• Anxiety and mood
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• v.2 no.1
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• pp.45-49
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• 2006

Puropse : Disturbances of dopaminergic system might be related to the possible mechanism of panic disorder. This study was aimed to examine the association of DRD2 Taq 1 polymorphism and panic disorder. Methods : One hundred and fourteen patients with panic disorder (62 male (54.4%), mean age $40.96{\pm}0.11$ years) and 200 comparison subjects (114 male (57.0%), mean age $35.57{\pm}8.81$ years)were tested for DRD2 TaqI A polymorphism. We excluded panic patients with comorbid alcohol related disorders, bipolar disorders, and any kinds of psychotic disorders because there have been some reports about association of these disease and DRD2 TaqI A polymorphism. Results : There was significant difference in the frequency of the genotype in DRD2 polymorphism between patients and controls (${\chi}^2$=6.09, df=2, p=0.048). The A1+ allele (A1A1 and A1A2) frequency analysis also showed significant association (${\chi}^2$=4.08, df=1, p=0.043). In addition, we observed a more strong and specific association between panic disorder and the A1+ allele of the DRD2 TaqI polymorphism for men (${\chi}^2$=4.71, df=1, p=0.03), but not for women (${\chi}^2$=0.45, df=1, p=0.50). Conclusion : These results in our Korean sample suggest that the DRD2 TaqI A polymorphism may be associated with panic disorder. Furthermore, we found sex-specific association of DRD2 A1 allele with panic disorder.

• Anxiety and mood
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• v.2 no.2
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• pp.108-114
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• 2006

Objectives : Only a few prospective studies of panic disorder are available. This study investigated naturalistic outcome of panic disorder patients at twelve months after the initial diagnosis. Methods : A total of 84 subjects were diagnosed with panic disorder by diagnostic interview, Structured Clinical Interview for DSM-IV (SCID-IV) and Anxiety Disorder Interview Schedule for DSM-IV (ADISIV). Among them, 80 subjects could be evaluated by means of Panic Disorder Severity Scale (PDSS) at follow-up interview after twelve months. Treatment continuation was also examined at follow-up interview. Results : At initial intake, 80 patients were classified into 22% with mild, 33% with moderate-to-marked, and 45% with severe symptoms on the basis of their PDSS total score. At twelve months, 20% of patients reached remission, 65% had mild and 15% had moderate-to-marked symptoms. Initial panic symptom severity, presence of agoraphobia, panic symptom duration before diagnosis, number of comorbid Axis I disorders were associated with significantly higher PDSS total score at twelve months. Forty six percent of total patients continued medication and 23% have stopped treatment by clinician's recommendation and 31% have selfdiscontinued their medication. At twelve months, all three groups were improved but self-discontinuation group had significantly higher PDSS total score. Conclusion : In the one-year naturalistic outcome study of panic disorder patients, high percentage of patients achieved remission or had mild symptoms.

• Journal of Korean Medical Science
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• v.33 no.46
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• pp.290.1-290.11
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• 2018

Background: The role of antidepressants (ADs) in bipolar disorder is long-standing controversial issue in psychiatry. Many clinicians have used ADs as a treatment for bipolar depression, and the selection of therapeutic agents is very diverse and inconsistent. This study aimed to examine recent AD prescription patterns for patients with bipolar disorder in Korea, using the nationwide, population-based data. Methods: This study utilized the Korean nationwide, whole population-based registry data of the year 2010, 2011, and 2013. All prescription data of the ADs, antipsychotics, and mood stabilizers of the sampled patients diagnosed with bipolar disorder (n = 2,022 [in 2010]; 2,038 [in 2011]; 2,626 [in 2013]) were analyzed for each year. Results: Annual prescription rate of ADs was 27.3%-33.6% in bipolar disorder, which was gradually increasing over the 3-year period. The combination pattern of ADs and antipsychotic drugs tended to increase over 3 years. The proportion of females and the prevalence of comorbid anxiety disorder were significantly higher in AD user group in all three years. Among individual ADs, escitalopram was prescribed most frequently, and fluoxetine and bupropion were prescribed to the next many patients. The mean duration of bipolar depressive episodes was 135.90-152.53 days, of which ADs were prescribed for 115.60-121.98 days. Conclusion: Our results show prescription rate of ADs in bipolar disorder was maintained at substantial level and increased in recent 3 years. More empirical data and evidence are needed to establish practical treatment consensuses.

