Depression, Rumination, and Suicide Attempts in Adolescents With Mood Disorders: Sex Differences in This Relationship.

Abstract.Background: Sex differences in suicide attempts have been widely recognized across domains such as depression and rumination. The relationship between depression, rumination, and suicide attempts in mood disorders has been studied before; however, how they interact across sexes remains unclear. This study aimed to examine the sex differences in the relationship between depression, rumination, and suicide attempts in Chinese adolescents with mood disorders.Methods: We recruited 681 adolescents with mood disorders who met ICD-10 criteria for having unipolar or bipolar depression with a current depressive episode at the time of the study and collected demographic and clinical data.Results: The prevalence of suicide attempts in female adolescents with mood disorders (64.36%) was significantly higher than that in male adolescents with mood disorders (49.47%), with an odds ratio of 1.84 (95% CI, 1.31-2.59). Regression analysis showed that PHQ-9 was independently associated with suicide attempts among male adolescents with mood disorders, while in female adolescents with mood disorders, total scores of PHQ-9 and RRS-10 were independently associated with suicide attempts. Importantly, in female adolescents with mood disorders, the mediating effect of RRS-10 total score on the relationship between PHQ-9 and suicide attempts was significant (standardized ß = 0.005, P = 0.003, 95% CI, 0.002-0.008), the mediating effect accounted for 31.25% of the total effect of depressive symptoms on suicide attempts.Conclusions: Our study suggests that there are sex differences in depression, rumination, and suicide attempts and in the interaction between them in adolescents with mood disorders. These sex differences may have important clinical implications, both for improving strategies to detect suicidal behaviors and for developing better early intervention programs for this population.

Suicide attempts and non-suicidal self-injury in Chinese adolescents: Predictive models using a neural network model.

INTRODUCTION: Suicide attempts (SA) are a significant contributor to suicide deaths, and non-suicidal self-injury (NSSI) can increase the risk of SA. Many adolescents experience both NSSI and SA, which are affected by various factors. This study aimed to identify the risk factors and essential warning signs of SA, establish a predictive model for SA using multiple dimensions and large samples, and provide a multidimensional perspective for clinical diagnosis and intervention. METHODS: A total of 9140 participants aged 12-18 years participated in an online survey; 6959 participants were included in the statistical analysis. A multilayer perceptron algorithm was used to establish a prediction model for adolescent SA (with or without); adolescents with NSSI behavior were extracted as a subgroup to establish a prediction model. RESULTS: Both the prediction model performance of the SA group and the NSSI-SA subgroup were strong, with high accuracy, and AUC values of 0.93 and 0.88, indicating good discrimination. Decision curve analysis (DCA) demonstrated that the clinical intervention value of the prediction results was high and that the clinical intervention benefits of the NSSI-SA subgroup were greater than those of the SA group. CONCLUSIONS: Our study demonstrated that the predictive model has a high degree of accuracy and discrimination, thereby identifying significant factors associated with adolescent SA. As long as adolescents exhibit NSSI behavior, relative suicide interventions should be implemented to prevent future hazards. This study can provide guidance and more nuanced insights for clinical diagnosis as well as a foundation for clinical treatment.

Rumination and Depression in Chinese Adolescents With Mood Disorders: The Mediating Role of Resilience.

Background: Adolescent mood disorders (MD) have become an important public health problem worldwide. However, the psychopathological mechanisms underlying the occurrence of adolescent MD remain poorly elucidated. Therefore, in this study, we explored the mediating role of psychological resilience in the effects of rumination on depression in Chinese adolescents with MD.Methods: A total of 569 adolescent MD patients were included. Recruitment took place between October 2019 and June 2022. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. The 21-item Chinese version of the Ruminative Responses Scale (RRS) was used to assess rumination, and the 10-item Chinese version of the Connor-Davidson Resilience Scale (CD-RISC-10) was used to measure psychological resilience.Results: The prevalence of MD in adolescents with severe depressive symptoms (SDS) was 46.05%. The prevalence of SDS was much higher in females (50.75%) than in males (35.09%). The prevalence of SDS was much higher in adolescents with MD living with grandparents (56.25%) and living in single-parent families (61.36%) than in those living with parents (43.00%) and those having one parent who was away for a long time (40.00%). Adolescents with MD and also with SDS had higher levels of rumination and lower levels of psychological resilience than adolescents without SDS. Resilience partially mediated the relationship between rumination and depression.Conclusions: Lifestyle influences the severity of depressive symptoms in adolescents with MD. Rumination and psychological resilience were the risk and protective factors for SDS in adolescents with MD, respectively. Furthermore, resilience can reduce the impact of rumination on depressive symptoms, suggesting that clinical interventions to improve patients' resilience and reduce rumination may be a viable consideration for adolescents with MD.

Depression and suicide attempts in Chinese adolescents with mood disorders: the mediating role of rumination.

