The Lancet Regional Health: Western Pacific最新文献

{"title":"Asia Pacific Heart Rhythm Society (APHRS) scientific statement on stroke prevention strategies in patients with device-detected atrial fibrillation: the 4S-DDAF approach","authors":"Tze-Fan Chao ,&nbsp;Chu-Pak Lau ,&nbsp;Eue-Keun Choi ,&nbsp;Chi-Keong Ching ,&nbsp;Ngai-Yin Chan ,&nbsp;Chung-Lieh Hung ,&nbsp;Boyoung Joung ,&nbsp;Rungroj Krittayaphong ,&nbsp;Hung-Fat Tse ,&nbsp;Gregory Y.H. Lip","doi":"10.1016/j.lanwpc.2025.101770","DOIUrl":"10.1016/j.lanwpc.2025.101770","url":null,"abstract":"<div><div>Device-detected atrial fibrillation (DDAF), including atrial high-rate episodes recorded at a cardiovascular implantable electronic device and subclinical atrial fibrillation detected by insertable cardiac monitor and smart wearables, poses an increasing challenge in stroke prevention. Although oral anticoagulants (OACs) are effective in clinical AF, their benefit-risk balance in DDAF remains uncertain. In response, the Asia Pacific Heart Rhythm Society (APHRS) proposes the 4S-DDAF approach (Strip documentation and longest AF duration, Symptoms, Stroke [ischemic] history, and Score) to guide anticoagulation decisions. This approach integrates electrogram review, symptom assessment, history of ischemic stroke or transient ischemic attack (TIA), and CHA₂DS₂-VASc scoring, emphasizing individualized care. OACs are recommended for patients with AF episodes ≥24 h, prior stroke/TIA, CHA₂DS₂-VASc score ≥4, or vascular disease. In patients not meeting these thresholds, close monitoring and risk factor management are advised. The 4S-DDAF approach provides a practical and evidence-informed strategy for clinical decision-making in the management of DDAF.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101770"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Epidemiological characteristics of heatstroke in China, 2010–2023: a longitudinal study based on a national heatstroke surveillance system” [The Lancet Regional Health – Western Pacific 64C (2025) 101722]","authors":"Xiaoye Wang ,&nbsp;Fan Ding ,&nbsp;Xiaoqi Qi ,&nbsp;Ziyi Wang ,&nbsp;Yingxin Pei ,&nbsp;Lijie Zhang ,&nbsp;Jinghuan Ren ,&nbsp;Yeping Wang ,&nbsp;Qing Guo ,&nbsp;Biao Zeng ,&nbsp;Shiyao Xu ,&nbsp;Tian Liu ,&nbsp;Rui Wang ,&nbsp;Zhifeng Wang ,&nbsp;Guoqing Shi","doi":"10.1016/j.lanwpc.2025.101778","DOIUrl":"10.1016/j.lanwpc.2025.101778","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101778"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, persistence, and severity of 12-month and 30-day DSM-5 disorders in the World Mental Health Hong Kong Study","authors":"Corine S.M. Wong ,&nbsp;Candi M.C. Leung ,&nbsp;Shiyi Wu ,&nbsp;Francis P. Flores ,&nbsp;Yoona Kim ,&nbsp;Xiao Xiao ,&nbsp;Solomon B.K. Wong ,&nbsp;Wing Chung Chang ,&nbsp;Wai Chi Chan ,&nbsp;Nancy Xiaonan Yu ,&nbsp;Calvin P.W. Cheng ,&nbsp;Albert K.K. Chung ,&nbsp;Edwin H.M. Lee ,&nbsp;Wai Tat Chiu ,&nbsp;William G. Axinn ,&nbsp;Ronald C. Kessler ,&nbsp;Michael Y. Ni","doi":"10.1016/j.lanwpc.2025.101757","DOIUrl":"10.1016/j.lanwpc.2025.101757","url":null,"abstract":"<div><h3>Background</h3><div>The World Mental Health Hong Kong (WMHHK) Study aims to estimate 12-month and 30-day prevalence, persistence, severity, and correlates of DSM-5 anxiety, mood, and externalising disorders in Hong Kong, a densely populated city impacted by consecutive population-level stressors, including social unrest and the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>Face-to-face interviews, either in-person or video-based online, were conducted from November 2022 to March 2024 with a population-representative sample of 3053 adults aged 18 years and above. Diagnostic assessment utilised the World Mental Health Composite International Diagnostic Interview for DSM-5 (CIDI-5), evaluating ten mental disorders: anxiety (panic disorder, generalised anxiety disorder, post-traumatic stress disorder, obsessive-compulsive and related disorders), mood (major depressive disorder, persistent depressive disorder, bipolar spectrum disorders), and externalising (intermittent explosive disorder, alcohol use disorder, substance use disorder) disorders. Persistence was defined as 12-month prevalence among lifetime cases and 30-day prevalence among 12-month cases. Sociodemographic correlates were analysed using multivariable logistic regression.