2.Spousal Concordance and Cross-Disorder Concordance of Mental Disorders: A Nationwide Cohort Study
Ming-Hong HSIEH ; Po-Chung JU ; Jeng-Yuan CHIOU ; Yu-Hsun WANG ; Jong-Yi WANG ; Cheng-Chen CHANG
Psychiatry Investigation 2022;19(10):788-794
Objective:
Although both partners of a married couple can have mental disorders, the concordant and cross-concordant categories of disorders in couples remain unclear. Using national psychiatric population-based data only from patients with mental disorders, we examined married couples with mental disorders to examine spousal concordance and cross-disorder concordance across the full spectrum of mental disorders.
Methods:
Data from the 1997 to 2012 Taiwan Psychiatric Inpatient Medical Claims data set were used and a total of 662 married couples were obtained. Concordance of mental disorders was determined if both spouses were diagnosed with mental disorder of an identical category in the International Classification of Diseases, Ninth Revision, Clinical Modification; otherwise, cross-concordance was reported.
Results:
According to Cohen’s kappa coefficient, the most concordant mental disorder in couples was substance use disorder, followed by bipolar disorder. Depressive and anxiety disorders were the most common cross-concordant mental disorders, followed by bipolar disorder. The prevalence of the spousal concordance of mental disorders differed by monthly income and the couple’s age disparity.
Conclusion
Evidence of spousal concordance and cross-concordance for mental disorders may highlight the necessity of understanding the social context of marriage in the etiology of mental illness. Identifying the risk factors from a common environment attributable to mental disorders may enhance public health strategies to prevent and improve chronic mental illness of married couples.
3.Association between Thioridazine Use and Cancer Risk in Adult Patients with Schizophrenia-A Population-Based Study.
Cheng Chen CHANG ; Ming Hong HSIEH ; Jong Yi WANG ; Nan Ying CHIU ; Yu Hsun WANG ; Jeng Yuan CHIOU ; Hsiang Hsiung HUANG ; Po Chung JU
Psychiatry Investigation 2018;15(11):1064-1070
OBJECTIVE: Several cell line studies have demonstrated thioridazine’s anticancer, multidrug resistance-reversing and apoptosis-inducing properties in various tumors. We conducted this nationwide population-based study to investigate the association between thioridazine use and cancer risk among adult patients with schizophrenia. METHODS: Based on the Psychiatric Inpatient Medical Claim of the National Health Insurance Research Database of Taiwan, a total of 185,689 insured psychiatric patients during 2000 to 2005 were identified. After excluding patients with prior history of schizophrenia, only 42,273 newly diagnosed patients were included. Among them, 1,631 patients ever receiving thioridazine for more than 30 days within 6 months were selected and paired with 6,256 randomly selected non-thioridazine controls. These patients were traced till 2012/12/31 to see if they have any malignancy. RESULTS: The incidence rates of hypertension and cerebrovascular disease were higher among cases than among matched controls. The incidence of hyperlipidemia, coronary artery disease and chronic pulmonary disease did not differ between the two groups. By using Cox proportional hazard model for cancer incidence, the crude hazard ratio was significantly higher in age, hypertension, hyperlipidemia, cerebrovascular disease, coronary artery disease and chronic pulmornary disease. However, after adjusting for other covariates, only age and hypertension remained significant. Thioridazine use in adult patients with schizophrenia had no significant association with cancer. CONCLUSION: Despite our finding that thioridazine use had no prevention in cancer in adult patients with schizophrenia. Based on the biological activity, thioridazine is a potential anticancer drug and further investigation in human with cancer is warranted.
Adult*
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Cell Line
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Cerebrovascular Disorders
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Coronary Artery Disease
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Humans
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Hyperlipidemias
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Hypertension
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Incidence
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Inpatients
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Lung Diseases
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National Health Programs
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Proportional Hazards Models
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Schizophrenia
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Taiwan
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Thioridazine*