Logistic Regression Analysis on the Correlation between Physical Diseases and Life Events and Depression in the Elderly

[Objectives]This study was conducted to explore the effects of physical diseases and life events on depression among urban elderly people.[Methods]Five hundred urban elderly people in Shiyan City were selected using a convenient sampling method to investigate and diagnose depression using the Geriatric Mental State Schedule and its accompanying computer diagnostic system.The Minimum Data Set(MDS)and related factor survey form were used to investigate physical diseases and life events,and statistical analysis was conducted using methods such as logistic regression analysis and factor analysis.[Results]The prevalence rates of angina,stroke,or partial paralysis,migraine,vision problems,hyperthyroidism or hypothyroidism,as well as the number of physical diseases were significantly higher in elderly depression patients than in objects free of depression.Stroke or partial paralysis[OR(95%CI)=6.389(1.684,24.237)],emotional trauma events[OR(95%CI)=1.438(1.069,1.934)]and adverse health and economic events[OR(95%CI)=1.652(1.099,2.483)]were risk factors for late life depression(LLD).[Conclusions]Some physical diseases and life events may affect the onset process of depression in urban elderly people,and various measures need to be taken to reduce the risk of physical diseases and life events on depression.

Coping as a Mechanism Linking Stressful Life Events and Mental Health Problems in Adolescents

Objective Although stressful life events represent an etiologic factor of mental health problems in adolescents, few studies have been conducted to address mechanisms linking the stress-psychopathology relation. The present study was designed to examine coping as a mediate factor on the relationship between stressful life events and symptoms of anxiety and depression. Methods The participants were 13 512 students from eight cities of China, who participated in a school-based survey. Data were collected by a questionnaire comprising coping, stressful life events, anxiety, and depressive symptoms. As a model, a series of regression equations were used to examine whether coping mediated the association between stressful life events and symptoms of anxiety and depression. Results Each dimension of stressful life events showed significant correlation with anxiety, depression and coping （all P〈0.001）. In the model to analyze mediate effects, all standardized coefficients （β） were significant （all P〈0.01）, indicating marked mediator effects. Furthermore, negative coping might account for more mediate effects than positive coping on this relationship. Conclusion Coping partially mediated the relationship between stressful life events and mental health during adolescence. This study highlighted an important public health priority for preventive interventions targeting stress-related psychopathology, and for further promoting adolescents＇ mental health.

Stressful life events,psychosocial health and general health in preschool children before age 4

Background The impact of stressful life events(SLEs)in early childhood is often ignored.We aimed to examine longitudinal associations between SLEs and psychosocial and general health in preschool children.Methods Twelve SLEs occurring before the age of 24 months were assessed and categorized by frequency(no events,1-2 SLEs,and>2 SLEs)and overall tension(no events,low,and high)(n=1431).Psychosocial and general health were meas-ured three times at the age of 24,36 and 45 months.The associations were examined by logistic regression models using generalized estimating equations to handle repeated measurements.Results Half(48.4%)of the families experienced SLEs,and 23.8%perceived high-tension SLEs before the children were aged 24 months.Gender differences were observed in the association between SLEs and psychosocial health.Compared to girls without SLEs,girls who experienced>2 SLEs[OR=3.31,95%confidence interval(CI)2.05-5.35]or high-tension SLEs(OR=3.01,95%CI 2.07-4.39)had higher odds of psychosocial problems from 24 to 45 months.The odds ratios in boys were 2.10(95%CI 1.36-3.24)and 1.47(95%CI 1.06-2.03),respectively.Moreover,only girls'risk of psychosocial problems increased after experiencing 1-2 SLEs(OR=2.15,95%CI 1.54-3.00)or low-tension SLEs(OR=1.90,95%CI 1.31-2.74).Regarding general health,children who experienced>2 SLEs(OR=1.96,95%CI 1.21-3.18)and high-tension SLEs(OR=1.60,95%CI 1.12-2.28)had higher odds of poor general health from 24 to 45 months.Conclusions The findings emphasized that young children's psychosocial and general health can be impacted by experienc-ing SLEs in early childhood.Attention and adequate support for families experiencing SLEs are needed to minimize the potential negative effect of SLEs on child health,particularly in girls.

