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Hualian, Taiwan

Liao S.-C.,National Taiwan University | Liao S.-C.,National Taiwan University Hospital | Chen W.J.,National Taiwan University | Chen W.J.,National Taiwan University Hospital | And 8 more authors.
Psychological Medicine | Year: 2012

Background This study examined the prevalence of major depressive disorder (MDD), and the correlations and co-morbid conditions associated with MDD, in the adult Taiwanese population, which a previous estimate in the 1980s had found to be at the lower end of the spectrum worldwide. Possible explanations for the reported low prevalence of MDD were evaluated.Method As part of a survey of common psychiatric disorders in a nationally representative sample of individuals aged ≥18 years who were non-institutionalized civilians in Taiwan, a face-to-face interview using the paper version of the World Mental Health Survey of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI) was conducted between 2003 and 2005. Functional impairment and help-seeking behaviors were compared between Taiwanese subjects with MDD and their counterparts in the USA.Results Among the 10 135 respondents, the lifetime prevalence of MDD was 1.20% [standard error (s.e.)=0.2%]. Individuals who were divorced or widowed, aged ≤40 years, and female were at increased risk, whereas rural residents were at lower risk for MDD. The proportion of MDD cases co-morbid with other psychiatric disorders in this study was much lower than in the US study. Only one-third of Taiwanese individuals with MDD sought help despite having twice the number of lost workdays compared with the US sample.Conclusions Despite the low prevalence of MDD in Taiwanese adults, the pattern of low help-seeking behavior and profound functional impairment indicates much room for improvement in the early detection of and intervention in major depression in this population. © 2012 Cambridge University Press. Source


Bai Y.M.,Taipei Veterans General Hospital | Bai Y.M.,National Yang Ming University | Chen T.-T.,Yuli Veterans Hospital | Liou Y.-J.,Taipei Veterans General Hospital | And 5 more authors.
Schizophrenia Research | Year: 2011

Background: Previous research indicates that common single-nucleotide polymorphisms (SNPs) in the serotonin 5-HT2C receptor gene (HTR2C) are associated with metabolic syndrome (MetS) related to antipsychotic treatment. This study analyzes a large sample of patients with schizophrenia treated with atypical antipsychotics to determine whether variation in the HTR2C is associated with MetS. Methods: Six tag SNPs, capturing all common genetic variations in the HTR2C gene in the Han population, were genotyped in 456 Chinese schizophrenic inpatients treated with atypical antipsychotics (clozapine: 171, olanzapine: 91, and risperidone: 194). Results: Single-marker based analysis shows that of the six HTR2C SNPs, the rs498177 SNP showed a significant association with MetS in female patients, and the C allele was associated with an increased risk of MetS (for genotype TT/TC/CC: MetS vs. non-MetS. = 50%/27%/23% vs. 69%/28%/3%, and for allele T/C: MetS vs. non-MetS. = 63%/37% vs. 83%/17%, p. = 0.0007). Haplotype analysis shows that the A-C type of rs521018-rs498177 in the HTR2C gene significantly decreased the risk of MetS (corrected p. = 0.0108) in female patients. Conclusions: The results of this study support the role of HTR2C genetic variants in susceptibility to MetS in patients treated with atypical antipsychotics. However, this association is gender-dependent. © 2010 Elsevier B.V. Source


Chao J.-K.,Yuli Veterans Hospital | Ma M.-C.,National Cheng Kung University | Hao L.-J.,Endocrinology and Metabolism | Chao I.-C.,Chinese Institute of Clinical Medicine
Journal of Sexual Medicine | Year: 2014

