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Hua MH, Huang KL, Hsu JW, Bai YM, Su TP, Tsai SJ, Li CT, Lin WC, Chen TJ, Chen MH. Early Pregnancy Risk Among Adolescents With ADHD: A Nationwide Longitudinal Study. J Atten Disord 2021; 25:1199-1206. [PMID: 31971056 DOI: 10.1177/1087054719900232] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective: ADHD potentially leads to risky sexual behaviors, and is considered a major risk factor for early pregnancy (EP). However, the association between ADHD and subsequent EP remains unknown. Method: Seven thousand five hundred five adolescents with ADHD and 30,020 age- and sex-matched individuals without ADHD were enrolled from 2001 to 2009 and were followed until the end of 2011. Adolescents who developed any pregnancy (at age ≤30 years) or EP (at age <20 years) during the follow-up period were identified. Results: Adolescents with ADHD were found to be prone to pregnancy (hazard ratio [HR] = 1.27) and EP (HR = 2.30) compared with those without ADHD. Long-term ADHD medication use was related to a lower risk of subsequent any pregnancy (HR = 0.72) and EP (HR = 0.69). Conclusion: Adolescents with ADHD had an increased risk of any pregnancy and EP compared with their non-ADHD counterparts. Long-term ADHD medication use was associated with a lower subsequent EP risk.
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Affiliation(s)
| | - Kai-Lin Huang
- Taipei Veterans General Hospital, Taipei.,National Yang-Ming University, Taipei
| | - Ju-Wei Hsu
- Taipei Veterans General Hospital, Taipei.,National Yang-Ming University, Taipei
| | - Ya-Mei Bai
- Taipei Veterans General Hospital, Taipei.,National Yang-Ming University, Taipei
| | - Tung-Ping Su
- Taipei Veterans General Hospital, Taipei.,National Yang-Ming University, Taipei.,Cheng Hsin General Hospital, Taipei
| | - Shih-Jen Tsai
- Taipei Veterans General Hospital, Taipei.,National Yang-Ming University, Taipei
| | - Cheng-Ta Li
- Taipei Veterans General Hospital, Taipei.,National Yang-Ming University, Taipei
| | - Wei-Chen Lin
- Taipei Veterans General Hospital, Taipei.,National Yang-Ming University, Taipei
| | - Tzeng-Ji Chen
- Taipei Veterans General Hospital, Taipei.,National Yang-Ming University, Taipei
| | - Mu-Hong Chen
- Taipei Veterans General Hospital, Taipei.,National Yang-Ming University, Taipei
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Risk of Respiratory Infectious Diseases and the Role of Methylphenidate in Children with Attention-Deficit/Hyperactivity Disorder: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115824. [PMID: 34071586 PMCID: PMC8199289 DOI: 10.3390/ijerph18115824] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 12/26/2022]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) are commonly affected by medical illness. The aim of the present study was to explore the risks of contracting respiratory infectious diseases (RIDs), including upper and lower RIDs and influenza, in children with ADHD. We also examined whether methylphenidate has a protective effect regarding the risk of contracting RIDs among children with ADHD who have a history of methylphenidate treatment. Children in the Taiwan Maternal and Child Health Database from 2004 to 2016 were included in the present study. Upper and lower RIDs, influenza, ADHD, age, sex, and records of methylphenidate prescription were identified. A Cox proportional hazards regression model was used to estimate the significance of the risk of RIDs among children with ADHD in comparison with that among children without ADHD after adjustment for sex and age. The self-controlled case series analysis was conducted to examine the protective effect of methylphenidate treatment against RIDs. In total, 85,853 children with ADHD and 1,458,750 children without ADHD were included in the study. After controlling for sociodemographic variables, we observed that children with ADHD had significantly higher risks of upper RIDs, lower RIDs, and influenza infection than did those without ADHD. Among the children with ADHD who had a history of methylphenidate treatment, the risk of contracting RIDs was lower during the methylphenidate treatment period than during the nontreatment period. Children with ADHD had a higher RID risk than those without ADHD. Methylphenidate might reduce the risk of RIDs among children with ADHD who have a history of methylphenidate treatment.
