Yuhui Wan

Early Menarche and Psychopathological Symptoms in Young Chinese Women

OBJECTIVE To evaluate the psychopathological symptoms, suicide, and self-harming behaviors among students with early, on-time, and late menarche in high school and college and the association of early menarche with these disorders. METHODS The design consisted of a cross-sectional study of 5597 high school students and 2768 college students. Menarche age, suboptimal mental health status, anxiety, depression, suicide, and self-harming behaviors were obtained by self-report questionnaire. RESULTS In high school students, all the disorders occurred at significantly higher frequency in those with early menarche than in those with on-time and late menarche. In college students, only suboptimal mental health status, depression, and suicidal ideation happened at significantly higher frequency in the early menarche group than in the other two groups. The college group had a lower frequency of all the disorders than the high school group for all three groups of girls, that is, with early, on-time, or late menarche. In a multivariate logistic regression model, early menarche persisted as a risk factor for all the disorders after other factors were controlled. CONCLUSIONS Psychopathological symptoms, suicide, and self-harming behaviors are more common in early menarche students than in on-time and late menarche students. The effects of early menarche on the disorders might dissipate over time. Early menarche might serve as a predictor for the disorders in Chinese girls.

Impact of childhood abuse on the risk of non-suicidal self-injury in mainland Chinese adolescents

Background Childhood abuse has been associated with significant increases in non-suicidal self-injury (NSSI) behaviors in adolescents; however, only general definitions of this risk indicator have been examined. This study identified relationships between specific forms of childhood abuse and NSSI in mainland Chinese adolescents. Method A total of 14,221 cases were retained from an epidemiological study involving adolescents from junior and senior middle schools. Information relating to the perpetrator, perceived harm, timing of exposure to different types of childhood abuse, and NSSI were obtained. Logistic regression was used to analyze relationships between each form of childhood abuse and NSSI. Results Approximately 51.0% of the students reported at least one abusive childhood experience. Nearly one in four students (24.9%) reported that they had engaged in NSSI in the past 12 months. Each type of childhood abuse, occurring at any time within the first 16 years of life, especially in situations of continuous exposure, was significantly associated with NSSI. A significant graded relationship was found between number of abusive childhood experiences and NSSI. Students maltreated by parents or others were at high risk of engaging in NSSI, the risk was greater in students maltreated by both; students who had been exposed to childhood abuse with no perceived harm still demonstrated an elevated risk for NSSI. The pattern of associations did not vary by gender. Conclusions These findings suggest that experiencing any of various forms of childhood abuse should be considered a risk factor for NSSI during adolescence. Further research should focus upon psychosocial, neural, and genetic factors that might moderate or mediate the onset of NSSI in adolescents who have experienced childhood abuse.

Self-reported weight status rather than BMI may be closely related to psychopathological symptoms among Mainland Chinese adolescents

Evidence in respect of the psychological consequences of child and adolescent obesity is mixed. More studies indicated that mental health appears to be more strongly associated with concern about weight and shape, regardless of body mass index (BMI). Using the data from a national large school-based cohort (N = 10 403), we examined the association between obesity, perceived obesity and mental health. There was no relationship between BMI weight status and psychopathological symptoms after adjusting for weight perception and other factors for both genders. More importantly, it was determined that perception of weight as either underweight or overweight was related to higher behavioral symptoms and social adaptation problems. In conclusion, psychological well-being of adolescents is more related to weight perception than BMI is.

The mediating effects of stress and coping on depression among adolescents in China.

AIMS To explore gender differences in Chinese adolescent depression related to the mediating effects of stress and coping. METHODS The data were collected using a cross-sectional design from a multisite follow-up investigation of adolescent physical and psychological study carried out in China. The study population consisted of 17,622 students aged from 11 to 22 years of age in junior high, senior high schools, and colleges/universities from eight large cities in China. RESULTS Overall, 44.3% of the sample reported depression during the past week. Male adolescents were more likely to have depression than female counterparts (46.8% versus 41.7%), especially those aged <15 and >17 years of age. Overall, stress in boys was statistically higher than that of girls. Boys experienced high levels of stress from school, family, health, and romantic domains, while girls suffered a higher level of peer stress. A multivariate logistic regression model showed that a high level of total stress was significantly associated with increased risk for depression, while peer stress and positive coping style were protective factors for depression in both boys and girls in China. CONCLUSIONS Unlike their Western counterparts, Chinese boys suffered more depression than girls, which is partly due to more stressful life events and less positive coping style. Our study has important implications for health officers and public health professionals to pay much attention to the relationship between stress and coping style in prevention on adolescent depression.

