Background: Increasing studies have supported the relationship between pain disorders and treatment-resistant depression (TRD) or chronic pain disorders may possibly impact the clinical characteristics of major depressive disorder (MDD). Thus, this linkage has been seen as a potential clinical marker to predict diagnostic conversion to bipolar disorder (BD) among patients with MDD. Methods: With the Taiwan National Health Insurance Research Database, we enrolled 4,760 adolescent and young adult patients with TRD, 19,040 counterparts with antidepressant-responsive depression, and 19,040 age-/sex-/residence-/family income-matched controls. Then, we followed up on their conversion from MDD to BD from enrollment to the end of 2011. Results: The incidence of diagnostic progression from MDD to BD was significantly higher in the TRD group than the non-TRD group (30.5% versus 10.6%, p < 0.001). Logistic regression analysis with adjustment of demographic characteristics showed that the TRD group had the highest risks of previous migraine, tension headache, fibromyalgia, peripheral neuropathy, dysmenorrhea, and irritable bowel syndrome, followed by the non-TRD group, and then the control group (p < 0.05). In further analysis of those data stratified by diagnostic progression to BD, we found no consistent results among different subgroups. Conclusion: Clinicians should be aware of the higher risk of developing TRD in depressive patients with comorbid pain disorders such as migraine, tension headache, fibromyalgia, peripheral neuropathy, dysmenorrhea, and irritable bowel syndrome. Besides, we found no consistent results in predicting diagnostic conversion from MDD to BD when the rôle of these pain disorders was evaluated.
{"title":"Associations between antidepressant resistance, risks of previous pain disorders, and risks of diagnostic conversion to bipolar disorder among adolescent and young adult patients with major depressive disorder","authors":"Ping Wu, S. Tsai, Tzeng-Ji Chen, Mu-Hong Chen","doi":"10.4103/TPSY.TPSY_14_23","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_14_23","url":null,"abstract":"Background: Increasing studies have supported the relationship between pain disorders and treatment-resistant depression (TRD) or chronic pain disorders may possibly impact the clinical characteristics of major depressive disorder (MDD). Thus, this linkage has been seen as a potential clinical marker to predict diagnostic conversion to bipolar disorder (BD) among patients with MDD. Methods: With the Taiwan National Health Insurance Research Database, we enrolled 4,760 adolescent and young adult patients with TRD, 19,040 counterparts with antidepressant-responsive depression, and 19,040 age-/sex-/residence-/family income-matched controls. Then, we followed up on their conversion from MDD to BD from enrollment to the end of 2011. Results: The incidence of diagnostic progression from MDD to BD was significantly higher in the TRD group than the non-TRD group (30.5% versus 10.6%, p < 0.001). Logistic regression analysis with adjustment of demographic characteristics showed that the TRD group had the highest risks of previous migraine, tension headache, fibromyalgia, peripheral neuropathy, dysmenorrhea, and irritable bowel syndrome, followed by the non-TRD group, and then the control group (p < 0.05). In further analysis of those data stratified by diagnostic progression to BD, we found no consistent results among different subgroups. Conclusion: Clinicians should be aware of the higher risk of developing TRD in depressive patients with comorbid pain disorders such as migraine, tension headache, fibromyalgia, peripheral neuropathy, dysmenorrhea, and irritable bowel syndrome. Besides, we found no consistent results in predicting diagnostic conversion from MDD to BD when the rôle of these pain disorders was evaluated.","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82042008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Freudian three elements in psychoanalysis needs the fourth element reticula","authors":"Z. Cai","doi":"10.4103/tpsy.tpsy_17_23","DOIUrl":"https://doi.org/10.4103/tpsy.tpsy_17_23","url":null,"abstract":"","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76372955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bupropion-associated aphthous ulcer in a female patient with bipolar depression","authors":"Pei Lin, Chun Lin, Ming‐Chyi Huang","doi":"10.4103/TPSY.TPSY_15_23","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_15_23","url":null,"abstract":"","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91167559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mental health literacy in Kashmir from conflict to post-abrogation of article 370","authors":"D. Dar, F. Paul, Arif Ali","doi":"10.4103/TPSY.TPSY_12_23","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_12_23","url":null,"abstract":"","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88940970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: I studied psychiatry in France from 1971 to 1974 as a French government-scholarship student. I became