The medical side-effects of China's stockmarket crash

by MICHAEL WOODHEAD

Headaches, irritability, depression and most of all insomnia are the most common medical side effects of China's stockmarket crash, doctors say.

Mental health specialists at Guangzhou's prestigious Sun Yat Sen Hospital say they have seen a stream of unwell patients this week suffering from the mental effects of severe stress from the stockmarket collapse.

"Some people can not sleep at night, have difficulty falling asleep or wake up in the early hours three or four times a night.
Many people have overt physical symptoms such as palpitations, chest tightness, aches and pains, stupor and confusion," says psychiatrist Dr Wei Qinling.

Dr Wei says the worst affected people are those with a casino mentality towards the stockmarket and those with little mental resilience, who are most at risk of severe depression, mental confusion and possible suicide risk. Other common reactions are despair, alcohol abuse and loss of motivation. Some workers in the finance industry say there is nothing to work for anymore, and they have lost a reason to work. Others have lost their livelihoods altogether. Dr Wei says some have gone on extreme drunken binges to try wipe out the stress.

And in what some are calling "stocks syndrome", people suffers from sever stress from the sudden reversal from riches to destitution. This is a mix of severe anxiety, guilt, frustration and mental paralysis. Dr Wei says some people have symptoms that are so severe they may require hospital admission and antidepressant treatment.

However, at the Beijing Union Medical College Hospital Department of Psychological Medicine, Dr Li Jianzhong says some people are looking for a quick fix for symptoms such as insomnia. Some of the most difficult to treat are those who were most greedy when the market was good and became obsessed with the stockmarket. After making large gains they are now in denial and are unable to accept that they have made losses and cannot adjust to reality. Counselling may be needed, but it requires people to learn about "spiritual wealth" as well as financial wealth, he says.

Dr Li says there are two steps to treating "stock syndrome". Firstly, people must identify the cause of their symptoms and learn to manage the stressors through activities such as deep breathing and findings distractive activities such as walking or sport. Secondly, people must find an alternative to obsession with the stockmarket and focus on that.

In Shanghai, psychologist Dr Chen Gong says there has been an increase in patients with 'financial stress' but it would be an exaggeration to say his department has been overwhelmed. For him, two of the most serious consequences of mental stress from the stockmarket are cardiovascular and cerebrovascular disease. These may be triggered by severe stress, and people must learn to change their habits and behaviour to have a more balanced life, he suggests. Another problem with financial stress is its effect on the family,and relationships, he adds. He recommends that people talk openly with their family and focus more on family activities rather than being preoccupied with speculating on shares.

Dr Wei, however, warns that for some people the stockmarket has become a form of addiction, just like gambling. He warns family members to look out for signs of addiction and to recommend counselling and treatment for those who have become addicted to the stocks - and are at risk of withdrawal symptoms.

Some good news about the chaining of mentally ill patients in China, from the 686 Program

by Michael Woodhead
In recent years there have been several media articles about mentally ill people in China being chained up - usually by families - because there are no mental health services. 

The impression given by the articles is that this is a widespread practice and is going unchallenged. "This is an example of how mental disorders are dealt with in rural China" said The Independent. It is enlightening, therefore, to read that such practices are rare and have been targeted for elimination for more than a decade. In a sobering paper published in PLOS One this week, Dr Lili Guan and colleagues at the Peking University Institute of Mental Health talk abut the so-called 686 program that has been running since 2005 to provide basic mental health services and ensure human rights are upheld for people with severe mental disorders.

In their article they describe how they recruited village health workers across China to seek out and identify mentally ill people who had been chained up by families. Their program found 271 such people - some of whom had been in chains for 28 years, but most had been chained for shorter periods and intermittently as circumstances arose, rather than continuously. Cases of chaining were rare - accounting for only 0.2% of mental health patients reviewed in the program.

Most of the chained people had schizophrenia and none of them were receiving care from mental health institutions, usually because there were no such community services in their area, or the families could not afford it. The patients were restrained mostly because they were violent and abusive, causing harm to people and property.

