Zhanjiang Li

Objective measures of prospective memory do not correlate with subjective complaints in schizophrenia.

While a number of studies have shown that individuals with schizophrenia are impaired on various types of prospective memory, few studies have examined the relationship between subjective and objective measures of this construct in this clinical group. The purpose of the current study was to explore the relationship between computer-based prospective memory tasks and the corresponding subjective complaints in patients with schizophrenia, individuals with schizotypal personality features, and healthy volunteers. The findings showed that patients with schizophrenia demonstrated significantly poorer performance in all domains of memory function except visual memory than individuals with schizotypal personality disorder and healthy controls. More importantly, there was a significant interaction effect of prospective memory type and group. Although patients with schizophrenia were found to show significantly poorer performance on computer-based measures of prospective memory than controls, their level of subjective complaint was not found to be significantly higher. While subjective complaints of prospective memory were found to associate significantly with self-reported executive dysfunctions, significant relationships were not found between these complaints and performance on a computer-based task of prospective memory and other objective measures of memory. Taken together, these findings suggest that subjective and objective measures of prospective memory are two distinct domains that might need to be assessed and addressed separately.

Meta-analysis of prospective memory in schizophrenia: Nature, extent, and correlates

Prospective memory (PM) is the ability to remember to carry out an intended action in the future and it is an important function for everyday living. Studies have found that the neural basis of PM is located mainly in the prefrontal lobes (particularly in Brodmann Area 10) and patients with schizophrenia have functional deficits in this area. The present study provided a meta-analytic review of PM performances in patients with schizophrenia in 11 studies. A total of 485 patients with schizophrenia and 409 controls were included. Results showed that patients with schizophrenia exhibited impairments in all time- (d=-1.33), event- (d=-0.827), and activity-based (d=-0.729) PM, with time-based PM more impaired than event-based PM. In addition, PM was found to be significantly correlated with negative symptoms (r=-0.18), general psychopathology (r=-0.168), medication dosage (r=-0.119), duration of illness (r=-0.131), age (r=-0.23), education (r=0.249), IQ (r=0.439) and premorbid IQ (r=0.356). It has theoretical and clinical implications. Theoretically, the results indicate time-based PM involves more initiation than event-based PM. Clinically, the results indicate patients on high dose of antipsychotic medication and with long duration of illness need special attention from care givers for PM problems.

Lifetime Prevalence of Suicidal Ideation, Suicide Plans and Attempts in Rural and Urban Regions of Beijing, China

Objective: There has been no large-scale survey of suicide-related behaviours including suicidal ideations, plans and attempts in China involving both rural and urban areas and using standardized assessment tools. The aim of the present study was to determine the lifetime prevalence of suicide-related behaviour and its relationship with sociodemographic factors and psychiatric disorders in the rural and urban regions of Beijing, China. Methods: A total of 5926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview. Basic sociodemographic and clinical data and data on suicide-related behaviour were also collected. Results: The overall lifetime prevalence estimates of suicidal ideation, plans and attempts were 2.3%, 1.4%, and 1.0%, respectively; the corresponding figures were 2.8%, 1.6%, and 1.3% in the rural sample, and 1.8%, 1.3%, and 0.9% in the urban sample. Age (>25years), female sex, unmarried status, lower education level, lower (RMB2000month−1) monthly income and presence of major medical disorders were significantly associated with increased risk of suicide-related behaviour. 36.2% of subjects with suicide-related behavior consulted a medical practitioner and 20.7% consulted a psychiatrist. Conclusions: The prevalence of lifetime suicide-related behaviour in Beijing is lower than in Western countries, but the low percentage of subjects treated for suicide-related behaviour indicates a major public health problem that should be addressed. National surveys are needed to further explore the prevalence of suicide-related behaviour in China.

