• Journal of Oriental Neuropsychiatry
• /
• v.31 no.3
• /
• pp.213-223
• /
• 2020

Objectives: To determine treatment effects of a combination of interpersonal and social rhythm therapy and Korean medicine for a patient with major depressive episode of bipolar II disorder. Methods: A patient was treated with Korean medicine (acupuncture, herbal medicine, etc.) and interpersonal and social rhythm therapy (IPSRT) for four months. Pattern identification for depressive mood and sleep associated symptoms was evaluated using Patient Health Questionnaire-9 (PHQ-9) and Social rhythm metric II-5 (SRM II-5). Results: At the end of the treatment, depression and delayed sleep symptoms were improved and social rhythm was recovered to the regular range. The patient acquired an insight to his interpersonal tensions and conflicts. Conclusions: Korean medicine in combination with interpersonal and social rhythm therapy can be used to treat patients with major depressive episode of bipolar II disorder. More cases are needed to develop guidelines for treating bipolar disorder.

• Korean Journal of Biological Psychiatry
• /
• v.9 no.2
• /
• pp.103-111
• /
• 2002

Neurocognitive research focusing on cognitive deficits in Depression has resulted in several important but yet potentially contradictory findings. Much literature documents the presence of significant neurocognitive impairments in depressive patients. Studies have shown that dysthymic disorder patients demonstrate a diffuse pattern of cognitive impairment which is frequently indistinguishable from that of focal braindamaged patients. Some reports have suggested that there is a focal pattern of deficit, such as anterior cingulate dysfunction, frontal lobe impairment, or dysfunction of the temporal-limbic cortex. The aim of this study is to evaluate the neurocognitive functions in dysthymic disorder patients, and to compare the functions with those of major depressive disorder patients. The subjects are 17 dysthymic disorder patients. And their neurocognitive functions are compared with those of 23 major depressive episode patients. Patients with a history of neurologic disease, alcohol dependence, substance abuse and mental retardation are excluded. They are assessed with a part of Vienna Test System which is computerized neurocognitive function tests and can evaluate attention, eductive ability, reproductive ability, visuoperceptual analysis, vigilance, visual immediate memory, the speed of information-processing, judgement, and fine motor coordinations. There are no other specific difference between two groups, except the result of cognitrone test. This study provides information about the neurocognitive functions and some difference between major depressive disorder patients and carefully diagnosed dysthymic disorder patients.

• Psychiatry investigation
• /
• v.15 no.12
• /
• pp.1188-1202
• /
• 2018

Objective This study protocol aims to determine, using a rigorous approach in patients with bipolar disorder (BD) and non-seasonal major depressive episode (MDE), the characteristics of bright light therapy (BLT) administration (duration, escalation, morning and mid-day exposures) depending on the tolerance (hypomanic symptoms). Methods Patients with BD I or II and treated by a mood stabilizer are eligible. After 1 week of placebo, patients are randomized between either morning or mid-day exposure for 10 weeks of active BLT with glasses using a dose escalation at 7.5, 10, 15, 30 and 45 minutes/day. A further follow-up visit is planned 6 months after inclusion. Patients will be included by cohorts of 3, with at least 3 days of delay between them, and 1 week between cohorts. If none meet a dose limiting toxicity (DLT; i.e hypomanic symptoms), the initiation dose of the next cohort will be increased. If one patient meet a DLT, an additionnal cohort will start at the same dose. If 2 or 3 patients meet a DLT, from the same cohort or from two cohorts at the same dose initiation, the maximum tolerated dose is defined. This dose escalation will also take into account DLTs observed during the intra-subject escalation on previous cohorts, with a "Target Ceiling Dose" defined if 2 DLTs occured at a dose. Discussion Using an innovative and more ergonomic device in the form of glasses, this study aims to better codify the use of BLT in BD to ensure a good initiation and tolerance.

• Korean Journal of Biological Psychiatry
• /
• v.15 no.2
• /
• pp.92-100
• /
• 2008

Objectives : The purpose of this study was to investigate 1) the neuropsychological deficits with major depressive disorder(MDD) in depressed state and 2) the changes of neuropsychological dysfunctions during depressed episodes and remitted periods in the MDD group. Methods : 12 patients with MDD and 70 normal controls who were diagnosed and classified by DSM-IV and SCID-IV interview participated in this study. The psychopathology was measured using the Hamilton rating scale for depression(HAM-D) and Brief Psychiatric Rating Scale(BPRS). The memory function, executive function, and sustained attention were measured by a trained psychologist using the Korean version of Memory Assessment Scale(K-MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone (COG) in Vienna Test System. After 6 weeks of treatment, we retested the cognitive tests in order to measure the cognitive functions in remitted states. Results : Patients with MDD achieved significantly lower score in sentence immediately recall, verbal memory score and total memory score of the K-MAS, total errors of the WCST, response time of Vigilance and response time at "Yes" response of Cognitrone than normal controls at baseline. After 6 weeks of medication, the psychiatric symptoms in the patient group were attenuated, and most of the neuropsychological functions including attention, memory, and frontal/executive function were improved except for response time of Cognitrone. Conclusions : This study provides evidence for distinct neuropsychological deficits in patients with MDD on their depressed states and remitted periods. The impairment on response time remains after remission, and this would be a trait marker of major depressive disorder.

