• Title/Summary/Keyword: 우울반응

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Cognitive Impairment in the Patients with Mildly Active Systemic Lupus Erythematosus (경증 전신성 홍반성 루프스 환자의 인지기능장애)

  • Kim, Jin-Hee;Lee, Chul;Lee, Chang-Uk;Paik, In-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.89-96
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    • 1997
  • This study was designed to determine whether cognitive impairment was evident in patients with SLE. Also, it aimed to examine the association of cognitive impairment with other clinical variables. The subjects consisted of 20 patients with mildly active SLE and 20 healthy controls. Methods : A total of 20 SLE patients and 20 normal controls completed a computerized neuropsychological test battery using Vienna Test System. These included Cognitrone test, Continuous attention test, Corsi block tapping test, Standard progressive matrices. Also, neuro-behavioral cognitive status examination was done. The symptom severity of depression was measured with Beck Depression Inventory, Hamilton Depression Rating Scale, and current medications were documented. Disease activity was rated using the SLE diasease activity index (SLEDAI). Results : SLE patients had poorer performance than normal controls on the tests of Cognitrone, attention, nonverbal IQ and memory, independent of age, education, disease activity, steroid use and depression status. Conclusion : Cognitive dysfunction was not uncommon in ambulatory SLE patients as measured by standardized neuropsychological tests. It seemed to occur independently of various clinical variables. These findings would suggest that cognitive dysfunction in SLE may be explained by reflecting subclinical central nervous system(CNS) involvement, rather than coexisting psychological distress due to chronic illness or side effect of medication.

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A CLINICAL STUDY ON CHILD SEXUAL ABUSE (소아 성학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Kwack, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.184-193
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    • 1994
  • This study was purposed to find out clinical characteristic of intra and extrafamilial sexual abuse, nature of offenders, difference of symptoms describe that sexually abused children and adolescents were experienced. Subjects were 10 sexually abused children and adolescents who visited Seoul National Mental Hospital, from Jan. 1992 to Dec. 1993. In intrafamilial sexual abuse, they had more chronic course than extrafamilial abuse and had more family psychopathology. In symptomatology, The preschool children mainly presented to somatic symptoms and anxiety, and The school children prominently exhibited depressive reaction and withdrawal. Most common reaction of parents was anger and guilt. They were treated with crisis intervention, play therapy, and hospitalization, if needed. The maintenance of treatment was difficult due to parent's avoidance and repression.

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The Effects of Academic Stress on Depression in Adolescents : The Moderating Role of Response Styles (청소년의 학업 스트레스가 우울증상에 미치는 영향과 반응양식의 조절효과)

  • Kim, Bit Na;Park, Ju Hee
    • Korean Journal of Child Studies
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    • v.34 no.3
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    • pp.113-128
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    • 2013
  • This study examined the effects of academic stress and response styles on depression in adolescents, focusing on the moderating role of responses styles. The subjects of this study comprised 419 high school students (185 boys and 234 girls) in two high schools. In order to measure the level of depression, the CES-D Scale (Radloff, 1977) was used. Academic stress and response styles were assessed by the Academic Stress Scale for adolescents (Lee & Kim, 2000) and the Response Styles Questionnaire (Kim, 1991) respectively. The data were analyzed by means of descriptive statistics, t-test, and multiple regressions. The results indicated that for both boys and girls, the levels of academic stress and rumination response style increased the level of depression, whereas the distraction response style decreased the level of depression. Second, both the rumination and distraction styles for girls moderated the effect of academic stress on their depression. On the contrary, there was no moderating effect of the response styles for boys.

