Ching-Yen Chen - Academia.edu (original) (raw)

Papers by Ching-Yen Chen

Background: Smoking tobacco, drinking alcohol, and chewing betel quid are health-risk behaviors f... more Background: Smoking tobacco, drinking alcohol, and chewing betel quid are health-risk behaviors for several diseases, such as cancer, cardiovascular disease, and diabetes, with severe impacts on health. However, health care providers often have limited time to assess clients' behaviors regarding smoking tobacco, drinking alcohol, and chewing betel quid and intervene, if needed. Objective: The objective of this study was to develop a Web-based survey system; determine the rates of tobacco-smoking, alcohol-drinking, and betel-quid-chewing behaviors; and estimate the efficiency of the system (time to complete the survey). Methods: Patients and their family members or friends were recruited from gastrointestinal medical-surgical, otolaryngology, orthopedics, and rehabilitation clinics or wards at a medical center in northern Taiwan. Data for this descriptive, cross-sectional study were extracted from a large series of research studies. A Web-based survey system was developed using a Linux, Apache, MySQL, PHP stack solution. The Web survey was set up to include four questionnaires: the Chinese-version Fagerstrom Tolerance Questionnaire, the Chinese-version Alcohol Use Disorders Identification Test, the Betel Nut Dependency Scale, and a sociodemographic form with several chronic diseases. After the participants completed the survey, the system automatically calculated their score, categorized their risk level for each behavior, and immediately presented and explained their results. The system also recorded the time each participant took to complete the survey. Results: Of 782 patient participants, 29.6% were addicted to nicotine, 13.3% were hazardous, harmful, or dependent alcohol drinkers, and 1.5% were dependent on chewing betel quid. Of 425 family or friend participants, 19.8% were addicted to nicotine, 5.6% were hazardous, harmful, or dependent alcohol drinkers, and 0.9% were dependent on chewing betel quid. Regarding the mean time to complete the survey, patients took 7.9 minutes (SD 3.0; range 3-20) and family members or friends took 7.7 minutes (SD 2.8; range 3-18). Most of the participants completed the survey within 5-10 minutes. Conclusions: The Web-based survey was easy to self-administer. Health care providers can use this Web-based survey system to save time in assessing these risk behaviors in clinical settings. All smokers had mild-to-severe nicotine addiction, and 5.6%-12.3%

Psychiatry Research-neuroimaging, May 1, 2020

Taking care of depressed patients significantly impacts caregivers' lives, both objectively a... more Taking care of depressed patients significantly impacts caregivers' lives, both objectively and subjectively. The effects of caregivers' burden on their responses to their patients has yet to be investigated. The aim of this study is to explore the relationships among caregivers' subjective and objective burden, depression, frequency of caregiving behaviors, and rejective attitude. A cross-sectional study was conducted among 134 caregivers of patients diagnosed with depressive disorders. We administered questionnaire to assess caregivers' demographics, care burden, reassurance seeking, depression, rejective attitude and caring behaviors. Both caregivers' objective and subjective burdens were associated with their depressive symptoms. Rejection towards patients was determined by the caregivers' level of depressive symptoms, subjective feeling of sadness, and anger, rather than by their objective burden. On the other hand, the frequency of caregiving behavior was determined by perceived reassurance seeking and anger, rather than by caregivers' depression or objective burden. These findings suggest that caregivers' subjective burden plays a more salient role in predicting their rejection and frequency of caregiving behaviors toward the patients than objective burden. The caregivers in this study could recognize their rejective attitude toward depressed patients but still had difficulty withdrawing their care when they were already in distress.

Táiwān jīngshén yīxué, 2023

PubMed, Sep 1, 2022

Background: In patients with heart failure (HF), anxiety or insomnia is prevalent and associated ... more Background: In patients with heart failure (HF), anxiety or insomnia is prevalent and associated with poor clinical outcomes. Benzodiazepines (BZDs) are one of the most commonly prescribed medications for anxiety or insomnia in Taiwan. Evidence regarding the effects of BZDs on patients with heart failure and reduced ejection fraction (HFrEF) is inconclusive. Objectives: To evaluate whether BZDs can mitigate the adverse effects of anxiety or insomnia on the prognosis of patients with HFrEF. Methods: Patients with HFrEF were identified from the Chang Gung Research Database between January 1, 2007 and December 31, 2018. Those who received BZD prescriptions were defined as the BZD group; patients in the BZD group were then paired with those who had never been prescribed BZDs after matching for age, sex, and baseline left ventricular ejection fraction, defined as the no-BZD group. Propensity score matching was used to balance baseline characteristics. Cox proportional hazards model and the Fine-Gray subdistribution hazard model were used to examine the association between BZD prescription and the risks of adverse cardiovascular outcomes. Results: After propensity score matching, there were 1,941 patients in both BZD and no-BZD groups. The composite of cardiovascular (CV) death or HF hospitalization (HFH) occurred in 64.4% and 54.4% of the patients in the BZD and no-BZD groups, respectively [hazard ratio (HR): 1.44; 95% confidence interval (CI): 1.32-1.56], which was mainly driven by HFH (HR: 1.52; 95% CI: 1.39-1.67). Conclusions: In the patients with HFrEF, those who received BZD were at a higher overall risk of CV death and HFH.

