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Taiwanese Journal of Psychiatry最新文献

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An invited companion comment on: The need for implementation of effective telepsychiatry services in the era of COVID-19 pandemic in Nigeria 特邀同行评论:在尼日利亚COVID-19大流行时期实施有效远程精神病学服务的必要性
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_11_21
C. Allgulander
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引用次数: 0
The need for implementation of effective telepsychiatry services in the era of COVID-19 pandemic in Nigeria 在尼日利亚COVID-19大流行时期实施有效远程精神病学服务的必要性
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_10_21
C. Okechukwu
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引用次数: 1
Risk of teenage pregnancy among adolescents with borderline personality disorder: A nationwide longitudinal study 边缘型人格障碍青少年怀孕的风险:一项全国性的纵向研究
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_6_21
Mu-Hong Chen, S. Tsai
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.
背景:有证据表明边缘性人格障碍(BPD)与危险性行为的可能性增加有关,是青少年怀孕最重要的危险因素之一。但是青春期BPD是否与少女怀孕有独立的关系仍不确定。方法:选取2001 - 2009年间患有BPD的青春期少女809名和未患有BPD的青春期少女8090名,随访至2011年底,以确定是否有少女怀孕和多次少女怀孕。评估抑郁症、双相情感障碍以及酒精和物质使用障碍的合并症。精神药物包括抗抑郁药、情绪稳定剂和第二代(非典型)抗精神病药物。结果:Cox回归分析显示,与非BPD对照组相比,BPD青少年在随访期间发生任何少女怀孕的风险(风险比[HR] = 14.53, 95%可信区间[CI] = 9.89 ~ 21.37, p < 0.05)和重复少女怀孕的风险(HR = 30.43, 95% CI = 17.32 ~ 53.45, p < 0.05)显著增加。精神药物与任何少女怀孕和多次少女怀孕的风险没有显著关联。讨论:青少年BPD是任何少女怀孕和多次少女怀孕的独立危险因素,无论是否有酒精和物质使用障碍的合并症。对青少年BPD的及时干预是否可以降低任何少女怀孕和重复少女怀孕的风险还需要进一步的研究。
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引用次数: 0
The Taiwanese Journal of Psychiatry is becoming more visible and international 《台湾精神病学杂志》正变得越来越有知名度和国际化
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_1_21
W. Shen
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引用次数: 0
Symptomatic hypothyroidism manifesting psychotic relapse in a patient with schizophrenia: A case report 精神分裂症患者表现为精神病性复发的症状性甲状腺功能减退1例报告
Pub Date : 2021-01-01 DOI: 10.4103/tpsy.tpsy_42_21
Chuan-Hsun Yu, Yu-Yu Ko, Yu-Hsia Kao, Chiao-Jung Lin, Huei-Yi Chang
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引用次数: 0
Predictors for probable posttraumatic stress disorder among outpatients with psychiatric disorders and their caregivers during the COVID-19 pandemic: A cross-sectional study in Taiwan COVID-19大流行期间精神障碍门诊患者及其护理人员可能的创伤后应激障碍预测因素:台湾的横断面研究
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_7_21
Kuan-Ying Hsieh, Wei-Tsung Kao, F. Chou, S. Hsu, Dian-Jeng Li, L. Chou, G. Lin, Wei- Chen, Joh‐Jong Huang
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.
目的:2019冠状病毒病(COVID-19)大流行可能对精神障碍患者及其照顾者产生心理影响。在本研究中,我们旨在探讨女性、既往创伤、缺乏社会支持、额外的生活压力和非精神病性症状是否可以预测2019冠状病毒病大流行期间精神疾病门诊患者及其护理人员发生创伤后应激障碍(PTSD)的可能性。方法:采用横断面研究方法,收集门诊精神障碍患者及其护理人员的社会人口学变量和ptsd相关症状水平。使用简单的线性回归分析确定与可能的PTSD水平相关的潜在预测因素。我们使用逻辑回归分析和多元线性回归分析来确定这些变量作为独立的预测因子。由于分布的非正态性,我们使用了1000个bootstrap样本的简单和逻辑线性回归分析来验证结果。结果:我们分析了145名参与者的研究数据。Logistic回归分析显示,活动(比值比[OR][95%可信区间(CI)] = 1.409 [0.178-3.711], p < 0.01)和恐慌症状(OR [95% CI] = 20.778 [18.509-23.638], p < 0.01)是可能发生PTSD的显著预测因子。多元回归分析显示,高学历个体(β = 0.210, p < 0.05)和应激源个体(β = 0.233, p < 0.05)与非可能PTSD组的可能PTSD症状水平显著相关。慢性躯体疾病多的个体(β = 0.512, p < 0.05)可能出现PTSD症状的水平显著升高。结论:在目前的研究中,我们发现活动、恐慌症状、高等教育、压力源和更多的慢性身体疾病是COVID-19大流行期间发生可能的PTSD或严重可能的PTSD症状的预测因素。进一步的研究是有必要的,以扩大我们的研究结果的应用和推广。
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引用次数: 1
Clinical features and risk factors of psychiatric disorders among maltreated children 受虐待儿童精神障碍的临床特征及危险因素
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_4_21
Kuo- Li, Cheng-Hsien Sung, Shih‐Kai Liu, Yuan-Chang Hsu, Chih-Nan Chen
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.
