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Featured researches published by Jj Lin.


Psychological Medicine | 2015

Delusional disorder and schizophrenia: a comparison of the neurocognitive and clinical characteristics in first-episode patients

Christy L.M. Hui; Edwin Ho Ming Lee; Wc Chang; Sherry Kit Wa Chan; Jj Lin; Jq Xu; Eric Y.H. Chen

BACKGROUND Delusional disorder (DD) is thought to be distinct from schizophrenia (SZ). However, few systematic investigations have been conducted on DD because of the difficulty in ascertaining a representative sample size. Existing knowledge has been mostly generated from inpatient cohorts, which may be biased towards a more severe sample. METHOD We compared the demographic, clinical and cognitive differences between 71 patients with first-episode DD and 71 age-matched patients with first-episode SZ. Participants were consecutively recruited from a population-based territory-wide study of early psychosis in Hong Kong targeting first-episode psychosis. Basic demographic information, premorbid functioning, duration of untreated psychosis, pathways to care, symptomatology, social, occupational, and cognitive functioning were comprehensively assessed using standardized measurements. RESULTS Patients with DD had less premorbid schizoid and schizotypal traits compared to patients with SZ. More patients with DD were married compared to patients with SZ. However, at first episode, there were no significant differences between the two groups in regards to the duration of untreated psychosis, pathways to care, symptom severity, neurocognitive performance, treatment, and functioning. CONCLUSIONS Our findings challenge previous thinking that patients with DD had better functioning than patients with SZ. This study not only provides an updated perspective into conceptualizing the clinical differences between DD and SZ, but also expands the descriptive account of the two disorders to include the neurocognitive dimension.


Schizophrenia Bulletin | 2011

The impacts of yoga and exercise on neuro-cognitive function and symptoms in early psychosis

Jj Lin; Mml Lam; Cpy Chiu; Michael Tse; Pl Khong; Cecilia L. W. Chan; Kf So; Skw Chan; Wc Chang; E. Y. H. Chen

Background: The large variation in individual clinical responses to antipsychotic treatment hampers the management of psychotic disorders. Genetic factors are considered a main cause of this variation. Pharmacogenetics studies have demonstrated significant associations between several candidate genes (a.o. D2, D3, 5HTR2A and 5HTR2C, GRM3, COMT and MTHFR) and the response to antipsychotic drugs. The present study investigates the effect of 12 polymorphisms for an association with antipsychotic treatment response in patients with a psychotic disorder. Methods: 335 Caucasian patients with a non-affective psychotic disorder using antipsychotics were included. All patients participated in the longitudinal GROUP-study in The Netherlands. We genotyped 12 SNPs in 7 candidate genes (DRD2: TaqI-A, TaqI-D, -141-C, C957T; DRD3: Ser9Gly; HTR2A: 102-T/C, His452Tyr; HTR2C: Cys23Ser, -759-T/C; COMT: Val108/158Met; MTHFR: 677-C/T, GRM3: rs274622) using standard protocols. Polymorphisms were based on previous studies showing associations with treatment response. The Clinical Global Impression- Schizophrenia scale was cross-sectionally used to assess improvement in positive psychotic symptoms since the start of current antipsychotic treatment. Ordinal regression was used to test for an association between polymorphisms and improvement in positive symptoms. All polymorphisms were tested in an additive model, with minor allele dose as the dependent variable. Results: Ninety percent of the patients used atypical antipsychotics, with olanzapine (31%) and risperidone (29%) being the most prescribed drugs. Ser9Gly of the dopamine D3 receptor gene (P value .029) and 677-C/T of MTHFR (P value .029) were tested significant. Gly carriers and T-carriers, respectively, showed better clinical improvement on the positive scale. All other polymorphisms did not show any association with treatment response (all P values >.10). Conclusion: We were able to replicate only two of the previously reported associations between polymorphisms and treatment response. Heterogeneity in patient samples and outcome variables as well as publication bias and false positive findings may all play a role in lack of replication, found in our study, as in others. The direction of the associations presented here in D3 (Ser9Gly) and MTHFR (677-C/T) are in line with previous association studies in Caucasian patients. These polymorphisms may be of value for predicting clinical response.


