Aims: Loneliness is increasingly recognised as a serious public health issue worldwide. However, there is scarce research addressing the association between loneliness and suicide in older adults in rural China. We set out to examine loneliness and other psychosocial factors in elderly suicide cases and explore their interaction effects. Methods: Using a 1 : 1 matched case–control design, data were collected from 242 elderly suicide cases and 242 living community controls by psychological autopsy method in rural China, including demographic characteristics, loneliness, depression, hopelessness and social support. The chi-square automatic interaction detection (CHAID) tree model and multivariable logistic regression analysis were used to explore the relationships of these factors and suicide. Results: The CHAID tree model showed that loneliness, hopelessness and depressive symptoms were closely associated with completed suicide and that loneliness and hopelessness interacted with each other. The result of multivariable logistic regression showed that individuals who were unemployed [odds ratio (OR) = 2.344; 95% confidence interval (CI): 1.233–4.457], living alone (OR = 2.176; 95% CI: 1.113–4.254), had lower levels of subjective social support (OR = 2.185; 95% CI: 1.243–3.843), experienced depressive symptoms (OR = 6.700; 95% CI: 3.405–13.182), showed higher levels of hopelessness (OR = 7.253; 95% CI: 3.764–13.974) and felt higher levels of hopelessness × higher levels of loneliness (OR = 2.446; 95% CI: 1.089–5.492) were significantly associated with an elevated suicide risk in older people in rural China. Conclusions: Regular evaluation of loneliness, hopelessness and depression can help detect older adults who are at risk of committing suicide. Interventions should target social support systems, particularly among people living alone, to alleviate feelings of loneliness and hopelessness. Treating depression is also key to preventing suicide among elderly people in rural China.

Introduction: Concern over mental health morbidity affecting people living with HIV is increasing worldwide. The objective of this study was to describe the longitudinal trajectories of depression and anxiety, and mental health service utilization among people newly diagnosed with HIV.Methods: This was an observational cohort study that enrolled people newly diagnosed with HIV consecutively and followed them for one year in Changsha, China. Socio‐demographic, clinical and psychological data were collected at the baseline and at one‐year follow‐up. Participants were recruited between March 1, 2013 and September 30, 2014. The final follow‐up was in September 30, 2015.Results: Among 557 people newly diagnosed with HIV enrolled at the baseline, 410 (73.6%) completed the one‐year follow‐up survey (median (interquartile range) age at follow‐up: 29 (25, 39) years; 376 men (91.7%)), and were included in the analysis. 39.3% and 30.2% of the 410 participants were screened with significant symptoms of depression and anxiety at baseline respectively. An overall drop in the prevalence of each condition was found at follow‐up, however, 10.5% and 6.1% of participants were found to have persistent depression and anxiety. The results of mixed‐effect models showed that bisexuality, homosexual transmission, other clinical symptoms (for example, not on antiretroviral therapy (ART)), non‐disclosure, higher levels of HIV/AIDS‐related stress, and lack of social support were associated with significant symptoms of depression and anxiety. One year after diagnosis, 8.3% had visited healthcare providers for emotional or psychological problems.Conclusions: Despite the obvious need people newly diagnosed with HIV in China rarely seek professional help. Integrating depression and anxiety screening and referral into HIV care settings is warranted.

Objective: In recent years, there has been a significant increase in research using ecological momentary assessment (EMA) to explore suicidal thoughts and behaviors (STBs). Meanwhile, concerns have been raised regarding the potential impacts of frequent and intense STBs assessments on the study participants.Methods: From November 2021 to June 2023, a total of 83 adolescent and young adult outpatients (M_age = 21.0, SD_age = 6.3, 71.1% female), who were diagnosed with mood disorders, were recruited from three psychiatric clinics in China. Smartphone-based EMA was used to measure suicidal thoughts three times per day at randomly selected times. We examined the change of suicidal thoughts in each measurement and within 1 day to evaluate potential adverse effects using Bayesian multilevel models.Results: The 3,105 effective surveys were nested in 83 participants (median follow-up days: 14 days). The results of two-level models indicated that suicidal thoughts decreased during the monitoring period. However, this effect varied among different individuals in the two-level model.Conclusion: Our findings did not support the notion that repeated assessment of suicidal thoughts is iatrogenic, but future research should continue to investigate the impact of frequent assessment on suicidal thoughts, taking into account individual differences and utilizing larger sample sizes.

