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Bruzeguini MV, Corassa RB, Wang YP, Andrade LH, Sarti TD, Viana MC. The performance of K6 as a screening tool for mood disorders: A population-based study of the São Paulo metropolitan area. Early Interv Psychiatry 2024; 18:320-328. [PMID: 37655542 DOI: 10.1111/eip.13460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
AIM The use of screening instruments allows the detection of psychological and behavioural manifestations there are often not identified in users of health services. We evaluated the performance of the Kessler Psychological Distress Scale (K6) in identifying mood disorders (MD), using the Composite International Diagnostic Interview (CIDI) as gold-standard, in a population-based sample (n = 5037) of adult residents of metropolitan São Paulo. METHODS Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated to assess the performance of K6 in detecting 30-day CIDI MD. All cut-points for each disorder were analysed using the Youden index and the area under the receiver operating characteristic curve (AUC), and the best cut-points were identified. Cronbach's alpha was calculated to assess internal consistency. RESULTS In total, 5.5% respondents screened positive for any MD (95% IC 4.84-6.14). A good detection performance was observed for all MD, with AUC values for any MD of 0.91 (95% IC 0.89-0.92), ranging from 0.80 (95% CI 0.71-0.98) for minor depression to 0.93 (95% CI 0.87-0.98) for bipolar I disorder. Best cut-points for each MD were identified, with overall sensitivity and specificity of 88.8% and 80.2%, respectively. Cronbach's alpha was 0.83. CONCLUSIONS K6 is a good screening tool for MD in the Brazilian population. It is a brief and easy to use instrument that can promote the early identification and treatment of MD, reducing the burden of mental illness.
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Affiliation(s)
| | - Rafael Bello Corassa
- Postgraduate Program in Tropical Medicine and Public Health, Federal University of Goias, Goiania, Brazil
| | - Yuan-Pang Wang
- Núcleo de Epidemiologia Psiquiátrica, Departamento e Instituto de Psiquiatria, Hospital das Clinicas da faculdade de Medicina da Universidade de São Paulo - LIM 23, São Paulo, Brazil
| | - Laura Helena Andrade
- Núcleo de Epidemiologia Psiquiátrica, Departamento e Instituto de Psiquiatria, Hospital das Clinicas da faculdade de Medicina da Universidade de São Paulo - LIM 23, São Paulo, Brazil
| | - Thiago Dias Sarti
- Department of Social Medicine, Postgraduate Program in Collective Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Collective Health, Federal University of Espírito Santo, Vitória, Brazil
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2
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Huang WL, Chang SS, Wu SC, Liao SC. Population-based prevalence of somatic symptom disorder and comorbid depression and anxiety in Taiwan. Asian J Psychiatr 2023; 79:103382. [PMID: 36493688 DOI: 10.1016/j.ajp.2022.103382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The nationwide prevalence of somatic symptom disorder (SSD) has not yet been investigated in Asia. SSD is often comorbid with depression and anxiety, and the effects of these conditions on medical utilization await clarification. We hence performed a study in Taiwan to explore these issues. METHODS Using telephone-based sampling and interview, we obtained data for 3161 participants whose age, gender and living area were compatible with the Taiwan population. We gathered scores of the Patient Health Questionnaire-15 (PHQ-15), Health Anxiety Questionnaire (HAQ) and Patient Health Questionnaire-4 (PHQ-4). Individuals with a PHQ-15 score of at least 4 and a HAQ score of at least 17 were considered to have SSD. Descriptive statistics were used to clarify the prevalence and normative data of the questionnaires. We used multiple logistic regression analyses to investigate the relation between diagnoses and medical utilization. RESULTS The prevalence of SSD was 5.00% and women had a higher SSD prevalence than men; participants aged 40-49 years had the highest SSD prevalence. In SSD patients, 33.58% had depression or anxiety. After correcting for demographics, SSD and anxiety (but not depression) were associated with a significantly high level of outpatient/emergency department attendance. Comorbid depression or anxiety did not significantly increase the medical utilization of SSD patients. CONCLUSION The nationwide SSD prevalence in Taiwan is compatible with the description in the DSM-5. The comorbidity of SSD and depression/anxiety is common, but depression or anxiety does not significantly increase the SSD patients' medical utilization.
