• Mood & Emotion
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• v.16 no.3
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• pp.109-122
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• 2018

Objectives : The objective of this study was to revise the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) 2014: Children and Adolescents. Methods : We performed the survey, using a questionnaire comprising 22 questions according to each situation, in children and adolescents with bipolar disorder. Results : First-line pharmacotherapeutic strategies for manic episode in children with bipolar disorder were a combination of mood stabilizer (MS) and an atypical antipsychotics (AAP), monotherapy with an AAP, risperidone, and aripiprazole. Aripiprazole was selected as first-line medication for depressive episode in children with bipolar disorder, and aripiprazole, and risperidone were selected as first-line at high-risk children. First-line pharmacotherapeutic strategies for manic episode in adolescents were a combination of MS and an AAP, monotherapy with an AAP valproate, lithium, risperidone (Treatment of Choice, TOC), aripiprazole, and quetiapine. First-line pharmacotherapeutic strategies for depressive episode in adolescents, were a combination of an atypical antipsychotics and lamotrigine, valproate, aripiprazole (TOC), risperidone, and quetiapine. For depressive episodes in adolescents at high risk for bipolar disorder, valproate, aripiprazole (TOC), and risperidone were selected as first-line medication. Conclusion : We expect that the present KMAP-BP 2018-children and adolescents, is useful for clinicians to treat children and adolescents with bipolar disorder.

• Mood & Emotion
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• v.16 no.3
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• pp.140-151
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• 2018

Objectives : The purpose of this study was to examine effects of adjunctive aripiprazole versus bupropion, on depressive symptoms of female depression. Methods : Sixty six female patients with major depressive disorders were enrolled from a six-week, randomized prospective open-label multi-center study. Participants were randomized to receive aripiprazole (2.5-10 mg/day) or bupropion (150-300 mg/day). Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale (HAM-D17), Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores, and Clinical Global Impression-Severity (CGI-S) were obtained at baseline and after one, two, four, and six weeks. Changes on individual items of HAM-D17 were assessed as well as on composite scales (anxiety, insomnia and drive), and on four core subscales that capture core depression symptoms. Results : Overall, both treatments improved depressive symptoms, without causing serious adverse events. There were significant differences in the HAM-D17 total score (p=0.046) and CGI-S (p=0.004), between aripiprazole and bupropion augmentation, favoring aripiprazole over bupropion. Aripiprazole revealed significantly greater effect size in depressed mood (p=0.006), retardation (p=0.005), anxiety psychic (p=0.032), and general somatic symptom (p=0.01). Conclusion : While both treatments were effective, results of this study suggested that aripiprazole may be preferable, in treating general and core symptoms of female depression.

• Journal of Oriental Neuropsychiatry
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• v.16 no.2
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• pp.233-242
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• 2005

'Ul-zeong' comes from obsturction of qi by stress. The mind affect the body. The patient has depressed mood, irritable sign, chest discomfort, costral pain, angry state or some strange feeling on the throat. $'Y{\acute{i}}q{\acute{i}}ngbi{\grave{a}}nq{\grave{i}}'$ is a psychological therapy that a doctor changes the patient ' s psychological condition by using various method. 'yi' means moving, 'qing' means changing. Art therapy means a therapy by using artistic activities and included in $'y{\acute{i}}q{\acute{i}}ngbi{\grave{a}}nq{\grave{i}}'$ In this case, a female patient, 35 years old, who suffered from 'ul-zeong' with depressed mood, anxiety, general body weakness, anorexia, constipation. We used $'y{\acute{i}}q{\acute{i}}ngbi{\grave{a}}nq{\grave{i}}'$ besides herbal medication, acupuncture to her and her condition got improved. Therefore we reported it for the treatment.

• Journal of Oriental Neuropsychiatry
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• v.17 no.2
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• pp.187-198
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• 2006

Bibliotherapy is the field of clinical counceling to treat the emotional, psychiatric and social maladjustment. Neurofeedback is a means by which participants can team voluntary control of the EEG and has been applied to a range of clinical conditions such as epilepsy, attention deficit hyperactivity disorder, depressive disorder. 'Ul-zeong' comes from obstruction of qi by stress. The mind affect the body. The patient has depressed mood, irritable sign, chest discomfort, flank pain, angry state and some strange feeling on the throat. In this case, a female patient, 30 years old, who complained of amnesia, deficiency of the power of the attention and concentration depersonalization, depressed mood, insomnia ect. We treated the patient with bibliotherapy, neurofeedback and oriental medical treatment such as heral medicine, acupuncture treatment and aroma therapy. In result, the symptoms which she complained were improved.

• Korean Journal of Biological Psychiatry
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• v.21 no.1
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• pp.14-20
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• 2014

Objectives The current study investigated the putative relationship between chronotype and suicidality or bipolarity in patients with major depressive disorder (MDD). Method Nineteen outpatients who met the criteria for MDD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision were recruited for the current study. The subjects were divided into two subgroups based on their Basic Language Morningness (BALM) scores (dichotomized according to the median BALM score). The Loudness Dependence of Auditory Evoked Potentials (LDAEP) was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents. In addition, K-Mood Disorder Questionaire (K-MDQ), Beck Scale for Suicidal Ideation (BSS), Beck Hopelessness Scale (BHS), Barratt Impulsiveness Scale (BIS) were applied. Results The K-MDQ, BSS, BHS, BIS score was higher for the eveningness group than for the morningness group. However, the LDAEP, Hamilton Depression Rating Scale, Hamilton Anxiety Scale scores did not differ significantly between them. There were negative correlations between the total BALM score and the total K-MDQ, BSS, and BHS scores (r=-0.64 and p=0.0033, r=-0.61 and p=0.0055, and r=-0.72 and p=0.00056, respectively). Conclusions Depressed patients with eveningness are more vulnerable to the suicidality than those with morningness. Eveningness is also associated with bipolarity.

