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Liu TL, Chen YL, Hsiao RC, Ni HC, Liang SHY, Lin CF, Chan HL, Hsieh YH, Wang LJ, Lee MJ, Chou WJ, Yen CF. Adolescent-Caregiver Agreement Regarding the School Bullying and Cyberbullying Involvement Experiences of Adolescents with Autism Spectrum Disorder. Int J Environ Res Public Health 2023; 20:3733. [PMID: 36834428 PMCID: PMC9961965 DOI: 10.3390/ijerph20043733] [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] [Received: 01/11/2023] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
School bullying and cyberbullying victimization and perpetration are prevalent in adolescents with autism spectrum disorder (AASD). However, the levels of adolescent-caregiver agreement regarding the bullying involvement of AASD and the factors associated with these levels remain to be evaluated. In the present study, we evaluated the levels of adolescent-caregiver agreement on the school bullying and cyberbullying involvement experiences of AASD and the factors associated with the levels of agreement. This study included 219 dyads of AASD and their caregivers. The school bullying and cyberbullying involvement experiences of the participating AASD were assessed using the School Bullying Experience Questionnaire and the Cyberbullying Experiences Questionnaire, respectively. Attention-deficit/hyperactivity disorder, oppositional defiant disorder (ODD), depressive and anxiety symptoms, and autistic social impairment were also assessed. AASD and their caregivers had poor to fair levels of agreement regarding the school bullying and cyberbullying victimization and perpetration experiences of AASD. Severe inattention, hyperactivity-impulsivity, ODD, depressive and anxiety symptoms, and autistic social impairment were associated with high levels of adolescent-caregiver agreement. When assessing the bullying involvement experiences of AASD, mental health professionals should obtain information from multiple sources. In addition, the factors influencing the levels of agreement should be considered.
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Affiliation(s)
- Tai-Ling Liu
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yi-Lung Chen
- Department of Psychology, Asia University, Taichung 41354, Taiwan
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA
- Department of Psychiatry, Seattle Children’s, Seattle, WA 98105, USA
| | - Hsing-Chang Ni
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Sophie Hsin-Yi Liang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Chiao-Fan Lin
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Hsiang-Lin Chan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Yi-Hsuan Hsieh
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Liang-Jen Wang
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Child and Adolescent Psychiatry, Kaohsiung Medical Center, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Min-Jing Lee
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Wen-Jiun Chou
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Child and Adolescent Psychiatry, Kaohsiung Medical Center, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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Chen HY, Yang CY, Hsieh TH, Peng CW, Chuang LL, Chang YL, Chi HJ, Lee HM, Liang SHY. Effects of transcranial direct current stimulation on improving performance of delayed- reinforcement attentional set-shifting tasks in attention-deficit/hyperactivity disorder rat model. Behav Brain Res 2023; 437:114145. [PMID: 36206819 DOI: 10.1016/j.bbr.2022.114145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/13/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022]
Abstract
Behavioral flexibility (or set-shifting), which is regulated by the prefrontal cortex (PFC), is often impaired in patients with attention-deficit/hyperactivity disorder (ADHD), which is characterized by poor inhibitory control and reinforcement learning. Transcranial direct current stimulation (tDCS) has been proposed as a means of noninvasive brain stimulation and a potential therapeutic tool for modulating behavioral flexibility. Animal studies can pave the way to know if tDCS application can potentially benefit rule- and goal-based activities in ADHD. Spontaneously hypertensive rats (SHRs) and inbred Wistar-Kyoto (WKY) rats were used as an animal model of ADHD and controls, respectively, and their strategy set-shifting abilities, including initial discrimination, set-shifting, and reversal learning tasks under 0-s or 15-s reinforcer delivery delay conditions, were evaluated. The tDCS treatment had a limited effect on the performance of the SHRs and WKY rats in initial discrimination task under 0-s delay condition. Under the 15-s delay condition, the SHRs had longer lever-press reaction times and/or more trial omissions than the WKY rats did when completing set-shifting and reversal-learning tasks. Among the SHRs, tDCS treatment improved the rats' reaction times and/or reduced their trial omissions in the set-shifting and reversal-learning tasks. Although tDCS may improve delayed reinforcement learning set-shifting performance in SHRs, further studies are required to clarify the responsible mechanism.
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Affiliation(s)
- Hsin-Yung Chen
- Department of Occupational Therapy & Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neurology and Dementia Center, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan
| | - Chia-Yen Yang
- Department of Biomedical Engineering, Ming-Chuan University, Taoyuan, Taiwan
| | - Tsung-Hsun Hsieh
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chih-Wei Peng
- Department of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Li-Ling Chuang
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ying-Ling Chang
- School and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Huang-Ju Chi
- Department of Neurology and Dementia Center, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan
| | - Hsin-Min Lee
- Department of Physical Therapy, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
| | - Sophie Hsin-Yi Liang
- Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan and Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Lee YC, Chen VCH, Liang SHY, Kelsen BA. Mother-Child Interaction of Boys With ADHD: A Behavioral Observation Study. J Atten Disord 2022; 26:1738-1746. [PMID: 35611550 DOI: 10.1177/10870547221101649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Investigate the quality of mothers' interactions with children with ADHD and a marginal disturbance in socioemotional competence (MDSC). RESEARCH METHODS A total of 49 mother-boy dyads were included, and we observed their communication on neutral and conflict topics for children with ADHD and MDSC, children with ADHD alone, and children with typical development (TD). The Chinese version of the Specific Affect Coding System 20-code was used to examine the affective presentation in communication. RESULTS Mothers of children with ADHD and MDSC had less negative disengagement affect compared with those of children with ADHD alone. Boys with ADHD and MDSC and boys with TD had constant positive engagement between neutral and conflict conditions in parent-child interaction. Boys with ADHD and MDSC had significantly less positive affect and more neutral affect than children with ADHD only. CONCLUSIONS AND IMPLICATIONS Boys with ADHD and MDSC and their mothers had worse quality of observed mother-child communication than children with ADHD only and their mothers.
