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Chang CC, Hsieh KY, Hsu ST, Wang YY, Chou FHC, Huang JJ. Understanding the mental health impacts of biological disasters: Lessons from Taiwan's experience with COVID-19. J Formos Med Assoc 2024:S0929-6646(24)00176-1. [PMID: 38519322 DOI: 10.1016/j.jfma.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/18/2024] [Accepted: 03/17/2024] [Indexed: 03/24/2024] Open
Abstract
Biological disasters pose a growing challenge in the 21st century, significantly impacting global society. Taiwan has experienced such disasters, resulting in long-term consequences like loss of life, trauma, economic decline, and societal disruptions. Post-disaster, mental health issues such as fear, anxiety, depression, post-traumatic stress disorder (PTSD), and stress surge, accompanied by increased suicide rates. The Coronavirus disease 2019 (COVID-19) (also called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) pandemic, recognized as a biological disaster, triggered lockdowns and quarantines in Taiwan, causing lifestyle changes, economic recession, and so on. These shifts may elevate uncertainty about the future, intensifying mental stress and leading to a rise in various mental illnesses. This article reviews mental health studies conducted in Taiwan during the pandemic, emphasizing the need to integrate this research for future preparedness and interventions regarding the mental health impacts of biological disasters, including COVID-19. Further research is essential to explore long-term effects, interventions, and generalizability.
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Affiliation(s)
- Chih-Chieh Chang
- Department of Addiction Prevention, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Kuan-Ying Hsieh
- Department of Child and Adolescent Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Taiwan
| | - Su-Ting Hsu
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Yu-Yuan Wang
- Department of Neuropsychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Frank Huang-Chih Chou
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
| | - Joh-Jong Huang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Li DJ, Huang JJ, Hsu ST, Wu HC, Hsieh KY, Lin GG, Wu PJ, Liu CL, Chou FHC. The Impact of Psychological Burdens and Vaccine Worries on Confidence and Adherence to Governmental Policies Against COVID-19 Among Patients with Substance Use Disorder: A Cross-Sectional Study in Taiwan. Neuropsychiatr Dis Treat 2024; 20:597-606. [PMID: 38496324 PMCID: PMC10944137 DOI: 10.2147/ndt.s453238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/28/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic has had an impact on patients with substance use disorder (SUD). We aimed to investigate factors associated with confidence and adherence to governmental policies against COVID-19 (social desirability) among patients with SUD. Methods This cross-sectional study was conducted during 2020 to 2021. Patients with SUD and healthy controls were recruited. The severity of sleep disturbance, social desirability, drug dependence, vaccine worries, other psychological burdens and demographic variables were collected through self-administrated questionnaires. Differences between the SUD and control groups were estimated. Hierarchical regression analysis was used to identify significant relationships between social desirability and other factors. Results In total, 58 of patients with SUD and 47 healthy controls were recruited. The patients with SUD had a lower level of social desirability and more severe sleep disturbance than the control group. Older age, more severe sleep disturbance, lower level of drug dependence, and lower level of vaccine worries were significantly associated with a higher level of social desirability among the patients with SUD. Conclusion Our results show the importance of timely interventions for drug dependence and to address vaccine worries in patients with SUD.
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Affiliation(s)
- Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Joh-Jong Huang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Su-Ting Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hui-Ching Wu
- Department of Social Work, Taiwan Social Resilience Center, National Taiwan University, Taipei, Taiwan
| | - Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Guei-Ging Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Pei-Jhen Wu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chin-Lien Liu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
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Chen KW, Lee SC, Chou FHC, Chiang HY, Hsueh IP, Chen PH, Wang SP, Ju YJ, Hsieh CL. Development of a Rasch-calibrated emotion recognition video test for patients with schizophrenia. Arch Clin Neuropsychol 2023:acad098. [PMID: 38163920 DOI: 10.1093/arclin/acad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/31/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Patients with schizophrenia tend to have deficits in emotion recognition (ER) that affect their social function. However, the commonly-used ER measures appear incomprehensive, unreliable and invalid, making it difficult to comprehensively evaluate ER. The purposes of this study were to develop the Computerized Emotion Recognition Video Test (CERVT) evaluating ER ability in patients with schizophrenia. This study was divided into two phases. First, we selected candidate CERVT items/videos of 8 basic emotion domains from a published database. Second, we validated the selected CERVT items using Rasch analysis. Finally, the 269 patients and 177 healthy adults were recruited to ensure the participants had diverse abilities. After the removal of 21 misfit (infit or outfit mean square > 1.4) items and adjustment of the item difficulties of the 26 items with severe differential item functioning, the remaining 217 items were finalized as the CERVT items. All the CERVT items showed good model fits with small eigenvalues (≤ 2) based on the residual-based principal components analysis for each domain, supporting the unidimensionality of these items. The 8 domains of the CERVT had good to excellent reliabilities (average Rasch reliabilities = 0.84-0.93). The CERVT contains items of the 8 basic emotions with individualized scores. Moreover, the CERVT showed acceptable reliability and validity, and the scores were not affected by examinees' gender. Thus, the CERVT has the potential to provide a comprehensive, reliable, valid, and gender-unbiased assessment of ER for patients with schizophrenia.
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Affiliation(s)
- Kuan-Wei Chen
- Department of Occupational Therapy, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Shih-Chieh Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Frank Huang-Chih Chou
- Superintendent Office, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hsin-Yu Chiang
- Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - I-Ping Hsueh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Hsi Chen
- Department of Educational Psychology and Counseling, Institute for Research Excellent in Learning Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - San-Ping Wang
- Department of Occupational Therapy, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Yu-Jeng Ju
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
- Department of Occupational Therapy, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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Chang CC, Hsu ST, Wang YY, Chou FHC. The impact of the COVID-19 pandemic on mental health in Taiwan. Asian J Psychiatr 2023; 88:103745. [PMID: 37625327 DOI: 10.1016/j.ajp.2023.103745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Chih-Chieh Chang
- Department of Addiction Prevention, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Su-Ting Hsu
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Yu-Yuan Wang
- Department of Neuropsychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Frank Huang-Chih Chou
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
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Lin CH, Chan HY, Chen CC, Chou FHC. Prescribing changes for bipolar patients discharged from two public psychiatric hospitals in Taiwan, 2006-2019. J Affect Disord 2022; 318:386-392. [PMID: 36103936 DOI: 10.1016/j.jad.2022.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/30/2022] [Accepted: 09/09/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND For bipolar disorder, a severe, recurring mental disorder, pharmacotherapy is a cornerstone of effective treatment. The purpose of this study was to investigate prescribing changes among patients with bipolar disorder discharged from two public psychiatric hospitals in Taiwan over a 14-year period. METHODS Patients with bipolar disorder discharged from the two study hospitals between 2006 and 2019 (n = 9071) were included in the analysis. Prescribed drugs for the treatment of bipolar disorder, including mood stabilizers (i.e., lithium, valproate, carbamazepine, and lamotrigine), any antipsychotics (i.e., second- and first-generation antipsychotics; SGAs & FGAs), and any antidepressants, were examined. Complex polypharmacy was defined as the use of 3 or more agents among the prescribed drugs. Temporal trends of each prescribing pattern were analyzed using the Cochran-Armitage Trend test. RESULTS The prescription rates of SGAs, any antidepressants, antidepressant monotherapy, antidepressants without mood stabilizers, and complex polypharmacy significantly increased over time, whereas the prescription rates of any mood stabilizers, lithium, carbamazepine, FGAs, and antidepressants plus mood stabilizers significantly decreased. LIMITATIONS Treatment allocation is not randomized in a retrospective study. The diagnoses of bipolar disorder were based on clinical judgments. This was a hospital-based study. CONCLUSIONS Substantial prescribing changes took place during the study period. The decreased use of lithium and the increased use of antidepressants were not in accordance with the evidence-based treatment and recommendations in treatment guidelines. Therefore, long-term outcomes of prescribing changes should be explored in the future.
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Affiliation(s)
- Ching-Hua Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Yu Chan
- Department of General Psychiatry, Taoyuan Psychiatric Center, Taoyuan, Taiwan; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Chung Chen
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
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Li DJ, Wu HC, Chou FHC, Hsu ST, Huang JJ, Hsieh KY, Lin GG, Wu PJ. The social and mental impact on healthcare workers: A comparative and cross-sectional study during two waves of the COVID-19 pandemic in Taiwan. Medicine (Baltimore) 2022; 101:e31316. [PMID: 36281087 PMCID: PMC9592143 DOI: 10.1097/md.0000000000031316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused a heavily burden on healthcare workers (HCWs) worldwide. The aim of this study was to compare differences in psychological and social impact between two waves of the pandemic among first- and second-line HCWs in Taiwan. The current study derived data from two cross-sectional surveys conducted in 2020 and 2021. Levels of depression, sleep disturbance, psychological distress, social impact, and demographic variables were collected through self-reported questionnaires. The independent t test was used to compare differences in scores between the first and second wave of the pandemic. Differences between first- and second-line HCWs were also analyzed. A total of 711 HCWs in the first wave and 560 HCWs in the second wave were recruited. For the first- and second-line HCWs, the social impact during the second wave was higher than during the first wave, and they expressed a higher intention to maintain social distancing and were more aware of the pandemic overseas in the second wave. The first-line HCWs had a trend of worse sleep quality during the second wave. In addition, sleep quality was worse in the first-line HCWs than in the second-line HCWs during both waves. The second-line HCWs expressed a greater desire to seek COVID-19-related information than the first-line HCWs during the first wave, and more intended to maintain social distancing during the second wave. Our results show the importance of evaluating the social and mental health burden of HCWs, and especially first-line workers.
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Affiliation(s)
- Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Hui-Ching Wu
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | | | - Su-Ting Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Joh-Jong Huang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Medical Humanities and Education, Kaohsiung Medical University, Kaohsiung City, Taiwan
- * Correspondences: Joh-Jong Huang, Department of Health, Kaohsiung City Government, No. 132-1, Kaisyuan 2nd Rd., Lingya District, Kaohsiung 802212, Taiwan (e-mail: )
| | - Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Guei-Ging Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Pei-Jhen Wu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
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Hsieh KY, Li DJ, Chou FHC, Hsu ST, Wu HC, Chou LS, Wu PJ, Lin GG, Chen WJ, Liu CL, Huang JJ. Relationship of Societal Adaptation with Vaccine Worries among Healthcare Workers during the COVID-19 Pandemic: The Mediating Effects of Posttraumatic Stress Disorder. IJERPH 2022; 19:ijerph19159498. [PMID: 35954849 PMCID: PMC9368662 DOI: 10.3390/ijerph19159498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 12/12/2022]
Abstract
Vaccine hesitancy has become a major public health problem among healthcare workers (HCWs) in this coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to examine the relationship between societal adaptation and vaccine worries and the mediating effects of posttraumatic stress disorder (PTSD) indicators in HCWs. A total of 435 HCWs (327 women and 108 men) were recruited. Their levels of societal adaptation were evaluated using the Societal Influences Survey Questionnaire (SISQ). Their severity and frequency of PTSD symptoms were examined using the Disaster-Related Psychological Screening Test (DRPST). The severity of vaccine worries was assessed using the Vaccination Attitudes Examination (VAX) Scale. The relationships among societal adaptation, PTSD, and vaccine worries were examined using structural equation modeling. The severity of societal adaptation was positively associated with both the severity of PTSD and the severity of vaccine worries. In addition, the severity of PTSD indicators was positively associated with the severity of vaccine worries. These results demonstrated that the severity of societal adaptation was related to the severity of vaccine worries, either directly or indirectly. The indirect relationship was mediated by the severity of PTSD. Societal adaptation and PTSD should be taken into consideration by the community of professionals working on vaccine hesitancy. Early detection and intervention of PTSD should be the objectives for programs aiming to lower vaccine hesitancy among HCWs.
