Breast milk lead and cadmium levels in suburban areas of Nanjing, China / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate levels of lead (Pb) and cadmium (Cd) in the breast milk in the second postpartum month, to investigate the relationship between Pb/Cd levels in breast milk and some sociodemographic parameters, and to explore whether these levels affect the infants' physical status or the mothers' psychological status (postpartum depression).</p><p><b>METHODS</b>A cross-sectional study was conducted between November 2009 and December 2010. Altogether 170 healthy mothers were enrolled from Nanjing Maternity and Child Health Care Hospital. The inclusion criteria were: voluntary to participate in this study, healthy, with no chronic disease, breastfeeding in the second postpartum month, living in a suburban but not non-industrial area of Nanjing, and not occupationally exposed to toxic metals. All the mothers completed a questionnaire and were evaluated based on the Edinburgh Postpartum Depression Scale (EPDS) to identify the risk of postpartum depression. Pb and Cd levels in breast milk were determined by inductively coupled plasma mass spectroscopy. The infants of these mothers were examined for their z scores of weight for age, length for age, head circumference for age, and body mass index for age.</p><p><b>RESULTS</b>The median breast milk levels of Pb and Cd were 40.6 μg/L and 0.67 μg/L, respectively. In 164 (96.5%) of the 170 samples, Pb levels were higher than the limit reported by the World Health Organization (> 5 μg/L). Breast milk Cd level was > 1 μg/L in 54 (31.8%) mothers. The mothers with a history of anemia had a higher breast milk Pb level than those without a history of anemia (41.1 μg/L vs. 37.9 μg/L, P = 0.050). The median breast milk Cd level in those who were active and passive smokers during pregnancy was significantly higher than that in non-smokers (0.88 μg/L vs. 0.00 μg/L, P = 0.025). The breast milk Cd level in the mothers not taking iron and vitamin supplements for 2 months postpartum was higher than in those taking the supplements (iron supplement: 0.74 μg/L vs. 0.00 μg/L, P = 0.025; vitamin supplement: 0.78 μg/L vs. 0.00 μg/L, P = 0.005). Breast milk Cd level at the second postpartum month was negatively correlated with the z scores of head circumference (r = - 0.248, P = 0.042) and weight for age at birth (r =- 0.241, P = 0.024) in girls. No correlation was found between the breast milk Pb/Cd levels and the EPDS scores.</p><p><b>CONCLUSION</b>Considering the high levels of Pb and Cd in breast milk in this study, breast milk monitoring programs are necessary.</p>

Blood lead levels during pregnancy and its influencing factors in Nanjing, China / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the blood lead levels (BLLs) in the duration of pregnancy and 6-12 weeks after delivery, and analyze the influencing factors of BLLs in healthy pregnant women.</p><p><b>METHODS</b>Pregnant women were recruited from September 2009 to February 2010 at the prenatal clinic in Nanjing Maternity and Child Health Care Hospital. Altogether 174 healthy pregnant women without pregnant or obstetric complications or abnormal pregnancy outcomes were enrolled as the gravida group, and 120 healthy non-pregnant women as the control group. BLLs during pregnancy were determined by flame atomic absorption spectroscopy.</p><p><b>RESULTS</b>BLLs in all the three pregnancy trimesters and postpartum were 59.8±24.3, 55.4±20.1, 55.9±19.7, and 67.6±17.4 μg/L, respectively, and the mean BLL in control group was 67.5±21.3 μg/L. BLLs during all the three trimesters were lower in the gravida group than in the control group (P=0.043, 0.021, and 0.028). Furthermore, occupations, nutrients supplementation, and time of house/apartment painted were associated with BLLs in pregnant women. Lead-related occupations, cosmetics use, and living in a house painted less than 1 year before are risk factors of high BLLs among pregnant women, while calcium, iron, zinc, and milk supplements are protective factors.</p><p><b>CONCLUSION</b>Supplementing calcium, iron, zinc, and milk, or avoiding contact with risk factors may help people, especially pregnant women, to reduce lead exposure.</p>

Neurotoxicity and biomarkers of lead exposure: a review / 中国医学科学杂志(英文版)