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Liu TL, Wang PW, Hsiao RC, Ni HC, Liang SHY, Lin CF, Chan HL, Hsieh YH, Wang LJ, Lee MJ, Chou WJ, Yen CF. Multiple types of harassment victimization in adolescents with autism spectrum disorder: Related factors and effects on mental health problems. J Formos Med Assoc 2022; 121:2161-2171. [DOI: 10.1016/j.jfma.2022.03.005] [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] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 12/27/2021] [Accepted: 03/09/2022] [Indexed: 10/31/2022] Open
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Su YJ, Liang SHY. Long-term mental health outcomes of severe burn injury: A 5-year follow-up of the 2015 Formosa Fun Coast Water Park fire disaster. Gen Hosp Psychiatry 2022; 75:10-16. [PMID: 35085876 DOI: 10.1016/j.genhosppsych.2022.01.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/13/2022] [Accepted: 01/19/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Severe burn injuries have profound mental health impacts on individuals, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Many burn survivors also report positive psychosocial changes, termed posttraumatic growth (PTG). This study investigated long-term mental health of severe burn injury (i.e., PTSD, MDD, and PTG) and the longitudinal influences of coping strategies and social support. METHODS Ninety-nine adult burn survivors of the 2015 Formosa Fun Coast Water Park fire disaster participated in the 5-year follow-up (Wave 3, W3), with 93% completing the earlier 2- (Wave 1, W1) and 3-year follow-up (Wave 2, W2). Participants averaged 22.1 years of age at burn, and 62.6% were females. The mean total body surface area burned (TBSA) was 50.3%, with a mean length of hospital stay of 87.6 days. RESULTS Five years after the 2015 fire disaster, 13.1%, and 14.1% of the survivors met probable DSM-5 PTSD and MDD, while 51.5% reported significant PTG. After controlling for demographic, burn-specific, and baseline outcome variables, avoidance coping at W2 prospectively predicted PTSD and depressive symptoms at W3 (p = .003 and 0.04), with medium-to-large and medium effect sizes (sr2 = 0.10 and 0.05). Approach coping at W2 prospectively predicted PTG at W3 (p = .014), with a medium-to-large effect size (sr2 = 0.07). CONCLUSION Rates of probable PTSD and MDD were still relatively high in long-term burn survivors. However, PTG continued to be highly prevalent. Our findings highlight the importance of coping in affecting the long-term mental health of severe burn injury.
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Affiliation(s)
- Yi-Jen Su
- Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan, Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Sophie Hsin-Yi Liang
- Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan, , Chang Gung University College of Medicine, Taoyuan, Taiwan
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Hwang-Gu SL, Ni HC, Liang SHY, Lin HY, Tsao L, Lin CF, Gau SSF. Contextual Factors Impact the Variability in ADHD Symptoms in Preschoolers with Situational Hyperactivity. J Atten Disord 2021; 25:1834-1846. [PMID: 32659134 DOI: 10.1177/1087054720938864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study examined preschoolers with teacher-reported or parent-reported situational hyperactivity, and whether they differed in terms of behavioral problems, attentional problems, and parenting perceptions. Method: We used the Conners' Kiddie Continuous Performance Test and the Color Flanker Task to assess 99 preschoolers with pervasive high-ADHD-symptoms (42), school-situational high-ADHD-symptoms (30), or home-situational high-ADHD-symptoms (27), plus 111 preschoolers with pervasive low-ADHD-symptoms. Parents and teachers reported externalizing/internalizing behavioral problems. Parenting perceptions were measured with the Parenting Stress Index-Short Form and a parenting perceptions scale. Results: Preschoolers with school-situational high-ADHD-symptoms had deficits in attentional control. Parents of preschoolers with home-situational high-ADHD-symptoms had higher levels of parental stress and perceived their parenting to be harsher. Preschoolers with pervasive high-ADHD-symptoms had deficits in attentional control, increased parental stress, and parents with harsher parenting perceptions. Conclusion: Preschoolers with situational high-ADHD-symptoms may have different contextual risk factors related to ADHD symptoms reported by parents versus teachers.
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Affiliation(s)
- Shoou-Lian Hwang-Gu
- Chang Gung University, Taoyuan.,Chang Gung Memorial Hospital, Linkou, Taoyuan
| | | | | | - Hsiang-Yuan Lin
- National Taiwan University Hospital and College of Medicine, Taipei
| | - Li Tsao
- Chang Gung University, Taoyuan
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Liang SHY, Lee YC, Kelsen BA, Chen VCH. Health-related quality of life in mothers of children with attention deficit hyperactivity disorder in Taiwan: The roles of child, parent, and family characteristics. Res Dev Disabil 2021; 113:103944. [PMID: 33836402 DOI: 10.1016/j.ridd.2021.103944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/21/2020] [Revised: 03/10/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND No study has examined how child and maternal psychopathological difficulties and family factors contribute to the health-related quality of life (HRQOL) of mothers of children with attention deficit hyperactivity (ADHD). AIMS To investigate the impact of children's diagnosis of ADHD, children's and maternal psychopathology and significant sociodemographic variables of the children, parents and family on HRQOL of mothers of children with ADHD and those of children with typical development (TD) in Taiwan. METHODS AND PROCEDURES Children with ADHD (n = 257) and children with typical development (n = 324) and their mothers were recruited from a psychiatric clinic of a medical center and 10 elementary schools and four high schools in northern Taiwan. Maternal HRQOL was assessed with the World Health Organization Quality of Life - BREF, while the other factors were screened using the Chinese version of the Childhood Autism Spectrum Test for autistic traits, the Swanson, Nolan, and Pelham, version IV scale for ADHD symptoms, the Child Behavior Checklist for behavioral and emotional problems, The Center for Epidemiologic Studies Depression Scale for maternal depression and interpersonal problems, the Adult ADHD Self-report Scale for maternal ADHD symptoms, and the Family APGAR for family support. OUTCOMES AND RESULTS Mothers of children with ADHD had significantly worse HRQOL in all four domains compared with those of children with typical development. Multiple regressions found that factors consistently related to the HRQOL of mothers of children with ADHD and those of children with TD were maternal depression and perceived family support after controlling for several familial, parental and child variables. HRQOL of mothers of children with ADHD and those of children with TD was more closely related to her own and family factors rather than mother- or teacher-rated ADHD symptoms, clinical diagnosis of ADHD or psychopathology of the child. CONCLUSIONS AND IMPLICATIONS Screening for maternal HRQOL, depressive symptoms and family support systems and mental health services for mothers of children with ADHD are warranted based on these findings.
