Tung-Ping Su

National Yang Ming University, T’ai-pei, Taipei, Taiwan

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Publications (131)452.95 Total impact

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    ABSTRACT: Previous studies showed that both attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD) were associated separately with a higher risk of allergic diseases. However, the comorbid effect of ADHD and ASD on the risk of allergic diseases is still unknown. Using the Taiwan National Health Insurance Research Database, 5386 children aged less than 18 years with ADHD alone, 578 with ASD alone, 458 with ADHD + ASD, and 25,688 non-ADHD/ASD age- and sex-matched (1:4) controls were enrolled in our study. The prevalence of allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, and allergic conjunctivitis, was evaluated among the four groups. Logistic regression analysis showed that the ADHD + ASD group (odds ratio [OR]: 2.26, 95% confidence interval [CI]: 1.83–2.79), ADHD-alone group (OR: 1.81, 95% CI: 1.70–1.93), and ASD-alone group (OR: 1.24, 95% CI: 1.04–1.48) had an increased risk of allergic comorbidities compared to the control after adjusting age, sex, and level of urbanization. ASD children with more allergic comorbidities (≧3: OR: 2.57, 95% CI: 1.74–3.79; 2: OR: 2.00, 95% CI: 1.41–2.84; 1: OR: 1.60, 95% CI: 1.16–2.22) were associated with a greater likelihood of ADHD. Children with ADHD or ASD had an increased risk of allergic comorbidities, and those with both ADHD and ASD had the highest. These results may inspire more research to clarify the underlying mechanisms among ASD, ADHD, and allergic diseases.
    Research in Autism Spectrum Disorders 10/2014; 8(10):1333–1338. · 2.96 Impact Factor
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    ABSTRACT: Higher rostral anterior cingulate cortex (rACC) activity correlated with frontal theta power (frontalθ) is associated with better antidepressant responses. The antidepressant efficacy of repetitive transcranial magnetic stimulation (rTMS) varied widely; however, the effects of TMS might be modulated by manipulating the pretreatment neural states. Therefore, we conducted a pilot study to investigate whether manipulated frontalθ before rTMS treatment could predict and augment antidepressant responses. A computerized rACC-engaging cognitive task (RECT) was exploited continuously for 10 min to patients with major depressive disorder. In total, 36 patients were randomized to 3 groups (Group-A: RECT[active] + rTMS[active]; Group-B: RECT[sham] + rTMS[active]; Group-C: RECT[active] + rTMS[sham]). Frontalθ and whole-brain glucose uptakes were assessed. We found that the RECT-modulated increases in frontalθ correlated well with rACC glucose uptakes. The treatment responders demonstrated a significant increase in frontalθ after RECT. Post-RECT frontalθ had good sensitivity/specificity in predicting antidepressant responses to rTMS. Group-A had more reduction in total depression scores, had more responders, and was more likely to achieve remission than other groups (Group-A [41.6%] > Group-B [16.6%] > Group-C [0%], P < 0.05). A significant enhancement in the post-1st-rTMS frontalθ was observed in Group-A responders but not in Group-B responders, supporting the argument that RECT-modulated rTMS augmented rTMS efficacy. In conclusion, this study suggests that manipulating pre-rTMS neural activity could predict and augment antidepressant effects to rTMS treatment.
    Cerebral cortex (New York, N.Y. : 1991). 08/2014;
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    ABSTRACT: Both atopic dermatitis and epilepsy have been regarded as chronic inflammatory diseases. However, their association has yet to be investigated.
