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目的：人格會影響人們對問題的看法以及問題解決的風格，進而影響他們的求醫行為和結果。本研究的目的是探討慢性疼痛病患雙親依附、人格特質和求醫行為間的關係。方法：共有86 位（82.6% 男性，平均年齡30.02 歲）由慢性疼痛門診，排除有精神診斷的病人完成所有的問卷。問卷包含治療滿意度問卷、雙親教養態度量表 (Parental Bonding Inventory) 及艾氏人格問卷 (Eysenck Personality... more
目的：人格會影響人們對問題的看法以及問題解決的風格，進而影響他們的求醫行為和結果。本研究的目的是探討慢性疼痛病患雙親依附、人格特質和求醫行為間的關係。方法：共有86 位（82.6% 男性，平均年齡30.02 歲）由慢性疼痛門診，排除有精神診斷的病人完成所有的問卷。問卷包含治療滿意度問卷、雙親教養態度量表 (Parental Bonding Inventory) 及艾氏人格問卷 (Eysenck Personality Inventory)。結果：感覺母親顯著的比較關懷的病人比較外向(β = 0.27, p ＜ 0.001)。顯著的比較外向的人比較有可能覺得治療有幫助 (β = 0.33, p ＜ 0.001)，並且對治療感到滿意 (β = 0.36, p ＜ 0.001)，而會顯著的影響他們再次接受治療的意願 (β =0.33, p ＜ 0.001)。覺得治療有幫助是為母親關懷、神經質及願意再接受治療顯著的中介因素 (β= 0.39, p ＜ 0.001)。年紀是重要的影響因素，年紀比較大的人顯著的比較可能覺得治療有幫助(β = 0.26, p ＜ 0.001)，並且顯著的感到滿意 (β = 0.38, p ＜ 0.001)，進而增加他們再次接受治療的意願。性別對求醫行為並沒有顯著的影響。結論：母親依附和人格特質是病人順從性的遠因；病人滿意度或再次願意接受治療的意願是近因。醫師或政策制定者可以使用本研究結果來促進慢性疼痛病患的治療效用及效率。進一步的研究必須瞭解不同族群的順從風格，以建立完整且具理論基礎的治療。
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Objectives: This study was intended to study the predictive factors of adherence to and completion of marital therapy of couples with intimate partner violence. Methods: The participants in this study were 70 couples with... more
Objectives: This study was intended to study the predictive factors of adherence to and completion of marital therapy of couples with intimate partner violence. Methods: The participants in this study were 70 couples with husband-initiated aggression against their wives, and who attended a study evaluating the effectiveness of ordinary psychiatric treatment. We analyzed variables such as social status, clinical factors, intimate partner violence, and marital power, to identify the predictive factors of adherence to marital therapy, and the cause-and-effect relation between those variables. Results: The result of the survival analysis showed that wife with higher income (p ＜ 0.05), later age of onset for intimate partner violence, lower frequency of mild violence, and husband with more affection predicted the adherence of couples to marital therapy (p ＜ 0.001). Structural equation modeling further revealed that a husband with more years of education had direct positive effects on a couple's adherence to marital therapy, husband's age had indirect positive effects, and high frequency of mild violence had direct negative effects on the couples' completing marital therapy. In short, husbands who were younger in age, with frequent mild violence, and with lower academic achievement had difficulty adhering to marital therapy. Conclusion: The results of this study can increase our understanding of intimate partner violence, provide intervention strategies for family domestic violence prevention and augment the quality of services.
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Schizophrenia is a multi-factorial genetic disease, and it is caused by a combination of different gene polymorphisms and not individual ones, however, its pathogenesis is still unclear. The purpose of this study was explored the... more
Schizophrenia is a multi-factorial genetic disease, and it is caused by a combination of different gene polymorphisms and not individual ones, however, its pathogenesis is still unclear. The purpose of this study was explored the association between the -1082G/A, -819T/C, and -592C/A polymorphisms of interleukin-10 (IL-10) in schizophrenia. A total of 659 schizophrenics were recruited from a teaching hospital, whereas 411 healthy non-schizophrenic individuals were recruited from community in the same geographical area. The -1082G/A, -819T/C and -592C/A polymorphisms were genotyped by using PCR-RFLP, direct sequencing and TaqMan(®) SNP assay. Both maximum likelihood method of UNPHASED program and Bayesian method of PHASE software were utilized for haplotypic analysis. An allelic frequency difference was found between the schizophrenics and community controls at -1082G/A polymorphism of IL-10 promoter (χ(2) =4.678, P=0.031). A haplotype of ACA was observed to be associated with schizophrenia after performing UNPHASED, PHASE and multivariate logistic regression analysis (P<0.001; P=0.001). In addition, the persons who carry haplotype ACA of IL-10 promoter SNPs were estimated for 5.789 fold higher risk to develop schizophrenia than controls. We postulated this haplotype association might due to variant-specific effect on IL-10 gene regulation, which leads to imbalance secretion of Th1/Th2 cytokines. Nevertheless, more detailed mechanism needs to be elucidated in further investigations in order to confirm this hypothesis.
