• Psychiatry investigation
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• 제15권12호
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• pp.1135-1143
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• 2018

Objective The aim of this study was to evaluate differences in psychopathology between offspring of parents with bipolar I disorder (BP-I) and those with bipolar II disorder (BP-II). Methods The sample included 201 offspring between 6 and 17 years of age who had at least one parent with BP-I or BP-II. The offspring were diagnostically evaluated using the Korean Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. Psychopathology and Clinical characteristics were evaluated, including lifetime DSM-5 diagnoses, depression, and childhood trauma. Lifetime DSM-5 diagnoses were also compared between schoolchildren aged 6 to 11 years and adolescents aged 12 to 17 years. Results In lifetime DSM-5 diagnoses, offspring of parents with BP-I had significantly increased risk of developing MDD and BP-I than those with BP-II. Regarding clinical characteristics, ADHD rating scale and childhood trauma scale were significantly higher in offspring of parents with BP-I than that in those with BP-II. Conclusion The present study supports that BP-I may be etiologically distinct from BP-II by a possible genetic liability. Our findings indicate that additional research related to bipolar offspring is needed to enhance understanding of differences between BP-I and BP-II.

• 생물정신의학
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• 제16권3호
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• pp.205-211
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• 2009

Objectives : Serum and plasma BDNF levels have been shown to be decreased in patients with mood disorder such as major depressive disorder and bipolar disorder. We investigated whether platelet BDNF levels would be lower in patients with acute bipolar manic episode compared with those of normal controls. Methods : BDNF levels were examined in platelet-rich plasma(PRP) and platelet-poor plasma(PPP) in 20 healthy controls and 20 hospitalized patients who were diagnosed as bipolar I disorder, most recent episode manic using a Structured Clinical Interview for DSM-IV. And severity of manic symptoms was measured using Young Mania Rating Scale(YMRS). Platelet BDNF level was calculated by subtracting PPP BDNF from PRP BDNF level, and dividing the result by the total platelet count, and it was expressed as pg/$10^6$ platelet. Results : Platelet BDNF levels were significantly lower in patients with acute bipolar manic episode(4.55${\pm}$3.36pg/$10^6$ platelet) than in normal controls(6.84${\pm}$2.32pg/$10^6$ platelet)(p=0.008). However we failed to reveal the significant negative correlation between platelet BDNF levels and YMRS scores in patients with acute bipolar episode. Conclusion : Our finding suggests that there is a decrease in the platelet BDNF of patients with acute bipolar manic episode.

• 동의신경정신과학회지
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• 제16권1호
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• pp.201-209
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• 2005

The purpose of this study was to investigate the clinical application of oriental medical therapy(OMT) and Myers-Briggs Type Indicator(MBTI) to Bipolar disorder. We treated the patient with OMT and Counseling. Counseling with the MBTI helped the patient to solve the life stress induced by the spouse conflict. Following the treatment, the patient's symptoms(somatic & mental) were improved. The applicability of Counseling with the MBTI has positive effects on the patient with Bipolar disorder.

• 정신신체의학
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• 제23권2호
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• pp.107-113
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• 2015

연구목적 본 연구는 자살 시도자를 대상으로 자살 생각의 심각성과 관련된 요인들을 찾아보고자 하였다. 방 법 일 대학병원 응급실에 자살 시도로 내원한 환자 중 50명을 대상으로 임상가가 면담, Columbia Suicide Severity Rating Scale(C-SSRS), Beck Depression Inventory(BDI), Korean Version of Mood Disorder Questionnaire(K-MDQ), Bipolar Spectrum Diagnostic Scale(BSDS)를 시행하였다. 결 과 자살 경향이 높은 고위험군은 C-SSRS의 자살 생각의 심각성 점수와 BDI 점수가 높았고(p<0.001), MDQ에서 양극성 장애 가능성의 양성으로 판정된 자는 자살생각의 심각성 점수가 높았다(p=0.033). 결 론 자살 시도자의 자살 생각의 심각성과 양극성 장애의 가능성은 서로 연관성이 있을 것으로 생각된다.

• 생물정신의학
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• 제13권1호
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• pp.32-37
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• 2006

Background : Several studies have suggested that alterations of cytokine level could be related to the pathophysiology of bipolar disorder. In this study, we measured plasma level of Interleukin-12(IL-12), a pro-inflammatory cytokine and transforming growth factor-${\beta}$1(TGF-${\beta}$1), an anti-inflammatory cytokine before and after treatment in acute manic patients. Methods : The plasma concentrations of IL-12 and TGF-${\beta}$1 were measured using quantitative ELISA in 18 bipolar disorder patients and 25 normal controls at admission and 6 weeks later. The psychopathology was measured by Brief Psychiatric Rating Scale(BPRS) and Young Mania Rating Scale(YMRS). Results : IL-12 levels were significantly higher in bipolar manic patients than in controls before treatment. Following the 6-week treatment, the IL-12 level was decreased than before treatment, but sustained still higher level than normal control. TGF-${\beta}$1 level was not significant different between manic patients and normal controls before treatment, but was increased after treatment comparing with before treatment in bipolar patients. The ratio of IL-12 and TGF-${\beta}$1 was significantly decreased after treatment. Conclusion : Cytokine abnormalities in bipolar disorder might be involved in the pathophysiology of the illness. It is possible that TGF-${\beta}$1 plays an important role in the regulation of immunological imbalance in bipolar disorder.

