Evaluation of psychometric properties of the Chinese Mandarin version State-Trait Anxiety Inventory Y form in Taiwanese outpatients with anxiety disorders.

This study was conducted to develop the Chinese Mandarin State-Trait Anxiety Inventory Y form and to evaluate its psychometric properties among Taiwanese outpatients with anxiety disorders. A three-phase survey questionnaire was used to gather cross-sectional data. Non-hospitalized adults (n= 306) with anxiety disorders were recruited from mental health clinics in central Taiwan. Cronbach's alpha reliabilities for the state and trait anxiety subscales were 0.91 and 0.92, respectively. The 2-week test-retest reliabilities for the state and trait anxiety subscales were 0.76 and 0.91, respectively. Criterion validity of the scale was supported by its high correlations with the interview version of the Chinese Hamilton Anxiety Rating Scale (r= 0.69 for state and 0.74 for trait anxiety). Construct validity of the scale was confirmed by a four-factor structure, showing slightly adequate representation of the data. The scale was shown to be reliable and may be valid for measuring anxiety in Taiwanese adults with anxiety disorders.

Low prevalence of major depressive disorder in Taiwanese adults: possible explanations and implications.

BACKGROUND: This study examined the prevalence of major depressive disorder (MDD), and the correlations and co-morbid conditions associated with MDD, in the adult Taiwanese population, which a previous estimate in the 1980s had found to be at the lower end of the spectrum worldwide. Possible explanations for the reported low prevalence of MDD were evaluated. METHOD: As part of a survey of common psychiatric disorders in a nationally representative sample of individuals aged ≥ 18 years who were non-institutionalized civilians in Taiwan, a face-to-face interview using the paper version of the World Mental Health Survey of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI) was conducted between 2003 and 2005. Functional impairment and help-seeking behaviors were compared between Taiwanese subjects with MDD and their counterparts in the USA. RESULTS: Among the 10 135 respondents, the lifetime prevalence of MDD was 1.20% [standard error (S.E.)=0.2%]. Individuals who were divorced or widowed, aged ≤ 40 years, and female were at increased risk, whereas rural residents were at lower risk for MDD. The proportion of MDD cases co-morbid with other psychiatric disorders in this study was much lower than in the US study. Only one-third of Taiwanese individuals with MDD sought help despite having twice the number of lost workdays compared with the US sample. CONCLUSIONS: Despite the low prevalence of MDD in Taiwanese adults, the pattern of low help-seeking behavior and profound functional impairment indicates much room for improvement in the early detection of and intervention in major depression in this population.

Genome-wide association study of bipolar I disorder in the Han Chinese population.

We report the first genome-wide association study in 1000 bipolar I patients and 1000 controls, with a replication of the top hits in another 409 cases and 1000 controls in the Han Chinese population. Four regions with most strongly associated single-nucleotide polymorphisms (SNPs) were detected, of which three were not found in previous GWA studies in the Caucasian populations. Among them, SNPs close to specificity protein 8 (SP8) and ST8 α-N-acetyl- neuraminide α-2,8-sialyltransferase (ST8SIA2) are associated with Bipolar I, with P-values of 4.87 × 10(-7) (rs2709736) and 6.05 × 10(-6) (rs8040009), respectively. We have also identified SNPs in potassium channel tetramerization domain containing 12 gene (KCTD12) (rs2073831, P=9.74 × 10(-6)) and in CACNB2 (Calcium channel, voltage-dependent, ß-2 subunit) gene (rs11013860, P=5.15 × 10(-5)), One SNP nearby the rs1938526 SNP of ANK3 gene and another SNP nearby the SNP rs11720452 in chromosome 3 reported in previous GWA studies also showed suggestive association in this study (P=6.55 × 10(-5) and P=1.48 × 10(-5), respectively). This may suggest that there are common and population-specific susceptibility genes for bipolar I disorder.

Effect of prenatal exposure to polychlorinated biphenyls on cognitive development in children: a longitudinal study in Taiwan.

BACKGROUND: From 1978 to 1979, a group of people in Taiwan were exposed to high levels of heat-degraded polychlorinated biphenyls (PCBs) owing to accidental ingestion of contaminated rice oil. Children born to mothers following the exposure ('Yucheng' children) were known to have hyperpigmented skin and other dysmorphology after birth. AIMS: To determine the effect of prenatal exposure to PCBs on cognitive development in Yucheng children. METHOD: One hundred and eighteen Yucheng children prenatally exposed to PCBs and degradation products, and community-matched control children who were exposed to background levels only, were followed from 1985 to 1998. The Bayley Scale for Infant Development, Chinese version of the Stanford-Binet IQ Test, Raven's Coloured Progressive Matrices and Raven's Standardised Progressive Matrices were used to assess the cognitive development of these children. RESULTS: The Yucheng children scored lower than control children on each of these methods of measurement between the ages of 2 and 12 years. CONCLUSIONS: Prenatal exposure to PCBs and their derivatives has long-term adverse effects on cognitive development in humans.

[Process analysis of cognitive-behavioral group psychotherapy for patients with panic disorder].

