Author
Wei Zhang
Bio: Wei Zhang is an academic researcher. The author has contributed to research in topics: Major depressive disorder & Sexual abuse. The author has an hindex of 5, co-authored 5 publications receiving 95 citations.
Papers
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Fudan University1, Shanghai Mental Health Center2, China Medical University (PRC)3, Zhengzhou University4, XinHua Hospital5, Shanxi Medical University6, Capital Medical University7, Sun Yat-sen University8, Jiangsu University9, Harbin Medical University10, Hebei Medical University11, Chongqing Medical University12, Sichuan University13, Lanzhou University14, Shantou University15, Tongji University16, Jinan University17, Wuhan University18, Tianjin First Center Hospital19, Wellcome Trust Centre for Human Genetics20, Clinical Trial Service Unit21, Virginia Commonwealth University22
TL;DR: CSA is strongly associated with recurrent MD and this association increases with greater severity of CSA, and among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes.
Abstract: Background
Our prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set?
Method
Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression.
Results
We confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19–5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58–3.15), genital (OR 5.24, 95% CI 3.52–8.15) and intercourse (OR 10.65, 95% CI 5.56–23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11–2.27) and phobia (OR 1.41, 95%CI 1.09–1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20–1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02–2.02). Intercourse (OR 3.47, 95%CI 1.66–8.22), use of force and threats (OR 1.95, 95%CI 1.05–3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20–1.64) were significantly associated with recurrent MD.
Conclusions
In Chinese women CSA is strongly associated with recurrent MD and this association increases with greater severity of CSA. Depressed women with CSA have some specific clinical traits. Some features of CSA were associated with greater likelihood of developing recurrent MD.
41 citations
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Wellcome Trust Centre for Human Genetics1, Zhengzhou University2, XinHua Hospital3, Shanxi Medical University4, China Medical University (PRC)5, Shanghai Mental Health Center6, Capital Medical University7, Sun Yat-sen University8, Jiangsu University9, Harbin Medical University10, Hebei Medical University11, Chongqing Medical University12, Sichuan University13, Lanzhou University14, Shantou University15, Tongji University16, Jinan University17, Wuhan University18, Tianjin First Center Hospital19, Clinical Trial Service Unit20, Virginia Commonwealth University21
TL;DR: Significantly more episodes of MDD occur among those with lower educational attainment (rather than longer episodes of disease), consistent with the hypothesis that the lower socioeconomic position increases the likelihood of developing MDD.
Abstract: Background
The prevalence of major depressive disorder (MDD) is higher in those with low levels of educational attainment, the unemployed and those with low social status. However the extent to which these factors cause MDD is unclear. Most of the available data comes from studies in developed countries, and these findings may not extrapolate to developing countries. Examining the relationship between MDD and socio economic status in China is likely to add to the debate because of the radical economic and social changes occurring in China over the last 30 years.
Principal findings
We report results from 3,639 Chinese women with recurrent MDD and 3,800 controls. Highly significant odds ratios (ORs) were observed between MDD and full time employment (OR = 0.36, 95% CI = 0.25–0.46, logP = 78), social status (OR = 0.83, 95% CI = 0.77–0.87, logP = 13.3) and education attainment (OR = 0.90, 95% CI = 0.86–0.90, logP = 6.8). We found a monotonic relationship between increasing age and increasing levels of educational attainment. Those with only primary school education have significantly more episodes of MDD (mean 6.5, P-value = 0.009) and have a clinically more severe disorder, while those with higher educational attainment are likely to manifest more comorbid anxiety disorders.
Conclusions
In China lower socioeconomic position is associated with increased rates of MDD, as it is elsewhere in the world. Significantly more episodes of MDD occur among those with lower educational attainment (rather than longer episodes of disease), consistent with the hypothesis that the lower socioeconomic position increases the likelihood of developing MDD. The phenomenology of MDD varies according to the degree of educational attainment: higher educational attainment not only appears to protect against MDD but alters its presentation, to a more anxious phenotype.
