Individual Characteristics Of Adolescent Psychiatric Patients Accessing Psychotherapy In China | Scientific Reports Nature.com
Individual Characteristics Of Adolescent Psychiatric Patients Accessing Psychotherapy In China | Scientific Reports – Nature.com https://clarkcountynewsnow.com/individual-characteristics-of-adolescent-psychiatric-patients-accessing-psychotherapy-in-china-scientific-reports-nature-com/
Abstract
Most mental health problems develop during childhood and adolescence, so identifying the mental health needs and care pathways of adolescents is crucial to improving prevention. This study aimed to understand the characteristics of adolescent patients with mental disorders receiving psychotherapy in China. Data were collected retrospectively from the psychotherapy records of 116 patients at the Weifang Mental Health Centre. Information collected included demographics, stressors, duration of psychotherapy, and clinical diagnosis. Chi-square tests and negative binomial regression models were used to explore the relationship between demographic and clinical variables. The results showed that depression was the most common diagnosis, followed by anxiety and stress-related disorders and bipolar and related disorders. Rural patients were more likely to report family stress, while urban patients were more likely to report school stress. Female patients were more likely to report family stress and to be diagnosed with depression. Family stress, social stress, school stress, patient origin and economic conditions were all significant predictors of the duration of psychological treatment. This study helps to understand the characteristics and psychotherapeutic needs of adolescents with mental disorders who receive psychotherapy in China so that the positive role of psychotherapy in the prevention, treatment and rehabilitation of mental disorders can be better utilised.
Introduction
The issue of youth mental health in China has attracted a great deal of attention and focus. As far as the issue of youth mental health itself is concerned, it is also a significant problem commonly faced by countries worldwide. According to a new study by the American Psychological Association, reported by Xinhua on 18 March 2019, young people’s mental health in the US has deteriorated (2019).”1. In the twenty-first century, due to the rapid development and changes in society, more and more adolescents are experiencing severe psychological stress and distress. They are even experiencing severe mental depression or suicide attempts. The China Mental Health Development Report (2019–2020) shows that the mental health index of adolescents aged 12–18 is decreasing with age, and the detection rate of depression among adolescents is 24.6%, with severe depression reaching 7.4%2.
There is a growing consensus that early detection, prevention and intervention in adolescence can help reduce the burden of mental illness3,4. For this reason, understanding the characteristics of adolescent mental illness, perceived stressors and pathways of care is essential for early detection and treatment. Psychotherapy has proven to be an effective theoretical technique and is widely used in mental health and mental health promotion practice5. With the growing understanding of the biopsychosocial model of medicine, the causes of the disease have been elevated from a single consideration of biological factors to a holistic view, highlighting the impact of psychological, socio-environmental and natural environmental factors on human health. Studies at home and abroad have pointed out that the combination of pharmacological treatment and systematic psychological treatment can help patients with mental disorders improve their compliance with treatment6,7, which is of great importance in strengthening the assistance for patients with mental disorders, effectively reducing mental disability, promoting their rehabilitation and return to society, and maintaining social harmony and stability7. However, little research has been conducted in China on the population of adolescents seeking psychotherapy services. A small number of studies on adolescents have highlighted the high prevalence of psychiatric disorders8,9, including depression10 and anxiety disorders11. Reluctance to seek psychological help has also been reported due to stigma and skepticism about the efficacy of psychotherapy12. Although there is a paucity of literature examining the psychological treatment of adolescents in China, this literature highlights the high prevalence of mental health problems. It confirms the need for more excellent prevention and early intervention in the region. To this end, a better understanding of the role that factors play in developing symptoms and the choice to seek help is crucial.