Appropriate selection and measurement of lead biomarkers of exposure are critically important for health care management purposes, public health decision making, and primary prevention synthesis. Lead is one of the neurotoxicants that seems to be involved in the etiology of psychologies. Biomarkers are generally classified into three groups: biomarkers of exposure, effect, and susceptibility.The main body compartments that store lead are the blood, soft tissues, and bone; the half-life of lead in these tissues is measured in weeks for blood, months for soft tissues, and years for bone. Within the brain, lead-induced damage in the prefrontal cerebral cortex, hippocampus, and cerebellum can lead to a variety of neurological disorders, such as brain damage, mental retardation, behavioral problems, nerve damage, and possibly Alzheimer's disease, Parkinsons disease, and schizophrenia. This paper presents an overview of biomarkers of lead exposure and discusses the neurotoxic effects of lead with regard to children and adults.

Gender difference on depressive symptoms among Chinese children and adolescents / 中华流行病学杂志

Objective To explore the epidemiological characteristics and gender difference of depressive symptoms among Chinese children and adolescents.Methods Based on the cluster sampling method,50 boys and 50 girls from each 9.0-18.9 year-olds in both urban and rural areas,were recruited from each research center.Children's Depression Inventory (CDI) was administered to all the participating students from grade 4 to 12 while physical examination indices including pubic hair were provided to both boys and girls.Development of breast in girls and genital development in boys were also measured.Results The overall prevalence on depressive symptoms was 14.81％ for the Chinese adolescents.Boys reported more depressive symptoms (15.35％) than that of girls (14.43％).Prevalence related to depressive symptoms among children and adolescents from rural areas (16.41％) was higher than that of the urban areas (13.23％).Prevalence of depression was higher in boys than in girls in both 10-year-old and 1 1-year-old groups (x2=11.625,P＜0.005; x2=5.807,P＜0.005).In the 17 year-old group,prevalence of depression (21.5％) was seen higher in girls than in boys (17.26％) (x2=6.192,P＜0.005).Only in the Tanner stage Ⅱ,the gender difference of depression showed statistically significant (x2=6.593,P＜0.005),with boys as 18.4％ and girls as 15.8％.Conclusion The gender differences of depression appeared in both special age groups and developmental stages in Chinese children that called for further longitudinal study to understand the nature of these findings.

Towards prenatal biomonitoring in Nanjing, China: lead and cadmium levels in the duration of pregnancy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Prenatal lead and cadmium exposure will not only influence the mother' organ systems, but also will provide an environment that may influence the fetus and neonate in a harmful way.In the present study, we detected the blood lead levels (BLLS) and cadmium levels for the duration of pregnancy and 6-12 weeks after delivery and to analyze the influencing factors of BLLs in healthy pregnant women.</p><p><b>METHODS</b>A cohort study survey was carried out. We recruited 174 healthy pregnant women without pregnancy or obstetric complications or abnormal pregnancy outcomes as the gravida group, and 120 healthy non-pregnant women as the control group.</p><p><b>RESULTS</b>The lead concentrations in the three pregnancy trimesters and in the postpartum period were: (5.98 ± 2.43), (5.54 ± 2.01), (5.59 ± 1.97), and (6.76 ± 1.74) µg/dl; and (6.75 ± 2.13) µg/dl in the control group. The cadmium concentrations in the three pregnancy trimesters and postpartum period were 1.61 ± 0.45, 1.63 ± 0.46, 1.64 ± 0.49, and 1.67 ± 0.57. We found that the BLLs in the gravida group were lower than in the control group during all three trimesters. Occupations, supplement nutritional elements (dietary supplements and nutritional (food) elements), and the time of house painting could affect BLLs in pregnant women. Lead-related occupations, using cosmetics, and living in a house painted more recently than one year previously are risk factors of high BLLs among pregnant women, while calcium, iron, zinc, and milk supplements are protective factors.</p><p><b>CONCLUSIONS</b>These findings may help people, especially pregnant women, to reduce lead exposure via supplements of calcium, iron, zinc, and milk or avoiding contacting risk factors.</p>

Relationship of childhood physical abuse and internet addiction disorder in adolescence: the mediating role of self-esteem / 中华流行病学杂志

