Effects of Yoga on Heart Rate Variability and Depressive Symptoms in Women: A Randomized Controlled Trial.

OBJECTIVES: The purpose of the study was to investigate the effects of a 12-week yoga program on heart rate variability (HRV) and depressive symptoms in depressed women. METHODS: This was a randomized controlled trial. Twenty-six sedentary women scoring ≥14 on the Beck Depression Inventory-II were randomized to either the yoga or the control group. The yoga group completed a 12-week yoga program, which took place twice a week for 60 min per session and consisted of breathing exercises, yoga pose practice, and supine meditation/relaxation. The control group was instructed not to engage in any yoga practice and to maintain their usual level of physical activity during the course of the study. Participants' HRV, depressive symptoms, and perceived stress were assessed at baseline and post-test. RESULTS: The yoga group had a significant increase in high-frequency HRV and decreases in low-frequency HRV and low frequency/high frequency ratio after the intervention. The yoga group also reported significantly reduced depressive symptoms and perceived stress. No change was found in the control group. CONCLUSIONS: A 12-week yoga program was effective in increasing parasympathetic tone and reducing depressive symptoms and perceived stress in women with elevated depressive symptoms. Regular yoga practice may be recommended for women to cope with their depressive symptoms and stress and to improve their HRV.

Self-esteem in adolescent aggression perpetrators, victims and perpetrator-victims, and the moderating effects of depression and family support.

The aims of this study were (1) to examine differences in the level of self-esteem among adolescents with different roles in aggression involvement (aggression perpetrators, victims, perpetrator-victims and neutrals) according to gender and (2) to examine the moderating effects of depression and family support on association between aggression involvement and self-esteem. A total of 8085 adolescents in Taiwan completed questionnaires. The relationships between self-esteem and aggression involvement were examined by multiple regression analysis. The moderating effects of depression and family support on the association between aggression involvement and self-esteem were examined. The results showed that in females, aggression victims had lower self-esteem than those in the other three groups (t=-2.940 to 2.173, p<0.05); however, there was no significant difference in self-esteem among perpetrators, perpetrator-victims, and neutrals (t=0.693-0.933, p>0.05). In males, self-esteem in victims and perpetrator-victims was lower than in neutrals and perpetrators (t=-3.339 to -2.704, p<0.01); however, there was no difference in self-esteem between victims and perpetrator-victims (t=-1.115, p>0.05) or between perpetrators and neutrals (t=-1.396, p>0.05). Family support had a moderating effect on the association between self-esteem and victimization in males. Depression had a moderating effect on the association between self-esteem and perpetration-victimization and victimization in males. The results indicate that self-esteem in adolescents with different patterns of involvement in aggression is not the same as in those without involvement. The moderating effects of depression and family support should be considered when developing intervention strategies to raise self-esteem in adolescents with aggression involvement.

Individual and peer factors associated with ketamine use among adolescents in Taiwan.

The aim of this cross-sectional study was to examine the individual (demographic characteristics, substance-using behaviors, emotional status, and negative outcome expectancy) and peer factors associated with ketamine use in Taiwanese adolescents. A total of 9,860 adolescents completed the self-report questionnaires without omission. Demographic characteristics, substance-using behaviors, emotional status, negative outcome expectancy, and peer factors were compared between the ketamine users and non-users using the Mann-Whitney U test and the Chi-square test, and then significant factors were further selected for stepwise logistic regression analysis to examine the associated factors of ketamine use. Sixty-nine (0.7%) participants reported having used ketamine in the past year. The results of logistic regression analysis indicated that ketamine users were more likely to use marijuana, smoke cigarettes, have peers using illicit drugs, and have a lower level of negative outcome expectancy regarding using ketamine than ketamine non-users. The associated factors found in this study should be taken into consideration when developing prevention and intervention programs for ketamine use in adolescents.

Quality of life of methylphenidate treatment-responsive adolescents with attention-deficit/hyperactivity disorder.

Quality of life (QOL) in methylphenidate treatment-responsive adolescents with attention deficit/hyperactivity disorder (ADHD) was assessed. Patients were 12- to 18-year-old adolescents with ADHD (total n = 45) who had been on methylphenidate treatment for at least 3 months and were clinically judged to be improved. The self-completed Taiwanese Quality of Life Questionnaire for Adolescents (TQOLQA) was used, and the resulting measures were compared between adolescents with ADHD and: (1) community adolescents (n = 2316); (2) treatment-responsive adolescents with a chronic medical condition (i.e., adolescents with leukemia in its first and complete continuous remission for at least 3 years after chemotherapy) (n = 39). Patients' cognitive profile and their daily executive functioning were also obtained for analysis. The QOL of the treated adolescents with ADHD was reported to be worse than that of both the community healthy adolescents and the adolescent leukemia survivors in the self-reported TQOLQA domain of "psychological well-being". Treated adolescents with ADHD still had impaired executive skills in natural, everyday environments, and the scores for daily executive abilities could predict the QOL measures. Factors besides pharmacotherapy should be explored to further improve the QOL of medication-treated adolescents with ADHD.

Naturalistic exploration of the effect of osmotic release oral system-methylphenidate on remission rate and functional improvement in Taiwanese children with attention-deficit-hyperactivity disorder.