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Affiliation(s)
- Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences and Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shang-Chi Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Biomedical Park Hospital, Zhubei City, Hsinchu County, Taiwan.
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3
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An J, Yin Y, Zhao L, Tong Y, Liu NH. Mental health problems among hotline callers during the early stage of COVID-19 pandemic. PeerJ 2022; 10:e13419. [PMID: 35646488 PMCID: PMC9135033 DOI: 10.7717/peerj.13419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/20/2022] [Indexed: 01/20/2023] Open
Abstract
Background The study aims to explore the mental health of the hotline callers during the COVID-19 pandemic in China. Methods Callers (N = 10,490) from the Beijing Psychological Support Hotline from January 21st to June 30th in 2019 and 2020 were enrolled and divided into two groups (during (2020) and before (2019) COVID-19 pandemic). The severity of depressive symptoms, psychological distress, hopefulness, and suicidal ideation (SI) was assessed. Demographic characteristics and major concerns were also collected. Mann-Whitney U and chi-square test were used to compare the differences in mental health conditions and major concerns between two years and between different age groups. The multivariable logistic regression was used to explore whether mental health conditions were associated with pandemic and demographic factors. Results Results from multivariable logistic regression analysis indicated that the change in suicidal ideation (OR = 1.52, 95% CI: 1.21-1.92) was significantly different across age groups. Callers during the pandemic reported a higher level of hopefulness (OR = 1.13, 95% CI [1.03-1.24]), a lower level of depressive symptoms (OR = 0.81, 95% CI [0.74-0.89]) and psychological distress (OR = 0.89, 95% CI [0.81-0.98]), and were less likely to report SI (OR = 0.69, 95% CI [0.61-0.77]) compared with callers before the pandemic. Conclusions Compared with callers before the pandemic, hotline callers during the early stage of COVID-19 pandemic did not present significant mental health problems. Younger callers during the pandemic were more vulnerable for the presence of suicidal ideation. Hotline-based crisis interventions might provide specific psychological support to cope with troubles during the pandemic.
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Affiliation(s)
- Jing An
- Beijing Huilongguan Hospital, Beijing, Beijing, China,Peking University HuiLongGuan Clinical Medical School, Beijing, China,WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Yi Yin
- Beijing Huilongguan Hospital, Beijing, Beijing, China,Peking University HuiLongGuan Clinical Medical School, Beijing, China,WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Liting Zhao
- Beijing Huilongguan Hospital, Beijing, Beijing, China,Peking University HuiLongGuan Clinical Medical School, Beijing, China,WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Yongsheng Tong
- Beijing Huilongguan Hospital, Beijing, Beijing, China,Peking University HuiLongGuan Clinical Medical School, Beijing, China,WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Nancy H. Liu
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States of America
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Zhuang X, Lau YY, Chan WMH, Lee BSC, Wong DFK. Risk and resilience of vulnerable families in Hong Kong under the impact of COVID-19: an ecological resilience perspective. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2311-2322. [PMID: 34100978 PMCID: PMC8185317 DOI: 10.1007/s00127-021-02117-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 06/02/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE Hong Kong has experienced four waves of COVID-19 since the first case was confirmed in January 2020. Several studies have highlighted the psychological impacts of the outbreak in Hong Kong but have largely ignored the protective factors that contribute to resilience among vulnerable families. This study adopted an ecological resilience framework to explore the impact of this epidemic on members of families with youth with a delinquent tendency/mental health concerns and the ecological protective factors for these vulnerable families. METHODS Random sampling based on a sampling frame provided by one of the largest local social service organizations in Hong Kong led to the recruitment of 407 respondents who were interviewed using a battery of standardized questionnaires. RESULTS The results showed that 30.6% and 11.5% of respondents reported a moderate and a severe level of psychological distress, respectively, almost double the percentages reported in a previous study conducted in Hong Kong before the COVID-19 outbreak. Around 36.6% of respondents indicated they had encountered financial problems and almost 40% indicated aggravated financial circumstances since the outbreak. Hierarchical regression analysis revealed that financial stress was the strongest predictor of psychological distress. Structural equation modeling indicated that family support, indoor leisure activities and community resources significantly mediated the negative influence of COVID-19-related stressors on psychological distress of family members. CONCLUSION Family leisure activities, family support, community spirit and mutual help within the context of social-distancing restrictions may need to be promoted to benefit vulnerable families in Hong Kong under the COVID-19 epidemic.