The program of 'unlocking' was focused on providing free antipsychotic medications. Patients were first admitted to psychiatric units and assessed, and then families were provided with free medications and a treatment plan. The 'unlocked' patients were then returned home to live in the community.
The good news from the program is that regular treatment rates went from 1% to 75% and most patients complied with treatment and showed great improvements. Their functioning improved and the family burden also lightened significantly. Relapse into ''locking' occurred with only 21 patients (8%), with families citing lack of adherence to medication and return to violence or harmful behaviour and lack of caretaker/financial resources to access help.

"The finding that more than 92% of those unlocked and entered into continuous treatment by the 686 Program remained free of restraints by 2012 demonstrates the feasibility of improving the human rights of persons with severe mental illness by increasing access to mental health care in the community, even with limited societal resources," the researchers said.

"Nevertheless, the failure to prevent relocking for 21 individuals suggests that considerable room for improvement of our mental health care practice still exists."

The researchers also noted that their program covered less than 1% of the population of mentally ill people in China, and said it would require more resources to allow it to cover the whole country.

"There is obviously much to be done in China to scale up the 686 Program for the whole nation and to improve quality of care. This will require substantially increased investment in mental health services. However, the success of the program in maintaining the severely ill individuals in treatment over three to seven years, and the benefits of the intervention for those who have lived for years with untreated psychosis and for their families, attests to the feasibility and social value of the “686” model."

Authors note: Restraint for people with mental illness is not uncommon practice in  western countries, particularly for elderly people in nursing homes. Medical groups in countries such as Australia have expressed concern that patients who are agitated and have challenging behaviour are sometimes restrained due to lack of staff and for convenience, rather than for their own wellbeing.

Psychiatry in China: ask a few questions, give a lot of pills

by Michael Woodhead

The neglected state of psychiatry in China is highlighted in an article published by Xinhua this week. In essence the article says that psychiatrists are overworked, underpaid and undertrained - and thus seldom have the time or inclination to provide any kind of talk therapy to patients with mental health or psychological problems. Just drugs.

According to the article, the typical psychiatric consultation involves filling in a form that consists of a few questions such as "Do you have trouble sleeping at night?" and "Do you think life has little meaning?" After reviewing the answers to the form, the doctor then hands over a bag of pills - or a prescription  - with little dialogue or questioning between doctor and patient. According to one young woman who sought help for nightmares and severe stress, the process made her think of the doctor as more of a pharmacy clerk than a psychiatrist.

The article then compares the cost of seeing a psychiatrist at a public hospital - about 50 yuan for 10-20 minutes, with the 1000 yuan fee for a similar consultation with a 'counsellor' in a private clinic. One psychiatrist said that psychiatry was a low priority for most hospitals because unlike 'procedural' branches of medicine there was very little profit to be made from seeing patients. He said some irresponsible doctors tried to increase their income by seeing as many as 30 patients in one morning and providing many kinds of expensive psychotropic drug  - all encouraged by pharmaceutical companies as part of the biomedical model of psychiatry. However, many patients said they wanted more time to talk with a doctor and discuss their problems in more depth. To do this, a doctor could not see more than 10 patients in one shift - but this is just not viable for public hospital psychiatric clinics.

Another psychiatrist told Xinhua that China had a mental illness rate of about 17% - which meant there would be 173 million people requiring psychiatric treatment. However, China has only about 10,000 qualified psychiatrists, which is far too few to manage this number of patients. The shortage of psychiatrists is especially bad in rural areas.

Experts said that typically a psychiatric patient might need at least four sessions of psychological treatment lasting one hour each. However this was not possible when hospitals could only charge 30-50 yuan per doctor visit. Therefore, some patients turn to private clinics which charge 500-1000 yuan for a single consultation, even though some of these are run by unqualified practitioners and offer unscientific therapies.

Patients often required non-drug therapies such as psychotherapy or even physical therapy, but these were not profitable for state-owned hospitals, the expert said. According to analysts, psychiatric clinics in China are underfunded and there are far too few psychiatrists and psychologists. The answer, they say, is to encourage the investment with 'social capital' (ie private business and corporations) and also to increase the awarenes of mental health problems and their treatment in China

China's first mental health law - 27 years in the making, but will it change negative attitudes?

by Michael Woodhead
There is a very severe stigma about mental health in China - just try calling someone "shenjingbing" (神经病, mentally ill)  and watch the reaction. This cultural taboo about mental health  is just as strong for doctors in China - a 2012 survey found that even Chinese psychiatrists had negative and unscientific views about mental illness. Most worryingly, many psychiatrists believed that the best approach for someone with mental illness was to institutionalise them, by force, if necessary. There is still a strong belief in involuntary treatment of mental health conditions in China.

