Changes in mental health levels among Chinese athletes from 1995 to 2023

Objective

In recent years, with the increasing intensity of sports competition and social pressure, the issue of mental health among athletes have gradually attracted attention. Understanding the changing trends of athletes' mental health is of great significance for formulating effective intervention measures and safeguarding the mental health of athletes.

Methods

A total of 306 articles were accumulated from September to November 2023 by selecting literature from databases that measured the mental health of Chinese athletes using the Symptom Checklist-90 (SCL-90). Based on the screening criteria, 28 articles (N = 4,227) were finally included. A cross-sectional historical meta-analysis of these 28 studies using the SCL-90 between 1995 and 2023 was conducted. Based on cross-sectional historical meta-analysis methods, specific statistical methods, such as correlation and regression analyses, were used to examine trends over time in the scores of the nine SCL-90 factors measured by the athletes in the studies, as well as athlete type and gender differences.

Results

(1) Athletes' scores on the depression, hostility, phobic anxiety, and paranoid ideation factors gradually increased with the change of era, and the explanation rate of the variation of each factor by era ranged from 18.8 to 27.2%; (2) During the period from 1995 to 2023, the mental health of athletes in China gradually deteriorated on the factors of depression, hostility, and phobic anxiety, the rate of change was rapid, with a medium to large magnitude (0.28-0.42); (3) The scores of female athletes on the depression and psychoticism factors scores showed a significant upward trend, while male mental health scores for each factor did not improve significantly over the years; (4) College athletes' scores on the depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism factors showed an upward trend as the years changed.

Conclusion

Chinese athletes' mental health has been on a downward trend for the past 28 years, which needs to be a cause for concern.

The relationship between typical dreams and mental health of residents in village-in-city

Aim

This study aimed to explore the relationship between typical dreams and the mental health of residents in village-in-city.

Methods

This study used the Chinese version of the Typical Dreams Questionnaire and Symptom Checklist 90 (SCL-90) to investigate the mental health status and typical dream themes of 1,190 residents recruited through random sampling from a village-in-city in Xi'an. Correlation analysis, t-test, and binary regression analysis were performed on the data using SPSS 24.0.

Results

The five most frequent dream themes among residents in the village-in-city were "falling"; "school, teacher, study"; "being chased but not physically injured"; "enjoying delicious food"; and "repeatedly trying to do something," in the given order. The most frequent dream theme with negative SCL-90 factors was "falling" and with positive SCL-90 factors was "school, teacher, study." Typical dreams on different themes were significantly correlated with SCL-90 factors. The theme of "enjoying delicious food" was not significantly associated with most factors in SCL-90.

Epidemiological analysis of axillary apocrine bromhidrosis in China: a survey from Chinese higher education students

Background

There are few epidemiological data on axillary apocrine bromhidrosis (AAB) in the Chinese population, making it impossible to accurately estimate its prevalence or impact on individuals.

Objective

To estimate the prevalence of AAB in China, and to survey and compare the psychological status of individuals with and without AAB.

Methods

Students in several universities in China were surveyed online for AAB, and the prevalence of AAB was calculated. The Symptom Checklist 90 (SCL-90) was used to evaluate the psychological status.

Results

The prevalence of AAB in the surveyed students was 7.5% (194/2571). The projected number of Chinese higher education students with AAB was about 3 million. The onset age of AAB was mainly between 11 and 20 years old (79.90%, 155/194). 68.04% (132/194) of individuals with AAB had a positive family history, and 60.30% (117/194) had wet earwax. Individuals with AAB often felt depression, anxiety, loneliness and social alienation, and scored significantly higher on the nine primary psychological symptom dimensions than individuals without AAB.

Conclusion

AAB affects a small proportion but large numbers of Chinese population. China and the West or East-Asia and the West have different perception, recognition and treatment preferences for AAB.

Effects of Physical Activity and Circadian Rhythm on SCL-90 Scores by Factors among College Students

OBJECTIVE

A study was conducted to investigate the effects of different levels of physical activity and circadian rhythm differences on the nine factors of obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoia, and psychoticism on the SCL-90 scale.

METHODS

A questionnaire and mathematical and statistical methods were used to conduct the study. Data were collected through a web-based cross-sectional survey of college students from three universities in Anhui. A statistical analysis of the collected data was conducted using mathematical and statistical methods.

RESULTS

A total of 1248 students were included in the statistics of this study. Binary logistic regression analysis revealed that low physical activity levels were associated with somatization (OR = 1.36, 95% CI = 0.95-1.94), obsessive-compulsive disorder (OR = 1.85, 95% CI = 1.25-2.75), interpersonal sensitivity (OR = 1.94, 95% CI = 1.30-2.88), depression (OR = 2.03, 95% CI = 1.31-3.16), anxiety (OR = 1.67, 95% CI = 1.03-2.69), hostility (OR = 1.80, 95% CI = 1.12-2.89), phobia (OR = 1.88, 95% CI = 1.20-2.94), and paranoia (OR = 2.23, 95% CI = 1.43-3.46). Circadian rhythm differences were associated with somatization (OR = 0.91, 95% CI = 0.87-0.96), obsessive-compulsive disorder (OR = 0.93, p < 0.01, 95% CI = 0.89-0.98), interpersonal sensitivity (OR = 0.90, 95% CI = 0.85-0.94), depression (OR = 0.92, 95% CI = 0.87-0.97), anxiety (OR = 0.89, 95% CI = 0.83-0.95), hostility (OR = 0.91, 95% CI = 0.86-0.97), phobia (OR = 0.87, 95% CI = 0.82-0.93), and paranoia (OR = 0.90, 95% CI = 0.85-0.95) were all negatively associated. In addition, gender was associated with somatization and obsessive-compulsive disorder (OR = 0.75, 95% CI = 0.57-0.98), depression (OR = 0.92, 95% CI = 0.87-0.97), and paranoia (OR = 0.55, 95% CI = 0.40-0.76).

CONCLUSIONS

Low-intensity physical activity was more likely to be associated with somatization, obsessive-compulsive disorder, relationship sensitivity, depression, anxiety, hostility, terror, and paranoia than high-intensity and moderate-intensity physical activity, and circadian rhythm differences showed that people who slept later (known as nocturnal) were more likely to have these problems.

The status and influencing factors of adolescents' mental health in a province of China: A cross-sectional study

OBJECTIVE

To understand the mental health status of adolescents in China and its influencing factors.

METHODS

The stratified cluster sampling method was used to evaluate the mental health status of 5633 adolescents using the Symptom Checklist (SCL-90).

RESULTS

There were statistically significant differences in the overall mean score of SCL-90 and the mean score of each subscale among adolescents in gender, grade, family, and region. The mean score of the interpersonal sensitivity and phobic anxiety subscales of the adolescents with rural household registration was higher than that of the urban household registration. Except for hostility and phobic anxiety subscales, there was a significant difference between junior high school and senior high school students in the remaining subscales. There were significant differences between only children and non-only children in the obsessive-compulsive symptoms and phobic anxiety subscales. The mean scores of depression, phobic anxiety, and other subscales of left-behind adolescents were significantly different from those of non-left-behind adolescents. Female gender (OR = 1.789), different-grade (junior high school sophomore: OR = 2.201; junior high school third grade: OR = 2.004; high school freshman: OR = 2.279; high school sophomore: OR = 2.947; high school senior: OR = 2.112), different-region (central region: OR = 1.302; southern region: OR = 1.925) and high school (OR = 1.281) adolescents had a higher risk of mental health problems, while those from two-parent families (OR = 0.68) had a lower risk.

LIMITATIONS

This study is a cross-sectional study and not widely representative.

CONCLUSION

Gender, grade, region, and academic period are risk factors, and a two-parent family is a protective factor for adolescents' mental health.

