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There is little investigation on the interaction effects of adverse childhood experiences (ACEs) and social support on non-suicidal self-injury (NSSI), suicidal ideation and suicide attempt in community adolescent populations, or gender differences in these effects.
To examine the individual and interaction effects of ACEs and social support on NSSI, suicidal ideation and suicide attempt in adolescents, and explore gender differences.
A school-based health survey was conducted in three provinces in China between 2013–2014. A total of 14 820 students aged 10–20 years completed standard questionnaires, to record details of ACEs, social support, NSSI, suicidal ideation and suicide attempt.
Of included participants, 89.4% reported one or more category of ACEs. The 12-month prevalence of NSSI, suicidal ideation and suicide attempt was 26.1%, 17.5% and 4.4%, respectively; all were significantly associated with increased ACEs and lower social support. The multiple adjusted odds ratio of NSSI in low versus high social support was 2.27 (95% CI 1.85–2.67) for girls and 1.81 (95% CI 1.53–2.14) for boys, and their ratio (Ratio of two odds ratios, ROR) was 1.25 (P = 0.037). Girls with high ACEs scores (5–6) and moderate or low social support also had a higher risk of suicide attempt than boys (RORs: 2.34, 1.84 and 2.02, respectively; all P < 0.05).
ACEs and low social support are associated with increased risk of NSSI and suicidality in Chinese adolescents. Strategies to improve social support, particularly among female adolescents with a high number of ACEs, should be an integral component of targeted mental health interventions.
We aimed to examine changes in serum bilirubin and uric acid (UA) levels in subcortical ischemic vascular disease (SIVD). In addition, we investigated if altered serum bilirubin and UA levels correlate with the subtypes of SIVD as well as the severity of leukoaraiosis (LA).
This cross-sectional study included 1098 consecutive patients with slight symptoms, such as dizziness, vertigo etc. According to magnetic resonance imaging (MRI) appearances, they were divided into either SIVD group or controls (CN), and the SIVD group was further grouped in lacunar infarction (LI) and LA subtypes, as well as different grades. Serum bilirubin and UA levels were determined by the vanadate oxidase method and enzymatic method respectively, after at least an eight hour overnight fasting, in all subjects.
The bilirubin level was obviously lower while the UA level was significantly higher in the SIVD group when compared with the controls. Moreover, the LA subgroup presented more significant changes in bilirubin and UA when compared to the LI subgroup in both males and females. The correlation was positive between the UA levels and the LA severity (r=0.134, p=0.006). Multivariate regression analysis revealed that the odds ratio (95% CI) for SIVD in the lowest tertile of total bilirubin (Tbil<9.58μmol/L) and highest tertile of UA (UA>339μmol/L) were 2.702(1.936–3.770) and 2.135(1.521–2.996) respectively after adjusting for confounding variables.
Serum bilirubin levels were lower, whereas UA levels were higher in SIVD patients when compared with controls in both males and females, especially in LA patients. Moreover, serum UA levels positively correlated to LA severity.