• Journal of Oriental Neuropsychiatry
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• v.35 no.3
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• pp.315-331
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• 2024

Objectives: To report the effectiveness of a comprehensive Korean medical approach, incorporating acupuncture, herbal medicine, Chuna therapy, and traditional Korean psychotherapy, in the management of a patient with cerebellar ataxia and major depressive disorder. Methods: A 45-year-old female patient diagnosed with cerebellar ataxia and major depressive disorder received a comprehensive Korean medicine treatment, including acupuncture, moxibustion, herbal medicine, Chuna therapy, and traditional Korean psychotherapy such as Giungoroen therapy, IiGyeungByunQi therapy, M&L therapy, and Emotional Freedom Technique (EFT). The efficacy was assessed through both subjective symptom reports and a range of psychological assessment tools, including the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Korean Symptom Checklist-95 (KSCL-95), Korean Beck Depression Inventory-II (K-BDI-II), Spielberger's State-Trait Anxiety Inventory XYZ form (STAI-XYZ), Korean version of the State-Trait Anger Expression Inventory (STAXI-K), Padua Inventory-Washington State University Revision (PI-WSUR), Penn State Worry Questionnaire (PSWQ), and the Korean Version of the Insomnia Severity Index (ISI-K). Results: Throughout treatment, the patient experienced marked improvements in physical symptoms, notably dizziness, and gait instability. Psychological evaluations demonstrated significant reductions in anxiety, depression, and insomnia. The overall quality of life was enhanced, with sustained benefits observed during follow-up assessments. Conclusions: This case suggests that a comprehensive Korean medicine approach that integrates acupuncture, herbal medicine, Chuna therapy, and traditional Korean psychotherapy may be effective in alleviating both physical and psychological symptoms associated with cerebellar ataxia and major depressive disorder.

• Journal of Oriental Neuropsychiatry
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• v.35 no.3
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• pp.247-256
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• 2024

Objectives: To examine effect of Korean medical treatment on child and adolescent patients with depressive disorder and correlations among changes in anxiety and anger psychological scales before and after treatment. Methods: Medical records of 28 adolescent and 9 child patients diagnosed with depressive disorder based on Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) who received Korean medical treatment (herbal-medication, acupuncture, Korean psychotherapy, and so on) for at least 8 weeks were retrospectively reviewed. Psychological scales including Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), State-Trait Anger Expression Inventory (STAXI), Children's Depression Inventory (CDI), State Anxiety Inventory for Children (SAIC), Trait Anxiety Inventory for Children (TAIC), and Children's Inventory of Anger (ChIA) were measured every four weeks and analyzed. Results: After eight weeks of treatment, STAI-X-1 (State Anxiety), STAI-X-2 (Trait Anxiety), BDI-2, BAI, STAXI-S (State Anger), AXI-K-I (Anger Expression-In) and AXI-K-O (Anger Expression-Out) showed statistically significant decreases in adolescent patients. In child patients, ChIA was significantly improved after eight weeks. For psychological scale pairs in adolescent patients, BDI-2 and STAI-X-1·STAI-X-2·BAI·STAXI-S·AXI-K-I, STAIX-T and STAXI-S·AXI-K-I showed significant positive correlations whereas AXI-K-O and AXI-K-C showed a negative correlation. In child paitents, there was a significant positive correlation for all psychological scales except for the relationship between SAIC and ChIA. In adolescent patients, low pretreatment BDI-2 predicted BAI, STAXI-S, and AXI-K-I score reduction after 8 weeks. Lower BAI scores significantly decreased STAI-X-2 and BDI-2 scores after 8 weeks but increased AXI-K-C. In child paitents, low pretreatment ChIA scores predicted a decrease in CDI score after treatment. Conclusions: Korean medical treatments including herbal medicine, acupuncture, and Korean psychotherapy were effective in improving depressive disorder and accompanying symptoms such as anxiety and anger of child and adolescent patients.