Changes in mental health levels among Chinese physical education college students from 1995 to 2019

To explore the changes in the mental health levels of Chinese physical education college students, the present study conducted a cross-temporal meta-analysis of 43 papers that adopted the Symptom Checklist 90 (SCL-90) from 1995 to 2019. The results showed that the average scores of the seven SCL-90 factors were negatively correlated with the year of data collection. The socioeconomic indicators (GDP, per capita GDP and household consumption level) were significantly negatively correlated with the eight dimension scores of the SCL-90 (except for phobic anxiety). The mean effect sizes of the sex differences in the seven dimension scores (except depression and phobic anxiety) were lower than the small effect size. In conclusion, Chinese physical education college students' mental health levels have increased in the past 25 years. This phenomenon may be related to Chinese socioeconomic growth, the implementation of national sports policies, and the provision of mental health education for college students. In addition, although the increasing trend in the mental health level of female students was more obvious, there were no significant sex differences.

SCL-90 empirical factors predict post-surgery weight loss in bariatric patients over longer time periods

PURPOSE

This longitudinal study examined how pre-intervention psychological health helps predict bariatric surgery (BS) success as percentage of expected body mass index loss (%EBMIL) over shorter to longer periods.

METHODS

Adult candidates for BS (N = 334, 67.4% females) completed the Symptoms Checklist 90 (SCL-90) questionnaire; on average, 11 months occurred between the pre-surgery psychological evaluations and the bariatric intervention. We explored the factor structure of the SCL-90 items and inspected how SCL-90 empirical factors compared with SCL-90 scales and general indices predicted %EBMIL at 3-6-month, 1-year, and 2-year follow-up occasions, adjusting for gender, pre-intervention use of antidepressants and actual and ideal BMIs.

RESULTS

Factor analysis combined the 90 items into 8 factors, which partially replicated the expected item structure. The SCL-90 empirical factors (but not the SCL-90 scales and indices) contributed to predict BS success. In fact, the Relational Distress factor directly protected from weight regain at 1-year follow-up, indirectly via 1-year %EBMIL at the 2-year follow-up, when it further strengthened the impact of the empirical factor of Generalized Anxiety on the 2-year BS outcome. The results also evidenced a cascade effect of the pre-surgery actual BMI across time as well as unique and direct effects of pre-surgery use of antidepressants and perceived ideal BMI on the 2-year outcome.

CONCLUSIONS

SCL-90 empirical factor scores for obese patients are more efficient in anticipating BS success compared with original scale scores. They reveal that relational distress and anxiety are risk factors for postoperative weight loss, in addition to pre-intervention actual BMI, antidepressant therapy, and perceived ideal BMI.

LEVEL OF EVIDENCE

III, well-designed cohort.

Alteration of Inflammatory Parameters and Psychological Post-Traumatic Syndrome in Long-COVID Patients

The aim of our study is to evaluate the correlation between the psychological status of patients recovered from SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection (long-COVID patients) and their inflammatory status. Three months after hospital discharge, ninety-three patients were recruited and categorized into two distinct populations: control and long-COVID (COrona VIrus Disease) group. Patients belonging to the control group presented with an entering diagnosis of cardiovascular, metabolic, or respiratory disease and a negative history of SARS-CoV-2 infection, whereas the long-COVID population presented with a severe SARS-CoV-2 infection treated in the sub-intensive Care Unit. Psychological evaluation was performed through the administration of the Symptom Checklist-90 (SCL90) and LDH (Lactate dehydrogenase), ferritin, CRPhs (C-high sensitivity Reactive Protein), NLR (Neutrophil-to-lymphocyte ratio), PLR (Platelet-to-lymphocyte ratio), and SII (systemic immune-inflammation index) were investigated. We highlighted that beyond the first three months after contagion, patients recovered from SARS-CoV-2 infection are characterized by the persistence of a systemic inflammatory state and are at high risk for developing somatization, depression, anxiety, and sleep disturbances. Interestingly, ferritin value was strongly correlated with sleep disorders (p < 0.05). Our study emphasizes how COVID-19 strategies for risk stratification, prognosis, and therapy management of patients should be implemented with a psychological follow-up.

A dimensional approach to affective disorder: The relations between Scl-90 subdimensions and QEEG parameters

OBJECTIVES

QEEG reflects neuronal activity directly rather than using indirect parameters, such as blood deoxygenation and glucose utilization, as in fMRI and PET. The correlation between QEEG spectral power density and Symptom Check List-90-R may help identify biomarkers pertaining to brain function, associated with affective disorder symptoms. This study aims at determining whether there is a relation between QEEG spectral power density and Symptom Check List-90-R symptom scores in affective disorders.

METHODS

This study evaluates 363 patients who were referred for the initial application and diagnosed with affective disorders according to DSM-V, with QEEG and Scl-90-R. Spectral power density was calculated for the 18 electrodes representing brain regions.

RESULTS

Somatization scores were found to be correlated with Pz and O1 theta, O1 and O2 high beta. Whereas FP1 delta activities were correlated with anxiety, F3, F4, and Pz theta were correlated with obsession scores. Interpersonal sensitivity scores were found to be correlated with F4 delta, P3, T5, P4, T6 alpha and T5, and T6 theta activities. While depression scores were correlated with P3 and T4 delta, as well as T4 theta, there was a correlation between anger and F4, as well as T4 alpha and F8 high beta activities. Paranoia scores are correlated with FP1, F7, T6 and F8 theta, T5 and F8 delta, and O2 high beta activities.

CONCLUSIONS

According to our results, anxiety, obsession, interpersonal sensitivity, depression, anger, and paranoia are related to some spectral powers of QEEG. Delta-beta coupling seems to be a neural biomarker for affective dysregulation.

Association between psychological symptoms and illegal driving behaviors in a sample of Chinese private car drivers

BACKGROUND

Findings on the associations between psychological symptoms and driving behaviors in private car drivers are inadequate.

METHOD

The study consisted of 3,115 private car drivers in Yulin, China. The measurements included socio-demographic data, traffic violations, accidents, and Symptom Checklist-90 (SCL-90). In addition, an ordered logistic regression model was employed to examine the association between each psychological symptom and risky driving behaviors.

RESULTS

The overall prevalence rate of any self-reported psychological symptom was 10.24%, with 9.22% for males and 11.49% for females. Among them, obsessive-compulsive, interpersonal sensitivity, additional items, hostility, and depression were the five most common psychological symptoms, with prevalence rates of 7.90, 6.29, 6.00, 5.91, and 5.62%, respectively. Any psychological symptom factor was associated with a higher risk of traffic violations and accidents. However, the intensity of the correlations varied, with obsessive-compulsive symptoms the strongest in general traffic violations and anxiety symptoms in traffic accidents. All psychological symptoms except phobic anxiety and paranoid ideation contributed to a higher risk of failing the driver's license test.

CONCLUSIONS

The prevalence rate of psychological symptoms was high in private car drivers. This study calls for an urgent need to establish a pilot tertiary prevention strategy to reduce risky driving behaviors through psychological symptom screening and interventions among private car drivers.

Improving the Measurement of Functional Somatic Symptoms With Item Response Theory

More than 40 questionnaires have been developed to assess functional somatic symptoms (FSS), but there are several methodological issues regarding the measurement of FSS. We aimed to identify which items of the somatization subscale of the Symptom Checklist-90 (SCL-90) are more informative and discriminative between persons at different levels of severity of FSS. To this end, item response theory was applied to the somatization scale of the SCL-90, collected from a sample of 82,740 adult participants without somatic conditions in the Lifelines Cohort Study. Sensitivity analyses were performed with all the participants who completed the somatization scale. Both analyses showed that Items 11 "feeling weak physically" and 12 "heavy feelings in arms or legs" were the most discriminative and informative to measure severity levels of FSS, regardless of somatic conditions. Clinicians and researchers may pay extra attention to these symptoms to augment the assessment of FSS.

