Chian-Jue Kuo

Chian-Jue Kuo
Taipei City Hospital | tch · Department of Psychiatry, Taipei City Psychiatric Center

M.D.,Ph.D.

About

111
Publications
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1,972
Citations
Additional affiliations
July 1996 - present
Taipei City Hospital
Position
  • Professor

Publications

Publications (111)
Article
Background and aims: Alcohol-related mental health burden and suicidality impose heavy burdens on global public health. This study measured the sex-specific incidence and risk profiles of suicide mortality in individuals with alcohol dependence in a non-Western context. Design: In this prospective cohort study, individuals with alcohol dependenc...
Article
Full-text available
Background Few studies have analyzed healthcare utilization before suicide among individuals with attention-deficit/hyperactivity disorder (ADHD). This study examined the pattern of healthcare utilization and comorbidities shortly before death among patients with ADHD who died by suicide and compared these data with those of living controls. This s...
Article
Background Atherosclerosis accounts for cardiovascular diseases (CVDs). This study aimed to explore the association between carotid intima-media thickness (CIMT), psycho-pharmacotherapy, and inflammatory markers along with other molecules related to atherosclerosis in bipolar disorder (BD). Methods The euthymic patients with bipolar I disorder (BD...
Article
Objectives Although alcohol dependence is highly prevalent in patients with bipolar disorder, the causal relationship is not yet well-established. This study estimated the incidence of alcohol dependence in a nationwide bipolar disorder cohort and examined risk factors for alcohol dependence. Methods Patients aged 15–65 years with consistent bipol...
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Affective switch is an important clinical issue when treating bipolar disorder. Though commonly seen in clinical practice, the benefits of prescribing antidepressants for bipolar depression are still controversial. To date, there have been few genetic studies and no genome-wide association study (GWAS), focusing on manic switch following bipolar de...
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Despite the consistent finding of an attenuated niacin-induced flush response in schizophrenia, its long-term stability and relationship to the membrane polyunsaturated fatty acid (PUFA) levels remain unknown. We conducted niacin skin tests and measured the membrane PUFAs using gas chromatography among 46 schizophrenia inpatients and 37 healthy con...
Article
Error patterns of facial emotion recognition (FER) indicate how individuals misinterpret others’ facial expressions, which helps clinicians to manage related deficits. However, previous investigations are limited and may have been biased due to methodological issues (e.g., no consideration of response bias). This study aimed to propose a detectabil...
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Objectives Panic disorder (PD) is associated with high psychiatric and physical comorbidity, but the cause of mortality has not been well studied. This study investigated mortality rates and causes of death in an Asian cohort with PD. Methods We enrolled a nationwide retrospective cohort of 298,466 persons diagnosed with PD from January 1, 2001, t...
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Background This study examined the pattern of medical utilization and the distribution of comorbidities shortly before death among adolescents who died from suicide and compared these data with those of living controls. Methods From Taiwan's National Health Insurance Research Database, this study identified adolescents aged 10–19 years who died fr...
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Background Since the late 1990s, methamphetamine use has become a considerable public health concern. Despite high suicide rates among methamphetamine users, studies exploring medical utilization and psychiatric and physical comorbidities before suicide are scant. We aim to examine the pattern of medical utilization and distribution of comorbiditie...
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Background: Evidence of patterns of medical utilization and distribution of comorbidities among individuals using methamphetamine remains limited. Objective: This study aims to investigate changes in medical utilization and comorbidities before and after a diagnosis of methamphetamine use disorder. Methods: A total of 3321 cases (79% were male...
Article
Objective Medical comorbidities are prevalent in patients with bipolar disorder. Evaluating longitudinal trends of the incidence of medical illnesses enables implementation of early prevention strategies to reduce the high mortality rate in this at-risk population. However, the incidence risks of medical illnesses in the early stages of bipolar dis...
Article
Background: Evidence on sex-specific incidence and comorbidity risk factors of suicide among patients with bipolar disorder is scarce. This study investigated the sex-specific risk profiles for suicide among the bipolar disorder population in terms of incidence, healthcare utilization and comorbidity. Methods: Using data from the Taiwan National...
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Purpose Suicide is a leading cause of death in patients with schizophrenia. This nationwide cohort study investigated the incidence of each suicide method in patients with schizophrenia compared with the general population. Methods In total, records of 174,039 patients with schizophrenia were obtained from the National Health Insurance Research Da...
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We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients (N = 128) were followed for an average of 6.5 years. Intelligence quotient (IQ) at index date was recorded, and premorbid IQ...
