Identification of secretory autophagy as a mechanism modulating activity-induced synaptic remodeling.

The ability of neurons to rapidly remodel their synaptic structure and strength in response to neuronal activity is highly conserved across species and crucial for complex brain functions. However, mechanisms required to elicit and coordinate the acute, activity-dependent structural changes across synapses are not well understood, as neurodevelopment and structural plasticity are tightly linked. Here, using an RNAi screen in Drosophila against genes affecting nervous system functions in humans, we uncouple cellular processes important for synaptic plasticity and synapse development. We find mutations associated with neurodegenerative and mental health disorders are 2-times more likely to affect activity-induced synaptic remodeling than synapse development. We report that while both synapse development and activity-induced synaptic remodeling at the fly NMJ require macroautophagy (hereafter referred to as autophagy), bifurcation in the autophagy pathway differentially impacts development and synaptic plasticity. We demonstrate that neuronal activity enhances autophagy activation but diminishes degradative autophagy, thereby driving the pathway towards autophagy-based secretion. Presynaptic knockdown of Snap29, Sec22, or Rab8, proteins implicated in the secretory autophagy pathway, is sufficient to abolish activity-induced synaptic remodeling. This study uncovers secretory autophagy as a transsynaptic signaling mechanism modulating synaptic plasticity.

National UK guidelines for the management of paediatric craniopharyngioma.

Although rare, craniopharyngiomas constitute up to 80% of tumours in the hypothalamic-pituitary region in childhood. Despite being benign, the close proximity of these tumours to the visual pathways, hypothalamus, and pituitary gland means that both treatment of the tumour and the tumour itself can cause pronounced long-term neuroendocrine morbidity against a background of high overall survival. To date, the optimal management strategy for these tumours remains undefined, with practice varying between centres. In light of these discrepancies, as part of a national endeavour to create evidence-based and consensus-based guidance for the management of rare paediatric endocrine tumours in the UK, we aimed to develop guidelines, which are presented in this Review. These guidelines were developed under the auspices of the UK Children's Cancer and Leukaemia Group and the British Society for Paediatric Endocrinology and Diabetes, with the oversight and endorsement of the Royal College of Paediatrics and Child Health using Appraisal of Guidelines for Research & Evaluation II methodology to standardise care for children and young people with craniopharyngiomas.

Image guidance and interfractional anatomical variation in paediatric abdominal radiotherapy.

OBJECTIVES: To identify variables predicting interfractional anatomical variations measured with cone-beam CT (CBCT) throughout abdominal paediatric radiotherapy, and to assess the potential of surface-guided radiotherapy (SGRT) to monitor these changes. METHODS: Metrics of variation in gastrointestinal (GI) gas volume and separation of the body contour and abdominal wall were calculated from 21 planning CTs and 77 weekly CBCTs for 21 abdominal neuroblastoma patients (median 4 years, range: 2 - 19 years). Age, sex, feeding tubes, and general anaesthesia (GA) were explored as predictive variables for anatomical variation. Furthermore, GI gas variation was correlated with changes in body and abdominal wall separation, as well as simulated SGRT metrics of translational and rotational corrections between CT/CBCT. RESULTS: GI gas volumes varied 74 ± 54 ml across all scans, while body and abdominal wall separation varied 2.0 ± 0.7 mm and 4.1 ± 1.5 mm from planning, respectively. Patients < 3.5 years (p = 0.04) and treated under GA (p < 0.01) experienced greater GI gas variation; GA was the strongest predictor in multivariate analysis (p < 0.01). Absence of feeding tubes was linked to greater body contour variation (p = 0.03). GI gas variation correlated with body (R = 0.53) and abdominal wall (R = 0.63) changes. The strongest correlations with SGRT metrics were found for anterior-posterior translation (R = 0.65) and rotation of the left-right axis (R = -0.36). CONCLUSIONS: Young age, GA, and absence of feeding tubes were linked to stronger interfractional anatomical variation and are likely indicative of patients benefiting from adaptive/robust planning pathways. Our data suggest a role for SGRT to inform the need for CBCT at each treatment fraction in this patient group. ADVANCES IN KNOWLEDGE: This is the first study to suggest the potential role of SGRT for the management of internal interfractional anatomical variation in paediatric abdominal radiotherapy.

Identification of secretory autophagy as a novel mechanism modulating activity-induced synaptic remodeling.

