Hai-Gwo Hwu

Cathay General Hospital, T’ai-pei, Taipei, Taiwan

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Publications (98)338.79 Total impact

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    ABSTRACT: To test whether gender and parental factors moderate the relationships between symptoms of eating disorder (ED) and other psychiatric symptoms. A total of 5,015 new entrants completed several questionnaires and 541individuals with ED symptoms were identified by the Adult Self-Report Inventory-4 that assessed a wide range of Diagnostic and Statistical Manual of Mental Disorders Fourth Edition psychopathology. The participants also reported on their parents' attitude toward them before their ages of 16. ED symptoms, female gender, less parental care, and more parental protection were associated with more severe co-occurring psychiatric symptoms. Gender and parental factors also demonstrated differential moderating effects on the relationships between ED and co-occurring psychiatric symptoms. Parenting counseling may be individualized to young adults with ED symptoms and different co-occurring psychiatric symptoms.
    Journal of Clinical Psychology 03/2014; 70(3):224-237. · 2.12 Impact Factor
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    ABSTRACT: A dysfunction in working memory (WM) is a core cognitive impairment in schizophrenia that involves the cortical-subcortical-cerebellar network. We propose that in addition to other often-referred markers, the signal reduction in the network during verbal working memory (VWM) is a stable and intrinsic indicator of illness. We presented a Sternberg VWM task to 46 patients with schizophrenia and 46 healthy controls matched on performance accuracy during functional magnetic resonance imaging (fMRI). Reduced activation was demonstrated in the thalamus, cerebellar vermis, pons and the triangular part of the inferior frontal gyrus (IFG) in the patient group. We also found a "failure of deactivation" in the default mode network (DMN) in patients as represented by a low versus high load VWM. In addition, a reduced left lateralization in the triangular and opercular parts of the IFG was observed in the patient group replicating previous "failure of lateralization" findings in schizophrenia. A comparison of long (10 to 19years) and short (3 to 9years) durations of illness (DoIs) demonstrated that the DoI was only associated with the activation changes in the middle frontal gyrus and lateral temporal cortex but not with the IFG-subcortico-cerebellar regions observed. These alterations were consistent with the cognitive dysmetria described in the cortical-subcortical-cerebellar network in schizophrenia. In conclusion, the combination of reduced activation in the cortical-subcortical-cerebellar network during VWM in particular, reduced deactivation in the DMN and reduced lateralization in the IFG is thought to be stable neuroimaging signatures of schizophrenia.
    Schizophrenia Research 11/2013; · 4.59 Impact Factor
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    ABSTRACT: A standard measure to assess and predict violence is important for psychiatric services. No prospective study has examined the history of violence and heterogeneity of violence in predicting specific types of violence among inpatient with schizophrenia. This study aimed to prospectively examine the accuracy of prediction of types of violence using the Chinese modified version of Violence Scale (VS-CM) among inpatients with schizophrenia based on their past history of violence and the real occurrence of violence during hospitalization. A prospective cohort study design. A total of 107 adult patients with schizophrenia spectrum disorders, consecutively admitted to an acute psychiatric ward of a university hospital in Taiwan, were recruited. In addition to data about demographics and clinical illness, count records of the history of violence within one month prior to admission by interview and the actual occurrence of violence during the whole course of hospitalization by participant observation were collected using the VS-CM. Multivariate logistic analysis and area under the Receiver Operating Characteristic curve (AUC) analysis were applied to examine the predictive ability of the VS-CM. A patient's history of violence assessed by the VS-CM predicted the actual occurrence of violence during hospitalization with the Odds Ratio of 17.5 (p=0.001). The predictive accuracy of the VS-CM had high sensitivity (97.0%), moderate positive predictive value (71.4%), and high negative predictive value (87.5%); however, the specificity was relatively low (35.0%). The AUC was 79.5% using the total scale of the VS-CM and 70.7-74.5% using the subscales in predicting corresponding types of violence. The VS-CM is a valid and reliable measure of potential violence. It can be applied to assess and predict specific types of violence among inpatient with schizophrenia.
