Publications by authors named "Chay Hoon Tan"
Aims: This study aimed to assess treatment patterns and the effectiveness of long-acting injectable antipsychotics (LAIs) in patients with bipolar disorder (BD) across various Asian countries. The study focused on comparing the choices of LAIs, other psychotropic medications, and their psychotropic drug load to explore real-world usage and evaluate the potential benefits of LAIs in BD treatment across different countries.
Methods: A retrospective cohort study was conducted with BD patients diagnosed according to ICD-10-CM codes F31.
Background: As clinical practices with lithium salts for patients diagnosed with bipolar disorder (BD) are poorly documented in Asia, we studied the prevalence and clinical correlates of lithium use there to support international comparisons.
Methods: We conducted a cross-sectional study of use and dosing of lithium salts for BD patients across 13 Asian sites and evaluated bivariate relationships of lithium treatment with clinical correlates followed by multivariate logistic regression modeling.
Results: In a total of 2139 BD participants (52.
Article Synopsis
- This study analyzes the prescription patterns of mood stabilizers, primarily used for bipolar disorder, across 10 Asian countries and highlights their use in treating other psychiatric conditions.
- It found that more than half of the patients had schizophrenia or similar disorders, and symptoms like irritability and aggression were common targets for treatment.
- The results suggest that while mood stabilizers are frequently used off-label for various psychiatric diagnoses, the effectiveness and justification of this practice need further research.
Background: Pharmacoepidemiological studies of clozapine use to treat bipolar disorder (BD), especially in Asia, are rare, although they can provide insights into associated clinical characteristics and support international comparisons of indications and drug dosing.
Methods: We examined the prevalence and clinical correlates of clozapine treatment for BD in 13 Asian countries and regions (China, Hong Kong SAR, India, Indonesia, Japan, Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, and Thailand) within an Asian Prescription Patterns Research Consortium. We compared BD patients treated with clozapine or not in initial bivariate comparisons followed by multivariable logistic regression modeling.
Background: The rich biodiversity of medicinal plants and their importance as sources of novel therapeutics and lead compounds warrant further research. Despite advances in debulking surgery and chemotherapy, the risks of recurrence of ovarian cancer and resistance to therapy are significant and the clinical outcomes of ovarian cancer remain poor or even incurable.
Objective: This study aims to investigate the effects of leaf extracts from a medicinal plant Leea indica and its selected phytoconstituents on human ovarian cancer cells and in combination with oxaliplatin and natural killer (NK) cells.
The factor structure of extrapyramidal symptoms evaluated using the Drug-Induced Extrapyramidal Symptoms Scale in patients with schizophrenia: Results from the 2016 REAP AP-4 study.
Hum Psychopharmacol
March 2023
Introduction: Drug-induced extrapyramidal syndrome (EPS) remains a major problem in clinical psychiatry. This study aimed to examine the factor structure of drug-induced extrapyramidal symptoms observed in patients with schizophrenia and assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS).
Methods: The participants were 1478 patients with a diagnosis of schizophrenia whose EPS was assessed using the DIEPSS in India, Indonesia, Japan, Malaysia, and Taiwan in the 2016 REAP AP-4 study.
Psychotic symptoms are rarely concurrent with the clinical manifestations of depression. Additionally, whether psychotic major depression is a subtype of major depression or a clinical syndrome distinct from non-psychotic major depression remains controversial. Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, we developed a machine-learning-algorithm-based prediction model for concurrent psychotic symptoms in patients with depressive disorders.
View Article and Find Full Text PDFAims: Schizophrenia is a major mental disorder with a wide range of psychiatric symptoms. This study explored the structure of psychiatric symptoms of schizophrenia using network analysis in a large representative Asian sample based on a survey of clinical features and treatment used in schizophrenia patients across 15 countries/territories in Asia.
Methods: Data on the demographic characteristics and psychiatric symptoms in schizophrenia patients were extracted from the dataset of the fourth Research on Asia Psychotropic Prescription for Antipsychotics (REAP-AP) project.
Article Synopsis
- Clozapine combined with electroconvulsive therapy (ECT) is an effective treatment for patients with schizophrenia who do not respond to standard therapies, particularly in Asian populations.
- A study utilized machine learning techniques, specifically random forest and LASSO models, to create a prediction model identifying key variables that influence the success of this treatment combination, with significant results from a sample of 3,744 patients.
- Findings highlighted important factors such as inpatient status, BMI, and duration of illness, enabling a more tailored approach in treating schizophrenia through personalized medicine.
Article Synopsis
- * Conducted across 13 Asian countries, the research found that out of 1,647 participants, 13.1% were on high doses, with factors like younger age, male sex, and prior electroconvulsive treatment linked to this higher dosing.
- * The findings indicate significant variations in MS usage among different countries and highlight specific patient characteristics that could help in the individualized treatment of BD.
Article Synopsis
- - The REAP BD study investigated psychotropic medication prescription patterns for bipolar disorder across 12 Asian countries, highlighting the prevalence of polypharmacy and varied treatment approaches.
- - Data collected from 2003 patients showed that a majority were on multiple medications: 80.8% took mood stabilizers, 82.14% took antipsychotics, and the study found that 70% of patients were involved in polypharmacy practices.
- - Results indicated a significant increase in antipsychotic use, with over 80% of patients receiving them, suggesting an emerging trend in their use for treating bipolar disorder.