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We aimed to determine the association and related factors of the apolipoprotein E (ApoE) genotype and Alzheimer's disease (AD) in Taiwan. We examined ApoE genotypes in 50 Chinese patients with AD and 50 age- and sex-matched controls. The... more
We aimed to determine the association and related factors of the apolipoprotein E (ApoE) genotype and Alzheimer's disease (AD) in Taiwan. We examined ApoE genotypes in 50 Chinese patients with AD and 50 age- and sex-matched controls. The patients met the criteria of probable AD of the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) and AD of the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV). There were 28 females and 22 males in the case and control groups. The mean age of onset of AD was 72. 62 years. The average interval between onset and research was 3.85 years. The frequency of ApoE epsilon 4 in the AD group was significantly higher than that in the controls (0.13 versus 0.02, p < 0.05). The odds ratio for AD in individuals with at least one ApoE epsilon 4 allele was 6.0 (95% CI 1.34 to 55.3, p < 0.001). The linear trend for AD in proportion to alleles of ApoE epsilon 4 was significant (chi 2 = 8.3, p = 0.004). The risk of ApoE epsilon 4 allele for the late-onset AD patients, males, or those who received less education was higher than that for the early-onset AD patients, females, or those who had received more education. The sensitivity of the epsilon 4 allele was 24%, the specificity 96%, the positive predictive value 86%, and the negative predictive value 56%. Our results supported that the ApoE epsilon 4 allele is related to AD in Taiwan. In addition, sex and education may play important roles in the presence of ApoE epsilon 4 allele. The epsilon 4 allele seemed helpful as an adjunct for diagnostic testing of AD.
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The aim of this study was to investigate the impact of autistic children on the mental health of their mothers. Autism is a complicated neuropsychiatric disorder. Evidence shows that mothers with autistic children experience greater... more
The aim of this study was to investigate the impact of autistic children on the mental health of their mothers. Autism is a complicated neuropsychiatric disorder. Evidence shows that mothers with autistic children experience greater stress than those having children with other chronic diseases. In this study we have 1) assessed the mental health of mothers with autistic children; 2) determined their prevalence of minor psychiatric morbidity (MPM); 3) classified their MPM; and 4) determined factors related to their mental health. A case-controlled design was used to compare the mental status among mothers having children with either autistic (n = 30), or Down syndrome (n = 11) and with normal children (n = 56). The mean score of the Chinese Health Questionnaire (CHQ) showed no differences between those mothers of case and control groups. Using a 9-point criterion to screen for MPM in the CHQ, more mothers (37%) in the case group had scores > or = 9 compared with the control group (18%). Mothers of the case group had significantly higher for MPM using logistic regression analysis. The educational level was inversely related to the CHQ scores. Mothers with a CHQ score > or = 9, were later diagnosed with either depression (36%) and anxiety (46%); or anxiety and depression (9%). A primary care model for mothers with autistic children should therefore be developed to prevent them from developing mental disorders.
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Research Interests: Psychology, Personality, Culture, Medicine, Distress, and 15 moreEmotions, Humans, Hallucinations, Female, Male, Middle Aged, Adult, Cross Sectional Studies, Eysenck Personality Questionnaire, Auditory Hallucination, Personality Inventory, Affective symptoms, Psychology and Cognitive Sciences, european psychiatry, and Medical and Health Sciences
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Objective: The aim of this study was to explore the treatment effect of olanzapine on the polymorphisms of monoamine oxidase A (MAOA) in schizophrenia. Method: During a 3-month period, 60 patients with schizophrenia were administered... more
Objective: The aim of this study was to explore the treatment effect of olanzapine on the polymorphisms of monoamine oxidase A (MAOA) in schizophrenia. Method: During a 3-month period, 60 patients with schizophrenia were administered olanzapine. Treatment response was assessed by checking for improvement in symptoms as measured on the Positive and Negative Syndrome Scale (PANSS). Results: The short form of MAOA demonstrated a better drug response in the dimension of aggression. Female patients had a better response to olanzapine. Patients who did not smoke had a better response to olanzapine in the dimension of aggression. Conclusion: The results of this study suggest that polymorphisms of MAOA, gender, and cigarette smoking may be three useful response predictors in schizophrenic patients who were treated with olanzapine.
