Browsing by Author "Wang, Yuan Yuan"
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Item Open Access Behind the rainbow, "Tongqi" wives of men who have sex with men in China: a systematic review(Frontiers, 2020-01-14) Wang, Yuan Yuan; Wilson, Amanda D.; Chen, Runsen; Hu, Zhishan; Peng, Ke; Xu, ShicunBackground: Due to the restrictions and stigmatization of homosexuality in China, there has emerged the “Tongqi,” or the wives of men who have sex with men (MSM). There are around 14 million Tongqi wives whose needs for support are often overshadowed. This phenomenon has been largely under researched, this review is the first to address the current data on the Tongqi. The aim of this systematic review is to begin to provide insight into the pre-existing data and the further support that is needed for the wives of MSM. Methods: The researchers searched PubMed, Web of Science, EMBASE, PsycINFO, CNKI, Sinomed and WangFang databases from their inception date until June 7, 2019. Handsearching was also completed to provide a rich data set. Results: The articles were summarized and analyzed for thematic clusters. From the selected article, five themes emerged, including Sexual Health Issues, Intimate Partner Violence, Mental Health Status, Marriage Dissatisfaction, and Coping Strategies. These themes often intersected to provide a complex understanding of the current gaps in support provided to Tongqi. Conclusion: Tongqi wives remain a hidden population in Chinese mainstream society, who deserves a sensitive approach to support. The study revealed that the MSM wives suffer severe mental, physical, health, and life related harms. However, instead of situating them into the victim roles, many women take on an identity of empowerment and are working together, aiming to make social changes. In order to address the Tongqi phenomenon, it is also essential to reduce the discrimination toward homosexuality. Tongqi are a special group of Chinese women, they require further intensive research attention.Item Open Access Changes in network centrality of psychopathology symptoms between the COVID-19 outbreak and after peak(Nature, 2020-09-14) Wang, Yuan Yuan; Wilson, Amanda D.; Hu, Zhishan; Feng, Yi; Chen, RunsenItem Open Access Cognitive behavioural therapy monotherapy for insomnia: A comprehensive meta-analysis of randomized controlled trials(Elsevier, 2019-10-13) Wang, Yuan Yuan; Yang, Yuan; Rao, Wen-Wang; Zhang, Shu-Fang; Zeng, Liang-Nan; Zheng, Wei; Ng, Chee H.; Ungvari, Gabor S.; Zhang, Ling; Xiang, Yu-TaoThis is a systematic review and meta-analysis on randomized controlled trials (RCTs) comparing the effects of cognitive behavioural therapy for insomnia (CBTI) as a monotherapy and active control treatments in persons with insomnia who have no major medical conditions or psychiatric comorbidities. PubMed, Embase,PsycINFO, and Cochrane Library databases, CNKI and WanFang were systematically and independently searched. Nine RCTs with 12 treatment arms comparing CBTI (n = 479) and active control (n = 510) groups were investigated. Compared to the active control group, the CBTI group demonstrated significantly less enhancement in insomnia at post-CBTI assessment in terms of sleep efficiency (SMD: 0.32, 95% CI: 0.00 to 0.63), sleep latency (SMD: -0.33, 95% CI: -0.56 to -0.09), wake after sleep onset (SMD: -0.27, 95% CI: -0.52 to -0.01) and the total scores of Pittsburgh Sleep Quality Index (SMD: -0.52, 95% CI: -0.86 to -0.19), the Insomnia Symptom Index (SMD: -0.68, 95% CI: -1.01 to -0.36), the Dysfunctional Attitudes and Beliefs About Sleep Scale (SMD: -0.76, 95% CI: -1.25 to -0.27), and the Athens Insomnia Scale (SMD: -0.66, 95% CI: -1.07 to -0.24). In this meta-analysis, CBTI monotherapy showed no advantage in improving insomnia compared with other standard treatments. Probably CBTI works well when it is combined with other treatments, such as pharmacotherapy. The findings need to be replicated in future RCTs with larger samples.Item Open Access Counselling and psychotherapy service use in Chinese sexual minority populations: a nationwide survey(Springer Nature, 2020-01-07) Wang, Yuan Yuan; Wilson, Amanda; Hu, Zhishan; Lu, Li; Li, Wengao; Peng, Ke; Wu, Lijuan; Xin, Ying; Drescher, Jack; Ou, Jianjun; Chen, RunsenBackground This study investigated