Su-Ting Hsu | National Kaohsiung Normal University (original) (raw)

Papers by Su-Ting Hsu

Medicine

The coronavirus disease 2019 (COVID-19) pandemic has caused a heavily burden on healthcare worker... more The coronavirus disease 2019 (COVID-19) pandemic has caused a heavily burden on healthcare workers (HCWs) worldwide. The aim of this study was to compare differences in psychological and social impact between two waves of the pandemic among first- and second-line HCWs in Taiwan. The current study derived data from two cross-sectional surveys conducted in 2020 and 2021. Levels of depression, sleep disturbance, psychological distress, social impact, and demographic variables were collected through self-reported questionnaires. The independent t test was used to compare differences in scores between the first and second wave of the pandemic. Differences between first- and second-line HCWs were also analyzed. A total of 711 HCWs in the first wave and 560 HCWs in the second wave were recruited. For the first- and second-line HCWs, the social impact during the second wave was higher than during the first wave, and they expressed a higher intention to maintain social distancing and were mo...

International Journal of Environmental Research and Public Health

Substance and alcohol use in the workplace have become a global health burden; however, the etiol... more Substance and alcohol use in the workplace have become a global health burden; however, the etiologies have seldom been explored. The aims of this study were to develop a Workplace Substance Reuse Questionnaire (WSRQ) to measure the multidimensional factors associated with the reuse of alcohol or illegal substances in the workplace. The predictors of reuse were also investigated. The WSRQs for alcohol (WSRQ-Alc) and illegal substances (WSRQ-Sub) were composed of 15 and 13 items, respectively. Factors associated with workplace substance reuse included workplace environment, workload, social interaction in the workplace and other cues. Construct validity and reliability were performed to verify the questionnaires. Multivariate linear regression was conducted to estimate the associations between the factors and WSRQ score. A total of 90 patients with substance or alcohol use disorder were recruited. The results demonstrated that the WSRQ-Alc and WSRQ-Sub had acceptable reliability, wit...

International Journal of Environmental Research and Public Health

Vaccine hesitancy has become a major public health problem among healthcare workers (HCWs) in thi... more Vaccine hesitancy has become a major public health problem among healthcare workers (HCWs) in this coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to examine the relationship between societal adaptation and vaccine worries and the mediating effects of posttraumatic stress disorder (PTSD) indicators in HCWs. A total of 435 HCWs (327 women and 108 men) were recruited. Their levels of societal adaptation were evaluated using the Societal Influences Survey Questionnaire (SISQ). Their severity and frequency of PTSD symptoms were examined using the Disaster-Related Psychological Screening Test (DRPST). The severity of vaccine worries was assessed using the Vaccination Attitudes Examination (VAX) Scale. The relationships among societal adaptation, PTSD, and vaccine worries were examined using structural equation modeling. The severity of societal adaptation was positively associated with both the severity of PTSD and the severity of vaccine worries. In addition, the...

Comprehensive Psychiatry, 2018

Objective: The mental health of caregivers of individuals with disabilities is frequently neglect... more Objective: The mental health of caregivers of individuals with disabilities is frequently neglected. This study investigated mental health status and suicidal ideation (SI) among caregivers and examined the predictive factors for SI. Method: Caregivers of individuals with physical or mental disabilities in a tertiary hospital in southern Taiwan were recruited through snowball sampling. They were assessed by self-report questionnaires, consisting of the Taiwanese Depression Questionnaire and a subset of the threeitem Chinese Health Questionnaire, to assess probable depression and common mental disorders (CMDs), with cutoff points of 19 and 3, respectively. Results: Among 255 caregivers, 32.9% had probable depression, 37.6% had probable CMDs, and 18.8% experienced SI. The level of SI was correlated with primary caregivers (p = .015), lack of support from co-caregivers (p = .023), caring for younger patients (p = .010), caring for patients with mental disability (p = .019) or catastrophic diseases (p = .005), and caregivers' probable depression (p < .001) and CMDs (p < .001). Regression analysis predicted the greatest SI among caregivers caring for younger patients (odds ratio [OR] = .98, p = .048) and for patients with catastrophic diseases (OR = 3.15, p =.008), as well as for caregivers with probable depression (OR = 3.90, p = .010) or CMDs (OR = 9.40, p < .001). Conclusions: When examining SI, clinicians should be aware of the mental health of caregivers who are responsible for people with disability. In particular, they should be vigilant regarding caregivers of individuals who are of younger age or have catastrophic diseases and regarding caregivers who exhibit probable depression and CMDs. Highlights • Mental health status and predictors for suicidal ideation (SI) among caregivers were investigated. • The proportion of SI among caregivers is higher than that of general population. • Younger patients, patients with catastrophic diseases, and caregivers with probable depression, or common mental disorders predict SI of caregivers.

