Jinzhou Kangning Hospital

This study focused on the preferences for psychological assistance and associated factors among Chinese healthcare workers (HCWs) during the COVID-19 pandemic. Cross-sectional analysis of survey data collected from Chinese HCWs during the COVID-19 pandemic. Nationwide psychological service platforms in China that facilitated participation of HCWs. A total of 901 HCWs aged 19-84 years, including doctors, nurses and other medical staff. Preference for psychological assistance was assessed through survey options, including psychological materials, stress management skills, telephone hotline, online non-video psychological counselling, online video psychological counselling and no need or others. Prevalence of mental health symptoms was evaluated using validated scales: Patient Health Questionnaire-2 (PHQ-2) for depression, Generalised Anxiety Disorder-7 (GAD-7) and Primary Care Post-Traumatic Stress Disorder (PTSD) Screen for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (PC-PTSD-5) for stress. Additional measures included sleep disturbance, suicidal ideation and demographic characteristics such as age, education level and occupation. Among 901 HCWs surveyed, the prevalence of depression, anxiety and stress was 12.32% (PHQ-2 score ≥3), 42.18% (GAD-7 score ≥5) and 28.75% (PC-PTSD-5 score ≥3), respectively. Sleep disturbance and suicidal ideation were reported by 29.41% (cut-off value=2) and 9.32% (cut-off value=1) of participants. Among the 602 respondents who preferred psychological assistance, the most preferred options were stress management skills, psychological materials and online non-video counselling. HCWs with severe suicidal ideation (item 9 of PHQ-9=3) preferred online video counselling (80%). Logistic regression indicated that age was negatively correlated with the preference for psychological materials (β=-0.86, p=0.034) but positively associated with the preference of telephone hotlines (26-35 years: β=1.69, p=0.035; ≥45 years: β=1.90, p=0.031). Higher educational attainment was associated with greater preference for psychological materials (undergraduates: β=0.71, p=0.014; masters: β=1.13, p=0.007) and online counselling (masters: β=1.743, p=0.002). Nurses were more likely to prefer stress management skills (β=0.71, p=0.014), while HCWs with suicidal ideation showed a stronger preference for online video counselling (β=0.66, p<0.05). Linear regression further showed that participants with a bachelor's or master's degree and those with severe anxiety were more likely to use multiple forms of psychological assistance. The high prevalence of mental health problems among HCWs highlights an urgent need for targeted psychological support. Distinct characteristics of HCWs were associated with different preferences for psychological assistance, highlighting the importance of tailoring interventions to the specific needs of HCWs.

Metabolic syndrome (MetS) is highly prevalent among individuals with schizophrenia. However, substantial regional variation exists, and evidence from large samples of hospitalized patients in China remains limited. This study aimed to estimate the prevalence of MetS and to explore its associated factors among individuals with schizophrenia in China. We included 3042 participants with schizophrenia from 25 hospitals in Zhejiang Province from April to December 2022. MetS was defined according to the Chinese Diabetes Society (CDS) criteria, the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and the International Diabetes Federation (IDF) criteria. The prevalence of MetS was estimated using the Clopper-Pearson method, and generalized additive models were used to fit smoothed age-specific prevalence curves. Multivariate logistic regression was used to explore potential factors associated with MetS. The overall prevalence of MetS was 34.9% (95% confidence interval [CI]: 33.2–36.7%), 42.6% (40.9–44.4%), and 38.9% (37.2–40.7%) based on the CDS, NCEP ATP III, and IDF criteria, respectively. The prevalence of MetS was significantly higher in female participants with schizophrenia compared to their male counterparts when applying the NCEP ATP III or IDF criteria. In addition, after reaching the age-specific peak, MetS prevalence declined in male participants but stabilized in females. High BMI (OR: 1.30 [1.27–1.33]) and comorbid endocrine diseases (OR: 1.79 [1.48–2.17]) were associated with increased odds of MetS. Metabolic syndrome is highly prevalent among individuals with schizophrenia, regardless of the diagnostic criteria used. Early identification and screening of metabolic abnormalities in individuals with schizophrenia should be considered.

Whether problematic smartphone use (PSU) positively or negatively links to depression, and whether developmental pathways differ across high-/low-risk groups, remain theoretically contested. This study advances the digital mental health discourse by resolving theoretical ambiguities in the Depression-PSU relationship through a novel symptom-network lens. We propose a dual-process framework across two risk groups, bridging gaps in existing models. Following prior work, participants scoring >51 on the Mobile Phone Addiction Index were designated high-risk (PSU+) users (N=778), and the remainder as low-risk (PSU-) users (N=645). Cross-sectional and longitudinal symptom-to-symptom associations and symptom centrality were analysed via R. The key results are as follows: (1) Core Circuit: Both groups exhibited a self-reinforcing loop between escapism symptom of depression ('work initiation difficulty') and addictive symptoms of PSU ('excessive/uncontrolled use'). (2) Distinct pathways emerged in the PSU+Group: Revealed paradoxical disengagement effects where addictive symptoms of PSU inversely predicted affective symptoms of depression, suggesting behavioural addiction as emotion regulation failure; escapism symptoms of PSU negatively predicted affect symptoms of depression, and addictive symptoms of PSU did not positively predict negative consequence of PSU ('productive loss'). (3) Network Centrality: Negative consequence of PSU ('productivity loss') and one affect symptom of depression ('hopelessness') had the strongest in-prediction in the PSU+group, while addictive use and escapism symptom of depression had the strongest in-prediction in the PSU- group. The results highlight that excessive smartphone use can indicate both digital stress (PSU - group) and digital relaxation (PSU+group), challenging the traditional view of an unidirectional link between PSU and depression. The identified network signatures enable precision interventions targeting specific symptom pathways, informing next-generation therapeutics for tech-related mental health challenges.