Normal Reference Values for Serum Lipid Levels in Chinese Adolescents Between 12 and 18 Years of Age

The purpose of this study was to develop representative gender- and age-specific percentile reference data for serum lipids for Chinese adolescents between 12 and 18 years of age. Blood samples were obtained from 2998 boys and 3225 girls in nine provinces from the mainland of China, including rural and urban areas. The data for serum lipid levels, including TC, TG, HDL-C and LDL-C, were calculated and measured between March and June 2008. Gender- and age-specific percentiles of serum lipid levels were calculated. Gender- and age-specific percentile-based reference data for serum lipids is presented for Chinese adolescents for the first time. The 95th percentile for the TC, TG and LDL-C levels was 5.07, 1.90 and 3.32 mmol/l, and the 5th percentile for the HDL-C level was 0.92 mmol/l among all the students. These reference values can be used to plan and implement preventive policies, and to study temporal trends.

Relationships between various forms of childhood abuse and suicidal behaviors among middle school students

OBJECTIVE To study the relationship between various forms of childhood abuse and suicidal behaviors among middle school students. METHODS A total of 14 221 cases were retained from an epidemiological study, involving students from junior and senior middle schools in Guangzhou, Xinxiang, Shenyang and Chongqing. Information related to the demographic characteristics, types, number, timing and perpetrators of exposure to childhood abuse and suicidal behaviors was obtained. Logistic regression was used to analyze the relationships of each form of childhood abuse and suicidal behaviors. RESULTS Number of cases (rates) of childhood abuse, physical abuse, emotional abuse, sexual abuse, suicidal ideation, suicidal planning and suicidal attempts among middle school students appeared as 7 246 (51.0%), 5 824 (41.0%), 5 409 (38.0%), 1 039 (7.3%), 2 042 (14.4%), 1 174 (8.3%) and 548 (3.9%), respectively. Boys reported more physical abuse than girls, while girls reported more emotional abuse and suicide ideation than boys (P<0.01). However, no gender differences were found in cases as sexual abuse, suicide planning or attempted suicide (P>0.01). After controlling for confounding variables, experiences on childhood abuse were significantly associated with suicidal ideation (OR=2.03, 95% CI: 1.72-2.40) and suicidal planning (OR=1.93, 95%CI: 1.57-2.37) among boys but significantly associated with suicidal ideation (OR= 2.45, 95% CI: 2.12-2.82), suicidal planning (OR=2.46, 95% CI: 2.02-3.00) and attempted suicide (OR=2.12, 95% CI: 1.61-2.78) among girls. RESULTS from multivariable logistic regression analysis showed that each type of childhood abuse, occurring at any time within the first 16 years of life, especially with continuous exposure, was significantly associated with suicidal behaviors. A significant graded-relationship was found between number of abusive childhood experiences and suicidal behaviors. Students that had been maltreated by parents or others were at high risk of engaging in suicidal behaviors. CONCLUSION The findings suggest that the experience of any form of childhood abuse should be considered a risk factor for suicidal behaviors among the middle school students.

Polygenic differential susceptibility to cumulative stress exposure and childhood obesity

ObjectiveTo examine whether polygenic susceptibility for body mass index (BMI) interacts with cumulative stress exposure, potentially exacerbating and buffering the effects of chronic stress, to predict obesity during childhood.MethodsData were analyzed from an established prospective puberty cohort in Anhui province, China. A total of 1000 children (421 boys and 579 girls, mean (standard deviation) age 8.97 (0.86) years) who had complete DNA genotyping, hair cortisol concentration and BMI were eligible for the study. The polygenic susceptibility score (PSS) was computed based on 11 SNPs derived from a published genome-wide association study for child obesity.ResultsChildren with different obesity polygenic susceptibility did not differ in BMI, obesogenic behaviors and HCC. The positive association between HCC with BMI was only found among children with highest PSS (r = 0.269, P < 0.001). When exposed in cumulative stress, children with highest PSS have higher BMI (β = 1.46, 95% CI: 0.63, 2.29; P = 0.001) than those having lowest PSS. The reverse pattern was found among children without cumulative stress exposure, those with highest PSS showed lowest BMI (β = −1.27, 95% CI: −2.17, −0.38; P = 0.001), compared to lowest PSS groups. Re-parameterized regression models provide strong support for the differential susceptibility hypothesis.ConclusionsThe findings underlie the importance of shifting perspectives from gene vulnerability to gene plasticity in the field of childhood obesity prevention. Children carrying additional BMI-raising alleles are at heightened risk of obesity are at heightened risk of obesity; however, they seem to be protected against obesity when the adverse psychosocial environment is removed.