familiar with a history of French psychiatry, the development of chlorpromazine, new movement of community psychiatry away from hospital-centered psychiatry. What I learned in France became the background for my clinical psychiatric practice after returning to Japan. My experience in France was also useful when I later worked at the World Health Organization (WHO), where I remained involved in shaping national policies concerning mental health in Asian countries. The lessons I have learned in France are innumerable. French psychiatry has made a monumental contributions to the world psychiatry. But these facts are not well-known to Asian countries. Methods: Based on my experiences, I would like to introduce several achievements made by French psychiatry. Results: During my studying psychiatry in France, 1971-1974, I learned France being one of birthplaces of psychiatry, witnessed the birth of the World Psychiatric Association (WPA), heard of discoveries of psychotropic drugs, experienced the academic activities at l'Hôpital Sainte Anne, as well as exposed myself to a community mental health center and deinstitutionalization to learn a different way in taking care chronic patients with schizophrenia. Conclusion: My valuable studying experiences in France have had huge influences in my later psychiatric career, such as helping the development of mental health policy in countries of the Western Pacific Region of WHO, doing the research on the use of psychotropic drugs in Asia (REAP), involving in the WPA, and founding the Asian Federation of Psychiatric Associations.
{"title":"What i have learned from French psychiatry","authors":"N. Shinfuku","doi":"10.4103/TPSY.TPSY_13_23","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_13_23","url":null,"abstract":"Background: I studied psychiatry in France from 1971 to 1974 as a French government-scholarship student. I became familiar with a history of French psychiatry, the development of chlorpromazine, new movement of community psychiatry away from hospital-centered psychiatry. What I learned in France became the background for my clinical psychiatric practice after returning to Japan. My experience in France was also useful when I later worked at the World Health Organization (WHO), where I remained involved in shaping national policies concerning mental health in Asian countries. The lessons I have learned in France are innumerable. French psychiatry has made a monumental contributions to the world psychiatry. But these facts are not well-known to Asian countries. Methods: Based on my experiences, I would like to introduce several achievements made by French psychiatry. Results: During my studying psychiatry in France, 1971-1974, I learned France being one of birthplaces of psychiatry, witnessed the birth of the World Psychiatric Association (WPA), heard of discoveries of psychotropic drugs, experienced the academic activities at l'Hôpital Sainte Anne, as well as exposed myself to a community mental health center and deinstitutionalization to learn a different way in taking care chronic patients with schizophrenia. Conclusion: My valuable studying experiences in France have had huge influences in my later psychiatric career, such as helping the development of mental health policy in countries of the Western Pacific Region of WHO, doing the research on the use of psychotropic drugs in Asia (REAP), involving in the WPA, and founding the Asian Federation of Psychiatric Associations.","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81898015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Subjective: To reduce the nonessential healthcare expenditure and to prevent patients from adverse consequences, we intended in this study to find the prevalence and characteristics of patients with psychiatric disorder with against medical advice (AMA) discharge. Methods: We did a review of medical records for patients who hospitalized on the acute psychiatric ward at Keelung Chang Gung Memorial Hospital in Taiwan from January 1, 2013, to August 31, 2018. Results: We found that 100 patients (8.1%) were discharged AMA out of total 1,237 discharges. Compared to patients with regular discharges, those with AMA discharge were significantly different between the groups in age (p < 0.05), first time admission (p < 0.001), comorbid substance use disorders (p < 0.05), previous suicide attempts (p < 0.01), and length of hospital stay (p < 0.001). With forward stepwise logistic regression model to look for the most influential predictors for AMA discharge, we found that odds ratio (95% confidence interval) of those with suicidal attempt history (1.931 [1.265–2.949], B = 0.658, p < 0.01) and those with the first-time psychiatric admission (3.435 [2.253–5.237], B = 1.234, p < 0.001) significantly predicted those AMA patients. Conclusion: The history of suicide attempt and first-time psychiatric ward admission is the most important predictors for patients with AMA discharge. We suggest that controlled prospective studies can strengthen the study findings and better describe the impact on patients with AMA discharge.
