Poor Family Economic Status Research Articles

Current Psychotic-Like Experiences Among Chinese College Students: Prevalence, Correlates, and Its Relationship with Suicidal Ideation.

Current psychotic-like experiences (PLEs) are prevalent among adolescents. However, epidemiological data on the prevalence rate of current PLEs among college students and its clinical correlates are scarce and limited. To address this study gap, this study aimed to investigate the prevalence and correlates of current PLEs among Chinese college students. A cross-sectional study was designed with a sample of 18,578 college students in China. Each participant completed a survey on social-demographic characteristics variables, PLEs, sleep disturbance, depression, anxiety, and suicidal ideation. Logistic regression analyses were conducted to explore the influential factors for PLEs among all participants and suicidal ideation among those with PLEs. Among Chinese college students, 40.3% of the participants reported having at least one PLE in the past month, while 7.5% had frequent PLEs. Males, age, residence location in town, left-behind experiences, poor family economic status, chronic physical illness, family history of mental disorder, BMI ≥ 28 [obesity], sleep disturbance, depression, anxiety, and suicidal ideation were independent correlates for frequent PLEs. Furthermore, the prevalence of suicidal ideation among participants with frequent PLEs was 32.1%. Lower grades, sleep disturbance, depression, and anxiety were independent predictors of suicidal ideation among college students who experience PLEs frequently. Current PLEs are widespread among Chinese college students. Suicidal ideation is largely prevalent among individuals who suffer frequent PLEs, suggesting that special measures and attention should be provided to these students based on relevant factors to prevent their suicidal ideation and behavior.

Combined effects of physical activity and life events on depression and PTSD in Chinese students aged 16-24 years.

Life events are important risk factors for depression and post-traumatic stress disorder (PTSD). Physical activity is a beneficial behavior to physiological and psychological health. While it has not been reported at present the combined effect of physical activity and life events on individual depression and PTSD, and whether it can alleviate the psychological risks induced by life events. To comprehensively investigate the current status of life events experiences in Chinese students aged 16-24 years and analyze the combined effects of physical activity and life events on their depression and PTSD. An online cross-sectional survey was conducted on physical activity levels, life events experiences, depression and PTSD of 1,552 Chinese students aged 16-24 using short version of International Physical Activity Questionnaire (IPAQ-S), adolescent self-rating life events checklist (ASLEC), PTSD Check List-Civilian Version (PCL-C) and Patient Health Questionnaire Depression Scale. Then, logistic regression equation and stratified analysis were used to explore the combined effects of physical activity and life events on depression and PTSD. Regression analysis showed that, except for female, <8 h of sleep, smoking, single parent/reorganized families and poor family economic status, experiencing medium-intensity and high-intensity life events were both risk factors for depression. Compared with those who experienced low-intensity life events, those who experienced medium- and high-intensity life events had a 27 and 131% increased risk of depression, respectively. In contrast, medium- and high-level physical activity could reduce the risk of depression by 49 and 53%, respectively. Similar results were obtained with PTSD as a dependent variable. Combined correlation analysis showed that, compared with those with high-level physical activity and low-intensity life events, those with low-level physical activity and high-intensity life events had a 209 and 121% increased risk of depression and PTSD, respectively. Stratified analysis showed that the threshold for life events induced depression and PTSD rose with the increase in the level of physical activity. Lack of physical activity and experience of high-intensity life events are independent risk factors for depression and PTSD, and strengthening physical activity can compensate for the harm of depression and PTSD caused by life events to some extent.

Preventive Behaviors, Psychological Distress, and their Associated Factors in Iranians during the SARS-CoV-2 Delta Variant Outbreak