Journal of Psychiatric Research, 2021

Cognitive deficits, which are core manifestations in schizophrenia and exhibit a limited response... more Cognitive deficits, which are core manifestations in schizophrenia and exhibit a limited response to antipsychotic treatment, contribute to poor treatment outcomes and functional disability. Evidence on the effect of aerobic walking (AW) and exercise intensity on cognitive function in patients with schizophrenia is lacking. In total, 79 patients with schizophrenia were recruited for a 12-week randomized control trial and allocated to the treatment-as-usual (TAU, n = 38) and treatment-as-usual plus AW (TAW, n = 39) groups. The TAW participants joined a supervised 12-week AW program consisting of 30-min sessions five times per week while wearing a Fitbit Charge 2 device. Cognitive function was evaluated using the Brief Assessment of Cognition in Schizophrenia. After randomization, 67 (34 TAU and 33 TAW) participants joined the 12-week trial and were included in the intention-to-treat analysis. Multivariate general linear model repeated measures analysis revealed no significant time × group interaction effect on cognitive function changes between the TAU and TAW groups and a marginally significant group effect on verbal fluency (p = 0.09). The interaction effect of time and treatment group on verbal fluency (p = 0.05) was marginally significant between the high and low AW intensity groups, whereas a significant group effect on attention and processing speed (p = 0.04) was observed. Supervised 12-week AW of moderate intensity may have potential cognitive benefits for patients with schizophrenia.

Scientific Reports, 2021

The aims of the current study were to identify factors associated with sleep disturbance and Coro... more The aims of the current study were to identify factors associated with sleep disturbance and Coronavirus disease-19 related psychological distress (CPD), and to develop a conceptual model to verify the mediating effect of CPD on the association between social impact and sleep disturbance. This study recruited patients with schizophrenia. Factors associated with the level of sleep disturbance and CPD were identified using univariate linear regression, and further selected into a stepwise multivariate linear regression model. Using structural equation modeling, a mediation model was developed to test the mediating effect of CPD on the association between social impact and sleep disturbance. After estimating with the stepwise and bootstrap regression, higher levels of CPD were associated with higher levels of social anxiety and subjects without a regular diet. Sleep disturbance was associated with a higher level of social anxiety, a history of psychological trauma, chronic disease, and...

Background The experiences of professionals in well-established recovery-oriented programs are va... more Background The experiences of professionals in well-established recovery-oriented programs are valuable for professionals in similar practice settings. This study explored professionals’ experiences with providing recovery-oriented services in community psychiatric rehabilitation organizations. Methods Semi-structured interviews were conducted with 14 professionals from five recovery-oriented psychiatric rehabilitation organizations in Taiwan. The interviews were recorded and transcribed verbatim. Thematic analysis was used for the qualitative data analysis. Results The analyses documented three main themes with 13 subthemes. Recovery-oriented service implementation included seven subthemes: Enabling clients to set their own goals and make decisions, using a strengths-based approach, establishing partnerships with clients, improving individuals’ self-acceptance, encouraging community participation, seeking family, peer, and organizational support, and building team collaboration. Pr...

International Journal of Environmental Research and Public Health, 2021

The coronavirus disease 2019 (COVID-19) pandemic can have a negative impact on patients with mood... more The coronavirus disease 2019 (COVID-19) pandemic can have a negative impact on patients with mood disorders. The aim of this study is to explore the societal influence of COVID-19 and associated impacts on levels of depression, sleep disturbance, and subjective pain among patients with mood disorders. This cross-sectional study recruited inpatients with depression and bipolar disorder. Levels of depression, sleep disturbance, subjective pain, and related demographic variables were collected through self-reported questionnaires. Potential factors associated with levels of depression, sleep disturbance, and subjective pain were identified using univariate linear regression and further entered into a stepwise multivariate linear regression model to identify the independent predictors. A total of 119 participants were included in the analysis, of whom 50.42% had bipolar disorder and 49.58% had unipolar depression. Multivariate analysis showed that a higher level of depression was associ...

Frontiers in Psychiatry, 2021

Background: The coronavirus infection disease 2019 (COVID-19) pandemic is likely to put healthcar... more Background: The coronavirus infection disease 2019 (COVID-19) pandemic is likely to put healthcare professionals across the world in an unprecedented situation.Methods: A total of 683 healthcare workers were recruited in this study. Short form-12 items (SF-12), Societal Influences Survey Questionnaire (SISQ), and Disaster-Related Psychological Screening Test (DRPST) were used to survey participants. Multiple linear regression and structural equation model (SEM) were used to explore the possible factors to the societal influences and quality of life.Results: After multiple linear regression analysis, female, older, more education years, married, regular intake, and posttraumatic stress disorder (PTSD) frequency had positive association with SISQ. To physical component summary (PCS) of SF-12, chronic illness, sleep score, PTSD frequency, and social distance had negative association, and exercise habits had positive association. A mental component summary (MCS) value of SF-12, age, par...

