Mei Fan

Prevalence of post-traumatic stress disorder among adolescents after the Wenchuan earthquake in China.

BACKGROUND The Wenchuan earthquake was a catastrophic earthquake in China. The aim of this study is to explore longitudinally the rates of post-traumatic stress disorder (PTSD) and depression in adolescents after the Wenchuan earthquake, and to identify independent predictors of PTSD. METHOD PTSD and depression symptoms among adolescents at 6, 12 and 18 months after the Wenchuan earthquake were investigated using the PTSD Checklist Civilian Version and the Beck Depression Inventory (BDI). Subjects in this study included 548 high school student survivors in a local boarding high school. RESULTS The rates of PTSD symptoms were 9.7%, 1.3% and 1.6% at the 6-, 12- and 18-month follow-ups, respectively. BDI scores were found to be the best predictor of severity of PTSD at 6, 12 and 18 months. Gender was another variable contributing significantly to PTSD at 6 and 12 months after the earthquake. In the 12-month follow-up, home damage was found to be a predictor of severity of PTSD symptoms. Being a child with siblings was found to be a predictor of severity of PTSD symptoms at 12 and 18 months after the earthquake. CONCLUSIONS PTSD symptoms changed gradually at various stages after the earthquake. Depression symptoms were predictive of PTSD symptoms in the 18-month follow-up study. Other predictors of PTSD symptoms included female gender and being a child with siblings. The results of this study may be helpful for further mental health interventions for adolescents after earthquakes.

Reduced severity of posttraumatic stress disorder associated with Val allele of Val66Met polymorphism at brain-derived neurotrophic factor gene among Chinese adolescents after Wenchuan earthquake

The aim of the present study was to longitudinally investigate the association of BDNF Val66Met with PTSD symptoms in Chinese Han adolescents who experienced the 2008 Wenchuan earthquake. Variants of BDNF Val66Met were identified by polymerase chain reaction-restriction fragment length polymorphism analyses and verified by DNA sequencing. PTSD symptoms were assessed by the PTSD Checklist-Civilian Version (PCL-C) among high school students at 6, 12, and 18 months after the earthquake. No differences of PTSD prevalence and PCL-C scores were found between the Val/Val homozygotes and the Met allele carriers at 6, 12, and 18 months after the earthquake regardless of gender. Decreased PTSD prevalence was observed at 12 and 18 months when compared with that at 6 months after the earthquake regardless of gender and the genotype. Meanwhile, PCL-C scores were decreased consecutively in the female subjects regardless of the genotypes. However, the scores at 18 months were lower when compared with those at 12 months in the male Val/Val homozygotes, but not in the male Met allele carriers. In addition, differences were found for the predictors of PCL-C scores and PTSD prevalence between the Val/Val homozygotes and the Met allele carriers during follow-up. These findings suggest that the association of BDNF Val66Met with PTSD is longitudinally different in Chinese Han adolescents after the 2008 Wenchuan earthquake. The Val allele may be associated with reduced PTSD severity in male adolescents in the later stage of PTSD rehabilitation during follow-up.

Risk factors of suicidal ideation among adolescents after Wenchuan earthquake in China

BACKGROUND Suicidal ideation is a common phenomenon in survivors after disaster event. AIM To identify the change of suicidal ideation, and to test hypotheses concerning the suicidal ideation, depression and PTSD symptoms among adolescent survivors after the 2008 Wenchuan earthquake in China. METHODS The suicidal ideation among high school students at 6, 12 and 18 months after the Wenchuan earthquake were investigated. Subjects included 737 student survivors in an affected high school. The PTSD Checklist-Civilian Version (PCL-C) and the Chinese Beck Depression Inventory (C-BDI) were used to measure the symptoms of PTSD and depression. RESULTS The rates of suicidal ideation among the adolescent survivors at 6-, 12- and 18-month after the earthquake were 35.6%, 35.6% and 30.7% respectively. Depression symptoms in the 18-month follow-up, suicidal ideations at 6 and 12 months after the earthquake were the independent risk factors of suicidal ideation in the 18-month follow-up. Depression symptoms were the strongest predictor of suicidal ideation after earthquake. CONCLUSION An increased rate of suicidal ideation after the earthquake may be mainly due to depression but not to PTSD symptoms. The disaster-related psychological sequelae and the risk factors of suicidal ideation, especially depression symptoms, should be considered in the mental health services and suicide prevention.

