Major Depressive Disorder In China Research Articles

Stigma and its associations with medication adherence in major depressive disorder

This study sought to evaluate internalized stigma (IS) and perceived stigma (PS), in persons (n = 522) living with major depressive disorder (MDD), with a view to analyzing the association of IS and PS with medication adherence in a cohort of participants with MDD in China. Perceived stigma is the awareness of societal negative views and attitudes towards depression, and IS is applying others’ attitudes to oneself, both measured by the Depression Stigma Scale (DSS). Medication adherence was assessed using the Medication Adherence Rating Scale (MARS). We observed that 76.0 % of participants reported IS and 84.5 % reported PS. Factors associated with increased IS included older age, marital status, disease history, and a higher baseline Patient Health Questionnaire-9 (PHQ-9). Higher education level, family income, and scores on the Connor-Davidson Resilience Scale (CD-RISC) were associated with lower levels of IS. Higher education levels, Childhood Trauma Questionnaire (CTQ) scores, and living with others were also associated with higher PS, while engagement in exercise and higher number of prior episodes were associated with lower PS. IS had a negative association with medication adherence, whereas PS did not significantly associate with adherence. In conclusion, a testable hypothesis is derived from our data that strategies targeting IS amongst persons with MDD may improve overall rates of adherence to antidepressant treatment, a necessary prelude to improving recovery.

Program of algorithm for pharmacological treatment of major depressive disorder in China: Benefits or not?

BackgroundThis research was designed to investigate Algorithm Guided Treatment (AGT) and clinical traits for the prediction of antidepressant treatment outcomes in Chinese patients with major depressive disorder (MDD). MethodsThis study included 581 patients who had reached treatment response and 406 patients remained non-responded observed after three months of treatment. Sociodemographic factors, clinical traits, and psychiatric rating scales for evaluating therapeutic responses between the two groups were compared. Logistic regression analysis was adopted to determine the risk factors of unresponsive to antidepressant (URA) in MDD. Kaplan-Meier survival analysis was utilized to compare the therapeutic response between AGT and treatment as usual (TAU). ResultsCompared to the MDD responsive to antidepressant (RA) group, the URA group had significantly lower rates of the following clinical traits: married status, anxious distress, moderate to severe depressive symptoms, and higher rates of comorbidity (p-value < 0.05). Logistic Regression Analysis showed that eight clinical traits from psychiatric rating scales, such as anxious characteristics, were correlated positively with URA, while the other eight symptoms, such as autonomic symptoms, were negatively correlated. Time to symptomatic remission was longer in TAU without statistically significant (p-value = 0.11) by log-rank testing. ConclusionsThe factors may affect the therapeutic responses and compliance of patients, increasing the non-response risk for antidepressants. Therapeutic responses might be improved by increasing the clarification and elucidation of different symptom clusters of patients. Benefits on treatment response to AGT were not found in our study, indicating a one-size-fits-all approach may not work.Trial Registration: We registered as a clinical trial at the International Clinical Trials Registry Platform (No. NCT01764867) and obtained ethical approval 2012-42 from SMHC.

Differences in the prevalence and clinical correlates of comorbid suicide attempts in patients with early- and late-onset major depressive disorder.

There are many studies on differences in the onset age of major depressive disorder (MDD) patients. However, study on differences in clinical correlates of suicide attempts between early- and late-onset MDD patients is limited. The aim of this study was to investigate the differences in the prevalence and clinical correlates of suicide attempts in patients with early- and late-onset MDD in China. A total of 1718 adult outpatients with MDD were recruited. Demographic and clinical data were collected. The 17-item Hamilton Rating Scale for Depression (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression-Severity (CGI-S) Scales were used to assess their depressive, anxiety, psychotic symptoms, and the severity of the clinical symptoms, respectively. The prevalence of suicide attempts was higher in late-onset MDD patients (291/1369, 21.3%) than in early-onset MDD patients (55/349, 15.8%) (p = 0.023). However after Bonferroni correction no significant difference was found in the prevalence of suicide attempts in late-onset and late-onset MDD patients (p > 0.05). In both early- and late-onset groups, univariate analysis showed that the following characteristics were significantly associated with suicide attempts: HAMA, HAMD and PANSS positive subscale scores, thyroid stimulating hormone (TSH) levels, blood glucose levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). In both the early- and late-onset groups, the prevalence rates of severe anxiety disorder and psychotic symptoms were significantly higher in the suicide attempt group than in the non-suicide attempt group. In regression analysis, disease duration, TSH levels and HAMA score were independently associated with suicide attempts in the early-onset group, while TSH levels, HAMA and HAMD score were independently associated with suicide attempts in the late-onset group. This study suggests that suicide attempts are not frequent in early-onset outpatients with MDD compared with late-onset, and some clinical correlates are associated with suicide attempt in early- and late-onset MDD.

