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  1. Ferraro KF, Su Y
    J Gerontol B Psychol Sci Soc Sci, 1999 Jan;54(1):S3-15.
    PMID: 9934397
    OBJECTIVES: This article examines how financial strain and social relations may independently and jointly influence psychological distress among older people in four nations.

    METHODS: Data from four Western Pacific nations (N = 3,277) are used to test additive and multiplicative models of the relationships between financial strain, social relations, and psychological distress.

    RESULTS: Financial strain is associated with higher levels of psychological distress in three of the four nations. Interactive models of the effects of financial strain and social relations on distress were uncovered in three of the four nations, but the type of social relation influencing the strain-distress relationship varied. Subjective-health and IADLs were significant predictors of psychological distress in all four nations.

    DISCUSSION: Findings suggest that although financial strain is quite likely to lead to psychological distress among elders, this can be mitigated, at least in part, by social relationships. Modernization was not associated with higher psychological distress.

  2. Su YP, Ferraro KF
    J Gerontol B Psychol Sci Soc Sci, 1997 Jan;52B(1):S27-36.
    PMID: 9008679
    Research on health assessments has shown the importance of social relations as a factor influencing health, especially among older people. Drawing upon sociological theories of social integration and social exchange, this research examines two domains of social relations which are expected to influence assessed health. In addition, the study uses a cross-national sample (N = 3,407) of noninstitutionalized older people from the Republic of Korea, Fiji, Malaysia, and the Philippines to determine if modernization conditions the relationships between social relations and health. Results indicate that social integration has a positive effect on subjective health assessments in all nations, whereas social contributions are significant only in Korea. Findings suggest that health assessments by elders in the most modernized nations appear to be much more influenced by the contributions they make to the social order than is the case in nations which are less modernized.
  3. Zhang Y, Li B, Su Y
    Molecules, 2023 Jul 21;28(14).
    PMID: 37513442 DOI: 10.3390/molecules28145571
    The advancement of efficient and stable single-atom catalysts (SACs) has become a pivotal pursuit in the field of proton exchange membrane fuel cells (PEMFCs) and metal-air batteries (MABs), aiming to enhance the utilization of clean and sustainable energy sources. The development of such SACs has been greatly significant in facilitating the oxygen reduction reaction (ORR) process, thereby contributing to the progress of these energy conversion technologies. However, while transition metal-based SACs have been extensively studied, there has been comparatively less exploration of SACs based on p-block main-group metals. In this study, we conducted an investigation into the potential of p-block main-group Sn-based SACs as a cost-effective and efficient alternative to platinum-based catalysts for the ORR. Our approach involved employing density functional theory (DFT) calculations to systematically examine the catalyst properties of Sn-based N-doped graphene SACs, the ORR mechanism, and their electrocatalytic performance. Notably, we employed an H atom-decorated N-based graphene matrix as a support to anchor single Sn atoms, creating a contrast catalyst to elucidate the differences in activity and properties compared to pristine Sn-based N-doped graphene SACs. Through our theoretical analysis, we gained a comprehensive understanding of the active structure of Sn-based N-doped graphene electrocatalysts, which provided a rational explanation for the observed high four-electron reactivity in the ORR process. Additionally, we analyzed the relationship between the estimated overpotential and the electronic structure properties, revealing that the single Sn atom was in a +2 oxidation state based on electronic analysis. Overall, this work represented a significant step towards the development of efficient and cost-effective SACs for ORR which could alleviate environmental crises, advance clean and sustainable energy sources, and contribute to a more sustainable future.
  4. Aizah N, Su Y, Shaifulnizam C, MRos M
    Malays Orthop J, 2014 Jul;8(2):66-8.
    PMID: 25279099 MyJurnal DOI: 10.5704/MOJ.1407.015
    Extruded bone is a rare complication of high energy open fractures, and there is only a handful of literature on reimplantation of the extruded segment. No clear guidelines exist regarding timing of reimplantation, stabilization of extruded bone segments, and also bone disinfection and sterilization techniques. Previous reports describe sterilization using thermal or chemical methods. We present a case of successful reimplantation of an extruded metaphyseal segment of femur after gamma sterilization in a fourteen- year old boy.