Background: Up to now, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected and killed millions of people across the globe. In these conditions, Iran was experiencing the fifth wave of the Coronavirus disease 2019 (COVID-19) pandemic, accrued by the Delta variant, over the course of the present study. Objectives: The present study aimed to reflect on preventive behaviors, psychological distress, and their associated factors in Iranians during the SARS-CoV-2 Delta variant outbreak. Methods: Utilizing a descriptive-analytical cross-sectional research design, this study was performed on 1,015 Iranian individuals referred to the comprehensive healthcare centers in Kashan, central Iran, selected via simple random sampling. Data collection tools included the sociodemographic information questionnaire, the Preventive Behaviors against COVID-19 Questionnaire (PBCQ), and the 12-item General Health Questionnaire (GHQ-12). Results: The study results revealed that the mean±standard deviation (SD) of PBCQ was 17.20±4.18 (12-36). In addition, involvement in preventive behaviors against COVID-19 was at higher levels in male (P=0.007), younger (P≤0.001), and self-employed (P=0.016) participants with a fair family economic status (P=0.007), as compared to other cases. Those receiving no vaccines (P=0.023), together with the subjects recently contracting COVID-19, also adhered to only some preventive behaviors (P≤0.001). The GHQ-12 mean±SD was equal to 2.15±2.41 (0-12). Moreover, the study results indicated that female (P=0.021) younger (P=0.017), married (P=0.024), self-employed (P=0.003) subjects with a fair or poor family economic status (P=0.001) and recent infection with COVID-19 (P=0.010) were more susceptible to psychological distress, as compared to others. Conclusion: The present study demonstrated that engagement in preventive behaviors against COVID-19 significantly dwindled, and the incidence rate of psychological distress augmented in the course of the fifth wave of the pandemic in Iranians. These findings could provide healthcare planners and policymakers with valuable information.

Influences and patterns of intimate partner violence among married Akha and Lahu women in northern Thailand

BackgroundIntimate partner violence (IPV) is a major global public health problem. Women are the principal victims of IPV, and some special populations have been particularly impacted. The Akha and Lahu women are vulnerable populations for IPV due to the modernization and changes of their culture and norms. This study aimed to understand premarriage factors related to IPV, including associated factors, influencers, patterns and impacts, in Akha and Lahu women in Thailand.MethodsA qualitative method was used to gather information among Akha and Lahu women who had experienced IPV in the previous year and were fluent in Thai. Women who had experienced IPV in the previous year and lived in the border area of Thailand and Myanmar were invited to provide information. A thematic analysis was used to extract information from the participants and develop findings.ResultsA total of fifty-two married women were recruited into the study: 46.2% were Akha and 53.8% were Lahu. Those married Akha and Lahu women younger than 39 years found their partner through social media, had conditions before getting married, had high self-confidence, and tended to marry people from different tribes. While those aged 40 years and over met their husbands in village activities, were highly compliant with the norms of their culture, and married men from the same tribe. Three factors were detected as associated factors of IPV: cultural differences between partners from different tribes, substance use, and personality. Differences in age between partners, living in poor family economic status, and poor education were also detected as influencers of IPV. Four patterns of IPV were observed among Akha and Lahu married women: neglect, emotional abuse, verbal abuse, and physical abuse. Several patterns of the impacts were presented: children were neglected, especially in the preparation of daily food, having stress, having poor family relationships, and having children with unsuccessful lives in terms of education and getting a good job. Almost all married Akha and Lahu women had no particular expectations in their lives.ConclusionAkha and Lahu women face IPV problems with several key influences and impacts. Effective implementations are required to monitor and reduce the problem in the Akha and Lahu families, especially where the women are younger than 40 years old and married to men from different tribes.

Mental Health Problems and Associated Factors among High School Students in Shandong Province of China: A Cross-Sectional Study.

Background: Although many studies have analyzed the mental health problems (MHP) of Chinese adolescents, the associations of Chinese high school students’ MHP with personal and family circumstances, parents’ educational level, physical activity, and school adaptation are rarely discussed. Methods: The participants were 9398 students who were randomly recruited from 30 high schools in Shandong, China. Self-reported questionnaires were used to collect data. Multivariate logistic regression models were used to investigate associations between MHP and related factors. Results: The positive rate of MHP among high school students was 27.0%. Female, intimate friends of the opposite sex, poor family economic status, father’s educational level of primary school or below, low social competence, and high antisocial behavior were significantly associated with higher odds of having MHP (p < 0.05). Students’ self-reported odds of having obsessive–compulsive disorder, interpersonal sensitivity, and depression were inversely related to their mother’s educational level. Compared with students who did not exercise, students who engaged in more than 30 min of physical activity 5–6 times per week had 60% lower self-reported odds of depression. Conclusions: We recommend strengthening the prevention, early detection, and treatment of MHP in high school students, especially those whose parents have low educational attainment, inactivity, and high disruptive behaviors.