Mood disorders (MD) are often associated with a higher incidence of suicidal behavior, especially in adolescent patients. However, the mechanisms by which depression affects suicide attempts in adolescents with MD remain poorly elucidated. Therefore, the purpose of this study was to determine the incidence, risk factors, and clinical correlates of suicide attempts in Chinese adolescent patients with MD, as well as the inter-relationship between depressive symptoms, rumination, and suicide attempts, and the role of rumination in mediating depression and suicide attempts. A total of 331 MD adolescent patients aged 11 ~ 18 years were recruited from a psychiatric hospital. Suicide attempts were assessed with the MINI Suicide Scale. Depressed symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9). To assess rumination, we used the 21-item Chinese version of the Ruminative Responses Scale (RRS). Overall, the percentage of suicide attempts among MD adolescents was 51.96%, with a higher percentage of females (58.62%) than males (36.36%). Compared to non-suicide attempters, suicide attempters had higher scores on PHQ-9, RRS, depression-related, brooding, and reflective pondering. Gender and RRS were independently associated with suicide attempts. Rumination played a fully mediating role between depression and suicide attempts. In addition, the mediating effect of depression between rumination and suicide attempts was not significant. The incidence of suicide attempts was higher in MD adolescents than in general adolescents. Gender and rumination were associated with suicide attempts in MD adolescents. Moreover, rumination mediated the correlation between depressive symptoms and suicide attempts, suggesting that rumination may be an important intervention component for clinical staff to prevent suicidal behavior in adolescents with MD.

Effects of fluorinated solvents on electrolyte solvation structures and electrode/electrolyte interphases for lithium metal batteries.

Electrolyte is very critical to the performance of the high-voltage lithium (Li) metal battery (LMB), which is one of the most attractive candidates for the next-generation high-density energy-storage systems. Electrolyte formulation and structure determine the physical properties of the electrolytes and their interfacial chemistries on the electrode surfaces. Localized high-concentration electrolytes (LHCEs) outperform state-of-the-art carbonate electrolytes in many aspects in LMBs due to their unique solvation structures. Types of fluorinated cosolvents used in LHCEs are investigated here in searching for the most suitable diluent for high-concentration electrolytes (HCEs). Nonsolvating solvents (including fluorinated ethers, fluorinated borate, and fluorinated orthoformate) added in HCEs enable the formation of LHCEs with high-concentration solvation structures. However, low-solvating fluorinated carbonate will coordinate with Li+ ions and form a second solvation shell or a pseudo-LHCE which diminishes the benefits of LHCE. In addition, it is evident that the diluent has significant influence on the electrode/electrolyte interphases (EEIs) beyond retaining the high-concentration solvation structures. Diluent molecules surrounding the high-concentration clusters could accelerate or decelerate the anion decomposition through coparticipation of diluent decomposition in the EEI formation. The varied interphase features lead to significantly different battery performance. This study points out the importance of diluents and their synergetic effects with the conductive salt and the solvating solvent in designing LHCEs. These systematic comparisons and fundamental insights into LHCEs using different types of fluorinated solvents can guide further development of advanced electrolytes for high-voltage LMBs.

Sexual Dysfunction in Chronically Medicated Male Inpatients With Schizophrenia: Prevalence, Risk Factors, Clinical Manifestations, and Response to Sexual Arousal.

BACKGROUND: Sexual dysfunction is a common symptom in patients with schizophrenia, especially in chronically medicated patients. However, the relationship between sexual dysfunction and emotional response to sexual arousal in male patients with schizophrenia remains unclear. This study aimed to assess the incidence, risk factors of sexual dysfunction in males, and their clinical correlations to sexual arousal in male patients with schizophrenia in China. METHODS: A total of 162 male patients, aged 18-50 years, with schizophrenia were recruited from a psychiatric hospital in Ganzhou. The clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). The Arizona Sexual Experience Scale was utilized to evaluate sexual dysfunction. Erotic images were selected from International Affective Picture System (IAPS). Sixty-eight out of the 162 subjects completed the erotic pictures reactivity task. RESULTS: Overall, 48 (29.6%) patients were measured as having global sexual dysfunction, 72 (44.4%) patients as having strength of sex drive dysfunction, 51 (31.5%) patients as having sexual arousal dysfunction, 55 (34.0%) patients as having penile erection dysfunction, 60 (37.0%) patients as having reached orgasm dysfunction, and 60 (37.0%) patients as having satisfaction with orgasm dysfunction. The sexual dysfunction patients had significantly higher scores on the negative symptoms of the PANSS. The only important predictor of sexual dysfunction was the severity of PANSS negative factor. The sense of pleasure and arousal post viewing erotic images in the sexual dysfunction group were lower compared to the non-sexual dysfunction group. The sense of pleasure and approach motivation were significantly negatively correlated with the severity of sexual dysfunction. CONCLUSIONS: This study shows that nearly one-third of young and middle-aged chronically medicated male inpatients with schizophrenia suffer from sexual dysfunction. The negative factor of the PANSS can be regarded as the risk factor of sexual dysfunction. Schizophrenia patients with sexual dysfunction experienced lower pleasure and higher avoidance motivation than non-sexual dysfunction patients when exposed to erotic stimuli.