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Affiliation(s)
- Xiaoyu Zhuang
- School of Humanities, Jinan University, Jinan University Zhuhai Campus, Room 324, Administration Building, No. 206 Qianshan Road, Zhuhai, Guangdong Province China
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Yin Yim Lau
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | | | | | - Daniel Fu Keung Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Louvardi M, Pelekasis P, Bacopoulou F, Vlachakis D, Chrousos GP, Darviri C. Studying Depression, Anxiety, Distress and Somatisation in a Community Sample of 2,425 Adults in Greece. EMBNET.JOURNAL 2021; 26. [PMID: 34722219 PMCID: PMC8553117 DOI: 10.14806/ej.26.1.972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A growing part of the literature has focused on depression, anxiety, distress and somatisation. Identifying their prevalence and populations at risk is essential to form relevant interventions. The aim of this study was to examine the prevalence and associated factors of distress, depression, anxiety, and somatisation in a community adult sample in Greece. Participants were recruited from two Greek cities; Giannitsa in the northern area and Athens in the southern area of the country, and completed sociodemographic assessments, as well as the 4-Dimensional Symptom Questionnaire (4-DSQ), a self-reported instrument assessing depression, anxiety, distress, and somatisation. A total of 2,425 adults, females (60.1%) and males (39.9%), 18 to 84 years of age (mean age±SD, 46.98±9.57 years) participated in the study. Mental health symptoms were reported by 10.8% for depression, 12% for anxiety, 13% for distress and 5.3% for somatisation. Females scored higher than males in anxiety, distress, and somatisation (p=0.000 in all cases), while there were no significant sex differences in depression (p=0.593). Statistically significant associations were found between age and depression, anxiety and distress (p=0.000 in all cases), since those between 18–34 years of age had higher scores than the older age groups in all variables. Higher scores of depression, anxiety and distress were reported by students and unemployed participants (p=0.000 in all cases) than participants with other occupations. This study mapped several sociodemographic groups with worse mental health. Studies in representative population samples are needed to guide public health interventions to improve the well-being of high-risk populations.
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Affiliation(s)
- Maya Louvardi
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Pelekasis
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Flora Bacopoulou
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Dimitrios Vlachakis
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.,Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece.,Lab of Molecular Endocrinology, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George P Chrousos
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Christina Darviri
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Tian P, Ma Y, Hu J, Zhou C, Liu X, Chen Q, Dang H, Zou H. Clinical and psychobehavioral features of outpatients with somatic symptom disorder in otorhinolaryngology clinics. J Psychosom Res 2021; 148:110550. [PMID: 34175726 DOI: 10.1016/j.jpsychores.2021.110550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE In the Otorhinolaryngology Department, patients exhibiting somatic symptoms without a medical cause are frequently neglected and left untreated. The aim of this study was to characterize the psychosomatic features of outpatients with somatic symptom disorder (SSD) to better identify patients needing treatment. METHODS This cross-sectional study enrolled 883 consecutive patients with medically unexplained symptoms. A semistructured clinical interview was employed to confirm the diagnosis of SSD. Data, including sociodemographic and clinical measures, were collected. The Patient Health Questionnaire-15 (PHQ-15) and Somatic Symptom Scale-China (SSS-CN) were used to assess the severity of somatic symptoms; the Patient Health Questionnaire-9 (PHQ-9) was used to assess depression; the General Anxiety Disorder-7 (GAD-7) was used to assess anxiety; and the 12-item Short-form Health Survey (SF-12) was used to assess quality of life (QoL). RESULTS Based on the DSM-5 criteria, 641 patients were placed in the SSD group, and 212 were placed in the normal group. Compared with the normal group, the SSD group had significantly more doctor visits, longer symptom durations, higher GAD-7 and PHQ-9 scores, and lower physical composite scores (PCSs) and mental composite scores (MCSs). Spearman's correlation analysis and multiple linear regression analyses showed that the SSS-CN score, PHQ-15 score and the patient's subjective feeling that his or her daily life was affected by the disorder were significant risk factors for low PCSs; the SSS-CN, PHQ-15, PHQ-9, and GAD-7 scores were independent risk factors for low MCSs. CONCLUSION Our findings demonstrated that SSD patients are not rare in otorhinolaryngology clinics in China and that their QoL is significantly affected by SSD. Otolaryngologists should thoroughly evaluate these patients from the perspective of psychosomatic medicine.
