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Biomedical subjects

K M Lin

Publications and source records attributed to K M Lin.

88 records · Page 5Linked to original sources

Adaptation problems of Vietnamese refugees. II. Life changes and perception of life events.

The Vietnamese refugees have encountered a multitude of acute psychological, social, cultural, economic, and political upheavals. This study documents the Vietnamese perceptions of the life events that have swirled about them as well as the occurrences of these life events. Questionnaires were administered in 1975 and 1976 as part of an ongoing study. The expected high amount of life change in the year of the evacuation and resettlement (1975) continued into the following year (1976). Financial, life-style, work, spouse, and schooling problems continued to plague them and were increased in the second year. There was a positive correlation between life change and health status. The Vietnamese rank ordered the impact of life events in a fashion similar to the Americans, but there were differences in mean magnitude estimations. Substantial reductions in magnitude estimations at second administration of the Social Readjustment Rating Questionnaire indicated a change in the situational perception set with time.

Acculturation↗

Adaptational problems of Vietnamese refugees. I. Health and mental health status.

The forced migratory influx of Vietnamese to the United States has raised questions regarding the resettlement process, the effect of culture shock, the refugees' coping behavior and adaptabilities, and their health and mental health status. We report the two-year results of ongoing research on the Vietnamese refugees based on the use of the Cornell Medical Index (CMI). The responses on the CMI on the first (1975) and second (1976) administrations indicate a high and continuing level of physical and mental dysfunction. The second administration also revealed significant shifts in dysfunctions as well as exposing factors that related to these dysfunctions, ie, age/sex interactions, marital status, family groupings, and public assistance. The follow-up CMI also showed an increase in anger and hostility with concomitant reductions in feelings of inadequacy.

Acculturation↗

Relationship of plasma levels of chlordiazepoxide and metabolites to clinical response.

The authors report on the relationship between the antianxiety effects of chronically administered chlordiazepoxide (CDX) and plasma levels of CDX and two of its metabolites, desmethylchlordiazepoxide (DMCDX) and demoxepam (DMX). Fifteen subjects with moderate to severe anxiety were studied in a double-blind, placebo-controlled, crossover design. Significant correlations were found between anxiety reduction and DMCDX and DMX plasma levels. No such correlation was observed between anxiety reduction and CDX levels. These data suggest that in chronically treated subjects, DMCDX and DMX have significant antianxiety properties which surpass those of CDX itself.

Adult↗

A comparative study of Asian FMG and USMG psychiatrists.

Of 367 East Asian and South Asian psychiatrists responding to a 1976 survey, 295 were identified as foreign medical graduates (FMGs) and 72 as U.S. medical graduates. Comparison of the two groups showed that the FMG'S WERE MORE LIKEly to be trained and employed in state mental hospitals and other nonacademic settings and to treat patients of other minorities. The Asian FMGs were less likely to have specialty board certification, a finding that seems to reflect their incomplete professional development and American acculturation. The authors conclude that Asian FMG psychiatrists shoulder much of the responsibility for treating minority patients in the United States, a job for which they may be ill equipped. Their need for special training in both cultural and professional areas is emphasized.

Asia, Southeastern↗

The pharmacologic treatment of anxiety and depression in African Americans. Considerations for the general practitioner.

A growing pool of recent research points to the importance of ethnicity in psychopharmacologic management of depression and anxiety disorders, with sometimes profound implications for efficacy and safety. Such research has provided provocative findings that illustrate important interethnic pharmacogenetic, pharmacokinetic, and pharmacodynamic differences, especially for African Americans. We did a systematic literature review of psychopharmacologic treatment considerations among African Americans with anxiety and mood disturbance seen by primary care physicians, who provide most psychopharmacologic treatment. The findings commonly point to a greater percentage of "poor metabolizers" among African Americans compared with Euro-Americans. General treatment considerations include greater attention to adverse effects and better clinical response and poorer compliance for a given dose, potential need for lower starting doses and slower increases, use of plasma drug levels if available, determination of past responses to a similar drug, and integration of pharmacogenetic information into an overall socioculturally and ethnically sensitive approach to assessment and treatment.

