Tsaotun Psychiatric Center

Taichung, Taiwan

Tsaotun Psychiatric Center

Taichung, Taiwan
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PubMed | Chang Gung University, National Taiwan University Hospital, Chung Shan Medical University, Tsaotun Psychiatric Center and 3 more.
Type: | Journal: Journal of affective disorders | Year: 2016

Experimental evidence indicates that serotonin is associated with both proliferative and pro-carcinogenic effects on colorectal tumors. The present study aims to investigate the associations between antidepressant use and colorectal cancer in an epidemiological sample.We conducted a population-based case-control study utilizing Taiwans National Health Insurance Research Database (NHIRD). We identified 49,342 cases with colorectal cancer and 240,985 controls between 1997 and 2008. We conducted conditional logistic regression analyses to assess the association between antidepressant use and colorectal cancer risk. Sensitivity analyses were conducted to assess whether genotoxic antidepressants (i.e. antidepressants which may exert procarcinogenic effects) would increase risk for colorectal cancer.Selective serotonin reuptake inhibitors (adjusted OR=1.00, 95% CI=0.94-1.06), tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and serotonin antagonist and reuptake inhibitors were not associated with increased incidence of colorectal cancer. Monoamine oxidase inhibitors were, however, associated with an increased incidence of colorectal cancer (adjusted OR=1.22, 95% CI=1.06-1.41). Higher cumulative dose of mirtazapine was associated with a decreased incidence of colorectal cancer (adjusted OR=0.39, 95% CI=0.17-0.90). A small sample size of individuals who received mirtazapine, however, precludes definitive conclusions regarding protective effects with mirtazapine.We could not discern the effects of obesity and other risk factors for colorectal cancer from the NHIRD.Contemporary first-line antidepressants (i.e. SSRI, SNRI), as well as older agents (i.e. TCA), are not associated with increased incidence of colorectal cancer.


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.


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.


Kuo C.-L.,Tsaotun Psychiatric Center | Kuo C.-L.,Central Taiwan University of Science and Technology | Chien I.-C.,Tsaotun Psychiatric Center | Chien I.-C.,National Yang Ming University | And 2 more authors.
Social Psychiatry and Psychiatric Epidemiology | Year: 2015

Purpose: The population-based National Health Insurance database was used to investigate the trends, correlates, and disease patterns for elderly people in Taiwan who use antidepressants. Methods: The National Health Research Institute provided a database of 1000,000 random subjects for study. We created a sample of subjects who were older than 65 years from 1997 to 2005. Trends, prevalence, and associated factors of antidepressant use were detected. We also examined the proportion of antidepressant use for psychiatric and medical disorders. Results: The one-year prevalence of antidepressant use in elderly persons increased from 5.8 % in 1997 to 9.8 % in 2005. The one-year prevalence rates of tricyclic antidepressant (TCA), selective serotonin reuptake inhibitor (SSRI), serotonin–norepinephrine reuptake inhibitor (SNRI), serotonin modulator, and other antidepressant use in 2005 were 5.3, 2.6, 0.4, 2.9, and 0.6 %, respectively. Overall antidepressant use was higher for those in the 75- to 84-year-old age group, females, and those with higher Charlson Comorbidity Index scores. Among subjects using TCAs, 77.6 % users did not have a psychiatric diagnosis. Psychiatric disorders were commonly found in most SSRI and SNRI users (85.1 and 90.1 %, respectively). Subjects using SSRIs and SNRIs had higher proportions of psychiatric disorders such as neurotic depression, major depression, senile and presenile organic psychotic conditions, and anxiety. Conclusion: The prevalence of antidepressant use among elderly persons increased greatly from 1997 to 2005. SSRIs, SNRIs, and other antidepressants were used mostly by subjects with psychiatric disorders, whereas TCAs were used mostly by subjects with nonpsychiatric disorders. © 2015, Springer-Verlag Berlin Heidelberg.


PubMed | Chiayi Chang Gung Memorial Hospital, Tsaotun Psychiatric Center and King's College London
Type: | Journal: Substance abuse treatment, prevention, and policy | Year: 2015

Little is known about differences between the characteristics and psychopathological symptoms of heroin users attending TC or MMT in Asia. This study aimed to compare characteristics and prevalence of depressive disorders among male heroin users in TC and MMT program in Nantou, Taiwan.The study sample (n=705) comprised male heroin users with heroin dependence recruited from the MMT program and TC program at a psychiatric center in Nantou, Taiwan between 2006 and 2014. Socio-demographic and heroin-related characteristics were obtained from self-report questionnaires. DSM-IV diagnoses of heroin dependence, major depressive disorder, and dysthymic disorder were evaluated by trained interviewers. T-test and chi-square test and multivariate logistic regression were performed to measure the differences on variables between samples of TC and MMT.Compared to MMT, TC participants had poorer family support, higher rate of unmarried, higher rate of unemployment, earlier onset of heroin use, longer length of heroin use, and lower daily dosage of heron. MMT heroin users had higher 1-month prevalence of major depressive disorder than TC participants. We found the distribution of current major depression disorder differed between heroin users choosing different treatment models even controlling for other demographic factors, substance related factors and psychosocial factors. The underlying explanations require further investigation.This study found differences in the characteristics and prevalence of psychopathology. Further study to explore the effect of these differences on the outcome between MMT and TC is warranted.


