What’s in Store in this Special Issue on Clinical Psychiatry A Preface

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PREFACE

What

’s in Store in this Special Issue on Clinical Psychiatry: A Preface

1. Introduction

The concept of having a special issue of the Journal of Experimental and Clinical Medicine (JECM) was the brainchild of Chuang C. Chiueh, the newly appointed Editor-in-Chief. He told me of the articles pub-lished in one special issue that had been contributed by speakers at a symposium on“Neurobiology of NO

and

OH,” producing a group of highly cited articles in the Annals of the New York Academy of Sciences. In the JECM (www.jecm-online.com), theﬁrst special issue was published on human motion analysis, and the second on oncology, these appearing in the October 2011 and December 2011 issues, respectively, of the JECM. This third special issue, published in April 2012, is on clinical psychiatry.

2. Contents of this special issue

2.1. Theﬁrst section, on disaster psychiatry

My immediate thought of what might be the main theme in clinical psychiatry in Taiwan is “disaster psychiatry”1 _because

this has been a recurrent theme in the Taiwanese Journal of Psychiatry (Taipei), of which I am Editor-in-Chief, and at the World Psychiatric Association Regional Meeting-Kaohsiung, November 3–5, 2011, for which I chaired the scientiﬁc program committee.

The _{ﬁrst thematic section of this issue includes two invited} reviews on disaster psychiatry. In theﬁrst review, “Disaster Psychi-atry in Taiwan,” Huei-Wen Angela Lo, Chao-Yueh Su, and Frank Huang-Chih Chou review 33 published articles from Taiwan from 2001 to 2011 on disaster psychiatry, mainly on experiences from the 1999 Chi Chi Earthquake and the 2009 Morakot Typhoon. In this review, major depressive episodes and post-traumatic stress disorder have been found to be the most common disaster-related psychiatric diagnoses. The articles also call for training enough specialists, for guidelines for standard clinical treatment, and for the creation of a standard operating procedure to reduce traumatic conditions after a disaster in Taiwan.

Based on global experiences, Helen Herrman, in the second review,“Promoting Mental Health and Resilience after a Disaster,” advocates effective interventions to promote mental health and resilience after a disaster, focusing on self-efﬁcacy and community participation. She describes in detail in both theoretical and prac-tical terms how to promote mental health and resilience. She also stresses the need for program evaluation and reﬁnement as well as for good practice after a disaster.

2.2. The second section, on psychiatric diseases

In the second thematic section, the diagnoses and treatment of four psychiatric diseases or clinical conditions are included.

In theﬁrst review “Generalized Anxiety Disorder: The Review of Recent Findings,” Christer Allgulander deﬁnes the diagnosis of generalized anxiety disorder (GAD), encompassing cognitive dysfunction, physical symptoms, and an impairment in work capacity, relationships, and leisure activities. He also stresses that the presence of GAD is a risk factor for somatic complications and for lowered adherence to somatic treatments. Finally, he provides an update on GAD treatment using cognitive-behavioral therapy and/or medication.

In the second review,“Overview of the Diagnosis and Treatment of Stuttering,_{” Gerald A. Maguire, Christopher Y. Yeh, and Brandon} S. Ito describe stuttering as a speech disorder with anxiety and cognitive avoidance. In addition, they outline the proposed changes in the diagnostic criteria for stuttering as given in the_{ﬁfth edition} of the Diagnostic and Statistical and Manual of Mental Disorders (DSM-5) by the American Psychiatric Association (www.dsm5. org). They also review the physiological etiology and provide insights into new strategies to treat stuttering. Finally, they address the need to focus on all aspects of stuttering and its treatment using a multidisciplinary approach.

In the last review in this section,“Evolutional Concept of Deﬁni-tion of Treatment-resistant Schizophrenia,” Juan D. Molina, Ana B. Jiménez-González, Francisco López-Muñoz, and Fernando Cañas have reviewed the criteria for treatment resistance that were proposed by Kane et al. in 1988, Brenner et al. in 1990, and Meltzer in 1992. They believe that these concepts should be more inclusive in the current vision of treatment-resistant schizophrenia as they could contribute a notion of a continuum whose response levels could range up to the recovery of premorbid functioning with regard to the individual’s life expectations.

In their case report on“Creutzfeld Jacob Disease,” Shu-Ping Chao and Yu-Hsuan Han describe a retired 85-year old Taiwanese professor who had lived in the United States of America. The patient had suffered from an initial rapid course of forgetfulness, personality change, and sleep disorder, followed by visual manifestations, dys-praxia, dysarthria, and myoclonic jerks. He showed a cortical ribbon sign and basal nuclear hyperintensity lesion in bothﬂuid-attenuated inversion recovery images on magnetic resonance imaging and bilat-eral periodic sharp wave complexes on the EEG tracings. The authors suggest that making the diagnosis of Creutzfeld Jacob disease is dif ﬁ-cult and challenging during the early course of the disease. Contents lists available atSciVerse ScienceDirect

Journal of Experimental and Clinical Medicine

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J Exp Clin Med 2012;4(2):75–76

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2.3. The third section, on substances (therapeutic drugs and abused substances)

The third thematic section of this issue is on substances, which in psychiatric terms include treatment medications (e.g., prescribed hypnotic drugs) and drug of abuse (e.g., alcohol).