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Affiliation(s)
- Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (K.-Y.H.); (D.-J.L.); (S.-T.H.); (L.-S.C.); (P.-J.W.); (G.-G.L.); (W.-J.C.); (C.-L.L.)
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (K.-Y.H.); (D.-J.L.); (S.-T.H.); (L.-S.C.); (P.-J.W.); (G.-G.L.); (W.-J.C.); (C.-L.L.)
- Department of Nursing, Meiho University, Pingtung 91200, Taiwan
| | - Frank Huang-Chih Chou
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (K.-Y.H.); (D.-J.L.); (S.-T.H.); (L.-S.C.); (P.-J.W.); (G.-G.L.); (W.-J.C.); (C.-L.L.)
- Correspondence: (F.H.-C.C.); (J.-J.H.)
| | - Su-Ting Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (K.-Y.H.); (D.-J.L.); (S.-T.H.); (L.-S.C.); (P.-J.W.); (G.-G.L.); (W.-J.C.); (C.-L.L.)
- Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung 80201, Taiwan
| | - Hui-Ching Wu
- Department of Social Work, National Taiwan University, Taipei 10617, Taiwan;
| | - Li-Shiu Chou
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (K.-Y.H.); (D.-J.L.); (S.-T.H.); (L.-S.C.); (P.-J.W.); (G.-G.L.); (W.-J.C.); (C.-L.L.)
| | - Pei-Jhen Wu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (K.-Y.H.); (D.-J.L.); (S.-T.H.); (L.-S.C.); (P.-J.W.); (G.-G.L.); (W.-J.C.); (C.-L.L.)
| | - Guei-Ging Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (K.-Y.H.); (D.-J.L.); (S.-T.H.); (L.-S.C.); (P.-J.W.); (G.-G.L.); (W.-J.C.); (C.-L.L.)
| | - Wei-Jen Chen
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (K.-Y.H.); (D.-J.L.); (S.-T.H.); (L.-S.C.); (P.-J.W.); (G.-G.L.); (W.-J.C.); (C.-L.L.)
- Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung 80201, Taiwan
| | - Chin-Lien Liu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (K.-Y.H.); (D.-J.L.); (S.-T.H.); (L.-S.C.); (P.-J.W.); (G.-G.L.); (W.-J.C.); (C.-L.L.)
| | - Joh-Jong Huang
- Department of Medical Humanities and Education, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Correspondence: (F.H.-C.C.); (J.-J.H.)
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Kao WT, Hsu ST, Chou FHC, Chou LS, Hsieh KY, Li DJ, Lin GG, Wu PJ, Chen WJ, Huang JJ. The Societal Influences and Quality of Life Among Healthcare Team Members During the COVID-19 Pandemic. Front Psychiatry 2021; 12:706443. [PMID: 34707517 PMCID: PMC8542799 DOI: 10.3389/fpsyt.2021.706443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/23/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The coronavirus infection disease 2019 (COVID-19) pandemic is likely to put healthcare professionals across the world in an unprecedented situation. Methods: A total of 683 healthcare workers were recruited in this study. Short form-12 items (SF-12), Societal Influences Survey Questionnaire (SISQ), and Disaster-Related Psychological Screening Test (DRPST) were used to survey participants. Multiple linear regression and structural equation model (SEM) were used to explore the possible factors to the societal influences and quality of life. Results: After multiple linear regression analysis, female, older, more education years, married, regular intake, and posttraumatic stress disorder (PTSD) frequency had positive association with SISQ. To physical component summary (PCS) of SF-12, chronic illness, sleep score, PTSD frequency, and social distance had negative association, and exercise habits had positive association. A mental component summary (MCS) value of SF-12, age, participate in social activities, and social information had positive association, and PTSD frequency, sleep score, social anxiety, and depression had negative association. Under SEM analysis, PTSD had positive influence on SISQ. Sleep score and MCS value had negative influences on SISQ. PTSD severity, older age, sleep score, smoking, and nursing staff had negative influences on PCS value. Young age, PTSD frequency, sleep score, and depression had negative influences on MCS value. Conclusion: Healthcare team members with severe PTSD symptoms suffered more societal influences. Relative to PTSD severity, PTSD frequency was more important to the quality of life. Members of older age who frequently participate in clubs, volunteers, or charity activities had better mental life quality.
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Affiliation(s)
- Wei-Tsung Kao
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Department of Sports, Health and Leisure and Graduate Institute of Sports, Health and Leisure, Cheng Shiu University, Kaohsiung, Taiwan
| | - Su-Ting Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | | | - Li-Shiu Chou
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- College of Medicine, Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Guei-Ging Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Pay-Jen Wu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Wei-Jen Chen
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Joh-Jong Huang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Health, Kaohsiung City Government, Kaohsiung, Taiwan
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Lo A, Hsieh KY, Lu WC, Shieh I, Chou FHC, Shieh V. Development and validation of the Lo's Healthy and Happy Lifestyle Scale (LHHLS): The resilience in general population facing COVID-19 in Taiwan. Int J Soc Psychiatry 2021; 67:532-539. [PMID: 33012222 DOI: 10.1177/0020764020960771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND This article explores the effectiveness of development of the Lo's Healthy and Happy Lifestyle Scale (LHHLS), which is an evaluative tool that monitors the resilience of the Taiwan population in times of such COVID-19 epidemic. Also, to verify factors of resilience, namely the reliability and validity of self-efficacy and positive thinking, and establishment of a prospective norm analysis. METHOD The study mainly applied Explorative Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) to develop LHHLS and establish the reliability and validity of the tool's structure, verify norm analysis and the reliability of data from each question using Cronbach's alpha. RESULTS According to statistics, LHHLS has a good factorial effectiveness and relatively high reliability, with factor reliability analyses where Cronbach's alpha lies between 0.83 to 0.94. The 14 questions in the LHHLS has a total variance of 67.04%. The tool includes two sub-assessments that are theoretically and statistically appropriate: mental health/self-efficacy and positive thinking. CONCLUSION The tool LHHLS can be applied to populations affected by COVID-19. With participants' self-awareness of mental health state and state of happy living, this tool is valid and reliable in assessing and evaluating the resilience of such participants against times of COVID-19. This study can become future use for epidemic prevention communities in monitoring residents' healthy living and changes in their resilience. Also, can become a reference standard for interventions to reduce the impacts populations' happy and healthy living, in times of biological disasters.
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Affiliation(s)
- Angela Lo
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung
| | - Kuan-Ying Hsieh
- Department of Child and Adolescent Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung
| | - Wan-Chun Lu
- Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung
| | - Ierna Shieh
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei
| | | | - Vincent Shieh
- Graduate Institute of Gender Education, National Kaohsiung Normal University, Kaohsiung
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Abstract
BACKGROUND The outbreak of coronavirus disease 2019 (COVID-19), like severe acute respiratory syndrome (SARS), provokes fear, anxiety and depression in the public, which further affects mental health issues. Taiwan has used their experience of the SARS epidemic for the management of foreseeable problems in COVID-19 endemic. AIM/OBJECTIVE This review summarizes issues concerning mental health problems related to infectious diseases from current literatures. RESULTS In suspected cases under quarantine, confirmed cases in isolation and their families, health care professionals, and the general population and related effective strategies to reduce these mental health issues, such as helping to identify stressors and normalizing their impact at all levels of response as well as public information and communication messages by electronic devices. The importance of community resilience was also addressed. Psychological first aid, psychological debriefing, mental health intervention and psychoeducation were also discussed. Issues concerning cultures and religions are also emphasized in the management plans. CONCLUSION Biological disaster like SARS and COVID-19 not only has strong impact on mental health in those being infected and their family, friends, and coworkers, but also affect wellbeing in general public. There are evidenced that clear and timely psychoeducation, psychological first aid and psychological debriefing could amileorate negative impact of disaster, thus might also be helpful amid COVID-19 pandemic.
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Affiliation(s)
- Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City
| | - Wei-Tsung Kao
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Department of Sports, Health and Leisure and Graduate Institute of Sports, Health and Leisure, Cheng Shiu University, Kaohsiung City
| | - Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City
| | - Wan-Chun Lu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City
| | - Kuan-Yi Tsai
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City
| | - Wei-Jen Chen
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung City
| | - Li-Shiu Chou
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City
| | - Joh-Jong Huang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung City
| | - Su-Ting Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City.,Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung City
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11
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Affiliation(s)
- Su-Ying Chung
- Department of Clinical Psychology, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Graduate Institute of Adult Education, National Kaohsiung Normal University, Taiwan
| | - Frank Huang-Chih Chou
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
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Hsu ST, Chou LS, Chou FHC, Hsieh KY, Chen CL, Lu WC, Kao WT, Li DJ, Huang JJ, Chen WJ, Tsai KY. Challenge and strategies of infection control in psychiatric hospitals during biological disasters-From SARS to COVID-19 in Taiwan. Asian J Psychiatr 2020; 54:102270. [PMID: 32619835 PMCID: PMC7320715 DOI: 10.1016/j.ajp.2020.102270] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 10/26/2022]
Abstract
Psychiatric hospitals play an important role in supporting patients with mental illness to relieve symptoms and improve functioning in a physically and psychologically safe environment. However, these hospitals are also vulnerable to emerging infectious diseases. In early 2020, a psychiatric hospital and a psychiatric unit were reported to have nosocomial coronavirus disease 2019 (COVID-19) infection. A large number of patients and staff were severely impacted. This type of nosocomial infection threatens patient safety and quality of care. By learning from previous experiences of severe acute respiratory syndrome (SARS) and previous studies, psychiatric hospitals can provide safeguards to prevent nosocomial infection among patients and staff during an epidemic or biological disaster. These strategies include a series of actions such as following national guidelines for infection control, reserving adequate support for disinfection equipment, providing relevant and sufficient pro-service and in-service education and training, establishing regular surveillance of hand hygiene habits, proper communication and health education, and providing opportunities for vaccination if possible. Based on the harm reduction concept, staff division of office breaks and ward classification and shunting are recommended and should be further implemented.
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Affiliation(s)
- Su-Ting Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Li-Shiu Chou
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | | | - Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Lan Chen
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Wan-Chun Lu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Wei-Tsung Kao
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Sports, Health and Leisure and Graduate Institute of Sports, Health and Leisure, Cheng Shiu University, Kaohsiung, Taiwan
| | - Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Joh-Jong Huang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Wei-Jen Chen
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Graduate Institute of Counseling Psychology and Rehabilitation Counseling, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Kuan-Yi Tsai
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
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13
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Lo A, Huang JJ, Chen CC, Chou FHC, Shieh V. From biological safety to social safety: How Taiwan's community centered prevention program controlled the COVID-19 outbreak. J Glob Health 2020; 10:020303. [PMID: 33110507 PMCID: PMC7533428 DOI: 10.7189/jogh.10.020303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Angela Lo
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung Taiwan
| | - Joh-Jong Huang
- Department of Family Medicine, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung Taiwan
| | - Cheng-Chung Chen
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung Taiwan
| | | | - Vincent Shieh
- Graduate Institute of Gender Education, National Kaohsiung Normal University, Kaohsiung Taiwan
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14
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Wang HY, Huang JJ, Su SF, Hsu SH, Chou LS, Chou FHC. From folk therapy to evidence-based psychiatry practice: The benefit of evidence-based psychiatry in treatment-naive psychotic patients. Int J Soc Psychiatry 2020; 66:593-599. [PMID: 32466700 DOI: 10.1177/0020764020924698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND As Taiwan's Mental Health Act (MHA) clearly states that the human rights and legal rights of psychotic patients should be respected and guaranteed; however, a temple asylum violates the law in the 21st century. Hundreds of patients were constrained in the asylum for years without consent. Because of outbreak of infectious diseases, patients were evacuated from the asylum by the official intervention. AIMS To evaluate the outcomes of these patients from folk therapy to conventional treatment. METHOD The study recruited the drug-naive psychotic patients constrained in an asylum for decades. Before and after the formal treatment, 253 patients were diagnosed with schizophrenia and other psychotic disorders with assessment of using the Mini Positive and Negative Syndrome Scale (Mini-PANSS) and Comprehensive Occupational Therapy Evaluation (COTE) scale. In addition, family function, self-care ability and nutritional status were also evaluated. RESULTS The initial data show the improvement in psychotic symptoms and occupational function in these patients. Furthermore, the ratio of patients who were classified as being at risk for malnutrition was decreased by 21.7% after treatment. There was no statistically significant difference in self-care ability before and after treatment. CONCLUSION The psychotic symptoms and occupational function of these patients were improved after the formal treatment compared to the folk therapy. The care model for the psychotic patients in the temple asylum should be more thoroughly discussed in consideration of the medical ethics principles.
