Background
To investigate through a two-stage clinic-based screening, the frequency and clinical features of risk for psychosis syndromes in a Chinese help-seeking sample.
Method
2101 consecutive new patients ages 15–45 were recruited at their first visit to the Shanghai Mental Health Center (SMHC) and screened with the Prodromal Questionnaire -brief version (PQ-B) and questions about genetic risk. The Structured Interview for Prodromal Syndromes (SIPS) was administered to a sub-sample to estimate rates of psychosis and clinical high risk (CHR) for psychosis syndromes.
Results
The frequency estimate of CHR syndromes in the total sample was 4.2%. Among 89 CHR patients, more than two-thirds met criteria for Attenuated Positive Symptom Syndrome (APSS); and nearly a quarter met the criteria for Genetic Risk and Deterioration Syndrome (GRDS). The frequency of CHR syndromes peaked between the ages of 16–21 years and declined with subsequent age. The mean total and distress scores on the PQ-B in subjects with APSS and psychosis were significantly higher than in individuals with GDRS and patients without psychosis or CHR. High frequencies and strong correlations were found among some positive and non-specific symptoms in SIPS interviews. Among the 53 CHR participants who were followed-up for two years, 14 (26.4%) converted to psychosis. Of the non-converters, 53.8% were diagnosed with Axis I disorders.
Conclusions
This two stage screening method can enhance detection of Chinese CHR patients in clinical settings. The validity of the procedures for detecting CHR is supported by rates of transition to psychosis and of non-converter Axis I disorders that are comparable to those reported in meta-analyses.
BackgroudCOVID-19 pandemic has significantly affected the sleep health of local medical and nursing staff.AimWe used wearable pulse oximeters to monitor and screen the medical and nursing staff working in hospitals designated for COVID-19 in the Wuhan area. This study aimed to establish a reliable basis to provide sleep intervention for the medical and nursing staff.MethodsThirty medical and nursing staff members with symptoms of insomnia were instructed to wear medical ring-shaped pulse oximeters to monitor their sleep overnight. We also used the Insomnia Severity Index (ISI) and the Chinese version of the Self-Reporting Questionnaire (SRQ-20) to evaluate the severity of insomnia and mental health status, respectively, for each participant.ResultsAmong the 30 participants, only 26 completed the screening. Ten cases (38.5%) demonstrated moderate to severe sleep apnoea–hypopnea syndrome (SAHS) when using an oxygen desaturation index ≥15 times/hour as the cut-off value. Participants with comorbid moderate to severe SAHS had significantly higher ISI and SRQ scores (p values 0.034 and 0.016, respectively) than those in the insomnia group. Correlation analysis revealed that ISI was positively correlated with total sleep time (TST) (r=0.435, p=0.026), and negatively correlated with deep sleep (r=−0.495, p=0.010); furthermore, patient SRQ scores were positively correlated with TST, sleep efficiency (SE) and REM (rapid eyes movement) sleep % (r=0.454 and 0.389, 0.512; p=0.020, 0.050 and 0.008, respectively). Stepwise logistic regression indicated that SRQ-20 and sex were risk factors for insomnia with comorbid SAHS, and their OR values were 1.516 and 11.56 (95% CI 1.053 to 2.180 and 1.037 to 128.9), respectively.ConclusionMedical and nursing staff with insomnia showed clear signs of comorbid sleep apnoea attributable to stress. The wearable pulse oximeters accurately monitored the participants’ breathing when asleep.
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