A phase 3, multicenter, double-blind, randomized, placebo-controlled clinical trial to verify the efficacy and safety of ansofaxine (LY03005) for major depressive disorder

Major depressive disorder (MDD) is the most prevalent form of depression and is becoming a great challenge for public health and medical practice. Although first-line antidepressants offer therapeutic benefits, about 35% of depressed patients are not adequately treated, creating a substantial unmet medical need. A multicenter, double-blind, randomized, placebo-controlled phase 3 clinical trial was conducted in patients with MDD in China to assess the efficacy and safety of ansofaxine (LY03005), a potential triple reuptake inhibitor of serotonin, norepinephrine, and dopamine. Eligible 588 MDD patients were included and randomly assigned (1:1:1) to 8-week treatment with ansofaxine 80 mg/day(n = 187), ansofaxine 160 mg/day(n = 186), or placebo(n = 185). The primary efficacy endpoint was the Montgomery-Åsberg Depression Rating Scale (MADRS) total score change from baseline to the end of the study. Safety indexes included adverse events, vital signs, physical examination, laboratory tests, 12-lead electrocardiogram (ECG), and evaluation of suicide tendency and sexual function. Significant differences were found in mean changes in MADRS total score at week 8 in the two ansofaxine groups (80 mg, −20.0; 160 mg, −19.9) vs. placebo (−14.6; p < 0.0001). All doses of ansofaxine were generally well-tolerated. Treatment-emergent adverse events (TEAEs) were reported by 137 (74.46%) patients in ansofaxine 80 mg group, 144 (78.26%) patients in ansofaxine 160 mg and 125 (67.93%) patients in the placebo group. The incidence of treatment-related adverse events (TRAEs) was 59.2% (109 patients), 65.22% (120 patients) in the 80, 160 mg ansofaxine groups, and 45.11% (83 patients) in the placebo group. The initial results of this trial indicate that ansofaxine at both the 80 mg/day and 160 mg/day was effective and safe in adult patients with MDD. ClinicalTrials.gov Identifier: NCT04853407.

Investigation of the pharmacological treatment patterns of Chinese patients with major depressive disorder under real-world settings using multi-channel sequence analysis.

Despite many treatment guidelines available now, the treatment patterns of major depressive disorder (MDD) in China haven't been well-understood due to complexity and diversity. To describe pharmacological treatment patterns of MDD patients in real-world settings using electronic health records from a major psychiatric hospital in China. MDD patients (18-65 years, ICD-10: F32.x, F33.x) newly initiated single antidepressant (AD) in 2015 were enrolled, the date of first AD prescription during the study period was defined as index date, and eligible patients were followed up to 1 year. Treatment patterns were revealed and analyzed using multi-channel sequence analysis (MCSA), considering patients' chronological sequences (in days) of AD prescription, cumulative treatment step(s), and polypharmacy usage during the follow-up. This study (n = 5,003) identified four types of MDD treatment patterns. The first type (1-time treatment) represents the largest proportion of patients (73.6%, n = 3,686), followed by the second type (6-month consistent treatment) and third type (long-term, consistent treatment) collectively accounted for 20.6% (n = 1,031) of patients, by contrast the last type (long-term, inconsistent treatment) made up the rest 5.7% (n = 286) of patients while exhibiting the most complicated treatments patterns. The choice of AD was dominated by selective serotonin reuptake inhibitors (SSRIs), while treatment duration spent in polypharmacy spanned at 2.8%, 16.4%, 2.0%, and 36.5% over the four types, respectively. Treatment patterns reflecting real-world pharmacological treatment practices of MDD in China were revealed using MCSA. The observed discrepancies between real-world practice and treatment guidelines provided additional insights in improving the clinical management of MDD.