An Examination of the Validity of the Differentiation-of-Self Hypothesis and Its Mechanism Related to Negative Life Event Aversion among Japanese University Students

This study examined the validity of the differentiation-of-self hypothesis for Japanese university students, and its mechanism in relation to negative life event aversion. Although the differentiation-of-self hypothesis is accepted as one of the basic hypotheses in the clinical field of family therapy in Japan, empirical studies on the subject are scarce. Further, there are few studies, internationally, on its mechanism. A questionnaire survey was conducted with university students (n = 250) to measure their differentiation of self, maladaptive states, and negative life event aversion. Compared to the better-differentiated group, the less-differentiated group had higher scores both for maladaptive states—somatic symptoms (t(223) = -2.70, p = 0.008), social dysfunction (t(211.00) = -3.30, p = 0.001), and severe depression (t(208.78) = -4.08, p < 0.001)—and negative life event aversion—interpersonal domain (t(223) = -3.96, p < 0.001) and achievement domain (t(223) = -3.83, p < 0.001). The results supported the validity of the differentiation-of-self hypothesis for Japanese university students, and that cognitive tendencies toward negative life events may be part of the mechanism for less-differentiated individuals’ subsequent vulnerability. This suggests the effectiveness of cognitive interventions.

Highly Secure Residents Life Event Management System Based on Blockchain by Hyperledger Fabric

This article describes the design and implementation of Residents Life Event Management System (hereinafter called as RLEMS) with high level reliability and security by blockchain technology. The data access environment provided by blockchain is highly secure and trustworthy. In Blockchain system, some data fragments are grouped into one piece called as blocks, and all blocks are connected to create a chain of blocks in database. When blocks are connected, hash value is used to connect blocks properly. Blockchain technology enables highly secure and reliable data management system under relatively poor ICT environment. For example, developing countries such as African countries do not have sufficient ICT environment. Therefore adopting blockchain technology is suitable for such countries. Based on this consideration, we have started to build RLEMS on the blockchain system. In previous work, we used the MultiChain as a blockchain platform. However, as MultiChain platform is mainly for private blockchain system, it is not suitable for government-level data management system. Therefore, we tried to use another blockchain framework. We selected Hyperledger Fabric which was developed by Linux Foundation. It enables to implement all styles of blockchain system. This article describes the design and implementation of RLEMS by using Hyperledger Fabric. Furthermore, to provide the best user experience, we also built the web application interface with Java web application framework named PrimeFace. The implementation of a prototype revealed that the Hyperledger Fabric blockchain technology is more suitable than MultiChain.

The experiences of menstrual symptom changes among international students studying in China during the acculturation period: A phenomenology study

Objectives Menstruation is a normal physiological phenomenon among female which could be influenced by the process of acculturation.Few studies have explored the experience of menstrual symptom changes among international female students studying in China.Therefore,this paper aims to summarize international female students’experiences of menstrual symptom changes when they were studying in China and interpret these changes through considering the influence of acculturation on their social and academic lives.Methods We used a descriptive phenomenology approach.Structured in-depth face-to-face interviews were conducted between May and November 2019 among ten international female students studying in one Province located in south central China.Participants were those who reported having experienced menstrual symptom changes during the acculturation period,which was defined as the first six months of living in China.All interviews were audio-recorded,transcribed verbatim,and analyzed using NVivo 11.0 with the guidance of Colaizzi's seven-step method.Results The international female students’experiences of menstrual symptom changes were summarized and grouped into five main categories and 13 subcategories.The main categories include:1)demonstration of menstrual symptom changes,2)challenges of maintaining menstrual function in the new setting,3)coping styles to take care of menstrual health,4)consequences of the menstrual symptom changes,and 5)culture-based attitude toward menstruation.Conclusions International female students reported experiences of menstrual symptom changes,including somatic and psychological symptoms during the acculturation period.Culture barriers,academic stress,and sleep patterns are common factors influencing their menstrual symptom changes.More culturally-tailored interventions should be explored to improve the menstrual health of international female students in China.