Objective To find out whether the effects of childhood physical abuse on internet addiction disorder in adolescence could be mediated by self-esteem.Methods 3798 high school students selected from 76 classes in Grade One and Grade Two,were asked to fill in the anonymous questionnaire,which including the demographic characteristics of students,Young' s Internet Addiction Scale,Parent-Child Conflict Tactics Scales and Rosenberg' s Self-Esteem Scale.Results Childhood physical abuse could directly predict less self-esteem and internet addiction disorder (r=-0.108,P＜0.01,r=0.057,P＜0.01 ) and had significant indirect effects on intemet addiction disorder which could be mediated through self-esteem (a=-0.703,standardized b=-0.104,z=5.052,P＜0.001 ).Self-esteem had mediated 22.5％ of the childhood physical abuse cases on their internet addiction disorders during the period of adolescence.Conclusion Self-esteem could partially mediate the relationship between childhood physical abuse and internet addiction disorder.The mediating roles of self-esteem suggested that salient leverage points could make a change through empowerment training,self-esteem group training on self-esteem enhancement in the stage of adolescence.

Psychopathological sub-healthy status as predictor on self-or unintentional injuries among Chinese adolescents: a school-based follow-up study / 中华流行病学杂志

Objective To investigate the association between psychological sub-healthy status and risks on injuries and related predictors among adolescents in China,in order to develop reasonable intervention programs.Methods Adolescents were selected from middle schools and colleges in eight cities.Baseline status on sub-healthy that related to psycho-pathology was measured using the Multidimensional Sub-health Questionnaire of Adolescents (MSQA).Data on Self- or unintentional injuries were collected using a standardized injury surveillance questionnaire every 3 months,for three times (T0,T1,T2 and T3).Results A total of 12 113 students completed the study.Prevalence rates related to self-injury among boys and girls were 19.4％ and 19.9％,respectively.The rates of having more than 4 types of self-injuries in boys and girls were 4.7％ and 4.2％,respectively.Boys had a significantly higher unintentional injury rate than that of girls (62.2％ vs.57.3％ ).The differences in the rates of having more than 4 types of unintentional injury between boys (3.8％) and girls (3.4％) were also statistically significant.Rates on self- and unintentional-injuries increased in T1,T2 and T3 when the psychological symptoms had an increase.Data from Multiple regression analysis demonstrated that the baseline psychological sub-healthy status was a predictive factor for higher risk of self- and unintentional- injuries at each of the follow-up waves.Conclusion Sub-healthy status of psycho-pathology was associated with an increased risk on self-and unintentional injuries among adolescents.Integrative psycho-pathological and behavioralintervention programs might help in reducing the risk of injuries among the Chinese adolescents.

Association between body mass index and physical fitness index among children and adolescents / 中华流行病学杂志

Objective To explore the relationship between body mass index (BMI) and physical fitness index (PFI) among children and adolescents.Methods The study sample included 8941 students aged 7 to 18 years in Anhui who attended the Physical Fitness and Health Surveillance program of Chinese School Students,in 2010.Within each sex- and age-specific group,students were classified into five BMI categories which were:very low,BMI ＜5th percentile; low,BMI ≥5th but ＜15th percentiles; normal,BMI ≥15th but ＜85th percentiles; high,BMI ≥85th but ＜95th percentiles; and very high,BMI ≥95th percentiles.Z-scores based on urban-rural,sex- and age-specific means and standard deviations were calculated,and the sum of Z-scores for the fitness tests was used as a PFI.Differences in PFI between BMI categories were compared with ANOVA.Sex- and grade-specific regressions of PFI on BMI were done by using a linear model.Results For 8941 students,the PFIs on very low,low,normal,high and very high group were-1.77,-0.91,0.32,-0.17 and -0.54,respectively,and showed an inverted U shape.The normal BMI group students presented the highest PFI.Data from Linear regression analysis revealed that PFI was significantly positively correlated with BMI,while negatively associated with BMI square,which indicated that PFI was the quadratic function of BMI.When BMI was increasing,PFI showed a parabolic curvilinear.Conclusion Relationships between BMI and PFI were parabolic curvilinear among the children and adolescents aged 7 to 18 in Anhui province.

