Aims:To examine the mediating effects of self-efficacy, coping, burnout, and social support in the link between job stress and depression and anxiety among young Chinese nurses. Design:A cross-sectional survey was used. Methods: Full-time young nurses (N = 1,029) who worked in nine tertiary grade A hospitals in Chengdu China were recruited from December 2016-March 2017. Structural equation modelling was applied to analyse the mediating effects. Results: Job stress had a direct positive effect on anxiety (β = 0.054) and it also exerted indirect positive effects on depression (β = 0.337) and anxiety (β = 0.325) through mediating factors. Emotional exhaustion and social support were the main mediating variables, accounting for 72.0% of the variation in anxiety and nearly 43.4% in depression. Conclusion:Emotional exhaustion and social support may have significant mediating effects in the link between job stress and depression and anxiety. Strategies including deceasing emotional exhaustion, enhancing social support in work environment, and reducing job stressors would be useful to prevent depression and anxiety among young nurses.Impact: What problems did the study address?Depression and anxiety have great impact on professional performance of nurses and even patient safety.Factors such as coping, burnout, etc., may have different mediating effects in the paths from job stress to depression and anxiety.What were the main findings?Job stress had direct and indirect positive effects on anxiety and it only had indirect positive effect on depression.

Highlights Most COVID-19 positive inpatients had sleep, depressive, and anxiety symptoms. Both physical and psychological symptoms significantly improved after clinical and psychosocial intervention. Female, severe pneumonia, worse social support and more relatives infected were associated with the symptomatology. Effective social support, improvement from COVID-19 and higher educational level predicted the psychological improvement.

BackgroundAnti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disease involving antibodies against the NR1 subunits of NMDARs. The disease shows variable clinical presentation, and involves new-onset acute psychotic symptoms, making it difficult to differentiate from major depressive disorder with psychotic symptoms. Potential associations between this autoimmune disorder and onset or progression of major depressive disorder remains unclear.Case presentationWe present a rare case of a patient who had both major depressive disorder and anti-NMDAR encephalitis and in whom the encephalitis initially went undetected. The patient had been suffering from depressive disorder for more than 6 years without any treatment, when she was hospitalized for new-onset psychotic symptoms. She was initially diagnosed only with major depressive disorder with psychotic symptoms, but antipsychotics did not alleviate symptoms and the patient’s psychiatric course began to fluctuate rapidly. Anti-NR1 IgG autoantibodies were detected in cerebrospinal fluid, and the combination of immunotherapy and antipsychotics proved more effective than antipsychotics alone. The patient was then also diagnosed with anti-NMDAR encephalitis.ConclusionsOur case suggests that clinicians should consider anti-NMDAR encephalitis when a patient with depressive disorder shows sudden fluctuations in psychiatric symptoms. It also highlights the need for research into possible relationships between anti-NMDAR encephalitis and major depressive disorder.

The study aimed to explore the association between family functioning and quality of life (QOL) in family caregivers of patients with schizophrenia. Totally 121 family caregivers were surveyed in the cross-sectional study by the self-administration questionnaires about sociodemographic characteristics, family functioning and QOL. Family functioning was evaluated in terms of the family assessment device and the Family Adaptability and Cohesion Evaluation Scale II China Version. QOL was evaluated in terms of TSDHE short-form 12-item health survey, version 2. Multiple regression models were built to explore the association between QOL and family functioning. A regression analysis showed that poorer physical health of family caregivers was significantly associated with the lower educational level of caregivers, the closer kinship with patients and the multiple episodes schizophrenia. The other regression analysis showed that better family adaptability and affective responsiveness were significantly associated with the better mental health of family caregivers. Family functioning is associated with mental health rather than the physical health of family caregivers. Psychoeducational intervention could focus on family caregivers with a lower educational level and closer kinship, and those who look after patients with multiple episodes schizophrenia. Further family intervention could focus on family adaptability and affective expression in family caregivers of patients with schizophrenia.

Background The relapse rate of alcohol dependence (AD) after detoxification is high, but few studies have investigated the clinical predictors of relapse after hospitalized detoxification in real-world clinical practice, especially among Chinese patients. Methods This longitudinal cohort study followed up 122 AD patients who were discharged from January 1, 2016 to January 30, 2018 from their most recent hospitalization for detoxification. These patients were interviewed by telephone from May 20, 2017, to June 30, 2018, at least 6 months after discharge. During the interview, the relapse were assessed by using a revised Chinese version of the Alcohol Use Disorder Identification Test. Candidate predictors, such as therapeutic modalities during hospitalization and at discharge, medical history data related to alcohol use, and demographic information, were obtained from the medical records in the hospital information system. Results During the 6–24 months (with a median of 9 months) follow-up period, the relapse rate was 53.3%. Individuals with a college education level and those who had not been treated with the brief comprehensive cognitive-motivational-behavioural intervention (CCMBI) were more likely than their counterparts to relapse after hospitalized detoxification, and their adjusted HRs (95% CIs) were 1.85 (1.09, 3.16) and 2.00 (1.16, 3.46), respectively. The CCMBI use predicted a reduction in the relapse rate by approximately one-fifth. Conclusion Undergoing the CCMBI during detoxification hospitalization and having less than a college-level education could predict a reduced risk of AD relapse. These findings provide useful information both for further clinical research and for real-world practice.