Objective: Pharmacogenomic-based antidepressant treatment (PGATx) may result in more precise pharmacotherapy of major depressive disorder (MDD) with better drug therapy guidance. Methods: An 8-week, randomized, single-blind clinical trial was conducted to evaluate the effectiveness and tolerability of PGATx in 100 patients with MDD. All recruited patients were randomly allocated either to PGATx (n=52) or treatment as usual (TAU, n=48) groups. The primary endpoint was a change of total score of the Hamilton Depression Rating Scale-17 (HAMD-17) from baseline to end of treatment. Response rate (at least 50% reduction in HAMD-17 score from baseline), remission rate (HAMD-17 score ${\leq}7$ at the end of treatment) as well as the change of total score of Frequency, Intensity, and Burden of Side Effects Ratings (FIBSER) from baseline to end of treatment were also investigated. Results: The mean change of HAMD-17 score was significantly different between two groups favoring PGATx by -4.1 point of difference (p=0.010) at the end of treatment. The mean change in the FIBSER score from baseline was significantly different between two treatment groups favoring PGATx by -2.5 point of difference (p=0.028). The response rate (71.7 % vs. 43.6%, p=0.014) were also significantly higher in PGATx than in TAU at the end of treatment, while the remission rate was numerically higher in PGATx than in TAU groups without statistical difference (45.5% vs. 25.6%, p=0.071). The reason for early drop-out associated with adverse events was also numerically higher in TAU (n=9, 50.0%) than in PGATx (n=4, 30.8%). Conclusion: The present study clearly demonstrate that PGATx may be a better treatment option in the treatment of MDD in terms of effectiveness and tolerability; however, study shortcomings may limit a generalization. Adequately-powered, well-designed, subsequent studies should be mandatory to prove its practicability and clinical utility for routine practice.
Middle-aged women experience diverse psychological and physical stresses and tensions through the menopause, aging, and taking up too many social roles, which often leads to sleep disorder. But there are not many scientific researches on the issue. Therefore, the research of efficacy of singing bowl that helps relax middle-aged women who have sleep disorder is needed to improve their health. This study was conducted with Giorgi's phenomenological method with 4 middle-aged women with sleep disorder, whose Pittsburgh sleeping quality scale marked over 5 points, who took part in singing bowl experience for 40 minutes and did the interview. The study resulted in following conclusions that through participants' singing bowl experience, 518 constructive meanings, 15 meaning units, 7 sub components, and 2 group subjects were drawn up. Firstly, when participants took part in the singing bowl experience, they underwent physical, mental, imagery experiences which are physical pain and muscle relaxation, mental relaxation, and positive mindset and imaginary images and colors. Secondly, physical changes that the participants felt after singing bowl experience was increased physical relaxation, improved physical symptoms and more physical activities, and psychologically participants also felt reduced anxiety, increased happiness and positive mentality. And behavioral changes are relaxed movements, increased activities, and improved sleep is huge benefit through changes of sleep pattern. In this study, singing bowl is confirmed to be effective both physically and psychologically on relaxing the middle-aged women's tensions that are caused by sleep disorders and singing bowl experience is meaningful in that the middle-aged women as well as modern people with the sleep disorders can be helped to have better lives.
Journal of the Korea Academia-Industrial cooperation Society
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v.22
no.5
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pp.207-220
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2021
This study aimed to evaluate the impact of education and counselling by nurses on anxiety, uncertainty, and pain in patients with benign uterine tumors. Electronic databases, including PubMed, OVID, CINAHL, Google Scholar, and Korean databases and were searched during January 2020. A total of 401 studies were identified of which 13 were suitable for meta-analysis. Cochrane's risk of bias tool and the R version 3.5.2 (Meta-analysis with R) program were used for analysis. The authors performed a meta-analysis of the 13 trials that met eligibility criteria. The findings in this study indicate that the effect size of nursing education for anxiety was Hedges' g=-0.89 (95% CI:-1.39 to -0.47), as indicated by a "large effect size" and the effect size of pain was Hedges' g=-0.49 (95% CI:-0.95 to -0.02) as indicated by a "moderate effect size". The effect size of uncertainty was Hedges' g=-1.38 (95% CI:-3.98 to 1.23), and it was not statistically significant. In the meta-subgroup analyses by approach intervention type, cognitive-behavioral programs, demonstration intervention, and relaxation therapy had a significant effect. The risk of publication bias was low. It may therefore be concluded that pre-operative education by nurses for patients with benign uterine tumors would affect their levels of anxiety, uncertainty, and pain.
