Economic growth and suicide rate changes: A case in China from 1982 to 2005

ObjectivesIt is to estimate the trend of suicide rate changes during the past three decades in China and try to identify its social and economic correlates.MethodsOfficial data of suicide rates and economic indexes during 1982–2005 from Shandong Province of China were analyzed. The suicide data were categorized for the rural / urban location and gender, and the economic indexes include GDP, GDP per capita, rural income, and urban income, all adjusted for inflation.ResultsWe found a significant increase of economic development and decrease of suicide rates over the past decades under study. The suicide rate decrease is correlated with the tremendous growth of economy.ConclusionThe unusual decrease of Chinese suicide rates in the past decades is accounted for within the Chinese cultural contexts and maybe by the Strain Theory of Suicide.     

Examining the link between economic strain and adolescent social behavior: Roles of social bonds and empathy

IntroductionThe detrimental effect of economic strain on adolescent behavioral development is well established, but the mechanisms explaining this relationship are less known. This study aims to explore the psychosocial factors operating as pathways connecting economic strain to adolescent antisocial and prosocial behaviors, and examine whether these effects differ by gender.MethodsThe sample includes 1280 adolescents from middle and high schools in Hebei province, China (Mean age = 15.68 years; 52.6% girls), collected by a multi-stage cluster random sampling. Multi-group structural equation modeling is adopted for data analysis.ResultsSocial bonds partially mediate the relationship between economic strain and adolescent antisocial behavior, and empathy fully mediates the relationship between economic strain and prosocial behavior after controlling for gender, age, household registration, and subjective socioeconomic status. In terms of gender differences, boys display more antisocial behaviors and less prosocial behaviors compared with girls. Significant gender differences are also found in the effect of economic strain on adolescent social behavior.ConclusionsThis study contributes to current knowledge by revealing the psychosocial mechanisms between economic strain and adolescent antisocial/prosocial behaviors. Findings highlight the gender differences in behavioral development among Chinese adolescents.     

Normative data of F-wave measures in China

ObjectiveTo establish normal ranges of F-wave measures in China as compared to published data in Brazil and Japan.MethodWe studied F waves in 127 healthy Chinese subjects, aged 21–78 years old, stimulating the median, ulnar, tibial and peroneal nerves distally and proximaly.ResultThe F-wave latencies had a linear correlation to the subject height in all nerves tested, showing a steeper (P < 0.05) regression line in Brazil compared to China and Japan for the tibial nerve. The Chinese population also had a higher distally elicited F-wave persistence and faster F wave conduction velocities than previously reported for both ulnar and tibial nerves. These values showed significant difference (P < 0.05) compared to Brazil but not to Japan.ConclusionF-wave latencies show a linear correlation to subject height, although the slope of regression lines varies among countries, reflecting the difference in F-wave persistence and F-wave conduction velocity.SignificanceOur study provides a rational for the use of a latency-height nomogram in clinical studies and underscores the importance of developing country specific normative data.     

The gender difference in Chinese suicide rates

Chinese women have a higher rate of suicide than Chinese men in the regions of mainland China currently reporting mortality data to the World Health Organization. This gender difference is documented, and possible reasons for the gender differences are explored using data from a survey of female suicides in Chuanzhou County in the Guangxi region of China. A definitive explanation for the gender difference must await detailed psychological autopsy studies.     

Children with autism spectrum disorder from China and the Netherlands: Age of diagnosis,gender and comorbidities

BackgroundIn recent years, an increasing number of studies have highlighted progress in ASD clinical practice and scientific research in China (Zheng & Zheng, 2015). However, little is known about the differences between clinical or scientific approaches to ASD between China and other countries. In our study we explored the impact of gender, comorbidity, parental educational and vocational status on the age of diagnosis in two samples of children with ASD from China and the Netherlands.Method433 children with ASD aged between 6 to 14 from China and 492 age matched children with ASD from the Netherlands were investigated based on national databases on individuals with ASD.ResultsWe found a lower diagnosis age in China compared to the Netherlands. The Chinese sample showed a higher male/female ratio and a higher proportion of co-morbid ADHD diagnoses, but lower age of first concern, diagnosis age and shorter delay from first concern to diagnosis. In the Dutch sample only, co-morbid ADHD resulted in lower age of first concern. The differential impact of comorbidity and gender across both countries may be related to cultural and clinical variations.ConclusionsThis study may help us understand ASD from a cross-cultural perspective.     

