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Yu TH, Lee TL, Hsuan CF, Wu CC, Wang CP, Lu YC, Wei CT, Chung FM, Lee YJ, Tsai IT, Tang WH. Inter-relationships of risk factors and pathways associated with all-cause mortality in patients with chronic schizophrenia. Front Psychiatry 2024; 14:1309822. [PMID: 38831863 PMCID: PMC11144862 DOI: 10.3389/fpsyt.2023.1309822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/18/2023] [Indexed: 06/05/2024] Open
Abstract
Introduction Of all psychiatric disorders, schizophrenia is associated with the highest risk of all-cause mortality. This study aimed to investigate independent risk factors for all-cause mortality in patients with chronic schizophrenia. In addition, the possible causal inter-relationships among these independent risk factors and all-cause mortality were also explored. Methods We conducted an analysis of 1,126 patients with chronic schizophrenia from our psychiatric department from April 2003 to August 2022, and retrospectively reviewed their medical records. The study endpoint was all-cause mortality. Baseline clinical characteristics including sociodemographic data, biochemical data, lifestyle factors, comorbidities and antipsychotic treatment were examined with Cox proportional hazards analysis. Results The all-cause mortality rate was 3.9% (44 patients). Multivariate Cox regression analysis revealed that several factors were independently associated with all-cause mortality, including diabetes mellitus (DM), hypertension, heart failure, gastroesophageal reflux disease (GERD), peptic ulcer disease, ileus, underweight, fasting glucose, triglycerides, albumin, and hemoglobin. Structural equation modeling (SEM) analysis revealed that several factors had statistically significant direct effects on all-cause mortality. Heart failure, hypertension, underweight, age at onset, and ileus showed positive direct effects, while albumin and hemoglobin demonstrated negative direct effects. In addition, several factors had indirect effects on all-cause mortality. GERD indirectly affected all-cause mortality through ileus, and peptic ulcer disease had indirect effects through albumin and ileus. Ileus, underweight, DM, and hypertension also exhibited indirect effects through various pathways involving albumin, hemoglobin, and heart failure. Overall, the final model, which included these factors, explained 13% of the variability in all-cause mortality. Discussion These results collectively suggest that the presence of DM, hypertension, heart failure, GERD, peptic ulcer disease, ileus, and underweight, along with lower levels of albumin or hemoglobin, were independently associated with all-cause mortality. The SEM analysis further revealed potential causal pathways and inter-relationships among these risk factors contributing to all-cause mortality in patients with chronic schizophrenia.
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Affiliation(s)
- Teng-Hung Yu
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Thung-Lip Lee
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Chin-Feng Hsuan
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
- Division of Cardiology, Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Cheng-Ching Wu
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
- Division of Cardiology, Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Chao-Ping Wang
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Yung-Chuan Lu
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Ching-Ting Wei
- Division of General Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
- The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Fu-Mei Chung
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
| | | | - I-Ting Tsai
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
- Department of Emergency, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Wei-Hua Tang
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualien, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Fekih-Romdhane F, Hajje R, Haddad C, Hallit S, Azar J. Exploring negative symptoms heterogeneity in patients diagnosed with schizophrenia and schizoaffective disorder using cluster analysis. BMC Psychiatry 2023; 23:595. [PMID: 37582728 PMCID: PMC10428523 DOI: 10.1186/s12888-023-05101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Dissecting the heterogeneity of schizophrenia may help foster progress in understanding its etiology and lay the groundwork for the development of new treatment options for primary or enduring negative symptoms (NS). In this regard, the present study aimed to: (1) to use cluster analysis to identify subgroups of Lebanese patients diagnosed with either schizophrenia or schizoaffective disorder based on NS clusters, and (2) to relate the statistically-derived subgroups to clinically relevant external validators (including measures if state and trait depression, stigma, insight, loneliness, social support). METHOD A total of 202 adult long-stay, chronic, and clinically remitted patients (166 diagnosed with schizophrenia and 36 with schizoaffective disorder) were enrolled. A cluster analysis approach was adopted to classify patients based on the five NS domains social withdrawal, emotional withdrawal, alogia, avolition and anhedonia. RESULTS A three-cluster solution was obtained based on unique NS profiles, and divided patients into (1) low NS (LNS; 42.6%) which characterized by the lowest mean scores in all NS domains, (2) moderate NS (MNS; 25.7%), and (3) high NS (HNS; 31.7%). Post-hoc comparisons showed that depression (state and trait), loneliness and social support could accurately distinguish the schizophrenia subgroups. Additionally, individuals in the HNS cluster had longer duration of illness, longer duration of hospitalization, and were given higher dosages of antipsychotic medication compared to those in the other clusters, but these differences did not achieve the statistical significance. CONCLUSION Findings provide additional support to the categorical model of schizophrenia by confirming the existence of three alternate subtypes based on NS. The determination of distinct NS subgroups within the broad heterogeneous population of people diagnosed with schizophrenia may imply that each subgroup possibly has unique underlying mechanisms and necessitates different treatment approaches.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi hospital, Manouba, 2010 Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Romy Hajje