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53
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Roberts DK, Alderson RM, Betancourt JL, Bullard CC. Attention-deficit/hyperactivity disorder and risk-taking: A three-level meta-analytic review of behavioral, self-report, and virtual reality metrics. Clin Psychol Rev 2021; 87:102039. [PMID: 34004385 DOI: 10.1016/j.cpr.2021.102039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 04/20/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
Meta-analytic methods were used to examine ADHD-related risk-taking in children and adults, and to compare the magnitude of risk taking across behavioral, self-report, and virtual reality metrics. Potential moderators of effect size heterogeneity were also examined via a three-level multi-level approach and a hybrid meta-analytic/systematic review approach. Aggregated effect sizes obtained from 56 behavioral-task studies (82 effect sizes; ADHDN = 2577; TDN = 2606), 51 self-report studies (130 effect sizes; ADHDN = 18,641; TDN = 113,163), and 8 virtual reality studies (16 effect sizes; ADHDN = 382; TDN = 436) suggest that children and adults with ADHD exhibit moderately more risk-taking compared to children and adults without the disorder. Notably, the aggregated effect size obtained from virtual reality simulations (Hedges', g = 0.43) was 30-40% larger than effect sizes obtained from self-report and behavioral task metrics (Hedges' g = 0.31 and 0.27), respectively. Suboptimal Decision Making was the only significant moderator identified via multi-level modeling; however, comparison of subgroup effect sizes revealed potential moderating effects of ADHD presentation and trial-by-trial feedback on behavioral tasks. Collectively, findings suggest that ADHD is reliably associated with small to moderate magnitude greater risk-taking behavior and virtual reality simulations appear be the most sensitive currently available metric.
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Affiliation(s)
| | - R Matt Alderson
- Oklahoma State University, Stillwater, OK, United States of America.
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54
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Rowe K, Duta M, Demeyere N, Wagner RG, Pettifor A, Kahn K, Tollman S, Scerif G, Stein A. The relationship between executive function, risky behaviour and HIV in young women from the HPTN 068 study in rural South Africa. AIDS Care 2021; 33:682-692. [PMID: 33258691 PMCID: PMC8650142 DOI: 10.1080/09540121.2020.1851016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
Executive function (EF) may predict sexual risk-taking and HIV risk in young women in rural South Africa. We tested associations between EF and seven risky behavioural outcomes: binge drinking, illicit substance use, unprotected vaginal sex, concurrent sexual relationships, transactional sex, herpes simplex virus type 2 (HSV-2) infection, and HIV infection. We compared EF in young women with HIV to matched controls. 1080 young women underwent cognitive assessments. Better verbal short-term memory was associated with a lower risk of HSV-2 (OR 0.77; 95% CI 0.69, 0.86; p < 0.001). Uncorrected trends (p < 0.05) were better verbal working memory being associated with a lower risk of concurrency, better planning with a lower risk of illicit drug use, and better affective inhibition with a lower risk of transactional sex. 78 participants with sexually acquired HIV were matched with 153 HIV-negative controls and had poorer verbal working memory than controls (Hedge's g = -0.38; 95% CI -0.66, -0.10; p = 0.0076), but this was non-significant after adjustment. EF's contribution to young women's risky behaviour in this context does not hold when stringent statistical corrections are applied, with only verbal short term memory reaching statistical significance as predictor. Replication in other samples is recommended.
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Affiliation(s)
- Kirsten Rowe
- Department of Psychiatry, University of Oxford, Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Mihaela Duta
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Ryan G. Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Audrey Pettifor
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Risks of Major Mental Disorders and Irritable Bowel Syndrome among the Offspring of Parents with Irritable Bowel Syndrome: A Nationwide Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094679. [PMID: 33924787 PMCID: PMC8124475 DOI: 10.3390/ijerph18094679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 04/23/2021] [Accepted: 04/25/2021] [Indexed: 12/12/2022]
Abstract
Irritable bowel syndrome (IBS) is a functional bowel disorder that is highly comorbid with mental disorders. However, few studies have examined the risk of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder, major depressive disorder (MDD), and schizophrenia in the offspring of parents with IBS. We used nationally representative cross-sectional survey data to analyze cross-generational transmission patterns of both IBS and major mental disorders. Odds ratio (OR) was calculated by using logistic regression models with adjustment for potential confounding factors. Offspring of parents with IBS were more likely to develop IBS themselves (OR = 2.41, 95% confidence interval (CI), 2.09–2.78), ADHD (OR = 1.33, 95% CI, 1.08–1.62), and MDD (OR = 1.32, 95% CI, 1.04–1.68) than the controls. Data stratification by parental sex revealed that paternal IBS increased risk of ADHD (OR = 1.34, 95% CI, 1.01–1.77) in the offspring, while maternal IBS increased the risk of MDD (OR = 1.51, 95% CI, 1.11–2.06). This is the first study to reveal parental IBS is associated with IBS, ADHD, and MDD among offspring, suggesting the necessity for early implementation of prevention strategies for at-risk children.
