• Title/Summary/Keyword: 기분장애

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Premenstrual Dysphoric Disorder : A Clinical Review (월경전 불쾌기분 장애에 대한 임상적 고찰)

  • Hwang, Gul
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.14-21
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    • 2007
  • Premenstural dysphoric disorder(PMDD) imposing 4-5% of women is possibly caused by an enhanced responsiveness to the changes of sex steroid hormones and the decrease of serotonin, melatonin and GABA. The common clinical features between PMDD and depression, seasonal affective disorder, panic disorder and anorexia nervosa suggest a relatedness between PMDD and each of them. The diagnostic criteria of DSM-IV-Tr for PMDD requires psychological symptoms, that commonly include irritability, anger, depression, mood swing, affect lability, tension, anxiety, fatigue and food craving. As of today, the best pharmacological treatment for PMDD is the selective serotonin reuptake inhibiter, and leuprolide, danazol, estradiol, spironolactone and bromocriptine are possible alternatives. Nonpharmacological treatments for patients with mild to moderate symptom severity are diet, exercise, light therapy, psychotherapy and keeping a diary.

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Pharmacotherapy for Obesity in Mood Disorders (기분장애 환자의 비만에 대한 약물치료)

  • Sohn, Inki;Lee, Kyu-Hang
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.63-70
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    • 2014
  • The prevalence of obesity and overweight is increasing in mood disorder, and it is connected to an increased cardiovascular mortality. Because of them, treatment for obesity may be an essential part of mood disorder treatment. Similar to the general population, non-pharmacological treatment such as correction of life habits should be considered first of all. If this approaches are fail, pharmacological treatment for obesity would be required as next step. Any drug for obesity is not approved officially in mood disorder. So approved drugs in general population, and drugs supported by several studies are prescribed in clinical settings. Several treatment guidelines for mood disorder and studies support that orlistat, metformin, topiramate and bupropion is effective and safe.

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The Relationship between Symptomatology and Temperament in Patients with Premenstrual Dysphoric Disorder (월경전 불쾌기분장애 환자에서 증상과 기질과의 관련성)

  • Kim, Sung-Eun;Lee, Jung-Hyun;Kim, Deok-Man;Park, Jin-Kyun;Ki, Seon-Wan;Kim, Ji-Woong
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.39-46
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    • 2006
  • Objectives: The study was intended to explore the relationships between temperament and premenstrual dysphoric disorder, to understand symptomatology of premenstrual dysphoric disorder and associated personality trait and to suggest therapeutic availability. Method : Twenty eight women, diagnosed as premenstrual dysphoric disorder by DSM-IV, were asked to complete the Korean version of Tridimensional Personality Questionnaire, and Shortened Premenstrual Assessment Form. The correlations between the severity of premenstrual symptoms and the scores of Tridimensional Personality Questionnaire were calculated. Results : The severity of symptoms of premenstrual dysphoric disorder was best explained by the harm-avoidance factor of the four dimensions of temperament. Conclusion : The symptoms of premenstrual dysphoric disorder are well explained by the harmavoidance factor and the reward-dependence factor of four dimensions of the temperament.

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Serotonin(2A) Receptor Gene Promoter Polymorphism in Mood Disorder and Mood-Related Disorders (기분장애 및 기분관련장애에서 세로토닌 수용체 유전자 프로모터 다형성)

  • Chee, Ik-Seung
    • Korean Journal of Biological Psychiatry
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    • v.9 no.1
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    • pp.3-7
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    • 2002
  • Genes involved in the serotonin system are good candidates for the pathogenesis of mood disorder and mood-related disorders, such as eating disorder, obsessive-compulsive disorder, alcoholism, and suicide. Serotonin type 2A(5-HT2A) receptor gene promoter polymorphism(-1438A/G) has been reported. In this article, authors reviewed the literatures regarding association studies between -1438A/G and mood disorder and mood-related disorders. There are controversial results with limited data to date. Further researches on the -1438A/G in psychiatric disorders are required.