Prevalence and Related Factors of Anxiety Among University Teachers 1 Year After the COVID-19 Pandemic Outbreak in China: A Multicenter Study.

ObjectivesThis study aimed to evaluate the prevalence of anxiety among university teachers 1 year after the onset of the coronavirus disease 2019 (COVID-19) pandemic and provide empirical evidence of psychological intervention.MethodsA multicenter study was conducted to examine the prevalence of anxiety among 10,302 teachers in 21 Chinese universities from February 12 to April 23, 2021. The generalized Anxiety Disorder 7-item Scale (GAD-7) was used to assess symptoms of anxiety. Multivariate logistic regression models were used to analyze the relationship between potential influence and anxiety symptoms.ResultsThe overall prevalence of anxiety was 40.0% 1 year after the onset of the COVID-19 pandemic, which was found to be higher in women than in men (41.32% vs. 38.22%; p < 0.0001). The multivariate logistic regression showed that being the female (OR = 1.207; 95%CI: 1.103–1.318), age ≥60 years (OR = 2.004; 95%CI: 1.128–3.560), being married (OR = 1.319; 95%CI: 1.150–1.513), and poor family economic status (OR = 1.580; 95%CI: 1.321–1.891) were significantly associated with anxiety. Participants with moderate, slight, or no impact of COVID-19 on life (OR for moderate, 0.557; 95%CI, 0.508–0.611; OR for slight/no, 0.377; 95%CI, 0.323–0.439) showed a reduced risk of anxiety compared to those who reported a significant effect.ConclusionsSymptoms of anxiety were found in about two-fifths of Chinese university teachers 1 year after the outbreak of the COVID-19 pandemic. Our findings suggest that the government should improve the dynamic tracking of mental health and adopt long-term intervention strategies.

Psychological Impact of COVID-19 Epidemic on Adolescents: A Large Sample Study in China.

Background: The COVID-19 pandemic is a major public health emergency. However, little is known about the psychological impact of this pandemic on adolescents. We aim to assess the prevalence and influencing factors of depression, anxiety, and posttraumatic growth (PTG) among adolescents in a large sample study.Methods: This cross-sectional study collected demographic data and mental health measurements from 175,416 adolescents covering 31 provinces, centrally administered municipalities, and autonomous regions in mainland China from February 23 to March 8, 2020. The status of depression, anxiety, and PTG was assessed by the nine-item Patient Health Questionnaire, seven-item generalized anxiety disorder questionnaire, and post-traumatic growth inventory.Results: The prevalence of depression, anxiety, and PTG in adolescents was 35.9, 28.0, and 45.6%, respectively. The prevalence of depression and anxiety in the slight or severe epidemic areas was similar. Regression analysis showed that female sex and older age were associated with higher levels of depression, anxiety, and lower levels of PTG. Symptoms related to COVID-19, excessive attention to epidemic information, living in urban or severe epidemic areas, and conflicts with parents during home quarantine were risk factors for depression, anxiety, and PTG. Frequent communication with peers, exercise, and receiving public welfare psychological assistance were protective factors. Poor family economic status was a significant risk factor for depression and PTG.Conclusion: Our findings suggested that positive and negative psychological reactions coexist in adolescents faced with the pandemic. The factors associated with psychological problems and PTG provide strategic guidance for maintaining adolescents' mental health in China and worldwide during any pandemic such as COVID-19.

Depression and Deliberate Self-Harm Among Rural Adolescents of Sichuan Province in Western China: A 2-Year Longitudinal Study.

