Chih-Hung Ko

Kaohsiung Medical University · Psychiatry

Background and aims The authors of the present study wanted to know whether the previously reported psychiatric comorbidities of internet gaming disorder (IGD) based on DSM-5 criteria were also more prevalent among gaming disorder (GD) or hazardous gaming (HG) based on ICD-11 criteria. Therefore, the present case-control study evaluated the psychia...

Background and Objectives: Exploring daily lifestyle characteristics in individuals with gaming disorder (GD) might identify underlying causes and intervention points. However, integrative and subjective assessments are lacking in studies on this topic. This study aimed to assess circadian typology and physical activity in young adults with GD. Mat...

Background: This study evaluated the associations between inattention, impulsivity, and attention deficit hyperactivity disorder (ADHD) in women with premenstrual dysphoric disorder (PMDD) across the menstrual cycle. Methods: This study enrolled 58 women with PMDD and 50 controls. Symptoms were assessed using the Attention and Performance Self-Asse...

Background and objectives: Substance use disorder (SUD) has become a major concern in public health globally, and there is an urgent need to develop an integrated psychosocial intervention. The aims of the current study are to test the efficacy of the integrated treatment with neuro-feedback and mindfulness-based therapy for SUD and identify the pr...

Background：The correct diagnosis of schizophrenia is essential to reduce the economic burden and avoid worsening patients’ comorbidities. However, current clinical diagnosis is subjective and time consuming. We propose a deep learning method using the bidirectional encoder representations from transformers (BERT) to identify lexical incoherence rel...

Background The eleventh revision of the International Classification of Diseases (ICD-11) defines the three key diagnostic criteria for gaming disorder (GD). These are loss of control over gaming, gaming as a priority over daily activities, and impaired functioning due to gaming. While this definition has implications for the prevention and treatme...

The alteration in circadian typology and insomnia were prevalent among both Individuals with IGD and those with attention deficit hyperactivity disorder (ADHD), the most comorbid psychiatric disorder of IGD. This study aimed to evaluate the relationships between circadian typologies, insomnia, and internet gaming disorder (IGD) and how ADHD affects...

Cognitive impairment is a key feature of depressive disorder. Various forms of cognitive function have yet to be investigated in women with premenstrual dysphoric disorder (PMDD) during early luteal (EL) and late luteal (LL) phases. Therefore, we evaluated response inhibition and attention in PMDD in these two phases. We also examined the associati...

Purpose of Review This review explores the differences in approach and diagnostic validity between the International Classification of Diseases, 11th Revision criteria for gaming disorder (ICD-11-GD), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for internet gaming disorder (DSM-5-IGD). Recent Findings A fe...

Aim This study evaluated the consistency between the International Classification of Diseases, 11th Edition ( ICD-11 ) for gaming disorder ( ICD-11 -GD) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5 ) criteria for internet gaming disorder ( DSM-5 -IGD). Moreover, the functional impairment of participants and their...

Purpose of Review This commentary aimed to propose the screening, brief intervention, and referral to treatment (SBIRT) model for gaming disorder (GD) and hazardous gaming (HG) on the basis of the International Classification of Disease, 11th version (ICD-11) classification. Recent Findings COVID-19 and its preventive measures increase the risk of...

Background Heart rate variability (HRV) and respiratory sinus arrhythmia (RSA) are indices of cardiac autonomic and cardiac vagal control (CVC), both of which are markers of emotional regulation and physical health. This study examined (1) the differences in cardiac autonomic regulation and CVC during baseline, depressive, and happiness autobiograp...

Objective: Cognitive and somatic symptoms were vital factors in developing personalized treatment of depressive disorder. The study aimed to evaluate the following: (1) the cognitive and somatic symptoms of premenstrual dysphoric disorder (PMDD) in the early luteal (EL) and later luteal (LL) phase; and (2) their association with depression and fun...

The aims of this study were to investigate the efficacy of heart rate variability biofeedback (HRVBFB) intervention in terms of reducing craving, severity of dependence, and rate of positive methamphetamine urine testing in men taking part in a methamphetamine use disorder outpatient treatment program. Sixty-one adult men received either HRVBFB tre...

