• Health Policy and Management
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• v.27 no.2
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• pp.177-185
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• 2017

Background: The mental problems of the elderly are at issue as a serious social phenomenon. The purpose of this study is to identify risk factors affecting the mood disorders of the elderly. Methods: The subjects were 1,779,236 aged ${\geq}65$ and participated in health screening. Dependent variable was mood disorders. Independent variables were consisted of community level (regional deprivation index and healthcare resources) and individual level (sex, age, insurance type, disability, smoking, alcohol, physical activity, body mass index, and healthcare utilization). Multilevel logistic regression was performed. Results: At the individual level, women, employed insured, severely disabled people, heavy alcohol drinkers, high-intensity physical activity, body mass index, and patients who had chronic disease and severe disease were significantly associated with mood disorders. As the age has increased, it has let increase of mood disorders. At the community level, as the regional deprivation index has increased by 1, mood disorders has been increased by 1.005 times. The intra-class coefficient was 7.04%. Conclusion: We found individual and community level factors are associated with mood disorders. Systematic approach is essential to reduce mood disorders.

• Korean Journal of Biological Psychiatry
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• v.9 no.1
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• pp.3-7
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• 2002

Genes involved in the serotonin system are good candidates for the pathogenesis of mood disorder and mood-related disorders, such as eating disorder, obsessive-compulsive disorder, alcoholism, and suicide. Serotonin type 2A(5-HT2A) receptor gene promoter polymorphism(-1438A/G) has been reported. In this article, authors reviewed the literatures regarding association studies between -1438A/G and mood disorder and mood-related disorders. There are controversial results with limited data to date. Further researches on the -1438A/G in psychiatric disorders are required.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.74-83
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• 2020

Objectives Psychological resilience plays a significant role in many aspects of mental health. The aim of this study was to find an association between childhood attention deficit hyperactivity disorder (ADHD) features and adulthood psychological resilience in patients with mood disorders. Methods A total of 213 patients with mood disorders including major depressive disorder or bipolar I, II disorder and 909 healthy controls were included. We assessed childhood ADHD features using the Wender Utah Rating Scale (WURS), adulthood psychological resilience using the Connor-Davidson Resilience Scale (CD-RISC), and current depressive mood using the Beck Depression Inventory (BDI). Pearson's correlation, multiple linear regression and a mediation analyses were performed to examine the relationships between three WURS factor (impulsivity, inattention, and mood instability) scores, the BDI score, and the CD-RISC score. Results The CD-RISC score was negatively correlated with the WURS childhood inattention factor score and current BDI score in patients with mood disorders. BDI score mediated the influence of the inattention factor score on CD-RISC score among patients with mood disorders. The CD-RISC score was significantly lower in patients with mood disorders than in controls even after controlling for age, WURS scores, and the BDI score. Conclusions An evaluation of psychological resilience is important for enhancing recovery and quality of life in patients with mood disorders. When assessing psychological resilience, current depression and ADHD features in childhood, particularly inattention, should be considered.

• Korean Journal of Biological Psychiatry
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• v.18 no.1
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• pp.15-24
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• 2011

Mood disorder is unlikely to be a disease of a single brain region or a neurotransmitter system. Rather, it is now generally viewed as a multidimensional disorder that affects many neural pathways. Growing neuroimaging evidence suggests the anterior cingulate-pallidostriatal-thalamic-amygdala circuit as a putative cortico-limbic mood regulating circuit that may be dysfunctional in mood disorders. Brain-imaging techniques have shown increased activation of mood-generating limbic areas and decreased activation of cortical areas in major depressive disorder(MDD). Furthermore, the combination of functional abnormalities in limbic subcortical neural regions implicated in emotion processing together with functional abnormalities of prefrontal cortical neural regions probably result in the emotional lability and impaired ability to regulate emotion in bipolar disorder. Here we review the biological correlates of MDD and bipolar disorder as evidenced by neuroimaging paradigms, and interpret these data from the perspective of endophenotype. Despite possible limitations, we believe that the integration of neuroimaging research findings will significantly advance our understanding of affective neuroscience and provide novel insights into mood disorders.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.198-210
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• 1997

To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.