</div></div><div><h3>Findings</h3><div>Twelve-month and 30-day prevalence of any DSM-5 mental disorder were 10.6% (95% CI: 9.5–11.8) and 7.8% (95% CI: 6.7–8.9), respectively. Twelve-month prevalence was highest for anxiety disorders (8.0%, 95% CI: 7.1–8.9), followed by mood (4.3%, 95% CI: 3.4–5.2) and externalising (1.7%, 95% CI: 0.9–2.4) disorders. Twelve-month persistence among lifetime cases was 49.0%, overall and higher for anxiety (55.6%) than mood (39.0%) or externalising (35.3%) disorders. Younger and middle-aged adults, and who were not currently married, had elevated risks, while lower education was associated with greater disorder severity. Comorbidity was associated with increased persistence and severity across disorders.</div></div><div><h3>Interpretation</h3><div>This study shows a substantial mental health burden in Hong Kong during the post-pandemic period, highlighting the need for tailored public mental health programmes to address urban stressors in this unique context.</div></div><div><h3>Funding</h3><div><span>WYNG Foundation</span>, Hong Kong; <span>State Key Laboratory of Brain and Cognitive Sciences</span>, The <span>University of Hong Kong</span>, Hong Kong Special Administrative Region, China; <span>Hong Kong Jockey Club Charities Trust</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101757"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From process to publication: the conduct and reporting of co-design in health research in the Western Pacific region","authors":"Yaqoot Fatima ,&nbsp;Michelle Olaithe ,&nbsp;Shannon Edmed ,&nbsp;Bushra Nasir","doi":"10.1016/j.lanwpc.2025.101766","DOIUrl":"10.1016/j.lanwpc.2025.101766","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101766"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends in sepsis hospitalisations and mortality in Aotearoa New Zealand, 2000–2019: a population-based study","authors":"Sharla McTavish ,&nbsp;Jane Zhang ,&nbsp;June Atkinson ,&nbsp;Amanda Kvalsivg ,&nbsp;Alice Hyun Min Kim ,&nbsp;Colin McArthur ,&nbsp;Paul Huggan ,&nbsp;Michael G. Baker","doi":"10.1016/j.lanwpc.2025.101767","DOIUrl":"10.1016/j.lanwpc.2025.101767","url":null,"abstract":"<div><h3>Background</h3><div>Globally, sepsis remains a substantial public health concern. To inform policy development and interventions for sepsis prevention, treatment, and surveillance in Aotearoa New Zealand (Aotearoa), we describe population-level epidemiological trends in hospitalised sepsis and mortality over two decades by major sociodemographic characteristics.</div></div><div><h3>Methods</h3><div>We undertook a retrospective, population-based descriptive study of all sepsis-associated hospitalisation (SAH) in Aotearoa between 2000 and 2019 using previously published case identification strategies and <em>International Classification of Diseases, Tenth Revision</em> (ICD-10) codes to identify SAHs in the National Minimum Dataset. Incidence and mortality rates, and case fatality risks were calculated along with analyses of trends over the 20-year observation period. Rate estimates were standardised to the age structure of the total population identified in the 2018 New Zealand Census.</div></div><div><h3>Findings</h3><div>We identified 266,105 unique SAH cases and 27,402 associated deaths, with an average age-standardised incidence rate (ASIR) of 320.4 admissions per 100,000 population and an age-standardised mortality rate (ASMR) of 34.2 deaths per 100,000 population. An average annual ASIR increase of 4.5% was observed, from 217.3 admissions in 2000 to 386.9 admissions per 100,000 population in 2019. ASMR decreased annually from 37.1 deaths in 2000 to 31.3 deaths per 100,000 population in 2019. Case fatality risk decreased from 15.9 deaths in 2000 to 8.1 deaths per 100 admissions in 2019, primarily driven by improvements in patient survival in ≥40-year age groups. Significant SAH incidence and mortality disparities were observed between patient populations, particularly by age, ethnicity and socioeconomic deprivation. Māori and Pacific Peoples had SAH incidence rates that were 1.7 and 2.3 times, respectively, higher than those of NMPA ethnicity, and had mortality rates that were 1.6 and 1.7 times higher. Similarly, those living in areas of high socioeconomic deprivation were twice as likely to develop SAH, and their SAH mortality rate was twice as high as that of those living in areas of the least socioeconomic deprivation.