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Loneliness in patients with schizophrenia 精神分裂症患者的孤独感
Pub Date : 2021-04-01 DOI: 10.4103/tpsy.tpsy_14_21
H. Liao, Y. Lee, S. Hsu, C. Yen
Background: The treatment goals for patients with schizophrenia are to address subjective well-being, quality of life, and recovery in recent decades. Loneliness is a negative subjective feeling and related to social isolation, which is thought to be a barrier to recovery. Few research exist to study loneliness in-depth in patients with schizophrenia. Methods: In this review, the authors intend to address the issues of the prevalence, the impacts, the associated factors, and the interventions of loneliness in patients with schizophrenia. Results: Studies showed that patients with schizophrenia have a greater degree of loneliness than those without. The physical and mental health problems associated with loneliness in patients with schizophrenia include hypertension, high blood level of glycated hemoglobin, activated hypothalamus–pituitary–adrenal axis, poor subjective quality of life, depression, anxiety, suicide, use of addictive substances, high perceived stress, low self-esteem, low sense of pleasure, pessimism, and low resilience. From an ecological approach, loneliness in patients with schizophrenia is associated with several personal disease factors, personal cognitive factors, personal socioeconomic factors, community integration, and residence. Social prescribing projects, cognitive behavioral therapy, mindfulness, and positive psychology interventions have been used to reduce loneliness in patients with schizophrenia. Conclusion: Loneliness is an important indicator of the physical and mental health in patients with schizophrenia. Several factors associated with loneliness in patients with schizophrenia have been identified in the past studies. Further intervention research are required for establish effective methods to reduce loneliness in patients with schizophrenia.
背景:近几十年来,精神分裂症患者的治疗目标是解决主观幸福感、生活质量和康复问题。孤独是一种消极的主观感觉,与社会孤立有关,被认为是康复的障碍。很少有研究深入研究精神分裂症患者的孤独感。方法:就精神分裂症患者孤独感的患病率、影响因素、相关因素及干预措施进行综述。结果:研究表明,精神分裂症患者比正常人更有孤独感。精神分裂症患者与孤独相关的身心健康问题包括高血压、高血糖血红蛋白水平、下丘脑-垂体-肾上腺轴活化、主观生活质量差、抑郁、焦虑、自杀、使用成瘾物质、高感知压力、低自尊、低快乐感、悲观和低恢复力。从生态学的角度来看,精神分裂症患者的孤独感与个人疾病因素、个人认知因素、个人社会经济因素、社区整合和居住有关。社会处方项目、认知行为疗法、正念和积极心理学干预已被用于减少精神分裂症患者的孤独感。结论:孤独感是衡量精神分裂症患者身心健康状况的重要指标。在过去的研究中,已经确定了与精神分裂症患者孤独感相关的几个因素。需要进一步的干预研究来建立有效的方法来减少精神分裂症患者的孤独感。
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引用次数: 1
Psychotropic drug prescription patterns and their predictors among older adult patients with schizophrenia in a tertiary-referral psychiatric hospital 精神科三级转诊医院老年精神分裂症患者的精神药物处方模式及其预测因子
Pub Date : 2021-04-01 DOI: 10.4103/tpsy.tpsy_16_21
Mun-Ju Lin, Hsing-Kang Chen
Objective: Medical treatments for patients with refractory schizophrenia can be roughly divided into three strategies – clozapine administration, adjuvant use of mood stabilizers, and antipsychotic polypharmacy. Few studies exist on older adult patients with schizophrenia. In this study, we intended to assess the prevalence of clozapine administration, adjuvant use of mood stabilizers, and antipsychotic polypharmacy, and to find their predictors in those patients with schizophrenia. Methods: In this cross-sectional study, we collected information of patients' sociodemographic and clinical details. Their psychotic symptoms were evaluated using a clinical interview with a positive and negative syndrome scale (PANSS). Results: We enrolled 240 study participants, with 74 patients (30.8%) receiving clozapine, 40 patients (16.7%) receiving adjuvant use of mood stabilizers, and 42 patients (17.5%) receiving antipsychotic polypharmacy. Younger age (p < 0.05), higher PANSS general symptoms subscales (p < 0.001), and higher dosage of antipsychotics (p < 0.01) were significantly related to patients with clozapine administration. As to patients with adjuvant therapy with mood stabilizers, only younger age (p < 0.01) and male gender (p < 0.05) showed significant association. Finally, patients receiving antipsychotic polypharmacy were significantly related to lower body mass index (BMI) (p < 0.05), higher PANSS positive symptoms subscale (p < 0.05), and higher dosage of antipsychotics (p < 0.001). Conclusions: Our findings showed that patients with clozapine prescription were 30.8% in prevalence which is higher than other studies in Asia. The prevalence of adjuvant mood stabilizers and antipsychotic polypharmacy were 16.7% and 17.5%, respectively. Those two findings are lower than those in other studies in Asia.
