Yen Kuang Yang

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.

PSYCHIATRIC MORBIDITY AND POST-TRAUMATIC SYMPTOMS AMONG SURVIVORS IN THE EARLY STAGE FOLLOWING THE 1999 EARTHQUAKE IN TAIWAN

This study reports the clinical psychiatric presentations and post-traumatic symptoms among 525 survivors at Yu-Chyr District in Nantou County who sought psychiatric service in the first month following the devastating earthquake that struck the central area of Taiwan. All subjects received psychiatric interviews and assessments using the 12-item Chinese Health Questionnaire (CHQ-12) and a checklist for post-traumatic symptoms. The most common psychiatric symptoms reported were insomnia, palpitations, nervousness, and dizziness with headache. Eleven percent of the subjects reported having thought of death or having suicidal ideation. The mean score on the CHQ-12 was 6.43 (S.D.=2.89). The rate of probable psychiatric morbidity as defined by a CHQ-12 score > or =3 was 89.9%. Post-traumatic symptoms were very prevalent, particularly symptoms of re-experiencing the earthquake and hyper-arousal. Factors significantly associated with high psychiatric morbidity were being female, serious destruction of property and house, and personality characteristics of nervousness and obsessiveness. Findings of this study suggest that early psychiatric intervention, including pharmacological treatment for acute stress disorder, is indicated during the early stages following a disastrous earthquake.

Psychiatric morbidity and posttraumatic symptoms among earthquake victims in primary care clinics

Three months after the devastating Chi-Chi earthquake (magnitude of 7.3 on the Richter scale) struck the central area of Taiwan, 663 victims were screened for psychiatric morbidity at a local general hospital in a community mental health program. The rate of psychiatric morbidity as defined by the 12-item Chinese Health Questionnaire as greater than 4, was 24.5%. Posttraumatic symptoms were still prevalent. The rate of posttraumatic stress disorder was 11.3%, and the rate of partial PTSD was 32.0%. Variables associated with the presence of psychiatric morbidity and posttraumatic symptoms included female gender, old age, financial loss, obsessive trait, and nervous trait. A disproportionate use of mental health services (18%) was found, suggesting an urgent need to deliver mental health care to disaster victims at local medical settings. In addition, health care professionals who work with the earthquake victims need to be promptly and efficiently trained in mental health crisis intervention.

A study on the sleep quality of incoming university students.

This study was designed to examine the prevalence and the risk factors of poor sleep quality in 4318 incoming university students in Taiwan. The test battery comprised a self-administered structured questionnaire, including items related to personal medical history and lifestyle habits, the Measurement of Support Functions (MSF), Pittsburgh Sleep Quality Index (PSQI), Chinese Internet Addiction Scale-Revision (CIAS-R), neuroticism subscale of the Maudsley Personality Inventory (MPI), and the 12-item Chinese Health Questionnaire (CHQ-12). Of the total study population, 2360 students (54.7%) were classified into the poor sleep quality group, as defined by a PSQI score ≥6. Based on the results of multivariate logistic regression analysis, poor sleep quality was significantly associated with undergraduate students, female gender, skipping breakfast, tea drinking, a higher tendency toward internet addition, poor social support, higher neuroticism, and higher CHQ scores. Poor sleep quality is prevalent among incoming university students in Taiwan, and more work is needed on the identification of the factors influencing poor sleep, and in providing systematic education in the importance of sleep and time management skills to university students.

Neuropsychological functions in patients with bipolar I and bipolar II disorder

UNLABELLED The literature reports persistent cognitive impairments in patients with bipolar disorder even after prolonged remission. However, a majority of studies have focused only on bipolar I disorder (BP-I), primarily because bipolar II disorder (BP-II) is often underdiagnosed or misdiagnosed. More attention should be paid to the differences between BP-I and BP-II, especially the aspects of neuropsychological functioning. We examined the different neuropsychological functions in BP-I and BP-II patients and compared them with those of healthy controls. METHODS The study included 67 patients with interepisode bipolar disorder (BP-I: n = 30; BP-II: n = 37) and 22 healthy controls compared using a battery of neuropsychological tests that assessed memory, psychomotor speed, and certain aspects of frontal executive function. RESULTS The BP-I group performed poorly on verbal memory, psychomotor speed, and executive function compared to the BP-II and control groups. Both bipolar groups performed significantly less well than the control group on measures of working memory and psychomotor speed, while the BP-II group showed an intermediate level of performance in psychomotor speed compared to the BP-I and control groups. There was no difference between the groups on visual memory. CONCLUSIONS BP-I was characterized by reduced performance in verbal memory, working memory, psychomotor speed, and executive function, while BP-II patients showed a reduction only in working memory and psychomotor speed. Cognitive impairment existed in both subtypes of bipolar disorder, and was greater in BP-I patients. Rehabilitation interventions should take into account potential cognitive differences between these bipolar subtypes.

Correlation between body mass index and striatal dopamine transporter availability in healthy volunteers--a SPECT study.

Recent lines of research suggest that, in addition to hypothalamic sites, the striatum dopaminergic system may be a target for regulating homeostasis that may be represented by the body mass index (BMI). Although it has been reported that the striatal dopamine receptor (DRD2) availability of very obese individuals was reduced in proportion to their BMI, the correlation between the striatal dopamine system and the BMI in healthy individuals remains unclear. To investigate this relationship, the striatal dopamine transporter (DAT) availability of 50 healthy volunteers was measured using single position emission computational topography (SPECT) and [99mTc]-TRODAT-1. The serum levels of sugar, C-peptide, insulin, glycosylated hemoglobin and leptin were measured. Our results showed that age and the BMI are significantly negatively associated with the striatal DAT availability. Moreover, BMI was the only significant predictor for striatal DAT availability. These results suggest that the striatal dopamine system may be involved in body mass index regulation. Thus, molecular imaging studies measuring the striatal DAT availability should consider the BMI, rather than age, as a covariant.