It is therefore interesting to see the reactions to the Mental Health Law that was enacted more than a year ago, in May 2013. This law had originally been proposed by the Ministry of Health back in 1985. Such was the lack of interest in change and the entrenched attitudes, it took more than 20 years to get even as far as the draft stage, when it was submitted to the State Council in 2007. After much more negotiation and consultation, the law was approved and came into effect on 1 May 2013.

To westerners, much of the law would appear unremarkable. It states that mental illness must be treated according to basic clinical guidelines, with an emphasis on prevention, treatment and rehabilitation. Where the law has proved controversial (in China at least) is on the matter of involuntary treatment. The new law states that for people with mental illness, "voluntary admission and treatment should be the priority".  It also states that involuntary admission should be based on “risk criteria", but this is a grey area that is untested in China.

In an article published this month by three psychiatrists from Shanghai's Jiaotong University School of Medicine, it is argued that the new law is flawed and will still allow mentally ill patients to be inappropriately 'committed' to an institution on flimsy pretenses. They argue that the risk criteria are too broad and open to interpretation. They say the regulations put too much weight on the opinions and wishes of the families of mentally ill people. In reality this will mean that families with 'backward' attitudes and knowledge about mental health will be able to 'get rid' of the stigma of mentally ill person in their family by having them admitted involuntarily.

The psychiatrists say the national law also lacks detail and may not be implemented at a local level. They point to local programs and treatment pathways for mental illness that have been adopted in advanced cities such as Shanghai and Beijing, and they say these should be the model for other parts of China. 

However, for the time being psychiatric treatment remains out of reach for many people with mental illness in China. There are an estimated 173 million people with psychiatric disorders in China, but only 20,000 psychiatrists and a few hundred mental hospitals and clinics. China has a long way to go in providing appropriate care for its many citizens with mental illness.

Mental health treatment in China: still in the dark ages?

by Michael Woodhead

Stigma and shame still feature highly in attitudes towards mental illness among the public - and even among family members of patients, a survey carried out at one of China's leading psychiatric hospitals has revealed. 

Guangzhou Psychiatric hospital was the first mental health treatment institution set up in China and is still one of the largest and most 'progressive' units in the country. Last year, researchers surveyed 87 doctors and 162 nurses at the hospital and 137 family members of people with mental illness, as well as 150 members of the public.

They found, unsurprisingly that medical staff tended to have enlightened views about mental illness - that it has biopsychosocial causes and may best be dealt with in community treatment. However, relatives of patients and the public tended to hold the traditional view that mental illness was something that should be treated in institutions and that patients do not belong in the community.

There was also support for involuntary treatment of mental illness. In rural areas there were also more superstitious beliefs that mental illness might be caused by curses, devils or bad luck.

The researchers said the negative attitudes held by family members might arise because they lived in close proximity to people with mental illness and had to cope with them in isolation as there was little community or health service support for mental illness. "Families must should much of the burden of mental illness alone,"they wrote.

"The results draw attention to the crucial issue of what has been called "family burden" the painful, often debilitating and health-endangering experience of caring for seriously mentally ill family members’ day in and day out. These experiences may be especially strong in Asian countries such as China in which the family, rather than the state or society, has a heavy burden of responsibility for mentally ill relatives, extending even to fiscal responsibility for their occasional damage of neighborhood property or criminal conduct."

The findings support provision of respite care for mentally ill people in China, "that gives family members some distance from the problems of their relatives and support in their care," the researchers concluded.

Smoking deprivation | Suicidal ideation in school students | Obesity surgery | Oestrogen in the environment

About 7% of Chinese people smoke so much their spending on cigarettes deprives the household of essential items like food, a study from Beijing has found. Low-income smokers were more likely to have smoking-induced deprivation.

Suicidal ideation occurs in one in three Chinese high school girls and 20% of boys, a study of 5249 students in Anhui Province of China has found.

Laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy are safe and effective for the treatment of morbid obesity, resulting in 63% and 76% loss of excess weight, a study from Nankai Hospital of Tianjin Medical University has shown.

The waist circumference cut off for high risk of central obesity and metabolic syndrome is 85 cm for women and 90 cm for men, researchers from Shandong have shown.

In Shanghai, almost one-in-five boys are obese and 8% of girls are obese. The prevalence of combined overweight and obesity is 49% for boys and 31% for girls aged 8-15-years, according to a study that found rates of obesity started to increase from age 10 years.

Oestrogen hormones are widely used in animal rearing in China and this leads to high levels of the hormones in excreted manure which is then used on crops, perpetuating the environmental contamination and human exposure, researchers from the State Key Laboratory of Water Environment Simulation, Beijing have shown.

The highly pathogenic strain of H7N9 avian influenza is quite different from other H7N9 strains seen in China and appears to have come about by re-assortment with the H9N2 strain, according to researchers from the Guangdong Provincial Center for Disease Control and Prevention.

Infliximab is safe and effective in Chinese patients with ulcerative colitis, resulting in 85% response rates and 62% remission rates after 30 weeks of treatment. However, relapse rates are high, say researchers from the Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou.

Africans face health discrimination in China | Cochlear implants success | Fake doctor operates on 1500 women | Psychiatrist says 10 words charges 1000 yuan fee

Africans in China face medical discrimination
With the growing economic links between China and Africa there are as many as 100,000 Africans in Guangzhou but they lack access to healthcare, an article in The Lancet this weeks says. Africans in China face racial discrimination, which fuels mental health problems and also is a barrier to them getting access to needed health services and support. Many Chinese people maintain stereotypes toward Africans viewing them as prone to violence and posing risks to public health through spreading diseases, the article says. While China sends medical teams to Africa, it ignores the Africans living within China.
"Providing Africans medical care is consistent with China's health-care reform, but the system has failed to close the treatment gap. Chinese doctors are not trained in culturally adapted care or in the management of specific diseases affecting Africans, and translation services are unavailable," the article concludes.

More Chinese medical tourists
Affluent Chinese are now seeking medical care overseas, according to CCTV. Their report says more Chinese are going to foreign countries for treatment and the trend is blamed on the lack of access to high quality clinics in China.

No takers for dispute insurance
Few people are choosing to take part in a new surgical insurance program that is designed to reduce medical disputes. The new medical insurance scheme pays only in the event of unsatisfactory results caused by medical malpractice not covered by traditional medical indemnity insurance.

Bionic ears work well in China
Cochlear implants have been used successfully in hundreds of Chinese deaf children and have had few complications, according to a new report from Henan. Cochlear implantation is a safe procedure and early postoperative complications are minor, say clinicians from the Department of Otology at the First Affiliated Hospital of Zhengzhou University.

Fake doctor did nearly 1500 operations
A bogus surgeon working at a gynaecology clinic in Henan performed 1485 operations on women and made almost half a million yuan in profit before being caught, Zhengzhou media report. The Pingdangshan court sentenced bogus doctor Ma Juan to nine years in prison and fined him 300,00 yuan for performing minimally invasive surgery on women at the Third Peoples Hospital gynaecology clinic. The manager of the clinic was also jailed for 12 years for employing the fake doctor and encouraging him to exaggerate illness and overtreat women with unnecessary but profitable operations such as cervical cauterisation and nerve blocks.

Psych clinic has few words of comfort
A Chongqing father has complained of extortionate charges and poor doctor-patient communication at a mental health clinic where he took his uncommunicative 'autistic' daughter for treatment. The man told the Chongqing Evening News that he had to pay almost 1000 yuan for antidepressant medicines after a brief consultation with a doctor who did not speak more than ten words to him or his daughter. The father sad the costs for the questionnaire test and brief consultation were excessive. A medical expert said mental health clinics were under a lot of time pressure and were not designed to provide psychotherapy but to treat psychiatric diseases. If patients want to talk more they should visit a psychologist, he suggested.

My top10 medical stories from China for Saturday 22 February

1. Smoking with a water pipe confers a 'profound' risk of chronic obstructive pulmonary disease (COPD) among people in south west China and also carries a high risk from passive smoking, researchers have shown.