    International journal of nursing studies 07/2013; · 1.91 Impact Factor
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    ABSTRACT: Disruption of disrupted-in-schizophrenia 1 (DISC1), a candidate susceptibility gene for schizophrenia, was first identified in a large Scottish family in which many members suffered from various psychiatric disorders, including schizophrenia. To model the Scottish DISC1 truncation, we established a Disc1 mutant mouse line in which the 129S6/SvEv 25-bp deletion variant was transferred into the C57BL/6J strain by backcrossing. A battery of behavioral tasks was conducted to evaluate the basic behaviors and cognitive function of these mice. In heterozygote and homozygote Disc1 mutant (Het and Homo) mice, behavioral impairments were noted in working memory test which is thought to be mediated by the function of the medial prefrontal cortex (mPFC). The properties of mPFC neurons were characterized in both morphological and physiological aspects. The dendritic diameters were decreased in layer II/III mPFC pyramidal neurons of Het and Homo mice, whereas a significant reduction in spine density was observed in Homo mice. Neuronal excitability was declined in layer II/III mPFC pyramidal neurons of Het and Homo mice, yet increased transmitter release was identified in Homo mice. Thus, the structural and functional alterations of the mPFC in Het and Homo mice might account for their cognitive impairment. Since most of the gene knockout mice are generated from 129 substrain-derived embryonic stem cells, potential Disc1 deficiency should be considered.
    Brain Structure and Function 05/2013; · 7.84 Impact Factor
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    ABSTRACT: This study assessed facial emotion recognition abilities in subjects with paranoid and non-paranoid schizophrenia (NPS) using signal detection theory. We explore the differential deficits in facial emotion recognition in 44 paranoid patients with schizophrenia (PS) and 30 non-paranoid patients with schizophrenia (NPS), compared to 80 healthy controls. We used morphed faces with different intensities of emotion and computed the sensitivity index (d') of each emotion. The results showed that performance differed between the schizophrenia and healthy controls groups in the recognition of both negative and positive affects. The PS group performed worse than the healthy controls group but better than the NPS group in overall performance. Performance differed between the NPS and healthy controls groups in the recognition of all basic emotions and neutral faces; between the PS and healthy controls groups in the recognition of angry faces; and between the PS and NPS groups in the recognition of happiness, anger, sadness, disgust, and neutral affects. The facial emotion recognition impairment in schizophrenia may reflect a generalized deficit rather than a negative-emotion specific deficit. The PS group performed worse than the control group, but better than the NPS group in facial expression recognition, with differential deficits between PS and NPS patients.
    Psychiatry research. 04/2013;
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    ABSTRACT: To study the outcome of a group of patients with schizophrenia receiving community home care case management programs by delineating the relationship among their psychopathology, rehospitalization rates and health-related quality of life (HRQoL). This is a cross-sectional study on HRQoL, functioning and associating factors and a retrospectivehistorical control study by comparing the frequency and duration of rehospitalization in a sample of 60 patients with schizophrenia under nonintensive case management (non-ICM) in Taiwan. All participants were assessed on the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) for psychopathology, on EuroQoL-5D (EQ-5D) and EQ visual analogue (EQ-VAS) for HRQoL, andGlobal Assessment of Functioning (GAF) for socio-occupational dysfunction. Other clinical characteristics are also gathered. Patients with schizophrenia treated with non-ICM had a significant reduction in admission frequency (-0.10 ± 0.36 times per year, p = 0.042) and length of inpatient stay (-27.8 ± 78.0 days per year, p = 0.008). Better EQ-5D and EQ-VAS are significantly associated with lower general psychopathology score, while better EQ-VAS is significantly associated with older age and higher negative symptoms subscale score. GAF is negatively associated with higher positive symptoms and negative symptoms subscale scores, while positively correlated with a greater reduction in number and frequency of admission. Non-ICM can help to decrease rehospitalization of home care patients. HRQoL and functioning can be assessed by the three perspectives we used, and each measure was correlated to different dimensions of patient psychopathology. It will be better if we include baseline and post-intervention PANSS scores, HRQoL and functioning as outcome indicators.