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Affiliation(s)
- Sophie Hsin-Yi Liang
- Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taiwan; Department of Psychiatry, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yi-Chen Lee
- School of Occupational Therapy, National Taiwan University, Taipei, Taiwan.
| | | | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
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Ni HC, Chen YL, Chao YP, Wu CT, Wu YY, Liang SHY, Chin WC, Chou TL, Gau SSF, Huang YZ, Lin HY. Intermittent theta burst stimulation over the posterior superior temporal sulcus for children with autism spectrum disorder: A 4-week randomized blinded controlled trial followed by another 4-week open-label intervention. Autism 2021; 25:1279-1294. [DOI: 10.1177/1362361321990534] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The posterior superior temporal sulcus is a potential therapeutic target of brain stimulation for autism spectrum disorder. We conducted a 4-week randomized, single-blind parallel sham-controlled trial, followed by additional 4-week open-label intervention to evaluate the feasibility and efficacy regarding intermittent theta burst stimulation over the bilateral posterior superior temporal sulcus in autism spectrum disorder. In total, 78 intellectually able children and adolescents were randomized to the active ( n = 40) and sham groups ( n = 38). During the first 4 weeks, the active group received two-session/week intermittent theta burst stimulation, whereas the sham group received the same number of sham stimulation. After unblinding, both groups received eight-session real stimulation over the additional 4 weeks. In total, 91% participants completed the protocol with mild and transitory side-effects. There was no significant group-by-time interaction for active versus sham group on clinical symptoms and social cognitive performances in the first 4 weeks. The within-group analysis revealed 8 weeks (including a 4-week blind trial and a 4-week open-label intervention) of intermittent theta burst stimulation achieved greater efficacy than 4-week interventions. Participants with higher intelligence, better social cognitive performances, alongside less attention-deficit hyperactivity disorder severity at baseline, were more likely to be responders. Our study demonstrated the feasibility of long-term intermittent theta burst stimulation over the posterior superior temporal sulcus in children and adolescents with autism spectrum disorder. However, the findings from the first 4-week blind trial do not support the therapeutic efficacy of intermittent theta burst stimulation over the posterior superior temporal sulcus on the clinical symptoms and cognitive performance of social impairment, given the current stimulation protocol. The exploratory analyses suggest that the therapeutic efficacy might be moderated by several individual characteristics and more intermittent theta burst stimulation sessions. Lay abstract Intermittent theta burst stimulation is a varied form of repetitive transcranial magnetic non-invasive brain stimulation technique used to treat several neurological and psychiatric disorders. Its feasibility and therapeutic effects on the bilateral posterior superior temporal sulcus in children with autism are unknown. We conducted a single-blind, sham-controlled parallel randomized clinical trial in a hitherto largest sample of intellectually able children with autism ( N = 78). Participants randomized to the active group received two-session/week intermittent theta burst stimulation for continuous 8 weeks. Those in the sham group received two-session/week sham stimulations in the first 4 weeks and then active intervention for the following 4 weeks after unblinding. First, we found that continuous 8-week intermittent theta burst stimulation on the bilateral posterior superior temporal sulcus in children with autism is safe and tolerable. Second, we found that 8-week intermittent theta burst stimulation produced greater therapeutic efficacy, although we did not find any significant effects of 4-week intermittent theta burst stimulation on core symptoms and social cognitive performances in autism. Further analysis revealed that participants with higher intelligence and better social cognitive performance, alongside less attention-deficit hyperactivity disorder severity at baseline, were more likely to be responders. This study identified that the factors contribute to responders and the results suggest that longer courses of non-invasive brain stimulation may be needed to produce therapeutic benefits in autism, with consideration of heterogeneous responses.
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Affiliation(s)
| | | | - Yi-Ping Chao
- Chang Gung Memorial Hospital at Linkou, Taiwan
- Chang Gung University, Taiwan
| | - Chen-Te Wu
- Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Yu-Yu Wu
- Chang Gung Memorial Hospital at Linkou, Taiwan
| | | | | | | | - Susan Shur-Fen Gau
- National Taiwan University, Taiwan
- National Taiwan University Hospital, Taiwan
| | - Ying-Zu Huang
- Chang Gung Memorial Hospital at Linkou, Taiwan
- Chang Gung University, Taiwan
- National Central University, Taiwan
| | - Hsiang-Yuan Lin
- Centre for Addiction and Mental Health, Canada
- University of Toronto, Canada
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Liang SHY, Tsai HWJ, Wu YY, Lee YC, Chen VCH, Wang LJ, Chou WJ, Kelsen BA. Reliability and validity of the traditional Chinese translation of the brief infant-toddler social and emotional assessment. Early Hum Dev 2020; 151:105162. [PMID: 32916591 DOI: 10.1016/j.earlhumdev.2020.105162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/02/2020] [Revised: 07/29/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Sophie Hsin-Yi Liang
- Chang Gung Memorial Hospital at Taoyuan- Chang Gung University College of Medicine, Department of Child and Adolescent Psychiatry, Taoyuan, Taiwan
| | - Hsiao-Wei Joy Tsai
- Department of Special Education, National Taipei University of Education, Taipei, Taiwan
| | - Yu-Yu Wu
- YuNing Psychiatric Clinic, Taipei, Taiwan; Chang Gung Memorial Hospital at Linkao- Chang Gung University College of Medicine, Department of Child and Adolescent Psychiatry, Taoyuan, Taiwan
| | - Yi-Chen Lee
- School of Occupational Therapy College of Medicine National Taiwan University, Taipei, Taiwan.
