Coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of people’s lives all over the world. This Facebook survey study aimed to investigate the COVID-19-related factors that were associated with sleep disturbance and suicidal thoughts among members of the public during the COVID-19 pandemic in Taiwan. The online survey recruited 1970 participants through a Facebook advertisement. Their self-reported experience of sleep disturbance and suicidal thoughts in the previous week were collected along with a number of COVID-19-related factors, including level of worry, change in social interaction and daily lives, any academic/occupational interference, levels of social and specific support, and self-reported physical health. In total, 55.8% of the participants reported sleep disturbance, and 10.8% reported having suicidal thoughts in the previous week. Multiple COVID-19-related factors were associated with sleep disturbance and suicidal thoughts in the COVID-19 pandemic. Increased worry about COVID-19, more severe impact of COVID-19 on social interaction, lower perceived social support, more severe academic/occupational interference due to COVID-19, lower COVID-19-specified support, and poorer self-reported physical health were significantly associated with sleep disturbance. Less handwashing, lower perceived social support, lower COVID-19-specified support, poorer self-reported physical health, and younger age were significantly associated with suicidal thoughts. Further investigation is needed to understand the changes in mental health among the public since the mitigation of the COVID-19 pandemic.

Background People obtain information on the coronavirus disease (COVID-19) from the internet and other sources. Understanding the factors related to such information sources aids health professionals in educating individuals. Objective This study used data collected from the online survey study on COVID-19 in Taiwan to examine what major COVID-19 information sources are available and which sources are significantly related to the self-confidence of people in coping with COVID-19 in Taiwan. Methods A total of 1904 participants (1270 non–health-care workers and 634 health care workers) were recruited from the Facebook advertisement. Their major sources of information about COVID-19, the relationships between the sources and demographic factors, and the relationships between the sources and the self-confidence in coping with COVID-19 were surveyed. Results Most Taiwanese people relied on the internet for COVID-19 information. Many respondents also used a variety of sources of information on COVID-19; such variety was associated with sex, age, and the level of worry toward COVID-19, as well as if one was a health care worker. For health care workers, the use of formal lessons as an information source was significantly associated with better self-confidence in coping with COVID-19. The significant association between receiving information from more sources and greater self-confidence was found only in health care workers but not in non–health-care workers. Conclusions Medical professionals should consider subgroups of the population when establishing various means to deliver information on COVID-19.

We conducted a systematic review and meta-analysis to investigate whether the use of statins could be associated with the risk of all-caused dementia, Alzheimer’s disease (AD), vascular dementia (VaD), and mild cognitive impairment (MCI). Major electronic databases were searched until December 27th, 2017 for studies investigating use of statins and incident cognitive decline in adults. Random-effects meta-analyses calculating relative risks (RRs) were conducted to synthesize effect sizes of individual studies. Twenty-five studies met eligibility criteria. Use of statins was significantly associated with a reduced risk of all-caused dementia (k = 16 studies, adjusted RR (aRR) = 0.849, 95% CI = 0.787–0.916, p = 0.000), AD (k = 14, aRR = 0.719, 95% CI = 0.576–0.899, p = 0.004), and MCI (k = 6, aRR = 0.737, 95% CI = 0.556–0.976, p = 0.033), but no meaningful effects on incident VaD (k = 3, aRR = 1.012, 95% CI = 0.620–1.652, p = 0.961). Subgroup analysis suggested that hydrophilic statins were associated with reduced risk of all-caused dementia (aRR = 0.877; CI = 0.818–0.940; p = 0.000) and possibly lower AD risk (aRR = 0.619; CI = 0.383–1.000; p = 0.050). Lipophilic statins were associated with reduced risk of AD (aRR = 0.639; CI = 0.449–0.908; p = 0.013) but not all-caused dementia (aRR = 0.738; CI = 0.475–1.146; p = 0.176). In conclusion, our meta-analysis suggests that the use of statins may reduce the risk of all-type dementia, AD, and MCI, but not of incident VaD.

COVID-19-related information sources and psychological well-being: An online survey study in Taiwan Dear editors Timely and accurate information is foundational to mitigating and curing the coronavirus disease 2019 (COVID-19) for both the public and the scientific community (Hua and Shaw, 2020). Misinformation on COVID-19, however, has also been proliferating on the Internet, especially on social media (Bastani and Bahrami, 2020). Moreover, repeated media exposure to crisis-related information elevates anxiety and stress responses among people (Garfin et al., 2020). The public may also receive information on COVID-19 from medical staff and laypeople. We were interested in the associations between the COVID-19-related information sources and people's psychological well-being. We were also interested in whether the associations differed between health care workers and the public. The Online Survey Study on COVID-19 in Taiwan recruited participants who were ≥20 years old and lived in Taiwan through a Facebook advertisement on April 10 to April 20, 2020. We also posted the link of the Facebook advertisement to social media groups joined by health care workers. In the online survey, participants were asked whether they received COVID-19-related information frequently from the following sources: the Internet (including blogs, Internet news, and social media, such as Facebook, Line, Twitter, and Plurk), friends, traditional media (including television, newspapers, and radio broadcasting), formal lessons on COVID-19 (whether online or in-person), medical staff in health care settings, coworkers, and family members. We also assessed participants' level of subjective psychological wellbeing on a 5-point Likert scale from 1 (much worse) to 5 (much better) (Ko et al., 2006). In total, the data of 1904 respondents (1282 female and 622 male participants; mean age = 38.0 years and standard deviation [SD] = 10.8 years) were analyzed. The mean score for psychological well-being were 3.3 (SD = 0.9). The major source of information on COVID-19 was the Internet (80.6%), followed by traditional media (53.5%). The associations of each information source with psychological well-being were examined using multiple regression analyses to control for sex, age, education and worry about COVID-19. We found that for non-health-care workers, receiving COVID-19 information from the Internet and from medical staff was negatively and positively related with psychological well-being, respectively; both relationships were significant. For health care workers, receiving COVID-19 information from formal lessons was significantly positively related with psychological well-being. This study found that approximately 80% of participants received COVID-19 information online. The Internet makes information on COVID-19 more accessible, especially for those staying indoors due to the pandemic, with the websites of official public health organizations being the highest-quality source of online information on COVID-19 and how to prevent it (Hernández-García an...