    Epilepsia 06/2014; · 3.96 Impact Factor
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    ABSTRACT: Abstract Introduction: Curriculum reform at Chinese medical schools has attracted a lot of attention recently. Several leading medical schools in China have undergone exploratory reforms and in so doing, have accumulated significant experience and have made considerable progress. Methods: An analysis of the reforms conducted by 38 Chinese medical colleges that were targeted by the government for upgrade was performed. Drawing from both domestic and international literature, we designed a questionnaire to determine what types of curricular reforms have occurred at these institutions and how they were implemented. Major questions touched upon the purpose of the reforms, curricular patterns, improvements in teaching methods post-reform, changes made to evaluation systems post-reform, intra-university reform assessment, and what difficulties the schools faced when instituting the reforms. Besides the questionnaire, relevant administrators from each medical school were also interviewed to obtain more qualitative data. Results: Out of the 38 included universities, twenty-five have undergone major curricular reforms. Among them, 60.0% adopted an organ system-based curriculum model, 32.0% adopted a problem-based curriculum model, and 8.0% adopted a hybrid curriculum model. About 60.0% of the schools' reforms involved both the "pre-clinical" and the "clinical" curricula, 32.0% of the schools' reforms were limited to the "pre-clinical" curricula, and 8.0% of the schools' reforms only involved the "clinical" curricula. Following curricular reform, 60.0% of medical schools experienced an overall reduction in teaching hours, 76.0% reported an increase in their students' clinical skills, and 60.0% reported an increase in their students' research skills. Discussion: Medical curricular reform is still in its infancy in China. The republic's leading medical schools have engaged in various approaches to bring innovative teaching methods to their respective institutions. However, due to limited resources and the shackle of traditional pedagogical beliefs among many faculty and administrators, progress has been significantly hindered. Despite these and other challenges, many medical schools report positive initial results from the reforms that they have enacted. Although the long term effects of such reforms remain unclear, curricular reform appears to be the inevitable solution to China's growing need for high-quality medical doctors.
    Medical Teacher 06/2014; · 1.82 Impact Factor
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    ABSTRACT: Theta-burst transcranial magnetic stimulation could modulate cortical excitability and has the potential to treat refractory depression. However, there has been a lack of large randomized studies of the antidepressant efficacy of different forms of theta-burst stimulation, such as intermittent and continuous theta-burst stimulation. A randomized sham-controlled study was conducted to investigate antidepressant efficacy of theta-burst stimulation and to compare efficacy among left-prefrontal intermittent theta-burst stimulation, right-prefrontal continuous theta-burst stimulation and a combination of them in patients showing different levels of antidepressant refractoriness. A group of 60 treatment-refractory patients with recurrent major depressive disorder were recruited and randomized to four groups (Group A: continuous theta-burst stimulation; Group B: intermittent theta-burst stimulation; Group C: a combination of continuous and intermittent theta-burst stimulation; and Group D: sham theta-burst stimulation; 15 patients were included in each group). After 2 weeks of theta-burst stimulation treatment, depression improved in all groups. Groups B and C had better antidepressant responses (as reflected by % decreases in depression score) than Groups A and D (P = 0.001, post hoc analysis: B > A, B > D, C > A, and C > D), even after controlling for age and refractoriness scores. The mean antidepressant effect was highest in Group C and followed by that in Group B. Additionally, a significant placebo effect was found in patients with low refractoriness; this disappeared in patients with moderate-to-high refractoriness. A significant correlation existed between refractoriness scores and treatment responses. Treatment refractoriness was a significant factor negatively predicting efficacy of theta-burst stimulation (P = 0.039). This randomized sham-controlled study demonstrated that active theta-burst stimulation is a well-tolerated form of repetitive transcranial magnetic stimulation and has good antidepressant efficacy, particularly in depressed subjects within a certain range of treatment refractoriness.
    Brain 05/2014; · 9.92 Impact Factor
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    ABSTRACT: Abstract Introduction: In North America, where it was born, problem-based learning (PBL) has seen dips and rises in its popularity, but its inherent strengths have led to its spread to medical schools all over the world. Although its use at medical schools in some Western countries has already been examined, no one has looked at its status in many other countries, including China. The aim of this study is to determine the number of schools currently using PBL in China, the degree to which they use it, and the reasoning behind such usage. Methods: We used survey and internet search to examine PBL usage at Chinese medical schools. We were able to collect data from 43 first-class Chinese medical schools that are geographically diverse and thus representative of medical schools all across China. Results: 34 (79.1%) of the 43 medical schools use PBL in the preclinical curriculum. Of the 34, data were collected from 24 (70.6%) medical schools regarding the extent of their PBL usage. Nine (37.5%) schools use PBL for less than 10% of preclinical hours, 14 (58.3%) schools use PBL for 10-50% of preclinical hours, and one (4.2%) school uses PBL for more than 50% of preclinical hours. Conclusion: In our sample of Chinese medical institutions, a large majority of schools use PBL, however, most schools use it for less than 50% of total preclinical curricular hours. Our results suggest that schools are interested in increasing the number of curricular hours devoted to PBL but are constrained by resources.
