A cross-sectional analysis of registry data of severe mental disorders in Fuzhou, China: current status and prospects.

OBJECTIVE: To investigate the proportion of registered cases relative to size, distribution characteristics, medication status, and management status of patients diagnosed with severe mental disorders (SMD) in Fuzhou. The medication status and management status were compared between patients in urban and non-urban areas to provide scientific evidence for improving SMD care, control, and treatment in primary health care institutions. METHODS: Data (case types, demographic data, distribution data, medication status, and management status, etc.) of patients diagnosed with SMD in 12 districts, counties, and prefectures in the urban and non-urban areas of Fuzhou City were collected from October 2017 to September 2018. Three distributions (population, local, and districts/counties) were used to describe the proportion of registered cases relative to size and clinical characteristics of diagnosed SMD. Chi squared (χ2) test was used to compare the severity in urban and non-urban areas. RESULTS: A total of 30,362 registered SMD patients were identified in Fuzhou City of which schizophrenia accounted for the highest number of cases (26,204, 86.31%), and paranoid psychosis had the least number of cases (47, 0.15%). Moreover, approximately half of SMD patients were 18 to 44 years old (45.38%). Close to one third of patients were farmers (30.23%), had a primary school or lower education level (54.17%), were poor, with most below the poverty line (55.35%). The proportion of diagnosed SMD relative to size was highest in Minqing County (0.53%) and lowest in Mawei District (0.38%). A total of 22,989 (75.72%) of the patients were taking medications, and only 17,509 (57.67%) were taking medications regularly. Moreover, the percentage of cases taking medications and those taking medications regularly were higher in urban areas than in non-urban areas (P<0.05). A total of 3065 patients were registered for management (10.09%). The managed proportion of SMD cases was higher in the urban areas than in the non-urban areas (P < 0.05). CONCLUSION: Schizophrenia is a key disease for comprehensive care and control of severe mental disorders in Fuzhou. The management of severe mental disorders should focus on poor groups with low educational backgrounds. Drug usage and management are better in urban areas than in non-urban areas, and thus management should be enhanced in non-urban areas. The medication management and case management of patients with severe mental disorders in Fuzhou need further improvements.

Sleep health and its related influencing factors in primary and middle school students in Fuzhou: A large multi-center cross-sectional study.

Background: This current study set out to investigate the status of sleep health in 7-20-year-old students in Fuzhou and explore the related influencing factors of sleep health. Methods: A total of 38,467 children and adolescents in Fuzhou were included in the study through a random stratified cluster sampling. Data were collected from May to June 2019, in 18 primary schools and 18 middle schools from nine districts, Fuzhou. Children's parents and adolescents of sampled classes were invited to fill out a series of questionnaires about the performance of the last 6 months (sociodemographic characteristics, sleep-related lifestyle behaviors, and electronic-products usage). Multiple linear regression was carried out to analyze data. Results: Of the total 40,888 questionnaires we released, 38,467 were valid and effective with the response rate was 94.08%. The age of the surveyed participants was 11.85 ± 3.1, including 20,013 boys and 18,454 girls. The multiple linear regression analysis identified factors associated with sleep health (p < 0.05): Boy (coef = 0.073, 95% CI: 0.030-0.115), age (coef = 1.797, 95% CI: 0.224-0.243), key school (coef = 2.069, 95% CI: 0.105-0.193), urban (coef = 0.096, 95% CI: 0.054-0.139), excessive daytime sleepiness (coef = 0.535, 95% CI: 0.432-0.639), unhealthy sleep habits (coef = 0.363, 95% CI: 0.307-0.419), eating before sleep (coef = 0.578, 95% CI: 0.527-0.630), using electronic products in bedroom (coef = 0.074, 95% CI: 0.028-0.121), screen time per day during school (coef = 0.260, 95% CI: 0.235-0.284), frequency of using electronics 30 min before bedtime (coef = 0.150, 95% CI: 0.134-0.166), strained relationship with parents (coef = 0.361, 95% CI: 0.270-0.452), strained relationship with peers (coef = 0.267, 95% CI: 0.171-0.363), excessive homework or learning (coef = 0.189, 95% CI: 0.141-0.237), time for doing homework (coef = 0.266, 95% CI: 0.245-0.287), and mood swings frequently (coef = 1.174, 95% CI: 1.127-1.221) negatively impact sleep health. Sleep alone (coef = -0.204, 95% CI: -0.262-0.147) were the risk factors for sleep health. Furthermore, frequent mood swings was considered the most influential factor on overall variables. Conclusions: Sleep health is associated with factors covered sociodemographic characteristics, family sleep habits, and routine activities before bedtime. Multiple measures should be taken to improve sleep quality in a targeted manner.

International Technologies on Prevention and Treatment of Neurological and Psychiatric Diseases: Bibliometric Analysis of Patents.

