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Chen MH, Pan TL, Cheng CM, Chang WH, Bai YM, Su TP, Chen TJ, Tsai SJ. Familial coaggregation of major psychiatric disorders and neurodevelopmental disorders among first-degree relatives of individuals with generalized anxiety disorder. J Affect Disord 2024; 368:48-54. [PMID: 39277032 DOI: 10.1016/j.jad.2024.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 07/18/2024] [Accepted: 09/11/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND Anxiety disorders, major psychiatric disorders (e.g., schizophrenia and major affective disorders), and neurodevelopmental disorders (e.g., autism and attention-deficit/hyperactivity disorder [ADHD]) may cluster together within families. However, whether the first-degree relatives (FDRs) of individuals with generalized anxiety disorder (GAD) are at an elevated risk of neurodevelopmental or major psychiatric disorders remains unknown. METHODS We identified 2,378,190 FDRs of patients with GAD and 9,512,760 birth year-matched and sex-matched controls from Taiwan's National Health Insurance Research Database. Neurodevelopmental disorders, including autism and ADHD, and major psychiatric disorders, including schizophrenia, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, and GAD, were identified. RESULTS The FDRs-parents, offspring, and siblings-of individuals with GAD were more likely to be diagnosed as having schizophrenia (relative risk: 1.22), bipolar disorder (1.36), major depressive disorder (1.29), autism (1.20), ADHD (1.52), obsessive-compulsive disorder (1.21), and GAD (1.61) than are the FDRs of individuals without GAD. CONCLUSION Our findings support the notion of a familial coaggregation between GAD, major psychiatric disorders, and neurodevelopmental disorders. Future studies should elucidate the definitive genetic etiology of this familial coaggregation.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Tai-Long Pan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan; Research Center for Chinese Herbal Medicine and Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Ma CH, Chang HY, Lee HC, Yu YF, Tien HS, Lin YH, Liu MY, Lin YL, Ma HM, Lin KF, Huang WL. The psychological and physiological effects of integrated cognitive-behavioral and biofeedback therapy on panic disorder: A randomized controlled trial. J Formos Med Assoc 2023; 122:1305-1312. [PMID: 37453901 DOI: 10.1016/j.jfma.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/17/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Cognitive-behavioral therapy (CBT) and biofeedback therapy are commonly regarded as effective treatment modalities for panic disorder. The aim of this study was to establish a Taiwanese version of an integrated cognitive-behavioral and biofeedback therapy (ICB) and examine its effects on panic disorder using psychological and physiological indicators. METHODS Thirty patients with panic disorder were enrolled in this study. They were randomly assigned to either the ICB group (n = 15) or the treatment as usual (TAU) group (n = 15). The intervention consisted of six sessions, conducted once a week. Psychological indicators were measured at baseline (prior to intervention), week 3, and week 6, while physiological indicators were measured at baseline and week 6. The psychological indicators included five scales, with the Panic Disorder Severity Scale (PDSS) being the primary measure. The physiological indicators included respiratory sinus arrhythmia (RSA) and skin conductance, which respectively represent parasympathetic and sympathetic activity. RESULTS Considering all participants, PDSS scores significantly decreased over time, but the difference between the ICB and TAU groups did not reach statistical significance. Among the physiological indicators, resting-state RSA and RSA under relaxation showed significant between-group differences over time, with the ICB group demonstrating a more pronounced improvement in RSA. CONCLUSION In the context of existing pharmacological treatments, the benefits of ICB for panic disorder may not be observable through psychological indicators. However, it can lead to enhancement of parasympathetic activity as evidenced by the physiological indicators.
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Affiliation(s)
- Chia-Hao Ma
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hung-Yeh Chang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Hui-Chun Lee
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Yu-Fang Yu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Hsin-Shan Tien
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | | | | | - Yi-Ling Lin
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Huei-Mei Ma
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Kuan-Fu Lin
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
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Sumala S, Ekalaksananan T, Pientong C, Buddhisa S, Passorn S, Duangjit S, Janyakhantikul S, Suktus A, Bumrungthai S. The Association of HHV-6 and the TNF-α (-308G/A) Promotor with Major Depressive Disorder Patients and Healthy Controls in Thailand. Viruses 2023; 15:1898. [PMID: 37766304 PMCID: PMC10535374 DOI: 10.3390/v15091898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Major depressive disorder (MDD) is a silent global health problem that can lead to suicide. MDD development is suggested to result from numerous risk factors, including genetic factors. A precise tool for MDD diagnosis is currently not available. Recently, inflammatory processes have been identified as being strongly involved in MDD development and the reactivation of human herpesvirus type 6 (HHV-6), upregulating cytokines such as TNF-α, which are associated with MDD. Therefore, this study aimed to determine the association of HHV-6 with genetic factors, especially TNF-α mutation, in MDD patients and their relatives compared to healthy controls. The Patient Health Questionnaire (PHQ-9) was used to evaluate MDD status, and 471 oral buccal samples were investigated for HHV-6 infection and viral copy number by qPCR. TNF-α (-308G/A) gene mutation and the cytokines TNF-α, IL-6, and IL-10 were analyzed by high-resolution melting (HRM) analysis and enzyme-linked immunosorbent assay (ELISA). Whole-exome sequencing of buccal samples was performed to analyze for genetic factors. The results showed significantly higher HHV-6 positivities and viral loads in MDD patients (15/59 (25.67%) and 14,473 ± 16,948 copies/µL DNA) and their relatives (blood relatives 17/36 (47.22%) and 8146 ± 5656 copies/µL DNA); non-blood relatives 7/16 (43.75%) and 20,721 ± 12,458 copies/µL DNA) compared to the healthy population (51/360 (14.17%) and 6303 ± 5791 copies/µL DNA). The TNF-α (-308G/A) mutation showed no significant difference. Surprisingly, 12/26 (46.15%) participants with the TNF-α (-308G/A) mutation showed HHV-6 positivities at higher rates than those with wild-type TNF-α (-308G) (70/267 (26.22%)). HHV-6-positive participants with TNF-α (-308G/A) showed higher levels of TNF-α, IL-6, and IL-10 than those of negative control. Exome analysis revealed that common mutations in immune genes were associated with depression. Therefore, this study unveiled the novel association of inflammatory gene TNF-α (-308G/A) mutations with HHV-6 reactivation, which could represent a combined risk factor for MDD. This result could induce further research on MDD development and clinical applications.
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Affiliation(s)
- Sasiwimon Sumala
- Division of Biotechnology, School of Agriculture and Natural resources, University of Phayao, Phayao 56000, Thailand
| | - Tipaya Ekalaksananan
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- HPV & EBV and Carcinogenesis Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Chamsai Pientong
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- HPV & EBV and Carcinogenesis Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Surachat Buddhisa
- Department of Medical Technology, Faculty of Allied Health Sciences, Burapha University, Chonburi 20131, Thailand
| | - Supaporn Passorn
- Division of Biotechnology, School of Agriculture and Natural resources, University of Phayao, Phayao 56000, Thailand
| | - Sureewan Duangjit
- Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani 34190, Thailand
| | - Somwang Janyakhantikul
- Division of Biopharmacy, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani 34190, Thailand
| | - Areeya Suktus
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- HPV & EBV and Carcinogenesis Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Sureewan Bumrungthai
- HPV & EBV and Carcinogenesis Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
- Division of Biopharmacy, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani 34190, Thailand
- Division of Microbiology and Parasitology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand
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Chao KY, Chou CC, Chen CI, Lee SR, Cheng W. Prevalence and Comorbidity of Gender Dysphoria in Taiwan, 2010-2019. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1009-1017. [PMID: 36692628 PMCID: PMC10102133 DOI: 10.1007/s10508-022-02500-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 05/11/2023]
Abstract
Gender dysphoria (GD) is a condition in which a person exhibits marked incongruence between their expressed or experienced gender and their sex assigned at birth. The last survey of individuals with GD in Taiwan was conducted approximately 10 years ago. In this study, we investigated the prevalence of GD in Taiwan within the last 10 years as well as comorbidities. A retrospective medical record review was performed for all patients in the database of the Health and Welfare Data Science Center covered by National Health Insurance in Taiwan from January 2010 until December 2019. The study population of persons with GD was defined as individuals who had been diagnosed with transsexualism (transgender or transsexual) or gender identity disorders. Our review found case numbers and prevalence of GD in 2019 were about twice that of patients in 2010 for both assigned males and assigned females at birth. Case numbers for 2010 versus 2019 were 440 versus 867 for assigned males at birth, and 189 versus 386 for assigned females at birth. The 1-year prevalence for 2010 versus 2019 was 3.8/100,000 versus 7.4/100,000 for assigned males at birth, and 1.6/100,000 versus 3.2/100,000 for assigned females at birth. Comorbidities of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and psychosis were more likely in children with GD younger than 12 years of age; comorbid depression was more likely in adolescents and adults with GD. Improvements in social and mental health support should be provided to help address these comorbidities of ADHD, ASD, and depression among individuals with GD.
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Affiliation(s)
- Kuo-Yu Chao
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Chiang Chou
- Department of Psychiatry, Centro Hospitalar Conde de São Januário, Sé, Macau SAR, China
| | - Ching-I Chen
- Department of Psychiatry, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Shu-Ru Lee
- Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan
| | - Wei Cheng
- Department of Pathology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan.
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan.
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Tseng MCM, Chien LN, Tu CY, Zheng CM, Liu HY. Risk of dialysis and renal diseases in patients with anorexia nervosa in Taiwan. Int J Eat Disord 2023; 56:991-1000. [PMID: 36680495 DOI: 10.1002/eat.23899] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To investigate the incidence and risk of renal-related complications in a nationwide cohort of Taiwanese patients with anorexia nervosa (AN). METHOD This longitudinal cohort study analyzed the data of 43,951 individuals-comprising 2091 patients with AN and their controls matched (1:20) using propensity scores according to sex, age, degree of urbanization of residence, socioeconomic status, and year of diagnosis-from a population-based health insurance database; the study lasted 16 years. We used Kaplan-Meier curves to estimate the cumulative incidence of renal events. We also performed Cox proportional regression and constructed a risk model with death as a competing event (both adjusted for basic characteristics, renal diseases, and psychiatric comorbidities) to examine the risk of dialysis and renal outcomes in the AN group relative to the control group. RESULTS In total, 204 and 10 patients with AN had renal-related outcomes and end-stage renal disease (ESRD), respectively. The cumulative incidence rates of all renal outcomes and ESRD in the AN group were 10.72% and .64%, respectively, at 10-year follow-up. Compared with the control group, the AN group had a significantly higher risk of acute dialysis (adjusted hazard ratio 2.10 [95% confidence interval 1.19-3.68]), hypokalemia, hypovolemia, nephritis, acute renal failure, and chronic renal failure. The AN group did not have a significantly higher risk of ESRD. DISCUSSION The elevated risks of acute dialysis and some renal outcomes in AN highlight the importance of monitoring electrolyte imbalance and renal malfunctioning. PUBLIC SIGNIFICANCE Malnutrition and purging behaviors may cause renal complications in patients with AN. In this longitudinal cohort study, we found that the 10-year cumulative incidence of all renal outcomes in AN was 10.72%, and that patients with AN had a two-fold higher risk of overall renal outcomes compared with those without AN. Our findings imply that weight restoration and ceasing purging behaviors are crucial for recovery from AN.