    Medical Teacher 05/2014; · 1.82 Impact Factor
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    ABSTRACT: Herpes zoster results from reactivation of the endogenous varicella zoster virus infection. Previous studies have shown that herpes zoster and postherpetic neuralgia were associated with anxiety, depression, and insomnia. However, no prospective study has investigated the association between herpes zoster and the development of depressive disorder. Subjects were identified through the Taiwan National Health Insurance Research Database. Patients 18 years or older with a diagnosis of herpes zoster and without a psychiatric history were enrolled in 2000 and compared with age-/sex-matched controls (1:4). These participants were followed up to the end of 2010 for new-onset depressive disorder. A total of 1888 patients with herpes zoster were identified and compared with 7552 age-/sex-matched controls in 2000. Those with herpes zoster had a higher incidence of developing major depression (2.2% versus 1.4%, p = .018) and any depressive disorder (4.3% versus 3.2%, p = .020) than did the control group. The follow-up showed that herpes zoster was an independent risk factor for major depression (hazard ratio = 1.49, 95% confidence interval = 1.04-2.13) and any depressive disorder (hazard ratio = 1.32, 95% confidence interval = 1.03-1.70), after adjusting demographic data and comorbid medical diseases. This is the first study to investigate the temporal association between herpes zoster and depressive disorder. Further studies would be required to clarify the underlying pathophysiology about this association and whether proper treatment of herpes zoster could decrease the long-term risk of depressive disorder.
    Psychosomatic Medicine 04/2014; · 4.08 Impact Factor
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    ABSTRACT: Body image is the internal representation of an individual's own physical appearance. Individuals with gender identity disorder (GID), commonly referred to as transsexuals (TXs), are unable to form a satisfactory body image due to the dissonance between their biological sex and gender identity. We reasoned that changes in the resting-state functional connectivity (rsFC) network would neurologically reflect such experiential incongruence in TXs. Using graph theory-based network analysis, we investigated the regional changes of the degree centrality of the rsFC network. The degree centrality is an index of the functional importance of a node in a neural network. We hypothesized that three key regions of the body representation network, i.e., the primary somatosensory cortex, the superior parietal lobule and the insula, would show a higher degree centrality in TXs. Twenty-three pre-treatment TXs (11 male-to-female and 12 female-to-male TXs) as one psychosocial group and 23 age-matched healthy cissexual control subjects (CISs, 11 males and 12 females) were recruited. Resting-state functional magnetic resonance imaging was performed, and binarized rsFC networks were constructed. The TXs demonstrated a significantly higher degree centrality in the bilateral superior parietal lobule and the primary somatosensory cortex. In addition, the connectivity between the right insula and the bilateral primary somatosensory cortices was negatively correlated with the selfness rating of their desired genders. These data indicate that the key components of body representation manifest in TXs as critical function hubs in the rsFC network. The negative association may imply a coping mechanism that dissociates bodily emotion from body image. The changes in the functional connectome may serve as representational markers for the dysphoric bodily self of TXs.
    PLoS ONE 01/2014; 9(1):e85914. · 3.53 Impact Factor
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    ABSTRACT: Lithium has been a first-line choice for maintenance treatment of bipolar disorders to prevent relapse of mania and depression, but many patients do not have a response to lithium treatment. We selected subgroups from a sample of 1761 patients of Han Chinese descent with bipolar I disorder who were recruited by the Taiwan Bipolar Consortium. We assessed their response to lithium treatment using the Alda scale and performed a genomewide association study on samples from one subgroup of 294 patients with bipolar I disorder who were receiving lithium treatment. We then tested the single-nucleotide polymorphisms (SNPs) that showed the strongest association with a response to lithium for association in a replication sample of 100 patients and tested them further in a follow-up sample of 24 patients. We sequenced the exons, exon-intron boundaries, and part of the promoter of the gene encoding glutamate decarboxylase-like protein 1 (GADL1) in 94 patients who had a response to lithium and in 94 patients who did not have a response in the genomewide association sample. Two SNPs in high linkage disequilibrium, rs17026688 and rs17026651, that are located in the introns of GADL1 showed the strongest associations in the genomewide association study (P=5.50×10(-37) and P=2.52×10(-37), respectively) and in the replication sample of 100 patients (P=9.19×10(-15) for each SNP). These two SNPs had a sensitivity of 93% for predicting a response to lithium and differentiated between patients with a good response and those with a poor response in the follow-up cohort. Resequencing of GADL1 revealed a novel variant, IVS8+48delG, which lies in intron 8 of the gene, is in complete linkage disequilibrium with rs17026688 and is predicted to affect splicing. Genetic variations in GADL1 are associated with the response to lithium maintenance treatment for bipolar I disorder in patients of Han Chinese descent. (Funded by Academia Sinica and others.).