Objective: To explore the change in the prevalence and association of depression and deliberate self-harm and their common and independent influencing factors among western Chinese rural adolescents.Methods: A total of 2,744 junior and senior high school students from two rural schools in Sichuan Province, China, participated in the baseline survey and were invited to participate in two follow-up surveys. The Center for Epidemiologic Studies-Depression Scale, a deliberate self-harm item, the Social Support Rating Scale, the Rosenberg Self-esteem Scale and the Connor-Davidson Resilience Scale were administered. A bivariate four-level logistic regression model was used for analysis.Results: The prevalence of depression and deliberate self-harm were 39.6 and 21.2%, respectively. Regular physical exercise, a good relationship with parents, high resilience, and high self-esteem were common protective factors for both depression and deliberate self-harm. Feeling disliked by teachers was a common risk factor for both. Being female, having a mother who emigrated as a migrant worker before the student was 3 years old, feeling disliked by classmates and having a poor family economic status were associated only with an increased risk of depression. Participants with medium social support were less likely to report deliberate self-harm than those with low or high support. Depression and deliberate self-harm were clustered at the class level.Conclusions: The comorbidity of depression and deliberate self-harm in rural adolescents should be given ample attention. Interventions should consider the class clustering of depression and deliberate self-harm and their common and unique influencing factors.

Change of poverty and outcome of persons with severe mental illness in rural China, 1994-2015.

It is unknown whether and how poverty influences the long-term outcome of persons with severe mental illness (SMI). To explore the change of poverty status in persons with SMI from 1994 to 2015 and examine the impact of poverty status on patients' outcome in rural China. Two mental health surveys using identical methods and International Classification of Disease (ICD-10) were conducted in 1994 and 2015 in the same six townships of Xinjin County, Chengdu, China. The annual net income per person was 19.8% and 100.2% higher for the general population than for persons with SMI in 1994 and 2015 respectively. Compared with 1994 (48.2%), persons with SMI in 2015 had significantly higher rates of poor family economic status (<mean) (65.2%) (p < .001). Persons with SMI in poor family economic status were significantly more likely to be male, unmarried, unable to work, with no family caregivers or a smaller number of family members, and in poor mental status in 1994 and 2015 (p < .05). The risk factors significantly associated with patients' poor mental status included poor work ability, younger age of first onset, never-treated status and poor family economic status. Relative poverty of persons with SMI has become more severe during the rapid socioeconomic development in rural China. Relative poverty of household, poor work ability, younger age of onset and never-treated status are risk factors of poor outcome. Culture-specific, community-based interventions and targeted poverty alleviation programs should improve patients' early identification, treatment and recovery.

Prevalence and correlates of depressive symptoms among Chinese patients with cataracts treated in tertiary general hospitals.

BackgroundPrevious studies recruited unrepresentative samples of Chinese patients with cataract and reported a wide range of prevalence of depressive symptoms in this patient population (18.0–89.7%). The present study determined the prevalence and correlates of depressive symptoms among a consecutive sample of Chinese patients with cataract treated in tertiary general hospitals.MethodsA total of 339 patients with cataract were consecutively selected from ophthalmology departments of two large general hospitals in Wuhan, China. Depressive symptoms were assessed with the Chinese Hospital Anxiety and Depression Scale. Logistic regression was used to identify factors that were associated with depression.ResultsThe prevalence of depressive symptoms was 23.9% (95% CI [19.4–28.4]%) among patients with cataract. Correlates for depressive symptoms include an education level of primary school and below (OR = 1.93, P = 0.038), marital status of “others” (OR =3.15, P < 0.001), poor family economic status (OR = 2.26, P = 0.010), nuclear cataract (OR =4.32, P < 0.001), and mixed cataract (OR = 2.76, P = 0.017).ConclusionsDepressive symptoms are common among Chinese patients with cataract treated in large general hospitals. Patients who are poorly educated, have a marital status other than “married”, have poor family economic status, and suffer from nuclear and mixed cataracts are at greater risk for depressive symptoms.