The ability of neurons to rapidly remodel their synaptic structure and strength in response to neuronal activity is highly conserved across species and crucial for complex brain functions. However, mechanisms required to elicit and coordinate the acute, activity-dependent structural changes across synapses are not well understood. Here, using an RNAi screen in Drosophila against genes affecting nervous system functions in humans, we uncouple cellular processes important for synaptic plasticity from synapse development. We find mutations associated with neurodegenerative and mental health disorders are 2-times more likely to affect activity-induced synaptic remodeling than synapse development. We further demonstrate that neuronal activity stimulates autophagy activation but diminishes degradative autophagy, thereby driving the pathway towards autophagy-based secretion. Presynaptic knockdown of Snap29, Sec22, or Rab8, proteins implicated in the secretory autophagy pathway, is sufficient to abolish activity-induced synaptic remodeling. This study uncovers secretory autophagy as a novel trans-synaptic signaling mechanism modulating structural plasticity.

The facilitators and barriers to physical activity scale for people with mental illness in Taiwan: development and validation.

PURPOSE: The purposes of this study were to develop a new measure, the Facilitators and Barriers to Physical Activity Scale for People with Mental Illness (FBPAS-MI) and to validate the psychometrics. METHODS: This study included two phases. In Phase I, a literature review and five focus groups were conducted to develop an item bank. Then, expert consultation and cognitive interviews were used for content validity. In Phase II, 147 participants with severe mental illness were recruited from 10 community-based psychiatric rehabilitation centers in Taiwan to examine the psychometrics. Principal axis factoring method with direct oblique rotation was used to identify the underlying constructs of FBPAS-MI. Concurrent validity, internal consistency and test-retest reliability were examined. RESULTS: The results revealed five domains in the facilitator subscale (15 items) and two domains in the barrier subscale (11 items). Both subscales showed satisfactory internal consistency (all Cronbach's α >0.80); the concurrent validity and test-retest reliability were established. CONCLUSIONS AND IMPLICATIONS OF PRACTICE: This study confirmed that the FBPAS-MI is a valid and reliable scale to understand perceived facilitators and barriers to physical activity for severe mental illness. The FBPAS-MI can provide useful information in the development of individualized health promotion program for this population.Implications for RehabilitationThe Facilitators and Barriers to Physical Activity Scale for People with Mental Illness (i.e., FBPAS-MI) is a valid and reliable assessment to examine key factors affecting physical activity participation among people with severe mental illness.Psychiatric rehabilitation practitioners could use the FBPAS-MI to help develop and tailor individualized physical activity promotion programs based on identified facilitators and barriers to activity.

Minibrain kinase and calcineurin coordinate activity-dependent bulk endocytosis through synaptojanin.

Neurons use multiple modes of endocytosis, including clathrin-mediated endocytosis (CME) and activity-dependent bulk endocytosis (ADBE), during mild and intense neuronal activity, respectively, to maintain stable neurotransmission. While molecular players modulating CME are well characterized, factors regulating ADBE and mechanisms coordinating CME and ADBE activations remain poorly understood. Here we report that Minibrain/DYRK1A (Mnb), a kinase mutated in autism and up-regulated in Down's syndrome, plays a novel role in suppressing ADBE. We demonstrate that Mnb, together with calcineurin, delicately coordinates CME and ADBE by controlling the phosphoinositol phosphatase activity of synaptojanin (Synj) during varying synaptic demands. Functional domain analyses reveal that Synj's 5'-phosphoinositol phosphatase activity suppresses ADBE, while SAC1 activity is required for efficient ADBE. Consequently, Parkinson's disease mutation in Synj's SAC1 domain impairs ADBE. These data identify Mnb and Synj as novel regulators of ADBE and further indicate that CME and ADBE are differentially governed by Synj's dual phosphatase domains.

Understanding factors relevant to poor sleep and coping methods in people with schizophrenia.

