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Cheng CM, Chen MH, Tsai SJ, Chang WH, Tsai CF, Lin WC, Bai YM, Su TP, Chen TJ, Li CT. Susceptibility to Treatment-Resistant Depression Within Families. JAMA Psychiatry 2024:2817088. [PMID: 38568605 PMCID: PMC10993159 DOI: 10.1001/jamapsychiatry.2024.0378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/22/2024] [Indexed: 04/06/2024]
Abstract
Importance Antidepressant responses and the phenotype of treatment-resistant depression (TRD) are believed to have a genetic basis. Genetic susceptibility between the TRD phenotype and other psychiatric disorders has also been established in previous genetic studies, but population-based cohort studies have not yet provided evidence to support these outcomes. Objective To estimate the TRD susceptibility and the susceptibility between TRD and other psychiatric disorders within families in a nationwide insurance cohort with extremely high coverage and comprehensive health care data. Design, Setting, and Participants This cohort study assessed data from the Taiwan national health insurance database across entire population (N = 26 554 001) between January 2003 and December 2017. Data analysis was performed from August 2021 to April 2023. TRD was defined as having experienced at least 3 distinct antidepressant treatments in the current episode, each with adequate dose and duration, based on the prescribing records. Then, we identified the first-degree relatives of individuals with TRD (n = 34 467). A 1:4 comparison group (n = 137 868) of first-degree relatives of individuals without TRD was arranged for the comparison group, matched by birth year, sex, and kinship. Main Outcomes and Measures Modified Poisson regression analyses were performed and adjusted relative risks (aRRs) and 95% CIs were calculated for the risk of TRD, the risk of other major psychiatric disorders, and different causes of mortality. Results This study included 172 335 participants (88 330 male and 84 005 female; mean [SD] age at beginning of follow-up, 22.9 [18.1] years). First-degree relatives of individuals with TRD had lower incomes, more physical comorbidities, higher suicide mortality, and increased risk of developing TRD (aRR, 9.16; 95% CI, 7.21-11.63) and higher risk of other psychiatric disorders than matched control individuals, including schizophrenia (aRR, 2.36; 95% CI, 2.10-2.65), bipolar disorder (aRR, 3.74; 95% CI, 3.39-4.13), major depressive disorder (aRR, 3.65; 95% CI, 3.44-3.87), attention-deficit/hyperactivity disorders (aRR, 2.38; 95% CI, 2.20-2.58), autism spectrum disorder (aRR, 2.26; 95% CI, 1.86-2.74), anxiety disorder (aRR, 2.71; 95% CI, 2.59-2.84), and obsessive-compulsive disorder (aRR, 3.14; 95% CI, 2.70-3.66). Sensitivity and subgroup analyses validated the robustness of the findings. Conclusions and Relevance To our knowledge, this study is the largest and perhaps first nationwide cohort study to demonstrate TRD phenotype transmission across families and coaggregation with other major psychiatric disorders. Patients with a family history of TRD had an increased risk of suicide mortality and tendency toward antidepressant resistance; therefore, more intensive treatments for depressive symptoms might be considered earlier, rather than antidepressant monotherapy.
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Affiliation(s)
- Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Graduate Institute of Statistics National Central University, Taoyuan, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu branch, Hsinchu, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
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Tu WC, Tsai WL, Lee CH, Tsai CF, Wei JT, Lin KF, Wu SM, Weng YM. Application and effectiveness of artificial intelligence for the border management of imported frozen fish in Taiwan. J Food Drug Anal 2024; 32:21-38. [PMID: 38526592 PMCID: PMC10962653 DOI: 10.38212/2224-6614.3490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 11/30/2023] [Indexed: 03/26/2024] Open
Abstract
In Taiwan, the number of applications for inspecting imported food has grown annually and noncompliant products must be accurately detected in these border sampling inspections. Previously, border management has used an automated border inspection system (import food inspection (IFI) system) to select batches via a random sampling method to manage the risk levels of various food products complying with regulatory inspection procedures. Several countries have implemented artificial intelligence (AI) technology to improve domestic governmental processes, social service, and public feedback. AI technologies are applied in border inspection by the Taiwan Food and Drug Administration (TFDA). Risk management of border inspections is conducted using the Border Prediction Intelligent (BPI) system. The risk levels are analyzed on based on the noncompliance records of imported food, the country of origin, and international food safety alerts. The subjects of this study were frozen fish products, which have been under surveillance by the BPI system. The purpose of this study was to investigate the relevance between the noncompliant trend of frozen fish products using the adoption of the BPI system and the results of postmarket sampling inspections. The border inspection and postmarket sampling data were divided into two groups: IFI and BPI groups (corresponding to before and after the adoption of the BPI system, respectively). The Chi-square test was employed to analyze the noncompliant differences in products between before and after the BPI system adoption. Despite the number of noncompliance batches being statistically insignificant after the adoption of the BPI system, the noncompliance rate of frozen fish products at the border increased from 3.0% to 4.7%. Meanwhile, the noncompliance rate in the postmarket decreased from 2.1% to 1.9%. The results indicate that the BPI system improves the effectiveness of interception of noncompliant products at the border, thereby preventing the entrance of noncompliant products to the postmarket. The variables were further classified and organized according to the scope of this study and product characteristics. Furthermore, ordinal logistic regression (OLR) was employed to determine the correlations among border, postmarket, and major influencing factors. Based on the analysis of major influencing factors, small fish and fish internal organ products exhibited significantly high risk for fish body type and product type, respectively. The BPI system effectively utilizes the large amount of data accumulated from border inspections over the years. Additionally, real-time information on bilateral data obtained from the border and postmarket should be bidirectionally shared for effectively intercepting noncompliance products and used for improving the border management efficiency.
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Affiliation(s)
- Wen-Chin Tu
- Food and Drug Administration, Ministry of Health and Welfare, Taipei,
Taiwan
- Department of Food Science, National Chiayi University, Chiayi,
Taiwan
| | - Wan-Ling Tsai
- Food and Drug Administration, Ministry of Health and Welfare, Taipei,
Taiwan
| | - Chi-Hao Lee
- Food and Drug Administration, Ministry of Health and Welfare, Taipei,
Taiwan
| | - Chia-Fen Tsai
- Food and Drug Administration, Ministry of Health and Welfare, Taipei,
Taiwan
| | - Jen-Ting Wei
- Food and Drug Administration, Ministry of Health and Welfare, Taipei,
Taiwan
| | - King-Fu Lin
- Food and Drug Administration, Ministry of Health and Welfare, Taipei,
Taiwan
| | - Shou-Mei Wu
- Food and Drug Administration, Ministry of Health and Welfare, Taipei,
Taiwan
| | - Yih-Ming Weng
- Department of Food Science, National Chiayi University, Chiayi,
Taiwan
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Li JR, Tsai CF, Huang MH, Lee JJ, Wang WF, Huang LC, Hsu CC, Lin YS, Kuo YS, Fuh JL. Predictors of live-in migrant caregiver employment for people with dementia in Taiwan. J Chin Med Assoc 2024; 87:219-225. [PMID: 38305484 DOI: 10.1097/jcma.0000000000001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND With the increasing number of individuals with dementia, families have hired an increasing number of live-in migrant caregivers (LIMCs). Currently, limited evidence is available regarding the influence of long-term care resource utilization on the hiring of LIMCs for caring for individuals with dementia in Taiwan. METHODS We recruited individuals with dementia who did not hire LIMCs and their primary family caregivers from nine hospitals in Taiwan as baseline. Multivariable logistic regression was used to evaluate the utilization of long-term care resources for individuals with dementia and other factors that may affect the decision to hire LIMCs. RESULTS The users of non-long-term care resources had the highest likelihood of hiring LIMCs (odds ratio [OR] = 4.24, 95% CI, 2.30-7.84). Compared with spouses, nonimmediate family caregivers (OR = 3.40, 95% CI, 1.16-9.90) were significantly more likely to hire LIMCs. A higher likelihood of hiring LIMCs was observed for those with Lewy body dementia compared with other individuals (OR = 2.31, 95% CI, 1.03-5.14). Compared with individuals who did not hire LIMCs, those who hired LIMCs exhibited higher scores on the Neuropsychiatric Inventory (NPI) and higher severity of individual NPI items. CONCLUSION Hiring LIMCs is strongly correlated with the utilization of non-long-term care resources and is influenced by the dynamics between individuals with dementia and their primary family caregivers. A higher likelihood of hiring LIMCs was observed for individuals with Lewy body dementia and individuals with elevated NPI scores compared with their counterparts. Given these observations, various support strategies and interventions should be tailored to the specific requirements of individuals with dementia and their families.
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Affiliation(s)
- Jia-Ru Li
- Division of Geriatric Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
| | - Chia-Fen Tsai
- Division of Geriatric Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Mao-Hsuan Huang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Psychiatry, YuanShan and Suao Branches of Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Jun-Jun Lee
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, ROC
- Department of Information Management, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC
- Chang Gung University, College of Medicine, Taoyuan, Taiwan, ROC
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan, ROC
- Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan, ROC
| | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, Taiwan, ROC
| | - Yung-Shuan Lin
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yu-Shan Kuo
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Jong-Ling Fuh
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Liu MN, Hu LY, Tsai CF, Hong CJ, Chou YH, Chang CC, Yang KC, You ZH, Lau CI. Abnormalities of Hippocampal Subfield and Amygdalar Nuclei Volumes and Clinical Correlates in Behavioral Variant Frontotemporal Dementia with Obsessive-Compulsive Behavior-A Pilot Study. Brain Sci 2023; 13:1582. [PMID: 38002542 PMCID: PMC10669726 DOI: 10.3390/brainsci13111582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: The hippocampus (HP) and amygdala are essential structures in obsessive-compulsive behavior (OCB); however, the specific role of the HP in patients with behavioral variant frontotemporal dementia (bvFTD) and OCB remains unclear. (2) Objective: We investigated the alterations of hippocampal and amygdalar volumes in patients with bvFTD and OCB and assessed the correlations of clinical severity with hippocampal subfield and amygdalar nuclei volumes in bvFTD patients with OCB. (3) Materials and methods: Eight bvFTD patients with OCB were recruited and compared with eight age- and sex-matched healthy controls (HCs). Hippocampal subfield and amygdalar nuclei volumes were analyzed automatically using a 3T magnetic resonance image and FreeSurfer v7.1.1. All participants completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Neuropsychiatric Inventory (NPI), and Frontal Behavioral Inventory (FBI). (4) Results: We observed remarkable reductions in bilateral total hippocampal volumes. Compared with the HCs, reductions in the left hippocampal subfield volume over the cornu ammonis (CA)1 body, CA2/3 body, CA4 body, granule cell layer, and molecular layer of the dentate gyrus (GC-ML-DG) body, molecular layer of the HP body, and hippocampal tail were more obvious in patients with bvFTD and OCB. Right subfield volumes over the CA1 body and molecular layer of the HP body were more significantly reduced in bvFTD patients with OCB than in those in HCs. We observed no significant difference in amygdalar nuclei volume between the groups. Among patients with bvFTD and OCB, Y-BOCS score was negatively correlated with left CA2/3 body volume (τb = -0.729, p < 0.001); total NPI score was negatively correlated with left GC-ML-DG body (τb = -0.648, p = 0.001) and total bilateral hippocampal volumes (left, τb = -0.629, p = 0.002; right, τb = -0.455, p = 0.023); and FBI score was negatively correlated with the left molecular layer of the HP body (τb = -0.668, p = 0.001), CA4 body (τb = -0.610, p = 0.002), and hippocampal tail volumes (τb = -0.552, p < 0.006). Mediation analysis confirmed these subfield volumes as direct biomarkers for clinical severity, independent of medial and lateral orbitofrontal volumes. (5) Conclusions: Alterations in hippocampal subfield volumes appear to be crucial in the pathophysiology of OCB development in patients with bvFTD.