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Affiliation(s)
- Peng Tian
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Yun Ma
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Junwu Hu
- Department of Psychology, School of Public Health, Southern Medical University, No. 1023. South Shatai Road, Baiyun District, Guangzhou, Guangdong 510515, People's Republic of China
| | - Chao Zhou
- Guangzhou Psychiatric Hospital, No. 36, Ming Xin Road, Fangcun, Liwan District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Xiang Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Qiujian Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China
| | - Hua Dang
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China.
| | - Hua Zou
- Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yan Jiang Xi Road, Haizhu District, Guangzhou, Guangdong 510120, People's Republic of China.
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Lin Q, Bonkano O, Wu K, Liu Q, Ali Ibrahim T, Liu L. The Value of Chinese Version GAD-7 and PHQ-9 to Screen Anxiety and Depression in Chinese Outpatients with Atypical Chest Pain. Ther Clin Risk Manag 2021; 17:423-431. [PMID: 34040380 PMCID: PMC8140931 DOI: 10.2147/tcrm.s305623] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background Atypical chest pain in some outpatients could derive from mental disorders. It is necessary for them to have a preliminary emotional assessment in the outpatient department of Cardiology before psychiatric outpatient visits. Methods This study included 122 Chinese outpatients with atypical chest pain in the department of Cardiology. They accepted routine examinations, including treadmill test, and were judged by the three-question method as highly likely to have emotional disorders. Then, a standard questionnaire package containing the Chinese version of the seven-item scale for General Anxiety Disorder (GAD-7), Self-rating Anxiety Scale (SAS), the nine-item Patient Health Questionnaire (PHQ-9) and Self-rating Depression Scale (SDS) was administered to evaluate anxiety and depression. Results The percentages of anxiety evaluated by GAD-7 and SAS were 62.3% and 26.2%, respectively. Analogously, the assessment by PHQ-9 showed a significantly higher percentage of depression than that by SDS (61.5% vs 29.5%) (P < 0.05). Kappa analysis showed that the consistency between GAD-7 and SAS, or that between PHQ-9 and SDS was not very good. About 73% outpatients suffered from emotional disorders, presenting as anxiety/depression evaluated by GAD-7 and PHQ-9. Furthermore, sleep disorders accounted for more than 80% of patients with mental disorders. Finally, the suicidal tendency of depression patients was about 17% that should not be ignored. Conclusion Compared with SAS and SDS, GAD-7 and PHQ-9 detected more participants with emotional disorders in the Chinese outpatients with atypical chest pain, indicating that GAD-7 and PHQ-9 could be briefly well-validated tools to screen emotional disorders in the outpatient department of Cardiology before psychiatric visits.