Analysis on physical and mental health and related influential factors among those ‘left behind ’ adolescents in Anhui province / 中华流行病学杂志

Objective To explore the physical and mental health status on the ‘left behind ’ students in Anhui province and the related influential factors.Methods Stratified cluster sampling method was used to investigate the 682 out of 3421 students from 7 middle schools in both south and north Anhui province,using multidimensional sub-health questionnaire of adolescents (MSQA) and mental health test (MHT),for assessment of the general condition,physical and mental health status.Results 14.22％ of the ‘left behind’ students were in sub-health condition compared to 11.28％ among the normal students,and the mental sub-health status represented 13.64％ for the former and 10.84％ for the latter.In addition,the ‘left behind’ students appeared less content with their life than those of staying with their parents (P＜0.05).MHT scores in the subjects were positively correlated with the scores on MSQA and showed significant difference (P＜0.01).Results from the multiple linear regression analysis showed that the mental health condition among the left behind students was in linear regression relationship with the decreased physical activity (β =1.456,P=0.001 ),emotional problems (β =1.096,P=0.000 ) and problems of social adaptation (β=1.011,P=0.006).The status of physical sub-health in the Anhui province showed that there was no significant difference in each of the study group (P＞0.05).Conclusion Decreased physical activity and emotion aporia as well as difficult social adaptation were major factors leading to degenerated mental health levels in the‘left-behind’ adolescents.The findings suggested that the mental health status could be improved inthis population through better management on their body-health condition.

Situation of common psychosomatic symptom in adolescent and its influence on 6 months later suicide and self-injurious behavior / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of common psychosomatic symptoms among Chinese adolescents and the influence on 6 months later suicide and self-injurious behavior.</p><p><b>METHODS</b>Based on the cluster sampling method, the participants who were recruited from 8 cities from 3 areas in China, including Eastern areas (Beijing, Shaoxing and Guangzhou), Middle areas (Ezhou, Harbin and Taiyuan) and Western areas (Guiyang and Chongqing), were administered by multidimensional sub-health questionnaire of adolescents (MSQA) in March 2008. Demographics, life style, psychosomatic symptoms, suicide and self-injurious behavior were also assessed. A total of 17 622 questionnaires were valid at baseline. Six months later, 14 407 questionnaires were eligible for two waves investigation. Analysis of Pearson chi-square and logistic model regression analysis were employed to compare the incidence of psychosomatic symptoms, suicide and self-injurious behaviors among different areas and to explore the possible risk factors of those symptoms and behaviors.</p><p><b>RESULTS</b>At baseline, rates of total common physiological and psychological symptoms were 24.1% (4255/17622) and 30.9% (5447/17622), respectively, with the highest being eating and drinking too much (6.4%, 1130/17622) and hardly feel ease to learn at home (11.8%, 2087/17 622). In males, the rate of common psychological symptoms (30.7%, 2637/8599) was higher than physiological symptoms (24.0%, 2061/8599) (P < 0.05); in females, the rate of common psychological symptoms (31.1%, 2810/9023) was higher than physiological symptoms (24.3%, 2194/9023) (P<0.05). The rate of the common psychosomatic symptoms in senior high school students (46.8%, 2905/6208) were significantly higher than those in middle high school students (37.3%, 2337/6262) and college students (33.2%, 1711/5152) (all P values <0.05). Students from Western areas had the highest incidences of the common physiological and psychological symptoms (30.2%, 1471/4871; 40.6%, 1979/4871), higher than students from Middle areas (22.4%, 1443/6453; 27.0%, 1743/6453) and Eastern areas (21.3%, 1341/6298; 27.4%, 1725/6298) (all P values <0. 05). Results from multiple logistic regression showed that physical symptoms > or = 2 at baseline were shared risk factors for suicidal ideation (RR = 1.44, 95% CI:1.16 - 1.79), attempted suicide (RR = 1.79, 95% CI: 1.22 - 2.61) and self-injurious behaviors (RR = 1.39, 95% CI: 1.17 - 1.66) 6 months later. Psychopathological symptoms > or = 4 at baseline was the shared risk factors for suicide ideation (RR = 1.74, 95% CI: 1.39 -2.17), attempted suicide (RR = 2.08, 95%CI: 1.39 - 3.11) and self-injurious (RR = 1.90, 95%CI: 1.59 - 2.28) 6 months later.</p><p><b>CONCLUSION</b>It is common in Chinese adolescents who have multiple psychosomatic symptoms simultaneously. What's important is that those common psychosomatic symptoms are shared risk factors of later suicidal and self-injurious behaviors.</p>