Efficacy of dynamic interpersonal therapy for major depressive disorder in China: results of a multicentered, three-arm, randomized, controlled trial.

Dynamic interpersonal therapy (DIT) is a brief, structured psychodynamic psychotherapy with demonstrated efficacy in treating major depressive disorder (MDD). The aim of the study was to determine whether DIT is an acceptable and efficacious treatment for MDD patients in China. Patients were randomized to 16-week treatments with either DIT plus antidepressant medication (DIT + ADM; n = 66), general supportive therapy plus antidepressant medication (GST + ADM; n = 75) or antidepressant medication alone (ADM; n = 70). The Hamilton Depression Rating Scale (HAMD) administered by blind raters was the primary efficacy measure. Assessments were completed during the acute 16-week treatment and up to 12-month posttreatment. The group × time interaction was significant for the primary outcome HAMD (F = 2.900, df1 = 10, df2 = 774.72, p = 0.001) in the acute treatment phase. Pairwise comparisons showed a benefit of DIT + ADM over ADM at weeks 12 [least-squares (LS) mean difference = -3.161, p = 0.007] and 16 (LS mean difference = -3.237, p = 0.004). Because of the unexpected high attrition during the posttreatment follow-up phase, analyses of follow-up data were considered exploratory. Differences between DIT + ADM and ADM remained significant at the 1-, 6-, and 12-month follow-up (ps range from 0.001 to 0.027). DIT + ADM had no advantage over GST + ADM during the acute treatment phase. However, at the 12-month follow-up, patients who received DIT remained less depressed. Acute treatment with DIT or GST in combination with ADM was similarly efficacious in reducing depressive symptoms and yielded a better outcome than ADM alone. DIT may provide MDD patients with long-term benefits in symptom improvement but results must be viewed with caution.

Clinical Guideline (CANMAT 2016) Discordance of Medications for Patients with Major Depressive Disorder in China.

This survey aims to explore the current medical treatment of major depressive disorder (MDD) in China and match its degree with Canadian Network for Mood and Anxiety Treatments (CANMAT). A total of 3275 patients were recruited from 16 mental health centers and 16 general hospitals in China. Descriptive statistics presented the total number and percentage of drugs, as well as all kinds of treatments. Selective serotonin reuptake inhibitors (SSRIs) accounted for the largest proportion (57.2%), followed by serotonin-noradrenaline reuptake inhibitors (SNRIs) (22.8%) and mirtazapine (7.0%) in the first therapy, while that of SNRIs (53.9%) followed by SSRIs (39.2%) and mirtazapine (9.8%) in the follow-up therapy. An average of 1.85 medications was administered to each MDD patient. SSRIs were the first choice in the first therapy, while the proportion of those drugs decreased during the follow-up therapy and were replaced by SNRIs. Plenty ofcombined pharmacotherapies were directly selected as the first trial of patients, which was inconsistent with guideline recommendations.

Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China.

Evidence suggested that thyroid-stimulating hormone (TSH) and lipid levels were associated with major depressive disorder (MDD). However, its role in suicide attempts in adolescents with MDD was unclear. This investigation was to probe into the relationship between TSH, lipid levels, and attempted suicide in adolescents with MDD. A total of 179 adolescents with MDD were included from January 2021 to January 2022. Socio-demographic data and clinical data were obtained through self-made questionnaires. TSH and lipid levels were analyzed by a recognized laboratory. The Epidemiological Studies Depression Scale (CES-D) was used to assess the severity of depression. Questions about whether there was a behavior of suicide attempts were completed through conversation interviews. Results showed that the CES-D total score, TSH, and low-density lipoprotein cholesterol (LDL-C) of suicide attempters were significantly higher than those of non-suicide attempters. Ordinary family relationships were more likely to attempt suicide than good family relationships. The CES-D total score, ordinary family relationships, TSH and LDL-C were still significant in binary logistic regression, with an adjusted odds ratio (OR) of 1.04, 3.42, 5.14, and 1.76, respectively. The area under the receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) ranged from 0.60 to 0.74. Suicide attempts are common among adolescents with MDD and were associated with CES-D total score, ordinary family relationships, TSH, and LDL-C. Given the association between suicide attempts and TSH and LDL-C, the dynamic changes in TSH and LDL-C levels should be detected regularly.