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Affiliation(s)
- Qiuzhen Lin
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, People's Republic of China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, People's Republic of China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, Hunan, 410011, People's Republic of China
| | - Ousseina Bonkano
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, People's Republic of China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, People's Republic of China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, Hunan, 410011, People's Republic of China.,Department of Cardiovascular and Internal Medicine Niger, Niamey Amirou Boubacar Diallo National Hospital, Abdou Moumouni University, Niamey, Niger
| | - Keke Wu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, People's Republic of China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, People's Republic of China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, Hunan, 410011, People's Republic of China
| | - Qiming Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, People's Republic of China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, People's Republic of China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, Hunan, 410011, People's Republic of China
| | - Toure Ali Ibrahim
- Department of Cardiovascular and Internal Medicine Niger, Niamey Amirou Boubacar Diallo National Hospital, Abdou Moumouni University, Niamey, Niger
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, People's Republic of China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, People's Republic of China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, Hunan, 410011, People's Republic of China
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Hou T, Zhang F, Mao X, Deng G. Chronotype and psychological distress among Chinese rural population: A moderated mediation model of sleep quality and age. PLoS One 2020; 15:e0241301. [PMID: 33125424 PMCID: PMC7598484 DOI: 10.1371/journal.pone.0241301] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/12/2020] [Indexed: 12/02/2022] Open
Abstract
PURPOSES Evidence suggests evening-type individuals have a higher risk of reporting psychological distress than morning-type individuals. However, less is known regarding the underlying processes that might mediate or moderate this association among Chinese rural population. This study aimed to evaluate the prevalence of psychological distress, investigate whether sleep quality would mediate the association between chronotype and psychological distress and explore whether age would moderate the direct or indirect effect of the mediation model. METHODS The cross-sectional study utilized a sample of 884 rural residents from rural regions in Anqing City, Anhui Province, China. Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI) and 21-item Depression Anxiety Stress Scale (DASS-21) were used to measure chronotype, sleep quality and psychological distress, respectively. MacKinnon's four-step procedure was employed to examine the mediation effect, while Hayes PROCESS macro (model 59) was used to perform the moderated mediation analysis. RESULTS The prevalence of psychological distress among Chinese rural population was 33.4%. The association between chronotype and psychological distress was partially mediated by sleep quality (indirect effect = - 0.05, 95% CI = [-0.08, -0.03]). In addition, age moderated the first stage (sleep quality-psychological distress) of the indirect effect, with the indirect effect being attenuated for older rural residents. As suggested by Johnson-Neyman technique, the association between sleep quality and psychological distress was only significant when the age of the participant was lower than 48.59. CONCLUSIONS The incidence of psychological distress among Chinese rural residents cannot be neglected. Interventions for the enhancement of sleep quality to prevent and reduce psychological distress should be prioritized to rural residents who are prone to eveningness, especially those who are younger.
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Affiliation(s)
- Tianya Hou
- Department of Psychology, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Fan Zhang
- Department of Psychology, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Xiaofei Mao
- Department of Psychology, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Guanghui Deng
- Department of Psychology, Naval Medical University (Second Military Medical University), Shanghai, China
