• 응용통계연구
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• 제20권3호
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• pp.449-458
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• 2007

양극성 장애 (bipolar disorder)는 조증 삽화 (manic episode)와 우울증 삽화 (depression episode)를 반복적으로 경험하는 기분장애이다. 양극성 장애환자에게 우울증은 조증보다 심각한 결과를 가져오며, 치료의 효과를 측정하기도 어렵다고 알려져 있다. 본 연구의 목적은 우울증(depression) 상태에 있는 환자들을 대상으로 항우울제를 사용하여 정상 (normal) 상태로 전환했을 때, 약물의 장기 사용으로 일어날 수 있는 조증 (mania)과 같은 부작용을 통제하고자 한다. 이를 위해 정상 상태에서 조증으로 전환하는데 소요되는 시간의 분포를 추정한다. 본 연구에서는 세 가지 방법, 모수적, 비모수적 그리고 준모수적 방법을 차례대로 적용하였다. 특히 기분 전환의 흐름을 파악하기 위해 3단계 모형을 사용하였다. 예를 들어, Illness-Death 모형하에서 기분 전환의 발생시점에 대한 분포를 추정하기 위해 계수 과정에 의해 기분 전환에 대한 과정을 모형화하였다.

• 생물정신의학
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• 제10권1호
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• pp.80-84
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• 2003

Objective : Bipolar disorder is known to have strong genetic background and cellular immune activation. Based on the hypothesis that abnormalities of normal inhibitory control of T cell immunity can contribute to the pathophysiology of bipolar disorder, we investigated the relationship between the first exon at position +49(A/G) polymorphism of cytotoxic T lymphocyte antigen 4(CTLA4) gene and bipolar disorder. Method : Among the Korean patients diagnosed as bipolar disorder according to DSM-IV, 90 patients without serious medical illness, neurologic illness, hormonal disorder, or concomitant mental illness were selected. The normal control group consisted of 149 age-and sex-matched subjects without current or past history of autoimmune diseases or mental disorder. DNA was extracted from whole blood and the exon 1 region of CTLA-4 gene was amplified by polymerase chain reaction. Gene typing was performed using single strand conformation polymorphism. Results : There were no significant differences in genotype frequencies of G/G, G/A, and A/A between the patients with bipolar disorder and the control group(48.9% vs 46.3%, 44.4% vs 39.6%, and 6.7% vs 14.1%, respectively). There were no significant differences in allelic frequencies of G and A between the patients with bipolar disorder and the control group(71.1% vs 66.1%, and 28.9% vs 33.9%, respectively). Conclusion : This study did not show the association of exon 1 polymorphism of CTLA-4 gene with bipolar disorder.

• 생물정신의학
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• 제18권4호
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• pp.217-224
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• 2011

Subsyndromal bipolar symptoms are common during maintenance treatment and appear to be associated with relapse into an episode of the same polarity. This implies subsyndromal symptoms are an important problem in recurrent bipolar disorder and require more additive and infallible therapeutic intervention. Undetected, untreated subsyndromal states lead patients to have poor prognosis and quality of life. The combination of a long undetected illness and significant psychosocial impairment renders early identification and intervention vital for the treatment of bipolar disorders. Methods for early identification includes finding prodromes, using screening tools such as the HCL-32 (Hypomania Checklist-32) and the BSDS (bipolar spectrum diagnostic scale). Various augmentation treatment methods would be needed to reduce subsyndromal symptoms, especially, psychosocial treatment has the potential to help patients address the multiple psychosocial problems associated with this chronic illness. To overcome difficulties of diagnosing subsyndromal disorder and to treat it appropriately, a staging system was suggested by some researchers. It assumes that earlier stages have better prognosis and require simpler therapeutic regimens. Staging may assist in treatment planning and prognosis of bipolar disorder, and emphasize the importance of early intervention. Further research is required in this exciting and novel area.

• 동서간호학연구지
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• 제28권2호
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• pp.160-169
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• 2022

Purpose: This study was conducted to identify predictors related to aggressive behavior of patients with mental illness admitted to a closed psychiatric ward. Methods: This study adopted a retrospective design which analyzed the hospital medical records of 363 patients with mental illness admitted to the psychiatric closed ward of a university hospital in Seoul, Korea. The collected data were analyzed using SPSS IBM 20.0 and STATA 12.0 SE. ZIP (Zero-Inflated Poisson) and count data analysis were used for the factor influencing the occurrence and frequency of aggressive behavior. Results: The results of ZIP model showed that the factors influencing non-probability of aggressive behavior were anxiety, non-adherence, and frustration. In addition, the factors influencing frequency of aggressive behavior were bipolar disorder and personality disorder trait. Conclusion: We found that bipolar disorder, frustration, and non-adherence are more likely to increase the likelihood of aggressive behavior in patients with mental illness. In particular, patients diagnosed with bipolar disorder were 1.95 times more likely to engage in repetitive aggressive behavior compared to those without a diagnose. However, since the results were different form previous studies, further studies on the traits of anxiety and personality disorders are needed.