Physical Mobility,Social Isolation and Cognitive Function: Are There Really Gender Differences?

ObjectiveThis study aimed to examine the mediating role of social isolation between physical mobility and cognitive function, and whether there are gender differences in the above mediating effects among Chinese older adults.MethodsThis is a prospective and cohort study. We obtained data from the 2011 (Time 1, T1), 2015 (Time 2, T2) and 2018 (Time 3, T3) waves of China Health and Retirement Longitudinal Study, including 3,395 participants aged 60 years or above. Cognition was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing, which was widely used in previous research. We used a cross-lagged model to test the hypothesis that social isolation mediated the association between physical mobility and cognitive function among Chinese older adults.ResultsThe total effects of T1 physical mobility limitations on T3 cognitive function (β = -0.055, bootstrap p < 0.001) were significantly negative. Social isolation played a mediating role among both males and females (male: β = -0.008, bootstrap p = 0.012; female: β = -0.006, bootstrap p = 0.023), demonstrating that the mediating effect of social isolation between physical mobility and cognitive function was not gender specific.ConclusionThis study confirmed that social isolation mediated the association between physical mobility and cognitive function among both Chinese male and female older adults. These findings indicate that reversing social isolation can be a priority intervention target for cognitive decline prevention and promote successful ageing, particularly among older adults with impaired physical mobility.     

Head Circumference Growth Reference Charts of Children Younger Than 7 Years in Chinese Rural Areas

BackgroundThe head circumference growth reference charts for children in China are presently based on urban children. However, the references may not apply to rural children because of the differences between urban and rural areas, such as economy, culture, and dietary habits. Our objective was to provide a reliable continuous set of head circumference growth reference charts for male and female children less than 7 years of age in Chinese rural areas.MethodsChildren in our study were identified by multistage stratified cluster sampling from rural areas of 10 provinces in China. Questionnaire survey and anthropometric measurements were conducted in data collection. Head circumference was measured with a nonelastic tape on a line passing over the glabella and posterior occipital protrusion in children. We compared the fiftieth percentile of our cross-sectional data with the data of Chinese cities, World Health Organization, and the United States.ResultsA total of 95,904 children (48,722 boys and 47,182 girls) were included in the study. We present age- and sex-appropriate head circumference growth charts younger than 7 years for Chinese rural areas. The head circumference percentiles of the children in rural China are much smaller than the children in Chinese urban areas, World Health Organization, and the US percentiles after 2 years old.ConclusionsHead circumference percentiles can be applied in growth monitoring, but current head circumference growth references promulgated in urban China may not be suitable for rural areas in China. Providing head circumference growth reference charts for rural Chinese children who are younger than 7 years old is very important.     

Association of insomnia disorder with sociodemographic factors and poor mental health in COVID-19 inpatients in China

PurposeTo examine insomnia disorder and its association with sociodemographic factors and poor mental health in 2019 novel coronavirus (COVID-19) inpatients in Wuhan, China.Designand Methods: A total of 484 COVID-19 inpatients in Wuhan Tongji Hospital were selected and interviewed with standardized assessment tools. Insomnia disorder was measured by the Chinese version of the Insomnia Severity Index (ISI-7), a total score of 8 or more was accepted as the threshold for diagnosing insomnia disorder.ResultsThe prevalence of insomnia disorder in the whole sample was 42.8%. Binary logistic regression analysis revealed that female gender, younger age, and higher fatigue and anxiety severity were more likely to experience insomnia disorder.ConclusionGiven the high rate of insomnia disorder status among COVID-19 inpatients in Wuhan, China, and its negative effects, follow-up assessments and appropriate psychological interventions for insomnia disorder are needed in this population.     