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Shi L, Lu ZA, Que JY, Huang XL, Liu L, Ran MS, Gong YM, Yuan K, Yan W, Sun YK, Shi J, Bao YP, Lu L. Prevalence of and Risk Factors Associated With Mental Health Symptoms Among the General Population in China During the Coronavirus Disease 2019 Pandemic. JAMA Netw Open 2020; 3:e2014053. [PMID: 32609353 PMCID: PMC7330717 DOI: 10.1001/jamanetworkopen.2020.14053] [Citation(s) in RCA: 493] [Impact Index Per Article: 123.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE People exposed to coronavirus disease 2019 (COVID-19) and a series of imperative containment measures could be psychologically stressed, yet the burden of and factors associated with mental health symptoms remain unclear. OBJECTIVE To investigate the prevalence of and risk factors associated with mental health symptoms in the general population in China during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS This large-sample, cross-sectional, population-based, online survey study was conducted from February 28, 2020, to March 11, 2020. It involved all 34 province-level regions in China and included participants aged 18 years and older. Data analysis was performed from March to May 2020. MAIN OUTCOMES AND MEASURES The prevalence of symptoms of depression, anxiety, insomnia, and acute stress among the general population in China during the COVID-19 pandemic was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Insomnia Severity Index, and Acute Stress Disorder Scale. Logistic regression analyses were used to explore demographic and COVID-19-related risk factors. RESULTS Of 71 227 individuals who clicked on the survey link, 56 932 submitted the questionnaires, for a participation rate of 79.9%. After excluding the invalid questionnaires, 56 679 participants (mean [SD] age, 35.97 [8.22] years; 27 149 men [47.9%]) were included in the study; 39 468 respondents (69.6%) were aged 18 to 39 years. During the COVID-19 pandemic, the rates of mental health symptoms among the survey respondents were 27.9% (95% CI, 27.5%-28.2%) for depression, 31.6% (95% CI, 31.2%-32.0%) for anxiety, 29.2% (95% CI, 28.8%-29.6%) for insomnia, and 24.4% (95% CI, 24.0%-24.7%) for acute stress. Participants with confirmed or suspected COVID-19 and their family members or friends had a high risk for symptoms of depression (adjusted odds ratios [ORs], 3.27 [95% CI, 1.84-5.80] for patients; 1.53 [95% CI, 1.26-1.85] for family or friends), anxiety (adjusted ORs, 2.48 [95% CI, 1.43-4.31] for patients; 1.53 [95% CI, 1.27-1.84] for family or friends), insomnia (adjusted ORs, 3.06 [95% CI, 1.73-5.43] for patients; 1.62 [95% CI, 1.35-1.96] for family or friends), and acute stress (adjusted ORs, 3.50 [95% CI, 2.02-6.07] for patients; 1.77 [95% CI, 1.46-2.15] for family or friends). Moreover, people with occupational exposure risks and residents in Hubei province had increased odds of symptoms of depression (adjusted ORs, 1.96 [95% CI, 1.77-2.17] for occupational exposure; 1.42 [95% CI, 1.19-1.68] for Hubei residence), anxiety (adjusted ORs, 1.93 [95% CI, 1.75-2.13] for occupational exposure; 1.54 [95% CI, 1.30-1.82] for Hubei residence), insomnia (adjusted ORs, 1.60 [95% CI, 1.45-1.77] for occupational exposure; 1.20 [95% CI, 1.01-1.42] for Hubei residence), and acute stress (adjusted ORs, 1.98 [95% CI, 1.79-2.20] for occupational exposure; 1.49 [95% CI, 1.25-1.79] for Hubei residence). Both centralized quarantine (adjusted ORs, 1.33 [95% CI, 1.10-1.61] for depression; 1.46 [95% CI, 1.22-1.75] for anxiety; 1.63 [95% CI, 1.36-1.95] for insomnia; 1.46 [95% CI, 1.21-1.77] for acute stress) and home quarantine (adjusted ORs, 1.30 [95% CI, 1.25-1.36] for depression; 1.28 [95% CI, 1.23-1.34] for anxiety; 1.24 [95% CI, 1.19-1.30] for insomnia; 1.29 [95% CI, 1.24-1.35] for acute stress) were associated with the 4 negative mental health outcomes. Being at work was associated with lower risks of depression (adjusted OR, 0.85 [95% CI, 0.79-0.91]), anxiety (adjusted OR, 0.92 [95% CI, 0.86-0.99]), and insomnia (adjusted OR, 0.87 [95% CI, 0.81-0.94]). CONCLUSIONS AND RELEVANCE The results of this survey indicate that mental health symptoms may have been common during the COVID-19 outbreak among the general population in China, especially among infected individuals, people with suspected infection, and people who might have contact with patients with COVID-19. Some measures, such as quarantine and delays in returning to work, were also associated with mental health among the public. These findings identify populations at risk for mental health problems during the COVID-19 pandemic and may help in implementing mental health intervention policies in other countries and regions.
