symptoms of the cognitive trio appear to play a central role in the psychopathology of MD in Chinese women. [ABSTRACT FROM PUBLISHER]

Background. The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms. Method. We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD. Results. Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9-6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt. Conclusions. This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide. [ABSTRACT FROM AUTHOR]

BackgroundThis study aimed to compare ‘cool’ [working memory (WM) and response inhibition] and ‘hot’ (delay aversion) executive functions (EFs) in children with and without attention deficit hyperactivity disorder (ADHD).MethodA total of 100 ADHD children (45 with family history of ADHD and 55 with no family history) and 100 healthy controls, all medication free, were tested on tasks related to the ‘hot’ (i.e. two choice-delay tasks) and ‘cool’ domains of EF (i.e. Digits backward, Corsi Block Task backward, Go/No-Go Task, Stop-Signal Task, and the Stroop).ResultsCompared with the controls, children with ADHD were found to perform significantly worse on one or more measures of response inhibition, WM, and delay aversion after controlling for co-morbidities and estimated IQ. In addition, comparisons between ADHD children with family history of ADHD and those with no family history found significant differences on measures of response inhibition and WM but not delay aversion. These results are largely supported by results of two logistic regressions.ConclusionsADHD was found to be associated with deficits on both cool and hot EFs. There is also evidence to suggest that cool EFs impairment is related to a family history of ADHD. Findings of this study have helped to elucidate the nature and extent of EF deficits in children with ADHD. [ABSTRACT FROM PUBLISHER]

BackgroundThere is relative little information about the prevalence and risk factors of co-morbid anxiety and depression in later life. These disorders are often associated with worse response to treatment than either condition alone, and researching their epidemiology in diverse settings is vital to policy makers. We therefore investigated the co-occurrence of anxiety and depressive syndromes amongst older adults living in developing countries and measured the separate and joint effect of these two disorders on levels of associated disability.MethodThe 10/66 study carried out cross-cultural surveys of all residents aged 65 years or over (n=15021) in 11 sites in seven countries (People's Republic of China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru). Anxiety was measured by using the Geriatric Mental State Examination and the Automated Geriatric Examination for Computer Assisted Taxonomy diagnostic system. Depression was assessed according to International Classification of Diseases 10th revision (ICD-10) and EURO-D criteria. Disability was measured by using the World Health Organization's Disablement Assessment Scale Version II. Zero-inflated negative binomial regression models were used to investigate the association of common mental disorders and disability.ResultsThe prevalence of co-occurring anxiety and depression (with the exclusion of subthreshold disorders) ranged between 0.9% and 4.2% across sites. Gender, socio-economic status, urbanicity and physical co-morbidities were associated with the different co-morbid states. Having both disorders was linked to higher disability scores than having anxiety or depression alone.ConclusionsGiven the close association of co-morbid anxiety and depression with disability, new policies to improve prevention, recognition and treatment will be needed to adapt to ageing populations and their mental health needs. [ABSTRACT FROM PUBLISHER]