2. Patients with pneumonia of unexplained origin should be promptly investigated for H7N9 risk factors such as exposure to poultry and they should also be given pre-emptive antiviral treatment such as Tamiflu, the Beijing health department has ordered.

3. About 85% of Chinese doctors experience burnout, with those who are younger, unmarried and working in emergcncy medicine having the highest risk of serious burnout, a study shows.

4. Fertility clinics in China need to become more patient-friendly as they are perceived as too impersonal and lacking in transparency and respect for patient informed consent, researchers say.

5. The stigma of mental illness in Chinese culture means that patients with schizophrenia often do not understand their medication and are unwilling to take any anti-psychotic medication, according to a study from the Guangzhou Psychiatric Hospital.

6. H. Pylori infection rates are over 90% among people in their thirties in Jiangsu, which may explain high rates of gastric cancer in the region, say researchers from Nanjing.

7. Babies in Shenyang have increased rates of neurodevelopmental deficits because their mothers were exposed to high levels of organophosphorous pesticides during pregnancy, according to a study in PLOS One.

8. Adenovirus has emerged as a significant cause of serious pneumonia in China, with a study showing that 5% of cases are attributable to the virus.

9.  People with tuberculosis are also at high risk of HIV, with rates of around 3% in groups tested in TB patients from Guangxi, Henan and Sichuan, say Chinese researchers.

10. A mediation service for patients involved in medical disputes with hospitals is to be launched in Shanghai and it will be open to patients where compensation claims exceed 30,000 yuan ($2900) regardless of whether the hospital refers them.

Hubei group protest forced psychiatric treatment of people without mental illness

People who complain against the government are being forced into mental institutions and given forced treatment with antipsychotics and electroconvulsive therapy, a human rights group in Hubei has told Radio Free Asia.. Liu Feiyue, a spokesman for the Civil Rights and Livelihood Watch says the psychiatric hospital system is being abused and there have been 40-50 cases of forced treatment of healthy people during 2013, in contravention of China's new Mental Health Law, which came into effect in 2013 but is not being implemented on the ground.

Sexual re-orientation clinics in China: AFP has the story

Sexual re-orientation clinics to convert gay people back into heterosexuals are doing booming business in China, according to an article by AFP from Beijing (no byline) .
The clinics use electric shock therapy on men while watching gay porn to try 'program' them against being gay. Sounds like the plot of the Tom Sharpe novel Indecent Exposure.
The article says 'conversion therapy' is a lucrative industry in China, with at least five clinics claiming to offer “sexuality adjustment” through various means, including hypnosis, drugs and electric shock therapy. One of them is the Haiming Psychological Consulting Centre in Beijing which offers electric shock treatment -- in 30-minute sessions every few days. Other clinics are reported to offer less severe 'treatments' for homosexuality such as counselling and antidepressants, claiming that homosexuality is changeable in people for whom it was not “innate”. One gay man who went to a clinic under pressure from his father said he was told to wrap an elastic band around his hand and hurt himself if he fantasised about gay sex.
The article adds that such clinics are now being opposed by LGBT groups in China, who say they “deeply damage homosexuals’ physical and mental health, and worse infringe on their self-respect”.

Medical news in China's media

HIV is one of several conditions newly listed as occupational diseases for police and  medical workers, meaning that those who develop the illness will be eligible for work-related injury insurance reimbursement. Other new conditions covered are leukasmus, blast exposure hearing damage, and ocular burns (such as to the cornea, lens of the eye or retina) caused by laser light and frostbite, according to Women of China.

The city of Lanzhou in Gansu has adopted tough new anti-smoking measures in public places. New legislation specifies "non-smoking" indoor areas, including medical institutions, schools, government office buildings, public dining places, and public transport carriers. Smokers, face fines from 50 to 200 yuan, according to the Peoples Daily.

Police in Henan broke up a fake medicine production ring that placed fake-drug ads on the radio and the internet and used bogus medical experts to talk with patients.According to CRI the fake drug operation had earned the fraudsters 300 million yuan

And in the China Daily, psychiatrists are reported to be looking at links between China's terrible smog problems and mental health. Clinicians say studies are needed on the negative impact of smoggy days on anxiety and depression due to lack of sunlight and production of the hormone melatonin.

