• 제목/요약/키워드: Bipolar disorders

검색결과 82건 처리시간 0.027초

한국판 우울과 신체 증상 평가 척도(Depression and Somatic Symptom Scale, DSSS)의 신뢰도와 타당도 (Reliability and Validity of Korean Version of Depression and Somatic Symptom Scale(DSSS))

  • 김건우;홍진표;박승진;최지혜;최혜라
    • 대한불안의학회지
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    • 제7권1호
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    • pp.9-15
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    • 2011
  • Objectives : We examined the reliability and validity of the Korean version of the Depression and Somatic Symptom Scale (DSSS) in Korean patients with depressive symptoms. Methods : Participants were 55 outpatients diagnosed with major depressive disorder, a depressive episode of bipolar I disorder, somatoform disorder, panic disorder, generalized anxiety disorder, or post-traumatic stress disorder according to the DSM-IV criteria. We assessed them using the Korean versions of the DSSS, Hamilton Depression Rating Scale (HDRS), and Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR). Results : The Korean version DSSS had a Cronbach's alpha of 0.90. Moreover, each item's correlation with the total score was statistically significant (r=0.24-0.71, p<0.01). The test-retest correlation coefficient (r=0.83, p<0.01) was relatively high, and the DSSS correlations with the HDRS and QIDS-SR were 0.77 and 0.74, respectively. Conclusion : These results demonstrate that the Korean version of the DSSS could be a reliable and valid tool for screening and assessing depressive patients. The Korean version of the DSSS will be a useful tool for screening both depressive and somatic symptoms in Korea.

RNA Binding Protein Rbms1 Enables Neuronal Differentiation and Radial Migration during Neocortical Development by Binding and Stabilizing the RNA Message for Efr3a

  • Habib, Khadija;Bishayee, Kausik;Kang, Jieun;Sadra, Ali;Huh, Sung-Oh
    • Molecules and Cells
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    • 제45권8호
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    • pp.588-602
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    • 2022
  • Various RNA-binding proteins (RBPs) are key components in RNA metabolism and contribute to several neurodevelopmental disorders. To date, only a few of such RBPs have been characterized for their roles in neocortex development. Here, we show that the RBP, Rbms1, is required for radial migration, polarization and differentiation of neuronal progenitors to neurons in the neocortex development. Rbms1 expression is highest in the early development in the developing cortex, with its expression gradually diminishing from embryonic day 13.5 (E13.5) to postnatal day 0 (P0). From in utero electroporation (IUE) experiments when Rbms1 levels are knocked down in neuronal progenitors, their transition from multipolar to bipolar state is delayed and this is accompanied by a delay in radial migration of these cells. Reduced Rbms1 levels in vivo also reduces differentiation as evidenced by a decrease in levels of several differentiation markers, meanwhile having no significant effects on proliferation and cell cycle rates of these cells. As an RNA binding protein, we profiled the RNA binders of Rbms1 by a cross-linked-RIP sequencing assay, followed by quantitative real-time polymerase chain reaction verification and showed that Rbms1 binds and stabilizes the mRNA for Efr3a, a signaling adapter protein. We also demonstrate that ectopic Efr3a can recover the cells from the migration defects due to loss of Rbms1, both in vivo and in vitro migration assays with cultured cells. These imply that one of the functions of Rbms1 involves the stabilization of Efr3a RNA message, required for migration and maturation of neuronal progenitors in radial migration in the developing neocortex.

Maternal separation in mice leads to anxiety-like/aggressive behavior and increases immunoreactivity for glutamic acid decarboxylase and parvalbumin in the adolescence ventral hippocampus