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Affiliation(s)
- Le Shi
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Zheng-An Lu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Jian-Yu Que
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Xiao-Lin Huang
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Peking University School of Public Health, Peking University, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yi-Miao Gong
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG, McGovern Institute for Brain Research, Beijing, China
| | - Kai Yuan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Wei Yan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Yan-Kun Sun
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Peking University School of Public Health, Peking University, Beijing, China
| | - Lin Lu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, China
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG, McGovern Institute for Brain Research, Beijing, China
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10
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Lindheimer N, Karnouk C, Hahn E, Churbaji D, Schilz L, Rayes D, Bajbouj M, Böge K. Exploring the Representation of Depressive Symptoms and the Influence of Stigma in Arabic-Speaking Refugee Outpatients. Front Psychiatry 2020; 11:579057. [PMID: 33281643 PMCID: PMC7689084 DOI: 10.3389/fpsyt.2020.579057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/12/2020] [Indexed: 11/13/2022] Open
Abstract
The number of distressed refugees from the Arab world is relatively high in Germany and other host countries worldwide. For this specific population, substantial challenges and barriers have already been identified that hamper access to Germany's health care system. This study aims to contribute to this line of research by exploring the representation of depressive symptoms, both somatic and psychological, in order to inform clinicians about the most prevalent symptoms reported by Arabic-speaking refugee outpatients. Furthermore, this paper investigates the longstanding claim that mental health stigma fosters the expression of bodily distress. For these purposes, a total of 100 Arabic-speaking refugee outpatients, mostly Syrians, were recruited in Berlin, Germany. Somatic and psychological symptoms were assessed with the Patient Health Questionnaire (PHQ) 15 and 9, while stigma was assessed with the Brief Version of the Internalized Stigma of Mental Illness Scale (ISMI-10). Study results show that both somatic and psychological symptom severity was moderate while sleeping problems and energy loss were the most reported symptoms across both scales. Stigma was low and showed no association with somatic complaints in a multiple regression analysis, but was associated with more psychological symptoms. A principal factor extraction on the PHQ-15 items revealed five independent, somatic symptom clusters that were interpreted considering the rich poetic resources of the Arabic language. In conclusion, both somatic and psychological symptoms were commonly reported by Arabic-speaking refugees with symptoms of depression. Whereas, stigma does not seem to influence the expression of somatic symptoms, the present results provide first empirical indications for the relationship of symptom expression with the use of explanatory models and conceptualizations of mental illness within the Arabic culture and language. Future research efforts should be dedicated to enhancing our understanding of mental health care needs in this population as well as to exploring other mediators that might help explain the varying degree of somatic symptoms in depression across cultures.
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Affiliation(s)
- Nico Lindheimer
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin, Berlin, Germany
| | - Carine Karnouk
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin, Berlin, Germany
| | - Dana Churbaji
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin, Berlin, Germany
| | - Laura Schilz
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin, Berlin, Germany
| | - Diana Rayes
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin, Berlin, Germany
| | - Malek Bajbouj
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin, Berlin, Germany
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11
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The Genetic Relationship Between Psychological Distress, Somatic Distress, Affective Disorders, and Substance Use in Young Australian Adults: A Multivariate Twin Study. Twin Res Hum Genet 2018; 21:347-360. [DOI: 10.1017/thg.2018.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Psychological distress (PSYCH), somatic distress (SOMA), affective disorders (AD), and substance use (SU) frequently co-occur. The genetic relationship between PSYCH and SOMA, however, remains understudied. We examined the genetic and environmental influences on these two disorders and their comorbid AD and SU using structural equation modeling. Self-reported PSYCH and SOMA were measured in 1,548 twins using the two subscales of a 12-item questionnaire, the Somatic and Psychological Health Report. Its reliability and psychometric properties were examined. Six ADs, involvement of licit and illicit substance, and two SU disorders were obtained from 1,663–2,132 twins using the World Mental Health Composite International Diagnostic Interview and/or from an online adaption of the same. SU phenotypes (heritability: 49–79%) were found to be more heritable than the affective disorder phenotypes (heritability: 32–42%), SOMA (heritability: 25%), and PSYCH (heritability: 23%). We fit separate non-parametric item response theory models for PSYCH, SOMA, AD, and SU. The IRT scores were used as the refined phenotypes for fitting multivariate genetic models. The best-fitting model showed the similar amount of genetic overlap between PSYCH–AD (genetic correlationrG= 0.49) and SOMA–AD (rG=0.53), as well as between PSYCH–SU (rG= 0.23) and SOMA–SU (rG= 0.25). Unique environmental factors explained 53% to 76% of the variance in each of these four phenotypes, whereas additive genetic factors explained 17% to 46% of the variance. The covariance between the four phenotypes was largely explained by unique environmental factors. Common genetic factor had a significant influence on all the four phenotypes, but they explained a moderate portion of the covariance.