• Korean Journal of Psychosomatic Medicine
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• v.15 no.1
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• pp.3-6
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• 2007

Anxiety disorders are common illness to general physician. The comorbidity between anxiety disorders and medical illness is not only a diagnostic issue, but also has implications of the course of the disease and its outcome. The comorbid condition requires consideration of each individual illness, their psychological and physiological condition. This article aims to review the literature on the prevalence of anxiety disorders in patients prescribing to psychiatrists and to discuss pharmacological treatment options for patients with a comorbid anxiety disorder and medical illness.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.3-10
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• 2010

Gilles de la Tourette syndrome is a chronic motor and vocal tic disorder of childhood onset. Abnornmalities in basal ganglia-thalamo-cortical circuits may play an important role in the pathophysiology underlying the involuntary tics. It is often complicated by comorbid attention-deficit/hyperactivity disorder or obsessive-compulsive disorder. Transcranial magnetic stimulation(TMS) is a neurophysiologic technique with research ap-plication. As there is good evidence that this technique can modify cortical activity, repetitive TMS is also used for treatment to change the cortical excitability and therefore affect underlying interconnected cortical-sub-cortical loop. We reviewed the neurophysiologic parameters and the clinical applicability of TMS and rTMS.

• Anxiety and mood
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• v.6 no.1
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• pp.3-9
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• 2010

Even experienced clinicians have difficulties in diagnosing posttraumatic stress disorder (PTSD) exactly, due to its diverse clinical features, which vary according to individuals, traumas, and various comorbid psychopathologies, and its related compensation issues. It is usually mandatory for clinicians and researchers to use screening and assessment tools when diagnosing and evaluating PTSD. To date, research has developed numerous PTSD screening and assessment tools ; therefore one of the cardinal issues is to select the best of the various tools, the one most suitable for the clinician's or researcher's purposes. This article reviews several currently-available subjective and objective instruments for the diagnosis and evaluation of PTSD and groups them according to whether they are Diagnostic and Statistical Manual for Mental Disorders-Correspondent Measures ; PTSD-Focused, Non-DSM-Correspondent Measures ; or Empirically Derived Measures. We present the instruments' psychometric properties and scoring methods and describe their merits and weak points, focusing on their practical usage.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.2
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• pp.58-69
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• 2017

Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.153-159
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• 2005

Autistic disorder and other PDD are currently viewed as a largely genetically determined neurodevelopmental disorder, although its underlying biological causes remain to be established. In this review, we examine the available neurodevelopmental literature on autistic disorder and discuss the findings that have emerged. Typical neuropathological observations are rather consistent with respect to the limbic system (increased cell packing density and smaller neuronal size), the cerebellum (decreased number of Purkinje cells) and the cerebral cortex ($>50\%$ of the cases showed features of cortical dysgenesis). However, most of the reported studies had to contend with the problem of small sample sizes, the use of quantification techniques, not free of bias and assumptions, and high percentages of autistic subjects with comorbid mental retardation or epilepsy. Furthermore, data from the limbic system and on age-related changes lack replication by independent groups. It is anticipated that future neuropathological studies held great promise, especially as new techniques such as design-based stereology and gene expression are increasingly implemented and combined, larger samples are analysed, and younger subjects free of comorbidities are investigated.

• Anxiety and mood
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• v.7 no.2
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• pp.119-125
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• 2011

Objectives : The three symptom clusters of posttraumatic stress disorder (PTSD) are reexperience, avoidance, and hyperarousal. Alcohol use disorders frequently co-occur with PTSD, and possible functional correlations are suspected. Scholarly evaluation of the differences between the symptoms of PTSD and those of alcohol problems may be useful in understanding the pathophysiology of the comorbidity. Methods : We recruited Vietnam veterans with PTSD (n=97) and without PTSD (n=132). The alcohol use disorder identification test (AUDIT), and clinician-administered PTSD scale (CAPS) were administered to participants. The PTSD group was divided into two categories: those with PTSD only (n=57) and those with concurrent alcohol-related problems (n=40). Results : The PTSD group showed higher AUDIT scores compared to the control group. In the PTSD group, participants with alcohol problems had a severer symptoms of recurrent dream and sleep disturbance symptoms compared to the PTSD only group. No significant differences were found in the three major symptom clusters of PTSD. Conclusion : These findings support the proposed existence of a functional correlation between PTSD and alcohol use disorder. Clinicians should carefully evaluate and treat comorbid alcohol use disorder in patients with PTSD.

• Anxiety and mood
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• v.9 no.2
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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.