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon
| | - Souheil Hallit
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Jocelyne Azar
- School of Medicine, Lebanese American University, Byblos, Lebanon
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Li X, Wei N, Song J, Liu J, Yuan J, Song R, Liu L, Mei L, Yan S, Wu Y, Pan R, Yi W, Jin X, Li Y, Liang Y, Sun X, Cheng J, Su H. The global burden of schizophrenia and the impact of urbanization during 1990-2019: An analysis of the global burden of disease study 2019. ENVIRONMENTAL RESEARCH 2023:116305. [PMID: 37268204 DOI: 10.1016/j.envres.2023.116305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/09/2023] [Accepted: 05/31/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND HYPOTHESIS The burden of schizophrenia is increasing. Assessing the global distribution of schizophrenia and understanding the association between urbanization factors and schizophrenia are crucial. STUDY DESIGN We conducted a two-stage analysis utilizing public data from GBD (global burden of disease) 2019 and the World Bank. First, the distribution of schizophrenia burden at the global, regional, and national levels as well as temporal trends was analyzed. Then, four composite indicators of urbanization (including demographic, spatial, economic, and eco-environment urbanization) were constructed from ten basic indicators. Panel data models were used to explore the relationship between urbanization indicators and the burden of schizophrenia. RESULTS In 2019, there were 23.6 million people with schizophrenia, an increase of 65.85% from 1990, and the country with the largest ASDR (age-standardized disability adjusted life years rate) was the United States of America, followed by Australia, and New Zealand. Globally, the ASDR of schizophrenia rose with the sociodemographic index (SDI). In addition, six basic urbanization indicators including urban population proportion, employment in industry/services proportion, urban population density, the population proportion in the largest city, GDP, and PM2.5 concentration were positively associated with ASDR of schizophrenia, with the largest coefficients being urban population density. Overall, demographic, spatial, economic, and eco-environment urbanization all had positive effects on schizophrenia, and the estimated coefficients indicated that demographic urbanization was the most significant influence. CONCLUSIONS This study provided a comprehensive description of the global burden of schizophrenia and explored urbanization as a factor contributing to the variation in the burden of schizophrenia, and highlighted policy priorities for schizophrenia prevention in the context of urbanization.
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Affiliation(s)
- Xuanxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Jiajun Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China.
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Kotzeva A, Mittal D, Desai S, Judge D, Samanta K. Socioeconomic burden of schizophrenia: a targeted literature review of types of costs and associated drivers across 10 countries. J Med Econ 2023; 26:70-83. [PMID: 36503357 DOI: 10.1080/13696998.2022.2157596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIMS Schizophrenia has the highest median societal cost per patient of all mental disorders. This review summarizes the different costs/cost drivers (cost components) associated with schizophrenia in 10 countries, including all cost types and stakeholder perspectives, and highlights aspects of disease associated with greatest costs. MATERIALS AND METHODS Targeted literature review based on a search of published research from 2006 to 2021 in the United States (US), United Kingdom (UK), France, Germany, Italy, Spain, Canada, Japan, Brazil, and China. RESULTS Sixty-four published articles (primary studies and literature reviews) were included. Comprehensive data were available on costs in schizophrenia overall, with very limited data for individual countries except the US. Most data is related to direct and not indirect costs, with extremely scarce data for several key cost components (adverse events, suicide, long-term care). Total schizophrenia-related per person per year (PPPY) costs were $2,004-94,229, with considerable variability among countries. Indirect costs were the main cost driver (50-90% of all costs), ranging from $1,852 to $62,431 PPPY. However, indirect costs are not collected systematically or incorporated in health technology assessments. Total schizophrenia-related PPPY direct costs were $4,394-31,798, with inpatient cost as the main cost driver (∼20-99% of direct costs). Intangible costs were not reported. Despite limited evidence, total schizophrenia-related costs were higher in patients with than without negative symptoms, largely due to increased costs of medication and medical visits. LIMITATIONS As this was not a systematic review, prioritization of studies may have resulted in exclusion of potentially relevant data. All costs were converted to USD but not corrected for inflation or subjected to a gross domestic product deflator. CONCLUSIONS Direct costs are most commonly reported in schizophrenia. The substantial underreporting of indirect and intangible costs undervalues the true economic burden of schizophrenia from a payer, patient, and societal perspective.
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Han M, Lee K. Effectiveness of a Metacognitive Intervention for Schizophrenia (MCI-S) Program for Symptom Relief and Improvement in Social Cognitive Functioning in Patients with Schizophrenia. Arch Psychiatr Nurs 2022; 41:43-50. [PMID: 36428074 DOI: 10.1016/j.apnu.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/25/2022] [Accepted: 07/03/2022] [Indexed: 11/19/2022]
Abstract
This study investigated the effectiveness of a metacognitive intervention program for symptom relief and improvement in social cognitive functioning among adults with schizophrenia. The program focused on enhancing metacognition to encourage self-awareness and step-by-step perspective expansion. There were 24 participants in the experimental group and 19 participants in the control group. Delusions decreased, and social cognition and social functioning improved in the experimental group compared to the control group. The program demonstrated utility as a treatment modality, which can be part of an overall program of a mental health promotion institution to improve functioning in patients with schizophrenia.
