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Biomedical subjects

Y M Bai

Publications and source records attributed to Y M Bai.

16 recordsLinked to original sources

A comparative efficacy and safety study of long-acting risperidone injection and risperidone oral tablets among hospitalized patients: 12-week randomized, single-blind study.

OBJECTIVE: The superiority of risperidone long-acting injection (RLAI) over oral typical and atypical antipsychotics demonstrated in previous studies may be related to the improved drug compliance. The aim of the 12-week randomized, single-blind study was to test whether the superiority of RLAI remained among hospitalized patients that drug compliance could be optimally controlled. METHODS: Fifty hospitalized stable schizophrenic patients, who had maintained on oral risperidone for more than 3 months, were randomized to the RLAI and oral risperidone group. Finally 49 patients (98 %) completed the study, and no dose change of oral risperidone, or RLAI was noted among all patients. RESULTS: The RLAI group showed significantly increased positive score of Positive and Negative Syndrome Scale (PANSS) than the risperidone group (0.72 +/- 3.52 vs. -1.24 +/- 3.81, p = 0.022), but without significance difference for the PANSS total, negative and general psychopathology scores. The RLAI group also showed a significantly improved Udvalg for Kliniske Undersogelser (UKU) Scale (p = 0.037), social life domains of Short-Form Health Survey (SF-36) (p = 0.011), and reduced prolactin level (p = 0.001). CONCLUSION: The results indicated that with optimal controlling of drug compliance among hospitalized patients, RLAI showed no benefit of efficacy over oral risperidone, but with advantages of improved side-effect profiles, social life ratings, and reduced prolactin levels.

Administration, Oral↗

Therapeutic effect of pirenzepine for clozapine-induced hypersalivation: a randomized, double-blind, placebo-controlled, cross-over study.

The objective of this study was to investigate the efficacy of pirenzepine in the treatment of clozapine-induced hypersalivation. Pirenzepine is reported to counteract hypersalivation by its selective antagonistic activity on the M4-muscarinic receptor, which is stimulated by clozapine. Twenty patients with clozapine-induced hypersalivation underwent a random-order, double-blind, placebo-controlled, cross-over trial which lasted 8 weeks each for the pirenzepine and placebo investigations, with a 4-week washout period in between. The severity of hypersalivation was assessed using an objective measure: saliva production monitored through the diameter of wetted surface on tissue paper placed over the patient's pillow. Our study showed that pirenzepine had no significant therapeutic effect on hypersalivation compared with placebo, suggesting that hypersalivation induced by clozapine might have a neurobiological basis other than the M4-muscarinic receptor.

Adult↗

Emerging homosexual conduct during hospitalization among chronic schizophrenia patients.

OBJECTIVE: The study investigated the emerging homosexual conduct during hospitalization among chronic schizophrenia patients. METHOD: We interviewed 55 male and 58 female chronic schizophrenic patients to investigate their sexual history before and after admission. Those patients were under 45 years old, without significant deteriorated cognitive function, lived in a homogeneous gender chronic ward and did not demonstrate homosexual behaviour before admission. RESULTS: Nineteen patients (16.8%) reported having homosexual conducts during hospitalization. Their characteristics were: 1) having sexual experience before admission; 2) with younger age at first sexual experience; and 3) female patients having more sexual partners before admission. CONCLUSION: A significant proportion of patients need a sexual outlet during long-term hospitalization. Sexual education and counselling are greatly needed.

Adult↗

No evidence for association of alpha 1a adrenoceptor gene polymorphism and clozapine-induced urinary incontinence.

Clozapine is an effective atypical antipsychotic that has high affinity for many neurotransmitter receptors. Among the adverse effects of clozapine, urinary incontinence is commonly found and is suggested to be caused by alpha-adrenergic blockade. We tested the hypothesis that clozapine-induced urinary incontinence is related to a genetic variant of the alpha(1a)-adrenoceptor. We also tested whether the alpha(1a)-receptor gene confers susceptibility to schizophrenic disorders. Our result indicated that the alpha(1a)-adrenoceptor gene polymorphism investigated plays no major role in the pathogenesis of schizophrenia or in clozapine-induced urinary incontinence. Considering the superior effects of clozapine and its potent adrenergic antagonistic effects, it is of interest to investigate the association between this polymorphism and the treatment response.

Adult↗

A retrospective study of clozapine and urinary incontinence in Chinese in-patients.

OBJECTIVE: This study investigated the incidence of clozapine-associated urinary incontinence (UI) in schizophrenic patients, the percentage of these patients with persistent urinary incontinence (PUI), and the possible factors affecting the occurrence of UI. METHOD: A total of 61 Chinese in-patients with schizophrenia (according to DSM-IV) treated with clozapine for more than 3 months were assessed retrospectively for the occurrence of UI. Patients who still had UI at the time of assessment were classified as having PUI. Patients whose UI had resolved at the time of assessment were classified as having self-limited urinary incontinence (SUI). We compared the characteristics of UI and non-UI cases and of PUI and SUI cases. RESULTS: The results showed that urinary incontinence developed at some time in 27 of 61 patients (44.3%), and that it was persistent in 15 of 61 patients (25%). There were no statistically significant differences in age, sex, clozapine dose, duration of clozapine use, duration of index admission, duration of illness, age at onset of schizophrenia, or concurrent treatment with other psychiatric medications between the UI and non-UI groups and between the PUI and SUI groups. CONCLUSION: Clozapine-associated urinary incontinence may be persistent in some patients, and it should be cautiously monitored in every patient taking clozapine.

