chih-hung Ko
Kaohsiung Medical University Hospital, Psychiatry, Department Member
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The aims of this prospective study were to examine the predictive values of self-stigma, insight, and perceived adverse effects of medication for remission of depressive symptoms, suicidal risk, and medication adherence in patients with... more
The aims of this prospective study were to examine the predictive values of self-stigma, insight, and perceived adverse effects of medication for remission of depressive symptoms, suicidal risk, and medication adherence in patients with depressive disorders over a 1-year follow-up period. One hundred seventy-four participants who were in a state of obvious depression underwent an index interview to determine their degree of self-stigma, insight, and perceived adverse effects of medication. One year later, they were reassessed to determine the severity of their depressive symptoms, suicidal risk, and the level of the medication adherence, and their associations with the 3 possible predictors at the index interview were examined. The results of this study indicated that perceiving more severe adverse effects of medication at the index interview increased the risks of the nonremission of depressive symptoms, occurrence of suicidal ideation or attempt, and medication nonadherence in patients with depressive disorders in the 1-year period. However, the degrees of self-stigma and insight did not predict the severity of depressive symptoms, suicidal risk, or the level of the medication adherence. Based on the results of this study, we suggest that it is important for clinicians to prevent the occurrence of and to help patients manage the adverse effects of medication. We also suggest that further prospective studies are needed to examine the predictive values of self-stigma and insight for clinical outcomes and medication adherence.
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Research Interests: Anxiety Disorders, Asthma, Adolescent, Medicine, Linear models, and 15 moreAnxiety, Humans, Child, Generalized Anxiety Disorder, Major Depressive Disorder, Environmental public health, Female, Male, Aged, Adult, ANXIETY, Cross Sectional Studies, Logistic Models, confounding, and Medical and Health Sciences
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The aim of the present study was to explore the associations between insight and medication adherence at index interview and at 1‐year follow‐up interview in bipolar and schizophrenic outpatients. The Schedule for Assessment of Insight... more
The aim of the present study was to explore the associations between insight and medication adherence at index interview and at 1‐year follow‐up interview in bipolar and schizophrenic outpatients. The Schedule for Assessment of Insight (SAI) and its expanded version (SAI‐E) were used to provide a baseline insight score for 65 bipolar subjects and 74 schizophrenic subjects considered to be in remission or to have minimal psychopathology. Medication adherence of subjects was assessed at index interview and at 1‐year follow‐up interview, and the association between insight and medication adherence was analyzed cross‐sectionally and prospectively. The results of the analysis reveal that in bipolar subjects, the index SAI scores for insight into treatment, mental‐health status and psychotic experiences, and total SAI‐E were positively correlated with medication adherence at both index and 1‐year follow‐up interviews. However, in schizophrenic subjects, insight into treatment and total SAI‐E correlated positively with medication adherence at index interview but not at 1‐year follow‐up interview. Medication adherence at index interview could predict medication adherence 1 year later in both bipolar and schizophrenic subjects. These results indicate that the predictive value of insight for medication adherence differs between bipolar and schizophrenic patients, and building insight is an important step for establishing medication adherence in bipolar patients.
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In adolescent populations worldwide, Internet addiction is prevalent and is often comorbid with depression, hostility, and social anxiety of adolescents. This study aimed at evaluating the exacerbation of depression, hostility, and social... more
In adolescent populations worldwide, Internet addiction is prevalent and is often comorbid with depression, hostility, and social anxiety of adolescents. This study aimed at evaluating the exacerbation of depression, hostility, and social anxiety in the course of getting addiction to Internet or remitting from Internet addiction among adolescents. This study recruited 2293 adolescents in grade 7 to assess their depression, hostility, social anxiety and Internet addiction. The same assessments were repeated one year later. The incidence group was defined as subjects classified as non-addicted in the first assessment and as addicted in the second assessment. The remission group was defined as subjects classified as addicted in the first assessment and as non-addicted in the second assessment. The incidence group exhibited increased depression and hostility more than the non-addiction group and the effect of on depression was stronger among adolescent girls. Further, the remission group showed decreased depression, hostility, and social anxiety more than the persistent addiction group. Depression and hostility worsen in the addiction process for the Internet among adolescents. Intervention of Internet addiction should be provided to prevent its negative effect on mental health. Depression, hostility, and social anxiety decreased in the process of remission. It suggested that the negative consequences could be reversed if Internet addiction could be remitted within a short duration.
