The prevalence of insomnia and its socio-demographic and clinical correlates in older adults in rural China: a pilot study.

OBJECTIVES: To investigate the prevalence of insomnia (DIS: difficulty initiating sleep; DMS: difficulty maintaining sleep; and EMA: early morning awakening), its socio-demographic and clinical correlates, and the treatment patterns in older adults in rural China. METHOD: A sample of 263 subjects was recruited in Mianyang and interviewed using standardized instruments. Basic socio-demographic and clinical data were collected. RESULTS: The expected mean total sleep time (TST) of the whole sample was 6.8 ± 2.2 hours, and the actual mean TST was 6.3 ± 2.1 hours. The 1-year prevalence of at least one type of insomnia was 7.6%; the rates of DIS, DMS, and EMA were 5.7%, 7.2%, and 6.8%, respectively. On multivariate analyses, female sex and psychiatric disorders were independently associated with more frequent insomnia. CONCLUSION: Insomnia is not uncommon in older adults in rural China, and the low percentage of subjects treated suggests that improved access to treatment might be indicated.

Conducting Community Research in Rural China -Addressing the Methodological Challenges of Recruiting Participants in Rapidly Changing Social Environments.

BACKGROUND: The paper addressed a unique challenge for public health and community research in rural China, i.e., the very large percentage of young adults that comprises a highly mobile working population that has been an essential component of the country's economic transformation. Fluid local demographic patterns potentially have a substantial impact on sample representativeness and data validity. METHODS: This report is based upon a cross sectional survey with face-to-face interviews of residents aged 16-34 years in rural communities of Mianyang, Sichuan Province, China. Two waves of fieldwork and other strategies were adopted in response to recruitment challenges. RESULTS: 1654 of 3008 potential participants took part in the study; this constituted 98% of those individuals approached and 55% of the persons enumerated in the local household registration system (hukou). Analyses revealed substantial differences among those who were interviewed during September and October 2005, versus those seen during the Chinese Lunar New Year of 2006 when many migrant workers and students returned to their homes. Both groups together differed from those who were unavailable during either recruiting episode. DISCUSSION AND CONCLUSIONS: We discuss potential responses to associated methodological challenges, including, (1) permanent hukou mismatches; (2) temporary hukou mismatches; (3) difficulties faced by potential participants to fully understand the purpose of research, the informed consent process, and specific research questions; and (4) appreciation of the importance of local social networks, as they pertain in particular to rural China. These findings underscore that there may be a need to make "on-the-ground" adjustments to varying local conditions to maximize sample representativeness and data validity.

The prevalence of sleep problems and their socio-demographic and clinical correlates in young Chinese rural residents.

This study aimed to determine the prevalence of basic forms of sleep disturbance (DIS: difficulty initiating sleep; DMS: difficulty maintaining sleep; and EMA: early morning awakening) as well as insomnia (defined as sleep disturbance accompanied by distress or daily functioning impairment), their socio-demographic and clinical correlates, and the treatment patterns in young Chinese rural people. A sample of 1642 subjects was recruited in Mianyang and interviewed using standardized instruments. Basic socio-demographic and clinical data were collected. The prevalence of at least one type of reported sleep disturbance was 8.0%, while the prevalence of at least one type of insomnia was 2.7%. In multivariate analyses, age between 30 and 34 years, having psychiatric disorders, poorer physical domain of quality of life (QOL), better social QOL domain, depressive symptoms and lower social support were independently associated with more frequent sleep disturbance. At the same time, age between 30 and 34 years, female sex, poorer physical QOL domain, better social QOL domain, depressive symptoms, lower life satisfaction, lower social support and more life events were independently associated with more frequent insomnia. Self-reported sleep disturbances are common among young Chinese residents. The low percentage of treated community residents might suggest a need to promote accessible and easily implemented interventions.

Characteristics of suicide attempters and nonattempters with schizophrenia in a rural community.

In this study, demographic and clinical characteristics of individuals with schizophrenia in a Chinese rural community who had attempted suicide at some time in their lives and those who had not made a suicide attempt were compared. Among individuals with schizophrenia, subjects with (n = 38) and without (n = 472) a lifetime history of suicide attempt were assessed with the Present State Examination. The results indicate that attempters had a significantly younger age, higher level of education, higher rate of lifetime depressed mood and hopelessness, and a larger number of positive symptoms than patients without suicide attempts. The logistic regression models also indicated that hopelessness, the number of positive symptoms and age were the most important predictors. Early interventions focusing on reducing hopelessness and controlling positive symptoms may help reduce the risk of suicide attempts among patients with schizophrenia.

The characteristics of expressed emotion among relatives of patients with schizophrenia in Chengdu, China.

We used the Mandarin Chinese version of the Camberwell Family Interview (CFI) to measure the components of expressed emotion among relatives of schizophrenic patients in urban and rural areas of Chengdu, China. The reliability and validity of the Chinese version of the CFI was examined. Seventy-one patients and their key relatives were included in the study. The results showed that high interrater reliabilities were found for the Chinese version of CFI. The proportion of relatives in our sample rated as high-EE was 28.2%, and the Chengdu relatives expressed significantly fewer critical comments (CCs) and less emotional overinvolvement (EOI) than respondents in other similar studies in the West. Within the Chengdu sample, city dwellers were significantly more expressive than villagers expressing warmth, positive remarks, and EOI (p < 0.05). The results of this study could indicate the impact of cultural and ethnic differences and geographical location on EE.