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Atopic dermatitis and dementia risk: A nationwide longitudinal study. Ann Allergy Asthma Immunol 2021; 127:200-205. [PMID: 33716147 DOI: 10.1016/j.anai.2021.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Retrospective studies have suggested that patients with dementia have higher prevalence of atopic dermatitis (AD) than those without dementia. However, the temporal association of AD with subsequent dementia remains unknown. OBJECTIVE To assess the temporal association of AD with subsequent dementia. METHODS We included data of patients with AD aged 45 years and older (n = 1059) and 1:10 age, sex, residence, income, and dementia-related comorbidity-matched controls (n = 10,590) from the Taiwan National Health Insurance Research Database and reviewed their subsequent dementia development from the enrollment date to the end of 2013. RESULTS After adjustments for dementia-related comorbidities, patients with AD were found to be more likely to develop any dementia (hazard ratio [HR], 2.02; 95% confidence interval [CI], 1.24-3.29), particularly Alzheimer's disease (HR, 3.74; 95% CI, 1.17-11.97), during the follow-up period than those in the control group. Moderate-to-severe AD was associated with a high subsequent dementia risk (HR, 4.64; 95% CI, 2.58-8.33). Sensitivity analyses with the exclusion of the first 3 (HR, 2.20; 95% CI, 1.28-3.80) or 5 (HR, 2.05; 95% CI, 1.08-3.89) years of observation revealed consistent findings. CONCLUSION AD may be an independent risk factor for new-onset dementia. Clinicians may monitor the trajectory of neurocognitive function among elderly patients with AD. Additional studies elucidating the pathomechanisms between AD and subsequent dementia are warranted.
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Huang MH, Cheng CM, Tsai SJ, Bai YM, Li CT, Lin WC, Su TP, Chen TJ, Chen MH. Familial coaggregation of major psychiatric disorders among first-degree relatives of patients with obsessive-compulsive disorder: a nationwide study. Psychol Med 2021; 51:680-687. [PMID: 31907096 DOI: 10.1017/s0033291719003696] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Whether the first-degree relatives (FDRs) of patients with obsessive-compulsive disorder (OCD) have an increased risk of the major psychiatric disorders, namely schizophrenia, bipolar disorder, OCD, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD), remains unclear. METHODS Using the Taiwan National Health Insurance Research Database with the whole population sample size (n = 23 258 175), 89 500 FDRs, including parents, offspring, siblings, and twins, of patients with OCD were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with OCD. RESULTS FDRs of patients with OCD had higher RRs of major psychiatric disorders, namely OCD (RR 8.11, 95% confidence interval (CI) 7.68-8.57), bipolar disorder (RR 2.85, 95% CI 2.68-3.04), MDD (RR 2.67, 95% CI 2.58-2.76), ASD (RR 2.38, 95% CI 2.10-2.71), ADHD (RR 2.19, 95% CI 2.07-2.32), and schizophrenia (RR 1.97, 95% CI 1.86-2.09), compared with the total population. Different familial kinships of FDRs, such as parents, offspring, siblings, and twins consistently had increased risks for these disorders. In addition, a dose-dependent relationship was found between the numbers of OCD probands and the risk of each major psychiatric disorder. CONCLUSIONS The FDRs, including parents, offspring, siblings, and twins, of patients with OCD have a higher risk of OCD, schizophrenia, bipolar disorder, MDD, ADHD, and ASD. The familial co-aggregation of OCD with OCD and other major psychiatric disorders was existent in a dose-dependent manner. Given the increased risks of psychiatric disorders, medical practitioners should closely monitor the mental health of the FDRs of patients with OCD.
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Affiliation(s)
- Mao-Hsuan Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
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Tseng HJ, Cheng CM, Tsai SJ, Lin WC, Bai YM, Tsai CF, Su TP, Li CT, Chen TJ, Chen MH. Proton Pump Inhibitor Exposure and Acute Myocardial Infarction Risk: A Nested Cohort Study. Cardiovasc Toxicol 2021; 21:444-450. [PMID: 33625647 DOI: 10.1007/s12012-021-09637-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Association of proton pump inhibitor (PPI) exposure with acute myocardial infarction (AMI) risk in the Caucasian population remains under debate. Here, we clarified whether PPI exposure might be related to an increased new-onset AMI risk in an Asian population. METHOD Data of 27,624 patients with PPI exposure followed by new-onset AMI development were extracted from Taiwan National Health Insurance Research Database and age- and sex-matched with 27,624 controls with PPIs exposure, but without subsequent AMI and ischemic heart disease development. The amount of PPI exposure was calculated based on the cumulative defined daily dose (cDDD) during the follow-up period. Subsequent AMI risk was measured after adjustments of demographic data and indication of PPI use. RESULTS AMI risk increased with an increase in PPI exposure: with cDDD ≤ 30 as the reference, the odds ratios (95% confidence intervals) for cDDDs of > 365 was 1.56 (1.45-1.69). All five PPI categories, including pantoprazole, lansoprazole, omeprazole, esomeprazole, and rabeprazole, increased AMI risk. CONCLUSIONS Our study demonstrated long-term or high-dose PPI exposure associated with increased new-onset AMI risk in patients without a history of any ischemic heart disease. The underlying mechanisms of PPI-related cardiovascular effects deserve more investigation.