  5. Ren C, Su Z, Su Y, Wang L
    Biomed Res Int, 2022;2022:5152911.
    PMID: 36093408 DOI: 10.1155/2022/5152911
    Polyurethane, as a rubber material, can relieve the load on the ground and provide seismic design for the venue, which is of great significance for sports venues. In order to improve the seismic resistance and abrasion resistance of materials for sports fields and reduce accidents in sports, this article has carried out research on the polyurethane elastomer layered nanocomposites for sports fields and their preparation. Today's world is a challenging era of science and technology. The fields of biotechnology, information, medicine, energy, environment, and national defense and security are closely related to the development of high tech, and the requirements for materials are becoming increasingly diversified. Polymer nanocomposite coating has the dual characteristics of organic and inorganic components. It not only retains the advantages of a polymer but also endows it with versatility. It meets the current application needs. It is a hot spot in today's research. Among them, there are two major problems in the composite process of nanomaterials and polymers: dispersion and compatibility. How to improve the dispersion of nanoparticles and enhance the compatibility between nanoparticles and polymers is an urgent problem to be solved. In the method part, this article introduces a small amount of polyurethane and polyurethane elastomers formed after polyurethane modification and introduces layered compounds and nanocomposites and introduces several models involved in nanomaterials in terms of algorithms. In the analysis part, this paper conducts a comprehensive analysis of the hard segment mass fraction, mechanical properties, thermal decomposition behavior, degradation mechanism, and dynamic mechanical properties. With the increase of GO content, the tensile strength increases significantly and the elongation at break becomes smaller and smaller. When the GO content increases from 0% to 2%, the tensile properties of the WPU film increase from 2.6 MPa to 7.9 MPa and the fracture of the elongation decreased from 201.7% to 62.8%. This shows that the increase in GO content will make the composite material harder and brittle. It can be seen from the experimental results that the preparation of the polyurethane elastomer layered nanocomposite material designed in this paper has a good application effect on sports venues.
  6. Su Y, Chai XH, Tan CP, Liu YF
    J Food Sci, 2024 Apr 25.
    PMID: 38660921 DOI: 10.1111/1750-3841.17028
    In this paper, the compatibility, phase behavior, and crystallization properties of the binary blends of palm kernel stearin (PKS) and anhydrous milk fat (AMF) were investigated by analyzing the solid fat content (SFC), thermal properties, polymorphism, and microstructure, with the aim of providing theoretical guidance for the blending of oils. The results showed that the PKS content primarily determined the SFC trend of the binary blends. However, the binary blends demonstrated poor miscibility and eutectic behavior was predominantly observed in the system, particularly at higher temperatures. Only α and β' forms appeared in this blended system. Simultaneously, the addition of PKS elevated the liquid phase transition temperature of the binary blends, considerably significantly increased their crystallization rate when the addition of PKS was more than 20% and increased the density and size of the fat crystals. Finally, the mixing design optimization method was used to get the most suitable ratio of the binary blends in the refrigerated cream system with PKS:AMF to be 0.914:0.086. The cream prepared with the above binary blends was indeed superior in overrun and firmness and had high stability. PRACTICAL APPLICATION: Some fats with special advantages are often limited in their wide application because of their poor crystallization ability. In this paper, the crystallization ability of fats is improved, and their application scenarios are increased through the combination of fats, so as to provide reference for the production of special fats for food.
  7. Li L, Su Y, Li F, Wang Y, Ma Z, Li Z, et al.
    BMC Microbiol, 2020 03 24;20(1):65.
    PMID: 32209070 DOI: 10.1186/s12866-020-01754-2
    BACKGROUND: It has recently been reported that intermittent fasting shapes the gut microbiota to benefit health, but this effect may be influenced to the exact fasting protocols. The purpose of this study was to assess the effects of different daily fasting hours on shaping the gut microbiota in mice. Healthy C57BL/6 J male mice were subjected to 12, 16 or 20 h fasting per day for 1 month, and then fed ad libitum for an extended month. Gut microbiota was analyzed by 16S rRNA gene-based sequencing and food intake was recorded as well.