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Research Interests: Endocrinology, Military Medicine, Adolescent, Medicine, Lipids, and 14 moreHumans, Internal Medicine, Smoking, Cholesterol, Taiwan, Alcohol Drinking, Male, Questionnaires, Adult, Public health systems and services research, High Density Lipoprotein, Military Personnel, Physical Education and training, and physical exertion
Suicide is one of the serious public health problems worldwide. Moreover, suicidal ideation seems as a risk factor for attempted and completed suicidal behaviors. It seems that number of different proximal precipitating and distal... more
Suicide is one of the serious public health problems worldwide. Moreover, suicidal ideation seems as a risk factor for attempted and completed suicidal behaviors. It seems that number of different proximal precipitating and distal predisposing risk factors, which include genetic backgrounds, personal characteristics, parental attachment and mental health problems, are associated with increased rates of suicide. The pathway from genes to mental health problems and suicidal behavior are complex and probabilistic. The aim of this overview is to provide a clear protocol for genetics, diathesis, psychopathology, and resilience in suicidal behavior. In this review article, I will assess relevant research articles dealing with direct and deterministic ways from genetic backgrounds, personal characteristics, mental health to suicidality (ideation, plans, attempts and completions) in structural equation modeling. Combining with my own data, I also explored the natural course of the path effect, current effect, and the regression in each contributing factor, using structural equation modeling. I first introduce the concept of stress-diathesis of suicide; then, discuss the relationship between genetics, gene-environment interactions, parental bonding, personality characteristics, and resilience in suicidality. Issues associated with the relationship between genetic backgrounds, parental bonding, personality characteristics and resilience, and its interaction between nature and nurture in suicidality, have not yet settled. But these research findings should improve understanding of the critical ingredients and their differential impact on various at-risk subgroups, and help with effective prevention and intervention in the future.
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ABSTRACT Zolpidem, a non-benzodiazepine hypnotic drug, shows a high affinity for the BZ1 (ω1) subtypes of the modulatory sites within the GABAA receptor complex, but classical benzodiazepines (diazepam, lorazepam) have a non-specific... more
ABSTRACT Zolpidem, a non-benzodiazepine hypnotic drug, shows a high affinity for the BZ1 (ω1) subtypes of the modulatory sites within the GABAA receptor complex, but classical benzodiazepines (diazepam, lorazepam) have a non-specific affinity profile at ω1 and ω2 subtypes of the GABAA receptor. Therefore, zolpidem is thought to be safer than benzodiazepines. We present five cases with withdrawal delirium, seizure, acute psychosis and orofacial dyskinesia that developed following cessation of zolpidem. Adverse effects such as withdrawal seizure and withdrawal delirium have been rarely reported in relation to zolpidem. Chemically unrelated to benzodiazepines, zolpidem is thought to have fewer adverse effects, but shares a pharmacokinetic profile with the benzodiazepines. It is advised that the normal criteria for the prescription of benzodiazepines also be used when prescribing non-benzodiazepine sedatives and hypnotics, as they act upon the same receptor, namely, the benzodiazepine-GABA-chloride complex. However, at higher than recommended doses for extended periods of time, the addictive potential of zolpidem may be similar to that of the benzodiazepines. It is possible that zolpidem abandons its selectivity for the BZ1 receptors and demonstrates all the actions of classic benzodiazepines.
