The mutual overlapping impact of stress and infection on mental health problems in adolescents and youths during and after COVID-19 pandemic in China.

BACKGROUND: It is unclear about the mutual impact of COVID-19 related psychological stress and infection on mental health of adolescent and youth students. This study aimed to explore the mutual impact of COVID-19 related psychological stress and infection on mental health problems among students. METHODS: This study was conducted from December 14, 2022 to February 28, 2023 in Sichuan, China. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, PTSD Checklist for DSM-5, Insomnia Severity Index, and Internet Addiction Test were used. Participants were grouped by COVID-19 infection and psychological stress level. The differences among groups were compared, and logistic regression analysis was used to investigate risk factors for depression, anxiety, PTSD and insomnia among groups. RESULTS: Of 90,118 participants, 82,873 (92.0 %) finished the questionnaires and were included in the study. Of 82,873 participants, 33,314 (40.2 %) reported to be infected with COVID-19. Participants had depression symptoms (38.1 %), anxiety symptoms (31.8 %), PTSD (33.9 %), insomnia (34.0 %), and internet addiction (60.3 %). Compared with participants uninfected with low psychological stress level, the risk for symptoms of depression, anxiety, PTSD and insomnia increased by 9.6 %, 12.3 %, 6.6 %, and 12.0 % in participants infected with low psychological stress level (p < 0.001), 106.8 %, 125.9 %, 125.2 %, and 95.7 % in participants uninfected with high psychological stress level (p < 0.001), and 147.3 %, 161.1 %, 158.7 %, and 141.0 % in participants infected with high psychological stress level (p < 0.001). LIMITATION: This study is a cross-sectional design, and no causal associations should be inferred. Infection status was based on self-report of participants with infectious symptoms. CONCLUSION: COVID-19 related psychological stress and infection per se have mutually overlapping impacts on mental health problems among students. Further health policies and psychosocial interventions should be developed to reduce mutually overlapping impact and improve the long-term mental health among students.

Academic performance and mental health among Chinese middle and high school students after the lifting of COVID-19 restrictions.

Background: Although the COVID-19 pandemic has greatly changed the way students studied, it is still unknown about the impact of the COVID-19 pandemic on students' academic performance and mental health. Objective: To explore the academic performance and mental health status of middle and high school students after the lifting of COVID-19 restrictions in China. Methods: An online survey was conducted in Sichuan province, China from Dec 14, 2022 to Feb 28, 2023. All participants were students in middle and high schools, recruited via their teachers. The general information, COVID-19-related information, and academic performance were collected. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Internet Addiction Test (IAT) were used to assess the mental health problems. Results: Of 60,268 participants, 36,247 (60.2%) middle and high school students reported that their studies were affected by the COVID-19 pandemic, and 24,864 (41.2%) reported that their academic performance had worsened. The prevalence of depression and anxiety symptoms was 38.4 and 32.7%, respectively. There was a significant association between academic performance change and mental health problems. The logistic regression analysis showed that improved academic performance was a protective factor for depression, and declined academic performance was a risk factor for depression and anxiety. Being COVID-19 infected, family members being infected, with quarantine experience, and with COVID-19-related stigma were risk factors for depression and anxiety. Conclusion: Academic studies and mental health status of middle and high school students in Sichuan, China have been negatively impacted by the COVID-19 pandemic, even after the lifting of COVID-19 restrictions. Students' academic performance, academic concerns, and mental health status should be considered for educational policymakers and institutions to improve students' academic studies and mental well-being.

Gastrinoma in multiple endocrine neoplasia type 1 after total pancreatectomy: A case report.

RATIONALE: Surgery for patients with multiple endocrine neoplasia type 1(MEN-1) related gastrinoma remains controversial and total pancreatectomy (TP) has rarely been performed. We reported a case of patient with MEN-1 related gastrinoma treated by TP. PATIENT CONCERNS: A 46-year-old female was admitted to our hospital due to abdominal distension and diarrhea for 2 years. The patient underwent pituitary tumor resection and kidney stone lithotripsy 10 years ago. DIAGNOSES: Abdominal computed tomography showed single lesion in the duodenum and multiple lesions throughout the pancreas. The patient's gastrin level was significantly increased (1080 pg/ml). These findings in combination with the pituitary tumor history suggested the presence of gastrinoma associated with MEN-1 syndrome. INTERVENTION: An exploratory laparotomy was performed. Intraoperative ultrasound confirmed the numerous tumors diffusely distributed throughout the pancreas and the patient eventually underwent TP. OUTCOMES: Twelve months later, the patient was hospitalized again for anastomotic fistula and underwent a partial gastrectomy, small bowel resection and drainage of the abscess. One month later, she received gastrostomy and jejunostomy due to digestive tract fistula, and died a month later (14 months after TP). LESSONS: There still might be the possibility of recurrence even after radical surgical resection of gastrinomas, and we suggest the need to measure the basal acid output and maintain regular anti-acid therapy in the long-term follow-up of patients with MEN-1 related gastrinoma.

[Negative symptoms predict the improvement of social functioning of patients with schizophrenia].