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Symptoms, Mood and Sleep Disturbance in Hemodialysis (혈액투석환자의 증상경험, 기분장애 및 수면장애)

  • Choi, Eun-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.13 no.2
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    • pp.105-113
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    • 2010
  • Purpose: The purpose of this study was to examine symptoms, mood and sleep disturbance in patients with hemodialysis. Method: A sample of 96 hemodialysis patients participated. Data were collected using symptom scale of hemodialysis patients, profile of mood state and the sleep scale. Statistical analytic methods included t-tes, ANOVA and Pearson correlation analyses. Results: Patients with spouse/partners experienced significantly less symptoms than those with no spouse (F=6.29, p=.003). Mood disturbance was not significantly correlated with age; but older patients experienced higher sleep disturbance (F=4.88, p=.010). Symptoms, mood and sleep disturbance are significantly related with each other. Conclusion: It is important to assess symptoms, mood and sleep disturbance in older hemodialysis patients with no spouse. It is needed to repeat extensive study and comparative study with other population in order to define clearly.

A Clinical Trial of Light Therapy on Patients with Premenstrual Dysphoric Disorder (월경전 불쾌기분장애 환자의 광치료 임상 시도)

  • Joe, Sook-Haeng;Kim, Jin-Se;Kim, Seung-Hyun;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.6 no.1
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    • pp.46-51
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    • 1999
  • Objectives: Patients with premenstrual dysphoric disorder(or PMDD) have impairments of the social, occupational or academic function due to psychological or somatic symptoms, which have the characteristic pattern of symptom exacerbation in the week before menses begin and remission shortly after the onset of menses. In the chronobiological view, many researchers have assumed that the etiology of PMDD is the advanced circadian rhythm. It has been suggested that light has a therapeutic effect on PMDD, because evening light results in phase delay of circadian rhythm through the biochemical changes including melatonin. Methods: The authors investigated the therapeutic effect of light therapy on four patients with prospectively diagnosed PMDD by DSM-IV criteria using clinical psychiatric interview, Premenstrual Assessment Form(PAF) and Daily Rating Form(or DRF). In the evening(6:30pm-8:00pm), the 2,500 lux light administered for seven consecutive days during the symptomatic late luteal phase of menstrual cycle. Beck Depression Inventory(or BDI), Hamilton Rating Scale for Depression(or HAM-D), Spielberg State Anxiety Inventory(or SA), and DRF were evaluated before and after seven days of light therapy. Results: Premenstrual symptoms of PMDD could be effectively treated with the evening bright light therapy, especially in PMDD patients with atypical symptoms. In addition, the light therapy seemed to more effective on the psychologic symptoms than the somatic symptoms of PMDD. There was no significant side-effect of light therapy, except the transient and mild eye-strain in one case. Conclusions: In spite of the results of limited data from our clinical trial, the authors suggest that the potential use of light therapy as an alternative to the pharmacological management of patients with PMDD.

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The Application of Multi-State Model to the Bipolar Disorder Study (양극성 장애 환자의 기분 전환 현상 연구를 위한 다단계 모형의 적용)

  • Kim, Yang-Jin;Kang, Si-Hyun;Kim, Chang-Yoon
    • The Korean Journal of Applied Statistics
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    • v.20 no.3
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    • pp.449-458
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    • 2007
  • Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in person's mood, energy, and ability to function. Compared with manic episode, the depression episode causes more serious results such as restless, loss of interest or pleasure, or thoughts of death or suicide and the cure rate of depression episode is lower than that of manic episode. Furthermore, a long term use of antidepressants in bipolar patients may result in manic episode. Our interest is to investigate the effect of antidepressant on switch of moods of bipolar patients and to estimate the transition probabilities of switch between moods, depression and (hypo) manic. In this study, three approaches are applied in terms of multi state model. Parametric model is applied using left censoring data and nonparametric model is implemented under illness-death model with counting process. In order to estimate the effect of covariates, a multiplicative model is used. These all methods have similar results.