Involvement of toll-like receptor 5 in mouse model of colonic hypersensitivity induced by neonatal maternal separation

BACKGROUND Chronic abdominal pain is the most common cause for gastroenterology consultation and is frequently associated with functional gastrointestinal disorders including irritable bowel syndrome and inflammatory bowel disease. These disorders present similar brain/gut/microbiota trialogue alterations, associated with abnormal intestinal permeability, intestinal dysbiosis and colonic hypersensitivity(CHS). Intestinal dysbiosis can alter colon homeostasis leading to abnormal activation of the innate immunity that promotes CHS, perhaps involving the toll-like receptors(TLRs), which play a central role in innate immunity.AIM To understand the mechanisms between early life event paradigm on intestinal permeability, fecal microbiota composition and CHS development in mice with TLRs expression in colonocytes.METHODS Maternal separation model(NMS) CHS model, which mimics deleterious events in childhood that can induce a wide range of chronic disorders during adulthood were used. Colonic sensitivity of NMS mice was evaluated by colorectal distension(CRD) coupled with intracolonic pressure variation(IPV) measurement. Fecal microbiota composition was analyzed by 16S rRNA sequencing from weaning to CRD periods. TLR mRNA expression was evaluated in colonocytes.Additionally, the effect of acute intrarectal instillation of the TLR5 agonist flagellin(FliC) on CHS in adult naive wildtype mice was analyzed.RESULTS Around 50% of NMS mice exhibited increased intestinal permeability and CHS associated with intestinal dysbiosis, characterized by a significant decrease of species richness, an alteration of the core fecal microbiota and a specific increased relative abundance of flagellated bacteria. Only TLR5mRNA expression was increased in colonocytes of NMS mice with CHS. Acute intrarectal instillation of FliC induced transient increase of IPV, reflecting transient CHS appearance.CONCLUSION Altogether, these data suggest a pathophysiological continuum between intestinal dysbiosis and CHS, with a role for TLR5.

Psychosocial factors affecting the etiology and management of type 1 diabetes mellitus:A narrative review

Type 1 diabetes(T1D)is one of the most common chronic diseases in children and adolescents worldwide.Its etiopathogenesis results from the interplay of genetic and environmental variables.Among the latter,psychological stress has been implicated in disease onset as well as disease management.Various studies,including large population-based studies,have highlighted the role of stressful life events in the etiopathogenesis of T1D.In this article,we also emphasize the importance of attachment in the early child-caregiver relationship,which can be seen as a measure of the quality of the relationship and is crucial for stress and emotional regulation.It serves as a model for all subsequent relationships in one’s life.We summarize some of the few studies performed in the field of attachment and T1D etiopathogenesis or management.T1D management demands a lifelong therapeutic regimen to prevent acute and chronic complications.In addition to psychological stress,psychological factors such as family functioning,developmental adjustment,autonomy,mental health problems and other factors have been found to relate to metabolic control.Psychological factors need to be understood not as a single directional causality-based principle but as a dynamic bi-or multidirectional system that is affected by the normal developmental transitions of childhood and adolescence.

Gene×environment interaction in major depressive disorder

Major depressive disorder(MDD)is a multifactorial disorder,where multiple susceptibility genes interact with environmental factors,predisposing individuals to the development of the illness.In this article,we reviewed different gene×environment interaction(G×E)studies shifting from a candidate gene to a genome-wide approach.Among environmental factors,childhood adversities and stressful life events have been suggested to exert crucial impacts on MDD.Importantly,the diathesis-stress conceptualization of G×E has been challenged by the differential susceptibility theory.Finally,we summarized several limitations of G×E studies and suggested how future G×E studies might reveal complex interactions between genes and environments in MDD.