In the ﬁrst review article, “Metabolic and Cardiovascular Adverse Effects Associated with Treatment with Antipsychotic Drugs,” Shen-Chieh Chang and Mong-Liang Lu describe antipsychotic-induced weight gain, type 2 diabetes mellitus, and cardiovascular disease. They then explore the risk factors and possible underlying pathophysiology. To control these side effects, they suggest close monitoring, psycho-education for lifestyle changes, and the use of medications such as metformin, topira-mate, amandatine, and so on.

In the regular article,“Complex Behaviors Related to Zolpidem: An Analysis of Published Clinical Cases from Taiwan,” Ana Isabel Wu-Chou and Winston W. Shen review the magnitude of this problem and provide possible explanations. They summarize 15 case reports and 5 clinical studies of zolpidem-related adverse effects in Taiwan, and review concerns about the safety of zolpidem that have been voiced in recent years by authors internationally. They suggest that clinicians should prescribe more antidepressants to treat underlying diseases presenting with insomnia (such as major depressive disorder or GAD).

In the meta-analytic article“Increases in Brain-derived Neuro-trophic Factor in Patients with Schizophrenia with Olanzapine Treatment,” Pao-Yen Lin has found that serum levels of brain-derived neurotrophic factor (BDNF) were found to be mildly but signiﬁcantly increased after antipsychotic treatment (p < 0.05). BDNF levels were signiﬁcantly increased only with olanzapine treatment (p< 0.001), but not with risperidone or other anti-psychotic treatments. He suggests a differential effect of antipsy-chotic drugs on serum BDNF levels in patients with schizophrenia, and speculates that serum BDNF may play a role in the disease process of a subset of patients, related to the use of antipsychotic agents.

In theﬁnal review, “Alcohol Dependence in Taiwan: From Epide-miology to Biomedicine,” Ming-Chyi Huang and Chiao-Chicy Chen have reviewed the literature on the prevalence of alcohol depen-dence among different ethnic populations. The heritability of alcohol dependence is estimated at roughly 50% to 60%. Until recently, the only genes established as affecting the risk for alcohol dependence are those encoding several alcohol-metabolizing enzymes, such as ADH1B and ALDH2. Huang and Chen have also found that alcohol intake produces long-lasting neuroadaptation, which is involved in developing and maintaining alcohol depen-dence. All the evidence presented provides an insight into under-standing the mechanisms of how alcohol disrupts the synergistic homeostasis of body systems and results in behavioral and physio-logical dysfunction.

2.4. The fourth section, on psychosocial topics

The ﬁnal thematic section of this special issue is on psychiatric psychosocial topics. In the regular paper “Donating a Kidney in Taiwan,” Eng-Kung Yeh, Hai Gao Hwu, and Agnes C. C. Wu report the decision-making process behind how a parent decides to

donate a kidney to a beloved child with end-stage renal disease who needs a kidney transplant. This article is based on interview data collected in the mid-1970s to mid-1980s when the authors interviewed 90 living relatives of the candidates for receiving a kidney transplant in Taiwan. These old data have provided a new insight into understanding the parental decision-making process behind donating a kidney in the context of psychosocial culture in Taiwan.

2.5. House-keeping business

Besides the articles dealing with the science, this issue also has a house-keeping editorial note, written by Chiueh, the newly appointed Editor-in-Chief of the JECM. In this note, he announces the brieﬁng of the March 2012 Editorial Board Meeting and the special JECM conference on "Do’s and Don’ts in Manuscript Prepara-tion,” as well as writing a thank you note to his predecessor, Edwin L. Cooper, the Emeritus JECM Editor-in-Chief, for his outstanding service in the past two years.

3. Looking to the future in theJECM

I would like to thank Chiueh for providing this opportunity to publish this special issue on clinical psychiatry, the third special issue in the journal’s publication history. After publishing this April 2012 issue on clinical psychiatry, I believe that the contents of future articles in the JECM will no longer be the samedacting as a herald for more psychiatric authors submitting articles to the journal.

In conclusion, readers of the JECM will in future have the chance to read more new articles on various psychiatric topics. At the time of going to press, we have just received a review on “Roles of Glycogen Synthase Kinase-3 (GSK3) in Alzheimer’s Disease: From Pathology to Treatment Target,” written by Hsing-Cheng Liu and Sy-Jye Leu of Taipei, Taiwan, as well as De-Maw Chuang, Bethesda, Maryland, USA.2In anticipation, we are also scheduled to receive more articles, such as_{“Drug Treatment for Autistic Spectrum} Disor-ders,” written by Luke Y. Tsai of Ann Arbor, Michigan, USA. These psychiatric articles will be scattered in future standard issues or appropriate special issues of the JECM. Stay tuned to read more on psychiatric advances.

References

1. Lo AH, Chen CC, Chou FH, Chang HT. The comparison of prevalence of trau-matic stress symptoms between Chi-Chi earthquake survivors and post-Morakotﬂood survivors. Taiwanese Journal of Psychiatry (Taipei) 2011;25:167–79. 2. Liu HC, Leu SJ, Chuang DW. Roles of glycogen synthase kinase 3 in Alzheimer's disease: from pathology to treatment target. Journal of Experimental and Clinical Medicine JECM in press.

Winston W. Shen Special Issue Editor and Senior Editor for Clinical Medicine Department of Psychiatry, Taipei Medical University-Wan Fang Medical Center, Taipei, Taiwan E-mail: <[email protected]>

Jan 31, 2012

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