BACKGROUND: Sleep disruption is pervasive in people with schizophrenia, but few studies have explored their sleep experiences. This study aims to identify factors relevant to sleep problems and explore coping methods used by community-dwelling people with schizophrenia. METHODS: Eighteen participants with schizophrenia were recruited from three mental health centers in Taiwan. They completed a semi-structured interview and the Pittsburgh Sleep Quality Index (PSQI) assessment. The Person-Environment-Occupation model offered a framework to assess factors related to sleep. Thematic analysis was used for the qualitative data analysis. RESULTS: Factors related to sleep were classified under person, environment, and occupation domains. The person domain included three subthemes: psychiatric symptoms, unpleasant emotions, and frustration about sleep. The environment domain included three subthemes: sensory intrusions from the environment, quality of bedding, and roommates. The occupation domain included sleep interruption and sleep preparation. There were notable discrepancies in sleep quality between the participants' narratives and their PSQI global scores. Regarding coping methods for poor sleep, sleep medication was the primary strategy while some participants also used other strategies, such as modifying the environment, adjusting routines, or engaging in activities that improve sleep quality. CONCLUSIONS: Psychiatric symptoms and nightmares were identified as unique sleep disruptions in people with schizophrenia, and poor economic status was also found to impact their sleep. The sleep quality of people with schizophrenia tends to be poor, as identified by the PSQI, even though they may have positive perceptions of their sleep quality. Our participants appeared to prefer to take hypnotics to address their sleep problems, which may be due to limited knowledge about alternatives. Mental health professionals are encouraged to receive training in the application of non-pharmacological approaches to support their clients' issues related to sleep.

Professional perspectives on providing recovery-oriented services in Taiwan: a qualitative study.

BACKGROUND: The experiences of professionals in well-established recovery-oriented programs are valuable for professionals in similar practice settings. This study explored professionals' experiences with providing recovery-oriented services in community psychiatric rehabilitation organizations. METHODS: Semi-structured interviews were conducted with 14 professionals from five recovery-oriented psychiatric rehabilitation organizations in Taiwan. The interviews were recorded and transcribed verbatim. Thematic analysis was used for the qualitative data analysis. RESULTS: The analyses documented three main themes with 13 subthemes. Recovery-oriented service implementation included seven subthemes: Enabling clients to set their own goals and make decisions, using a strengths-based approach, establishing partnerships with clients, improving individuals' self-acceptance, encouraging community participation, seeking family, peer, and organizational support, and building team collaboration. Problems with implementing recovery-oriented services included limited policy and organizational support, a lack of understanding of recovery among professionals, stigma, clients' lack of motivation or self-confidence in their own ability to achieve recovery, and passive or overprotective family members. Strategies to resolve implementation problems included policy changes and organizational support, improving the recovery competence and confidence of professionals, and family and public education. CONCLUSIONS: To date, this is the first known study examining the perspectives of mental health professionals who have experience implementing recovery-oriented services in Asia. The participants identified family collaboration, anti-stigma efforts, and changes in policy and attitudes as critical to successful implementation and delivery of recovery-oriented services.

Using an Optimization Algorithm to Detect Hidden Waveforms of Signals.

Source signals often contain various hidden waveforms, which further provide precious information. Therefore, detecting and capturing these waveforms is very important. For signal decomposition (SD), discrete Fourier transform (DFT) and empirical mode decomposition (EMD) are two main tools. They both can easily decompose any source signal into different components. DFT is based on Cosine functions; EMD is based on a collection of intrinsic mode functions (IMFs). With the help of Cosine functions and IMFs respectively, DFT and EMD can extract additional information from sensed signals. However, due to a considerably finite frequency resolution, EMD easily causes frequency mixing. Although DFT has a larger frequency resolution than EMD, its resolution is also finite. To effectively detect and capture hidden waveforms, we use an optimization algorithm, differential evolution (DE), to decompose. The technique is called SD by DE (SDDE). In contrast, SDDE has an infinite frequency resolution, and hence it has the opportunity to exactly decompose. Our proposed SDDE approach is the first tool of directly applying an optimization algorithm to signal decomposition in which the main components of source signals can be determined. For source signals from four combinations of three periodic waves, our experimental results in the absence of noise show that the proposed SDDE approach can exactly or almost exactly determine their corresponding separate components. Even in the presence of white noise, our proposed SDDE approach is still able to determine the main components. However, DFT usually generates spurious main components; EMD cannot decompose well and is easily affected by white noise. According to the superior experimental performance, our proposed SDDE approach can be widely used in the future to explore various signals for more valuable information.

Spectrum of neuroimaging findings post-proton beam therapy in a large pediatric cohort.

