PubMed Health⌕ Search

Biomedical subjects

M Y Chong

Publications and source records attributed to M Y Chong.

At least 19 recordsLinked to original sources
PubMed2005

A 3-year panel study of mental disorders among adolescents in Taiwan.

OBJECTIVE: This study investigated the prevalence and changing trends of mental disorders and the effects of gender and urbanization among adolescents in Taiwan. METHOD: A random sample of seventh-grade students (N=1,070) was recruited from one urban and one rural junior high school in which 1,051 (98.2%) and 1,035 (96.7%) were reassessed in the second and third years, respectively. A two-stage case identification was conducted by mental health professionals with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version, supplemented by information from the Child Behavior Checklist. RESULTS: The weighted 3-month prevalence rates across the 3 consecutive years for overall psychiatric disorders were 20.3%, 22.7%, and 14.8%, respectively. The most prevalent psychiatric condition was attention deficit hyperactivity disorder (ADHD) in the first 2 years and substance use disorders in the third. During the 3 years, the rates for ADHD, specific phobia, and social phobia decreased, and the rates for major depression and substance use disorders, conversely, increased. Although conduct disorder, ADHD, and substance use disorders were more prevalent among boys, the rates for major depression, social phobia, specific phobia, and adjustment disorder were higher among girls. Rural adolescents had higher rates of conduct disorder, oppositional defiant disorder, and substance use disorders than their urban counterparts. CONCLUSIONS: Our findings are similar to those of previous studies among adolescents in prevalence rates, changing trends of most mental disorders, and gender effects. The differential changing trends in various diagnostic groups may imply the importance of specific measures for prevention during adolescence.

Adolescent↗
PubMed2004

High dose antipsychotic use in schizophrenia: findings of the REAP (research on east Asia psychotropic prescriptions) study.

BACKGROUND: High-dose antipsychotic regimes (defined as the prescription of more than 1000 chlorpromazine-equivalents milligrams of antipsychotic per day) in the management of patients with schizophrenia are not uncommon, but most reports are from western countries. Recent functional neuroimaging studies have found that the previous notion concerning the use of antipsychotic medication, especially in high doses, was unsupported and untenable. METHODS: This international study examined the use of high dose antipsychotic medication and its clinical correlates in schizophrenia patients within six East Asian countries/territories. RESULTS: Within the study group (n = 2399), 430 patients (17.9%) were prescribed high dose antipsychotics. Antipsychotic use varied significantly between countries, with Japan, Korea, and Singapore using higher doses than the other countries. High dose antipsychotic use was associated with younger age in Japan (p < 0.001), longer duration of admission (p < 0.001), duration of illness (p < 0.001, particularly in Korea and Taiwan), positive psychotic symptoms (p < 0.001, particularly in Japan and Korea), and aggression (p < 0.05, particularly in Japan), and also with a higher likelihood of extrapyramidal and autonomic adverse effects (p < 0.05, particularly in China). Country, younger age, the presence of delusions and disorganized speech, polypharmacy, and receiving depot medication but not atypical antipsychotic drugs were important predictors of high antipsychotic use. CONCLUSIONS: This survey revealed that high antipsychotic dosing is not an uncommon practice in East Asia. It behooves the prescribing clinicians to constantly reevaluate the rationale for such a practice.

Adult↗
PubMed2001

Community study of depression in old age in Taiwan: prevalence, life events and socio-demographic correlates.

BACKGROUND: Published studies of prevalence of depression in old age in Taiwan have yielded equivocal results. AIMS: To study the prevalence of depressive disorders among community-dwelling elderly; further, to assess socio-demographic correlates and life events in relation to depression. METHOD: A randomised sample of 1500 subjects aged 65 and over was selected from three communities. Research psychiatrists conducted all assessments using the Geriatric Mental State Schedule. The diagnosis of depression was made with the GMS-AGECAT (Automated Geriatric Examination for Computerised Assisted Taxonomy); data on life events were collected with the Taiwanese version of the Life Events and Difficulties Schedule. RESULTS: One-month prevalence of psychiatric disorders was 37.7%, with 15.3% depressive neurosis and 5.9% major depression. A high risk of depressive disorders was found among widows with a low educational level living in the urban community, and among those with physical illnesses. CONCLUSIONS: Contrary to most previous reports, we found that the prevalence of depressive disorders among the elderly in the community in Taiwan is high and comparable to rates reported in some studies of UK samples.