Decreased dopamine transporter availability in male smokers — A dual isotope SPECT study

INTRODUCTION Although the mesolimbic dopaminergic system has been shown to play a role in reinforcing tobacco smoking, results of imaging studies that examine the relationship between tobacco smoking and the central dopamine system remain discrepant. To delineate the role of tobacco addiction in central pre- and post-synaptic dopaminergic activities, we analyzed the central D2-family receptors, the dopamine transporters (DAT), and degrees of dependence in male smokers. METHODS Eleven male smokers and 11 healthy non-smokers were recruited. The striatal dopamine D2/D3 receptor availability was approximated using SPECT and [123 I] IBZM while the DAT availability was approximated using SPECT and [99m Tc] TRODAT-1. All of the smokers completed the Fagerström Test for Nicotine Dependence (FTND) and other related questionnaires. RESULTS A decrease in DAT availability in the striatum of male smokers is noted (p<05). However, the striatal D2/D3 receptor availability in male smokers does not differ from that of non-smokers. CONCLUSIONS These findings suggest that cigarette smoking may alter central dopamine functions in males, particularly at the pre-synaptic sites.

Greater availability of dopamine transporters in patients with major depression — A dual-isotope SPECT study

In order to explore the neuropathology of the pre- and post-synaptic dopamine neurons of patients with major depression, we examined striatal D(2)/D(3) receptor uptake and dopamine transporter (DAT) availability simultaneously in drug-free depressed patients using a dual-isotope single photon emission computed tomography (SPECT) imaging technique. Ten unmedicated patients with unmediated depression and ten healthy controls were recruited. The striatal dopamine D(2)/D(3) receptor availability was measured using SPECT and [(123)I] IBZM, while DAT was measured using SPECT and [(99m)Tc] TRODAT-1. The symptom changes of the drug-free patients were reassessed after a 4-week antidepressant treatment. DAT binding in the patient group were significantly higher than in control group. That was not the case, however, for striatal D(2)/D(3) receptor availability. Pre-treatment striatal DAT availability correlated only marginally with changes in the Hamilton Depression Rating Scale after 4 weeks of treatment. Central dopamine functions may be altered in patients with major depression, particularly in the pre-synaptic sites.

Interaction of serotonin-related genes affects short-term antidepressant response in major depressive disorder

BACKGROUND Four serotonin-related genes including guanine nucleotide binding protein beta polypeptide 3 (GNB3), 5-hydroxytryptamine receptor 1A (HTR1A; serotonin receptor 1A), 5-hydroxytryptamine receptor 2A (HTR2A; serotonin receptor 2A), and solute carrier family 6 member 4 (SLC6A4; serotonin neurotransmitter transporter) have been suggested to be candidate genes for influencing antidepressant treatment outcome. The aim of this study was to explore whether interaction among these genes could contribute to the pharmacogenomics of short-term antidepressant response in a Taiwanese population with major depressive disorder (MDD). METHODS Included in this study were 101 MDD patients who were treated with antidepressants, 35 of whom were rapid responders and 66 non-responders after 2weeks of treatment. We genotyped four single nucleotide polymorphisms (SNPs), including GNB3 rs5443 (C825T), HTR1A rs6295 (C-1019G), HTR2A rs6311 (T102C), and SLC6A4 rs25533, and employed the generalized multifactor dimensionality reduction (GMDR) method to investigate gene-gene interactions. RESULTS Single-locus analyses showed the GNB3 rs5443 polymorphism to be associated with short-term antidepressant treatment outcome (P-value=0.029). We did not correct for multiple testing in these multiple exploratory analyses. Finally, the GMDR approach identified a significant gene-gene interaction (P-value=0.025) involving GNB3 and HTR2A, as well as a significant 3-locus model (P-value=0.015) among GNB3, HTR2A, and SLC6A4. CONCLUSIONS These results support the hypothesis that GNB3, HTR2A, and SLC6A4 may play a role in the outcome of short-term antidepressant treatment for MDD in an interactive manner. Future research with independent replication using large sample sizes is needed to confirm the functions of the candidate genes identified in this study as being involved in short-term antidepressant treatment response.

Correlation between fine motor activity and striatal dopamine D2 receptor density in patients with schizophrenia and healthy controls.

Striatal dopamine D2 receptor density is an important indicator of many neuropsychiatric disorders and also of motor activity. This study examined the relationship between a fine motor task (finger tapping test, FTT) and striatal D2 dopamine receptor density by examining 20 healthy volunteers and 20 schizophrenic patients. Striatal D2 receptor density was determined with single photon emission computed tomography using [123I]IBZM (iodo-benzamide). The correlation between the FTT score and striatal D2 receptor density was statistically significant not only in the patient group but also in healthy controls. The FTT scores and striatal D2 receptor density were lower in medicated patients than that in healthy controls. Compared with the Simpson-Angus Scale scores, the FTT scores were more strongly associated with striatal D2 receptor density. The use of neuroleptic medication seemed to influence the associations between FTT scores and striatal D2 receptor density in the patient group. The FTT scores and striatal D2 receptor density were age-sensitive in healthy controls. FTT may be a more sensitive tool for detecting neuroleptic-induced motor impairment in patients with schizophrenia. The sensitivity of the FTT to age and neuroleptic effects may be explained in part by a decline in dopamine D2 density.