ObjectivesTraditional approaches in Alzheimer’s disease (AD) research examine cognitive symptoms in isolation, potentially overlooking dynamic interrelationships among impairment domains. This study employed network analysis to examine structural organization of cognitive and functional domains in mild (mAD) and moderate-to-severe (Mod-sAD) Alzheimer’s disease, aiming to identify stage-specific symptom structures and inform targeted interventions.MethodsA cross-sectional study included 134 participants diagnosed with AD according to DSM-5 criteria. Participants were classified into mAD (n=37) and Mod-sAD (n=97) groups. Regularized partial correlation networks with extended Bayesian information criterion regularization examined symptom interdependencies across six CDR domains: memory, orientation, judgment and problem solving, community affairs, home and hobbies, and personal care. Network comparison tests and centrality analyses identified structural differences between disease stages.ResultsThe Mod-sAD group demonstrated significantly higher impairment scores across all domains (p < 0.001) with large effect sizes (Cohen’s d: 1.83-2.71). Network analysis revealed increased global strength in Mod-sAD versus mAD networks (2.60 vs. 2.49, p < 0.05), indicating greater symptom interconnectedness in advanced stages. Centrality analyses revealed fundamental reorganization: memory emerged as most central in Mod-sAD (strength = 1.62), while judgment and problem-solving showed highest centrality in mAD (strength = 1.65). Orientation centrality increased substantially across progression (strength: -1.32 to 0.40).ConclusionsAD progression features increasing network density and centrality shifts from executive-function-centered networks in mild AD to memory-centered networks in moderate-to-severe stages. Findings suggest stage-specific interventions: executive enhancement in mild AD and memory-focused approaches in advanced stages.

BackgroundDepression and anxiety are significant public health concerns among township grassroots civil servants, the largest segment of China’s civil service. This study aims to investigate the prevalence of depression and anxiety within this population, identify key distal and proximal adversity factors using the Developmental Adaptation Model, explore the association between cumulative adversity and mental health outcomes, and analyze the underlying pathways of association.MethodsA cross-sectional study of 1,275 township grassroots civil servants collected data on demographics, distal adversities (e.g., left-behind experiences, emotional abuse), proximal adversities (e.g., parent-child conflict, divorce intentions, work stress), depression and anxiety using self-report questionnaires. Logistic regression was used to identify predictors, while ANOVA and hierarchical regression were used to examine the functional form of the relationship between cumulative adversity and mental health. Finally, mediation analysis was conducted to explore the role of proximal adversity in linking distal adversity to mental health outcomes.ResultsThe prevalence of depression and anxiety among township grassroots civil servants was high, at 36.7% and 29.6%, respectively. Multiple distal and proximal factors were significantly associated with both outcomes. Among distal adversities, domestic violence (aOR = 3.42) and emotional abuse (aOR = 2.89) were the strongest correlates of depression; among proximal adversities, work stress (aOR = 5.02) and economic poverty (aOR = 4.92) had the most substantial associations. Cumulative adversity was significantly and positively associated with both depression and anxiety (p < 0.001), showing a clear linear pattern. Mediation analysis revealed that the effect of cumulative distal adversity on both depression and anxiety was fully mediated by cumulative proximal adversity.ConclusionThis study highlights an alarming prevalence of depression and anxiety among township grassroots civil servants. The findings underscore that while early life adversity creates a foundation of risk, current (proximal) stressors are the primary mechanism through which this risk translates into psychological distress. These insights can help government agencies develop more effective, targeted interventions by focusing on mitigating current work and life pressures.

ABSTRACTExperiences during the COVID‐19 pandemic may be traumatic to healthcare workers (HCWs). This study investigated the associations of resilience and mindfulness with posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG), and the mediation role of adaptive coping and stigmatisation related to HCWs' role in these associations from the perspective of trauma and positive psychology research. An anonymous online survey was conducted among 1449 doctors and nurses (85.4% females; mean age 34.1 years) from five hospitals in different regions of China between October and November 2020, which was about six months after the COVID‐19 outbreak was almost ‘put under control’ in China. PTSS and PTG were assessed using the 17‐item PTSS Scale‐Self‐Report and Posttraumatic Growth Inventory, respectively. The prevalence of PTSS and PTG was 42% and 65%, respectively. Results of structural equation modelling suggested that the association between resilience and PTSS was partially mediated by adaptive coping, self‐stigma, and the serial path via adaptive coping and self‐stigma, which accounted for 66% of the total association. The association between mindfulness and PTSS was partially mediated by adaptive coping and serially mediated by adaptive coping and self‐stigma. In contrast, only adaptive coping was a significant mediator in the associations between resilience/mindfulness and PTG. The findings first unravelled the mechanisms between resilience, mindfulness, and posttraumatic outcomes of COVID‐19 among a large sample of HCWs. Health promotion may consider alleviating PTSS and promoting PTG for HCWs experiencing traumatic stressful events via strengthening resilience and mindfulness, fostering adaptive coping, and reducing stigmatisation.