    RESULTS: We found that cumulative food intake was not changed in the group with 12 h daily fasting, but significantly decreased in the 16 and 20 h fasting groups. The composition of gut microbiota was altered by all these types of intermittent fasting. At genus level, 16 h fasting led to increased level of Akkermansia and decreased level of Alistipes, but these effects disappeared after the cessation of fasting. No taxonomic differences were identified in the other two groups.

    CONCLUSIONS: These data indicated that intermittent fasting shapes gut microbiota in healthy mice, and the length of daily fasting interval may influence the outcome of intermittent fasting.

  8. Liu Z, Li H, Gao D, Su J, Su Y, Ma Z, et al.
    Open Life Sci, 2022;17(1):1629-1640.
    PMID: 36567720 DOI: 10.1515/biol-2022-0516
    Ghee is a traditional Tibetan dairy product with high-fat content, low yield, plasticity, caseation, and rich nutrition. In this study, we analyzed the diversity of microbial communities in yak milk and ghee samples at high and low altitudes, especially the Lactobacillus genus, and further used metabolomic techniques to compare the differences in metabolites in yak ghee at different altitudes. The results showed that the increase in altitude had a significant and generally inhibitory effect on the microbial community diversity in milk ghee, and yak milk at high altitude was abundant in nutrients, which could antagonize the negative impact of increased altitude. Using non-targeted metabolomics, we infer the composition of flavor compounds in ghee: nine kinds of carboxylic acids, 11 kinds of esters, six kinds of ketones, two kinds of alcohols, and four kinds of alkene compounds, among which the key flavor compounds are dl-2-(acetylamino)-3-phenylephrine acid, 1-(4-methoxyphenyl)-2-propanone, sebacic acid, Lysope 18:1, and uracil 1-beta-d-arabinofuranoside. These flavor substances are found in Lactococcus, Lactobacillus, and Streptococcus. With the participation of Lactobacillus, it is synthesized through biosynthesis of alkaloids derived from ornithine, lysine, and nicotine acid and glyoxylate and decarboxylate metabolism, among which Lactococcus plays a key role. In this study, a variety of lactic acid bacteria related to ghee fermentation were screened out, revealing the composition of volatile flavor compounds in Gannan yak milk ghee in the Qinghai-Tibet Plateau and providing a reference for further key volatile flavor compounds and the formation mechanism of flavor compounds.
  9. Gou Z, Zheng H, He Z, Su Y, Chen S, Chen H, et al.
    Environ Pollut, 2023 Jan 15;317:120790.
    PMID: 36460190 DOI: 10.1016/j.envpol.2022.120790
    This study aims to investigate the positive effects of the combined use of Enterobacter cloacae and biochar on improving nitrogen (N) utilization. The greenhouse pots experimental results showed the synergy of biochar and E. cloacae increased soil total N content and plant N uptake by 33.54% and 15.1%, respectively. Soil nitrogenase (NIT) activity increased by 253.02%. Ammonia monooxygenase (AMO) and nitrate reductase (NR) activity associated with nitrification and denitrification decreased by 10.94% and 29.09%, respectively. The relative abundance of N fixing microorganisms like Burkholderia and Bradyrhizobium significantly increased. Sphingomonas and Ottowia, two bacteria involved in the nitrification and denitrification processes, were found to be in lower numbers. The E. cloacae's ability to fix N2 and promote the growth of plants allow the retention of N in soil and make more N available for plant development. Biochar served as a reservoir of N for plants by adsorbing N from the soil and providing a shelter for E. cloacae. Thus, biochar and E. cloacae form a synergy for the management of agricultural N and the mitigation of negative impacts of pollution caused by excessive use of N fertilizer.
  10. Yan S, Su Y, Xiao J, Luo X, Ji Y, Ghazali KHB
    Sensors (Basel), 2023 Oct 24;23(21).
    PMID: 37960380 DOI: 10.3390/s23218680
    Indoor location-based services (LBS) have tremendous practical and social value in intelligent life due to the pervasiveness of smartphones. The magnetic field-based localization method has been an interesting research hotspot because of its temporal stability, ubiquitousness, infrastructure-free nature, and good compatibility with smartphones. However, utilizing discrete magnetic signals may result in ambiguous localization features caused by random noise and similar magnetic signals in complex symmetric and large-scale indoor environments. To address this issue, we propose a deep neural network-based fusion indoor localization system that integrates magnetic and pedestrian dead reckoning (PDR). In this system, we first propose a ResNet-GRU-LSTM neural network model to achieve magnetic localization more accurately. Afterward, we put forward a multifeatured-driven step length estimation. A hierarchy GRU (H-GRU) neural network model is proposed, and a multidimensional dataset using acceleration and a gyroscope is constructed to extract more valid characteristics. Finally, more reliable and accurate pedestrian localization can be achieved under the particle filter framework. Experiments were conducted at two trial sites with two pedestrians and four smartphones. Results demonstrate that the proposed system achieves better accuracy and robustness than other traditional localization algorithms. Moreover, the proposed system exhibits good generality and practicality in real-time localization with low cost and low computational complexity.
  11. Gao K, Su Z, Meng J, Yao Y, Li L, Su Y, et al.
    Biol Res Nurs, 2024 Jan;26(1):125-138.
    PMID: 37579279 DOI: 10.1177/10998004231195541
    OBJECTIVE: This study aimed to investigate the effects of aerobic interval training and resistance training on anti-inflammatory adipokines, high sensitivity C-reactive protein, and clinical outcomes in sedentary men with metabolic syndrome.