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Affiliation(s)
- Hung-Yu Wang
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City
| | - Joh-Jong Huang
- Department of Family Medicine, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung City.,Department of Health, Kaohsiung City Government, Kaohsiung City.,Bureau of Social Affairs, Tainan City Government, Kaohsiung City
| | - Shu-Fang Su
- Department of Health, Kaohsiung City Government, Kaohsiung City
| | - Sheng-Hao Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City
| | - Li-Shiu Chou
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City
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15
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Li DJ, Kao WT, Shieh V, Chou FHC, Lo HWA. Development and Implementation of Societal Influences Survey Questionnaire (SISQ) for Peoples during COVID-19 Pandemic: A Validity and Reliability Analysis. Int J Environ Res Public Health 2020; 17:ijerph17176246. [PMID: 32867323 PMCID: PMC7503324 DOI: 10.3390/ijerph17176246] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 12/23/2022]
Abstract
The emergence of Coronavirus disease 2019 (COVID-19) had rapidly spread since FEB/MAR 2020. Policy to prevent transmission of COVDI-19 resulted in multi-dimensional impact on social interaction. We aimed to develop a beneficial survey tool with favorable quality and availability, the Societal Influences Survey Questionnaire (SISQ), to evaluate social influences on people during this pandemic. The SISQ was developed with 15 items and 4-point Likert scales consisting of five factors. These include social distance, social anxiety, social desirability, social information, and social adaptation. Construct validity and reliability were performed to verify the SISQ. A total of 1912 Taiwanese were recruited. The results demonstrated that the SISQ has acceptable reliability, with Cronbach’s alphas ranging between 0.57 and 0.76. The SISQ accounted for 58.86% and satisfied the requirement of Kaiser–Mayer–Olkinvalues (0.78) and significant Bartlett’s Test of sphericity. Moreover, the confirmatory factor analysis fit indices also indicated the adequacy of the model. As for multiple comparison, females scored higher than males in factor of social distance. Unemployed participants and those without partners scored higher in several domains of factors. The survey method and survey instrument prove reliable and valuable, also providing different categories of assessment results regarding social influences and their impacts. Further studies are warranted to extend the applicability of SISQ.
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Affiliation(s)
- Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80708, Taiwan; (W.-T.K.); (F.H.-C.C.)
- Department of Nursing, Meiho University, Pingtung 91200, Taiwan
- Correspondence: (D.-J.L.); (H.-W.A.L.)
| | - Wei-Tsung Kao
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80708, Taiwan; (W.-T.K.); (F.H.-C.C.)
| | - Vincent Shieh
- Graduate Institute of Gender Education, National Kaohsiung Normal University, Kaohsiung 80201, Taiwan;
| | - Frank Huang-Chih Chou
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 80708, Taiwan; (W.-T.K.); (F.H.-C.C.)
| | - Huei-Wen Angela Lo
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (D.-J.L.); (H.-W.A.L.)
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16
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Wu LC, Lai CY, Huang CJ, Chou FHC, Yu ET, Yu CY. Psychological distress and diabetes self-management in patients with type 2 diabetes and comorbid serious mental illness. Arch Psychiatr Nurs 2020; 34:218-223. [PMID: 32828352 DOI: 10.1016/j.apnu.2020.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 03/18/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Lin-Chuan Wu
- Department of Nursing, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, No. 130, Kaisyuan 2nd Rd., Lingya Dist., Kaohsiung City 802, Taiwan.
| | - Chien Yu Lai
- School of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Ming-Te Road, Peitou District, Taipei City 807, Taipei, Taiwan.
| | - Chun-Jen Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, No. 100, Ziyou 1st Rd., Sanmin Dist, Kaohsiung City 807, Taiwan; Department of Psychiatry, Faculty of medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 100, Shih-Chuan 1st Road, San Ming District, Kaohsiung City 807, Taiwan.
| | - Frank Huang-Chih Chou
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, No. 130, Kaisyuan 2nd Rd., Lingya Dist., Kaohsiung City 802, Taiwan
| | - Erica TengYuan Yu
- Department of Undergraduate Studies, Jane and Robert Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Avenue, Houston, TX 77030-3901, USA.
| | - Ching-Yun Yu
- School of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanming District, Kaohsiung City 807, Taiwan.
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Hsieh KY, Tsai KY, Chou FHC, Chou YM. Reduced risk of stroke among psychiatric patients receiving ECT: A population-based cohort study in Taiwan. Psychiatry Res 2019; 276:107-111. [PMID: 31048180 DOI: 10.1016/j.psychres.2019.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/20/2019] [Accepted: 04/22/2019] [Indexed: 10/27/2022]
Abstract
Electroconvulsive therapy (ECT) as well as the diseases it treats have been associated with stroke and cognitive impairment. We investigate the relationship between ECT and the subsequent development of stroke in patients with different severe mental illnesses. Tapping Taiwan's National Health Insurance Research Database, we identified patients diagnosed with severe mental illnesses who had received ECT between Jan 1, 2002 and Dec 31, 2007. A comparison cohort was constructed of patients who were matched by age, gender, and diagnosis but did not receive ECT. The patients were then followed up for occurrence of subsequent new-onset stroke. We identified 6264 patients had been diagnosed with mental illness and had received ECT. They were matched with 18,664 mentally ill patients who had not. The study cohort had a lower incidence of subsequent stroke than the matched controls, after controlling for age, diabetes, hypertension, coronary heart disease and enrollee sociodemographic category, risk factors for stroke in both study and control cohorts. ECT is associated with reduced risk of subsequent stroke in patients with severe mental illnesses in Taiwan. Therefore, clinicians should not let risk of stroke stop them from suggesting ECT to physically healthy patients who might benefit from this therapy.
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Affiliation(s)
- Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuan-Yi Tsai
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | | | - Yu-Mei Chou
- Department of Anesthesiology, Kaohsiung Veterans General Hospital, Taiwan; Department of Nursing, Meiho University, Ping-Tong County, Taiwan.
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Shieh V, Huang JJ, Wu TEG, Chiu JY, Chen YC, Lin G, Su CY, Chou FHC. Rate of psychiatric disorders and associations with quality of life among community members following the Kaohsiung gas explosion: an 18-month cross-sectional follow-up study. Health Qual Life Outcomes 2019; 17:7. [PMID: 30635003 PMCID: PMC6330396 DOI: 10.1186/s12955-018-1076-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 12/20/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To conduct a follow-up on the rate and related risk factors of probable disaster-related psychiatric disorders such as depressive disorder (major depressive episode, MDE), stress disorders, post-traumatic (posttraumatic stress disorder, PTSD), and the quality of life of the survivors of a fossil gas explosion in Taiwan 18 months after the event. METHODS A community-based survey of residents of a community that experienced a petrochemical gas explosion with cross-sectional assessments was conducted 18 months after the event. Two screening tools, including the Disaster-Related Psychological Screening Test (DRPST) and Short Form 12v2 (SF-12v2), were used to survey a representative sample of 388 participants. RESULTS The average age of 388 participants is 43.27 ± 15.98 years (males: 203, average age: 41.44 ± 15.74 years; females: 185; average age: 45.27 ± 16.03 years). Probable PTSD, probable MDE, probable PTSD and MDE, and non-PTSD or non-MDE (non-P or -M) were present in 34 (8.8%), 14 (3.6%), 9 (2.3%), and 331 (85.3%) participants, respectively. The significant associated factor for probable PTSD or MDE among those who experienced disaster was financial problems. The associated factors on different quality of life subscales were old age, physical injury, employment, educational level, financial problems, probable PTSD and probable MDE. CONCLUSION While participants' psychiatric status improved after 18 months, their quality of life continued to be affected, especially the quality of life of those with probable PTSD combined with MDE. Postdisaster treatment and follow-up should be addressed to a greater degree, especially for victims with mental illness, physical injuries and financial problems.
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Affiliation(s)
- Vincent Shieh
- Graduate Institute of Gender Education, National Kaohsiung Normal University, Kaohsiung City, Taiwan
| | - Joh-Jong Huang
- Kaohsiung City Government Department of Health, Kaohsiung City, Taiwan
| | - Tsyr-En Grace Wu
- Department of Theology, Chang Jung Christian University, Tainan City, Taiwan
| | - Ju-Yu Chiu
- Department of Surgery, Tainan Municipal AN-NAN Hospital-China Medical University, Tainan City, Taiwan
| | - Yi-Chen Chen
- Department of Nursing, Meiho University, Ping-Tong County, Taiwan
| | - Guijing Lin
- Department of Nursing, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Chao-Yueh Su
- Department of Nursing, I-Shou University, Kaohsiung County, Taiwan
| | - Frank Huang-Chih Chou
- Department of Nursing, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.
- Superintendent office, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, 130 Kai-Syuan 2nd Rd, Lingya District, Kaohsiung City, Taiwan.
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Shen SP, Chen YC, Wu HC, Chung TC, Tsai CH, Liang WM, Huang JJ, Chou FHC. A comparison of hospital and community stay in patients who underwent compulsory admission before and after the 2007 Amendment to the Mental Health Act in Taiwan. Int J Law Psychiatry 2018; 58:87-96. [PMID: 29853017 DOI: 10.1016/j.ijlp.2018.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 02/24/2018] [Accepted: 02/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The main purpose of this study was to assess the empirical findings of compulsory admission for psychiatric disorders before and after the 2007 amendment to the Mental Health Act in Taiwan. METHODS A matched case-control study design was applied. Participants were selected using the National Health Insurance Research Database (NHIRD) in Taiwan. The control and case data were collected in 2006 and 2011, and the number of compulsory admission cases was recorded with a case-control ratio of 1:4, along with information on age (±3 years) and gender. In 2006, the number of patients recruited was 9265, including 1853 compulsorily admitted patients and 7412 voluntarily admitted patients. In 2011, the number of patients recruited was 4505, including 901 compulsorily admitted patients and 3604 voluntarily admitted patients. RESULTS The data collected for the patients who underwent compulsory admission before and after the amended Mental Health Act included gender, diagnosis, Charlson Comorbidity Index Score (CCIS), length of stay in an acute hospital ward (days), hospital accreditation level, ownership, teaching hospital status, psychiatrist gender and age, and hospital location. Although the number of compulsory admission cases (1853 vs. 901) markedly decreased and the length of stay in an acute hospital ward (30.7 ± 25.0 days vs. 39.0 ± 22.6 days) increased from 2006 to 2011, the readmission rate was reduced from 52.6% in 2006 to 42.5% in 2011. CONCLUSIONS The average lengths of hospital stay and community survival time were greater for compulsorily admitted patients than those for voluntarily admitted patients. This result might be attributed to a number of changes implemented since the 2007 amendment of the Mental Health Act, including a strict review process for compulsory admissions and a new discharge planning process, which require further research for approval.