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Affiliation(s)
- Mihwa Han
- Department of Nursing Science, Sunlin University, 30, 36beon-gil, Chogok-gil, Heunghae-eup Pohang-si, Gyeongbuk 37560, Republic of Korea
| | - Kyunghee Lee
- Research Institute of Nursing Science, Keimyung University, 1095 Dalgubeol-daero, Dalseo-Gu, Daegu 42601, Republic of Korea.
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Benson NM, Yang Z, Weiss M, Fung V, Moran LV, Öngür D, Hsu J. Identifying Diagnoses of Schizophrenia Spectrum Disorder in Large Data Sets. Psychiatr Serv 2022; 73:1210-1216. [PMID: 35440163 PMCID: PMC9582046 DOI: 10.1176/appi.ps.202100696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objective The authors used a large clinical data set to determine which index diagnoses of schizophrenia spectrum disorder were new diagnoses. Methods Using the Massachusetts All-Payer Claims Database (2012–2016), the authors identified patients with a schizophrenia spectrum disorder diagnosis in 2016 (index diagnosis) and then reviewed patients’ care histories for the previous 12, 24, 36, and 48 months to identify previous diagnoses. Logistic regression was used to examine patient characteristics associated with the index diagnosis being a new diagnosis. Results Overall, 7,217 individuals ages 15–35 years had a 2016 diagnosis of schizophrenia spectrum disorder; 67.7% had at least 48 months of historical data. Among those with at least 48 months of care history, 23% had no previous diagnoses. Diagnoses from inpatient psychiatric admissions or among female or younger patients were more likely to represent new diagnoses, compared with diagnoses from most other diagnosis locations or among males or older age groups, and outpatient diagnoses were less likely to represent new diagnoses than were most other diagnosis settings. Reviewing 48 instead of 12 months of data reduced estimated rates of new diagnoses from 112 to 66 per 100,000 persons; historical diagnoses were detected for 61% and 77% of patients with 12 or 48 months of care history, respectively. Conclusions Examining multiple years of patient history spanning all payers and providers is critical to identifying new schizophrenia spectrum disorder diagnoses in large data sets. Review of 48 months of care history resulted in lower rates of new schizophrenia spectrum disorder diagnoses than previously reported.
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Affiliation(s)
- Nicole M. Benson
- McLean Hospital, Harvard Medical School, Belmont, MA
- Mongan Institute, Massachusetts General Hospital, Boston, MA
| | - Zhiyou Yang
- Mongan Institute, Massachusetts General Hospital, Boston, MA
| | - Max Weiss
- Mongan Institute, Massachusetts General Hospital, Boston, MA
| | - Vicki Fung
- Mongan Institute, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | | | - Dost Öngür
- McLean Hospital, Harvard Medical School, Belmont, MA
| | - John Hsu
- Mongan Institute, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
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Cho SJ, Kim J, Lee JY, Sohn JH. Adherence to Antipsychotic Drugs by Medication Possession Ratio for Schizophrenia and Similar Psychotic Disorders in the Republic of Korea: A Retrospective Cohort Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:491-497. [PMID: 35879033 PMCID: PMC9329107 DOI: 10.9758/cpn.2022.20.3.491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/18/2022]
Abstract
Objective Pharmacotherapy is considered as an essential element in the treatment of psychotic disorders including schizophrenia. Discontinuation of antipsychotic drugs increases medical use and economic burden. Therefore, maintenance of medication is essential to reduce the social burden caused by schizophrenia and schizophrenia similar psychosis (SSP), and hence, it is important to investigate the rate at which pharmacotherapy is maintained. Therefore, this study aimed to examine the current status of drug compliance using national health insurance data. Methods This was a retrospective cohort study, which analyzed data from the nationwide insurance claims database. A total of 343,134 patients who were newly diagnosed with schizophrenia and SSP during 2011−2015. The adherence to antipsychotic drugs was assessed by medication possession ratio (MPR) and the risk factors of poor adherence were defined as MPR < 40%. Results The average of the MPRs was 45.8%, and the proportion of patients with less than 40% of MPR was 50.8%. It was found that female patients, the experience of “general hospital outpatient,” “psychiatric hospital admission,” “general hospital admission,” and patients receiving “health insurance” showed high risk of having statistically significant low MPR (< 40%). Conclusion In this study, the drug adherence of schizophrenia and SSP patients currently under treatment, as estimated by MPR, was very low. However, it was also found that the MPR was high among patients receiving medical aid, with less medical expenses. Thus, it is possible to consider an institutional mechanism in which schizophrenia and SSP patients can be treated with less economic burden.