    METHODS: A total of 33 sedentary men with metabolic syndrome (age: 46.2 ± 4.6 years; body mass index: 35.4 ± 1.9 kg.m2) were randomly assigned to one of 3 groups: aerobic interval training (n = 12), resistance training (n = 10), or control (n = 11). Participants in the exercise groups completed a 12-week training program, 3 sessions per week, while those in the control group maintained their sedentary lifestyle. The levels of high sensitivity C-reactive protein (hs-CRP), omentin-1, adiponectin, lipid profiles, blood pressure, glucose metabolism, body composition, and peak oxygen uptake (VO2peak) were measured at baseline and after the intervention.

    RESULTS: Both aerobic interval training and resistance training significantly improved the levels of omentin-1 and adiponectin, as well as reduced inflammation, as indicated by a decrease in hs-CRP levels. Exercise training also led to significant improvements in lipid profiles, blood pressure, glucose metabolism, and body composition. Specifically, the aerobic interval training group had significantly greater increases in high-density lipoprotein cholesterol and VO2peak, as well as greater reductions in low-density lipoprotein cholesterol, triglycerides, and total cholesterol compared to the resistance training group.

    CONCLUSION: Exercise training, particularly aerobic interval training and resistance training, can be an effective non-pharmacological intervention for managing inflammation and improving cardiovascular health in metabolic syndrome patients.

  12. Tung KM, Su Y, Kang YN, Hou WH, Hoang KD, Chen KH, et al.
    J Psychosom Res, 2024 Apr 13;181:111666.
    PMID: 38657565 DOI: 10.1016/j.jpsychores.2024.111666
    OBJECTIVE: Patients often experience pain and psychological distress when undergoing elective surgeries. Mindfulness-based interventions have been proposed as potential strategies to address these challenges. This meta-analysis aims to evaluate the efficacy of preoperative mindfulness-based interventions on several outcomes for patients undergoing elective surgery, including preoperative anxiety/depression, postoperative anxiety/depression, postoperative pain, and quality of life (QOL).