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Affiliation(s)
- Shih-Pei Shen
- Department of Public Health, China Medical University, Taichung City, Taiwan; Graduate Institute of Biostatistics, Biostatistics Center, China Medical University, Taichung City, Taiwan
| | - Yi-Chen Chen
- Graduate institute of Health Care, Meiho University, Ping-Tong County, Taiwan
| | - Hung-Chi Wu
- Department of Community Psychiatry, Municipal Kaohsiung Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Tieh-Chi Chung
- Graduate institute of Health Care, Meiho University, Ping-Tong County, Taiwan; Hope Doctors Hospital, Miaoli County, Taiwan
| | - Ching-Hong Tsai
- Department of Child and Adolescent Psychiatry, Municipal Kaohsiung Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Wen-Miin Liang
- Department of Public Health, China Medical University, Taichung City, Taiwan; Graduate Institute of Biostatistics, Biostatistics Center, China Medical University, Taichung City, Taiwan
| | - Joh-Jong Huang
- Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Frank Huang-Chih Chou
- Graduate institute of Health Care, Meiho University, Ping-Tong County, Taiwan; Department of Community Psychiatry, Municipal Kaohsiung Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.
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Huang JJ, Wu TEG, Chen YC, Chiu JY, Chou P, Chou FHC. A preliminary report on psychiatric impairments and quality of life among Kaohsiung gas explosion victims 6 months after the event. Qual Life Res 2017; 27:631-638. [DOI: 10.1007/s11136-017-1727-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 01/24/2023]
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21
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Wang PH, Ku YC, Chen CC, Jeang SR, Chou FHC. Work-related frustration among senior nurses at a medical centre. J Clin Nurs 2016; 25:2040-51. [DOI: 10.1111/jocn.13241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Pei-Hern Wang
- Graduate Institute of Health Care; Meiho University; Ping-Tung County Taiwan
- Department of Nursing; Kaohsiung Veterans General Hospital; Kaohsiung City Taiwan
| | - Yan-Chiou Ku
- Department of Nursing; Kaohsiung Veterans General Hospital; Kaohsiung City Taiwan
- National Taiwan Normal University; Kaohsiung City Taiwan
| | - Chi-Chi Chen
- Department of Nursing; Kaohsiung Veterans General Hospital; Kaohsiung City Taiwan
- Fooyin University; Kaohsiung City Taiwan
| | - Shiow-Rong Jeang
- Department of Nursing; Kaohsiung Veterans General Hospital; Kaohsiung City Taiwan
- National Cheng Kung University; Kaohsiung City Taiwan
| | - Frank Huang-Chih Chou
- Graduate Institute of Health Care; Meiho University; Ping-Tung County Taiwan
- Superintendent Office; Kaohsiung Municipal Kai-Syuan Psychiatric Hospital; Kaohsiung City Taiwan
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Abstract
Many catastrophic disasters have happened in Taiwan over the last decade. As disaster is not a special occurrence but rather a part of the norm, mental rehabilitation should be treated as a mainstream issue in psychiatry. The internalization of emergency psychological interventions is necessary for every mental-health professional. The two primary categories of major manmade disasters in Taiwan over the past decade have been gas explosions and powder burns. Both categories have led to the serious injury of many individuals. The physical deformities and job problems faced by burn patients affect their psychiatric and emotional states both directly and indirectly. The psychiatric comorbidities of burn patients include: major depression, generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD), with GAD and PTSD comprising the most significant comorbidities in terms of numbers of diagnoses. To reduce psychological problems in the future, mental-health professionals should use appropriate psychological first aid (PFA) interventions in the early stages of treatment and rehabilitation. Mental rehabilitation is a major and comprehensive rehabilitation process. Mental-health professionals should thus use PFA to treat burn patients as well as provide long-term mental rehabilitation after discharge.
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Affiliation(s)
- Frank Huang-Chih Chou
- MD, PhD, Consultant, Superintendent Office, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, and Professor, Graduate Institute of Health Care, Mei-Ho University, Taiwan, ROC.
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Chang YC, Chou FHC. Effects of Home Visit Intervention on Re-hospitalization Rates in Psychiatric Patients. Community Ment Health J 2015; 51:598-605. [PMID: 25563484 DOI: 10.1007/s10597-014-9807-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 12/08/2014] [Indexed: 11/30/2022]
Abstract
To examine the home visit intervention (HoVI) effects on the re-hospitalization rate and medical costs in patients with schizophrenia or other psychiatric disorders. The subjects who received more than 3 HoVIs were defined as the HoVI group, whereas the subjects who received equal to or less than 3 HoVIs were defined as the HoVI < 4 group; the subjects who had never received an HoVI were defined as the non-HoVI group. Differences in the re-hospitalization rates and National Health Insurance (NHI) costs among the three groups were examined. The re-hospitalization rate of the HoVI group was significantly lower than that of the non-HoVI group. The hospitalization days and the NHI costs of the HoVI group were also lower than those of the non-HoVI group. However, the HoVI < 4 group was not different than the non-HoVI group regarding the re-hospitalization rate or the hospitalization days. The re-hospitalization rate was significantly higher before compared with after the HoVIs. The NHI costs were significantly higher before compared with after the HoVIs. HoVIs (More than 3 HoVIs) produced a lower re-hospitalization rate, number of hospitalization days, and NHI costs in patients who received care through the Home Visit. Project to strengthen the Community Rehabilitation Program.
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Affiliation(s)
- Yun-Chang Chang
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
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Tsai KY, Lee CC, Chou YM, Shen SP, Su CY, Wu HC, Huang MW, Shie JP, Chou FHC. The risks of major osteoporotic fractures in patients with schizophrenia: a population-based 10-year follow-up study. Schizophr Res 2014; 159:322-8. [PMID: 25445622 DOI: 10.1016/j.schres.2014.09.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 09/07/2014] [Accepted: 09/20/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the study is to explore the incidence and the risks associated with major osteoporotic fractures, all-cause mortality with osteoporotic fractures and the effect of the psychiatric drug exposure in patients with schizophrenia during a 10-year follow-up period. METHODS Two nationwide cohorts were selected from the Taiwan National Health Insurance Research Database (NHIRD) consisting of 30,335 patients with schizophrenia (age ≥ 40 years) and 121,340 age- and sex-matched control participants without schizophrenia. The psychiatric proportion of days covered (PDC) is an indicator of the intensity of drug exposure in patients with schizophrenia. The incidence and risk factors of major osteoporotic fractures were calculated for both cohorts. Additionally, the patient survival rate after major osteoporotic fractures was also calculated. RESULTS During a 10-year follow-up period, 1677 (5.53%) schizophrenia and 4257 (3.51%) control subjects had major osteoporotic fractures (P < 0.001). The schizophrenia patients with a PDC > 0.1 showed a significantly higher incidence of major osteoporotic fractures than did the non-schizophrenia controls; however, those with a psychiatric PDC ≤ 0.1 did not. After adjustment, the psychiatric PDC was significantly and independently associated with the risk of major osteoporotic fractures except some medical morbidities but the schizophrenia diagnosis was not. In addition, among all 5934 patients with major osteoporotic fracture, the adjusted mortality hazard ratio for psychiatric PDC was 1.92 (95% CI = 1.63-2.26). CONCLUSIONS Patients with schizophrenia are at a higher risk for major osteoporotic fractures than the general population and also have a higher mortality rate due to major osteoporotic fractures. These findings may be caused by psychiatric drug use rather than schizophrenia, which suggests that directions can be taken in future studies.
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Affiliation(s)
- Kuan-Yi Tsai
- Department of Community Psychiatry, Municipal Kaohsiung Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan; Department of Nursing, Meiho University, Ping-Tong County, Taiwan
| | - Ching-Chih Lee
- Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Yu-Mei Chou
- Department of Anesthesiology, Kaohsiung Veterans General Hospital, Taiwan
| | - Shih-Pei Shen
- Department of Community Psychiatry, Municipal Kaohsiung Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Chao-Yueh Su
- Department of Nursing, I-Shou University, Kaohsiung City, Taiwan
| | - Hung-Chi Wu
- Department of Addiction Science, Municipal Kaohsiung Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Min-Wei Huang
- Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | - Jia-Pei Shie
- Department of Community Psychiatry, Municipal Kaohsiung Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Frank Huang-Chih Chou
- Department of Community Psychiatry, Municipal Kaohsiung Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan; Graduate Institute of Health Care, Meiho University, Ping-Tong County, Taiwan.
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Lee CC, Tsai KY, Hung YT, Chou FHC, Huang YS. Association of hypnotics with stroke risk: a population-based case-control study. Prim Care Companion CNS Disord 2014; 16:13m01583. [PMID: 25133061 DOI: 10.4088/pcc.13m01583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 11/27/2013] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The aim of this study was to determine what association, if any, hypnotics have on the risk of stroke events. METHOD In a nationwide population-based case-control study, cases were patients with incident stroke diagnosed between January 1, 2006, and December 31, 2006. Patients with hemorrhagic or ischemic stroke diagnosis codes (ICD-9-CM codes 430-438) and who had been hospitalized for further treatment were included in the study. Patients with any type of stroke diagnosed before 2006 were excluded. The authors selected 2,779 stroke patients and 27,790 controls matched for age, gender, physician visit date, and comorbidities. The impact of hypnotics on stroke was examined by multiple logistic regression models and sensitivity analyses. RESULTS Individuals prescribed any hypnotic had elevated risk of stroke compared to those prescribed no hypnotics. For groups prescribed 1-27, 28-148, and ≥ 149 pills, odds ratios for stroke were 1.71 (95% CI, 1.49-1.96), 1.84 (95% CI, 1.62-2.11), and 1.45 (95% CI, 1.26-1.68), respectively. Adjusted odds ratios were elevated in separate analyses for zolpidem and estazolam. The observed results were robust with stratification by comorbidities, such as hypertension and diabetes, and using ischemic stroke as the case group. CONCLUSIONS This study shows that, in a case-control study matched for age, gender, and comorbidities using multiple logistic regression and sensitivity tests, zolpidem and estazolam were slightly associated with an increased risk of stroke. Further large-scale and in-depth studies should be performed. Use of hypnotics should always be determined by specialists, and adverse effects should be continuously monitored.