  • Eu-Gene Kim;Wonseok Chang;SangYep Shin;Anjana Silwal Adhikari;Geun Hee Seol;Dae-Yong Song;Sun Seek Min
    • The Korean Journal of Physiology and Pharmacology
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    • 제27권1호
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    • pp.113-125
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    • 2023
  • It has been reported that stressful events in early life influence behavior in adulthood and are associated with different psychiatric disorders, such as major depression, post-traumatic stress disorder, bipolar disorder, and anxiety disorder. Maternal separation (MS) is a representative animal model for reproducing childhood stress. It is used as an animal model for depression, and has well-known effects, such as increasing anxiety behavior and causing abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis. This study investigated the effect of MS on anxiety or aggression-like behavior and the number of GABAergic neurons in the hippocampus. Mice were separated from their dams for four hours per day for 19 d from postnatal day two. Elevated plus maze (EPM) test, resident-intruder (RI) test, and counted glutamic acid decarboxylase 67 (GAD67) or parvalbumin (PV) positive cells in the hippocampus were executed using immunohistochemistry. The maternal segregation group exhibited increased anxiety and aggression in the EPM test and the RI test. GAD67-positive neurons were increased in the hippocampal regions we observed: dentate gyrus (DG), CA3, CA1, subiculum, presubiculum, and parasubiculum. PV-positive neurons were increased in the DG, CA3, presubiculum, and parasubiculum. Consistent with behavioral changes, corticosterone was increased in the MS group, suggesting that the behavioral changes induced by MS were expressed through the effect on the HPA axis. Altogether, MS alters anxiety and aggression levels, possibly through alteration of cytoarchitecture and output of the ventral hippocampus that induces the dysfunction of the HPA axis.

자살 및 관련 질환과 침치료 및 혈위지압에 대한 대중과 연구자의 관심도 분석: Google Trends와 주요 전자 데이터베이스를 이용하여 (Analysis of Public and Researcher Interests in Suicide and Related Illnesses, and Acupuncture and Acupressure: Utilizing Google Trends and Major Electronic Database)

  • 강성현;이정경;권찬영
    • 동의신경정신과학회지
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    • 제34권3호
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    • pp.235-245
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    • 2023
  • Objectives: The aim of this study was to analyze public and researcher interests in suicide and related illnesses and acupuncture and acupressure treatment using Google Trends and some electronic databases. Methods: Search results for keywords "suicide," "acupuncture," "acupressure," and several illnesses related to suicide were analyzed in Google Trends from January 2004 to June 2023. Illnesses included anxiety, depression (including major depressive disorder), schizophrenia, bipolar disorder, post- traumatic stress disorder (PTSD), eating disorder (including anorexia nervosa and bulimia nervosa), substance use disorder, autism spectrum disorder, personality disorder (including borderline person- ality disorder), and chronic pain. Search results were extracted using relative search volume (RSV) scores between 0 and 100. Search terms were also searched in online databases, including PubMed, CNKI, and OASIS, to estimate the number of related studies, and descriptive analysis was conducted. Results: Google Trends analysis showed a strong positive correlation between the RSVs of "suicide and depression," "acupuncture and chronic pain," and "acupressure and PTSD." The electronic database search results produced numerous studies published on "suicide and depression," "acupuncture and depression," and "acupressure and anxiety." High interest in "suicide and depression," "acupuncture and chronic pain," and "acupressure and anxiety" was seen among the public and researchers. Interest in "suicide and chronic pain," "acupuncture and eating disorder," and "acupressure and PTSD" was higher in the public than among researchers, while "anxiety and suicide" and "anxiety and acu- puncture" showed opposite trends. Conclusions: The results of this research enable an understanding of public and researcher interest in suicide, acupuncture, acupressure, and suicide-related illnesses. The results also provide a basis for fu- ture research and examining public health implications in Korean medicine.

한국형 주의력결핍 과잉행동장애 약물치료 알고리듬 개발을 위한 예비연구 (A Preliminary Study on the Development of Korean Medication Algorithm for Attention-Deficit Hyperactivity Disorder)

  • 박재홍;김붕년;김재원;김지훈;손정우;신동원;신윤미;양수진;유한익;유희정;이소영;천근아;홍현주;황준원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권1호
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    • pp.25-37
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    • 2011
  • Objectives:This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods:Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results:Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion:We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.