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Grants
- 102-2314-B-075 -082, 105-2314-B-075 -024 -MY2, 104-2314-B-075 -039, 111-2314-B-075 -015 Ministry of Science and Technology, Taiwan
- V108B-009, V112B-039, V110B-028, V111B-033 Taipei Veterans General Hospital, Taiwan
- RVHCY111024 Chiayi branch of Taichung Veterans General Hospital, Taiwan
- 2021SKHADR016 Shin Kong Wu Ho-Su Memorial Hospital, Taiwan
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Affiliation(s)
- Mu-N Liu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (M.-N.L.); (C.-J.H.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Li-Yu Hu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (M.-N.L.); (C.-J.H.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (M.-N.L.); (C.-J.H.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Chen-Jee Hong
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (M.-N.L.); (C.-J.H.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Yuan-Hwa Chou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (M.-N.L.); (C.-J.H.)
- Center for Quality Management, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Chiung-Chih Chang
- Department of Neurology, Cognition and Aging Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Kai-Chun Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (M.-N.L.); (C.-J.H.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Zi-Hong You
- Department of Nephrology, Chiayi Branch, Taichung Veterans General Hospital, Chiayi 60090, Taiwan
| | - Chi Ieong Lau
- Dementia Center, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, No.95, Wenchang Rd., Shilin Dist., Taipei 11101, Taiwan
- Department of Neurology, University Hospital, Taipai, Macao SAR, China
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan
- Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, 17 Queen Square, University College London, London WC1N 3AZ, UK
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Cheng CM, Chang WH, Tsai SJ, Li CT, Tsai CF, Bai YM, Lin WC, Su TP, Chen TJ, Chen MH. Risk of All-Cause and Suicide Death in Patients With Schizophrenia: An Entire-Population Longitudinal Study in Taiwan. J Clin Psychiatry 2023; 84:22m14747. [PMID: 37707313 DOI: 10.4088/jcp.22m14747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Background: Schizophrenia increases mortality from all causes and specific causes. Comprehensive research on modifiable risk factors for early mortality from multiple sources is needed. Methods: Taiwan's National Health Insurance Research Database, which contains claims data from a lifetime insurance program for the whole population, provided extensive medical inpatient and outpatient data categorized by ICD-9-CM and ICD-10 for this nationwide retrospective longitudinal cohort study. The National Mortality Registry provided data on all-cause, natural, suicide, and accidental deaths. 191,553 patients with schizophrenia and 26,362,448 individuals without schizophrenia were monitored from January 1, 2003, to December 31, 2017. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for mortality risk were calculated using Cox regression models. We compared different mortality risks associated with schizophrenia across age, sex, and Charlson Comorbidity Index (CCI) subgroups. Results: We found that schizophrenia results in a relatively higher increase in suicidal mortality in those aged ≤ 20 years (aHR = 15.55; 95% CI, 13.95-17.34), and that effect decreased with age. The effect of schizophrenia in female individuals (suicide death: female, aHR = 11.82, 95% CI, 11.21-12.46; male, aHR = 8.11, 95% CI, 7.77-8.47; difference, P < .001) and individuals without comorbidity (natural cause of death, CCI = 0 aHR = 5.94, 95% CI, 5.68-6.22; CCI = 1-2 aHR = 3.62, 95% CI, 3.52-3.73; CCI > 2 aHR = 1.61, 95% CI, 1.58-1.64) led to comparatively higher mortality risks. The effect of schizophrenia in individuals with AIDS (suicide death, aHR = 2.73, 95% CI, 1.70-4.39) resulted in a relatively smaller increase in suicide mortality compared to individuals with other comorbidities; however, in patients with connective tissue diseases, a diagnosis of schizophrenia still leads to an alarming increase in natural and unnatural mortality. Conclusions: Schizophrenia in combination with younger age, female sex, comorbid connective tissue disease, or major organ problems necessitates more tailored countermeasures to lessen the higher mortality risk in these patients compared with patients who have these characteristics and conditions but do not have schizophrenia.
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Affiliation(s)
- Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
- Graduate Institute of Statistics National Central University, Taoyuan, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taiwan
- Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
- Institute of Brain Science, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Corresponding Author: Mu-Hong Chen, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, No 201, Sec 2, Shih-Pai Road, Beitou District, Taipei, 112, Taiwan
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Tsai CF, Huang MH, Lin YS, Chen CY, Fuh JL. Health-related quality of life and mild behavioral impairment in older adults without dementia. Int J Geriatr Psychiatry 2023; 38:e6003. [PMID: 37732590 DOI: 10.1002/gps.6003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The Mild Behavioral Impairment Checklist (MBI-C) was developed to assess neuropsychiatric symptoms (NPS) and to identify mild behavioral impairment (MBI). This study validated the Taiwanese version of the MBI-C and examined its association of health-related quality of life (HR-QoL). METHODS We recruited 242 older individuals without dementia (129 amnestic mild cognitive impairment, 113 cognitively normal). Their family completed the MBI-C, the Neuropsychiatric Inventory Questionnaire (NPI-Q), and instrumental activities of daily living scale. Participants completed the Geriatric Depression Scale (GDS-15), the Mini-Mental State Examination, the 12-item word recall test, the category verbal fluency test and the EuroQol 5 dimensions questionnaire (EQ-5D). Cronbach's α was used to evaluate the internal consistency of the MBI-C. Linear regression models were used to examined the association between MBI-C score and HR-QoL assessed using ED-5D. RESULTS The prevalence of MBI was 12% of all participants. Cronbach's α of the MBI-C was 0.893. The optimal cut-off point of MBI-C was 7.5 for identifying MBI, with a sensitivity of 100% and specificity of 85%. The MBI-C total score (β = -0.01, 95% confidence interval [CI] = -0.02 to -0.01, p < 0.001), MBI-C subdomain of decreased motivation (β = -0.04, 95% CI = -0.05 to -0.02, p < 0.001) and emotional dysregulation (β = -0.02, 95% CI = -0.04 to -0.004, p = 0.01) were factors related to EQ-5D index scores. CONCLUSION Among older adults without dementia, the Taiwanese version of the MBI-C has good reliability and validity for detecting MBI. The total and subdomains of MBI-C were associated with decreased HR-QoL among individuals without dementia.
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Affiliation(s)
- Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mao-Hsuan Huang
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, YuanShan and Suao Branches of Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yung-Shuan Lin
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Brain Research Center, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Yu Chen
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Brain Research Center, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Jong-Ling Fuh
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Brain Research Center, National Yang-Ming Chiao Tung University, Taipei, Taiwan
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Wang SC, Yokoyama JS, Tzeng NS, Tsai CF, Liu MN. Treatment resistant depression in elderly. Prog Brain Res 2023; 281:25-53. [PMID: 37806715 DOI: 10.1016/bs.pbr.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Treatment refractory depression (TRD) in the elderly is a common psychiatric disorder with high comorbidity and mortality. Older adults with TRD often have complicated comorbidities and several predisposing risk factors, which may lead to neuropsychiatric dysfunction and poor response to treatment. Several hypotheses suggest the underlying mechanisms, including vascular, immunological, senescence, or abnormal protein deposition. Treatment strategies for TRD include optimization of current medication dose, augmentation, switching to an alternative agent or class, and combination of different antidepressant classes, as well as nonpharmacological adjuvant interventions such as biophysical stimulation and psychotherapy. In summary, treatment recommendations for TRD in the elderly favor a multimodal approach, combining pharmacological and nonpharmacological treatments.
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Affiliation(s)
- Sheng-Chiang Wang
- School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan; Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Jennifer S Yokoyama
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-N Liu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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8
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Tsai YW, Tsai CF, Wu JY, Huang PY, Liu TH, Lai CC. The risk of methicillin-resistant Staphylococcus aureus infection following COVID-19 and influenza: A retrospective cohort study from the TriNetX network. J Infect 2023; 86:256-308. [PMID: 36632945 PMCID: PMC9867601 DOI: 10.1016/j.jinf.2023.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Affiliation(s)
- Ya-Wen Tsai
- Center for Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Medical Laboratory Sciences and Biotechnology, Fooyin University
| | - Chia-Fen Tsai
- Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
| | - Po-Yu Huang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ting-Hui Liu
- Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan.
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9
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Lee YT, Tsai CF, Yen YC, Huang LK, Chao SP, Hu LY, Shen CC, Lee HC. Periodontitis is a potential risk factor for transient ischemic attack and minor ischemic stroke in young adults: A nationwide population-based cohort study. J Periodontol 2022; 93:1848-1856. [PMID: 35297043 DOI: 10.1002/jper.21-0528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/26/2021] [Accepted: 01/09/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND This study aims to determine whether periodontitis is a risk factor for transient ischemic attack (TIA) in young adults. METHODS The National Health Insurance (NHI) Research Database in Taiwan was the source of the data used in this retrospective cohort study. Individuals aged 20 to 53 years with periodontitis in 2001 and 2002 (n = 792,426) and an age- and sex-matched control group (n = 792,426) were selected. All participants were followed up until TIA diagnosis, 55 years of age, removal from the NHI program, death, or December 31, 2016. The incidence density and hazard ratio (HR) of new-onset TIA were compared between individuals with periodontitis and controls. Periodontitis was defined by dentists according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 523.3-5 with concurrent antibiotic prescription or periodontal treatment excluding scaling performed by certified dentists. TIA was defined according to the ICD-9-CM code 435.x at hospital discharge. RESULTS After adjustment for confounding factors, the risk of developing TIA/minor ischemic stroke was calculated to be higher in participants with periodontitis (HR, 1.24; 95% confidence interval, 1.15-1.32; P <0.001) than in those without. The HR was slightly higher among people aged 20 to 40 years than among those aged 40 to 53 years. CONCLUSION Periodontitis is associated with an increased risk of developing TIA/minor ischemic stroke. Periodontitis might be a modifiable risk factor for stroke in young adults. Clinicians must devote greater attention to this potential association to develop new preventive and therapeutic strategies for stroke in young adults.
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Affiliation(s)
- Yao-Tung Lee
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Center of Dementia, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Neurological Institute, Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chun Yen
- Biostatistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Li-Kai Huang
- Center of Dementia, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shu-Ping Chao
- Center of Dementia, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Li-Yu Hu
- Division of Psychiatry, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Che Shen
- Division of Psychiatry, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry & Sleep Center, Taipei Medical University Hospital, Taipei, Taiwan
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10
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Tsai CF, Chuang CH, Wang YP, Lin YB, Tu PC, Liu PY, Wu PS, Lin CY, Lu CL. Differences in gut microbiota correlate with symptoms and regional brain volumes in patients with late-life depression. Front Aging Neurosci 2022; 14:885393. [PMID: 35966787 PMCID: PMC9365093 DOI: 10.3389/fnagi.2022.885393] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Depression is associated with gut dysbiosis that disrupts a gut-brain bidirectional axis. Gray matter volume changes in cortical and subcortical structures, including prefrontal regions and the hippocampus, have also been noted in depressive disorders. However, the link between gut microbiota and brain structures in depressed patients remains elusive. Neuropsychiatric measures, stool samples, and structural brain images were collected from 36 patients with late-life depression (LLD) and 17 healthy controls. 16S ribosomal RNA (rRNA) gene sequencing was used to profile stool microbial communities for quantitation of microbial composition, abundance, and diversity. T1-weighted brain images were assessed with voxel-based morphometry to detect alterations in gray matter volume between groups. Correlation analysis was performed to identify the possible association between depressive symptoms, brain structures and gut microbiota. We found a significant difference in the gut microbial composition between patients with late-life depression (LLD) and healthy controls. The genera Enterobacter and Burkholderia were positively correlated with depressive symptoms and negatively correlated with brain structural signatures in regions associated with memory, somatosensory integration, and emotional processing/cognition/regulation. Our study purports the microbiota-gut-brain axis as a potential mechanism mediating the symptomatology of LLD patients, which may facilitate the development of therapeutic strategies targeting gut microbes in the treatment of elderly depressed patients.