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Affiliation(s)
- Ching-Chih Lee
- Department of Otolaryngology (Dr Lee), Department of Pediatrics (Dr Hung), and Division of Neurology, Department of Internal Medicine (Dr Huang), Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan; Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan (Dr Lee); Department of Community Psychiatry, Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan (Drs Lee, Tsai, and Chou); School of Medicine, Tzu Chi University, Hualian, Taiwan (Drs Lee and Hung); and Graduate Institute of Health Care (Dr Chou) and Department of Nursing (Drs Chou and Tsai), Meiho University, Ping-Tong County, Taiwan
| | - Kuan-Yi Tsai
- Department of Otolaryngology (Dr Lee), Department of Pediatrics (Dr Hung), and Division of Neurology, Department of Internal Medicine (Dr Huang), Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan; Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan (Dr Lee); Department of Community Psychiatry, Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan (Drs Lee, Tsai, and Chou); School of Medicine, Tzu Chi University, Hualian, Taiwan (Drs Lee and Hung); and Graduate Institute of Health Care (Dr Chou) and Department of Nursing (Drs Chou and Tsai), Meiho University, Ping-Tong County, Taiwan
| | - Yeh-Ting Hung
- Department of Otolaryngology (Dr Lee), Department of Pediatrics (Dr Hung), and Division of Neurology, Department of Internal Medicine (Dr Huang), Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan; Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan (Dr Lee); Department of Community Psychiatry, Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan (Drs Lee, Tsai, and Chou); School of Medicine, Tzu Chi University, Hualian, Taiwan (Drs Lee and Hung); and Graduate Institute of Health Care (Dr Chou) and Department of Nursing (Drs Chou and Tsai), Meiho University, Ping-Tong County, Taiwan
| | - Frank Huang-Chih Chou
- Department of Otolaryngology (Dr Lee), Department of Pediatrics (Dr Hung), and Division of Neurology, Department of Internal Medicine (Dr Huang), Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan; Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan (Dr Lee); Department of Community Psychiatry, Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan (Drs Lee, Tsai, and Chou); School of Medicine, Tzu Chi University, Hualian, Taiwan (Drs Lee and Hung); and Graduate Institute of Health Care (Dr Chou) and Department of Nursing (Drs Chou and Tsai), Meiho University, Ping-Tong County, Taiwan
| | - Yung-Sung Huang
- Department of Otolaryngology (Dr Lee), Department of Pediatrics (Dr Hung), and Division of Neurology, Department of Internal Medicine (Dr Huang), Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan; Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan (Dr Lee); Department of Community Psychiatry, Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan (Drs Lee, Tsai, and Chou); School of Medicine, Tzu Chi University, Hualian, Taiwan (Drs Lee and Hung); and Graduate Institute of Health Care (Dr Chou) and Department of Nursing (Drs Chou and Tsai), Meiho University, Ping-Tong County, Taiwan
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Tsai KY, Chung TC, Lee CC, Chou YM, Su CY, Shen SP, Lin CH, Chou FHC. Is low individual socioeconomic status (SES) in high-SES areas the same as low individual SES in low-SES areas: a 10-year follow-up schizophrenia study. Soc Psychiatry Psychiatr Epidemiol 2014; 49:89-96. [PMID: 23728232 DOI: 10.1007/s00127-013-0716-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 05/17/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study investigates the relationship between individual and neighborhood socioeconomic status (SES) and mortality among patients with schizophrenia. METHODS A study population was identified from the National Health Insurance Research Database (NHIRD) prior to the end of 1999 that included 60,402 patients with schizophrenia. Each patient was tracked until death or to the end of 2009. Individual SESs were defined by enrollee category. Neighborhood SES was defined by enrollee category (as a proxy for occupation) and education, which were classified according to the conventions of Hollingshead. Neighborhoods were also grouped into advantaged and disadvantaged areas. The Cox proportional hazards model was used to compare the death-free survival rate between the different SES groups after adjusting for possible confounding factors and risk factors. RESULTS During the 10-year follow-up period, the mortality rates among high, moderate, and low individual SES groups were 12.22, 14.75, and 18.48%, respectively (P < 0.001). Schizophrenia patients with low individual SESs in disadvantaged neighborhoods had a risk of death that was 18-22% higher than that of those with high individual SES in advantaged neighborhoods. The analysis of the combined effect of individual SES and neighborhood SES revealed that the death rates were highest among those with low individual SES and low neighborhood SES (P < 0.001). CONCLUSIONS Schizophrenia patients with low individual SES in disadvantaged neighborhoods have the highest risk of mortality despite a universal health-care system. Public health strategies and welfare policies must continue to focus on this vulnerable group.
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Affiliation(s)
- Kuan-Yi Tsai
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Rd, Lingya District, Kaohsiung City, Taiwan
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Chen WJ, Shyu SS, Lin GG, Chen CC, Ho CK, Lee MB, Chou FHC. The predictors of suicidality in previous suicide attempters following case management services. Suicide Life Threat Behav 2013; 43:469-78. [PMID: 23638619 DOI: 10.1111/sltb.12031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 02/24/2013] [Indexed: 11/30/2022]
Abstract
Suicide attempts constitute a serious clinical problem. People who have attempted suicide are at an elevated risk for additional suicide attempts, but there is limited evidence regarding the predictors of suicidality of suicide attempters following case management services. In the present study the indicators of suicidality after case management were examined. A total of 1,056 subjects who had recently attempted suicide were recruited from January 1, 2011, to June 30, 2011. The suicide prevention center of Kaohsiung City in Taiwan provided case management services and followed up on suicide attempt cases for 6 months. The salient factors for repeat suicide attempts were estimated using a logistic regression analysis. The results showed that multiple factors, including a "willingness to receive mental health services during a crisis," "social support," "a history of mental disorders," and "a history of suicide," could predict repeat suicide attempts with hazard ratios (0.58, 0.54, 3.84, 1.51) and 95% confidence interval (0.39-0.86, 0.36-0.83, 2.41-6.10, 1.03-2.21). The four factors mentioned above were the most accurate predictors of subsequent suicidality when case management services were utilized after 6 months of follow-up. The findings of our study could help clarify future strategies for suicide prevention.
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Affiliation(s)
- Wei-Jen Chen
- Kaohsiung City Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Graduate Institute of Counseling psychology and Rehabilitation counseling, National Kaohsiung Normal University, Kaohsiung, Taiwan
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Chen WJ, Ho CK, Shyu SS, Chen CC, Lin GG, Chou LS, Fang YJ, Yeh PY, Chung TC, Chou FHC. Employing crisis postcards with case management in Kaohsiung, Taiwan: 6-month outcomes of a randomised controlled trial for suicide attempters. BMC Psychiatry 2013; 13:191. [PMID: 23865947 PMCID: PMC3720180 DOI: 10.1186/1471-244x-13-191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 07/12/2013] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Suicide attempts constitute a serious clinical problem and have important implications for healthcare resources. The aim of the present study was to evaluate the effectiveness of case management using crisis postcards over a 6-month follow-up period. METHOD A randomised controlled trial was conducted in Kaohsiung, Taiwan. Prevention of further suicide attempts was compared between two groups with and without the postcard intervention. The intervention group consisted of 373 participants (139 males, 234 females; age: 39.8 ± 14.0 yrs.). The control group consisted of 388 participants (113 males, 275 females; age: 40.0 ± 16.0 yrs.). A survival analysis was used to test the effectiveness of the crisis postcard intervention for the prevention of suicide reattempts. Per-protocol and intention-to-treat analyses were conducted. RESULTS The intention-to-treat analysis indicated that the crisis postcard had no effect (hazard ratio = 0.84; 95% CI = 0.56 - 1.29), whereas the per-protocol analysis showed a strong benefit for the crisis postcard (hazard ratio = 0.39; 95% CI = 0.21 - 0.72). CONCLUSION Although the results of the present study indicated that the postcard intervention did not reduce subsequent suicide behaviour, our study provides an alteration to the postcard intervention. Further studies need to be conducted to clarify whether this type of intervention can reduce subsequent suicidal behaviour, with a particular focus on reducing the rate of loss to follow-up.
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Affiliation(s)
- Wei-Jen Chen
- Kaohsiung City Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Road, Ling-Ya District, Kaohsiung 802, Taiwan,Graduate Institute of Counselling Psychology and Rehabilitation Counselling, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Chi-Kung Ho
- Kaohsiung City Government Bureau of Health, Kaohsiung, Taiwan
| | - Shi-Sen Shyu
- Graduate Institute of Counselling Psychology and Rehabilitation Counselling, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Cheng-Chung Chen
- Kaohsiung City Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Road, Ling-Ya District, Kaohsiung 802, Taiwan
| | - Guei-Ging Lin
- Kaohsiung City Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Road, Ling-Ya District, Kaohsiung 802, Taiwan
| | - Li-Shiu Chou
- Kaohsiung City Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Road, Ling-Ya District, Kaohsiung 802, Taiwan
| | - Yun-Ju Fang
- Kaohsiung City Government Bureau of Health, Kaohsiung, Taiwan
| | - Pin-Yang Yeh
- Kaohsiung City Government Bureau of Health, Kaohsiung, Taiwan
| | - Tieh-Chi Chung
- Institute of Health Care, Meiho University, Neipu, Pingtung, Taiwan
| | - Frank Huang-Chih Chou
- Kaohsiung City Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Road, Ling-Ya District, Kaohsiung 802, Taiwan,Institute of Health Care, Meiho University, Neipu, Pingtung, Taiwan
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Chou FHC, Tsai KY, Chou YM. The incidence and all-cause mortality of pneumonia in patients with schizophrenia: a nine-year follow-up study. J Psychiatr Res 2013; 47:460-6. [PMID: 23317876 DOI: 10.1016/j.jpsychires.2012.12.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 12/16/2012] [Accepted: 12/19/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study sought to estimate the incidence, all-cause mortality and relative risks for patients with schizophrenia after a pneumonia diagnosis. METHODS The population was identified from the Taiwanese National Health Insurance Research Database (NHIRD) in 1999 and included 59,021 patients with schizophrenia and 236,084 age- and sex-matched control participants without schizophrenia. These participants were randomly selected from the 23,981,020-participant NHIRD, which contain 96% of the entire population. Using the 2000-2008 NIHRD, the incidence and nine-year pneumonia-free survival rate of pneumonia (ICD-9-CM codes 486 and 507.0-507.8) were calculated. RESULTS Over nine years, 6055 (10.26%) patients with schizophrenia and 7844 (3.32%) controls had pneumonia. The pneumonia incidence density was 11.4/1000 person-years among the patients with schizophrenia, who experienced a 3.09-fold increased risk of developing pneumonia. After adjusting for other covariates, the patients with schizophrenia still experienced a 1.77-fold increased risk of developing pneumonia. Although, without adjustment, fewer schizophrenia patients than controls died after having pneumonia (2121 [35.12%] vs. 3497 [44.62%]), after adjusting for other variables, the mortality hazard ratio for patients with schizophrenia was 1.39. CONCLUSIONS During a nine-year follow-up, the likelihood of developing pneumonia and all-cause mortality among patients with schizophrenia was higher than that of the non-schizophrenia group as was the mortality rate. Interestingly, the psychiatric proportion of days covered (PDC) was positively associated with pneumonia (OR: 2.51) but negatively associated with death (HR: 0.72). These findings imply the importance of iatrogenic factors and psychotropic drugs (including their benefits and side effects) and highlight the directions for future studies.
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Affiliation(s)
- Frank Huang-Chih Chou
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
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Huang RR, Chen YS, Chen CC, Chou FHC, Su SF, Chen MC, Kuo MH, Chang LH. Quality of life and its associated factors among patients with two common types of chronic mental illness living in Kaohsiung City. Psychiatry Clin Neurosci 2012; 66:482-90. [PMID: 22989344 DOI: 10.1111/j.1440-1819.2012.02380.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AIM This study explored the associations of personal, disease, family, and social factors with quality of life (QoL) in patients with two common types of chronic mental illness (CMI) living in Kaohsiung City, Taiwan. METHODS Using a convenience sample and a cross-sectional design, 714 patients (50.1% male, 49.9% female) with CMI (72.1% schizophrenia and 27.9% affective disorder) and their caregivers were recruited. Demographic information was collected via the following questionnaires: 12-Item Short-Form Health Survey (SF-12), five-item Brief Symptom Rating Scale (BSRS-5), Caregiver Burden Scale, and Clinical Global Impressions (CGI-S) Scale. Pearson correlations and hierarchical regression analyses were used to predict QoL. RESULTS Disease factors accounted for 17-50% of the change in variance. Predictors of low mental subscale scores included the following: high psychological distress and high family burden as well as a history of suicide attempts, negative caregiver attitudes, and living away from home. Disease factors also explained the greatest variance in the physical subscales. Predictors of low physical subscale scores included the following: high psychological distress, age, unemployment, a history of suicide attempts, high family burden, and living alone. CONCLUSIONS Disease factors were the most important predictors of QoL in patients with CMI. Family factors were more important than social factors on the mental subscales. Differential relationships were also found for the other two dimensions. Together, these results indicate that a wide range of factors improve the QoL in patients with CMI.