Investigation on the Mental Health Status of ICU Practitioners and Analysis of Influencing Factors During the Stable Stage of COVID-19 Epidemic in China

Objective: To understand the impact of COVID-19 epidemic on the mental health status of intensive care unit (ICU) practitioners in China, and to explore the relevant factors that may affect the mental health status of front-line medical workers so as to adopt efficient and comprehensive measures in a timely manner to protect the mental health of medical staff. Methods: The study covered most of the provinces in China, and a questionnaire survey was conducted based on the WeChat platform and the Wenjuanxing online survey tool. With the method of anonymous investigation, we chose ICU practitioners to participate in the investigation from April 5, 2020 to April 7, 2020. The respondents were divided into two groups according to strict criteria of inclusion and exclusion, those who participated in the rescue work of COVID-19 (COVID-19 group) and those who did not (non-COVID-19 group). The SCL-90 self-evaluation scale was used for the evaluation of mental health status of the subjects. Results: A total of 3,851 respondents completed the questionnaire. First, the overall mental health status of the targeted population, compared with the Chinese norm (n = 1,388), was reflected in nine related factor groups of the SCL-90 scale, and significant differences were found in every factor in both men and women, except for the interpersonal sensitivity in men. Second, the overall mental health of the non-COVID-19 group was worse than that of the COVID-19 group by the SCL-90 scale (OR = 1.98, 95% CI, 1.682-2.331). Third, we have revealed several influencing factors for their mental health in the COVID-19 group, current working status (P < 0.001), satisfaction of diet and accommodation (P < 0.05), occupational exposure (P = 0.005), views on the risk of infection (P = 0.034), and support of training (P = 0.01). Conclusion: The mental health status of the ICU practitioners in the COVID-19 group is better than that of the non-COVID-19 group, which could be attributed to a strengthened mentality and awareness of risks related to occupational exposure and enforced education on preventive measures for infectious diseases, before being on duty.

Unemployment and mental health in a community population from a border city in Mexico

BACKGROUND

The constant changes in the global economy generate instability in the markets, favoring the closing of companies, dismissals of personnel, job losses. Unemployment has been associated with adverse psychological effects, serving as a predictor of poor mental health.

OBJECTIVE

The main goal was to analyze the relation between work status and mental health.

METHODS

A cross-sectional, quantitative study was carried out with a sample of community population, inhabitants of the urban area of a Mexican city. The sample consisted of 1351 participants, being 577 men (43%) and 774 women (57%) with an average age of 41.46 (SD = 17.00). The participants were selected by a quota sampling, in 13 representative points of Matamoros' city urban area. Home surveys were applied; the Spanish version of the Symptom Checklist 90 (SCL-90) was used for mental health assessment.

RESULTS

The model explaining the relation between work status and mental health (GFI) was significant (p < 0.01). Unemployment was related to higher scores in all sub-scales of psychopathologies evaluated by the SCL-90, in comparison with the rest of work status categories.

CONCLUSIONS

The unemployed, followed by housewives, presented indicators of poorer mental health, while the retired and those in strikes or lockouts showed the best mental health indexes.

Longitudinal Change of Mental Health among Active Social Media Users in China during the COVID-19 Outbreak

During the COVID-19 pandemic, every day, updated case numbers and the lasting time of the pandemic became major concerns of people. We collected the online data (28 January to 7 March 2020 during the COVID-19 outbreak) of 16,453 social media users living in mainland China. Computerized machine learning models were developed to estimate their daily scores of the nine dimensions of the Symptom Checklist-90 (SCL-90). Repeated measures analysis of variance (ANOVA) was used to compare the SCL-90 dimension scores between Wuhan and non-Wuhan residents. Fixed effect models were used to analyze the relation of the estimated SCL-90 scores with the daily reported cumulative case numbers and lasting time of the epidemic among Wuhan and non-Wuhan users. In non-Wuhan users, the estimated scores for all the SCL-90 dimensions significantly increased with the lasting time of the epidemic and the accumulation of cases, except for the interpersonal sensitivity dimension. In Wuhan users, although the estimated scores for all nine SCL-90 dimensions significantly increased with the cumulative case numbers, the magnitude of the changes was generally smaller than that in non-Wuhan users. The mental health of Chinese Weibo users was affected by the daily updated information on case numbers and the lasting time of the COVID-19 outbreak.

Extreme sleep state misperception: From psychopathology to objective-subjective sleep measures

STUDY OBJECTIVES

We tested the hypothesis that patients with extreme sleep state misperception display higher levels of psychopathology and reduced quantitative estimation abilities compared to other patients with insomnia. Secondary aims included the evaluation of group differences in subjective self-reported quality of life and sleep quality and objective sleep parameters.

METHODS

In this cross-sectional, observational study, 249 patients with insomnia underwent a video-polysomnography with a subsequent morning interview to assess self-reported sleep estimates and filled in a large battery of questionnaires. Patients were classified into High Misperception (HM) and Moderate Misperception (MM) groups, according to the complement of the ratio between self-reported total sleep time and objective total sleep time (Misperception Index).

RESULTS

No significant differences emerged in any of the psychopathological measures considered between the HM and the MM group. Similarly, no effect was observed in quantitative estimation abilities. HM patients displayed a significantly increased number of awakenings per hour of sleep and a reduced dream recall rate. Their overall sleep quality and quality of life was significantly impaired.

CONCLUSIONS

Future research on sleep misperception should focus on factors other than the level of psychopathology and estimation abilities, in particular sleep microstructure and quantitative EEG studies in both REM and NREM sleep.

An assessment of the mental health of front-line medical staff involved in the COVID-19 outbreak in Chongqing, China

In response to the coronavirus disease 2019 (COVID-19) outbreak in December 2019 in China, medical staff went to work across the country to combat widespread infection. When health workers are suddenly faced with such a serious event, it is important to assess their mental health in order to determine whether they can meet the challenge effectively. Herein, Symptom Checklist-90 (SCL-90) was used to assess the psychological problems of 382 front-line medical staff in Chongqing. The average SCL-90 score was low, and no specific mental health problems were found. With the exception of the phobic-anxiety factor, the scores were close to normal values. A single-factor analysis of variance showed that the SCL-90 scores of male and older staff were higher than those of female and younger staff, implying that they were at greater psychological risk. We found that both gender and age have a significant impact on mental health, and our findings suggest that more attention should be given to the mental health of male and older front-line medical staff.

The effect of refined nursing intervention on patients undergoing maintenance hemodialysis in the hemodialysis center during the COVID-19 epidemic

Background

The outbreak of novel coronavirus pneumonia has exerted considerable psychological pressure on patients undergoing hemodialysis, resulting in unhealthy psychological emotions. Therefore, it is of great significance to carry out strict management and refined nursing intervention for patients undergoing maintenance hemodialysis during the prevention and control of novel coronavirus. This study aims to analyze and discuss the effect of clinical refined nursing intervention on patients undergoing maintenance hemodialysis during the coronavirus disease 2019 (COVID-19) epidemic.

Methods

This was a prospective cohort study. In this study, we used the Symptom Checklist-90 (SCL-90) or the Chinese adult SCL-90 norm to conduct nursing interventions for patients undergoing maintenance hemodialysis to investigate the effect of clinical refined nursing intervention on patients undergoing maintenance hemodialysis during the COVID-19 epidemic.

Results

The scores for all the factors of SCL-90 of patients undergoing maintenance hemodialysis were higher than those of the Chinese SCL-90, and patients with a single factor score ≥ 2 had a higher level of depression and anxiety, with extremely significant difference (p < 0.01). The depression and anxiety of the patients were reduced after the intervention, and there was a statistical difference. Among the 172 patients, the results of both nucleic acid tests were negative.

