台灣精神醫學/Taiwanese Journal of Psychiatry
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台灣精神醫學會,正常發行
選擇卷期
- 期刊
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Background: The term ＂addiction＂ encompasses both substance dependence and behavioral addiction and is associated with major societal problems. Measures to combat addiction are currently insufficient in Japan, and further research on addiction is necessary. Methods: Science Council of Japan (SCJ) has three subcommittees - the Addiction Subcommittee, Brain and Mind Subcommittee, and Neuroscience Subcommittee among others. Those three subcommittees are dealing directly or indirectly with addiction problems in Japan. Thus, all authors of this review, members of those subcommittees, collectively recommended what research activities are required in Japan for continuing effort in overcoming addiction problems in Japan. Results: We proposed the following measures. Proposal 1: Understand diversity in addiction and promote related research and education; Proposal 2: Promote personalized measures for patients with addiction disorders; Proposal 3: Foster addiction research personnel; Proposal 4: Develop new guidelines for the rehabilitation of patients with drug dependence; Proposal 5: Establish an institute specializing in addiction research and comprehensively handling information collection, research, countermeasures, treatment, and public relation related to addiction. Conclusion: The opinions of the review are based on the recommendations that were published in 2020 in Japanese by the Addiction Subcommittee, Brain and Mind Subcommittee, and Neuroscience Subcommittee of the SCJ. The authors here are sharing colleagues of Taiwanese Society of Psychiatry with these proposed research activities required to overcome addiction problems in Japan.
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Objective: In this survey, we intended to study the clinical features and possible risk factors including types of maltreatment, family factors, and psychopathology of maltreated children. Methods: We reviewed the clinical case reports of comprehensive assessment in annual projects of maltreated children placed in the children's homes between 1997 and 2016. The comprehensive assessment included history of maltreatment, family condition, psychiatric interview, physical examination, and psychological assessment. We divided maltreated children into Axis I psychiatric disorder and non-Axis I psychiatric disorder groups for comparing the difference in clinical features and risk factors. Results: Among the 377 participants, the average age was 9.1 ± 3.0 years. The majority were male (60.5%) and pupils of elementary school (69.9%). Only 22.5% of their parents still maintained as married in marital status. In Axis I psychiatric disorder group, both age (p ＜ 0.05) and full intelligence (p ＜ 0.001) were significantly lower than non-Axis I psychiatric disorder group. Besides, the study participants in the Axis I psychiatric disorder group had significantly more times of changes in placement (p ＜ 0.05) and stayed longer in a placement (p ＜ 0.05). In both groups, around 40% of all the participants were 25 percentile or less in height. The feature was not found in weight dimension. Conclusion: While the problem of psychiatric disorder adds complexity to child maltreatment issues, the promotion, protection, and restoration of mental health can be regarded as a vital concern in these vulnerable children.
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Objective: In this study, we intended to study the differences of the clinical characteristics between patients with schizophrenia with or without history of amphetamine abuse and risk factors of rehospitalization. Methods: We used medical records and reviewed electronic database to collect the two schizophrenia groups discharged from the Taoyuan Psychiatric Center from January 1, 2012, to December 31, 2015. Patients with and without amphetamine abuse were defined as case group and control group, respectively. The patients' demographic data and clinical variables were extracted and examined. Results: We identified 80 patients in the case group and 142 patients in the control group. Up to 32.5% of the case group patients still showed a positive urine amphetamine test. The univariate analysis showed that significant differences existed in gender (p ＜ 0.001), age (p ＜ 0.001), marriage (p ＜ 0.05), education (p ＜ 0.001), psychiatric comorbidity (p ＜ 0.05), family history of schizophrenia (p ＜ 0.01), family history of illicit substance use (p ＜ 0.001), history of suicide (p ＜ 0.01), history of violence (p ＜ 0.001), hospitalization days (p ＜ 0.001), and rehospitalization rate (p ＜ 0.05). The result of the logistic regression showed that the number of previous admissions was a positive predictor of rehospitalization and that with family history of schizophrenia was a negative predictor of rehospitalization. The Cox proportional hazards regression model analysis showed that the number of previous admissions was still a positive predictive factor for the rehospitalization. Conclusion: In this study, the characteristics of two study patient groups were different. Patients with schizophrenia and with a history of amphetamine abuse had a tendency of amphetamine abuse and a higher rate of rehospitalization. Further treatment for amphetamine abstinence in the community for this population is warranted to strengthen the study results.
