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Highlights l Our study confirmed the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) has good reliability and validity in frontline health workers during the outbreak of Corona Virus Disease 2019. l The Chinese version of PCL-5 can be used as a reliable screening tool to conduct psychological screening for Chinese healthcare workers during the outbreak of 2019-nCoV. l Almost 60% of frontline healthcare workers met the criteria of provisional PTSD diagnosis in the outbreak of 2019-nCoV., Background Previous studies about the reliability and validity of the updated PCL version for the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (PCL-5) have only been evaluated in certain samples of the population, which lacks in the sample of Healthcare Workers. Our study focused on the factor structure, reliability and validity of the PCL-5 among Chinese Healthcare Workers during the Outbreak of Corona Virus Disease 2019. Methods We conducted an online survey of frontline healthcare workers using the PCL-5 for PTSD. Total of 212 frontline healthcare providers were included in this study. Results The findings showed that PCL-5 is a reliable instrument in our sample. The total and subscale scores showed good internal consistency. The convergent and discriminant validity of the PCL-5 were also well demonstrated. Our result showed a better fit with the seven-factor hybrid model compared with other models and supported that the PCL-5 Chinese version can be used as a reliable screening tool to conduct psychological screening for Chinese healthcare workers. Limitation We could not examine other aspects of reliability and validity like test-retest reliability or criterion validity. We didn't use the gold-standard structured interview for PTSD in our study. Besides, most of our samples were young people who had access to the internet. Not all professional levels and seniorities were presented because our sample had a lower mean income and educational level. Conclusion Our study shows that the Chinese PCL-5 has good validity and reliability in frontline healthcare workers during the outbreak.

Introduction Sexual assault is one of the most traumatic stressors one may experience in life. Although studies have investigated the prevalence of posttraumatic stress disorder (PTSD) and associated psychosocial factors on victims of sexual assault internationally, such studies in Mainland China are limited. Methods Two hundred thirt-three Chinese females (aged 17–38) victims of sexual assault were surveyed in three Guangdong province cities (Guangzhou city, Shenzhen city, and Huizhou city). The Clinician-Administered PTSD Scale, Eysenck Personality Questionnaire, PTSD Checklist Civilian Version, Social Support Rating Scale, and Trait Coping Style Questionnaire were used. Results The prevalence of PTSD in Chinese female victims of sexual assault was 15.25% (34/223). Six psychosocial factors were found to be significant for PTSD symptomatology, including objective support (β = −1.01, P = 0.001), subjective support (β = −0.59, P

Signal transduction has been reported to be involved in antidepressant treatment outcomes; however, its mechanisms remain unclear. The aims of this study were to explore the associations between antidepressant remission and single nucleotide polymorphisms (SNPs), haplotypes, and gene-gene interactions in the Ras-Raf-MAPK intracellular signaling pathway. A total of 302 inpatients with major depressive disorder (DSM-IV Axis I) were assessed using the 17-item Hamilton Depression Rating Scale before and after 8 weeks of antidepressant treatment to determine the remission rate in the samples. Twenty-four SNPs at five kinase genes (Ras-Raf-MEK-ERK-RSK), which are a part of the Ras-Raf-MAPK signaling pathway, were identified to investigate a genetic association with antidepressant drug outcome. Correlations between 24 SNPs at the five kinase genes in the Ras-Raf-MAPK signaling pathway and antidepressant drug outcome were not found. The percentage of the CCAGA haplotype that RSK(2/3/4)-RSKL(1/2) gene loci SNPs constructed was markedly lower in the remitter group when compared with the nonremitter group in female depressed patients (P=0.04), whereas the proportion of AAAGGG haplotype that RSK(2/3/4)-RSKL(1/2) gene loci SNPs constructed in the remitter group was significantly greater than that in the nonremitter group in male patients (P=0.02). In addition, MEK1 (rs28730804) and RSK3 (rs2229712) in the Ras-Raf-MAPK signaling pathway showed a gene-gene interaction that affected antidepressant drug outcome in female depressed patients (P=0.041). Although this study did not find that SNPs at the five kinase genes in the Ras-Raf-MAPK signaling pathway are important markers for antidepressant outcome, certain haplotypes that SNPs at the RSK(2/3/4)-RSKL(1/2) gene constructed may be important markers for antidepressant drug efficacy. We observed a gene-gene interaction in this signaling pathway that influenced antidepressant efficacy in female depressed patients. Therefore, it is likely that in female depressed patients, different haplotypes and gene-gene interaction in the Ras-Raf-MAPK signaling pathway are involved in mediating the pharmacological action of an antidepressant, and eventually influence antidepressant efficacy.