    Journal of the Formosan Medical Association 04/2013; 112(4):208-15. · 1.00 Impact Factor
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    ABSTRACT: Previous studies have reported significant associations between schizophrenia and the dopamine receptor D2 gene (DRD2) variants. The relationships between DRD2 and clinical phenotypes are of particular interest because DRD2 has been shown to associate with treatment response and prefrontal dopamine transmission. Glatt et al. reported significant associations between schizophrenia and DRD2 variants (two single-nucleotide polymorphisms (SNPs) rs1079727 and rs2283265, and two haplotypes, block 3 (rs1079727(A)-rs2440390(C)-rs2283265(G)) and block 4 (rs1801028(G)-rs1110977(A)-rs1124492(C)-rs2734841 (T))) in 2408 Han Chinese individuals in Taiwan. To further investigate the relationships between the SNPs/haplotypes of DRD2 and clinical symptoms and neuropsychological function, we compared the quantitative phenotypes in patients with risk alleles/haplotypes and those without. The results showed that the A allele of rs1079727, G allele of rs2283265, A allele of rs1124492 and the risk haplotype (A-C-G) of block 3 were associated with more severe negative symptoms. With regard to neuropsychological performance, the risk haplotype (G-A-C-T) of block 4 was associated with poorer performance in the sustained attention task. Our results imply that the genetic variants of DRD2 might not only have a role in susceptibility to schizophrenia, but also influence the phenotypes of negative symptoms and sustained attention in schizophrenia. This association warrants further validation.Journal of Human Genetics advance online publication, 31 January 2013; doi:10.1038/jhg.2012.157.
    Journal of Human Genetics 01/2013; · 2.37 Impact Factor
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    ABSTRACT: Thought disorder is a core symptom of schizophrenia. However, the underlying mechanism is not well understood. Functional MRI (fMRI) was used to examine the neural mechanism of thought disorder in 20 patients with schizophrenia and 20 healthy controls during semantic judgments. Two indexes of disorganized thought were further used to evaluate individual differences in thought disturbance in the patients. Compared with the controls, the patients showed greater activation in left inferior frontal gyrus (BA45) and reduced activation in the left caudate nucleus for meaning-related pairs. Moreover, in patients, effective connectivity from Dynamic Causal Modeling showed that the modulatory effect from the caudate nucleus to the inferior frontal gyrus was weaker than that in controls, indicating a disrupted cortical-subcortical language loop for semantic processing in patients. Finally, increasing scores of disorganized thought were correlated with greater activation in the inferior frontal gyrus and weaker connection strength from the caudate nucleus to the inferior frontal gyrus. Patients with more severe disorganized symptoms might receive less efficient regulation from the caudate nucleus, resulting in increased demands for the inferior frontal gyrus to retrieve or select semantic knowledge in the cortical-subcortical circuit.
    Neuroreport 01/2013; · 1.40 Impact Factor
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    ABSTRACT: The copy number variation (CNV) is a type of genetic variation in the genome. It is measured based on signal intensity measures and can be assessed repeatedly to reduce the uncertainty in PCR-based typing. Studies have shown that CNVs may lead to phenotypic variation and modification of disease expression. Various challenges exist, however, in the exploration of CNV-disease association. Here we construct latent variables to infer the discrete CNV values and to estimate the probability of mutations. In addition, we propose to pool rare variants to increase the statistical power and we conduct family studies to mitigate the computational burden in determining the composition of CNVs on each chromosome. To explore in a stochastic sense the association between the collapsing CNV variants and disease status, we utilize a Bayesian hierarchical model incorporating the mutation parameters. This model assigns integers in a probabilistic sense to the quantitatively measured copy numbers, and is able to test simultaneously the association for all variants of interest in a regression framework. This integrative model can account for the uncertainty in copy number assignment and differentiate if the variation was de novo or inherited on the basis of posterior probabilities. For family studies, this model can accommodate the dependence within family members and among repeated CNV data. Moreover, the Mendelian rule can be assumed under this model and yet the genetic variation, including de novo and inherited variation, can still be included and quantified directly for each individual. Finally, simulation studies show that this model has high true positive and low false positive rates in the detection of de novo mutation.
