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Article ; Online: Exposure to psychotropic drugs and breast cancer risk in patients with bipolar disorder and major depressive disorder: a nested case-control study.

Li, Dian-Jeng / Tsai, Shih-Jen / Chen, Tzeng-Ji / Liang, Chih-Sung / Chen, Mu-Hong

European archives of psychiatry and clinical neuroscience

2024

Abstract: Breast cancer is one of the most prevalent and serious types of cancer globally. Previous literature has shown that women with mental illness may have an increased risk of breast cancer, however whether this risk is associated with the use of ... ...

Abstract	Breast cancer is one of the most prevalent and serious types of cancer globally. Previous literature has shown that women with mental illness may have an increased risk of breast cancer, however whether this risk is associated with the use of psychotropic drugs has yet to be elucidated. This study aimed to assess such risk among women with major depressive disorder (MDD) and bipolar disorder (BD). A nested case-control study design was used with data obtained from the Taiwan National Health Insurance Research Database. Logistic regression analysis with adjustments for demographic characteristics, medical and mental comorbidities, and all-cause clinical visits was performed to estimate the risk of breast cancer according to the cumulative defined daily dose (cDDD) of psychotropic drugs. The study included 1564 women with MDD or BD who had breast cancer, and 15,540 women with MDD or BD who did not have breast cancer. After adjusting for important confounders, the long-term use of valproic acid (odds ratio, 95% confidence interval: 0.58, 0.39-0.56, cDDD ≥ 365), citalopram (0.58, 0.37-0.91, cDDD 180-365), and sertraline (0.77, 0.61-0.91, cDDD ≥ 365) was associated with a lower risk of breast cancer compared to a cDDD < 30. The short-term use of fluvoxamine (0.82, 0.69-0.96, cDDD 30-180), olanzapine (0.54, 0.33-0.89, cDDD 30-179), risperidone (0.7, 0.51-0.98, cDDD 30-179), and chlorpromazine (0.48, 0.25-0.90, cDDD 30-179) was associated with a lower risk of breast cancer. We found no evidence of an increased risk of breast cancer in patients with MDD or BD receiving psychotropic drugs.
Language	English
Publishing date	2024-03-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1045583-8
ISSN	1433-8491 ; 0175-758X ; 0940-1334
ISSN (online)	1433-8491
ISSN	0175-758X ; 0940-1334
DOI	10.1007/s00406-024-01798-9
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Article ; Online: The impact of housing-price-related indices on suicide rates in Taiwan.

Chen, Yi-Lung / Li, Dian-Jeng / Chen, Ying-Yeh / Yen, Cheng-Fang

The International journal of social psychiatry

2023 Volume 70, Issue 1, Page(s) 40–47

Abstract: Background: While certain socioeconomic factors have been studied in relation to suicide, housing-price-related indexes have rarely been investigated.: Aims: This article aims to examine the impact of housing-price-related indexes on suicide rates in ...

Abstract	Background: While certain socioeconomic factors have been studied in relation to suicide, housing-price-related indexes have rarely been investigated. Aims: This article aims to examine the impact of housing-price-related indexes on suicide rates in the general population of Taiwan, a country with high housing costs and suicide rates. Methods: The study utilized three national housing-price-related indexes from 2012 to 2019: (1) housing price index, (2) housing price to income ratio, and (3) housing rental index. Cause of Death Data was employed to calculate suicide rate. A linear regression model with autoregressive errors was used to analyze the association between housing-price-related indexes and suicide rates among different sex and age groups. Results: The findings revealed that higher housing rental index values were associated with increased suicide rates in young and middle-aged adults compared to the elderly population, regardless of sex. However, this association was not observed with the other two housing-price-related indexes (i.e. housing price index and housing price to income ratio). Conclusion: These results offer valuable insights for policymakers, mental health professionals, and housing advocates to improve housing affordability and reduce the burden of suicide in the general population, particularly among younger generations.
MeSH term(s)	Adult ; Middle Aged ; Humans ; Aged ; Housing ; Taiwan/epidemiology ; Socioeconomic Factors ; Suicide ; Income
Language	English
Publishing date	2023-09-04
Publishing country	England
Document type	Journal Article
ZDB-ID	3062-4
ISSN	1741-2854 ; 0020-7640
ISSN (online)	1741-2854
ISSN	0020-7640
DOI	10.1177/00207640231194484
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Article ; Online: Efficacy of music therapy and predictors of sleep disturbance among patients with chronic schizophrenia: A prospective study.