Shanghai pioneers mental health laboratory

Shanghai has set up a key mental health research laboratory to intensify efforts to diagnose and treat severe mental illnesses, which affect nearly 1 percent of China's population.
"Over the past 20 years, there has been little progress in the field," Xu Yifeng, president of the Shanghai Mental Health Center, said in a recent interview.
"The question of how to combine basic science and clinical research has not been solved."
The new lab, opened in November, will focus on solving a bottleneck in the study of severe mental illnesses through a combination of multiple disciplines, such as molecular and cell biology, brain imaging and bioinformatics, a method for processing biological data using computer science and mathematics.

Psychiatric hospital sued for detaining healthy woman

Huilongguan Hospital in Beijing was sued by a female engineer named Chen Dan for 200,000 yuan ($32,820) for infringement of liberty.

Chen had been taken to the mental hospital by her parents against her will. After spending three days in the inpatient wards, she was pronounced to be not ill. Chen said the hospital violated her rights by failing to conduct any psychiatric exam or diagnosis before admitting her.

The hospital has countersued Chen Dan for 200,000 yuan for damaging its public image. They argued that Chen's parents were responsible for checking her into the hospital, and that they had provided effective medical treatment. Because Chen has refused to accept mediation, the case is still pending.

Source: East China News Service

In China, depression goes untreated due to stigma and lack of psychiatrists

China has only 15 psychiatrists per million people

In China, long-standing social stigma around depression is a major obstacle. 
In rural areas in particular, people lack awareness and those with depression are often written off as being simply too lazy to do anything. Other times, people with mood disorders are considered insane and patients and their families are usually embarrassed or ashamed to do anything about it.
A lack of understanding is another factor. People mistakenly believe that they can simply get better through sheer willpower. An online survey by the World Psychiatry Association and sohu.com in July 2012 showed that about 45 percent of respondents said they wouldn't go to a hospital if they had depression. Over 75 percent of them believed that they would not need to see a doctor or be medicated.
Among those who do choose to seek help, most visit general hospitals, which highlights the importance for doctors in community hospitals to receive psychiatric training and learn how to recognize and diagnose depression.
The survey showed that of the patients who went to treat cardiovascular, gastrointestinal or other diseases in general hospitals, over 20 percent also had clinical depression or anxiety disorder, said He Yanling, director of clinical epidemiology at Shanghai Institute of Mental Health, the Xinhua News Agency reported in July last year. But the diagnostic rate in general hospitals remains abysmal.
There are about 20,000 registered psychiatrists in China, which translates to about 15 psychiatrists per million people, according to Xinhua. There are also around 40,000 certified counseling psychologists in the country, but they do not have the legal right to prescribe medication for depression but only offer counseling as a complement to treatment.
Not only is professional help limited by these numbers but the abilities of these professionals vary greatly. Many people who suffer from depression have been bounced around between several different doctors who all fail to give them the help they need.
Read the full article: Global Times

Journal watch - clinical news

Waste water from Beijing hospitals is replete with anti-psychotics, antidepressants and sedatives.  
Source: Chemosphere.

Many Chinese people with depression have chronic back pain or neck pain.
Source: Psychiatric Research

Concern about drug resistant malaria from Plasmodium vivax in Central China.
Source: Korean Journal of Parasitology.

Almost 60% of prostitutes on China-Vietnam border have herpes, 5% have HIV.
Source: Biomedical and Environmental Sciences

Backyard duck breeders in Beijing at risk of avian flu.
Source: PLOS One.