Brain, Behavior, and Immunity, 2020

COVID-19-related information sources and psychological well-being: An online survey study in Taiw... more COVID-19-related information sources and psychological well-being: An online survey study in Taiwan Dear editors Timely and accurate information is foundational to mitigating and curing the coronavirus disease 2019 (COVID-19) for both the public and the scientific community (Hua and Shaw, 2020). Misinformation on COVID-19, however, has also been proliferating on the Internet, especially on social media (Bastani and Bahrami, 2020). Moreover, repeated media exposure to crisis-related information elevates anxiety and stress responses among people (Garfin et al., 2020). The public may also receive information on COVID-19 from medical staff and laypeople. We were interested in the associations between the COVID-19-related information sources and people's psychological well-being. We were also interested in whether the associations differed between health care workers and the public. The Online Survey Study on COVID-19 in Taiwan recruited participants who were ≥20 years old and lived in Taiwan through a Facebook advertisement on April 10 to April 20, 2020. We also posted the link of the Facebook advertisement to social media groups joined by health care workers. In the online survey, participants were asked whether they received COVID-19-related information frequently from the following sources: the Internet (including blogs, Internet news, and social media, such as Facebook, Line, Twitter, and Plurk), friends, traditional media (including television, newspapers, and radio broadcasting), formal lessons on COVID-19 (whether online or in-person), medical staff in health care settings, coworkers, and family members. We also assessed participants' level of subjective psychological wellbeing on a 5-point Likert scale from 1 (much worse) to 5 (much better) (Ko et al., 2006). In total, the data of 1904 respondents (1282 female and 622 male participants; mean age = 38.0 years and standard deviation [SD] = 10.8 years) were analyzed. The mean score for psychological well-being were 3.3 (SD = 0.9). The major source of information on COVID-19 was the Internet (80.6%), followed by traditional media (53.5%). The associations of each information source with psychological well-being were examined using multiple regression analyses to control for sex, age, education and worry about COVID-19. We found that for non-health-care workers, receiving COVID-19 information from the Internet and from medical staff was negatively and positively related with psychological well-being, respectively; both relationships were significant. For health care workers, receiving COVID-19 information from formal lessons was significantly positively related with psychological well-being. This study found that approximately 80% of participants received COVID-19 information online. The Internet makes information on COVID-19 more accessible, especially for those staying indoors due to the pandemic, with the websites of official public health organizations being the highest-quality source of online information on COVID-19 and how to prevent it (Hernández-García and Giménez-Júlvez, 2020).

Asian Journal of Psychiatry, 2020

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

International Journal of Social Psychiatry, 2020

Background: The outbreak of coronavirus disease 2019 (COVID-19), like severe acute respiratory sy... more Background: The outbreak of coronavirus disease 2019 (COVID-19), like severe acute respiratory syndrome (SARS), provokes fear, anxiety and depression in the public, which further affects mental health issues. Taiwan has used their experience of the SARS epidemic for the management of foreseeable problems in COVID-19 endemic. Aim/Objective: This review summarizes issues concerning mental health problems related to infectious diseases from current literatures. Results: In suspected cases under quarantine, confirmed cases in isolation and their families, health care professionals, and the general population and related effective strategies to reduce these mental health issues, such as helping to identify stressors and normalizing their impact at all levels of response as well as public information and communication messages by electronic devices. The importance of community resilience was also addressed. Psychological first aid, psychological debriefing, mental health intervention and ...

Psychoneuroendocrinology, Jan 26, 2017

Past research has indicated gender differences in the clinical characteristics and course of schi... more Past research has indicated gender differences in the clinical characteristics and course of schizophrenia. In this study, we investigated whether gender differences in the manifestation of schizophrenia are correlated with neurosteroids, including dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), and pregnenolone. We further explored the potential relationship between the aforementioned neurosteroids and psychopathology. We recruited 65 schizophrenic patients (36 males and 29 females) and 103 healthy control subjects (47 males and 56 females) and obtained blood samples from the subjects in the morning while in a fasting state to determine the serum levels of DHEA, DHEA-S, and pregnenolone. The psychopathology and mood symptoms of patients with schizophrenia were evaluated using the Positive and Negative Syndrome Scale (PANSS) and 17-item Hamilton Depression Rating Scale, respectively. Compared to the male control subjects, male patients with schizophrenia had ...

Schizophrenia research, Feb 28, 2017

Oxidative stress has been implicated in the psychopathology of schizophrenia. Cysteine, a semi-es... more Oxidative stress has been implicated in the psychopathology of schizophrenia. Cysteine, a semi-essential amino acid, is the precursor of the antioxidant glutathione. The aim of this study was to investigate the differences in serum levels of cysteine between patients with schizophrenia and healthy controls. The relationships between levels of cysteine, psychopathology and cognitive function were also explored. We recruited 65 patients with schizophrenia and 65 age- and gender-matched healthy controls. Blood samples were collected to determine the serum levels of cysteine and plasma levels of metabolic parameters. The cognitive function of participants was assessed using the Brief Assessment of Cognition in Schizophrenia (BACS). The psychopathology of schizophrenic patients was evaluated using the Positive and Negative Syndrome Scale. Serum cysteine levels were significantly higher in schizophrenic patients than in controls (P<0.001). In patients with schizophrenia, serum levels o...