the prevalence and factors associated with counselling and psychotherapy service use among Chinese sexual minority populations. Methods A nationwide cross-sectional study was performed using snowball sampling method, which led to the inclusion of 18,193 participants. Participants’ sociodemographic background, clinical, and psychological data were gathered. Multivariate logistic regression analysis was performed to explore any associated factors. Results There were 2007 participants who had used counselling and psychotherapy service out of the total population. Among those who had used psychotherapy services, 80.2% participants perceived discrimination, 1.1% reported that they had been refused treatment by a counsellor and/or psychotherapist, 1.6% had experienced verbal harassment, and 8.4% reported that their counsellor and/or psychotherapist lacked knowledge and experience in treating sexual minorities. In addition, regression analyses indicated that those who were divorced/widowed, had religious beliefs, and those who had experienced discrimination, verbal harassment, and rejection for treatment by health professionals all had an increased likelihood of utilising counselling and psychotherapy service. Conclusions Service providers and policy makers in China should improve the quality and availability of counselling and psychotherapy services to address the mental health needs of sexual minority populations.Item Open Access The experience of long-stay patients in a forensic psychiatric hospital in China: a qualitative study(Springer Nature, 2019-09-02) Wang, Yuan Yuan; Zhong, Shaoling; Guo, Huijuan; Cook, Stephanie; Chen, Yanan; Luo, Chenyuli; Peng, Ke; Wang, Fanglan; Liang, Xiaoxi; Chen, Hui; Li, Qiguang; Zhou, Jiansong; Wang, Xiaoping; Chen, RunsenBackground Long stay in forensic psychiatric hospitals is common in patients who are defined as “not criminally responsible on account of mental disorder”. However, little is known about how these patients experience and perceive the long stay within these settings. The aim of this study is to explore the perception and needs of long-stay patients in forensic psychiatric hospitals in China. Methods In-depth semi-structured interviews were conducted with 21 participants who had lived in the forensic psychiatry hospital for more than 8 years. We used thematic analysis strategies to analyse the qualitative data. Results Participants’ perceptions clustered seven themes: hopelessness, loneliness, worthlessness, low mood, sleep disturbances, lack of freedom, and lack of mental health intervention. Conclusions The views and opinions expressed by long-stay patients showed that psychological distress is prevailing in forensic psychiatric hospitals. Adequate and effective care and mental health interventions are recommended to be tailored for their special needs.Item Open Access Mental health outcomes among Chinese prenatal and postpartum women after the implementation of universal two-child policy(Elsevier, 2019-12-11) Lu, Li; Duan, Zhizhou; Wang, Yuan Yuan; Wilson, Amanda D.; Yang, Yong; Zhu, Longjun; Guo, Yan; Yonglang, Lv; Yang, Xiaonan; Yu, Renjie; Wang, Shuilan; Wu, Zhengyan; Jiang, Ping; Xia, Mengqing; Wang, Guosheng; Wang, Xuixia; Tao, Ye; Li, Xiaohong; Ma, Ling; Huang, Liming; Dong, Qin; Shen, Hong; Sun, Jue; Li, Shun; Deng, Wei; Chen, RunsenBackground Poor health status among both pregnant and postpartum women is commonly reported worldwide. The associations between mental health outcomes and giving birth to the second child since the implementation of China's universal two-child policy have not been identified. Methods A large-scale based mental health survey was conducted between March 2017 and December 2018 in Suzhou, China. The survey evaluated the symptoms of anxiety, hypomania, depression and poor sleep quality among both pregnant and postpartum women. Results A total of 3,113 questionnaires were collected, the prevalence of anxiety, hypomanic and depressive symptoms and poor sleep quality in our sample were 3.2% (95%CI: 2.6%-3.9%), 51.7% (95%CI: 49.9%-53.4%), 12.4% (95%CI: 11.3%-13.6%) and 37.8% (95%CI: 36.0%-39.5%), respectively. Logistic regression showed that giving birth to the second child was positively associated with women's age, and was negatively correlated with higher