Psychiatric hospital used to detain outspoken professor, dissidents say

A law lecturer at Jiliang Universty Hangzhous was sent to a psychiatric institution after speaking about 1989

Authorities in the eastern Chinese province of Zhejiang have had an outspoken professor who talked to his students about the 1989 Tiananmen Square massacre forcibly committed to a psychiatric facility, rights groups and fellow activists said on Tuesday.
Professor Wang Peijian, who teaches at China Jiliang University in Hangzhou, initially resisted being forced into a psychiatric hospital by authorities for expressing “politically sensitive” opinions in class over the past few weeks, the China Human Rights Defenders (CHRD) said in an e-mailed statement.
Wang was informed by a school administrator on Dec. 7 that his classes would be suspended beginning the next day.
"Wang believed that this was because he had spoken to students about his views on, among other topics, the [ruling] Chinese Communist Party’s monopoly on power, the 1989 massacre around Tiananmen Square, and suppression of human rights lawyers," CHRD said.
Hangzhou-based writer Zan Aizong, who is a close friend of Wang's, said Wang had managed to evade psychiatric committal for a while by locking himself inside a room.
"Wang Peijian called me a number of times ... and he told me the school had contacted his brother to try to get him to go along with the school in having him taken to a mental hospital," Zan said.
Wang Peijian had also said that his comments to students that the ruling Communist Party should relinquish power had probably been reported by his students to the authorities, he added.
"The school thought he must be having a mental breakdown, or that his mood must be unstable, and that they should suspend his classes and have him taken to a psychiatric unit," Zan said.
The school's security personnel later succeeded in taking Wang to the No. 7 Hangzhou Psychiatric Hospital, according to sources close to the family.
Wang's brother, Wang Zhuangjian, said he was unable to manage the situation without help, and confirmed that he had collaborated with school security officials.
"Everything went pretty smoothly, with a minimum of physical resistance," he said. "We have already taken the measures most likely to protect my brother."
According to a post on the popular Sina Weibo microblogging service by Beijing-based legal scholar Teng Biao, Wang had been a founding member of the banned opposition China Democracy Party (CDP).
Trained in law, Wang had been refused a license to practice as a lawyer after he graduated and finished his law firm apprenticeship, Teng said.
"He had divorced a few months ago ... and was under huge psychological pressure," Teng's post said.
Chinese psychiatric patients are routinely subjected to abuse of their rights in a system that makes scant distinction between different kinds of mental illness, according to a recent report by CHRD.
While reports have become more widespread in recent years of the incarceration of rights activists and petitioners in psychiatric institutions for political reasons, genuine mental health patients are also highly vulnerable to abuses under the current system, the group said.
The report, titled "The Darkest Corners," detail the grim conditions and human rights abuses faced by people who are committed to psychiatric care against their will, even if they do not pose a demonstrable threat of harm to themselves or to others.
Source: Radio Free Asia

China clinical news in brief

* IV alteplase improves stroke outcomes in Chinese patients if given within the 'golden window' of four hours.   
Read more: CNS Neuroscience and Therapeutics

* Eradication of schistosomiasis in China may not be as straightforward as expected.  
Read more: Parasites and Vectors

* Emotionally abused Chinese children more likely to have ADHD.  
Read more: PLOS One

* Oral Supplementation with vitamin D (cholecalciferol) ameliorates albuminuria in Chinese Type 2 diabetes patients .  
Read more:PLOS One

Almost one in three elderly Chinese have contemplated suicide

In a study of 263 people over 50 years of age in Mianyang, Sichuan, the lifetime prevalence of suicidal ideation was 28.9%, planning 11.4% and attempt 5.3%  respectively. The corresponding 12-month prevalence was 8.8% for ideation,  2.7% for planning and 0% for attempting suicide, respectively.

Correlates of suicidal thoughts/behaviors of this group are similar to findings from other community studies, such as female gender, unmarried status, major medical conditions, insomnia, financial difficulties and lower education, depressive symptoms, recent stressful life events, greater life dissatisfaction.

Read more: International Journal of Geriatric Psychiatry 27: 1124

Health ministry promotes family co-operation model of care for schizophrenia

China's health ministry plans to promote therapies for schizophrenia patients based on closer interactions between family members and doctors, an official said on Thursday.
The therapeutic alliance formed between doctors and a patient's family will help patients receive continuous treatment and prevent relapses, Yan Jun, head of the mental health division under the disease control department of the Ministry of Health, said at an event here.
The ministry will select several psychiatric hospitals to run trials of the therapeutic patterns, he said.
Currently, 41 percent of schizophrenia patients in China relapse within a year after being released from hospital, said Yang Fude, head of Beijing Huilongguan Hospital, a leading psychiatric hospital and one of the hospitals set to participate in the trial.
Xinhua