• Korean Journal of Biological Psychiatry
• /
• v.16 no.3
• /
• pp.205-211
• /
• 2009

Objectives : Serum and plasma BDNF levels have been shown to be decreased in patients with mood disorder such as major depressive disorder and bipolar disorder. We investigated whether platelet BDNF levels would be lower in patients with acute bipolar manic episode compared with those of normal controls. Methods : BDNF levels were examined in platelet-rich plasma(PRP) and platelet-poor plasma(PPP) in 20 healthy controls and 20 hospitalized patients who were diagnosed as bipolar I disorder, most recent episode manic using a Structured Clinical Interview for DSM-IV. And severity of manic symptoms was measured using Young Mania Rating Scale(YMRS). Platelet BDNF level was calculated by subtracting PPP BDNF from PRP BDNF level, and dividing the result by the total platelet count, and it was expressed as pg/$10^6$ platelet. Results : Platelet BDNF levels were significantly lower in patients with acute bipolar manic episode(4.55${\pm}$3.36pg/$10^6$ platelet) than in normal controls(6.84${\pm}$2.32pg/$10^6$ platelet)(p=0.008). However we failed to reveal the significant negative correlation between platelet BDNF levels and YMRS scores in patients with acute bipolar episode. Conclusion : Our finding suggests that there is a decrease in the platelet BDNF of patients with acute bipolar manic episode.

• Anxiety and mood
• /
• v.6 no.2
• /
• pp.119-124
• /
• 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
• /
• v.7 no.1
• /
• pp.9-15
• /
• 2011

Objectives : We examined the reliability and validity of the Korean version of the Depression and Somatic Symptom Scale (DSSS) in Korean patients with depressive symptoms. Methods : Participants were 55 outpatients diagnosed with major depressive disorder, a depressive episode of bipolar I disorder, somatoform disorder, panic disorder, generalized anxiety disorder, or post-traumatic stress disorder according to the DSM-IV criteria. We assessed them using the Korean versions of the DSSS, Hamilton Depression Rating Scale (HDRS), and Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR). Results : The Korean version DSSS had a Cronbach's alpha of 0.90. Moreover, each item's correlation with the total score was statistically significant (r=0.24-0.71, p<0.01). The test-retest correlation coefficient (r=0.83, p<0.01) was relatively high, and the DSSS correlations with the HDRS and QIDS-SR were 0.77 and 0.74, respectively. Conclusion : These results demonstrate that the Korean version of the DSSS could be a reliable and valid tool for screening and assessing depressive patients. The Korean version of the DSSS will be a useful tool for screening both depressive and somatic symptoms in Korea.

• The Korean Journal of Applied Statistics
• /
• v.27 no.2
• /
• pp.317-330
• /
• 2014

Bipolar disorder is a psychopathy characterized by manic and major depressive episodes. It is important to determine the degree of depression when treating patients with bipolar disorder because 810% of bipolar patients commit suicide during the periods in which they experience major depressive episodes. The Hamilton depression rating scale is most commonly used to estimate the degree of depression in a patient. This paper proposes using the Hamilton depression rating scale to estimate the effectiveness of patient treatment based on the linear mixed effects model and the transition model. Study subjects were recruited from the Seoul National University Bundang Hospital who scored 8 points or above in the Hamilton depression rating scale on their first medical examination. The linear mixed effects model and the transition model were fitted using the Hamilton depression rating scales measured at the baseline, six month, and twelve month follow-ups. Then, Hamilton depression rating scale at the twenty-four month follow-up was predicted using these models. The prediction models were then evaluated by comparing the observed and predicted Hamilton depression rating scales on the twenty-four month follow-up.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.11 no.2
• /
• pp.209-220
• /
• 2000

The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

• Bioinformatics and Biosystems
• /
• v.1 no.2
• /
• pp.134-138
• /
• 2006

Depression is the most common and widespread mood disorder. About 20% of the population might suffer a major, incapacitating episode of depression during their lifetime. This disorder can be classified into two types: major depressive disorders and bipolar disorder. Since pharmaceutical treatments are different according to types of depression disorders, correct and fast classification is quite critical for depression patients. Yet, classical statistical method, such as minnesota multiphasic personality inventory (MMPI), have some difficulties in applying to depression patients, because the patients suffer from concentration. We used electroencephalogram (EEG) analysis method fer classification of depression. We extracted nonlinearity of information flows between channels and estimated approximate entropy (ApEn) for the EEG at each channel. Using these attributes, we applied two types of data mining classification methods: decision tree and possibilistic support vector machines (PSVM). We found that decision tree showed 85.19% accuracy and PSVM exhibited 77.78% accuracy for classification of depression, 30 patients with major depressive disorder and 24 patients having bipolar disorder.