Disability and Rehabilitation, Aug 7, 2019

PubMed, 2016

Comment on "Heart failure functional class associated with depression severity but not anxiety se... more Comment on "Heart failure functional class associated with depression severity but not anxiety severity" by Celik E. et al. Acta Cardiologica Sinica 2016;32:55-61.

Chang Gung medical journal, 2008

Background: Congenital adrenal hyperplasia (CAH) is a syndrome of prenatal and/or postnatal andro... more Background: Congenital adrenal hyperplasia (CAH) is a syndrome of prenatal and/or postnatal androgen excess secondary to genetic deficits in the cytochrome p450 enzymes of the cortisol synthesis pathway. Women with CAH may suffer from different degrees of androgenization. This study documented psychiatric manifestations in young women born with CAH in Taiwan. Methods: From July 1, 2005 to February 31, 2006 the psychiatric morbidity, gender identity and sex-typed behavior during childhood of 11 young women with CAH were assessed either using questionnaire-based semi-structured interviews or self-reported questionnaires. Results: Of the 11 young women (mean age 15.3 5.6 years), 3 (27.3%) had saltwasting CAH and 8 (72.7%) had simple-virilizing CAH. Two patients without prior gender assignment (delayed diagnosis) were evaluated for primary amenorrhea at age 19 and 24 years, respectively. Four of the eleven participants (36.4%) had had an axis I psychiatric diagnosis within the past year. The subjects with more atypical sex-typed behavior in childhood tended to have a higher risk of minor psychiatric illness (r =-0.706, p < 0.05). Conclusions: This study examined the impact of CAH on the patients' psychological wellbeing. Psychiatric needs were found to be unmet. Earlier psychiatric evaluation and intervention for these patients is suggested.

Neuropsychiatric Disease and Treatment, May 1, 2018

During medical school training, increased stress, depression, and anxiety are common. Certain per... more During medical school training, increased stress, depression, and anxiety are common. Certain personality traits, particularly harm avoidance (HA), may increase the risk of psychopathological disorders, insomnia, and migraine among medical students. This study evaluated the role HA may play on levels of stress, depression, anxiety, and insomnia among Taiwanese medical students starting their fifth and final year of medical school. Patients and methods: A series of self-report questionnaires were used to measure the severity of anxiety, depression, and insomnia, as well as somatic symptoms, particularly migraine headache, among 143 Taiwanese fifth-year medical students (94 males and 49 females). Most had normal or mild levels of anxiety, depression, insomnia, and migraine. Results: HA personality trait was significantly associated with depression (all P # 0.001) after adjusting for other factors. HA was not significantly associated with anxiety, insomnia, or migraine headache days. Conclusion: HA personality trait was significantly associated with depression among fifth-year medical students in Taiwan.

Psychiatry Research-neuroimaging, Mar 1, 2009

This cross-sectional study is an evaluation of the extent to which proxy assessment may appropria... more This cross-sectional study is an evaluation of the extent to which proxy assessment may appropriately substitute for or add to self-assessment regarding somatic complaints, physical activities of daily living, and instrumental activities of daily living in elderly patients diagnosed with depression according to DSM-IV criteria. A total of 102 patient-caregiver dyads met the study's inclusion criteria. The intraclass correlation coefficients (ICCs) between proxies and patients were all significant for the number of somatic complaints, physical activities of daily living. Proxy-patient responses were consistent for most subtypes of geriatric depression, with the exception of instrumental activities of daily life in patients with recurrent major depressive disorder. Proxy reports assessing somatic complaints and physical and instrumental activities of daily living may therefore be a valid supplement to retrospective self-reports in the management of clinical depression in the elderly.