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Affiliation(s)
- Sung Joon Cho
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jungmee Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Yong Lee
- Public Healthcare Center, Seoul National University Hospital, Seoul, Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- HIRA Research Institute, Health Insurance Review and Assessment Service, Wonju, Korea
| | - Jee Hoon Sohn
- Institue of Public Health and Medical Service, Seoul, Korea
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
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Oh GM, Jung K, Kim JH, Kim SE, Moon W, Park MI, Park SJ. Can the patient pinpoint where the ingested fish bone is impacted?: A single-center, retrospective study. Medicine (Baltimore) 2022; 101:e29399. [PMID: 35905236 PMCID: PMC9333482 DOI: 10.1097/md.0000000000029399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Among the plethora of foreign body impactions, fish bones are common examples that patients may struggle to properly disclose in clinical situations. This study investigated whether patients could pinpoint where the ingested fish bone was lodged. In addition, we investigated the differences between fish bone and other foreign bodies, the usefulness of computed tomography (CT), and the related risk factors for hospitalization. The cases of patients who underwent an endoscopic removal of fish bone between April 2008 and April 2020 were retrospectively reviewed. The clinical outcomes, X-ray scan, CT, and complications of each patient were investigated. A total of 96 patients were included in this study. The mean size of the impacted fish bone was 23.78 mm, and most were found in the upper esophagus (n = 38). There was a weak correlation between pain location and the actual lesion location (r = 0.419, P < .001). Compared to those of other foreign bodies, the location of impacted fish bones was different (P < .001), the X-ray detection rate of fish bones was lower (P < .001), and the complication incidence was higher (P = .030). CT (95.89%) showed higher sensitivity than X-ray scanning (11.24%) (P < .001). Foreign body size (P = .004) and door-to-endoscopy time (P = .029) were related to admission. Patients only managed to point out the approximate location of the ingested fish bone. CT detected fish bones well, but scans should include at least the entire esophagus instead of solely the area where pain is felt. Fish bone impaction has different clinical characteristics from other foreign bodies. Endoscopic removal without delay can reduce the admission rates.
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Affiliation(s)
- Gyu Man Oh
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Kyoungwon Jung
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
- *Correspondence: Kyoungwon Jung, Department of Internal Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea (e-mail: )
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Ryu S, Nam HJ, Baek SH, Jhon M, Kim JM, Kim SW. Decline in Hospital Visits by Patients with Schizophrenia Early in the COVID-19 Outbreak in Korea. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2022; 20:185-189. [PMID: 35078961 PMCID: PMC8813312 DOI: 10.9758/cpn.2022.20.1.185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 12/30/2022]
Abstract
Objective This study investigated trends in hospital utilization by patients with schizophrenia during the first wave of the COVID-19 outbreak in Korea. Methods The Prophet algorithm was used to predict the monthly number of patients with schizophrenia in 2020 based on medical insurance data between 2010 and 2019. The projected expectations were compared with the actual number of patients receiving outpatient and inpatient treatment each month in the first half of 2020. We conduct interrupted time series analyses of short-term data to determine the significance of recent changes in the trend of hospital visits by patients with schizophrenia. Results The prediction model showed that the actual number of patients receiving treatment each month during the early COVID-19 outbreak decreased by up to 3.6% compared to the projected expectations. The interrupted time series model also revealed a significant change in hospital utilization compared to the year before the onset of COVID-19 in Korea (F = 8.961, p = 0.010). Conclusion This suggests that many patients with schizophrenia were not receiving adequate treatment during the COVID-19 outbreak. A strategy should be developed to keep treating patients with schizophrenia during the COVID-19 pandemic.
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Affiliation(s)
- Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Jung Nam
- Department of Psychiatry, Seoul Medical Center, Seoul, Korea
| | - Seon-Hwa Baek
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.,Gwangju Mental Health and Welfare Commission, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.,Gwangju Mental Health and Welfare Commission, Gwangju, Korea
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Xia J, Chen S, Li Y, Li H, Gan M, Wu J, Prohaska CC, Bai Y, Gao L, Gu L, Zhang D. Immune Response Is Key to Genetic Mechanisms of SARS-CoV-2 Infection With Psychiatric Disorders Based on Differential Gene Expression Pattern Analysis. Front Immunol 2022; 13:798538. [PMID: 35185890 PMCID: PMC8854505 DOI: 10.3389/fimmu.2022.798538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/13/2022] [Indexed: 12/11/2022] Open
Abstract
Existing evidence demonstrates that coronavirus disease 2019 (COVID-19) leads to psychiatric illness, despite its main clinical manifestations affecting the respiratory system. People with mental disorders are more susceptible to COVID-19 than individuals without coexisting mental health disorders, with significantly higher rates of severe illness and mortality in this population. The incidence of new psychiatric diagnoses after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is also remarkably high. SARS-CoV-2 has been reported to use angiotensin-converting enzyme-2 (ACE2) as a receptor for infecting susceptible cells and is expressed in various tissues, including brain tissue. Thus, there is an urgent need to investigate the mechanism linking psychiatric disorders to COVID-19. Using a data set of peripheral blood cells from patients with COVID-19, we compared this to data sets of whole blood collected from patients with psychiatric disorders and used bioinformatics and systems biology approaches to identify genetic links. We found a large number of overlapping immune-related genes between patients infected with SARS-CoV-2 and differentially expressed genes of bipolar disorder (BD), schizophrenia (SZ), and late-onset major depressive disorder (LOD). Many pathways closely related to inflammatory responses, such as MAPK, PPAR, and TGF-β signaling pathways, were observed by enrichment analysis of common differentially expressed genes (DEGs). We also performed a comprehensive analysis of protein-protein interaction network and gene regulation networks. Chemical-protein interaction networks and drug prediction were used to screen potential pharmacologic therapies. We hope that by elucidating the relationship between the pathogenetic processes and genetic mechanisms of infection with SARS-CoV-2 with psychiatric disorders, it will lead to innovative strategies for future research and treatment of psychiatric disorders linked to COVID-19.
