Search

Jia-Yin Yeh,1 Tsai-Yu Hou,1 Wei-Ting Tseng,1 Vincent Chin-Hung Chen,2,3 Yao-Hsu Yang,4,5 Ting-Yu Kuo,4 Jun-Cheng Weng,6,7 Charles Tzu-Chi Lee,8 Yi-Lung Chen,9,10 Min-Jing Lee2,3 1Department of Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung, Taiwan; 2Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 3School of Medicine, Chang Gung University, Taoyuan, Taiwan; 4Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 5Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 6Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; 7Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; 8Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan; 9Department of Healthcare Administration, Asia University, Taichung, Taiwan; 10Department of Psychology, Asia University, Taichung, TaiwanCorrespondence: Min-Jing LeeDepartment of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan, No. 6, W. Sec., Jiapu Road, Puzi City, Chiayi County 613, TaiwanTel +886-5-3621000 ext2303Fax +886-5-3622188Email 8035c@cgmh.org.twPurpose: Literature suggests that attention deficit hyperactivity disorder (ADHD) is associated with a high risk of unintentional injury. However, few studies have focused on whether risk of burn injury is relatively high among patients with ADHD. The aim of this study was to investigate whether ADHD affects the risk of burn injury.Materials and Methods: Individuals aged < 18 years with a current diagnosis of ADHD (N = 52,705) and age-, sex-, and other comorbidity-matched controls were selected from Taiwan’s National Health Insurance Research Database for the period of January 1996 to December 2013. Burn injury was identified in both groups, and risk was evaluated using Cox proportional hazards models. We also explored the effects of age and sex on the association.Results: We determined that patients with ADHD had an increased probability of burn injury compared with the control group (ADHD vs controls, 4.6% vs 2.6%; adjusted hazard ratio [aHR] = 1.78; 95% confidence interval [CI] = 1.66– 1.90). The effect of ADHD on burn injury was more prominent among those aged < 6 years (aHR = 1.96; 95% CI = 1.75– 2.20) relative to those aged ≥ 6 years (aHR = 1.69; 95% CI = 1.56– 1.83). Both sexes had similar risk profiles.Conclusion: The study findings contribute to the increasing body of evidence that ADHD is associated with proneness to burn injury, particularly in children aged < 6 years.Keywords: ADHD, burn injury, propensity-matched, cohort

Pei-Lun Chung,1 Chien-Wei Huang,2 Min-Jing Lee,1,3 Yao-Hsu Yang,4,5 Ko-Jung Chen,4 Mong-Liang Lu,6 Jun-Cheng Weng,1,7 Vincent Chin-Hung Chen1,3 1Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 2Division of Nephrology, Department of Medicine, School of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, Taiwan; 3School of Medicine, Chang Gung University, Taoyuan, Taiwan; 4Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 5Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; 6Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 7Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, TaiwanCorrespondence: Vincent Chin-Hung ChenDepartment of Psychiatry, Chang Gung Memorial Hospital, Chiayi, TaiwanEmail cch1966@gmail.comPurpose: This study explored and compared the effects of depression and antidepressants on sexual dysfunction in men with diabetes mellitus (DM).Patients and Methods: Patients older than 18 years who had been newly diagnosed with DM (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 250) between 1999 and 2010 were identified from Taiwan’s National Health Insurance Research Database and were followed up until 2013. Patients with preexisting depression or sexual dysfunction were excluded. A total of 636,210 patients with DM were enrolled. These patients were divided into two groups: DM with comorbid depression and a matched cohort without depression. The groups were followed up until the end of 2010 for the first diagnosis of sexual dysfunction (ICD-9-CM codes 302.70, 302.71, 302.72, 302.74, 302.75, 302.76, 302.79, 607.84, and V417). A Cox proportional hazard model and a Cox regression model with time-dependent covariates were applied.Results: Patients with DM and depression had a higher risk of sexual dysfunction than those with DM without depression (hazard ratio [HR] =  1.44; 95% confidence interval [CI], 1.33– 1.55). The risk of sexual dysfunction was lower in the subgroup who used antidepressants (per 28 cumulative defined daily doses [cDDDs]), HR = 0.96; 95% CI, 0.94– 0.97). A significantly lower incidence of sexual dysfunction was also associated with the use of selective serotonin reuptake inhibitors (SSRIs, per 28 cDDD). The adjusted HR was 0.95 (95% CI, 0.93– 0.97). Subgroup analysis indicated that SSRI use was significantly associated with an amelioration of erectile dysfunction (per 28 cDDD), with an HR of 0.95 (95% CI, 0.92– 0.97).Conclusion: Male patients with DM and depression are at increased risk of sexual dysfunction. Antidepressant use had a small inverse association with the risk of sexual dysfunction in men with DM and depression. Antidepressants, in particular SSRIs, did not increase the risk of sexual dysfunction in this population.Keywords: selective serotonin reuptake inhibitor, SSRI, sexual functioning, diabetes mellitus, depression