BACKGROUND: Neurological and psychiatric disorders are serious and expensive global public health problems. Therefore, exploring effective intervention technologies plays an important role in improving patients' clinical symptoms and social functions, as well as reducing medical burden. OBJECTIVE: The aim of this study is to analyze and summarize the key new technologies and innovative development trends witnessed globally for neurological illness and psychiatric disorders by mining the relevant patent data. METHODS: A bibliometric analysis was conducted on patent applications, priority countries, main patentees, hot technologies, and other patent information on neurological and psychiatric disorders, revealing the current situation along with the trend of technology development in this field. RESULTS: In recent years, inventions and innovations related to neurological and psychiatric diseases have become very active, with China being the largest patent priority country. Of the top patent holders, Visicu (headquartered in the United States) is the leader. The distribution of patent holders in China remains relatively scattered, with no monopoly organization at present. Global technologies on neurological illness and psychiatric disorders are mainly concentrated around A61B (diagnosis, surgery, and identification). CONCLUSIONS: This paper analyzed and summarized the key new technologies and global innovative development trends of neurological and psychiatric diseases by mining the relevant patent data, and provides practical references and research perspectives for the prevention and treatment of the aforesaid diseases.

Reliability and validity of the Pittsburgh Sleep Quality Index among frontline COVID-19 health care workers using classical test theory and item response theory.

STUDY OBJECTIVES: The applicability of sleep-related scales to frontline medical staff for the COVID-19 pandemic has not been fully proved, so sleep survey results lack credibility and accuracy, creating difficulties for the guidance and treatment of frontline medical staff with sleep disorders, which is not conducive to the prevention and control of COVID-19. This study sought to analyze the reliability and validity of the Pittsburgh Sleep Quality Index (PSQI) among frontline medical staff fighting the COVID-19 pandemic. METHODS: A network questionnaire survey was used to investigate the PSQI among frontline medical staff who fought COVID-19 in Wuhan, China from March 19 to April 15, 2020. Combined with classical test theory and item response theory, the content validity, internal consistency, construct validity, and other aspects of the PSQI were evaluated. RESULTS: According to classical test theory, content validity, criterion validity, and construct validity of the PSQI were good. But the internal consistency was better after the deletion of the "daytime dysfunction" subscale. With regard to item response theory, difficulty, the differential item function, and the Wright map performed well. CONCLUSIONS: The original PSQI showed acceptable applicability in frontline COVID-19 medical staff, and its characteristics moderately improved after the "daytime dysfunction" subscale was removed. CITATION: Wang L, Wu Y-X, Lin Y-Q, et al. Reliability and validity of the Pittsburgh Sleep Quality Index among frontline COVID-19 health care workers using classical test theory and item response theory. J Clin Sleep Med. 2022;18(2):541-551.

Association study of hsa_circ_0001946, hsa-miR-7-5p and PARP1 in coronary atherosclerotic heart disease.

BACKGROUND: Our previous work identified an aberrant expression of hsa_circ_0001946 in coronary atherosclerotic heart disease (CHD). Here we aimed to verify the role of hsa_circ_0001946 as a biomarker for CHD, and explore the clues of its downstream regulation. METHODS: The hsa_circ_0001946 expression in CHD patients (n = 120) and controls (n = 120) were confirmed with qRT-PCR. CircBank and miRDB were used for target analysis in silico. Spearman correlation test was performed to infer potential interrelationships among the nucleic acid molecular biomarkers, and their predictive abilities were examined using receiver operating characteristic (ROC) curves. RESULTS: Hsa_circ_0001946 was validated to be significantly up-regulated in the peripheral blood mononuclear cells of CHD patients, and revealed as an independent indicator of increased CHD risk (odds ratio: 2.364; 95% confidence interval [CI]: 1.765-3.165) after adjusting for confounding factors. Hsa-miR-7-5p was found to own the largest number of binding sites in has_circ_0001946 sequence, and among its targets predicted, the poly ADP-ribose polymerase 1 (PARP1) has been implicated in the pathophysiology of CHD. Spearman analysis indicated negative correlations of hsa-miR-7-5p with hsa_circ_0001946 and PARP1, respectively; while hsa_circ_0001946 was positively correlated with PARP1. The prediction accuracy of hsa_circ_0001946 in CHD was evaluated, showing an area under the ROC curve of 0.897 (95% CI: 0.791-0.961), which could further increase to 0.957 (95% CI: 0.870-0.992) upon a combination of hsa-miR-7-5p and PARP1. CONCLUSION: The present work demonstrated the predictive power of hsa_circ_0001946, hsa-miR-7-5p and PARP1 as combined biomarkers for CHD, and suggests a regulatory axis they consisted might contribute to the CHD development.

Risk factors for disease severity in COVID-19 patients: A single-center retrospective study.