    New England Journal of Medicine 01/2014; 370(2):119-28. · 51.66 Impact Factor
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    ABSTRACT: Increasing studies have implicated the thalamus in schizophrenia, supporting the view that this structure has an important role in this disorder. Given that extensive reciprocal connections exist between the thalamus and the cerebral cortex, it is believed that disruptions of the thalamo-cortical connections may underlie the multiplicity of schizophrenic symptoms. Therefore, assessing the relationship between the thalamus and the neocortex may provide new insights into the pathophysiology of schizophrenia. We analyzed magnetic resonance images from a sample of 101 schizophrenic patients and 101 healthy controls. By assessing the correlation between the thalamic volume and cortical thickness at each vertex on the cortical surface, a thalamo-cortical network was obtained for each group. We compared the patterns of thalamo-cortical connectivity between the two groups. Compared with healthy controls, less distributed cortical regions were identified in the thalamo-cortical network in patients with schizophrenia. Vertex-wise comparison revealed decreased thalamo-cortical connectivity in bilateral inferior frontal gyrus, the left superior temporal gyrus and the right parieto-occipital region in schizophrenia. The observed disruptions in thalamo-cortical connectivity might be the substrate underlying the wide range of schizophrenic symptoms and provide further evidence to support the notion of schizophrenia as a disorder of brain dysconnectivity.
    Schizophrenia Research 01/2014; · 4.59 Impact Factor
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    ABSTRACT: To elucidate the associations between polypharmacy and age- and gender-specific risks of admission for fall-related fractures. Nested case-control study. This analysis was randomly selected from all elderly beneficiaries in 2007-2008, and represents some 30% of the whole older insurers using Taiwan's National Health Insurance Research Database. We identified 5933 cases newly admitted for fall-related fractures during 2007-2008, and 29 665 random controls free from fracture. Polypharmacy was defined as the use of fall-related drugs of four or more categories of medications and prescribed related to fall within a 1-year period. Logistic regression models were employed to estimate the ORs and related 95% CIs. The interaction of polypharmacy with age and sex was assessed separately. Compared with those who consumed no category of medication, older people who consumed 1, 2, 3 and ≥4 categories of medications were all at significantly increased odds of developing fall-related fractures, with a significant dose-gradient pattern (β=0.7953; p for trend <0.0001). There were significant interactions between polypharmacy and age, but no significant interactions between polypharmacy and gender. The dose-gradient relationship between number of medications category and risk of fall-related fractures was more obvious in women than in men (β=0.1962 vs β=0.1873). Additionally, it was most evident in older people aged 75-84 years (β=0.2338). This population-based study in Taiwan confirms the link between polypharmacy and increased risk of fall-related fractures in older people; and highlights that elderly women and older people aged 75-84 years will be the targeted participants for further prevention from fall-related fractures caused by polypharmacy.
    BMJ Open 01/2014; 4(3):e004428. · 1.58 Impact Factor
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    ABSTRACT: Objective Inflammatory cytokines have been suggested to be the trait or state markers of bipolar disorder, but with inconsistent results. This may be related to small sample sizes and poor control of some important confounding factors. Methods Gender/age-matched outpatients with bipolar disorder and normal controls were enrolled. The clinical symptoms were rated using the Montgomery Åsberg Depression Rating Scale and Young Mania Rating Scale. Inflammatory cytokines, including soluble interleukin-6 receptor (sIL-6R), soluble interleukin-2 receptor (sIL-2R), C-reactive protein (CRP), soluble tumor necrosis factor receptor type 1 (sTNF-R1), soluble P-selectin receptor (sP-selectin), and monocyte chemotactic protein-1 (MCP-1), were assessed by enzyme-linked immunosorbent assays. Results In total, 130 patients with bipolar disorder and 130 normal subjects were enrolled. Among the patients with bipolar disorder, 77 (59.2%) had bipolar I disorder, 53 (40.8%) had bipolar II disorder; 75 (57.7%) were in a euthymic state, 14 (10.8%) were in a manic/hypomanic state, and 41 (31.5%) were in a depressive state. The 130 bipolar patients had significantly higher levels of all cytokines than the normal controls (all p<0.0001). Using multivariate regression analysis with controlling of age, gender, BMI, smoking, duration of illness, and medication grouping, the patients with bipolar II disorder had significantly lower levels of sTNF-R1 than the patients with bipolar I disorder (p=0.038); the patients in a depressive state had significantly lower levels of sTNF-R1 than the patients in manic/hypomanic and euthymic states (p=0.009). Conclusion The study supported the association of bipolar disorder with inflammatory dysregulation, and sTNF-R1 may be a potential biomarker for staging bipolar disorder.