| | - Vincent Chin-Hung Chen
- Chang-Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Department of Psychiatry, Chiayi, Taiwan
| | - Liang-Jen Wang
- Chang Gung Memorial Hospital at Kaohsiung Medical Center- Chang Gung University College of Medicine, Department of Child and Adolescent Psychiatry, Kaohsiung, Taiwan
| | - Wen-Jiun Chou
- Chang Gung Memorial Hospital at Kaohsiung Medical Center- Chang Gung University College of Medicine, Department of Child and Adolescent Psychiatry, Kaohsiung, Taiwan
| | - Brent Allan Kelsen
- National Taipei University, Language Center, New Taipei City, Taiwan; Department of Psychology, Auckland University of Technology, Auckland, New Zealand
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Hwang-Gu SL, Chen YC, Liang SHY, Ni HC, Lin HY, Lin CF, Gau SSF. Exploring the Variability in Reaction Times of Preschoolers at Risk of Attention-Deficit/Hyperactivity Disorder: an ex-Gaussian Analysis. J Abnorm Child Psychol 2020; 47:1315-1326. [PMID: 30706251 DOI: 10.1007/s10802-018-00508-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Reaction times (RTs) are typically slower and more variable in individuals with attention-deficit/hyperactivity disorder (ADHD). Analysis of the ex-Gaussian RT distribution, which is described by mu, sigma (mean and standard deviation, respectively, of the normal distribution) and tau (that of exponential distribution), reveals that individuals with ADHD do not display overall slower RTs but have a high proportion of extremely slow RTs, represented by a high tau value. Although this is a vital component for describing ADHD-related RT variability in school-aged children, adolescents, and adults, it has not been thoroughly studied at the preschool age. We assessed 65 preschoolers at risk of ADHD and 98 typically developing preschoolers with the Conners' Kiddie Continuous Performance Test (K-CPT) and parental and teacher reports of ADHD symptoms. We found that preschoolers at risk of ADHD had greater values for RT standard deviation, sigma, and tau than typically developing preschoolers at long inter-stimulus intervals (ISIs) (3 s), but not at short ISIs (1.5 s). This suggests that attention problems in preschool children may only be apparent in the tasks with a relatively slow event rate. Our study demonstrates that the ex-Gaussian tau value is essential for describing the inattentive component of task performance in preschoolers with heightened ADHD symptoms. Furthermore, the fact that the tau effect was modulated by ISI suggests that the longer duration (3 s vs. 1.5 s) is a non-optimal energetic state in preschoolers at risk of ADHD, and that this might account for the subtle attentional flaw in task performance.
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Affiliation(s)
- Shoou-Lian Hwang-Gu
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yu-Chi Chen
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Sophie Hsin-Yi Liang
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsing-Chang Ni
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsiang-Yuan Lin
- Department of Psychiatry, National Taiwan University Hospital, and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Chiao-Fan Lin
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
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Lee H, Chen VCH, Yang YH, Kuo TY, Lin TC, Wu SI, Kao KL, Weng JC, Kelsen BA, Liang SHY. Decreased Risk of Influenza in Child and Adolescent Patients with Attention-Deficit Hyperactivity Disorder Following Methylphenidate Treatment: A Nationwide Cohort Study in Taiwan. Neuropsychiatr Dis Treat 2020; 16:1309-1319. [PMID: 32547034 PMCID: PMC7247598 DOI: 10.2147/ndt.s242519] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/22/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Young individuals with attention-deficit hyperactivity disorder (ADHD) may have an elevated risk of influenza because of the difficulty in complying with the behavioral procedures that help protect against influenza. Moreover, the effects of sufficient methylphenidate treatment on influenza have received little attention. OBJECTIVE This study evaluated the association between ADHD medication usage and influenza and assessed the effect of duration of ADHD treatment on the risk of influenza using a nationwide population-based database. METHODS This study investigated methylphenidate usage and the risk of influenza among children and adolescents with ADHD. We identified 5259 young individuals aged less than 18 years who were diagnosed as having ADHD between 1996 and 2013 from the National Health Insurance Research Database of Taiwan, and we tested whether methylphenidate use affects influenza risk using Cox proportional hazard models. RESULTS After controlling for confounding factors, the results indicated that influenza risk significantly reduced in the group of ADHD patients who were prescribed methylphenidate for 90 days and more (hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.52-0.75, p<0.001), demonstrating a 38% reduction in the risk of influenza in this group. However, this was not observed in the group of ADHD patients who used methylphenidate for 1-90 days (HR: 0.69, 95% CI: 0.89-1.05, p=0.12). CONCLUSION The lower incidence of influenza observed in the group prescribed with methylphenidate for a longer period highlights the importance of compliance to medication and psychoeducation with regard to ADHD management.
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Affiliation(s)
- Hsuan Lee
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Chiayi,Chiayi,Taiwan
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi Branch, Chiayi,Taiwan.,Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital,Taiwan.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Yu Kuo
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi Branch, Chiayi,Taiwan
| | - Tzu-Chin Lin
- Bethel Psychiatric Clinic, Taipei, Taiwan.,Institute of Science, Technology and Society, National Yang-Ming University Taipei, Taiwan
| | - Shu-I Wu
- Mackay Memorial Hospital, Section of Psychiatry, Taipei, Taiwan.,Department of Medicine, Mackay Medical College, Taipei, Taiwan
| | - Kai-Liang Kao
- Department of Pediatrics, Far Eastern Memorial Hospital, Taipei, Taiwan.,Department of Industrial Management, Oriental Institute of Technology, Taipei, Taiwan
| | - Jun-Cheng Weng
- Department of Psychiatry, Chang Gung Memorial Hospital at Chiayi,Chiayi,Taiwan.,Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Brent Allan Kelsen
- Language Center, National Taipei University, New Taipei City, Taiwan.,Department of Psychology, Auckland University of Technology, Auckland, New Zealand
| | - Sophie Hsin-Yi Liang
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Child Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan
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12
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Hu HF, Liu TL, Hsiao RC, Ni HC, Liang SHY, Lin CF, Chan HL, Hsieh YH, Wang LJ, Lee MJ, Chou WJ, Yen CF. Cyberbullying Victimization and Perpetration in Adolescents with High-Functioning Autism Spectrum Disorder: Correlations with Depression, Anxiety, and Suicidality. J Autism Dev Disord 2019; 49:4170-4180. [PMID: 31267285 DOI: 10.1007/s10803-019-04060-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 12/21/2022]
Abstract
The present study examined the associations between cyberbullying involvement and sociodemographic characteristics, autistic social impairment and attention-deficit/hyperactivity disorder and oppositional defiant disorder (ODD) symptoms in 219 adolescents with high-functioning autism spectrum disorder (ASD). Moreover, the associations between cyberbullying involvement and depression, anxiety, and suicidality were also examined. Adolescents self-reported higher rates of being a victim or perpetrator of cyberbullying than were reported by their parents. Increased age and had more severe ODD symptoms were significantly associated with being victims or perpetrators of cyberbullying. Being a victim but not a perpetrator of cyberbullying was significantly associated with depression, anxiety, and suicidality. Cyberbullying victimization and perpetration should be routinely surveyed in adolescents with high-functioning ASD.