PURPOSE: Proton beam therapy (PBT) is now well established for the treatment of certain pediatric brain tumors. The intrinsic properties of PBT are known to reduce long-term negative effects of photon radiotherapy (PRT). To better understand the intracranial effects of PBT, we analyzed the longitudinal imaging changes in a cohort of children with brain tumors treated by PBT with clinical and radiotherapy dose correlations. MATERIALS AND METHODS: Retrospective imaging review of 46 patients from our hospital with brain tumors treated by PBT. The imaging findings were correlated with clinical and dose parameters. RESULTS: Imaging changes were assessed by reviewing serial magnetic resonance imaging (MRI) scans following PBT over a follow-up period ranging from 1 month to 7 years. Imaging changes were observed in 23 patients undergoing PBT and categorized as pseudoprogression (10 patients, 43%), white matter changes (6 patients, 23%), parenchymal atrophy (6 patients, 23%), and cerebral large vessel arteriopathy (5 patients, 25%). Three patients had more than one type of imaging change. Clinical symptoms attributable to PBT were observed in 13 (28%) patients. CONCLUSION: In accordance with published literature, we found evidence of varied intracranial imaging changes in pediatric brain tumor patients treated with PBT. There was a higher incidence (10%) of large vessel cerebral arteriopathy in our cohort than previously described in the literature. Twenty-eight percent of patients had clinical sequelae as a result of these changes, particularly in the large vessel arteriopathy subgroup, arguing the need for angiographic and perfusion surveillance to pre-empt any morbidities and offer potential neuro-protection.

Relationship Among Sensory Over-Responsivity, Problem Behaviors, and Anxiety in Emerging Adults with Autism Spectrum Disorder.

INTRODUCTION: Despite the highly prevailing rate of sensory over-responsivity, problem behaviors, and anxiety among emerging adults with autism spectrum disorder (ASD), little is known about the nature of their experiences. While previous studies have indicated potential relationships among these conditions, their connections still need to be clarified. This study aimed to examine the relationships between sensory over-responsivity, problem behaviors, and anxiety. METHODS: Fifty-seven emerging adults with ASD (Mage = 21.4, SD = 2.5; males = 80.7%) were recruited. The Adult Sensory Profile - Chinese version, Problem Behavior Scale of Scales of Independent Behavior - Revised, and Generalized Anxiety Disorder-7 - Chinese version (GAD-7) were used. RESULTS: The percentage of emerging adults with ASD who scored more than most people in the two quadrants were sensation sensitivity = 33.3% and sensation avoiding = 26.3%. Approximately 66.7%, 27.5%, and 50.9% of participants had internalizing behaviors, externalizing behaviors, and asocial behaviors, respectively. Approximately, 64.9% of the participants scored on or above the cut-off score of 6 on the GAD-7. Sensation sensitivity and sensation avoiding were significantly correlated to problem behaviors; and anxiety was a mediating variable that accounts for the relationships between sensory over-responsivity and problem behaviors. CONCLUSION: These results indicated that emerging adults with ASD showing problem behaviors might also report more exaggerated responses toward sensory inputs and experience more anxiety symptoms. The results indicate that sensory over-responsivity, problem behaviors, and anxiety may have common underlying mechanisms. Findings can be useful to understand the impacts of such difficulties for emerging adults with ASD.

Recovery Programs for People With Mental Illness in Taiwan: A Feasibility Study.

IMPORTANCE: Most recovery programs have been developed in Western countries. This study explores the cultural adaptation of a recovery program to a non-Western country. OBJECTIVE: To test the feasibility of a recovery group developed for people with mental illness in Taiwan. DESIGN: Mixed-methods feasibility study. SETTING: Community psychiatric rehabilitation center in southern Taiwan. PARTICIPANTS: Twenty-four people with mental illness living in the community. INTERVENTION: The authors designed a recovery group based on the Pathways to Recovery program and the mental health recovery literature. The curriculum included two phases: recovery profile and recovery plan. The group gathered for a 1-hr session once a week for 18 wk. OUTCOMES AND MEASURES: Outcomes were assessed preintervention, mid-intervention, and postintervention. Data collected included Stages of Recovery Scale (SRS) scores, course assessments, and course discussions. RESULTS: Most participants were satisfied with the recovery program and its implementation. Scores on the Social Functioning/Role Performance subscale of the SRS showed a medium to large effect size (r = .36) for the Recovery Stage 1-3 subsample (n = 16). CONCLUSION AND RELEVANCE: This study affirmed the feasibility of a recovery group for people with mental illness in Taiwan. Prospective randomized controlled trials should be used to verify recovery groups' effectiveness. WHAT THIS ARTICLE ADDS: Recovery programs tailored to people with mental illness in non-Western countries may need more examples and longer sessions to enable participants to fully understand and implement the concepts of recovery.