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Affiliation(s)
- Hsiang-Jung Tseng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan. .,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Zhang B, Wang HE, Bai YM, Tsai SJ, Su TP, Chen TJ, Wang YP, Chen MH. Inflammatory bowel disease is associated with higher dementia risk: a nationwide longitudinal study. Gut 2021; 70:85-91. [PMID: 32576641 DOI: 10.1136/gutjnl-2020-320789] [Citation(s) in RCA: 159] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Increasing evidence supports reciprocal communication between the enteric and the central nervous system in disease, termed the 'gut-brain axis'. Recent findings suggest a connection between IBD and development of Parkinson's disease. The role of IBD in dementia, another insidious neurodegenerative disorder, has not been explored. DESIGN Using the Taiwanese National Health Insurance Research Database, we performed comparative analysis of 1742 patients with IBD ≥45 years old against 17 420 controls to assess dementia risk following IBD diagnosis. Controls were matched on bases of sex, access to healthcare, income and dementia-related comorbidities. All individuals were followed for dementia diagnosis for up to 16 years. Subanalyses included the relationship between sex, ulcerative colitis (UC) and Crohn's disease (CD), and dementia risk. RESULTS Overall incidence of dementia among patients with IBD was significantly elevated (5.5% vs 1.4% among controls). Patients with IBD were diagnosed with dementia at 76.24 years old on average, compared with 83.45 among controls. The HR of developing dementia among patients with IBD was 2.54 (95% CI 1.91 to 3.37). Among dementia types, the risk of developing Alzheimer's dementia demonstrated the greatest increase. Dementia risk did not differ between sex differences nor UC versus CD. CONCLUSION This population-based cohort study demonstrates significant association between IBD and subsequent development of dementia. Dementia was diagnosed at an earlier age among patients with IBD, and disease risk appeared to increase with IBD chronicity. These findings highlight the need for future research to elucidate the relationship between IBD and dementia.
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Affiliation(s)
- Bing Zhang
- Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Div Gastroenterology, University of California San Francisco, San Francisco, California, USA
| | - Hohui E Wang
- Psychiatry, University of California San Francisco, San Francisco, California, USA
| | - Ya-Mei Bai
- Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Po Wang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- Div Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan
- Endoscopy Center For Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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Lin SH, Cheng CM, Tsai SJ, Tsai CF, Bai YM, Su TP, Li CT, Lin WC, Chen TJ, Chen MH. A Population-Based, Nationwide Longitudinal Study of Bipolar Disorder With Incident Dementia in Taiwan. Am J Geriatr Psychiatry 2020; 28:530-541. [PMID: 31761661 DOI: 10.1016/j.jagp.2019.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Affective disorders are associated with increased risk of dementia, yet most studies focus on the association of major depressive disorder or depressive episodes of bipolar disorder with increased dementia risk. The association of manic/mixed episodes of bipolar disorder with increased dementia risk is unclear. PARTICIPANTS Between January 1, 2001 and December 31, 2009, 20,535 individuals aged 45-80 years with bipolar disorder and 82,140 age- and sex-matched comparisons were enrolled and followed up to December 2011 in Taiwan. Those who developed dementia (ICD-9-CM codes: 290.0-290.4, 294.1-294.2, and 331.0-331.2) during the follow-up period were identified. DESIGN AND METHODS Cox proportional hazards models were used to examine the relationship between manic/mixed/depressive episodes of bipolar disorder and incident dementia. We also assessed the association between the frequency of psychiatric admissions (total, manic/mixed, and depressive episodes per year) for bipolar disorder and dementia risk. RESULTS Bipolar disorder was associated with increased risk of incident dementia (hazard ratio [HR]: 7.52, 95% confidence interval [CI]: 6.86-8.25). Greater frequency of manic/mixed (>2/year: HR: 4.50, 3.50-5.79; 1-2/year: HR: 3.17, 2.31-4.36) and depressive episodes (>2/year: HR: 7.84, 5.93-10.36; 1-2/year: HR: 2.93, 2.05-4.19) were associated with increased risk of incident dementia. CONCLUSIONS Not only depressive episode of bipolar disorder, but manic/mixed episodes of bipolar play a role as a risk factor of incident dementia, especially for those patients with more than two manic/mixed episodes per year. These findings remind the clinicians the importance of preventing the relapse of bipolar disorder for the potential subsequent cognitive decline and disease.
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Affiliation(s)
- Shen-Hsiung Lin
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital (C-MC), Taipei, Taiwan.
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital (T-PS), Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital (T-JC), Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University (T-JC), Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan.
