BackgroundThe delivery of mental health services in rural China has been notably limited due to lack of qualified mental health professionals among other impeding factors. A village doctor-based cognitive behavioral therapy intervention may be one way of improving accessibility. The purpose of this study was to explore the advantages and challenges of implementing this intervention, as delivered by trained village doctors, to treat late-life depression in rural China.MethodsWe conducted one focus group discussion with 10 village doctors, 10 individual interviews with each of the village doctors, and individual interviews with 19 older adults. The topic guides were advantages and challenges of the intervention program from the perspective of the village doctors and older adults. Interviews were audio-recorded, transcribed, coded using NVivo 8, and analyzed using thematic analysis.ResultsThe village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. The benefits received from the intervention for the village doctors and the elders were positive such that both the doctors and the older adults were willing to implement/receive this intervention. Cultural and political factors (renqing and perceived policy consideration) facilitated the elders’ access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered. Other impediments to the successful implementation of the intervention included the time constraints of village doctors and the presence of other people when conducting the intervention.ConclusionsThe present study has demonstrated that the intervention program is likely to be an acceptable geriatric depression intervention in rural China if several challenges are appropriately addressed.
This study aimed to determine whether smartphone addiction and depression sequentially mediate the relationship between body dissatisfaction and disordered eating behaviors (e.g., restrained eating, emotional eating and external eating). A total of 5986 participants (54.1% females, average age = 19.8 years, age range = 17–32) completed the Satisfaction and Dissatisfaction with Body Parts Scale, the Three-Factor Eating Questionnaire, the Smartphone Addiction Scale and the Patient Health Questionnaire-9. Mediational analysis showed that, after controlling for age, sex and body mass index, body dissatisfaction was related to disordered eating behaviors through (a) the mediating effect of smartphone addiction, (b) the mediating effect of depression, and (c) the serial mediating effect of smartphone addiction and depression. In conclusion, our study showed for the first time that smartphone addiction and depression can be sequential mediator variables in the association between body dissatisfaction and disordered eating. However, this study is a cross-sectional study; future longitudinal studies could further test the causal associations between these study variables.
Background: Late-life depression issues in developing countries are challenging because of understaffing in mental health. Cognitive behavioural therapy (CBT) is effective for treating depression. Aim: This pilot trial examined the adherence and effectiveness of an eight-session adapted CBT delivered by trained lay health workers for older adults with depressive symptoms living in rural areas of China, compared with the usual care. Method: Fifty with screen-positive depression were randomly assigned to the CBT arm or the care as usual (CAU) arm. The primary outcomes were the session completion of older adults and changes in depressive symptoms, assessed using the Geriatric Depression Scale (GDS). Results: The majority (19/24) of participants in the CBT arm completed all sessions. Mixed-effect linear regression showed that the CBT reduced more GDS scores over time compared with CAU. Conclusion: Lay-delivered culturally adapted CBT is potentially effective for screen-positive late-life depression.
Purpose: This article presents national survey data related to the mental health of participants (N = 13,824) from every province in the People's Republic of China, in the period of early February, during the early days of the outbreak of the COVID-19 virus. The goal was to examine stress and anxiety levels, even as the virus was spreading across the country. This goal was facilitated by data collected specifically from Wuhan city, which was the geographical epicenter of the outbreak, Hubei, the province in which Wuhan is located, and the rest of China. Methods: The survey included a series of validated measures of mental health, as well as measured constructs such as stress and anxiety, depression, sleep, workplace wellness and social cohesion. To the extent possible, the measures had been previously validated in China and were available in Simplified Chinese, although some measures were created for the unique characteristics of the viral outbreak. The survey was distributed electronically through a network of researchers. Results: The measures were generally reliable, with expected inter-correlations. The factor structure of the Symptom Checklist-90 items was generally consistent with its conceptual dimensions. Mostly importantly, the study revealed a gradient of mental health outcomes, with participants from the city of Wuhan having the highest scores on most mental health measures, with the great Hubei province similar or slightly lower, and the rest of China having elevated, but lower scores on most outcomes. Sleep disturbance also revealed a similar gradient, with participants in the epicenter reporting the most sleep disturbance. Discussion: These results reveal the ability to capture the mental health of citizens during a viral outbreak, and the sensitivity of measures to the mental challenges such
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