Lu, Mei-Jou / Chen, Wan-Yi / Li, Dian-Jeng

Archives of psychiatric nursing

2022 Volume 40, Page(s) 1–7

Abstract: Study objectives: Patients with schizophrenia often suffer from sleep disturbance. Music therapy, as a non-invasive intervention, may have benefit on sleep problem in such population. Our study aimed to investigate the efficacy of music therapy on sleep ...

Abstract	Study objectives: Patients with schizophrenia often suffer from sleep disturbance. Music therapy, as a non-invasive intervention, may have benefit on sleep problem in such population. Our study aimed to investigate the efficacy of music therapy on sleep disturbance among patients with schizophrenia. Method: This prospective study recruited participants with schizophrenia along with sleep disturbances in the chronic wards. Patients in the control group received standard care, and those in the intervention group received additional music therapy before sleeping at night for four weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to measure the severity of sleep disturbance. The generalized estimating equation (GEE) was used to analyze measure the difference of change in PSQI scores between both groups at the baseline and four weeks later. It was also applied to find the predictors of treatment efficacy within intervention group. Findings: A total of 66 (31 in control group and 35 in intervention group) participants were recruited. After adjusting with the demographic variables, the change of PSQI among intervention group was significantly more than the change among control group (Group × time; Estimate = -7.05, p < 0.001), indicating the efficacy of music therapy. In addition, irreligious patients and those with chronic medical disease predicted better efficacy. Whereas, elderly patients had compromising efficacy of music therapy. Conclusion: Music therapy demonstrated its merit on sleep disturbance among patients with schizophrenia. Whereas, healthcare workers should consider the variability of severity in schizophrenia during clinical practice.
MeSH term(s)	Aged ; Chronic Disease ; Humans ; Music Therapy ; Prospective Studies ; Schizophrenia/complications ; Schizophrenia/therapy ; Sleep ; Sleep Wake Disorders/therapy
Language	English
Publishing date	2022-04-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	639197-7
ISSN	1532-8228 ; 0883-9417
ISSN (online)	1532-8228
ISSN	0883-9417
DOI	10.1016/j.apnu.2022.04.001
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Article: Erroneous Thought in Inpatients with Major Depressive Disorder: The Role of Psychological Trauma During Childhood and Adulthood.

Chiu, Chui-De / Chou, Li-Shiu / Hsieh, Yung-Chi / Lin, Ching-Hua / Li, Dian-Jeng

Neuropsychiatric disease and treatment

2023 Volume 19, Page(s) 337–348

Abstract: Background: The pathogenic role of trauma in psychotic-like experiences has yet to be clarified. The aim of this study was to investigate the role of childhood and adulthood trauma on erroneous thoughts among patients with major depressive disorder.: ... ...

Abstract	Background: The pathogenic role of trauma in psychotic-like experiences has yet to be clarified. The aim of this study was to investigate the role of childhood and adulthood trauma on erroneous thoughts among patients with major depressive disorder. Materials and methods: Inpatients with major depressive disorder (MDD) and healthy controls (HCs) were enrolled, and paper-and-pencil questionnaires were applied. Clinical rating and self-reported scales were used to measure levels of depression, dissociation, psychological trauma, parental maltreatment, and erroneous thoughts. Pearson's correlation analysis was conducted to explore potentially significant associations between erroneous thoughts and other independent variables, and standardized regression coefficients of hierarchical regression analysis were used to predict the significant relationships between erroneous thoughts and adulthood or childhood trauma. Results: A total of 99 participants were included into the analysis, of whom 59 were patients with MDD and 40 were HCs. After treatment, the patients with MDD showed significantly higher levels of depression, childhood maltreatment, interpersonal trauma and erroneous thoughts than the HCs. After estimating and verifying correlations with hierarchical regression among the patients with MDD, a link between adulthood betrayal trauma and higher level of conviction along with the number of erroneous thoughts was found. However, no significant association was identified between childhood trauma and erroneous thought. The concurrent level of depression significantly predicted a higher level of being preoccupied, along with the number of erroneous thoughts. Conclusion: The current study fills a gap in the literature by showing a link between adulthood trauma and erroneous thoughts in non-psychotic patients. Further studies with well-controlled comparisons and prospective cohort with longer follow-up are warranted to extend the applicability and generalizability of the current study.
Language	English
Publishing date	2023-02-05
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2186503-6
ISSN	1178-2021 ; 1176-6328
ISSN (online)	1178-2021
ISSN	1176-6328
DOI	10.2147/NDT.S396451
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Article ; Online: Predictors of Workplace Substance Reuse among Patients with Alcohol or Illegal Substance Use Disorder in the Workplace.