Adult↗

Apolipoprotein E genotype and schizophrenia.

Schizophrenic disorders are complex genetic disorders and may involve multiple genes of small effect. The presence of apolipoprotein E (apoE) is associated with several neuropsychiatric disorders. Previous studies on apoE genotype distribution in schizophrenia have reported conflicting findings. We studied the genotype frequencies in a large group of schizophrenic patients. The genotype distribution was significantly different between the schizophrenic patients and the control subjects. Persons who were sigma3 carriers have an increased risk of schizophrenia. This result suggests that apoE isoforms may play a functional role in the pathogenesis of schizophrenic disorders. Some possible mechanisms regarding the effect of apoE on the development of schizophrenia are discussed.

Aging↗

Alpha-1-antichymotrypsin polymorphism in schizophrenia: frequency, age at onset and cognitive function.

A common polymorphism in the alpha1-antichymotrypsin (ACT) gene is associated with Alzheimer's disease. ACT is also a trophic factor in the hippocampal neurons. In order to examine if the ACT gene plays a role in the pathogenesis of schizophrenic disorders, patients (n = 175) and control subjects (n = 114) were genotyped for ACT. We also investigated the relationship between genotypes and patients' cognitive function as evaluated by the Clinical Dementia Rating Scale and the Mini-Mental State Examination. The results demonstrated no association between schizophrenia and/or cognitive deficit in schizophrenia and ACT polymorphism. The data suggest that the ACT gene is not of major importance for the genesis of schizophrenia. Further studies measuring ACT expression as messenger RNA or serum ACT level may help to exclude the role of ACT in the pathogenesis of schizophrenia.

Adult↗

Substance use disorders among inpatients with bipolar disorder and major depressive disorder in a general hospital.

The prevalence and type of substance abuse and dependence were determined for 49 patients with mood disorders on a general hospital psychiatric unit. A standardized diagnostic interview was conducted with a high value of inter-rater reliability. This study found that 18.4% of mood disorder inpatients met the diagnostic criteria for psychoactive substance use disorders by DSM-III-R. Sedatives-hypnotics-anxiolytics was the most common substance use disorder (10.2%), followed by alcohol (6.1%). Patients with major depression had a higher rate of comorbidity with substance use disorders than did the bipolar disorder patients (p = 0.011). The prevalence of sedatives-hypnotics-anxiolytics use disorder among major depression patients was 35.7%, which was higher than that among bipolar disorder patients (0%). Male patients had a significantly higher percentage of substance use disorders than did female patients (p = 0.054). Seventy-seven percent of the patients with a dual diagnosis of mood and substance use disorder were not diagnosed as having substance use disorders by psychiatrists in charge.

Adolescent↗

Risk factors for substance use disorders among inpatients with major affective disorders in Taiwan Chinese.

An assessment of potential risk factors for substance use disorders was performed in 49 patients with major affective disorders in a general hospital acute care unit in Taiwan. The major depression patients were noted to have a higher prevalence of substance use disorder than bipolar disorder patients (p = 0.011). Those patients with substance use disorders were noted to be significantly male-predominated (p = 0.043), to have a later onset age of affective disorder (p = 0.009), and to have more visits to the emergency room in the recent one year (p = 0.009). The sedatives-hypnotics-anxiolytics was the most frequently used forms of drug abuse. The major depression patients had a significantly higher sedative-hypnotics-anxiolytics use disorder rate than the bipolar disorder patients (p = 0.001). All patients with alcohol use disorder were noted to have other substance use disorders as well. Fifty six percent of those patients with substance use disorder were polysubstance users. Eighty three percent of the male patients with substance use disorder had poly-substance use disorder.

Adolescent↗

Risk factors for parasuicide among psychiatric inpatients.

To improve suicide prevention during hospitalization, this study examined risk factors for parasuicide among psychiatric inpatients. A group of 58 psychiatric inpatients (19 with schizophrenia, 20 with depression, and 19 with other diagnoses) who displayed suicidal behavior during hospitalization were compared with two control groups of nonparasuicidal inpatients. For inpatients with schizophrenia, a history of parasuicide was a risk factor; for those with depression, it was suicidal behavior on admission; and for patients with other diagnoses, it was violence during hospitalization.

Adolescent↗

Suicide and parasuicide in psychiatric inpatients: ten years experience at a general hospital in Taiwan.

We investigated 64 suicidal acts of 62 psychiatric inpatients over a 10-yr. period. The findings indicated the frequency of suicidal behavior of psychiatric inpatients was 0.91% of total admissions, two thirds of the patients who attempted suicide were diagnosed with schizophrenia or depression, and patients suffering from depression, substance abuse, and personality disorders had a higher parasuicide rate, among whom those diagnosed bipolar disorder with depressive episode had an extremely high parasuicide rate. Most of the incidents occurred in concealed places, and most of the patients used nonviolent methods. About half of the incidents occurred during the evening shift and depressed patients tended to attempt suicide during the night shift. Most suicidal attempts were unsuccessful and led to minor injury. There were two deaths.

Adult↗