Article
Background Facial emotion recognition deficit (FERD) seems to be an obvious feature of patients with schizophrenia and has great potential for classifying patients and non-patients. The FERD screener was previously developed to classify patients from healthy adults. However, an obvious drawback of this screener is that the recommended cut-off score...
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The search for susceptibility genes underlying the heterogeneous bipolar disorder has been inconclusive, often with irreproducible results. There is a hope that narrowing the phenotypes will increase the power of genetic analysis. Early-onset bipolar disorder is thought to be a genetically homogeneous subtype with greater symptom severity. We condu...
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Background and aims Although methamphetamine use is a serious public health problem, large‐scale cohort studies assessing methamphetamine‐related mortality are scant. This study investigated all‐cause mortality and suicide methods in people with methamphetamine use disorder. Design A cohort record‐linkage study using data from Taiwan's National He...
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Objective: The authors investigated the distributions and trajectories of physical illnesses preceding the diagnosis of bipolar disorder with comparison to schizophrenia and general populations. Methods: Using data from the Taiwan National Health Insurance Research Database entered from 1996 to end of 2012, we identified 13,079 patients newly diagn...
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The introduction of pre-trained language models in natural language processing (NLP) based on deep learning and the availability of electronic health records (EHRs) presents a great opportunity to transfer the “knowledge” learned from data in the general domain to enable the analysis of unstructured textual data in clinical domains. This study expl...
Preprint
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Background: We characterized the heterogeneity and risk factors of cognitive decline in bipolar disorder (BD), and their magnitude of associations with subjective daily functions. Methods: Recruited BD patients (N=127) were followed for an average of 6.5 years. Baseline intelligence quotient was measured, and Brief Assessment of Cognition in Affect...
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Objectives Patients with bipolar disorder are at high risk of cardiovascular diseases. Among cardiovascular diseases, coronary heart disease and stroke are the leading causes of premature death and both share the pathogenesis of arterial atherosclerosis. Increased carotid intima-media thickness is sensitive for detecting early atherosclerosis and a...
Article
Objective The pathogenesis of sudden cardiac death may differ between younger and older adults in schizophrenia, but evidence remains scant. This study investigated the age effect on the incidence and risk of the physical and psychiatric comorbidity for sudden cardiac death. Methods Using 2000 to 2016 data from the Taiwan National Health Insurance...
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Background: Difficulties in prognostication are common deterrents to palliative care among dementia patients. This study aimed to evaluate the effectiveness of palliative care in reducing the extent of utilization of medical services and the potential risk factors of mortality among dementia patients receiving palliative care. Methods: We survey...
Article
Aim Home care case management (CM) is the main intervention for patients with severe mental disorders (SMDs) requiring outreach care. This study investigated the long-term mortality outcome and associated risk factors in patients who received home care CM. Methods This nationwide study enrolled patients who received home care CM (n = 10,255) betwe...
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Aims Research regarding the effects of age in patients with schizophrenia taking antipsychotics on the risk of sudden cardiac death is lacking. We determined the effect of patient age on the association between exposure to antipsychotics and the risk of sudden cardiac death in a nationwide schizophrenia cohort. Methods From the Taiwan National Hea...
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Background Schizophrenia is a debilitating mental illness that causes significant disability. However, the lack of evidence for functional decline yields difficulty in distinguishing patients with schizophrenia from healthy adults. Since patients with schizophrenia demonstrate severe facial emotion recognition deficit (FERD), FERD measurement appea...
Article
Aim Research regarding the effect of antipsychotic medications on the risk of upper respiratory infection (URI) progression to pneumonia in patients with schizophrenia is rare. This study investigated the effect of antipsychotic use on the risk of URI progression to pneumonia in patients with schizophrenia. Methods This cohort study used the Taiwa...
Article
Objective Data on the incidence and risk factors of sudden cardiac death in patients with bipolar disorder are lacking in the literature. Methods By using data from the Taiwan National Health Insurance Research Database and Department of Health Death Certification System between 2000 and 2016, we conducted a prospective national cohort study to de...
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Methamphetamine is a prevalent recreational drug among men who have sex with men (MSM) living with HIV and could cause the cognitive impairment and memory loss. However, studies on the association between methamphetamine use and adherence to antiretroviral treatment (ART) are limited and had inconsistent findings. This study aimed to determine the...
Article
Objective: Panic disorder (PD) is associated with somatization and high medical utilization in primary care settings. Treatment of PD could reduce the frequency of panic attacks and visits to emergency departments (EDs), but the associated change in medical utilization is unknown. This study investigated the change in medical utilization before an...