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Affiliation(s)
- Rong-Rong Huang
- Department of Child and Adolescent Psychiatry, Kai-Suan Psychiatric Hospital, Kaohsiung City, Taiwan
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Tsai KY, Lee CC, Chou YM, Su CY, Chou FHC. The incidence and relative risk of stroke in patients with schizophrenia: a five-year follow-up study. Schizophr Res 2012; 138:41-7. [PMID: 22386734 DOI: 10.1016/j.schres.2012.02.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 01/31/2012] [Accepted: 02/10/2012] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to estimate the incidence and relative risk of stroke and post-stroke all-cause mortality in patients with schizophrenia. METHODS This study identified a study population from the National Health Insurance Research Database (NHIRD) between 1999 and 2003 that included 80,569 patients with schizophrenia and 241,707 age- and sex-matched control participants without schizophrenia. The participants were randomly selected from the 23,981,020-participant NHIRD, which consists of 96% Taiwanese participants. Participants who had experienced a stroke between 1999 and 2003 were excluded. Using data from the NHIRD between 2004 and 2008, the incidence of stroke (ICD-9-CM code 430-438) and patient survival after stroke were calculated for both groups. After adjusting for confounding risk factors, a Cox proportional-hazards model was used to compare the five-year stroke-free survival rate to the all-cause mortality rate across the two cohorts. RESULTS Over five years, 1380 (1.71%) patients with schizophrenia and 2954 (1.22%) controls suffered from strokes. After adjusting for demographic characteristics and comorbid medical conditions, patients with schizophrenia were 1.13 times more likely to have a stroke (95% CI=1.05-1.22; P=0.0006). In addition, 1039 (24%) patients who had a stroke died during the follow-up period. After adjusting for patient, physician and hospital variables, the all-cause mortality hazard ratio for patients with schizophrenia was 1.23 (95% CI=1.06-1.41; P=0.0052). CONCLUSIONS During a five-year follow-up, the likelihood of developing a stroke and the all-cause mortality rate were greater among patients with schizophrenia as compared with the control group.
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Affiliation(s)
- Kuan-Yi Tsai
- Department of Community Psychiatry, Kai-Suan Psychiatric Hospital, Kaohsiung City, Taiwan
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Angela Lo HW, Su CY, Chou FHC. Disaster Psychiatry in Taiwan: A Comprehensive Review. ACTA ACUST UNITED AC 2012; 4:77-81. [PMID: 32288930 PMCID: PMC7102803 DOI: 10.1016/j.jecm.2012.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 01/16/2012] [Accepted: 01/18/2012] [Indexed: 11/24/2022]
Abstract
Natural disasters have caused millions of deaths worldwide, and hundreds of millions of people have suffered from various types of physical or mental traumas. Disasters change patterns of thinking and the concept of security among members of a community, which highlights the importance of mental rehabilitation in disaster psychiatry. Mental rehabilitation is not only a short-term intervention, but also involves long-term follow-up and referral of cases to regular psychiatric management. We used PubMed (http://www.ncbi.nlm.nih.gov/pubmed) to search for papers related to the Chi-Chi Earthquake and the Morakot Typhoon published between January 2001 and November 2011. We found that 33 articles are involved in seven topics. The most common disaster-related psychiatric diagnoses were major depressive episodes and posttraumatic stress disorder. The prevalence of posttraumatic stress disorder ranged from 8.0% to 34.3% in Taiwan after the 1999 Earthquake. However, lifetime and current prevalence for psychiatric disorders ranged from 1% to 74%, affecting women twice more than men. Because disasters are becoming increasingly common, it is vital to train a sufficient number of specialists with guidelines for standard clinical treatment, and to create a standard operating procedure for reducing traumatic conditions.
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Affiliation(s)
- Huei-Wen Angela Lo
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Yueh Su
- Department of Nursing, I-Shiou University, Kaohsiung City, Taiwan
| | - Frank Huang-Chih Chou
- Kai-Suan Psychiatric Hospital, Kaohsiung City, Taiwan.,Meiho University, Pingtong County, Taiwan
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Ho WW, Chen WJ, Ho CK, Lee MB, Chen CC, Chou FHC. Evaluation of the suicide prevention program in Kaohsiung City, Taiwan, using the CIPP evaluation model. Community Ment Health J 2011; 47:542-50. [PMID: 21132460 DOI: 10.1007/s10597-010-9364-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 11/15/2010] [Indexed: 10/18/2022]
Abstract
The purpose of this study is to evaluate the effectiveness of the Kaohsiung Suicide Prevention Center (KSPC) of Kaohsiung City, Taiwan, during the period from June 2005 to June 2008. We used a modified CIPP evaluation model to evaluate the suicide prevention program in Kaohsiung. Four evaluation models were applied to evaluate the KSPC: a context evaluation of the background and origin of the center, an input evaluation of the resources of the center, a process evaluation of the activities of the suicide prevention project, and a product evaluation of the ascertainment of project objectives. The context evaluation revealed that the task of the KSPC is to lower mortality. The input evaluation assessed the efficiency of manpower and the grants supported by Taiwan's Department of Health and Kaohsiung City government's Bureau of Health. In the process evaluation, we inspected the suicide prevention strategies of the KSPC, which are a modified version of the National Suicide Prevention Strategy of Australia. In the product evaluation, four major objectives were evaluated: (1) the suicide rate in Kaohsiung, (2) the reported suicidal cases, (3) crisis line calls, and (4) telephone counseling. From 2005 to 2008, the number of telephone counseling sessions (1,432, 2,010, 7,051, 12,517) and crisis line calls (0, 4,320, 10,339, 14,502) increased. Because of the increase in reported suicidal cases (1,328, 2,625, 2,795, and 2,989, respectively), cases which were underreported in the past, we have increasingly been able to contact the people who need help. During this same time period, the half-year suicide re-attempt rate decreased significantly for those who received services, and the committed suicide rate (21.4, 20.1, 18.2, and 17.8 per 100,000 populations, respectively) also decreased. The suicide prevention program in Kaohsiung is worth implementing on a continual basis if financial constraints are addressed.
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Affiliation(s)
- Wen-Wei Ho
- Kai-Suan Psychiatric Hospital, No. 130, Kai-Suan 2nd Road, Ling-Ya District, Kaohsiung 802, Taiwan, Republic of China
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Abstract
This study presents information on the design and creation of a standard operation procedure (SOP) for psychiatric service after an earthquake. The strategies employed focused on the detection of survivors who developed persistent psychiatric illness, particularly post-traumatic stress and major depressive disorders. In addition, the study attempted to detect the risk factors for psychiatric illness. A Disaster-Related Psychological Screening Test (DRPST) was designed by five psychiatrists and two public health professionals for rapidly and simply interviewing 4,223 respondents within six months of the September 1999 Chi-Chi earthquake. A SOP was established through a systemic literature review, action research, and two years of data collection. Despite the limited time and resources inherent to a disaster situation, it is necessary to develop an SOP for psychiatric service after an earthquake in order to assist the high number of survivors suffering from subsequent psychiatric impairment.
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Affiliation(s)
- Chao-Yueh Su
- Department of Nursing, I-Shiou University, Taiwan
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Chou FHC, Tsai KY, Su CY, Lee CC. The incidence and relative risk factors for developing cancer among patients with schizophrenia: a nine-year follow-up study. Schizophr Res 2011; 129:97-103. [PMID: 21458957 DOI: 10.1016/j.schres.2011.02.018] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 02/17/2011] [Accepted: 02/22/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To estimate the incidence and relative risk of developing cancer as well as the mortality rate after cancer diagnosis for patients with schizophrenia compared with the general population. METHODS Our population for this study was identified before the end of 1999. The study included 59,257 patients with schizophrenia and 178,156 age- and gender-matched individuals without schizophrenia as controls, who were selected from the 23,981,020 subjects in the National Health Insurance Research Database (NHIRD), which consists of 96% of the entire Taiwanese population. From the 2000 to 2008 NHIRD, we calculated the cancer incidence and survival time after cancer diagnosis in each of the two groups. Based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), the cancers were divided into nine groups. RESULTS During the nine-year follow-up period, 1145 (1.93%) of the patients with schizophrenia and 5294 (2.97%) of the control group developed cancer. The patients with schizophrenia had a significantly lower cancer incidence than those in the control group in both the male (OR=0.50, 95% CI, 0.46-0.55) and female (OR=0.81, 95% CI, 0.74-0.88) populations. Patients with schizophrenia were less likely to develop cancer than individuals in the control group for every cancer type except breast and cervical/uterine cancer. After adjustment using the Cox regression model, patients with schizophrenia had an overall decreased cancer risk (adjusted hazard ratio 0.71, 95% CI, 0.66-0.76) compared to the control population. For all cancer patients, the mortality adjusted hazard ratio for patients with schizophrenia versus the control group was 1.36 (95% CI, 1.24-1.50) after adjusting for other variables. CONCLUSIONS Although the likelihood of developing cancer among patients with schizophrenia (0.64) was less than that of the non-schizophrenia group, the mortality rate among patients with schizophrenia was higher than that of the control group.
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Affiliation(s)
- Frank Huang-Chih Chou
- Department of Community Psychiatry, Kai-Suan Psychiatric Hospital, Kaohsiung City, Taiwan
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Huang MW, Chou FHC, Lo PY, Cheng KS. A comparative study on long-term evoked auditory and visual potential responses between Schizophrenic patients and normal subjects. BMC Psychiatry 2011; 11:74. [PMID: 21542917 PMCID: PMC3113739 DOI: 10.1186/1471-244x-11-74] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 05/04/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The electrical signals measuring method is recommended to examine the relationship between neuronal activities and measure with the event related potentials (ERPs) during an auditory and a visual oddball paradigm between schizophrenic patients and normal subjects. The aim of this study is to discriminate the activation changes of different stimulations evoked by auditory and visual ERPs between schizophrenic patients and normal subjects. METHODS Forty-three schizophrenic patients were selected as experimental group patients, and 40 healthy subjects with no medical history of any kind of psychiatric diseases, neurological diseases, or drug abuse, were recruited as a control group. Auditory and visual ERPs were studied with an oddball paradigm. All the data were analyzed by SPSS statistical software version 10.0. RESULTS In the comparative study of auditory and visual ERPs between the schizophrenic and healthy patients, P300 amplitude at Fz, Cz, and Pz and N100, N200, and P200 latencies at Fz, Cz, and Pz were shown significantly different. The cognitive processing reflected by the auditory and the visual P300 latency to rare target stimuli was probably an indicator of the cognitive function in schizophrenic patients. CONCLUSIONS This study shows the methodology of application of auditory and visual oddball paradigm identifies task-relevant sources of activity and allows separation of regions that have different response properties. Our study indicates that there may be slowness of automatic cognitive processing and controlled cognitive processing of visual ERPs compared to auditory ERPs in schizophrenic patients. The activation changes of visual evoked potentials are more regionally specific than auditory evoked potentials.
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Affiliation(s)
- Min-Wei Huang
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan,Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chia-Yi 600, Taiwan
| | | | - Pei-Yu Lo
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan
| | - Kuo-Sheng Cheng
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan
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Wang PW, Cheng CC, Chou FHC, Tsang HY, Chang YS, Huang MF, Yen CF. Using multiple assessments to evaluate medical students' clinical ability in psychiatric clerkships. Acad Psychiatry 2011; 35:307-311. [PMID: 22007087 DOI: 10.1176/appi.ap.35.5.307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND No single assessment method can successfully evaluate the clinical ability of medical students in psychiatric clerkships; however, few studies have examined the efficacy of multiple assessments, especially in psychiatry. The aim of this study was to examine the relationship among different types of assessments of medical students' clinical ability in psychiatric clerkships and whether it is reasonable to use multiple assessments. METHOD A group of 196 students were enrolled during their psychiatric clerkship between September 2008 and May 2009 in Kaohsiung, Taiwan. The mini-clinical evaluation exercise (mini-CEX) and standardized patient (SP)-based test were used to evaluate "does" and "show how" in psychiatric clinical ability. A multiple-choice examination was used to evaluate knowledge of psychiatry. RESULTS There were statistically significant but weak correlations among the scores on the multiple-choice examination, SP-based test, and overall clinical competence domain on the mini-CEX. CONCLUSION A blended assessment composed of a multiple-choice examination, mini-CEX, and SP-based test can evaluate different dimensions of clinical ability. It is reasonable to use multiple methods to assess medical students' competency in psychiatric clerkships.
