Kao Ching Chen

The risk factors of Internet addiction—A survey of university freshmen

This study was designed to explore the risk factors of Internet addiction in 1360 freshmen of the National Cheng Kung University in Taiwan in 2003. The test battery included a self-administrated structured questionnaire, the Chinese Internet Addiction Scale-Revision (CIAS-R), the 12-item Chinese Health Questionnaire (CHQ-12), the Measurement of Support Functions (MSF), and the neuroticism subscale of the Maudsley Personality Inventory (MPI). Of the total study population, there were 680 college freshmen (17.9%) in the Internet addiction group, as defined by high CIAS-R scores. Using logistic regression analyses, we found positive relationships between Internet addiction and male gender, neuroticism scores and the CHQ score. In addition, the freshmen who skipped breakfast and those who had poorer social support also had a higher probability of Internet addiction. Internet addiction is prevalent among university freshmen in Taiwan. Risk factors included male gender, habit of skipping breakfast, mental health morbidity, deficient social support; and neurotic personality characteristics.

Association between serotonin transporter availability and hostility scores in healthy volunteers—A single photon emission computed tomography study with [123I] ADAM

The present study examined the relationship between serotonin transporter (SERT) availability and hostility scores in healthy volunteers. SERT availability was measured by using SPECT with [(123)I] ADAM in 10 healthy participants. Hostility was measured with the Cook-Medley Hostility Scale. Hostile attribution, but not the other subscales of hostility, was negatively correlated with SERT availability. Central serotoninergic activities may play a role in hostility.

The relationships between daily life events and the availabilities of serotonin transporters and dopamine transporters in healthy volunteers-A dual-isotope SPECT study

The aim of this study was to examine the relationships between the daily life events and the availabilities of serotonin transporters (SERT) and dopamine transporters (DAT) in healthy volunteers. Thirty-seven volunteers, 19 males and 18 females, were recruited. The SERT availability was approximated using SPECT and [123I] ADAM while the DAT availability was approximated using SPECT and [99mTc] TRODAT-1. All participants completed the Recent Life Change Questionnaire. The results showed that SERT and DAT may be sensitive to the presence of stressful events.

The relationship among insight, cognitive function of patients with schizophrenia and their relatives’ perception

Abstract  Medically, insight is a multidimensional concept. Results of previous studies are inconclusive regarding the relationship between insight and global and cognitive functions. The aim of this study was to evaluate the relationship among insight, patients’ global function, cognitive function of patients with schizophrenia and their key caregivers’ perception about this disorder. Thirty‐one patients with schizophrenia were recruited. Cognitive function such as memory index proved to be a significant predictor for patients’ insight; environmental factors such as caregivers’ perception was not. In addition to cognitive deficit, whether the other factors such as genetic variability, medication use, environmental factors, and illness severity, etc., could influence insight of patients will still be a controversial issue. Further multidimensional survey of the relationship with insight in a larger and comprehensive design is necessary.

Association between serotonin transporter availability and overall rating scores of quality of life in healthy volunteers.

Depression and impaired quality of life (QOL) are frequently observed in patients suffering from a variety of diseases. In addition, it has been reported that an enhanced degradation of the serotonin precursor tryptophan may contribute to QOL deterioration in some diseases. However, it is unclear whether the correlation between the QOL scores and the central serotonergic tone is only mediated by the severity of either the depression symptoms or the physical illness itself. The present study examined the relationship between serotonin transporter (SERT) availability and life quality as measured by the World Health Organization Quality of Life brief version questionnaire (WHO-QOL) in healthy participants in order to exclude the influence of depressive mood and disease. The SERT availability in the midbrain was approximated using SPECT with [(123)I] ADAM ligand in fifty-eight healthy volunteers. The overall rating sub scores of the WHO-QOL correlated positively with serotonin transporter availability in the males. Central serotoninergic activity may play a role in the overall rating scores of the WHO-QOL.

The association between the harm avoidance subscale of the Tridimensional Personality Questionnaire and serotonin transporter availability in the brainstem of male volunteers.

