A comparison of clinical characteristics of psychiatric inpatients in three hospitals from Western China and America.

BACKGROUND: Different countries have differences in social and cultural context and health system, which may affect the clinical characteristics of psychiatric inpatients. This study was the first to compare cross-cultural differences in the clinical characteristics of psychiatric inpatients in three hospitals from Western China and America. METHODS: Overall, 905 and 1318 patients from three hospitals, one in America and two in Western China, respectively, were included. We used a standardised protocol and data collection procedure to record inpatients' sociodemographic and clinical characteristics. RESULTS: Significant differences were found between hospitals from the two countries. Positive symptoms were the main reason for admission in the Chinese hospitals, while reported suicide and self-injury symptoms more frequently led to hospital admission in America. Moreover, there were more inpatients with combined substance abuse in the American hospital (97.6% vs. 1.9%, P < 0.001). The length of stay (LOS) in America was generally shorter than in China (10.5 ± 11.9 vs. 20.7 ± 13.4, P < 0.001). The dosage of antipsychotic drugs used in the American hospital was higher than in China (275.1 ± 306.9 mg vs. 238.3 ± 212.5 mg, P = 0.002). Regression analysis showed that male sex, older age, retirees, being admitted because of physical symptoms, and using higher doses of antipsychotic drugs were significantly associated with longer hospitalisation in the American hospital (P < 0.05). Comparatively, patients who were divorced, experiencing suicidal ideation, admitted involuntarily, admitted because of physical, depression, or anxiety symptoms, and using higher doses of antipsychotic drugs had longer hospitalisation in Chinese hospitals (P < 0.05). CONCLUSION: Significant variations in clinical characteristics of inpatients were found between hospitals from Western China and America. The LOS in Chinese hospitals was significantly longer, but patients used higher doses of antipsychotic drugs in the American hospital. Admission due to physical symptoms and the use of higher dosage drugs were related to longer LOS in both countries.

Association of incident angina pectoris and rapid eye movement sleep in a large community-based study: the sleep heart health study.

BACKGROUND: Sleep-disordered breathing may precipitate angina pectoris (AP) in rapid eye movement (REM) sleep. The purpose of this study was to investigate whether REM sleep is associated with the incidence of AP in different categories of apnea-hypopnea index (AHI). METHODS: A total of 2710 participants from Sleep Heart Health Study (59.3% women; mean age 61.7 years), who had 6-8 h of sleep; experienced an almost 11-year follow-up period. Complete polysomnography data and medical records were available for all participants. Percentage of REM sleep time (REM%) was classified into grade 1 (<20%), grade 2 (20-25%) and grade 3 (>25%). Logistic regression analysis was used to characterize the independent association between REM sleep and prevalent AP in this multi-center community-based cohort study. RESULTS: Patients with REM% of grade 3 had a higher incidence of AP than those with grade 1 and grade 2 (50.3% vs 42.4% vs 42.1%, respectively; p = 0.003). After adjusting for age, gender, race, AHI, marital status, education level, body mass index, sleep duration, arousal index, diabetes, hypertension and smoking status, multivariate logistic regression analysis revealed that REM% >25% was independently associated with the occurrence of AP (odds ratio = 1.500; 95% confidence interval = 1.188-1.894; p = 0.001). CONCLUSIONS: The percentage of REM sleep time may affect the incidence of AP irrespective of AHI level. Therefore, the relationship between sleep structure and cardiovascular disease merits further exploration.