A correlation analysis of HBV-DNA load levels between in perinatal mother's serum and neonatal cord blood / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the correlations of hepatitis B virus markers and hepatitis B virus -DNA vectors in blood between women in perinatal period and cord blood, and to assess the risk of HBV infections status in pregnant women to intrauterine fetal infective.</p><p><b>METHODS</b>We selected 612 pregnant women who decided to delivery in hospital, in compliance with the principles of informed consent. According the difference of hepatitis virus serological markers existing in pregnant women, samples were divided into six groups. We used enzyme-linked immunosorbent assay to detect hepatitis virus serological markers, existing in serum of mother and cord blood. Real-time fluorescence quantitative PCR was supplied to test HBV-DNA load levels in these two kinds of biological specimen.</p><p><b>RESULTS</b>In group A, hepatitis B virus "big 3 positives" or 1,3 positive 149 lying-in woman examples, two positive rates of HBV-DNA about pregnant women and cord blood are 99.33% and 32.21%; in group B, positive rates of HBV-DNA in two kinds of specimen are 20.00% and 3.08%; in group C and D, two positive rates are and the average contents of HBV-DNA, the results as mentioned in each group respectively are 65.52%, 12.07% and 13.56%, 1.69% respectively. Control group is group E, 86 lying-in woman examples and the detecting results orderly are 1.16%, 0. There was a significant difference in positive rate of HBV-DNA in cord blood between group A and group B subgroups (chi2 = 54.09, P < 0.01). There is significant positive correlation between HBV-DNA vectors existing in mother's serum and the positive rate of HBV-DNA in cord blood. Hepatitis B virus the mother blood " big 3 positives " is the umbilicus blood HBV-DNA 6345 times that carries quantity in average.</p><p><b>CONCLUSION</b>(1) During the perinatal period, along with the HBV-DNA load levels arising of pregnant women, the risk of HBV infections status in pregnant women to intrauterine fetal infective increased. (2) Suggested to develop the compound pattern human hepatitis B immunoglobulin: Increase the composition of efficient price HBeAb-can be combinated HBeAg, HBsAb can be combinated HBsAg, strengthen the hinderance and break hepatitis B virus disseminate. (3) Our government should strengthen the propaganda of hepatitis B virus education. Establish and perfect to surround and produce the system of health protection.</p>

Association between self-assessed somatotypes and symptom depression among children and adolescents / 中华流行病学杂志

Objective To examine the association between self-assessed somatotypes and depression related symptoms.Methods The study sample included 5555 students aged 9 to 18 years who had attended the Physical Fitness and Health Surveillance of Chinese School Students(2010)in Chizhou city,Anhui province.Association between self-assessed somatotypes,body mass index(BMI)and depression symptom were examined.Results There was a slight consistency between self-assessed somatotypes and BMI in both boys and girls(Kappa=0.217,P=0.000; Kappa=0.203,P=0.000).Significant difference in the prevalence of depression was found among weight misperception groups in both genders(x2=145.223,P=0.000).The prevalence of umderestimation of somatotypes was significantly higher in boys than in girls,while the result was reversive on the prevalence of overestimation.Additionally,the prevalence of depression was higher in girls than in boys(x2=5.199,P=0.023).Through logistic regression,data showed that self-assessed somatotypes and miscalculated groups were significantly associated with depressive symptoms.Compared to the group that self-assessment as being normal,those students when self-assessed as being slim,overweight or obesity were more likely to be depressive,with odds ratio(ORs)as 1.255(95％CI:1.066-1.478),1.538(95％CI:1.275-1.856)and 1.713(95％ CI:1.035-2.834),respectively.Overestimated and underestimated somatotypes appeared to be risk factors causing symptoms of depression(OR=1.705,95％CI:1.382-2.105; OR=1.241,95％CI:1.059-1.454).Conclusion Slight consistency was found between self-assessed somatotypes and BMI,while the misjudged somatotypes were the risk factor related to depressive symptoms.It was suggested that life skills education should be carried out as preventive intervention approach,to improve the physical and mental health well-being of children and adolescents.