educational level and living in rented housing. Women with the second pregnancy or child were positively associated with anxiety symptoms in the whole sample (OR=1.75, 95%CI: 1.11-2.75) and among prenatal women (OR=2.11, 95%CI: 1.16-3.83), while it was inversely correlated with depressive symptoms among postpartum women (OR=0.63, 95%CI: 0.41-0.99). Conclusions Women giving birth a second time were more prone to have anxiety symptoms among the prenatal women and the whole sample, and less likely to have depressive symptoms among the postpartum women. Efficacious measures and interventions are essential to improve maternal mental health.Item Open Access Mental Health Status of Cisgender and Gender-Diverse Secondary School Students in China(American Medical Association, 2020-10-27) Wang, Yuan Yuan; Yu, Hui; Yang, Yong; Drescher, Jack; Li, Ronghua; Yin, Weijia; Yu, Renjie; Wang, Shuilan; Deng, Wei; Jia, Qiufang; Zucker, K. J.; Chen, RunsenItem Open Access Older adults at high risk of HIV infection in China: a systematic review and meta-analysis of observational studies(PeerJ, 2020-10-21) Wang, Yuan Yuan; Yang, Yuan; Chen, C.; Zhang, L.; Ng, C.H.; Ungvari, G.S.; Zang, X.D.; Xiang, Y-T.There is an increasing prevalence of human immunodeficiency virus (HIV) infection in older adults in China, but the findings across prevalence studies have been mixed. This is the first meta-analysis of the prevalence of HIV infection and its moderating factors in older adults in China. Two investigators systematically and independently earchedbothinternational(PubMed,PsycINFO,WebofSciencesandEMBASE)and Chinese (WanFang, CNKI, and CQVIP) databases. HIV infection rates in older adults wereanalyzedusingtherandom-effectsmodel.Altogether46studieswereincludedin the analysis. The pooled prevalence of HIV infection in older adults was 2.1% (95% CI[1.9%–.3%],I2=99.4%).Subgroupanalysesrevealedthatmenwhohavesexwith men(MSM),hospitalpopulationsamples,publicationsafter2014,studiesconductedin thewesternregionofChina,andhigherstudyqualityweresignificantlyassociatedwith higherHIVinfectionrate.Thismeta-analysisfoundthattheHIVinfectionprevalence in older adults is significantly higher than the general population in China. Attention should be given to this urgent public health issue, and effective HIV/AIDS preventive, screening and treatment measures are warranted in this populationItem Embargo Prospective memory in schizophrenia: a meta-analysis of comparatives studies(Elsevier, 2019-08-22) Wang, Yuan Yuan; Zhou, Fu-Chun; Zheng, Wei; Lu, Li; Ng, Chee H.; Ungvari, Gabor S.; Li, Jun; Xiang, Yu-TaoBackground Impairment of prospective memory (PM) in schizophrenia has gained increasing attention. This meta-analysis systematically examined PM impairment in schizophrenia. Methods Both English (PubMed, PsycINFO, EMBASE, and Cochrane Library) and Chinese (WanFang, Chinese Biomedical and China Journal Net databases) databases were systematically searched from their inception until August 14, 2017. Case-control studies of PM in schizophrenia were included. Standardized mean differences (SMDs) and their 95% confidence interval (CI) were calculated using the random-effects model. Results Twenty-nine case-control studies (n = 2492) were included in the analyses. The overall and three subtypes of PM were compared between patients with schizophrenia (n = 1284) and healthy controls (n = 1208). Compared to healthy controls, patients performed significantly poorer in overall (SMD = −1.125), time-based (SMD = −1.155), event-based (SMD = −1.068), and activity-based PM (SMD = -0.563). Subgroup analyses revealed significant differences between older and younger patients (SMD = -1.398 vs. -0.763), higher male predominance and no sex predominance (SMD = -1.679 vs. -0.800), lower and higher education level (SMD = -1.373 vs.