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   Table of Contents - Current issue
October-December 2022
Volume 36 | Issue 4
Page Nos. 145-191

Online since Tuesday, December 27, 2022

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Enhancing efficacy and acceptance of cognitive behavioral therapy through understanding its neuroscience Highly accessed article p. 145
Susmita Halder, Akash Kumar Mahato
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Development of monoclonal antibody therapeutics for alzheimer's disease p. 148
Masatoshi Takeda
Background: In a previous review article in the Taiwanese Journal of Psychiatry (Takeda and Tagami: Taiwanese J. Psychiatry 2020; 34: 152-61), we gave the development status of drugs for Alzheimer's disease, presented a relatively pessimistic view, and highlighted the difficulties in their development. Methods: Since I have witnessed some encouraging development of monoclonal antibody therapeutics against Alzheimer's disease, I have decided to contribute this article. I reviewed new data from published journals and from internal reports of pharmaceutical companies. I have also offered some explanations and comments. Results: In 2021, I saw promising clinical trial results reporting the use of aducanumab, a monoclonal antibody treatment against amyloid β protein, and the U.S. Food and Drug Administration (FDA) announced a decision for expedited approval of aducanumab. But the results of aducanumab's phase III clinical trials were considered by some to be insufficient for the approval, and the FDA's decision was controversial. The European and Japanese regulatory authorities did not approve aducanumab. In September 2022, however, more promising results were announced from Phase III clinical trials of another monoclonal antibody, lecanemab. Conclusion: In this review, I have recounted the state of the arts of drugs for treating dementia and highlighted remarkable recent progress in the development of monoclonal antibody therapeutics for Alzheimer's disease.
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Lung cancer and posttraumatic stress symptoms: Predictive factors and subgroup analysis p. 157
Pei- Lun Chung, Shu- I Wu, Hong- Ming Chen, Vincent Chin-Hung Chen, Min- Jing Lee
Objective: Lung cancer is the most common cancer and the leading cause of cancer death worldwide. Research on the correlation between posttraumatic stress symptoms (PTSSs) and lung cancer is limited. In this study, we intended to study PTSS predictors in patients with lung cancer and their subgroups. Methods: Patients aged ≥ 20 years with lung cancer diagnosis were recruited. We collected information on demographic characteristics, depressive symptoms, and cognitive function, to examine the effect on PTSSs. With the Chinese version of the startle, physiological arousal, anger, and numbness questionnaire, we analyzed the variables to identify the independent correlates of PTSSs and to compare differences among treatment and cancer stage subgroups. Results: A total of 329 lung cancer patients were included with prominent male, below senior high school education level, married status, unemployment, smoking history, non-alcohol drinker, without psychiatric history and comorbid diabetes and hypertension. The correlates of PTSSs were significantly higher in education level (β = 0.197, p < 0.01), cognitive function (β = −0.269, p < 0.001), and depressive symptoms (β = 0.294, p < 0.001). In subgroup analysis, high education level was significantly correlated of PTSSs in different treatment groups surgery group (β = 0.266, p < 0.05), nonsurgery group (β = 0.204, p < 0.05), chemotherapy group (β = 0.189, p < 0.05), and nonchemotherapy group (β = 0.220, p < 0.05). Cognitive function was significantly correlated of PTSSs in different cancer stages in early stage (β = −0.401, p < 0.01) and advanced stage (β = −0.182, p < 0.05). Conclusion: Depressive symptoms, high education level, and the poor cognitive function were significantly associated with PTSSs in patients with lung cancer. Health professionals in oncology should consider psychological burden screening, cognitive function examination, and rehabilitation in clinical practice.
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Mental health states of soldiers with histories of corona virus disease 2019 infection in Taiwan: A comparison study with non-infected soldiers p. 164
Hao Ming Yang, Yueh- Ming Tai, Szu- Nian Yang
Objectives: According to the most recent studies on the mental health impacts of coronavirus disease 2019 (COVID-19), psychological effects are salient in the community, but they are not obvious in the military population. In the study, we intended to examine mental health state and suicide ideation among soldiers with past histories of COVID-19 and to compare them with non-infected controls. Methods: We recruited 193 active-duty military personnel from northern Taiwan and collected their responses of a series of copies of the questionnaire, i.e., Beck's Depression Inventory for depression, Beck's Anxiety Inventory for anxiety, Davidson Trauma Scale for symptoms of posttramatic stress disorder (PTSD), Pittsburgh Sleep Quality Index for sleep disturbance and sleep dissatisfaction, and Five-item Brief Symptom Rating Scale for suicide ideation. Results: Among our samples, about 58.5% (113/193) reported a past history of COVID-19 infection (infected group) at least once. More than 85% had vaccinated in more than two doses. The infected soldier group presented themselves significantly higher magnitude (1.92 ± 0.54) of impacts on their lives than noninfected control group (1.72 ± 0.66, p < 0.05). The discrepancy in life impact between infected and non-infected groups was significantly more salient in male soldiers (p < 0.05) comparing with female. In male soldiers, most mental health states were higher in the non-infected group than the infected group but nonsignificant. Conclusion: This study shows the common and differences in mental health states and suicide ideation between COVID-19 infected and non-infected soldiers in Taiwan and genders. In line with the findings of current studies, our results showed nonsignificant differences between male and female groups in the military population although significant differences among the community population. Further studies with larger sample sizes and more details are needed to confirm our assumption.