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Research Interests: Psychology, Psychiatry, Anxiety Disorders, Addiction, Adolescent, and 15 moreMedicine, Comorbidity, The Internet, Anxiety, Humans, Child, Aggression, Young Adult, Mental Disorders, ANXIETY, Internet, Attention deficit disorder with hyperactivity, Psychology and Cognitive Sciences, european psychiatry, and Medical and Health Sciences
Background: Treatment for depressive elders is a challenge due to the complexity in clinical manifestation, medical comorbidity and etiologies. There has been scant of the literature regarding treatment outcomes and their correlates among... more
Background: Treatment for depressive elders is a challenge due to the complexity in clinical manifestation, medical comorbidity and etiologies. There has been scant of the literature regarding treatment outcomes and their correlates among the elderly patients with major depressive disorder at acute stage in Taiwan. We conducted a preliminary 12-week open-labeled trial of antidepressants for the late-life major depressive disorder, and examined the predictors of patients with poor outcome. Methods: Sixty elderly patients with late-life major depressive disorder were recruited for a 12-week open-labeled study of acute antidepressants treatment. Depressive severities were assessed using 17-item Hamilton Depression Rating Scale for Depression (HAMD17) at weeks, 0, 2, 4, 8, and 12-week. Treatment remission were defined by HAMD17 ≦7 and Clinical Global Inventory (CGI) ≦2. Antidepressants were prescribed according to clinical judgment. The intent-to-treat population using the last observation carried forward (LOCF) method was used for analysis. Results: Among the patients achieving remission during the trial, the proportions of remitted patients of each visit were: 15.4% at the 2-week, 23.1% at the 4-week, 50% at the 8-week, and 11.5% at the 12-week. We found that the elderly patients with late-onset of first major depressive episode, higher scores of mood factor, and sleep factor were likely to be non-remitted from antidepressant treatments. Conclusions: In this study, only 40% of elder patients could complete 12-week acute antidepressant treatments. Near half of all study participants reached remission. In summary, late-onset of the disease, severe depressed mood, and sleep disturbances could be the predictors for non-remission. But the study results need to be validated in future studies with larger sample sizes in the numbers of the study subjects as well as group comparation and randomization in design.
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Research Interests: Demography, Psychiatry, Adolescent, Medicine, Activities of Daily Living, and 15 moreHumans, Major Depressive Disorder, Female, Male, Caregivers, Caregiver burden, Aged, Middle Aged, Adult, Cost of Illness, Frontal Lobe, Functional Disability, Disabled Persons, Elderly patient, and Medical and Health Sciences
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To examine the prevalence rates and correlates of dependence on, misuse of, and beliefs regarding use of hypnotics in elderly psychiatric patients with long-term use of zolpidem, estazolam, or flunitrazepam. A total of 139 psychiatric... more
To examine the prevalence rates and correlates of dependence on, misuse of, and beliefs regarding use of hypnotics in elderly psychiatric patients with long-term use of zolpidem, estazolam, or flunitrazepam. A total of 139 psychiatric outpatients 65 or more years of age who used zolpidem, estazolam, or flunitrazepam for at least 3 months were studied. The levels of hypnotic dependence and beliefs regarding hypnotic use (necessity and concern) were assessed. Three patterns of hypnotic misuse in the past 1 month were also explored. The correlates of high dependence, misuse, and unfavorable attitude and high concern toward hypnotic use were examined using logistic regression analyses. A total of 28.8%, 7.9%, 12.2%, and 22.3% of participants reported high dependence on, misuse of, unfavorable attitude toward, and high concern toward hypnotic use, respectively. Males were more likely to report unfavorable attitude toward hypnotic use than females. Elders with significant depression were more likely to report high concern toward hypnotic use than those without significant depression. Elders with high concern toward hypnotic use were more likely to report high dependence on hypnotics than those with low concern. Elders with significant depression and taking zolpidem were more likely to misuse hypnotics than those without significant depression and taking estazolam or flunitrazepam, respectively. Clinicians should monitor the possibility of dependence on and misuse of hypnotics among elderly psychiatric patients who had the correlates identified in this study.