</div></div><div><h3>Interpretation</h3><div>Sepsis is common in Aotearoa and makes a substantial contribution to population mortality. Significant variation in incidence and mortality rate estimates was observed between patient populations, with higher rates in those &lt;1 year and ≥70 years, of Māori or Pacific ethnicity, and those living in areas of high socioeconomic deprivation. Our findings highlight the burden of SAH and the need for targeted interventions to address sepsis prevention, surveillance and support for sepsis survivors in Aotearoa.</div></div><div><h3>Funding</h3><div><span>Health Research Council</span> of New Zealand.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101767"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the landscape of healthcare-associated infections in China, 2015–2019: a nation-wide observational study","authors":"Hong-Wu Yao ,&nbsp;Chen-Long Lv ,&nbsp;Yao Tian ,&nbsp;Yu-Zheng Zhang ,&nbsp;Zheng-Hao Yu ,&nbsp;Ming-Mei Du ,&nbsp;Cheng-Xue Ma ,&nbsp;Ji-Jiang Suo ,&nbsp;Shuo Zhao ,&nbsp;Yu Zhang ,&nbsp;Yu-Bin Xing ,&nbsp;An-Ran Zhang ,&nbsp;Yan-Ling Bai ,&nbsp;Bo-Wei Liu ,&nbsp;Zhong-Qiang Yan ,&nbsp;Ju-Yuan Liu ,&nbsp;Meng Cai ,&nbsp;Rui Huo ,&nbsp;Jian Lin ,&nbsp;Chun-Ping Chen ,&nbsp;Yun-Xi Liu","doi":"10.1016/j.lanwpc.2025.101775","DOIUrl":"10.1016/j.lanwpc.2025.101775","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare-associated infections (HAIs), complicated by antimicrobial resistance continue to affect all countries with unprecedented threat, especially for developing countries. Our objective was to explore the epidemiological features, spatiotemporal heterogeneity and associated factors of HAIs and HAI related multi-drug resistant organisms (MDROs) in China.</div></div><div><h3>Methods</h3><div>We used national surveillance data that were collected from 6867 sampled hospitals during 2015–2019 to determine the annual incidence of HAIs, key HAI-related quality indicators and associated factors.</div></div><div><h3>Findings</h3><div>During 2015–2019, total of 4,959,230 HAIs were reported in sampled hospitals in China, with the overall incidence and prevalence estimated as 1.1 and 2.3 per 100 inpatients, which showed decline trend over time. Carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB) had the highest overall detection rate (51.1%), followed by methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) (31.0%), carbapenem-resistant <em>Pseudomonas aeruginosa</em> (CRPA) (22.8%), and carbapenem-resistant <em>Klebsiella pneumonia</em> (CRKP) (12.4%). Detection rates of MRSA, carbapenem-resistant <em>Escherichia coli</em> (CREC), and vancomycin-resistant <em>Enterococcus faecium</em> (VREfm) reduced, in contrast with an increasing trend for CRKP. Higher risk of HAIs was associated with hospitals located in urban areas (incidence rate ratio [IRR]: 1.39, p &lt; 0.001), in regions with higher GDP per capita (IRR: 1.03, p &lt; 0.001), with more beds (IRR: 1.64 and 2.16 for 500−1500 and ≥ 1500 beds respectively, p &lt; 0.001), as well as in south region of China (IRR: 1.23, p &lt; 0.001). The reduced annual rates of HAIs were observed after 2017 (IRR: 0.92, p &lt; 0.001), when 12 new standards targeted for HAIs were implemented.</div></div><div><h3>Interpretation</h3><div>The study increases the understanding of HAIs and antimicrobial resistance. It highlights high-risk areas of HAIs and MDROs of concern, where targeted measures to continuously enhance management and policies implementation of HAIs are needed.</div></div><div><h3>Funding</h3><div><span>The Foundation of State Key Laboratory of Pathogen and Biosecurity of China</span> (Grant No. <span><span>SKLPBS2443</span></span>) and <span>Infection Prevention and Control Research Project of “Gan·Dong China”</span> (Grant No. <span><span>GY2023022-A</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101775"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation of potential national childhood screening strategies for type 1 diabetes in Australia","authors":"Winnie Chen ,&nbsp;Kirsten Howard ,&nbsp;Sarah Norris ,&nbsp;Natasha Nassar ,&nbsp;Maria E. Craig ,&nbsp;Kirstine J. Bell","doi":"10.1016/j.lanwpc.2025.101755","DOIUrl":"10.1016/j.lanwpc.2025.101755","url":null,"abstract":"<div><h3>Background</h3><div>Type 1 diabetes (T1D) is an autoimmune condition affecting children. We aimed to investigate the costs and cost-effectiveness of potential national childhood screening strategies for T1D compared to no screening (usual care).