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Background The purpose of this study was to explore the effect of support groups on the mental health and quality of life for mothers with autistic children.Method A quasi‐experimental pre‐post control group design was used in this... more
Background The purpose of this study was to explore the effect of support groups on the mental health and quality of life for mothers with autistic children.Method A quasi‐experimental pre‐post control group design was used in this study. The mothers had children without chronic diseases diagnosed as autistic based on Diagnostic and Statistical Manual of Mental Disorder‐Fourth Edition (DSM‐IV) and were their primary caregivers. The mothers were assigned to control or intervention groups based on their willingness. The 10 weeks of the support group programme served as an intervention. There were three waves of data collection: pre‐test, post‐test, and after 1 month follow‐up. A total of 27 mothers with autistic children were assigned into experimental and control groups. In total, there were eight mothers in the experimental group and 19 mothers served as the control group.Results The results of this study showed that mental health had not significantly improved in the intervention group compared to those in the control group at the end of the first month during follow‐up. However, the subjective well‐being and employment status had an effect on their mental health. Only the subjective well‐being had an effect on their quality of life.Conclusion According to the results of this study, recommendations included (1) regularly promulgating a caregiver support group, (2) the advancement of training skills within the group, and (3) upgrading and promoting nurses’ ability to lead support groups in the future.
Research Interests: Psychology, Education, Mental Health, Quality of life, Social Support, and 15 moreIntellectual Disability, Group Psychotherapy, Medicine, Humans, Child, Female, Mothers, Mental Disorders, Middle Aged, Questionnaires, Adult, Guidance and Counseling Intervention Programs, Autistic disorder, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Psychology, Cognitive Science, Geriatrics, Gerontology, Cognition, and 15 moreCommunity, Medicine, Humans, Female, Male, Clinical Sciences, Geriatric Psychiatry, Geriatric, Aged, Prevalence, Cognitive impairment, Cross Sectional Studies, Logistic Models, Cognition disorders, and Neuropsychological Tests
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ETHNOPHARMACOLOGICAL RELEVANCE Obesity in patients with schizophrenia is related to antipsychotic drug use, hypertension, diabetes, and dyslipidemia, which are critical risk factors for cardiovascular disease. Cassia seed is a traditional... more
ETHNOPHARMACOLOGICAL RELEVANCE Obesity in patients with schizophrenia is related to antipsychotic drug use, hypertension, diabetes, and dyslipidemia, which are critical risk factors for cardiovascular disease. Cassia seed is a traditional Chinese medicine that can be used to treat various eye disorders. Anthraquinone-containing Cassia seed were used to lower serum levels of fat and cholesterol. AIM OF STUDY The effects of Cassia seed powder on body weight and lipids were investigated in overweight or obese patients with schizophrenia. METHODS The present study was designed as a double-blind, randomized, controlled trial. Ninety-four patients with schizophrenia who were overweight or obese were assigned to a control group (CG, 47 patients) and treatment group (TG, 47 patients) that received low dose Cassia seed power (0.3 g once daily) and Cassia seed powder (3.0 g once daily), respectively, for 36 weeks. The main outcome was the change in body mass index and waist circumference (WC). The secondary outcome was the change in serum lipids, C-reactive protein, interleukin-6, and glycated hemoglobin. RESULTS Seventy-four patients completed the study (n = 36, CG; n = 38, TG). WC was significantly lower at the second (24 weeks, 98.63 ± 9.44 vs 95.80 ± 10.26 cm, p = 0.023), third (36 weeks, 98.35 ± 9.46 vs 95.05 ± 10.07 cm, p = 0.002), and fourth (48 weeks, 98.78 ± 9.48 vs 93.73 ± 10.28 cm, p < 0.001) follow-ups than at baseline in the TG, but only significantly lower than baseline at the fourth follow-up (100.78 ± 13.98 vs 94.03 ± 9.74 cm, p = 0.006); no significant difference in CG was observed at both the second (101.03 ± 13.62 vs 97.35 ± 8,29 cm, p = 0.08) and third (100.55 ± 13.69 vs 96.55 ± 8.29 cm, p = 0.066) follow-up. The difference in serum total cholesterol and low-density lipoprotein levels between the baseline and the third follow-up was greater in the TG than in the CG (149.68 ± 34.85 vs 179.08 ± 75.87 mg/dL, p = 0.033; 84.40 ± 28.06 vs102.08 ± 34.12 mg/dL, p = 0.015, respectively). CONCLUSION In patients with schizophrenia who were overweight or obese, oral administration of Cassia seed powder (3.0 g) for 24 weeks and 36 weeks reduced WC, and oral administration of Cassia seed powder for 36 weeks reduced total cholesterol and low-density lipoprotein levels, suggesting that Cassia seed powder aids the management of patients with schizophrenia who are overweight or obese. However, these results are preliminary, and future studies should use larger sample sizes, multiple testing centers, and multiple dosing.
