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Psychophysiologic Response in Patients with Panic Disorder (공황장애환자의 정신생리적 반응)

  • Chung, Sang-Keun;Cho, Kwang-Hyun;Jung, Ae-Ja;Park, Tae-Won;Hwang, Ik-Keun
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.52-58
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    • 2001
  • Objectives: An Increased level of psychophysiologic arousal and diminished physiologic flexibility would be observed in patients with panic disorder compared with a normal control group. We investigated the differences of psychophysiologic response between patients with panic disorder and normal control to examine this hypothesis. Methods: Ten Korean patients with panic disorder who met the diagnostic criteria of DSM-IV were compared with 10 normal healthy subjects. In psychological assessment, levels of anxiety and depression were evaluated by State-Trait Anxiety Inventory, Beck's Depression Inventory and Hamilton Rating Scale For Anxiety and Depression. Heart rate, respiration rate, electrodermal response, and electromyographic activity were measured by biofeedback system (J & J I-330 model) to determine psychophysiologic responses on autonomic nervous system. Stressful tasks included mental arithmetic, video game, hyperventilation, and talking about a stressful event. Psychophysiologic responses were measured according to the following procedures : baseline(3 min)-mental arithmetic (3 min)-rest (3 min)-video game (3 min)-rest (3 min)-hyperventilation (3 min)-rest (3 min)-talking about a stressful event (3 min). Results: The baseline level of anxiety and depression, electrodermal response (p=.017), electromyographic activity (p=.047) and heart rate (p=.049) of patients with panic disorder were significantly higher than those of the normal subject group. In electrodermal response, patient group had significantly higher startle response than the control group during hyperventilation (p=.001). Startle and recovery responses of heart rate in the patient group were significantly lower than responses in the control group during mental arithmetic (p=.007, p=.002). In electrodermal response of the patient group, startle response was significantly higher than recovery response during mental arithmetic (p=.000) and video game task (p=.021). Recovery response was significantly higher than startle response in respiratory response during hyperventilation. Conclusion: The results showed that patients with panic disorder had higher autonomic arousal than the control group, but the physiologic flexibility was variable. We suggest that it is helpful for treatment of panic disorder to decrease the level of autonomic arousal and to recover the physiologic flexibility in certain stressful event.

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A PSYCHIATRIC STUDY ON THE CHILDREN WITH RECURRENT ABDOMINAL PAIN (반복적 복통 환아의 정신과적 연구(反復的 腹痛 患兒의 精神科的 硏究))

  • Choi, Jin-Sook;Hong, Kang-E;Seo, Jeong-Kee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.117-129
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    • 1990
  • 35 children(17 boys, 18 girls) with Recurrent Abdominal pain(RAP) without apparent organic causes, referrd from pediatric department of Seoul National University Children's Hospital were studied during 1988. 7. 1 ${\sim}$ 1989. 2. 28. The aims of this study are to examine clinical characteristics of the patients with RAP, to find possible factors influencing the onset and the course of the disorder, to evaluate the psychological status and the relationship with psychiatric diagnoses. The study subjects were compared with the age and sex matched control subjects on measures of social and school functioning, family-environment, behavior traits by CBCL and parent-environment rating scale. All patients and their mothers were interviewed by a child psychiatrist. The results were as follows ; 1) Abdominal pain was found to be more frequent when with a care taker, and related with traumatic life stresses such as separation from parents, death of family members. 2) Family members of the patients with RAP also had a high rate of a history of gastrointestinal dysfunctions with could not be attributed to organic etiologies. 3) Among 35 patients with RAP, 16 were diagnosed as psychiatric disorders. They were adjustment disorders (4), overanxious disorders (4), depression (2), tic disorders (2), attention deficit disorders (2), separation anxiety disorders (1), enuresis (1). 4) On CBCL, the patients with RAP were more internalized, socially less competent and less active compared with the control subjects. 5) According to the parent-environment rating scale, the patients with RAP had more conflicts with their parents about control issues. Family members of the patients with RAP were socially less competent and less abjustable. The parents of the patients with RAP were more affectionate and spent more time with their children but they were unfair and vague on instruction and discipline.