Research Interests: Psychology, Psychiatry, Medicine, Humans, Female, and 14 moreMale, Hypnotic, Clinical Sciences, Aged, Public health systems and services research, Sex Factors, Pyridines, Zolpidem, Substance-Related Disorders, Flunitrazepam, Estazolam, Psychiatric Status Rating Scales, attitude to health, and Sleep initiation and maintenance disorders
Objective: Depression, anxiety, and irritability are the three most studied symptoms of premenstrual dysphoric disorder (PMDD). This study aimed to assess the premenstrual exacerbation of these symptoms and their role in the diagnosis or... more
Objective: Depression, anxiety, and irritability are the three most studied symptoms of premenstrual dysphoric disorder (PMDD). This study aimed to assess the premenstrual exacerbation of these symptoms and their role in the diagnosis or functional impairment of PMDD. Methods: We recruited women with PMDD not undergoing any treatment and control subjects from the community. The diagnosis of PMDD was based on a positive score on the Premenstrual Symptoms Screening Tool and confirmed by psychiatric interviews and questionnaire follow-up for three menstrual cycles. A total of 67 women with PMDD and 75 control subjects participated the survey and reach the final analysis. They complete the Center for Epidemiological Studies, the Chinese Version of the Buss-Durkee Hostility Inventory-Short Form, and the Penn State Worry Questionnaire in both the premenstrual and follicular phases. Results: Women with PMDD, but no controls, demonstrate the premenstrual exacerbation of these three symptoms. Depression was the most prominent feature of the PMDD diagnosis while irritability was most frequently associated with functional impairment. Conclusions: Depression and irritability should be properly evaluated and treated among women with PMDD.
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Research Interests: Clinical Psychology, Psychiatry, Mental Health, Depression, Bullying, and 15 moreAdolescent, Medicine, Anxiety, Humans, Child, Male, Crime Victims, Developmental disabilities, Health Status, Prevalence, Age Factors, ANXIETY, Internet, Logistic Models, and Attention deficit disorder with hyperactivity
This study was aimed to evaluate the association between Internet addiction and depressive disorder, social phobia and adult attention-deficit/hyperactivity disorder (ADHD) in a sample of Taiwanese college students; and examine gender... more
This study was aimed to evaluate the association between Internet addiction and depressive disorder, social phobia and adult attention-deficit/hyperactivity disorder (ADHD) in a sample of Taiwanese college students; and examine gender differences in the psychiatric comorbidity of Internet addiction in this student population. Two hundred sixteen college students (132 males, 84 females) were recruited. Internet addiction, major depressive disorder, dysthymic disorder, social phobia, and adult ADHD of all participants were diagnosed based on psychiatric diagnostic interview. This study revealed that adult ADHD and depressive disorders were associated with Internet addiction among college students. However, depressive disorders were associated with Internet addiction in the males but not the females. With these results, it seems reasonable to suggest that effective evaluation of, and treatment for, adult ADHD and depressive disorders is required for college students with Internet addiction.
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To: (1) determine the association between Internet addiction and depression, self-reported symptoms of attention deficit and hyperactivity disorder (ADHD), social phobia, and hostility for adolescents; and (2) evaluate the sex differences... more
To: (1) determine the association between Internet addiction and depression, self-reported symptoms of attention deficit and hyperactivity disorder (ADHD), social phobia, and hostility for adolescents; and (2) evaluate the sex differences of association between Internet addiction and the above-mentioned psychiatric symptoms among adolescents. A total of 2114 students (1204 male and 910 female) were recruited for the study. Internet addiction, symptoms of ADHD, depression, social phobia, and hostility were evaluated by the self-report questionnaire. The results demonstrated that adolescents with Internet addiction had higher ADHD symptoms, depression, social phobia, and hostility. Higher ADHD symptoms, depression, and hostility are associated with Internet addiction in male adolescents, and only higher ADHD symptoms and depression are associated with Internet addiction in female students. These results suggest that Internet addiction is associated with symptoms of ADHD and depressive disorders. However, hostility was associated with Internet addiction only in males. Effective evaluation of, and treatment for ADHD and depressive disorders are required for adolescents with Internet addiction. More attention should be paid to male adolescents with high hostility in intervention of Internet addiction.