The prevalence and influencing factors of abuse and negligence against elderly in rural areas of Anhui province / 中华流行病学杂志

Objective To investigate the prevalence and influencing factors related to abuse and negligence against the elderly in the rural areas. Methods 975 elderly over 60 years from 41counties in Anhui province were included. All participants completed an anonymous questionnaire including items as: educational background, marital condition, income, child-discipline, rude action to parents, daily activities, physical functions, having chronic illness, abuse and negligence against the elderly, etc. Results In the last year, rates of common physical abuse, serious physical abuse,emotional abuse, financial exploitation, negligence, overall abuse and negligence against the elderly were 4.5%, 1.5%, 26.9%, 4.9%, 7.2%, 29.9% respectively. Among the 281 victims, 80.4% reported that they were suffered more than 3 times of abuse and neglect episodes, and 34.9% reported that they were suffered more than 2 forms of abuse and negligence. The primary sadism was carried out by the daughter-in-law or son-in-law (43.2%) of the elderly. Low activity on daily life and having chronic illness were the risk factors causing common physical abuse while better education was the protective factor to it, Low ability in managing daily activity of living was the risk factor causing serions physical abuse. Less active on daily life and having rude action to parents were the risk factors to emotional abuse, but being strict with their children was the protective factor to emotional abuse. Less active on daily life, often beating their children and having rude action to parents were the risk factors related to financial exploitation. Less active on daily life, having rude action to parents and having bad physical functions were the risk factors causing negligence. Less active on daily life and having rude manner to parents were the risk factors of overall elderly abuse and negligence, but being strict with their children was protective factor to the abuse and negligence against the elderly. Conclusion High prevalence on abuse and negligence against the elderly was seen in the rural areas of China. Different forms on elderly abuse and negligence were affected by different factors that called for more attention to be paid to those elderly with lower ability in managing their daily life.

An investigation on the epidemic situation of intimate partner violence in 2575 college students / 中华流行病学杂志

Objective To investigate the prevalence of love affairs and intimate partner violence,and to explore the relationship between intimate partner violence and other mental health and risk behavior in college students.Methods Three universities were selected using cluster sampling method in Hefei and Wuhu.Totally.2575 college students completed an anonymous questionnaire.Intimate partner violence,depression,satisfaction of school life,self-esteem,suicidal psychology and behavior were evaluated to estimate the relationship between intimate partner violence and mental health/risk behavior.Results There were 46.9%students reported that they had intimate partner currently or in the past.The rate of having intimate partner in male students was higher than that in female students(x2=44.13,P<0.001).And the rates were higher in sophomores and juniors than in freshmen(x2=161.84,P<0.05).There were 21.1% students had sexual behavior with their intimate partners.But only 21.8%(34/156)intimate partners reported that they used condom every time.There were 11.5%(18/156)intimate partners reported that they never took any contraception.There were 18.6%(29/156)students reported that they were pregnant or led to their girlfriend becoming pregnant,but only less than 50.0% adolescents induced abortion in a legal hospitals.The rates of being the victim of physical assault,emotional abuse,sexual coercion,the total intimate partner violence were 18.0%,33.6%,5.1%.37.1%.The rates of being the victim of physical assault,emotional abuse,total intimate partner violence in male adolescents were higher than those in female adolescents,but the rate of sexual coercion was on the contrary(x2=70.21,13.25,14.04,5.77,P<0.05).Among the intimate partners who had suffered from intimate partner,74.2%(345/446)students had underwent more than 3 times.and 47.1% had underwent more than 2 types of intimate partner violence.The score of depression was highest in the victims of intimate partner violence,but the scores of self-esteem and school life satisfaction were on the contrary(F=4.00,16.39,8.76,P<0.05).The rates of suicidal ideation,suicidal plan,suicidal preparative and attempted suicide were highest in the victims of intimate partner violence(x2=13.80,9.72,8.52,11.96,P<0.05).Conclusion The rate of having sexual behavior with their intimate partners was high in college students,but their self-protection awareness was insufficient.In the present study,a high prevalence of intimate partner violence among university students was observed,and highlighted a need for attention to the other mental health and risk behavior in adolescents with intimate partner violence.

Impact of psychosocial factors on suicide attempts in high school and college students, data from eight cities of China / 中华流行病学杂志

Objective This paper aimed to report the rate of suicide attempts among adolescent and young students of eight cities in China, and to examine the impact of related psychosocial factors on suicide attempts. Methods The investigation was obtained in senior and junior high school and college students in eight cities of China. All of the 17 622 participants were recruited to complete anonymous questionnaires regarding their experiences of suicide attempts and related psychosocial factors. Results Overall, 2.2 percent of the respondents reported that they had experienced attempted suicide during the previous year. Scores on high anxiety (OR=2.61,95%CI: 1.64-4.16),high depression (OR=2.05, 95%CI: 1.35-3.10),suicide idea (OR= 14.21, 95%CI: 9.88-20.43),suicide plan(OR=3.50,95%CI:2.59-4.73) were revealed as common risk factors while the whole time span being accompanied by mothers during juvenile years (OR=0.38, 95% CI: 0.20-0.74) seemed to be protective factor for suicide attempts through multivariate logistic regression analysis. Conclusion Our results showed that emotional symptom, idea and plans for suicide were statistically associated with suicide attempted in high school and college students.

