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Su-Fang L.,Kaohsiung Kai Suan Psychiatric Hospital | Chen-Chung M.,I - Shou University | Chou-Ping C.,I - Shou University | Shu-Fang S.,Kaohsiung Kai Suan Psychiatric Hospital
Journal of Nursing and Healthcare Research | Year: 2012

Background: Acknowledging the professionalism, dedication and loyalty of psychiatric mental health nurses can reduce manpower loss from this sector and may provide an indicator of the professional commitment of nurses to their jobs. Purpose: This research explored the professional commitment of psychiatric nurses and related factors of influence in a public psychiatric teaching hospital. Methods: Researchers used a cross-sectional, correlational design and developed a professional commitment scale, which was administered to 190 nurses working at a regional public psychiatric teaching hospital in southern Taiwan. A total of 181 completed questionnaires were returned. Data were analyzed using descriptive statistics, t -test, one-way ANOVA, and multiple regression analysis. Results: (1) Background variables including age, marital status, education level, number of children, family support for working as a psychiatric nurse, seniority as a clinical nurse, seniority in current position, current professional ladder level, current position and monthly salary were all identified as significantly influencing participants' professional commitment; (2) Seven background variables showed significant predictive value in terms of professional commitment. These included age, family support for working as a psychiatric nurse, seniority as a clinical nurse, seniority in current position, current professional ladder level, monthly salary and current position. These 7 items explained 42% of total variance for professional commitment. Conclusions / Implications for practice: Study results suggested the following: (1) promoting the ladder system is important to advancing psychiatric health professional abilities; (2) significant attention should be focused on training, guiding and managing new nurses and contract nurses; (3) administrators should promote positive peer relationships and extend professional commitment support networks; (4) psychiatric professional proficiency training should be intensified for psychiatric nurses and their accomplishments should be promoted.


Lai C.-Y.,Kaohsiung Medical University | Su Y.-Y.,Kaohsiung Medical University | Lin S.-T.,Kaohsiung Kai Suan Psychiatric Hospital | Yu C.-Y.,Kaohsiung Medical University | Lin Y.-C.,Kaohsiung Medical University
Journal of Nursing and Healthcare Research | Year: 2010

Background: In psychiatric acute care settings, patients with severe psychotic symptoms commonly exhibit violent behaviors due to uncontrolled emotions. Seclusion and restraint are widely used to protect and calm such patients as well as to save others from harm. However, few studies have shown the efficacy of restraint on emotional control of psychiatric patients. The use of restraint may easily disrupt the therapeutic rapport between psychiatric nurses and the patient. Previous studies suggest that music therapy can help psychotics manage their own agitated emotions and violent behaviors. Few studies have, however, researched the possible effects of music on psychotic patients restrained in a seclusion room. Purpose: This study compared the effects and differences of music and restraint on psychiatric patients' emotional control in a seclusion room in a psychiatric acute setting. Methods: An experimental research design was used. The duration of study intervention was from April to November, 2007. Psychiatric patients who were restrained in a seclusion room were recruited and randomly assigned to one experimental and one control group. Each group consisted of 28 subjects. The experimental group completed the Brief Symptom Rating Scale (BSRS) before and after a 30-minute music intervention to evaluate emotional status. In addition, subject physical condition, such as breathing, pulse rate, and blood pressure, were also examined before and after music intervention. The control group received no music intervention and experienced only an equivalent 30-minute period of restraint and seclusion. Results: Music intervention was found to reduce significantly the anxiety (F = 18.75, p < .001) and hostility (F = 13.56, p < .001) of patients isolated in a seclusion room; the anxiety (F = 16.81, p < .001) and hostility (F = 14.66, p < .001) of patients who were simply restrained also changed significantly. Results indicate that both restraint and music intervention may be effective in controlling the impulse and aggressive emotions of psychiatric patients. Furthermore, music was found to have a more prolonged effect than restraint on emotional control in psychiatric patients. Implications: Findings may be used to guide future research on this topic and to shape emotion-control interventions in psychiatric wards.