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Affiliation(s)
- Mei-Chih Meg Tseng
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Li-Nien Chien
- Institute of Health and Welfare Policy, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Chao-Ying Tu
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
| | - Cai-Mei Zheng
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
| | - Hung-Yi Liu
- Health Data Analytics and Statistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
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Li Y, Tian Y, Fan F, Chen J, Fu F, Zhu R, Wei D, Tang S, Zhou H, Wang D, Zhang X. Prevalence, demographics, and clinical correlates of antisocial personality disorder in Chinese methamphetamine patients. Am J Addict 2023; 32:47-53. [PMID: 36403120 DOI: 10.1111/ajad.13361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Antisocial personality disorder (ASPD) is very common among methamphetamine (MA) patients, but very few studies have been conducted in China. This study aimed to investigate the prevalence and clinical correlates of ASPD among Chinese MA patients. METHODS We recruited 627 MA patients and collected demographic and MA use data through one-on-one semi-structured interviews. ASPD was measured by the Mini International Neuropsychiatric Interview (M.I.N.I.). The Desires for Drug Questionnaire (DDQ) and visual analog scale (VAS) were used to assess drug cravings. RESULTS The prevalence rate of ASPD among MA patients was 27.59% (173/627). Patients with ASPD had greater age at the first onset, duration of MA use, length of abstinence, VAS, DDQ desire and intention, negative reinforcement, and total DDQ scores than patients without ASPD. Stepwise binary logistic regression analysis revealed that age, age at the first onset, length of abstinence, and DDQ-negative reinforcement were independently associated with ASPD in MA patients. DISCUSSION AND CONCLUSIONS Our findings suggest that the prevalence of ASPD is high among Chinese MA patients. Furthermore, some demographic and clinical variables are associated with ASPD in MA patients. SCIENTIFIC SIGNIFICANCE We focused our study on the clinical profile of ASPD and the reasons for its high prevalence in Chinese methamphetamine patients. We identified several demographic and clinical variables as correlates of the occurrence of ASPD in methamphetamine patients, which provides evidence for ASPD comorbidity in methamphetamine patients.
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Affiliation(s)
- Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Shan JC, Chen IM, Lin PH, Chen WJ, Liao SC, Lee MB, Kuo PH. Associations between lifetime mental disorders and suicidal behaviors: findings from the Taiwan psychiatry morbidity survey. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1579-1589. [PMID: 35150308 DOI: 10.1007/s00127-022-02236-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/22/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND East Asia has high suicide rates but low prevalence of mental disorders. We examined the associations between prior lifetime mental disorders (mood disorders, anxiety disorders, substance use disorders, and impulse control disorders) and subsequent suicidal behaviors (suicidal ideation and attempts in the general population and suicide plans, planned attempts, and unplanned attempts in suicidal ideators) in Taiwan. METHODS This survey applied the World Mental Health Survey Composite International Diagnostic Interview to a population representative sample of noninstitutionalized adults between 2003 and 2005. Odds ratios (ORs) obtained using discrete-time survival analysis were used to estimate population attributable fractions (PAFs) of suicidal behaviors due to lifetime mental disorders. RESULTS Lifetime mental illness was a significant risk factor for subsequent suicidal behaviors (except unplanned attempts among ideators) despite the relatively low prevalence of mental disorders in people with suicidality (16.1%-35.0%). Each diagnosis increased the odds of suicidal ideation. In terms of acting on suicidal ideation, mood disorders were most strongly associated with having plans (OR = 10.0; 95% confidence interval, CI 4.3-21.1), whereas substance use disorders most strongly with either planned (OR = 27.3; 95% CI 6.3-118.5) or unplanned attempts (OR = 14.5; 95% CI 1.7-121.5). PAFs of all mental disorders on suicidality lay between 20 and 30% (except 11% of unplanned attempts among ideators). Mood, anxiety, and substance use disorders had higher PAFs than impulse control disorders. CONCLUSIONS In addition to mood disorders, considering anxiety and substance use disorders is essential in devising population-based suicide prevention strategies.
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Affiliation(s)
- Jia-Chi Shan
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan
| | - Po-Hsien Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan
- Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Wei J Chen
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
| | - Ming-Been Lee
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan.
- Department of Psychiatry, Shin Kong Wu Ho Su Hospital, Taipei, Taiwan.
| | - Po-Hsiu Kuo
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 100, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17, Xuzhou Rd., Zhongzheng Dist., Taipei, 100, Taiwan
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Asthma and early smoking associated with high risk of panic disorder in adolescents and young adults. Soc Psychiatry Psychiatr Epidemiol 2022; 57:583-594. [PMID: 34279695 DOI: 10.1007/s00127-021-02146-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Studies have reported a strong link between asthma and panic disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and panic disorder during adolescence and early adulthood. METHODS A total of 162,766 participants aged 11-16 years were categorized into asthma and nonasthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant's gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and panic disorder. RESULTS Our findings revealed that asthma increased the risk of panic disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.70, 95% CI 1.28-2.26). Hospitalizations or visits to the emergency department for asthma exhibited a dose-response effect on the panic disorder (adjusted HR: 2.07, 95% CI 1.30-3.29). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for panic disorder (adjusted HR: 4.95, 95% CI 1.23-19.90). CONCLUSIONS Patients newly diagnosed with asthma had a 1.7-times higher risk of developing panic disorder. Smoking during late childhood or adolescence increased the risk for developing the panic disorder in patients with asthma.
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Shan JC, Chen IM, Lin PH, Chen WJ, Liao SC, Lee MB, Kuo PH. Prevalence and correlates of suicidal behaviors in the Taiwan Psychiatric Morbidity Survey. J Formos Med Assoc 2021; 121:1238-1247. [PMID: 34879975 DOI: 10.1016/j.jfma.2021.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/08/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND/PURPOSE Suicide is a huge global health burden. High suicide rates with a low prevalence of major depressive disorder were reported in East Asia. This study aimed to investigate the prevalence of suicidal behaviors in relation to the demographic characteristics and major depressive disorder in Taiwan. METHODS This study was based on the Taiwan Psychiatric Morbidity Survey, conducted between 2003 and 2005, a survey of common psychiatric disorders in a nationally representative sample of non-institutionalized civilians aged 18 or above. Demographic data, major depressive disorder, and suicidal behaviors were ascertained by a face-to-face interview using the paper version of the World Mental Health Survey Composite International Diagnostic Interview. RESULTS According to the total sample of 10,135 participants, the lifetime prevalence of suicidal ideation, plans and attempts was 7.52% (S.E = 0.46%), 1.31% (S.E. = 0.16%) and 1.29% (S.E. = 0.16%), respectively. Among suicide ideators, the conditional probability of making a suicide plan was 17.39% (S.E. = 1.92%), and a suicide attempt 17.16% (S.E. = 2.15%). Age ≤ 40, female sex, and major depressive disorder were related to a higher risk of suicidal behaviors in the general population; the former two were associated with further developing suicide attempts and the latter one developing plans among ideators. CONCLUSION Despite low prevalence, major depressive disorder remained a significant risk factor for suicidal behaviors in Taiwan.
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Affiliation(s)
- Jia-Chi Shan
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Po-Hsien Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Wei J Chen
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
| | - Ming-Been Lee
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Psychiatry, Shin Kong Wu Ho Su Hospital, Taipei, Taiwan.
| | - Po-Hsiu Kuo
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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10
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Peng K, Zhou L, Liu X, Ouyang M, Gong J, Wang Y, Shi Y, Chen J, Li Y, Sun M, Wang Y, Lin W, Yuan S, Wu B, Si L. Who is the main caregiver of the mother during the doing-the-month: is there an association with postpartum depression? BMC Psychiatry 2021; 21:270. [PMID: 34034695 PMCID: PMC8147344 DOI: 10.1186/s12888-021-03203-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine the relationship between the main caregiver during the "doing-the-month" (a traditional Chinese practice which a mother is confined at home for 1 month after giving birth) and the risk of postpartum depression (PPD) in postnatal women. METHODS Participants were postnatal women stayed in hospital and women who attended the hospital for postpartum examination, at 14-60 days after delivery from November 1, 2013 to December 30, 2013. Postpartum depression status was assessed using the Edinburgh Postnatal Depression Scale. Univariate and multivariable logistic regressions were used to identify the associations between the main caregiver during "doing-the-month" and the risk of PPD in postnatal women. RESULTS One thousand three hundred twenty-five postnatal women with a mean (SD) age of 28 (4.58) years were included in the analyses. The median score (IQR) of PPD was 6.0 (2, 10) and the prevalence of PPD was 27%. Of these postnatal women, 44.5% were cared by their mother-in-law in the first month after delivery, 36.3% cared by own mother, 11.1% by "yuesao" or "maternity matron" and 8.1% by other relatives. No association was found between the main caregivers and the risk of PPD after multiple adjustments. CONCLUSIONS Although no association between the main caregivers and the risk of PPD during doing-the-month was identified, considering the increasing prevalence of PPD in Chinese women, and the contradictions between traditional culture and latest scientific evidence for some of the doing-the-month practices, public health interventions aim to increase the awareness of PPD among caregivers and family members are warranted.
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Affiliation(s)
- Ke Peng
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China ,grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lin Zhou
- Shenzhen Centre for Disease Control and Prevention, Shenzhen, China
| | - Xiaoying Liu
- grid.1013.30000 0004 1936 834XSchool of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Menglu Ouyang
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Jessica Gong
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Yuanyuan Wang
- grid.48815.300000 0001 2153 2936Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yu Shi
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Jiani Chen
- grid.259384.10000 0000 8945 4455University International College, Macau University of Science and Technology, Macau, China
| | - Yichong Li
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Mingfan Sun
- National Clinical Research Center for Cardiovascular Diseases, Shenzhen, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China
| | - Yueyun Wang
- Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.
| | - Wei Lin
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shixin Yuan
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Bo Wu
- grid.284723.80000 0000 8877 7471Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lei Si
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia ,grid.89957.3a0000 0000 9255 8984School of Health Policy & Management, Nanjing Medical University, Nanjing, China
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11
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Barkhatova AN. [About diagnosis and therapy of bipolar disorder]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:155-159. [PMID: 33834734 DOI: 10.17116/jnevro2021121031155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The author describes diagnostic criteria and clinical symptoms of bipolar affective disorder (BAD) and summarizes the results of clinical studies on using modern antipsychotics to optimize BAD treatment. Preliminary recommendations for the use of aripiprazole in treatment of BAD, including exacerbation therapy and long-term maintenance therapy to prevent relapses, are presented.