ObjectivesTo compare cognitive effects and acceptability of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in patients with Alzheimer’s disease (AD) or mild cognitive impairment (MCI), and to determine whether cognitive training (CT) during rTMS or tDCS provides additional benefits.MethodsElectronic search of PubMed, Medline, Embase, the Cochrane Library and PsycINFO up to 5 March 2020. We enrolled double-blind, randomised controlled trials (RCTs). The primary outcomes were acceptability and pre–post treatment changes in general cognition measured by Mini-Mental State Examination, and the secondary outcomes were memory function, verbal fluency, working memory and executive function. Durability of cognitive benefits (1, 2 and ≥3 months) after brain stimulation was examined.ResultsWe included 27 RCTs (n=1070), and the treatment components included high-frequency rTMS (HFrTMS) and low-frequency rTMS, anodal tDCS (atDCS) and cathodal tDCS (ctDCS), CT, sham CT and sham brain stimulation. Risk of bias of evidence in each domain was low (range: 0%–11.1%). HFrTMS (1.08, 9, 0.35–1.80) and atDCS (0.56, 0.03–1.09) had short-term positive effects on general cognition. CT might be associated with negative effects on general cognition (−0.79, –2.06 to 0.48) during rTMS or tDCS. At 1-month follow-up, HFrTMS (1.65, 0.77–2.54) and ctDCS (2.57, 0.20–4.95) exhibited larger therapeutic responses. Separate analysis of populations with pure AD and MCI revealed positive effects only in individuals with AD. rTMS and tDCS were well tolerated.ConclusionsHFrTMS is more effective than atDCS for improving global cognition, and patients with AD may have better responses to rTMS and tDCS than MCI.

This meta-analysis provides evidence that breastfeeding (exclusively or including additional supplements) may protect against ASD. Prospective longitudinal research is required to disentangle the complex relationships and to explore potential pathophysiological mechanisms.

This study used data collected from an online survey study on coronavirus disease 2019 (COVID-19) in Taiwan to examine changes in sex life during the pandemic and the factors affecting such changes. In total, 1954 respondents were recruited from a Facebook advertisement. The survey inquired changes in sex life during the pandemic, including satisfaction with the individual’s sex life, frequency of sexual activity, frequency of sex-seeking activity, and frequency of using protection for sex. The associations of change in sex life with risk perception of COVID-19, general anxiety, gender, age, and sexual orientation were also examined. For each aspect of their sex life, 1.4%–13.5% of respondents reported a decrease in frequency or satisfaction, and 1.6%–2.9% reported an increase in frequency or satisfaction. Risk perception of COVID-19 was significantly and negatively associated with frequencies of sexual and sex-seeking activities. Higher general anxiety was significantly and negatively associated with satisfaction of sex life and frequencies of sexual and sex-seeking activities. Sexual minority respondents were more likely to report decreased satisfaction with sex life and frequencies of sexual activity and sex-seeking activities during COVID-19. Health care providers should consider these factors when developing strategies for sexual wellness amid respiratory infection epidemics.

R ecent evidence suggests that psychiatric patients may be at increased risk for cardiovascular events. Large community studies report that people with mental illnesses have a 2-to 5-fold greater risk of coronary heart disease and a 2-to 3-fold greater risk of cardiac mortality than the general population. [1][2][3] This increased risk might be explained by risk factors commonly noted in these patients, including smoking, obesity, and unhealthy lifestyles. 4-6 Clinical Perspective on p 243The association of risk for acute myocardial infarction (AMI) with antipsychotic treatment remains unclear because earlier analyses have methodological issues (eg, residual confounding and limited statistical power and external validity). 3,[7][8][9][10][11] If the link exists, more attention might be paid to monitoring drug safety, especially because of current increased use of antipsychotics and the widening range of disorders for which they are being indicated. 12This study tapped a large nationwide population-based data set to investigate the association between antipsychotic treatment and risk of AMI in patients with mental disorders. A casecrossover design was used to eliminate known or unknown within-subject time-invariant confounders while examining the acute effects of various antipsychotics on subsequent AMI Background-Antipsychotic medications have been increasingly and more widely prescribed despite continued uncertainty about their association with the incidence of acute myocardial infarction (AMI