Background: Maternal Toxoplasma gondii (T. gondii) infection during pregnancy has been associated with various mental illnesses in the offspring. Ginsenoside Rh2 (GRh2) is a major bioactive compound obtained from ginseng that has an anti-T. gondii effect and attenuates microglial activation through toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling pathway. GRh2 also alleviated tumor-associated or lipopolysaccharide-induced depression. However, the effects and potential mechanisms of GRh2 on depression-like behavior in mouse offspring caused by maternal T. gondii infection during pregnancy have not been investigated. Methods: We examined GRh2 effects on the depression-like behavior in mouse offspring, caused by maternal T. gondii infection during pregnancy, by measuring depression-like behaviors and assaying parameters at the neuronal and molecular level. Results: We showed that GRh2 significantly improved behavioral measures: sucrose consumption, forced swim time and tail suspended immobility time of their offspring. These corresponded with increased tissue concentrations of 5-hydroxytryptamine and dopamine, and attenuated indoleamine 2,3-dioxygenase or enhanced tyrosine hydroxylase expression in the prefrontal cortex. GRh2 ameliorated neuronal damage in the prefrontal cortex. Molecular docking results revealed that GRh2 binds strongly to both TLR4 and high mobility group box 1 (HMGB1). Conclusion: This study demonstrated that GRh2 ameliorated the depression-like behavior in mouse offspring of maternal T. gondii infection during pregnancy by attenuating the excessive activation of microglia and neuroinflammation through the HMGB1/TLR4/NF-κB signaling pathway. It suggests that GRh2 could be considered a potential therapy in preventing and treating psychiatric disorders in the offspring mice of mothers with prenatal exposure to T. gondii infection.
Burning mouth syndrome (BMS) is a chronic oral disorder of unknown etiology which presents therapeutic challenges. Alpha-lipoic acid (ALA) has been studied as a potential treatment for BMS. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of ALA compared to that of placebo or other interventions in individuals with BMS. Randomized controlled trials (RCT) using ALA to treat BMS were identified from MEDLINE, Cochrane Library, EMBASE, and Web of Science up to February 3, 2021. The assessment of the risk of bias in the included studies was based on the Cochrane guidelines. The primary outcome evaluated was the visual analog scale (VAS) pain intensity. ALA was compared with placebo, clonazepam, gabapentin, pregabalin, ALA plus gabapentin, capsaicin, Biotène®, and laser therapy. Altogether, 137 records were scanned for inclusion/exclusion, and nine RCTs (two unclear and seven at high risk of bias) were included in the qualitative and quantitative analyses, with a total of 594 patients with BMS included in this review. All studies reported an improvement in VAS pain scores ranging from -0.72 to -2.77. Meta-analysis results showed a non-significant reduction in pain intensity for ALA (P = 0.616) compared to that of placebo on a VAS of 0-10. Patients taking ALA were 1.923 times more likely to show an improvement in self-reported BMS symptoms (P = 0.031) than those in the placebo group. Clonazepam and pregabalin showed a significant VAS pain reduction of 4.08 and 4.68 (P < 0.001), respectively, compared to that with ALA. Although ALA intervention provided a non-significant improvement in the pain score and was more likely to produce a reduction in BMS symptoms, the evidence was of low quality. Further research is needed to establish clear guidelines for the use of ALA for BMS treatment.