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Affiliation(s)
- Peng-Wei Wang
- Dept. of Psychiatry, Kaohsiung Medical University Hospital, Taiwan
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Lee CY, Chao SS, Chen SP, Chou FHC, Su CY, Ho WW. The characteristics of and risk factors associated with incarcerated sex offenders in Taiwan. Int J Law Psychiatry 2010; 33:144-148. [PMID: 20388571 DOI: 10.1016/j.ijlp.2010.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This article presents the demographic characteristics of a sample of Taiwanese sex offenders, examines the rate of sexual recidivism in Taiwan, and describes which factors distinguish recidivists from non-recidivists. This article assesses the recidivism rate of a sample of 503 male sex offenders incarcerated from 1999 to 2004. The sample is divided into two groups: non-recidivists (88.7%) and recidivists (11.3%). The variables are categorized into demographic characteristics, criminal history, interpersonal relationships, and offending behaviors. Multivariate logistic regression analysis suggests that recidivism is significantly related to male victims, poor interactions with employers, verbal control (i.e., threats to or verbal control of victims), weapon control (threatening or controlling victims with weapons), and familiarity with victims. Furthermore, this article will establish a database for demographic characteristics and associated risk factors related to recidivism in incarcerated sex offenders in Taiwan. These data will be useful for preventing future sex crimes.
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Affiliation(s)
- Chun-Ying Lee
- Department of Psychiatry, Chia-Yi Veterans Hospital, Taiwan
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Lin SH, Liu CM, Liu YL, Fann CSJ, Hsiao PC, Wu JY, Hung SI, Chen CH, Wu HM, Jou YS, Liu SK, Hwang TJ, Hsieh MH, Chang CC, Yang WC, Lin JJ, Chou FHC, Faraone SV, Tsuang MT, Hwu HG, Chen WJ. Clustering by neurocognition for fine mapping of the schizophrenia susceptibility loci on chromosome 6p. Genes Brain Behav 2009; 8:785-94. [PMID: 19694819 PMCID: PMC4286260 DOI: 10.1111/j.1601-183x.2009.00523.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chromosome 6p is one of the most commonly implicated regions in the genome-wide linkage scans of schizophrenia, whereas further association studies for markers in this region were inconsistent likely due to heterogeneity. This study aimed to identify more homogeneous subgroups of families for fine mapping on regions around markers D6S296 and D6S309 (both in 6p24.3) as well as D6S274 (in 6p22.3) by means of similarity in neurocognitive functioning. A total of 160 families of patients with schizophrenia comprising at least two affected siblings who had data for eight neurocognitive test variables of the continuous performance test (CPT) and the Wisconsin card sorting test (WCST) were subjected to cluster analysis with data visualization using the test scores of both affected siblings. Family clusters derived were then used separately in family-based association tests for 64 single nucleotide polymorphisms (SNPs) covering the region of 6p24.3 and 6p22.3. Three clusters were derived from the family-based clustering, with deficit cluster 1 representing deficit on the CPT, deficit cluster 2 representing deficit on both the CPT and the WCST, and a third cluster of nondeficit. After adjustment using false discovery rate for multiple testing, SNP rs13873 and haplotype rs1225934-rs13873 on BMP6-TXNDC5 genes were significantly associated with schizophrenia for the deficit cluster 1 but not for the deficit cluster 2 or nondeficit cluster. Our results provide further evidence that the BMP6-TXNDC5 locus on 6p24.3 may play a role in the selective impairments on sustained attention of schizophrenia.
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Affiliation(s)
- Sheng-Hsiang Lin
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Division of Genomic Medicine, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Li Liu
- Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Zhunan, Taiwan
| | | | - Po-Chang Hsiao
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Division of Genomic Medicine, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
| | - Jer-Yuarn Wu
- National Genotyping Center, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Shuen-Iu Hung
- National Genotyping Center, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Chun-Houh Chen
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Han-Ming Wu
- Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Yuh-Shan Jou
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Shi K. Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Tzung J. Hwang
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | - Wei-Chih Yang
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- Molecular Medicine Program, Taiwan International Graduate Program, Academia Sinica, Taipei, Taiwan
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei, Taiwan
| | - Jin-Jia Lin
- Department of Psychiatry, Chimei Medical Center, Tainan, Taiwan
| | | | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ming T. Tsuang
- Harvard Institute of Psychiatric Epidemiology and Genetics, and Departments of Epidemiology and Psychiatry, Harvard University, Boston, Massachusetts, USA
- Center for Behavioral Genomics, Department of Psychiatry, University of California, San Diego, California, USA
| | - Hai-Gwo Hwu
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Wei J. Chen
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Division of Genomic Medicine, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Chen WJ, Chen CC, Ho CK, Lee MB, Chung YT, Wang YC, Lin GG, Lu RY, Sun FC, Chou FHC. The suitability of the BSRS-5 for assessing elderly who have attempted suicide and need to be referred for professional mental health consultation in a metropolitan city, Taiwan. Int J Geriatr Psychiatry 2009; 24:1151-7. [PMID: 19259981 DOI: 10.1002/gps.2239] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The goals of this study are to (1) investigate the prevalence of necessary referral for professional mental health consultation for elderly people who attempted suicide ("suicide-attempted") in Kaohsiung city, Taiwan during 2006-2007, (2) assess whether the 5-item Brief Symptom Rating Scale (BSRS-5) can be used as an efficient screening instrument for assessing the probability of a second suicide attempt among the elderly, and (3) examine predictors of needing referral among the suicide-attempted. METHODS During the study period, 144 suicide-attempted elderly subjects were enrolled. Demographic data, BSRS-5, SAD PERSONS scale, and Medical Outcome Study Short Form-12 (MOS SF-12) data were collected by a trained semi-professional. The prevalence of necessary referrals for the suicide-attempted elderly was estimated, and the salient factors for their referral were evaluated with logistic regression analysis. RESULTS A total of 109 participants out of the 144 recruited completed the questionnaires, giving a response rate of 75.7%. The prevalence of necessary referrals for professional mental health consultation was 33.9% (37/109). The significant predictors of needing referrals were lower scores for MCS (OR = 0.89; 95% CI = 0.83-0.96), family discord (OR = 3.86; 95% CI = 1.17-12.75), and type of interviewee (OR = 4.97; 95% CI = 1.57-15.74). CONCLUSION When the BSRS-5 is used to evaluate the referral of elderly patients who have attempted suicide for a professional mental health consultation, it is best to conduct in-person interviews to ask whether the elderly patient still has any suicidal ideation. In addition, evaluating quality of life and level of family discord may also be crucial for suicide prevention in the elderly.
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Affiliation(s)
- Wei-Jen Chen
- Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan, ROC
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41
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Liu YL, Fann CSJ, Liu CM, Chen WJ, Wu JY, Hung SI, Chen CH, Jou YS, Liu SK, Hwang TJ, Hsieh MH, Chang CC, Yang WC, Lin JJ, Chou FHC, Faraone SV, Tsuang MT, Hwu HG. RASD2, MYH9, and CACNG2 genes at chromosome 22q12 associated with the subgroup of schizophrenia with non-deficit in sustained attention and executive function. Biol Psychiatry 2008; 64:789-96. [PMID: 18571626 DOI: 10.1016/j.biopsych.2008.04.035] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Revised: 04/21/2008] [Accepted: 04/21/2008] [Indexed: 02/03/2023]
Abstract
BACKGROUND In a previous linkage study of schizophrenia that included Taiwanese samples, the marker D22S278 (22q12.3) was significantly linked to schizophrenia (p = .001). METHODS We conducted fine mapping of the implicated genomic region, with 47 validated single nucleotide polymorphism (SNP) markers around 1 Mb of D22S278, in a Taiwanese sample of 218 pedigrees with at least 2 siblings affected with schizophrenia. We examined the association of these SNPs and their haplotypes with schizophrenia and with subgroups defined by the presence and absence of deficits in sustained attention as assessed by undegraded and degraded continuous performance tests (CPTs). We also examined subgroups defined by deficits in categories achieved in the Wisconsin Card Sort Test (WCST). RESULTS Three of five candidate vulnerability genes (RASD2, APOL5, MYH9, EIF3S7, and CACNG2), which had marginally significant associations with schizophrenia, had significant associations with schizophrenic patients who did not have deficits in sustained attention on the undegraded CPT (RASD2 gene SNP rs736212; p = .0008 with single locus analysis) and the degraded CPT (MYH9 gene haplotype 1-1-1-1 of SNP rs3752463 - rs1557540 - rs713839 - rs739097; p = .0059 with haplotype analysis). We also found a significant association for patients who showed no deficits in executive function as measured by categories achieved in the WCST (CACNG2 gene haplotype 2-1-1-1 of SNP rs2267360 - rs140526 - rs1883987 - rs916269; p = .0163 with haplotype analysis). CONCLUSIONS The genes RASD2, MYH9, and CACNG2 might be vulnerability genes for neuropsychologically defined subgroups of schizophrenic patients.
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Affiliation(s)
- Yu-Li Liu
- Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Taipei, Taiwan
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Chen YS, Chen MC, Chou FHC, Sun FC, Chen PC, Tsai KY, Chao SS. The relationship between quality of life and posttraumatic stress disorder or major depression for firefighters in Kaohsiung, Taiwan. Qual Life Res 2007; 16:1289-97. [PMID: 17668289 DOI: 10.1007/s11136-007-9248-7] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2007] [Accepted: 07/16/2007] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The work of firefighters involves the risk of exposure to the harmful effects of toxic substances as well as the possibility of enormous emotional shock from disasters, which may result in psychiatric impairments and a lower quality of life. Therefore, we examined quality of life, prevalence of posttraumatic stress disorder (PTSD) and major depression, and the related risk factors for firefighters in Kaohsiung, Taiwan. METHODS This is a two-stage survey study. During the first stage, we used the 36-item Short-Form Health Survey (SF-36) and the Disaster-Related Psychological Screening Test (DRPST) to assess quality of life, probable PTSD, probable major depression, and the related risk factors for 410 firefighters. During the second stage, psychiatrists categorized these probable cases according to self-reported questionnaires against DSM-IV into PTSD or major depression group, subclinical group, and health group. All the data were analyzed with SPSS 10.0 Chinese version. RESULTS The estimated current prevalence rates for major depression and PTSD were 5.4% (22/410) and 10.5% (43/410), respectively. The firefighters with estimated PTSD or major depression scored significantly lower on quality of life measures than subclinical PTSD/major depression and mentally healthy groups, which was evident in eight concepts and two domains of the SF-36. The major predictors of poor quality of life and PTSD/major depression were mental status, psychosocial stressors, or perceived physical condition. CONCLUSION Firefighters have a higher estimated rate of PTSD, and the risk factors that affect quality of life and PTSD/major depression should encourage intervention from mental health professionals.
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Affiliation(s)
- Yong-Shing Chen
- Department of Community Psychiatry, Kai-Suan Psychiatric Hospital, 130 Kai-Suan 2nd Rd, Kaohsiung, Taiwan
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Chou FHC, Wu HC, Chou P, Su CY, Tsai KY, Chao SS, Chen MC, Su TTP, Sun WJ, Ou-Yang WC. Epidemiologic psychiatric studies on post-disaster impact among Chi-Chi earthquake survivors in Yu-Chi, Taiwan. Psychiatry Clin Neurosci 2007; 61:370-8. [PMID: 17610661 DOI: 10.1111/j.1440-1819.2007.01688.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of the present study was to survey a cohort population for the risk factors of post-traumatic stress disorder (PTSD) and major depression, and the prevalence of different psychiatric disorders at 6 months and 2 and 3 years after a major earthquake. The Disaster-Related Psychological Screening Test (DRPST), part I, and the Mini-International Neuropsychiatric Interview (MINI) were, respectively, administered by trained interviewers and psychiatrists in this community-interview program. The prevalence of PTSD decreased from 8.3% at 6 months to 4.2% at 3 years after the earthquake. Suicidality increased from 4.2% at 6 months and 5.6% at 2 years to 6.0% at 3 years after the earthquake; drug abuse/dependence increased from 2.3% at 6 months to 5.1% at 3 years after the disaster. The risk factors for PTSD and major depression in various post-disaster stages were determined. Earthquake survivors had a high percentage of psychiatric disorders in the first 2 years, and then the prevalence declined. Following the devastation caused by the Chi-Chi earthquake, it is important to focus on treating symptoms of major depression and PTSD and eliminating the risk factors for both of these disorders in survivors to avoid the increase in suicidality.