Objectives: We aimed to assess the quality of information regarding depression on Chinese websites and popular video platforms.Methods: We conducted searches on website platforms (Baidu, Bing) and video platforms (Bilibili, Douyin) using search terms “depression”, “depressive disorder”, “depression treatment”, “depressive anxiety”, “depressed patient”, and “depressive symptoms”. We collected the first 50 results with each search term in each platform. Each website and video included in this study was assessed using The DISCERN instrument (DISCERN), Journal of American Medical Association benchmark criteria (JAMA), Hexagonal Radar Schema (HRS), and Global Quality Scores (GQS).Results: A total of 177 websites, 216 Bilibili videos, and 244 Douyin videos were included. Among all the platforms, websites had the highest median scores on DISCERN and HRS, at 33 and 2 respectively, but were still classified as “poor” and “very poor” according to the classification. Bilibili, Douyin, and websites had median scores of 3, 2, and 2 respectively in JAMA, indicating a moderate level of quality. Bilibili, Douyin, and websites all had a median score of 2 for GQS, and were of poor quality. Only the percentage score for JAMA was more than half of the weighted score, while none of the other scales reached half of the score. The median percentage scores of the websites in DISCERN, HRS, and GQS were higher than those of Bilibili and Douyin (P < 0.001). Compared to other sources, news media on websites and medical organizations on videos demonstrated higher quality (all P values < 0.05).Conclusions: The findings of the study indicated an overall low quality of online depression information. Collaborative efforts between platforms and professionals are necessary to improve the comprehensiveness and quality of depression-related information available online. In addition, the platform needs to prioritize optimizing the algorithm of recommendations and present real high-quality health information to the audience.

Background: West African countries experienced the highest under-5 mortality rate (U5MR), the lowest life expectancy, and the poorest economic development. This study aimed to explore the spatiotemporal trend of U5MR and spatial spillover effects of health resources and services to provide a basis for establishing health policies and international cooperative mechanisms in West Africa.Methods: We retrieved data from the World Health Organization’s Global Health Observatory, the United Nations Human Development Report, and the Global Burden of Disease Study 2019. Joinpoint regression analysis and Moran’s I method were used to examine the temporal trend and spatial dependence of U5MR, respectively. Spatial regression analysis was used to examine the spatial spillover effects.Results: The long-term downward trends in U5MR were divided into multiple segments by two or three change points in 2013, 2014, or 2015, and the annual percentage change after 2015 was higher than before 2015. Global Moran’s I was positive, significantly indicating positive spatial autocorrelation, which increased from 0.2850 (p = 0.0210) to 0.3597 (p = 0.0080). Based on spatial regression analysis, human development index (HDI), physicians density, nurses and midwives density, health center density, percentage of infants lacking immunization for diphtheria and measles, and coverage rate of at least one antenatal visit had negative spatial spillover effects on U5MR. HDI had the strongest negative correlation (β = −0.0187 to −0.1054, p < 0.0001). Current health expenditure (CHE) per capita had positive spatial spillover effects on U5MR.Conclusion: This study revealed the spatiotemporal trend of U5MR in West African countries and spatial spillover effects of health resources and services. Promoting economic development, increasing health human resources, health expenditure, vaccination rate, antenatal care coverage, and the proportion of health professionals attending births not only reduced the local U5MR but also exerted spatial spillover effects on adjacent countries. The West African Health Organization may consider regional spillover mechanisms to develop regional health policy and intervention cooperation mechanisms, which will contribute to achieving the sustainable development goal on U5MR, Africa Agenda 2063, and universal health coverage.