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The association of depression and quality of life in patients with neurocognitive disorder in a tertiary care center: An observational study p. 170
Ananda Reddy Endreddy, Lakshmi Rajesh Chennareddy, V Harshitha
Objective: Depression can be a psychological reaction of a patient toward the diagnosis of neurocognitive disorder, and it can be a part of the complex biological response involving both illnesses. Both depression and neurocognitive disorders can cause low quality of life (QoL), especially in the elderly population. In this present study, we intended to assess the association of depression and the QoL among patients suffering from mild to major neurocognitive disorder at a tertiary hospital. Methods: This observational study was carried out at the department of psychiatry in a tertiary care hospital, among 100 patients, whose diagnosis was made according to DSM-5 criteria for mild to major neurocognitive disorder. Patients were administered semi-structured pro forma for collection of sociodemographic data, Addenbrooke'sCognitive Examination III R, Mini-Mental State Examination (MMSE) to assess the severity of mild and major neurocognitive disorders, Cornell Scale for Depression in Dementia was administered to assess the depression, World Health Organization (WHO) QoL-BREF Scale to assess the QoL among patients with mild to major neurocognitive disorders. Results: The mean age ± standard deviation of the study population was 70.31 ± 6.9 years. The sum of 43.3% of the study population belonged to the category of mild cognitive impairment, 46.7% the moderate, and 10% the severe type of cognitive impairment. The sum of 29.2% of the study population had depressive episodes, and 6.7% of the study population belonged to the category of definite major depression. Domain 2 of WHO QoL-BREF was maximum affected by mild and major neurocognitive disorders (p < 0.001). Conclusion: This study found that majority of the patients with neurocognitive disorders was affected by higher levels of depressive scores with a remarkable decrease in their QoL. Compared to neurodegenerative disorders, depression is much easily been effectively treated, this study stresses the importance of the aggressive diagnosis and treatment for depression for all patients with neurocognitive disorder.
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Prevalence of burnout and psychiatric illness among postgraduate trainee doctors of a tertiary care hospital p. 176
Surjya Roy, Nitu Mallik, Indranil Saha, Subhendu Datta, Asim Kr Mallick
Objective: Burnout is a state of physical and emotional depletion, and it is a result of prolonged exposure to the stressful working environment. Burnout has three primary symptoms: (a) emotional exhaustion (EE) occurs due to a depletion of emotional resources, feeling no longer to give any more to their job; (b) depersonalization (DP) occurs in response to EE, making employees detached from their job and developing uncaring attitudes to their work; and (c) reduced personal accomplishment (PA) with perceiving less enjoyment from their work. Psychological distress is also higher among medical students and doctors than that in the general population. In this study, we intended to study the prevalence of burnout and various psychological problems among postgraduate trainee (PGT) doctors of a tertiary care hospital. Methods: In this cross-sectional study of one year, we recruited postgraduate training doctors whoever gave valid and informed consent. Results: We included 170 PGTs from various clinical departments at the time of our study, but 126 PGTs were included as the sample population. They were assessed for sociodemographic determinants first. Then received assessment using sociodemographic pro forma and Abbreviated Maslach Burnout Inventory and International Classification of Diseases 10 for screening psychiatric morbidity among them. Results: In this study, 31.7% of PGTs had high EE, 34.9% of them higher DP, and 30.2% of them a high burnout rate. Of them, 31.7% of PGTs had a reduced PA with a score ≤ 25 percentile. In this study, 83.3% had no psychiatric illness and 16.7% had a psychiatric disorder. Among psychiatric disorders, 4% had harmful use of tobacco, 4% had mild depression, 1.6% had panic disorder, 4.8% had mixed anxiety depression, 1.6% had obsessive-compulsive disorder, 0.8% had harmful use of alcohol. Highest EE was noted among PGTs from the Department of Anesthesiology, followed by those from the Departments of Pulmonary Medicine and then Radiotherapy. Conclusion: One-third of PGTs suffered from burnout. Psychiatric diseases were also increased with a higher burnout rate.
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Protective effect of interferon-based antiviral therapy on risk of bipolar disorder in patients with hepatitis C Virus infection: A nationwide longitudinal study p. 182
Mu- Hong Chen, Shih- Jen Tsai, Tzeng- Ji Chen
Background: A recent study has shown the beneficial effects of interferon (IFN)-based antiviral therapy (AVT) in reducing the risk of newly diagnosed depression among patients with hepatitis C virus (HCV) infection. But whether IFN-based AVT reduces the risk of bipolar disorder remains unknown. Methods: This is a retrospective study based on the Taiwan National Health Insurance Research Database. From enrollment to the end of 2013, 24,240 patients with HCV infection (4473 treated with IFN-based AVT and 19,767 without such treatment) as well as 96,960 age- and sex-matched controls were included in this study. Time-dependent Cox regression models were used to study the differences in risk of newly-diagnosed bipolar disorder between patients being treated with and without IFN-based AVT and the control participants. Results: Patients with HCV infection who had not yet received IFN-based AVT (hazard ratio = 4.86, 95% confidence interval = 1.87–12.66, p = 0.001), but not those who were receiving IFN-based AVT (1.69, 0.94 - 30.50, nonsignificance) and those who completed the IFN-based AVT (1.77, 0.69 - 4.54, nonsignificance), were significantly more to be diagnosed with bipolar disorder compared with the control group. Conclusion: Our study supports the temporal association between HCV infection and subsequent bipolar disorder, further suggesting that the optimal AVT to eradicate HCV may be associated with a reduced risk of incident bipolar disorder later in life.
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Short-term naltrexone use associated with delayed-onset fever and hepatotoxicity: A case report p. 188
Chao- Chun Hsu, Yu- Hui Ku, Hong- Ming Chen
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Neutropenia following electroconvulsive therapy: A case report p. 190
Jhen- Wu Lai, Ya- Mei Bai
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