Lithium 이온의 배설에 미치는 Corticosteroid의 영향 (Effect of Corticosteroids on Renal Excretion of Lithium)

  • 오신열;하정희;이광윤;김원준
    • Journal of Yeungnam Medical Science
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    • 제3권1호
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    • pp.229-235
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    • 1986
  • rat에 주사된 lithium 이온의 배설에 미치는 수종의 corticosteroid의 영향을 검색한 결과 다음과 같은 결론을 얻었다. 1. fludrocortisone을 10mg/kg 투여하여 혈청내 lithium 농도를 줄일 수 있었고, lithium의 뇨중 배설량도 증가시켰다. 2. dexamethasone을 0.1mg/kg 투여하여 혈청내 lithium 농도를 줄일 수 있었고, 1mg/kg을 투여하여 lithium의 뇨중 배설량도 증가시켰다. 3. dexamethasone에 의하여서는 혈중 $Na^+$$K^+$에 대한 농도비가 감소하였고, 반대로 뇨중 $Na^+$$K^+$에 대한 농도비가 감소하였다. 이상의 실험 결과를 미루어 corticosteroid는 lithium의 뇨중 배설량을 증가시키고 그 혈중 농도를 감소시킬 수 있으나, 이러한 작용은 신장을 통한 $Na^+$ 이나 $K^+$의 이동과는 전혀 상관이 없다고 생각된다.

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Topiramate의 신경성 폭식증 치료효과: 국내외 보고된 임상연구결과 및 치험사례 중심으로 (Topiramate for the Treatment of Binge Eating Disorder or Bulimia Nervosa : A Systemic Review of Human Clinical Studies and Case Reports)

  • 이유정;방준석
    • 한국임상약학회지
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    • 제17권1호
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    • pp.6-12
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    • 2007
  • 지난 20 여 년 간 서구 선진사회에서는 식사장애(Eating disorder) 중에서 신경성 폭식증(Bulimia nervosa)의 발병률이 급격히 상승하였고, 우리나라는 특히 젊은 여성층에서 발병률이 빠르게 상승하고 있다. 치료약물로는 주로 항우울제가 선택되지만, 치료효과가 미흡한 바, 항경련제인 topiramate가 효과가 있다는 보고들이 있어 이를 신경성 폭식증치료에 적극 사용할 수 있는가에 관심이 고조되었다. 본 연구는 topiramate가 지닌 신경성 폭식증 치료효과에 대한 최신 지견을 얻고자, 1990년부터 2006년 사이 MEDLINE과, 한국의학논문데이터베이스에 등재된 국내외 자료를 binge eating disorder, bulimia nervosa, topiramate라는 3개의 주요어휘로 검색하여 추출한 자료중에서, 대조군이 사용된 무작위 배정, 이중맹검 임상연구 및 치험사례 만을 선별하여 임상적유용성을 평가하였다. 국외 임상연구 및 치험사례에 따르면, topiramate가 신경성 폭식증에 수반되는 유해한 증상의 발생빈도를 경감시키는데 유효함을 나타내었다. 국내에는 아직 topiramate의 신경성 폭식증 치료효과를 검증한 체계화된 임상연구나 치험사례가 보고된 바 없었다. 피험자의 규모가 작다는 한계에도 불구하고, 일일 투여량 25 mg로 시작하여 점차 증량후 최대 600 mg까지 투여한 국외의 연구결과는, topiramate가 신경성 폭식증 치료에 유효한 결과를 보인다고 사료되므로, 국내 신경성 폭식증 임상치료와 연구에 반영되기를 기대한다.

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쥐오줌풀 추출물이 MIA동물모델에서의 신경발달 단백질의 발현과 행동증상에 미치는 영향 (Effect of Valeriana fauriei Extract on the Neurodevelopmental Proteins Expression and Behavioral Patterns in Maternal Immune Activation Animal Model)

