• Korean Journal of Biological Psychiatry
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• v.30 no.1
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• pp.17-23
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• 2023

Objectives This study aims to develop valid experimental models for depression through chronic reserpine exposure to zebrafish (Danio rerio). Methods The effect of chronic reserpine on zebrafish behavior in the novel tank was examined. Changes of gene expression on telencephalon were also investigated. Results Chronic reserpine (40 mg/L, 7 days) induced overt behavioral effects, but markedly reduced activity, resembling motor retardation in depression. In telencephalon of zebrafish, gene expression associated with monoamine oxidase and norepinephrine transporter was decreased. Expression of serotonin transporter gene was increased. Conclusions Our results show that the pharmacological model of depression in zebrafish can induce not only behavioral changes, but also monoamine changes in the homology of human mood regulation centers.

• Mood & Emotion
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• v.16 no.3
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• pp.129-133
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• 2018

Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed in 2018, to provide newer guidelines for clinicians. In this section, we examined expert opinions to facilitate clinical decisions relative to treating bipolar disorder with medical comorbidity. Methods : The survey was completed by the review committee, consisting of 61 experienced psychiatrists. This part of the survey constitutes treatment strategies, under major medical comorbidities. The executive committee analyzed results, and discussed the final production of algorithm. Results : Aripiprazole was the first-line medication for bipolar patients with metabolic syndrome, cardiovascular, hepatic, renal, and cerebrovascular comorbidities. Ziprasidone also was recommended as the first-line medication in case of metabolic syndrome. Lithium also was regarded as the first-line medication, in case of hepatic problems. Valproate also was considered as the first-line medication, in case of cerebrovascular problems. Conclusion : This study provided the most recent consensus among experts, for treatment of bipolar disorder with physical problems.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.2
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• pp.114-120
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• 2015

Objectives : This study aimed to investigate the risk factors of depression for patients with tuberculosis(TB). Methods : A total of 57 patients with TB were recruited. All participants completed the Becks Depression Inventory-II for evaluating depressive symptoms. The risk factor for depression was analyzed by binary logistic regression analysis. Nomogram was performed for probability of depression. Results : Low body mass index(BMI, OR 0.801, 95% CI 0.65, 0.98), interruption of treatment for TB(OR 5.908, 95% CI 1.19, 29.41), past history of depression(OR 24.653, 95% CI 1.99, 308.44) were associated with increased risk for depression. The calibration curve for predicting probability of survival showed a good agreement between the nomogram and actual observation(Original C-index=0.789, bias corrected C-index=0.754). Conclusions : The result of the present study indicate that low BMI, interruption of treatment for TB, and past history of depression were risk factors for depression in patients with TB. The psychiatric intervention may be needed to prevent depression if the patients with TB have risk factor during treatment for TB.

• Korean Journal of Biological Psychiatry
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• v.29 no.1
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• pp.32-32
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• 2022

• Journal of the Korean society of biological therapies in psychiatry
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• v.24 no.3
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• pp.194-201
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• 2018

Objectives : Some studies have reported that chronotypes, among several factors, could contribute to problematic drinking. However, there is little evidence confirming this relationship between chronotype and problematic drinking based on gender differences in mood disorder. This study is to investigate the difference of the relationship between chronotype and problematic drinking according to gender differences in mood disorder. Methods : Two hundred fifteen patients with mood disorder were recruited. Problematic drinking and chronotypes were assessed by the Alcohol Use Disorder Identification Test in Korea(AUDIT) and the Korean translation of composite scale of morningness(KtCS). We analyzed the correlation between KtCS and AUDIT using Pearson's correlation, and compared AUDIT scores according to chronotypes classified by KtCS between male and female patients using analysis of variance(ANOVA). Results : There was no significant difference in AUDIT scores between the male and female patients(t=0.91, p=0.183). In female patients, eveningness had significantly higher AUDIT scores than other chronotypes(F=0.199, p=0.033). Meanwhile, in male patients, there was no significant difference in AUDIT score among chronotypes(F=0.008, p=0.933). Conclusion : This study suggests that eveningness might be associated with problematic drinking in female patients who suffer from mood disorder. It also suggests that chronotherapeutical treatment might be able to help improve the course in female patients with mood disorder. In the future, a large-scale prospective study is needed to confirm these results.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.1
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• pp.32-39
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• 2012

Objective : Psychiatry in North Korea is believed to seem very different from psychiatry in South Korea. However, there is nearly no information regarding psychiatry in North Korea until now. Our study aimed to get information about North Korean psychiatry. Methods : Three North Korean defectors in South Korea, whose clinical experience as medical doctors in North Korea was over 10 years, were recruited. They underwent the semi-structured interview, content of which included the clinical experience with psychiatric patients, the details of psychiatry, the treatment of psychiatric patients, the stigma of mental illness, and the suicide, in North Korea. Results : In North Korea, psychiatric department was called as 49th(pronounced as Sahsip-gu-ho in Korean). Only patients with vivid psychotic symptoms came to psychiatric department. Non-psychotic depression or anxiety disorders usually were not dealt in psychiatry. The etiology of mental illness seemed to be confined to biological factors including genetic predisposition. Psychosocial or psychodynamic factors as etiology of mental illness appeared to be ignored. Psychiatry was apparently separated from political or ideological issues. The mainstay of psychiatric treatment is the inpatient admission and out-of-date therapy such as insulin coma therapy. Stigma over mental illness was common in North Korea. Suicide is considered as a betrayal to his/her nation, and has been reported to be very rare. Conclusion : The situation of psychiatry in North Korea is largely different from that of South Korea. Although some aspects of North Korean psychiatry are similar to psychiatry in former socialist countries, North Korean psychiatry is considered to have also its unique characteristics.