The relationship between harm avoidance scores of the Tridimensional Personality Questionnaire and serotonin transporter availability, as approximated using single photon emission computed tomography with [(123)I] ADAM, was examined. Our results showed a significant negative correlation between the harm avoidance total score, as well as the asthenia subscore, and serotonin transporter availability, particularly in males.

Association of novelty seeking scores and striatal dopamine D2/D3 receptor availability of healthy volunteers: Single photon emission computed tomography with 123I-iodobenzamide

It has been speculated that novelty seeking (NS) behavior is related to the dopaminergic system. Fifty-two subjects completed the Tridimensional Personality Questionnaire and underwent single photon emission computed tomography with (123)I-iodobenzamide. A marginally positive correlation was noted between NS and striatal dopamine D(2)/D(3) receptor availability (r = 0.25, p =0.07). A positive association was noted between the NS scores and left striatal D(2)/D(3) receptor availability (r= 0.29, p =0.04). The results suggest that a relationship might exist between NS score and dopaminergic activity.

Two case studies of hypothermia induced by an increased dosage of zotepine in a combination therapy

Abstract The purpose of the present paper was to remind physicians that hypothermia is a possible side‐effect of combining zotepine, valproate,and benzodiazepine. Two cases of hypothermia occurred after combining the use of zotepine, valproate, and benzodiazepine. The valproate was under therapeutic blood level when zotepine dosage was raised to 200 mg/day, and hypothermia occurred. The dosage of zotepine might constitute a positive correlation with hypothermia. The combination of zotepine, valproate or benzodiazepine may cause hypothermia as a side‐effect.

Screening for bipolar disorder in medicated patients treated for unipolar depression in a psychiatric outpatient clinic using the Mood Disorder Questionnaire

Objective. The aim of this study was to examine the rate of the misdiagnosis of bipolar disorder in outpatients who had been treated for unipolar depression with antidepressants in Taiwan and to verify the validity of the Mood Disorder Questionnaire (MDQ) in this population. Method. Fifty-three outpatients who had been treated for unipolar depression were recruited. All patients completed the MDQ and were administered the Structured Clinical Interview. The sensitivity and specificity were calculated for each possible MDQ symptom cut-off score relative to a Structured Clinical Interview diagnosis of bipolar spectrum disorder. Results. A total of 11.3% were diagnosed with bipolar spectrum disorder. The optimal model we found contained only the first portion of the MDQ with a cut-off score of 2. This model provided both good sensitivity (0.83) and specificity (0.53). Conclusion. The misdiagnosis of bipolar disorder as unipolar depression disorder is prevalent. Based on the results of the current study, the probability of bipolar disorder in depression outpatients who are in a mildly depressed state and score higher than 2 points in the first portion of the MDQ deserves to be investigated.

The reliability and validity of the Chinese version of the Modified Overt Aggression Scale

Objective. Instruments to assess aggressive behaviors in the psychiatric ward are crucial for monitoring risky behaviors. The purpose of this study was to assess the validity and reliability of the Chinese version of the Modified Overt Aggression Scale (MOAS). Methods. We translated the English version of MOAS into Chinese. We interviewed and trained two volunteers to act as agitated patients in the seclusion room. One senior psychiatrist, experienced in using the MOAS, directed scenarios of different aggressive intensity and established the standard scores. The validity was assessed by comparing the other raters’ scores with those of the directors. Inter-rater reliability was also assessed. Results. Inter-rater reliability, based on Intra-class correlation coefficient (ICC=0.94, P<0.001) and Kendalls W coefficient of concordance (W=0.83, P= 0.001), was high. The validity was assessed by the Mann–Whitney test. The results showed that the raters adequately differentiated (z=− 2.89, P= 0.002) between the above-average and below-average scores of the MOAS. Conclusion. The Chinese version of the MOAS has modest psychometric properties. The model, which used trained volunteers acting as patients and compared their scores with those of the director, may be used in further studies for developing psychometric instruments to assess abrupt behaviors.