Conclusion

During the COVID-19 epidemic, providing patients undergoing maintenance hemodialysis with refined nursing intervention can regulate negative emotions, reduce related complications, improve their quality of life, and improve the nurse–patient relationship.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00584-5.

Psychological symptoms of cancer survivors during the COVID-19 outbreak: A longitudinal study

OBJECTIVE

Due to the coronavirus disease 2019 (COVID-19) pandemic, self-isolation at home was adopted to control the spread of COVID-19 in China for 3 months from 29 January 2020. The psychological status of cancer survivors is affected by their social environment. In this study, we investigated the psychological status and psychological symptoms of Chinese cancer survivors.

METHODS

A longitudinal study design was adopted, and an online sample of cancer survivors was successfully recruited via the Internet communities of cancer support groups. From 14 February to 25 May, 111 cancer survivor families completed the symptom checklist 90 (SCL-90) online three times (T1:14 to 24 February; T2: 1 to 10 April; T3: 15 to 25 May).

RESULTS

For survivors and their family members, the mean total score of the SCL-90 was 172.05 (13.30) and 142.76 (26.80) at T1, 155.91 (12.18) and 133.42 (15.93) at T2, and 142.75 (11.56) and 130.14 (14.16) at T3, respectively. The SCL-90 scores of cancer survivors were significantly higher than those of family members and Chinese norms at T1, T2, and T3. Nine psychological symptoms of the SCL-90 in cancer survivors significantly declined from T1 to T2 and T3.

CONCLUSIONS

The COVID-19 pandemic has had a significant adverse impact on cancer survivors and their families. Psychological assistance should be provided to cancer survivors.

Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic

OBJECTIVE

Mindfulness disposition is associated with various psychological factors and prevents emotional distress in chronic diseases. In the present study, we analyzed the key role of mindfulness dispositions in protecting the individual against psychological distress consequent to COVID-19 social distancing and quarantining.

METHODS

An online survey was launched on March 13, 2020, with 6,412 responses by April 6, 2020. Socio-demographic information, exposure to the pandemic, and quarantining were assessed together with psychological distress and mindfulness disposition. Multivariate linear regression analysis was performed to study the influence of predictive factors on psychological distress and quality of life in Italian responders during the early days of lockdown. Pearson correlations were calculated to study the relationship between mindfulness and psychiatric symptoms.

RESULTS

Multivariate linear regression run on socio-demographics, COVID-19-related variables, and mindfulness disposition as moderators of overall psychological distress showed that mindfulness was the best predictor of psychological distress (β = -0.504; p < 0.0001). High negative correlations were found between mindfulness disposition and the overall Global Severity Index (r = -0.637; p < 0.0001), while moderate to high associations were found between mindfulness and all SCL-90 sub-scales.

DISCUSSION

Findings showed that high dispositional mindfulness enhances well-being and helps in dealing with stressful situations such as the COVID-19 pandemic. Mindfulness-based mental training could represent an effective intervention to stem post-traumatic psychopathological beginnings and prevent the onset of chronic mental disorders.

The prevalence of mental distress and association with social changes among postgraduate students in China: a cross-temporal meta-analysis

OBJECTIVE

This study aims to estimate the mental distress prevalence of Chinese postgraduate students and the association with the social changes based on the data between 2000 and 2019.

STUDY DESIGN

This is a cross-temporal meta-analysis study.

METHODS

The literature was retrieved with both English and Chinese electronic databases, including articles published from 2002 to 2019. Statistical analyses were performed with R 3.6.1 and SPSS 22.

RESULTS

Eighty-nine primary studies with 99 reports were included in our meta-analysis, totaling 54,722 Chinese postgraduate students. The result showed that: (a) the prevalence of mental distress was 28% (95% confidence interval [CI]: 25%-31%), and the prevalence of moderately positive symptoms was 9% (95% CI: 7%-11%); (b) the prevalence of positive symptoms was negatively correlated with the years of data collection and the prevalence of mental distress decreased by at least 16% from 2000 to 2019; and (c) social changes, particularly the policies of mental health and the educational environment had a significant contribution to these changes.

CONCLUSIONS

More than a quarter of postgraduate students have mental illness in China, whereas the prevalence of their mental distress has been decreasing. Social changes are shown to play an important role in contributing to this change.

Psychological characteristics of Chinese patients with genuine halitosis

OBJECTIVE

The present case-control study aimed to compare the psychological status of patients with and without halitosis, and investigate the association between psychological disorders and halitosis.

METHODS

Patients who complained about bad breath and diagnosed with genuine halitosis were assigned to the halitosis group, while patients without genuine halitosis were assigned to the control group (n = 106, each group). Information on the demographics and Symptom Checklist-90 (SCL-90) of participants was collected. The organoleptic score and Halimeter measurement were used to measure halitosis.

RESULTS

The mean SCL-90 score of participants in the halitosis group (0.63) was significantly greater than that in the control group (0.48) (p = .002). The scores of the domains of interpersonal sensitivity, anxiety, depression, and paranoid ideation were found to be significantly different between the two groups (p < .05). However, there were no significant differences in SCL-90 scores between the mild and moderate-severe halitosis groups (p = .479).

CONCLUSION

The psychological status of genuine halitosis patients was significantly worse than normal patients without halitosis complaint and also without halitosis. The main problems were in the aspects of interpersonal sensitivity, anxiety, depression, and paranoia. However, the negative impact was not related to the severity of halitosis.

Identifying Psychological Symptoms Based on Facial Movements

Background: Many methods have been proposed to automatically identify the presence of mental illness, but these have mostly focused on one specific mental illness. In some non-professional scenarios, it would be more helpful to understand an individual's mental health status from all perspectives. Methods: We recruited 100 participants. Their multi-dimensional psychological symptoms of mental health were evaluated using the Symptom Checklist 90 (SCL-90) and their facial movements under neutral stimulation were recorded using Microsoft Kinect. We extracted the time-series characteristics of the key points as the input, and the subscale scores of the SCL-90 as the output to build facial prediction models. Finally, the convergent validity, discriminant validity, criterion validity, and the split-half reliability were respectively assessed using a multitrait-multimethod matrix and correlation coefficients. Results: The correlation coefficients between the predicted values and actual scores were 0.26 and 0.42 (P < 0.01), which indicated good criterion validity. All models except depression had high convergent validity but low discriminant validity. Results also indicated good levels of split-half reliability for each model [from 0.516 (hostility) to 0.817 (interpersonal sensitivity)] (P < 0.001). Conclusion: The validity and reliability of facial prediction models were confirmed for the measurement of mental health based on the SCL-90. Our research demonstrated that fine-grained aspects of mental health can be identified from the face, and provided a feasible evaluation method for multi-dimensional prediction models.

Study of the SCL-90 Scale and Changes in the Chinese Norms

Objective: This study aimed to investigate the Chinese norms for the Symptom Checklist 90 (SCL-90) scale and its application. Methods: In total, 7,489 adults from Tianjin and Qingdao in China were included. Their data were compared with the norm data of 1,388 people published by Jin et al., the combined norms published by Tang et al., the data of 2,808 adults published by Chen and Li, and the data of 1,890 adults from Tong in China. Results: In five different periods, notable changes were observed in each factor of the SCL-90 that significantly differed from the previous norms. The scores of each factor showed an increasing annual trend. Compulsion consistently obtained the highest scores, and phobia consistently obtained the lowest scores. The scores tended to decrease from compulsion to anxiety, and psychosis scored lower than paranoia. There was a significant difference in the detection rate between the critical screening value of two points and the standard score. Using the standard score as the critical value, the detection rate ranged between 13 and 16% and was relatively concentrated. Using two points as the critical value, the detection rate ranged between 38 and 50%. Conclusion: The usual model in China is not consistent with social development. Using two points as the critical value is no longer suitable for the SCL-90. New Chinese norms and measurement standards should be developed. The mean value plus one standard deviation could be used as the new measurement standard.