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12
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Preti A, Demontis R, Cossu G, Kalcev G, Cabras F, Moro MF, Romano F, Balestrieri M, Caraci F, Dell'Osso L, Di Sciascio G, Drago F, Hardoy MC, Roncone R, Faravelli C, Gonzalez CIA, Angermayer M, Carta MG. The lifetime prevalence and impact of generalized anxiety disorders in an epidemiologic Italian National Survey carried out by clinicians by means of semi-structured interviews. BMC Psychiatry 2021; 21:48. [PMID: 33472585 PMCID: PMC7816458 DOI: 10.1186/s12888-021-03042-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 01/05/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is one of the most reported diagnoses in psychiatry, but there is some discrepancy between the cases identified in community studies and those identified in tertiary care. This study set out to evaluate whether the use of clinicians as interviewers may provide estimates in a community survey close to those observed in primary or specialized care. METHODS This is a community survey on a randomly selected sample of 2338 adult subjects. The Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS) was administered by clinicians, providing lifetime diagnosis based on the DSM-IV-TR. Health-related quality of life (HR-QoL) was measured with the Short-Form Health Survey (SF-12). RESULTS Overall, 55 (2.3%) subjects met the criteria for GAD, with greater prevalence in women (3.6%) than in men (0.9%): OR = 4.02; 95%CI: 1.96-8.26. Up to 40% of those with GAD had at least another diagnosis of mood, anxiety, or eating disorders. The mean score of SF-12 in people with GAD was 32.33 ± 6.8, with a higher attributable burden than in other conditions except for major depressive disorder. CONCLUSIONS We found a relatively lower lifetime prevalence of GAD than in community surveys based on lay interviewers and a structured interview. The identified cases of GAD showed a strong impact on the quality of life regardless of co-morbidity and high risk in women, suggesting a profile similar to the one identified from studies in primary and specialized care.
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Affiliation(s)
- Antonio Preti
- University of Cagliari, Cagliari, Italy.
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, via Cherasco 15, 10126, Turin, Italy.
| | | | | | - Goce Kalcev
- Department of Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | | | | | | | | | - Filippo Caraci
- Department of Drug Sciences, University of Catania, Catania, Italy
- Oasi Research Institute-IRCCS, Troina, Italy
| | | | | | - Filippo Drago
- Department of Drug Sciences, University of Catania, Catania, Italy
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Dai YX, Tai YH, Chang YT, Chen TJ, Chen MH. Association between major depressive disorder and subsequent autoimmune skin diseases: A nationwide population-based cohort study. J Affect Disord 2020; 274:334-338. [PMID: 32469824 DOI: 10.1016/j.jad.2020.05.070] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) has been implicated as a risk factor for various immune-related disorders; however, the association between MDD and subsequent autoimmune skin diseases (ASDs) remains unclear. This study aimed to investigate the association of MDD with risk of subsequent ASDs. METHODS Subjects were recruited from the National Health Insurance Research Database in Taiwan. We included 222,522 patients with MDD and 890,088 matched controls to assess the risk of developing ASDs. RESULTS After controlling for confounders, we found an increased risk of ASDs among the patients with MDD (adjusted hazard ratio [aHR], 10.41; 95% CI, 9.62-11.42) compared to matched controls. Subgroup analyses showed that MDD patients had a significantly increased risk of developing psoriasis (aHR, 12.01; 95% CI, 10.37-13.91), lichen planus (aHR, 11.84; 95% CI, 8.90-15.75), alopecia areata (aHR, 11.61; 95% CI, 9.92-13.59), morphea (aHR, 6.03; 95% CI, 2.47-14.73), autoimmune bullous diseases (aHR, 7.67; 95% CI, 5.94-9.90), hidradenitis suppurativa (aHR, 8.45; 95% CI, 3.61-19.74), vitiligo (aHR, 7.24; 95% CI, 5.65-9.28), lupus erythematosus (aHR, 11.30; 95% CI, 9.21-13.86), systemic sclerosis (aHR, 8.07; 95% CI, 4.30-15.14), Sjogren's syndrome (aHR, 6.71; 95% CI, 5.29-8.50), and dermatomyositis (aHR, 14.44; 95% CI, 5.55-37.55). CONCLUSIONS Patients with MDD had an increased risk of developing ASDs as compared to the controls. Further studies are needed to better understand the underlying mechanisms.
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Affiliation(s)
- Ying-Xiu Dai
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Hsuan Tai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yun-Ting Chang
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
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Abstract
The conceptualisation and investigation of panic disorder have developed on two different axes, medical and psychological, for more than 100 years. In medicine, reports of acute anxiety attacks with cardiac, circulatory, and respiratory symptoms date back to the French Revolution, and terms such as “soldier's heart”, “neurocirculatory neurasthenia”, or “hyperventilation syndrome” have been used to describe them. In psychological medicine, anxiety attacks were first reported by Domrich in 1849. These attacks, which were thought to be caused by strong emotions, were classified mainly within neurasthenia, until Freud created the concept of anxiety neurosis in 1895.
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15
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Dai YX, Tai YH, Chen CC, Chang YT, Chen TJ, Chen MH. Bidirectional association between alopecia areata and major depressive disorder among probands and unaffected siblings: A nationwide population-based study. J Am Acad Dermatol 2020; 82:1131-1137. [PMID: 32007291 DOI: 10.1016/j.jaad.2019.11.064] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/23/2019] [Accepted: 11/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alopecia areata (AA) has long been associated with major depressive disorder (MDD). However, most evidence to date has derived from cross-sectional or case-control studies. OBJECTIVE To investigate the bidirectional association between AA and MDD among probands and unaffected siblings. METHODS Study participants were recruited from the National Health Insurance Research Database in Taiwan. We included 2123 probands with AA, 2298 unaffected siblings, and 9192 matched controls to assess the risk of MDD. We included 16,543 probands with MDD, 17,352 unaffected siblings, and 69,408 matched controls to assess the risk of AA. The Breslow-Cox model was used to calculate the adjusted relative risk. RESULTS Compared with controls, AA probands and unaffected siblings had adjusted relative risks of 8.22 (95% confidence interval [CI], 6.41-10.54) and 2.55 (95% CI, 1.91-3.40), respectively, for MDD. MDD probands and unaffected siblings had adjusted relative risks for AA of 1.66 (95% CI, 1.24-2.22) and 1.64 (95% CI, 1.27-2.12), respectively. LIMITATION The National Health Insurance Research Database lacked information on disease severity, body mass index, smoking habit, alcohol consumption, and stressful life events. CONCLUSION Our study demonstrated a bidirectional association between AA and MDD among probands and unaffected siblings, thus suggesting shared familial mechanisms underlying AA and MDD.
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Affiliation(s)
- Ying-Xiu Dai
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Hsuan Tai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chen
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yun-Ting Chang
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
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16
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Zucker KJ. Epidemiology of gender dysphoria and transgender identity. Sex Health 2019; 14:404-411. [PMID: 28838353 DOI: 10.1071/sh17067] [Citation(s) in RCA: 228] [Impact Index Per Article: 45.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 05/22/2017] [Indexed: 01/11/2023]
Abstract
This review provides an update on the epidemiology of gender dysphoria and transgender identity in children, adolescents and adults. Although the prevalence of gender dysphoria, as it is operationalised in the fifth edtion of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), remains a relatively 'rare' or 'uncommon' diagnosis, there is evidence that it has increased in the past couple of decades, perhaps reflected in the large increase in referral rates to specialised gender identity clinics. In childhood, the sex ratio continues to favour birth-assigned males, but in adolescents, there has been a recent inversion in the sex ratio from one favouring birth-assigned males to one favouring birth-assigned females. In both adolescents and adults, patterns of sexual orientation vary as a function of birth-assigned sex. Recent studies suggest that the prevalence of a self-reported transgender identity in children, adolescents and adults ranges from 0.5 to 1.3%, markedly higher than prevalence rates based on clinic-referred samples of adults. The stability of a self-reported transgender identity or a gender identity that departs from the traditional male-female binary among non-clinic-based populations remains unknown and requires further study.
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17
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Goodman M, Adams N, Corneil T, Kreukels B, Motmans J, Coleman E. Size and Distribution of Transgender and Gender Nonconforming Populations: A Narrative Review. Endocrinol Metab Clin North Am 2019; 48:303-321. [PMID: 31027541 DOI: 10.1016/j.ecl.2019.01.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Accurate estimates of the number and proportion of transgender and gender nonconforming people in a population are necessary for developing data-based policy and for planning and funding of health care delivery and research. The wide range of estimates reported in the literature is attributable primarily to differences in definitions. Other sources of variability include diverse cultural and geographic settings and important secular trends. The transgender and gender nonconforming population is undergoing rapid changes in size and demographic characteristics. More accurate and precise estimates will be available when population censuses collect data on sex assigned at birth and gender identity.
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Affiliation(s)
- Michael Goodman
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road, Northeast, CNR 3021, Atlanta, GA 30322, USA.
| | | | - Trevor Corneil
- University of British Columbia, School of Population and Public Health, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| | - Baudewijntje Kreukels
- Department of Medical Psychology, VU University Medical Center, MF-H243, Van der Boechorststraat 7, 1007 MB Amsterdam, Netherlands
| | - Joz Motmans
- Ghent University Hospital, Blandijnberg 2, 9000 Ghent, Belgium
| | - Eli Coleman
- University of Minnesota, 180 West Bank Office Building, 1300 S Second Street, Minneapolis, MN 55454, USA
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18
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Ding G, Niu L, Vinturache A, Zhang J, Lu M, Gao Y, Pan S, Tian Y. "Doing the month" and postpartum depression among Chinese women: A Shanghai prospective cohort study. Women Birth 2019; 33:e151-e158. [PMID: 31060983 DOI: 10.1016/j.wombi.2019.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND The Chinese postpartum custom of "doing the month" characterized by generous social support available through the traditional cultural practices was considered to protect women from postpartum depression in early puerperium. METHODS This study used data from the Shanghai Birth Cohort, a study of 2615 postpartum women from Shanghai, China, that was conducted between 2013 and 2016. Detailed information on the traditional "doing the month" practices and the on the Edinburgh Postnatal Depression Scale scores was collected from questionnaires administered on the 42nd day after childbirth. Logistic regression models were used to examine the association between the adopting traditional puerperium practices and postpartum depression. RESULTS The estimated prevalence of postpartum depression in women from the Shanghai area in China was 11.8% (n = 308) at six weeks postpartum. Women who went outside their homes during the first month postpartum showed higher risks of postpartum depression compared with those who never left the house (1-2 times: OR = 1.9, 95% CI = 1.4-2.4; 3-5 times: OR = 2.3, 95% CI = 1.5-3.5; ≥6 times: OR = 2.5, 95% CI = 1.2-5.1). Women with average sleep of 6 h or less per night were more likely to suffer from postpartum depression compared with those who slept 8 h (6 h: OR = 1.7, 95% CI = 1.2-2.4; less than 6 h : OR = 3.3, 95% CI = 2.2-5.0). Women who opened the house windows most of the time exhibited decreased risks of postpartum depression compared to those who never or rarely opened the windows (often: OR = 0.6, 95% CI = 0.4-0.9; always: OR = 0.4, 95% CI = 0.3-0.7). CONCLUSIONS Our results suggested that not all the activities of "doing the month" provided protection against developing PPD. This study emphasized the need for flexibility to fit and adjust the ritual into the modern life to enhance the positive effects of traditional practices on maternal health.