Gender differences in REM sleep behavior disorder: a clinical and polysomnographic study in China

ObjectiveRapid eye movement (REM) sleep behavior disorder (RBD) has been considered a male-predominant parasomnia, and there is little comparative data on potential differences between males and females. Therefore, the aim of our study was to examine and characterize gender difference in RBD.MethodsNinety patients diagnosed with RBD were consecutively recruited from a sleep medicine clinic. All patients were assessed by a RBD questionnaire and overnight video polysomnography. Demographic, clinical data, presence of dreams and dream-enacting behaviors, sleep parameters and electromyographic (EMG) activity were compared for male and female patients with RBD.ResultsFemales were significantly younger than males, both in the mean age of RBD onset (45.3 ± 19.3 vs. 56.2 ± 14.1; p = 0.027) and the mean age at diagnosis (50.4 ± 18.2 vs. 61.1 ± 14.1; p = 0.022). Secondary RBD was 21% in males and 44% in females (p = 0.021). Antidepressant use was more common among females (22%) than males (2%; p = 0.003). There was no significant gender difference in dream content (eg, violent and frightening dreams) of RBD patients. However, females had less dream-enacting behaviors, especially in movement related dreams and falling out of bed. Interestingly, no significant difference was found in the quantification of EMG activity during REM sleep between male and female patients.ConclusionsWe found significant gender differences in demographics, associated comorbidities, and dream-related behaviors in patients with RBD. Female RBD patients reported significantly less behavior during dreams, but there was no significant gender difference in EMG activity during REM sleep.     

Depressive symptoms among adult children caregivers in China: moderating effects of working status and gender

Abstract

Objectives: With over one-fifth of the world’s older population, shrinking family size and increasing number of women in the workforce, elder care is a growing challenge for families in mainland China. This study explored the moderating effect of working status and gender on caregiving time and depressive symptoms among adult children caregivers in mainland China.

Method: Participants were 660 adult children caregivers from a nationally representative sample of individuals aged 45?+?(N?=?13,204) who participated in the China Health and Retirement Longitudinal Study (CHARLS) Wave 2 (2013). Multiple linear regression was used to analyze the direct effect of caregiving time and the moderating effects of working status and gender on symptoms of depression among caregivers.

Results: Significant main effect between caregiving time and depressive symptoms was found controlling for demographic covariates. The three-way interaction between working status, gender and caregiving time was also significant. Working status and gender moderate the effect of caregiving time on depressive symptoms: among employed men and women caregivers, spending more hours providing care predicted fewer depression symptoms. Unemployed men caregivers who spent more hours providing care showed highest level of depressive symptoms.

Conclusion: The relationship between caregiving time and depressive symptoms was moderated by working status and gender. Future research is needed to explore factors that influence changes in caregivers’ health and well-being over time.     

Comparison of obesity among Chinese and U.S. Special Olympic athletes with intellectual disabilities

Background/objectivesObesity is a health problem in China, but there are no reports on the obesity status of Chinese citizens with intellectual disabilities (ID). Research has shown that adults with ID have higher body mass index (BMI) than adults without ID, but this information is primarily based on populations residing in North American and European countries. The purpose of this study was to compare BMI and obesity status of Chinese and U.S. Special Olympic athletes with ID.Subjects/methodsHeight, weight, BMI and self-reported physical activity (SRPA) data from the Special Olympics 2006 U.S. National Games and 2007 Shanghai World Games databases were analyzed. Linear and logistic analyses were conducted for continuous data and dichotomous variables, respectively. Predictor variables were age, gender, country, SRPA, and obesity status according to country specific criteria. Significance was set at p < 0.05.ResultsThe U.S. group had significantly higher BMI values than their Chinese counterparts. Age (p = 0.001) and country (p = <0.001) were the main predictors of BMI and obesity status, even when country-specific standards of obesity classifications were used. Holding all other factors constant, each unit increase of age was associated with increased odds for obesity by a factor of 1.04 and the odds of obesity occurring in U.S. athletes was 2.47 times greater than in Chinese athletes.ConclusionObesity is an emerging health problem for Chinese adults with ID. Participation in Special Olympics does not offset obesity in people with ID and other methods of intervention are needed to address obesity in this population segment. This is a global health concern that requires immediate attention.     