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Affiliation(s)
- Huei-Fan Hu
- Department of Psychiatry, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Rd, Kaohsiung City, 807, Taiwan
| | - Ray C Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.,Department of Psychiatry, Children's Hospital and Regional Medical Center, Seattle, WA, USA
| | - Hsing-Chang Ni
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Sophie Hsin-Yi Liang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chiao-Fan Lin
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Hsiang-Lin Chan
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Yi-Hsuan Hsieh
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Liang-Jen Wang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 123, Dapi Road, Niaosong District, Kaohsiung City, 833, Taiwan
| | - Min-Jing Lee
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 123, Dapi Road, Niaosong District, Kaohsiung City, 833, Taiwan
| | - Wen-Jiun Chou
- College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 123, Dapi Road, Niaosong District, Kaohsiung City, 833, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan. .,Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Rd, Kaohsiung City, 807, Taiwan.
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13
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Hsieh YH, Chan HL, Lin CF, Liang SHY, Lu ML, McIntyre RS, Lee Y, Lin TC, Chiu WC, Chen VCH. Antipsychotic use is inversely associated with gastric cancer risk: A nationwide population-based nested case-control study. Cancer Med 2019; 8:4484-4496. [PMID: 31183993 PMCID: PMC6675741 DOI: 10.1002/cam4.2329] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 12/26/2022] Open
Abstract
Objective The association between antipsychotic use and gastric cancer risk remains unclear. Therefore, this study aimed to determine the association between antipsychotic exposure and the incidence of gastric cancer. Methods Using a nested case‐control design, a total of 34 470 gastric cancer patients and 163 430 nongastric cancer controls were identified from Taiwan's National Health Insurance Research Database between 1 January 1997 and 31 December 2013. We analyzed the data using a conditional logistic regression model to adjust for possible confounding variables. Results Antipsychotic use was independently inversely associated with gastric cancer risk after controlling for potential confounding factors including income, urbanization, medications, physical and medical illness, aspirin use, nonsteroidal anti‐inflammatory drug use and triple therapy. In addition, dose‐dependent trends against gastric cancer risk were also shown with individual antipsychotic compounds including thioridazine, haloperidol, sulpiride, clozapine, olanzapine, quetiapine, amisulpride, and risperidone. A sensitivity analysis showed that second‐generation antipsychotics had significant dose‐dependent effects in reducing the risk of gastric cancer risk in patients with and without peptic ulcer disease. Conclusions Antipsychotic use was inversely associated with gastric cancer risk, and dose‐dependent effects against gastric cancer were also seen with several individual antipsychotic compounds.
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Affiliation(s)
- Yi-Hsuan Hsieh
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan.,Department of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiang-Lin Chan
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Child Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chiao-Fan Lin
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Child Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Sophie Hsin-Yi Liang
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan.,Department of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan-Fang Hospital & School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Brain and Cognition Discovery Foundation, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | | | - Wei-Che Chiu
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
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14
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Hsieh MT, Liang SHY, Yang YH, Kuo TY, Lin TY, Wang TN, Chen VCH, Wu MH. Allergic rhinitis increases the risk of incident panic disorder among young individuals: A nationwide population-based cohort study in Taiwan. J Affect Disord 2019; 252:60-67. [PMID: 30981057 DOI: 10.1016/j.jad.2019.04.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 03/12/2019] [Accepted: 04/07/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Studies have reported an association between allergy and panic disorder. However, few studies have explored the relationship between allergic rhinitis and panic disorder. Previous studies were limited by cross-sectional study designs, self-reported symptoms, absence of matched controls, and lack of consideration of the influence of steroid and comorbidities. This study aimed to explore the longitudinal association between allergic rhinitis and panic disorder in a large population-based cohort of young people. METHODS In this study, 79,917 new cases of allergic rhinitis between 1998 and 2012 in individuals younger than 20 years were identified from Taiwan's National Health Insurance Research Database. One control (nonallergic rhinitis) per case (allergic rhinitis) was randomly selected from the remaining sample, matching for age, sex, residence, and insurance premium. Both groups were followed until the end of 2013 for incidence of panic disorder. Cox regression analysis was performed, adjusting for sex, age, residence, insurance premium, systemic steroids, asthma, atopic dermatitis, allergic conjunctivitis, attention deficit hyperactivity disorder, depression, and Charlson index. RESULTS Allergic rhinitis was associated with a 2-fold increase in risk for panic disorder after adjustment for other variables. Additional independent risk factor of panic disorders were female sex, older age group, and depression. LIMITATIONS Lifestyle, substance use, smoking by the patient or family members, and psychosocial stressors were not evaluated. CONCLUSIONS Allergic rhinitis was associated with increased risk of panic disorder. Assessment and intervention of allergy rhinitis among young people with panic disorder are critical.