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Affiliation(s)
- Frank Huang-Chih Chou
- Department of Community Psychiatry, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan.
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Lung FW, Chou FHC, Lu YC, Wen JK, Yen YC, Kao CY. In-prison treatment for sexual offenders in Taiwan. Int J Offender Ther Comp Criminol 2007; 51:340-7. [PMID: 17478863 DOI: 10.1177/0306624x06292676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The present study was designed to investigate the current status of mandated treatment in prison for sexual offenders in Taiwan. The information-gathering methods were composed of two parts: questionnaires and interviews. The results showed the difficulties of mandated treatment in prison, including poor client adherence, the lack of consistent disciplines for the therapists, a standardized algorithm, and explicit laws and rules, the safety concerns of the therapists, and a shortage of staff. The development of mandated treatment in prison of sexual offenders in Taiwan is still in its early stage, and the treatment models have not yet been integrated. A cooperative and collaborative center for the mandated treatment in prison of sexual offenders and an integrated rule and treatment model should be set up in the future.
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Affiliation(s)
- For-Wey Lung
- Military Kaohsiung General Hospital, Kaohsiung Medical University
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Tsai KY, Chou P, Chou FHC, Su TTP, Lin SC, Lu MK, Ou-Yang WC, Su CY, Chao SS, Huang MW, Wu HC, Sun WJ, Su SF, Chen MC. Three-year follow-up study of the relationship between posttraumatic stress symptoms and quality of life among earthquake survivors in Yu-Chi, Taiwan. J Psychiatr Res 2007; 41:90-6. [PMID: 16325854 DOI: 10.1016/j.jpsychires.2005.10.004] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Revised: 09/29/2005] [Accepted: 10/24/2005] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To prospectively evaluate the relationship between the clinical course of posttraumatic stress symptoms (PTSS) and quality of life (QOL) among Taiwan earthquake survivors for 3 years. METHODS A population survey was done in a Taiwan township near the epicenter of a severe earthquake (7.3 on the Richter scale). Trained assistants used the Medical Outcomes Study Short Form-36 (MOS SF-36) and the Disaster-Related Psychological Screening Test to interview earthquake survivors 16 and older. A total of 1756 respondents were surveyed during the 3-year follow-up period. RESULTS At 0.5 and 3 years after the earthquake, the estimated rate of PTSS (cutoff point, 3/4) was 23.8% and 4.4%, respectively. The survivors with PTSS scored lower for each concept of the MOS SF-36 at these two intervals. Three years after the earthquake, the survivors in the persistently healthy group showed the highest scores in all subscales and domains of the MOS SF-36; second-highest was the recovering group; third-highest was the delayed PTSS group; and the persistent PTSS group showed the lowest scores in all concepts and domains. Notably, survivors with delayed onset PTSS exhibited a lower QOL when PTSS occurred. CONCLUSIONS Three years after the earthquake, the estimated rate of PTSS had declined, and the QOL of the survivors varied according to how their PTSS had progressed.
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Affiliation(s)
- Kuan-Yi Tsai
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taiwan
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Faraone SV, Hwu HG, Liu CM, Chen WJ, Tsuang MM, Liu SK, Shieh MH, Hwang TJ, Ou-Yang WC, Chen CY, Chen CC, Lin JJ, Chou FHC, Chueh CM, Liu WM, Hall MH, Su J, Van Eerdewegh P, Tsuang MT. Genome scan of Han Chinese schizophrenia families from Taiwan: confirmation of linkage to 10q22.3. Am J Psychiatry 2006; 163:1760-6. [PMID: 17012687 DOI: 10.1176/ajp.2006.163.10.1760] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Genome-wide linkage analyses of schizophrenia have identified several regions that may harbor schizophrenia susceptibility genes, but given the complex etiology of the disorder, it is unlikely that all susceptibility regions have been detected. To address this issue, the authors ascertained 606 Han Chinese families comprising 1,234 affected members. METHOD Probands with schizophrenia were recruited from six data collection field research centers in Taiwan. Each proband underwent a diagnostic screen with supplemental medical records and a semistructured interview. Following this screen, the authors administered the Mandarin Chinese version of the Diagnostic Interview for Genetic Studies. Best-estimate final diagnoses were made by two board-certified psychiatrists. The genotyping was conducted by the Center for Inherited Disease Research, with 386 markers spaced at an average of 9-centimorgan (cM) intervals. Empirical simulations were generated to determine genome-wide significance. RESULTS The authors found five regions with nonparametric linkage z scores 2.0 or greater. These were the following: 2.08 was reached for D1S551 (113.7) cM at 1p31.1 and 2.31 for D2S410 (125.2 cM) at 2q14.1; 2.00 was reached for D4S2361 (93.5 cM) at 4q21.23, and 2.07 for D15S1012 (36 cM) at 15q14, the largest nonparametric linkage z score was 2.88 for D10S2327 (100.92 cM) at 10q22.3. CONCLUSIONS Our 10q22.3 finding at 100.9 cM is consistent with a previously reported nonparametric linkage score of 4.27 at 107.2 cM on chromosome 10, although it did not attain genome-wide significance in this study.
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Affiliation(s)
- Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams St., Syracuse, NY 13210, USA.
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Chen HC, Chou FHC, Chen MC, Su SF, Wang SY, Feng WW, Chen PC, Lai JY, Chao SS, Yang SL, Tsai TC, Tsai KY, Lin KS, Lee CY, Wu HC. A survey of quality of life and depression for police officers in Kaohsiung, Taiwan. Qual Life Res 2006; 15:925-32. [PMID: 16721651 DOI: 10.1007/s11136-005-4829-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The enormous job stress of police work may result in depression, which is highly correlated with work disability and poor quality of life. We investigated the quality of life, the probability of depression, and the related risk factors for police officers in Kaohsiung, Taiwan. METHODS We used the 12-item Short-Form Health Survey (SF-12) and the Disaster-Related Psychological Screening Test (DRPST) to assess the quality of life and prevalence of depression for 832 police officers in Kaohsiung. RESULTS The estimated rate of probable major depression was 21.6% (180/832). Those with an educational level of university or above and nondepressed police officers had higher scores in every subscale for quality of life. Police officers older than 50 had higher scores in the mental aspects of quality of life. Family problems and job stress related to achievement, peer pressure about performance, and heavy workloads were predictive factors for depression. CONCLUSION Police officers might have a higher estimated rate of depression than previously thought, and those with depression have a poorer quality of life.
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Affiliation(s)
- Hsiu-Chao Chen
- Department of Community Psychiatry, Kai-Suan Psychiatric Hospital, 130 Kai-Suan 2nd Rd., Kaohsiung, Taiwan
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Liu YL, Shen-Jang Fann C, Liu CM, Wu JY, Hung SI, Chan HY, Chen JJ, Lin CY, Liu SK, Hsieh MH, Hwang TJ, Ouyang WC, Chen CY, Lin JJ, Chou FHC, Chueh CM, Liu WM, Tsuang MM, Faraone SV, Tsuang MT, Chen WJ, Hwu HG. Evaluation of RGS4 as a candidate gene for schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2006; 141B:418-20. [PMID: 16526029 DOI: 10.1002/ajmg.b.30286] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Several studies have suggested that the regulator of G-protein signaling 4 (RGS4) may be a positional and functional candidate gene for schizophrenia. Three single nucleotide polymorphisms (SNP) located at the promoter region (SNP4 and SNP7) and the intron 1 (SNP18) of RGS4 have been verified in different ethnic groups. Positive results have been reported in these SNPs with different numbers of SNP combinatory haplotypes. In this study, these three SNP markers were genotyped in 218 schizophrenia pedigrees of Taiwan (864 individuals) for association analysis. Among these three SNPs, neither SNP4, SNP7, SNP18 has shown significant association with schizophrenia in single locus association analysis, nor any compositions of the three SNP haplotypes has shown significantly associations with the DSM-IV diagnosed schizophrenia. Our results fail to support the RGS4 as a candidate gene for schizophrenia when evaluated from these three SNP markers.
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Affiliation(s)
- Yu-Li Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Wu HC, Chou P, Chou FHC, Su CY, Tsai KY, Ou-Yang WC, Su TTP, Chao SS, Sun WJ, Chen MC. Survey of quality of life and related risk factors for a Taiwanese village population 3 years post-earthquake. Aust N Z J Psychiatry 2006; 40:355-61. [PMID: 16620318 DOI: 10.1080/j.1440-1614.2006.01802.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate quality of life (QOL) and related risk factors in Taiwanese earthquake survivors diagnosed with different psychiatric disorders 3 years after the 1999 Chi-Chi earthquake. METHOD This study was a population survey. Trained assistants used the Medical Outcomes Study Short Form-36 (MOS SF-36) and questionnaires to interview 405 respondents (189 men and 216 women) aged 16 years or older, who had been exposed to the earthquake. Psychiatrists interviewed the same respondents using the Mini-International Neuropsychiatric Interview, with an adjusted response rate of 70.2%. RESULTS The prevalence range for psychiatric disorders in the earthquake survivors was 0.2-7.2% 3 years after the Chi-Chi earthquake, with rates for major depression (MD) and posttraumatic stress disorder (PTSD) of 6.4% and 4.4%, respectively. The QOL scores for the PTSD/MD group were lower than for the other two diagnostic groups, as determined by assessment of physical and mental aspects of functional integrity from MOS SF-36 scores. The predictors for poor QOL were age, female gender, economic problems, physical illness, subjective assessment of memory and social-activity decline and diagnosis of PTSD or MD. CONCLUSION The QOL for earthquake survivors with psychiatric disorders, especially PTSD or MD, was inferior compared with the mentally healthy analogues, with contemporaneous decreases in mental and physical function scores across the QOL subscales. The persistence of long-term economic problems was one of many important factors affecting QOL.
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Affiliation(s)
- Hung-Chi Wu
- Department of Community Psychiatry, Kai-Suan Psychiatric Hospital, Kaohsiung, and Department of Nursing, I-Shou University 1, Taiwan
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Liu YL, Fann CSJ, Liu CM, Wu JY, Hung SI, Chan HY, Chen JJ, Pan CC, Liu SK, Hsieh MH, Hwang TJ, Ouyang WC, Chen CY, Lin JJ, Chou FHC, Chueh CM, Liu WM, Tsuang MM, Faraone SV, Tsuang MT, Chen WJ, Hwu HG. Absence of significant associations between four AKT1 SNP markers and schizophrenia in the Taiwanese population. Psychiatr Genet 2006; 16:39-41. [PMID: 16395129 DOI: 10.1097/01.ypg.0000180681.80546.f3] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AKT1 (V-akt murine thymoma viral oncogene homolog 1) is a protein kinase isoform of AKT. Five single-nucleotide polymorphisms, rs3803300, rs1130214, rs3730358, rs2498799 and rs2494732, at the genomic region of AKT1 have been reported to be significantly associated with schizophrenia. We tested for the presence of these five single-nucleotide polymorphisms in a Taiwanese population by genotyping 218 co-affected schizophrenia families. Both single locus and haplotypes analyses showed no association of these single-nucleotide polymorphisms with schizophrenia. These findings fail to support AKT1 as a susceptibility gene for schizophrenia in the Taiwanese population.
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Affiliation(s)
- Yu-Li Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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