Research Interests: Psychology, Clinical Psychology, Psychiatry, Education, Addiction, and 15 moreDepression, Adolescent Health, Adolescent, Medicine, Comorbidity, Humans, Female, Male, Hostility, Internet, Attention deficit disorder with hyperactivity, Psychology and Cognitive Sciences, Phobic disorders, Attention Deficit and Hyperactivity Disorder, and Medical and Health Sciences
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Research Interests: Information Systems, Clinical Psychology, Cognitive Science, Computer Science, Cyberpsychology, and 15 moreAddiction, Adolescent, Medicine, Comorbidity, Impulsivity, Humans, Female, College Students, Male, Gender Difference, Adult, Health surveys, Cross Sectional Studies, Impulsive behavior, and Attention deficit disorder with hyperactivity
AimThe study explores IGD withdrawal-related presentations, including autonomic reaction, affective symptoms, anhedonia, and gaming urge during abstinence from gaming. We prospectively evaluated these withdrawal-related symptoms (WRS) and... more
AimThe study explores IGD withdrawal-related presentations, including autonomic reaction, affective symptoms, anhedonia, and gaming urge during abstinence from gaming. We prospectively evaluated these withdrawal-related symptoms (WRS) and gaming craving during abstinence from gaming.MethodsWe examined 69 individuals with IGD and 69 regular gamers and evaluated their WRS (using an exploratory questionnaire), affective and behavioral WRS (using the Questionnaire on Gaming Urge-Brief Version gaming disorder questionnaire), and heart rate. All the participants attempted to abstain from gaming before our assessment. Subsequently, some participants’ WRS and gaming craving before they engaged in gaming were prospectively evaluated.ResultsIn the IGD group, 85.5% experienced gaming WRS, including affective, anhedonia, and gaming urge symptoms. They could relieve these symptoms through gaming. The IGD group experienced more severe gaming WRS, gaming craving, and a higher heart rate than the regular gamer group. Gaming urge was most associated WRS of IGD. Participants with IGD experienced more severe gaming cravings when their gaming abstinence before the assessment was shorter. WRS attenuated at night and the following morning when they maintained their gaming abstinence after assessment.ConclusionIndividuals with IGD experience withdrawal-related affective, anhedonia, and gaming urge symptoms and a higher heart rate during abstinence. The WRS attenuated in 1 day. Most participants agreed that these symptoms could be relieved through gaming. Further prospective evaluation by objective assessment in an adequate sample was required to understand gaming withdrawal symptoms comprehensively.
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Purpose of review Understanding the association between urbanization and Internet addiction is essential to the design and implementation of Internet addiction prevention measures in urban areas. This epidemiological review explores the... more
Purpose of review Understanding the association between urbanization and Internet addiction is essential to the design and implementation of Internet addiction prevention measures in urban areas. This epidemiological review explores the urbanization-Internet addiction association and its potential underlying factors. Recent findings Nine studies have reported that Internet addiction prevalence is higher in urban areas, but three studies have noted the opposite. Psychiatric disorders and stress are the most commonly mentioned factors underlying the association. The effects of urbanization on Internet availability, Internet cafes, online gaming, outdoor or interactive activities, and family regulation and monitoring have been suggested to lead to higher Internet addiction risk. The ongoing COVID-19 pandemic, obesity, sleep problems, and the migration of parents to urban areas in search of work have strengthened the effect of urbanization on Internet addiction. Summary Early assessment and treatment provided by mental health services are crucial for mitigating the effect of urbanization on Internet addiction risk. Cities should be designed to provide adequate space for physical and interactive activities. To promote outdoor activities, air pollution, traffic congestion, and crime should be controlled. Prospective face-to-face studies involving analysis of data on pollution, traffic, and Internet addiction could provide evidence to elucidate the urbanization- Internet addiction association.
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Digital technologies are powerful tools for connecting individuals to each other and the world. Although concerns about the effects of mass media in varying forms (e.g., television and movies) on violence have been raised for decades,... more
Digital technologies are powerful tools for connecting individuals to each other and the world. Although concerns about the effects of mass media in varying forms (e.g., television and movies) on violence have been raised for decades, causal relationships between long-standing and more recently developed technologies and mental health considerations often remain obscure. Furthermore, variations and use of digital technologies and the Internet have expanded rapidly in recent years in Asia areas, as in Western society, and are increasingly impacting peoples’ lives. This review covers research on potential positive and negative effects of digital technologies, with an emphasis on Asian children and adolescents. The authors focus on problem Internet use or addiction, risky behaviors, and mental health problems related to excessive use of digital technologies, which appear to have a sizeable impact on children and adolescents, particularly in Asia. They also review how digital technologi...
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Objective: The aims of this study were to examine the associations between four types of bullying involvement and three body weight statuses (underweight, overweight and obesity) in adolescents, as well as the moderating effects of... more
Objective: The aims of this study were to examine the associations between four types of bullying involvement and three body weight statuses (underweight, overweight and obesity) in adolescents, as well as the moderating effects of socio-demographic characteristics, family factors, school factors, peer affinity, and self-esteem on the associations between bullying involvement and body weight statuses. Methods: Experiences of bullying involvement in 5,621 adolescents were obtained using the self-reported Chinese version of the School Bullying Experience Questionnaire (C-SBEQ). We determined underweight, overweight and obesity with the International Obesity Task Force (IOTF) cutoff references for body mass index (BMI). We examined the associations between four types of bullying involvement and body weight status and the moderating effects of socio-demographic characteristics, family factors, school factors, peer affinity, and self-esteem with logistic regression analysis models, using...