Antidepressive Agents↗

Comparative study of diagnostic systems: Chinese Classification of Mental Disorders-Second Edition versus DSM-III-R.

We report on the diagnostic comparative study of the Chinese Classification of Mental Disorders-Second Edition (CCMD-2) and the DSM-III-R in a field trial in China. The Adult Diagnostic Interview Schedule-Second Edition (ADIS-2), a modified diagnostic interview schedule that can generate both CCMD-2 and DSM-III-R diagnoses, was used to test 254 psychiatric patients in China. It was found that the reliability and validity of the CCMD-2 and DSM-III-R are compatible in most diagnostic categories such as schizophrenia, delusional disorder, bipolar disorders, and depressive disorders. The discrepancies between Chinese and American diagnostic systems were found mainly in neurasthenia and hysterical neuroses. Such discrepancies may have resulted from frequent changes of the diagnostic terms in the West, such as the phenomenon of neurasthenia, or from creating a new disorder entity in CCMD-2, such as "Eastern gymnastic exercises-induced mental disorder. "Further cross-cultural studies focusing on these discrepant disorders are urgently needed to understand the cultural influences on diagnosis, as well as to improve the professional classification of mental disorders in different diagnostic systems.

Adolescent↗

An epidemiological study of neurasthenia in Chinese-Americans in Los Angeles.

This study examined the prevalence and clinical features of ICD-10-defined neurasthenia (NT) in Chinese-Americans and its relations to other psychiatric disorders. In this community epidemiological survey, the enhanced Composite International Diagnostic Interview [CIDI], with a supplemental NT module, was administered to 1,747 Chinese-Americans, selected with a stratified cluster sampling method. The SCL-90-R was also used for measuring psychiatric morbidity and symptoms. Dimensions of social stress and social support were measured by established instruments. A total of 112 ICD-10 NT subjects (6.4%) were identified. Of these, 63 (56.3%) did not experience any current and lifetime DSM-III-R diagnoses, yielding a 12-month or lifetime prevalence rate of "pure" NT of 3.61%. This rate was much higher than any of the other psychiatric disorders in this sample. Compared with normal subjects, "pure" NT subjects had significantly higher SCL-90-R total and factor scores, experienced more psychosocial stress, and perceived less social support (P < .05 or .01). Compared with subjects with depression and anxiety disorders, "pure" NT cases reported significantly less SCL-90-R psychological symptoms (P < .05 or .01), but had a strikingly similar elevation in the somatization subscale score. These data suggest that NT is a distinctive clinical condition overlapping only partially with the other better recognized diagnostic entities. In view of its high prevalence and the salience of its impact on the health of those afflicted, it is imperative that concerted research efforts be made to further elucidate the temporal stability, natural course, and outcome of such a condition.

Adolescent↗

Relationship between ethnicity and sleep patterns in normal controls: implications for psychopathology and treatment.

The purpose of the study was to examine ethnic influences on sleep regulation. Seventy-three normal volunteers from four ethnic groups (17 African-Americans, 10 Asians, 30 Caucasians and 16 Hispanics) were studied for two consecutive nights with sleep polysomnography recordings in the laboratory. The subjects were in good physical and psychological health, and were asymptomatic with respect to sleep/wake complaints or sleep disorders. With the exception of minor differences, sleep continuity, sleep architecture and rapid eye movement (REM) sleep patterns were comparable among the four groups. African-Americans had evidence of more stages 1 and 2 and diminished stage 4 sleep, whereas the Hispanics had higher REM density. These preliminary findings suggest that sleep patterns are remarkably similar across cultures. There are, however, important cross-ethnic differences, specifically in the depth of sleep and in phasic REM measures. Because sleep disturbances are common symptoms of emotional disorders and since many psychoactive agents affect sleep, cross-ethnic differences in sleep patterns may have potential implications for the treatment and prevention of psychiatric disorders.