The study explores the verbal interaction relationship between therapists and members, and the interaction model of this group. Six subjects were chosen by convenience sampling from the psychiatric OPD of a medical center in the Taichung area. Subjects with informed consent participated in a 12-week course of closed group psychotherapy. All data was tape-recorded and the Hill Interaction Matrix (HIM) scale was applied for simultaneous triangulation, in order to analyze the group's dynamic development of cognitive-behavioral psychotherapy for patients with panic disorder. The results indicated that the interactive relationship between therapists and members fluctuated during the group process. Development of the group process can be subdivided into three stages: initial stage-adaptive and familiar, middle stage-explorative, and terminal stage-productive. The amount of verbal interaction was greatest in the third quadrant. In the group interaction model, the therapist tended to explore the members' problems most. Providing support was the second most frequent. Meanwhile, members also tended to discuss personal problems. It was revealed that the verbal interaction of the therapists and members were the same. The content style of this group session is member-centered, and work style is pre-worked. The results showed that the group sessions did have great therapeutic value for members.

Mid-trimester beta-hCG levels incorporated in a multifactorial model for the prediction of severe pre-eclampsia.

Pre-eclampsia remains a major cause of perinatal morbidity and mortality worldwide. Proposed predicting tests for early detection of pregnant women destined to develop pre-eclampsia remain unsatisfactory. The aim of this study was to investigate the clinical utility of combining mid-trimester maternal serum beta-human chorionic gonadotrophin (MShCG) levels with selected clinical determining factors as a multifactorial predictive test for pre-eclampsia. Thirty-nine cases with mild pre-eclampsia and 56 with severe pre-eclampsia were recruited as the study groups. Normotensive women (957) were enrolled as controls. Potential determining risk factors for severe pre-eclampsia were selected using a multiple logistic regression to build various combined prediction models. A receiver-operator characteristic curve was employed to assess the performance of each prediction test for pre-eclampsia. The prediction efficacy of each test was examined by the area under the curve (AUC). Our data show that mid-trimester MShCG levels significantly correlated with severity of pre-eclampsia (Spearman rank correlation coefficient=0.195, p<0.001). Women with mild pre-eclampsia had a 2.61-times greater chance, while women with severe pre-eclampsia had a 6.13-times greater chance of having MShCG exceeding 2.0 multiples of the median than did women with a normal pregnancy. A combined prediction model composed of MShCG levels, body mass index (BMI), parity, and age as a predictive test for severe pre-eclampsia was superior to MShCG levels alone (AUC 0.765 versus 0.648). The integrated multifactorial model could identify women at risk early on for developing severe pre-eclampsia, with a sensitivity of 70% and a specificity of 71%. Thus, we demonstrate a potentially effective and convenient method by which women at risk for developing severe pre-eclampsia can be identified early, based on a multifactorial predictive model composed of midtrimester MShCG levels, BMI, parity, and age.

Development of the Taiwanese Depression Questionnaire.

BACKGROUND: Previous studies have shown that different cultures have various modes for emotional expression which suggest that Western scales have certain limitations. The purpose of this study was to develop a culturally relevant depression screening questionnaire: the "Taiwanese Depression Questionnaire" (TDQ) which can be used to conduct epidemiological surveys in Taiwanse society. METHODS: Based on the results of previous studies and related references, a draft of the TDQ was constructed. After several research group discussions, the first version of a 20-item draft was developed. By purposive sampling, 48 patients, from depressive disorder and anxiety disorder groups of Chang Gung Memorial Hospital's psychiatric clinics, self-rated the draft to test the wording, sequences, and its concurrent validity. After item analysis, a meeting of experts, and draft modification, an 18-item second version of the draft was established. Afterwards, 107 community subjects, recruited from Jenwu Township of Kaohsiung County, were sampled for the receiver operating characteristic (ROC) curve analysis, conventional validity index, and internal consistency of reliability. RESULTS: The results demonstrate that Cronbach's alpha coefficient (0.90), concurrent validity, and the area under the ROC curves (0.92) are all quite satisfactory. The 18-item TDQ had a sensitivity of 0.89 and a specificity of 0.92 at a cutoff score of 19. CONCLUSIONS: The TDQ is a culturally relevant questionnaire, which is adaptable for screening depressive people in the local communities.

Disordered behavior in the early-born Taiwan Yucheng children.

Behavioral problems were evaluated in Taiwanese children who were born between July 1978 and June 1985 to women who had consumed rice oil that was contaminated by heat-degraded polychlorinated biphenyls (PCBs). One hundred and eighteen such children, referred to as 'the early-born Yucheng children', and matched controls were followed with the Chinese version of Rutter's Child Behavior Scale A annually from 1985 to 1991. At any fixed age, the early-born Yucheng children had mean Rutter behavior scores 1.75 to 2.40 points higher (14-38% worse) than that of their controls. The effects were similar in the health, habit, and behavioral subscores and persistent as the children aged.

Cognitive development in Yucheng children.

We have been following up the biological and mental development of children exposed prenatally to polychlorinated biphenyls and their contaminants (Yucheng children). When we started this 12-year follow-up study in August 1985, 118 Yucheng children we assigned a non-exposed child matched by sex, age, locality of residence, mother's age, socio-economic status of the family. This article reports the cognitive aspect of the development of Yucheng children as compared to their matched controls. A consistent tendency which indicates that Yucheng children score lower in each kind of measurement tool at each age level has been observed. This seems to imply that congenitally exposure to PCBs and their contaminants has long-term adverse effects on the cognitive development of human being.

Molecular and cytogenetic analyses of autism in Taiwan.

Karyotypic and DNA analyses were both performed on 104 autistic children referred from Taichung Autism Education Academy and Tainan Autism Association in Taiwan. The frequency of fragile sites of the autistic patients did not differ significantly from that of the normal individuals. Of the 12 autistic children with chromosomal abnormalities, 8 had the fragile X, 2 had Down syndrome, and the remaining had other aneuploid constitutions. The results of this study illustrate the contribution of chromosomal abnormalities or variants to the pathogenesis of infantile autism.