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Affiliation(s)
- Chia-Fen Tsai
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Yen-Po Wang
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ya-Bo Lin
- Institute of Information Science, Academia Sinica, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Yi Liu
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Shan Wu
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Dietetics and Nutrition, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chung-Yen Lin
- Institute of Information Science, Academia Sinica, Taipei, Taiwan
| | - Ching-Liang Lu
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- *Correspondence: Ching-Liang Lu ;
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11
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Huang MH, Tsai CF, Cheng CM, Lin YS, Lee WJ, Kuo YS, Chan YLE, Fuh JL. Predictors of emergency department visit among people with dementia in Taiwan. Arch Gerontol Geriatr 2022; 101:104701. [DOI: 10.1016/j.archger.2022.104701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/02/2022] [Accepted: 04/03/2022] [Indexed: 01/01/2023]
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12
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Tsai CF, Huang MH, Cheng CM, Lee JJ, Wang WF, Huang LC, Huang LK, Lee WJ, Sung PS, Liu YC, Ouyang WC, Hsu CC, Fuh JL. Determinants of long-term care service use by persons with dementia: A national dementia registry study conducted in Taiwan. Int J Geriatr Psychiatry 2022; 37. [PMID: 35437817 DOI: 10.1002/gps.5719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 04/04/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study investigated the determinants and use of Taiwan's long-term care (LTC) Plan Version 2.0 (LTC 2.0) services by persons with dementia (PWDs) and their caregivers. METHODS In total, 1268 PWD-caregiver dyads were enrolled for analysis from a national dementia registry. Andersen's Behavioral Model of Health Services Use was used to investigate the association of LTC service use with several factors, namely the demographic data of PWDs and their caregivers, migrant caregiver employment, monthly household income, caregiver burden as determined by the Zarit Burden Interview (ZBI), Mini-Mental State Examination score, Clinical Dementia Rating scores, neuropsychiatric inventory scores for the behavioral and psychological symptoms of dementia, and PWDs' activities of daily living (ADLs). RESULTS Among the studied family caregivers, 81.4% did not use LTC resources. A multivariable logistic analysis revealed that aberrant motor behaviors (odd ratio [OR] = 1.31, 95% confidence interval [CI] = 1.10-1.56, p = 0.003), dysfunction in ADLs (OR = 1.06, 95% CI = 1.02-1.10, p = 0.002), higher ZBI scores (OR = 1.02, 95% CI = 1.01-1.03, p = 0.004), not residing with family members (OR = 1.88, 95% CI = 1.32-2.66, p < 0.001), and not employing a migrant caregiver (OR = 4.41, 95% CI = 2.59-7.51, p < 0.001) were the factors most significantly associated with LTC service use. CONCLUSION Factors such as whether PWDs live alone, specific neuropsychiatric symptoms, and impaired function should be considered in future policy amendments to provide required activities and care resources for PWDs and their caregivers.
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Affiliation(s)
- Chia-Fen Tsai
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mao-Hsuan Huang
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, YuanShan and Suao Branches of Taipei Veterans General Hospital, Ilan, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jun-Jun Lee
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan
- Department of Information Management, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Li-Kai Huang
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan
- The PhD program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Wei-Ju Lee
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chien Liu
- Neurological Center of Cardinal Tien Hospital, Taipei, Taiwan
- Fu Jen University School of Medicine, Taipei, Taiwan
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Rende, Taiwan
- Departemnt of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Jong-Ling Fuh
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
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13
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Tsai CF, Huang MH, Lee JJ, Jhang KM, Huang LC, Huang LK, Lee WJ, Sung PS, Liu YC, Ouyang WC, Cheng CM, Hsu CC, Fuh JL. Factors associated with burden among male caregivers for people with dementia. J Chin Med Assoc 2022; 85:462-468. [PMID: 35286289 DOI: 10.1097/jcma.0000000000000704] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is a dearth of information on male dementia caregivers in Asia and, in particular, on the factors relating to caregiver burden. We aimed to identify factors that may be associated with burden among male caregivers of people with dementia (PWD). METHODS Data were collected from a national dementia registration survey. The caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). We analyzed the correlation between ZBI scores and variables, such as demographic data of PWD and their male caregivers, caregivers' monthly income, the relationship between PWD and caregivers, the severity of dementia, physical comorbidities and activities of daily living (ADL) of PWD, and neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory (NPI). RESULTS A total of 509 PWD and their male caregivers were included. The majority of caregivers were sons (72.1%) and husbands (22.0%). Sons had higher ZBI scores than husbands (28.5 ± 15.2 vs 22.0 ± 17.0; p < 0.001). Multivariable linear regression showed that sons as caregivers (β = 7.44, p = 0.034), ADL (β = 0.52, p = 0.002), and NPI_severity subscore of apathy (β = 2.74, p = 0.001) were positively associated with ZBI scores. CONCLUSION Poor ADL and apathy in PWD and being a patient's son were associated with higher levels of burden among male dementia caregivers. Effective interventions are needed to assist male caregivers in accomplishing their caregiving role and at the same time to alleviate their caregiver burden.
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Affiliation(s)
- Chia-Fen Tsai
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Mao-Hsuan Huang
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Psychiatry, Suao and Yuanshan Branches of Taipei Veterans General Hospital, Ilan, Taiwan, ROC
| | - Jun-Jun Lee
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan, ROC
- Department of Information Management, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC
| | - Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan, ROC
| | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC
| | - Li-Kai Huang
- Department of Neurology, Shuang Ho Hospital, Taipei, Taipei Medical University, New Taipei City, Taiwan, ROC
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan, ROC
- Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC
| | - Wei-Ju Lee
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Yi-Chien Liu
- Neurological Center of Cardinal Tien Hospital, Taipei, Taiwan, ROC
- Fu Jen University School of Medicine, Taipei, Taiwan, ROC
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan, ROC
- Departemnt of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan, ROC
| | - Chih-Ming Cheng
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC
| | - Jong-Ling Fuh
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Wu CT, Huang HC, Huang S, Chen IM, Liao SC, Chen CK, Lin C, Lee SH, Chen MH, Tsai CF, Weng CH, Ko LW, Jung TP, Liu YH. Resting-State EEG Signal for Major Depressive Disorder Detection: A Systematic Validation on a Large and Diverse Dataset. Biosensors (Basel) 2021; 11:499. [PMID: 34940256 PMCID: PMC8699348 DOI: 10.3390/bios11120499] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/26/2021] [Accepted: 12/04/2021] [Indexed: 05/09/2023]
Abstract
Major depressive disorder (MDD) is a global healthcare issue and one of the leading causes of disability. Machine learning combined with non-invasive electroencephalography (EEG) has recently been shown to have the potential to diagnose MDD. However, most of these studies analyzed small samples of participants recruited from a single source, raising serious concerns about the generalizability of these results in clinical practice. Thus, it has become critical to re-evaluate the efficacy of various common EEG features for MDD detection across large and diverse datasets. To address this issue, we collected resting-state EEG data from 400 participants across four medical centers and tested classification performance of four common EEG features: band power (BP), coherence, Higuchi's fractal dimension, and Katz's fractal dimension. Then, a sequential backward selection (SBS) method was used to determine the optimal subset. To overcome the large data variability due to an increased data size and multi-site EEG recordings, we introduced the conformal kernel (CK) transformation to further improve the MDD as compared with the healthy control (HC) classification performance of support vector machine (SVM). The results show that (1) coherence features account for 98% of the optimal feature subset; (2) the CK-SVM outperforms other classifiers such as K-nearest neighbors (K-NN), linear discriminant analysis (LDA), and SVM; (3) the combination of the optimal feature subset and CK-SVM achieves a high five-fold cross-validation accuracy of 91.07% on the training set (140 MDD and 140 HC) and 84.16% on the independent test set (60 MDD and 60 HC). The current results suggest that the coherence-based connectivity is a more reliable feature for achieving high and generalizable MDD detection performance in real-life clinical practice.
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Affiliation(s)
- Chien-Te Wu
- International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo 113-0033, Japan;
| | - Hao-Chuan Huang
- Hipposcreen Neurotech Corp. (HNC), Taipei 114, Taiwan; (H.-C.H.); (S.H.); (C.-H.W.)
| | - Shiuan Huang
- Hipposcreen Neurotech Corp. (HNC), Taipei 114, Taiwan; (H.-C.H.); (S.H.); (C.-H.W.)
| | - I-Ming Chen
- Division of Psychosomatic Medicine, Department of Psychiatry, National Taiwan University Hospital, Taipei 100229, Taiwan; (I.-M.C.); (S.-C.L.)
- Institute of Health Policy and Management, National Taiwan University, Taipei 10617, Taiwan
| | - Shih-Cheng Liao
- Division of Psychosomatic Medicine, Department of Psychiatry, National Taiwan University Hospital, Taipei 100229, Taiwan; (I.-M.C.); (S.-C.L.)
| | - Chih-Ken Chen
- Department of Psychiatry & Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-K.C.); (C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
| | - Chemin Lin
- Department of Psychiatry & Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-K.C.); (C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
| | - Shwu-Hua Lee
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (M.-H.C.); (C.-F.T.)
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (M.-H.C.); (C.-F.T.)
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
| | - Chang-Hsin Weng
- Hipposcreen Neurotech Corp. (HNC), Taipei 114, Taiwan; (H.-C.H.); (S.H.); (C.-H.W.)
| | - Li-Wei Ko
- Department of Bio Science & Tech., National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
| | - Tzyy-Ping Jung
- Institute for Neural Computation, University of California, San Diego, CA 92093, USA
| | - Yi-Hung Liu
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 106335, Taiwan
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15
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Yang YK, Chen CS, Tsai CF, Chang CM, Lai TJ, Lee CT, Lin CC, Lan TH, Herr KJ. A Taiwanese study on real-world evidence with vortioxetine in patients with major depression in Asia (TREVIDA). Curr Med Res Opin 2021; 37:2163-2173. [PMID: 34515596 DOI: 10.1080/03007995.2021.1980869] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The TREVIDA study aimed to evaluate vortioxetine for the treatment of major depressive disorder (MDD) in Taiwanese adults. METHODS Patients with active depressive episode were recruited in this non-interventional, prospective, multi-site study conducted between June 2019 and August 2020 in Taiwan. Patient eligibility was independent of the physician's decision to prescribe vortioxetine for an MDD episode. Vortioxetine was initiated on the first visit. Depression severity, cognitive function, work productivity, functioning and safety were evaluated over 3 months. RESULTS Overall, 242 patients were analyzed. At baseline, 70.7% and 90.4% of patients had moderately severe-to-severe depression based on PHQ-9 (Patient Health Questionnaire-9) and TDQ (Taiwanese Depression Questionnaire), respectively. By Month 3, significant improvements from baseline in depression severity (mean [SD] changes in PHQ-9, TDQ and CGI-S [Clinical Global Impression-Severity]: -6.3 [7.3]; -13.2 [14.0]; -1.5 [1.3], respectively), cognitive function (mean [SD] change in PDQ-D: -8.0 [17.5]), functioning (mean [SD] change in SDS: -5.4 [7.6]), and presenteeism (38.9% from 56.3%), work productivity loss (40.9% from 58.7%) and activity impairment (43.2% from 61.0%) were observed (p < .001 for all). By month 3, patient-reported (PHQ-9) response and remission rates were 43.4% and 52.9%, respectively; physician-reported (CGI-S) response and remission rates were 29.0% and 31.6%, respectively. Vortioxetine was well-tolerated and no unexpected side effects were reported. CONCLUSIONS Vortioxetine reduced depression severity and improved cognitive function, work productivity, and functioning in Taiwanese patients with MDD in the real-world setting. Vortioxetine was well-tolerated in this Taiwanese population.
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Affiliation(s)
- Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Chia-Ming Chang
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Te-Jen Lai
- Department of Psychiatry, Chung Shan Medical University & Hospital, Taichung City, Taiwan
| | - Chun-Te Lee
- Department of Psychiatry, Chung Shan Medical University & Hospital, Taichung City, Taiwan
| | - Chih-Chien Lin
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Tsuo-Hung Lan
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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16
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Chan YLE, Cheng CM, Huang MH, Lee HJ, Tang LY, Tsai CF. Risk factors for mild behavioral impairment in non-demented geriatrics: a population-based survey in Taiwan - RETRACTION. Int Psychogeriatr 2021; 34:1. [PMID: 34794525 DOI: 10.1017/s1041610221002635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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17
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Su CH, Lo CH, Tsai CF. CHA2DS2-VASc score as independent outcome predictor in patients with acute ischemic stroke with and without atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Atrial fibrillation (AF) was a significant independent risk factor for 1-year mortality of first acute ischemic stroke. The CHA2DS2-VASc scores were initially developed to assess the risk of stroke or systemic embolism in patients with AF. Recently, this scoring system have been demonstrated to have clinical value for predicting the severity of infarction and long-term clinical outcomes in acute ischemic stroke but the evidence is not strong enough due to limited numbers and single center data.