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Chou WJ, Liu TL, Hsiao RC, Chen YM, Chang CC, Yen CF. Application and Perceived Effectiveness of Complementary and Alternative Intervention Strategies for Attention-Deficit/Hyperactivity Disorder: Relationships with Affiliate Stigma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051505. [PMID: 32110955 PMCID: PMC7084270 DOI: 10.3390/ijerph17051505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/13/2020] [Accepted: 02/25/2020] [Indexed: 11/24/2022]
Abstract
This cross-sectional questionnaire survey study was designed to examine the complementary and alternative intervention strategies (CAIS) employed by caregivers for their children’s attention-deficit/hyperactivity disorder (ADHD) and the associations of affiliate stigma with the employment and rated effectiveness of these strategies in Taiwan. A total of 400 caregivers of children with ADHD participated. CAIS that the caregivers employed and their effectiveness rated by the caregivers were surveyed. Associations of affiliate stigma with the application and rated effectiveness of the strategies were determined using logistic regression analysis. The results indicated that sensory integration (30.3%), exercise training (29.3%), sugar restriction (20.5%), and omega fatty acid supplementation (11.3%) were the most common CAIS that the caregivers employed. Caregivers with stronger affiliate stigma were more likely to employ sensory integration, exercise training, and omega fatty acid supplementation but also rated them as ineffective in treating their children’s ADHD. Various CAIS were employed by the caregivers to manage their children’s ADHD. Affiliate stigma was significantly associated with the application and rated ineffectiveness of several CAIS.
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Affiliation(s)
- Wen-Jiun Chou
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (T.-L.L.); (Y.-M.C.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195-6560, USA;
- Department of Psychiatry, Children’s Hospital and Regional Medical Center, Seattle, WA 98105, USA
| | - Yu-Min Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (T.-L.L.); (Y.-M.C.)
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan
- Department of Health Psychology, College of Health Sciences, Chang Jung Christian University, Tainan 71101, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2812811 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6816) (C.-F.Y.); Fax: +886-6-2203702 (C.-C.C.); +886-7-3134761 (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (T.-L.L.); (Y.-M.C.)
- Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2812811 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6816) (C.-F.Y.); Fax: +886-6-2203702 (C.-C.C.); +886-7-3134761 (C.-F.Y.)
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Chen LC, Chen YH, Bai YM, Chen TJ, Chen MH, Su TP. Antidepressant resistance in adolescents with major depressive disorder: A nationwide longitudinal study. J Affect Disord 2020; 262:293-297. [PMID: 31733920 DOI: 10.1016/j.jad.2019.11.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 11/04/2019] [Accepted: 11/09/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Studies have suggested that psychiatric comorbidities have major effects on antidepressant resistance in adult patients with major depressive disorder (MDD). However, the association between psychiatric comorbidities and antidepressant resistance remains unclear in adolescents with MDD. METHODS A total of 10,624 adolescents with MDD were selected from the Taiwan National Health Insurance Research Database between 2001 and 2010 and followed for one year. Treatment-resistant depression (TRD) was defined as unresponsiveness to at least two antidepressants, and treatment resistant tendency was defined as unresponsiveness to the first antidepressant. Psychiatric comorbidities, such as anxiety disorders, substance use disorders, and attention deficit hyperactivity disorder (ADHD), were assessed as confounding factors. RESULTS In our study, only 1.7% (n = 184) of adolescents with MDD met the TRD criteria but 23.3% (n = 2480) were classified as exhibiting treatment resistant tendency. Anxiety disorders (OR: 2.34, 95% CI: 1.73-3.16) and substance use disorders (OR: 2.41, 95% CI: 1.28-4.54) exhibited a correlation with TRD, and ADHD (OR: 1.34, 95% CI: 1.08-1.66) was associated with treatment resistant tendency. CONCLUSIONS Approximately one-fourth of adolescents with MDD respond poorly to the first antidepressant treatment. The psychiatric comorbidities of anxiety disorders, substance use disorders, and ADHD may increase the risk of treatment resistance in adolescents with MDD.
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Affiliation(s)
- Li-Chi Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Yu-Hsiung Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Branch of Linsen, Chinese Medicine, and Kunming, Taipei City Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan.
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Silverstein MJ, Faraone SV, Leon TL, Biederman J, Spencer TJ, Adler LA. The Relationship Between Executive Function Deficits and DSM-5-Defined ADHD Symptoms. J Atten Disord 2020; 24:41-51. [PMID: 30296883 DOI: 10.1177/1087054718804347] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To identify the relationship between the core Diagnostic and Statistical Manual of Mental Disorders (5th ed.) ADHD symptoms and executive function deficits (EFDs), to evaluate ADHD characteristics of those with executive dysfunction (ED), and to examine the predictive utility of the Adult ADHD Investigator Symptom Rating Scale (AISRS) in identifying those with adult ADHD and ED. Method: Two samples (referred and primary care practice) were pooled together for present analysis. Results: Final analysis included 297 respondents, 171 with adult ADHD. Spearman correlation coefficients and binary logistic regressions demonstrated that ADHD inattentive (IA) and hyperactive-impulsive (H-I) symptoms were moderately to strongly correlated with and highly predictive of EFDs. Receiver operating characteristic curve analysis showed that an AISRS DSM 18-item score of ⩾ 28 was most predictive of clinical ED. Conclusion: ADHD symptoms were strongly correlated with and predictive of EFDs, clinicians should screen adults with ADHD for EFDs and ADHD treatment providers should track EFD improvement in addition to DSM-5 ADHD symptoms.
