• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.26-35
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• 2015

Objectives:The purpose of this study was to evaluate reliability and validity of the Korean version of the Postconcussional Syndrome Questionnaire(KPCSQ) which was originally developed in 1992 by Lees-Haley. Methods:Patients with traumatic brain injury were recruited from April 2009 to December 2011 from the Korean University Ansan Hospital. We selected patients that met the ICD-10 diagnostic criteria of postconcussional syndrome and organic mental disorder including organic mood disorder, organic emotionally labile disorder, organic anxiety disorder and organic personality disorder. The KPCSQ, Trait and State Anxiety Inventory(STAI-I, II), and Center for Epidemiologic Studies Depression Scale(CESD) were administered to all subjects. Factor analysis of the items were performed and test-retest correlation were evaluated. Internal consistency of the KPCSQ and its subscales was assessed with Cronbach's alpha. External validity of the KPCSQ were examined by correlation coefficient with the STAI-I, II, and CESD. Results:The Cronbach's alpha coefficient of the total PCSQ was 0.956. The test-retest reliability coefficient was 0.845. The PCSQ showed significant correlation with STAI-I, II and CESD. The factor analysis of the PCSQ yielded 4 factors model. Factor 1 represented 'affective and cognitive symptoms', factor 2 represented 'somatic symptoms', factor 3 represented 'infrequent symptoms' and factor 4 represented 'exaggeration or inattentive response'. There was no significant difference between the PCS group and the organic mental disorder group in the score on each measure. The scores on KPCSQ and its subscales in the subjects that had scored 5 or more in 'exaggeration or inattentive response' are significantly higher than those in the subjects had scored 4 in 'exaggeration or inattentive response'. Conclusions:This study suggests that the Korean version of PCSQ is a valid and reliable tool for assessing psychiatric symptomatology of patients with traumatic brain injury. Further investigations with greater numbers of subjects are necessary to assess the clinical usefulness of the KPCSQ.

• Anxiety and mood
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• v.3 no.1
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• pp.41-45
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• 2007

Objective : The present study investigates patterns of consumption of alcohol, cigarettes, and over the counter drugs (OTC) in Korean patients with PTSD and psychiatric patient controls and healthy controls from multicenter hospital samples. Method : Data were collected from 18 hospitals nationwide. Patients with PTSD were compared with nonpsychotic psychiatric disorders control and healthy control subjects on psychometric measures of consumption of alcohol, cigarettes, and OTC drugs. Result : Ninety-three patients with PTSD, 73 patients with psychiatric disorders control, and 88 healthy control subjects were enrolled. There were significant differences in the frequency of alcohol drinking among the three groups ($X^2$=12.93, df=6, p=0.044). Only 3.2% of healthy control subjects drank alcohol more than 4 times a week, but 43.9% of PTSD group and 46.5% of mental disorder controls drank alcohol more than 4 times a week, respectively. Regarding cigarette smoking, there were no differences among the three groups. There were significant differences in uses of OTC drugs among the three groups; 16.7 % in the PTSD group, 14.9% in the psychiatric control group and 1.3% in the heath control group, respectively ($X^2$=11.31, df=2, p=0.004). Conclusion : In this study, patients with PTSD showed significant differences in the frequency of consumption of alcohol and OTC drugs, as compared with healthy controls. However, there were no differences between the PTSD and psychiatric patient control groups. Since all subjects were enrolled from hospital based sample, results may differ in the community samples. Further studies will be needed for the evaluation of substance uses in these groups.

• Anxiety and mood
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• v.3 no.2
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• pp.104-109
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• 2007

Objective : In the present study, we evaluated the differences between the skin electric conductance of patients with posttraumatic stress disorder (PTSD) and normal controls in order to determine the possibility of using skin electric conductance as a diagnostic measure. Method : The PTSD group included 14 subjects who were diagnosed with PTSD in St. Mary's Hospital after a motor vehicle accident, and the normal control group included 12 healthy subjects. The conductivity and capacitance of both groups were measured twice, and the data from each group was compared. Results : There was no significant difference in gender, but the patients in the PTSD group were significantly older than those in normal control group. The activity (conductivity) between the left head-left hand, right hand-right head, and right head-left head was significantly elevated in the PTSD group as compared with the normal control group. In addition, the reactivity (capacitance) between the right head-left head, left head-left hand, right hand-left hand, right hand-right foot, right foot-left foot, and left foot-left hand was significantly elevated in the PTSD group. Conclusion : In this study, the skin electric conductance of the patients with PTSD was significantly elevated in comparison with that of the healthy subjects. Although there were some limitations of this study, the results of this study suggested that skin electric conductance can be used to evaluate elevated psychophysiological responses in patients with PTSD. Future studies with more subjects and more structure are needed in order to confirm our results.