    Journal of Affective Disorders. 01/2014; 166:187–192.
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    ABSTRACT: Background Previous studies have suggested an association between asthma and dementia, but the results are still inconsistent. Methods Using the Taiwan National Health Insurance Database, we enrolled 11,030 participants aged more than 45 years with asthma and 44,120 (1:4) age-/sex-matched controls between 1998 and 2008, and followed them to the end of 2011. Cases of any dementia or Alzheimer's disease that developed during the follow-up period were identified. Results Asthma was associated with an increased risk of developing any dementia [hazard ratio (HR): 2.17, 95% confidence interval (CI): 1.87–2.52] and Alzheimer's disease (HR: 2.62, 95% CI: 1.71–4.02). Stratified by age, both asthma in midlife (>45 years and <65 years) and in late life (≥65 years) was associated with a greater likelihood of any dementia (HR: 2.48, 95% CI: 1.80–3.41; HR: 2.06, 95% CI: 1.74–2.44). Discussion Asthma in midlife and in late life increased the risk of developing any dementia and Alzheimer's disease. The underlying mechanisms between asthma and dementia require further investigation.
    Journal of the American Medical Directors Association. 01/2014;
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    ABSTRACT: To evaluate the risk of depressive disorders among non-alcoholic patients by using the Taiwan National Health Insurance Research Database (NHIRD). We conducted a retrospective study of a matched cohort of 52 725 participants (10 545 non-alcoholic cirrhotic patients and 42 180 control patients) who were selected from the NHIRD. Patients were observed for a maximum of 11 years to determine the rates of newly onset depressive disorders, and Cox regression was used to identify the risk factors associated with depressive disorders in cirrhotic patients. During the 11-year follow-up period, 395 (3.75%) non-alcoholic cirrhotic patients and 1 183 (2.80%) control patients were diagnosed with depressive disorders. The incidence risk ratio of depressive disorders between non-alcoholic cirrhotic patients and control patients was 1.76 (95% CI, 1.57-1.98, P<.001). After adjusting for age, sex, and comorbidities, non-alcoholic cirrhotic patients were 1.75 times more likely to develop depressive disorders (95% CI, 1.56-1.96, P<.001) compared with the control patients. The hazard ratios for patients younger than 60 years old (1.31) and female (1.25) indicated that each is an independent risk factor for depressive disorders in non-alcoholic cirrhotic patients. The likelihood of developing depressive disorders is greater among non-alcoholic cirrhotic patients than among patients without cirrhosis. Symptoms of depression should be sought in patients with cirrhosis.
    PLoS ONE 01/2014; 9(2):e88721. · 3.53 Impact Factor
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    ABSTRACT: Previous research has suggested an association between autism spectrum disorder (ASD) and allergic disorders, but epidemiological evidence regarding asthma remains limited. We conducted a nationwide population-based prospective cohort study (1:4 case:control patients, age- and gender-matched), hypothesizing that asthma in infancy or toddlerhood increased the risk of ASD. The participants comprised 2134 asthmatic infants and children and 8536 controls aged 0–3 years in 2002. We identified cases of ASD that occurred near the end of the follow-up period (December 31, 2010), determining that asthmatic infants and children exhibited a higher accumulative incidence rate of ASD than did the controls (1.3% vs 0.7%, P = .007). After adjusting for age at enrollment, gender, level of urbanization, and comorbid allergic diseases (i.e., allergic rhinitis and atopic dermatitis), asthmatic infants and children exhibited an elevated risk of developing ASD (hazard ratio: 2.01, 95% confidence interval: 1.19–3.40). This prospective study indicated a temporal relation between asthma and subsequent ASD diagnosis, supporting the immune hypothesis of ASD pathogenesis. Further studies are required to clarify the probable interactional effects between these disorders and define a homogenous ASD subgroup.