Network Analysis-Based Disentanglement of the Symptom Heterogeneity in Asian Patients with Schizophrenia: Findings from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics.
J Pers Med
January 2022
The symptom heterogeneity of schizophrenia is consistent with Wittgenstein's analogy of a language game. From the perspective of precision medicine, this study aimed to estimate the symptom presentation and identify the psychonectome in Asian patients, using data obtained from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics. We constructed a network structure of the Brief Psychiatric Rating Scale (BPRS) items in 1438 Asian patients with schizophrenia.
View Article and Find Full Text PDFObjective: Recently, rational polypharmacy approaches have been proposed, regardless of the lower risk and cost of monotherapy. Considering monotherapy as first-line treatment and polypharmacy as rational treatment, a balanced attitude toward polypharmacy is recommended. However, the high prevalence of polypharmacy led the Japanese government to establish a polypharmacy reduction policy.
View Article and Find Full Text PDFBackground: Disruptive behavior can harm high-quality care and is prevalent in many Western public health systems despite increasing spotlight on it. Comparatively less knowledge about it is available in Asia, a region commonly associated with high-power distance, which may limit its effectiveness in addressing disruptive behavior.
Purpose: The aim of this study was to develop a comprehensive framework for tackling disruptive behavior among health care professionals in a public health system.
We conducted a randomized controlled trial to examine choral singing's effect on cognitive decline in aging. Older Singaporeans who were at high risk of future dementia were recruited: 47 were assigned to choral singing intervention (CSI) and 46 were assigned to health education program (HEP). Participants attended weekly one-hour choral singing or weekly one-hour health education for two years.
View Article and Find Full Text PDFAlthough the association between antipsychotic use and corrected QT interval (QTc) prolongation has been repeatedly confirmed, the relationship has been rarely studied in a practical setting. Using data from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP) survey, our study aimed to investigate the prevalence and clinical correlates of QTc prolongation in 2553 Asian patients with schizophrenia. After adjusting for the potential effect of confounding factors, the baseline and clinical characteristics of the schizophrenia patients with and without QTc prolongation were compared using analyses of covariance and binary logistic analyses.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the coprescription of mood stabilizers (MSs) with antipsychotics in patients with schizophrenia across 14 Asian countries, finding that 13.6% of patients received MSs, often at high doses.
- Factors associated with MS use included demographic variables like younger age and female sex, as well as clinical aspects like longer illness duration and more severe symptoms.
- Results suggest that patients on high doses of MSs had a less favorable illness trajectory and were more challenging to treat, indicating that adjunctive MS treatment may reflect greater severity of illness.
Dyskinesia is most centrally situated in an estimated network of extrapyramidal syndrome in Asian patients with schizophrenia: findings from research on Asian psychotropic prescription patterns for antipsychotics.
Nord J Psychiatry
January 2021
Article Synopsis
- Network analysis, referred to as 'symptomics', identifies interconnected symptoms as part of a dynamic structure, applied to various symptom-related areas.
- The study used data from the REAP-AP project to create a network model of extrapyramidal syndrome in 1,046 Asian patients diagnosed with schizophrenia.
- Results indicated that dyskinesia was the most central symptom in the network, with three distinct clusters of extrapyramidal symptoms identified, suggesting a relationship between acute movement disorders and the risk of tardive dyskinesia.
Article Synopsis
- Patterns of clinical use of long-acting injectable (LAI) antipsychotics for treating schizophrenia in Asia are not well documented, with an average of 17.9% of patients receiving these medications across 15 countries.
- Patients on LAIs tend to be older, have a history of multiple hospitalizations, and experience more severe symptoms like disorganized behavior or aggression, but they also show slightly better psychosocial functioning.
- There are significant variations in the use of LAI antipsychotics among Asian countries, and clinicians need to consider both the benefits and potential adverse effects when prescribing these treatments.
Background: Dysregulation of pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) form the basis of immune-mediated inflammatory diseases. Vitex trifolia L. is a medicinal plant growing in countries such as China, India, Australia and Singapore.
View Article and Find Full Text PDFNetwork analysis of the depressive symptom profiles in Asian patients with depressive disorders: Findings from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD).
Psychiatry Clin Neurosci
June 2020
Article Synopsis
- The study aimed to analyze and compare the network structures of depressive symptoms among Asian patients using network analysis techniques.
- Researchers used data from 1174 patients and found that persistent sadness, fatigue, and loss of interest were the most central symptoms in the network of depressive disorders.
- The results indicated that geographic and economic factors may affect the expression and organization of depressive symptoms, suggesting cultural influences in how these symptoms manifest among different groups of Asian patients.
Objective: Regular surveys are important to monitor the use of psychotropic medications in clinical practice. This study examined the psychotropic prescription patterns in adult Asian schizophrenia patients based on the data of the Research on Asian Psychotropic Prescription (REAP) 2016 survey.
Methods: This cross-sectional survey across 15 Asian countries/territories collected socio-demographic and clinical data with standardized procedures between March and May 2016.
Background And Objective: Antipsychotic polypharmacy (APP) is a controversial topic in the treatment of older adults with schizophrenia. The objective of this study was to examine the use of APP in older adult Asian patients with schizophrenia and its associated demographic and clinical factors.
Methods: This study was based on the fourth survey of the consortium known as the Research on Asian Psychotropic Prescription Pattern for Antipsychotics.