Aim The study explores IGD withdrawal-related presentations, including autonomic reaction, affective symptoms, anhedonia, and gaming urge during abstinence from gaming. We prospectively evaluated these withdrawal-related symptoms (WRS) and gaming craving during abstinence from gaming. Methods We examined 69 individuals with IGD and 69 regular game...

Purpose of review: Understanding the association between urbanization and Internet addiction is essential to the design and implementation of Internet addiction prevention measures in urban areas. This epidemiological review explores the urbanization-Internet addiction association and its potential underlying factors. Recent findings: Nine studi...

Dopamine functioning is an essential mechanism underlying addictive behaviors. This paper evaluates the association of Internet gaming disorder (IGD) with the catechol‐O‐methyltransferase (COMT) val158met polymorphism and examines the roles of impulsivity and reinforcement sensitivity in this association. Using diagnostic interviews, this study rec...

The metabolism of bioamine in the central nervous system contributes to the development of addiction. We examined the roles of hostility and depression in the association between internet gaming disorder (IGD) and monoamine oxidase-A (MAOA) EcoRV polymorphism (rs1137070). A total of 69 adults with IGD and 138 without IGD were recruited through diag...

Aim: Premenstrual dysphoric disorder (PMDD) has predictable, cyclic, psychological, and somatic symptoms, such as sleep problems. They result in functional impairment, are aggravated in the late luteal phase of the menstrual cycle, and are resolved by menstruation. The present study evaluated the insomnia, inattention, and fatigue symptoms of PMDD...

This study aimed to evaluate the belief of frustration intolerance of individuals with internet gaming disorder (IGD) and its association with depression among them. We recruited 69 participants with IGD and 138 controls (69 regular gamers and other non‐gamers). IGD is diagnosed based on DSM‐5 (DSM stands for diagnostic and statistical manual of me...

Craving is a core feature of heroin use disorder. Craving for heroin is a conscious cognitive process. Recently, implicit (i.e., an implicit attitude toward heroin use) cognitive processes have been thought to be precursors of cravings. This study aimed to explore the associations of craving and implicit attitude toward heroin use with the level of...

Aim: Gaming escapism is an essential factor for developing internet gaming disorder (IGD). We evaluated coping strategies, resilience, stress, and depression in individuals with IGD. Methods: We included 69 participants with IGD and 138 controls (69 regular gamers and other non-gamers) in Taiwan. The self-reported coping strategies, coping stres...

Background and aims Following the recognition of ‘internet gaming disorder’ (IGD) as a condition requiring further study by the DSM‐5, ‘gaming disorder’ (GD) was officially included as a diagnostic entity by the World Health Organization (WHO) in the eleventh revision of the International Classification of Diseases (ICD‐11). However, the proposed d...

Using a self‐administered questionnaire (the five‐item Brief Symptom Rating Scale, BSRS‐5), determine the prevalence of suicide ideation (SI), psychiatric morbidity (PM), and the factors associated with these conditions in a general hospital in Taiwan. All individuals aged 12 years or older, who were admitted to a Medical University Hospital betwee...

Sleep problems are common in Taiwan. Poor sleep may be associated with many illnesses, including substance use disorders. Ketamine use disorder has significantly increased in Taiwan in recent years and may lead to physical and cognitive problems. Craving for ketamine is a risk factor for ketamine use and relapse, and poor sleep quality may increase...

Objective: In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) included the diagnostic criteria of Internet gaming disorder (IGD). Then, in 2019, the 11th Revision of the International Classification of Diseases (ICD-11) categorized gaming disorder (GD) as an addictive disorder. This review aimed to review the...

Digital technologies are powerful tools for connecting individuals to each other and the world. Although concerns about the effects of mass media in varying forms (e.g., television and movies) on violence have been raised for decades, causal relationships between long-standing and more recently developed technologies and mental health consideration...

The global coronavirus disease 2019 (COVID-19) outbreak has necessitated physical distancing, lockdown, contact tracing, and self-quarantine so as to prevent the spread of the disease. Amid the outbreak, gaming data usage has reportedly increased in the United States, and game download volume has reached a record high in Europe. Because gaming can...

