Chang Qi

Prevalence and correlates of problematic smartphone use in a large random sample of Chinese undergraduates

BackgroundSmartphones are becoming a daily necessity for most undergraduates in Mainland China. Because the present scenario of problematic smartphone use (PSU) is largely unexplored, in the current study we aimed to estimate the prevalence of PSU and to screen suitable predictors for PSU among Chinese undergraduates in the framework of the stress-coping theory.MethodsA sample of 1062 undergraduate smartphone users was recruited by means of the stratified cluster random sampling strategy between April and May 2015. The Problematic Cellular Phone Use Questionnaire was used to identify PSU. We evaluated five candidate risk factors for PSU by using logistic regression analysis while controlling for demographic characteristics and specific features of smartphone use.ResultsThe prevalence of PSU among Chinese undergraduates was estimated to be 21.3%. The risk factors for PSU were majoring in the humanities, high monthly income from the family (≥1500 RMB), serious emotional symptoms, high perceived stress, and perfectionism-related factors (high doubts about actions, high parental expectations).ConclusionsPSU among undergraduates appears to be ubiquitous and thus constitutes a public health issue in Mainland China. Although further longitudinal studies are required to test whether PSU is a transient phenomenon or a chronic and progressive condition, our study successfully identified socio-demographic and psychological risk factors for PSU. These results, obtained from a random and thus representative sample of undergraduates, opens up new avenues in terms of prevention and regulation policies.

Gender and Regional Differences in Sleep Quality and Insomnia: A General Population-based Study in Hunan Province of China

Insomnia and the inability to sleep affect people’s health and well-being. However, its systematic estimates of prevalence and distribution in the general population in China are still lacking. A population-based cluster sampling survey was conducted in the rural and urban areas of Hunan, China. Subjects (n = 26,851) were sampled from the general population, with a follow-up using the Pittsburgh Sleep Quality Index (PSQI) for interview to assess quality of sleep and Insomnia (PSQI score >5). While the overall prevalence of insomnia was 26.6%, and little difference was found between males (26.3%) and females (27.0%); the mean PSQI score was 4.26 (±2.67), and significant higher in females (4.32 ± 2.70) than males (4.21 ± 2.64, p = 0.003). Individuals in the rural areas tended to report a higher PSQI score (4.45 ± 2.81) than urban residents did (4.18 ± 2.60) (p < 0.001) and the estimates of prevalence of insomnia was 29.4% in the rural areas, significant higher than 25.5% in the urban areas (p < 0.001). Multiple logistic regression analysis showed that female gender, older age, higher level of education, being unmarried, living in the rural area, cigarette smoking and alcohol drinking were associated with insomnia. Our study may provide important information for general and mental health research.

A latent class analysis of external barriers to drug treatment in China

Drug treatment services of varying types have been scaled up in China over the past decade. Yet, barriers to treatment remain among the population of drug users in China. In this paper, we use a person-centered approach to examine external barriers to drug treatment among a sample of Chinese drug users. Specifically, we used a latent class analysis to determine a typology of external barriers to treatment among a sample of 262 drug users. The results of the analyses suggest three-classes of drug users with respect to their perceptions of external barriers to treatment--Major Barriers, Low Barriers, and Systems-level Barriers--indicating that drug users are a heterogeneous population on this matter. Age and types of drugs used were predictors of class membership. In this regard, different tactics must be utilized in order to successfully reach this wide ranging group of individuals.

Psychiatric symptoms in individuals who use ketamine versus methamphetamine—implications for glutamatergic and dopaminergic model for schizophrenia: a cohort study