Purpose
This large-scale prospective cohort study aimed to investigate the independent predictive value of CHA2DS2-VASc scores and AF in such patients.
Materials and methods
We included patients from Taiwan Stroke Registry (TSR) with ischemic stroke within 2006 to 2016 as the present study population. Patients were mainly divided in atrial fibrillation (AF) group and non-AF group. We future classified patient by CHA2DS2-VASc (congestive heart failure, hypertension, age≥75 years, diabetes, previous stroke, vascular disease, age 65–74 years, sex category) score 0–1 and ≥2. The primary outcome was major adverse cardiovascular events (MACE), which include re-stroke, myocardial infarction and cardiovascular death, occurred within 1 year after the onset of stroke. The secondary outcome was the all-cause mortality.
Results
We defined 2972 patients with MACE and 61,937 patients without MACE. With adjusting with the confounding of CHA2DS2-VASc scores, The AF group was associated with increased MACE (OR=1.15; 95% CI=1.00, 1.33), myocardial infarction (adjusted OR=3.89; 95% CI=1.81, 8.34), CV death (OR=5.73; 95% CI=3.77, 8.69) and all-cause mortality (OR=1.50; 95% CI=1.37, 1.65) but not in re-stroke (adjusted OR=1.02; 95% CI=0.88, 1.18). After controlling for AF, patients with CHA2DS2-VASc scores ≥2 had significantly higher odds of MACE (OR=1.28; 95% CI=1.16, 1.41), re-stroke (OR=1.27; 95% CI=1.16, 1.40) and all-cause mortality (OR=2.26; 95% CI=2.06, 2.48) than that of patients with CHA2DS2-VASc scores 0–1. The survival curve revealed both AF and CHA2DS2-VASc scores are independent risk factors of 1 year MACE and mortality. By investigating the individual risk factor of CHA2DS2-VASc score, diabetes, hypertension and age over 65 years old increase the risk of MACE significantly.
Conclusions
CHA2DS2-VASc scores appear to have potent independent value as AF for predicting 1 year MACE and all-cause mortality in patients of acute ischemic stroke.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- C H Su
- Chung Shan Medical University Hospital, Division of Cardiology, Department of Internal Medicine, Taichung, Taiwan
| | - C H Lo
- Chung Shan Medical University Hospital, Division of Cardiology, Department of Internal Medicine, Taichung, Taiwan
| | - C F Tsai
- Chung Shan Medical University Hospital, Division of Cardiology, Department of Internal Medicine, Taichung, Taiwan
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18
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Tsai CF, Chen CC, Wu EHK, Chung CR, Huang CY, Tsai PY, Yeh SC. A Machine-Learning-Based Assessment Method for Early-Stage Neurocognitive Impairment by an Immersive Virtual Supermarket. IEEE Trans Neural Syst Rehabil Eng 2021; 29:2124-2132. [PMID: 34623270 DOI: 10.1109/tnsre.2021.3118918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder. Though it is not yet curable or reversible, research has shown that clinical intervention or intensive cognitive training at an early stage may effectively delay the progress of the disease. As a result, screening populations with mild cognitive impairment (MCI) or early AD via efficient, effective and low-cost cognitive assessments is important. Currently, a cognitive assessment relies mostly on cognitive tests, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA), which must be performed by therapists. Also, cognitive functions can be divided into a variety of dimensions, such as memory, attention, executive function, visual spatial and so on. Executive functions (EF), also known as executive control or cognitive control, refer to a set of skills necessary to perform higher-order cognitive processes, including working memory, planning, attention, cognitive flexibility, and inhibitory control. Along with the fast progress of virtual reality (VR) and artificial intelligence (AI), this study proposes an intelligent assessment method aimed at assessing executive functions. Utilizing machine learning to develop an automatic evidence-based assessment model, behavioral information is acquired through performing executive-function tasks in a VR supermarket. Clinical trials were performed individuals with MCI or early AD and six healthy participants. Statistical analysis showed that 45 out of 46 indices derived from behavioral information were found to differ significantly between individuals with neurocognitive disorder and healthy participants. This analysis indicates these indices may be potential bio-markers. Further, machine-learning methods were applied to build classifiers that differentiate between individuals with MCI or early AD and healthy participants. The accuracy of the classifier is up to 100%, demonstrating the derived features from the VR system were highly related to diagnosis of individuals with MCI or early AD.
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19
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Cheng CM, Chen MH, Chang WH, Tsai CF, Tsai SJ, Bai YM, Su TP, Chen TJ, Li CT. Risks of Coaggregation of Major Psychiatric Disorders Among First-Degree Relatives of Patients With Bipolar I and Bipolar II Disorder: Evidence From a Nationwide Population-Based Study. J Clin Psychiatry 2021; 82. [PMID: 34496462 DOI: 10.4088/jcp.20m13810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: Etiologic differences between bipolar I disorder (BD-I) and bipolar II disorder (BD-II) have been challenged recently, and family epidemiologic studies may elucidate the matter. Nevertheless, it remains unclear whether BD-I and BD-II display different familial aggregation patterns within each bipolar disorder subtype and coaggregation with other psychiatric disorders. Method: Per the Taiwan National Health Insurance Research Database (N = 23,258,175), patients with bipolar disorder were classified as having BD-I or BD-II based on the history of psychiatric hospitalization for a manic episode. During the study period (2001-2011), 184,958 first-degree relatives (FDRs) of patients with BD-I and BD-II were identified. By comparing patients with 1:4 age-, sex-, and kinship-matched samples without BD-I/BD-II probands, the relative risks (RRs) of major psychiatric disorders were estimated. Results: FDRs of BD-I probands had a significantly higher risk of BD-I than those of BD-II probands (BD-I proband: RR = 15.80 vs BD-II proband: RR = 5.68, P < .001). The risk of BD-II was similar between FDRs of BD-I and BD-II probands (BD-I proband: RR = 6.48 vs BD-II proband: RR = 5.89, P = .1161). Familial aggregation was greater within each BD subtype than among cross-subtypes. Furthermore, FDRs of BD-I probands had an increased risk of schizophrenia (BD-I probands: RR = 5.83 vs BD-II probands: RR = 2.72, P < .001); FDRs of BD-II probands had a higher likelihood of attention-deficit/hyperactivity disorder (BD-II probands: 2.36 vs BD-I probands: 1.93, P = .0009). Conclusions: The risk of psychiatric disorders is higher among the FDRs of patients with either BD-I or BD-II. Furthermore, the familial specificity of BD-I and BD-II assessed in this study may further the current understanding of etiologic boundaries between bipolar disorder subtypes.
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Affiliation(s)
- Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Equally contributed
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Equally contributed
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Graduate Institute of Statistics National Central University, Taoyuan, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Institute of Brain Science, 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
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Corresponding author: Cheng-Ta Li, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Rd, Sec. 2, 11217, Taipei, Taiwan
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20
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Trinh TT, Tsai CF, Hsiao YT, Lee CY, Wu CT, Liu YH. Identifying Individuals With Mild Cognitive Impairment Using Working Memory-Induced Intra-Subject Variability of Resting-State EEGs. Front Comput Neurosci 2021; 15:700467. [PMID: 34421565 PMCID: PMC8373435 DOI: 10.3389/fncom.2021.700467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/30/2021] [Indexed: 11/22/2022] Open
Abstract
Individuals with mild cognitive impairment (MCI) are at high risk of developing into dementia (e. g., Alzheimer's disease, AD). A reliable and effective approach for early detection of MCI has become a critical challenge. Although compared with other costly or risky lab tests, electroencephalogram (EEG) seems to be an ideal alternative measure for early detection of MCI, searching for valid EEG features for classification between healthy controls (HCs) and individuals with MCI remains to be largely unexplored. Here, we design a novel feature extraction framework and propose that the spectral-power-based task-induced intra-subject variability extracted by this framework can be an encouraging candidate EEG feature for the early detection of MCI. In this framework, we extracted the task-induced intra-subject spectral power variability of resting-state EEGs (as measured by a between-run similarity) before and after participants performing cognitively exhausted working memory tasks as the candidate feature. The results from 74 participants (23 individuals with AD, 24 individuals with MCI, 27 HC) showed that the between-run similarity over the frontal and central scalp regions in the HC group is higher than that in the AD or MCI group. Furthermore, using a feature selection scheme and a support vector machine (SVM) classifier, the between-run similarity showed encouraging leave-one-participant-out cross-validation (LOPO-CV) classification performance for the classification between the MCI and HC (80.39%) groups and between the AD vs. HC groups (78%), and its classification performance is superior to other widely-used features such as spectral powers, coherence, and the complexity estimated by Katz's method extracted from single-run resting-state EEGs (a common approach in previous studies). The results based on LOPO-CV, therefore, suggest that the spectral-power-based task-induced intra-subject EEG variability extracted by the proposed feature extraction framework has the potential to serve as a neurophysiological feature for the early detection of MCI in individuals.
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Affiliation(s)
- Thanh-Tung Trinh
- Neural Engineering and Smart Systems Laboratory, Graduate Institute of Manufacturing Technology, College of Mechanical and Electrical Engineering, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Tsung Hsiao
- Neural Engineering and Smart Systems Laboratory, Graduate Institute of Mechatronic Engineering, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan
| | - Chun-Ying Lee
- Department of Mechanical Engineering, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan
| | - Chien-Te Wu
- International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Yi-Hung Liu
- Department of Mechanical Engineering, National Taiwan University of Science and Technology (Taiwan Tech), Taipei, Taiwan
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21
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Tsai CF, Chen MH, Wang YP, Liu PY, Hou MC, Lee FY, Lu CL. Increased risk of short-term depressive disorder after Helicobacter pylori eradication: A population-based nested cohort study. Helicobacter 2021; 26:e12824. [PMID: 34117671 DOI: 10.1111/hel.12824] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depressive disorder is a major psychiatric illness, and a disturbed brain-gut-microbiome axis may contribute to its pathophysiology. Chronic Helicobacter pylori (H. pylori) infections are common in the general population and using multiple antibiotics is required for its eradication, which is associated with gut dysbiosis and may lead to depression. We aimed to evaluate the risk of psychiatrist-diagnosed depression in patients with peptic ulcer diseases (PUD) receiving anti-H. pylori therapy. MATERIALS AND METHODS We collected data from the National Health Insurance Research Database (NHIRD) in Taiwan on PUD patients undergoing antibiotic treatment for H. pylori infection; patients and controls were matched for age, sex, income, level of urbanization, and comorbidities. RESULTS Of the 1 million beneficiaries in the NHIRD, we identified 7087 patients for inclusion in the eradication cohort and 7087 matched non-eradication controls with PUD. Antibiotic therapy is associated with a short-term (<30 days) increase in the incidence of psychiatrist-diagnosed depressive disorder (p = 0.009, after multiple comparisons with Bonferroni correction) in the eradication cohort compared with the controls. Female (OR: 4.55, 95% CI: 1.53-13.48) PUD patients were more likely to display an increased risk of depression within 30 days after eradication therapy. Clarithromycin use was related to an elevated likelihood (OR: 3.14, 95% CI: 1.45-6.80) of subsequent depressive disorder within 30 days after eradication therapy. CONCLUSIONS Antibiotic eradication treatment for H. pylori infection is associated with a significant short-term (less than 30 days) increase in the incidence of psychiatrist-diagnosed depressive disorder, which can be overlooked by gastroenterologists and general practitioners.