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Affiliation(s)
- Jing Xia
- Department of Pharmacognosy, School of Pharmacy, China Medical University, Shenyang, China
| | - Shuhan Chen
- Department of Pharmacognosy, School of Pharmacy, China Medical University, Shenyang, China
| | - Yaping Li
- Department of Pharmacognosy, School of Pharmacy, China Medical University, Shenyang, China
| | - Hua Li
- Department of Pharmacognosy, School of Pharmacy, China Medical University, Shenyang, China
| | - Minghong Gan
- Department of Pharmacognosy, School of Pharmacy, China Medical University, Shenyang, China
| | - Jiashuo Wu
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Clare Colette Prohaska
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Department of Medicine, Indiana University, Indianapolis, IN, United States
| | - Yang Bai
- Department of Clinical Pharmacology, School of Pharmacy, China Medical University, Shenyang, China
| | - Lu Gao
- Department of Pharmacognosy, School of Pharmacy, China Medical University, Shenyang, China
| | - Li Gu
- Department of Pharmacognosy, School of Pharmacy, China Medical University, Shenyang, China
| | - Dongfang Zhang
- Department of Pharmacognosy, School of Pharmacy, China Medical University, Shenyang, China
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11
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Kiraz S, Demir E. Global Scientific Outputs of Schizophrenia Publications From 1975 to 2020: a Bibliometric Analysis. Psychiatr Q 2021; 92:1725-1744. [PMID: 34341886 DOI: 10.1007/s11126-021-09937-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 12/30/2022]
Abstract
Schizophrenia is a choronic, complex and powerfully inherited mental illness that seriously affects quality of life. The illness is one of the most researched psychiatric disorders from past to present. This study aims to provide a holistic summary of the global scientific outputs through bibliometric analyses and reveal the trend topics. The articles published between the years 1975 and 2020 were downloaded from the Web of Science (WoS) database and analyzed using bibliometric methods. The literature review was conducted using the keyword ''schizophren*'' in the ''Research Area'' category. The relation between the number of publications of the countries and the Gross Domestic Products and Human Development Index values were analyzed using Spearman's correlation coefficient. The number of articles between the years 2021 and 2032 was estimated through linear regression analysis.There were 103,992 publications, 51,117 of which were articles. The number of studies has increased in direct proportion to the development level of the countries. Schizophrenia Research was the most active journal. The most used research topics are cognition, negative symptoms, bipolar disorder, antipsychotics, depression, clozapine, quality of life. Trend keywords used in recent years are 'inflammation', 'biomarker', 'oxidative stress', 'Brain Derived Neurotrophic Factor (BDNF)', 'social cognition', 'metacognition', 'motivation', 'social functioning', 'functioning', 'mental health', 'metabolic syndrome', 'functional connectivity', 'adherence' and 'recovery' indicated new research frontiers in this field. Although schizophrenia has not been fully elucidated, studies are growing like an avalanche. Our study includes the most up-to-date and most comprehensive data ever made in this field.
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Affiliation(s)
- Seda Kiraz
- Department of Psychiatry, Hitit University Erol Olçok Training and Research Hospital, Çorum, Turkey.
