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Lin Y.-C.,Jianan Mental Hospital | Lin Y.-C.,China Medical University at Taichung | Wynn J.K.,VA Greater Los Angeles Healthcare System | Wynn J.K.,University of California at Los Angeles | And 3 more authors.
Schizophrenia Research | Year: 2012

Social cognition, which includes emotional intelligence, is impaired in schizophrenia. The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) is a widely-used assessment of emotional intelligence, with a four-factor structure in healthy individual. However, a recent factor analysis in schizophrenia patients revealed a two-factor structure of the MSCEIT. The current study aimed to replicate this finding in a larger, more diverse, schizophrenia sample (n = 194). Our findings revealed an identical two-factor structure as in the previously-reported study, indicating that emotional intelligence is organized in a different manner in schizophrenia than it is in healthy controls. © 2012 .


Chien I.-C.,Taoyuan Mental Hospital | Chien I.-C.,National Yang Ming University | Chang K.-C.,Jianan Mental Hospital | Lin C.-H.,Taichung Veteran General Hospital | And 2 more authors.
General Hospital Psychiatry | Year: 2010

Objective: We investigated the prevalence and correlates of diabetes in patients with bipolar disorder in Taiwan. Methods: The National Health Research Institute provided a database of 1,000,000 random subjects from which we selected a sample of 766,427 subjects aged 18 years and over. We identified study subjects who had at least one service claim during 2005, with a primary diagnosis of bipolar disorder or with a prescription for treatment of diabetes. Results: The prevalence of diabetes in patients with bipolar disorder was higher than in the general population (10.77% vs. 5.57%, OR, 2.01; 99% CI, 1.64-2.48). Compared with the general population, patients with bipolar disorder had a higher prevalence of diabetes in all age groups under 60 years; among females and males; among lower insurance amount groups; among those living in the northern, central and southern regions and among residents living in urban and rural areas. Antipsychotic use was associated with a higher prevalence of diabetes in persons with bipolar disorder. Conclusions: Patients with bipolar disorder had a higher prevalence of diabetes than the general population. Prevention, early detection and treatment of diabetes are important issues for patients with bipolar disorder. © 2010 Elsevier Inc.


Lee H.-Y.,Kaohsiung Medical University | Li J.-H.,Kaohsiung Medical University | Wu L.-T.,Duke University | Wu J.-S.,Executive Yuan | And 2 more authors.
Substance Abuse: Treatment, Prevention, and Policy | Year: 2012

Background: Although methadone has been used for the maintenance treatment of opioid dependence for decades, it was not introduced in China or Taiwan until 2000s. Methadone-drug interactions (MDIs) have been shown to cause many adverse effects. However, such effects have not been scrutinized in the ethnic Chinese community.Methods: The study was performed in two major hospitals in southern Taiwan. A total of 178 non-HIV patients aged ≥ 20 years who had participated in the Methadone Maintenance Treatment Program (MMTP) ≥ 1 month were recruited. An MDI is defined as concurrent use of drug(s) with methadone that may result in an increase or decrease of effectiveness and/or adverse effect of methadone. To determine the prevalence and clinical characteristics of MDIs, credible data sources, including the National Health Insurance (NHI) database, face-to-face interviews, medical records, and methadone computer databases, were linked for analysis. Socio-demographic and clinical factors associated with MDIs and co-medications were also examined.Results: 128 (72%) MMTP patients took at least one medication. Clinically significant MDIs included withdrawal symptoms, which were found among MMTP patients co-administered with buprenorphine or tramadol; severe QTc prolongation effect, which might be associated with use of haloperidol or droperidol; and additive CNS and respiratory depression, which could result from use of methadone in combination with chlorpromazine or thioridazine. Past amphetamine use, co-infection with hepatitis C, and a longer retention in the MMTP were associated with increased odds of co-medication. Among patients with co-medication use, significant correlates of MDIs included the male gender and length of co-medication in the MMTP.Conclusions: The results demonstrate clinical evidence of significant MDIs among MMTP patients. Clinicians should check the past medical history of MMTP clients carefully before prescribing medicines. Because combinations of methadone with other psychotropic or opioid medications can affect treatment outcomes or precipitate withdrawal symptoms, clinicians should be cautious when prescribing these medications to MMTP patients and monitor the therapeutic effects and adverse drug reactions. Although it is difficult to interconnect medical data from different sources for the sake of privacy protection, the incumbent agency should develop pharmacovigilant measures to prevent the MDIs from occurring. Physicians are also advised to check more carefully on the medication history of their MMTP patients. © 2012 Lee et al; licensee BioMed Central Ltd.