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Affiliation(s)
- Chia-Fen Tsai
- Institute of Brain Science, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - Mu-Hong Chen
- Institute of Brain Science, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - Yen-Po Wang
- Institute of Brain Science, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Gastroenteorlogy, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Yi Liu
- Institute of Brain Science, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- Institute of Brain Science, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Gastroenteorlogy, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fa-Yauh Lee
- Institute of Brain Science, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Gastroenteorlogy, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Liang Lu
- Institute of Brain Science, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Gastroenteorlogy, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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22
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Liu YW, Wang YP, Yen HF, Liu PY, Tzeng WJ, Tsai CF, Lin HC, Lee FY, Jeng OJ, Lu CL, Tsai YC. Lactobacillus plantarum PS128 Ameliorated Visceral Hypersensitivity in Rats Through the Gut-Brain Axis. Probiotics Antimicrob Proteins 2021; 12:980-993. [PMID: 31691208 DOI: 10.1007/s12602-019-09595-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by abdominal pain and alterations in bowel habits. Current treatments for IBS are unsatisfactory due to its multifactorial pathogenesis involving the microbiota-gut-brain axis. Lactobacillus plantarum PS128 (PS128) was reported to exhibit neuromodulatory activity which may be beneficial for improving IBS. This study aimed to investigate the effect of PS128 on visceral hypersensitivity (VH) and the gut-brain axis using a 5-hydroxytryptophan (5-HTP)-induced VH rat model without colonic inflammation induction, mimicking the characteristics of IBS. Male Sprague-Dawley rats were administered with PS128 (109 CFU in 0.2 mL saline/rat/day) or saline (0.2 mL saline/rat/day) for 14 days. Colorectal distension (CRD) with simultaneous electromyography recording was performed 30 min before and 30 min after the 5-HTP injection. Levels of neuropeptides and neurotrophins were analyzed. PS128 significantly reduced VH induced by the 5-HTP injection and CRD. Neurotransmitter protein levels, substance P, CGRP, BDNF, and NGF, were decreased in the dorsal root ganglion but increased in the spinal cord in response to the 5-HTP injection; PS128 reversed these changes. The hypothalamic-pituitary-adrenal axis was modulated by PS128 with decreased corticosterone concentration in serum and the expression of mineralocorticoid receptors in the amygdala. Oral administration of PS128 inhibited 5-HTP-induced VH during CRD. The ameliorative effect on VH suggests the potential application of PS128 for IBS.
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Affiliation(s)
- Yen-Wenn Liu
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan.,Microbiome Research Center, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan
| | - Yen-Po Wang
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou Dist., Taipei, 11217, Taiwan.,Institute of Brain Science, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan.,School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan
| | - Hsu-Fang Yen
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan
| | - Pei-Yi Liu
- Institute of Brain Science, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan
| | - Wen-Jian Tzeng
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan
| | - Chia-Fen Tsai
- School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou Dist., Taipei, 11217, Taiwan
| | - Han-Chieh Lin
- School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan.,Division of Gastroenterology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou Dist., Taipei, 11217, Taiwan
| | - Fa-Yauh Lee
- School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan.,Division of Gastroenterology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou Dist., Taipei, 11217, Taiwan
| | | | - Ching-Liang Lu
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou Dist., Taipei, 11217, Taiwan. .,Institute of Brain Science, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan. .,School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan. .,Division of Gastroenterology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou Dist., Taipei, 11217, Taiwan.
| | - Ying-Chieh Tsai
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan. .,Microbiome Research Center, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, 11221, Taiwan.
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Chen MH, Cheng CM, Tsai SJ, Tsai CF, Su TP, Li CT, Lin WC, Chen TJ, Bai YM. Obsessive-Compulsive Disorder and Dementia Risk: A Nationwide Longitudinal Study. J Clin Psychiatry 2021; 82. [PMID: 34004091 DOI: 10.4088/jcp.20m13644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Several case reports have suggested an association between obsessive-compulsive disorder (OCD) and dementia. However, the exact relationship remains unclear. METHODS Using the Taiwan National Health Insurance Research Database, 1,347 patients with OCD (ICD-9-CM code 300.3) aged ≥ 45 years and 13,470 controls matched for age, sex, residence, income, and dementia-related comorbidities were included between 1996 and 2013 for investigation of subsequent dementia from enrollment to the end of 2013. Stratified Cox regression analysis on each matched pair was applied to assess the dementia risk between the OCD and control groups. The analysis for the current study was performed in 2018. RESULTS Patients with OCD had increased risk of developing any dementia (hazard ratio [HR] = 4.28; 95% confidence interval [CI], 2.96-6.21), Alzheimer's disease (HR = 4.04; 95% CI, 1.55-10.54), and vascular dementia (HR = 3.95; 95% CI, 1.70-9.18) compared with controls. DISCUSSION Future research on the pathogenic mechanisms and molecular underpinnings of the relationship between OCD and dementia may lead to the development of novel therapeutics.
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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 University, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.,Corresponding author: Ya-Mei Bai, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Rd, Sec 2, 11217, Taipei, Taiwan
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24
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Abstract
BACKGROUND Alzheimer's disease (AD) exerts significant financial expenses on caregivers, and knowledge of caregivers' support for out-of-pocket payment is of great importance for policymaking on the insurance coverage of future AD medication in Taiwan. We aimed to investigate caregivers' willingness to pay (WTP) for a hypothetical curative AD medication and the effect of different factors on the amount of WTP. METHODS Informal caregivers of patients with AD and informants of patients with amnestic mild cognitive impairment (MCI) were included. An iterative bidding game technique, followed by a dichotomous choice question and a final open-ended question were used to elicit caregivers' maximum WTP. The correlations between the WTP and characteristics of caregiver and patient were analyzed, including sex, educational level, severity of dementia, neuropsychiatric symptoms assessed by Neuropsychiatric Inventory, time needed to support patients assessed by Caregiver Activity Survey, and caregivers' monthly income. RESULTS A total of 1134 informal caregivers of patients with AD or MCI were included. Caregivers of patients with AD were willing to pay for a curative AD medication, and their maximum WTP value was higher than informants of MCI patients. Among patients with AD and patients with MCI, caregivers' monthly income was positively correlated with WTP. Apathy subsyndrome was the only factor correlated with percentage of WTP in caregiver's income in the MCI group. CONCLUSION Support for out-of-pocket WTP for a hypothetical curative AD medication was significantly related to caregiver's income.
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Affiliation(s)
- Mao-Hsuan Huang
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Psychiatry, Taipei Veterans General Hospital, Yuanshan and Suao Branch, Ilan, Taiwan, ROC
| | - Chia-Fen Tsai
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Wei-Ju Lee
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, ROC
- Dementia and Parkinson's Disease Integrated Center, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan, ROC
- Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan, ROC
| | - Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan, ROC
| | - Shuu-Jiun Wang
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Jong-Ling Fuh
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, ROC
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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25
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Huang MH, Wang YP, Wu PS, Chan YLE, Cheng CM, Yang CH, Tsai SJ, Lu CL, Tsai CF. Association between gastrointestinal symptoms and depression among older adults in Taiwan: A cross-sectional study. J Chin Med Assoc 2021; 84:331-335. [PMID: 33186213 DOI: 10.1097/jcma.0000000000000460] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Older adults with depression more frequently experience somatic and gastrointestinal (GI) problems compared with people without depression and younger adults with depression. However, whether GI symptoms are predictive of elevated rates of depression among older adults is unclear. METHODS We enrolled 106 older adults (>60 years old); 69 had late-life depression (LLD), and 37 were controls. All participants gave ratings on the Gastrointestinal Symptom Rating Scale (GSRS) and Hamilton Depression Rating Scale. Food consumption was assessed using a food frequency questionnaire, and a Mediterranean diet score was used as a covariate. RESULTS Compared with the controls, patients with LLD reported higher levels of depressive and GI symptoms and reported more reflux, abdominal pain, and dyspepsia symptoms, and these symptoms were correlated with Hamilton Depression Rating Scale scores (GSRS total: β = 0.47; reflux: β = 1.47; abdominal pain: β = 1.98; dyspepsia: β = 1.02; all p < 0.01). After demographic variables and Mediterranean diet score were controlled for, a logistic regression analysis indicated that total GSRS score was an independent determinant of LLD (odds ratio: 1.20, 95% CI: 1.04-1.38). Moreover, a stratified analysis by depression severity indicated that higher total GSRS score may contribute to greater depression severity (odds ratio: 1.25, 95% CI: 1.04-1.52). CONCLUSION We provide evidence that GI symptoms are associated with depressive symptoms among patients with LLD. Older people with more specific GI symptoms, such as reflux, abdominal pain, and dyspepsia, are potentially at greater risk of having LLD.
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Affiliation(s)
- Mao-Hsuan Huang
- Department of Psychiatry, Suao and Yuanshan Branches of Taipei Veterans General Hospital, Hualien, Taiwan, ROC
- Faculty of Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan, ROC
| | - Yen-Po Wang
- Department of Psychiatry, Suao and Yuanshan Branches of Taipei Veterans General Hospital, Hualien, Taiwan, ROC
- Faculty of Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan, ROC
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Endoscopic Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Clinical Nutrition, Department of Dietetics and Nutrition, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Psychiatry, Cheng Hsin Hospital, Taipei, Taiwan, ROC
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Po-Shan Wu
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of Clinical Nutrition, Department of Dietetics and Nutrition, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yee-Lam E Chan
- Department of Psychiatry, Cheng Hsin Hospital, Taipei, Taiwan, ROC
| | - Chih-Ming Cheng
- Faculty of Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan, ROC
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Cheng-Hung Yang
- Faculty of Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan, ROC
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shih-Jen Tsai
- Faculty of Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan, ROC
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ching-Liang Lu
- Department of Psychiatry, Suao and Yuanshan Branches of Taipei Veterans General Hospital, Hualien, Taiwan, ROC
- Faculty of Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan, ROC
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Endoscopic Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Clinical Nutrition, Department of Dietetics and Nutrition, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Psychiatry, Cheng Hsin Hospital, Taipei, Taiwan, ROC
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chia-Fen Tsai
- Faculty of Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan, ROC
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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26
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Tseng HJ, Cheng CM, Tsai SJ, Lin WC, Bai YM, Tsai CF, Su TP, Li CT, Chen TJ, Chen MH. Proton Pump Inhibitor Exposure and Acute Myocardial Infarction Risk: A Nested Cohort Study. Cardiovasc Toxicol 2021; 21:444-450. [PMID: 33625647 DOI: 10.1007/s12012-021-09637-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Association of proton pump inhibitor (PPI) exposure with acute myocardial infarction (AMI) risk in the Caucasian population remains under debate. Here, we clarified whether PPI exposure might be related to an increased new-onset AMI risk in an Asian population. METHOD Data of 27,624 patients with PPI exposure followed by new-onset AMI development were extracted from Taiwan National Health Insurance Research Database and age- and sex-matched with 27,624 controls with PPIs exposure, but without subsequent AMI and ischemic heart disease development. The amount of PPI exposure was calculated based on the cumulative defined daily dose (cDDD) during the follow-up period. Subsequent AMI risk was measured after adjustments of demographic data and indication of PPI use. RESULTS AMI risk increased with an increase in PPI exposure: with cDDD ≤ 30 as the reference, the odds ratios (95% confidence intervals) for cDDDs of > 365 was 1.56 (1.45-1.69). All five PPI categories, including pantoprazole, lansoprazole, omeprazole, esomeprazole, and rabeprazole, increased AMI risk. CONCLUSIONS Our study demonstrated long-term or high-dose PPI exposure associated with increased new-onset AMI risk in patients without a history of any ischemic heart disease. The underlying mechanisms of PPI-related cardiovascular effects deserve more investigation.
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Affiliation(s)
- Hsiang-Jung Tseng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan. .,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Li JR, Lau CI, Huang MH, Hu LY, Tsai CF, Liu MN. Language impairment as diagnostic clue to lvPPA in a young-onset dementia patient mimicking bvFTD. Aust N Z J Psychiatry 2021; 55:225-226. [PMID: 32856929 DOI: 10.1177/0004867420950797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jia-Ru Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei
| | - Chi-Ieong Lau
- Dementia Center, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei.,Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, UK.,College of Medicine, Fu-Jen Catholic University, Taipei.,Institute of Biophotonics, National Yang-Ming University, Taipei.,University Hospital, Taipa, Macau
| | - Mao-Hsaun Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei
| | - Li-Yu Hu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei.,University Hospital, Taipa, Macau
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei.,Institute of Brain Science, National Yang University, Taipei
| | - Mu-N Liu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei.,Institute of Brain Science, National Yang University, Taipei.,Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
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28
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Tsai CF, Hwang WS, Lee JJ, Wang WF, Huang LC, Huang LK, Lee WJ, Sung PS, Liu YC, Hsu CC, Fuh JL. Predictors of caregiver burden in aged caregivers of demented older patients. BMC Geriatr 2021; 21:59. [PMID: 33446114 PMCID: PMC7809883 DOI: 10.1186/s12877-021-02007-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/04/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Dementia in the oldest-old is projected to increase exponentially as is the burden of their caregivers who may experience unique challenges and suffering. Thus, we aim to investigate which factors are associated with older caregivers' burden in caring demented outpatients in a multicenter cohort. METHODS Patients and their caregivers, both aged ≧65 years, in the National Dementia Registry Study in Taiwan (T-NDRS) were included in this study. Caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). The correlations between the ZBI scores and characteristics of caregivers and patients, including severity of dementia, physical comorbidities, instrumental activities of daily living (IADL), neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory (NPI), and family monthly income, were analyzed. RESULTS We recruited 328 aged informal caregiver-patient dyads. The mean age of caregivers was 73.7 ± 7.0 years, with female predominance (66.8%), and the mean age of patients was 78.8 ± 6.9 years, with male predominance (61.0%). Multivariable linear regression showed that IADLs (β = 0.83, p < 0.001) and NPI subscores of apathy (β = 3.83, p < 0.001)and irritability (β = 4.25, p < 0.001) were positively associated with ZBI scores. The highest family monthly income (β = - 10.92, p = 0.001) and caregiver age (β = - 0.41, p = 0.001) were negatively correlated with ZBI scores. CONCLUSIONS Older caregivers of older demented patients experience a higher care burden when patients had greater impaired functional autonomy and the presence of NPI symptoms of apathy and irritability. Our findings provide the direction to identify risky older caregivers, and we should pay more attention to and provide support for these exhausted caregivers.