An epidemiologic study of sleep-disordered breathing in a large sample of Chinese adolescents

Sleep-disordered breathing (SDB) is common among adolescents and is associated with short- and long-term consequences. Data on the prevalence and epidemiologic characteristics of SDB in Chinese adolescents are limited. The purpose of this study was to examine the prevalence, epidemiologic characteristics, and associated factors of SDB using a large sample of Chinese adolescents. Participants were from the baseline of the Shandong Adolescent Behavior and Health Cohort (SABHC) and included 11,831 adolescents (aged 14.97 ± 1.46 years old) from five middle schools and three high schools in Shandong Province, China. Adolescents completed a self-administered questionnaire on sleep-related variables, demographics, general health, family, and school information. SDB was defined as report of loud snoring or snorting/gasping or stopping breathing during sleep occurring weekly. In this sample, 8.3% of the adolescents snored loudly at least once per week and 2.1% snored loudly almost every night. Snorting/gasping and stopping breathing at least once a week affected 6.6% and 2.0% of adolescents, respectively. The prevalence of weekly SDB was 13.4% according to adolescent report. Multiple logistic regression analysis revealed that SDB was independently associated with male gender, body mass index (BMI), chronic diseases, ever smoking, ever drinking, insomnia, daytime sleepiness, poor family economic status, and low father education level. SDB is prevalent in Chinese adolescents, and multiple factors are associated with SDB. These associations also require longitudinal epidemiologic studies to clarify the complex nature of their relationships and opportunities for and effects of intervention.

Association of e-health literacy and social support with depressive symptoms among female nursing students

Objective To explore the relationship between eHealth literacy and social support and depressive symptoms in female nursing students, and to provide a reference for improving the mental health of female nursing students. Methods In November 2019, 1 115 female nursing students from freshmen to junior years in four medical colleges in Changsha were investigated eHealth Literacy Scale, Perceived Social Support Scale, Center for Epidemiological Studies Depression Scales and demographic information questionnaire. Results The detection rate of depressive symptoms in female nursing students was 20.1%(224/1 115), and the qualification rate of eHealth literacy was 29.2%(326/1 115). The incidence of depressive symptoms were higher in female nursing students with urban household registration and their parents with high school education and above and poor family economic status (χ 2 = 9.46, 20.02, 7.16, 12.40, P <0.05). Multivariate Logistic regression analysis showed that poor eHealth literacy and low social support were positively correlated with depressive symptoms in female nursing students ( OR = 3.16, 3.65, P <0.05). There was a correlation between the interaction of eHealth literacy and social support with depressive symptoms. In the same type of social support, the lower eHealth literacy level, the greater the risk of depressive symptoms was for female nursing students ( P <0.05). Conclusion Health literacy and social support are the influencing factors of depressive symptoms in female nursing students. The occurrence of depressive symptoms can be reduced by improving the level of electronic health literacy and social support. 【摘要】 目的 探讨护理专业女生电子健康素养和社会支持与抑郁症状的关联, 为提高护理专业女生心理健康水平 提供参考。 方法 2019 年 11月, 采用电子健康素养量表、领悟社会支持量表、流调中心抑郁量表、社会人口学信息调查 表, 对多阶段整群抽取的长沙市 4 所医学院校大一至大三年级 1 115 名护理专业女生进行调查。 结果 护理专业女生抑 郁症状的检出率为 20.1% (224/1 115), 电子健康素养合格率为29.2% (326/1 115)。生源地为城镇、父/母受教育程度为高 中及以上、家庭经济状况较差的护理专业女生抑郁症状检出率较高 (χ 2 值分别为 9.46, 20.02, 7.16, 12.40, P 值均<0.05)。 多因素 Logistic 回归分析显示, 电子健康素养不合格和低社会支持均与护理专业女生抑郁症状呈正关联 ( OR 值分别为 3.16, 3.65, P 值均<0.05)。电子健康素养和社会支持的交互作用与抑郁症状之间的相关有统计学意义, 相同社会支持情况 下, 电子健康素养不合格, 护理专业女生抑郁症状发生风险大 ( P 值均<0.05)。 结论 电子健康素养和社会支持是护理专 业女生抑郁症状的影响因素。提高电子健康素养水平和社会支持有助于降低抑郁症状的发生。

The Knowledge and Attitude Towards Advance Care Planning Among Chinese Patients with Advanced Cancer.