{"title":"Who determines to discharge against medical advice from an acute psychiatric hospitalization: A clinical study","authors":"Yu-lian hsieh, Hui-Tzu Huang, Ching Chen","doi":"10.4103/TPSY.TPSY_21_23","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_21_23","url":null,"abstract":"Subjective: To reduce the nonessential healthcare expenditure and to prevent patients from adverse consequences, we intended in this study to find the prevalence and characteristics of patients with psychiatric disorder with against medical advice (AMA) discharge. Methods: We did a review of medical records for patients who hospitalized on the acute psychiatric ward at Keelung Chang Gung Memorial Hospital in Taiwan from January 1, 2013, to August 31, 2018. Results: We found that 100 patients (8.1%) were discharged AMA out of total 1,237 discharges. Compared to patients with regular discharges, those with AMA discharge were significantly different between the groups in age (p < 0.05), first time admission (p < 0.001), comorbid substance use disorders (p < 0.05), previous suicide attempts (p < 0.01), and length of hospital stay (p < 0.001). With forward stepwise logistic regression model to look for the most influential predictors for AMA discharge, we found that odds ratio (95% confidence interval) of those with suicidal attempt history (1.931 [1.265–2.949], B = 0.658, p < 0.01) and those with the first-time psychiatric admission (3.435 [2.253–5.237], B = 1.234, p < 0.001) significantly predicted those AMA patients. Conclusion: The history of suicide attempt and first-time psychiatric ward admission is the most important predictors for patients with AMA discharge. We suggest that controlled prospective studies can strengthen the study findings and better describe the impact on patients with AMA discharge.","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86332915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Addressing burnout problems among postgraduate trainee doctors: Reflexing on the article “Prevalence of Burnout and Psychiatric Illness among Postgraduate Trainee Doctors of a Tertiary Care Hospital”","authors":"Lien-Chung Wei","doi":"10.4103/TPSY.TPSY_16_23","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_16_23","url":null,"abstract":"","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75203581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Suicide attempts and self-harm in adolescent patients: A series of three cases from Taiwan","authors":"Chia-Heng Lin, Cheng-Hsien Sung","doi":"10.4103/TPSY.TPSY_19_23","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_19_23","url":null,"abstract":"","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76193904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: The association between obsessive–compulsive disorder (OCD) and sexually transmitted infections (STIs) and the effects of OCD medication on STI risk remain unknown. In the present study, we intended to study the risks of subsequent STIs after an OCD diagnosis and the effects of related OCD medications on STI risk. Methods: With the Taiwan National Health Insurance Research Database, we enrolled 15,908 adolescent and young adult patients with OCD and 159,080 age- and sex-matched individuals without OCD between 2001 and 2009, and followed them up until the end of 2011 for subsequent STI diagnoses. Results: The total patients with OCD were significantly more to acquire an STI, with a hazard ratio (95% confidence interval) being 3.25 (2.61–4.03), than their counterparts without OCD (p < 0.05). The associations between OCD medications, including antidepressants, mood stabilizers, and second-generation (atypical) antipsychotic drugs, and subsequent STI risk did not reach any significant differences. Conclusion: In this study, we found that OCD is an independent risk factor of acquiring any STI in the adolescent and young adult population. We recommend that clinicians should be more alert in identifying risky sexual behaviors and STI risks in such patients with OCD.