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Affiliation(s)
- Michael J Silverstein
- Drexel University, Philadelphia, PA, USA.,New York University School of Medicine, New York City, USA
| | | | - Terry L Leon
- New York University School of Medicine, New York City, USA
| | | | | | - Lenard A Adler
- New York University School of Medicine, New York City, USA
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Tsai SJ, Chen MH, Huang KL, Hsu JW, Bai YM, Chen TJ. Maternal hyperthyroidism during pregnancy and offspring risks of attention-deficit/hyperactivity disorder and autism spectrum disorder: A nationwide study. TAIWANESE JOURNAL OF PSYCHIATRY 2020. [DOI: 10.4103/tpsy.tpsy_27_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chung W, Jiang SF, Paksarian D, Nikolaidis A, Castellanos FX, Merikangas KR, Milham MP. Trends in the Prevalence and Incidence of Attention-Deficit/Hyperactivity Disorder Among Adults and Children of Different Racial and Ethnic Groups. JAMA Netw Open 2019; 2:e1914344. [PMID: 31675080 PMCID: PMC6826640 DOI: 10.1001/jamanetworkopen.2019.14344] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE An increasing prevalence of adult attention-deficit/hyperactivity disorder (ADHD) diagnosis and treatment has been reported in clinical settings and administrative data in the United States. However, there are limited data on recent trends of adult ADHD diagnosis among racial/ethnic subgroups. OBJECTIVE To examine trends, including associated demographic characteristics, psychiatric diagnoses, and negative outcomes, in the prevalence and incidence of adult ADHD diagnosis among 7 racial/ethnic groups during a 10-year period. DESIGN, SETTING, AND PARTICIPANTS This cohort study investigated trends in the diagnosis of ADHD in adults who identified as African American or black, Native American, Pacific Islander, Latino or Hispanic, non-Hispanic white, Asian American, or other using the Kaiser Permanente Northern California health plan medical records. A total of 5 282 877 adult patients and 867 453 children aged 5 to 11 years who received care at Kaiser Permanente Northern California from January 1, 2007, to December 31, 2016, were included. Data analysis was performed from January 2017 through September 2019. EXPOSURES Period of ADHD diagnosis. MAIN OUTCOMES AND MEASURES Prevalence and incidence of licensed mental health clinician-diagnosed ADHD in adults and prevalence of licensed mental health clinician-diagnosed ADHD in children aged 5 to 11 years. RESULTS Of 5 282 877 adult patients (1 155 790 [21.9%] aged 25-34 years; 2 667 562 [50.5%] women; 2 204 493 [41.7%] white individuals), 59 371 (1.12%) received diagnoses of ADHD. Prevalence increased from 0.43% in 2007 to 0.96% in 2016. Among 867 453 children aged 5 to 11 years (424 449 [48.9%] girls; 260 236 [30.0%] white individuals), prevalence increased from 2.96% in 2007 to 3.74% in 2016. During the study period, annual adult ADHD prevalence increased for every race/ethnicity, but white individuals consistently had the highest prevalence rates (white individuals: 0.67%-1.42%; black individuals: 0.22%-0.69%; Native American individuals: 0.56%-1.14%; Pacific Islander individuals: 0.11%-0.39%; Hispanic or Latino individuals: 0.25%-0.65%; Asian American individuals: 0.11%-0.35%; individuals from other races/ethnicities: 0.29%-0.71%). Incidence of ADHD diagnosis per 10 000 person-years increased from 9.43 in 2007 to 13.49 in 2016. Younger age (eg, >65 years vs 18-24 years: odds ratio [OR], 0.094; 95% CI, 0.088-0.101; P < .001), male sex (women: OR, 0.943; 95% CI, 0.928-0.959; P < .001), white race (eg, Asian patients vs white patients: OR, 0.248; 95% CI, 0.240-0.257; P < .001), being divorced (OR, 1.131; 95% CI, 1.093-1.171; P < .001), being employed (eg, retired vs employed persons: OR, 0.278; 95% CI, 0.267-0.290; P < .001), and having a higher median education level (OR, 2.156; 95% CI, 2.062-2.256; P < .001) were positively associated with odds of ADHD diagnosis. Having an eating disorder (OR, 5.192; 95% CI, 4.926-5.473; P < .001), depressive disorder (OR, 4.118; 95% CI, 4.030-4.207; P < .001), bipolar disorder (OR, 4.722; 95% CI, 4.556-4.894; P < .001), or anxiety disorder (OR, 2.438; 95% CI, 2.385-2.491; P < .001) was associated with higher odds of receiving an ADHD diagnosis. Adults with ADHD had significantly higher odds of frequent health care utilization (OR, 1.303; 95% CI, 1.272-1.334; P < .001) and sexually transmitted infections (OR, 1.289; 95% CI 1.251-1.329; P < .001) compared with adults with no ADHD diagnosis. CONCLUSIONS AND RELEVANCE This study confirmed the reported increases in rates of ADHD diagnosis among adults, showing substantially lower rates of detection among minority racial/ethnic subgroups in the United States. Higher odds of negative outcomes reflect the economic and personal consequences that substantiate the need to improve assessment and treatment of ADHD in adults.