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Affiliation(s)
- Chia-Fen Tsai
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Shen Hwang
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, Tungs' Taichung Metroharbor Hospital, Taichung, Taiwan
| | - Jun-Jun Lee
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan.,Department of Information Management, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.,Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan
| | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, 112, Taiwan
| | - Li-Kai Huang
- Department of Neurology, Shuang Ho Hospital, Taipei, Taipei Medical University, New Taipei City, Taiwan.,Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan.,The PhD program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Wei-Ju Lee
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.,Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chien Liu
- Neurological Center of Cardinal Tien Hospital, Taipei, Taiwan.,Fu Jen University School of Medicine, Taipei, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Jong-Ling Fuh
- Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan. .,Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
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29
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Chen SY, Fang M, Lin YT, Tsai CF, Cheng HF, Wang DY. Elucidation of two new corticosteroids, betamethasone dibutyrate and betamethasone tributyrate. Steroids 2021; 165:108739. [PMID: 33075400 DOI: 10.1016/j.steroids.2020.108739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/14/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
Corticosteroids were used normally as anti-inflammatory drugs. However, in some area certain corticosteroids might be illegally used as growth promoting agent in feed, and as prohibited doping substances in game and sport for human or/and animal performance-enhancing. Synthesized structural similar corticosteroids were popular in black market because they can pass routine drug screening. In this study two new artificial synthesized corticosteroids were found in claimed hydrolyzed wheat product. Liquid chromatography coupled with high resolution mass spectrometry (HRMS, Orbitrap) was applied to separate and elucidate the corticosteroids in the sample. Two unknown peaks with optical spectra similar to corticosteroids were first screened out at the beginning, and then their accurate molecular weight (M + H+) m/z 533.29059 and m/z 603.33289 were detected by HRMS. Element formulas of unknowns were calculated by the accurate mass and isotopes abundance. Structures were proposed by their fragment ions at high energy collision dissociation (HCD, 10 eV) and compared with candidate standard compounds. The two unknowns shared similar molecular skeleton with steroid core structure and presented man made fluorine element in their molecule. As the results, the unknowns in the sample were artificial synthesized, and the sample product was not a real food. The detected corticosteroids were also synthesized as reference compounds for conformation. Two new corticosteroids named betamethasone dibutyrate and betamethasone tributyrate were found and first time reported in this work. The legality of structural similar/modified corticosteroids were blurry and their safety were unverified. The confirmed identifications of two new found corticosteroids, and their mass spectra were provided in this paper for the reference of drug detection.
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Affiliation(s)
- Shin-Yu Chen
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei, Taiwan
| | - Mingchih Fang
- Department of Food Science, National Taiwan Ocean University, Keelung, Taiwan.
| | - Ya-Tze Lin
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei, Taiwan
| | - Chia-Fen Tsai
- Southern Center for Regional Administration, Taiwan Food and Drug Administration, Kaohsiung, Taiwan
| | - Hwei-Fang Cheng
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei, Taiwan
| | - Der-Yuan Wang
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei, Taiwan
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30
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Fang CJ, You HC, Huang ZL, Hsu CL, Tsai CF, Lin YT, Kao YM, Tseng SH, Wang DY, Su NW. Simultaneous Analysis of the Stable Carbon Isotope Ratios of Acetoin and Acetic Acid by GC-C-IRMS for Adulteration Detection in Brewed Rice Vinegar Products. J Agric Food Chem 2020; 68:14252-14260. [PMID: 33215927 DOI: 10.1021/acs.jafc.0c05674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In this study, we developed a method to simultaneously measure the stable carbon isotope ratio for acetic acid (δ 13Cacetic acid) and acetoin (δ13Cacetoin) in rice vinegar by gas chromatography-combustion-isotope ratio mass spectrometry. The method showed good precision and accuracy. With this method, data from 16 brewed rice vinegars and 10 acetic acid samples were used to evaluate the feasibility of adulteration detection. On the basis that all δ13Cacetoin values of brewed rice vinegars are nearly constant, a characteristic pattern of the stable carbon isotope in rice vinegar was built with the 95% confidence intervals for δ13Cacetic acid (-26.97 to -25.38‰), δ13Cacetoin (-28.14 to -27.09‰), and Δδ13C (0.61 to 2.27‰). An adulteration detection curve of Δδ13C was proposed based on the results of vinegar and acetic acid samples and confirmed by vinegar spiked with different amounts of acetic acid. This method could be useful in estimating the blending ratio of adulterated rice vinegar products. Products containing more than 10% of synthetic acetic acid could be possibly identified.
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Affiliation(s)
- Chun-Jen Fang
- Department of Agricultural Chemistry, National Taiwan University, No. 1, Sec. 4, Roosevelt Road., Da'an District, Taipei City 106216, Taiwan
- Taiwan Food and Drug Administration, 161-2 Kunyang Street, Nangang District, Taipei City 115209, Taiwan
| | - Hsin-Cheng You
- Taiwan Food and Drug Administration, 161-2 Kunyang Street, Nangang District, Taipei City 115209, Taiwan
| | - Zih-Ling Huang
- Taiwan Food and Drug Administration, 161-2 Kunyang Street, Nangang District, Taipei City 115209, Taiwan
| | - Che-Lun Hsu
- Taiwan Food and Drug Administration, 161-2 Kunyang Street, Nangang District, Taipei City 115209, Taiwan
| | - Chia-Fen Tsai
- Taiwan Food and Drug Administration, 161-2 Kunyang Street, Nangang District, Taipei City 115209, Taiwan
| | - Ya-Tze Lin
- Taiwan Food and Drug Administration, 161-2 Kunyang Street, Nangang District, Taipei City 115209, Taiwan
| | - Ya-Min Kao
- Taiwan Food and Drug Administration, 161-2 Kunyang Street, Nangang District, Taipei City 115209, Taiwan
| | - Su-Hsiang Tseng
- Taiwan Food and Drug Administration, 161-2 Kunyang Street, Nangang District, Taipei City 115209, Taiwan
| | - Der-Yuan Wang
- Taiwan Food and Drug Administration, 161-2 Kunyang Street, Nangang District, Taipei City 115209, Taiwan
| | - Nan-Wei Su
- Department of Agricultural Chemistry, National Taiwan University, No. 1, Sec. 4, Roosevelt Road., Da'an District, Taipei City 106216, Taiwan
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31
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Huang MH, Tsai CF, Hu CJ, Lin YT, Yang YH, Wang WF, Lee WJ, Fuh JL. Reliability and validity of the severe impairment battery in Taiwanese patients with moderate to severe Alzheimer's disease. J Chin Med Assoc 2020; 83:1014-1019. [PMID: 32796320 PMCID: PMC7647445 DOI: 10.1097/jcma.0000000000000412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The severe impairment battery (SIB) was developed to evaluate cognitive functions in moderate to severe dementia patients. We aimed to examine the reliability and validity of the Taiwanese version of the SIB (T-SIB) in patients with moderate to severe Alzheimer's disease (AD). METHODS AD patients with clinical dementia rating (CDR) stage 2 (n = 79) or 3 (n = 21) and scores <15 on the Taiwanese version of mini mental state examination (T-MMSE) were recruited from six hospitals in Taiwan. Cronbach's alpha was used to evaluate the internal consistency of the T-SIB. The CDR and functional assessment staging (FAST) scores were used to assess dementia severity. RESULTS We recruited 100 AD patients (73 women and 27 men; mean T-SIB score, 56.4 ± 24.8). The mean T-SIB total score for patients with CDR 2 and 3 were 60.3 ± 23.3 and 41.2 ± 24.9, respectively. The internal consistency of the T-SIB was 0.96. The T-SIB was moderately correlated with the T-MMSE (Pearson's correlation coefficient = 0.76). The areas under the curve for discriminating between CDR 2 and CDR 3 were 0.81 (95% CI = 0.91-0.71) and 0.72 (95% CI = 0.84-0.61), respectively. Using a cut-off score of 59, the T-SIB had a sensitivity of 80% and specificity of 61% for discriminating between CDR 2 and CDR 3. Using a cut-off score of 45, the T-SIB had a sensitivity of 83.3% and specificity of 73.1% for discriminating between the FAST stage 7c. CONCLUSION T-SIB is a reliable and valid instrument for measuring cognition of severely demented Taiwanese AD patients.
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Affiliation(s)
- Mao-Hsuan Huang
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chia-Fen Tsai
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chaur-Jong Hu
- Dementia Center, Department of Neurology, Taipei Neuroscience Institute, Shuang Ho Hospital, College of Medicine, Taipei Medical University, New Taipei City, Taiwan, ROC
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Department of and Master’s Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan, ROC
- Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan, ROC
| | - Wei-Ju Lee
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan, ROC
- Dementia and Parkinson’s Disease Integrated Center, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Jong-Ling Fuh
- Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan, ROC
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Address correspondence. Dr. Jong-Ling Fuh, Neurological Institute, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: (J.-L. Fuh)
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32
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Chan YLE, Chen MH, Tsai SJ, Bai YM, Tsai CF, Cheng CM, Su TP, Chang WH, Chen TJ, Li CT. Treatment-Resistant depression enhances risks of dementia and alzheimer's disease: A nationwide longitudinal study. J Affect Disord 2020; 274:806-812. [PMID: 32664018 DOI: 10.1016/j.jad.2020.05.150] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/17/2020] [Accepted: 05/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous evidence indicates late-onset depression or depression with greater severity are associated with subsequent risk of dementia or Alzheimer's disease (AD). However, whether treatment-resistant depression is associated with such risks remain elusive. METHODS Using the Taiwan Nationwide Health Insurance Research Database, 3,345 patients with newly-diagnosed major depressive disorder (MDD) and 13,380 well-matched controls were enrolled between 2002 and 2004. MDD patients were stratified according to their treatment response to adequate antidepressant trials, and all participants were followed up until the end of 2013. Those who developed dementia and AD were identified. RESULTS MDD patients were more likely to develop dementia and AD than controls. Difficult-to-treat patients (i.e., DTT; those who failed to respond to at least two adequate antidepressant trials) had the highest risk of developing dementia (hazard ratio [HR] = 5.19) and AD (HR 4.44), whereas easy-to-treat patients (i.e., ETT-1; those who had no prescription of antidepressants) had the lowest risk of developing dementia (HR 2.37) and AD (HR 2.59) compared with controls. Subsequent analysis demonstrated that only among patients with late-onset depression (age > 65 years), DTT patients consistently showed higher risks and faster development of dementia (HR 6.64, mean: 1.45 yr) and AD (HR 4.97, mean: 1.67 yr) than did ETT-1 patients and controls. LIMITATIONS Subjects who have not received medical examination were not included as diagnosis were determined by ICD codes. Also, longer follow-up period might be needed for the younger group. CONCLUSIONS Late-onset treatment-resistant depression is associated with an elevated risk of dementia and AD.
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Affiliation(s)
- Yee-Lam E Chan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science and Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science and Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Cognitive Neuroscience, National Central University, Jhongli, Taiwan.