• Anxiety and mood
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• v.4 no.2
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• pp.142-147
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• 2008

Objective : Evidence from recent studies supports the role of genetic factors in the development of Posttraumatic Stress Disorder (PTSD). The primary aim of this study is to investigate the association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. The second aim is to examine the association between the DRD2 TaqI A polymorphism and clinical symptoms in patients with PTSD. Methods : We recruited 189 Vietnam veterans for participation in this study, among whom 99 were PTSD patients and 90 were control subjects. The presence of the DRD2 TaqI A polymorphism was determined by polymerase chain reaction (PCR). Several standardized research scales were used in the clinical assessment of PTSD, including the Combat Exposure Scale (CES), Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI). Results : There was no significant difference in the distribution of the DRD2 genotype, frequency and prevalence of the A1 allele, or the frequency of heterozygotes between the patients with PTSD and the controls. In the PTSD group, the patients with the A1 allele (A1A1, A1A2) scored higher on the CAPS-total (p=0.044), CAPS-avoidance symptoms (p=0.016) and BDI (p=0.024) than those without the A1 allele (A2A2). Conclusion : We could not find an association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. However, the A1 allele of DRD2 seemsto influence avoidance symptoms in patients with PTSD.

• Anxiety and mood
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• v.16 no.2
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• pp.49-56
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• 2020

Objective : The present study aims to investigate differences in anger-related features in patients with somatic symptom disorder (SSD) compared to healthy controls, and to examine whether anger trait and anger regulation strategy are associated with clinical characteristics in patients with SSD. In addition, we examined the relationship between childhood adversity and SSD. Methods : 26 patients with SSD and 28 healthy controls were included. Anger-related features were assessed with State-Trait Anger Expression Inventory (STAXI). Clinical somatic symptoms were assessed using the somatization subscale of the Symptom Checklist-90-Revised and the Somatosensory Amplification Scale. Childhood adversity was assessed by the Childhood Traumatic Events Scale. Multivariate analysis of covariance was performed. Results : Disease status of SSD had a significant overall effect on anger-related features (Wilks λ=0.725, F(5, 44)=3.332, p=0.012). Patients with SSD showed a significantly high Trait-Anger (p=0.017) and they had a high score in both Anger-Out (p=0.013) and Anger-In (p=0.001) of anger expression styles. In particular, a directed inward style of anger expression was significantly associated with somatization symptom severity (p=0.003). Regarding childhood adversity, more childhood extreme illness was experienced by the SSD group than the control group (p=0.012). Within the SSD group, childhood extreme illness was associated with higher Trait-Anger (p=0.027) and Anger-Out (p=0.001). Conclusion : The present findings suggest that trait anger, anger expression styles, and childhood adversity of extreme illness may be involved in SSD. Further studies are needed to explore the role of anger-related features and its relationship with childhood adversity in the pathophysiology of SSD.

• Anxiety and mood
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• v.16 no.2
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• pp.98-105
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• 2020

Objective : The purpose of this study was to investigate the prevalence of social anxiety disorder (SAD) and its association with psychosocial factors including self-esteem, ego-resiliency, and social support in a sample of medical students. Methods : A total of 405 medical students were included in this study. Subjects were asked to complete a self-reported questionnaire, measures of the Social Phobia Inventory (SPIN), the Rosenberg's Self-Esteem Scale (RSES), the Ego-Resiliency Scale (ERS), and the Duke-UNC Functional Social Support Questionnaire (DUFSS). The SAD and non-SAD group were defined using the SPIN score of 25 as a cut-off. The multiple regression analyses were performed to examine the association of self-esteem, ego-resiliency, and social support with SAD symptoms. Results : A total of 79 subjects (19.5%) were identified with SAD. The total RSES score, ERS score, and DUFSS score were significantly lower in the SAD group than the non-SAD group. The total SPIN score negatively correlated with the total RSES score (r=-0.481, p<0.001), the ERS score (r=-0.417, p<0.001), and the DUFSS score (r=-0.406, p<0.001). In the multiple regression, SAD symptoms were associated with self-esteem (β=-0.549, p<0.001), ego-resiliency (β=-0.395, p<0.001), and social support (β=-0.346, p<0.001). Conclusion : This study revealed the prevalence of SAD and its negative association with self-esteem, ego-resiliency, and social support among medical students. Our findings indicate that improving self-esteem and ego-resiliency as well as perceived social support may contribute to the management of SAD symptoms among medical students.