PubMed | Chung Shan Medical University, King's College London, Tsaotun Psychiatric Center and Chang Gung University
Type: | Journal: The American journal on addictions | Year: 2016

Comorbid attention deficit hyperactivity disorder (ADHD) symptoms are highly prevalent among heroin-dependent patients. We aim to investigate differences in dependence severity, depression, and quality of life between heroin-dependent patients with and without ADHD-screened positive.Heroin-dependent participants (n=447) entering methadone maintenance treatment were divided into ADHD-screened positive (ADHD-P) and ADHD-screened negative (ADHD-N) groups according to scores of Adult ADHD Self-Report Scale (ASRS). Mini-International Neuropsychiatric Interview was used to identify current and lifetime depressive episodes and suicidality. Substance use disorder, depression, family support, and quality of life in two groups were also assessed.About 7.8% (n=35) scored 24 or higher of ASRS indicating highly likely Adult ADHD. More heroin-dependent patients of ADHD-P had a current depressive episode (p=.02). They had higher Center for Epidemiological Studies Depression (CESD) scores (p=.003), and more severe heroin dependence (p=.006). Poorer family support and quality of life in physical, and psychological domains were found in patients of ADHD-P compared to ADHD-N.Heroin-dependent patients of ADHD-P represent a vulnerable minority. They were comorbid with regard to depression, greater substance dependence severity, and poorer quality of life.Assessment for ADHD symptoms in heroin-dependent patients may be indicated for the effective management of the complex problems of these patients. (Am J Addict 2016;XX:XX-XX).


PubMed | China Medical University at Taichung, Chang Gung University, Kai Suan Psychiatric Hospital and Tsaotun Psychiatric Center
Type: | Journal: Journal of psychiatric research | Year: 2015

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.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.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(-C)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 CT 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).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.


PubMed | Chung Shan Medical University, National Changhua University of Education, Tsaotun Psychiatric Center, National Taiwan University and 2 more.
Type: Journal Article | Journal: Depression and anxiety | Year: 2016

Second-generation antipsychotics (SGA) augmentation treatment has showed better efficacy in patients with major depressive disorder (MDD). However, the association between SGA and diabetes mellitus (DM) in MDD patients deserves further investigation. The study aimed to examine the risk of new onset type II DM in MDD patients receiving SGA treatment.From the Psychiatric Inpatient Medical Claim Dataset, MDD patients treated with SGA continuously for more than 8 weeks were analyzed in a 1:1 propensity score matched pair sample to 1,049 patients that had never been treated with SGA. Patients were followed up to 5 years based on ICD-9 CM codes indicating incident type II DM. Cumulative incidences of type II DM were calculated and the Cox proportional hazards model with competing risk was applied to determine the risk factors for type II DM onset.Cumulative incidences of new-onset type II DM between the two groups were similar. Use of SGA showed no significant increase in risk for new-onset type II DM (hazard ratio [HR] = 0.898; 95% confidence interval [CI], 0.605-1.334; P-value = 0.596). Increased risk for type II DM was shown to be associated with aging (per year) (HR= 1.039; 95% CI, 1.026-1.053; P-value < 0.001) and history of hyperlipidemia (HR= 2.323; 95% CI, 1.469-3.675; P-value < 0.001).This study indicated that there is no significant difference in the risk of developing type II DM between MDD patients with and without SGA exposure. More studies focused on the benefit-risk assessment of SGA treatment in patients with MDD are warranted.


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.


PubMed | China Medical University at Taichung, Chung Shan Medical University, Taichung Armed Force General Hospital and Tsaotun Psychiatric Center
Type: Journal Article | Journal: Biomedical reports | Year: 2015

The present study evaluated the effects of physiological serum estrogen during the menstrual cycle on glutathione (GSH) and catalase activities. The sample included 43 healthy females between the ages of 22 and 51 years. The subjects were divided into two groups according to the stage of the menstrual cycle. Group A consisted of 16 samples extracted between days 10 and 20 from the first day of menstruation when estrogen levels were considered to be at their highest. Group B consisted of 27 samples extracted during other times of the estimated 30 days of menstruation. Data showed that the estrogen level in group A (184106 pg/ml) was higher than that in group B (10556 pg/ml) (P<0.01). The GSH and catalase levels in group A (4.42.3 g/mg and 21072 IU/mg, respectively) were also significantly higher compared to the levels in group B (3.21.8 g/mg and 16862 IU/mg, respectively) (P <0.05). Spearmans rank correlation showed that the expression of catalase in red blood cells significantly correlated with serum estrogen level but not with GSH. However, the changes in estrogen plasma levels, erythrocyte GSH level and catalase activity suggested that the consumption of GSH and catalase in erythrocyte during the menstrual cycle may be associated with the level of estrogen present in the bloodstream.

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