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12
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Xiong N, Wei J, Fritzsche K, Leonhart R, Hong X, Li T, Jiang J, Zhu L, Tian G, Zhao X, Zhang L, Schaefert R. Psychological and somatic distress in Chinese outpatients at general hospitals: a cross-sectional study. Ann Gen Psychiatry 2017; 16:35. [PMID: 29075308 PMCID: PMC5644179 DOI: 10.1186/s12991-017-0158-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/05/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Our study aimed (1) to describe the proportion of psychological distress among Chinese outpatients at general hospitals, (2) to compare cognitive and behavioral characteristics of patients with different distress patterns, and (3) to investigate the discriminant function of the analyzed variables in indicating the affinity towards the different distress patterns. METHODS This multicenter cross-sectional study was conducted at ten outpatient departments at Chinese general hospitals. The somatic symptom severity scale (PHQ-15), the nine-item depression scale (PHQ-9), and the seven-item anxiety scale (GAD-7) were employed to classify patients in terms of four distress patterns. RESULTS A total of 491 patients were enrolled. Among them, the proportion of patients with high psychological distress was significantly higher within those with high somatic distress (74.5% vs. 25.5%, p < .001). Patients with psychological distress alone and mixed distress were significantly younger and with lower monthly family income, while the proportion of female patients (80.9%) was highest in the somatic distress group. Patients with mixed distress had the most negative cognitive and behavioral characteristics [highest health anxiety (5.0 ± 1.9), lowest sense of coherence (35.5 ± 10.0), the worst doctor-patient relationship from both patients' (36.0 ± 7.3) and doctors' perspectives (23.3 ± 7.0)], as well as most impaired quality of life (41.6 ± 7.4 and 31.9 ± 10.3). In addition, compared with patients with somatic distress alone, those with psychological distress alone had lower sense of coherence, worse doctor-patient relationship, and more impaired mental quality of life, but less doctor visits. Discriminant analysis showed that gender, mental quality of life, health anxiety, sense of coherence, and frequent doctor visits were significant indicators in identifying patients with different distress patterns. CONCLUSIONS Our study found that (1) psychological distress was not rare in the Chinese general hospital outpatients, especially in those with high somatic distress; (2) patients with psychological distress alone sought less help from doctors, despite their severe psychosocial impairment; and (3) gender, health anxiety, sense of coherence, mental quality of life, and frequent doctor visits could help to identify different distress patterns.
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Affiliation(s)
- Nana Xiong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Freiburg, Freiburg, Germany
| | - Rainer Leonhart
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Xia Hong
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Tao Li
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Jing Jiang
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 People's Republic of China
| | - Liming Zhu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Guoqing Tian
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xudong Zhao
- Department of Psychosomatic Medicine, Dongfang Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lan Zhang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, Sichuan China
| | - Rainer Schaefert
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
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Asian Adults’ Hypercompetitiveness and Distress: the Mediating Role of a Negative Problem-Solving Orientation. CURRENT PSYCHOLOGY 2016. [DOI: 10.1007/s12144-016-9502-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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Kirmayer LJ, Ryder AG. Culture and psychopathology. Curr Opin Psychol 2016; 8:143-148. [DOI: 10.1016/j.copsyc.2015.10.020] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 10/08/2015] [Indexed: 02/06/2023]
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