Oh, Sang Hoon;Kim, Sung Nyun;Han, Jaewook;Lee, Junhee;Lee, Tae Young;Shin, Min-Sup;Kwon, Jun Soo
Korean Journal of Biological Psychiatry
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v.24
no.2
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pp.75-81
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2017
Objectives Obsessive-compulsive disorder (OCD) is a chronic and disabling psychiatric disorder. The duration of untreated illness (DUI) has been suggested as one of the predictors of clinical course and outcome in various psychiatric disorders. There is increasing evidence that cognitive dysfunction is associated with the prognosis of OCD. The aim of this study was to investigate the influence of DUI on the neurocognitive functions in patients with OCD. Methods Sixty-two patients with a DSM-IV diagnosis of OCD from the outpatient clinic were included in this study. We defined the short DUI if the DUI was 2-year or less and the long DUI if it was longer than 2-year. Neurocognitive functions were assessed by visuospatial memory function test and 4 subsets of K-WAIS such as vocabulary, arithmetic, block design and picture arrangement. Differences in neurocognitive functions as well as clinical variables between OCD patients with short DUI and those with long DUI were investigated. Correlation analyses were also performed to determine the correlation between DUI and neurocognitive functions. Results Compared with the short DUI group, the long DUI group performed worse in the block design test, which measures executive function. The long DUI group also had a higher level of compulsive symptom severity than the short DUI group. However, the DUI was not correlated with neurocognitive functions. Conclusions Findings in this preliminary study suggest that the long DUI in patients with OCD is associated with more severe executive dysfunction. Studies with larger samples and longitudinal design are needed to further confirm the prognostic role of the DUI in OCD.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.11
no.1
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pp.60-69
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2000
Objective:This study was carried out to evaluate the reliability and validity of the Korean form of the Children's Yale-Brown Obsessive Compulsive Scale(CY-BOCS). Method:Forty-two children with obsessive-compulsive disorder(OCD)(31 boys and 11 girls, aged 7 to 18 years) were assessed with CY-BOCS. Interrater agreement was assessed by two raters in subsample(n=20). discriminant and convergent validity were assessed by comparing CY-BOCS scores to Clinical Global Impression-OCD(CGI-OCD), Leyton Obsessional Inventory-Child Version (LOI-CV), State-Trait Anxiety Inventory for Children(STAI-C), and Child Depression Inventory(CDI). Results:Internal consistency was high, measuring 0.86 for the 10 items and total score. The intraclass correlations for the CY-BOCS total, obsession, and compulsion scores were 0.94, 0.94, 0.84, suggesting excellent interrater agreement for subscale and total scores. The CY-BOCS total score showed highest correlation with CGI-OCD(r=0.88), and significant correlation with LOI-CV(r=0.51), Trait Anxiety score(r=0.43), and CDI scores(r=0.49), but it was not correlated with State-Anxiety score(r=0.25). Conclusion:The results of this study indicate that the Korean form of CY-BOCS is a reliable and valid scale for rating obsessive-compulsive symptom severity.
Park, Sung-Kun;Choi, Jung-Seok;Yu, Soh-Young;Lee, Bo Reom;Kang, Seung-Suk;Roh, Kyu Sik;Ha, Tae-Hyun;Kwon, Jun Soo
Korean Journal of Biological Psychiatry
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v.10
no.2
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pp.168-176
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2003
Objectives:We investigated the characteristics of P300 generators in obsessive-compulsive disorder(OCD) patients by using voxel-based statistical parametric mapping of current density images. Methods:P300 generators, produced by a rare target tone of 1500Hz under a frequent non-target tone of 1,000Hz, were measured in 15 right-handed OCD patients and 15 controls. Low Resolution Electromagnetic Tomography(LORETA), using a realistic head model of the boundary element method based on individual MRI, was applied to the 128-channel EEG. Statistical parametric mapping(SPM) was applied for the statistical analysis. Results:We found that both groups had the mean current density of P300 in the parietal, temporal and prefrontal lobe. There was a trend for decreased current density in the prefrontal area in OCD patients. The statistical comparison showed current density increase in the supraparietal area, a statistically significant longer P300 latency and a trend for reduced P300 amplitude in OCD patients. Conclusion:It suggests that P300 source of both groups exists in multiple brain regions at the same time. And both groups had no statistically significant differences in the current density of P300 except for increased current density in the supraparietal area in OCD patients. But, considering the statistically significant longer P300 latency, a trend for reduced P300 amplitude and relative mean current density reduction in the prefrontal area in OCD patients, this study suggests that the frontal lobe may have a reduced normal inhibitory process in OCD patients.