Neuropsychiatric Disease and Treatment, 2016

AIDS Education and Prevention, 2016

High cost of pre-exposure prophylaxis (PrEP) is a major concern for acceptability. This study det... more High cost of pre-exposure prophylaxis (PrEP) is a major concern for acceptability. This study determined the willingness of men who have sex with men to self-pay for PrEP and factors associated with the likelihood of condom use if taking PrEP. The Taiwan 2014 MSM Online Sex Survey was conducted and data such as demographics, attitudes toward PrEP, and sexual behaviors in the previous 3 months were collected. Of the 1,151 MSM who participated, 56% were willing to take PrEP, but only 23% were willing to self-pay $340 for PrEP. Willingness to self-pay for PrEP was significantly associated with the previous receipt of nonoccupational post-exposure prophylaxis (adjusted odds ratio [AOR], 3.02, 95%CI [1.49, 6.12]), and positive attitudes toward PrEP (AOR, 3.02, 95%CI [2.19, 4.17]). Of MSM who are willing to use PrEP, 73.6% would maintain condom use if taking PrEP. If PrEP is made available in Taiwan, more efforts should be focused on increasing awareness of MSM who are practicing risky behaviors.

Psychoneuroendocrinology, Nov 16, 2016

The disturbances of β-hydroxybutyrate (β-HB) and pyruvate are linked with impaired brain energy u... more The disturbances of β-hydroxybutyrate (β-HB) and pyruvate are linked with impaired brain energy utilization which involves in the psychopathology of schizophrenia. This study investigates the difference in levels of β-HB and pyruvate between patients with schizophrenia and healthy controls, and explores their relationship with metabolic profiles and disease characteristics. We recruited 54 physically-health schizophrenic patients and 54 age- and gender-matched healthy control subjects. Blood samples were gathered to determine the serum levels of β-HB and pyruvate and plasma levels of metabolic profiles, including fasting glucose, triglycerides, total cholesterol, high- and low-density lipoprotein-cholesterol and adiponectin. The disease characteristics and psychopathology of patients with schizophrenia were assessed by using the Positive and Negative Syndrome Scale. Of patients with schizophrenia, serum levels of β-HB were significantly correlated with fasting glucose (p=0.007) and ...

The Australian Journal of Rehabilitation Counselling, 2015

Background: Self-determination theory (SDT) has increasingly been used as a theoretical framework... more Background: Self-determination theory (SDT) has increasingly been used as a theoretical framework for evaluating key elements of the recovery paradigm in rehabilitation and mental health services research and policy-making for people living with severe mental illnesses.Purpose: The purpose of this study was to validate the Behavioral Regulation in Work Questionnaire (BRWQ), an adaptation of the Behavioral Regulation in Exercise Questionnaire-2, as a measure of self-determined work motivation for use in psychiatric rehabilitation settings.Methods: One hundred and twenty-four individuals with severe mental illness were recruited from eight Clubhouse programmes in Hawaii. Factorial validity of the BRWQ was evaluated using exploratory factor analysis.Findings: Principal components analysis of the BRWQ yielded four factors (amotivation, external regulation, introjection and autonomous motivation). The autonomous motivation factor was found to be significantly related to other SDT constru...

Journal of Studies on Alcohol and Drugs, 2012

This study examined the predictors of self-efficacy in reducing risky injection behaviors among h... more This study examined the predictors of self-efficacy in reducing risky injection behaviors among heroin users receiving methadone maintenance treatment (MMT). The Methadone Maintenance Treatment Outcome Study was an 18-month prospective study from March 2007 to July 2008. Data collection was conducted in the substance use disorders treatment outpatient clinics of three hospitals in southern Taiwan. A total of 368 opioid-dependent heroin users (13.6% women) were interviewed at baseline and at 3-, 6-, 9-, 12-, 15- and 18-month follow-ups. The level of self-efficacy in reducing risky injection behaviors was repeatedly assessed using the Self-Efficacy Scale for HIV Risk Behaviors. Demographic and substance use characteristics, HIV serostatus, family function, depression, and pros and cons of heroin use were collected at baseline, and methadone dosage at each follow-up interview and the duration of retention in the MMT program were also recorded. The results of the generalized estimating equation indicated that a lower educational level, concurrent methamphetamine use, a younger age at first heroin use, a lower methadone dosage, a higher level of depression, and a shorter duration of retention in the MMT program were predictive of a lower level of self-efficacy in reducing risky injection behaviors. This study found that personal and MMT-related factors were predictive of a lower level of self-efficacy among heroin users receiving MMT. Programs implemented to promote a higher level of self-efficacy should be provided to heroin users in the MMT program.