Adult↗

Cumulative incidence of colorectal and extracolonic cancers in MLH1 and MSH2 mutation carriers of hereditary nonpolyposis colorectal cancer.

The extracolonic tumor spectrum of hereditary nonpolyposis colorectal cancer (HNPCC) includes cancer of the endometrium, ovaries, stomach, biliary tract, and urinary tract. This study was designed to determine the penetrance of colorectal and extracolonic tumors in HNPCC mutation carriers. Forty-nine patients (22 females and 27 males) were identified with an MSH2 germline mutation, and 56 patients (28 females and 28 males) were identified with an MLH1 I mutation. Cumulative incidence by age 60 (lifetime risk) and mean age of cancer diagnosis were compared. The lifetime risk of extracolonic cancers in MSH2 and MLH1 carriers was 48% and 11%, respectively (P = 0.016). Extracolonic cancer risk in MSH2 females and males was 69% and 34%, respectively (P = 0.042). Mean age of extracolonic cancer diagnosis was significantly older for MSH2 males than females (55.4 vs. 39.0, P = 0.013). No difference was observed in colorectal cancer risk between MLH1 and MSH2 carriers (84% vs. 71%). Colorectal cancer risk was 96% in MSH2 males compared to 39% in MSH2 females (P = 0.034). No differences in colorectal and extracolonic cancer risks between MLH1 females and males were identified. The risk of extracolonic cancer by age 60 was greater in MSH2 mutation carriers than in MLH1 carriers. Gender differences in colorectal and extracolonic cancer risk were observed for MSH2 carriers only. These phenotypic features of HNPCC genotypes may have clinical significance in the design of genotype-specific screening, surveillance, and follow-up for affected individuals.

Adaptor Proteins, Signal Transducing↗

A nationwide study of stressful life events in Mainland China.

The Stressful Life Events Rating Scale, a recently developed instrument specifically designed for the measurement of stressful life events in Mainland China, was administered along with the Chinese version of the Hopkins Symptom Checklist to 4054 Chinese "normal" subjects who were sampled from 24 sites across Mainland China. "Problems with Interpersonal Relationship" was the most commonly encountered psychosocial stressor in Chinese daily life. At least once a year, about 34% of normal Chinese subjects were stressed by being misunderstood or berated; 17% of married persons experienced difficulties with child rearing; 15% of married women had troubles with mothers-in-law. These stressors strongly influenced the well-being of Chinese residing in Mainland China. Stressors in the categories of "Study" and "Health" also contributed substantially. The life events experienced and stressfulness perceived varied in different life stages. Similarly, the major patterns of psychological responses obtained from the Hopkins Symptom Checklist differed in age groups. Similar to reports from other cultures, death of spouse is the most stressful life event in China. On the other hand, the rank order of stressfulness of several other stressful life events differed significantly across cultures. The impact of divorce was ranked more highly in most previous Western studies, whereas among the Chinese, death of a close family member received the second highest ranking. The total score of the Stressful Life Events Rating Scale for 99% of normal Chinese was below 74. A score over 74 suggests that the individual's psychosocial stress may be perceived as excessive or an overload and may be associated with a heightened risk of psychological and/or psychophysiological dysfunction(s).

Adolescent↗

SIADH: a serious side effect of psychotropic drugs.

In this communication two cases of possibly drug induced hyponatremia secondary to amitriptyline and thioridazine have been reported. What is particularly important is the fact that in one, irreversible neurological symptoms were left as sequelae and in the other, the patient was in a coma and thus suffered from a potentially lethal complication. The physicians should be aware of this disturbing side effect while treating their patients with antidepressant and neuroleptic medications.

Adult↗