Impact of the HealthMatters Train-the-Trainer Program on the Health and Health Behaviors of Staff Supporting Adults With Intellectual and Developmental Disabilities.

The health status and health behaviors among support staff providing daily support for people with intellectual and developmental disabilities (IDD-SS) in community-based organizations (CBOs) have not been systematically studied. This study examined the health impact of IDD-SS workers who participated in a HealthMatters Program: Train-the-Trainer Certified Instructor Workshop followed by implementing a 12-week HealthMatters Program for people with intellectual and developmental disabilities (IDD) that they care for as part of their employment. A total of 48 IDD-SS were enrolled into either an intervention (n = 28) or control group (n = 20). IDD-SS in the intervention group received an 8-hour HealthMatters Program: Train-the-Trainer Workshop immediately prior to teaching a 12-week HealthMatters Program for people with IDD. Assessments were conducted with IDD-SS before and after completing the 12-week HealthMatters Program to evaluate whether IDD-SS experienced any benefit of the training and teaching the program on their own health and health behaviors. Relative to the control group, the IDD-SS in the intervention group showed significant improvements in social/environmental supports for nutrition (F = 4.92, p = .032), exercise outcome expectations (F = 6.58, p = .014), nutrition outcome expectations (F = 8.87, p = .005), fruit and vegetable intake (F = 13.62, p = .001), knowledge of fruit and vegetable intake recommendations (F = 11.25, p = .002), and stages of change for eating fruits and vegetables (F = 6.86, p = .012). Results demonstrated that IDD-SS benefited from the health education programming. Findings support the need to develop programs and organizational policies for health promotion activities for direct care staff.

Temporal and spatial order of photoreceptor and glia projections into optic lobe in Drosophila.

Photoreceptor (PR) axons project from the retina to the optic lobe in brain and form a precise retinotopic map in the Drosophila visual system. Yet the role of retinal basal glia in the retinotopic map formation is not previously known. We examined the formation of the retinotopic map by marking single PR pairs and following their axonal projections. In addition to confirming previous studies that the spatial information is preserved from the retina to the optic stalk and then to the optic lamina, we found that the young PR R3/4 axons transiently overshoot and then retract to their final destination, the lamina plexus. We then examined the process of wrapping glia (WG) membrane extension in the eye disc and showed that the WG membrane extensions also follow the retinotopic map. We show that the WG is important for the proper spatial distribution of PR axons in the optic stalk and lamina, suggesting an active role of wrapping glia in the retinotopic map formation.

Evaluating Molecular Properties Involved in Transport of Small Molecules in Stratum Corneum: A Quantitative Structure-Activity Relationship for Skin Permeability.

The skin permeability (Kp) defines the rate of a chemical penetrating across the stratum corneum. This value is widely used to quantitatively describe the transport of molecules in the outermost layer of epidermal skin and indicate the significance of skin absorption. This study defined a Kp quantitative structure-activity relationship (QSAR) based on 106 chemical substances of Kp measured using human skin and interpreted the molecular interactions underlying transport behavior of small molecules in the stratum corneum. The Kp QSAR developed in this study identified four molecular descriptors that described the molecular cyclicity in the molecule reflecting local geometrical environments, topological distances between pairs of oxygen and chlorine atoms, lipophilicity, and similarity to antineoplastics in molecular properties. This Kp QSAR considered the octanol-water partition coefficient to be a direct influence on transdermal movement of molecules. Moreover, the Kp QSAR identified a sub-domain of molecular properties initially defined to describe the antineoplastic resemblance of a compound as a significant factor in affecting transdermal permeation of solutes. This finding suggests that the influence of molecular size on the chemical's skin-permeating capability should be interpreted with other relevant physicochemical properties rather than being represented by molecular weight alone.

Involvement of TRPV1 and TDAG8 in Pruriception Associated with Noxious Acidosis.