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Affiliation(s)
- Winston Chung
- Department of Psychiatry, Kaiser Permanente Northern California, San Francisco
| | - Sheng-Fang Jiang
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Diana Paksarian
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Aki Nikolaidis
- Center for the Developing Brain, Child Mind Institute, New York, New York
| | - F. Xavier Castellanos
- Department of Child and Adolescent Psychiatry, Hassenfeld Children’s Hospital at NYU Langone, New York, New York
- Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Michael P. Milham
- Center for the Developing Brain, Child Mind Institute, New York, New York
- Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
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Chen MH, Hsu JW, Huang KL, Su TP, Li CT, Lin WC, Tsai SJ, Cheng CM, Chang WH, Pan TL, Chen TJ, Bai YM. Risk and coaggregation of major psychiatric disorders among first-degree relatives of patients with bipolar disorder: a nationwide population-based study. Psychol Med 2019; 49:2397-2404. [PMID: 30415649 DOI: 10.1017/s003329171800332x] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Bipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear. METHODS Among the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder. RESULTS FDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95-6.30), MDD (RR 2.89, 95% CI 2.82-2.96), schizophrenia (RR 2.64, 95% CI 2.55-2.73), ADHD (RR 2.21, 95% CI 2.13-2.30), and ASD (RR 2.10, 95% CI 1.92-2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients. CONCLUSIONS Our study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kei-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tai-Long Pan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
- Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Research Center for Chinese Herbal Medicine and Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Abstract
BACKGROUND Research suggests an association between metabolic disorders, such as type 2 diabetes mellitus (T2DM), and schizophrenia. However, the risk of metabolic disorders in the unaffected siblings of patients with schizophrenia remains unclear. METHODS Using the Taiwan National Health Insurance Research Database, 3135 unaffected siblings of schizophrenia probands and 12,540 age-/sex-matched control subjects were included and followed up to the end of 2011. Individuals who developed metabolic disorders during the follow-up period were identified. RESULTS The unaffected siblings of schizophrenia probands had a higher prevalence of T2DM (3.4% vs. 2.6%, p = 0.010) than the controls. Logistic regression analyses with the adjustment of demographic data revealed that the unaffected siblings of patients with schizophrenia were more likely to develop T2DM (odds ratio [OR]: 1.39, 95% confidence interval [CI]: 1.10-1.75) later in life compared with the control group. Moreover, only female siblings of schizophrenia probands had an increased risk of hypertension (OR: 1.47, 95% CI: 1.07-2.01) during the follow-up compared with the controls.DiscussionThe unaffected siblings, especially sisters, of schizophrenia probands had a higher prevalence of T2DM and hypertension compared with the controls. Our study revealed a familial link between schizophrenia and T2DM in a large sample. Additional studies are required to investigate the shared pathophysiology of schizophrenia and T2DM.
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Huang MH, Cheng CM, Huang KL, Hsu JW, Bai YM, Su TP, Li CT, Tsai SJ, Lin WC, Chen TJ, Chen MH. Bipolar disorder and risk of Parkinson disease: A nationwide longitudinal study. Neurology 2019; 92:e2735-e2742. [PMID: 31118242 DOI: 10.1212/wnl.0000000000007649] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/01/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the risk of Parkinson disease (PD) among patients with bipolar disorder (BD). METHODS Using the Taiwan National Health Insurance Research Database, we examined 56,340 patients with BD and 225,360 age- and sex-matched controls between 2001 and 2009 and followed them to the end of 2011. Individuals who developed PD during the follow-up period were identified. RESULTS Patients with BD had a higher incidence of PD (0.7% vs 0.1%, p < 0.001) during the follow-up period than the controls. A Cox regression analysis with adjustments for demographic data and medical comorbid conditions revealed that patients with BD were more likely to develop PD (hazard ratio [HR] 6.78, 95% confidence interval [CI] 5.74-8.02) than the control group. Sensitivity analyses after exclusion of the first year (HR 5.82, 95% CI 4.89-6.93) or first 3 years (HR 4.42; 95% CI 3.63-5.37) of observation showed consistent findings. Moreover, a high frequency of psychiatric admission for manic/mixed and depressive episodes was associated with an increased risk of developing PD. CONCLUSION Patients with BD had a higher incidence of PD during the follow-up period than the control group. Manic/mixed and depressive episodes were associated with an elevated likelihood of developing PD. Further studies are necessary to investigate the underlying pathophysiology between BD and PD.