</div></div><div><h3>Methods</h3><div>Screening costs were obtained from trial-based estimates. A Markov microsimulation model was developed to identify the most cost-effective childhood T1D screening strategy. The three screening strategies modelled were: Strategy 1) newborn genetic risk-stratification with bloodspot sampling, followed by autoantibody screening in at-risk children; Strategy 2) infant genetic risk-stratification using saliva sampling, followed by autoantibody screening in at-risk children; Strategy 3) population-wide autoantibody screening at two childhood ages. The model tracked 100,000 individuals from birth to 30 years of age. One-way and probabilistic sensitivity analyses were conducted.</div></div><div><h3>Findings</h3><div>Newborn bloodspot genetic risk-stratified screening (strategy 1) was the most cost-effective strategy. Incremental cost-effectiveness ratios (ICERs) were $50,682 per quality-adjusted life year (QALY) gained for strategy 1, $85,440 per QALY gained for strategy 2, and $133,285 per QALY gained for strategy 3. In the optimal strategy (strategy 1), the cost was $480,798 per screen-detected T1D and $12,183 per episode of diabetic ketoacidosis avoided. Results were sensitive to changes in time horizon, discount rates, and cost of the screening tests.</div></div><div><h3>Interpretation</h3><div>Of the three modelled T1D screening strategies, newborn bloodspot genetic risk-stratified screening was the most cost-effective. Varying cost inputs may change this hierarchy. Our economic evaluation will be useful for informing future T1D childhood screening policy in Australia and other high-income countries.</div></div><div><h3>Funding</h3><div>JDRF Australia.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101755"},"PeriodicalIF":8.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The changing epidemiology of syphilis: new strategies for new challenges in China","authors":"Guiying Cao ,&nbsp;Huang Jing ,&nbsp;Cai Jie ,&nbsp;Min Liu","doi":"10.1016/j.lanwpc.2025.101752","DOIUrl":"10.1016/j.lanwpc.2025.101752","url":null,"abstract":"<div><div>Syphilis was nearly eliminated from China in the 1960s; however, it has resurgent and continued to spread in the country since the 1980s. Surveillance data from China revealed that the notification rate of syphilis increased 11.88% annually between 2004 and 2019, with an notification rate of 38.37 per 100,000 population in 2019. This paper aims to summarize the national policies and plans for syphilis since the 1980s; the full-cycle management strategy for the publicity and education, screening, diagnosis and treatment, management, and surveillance and monitoring of syphilis; the epidemiology of syphilis; and challenges in the prevention and control in China. Finally, we propose a series of new strategies to better manage syphilis to help eliminate the infection in China.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101752"},"PeriodicalIF":8.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive epidemiological analysis of severe fever with thrombocytopenia syndrome in Japan, 2013–2023: descriptive observational study","authors":"Tomohiro Ohno ,&nbsp;Hirofumi Kato ,&nbsp;Yusuke Kobayashi ,&nbsp;Masami Kitaoka ,&nbsp;Minako Kanesaki ,&nbsp;Shimpei Murai ,&nbsp;Masaru Jinushi ,&nbsp;Mitsuki Aoki ,&nbsp;Takuri Takahashi ,&nbsp;Tomoe Shimada ,&nbsp;Taro Kamigaki ,&nbsp;Tomimasa Sunagawa","doi":"10.1016/j.lanwpc.2025.101747","DOIUrl":"10.1016/j.lanwpc.2025.101747","url":null,"abstract":"<div><h3>Background</h3><div>Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne zoonotic disease that poses a serious public health challenge in several Asian countries. In this study, we aimed to describe the recent epidemiological characteristics of SFTS in Japan using denominator-based test data.</div></div><div><h3>Methods</h3><div>We analysed reported SFTS case-patients in Japan using national surveillance data from March 2013 to April 2024. The case-fatality ratio (CFR) was calculated using the National Vital Statistics Surveillance System (NVSSS) for 2013–2022. Trends in test numbers and positivity rates were examined using data from annual reports and public health institute surveys.