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Affiliation(s)
- Men-Ting Hsieh
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sophie Hsin-Yi Liang
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang-Gung Memorial Hospital at Taoyuan and Chang Gung University College of Medicine, Taiwan
| | - Yao-Hsu Yang
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
| | - Ting-Yu Kuo
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan.
| | - Tsang-Yaw Lin
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, 542 No.161, Yu-Pin Rd, Caotun Township, Nantou, Taiwan, R.O.C
| | - Tsu-Nai Wang
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, No. 100, Shiquan 1st Road, Kaohsiung City, Taiwan, R.O.C..
| | - Vincent Chin-Hung Chen
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, 613 Chiayi County, Taiwan
| | - Meng-Huan Wu
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, 542 No.161, Yu-Pin Rd, Caotun Township, Nantou, Taiwan, R.O.C..
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15
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Chou WJ, Hsiao RC, Ni HC, Liang SHY, Lin CF, Chan HL, Hsieh YH, Wang LJ, Lee MJ, Hu HF, Yen CF. Self-Reported and Parent-Reported School Bullying in Adolescents with High Functioning Autism Spectrum Disorder: The Roles of Autistic Social Impairment, Attention-Deficit/Hyperactivity and Oppositional Defiant Disorder Symptoms. Int J Environ Res Public Health 2019; 16:ijerph16071117. [PMID: 30925769 PMCID: PMC6479357 DOI: 10.3390/ijerph16071117] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/23/2019] [Accepted: 03/26/2019] [Indexed: 11/17/2022]
Abstract
The aim of this study was to examine the prevalence of self-reported and parent-reported bullying victimization, perpetration, and victimization-perpetration and the associations of autistic social impairment and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms with bullying involvement in adolescents with high functioning autism spectrum disorder (ASD). A total of 219 adolescents with high functioning ASD participated in this study. The associations of sociodemographic characteristics, parent-reported autistic social impairment, and parent-reported ADHD and ODD symptoms with self-reported and parent-reported bullying victimization, perpetration, and victimization-perpetration were examined using logistic regression analysis. The results found that the agreement between self-reported and parent-reported bullying involvement was low. Compared with bullying involvement experiences reported by adolescents themselves, parents reported higher rates of pure bullying victimization (23.7% vs. 17.8%) and victimization-perpetration (28.8% vs. 9.1%) but a lower rate of pure bullying perpetration (5.9% vs. 9.1%). Deficit in socio-communication increases the risk of being pure victims and victim-perpetrators. Parent-reported victim-perpetrators had more severe ODD symptoms than did parent-reported pure victims.
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Affiliation(s)
- Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
| | - Ray C Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98105-0371, USA.
- Department of Psychiatry, Children's Hospital and Regional Medical Center, Seattle, WA 98105-0371, USA.
| | - Hsing-Chang Ni
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan city 33305, Taiwan.
| | - Sophie Hsin-Yi Liang
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan city 33305, Taiwan.
| | - Chiao-Fan Lin
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan city 33305, Taiwan.
| | - Hsiang-Lin Chan
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan city 33305, Taiwan.
| | - Yi-Hsuan Hsieh
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan city 33305, Taiwan.
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
| | - Min-Jing Lee
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan.
| | - Huei-Fan Hu
- Department of Psychiatry, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan 701, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
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16
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Liang SHY, Chou JY, Wu YY, Lee CP, Kelsen BA, Lee YC. Validity and Reliability Study of the Chinese (Traditional) Version of the Devereux Early Childhood Assessment for Toddlers (DECA-T). Neuropsychiatr Dis Treat 2019; 15:3375-3385. [PMID: 31824161 PMCID: PMC6901051 DOI: 10.2147/ndt.s218943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/15/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Devereux Early Childhood Assessment for Toddlers (DECA-T), which is one of the few standardized, norm-referenced behavioral rating scales related to young children's mental health, resilience, and social-emotional development, was developed for toddlers aged between 18 and 36 months. OBJECTIVE The aim of this study was to test the clinimetric properties of the Chinese (Traditional) version of the DECA-T (C-DECA-T) using a classical test theory analysis and an item response theory analysis. METHODS Seventy-five community-based toddlers aged from 18 to 36 months and 50 clinic-based participants recruited in hospitals in northern Taiwan participated in this study. Social-emotional competence was assessed by the C-DECA-T and children's behavior problems were rated via the Child Behavior Checklist 1.5 to 5 (CBCL/1.5-5). Homogeneity of the C-DECA-T was assessed by Mokken analysis; sensitivity and specificity were assessed via receiver operating characteristic curve. RESULTS The results showed the C-DECA-T demonstrated good test-retest reliability (r=0.8) and high internal consistency (Cronbach's alpha = 0.94). Inter-rater reliability between father and mother was fair (ICC = 0.46). Convergent validity of the CBCL/1.5-5 total behavior problems (r=-0.26) demonstrated acceptable psychometric performance. The overall measure of the sampling adequacy of the C-DECA-T assessed by principal component analysis was 0.93. Mokken scale analysis showed the 36-items of the C- DECA-T formed a weak unidimensional scale (Hs =0.35), supporting its construct validity. The area under curve of the C-DECA-T in prediction of social-emotional disturbance was 0.70. The optimal cutoff of the Total Protective Factor score of the C-DECA-T was a T score of 40.1 (T40.1), with a sensitivity of 95% and a specificity of 68%. Item 2 ("show affection for a familiar adult") and item 33 ("calm herself/himself") provide a good amount of information for the assessment of social-emotional strength and needs of a toddler in clinical practice. CONCLUSION The C-DECA-T showed good psychometric properties. Our findings of high internal consistency of the three subscales and total score of the C-DECA-T suggest symptom manifestation of social-emotional competence and needs in Taiwanese toddlers is not culturally different from American toddlers. The clinimetric properties of the C-DECA-T examined by a classical test theory analysis approach and an item response theory analysis approach suggest that the C-DECA-T is a reliable and valid instrument for measuring social-emotional strength and needs in the population in Taiwan.