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Affiliation(s)
- Guodong Ding
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
| | - Lei Niu
- Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Angela Vinturache
- Department Obstetrics & Gynecology, St. George's Hospital, St. George's University Hospitals NHS Foundation Trust, London, UK.
| | - Jun Zhang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Lu
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
| | - Yu Gao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Shuming Pan
- Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ying Tian
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Wallace R. Culture and the Trajectories of Developmental Pathology: Insights from Control and Information Theories. Acta Biotheor 2018; 66:79-112. [PMID: 29616380 DOI: 10.1007/s10441-018-9320-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/30/2018] [Indexed: 12/17/2022]
Abstract
Cognition in living entities-and their social groupings or institutional artifacts-is necessarily as complicated as their embedding environments, which, for humans, includes a particularly rich cultural milieu. The asymptotic limit theorems of information and control theories permit construction of a new class of empirical 'regression-like' statistical models for cognitive developmental processes, their dynamics, and modes of dysfunction. Such models may, as have their simpler analogs, prove useful in the study and re-mediation of cognitive failure at and across the scales and levels of organization that constitute and drive the phenomena of life. These new models particularly focus on the roles of sociocultural environment and stress, in a large sense, as both trigger for the failure of the regulation of bio-cognition and as 'riverbanks' determining the channels of pathology, with implications across life-course developmental trajectories. We examine the effects of an embedding cultural milieu and its socioeconomic implementations using the 'lenses' of metabolic optimization, control system theory, and an extension of symmetry-breaking appropriate to information systems. A central implication is that most, if not all, human developmental disorders are fundamentally culture-bound syndromes. This has deep implications for both individual treatment and public health policy.
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Lim MSM, Rogers RD. Chinese Beliefs in Luck are Linked to Gambling Problems via Strengthened Cognitive Biases: A Mediation Test. J Gambl Stud 2018; 33:1325-1336. [PMID: 28434053 DOI: 10.1007/s10899-017-9690-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Problematic patterns of gambling and their harms are known to have culturally specific expressions. For ethnic Chinese people, patterns of superstitious belief in this community appear to be linked to the elevated rates of gambling-related harms; however, little is known about the mediating psychological mechanisms. To address this issue, we surveyed 333 Chinese gamblers residing internationally and used a mediation analysis to explore how gambling-related cognitive biases, gambling frequency and variety of gambling forms ('scope') mediate the association between beliefs in luck and gambling problems. We found that cognitive biases and scope were significant mediators of this link but that the former is a stronger mediator than the latter. The mediating erroneous beliefs were not specific to any particular type of cognitive bias. These results suggest that Chinese beliefs in luck are expressed as gambling cognitive biases that increase the likelihood of gambling problems, and that biases that promote gambling (and its harms) are best understood within their socio-cultural context.
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Affiliation(s)
- Matthew S M Lim
- Department of Psychology, National University of Singapore, 9 Arts Link, Singapore, 117570, Singapore.
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21
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Yoon H, Oh DJ, Suh HS, Lee KU, Lim SW, Lee JY, Yang JC, Lee JH, Ha J, Lee BH, Kang SG, Yoon HK, Moon J, Bae SM, Kwon Y, Kim HC, Oh KS. Korean Guidelines for the Pharmacological Treatment of Social Anxiety Disorder: Initial Treatment Strategies. Psychiatry Investig 2018; 15:147-155. [PMID: 29475215 PMCID: PMC5900408 DOI: 10.30773/pi.2017.05.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/15/2017] [Accepted: 05/01/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The aim of the present study was to provide clinical consensus and evidence regarding initial treatment strategies for the pharmacological treatment of social anxiety disorder (SAD) in Korea. METHODS We prepared a questionnaire to derive a consensus from clinicians regarding their preference for the pharmacological treatment of SAD in Korea. Data regarding medication regimens and psychotropic drugs used during initial treatment, the doses used, and the pharmacological treatment duration were obtained. Responses were obtained from 66 SAD experts, and their opinions were classified into three categories (first-line, second-line, third-line) using a chi-square analysis. RESULTS Clinicians agreed upon first-line regimens for SAD involving monotherapy with selective serotonin reuptake inhibitors (SSRIs) or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine, or combined therapy using antidepressants with betablockers or benzodiazepines on a standing or as-needed basis. First-line psychotropic drug choices for initial treatment included the following: escitalopram, paroxetine, sertraline, venlafaxine, and propranolol. The medication dosage used by domestic clinicians was found to be comparable with foreign guidelines. Domestic clinicians tended to make treatment decisions in a shorter amount of time and preferred a similar duration of maintenance treatment for SAD when compared with foreign clinicians. CONCLUSION This study may provide significant information for developing SAD pharmacotherapy guidelines in Korea, especially in the early stage of treatment.
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Affiliation(s)
- Hyungkun Yoon
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Jae Oh
- Miso Psychiatric Clinic, Seoul, Republic of Korea
| | - Ho-Suk Suh
- Department of Psychiatry, School of Medicine, CHA University, CHA Gangnam Medical Center, Seoul, Republic of Korea
| | - Kyoung-Uk Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea
| | - Se-Won Lim
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | - Jong-Chul Yang
- Department of Psychiatry, Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Jae-Hon Lee
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.,Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Juwon Ha
- Yonsei Forest Mental Health Clinic, Seoul, Republic of Korea
| | - Bun-Hee Lee
- Maum & Maum Clinic, Seoul, Republic of Korea
| | - Seung-Gul Kang
- Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jihyun Moon
- Miso Psychiatric Clinic, Seoul, Republic of Korea
| | - Seung-Min Bae
- Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea
| | - Youngdo Kwon
- Smart Psychiatry Clinic, Sejong, Republic of Korea
| | - Hyun-Chung Kim
- Department of Psychiatry, National Medical Center of Korea, Seoul, Republic of Korea
| | - Kang Seob Oh
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Huang CJ, Hsieh HM, Tu HP, Jiang HJ, Wang PW, Lin CH. Major depressive disorder in patients with type 2 diabetes mellitus: Prevalence and clinical characteristics. J Affect Disord 2018; 227:141-148. [PMID: 29073576 DOI: 10.1016/j.jad.2017.09.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 06/12/2017] [Accepted: 09/24/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND This study investigated the prevalence of major depressive disorder (MDD) among Taiwanese patients with type 2 diabetes mellitus (T2DM). METHODS We enrolled patients with at least one service claim for ambulatory or inpatient care with a principal diagnosis of MDD and at least two service claims for ambulatory care or one service claim for inpatient care with a principal diagnosis of T2DM, as listed in Taiwan's National Health Insurance database. RESULTS We enrolled 715,756 people from the general population (GP), 61,589 patients with T2DM but without MDD, and 778 patients with both T2DM and MDD. The prevalence of MDD increased from 0.70% to 1.25% in the patients with T2DM, whereas it increased from 0.25% to 0.67% in the GP from 2000 to 2010. The higher prevalence of MDD was associated with the female sex, residing in the southern regions of Taiwan, and having comorbidities of cerebrovascular disease and anxiety disorder as well as higher comorbidity severity (Charlson comorbidity index, 1-2 and > 2). LIMITATIONS One limitation is the use of secondary data on diagnoses of MDD and T2DM. Another limitation is that we could not access some crucial related variables. CONCLUSIONS The prevalence of MDD was higher in the patients with T2DM than in the GP. In this study, the prevalence of MDD in the patients with T2DM was lower than that reported in Western countries.
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Affiliation(s)
- Chun-Jen Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan; Department of Psychiatry, Faculty of medicine, College of medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - He-Jiun Jiang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan; Department of Psychiatry, Faculty of medicine, College of medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Hua Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan; Department of Psychiatry, Faculty of medicine, College of medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Coid J, Hu J, Kallis C, Ping Y, Zhang J, Hu Y, Bui L, Ullrich S, Bebbington P. A cross-national comparison of violence among young men in China and the UK: psychiatric and cultural explanations. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1267-1279. [PMID: 28801755 PMCID: PMC5617870 DOI: 10.1007/s00127-017-1420-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 07/14/2017] [Indexed: 11/17/2022]
Abstract
PURPOSE Public health psychiatry has a key role in violence prevention. Cross-national comparisons of violence and associated psychiatric morbidity can indicate targets for preventive interventions. METHOD Data on young adult men in households, 18-34 years, were drawn from the Second Men's Modern Lifestyles survey in Great Britain (n = 2046) and from a corresponding survey in Chengdu, China (n = 4132), using a translated questionnaire. Binary logistic regression models were carried out to estimate the cross-national differences for different types of violence and to identify explanatory variables. RESULTS Chinese men were less likely to report violence in the past 5 years (AOR 0.59, 95% CI 0.48-0.72, P < 0.001). All levels of violence were lower among Chinese men except intimate partner violence (AOR 2.43, 95% CI 1.65-3.59, P < 0.001) and a higher proportion of Chinese men were only violent towards their partners (AOR 7.90, 95% CI 3.27-19.07, P < 0.001). CONCLUSIONS Cross-national differences were explained by British men's reports of early violence persisting into adulthood, confidence in fighting ability, perception that violence is acceptable behaviour, and experience of violent victimization. More British men screened positive for antisocial personality disorder and substance misuse. Attitudes which condone violence and a serious problem of alcohol-related, male-on-male violence are key targets for preventive interventions among British men. The higher prevalence of life course-persistent antisocial behaviour among British men is of concern and requires further investigation. Higher prevalence of intimate partner violence among Chinese men reflects patriarchal approaches to conflict resolution and confirms an important public health problem in China which requires further cross-national investigation.