Objective : Stereotactic psychosurgery is known as one of effective means of treating in some medically intractable psychiatric illness. However, it is unfamiliar and it's long-term clinical result has not reported in our country. The authors evaluated its long-term results of pscychosurgery and discussed its neuroanatomical basis. Methods : Since 1993, eight patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses. All were referred from psychiatrist of these disorders, one was aggressive behavior, five were obsessive-compulsive disorders(OCD), and two were depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior, and limbic leukotomy was done for OCD and depression with anxiety. The results of OCD were evaluated with with YBOCS(Yale-Brown obsessive compulsive scale) and VAS (visual analogue scale), CGI(clinical global impairment) in OCD, and OAS(overt aggression scale), MMS, WAIS were checked for the evaluation of aggressive behavior. Hamilton depression scale(HAMD) was used for evaluation of depression. Ventriculography was used in the first five patients and MR-guided stereotaxy was used in recent three cases for localization of target. The lesions were made with radiofrequency lesion generator. Results : With long-term follow up(mean 45 months) in five OCDs, mean YBOCS declined from 34 to 3(n=5). All returned to previous social life. In OAS scores of aggressive behavior during six-year follow up, scores declined from 8 to 2 with clinical improvement. In two patients with depression with anxiety, HAMD declined from 28.5 to 16.5(n=2). There was no operative mortality and no significant morbidity except one case of mild transient urinary incontinence. Conclusion : With these long-term results, authors assumed that stereotactic psychosurgery could be one of safe and effective mtherapeutic methods in several medically intractable psychiatric illness.
Kim, Chan-Hyung;Lee, Sung-Hoon;Kim, Ji-Woong;Lee, Hee-Sang;Kim, Kyung-Hee;Lee, Hong-Shick
Sleep Medicine and Psychophysiology
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v.5
no.2
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pp.194-201
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1998
Objectives : This study was aimed to investigate the differences in intelligence and neuropsychological test findings between patients with obsessive-compulsive disorder(OCD) and normal controls, and to find out brain functions. Methods : To examine the brain functions, Halsted Reitan neuropsychological test, computerized neuropsychological test, Wechsler Memory scale and K-WAIS were applied. Subjects of this study consisted of 12 patients with OCD and 17 normal controls who were matched for age, handedness and education year. Results : The verbal intelligence of OCD was significantly higher than that of normal controls. But there was no significant difference in total and performance intelligence between groups. The total time of tactual performance test in OCD was significantly delayed than that in normal controls. Also the visual recall of Wechsler memory scale in OCD was more impaired than that in normal controls. Conclusion : These findings support that visual-spatial memory, which is related to basal ganglia, is impaired in OCD.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.4
no.1
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pp.164-172
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1993
By observing the psychotherapy process expressed by an adolescent with obssessive compulsive disorder, the author suggests that the main problem of OCD is not merely a product of an unconscious process as traditionally thought, but a learned problem solving process as a method surviving the more realistic conflicts, and therefore the treatment should be directed to more or less conscious and realistic issues and conflicts, family therapy should be offered too.
