• Title/Summary/Keyword: Mood disorder

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Neurotransmitter and Neuroendocrine Markers as Predictors of Therapeutic Responses In Psychiatric Disorders (신경전달물질 및 신경내분비 Marker를 이용한 치료반응의 평가)

  • Han, Chang-Hwan
    • Korean Journal of Biological Psychiatry
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    • v.2 no.1
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    • pp.3-19
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    • 1995
  • Numerous investigators have conducted extensive investigation in the search for biological markers in psychiatric illness. There are, as a test of q biological approach to the diagnosis of the psychiatric illness, tests for the neurotransmitters, their metabolites, and related enzymes, the neurotransmitter receptors, the neuroendocrine output and response, the membrane transport, peptides and eletrolytes. They are called the biological markers, and they are helpful for the diagnosis or differential diagnosis, choice of treatment or drugs, symptom improvement, predictor of recurrence and anticipation of suicidal attempt. These studies are among the main purposes that are pursued in the neuroscience and based on the potential utility of the biological markers mentioned above. Since 1970's, lots 01 biological markers' studies for the diagnosis, differential diagnosis or subtypes differentiation have been done but varieties of different opinions have been drawn since then through they could explain the charaters of main psychiatric illness(especially schizophrenia and mood disorder). But, the search for biological markers, including displines of neuroendoclinology and neurochemistry(neurotransmitter and thair metabolite), has yielded a number of putative trait merkers and state markers for psychayric illness. This paper aims to anticipate or evaluate the good response to the therapy(Therpeutic response) with lots of markers. Acoording to the diagnosis of lots of diseases or subtypes, we are going to review the papers, mainly concern with 'Is there any Marker' or 'Is any test possible to detect the improvement clinically?' 'Is it possible to predict the recurrence or good prognsis?' or 'Is it possible to select any drug or therapy to bring the good response?' The biological tests to review are mainly the metabolites of catecholamine neurotransmitter, and especially neuroendocrine test based on the knowledge that hormons of the adenohypophysis are influenced by activity of the cerebral or limbic neurons as well as the hypothalamus ones. Among them, author introduced some clinically available tests that are DST, TRH stimulation test(TRHST), GH stimulation test, and the urine MHPG test that can give us the evaluation of the treatment response, the predictor for recurrence or choice of drug that can bring a good response. So author discussed thair potential utility in clarifying, therapeutic, and prognostic issues in psychatric illness. We hope they'll be used and look forward to more active study on the different opinion.

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Association between Sleep and Loneliness in the Elderly Living Alone (독거노인의 외로움과 수면의 관계)

  • Choi, Yu Jung;Lee, Kyung Kyu;Lee, Seok Bum;Kim, Kyung Min;Kim, Dohyun;Lee, Jung Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.168-176
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    • 2020
  • Objectives : Loneliness and poor sleep quality are common phenomena in old age and are associated with negative physical and mental health. However, little is known regarding the relation between loneliness and sleep quality. The aim of this study was to examine the association of loneliness and sleep quality among the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,090 subjects who are the community-residing elderly living alone. Sociodemographic status, medical condition, cognition, mood disorder, sleep quality and levels of loneliness were collected using a self-administered questionnaire and a specific semi-structured interview conducted by trained nurses. Descriptive statistics were used to analyze data regarding sociodemographic variable and loneliness. Univariate and Multivariate regression analyses were applied to examine the association between loneliness and sleep quality after adjustment for multiple confounding variables. Results : The Pittsburgh Sleep Quality Index (PSQI) mean score of "lonely group" (9.2±4.2) was significantly higher than that of "not lonely group" (7.3±3.7) (student-t test, p<0.001). Loneliness was significantly associated with PSQI (standardized β=0.065, p=0.025), sleep disturbance (standardized β=0.086, p=0.005), use of sleep medication (standardized β=0.065, p=0.034) after adjustment for possible confounding variables including sex and mood disorder. Conclusions : Loneliness was associated with sleep disturbance and this finding implied negative impact of loneliness on sleep quality of older adults. Public health promotion efforts to reduce loneliness may improve sleep quality and mental health in the elderly living alone.