Psychological Reports, Aug 1, 2007

Sz~mmaq.-This study was to assess whether the Chinese version of thc Aging Males' Symptoms scale ... more Sz~mmaq.-This study was to assess whether the Chinese version of thc Aging Males' Symptoms scale could measure aging men's symptoms as effectively as the English version. 176 psychiatric outpatient men wcre assessed to analyze internal consistency reliability and construct validity, and 45 male school staff were interviewed in estimating retest reliability. Cronbach a was .90, and the 3-wk. retest reliability was .72. Factor analysis yielded a two-factor structure. Construct validity was indicated by significant correlation between the two factors and the criterion variables. This scale is a validated and sensitive test for measuring symptoms in aging men in the Taiwanese Chinese-speaking population. It is suggested that the scale could be used to measure and compare health-related quality of life in groups of men over 40 years old.

Applied Nursing Research, Nov 1, 2006

This descriptive study explored self-care management strategies for controlling auditory hallucin... more This descriptive study explored self-care management strategies for controlling auditory hallucinations (AH) among Taiwanese patients with schizophrenia. Patients with schizophrenia (N = 200) were recruited by convenience from 2 general hospitals. Self-report and semistructured questionnaires were used to identify 41 self-management strategies. Strategies were categorized into 3 groups: physiological, cognitive, and behavioral. Ignoring AH, a cognitive strategy, was the single most frequently used strategy. As a group, strategies in the behavioral category were used the most. The most common resource for strategies was self-learning. These results can help health care providers better understand self-care management strategies for coping with AH among outpatients with schizophrenia. We suggest the development of a manual of selected self-care strategies identified by these patients to empower other patients to use self-care for AH.

Alcoholism: Clinical and Experimental Research, Feb 11, 2011

Journal of Advanced Nursing, May 13, 2010

Alcoholism: Clinical and Experimental Research, 2009

Background: Alcohol is a legal and accessible substance in Taiwan. As excessive alcohol has been ... more Background: Alcohol is a legal and accessible substance in Taiwan. As excessive alcohol has been linked to health and social problems, it is necessary to develop a brief, rapid, and low-cost tool to help health care providers deal with persons in Taiwan whose alcohol consumption has become hazardous or harmful to their health. Methods: A randomized controlled clinical trial with 6-and 12-month follow-ups was designed. Eighteen medical ⁄ surgical units at a medical center in northern Taiwan were randomly assigned to 2 groups: experimental (n = 9) and control (n = 9). Inpatients on the units were enrolled if they met the following criteria: were older than 18 years, had no severe psychiatric illness, and were not pregnant. The experimental group (n = 138) received the intervention, a 15-minute counseling visit in which nurses screened participants using the Alcohol Use Disorders Identification Test (AUDIT), provided a health promotion booklet for adults, and individually discussed the booklet contents with patients based on their drinking level (AUDIT score). The control group (n = 137) received no treatment. Patterns of alcohol consumption were determined by AUDIT scores at baseline, 6, and 12 months later. Results: Alcohol use disorders identification test scores decreased significantly in both groups at 6 months after the intervention, but did not differ significantly between the 2 groups. However, 12 months after the brief alcohol intervention, experimental subjects' AUDIT scores were significantly better than those of the control group. Conclusions: Our brief alcohol intervention provided a 12-month benefit for problem drinkers in Taiwan.

臺灣精神醫學, Mar 1, 2009

Objectives: The aims of this study were to identify and to analyze the characteristics of the pat... more Objectives: The aims of this study were to identify and to analyze the characteristics of the patients who missed appointment at psychiatric clinics in a general hospital. Methods: We collected the appointment data in a general hospital during the month of December 2006. Patients' demographic data, diagnoses, and whether the appointment of initial or follow-up clinic visits were recorded retrospectively from patients' medical records. With descriptive and analytical statistics, we compared the differences between patients who kept and those who missed their appointments. We also identified the reasons for failure to keep appointments. Results: We found that 970 patients who made appointments over the month. Of these, 177 patients were found to miss their appointments with a rate of absence of 18.2%. No significant sex difference was found between those two groups. However, we found that the patients who missed their appointments tended to be younger, to have more diagnosis with depressive disorders, and they were likely to miss a follow-up appointment, and that 86 patients returned to psychiatric clinics within three months of their missing the index appointments (48.6%). Conclusion: In our study, younger patients, patients with depressive disorders, and follow-up patients had a higher rate of failed clinic appointments. These results of this study can be used to identify patients who are at risk of not showing up their appointments, and to design interventions to reduce the risk factors for nonattendance.