Article
Some physical illnesses are potentially associated with the development of schizophrenia. However, few studies have investigated these associations. Here, we examined physical illnesses and medical utilization patterns existing before patients received a diagnosis of schizophrenia. We enrolled a large representative cohort of the general population...
Article
Aim: Older community-dwelling patients with severe mental illness (SMI), particularly those with illness onset at young age, constitute a group of survivors with unique long-term care needs. Using an Asian sample in Taiwan, we attempted to find out the differences in outcomes related to physical health, cognition, and social functioning between ol...
Article
Background: Sex differences in the development of alcohol dependence (AD) among patients with panic disorder (PD) remain unexplored. The study investigated sex as an effect modifier in the incidence of AD among patients with PD. Method: We included 9480 patients with PD from the Taiwan National Health Insurance Research Database. A total of 169...
Preprint
Background: Home care case management (CM) is the main intervention for patients with severe mental disorders (SMDs) requiring outreach care. The present study investigated the long-term mortality outcome and associated risk factors in patients who received home care CM. Methods: In this nationwide study, we enrolled patients who received home care...
Article
Background: Many studies have used Taiwan's National Health Insurance Research database (NHIRD) to conduct psychiatric research. However, the accuracy of the diagnostic codes for psychiatric disorders in NHIRD is not validated, and the symptom profiles are not available either. This study aimed to evaluate the accuracy of diagnostic codes and use...
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Objective: Ascertaining comorbid illnesses and patterns of medical utilization early in the course of psychiatric illness can help identify patients with panic disorder. We investigated how such cases were diagnosed and the comorbidities associated with newly diagnosed panic disorder in a nationwide database. Methods: We enrolled a large represe...
Article
Purpose/background: Patients with schizophrenia are vulnerable to pneumonia. Clozapine is associated with the greatest risk of pneumonia. We investigated the risk factors of pneumonia in patients with schizophrenia who use clozapine. Methods/procedures: We used a large cohort of patients with schizophrenia (N = 22,774) who newly use clozapine (b...
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[This corrects the article DOI: 10.1371/journal.pone.0179424.].
Article
Aim: This nationwide study investigated the change in medical utilization of psychiatric home care case management (CM). Methods: This nationwide study enrolled patients receiving CM (N = 10,274) from January 1, 1999 to December 31, 2010, from Taiwan's National Health Insurance Research Database. Through a 2-year mirror-image comparison weighted...
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PurposeExcessive mortality has been seen in patients with personality disorder (PD), but it has not been well-studied when patients also have other psychiatric comorbidities. This study investigated the mortality rates and causes of death in an Asian cohort with PD. Method We enrolled patients ≥ 18 years of age with PD as defined by DSM-IV criteria...
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Objectives To investigate the relationship between benzodiazepine and risk of developing pneumonia in patients with schizophrenia, whose benzodiazepine dosage and usage frequency was higher than that of the general population. Methods We conducted a nested case–control study to assess the association between benzodiazepine use and pneumonia among...
Article
Background Research on the risk of stroke following the use of mood stabilisers specific to patients with bipolar disorder is limited. Aims In this study, we investigated the risk of stroke following the exposure to mood stabilisers in patients with bipolar disorder. Method Data for this nationwide population-based study were derived from the Tai...
Article
Aims Patients with schizophrenia have a higher incidence of tuberculosis than do people in the general population. The information regarding the association between antipsychotic agents and the risk of tuberculosis in the patients with schizophrenia is limited. This exploratory study assessed the risk of tuberculosis among patients with schizophren...
Article
Background: Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide...
Article
Patients with schizophrenia have higher mortality and shortened life expectancy than the general population, and cardiovascular disease (CVD) accounts for up to 50% cases of early mortality in schizophrenia. We determined risk factors, particularly pathophysiological changes, for early circulatory mortality in schizophrenia. In this multi-instituti...
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Aim: Patients with bipolar disorder had poorer outcomes after pneumonia and could have a higher risk for recurrence of pneumonia. We aimed to investigate the incidence and risk factors of recurrent pneumonia in patients with bipolar disorder. Methods: In a nationwide cohort of bipolar patients (derived from the National Health Insurance Research...
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Purpose: Our aim was to evaluate the effects of problem-solving skills training (PSST) on self-control behaviors and the positive and negative psychotic symptoms of schizophrenia in community-dwelling patients.Method: This quasi-experimental study was conducted in 63 adult community-dwelling outpatients with schizophrenia in Taiwan. The control gro...