Aged↗
PubMed2001

Apolipoprotein E polymorphism and Alzheimer's disease.

We aimed to determine the association and related factors of the apolipoprotein E (ApoE) genotype and Alzheimer's disease (AD) in Taiwan. We examined ApoE genotypes in 50 Chinese patients with AD and 50 age- and sex-matched controls. The patients met the criteria of probable AD of the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) and AD of the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV). There were 28 females and 22 males in the case and control groups. The mean age of onset of AD was 72. 62 years. The average interval between onset and research was 3.85 years. The frequency of ApoE epsilon 4 in the AD group was significantly higher than that in the controls (0.13 versus 0.02, p < 0.05). The odds ratio for AD in individuals with at least one ApoE epsilon 4 allele was 6.0 (95% CI 1.34 to 55.3, p < 0.001). The linear trend for AD in proportion to alleles of ApoE epsilon 4 was significant (chi 2 = 8.3, p = 0.004). The risk of ApoE epsilon 4 allele for the late-onset AD patients, males, or those who received less education was higher than that for the early-onset AD patients, females, or those who had received more education. The sensitivity of the epsilon 4 allele was 24%, the specificity 96%, the positive predictive value 86%, and the negative predictive value 56%. Our results supported that the ApoE epsilon 4 allele is related to AD in Taiwan. In addition, sex and education may play important roles in the presence of ApoE epsilon 4 allele. The epsilon 4 allele seemed helpful as an adjunct for diagnostic testing of AD.

Aged↗
PubMed2001

A multidimensional assessment of insights in schizophrenic patients.

This study aims to construct a multidimensional instrument in assessing insight of schizophrenic patients and further to examine its relationships with other factors such as psychiatric symptoms, demographic characteristics, and course of illness. An instrument (the Schedule for assessment of Insight in Psychosis, SIP) with a 4-point rating scale was constructed to assess the insight of schizophrenic patients in five dimensions. One hundred schizophrenic patients were recruited for the study and all of them received a semi-structured interview using the SIP. Their demographic variables, length of illness and severity of psychotic symptoms were analyzed for insight. The reliability and validity of the SIP were satisfactory. Significant factors related to insight were psychotic symptoms, including both positive and negative symptoms. This study showed insight was affected by a multitude of factors, and it could be assessed quantitatively in various dimensions.

Hospitalization↗
PubMed2000

Retrospective estimation of the birth prevalence for delayed onset disorders: application to cystic fibrosis in Nova Scotia.

Maximum likelihood methods are used to estimate the birth prevalence, the age-at-diagnosis distribution, and the number of infants born with CF in Nova Scotia over a 20 year period. The data were taken from a registry of CF cases, and, because of the delayed onset of symptoms, some CF affected individuals were not diagnosed by the end of the study period. A goodness-of-fit test for assessing whether the age-at-diagnosis distribution is stable over the 20 years is provided. These methods could be applied equally well to data on any genetic disorder with delayed onset.

Adolescent↗
PubMed2000

Validation of the Chinese Health Questionnaire (CHQ-12) in community elders.

There has been no validated screening instrument for use in non-psychotic illness of the elderly in Taiwan. This study aims to test the validity of the 12-item Chinese Health Questionnaire (CHQ-12) among the elderly in a community study. The CHQ-12 was administrated via reading-out to 222 subjects aged 65 and over from three communities. Psychiatrists using the Geriatric Mental Status Schedule (GMS) assessed psychiatric condition while the diagnosis was made according to the computerized program, AGECAT. Validity indices of the CHQ-12 were calculated, using the Relative Operating Characteristic (ROC) analysis for its optimal cut-off point. Variables hypothesized to affect its performance were assessed. Validity of the CHQ-12 at optimal cut-off point 2/3 were estimated with a sensitivity of 79.7%, a specificity of 83.6%, a positive predictive value of 68.9%, a negative predictive value of 90.0% and an overall misclassification rate of 17.6%, and an estimate of the area under the ROC curve of 0.81. The performance of the CHQ-12 was better in males, in those who were literate, and in those without any physical illness. This study demonstrated that the use of CHQ-12 in the elderly community is as valid as in the general population survey. However, it should be read out by the investigator rather than self-administered due to the high proportion of illiteracy among the Taiwanese elderly.