• 생물정신의학
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• 제10권2호
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• pp.121-125
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• 2003

Objective:Recently, many experimental evidences have been reported that psychiatric diseases are closely related with neurodevelopmental abnormalities and this can be properly explained by apoptosis. It is known that Apo-1/Fas is one of the genes in charge of apoptosis related with neurodevelopmental abnormalities. In this study, the association between bipolar disorder and functional polymorphism in Apo-1/Fas promoter gene has been investigated. Method:For 81 bipolar disorder patients and 217 healthy control subjects, MvaI restriction fragment length polymorphism(RFLP) of Apo-1/Fas promoter gene was analyzed after polymerase chain reaction(PCR) amplification. Result:There was a statistical significant difference in genotypic distribution(${\chi}^2$=16.656, df=2, p=0.0002) and allelic frequencies(${\chi}^2$=14.225, df=1, p=0.0002) between bipolar disorder patients and healthy control subjects. Conclusion:Our results suggest an association between functional polymorphism in Apo-1/Fas promoter gene and bipolar disorder and provide the important genetic information related with the pathogenesis of the disease. Further studies employing larger samples are required to clarify the present results.

• 생물정신의학
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• 제18권4호
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• pp.245-253
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• 2011

Objectives In the current study, we quantitatively estimated changes in appetite and eating behavior of bipolar disorder patients during the pharmacotherapy. We also investigated their contribution to the weight gain and their association with specific food-craving characteristics of the patients. Methods Subjects included forty-one bipolar disorder patients and fifty-six controls. Currently sustained natures of food craving were assessed using the General-Food Craving Questionnaire-Trait (G-FCQ-T) and changes in appetite and eating behavior were measured using the Drug-Related Eating Behavior Questionnaire (DR-EBQ). Results Compared to the control group, the patients' group showed significantly higher body mass index (t=2.028, p=0.045). The patients' group had significantly higher 'Preoccupation with food' factor score of G-FCQ-T (p=0.016) than that of the control group. Hierarchical multiple regression analysis showed that only 'preoccupation with food' factor independently predicted psychotropic medication-induced appetite change. Conclusions Appetite change while receiving psychotropic medication seems to be related to the weight-gain and associated with craving natures of 'preoccupation with food' in bipolar disorder. Appetite and/or eating behavioral changes measured by G-FCQ-T and DR-EBQ could be regarded as an important mediating factor in future studies exploring biological mechanisms of weight gain related with pharmacotherapy for bipolar disorder.

• 한국임상약학회지
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• 제33권3호
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• pp.153-167
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• 2023

Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea's bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches-expert consensus versus metaanalysis results-forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea's unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.

• 우울조울병
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• 제16권3호
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• pp.123-128
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• 2018

Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed to provide more proper guidelines for clinicians. In this study, we evaluated treatment strategies of elderly patients with bipolar disorders of KMAP-BP 2018. Methods : Sixty-one psychiatrists of the review committee with vast clinical experiences in treating bipolar disorders, completed the survey. An expert consensus was obtained, on pharmacological treatment strategies for elderly patients with bipolar disorder. The executive committee analyzed results, and discussed the results to produce the final algorithm. Results : In elderly patients with bipolar disorder, first-line treatment option for acute manic episode is monotherapy, with atypical antipsychotics or mood stabilizer, and a combination of mood stabilizer and atypical antipsychotics. First-line treatment option for acute depressive episode, was a combination of mood stabilizer and atypical antipsychotics, monotherapy with atypical antipsychotic or mood stabilizer, and atypical antipsychotics with lamotrigine. Conclusion : In KMAP-BP 2018, the recommendation for treatment option in elderly patients with bipolar disorder, was newly introduced. We expect this algorithm may provide valuable information, and facilitate treatment of elderly patients with bipolar disorder.

• 우울조울병
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• 제16권3호
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• pp.109-122
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• 2018

Objectives : The objective of this study was to revise the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) 2014: Children and Adolescents. Methods : We performed the survey, using a questionnaire comprising 22 questions according to each situation, in children and adolescents with bipolar disorder. Results : First-line pharmacotherapeutic strategies for manic episode in children with bipolar disorder were a combination of mood stabilizer (MS) and an atypical antipsychotics (AAP), monotherapy with an AAP, risperidone, and aripiprazole. Aripiprazole was selected as first-line medication for depressive episode in children with bipolar disorder, and aripiprazole, and risperidone were selected as first-line at high-risk children. First-line pharmacotherapeutic strategies for manic episode in adolescents were a combination of MS and an AAP, monotherapy with an AAP valproate, lithium, risperidone (Treatment of Choice, TOC), aripiprazole, and quetiapine. First-line pharmacotherapeutic strategies for depressive episode in adolescents, were a combination of an atypical antipsychotics and lamotrigine, valproate, aripiprazole (TOC), risperidone, and quetiapine. For depressive episodes in adolescents at high risk for bipolar disorder, valproate, aripiprazole (TOC), and risperidone were selected as first-line medication. Conclusion : We expect that the present KMAP-BP 2018-children and adolescents, is useful for clinicians to treat children and adolescents with bipolar disorder.