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Aims: The aim of the present study was to gain insight into the prevalence of depression and its association with self‐esteem, family, peer and school factors in a large‐scale representative Taiwanese adolescent population.Methods: A... more
Aims: The aim of the present study was to gain insight into the prevalence of depression and its association with self‐esteem, family, peer and school factors in a large‐scale representative Taiwanese adolescent population.Methods: A total of 12 210 adolescent students were recruited into the present study. Subjects with a score >28 on the Center for Epidemiological Studies' Depression Scale were defined as having significant depression; the Rosenberg Self‐Esteem Scale, Adolescent Family and Social Life Questionnaire and Family C‐APGAR Index were applied to assess subjects' self‐esteem, family, peer and school factors. The association between depression and correlates were examined on t‐test and χ2 test. The significant factors were further included in logistic regression analysis.Results: Among 9586 participants (response rate: 86.3%), the prevalence of depression was 12.3%. The risk factors associated with depression in univariate analysis included female gender, old...
Research Interests: Psychology, Cognitive Science, Psychiatry, Adolescent, Medicine, and 15 moreLogistic Regression, Humans, Female, Achievement, Male, Depressive Disorder, Risk factors, Clinical Sciences, Family Relations, Peer group, Health surveys, Risk Factors, Cross Sectional Studies, Neurosciences, and Personality Inventory
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BackgroundThe eleventh revision of the International Classification of Diseases (ICD-11) defines the three key diagnostic criteria for gaming disorder (GD). These are loss of control over gaming, gaming as a priority over daily... more
BackgroundThe eleventh revision of the International Classification of Diseases (ICD-11) defines the three key diagnostic criteria for gaming disorder (GD). These are loss of control over gaming, gaming as a priority over daily activities, and impaired functioning due to gaming. While this definition has implications for the prevention and treatment of GD, there is significant heterogeneity in the symptoms and etiology of GD among individuals, which results in different treatment needs. Cognitive control, emotional regulation, and reward sensitivity are three critical dimensions in the etiology model for GD. Aspects such as gender, comorbidity, motivation for gaming, stage or severity of GD, and risk factors all contribute to the heterogeneity of etiology among individuals with the disorder.MethodOn the basis of clinical symptoms and comorbidity characteristics among approximately 400 patients with gaming disorder, the present paper proposes a clinical typology of patients with GD b...
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References 1. Fuse-Nagase Y, Kajitani K, Hirai N, Namura I, Sato T. The survey of undergraduate students who require temporary leave from school, drop out of school, or repeat the same class–results of the academic year 2017–2018. Jpn. J.... more
References 1. Fuse-Nagase Y, Kajitani K, Hirai N, Namura I, Sato T. The survey of undergraduate students who require temporary leave from school, drop out of school, or repeat the same class–results of the academic year 2017–2018. Jpn. J. Coll. Mental Health. 2021; 4: 47–59 (in Japanese). 2. Marutani T, Yasumi K, Takayama J, Saito K, Sato T. The survey of graduate students who require temporary leave from school, drop out of school, or repeat the same class–results of the academic year 2017–2018. Jpn. J. Coll. Mental Health. 2021; 4: 60–70 (in Japanese). 3. Tanaka T, Okamoto S. Increase in suicide following an initial decline during the COVID-19 pandemic in Japan. Nat. Hum. Behav. 2121; 5: 229–238. 4. Suicide Countermeasures Promotion Office, the Ministry of Health, Labor and Welfare and Life Safety Bureau Life Safety Planning Division, National Police Agency Suicide situation in 2020. [Cited 01 July 2021.] Available from URL: https://www.mhlw.go.jp/content/ R2kakutei-01.pdf (in Japanese). 5. Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F. Investigating mental health of US College students during the COVID-19 pandemic: Cross-sectional survey study. J. Med. Internet Res. 2020; 22: e22817. 6. Batra K, Sharma M, Batra R, Singh TP, Schvaneveldt N. Assessing the psychological impact of COVID-19 among college students: An evidence of 15 countries. Healthcare (Basel) 2021; 9: 222. 7. Kohls E, Baldofski S, Moeller R, Klemm SL, Rummel-Kluge C. Mental health, social and emotional well-being, and perceived burdens of university students during COVID-19 pandemic lockdown in Germany. Front. Psych. 2021; 12. https://doi.org/10.3389/fpsyt.2021.643957 8. Wathelet M, Duhem S, Vaiva G et al. Factors associated with mental health disorders among university students in France confined during the COVID-19 pandemic. JAMA Netw. Open 2020; 3: e2025591. 9. Kassir G, El Hayek S, Zalzale H, Orsolini L, Bizri M. Psychological distress experienced by self-quarantined undergraduate university students in Lebanon during the COVID-19 outbreak. Int. J. Psychiatry Clin. Pract. 2021; 25: 172–179. 10. L opez Steinmetz LC, Leyes CA, Dutto Florio MA, Fong SB, L opez Steinmetz RL, Godoy JC. Mental health impacts in Argentinean college students during COVID-19 quarantine. Front. Psych. 2021; 12. https:// doi.org/10.3389/fpsyt.2021.557880