    METHODS: This meta-analysis encompassed randomized controlled trials published in the database PubMed, Cochrane, and Embase to August 2023. Mindfulness-based interventions were compared to control groups, who received treatment as usual (TAU). The RevMan software was employed to assess each outcome by using standardized mean difference based on patient-reported data. Subgroup analyses were further performed according to different categories of surgical types.

    RESULTS: Eight RCTs with a total of 685 patients were identified. This meta-analysis demonstrated significant difference in preoperative anxiety (SMD:-0.36, 95% CI: -0.62 to -0.11, p = .006) and postoperative pain immediately (SMD:-0.65,95% CI: -1.09 to -0.20, p = .004), 2-3 days (SMD:-0.40, 95% CI:-0.78 to -0.02, p = .04),at 14 days (SMD:-0.48,95% CI: -0.85 to -0.12, p = .009) and 28 days (SMD:-0.89,95% CI: -1.55 to -0.23, p = .008) postoperatively. However, there were no differences between postoperative anxiety, preoperative/postoperative depression, and QOL.

    CONCLUSION: Our findings suggest preoperative mindfulness-based interventions can effectively manage preoperative anxiety and postoperative pain in patients scheduled for elective surgery. Further research is warranted to explore the different timing and types of mindfulness-based intervention.

  13. Zhang Y, Gong X, Peng P, Wang J, Lu D, Zhan J, et al.
    Environ Pollut, 2024 Sep 03.
    PMID: 39236843 DOI: 10.1016/j.envpol.2024.124872
    Heterocapsa bohaiensis is a newly identified dinoflagellate species that causes harmful blooms in coastal areas in China, Malaysian, and New Caledonian. These blooms have led to substantial economic losses for local aquaculture. Previous studies have mainly focused on understanding the toxicity of H. bohaiensis. However, the causes of H. bohaiensis blooms remain unknown. In this study, we aimed to ascertain nitrogen (N) and phosphorus (P) requirements for the growth and reproduction of H. bohaiensis. Additionally, we sought to understand the functional mechanisms by comparing the transcriptomes of H. bohaiensis under nutrient-limited conditions and control conditions. The results revealed a wide range of acceptable N:P ratios for H. bohainensis, attributed to a mechanism involving nutrient storage, which allowed H. bohainensis to sustain its growth even when either nitrate or phosphate was depleted. Higher N:P ratios (> 27.5) were more conducive to the growth of H. bohainensis than f/2 medium or low ratios, which is related to the N:P ratios absorbed by H. bohainensis. The toxicity of H. bohainensis was significantly enhanced in N-limited or P-limited states. These findings underscore the significance of the physiological metabolism of H. bohainensis in adapting to environmental stresses induced by human activities and establishing the dominance of blooms.
  14. Gou Z, Ma NL, Zhang W, Lei Z, Su Y, Sun C, et al.
    Environ Res, 2020 09;188:109829.
    PMID: 32798948 DOI: 10.1016/j.envres.2020.109829
    Intensive studies have been performed on the improvement of bioethanol production by transformation of lignocellulose biomass. In this study, the digestibility of corn stover was dramatically improved by using laccase immobilized on Cu2+ modified recyclable magnetite nanoparticles, Fe3O4-NH2. After digestion, the laccase was efficiently separated from slurry. The degradation rate of lignin reached 40.76%, and the subsequent cellulose conversion rate 38.37% for 72 h at 35 °C with cellulase at 50 U g-1 of corn stover. Compared to those of free and inactivated mode, the immobilized laccase pre-treatment increased subsequent cellulose conversion rates by 23.98% and 23.34%, respectively. Moreover, the reusability of immobilized laccase activity remained 50% after 6 cycles. The storage and thermal stability of the fixed laccase enhanced by 70% and 24.1% compared to those of free laccase at 65 °C, pH 4.5, respectively. At pH 10.5, it exhibited 16.3% more activities than its free mode at 35 °C. Our study provides a new avenue for improving the production of bioethanol with immobilized laccase for delignification using corn stover as the starting material.