• 통합자연과학논문집
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• 제16권3호
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• pp.75-80
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• 2023

Bipolar disorder is a mental illness characterized by extreme mood and behavioral swings, such as highs of euphoria and lows of depression. It is a socially significant disorder in which people with the disorder experience intense mood swings and, for those with severe bipolar disorder, it is even difficult leading a normal life. High stress levels in people with mental illness can lead to neuroendocrine disruption, and it is strongly linked to aging. When the neuroendocrine system becomes vulnerable to these mental illnesses and stress, it is likely to accelerate aging. And it's the epigenetic clock that can measure the extent of this accelerated aging. The Epi clock, a pan tissue clock, measures aging through DNA methylation, and the degree of methylation is modified and changed by environmental conditions in the body. Therefore we wanted to check the changes in the epigenetic age of the patients with bipolar disorder. While we found no significant differences in epigenetic age, we did confirm the possibility that people with bipolar disorder have different methylation than normal people. We also found that the EPIC array data fit better on the Epi clock than on the Horvath clock with age-accelerated data from normal people.

• 대한불안의학회지
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• 제9권2호
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• pp.101-105
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• 2013

Objectives : This study was conducted to evaluate the association between first episode polarity of pediatric bipolar disorder and prognosis. Methods : We analyzed the clinical records of 66 inpatient subjects with DSM-IV defined pediatric bipolar disorder. The patients were split into 2 groups according to the polarity of the illness onset [depressive onset (DO) vs. manic/hypomanic/mixed onset (MO)]. Clinical feature and prognosis were compared between the two groups of patients. Results : In our sample, 68% of patients experienced a depressive onset. In DO patients, rates of suicidal attempt, episodic illness course and comorbid disruptive behavior disorder were higher than rates in MO patients. Conclusion : Findings from this study suggest that polarity of illness onset may be useful in predicting the prognosis of pediatric bipolar disorder.

• 성인간호학회지
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• 제16권2호
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• pp.288-296
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• 2004

Purpose: Illness intrusiveness (illness induced lifestyle disruption) by symptoms was investigated in 439 patients with rheumatoid arthritis. Method: The cross-sectional and retrospective survey design was used. Fatigue, disability, pain, and depression were considered as symptoms of rheumatoid arthritis. Result: Patients were reported to perceive more illness intrusiveness than other chronic disease patients such as end stage renal disease, bipolar disorder, and peritoneal dialysis patients. They were especially intrusive into work, health, and active recreation domains. Stepwise regression analysis identified four variables counting for 26% of illness intrusiveness variances: fatigue, disability, marital status, and depression. All of the symptoms except pain were found to significantly predict illness intrusiveness. Fatigue explained 16% of illness intrusiveness variances. Conclusion: Fatigue and depression usually overlooked by health professionals must be carefully assessed and managed to reduce perceived illness for rheumatoid arthritis patients.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제23권1호
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• pp.3-7
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• 2012

Objectives : The early onset of mood symptoms in bipolar disorder has been associated with poor outcomes in many studies. However, aspects of the clinical course of bipolar disorder in children and adolescents are controversial. The goal of this article is to review the clinical characteristics and longitudinal course of children and adolescents with bipolar disorders. Methods : Searches were conducted in MedLine, PsycINFO, KISS, and RISS using the terms phenomenology, clinical course, outcome, BPD, pediatric, children and adolescents. Twenty-one reports were selected : either original articles reporting symptoms and clinical characteristics of subjects (ages 5-18 years), or published articles in reviewed journals about bipolar disorder in children and adolescents. Results : Approximately 70% of subjects with bipolar disorder recovered from their index episode, and 50% had at least 1 syndromal recurrence, particularly depressive episodes. For 60% of the follow-up time, subjects had syndromal or subsyndromal symptoms with numerous changes in symptoms and shifts of polarity. Approximately 20% of BP-II subjects converted BP-I. Conclusion : Bipolar disorders in children and adolescents are characterized by episodic illness with subsyndromal and syndromal episodes with mainly depressive and mixed symptoms and rapid mood changes. Extensive follow-up time is needed to evaluate the continuity of bipolar disorder symptoms from childhood to adulthood.

• 수면정신생리
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• 제29권2호
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• pp.40-44
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• 2022

Bipolar disorders are a group of mood disorders characterised by relapsing mood episodes throughout the course of illness. Patients with bipolar disorders commonly present with various sleep problems. Patients in a manic episode generally show decreased need of sleep and those in a depressed episode frequently complain about hypersomnia. Current literature even points to evidence that patients with bipolar disorder in euthymic state may still show signs of sleep disturbances when compared to the general population. Clinicians may also note intricate interactions between changes of circadian rhythm and evolution of mood episodes in patients with bipolar disorder. Also, commonly prescribed medications which plays a crucial role in treatment of bipolar disorders including mood stabilisers and antipsychotic medications often cause significant weight gain over time. Being a risk factor of sleep apnoea, weight gain can predispose the patient to develop sleep apnoea. In this narrative review, we summarised current evidence and literature regarding characteristics of circadian rhythm and comorbid sleep apnoea in patients with bipolar disorder. We also present literature regarding implications of circadian disturbance and comorbid sleep apnoea in managing patients with bipolar disorder.

• 근관절건강학회지
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• 제10권2호
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• pp.119-130
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• 2003

Illness intrusiveness(illness induced lifestyle disruption) was investigated in 902 patients with arthritis and compared between rheumatoid arthritis(N=439) and osteoarthritis(N=463) patients. Arthritis patients were reported to perceive illness intrusiveness similar to patients with ESRD(end stage renal disease), bipolar disorder and peritoneal dialysis. Especially they were intrusive into health, work, and active recreation domains. And patients with rheumatoid arthritis were significantly more intrusive into activities, especially in diet, financial situation, family relations, other social relations, self-expression/self improvement, religious expression, and community and civic involvement. Differences in treatment regimens and age were hypothesized to account for these differences in illness intrusiveness.