Differences of Illness Behavior in Depressive Patients According to the Presence of Somatization (우울증 환자에서 신체화 증상에 따른 질병행동의 차이)

  • Yoon, Chang-Young;Jang, Se-Heon;Jae, Young-Myo;Lee, Dae-Su;Choi, Jin-Hyuk
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.2
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    • pp.68-74
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    • 2009
  • Objectives : Illness behavior is defined as the persistence of an adaptive/maladaptive mode of perceiving, evaluating and responding to health status and symptoms according to the status. In a cognitive aspect, somatizing symptoms are regarded as being originated from distortions, including magnification and/or amplification, of perceiving, evaluating and responding to symptoms such as bodily sensations. That is somatization may be explained by maladaptive illness behavior. In this study, we tried to investigate differences of illness behavior in depressive patient according to the presence of somatization. Methods : We divided 45 patients who were diagnosed as depression with ICD-10 diagnostic criteria into two groups(somatizing and non-somatizing group) according to the somatization subscale of Korean Depression Scale and compared two groups in the differences of illness behavior using the Illness Behavior Questionnaire. Results : Somatizing group showed significantly higher scores than non-somatizing group on the disease affirmation subscale($6.79{\pm}2.08$ vs. 4.76, p=0.003) and the denial subscale($3.25{\pm}1.22$ vs. $2.10{\pm}1.41$, p=0.006). There were no significant differences between two groups on the general hypochondriasis subscale and the affective unstability subscale. In a logistic regression analysis, somatizing group also showed higher odds ratio (OR) scores on the disease affirmation subscale(OR=1.418, p=0.089) and the denial subscale(OR=1.880, p=0.083). Conclusion : The disease affirmation and denial may be a discriminative mechanism of somatization in depressive patients. These subscales of Illness Behavior Questionnare could be useful markers, and psychiatric illnesses with somatizing and depressive symptoms may be differentially diagnosed and be predicted through these subscales.

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The Physics of Toegye's Sensational Experience and Mental Response: The Study on the 4th Song of (퇴계선생의 감각경험과 심적반응의 의학생리학: <도산십이곡>중 제4곡을 중심으로)

  • kim, mung hee
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.3
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    • pp.283-290
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    • 2022
  • Sijo therapy is to overcome depression and establish the authenticity of existence. This study aims to investigate whether the image of Toegye's Sijo fuses the medical and scientific sensory experience with mental reaction. Toegye's Sijo is operated by the principle of activating vitality. The teacher's sijo is to help the principle of creating the authenticity of existence to overcome depression through the sensory experience and mental response of the human body and to change the life of existence now - here. Therefore, this study aims to prove the healing power of the fourth song of Toegye's Sijo . In the future, it is meaningful that the study of Sijo therapy on sensory experience and mental response is provided as a data for the development of programs to help medical student understanding.

Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation for Treatment of Depression and Latest Trends in TMS Techniques (반복 경두개자기자극술의 우울증 치료효과 및 최신동향에 대한 고찰)

  • Kim, Shin Tae;Kim, Hae Won;Kim, Se Joo;Kang, Jee In
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.95-109
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    • 2017
  • Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique which can change cortical excitability in targeted area by producing magnetic field pulses with an electromagnetic coil. rTMS treatment has been used to treat various neuropsychiatric disorders including depression. In this review, we evaluate the literature on rTMS for depression by assessing its efficacy on different subtypes of depression and different technical parameters. In particular, we focus on the results of randomized clinical trials and meta-analyses for depression after the US Food and Drug Administration approval in 2008, which acknowledged its efficacy and acceptability. We also review the new forms of rTMS therapy including deep TMS, theta-burst stimulation, and magnetic seizure therapy (MST) that have been under recent investigation. High frequency rTMS over left dorsolateral prefrontal cortex (DLPFC), low frequency rTMS over right DLPFC, or bilateral rTMS is shown to be effective and acceptable in treatment for patients with non-psychotic, unipolar depression either as monotherapy or adjuvant. Deep TMS, theta-burst stimulation and MST are promising new TMS techniques which warrant further research.

Treatment Strategies for Psychotic Depression (정신병적 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.234-243
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    • 2006
  • Objectives : Several factors, such as biological markers, clinical correlates, and course of the depressive disorders with psychotic symptoms differ from those without psychotic symptoms. Therefore, specification of a treatment algorithm for depressive disorder with psychotic symptoms is legitimated. This article provides a systematic review of somatic treatments for depressive disorder with psychotic symptoms. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, first, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders with psychotic symptoms(until July 2006). Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Treatment options, such as a combination of an antidepressant and an antipsychotic versus an antidepressant or an antipsychotic alone are summarized. In addition, issues regarding the electroconvulsive therapy( ECT), combination therapy, and maintenance treatment are discussed. Conclusion : In former times, the combination of an antidepressant and an antipsychotic or ECT were recommended as the first line treatment for depressive disorder with psychotic symptoms. Recently, however, there was a suggestion that there was no conclusive evidence that the combination of an antidepressant and an antipsychotic drug is more effective than an antidepressant alone. More evidence regarding the pharmacological treatment for depressive disorder with psychotic symptoms is needed.