Sui SG, Wu MX, King ME, Zhang Y, Ling L, Xu JM, Weng XC, Duan L, Shan BC, Li LJ. Abnormal grey matter in victims of rape with PTSD in Mainland China: a voxel-based morphometry study.Objective:This study examined changes in brain grey matter in victims of rape (VoR) with and without post-traumatic stress disorder (PTSD). Previous research has focused on PTSD caused by various traumatic events, such as war and disaster, among others. Although considerable research has focused on rape-related PTSD, limited studies have been carried out in the context of Mainland China.Methods:The study included 11 VoR with PTSD, 8 VoR without PTSD and 12 healthy comparison (HC) subjects. We used voxel-based morphometry to explore changes in brain grey-matter density (GMD) by applying statistical parametric mapping to high-resolution magnetic resonance images.Results:Compared with HC, VoR with PTSD showed significant GMD reductions in the bilateral medial frontal cortex, left middle frontal cortex, middle temporal gyrus and fusiform cortex and significant GMD increases in the right posterior cingulate cortex, postcentral cortex, bilateral precentral cortex and inferior parietal lobule. Compared to VoR without PTSD, VoR with PTSD showed significant GMD reductions in the right uncus, left middle temporal gyrus, and the fusiform cortex, and increases in the left precentral cortex, inferior parietal lobule and right post-central cortex.Conclusion:The findings of abnormal GMD in VoR with PTSD support the hypothesis that PTSD is associated with widespread anatomical changes in the brain. The medial frontal cortex, precentral cortex, posterior cingulate cortex, post-central cortex and inferior parietal lobule may play important roles in the neuropathology of PTSD.

To identify susceptibility loci for schizophrenia, we performed a two-stage genome-wide association study (GWAS) of schizophrenia in the Han Chinese population (GWAS: 746 individuals with schizophrenia and 1,599 healthy controls; validation: 4,027 individuals with schizophrenia and 5,603 healthy controls). We identified two susceptibility loci for schizophrenia at 6p21-p22.1 (rs1233710 in an intron of ZKSCAN4, P(combined) = 4.76 × 10(-11), odds ratio (OR) = 0.79; rs1635 in an exon of NKAPL, P(combined) = 6.91 × 10(-12), OR = 0.78; rs2142731 in an intron of PGBD1, P(combined) = 5.14 × 10(-10), OR = 0.79) and 11p11.2 (rs11038167 near the 5' UTR of TSPAN18, P(combined) = 1.09 × 10(-11), OR = 1.29; rs11038172, P(combined) = 7.21 × 10(-10), OR = 1.25; rs835784, P(combined) = 2.73 × 10(-11), OR = 1.27). These results add to previous evidence of susceptibility loci for schizophrenia at 6p21-p22.1 in the Han Chinese population. We found that NKAPL and ZKSCAN4 were expressed in postnatal day 0 (P0) mouse brain. These findings may lead to new insights into the pathogenesis of schizophrenia.

In addition, approximately 30 million children and young adolescents are suffering from mood and/or behavioral disorders. Drug and alcohol problems and other psychosocial disorders affecting women, elders and survivors of disasters are also important problems adding to the overall national mental health burden. Research from both China and abroad indicate that mental and behavioral problems will continue to increase in the future. The World Health Organization (WHO) has warned that the financial burden from mental disorders in China will constitute 1/4 of total burden from various diseases in 2020.