  15. Li Y, Babazono A, Jamal A, Liu N, Fujita T, Zhao R, et al.
    Soc Sci Med, 2022 Dec;314:115468.
    PMID: 36327638 DOI: 10.1016/j.socscimed.2022.115468
    Metabolic syndrome (MetS) prevalence has increased globally with considerable morbidity and economic burden at both individual and national levels. Japan is the first and only country that has introduced a nationwide lifestyle guidance intervention program to manage and control MetS. We conducted a quasi-experiment approach-regression discontinuity design-to evaluate the impact of this intervention on health outcomes at the population level. We retrospectively collected data of adults aged ≥35 years who participated in health checkups in 2015. Age in 2015 was used as the assignment variable, and an age of 40 years old was the threshold because those with MetS aged ≥40 were required to receive lifestyle guidance intervention. Among 26,772 MetS adults, those who received the intervention had significant reductions in obesity measurements (bodyweight, waist circumference, and body mass index [BMI]) after 1 year of this intervention. Blood pressure was also significantly reduced in men after 1 year of undertaking the intervention. The results were similar when including demographic, socioeconomic, and behavioral covariates and using alternative functional forms to estimate the impact, or when bandwidths around intervention thresholds were changed. Our results showed that lifestyle guidance intervention for MetS has an important impact on weight loss and blood pressure reduction at the population level. This intervention could address the high burden of obesity and cardiovascular diseases in Japan and other countries with an unmet need for MetS prevention and management.
  16. Ma J, Ma NL, Fei S, Liu G, Wang Y, Su Y, et al.
    Environ Pollut, 2024 Apr 01;346:123646.
    PMID: 38402938 DOI: 10.1016/j.envpol.2024.123646
    Stover and manure are the main solid waste in agricultural industry. The generation of stover and manure could lead to serious environmental pollution if not handled properly. Composting is the potential greener solution to remediate and reduce agricultural solid waste, through which stover and manure could be remediated and converted into organic fertilizer, but the long composting period and low efficiency of humic substance production are the key constraints in such remediation approach. In this study, we explore the effect of lignocellulose selective removal on composting by performing chemical pretreatment on agricultural waste followed by utilization of biochar to assist in the remediation by co-composting treatment and reveal the impacts of different lignocellulose component on organic fertilizer production. Aiming to discover the key factors that influence humification during composting process and improve the composting quality as well as comprehensive utilization of agricultural solid waste. The results demonstrated that the removal of selective lignin or hemicellulose led to the shift of abundances lignocellulose-degrading bacteria, which in turn accelerated the degradation of lignocellulose by almost 51.2%. The process also facilitated the remediation of organic waste via humification and increased the humic acid level and HA/FA ratio in just 22 days. The richness of media relies on their lignocellulose content, which is negatively correlated with total nitrogen content, humic acid (HA) content, germination index (GI), and pH, but positively correlated with fulvic acid (FA) and total organic carbon (TOC). The work provides a potential cost effective and efficient framework for agricultural solid waste remediation and reduction.
  17. Su Y, Ma T, Wang Z, Dong B, Tai C, Wang H, et al.
    ESC Heart Fail, 2020 Dec;7(6):4465-4471.
    PMID: 32945150 DOI: 10.1002/ehf2.12997
    AIMS: Elevated heart rate (HR) in heart failure (HF) is associated with worse outcomes, particularly in acute HF (AHF). HR reduction with ivabradine reduces cardiovascular events in HF patients with reduced ejection fraction. The present trial aimed to test the hypothesis that the early HR reduction using ivabradine improves clinical outcomes in patients with AHF.