{"title":"Sexually transmitted infections among adolescent and young adult patients with obsessive–compulsive disorder","authors":"Y. Ho, S. Tsai, Mu-Hong Chen","doi":"10.4103/TPSY.TPSY_20_23","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_20_23","url":null,"abstract":"Objectives: The association between obsessive–compulsive disorder (OCD) and sexually transmitted infections (STIs) and the effects of OCD medication on STI risk remain unknown. In the present study, we intended to study the risks of subsequent STIs after an OCD diagnosis and the effects of related OCD medications on STI risk. Methods: With the Taiwan National Health Insurance Research Database, we enrolled 15,908 adolescent and young adult patients with OCD and 159,080 age- and sex-matched individuals without OCD between 2001 and 2009, and followed them up until the end of 2011 for subsequent STI diagnoses. Results: The total patients with OCD were significantly more to acquire an STI, with a hazard ratio (95% confidence interval) being 3.25 (2.61–4.03), than their counterparts without OCD (p < 0.05). The associations between OCD medications, including antidepressants, mood stabilizers, and second-generation (atypical) antipsychotic drugs, and subsequent STI risk did not reach any significant differences. Conclusion: In this study, we found that OCD is an independent risk factor of acquiring any STI in the adolescent and young adult population. We recommend that clinicians should be more alert in identifying risky sexual behaviors and STI risks in such patients with OCD.","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75450153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rayaji Shaktidevi, M. Aswath, H. Kshamaa, Vathsalya Gowda
Background: Mental illness is one of the leading causes of disability worldwide. General health facilities are the first point of contact for patients with mental illness. Physicians seldom detect mental health issues, and referrals to mental health professionals are made infrequently. Therefore, health-care professionals need to be educated to have adequate knowledge and positive attitude for detection and timely intervention for the mentally ill. In this study, we intended to concentrate on the attitude of nonpsychiatric health-care professionals toward mental illness. Methods: This study is a cross-sectional study. We studied 260 nurses, interns, and postgraduates at a medical college in Bangalore, Karnataka, with copies of a semi-structured socioeconomical questionnaire and Mental Illness: Clinicians' Attitude Scale-Version 4. Results: We found that younger age group (p < 0.001), history of previous psychiatric consultations with themselves (p < 0.001) or with families/friends (p < 0.05), and postgraduates (p < 0.05) had a significantly more positive attitude toward mental illness, but that the group with older age group (p < 0.001), and nursing staff (p < 0.001), had a significantly more negative attitude toward mental illness. Conclusion: Adequate training and knowledge about mental illness are needed for health-care providers, to enable them for early detection, decreased morbidity, and reduced stigma of the mentally ill.
{"title":"A cross-sectional study on the attitude of nonpsychiatric health-care professionals toward mental health","authors":"Rayaji Shaktidevi, M. Aswath, H. Kshamaa, Vathsalya Gowda","doi":"10.4103/TPSY.TPSY_18_23","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_18_23","url":null,"abstract":"Background: Mental illness is one of the leading causes of disability worldwide. General health facilities are the first point of contact for patients with mental illness. Physicians seldom detect mental health issues, and referrals to mental health professionals are made infrequently. Therefore, health-care professionals need to be educated to have adequate knowledge and positive attitude for detection and timely intervention for the mentally ill. In this study, we intended to concentrate on the attitude of nonpsychiatric health-care professionals toward mental illness. Methods: This study is a cross-sectional study. We studied 260 nurses, interns, and postgraduates at a medical college in Bangalore, Karnataka, with copies of a semi-structured socioeconomical questionnaire and Mental Illness: Clinicians' Attitude Scale-Version 4. Results: We found that younger age group (p < 0.001), history of previous psychiatric consultations with themselves (p < 0.001) or with families/friends (p < 0.05), and postgraduates (p < 0.05) had a significantly more positive attitude toward mental illness, but that the group with older age group (p < 0.001), and nursing staff (p < 0.001), had a significantly more negative attitude toward mental illness. Conclusion: Adequate training and knowledge about mental illness are needed for health-care providers, to enable them for early detection, decreased morbidity, and reduced stigma of the mentally ill.","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89016890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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