| | - Emre Demir
- Department of Biostatistics, Faculty of Medicine, Hitit University, Çorum, Turkey
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12
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Rao WW, Zhang YS, Ng CH, Cui LJ, Li JF, Li L, Ungvari GS, Li KQ, Xiang YT. Prevalence of schizophrenia and its association with socio-demographic correlates in an agricultural region of China. Asian J Psychiatr 2021; 64:102743. [PMID: 34400109 DOI: 10.1016/j.ajp.2021.102743] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/03/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
Little is known about the epidemiology of schizophrenia in the agricultural regions of China. This study examined the 1-month and lifetime prevalence of schizophrenia and their association with socio-demographic factors in Hebei province which is an important agricultural region of China. A multi-stage, stratified, cluster random sampling method was adopted. The diagnosis of schizophrenia was ascertained with the validated Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I/P/C). Altogether, 23,675 subjects were screened, of whom, 20,884 were included for analyses. The weighted 1-month and lifetime prevalence of schizophrenia were 0.5 % [95 % confidence interval (CI): 0.4-0.5 %] and 0.6 % (95 %CI: 0.5-0.7 %), respectively. Multiple logistic regression analyses found that unmarried marital status [P < 0.001, Odd Ratio(OR)=2.670, 95 %CI:1.767-4.036], lower education level (primary school or below: P = 0.042, OR=2.447, 95 % CI: 1.034-5.933; secondary school: P = 0.002, OR = 4.261, 95 % CI:1.692-10.730), unemployment (P = 0.006, OR=1.870, 95 % CI:1.198-2.920), lower income (P < 0.001, OR=4.017, 95 % CI:2.207-7.310) and family history of psychiatric disorders (P < 0.001, OR=16.278, 95 % CI:10.435-25.393) were independently associated with a higher risk of schizophrenia, while age above 60 years (P = 0.004, OR=0.440, 95 % CI:0.253-0.765) was associated with a lower risk of schizophrenia. The prevalence of schizophrenia appeared to be lower in Hebei province compared to other regions of China or other countries. Socioeconomic factors should be further examined to inform the public health surveillance and policies relevant to schizophrenia in the agricultural regions of China.
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Affiliation(s)
- Wen-Wang Rao
- Institute of Mental Health, Hebei Mental Health Centre, Hebei Province, China; Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yun-Shu Zhang
- Institute of Mental Health, Hebei Mental Health Centre, Hebei Province, China; Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Li-Jun Cui
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China
| | - Jian-Feng Li
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China
| | - Lin Li
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China
| | - Gabor S Ungvari
- University of Notre Dame, Australia, Perth, Australia; Division of Psychiatry, School of Medicine, University of Western Australia / Graylands Hospital, Perth, Australia
| | - Ke-Qing Li
- Institute of Mental Health, Hebei Mental Health Centre, Hebei Province, China; Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Science, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
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13
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Kim CB, Ock M, Jung YS, Kim KB, Kim YE, Kim KA, Yoon SJ. Estimation of Years Lived with Disability Using a Prevalence-Based Approach: Application to Major Psychiatric Disease in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9056. [PMID: 34501645 PMCID: PMC8431236 DOI: 10.3390/ijerph18179056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022]
Abstract
To help develop policies concerning the prevention of psychiatric disease in Korea, we reviewed the literature on this topic in different countries and used a prevalence-based approach to estimate the years lived with disability (YLDs) in Korean patients with major psychiatric diseases. We calculated YLDs by extracting data on the number of patients with mild, moderate, and severe cases of schizophrenia, bipolar disorder, and major depressive disorder, as classified by International Statistical Classification of Disease (ICD) codes. YLDs were highest for patients with major depressive disorder (1190.6; 73.9%), schizophrenia (303.3; 18.8%) and bipolar disorder (117.9; 7.3%). Men had higher YLDs for schizophrenia, 2502 (20-24 years); bipolar disorder, 477 (40-44 years); and major depressive disorder, 2034 (75-79 years). Women had higher YLDs for schizophrenia, 484 (45-49 years); bipolar disorder, 214 (≥80 years); and major depressive disorder, 3541 (75-79 years). The prevalence-based approach and severity distribution is useful for estimating long-term psychiatric disease burden and YLDs. However, YLD-estimation studies must compensate for the shortcomings of the ICD-10 by referencing the Diagnostic and Statistical Manual of Mental Disorders 5th edition, as well as updating the disability weight score according to disease severity.
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Affiliation(s)
- Chae-Bong Kim
- Department of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (C.-B.K.); (Y.-S.J.); (K.-B.K.)
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Korea;
| | - Yoon-Sun Jung
- Department of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (C.-B.K.); (Y.-S.J.); (K.-B.K.)
| | - Ki-Beom Kim
- Department of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea; (C.-B.K.); (Y.-S.J.); (K.-B.K.)