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Affiliation(s)
- Jeremy Coid
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Garrod Building, Turner Street, London, E1 2AD, UK
| | - Junmei Hu
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Evidence Science, China University of Political Science and Law, Ministry of Education, Beijing, 102249, China
| | - Constantinos Kallis
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Garrod Building, Turner Street, London, E1 2AD, UK
| | - Yuan Ping
- West China School of Public Health, Sichuan University, Chengdu, 610041, China
| | - Juying Zhang
- West China School of Public Health, Sichuan University, Chengdu, 610041, China
| | - Yueying Hu
- Chengdu Academy of Social Sciences, Chengdu, 610031, China
| | - Laura Bui
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Garrod Building, Turner Street, London, E1 2AD, UK
| | - Simone Ullrich
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Garrod Building, Turner Street, London, E1 2AD, UK.
| | - Paul Bebbington
- Division of Psychiatry, University College London, London, W1T 7NF, UK
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Chang WC, Wong CSM, Chen EYH, Lam LCW, Chan WC, Ng RMK, Hung SF, Cheung EFC, Sham PC, Chiu HFK, Lam M, Lee EHM, Chiang TP, Chan LK, Lau GKW, Lee ATC, Leung GTY, Leung JSY, Lau JTF, van Os J, Lewis G, Bebbington P. Lifetime Prevalence and Correlates of Schizophrenia-Spectrum, Affective, and Other Non-affective Psychotic Disorders in the Chinese Adult Population. Schizophr Bull 2017; 43:1280-1290. [PMID: 28586480 PMCID: PMC5737409 DOI: 10.1093/schbul/sbx056] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Lifetime prevalence of psychotic disorders varies widely across studies. Epidemiological surveys have rarely examined prevalences of specific psychotic disorders other than schizophrenia, and the majority used a single-phase design without employing clinical reappraisal interview for diagnostic verification. The current study investigated lifetime prevalence, correlates and service utilization of schizophrenia-spectrum, affective, and other non-affective psychotic disorders in a representative sample of community-dwelling Chinese adult population aged 16-75 years (N = 5719) based on a territory-wide, population-based household survey for mental disorders in Hong Kong. The survey adopted a 2-phase design comprising first-phase psychosis screening and second-phase diagnostic verification incorporating clinical information from psychiatrist-administered semi-structured interview and medical record review to ascertain DSM-IV lifetime diagnosis for psychotic disorders. Data on sociodemographics, psychosocial characteristics and service utilization were collected. Our results showed that lifetime prevalence was 2.47% for psychotic disorder overall, 1.25% for schizophrenia, 0.15% for delusional disorder, 0.38% for psychotic disorder not otherwise specified, 0.31% for bipolar disorder with psychosis, and 0.33% for depressive disorder with psychosis. Schizophrenia-spectrum disorder was associated with family history of psychosis, cigarette smoking and variables indicating socioeconomic disadvantage. Victimization experiences were significantly related to affective psychoses and other non-affective psychoses. Around 80% of participants with any psychotic disorder sought some kind of professional help for mental health problems in the past year. Using comprehensive diagnostic assessment involving interview and record data, our results indicate that approximately 2.5% of Chinese adult population had lifetime psychotic disorder which represents a major public health concern.
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Affiliation(s)
- Wing Chung Chang
- Department of Psychiatry, the University of Hong Kong, Hong Kong,State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong,To whom correspondence should be addressed; Department of Psychiatry, Queen Mary Hospital, Pokfulam, Hong Kong; tel: 852-22554486, fax: 852-28551345, e-mail:
| | | | - Eric Yu Hai Chen
- Department of Psychiatry, the University of Hong Kong, Hong Kong,State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong
| | - Linda Chiu Wa Lam
- Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong
| | - Wai Chi Chan
- Department of Psychiatry, the University of Hong Kong, Hong Kong
| | | | - Se Fong Hung
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | | | - Pak Chung Sham
- Department of Psychiatry, the University of Hong Kong, Hong Kong,State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong
| | | | - Ming Lam
- Department of Psychiatry, Castle Peak Hospital, Hong Kong
| | | | - Tin Po Chiang
- Department of Psychiatry, Castle Peak Hospital, Hong Kong
| | - Lap Kei Chan
- Department of Psychiatry, Kwai Chung Hospital, Hong Kong
| | | | | | | | | | - Joseph Tak Fai Lau
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, Netherlands
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
| | - Paul Bebbington
- Division of Psychiatry, University College London, London, UK
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Sun LM, Liang JA, Lin CL, Sun S, Kao CH. Risk of mood disorders in patients with colorectal cancer. J Affect Disord 2017; 218:59-65. [PMID: 28458117 DOI: 10.1016/j.jad.2017.04.050] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 03/16/2017] [Accepted: 04/24/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND To assess the risk of mood disorders among patients with colorectal cancer (CRC), a population-based cohort study was performed using the Taiwanese National Health Insurance Research Database. METHODS The study cohort included 27242 patients diagnosed with CRC between January 1, 2000 and December 31, 2010. Four insurants from the general population without CRC were frequency matched to each case by age, sex, and index year/month to create the control group. Cox's proportional hazard regression model with hazard ratios (HRs) and 95% confidence intervals (CIs) was conducted to estimate the impact of CRC on the risk of mood disorders. RESULTS Patients with CRC exhibited a significantly higher risk of developing mood disorders (adjusted HR=3.05, 95% CI=2.89-3.20) compared with the control group. This phenomenon was also observed for each type of mood disorder (depression, bipolar disease and anxiety), as well as across different subgroups by patient characteristics. However, a follow-up time longer than 1 year was more likely to have significantly increased risks, and we unexpectedly found that some treatments in CRC patients tended to have a decreased risk of anxiety compared to their counterparts. CONCLUSION The findings of this population-based cohort study suggest that patients with CRC are at a higher risk of mood disorders, especially when follow-up time is longer than 1 year, but various treatments may inversely affect this association.
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Affiliation(s)
- Li-Min Sun
- Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Ji-An Liang
- Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 40447, Taiwan; Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Sean Sun
- Department of Wound Healing & Hyperbaric Center, Arrowhead Hospital, Glendale, AZ, USA
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 40447, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
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Gender differences in social anxiety disorder: A review. Clin Psychol Rev 2017; 56:1-12. [PMID: 28578248 DOI: 10.1016/j.cpr.2017.05.004] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 05/24/2017] [Accepted: 05/29/2017] [Indexed: 11/23/2022]
Abstract
Gender differences in social anxiety disorder (SAD) have not received much empirical attention despite the large body of research on the disorder, and in contrast to significant literature about gender differences in other disorders such as depression or posttraumatic stress disorder. To address this gap, we comprehensively reviewed the literature regarding gender differences in eight domains of SAD: prevalence, clinical presentation, functioning and impairment, comorbidity, course, treatment seeking, physiological arousal, and the oxytocin system. Findings from the present review indicate that women are more likely to have SAD and report greater clinical severity. Notwithstanding, men with the disorder may seek treatment to a greater extent. According to the present review, the course of SAD seems to be similar for men and women, and findings regarding gender differences in functional impairment and comorbidity are inconclusive. We highlight areas requiring future research and discuss the findings in the context of a number of theoretical perspectives. We believe that further research and integration of scientific findings with existing theories is essential in order to increase our understanding and awareness of gender differences in SAD, thus facilitating gender-sensitive and specifically-tailored interventions for both men and women with the disorder.
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Wang WC, Lu ML, Chen VCH, Ng MH, Huang KY, Hsieh MH, Hsieh MJ, McIntyre RS, Lee Y, Lee CTC. Asthma, corticosteroid use and schizophrenia: A nationwide population-based study in Taiwan. PLoS One 2017; 12:e0173063. [PMID: 28350822 PMCID: PMC5369699 DOI: 10.1371/journal.pone.0173063] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 02/14/2017] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Asthma and corticosteroid use have been implicated as possible risk factors for schizophrenia. The retrospective cohort study herein aimed to investigate the association between asthma, corticosteroid use, and schizophrenia. METHOD Longitudinal data (2000 to 2007) from adults with asthma (n = 50,046) and without asthma (n = 50,046) were compared on measures of schizophrenia incidence using Taiwan's National Health Insurance Research Database (NHIRD). Incidence of schizophrenia diagnosis (ICD-9 codes 295.XX) between 2000 and 2007 were compared between groups. Competing risk-adjusted Cox regression analyses were conducted, adjusting for sex, age, residence, socioeconomic status, corticosteroid use, outpatient and emergency room visit frequency, Charlson comorbidity index, and total length of hospital stays days for any disorder. RESULTS Of the 75,069 subjects, 238 received a diagnosis of schizophrenia. The mean (SD) follow-up interval for all subjects was 5.8 (2.3) years. After adjusting for potential confounding factors, asthma was associated with significantly greater hazard ratio for incident schizophrenia 1.40 (95% CI = 1.05, 1.87). Additional factors associated with greater incidence of schizophrenia were rural residence, lower economic status, and poor general health. Older age (i.e. ≥65 years) was negatively associated with schizophrenia incidence. Corticosteroid use was not associated with increased risk for schizophrenia. CONCLUSIONS Asthma was associated with increased risk for schizophrenia. The results herein suggest that a convergent disturbance in the immune-inflammatory system may contribute to the pathoetiology of asthma and schizophrenia.
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Affiliation(s)
- Wei-Chen Wang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Mei-Hing Ng
- Department of Health, Tsaotun Psychiatric Center, Nantou, Taiwan
| | - Kuo-You Huang
- Department of Speech, Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Hong Hsieh
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Meng-Jer Hsieh
- Department of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan
- Department of Pulmonary and Critical Care Medicine, Chang Gung Medical Foundation, Chiayi Chang-Gung Memorial Hospital, Chiayi, Taiwan
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | - Charles Tzu-Chi Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
- * E-mail:
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Wallace R. Western Atomism and Its Culture-Bound Syndromes. COMPUTATIONAL PSYCHIATRY 2017. [DOI: 10.1007/978-3-319-53910-2_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tu HP, Hsieh HM, Liu TL, Jiang HJ, Wang PW, Huang CJ. Prevalence of Depressive Disorder in Persons With Type 2 Diabetes: A National Population-Based Cohort Study 2000-2010. PSYCHOSOMATICS 2016; 58:151-163. [PMID: 28190545 DOI: 10.1016/j.psym.2016.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 11/08/2016] [Accepted: 11/14/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Diabetes mellitus, a chronic and disabling disease, is epidemic worldwide. Depressive disorder affects the productivity of workers and leads to disability. OBJECTIVE This study investigated the prevalence of depressive disorder among persons with type 2 diabetes in Taiwan. METHODS We extracted service claims data for subjects who had at least 2 ambulatory care service claims or 1 inpatient service claim with a principal diagnosis of type 2 diabetes and at least 1 ambulatory or inpatient service claim with a principal diagnosis of depressive disorder from Taiwan's National Health Insurance Database. RESULTS From 2000-2010, the prevalence of depressive disorder increased from 3.50-4.07% in people with type 2 diabetes, and from 1.05-2.27% in the general population. The higher prevalence of depressive disorder in persons with type 2 diabetes was associated with being female; residence in central, southern, and eastern Taiwan; residence in urban areas; the comorbidities of hemiplegia or paraplegia, cerebrovascular disease, and anxiety disorder; Charlson Comorbidity Index scores ≥1; diabetes duration >9 years; and the use of rapid-acting insulin injection therapy. CONCLUSIONS The prevalence of depressive disorder is higher among persons with type 2 diabetes than the general population. Consequently, more public health attention should be devoted to the prevention and treatment of this debilitating disease in persons with type 2 diabetes, especially those with the earlier mentioned risk factors.