• Anxiety and mood
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• v.6 no.2
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• pp.119-124
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• 2010

Objective : The reliability and validity of the Korean version of the Patient Health Questionnaire-9 (PHQ- 9) was examined in Korean patients with depressive symptoms. Methods : Eighty six outpatients diagnosed as major depressive disorder or depressive episode of bipolar I disorder according to the DSM-IV criteria were assessed with the PHQ-9, Hamilton Depression Rating Scale (HDRS), the Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR), and the Center for Epidemiologic Studies Depression Scale (CES-D). Results : The Cronbach's alpha coefficient from the PHQ-9 was 0.81. And the correlations of each item with the total score were statistically significant (r=0.28-0.70, p<0.01). The test-retest correlation coefficient (r=0.89, p<0.01) was relatively high and correlations of the PHQ-9 with the HDRS, QIDS-SR and CES-D were 0.70, 0.81, and 0.81 respectively. Conclusion : These results demonstrated that the Korean version of PHQ-9 could be a reliable and valid tool for the screening and assessment of depressive patients. The Korean version of PHQ-9 will be a useful tool for screening depressive symptoms in Korea.

• Anxiety and mood
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• v.9 no.2
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• pp.140-146
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• 2013

Objective : There have been few comprehensive studies on the analysis of 24-hour HRV of major depressive disorder (MDD). The purpose of this study was to compare the autonomic nerve system of patients with a MDD with healthy patients and to examine the physiologic and clinical effects of 24-hour HRV by analyzing whether the HRV demonstrates the level of depressive symptoms after improving the symptoms in patients with a MDD. Methods : The 24-hour HRV was measured in patient groups with a MDD (n=16) and control groups (n=16). The patients with a MDD received the follow up test for two months after the treatment. Results : There were significant differences among the indexes (SDNN, rMSSD, SDNN index, and pNN50) of time-domain analysis and the indexes (TP, VLF, LF, HF, and ULF) of frequency-domain analysis of HRV between patient and control groups. The means of RR, SDNN, SDANN, and TP increased after two month of the treatment, comparing them with before the treatment, but there were no statistical significance. Conclusion : The results of 24-hour HRV analysis indicated significant decrease of HRV indexes among MDD patients which may suggest decrease of parasympathetic nervous functions.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2039-2043
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• 2012

Objectives: Depression is common in cancer patients. However, only limited evidence is available for Asian populations. The authors therefore examine the prevalence of depression in Thai patients with cancer. In addition, associated factors were determined. Methods: This cross-sectional study was conducted in cancer patients admitted to a university hospital during December 2006 - December 2007. The Patient Health Questionnaire (PHQ-9) was used to assess all cancer patients. Suicidal risk was assessed by using the Mini-International Neuropsychiatric Interview (MINI) in the module of suicidal risk assessment. Results: Of 108 cancer patients, 29.6 % were diagnosed with a depressive disorder (mild, 14.8 %; moderate, 5.6 %; severe, 9.3 %). However, only 25.0 % of these were recognized as being depressed by the primary physician. According to the MINI., 28.1 % of these depressed cancer patients had a moderate to severe level of suicidal risk. In addition, the findings suggest that increased risk of depression is significantly associated with increased pain score, lower number of cancer treatments (< 2 methods), increased educational duration (>13 years), increased age (> 50 years old) and being female. Conclusions: The prevalence of depression is high in Thai cancer patients. However, depressive disorder in those patients is frequently undiagnosed. It is associated with several factors including pain, a number of cancer treatments, education duration, age and sex. To improve quality of life, increase compliance with treatments and prevent of suicide, screening for depressive disorders in this patient group is strongly recommended.

• YAKHAK HOEJI
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• v.57 no.2
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• pp.101-109
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• 2013

Depressive disorders are the most common psychiatric problem in the elderly. Most depression treatment guidelines emphasize treatment with antidepressant medication and recommend that benzodiazepine use be minimized for limited period, particularly to elderly patients. In order to evaluate appropriate use of antidepressants and benzodiazepine, retrospective review of prescriptions was performed. The study population are older than 65 years who had been newly diagnosed with major depressive disorder in specialty mental health at a community general hospital from January $1^{st}$, 2007 to October $31^{th}$, 2012 (N=373). Initial antidepressant accounted for 89.5% with SSRI, and escitalopram accounted for 60.9% of SSRI group. 79% or more of the patients were prescribed the recommended dosage. The maintenance rate for 4 weeks of initial antidepressant was 48% and 6 weeks was 39%. Treatment-discontinuation rate was 68% at 3 month. Alprazolam (short acting benzodiazepine) was prescribed the most, followed by clonazepam (long acting benzodiazepine) and then diazepam. 55% of patients received a duplicated prescription for short acting plus long acting benzodiazepine. 61% of patients used long acting benzodiazepines. Prescribed dosages of benzodiazepines were commonly within a recommended range, while no one was prescribed a appropriate period (up to 2 weeks) except for the early discontinued patients. Appropriate use of zolpidem was only 16.2%. The depressed elderly treated in specialty mental health mostly received long-term treatment with benzodiazepines in combination with antidepressants, guideline recommendations was not followed. Multidisciplinary interventions like audit and feedback of benzodiazepine use are needed and education for the elderly is needed to properly maintain antidepressant treatment.