AIM: To determine the differences in the remission rate, recovery rate, functional improvement, and treatment adherence related to treatment with short-acting immediate-release methylphenidate (IR-MPH) and long-acting osmotic-release oral system-methylphenidate (OROS-MPH) in a naturalistic setting among Taiwanese children with attention-deficit-hyperactivity disorder (ADHD). METHODS: A total of 757 children with ADHD, aged 6-18 years, was evaluated using the following in order determine functional improvement and treatment adherence: the Chinese version of the Swanson, Nolan, and Pelham, version IV scale (SNAP-IV-C), Clinical Global Impression-ADHD-Severity (CGI-S) to measure remission and recovery rates, the Chinese version of the Social Adjustment Inventory for Children and Adolescents (CSAICA), and caregiver's satisfaction rate, treatment adherence, and frequency of adverse effects. RESULTS: According to the SNAP-IV-C scores, the remission rate was 30.72%, and the recovery rate was 16.38%. Compared to short-acting IR-MPH, OROS-MPH was associated with greater functional improvement and treatment adherence among children with ADHD. CONCLUSION: OROS-MPH treatment at the adequate dosage can achieve higher remission and recovery rates, produce greater functional improvement, and result in better treatment adherence than IR-MPH treatment.

Enantioseparation of (±)-threo-methylphenidate in human plasma by cyclodextrin-modified sample stacking capillary electrophoresis.

The (±)-threo-methylphenidate ((±)-threo-MP) is widely used for treatment of attention-deficit hyperactivity disorder (ADHD). According to clinical evidence, (+)-threo-MP possesses higher potency than (-)-threo-MP. Due to ppb level in plasma, till now, none of the capillary electrophoresis (CE) methods have been able to provide adequate sensitivity for therapeutic (±)-threo-MP monitoring. In this study, a cyclodextrin-modified field-amplified sample stacking CE method (CD-FASS-CE) for enantioseparation of (±)-threo-MP in human plasma was established for clinical applications. Phosphate buffer (50mM, pH 3.0) was filled into uncoated fused silica capillary (40 cm, 50 µm I.D.), followed by a water plug (0.5 psi, 10s). Electrokinetic injection (6 kV, 200 s) was used to load samples and to enhance sensitivity. Stacking and separation were performed at 20 kV and 200 nm using phosphate buffer (50mM, pH 3.0) containing 20mM HP-ß-CD and 30 mM triethanolamine. Analytes were separated simultaneously by using CD-FASS-CE and had a lower detection limit of equal to the sub-ppb level. Linear calibration curves were obtained from 1 to 80 ng/mL (r=0.998). The limit of detection for both isomers was 600 pg/mL. RSD and RE of precision and accuracy in intra- and inter-day assays were below 7.89%. This method was further applied to analyze (±)-threo-MP in four healthy Asian volunteers and that provided some relevant information for clinical treatments.

Effectiveness of behavioral parent therapy in preschool children with attention-deficit hyperactivity disorder.

The purpose of this study was to assess the effectiveness of a behavioral parent therapy (BPT) program in children with attention-deficit hyperactivity disorder (ADHD) using multidimensional evaluations, the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF). Between 2001 and 2005, the parents of 21 preschool children with ADHD were divided into six groups and participated in a series of 11 BPT sessions. Before and after BPT, the parents completed the CBCL, and the teachers completed the TRF. The behavioral and emotional problems of the children showed improvement after the BPT sessions, specifically for the following categories: internalizing problems, anxious/depressed syndromes, somatic complaints, externalizing problems, rule-breaking behaviors, aggressive behaviors, social problems, thought problems, and attention problems. In the DSM-oriented scale of the CBCL, affective problems, anxiety problems, somatic problems, ADHD problems, oppositional defiant disorder problems, and conduct disorder problems showed significant improvements. On the DSM scale of the TRF, Inattention syndrome improved significantly after the BPT sessions, while other syndromes showed non-significant changes. We conclude that the BPT program significantly improved the childrens behavioral problems at home and inattention problems at school.

Behavioral parent training for Taiwanese parents of children with attention-deficit/hyperactivity disorder.

It has been observed that it is relatively difficult for children with attention-deficit/hyperactivity disorder (ADHD) to follow social rules and behave in a socially desirable manner. The ADHD children in Chinese culture, which emphasizes Confucian values, might encounter even greater adjustment difficulties. The purpose of the present study is to implement a behavioral parent training program in a Confucian environment and examine its effectiveness. Twenty-three ADHD preschoolers (age: 3-6 years) and their parents were selected to participate in the present study. Fourteen of these 23 parents completed a 10-session parent training program. Parent ratings of ADHD/oppositional defiant disorder (ODD) symptoms and problem behaviors at home were collected at the first, fourth, sixth, seventh, and tenth sessions. Three instruments were used to evaluate treatment outcome: the Disruptive Behavior Rating Scale-Parent Form, Child Attention Profile, and Home Situations Questionnaire. The results showed that both ADHD/ODD symptoms and home behaviors of these 14 children improved significantly after the parent training. There was also a significant decline in the severity of symptoms and problem behaviors at home with the progression of training. These findings support the effectiveness of this parent training program for parents of ADHD children in an environment of Confucianism. Limitations of the present study and future direction for research are discussed.