• Korean Journal of Psychosomatic Medicine
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• v.3 no.2
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• pp.115-125
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• 1995

Reports about the prevalence of premenstrual symptoms state that occurs in 20 to 100% of most reproductive-age women. There is a close association between premenstrual syndrome and affective disorders as well as same some other psychiatric disorders. Late luteal phase dysphoric disorder (LLPDD) is a premenstrual condition defined in DSM-III-R by severe mood changes and other symptoms that repeatedly occur only in the luteal phase of the menstrual cycle. However, DSM-III-R does not specify how to compute the change from the follicular to the luteal phase or how to determine when the amount of change is great enough to warrant the diagnosis nor how to determine occupational or social functional impairment. This study was conducted to evaluate the nature, severity and magnitude of premenstrual syndrome in women with current psychiatric disorders by using prospective Daily Rating Form(DRF), and to measure symptom changes according to three scoring methods for diagnosing LLPDD. Our study obtains the data about premenstrual changes estimated by DRF from 22 women with psychiatric disorders who had met criteria for major depressive syndrome on the Premenstrual Assessment Form (PAF). The data was scored by each three methods and was determined to meet criteria A for LLPDD. The results are as follows: 1) the subjects, when scored according to the percent change method, effect size method and absolute severity method, met the DSM-III-R criteria A for LLPDD in 36.4% (8 subjects), 14% (3 subjects) and 4.5% (1 subject) of the cases respectively. 2) The items of irritability, anger and impatience were occurred most frequently on the DRF, when it was scored according to the three scoring methods. And the item of breast pain was next frequent according to the effect size method and the percent change method but according to the absolute severity method. 3) The PAF item of impaired social functioning was reported by 16 (73%) of the subjects. 4) 4 (18%) of the subjects met criteria A for LLPDD and reported impaired social functioning. The prevalency of LLPDD according to each method varied. The percent change method yielded the greatest (36.4%), and the absolute seventy method yielded the laest (4.5%), The effect size method yielded an intermediate frequency (14%). Therefore, for maximizing the diagnostic accuracy of LLPDD, a diagnostic procedure including a measure of change (e.q., effect size method, percent change method) as well as confirmed diagnosis by DRF, will be needed. Also, an accurate tool to evaluate impaired social functioning will be required.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.77-85
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• 2021

Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

• Anxiety and mood
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• v.18 no.2
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• pp.39-47
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• 2022

Objective : This study investigated brain functional connectivity in male firefighters who showed subclinical post-traumatic stress disorder (PTSD) symptoms. Methods : We compared the data of 17 firefighters who were not diagnosed with PTSD and 18 healthy controls who had no trauma exposure. The following instruments were applied to assess psychiatric symptoms: Korean version of the Post-traumatic stress disorder Checklist for DSM-5 (PCL-5-K), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI). For all subjects, functional magnetic resonance imaging was performed, and functional connectivity was compared between the two groups (family-wise error-corrected p<0.05). Additionally, correlations between psychiatric symptoms and functional connectivity were explored. Results : The following connectivity was higher than that of healthy controls: 1) the central opercular cortex-superior temporal gyrus, 2) planum polare-parahippocampal gyrus, 3) angular gyrus-amygdala, and 4) temporal fusiform cortex-parahippocampal gyrus. The functional connectivity of 1) the lateral occipital cortex-inferior temporal gyrus, 2) superior parietal lobule-caudate, and 3) middle temporal gyrus-thalamus were lower in firefighters. In firefighters, the connectivity of the planum polare-parahippocampal gyrus showed a negative correlation with the severity of arousal symptoms (rho=-0.586, p=0.013). The connectivity of the middle temporal gyrus-thalamus showed a positive correlation with the severity of intrusion (rho=0.552, p=0.022) and arousal symptoms (rho=0.619, p=0.008). The connectivity of the temporal fusiform cortex-parahippocampal gyrus was negatively correlated with intrusion (rho=-0.491, p=0.045) and arousal (rho=-0.579, p=0.015). Conclusion : Our results indicate that the brain functional connectivity is associated with occupational trauma exposure in firefighters without PTSD. Therefore, this study provides evidence that close monitoring and early intervention are important for firefighters with traumatic experience even at a subthreshold level.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.118-124
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• 2023

Objectives : Depressive disorder and anxiety disorder frequently co-occur, even at sub-threshold level. This study aims to identify network structure of co-morbid depression and anxiety at symptom level in nonclinical population and to reveal the central symptoms and bridge symptoms of the co-morbidity. Methods : This study was based on 2022 Asan Youth Mental Health Screening. Patient health questionnaire (PHQ-9) and Generalized anxiety disorder scale (GAD-7) were used to assess depressive and anxiety symptoms of 810 young adult participants from community sample. Network structure of co-morbid depressive and anxiety symptoms was estimated by Isingfit model. Results : Depressed mood, Restlessness and Nervousness were the most central symptoms in the network. Bridge symptoms between anxiety and depression were Restlessness and Irritability. Conclusions : This study revealed key central symptoms and bridge symptoms of co-morbid depression and anxiety in nonclinical population and provided potential insight for treatment targets to reduce co-morbidity.