Medicine

The coronavirus disease 2019 (COVID-19) pandemic has caused a heavily burden on healthcare worker... more The coronavirus disease 2019 (COVID-19) pandemic has caused a heavily burden on healthcare workers (HCWs) worldwide. The aim of this study was to compare differences in psychological and social impact between two waves of the pandemic among first- and second-line HCWs in Taiwan. The current study derived data from two cross-sectional surveys conducted in 2020 and 2021. Levels of depression, sleep disturbance, psychological distress, social impact, and demographic variables were collected through self-reported questionnaires. The independent t test was used to compare differences in scores between the first and second wave of the pandemic. Differences between first- and second-line HCWs were also analyzed. A total of 711 HCWs in the first wave and 560 HCWs in the second wave were recruited. For the first- and second-line HCWs, the social impact during the second wave was higher than during the first wave, and they expressed a higher intention to maintain social distancing and were mo...

International Journal of Environmental Research and Public Health

Substance and alcohol use in the workplace have become a global health burden; however, the etiol... more Substance and alcohol use in the workplace have become a global health burden; however, the etiologies have seldom been explored. The aims of this study were to develop a Workplace Substance Reuse Questionnaire (WSRQ) to measure the multidimensional factors associated with the reuse of alcohol or illegal substances in the workplace. The predictors of reuse were also investigated. The WSRQs for alcohol (WSRQ-Alc) and illegal substances (WSRQ-Sub) were composed of 15 and 13 items, respectively. Factors associated with workplace substance reuse included workplace environment, workload, social interaction in the workplace and other cues. Construct validity and reliability were performed to verify the questionnaires. Multivariate linear regression was conducted to estimate the associations between the factors and WSRQ score. A total of 90 patients with substance or alcohol use disorder were recruited. The results demonstrated that the WSRQ-Alc and WSRQ-Sub had acceptable reliability, wit...

International Journal of Environmental Research and Public Health

Vaccine hesitancy has become a major public health problem among healthcare workers (HCWs) in thi... more Vaccine hesitancy has become a major public health problem among healthcare workers (HCWs) in this coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to examine the relationship between societal adaptation and vaccine worries and the mediating effects of posttraumatic stress disorder (PTSD) indicators in HCWs. A total of 435 HCWs (327 women and 108 men) were recruited. Their levels of societal adaptation were evaluated using the Societal Influences Survey Questionnaire (SISQ). Their severity and frequency of PTSD symptoms were examined using the Disaster-Related Psychological Screening Test (DRPST). The severity of vaccine worries was assessed using the Vaccination Attitudes Examination (VAX) Scale. The relationships among societal adaptation, PTSD, and vaccine worries were examined using structural equation modeling. The severity of societal adaptation was positively associated with both the severity of PTSD and the severity of vaccine worries. In addition, the...

Comprehensive Psychiatry, 2018

Objective: The mental health of caregivers of individuals with disabilities is frequently neglect... more Objective: The mental health of caregivers of individuals with disabilities is frequently neglected. This study investigated mental health status and suicidal ideation (SI) among caregivers and examined the predictive factors for SI. Method: Caregivers of individuals with physical or mental disabilities in a tertiary hospital in southern Taiwan were recruited through snowball sampling. They were assessed by self-report questionnaires, consisting of the Taiwanese Depression Questionnaire and a subset of the threeitem Chinese Health Questionnaire, to assess probable depression and common mental disorders (CMDs), with cutoff points of 19 and 3, respectively. Results: Among 255 caregivers, 32.9% had probable depression, 37.6% had probable CMDs, and 18.8% experienced SI. The level of SI was correlated with primary caregivers (p = .015), lack of support from co-caregivers (p = .023), caring for younger patients (p = .010), caring for patients with mental disability (p = .019) or catastrophic diseases (p = .005), and caregivers' probable depression (p < .001) and CMDs (p < .001). Regression analysis predicted the greatest SI among caregivers caring for younger patients (odds ratio [OR] = .98, p = .048) and for patients with catastrophic diseases (OR = 3.15, p =.008), as well as for caregivers with probable depression (OR = 3.90, p = .010) or CMDs (OR = 9.40, p < .001). Conclusions: When examining SI, clinicians should be aware of the mental health of caregivers who are responsible for people with disability. In particular, they should be vigilant regarding caregivers of individuals who are of younger age or have catastrophic diseases and regarding caregivers who exhibit probable depression and CMDs. Highlights • Mental health status and predictors for suicidal ideation (SI) among caregivers were investigated. • The proportion of SI among caregivers is higher than that of general population. • Younger patients, patients with catastrophic diseases, and caregivers with probable depression, or common mental disorders predict SI of caregivers.