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Research Interests: Education, Mental Health, Cerebral Palsy, Intellectual Disability, Medicine, and 15 moreHome Care, Down Syndrome, Humans, Child, Female, Male, Caregivers, Middle Aged, Adult, Family caregivers, Cost of Illness, Home Care Services, Cohort Studies, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests: Psychology, Gerontology, Aging, Medicine, Linear models, and 15 moreMultivariate Analysis, Humans, Female, Disease, Male, Polymerase Chain Reaction, Income, Clinical Sciences, Aged, Questionnaires, Public health systems and services research, Age Factors, Cross Sectional Studies, Leukocytes, and Marital Status
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Background: The consequence of quarantine might have increased the emotional distress during the period of COVID-19 pandemic. Parental bonding plays an important role in the developing of emotional problems. Hence, this study tried to... more
Background: The consequence of quarantine might have increased the emotional distress during the period of COVID-19 pandemic. Parental bonding plays an important role in the developing of emotional problems. Hence, this study tried to compare the difference of parental bonding in the developing of mental distress during the COVID-19 pandemic in Changchun of China and Taiwan.Methods: Total of 191 healthcare workers in Changchun area of China, and 458 healthcare workers in Taiwan, including 374 healthcare workers in two general hospitals and 84 in psychiatric center were recruited in this study.Findings: The findings showed that the healthcare workers tend to have more maternal affectionate constraint features in Changchun, compared to those with more maternal affectionless control features in Taiwan. Linear regression analysis showed the maternal affectionate constraint have contributed to the developing of mental health problems, and maternal affectionate constraint and maternal optimal bonding to developing of happiness in Changchun;comparing gender, hospital type and maternal optimal bonding have impact to the developing of mental health problems, and age, gender, hospital type, paternal optimal bonding and maternal affectionless control to the developing of happiness in Taiwan. SEM model also verified better mental health and maternal affectionate constraint have mainly contributed to the developing of happiness in Changchun.Interpretation: In conclusion, Changchun and Taiwan presented different kinds of parental bonding. Even in different culture vicissitudes, the maternal caring seems to be the unique contributing factor in developing of mental health problem and happiness, whether in Changchun or Taiwan, and, whether in 2003 SARS or 2020 COVID-19 pandemic. The results of the study may provide the references to policy-maker and prevention programs in the community. Further larger sample size with follow-up studies have to be considered to verify the role of parental bonding in the developing of resilience, emotional distress and suicidal ideation.Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: The Institutional Review Board of the Kaohsiung Armed Forces General Hospital in Taiwan approved the study (KAFGHIRB 108-037).
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The two-point lod score linkage analysis of familial Alzheimer&#39;s disease is sensitive to the parameters of age-dependent penetrance rate, phenocopy rate, heterogeneity, and marker gene frequency. If unsuitable parameters are used,... more
The two-point lod score linkage analysis of familial Alzheimer&#39;s disease is sensitive to the parameters of age-dependent penetrance rate, phenocopy rate, heterogeneity, and marker gene frequency. If unsuitable parameters are used, it may lead to false negative evidence against linkage. However, it is clear that, in some cases, it may lead to false positive evidence of linkage.
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AimTo evaluate the association between ambient particulate matter no larger than 2.5 μm in diameter (PM2.5) during the prenatal and postnatal periods and infant neurodevelopmental parameters.MethodWe conducted a population‐based birth... more
AimTo evaluate the association between ambient particulate matter no larger than 2.5 μm in diameter (PM2.5) during the prenatal and postnatal periods and infant neurodevelopmental parameters.MethodWe conducted a population‐based birth cohort study using the Taiwan Birth Cohort Study. Participants were assessed for developmental conditions through home interviews at 6 months and 18 months of age. Exposure to PM2.5 of mothers and infants during perinatal periods was estimated using hybrid kriging/land‐use regression. The exposure was linked to each participant by home address. Logistic regression was then conducted to determine the risk of neurodevelopmental delay in relation to PM2.5.ResultsA total of 17 683 term singletons without congenital malformations were included in the final analysis. PM2.5 during the second trimester was associated with increased risks of delays in gross motor neurodevelopmental milestones (adjusted odds ratio [aOR] 1.09 per 10 μg/m3 increase in exposure to ...