Changes in Chinese nurses' mental health during 1998-2016: A cross-temporal meta-analysis

In China, nursing is a profession with considerable stress, which may cause both physiological and psychological problems. The present study conducted a cross-temporal meta-analysis of 244 papers using the Symptom Checklist 90 (SCL-90) to investigate the changes in the mental health level of Chinese nurses (N = 71,286) from 1998 to 2016. Results showed that (a) relationships between scores of all nine types of mental problems in the SCL-90 and year were significantly positive, indicating that the mental health level of nurses decreased steadily in the past 19 years; (b) relationships between three social indicators (patient-to-nurse ratio, unemployment rate, and divorce rate) and scores of all nine types of mental problems in the SCL-90 were significantly positive, suggesting that the increase in these social indicators may be responsible for the decrease in Chinese nurses' mental health level.

A glimpse into the psychological status of E.N.T inpatients in China: A cross-sectional survey of three hospitals in different regions

Objective

To determine whether E.N.T inpatients have a higher prevalence of mental illness than the general population and whether certain diseases are more likely to be associated with mental illness than other diseases.

Methods

This cross-sectional survey was conducted in the E.N.T departments of three hospitals in different cities in China. The psychological status of all consecutive adult inpatients was assessed within 1–2 days following hospital admission using the Symptom Checklist-90 (SCL-90), Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS). Inpatients from the general surgery and pneumology departments at the same hospital were enrolled and surveyed as control groups.

Results

The 439 patients enrolled in the final analysis accounted for 88.0% of all E.N.T inpatients during the study period. Of these patients, 16.4% were in an anxious state and 79.5% were in a depressive state. The overall anxiety (41.7 ± 9.7) and depression (55.9 ± 29.2) scores were much higher than Chinese norm (29.8 ± 10.0 and 33.5 ± 8.6, respectively), and significant differences were observed (t = 20.89, P < 0.01 and t = 13.12, P < 0.01, respectively). Although 18.7% of the E.N.T patients were psychiatric distress, these patients scored lower on the SCL-90 than the Chinese norm. Furthermore, the patients in the E.N.T department had a higher prevalence of anxiety and depression than those in the general surgery department but a similar prevalence to those in the respiratory department.

Conclusion

Psychological distress, particularly anxiety and depression, are widespread in patients with otolaryngological diseases. Therefore, the identification and treatment of co-occurring psychiatric disorders in this high risk and clinically challenging group of patients are urgent in China.

The relationship between the psychological stress of adolescents in school and the prevalence of chronic low back pain: a cross-sectional study in China

BACKGROUND

Accumulating evidence supports an association between an unhealthy mental state and low back pain (LBP). However, the degree of the association between mental health and chronic low back pain (CLBP) in the general population is poorly understood. The objective of this study was to analyze the incidence of CLBP in Chinese college students and to examine the association between students' unhealthy mental states and the prevalence of CLBP.

METHODS

This is a cross-sectional study. A total of 10,000 questionnaires were distributed in the second semester of the 2017-2018 academic year by the School of Medicine, Shanghai JiaoTong University. Eligible participants were students aged ≥ 18 years from randomly selected Chinese colleges. Participants completed a questionnaire survey that included items from the Symptom Checklist-90 (SCL-90) and items on demographic factors, LBP prevalence, quality of life at their university, study-related stress and interpersonal relationships. The evaluation of students' mental states in the survey was divided into two major parts: direct and indirect indicators. A multivariate logistic regression model was mainly used to explore the relationship between CLBP and the students' mental health.

RESULTS

There was a high incidence of CLBP in the college students. Multiple logistic regression analysis indicated that the risk of CLBP increased with increasing scores on the SCL-90, and a clinically unhealthy mental state (scores greater than 3) was significantly associated with CLBP (adjusted odds ratios for depression, anxiety, coercion, paranoia, and interpersonal sensitivity were 7.209, 6.593, 3.959, 4.465, and 4.283, respectively; p < 0.001). Participants who had poor living habits or uncomfortable campus lives and those who experienced heavy academic pressure also showed a higher positive association with CLBP compared with the full sample.

CONCLUSIONS

Unhealthy psychological conditions, which may be attributed to unsatisfying school lives, excessive learning pressure, and uncomfortable interpersonal relationships, represent a risk factor for CLBP in college students.

Childhood Maltreatment Influences Mental Symptoms: The Mediating Roles of Emotional Intelligence and Social Support

Childhood maltreatment and its influence on mental health are key concerns around the world. Previous studies have found that childhood maltreatment is a positive predictor of mental symptoms, but few studies have been done to explore the specific mediating mechanisms between these two variables. Previous studies have found that there is a negative correlation between childhood maltreatment and emotional intelligence and between childhood maltreatment and social support, both of which are strong indicators of mental symptoms. Therefore, in this study, we took emotional intelligence and social support as mediating variables, exploring their mediating effects between childhood maltreatment and mental symptoms via the structural equation modeling method. We recruited 811 Chinese college students to complete the Childhood Trauma Questionnaire (CTQ), the Symptom Checklist 90 Scale (SCL-90), the Wong Law Emotional Intelligence Scale (WLEIS), and the Perceived Social Support Scale (PSSS). The results showed a significant and positive correlation between childhood maltreatment and mental symptoms (β = 0.26, P < 0.001); meanwhile, social support played a significant mediating role in the influence of childhood maltreatment on emotional intelligence [95% confidence intervals, (-0.594 to -0.327)]; and emotional intelligence likewise played a significant mediating role in the effect of social support on mental symptoms [95% confidence intervals, (-0.224 to -0.105)]. These results indicated that childhood maltreatment not only directly increases the likelihood of developing mental symptoms, but also affects emotional intelligence through influencing social support and then indirectly increasing the likelihood of developing mental symptoms. This study provided a theoretical basis for ameliorating adverse effects of childhood maltreatment on mental symptoms by enhancing emotional intelligence and social support.

Psychological symptoms and self-image of patients with complaints attributed to dental restorative materials

OBJECTIVES

The aim was to study self-image and the level of psychological symptoms in patients with symptoms attributed to their dental restorative materials.

MATERIALS AND METHODS

A questionnaire containing questions regarding dental and medical history was answered by 257 participants, one group with local oral symptoms only (LSO), and one group with multi-symptoms (M-S). A reference group was randomly selected from a research database at the Department of Psychology, Umeå University, Sweden. The self-image was assessed using the Structural Analysis of Social Behavior (SASB). Psychological symptoms such as somatization, depression, and anxiety were assessed using the Symptom Check List 90 (SCL-90) and the Global Severity Index (GSI) was used to determine the level of psychological symptoms.

RESULTS

SASB showed that the M-S group and the LSO-group scored significantly higher on the "spontaneous" and "positive self-image" than the reference group. In the SCL-90, the M-S group scored significantly higher than the LSO-group and the references on the somatization subscales. On depression, anxiety, and the GSI scale, the M-S group scored significantly higher than the reference group.

CONCLUSIONS

The two subgroups scored significantly higher on the SASB Spontaneous and Positive clusters which indicates that these patients have an excessively positive self-image, are very spontaneous and have an overconfidence in themselves compared to the reference group. In the M-S group there was a clear tendency to somatization, depression, and anxiety and they were more psychologically stressed than the reference group.

CLINICAL RELEVANCE

Among the patients with illness attributed to their dental materials, the M-S-patients had a significantly higher level of general psychological distress and somatization than the control group which may lead to mental stress.