Aged↗
PubMed1999

Substance use disorders among adolescents in Taiwan: prevalence, sociodemographic correlates and psychiatric co-morbidity.

BACKGROUND: This paper reports prevalences, sociodemographic correlates and psychiatric co-morbidity of substance use disorders (SUDs) among adolescents in Taiwan. METHODS: A random sample of ninth grade students (N = 774) was selected from an urban, a suburban and a rural community. Two-stage case identification was employed with a brief screening tool and a modified Chinese version of the Kiddie-SADS conducted by child psychiatrists. RESULTS: The overall prevalence of any SUD was 11.0%, with nicotine (96.0%) as the most prevalent substance. The prevalences of SUDs were significantly higher in boys, rural community and classes with poor academic performance. Sixty-two per cent of all SUD cases suffered from other concurrent psychiatric disorders. The most common co-morbid conditions were conduct disorder, attention deficit hyperactivity disorder and mood disorders. CONCLUSIONS: High prevalences of SUDs were found among adolescent school children in Taiwan. Effects of urbanization, selective migration and the availability of substances are possible explanations for the urban-rural difference on the risk for SUDs. Psychiatric co-morbid conditions for SUD among adolescents in Taiwan were similar to those in Western societies.

Adolescent↗
PubMed1998

Schizophrenia: conceptual change in modern psychiatry.

Schizophrenia is perhaps the most devastating mental illness that psychiatrists must treat. Its chronic course with deteriorating consequences has been the focus of study throughout this century. This paper reviews the concept of schizophrenia, from fundamental Kraepelinian theory of 'dementia praecox' to biological correlates and explanation. Its causes, however, remain obscure and there were no appreciable changes in its treatment modality. A 'bio-psycho-social' model of care is emphasized, aiming at the prevention of deterioration of symptoms, functional impairment, disability and social handicap.

Humans↗
PubMed1998

[Group psychotherapeutic factors in a self-assertive group].

The technique of group psychotherapy has recently been introduced to the practice in self-assertiveness training group. This study aims to assess various group factors that are hypothesized to be effective in the group process in a self-assertive group. Subjects of the study were participants in a 13-member self-assertiveness training group, with 4 female nurses and 8 male employees and 1 male student. The average age of this group was 35.2 years. Assessment of the group was based on Yalom's concept of twelve therapeutic factors in the group process. The results showed that 'identification', 'The existential factor' and 'interpersonal learning-input' were the three most important factors demonstrated during the group process. There were no significant age and gender differences in the above 'identification' and 'existential' factors. However, different beneficial factors were found for each group: for subjects aged 40 and above and males, it was 'interpersonal learning-output'; while in those with aged under 40 and females, 'universality' was more important than 'interpersonal learning-input'. Comparison of therapeutic factors among different groups was attempted. The above results were found different from patient groups, or the groups of university students. The discrepancy is due to different composition and tasks of each group.

Adult↗
PubMed1997

Severe granulocytopenia secondary to chlorpromazine despite concurrent lithium treatment: a case report.

Severe chlorpromazine-induced granulocytopenia where the white-cell count decreases to below 1,000/mm3 rarely occurs and lithium is known to cause leucocytosis. The use of lithium in the prevention of granulocytopenia induced by drugs is still controversial. This report describes a patient with bipolar disorder suffering from severe granulocytopenia and severe respiratory infection after receiving chlorpromazine 50 to 150 mg per day along with long term lithium therapy. Bone-marrow aspiration and biopsy revealed inhibited maturation of myeloid series in the promyelocyte stage. The findings were consistent with a drug-induced effect. White-cell count return to normal after the discontinuation of chlorpromazine. It was proved in this case that combined lithium therapy had no effect in preventing agranulocytosis induced by chlorpromazine.