BACKGROUND Both ketamine and methamphetamine have been used for studying the positive, negative, and cognitive symptoms, and dopaminergic and GABAergic dysfunction observed in acute schizophrenia. We aimed to explore and compare the prevalence and factor structure of psychotic symptoms in chronic ketamine and methamphetamine users. METHODS We recruited chronic ketamine and methamphetamine users from the Guangzhou Baiyun and Kangda voluntary drug rehabilitation centres in the Hunan Province, China. All these participants met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for lifetime ketamine or methamphetamine dependence determined from the Structured Clinical Interview. Participants were excluded if they met criteria for other substance dependence (excluding nicotine) at any time. All participants gave a full history of psychiatric symptoms. We used The Positive and Negative Syndrome Scale (PANSS) to assess the psychotic symptoms in these two groups. Independent sample t-tests or χ2-square test were done to determine group differences. The protocol was approved by the university ethics committee (S163, 2011). FINDINGS We recruited 344 chronic ketamine users (34 were female; mean age 26·8 years, SD 5·43; mean years of education 11·6 years, SD 2·45) and 456 chronic methamphetamine users (28 were female; mean age 29·3 years SD 6·33, mean years of education 11·1 years, SD 2·78) between Jan 1, 2012, to Dec 31, 2015. 183 (53%) of 344 ketamine users and 375 (82%) of 456 methamphetamine users (χ2 t=78·37, p<0·0001) had psychiatric symptoms, with a mean duration of 23·5 months (SD 24·58) for ketamine users and 15·0 months (SD 19·42) for methamphetamine users (t=4·05, p<0·0001). The mean age when first having psychotic symptoms was 25·4 years (SD 5·55) in ketamine users and 28·5 years (6·33) in methamphetamine users (t=-5·84, p<0·0001). Mean scores on PANSS TOTAL were 52·6 (SD 23·34) in ketamine users and 61·7 (29·61) in methamphetamine users (t=-4·84, p<0·0001). Mean scores for ketamine and methamphetamine use groups on positive, negative, and general subscales were 10·8 (SD 5·45) versus 15·0 (8·26; t=-8·80, p<0·0001), 12·2 (6·91) versus 14·5 (8·68; t=-4·07, p<0·0001), and 29·7 (12·98) versus 32·2 (15·22; t=-2·55, p=0·011), respectively. INTERPRETATION This study provides first evidence for comparing psychotic symptoms in chronic ketamine and chronic methamphetamine users. The findings suggest that chronic methamphetamine users have higher risk of suffering from psychiatric symptoms and more severity of chronic drug-induced schizophrenia-like symptoms than do chronic ketamine users. These findings might provide some implications for pharmacological (glutamatergic and dopaminergic) models of schizophrenia. FUNDING Natural Science Foundation of China (81100996 to YL, and 81371480 to JT). The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.

A Multiple Indicators Multiple Causes (MIMIC) model of internal barriers to drug treatment in China.

BACKGROUND Although evidence exists for distinct barriers to drug abuse treatment (BDATs), investigations of their inter-relationships and the effect of individual characteristics on the barrier factors have been sparse, especially in China. A Multiple Indicators Multiple Causes (MIMIC) model is applied for this target. METHODS A sample of 262 drug users were recruited from three drug rehabilitation centers in Hunan Province, China. We applied a MIMIC approach to investigate the effect of gender, age, marital status, education, primary substance use, duration of primary drug use, and drug treatment experience on the internal barrier factors: absence of problem (AP), negative social support (NSS), fear of treatment (FT), and privacy concerns (PC). RESULTS Drug users of various characteristics were found to report different internal barrier factors. Younger participants were more likely to report NSS (-0.19, p=0.038) and PC (-0.31, p<0.001). Compared to other drug users, ice users were more likely to report AP (0.44, p<0.001) and NSS (0.25, p=0.010). Drug treatment experiences related to AP (0.20, p=0.012). In addition, differential item functioning (DIF) occurred in three items when participant from groups with different duration of drug use, ice use, or marital status. CONCLUSIONS Individual characteristics had significant effects on internal barriers to drug treatment. On this basis, BDAT perceived by different individuals could be assessed before tactics were utilized to successfully remove perceived barriers to drug treatment.