Journal of Psychiatric Research, 2021

Cognitive deficits, which are core manifestations in schizophrenia and exhibit a limited response... more Cognitive deficits, which are core manifestations in schizophrenia and exhibit a limited response to antipsychotic treatment, contribute to poor treatment outcomes and functional disability. Evidence on the effect of aerobic walking (AW) and exercise intensity on cognitive function in patients with schizophrenia is lacking. In total, 79 patients with schizophrenia were recruited for a 12-week randomized control trial and allocated to the treatment-as-usual (TAU, n = 38) and treatment-as-usual plus AW (TAW, n = 39) groups. The TAW participants joined a supervised 12-week AW program consisting of 30-min sessions five times per week while wearing a Fitbit Charge 2 device. Cognitive function was evaluated using the Brief Assessment of Cognition in Schizophrenia. After randomization, 67 (34 TAU and 33 TAW) participants joined the 12-week trial and were included in the intention-to-treat analysis. Multivariate general linear model repeated measures analysis revealed no significant time × group interaction effect on cognitive function changes between the TAU and TAW groups and a marginally significant group effect on verbal fluency (p = 0.09). The interaction effect of time and treatment group on verbal fluency (p = 0.05) was marginally significant between the high and low AW intensity groups, whereas a significant group effect on attention and processing speed (p = 0.04) was observed. Supervised 12-week AW of moderate intensity may have potential cognitive benefits for patients with schizophrenia.

Scientific Reports, 2021

The aims of the current study were to identify factors associated with sleep disturbance and Coro... more The aims of the current study were to identify factors associated with sleep disturbance and Coronavirus disease-19 related psychological distress (CPD), and to develop a conceptual model to verify the mediating effect of CPD on the association between social impact and sleep disturbance. This study recruited patients with schizophrenia. Factors associated with the level of sleep disturbance and CPD were identified using univariate linear regression, and further selected into a stepwise multivariate linear regression model. Using structural equation modeling, a mediation model was developed to test the mediating effect of CPD on the association between social impact and sleep disturbance. After estimating with the stepwise and bootstrap regression, higher levels of CPD were associated with higher levels of social anxiety and subjects without a regular diet. Sleep disturbance was associated with a higher level of social anxiety, a history of psychological trauma, chronic disease, and...

Background The experiences of professionals in well-established recovery-oriented programs are va... more Background The experiences of professionals in well-established recovery-oriented programs are valuable for professionals in similar practice settings. This study explored professionals’ experiences with providing recovery-oriented services in community psychiatric rehabilitation organizations. Methods Semi-structured interviews were conducted with 14 professionals from five recovery-oriented psychiatric rehabilitation organizations in Taiwan. The interviews were recorded and transcribed verbatim. Thematic analysis was used for the qualitative data analysis. Results The analyses documented three main themes with 13 subthemes. Recovery-oriented service implementation included seven subthemes: Enabling clients to set their own goals and make decisions, using a strengths-based approach, establishing partnerships with clients, improving individuals’ self-acceptance, encouraging community participation, seeking family, peer, and organizational support, and building team collaboration. Pr...

International Journal of Environmental Research and Public Health, 2021

The coronavirus disease 2019 (COVID-19) pandemic can have a negative impact on patients with mood... more The coronavirus disease 2019 (COVID-19) pandemic can have a negative impact on patients with mood disorders. The aim of this study is to explore the societal influence of COVID-19 and associated impacts on levels of depression, sleep disturbance, and subjective pain among patients with mood disorders. This cross-sectional study recruited inpatients with depression and bipolar disorder. Levels of depression, sleep disturbance, subjective pain, and related demographic variables were collected through self-reported questionnaires. Potential factors associated with levels of depression, sleep disturbance, and subjective pain were identified using univariate linear regression and further entered into a stepwise multivariate linear regression model to identify the independent predictors. A total of 119 participants were included in the analysis, of whom 50.42% had bipolar disorder and 49.58% had unipolar depression. Multivariate analysis showed that a higher level of depression was associ...

Frontiers in Psychiatry, 2021

Background: The coronavirus infection disease 2019 (COVID-19) pandemic is likely to put healthcar... more Background: The coronavirus infection disease 2019 (COVID-19) pandemic is likely to put healthcare professionals across the world in an unprecedented situation.Methods: A total of 683 healthcare workers were recruited in this study. Short form-12 items (SF-12), Societal Influences Survey Questionnaire (SISQ), and Disaster-Related Psychological Screening Test (DRPST) were used to survey participants. Multiple linear regression and structural equation model (SEM) were used to explore the possible factors to the societal influences and quality of life.Results: After multiple linear regression analysis, female, older, more education years, married, regular intake, and posttraumatic stress disorder (PTSD) frequency had positive association with SISQ. To physical component summary (PCS) of SF-12, chronic illness, sleep score, PTSD frequency, and social distance had negative association, and exercise habits had positive association. A mental component summary (MCS) value of SF-12, age, par...