Objective : Cognitive fusion, or believability, in acceptance and commitment therapy (ACT), refers to the tendency to become entangled in one's thoughts or feelings. It is an important factor in the development and maintenance of anxiety disorders. However, there is a lack of validated self-report measures for cognitive fusion and defusion, particularly for individuals with anxiety. To address this gap, this study aimed to evaluate the Korean Version of Believability of Anxious Feelings and Thoughts Questionnaire (K-BAFT). Methods : A total of 608 university students and 85 patients with obsessive-compulsive disorder (OCD) took part in this study. They were asked to complete various psychological measures, including the K-BAFT, other measures of ACT processes, and symptom scales. The researchers then analyzed the psychometric characteristics of the K-BAFT. Results : The results of the exploratory and confirmatory factor analyses indicated that the three-factor structure of the K-BAFT, which was reported in the original study, was also found in the university sample. Additionally, both the student and the OCD group demonstrated strong internal consistency (α=0.86 and 0.91, respectively). In the university sample, the K-BAFT showed a strong correlation with the Cognitive Fusion Questionnaire (rs=0.53, p<0.001). However, it had a weak correlation with symptoms scales for depression, anxiety, and stress (all rs<0.32). Furthermore, the OCD group had higher scores on the K-BAFT compared to the university sample. Conclusion : K-BAFT is considered to be a reliable and valid self-report tool for measuring cognitive fusion with anxious thoughts and feelings.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.4
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pp.250-263
/
2019
This study aimed to improve the public perception of people with mental illness by suggesting the need for public efforts and proposing specific plans. Demographic differences in the attitudes towards mental illness, the need of public service announcements to improve public perception of mental illness, and the current and expected situation of each advertising medium were analyzed, and plans to improve the advertising were proposed. Three mental illnesses that are possible to recover from through treatment-depression, obsessive-compulsive disorder(OCD), and panic disorder-were examined primarily, and the general public residing in Seoul and the capital area were surveyed. A comparison of the respondents' attitudes towards people with mental illness showed that there were significant differences in their attitudes with respect to gender, marital status, age, and family history. On the other hand, there was no significant difference with respect to religion, monthly income, or academic background. Most of the respondents recognized that public efforts to improve the public perceptions of mental illness, i.e., efforts through the mass media, were necessary and should be intensified though television, Internet, radio, billboard, and transport advertising. Based on the above findings, this study highlights the necessity for advertising through mass media for positive public perceptions of people with mental illness and proposes plans to intensify the advertising, focusing on social, organizational, and individual levels.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.15
no.2
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pp.143-151
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2004
Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.12
no.1
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pp.149-156
/
2001
After the fact that obsessive-compulsive symptoms or tic symptoms are common in Sydenham's chorea which is a sequale of rheumatic fever produced by group A beta-hemolytic streptococcus was reported, the association between group A beta-hemolytic streptococcus and a subgroup of obsessivecompulsive disorder(OCD) or tic disorder has been attentioned. This subgroup shared a unique clinical course, characterized by an abrupt onset of symptoms and/or dramatic exacerbations. And this subgroup was distinguished by pre-pubertal onset of symptoms, neurological abnormalities(choreiform movements and a unique pattern of motoric hyperactivity), as well as by relapsing and remitting symptom course. Acronym PANDAS(pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection) was used to denote a subgroup of OCD or tic disorder patients with these clinical characteristics. Then, there was a report suggesting that PANDAS category include some of attention-deficit/hyperactivity disorder(ADHD) and were two case reports of anorexia nervosa and body dysmorphic disorder with characteristics of PANDAS. This case is a patient who developed normally until age of 7, but after pharyngeal inflammation with high fever, he showed disturbance of cognition, social relationship, and language and communication, as well as tic symtoms and abnormal movement on face, hand, and foot. We report this case with review of literatures, because we think that this case belongs to the PANDAS category. Based on this observation, we suggest that PANDAS category include some of childhood disintegrative disorder as well as OCD, tic disorder, and ADHD.
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