</div></div><div><h3>Findings</h3><div>During the study period, 931 case-patients were reported, including 11 veterinary healthcare workers. The annual notification rate rose from 3.12 per ten million in 2013 to 10.46 in 2023, with 30 (64%) estimated infection prefectures, primarily in western and central Japan. The NVSSS CFRs remained high at approximately 20%. Test numbers and positive results increased from 2013 (n = 350, n = 41) to 2022 (n = 923, n = 95); however, positivity decreased from 12% to 10%.</div></div><div><h3>Interpretation</h3><div>The annual SFTS notification rate increased, and infection regions expanded between 2013 and 2023, with persistently high CFRs and increased testing. Veterinary healthcare workers appear to be a potential high-risk group. These findings highlight that SFTS remains a public health concern in Japan, requiring a comprehensive health strategy.</div></div><div><h3>Funding</h3><div>This work was supported by the Japan Society for the Promotion of <span>Science Kakenhi</span> Grants-in-Aid for Young Scientists (grant number: <span><span>24K19277</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101747"},"PeriodicalIF":8.1,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-differences in the intergenerational transmission of mental disorders among schizophrenia probands: familial risk and protective factors in a population-based study","authors":"Zhi Sheng ,&nbsp;Tianhang Zhou ,&nbsp;Chunyu Du ,&nbsp;Tingfang Wu ,&nbsp;Liping Wen ,&nbsp;Xianmei Yang ,&nbsp;Wencai Chen ,&nbsp;Xuehong Ma ,&nbsp;Hua Deng ,&nbsp;Ling Ge ,&nbsp;Changchun Zhang ,&nbsp;Xu Hong ,&nbsp;Rui He ,&nbsp;Xiangdong Du ,&nbsp;Lingyan Zhu ,&nbsp;Hu Xiang ,&nbsp;Sijing Chen ,&nbsp;Jiachen Liu ,&nbsp;Yongzhuo Ding ,&nbsp;Guangming Liang ,&nbsp;Xin Yu","doi":"10.1016/j.lanwpc.2025.101750","DOIUrl":"10.1016/j.lanwpc.2025.101750","url":null,"abstract":"<div><h3>Background</h3><div>Parental schizophrenia confers intergenerational mental health risks. The sex-specific transmission patterns remain poorly quantified. This study examined parent-reported transmission rate and familial risk factors among Chinese offspring of schizophrenia probands.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, we enrolled 27,315 schizophrenia probands and 35,772 offspring. Psychiatric disorder diagnoses of offspring were parent-reported and subsequently verified via the medical management system. Age- and sex-standardized rate referenced China's 2020 census. Robust Poisson regression generated adjusted rate ratios (aRR). Multivariable logistic models were used to identify risk factors for young offspring. This study was registered with ClinicalTrials (<span><span>NCT07005245</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>The parent-reported transmission rate in offspring was 2.68% (95% CI, 2.52%–2.85%), dominated by schizophrenia spectrum disorders (1.42%). Standardized rates reached 2.53% (95% CI, 2.01%–3.05%) after demographic standardization. Offspring risk increased by 86.0% when conception occurred post-parental illness onset. Firstborn status (aRR = 1.67), low-income household (aRR = 1.43), and being a male child (aRR = 1.14) were significantly associated with elevated risk. Sex-specific parental age effects were also observed. In the subgroup analysis of underage (&lt;17 years) offspring, maternal transmission was associated with post-parental-onset birth (OR = 2.48, <em>p</em> &lt; 0.001), lower household income (OR = 2.32, <em>p</em> &lt; 0.001), and prenatal antipsychotic exposure (OR = 1.69, <em>p</em> &lt; 0.001). Paternal transmission was related to father-only caregiving (OR = 2.15, <em>p</em> &lt; 0.001), lower household income (OR = 1.97, <em>p</em> &lt; 0.001), and male offspring (OR = 1.79, <em>p</em> = 0.001). Dual-parent care demonstrated a robust protective effect across both maternal and paternal schizophrenia groups (OR = 0.75, 95% CI, 0.51–1.10).</div></div><div><h3>Interpretation</h3><div>Our findings highlighted critical interactions between familial aggregation, sex-differentiated perinatal exposures, and caregiving environments. Policy priorities should integrate sex-stratified genetic counselling, prenatal medication monitoring, and family support programs targeting caregiving inequalities.</div></div><div><h3>Funding</h3><div>This study was supported by the <span>National Natural Science Foundation of China</span> (32070589).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101750"},"PeriodicalIF":8.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}