Prevalence and socio-demographic correlates of schizophrenia in Beijing, China

OBJECTIVE There has been no large-scale survey of schizophrenia in China involving both rural and urban areas using standardized assessment tools and diagnostic criteria. This study aimed to determine the lifetime prevalence of schizophrenia and its socio-demographic correlates in Beijing, China. METHODS A total of 5926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview (CIDI 1.0). Basic socio-demographic and clinical data were collected during the interviews. RESULTS The lifetime prevalence of schizophrenia was 0.49%, and 0.44% and 0.55% for men and women, respectively. Unmarried status, lower monthly income, urban abode and positive family history were associated with an increased risk of schizophrenia; 9.7% of the subjects with lifetime schizophrenia reported a history of suicide attempts. The percentage of subjects with schizophrenia who were receiving treatment and their preference to seek treatment from mental health professionals were 58% and 29%, respectively. CONCLUSIONS National surveys are urgently needed to further explore the prevalence of schizophrenia in China. The low percentage of subjects treated for schizophrenia is a serious public health issue that should be addressed in the near future.

Neurological soft signs and their relationships to neurocognitive functions: a re-visit with the structural equation modeling design.

Background Neurological soft signs and neurocognitive impairments have long been considered important features of schizophrenia. Previous correlational studies have suggested that there is a significant relationship between neurological soft signs and neurocognitive functions. The purpose of the current study was to examine the underlying relationships between these two distinct constructs with structural equation modeling (SEM). Methods 118 patients with schizophrenia and 160 healthy controls were recruited for the current study. The abridged version of the Cambridge Neurological Inventory (CNI) and a set of neurocognitive function tests were administered to all participants. SEM was then conducted independently in these two samples to examine the relationships between neurological soft signs and neurocognitive functions. Results Both the measurement and structural models showed that the models fit well to the data in both patients and healthy controls. The structural equations also showed that there were modest to moderate associations among neurological soft signs, executive attention, verbal memory, and visual memory, while the healthy controls showed more limited associations. Conclusions The current findings indicate that motor coordination, sensory integration, and disinhibition contribute to the latent construct of neurological soft signs, whereas the subset of neurocognitive function tests contribute to the latent constructs of executive attention, verbal memory, and visual memory in the present sample. Greater evidence of neurological soft signs is associated with more severe impairment of executive attention and memory functions. Clinical and theoretical implications of the model findings are discussed.

Prospective memory in schizophrenia: Further clarification of nature of impairment

Prospective memory (PM) refers to the ability to execute a delayed intention and is different from retrospective memory (RM) in its nature and underlying mechanism (e.g., intention formation, maintenance, detection of PM cue and intention execution). Although preliminary studies have found PM impairment in patients with schizophrenia, the nature and magnitude of this problem in this clinical group is not yet fully known. The current study aimed to further clarify the nature of this impairment in schizophrenia. Fifty-four patients with schizophrenia and fifty-four healthy volunteers matched on demographic variables, IQ and executive functions took part in the study. Time-, event-, and activity-based PM tasks and a set of neurocognitive tests were administered to the participants. Results showed that patients with schizophrenia performed significantly worse on all sub-types of PM tasks, even after controlling for neurocognitive functions such as working memory, verbal memory, visual memory, and executive function. These findings suggest PM deficit is a primary deficit rather than a secondary consequence of neurocognitive impairments in schizophrenia. Analysis found that PM deficits may be mainly due to the impairment of the cue detection and intention retrieval stage.

Alcohol-related disorders in Beijing, China: prevalence, socio-demographic correlates, and unmet need for treatment.

BACKGROUND The study aimed to determine the prevalence of alcohol use, episodic heavy drinking, and alcohol dependence and their socio-demographic correlates in Beijing, China. methods: A total of 5,926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview (CIDI 1.0). Data on basic socio-demographic and current major medical conditions were also collected. RESULTS The 12-month prevalence of alcohol use and episodic heavy drinking were 32.5 and 13.8%, respectively. The 12-month and lifetime prevalence of alcohol dependence were 1.7 and 4.3%, respectively. Age above 24 years, male sex, being married and employed, low education level (junior high school, primary school or illiterate), rural residence, and having comorbid psychiatric disorders were all significantly associated with a higher likelihood of alcohol-related disorders. Only 2.4% of the subjects with alcohol dependence were receiving treatment, and a mere 1.4% had sought treatment from mental health professionals. CONCLUSIONS Nationwide surveys are urgently needed to further explore the prevalence of alcohol-related disorders in China.