    Frontiers in Genetics 01/2013; 4:185.
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    ABSTRACT: Schizophrenia is a highly heritable disease with a polygenic mode of inheritance. Many studies have contributed to our understanding of the genetic underpinnings of schizophrenia, but little is known about how interactions among genes affect the risk of schizophrenia. This study aimed to assess the associations and interactions among genes that confer vulnerability to schizophrenia and to examine the moderating effect of neuropsychological impairment. We analyzed 99 SNPs from 10 candidate genes in 1,512 subject samples. The permutation-based single-locus, multi-locus association tests, and a gene-based multifactorial dimension reduction procedure were used to examine genetic associations and interactions to schizophrenia. We found that no single SNP was significantly associated with schizophrenia. However, a risk haplotype, namely A-T-C of the SNP triplet rsDAO7-rsDAO8-rsDAO13 of the DAO gene, was strongly associated with schizophrenia. Interaction analyses identified multiple between-gene and within-gene interactions. Between-gene interactions including DAO*DISC1 , DAO*NRG1 and DAO*RASD2 and a within-gene interaction for CACNG2 were found among schizophrenia subjects with severe sustained attention deficits, suggesting a modifying effect of impaired neuropsychological functioning. Other interactions such as the within-gene interaction of DAO and the between-gene interaction of DAO and PTK2B were consistently identified regardless of stratification by neuropsychological dysfunction. Importantly, except for the within-gene interaction of CACNG2, all of the identified risk haplotypes and interactions involved SNPs from DAO. These results suggest that DAO, which is involved in the N-methyl-d-aspartate receptor regulation, signaling and glutamate metabolism, is the master gene of the genetic associations and interactions underlying schizophrenia. Besides, the interaction between DAO and RASD2 has provided an insight in integrating the glutamate and dopamine hypotheses of schizophrenia.
    PLoS ONE 01/2013; 8(3):e60099. · 3.73 Impact Factor
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    ABSTRACT: Endophenotypes in schizophrenia research is a contemporary approach to studying this heterogeneous mental illness, and several candidate neurophysiological markers (e.g. P50 sensory gating) and neuropsychological tests (e.g. Continuous Performance Test (CPT) and Wisconsin Card Sorting Test (WCST)) have been proposed. However, the clinical utility of a single marker appears to be limited. In the present study, we aimed to construct a diagnostic model incorporating P50 sensory gating with other neuropsychological tests in order to improve the clinical utility. We recruited clinically stable outpatients meeting DSM-IV criteria of schizophrenia and age- and gender-matched healthy controls. Participants underwent P50 sensory gating experimental sessions and batteries of neuropsychological tests, including CPT, WCST and Wechsler Adult Intelligence Scale Third Edition (WAIS-III). A total of 106 schizophrenia patients and 74 healthy controls were enrolled. Compared with healthy controls, the patient group had significantly a larger S2 amplitude, and thus poorer P50 gating ratio (gating ratio = S2/S1). In addition, schizophrenia patients had a poorer performance on neuropsychological tests. We then developed a diagnostic model by using multivariable logistic regression analysis to differentiate patients from healthy controls. The final model included the following covariates: abnormal P50 gating (defined as P50 gating ratio >0.4), three subscales derived from the WAIS-III (Arithmetic, Block Design, and Performance IQ), sensitivity index from CPT and smoking status. This model had an adequate accuracy (concordant percentage = 90.4%; -statistic = 0.904; Hosmer-Lemeshow Goodness-of-Fit Test, = 0.64>0.05). To the best of our knowledge, this is the largest study to date using P50 sensory gating in subjects of Chinese ethnicity and the first to use P50 sensory gating along with other neuropsychological tests to develop a diagnostic model for schizophrenia. Further research to validate the predictive accuracy of this model by applying it on other samples is warranted.