  • 원한솔;김영옥;이화영;임지윤;이상현;조익현;이상원;박춘근;김형기;권준택;김학재
    • 한국약용작물학회지
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    • 제24권5호
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    • pp.341-350
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    • 2016
  • Background: Prenatal exposure to infectious and/or inflammatory insults can increase the risk of developing neuropsychiatric disorder such as bipolar disorder, autism, and schizophrenia later in life. We investigated whether Valeriana fauriei (VF) treatment alleviates prepulse inhibition (PPI) deficits and social interaction impairment induced by maternal immune activation (MIA). Methods and Results: Pregnant mice were exposed to polyriboinosinic-polyribocytidilic acid (5 mg/kg, viral infection mimic) on gestational day 9. The adolescent offspring received daily oral treatment with VF (100 mg/kg) and injections of clozapine (5 mg/kg) for 30 days starting on the postnatal day 35. The effects of VF extract treatment on behavioral activity impairment and protein expression were investigated using the PPI analysis, forced swim test (FST), open field test (OFT), social interaction test (SIT), and immunohistochemistry. The MIA-induced offspring showed deficits in the PPI, FST, OFT, and SIT compared to their non MIA-induced counterparts. Treatment with the VF extract significantly recovered the sensorimotor gating deficits and partially recovered the aggressive behavior observed in the SIT. The VF extract also reversed the downregulation of protein expression induced by MIA in the medial prefrontal cortex. Conclusions: Our results provide initial evidence of the fact that the VF extract could reverse MIA-induced behavioral impairment and prevent neurodevelopmental disorders such as schizophrenia.

정신분열병과 기분장애에서의 수면마비 (Sleep Paralysis in Schizophrenia and Mood Disorder)

  • 박재홍;양창국
    • 수면정신생리
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    • 제9권2호
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    • pp.115-121
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    • 2002
  • 목 적 : 한국인들에게 가위눌림이라고 알려진 수면마비는 일반인들이 흔히 경험하는 현상이지만, 주요 정신질환에서의 발생율과 특성에 대한 연구는 드물다. 본 연구의 목적은 정신분열병 및 기분장애 환자와 일반인에서의 수면마비 발생율을 비교하고 그들이 경험하는 수면마비의 임상적 특징을 조사하는데 있다. 방 법 : 2002년 4월부터 9월까지 부산 소재 일 대학병원 정신과 입원 및 외래 환자 중 정신분열병, 양극성 정동장애, 또는 주요 우울증으로 진단 받은 환자들과 부산시내 거주하는 건강한 성인들을 대상으로 가위눌림 경험 설문지, 수면-각성 일정 설문지, 불면증 척도, 졸음 척도 등을 시행하였다. 결 과 : 단독성 수면마비 발생율은 환자군이 41.9%, 대조군이 38.7%이었다. 환자군은 대조군에 비해 중증과 중등도 수면마비의 비율이 높은 반면, 대조군은 환자군에 비해 경도 수면마비의 비율이 높았다(p<0.05). 수면마비의 첫 삽화를 경험한 나이는 두 군 모두 주로 $16{\sim}25$세에 분포하였다. 수면마비의 발생시간은 환자군과 대조군 모두 입면시와 각성시에 비해 수면 중간의 경험(환자군 52.3%, 대조군 63.6%)이 많았다(p<0.001). 환자군의 38.5%와 대조군의 38.2%는 수면마비를 경험하기 전 신체적, 심리적 스트레스가 선행했던 것으로 나타났다. 환각은 수면마비에서 흔히 동반되는 증상이었으며(환자군 90.8%, 대조군 85.5%), 두 군간에 유의한 차이는 없었다. 수면마비시 경험하는 감정으로는 공포(환자군 72.3%, 대조군 80.0%)가 가장 많았다. 결 론 : 정신분열병과 기분장애 환자들의 수면마비 발생율은 일반인들의 그것과 차이가 없었다. 그러나 환자들은 일반인보다 수면마비를 경험하는 횟수가 더 많았다. 수면마비에는 흔히 다양한 환각과 공포가 동반되었다.

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안전한 진료환경 구축을 위한 정책 개선과제 (A Review of Improvements for Providing Safe and Secure Environments for Medical Treatment)

  • 최아름;김성은;백경희
    • 보건행정학회지
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    • 제29권2호
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    • pp.105-111
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    • 2019
  • On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.