A novel SCL-90-R six-item factor identifies subjects at risk of early adverse outcomes in public mental health settings

To increase access to treatment, Italy made assessment at community mental health centers (CMHCs) independent of medical referral, resulting in increased numbers of patients to be triaged efficiently. To support this process, we evaluated SCL-90-R item-ratings to identify factors that best predicted adverse early outcomes among persons seeking first-time CMHC care in a 24-month period in Rome. A psychiatric nurse screened subjects with a brief interview and self-administered SCL-90-R and psychiatrists provided CGI ratings and ICD-9 diagnosis. Of 832 screened subjects, 32 (3.85%) were hospitalized or attempted suicide within 90 days. Six SCL-90 items (15,41,55,57,78,88) scored much higher with than without such adverse outcomes; their sum is proposed as a predictive measure ("SCL-6″). In binary multivariable logistic modeling, this factor, but not age, sex, diagnosis, or other SCL-90-derived subscales strongly predicted adverse outcomes. A ROC curve for SCL-6 reflected a strong separation between subjects with versus without adverse outcomes (AUC = 0.76). This simple screening tool may support timely identification of patients at risk of early adverse clinical outcome who require especially close follow-up.

Brief Report: Relationship Between ADOS-2, Module 4 Calibrated Severity Scores (CSS) and Social and Non-Social Standardized Assessment Measures in Adult Males with Autism Spectrum Disorder (ASD)

The ADOS-2 Modules 1-3 now include a standardized calibrated severity score (CSS) from 1 to 10 based on the overall total raw score. Subsequent research published CSS for Module 4 (Hus, Lord, Journal of Autism and Developmental Disorders 44(8):1996-2012, 2014); however more research is needed to examine the psychometric properties of this CSS. Forty males with ASD completed an assessment battery consisting of ADOS-2 Module 4 and other clinical measures assessing core ASD symptomology and comorbidity. Pearson correlation analyses found that CSS did not correlate with measures that assessed core social deficits of ASD or general psychiatric co-morbidity, but CSS did correlate negatively with intellectual quotient. These findings provide information on the limitations and relevance of CSS to be taken into account in future clinical evaluations of ASD.

Effects of Amitriptyline and Escitalopram on Sleep and Mood in Patients With Functional Dyspepsia

BACKGROUND & AIMS

Tricyclic antidepressants are effective in reducing symptoms of functional dyspepsia (FD). We performed a post hoc analysis of data from a previous randomized clinical trial to determine whether the benefits of an antidepressant on gastrointestinal symptoms in patients with FD were mediated by improving sleep or reducing anxiety. We explored the relationships between psychological measures, quality of sleep, and relief of symptoms.

METHODS

We analyzed data from a multicenter, double-blind trial that evaluated the efficacy of antidepressants on symptoms of FD, from October 2006 through October 2012. Patients (n = 292) were randomly assigned to groups given 50 mg amitriptyline, 10 mg escitalopram, or placebo for 12 weeks. During the study, participants completed the following validated psychological questionnaires: Symptom Check List 90, Symptom Somatic Checklist, Hospital Anxiety Depression Scale, Profile of Mood States, State Trait Anxiety Inventory, and Pittsburgh Sleep Quality Index at baseline and 12 weeks following treatment.

RESULTS

Baseline scores for the psychological and sleep measures were similar among groups; after 12 weeks there were no significant differences in scores among groups. Baseline mean global Pittsburgh Sleep Quality Index scores indicated poor sleep quality in all groups at baseline and after 12 weeks. Overall, antidepressants affected sleep duration scores: patients given amitriptyline had lower (better) scores than patients given placebo or escitalopram (P = .019). In all groups, responders had decreased anxiety and improvements in some sleep components.

CONCLUSIONS

In a post hoc analysis of data from a clinical trial that evaluated the effects of antidepressants in patients with FD, amitriptyline was found to reduce symptoms of FD, but its mechanism is unlikely to involve reductions in psychological distress. The drug may modestly improve sleep. Clinicaltrials.gov no: NCT00248651.

Prospective psychometric characterization of hip and knee arthroplasty patients

BACKGROUND

Psychiatric conditions and psychopharmacological treatments have been demonstrated to be important risk-factors for prolonged hospital length of stay, readmission and morbidity, following fast-track total hip (THA) and total knee arthroplasty (TKA).

AIMS

The aim of the study was to provide a detailed description of the preoperative psychiatric characteristics of a well-defined patient population undergoing THA and TKA, using the 90-item Symptom Checklist (SCL-90-R).

METHODS

A pre-surgical population of 2183 patients completed the full SCL-90-R prior to THA/TKA from 2015 to 2016. The SCL-90-R scale and total scores of the pre-surgical sample were compared to the scores of an age- and gender stratified Danish sample of healthy controls. A Mokken scalogram analysis was conducted to assess the scalability of the SCL-90-R in both samples.

RESULTS

The Mokken analysis yielded acceptable scalability coefficients above 0.30 in all subscales of the SCL-90-R except psycoticism (0.28). There was no clinically significant difference (effect size = <0.50) in the SCL-90-R total score between the pre-surgical and the healthy controls samples, although pre-surgical patients had lower mean scores compared to the healthy controls in all subscales except somatization (effect size = -0.22).

CONCLUSION

The Mokken analysis demonstrated that the SCL-90-R and its subscales express valid measures of psychopathology in our surgical sample. The psychiatric profile of the pre-surgical patient sample indicates that patients undergoing THA/TKA are not more burdened by psychiatric symptoms than a healthy control group with the exception of symptoms relating to somatization.

Toward the Identification of a Specific Psychopathology of Substance Use Disorders

Addiction is a mental illness in which psychiatric conditions imply a prominent burden. Psychopathological symptoms in substance use disorder (SUD) patients are usually viewed as being assignable to the sphere of a personality trait or of comorbidity, leaving doubts about the presence of a specific psychopathology that could only be related to the toxicomanic process. Our research group at the University of Pisa has shed light on the possible definition of a specific psychopathological dimension in SUDs. In heroin use disorder patients, performing an exploratory principal component factor analysis (PCA) on all the 90 items included in the SCL-90 questionnaire led to a five-factor solution. The first factor accounted for a depressive "worthlessness and being trapped" dimension; the second factor picked out a "somatic symptoms" dimension; the third identified a "sensitivity-psychoticism" dimension; the fourth a "panic-anxiety" dimension; and the fifth a "violence-suicide" dimension. These same results were replicated by applying the PCA to another Italian sample of 1,195 heroin addicts entering a Therapeutic Community Treatment. Further analyses confirmed the clusters of symptoms, independently of demographic and clinical characteristics, active heroin use, lifetime psychiatric problems, kind of treatment received, and, especially, other substances used by the patient such as alcohol or cocaine. Moreover, these clusters were able to discriminate patients affected by addiction from those affected by psychiatric diseases such as major depressive disorder. Our studies seem to suggest the trait-dependent, rather than the state-dependent, nature of the introduced psychopathology dimensions of SUDs.

Associations between obesity and mental distress in late midlife: results from a large Danish community sample

BACKGROUND

To examine associations of Body mass Index (BMI) and mental distress in late midlife in a large Danish community sample and to investigate the effect of socio-demographic factors.

METHODS

The study sample comprised 3613 Danish men and 1673 women aged 49-63 years from the Copenhagen Ageing and Midlife Biobank (CAMB) with complete information on measured BMI, severity of mental symptoms assessed by the Symptom Check-List' (SCL-90), and socio-demographic factors including sex, age, occupational social class, and educational duration. Linear and logistic regression were used to evaluate associations between BMI category and SCL-90.

RESULTS

Unadjusted SCL-90 subscale scores differed significantly across BMI categories (p < 0.001) among both men and women with more mental distress in the underweight, obese and severely obese BMI categories except for the anxiety scale which was not associated with BMI category in women. In the adjusted analyses, all symptom scales remained significantly associated with BMI among men after adjusting for socio-demographic factors while only associations with somatization and depression scales remained significant for women.. When SCL-90 case status was applied as an outcome, significant unadjusted associations with BMI category were observed for somatization (p < 0.001), depression (p = 0.026) and the General Severity Index (p = 0.002) among men and somatization (p = 0.002) among women. Furthermore, somatization case-status was significantly predicted by BMI category (p < 0.001) in men after adjusting for socio-demographic factors.