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Research Interests: Psychology, Clinical Psychology, Addiction, Psychometrics, Mental Health, and 15 moreAdolescent, Hong Kong, Medicine, Humans, Female, Confirmatory factor analysis, Male, Abnormal Child Psychology, Prevalence, Questionnaires, Reproducibility of Results, Asian Continental Ancestry Group, Adolescent Behavior, Internet, and Psychiatric Status Rating Scales
The alteration in circadian typology and insomnia were prevalent among both Individuals with IGD and those with attention deficit hyperactivity disorder (ADHD), the most comorbid psychiatric disorder of IGD. This study aimed to evaluate... more
The alteration in circadian typology and insomnia were prevalent among both Individuals with IGD and those with attention deficit hyperactivity disorder (ADHD), the most comorbid psychiatric disorder of IGD. This study aimed to evaluate the relationships between circadian typologies, insomnia, and internet gaming disorder (IGD) and how ADHD affects this relationship. We recruited three groups of 69 young adults: an IGD group, a control group comprising age- and sex-matched nongamers, and a group of gamers without IGD through diagnostic interviews. The participants with IGD exhibited lower composite scale of morningness (CSM) scores and thus a higher eveningness preference In addition, the score of Pittsburgh insomnia rating scale—20-item version (PIRS_20) was significantly higher among those with IGD. The participants with IGD and ADHD exhibited lower CSM scores but higher PRIS_20 scores than the participants with IGD but without ADHD. The present findings indicate that participants...
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Background: The Iowa Gambling Task (IGT) was established to evaluate emotion-based decision-making ability under uncertain circumstances in clinical populations, including schizophrenia (Sz). However, there remains a lack of stable... more
Background: The Iowa Gambling Task (IGT) was established to evaluate emotion-based decision-making ability under uncertain circumstances in clinical populations, including schizophrenia (Sz). However, there remains a lack of stable behavioral measures regarding discrimination for decision-making performance in IGT between schizophrenic cases and healthy participants. None of the Sz-IGT studies has specifically verified the prominent deck B (PDB) phenomenon gradually revealed in other populations. Here, we provided a global review and empirical study to verify these Sz-IGT issues.Methods: Seeking reliable and valid behavioral measures, we reviewed 38 studies using IGT to investigate decision-making behavior in Sz groups. The IGT, the Wisconsin Card Sorting Test (WCST), and clinical symptoms evaluations were administered to 61 schizophrenia or schizoaffective cases diagnosed by psychiatrists and 62 demographically matched healthy participants.Results: There were no valid behavioral me...
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Zolpidem and zopiclone are the two most commonly prescribed Z-drugs approved to treat insomnia. To examine the demographic and clinical correlates of dependence and beliefs about hypnotic use among long-term zolpidem and zopiclone users... more
Zolpidem and zopiclone are the two most commonly prescribed Z-drugs approved to treat insomnia. To examine the demographic and clinical correlates of dependence and beliefs about hypnotic use among long-term zolpidem and zopiclone users in psychiatric treatment for insomnia. A total of 392 psychiatric outpatients who received zolpidem or zopiclone treatment for at least 3 months for insomnia were studied. Participants' severity of hypnotic dependence and beliefs about the use of hypnotics to treat sleep problems were assessed. The correlation of dependence and beliefs about zolpidem and zopiclone treatment with demographic characteristics, hypnotic-using behaviors, co-use of addictive substances, and depressive symptoms were analyzed using multiple regression analysis models. Zolpidem users reported more severe dependence and a lower level of necessity regarding the use of hypnotics than zopiclone users did. High equivalent doses of hypnotics and long duration of use were significantly associated with severe dependence and a low level of necessity. Severe depressive symptoms were signiciantly associated with severe dependence, a low level of necessity, and a low level of concern. Educational level was also associated with the levels of concern and necessity. Conclusions/Importance: There were differences in the level of dependence and belief about hypnotic use between zolpidem and zopiclone users. The correlates of dependence and belief identified in this study can serve as the basis for prevention and intervention programs.