    PLoS ONE 01/2013; 8(2):e57197. · 3.73 Impact Factor
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    ABSTRACT: Low frequency oscillations are essential in cognitive function impairment in schizophrenia. While functional connectivity can reveal the synchronization between distant brain regions, the regional abnormalities in task-independent baseline brain activity are less clear, especially in specific frequency bands. Here, we used a regional homogeneity (ReHo) method combined with resting-state functional magnetic resonance imaging to investigate low frequency spontaneous neural activity in the three different frequency bands (slow-5∶0.01-0.027 Hz; slow-4∶0.027-0.08 Hz; and typical band: 0.01-0.08 Hz) in 69 patients with schizophrenia and 62 healthy controls. Compared with controls, schizophrenia patients exhibited decreased ReHo in the precentral gyrus, middle occipital gyrus, and posterior insula, whereas increased ReHo in the medial prefrontal cortex and anterior insula. Significant differences in ReHo between the two bands were found in fusiform gyrus and superior frontal gyrus (slow-4> slow-5), and in basal ganglia, parahippocampus, and dorsal middle prefrontal gyrus (slow-5> slow-4). Importantly, we identified significant interaction between frequency bands and groups in the inferior occipital gyrus and caudate body. This study demonstrates that ReHo changes in schizophrenia are widespread and frequency dependent.
    PLoS ONE 01/2013; 8(3):e57516. · 3.73 Impact Factor
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    ABSTRACT: Patients with schizophrenia perform significantly worse on emotion recognition tasks than healthy participants across several sensory modalities. Emotion recognition abilities are correlated with the severity of clinical symptoms, particularly negative symptoms. However, the relationships between specific deficits of emotion recognition across sensory modalities and the presentation of psychotic symptoms remain unclear. The current study aims to explore how emotion recognition ability across modalities and neurocognitive function correlate with clusters of psychotic symptoms in patients with schizophrenia. 111 participants who met the DSM-IV diagnostic criteria for schizophrenia and 70 healthy participants performed on a dual-modality emotion recognition task, the Diagnostic Analysis of Nonverbal Accuracy 2-Taiwan version (DANVA-2-TW), and selected subscales of WAIS-III. Of all, 92 patients received neurocognitive evaluations, including CPT and WCST. These patients also received the PANSS for clinical evaluation of symptomatology. The emotion recognition ability of patients with schizophrenia was significantly worse than healthy participants in both facial and vocal modalities, particularly fearful emotion. An inverse correlation was noted between PANSS total score and recognition accuracy for happy emotion. The difficulty of happy emotion recognition and earlier age of onset, together with the perseveration error in WCST predicted total PANSS score. Furthermore, accuracy of happy emotion and the age of onset were the only two significant predictors of delusion/hallucination. All the associations with happy emotion recognition primarily concerned happy prosody. Deficits in emotional processing in specific categories, i.e. in happy emotion, together with deficit in executive function, may reflect dysfunction of brain systems underlying severity of psychotic symptoms, in particular the positive dimension.