European Psychiatry | 2015

The Impacts of Yoga On Cortical Thickness, Neural Connectivity and Cognitive Function in Early Psychosis: Preliminary Results From a Randomized Controlled Clinical Trial

Jj Lin; X. Geng; Wayne Su; K.W. Chan; Ehm Lee; Wc Chang; William G. Honer; E. Y. H. Chen

Background Impairments of attention and memory are evident in early psychosis, and often lead to severe, longstanding functional disability. Effective non-pharmacological interventions are needed due to the unsuccessful results of pharmacological interventions. Aims To determine whether yoga is effective for cognitive impairments, and the neural mechanism underlying these effects. Methods It was a randomized controlled study of 12-week of yoga and aerobic exercise (walking and cycling) intervention vs wait-list control for female early psychotic patients. Memory was measured with Hong Kong List Learning Test and Digit Span test, and attention was measured with Letter Cancellation test. Cognitive data analysis was based on the Intention-to-Treat method using a mixed-model analysis. Seed based functional connectivity was applied using posterior cingulate cortex (PCC) as seed with AFNI. Cortical thickness analyses were performed using FreeSurfer. Results from yoga and control groups were presented. Results A total of 140 women were recruited and randomized into three groups. 95 completed the study, and 115 were included for cognitive data analysis. For imaging data, 42 participants were used for cortical thickness analyses; and 60 were included for neural connectivity analyses. Yoga group demonstrated significant improvements in working memory, verbal acquisition and attention (P=.01). Cortical thickness increased in the postcentral gyrus (P Conclusions Yoga has been found to be effective for memory and attention in early psychotic patients. The increases of thickness and neural connectivity indicate the possible neural mechanisms underlying the improvements of cognition.


Archive | 2016

Prevalence of psychiatric comorbidity and its associations with clinical, cognitive and functional variables in individuals with at-risk mental state for psychosis in Hong Kong

Vhc Lee; Wc Chang; Ssi Chan; Ss Chiu; Hme Lee; Skw Chan; Clm Hui; Jj Lin; Eyh Chen

IEPA 10th International Conference on Early Intervention in Mental Health – “Looking Back, Moving Forward” Milan, Italy, 20th – 22nd October 2016


Archive | 2016

Differential relationships of amotivation and diminished expression with clinical and cognitive variables in individuals with at-risk mental state for psychosis in Hong Kong

Ssi Chan; Wc Chang; Vhc Lee; Ss Chiu; Hme Lee; Skw Chan; Clm Hui; Jj Lin; Eyh Chen

IEPA 10th International Conference on Early Intervention in Mental Health – “Looking Back, Moving Forward” Milan, Italy, 20th – 22nd October 2016


Archive | 2016

Ten-year population-based retrospective study of psychiatric admission trend of mental disorders in Hong Kong

Hme Lee; Clm Hui; Jj Lin; Wc Chang; Skw Chan; Eyh Chen

IEPA 10th International Conference on Early Intervention in Mental Health – “Looking Back, Moving Forward” Milan, Italy, 20th – 22nd October 2016


Schizophrenia Bulletin | 2015

Aerobic exercise and yoga hold promises for improving neurocognition and symptom in early psychosis

Jj Lin; Ehm Lee; Wc Chang; Skw Chan; Michael Tse; Pl Phong; Clw Chan; William G. Honer; Eyh Chen

Background: Cardiovascular and metabolic problems combined with a bad lifestyle are a major cause of a shortened life expectancy in chronic psychotic disorders. While the incidence of cannabis use is twice as high in psychosis compared to the general population, use of cannabis has been associated with better outcomes on cardiometabolic risk factors. This study investigates whether this effect is mediated by the AKT1 gene, as activation of the related enzyme by cannabis may cause changes in metabolism. Methods: Patients with a recent onset psychosis (n=623) were included from a cohort study (GROUP). Cannabis use, based on self-report and urine screening, was related to Body Mass index (BMI). Next the mediating effects of six AKT1 polymorphisms (rs1130214, rs1130233, rs2494732, rs2498784, rs3730358 and rs3803300) were investigated. Results: There was a strong, negative association between BMI and cannabis use. Moreover, two SNPs (rs1130233 and rs2494732) showed an association with cannabis use, but did not mediate the effect of cannabis on BMI. Conclusion: In conclusion, cannabis use results in a lower body weight in patients with a psychosis. While AKT1 is related to cannabis use, it does not affect body mass via AKT1. Instead, AKT1 risk alleles may increase the incidence of cannabis use. Future studies may investigate whether other genes mediate the effect between cannabis and metabolic risk factors.