An investigation on self-harm episodes and their relationship with suicidal psychology and behaviors in 2713 college students / 中华流行病学杂志

Objective To investigate the episodes and influencing factors on self-harm and to explore the relationship between self-harm episodes and suicidal psychology and behaviors in college students. Methods Four universities were selected using cluster sampling method in Anqing city and Chaohu city. Totally, 2713 college students completed this survey. Data were analyzed by Pearson Chi-square and logistic regression. Results In the last six months, rates of highly lethal self-harm,less lethal self-harm with visible tissue damage, self-injury without visible tissue damage,self-harmful behaviors with latency damage, other self-harmful behaviors with menticide were 1.9%,5.5%, 15.3%, 21.2% and 17.0% respectively. The total rate of self-harm was 31.3%. 73.1% of the students with self harmful experiences had the above mentioned behaviors more than 3 times in the last six months. The top 3 reasons for taking self-harm actions were: having learning problems (43. 1% ), failed love affairs (25.0%) and having conflicts with others (23.9%). There were different influencing factors among different kinds of self-harm episodes. Depression was the risk factor of self-harm. The higher score of having high self-esteem was the protective factor of all kinds of self-harm actions except highly lethal ones. Higher score of difficulties in identifying feelings was one of the risk factors. The rates of suicidal psychology and behaviors in students with self-harm were significantly higher than those in students without those behaviors. Result from linear x2 test indicated that the graveness of tissue damage of self-harm was higher along with the rates of suicidal psychology and behaviors (P＜0.01). Conclusion Among 2713 college students, about 1/3adolescents having experienced self-harm in the last 6 months, many with repeated ones. Depression and difficulties in identifying feelings were the two risk factors while self-esteem was the protective factor related to most of the self-harm cases.

Association between adolescent internet addiction and suicidal behaviors / 中华流行病学杂志

Objective To examine the association between internet addiction and suicidal behaviors in adolescences and to explore whether the association could be partly or fully accounted by depression or/and behaviors related to the impulsity. Methods A total of 3507 urban adolescent students in Hefei were administered to complete the questionnaire concerning interact addiction disorder(IAD), suicidal behaviors during the 12 months preceding the survey, behaviors related to the impulsity, Center for Epidemiologic Studies Depression Scale and early childhood adversities,respectively. Hierarchical logistic regressions were used to evaluate the associations and possible roles of depression and behaviors related to the impulsity between internet addition and suicidal behaviors after adjustment for confounding factors. Results Of the 3507 participants, 5.2% were diagnosed as IAD, 27.4% reported suicidal ideation during the 12 months preceding the survey, with another 9.5% had a plan and 2.6% had an attempt. Internet addition was associated with suicidal ideation(OR=1.79, 95%CI: 1.32-2.44), plan(OR=2.32, 95%CI: 1.57-3.42), and attempt(OR=2.08, 95%CI:1.03-4.22). After adjustment for potential confounding factors, the association between internet addition and attempt was insignificant. When depression and behaviors related to the impulsity were entered into Hierarchical regression respectively, the associations between internet addition, suicidal ideation and plan were substantially reduced. While internet addition was enter into Hierarchical regression, the associations between depression, behaviors related to the impulsity, suicidal ideation and plan were not reduced. Conclusion Adolescent intemet addition seems to be associated with suicidal ideation and plan, and the association is possibly mediated by depression and behaviors related to the impulsity.