Associations between gastrointestinal symptoms, medication use, and spontaneous drug discontinuation in patients with major depressive disorder in China

BackgroundThe study was designed to investigate the associations between gastrointestinal (GI) symptoms, medication use, and spontaneous drug discontinuation (SDD) in patients with major depressive disorder (MDD). MethodsThis cross-sectional study included 3256 MDD patients from the National Survey on Symptomatology of Depression (NSSD). Differences in the sociodemographic factors, clinical characteristics, medication use, and self-reported reasons for SDD were compared in patients with different frequencies of GI symptoms. A multiple logistic regression analysis was employed to assess the contribution of GI symptoms to the risk of spontaneous drug discontinuation. ResultsMDD patients with a higher frequency of GI symptoms were prone to have higher proportions of mood stabilizer and benzodiazepine uses (ps for trend < 0.001) but a lower proportion of SNRI use (pfor trend < 0.001). With the increase in GI symptoms, patients were prone to report worries about long-term side effects (pfor trend < 0.001), with the patients stating ineffective treatments (pfor trend = 0.002) and intolerance of adverse drug reactions (pfor trend = 0.022) as the reasons for SDD. Compared with those patients without GI symptoms, all of the MDD patients with GI symptom frequencies of several days (OR = 1.317; 95 % CI: 1.045–1.660), more than half of all days (OR = 1.305; 95 % CI: 1.005–1.695), and nearly every day (OR = 1.820; 95 %: 1.309–2.531) had an increased risk of SDD. ConclusionGI symptoms are highly associated with drug discontinuation in MDD patients. These findings may have important implications for clinical treatment options, as well as for drug adherence management, in MDD patients.

Factors related to the length of stay for major depressive disorder patients in China: A real-world retrospective study.

BackgroundAs numerous patients with depression have to be hospitalized because of various reasons, the demand far exceeds the limited bed count in the psychiatry department. Controlling the length of stay (LOS) of the patient is gradually being considered an effective method to alleviate this problem. Given the lack of statistical evidence of the LOS of patients with major depressive disorder (MDD) in China and the strain on the limited psychiatric resources, the purpose of our study was to investigate the LOS of patients with MDD among in-patient samples and to analyze related factors of the LOS in China by building a regression model.MethodThe data were exported from the electronic medical record system. A total of three categories of independent variables were enrolled in our study, namely, demographic, clinical, and biochemical. Univariate analysis and binominal regression analysis were applied comprehensively to find the factors related to the LOS among MDD samples. The discrimination accuracy of the model was evaluated by the receiver operating characteristic (ROC) analysis. ROC analysis indicated that the discrimination accuracy of our model was acceptable (AUC = 0.790, 95% CI = 0.714–0.865, P < 0.001).ResultA total of 254 patients were finally brought into analysis after filtering. Regression analysis indicated that abnormal LDL was the only risk factor of long LOS (OR = 3.352, 95% CI = 1.087–10.337, P = 0.035) among all the kinds of variables. Notably, in the statistically irrelevant factors of the LOS, the category of anti-depressant drugs [serotonin–norepinephrine reuptake inhibitor (SNRI) or selective serotonin reuptake inhibitor (SSRI)] prescribed to patients with MDD was not associated statistically with the LOS, which was against our initial hypothesis that the LOS of patients with MDD treated with SNRI would vary from that of the patients treated with SSRI.ConclusionUp to our knowledge, our research is the first study to show the potential factors related to the LOS from various domains, especially biochemical indexes, and the effect of drugs, among clinical patients with MDD in China. Our results could provide a theoretical reference for efficient psychiatry hospitalization management and prioritization of allocating medical resources. Future studies are required for updating independent variables which are potentially related to the LOS and verifying existing results in a larger sample.