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Affiliation(s)
- Mao-Hsuan Huang
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Chih-Ming Cheng
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan.
| | - Kai-Lin Huang
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Ju-Wei Hsu
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Ya-Mei Bai
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Tung-Ping Su
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Cheng-Ta Li
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Shih-Jen Tsai
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Wei-Chen Lin
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Tzeng-Ji Chen
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Mu-Hong Chen
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan.
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Schmidt EK, Hand BN, Simpson KN, Darragh AR. Sexually transmitted infections in privately insured adults with intellectual and developmental disabilities. J Comp Eff Res 2019; 8:599-606. [PMID: 30838884 DOI: 10.2217/cer-2019-0011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Individuals with intellectual and developmental disabilities (I/DD) may have an increased risk of sexually transmitted infections (STIs) due to limited sexual health education and higher rates of sexual abuse, yet little is known about the prevalence of STIs and STI testing in this population. Methods: This study compared national samples of privately insured individuals with (n = 25,193) and without I/DD (n = 25,193) on the prevalence of STIs and STI testing. Results: In multivariable models, individuals with I/DD were significantly less likely to have an STI diagnosis and no difference was found between groups on the odds of STI testing overall. Conclusion: Findings may, in part, be explained by fewer sexual experiences, increased supervision in social settings and delayed onset of sexual activity among those with I/DD.
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Affiliation(s)
- Elizabeth K Schmidt
- Department of Health & Rehabilitation Sciences & The Department of Occupational Therapy, The Ohio State University, OH 432102, USA
| | - Brittany N Hand
- Department of Health & Rehabilitation Sciences & The Department of Occupational Therapy, The Ohio State University, OH 432102, USA
| | - Kit N Simpson
- Healthcare Leadership & Management, Medical University of South Carolina, SC 29403, USA
| | - Amy R Darragh
- Department of Health & Rehabilitation Sciences & The Department of Occupational Therapy, The Ohio State University, OH 432102, USA
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70
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Wei HT, Pan TL, Hsu JW, Huang KL, Bai YM, Ko NY, Su TP, Li CT, Tsai SJ, Lin WC, Chen TJ, Chen MH. Risks of bipolar disorder, depressive disorder, and traumatic brain injury among siblings of patients with attention-deficit hyperactivity disorder. J Affect Disord 2019; 245:335-339. [PMID: 30419534 DOI: 10.1016/j.jad.2018.11.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/06/2018] [Accepted: 11/03/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies have suggested that the unaffected siblings of patients with attention-deficit hyperactivity disorder (ADHD) experience deficits in attention, impulsivity control, and behavior inhibition, which are associated with health-risk behaviors. However, risks to mental and physical health among the unaffected siblings of ADHD probands have rarely been investigated. METHODS Using the Taiwan National Health Insurance Research Database, 5128 unaffected siblings of ADHD probands born between 1980 and 2000 were included in our study along with 20,512 age- and sex-matched controls, and they were followed from 1996 or birth until the end of 2011. Mental and physical health risks, including affective disorders, traumatic brain injury (TBI), and sexually transmitted infection were identified during the follow-up period. RESULTS Logistic regression analyses with adjustments for demographic data showed that the unaffected siblings were more likely to develop unipolar depression (odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.39-2.22), bipolar disorder (OR: 2.10, 95% CI: 1. 09-4.05), and TBI (OR: 1.24, 95% CI: 1.14-1.36) than were the control group. DISCUSSION The unaffected siblings of patients with ADHD were prone to developing unipolar depression, bipolar disorder, and TBI later in life.
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Affiliation(s)
- Han-Ting Wei
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Kunming Branch, Taipei City Hospital, Taipei, Taiwan; Branch of Linsen, Chinese Medicine and Kunming, Taipei City Hospital, Taipei, Taiwan
| | - Tai-Long Pan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Research Center for Food and Cosmetic Safety, Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
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71
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Adler LA, Silverstein MJ. Emotional Dysregulation in Adult ADHD. Psychiatr Ann 2018. [DOI: 10.3928/00485713-20180607-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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