• Anxiety and mood
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• v.4 no.1
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• pp.19-27
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• 2008

Objective : This study was conducted to evaluate the changes in the levels of neurotransmitters and cortisol in patients with chronic posttraumatic stress disorder (PTSD) and to evaluate their correlation with symptoms after long-term pharmacological treatment. Methods : Twenty-eight Vietnam veterans with chronic PTSD and 34 non-PTSD patients were consecutively recruited. The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD) and Hamilton Anxiety Scale (HAS) were used to evaluate symptom severity. High performance liquid chromatography (HPLC) was used to measure the plasma levels of epinephrine, norepinephrine, and dopamine, and a radioimmunoassay (RIA) was performed to evaluate the plasma level of cortisol. Results : Plasma cortisol was significantly lower in PTSD patients than in control subjects, while there was no significant difference in plasma epinephrine, norepinephrine and dopamine between the two groups. The scores of M-PTSD, CAPS, HAMD and HAMA were signigicantly higher in PTSD patients than control group. Conclusion : After long-term treatment, the levels of neurotransmitters in PTSD patients returned to within the normal range, and the patients' symptoms showed some improvement. However, the core symptoms of PTSD continued to appear intermittently, and they are thought to be associated with hormonal systems, such as the HPA axis. It is also suggested that PTSD should be considered to be a complex disorder associated with multiple systems and that combinations of the effective medications for each system should be used to treat patients with PTSD.

• Anxiety and mood
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• v.9 no.2
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• pp.147-153
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• 2013

Objective : Despite the chronic nature and high social costs, individuals with anxiety disorders seldom seek treatment. Thus, education for public awareness and screening for the illness is tremendously important for mental health professionals. This study summaries and presents the results from Anxiety Disorder Screening Program during the Mental Health Exposition held in Seoul in April, 2013. Methods : We analyzed the data from 116 participants who agreed and completed the screening questionnaires during their visits to two-day Anxiety Disorder Screening Program prepared by the Korean Academy of Anxiety Disorder. The questionnaire comprised of modified Mobility inventory for agoraphobia, Contents of worries, Penn State Worry Questionnaire, Life Events Checklist, and Abbreviated Posttraumatic Stress Disorder Checklist. Results : Participants demonstrated high rates of anxiety symptoms and possible anxiety disorders. Experience of panic attack was reported by 45%, lifetime and 16% in the past month by respondents. Phobia was reported by 46%. Participants had an average of 3.3 pathological worries and among those, social or interpersonal content was most common (46%). At least one lifetime traumatic event was reported by 64%. By the cut-off scores in the literature, 46% had possible generalized anxiety disorder and 58% possible posttraumatic stress disorder. Conclusion : Our results suggested that many visitors to Anxiety Disorder Screening Program were in fact treatment seeking after experiencing some forms of anxiety symptoms. Further efforts for delivery of medical information and increasing public awareness for anxiety disorders are needed.

• Psychiatry investigation
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• v.15 no.11
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• pp.1087-1093
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• 2018

Objective Posttraumatic stress disorder (PTSD) is distinct from anxiety disorders in its etiology and clinical symptomatology, and was reclassified into trauma- and stressor-related disorders in DSM-5. This study aimed to find neurophysiological correlates differentiating PTSD from anxiety disorders using resting-state quantitative electroencephalography (qEEG). Methods Thirty-six patients with either PTSD or acute stress disorder and 79 patients with anxiety disorder were included in the analysis. qEEG data of absolute and relative powers and patients' medication status on the day of qEEG examination were obtained. Electrodes were grouped into frontal, central, and posterior regions to analyze for regional differences. General linear models were utilized to test for group differences in absolute and relative powers while controlling for medications. Results PTSD patients differed from those with anxiety disorders in overall absolute powers [F(5,327)=2.601, p=0.025]. Specifically, overall absolute delta powers [F(1,331)=4.363, p=0.037], and overall relative gamma powers [F(1,331)=3.965, p=0.047] were increased in PTSD group compared to anxiety disorder group. Post hoc analysis regarding brain regions showed that the increase in absolute delta powers were localized to the posterior region [F(1,107)=4.001, p=0.048]. Additionally, frontal absolute gamma powers [F(1,107)=4.138, p=0.044] were increased in PTSD group compared to anxiety disorder group. Conclusion Our study suggests increased overall absolute delta powers and relative gamma powers as potential markers that could differentiate PTSD from anxiety disorders. Moreover, increased frontal absolute gamma and posterior delta powers might pose as novel markers of PTSD, which may reflect its distinct symptomatology.