This study tried to derive implications by analyzing the literature related to food psychology to understand the psychological and emotional influence of food. The results of an exploratory study on food psychology are as follows. First, it was found that the perception of taste is related to an individual's state of mind. Second, as the theories for understanding the psychological aspects of food intake, the eating inhibition theory, the emotion regulation theory, and the escape model for binge eating based on the narcissistic theory were confirmed. Third, it was found that tools that can measure symptoms related to binge eating occupy a large portion of food-related diagnostic tools. Fourth, research on food-related psychological disorders was conducted on food cravings, binge eating disorder, bulimia nervosa, eating inhibition, and healthy food obsession. Fifth, it was found that studies related to the treatment of food-related psychological disorders were focused on the cognitive behavioral therapy approach. This study will serve as a basis for understanding and intervening in the emotional impact of food and psychological problems related to food.
The Journal of Korean Academy of Sensory Integration
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v.9
no.2
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pp.41-49
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2011
Objective : This study aims to compare children with and without pervasive developmental disorders in terms of the sensory processing ability and behavioral characteristic of oral feeding. This study also aims to identify correlation between sensory processing and characteristics of eating. Methods : The subjects of this research were normal children and those who have diagnosis of a pervasive developmental disorder, aged from 4 to 6. The research instruments were composed of Short Sensory Profile (SSP), Brief Autism Mealtime Behavior Inventory (BAMBI) and Food Items of the Sensory Checklist. Data collection was done by a professional survey institute located in 10 cities including Busan, South Korea. The survey questionnaires were distributed to 455 parents of children with and without pervasive developmental disabilities through the survey institutes. Total 263 answers were collected out of 455 questionnaires (62%) and 154 answers were used in data analysis. Out of 154 answers, 45 were for children with pervasive developmental disabilities and 109 were for normal children. Data analysis was done to identify correlations between sensory processing and characteristics of eating such as eating behavior and oral feeding. Results : 1. There was a significant difference between children with and without pervasive developmental disorders in all area of sensory processing ability (p<.05). 2. There was no difference between children with and without pervasive developmental disorders in eating behavior (p=0.881) and oral feeding (p=0.324). 3. In the group of children with a pervasive developmental disorders, it is found that there is negative correlation between sensory processing, eating behavior and oral feeding (r=-0.384, p<.01). 4. A remarkable significant correlation was found between sensory processing and eating behavior especially in taste/smell sensitivity (r=-0.6, p<.01) and auditory filtering (r=-0.326, p<.05). The correlation between sensory processing and oral feeding was most significant in under responsiveness/seeking sensation (r=-0.372, p<.05) and auditory filtering (r=-0.382, p<.05). Conclusion : This study found that there are significant correlations between sensory processing ability and some characteristics of eating behaviors for children with pervasive developmental disorders. This information can be useful to develop a program to intervene eating behavior problems of children with pervasive developmental disorders.
Enuresis is a common voiding disorder among children. There are several therapeutic regimens for the disorder available today; behavioral therapies, psychotherapy, bladder training, sleep interruption, hypnosis and drug therapy. Recently, the efficacy of drug therapy has been acknowledged, particularly of antidepressants. Among the tricyclic antidepressants, imipramine is most frequently employed for the treatment of enuresis. Present study was undertaken to investigate the mechanism of imipramine on the contractility of urinary bladder in relation to the calcium modulation using isolated strips of rat detrusor urinae. 1. The electric fileld stimulation-induced contraction was abolished by imipramine, but partially inhibited by atropine. 2. Imipramine reduced the basal tone and diminished the phasic activity of detrusor muscle concentration-dependently, which was similar to that of diltiazem, a calcium channel blocker. 3. Imipramine suppressed the maximal responses and shifted the concentration-response curves of bethanechol and ATP to right. 4. Imipramine inhibited the calcium-induced recovery of tension in calcium-free physiologic salt solution (PSS) with a mode of action similar to that of diltizaem. 5. A23187, a calcium ionophore recovered the basal tone which had been reduced by imipramine in normal PSS. 6. In calcium-free PSS, A23187 could recover the abolished basal tone with the pretreatment of imipramine, but it exerted a partial recovery with the pretreatment of TMB-8, an inhibitor of intracellular calcium release. Based on these results, it is suggested that the inhibitory action of imipramine on the detrusor muscle exerted in part by blockade of the muscarinic and purinergic receptors, and interference with the influx of extracellular calcium, but not with the release of intracellular stored calcium, is involved in its mechanism of action.