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Lin SH, Cheng CM, Tsai SJ, Tsai CF, Bai YM, Su TP, Li CT, Lin WC, Chen TJ, Chen MH. A Population-Based, Nationwide Longitudinal Study of Bipolar Disorder With Incident Dementia in Taiwan. Am J Geriatr Psychiatry 2020; 28:530-541. [PMID: 31761661 DOI: 10.1016/j.jagp.2019.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Affective disorders are associated with increased risk of dementia, yet most studies focus on the association of major depressive disorder or depressive episodes of bipolar disorder with increased dementia risk. The association of manic/mixed episodes of bipolar disorder with increased dementia risk is unclear. PARTICIPANTS Between January 1, 2001 and December 31, 2009, 20,535 individuals aged 45-80 years with bipolar disorder and 82,140 age- and sex-matched comparisons were enrolled and followed up to December 2011 in Taiwan. Those who developed dementia (ICD-9-CM codes: 290.0-290.4, 294.1-294.2, and 331.0-331.2) during the follow-up period were identified. DESIGN AND METHODS Cox proportional hazards models were used to examine the relationship between manic/mixed/depressive episodes of bipolar disorder and incident dementia. We also assessed the association between the frequency of psychiatric admissions (total, manic/mixed, and depressive episodes per year) for bipolar disorder and dementia risk. RESULTS Bipolar disorder was associated with increased risk of incident dementia (hazard ratio [HR]: 7.52, 95% confidence interval [CI]: 6.86-8.25). Greater frequency of manic/mixed (>2/year: HR: 4.50, 3.50-5.79; 1-2/year: HR: 3.17, 2.31-4.36) and depressive episodes (>2/year: HR: 7.84, 5.93-10.36; 1-2/year: HR: 2.93, 2.05-4.19) were associated with increased risk of incident dementia. CONCLUSIONS Not only depressive episode of bipolar disorder, but manic/mixed episodes of bipolar play a role as a risk factor of incident dementia, especially for those patients with more than two manic/mixed episodes per year. These findings remind the clinicians the importance of preventing the relapse of bipolar disorder for the potential subsequent cognitive decline and disease.
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Affiliation(s)
- Shen-Hsiung Lin
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital (C-MC), Taipei, Taiwan.
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital (T-PS), Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital (T-JC), Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University (T-JC), Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital (S-HL, C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University (C-MC, S-JT, C-FT, Y-M, T-PS, C-TL, W-CL, M-HC), Taipei, Taiwan.
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Cheng CM, Chen MH, Yang CH, Tsai SJ, Tsai CF. Dr Cheng and Colleagues Reply. J Clin Psychiatry 2020; 81. [PMID: 32237295 DOI: 10.4088/jcp.19lr13217a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Hung Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Fen Tsai
- .,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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Chen YJ, Tsai CF, Wang YP, Lu CL. Letter to the Editor: Proton Pump Inhibitors Are Associated With Minimal and Overt Hepatic Encephalopathy and Increased Mortality in Patients With Cirrhosis. Hepatology 2019; 70:760-761. [PMID: 30959562 DOI: 10.1002/hep.30641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- Yu-Jen Chen
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Po Wang
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Liang Lu
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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36
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Cheng CM, Chang WH, Chiu YC, Chen MH, Liao WT, Yang CH, Hwang JP, Li CT, Bai YM, Tsai SJ, Chen TJ, Tsai CF. Risk Score for Predicting Mortality in People With Dementia: A Nationwide, Population-Based Cohort Study in Taiwan With 11 Years of Follow-Up. J Clin Psychiatry 2019; 80. [PMID: 31184810 DOI: 10.4088/jcp.18m12629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 02/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Many researchers and physicians attempt to determine the prognosis and short- and long-term mortality risks of dementia for formulating suitable care plans for patients and their families. However, the published prediction models have been insufficient for this purpose and have worked only in certain specific populations. For medical autonomy and end-of-life decisions, an informative tool to predict 6-month, 1-year, 2-year, 3-year, and 5-year mortality rates for dementia patients merits further investigation. METHODS Patients aged ≥ 65 years who received ICD-9-CM diagnoses of dementia between 2002 and 2009 were identified from Taiwan's National Health Insurance Research Database and followed until the end of 2013. Patient characteristics and comorbidities that were considered potential risk factors for mortality were assessed. Mortality-predicting risk scores were developed using a regression coefficient-based scoring approach. In total, 6,556 patients were identified and then randomly divided into a derivation cohort (n = 4,371) and validation cohort (n = 2,185). RESULTS By the end of the study, 1,693 of the 4,371 dementia patients (38.7%) in the derivation cohort were deceased. Mean duration of follow-up was 6.26 years. Eleven acute and chronic factors were identified for building the predictive score model, which produced scores from 0 to 24 points (higher scores indicated higher mortality). The score model exhibited good predictive power for various life expectancies (area under receiver operating characteristic curve: 6-month = 0.852, 1-year = 0.779, 2-year = 0.725, 3-year = 0.721, 5-year = 0.703) and good calibration in the validation cohort (Hosmer-Lemeshow test, χ² = 4.709, P = .788). CONCLUSIONS The developed predictive score model may be the first tool that uses the same clinical factors to determine both short- and long-term mortality risks in patients with dementia.
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Affiliation(s)
- Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Graduate Institute of Statistics National Central University, Taoyuan, Taiwan
| | - Yu-Chuan Chiu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ting Liao
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Hung Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jen-Ping Hwang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Beitou District, Taipei, 112, Taiwan. .,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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Chen HC, Chen CH, Hsu CS, Chen TL, Liao MY, Wang CC, Tsai CF, Chen HM. In Situ Creation of Surface-Enhanced Raman Scattering Active Au-AuO x Nanostructures through Electrochemical Process for Pigment Detection. ACS Omega 2018; 3:16576-16584. [PMID: 31458290 PMCID: PMC6643664 DOI: 10.1021/acsomega.8b02677] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 11/19/2018] [Indexed: 05/04/2023]
Abstract
Roughing the metallic surface via oxidation-reduction cycles (ORC) to integrate the surface plasmon resonance and surface-enhanced Raman scattering (SERS) is predominant in developing sensor systems because of the facile preparation and uniform distribution of nanostructures. Herein, we proposed a distinctive ORC process: the forward potential passed through the oxidation of Au and reached the oxygen evolution reaction, and once the potential briefly remained at the vertex, the various reverse rates were employed to control the reduction state. The created hybrid Au-AuO x possessed electromagnetic and chemical enhancements concurrently, wherein the rough surface provided the strong local electromagnetic fields and significant interaction between AuO x and molecule to improve the charge transfer. The synergistic effects significantly amplified the intensity of Raman signal with an enhancement factor of 5.5 × 106 under the optimal conditions. Furthermore, the prepared SERS substrate can simultaneously identify and quantify the mixed edible pigments, Brilliant Blue FCF and Indigo Carmine, individually. This result suggested that the development of SERS sensor based on the proposed SERS-activated methodology is feasible and reliable.
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Affiliation(s)
- Hsiao-Chien Chen
- Department of Chemistry, National Taiwan University, 1, Section 4, Roosevelt Road, Taipei 106, Taiwan
- Center of Applied Nanomedicine, National
Cheng Kung University, 35, Xiaodong Road, North District, Tainan 704, Taiwan
| | - Ching-Hsiang Chen
- Sustainable
Energy Development Center, National Taiwan
University of Science and Technology, 43, Section 4, Keelung Road, Taipei 106, Taiwan
| | - Chia-Shuo Hsu
- Department of Chemistry, National Taiwan University, 1, Section 4, Roosevelt Road, Taipei 106, Taiwan
| | - Tai-Lung Chen
- Department of Chemistry, National Taiwan University, 1, Section 4, Roosevelt Road, Taipei 106, Taiwan
| | - Mei-Yi Liao
- Department of Applied Chemistry, National
Pingtung University, 1, Linsen Road, Pingtung 900, Taiwan
- E-mail: (M.-Y.L.)
| | - Chia-Ching Wang
- Sustainable
Energy Development Center, National Taiwan
University of Science and Technology, 43, Section 4, Keelung Road, Taipei 106, Taiwan
| | - Chia-Fen Tsai
- Taiwan Food
and Drug Administration, 161-2, Kunyang Street, Nangang District, Taipei 115, Taiwan
- E-mail: (C.-F.T.)
| | - Hao Ming Chen
- Department of Chemistry, National Taiwan University, 1, Section 4, Roosevelt Road, Taipei 106, Taiwan
- E-mail: (H.M.C.)
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Cheng CM, Chang WH, Chiu YC, Sun Y, Lee HJ, Tang LY, Wang PN, Chiu MJ, Yang CH, Tsai SJ, Tsai CF. Association of Polypharmacy With Mild Cognitive Impairment and Cognitive Ability: A Nationwide Survey in Taiwan. J Clin Psychiatry 2018; 79. [PMID: 30256550 DOI: 10.4088/jcp.17m12043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Polypharmacy, defined as the concomitant use of 5 or more medications, has a documented negative association with cognitive impairment such as delirium and is associated, potentially, with a higher risk of dementia. However, whether polypharmacy contributes to increased risk of mild cognitive impairment (MCI) or decreased cognitive capacity requires further investigation. This nationwide population survey investigated the association among polypharmacy, MCI, and dementia. METHODS Through random sampling based on the proportion of all Taiwan counties, subjects were recruited and received in-person interviews between December 2011 and March 2013. Demographic data and clinical information included medical histories, medication use, and mental status measured by the Taiwanese Mini-Mental State Examination (TMSE) and Clinical Dementia Rating (CDR). Data on lifestyle and habits were collected, and subjects were distributed to cognitively normal, MCI, or all-cause dementia groups based on criteria by the National Institute on Aging and the Alzheimer's Association. RESULTS A total of 7,422 people aged 65 years or older were recruited. After adjustment for age, sex, body mass index, education, medical comorbidities, and lifestyle and habits, polypharmacy was associated with a 1.75-fold increased odds of MCI and 2.33-fold increased odds of dementia. Polypharmacy was associated with a 0.51-point decrease in TMSE scores (P = .001) and a 0.10-point increase in CDR score (P < .001). Additionally, for those without specific vascular comorbidities, polypharmacy had a greatly more negative impact on cognitive capacity. CONCLUSIONS Polypharmacy is common in the elderly and is associated with significantly lower cognitive capacity and higher risks of MCI and dementia, especially for persons without diabetes, hypertension, hyperlipidemia, or cerebrovascular diseases.
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Affiliation(s)
- Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Taiwanese Society of Geriatric Psychiatry, Taichung, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Graduate Institute of Statistics, National Central University, Taoyuan, Taiwan
| | - Yu-Chuan Chiu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yu Sun
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Huey-Jane Lee
- Taiwan Alzheimer's Disease Association, Taipei, Taiwan
| | - Li-Yu Tang
- Taiwan Alzheimer's Disease Association, Taipei, Taiwan
| | - Pei-Ning Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Hung Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Beitou district, Taipei, 112, Taiwan. .,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Taiwanese Society of Geriatric Psychiatry, Taichung, Taiwan.,Taiwan Alzheimer's Disease Association, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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Huang WS, Bai YM, Hsu JW, Huang KL, Tsai CF, Su TP, Li CT, Lin WC, Tsai SJ, Pan TL, Chen TJ, Chen MH. Use of Proton Pump Inhibitors and Risk of Major Depressive Disorder: A Nationwide Population-Based Study. Psychother Psychosom 2018; 87:62-64. [PMID: 29306949 DOI: 10.1159/000485190] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/13/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Wei-Sheng Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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Lee HC, Lin YL, Huang YC, Tsai CF, Wang DY. Identification of a new tadalafil analogue, N-3-hydroxypropylnortadalafil, in a supplement product. J Pharm Biomed Anal 2018; 158:257-261. [DOI: 10.1016/j.jpba.2018.05.049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/28/2018] [Accepted: 05/30/2018] [Indexed: 10/14/2022]
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Lo CH, Wei JCC, Tsai CF, Li LC, Huang SW, Su CH. Syncope caused by complete heart block and ventricular arrhythmia as early manifestation of systemic lupus erythematosus in a pregnant patient: a case report. Lupus 2018; 27:1729-1731. [PMID: 29954280 DOI: 10.1177/0961203318782425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Systemic lupus erythematosus (SLE) can affect all heart structures including the conduction system, with either reversible or permanent derangement. However, only a few cases of adult SLE and complete atrioventricular (AV) block have been reported. We describe a young pregnant woman who initially presented with complete AV block on electrocardiography before the diagnosis of SLE. Syncope subsequently developed during the postpartum period due to frequent nonsustained polymorphic ventricular tachycardia, suggesting lupus myocarditis. The ventricular arrhythmia was successfully treated by intravenous corticosteroids, lidocaine and implantation of a permanent pacemaker. This may represent the first report of complete AV block with polymorphic ventricular tachycardia, which was identified before the other clinical features of SLE fully manifested. SLE should be considered if a patient presents with complete AV block without other clinical features. It may warn for early diagnosis and appropriate treatment of SLE including lupus-related heart disease.