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Affiliation(s)
- Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - He-Jiun Jiang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Jen Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Staley D, Wand RR. Obsessive-Compulsive Disorder: A Review of the Cross-Cultural Epidemiological Literature. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/136346159503200201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Early clinical studies suggested that obsessive-compulsive disorder (OCD) was a rare disorder, but recent large-scale epidemiological research conducted in North America using standardized diagnostic criteria (DSM-III) report prevalence rates between 1 to 3%. A review of clinical and case reports of OCD among psychiatric population in non-Western countries reveals similar sociodemographic and clinical correlates for the disorder compared to Western findings. Epidemiological studies using translated versions of standardized diagnostic instruments and conducted in non-Western countries, report similar prevalence rates and clinical phenomenology for O CD as that found in Western settings. Methodological and measurement issues relevant to conducting valid cross- cultural psychiatric research are discussed in relationship to the diagnosis of OCD. The review concludes that OCD is generally similar in prevalence, sociodemographic characteristics and clinical features in both Western and non-Western countries for adult populations.
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Chien IC, Lin CH. Increased risk of diabetes in patients with anxiety disorders: A population-based study. J Psychosom Res 2016; 86:47-52. [PMID: 27302546 DOI: 10.1016/j.jpsychores.2016.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/03/2016] [Accepted: 05/07/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Few known studies have investigated the epidemiology of diabetes in patients with anxiety disorders. Therefore, the study aimed to determine the prevalence and incidence of diabetes in patients with anxiety disorders. METHODS The National Health Research Institute provided a database of 1,000,000 random subjects for study. We obtained a random sample aged 18years and over 766,427 subjects in 2005. Those study subjects who had at least two primary or secondary diagnoses of anxiety disorders were identified. We compared the prevalence of diabetes in anxiety patients with the general population in 2005. Furthermore, we investigated this cohort from 2006 to 2010 to detect the incident cases of diabetes in anxiety patients compared with the general population. RESULTS The prevalence of diabetes in patients with anxiety disorders was higher than that in the general population (11.89% vs. 5.92%, odds ratio, 1.23; 95% confidence interval, 1.17-1.28) in 2005. The average annual incidence of diabetes in patients with anxiety disorders was also higher than that in the general population (2.25% vs. 1.11%, risk ratio 1.34; 95% confidence interval, 1.28-1.41) from 2006 to 2010. Compared with the general population, patients with anxiety disorders revealed a higher incidence of diabetes in all age groups among both females and males. CONCLUSIONS Patients with anxiety disorders had a much higher prevalence and incidence of diabetes in the younger adult age group than in the general population. The higher incidence of diabetes among anxiety patients was related to increased age, antipsychotic use, hypertension, and hyperlipidemia.
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Affiliation(s)
- I-Chia Chien
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan; Department of Public Health & Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
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Wu CY, Lee JI, Lee MB, Liao SC, Chang CM, Chen HC, Lung FW. Predictive validity of a five-item symptom checklist to screen psychiatric morbidity and suicide ideation in general population and psychiatric settings. J Formos Med Assoc 2016; 115:395-403. [DOI: 10.1016/j.jfma.2015.05.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 05/08/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022] Open
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Luczak SE, Wall TL. Gambling problems and comorbidity with alcohol use disorders in Chinese-, Korean-, and White-American college students. Am J Addict 2016; 25:195-202. [PMID: 26935871 PMCID: PMC5319422 DOI: 10.1111/ajad.12350] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/07/2016] [Accepted: 02/14/2016] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This study examined gambling behaviors and the relationship between gambling problems and alcohol use disorders (AUDs) among Chinese-, Korean-, and White-American college students. METHODS Participants were 678 (179 Chinese, 194 Korean, and 305 White; 50% female) 21-26 year-old (M = 22.0 ± 1.36) students attending one university in California. The South Oaks Gambling Screen was administered to assess gambling behavior and the Semi-Structured Assessment for the Genetics of Alcoholism was administered to diagnose lifetime AUDs. Chi-squares and multinomial logistic regressions were conducted to test our hypotheses. RESULTS Rates of lifetime ever gambling and weekly gambling were similar across the three ethnic groups, but participation in five types of gambling behavior differed. Chinese had the highest rates of gambling problems followed by Koreans and then Whites. Univariate odds ratios determined being Chinese or Korean, being male, and having an AUD were risk factors for gambling problems. When stratified by gender and ethnicity, having an AUD was not related to gambling problems in women, but was strongly associated with gambling problems in Chinese and White men and modestly associated in Korean men. This was true despite low rates of AUDs in Chinese men. DISCUSSION AND CONCLUSIONS Gambling problems were strongly comorbid with AUDs in Chinese- and White-American men, and moderately comorbid in Korean-American men. No relationship of AUD with gambling problems was found in women. SCIENTIFIC SIGNIFICANCE The results highlight the importance of assessing disaggregated Asian-American subgroups with respect to addictive behaviors and their comorbidity.
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Affiliation(s)
| | - Tamara L. Wall
- University of California, San Diego
- Veterans Affairs San Diego Healthcare System
- Veterans Medical Research Foundation
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Collin L, Reisner SL, Tangpricha V, Goodman M. Prevalence of Transgender Depends on the "Case" Definition: A Systematic Review. J Sex Med 2016; 13:613-26. [PMID: 27045261 DOI: 10.1016/j.jsxm.2016.02.001] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 01/28/2016] [Accepted: 02/01/2016] [Indexed: 12/15/2022]
Abstract
INTRODUCTION A systematic review and meta-analysis was conducted to evaluate how various definitions of transgender affect prevalence estimates. AIMS To evaluate the epidemiology of transgender and examine how various definitions of transgender affect prevalence estimates and to compare findings across studies that used different methodologies, in different countries, and over different periods. METHODS PubMed, EMBASE, and Medline were searched to identify studies reporting prevalence estimates of transgender in a population. All studies were grouped based on the case definition applied to the numerator. Summary estimates were derived using a random-effects model for total prevalence of transgender and for male-to-female and female-to-male subgroups. Overall and stratum-specific meta-prevalence estimates (mPs) and 95% confidence intervals (CIs) were accompanied by tests for heterogeneity and meta-regressions to assess sources of heterogeneity. MAIN OUTCOME MEASURES The main outcome measure was population prevalence of transgender. Secondary outcomes included gender-specific prevalence estimates for male-to-female and female to male subgroups. RESULTS Thirty-two studies met the inclusion criteria for systematic review. Of those, 27 studies provided necessary data for a meta-analysis. Overall mP estimates per 100,000 population were 9.2 (95% CI = 4.9-13.6) for surgical or hormonal gender affirmation therapy and 6.8 (95% CI = 4.6-9.1) for transgender-related diagnoses. Of studies assessing self-reported transgender identity, the mP was 871 (95% CI = 519-1,224); however, this result was influenced by a single outlier study. After removal of that study, the mP changed to 355 (95% CI = 144-566). Significant heterogeneity was observed in most analyses. CONCLUSION The empirical literature on the prevalence of transgender highlights the importance of adhering to specific case definitions because the results can range by orders of magnitude. Standardized and routine collection of data on transgender status and gender identity is recommended.
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Affiliation(s)
- Lindsay Collin
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Michael Goodman
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Chiang CL, Chen PC, Huang LY, Kuo PH, Tung YC, Liu CC, Chen WJ. Impact of universal health coverage on urban-rural inequity in psychiatric service utilisation for patients with first admission for psychosis: a 10-year nationwide population-based study in Taiwan. BMJ Open 2016; 6:e010802. [PMID: 26940114 PMCID: PMC4785302 DOI: 10.1136/bmjopen-2015-010802] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine the disparities in psychiatric service utilisation over a 10-year period for patients with first admission for psychosis in relation to urban-rural residence following the implementation of universal health coverage in Taiwan. DESIGN Population-based retrospective cohort study. SETTING Taiwan's National Health Insurance Research Database, which has a population coverage rate of over 99% and contains all medical claim records of a nationwide cohort of patients with at least one psychiatric admission between 1996 and 2007. PARTICIPANTS 69,690 patients aged 15-59 years with first admission between 1998 and 2007 for any psychotic disorder. MAIN EXPOSURE MEASURE Patients' urban-rural residence at first admissions. MAIN OUTCOME MEASURES Absolute and relative inequality indexes of the following quality indicators after discharge from the first admission: all-cause psychiatric readmission at 2 and 4 years, dropout of psychiatric outpatient service at 30 days, and emergency department (ED) treat-and-release encounter at 30 days. RESULTS Between 1998 and 2007, the 4-year readmission rate decreased from 65% to 58%, the 30-day dropout rate decreased from 18% to 15%, and the 30-day ED encounter rate increased from 8% to 10%. Risk of readmission has significantly decreased in rural and urban patients, but at a slower speed for the rural patients (p=0.026). The adjusted HR of readmission in rural versus urban patients has increased from 1.00 (95% CI 0.96 to 1.04) in 1998-2000 to 1.08 (95% CI 1.03 to 1.12) in 2005-2007, indicating a mild widening of the urban-rural gap. Urban-rural differences in 30-day dropout and ED encounter rates have been stationary over time. CONCLUSIONS The universal health coverage in Taiwan did not narrow urban-rural inequity of psychiatric service utilisation in patients with psychosis. Therefore, other policy interventions on resource allocation, service delivery and quality of care are needed to improve the outcome of rural-dwelling patients with psychosis.