Brain, Behavior, and Immunity, 2020

COVID-19-related information sources and psychological well-being: An online survey study in Taiw... more COVID-19-related information sources and psychological well-being: An online survey study in Taiwan Dear editors Timely and accurate information is foundational to mitigating and curing the coronavirus disease 2019 (COVID-19) for both the public and the scientific community (Hua and Shaw, 2020). Misinformation on COVID-19, however, has also been proliferating on the Internet, especially on social media (Bastani and Bahrami, 2020). Moreover, repeated media exposure to crisis-related information elevates anxiety and stress responses among people (Garfin et al., 2020). The public may also receive information on COVID-19 from medical staff and laypeople. We were interested in the associations between the COVID-19-related information sources and people's psychological well-being. We were also interested in whether the associations differed between health care workers and the public. The Online Survey Study on COVID-19 in Taiwan recruited participants who were ≥20 years old and lived in Taiwan through a Facebook advertisement on April 10 to April 20, 2020. We also posted the link of the Facebook advertisement to social media groups joined by health care workers. In the online survey, participants were asked whether they received COVID-19-related information frequently from the following sources: the Internet (including blogs, Internet news, and social media, such as Facebook, Line, Twitter, and Plurk), friends, traditional media (including television, newspapers, and radio broadcasting), formal lessons on COVID-19 (whether online or in-person), medical staff in health care settings, coworkers, and family members. We also assessed participants' level of subjective psychological wellbeing on a 5-point Likert scale from 1 (much worse) to 5 (much better) (Ko et al., 2006). In total, the data of 1904 respondents (1282 female and 622 male participants; mean age = 38.0 years and standard deviation [SD] = 10.8 years) were analyzed. The mean score for psychological well-being were 3.3 (SD = 0.9). The major source of information on COVID-19 was the Internet (80.6%), followed by traditional media (53.5%). The associations of each information source with psychological well-being were examined using multiple regression analyses to control for sex, age, education and worry about COVID-19. We found that for non-health-care workers, receiving COVID-19 information from the Internet and from medical staff was negatively and positively related with psychological well-being, respectively; both relationships were significant. For health care workers, receiving COVID-19 information from formal lessons was significantly positively related with psychological well-being. This study found that approximately 80% of participants received COVID-19 information online. The Internet makes information on COVID-19 more accessible, especially for those staying indoors due to the pandemic, with the websites of official public health organizations being the highest-quality source of online information on COVID-19 and how to prevent it (Hernández-García and Giménez-Júlvez, 2020).

Asian Journal of Psychiatry, 2020

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

International Journal of Social Psychiatry, 2020

Background: The outbreak of coronavirus disease 2019 (COVID-19), like severe acute respiratory sy... more Background: The outbreak of coronavirus disease 2019 (COVID-19), like severe acute respiratory syndrome (SARS), provokes fear, anxiety and depression in the public, which further affects mental health issues. Taiwan has used their experience of the SARS epidemic for the management of foreseeable problems in COVID-19 endemic. Aim/Objective: This review summarizes issues concerning mental health problems related to infectious diseases from current literatures. Results: In suspected cases under quarantine, confirmed cases in isolation and their families, health care professionals, and the general population and related effective strategies to reduce these mental health issues, such as helping to identify stressors and normalizing their impact at all levels of response as well as public information and communication messages by electronic devices. The importance of community resilience was also addressed. Psychological first aid, psychological debriefing, mental health intervention and ...

Psychoneuroendocrinology, Jan 26, 2017

Past research has indicated gender differences in the clinical characteristics and course of schi... more Past research has indicated gender differences in the clinical characteristics and course of schizophrenia. In this study, we investigated whether gender differences in the manifestation of schizophrenia are correlated with neurosteroids, including dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), and pregnenolone. We further explored the potential relationship between the aforementioned neurosteroids and psychopathology. We recruited 65 schizophrenic patients (36 males and 29 females) and 103 healthy control subjects (47 males and 56 females) and obtained blood samples from the subjects in the morning while in a fasting state to determine the serum levels of DHEA, DHEA-S, and pregnenolone. The psychopathology and mood symptoms of patients with schizophrenia were evaluated using the Positive and Negative Syndrome Scale (PANSS) and 17-item Hamilton Depression Rating Scale, respectively. Compared to the male control subjects, male patients with schizophrenia had ...

Schizophrenia research, Feb 28, 2017

Oxidative stress has been implicated in the psychopathology of schizophrenia. Cysteine, a semi-es... more Oxidative stress has been implicated in the psychopathology of schizophrenia. Cysteine, a semi-essential amino acid, is the precursor of the antioxidant glutathione. The aim of this study was to investigate the differences in serum levels of cysteine between patients with schizophrenia and healthy controls. The relationships between levels of cysteine, psychopathology and cognitive function were also explored. We recruited 65 patients with schizophrenia and 65 age- and gender-matched healthy controls. Blood samples were collected to determine the serum levels of cysteine and plasma levels of metabolic parameters. The cognitive function of participants was assessed using the Brief Assessment of Cognition in Schizophrenia (BACS). The psychopathology of schizophrenic patients was evaluated using the Positive and Negative Syndrome Scale. Serum cysteine levels were significantly higher in schizophrenic patients than in controls (P<0.001). In patients with schizophrenia, serum levels o...