    Research in Autism Spectrum Disorders 01/2014; 8(4):381–386. · 2.96 Impact Factor
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    ABSTRACT: Objective Previous studies have found a temporal concordance in the increased prevalence of atopic diathesis/atopic diseases, attention-deficit hyperactivity disorder (ADHD), and autistic spectrum disorder (ASD) worldwide. But, the temporal association among these 3 distinct diseases is unknown. Method 14,812 atopic subjects diagnosed with any atopic disease (asthma, atopic dermatitis, allergic rhinitis, or allergic conjunctivitis) before the age of 3 (atopic cohort) and 6944 non-atopic subjects with no lifetime atopic disease (non-atopic cohort), born between 1997 and 2000, were enrolled and followed to December 31 2010 to identify the development of ADHD and ASD. Results The presence of any atopic disease in early childhood increased the risk of developing ADHD (hazard ratio [HR]: 1.97) and ASD (HR: 3.40) in later life. Greater numbers of atopic comorbidities (4 comorbidities: ADHD: HR: 2.53; ASD: HR: 4.29) were significantly related to a greater risk of developing ADHD and ASD. Discussion Atopic diathesis in early childhood elevated the risk of developing ADHD and ASD in later life, with the dose-dependent relationship of more atopic comorbidities with a greater likelihood of ADHD and ASD.
    Journal of Psychosomatic Research. 01/2014;
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    ABSTRACT: Neonatal jaundice may cause the lifelong sequelae of central nerve system developmental disorders. However, the results are inconsistent. 2016 newborns with neonatal jaundice and 8064 age-/gender-matched (1:4) controls were enrolled during 1999–2000. Participants of autistic spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), and other developmental disorders that occurred during the follow-up were identified. Newborns with neonatal jaundice had increased risks of developing ASD (hazard ratio [HR]: 1.75, 95% confidence interval [CI]: 1.05–2.90), any developmental delay (HR: 1.27, 95% CI: 1.02–1.58), and developmental speech or language disorder (HR: 1.41, 95% CI: 1.11–1.79). Newborn exposure to hyperbilirubinemia was related to the increased risk of developing ASD, any developmental delay, and developmental speech or language disorder in later life.
    Research in Autism Spectrum Disorders 01/2014; 8(6):625–632. · 2.96 Impact Factor
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    ABSTRACT: The rates of sleep related breathing disorders (SRBD) and treatment outcomes of depression were compared among insomnia patients who had stratified levels of hypnotic use during a 10-year follow-up (2001-2010). A nationwide population-based cohort study. A nationally representative cohort of 1,000,000 enrollees. Data were collected from patients with major depressive disorder (MDD) and comorbid insomnia during January 2001 to December 2003 (study cohort N = 3,235). The mean dosage of hypnotics at baseline in the study cohort was calculated, and this information was used to categorize the cohort into three equal-sized groups based on levels of hypnotic dosage. Patient response to antidepressants during a period that extended from 1 year before to 1 year after the study (short-term outcome) and patient psychiatric and non-psychiatric visits and hospitalizations during follow-up (long-term outcome) were analyzed. High-dosage patients presented the highest rates of subsequent SRBD diagnosis (3.9%), compared to medium-dosage patients (2.2%) and low-dosage patients (2.0%) (P = 0.011). Significantly more patients in the high-dosage group were difficult to treat with antidepressants compared to the other 2 groups (8.7% vs. 4.1% vs. 3.0%, P < 0.001), and their long-term depression outcome was worse for most parameters. Logistic regression showed that high-dosage hypnotics predicted the development of SRBD later (OR 1.678 [CI, 1.051 to 2.680], P = 0.030). There is a reliable association between a history of high dosages of hypnotics, subsequent diagnosis of sleep related breathing disorder, and worse depression outcomes. Li CT; Bai YM; Lee YC; Mao WC; Chen MH; Tu PC; Chen YS; Chen TJ; Chang WH; Su TP. High dosage of hypnotics predicts subsequent sleep-related breathing disorders and is associated with worse outcomes for depression. SLEEP 2014;37(4):803-809.