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, 32 Geongang-ro, Wonju 26464, Korea;
| | - Keun-A Kim
- School of Military Medicine, The Armed Force Medical Command, 90 Jaun-ro, Daejeon 34059, Korea;
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea
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14
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Jung YS, Kim YE, Go DS, Yoon SJ. The prevalence, incidence, and admission rate of diagnosed schizophrenia spectrum disorders in Korea, 2008-2017: A nationwide population-based study using claims big data analysis. PLoS One 2021; 16:e0256221. [PMID: 34383865 PMCID: PMC8360527 DOI: 10.1371/journal.pone.0256221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
Abstract
This study estimated the prevalence and incidence rate of schizophrenia, schizotypal, and delusional disorders (SSDD) in Korea from 2008 to 2017 and analyzed the hospital admission rate, re-admission rate, and hospitalization period. It used the Korean nationwide National Health Insurance Service claims database. SSDD patients who had at least one visit to Korea's primary, secondary, or tertiary referral hospitals with a diagnosis of SSDD, according to the International Classification of Diseases, 10th Revision (ICD-10), were identified as SSDD cases if coded as F20-F29. Data were analyzed using frequency statistics. Results showed that the 12-month prevalence rate of SSDD increased steadily from 0.40% in 2008 to 0.45% in 2017. Analysis of the three-year cumulative prevalence rate of SSDD showed an increase from 0.51% in 2011 to 0.54% in 2017. In 2017, the five-year cumulative prevalence rate was 0.61%, and the 10-year cumulative prevalence rate was 0.75%. The hospital admission rate among SSDD patients decreased from 2008 (30.04%) to 2017 (28.53%). The incidence of SSDD was 0.05% and no yearly change was observed. The proportion of SSDD inpatients whose first hospital visit resulted in immediate hospitalization was 22.4% in 2017. Epidemiological indicators such as prevalence, incidence, and hospitalization rate play an important role in planning social and financial resource allocation. Therefore, efforts to produce more accurate epidemiological indicators are very important and this study's findings could have a significant social impact.
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Affiliation(s)
- Yoon-Sun Jung
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, Korea
| | - Dun-Sol Go
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
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15
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Ryu S, Nam HJ, Kim JM, Kim SW. Current and Future Trends in Hospital Utilization of Patients With Schizophrenia in Korea: A Time Series Analysis Using National Health Insurance Data. Psychiatry Investig 2021; 18:795-800. [PMID: 34404120 PMCID: PMC8390944 DOI: 10.30773/pi.2021.0071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/23/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE This study aimed to investigate trends in hospital utilization of patients with schizophrenia during the last 10 years in Korea and to predict future trends using time series analysis. METHODS We determined the numbers of patients receiving outpatient or inpatient treatment for schizophrenia per month between 2010 and 2019, using National Health Insurance claims data. Facebook's Prophet was used to fit time series models based on observations for the previous 120 months, and to predict trends over the next 36 months. RESULTS The number of hospitalized patients per month has declined rapidly since 2015, but the monthly number of outpatient visits has steadily increased. Monthly hospital utilization has increased in patients aged ≤29 and ≥50 years, but has declined rapidly since 2014-2015 in patients in their 30s and 40s. The upward trend in overall hospital utilization has slowed considerably in recent years. These trends are expected to continue over the next few years. CONCLUSION This study revealed some notable changes in the hospital utilization patterns of patients with schizophrenia in recent years. There is a need to closely monitor and anticipate potential problems caused by these changing trends.
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Affiliation(s)
- Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee Jung Nam
- Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Mindlink, Gwangju Buk-gu Mental Health Center, Gwangju, Republic of Korea
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16
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Jeong H, Lee SH, Lee SY, Kim J, Kim G, Kwon H, Waterreus A, Yim HW. Validation of the Korean Version of the Psychosis Screener to Identify Patients With Psychosis. Psychiatry Investig 2021; 18:736-742. [PMID: 34333895 PMCID: PMC8390939 DOI: 10.30773/pi.2020.0456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/30/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to validate the Korean version of a short screening tool for psychosis as the first stage in finding undiagnosed psychosis in the community. METHODS The sample contained 126 consecutive psychiatric outpatients in National Medical Center, Seoul, Korea, between July 20 and July 22, 2020. The Psychosis Screener (PS) comprises 7 items covering psychotic symptoms. The presence of each psychotic symptom was determined by a trained mental health professional and coded "yes" or "no." Two psychiatrists reviewed the medical records independently and extracted the ICD-10-based diagnoses. Any differences between the two clinicians were resolved by consensus, and the agreed diagnosis was used as a gold standard in the study. RESULTS Among 126 psychiatric outpatients who were enrolled in a consecutive manner during the study period, the proportion of psychosis was 15.1%. The PS showed 78.9% sensitivity and 72.0% specificity when the optimal cut-off was 2, indicating that a score of 2 or more on the screener identified a likely case of psychosis. The area under the curve for the PS was 0.78 (95% CI: 0.67-0.87). CONCLUSION The Korean version of the PS has an ability to discriminate between those who meet the diagnostic criteria for psychosis and those who do not in a high-prevalence group.