Despite the increasing research attention being paid to gaming disorder globally, a screening tool developed specifically for the Chinese population is still lacking. This study aims to address this gap by constructing a screening tool to assess Internet gaming disorder (IGD) symptomology, defined by the fifth edition of the Diagnostic and Statisti...

Purpose: Lack of control over Internet gaming habits may result in negative consequences. This study aimed to evaluate the emotional regulation of adults with Internet gaming disorder (IGD) and the association of emotion regulation, depression, and hostility. Methods: Advertisements were used to recruit 69 young adults with IGD, 69 sex- and age-...

Objectives In this study, we evaluated the changes in leptin and ghrelin concentrations, eating behavior, depression, and impulsivity and their correlations within the luteal phase among women with premenstrual dysphoric disorder (PMDD). Methods In 63 women with PMDD and 53 healthy controls, we prospectively evaluated serum levels of leptin and gh...

Objectives: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) includes the diagnostic criteria for Internet gaming disorder (IGD). This study evaluated (1) the screening, diagnostic, and prevalence-estimated cutoff points of the Chen Internet Addiction Scale–Gaming Version (CIAS-G) for IGD in the DSM-5; and (2) the di...

Background Many concerns have been raised regarding the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for Internet gaming disorder and International Classification of Diseases, 11th Revision (ICD-11) criteria for gaming disorder. Aims In this study, we demonstrated the diagnostic validity of each criterion for Int...

Background and Aims: Using gaming to escape emotional difficulty has been suggested to be a candidate mechanism contributing to Internet gaming disorder (IGD). This study evaluated the associations among resilience, perceived stress, depression, and IGD. Methods: A total of 87 participants in an IGD group and 87 participants in a control group were...

Purpose End-stage renal disease (ESRD) patients exhibit silent white-matter alterations after long-term hemodialysis, which may be due to ESRD itself or the hemodialysis. The purpose of this study was to investigate the longitudinal white-matter alterations in the ESRD patients under 3-year long-term hemodialysis using voxel-wise analysis of diffus...

Multiple regression analysis for correlations between white matter alterations and age in healthy controls. Red-yellow colors show the regions with significant positive correlations between AD (a-c), RD (d-f), MD (g-i) and age, and a significant negative correlation between FA (j-l) and age. Color bars in the right-hand side indicate T-value. (TIF)

Multiple regression analysis for correlations between white matter alterations and age in ESRD patients. Red-yellow colors show the regions with significant positive correlations between RD (a-c), MD (d-f) and age, and a significant negative correlation between FA (g-i) and age. Color bars in the right-hand side indicate T-value. (TIF)

Group comparisons of the DTI indices between patient and control groups at the first scan. The table shows MNI coordinates of regions with significantly different AD, RD, MD, and FA values of the first scan between the two groups. (PDF)

Group comparisons of the DTI indices between patient and control groups at the second scan 3 years later. The table shows MNI coordinates of regions with significantly different AD, RD, MD, and FA values of the second scan between the two groups. (PDF)

Objective: In this study, we intended to evaluate the association between reinforcement sensitivity and male adults with attention-deficit/hyperactivity disorder (ADHD), as well as the association between reinforcement sensitivity and Internet addiction. Methods: We recruited 52 male adults with ADHD and 52 healthy male controls. All participants r...

Internet gaming disorder is gaining attention around the world. Some efforts have been directed toward preventing gaming problems from developing or persisting, but few approaches have been empirically evaluated. No known effective prevention intervention exists. Reviewing the broader field of prevention research should help research and best pract...

Introduction: Antipsychotic treatment can improve the symptoms of schizophrenia; however, residual symptoms after antipsychotic treatment are frequent. The effects of exercise on the symptoms of schizophrenic patients under antipsychotic treatment are inconclusive. The aim of this randomized case-control study was to examine the effects of aerobic...

Objective: End-stage renal disease (ESRD) patients on hemodialysis were demonstrated to exhibit silent and invisible white-matter alterations which would likely lead to disruptions of brain structural networks. Therefore, the purpose of this study was to investigate the disruptions of brain structural network in ESRD patients. Materials and metho...