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Affiliation(s)
- Chih-Lin Chiang
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Pei-Chun Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ling-Ya Huang
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Chi Tung
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chen-Chung Liu
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei J Chen
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
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Abstract
Gender dysphoria (GD), a term that denotes persistent discomfort with one's biologic sex or assigned gender, replaced the diagnosis of gender identity disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013. Subtypes of GD in adults, defined by sexual orientation and age of onset, have been described; these display different developmental trajectories and prognoses. Prevalence studies conclude that fewer than 1 in 10,000 adult natal males and 1 in 30,000 adult natal females experience GD, but such estimates vary widely. GD in adults is associated with an elevated prevalence of comorbid psychopathology, especially mood disorders, anxiety disorders, and suicidality. Causal mechanisms in GD are incompletely understood, but genetic, neurodevelopmental, and psychosocial factors probably all contribute. Treatment of GD in adults, although largely standardized, is likely to evolve in response to the increasing diversity of persons seeking treatment, demands for greater client autonomy, and improved understanding of the benefits and limitations of current treatment modalities.
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Affiliation(s)
- Kenneth J Zucker
- Gender Identity Clinic, Child, Youth, and Family Services, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada;
| | - Anne A Lawrence
- Department of Psychology, University of Lethbridge, Lethbridge, Alberta T1K 3M4, Canada
| | - Baudewijntje P C Kreukels
- Department of Medical Psychology, VU University Medical Center and EMGO Institute for Health and Care Research, Amsterdam 1081 HV, The Netherlands
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Fujise N, Abe Y, Fukunaga R, Nakagawa Y, Nishi Y, Koyama A, Ikeda M. Comparisons of prevalence and related factors of depression in middle-aged adults between urban and rural populations in Japan. J Affect Disord 2016; 190:772-776. [PMID: 26618770 DOI: 10.1016/j.jad.2015.11.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/29/2015] [Accepted: 11/15/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Findings of urban-rural differences in the prevalence of depression have been controversial, and few reports have directly compared the related factors of depression between urban and rural areas. The present study aimed to investigate differences between urban and rural areas in Japan with regards to the prevalence of and related factors of depression in middle-aged adults, in order to further understanding of the features of depression in this demographic. METHODS We used a multistage, random sampling procedure and mailing method. In total, 5000 participants were recruited from urban and rural areas in Kumamoto Prefecture (2500 in each area). Participants were aged from 40 to 64 years. Depression was assessed using the Center for Epidemiologic Studies Depression scale (CES-D). RESULTS The prevalence of middle-aged depression was not different between the urban and rural areas. Logistic regression analysis found that being female, living alone, and having a chronic illness were significantly associated with depression in urban-dwelling middle-aged adults. Younger age, sleep disturbance, and financial strain were significantly associated with depression in both urban and rural areas. LIMITATIONS The definition of depression was based on CES-D scores, without corroborating clinical evaluation. CONCLUSIONS We found no marked differences in the prevalence of middle-aged depression between the urban and rural areas. Some related factors of depression in middle-aged adults differed between urban and rural areas in Japan. Effective intervention programs for middle-aged adults with depression should consider regional differences.
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Affiliation(s)
- Noboru Fujise
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University Graduate School of Medical Science, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - Yasuhisa Abe
- Yatsushiro Kousei Hospital, 1705 furushiromachi, Yatsushiro, Kumamoto, 866-0043, Japan
| | - Ryuta Fukunaga
- Yatsushiro Kousei Hospital, 1705 furushiromachi, Yatsushiro, Kumamoto, 866-0043, Japan
| | - Youichi Nakagawa
- Kumamoto Prefectural Government, 6-18-1 Suizenji, Chuo-ku, Kumamoto, 862-8570, Japan
| | - Yoshitomo Nishi
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University Graduate School of Medical Science, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Asuka Koyama
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University Graduate School of Medical Science, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Manabu Ikeda
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University Graduate School of Medical Science, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
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Closed-system ‘economic’ models for psychiatric disorders: Western atomism and its culture-bound syndromes. Cogn Process 2015; 16:279-90. [DOI: 10.1007/s10339-015-0659-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
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Loh SY, Abdullah A, Abu Bakar AK, Thambu M, Nik Jaafar NR. Structured Walking and Chronic Institutionalized Schizophrenia Inmates: A pilot RCT Study on Quality of Life. Glob J Health Sci 2015; 8:238-48. [PMID: 26234968 PMCID: PMC4804032 DOI: 10.5539/gjhs.v8n1p238] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/19/2015] [Accepted: 05/17/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Lifestyle moderate-intensity physical activity can lower the risk of over twenty chronic health conditions, whilst inactivity reduces daily functioning and physical health of individuals living with schizophrenia. This study conducted in 2014 examines the effect of structured walking participation on QOL, psychosocial functioning and symptoms in Hospital Permai, one of the largest psychiatry institution in Asia METHOD Chronic patients with schizophrenia (n=104) who met inclusion criteria were randomised to either a 3-month structured walking intervention or a treatment-as-usual arm. The Positive and Negative Syndrome Scale (PANSS), global functioning (PSP) and QOL (SF-36) were measured at baseline and after the 3-month interval. RESULTS At 3 month follow-up, there were significant within group differences in QOL (SF-36), psychiatric symptoms (PANSS), and personal and social performance (PSP). There were statistically significant increase in the median SF-36 scores, with increases shown in physical functioning (p<.001), physical role limitations (p<.05), social functioning (p<.01) in the intervention group compared to treatment-as-usual group. Statistically significant reduction of median PANSS score of the intervention group were noted in positive (p<0.001) and negative (p<0.01) symptom, and general psychopathology (p<0.01) scales. Statistically significant increase in the median PSP score (p<0.01) was found in the intervention group compared with the treatment-as-usual group. Between-group differences at post intervention (favouring Intervention) were significant for PANSS positive and SF36 Physical CONCLUSION In long stayed chronic inmates, a simple but consistent, organized walking intervention has the potential to bring improvement in functioning, reduction in psychiatric symptoms and quality of Life. The emphasis of rehabilitation should target at lifestyle redesign intervention.
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Clemente AS, Diniz BS, Nicolato R, Kapczinski FP, Soares JC, Firmo JO, Castro-Costa É. Bipolar disorder prevalence: a systematic review and meta-analysis of the literature. ACTA ACUST UNITED AC 2015; 37:155-61. [PMID: 25946396 DOI: 10.1590/1516-4446-2012-1693] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 02/26/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Bipolar disorder (BD) is common in clinical psychiatric practice, and several studies have estimated its prevalence to range from 0.5 to 5% in community-based samples. However, no systematic review and meta-analysis of the prevalence of BD type 1 and type 2 has been published in the literature. We carried out a systematic review and meta-analysis of the lifetime and 1-year prevalence of BD type 1 and type 2 and assessed whether the prevalence of BD changed according to the diagnostic criteria adopted (DSM-III, DSM-III-R vs. DSM-IV). METHODS We searched MEDLINE, Scopus, Web of Science, PsycINFO, and the reference lists of identified studies. The analyses included 25 population- or community-based studies and 276,221 participants. RESULTS The pooled lifetime prevalence of BD type 1 was 1.06% (95% confidence interval [95%CI] 0.81-1.31) and that of BD type 2 was 1.57% (95%CI 1.15-1.99). The pooled 1-year prevalence was 0.71% (95%CI 0.56-0.86) for BD type 1 and 0.50% (95%CI 0.35-0.64) for BD type 2. Subgroup analysis showed a significantly higher lifetime prevalence of BD type 1 according to the DSM-IV criteria compared to the DSM-III and DSM-IIIR criteria (p < 0.001). CONCLUSION This meta-analysis confirms that estimates of BD type 1 and type 2 prevalence are low in the general population. The increase in prevalence from DSM-III and DSM-III-R to DSM-IV may reflect different factors, such as minor changes in diagnostic operationalization, use of different assessment instruments, or even a genuine increase in the prevalence of BD.
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Affiliation(s)
| | - Breno S Diniz
- Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rodrigo Nicolato
- Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Flavio P Kapczinski
- Molecular Psychiatry Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Jair C Soares
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, Texas Health and Science University, Houston, TX, USA
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Barahmand U, Shahbazi Z. Prevalence of and associations between body dysmorphic concerns, obsessive beliefs and social anxiety. Asia Pac Psychiatry 2015; 7:54-63. [PMID: 23857955 DOI: 10.1111/appy.12085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 03/27/2013] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Physical attractiveness has been of concern in different cultures and at different times. Physical attractiveness can influence one's thoughts and actions, and concerns regarding body image can be destructive, giving rise to psychological problems. The purpose of the present study was to determine the prevalence of body dysmorphic concerns, related sex differences and comorbidity with social anxiety and obsessive beliefs. METHOD Using a stratified and cluster sampling procedure, 1,200 males and females were randomly selected. Self-report measures on body image, social anxiety and obsessive beliefs were distributed of which 843 completed questionnaires (54.9% males and 45.1% females) were returned (return rate of 70.25%). Therefore, data pertaining to 463 males and 380 females ranging in age from 17 to 20 years with a mean age of 18.12 years (SD = 1.06) were analyzed. RESULTS Findings suggest a prevalence rate of 19.1% for body dysmorphic disorder, 23.6% for social anxiety and 8.8% for obsessive beliefs. Both social anxiety and obsessive beliefs were found to be comorbid with body dysmorphic concerns. The percentage of individuals reporting comorbid social anxiety (12.9%) was greater than that of those reporting comorbid obsessive beliefs (6.4%). Males with body dysmorphic concerns reported more obsessive beliefs (8.2% versus 4.1%), while their female counterparts reported more social anxiety (23.4% versus 4.2%). DISCUSSION In males, body image concerns appear to be more cognitive in quality, while in females, body image concerns seem more emotional in tone. As the measures used do not yield formal diagnoses, findings should be viewed with caution.
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Pan PY, Lee MS, Yeh CB. The efficacy and safety of once-daily quetiapine extended release in patients with schizophrenia switched from other antipsychotics: an open-label study in Chinese population. BMC Psychiatry 2015; 15:1. [PMID: 25609320 PMCID: PMC4308905 DOI: 10.1186/s12888-014-0378-5] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 12/20/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Non-adherence to antipsychotic medication in schizophrenic patients is common and associated with symptom relapse and poorer long-term outcomes. The risk factors for treatment non-adherence include dosing frequency and complexity. Besides, slower dose titration in an acute schizophrenic episode may lead to attenuated efficacy. Therefore, the convenient dosage regimen and rapid initiation scheme of quetiapine extended release (XR) were expected to provide better effectiveness and promote adherence in patients with schizophrenia. This study was implemented to assess the efficacy and safety of once-daily quetiapine XR in schizophrenic patients with switched from other antipsychotics which were suboptimal due to insufficient efficacy or tolerability. METHODS This was a 12-week, open-label study conducted in the Chinese population in Taiwan. Patients who had a score of 4 (moderate) or greater on any of the 7 items of the Positive and Negative Syndrome Scale (PANSS) Positive Symptom Subscale and needed to switch from previous antipsychotics were recruited. Quetiapine XR was administered at 300 mg on day 1, 600 mg on day 2 and up to 800 mg after day 2. From day 8 until the end of the study, the dose of quetiapine XR was adjusted within 400-800 mg per day, depending on the clinical response and tolerance of the patients. The variable of the primary outcome was the change from baseline to Week 12 in PANSS total and subscale scores. Secondary outcome was the baseline-to-endpoint difference in the Clinical Global Impression-Severity (CGI-S) scores of the participants. RESULTS Sixty-one patients were recruited and 55.7% of them completed the study. The mean changes in the PANSS total score and CGI-S score showed significant improvement (-18.4, p < .001 and -1.0, p < .001, respectively). Four patients (6.7%) experienced adverse events including headache, exacerbation of psychosis and dysuria. The use of concomitant anticholinergics decreased from 15.0% to 8.3%. CONCLUSIONS The results of our investigation implicated that quetiapine XR was an effective and well tolerated alternative for Chinese schizophrenic patients with previous suboptimal treatment. Future large-scale studies are warranted to validate our results. TRIAL REGISTRATION ClinicalTrials.gov ID NCT02142556 . Registered 15 May 2014.