OBJECTIVE: To identify predictive factors associated with the improvement of social functioning of schizophrenia patients in a community. METHODS: 101 schizophrenia patients undergoing community rehabilitation were assessed with the Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale (PSP), Self-Esteem Scale (SES), Family Function Questionnaire (APGAR), and the World Health Organization Disability Assessment Scale II (WHODAS-II) twice 6 months apart. Pearson correlation and hierarchical multiple linear regression analyses were performed to identify the influencing and predictive factors associated with the improvement of social functioning. RESULTS: The increase of PSP score was correlated with age (r = 0.220), reduced PANSS negative score (r = 0.468), reduced PANSS general score (r = 0.392), reduced PANSS total score (r = 0.472), and reduced WHODAS-II Score (r = 0.247). The predictive factors of the change of PSP score followed the following order: change of PANSS negative score [the change of coefficient of determination (deltaR2 ) = 0.197], age of onset (deltaR2 = 0.048), change of WHODAS-II score and psychiatric rehabilitation (deltaR2 = 0.031). CONCLUSION: Improvement of negative symptoms predicts the short-term improvement of social functioning of schizophrenia patients.

Effectiveness RCT of a CBT intervention for youths who lost parents in the Sichuan, China, earthquake.

OBJECTIVE: Many children who lost parents in the 2008 earthquake in Sichuan Province, China, experienced symptoms of posttraumatic stress disorder (PTSD) and depression. This randomized controlled study compared the treatment effectiveness of short-term cognitive-behavioral therapy (CBT) with a general supportive intervention and with a control group of nontreatment. METHODS; Thirty-two Chinese adolescents were randomly assigned to three treatment groups. Participants were compared for psychological resilience (Connor-Davidson Resilience Scale), symptoms of PTSD (Children's Revised Impact of Events Scale), and depression (Center for Epidemiologic Studies Depression Scale) at baseline, after treatment, and three-month follow-up. RESULTS: CBT was effective in reducing PTSD and depressive symptoms and improved psychological resilience. General support was more effective than no intervention in improving psychological resilience. CONCLUSIONS: Short-term CBT group intervention seems to be a robust intervention for natural disaster victims. Short-term CBT group intervention was more effective than the general supportive intervention and the no-treatment group in enhancing psychological resilience and reducing PTSD and depression among adolescents who had lost parents in the earthquake. The general supportive intervention was effective only in improving psychological resilience.

[Clinical analysis of patients with acute and severe mental disorders complicated with hypokalemia].

OBJECTIVE: To study the occurrence and characteristics of hypokalemia to the patients with acute and severe mental disorders, and analyze its influencing factors. METHODS: There were 815 patients with actue and severe mental disorder admitted into our psychiatry department from June 2009 to May 2010, who all received the examination of potassium concentration routinely at the admission. The patients were divided into hypokalemia group and non-hypokalemia group, and the clinical information were surveyed and compared between the two groups to find out the influencing factors of hypokalemia. RESULTS: There were 177 patients with hypokalemia, and the proportion was 21.72%. Between the two groups, the difference of age, sex, admission season, whether with physical diseases and diagnosis were statistically significant (P < 0.05), while spiritual movement situation was not significant different (P > 0.05). Spearman rank correlation analysis showed that the incidence of hypokalemia was negatively correlated with age (r = -0.55, P = 0.00). Furthermore, multivariate analysis found that women, poor diet and physical disease were risk factors of hypolalemia (P < 0.05). CONCLUSION: There is relatively high probability of hypokalemia occurrence to the patients with acute and severe mental disorders, which should be distinguished and treated at the admission timely.

[Telephone follow-up improves quality of life of postoperative patients with severe acute pancreatitis].

OBJECTIVE: To evaluate the impact of telephone follow-up on the quality of life of postoperative patients with severe acute pancreatitis. METHODS: 109 postoperative patients with severe acute pancreatitis were divided into interventional and control groups randomly. Telephone follow-up was given to the patients in the interventional group 1 week, 1 month, 3 months and 6 months after discharge. The patients in the control group received routine discharge guidance only. The quality of life of the patients was assessed with the Generic Quality of Life Inventory 6 months after discharge. The disease-related knowledge and incidence of complications of the patients were also assessed. RESULTS: The patients who received telephone follow-up had greater quality of life scores in physical function, psychological function and social function than the controls (P < 0.05). The interventional group also had better disease-related knowledge (P < 0.05) and lower incidence of complications such as jejunostoma tube plugging and recurrence than the control group (P < 0.05). CONCLUSION: Telephone follow-up improves the quality of life of postoperative patients with severe acute pancreatitis and reduces the incidence of complications.

[A study on the psychological state of nurse-students of a university in affected areas of Wenchuan earthquake].

BACKGROUND: The 8.0-magnitude earthquake that struck Wenchuan County in Sichuan was the most destructive earthquake to hit China since the People's Republic of China was founded in 1949. It caused great environmental harm and property damage, and brought considerable psychological stress and emotional problems to many in the population. PURPOSE: This study was designed to investigate the psychological state of nursing students studying at a university located within the Wenchuan earthquake zone. METHODS: Nurses were recruited using a striated cluster sampling approach. The study was conducted using a self-designed questionnaire, Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Social Support Rating Scale (SSRS) and Coping Style Questionnaire. RESULTS: Most (68.8%) participants lacked sufficient knowledge regarding the earthquake, and the social support condition of college nursing students was lower than the population average (p < .001). However, degree of anxiety and depression was higher than the population average (p < .001). SSRS scores and its three dimensions were positively correlated with SAS scores and negatively correlated with SDS scores (p < .001). Participants most often employed basic problem solving approaches to deal with psychological conflicts arising from their earthquake experience. No significant difference between nursing students in different class years in terms of study variables was identified. CONCLUSION: Nursing students in areas affected by the Wenchuan earthquake suffer from anxiety and depression disorders. Adequate social support represents an important intervention needed to maintain and enhance their mental health.