To describe the knowledge and attitude of Chinese patients with advanced cancer towards advanced care planning (ACP), a convenience sample of 275 patients with advanced cancer was recruited from a tertiary cancer hospital in Beijing, China, between February and December 2017. The multi-item questionnaire focused on patients' demographics, disease characteristics and knowledge about and attitude towards ACP and was administered to eligible patients. Descriptive statistics were performed. Most patients had never heard about ACP (82.2%) and had never talked about ACP (83.0%), but only a few (18.3%) were not willing to talk about ACP. A total of 67.8% patients chose to refuse resuscitation attempts or life-sustaining medical interventions, and 70.8% of patients hoped to have surrogate decision makers when they became unconscious. By binary logistic regression analysis, patients who were of greater age, female and living in urban areas preferred to refuse resuscitation attempts or life-sustaining medical interventions (OR = 1.023, P = 0.042; OR = 2.011, P = 0.020; OR = 0.254, P < 0.01); patients who had very rich or rich family economic status preferred to involve surrogate decision makers compared with patients of very poor family economic status (OR =0.250, P = 0.011). There is a large gap between the knowledge about ACP and the expectation of implementing ACP in Chinese patients with advanced cancer. To develop culturally appropriate and individualized programmes to promote knowledge and implementation in practice of ACP among Chinese patients with advanced cancer and their relatives is still a significant challenge.

Risk Factors for the First Dose Measles Immunization Drop Out in Mempawah District, West Kalimantan Province

One factor in the occurrence of measles in children was measles immunization drop out during infancy. The purpose of this study was to determine the risk factors for measles immunization drop out in children aged 9–17 months. This study uses a cross-sectional design. Sample in this study was 126 mothers who had children aged 9–17 months. Study variables were measured using a questionnaire with the interview method. Logistic regression was used to look at the risk factors for measles immunization drop out and the odds ratio of these risk factors. Factors that influence the incidence of measles immunization drop out were the poor family economic status of AOR 7.0 (95% CI 2.55–18.65, p = 0.0001), lack of maternal knowledge AOR 3.61 (95% CI 1, 43-9.08, p = 0.006) and lack of family support AOR 6.54 (95% CI; 2.39–17.89, p = 0.006). Factors that did not influence the incidence of measles immunization drop out were the age of mothers <30 years old, mothers with elementary education, status of working mothers, perceptions of the role of health officers, perceptions of services at posyandu and distance to health facilities. Health officer is expected to provide information on the importance of measles immunization to mothers of children <5 years and include families at the time of counseling so that families know and support measles immunization, and provide information to the public through the media.

Sleep quality among Chinese elderly people: A population-based study

Little was known about sleep quality among Chinese population. Using data from a population-based survey, we aimed to describe the prevalence of poor sleep quality among Chinese elderly people, to analyze factors associated with poor sleep quality, and to explore the relation between sleep quality and life quality as well as the risk for mental disorders. Data was derived from the Tianjin Mental Health Survey. The 19-item Pittsburg Sleep Quality Index was used to assess sleep quality. Life quality was evaluated using a Chinese version of Quality of Life Scale. To investigate the risk for mental disorders, the Chinese version of General Health Questionnaire was administered. Female gender, older age, low educational attainment, poor subject family economic status, and not having health insurance were significantly associated with elevated risk of poor sleep quality. Poor sleep quality was associated with poor life quality and increased odds of mental disorders. Further studies are warranted for the evaluation of effectiveness of screening tools for sleep problems and the generalization of early screening and diagnosing programs in the nation. Early screening is necessary and appropriate intervention programs should be conducted in the population with high risk.

Bullying victimization: Associated contextual factors in a Greek sample of children and adolescents.