    PLoS ONE 01/2013; 8(6):e66571. · 3.73 Impact Factor
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    ABSTRACT: INTRODUCTION: This study aimed to observe treatment response using aripiprazole for subjects with ultra-high risk (UHR) state of psychosis or at their first-episode psychosis (FEP) who were drug-naive or only have received antipsychotic therapy temporarily. METHODS: All patients received aripiprazole 3.75 mg/d initially to test tolerability and increased to 7.5 mg during the first 2 weeks. A flexible dosing strategy based on clinical improvement and tolerability with a target dose 15 mg/d by the end of the fourth week. Clinical severity was assessed by a Mandarin version of the positive and negative syndrome scale for schizophrenia at baseline, the end of the second and the fourth week. Adverse reactions were recorded by a log, and concomitant medications were allowed. RESULTS: A total of 20 FEP and 11 UHR patients, including 18 drug-naive (11 FEP and 7 UHR) and 13 antipsychotic-short-exposure patients (9 FEP and 4 UHR), participated in and 29 completed the study. Most of them received aripiprazole no more than 7.5 mg/d at end point with favorable response, although many of them reported adverse events. Both UHR and FEP patients got significant decrease of positive symptom scores in a similar pattern. Both groups did not show significant changes in negative symptom scores. CONCLUSION: The treatment response of UHR patients is likely a continuum from that of the FEP patients. Low-dose aripiprazole revealed potential efficacy for patients with less severe psychopathology, at putative prodromal or early state of psychosis, yet still was accompanied by adverse events while treating this mostly drug-naive population.
    Journal of clinical psychopharmacology 12/2012; · 5.09 Impact Factor
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    ABSTRACT: Despite the consistent presence of performance deficits on the Wisconsin Card Sorting Test (WCST) in schizophrenia patients, whether poorer performance is also present in their nonpsychotic relatives is not certain. This study aimed to estimate both the recurrence risk ratio (λs) and the heritability of WCST scores in simplex and multiplex families, respectively, and to examine the influence of familial loading on these estimates. Participants were patients with schizophrenia and their nonpsychotic first-degree relatives from 168 simplex families and 653 multiplex families as well as 440 normal comparisons. On the basis of adjusted z scores, both the λs at a series of cutoff points and heritability estimates based on variance component modeling in the nonpsychotic relatives of schizophrenia patients were estimated. The WCST deficits in schizophrenia patients were more prominent in multiplex families than in simplex ones. Among relatives, WCST deficits were limited to parents of multiplex families for most WCST scores and siblings from multiplex families for total errors, perseverative responses, and perseverative errors. Pertaining to λs, the estimates for multiplex families (highest estimates ranging from 7.9 to 11.0) were greater than those for simplex ones (<2.5). Nevertheless, the heritability estimates were very similar between simplex (ranging from 0% to 17%) and multiplex (ranging from 0% to 21%) families, with the latter having slightly greater values than the former. There is only a small-to-modest familial aggregation on part of WCST scores in families of schizophrenia patients, and this may limit its use as endophenotypic markers to schizophrenia susceptibility.
    Schizophrenia Bulletin 11/2012; · 8.80 Impact Factor
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    ABSTRACT: BACKGROUND: Several self-report instruments were developed to capture psychotic prodrome, and were claimed to have good predictive validity. The feasibility of screening is questionable considering the heterogeneity of the targeted populations and the negative ramifications of false positive identification. This study developed a questionnaire using data covering a wide range of clinical characteristics. METHODS: One hundred and eleven putative pre-psychotic participants, 129 normal comparison subjects, and 95 non-psychotic psychiatric outpatients completed a 231-item questionnaire comprising a 110-item Wisconsin psychotic prone scale, 74-item schizotypal personality questionnaire, 33-item basic symptoms, and 14-item cognitive symptoms. Items showing the best discriminating power, estimated using chi-square statistics with Bonferroni correction, were extracted to create a brief version. A two-stage cut-off approach emphasizing specific items was applied to maximize sensitivity and specificity. The concurrent validity of the proposed approach was estimated using a ten-fold cross-validation procedure. RESULTS: A 15-item self-report questionnaire was developed. Respondents checking at least eight items, or those checking three to seven items including any of the three referring to feeling stress in crowds, aloofness, and perceptual disturbance, would be considered putatively pre-psychotic with the largest sensitivity+specificity (0.784+0.705=1.489). This cut-off selection was the best estimate by calculating 1000 permutations in the cross-validation procedure. CONCLUSIONS: This investigation proposes a different orientation for applying questionnaires to screen putative pre-psychotic states, with less emphasis on attenuated psychotic symptoms and predictive values. Besides providing a handy tool for increasing awareness and referral, the instructions of such a screening questionnaire should be carefully worded.