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Affiliation(s)
- C H Lo
- 1 Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - J C C Wei
- 2 Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital; Institute of Medicine, Chung Shan Medical University; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - C F Tsai
- 1 Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.,3 School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| | - L C Li
- 4 Department of Internal Medicine, Da Chien General Hospital, Miao Li City, Taiwan
| | - S W Huang
- 1 Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - C H Su
- 1 Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.,3 School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
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Abstract
PLA2G6-associated neurodegeneration is a major subtype of neurodegeneration with brain iron accumulation. Patients with PLA2G6-associated neurodegeneration usually present degenerative motor symptoms with neuropsychiatric disturbance. This report presents a patient with PLA2G6-related dystonia-parkinsonism, who had neuropsychiatric symptoms preceding movement symptoms. Antipsychotic drug was prescribed, and he developed parkinsonism years later. Differential diagnosis between drug-induced parkinsonism and PLA2G6-related dystonia-parkinsonism could be challenging. PLA2G6 sequencing has to be considered facing a patient with adulthood parkinsonism, especially when it is associated with initial psychiatric symptoms. Our case highlights a common problem treating psychiatric symptoms in neurodegenerative diseases that lead to parkinsonism. The use of antipsychotics requires a special caution in these patients because it may cause extrapyramidal symptoms. Aripiprazole had therapeutic effect on both mood and psychotic symptoms and less impact on motor features, which may be considered an ideal pharmacological approach in treating these patients.
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43
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Huang YC, Lee HC, Lin YL, Tsai CF, Cheng HF. Identification of a new type tadalafil analogue in a supplement product. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2018; 35:1233-1237. [DOI: 10.1080/19440049.2018.1459052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Yen-Chun Huang
- Chemical Lab, Super Laboratory Company Limited, New Taipei City, Taiwan (R.O.C)
| | - Hui-Chun Lee
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei City, Taiwan(R.O.C)
| | - Yun-Lian Lin
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, China Medical University, Taichung, Taiwan (R.O.C)
| | - Chia-Fen Tsai
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei City, Taiwan(R.O.C)
| | - Hwei-Fang Cheng
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei City, Taiwan(R.O.C)
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44
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Chan YLE, Tsai CF. 6-Month follow-up of a case with psychosis triggered by valacyclovir. J Chin Med Assoc 2018; 81:187-188. [PMID: 29198553 DOI: 10.1016/j.jcma.2017.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 11/18/2022] Open
Affiliation(s)
- Yee-Lam E Chan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
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45
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Lee HF, Liu PY, Wang YP, Tsai CF, Chang FY, Lu CL. Sexual Abuse Is Associated With an Abnormal Psychological Profile and Sleep Difficulty in Patients With Irritable Bowel Syndrome in Taiwan. J Neurogastroenterol Motil 2018; 24:79-86. [PMID: 29291609 PMCID: PMC5753906 DOI: 10.5056/jnm17004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/27/2017] [Accepted: 07/12/2017] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Both sexual and physical abuse history have been reported to be associated with irritable bowel syndrome (IBS) in Western countries. The impact of abuse history in IBS patients in Asia remains unclear. We aim to determine the prevalence of abuse history, its associated psychological profiles, and sleep problems among IBS patients in Taiwan. Methods In total, 194 Rome III-defined IBS patients were invited to participate. Age- and sex-matched healthy carriers of chronic hepatitis B or hepatitis C without chronic abdominal symptoms were identified as disease-controls. We administered a validated questionnaire to evaluate bowel symptoms, physical/sexual abuse history, anxiety/depression (Hospital Anxiety and Depression Scale [HADS]), and sleep quality. Results IBS patients had a significantly higher prevalence of sexual abuse history than the disease-control group both before (16.5% vs 6.7%, P < 0.05) and after (16.0% vs 6.6%, P < 0.05) adolescence. These significant differences were mainly observed in women (13.4% vs 3.4%, P < 0.05). No difference was noted in history of physical abuse between the 2 groups. IBS patients with a history of sexual abuse had significantly higher HADS scores and higher frequencies of sleep difficulty than those without. Conclusions In Taiwan, sexual abuse history was more prevalent in female IBS patients than controls. Sexual abuse history may contribute to higher anxiety/depression levels and sleep difficulties, which are commonly experienced in IBS patients. In Asia, abuse history should be obtained when approaching IBS patients to facilitate better management.
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Affiliation(s)
- Hsing-Feng Lee
- Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Chia-Yi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Pei-Yi Liu
- Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Yen-Po Wang
- Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Endoscopic Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Fen Tsai
- Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Full-Young Chang
- Endoscopic Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Gastroenterology, Departments of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Liang Lu
- Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Endoscopic Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Gastroenterology, Departments of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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46
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Chang FM, Wang YP, Lang HC, Tsai CF, Hou MC, Lee FY, Lu CL. Statins decrease the risk of decompensation in hepatitis B virus- and hepatitis C virus-related cirrhosis: A population-based study. Hepatology 2017; 66:896-907. [PMID: 28318053 DOI: 10.1002/hep.29172] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/22/2017] [Accepted: 03/16/2017] [Indexed: 12/12/2022]
Abstract
UNLABELLED Statin use decreases the risk of decompensation and mortality in patients with cirrhosis due to hepatitis C virus (HCV). Whether this beneficial effect can be extended to cirrhosis in the general population or cirrhosis due to other causes, such as hepatitis B virus (HBV) infection or alcohol, remains unknown. Statin use also decreases the risk of hepatocellular carcinoma (HCC) in patients with chronic HBV and HCV infection. It is unclear whether the effect can be observed in patients with pre-existing cirrhosis. The goal of this study was to determine the effect of statin use on rates of decompensation, mortality, and HCC in HBV-, HCV-, and alcohol-related cirrhosis. Patients with cirrhosis were identified from a representative cohort of Taiwan National Health Insurance beneficiaries from 2000 to 2013. Statin users, defined as having a cumulative defined daily dose (cDDD) ≥28, were selected and served as the case cohort. Statin nonusers (<28 cDDD) were matched through propensity scores. The association between statin use and risk of decompensation, mortality, and HCC were estimated. A total of 1350 patients with cirrhosis were enrolled. Among patients with cirrhosis, statin use decreased the risk of decompensation, mortality, and HCC in a dose-dependent manner (P for trend <0.0001, <0.0001, and 0.009, respectively). Regression analysis revealed a lower risk of decompensation among statin users with cirrhosis due to chronic HBV (adjusted hazard ratio [HR], 0.39; 95% confidence interval [CI], 0.25-0.62) or HCV infection (HR, 0.51; 95% CI, 0.29-0.93). The lowered risk of decompensation was of borderline significance among statin users with alcohol-related cirrhosis (HR, 0.69; 95% CI, 0.45-1.07). CONCLUSION Statin use decreases the decompensation rate in both HBV- and HCV-related cirrhosis. Of borderline significance is a decreased decompensation rate in alcohol-related cirrhosis. (Hepatology 2017;66:896-907).
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Affiliation(s)
- Fu-Ming Chang
- Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.,Yuanshan Branch, Taipei Veterans General Hospital, I-Lan, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Po Wang
- Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Hui-Chu Lang
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fa-Yauh Lee
- Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Liang Lu
- Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
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47
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Affiliation(s)
- Chia-Fen Tsai
- Institute of Brain Science and Faculty of Medicine, National Yang-Ming University School of Medicine and Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Institute of Brain Science and Faculty of Medicine, National Yang-Ming University School of Medicine and Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Po Wang
- Institute of Brain Science and Faculty of Medicine, National Yang-Ming University School of Medicine and Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Liang Lu
- Institute of Brain Science and Faculty of Medicine, National Yang-Ming University School of Medicine and Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
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48
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Peng GJ, Chang MH, Fang M, Liao CD, Tsai CF, Tseng SH, Kao YM, Chou HK, Cheng HF. Incidents of major food adulteration in Taiwan between 2011 and 2015. Food Control 2017. [DOI: 10.1016/j.foodcont.2016.07.043] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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49
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Tsai CF, Chen MH, Wang YP, Chu CJ, Huang YH, Lin HC, Hou MC, Lee FY, Su TP, Lu CL. Proton Pump Inhibitors Increase Risk for Hepatic Encephalopathy in Patients With Cirrhosis in A Population Study. Gastroenterology 2017; 152:134-141. [PMID: 27639806 DOI: 10.1053/j.gastro.2016.09.007] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/23/2016] [Accepted: 09/05/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Hepatic encephalopathy (HE) is a serious complication of cirrhosis and is associated with gut dysbiosis. Proton pump inhibitors (PPIs), frequently prescribed to patients with cirrhosis, can contribute to small-bowel bacterial overgrowth. We investigated whether PPI predisposes patients with cirrhosis to HE using a large database of patients. METHODS We performed a case-control study nested within a sample of Taiwan National Health Insurance beneficiaries (n = 1,000,000), followed up longitudinally from 1998 through 2011. Patients with cirrhosis and an occurrence of HE (n = 1166) were selected as the case cohort and matched to patients without HE (1:1, controls) for sex, enrollment time, end point time, follow-up period, and advanced cirrhosis. Information on prescribed drugs, drug dosage, supply days, and numbers of dispensed pills was extracted from the Taiwan National Health Insurance database. PPI use was defined as more than 30 cumulative defined daily doses (cDDDs); PPI nonuse was defined as 30 cDDDs or fewer. We performed logistic regression analyses to estimate the association between PPI use and the occurrence of HE. RESULTS Among patients with cirrhosis and an occurrence of HE, 38% (n = 445) had a history of PPI use before HE occurrence. We observed a relationship between dose of PPI taken and HE risk. The confounder-adjusted odd ratios were 1.41 (95% confidence interval [CI], 1.09-1.84), 1.51 (95% CI, 1.11-2.06), and 3.01 (95% CI, 1.78-5.10) for patients with 30-120 cDDDs, 120-365 cDDDs, and more than 365 cDDDs, respectively, compared with PPI nonusers. All categories of PPIs, except rabeprazole, were associated with an increased risk of HE. CONCLUSIONS Based on an analysis of data from Taiwan National Health Insurance beneficiaries, we found that use of PPIs in patients with cirrhosis increases the risk for HE; risk increases with dose. It therefore is important for health care providers to carefully consider prolonged PPI use by patients with cirrhosis.
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Affiliation(s)
- Chia-Fen Tsai
- Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Po Wang
- Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chi-Jen Chu
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Hsiang Huang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Han-Chieh Lin
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fa-Yauh Lee
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Ping Su
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Liang Lu
- Institute of Brain Science, National Yang-Ming University School of Medicine, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
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50
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Lin YT, Huang YC, Lee HC, Liao CH, Lin YL, Tsai CF, Cheng HF. Isolation and identification of a novel sildenafil analogue adulterant in herbal products. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2016; 34:330-334. [DOI: 10.1080/19440049.2016.1272137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ya-Tze Lin
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei City, Taiwan (ROC)
| | - Yen-Chun Huang
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei City, Taiwan (ROC)
| | - Hui-Chun Lee
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei City, Taiwan (ROC)
| | - Chen-Hsiang Liao
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei City, Taiwan (ROC)
| | - Yun-Lian Lin
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, China Medical University, Taichung, Taiwan (ROC)
| | - Chia-Fen Tsai
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei City, Taiwan (ROC)
| | - Hwei-Fang Cheng
- Division of Research and Analysis, Taiwan Food and Drug Administration, Taipei City, Taiwan (ROC)
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