European Psychiatry | 2015

Exercise intervention and the sleep quality in relation with the procedural learning in psychosis

L.H.L. Lo; Jj Lin; Hm Lee; Wc Chang; K.W. Chan; L.M. Hui; Yh Chen

Sleep quality in psychosis has been reported to have abnormalities in terms of sleep efficiency, initiation, maintenance and total sleep time (Bromundt et al., 2011; Wulff et al., 2012; Wilson & Argyropoulos, 2012). Some have even argued that such sleep abnormalities may have caused a few cognitive symptoms in psychosis (e.g., Wamsley et al., 2011). In recent years, physical exercise has been reported to have significant effects in reducing cognitive symptoms in patients with psychosis. However, there is no up-to-date study that has investigated the correlation between physical exercise, sleep quality and the cognitive function of patients with psychosis. The aim of this study is to promote a 12-week physical exercise intervention to the psychotic population, and investigate whether the intervention can improve the sleeping quality as well as procedural memory performance. A randomised control trial has been carried out for this study. Patients with psychosis were recruited and randomly assigned to either a 12-week physical exercise intervention or a 12-week Carrom control intervention. Sleep quality (i.e., Insomnia Sleep Index; Bastien et al., 2001, Pittsburgh Sleep Quality Index; Buysee et al., 1988), cognitive function and clinical scale will be assessed before and after the 12-week intervention.


European Psychiatry | 2015

A Pilot Study of Mindfulness-based Intervention for the Depressive Symptoms of Early Psychosis

Jj Lin; C.Y. Tong; Ehm Lee; V.Y.K. Cheung; Clm Hui; Wc Chang; K.W. Chan; C.H.E.N. Eyh

Background The present pilot study aimed to evaluate the effectiveness of a 7-week mindfulness-based intervention program (MBI-p), as a part of a RCT of larger scale. The MBI-p was developed by the Early Psychosis Studies and Intervention (EPSI) team in Hong Kong designated for patients with early psychotic disorders. In particular, the objective was to investigate the effects of MBI-p on depressive and anxiety symptoms associated with psychosis. Methods An uncontrolled design was used. Nine participants with psychotic disorders received MBI-p were assessed at baseline and post-treatment on outcomes of symptom severity (Positive and Negative Syndrome Scale, PANSS), depression and anxiety (Calgary Depression Scale, CDS, and Depression Anxiety Stress Scale-21, DASS), and mindfulness skills (Five Facet Mindfulness Questionnaire, FFMQ). Results Significant improvements were found on the PANSS total score (P Conclusion These pilot results indicated initial effectiveness of a group intervention based on mindfulness principles for patients with early psychosis. Significance in various measures despite small sample revealed a potentially robust effect of improving patients’ mood condition. It provides the foundation for future studies of larger scale and implementation of a promising and cost-efficient treatment option.


Archive | 2014

Community exercise program (FitMind) for patients with psychosis

Ehm Lee; Clm Hui; Wc Chang; Skw Chan; Jj Lin; Mjq Xu; Ld de Sousa; Eyh Chen

Cannabis use has been associated with the onset, course and relapse of psychosis. Population studies and data from samples of young people at high risk for psychosis have indicated that cannabis use may be related to the onset of psychosis. Cannabis use has also been found to have a deleterious impact on psychotic symptom severity and has emerged as the strong predictor of psychotic relapse. To date, there has been little collaboration between neuroscience and clinical research groups examining the link between cannabis use and psychosis, despite the potential for these fi elds to inform the other. This symposium seeks to begin to redress this gap.

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Wc Chang

University of Hong Kong

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Eyh Chen

University of Georgia

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Clm Hui

University of Hong Kong

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Ehm Lee

University of Hong Kong

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Skw Chan

University of Hong Kong

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Kannie W.Y. Chan

Johns Hopkins University School of Medicine

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Cpy Chiu

University of Hong Kong

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William G. Honer

University of British Columbia

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