低密度脂蛋白受体相关蛋白1基因多态性与中国人阿尔茨海默病发病风险的meta分析

目的探讨低密度脂蛋白受体相关蛋白1(LRP-1)基因C766T位点多态与中国人阿尔茨海默病(AD)发病风险的关系。方法应用LRP-1、low density lipoprotein receptor related protein 1 gene、阿尔茨海默病等关键词,检索中国期刊全文数据库(CJFD)、Medline、Cochrane图书馆与中国生物医学文献数据库(CBMdisc)4个数据库,对1997年1月至2019年6月公开发表的关于中国人阿尔茨海默病LRP-1基因多态性的病例对照研究进行meta分析。结果共纳入16项病例对照研究。综合数据分析,CC基因型及C等位基因与中国人AD发病相关,均P0.05,差异有统计学意义;中国人携带CC基因型发生AD的风险是携带CT/TT基因型的1.477倍,携带C等位基因发生AD的风险是携带T等位基因的1.669倍。CC基因型及C等位基因与汉族人AD发病亦相关,均P0.05,差异有统计学意义;汉族人携带CC基因型发生AD的风险是携带CT/TT基因型的1.711倍,携带C等位基因发生AD的风险是携带T等位基因的2.005倍。结论 LRP-1基因C766T位点多态性与中国人,尤其是汉族人AD发病风险相关,携带CC基因型和C等位基因的个体有更大风险发生AD。     

Loneliness and the risk of dementia among older Chinese adults: gender differences

Objective: The objective of this study was to examine whether loneliness was associated with the risk of developing dementia in Chinese older adults and whether the association was moderated by gender.

Method: A 3-year cohort study was conducted using data from the 2008/2009 and 2011/2012 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Multiple logistic regression was used to analyze the relationship between loneliness and dementia. The interaction between loneliness and gender was also evaluated.

Results: At 3-year follow-up, 393 of the 7867 participants had dementia. Loneliness was associated with dementia (odds ratio (OR) = 1.31, 95% confidence interval (CI) = 1.11–1.56) after adjustment for sociodemographic characteristics, lifestyle, and baseline health status. A significant interaction between loneliness and gender was also found (OR = 0.81, 95% CI = 0.65–0.99).

Conclusion: Loneliness increased the risk of developing dementia among people aged 65 years and older in China. Moreover, the effect of loneliness on dementia risk varied by gender. Specifically, men who felt lonely were more likely to suffer from dementia than women.     

Sleep duration associated with body mass index among Chinese adults

ObjectiveThe objective of this study was to investigate the relationship between sleep duration and obesity among Chinese adults.MethodsA community-based cross-sectional study was conducted among Chinese adults in 2008. In total, 3225 participants were selected by a multistage cluster sampling method. Self-reported sleep duration was measured by a standardized questionnaire. Logistic regression models were used to estimate the odds ratios (ORs) (95% confidence intervals, CIs) of obesity with sleep duration, separated by gender, and adjusted for age, education, occupation, marriage, smoking, drinking, body pain, and health status.ResultsThe mean sleep duration was 7.8 h. Among the 2962 participants, 7.2% had short sleep duration (≤6 h/day). There were 171 obese participants (5.7%) in this population. After adjustment for age, short sleep duration (<6 h) was significantly associated with obesity among men (OR: 2.15; 95% CI: 1.193.90), but not among women; additional adjustment for potential confounders did not attenuate the association among men. Increasing sleep duration (a continuous variable) was significantly and negatively associated with obesity in women after adjustment for education level, occupation, marital status, smoking, drinking, body pain, and health status. The adjusted OR per-hour increase in sleep duration was 0.74 (0.56–0.97) for obesity, suggesting that for a 1-h increase in sleep duration among women, obesity risk decreased by 26%.ConclusionShort sleep duration was associated with increasing obesity in Chinese men, and sleep duration was associated with obesity in Chinese women, although the underlying mechanism is unclear. This possible gender difference warrants further studies.     