Predictive factors of depression symptoms among adolescents in the 18-month follow-up after Wenchuan earthquake in China

Abstract Background: It is unclear about the change and risk factors of depression among adolescent survivors after earthquake. Aims: This study aimed to explore the change of depression, and identify the predictive factors of depression among adolescent survivors after the 2008 Wenchuan earthquake in China. Methods: The depression among high school students at 6, 12 and 18 months after the Wenchuan earthquake were investigated. The Beck Depression Inventory (BDI) was used in this study to assess the severity of depression. Results: Subjects included 548 student survivors in an affected high school. The rates of depression among the adolescent survivors at 6-, 12- and 18-month after the earthquake were 27.3%, 42.9% and 33.3%, respectively, for males, and 42.9%, 61.9% and 53.4%, respectively, for females. Depression symptoms, trauma-related self-injury, suicidal ideation and PTSD symptoms at the 6-month follow-up were significant predictive factors for depression at the 18-month time interval following the earthquake. Conclusions: This study highlights the need for considering disaster-related psychological sequela and risk factors of depression symptoms in the planning and implementation of mental health services. Long-term mental and psychological supports for victims of natural disasters are imperative.

D allele of insertion/deletion polymorphism at angiotensin-converting enzyme gene is associated with reduced prevalence and severity of depression among Chinese adolescents at early stage after Wenchuan earthquake

Abstract Objective: The purpose of the present study was to longitudinally investigate the association of insertion/deletion (I/D) polymorphism at angiotensin-converting enzyme gene (ACE) with depression in Chinese adolescents experiencing the 2008 Wenchuan earthquake. Methods: Variants of ACE I/D were identified by polymerase chain reaction and verified by DNA sequencing. Depression symptoms were assessed by the Beck Depression Inventory (BDI) among high school students at 6, 12 and 18 months after the earthquake. Results: The D-allele carriers had lower depression prevalence than II homozygotes at 6, 12 and 18 months after the earthquake only in females, but not in males. Meanwhile, BDI scores were reduced in the female D-allele carriers when compared with those in the female II homozygotes at 6 and12 months after the earthquake. In addition, ACE I/D was found to be the predictors of BDI scores and depression prevalence at 6 and 12 months after the earthquake. Conclusions: These results suggest that the association of ACE I/D with depression are longitudinally different in Chinese Han adolescents after the 2008 Wenchuan earthquake. The D allele may be associated with reduced depression prevalence and severity in female adolescents in the early stage of depression rehabilitation during the follow-up.

Reduced Recovery of Depression in Female T Allele Carriers of TNF-RII rs1061622 at Earlier Stage after Wenchuan Earthquake

Objective: The aim of current study was to explore longitudinally the prevalence, severity, potential factors, and predictors of depression among Chinese Han adolescent survivors with different genotypes of tumor necrosis factor receptor-II (TNF-RII) rs1061622 after the 2008 Wenchuan earthquake. Method: TNF-RII rs1061622 variants were examined by polymerase chain reaction–restriction fragment length polymorphism and verified by DNA sequencing. Depression symptoms were assessed by Beck Depression Inventory (BDI) among 439 high school students at 6, 12, and 18 months after the earthquake. Results: No significant differences were observed in depression prevalence and BDI scores between the TT homozygotes and the G allele carriers in both the male and female subjects. However, the female TT homozygotes had a higher depression prevalence than the male TT homozygotes at 6, 12, and 18 months, whereas the female G allele carriers had a higher depression prevalence than the male G allele carriers only at 6 and 12 months after the earthquake. Moreover, BDI scores declined in the male subjects with both genotypes and only in the female G allele carriers at 12 months when compared with those at 6 months. Furthermore, the predictors of depression severity or potential factors of depression prevalence were different between the G allele carriers and the TT homozygotes at different times after the earthquake. Conclusion: It is concluded that the association of TNF-RII rs1061622 with depression is longitudinally different in Chinese Han adolescents after the 2008 Wenchuan earthquake. The T allele may be associated with reduced recovery of depression in female adolescents in the earlier stage of depression rehabilitation.

Longitudinal interplays of estrogen receptor alpha gene rs9340799 with social-environmental factors on post-traumatic stress disorder in Chinese Han adolescents after Wenchuan earthquake

Indirect evidences suggested associations of estrogen receptor alpha (ESR1) with post‐traumatic stress disorder (PTSD). However, the relationship between rs9340799 on ESR1 gene and PTSD has not been reported yet. The present study was to explore the longitudinal changes of prevalence and severity of PTSD in adolescents with different genotypes of rs9340799 after the 2008 Wenchuan earthquake. Social‐environmental factors were collected by questionnaires in 465 high school students. Variants of rs9340799 were determined by polymerase chain reaction‐restriction fragment length polymorphism analyses and verified by DNA sequencing. PTSD symptoms were assessed by PTSD Checklist‐Civilian Version (PCL‐C) at 6, 12, and 18 months after the earthquake. The female AA homozygotes had a trend of higher prevalence of PTSD and significantly higher PCL‐C scores than the female G allele carriers at 6 months after the earthquake. The female students had higher prevalence of PTSD and higher PCL‐C scores than the male subjects at 6 months in the AA homozygotes, but not in the G allele carriers. Consecutive decreases in PCL‐C scores were observed only in the female AA homozygotes. Only in the female, the AA genotype was the risk factor and predictor of PCL‐C scores at 6 months. Potential factors of PTSD prevalence and predictors of PCL‐C scores were different between the AA homozygotes and G allele carriers at different time during the follow‐up. These results suggest gene‐environment interactions may occur among rs9340799 and social‐environmental factors, and influence the development and natural rehabilitation of PTSD in the course after stressed by the earthquake.