Liou Y.-J.,Taipei Veterans General Hospital | Liou Y.-J.,National Yang Ming University | Wang H.-H.,Academia Sinica, Taiwan | Lee M.-T.M.,Academia Sinica, Taiwan | And 28 more authors.
PLoS ONE | Year: 2012

We report the first genome-wide association study of a joint analysis using 795 Han Chinese individuals with treatment-refractory schizophrenia (TRS) and 806 controls. Three loci showed suggestive significant association with TRS were identified. These loci include: rs10218843 (P = 3.04×10 -7) and rs11265461 (P = 1.94×10 -7) are adjacent to signaling lymphocytic activation molecule family member 1 (SLAMF1); rs4699030 (P = 1.94×10 -6) and rs230529 (P = 1.74×10 -7) are located in the gene nuclear factor of kappa light polypeptide gene enhancer in B-cells 1 (NFKB1); and rs13049286 (P = 3.05×10 -5) and rs3827219 (P = 1.66×10 -5) fall in receptor-interacting serine/threonine-protein kinase 4 (RIPK4). One isolated single nucleotide polymorphism (SNP), rs739617 (P = 3.87×10 -5) was also identified to be associated with TRS. The -94delATTG allele (rs28362691) located in the promoter region of NFKB1 was identified by resequencing and was found to associate with TRS (P = 4.85×10 -6). The promoter assay demonstrated that the -94delATTG allele had a significant lower promoter activity than the -94insATTG allele in the SH-SY5Y cells. This study suggests that rs28362691 in NFKB1 might be involved in the development of TRS. © 2012 Liou et al.


Liu M.-E.,Long Cyuan Veterans Hospital | Tsai S.-J.,Taipei Veterans General Hospital | Jeang S.-Y.,Long Cyuan Veterans Hospital | Peng S.-L.,Long Cyuan Veterans Hospital | And 4 more authors.
Psychiatry Research | Year: 2011

To explore the effects of varenicline on the psychopathology and cognition of chronic inpatients with schizophrenia, we conducted a non-randomized control group time series investigation between March 2009 and April 2010. In a mandatory smoking cessation intervention, 41 male inpatient smokers were scheduled to undergo either a 5-week varenicline treatment (varenicline group) or the use of no drugs (non-treatment group). Depression (HAM-D), anxiety (HAM-A), and psychosis (PANSS) were evaluated at baseline, and at the 2nd, 4th, 8th and 12th week after abstinence; four neuropsychological tests, including Digit Span Forward and Backward (DSF and DSB), and Trail Making Test-A and -B, were evaluated at baseline and at the 4th, 8th and 12th week. Thirty patients completed the study. Among 15 patients in the non-treatment group, the HAM-D, HAM-A, DSF, and DSB scores were exacerbated during the 2-8. weeks of abstinence, but there were no changes in psychotic symptoms and the other two neuropsychological tests. Compared with the non-treatment group, varenicline users experienced less impairment in HAM-D and HAM-A scores at the 2nd and 4th weeks, and in DSF tasks at the 4th week after abstinence. In conclusions, varenicline can attenuate abstinence-induced adverse outcomes and appears to be well-tolerated in smokers with schizophrenia. © 2011 Elsevier Ireland Ltd.