Childhood Adversities Associated with Eating Disorders Reported by Adults

Background: It has been suggested that childhood events increase the risk of suffering from an eating disorder (ED) in adolescence or young adulthood. Our study here aimed at investigating whether there was an association between stressful childhood events and eating disorders later in life. Methods: Our population-based study was a part of the HeSSup (The Health and Social Support) postal survey in 2003, a follow-up survey with a random sample of working-aged subjects drawn from the Finnish Population Register in 1998. Participants in this study reported having been suffering from ED (N = 374), while controls (N = 18,639) reported no history of eating disorder in the questionnaire both in 1998 and 2003. The questionnaire included six questions related to childhood adversities. Results: Each childhood stressor increased the risk of developing ED cumulatively (one adversity OR 1.7 versus all six OR 8.3). Intrafamiliar conflicts (OR 2.0), being afraid of a family member (OR 1.5) or long-term illnesses in the family (OR 1.4) increased the ED-risk statistical significantly. Conclusion: Children exposed to stress are more likely to suffer from eating disorders as adults than those not exposed.

Understanding the Unique Characteristics of Suicide in China: National Psychological Autopsy Study

Objective To compare the characteristics of suicides in the four main demographic groups： urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China. Methods A detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country. Results Pesticide ingestion accounted for 58% （519） of all suicides and 61% （3181519） of deaths were due to unsuccessful medical resuscitation. A substantial proportion （37%） of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% （76/563） received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion （79%）, the lowest prevalence of mental illness （39%）, and the highest acute stress from precipitating life events just prior to the suicide. Contusion Many suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.

Nonspecific Effect of Stress on Brain Gray Matter Volume in Drug-naive Female Patients with First Depressive Episode

Background： This study aimed to observe the differences in brain gray matter volume in drug-naive female patients after the first episode of major depression with and without stressful life events （SLEs） before the onset of depression.Methods： Forty-three drug-naive female patients voluntarily participated in the present study after the first major depressive episode.The life event scale was used to evaluate the severity of the impact of SLEs during 6 months before the onset of the major depressive episode.High-field magnetic resonance imaging （MRI） scans were obtained, and the VBM and SPM8 software process were used to process and analyze the MRI.Results： Compared to that in patients without SLEs, the volume of brain gray matter was lower in the bilateral temporal lobe, right occipital lobe, and right limbic lobe in the SLE group.However, the gray matter volume did not differ significantly between the two groups after the application of false discovery rate （FDR） correction.Conclusions： Although the results of the present study suggest the absence of significant differences in brain gray matter volume between female drug-naive patients after the first episode of major depression with and without SLEs after FDR correction, the study provides useful information for exploring the definitive role of stress in the onset of depression.

Association of psychological risk factors and acute myocardial infarction in China： the INTER-HEART China study

Background Most data about psychological factors relating to acute myocardial infarction （AMI） were obtained from studies carried out in western countries. Results from small descriptive cross-sectional studies in China were inconclusive. The aim of this study was to explore possible associations between psychological risk factors and AMI among the Chinese population with a large-scale case-control study.Methods This study was part of the INTER-HEART China study, itself part of the large international INTER-HEART study of cardiovascular risk factors. In this case-control study, 2909 cases and 2947 controls were recruited from 17 cities.Psychological stress, negative life events, depression and controllability of life circumstances were assessed.Results Cases reported more psychological stress at home or work and odds ratios （ORs） were 3.2 （95% CI 2.1-4.9）for permanent stress and 2.1 （95% CI 1.5-2.8） for several periods of stress respectively. More cases experienced depression compared with controls （19.6% vs. 9.3%） and ORs were 2.2 （95% CI 1.9-2.6）. Subjects with 1, 2 and 3 or more depressive symptoms had increased risk of AMI by 2.1, 2.2 and 2.6 fold, respectively, i.e., more depressive symptoms were associated with higher risks of AMI （P for trend ＜0.0001）. Women had a greater risk of AMI from depression （OR 3.0, 95% CI 2.2-4.0） compared to men （OR 2.0, 95% CI 1.6-2.4）, P for interaction =0.0364. Negative life events in subjects were associated with increased risk of AMI, OR 1.7 （95% CI 1.4-2.0） for one event and 1.8 （95% CI 1.3-2.4） for two or more events. High levels of controllability of life circumstances reduced the risk for AMI （OR 0.8, 95%CI 0.7-1 .0）.Conclusions Several psychological factors were closely associated with increased AMI risk among Chinese population.Psychological stress had a greater AMI risk in men but depression was more significant among women.