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Affiliation(s)
- Pei-Yin Pan
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec.2,Chenggong Rd., Neihu Dist., Taipei City, 114, Taiwan.
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 114, Taiwan.
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec.2,Chenggong Rd., Neihu Dist., Taipei City, 114, Taiwan.
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Huang LC, Tsai KJ, Wang HK, Sung PS, Wu MH, Hung KW, Lin SH. Prevalence, incidence, and comorbidity of clinically diagnosed obsessive-compulsive disorder in Taiwan: a national population-based study. Psychiatry Res 2014; 220:335-41. [PMID: 25169892 DOI: 10.1016/j.psychres.2014.08.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 08/06/2014] [Accepted: 08/09/2014] [Indexed: 12/29/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a chronic debilitating anxiety disorder significant in intrusive thoughts and compensation repetitive behaviors. Few studies have reported on this condition Asia. This study estimated the prevalence, incidence and psychiatric comorbidities of OCD in Taiwan. We identified study subjects for 2000-2008 with a principal diagnosis of OCD according to the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic criteria by using National Health Research Institute database. These patients received either outpatient or inpatient care for their condition. Rates were directly age- and sex-adjusted to the 2004 Taiwan population distribution. The estimated mean annual incidence was 27.57 per 10(5) inhabitants and the one year prevalence was 65.05 per 10(5) inhabitants. Incidence and prevalence increased with age, peaking at age 18-24 years in males and at 35-44 years in females. About 53% of adults (≥18 years) and 48% of child and adolescent patients (6-17 years) had one or more comorbid psychiatric conditions. The most common comorbid diagnosis was depressive disorders for both adult and child-adolescent patients. We found a lower prevalence and incidence of clinically diagnosed OCD than that of community studies. Many Asian patients with OCD also had various psychiatric comorbidities, a clinically relevant finding.
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Affiliation(s)
- Li-Chung Huang
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Kuen-Jer Tsai
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hao-Kuang Wang
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Pi-Shan Sung
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ming-Hsiu Wu
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Neurology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Kuo-Wei Hung
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Neurology, Yuan׳s General Hospital, Kaohsiung, Taiwan
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan.
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Wu CS, Lai MS, Gau SSF, Wang SC, Tsai HJ. Concordance between patient self-reports and claims data on clinical diagnoses, medication use, and health system utilization in Taiwan. PLoS One 2014; 9:e112257. [PMID: 25464005 PMCID: PMC4251897 DOI: 10.1371/journal.pone.0112257] [Citation(s) in RCA: 194] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 10/14/2014] [Indexed: 11/26/2022] Open
Abstract
Purpose The aim of this study was to evaluate the concordance between claims records in the National Health Insurance Research Database and patient self-reports on clinical diagnoses, medication use, and health system utilization. Methods In this study, we used the data of 15,574 participants collected from the 2005 Taiwan National Health Interview Survey. We assessed positive agreement, negative agreement, and Cohen's kappa statistics to examine the concordance between claims records and patient self-reports. Results Kappa values were 0.43, 0.64, and 0.61 for clinical diagnoses, medication use, and health system utilization, respectively. Using a strict algorithm to identify the clinical diagnoses recorded in claims records could improve the negative agreement; however, the effect on positive agreement and kappa was diverse across various conditions. Conclusion We found that the overall concordance between claims records in the National Health Insurance Research Database and patient self-reports in the Taiwan National Health Interview Survey was moderate for clinical diagnosis and substantial for both medication use and health system utilization.
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Affiliation(s)
- Chi-Shin Wu
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mei-Shu Lai
- College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sheng-Chang Wang
- Center of Neuropsychiatric Research, National Health Research Institutes, Zhunan, Taiwan
| | - Hui-Ju Tsai
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
- Department of Medical Genetics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- * E-mail:
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Kim J, Ahlgren M, Bernhard B. The mediating effect of depression between superstitious beliefs and problem gambling: a cross-cultural study of Chinese and Caucasians residing in the United States. JOURNAL OF GAMBLING ISSUES 2014. [DOI: 10.4309/jgi.2014.29.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to address the mediational role of depression in the association between superstitions and problem gambling and to test whether this mediating process is significantly different between Chinese and Caucasian Americans. Eight items assessing superstitious beliefs, the 21-item Beck Depression Inventory-II, and the 20-item South Oaks Gambling Screen (SOGS) were completed by 115 Chinese gamblers and 187 Caucasian gamblers residing in the United States, and the responses between tests and between groups compared. Path analysis results showed that superstitious beliefs had a significant effect on both Chinese and Caucasian gamblers' SOGS scores (i.e., problem gambling symptoms). In both groups, depression played a significant mediating role between the superstitious beliefs variable and the problem gambling variable. Future clinical research might use the findings of this study to develop specific prevention and treatment approaches focusing on a gambler's cognitive bias and negative mood.
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A community-based walk-in screening of depression in Taiwan. ScientificWorldJournal 2014; 2014:184018. [PMID: 25133204 PMCID: PMC4124201 DOI: 10.1155/2014/184018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 07/02/2014] [Indexed: 11/17/2022] Open
Abstract
Depression is a crucial public health problem because of its relatively high association with suicidal attempts, prolonged social isolation, poor physical health, and dementia. However, the available data and study on the prevalence of depression in Taiwan were mostly completed within the previous 1 to 2 decades, and these studies were limited to certain areas or populations. Little is known regarding the current status of depression in Taiwan. We used a brief tool, the Center for Epidemiological Studies Depression Scale (CES-D), to screen depression in 4 areas among the general and aged population. The results showed a higher CES-D score in the southern area among general (mean ± SD: 7.8 ± 8.4) or aged participants (mean ± SD: 7.2 ± 8.0) compared with other areas. The ratio of suspected depression patients was 16.4% of all recruited participants and 13.3% of aged participants. These results may provide information for this public health issue.
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Abstract
The American Psychiatric Association's rejection of proposals for radical change in the classification of personality disorders was a result of divisions among researchers studying these diagnoses. This article examines the current state of the field and its prospects, with emphasis on definitions, diagnosis, etiology, prevalence, outcome, and treatment. More definitive conclusions will require a larger body of research than is currently available, including multivariable studies in which biological, psychological, and social factors, as well as their interactions, are examined in the same research design.
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Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. Int J Epidemiol 2014; 43:476-93. [PMID: 24648481 PMCID: PMC3997379 DOI: 10.1093/ije/dyu038] [Citation(s) in RCA: 1503] [Impact Index Per Article: 150.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Since the introduction of specified diagnostic criteria for mental disorders in the 1970s, there has been a rapid expansion in the number of large-scale mental health surveys providing population estimates of the combined prevalence of common mental disorders (most commonly involving mood, anxiety and substance use disorders). In this study we undertake a systematic review and meta-analysis of this literature. METHODS We applied an optimized search strategy across the Medline, PsycINFO, EMBASE and PubMed databases, supplemented by hand searching to identify relevant surveys. We identified 174 surveys across 63 countries providing period prevalence estimates (155 surveys) and lifetime prevalence estimates (85 surveys). Random effects meta-analysis was undertaken on logit-transformed prevalence rates to calculate pooled prevalence estimates, stratified according to methodological and substantive groupings. RESULTS Pooling across all studies, approximately 1 in 5 respondents (17.6%, 95% confidence interval:16.3-18.9%) were identified as meeting criteria for a common mental disorder during the 12-months preceding assessment; 29.2% (25.9-32.6%) of respondents were identified as having experienced a common mental disorder at some time during their lifetimes. A consistent gender effect in the prevalence of common mental disorder was evident; women having higher rates of mood (7.3%:4.0%) and anxiety (8.7%:4.3%) disorders during the previous 12 months and men having higher rates of substance use disorders (2.0%:7.5%), with a similar pattern for lifetime prevalence. There was also evidence of consistent regional variation in the prevalence of common mental disorder. Countries within North and South East Asia in particular displayed consistently lower one-year and lifetime prevalence estimates than other regions. One-year prevalence rates were also low among Sub-Saharan-Africa, whereas English speaking counties returned the highest lifetime prevalence estimates. CONCLUSIONS Despite a substantial degree of inter-survey heterogeneity in the meta-analysis, the findings confirm that common mental disorders are highly prevalent globally, affecting people across all regions of the world. This research provides an important resource for modelling population needs based on global regional estimates of mental disorder. The reasons for regional variation in mental disorder require further investigation.
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Affiliation(s)
- Zachary Steel
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Claire Marnane
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Changiz Iranpour
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Tien Chey
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - John W Jackson
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Vikram Patel
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Derrick Silove
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
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Chartier KG, Scott DM, Wall TL, Covault J, Karriker-Jaffe KJ, Mills BA, Luczak SE, Caetano R, Arroyo JA. Framing ethnic variations in alcohol outcomes from biological pathways to neighborhood context. Alcohol Clin Exp Res 2014; 38:611-8. [PMID: 24483624 PMCID: PMC3959254 DOI: 10.1111/acer.12304] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 09/25/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND Health disparities research seeks to eliminate disproportionate negative health outcomes experienced in some racial/ethnic minority groups. This brief review presents findings on factors associated with drinking and alcohol-related problems in racial/ethnic groups. METHODS Those discussed are as follows: (i) biological pathways to alcohol problems, (ii) gene × stress interactions, (iii) neighborhood disadvantage, stress, and access to alcohol, and (iv) drinking cultures and contexts. RESULTS These factors and their interrelationships are complex, requiring a multilevel perspective. CONCLUSIONS The use of interdisciplinary teams and an epigenetic focus are suggested to move the research forward. The application of multilevel research to policy, prevention, and intervention programs may help prioritize combinations of the most promising intervention targets.
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Affiliation(s)
- Karen G Chartier
- Virginia Commonwealth University School of Social Work , Richmond, Virginia
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