• Anxiety and mood
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• v.6 no.1
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• pp.3-9
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• 2010

Even experienced clinicians have difficulties in diagnosing posttraumatic stress disorder (PTSD) exactly, due to its diverse clinical features, which vary according to individuals, traumas, and various comorbid psychopathologies, and its related compensation issues. It is usually mandatory for clinicians and researchers to use screening and assessment tools when diagnosing and evaluating PTSD. To date, research has developed numerous PTSD screening and assessment tools ; therefore one of the cardinal issues is to select the best of the various tools, the one most suitable for the clinician's or researcher's purposes. This article reviews several currently-available subjective and objective instruments for the diagnosis and evaluation of PTSD and groups them according to whether they are Diagnostic and Statistical Manual for Mental Disorders-Correspondent Measures ; PTSD-Focused, Non-DSM-Correspondent Measures ; or Empirically Derived Measures. We present the instruments' psychometric properties and scoring methods and describe their merits and weak points, focusing on their practical usage.

• Anxiety and mood
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• v.7 no.1
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• pp.29-33
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• 2011

Objective : This study was performed to analyze the relationship between posttraumatic stress, coping style, and dissociation in Korean firefighters. Methods : Subjects included 193 male and 9 female firefighters in the metropolitan city of Daejeon. Their age ranged from 25 to 57 with an average of 39.17 (SD : 7.572) years. Their posttraumatic stress or traumatic experiences were assessed with the Korean Version of the Posttraumatic Stress Diagnostic Scale. Their coping style was categorized with the Korean version of the Ways of Coping Checklist. Their dissociation was assessed with the Korean version of Dissociative Experiences Scale. The data analysis included a correlation analysis and structural equation modeling. The modeling tested the validity of the model that posttraumatic stress had a direct effect on dissociation and coping style had an mediatory effect between stress and dissociation. Results : First, firefighters' posttraumatic stress or traumatic experiences had a direct effect on dissociation, a symptom of a mental disorder. Second, the firefighters employed passive styles to cope with their stress. This is explained that they had been exposed to their traumatic events repeatedly without being able to control it themselves. Third, coping style had no effect on the mediation between posttraumatic stress and dissociation. This is explained in terms of repeated exposure to the traumatic events. Conclusion : Based on the results, it is concluded that Korean firefighters' dissociation was not relieved by their coping effort but associated directly with their traumatic experiences. To decrease their dissociation, it is necessary to reduce the exposure to their traumatic events.

• Journal of Ginseng Research
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• v.44 no.4
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• pp.644-654
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• 2020

Background: Posttraumatic stress disorder (PTSD), a mental disorder induced by traumatic stress and often accompanied by depression and/or anxiety, may involve an imbalance in the neurotransmitters associated with the fear response. Korean Red Ginseng (KRG) has long been used as a traditional medicine and is known to be involved in a variety of pharmacological activities. We used the open field test and forced swimming test to examine the effects of KRG on the depression-like response of rats after exposure to single prolonged stress (SPS), leading to activation of the serotonergic system. Methods: Male rats received KRG (30, 50, and 100 mg/kg, intraperitoneal injection) once daily for 14 days after exposure to SPS. Results: Daily KRG administration significantly improved depression-like behaviors in the forced swimming test, increased the number of lines crossed and time spent in the central zone in the open field test, and decreased freezing behavior in contextual and cued fear conditioning. KRG treatment attenuated SPS-induced decreases in serotonin (5-HT) tissue concentrations in the hippocampus and medial prefrontal cortex. The increased 5-HT concentration during KRG treatment may be partially attributable to the 5-hydroxyindoleacetic acid/5-HT ratio in the hippocampus of rats with PTSD. These effects may be caused by the activation of hippocampal genes encoding tryptophan hydroxylase-1 and 2 mRNA levels. Conclusion: Our findings suggest that KRG has an antidepressant effect in rats subjected to SPS and may represent an effective use of traditional medicine for the treatment of PTSD.