    Sleep 01/2014; 37(4):803-9. · 5.10 Impact Factor
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    ABSTRACT: Bipolar disorder is characterized by internally affective fluctuations. The abnormality of inherently mental state can be assessed using resting-state fMRI data without producing task-induced biases. In this study, we hypothesized that the resting-state connectivity related to the frontal, striatal, and thalamic regions, which were associated with mood regulations and cognitive functions, can be altered for bipolar disorder. We used the Pearson's correlation coefficients to estimate functional connectivity followed by the hierarchical modular analysis to categorize the resting-state functional regions of interest (ROIs). The selected functional connectivities associated with the striatal-thalamic circuit and default mode network (DMN) were compared between bipolar patients and healthy controls. Significantly decreased connectivity in the striatal-thalamic circuit and between the striatal regions and the middle and posterior cingulate cortex was observed in the bipolar patients. We also observed that the bipolar patients exhibited significantly increased connectivity between the thalamic regions and the parahippocampus. No significant changes of connectivity related to the frontal regions in the DMN were observed. The changed resting-state connectivity related to the striatal-thalamic circuit might be an inherent basis for the altered emotional and cognitive processing in the bipolar patients.
    PLoS ONE 01/2014; 9(5):e96422. · 3.53 Impact Factor
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    ABSTRACT: Background Previous studies have shown that both severe mental disorders (schizophrenia and bipolar disorder) and atopic diseases were associated with an increased risk of metabolic syndrome. However, the role of atopy/the predisposition for allergies in the development of metabolic syndrome is still unknown among those with severe mental disorders. Methods Using the Taiwan National Health Insurance Research Database, 5826 patients with schizophrenia or bipolar disorder (1908 with a predisposition for allergies and 3918 without) were enrolled between 1998 and 2008. Those who developed hypertension, dyslipidemia, and/or diabetes mellitus were identified during the follow-up to the end of 2011. Results A predisposition for allergies increased the risk of developing hypertension (HR: 1.67), dyslipidemia (HR: 1.82), and diabetes mellitus (HR: 1.37) in later life among those with severe mental disorders. A dose-dependent relationship was noted between having more atopic comorbidities and a greater likelihood of hypertension (1 atopic disease: HR: 1.60; ≧ 2 atopic comorbidities: HR: 1.87), dyslipidemia (HR: 1.73; HR: 2.12), and diabetes mellitus (HR: 1.26; HR: 1.69). Conclusion A predisposition for allergies was an independent risk factor for hypertension, dyslipidemia, and diabetes mellitus among patients with schizophrenia or bipolar disorder. Further studies would be required to elucidate the underlying pathophysiology among atopy, schizophrenia, bipolar disorder, and metabolic syndrome.
    Schizophrenia Research 01/2014; · 4.59 Impact Factor

Publication Stats

829 Citations
452.95 Total Impact Points

Institutions

  • 2003–2014
    • National Yang Ming University
      • • Department of Psychiatry
      • • Institute of Biomedical Informatics
      • • Institute of Public Health
      T’ai-pei, Taipei, Taiwan
    • Kaohsiung Municipal Kai-Syuan Psychiatric Hospital
      Kao-hsiung-shih, Kaohsiung, Taiwan
  • 2002–2014
    • Taipei Veterans General Hospital
      • Division of Psychiatry
      T’ai-pei, Taipei, Taiwan
  • 2013
    • East-Taiwan Veterans Hospital
      Hua-lien, Taiwan, Taiwan
    • National Taiwan University Hospital
      • Department of Psychiatry
      T’ai-pei, Taipei, Taiwan
    • Taichung Veterans General Hospital
      臺中市, Taiwan, Taiwan
  • 2011
    • Northeast Institute of Geography and Agroecology
      • Institute of Automation
      Beijing, Beijing Shi, China
    • Uniformed Services University of the Health Sciences
      • Department of Psychiatry
      Bethesda, MD, United States
  • 2010
    • Massachusetts General Hospital
      • Department of Psychiatry
      Boston, MA, United States
    • National Chiao Tung University
      • Department of Computer Science
      Hsinchu, Taiwan, Taiwan
  • 2009
    • Jianan Mental Hospital
      臺南市, Taiwan, Taiwan
  • 2008
    • National Cheng Kung University
      • Department of Computer Science and Information Engineering
      Tainan, Taiwan, Taiwan
    • National Taiwan Normal University
      • Department of Mathematics
      Taipei, Taipei, Taiwan