CONCLUSION

Results indicate more mental distress among underweight, obese and severely obese men and women after adjusting for socio-demographic factors. Furthermore, obese men have higher risk of reporting clinically relevant symptoms of somatization independently of socio-demographic factors.

Psychometric properties of the Symptom Checklist-90 in adolescent psychiatric inpatients and age- and gender-matched community youth

BACKGROUND

The Symptom Checklist-90 (SCL-90) is a questionnaire that is widely used to measure subjective psychopathology. In this study we investigated the psychometric properties of the SCL-90 among adolescent inpatients and community youth matched on age and gender.

METHODS

The final SCL-90 respondents comprised three subsets: 201 inpatients at admission, of whom 152 also completed the instrument at discharge, and 197 controls. The mean age at baseline was 15.0 years (SD 1.2), and 73 % were female. Differential SCL-90 item functioning between the three subsets was assessed with an iterative algorithm, and the presence of multidimensionality was assessed with a number of methods. Confirmatory factor analyses for ordinal items compared three latent factor models: one dimension, nine correlated dimensions, and a one-plus-nine bifactor model. Sensitivity to change was assessed with the bifactor model's general factor scores at admission and discharge. The accuracy of this factor in detecting the need for treatment used, as a gold standard, psychiatric diagnoses based on clinical records and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) interview.

RESULTS

Item measurement properties were largely invariant across subsets under the unidimensional model, with standardized factor scores at admission being 0.04 higher than at discharge and 0.06 higher than those of controls. Determination of the empirical number of factors was inconclusive, reflecting a strong main factor and some multidimensionality. The unidimensional factor model had very good fit, but the bifactor model offered an overall improvement, though subfactors accounted for little item variance. The SCL-90s ability to identify those with and without a psychiatric disorder was good (AUC = 83 %, Glass's Δ = 1.4, Cohen's d = 1.1, diagnostic odds ratio 12.5). Scores were also fairly sensitive to change between admission and discharge (AUC 72 %, Cohen's d = 0.8).

CONCLUSIONS

The SCL-90 proved mostly unidimensional and showed sufficient item measurement invariance, and is thus a useful tool for screening overall psychopathology in adolescents. It is also applicable as an outcome measure for adolescent psychiatric patients. SCL-90 revealed significant gender differences in subjective psychopathology among both inpatients and community youth.

[Impacts on physical and mental health of patients with polycystic ovary syndrome treated with electroacupuncture:a randomized controlled trial]

OBJECTIVE

To explore the impacts on physical and mental health of the patients with polycystic ovary syndrome (PCOS) treated with electroacupuncture (EA) or Diane 35.

METHODS

Seventy-two patients of PCOS were randomized into an acupuncture group and a western medication group, 36 cases in each group. In the acupuncture group, acupuncture was applied to relieving liver stagnation and regulating qi activity at Ganshu (BL 18), Danzhong (CV 17), Qimen (LR 14), Zhongwan (CV 4), Tianshu (ST 25), Guanyuan (CV 4), Zigong (EX-CA 1), Sanyinjiao (SP 6), Zusanli (ST 36) and Taichong (LR 3). After qi arrival, the electric stimulation was added for 30 min. Acupuncture treatment was given 3 times a week. In the western medication group, Diane 35 was taken since the 5th day of menstruation and lasted for 21 days. The cycle of treatment was 3 months in the two groups. Before treatment and at the end of treatment, the symptom scores were evaluated and the self-report symptom inventory, symptom checklist-90 (SCL-90) was used for the mental health evaluation and the comparison was made between the two groups.

RESULTS

Compared with those before treatment in the same group, the symptom scores were reduced significantly after treatment in the two groups (both P<0.01). After treatment, the symptom scores in the acupuncture group were reduced significantly as compared with those in the western medicationgroup (P<0.01). After treatment, the scores of somatization, interpersonal sensitivity, depression, anxiety and hostility were reduced significantly as compared with those before treatment in the acupuncture group (all P<0.05). After treatment, the scores of somatization, interpersonal sensitivity, depression, anxiety, hostility and phobic factor were lower significantly than those in the western medication group (all P<0.05).

CONCLUSIONS

EA with relieving liver stagnation and regulating qi activity reduces the symptom scores of PCOS and SCL-90 scores, acting on regulating both physical and mental conditions. The effects achieved with acupuncture are better than those with Diane 35.

The impact of psychopathological subtypes on retention rate of patients with substance use disorder entering residential therapeutic community treatment

BACKGROUND

A specific psychopathology of addiction has been proposed and described using the self-report symptom inventory (SCL-90), leading to a 5-factor aggregation of psychological/psychiatric symptoms: 'worthlessness and being trapped', 'somatic symptoms', 'sensitivity-psychoticism', 'panic-anxiety' and 'violence-suicide' in various populations of patients with heroin use disorder (HUD) and other substance use disorders (SUDs). These clusters of symptoms, according to studies that have highlighted the role of possible confounding factors (such as demographic and clinical characteristics, active heroin use, lifetime psychiatric problems and kind of treatment received by the patients), seem to constitute a trait rather than a state of the psychological structure of addiction. These five psychopathological dimensions defined on the basis of SCL-90 categories have also been shown to be correlated with the outcomes of a variety of agonist opioid treatments. The present study aims to test whether the 5-factor psychopathological model of addiction correlates with the outcome (retention rate) of patients with SUDs entering a therapeutic community (TC) treatment.

METHODS

2016 subjects with alcohol, heroin or cocaine dependence were assigned to one of the five clusters on the basis of the highest SCL-90 factor score shown. Retention in treatment was analysed by means of the survival analysis and Wilcoxon statistics for comparison between the survival curves. The associations between the psychopathological subtypes defined by SCL-90 categories and length of retention in treatment, after taking into account substance of abuse and other sociodemographic and clinical variables, were summarized using Cox regression.

RESULTS

Patients with cocaine use disorder (CUD) showed poorer outcomes than those with heroin dependence (HUD). Prominent symptoms of "worthlessness-being trapped" lead to a longer retention in treatment than in the case of the other four prominent psychopathological groups. At the multivariate level, age, detoxified status and total number of psychopathological symptoms proved to influence outcome negatively, especially in CUD. Somatic symptoms and violence-suicide symptoms turned out to correlate with dropout from residential treatment.

CONCLUSIONS

The SCL-90 5-factor dimensions can be appropriately used as a prognostic tool for drug-dependent subjects entering a residential treatment.

Psychopathology of addiction: May a SCL-90-based five dimensions structure be applied irrespectively of the involved drug?

BACKGROUND

We previously found a five cluster of psychological symptoms in heroin use disorder (HUD) patients: 'worthlessness-being trapped', 'somatic-symptoms', 'sensitivity-psychoticism', 'panic-anxiety', and 'violence-suicide'. We demonstrated that this aggregation is independent of the chosen treatment, of intoxication status and of the presence of psychiatric problems.

METHODS

2314 Subjects, with alcohol, heroin or cocaine dependence were assigned to one of the five clusters. Differences between patients dependent on alcohol, heroin and cocaine in the frequency of the five clusters and in their severity were analysed. The association between the secondary abuse of alcohol and cocaine and the five clusters was also considered in the subsample of HUD patients.

RESULTS

We confirmed a positive association of the 'somatic symptoms' dimension with the condition of heroin versus cocaine dependence and of the 'sensitivity-psychoticism' dimension with the condition of alcohol versus heroin dependence. 'Somatic symptoms' and 'panic anxiety' successfully discriminated between patients as being alcohol, heroin or cocaine dependents. Looking at the subsample of heroin dependents, no significant differences were observed.

