• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.103-115
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• 1999

Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.68-75
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• 2018

Objectives : Since pain in cancer patients is an important factor that greatly affects the quality of life and prognosis, many attempts have been actively made to reduce the pain. Despite continuous effort on reducing pain after Endoscopic submucosal dissection (ESD), research has not been done on psychological factors as much as on biological factors affecting pain. The objective of this study is to investigate the psychological factors affecting postoperative pain in gastric tumor patients who underwent gastric ESD. Methods : 91 gastric tumor patients who visited National Health Service Ilsan Hospital in Korean between May 2015 and June 2016, and received ESD were evaluated. Baseline characteristics including sociodemographic factors, anxiety, depression, and resilience were evaluated before the procedure. Multivariate logistic regression was done to analyze factors affecting postoperative pain. Results : The group with high postoperative pain showed lower alcohol consumption and higher depressive symptom scores than the group with low postoperative pain. Also, the group with high postoperative pain showed lower total resilience score with lower subtotal scores in self-control and positive item. Multivariate logistic regression analysis of the postoperative pain showed that patients with lower score in self-control of resilience [odd ratio (OR), 0.911 ; 95% CI, 0.854-0.971, p=0.004) reported more pain after ESD. Conclusions : This study showed that patients with lower self-control ability of resilience felt more pain after ESD. Among the psychological factors evaluated in this study, resilience of an individual seems to have effect on pain.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.35-43
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• 2018

Objectives : Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. Methods : Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's ${\alpha}$ for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). Results : Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's ${\alpha}=0.94$) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. Conclusions : Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study demonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.

• The Korean Journal of Pharmacology
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• v.32 no.3
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• pp.357-371
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• 1996

Lithium (Li) is known to be used not only during acute manic psychosis but also acute depressive phase in manic-depression. In the present study, it was attempted to investigate the effect of lithium on catecholamine (CA) secretion from the isolated perfused rat adrenal gland and to clarify the mechanism of its action. Replacement of $Na^+$ (118.4 mM) by lithium in the normal Krebs-bicarbonate solution used to perfuse the gland produced gradually an increased response in the spontaneous catecholamine release, which was peaked at $30{\sim}60$ min after its perfusion. Li-Krebs solution was perfused into an adrenal vein for 2 hours in every experiments. Li-Krebs-evoked CA secretory responses were depressed significantly under loading with $Ca^{++}-free$ medium. This CA secretion evoked by lithium loading was also reduced markedly by the pretreatment with nicardipine ($10^{-6}$ M), TMB-8 ($10^{-5}$ M) and chlorisondamine ($10^{-6}$ M) for 20 min, respectively, while was not affected by preloading with a pirenzepine ($2{\times}10^{-6}$ M)-containing Krebs. $Na^+$ pump inhibition by pretreatment with ouabain ($10^{-4}$ M) for 20 min did make the marked depression in Li-evoked CA secretory responses. Moreover, Li-evoked CA release was also diminished markedly by preloading with tetrodotoxin ($5{\times}10^{-7}$ M)-contaming Krebs for 20 min. All these experimental results taken together suggest that lithium enhances CA secretion in a $Ca^{++}$-dependent fashion by its accumulation in the adrenomedullary chromaffin cells of the rat, and that this secretory effect may be meidated by a dual mechanism: (i) chromaffin cell depolarization and subsequent opening of voltage-sensitive $Ca^{++}$ channels and (ii) activation of a $[Li]_i-[Ca]_0$ counter-transport system.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.18-29
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• 2005