Effect of intrahepatic cholestasis of pregnancy on the functions of hypothalamic-pituitary-adrenocortical axis and adrenal cortex in normal neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effect of intrahepatic cholestasis of pregnancy (ICP) on the functions of the hypothalamic-pituitary-adrenocortical (HPA) axis and adrenal cortex in normal neonates.</p><p><b>METHODS</b>Demographic characteristics, prenatal anxiety and depression, and perceived stress during delivery were investigated in 32 ICP women and 32 controls. The cord blood levels of cortisal, adrenocorticotropic hormone (ACTH), and dehydroepiandrosterone sulfate (DHEAS) were measured by the radioimmunity technique in normal neonates immediately after birth.</p><p><b>RESULTS</b>The scores of prenatal anxiety and depression in ICP women were significantly higher than those in controls (p<0.05 and p<0.01, respectively). There were no significant differences in the perceived stress during delivery between the two groups. The cord blood levels of cortisol and ACTH in neonates from ICP women were significantly lower (p<0.01), while the DHEAS level was significantly higher (p<0.01) than in neonates from controls. The DHEAS/ACTH ratio was significantly higher (p<0.01), while the cortisol/DHEAS ratio was significantly lower in the ICP group (p<0.01) than in the control group. The glycocholic acid level in ICP women was positively correlated with the DHEAS level in neonatal cord blood (r=0.47, p<0.01).</p><p><b>CONCLUSIONS</b>There may be a dissociation between cortisol and DHEAS in neonates with normal birth outcome from ICP women. ICP may result in a decreased responsiveness of HPA axis and an increased secretion of DHEAS by adrenal cortex in these neonates. This suggests that there might be dysfunction of the fetal zones of the adrenal cortex.</p>

Study on the school-related-factors of attempted suicide among rural middle school students / 中华流行病学杂志

Objective This study was undertaken to examine possible relationship between attempted suicide and underachievement,bullying,low life satisfaction and low self-concept at school.Methods An anonymous self-report survey assessing demographic characteristics and the major risk factors of teenage attempted suicide was completed by students from 16 middle schools in grades seven to twelve in 4 counties of Anhui province (age 10 to 21 years).An anonymous questionnaire was used to rate attempted suicide,bullying involvement and learning performance.Attempted suicide was defined as: experiencing specific suicide actions at least one time during the 12 months preceding the survey.Multidimensional Students' Life Satisfaction Scale and Children' s Self-concept Scale were used to evaluate satisfaction and self-conscience on and at respectively.In total,10 894 respondents substantially completed the survey.Multiple logistic-regression analyses,controlling for socio-demographic variables,was used to analyze if underachievement,bullying,low school life satisfaction and low children' s self-conscience at school had been risk factors.Results 629 participants (5.8%) reported having made at least one attempted suicide within the last 12 months.Students being underachieved were significantly having more attempted suicide events than those excellent students (X2=11.39,P=0.023).Students being both bully-victims and practiced bully were significantly more than those being only practiced bully (28.7% vs.15.8%,P＜0.001),being victims (28.7% vs.10.6%,P＜0.001) or having neither of them (28.7% vs.4.8%,P＜0.001).Results from multiple logistic regression analyses showed that underachievement,bullying,lower school life satisfaction and low self-conscience were risk factors for attempted suicide.Conclusion Data from this study confirmed that school bullying and children' s self-conscience at school were significantly associated with attempted suicide among rural middle school students in Anhui province.It is of importance to improve the school' s environments to reduce the risk of attempted suicide among this group.

The relationship between emotional,physical abuse and internet addiction disorder among middle school students / 中华流行病学杂志

Objective To study the relationship between emotional,physical abuse and internet addiction disorder(IAD)among middle school students.in order to lay foundation for the development of prevention and control programs on IAD.Methods Students selected from 76 classes in Grade One and Grade Two,filled out the anonymous questionnaire,which including demographic characteristics of students,Young's Intemet Addiction Scale,Parent-Child Conflict Tactics Scales.etc.Non-conditional multivariate logistic regression model was employed to explore the relationship between child abuse and IAD.Independent variable was child abUSe while dependent variable was IAD.Covariant variables would include demographic characteristics,as sex,age,style of household,et al.Results Among 3798 students,the overail prevalence of emotional abuse was 81.1%.with 55.1% of them reported having experienced physical abuse.Among 3507 intemet users,5.2%was diagnosed as IAD.Results from the nonconditional multivariate Iogistic regression model showed that odds ratio of severe physical abuse and moderate physical abuse were 3.02(1.63-5.58)and 4.00(2.01-7.93).Conclusion Moderate physical abuse and severe physical abuse were possible risk factors of IAD.