Itch and pain are closely related but are distinct sensations. Intradermal injection of acid generates pain in both rodents and humans; however, few studies have addressed the intriguing question of whether acid (protons) can evoke itch like other algogens by spatial contrast activation of single nociceptors. Here, we report that (i) citric acid (0.2 mol/L) pH-dependently induced a scratching response in mice when applied intradermally to nape or cheek skin, (ii) acidified buffer elevated intracellular calcium levels in dorsal root ganglion pruriceptors, and (iii) injection of intradermal citric acid (pH 3.0) into the nape induced a pruritogen-like but not algogen-like c-Fos immunoreactivity pattern in the cervical spinal cord. Using pharmacological and genetic approaches, we identified potential acid-sensing channels/receptors involved in acidic citrate-evoked itch. Results indicate that TRPV1, but neither ASIC3 nor TRPA1, is involved in the acidic citrate-induced scratching response. Furthermore, one of the proton-sensing G-protein-coupled receptors, TDAG8, was highly (∼71%) expressed in Nppb+ dorsal root ganglion pruriceptors. Itch induced by acidic citrate, but not α-methyl-5-hydroxytryptamine, chloroquine, compound 48/80, or bile acid, was markedly decreased in TDAG8-/- mice. In a heterologous expression system, TDAG8 potentiated the acid-induced calcium response by regulating TRPV1. Thus, protons could evoke pruriception by acting on TDAG8 to regulate TRPV1 activation with its mechanism of future therapeutic relevance.

Influences of Aerobic Dance on Cognitive Performance in Adults with Schizophrenia.

Cognitive impairment is one of the core features of schizophrenia. This study examined the influences of an aerobic dance programme on the cognitive functions of people with schizophrenia. A quasi-experimental matched-control design was applied. The experimental group (n = 17) participated in a 60-minute aerobic dance group class three times a week for 3 months. The control group (n = 19) participated in colouring and handwriting activities. Cognitive functions were measured before and after the interventions for both groups. The intervention group experienced significant improvements in processing speed, memory and executive function, whereas no significant changes were noted in any measures in the control group. While there were no significant between-group differences, the data showed approximately medium effect sizes that favoured the intervention group in regard to processing speed (Cohen's d = 0.51), memory (d = 0.35-0.41) and the spontaneity and fluency aspects of executive function (d = 0.51). While the small sample size and lack of randomization were the primary methodological shortcomings, this study provides preliminary results supporting aerobic dance as an adjunct activity-based intervention to improve cognitive functions in people with schizophrenia. More rigorous studies are needed to validate the findings. Copyright © 2016 John Wiley & Sons, Ltd.

Efficacy of Baduanjin Exercise and Feasibility of Mobile Text Reminders on Follow-up Participation in People With Severe Mental Illness: An Exploratory Study.

BACKGROUND: People with severe mental illness (SMI) frequently have poor physical health, which can in part be related to a low level of physical activity. The goal of this exploratory study was to examine the efficacy of a group participating in Baduanjin (a type of traditional Chinese exercise) on the health of individuals with SMI and the feasibility/acceptability of using short message service (SMS) reminder strategies to prompt continued exercise during a follow-up period. METHOD: Participants (N=11) participated in a Baduanjin group session for 8 weeks and then maintained home-based Baduanjin with SMS reminders for another 8 weeks. Physical and psychological tests were administered to participants. RESULTS: Significant improvements were found in balance and processing speed and in some domains of the 36-Item Short Form Health Survey (SF-36) after the Baduanjin program. Participants were able to maintain engagement in 80% of the expected practice time during the follow-up period. The acceptability of strategies to support home-based exercise, including SMS reminders, was high. CONCLUSIONS: This preliminary study suggested the efficacy of Baduanjin and the feasibility of SMS reminders in maintaining follow-up participation in people with SMI. Future studies using a larger sample size and a control group are needed to confirm the findings.

Personnel attitudes toward people with mental illness at a psychiatric hospital in Taiwan.

BACKGROUND: The attitudes of psychiatric hospital personnel are critically related to the quality of mental health care, but few studies have investigated this issue. AIMS: This study is aimed at an exploration of the attitudes of psychiatric hospital personnel toward people with mental illness and at an examination of the associated factors. METHOD: A self-report questionnaire, the Mental Illness Attitude Scale (MIAS), was used to collect data from psychiatric hospital personnel in Taiwan (n = 290). The MIAS included 46 items and 4 dimensions: acceptance, rehabilitation and prognosis, social distance and recommendations for interventions. RESULTS: Rehabilitation and prognosis had the highest item average scores (4.03) and social distance had the lowest item average scores (3.22). Stigmatization and the number of different types of contacted clients were two significantly associated attitude factors. CONCLUSION: Psychiatric hospital personnel in Taiwan tend to have positive attitudes toward people with mental illness in general situations but hold less positive attitudes in terms of community integration-related issues and intimate relationships. More evidence-based community services should be conducted to decrease personnel concerns about the successful community integration of those who are mentally ill. Future studies can investigate the concept and impact of stigmatization more deeply.