• Psychiatry investigation
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• v.15 no.11
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• pp.1009-1010
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• 2018

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.46-50
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• 1996

This study was designed to examine the basal cyclic AMP levels and the $10^{-5}mol/L$ isoproterenol-stimulated cyclic AMP levels of lymphocytes, by which ${\beta}$-adrenoceptor function was shown, between to normal controls and 17 drug free patients(8 major depresive patients and 9 dysthymic patients), who were diagnosed by DSM-III-R. The severity of depression was assessed by Hamilton Rating Scale for Depression (HDRS). Cyclic AMP levels were measured by radioimmunoassay(double antibody). The results were as follows ; 1) HDRS score was significantly higher in major depressive patients($41.8{\pm}4.6$) than in dysthymic patients($24.0{\pm}4.2$)(p<005). 2) There was no Significant difference in basal cyclic AMP levels among normal controls($3.9{\pm}1.7pmol/10^6cells/10min$), major depressive patients($2.1{\pm}0.5pmol/10^6cells/10min$), and dysthymic patients($3.9{\pm}1.8pmol/10^6cells/10min$). 3) There was significant difference in net cyclic AMP levels($10^{-5}mol/L$ isoproterenol-stimulated cyclic AMP levels minus basal cyclic AMP levels) among normal controls($16.5{\pm}6.0pmol/10^6cells/10min$), major depressive patients($3.0{\pm}1.4pmol/10^6cells/10min$), dysthymic patients($10.9{\pm}4.4pmol/10^6cells/10min$)(p <005). 4) The net cyclic AMP levels were significantly correlated with HDRS scores in major depressive patients(${\gamma}=-0.8^6$, p<0.05), but not in dysthymic patients(${\gamma}=0.43$, p=0.25). In conclusion, we suggested that the dysthymic disorder might differ from the molar depressive disorder not only in the severity of depressive symptoms but also in ${\beta}$-adrenergic responsiveness of lymphocytes, which was regarded as a biological marker of depressive disorder.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.2
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• pp.201-211
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• 2000

Objectives : The purpose of this study was to determine the validity and reliablity of the Korean version of the Global Assessment of Recent Stress(GARS) Scale developed for assessing the severity of current perceived stressors, and then to use the scale in clinical practice. Methods : The questionnaire was completed by 215 healthy subjects. A comparison was made regarding the perception of stressors among 242 patients(71 with anxiety disorder, 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Factor analysis was done using oblique rotation after maximum-likelihood factor analysis. Results : Factor analysis yielded 1 subscale. Reliability was computed by administering the GARS Scale to 69 healthy subjects during a 2-week interval. Test-retest reliability for 8 items and the total score was significantly high, ranging between 0.85-.95. Internal consistency was significant(Cronbach's a for 7 items : .86). Convergent validity was computed by correlating the 8 items and the total score with the total score of the stress response inventory(SRI), the perceived stress questionnaire(PSQ), and the somatization, anxiety, depression, hostility subscales and general indices of the symptom checklist-90-revised(SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the 8 item scores of the patient and control groups. Significant differences were found in area relevant to sickness or illness and the overill global area. The patients with anxiety disorder were significantly higher in area relevant to sickness or illness than the healthy group, whereas the patients with depressive disorder was significantly higher in the overall global score than healthy group. The depressive disorder group was the highest in overall global score of the GARS scale among 4 patient groups, and showed a significant higher scores in interpersonal relationship and overall global area than the psychosomatic disorder group. Conclusions : These results indicate that the Korean version of the GARS scale is highly reliable and valid, and that it can be utilized as an effective measure of perceived stressors for research in stress-related fields. It is suggested that depressive disorder patients are more likely to perceive recent stressors than psychosomatic disorder patients.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.174-183
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• 2016

Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.