School bullying is increasingly recognized as an important factor affecting both individual's wellbeing and social functioning. Several studies provide evidence for the potential role of contextual factors that relate to bullying victimization such as the socioeconomic status of the parents/ family, the quality of family and home environment, the school climate, structure and ethos, and also various community characteristics. The objectives of this school-based, cross-sectional study were to report the prevalence of the perception of being bullied in a sample of Greek children and adolescents from 6 to 17 years of age and to investigate the relations among the subjective impression of bullying victimization and several sociodemographic and socioeconomic factors. We hypothesized that influences external to individual children and adolescents play a decisive role to their perception of being victimized. Bullying victimization was measured through a simple "yes/no" question, which confirmed or rejected respectively the fact that the child or adolescent has been at some time victimized in the school environment. Also, demographic and socioeconomic data about the families of children and adolescents were collected. A total of 1,588 children (51.8% females, mean age ± SD: 12.9±2.8 years) were assessed. The overall prevalence of victimization was 10.4%. Multiple logistic regression analysis on the probability of being victimized identified that living at a main urban center (Odds Ratio[OR]: 2.63, CI: 1.78-3.87, p<0.001), presence of a person with a chronic illness at home (OR: 1.90, CI: 1.12-3.20, p=0.016), poor family economic status (OR: 1.83, CI: 1.05-3.20, p=0.032),and increased number of adults at home (OR: 2.00, CI: 1.00-3.77, p=0,041) had a positive correlation with the prevalence of reported bullying victimization. Moreover, higher parental educational level related to lower probability of victimization (OR: 0.88, CI: 0.78-0.99, p=0.05). These findings demonstrate that several demographic and socioeconomic factors play a potential role in bullying victimization among schoolchildren. Our results also highlight the need to consider the influence of contextual factors in the design of targeting efforts countering and/or preventing bullying victimization.

Changes in treatment status of patients with severe mental illness in rural China, 1994-2015.

Although it is crucial to improve the treatment status of people with severe mental illness (SMI), it is still unknown whether and how socioeconomic development influences their treatment status.AimsTo explore the change in treatment status in people with SMI from 1994 to 2015 in rural China and to examine the factors influencing treatment status in those with SMI. Two mental health surveys using identical methods and ICD-10 were conducted in 1994 and 2015 (population ≥15 years old, n = 152 776) in the same six townships of Xinjin County, Chengdu, China. Compared with 1994, individuals with SMI in 2015 had significantly higher rates of poor family economic status, fewer family caregivers, longer duration of illness, later age at first onset and poor mental status. Participants in 2015 had significantly higher rates of never being treated, taking antipsychotic drugs and ever being admitted to hospital, and lower rates of using traditional Chinese medicine or being treated by traditional/spiritual healers. The factors strongly associated with never being treated included worse mental status (symptoms/social functioning), older age, having no family caregivers and poor family economic status. Socioeconomic development influences the treatment status of people with SMI in contemporary rural China. Relative poverty, having no family caregivers and older age are important factors associated with a worse treatment status. Culture-specific, community-based interventions and targeted poverty-alleviation programmes should be developed to improve the early identification, treatment and recovery of individuals with SMI in rural China.Declaration of interestNone.

Poverty and outcomes of people with severe mental disorders in rural China: a 21-year survey

BackgroundLittle is known about the relationship between poverty and outcomes of severe mental illness (SMI) during a period of sustained rapid socioeconomic development. This study explored the relationship between poverty and outcomes of people with SMI in a 21-year longitudinal study in a rural area of China. MethodsEpidemiological surveys of mental disorders were conducted in May, 1994, and October, 2015, in the same six townships (total population 170 174 in 2015) in Xinjin County, Chengdu, China. Psychoses Screening Schedule together with key informant method for household survey and general psychiatric interview were administered to identify people with SMI (including schizophrenia, bipolar disorders, and major depressive disorder) according to International Classification of Mental and Behavioural Disorders-10 criteria. FindingsWe identified 711 people with SMI aged 15 years and older in 1994 and 1042 in 2015. The annual net income per person in people with SMI was significantly lower in 1994 (1110·0 RMB) and 2015 (8420·1 RMB) (p<0·0001) than in the population of Xinjin (1330·0 RMB and 16856·0 RMB, respectively). The rate of having poor family economic status (<mean level) in people with SMI was significantly higher in 2015 (65·2%) than in 1994 (48·2%, p<0·0001). Poor family economic status was significantly associated with being male and unmarried, a lower number of family members, and lower rates of partial and full remission of SMI in 1994 and 2015 (p<0·05). Poor family economic status was also significantly associated with lower education level, lower rate of having a family caregiver, higher total score on the Positive and Negative Syndrome Scale, lower total score of Global Assessment of Functioning, and lower rates of medication in 2015 (p<0·05). InterpretationRelative poverty has become more severe in people with SMI during the period of rapid socioeconomic development from 1994 to 2015 in China, and it is associated with poor outcomes of SMI. Prevention of the cycle of poverty and mental illness should be vital for Healthy China 2030. Targeted poverty alleviation programmes and community-based mental health care should be crucial for enhancing economic status and improving outcomes of people with SMI. FundingThe survey in 1994 was supported in part by China Medical Board of New York (92-557, principal investigator: MZX). The survey in 2015 was supported in part by Seed Funding Programme for Basic Research (Hong Kong University, 2014–2016, principal investigator: MSR), Seed Funding Programme for Applied Research (HKU, 2014–2016, principal investigator: MSR), Strategic Research Theme: Contemporary China Seed Funding (HKU, 2014–2016, principal investigator: MSR), Small Project Funding (HKU, 2014-2016, principal investigator: CLWC), and Mental Health Research in Chengdu, China (Department Matching Fund, 2015–2017, principal investigator: MSR).