Research on major depression in China: A perspective from bibliometric analysis

BackgroundMajor depressive disorder (MDD) is a major psychiatric disorder with increasing research intensity. However, papers written in languages other than English are less accessible to international readers. This study examined the bibliometric features of English and Chinese language research papers about major depressive disorder in China. MethodsThe Web of Science (WoS) and China National Knowledge Infrastructure (CNKI) databases were searched for eligible studies. Authorship collaboration networks and keyword co-occurrences were estimated and visualized. ResultsThere were 2,220 and 63,306 publications on MDD in the WoS and CNKI between 1990 and 2021, respectively. The number of papers increased annually during the period. For papers written in English, the Journal of Affective Disorders (201; 9.05 %) had the highest activity and the Shanghai Jiao Tong University had the most publications (232; 10.45 %). For papers in Chinese, the highest activity was with the Journal of Clinical Psychiatry (1,025; 1.62 %) and the Beijing University of Chinese Medicine (1,098; 1.73 %). Xiang YT (68; 3.06 %) and Yuan YG (179; 0.28 %) were the most productive authors in the English and Chinese languages, respectively. Keyword analysis showed that English and Chinese publications differed in emphasis (English: related psychiatric conditions, study design, clinical aspects, and assessment instruments; Chinese: somatic comorbidities, antidepressants, related psychiatric conditions, treatment of depression, and electrophysiological). ConclusionsThe number of scientific papers on MDD increased yearly, and Chinese authors writing in English have an increasing influence. Except for a few authors, productivity and influence were dominated by national universities and specialized medical universities.

The prevalence and clinical correlates of suicide attempts in comorbid subclinical hypothyroidism in patients with never-treated major depressive disorder in China

BackgroundPrevious studies have emphasized the possible association between subclinical hypothyroidism (SCH) and major depressive disorder (MDD). This study aimed to further investigate suicide attempts and their clinical correlates in MDD patients with comorbid SCH. MethodsThis cross-sectional study recruited 1706 eligible MDD outpatients. The Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression of Severity Scale (CGI-S) were applied to evaluate mental status. Fasting blood samples were collected to examine thyroid function. SCH was defined as thyroid stimulating hormone (TSH) > 8 mIU/L with normal free thyroxine levels. ResultsThe prevalence of suicide attempts in the SCH group (51.7 %) was significantly higher than that in the non-SCH group (15.4 %; p < 0.001). Logistic regression showed that patients with comorbid SCH were 1.81 times more likely to have attempted suicide as compared with those without (p = 0.001). Among those with TSH > 8 mIU/L, patients with severe anxiety were 3.57 times more likely to attempt suicide compared with those without (p < 0.01). Logistic regression also showed that the CGI-S score (p < 0.001) was independently associated with suicide attempts, while TSH level was not. ConclusionsSCH comorbidity may pose a specific hazard in MDD patients due to increased suicide attempts. Exhibiting severe anxiety, overall severity of depressive and psychotic symptoms, but not TSH levels, may be independently correlated with suicide attempts in MDD patients with TSH > 8 mIU/L.

The efficacy and safety of Anyu Peibo Capsule in the treatment of patients with major depressive disorder in China: study protocol for a randomized placebo-controlled trial

BackgroundMajor depressive disorder is the second leading cause of years lost to disability worldwide. Anyu Peibo Capsule has been shown to be effective and safe in phase II trials.MethodsThis clinical study is a multi-center, randomized, double-blinded, placebo-controlled, parallel-group, phase III trial of Anyu Peibo Capsule in China. The aim is to test whether the administration of Anyu Peibo Capsule compared to placebo improves clinical outcomes in adults (aged 18 to 65 years) with MDD. Patients will receive an 8-week treatment of Anyu Peibo Capsule 1.6 g per day or placebo. The primary outcome will be the change from baseline in the total score for the Montgomery-Asberg Depression Rating Scale at the end of the 8-week treatment.DiscussionThe trial aims to provide pivotal evidence for the efficacy and safety of Anyu Peibo Capsule in patients with major depressive disorder.Trial registrationClinicalTrials.govNCT04210973. Registered on December 26, 2019

Increased occurrence of PTSD symptoms in adolescents with major depressive disorder soon after the start of the COVID-19 outbreak in China: a cross-sectional survey