• Anxiety and mood
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• v.3 no.1
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• pp.32-40
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• 2007

Objectives : To investigate the validity of an abbreviated self-rated Korean version of MINI (Mini International Neuropsychiatric Interview) patient health survey which screening social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder. Methods : 115 subjects completed MINI and MINI patient health survey. The validity of MINI patient health survey was assessed by whether the results from MINI patient health survey were compatible with the results from MINI or not. The Cohen's kappa value, specificity, sensitivity, positive predictive value, and negative predictive value was calculated for this purpose. Results : The Kappa values of social anxiety disorder (0.60), panic disorder (0.49), generalized anxiety disorder (0.60) and major depressive disorder without other co-morbid disorder (0.59) were at least moderate in strength of agreement. Conclusion : The abbreviated self-rated Korean version of MINI patient health survey has the moderate to good validity in social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder without other co-morbid disorders. Our result suggests that this instrument might be useful for screening above 4 disorders if it is used under careful supervision of experienced clinicians.

• Anxiety and mood
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• v.16 no.2
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• pp.76-82
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• 2020

Objective : Previous studies have shown that depression, anxiety and embitterment are highly related to suicide. This study aims to investigate the mediating effect of embitterment between depression, anxiety and suicide. Methods : A total of 174 participants with depressive and anxiety disorders were evaluated with STAI-S, STAI-T, PHQ-9, PTED scale, SSI and suicide attempt history. A mediation analysis using bootstrapping was utilized in order to estimate the indirect effects of depression and anxiety on suicide through embitterment. Results : Embitterment significantly mediated the relationship between depression and suicidal ideation [b=0.291, 95% CI(0.18, 0.40)], and also it mediated the relationship between depression and suicide attempt [b=0.066, 95% CI(0.02, 0.16)]. Although a direct effect of anxiety on suicide attempt was not significant, but embitterment significantly mediated the relationship between anxiety and suicide attempt Conclusion : This suggests that embitterment may be a significant important factor to consider in the relationship between depression, anxiety and suicide. Understanding the mediating role of embitterment on suicide may helpful to prevent suicide.

• Mood & Emotion
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• v.15 no.3
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• pp.117-122
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• 2017

Objectives : Early life stress (ELS) may have impact on functions of the autonomic nervous system. Heart rate variability (HRV) is a reliable psychophysiological marker for functions of the autonomic nervous system. The purpose of this study was to investigate characteristics of HRV associated with ELS in patients with major depressive disorder (MDD). Methods : We compared HRV measures of MDD patients with ELS and without ELS in a 5-minute resting-state electrocardiogram recoding. Forty subjects participated in the study (25 with ELS, 15 without ELS). The Mann-Whitney test was conducted to identify group differences. Results : We found significant group differences in standard deviation of the NN interval (SDNN) and total power (TP). SDNN was lower in the ELS group (M=38.80 ms, SD=13.05 ms) than in the Non-ELS group (M=53.53 ms, SD=19.47 ms). TP was lower in the ELS group ($M=7.07ms^2$, $SD=0.69ms^2$) than in the Non-ELS group ($M=7.72ms^2$, $SD=0.77ms^2$). Conclusion : ELS may have a negative impact on the autonomic nervous system function in patients with MDD. ELS and dysfunction of autonomic nervous system should be considered in treatment for patients with MDD.

• Anxiety and mood
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• v.17 no.2
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• pp.84-91
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• 2021

Objective : Mismatch negativity (MMN) is known to reflect several abnormalities of cognitive functioning. This study is aimed to investigate the differences in MMN among major depressive disorder (MDD) patients with or without suicidal ideation. Methods : Sixty-seven patients with MDD were recruited into this study. MMN was measured by a 64-channel electroencephalography (EEG) using oddball paradigm over the front-central area. Clinical characteristics were assessed using the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II), and the Beck Scale for Suicide ideation (SSI-BECK). Patients were divided into two groups, no suicidal ideation (N=12) and suicidal ideation (N=55), depending on the presence of suicide ideation in SSI-BECK questionnaires. Results : The MMN latencies were significantly longer in the MDD patients with suicidal ideation than in the MDD patents without suicidal ideation (p<0.05). The MMN amplitudes were not significantly different between the two groups. Conclusion : Suicidal ideation may be associated with longer MMN latencies, and it suggests that MMN may play a potential role in assessing the suicidal risk among MDD patients.

• Anxiety and mood
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• v.15 no.1
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• pp.20-28
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• 2019

Objective : The purpose of this study was to compare and analyze effectiveness of various psychotherapies of depressive symptoms in patients with anxiety disorders by means of a systemic review. Methods : A systematic search using key words was conducted using EMBASE, MEDLINE and CENTRAL. Results : Five studies were included in this systematic review. The Scottish Intercollegiate Guidelines Network (SIGN) was used for quality assessment. Diagnostic-specific cognitive behavioral therapies for various anxiety disorders (ds CBT) were also effective in reducing comorbid depression. Transdiagnostic cognitive behavioral therapies targeting anxiety and depression (tCBT-AD) were not superior than ds CBT for anxiety disorders. Mindfulness-based stress reduction (MBSR) was more effective than traditional cognitive behavioral therapy. Conclusion : ds CBT relieves anxiety symptoms as well as depressive symptoms comorbid with anxiety disorders effectively. In addition, MBSR is more successful for anxiety disorders with co-occurring depression by focusing broadly on the shifting relationship to internal experience rather than focusing narrowly on specific symptoms.