Research Interests: Psychology, Medicine, Hospitals, Insomnia, Prescription drug misuse, and 15 moreHumans, Taiwan, Female, Male, Regression Analysis, Depressive Disorder, Hypnotic, Prescription drugs, Middle Aged, Outpatients, Adult, Pyridines, Severity of Illness Index, Psychiatric Status Rating Scales, and Sleep initiation and maintenance disorders
Research has revealed that a lack of insight is associated with poorer clinical outcomes in schizophrenia; however, the predictive value of insight on adverse clinical outcomes among bipolar patients is quite understudied. The aim of this... more
Research has revealed that a lack of insight is associated with poorer clinical outcomes in schizophrenia; however, the predictive value of insight on adverse clinical outcomes among bipolar patients is quite understudied. The aim of this prospective study was to examine the impact of insight on adverse clinical outcomes among the patients with bipolar I disorder over a 2-year period. Sixty- five remitted bipolar I disorder patients received follow-up assessments at 3, 6, 9, 12, 18, and 24 months to detect the adverse clinical outcomes defined by the incidence of bipolar-related psychiatric hospitalization, emergency room visits, violent or suicidal behavior. The Schedule of Assessment of Insight was used to provide a baseline insight score. Cox regression analysis was used to examine the predictive value of insight on the adverse clinical outcomes. Impaired insight into treatment and a greater number of previous hospitalizations significantly increased the risk of adverse clinical ...
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Young adults with Internet gaming disorder (IGD) usually postpone the tasks of their daily lives to engage in Internet gaming. This study evaluates the association between procrastination and IGD and the association between the negative... more
Young adults with Internet gaming disorder (IGD) usually postpone the tasks of their daily lives to engage in Internet gaming. This study evaluates the association between procrastination and IGD and the association between the negative consequences of IGD and procrastination. We recruited 87 individuals with IGD and 87 controls without a history of IGD. All participants underwent a diagnostic interview based on the DSM-5 IGD criteria to assess the clinical global score. They also completed questionnaires regarding IGD, procrastination, impulsivity, depression, and hostility. Young adults with IGD had higher levels of procrastination. Procrastination was positively associated with depression, hostility, and impulsivity. After controlling for depression, hostility, and impulsivity, procrastination was still found to be associated with IGD. Further, procrastination was positively associated with the clinical global impressions score among young adults with IGD. Procrastination is asso...
Research Interests: Psychology, Clinical Psychology, Psychiatry, Video Games, Medicine, and 15 moreProcrastination, Impulsivity, Humans, Female, Male, Young Adult, Adult, Hostility, Cross Sectional Studies, Internet, Impulsive behavior, Severity of Illness Index, Surveys and Questionnaires, Psychology and Cognitive Sciences, and Medical and Health Sciences
Objective: Cognitive and somatic symptoms were vital factors in developing personalized treatment of depressive disorder. The study aimed to evaluate the following: (1) the cognitive and somatic symptoms of premenstrual dysphoric disorder... more
Objective: Cognitive and somatic symptoms were vital factors in developing personalized treatment of depressive disorder. The study aimed to evaluate the following: (1) the cognitive and somatic symptoms of premenstrual dysphoric disorder (PMDD) in the early luteal (EL) and later luteal (LL) phase; and (2) their association with depression and functional impairment of PMDD. Methods: We prospectively evaluated executive function, emotion regulation, cognitive and somatic symptoms, and depression in the EL and LL phases in women with PMDD. Sixty-three women with PMDD and 53 healthy controls completed Simon’s task and questionnaire to assess emotion regulation, inattention, fatigue, insomnia, and depression. Results: Women with PMDD had a poor performance in Simon’s task during the LL phase. They were less likely to exercise cognitive reappraisal during EL and LL phases. Their cognitive reappraisal positively correlated with executive function and negatively associated with depression....
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Internet addiction is a newly emerged disorder having great globalized psychosocial impact. Depressive disorder is one of the most reported comorbidities. To understand the comorbidity of Internet addiction and depressive disorder can... more
Internet addiction is a newly emerged disorder having great globalized psychosocial impact. Depressive disorder is one of the most reported comorbidities. To understand the comorbidity of Internet addiction and depressive disorder can shed light on the mechanism of Internet addiction. In this overview, we review the association between Internet addiction and depression. The cross-section study has shown a solid association between Internet addiction and depression. The prospective study has also demonstrated both temporal directions of a causal relationship between the two disorders. Covariance analysis has demonstrated a complex interaction between the two disorders. Here, we propose four candidate models-the escape, the negative consequences, the bi-direction, and the shared mechanisms model-as working candidate models in our temporary attempt to explain the association between those two disorders. While awaiting the validation for those models, we also suggest future directions f...