目的:难治性精神分裂症患者的药物治疗大致分为三种策略:氯氮平、辅助使用情绪稳定剂和综合抗精神病药物。关于老年精神分裂症患者的研究很少。在这项研究中,我们打算评估氯氮平的使用、情绪稳定剂的辅助使用和抗精神病药物的综合使用的流行程度,并找到它们在精神分裂症患者中的预测因子。方法:在横断面研究中,我们收集了患者的社会人口学信息和临床细节。他们的精神病症状通过临床访谈评估阳性和阴性症状量表(PANSS)。结果:我们招募了240名研究参与者,74名患者(30.8%)接受氯氮平治疗,40名患者(16.7%)辅助使用情绪稳定剂,42名患者(17.5%)接受抗精神病药物综合治疗。年龄较小(p < 0.05)、PANSS一般症状亚量表较高(p < 0.001)、抗精神病药物剂量较高(p < 0.01)与氯氮平给药相关。在使用情绪稳定剂辅助治疗的患者中,只有年龄较小(p < 0.01)和男性(p < 0.05)有显著相关性。最后,服用多种抗精神病药物的患者与较低的身体质量指数(BMI)、较高的PANSS阳性症状分量表(p < 0.05)和较高的抗精神病药物剂量(p < 0.001)显著相关。结论:我们的研究结果显示,氯氮平处方患者的患病率为30.8%,高于亚洲其他研究。辅助情绪稳定剂和综合抗精神病药物的患病率分别为16.7%和17.5%。这两项研究结果低于亚洲其他研究的结果。
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引用次数: 0
Mental health services and research and development in South Korea 韩国的精神卫生服务和研究与发展
Pub Date : 2021-04-01 DOI: 10.4103/TPSY.TPSY_22_21
Youngin Chung, Subin Park, Sun-sik Roh, Bomi Lee, Y. Lee, F. Rami, Ling Li, J. Shen
Background: South Korea or the Republic of Korea has an area of 100,412.6 km2, and population of 52 million (51,781,000). Methods: Besides our lifetime experiences in receiving training, teaching, and practicing psychiatry, the authors collected information from the literature pertinent to the mental health care in South Korea. This review is intended to familiarize the readers of the Taiwanese Journal of Psychiatry with the information of mental health-care service as well as research and development (R and D) in South Korea. Results: Despite consistent improvement in the overall health status in Korea, the mental health status of the population is low compared with other countries in the Organization for Economic Co-operation and Development (OECD). For example, Korea has the highest suicide-related mortality and more years of life lost due to mental/behavioral diseases, compared to those of the average and a longer-than-average duration of hospital stay, respectively, of the OECD. Conversely, the government has made efforts to overhaul the mental health system. Several remarkable changes have been made in the areas of community-based service, involuntary admission, and unequal treatment. Conclusion: The mental health status is closely associated with the mental health service system, prevalence of mental disorders, health insurance system, admission system, and R and D budget for mental health. To change attitudes related to mental health, strong leadership among mental health professionals is urgently needed.