Psychometric analysis of a Chinese version of the Sleep Hygiene Index in nursing students in China: a cross-sectional study

ObjectiveThe aim of the study had two stages. One was to examine the psychometric quality of the Sleep Hygiene Index (SHI) in Chinese version and its predicted function for the prevalence of insomnia. The other was to describe the prevalence of poor sleep hygiene habits and associated factors of sleep hygiene habits in Chinese nursing students.MethodAccording to Brislin translation model, the English version of SHI was translated into Chinese. And a pilot-survey was carried out to measure psychometric quality of the Chinese version of SHI with 260 nursing students by convenient sampling. Then a cross-sectional survey was conducted. 659 undergraduates were recruited by simple random sampling in a medical university in China. Data collection instruments consisted of a demographic questionnaire, the Sleep Hygiene Index (SHI), the Insomnia Severity Index (ISI) and the Brief Insomnia Questionnaire (BIQ). Data were analyzed by SPSS 24.0 and Amos 24.0 with P = 0.05 as the significant test value.ResultsThe internal consistency reliability of SHI in Chinese version was more than 0.60 (α = 0.62, ω = 0.63). The concurrent validity presented significantly (r = 0.25, P < 0.001). Exploratory factor analysis found that a six component model explained 63.06% of total variance and confirmatory factor analysis showed good fitness (${\text{χ}}^2/\text{df}=2.14,$ RMSEA = 0.04). ROC analysis showed that the cut-off value predicting for insomnia was 5.50 (52.90% sensitivity and 75.80% specificity). The area under the ROC curve was 0.66 (95% confidence interval = 0.61–0.71). 199 (30.20%) participant had poor sleep hygiene habits, especially in the aspects of staying too longer in bed (65.25%) and irregular sleep schedule. Multiple linear regression analysis showed health condition, academic difficulties and gender were more common associated factors of sleep hygiene.ConclusionsThe Chinese version of the Sleep Hygiene Index demonstrates satisfactory psychometric qualities and has higher sensitivity and specificity to predict for insomnia. So SHI could be used in Chinese nursing students and detect high levels of insomnia. The status of sleep hygiene of nursing students in China should be concerned. Sleep hygiene education should be carried out in nursing students with different gender, health condition, and academic performance.     

Validation of the Chinese version of public attitudes toward epilepsy scale in Mainland China

PurposeEpilepsy is a significant yet seriously underappreciated public health issue in Mainland China. The stigma and discrimination toward people with epilepsy (PWE) and their families are especially severe in China based on cultural misconceptions which cause tremendous psychological, economic and social burdens. It is imperative to formulate a targeted public intervention to eliminate knowledge gaps and correct these misconceptions of epilepsy. However, to date, the essential tools that may drive such an intervention by measuring the public perspective on PWEs is lacking in China. The goal of this study is to test the reliability and validity of a Simplified Chinese version of the “Public Attitude Toward Epilepsy” scale (PATE) in Mainland China which can be used to understand the content and identify the possible sources of stigma to better inform the design and focus of future stigma reduction interventions.MethodsThe standard procedure of cross-cultural adaptation was used in the translation process. Subjects from different economic and social backgrounds were enrolled by convenience sampling in central China. Exploratory factor analysis and confirmatory factor analysis were used to check the underlying factor structure of the items. Furthermore, Cronbach's alpha was utilized to assess internal consistency.Results199 respondents were included in the final analysis. Content validity of this Chinese PATE was assessed to be adequate for assessing public attitudes toward epilepsy among the mainland Chinese. Two factors were extracted from the data by exploratory factor analysis; confirmatory factor analysis further confirmed good consistency of theoretical constructs between the original Public Attitudes Toward Epilepsy scale and our Chinese PATE. Our Chinese PATE presented excellent internal consistency (α = 0.853–0.909).ConclusionThis version of the Chinese PATE showed acceptable psychometric properties, indicating that it can be implemented in surveying public attitudes toward epilepsy in Mainland China.     