Objective of study: Alcohol use disorder is one of the most important factors contributing to dementia. This study examined the protective effect of thiamine administration on the incidence of dementia among patients with alcohol use disorder in Taiwan by evaluating a nationwide database. Methods: We retrieved data for this retrospective cohort...

Aim Chronic heroin use can cause various neuropathological characteristics that may compromise brain function. The present study evaluated the alteration of gray matter volume (GMV) and its resting‐state functional connectivity (rsFC) over dorsolateral prefrontal cortex (DLPFC) among male heroin users. Methods Thirty heroin‐dependent men undergoin...

The aim of the study was to evaluate changes in late-luteal appetite for highly sweet (HS) and highly salty and fatty (HSF) foods in women with premenstrual dysphoric disorder (PMDD). After initial assessment in a psychiatric interview, the premenstrual symptoms screening tool (PSST) was used to identify women with moderate-to-severe premenstrual s...

People diagnosed with Internet gaming disorder (IGD) have been frequently reported to experience depression, anxiety, and hostility. Emotional regulation contributes to these mood symptoms. This study evaluated emotional regulation in subjects with IGD and examined relationships between emotional regulation, depression, anxiety, and hostility in yo...

Introduction This study evaluates the association between generalized anxiety disorder (GAD) and Internet gaming disorder (IGD) and the role of behavior inhibition in young adults. Methods We recruited 87 people with IGD and a control group of 87 people without a history of IGD. All participants underwent a diagnostic interview based on the fifth...

Background: This study evaluated the association between estrogen levels, emotion regulation, depression, anxiety, and stress of women with premenstrual dysphoric disorder (PMDD). We also evaluated the moderating effect of estrogen receptor (ESR) α-Xbal polymorphism on the aforementioned association. Methods: A total of 100 women were diagnosed...

Aim To examine the relationship between borderline personality symptoms and Internet addiction as well as the mediating role of mental health problems between them. Methods A total of 500 college students from Taiwan were recruited and assessed for symptoms of Internet addiction using the Chen Internet Addiction Scale, borderline personality sympt...

Purpose: This study examined the differences in mental health and behavioral problems among young adults with borderline personality symptoms of various severities. Methods: 500 college students participated in this study. Borderline personality symptoms were evaluated using the Taiwanese version of the Borderline Symptom List (BSL-23). Mental h...

Background: Persistent gaming, despite acknowledgment of its negative consequences, is a major criterion for individuals with Internet gaming disorder (IGD). This study evaluated the adaptive decision-making, risky decision, and decision-making style of individuals with IGD. Methods: We recruited 87 individuals with IGD and 87 without IGD (match...

Background The aim of the present study was to evaluate the impulsivity and brain correlates of response inhibition and error processing among females with obesity and sweet food addiction (O & SFA). Methods We evaluated the response inhibition and error processing by functional magnetic resonance imaging (fMRI) in subjects with O & SFA and contro...

Young adults with Internet gaming disorder (IGD) usually postpone the tasks of their daily lives to engage in Internet gaming. This study evaluates the association between procrastination and IGD and the association between the negative consequences of IGD and procrastination. We recruited 87 individuals with IGD and 87 controls without a history o...

Abnormal interhemispheric functional connectivity is attracting more and more attention in the field of substance use. This study aimed to examine 1) the differences in interhemispheric functional connections of the insula with the contralateral insula and other brain regions between heroin users under methadone maintenance treatment (MMT) and heal...

Internet gaming disorder (IGD) and attention deficit and hyperactivity disorder (ADHD) are associated with impulsivity and hostility. This study evaluated the associations among ADHD, impulsivity, hostility, and IGD. We recruited 87 individuals with IGD and 87 controls without a history of IGD. All participants underwent a diagnostic interview base...

Aims: A possible addiction mechanism has been represented by altered functional connectivity (FC) in the resting state. The aim of this study was to evaluate the FCs of the insula and nucleus accumbens among subjects with Internet gaming disorder (IGD). Methods: We recruited 30 males with IGD and 30 controls and evaluated their FC using function...

Objective This study examines the differences in explicit and implicit stigma between medical and non-medical undergraduate students at baseline; the changes of explicit and implicit stigma in medical undergraduate and non-medical undergraduate students after a 1-month psychiatric clerkship and 1-month follow-up period; and the differences in the c...