-0.637), chronic and first-episode patients (SMD = -1.237 vs. -0.641) and between eco-valid and dual-task laboratory measurements (SMD = -1.542 vs. -0.725) regarding overall PM. Meta-regression analysis showed that higher negative symptom score was significantly associated with more severe overall PM impairment in patients (P = 0.022). Conclusions In this meta-analysis the overall PM and all its subtypes, particularly the time-based PM, were significantly impaired in schizophrenia.Item Open Access Relationship between trait neuroticism and suicidal ideation among postpartum women in China: Testing a mediation model(Elsevier, 2019-06-29) Wang, Yuan Yuan; Duan, Zhizhou; Tao, Ye; Bower, Joanne L.; Yu, Renjie; Wang, Shuilan; Wu, Zhengyan; Lv, Yongliang; Yang, Xiaonan; Li, Xiaohong; Huang, Liming; Ma, Ling; Dong, Qin; Sun, Jue; Li, Shun; Yang, Yong; Yang, Yuan; Peng, Ke; Chen, RunsenBackground Suicidal ideation is a common phenomenon among postpartum women around the world. However, evidence of the relationship between neuroticism and suicidal ideation among postpartum women is still lacking. Methods From March 2017 to December 2018, a total of 1027 postpartum women (assessed no later than one month post-birth) were recruited to complete questionnaires assessing neuroticism, depression, anxiety and suicidal ideation. Results Anxiety and depression fully mediated the association between neuroticism and suicidal ideation (Total indirect effects = 0.11, 95%CI: 0.07, 0.15). The indirect effect of the pathway of EPQ (Neuroticism)-Anxiety-Suicidal ideation was more significant than other pathways (Indirect effects=0.04, 95%CI: 0.02, 0.07). Conclusion Interventions for suicidal ideation in postpartum women need to target neuroticism and further research is necessary understand the mechanisms by which neuroticism affects suicidal ideation.Item Open Access Screening for postpartum hypomania among Chinese women after childbirth(Elsevier, 2019-09-30) Wang, Yuan Yuan; Li, Xiaohong; Duan, Z.; Wilkinson, Meredith; Yu, Renjie; Li, Shun; Huang, Liming; Guo, Y.; Ma, Ling; Dong, Qin; Sun, Jue; Yang, Xiaonan; Tao, Ye; Lv, Yongliang; Yang, Yong; Chen, RunsenThis study examines the prevalence and risk factors for postpartum hypomania in women after childbirth as well as examining the potential influence of personality traits in relation to experiencing symptoms of postpartum hypomania A total of 1022 women no later than 1 month post-birth were recruited in Suzhou, China, between March 2017 and December 2018. Hypomanic symptoms were assessed with the Hypomania Checklist-32 (HCL-32), and a total score of 14 or higher was defined as having hypomanic symptoms. We found 43.6% of the women in our sample had hypomanic symptoms. The results of multiple logistic regression showed that rural residence [p = 0.01, odds ratio (OR) = 0.7, 95% confidence interval (CI) = 0.5-0.9], education background (p = 0.005, OR = 0.6, 95% CI = 0.5-0.9), marriage satisfaction (p = 0.048, OR = 0.9, 95% CI =0.8-1.0), Pittsburgh Sleep Quality Index (PSQI) (p = 0.001, OR = 0.9, 95% CI = 0.9-1.0), Eysenck Personality Questionnaire-Extraversion (p < 0.001, OR = 1.2, 95% CI = 1.1-1.2), Eysenck Personality Questionnaire-Lie (p = 0.01, OR = 0.9, 95% CI = 0.9-1.0), and General Anxiety Disorder-7 (p = 0.02, OR = 1.1, 95% CI = 1.0-1.1) were independently associated with exhibiting hypomanic symptoms. The current study provided insights into hypomanic symptoms in Chinese postpartum women. We also found that extraversion and lie personality were significantly associated with an increased risk of hypomanic symptoms in postpartum women. It is urgent to arrange screening for women at risk of developing postpartum hypomania as soon as possible after giving birth and at regular intervals in the first 6 months to prevent the women developing psychological disorders such as depression and bipolar disorder later on.Item Open Access Self-reported Rates of Abuse, Neglect, and Bullying Experienced by Transgender and Gender-Nonbinary Adolescents in China(JAMA Network, 2019-09-06) Wang, Yuan Yuan; Peng, Ke; Zhu, Xuequan; Gillespie, Amy; Gao, Yue; Xin, Ying; Qi, Ji; Ou, JianJun; Zhong, Shaoling; Zhao, Lixian; Liu, Jianbo; Wang, Chaoyue; Chen, RunsenImportance This is the first comprehensive national study reporting the rates of abuse, neglect, and bullying from family and classmates or teachers among Chinese transgender and gender-nonbinary adolescents and identifying risk factors associated with poor mental health in this population. Objective To assess the rates of abuse, neglect, and bullying and their association with poor mental health among Chinese transgender and gender nonbinary adolescents. Design, Setting, and Participants This national survey study used an online self-selecting