The purpose of this study was to find out various problem behaviors of children who were not diagnosed with any disability, but instead, engaged in problem behaviors. This study also intended to review the difficulties of children with problem behaviors, their teachers' difficulties and needs, to suggest support for child care and education teachers. This study conducted semi-structured qualitative interviews with eight child care and education teachers. The interviews were transcribed into text and analyzed by contents. The results of this study are as follows. Problem behaviors of children described by teachers were classified into external and internal types. In addition, children with problem behaviors had experienced difficulties in maintaining relationships with their teachers, peers and parents. Many teachers were not successful to provide appropriate support for preschoolers who demonstrated problem behaviors in classrooms or some teachers provided individualized support. Teachers adapted the behavioral and the psychological approaches to problem behaviors of preschoolers. However, teachers reported difficulties with children with problem behavior and brought up the following issues on teaching children with problem behaviors; managing troubled matters happening in the class, difficulty in controlling teacher's emotions on problem behaviors, the lack of time, the integrated child care time without teacher in charge of child, the interruption in activity progress, the lack of a special way to deal with problem behaviors, and difficulty in cooperation with families through parents-teacher counseling sessions. Teachers counseled with parents who had a child with problem behaviors and revealed that parents reacted to problem behaviors in various ways such as embarrassment, acceptance, ignorance, or avoidance. Most teachers received assistance and support for teaching children with problem behaviors, from families, local communities and in-service training. Lastly, teachers with preschoolers with problem behaviors needed the support of experts on managing behavior problems, assistant teaching personnel, education for parents and teachers, respects for teachers, psychological counseling or play therapy from professional service agencies, diagnosis service at child care and education centers which children attended, and support networking with agencies. Teachers also required the family support of medical diagnosis and psychological counseling and financial support from the government.
Lee, Jun Ah;Lee, Jae Min;Park, Hyeon Jin;Park, Meerim;Park, Byung Kiu;Ju, Hee Young;Kim, Ji Yoon;Park, Sang Kyu;Lee, Young Ho;Shim, Ye Jee;Kim, Heung Sik;Park, Kyung Duk;Lim, Yeon-Jung;Chueh, Hee Won;Park, Ji Kyoung;Kim, Soon Ki;Choi, Hyoung Soo;Ahn, Hyo Seop;Hah, Jeong Ok;Kang, Hyoung Jin;Shin, Hee Young;Lee, Mee Jeong
Clinical and Experimental Pediatrics
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v.63
no.4
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pp.141-145
/
2020
Background: For children and adolescents with cancer, going back to school is a key milestone in returning to "normal life." Purpose: To identify the support vital for a successful transition, we evaluated the parents' needs and the challenges they face when their children return to school. Methods: This multi-institutional study was conducted by the Korean Society of Pediatric Hematology and Oncology. The written survey comprised 24 questions and was completed by 210 parents without an interviewer. Results: Most parents (165 of 206) reported that their children experienced difficulties with physical status (n=60), peer relationships (n=30), academic performance (n=27), emotional/behavioral issues (n=11), and relationships with teachers (n=4) on reentering school. Parents wanted to be kept informed about and remain involved in their children's school lives and reported good parent-teacher communication (88 of 209, 42.1%). Parents reported that 83.1% and 44.9% of teachers and peers, respectively, displayed an adequate understanding of their children's condition. Most parents (197 of 208) answered that a special program is necessary to facilitate return to school after cancer therapy that offers emotional support (n=85), facilitates social adaptation (n=61), and provides tutoring to accelerate catch up (n=56), and continued health care by hospital outreach and school personnel (n=50). Conclusion: In addition to scholastic aptitude-oriented programs, emotional and psychosocial support is necessary for a successful return to school. Pediatric oncologists should actively improve oncology practices to better integrate individualized school plans and educate peers and teachers to improve health literacy to aid them in understanding the needs of children with cancer.
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