Background: Craving for substance use has been added as one of the diagnostic criteria of substance use disorders in DSM-5. However, further research is necessary to examine and expand the clinical potential of craving in the assessment and treatment for heroin users. This study aimed to examine the psychometrics of the Desire for Drug Questionnai...

This research aims to construct the Chen Internet Addiction Scale: Elementary School Parent Version (CIAS-P) and examine its validity and reliability. The construction of CIAS-P is based on the framework of the Chen Internet Addiction Scale (CIAS) and the Chen Internet Addiction Scale-Children Version (CIAS-C), and is modified with other relevant l...

The present study aimed to reveal the brain correlates of phonological working memory (WM), dual tasking, and distraction in adult ADHD combined with the effect of polymorphisms of monoamine oxidase A (MAOA rs1137070 Asp470Asp). A total of 29 participants with adult ADHD and 21 controls were recruited. They completed 0-back and 2-back tasks, as wel...

Individuals with adult attention deficit/hyperactivity disorder (ADHD) have a deficit in their cognitive control. The aim of this study was to reveal the brain correlates of the deficits in response inhibition or error processing in adult ADHD. A total of 29 adults with ADHD and 25 control individuals were recruited. They completed an event-related...

Background: Zolpidem and zopiclone are the two most commonly prescribed Z-drugs approved to treat insomnia. Objectives: To examine the demographic and clinical correlates of dependence and beliefs about hypnotic use among long-term zolpidem and zopiclone users in psychiatric treatment for insomnia. Methods: A total of 392 psychiatric outpatien...

The aim of this study was to evaluate the altered brain structure and functional connectivity (FC) among subjects with Internet gaming disorder (IGD).Methods We recruited 30 males with IGD and 30 controls and evaluated their gray matter density (GMD) and FC using resting fMRI. The severities of IGD, gaming urge, and impulsivity were also assessed.R...

Complex sleep-related behaviors (CSBs) are often associated with hypnotic use, especially zolpidem. The age effect on the occurrence of CSBs has not been adequately investigated. This study aimed to investigate and compare the clinical correlates of CSBs between adult and elderly subjects who were taking zolpidem. A total of 253 adults (aged 20-55...

This study compared physical child abuse and teacher harassment of bully-victims with other groups and examined their associations with mental health problems in bully-victims. For 6,160 adolescents, experiences of physical child abuse, teacher harassment, peer bullying, and six mental health problem indicators were assessed. Adolescents that had e...

Introduction: To examine the prevalence rates and correlates of dependence on, misuse of, and beliefs regarding use of hypnotics in elderly psychiatric patients with long-term use of zolpidem, estazolam, or flunitrazepam. Methods: A total of 139 psychiatric outpatients 65 or more years of age who used zolpidem, estazolam, or flunitrazepam for at...

The aims of this study were to examine the prevalence rates and multilevel correlates of cyberbullying victims and perpetrators among male adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) in Taiwan. The relationships between cyberbullying involvement and depression, anxiety, and suicidality were also examined. The experien...

Internet gaming disorder (IGD), one type of internet addiction, was recruited in DSM-5 as an addictive disorder. The concept, diagnosis, research, and treatment of internet addiction should move forward to contribute to society and science. We need have more consensus in concept of internet addiction, particular to define what is the core presentat...

Introduction. Internet gaming disorder (IGD) was a newly defined behavior addiction. However, its associated with other addictive disorder had not been well investigated. This study aimed at evaluating the association between Internet gaming disorder and nicotine dependence. Methods. The subjects with IGD were recruited by advertising post for heav...

Background Craving is an important issue in substance use disorder. To achieve a better understanding of the cognitive processing systems of craving, the cognitive processes of craving have been considered as two distinct processes. One system, based on rule-based inferences and named explicit cognition, is more conscious and effortful. The other s...

AimsThe present study aimed to evaluate the brain correlates of response inhibition among subjects with Internet gaming disorder (IGD).Methods For this purpose, 15 men with IGD for at least 1 year, and 15 controls with no history of IGD were recruited to perform the Go/Nogo task under functional magnetic resonance imaging investigation. Prior to sc...