• Korean Journal of Biological Psychiatry
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• v.6 no.1
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• pp.125-134
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• 1999

The purposes of this study were to test the negative association between schizophrenia and rheumatoid arthritis(RA) and to clarify the role of prolactin and estrogen as protective factors in this association. The author compared the prevalence rate of RA between 561 patients with schizophrenia and 222 patients with mood disorder. For investigating the role of estrogen and prolactin, the author checked the plasma prolactin and estradiol level in 80 patients with paranoid schizophrenia and 77 patients with RA. The results were as follows. 1) Epidemiological data The prevalence rate of RA in the schizophrenic group was 0/561 and that of RA in the mood disorder group was 2/222. To compare these results between two groups, the author applied the Binomial test using the average prevalence rate of RA(0.8%) in the general population as a reference rate. The prevalence rate of RA in the schizophrenic group was significantly lower than that of RA in the general population. However, the prevalence rate of RA in the mood disorder group was not significantly different to that of RA in the general population. 2) Comparison of plasma prolactin and estradiol level between two groups The plasma level of prolactin in the schizophrenic group was significantly higher than that of prolactin in the RA group(p=0.000). However, the plasma level of estradiol in the schizophrenic group was significantly lower than that of estradiol in the RA group(p=0.017). These results were not consistent across gender. To contrast with the results in the female group, which were consistent with the results in the total subjects, for the male group, the plasma levels of prolactin and estradiol in the schizophrenic group were significantly higher than those of prolactin and estradiol in the RA group. These results support the results of previous studies which confirm the negative association between schizophrenia and RA. These results also suggest that the elevation of plasma prolactin level in the patients with schizophrenia has a antirheumatic effect while the elevation of plasma estradiol level in the patients with RA has a anti-schizophrenic effect, and that these effects act as a possible mechanism in the negative association between two disorders. However, these results suggest that this association is specific to female patients.

• Korean Journal of Biological Psychiatry
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• v.20 no.4
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• pp.151-158
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• 2013

Objectives To investigate the pattern of subclinical hypothyroidism (SCH) in patients with bipolar disorders managed by lithium or valproic acid. Methods The study participants were 106 patients with DSM-IV bipolar disorders receiving planned maintenance treatment at the Mood Disorders Clinic of Seoul National University Bundang Hospital (aged between 17 and 64, mean duration of follow-up = 875.65 days). Using the bipolar disorder registry, thyroid function data were analyzed to assess the frequency of and the risk factors for SCH in patients managed by lithium (n = 64) or valproic acid (n = 42) for more than 5 months. Results Overall frequencies of SCH were 20.3% (13/64) in the lithium group, 14.3% (6/42) in the valproic acid group, and between the two groups there is no difference (p = 0.43). No differences were observed in the potential risk factors for SCH between the two groups including age, sex, subtype of bipolar disorder, baseline TSH, and concomitant antipsychotic use. In cases with SCH, thyroid-stimulating hormone (TSH) showed a tendency to increase at 3 month after the initiation of lithium or valproic acid. A gradual increase in the number of patients showing SCH was found within the first 3 years of medication. Conclusions With regular monitoring and careful assessment, there was no difference in the risk of SCH between lithium and valproic acid maintenance. The risk of mood stabilizer-associated SCH may gradually increase within 3 years following the commencement of medication, thereby mandating close monitoring for the first 3 years of treatment. Further studies with large sample size would be needed to confirm these findings.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.40-47
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• 2010

Objectives：Body image is closely related to self-esteem and weight-control related behaviors. In particular, relationship between two factors would be stronger in female adolescents. False recognition on body image and weight can be a risk factor of eating disorder, depression, and suicidal ideation. This study aimed to examine the effects of body image and eating disorders on developing depressive symptoms and suicidal ideation in female adolescents. Methods：Two hundred thirty nine students of a Girls' Commercial High School in Seoul were recruited. Eating Attitude Test for Korean Adolescents, Self-Esteem Scales, Impulsiveness Scale, Beck's Depression Inventory and Beck's Suicidal Ideation Scale were used to measure eating attitude and severity of psychiatric symptoms. Results：Among 239 subjects, the estimated risk group of eating disorders was 10%(n=24). They experienced more depressive symptoms than the control group. The bigger discrepancy in current and ideal body mass index was significantly related with higher depressive mood, suicidal idea, abnormal eating habits and lower self-esteem. Discrepancy between current and idea BMI was the most meaningful predictive factor about depression and suicidal thoughts by linear regression analysis. Conclusion：In spite of normal weight range of enrolled subjects, they experienced significant depressive mood, suicide thoughts and lower self-esteem associated with the discrepancy of their own subjective body image and current body mass index. Hence educational approach regarding normal body image and healthy weight control is needed for their mental health and preventing eating disorder.

• Korean Journal of Biological Psychiatry
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• v.28 no.1
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• pp.13-22
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• 2021

Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

• Sleep Medicine and Psychophysiology
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• v.11 no.2
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• pp.95-99
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• 2004