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Affiliation(s)
- Sophie Hsin-Yi Liang
- Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jen-Yu Chou
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Yu Wu
- Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taiwan, YuNing Psychiatric Clinic, Taipei, Taiwan
| | - Chin-Pang Lee
- Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Brent Allan Kelsen
- Language Center, National Taipei University, New Taipei City, Taiwan, Department of Psychology, Auckland University of Technology, Auckland, New Zealand
| | - Yi-Chen Lee
- Department of Psychiatry, Chang-Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Chiayi, Taiwan
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17
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Tsai CJ, Lee CTC, Liang SHY, Tsai PJ, Chen VCH, Gossop M. Risk of ADHD After Multiple Exposures to General Anesthesia: A Nationwide Retrospective Cohort Study. J Atten Disord 2018; 22:229-239. [PMID: 26023173 DOI: 10.1177/1087054715587094] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To study the association between general anesthesia exposure before age 3 years and having a later ADHD diagnosis. METHOD In a birth cohort, data were collected from a nationwide population database for children born between 1997 and 1999 who were exposed to general anesthesia before their third birthday. Age- and gender-matched enrollees without general anesthesia exposure were taken as the comparison. Groups were compared to identify the incidence of ADHD after age 4 and anesthesia-related predictive factors. RESULTS Among the 1,146 exposed children, 74 ADHD cases were identified, and 158 ADHD cases were identified in 3,438 matched controls. After adjusting for comorbid conditions and possible confounding factors, if exposure on more than one occasion or ≥3 hr, an increased likelihood of having a later ADHD diagnosis was found (HR, 1.71 and 2.43, respectively). CONCLUSION Children with multiple or ≥3 hr general anesthesia exposures before age 3 years have an increased likelihood of a later ADHD diagnosis.
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Affiliation(s)
| | - Charles Tzu-Chi Lee
- 2 Kaohsiung Medical University, Taiwan.,3 National Taiwan Normal University, Taipei, Taiwan
| | - Sophie Hsin-Yi Liang
- 4 Chang Gung Memorial Hospital, Taoyuan, Taiwan.,5 Chang Gung University, Taoyuan, Taiwan
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18
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Liang SHY, Yang YH, Kuo TY, Liao YT, Lin TC, Lee Y, McIntyre RS, Kelsen BA, Wang TN, Chen VCH. Suicide risk reduction in youths with attention-deficit/hyperactivity disorder prescribed methylphenidate: A Taiwan nationwide population-based cohort study. Res Dev Disabil 2018; 72:96-105. [PMID: 29121517 DOI: 10.1016/j.ridd.2017.10.023] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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: 06/01/2017] [Revised: 10/09/2017] [Accepted: 10/25/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) youths have increased suicide risk. Nevertheless, the beneficial effects of methylphenidate (MPH) on suicide attempt have received relatively little attention. AIMS To investigate the MPH usage and the risk of suicide attempt among ADHD youths. METHODS We identified 84,898 youths less than 18 years old with ADHD diagnosis between 1997 and 2013 from National Health Insurance, and examined whether MPH use affected suicide attempt risk using Cox proportional-hazards models. OUTCOME AND RESULTS Among ADHD youths, reduction of suicide risk was found in patients prescribed 90-180days of MPH after adjusting for confounding factors (hazard ratio (HR): 0.41, 95% confidence interval (CI): 0.19-0.90) and a greater reduction in those prescribed more than 180days of MPH (HR: 0.28, 95% CI: 0.17-0.48). CONCLUSIONS AND IMPLICATIONS We observed a 59% suicide attempt risk reduction among ADHD youths prescribed between 90 and 180days and a 72% risk reduction in those prescribed more than 180days of MPH. The protective benefit observed by the group prescribed MPH for longer duration underscores the importance of psychoeducation and compliance enhancement as part of ADHD management. Indication bias is identified as a limitation of this study, and future self-case control study to investigate the association between suicide attempt and ADHD medication is suggested. WHAT THIS PAPER ADDS This nationwide population-based cohort study showed that among ADHD youths, reduction of suicide risk was observed in patients prescribed MPH for duration 90days and longer, underscoring the importance of appropriate ADHD pharmacotherapy and enhancing drug compliance.
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Affiliation(s)
- Sophie Hsin-Yi Liang
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC; Department of Child Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan, ROC
| | - Yao-Hsu Yang
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC; Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Ting-Yu Kuo
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Yin-To Liao
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC; Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
| | - Tzu-Chin Lin
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC; Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada; Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada
| | - Brent A Kelsen
- Language Center, National Taipei University, New Taipei City, Taiwan, ROC
| | - Tsu-Nai Wang
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Vincent Chin-Hung Chen
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC; Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC.
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19
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Chen VCH, Shen CY, Liang SHY, Li ZH, Hsieh MH, Tyan YS, Lu ML, Lee Y, McIntyre RS, Weng JC. Assessment of brain functional connectome alternations and correlation with depression and anxiety in major depressive disorders. PeerJ 2017; 5:e3147. [PMID: 29181274 PMCID: PMC5702252 DOI: 10.7717/peerj.3147] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 12/18/2016] [Accepted: 03/05/2017] [Indexed: 12/17/2022] Open
Abstract
Major depressive disorder (MDD) is highly prevalent, recurrent, and associated with functional impairment, morbidity, and mortality. Herein, we aimed to identify disruptions in functional connectomics among subjects with MDD by using resting-state functional magnetic resonance imaging (rs-fMRI). Sixteen subjects with MDD and thirty health controls completed resting-state fMRI scans and clinical assessments (e.g., Hamilton Depression Rating Scale (HAMD) and Hospital Anxiety and Depression Scale (HADS)). We found higher amplitude of low frequency fluctuations (ALFF) bilaterally in the hippocampus and amygdala among MDD subjects when compared to healthy controls. Using graph theoretical analysis, we found decreased clustering coefficient, local efficiency, and transitivity in the MDD patients. Our findings suggest a potential biomarker for differentiating individuals with MDD from individuals without MDD.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Current affiliation: Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chao-Yu Shen
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Sophie Hsin-Yi Liang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Section of Child Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan
| | - Zhen-Hui Li
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Hong Hsieh
- Department of Psychiatry, Chung Shan Medical University and Hospital, Taichung, Taiwan
| | - Yeu-Sheng Tyan
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital & School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yena Lee
- Mood Disorder Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Jun-Cheng Weng
- Current affiliation: Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan.,Current affiliation: Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
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20
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Chen YC, Hwang-Gu SL, Ni HC, Liang SHY, Lin HY, Lin CF, Tseng YH, Gau SSF. Relationship between parenting stress and informant discrepancies on symptoms of ADHD/ODD and internalizing behaviors in preschool children. PLoS One 2017; 12:e0183467. [PMID: 29016602 PMCID: PMC5634535 DOI: 10.1371/journal.pone.0183467] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/04/2017] [Indexed: 12/02/2022] Open
Abstract
Parent and teacher ratings of child behaviors are often discrepant, and these discrepancies may be correlated with parenting stress. The present study explored whether various parenting stress factors are associated with discrepancies between parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder (ODD) as well as internalizing symptoms in preschool children. We recruited 299 Taiwanese preschool children (aged 4-6 years) from the community or via clinical referrals. A structural equation modeling was used to analyze the relationships among three factors derived from the Parenting Stress Index-Short Form and informant discrepancies on symptoms of inattention, hyperactivity/impulsivity, ODD, and internalizing behaviors. Scores reported by parents were higher for each of the symptoms examined than those reported by teachers, and the degree of agreement between informants ranged from low to moderate. The parental distress factor of parenting stress was associated only with parent ratings, whereas other factors of parenting stress-parent-child dysfunctional interaction and parents' stress resulted from their child's temperament-were correlated with both parent and teacher ratings. Only parental distress factor predicted informant discrepancies for all behavioral symptoms assessed. Our findings suggest that parental distress should be considered when parent rating scores show significant discrepancies from that of teacher rating scores.