Hsu, Su-Ting / Wu, Hung-Chi / Chien, Hui-Tzu / Li, Dian-Jeng

International journal of environmental research and public health

2022 Volume 19, Issue 16

Abstract: Substance and alcohol use in the workplace have become a global health burden; however, the etiologies have seldom been explored. The aims of this study were to develop a Workplace Substance Reuse Questionnaire (WSRQ) to measure the multidimensional ... ...

Abstract	Substance and alcohol use in the workplace have become a global health burden; however, the etiologies have seldom been explored. The aims of this study were to develop a Workplace Substance Reuse Questionnaire (WSRQ) to measure the multidimensional factors associated with the reuse of alcohol or illegal substances in the workplace. The predictors of reuse were also investigated. The WSRQs for alcohol (WSRQ-Alc) and illegal substances (WSRQ-Sub) were composed of 15 and 13 items, respectively. Factors associated with workplace substance reuse included workplace environment, workload, social interaction in the workplace and other cues. Construct validity and reliability were performed to verify the questionnaires. Multivariate linear regression was conducted to estimate the associations between the factors and WSRQ score. A total of 90 patients with substance or alcohol use disorder were recruited. The results demonstrated that the WSRQ-Alc and WSRQ-Sub had acceptable reliability, with variance of 76.4% and 75.4%, respectively. The confirmatory factor analysis fit indices also indicated the adequacy of the model. A longer duration of alcohol use (β = 0.44;
MeSH term(s)	Alcohol Drinking ; Alcoholism/epidemiology ; Ethanol ; Humans ; Reproducibility of Results ; Substance-Related Disorders/epidemiology ; Surveys and Questionnaires ; Workplace
Chemical Substances	Ethanol (3K9958V90M)
Language	English
Publishing date	2022-08-14
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph191610023
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Article ; Online: Factors impeding switching from clozapine to paliperidone among patients with chronic schizophrenia-A retrospective cohort study.

Li, Dian-Jeng / Lin, Ching-Hua / Chen, Cheng-Chung

Experimental and clinical psychopharmacology

2021 Volume 30, Issue 3, Page(s) 351–358

Abstract: Clozapine is an old antipsychotic that is effective for schizophrenia, however undesirable side effects affect drug adherence. The present study aimed to investigate the predictors for failed switching from clozapine to paliperidone (FSCP) among patients ...

Abstract	Clozapine is an old antipsychotic that is effective for schizophrenia, however undesirable side effects affect drug adherence. The present study aimed to investigate the predictors for failed switching from clozapine to paliperidone (FSCP) among patients with chronic schizophrenia. This 9-year (January 2010-December 2018) retrospective study included 78 individuals with schizophrenia who wished to switch from clozapine to paliperidone and resided in a nursing home in Taiwan. The univariate Cox proportional hazards regression model (Cox model) was applied to estimate the potential factors for subsequent FSCP, followed by a multivariate Cox model to determine significant predictors of FSCP after adjusting for other covariates. Thirty eight of the 78 participants (48.7%) failed to switch from clozapine to paliperidone. After forward selection in the Cox hazard regression model, a higher number of total admission days during 1 year before switching, longer duration of clozapine use before switching, and higher average daily dose of clozapine during 1 year before switching were significantly associated with FSCP. It is suggested that clinicians should discuss with their patients about the risk factors if they intend to switch from clozapine to paliperidone. Further studies are warranted to verify our findings and extend the applicability. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
MeSH term(s)	Antipsychotic Agents/adverse effects ; Clozapine/adverse effects ; Humans ; Paliperidone Palmitate/therapeutic use ; Retrospective Studies ; Schizophrenia/drug therapy
Chemical Substances	Antipsychotic Agents ; Clozapine (J60AR2IKIC) ; Paliperidone Palmitate (R8P8USM8FR)
Language	English
Publishing date	2021-03-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1209960-0
ISSN	1936-2293 ; 1064-1297
ISSN (online)	1936-2293
ISSN	1064-1297
DOI	10.1037/pha0000434
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Article ; Online: The moderation of maternal parenting on the association of trauma, dissociation, and psychosis in depressive inpatients.