Annals of General Psychiatry, Nov 17, 2020

Background: Women are well known to be susceptible to developing affective disorders, yet little ... more Background: Women are well known to be susceptible to developing affective disorders, yet little attention has been given to effects of ovariectomy-reduced hormones and links with depression. This population-based crosssectional study aimed to investigate possible associations between ovariectomy-reduced hormones and depression symptom scores of the Patient Health Questionnaire-9 (PHQ-9) in ovariectomized women. Methods: Data of PHQ-9 scores, demographics and comorbidities of ovariectomized women were extracted from the U.S. National Health and Nutrition Examination Survey (NHANES) database (2013-2016) and were analyzed retrospectively. Results: Among ovariectomized women in the NHANES database, serum estradiol levels were significantly positively associated with PHQ-9 scores (ß = 0.014, 95% CI: 0.001, 0.028, P = 0.040), whereas serum testosterone was negatively associated with PHQ-9 scores (ß =-0.033, 95% CI: − 0.048, − 0.018, P < 0.001) after adjusting for confounders. Further stratified analyses revealed that serum estradiol was positively associated with PHQ-9 only among women with history of estrogen use. Serum testosterone levels were negatively associated with PHQ-9 among women with or without prior estrogen use but this was only observed among women aged < = 60 years (ß = − 0.057, − 0.076, − 0.038, P < 0.001). Conclusions: Serum estradiol and testosterone are associated with PHQ-9 scores indicative for depression in ovariectomized women. The associations are modified by age and history of estrogen use. Future prospective studies are warranted to confirm these findings, carefully addressing possible confounding of age-related dementia.

Psychology Research and Behavior Management, Dec 1, 2018

To examine the effect of mindfulness-based training on performance and mental health among a grou... more To examine the effect of mindfulness-based training on performance and mental health among a group of elite athletes. Methods: This study aimed to evaluate the effect of mindful sport performance enhancement (MSPE) on mental health, flow state, and competitive state anxiety using a 4-week workshop. We recruited an amateur baseball team (N=21) in Taiwan, and collected information by selfreported questionnaires administered before, immediately after, and at a 4-week follow-up. The primary outcome was to evaluate sports performance by flow state and competitive state anxiety, which included self-confidence, somatic anxiety, and cognitive anxiety. The secondary outcome was to explore whether MSPE intervention can improve anxiety, depression, sleep disturbance, and eating disorders. Result: After the workshop and follow-up 1 month later, we found improvements in flow state (P=0.001; P=0.045), cognitive anxiety in competitive anxiety (P=0.056; P=0.008), global eating disorder (P=0.009; P<0.001), marked shape concern (P=0.005; P<0.001), and weight concern (P=0.007; P<0.001). Scores of sleep disturbance (P=0.047) showed significant improvement at follow-up. We also found significant association between flow state and mindfulness ability (P<0.001). Conclusion: This is the first mindfulness intervention to enhance athletes' performance in Taiwan, and also the first application of MSPE for team sports. Our study results suggested that mindfulness ability is associated with flow state, and that MSPE is a promising training program for strengthening flow state and mental health.

Neuropsychiatric Disease and Treatment, 2015

Introduction: The Androgen Deficiency in the Aging Male (ADAM) questionnaire is widely used to sc... more Introduction: The Androgen Deficiency in the Aging Male (ADAM) questionnaire is widely used to screen for late-onset hypogonadism. The positive response to the ADAM questionnaire (positive ADAM) has been associated with depression and poorer quality of life in a number of studies. It is unclear whether there is any value of the ADAM questionnaire in psychiatric populations. In this study, we aimed to determine the utility of the ADAM questionnaire in a convenient sample of male psychiatric outpatients. Methods: One hundred and seventy-six men (mean age: 54.3 years; standard deviation: 10.7 years; range: 40-80 years) completed the ADAM questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Aging Males' Symptoms (AMS) scale. Anxiety was defined as a HADS anxiety subscore 8;depressionasaHADSdepressionsubscore8; depression as a HADS depression subscore 8;depressionasaHADSdepressionsubscore8; and moderate/ severe impairment of health-related quality of life (HQoL) as AMS $37. ADAM, anxiety, and depression was used to model the moderate/severe impairment of HQoL. Results: One hundred and sixty-four (93%) men had positive ADAM. Positive ADAM was associated with a lower body mass index (P,0.05) and moderate/severe impairment of HQoL (P,0.001), but was not associated with anxiety or depression (P.0.05). Positive ADAM was associated with five symptoms of the AMS scale: "decline of one's feeling of general well-being", "depressive mood", and three sexual symptoms. In regression analysis, positive ADAM was associated with increased risk of moderate/severe impairment of HQoL (unadjusted odds ratio 20.1, 95% confidence interval 3.77-372, P,0.01), which remained significant with covariates of anxiety and depression (adjusted odds ratio 15.6, 95% confidence interval 2.52-309, P,0.05). Conclusion: The ADAM questionnaire can be used to screen the sexual symptoms but not depression/anxiety in male psychiatric outpatients. Positive ADAM may indicate moderate/ severe impairment of HQoL.