Longitudinal changes of associations between the preproghrelin Leu72Met polymorphism with depression in Chinese Han adolescents after the Wenchuan earthquake

Aim The present study aimed to investigate longitudinal associations of preproghrelin Leu72Met with depression in Chinese Han adolescents after the Wenchuan earthquake in 2008. Materials and methods A total of 709 volunteers were enrolled from a high school near the epicenter of the earthquake and 662, 643, and 510 students were finally included at 6, 12, and 18 months, respectively, after the earthquake. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). The genotypes were identified by PCR-restriction fragment length polymorphism analyses and verified by DNA sequencing. Results Females had a higher prevalence of depression than males at 6 months after the earthquake in 72Leu/Leu homozygotes (&khgr;2-test, P=0.007), but not in 72Met allele carriers. 72Met allele carriers had lower prevalence (&khgr;2-test, P=0.025) and BDI scores (Kruskal–Wallis test, P=0.034) than 72Leu/Leu homozygotes only among males at 18 months, but not at 6 or 12 months. The prevalence was consecutively decreased in male 72Met allele carriers (&khgr;2-test, P=0.010), but not in male 72Leu/Leu homozygotes, female 72Met allele carriers, or female 72Leu/Leu homozygotes during follow-up. Potential factors of depression prevalence and predictors of BDI scores were different between 72Leu/Leu homozygotes and 72Met allele carriers at different time points during follow-up. Conclusion These results suggest that the 72Met allele of the preproghrelin Leu72Met polymorphism may be associated with rehabilitation of depression in male Chinese Han adolescents after the natural disaster.

Association of Val66Met polymorphism at brain derived neurotrophic factor gene with depression among Chinese adolescents after Wenchuan earthquake: An 18 months longitudinal study

To longitudinally investigate the association of Val66Met polymorphism at brain derived neurotrophic factor (BDNF) gene (BDNF) with depression in Chinese Han adolescents after the 2008 Wenchuan earthquake, BDNF Val66Met was identified by polymerase chain reaction-restriction fragment length polymorphism analyses and verified by DNA sequencing. Depression was assessed by Beck Depression Inventory (BDI) among high school students at 6, 12 and 18months after the earthquake. The results showed that the females constantly had higher depression prevalence than the males during the follow-up in the Met allele carriers, but not in the Val/Val homozygotes. When compared to that at 6months, the prevalence was lowered at 12months in the male Met allele carriers, and at 18months in all the females and the male Met allele carriers. Moreover, the Met allele carriers had higher BDI scores than the Val/Val homozygotes only in the females at 18months. The females had higher BDI scores than the males constantly during the follow-up in the Met allele carriers and at 12months only in the Val/Val homozygotes. When compared to those at 12months, the scores decreased at 18months in all the females and the male Met allele carriers. In addition, the potential factors of prevalence or predictors of severity of depression were different between the Val/Val homozygotes and the Met allele carriers at different times after the earthquake. The results suggest that interactions may occur after stresses among BDNF Val66Met, gender and time course to influence depression. This may be one of the explanations for the inconsistent relationships reported before between depression and BDNF Val66Met and need to take into account for precision medical and more effective interference of depression in adolescents after disasters.

Longitudinal interactions of estrogen receptor alpha gene rs9340799 with social-environmental factors on depression in adolescents after Wenchuan earthquake

Inconsistent relationships were reported between rs9340799 on estrogen receptor alpha gene (ESR1) and depression in previous studies. The present study was to explore the longitudinal changes of prevalence and severity of depression in 439 Chinese Han adolescents with different genotypes of ESR1 rs9340799 at 6, 12 and 18months after the 2008 Wenchuan earthquake. Social-environmental factors were collected by questionnaires from 465 high school students. Variants of rs9340799 were genotyped by polymerase chain reaction-restriction fragment length polymorphism analyses and verified by DNA sequencing. Depression symptoms were assessed by Beck Depression Inventory (BDI). The results showed the female AA homozygotes had higher prevalence of depression at 12months and higher BDI scores at 18months than the female G allele carriers. Significantly decreased prevalence of depression was observed only in the female AA homozygotes at 18months when compared with that at 6 or 12 months. Consecutive decreases in BDI scores were observed only in the female AA homozygotes. The AA genotype was one of the risk factors at 12months and predictors of BDI scores at 18months. These results firstly suggest different interactions may occur in a gender and time dependent manner among rs9340799 and other potential factors of depression or predictors of its severity, and influence the development and natural rehabilitation of depression.