• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.181-188
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• 2005

Objectives:Hwa-byung has been studied clinically for several years and introduced as Korean Culture- Bound Syndrome. However, the definition and the diagnostic method are not yet clarified, and there has not been any sufficient comparative study on this disease entity. This study was conducted to determine the clinical symptoms and the profile of the neurocognitive functions in Hwa-byung(HB) and Major Depressive Disorder(MDD), and We wish to identify any critical factors that differentiate the disorders. Methods:A total of 102 participants were examined, including 34 participants with MDD, 34 with HB, and 34 healthy controls. The MDD and HB patients were recruited from among inpatients and outpatients at the National Medical Center for the period from May to December of 2004. As a major diagnostic tool of MDD, diagnostic reference of DSM-IV-TR was used and as HB's diagnostic tool, We used computerized neurocognitive function test. Psychiatric symptomatology was evaluated by the Beck Depression Inventory(BDI), and Symptom Checkist-90-Revision(SCL-90-R). Oneway ANOVA, Scheffe post-hoc test and Chi-Squre Tests were used for statistical analysis. Results:The participants in three groups did not differ in terms of age, sex, and education. Assessment of BDI indicated that the MDD group had significantly higher total score than the HB group. MDD and HB groups showed significantly higher total scores on the SCL-90-R in comparison to the controls. The MDD group was found to have significantly more symptoms of depression than the HB group, based on the depression subscale of the SCL-90-R. The computerized neurocognitive function test suggest several results 1) Within the memory domain, it was found that one of the two memory tests in MDD and HB groups were significantly impaired in comparison to the control group. 2) Within the attention domain, it was found that only the MDD group was significantly impaired in comparison to the control group. 3) Within the higher cortical function domain, it was found that significant impairment exist in MDD group and HB group compared to the control group; the severity of impairment was found to be more profound in the MDD group than in the HB group. Conclusion:These results suggest that both HB group and MDD group have significantly decreased neurocognitive function than the control group, and neurocognitive function of the HB group is better than that of the MDD group.

• Korean Journal of Biological Psychiatry
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• v.14 no.4
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• pp.241-248
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• 2007

Objectives : Schizophrenia is equally distributed in both sexes. However, later-onset, milder psychopathology, and better outcome are associated with the females. This reason is thought to be partly due to the estrogen system. Recently, it was suggested that estrogen receptor 1(ESR1) gene polymorphisms might affect the expression of ESR1 and were associated with several psychiatric disorders. Thus, we investigated the association between two single nucleotide polymorphisms(SNPs) in the ESR1 gene and Korean schizophrenic patients in this study. Methods : Genotype, allele, and haplotype frequencies of the two SNPs(rs 2234693 and rs 2228480) were analyzed between 218 Korean controls and 158 Korean schizophrenic patients. Also, age of onset and negative symptom scale scores according to genotypes were analyzed in the patients with schizophrenia. Results : There was a significant difference in allele frequencies of rs 2234693 between the schizophrenic patients and the controls(p=0.03). Genotype distributions(p=0.03) and allele frequencies(p=0.01) of rs 2234693 were significantly different between the female schizophrenic patients and the female controls. The frequency of TC-CC genotypes compared with TT genotype in the female schizophrenic patients was significantly higher than that in the female controls(OR=2.36). The mean age of onset in the schizophrenic patients with TC-CC genotypes was significantly lower than that in the patients with TT genotype. The frequency of rs 2234693C- rs 2228480G haplotype in the female schizophrenic patients was relatively higher than that in the female controls. Conclusions : These results of our study support the possibility that the ESR1 gene polymorphisms might be involved in the susceptibility of females to schizophrenia and play a role in sex difference of schizophrenia.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.81-92
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• 2001

Stress has been linked to the pathophysiology and pathogenesis of various psychiatric illnesses. Over the past few years, our understanding of the brain and neuroendocrine systems that are linked to stress responses has increased enormously. This article reviews a series of animal and human studies to understand what are the central pathways by which stress is perceived, processed, and transduced into a neuroendocrine response. We focus on the limbic-hypothalamic-pituitary-adrenal(LHPA) axis and several neurotransmitter systems such as norepinephrine, CRF, serotonin, acetylcholine, and dopamine. LHPA stress circuit is a complex system with multiple control mechanisms which are altered in pathological states. CRF and related peptides in the central nervous system appear to enhance behavioral responses to stressors. Norepinephrine systems are also activated by stressors and cause the release of catecholamines from the autonomic nervous system. CRF-norepinephrine interaction makes a feed-forward system which may be important for an organism to mobilize not only the pituitary system but also the central nervous system, in response to environmental challenges. The interactions among several neurotransmitters and endocrine systems appear to play key roles in mediating various behavioral and psychological stress responses involving abnormal responses to stressors such as anxiety and affective disorders.