    Schizophrenia Research 11/2012; · 4.59 Impact Factor
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    ABSTRACT: Schizophrenia has been associated with abnormal task-related brain activation in sensory and motor regions as well as social cognition network. Recently, two studies investigated temporal correlation between resting-state functional magnetic resonance imaging (R-fMRI) low-frequency oscillations (LFOs) in schizophrenia but reported mixed results. This may be due to the different frequency bands used in these studies. Here we utilized R-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF) in three different frequency bands (slow-5: 0.01-0.027 Hz; slow-4: 0.027-0.08 Hz; and typical band: 0.01-0.08 Hz) in 69 patients with schizophrenia and 62 healthy controls. We showed that there were significant differences in ALFF/fALFF between the two bands (slow-5 and slow-4) in regions including basal ganglia, midbrain, and ventromedial prefrontal cortex. Importantly, we also identified significant interaction between frequency bands and groups in inferior occipital gyrus, precunus, and thalamus. The results suggest that the abnormalities of LFOs in schizophrenia is dependent on the frequency band and suggest that future studies should take the different frequency bands into account when measure intrinsic brain activity. Hum Brain Mapp, 2012. © 2012 Wiley Periodicals, Inc.
    Human Brain Mapping 11/2012; · 6.88 Impact Factor
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    ABSTRACT: Recent schizophrenia research exploring the complicated pathogenesis of schizophrenia has focused on the subjects with at-risk mental states in order to exclude the influence of confounding factors. This study explores 3 sets of auditory-related event potentials in subjects with different risk levels of psychosis. Subjects were recruited from the SOPRES study in Taiwan. P50 and N100 using an auditory paired-click paradigm and duration MMN were assessed on 32 first-episode psychosis (FEP), 30 ultra-high risk (UHR), 37 E-BARS (early/broad at-risk mental states) participants and 56 controls. MMN was correlated with neither P50 nor N100, whereas many parameters of the latter two were intercorrelated with each other. Compared to healthy controls, MMNs were significantly lower in all 3 clinical groups (E-BARS, UHR and FEP). A gradient of sensory-gating deficits, manifested by increased P50 ratios (S2/S1) and decreased N100 differences, across different levels of clinical severity was suggested by a linear trend. For the UHR subjects, P50 gating ratio, N100 gating ratio, N100 difference, and N100S2 amplitude might be potential indicators to discriminate converters from non-converters. By including subjects with E-BARS, our results provide new insight regarding pre-attentive auditory event-related potential in subjects across different risk levels of psychotic disorders. Impaired deviance detection shown by MMNs already exists in people at a pre-psychotic state regardless of clinical severity, while sensory-gating deficits shown by P50/N100 varies depending on the risk levels in prodromal period. Further longitudinal research exploring the relationship between ERPs and subjects with a suspected pre-psychotic state is needed.
    Schizophrenia Research 07/2012; 140(1-3):243-9. · 4.59 Impact Factor
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    ABSTRACT: The intermediate course of schizophrenia is a complex intertwined with the heterogeneity of the illness. This article attempts to simplify this complexity using a hypothetical tripartite based on the profile of symptoms at 6 months after acute treatment. This is a prospective 5-year follow-up study including 163 schizophrenic inpatients in northern Taiwan comparing patients' demographic data at index admission, scores on the Positive and Negative Syndrome Scale (PANSS) for schizophrenia and social function scale measured at admission, 6-month follow-up, and annually, and scores on a neuropsychologic test battery measured approximately 5 years after recruitment. Patients were grouped into three subtypes based on their sixth-month symptomatology by Generalized Association Plots, designated as remitted (RM), persistent delusion/hallucination (PDH), and markedly blunting (MB) groups. These three subtypes presented with similar positive symptom profiles at recruitment, yet during follow-up, the PDH group tended to maintain the highest risk of having worse clinical symptomatology, social functioning, and neuropsychologic functioning, and the RM was the best outcome group. This three-subtype model provides a practical reference to predict medium-term outcomes by the subject's response to acute treatment and serves as a model to sort out part of the heterogeneous nature of schizophrenia that still should be examined by further psychopharmacological, neurobiological, and genetic studies.