Introduction: Obesity has been receiving an increasing amount of attention recently, but investigations regarding the potential impact of obesity, sexual behaviors, and sex hormones on erectile dysfunction (ED) in men have not completely clarified the association. Aim: To identify the relationship between ED, sexual behavior, sexual satisfaction, sex hormones, and obesity in older adult males in Taiwan. Methods: Data were obtained from a baseline survey of 476 older adult males (≧40 years old). Their demographic data, body mass index (BMI), sex hormones, sexual desire, sexual satisfaction, and ED status were assessed. Main Outcome Measures: The International Index of Erectile Function-5 (IIEF-5), Sexual Desire Inventory (SDI), and Sexual Satisfaction Scale (SSS) were used to assess ED, sexual desire, and sexual satisfaction. Results: In all, 476 men were available for analysis. The mean age of the sample was 51.34±7.84 years (range 40 to 70 years). The IIEF total score had a mean of 19.44±4.98; 264 (55.5%) subjects had ED, 250 (52.9%) were currently obese (BMI≧27), and 297 (62.4%) had metabolic syndrome. The results showed an increased risk of ED among obese men and subjects with lower levels of sex hormones and lower sexual desire. Testosterone levels were lower in subjects with obesity (P<0.001). Among the predictors of ED, obesity (odds ratio [OR]=1.62, 95% CI=1.07-2.44, P=0.021), abnormal high sensitivity C-reactive protein (hs-CRP) (OR=10.59, 95% CI=4.70-23.87, P<0.001), and lower serum full testosterone (OR=3.27, 95% CI=2.16-4.93, P<0.001) were significantly independent factors. Conclusions: This study supports the idea of a close relationship between low levels of sex hormones, sexual desire, sexual satisfaction, obesity, and ED, and also shows that low free testosterone and hs-CRP may predict ED, even in obese populations. © 2013 International Society for Sexual Medicine. Source


Liao H.-M.,National Tsing Hua University | Chao Y.-L.,Tzu Chi University | Huang A.-L.,Yuli Veterans Hospital | Cheng M.-C.,Yuli Mental Health Research Center | And 7 more authors.
Schizophrenia Research | Year: 2012

Schizophrenia is a complex mental disorder with high degree of genetic influence in its etiology. Several recent studies revealed that copy number variations (CNVs) of genomic DNA contributed significantly to the genetic architecture of sporadic schizophrenia. This study aimed to investigate whether CNVs also contribute to the familial forms of schizophrenia. Using array-based comparative genomic hybridization technology, we searched for pathogenic CNV associated with schizophrenia in a sample of 60 index cases from multiplex schizophrenia families. We detected three inherited CNVs that were associated with schizophrenia in three families, including a microdeletion of ~. 4.4. Mb at chromosome 6q12-q13, a microduplication of ~. 1. Mb at chromosome 18q12.3, and an interstitial duplication of ~. 5. Mb at chromosome 15q11.2-q13.1. Our data indicate that CNVs contribute to the genetic underpinnings of the familial forms of schizophrenia as well as of the sporadic form. As 15q11-13 duplication is a well-known recurrent CNV associated with autism in the literature, the detection of the 15q11.2-q13.1 duplication in our schizophrenia patients provides additional support to other studies reporting that schizophrenia is part of the clinical spectrum of 15q11-q13 duplication syndrome. © 2012 Elsevier B.V. Source


Lin C.-C.,Taipei Medical University | Lin C.-C.,National Taiwan University Hospital | Bai Y.-M.,Taipei Veterans General Hospital | Bai Y.-M.,National Yang Ming University | And 5 more authors.
Journal of Clinical Psychiatry | Year: 2010

Objective: Metabolic syndrome (MetS) is an important side effect of second-generation anti- psychotics (SGAs). However, many SGA-treated patients with MetS remain undetected. In this study, we trained and validated artificial neural network (ANN) and multiple logistic regression models without biochemical parameters to rapidly identify MetS in patients with SGA treatment. Method: A total of 383 patients with a diagnosis of schizophrenia or schizoaffective disorder (DSM-IV criteria) with SGA treatment for more than 6 months were investigated to determine whether they met the MetS criteria according to the International Diabetes Federation. The data for these patients were collected between March 2005 and September 2005. The input variables of ANN and logistic regression were limited to demographic and anthropometric data only. All models were trained by randomly selecting two-thirds of the patient data and were Internally validated with the remaining one-third of the data. The models were then externally validated with data from 69 patients from another hospital, collected between March 2008 and June 2008. The area under the receiver operating characteristic curve (AUC) was used to measure the performance of all models. Results: Both the final ANN and logistic regression models had high accuracy (88.3% vs 83.6%), sensitivity (93.1% vs 86.2%), and specificity (86.9% vs 83.8%) to identify MetS in the internal validation set. The mean ± SD AUC was high for both the ANN and logistic regression models (0.934 ± 0.033 vs 0.922 ± 0.035, P= .63). During external validation, high AUC was still obtained for both models. Waist circumference and diastolic blood pressure were the common variables that were left in the final ANN and logistic regression models. Conclusion: Our study developed accurate ANN and logistic regression models to detect MetS in patients with SGA treatment. The models are likely to provide a noninvasive tool for large-scale screening of MetS in this group of patients. © Copyright 2010 Physicians Postgraduate Press, Inc. Source

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