Alexithymia in Somatoform Disorder and Diabetes Mellitus (신체형장애 환자와 당뇨병 환자에서의 Alexithymia)

  • Lee, Kyung-Kyu;Lee, Jeong-Yeob;Kim, Hyun-Woo;Choi, Sang-Jun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.203-212
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    • 1999
  • Objectives : "Alexithymia" mean literally "no word for mood(or emotion)". It is not only a marked constriction in emotional functioning but a deficit in their cognitive processing. We designed this study to investigate the level of alexithymia, psychopathology and personality factors of patients with somatoform disorder and with diabetes mellitus. Methods : The subjects were consisted of patients with somatoform disorder(N=20), patients with diabetes mellitus(N=20), and normal control(N=20). The level of alexithymia, psychopathology and personality factors were assessed by the Toronto Alexithymia Scale(TAS), the Symptom Checklist 90-Revision(SCL 90-R), and the Sixteen Personality Factor Questionnaire(16-PF). And we compared demographic characteristics, psychopathology and personality factors among three groups, and assessed the relationship between alexithymia and psychopathology, and between alexithymia and personality factors. Results : The results were as follows. 1) Patients with somatoform disorder showed significantly higher TAS scores compared to patients with diabetes mellitus and the normal control group. 2) Patients With somatoform disorder showed significantly higher scores of somatization, anxiety scales than patients with diabetes mellitus and the normal control group, and showed significantly higher scores of obsessive-compulsive, depression, phobic anxiety, psychoticism scales than the normal control group by the SCL-90-R. 3) The normal control group showed high intelligence scores only as compared to patients with somatoform disorder by the 16-PF. 4) A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. 5) All three groups did not shown any correlation between TAS and 16-PF. Conclusion : Patients with somatoform disorder showed higher TAS scores and more multiple psychopathology than patients with diabetes mellitus and the normal controls. A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. We suggest that the therapeutic approach to patients with somatoform disorder to express emotions and manage psychopathology, and that the treatment methods of patients with diabetes mellitus aims to improve firstly physical conditions are more helpful.

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IMPACT OF PARENTAL PSYCHIATRIC DISORDER ON OFFSPRING'S DEPRESSION, ANXIETY, SELF CONCEPT AND PERCEPTION OF FAMILIAL RELATIONSHIP (정신과 환자 자녀의 우울, 불안, 자기 개념 그리고 가정환경의 특성에 대한 연구)

  • Lee, Jung-Bum;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.54-66
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    • 1998
  • Objectives:This study was to investigate the impact of parental psychiatric disorder on offspring's depression, anxiety, self concept, perception of familial relationship compared with offspring of normal control. In offsprings of parents with psychiatric disorder, this study explored whether their psychopathology, self concept, and perception of familial relationship were influenced by parent’s sex, onset time of parent’s psychiatric disorder and parent’s psychiatric diagnosis. Methods:52 offsprings aged 10-18 years of 39 psychiatric outpatient were surveyed from June, 1997 to April, 1998 and completed several questionnaaire, including Korean from of the Family Environment Scale, Korean form of the State-Trait Anxiety Inventory for Children, Korean form of Kovac’s Children’s Depression Inventory, and Korean form of Piers-Harris Children’s Self-Concept Scale. Their score was compared with offsprings’ of normals. In offsprings of parents with psychiatric disorder, they were compared according to parent’s sex, onset time of parent's psychiatric disorder and parent’s psychiatric diagnosis. Results:The results were as follows:1) Offsprings of parents with psychiatric disorder reported higher level of state anxiety and lower level of the FES expressive subscale than offsprings of normals(p<0.05). But they reported higher level of PHCSCS intellectual & school status subscale and popularity subscale than normals(p<0.05). 2) There were no differences in anxiety, depression, self concept, and perception of familial relationship between patient’s sex. 3) Offsprings less than 3 years old when parent’s psychiatric disorder had developed showed higher level of trait anxiety and lower level of FES control subscale than offsprings more than 3 years old (p<0.05). 4) There were no diferences in anxiety, depression, self concept, and perception of familial relationship between patient’ diagnostic groups(schizophrenia spectrum disorder-mood disoderneurosis). Conclusion:The finding indicated that self reported scale of anxiety and depression showed no significant difference between offsprings of psychiatric patients and offsprings of normals. In offsprings of parents with psychiatric disorder, parent’s sex and psychiatiric diagnosis had no influence on offspring’s psychopathology. But the offspring’s age(before 3 years old) when the parent’s psychiatriric disorder developed had influence on higher level of offspring’s trait anxiety. For further high risk group study, direct interview and evaluation of parent-child agreement or teacher-child agreement will be needed in longitudinal study.