Attentional Dysfunction in Major Psychiatric Disorders (주요 정신장애에서의 주의력 장애)

  • Ha, Kyoo-Seob
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.155-169
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    • 1998
  • Attentional dysfunction is considered as one of the core deficits in schizophrenic process. The findings, pathophysiological mechanisms, and their clinical implications of clinical and experimental neurocognitive tests for the attentional impairment in schizophrenics are reviewed. The influences of psychopathology, antipsychotic treatment, and chronic institutionalization are also included in the review. In contrast, there are only a few evidences that attentional dysfunction would be a core deficit of depressive, manic, and anxiety disorders. Some recent findings of attentional impairment in these disorders are reviewed.

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Diurnal Variation and Sleep Pattern in Depressive Patients (우울증 환자의 주간기분변동과 수면 양상)

  • Park, Young-Min;Kim, Leen;Suh, Kwang-Yoon;Joe, Sook-Haeng;Kang, Seung-Gul;Yoon, Ho-Kyung
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.30-36
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    • 2001
  • Object: Diurnal variation is included in the diagnostic criteria of the major depressive disorder, melancholic specifier. But there has been controversy over whether diurnal variation is an unique depressive symptoms or a symptom related to a change of sleep patterns, or that of another mechanism, when the previous studies are reviewed. We investigated the existence of diurnal variation according to the subtype of depression and whether diurnal variation is charateristic of melancholic depression or not. We also compared sleep variables according to the existence of diurnal variation. Method: We examined diurnal variation, sleep patterns, severity of depression using the Visual Analogue Mood Scale, Pittsburgh Sleep Quality Index, and Hamilton Depression Rating Scale. Patients recorded their mood state on the Visual Analogue Mood Scale twice a day, morning and evening, for diurnal variation. We divided depressive patients into two groups,-diurnal variation group and nondiurnal variation group,-and compared the mood and sleep variables using SPSS. Results: The frequency of diurnal variation is not significantly different among the subtypes of depression. Significant differences between the diurnal variation group and the nondiurnal variation group existed in middle insomnia and sleep time (p<0.05). In melancholic type, al significant difference between the diurnal variation group and the nondiurnal variation group was noticed in PSQI total, sleep latency, sleep disturbances, daytime dysfunction as well as middle insomnia and sleep time (p<0.05). Conclusions: Diurnal variation existed in other types of depression as well as melancholic type. The results showed that diurnal variation was not a specific symptom of melancholic type, and existence of diurnal variation might be related to sleep patterns.

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Sleep Paralysis in Schizophrenia and Mood Disorder (정신분열병과 기분장애에서의 수면마비)

  • Park, Jae-Hong;Yang, Chang-Kook
    • Sleep Medicine and Psychophysiology
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    • v.9 no.2
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    • pp.115-121
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    • 2002
  • Objectives: Although sleep paralysis (SP) has been known as one of the symptoms of narcolepsy, recently it has become recognized as occurring frequently in the general population. However, the prevalence of SP and its associated factors in patients with major psychiatric disorders remain unknown. This study investigated the prevalence of SP and a variety of associated experiences in those patients. Methods: The subjects were 160 psychiatric patients and 143 age- and sex-matched controls. The Korean version SP questionnaire as well as the Sleep-Wake Schedule, Epworth Sleepiness Scale and Insomnia Severity Index were administered to all the subjects. The patients were referred from Dong-A University Hospital and consisted of 74 diagnosed as schizophrenia (47.7%), 26 as bipolar disorder (16.8%) and 55 as major depression (35.5%). Results: Nearly 42% of the patient group and 39% of the control group had experienced at least one episode of SP in their lifetime, with no significant difference between the groups. However, the patient group had experienced SP more frequently than the control group. Among all subjects, no gender difference in SP incidence was found. The peak age of onset was in the range of 16-25 years for both groups. Over eight tenths of both groups reported hallucinations and over seven tenths of both groups experienced fear accompanying SP. Conclusion: This study shows that there is no difference in the lifetime prevalence of SP between psychiatric patients and the general population, whereas frequency of SP experience is higher in psychiatric patients. Terrifying hallucinations and fearful feelings frequently accompany SP in both groups.

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