Neuropsychiatric Disease and Treatment, 2016

AIDS Education and Prevention, 2016

High cost of pre-exposure prophylaxis (PrEP) is a major concern for acceptability. This study det... more High cost of pre-exposure prophylaxis (PrEP) is a major concern for acceptability. This study determined the willingness of men who have sex with men to self-pay for PrEP and factors associated with the likelihood of condom use if taking PrEP. The Taiwan 2014 MSM Online Sex Survey was conducted and data such as demographics, attitudes toward PrEP, and sexual behaviors in the previous 3 months were collected. Of the 1,151 MSM who participated, 56% were willing to take PrEP, but only 23% were willing to self-pay $340 for PrEP. Willingness to self-pay for PrEP was significantly associated with the previous receipt of nonoccupational post-exposure prophylaxis (adjusted odds ratio [AOR], 3.02, 95%CI [1.49, 6.12]), and positive attitudes toward PrEP (AOR, 3.02, 95%CI [2.19, 4.17]). Of MSM who are willing to use PrEP, 73.6% would maintain condom use if taking PrEP. If PrEP is made available in Taiwan, more efforts should be focused on increasing awareness of MSM who are practicing risky behaviors.

Psychoneuroendocrinology, Nov 16, 2016

The disturbances of β-hydroxybutyrate (β-HB) and pyruvate are linked with impaired brain energy u... more The disturbances of β-hydroxybutyrate (β-HB) and pyruvate are linked with impaired brain energy utilization which involves in the psychopathology of schizophrenia. This study investigates the difference in levels of β-HB and pyruvate between patients with schizophrenia and healthy controls, and explores their relationship with metabolic profiles and disease characteristics. We recruited 54 physically-health schizophrenic patients and 54 age- and gender-matched healthy control subjects. Blood samples were gathered to determine the serum levels of β-HB and pyruvate and plasma levels of metabolic profiles, including fasting glucose, triglycerides, total cholesterol, high- and low-density lipoprotein-cholesterol and adiponectin. The disease characteristics and psychopathology of patients with schizophrenia were assessed by using the Positive and Negative Syndrome Scale. Of patients with schizophrenia, serum levels of β-HB were significantly correlated with fasting glucose (p=0.007) and ...

The Australian Journal of Rehabilitation Counselling, 2015

Background: Self-determination theory (SDT) has increasingly been used as a theoretical framework... more Background: Self-determination theory (SDT) has increasingly been used as a theoretical framework for evaluating key elements of the recovery paradigm in rehabilitation and mental health services research and policy-making for people living with severe mental illnesses.Purpose: The purpose of this study was to validate the Behavioral Regulation in Work Questionnaire (BRWQ), an adaptation of the Behavioral Regulation in Exercise Questionnaire-2, as a measure of self-determined work motivation for use in psychiatric rehabilitation settings.Methods: One hundred and twenty-four individuals with severe mental illness were recruited from eight Clubhouse programmes in Hawaii. Factorial validity of the BRWQ was evaluated using exploratory factor analysis.Findings: Principal components analysis of the BRWQ yielded four factors (amotivation, external regulation, introjection and autonomous motivation). The autonomous motivation factor was found to be significantly related to other SDT constru...

Journal of Studies on Alcohol and Drugs, 2012

This study examined the predictors of self-efficacy in reducing risky injection behaviors among h... more This study examined the predictors of self-efficacy in reducing risky injection behaviors among heroin users receiving methadone maintenance treatment (MMT). The Methadone Maintenance Treatment Outcome Study was an 18-month prospective study from March 2007 to July 2008. Data collection was conducted in the substance use disorders treatment outpatient clinics of three hospitals in southern Taiwan. A total of 368 opioid-dependent heroin users (13.6% women) were interviewed at baseline and at 3-, 6-, 9-, 12-, 15- and 18-month follow-ups. The level of self-efficacy in reducing risky injection behaviors was repeatedly assessed using the Self-Efficacy Scale for HIV Risk Behaviors. Demographic and substance use characteristics, HIV serostatus, family function, depression, and pros and cons of heroin use were collected at baseline, and methadone dosage at each follow-up interview and the duration of retention in the MMT program were also recorded. The results of the generalized estimating equation indicated that a lower educational level, concurrent methamphetamine use, a younger age at first heroin use, a lower methadone dosage, a higher level of depression, and a shorter duration of retention in the MMT program were predictive of a lower level of self-efficacy in reducing risky injection behaviors. This study found that personal and MMT-related factors were predictive of a lower level of self-efficacy among heroin users receiving MMT. Programs implemented to promote a higher level of self-efficacy should be provided to heroin users in the MMT program.