Yeh Y.-C.,Kaohsiung Medical University | Ouyang W.-C.,Jianan Mental Hospital | Ouyang W.-C.,Chung Hwa University of Medical Technology
Kaohsiung Journal of Medical Sciences | Year: 2012

Behavioral and psychological symptoms of dementia (BPSD) are common and debilitating problems, but current treatments are limited. Antipsychotic agents show some efficacy on BPSD, but their use is limited by the associated risk of cerebrovascular events and mortality. Reports have shown the efficacy of mood stabilizers on BPSD, but systemic reviews on this issue are scant. This article aims to review studies of the efficacy of mood stabilizers on BPSD, and the quality of the available evidence. We searched for articles published in English during the period 1990 to 2010 and included in the PubMed database that concerned treatment of BPSD with mood stabilizers, such as carbamazepine, valproate, gabapentin, topiramate, lamotrigine, oxcarbazepine and lithium. The quality of the studies was assessed by considering the trial designs, analyses, subjects and results. We found one meta-analysis and three randomized controlled trials (RCTs) supporting the efficacy of carbamazepine in managing global BPSD, particularly aggression and hostility. With regard to valproate, current evidence from one meta-analysis and five RCTs did not strongly support its efficacy for global BPSD, including agitation and aggression. Only open trials or case series showed some efficacy of gabapentin, topiramate and lamotrigine in controlling BPSD. The single RCT investigating the effect of oxcarbazepine on agitation and aggression showed negative results. Case series reports on lithium tended to show it to be ineffective. Thus far, among mood stabilizers, carbamazepine has the most robust evidence of efficacy on BPSD. More RCTs are needed to strengthen evidence regarding the efficacy of gabapentin, topiramate and lamotrigine. Valproate, oxcarbazepine and lithium showed low or no evidence of efficacy. Large and well designed RCTs focusing on specific symptoms of BPSD are needed to deal with the issue. Copyright © 2012, Elsevier Taiwan LLC. All rights reserved.


Chu K.-Y.,National Yang Ming University | Yang N.-P.,National Yang Ming University | Chou P.,National Yang Ming University | Chiu H.-J.,Jianan Mental Hospital | And 2 more authors.
Journal of the Formosan Medical Association | Year: 2012

Background/Purpose: There is little comparative research evidence to support the claim that there is disparity in dental care between inpatients with schizophrenia and the disabled people or the general population. This study aimed to investigate whether schizophrenia inpatients had poorer dental care and worse oral health than the disabled people and the general population, respectively. Methods: An oral health survey was conducted in a specific-psychiatric long-term care institution in Taiwan in 2006. The results of this survey were compared with the findings of oral health investigations of the disabled people or the general population in Taiwan using proportion test and t-test. Results: This study used decayed, missing, and filled teeth index (DMFT) to describe the condition of dental caries. Compared with the disabled people, schizophrenia inpatients aged 19 to 44 years had a lower subjects' filling rate of DMFT index (FI) and a higher caries experience, but schizophrenia inpatients aged 45 or more had a lower mean number of DMFT. Compared with the general population, schizophrenia inpatients had higher caries experience, mean number of DMFT, percentage edentulous, and community periodontal index and lower FI and number of remaining tooth among various gender or age groups. Conclusion: In Taiwan, inpatients with schizophrenia have a lower FI than the disabled people and a worse overall oral health status than the general population. © 2012.

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