Prevalence and socio-demographic correlates of major depressive episode in rural and urban areas of Beijing, China

OBJECTIVE This study aimed to determine the 12-month and lifetime prevalence of major depressive episode (MDE) and their socio-demographic correlates in both the urban and rural areas of Beijing, China. METHODS A total of 4767 adults were randomly selected and interviewed in Beijing using the Composite International Diagnostic Interview (CIDI 1.0). Basic socio-demographic and clinical data were collected during the interviews. RESULTS The overall 12-month prevalence of MDE was 3.2%; 2.8% and 3.8% for men and women, respectively. The overall lifetime prevalence of MDE was 5.3%; 4.4% and 6.3% for men and women, respectively. Being older than 25 years of age was independently associated with increased risk of MDE. Sixteen point three percent of the subjects with lifetime MDE attempted suicide while the rate of suicide attempts was only 0.2% in subjects without MDE. The percentage of subjects with MDE who received any type of treatment from medical practitioners was 33.1%; of them, only 5.4% sought help from mental health professionals. CONCLUSIONS National epidemiologic surveys are needed to further explore the prevalence of MDE in China. The low percentage of subjects treated for MDE constitutes a major public health problem that should be urgently addressed.

Relationships of sleep duration with sleep disturbances, basic socio-demographic factors, and BMI in Chinese people

OBJECTIVE This study aimed at determining the mean total sleep time (TST) and the relationship between sleep duration and basic socio-demographic factors and BMI sleep problems in Chinese subjects. METHOD A total of 5926 subjects were randomly selected and interviewed using standardized assessment tools. RESULTS The reported mean TST was 7.76 h. Short sleepers were significantly older than medium and long sleepers. There were more urban residents who were short sleepers than medium and long sleepers. Short sleepers reported more sleep problems than medium and long sleepers. Short and long sleepers reported more psychiatric disorders than medium sleepers in both sexes, and short sleepers also had more major medical conditions in women. Short sleepers had a lower BMI than medium and long sleepers after controlling for the effects of age and psychiatric disorders in women. CONCLUSIONS Nationwide epidemiologic surveys in China are needed to further explore the relationship between sleep duration and sleep problems.

Smoking and psychiatric disorders in the rural and urban regions of Beijing, China: a community-based survey.

BACKGROUND In China, there is limited information on smoking and its socio-demographic correlates in general, and in psychiatric patients in particular. The aim of this study was to determine the prevalence of lifetime, current mild, and heavy smoking, the socio-demographic correlates of current smoking, and its relationship with psychiatric disorders in the Beijing municipality, China. METHODS A total of 5926 subjects who met the studys entry criteria were randomly selected from the urban and rural areas of Beijing and interviewed using standardized assessment tools, including the collection of basic socio-demographic and clinical data. All subjects fully cooperated in the interviews and readily disclosed all of the information. RESULTS The prevalence of lifetime smoking was 35.9%; the rates for current mild and heavy smoking were 21.8% and 10.8%, respectively. An age of 24 years or above, male sex, married, divorced, separated or widowed marital status, relatively low level of education (less than college level), being employed, a relatively high monthly income (more than RMB500), rural abode, and having a psychiatric disorder were risk factors of current smoking. Both current mild and heavy smoking were significantly associated with alcohol dependence, and current heavy smoking was also associated with a history of a major depressive episode. CONCLUSIONS The prevalence of smoking in the rural and urban areas of Beijing is unacceptably high. In addition to certain socio-demographic factors, smoking was associated with common psychiatric disorders. Nationwide surveys are warranted to further explore the prevalence of smoking in China. Effective strategies to reduce the high rate of smoking are also needed.