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Risk Factors Affecting Severity of Menopausal Symptoms in Early and Late Postmenopasusal Woman (초기와 후기 폐경후기 여성에서의 폐경기 증상의 심각도와 위험 요인들)

  • Kim, Jong-Hun;Lee, Moon-Soo;Yang, Jae-Won;Ko, Young-Hoon;Ko, Seung-Duk;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.2
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    • pp.52-61
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    • 2009
  • Objectives : The aim of this study was to assess health-related quality of life and evaluate the risk factors affecting severity of menopausal symptoms in early and late postmenopausal women based on the stages of reproductive aging workshop(STRAW) paradigm. Methods : This cross-sectional study examined 497 Korean postmenopausal women aged 41-59 years in Seoul and Gyeonggi province. We divided subjects into early postmenopause group and late postmenopause group. Menopause Rating Scale(MRS) was used to measure the quality of life. MRS scores, sociodemographic variables, smoking, alcohol use, age at menopause, and risk factors such as attitude to menopause, depression, history of premenstrual dysphoric disorder were compared between early and late postmenopause groups. Multiple regression analysis was performed in each group to assess the independent contribution of several variables. Results : Early postmenopause group showed significantly higher MRS scores, more negative attitude toward menopause, higher scores of depressive symptoms than late postmenopause group. Moderate to very severe hot flush group showed significantly, more negative attitude toward menopause, higher score of depressive symptoms, and higher MRS scores than none to mild hot flush groups. Depressive symptoms and attitude toward menopause contributed to the severity of menopausal symptom in both early and late postmenopause groups. Chronological age, age at menopause, history of PMDD contributed to severity of menopausal symptoms in early postmenopause group while marital status and occupation contributed in late postmenopause group. Conclusion : Health-related quality of life in postmenopause women was significantly lower in early postmenopause group than the late. Attitude toward menopause and depressive symptoms contributed significantly to quality of life in both early and late postmenopause groups but other variables contributed differently in each group. Further studies on clinical samples of postmenopausal women in order to confirm quality of life and its risk factor are needed to be done.

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Depressive Symptoms in Patients with Parkinson's Disease (파킨슨병 환자에서의 우울증상)

  • Lee, Moon-Sook;Yang, Chang-Kook;Hah, Hong-Moo;Kim, Jae-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.25-35
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    • 2003
  • Objectives: The aim of this study was to investigate 1) the prevalence of depressive symptoms, 2) the severity of depressive symptoms, 3) the correlation of depressive symptoms with clinical variables, and 4) factors that contribute to depressive symptoms in patients with Parkinson's disease. Methods: One hundred eighteen patients with Parkinson's disease referred from the Parkinson's Disease Clinic of Dong-A University Hospital, Busan, Korea, completed a self-administered questionnaire package, which included basic demographic data, the Beck Depression Inventory, the Parkinson's disease quality of life questionnaire, the Symptom Checklist-90-Revision(SCL-90-R), and the Spielberger's State-Trait Anxiety Inventory. In addition, a structured interview and a complete neurological examination, including the Hoehn and Yahr stage, the motor part of the Unified Parkinson's Disease Rating Scale(some selected scales of UPDRS part III), the Schwab and England Activities of Daily Living scale(ADL), and the Korean version of Mini-Mental State Examination were performed. Results: 1) Based on BDI score, subjects were divided into four groups:severely(40.7%), moderately(13.6%) and mildly(12.7%) depressive and non-depressive(33.1%). 2) The severity of depressive symptom in Parkinson's disease was positively correlated with Hoehn and Yahr(H & Y) stage(r=0.34, p<0.0001), the severity of motor symptom(r=0.35, p<0.0001), and trait anxiety inventory(r=0.33, p<0.001). On the other hand, the severity of depressive symptom was negatively correlated with educational level(r=-0.34, p<0.001), ADL(r=-0.37, p<0.0001) and Parkinson's disease quality of life (PDQL)(r=-0.69, p<0.0001). Among several clinical variables, the PDQL was the most influential factor predicting whether the depressive symptom was present or not. Conclusion: This study suggests that depressive symptom is very prevalent among patients with Parkinson's disease. Data from this study indicate that medical staffs who take care of patients with Parkinson's disease should pay attention to finding and treating depressive symptom among their patients. With appropriate psychiatric intervention, patient's depressive symptom can be minimized or alleviated and thus, the quality of life in these patients is likely enhanced.

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Correlation of Behavioral and Psychological Symptoms and Homocysteine in Patients with Dementia of Alzheimer's Type (알쯔하이머형 치매 환자에서 행동심리증상과 호모시스테인과의 연관)

  • Lee, Ji Min;Im, Woo-Young;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.23-30
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    • 2014
  • Objectives : Homocysteine has been associated with cognitive impairment and various psychiatric symptoms. This study was designed to examine the relationship exists between plasma homocysteine concentration and behavioral and psychological symptoms of dementia(BPSD). Methods : 41 subjects with dementia of Alzheimer's type were included in this study. We carried out history taking, physical examination, and cognitive assessment for the diagnosis of dementia of Alzheimer's type based on DSM-IV. We scored the Mini Mental State Examination(MMSE), Global Deterioration Scale(GDS), Clinical Dementia Rating(CDR), and the Korean Neuropsychiatric Inventory(K-NPI). We also measured levels of homocysteine, folate, and vitamin $B_{12}$ in the plasma. Results : We found statistically significant positive correlations between homocysteine concentration with NPI total score, and with scores of several sub-domains such as delusion, agitation/aggression, depression/dysphoria, and elation/euphoria. No significant correlation existed between homocysteine levels and scores of MMSE, GDS, and CDR. Conclusions : This study shows that plasma homocysteine levels are associated with BPSD. Further research is necessary to identify pathophysiologic mechanisms underlying these relationships.