背景:韩国的国土面积为100,412.6平方公里,人口为5200万(51,781,000)。方法:作者在查阅韩国精神卫生保健相关文献的基础上,结合本人接受精神病学培训、教学和实践的经验。本综述旨在让《台湾精神病学杂志》的读者了解韩国的精神卫生保健服务和研究与发展(R and D)的信息。结果:尽管韩国的整体健康状况持续改善,但与经济合作与发展组织(OECD)的其他国家相比,韩国人口的心理健康状况较低。例如,与经合组织的平均住院时间和高于平均住院时间相比,韩国与自杀有关的死亡率和因精神/行为疾病而损失的寿命年数最高。相反,政府也在努力改革精神卫生系统。在以社区为基础的服务、非自愿入院和不平等待遇方面已经发生了一些显著的变化。结论:心理健康状况与心理卫生服务体系、精神障碍患病率、健康保险制度、入院制度、心理卫生研发预算密切相关。为了改变与精神卫生有关的态度,迫切需要精神卫生专业人员中强有力的领导。
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引用次数: 1
A pilot study of antidepressant therapy on sleep architecture in patients with depression in Congo 刚果抑郁症患者抗抑郁药物治疗睡眠结构的初步研究
Pub Date : 2021-04-01 DOI: 10.4103/tpsy.tpsy_17_21
H. Dhillon, S. Sasidharan
Background: A pilot prospective cohort study was conducted to study the sleep architecture and correlated perceived sleep disturbances in depressed Congolese patients with objective changes in sleep architecture using polysomnography (PSG) before and after antidepressant therapy. Methods: Patients were recruited into the study after applying strict inclusion and exclusion criterion to rule out other comorbidities which could influence sleep. A diagnosis of depressive episode was made based on the International Classification of Diseases-10 Edition DCR. Patients were evaluated using Beck Depressive inventory (BDI) and (Hamilton Depression Rating Scale (HAM-D) insomnia subscale on day 1 of admission. Patients also received sleep study using polysomnography on day 3 of the hospitalization. Patients were started on antidepressant treatment after polysomnography. Patients received an eight-week adequate trial of antidepressants, and BDI score being lower than 9 was considered as being remitted from depression. Polysomnography was repeated after that the patients achieved remission. Statistical analysis was done using Kruskal–Wallis test and Pearson's correlation coefficient. Results: The study results showed that significantly improved polysomnographic findings existed in total sleep time (p < 0.001), sleep efficiency (p < 0.001), wake after sleep onset (p < 0.001), and percentage wake time (p < 0.001) after taking antidepressants. HAM-D insomnia subscale was correlated with total sleep time (p < 0.001), sleep efficiency (p < 0.001), wake after sleep onset (p < 0.001), total wake time (p < 0.001), and N2 stage percentage (p < 0.001). Conclusion: Antidepressant treatment effectively improved sleep architecture in depressive disorder. HAM-D insomnia subscale was correlated with objective findings of total sleep time, sleep efficiency, wake after sleep onset, as well as total wake time and duration of N2 stage of nonrapid eye movement (NREM).
