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Taichung, Taiwan

Lin C.-H.,Chang Gung University | Lin C.-H.,China Medical University at Taichung | Lin P.-P.,China Medical University at Taichung | Lin C.-Y.,Tsaotun Psychiatric Center | And 4 more authors.
Journal of Psychiatric Research | Year: 2016

Background: The cystine/glutamate antiporter system xc -, playing a critical role in the regulation of glutamate release, might be implicated in the pathogenesis of schizophrenia. This study examined whether peripheral expressions of the system xc - subunits are characteristic of schizophrenia. Methods: Expression of system xc - genes including SLC3A2 and SLC7A11 in peripheral WBCs of patients with schizophrenia and healthy individuals were measured using quantitative PCR. Both psychotropic-free and medicated patients with schizophrenia were recruited. Results: A total of 96 schizophrenia patients (48 medicated and 48 drug-free) and 96 healthy individuals were enrolled. The mRNA expression levels using the 2-δδC T Method of both SLC3A2 and SLC7A11 in WBCs of schizophrenia patients were markedly lower than that of healthy individuals (0.22 and 0.48, respectively, the mRNA expression level of normal controls was normalized to 1). There was no significant difference between medicated and drug-free patients in the mRNA expressions of both SLC3A2 and SLC7A11. The Receiver Operating Characteristics (ROC) analysis of SLC3A2 mRNA levels using δδCT values for drug-free schizophrenia patients vs. healthy controls determined an optimal cutoff value, 0.801, with high sensitivity (1.000) and modest specificity (0.694) (area under curve of ROC = 0.794). Conclusion: This is the first study indicating that the peripheral mRNA expression levels of SLC7A11 and SLC3A2 may be lower in patients with schizophrenia than healthy individuals. The finding supports the hypo-glutamatergic neurotransmission hypothesis in schizophrenia. Whether mRNA expression of system xc - subunits genes, particularly SLC3A2, could serve as a potential biomarker of schizophrenia needs further studies. © 2015 Elsevier Ltd. Source


Shao W.-C.,Tsaotun Psychiatric Center | Chen H.,Taoyuan General Hospital | Chang Y.-F.,HongEn Hospital | Lin W.-C.,HongEn Hospital | Lin E.C.-L.,National Cheng Kung University
Journal of Nursing | Year: 2013

Background: Antipsychotics have been regarded as the most effective therapy for schizophrenia; however, Taiwan's non-adherence rate for prescribed antipsychotics of 50-80% is an important issue that relates directly and significantly to schizophrenia patient relapse rates. Purposes: This study examines the correlational and predictive relationships between medication adherence and rehospitalization in schizophrenia patients discharged from an acute ward. Methods: This study used a prospective research design. Schizophrenia patients discharged from a psychiatric acute ward who stated their plan to live in the community were recruited as participants. Participant medication adherence was assessed via home visits during the 6-month follow-up period using scales including the Medication Adherence Questionnaire (MAQ), drug attitudes, and regimen knowledge. Rehospitalization data were retrieved from electronic medical records. Relationships between medication adherence and rehospitalization were analyzed using t-tests and regression analysis. Results: Seventy-seven patients with schizophrenia discharged from the acute ward were recruited in accordance with sampling criteria. The majority were male, young, unmarried, had poorer global function, had 12 years of education, and were not rehospitalized during the past 6-month period. Using binomial regression analysis, we found the relative risk for number of rehospitalizations during the 6-month period to be significantly less and the average scores for the total scale, attitude subscale, and knowledge subscale of medication adherence to have increased (0.194-0.79 times). Conclusions / Implications for Practice: Our findings support that better medication adherence in people with schizophrenia decreases rehospitalization risk. We urge clinicians to develop sensitive interventions to promote antipsychotics adherence in this population. Source


Chien I.-C.,Tsaotun Psychiatric Center | Chien I.-C.,National Yang Ming University | Lin C.-H.,Taichung Veteran General Hospital
Journal of Psychosomatic Research | Year: 2016