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Affiliation(s)
- Hyunsuk Jeong
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Republic of Korea
| | - Seung-Yup Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jangrae Kim
- Department of Psychiatry, National Medical Center, Seoul, Republic of Korea
| | - Gyeongmin Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hanseul Kwon
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Mohan M, Perry BI, Saravanan P, Singh SP. COVID-19 in People With Schizophrenia: Potential Mechanisms Linking Schizophrenia to Poor Prognosis. Front Psychiatry 2021; 12:666067. [PMID: 34079487 PMCID: PMC8166317 DOI: 10.3389/fpsyt.2021.666067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/15/2021] [Indexed: 01/08/2023] Open
Abstract
As the global burden of mortality from COVID-19 continues to rise, an understanding of who is most at risk of adverse outcomes is of paramount importance. Pre-existing cardiometabolic, renal and respiratory diseases as well as old age are well-established risk factors associated with disease severity and mortality among patients with COVID-19. However, mounting evidence also indicates an increased susceptibility to, and risk of adverse outcomes from COVID-19 in people with schizophrenia, independent of age and comorbidity. Therefore, elucidating the underlying pathophysiological mechanisms which may increase the risk of poor outcomes in people with schizophrenia is of crucial importance. Here, we provide a narrative on the current understanding of COVID-19 in patients with schizophrenia and propose potential mechanisms which may link schizophrenia with an increased susceptibility to, and greater risk of adverse outcomes from COVID-19. Given the existing knowledge gaps, robust clinical and biological studies are required to further our understanding of some of these underlying mechanisms, so that effective prevention and treatment strategies for COVID-19 in patients with schizophrenia can be developed.
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Affiliation(s)
- Mohapradeep Mohan
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Benjamin Ian Perry
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Ponnusamy Saravanan
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Academic Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, United Kingdom
| | - Swaran Preet Singh
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Coventry and Warwickshire Partnership Trust, Coventry, United Kingdom
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18
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Cha HY, Yang SJ. Anti-Inflammatory Diets and Schizophrenia. Clin Nutr Res 2020; 9:241-257. [PMID: 33204665 PMCID: PMC7644368 DOI: 10.7762/cnr.2020.9.4.241] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
Schizophrenia is a mental illness characterized by symptoms such as hallucinations, delusions, disorganized speech, disorganized or catatonic behavior, and negative symptoms (emotional flatness, apathy, and lack of speech). It causes social and economic burdens to patients and their family. Although etiology of schizophrenia is still uncertain, dopamine dysregulation is traditionally considered as a main etiological factor of schizophrenia, which has been utilized to develop drugs for treating schizophrenia. Recently, inflammation has presented being a risk factor for schizophrenia in that neuroinflammation contributes to the pathophysiology of schizophrenia and the exacerbation of symptom severity. Various factors including diet can regulate inflammatory state. Specific foods or dietary patterns have anti- or pro-inflammatory potentials. Increased levels of pro-inflammatory cytokines and microglia activation have been reported in schizophrenia populations and were related to the pathogenesis of schizophrenia. Omega-3 fatty acids were often recommended to schizophrenia patients because of their anti-inflammatory activities. In this review, we investigate the inflammation-related pathogenesis of schizophrenia and summarize potential nutritional approaches to inhibit the manifestation of symptoms and to alleviate symptom severity using anti-inflammatory nutrients or functional components.
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Affiliation(s)
- Hee Yun Cha
- Department of Food and Nutrition, Seoul Women's University, Seoul 01797, Korea
| | - Soo Jin Yang
- Department of Food and Nutrition, Seoul Women's University, Seoul 01797, Korea
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Kwon HS, Yang HR, Yun K, Baek JS, Kim YU, Park S, Choi H. The Effect of Cognitive Training in a Day Care Center in Patients with Early Alzheimer's Disease Dementia: A Retrospective Study. Psychiatry Investig 2020; 17:829-834. [PMID: 32777919 PMCID: PMC7449833 DOI: 10.30773/pi.2020.0170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/14/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the effect of cognitive training programs on the progression of dementia in patients with early stage Alzheimer's disease dementia (ADD) at the day care center. METHODS From January 2015 to December 2018, a total of 119 patients with early ADD were evaluated. All subjects were classified into two groups according to participate in cognitive training program in addition to usual standard clinical care. Changes in scores for minimental status examination-dementia screening (MMSE-DS) and clinical dementia rating-sum of boxes (CDR-SOB) during the 12 months were compared between two groups. Multivariable logistic regression analyses were performed. RESULTS As compared to case-subjects (n=43), the MMSE-DS and CDR-SOB scores were significantly worse at 12 months in the control-subjects (n=76). A statistically significant difference between the two groups was observed due to changes in MMSE-DS (p=0.012) and CDR-SOB (p<0.001) scores. Multivariable logistic regression analysis showed that the cognitive training program (odds ratio and 95% confidence interval: 0.225, 0.070-0.725) was independently associated with less progression of ADD. CONCLUSION The cognitive training program was associated with benefits in maintaining cognitive function for patients with earlystage ADD that were receiving medical treatment.
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Affiliation(s)
- Hyuk Sung Kwon
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Ha-Rin Yang
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Kyungtaek Yun
- Namyangju City Public Health Center, Namyangju, Republic of Korea
| | - Jong Sook Baek
- Namyangju City Public Health Center, Namyangju, Republic of Korea
| | - Young Un Kim
- Namyangju City Public Health Center, Namyangju, Republic of Korea
| | - Seongho Park
- Department of Neurology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Hojin Choi
- Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
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