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.

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

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.

China's medical news for Friday 31 January

Breast milk contains high levels of DDT
Breastfeeding mothers in Zhejiang have high levels of DDT in their milk, a study has shown. Researchers said the high levels of DDT found in breast milk were in excess of safe limits and showed that human milk was "grossly polluted". The DDT was thoght to come from seafood in the diet, the researchers said in the journal Environment International.

Shanghai obesity myth dispelled
Shanghai researchers have dispelled the concept of 'metabolically healthy obese'. In a study of more than 211,000 people over 40 i 25 areas of China they showed that  obesity was a risk factor for  CHD regardless of the presence or absence of insulin resistance. The findings are published in the International Journal of Cardiology.

Zinc levels linked to naughty children
Low zinc levels have been linked to behavioural problems in pre-school children in China. A study conducted in 1314 children in Jintan, Jiangsu found that low zinc levels were significantly associated with increased reports of total behavior problems. Living in the suburbs was associated with increased internalizing problems, while higher mother’s education and being female were associated with decreased externalizing problems, the study in the journal Nutrients found.

N95 face masks prove effective

A study of the effectiveness of N95 masks in Beijing has found that they are protective against bacterial colonization, co-colonization and viral-bacterial co-infection. The clinical trial of 1441 hospital staff found the rate of bacterial colonization was 2.8% with N95 mask users, 5.3% in medical mask users  and 7.5% in staff who did not wear any mask. Co-infections of bacteria and/or a virus  occurred in up to 3.7% of healthcare workers and were significantly lower in N95 wearers, the study in Preventive Medicine showed. (NB: See our earlier story that found N95 masks were a poor fit for Chinese faces).

Medicine costs and hospitals

The Economist has an article explaining why China's hospitals are dependent on revenue from drug sales for their financial viability. The magazine says efforts to reduce corruption will be difficult until the system is reformed, as hospital derive 40% of income from commissions on medicines and medical products.

China has psychotherapy boom

Mental disorders have traditionally been a taboo subject in China, but SBS reports that a reality television show Psychological Sessions has been captivating audiences across China. And a researcher says there is now a 'psychotherapy-boom' in China as people have become aware of modern-day stresses and the need for treatment. 

Women don't get a fair go in health

Women face medical discrimination in China as they appear to have lower rates of treatment than men, a study suggests. Published in the International Journal for Equity in Health, the study finds that women have lower rates of hospital admission than men for the same conditions. Women also have lower rates of investigations and shorter hospital stays compared to their male equivalents.

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”.