Mental health literacy survey of non-mental health professionals in six general hospitals in Hunan Province of China

Background Mental illness has brought great economic burden related to misdiagnosis by non-mental health professionals in general hospitals. The aim of this study was to explore non-mental health professionals’ conceptions related to the identification of mental illness and perceived treatments, first aid and prognosis. Methods In 2014–2015, we presented 1123 non-mental health professionals from six general hospitals in Hunan Province with one of three vignettes describing a person with schizophrenia, depression, or generalized anxiety disorder. Identification rates, beliefs about various interventions, best methods, and the prognosis with or without treatment were measured. Results Less than 60% of the non-mental health professionals could identify the mental disorders correctly. Psychiatrists and psychologists were considered to be the people who would be most helpful in all vignettes. Over 70% of participants identified the correct medication for each vignette. Participants gave higher ratings to lifestyle interventions than to psychological and medical interventions, especially in the depression and generalized anxiety disorder vignettes. For the question about how the person could best be helped, about half of the participants rated listening or talking with the person more highly than accompanying the person to professional help or encouraging the person to visit a psychiatrist or psychologist. Participants believed that, with professional help, the people in the vignettes would fully recover but that problems would probably reoccur and that, without professional help, the people described would get worse. Conclusions The beliefs that non-mental health professionals hold about mental disorders are inadequate to provide appropriate help. There is an urgent need for mental health education campaigns to improve non-mental health professionals’ mental health knowledge in mainland China in order to provide better support for mental health service users.

Mental health literacy about schizophrenia and depression: a survey among Chinese caregivers of patients with mental disorder

ObjectiveTo investigate the knowledge of schizophrenia and depression among caregivers of patients with mental disorder in China.MethodA convenience sample of 402 caregivers at the Department of Psychiatry of a general hospital in China was investigated (response rate 95.7%), using vignettes based investigation methodology.ResultsThe number of caregivers using the term “depression” to describe the depression vignette was 43.6%, which was significantly higher than the number of caregivers using the term “schizophrenia” to describe the schizophrenia one (28.5%). A high percentage of caregivers believed that “psychiatrist”, “psychologist” and “close family members” would be helpful, and the top three most helpful interventions were “becoming more physically active”, “getting out and learning more” and “receiving psychotherapy”. The number of caregivers endorsed “antipsychotics” and “antidepressants” as helpful for the schizophrenia and the depression vignettes were 82.0 and 80.7%, respectively. Regarding the causes of mental illness, items related to psychosocial factors, including “daily problems” and “work or financial problems”, and “weakness of character” were highly rated, with half considered genetic or chemical imbalance causes.ConclusionCaregivers expressed a high knowledge about treatments and interventions of mental disorders. But there are still some areas, particularly regarding the recognition and causes of mental disorders, that are in need of improvement. This is particularly the case for schizophrenia.

Cue-Induced Brain Activation in Chronic Ketamine-Dependent Subjects, Cigarette Smokers, and Healthy Controls: A Task Functional Magnetic Resonance Imaging Study

Background Observations of drug-related cues may induce craving in drug-dependent patients, prompting compulsive drug-seeking behavior. Sexual dysfunction is common in drug users. The aim of the study was to examine regional brain activation to drug (ketamine, cigarette smoking) associated cues and natural (sexual) rewards. Methods A sample of 129 [40 ketamine use smokers (KUS), 45 non-ketamine use smokers (NKUS) and 44 non-ketamine use non-smoking healthy controls (HC)] participants underwent functional magnetic resonance imaging (fMRI) while viewing ketamine use related, smoking and sexual films. Results We found that KUS showed significant increased activation in anterior cingulate cortex and precuneus in response to ketamine cues. Ketamine users (KUS) showed lower activation in cerebellum and middle temporal cortex compared with non-ketamine users (NKUS and HC) in response to sexual cues. Smokers (KUS and NKUS) showed higher activation in the right precentral frontal cortex in response to smoking cues. Non-ketamine users (NKUS and HC) showed significantly increased activation of cerebellum and middle temporal cortex while viewing sexual cues. Conclusion These findings clearly show the engagement of distinct neural circuitry for drug-related stimuli in chronic ketamine users. While smokers (both KUS and NKUS) showed overlapping differences in activation for smoking cues, the former group showed a specific neural response to relevant (i.e., ketamine-related) cues. In particular, the heightened response in anterior cingulate cortex may have important implications for how attentionally salient such cues are in this group. Ketamine users (KUS) showed lower activation in response to sexual cues may partly reflect the neural basis of sexual dysfunction.