Li, Dian-Jeng / Hsieh, Yung-Chi / Chiu, Chui-de / Lin, Ching-Hua / Chou, Li-Shiu

European journal of psychotraumatology

2022 Volume 13, Issue 1, Page(s) 2024974

Abstract: Background: The effect of dissociation and parenting style on the relationship between psychological trauma and psychotic symptoms has not previously been investigated.: Objective: The aim of this study was to develop a moderated mediation model to ... ...

Abstract	Background: The effect of dissociation and parenting style on the relationship between psychological trauma and psychotic symptoms has not previously been investigated. Objective: The aim of this study was to develop a moderated mediation model to assess whether the association between psychological trauma and psychotic symptoms is mediated by dissociation and moderated by parental maltreatment. Methods: Inpatients with major depressive disorder (MDD) and bipolar depression (BP) were recruited. Self-reported and clinical rating scales were used to measure the level of dissociation, psychotic symptoms, history of psychological trauma and parental maltreatment. The PROCESS macro in SPSS was used to estimate path coefficients and adequacy of the moderated mediation model. High betrayal trauma (HBT), low betrayal trauma (LBT), paternal maltreatment, and maternal maltreatment were alternatively entered into the conceptual model to test the adequacy. Results: A total of 91 patients (59 with MDD and 32 with BP) were recruited, with a mean age of 40.59 ± 7.5 years. After testing with different variables, the moderated mediation model showed that the association between LBT and psychotic symptoms was mediated by dissociation and moderated by maternal maltreatment. A higher level of maternal maltreatment enhanced the effect of LBT on dissociation. Conclusions: Healthcare workers should be aware of the risk of developing psychotic symptoms among depressive patients with a history of LBT and maternal maltreatment.
MeSH term(s)	Adult ; Bipolar Disorder/psychology ; Child ; Child Abuse/psychology ; Cross-Sectional Studies ; Depressive Disorder, Major/psychology ; Dissociative Disorders/etiology ; Dissociative Disorders/psychology ; Female ; Humans ; Male ; Middle Aged ; Mother-Child Relations ; Parenting ; Psychological Trauma/etiology ; Psychological Trauma/psychology
Language	English
Publishing date	2022-02-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2586642-4
ISSN	2000-8066 ; 2000-8066
ISSN (online)	2000-8066
ISSN	2000-8066
DOI	10.1080/20008198.2021.2024974
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Article ; Online: Efficacy of online training at the International Mental Health Training Center Taiwan (IMHTCT): Pre and during the COVID-19 pandemic.

Chen, Cheng-Chung / Wang, Shu-Hui / Chou, Li-Shiu / Shen, Lih-Jong / Li, Dian-Jeng

Archives of psychiatric nursing

2022 Volume 42, Page(s) 40–44

Abstract: Study objectives: The coronavirus disease 2019 (COVID-19) pandemic has resulted in major disruption to regular learning and training for medical staff. The aim of this study was to compare the learning efficacy between on-site training before the COVID- ... ...

Abstract	Study objectives: The coronavirus disease 2019 (COVID-19) pandemic has resulted in major disruption to regular learning and training for medical staff. The aim of this study was to compare the learning efficacy between on-site training before the COVID-19 pandemic and online training during the pandemic for nurses, psychologists, social workers, and occupational therapists from Southeast Asia. Method: The current study derived data from the International Mental Health Training Center Taiwan (IMHTCT) from 2018 to 2020. IMHTCT Trainees Learning Effect Questionnaire (ITLEQ) scores of the medical staff and demographic variables were collected. Reliability and validity of the ITLEQ were estimated. The independent t-test was used to compare differences in ITLEQ scores between the pre-training and post-training stages among the trainees. In addition, generalized estimating equations were used to estimate the predictive effect of online training on changes in ITLEQ scores over time. Findings: A total of 190 trainees were enrolled, including 92 social workers, 16 occupation therapists, 24 psychologists, and 58 nurses. The reliability and validity were satisfactory. The efficacy of the training programs at IMHTCT was significant for all of the healthcare workers. Furthermore, better training efficacy was found in the social workers and occupational therapists who received online training compared to those who received on-site training. The potential efficacy of online training was found in the nurses. Conclusion: Our results demonstrate the importance of online training for mental healthcare workers during the COVID-19 pandemic. Online training may be implemented into regular training courses in the future.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Pandemics ; SARS-CoV-2 ; Mental Health ; Taiwan ; Reproducibility of Results ; Health Personnel/psychology
Language	English
Publishing date	2022-12-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639197-7
ISSN	1532-8228 ; 0883-9417
ISSN (online)	1532-8228
ISSN	0883-9417
DOI	10.1016/j.apnu.2022.12.008
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Article ; Online: Associations between Allergic and Autoimmune Diseases with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder within Families: A Population-Based Cohort Study.