BackgroundThe Coronavirus Disease 2019 (COVID-19) pandemic continues to threaten the physical and mental health of people across the world. This study aimed to understand the psychological impact of this disease on adolescents with major depressive disorder (MDD) at 1 month after the start of the outbreak in China.MethodsUsing the Children’s Impact of Event Scale (CRIES-13) questionnaire, we investigated the occurrence of posttraumatic stress disorder (PTSD) in two groups of adolescents: MDD patients who were in continuous antidepressant therapy and healthy controls. Total scores and factor subscores were compared between the two groups and subgroups stratified by sex and school grade. Logistic regression was used to identify variables associated with high total CRIES-13 scores.ResultsCompared to controls (n = 107), the MDD group (n = 90) had higher total CRIES-13 scores and a higher proportion with a total score ≥ 30. They also had a lower intrusion subscore and a higher arousal subscore. In the MDD group, males and females did not differ significantly in total CRIES-13 scores or factor subscores, but junior high school students had higher avoidance subscores than senior high school students. Logistic regression showed high total CRIES-13 scores to be associated with MDD and the experience of “flashbacks” or avoidance of traumatic memories associated with COVID-19.ConclusionsIt is crucial to understand the psychological impact of COVID-19 on adolescents with MDD in China, especially females and junior high school students. Long-term monitoring of adolescents with a history of mental illness is required to further understand these impacts.Trial registrationChiCTR, ChiCTR2000033402, Registered 31 May 2020,

Readiness for Hospital Discharge of Adult Patients with Major Depressive Disorder in China: A Cross-Sectional Study.

PurposeBeing ready for discharge is vital to successful hospital-to-home transitions. However, despite a wealth of evidence on its effectiveness, little is known about readiness for hospital discharge (RHD) in adult patients with major depressive disorder (MDD) and its influencing factors. In this study, we investigated the patient-reported RHD and its influencing factors among Chinese adult patients with MDD.Patients and MethodsIn this cross-sectional design study, 230 adult patients with MDD were recruited according to the inclusion and exclusion criteria, 6 were excluded due to incomplete questionnaires, finally 224 patients were included in our study. Data were collected from March to September 2019 in a tertiary general hospital in Hunan Province (China). The general information, RHD, quality of discharge teaching and level of depression were assessed by using questionnaires. Univariate analysis and ordinal logistic regression analysis were performed to explore the influencing factors of RHD.ResultsThe RHD score was 7.37 ± 1.40, and 36.2% of participants were not ready for discharge. The score of quality of discharge teaching scale (QDTS) was 6.36 ± 1.89, the dimension of delivery scored highest, followed by content-needed and content-received. The proportions of patients with no, mild, moderate, moderately severe and severe depression were 12.5%, 27.7%, 25.0%, 25.4% and 9.4%, respectively. The following factors were associated with RHD: the level of depression (OR=0.66), the content-received dimension of QDTS (OR=1.16), education level (OR=1.24), work status (OR=1.76) and length of hospitalization (OR=0.53).ConclusionThe RHD among participants was at a moderate level. It is strongly suggested to take the assessment of RHD as a routine process. High education level, employment and the content-received dimension of QDTS were protective factors of participants’ RHD, and long-term hospitalization, the high level of depression were its risk factors.

Incidence trends of major depressive disorder in China: an age-period-cohort modeling study

BackgroundMajor depressive disorder (MDD) is a common public health problem in China. However, few studies have focused on its incidence and separated age, period, and cohort effects. This study aimed to assess the age, period, and cohort effects on the incidence trends of MDD in China between 1993 and 2017. MethodsThe incidence data of MDD were obtained from the Global Burden of Diseases Study 2017. Age-period-cohort modeling method was used to separate the age, period, and cohort effects on MDD incidence rate. ResultsThe incidence number of MDD increased by 22.8% while the age-standardized incidence rate decreased by 15.6% over 25 years. Age-period-cohort analysis indicated that the net drift was -0.433% per year, with -0.486% for females and -0.385% for males. For both sexes, the local drifts were all <0 in 10 to 54 years age groups but >0 in 55 to 94 years age groups. The longitudinal age curves of MDD incidence basically showed an increasing trend, except for a subpeak at 20−24 years age group. The period rate ratio largely declined over time, except for an uptick after 2003−2007. The cohort rate ratio followed an inverted U-shaped pattern and was highest in 1951−1955 birth cohort. LimitationsThe MDD data were estimated and wide social factors were not included in the analyses. ConclusionThe changes of MDD incidence rate in China are likely to be related to rapid social and economic development, and major historical events. However, the associations need to be interpreted with caution.

