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Zhang S.,Tongji University | Edwards H.,Queensland University of Technology | Yates P.,Queensland University of Technology | Li C.,Shanghai Institute of Mental Health | And 2 more authors.
Dementia and Geriatric Cognitive Disorders | Year: 2014

Background: There is a paucity of research assessing health-related quality of life (HRQoL) and self-efficacy in caregivers of relatives with dementia in mainland China. Aims: To compare the level of HRQoL between caregivers and the general population in mainland China and to assess the role of caregiver self-efficacy in the relationship between caregiver social support and HRQoL. Methods: A cross-sectional study was conducted in Shanghai, China. The caregivers were recruited from the outpatient department of a teaching hospital. A total of 195 participants were interviewed, using a survey package including the Chinese version of the 36-Item Short-Form Health Survey (SF-36), demographic data, the variables associated with the impairments of care recipients, perceived social support and caregiver self-efficacy. The caregivers' SF-36 scores were compared with those of the general population in China. Results: The results indicated that the HRQoL of the caregivers was poorer compared with that of the general population when matched for age and gender. Multiple regression analyses revealed that caregiver self-efficacy is a partial mediator between social support and HRQoL, and a partial mediator between behavioral and psychological symptoms of dementia (BPSD) and caregiver mental health. Conclusion: Assisting with managing BPSD and enhancing caregiver self-efficacy can be considered integral parts of interventions to improve caregiver HRQoL. © 2013 S. Karger AG, Basel.

Zhang S.,Tongji University | Guo Q.,Fudan University | Edwards H.,University of Queensland | Yates P.,University of Queensland | Li C.,Shanghai Institute of Mental Health
International Psychogeriatrics | Year: 2014

Background: This study aims to explore moderation and mediation roles of caregiver self-efficacy between subjective caregiver burden and (a) behavioral and psychological symptoms (BPSD) of dementia; and (b) social support. Methods: A cross-sectional study with 137 spouse caregivers of dementia patients was conducted in Shanghai. We collected demographic information for the caregiver-patient dyads, as well as information associated with dementia-related impairments, caregiver social support, caregiver self-efficacy, and SF-36. Results: Multiple regression analysis showed that caregiver self-efficacy was a moderator both between BPSD and subjective caregiver burden, and social support and subjective caregiver burden. Results also showed a partial mediation effect of caregiver self-efficacy on the impact of BPSD on subjective caregiver burden, and a mediation effect of social support on subjective caregiver burden. Caregiver self-efficacy and subjective burden significantly influenced BPSD and social support. Conclusion: Caregiver self-efficacy played an important role in the paths by which the two factors influenced subjective burden. Enhancing caregiver self-efficacy for symptom management (particularly BPSD) can be an essential strategy for determining interventions to support dementia caregivers in China, and possibly in other countries. © International Psychogeriatric Association 2014.

Li J.,Shanghai JiaoTong University | Zhou G.,Shanghai JiaoTong University | Ji W.,Shanghai JiaoTong University | Feng G.,Shanghai Institute of Mental Health | And 14 more authors.
Archives of General Psychiatry | Year: 2011

Context: Recent genome-wide association studies have revealed that common variations and rare copy-number variations contribute to the risk of mental disorders. Rare recurrent microdeletions at 1q21.1 were reported to be associated with schizophrenia, and the BCL9 gene at 1q21.1 was also a functional candidate gene for mental disorders. Objectives: To investigate and validate whether common variations exist in a functional candidate gene in the copy-number variation region, and, if so, to determine whether these variations confer risk of schizophrenia or other mental disorders. Design: A 3-stage case-control study. Setting: Shanghai, China. Participants: A total of 12 229 subjects were included: 5772 normal controls, 4187 patients with schizophrenia, 1135 patients with bipolar disorder patients, and 1135 patients with major depressive disorder. Main Outcome Measure: During the first and second stages of our study, we genotyped 10 singlenucleotide polymorphisms using the ligation detection reaction method. During the third stage of our study, all single-nucleotide polymorphisms were genotyped using TaqMan technology (Applied Biosystems, Foster City, California). Results: During the first stage of our study, we found that rs672607 was significantly associated with schizophrenia (P = 2.69 × 10-5). During the second stage, rs672607 was successfully replicated (P = 1.33 × 10-5), and rs9326555 (P = .002), rs1240083 (P = 1.7 × 10-4), and rs688325 (P = .006) were newly identified to be significant. During the third stage, we genotyped all singlenucleotide polymorphisms in 1135 patients with schizophrenia, 1135 patients with bipolar disorder, 1135 patients with major depressive disorder, and 1135 normal controls for further validation. Finally, when we combined all the data from the 3 stages of our schizophrenia study, we found that rs9326555 (P = 1.53 × 10-5), rs10494251 (P = .02), rs1240083 (P = 1.52 × 10-4), rs672607 (P = 1.23 × 10-11), rs688325 (P = 2.54 × 10-4), and rs3766512 (P = .01) were significant. Moreover, we found that rs672607 was significant in major depressive disorder (P = .001) and bipolar disorder (P = .03), and rs10494251 (P = .04), rs1541187 (P = .04), rs688325 (P = .02), and rs946903 (P = .006) were significant in major depressive disorder. Conclusion: These findings indicate that common variations in the BCL9 gene confer risk of schizophrenia and may also be associated with bipolar disorder and major depressive disorder in the Chinese Han population. ©2011 American Medical Association. All rights reserved.