Objectives: Although many studies on seasonal variations in mood and behavior have been carried out in foreign countries, no such study has previously been undertaken in Korea. The goal of this study was to estimate the frequency of seasonal variations in mood and behavior among Korean medical students. Methods: 297 medical students from Korea University College of Medicine participated in this study. The subjects were surveyed with a Korean translation of the Seasonal Pattern Assessment Questionnaire (SPAQ), and their responses were evaluated for seasonal patterns of mood and behavioral change, including seasonal affective disorder (SAD) and subsyndromal seasonal affective disorder (S-SAD), derived from the case-finding criteria of Kasper et al. Results: The mean global seasonality score was 6.6 (SD=3.6). 83.5% (N=248) of the subjects reported some changes in behavior and mood associated with the seasons. Only 3.7% (N=11) reported no behavioral changes across the seasons. Total prevalence rates were 15.2% for SAD, and 2.7% for S-SAD. The estimated frequencies were 3.0% for summer SAD, 2.7% for summer S-SAD, 11.4% for winter SAD, and 5.8% for winter S-SAD. The prevalence rates for winter SAD or S-SAD were higher than the prevalence rates for summer SAD or S-SAD. Conclusion: These results suggest that seasonal variations in mood and behavior are common among Koreans. The higher prevalence rate of winter SAD or S-SAD than summer SAD or S-SAD is consistent with most western studies and stands in contrasts to studies in other Asian countries, such as Japan and China.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.34-42
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• 1995

Borderline personality disorder in adolescents present with suicide attempts or gestures, and they are characterized by the same patterns of splitting, devaluation, manipulation, need-gratifying object relations, impulsivity, and ego deficits that are finds in borderline adults, Symptomatolgy are depression, anxiety, identity crisis, and occasionally antisocial behavior in borderline personality disorder in adolescents. These findings should be differentiated to normal stormy adolescents. Theses borderline personality disorder in adolescents are known about the instability of object relations, labile affect, splitting, and psychotic episode in severe stress. According to thses finding, schizophrenia, mood disorder, schizoptypal personality disorder, paranoid personality disorder could be differentiated. Etiology is complex including psychodynamic, genetic, familial factor. Treatments are individual psychotherapy, group therapy, and pharmacotherapy. The continuity or discontinuity of borderline states from childhoon to adult life is controversy.

• Anxiety and mood
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• v.11 no.1
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• pp.69-74
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• 2015

Objective : Positive psychotherapy is based on the premise that positive thoughts and satisfaction with life are determinants for improving the symptoms of depressive disorder. This article highlights the effectiveness of group positive psychotherapy on the elderly living alone with depressive disorder in Korea. Methods : A total of 25 Korean elderly living alone with depressive disorder participated in group positive psychotherapy. The participants completed the Hamilton rating scale for depression (HAMD) and the Positive Thinking Questionnaire (PTQ) before and after the group positive psychotherapy. Results : The HAMD and PTQ scores of the participants after the group positive psychotherapy were higher than before the psychotherapy. A correlation between the age of patients and improvement of symptoms after group positive psychotherapy was found : the older the patients were, the better the improvements were. Conclusion : The study shows that group positive psychotherapy in the elderly living alone is effective in improving the symptoms of depressive disorder. The participant's age was found to be a factor that affects the improvement of depressive disorder symptoms.

• Anxiety and mood
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• v.14 no.2
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• pp.120-126
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• 2018

Objective : Psychopathy has been suggested as one of the important cause of violence in patients with schizophrenia. The purpose of this study was to evaluate the personality disorder in criminal schizophrenia. Methods : A total of 187 criminal schizophrenia participated in this study. All participants filled out the Korean Inventory of Interpersonal Problem Personality Disorder Scales (K-IIP-PD), Psychopathic Personality Inventory-Revised (PPI-R), Personality Assessment Inventory (PAI). Using the correlations between the scales, we investigated whether K-IIP-PD could be used to evaluate personality disorder in criminal schizophrenia. Moreover, participants were divided into two groups of psychopathic and nonpsychopathic schizophrenics, and scores of K-IIP-PD were compared between the two subgroups. Results : The overall correlation between the scales was very high. In particular, sum of 3 item scores (interprsonal sensitivity+interpersonal ambivalence+aggression) and aggression of K-IIP-PD were highly correlated with PPI-R and PAI. Total score of personality disorder scale and subscales were higher in psychopathic schizophrenic group compared to nonpsychopathic schizophrenic group. Conclusion : The K-IIP-PD could be used to assess the antisocial and aggressive nature of criminal schizophrenia. Further studies in various clinical groups including the general population are required.

• Anxiety and mood
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• v.14 no.2
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• pp.127-134
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• 2018

Objective : The aim of this study was to examine the psychometric features of the Korean version of the Eating Disorder Diagnostic Scale-the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (K-EDDS DSM-5). Methods : A total of 72 patients diagnosed with eating disorders participated in the study. The diagnosis was based on the Korean version of the Eating Disorder Examination (KEDE) interview. All participants completed the K-EDDS and the Eating Disorder Examination Questionnaire version 6.0 (EDE-Q 6.0) for this study. The psychometric features of the K-EDDS were examined using exploratory factor analysis, convergent validity of agreement between the K-EDDS and the KEDE, and internal consistency. Results : The exploratory factor analysis initially extracted 6-factor structures which were reconstructed into 4 factors of body dissatisfaction, binge behavior, binge frequency, and compensatory behavior based on appropriateness of the items. The internal consistency of the K-EDDS was fairly acceptable (Cronbach's alpha=0.72). The diagnostic agreement between the K-EDDS and the KEDE was high (98.61%). The 4 factors of the K-EDDS showed significant correlation with the 4 subscales of the EDE-Q 6.0. Conclusion : Our data suggests that the K-EDDS is a reliable and valid tool for the diagnosis of eating disorders based on the DSM-5.

• Anxiety and mood
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• v.2 no.1
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• pp.9-16
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• 2006

As an aging population is increasing, more elderly people are exposed to traumatic stress. Although this issue has received more attention in some literature, it is clear that numerous questions exist in aftermath of trauma exposure in elderly people. In case of Korean elderly suffers, traumatic experience includes the Korean war, military dictatorship and violent demonstration. Studies regarding elderly PTSD is not active and a lot of patients are not still engaged in treatment. We suggest that concerns that are unique to this population are necessary.