Article
Objective Serum lipid levels may be associated with the affective severity of bipolar disorder, but data on lipid profiles in Asian patients with bipolar disorder and the lipid alterations in different states of opposite polarities are scant. We investigated the lipid profiles of patients in the acute affective, partial, and full remission state in...
Article
Aim: The change in psychiatric diagnoses in clinical practice is not an unusual phenomenon. The interchange between the diagnoses of schizophrenic disorders and bipolar disorders is a major clinical issue because of the differences in treatment regimens and long-term prognoses. In this study, we used a nationwide population-based sample to compare...
Article
Objective The aim of this paper was to analyze medical utilization patterns of female patients with anorexia nervosa before their first inpatient care visit for anorexia nervosa using the National Health Insurance Research Database (NHIRD) of Taiwan. Method We selected female anorexia nervosa patients (n = 239) and control participants hospitalize...
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Full-text available
Background: The association between antipsychotic use and the risk of stroke in schizophrenic patients is controversial. We sought to study the association in a nationwide cohort with schizophrenia. Methods: Using a retrospective cohort of patients with schizophrenia (N = 31,976) derived from the Taiwan National Health Insurance Research Databas...
Article
Aim: We attempted to determine risk factors, particularly pathophysiological changes, for the early cardiovascular mortality in bipolar disorder. Methods: A total of 5416 in-patients with bipolar I disorder were retrospectively followed through record linkage for cause of death. A total of 35 patients dying from cardiovascular disease (CVD, ICD...
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Background Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. Chinese herbal medicine (CHM) is frequently provided to HCC patients. The aim of this study was to understand the prescription frequency and patterns of CHM for HCC patients by analyzing the claims data from the National Health Insurance (NHI) i...
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Aims For nearly a century, the incidence of cancer in people with schizophrenia was lower than in the general population. In the recent decade, the relationship between cancer and schizophrenia has become obscured. Thus, we investigated the cancer risk among young and middle-aged patients with schizophrenia. Methods Records of newly admitted patie...
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Background: This study assessed the risk of developing acute coronary syndrome requiring hospitalization in association with the use of certain antipsychotic medications in schizophrenia patients. Methods: A nationwide cohort of 31,177 inpatients with schizophrenia between the ages of 18 and 65 years whose records were enrolled in the National H...
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Objective: Long-term follow-up data regarding the association between methamphetamine use and cardiovascular and cerebrovascular complications are scarce. We investigated the risk of complications in methamphetamine users over a decade. Methods: A total of 1,315 inpatients treated for methamphetamine use were recruited from the Psychiatric Inpat...
Article
Objective: People with alcohol dependence suffer from poor health outcomes, including excessive suicide mortality. This study estimated the suicide rate and explored the risk and protective factors for suicide in a large-scale Asian population. Method: We enrolled patients with alcohol dependence (ICD-9 code 303**) consecutively admitted to a ps...
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Objective: Few studies have used systematic datasets to assess the safety of antipsychotic rechallenge after an adverse event. This nested case-control study estimated the risk for recurrent pneumonia after reexposure to antipsychotic treatment. Method: In a nationwide schizophrenia (ICD-9-CM code 295) cohort (derived from the National Health In...
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Full-text available
A performance-based measure for assessing executive functions (EF) is useful to understand patients' real life performance of EF. This study aimed to develop a performance-based measure of executive functions (PEF) based on the Lezak model and to examine psychometric properties (i.e., unidimensionality and reliability) of the PEF using Rasch analys...
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Objective: Coronary heart disease (CHD) remains the principal cause of excessive natural deaths in bipolar patients; however, electrocardiogram analyses and clinical features predicting CHDs in elderly bipolar patients remain limited. We sought to examine the relationship between CHDs, as determined by electrocardiogram, and clinical characteristi...
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Objective: Patients with bipolar disorder are at a high risk for comorbid alcohol use disorder, and both disorders are associated with poor outcomes and multiple morbidities. This study aimed to explore not only the psychosocial functioning and psychopathological outcomes but also the medical morbidity of patients with bipolar disorder with and wi...
Article
Patients with schizophrenia before reaching geriatric age are at high risk of circulatory mortality. However, investigations are lacking on the characteristics of physiological measurement among these at-risk patients. In this study, we followed acutely inpatients with schizophrenia disorder for cause of death through record linkage to the Death Ce...
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The association between smoking and suicide is still controversial, particular for early life cigarette smoking exposure. Few studies have investigated this association in adolescents using population-based cohorts, and the relationship with second hand smoking (SHS) exposure has not been addressed. In this study, we followed a large population-bas...
Article
Excessive alcohol consumption causes a broad range of health problems, including premature mortality and su