Hong-Ming Chen,1,2,* Vincent Chin-Hung Chen,1,2,* Han-Pin Hsiao,1 Yi-Ping Weng,1 Ya-Ting Hsu,1 Jun-Cheng Weng,1,3 Jian-An Su,1,2,4Yi-Lung Chen5,6 1Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; 2School of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; 4Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan; 5Department of Healthcare Administration, Asia University, Taichung, Taiwan; 6Department of Psychology, Asia University, Taichung, Taiwan*These authors contributed equally to this workCorrespondence: Yi-Lung ChenDepartment of Healthcare Administration, Asia University, 500, Lioufeng Road, Wufeng, Taichung 413, TaiwanTel +886 4 2332 3456 Ext 20106Fax +886 4 2331 6699Email elong@asia.edu.twJian-An SuDepartment of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, No. 6 West Sec., Chia-Pu Road, Puzi City, Chiayi 613, TaiwanTel +886 5 362 1000 Ext 2855Fax +886 5 362 3002Email jian.7715@gmail.comPurpose: Although post-traumatic growth (PTG) and post-traumatic stress symptoms (PTSS) might develop and coexist after a major trauma, few studies have simultaneously examined them in patients with breast cancer. This study investigated the correlation between PTG and PTSS and their differential correlates in patients with breast cancer.Patients and methods: Overall, 145 patients with breast cancer were recruited. PTG and PTSS were assessed using the PTG inventory and the Chinese version of startle, physiological arousal, anger, and numbness, respectively. We investigated the effects of demographics, chemotherapy, depression, family support, alexithymia, and anxiety symptoms on PTG and PTSS. Multivariate linear regression analyses were performed to select the independent correlates of PTSS and PTG.Result: An association was observed between PTG and PTSS (r = 0.21). Based on multiple regression models, the common correlate of PTG (β = 0.271) and PTSS (β = 0.212) was anxiety symptoms. Differential independent correlates were years of education (β = 0.272), receiving chemotherapy (β = 0.248), and family support (β = 0.259) for PTG, and chronic pain (β = 0.316) and poor cognition (β = −0.350) for PTSS.Conclusion: Differential correlates were observed for PTG and PTSS in patients with breast cancer. Possible mechanisms and relationships between PTG and PTSS were discussed.Keywords: post-traumatic stress symptoms, post-traumatic growth, breast cancer, chemotherapy, family support

Mei-Hing Ng,1,2 Vincent Chin-Hung Chen,3,4 Hua Ting,1,5 Tsang-Yaw Lin,2 Sheng-Huang Chang,2 Michael Gossop61Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; 2Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County, Taiwan; 3Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi County, Taiwan; 4Department of Psychiatry, School of Medicine, Chang Gung University, Taoyuan City, Taiwan; 5Department of Physical Medicine and Rehabilitation, Chung-Shan Medical, University Hospital, Chung-Shan Medical University, Taichung, Taiwan; 6National Addiction Center, Institute of Psychiatry, King’s College London, London, UKPurpose: Few empirical studies have investigated hematological parameters among people with a heroin use disorder. This study explores the prevalence of macrocytosis and associated factors among patients with heroin use disorder who were entering methadone maintenance treatment (MMT) in Taiwan.Patients and methods: In this cross-sectional study, hematological parameters were measured and the prevalence of macrocytosis was assessed in a sample of 958 patients with a heroin use disorder entering the MMT program at Tsaotun Psychiatric Center in Taiwan. The demographic characteristics, heroin-related issues, other substance use history, and other clinical variables were analyzed. Univariate analysis was used to assess the association of all variables. Multivariable logistic regression was used to identify the relationship between the significant factors and macrocytosis.Results: The study found that nearly one-fifth (19.5%) of the participants had macrocytosis. Older age, longer duration of heroin use, and more days of alcohol use within the previous month were associated with macrocytosis.Conclusion: We found that concurrent use of alcohol was an important factor related to macrocytosis among people with a heroin use disorder. The prevalence of macrocytosis indicated that alcohol use is common among this population. It is suggested that policies and practices regarding alcohol use should be addressed within methadone maintenance programs.Keywords: addiction, opioid dependence, substitution treatment, megalocytes