29 citations
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China Medical University (PRC)1, Fudan University2, Shanghai Mental Health Center3, Zhengzhou University4, XinHua Hospital5, Shanxi Medical University6, Capital Medical University7, Sun Yat-sen University8, Jiangsu University9, Harbin Medical University10, Hebei Medical University11, Chongqing Medical University12, Sichuan University13, Lanzhou University14, Shantou University15, Tongji University16, Jinan University17, Wuhan University18, Tianjin First Center Hospital19, Wellcome Trust Centre for Human Genetics20, Clinical Trial Service Unit21, Virginia Commonwealth University22
TL;DR: The present findings indicate that specific factors act to increase the likelihood of suicide in MD, and may help improve the clinical assessment of suicide risk in depressed patients, especially for women.
Abstract: The relationship between suicidality and major depression is complex. Socio- demography, clinical features, comorbidity, clinical symptoms, and stressful life events are important factors influencing suicide in major depression, but these are not well defined. Thus, the aim of the present study was to assess the associations between the above-mentioned factors and suicide ideation, suicide plan, and suicide attempt in 6008 Han Chinese women with recurrent major depression (MD). Patients with any suicidality had significantly more MD symptoms, a significantly greater number of stressful life events, a positive family history of MD, a greater number of episodes, a significant experience of melancholia, and earlier age of onset. Comorbidity with dysthymia, generalized anxiety disorder (GAD), social phobia, and animal phobia was seen in suicidal patients. The present findings indicate that specific factors act to increase the likelihood of suicide in MD. Our results may help improve the clinical assessment of suicide risk in depressed patients, especially for women.
24 citations
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China Medical University (PRC)1, Zhengzhou University2, Shanghai Mental Health Center3, XinHua Hospital4, Shanxi Medical University5, Capital Medical University6, Sun Yat-sen University7, Jiangsu University8, Harbin Medical University9, Hebei Medical University10, Chongqing Medical University11, Sichuan University12, Lanzhou University13, Shantou University14, Tongji University15, Jinan University16, Wuhan University17, Tianjin First Center Hospital18, Wellcome Trust Centre for Human Genetics19, Clinical Trial Service Unit20, Virginia Commonwealth University21
TL;DR: Although depressed women smokers experience more severe illness, smoking rates remain low in MDD patients, consistent with the hypothesis that the association of smoking and depression may be caused by common underlying factors.
Abstract: Objective
To investigate the risk factors that contribute to smoking in female patients with major depressive disorder (MDD) and the clinical features in depressed smokers.
Methods
We examined the smoking status and clinical features in 6120 Han Chinese women with MDD (DSM-IV) between 30 and 60 years of age across China. Logistic regression was used to determine the association between clinical features of MDD and smoking status and between risk factors for MDD and smoking status.
Results
Among the recurrent MDD patients there were 216(3.6%) current smokers, 117 (2.0%) former smokers and 333(5.6%) lifetime smokers. Lifetime smokers had a slightly more severe illness, characterized by more episodes, longer duration, more comorbid illness (panic and phobias), with more DSM-IV A criteria and reported more symptoms of fatigue and suicidal ideation or attempts than never smokers. Some known risk factors for MDD were also differentially represented among smokers compared to non-smokers. Smokers reported more stressful life events, were more likely to report childhood sexual abuse, had higher levels of neuroticism and an increased rate of familial MDD. Only neuroticism was significantly related to nicotine dependence.
Conclusions
Although depressed women smokers experience more severe illness, smoking rates remain low in MDD patients. Family history of MDD and environmental factors contribute to lifetime smoking in Chinese women, consistent with the hypothesis that the association of smoking and depression may be caused by common underlying factors.
