The purpose of this study was to examine the effects of participation in a forest program on the level of depression changes in the participants. Total of 501 university students residing in the middle province of Korea were administered Beck Depression Inventory(BDI). Among them, 32 students were selected as participants of the program based on the scores of the BDI. A 5-day forest program included climbing, sharing experience with others and so on. Pre and post tests control group research design was employed for this study, with BDI measures taken from each of 32 participants on three time frames : 2 weeks before the program, immediately before participation, and immediately after participation. BDI scores were expected to decrease as a result of forest program participation. The study results supported this hypothesis.
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.14
no.1
/
pp.12-25
/
2003
Objectives:As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods:Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results:1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion:Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.
This study aimed to compare changes in cognitive function, depression and ability to perform activity of daily living (ADL) in patients with dementia, mild cognitive impairment (MCI), and ischemic stroke (IS) and to identify factors associated with changes in instrumental ADL. A total of 86 patients (dementia=30, MCI=32, and IS=24) were included to analyse cognitive function, depression, and basic and instrumental ADL obtained at the time of diagnosis and 1 year after baseline. Repeated measures analysis of variance and multiple linear regression were used. A significant group by time interaction was found in executive function (p=.037) and instrumental ADL (p=.023) across groups. The MCI group has little change in executive function and instrumental ADL from the baseline to 1 year after diagnosis while other two groups showed changes with the dementia group showing declines and the group of IS having improvement in these factors over time. Changes in executive function(p=.030) and basic ADL (p<.001) explained 26.9% in the variance of changes in instrumental ADL. These findings showed a different changing pattern in executive function during the first year after diagnosis of dementia, MCI, and IS which have cognitive changes as their main symptoms, probably leading to a different changing pattern in instrumental ADL. Healthcare professionals should routinely assess for executive function and instrumental ADL problems and intervene to maintain and improve these functional outcomes immediately after disease.
Objectives : Early life stress (ELS) may have impact on functions of the autonomic nervous system. Heart rate variability (HRV) is a reliable psychophysiological marker for functions of the autonomic nervous system. The purpose of this study was to investigate characteristics of HRV associated with ELS in patients with major depressive disorder (MDD). Methods : We compared HRV measures of MDD patients with ELS and without ELS in a 5-minute resting-state electrocardiogram recoding. Forty subjects participated in the study (25 with ELS, 15 without ELS). The Mann-Whitney test was conducted to identify group differences. Results : We found significant group differences in standard deviation of the NN interval (SDNN) and total power (TP). SDNN was lower in the ELS group (M=38.80 ms, SD=13.05 ms) than in the Non-ELS group (M=53.53 ms, SD=19.47 ms). TP was lower in the ELS group ($M=7.07ms^2$, $SD=0.69ms^2$) than in the Non-ELS group ($M=7.72ms^2$, $SD=0.77ms^2$). Conclusion : ELS may have a negative impact on the autonomic nervous system function in patients with MDD. ELS and dysfunction of autonomic nervous system should be considered in treatment for patients with MDD.
Yoon, Jin-Sang;Lee, Hyung-Young;Kook, Seung-Hee;Choi, Young
Korean Journal of Biological Psychiatry
/
v.3
no.1
/
pp.102-108
/
1996
This was an open trial to evaluate the efficacy and safety of moclobemide twice daily for treatment of Korean patients with major depressive disorder(DSM-III-R). The duration of the trial was 6 weeks with the initial dose of moclobemide being fixed lor the first two weeks at 300mg/day(150mg twice daily, each token after morning and evening meals). Thereafter, when necessary, the dose was allowed to increase to 600mg/day or decrease to 150mg/day according to the seventy of the depression and/or the tolerability of the drug. Hypnotics and/or sedatives from a benzodiazepine group could be concomitantly administered at usual dosage. Patients were assessed at baseline and at days 14, 28 and 42. Efficacy was primarily judged on the Hamilton Rating Scale for Depression(HAM-D) and Beck Depression Inventory(BDI). Patients had to score at least 17 respectively an both scales to enter the trial. Secondary efficacy parameters included Clinical Global Impression(CGI) for severity of illness and improvement. Safety and tolerability were judged on reported adverse events, vital signs and laboratory parameters. In addition, there was a series of questions and assessments for the psychiatrists and patients to complete at the end of the trial Twenty nine patients completing trial were included in the analysis of efficacy : of thirty one patients participating in the safety and tolerability analysis, those who withdraw voluntarily without particular reasons or violated the treatment schedule were not included. The efficacies as determined by HAM-D, BDI or CGI were found to be significant compared to baseline. The number of responders defined as patients with a total score of 10 or less or with a total score of 50% or less of the baseline score on HAM-D and BDI were 17(59%) and 18(62%) respectively. Regarding safety and tolerability, nine patients(29%) reported mild adverse events probably related to moclobemide : of these one patient dropped out because of poor tolerability : however, there were no appreciable changes in blood pressure, pulse rate, body weight or laboratory parameters for all patients over the trial period. Furthermore, the physicians' and patients' opinions at final evaluation showed that moclabemide has a good antidepressant effect as well as a favorable tolerability. In conclusion, a twice-daily dosage schedule with maclobemide is recommendable for the treatment of Korean patients with major depressive disorder since its efficacy and safety were demonstrated in this study.