    Journal of the Formosan Medical Association 05/2012; 111(5):265-74. · 1.00 Impact Factor
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    ABSTRACT: The Chinese Facial Emotion Recognition Database (CFERD), a computer-generated three-dimensional (3D) paradigm, was developed to measure the recognition of facial emotional expressions at different intensities. The stimuli consisted of 3D colour photographic images of six basic facial emotional expressions (happiness, sadness, disgust, fear, anger and surprise) and neutral faces of the Chinese. The purpose of the present study is to describe the development and validation of CFERD with nonclinical healthy participants (N=100; 50 men; age ranging between 18 and 50 years), and to generate normative data set. The results showed that the sensitivity index d' [d'=Z(hit rate)-Z(false alarm rate), where function Z(p), p∈[0,1]], for all emotions was 0.94. The emotion was more readily detected in happiness, and less easily detected in surprise and sadness. In general, this study replicated the previous findings on the recognition accuracy of emotional expression with the Westerner faces. However, our paradigm extends the previous work by including a wider sensitivity range to differentiate subtle perception of emotion intensities. The CFERD will be a useful tool for emotion recognition assessment in affective neurosciences research, especially for the Chinese and cross-cultural studies.
    Psychiatry Research 04/2012; · 2.46 Impact Factor

Publication Stats

836 Citations
3k Downloads
338.79 Total Impact Points

Institutions

  • 2013
    • Cathay General Hospital
      T’ai-pei, Taipei, Taiwan
    • Taipei Medical University
      T’ai-pei, Taipei, Taiwan
    • Academia Sinica
      • Institute of Statistical Science
      Taipei, Taipei, Taiwan
    • California Institute of Technology
      Pasadena, California, United States
    • King's College London
      • Department of Psychosis Studies
      Londinium, England, United Kingdom
  • 2012
    • South China Normal University
      Shengcheng, Guangdong, China
  • 2011–2012
    • National Cheng Kung University
      • Institute of Clinical Medicine
      Tainan, Taiwan, Taiwan
    • Chi-Mei Medical Center
      臺南市, Taiwan, Taiwan
    • Chang Jung Christian University
      臺南市, Taiwan, Taiwan
    • Asia University
      臺中市, Taiwan, Taiwan
  • 2002–2012
    • National Taiwan University
      • • Department of Psychology
      • • Graduate Institute of Epidemiology and Preventive Medicine
      • • School of Nursing
      • • College of Medicine
      Taipei, Taipei, Taiwan
  • 2006–2011
    • National Taiwan University Hospital
      • Department of Psychiatry
      Taipei, Taipei, Taiwan
    • State University of New York Upstate Medical University
      Syracuse, New York, United States
  • 2010
    • National Chiao Tung University
      • Institute of Statistics
      Hsinchu, Taiwan, Taiwan
  • 2006–2009
    • National Health Research Institutes
      • Institute of Population Health Sciences
      Miao-li-chieh, Taiwan, Taiwan
  • 2008
    • National Yang Ming University
      • Institute of Biomedical Informatics
      Taipei, Taipei, Taiwan
  • 2007
    • The Chinese University of Hong Kong
      • The Nethersole School of Nursing
      Hong Kong, Hong Kong
    • Taoyuan General Hospital
      Taoyuan City, Taiwan, Taiwan