Correlates of Academic Performance in Pupils under a Feeding Program

School feeding (SF) has long been a welfare scheme adopted in the Philippines but there are very limited empirical studies that assessed its effectiveness. The nutrition-cognition nexus needs to be examined especially that regular SF program has been institutionalized recently by the government. From a set of socioeconomic factors and anthropometric measures, the present study determined which of them are significantly associated with the composite final grade of pupils. All recipients (N=80 malnourished primary schoolchildren were served lunch) of the “Busog-Lusog-Talino” (“Full-Healthy-Bright”) School Feeding Program in San Carlos Elementary School in southern Bicol (Philippines) for two school years were participants to the study. Pearson correlation analysis revealed that parents’ education and pupils’ concurrent body mass index (BMI) are positive explanatory factors correlated with the final grade. Differing from many studies where mother’s education had commonly been a dominant and only parent gender significant factor to pupils’ academic achievement, the study revealed that under circumstances of poor family economic status the education of fathers had higher association than mothers’. Concurrent BMI (i.e., measured while the school feeding was implemented) is significantly linked to pupils’ grades providing evidence for the need in sustaining good nutrition from school to the home. Schoolchildren under varying low levels of nutritional status and with low parents’ education are predisposed to low academic performance. Implications of the findings to improving school feeding monitoring were elucidated.

Sexual dysfunction and associated factors in Chinese Han women with epilepsy

PurposeWomen with epilepsy (WWE) are believed to be at risk of sexual dysfunction (SD) and face many sexual challenges because of multiple factors. This study aimed to assess the factors associated with SD in Chinese Han WWE. MethodsThis cross-sectional study examined 112 married WWE in the Affiliated Hospital of Yangzhou University with focal (FE) or generalized epilepsy (GE) on antiepileptic drugs (AEDs), and 120 healthy controls without epilepsy, all of Chinese Han nationality. Data collection tools included the Chinese version of Female Sexual Function Index (FSFI), the Chinese version of Zung Self-Rating Anxiety Scale (SAS), the Chinese version of the Zung Self-Rating Depression Scale (SDS), the Chinese version of the revised Morisky Medication Adherence Scale (MMAS-8), and the Chinese version of the National Hospital Seizure Severity Scale (NHS3). Chi-square test, t-test, one-way analysis of variance (ANOVA), and binary logistic regression were used for statistical analysis. ResultsA high rate (70.5%) of SD was detected in WWE, with 24.2% in controls. Sexual dysfunction affected all dimensions: desire (85.7%), arousal (56.3%), lubrication (47.3%), orgasm (66.1%), satisfaction (58.9%), and pain (41.1%). Elevated rates of anxiety (40.2%) and depression (33%) and poor medication adherence (31.3%) were also found in WWE. Binary logistic regression found that poor economic status (odds ratio (OR) = 13.904, 95% confidence interval (CI): 2.025–95.472, P = 0.007 and OR = 6.350, 95% CI: 1.323–30.477, P = 0.021), anxiety (OR = 1.222, 95% CI: 1.055–1.415, P = 0.007), and poor medication adherence (OR = 0.297, 95% CI: 0.124–0.707, P = 0.006) were associated with SD. ConclusionsThe associated factors of SD in Chinese Han WWE are multifactorial. The WWE have higher levels of anxiety, poor family economic status, and poor medication adherence. Medical professionals should not only better control seizures but also evaluate and improve patients' sexual function so as to improve the quality of life of WWE.