• Anxiety and mood
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• v.5 no.1
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• pp.14-20
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• 2009

Objective : The objective of this study was to examine the relationship between plasma serotonin concentration and posttraumatic stress disorder (PTSD) symptoms in chronic PTSD patients who have been taking medication. Methods : Plasma serotonin level of 14 PTSD patients and a control group of 28 Vietnam War veterans was measured by HPLC (high performance liquid chromatography). The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD), and Hamiltion Anxiety Scale (HAS) were used to evaluate PTSD symptom severity. Results : Serotonin level was significantly higher in the PTSD group than in the control group (p=0.036, p=0.006, respectively). M-PTSD (p<0.001), CAPS (p<0.001), HRSD (p<0.001), and HAS (p<0.001) scale scores were significantly higher in the PTSD group than in the control group; however, the CES score failed to show a significant improvement (p=0.964). There were no significant differences between plasma serotonin and PTSD symptoms. Conclusion : In chronic PTSD patients who have been taking medications, we can not predict treatment effect and symptom severity by measuring only plasma serotonin levels. PTSD is a complicated disorder which may likely be related to a variety of neurotransmitter systems. Therefore, further research which investigate relationships with norepinephrine, dopamine, and other neurotransmitters as well as serotonin is needed to improve the treatment of PTSD.

• Psychiatry investigation
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• v.15 no.11
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• pp.1071-1078
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• 2018

Objective We developed easily accessible imagery-based treatment program for patients with post-traumatic stress disorder (PTSD) related to workplace accidents and investigated the effects of the program on various PTSD related symptoms. Methods The program was based on an online platform and consisted of eight 15-min sessions that included script-guided imagery and supportive music. Thirty-five patients with workplace-related PTSD participated in this program 4 days per week for 4 weeks. Its effects were examined using self-report questionnaires before and after the take-home online treatment sessions. Results After completing the 4-week treatment program, patients showed significant improvements in depressed mood (t=3.642, p=0.001) based on the Patient Health Questionnaire-9 (PHQ-9), anxiety (t=3.198, p=0.003) based on the Generalized Anxiety Disorder seven-item (GAD-7) scale, and PTSD symptoms (t=5.363, p<0.001) based on the Posttraumatic Stress Disorder Check List (PCL). In particular, patients with adverse childhood experiences exhibited a greater degree of relief related to anxiety and PTSD symptoms than those without adverse childhood experiences. Conclusion The present results demonstrated that the relatively short online imagery-based treatment program developed for this study had beneficial effects for patients with workplace-related PTSD.

• Anxiety and mood
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• v.10 no.1
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• pp.3-10
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• 2014

Reactive disorder is a group of diagnosis with a definitely known etiology and whose etiological factor is essential to the diagnosis. In DSM system, such reactive disorders are listed as adjustment disorder, acute stress disorder, brief psychotic disorder with marked stressor and posttraumatic stress disorder (PTSD). However, a growing number of individuals is suffering from a prolonged feeling of embitterment after exceptional negative life events and this condition could be diagnosed neither PTSD nor adjustment disorder nor depressive disorder in the context of DSM-IV diagnostic system. This clinical condition can be described as 'posttraumatic embitterment disorder' (PTED). PTED is a reactive disorder triggered by exceptional, though normal negative life events such as conflict in the workplace, unemployment, death of a relative, divorce, severe illness, or experience of loss or separation. The common feature of such events is that they are experienced as unjust, as a personal insult, accompanied by psychological violation of basic beliefs and values. The central psychopathological response pattern in PTED is a prolonged feeling of embitterment. In particular, the core emotion of embitterment can lead to the rejection of treatment. Therefore, "wisdom therapy" as a new treatment approach specifically designed for PTED has been developed. It is assumed that many patients suffering from PTED are often misunderstood and misdiagnosed. This review would help to introduce PTED into the clinical field in psychiatry.

• Anxiety and mood
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• v.7 no.2
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• pp.119-125
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• 2011

Objectives : The three symptom clusters of posttraumatic stress disorder (PTSD) are reexperience, avoidance, and hyperarousal. Alcohol use disorders frequently co-occur with PTSD, and possible functional correlations are suspected. Scholarly evaluation of the differences between the symptoms of PTSD and those of alcohol problems may be useful in understanding the pathophysiology of the comorbidity. Methods : We recruited Vietnam veterans with PTSD (n=97) and without PTSD (n=132). The alcohol use disorder identification test (AUDIT), and clinician-administered PTSD scale (CAPS) were administered to participants. The PTSD group was divided into two categories: those with PTSD only (n=57) and those with concurrent alcohol-related problems (n=40). Results : The PTSD group showed higher AUDIT scores compared to the control group. In the PTSD group, participants with alcohol problems had a severer symptoms of recurrent dream and sleep disturbance symptoms compared to the PTSD only group. No significant differences were found in the three major symptom clusters of PTSD. Conclusion : These findings support the proposed existence of a functional correlation between PTSD and alcohol use disorder. Clinicians should carefully evaluate and treat comorbid alcohol use disorder in patients with PTSD.