Lee M.T.M.,Academia Sinica, Taiwan | Lee M.T.M.,China Medical University at Taichung | Chen C.H.,Academia Sinica, Taiwan | Chen C.H.,China Medical University at Taichung | And 36 more authors.
Molecular Psychiatry | Year: 2011

We report the first genome-wide association study in 1000 bipolar I patients and 1000 controls, with a replication of the top hits in another 409 cases and 1000 controls in the Han Chinese population. Four regions with most strongly associated single-nucleotide polymorphisms (SNPs) were detected, of which three were not found in previous GWA studies in the Caucasian populations. Among them, SNPs close to specificity protein 8 (SP8) and ST8 α-N-acetyl- neuraminide α-2,8-sialyltransferase (ST8SIA2) are associated with Bipolar I, with P-values of 4.87 × 10-7 (rs2709736) and 6.05 × 10-6 (rs8040009), respectively. We have also identified SNPs in potassium channel tetramerization domain containing 12 gene (KCTD12) (rs2073831, P9.74 × 10-6) and in CACNB2 (Calcium channel, voltage-dependent, Β-2 subunit) gene (rs11013860, P=5.15 × 10 -5), One SNP nearby the rs1938526 SNP of ANK3 gene and another SNP nearby the SNP rs11720452 in chromosome 3 reported in previous GWA studies also showed suggestive association in this study (P=6.55 × 10-5 and P=1.48 × 10-5, respectively). This may suggest that there are common and population-specific susceptibility genes for bipolar I disorder. © 2011 Macmillan Publishers Limited All rights reserved.


Tsai J.-H.,Kaohsiung Municipal Ta Tung Hospital | Tsai J.-H.,Kaohsiung Medical University | Tang T.-C.,Kaohsiung Medical University | Yeh Y.-C.,Kaohsiung Medical University | And 4 more authors.
Kaohsiung Journal of Medical Sciences | Year: 2012

The development of an instrument to estimate the incidence, characteristics, and risk factors of benzodiazepine (BZD) dependence broadly in Taiwan is an important task. This study assessed the validity of the Chinese version of the Severity of Dependence Scale (SDS [Ch]) among regular BZD users in Taiwan (n = 228). A positive correlation was shown between SDS [Ch] and Mini-International Neuropsychiatric Interview diagnosed of BZD dependence. Thirty-six percent of the users received a Mini-International Neuropsychiatric Interview diagnosis of current BZD dependence. The dependent users tended to be divorced/widowed; not schizophrenic; and have higher SDS [Ch] scores, a longer duration of use, and multiple-BZD use. The SDS [Ch] for BZD dependence was shown to have high diagnostic utility (area under the receiver operating characteristic curve = 0.779), a sensitivity of 80.5%, and a specificity of 85.7%, with a cutoff point of 7. The findings support that the SDS [Ch] is a valid brief self-reported questionnaire for the assessment of BZD dependence among chronic users in Taiwan. Copyright © 2012, Elsevier Taiwan LLC. All rights reserved.


Wang C.-C.,Kaohsiung Medical University | Chen C.-C.,Kaohsiung Kai Suan Psychiatric Hospital | Wang S.-J.,Kaohsiung Kai Suan Psychiatric Hospital | Wu S.-M.,Kaohsiung Medical University
Journal of Chromatography A | Year: 2011

Methadone (MET) metabolism has been largely demonstrated with a high inter-individual variability and, therefore, quantification of MET is very important for therapeutic drug monitoring. A cation-selective exhaustive injection and sweeping MEKC (CSEI-Sweeping) was first developed to analyze MET and its two metabolites, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) and 2-ethyl-5-methyl-3,3-diphenyl-1-pyrroline (EMDP), in human serum. After pretreatment, the samples were electrokinetically injected into capillary (10. kV, 500. s) and swept by the separation phosphate buffer (100. mM, pH 4.0) containing 20% tetrahydrofuran and 100. mM SDS at -15. kV. The LODs were 200. pg/mL for MET and EMDP, and 400. pg/mL for EDDP. Ten volunteers were administered MET (5.0-120.0. mg/day) orally for 84 days and serum samples were taken after the daily dose of MET (days 1, 2, 7, 14, 28, 56 and 84) individually. This method was used for monitoring MET and its metabolites in heroin addicts and for pharmacokinetic investigations. © 2011 Elsevier B.V.