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Objective: Health-related quality of life (HRQoL) has become one of the most valuable indicators of treatment in patients with schizophrenia. The purpose of this study was to establish the construct validity of eight domains in a HRQoL... more
Objective: Health-related quality of life (HRQoL) has become one of the most valuable indicators of treatment in patients with schizophrenia. The purpose of this study was to establish the construct validity of eight domains in a HRQoL scale. Methods: From four psychiatric rehabilitation centers, 237 patients were chosen for participation in the study. Inclusion criteria were a DSM-IV-R diagnosis of schizophrenia. Quality of life was measured using the Quality of Life for Mental Disorders (QoLMD) scale. Structural equation modeling (SEM) was chosen to investigate the construct of the QoLMD. Results: This model of HRQoL for patients with schizophrenia was acceptable (Chi-square=1004.484 (df=789), p=0.192, GFI=0.852, RMSEA=0.034, TLI=0.940). The relationship between eight domains of the QoLMD can be interpretive into three parts: (A) under family support, patients with schizophrenia had significantly directly related to mental and physical health (β=0.849 and 0.738) and significantly indirectly related to HRQoL (i.e., life satisfaction, autonomy, health maintenance); (B) under physical health, schizophrenia patients had significantly directly related to HRQoL (β=0.745-0.921) (p＜0.001); and (C) under mental health had significantly directly related to physical health (β=0.217) (p＜0.05). Conclusion: The SEM revealed that HRQoL was interpreted by the pathways between eight domains of QoLMD, and therefore it made clinical therapists understood clearly about the correlation and mutual-influential pathway between HRQoL and QoLMD.
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Background: Early parent-child attachment has been thought to influence the diverse functional development of the individual in later life. The research results of the influence of parental attachment on individuals show only the... more
Background: Early parent-child attachment has been thought to influence the diverse functional development of the individual in later life. The research results of the influence of parental attachment on individuals show only the precipitating and perpetuating factors. But the predisposing and possibly mediating latent covariates, or several confounding variables, can be neglected, and pseudo-associations can be identified. The aim of this overview was to provide a clear protocol for the investigation of the influence of parent-child attachment on the personality, mental health, experience of chronic pain, sexual orientation, and criminal behavior of an individual. Methods: In this review article, I assessed relevant research articles dealing with developmental aspects of parental attachment and mental health in structural equation modeling. Combining with my own data, I also explored the natural course of the path effect, current effect, and the regression and concurrent validity i...
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Objective: Priapism is a persistent, painful erection that occurs without sexual stimulation. It has been associated with the use of many antipsychotic agents, including clozapine, olanzapine and risperidone but has not been reported as a... more
Objective: Priapism is a persistent, painful erection that occurs without sexual stimulation. It has been associated with the use of many antipsychotic agents, including clozapine, olanzapine and risperidone but has not been reported as a side effect of long-acting risperidone injection. Here we report a case of this adverse event in a patient treated with long-acting risperidone. Case report: A 27-yearold man with a 10-year history of paranoid-type schizophrenia developed priapism two weeks after a long-acting risperidone injection. After treatment, he denied any erectile abnormalities and had had no subsequent episodes of priapism during 6 months of follow up. Conclusion: Priapism rarely results from treatment with antipsychotic agents. Clinicians, however, must be aware of the possibility of this complication when prescribing these drugs.
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Background: Healthcare workers in the front line of diagnosis, treatment, and care of patients with coronavirus disease 2019 (COVID-19) are at great risk of both infection and developing mental health symptoms. This study aimed to... more
Background: Healthcare workers in the front line of diagnosis, treatment, and care of patients with coronavirus disease 2019 (COVID-19) are at great risk of both infection and developing mental health symptoms. This study aimed to investigate the following: (1) whether healthcare workers in general hospitals experience higher mental distress than those in psychiatric hospitals; (2) the role played by religion and alexithymic trait in influencing the mental health condition and perceived level of happiness of healthcare workers amidst the stress of the COVID-19 pandemic; and (3) factors that influence the resilience of healthcare workers at 6 weeks' follow-up.Methods: Four-hundred and fifty-eight healthcare workers were recruited from general and psychiatric hospitals, and 419 were followed-up after 6 weeks. All participants filled out the 20-item Toronto Alexithymia Scale, five-item Brief-Symptom Rating Scale, and the Chinese Oxford Happiness Questionnaire.Results: Under the str...