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.6
no.1
/
pp.34-42
/
1995
Borderline personality disorder in adolescents present with suicide attempts or gestures, and they are characterized by the same patterns of splitting, devaluation, manipulation, need-gratifying object relations, impulsivity, and ego deficits that are finds in borderline adults, Symptomatolgy are depression, anxiety, identity crisis, and occasionally antisocial behavior in borderline personality disorder in adolescents. These findings should be differentiated to normal stormy adolescents. Theses borderline personality disorder in adolescents are known about the instability of object relations, labile affect, splitting, and psychotic episode in severe stress. According to thses finding, schizophrenia, mood disorder, schizoptypal personality disorder, paranoid personality disorder could be differentiated. Etiology is complex including psychodynamic, genetic, familial factor. Treatments are individual psychotherapy, group therapy, and pharmacotherapy. The continuity or discontinuity of borderline states from childhoon to adult life is controversy.
Kim, Won;Woo, Jong-min;Lim, Seong Kyeon;Chung, Eun Joo;Yoo, Rhee Hwa
Journal of Korean Society of Forest Science
/
v.98
no.1
/
pp.26-32
/
2009
The use of natural environments to change lifestyle and health has been long recognized. In particular, forests, trees, and open space have been shown to promote mental health. In this study, we examined the effectiveness of the structured psychotherapeutic program using forest environment ("forest activity program") to improve the symptoms of nine patients with Major Depressive Disorder (MDD) who were taking variable doses of antidepressants. We assessed the depressive symptoms, quality of life, and autonomic nerve regulation among the MDD patients. Hamilton Rating Scales for Depression (HRSD) scores significantly decreased after the forest therapy (13.56 vs. 5.56, p=0.003), and some subscores of Short Form 36 health survey questionnaire (SF-36) and heart rhythm coherence are improved as well. Combined with antidepressant pharmacotherapy, the structured psychotherapeutic program using forest environment showed an improved health status for MDD patients and thus has potential as an adjuvant treatment for MDD, especially for rehabilitation and relapse prevention.
Objectives : Cognitive therapy is the most extensively researched psychological treatment for nonpsychotic unipolar outpatient depressive disorders. This review focused on the utility of this approach in severe or chronic depressive disorders, in relapse prevention and also on the potential benefits of combining cognitive therapy with medication. Methods : The author reviewed original studies and quantitative analyses on the effects of cognitive therapy, predictors of response, and neuroimaging studies of cognitive therapy in major depressive disorder. The sources used for the literature search were data bases : PubMed, EMBASE, CDSR on the internet, references in papers or books. Results : This review suggests that cognitive therapy is as effective as antidepressant medication in severe depressive disorders. And cognitive therapy can be an effective alternative to antidepressant medication. Patients benefited significantly more from combined cognitive therapy and antidepressant treatment than from either treatment alone. Most importantly, the addition of cognitive therapy to usual treatment appears to protect against future relapse in individuals known to be at high risk of repeated episodes of depression. In addition, subjects who received cognitive therapy showed significantly greater improvements in chronic depression than receiving antidepressant medication. Pooled data suggests that there is a significant relationship between the therapist's level of training or experience, the type of therapy used and patient outcome. Recent functional imaging studies examining brain changes following cognitive therapy report a variety of regional effects, but there is no consistent pattern across the few published studies. Conclusion : Cognitive therapy has proved beneficial in treating depressive patients. Despite empirical data supporting its efficacy, there are still problems in gaining access to cognitive therapy in clinical practice.
Lee, Jun-Seok;Yang, Byung-Hwan;Lee, So Hee;Lee, Seung-Min
Korean Journal of Biological Psychiatry
/
v.14
no.1
/
pp.42-47
/
2007
Objectives : Studies have reported differences between depressed adults and controls in quantitative measures of EEG alpha asymmetry, but, there are few using Korean subjects. So, the present study compared EEG regional alpha asymmetries of patients having major depressive disorder(MDD) and normal controls. Methods : The subjects in this study were 11 unmedicated unipolar depressed patients and 11 non-depressed, age matched controls. Resting EEG(eyes closed and eyes open) was recorded from each participant using 8 scalp electrodes. Beck Depression Inventory(BDI), 17-item Hamilton Depression Rating Scale(HDRS), Zung's Self-Rating Depression Scale(SDS) and Spielberger's State-Trait Anxiety Inventory(STAI) were used to evaluate depression and anxiety symptoms. Results : The severities of depression measured by self-report questionnaires were positively associated with those of anxiety(state and trait) ; The subjects were both anxious and depressed. Anxious-depressed patients differed from controls in alpha asymmetry at T4 channels. They showed evidence of greater activation over right than left temporal site. Conclusion : These findings are consistent with the previousely reported alpha asymmetry of depressed patients with an anxiety disorder. The failure to find the evidence of reduced right parietal activity in depression is presumed to be due to opposing effects of comorbid anxiety on parietotemporal activity.
Objective : The purpose of this study was to investigate the cognitive performance of major depressive disorder (MDD) in military service/conscription personnel who visited the psychiatric clinic for a medical certificate to consider the situation from the perspective of Korea's unique compulsory military system. We used the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) as the test for verifying the suitable level of cognitive functioning for military service and as the embedded measure with reflecting suboptimal effort. Methods : The study was conducted on 56 (28 males, age 19-34) in/out-patients admitted to the psychiatry department and diagnosed with MDD (DSM-IV). All participants completed a structured clinical interview (MINI-Plus), as well as self-report questionnaires related to demographics and severity of clinical symptoms. K-WAIS-IV was administered to each subject to assess cognitive characteristics. Results : Military group showed significantly lower processing speed index (PSI) score including subtests of symbol search (SS) and coding (CD) score, compared to the control group. There was no other significant differences in the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) scores including sub-tests comprised of the above indices, and Reliable Digit Span (RDS), Enhanced-RDS-Revised (E-RDS-R) between the study and control groups. Conclusion : This study was the first effort to verify the characteristics of Korea's military group with MDD and suggest the applicability of PSI and processing speed of K-WAIS-IV as an embedded performance index to test sub-optimal effort or low motivation beyond the purpose of testing cognitive deficits.
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