Against this background, this study intends to quantitatively analyse the psychotherapy records of 116 patients to understand the characteristics and psychotherapy needs of young people with mental disorders receiving psychotherapy in China, and on this basis, propose a mental health service model that better meets the needs of patients, to better exploit the positive role of psychotherapy in the prevention, treatment and rehabilitation of mental disorders. The first goal of this study was to describe our sample by looking at demographic factors (gender and residential status), stressor types, frequency of self-harm and suicidality, and clinical diagnoses. The study’s second goal was to look at the relationship between residential status, stressor frequency, and clinical diagnoses and the relationship between gender, stressor frequency, and clinical diagnoses. The third objective of this study was to find potential predictors of the duration of psychotherapy. Our study is the first attempt to describe the situation of adolescents with mental disorders receiving psychological treatment in China.
Methods
Study population and sample
This study was conducted in the psychotherapy outpatient clinic of a tertiary-level psychiatric hospital in Weifang. Retrospective data collection and variable extraction were conducted on psychotherapy records of adolescent patients in psychotherapy clinics between June 2019 and June 2021. The main techniques used in psychotherapy include cognitive therapy, supportive psychotherapy, and family therapy.
Psychotherapy records include information collected from adolescent patients and their families at treatment. Patients diagnosed with schizophrenia spectrum and other psychotic disorders, bipolar disorder and related disorders, depression, anxiety disorders, obsessive–compulsive disorder or trauma and stress-related disorders according to ICD-10 diagnostic criteria and aged between 12 and 18 years were included in the study. Patients were excluded if they also had a neurological disorder or if another severe disorder could explain their symptoms.
Data extracted from psychotherapy records included demographics (age, gender, residence, grade), presence of intentional self-harm and suicidal thoughts, primary diagnosis, and presence of psychotic features in the patient’s symptoms.
As described in the case list, perceived life stressors that may trigger symptoms were divided into five categories: Family stress (e. g., conflict with a family member), Social stress (e. g. no friends), School stress (e. g. declining academic performance), Physiological stress (e. g. lack of sleep) and Spiritual stress (e. g. fear of death; see Table 1 for more details). Each category was treated as a dichotomous variable (yes = 1; no = 0). The duration of psychotherapy includes the duration of treatment in terms of the number of sessions (i.e. the time from the first psychotherapy session to the end of treatment).
Data analysis
Statistical analyses were performed using SPSS version 26. Frequency analysis was used to describe our sample’s demographic and clinical characteristics and the frequency of stressors experienced. The Mann–Whitney U test was used to compare the psychotherapy duration of different genders. Chi-square tests were performed to investigate the impact of demographic differences on the stressors faced by adolescent patients and clinical diagnoses. Regression models using count data were used to identify predictors of psychotherapy duration (i.e. number of sessions). Violations of the equidiscrete assumption were assessed following Payne et al.13; the Chi-square/df ratio indicated overdispersion. Therefore, a negative binomial regression model was chosen based on Poisson13. The model’s potential predictors of psychotherapy duration included family stress, social stress, school stress, depressive disorders, anxiety and stress-related disorders, bipolar disorder, patient origin, economic conditions, self-harm, and suicidality.
Ethics approval and consent to participate
Weifang Medical University Ethics Committee has granted ethics approval (project ID: 2022YX043). Participants and their legal guardians gave verbal and electronic informed consent to participate in this study. This study adheres to the ethical principles set out by the World Medical Association WMA through the Declaration of Helsinki (1996 edition, revised 2013), the International Ethical Guidelines for Biomedical Research Involving Human Beings (2002) in collaboration with the International Council for Medical Sciences (CIOMS) of the World Health Organization (WHO). All methods were performed following relevant guidelines and regulations.
Results
The initial sample consisted of 146 patients. Thirty of these were later excluded, either because they did not meet the inclusion criteria or because the psychotherapy record form contained insufficient information. The final sample consisted of 116 patients, and the demographic characteristics of the sample are shown in Table 2.
In terms of the categories of stressors in the overall sample, family stress was the most frequently reported (62.9%), followed by social stress (37.1%), school stress (38.8%), and physiological stress (10.3%) and spiritual stress (6.9%).
Table ...