Purpose: Aroma therapy is one modality of alternative medicine. It was well known to have an analgesic, antidepressive and anxiolytic effects. This study is designed to investigate the effect of aroma self hand massage on vital signs, pain, depression, anxiety and stress in breast cancer patients. Methods: 32 female patient over 20 years old were divided into two groups by a non-blinded randomized controlled method. Patient in the aroma group (n=15) massaged their hands twice a day using aroma oil by themselves in their home for 2 weeks. However, those in control group (n=17) had not received my intervention during the study periods. Pain intensity, state anxiety, depression and stress of subjects were evaluated three times (0, 1, 3 weeks) using Visual Analogue Scale (VAS, $0{\sim}10cm$), State Trait Anxiety Inventory (STAI), Beck Depression Inventory Scales (BDIS), Brief Encounter Psychosocial Instrument (BEPSI revised edition). Also the change of patients' accompanying symptoms after aroma massage were analyzed using a structured questionnaire. Results: Pain Intensity decreased in the aroma group compared with control group (VAS changes $-0.83{\pm}1.01\;vs\;0.38{\pm}0.86$, P=0.005). The numbers of accompanying symptoms (P=0.044), depression score (P=0.001) and anxiety score (P=0.008) were significantly decreased in the aroma group, while in control group they increased after 2 weeks. However, the stress score showed no significant changes in both groups ($0.05{\pm}0.85\;vs\;0.04{\pm}0.20$, P=0.1519). The depression, anxiety and stress score showed negative correlation with compliance of aroma massage, but statistically no significant. The systolic blood pressure was a little increased in aroma group ($4.53{\pm}14.43\;vs\;0.0{\pm}7.22$, P=0.026), but was not significant clinically. Patients in the aroma group complained of several symptoms such as headache (20%), paresthesia (6.75%) and nausea (6.7%). However, there were no drop-out patients for those side effects. Conclusion: Aroma self massage during two weeks in breast cancer patients alleviates the pain intensity, depression and anxiety significantly.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.53-61
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• 2006

Objectives: This study was designed to evaluate difference of the alexithymia between panic patients and normal controls by examination of the relationships between different components of the alexithymia construct and level of anxiety and depression in panic patients and normal controls. Methods The subjects were 167 patients who met DSM-IV criteria for panic disorder and 110 normal controls. They drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorders Interview Schedule-Panic attack & Agoraphobia(ADIS-P & A), Korean version of Toronto Alexithymia Scale (TAS-20K), Spielberger State-Trait Anxiety Inventory-State & Trait (STAI-S & T), Beck Depression Inventory (BDI), and Revised Anxiety Sensitivity Index (ASI-R). For statistical analysis, we performed t-test to compare the sociodemographic characteristics and the scores of self reported scales between panic patients and normal controls. Pearson correlation was performed between TAS-20K and it's subfactors, STAI-S & T, ASI-R and BDI in panic patients and normal controls. And stepwise multiple regression analysis was preformed to explain results of correlation analysis for alexithymia. Results: The panic patients reported more significant alexithymic (p<0.001), more difficulty identifying feeling (p<0.001) and describing feeling (p=0.001) than normal controls. Futhermore, panic patients were more significant anxious, sensitive to anxious feeling and depressive than normal controls. Moreover, the alexithymia of panic patients was explained by trait-anxiety $({\Delta}R^2=0.255)$ and anxiety sensitivity $({\Delta}R^2=0.062)$, that of normal controls was predicted by depression $({\Delta}R^2=0.144)$ and anxiety sensitivity $({\Delta}R^2=0.033)$ Conclusion: The panic patients reported more anxious and sensitive to anxious feeling, and these symptoms predict alexithymia in panic patients. However, the alexithymia of normal controls was explained by depression more than anxiety sensitivity, and such a result isn't consistent with previous studies and this may be mainly due to difference of the homogeneity in object of the studies.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.75-81
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• 2012