CONCLUSIONS

The available evidence coming from our results, taken as a whole, seems to support the extension of the psychopathological structure previously observed in opioid addicts to the population of alcohol and cocaine dependents.

Effect of Helicobacter pylori infection on mental status

AIM: To investigate the effect of Helicobacter pylori (H. pylori) infection on mental status of patients.

METHODS: Eighty-four patients diagnosed with H. pylori infection by ¹³C-Urea breath test (¹³C-UBT) at Tongling Municipal Hospital were included in an experimental group, and 84 healthy controls were used as a control group. The differences between the two groups were compared using the Symptom Checklist 90 (SCL-90) rating scale. Patients with H. pylori infection received H. pylori eradication, and then underwent ¹³C-UBT again. Patients who had successful H. pylori eradication were scored with the SCL-90 rating scale again, and the scores were compared between before and after treatment.

RESULTS: Somzatization, compulsion symptom, interpersonal relations, depression, anxiety, and terror scores differed significantly between patients with H. pylori infection and those without H. pylori infection, as well as between before and after successful eradication therapy (P < 0.05).

CONCLUSION: H. pylori infection can result in negative psychological status, and successful H. pylori eradication significantly improves such negative mental status.

Impulse control disorders are associated with multiple psychiatric symptoms in Parkinson's disease

BACKGROUND

Impulse control disorders can have serious adverse consequences to the life of a patient with Parkinson's disease. Although impulse control disorders are common, a possible psychiatric comorbidity has not been fully characterized.

OBJECTIVE

The aim of this study was to investigate the psychiatric symptoms exhibited by Parkinson's disease patients with impulse control disorders.

METHODS

The study was conducted as a postal survey to patients in the registry of the Finnish Parkinson Association. A total of 290 Parkinson's disease patients were evaluated for impulse control disorders using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease. Psychiatric symptoms were systematically screened using the Symptom Checklist 90.

RESULTS

We found that 108 of the evaluated patients had one or more impulse control disorders. Patients with impulse control disorders had markedly higher scores for symptoms of psychoticism (Bonferroni corrected p < 0.001), interpersonal sensitivity (p < 0.001), obsessive-compulsive disorder (p < 0.001), and depression (p = 0.01) when compared with patients without impulse control disorders. Impulse control disorders were shown to be independently associated with these symptoms. Patients with multiple impulse control disorders had higher scores for depression and obsessive-compulsive symptoms when compared with patients that exhibited only one impulse control disorder. COUNCLUSIONS: Our results confirm the previous observations that impulse control disorders in Parkinson's disease are linked with multiple psychiatric symptoms, including psychoticism, interpersonal sensitivity, obsessive-compulsive symptoms and depression. Clinicians treating these patients should acknowledge the concomitant psychiatric symptoms.

Psychopathological symptoms of patients with heroin addiction entering opioid agonist or therapeutic community treatment

BACKGROUND

The relationship between substance use disorders and psychiatric pathology is still an open question. The main aim of the present study was to verify whether the five psychopathological dimensions identified through the SCL-90 tool in a previous study carried out on patients with heroin addiction entering an outpatient opioid agonist treatment (OAT) were also observable in those entering a residential treatment community (TC). Further aims were to look at differences in the psychopathological profiles of patients entering a TC versus an OAT treatment and at the correlation between gender and the observed psychopathology.

METHODS

A confirmatory factor analysis was performed on the results of SCL-90 filled by 1,195 patients with heroin dependence entering TC treatment. It replicates the extraction method previously used on 1,055 OAT patients with heroin addiction by using a principal component factor analysis (PCA). The association between the kind of treatment received (TC or OAT), gender, and the psychopathological dimensions was assessed through logistic regression and general linear model (GLM) analysis.

RESULTS

The PCA carried out on the SCL-90 results of patients entering a TC yielded a five-factor solution, confirming the same dimensions observed in patients entering an OAT: 'worthlessness and being trapped', 'somatization', 'sensitivity-psychoticism', 'panic anxiety', and 'violence-suicide'. The logistic regression analysis showed a statistically significant association between 'somatization' and 'violence-suicide' severity score and OAT. GLM analysis showed that psychopathological factorial scores for 'worthlessness-being trapped', 'somatic symptoms', and 'panic anxiety' dimensions were more severe in OAT vs TC male patients and in TC vs OAT female ones. 'Violence suicide' followed the same severity pattern for males, but did not differ in TC vs OAT females, while 'sensitivity-psychoticism' did not differ in OAT vs TC patients. The five dimensions did not differ in OAT males vs females.

CONCLUSIONS

Our research appears to confirm the existence of a specific aggregation of psychological/psychiatric features within the category of individuals with heroin addiction. It also shows a correlation between the dominant psychopathological subgroup and the assignment to TC versus OAT. Further research is needed to clarify the differences between the five psychopathological subgroups and their determinants.

Assessing personality traits by questionnaire: psychometric properties of the Greek version of the Zuckerman-Kuhlman personality questionnaire and correlations with psychopathology and hostility

BACKGROUND

The Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) was developed in an attempt to define the basic factors of personality or temperament. We aimed to assess the factor structure and the psychometric properties of its Greek version and to explore its relation to psychopathological symptoms and hostility features.

METHODS

ZKPQ was translated into Greek using back-translation and was administered to 1,462 participants (475 healthy participants, 619 medical patients, 177 psychiatric patients and 191 opiate addicts). Confirmatory and exploratory factor analyses were performed. Symptoms Distress Check-List (SCL-90R) and Hostility and Direction of Hostility Questionnaire (HDHQ) were administered to test criterion validity.

RESULTS

Five factors were identified, largely corresponding to the original version's respective factors. Retest reliabilities were acceptable (rli's: 0.79-0.89) and internal consistency was adequate for Neuroticism-Anxiety (0.87), Impulsive Sensation Seeking (0.80), Aggression-Hostility (0.77) and Activity (0.72), and lower for Sociability (0.64). Most components were able to discriminate psychiatric patients and opiate addicts from healthy participants. Opiate addicts exhibited higher rates on Impulsive Sensation Seeking compared to healthy participants. Neuroticism-Anxiety (p<0.001) and Impulsive Sensation Seeking (p<0.001) were significantly associated with psychological distress and Aggression-Hostility was the most powerful correlate of Total Hostility (p<0.001), and Neuroticism-Anxiety was the stronger correlate of introverted hostility (p<0.001), further supporting the instrument's concurrent validity.

CONCLUSIONS

Present findings support the applicability of the Greek version of ZKPQ within the Greek population. Future studies could improve its psychometric properties by finding new items, especially for the Sociability scale.

Affective temperaments and residual symptoms in patients with mood and anxiety disorders

Objective. Temperament conventionally refers to stable behavioural and emotional reactions that appear early in life and are influenced in part by genetic constitution. Few studies compared temperamental traits in anxiety and mood disorders even though some authors suggested a clinical and neurobiological continuum between them. The aim of the study was to compare temperamental traits and psychopathological dimensions in subjects with DSM-IV diagnoses of mood and anxiety disorders. Methods. A total of 101 clinically stabilized consecutive outpatients (45 subjects with anxiety disorders and 56 with mood disorders diagnoses) were evaluated. The brief version of Temperament Evaluation of Memphis, Pisa, Paris and San Diego (briefTEMPS-M) and Symptom Checklist-90 (SCL-90) were used to assess temperamental traits and psychopathological dimensions, respectively. Results. No significant differences between anxiety disorders and mood disorders subjects for TEMPS-M or SCL-90 mean scores were observed. Different TEMPS-M scores differentially affect residual clinical symptoms. Conclusions. Our data represent an indirect indicator of possible common diathesis between the two different disorders. The temperament "paradigm" could explain part of the residual symptomatology. The evaluation of affective temperaments seems to add considerable clinical information to psychopathological and diagnostic descriptions.