背景:本研究采用多导睡眠图(PSG)研究抗抑郁治疗前后睡眠结构客观改变的刚果抑郁症患者的睡眠结构和相关感知睡眠障碍。方法:采用严格的纳入和排除标准,排除其他影响睡眠的合并症后纳入研究。根据国际疾病分类-10版DCR诊断抑郁发作。入院第1天采用贝克抑郁量表(BDI)和汉密尔顿抑郁评定量表(HAM-D)失眠量表对患者进行评估。住院第3天采用多导睡眠描记仪对患者进行睡眠研究。患者在多导睡眠检查后开始抗抑郁治疗。患者接受为期8周的充分抗抑郁药物试验,BDI评分低于9分被视为抑郁症得到缓解。患者病情缓解后再次进行多导睡眠检查。采用Kruskal-Wallis检验和Pearson相关系数进行统计分析。结果:研究结果显示,服用抗抑郁药后,总睡眠时间(p < 0.001)、睡眠效率(p < 0.001)、睡眠后醒度(p < 0.001)和醒度百分比(p < 0.001)均有显著改善。HAM-D失眠子量表与总睡眠时间(p < 0.001)、睡眠效率(p < 0.001)、睡眠后清醒时间(p < 0.001)、总清醒时间(p < 0.001)和N2阶段百分比(p < 0.001)相关。结论:抗抑郁药物治疗可有效改善抑郁症患者的睡眠结构。HAM-D失眠量表与总睡眠时间、睡眠效率、入睡后清醒时间、非快速眼动(NREM) N2期总清醒时间和持续时间等客观结果相关。
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引用次数: 0
Using early recollections to explore personality trait, self-efficacy, and insight in depressive patients 利用早期回忆探索抑郁症患者的人格特质、自我效能和洞察力
Pub Date : 2021-04-01 DOI: 10.4103/tpsy.tpsy_15_21
Wei- Chen, Frank Chou
Objective: Early life experience forms a template for the self-perception of an individual, and negative representations make individuals vulnerable to depression. To explore the deep inner world of patients with depression using objective early life experience measures is not easy. In the present study, we intended to clarify the use of subjective early recollections (ER) in exploring the inner world of depressive patients. Methods: We interviewed 80 depressive inpatients with ER and evaluated whether they had a feeling sense of belonging to their caregivers, and whether they had a positive self-image. They were also assessed using the Taiwanese version Type D Scale-14, Chinese version General Self-efficacy Scale, the Taiwanese version of the Mini-International Neuropsychiatric Interview, and Insight Interview. Results: Independent t-test was used to test the significant differences between feeling belonging/not feeling belonging groups and between positive or negative self-image groups on the variables of Type D personality traits, self-efficacy, illness insight, and comorbid psychiatric disorders with effect sizes ranging from 0.4 to 1.3. Conclusion: Our study showed that ER could function as a window through which depressive patients' inner life. Thus, we suggested that ER can be considered an important part of the clinical assessment methods for depressive patients.
目的:早期生活经历形成了个体自我认知的模板,消极表征使个体易患抑郁症。用客观的早期生活体验量表来探索抑郁症患者的内心世界并非易事。在本研究中,我们旨在阐明主观早期回忆(ER)在探索抑郁症患者内心世界中的应用。方法:对80例急诊住院抑郁症患者进行访谈,评估其对照顾者的归属感和积极的自我形象。采用台湾版D型量表-14、中国版一般自我效能感量表、台湾版迷你国际神经精神病学访谈和内观访谈进行评估。结果:采用独立t检验检验感觉归属组与不感觉归属组、积极自我形象组与消极自我形象组在D型人格特质、自我效能感、疾病洞察力、共病精神障碍等变量上的显著差异,效应量在0.4 ~ 1.3之间。结论:我们的研究表明,ER可以作为抑郁症患者内心生活的窗口。因此,我们建议将ER作为抑郁症患者临床评估方法的重要组成部分。
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引用次数: 0
Contemporary psychotherapeutic approaches to patients with schizophrenia in Taiwan 台湾精神分裂症患者的当代心理治疗方法
Pub Date : 2021-04-01 DOI: 10.4103/tpsy.tpsy_21_21
S. Li, K. Lee, Shu- Lu, W. Peng
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引用次数: 0
Malingering by proxy presenting with symptoms of posttraumatic stress disorder: A case report of child abuse 以创伤后应激障碍症状为表现的代理装病:儿童虐待案例报告
Pub Date : 2021-04-01 DOI: 10.4103/tpsy.tpsy_12_21
Hsing-Jung Li, Frank Chou, Wen- Lin, Kuan-Hsin Chen, Ching-Hong Tsai