Objectives : Thyroid cancer patients may experience emotional distress during cancer treatment including surgical operation and radioactive iodine treatment. The aims of this prospective study were to investigate changes of anxiety and depressive symptoms in patients with differentiated thyroid cancer(DTC) under preoperative, postoperative and short-term hypothyroidism state. Methods : Using the Hospital Anxiety and Depression scale(HAD) and the Distress Thermometer, we sequentially assessed the levels of anxiety, depression and distress in 41 DTC patients at 3 time points such as preoperative state, postoperative state and short-term hypothyroidism state. Results : The HAD-anxiety score was significantly higher in preoperative state($6.93{\pm}3.97$) than postoperative state($4.22{\pm}2.92$) and short-term hypothyroidism state($4.93{\pm}3.64$). Any other significant change in depression or distress thermometer score was not observed. Especially, difference of HADS score between the distress and none-distress groups was significant in preoperative state and post-operative state, but the difference become not significant in the short-term hypothyroidism state. Conclusions : Induced thyroid hormone deficiency during cancer treatment does not significantly affect emotional distress in patient with DTC. Anxiety and depression in these patients may be associated with distress of the patient before active cancer treatment.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.129-135
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• 2017

Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.57-69
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• 1997

Objective：At the present time in Korea, for a considerable proportion of children and adolescent, delinquent behavior and violence has become as a way of life in their lives and a major social problem issue as well. The contributing factors to this problem were assumed to be the negative interaction between family environment and character of adolescent. The purpose of this study is to search the relationship between these constructs and juvenile delinquency. Method：Data were collected through questionnaire survey over a period of 2 months. Subjects served for this study consisted of 1,863 adolescents including 657 delinquent adolescents and 1,206 student adolescents in Korea, sampled from Korean student population and delinquent adolescent population confined in juvenile corrective institutions, using proportional stratified random sampling method. Their age ranged between 12 and 18 years. Data were analysed by IBM PC using SAS program. Statistical methods employed were Chi-square and principal component analysis. Results：The results of this study were as follows：Inconsistency by parental child rearing patterns tended to affect delinquent behavior among delinquent adolescents. On the other hand, adolescent students were consistently reared by their parent with democratic, flexible, trusting their children and reward-oriented attitudes. In comparison of both parents in the degree of influence on their children, it was revealed that paternal child rearing pattern was more influential on their children’s behaviors than maternal’s. The psychological instability of family, disharmonious parent-child relationships tended to be contributing to delinquent behavior among delinquent adolescents. Especially, It was an interesting finding that student’s mother is the higher employed than delinquent’s mother. However working mother was more prevalent in the student’ adolescents than in student adolescents in previous studies. The delinquent adolescents have more depressive trend, more complaints of psychosomatic symptoms, the higher degree of need frustration, the more maladaptive and antisocial personality pattern than student adolescents. Conclusion：Recently, many studies on association between family factor, character of adolescent and juvenile delinquent behavior have produced relatively consistent results. This study showed that family environment and character trait of adolescent also were linked with delinquent behavior such as smoking, drinking, runaway and physical assaults etc. The results of this survey may provide impetus for future speculation and study of correlation or reciprocal interaction between family factor, character trait of adolescent and delinquent behavior during adolescence and beyond.

• Journal of agricultural medicine and community health
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• v.39 no.4
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• pp.209-221
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• 2014

Objectives: The objective of this study was to identify the effects of area-based health promotion initiatives with community participation and partnerships conducted in Sabong-Myeon, Jinju City for three years. Methods: We used data from the '2008 Sabong-Myeon Health Survey' and the '2011 Health Plus Happiness Plus Community Health Survey'. The study comprised 520 systematically sampled individuals, composed of 300 adults in 2008 and 200 adults in 2011. We compared some health behavior and mental health indicators as well as social capital levels between these two surveys. Results: The prevalences of smoking and walking exercise in 2011 were significantly higher than those in 2008. The prevalences of high risk alcohol consumption in men, stress perception, depressive symptoms experience, and suicide ideation were significantly lower than those in 2008. The proportion of people having a high level of social capital in 2011 was significantly higher than that in 2008, regardless of sex or marital status. However, the difference in the proportion was not statistically significant among people with a high educational background. Conclusions: This study suggested that the 3 years' implementation of area-based health promotion initiatives conducted in Sabong-Myeon might help to improve the mental health and social capital level of this community. The long-term health effects of area-based health promotion initiatives with community participation and partnerships need to be studied further, and lessons from these initiatives can be obtained by adapting proper evaluation methods.