Li, Dian-Jeng / Tsai, Ching-Shu / Hsiao, Ray C / Chen, Yi-Lung / Yen, Cheng-Fang

International journal of environmental research and public health

2022 Volume 19, Issue 8

Abstract: Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are commonly comorbid with allergic and autoimmune diseases in children. The aim of the current study was to investigate the association between children's and first- ... ...

Abstract	Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are commonly comorbid with allergic and autoimmune diseases in children. The aim of the current study was to investigate the association between children's and first-degree relatives' (i.e., mother, father, and full sibling) allergic and autoimmune diseases and children's ASD and ADHD. We enrolled participants from Taiwan's Maternal and Child Health Database. We used the Cox regression model to examine the associations of familial, siblings' and children's allergic and autoimmune diseases with children's ASD and/or ADHD. In total, we included 1,386,260 children in the current study. We found the significant association between familial allergic or autoimmune disease and development of ASD or ADHD among children. We also identified the predominant impact of familial aggregation on the above associations. The associations between some parental diagnoses of autoimmune or allergic diseases in children's ASD and/or ADHD were stronger in mothers than those in fathers. Early assessment of the possibility of ASD and ADHD is required for children who have a parent with an allergic or autoimmune disease.
MeSH term(s)	Attention Deficit Disorder with Hyperactivity/complications ; Autism Spectrum Disorder/diagnosis ; Autoimmune Diseases/epidemiology ; Child ; Cohort Studies ; Female ; Humans ; Mothers
Language	English
Publishing date	2022-04-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19084503
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Article ; Online: Linking childhood trauma and dissociation to psychotic symptoms in major depressive disorder, bipolar disorders, and schizophrenia: A transdiagnostic examination using patient and clinician ratings.

Chiu, Chui-De / Li, Dian-Jeng / Hsieh, Yung-Chi / Chou, Li-Shiu / Au, Josephine Sheron / Chen, Yi-Lung / Lin, Ching-Hua

Psychological trauma : theory, research, practice and policy

2023 Volume 16, Issue Suppl 1, Page(s) S242–S249

Abstract: Objective: Symptomatic overlap between dissociation and psychosis is well documented; however, the pathogenesis of these two phenomena might be distinct. Few studies have analyzed the relation of dissociative and psychotic symptoms transdiagnostically. ... ...

Abstract	Objective: Symptomatic overlap between dissociation and psychosis is well documented; however, the pathogenesis of these two phenomena might be distinct. Few studies have analyzed the relation of dissociative and psychotic symptoms transdiagnostically. The current study examines an emerging trauma-dissociation theoretical model that accounts for psychotic symptoms across affective disorders and schizophrenia (SCZ). Method: Psychiatric inpatients with Results: Dissociation was commonly experienced by clinical participants, particularly for those with MDD or BD. For the SCZ group, ratings of dissociation differed between patient and clinician; specifically, patient-reported dissociation scores, but not clinician-rated scores, were higher than that of the HC group. Importantly, the links between childhood trauma, dissociation, and psychotic symptoms were not homogenous across the diagnostic groups. Dissociation mediated the relationship between childhood trauma and psychotic symptoms in the MDD and BD groups, but not the SCZ group. Conclusion: Depending on the psychiatric condition, dissociation and psychosis have different clinical implications. Childhood trauma and dissociation provide an account for psychotic symptoms in patients diagnosed with MDD and BD, but not with SCZ. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
MeSH term(s)	Humans ; Depressive Disorder, Major/complications ; Depressive Disorder, Major/diagnosis ; Schizophrenia/complications ; Schizophrenia/diagnosis ; Bipolar Disorder/diagnosis ; Bipolar Disorder/complications ; Bipolar Disorder/psychology ; Adverse Childhood Experiences ; Psychotic Disorders/diagnosis ; Psychotic Disorders/etiology ; Psychotic Disorders/psychology
Language	English
Publishing date	2023-09-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0001584
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