• Anxiety and mood
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• v.6 no.1
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• pp.10-16
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• 2010

Researchers consider obsessive-compulsive disorder (OCD) to be an anxiety disorder, but it often shows comorbidity with other disorders in the affective spectrum. Epidemiological and clinical studies have shown a strong association between OCD and mood disorders. In addition, some reports show the patients with OCD have attentional-processing impairments regarding emotional information. However, research has not revealed the exact nature and degree to which OCD constitutes an affective problem. In this review, we discuss the affective aspects of OCD and the relationship between OCD and mood disorders.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.168-178
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• 1997

The serotonin has been known to play important roles in pathology of the mood disorders. We summerize the evidences of serotonin in pathology of the mood disroders in a view of neuroanatomical and neurochemical aspects. Nowaday, the selective serotonin reuptake inhibitors(SSRIs) may be practically the first line of antidepressants with traditional tricyclic antidepressants(TCAs). Authors review the role of serotonin in the treatment of the mood disorders, in a view of the general considerations in selecting antidepressants, pharmacology, therapeutic indications, side effects, doses of medication, drug-discontinuation syndrome, drug-to-drug interactions, and special therapeutic situations.

• Sleep Medicine and Psychophysiology
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• v.29 no.2
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• pp.40-44
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• 2022

Bipolar disorders are a group of mood disorders characterised by relapsing mood episodes throughout the course of illness. Patients with bipolar disorders commonly present with various sleep problems. Patients in a manic episode generally show decreased need of sleep and those in a depressed episode frequently complain about hypersomnia. Current literature even points to evidence that patients with bipolar disorder in euthymic state may still show signs of sleep disturbances when compared to the general population. Clinicians may also note intricate interactions between changes of circadian rhythm and evolution of mood episodes in patients with bipolar disorder. Also, commonly prescribed medications which plays a crucial role in treatment of bipolar disorders including mood stabilisers and antipsychotic medications often cause significant weight gain over time. Being a risk factor of sleep apnoea, weight gain can predispose the patient to develop sleep apnoea. In this narrative review, we summarised current evidence and literature regarding characteristics of circadian rhythm and comorbid sleep apnoea in patients with bipolar disorder. We also present literature regarding implications of circadian disturbance and comorbid sleep apnoea in managing patients with bipolar disorder.

• Anxiety and mood
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• v.4 no.2
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• pp.111-120
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• 2008

Objective : This study investigated the temperament and character traits associated with suicide attempts in patients with mood disorders. Methods : The temperament and character inventory (TCI) was administered to 150 patients who visited psychiatric clinics seeking treatment for mood symptoms. The patients were divided into three groups as follows : non-suicide ideation, suicide ideation and suicide attempt. We also gathered socio-economic data in order to rule out confounding variables. MANOVA was performed to analyze differences in personal temperament and character scores on the TCI between the three groups. Results : The self-directedness and cooperativeness subscales of the TCI are most influenced by the clinical symptoms rated by Beck Suicide Ideation Scale and Hamilton Depression Rating Scale. In the temperament scale, the suicide attempt group scored higher on the novelty seeking and harm avoidance items than the other two groups. The specific temperaments associated with suicidal behavior in patients with depression are impulsivity (NS2) and anticipatory anxiety or pessimism (HA1). Conclusion : In this study, we found that more risky patients who had previously attempted suicide had a temperament of impulsivity or pessimism. This finding suggests that a more cautious approach is needed to assess mood disorder patients with impulsive or pessimistic temperaments in order to prevent suicide attempts.

• Korean Journal of Biological Psychiatry
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• v.1 no.1
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• pp.40-59
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• 1994

The introduction of lithium salts for the treatment of mood disorder by Code in 1949 was a major therapeutic breakthrough. Yet it is far from the universal therpeutic agent in the treatment of mood disorders. Indeed, some acutely manic patients do not respond adeqately to lithium and some individuals experience breakthrough affective episodes during lithium maintenance. In the last decode, it has become c1ear that a significant number of patients with more highly recurrent disorders may require alternative or enhanced forms of prophylactic treatment. For these reasons, a variety of other drugs hove been employed for the treatment and prophylaxis of mood disorders. Efforts to develop new pharmacologic strategies for mood disorder hove included a diverse array of medications, ranging from potent benzodiazepines to novel neuroleptics and from anticonvulsants to calcium channel blockers. The anticonvulsants appear particularly useful in cases of dysphoric mania and rapid cycling state, subforms of bipolar disorder that respond quite poorly to conventional treatments. Among all of these new pharmacologic strategy, carbamazepine and sodium valproate have received the broadest clinical applications as maintenance therapies. The data documenting the short-term antimanic effectiveness of the calcium channel blocker verapamil and benzodiazepins such as clonazepam and lorazepam appear also promising. A number of other theoretically interesting, as well as clinically relevant therapies, which are not presently employed routinly, hove also been studied, including 2 blocker clonidine, atypical antipsychotic clozapine, cholinomimetics, 5-HT enhancers, thyroid and magnesium preparations. Now prophylaxis in mood disorder remains a considerable therapeutic challenge. Controlled testing of the prophylactic efficacy of compounds such as carbamazepine, valproic acid, and the calcium channel blockers represent important next step in the clinical trials for mood disorder.