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A Trial for Development of Health Profile (KHP 1.0) to Measure the Self-Perceived Health Status of Korean (한국인의 자가평가 건강수준 측정도구(KHP 1.0) 개발)

  • Yang, Jin-Sun;Chun, Jin-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.1
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    • pp.11-23
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    • 2003
  • Objectives : The 1990s has seen advances in the conceptualization of self-perceived health status which has important roles for individual health and the quality of life. Many types of standardized questionnaires have been developed with the current wide use of SF-36, NHP, andEuroQol. However, the outcomes of these tools may be different with regard to regional, cultural and emotional backgrounds. The purpose of this study was to trial the development of a Korean Health Profile (KHP 1.0) to measure the self-perceived health stati of Koreans. Methods : The KHP 1.0 was designed on the basis of the Medical Outcome Study Form 36 (SF-36), the Nottingham Health Profile (NHP), and the EuroQOL. It was composed of 9 scales; physical functioning, role limitation-physical, pain, general health, energy, social isolation, sleep, role limitation-emotional, and e-motional health. Self-reported chronic disease conditions, and the Zung's Self-Rating Depression Scale (SDS), were also checked for the evaluation of clinical validity. This study was conducted, from December 2000 to January 2001, on 800 middle-aged parents, with four high school students, with 100 retest sets being conducted two weeks later. From the 800 subjects there were 588 complete responses (effective response 73.5%). The reliability of the test-retest results, and the factor analysis on the validity of the KHP 1.0 components, were evaluated using the SPSS (ver 10.0) software. Results : The reliability of the KHP 1.0 was good with Cronbach's alpha (>0.6), test-retest correlation coefficients (>0.5), but with no significant differences from the paired t-test. From the psychometric validity tests, the 9 scales of the KHP 1.0 were divided into two components; physical and mental, and trimmed to the established model with 55% of the total variance, with the exception of role limitation-emotional. The clinical validity on the basis of the comparison for the four characteristic groups; healthy, physical conditions only, mental conditions only, and physical and mental conditions were also good. Conclusions : The KHP 1.0 appears to be a valid measurement tool of self-perceived health stati of Koreans, although there are limitations, i.e. sample size was too small, a limited number of middle-aged subjects, and it was based on unconfirmed diagnoses, etc. Therefore, further study is required to standardize the assessment.

Prevalence of School Bullying and Related Psychopathology in Children and Adolescents (소아청소년 집단에서 집단 따돌림의 유병률과 이와 관련된 정신병리 현상)

  • Kwon, Soon-Jae;Park, Tae-Won;Park, Seon-Hee;Yang, Jong-Chul;Chung, Young-Chul;Chung, Sang-Keun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.3
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    • pp.143-153
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    • 2012
  • Objectives : This study examined the current prevalence rate of school bullying and its related psychopathology. Methods : A total of 3,550 elementary/middle school students and their parents were recruited for this study. A self-report questionnaire on perpetration and victimization in school bullying was used for collection of data regarding prevalence and the present state of school bullying. For evaluation of associated psychopathology, self report forms, including the Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), attention-deficit hyperactivity disorder Rating Scale (ARS), Korean-Child Behavior Checklist (K-CBCL), Korean-Youth Self Report (K-YSR), and the Korean Eppendorf Schizophrenia Inventory (K-ESI) were applied. Samples were classified according to four subtype groups (control, victim, perpetrator, and victim-perpetrator) and characteristics of each group were compared. Results : Overall, the prevalence rate for bullying perpetration was 64.4% and the prevalence rate for bullying victimization was 63.4%, indicating involvement of more than half of students in school bullying. Bully-victims reported high social immaturity and depressive and suicidal tendency, whereas bully-perpetrators reported less social immaturity and more externalizing problems. Among the subtype groups, the victim-perpetrator group showed the most prominent depressive/anxiety tendency and behavioral problems. Conclusions : Both victimization and perpetration of bullying are common problems for child and adolescent groups and several psycho-social problems were found to be related. The results of this study will guide direction of future study and development of strategies for prevention of bullying.