Prevalence and Related Factors of Insomnia Among Chinese Medical Staff in the Middle and Late Stage of COVID-19.

Background: The outbreak of novel coronavirus disease (COVID-19) has brought serious psychological pressure to people, especially medical health staff. At present, there are few studies on insomnia and related factors of medical health staff in the middle and late stage of the epidemic of COVID-19. Therefore, the purpose of this study was to investigate the prevalence of insomnia and its related risk factors among medical workers in China in the middle and later stage of COVID-19 epidemic, as well as the relationship between insomnia and psychological resilience. Methods: From February 14 to March 29, 2020, a cross-sectional survey was conducted among 606 medical staff in China through Ranxing Technology's "SurveyStar" network platform. All subjects were assessed with the Insomnia Severity Index (ISI) and simplified Chinese version of Connor-Davidson Resilience scale (CD-RISC-10). Results: In the middle and later stages of the COVID-19 outbreak, the incidence of insomnia among medical staff was 32.0%. Compared with non-insomnia group, the insomnia group had younger age, lower education level, longer daily working hours and less psychological resilience. In addition, the prevalence of insomnia was higher in medical staff with a history of somatic diseases. The severity of insomnia of Chinese medical staff was associated with age, education level, daily working hours, psychological resilience and somatic diseases. Conclusions: Our study shows that nearly 1/3 of Chinese medical workers suffer from insomnia nearly a month after the COVID-19 outbreak. Compared with the general population, medical staff who are working with COVID are more prone to insomnia. Risk factors for insomnia include younger age, lower education level, longer working hours per day, and physical illness. The tenacious dimension of psychological resilience is a protective factor for insomnia.

Obesity in Chinese patients with chronic schizophrenia: Prevalence, clinical correlates and relationship with cognitive deficits.

The prevalence of obesity in schizophrenia patients is high, especially in chronic and medicated patients. Few studies have explored the relationships between obesity, cognition and clinical correlates in patients with schizophrenia. This study was designed to assess the prevalence and clinical correlates of obesity and its relationship to cognitive impairment in Chinese patients with schizophrenia. We recruited 633 inpatients and collected clinical, demographic data and lipid parameters. The Positive and Negative Syndrome Scale (PANSS) and its five-factor model were adopted for psychopathological symptoms. The prevalence of comorbid obesity in schizophrenia patients was 16.4%. The plasma levels of glucose, triglyceride, low density lipoprotein (LDL), apolipoprotein B, and cholesterol were higher, but high density lipoprotein (HDL) levels were lower in obese patients than those in non-obese patients (all p < 0.05). Furthermore, obese patients had lower PANSS negative symptom, cognitive factor and total scores than non-obese patients (all p < 0.05). Correlation analysis showed a significant correlation between BMI and the following variables: age, marriage, gender, negative symptoms, general psychopathological symptoms, cognitive factor, PANSS total score, glucose, triglycerides, HDL, LDL, cholesterol and apolipoprotein B (all p < 0.05). Further multiple regression showed that PANSS cognitive factor, PANSS total score, and triglyceride were important independent predictors of obesity. Our results indicate a high prevalence of obesity in Chinese patients with chronic schizophrenia. Multiple demographics, clinical variables, and lipid parameters are associated with obesity in schizophrenia. Moreover, obesity appears to be a protective factor for psychological symptoms. However, not having objective assessments for cognition in this study is a limitation.

Research Progress toward the Practical Applications of Lithium-Sulfur Batteries.

The renaissance of Li-S battery technology is evidenced by the intensive R&D efforts in recent years. Although the theoretical capacity and energy of a Li-S battery is theoretically very high, the projected usable energy is expected to be no more than twice that of state-of-the-art Li-ion batteries, or 500 Wh/kg. The recent "sulfur fever" has certainly gathered new knowledge on sulfur chemistry and electrochemistry, electrolytes, lithium metal, and their interactions in this "new" system; however, a real advance toward a practical Li-S battery is still missing. One of the main reasons behind this is the sensitivity of Li-S batteries to the experimental testing parameters. Sophisticated nanostructures are usually employed, while the practicality of these nanomaterials for batteries is rarely discussed. The sulfur electrode, usually engineered in a thin-film configuration, further poses uncertainties in the knowledge transfer from the lab to industry. This review article briefly overviews the recent research progress on Li-S batteries, followed by a discussion of the Li-S battery system from the authors' own understandings collected from their past few years of research. The critical findings, the unresolved issues, and the scientific gap between lab research and industrial application are discussed. The future work in Li-S battery research is also explored to propel relevant research efforts toward industrial applications.