Background: The outbreak of coronavirus disease 2019 (COVID-19) has posed a huge threat to human health. However, little is known regarding the risk factors associated with COVID-19 severity. We aimed to explore early-stage disease risk factors associated with eventual disease severity. Methods: This study enrolled 486 hospitalized, non-intensive care unit (ICU)-admitted adult patients with COVID-19 (age ≥ 18 years) treated at Wuhan Jinyintan Hospital, who were divided into three groups according to disease severity. The demographic, clinical, and laboratory data at admission and clinical outcomes were compared among severity groups, and the risk factors for disease severity were identified by multiple regression analysis. Results: Of 486 patients with COVID-19, 405 (83.33%) were discharged, 33 (6.71%) died outside of the ICU, and 48 (7.20%) were still being treated in the ICU by the time the study period ended. Significant differences in age, lymphocyte counts, and the levels of procalcitonin, aspartate aminotransferase, and D-dimer (P < 0.001 for all) among the three groups. Further analysis showed that older age, decreased lymphocyte counts, and increased procalcitonin, aspartate aminotransferase, and D-dimer levels were significantly associated with disease progression. Conclusion: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may impair the immune system, the blood coagulation system, and hepatic and cardiac function. Some clinical characteristics and laboratory findings can help identify patients with a high risk of disease severity, which can be significant for appropriate resource allocation during the COVID-19 pandemic.

Weekday and weekend sleep deprivation are associated with recurrent nightmare in adolescents: a cross-sectional study.

OBJECTIVE: Our study aimed to investigate the association between sleep deprivation and parasomnias including nightmare and sleepwalking in Chinese adolescents. METHODS: A total of 19,229 high school students aged 10-20 in Fuzhou were invited to complete questionnaires regarding sleep duration, parasomnias including nightmare and sleepwalking, and emotional problems. Subjects with sleep deprivation (SD) defined as sleeping less than 8 h either on weekdays or on weekends were categorized as three groups: weekday SD, weekend SD and habitual SD. RESULTS: The prevalence of recurrent nightmare was significantly higher for subjects with SD (SD vs non sleep deprivation (NSD): 7.6% vs 3.7%). In all subjects, habitual SD was associated with the highest risk of recurrent nightmare [Odds ratio (OR) = 2.19, 95% Confidential interval (95% CI) = 1.73-2.75, P < 0.001], followed by weekday SD (OR = 2.06, 95% CI = 1.64-2.61, P < 0.001) and weekend SD (OR = 1.45, 95% CI = 1.01-2.08, P = 0.045). No significant association was found between sleepwalking and sleep deprivation. In further age-based (10-13/14-17 years) and sex-based subgroup analyses, the findings were consistent except that association between weekend SD and recurrent nightmare disappeared among subjects aged 14-17 or among girls. CONCLUSIONS: Our study found a significant association between recurrent nightmare and sleep deprivation either on weekdays or on weekends in adolescents, which was stronger with more deprivation episodes. No significant association was found between sleepwalking and sleep deprivation. Association between weekend SD and recurrent nightmare disappeared among subjects aged 14-17 or among girls.

Reduced Sleep Duration and Sleep Efficiency Were Independently Associated With Frequent Nightmares in Chinese Frontline Medical Workers During the Coronavirus Disease 2019 Outbreak.

OBJECTIVES: Nightmares were related to emotion and behavioral problems and also emerged as one of the core features of post-traumatic stress disorder (PTSD). Our study aimed to investigate the associations of frequent nightmares with sleep duration and sleep efficiency among frontline medical workers in Wuhan during the coronavirus disease 2019 (COVID-19) outbreak. METHODS: A total of 528 health-care workers from the province of Fujian providing medical aid in Wuhan completed the online questionnaires. There were 114 doctors and 414 nurses. The age, sex, marital status, and work situation were recorded. A battery of scales including the Pittsburgh Sleep Quality Index (PSQI) and the 12-item General Health Questionnaire (GHQ-12) were used to evaluate subjects' sleep and general mental health. Frequent nightmares were defined as the response of at least once a week in the item of "nightmare" of PSQI. RESULTS: Frequent nightmares were found in 27.3% of subjects. The frequent nightmare group had a higher score of PSQI-sleep duration and PSQI-habitual sleep efficiency (frequent nightmares vs. non-frequent nightmares: PSQI-sleep duration, 1.08 ± 0.97 vs. 0.74 ± 0.85, P < 0.001; PSQI-habitual sleep efficiency, 1.08 ± 1.10 vs. 0.62 ± 0.88, P < 0.001). Reduced sleep duration and reduced sleep efficiency were independently associated with frequent nightmares after adjustment for age, sex, poor mental health, and regular sleeping medication use (reduced sleep duration: OR = 1.96, 95% CI = 1.07-3.58, P = 0.029; reduced sleep efficiency: OR = 2.17, 95% CI = 1.09-4.32, P = 0.027). Subjects with both reduced sleep duration and sleep efficiency were also associated with frequent nightmares (OR = 2.70, 95% CI = 1.57-4.65, P < 0.001). CONCLUSION: The present study found that sleep duration and sleep efficiency were both independently associated with frequent nightmares among frontline medical workers in Wuhan during the COVID-19 pandemic. We should pay attention to nightmares and even the ensuing PTSD symptoms among subjects with reduced sleep duration or sleep efficiency facing potential traumatic exposure.