10 citations
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Jiangsu University1, Shanghai Mental Health Center2, Zhengzhou University3, XinHua Hospital4, Shanxi Medical University5, China Medical University (PRC)6, Capital Medical University7, Sun Yat-sen University8, Harbin Medical University9, Hebei Medical University10, Chongqing Medical University11, Sichuan University12, Lanzhou University13, Shantou University14, Tongji University15, Jinan University16, Wuhan University17, Tianjin First Center Hospital18, Wellcome Trust Centre for Human Genetics19, Clinical Trial Service Unit20, Virginia Commonwealth University21
TL;DR: The pattern does not fit a simple dose-response relationship, suggesting that there are moderating factors involved in the relationship between environmental precipitants and the onset of dysthymia, and it is possible that severe life events in childhood events index a general susceptibility to chronic depression.
Abstract: Background
Dysthymia is a form of chronic mild depression that has a complex relationship with major depressive disorder (MDD). Here we investigate the role of environmental risk factors, including stressful life events and parenting style, in patients with both MDD and dysthymia. We ask whether these risk factors act in the same way in MDD with and without dysthymia.
5 citations
Cited by
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TL;DR: In the general Chinese population, the Chinese version of the PHQ-9 is a valid and efficient tool for screening depression, with a recommended cutoff score of 7 or more.
582 citations
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TL;DR: The findings clearly highlight the potential impact of the more "silent" types of childhood maltreatment (other than physical and sexual abuse) on the development of depression.
346 citations
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Wellcome Trust Centre for Human Genetics1, Chang Gung University2, Max Planck Society3, University of Granada4, University of Cambridge5, National Institute for Health Research6, Sichuan University7, Harbin Medical University8, Zhengzhou University9, China Medical University (PRC)10, Chongqing Medical University11, Nanjing Medical University12, Zhejiang Chinese Medical University13, Capital Medical University14, Hebei Medical University15, Sun Yat-sen University16, Shanxi Medical University17, Jiangsu University18, University of Oxford19, Peking Union Medical College20, Virginia Commonwealth University21, East China Normal University22
TL;DR: It is demonstrated that changes in the amount of mtDNA and telomere length are consequences of stress and entering a depressed state and have important implications for understanding how stress causes the disease.
205 citations
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01 Nov 2004-Centre for Health Research; Faculty of Health; Institute of Health and Biomedical Innovation
TL;DR: The psychological and behavioral profile of abused, young Chinese people, including the additional burden associated with contact abuse, is similar to that found in other cultures.
Abstract: Objective:
Little is known about Child Sexual Abuse (CSA) in Chinese societies. This study examined CSA experiences and associations with demographic factors, self-reported health and risky behaviors among senior high school students in four provinces in central and northern China.
Method:
Students in four schools in Hubei, Henan, Hebei, and Beijing provinces participated in an anonymous, self-completed questionnaire survey. From a total enrolment of 3,261 students in the target classes in years 11 and 12, 2,300 (70.5%) returned valid questionnaires. Mean age was 17.2 years. The questionnaire was adapted from prior CSA research in Australia and utilized standard scales for depression, self-esteem, and youth risk behavior.
Results:
Prevalence of any unwanted sexual experience before the age of 16 years was higher among females (16.7%) than males (10.5%). Sexual penetration was rarely reported (1%), while 7% reported at least one type of physical contact abuse (female 8.9%, male 5.0%). Risk of any CSA was not associated with the existence of siblings (one-child vs. two- or more child families), rural/urban residence during childhood, or parental education. Males and females with CSA were more depressed and suicidal, and drank alcohol more often, than unaffected adolescents. Contact CSA was strongly associated with sexual intercourse (ever) for both males and females. Females with CSA were more likely than others to engage in anorexic and bulimic behaviors, while males with CSA were often involved in violence.
Conclusion:
Social norms for consensual sexual experiences differ between Eastern and Western societies. CSA experiences also differ, with substantially less penetrative and physical contact abuse in China. However, the psychological and behavioral profile of abused, young Chinese people, including the additional burden associated with contact abuse, is similar to that found in other cultures.
154 citations
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129 citations