目的:本调查旨在探讨受虐待儿童的临床特征及可能的危险因素,包括虐待类型、家庭因素和精神病理。方法:回顾1997 - 2016年儿童之家受虐待儿童年度项目综合评估的临床病例报告。综合评估包括虐待史、家庭状况、精神病学访谈、体格检查和心理评估。我们将受虐待儿童分为I轴精神障碍组和非I轴精神障碍组,比较临床特征和危险因素的差异。结果:377例患者平均年龄9.1±3.0岁。大多数是男性(60.5%)和小学生(69.9%)。只有22.5%的父母在婚姻状态上保持已婚。I轴精神障碍组的年龄(p < 0.05)和全智力(p < 0.001)均显著低于非I轴精神障碍组。此外,第I轴精神障碍组的研究参与者的位置变化次数显著增加(p < 0.05),并且在一个位置停留的时间更长(p < 0.05)。在这两组中,大约40%的参与者身高不超过25%。在权重维度中找不到该特征。结论:虽然精神障碍问题增加了儿童虐待问题的复杂性,但促进、保护和恢复心理健康可以被视为这些弱势儿童的重要关注点。
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引用次数: 0
Nocebo effects from COVID-19 and vaccination Hesitancy: The question of to be or not to be vaccinated COVID-19的反安慰剂效应与疫苗接种犹豫:是否接种疫苗的问题
Pub Date : 2021-01-01 DOI: 10.4103/tpsy.tpsy_33_21
ChaucerChiao-Hsiang Lin
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引用次数: 0
Involuntary hospitalization review mechanism in Taiwan: Lessons learned from a 12-Year experience 台湾非自愿住院审查机制:12年经验的教训
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_2_21
Shin-Min Lee, Ding-Lieh Liao
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引用次数: 2
Clinical characteristics and rehospitalization in patients with schizophrenia with or without history of amphetamine abuse 有或无安非他明滥用史的精神分裂症患者的临床特征及再住院情况
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_5_21
Wei Huang, H. Chan
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.
目的:本研究旨在研究有或无安非他命滥用史的精神分裂症患者临床特征及再住院危险因素的差异。方法:对2012年1月1日至2015年12月31日在桃园精神病院出院的两组精神分裂症患者进行病历和电子数据库检索。有安非他明滥用和无安非他明滥用的患者分别被定义为病例组和对照组。提取并检验患者的人口学资料和临床变量。结果:病例组80例,对照组142例。高达32.5%的病例组患者尿安非他明检测仍呈阳性。单因素分析显示,性别(p < 0.001)、年龄(p < 0.001)、婚姻(p < 0.05)、文化程度(p < 0.001)、精神合并症(p < 0.05)、精神分裂症家族史(p < 0.01)、非法药物家族史(p < 0.001)、自杀史(p < 0.01)、暴力史(p < 0.001)、住院天数(p < 0.001)、再住院率(p < 0.05)存在显著差异。logistic回归分析结果显示,既往入院次数与再住院呈正相关,有精神分裂症家族史与再住院负相关。Cox比例风险回归模型分析显示,既往入院次数仍是再次住院的积极预测因素。结论:在本研究中,两组研究患者的特征不同。有安非他明滥用史的精神分裂症患者有滥用安非他明的倾向,再住院率较高。在社区对这一人群进行进一步的安非他命戒断治疗是有必要的,以加强研究结果。
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Taiwanese Journal of Psychiatry
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