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Quantitative Electroencephalogram Markers for Predicting Cerebral Amyloid Pathology in Non-Demented Older Individuals With Depression: A Preliminary Study (비치매 노인 우울증 환자에서 대뇌 아밀로이드 병리 예측을 위한 정량화 뇌파 지표: 예비연구)

  • Park, Seon Young;Chae, Soohyun;Park, Jinsick;Lee, Dong Young;Park, Jee Eun
    • Sleep Medicine and Psychophysiology
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    • v.28 no.2
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    • pp.78-85
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    • 2021
  • Objectives: When elderly patients show depressive symptoms, discrimination between depressive disorder and prodromal phase of Alzheimer's disease is important. We tested whether a quantitative electroencephalogram (qEEG) marker was associated with cerebral amyloid-β (Aβ) deposition in older adults with depression. Methods: Non-demented older individuals (≥ 55years) diagnosed with depression were included in the analyses (n = 63; 76.2% female; mean age ± standard deviation 73.7 ± 6.87 years). The participants were divided into Aβ+ (n = 32) and Aβ- (n = 31) groups based on amyloid PET assessment. EEG was recorded during the 7min eye-closed (EC) phase and 3min eye-open (EO) phase, and all EEG data were analyzed using Fourier transform spectral analysis. We tested interaction effects among Aβ positivity, condition (EC vs. EO), laterality (left, midline, or right), and polarity (frontal, central, or posterior) for EEG alpha band power. Then, the EC-to-EO alpha reactivity index (ARI) was examined as a neurophysiological marker for predicting Aβ+ in depressed older adults. Results: The mean power spectral density of the alpha band in EO phase showed a significant difference between the Aβ+ and Aβ- groups (F = 6.258, p = 0.015). A significant 3-way interaction was observed among Aβ positivity, condition, and laterality on alpha-band power after adjusting for age, sex, educational years, global cognitive function, medication use, and white matter hyperintensities on MRI (F = 3.720, p = 0.030). However, post-hoc analyses showed no significant difference in ARI according to Aβ status in any regions of interest. Conclusion: Among older adults with depression, increased power in EO phase alpha band was associated with Aβ positivity. However, EC-to-EO ARI was not confirmed as a predictor for Aβ+ in depressed older individuals. Future studies with larger samples are needed to confirm our results.

CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 2000
  • The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

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A STUDY OF RELATIONSHIP BETWEEN SELF-IMAGE AND SOCIAL SENSITIVITY IN ADOLESCENTS : THE STRUCTURAL RELATION AMONG SELF-IMAGE, DEPRESSION, ANXIETY, AND SOCIAL SENSITIVITY (청소년의 자아상과 사회적 민감성간의 관계에 대한 연구: 자아상-우울-불안-사회적 민감성간의 구조적 관계분석)

  • Shin, Min-Sup;Soh, Jun-Hyun;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.61-67
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    • 1996
  • The purpose of the present study was to investigate empirically the relationship among self-image, depression, anxiety, and social sensitivity in adolescents. 1602 normal adolescents(697 males and 905 females) responded to self report scales-Offer Self-Image Questionnaire-Revised, 3 subscales of Symptom Checklist-90-Revised. The data were analyzed with ANOVA and LISREL to examine the effect of self-image on depression, anxiety, and social sensitivity, and to test the relationship among the above 4 variables. Adolescents with low self-image showed significantly higher scores in the scales of depression, anxiety, and social sensitivity than did adolescents with high self-image. The result of LISREL showed that the low self-image leads to the emotional state of depression and anxiety, and those of depression and anxiety lead to the increase of social sensitivity, suggesting that self-image has a direct effect on depression and anxiety, and has a direct effect on social sensitivity in adolescent. These results were discussed in terms of implications for the prevention and treatment of adolescent social phobia.

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