Objective: Few known studies have investigated the epidemiology of diabetes in patients with anxiety disorders. Therefore, the study aimed to determine the prevalence and incidence of diabetes in patients with anxiety disorders. Methods: The National Health Research Institute provided a database of 1,000,000 random subjects for study. We obtained a random sample aged 18 years and over 766,427 subjects in 2005. Those study subjects who had at least two primary or secondary diagnoses of anxiety disorders were identified. We compared the prevalence of diabetes in anxiety patients with the general population in 2005. Furthermore, we investigated this cohort from 2006 to 2010 to detect the incident cases of diabetes in anxiety patients compared with the general population. Results: The prevalence of diabetes in patients with anxiety disorders was higher than that in the general population (11.89% vs. 5.92%, odds ratio, 1.23; 95% confidence interval, 1.17-1.28) in 2005. The average annual incidence of diabetes in patients with anxiety disorders was also higher than that in the general population (2.25% vs. 1.11%, risk ratio 1.34; 95% confidence interval, 1.28-1.41) from 2006 to 2010. Compared with the general population, patients with anxiety disorders revealed a higher incidence of diabetes in all age groups among both females and males. Conclusions: Patients with anxiety disorders had a much higher prevalence and incidence of diabetes in the younger adult age group than in the general population. The higher incidence of diabetes among anxiety patients was related to increased age, antipsychotic use, hypertension, and hyperlipidemia. © 2016 Elsevier Inc. Source


Chen L.-H.,Taoyuan Psychiatric Center | Chang F.-C.,National Taiwan Normal University | Chien I.-C.,Tsaotun Psychiatric Center | Day G.-I.,Asia University, Taiwan
Taiwan Journal of Public Health | Year: 2016

Objectives: This study determined the effects of a "pay-for-performance program for schizophrenia" on patient utilization of the outpatient department, emergency services, and hospitalization. Methods: This study analyzed 2236 patients from a psychiatric hospital in northern Taiwan who joined the "pay-for-performance program for schizophrenia." Two datasets were analyzed, including the 2009-2013 Hospital Information System and the Schizophrenia Case Management System. The Generalized Estimating Equation (GEE) method was used to determine the effects of the program on patient utilization measures. Results: The "pay-for-performance program for schizophrenia" significantly decreased the yearly incidence of compulsory hospitalization, days of acute psychiatric hospitalization, and annual emergency department visits. In addition, the number of psychiatric outpatient visits decreased significantly, but persisted at > 12 times per year. The number of 6-month readmissions to the acute psychiatric ward did not change significantly after implementing the program. Conclusions: Implementing the "pay-for-performance program for schizophrenia" enhanced self-management of schizophrenic patients, improved medical care outcomes, and prevented worsening of diseases. Source


Wu E.-L.,Taoyuan Psychiatric Center | Chien I.-C.,Tsaotun Psychiatric Center | Chien I.-C.,National Yang Ming University | Lin C.-H.,Taichung Veteran General Hospital
Journal of Psychosomatic Research | Year: 2014

Objective: We designed this study to examine the prevalence and incidence of hypertension and risk factors in patients with anxiety disorders. Methods: The National Health Research Institute provided a database of 1,000,000 random subjects for study. We obtained a random sample of 766,427 subjects aged ≥ 18 years in 2005. The differences in the prevalence of hypertension between patients with anxiety disorders and the general population in 2005 were tested by multiple logistic regression adjusted for other covariates, including age, sex, insurance amount, region, urbanicity and depression. The differences in the incidence of hypertension between patients with anxiety disorders and the general population according to age group and sex from 2006 to 2010 were tested by a Cox regression adjusted for the other covariates. Results: The prevalence of hypertension in patients with anxiety disorders was higher than that in the general population (37.9% vs. 12.4%, odds ratio, 2.61; 95% confidence interval, 2.52-2.70) in 2005. The average annual incidence of hypertension in patients with anxiety disorders from 2006 to 2010 was also higher than that in the general population (3.63% vs. 1.95%, risk ratio, 1.29; 95% confidence interval, 1.23-1.36). Compared with the general population, patients with anxiety disorders had a higher incidence of hypertension in all age and sex groups. Conclusions: Patients with anxiety disorders had a higher prevalence and a higher incidence of hypertension than that in the general population. Age, male sex, diabetes, and hyperlipidemia were risk factors for hypertension in patients with anxiety disorders. © 2014 Elsevier Inc. Source

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