Sexual assault is one of the most traumatic stressors one may experience in life. Although studies have investigated the prevalence of posttraumatic stress disorder (PTSD) and associated psychosocial factors on victims of sexual assault internationally, such studies in Mainland China are limited.Two hundred thirt-three Chinese females (aged 17-38) victims of sexual assault were surveyed in three Guangdong province cities (Guangzhou city, Shenzhen city, and Huizhou city). The Clinician-Administered PTSD Scale, Eysenck Personality Questionnaire, PTSD Checklist Civilian Version, Social Support Rating Scale, and Trait Coping Style Questionnaire were used.The prevalence of PTSD in Chinese female victims of sexual assault was 15.25% (34/223). Six psychosocial factors were found to be significant for PTSD symptomatology, including objective support (β = -1.01, P = 0.001), subjective support (β = -0.59, P 0.001), support utilization (β = -1.03, P = 0.005), negative coping style (β = 0.58, P 0.001), positive coping style (β = -0.44, P 0.001), and neuroticism (β = 0.48, P 0.001).These findings suggest that negative coping bias and neuroticism were predisposing risk factors that increase PTSD symptoms, while objective support, subjective support, support utilization, and positive coping style were protective factors for PTSD following sexual assault, and provide prima facie evidence for posttrauma intervention.

A highly osteogenic hybrid bioabsorbable scaffold was developed for bone reconstruction/augmentation. Through the use of a solid free-form fabrication technology, a bioabsorbable polycaprolactone (PCL) cage scaffold with a desired size and shape was produced and then filled with osteogenic bone graft particles, that is, morselized autologous bone chips. A rabbit total lamina defect model was chosen to demonstrate its efficacy in regenerating bone with a complicated anatomic shape. Both iliac bone and morselized iliac bone grafts were used in this study for comparison purposes. Serum osteocalcin and collagen type I cross-linked C-terminal telopeptide (CTx) determination showed that active bone remodeling occurred after bone grafts were implanted. X-ray images showed that the bony defects were completely filled with bone mass in all the groups with bone grafts. However, biomechanical tests showed that only the iliac bone and hybrid scaffold groups could restore the mechanical properties to the normal level after 10 weeks of implantation. A histology study showed that both iliac and hybrid scaffold groups had extensive new bone formation, and no adhesion and fibrosis were found. These results indicated that this osteogenic hybrid scaffold can be a good alternative to autologous iliac bone, because it does not need a second iliac bone-harvesting surgery, and thus the morbidity and the possible infections that are often associated with the bone harvesting surgery can be avoided.

Posttraumatic stress disorder (PTSD) is a relatively common and predictable psychological syndrome (Miller, 1999). PTSD occurs in a proportion of individuals exposed to severe psychological trauma (Kasai et al., 2006) and in which the individual responds with fear, helplessness, or horror (Danckwerts & Leathem, 2003). Individuals with PTSD suffer from intrusive memories about the traumatic event, persistent avoidance of stimuli associated with the trauma, and persistent symptoms of increased arousal. These symptoms become uncontrollable and disabling (Bremner & Charney, 1994) that serious threaten human health and social function. Due to its debilitating nature, PTSD has emerged as an important public health problem in the general population (Sareen et al., 2007). In recent years, a great deal of research has been directed towards understanding the etiology, phenomenology, neurobiology, clinical characteristics and treatment of PTSD (Nemeroff et al., 2006). However, a number of core psychological processes underlying PTSD have yet to be elucidated (Shin et al., 2006; Liberzon & Sripada, 2008). Over the past decade, findings from neuroimaging studies have allowed for tremendous advances in our understanding of the experience of emotions in healthy individuals and the dysregulation of these processes associated with PTSD. These studies have been useful in both generating hypotheses on the neurobiology of normative human responses to trauma and complementing our understanding of the wide-ranging alterations in trauma survivors who develop PTSD. Structural neuroimaging studies have focused primarily on hippocampal volumetry (Geuze et al., 2005) as well as the prefrontal cortex (Geuze et al., 2008a) and other brain structures. Hippocampal morphology has been correlated with severity of PTSD symptomatology (Gilbertson et al., 2002; Villarreal & King, 2004). However, the results have been inconsistent, with studies reporting significant reductions or increases, as well as unchanged volumes. For example, studies have shown that patients with PTSD are associated with bilateral lower hippocampal volume (Bossini & Castrogiovanni, 2007; Bremner et al., 2003; Emdad et al., 2006; Lindauer et al., 2004a; Vythilingam et al., 2005; Li et al., 2006), which are