• Sleep Medicine and Psychophysiology
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• v.25 no.2
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• pp.68-73
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• 2018

Objectives: The purpose of this study was to explore insomniac demographic characteristics and the type of consultation provided to hospitalized patients asked to the Department of Psychiatry for insomnia and to compare patient insomnia characteristics by consultation type. Methods: We performed a retrospective chart review of 4,966 patients who were hospitalized from August 1, 2005 to December 31, 2011 that received consultation in the Department of Psychiatry. Among them, 236 patients were referred for insomnia. We compared the differences in demographic characteristics and types of consultation between the insomnia patient group and other patient group. We also compared the difference between demographic characteristics and type of consultation by dividing total subjects into 'with reconsultation' and 'without reconsultation' groups. Results: Our results came from the analysis of 9,689 consecutive consultation requests. There were 4,966 patients that participated in the study over 6 years and 6 months. The overall consultation rate was 3.3% of all admissions and insomnia patients comprised 4.8% of those. The ratio of re-consultation for insomnia was 27.5%. There was no significant difference in mean age between the insomnia 'with reconsultation group' and the insomnia 'without reconsultation group', but the 'with reconsultation' group had significantly more male patients and medical patients than the 'without re-consultation' group. For insomnia patients, consultation types were in the order of Mending request (51.3%), Paralle request (36.6%), Complementary request (9.0%) and this composition differed from that of total admission patients. Conclusion: Hospitalized patients referred for insomnia showed a higher proportion of male patients, lower rates of re-consultation compared with other patients, and most of these were for secondary insomnia. Each doctor should be aware of the possibility of inpatient insomnia, conduct positive assessments and referrals as necessary, and psychiatrists who might be asked for consultation need to prepare an active intervention with initial diagnosis and treatment, as well as recommendations for the timing of reconsultation.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.12-18
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• 2017

Objectives : Psychiatric staffs may experience excessive work stress, burnout, and reduced job satisfaction in clinical settings. This can increase chances of diminishing their overall working efficiency or having difficulty managing their own mental health. The purpose of this study was to investigate the effect of group mindfulness-based cognitive therapy(MBCT) on job stress, burnout, self-efficacy, resilience, and job satisfaction. Methods : Twenty eight psychiatric staffs who agreed to participate in the study were included. Self-report questionnaires were used to measure job stress, burnout, resilience, self-efficacy, and job satisfaction. To examine the effects of group MBCT, the scores were compared before and after MBCT. Results : Work stress and burnout scale scores were significantly decreased after group MBCT. Resilience, job satisfaction, and self-efficacy scale scores were significantly increased after group MBCT. Conclusions : In the current study, group MBCT for psychiatric staffs helped to reduce their work stress and burnout, and, as well, helped to improve resilience, self-efficacy, and job satisfaction. This suggests that, in mental health treatment settings, psychiatric staffs can improve their mental health through group MBCT. Improving mental health of psychiatric staff may also have a positive impact on their patients.

• Korean Journal of Schizophrenia Research
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• v.20 no.2
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• pp.37-43
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• 2017

Objectives : This study was aimed to investigate the associations of childhood trauma with psychopathology and clinical characteristics in patients with schizophrenia. Methods : This study enrolled 66 inpatients with schizophrenia. Korean Childhood Trauma Questionnaire (K-CTQ) and Life Event Questionnaire (LEQ) were administered to assess childhood trauma. Psychopatholgy and clinical characteristics were assessed with the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI), Korean Version of Internalized Stigma of Mental Illness (K-ISMI), Perceived Stress Scale (PSS), and visual analogue scale of EuroQoL-5 Dimension Index (EQ-5D). Results : Total scores on K-CTQ were positively associated with scores on the BDI, K-ISMI, PSS, and PANSS and negatively associated with the score on the EQ-5D. Among subscales of K-CTQ, emotional abuse was significantly associated with all measures for psychopathology and clinical characteristics. Patients with physical abuse (36.5%), emotional abuse (30.2%), or bullying (30.6%) according to the LEQ showed sighificanlty higher the ISMI score and lower EQ-5D score. Emotional abuse and bullying were also significantly associated with higher scores on BDI and/or PSS. Conclusion : Our results suggest that childhood trauma negatively influences on internalized stigma, depression, perceived stress and quality of life in patients with schizophrenia. Clinicians should carefully evalute and manage childhood traumatic experience of patients with schizophrenia.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.66-72
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• 2022

Clozapine is accepted as the "gold standard" antipsychotics for treatment-resistant schizophrenia. Clozapine rarely causes extrapyramidal syndrome and tardive dyskinesia, which are common with other antipsychotics, and only a transient elevation of hyperprolactinemia has been reported. Despite such clinical usefulness, there are limitations to the use of clozapine due to adverse drug reactions (ADR). Fever is a common in adverse drug reactions associated with clozapine. At initiation of clozapine most fatal ADR such as agranulocytosis and neuroleptic malignant syndrome associated with fever, in which case clozapine should be discontinued immediately. However, as benign causes of fever are much more frequent than life-threatening ADR, clozapine should not be discontinued unconditionally in the event of fever during clozapine initiation. In addition, fever may occur at any time during the maintenance of clozapine treatment. In particular, since the risk of pneumonia does not decrease over time, and clozapine has a higher risk of pneumonia than other antipsychotic drugs, it is recommended to adjust clozapine dosage through therapeutic drug monitoring.