Browsing by Author "Hwang, Tzung-Jeng"

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Intramuscular olanzapine versus intramuscular haloperidol plus lorazepam for the treatment of acute schizophrenia with agitation: An open-label, randomized controlled trial
(2015-05-01)
Huang, Charles Lung-Cheng
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Hwang, Tzung-Jeng
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Chen, Yi-Hsing
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Huang, Guan-Hua
;
Hsieh, Ming H.
Background/Purpose: To compare the efficacy and safety profile between intramuscular (IM) olanzapine and IM haloperidol plus IM lorazepam in acute schizophrenic patients with moderate to severe agitation. Methods: This was a prospective, randomized, open-label study. Acutely agitated patients with schizophrenia or schizoaffective disorder (n = 67) were randomized to receive 10 mg IM olanzapine (n = 37) or 5 mg IM haloperidol plus 2 mg IM lorazepam (n = 30). Agitation was measured with Positive and Negative Syndrome Scale Excited Component (PANSS-EC) and AgitationeCalmness Evaluation Scale (ACES) during the first 2 hours and at 24 hours after the first injection. Safety was assessed using the SimpsoneAngus Scale and Barnes Akathisia Rating Scale and by recording adverse events at 24 hours following the first injection. The Clinical Global Impression-Severity scale was also rated. Results: The PANSS-EC scores decreased significantly at 2 hours after the first injection in both groups (olanzapine: -10.2, p < 0.001; haloperidol + lorazepam: -9.9, p < 0.001). Haloperidol plus lorazepam was not inferior to olanzapine in reducing agitation at 2 hours. There were no significant differences in PANSS-EC or ACES scores between the two groups within 2 hours following the first injection. The frequencies of adverse events and changes in Clinical Global Impression-Severity, SimpsoneAngus Scale, and Barnes Akathisia Rating Scale scores from baseline to 24 hours showed no significant differences between the groups. Conclusion: The findings suggest that IM haloperidol (5 mg) plus lorazepam (2 mg) is not inferior to IM olanzapine (10 mg) in the treatment of acute schizophrenic patients with moderate to severe agitation. Copyright (C) 2015, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
Mindfulness Improves Emotion Regulation and Executive Control on Bereaved Individuals: An fMRI Study
(2019-01-28)
Huang, Feng-Ying
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Hsu, Ai-Ling
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Hsu, Li-Ming
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Tsai, Jaw-Shiun
;
Huang, Chih-Mao
The grief of bereavement is recognized as a severe psychosocial stressor that can trigger a variety of mental and physical disorders, and the long-lasting unresolved grief has a detrimental effect on brain functionality. Literature has documented mindfulness-based cognitive therapy (MBCT) as an efficient treatment for improving well-being, specifically related to the mood and cognition, in a variety of populations. However, little attention has been devoted to neural mechanisms with regard to bereaved individuals' cognition after MBCT intervention. In this study, we recruited 23 bereaved participants who lost a significant relative within 6 months to 4 years to attend 8-week MBCT course. We used self-reporting questionnaires to measure emotion regulation and functional magnetic resonance imaging (fMRI) with the numerical Stroop task to evaluate the MBCT effect on executive control among the bereaved participants. The self-reported questionnaires showed improvements on mindfulness and reductions in grief, difficulties in emotion regulation, anxiety, and depression after the MBCT intervention. The fMRI analysis demonstrated two scenarios: (1) the activity of the fronto-parietal network slightly declined accompanied with significant improvements in the reaction time of incongruent trials; (2) the activities in the posterior cingulate cortex and thalamus were positively associated with the Texas Revised Inventory of Grief, implying emotional interferences on cognitive functions. Results indicated that MBCT facilitated the executive control function by alleviating the emotional interferences over the cognitive functions and suggested that the 8-week MBCT intervention significantly improved both executive control and emotion regulation in bereaved individuals.
Outcome of Severe Obsessive-compulsive Disorder With Schizotypal Features: A Pilot Study
(2011-02-01)
Huang, Lung-Cheng
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Hwang, Tzung-Jeng
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Huang, Guan-Hua
;
Hwu, Hai-Gwo
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統計學研究所
Background/Purpose: Long-term outcome of patients with severe obsessive-compulsive disorder (OCD) and schizotypal features has been rarely studied. We investigated this issue in this retrospective pilot study. Methods: Twenty-two patients with severe OCD and schizotypal features were identified by chart review. Another 22 ()CD patients without schizotypal features (OCD-NS) served as the comparison group. Those with schizotypal features must not fulfill a diagnosis of schizophrenia or schizotypal disorder. After an average follow-up of 6.6 years, each patient received a re-diagnosis clinical interview. Relevant demographic and clinical data were collected. Patients with schizotypal features were classified into two groups after re-diagnosis: those with schizophrenia or schizotypal disorder (OCD-SS group, n=9) and those with only schizotypal traits (OCD-ST group, n=13) that did not fulfill a well-formed schizophrenia-spectrum disorder. Demographic data, family history, clinical symptoms, and OCD course were compared among the three patient groups. Results: Compared with the OCD-NS group, the OCD-SS group was significantly less educated, less likely to be married or female, and had earlier onset of illness and poorer OCD course (p < 0.05). There was no significant difference in any demographic and clinical variables between the OCD-SS and OCD-ST groups except that the OCD-ST group had a significantly better OCD course (p < 0.01). Conclusion: The findings suggest that a substantial proportion of the patients with severe OCD and schizotypal features evolve into schizophrenia spectrum disorder and are associated with a poor long-term outcome, whereas the OCD-NS group might stay with limited manifestations of schizotypal features and have a better outcome.