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Affiliation(s)
- Yu-Chi Chen
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Shoou-Lian Hwang-Gu
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Hsing-Chang Ni
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Sophie Hsin-Yi Liang
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Hsiang-Yuan Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chiao-Fan Lin
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Yu-Han Tseng
- Department of Psychology, Soochow University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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21
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Chen CY, Yang YH, Lee CP, Wang TY, Cheng BH, Huang YC, Chen PC, Liang SHY, Dewey M, Chen VCH. Risk of depression following uterine cancer: A nationwide population-based study. Psychooncology 2017; 26:1770-1776. [PMID: 28029721 DOI: 10.1002/pon.4360] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/18/2016] [Accepted: 12/22/2016] [Indexed: 01/17/2023]
Affiliation(s)
- Chao-Yu Chen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi and College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Yao-Hsu Yang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, and School of Traditional Chinese Medicine, College of Medicine; Chang Gung University; Taoyuan Taiwan
- Center of Excellence for Chang Gung Research Datalink; Chang Gung Memorial Hospital; Chiayi Taiwan
- Institute of Occupational Medicine and Industrial Hygiene; National Taiwan University College of Public Health; Taipei Taiwan
| | - Chuan-Pin Lee
- Center of Excellence for Chang Gung Research Datalink; Chang Gung Memorial Hospital; Chiayi Taiwan
| | - Ting-Yao Wang
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi and College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Bi-Hua Cheng
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi and College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Yin-Cheng Huang
- Department of Neurosurgery, Chang Gung Memorial Hospital, Chiayi and College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene; National Taiwan University College of Public Health; Taipei Taiwan
- Department of Environmental and Occupational Medicine; National Taiwan University Hospital and National Taiwan University College of Medicine; Taipei Taiwan
| | - Sophie Hsin-Yi Liang
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, and School of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Michael Dewey
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience; King's College London; London UK
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, and School of Medicine, Chang Gung University; Taoyuan Taiwan
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22
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Chen VCH, Shen CY, Liang SHY, Li ZH, Tyan YS, Liao YT, Huang YC, Lee Y, McIntyre RS, Weng JC. Assessment of abnormal brain structures and networks in major depressive disorder using morphometric and connectome analyses. J Affect Disord 2016; 205:103-111. [PMID: 27423425 DOI: 10.1016/j.jad.2016.06.066] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND It is hypothesized that the phenomenology of major depressive disorder (MDD) is subserved by disturbances in the structure and function of brain circuits; however, findings of structural abnormalities using MRI have been inconsistent. Generalized q-sampling imaging (GQI) methodology provides an opportunity to assess the functional integrity of white matter tracts in implicated circuits. METHODS The study population was comprised of 16 outpatients with MDD (mean age 44.81±2.2 years) and 30 age- and gender-matched healthy controls (mean age 45.03±1.88 years). We excluded participants with any other primary mental disorder, substance use disorder, or any neurological illnesses. We used T1-weighted 3D MRI with voxel-based morphometry (VBM) and vertex-wise shape analysis, and GQI with voxel-based statistical analysis (VBA), graph theoretical analysis (GTA) and network-based statistical (NBS) analysis to evaluate brain structure and connectivity abnormalities in MDD compared to healthy controls correlates with clinical measures of depressive symptom severity, Hamilton Depression Rating Scale 17-item (HAMD) and Hospital Anxiety and Depression Scale (HADS). RESULTS Using VBM and vertex-wise shape analyses, we found significant volumetric decreases in the hippocampus and amygdala among subjects with MDD (p<0.001). Using GQI, we found decreases in diffusion anisotropy in the superior longitudinal fasciculus and increases in diffusion probability distribution in the frontal lobe among subjects with MDD (p<0.01). In GTA and NBS analyses, we found several disruptions in connectivity among subjects with MDD, particularly in the frontal lobes (p<0.05). In addition, structural alterations were correlated with depressive symptom severity (p<0.01). LIMITATIONS Small sample size; the cross-sectional design did not allow us to observe treatment effects in the MDD participants. CONCLUSIONS Our results provide further evidence indicating that MDD may be conceptualized as a brain disorder with abnormal circuit structure and connectivity.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chao-Yu Shen
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Sophie Hsin-Yi Liang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Zhen-Hui Li
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Yeu-Sheng Tyan
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yin-To Liao
- Department of Psychiatry, Chung Shan Medical University, Taichung, Taiwan
| | - Yin-Chen Huang
- Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan.
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