{"title":"Malingering by proxy presenting with symptoms of posttraumatic stress disorder: A case report of child abuse","authors":"Hsing-Jung Li, Frank Chou, Wen- Lin, Kuan-Hsin Chen, Ching-Hong Tsai","doi":"10.4103/tpsy.tpsy_12_21","DOIUrl":"https://doi.org/10.4103/tpsy.tpsy_12_21","url":null,"abstract":"","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":"48 1","pages":"99 - 100"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83393692","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}
引用次数: 0
Munchausen syndrome and munchausen syndrome by proxy: A case report 孟乔森综合征和代用孟乔森综合征1例报告
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_9_21
Wei-Jen Lin, Y. Chan
{"title":"Munchausen syndrome and munchausen syndrome by proxy: A case report","authors":"Wei-Jen Lin, Y. Chan","doi":"10.4103/TPSY.TPSY_9_21","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_9_21","url":null,"abstract":"","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":"32 1","pages":"42 - 43"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75618646","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}
引用次数: 0
Constructing the understanding of emerging clinical entity of flirtatious personality 建构对轻浮人格显现临床实体的认识
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_8_21
M. Sharma, S. Chaturvedi, S. Ganjekar
{"title":"Constructing the understanding of emerging clinical entity of flirtatious personality","authors":"M. Sharma, S. Chaturvedi, S. Ganjekar","doi":"10.4103/TPSY.TPSY_8_21","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_8_21","url":null,"abstract":"","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":"30 1","pages":"40 - 41"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87293330","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}
引用次数: 0
Required research activities to overcome addiction problems in Japan 需要开展研究活动以克服日本的成瘾问题
Pub Date : 2021-01-01 DOI: 10.4103/TPSY.TPSY_3_21
K. Ikeda, S. Ide, H. Takahashi-Omoe, M. Minami, H. Miyata, M. Kawato, Hitoshi Okamoto, T. Kikuchi, Yumiko Saito, T. Shirao, Y. Sekino, T. Murai, T. Matsumoto, M. Iseki, Y. Nishitani, M. Sumitani, Hidehiko Takahashi, S. Yamawaki, Tadashi Isa, Y. Kamio
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.
背景:“成瘾”一词包括物质依赖和行为成瘾,并与重大社会问题有关。目前,日本对抗成瘾的措施不足,有必要进一步研究成瘾问题。方法:日本科学委员会(SCJ)下设三个小组委员会——成瘾小组委员会、大脑和精神小组委员会、神经科学小组委员会等。这三个小组委员会直接或间接处理日本的成瘾问题。因此,本综述的所有作者,这些小组委员会的成员,共同建议日本需要进行哪些研究活动,以继续努力克服日本的成瘾问题。结果:我们提出了以下措施。提案1:了解成瘾的多样性,促进相关研究和教育;提案2:促进成瘾障碍患者的个性化措施;建议3:培养成瘾研究人才;建议4:为药物依赖患者的康复制定新的指导方针;建议5:成立专门从事成瘾研究的机构,综合处理与成瘾有关的信息收集、研究、对策、治疗和公共关系。结论:该综述的意见基于SCJ成瘾小组委员会、大脑和精神小组委员会和神经科学小组委员会于2020年以日语发表的建议。本文作者与台湾精神病学学会的同事分享了这些建议的研究活动,以克服日本的成瘾问题。
{"title":"Required research activities to overcome addiction problems in Japan","authors":"K. Ikeda, S. Ide, H. Takahashi-Omoe, M. Minami, H. Miyata, M. Kawato, Hitoshi Okamoto, T. Kikuchi, Yumiko Saito, T. Shirao, Y. Sekino, T. Murai, T. Matsumoto, M. Iseki, Y. Nishitani, M. Sumitani, Hidehiko Takahashi, S. Yamawaki, Tadashi Isa, Y. Kamio","doi":"10.4103/TPSY.TPSY_3_21","DOIUrl":"https://doi.org/10.4103/TPSY.TPSY_3_21","url":null,"abstract":"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.","PeriodicalId":22278,"journal":{"name":"Taiwanese Journal of Psychiatry","volume":"24 1","pages":"6 - 11"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82994149","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}
引用次数: 1
期刊
Taiwanese Journal of Psychiatry
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