Zhang S.,Tongji University | Edwards H.,Queensland University of Technology | Yates P.,Queensland University of Technology | Guo Q.,Fudan University | Li C.,Shanghai Institute of Mental Health
PLoS ONE | Year: 2013

We explored the mediation effect of caregiver self-efficacy on the influences of behavioral and psychological symptoms (BPSD) of dementia care recipients (CRs) or family caregivers' (CGs) social supports (informational, tangible and affectionate support and positive social interaction) on CGs' mental health. We interviewed 196 CGs, using a battery of measures including demographic data of the dyads, CRs' dementia-related impairments, and CGs' social support, self-efficacy and the Medical Outcome Study (MOS) Short-Form (SF-36) Health Survey. Multiple regression analyses showed that gathering information on self-efficacy and managing CG distress self-efficacy were the partial mediators of the relationship between positive social interaction and CG mental health. Managing caregiving distress self-efficacy also partial mediated the impact of BPSD on CG mental health. We discuss implications of the results for improving mental health of the target population in mainland China. © 2013 Zhang et al.

Liu J.,Shanghai JiaoTong University | Li Z.-Q.,Shanghai JiaoTong University | Li J.-Y.,Shanghai JiaoTong University | Li T.,Shanghai JiaoTong University | And 7 more authors.
Journal of Clinical Psychiatry | Year: 2012

Background: Schizophrenia and bipolar disorder are 2 major psychiatric illnesses sharing some specific genetic risk factors. Increasing evidence suggests the 2 illnesses might be more closely related than previously considered. Objective: To test this hypothesis, we investigated the allele and genotype frequencies of 11 single nucleotide polymorphisms (SNPs) and the haplotypes in these SNPs of the YWHAE gene. Method: 1,982 patients were interviewed by 2 independent, experienced psychiatrists. Bipolar disorder diagnoses were made in strict accordance with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria using the Structured Clinical Interview for DSM-IV Axis I Disorders. In 2011, we conducted this genetic association analysis between 11 SNPs in YWHAE and bipolar disorder, involving a male group and a female group. Results: In the analysis of allele and genotype frequencies, the SNP rs1873827 increased susceptibility to bipolar disorder in the male group. The haplotype analysis of CAC in rs3752826, rs2131431, and rs1873827 in the male group (χ2 = 25.744, P = 3.97E-07, OR = 0.478 [95% CI, 0.358-0.639]) and of ACT and CAC in rs3752826, rs2131431, and rs1873827 in the female group (for ACT, χ2 = 30.365, P = 3.67E-08, OR = 0.040 [95% CI, 0.007-0.218]; for CAC, χ2 = 16.874, P = 4.04E-05, OR = 0.597 [95% CI, 0.466-0.765]) showed they are protective factors for bipolar disorder. However, the haplotype analysis of CAT in the male group (χ2 = 19.874, P = 8.39E-06, OR = 2.314 [95% CI, 1.587-3.374]) and of AAC and CAT in the female group (for AAC, χ2 = 38.561, P = 5.47E-10, OR = 7.104 [95% CI, 3.471-14.540]; for CAT, χ2 = 25.497, P = 4.52E-07, OR = 2.076 [95% CI, 1.556-2.770]) showed they are risk factors for bipolar disorder. Conclusions: Considering the size of our sample, the results suggest that YWHAE does play a major role in bipolar disorder in the Han Chinese population. © Copyright 2012 Physicians Postgraduate Press, Inc.

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