Right Amygdalar Laterobasal Subregional Differences in Healthy Adults with Different Novelty Seeking Tendencies (정상 성인에서 자극추구 기질에 따른 우측 편도체의 측기저 세부구조의 차이)

  • Cho, Han-Byul;Kim, Bin-Na;Choi, Ji-Hye;Jeon, Yu-Jin;Kim, Ji-Hyun H.;Jung, Ji-Young J.;Im, Joo-Yeon Jamie;Lee, Sun-Hea
    • Korean Journal of Biological Psychiatry
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    • v.19 no.2
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    • pp.71-76
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    • 2012
  • Objectives : Novelty seeking (NS) represents a dopaminergically modulated tendency toward frequent exploratory activity. Considering the reports showing the relationship between exploratory activity and amygdalar function and structure, and the fact that amygdala is one of the key structures that constitute the dopaminergic pathway in the brain, amygdala might be closely related to NS tendencies. Amygdalar subregional analysis method, which has the enhanced sensitivity compared to the volumteric approach would be appropriate in investigating the subtle differences of amygdalar structures among healthy individuals. The aim of the current study was to examine whether amygdalar subregional morphometric characteristics are associated with the NS tendencies in healthy adults using the amygdalar subregional analysis method. Methods : Twenty-six healthy adults (12 males, 14 females ; mean age $29.8{\pm}6.2$ years) were screened for eligibility. All subjects completed the Korean version of the Temperament and Character Inventory (TCI) and underwent high-resolution brain magnetic resonance imaging. Individuals were divided into 2 groups according to NS scores of the TCI. Results : Individuals of the high NS group had significantly larger laterobasal subregions in right amygdala, after adjustment with the brain parenchymal volumes. Sensitivity analyses for each potential confounding factor such as age, education years and Hamilton Depression Rating Scale (HDRS) scores demonstrated consistent results. Conclusions : This study suggests that NS differences are associated with the laterobasal subregion of the amygdala.

A STUDY ON THE CONSCIOUS SEDATIVE EFFECT OF CHLORAL HYDRATE/HYDROXYZINE WITH AND WITHOUT $N_2O-O_2$ (Chloral hydrate와 Hydroxyzine의 경구투여와 $N_2O-O_2$ 병용투여시 진정효과에 관한 연구)

  • Hong, Sung-Joon;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.489-497
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    • 2002
  • The purpose of this study was to compare the clinical sedation effect of chloral hydrate and hydroxyzine combination with and without nitrous oxide/oxygen inhalation when young children were sedated for dental treatment. The uncooperative 20 children aged, 21 to 47 months of age(ASA Class I), participated in the study. The author examined 20 children(male 12, female 8). Each patient was assigned to receive chloral hydrate(50mg/kg) and hydroxyzine(25mg). Next appointment, each patient was assigned to receive $N_2O-O_2$, choral hydrate and hydroxyzine. Sleep, crying, movement, and overall behavior response were evaluated, and the sedative effects were evaluated by Houpt's rating scale. Pulse rate and peripheral oxygen saturation were also measured for monitoring the sedated patients during treatment period by pulse oximeter. The result were as follows : 1. In the evaluation of sleep scores, crying scores, and movement scores, chloral $hydrate/hydroxyzine/N_2O-O_2$ combination group was significantly rated high(p<0.05). 2. In the evaluation of overall behavior scores, chloral hydrate/hydroxyzine/$N_2O-O_2$ combination group was significantly rated high(p<0.05). 3. In the evaluation of overall behavior evaluation scores(by Houpt), 93.3% in chloral $hydrate/hydroxyzine/N_2O-O_2$ combination group and 63.3% in chloral hydrate/hydroxyzine combination group were rated "good" or "very good". 4. There was no adverse side effect(i.e. respiratory depression) in both group.

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Personality Trait in Panic Disorder Patient and Its Clinical Significance (공황장애 환자의 성격특성과 임상적 의의)

  • Chae, Young-Lae;Lee, Chung-Tai;Kim, Bo-Yeon;Lee, Sung-Pil;Hong, Seung-Chul;Kim, Chong-Woo;Keh, Yoon-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.139-146
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    • 1995
  • Forty patients meeting DSM-III-H criteria for panic disorder and 51 normal controls were assessed with the Personality Diagnostic Questionnaire-Revised(PDQ-R), a self-rating scale designed to assess Axis II personality disorders and traits. Results replicated previous findings of a preponderance of dependent, avoidant, and histrionic features. But our result showed other features such as paranoid, schizotypal, borderline, and antisocial traits also. Patients were divided into two groups according to the severity of their personality traits(high or low). These groups were compared in various panic symptomatology and SCL-90-R. None of the specific symptom dimensions in panic disorder, i.e. panic, anxiety, agoraphobia, social impairment, or chronicity was different between groups. Rather, high personality trait groups were found to have significantly more symptomatology in SCR-90-R than low personality groups. Result indicated that patients exhibiting a greater number of personality traits were also significantly more symptomatic. The results suggested a possible link beteween panic disorder and personality disorder. And, general factors such as depression, social or interpersonal sensitivity might provide a much better explanation of personality disorders in panic patients.

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