The first national action plan on depression in China: Progress and challenges

The first national action plan on depression in China: Progress and challenges

Prevalence and risk factors of overweight and obesity in Chinese patients with first-episode drug-naïve major depressive disorder

BackgroundsObesity and overweight are common in patients with major depressive disorder (MDD); the results are inconsistent due to confounding variables involved in studies. Furthermore, no well-designed study has been published to investigate the prevalence, risk factors and underlying mechanisms of obesity/overweight in Chinese MDD patients. This study aimed to investigate the prevalence of obesity/overweight and related risk factors in first-episode, drug-naïve (FEDN) patients with MDD in China. MethodsA total of 1718 patients were recruited. Their clinical and anthropometric data, thyroid function and biochemical parameters were collected. All patients were evaluated on the 17-item Hamilton Rating Scale for Depression, 14-item Hamilton Anxiety Rating Scale and the Positive and Negative Syndrome Scale. ResultsThe prevalence of obesity and overweight was 3.73% and 56.00%, respectively. Multivariable logistic regression analysis showed that TSH was the only independent risk factor for weight gain in MDD patents. The fitting curve of the relationship between TSH and BMI formed an inverted U-shaped parabola. The ordinal logit mode showed that when TSH<=2.68 was set as a reference, the odd rates of weight increased with the increase of TSH, and the highest rate was 3.929 (95%CI: 2.879–5.361, P<0.0001). LimitationCausality cannot be drawn due to cross-sectional design. ConclusionOur results suggest that overweight is very common among patients with FEDN MDD rather than obesity. TSH is a promising predictor and potential biomarker of high weight in MDD patients, and there is an inverted U-shaped parabolic relationship between TSH and BMI.

Demographic and Psychosocial Variables Could Predict the Occurrence of Major Depressive Disorder, but Not the Severity of Depression in Patients with First-episode Major Depressive Disorder in China

Background: This study aimed to investigate the association between psychosocial variables and depression severity among Chinese patients with first-episode major depressive disorder (MDD). Methods: This multicenter case-control study enrolled patients with first-episode MDD and healthy controls (HCs) from nine sites in China. Depressive symptoms, clinical features, and psychosocial variables were evaluated. Based on the total score of the Hamilton Rating Scale of Depression (HRSD-17), patients with MDD were classified into three subgroups of severity (mild, moderate and severe). The logistic regression analyses were conducted to investigate the independent risk factors of MDD and different severities of depression. Results: Overall, 598 MDD patients and 467 HCs were included. The proportions of patients with mild, moderate, and severe depression were 260 (29.5%), 443 (50.2%), and 179 (20.3%), respectively. The logistic regression model revealed that the demographic and psychosocial factors could explain 50.6% of the total variance of occurrence of MDD in the whole sample with HCs. However, in the subsample of MDD patients, only older age [OR=1.03 (95%CI: 1.02-1.05)], stressful social events [OR=1.04 (95%CI: 1.02-1.06)], and melancholic feature [OR=2.68 (95%CI: 1.91-3.74)] were independent risk factors for moderate and severe depression; these factors combined to explain only 10.2% of the total variance. Limitations: Only patients with first-episode MDD were included in this study, leaving the associated factors for the severity of recurrent depression uninvestigated. Conclusion: Demographic and psychosocial variables had satisfactory performance in predicting the occurrence of MDD, but showed inadequate value in predicting the depression severity of MDD patients.

Treatment Rate for Major Depressive Disorder in China: a Meta-Analysis of Epidemiological Studies.

Major depressive disorder (MDD) is a common psychiatric disorder in China, but its reported treatment rate varies largely across different studies. The objective of this meta-analysis was to determine the pooled treatment rate for people with MDD in China and its associated factors. Both English (PubMed, Cochrane Library, PsycINFO, Web of Science) and Chinese (Chinese National Knowledge Infrastructure, WanFang and SinoMed) databases were searched from their commencement date to November 13, 2018. Epidemiological studies that reported the treatment rate of MDD were included and synthesized using a random effects model. Fifteen studies covering 609,054 participants were included. The pooled treatment rate for MDD in China was 19.5% (95% CI: 10.7%-28.4%). Among the 15 studies, 9 reported the number of patients who received treatments in psychiatric hospitals with a pooled treatment rate of 5.2% (95% CI: 2.8%-7.5%). Meta-regression found that study quality (β = 0.131, P = 0.028) and male gender (β = 0.006, P = 0.039) were significantly associated with a higher treatment rate for MDD. In China, the treatment rate for MDD, particularly in psychiatric hospitals, was low. Effective public education and increasing access to mental health services will probably increase the number of people seeking and receiving treatment.