Aged↗
PubMed1993

Prevalence of attention deficit hyperactivity disorder in primary school children in Taiwan.

Chinese versions of Conners' Teacher's Rating Scale (CTRS) and the Werry-Weiss-Peters Activity Scale (WWPAS) were applied to 4,290 randomly selected primary school children in Kaohsiung. Using relative operational characteristic analysis to determine the best cut-off points, the validity of the WWPAS and CTRS for estimating the prevalence of attention deficit hyperactivity disorder (ADHD) was established. It was found that CTRS had satisfactory results, but the WWPAS did not have an optimal cut-off score. Using CTRS as a screening tool, the estimated overall prevalence rate of ADHD among Kaohsiung primary school children was found to be 9.9%, while the rate in boys (14.9%) was 3.3 times higher than in girls (4.5%). The assumption that hyperactivity is uncommon among Chinese children was proven to be unreliable.

Attention Deficit Disorder with Hyperactivity↗
PubMed1992

[Schizophrenia and factitious cheilitis: a case report].

Factitious Cheilitis is a rare skin disorder which has been seen in patients with emotional disturbances, particularly in cases with neurotic and personality disorders. However, there have been no reports of factitious cheilitis seen in cases of schizophrenia. This study reports on a case of schizophrenic disorder, where the patient was observed to develop factitious cheilitis whilst subject to unstable psychiatric conditions. The case reported here is of a 59 year-old female widow, who has experienced the delusion of being controlled, the delusion of being possessed. Been subject to auditory hallucination and vague somatic pain for eight years and had a very poor psychotropic drug compliance. Observation revealed frequent licking of the lips unrelated to drug-induced dyskinesia, but as a possibly linked response to hallucination whilst subject to an intense unstable emotional and painful state. Factitious cheilitis was proved with biopsy of the lips and pathological findings of acanthosis, hyperkeratosis and parakeratosis. After psychiatric and dermatologic care, her cheilitic condition improved. This study demonstrates that factitious cheilitis can be seen in a schizophrenic patient, specifically where hallucination and emotional instability coupled with long-term licking of the lips can result in factitious cheilitis. The relationship of skin disorder and psychiatric illness is discussed.

Cheilitis↗
PubMed1990

Internal consistency and factor structure of the Chinese Health Questionnaire.

The internal consistency and factor structure of the Chinese Health Questionnaire (CHQ) were investigated in 2 samples in Taiwan, one from 3 communities (n = 1023) and the other from consecutive attenders for health screening in a general hospital (n = 386). Cronbach's alpha coefficients were calculated to be 0.84 and 0.83 for the 12-item and 0.90 and 0.92 for the 30-item CHQ version. Four factors similarly extracted for the CHQ-30 in both samples include somatic symptoms, anxiety and worrying, social dysfunction, and depression and poor family relationship. The implications of these findings were discussed from a cross-cultural perspective.

Anxiety Disorders↗
PubMed1989

Validation of 30- and 12-item versions of the Chinese Health Questionnaire (CHQ) in patients admitted for general health screening.

A study of the validity of the 30- and 12-item versions of the Chinese Health Questionnaire (CHQ) was carried out with a consecutive sample of 386 patients admitted during one year to a medical centre in Taiwan for a 3-day comprehensive general health screening. The Chinese version of the Clinical Interview Schedule was used to derive a criterion measure of minor psychiatric morbidity. The areas under the Relative Operating Characteristic curves of both short versions of the CHQ were equivalent (area = 0.85, S.D. = 0.02). The sensitivities of the CHQ-30 and CHQ-12 were found to be 76 and 78% respectively, while the specificity of both was 77%. The estimated prevalence of minor psychiatric morbidity in the sample was 37% (95% confidence intervals 32-41%). In contrast, physicians diagnosed 11% of these patients as having psychiatric disorders, and their sensitivity was 29%. Taken altogether, the above findings suggest that the CHQ-12 is as effective as and is more efficient than the CHQ-30 in this context, and could be used by physicians in similar settings to improve their identification of minor psychiatric disorders in Chinese patients.

Anxiety Disorders↗