survey conducted between January 1, 2017, and September 29, 2017, in China. Eligibility criteria included reporting being aged 12 to 18 years and being transgender or gender nonbinary. Data analysis was performed from March 25 to 28, 2019. Main Outcomes and Measures The main outcome was self-reported poor mental health, including depressive symptoms, anxiety symptoms, and suicidal ideation. Depressive symptoms were measured using the Center for Epidemiological Studies Depression 9-item scale. Anxiety symptoms were measured using the 7-item General Anxiety Disorder scale. Suicidal ideation was measured using standardized questions adapted from previous Chinese studies. Abuse, neglect, and bullying were measured using specifically designed questions. Results Of 564 responses collected, 385 respondents (mean [SD] age, 16.7 [1.2] years) met inclusion criteria, including 109 (28.3%) transgender adolescent boys, 167 (43.4%) transgender adolescent girls, and 109 (28.3%) gender-nonbinary adolescents. Among 319 respondents who reported that their parents were aware of their gender identity, 296 (92.8%) reported having experienced parental abuse or neglect. Among the full cohort, 295 respondents (76.6%) reported having experienced abuse or bullying owing to being transgender or gender nonbinary in school from classmates or teachers. There were 173 respondents (44.9%) with Center for Epidemiological Studies Depression 9-item scale scores indicating they were at risk of major depressive disorder, and 148 respondents (38.4%) had 7-item General Anxiety Disorder scale scores indicating they were at risk of an anxiety disorder. In univariate analysis, reporting experiences of bullying from a classmate or teacher was significantly associated with suicidal ideation (odds ratio, 1.68 [95% CI, 1.04-2.70]; P = .03), but the association was no longer statistically significant after controlling for level of educational attainment, aversion to assigned sex, and depressed mood at the onset of puberty (odds ratio, 1.63 [95% CI, 0.97-2.73]; P = .06). Conclusions and Relevance In this survey study, transgender and gender-nonbinary adolescents in China reported high rates of abuse, neglect, and bullying at home and in school and high rates of symptoms associated with poor mental health. This study highlights the importance of reducing home- and school-based abuse, neglect, and bullying of transgender and gender-nonbinary adolescents in China to improve mental health outcomes; however, broader change in the social environment may be required to address the prejudice and stigma aimed at gender minorities.Item Open Access The victim-bully cycle of sexual minority school adolescents in China: prevalence and the association of mood problems and coping strategies(Cambridge University Press, 2020-11-06) Wang, Yuan Yuan; Yu, Hui; Yang, Yong; Li, Ronghua; Wilson, Amanda; Wang, Shuilan; Drescher, Jack; Chen, RunsenItem Embargo Voluntary and involuntary admissions for severe mental illness in China: a systematic review and meta-analysis(American Psychiatric Association Publishing, 2019-10-02) Wang, Yuan Yuan; Yang, Yuan; Li, W.; An, F-R.; Ungvari, Gabor S.; Balbuena, L.; Xiang, Y-T.Aim: The aim of this systematic review and meta-analysis was to examine the prevalence of voluntary and involuntary psychiatric admissions for severe mental illness in China and explore their associated factors. Method: PubMed, Cochrane Library, PsycINFO, EMBASE, CNKI, CQVIP and WanFang databases were systematically searched. Meta-analyses were conducted using the random-effects model. Results: Fourteen studies with 94,305 patients were included. The voluntary and involuntary admission rates for all severe mental illness were 30.3% (95%CI: 18.06-46.23%), and 32.3% (95%CI: 10.39-66.21%), respectively for severe mental illness. The corresponding figures were 19.6% (95%CI: 14.09-26.54%) and 44.3% (95%CI: 5.98-90.88%), respectively for schizophrenia. Meta-regression analyses found an increase in the voluntary admission rate over time between 1998 and 2018. Conclusion: Voluntary admission rate for severe mental illness increased in China, while involuntary admission rates remained high, especially for schizophrenia. Concerted efforts are made to further decrease the rate of involuntary admissions.