Differences in sleep problems between Japanese and Chinese preschoolers: a cross-cultural comparison within the Asian region

Study objectivesPrevious studies have performed cross-cultural comparisons of differences in childhood sleep problems between Asian and Western countries. However, whether such differences can be observed among Asian countries remains unclear. The present study aimed to investigate differences in the pattern of sleep problems between Japanese and Chinese preschoolers.MethodsData were collected from one city in Japan and 10 cities in China. The present study recruited 438 Japanese and 1020 Chinese preschoolers aged four and five years. Sleep problems and patterns were assessed on the basis of parental reports using the Children's Sleep Habits Questionnaire (CSHQ).ResultsAnalysis of covariance revealed no significant difference in total CSHQ scores between Japanese and Chinese preschoolers, thus indicating that the total severity of sleep problems did not differ between the groups. Japanese preschoolers exhibited higher scores on the bedtime resistance subscale of the CSHQ than Chinese preschoolers. Conversely, Chinese preschoolers exhibited higher subscale scores for night wakings and sleep-disordered breathing. In addition, Japanese preschoolers exhibited earlier bedtimes and wake times and shorter total sleep times than Chinese preschoolers.ConclusionsOur findings indicate that the patterns of sleep problems in preschoolers differ between Japan and China and that such differences may be due to differences in cosleeping practices, bedtime routines, and/or environmental conditions. Thus, investigators studying sleep in preschoolers should consider regional differences in the pattern of sleep problems, even among Asian countries.     

Gender differences of neurocognitive functioning in patients with first-episode schizophrenia in China

AimsTo investigate the gender differences in neurocognitive functioning in patients with first-episode schizophrenia (FES) in China.MethodsA total of 449 Chinese patients with FES (210 males, 239 females) were included in this study. Participants’ psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Neurocognitive functioning was assessed by 10 neuropsychological tests from a battery. Neurocognitive test scores were converted to scale scores and t-scores using normative data from Chinese populations.ResultsMales were younger and less likely to be married, had an earlier age of illness onset and a longer duration of untreated psychosis (DUP), and scored higher on the PANSS negative, general and total scales than females. After controlling for potential confounders, females performed better than males in the verbal learning and memory domain (p=0.016). While most neurocognitive domains were correlated with PANSS negative scores for male patients with FES, for female patients with FES, negative associations were found between scores on the PANSS general subscales and neurocognitive domains. We also performed a case-control comparison with a group of patients with clinically stable schizophrenia (CSS) (n = 60) who were matched by age, sex and education years with patients with FES (n = 58). After controlling for potential confounders, no significant differences were found between patients with FES and patients with CSS in all neurocognitive domains. Female patients still performed better in the verbal learning and memory domain (t = 2.14, p = 0.034). No interaction effects of gender and disease were found.ConclusionsGender was an independent influence factor for the verbal learning and memory domain. Both female patients with first-episode schizophrenia and female patients with clinically stable schizophrenia performed better than male patients.     

Are higher rates of depression in women accounted for by differential symptom reporting?

Abstract.Background: The gender difference in prevalence and incidence rates of depression is one of the most consistent findings in psychiatric epidemiology. We sought to examine whether any gender differences in symptom profile might account for this difference in rates.Method: This study was a population-based 13-year follow-up survey of community-dwelling adults living in East Baltimore in 1981. Subjects were the continuing participants of the Baltimore Epidemiologic Catchment Area Program. Participants interviewed between 1993 and 1996 with complete data on depressive symptoms and covariates were included (n = 1,727). We applied structural equations with a measurement model for dichotomous data (the MIMIC—multiple indicators, multiple causes—model) to compare symptoms between women and men, in relation to the nine symptom groups comprising the diagnostic criteria for major depression, adjusting for several potentially influential characteristics (namely, age, self-reported ethnicity, educational attainment, marital status, and employment).Results: There were no significant gender differences in the self-report of depression symptoms even taking into account the higher level of depressive symptoms of women and the influence of other covariates. For example, women were no more likely to endorse sadness than were men, as evidenced by a direct effect coefficient that was not significantly different from the null [adjusted estimated direct effect of gender on report of sadness = 0.105, 95% confidence interval (–0.113, 0.323)].Conclusions: Men and women in this community sample reported similar patterns of depressive symptoms. No evidence that the presentation of depressive symptoms differs by gender was found.