Internet addition disorder (IAD) is currently becoming a serious mental health problem among Chinese adolescents. The pathogenesis of IAD, however, remains unclear. The purpose of this study applied regional homogeneity (ReHo) method to analyze encephalic functional characteristic of IAD college students under resting state.Functional magnetic resonanc image (fMRI) was performed in 19 IAD college students and 19 controls under resting state. ReHo method was used to analyze the differences between the average ReHo in two groups.The following increased ReHo brain regions were found in IAD group compared with control group: cerebellum, brainstem, right cingulate gyrus, bilateral parahippocampus, right frontal lobe (rectal gyrus, inferior frontal gyrus and middle frontal gyrus), left superior frontal gyrus, left precuneus, right postcentral gyrus, right middle occipital gyrus, right inferior temporal gyrus, left superior temporal gyrus and middle temporal gyrus. The decreased ReHo brain regions were not found in the IAD group compared with the control group.There are abnormalities in regional homogeneity in IAD college students compared with the controls and enhancement of synchronization in most encephalic regions can be found. The results reflect the functional change of brain in IAD college students. The connections between the enhancement of synchronization among cerebellum, brainstem, limbic lobe, frontal lobe and apical lobe may be relative to reward pathways.

On July 29, 2007, a severe coalmine-flooded disaster occurred in central China and 69 miners were trapped in an about 1400 m underground coal pit. Fortunately, all of them were rescued after 75 h of the ordeal. At 3 and 6 months after the disaster, psychopathological profiles, plasma levels of cortisol and adrenocorticotropic hormone (ACTH) were evaluated in 48 survivors for posttraumatic stress disorder (PTSD) and comorbid symptoms. Magnetic resonance imaging (MRI) study was performed at 6 months. The prevalence of PTSD was 35.4% (17/48) at 3 months and 31.3% (15/48) at 6 months post-disaster, with high rates of comorbid symptoms. Risk factors for PTSD included previous traumatic experience, less than 5 years of being a miner, in an extremely exhausted or sick during the disaster, poor interpersonal relationship and poor sleep quality experienced before the disaster. Mean plasma cortisol levels at 6 months, but not at 3 months, were significantly higher in PTSD-positive subjects than the negative, and positively correlated with the severity of several comorbid symptoms. Either whole or regional brain volumes of PTSD-positive subjects were not significantly different from PTSD-negative subjects, but PTSD subjects had significantly reduced fractional anisotropy values in the right posterior cingulum and bilateral hippocampal body compared to subjects without PTSD. These results suggest that traumatic exposure in severe coalmining disasters results in considerable psychological consequences, with highly prevalent PTSD and comorbid symptoms, which are associated with previous traumatic experience, shorter-length underground services, and poor interpersonal relationships and sleep quality experienced before the disaster. Baseline cortisol level may be a useful biological predictor for different phases of the development of PTSD. The aberrant connectivity of the hippocampus and the cingulum may represent an early pathological response to trauma exposure.

To investigate the prevalence of posttraumatic stress disorder (PTSD) among survivors from a coal mining accident after 2 and 10 months and factors related to PTSD.To estimate the prevalence of PTSD, 104 miners were surveyed through the PTSD Checklist-Civilian Version (PCL-C). Forty survivors including 24 severe PTSD patients and 24 non-PTSD subjects were evaluated thoroughly.The current prevalence rate among survivors from the coal mining accident at 2 months was 50%. There were significant differences in PTSD symptoms, anxiety and depression, personality, and memory performance between the PTSD patients and non-PTSD controls. State anxiety, time to renew the work, depression, neuroticism, and the place they were staying, and length of service were predictors of PTSD. After 10 months of the accident, 30.6% survivors still met the criterion of PTSD. Compared with 2 months after the accident, PTSD symptoms, anxiety, and memory performance improved clearly, while the depressive symptoms had no significant difference. The state anxiety, time to renew the work, positive coping, emotional balance, and length of service were the factors of PTSD symptom healing.The current prevalence of PTSD among survivors from coal mining accident is high. The mining accident has great influence on victims, and psychological or medication interventions are necessary. There are lots of risk factors for the prevalence of PTSD, such as state anxiety, depression, neuroticism, and shorter duration of service. Positive coping may be a beneficial factor for PTSD recovery.