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The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(II) - 진단 및 평가 -)

  • Lee, Moon-Soo;Park, Su-Bin;Kim, Gyung-Mee;Kim, Hyun-Jin;Park, Sangwon;Kim, Yunsin;Lee, Young Sik;Kweon, Yong-sil;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.58-69
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

Clinical Characteristics of Night Eating Syndrome in Outpatients with Bipolar Disorder (양극성 장애 외래환자에서 야간식이증후군의 임상적 특성)

  • Jung, Haran;Yoon, Bo-Hyun;Sea, Young-Hwa;Song, Je-Heon;Park, Suhee;Koo, Bonki;Kim, Kyung-Min;Nam, Seok-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.112-120
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    • 2014
  • Objectives : The aim of this study is to evaluate the clinical characteristics of night eating syndrome(NES) in bipolar disorder outpatients. Methods : The 14 items of self-reported night eating questionnaire(NEQ) was administered to 84 bipolar patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating & weight-related quality of life using Beck's Depression Inventory (BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. Results : The prevalence of night eating syndrome in bipolar outpatients was 14.3%(12 of 84). Comparisons between NES group and non-NES group revealed no significant differences in demographic characteristics, BMI and clinical status except economic status and comorbid medical illnesses. However, compared to non-NES, patients with NES was more likely to have binge eating pattern and poorer weight-related quality of life. Conclusions : This study is to be the first to describe the clinical correlates of night eaters in bipolar outpatients. Although there were few significant correlates of NES in bipolar outpatients, relatively high prevalence of NES suggest that clinicians should be aware to assess the patients with bipolar disorder on NES, regardless of obesity status of patients.

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Korean Medication Algorithm for Bipolar Disorder 2018 : Safety and Tolerability (한국형 양극성 장애 약물치료 알고리듬 2018 : 안정성과 내약성)

  • Sohn, InKi;Bahk, Won-Myong;Yoon, Bo-Hyun;Jon, Duk-In;Seo, Jeong Seok;Kim, Won;Lee, Jung Goo;Woo, Young Sup;Jeong, Jong-Hyun;Kim, Moon-Doo;Jung, Young-Eun;Shim, Se-Hoon;Song, Hoo-Rim;Min, Kyung Joon
    • Mood & Emotion
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    • v.16 no.3
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    • pp.134-139
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    • 2018
  • Objectives : Treatment for bipolar disorder is often complicated by various clinical situations. We undertook a survey of expert opinions to facilitate clinical decisions in special situations such as weight gain, metabolic syndrome, hyperprolactinemia, genetic counseling, and treatment adherence. Methods : A written survey that asked treatment strategies related to safety and tolerability, was prepared focused on weight gain, antipsychotic related hyperprolactinemia, lamotrigine related skin rash, treatment non-adherence and genetic counseling. Sixty-one experts of the review committee completed the survey. Results : In the case of weight gain related to medications, experts preferred exercise and education for diet-control. First chosen medications were lamotrigine, aripiprazole and ziprasidone. Recommendations based on expert survey results for treatment of bipolar patients in other special situations are outlined. Conclusion : With limitation of expert opinions, authors hope that results of this study provide valuable information to make clinical decisions about treatment of bipolar disorder in complicated situations.

CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 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.

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Symptoms of Posttraumatic Stress Disorder and Mental Health in Female Victims by Sex Trade : A Follow-Up Study in Shelter Samples (성매매 피해 여성의 외상 후 스트레스 증상과 정신건강-탈 성매매 후 추적 연구)

  • Kim, Seong-Cheol;Lee, Jun-Woo;Song, Jeong-Min;Jun, Tae-Youn;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.2 no.1
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    • pp.33-38
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    • 2006
  • Objectives : Since prostitution is multitraumatic phenomena, it is known that most women in prostitution have symptoms of posttraumatic stress disorder (PTSD) and other mental illness. In Korea, new anti-prostitution law launched in the year of 2004 imposes protecting prostituted victims at government-supported shelter. The objective of this study was to compare the mental symptoms, especially PTSD features of women who escaped from prostitution with those of control subjects. Methods : We assessed 113 ex-prostituted women who live in shelter for 8 months on the average and 65 normal control subjects. Demographic data, questionnaire for sleep, physical illness, smoking, alcohol and drug use, Stress Response Inventory, Davidson Trauma Scale (DTS), Impact of Event Scale-Revised (IES-R) were used. Results : Ex-prostituted women had significantly higher scores of DTS, IES-R, stress related responses, sleep problems, smoking problems, and alcohol problems than control group. Age and duration of sex trade of the subjects were significantly correlated with the severity or frequency of PTSD symptoms. The degree of smoking, alcohol drinking and sleep problems were also significantly correlated with the PTSD symptoms. Conclusion : These results suggested mental symptoms did not disappear even after women escaped from prostitution.

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Psychometric Properties of the Korean version of the PTSD Checklist-5 in Elderly Korean Veterans of the Vietnam War (월남전 참전 노인에서 한글판 외상후 스트레스 장애 체크리스트-5의 정신측정학적 특성)

  • Kim, Jong Won;Chung, Hae Gyung;Choi, Jin Hee;So, Hyung Seok;Kang, Suk-Hoon;Kim, Dong Soo;Moon, Jung Yoon;Kim, Tae Yong
    • Anxiety and mood
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    • v.13 no.2
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    • pp.123-131
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    • 2017
  • Objective : The PTSD Checklist (PCL) is a self-report screen for posttraumatic stress disorder (PTSD) that can be scored for both diagnostic assessment and symptom severity measurement. The most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) contains a number of changes to the definition of PTSD, and the aim of this study was to assess the psychometric properties of the Korean version of the PCL for the DSM-5 (PCL-5-K). Methods : The participants were 204 Korean veterans of the Vietnam War who completed the PCL-5-K, the Mini Mental Status Examination (MMSE), PTSD module of Structured Clinical Interview for DSM-5, Research Version (SCID5-RV PTSD module), Korean version of Impact of Event Scale-Revised (IES-R-K) and Combat Exposure Scale (CES-K). Results : The PCL-5-K demonstrated good internal consistency (${\alpha}=0.972$) and test-retest reliability (r=0.96); the suggested cut-off score for PTSD diagnosis was ${\geq}37$ with 0.88 sensitivity and 0.96 specificity. The PCL-5-K scale correlated highly with the IES-R-K and CES-K. Factor analysis identified only one factor. Conclusion : Among elderly Korean veterans of the Vietnam War, the PCL-5-K demonstrated similar psychometric qualities to those of both the original PCL and subsequent versions. It is expected that the PCL-5-K will be a useful PTSD screening tool.