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Background: Evidence suggested that borderline personality disorder (BPD) is related to the increased likelihood of risky sexual behaviors and that BPD is one of the most important risk factors of teenage pregnancy among adolescents. But whether adolescent BPD is independently associated with teenage pregnancy remains uncertain. Methods: We enrolled 809 adolescent girls with BPD and 8,090 without BPD between 2001 and 2009 and followed them up to the end of 2011 for the identifying any teenage pregnancy and repeated teenage pregnancy. Comorbidities of depressive disorder, bipolar disorder, as well as alcohol and substance use disorder were assessed. Psychotropic medications including antidepressants, mood stabilizers, and second-generation (atypical) antipsychotics were also identified. Results: Using Cox regression analyses with an adjustment of demographic characteristics, psychiatric comorbidities, and psychotropic medications showed that adolescents with BPD had significant increased risks of any teenage pregnancy (hazard ratio [HR] = 14.53, 95% confidence interval [CI] = 9.89-21.37, p ＜ 0.05), and repeated teenage pregnancy (HR = 30.43, 95% CI = 17.32-53.45, p ＜ 0.05) during the follow-up compared with non-BPD controls. Psychotropic medications were not significantly associated with the risks of any teenage pregnancy and repeated teenage pregnancy. Discussion: Adolescent BPD was an independent risk factor of any teenage pregnancy and repeated teenage pregnancy, regardless of the comorbidities of alcohol and substance use disorders. Whether the prompt intervention toward adolescent BPD may reduce the risks of any teenage pregnancy and repeated teenage pregnancy would need further investigation.
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Objective: The coronavirus disease 2019 (COVID-19) pandemic may have psychological impacts on patients with mental disorders and their caregivers. In this study, we intended to explore whether female, previous trauma, lack of social support, additional life stress, and nonpsychotic symptoms, can predict to develop probable posttraumatic stress disorder (PTSD) during COVID-19 pandemic among outpatients with psychiatric disorders and their caregivers. Methods: In this cross-sectional study, we recruited outpatients with psychiatric disorders and their caregivers and collected their sociodemographic variables and levels of PTSD-related symptoms with a copy of self-reported questionnaire. Potential predictors associated with the levels of probable PTSD were identified using simple linear regression analyses. We used logistical regression analysis and multiple linear regression analyses to identify those variables for the independent predictors. Due to the nonnormality of distribution, we used simple and logistic linear regression analyses with 1,000 bootstrap samples to verify the results. Results: We analyzed the study data of 145 participants. Logistic regression analysis showed that activity (odds ratio [OR] [95% confidence interval (CI)] = 1.409 [0.178-3.711], p ＜ 0.01) and panic symptoms (OR [95% CI] = 20.778 [18.509-23.638], p ＜ 0.01) were significant predictors of developing probable PTSD. Multiple regression analyses showed that individuals with higher education (β = 0.210, p ＜ 0.05) and stressor (β = 0.233, p ＜ 0.05) were significantly associated with higher level of probable PTSD symptoms in the nonprobable PTSD group. Individuals with more chronic physical illness (β = 0.512, p ＜ 0.05) were associated with significantly higher level of probable PTSD symptoms. Conclusion: In the current study, we identified that activity, panic symptoms, high education, stressors, and more chronic physical illness were predictors either in developing probable PTSD or severe probable PTSD symptoms during the COVID-19 pandemic. Further studies are warranted to extend the application and generalizability of our study results.