    METHODS AND RESULTS: SHIFT-AHF is a prospective, multi-centre, double-blind, randomized, placebo-controlled trial to evaluate the efficacy and safety of ivabradine when adding to standard therapy in AHF patients (SHIFT-AHF). The trial will include 674 AHF patients with left ventricular ejection fraction 

  18. Su Y, Zhang W, Liang Y, Wang H, Liu Y, Zheng K, et al.
    Microbiol Spectr, 2023 Sep 20;11(5):e0191223.
    PMID: 37728551 DOI: 10.1128/spectrum.01912-23
    Viruses play crucial roles in the ecosystem by modulating the host community structure, mediating biogeochemical cycles, and compensating for the metabolism of host cells. Mariana Trench, the world's deepest hadal habitat, harbors a variety of unique microorganisms that have adapted to its extreme conditions of low temperatures, high pressure, and nutrient scarcity. However, our knowledge about isolated hadal phage strains in the hadal trench is still limited. This study reported the discovery of a temperate phage, vB_HmeY_H4907, infecting Halomonas meridiana H4907, isolated from surface sediment from the Mariana Trench at a depth of 8,900 m. To our best knowledge, it is the deepest isolated siphovirus from the ocean. Its 40,452 bp linear dsDNA genome has 57.64% GC content and 55 open reading frames, and it is highly homologous to its host. Phylogenetic analysis and average nucleotide sequence identification reveal that vB_HmeY_H4907 is separated from the isolated phages and represents a new family, Suviridae, with eight predicted proviruses and six uncultured viral genomes. They are widely distributed in the ocean, suggesting a prevalence of this viral family in the deep sea. These findings expand our understanding of the phylogenetic diversity and genomic features of hadal lysogenic phages, provide essential information for further studies of phage-host interactions and evolution, and may reveal new insights into the lysogenic lifestyles of viruses inhabiting the hadal ocean. IMPORTANCE Halomonas phage vB_HmeY_H4907 is the deepest isolated siphovirus from the ocean, and it represents a novel abundant viral family in the ocean. This study provides insights into the genomic, phylogenetic, and ecological characteristics of the new viral family, namely, Suviridae.
  19. Chen L, Xu YY, Lin JY, Ji ZP, Yang F, Tan S, et al.
    Asian J Psychiatr, 2024 Mar;93:103958.
    PMID: 38364597 DOI: 10.1016/j.ajp.2024.103958
    BACKGROUND AND AIM: Suicide is nearly always associated with underlying mental disorders. Risk factors for suicide attempts (SAs) in patients with bipolar disorder (BD) misdiagnosed with major depressive disorder (MDD) remain unelucidated. This study was to evaluate the prevalence and clinical risk factors of SAs in Chinese patients with BD misdiagnosed with MDD.

    METHODS: A total of 1487 patients with MDD from 13 mental health institutions in China were enrolled. Mini International Neuropsychiatric Interview (MINI) was used to identify patients with BD who are misdiagnosed as MDD. The general sociodemographic and clinical data of the patients were collected and MINI suicide module was used to identify patients with SAs in these misdiagnosed patients.

    RESULTS: In China, 20.6% of patients with BD were incorrectly diagnosed as having MDD. Among these misdiagnosed patients, 26.5% had attempted suicide. These patients tended to be older, had a higher number of hospitalizations, and were more likely to experience frequent and seasonal depressive episodes with atypical features, psychotic symptoms, and suicidal thoughts. Frequent depressive episodes and suicidal thoughts during depression were identified as independent risk factors for SAs. Additionally, significant sociodemographic and clinical differences were found between individuals misdiagnosed with MDD in BD and patients with MDD who have attempted suicide.

    CONCLUSIONS: This study highlights the importance of accurate diagnosis in individuals with BD and provide valuable insights for the targeted identification and intervention of individuals with BD misdiagnosed as having MDD and those with genuine MDD, particularly in relation to suicidal behavior.

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