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Abstract Craving is a core feature of heroin use disorder. Craving for heroin is a conscious cognitive process. Recently, implicit (i.e., an implicit attitude toward heroin use) cognitive processes have been thought to be precursors of... more
Abstract Craving is a core feature of heroin use disorder. Craving for heroin is a conscious cognitive process. Recently, implicit (i.e., an implicit attitude toward heroin use) cognitive processes have been thought to be precursors of cravings. This study aimed to explore the associations of craving and implicit attitude toward heroin use with the level of heroin use disorder and adherence to methadone maintenance treatment (MMT). This study recruited 213 intravenous heroin users (196 males and 17 females) from MMT clinics of two hospitals. The mean age of participants was 42.3 years. They provided details of their severity of heroin use disorder and craving for heroin via questionnaires and also completed a computerized test to assess implicit attitude toward heroin use. The relationships between implicit attitude, craving, age, heroin use disorder, and MMT adherence were examined using path analysis. Craving was positively related to heroin use disorder (beta = 0.4). Implicit attitude directly and indirectly positively contributed to heroin use disorder (betas: 0.1 and 0.3). Craving was positively related to MMT adherence (beta: 0.2), whereas implicit attitude had an indirect effect on MMT adherence (beta: 0.03). Age was negatively associated with craving but was not associated with implicit attitude toward heroin. Methadone dosage was negatively associated with craving. Craving is significantly associated with the levels of heroin use disorder and MMT adherence. Meanwhile, craving mediates the relationship between implicit attitude and heroin use disorder, as well as MMT adherence. Implicit attitude also contributes to the level of heroin use disorder directly. For reducing craving, adequate dosage may be necessary.
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Research Interests: Psychology, Adolescent, Medicine, Logistic Regression, Insomnia, and 15 moreBiological Sciences, Humans, Taiwan, Female, Male, Sleep, Depressive Disorder, Prevalence, International Classification of Diseases, Questionnaires, Cross Sectional Studies, Severity of Illness Index, Psychology and Cognitive Sciences, Medical and Health Sciences, and Sleep initiation and maintenance disorders
Individuals with adult attention deficit/hyperactivity disorder (ADHD) have a deficit in their cognitive control. The aim of this study was to reveal the brain correlates of the deficits in response inhibition or error processing in adult... more
Individuals with adult attention deficit/hyperactivity disorder (ADHD) have a deficit in their cognitive control. The aim of this study was to reveal the brain correlates of the deficits in response inhibition or error processing in adult ADHD. A total of 29 adults with ADHD and 25 control individuals were recruited. They completed an event-related-design Go/No-go task under functional magnetic resonance imaging scanning. Both the ADHD group and the control group exhibited activation of the frontostriatal network when processing response inhibition. They also exhibited activation of the frontoinsula cortex and anterior cingulate in error processing. Adults with ADHD have a lower brain activation of error processing over the right inferior frontal lobe adjacent to the insula than control individuals. The altered frontoinsula cortex activation may represent the mechanism of error processing deficit among adults with ADHD.
Research Interests: Audiology, Magnetic Resonance Imaging, Medicine, Brain Mapping, Brain, and 13 moreHumans, Insula, Functional Magnetic Resonance Imaging, Female, Male, Young Adult, Adult, Frontal Lobe, Anterior cingulate cortex, Neuropsychological Tests, Attention deficit disorder with hyperactivity, Attention deficit hyperactivity disorder, and Medical and Health Sciences
Research Interests:
Research Interests: Information Systems, Psychology, Cognitive Science, Computer Science, Addiction, and 15 moreSocial Anxiety, Depression, Medicine, Anxiety, Humans, Female, Male, Psychological Intervention, Interpersonal Relations, Psychological Tests, Sex Factors, ANXIETY, Internet, Psychiatric Status Rating Scales, and Phobic disorders
Aim This study evaluated the consistency between the International Classification of Diseases, 11th Edition (ICD-11) for gaming disorder (ICD-11-GD) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria... more
Aim This study evaluated the consistency between the International Classification of Diseases, 11th Edition (ICD-11) for gaming disorder (ICD-11-GD) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for internet gaming disorder (DSM-5-IGD). Moreover, the functional impairment of participants and their insight of their GD were evaluated. Methods We recruited 60 participants with GD, 45 participants who engaged in hazardous gaming (HG), and 120 controls based on a diagnostic interview. Their operationalization of functional impairment and stage of change were evaluated by interviews and questionnaires, including the Brief Gaming Negative Consequence Scale (BGNCS). Results We observed satisfactory consistency (kappa value = 0.80) with a diagnostic accuracy of 91.5% between the ICD-11-GD and DSM-5-IGD criteria. Furthermore, 16 participants with IGD in DSM-5 were determined to have HG based on the ICD-11 criteria. Participants of GD group experienc...