Huang C.-W.,National Yang Ming University | Huang C.-W.,Pingtung Christian Hospital | Wang S.-J.,Kaohsiung Medical University | Wang S.-J.,Kaohsiung Kai Suan Psychiatric Hospital | And 5 more authors.
American Journal of Alzheimer's Disease and other Dementias | Year: 2013

The identification of blood biomarkers for Alzheimer's disease (AD) could contribute for improvement in early diagnosis. To define AD biomarkers, we compared serum/plasma levels of amyloid β (Aβ), tau, cytokines, and biometals between AD and non-AD groups. Cognitive impairment was assessed by Mini-Mental Status Examination (MMSE) and Clinical Dementia Rating scales. Plasma concentrations of total Aβ, Aβ42, tumor necrosis factor α (TNF-α), and interleukin 6 were quantified by immunoassays. Serum biometal concentrations were determined using flame atomic absorption spectrometry. We found that serum zinc (Zn) was lower in patients with AD. After controlling for age, the MMSE score correlated with both TNF-α and total Ab levels in the AD group, while the MMSE score correlated with iron only in the non-AD group. Our finding that blood Zn, TNF-α, and total Aβ are possible biomarkers for AD diagnosis and prognosis validates the pervious publication on potential biomarker in the Taiwanese population. © The Author(s) 2012.


Liu M.-E.,Kaohsiung Veterans General Hospital | Tsai S.-J.,Taipei Veterans General Hospital | Tsai S.-J.,National Yang Ming University | Lu T.,Kaohsiung Veterans General Hospital | And 6 more authors.
NeuroMolecular Medicine | Year: 2011

Previous research studies have related the insertion/deletion (I/D) polymorphism of the angiotensin I converting enzyme (ACE) gene to cognitive function in various neuropsychiatric or neurodegenerative disorders, but not yet investigated its genetic association with specific cognitive domains. Thus, the aim of this study was to assess the possible association of the ACE I/D polymorphism with domain-specific cognitive function in normal cognitive aging. Four hundred and sixty-nine-aged ethnic Chinese men without dementia were enrolled for geno-typing and evaluated using several neuropsychological tests [Mini-Mental Status Examination (MMSE), Digit Span Forward and Backward, and Cognitive Ability Screening Instrument Chinese language version (CASI C-2.0)]. No direct association was found between ACE genotypes and the MMSE, Digit Span tests, or CASI total scores. Although subjects with I/I genotype had the lowest cognitive performance in the CASI visual construction domain (P = 0.031), this statistical difference disappeared after correction for multiple comparisons. This study suggests that the ACE I/D polymorphism does not have any genetic association with global or specific cognitive domain in aged men without dementia. © Springer Science+Business Media, LLC 2011.


Lin S.-T.,Kaohsiung Kai Suan Psychiatric Hospital | Lin S.-T.,Kaohsiung Medical University | Yang P.,Kaohsiung Medical University | Lai C.-Y.,Kaohsiung Medical University | And 6 more authors.
Harvard Review of Psychiatry | Year: 2011

Neuroscientific and clinical studies of music over the past two decades have substantially increased our understanding of its use as a means of therapy. The authors briefly review current literature related to music's effect on people with different mental illnesses, and examine several neurobiological theories that may explain its effectiveness or lack thereof in treating psychiatric disorders. Neuroscientific studies have shown music to be an agent capable of influencing complex neurobiological processes in the brain and suggest that it can potentially play an important role in treatment. Clinical studies provide some evidence that music therapy can be used as an alternative therapy in treating depression, autism, schizophrenia, and dementia, as well as problems of agitation, anxiety, sleeplessness, and substance misuse, though whether it can actually replace other modes of treatment remains undetermined. Future research should include translational studies involving both neuroscience and clinical medicine that investigate the long-term effects of music intervention and that lead to the development of new strategies for music therapy. © 2011 President and Fellows of Harvard College.

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