• Korean Journal of Cognitive Science
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• v.26 no.2
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• pp.167-207
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• 2015

This study focused on the awareness and coping methods of psychological trauma and human suffering in the contemporary era after the development of posttraumatic stress disorder(PTSD) including the situations in the Korean society, and proposed principles for an alternative paradigm of trauma recovery. Trauma is defined as an 'external' stress causing chronic suffering mediated by memory, and the American Psychiatric Association approved PTSD in the Diagnostic and Statistical Manual of Mental Disorders in 1980. The development of PTSD empowered moral legitimacy to the victims, opened a successful way to treatment, and accomplished explosive amount of research in the area of neurobiology and cognitive neuroscience. However, this also narrowed the understanding of human suffering, and the importance of an alternative coping method which overcomes the limitations of technical intervention became overlooked. Moreover, the Korean society has an underlying mechanism of replacing the matter of trauma to a problem of an individual. This is shown among the historical context of splitting and denial, and among medicalized bureaucracy. Trauma should be acknowledged as a social suffering, and searching for an alternative paradigm is in need. This study suggested the following principles; seeking for truth and justice, survivor as the agent of recovery emphasizing the responsibility of the community, ecological adaptations of recent bio-psychological achievements, and finally putting emphasis on continuous discussions about the definition of recovery.

• Anxiety and mood
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• v.7 no.2
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• pp.85-91
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• 2011

Objective : This study aimed to investigate the characteristics of the early maladaptive schemas in patients with panic disorder. Methods : Patients (n=35) included people who had met the DSM-IV-TR criteria for panic disorder. The normal control group (n=35) were those people who had no psychiatric disorder and had never experienced panic attack. The early maladaptive schemas and the severity of depression and anxiety were assessed by the Young Schema Questionnaire Short-form (YSQ-SF), the Beck Depression Inventory (BDI), and the Spielberger State-Trait Anxiety Inventory (STAI). Results : The scores on the STAI-S, STAI-T, and BDI were significantly higher in the patient group. Compared to the control group, the scores of vulnerability to harm and illness, and abandonment/instability schemas were significantly higher in the patient group. In the patient group, defectiveness/shame and subjugation schemas were found to predict BDI, dependent/incompetence, abandonment/instability schemas were found to predict STAI-S, and vulnerability to harm and illness, and abandonment/instability schemas were found to predict STAI-T. In normal controls, failure and insufficient self-control/self-discipline, failure, and emotion inhibition schemas were found to predict BDI, STAI-T, and STAI-S. Conclusions : Vulnerability to harm and illness and abandonment/instability schemas may be characteristic schema in patients with panic disorder.

• The Korean Journal of Physiology and Pharmacology
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• v.12 no.4
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• pp.205-209
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• 2008

Recently, Sun et al (2008) reported that the IL6R polymorphism is associated with schizophrenia. Therefore, to detect the association between polymorphisms of interleukin 31 receptor A (IL31RA) and schizophrenia, we genotyped 9 SNPs [rs9292101 (intron 1), rs1009639 (exon 2, Pr043Pro), rs2161582 (intron 2), rs68761890 (intron 5), rs16884629 (intron 6), rs11956465 (intron 12), rs12153724 (intron 12), and rs16884641 (intron 14)] using the Golden Gate assay on Illumina BeadStation 500 GX. Two hundred eighteen patients with schizophrenia and 379 normal subjects were recruited. Patients with schizophrenia were diagnosed according to DSM-IV, and control subjects without history of psychiatric disorders were selected. We used SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs for the evaluation of genetic data. Of nine polymorphisms, three SNPs (rs9292101, rs1009639, and rs11956465) were associated with schizophrenia. The rs9292101 and rs11956465 showed significant associations with the risk of schizophrenia in the codominant [rs9292101, odds ratio (OR)=0.74, 95% confidence interval (CI)=0.58${\sim}$0.95, p=0.017] and recessive (rs11956465, OR=0.64, 95% CI=0.42${\sim}$0.96, p=0.034) models, respectively. The rs1009639 also was statistically related to schizophrenia in both codominant (OR=0.76, 95% CI=0.60${\sim}$0.97, p=0.025) and dominant (OR=0.66, 95% CI=0.44${\sim}$0.98, p=0.035) models. Two linkage disequilibrium (LD) blocks were made. In the analysis of haplotypes, a haplotype (GCT) in block 1 and a haplotype (CCACAG) in block 2 showed significant associations between schizophrenia and control groups (haplotype GCT, frequency=0.509, chi square=4.199, p=0.040; haplotype CCACAG, frequency=0.289, chi square=5.691, p=0.017). The results suggest that IL31RA may be associated with risk of schizophrenia in Korean population.

• Korean Journal of Biological Psychiatry
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• v.19 no.2
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• pp.106-113
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• 2012

Objectives : The purpose of this study is to investigate the relationship between the triallelic serotonin transporter gene and stressful life events to determine their effect on depression with alcohol dependence. Methods : Ninety-five hospitalized patients with alcohol dependence (73 male, 22 female) were enrolled in this study. Thirty-two (33.7%) of the total patients were diagnosed with major depressive disorder and dysthymic disorder by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV. The characteristics of stress were evaluated using the stressful life events scale, and depressive symptoms were assessed using the depression scale (Beck Depression Inventory, BDI). Alcoholism with depression (n = 32) and alcoholism without depression (n = 63) were genotyped for the triallelic serotonin transporter gene ($L_A$ : higher expressing allele, $L_G$/S : lower expressing allele). Results : There was no significant difference in the allele frequency between the depression group and the non-depression group (${\chi}^2$ = 0.345, p = 0.619). $L_G$/S alleles had more comorbid depression in the higher score of stressful life events scale [Mental-Haenszel (MH)-${\chi}^2$ = 4.477, p = 0.034]. But there was no significant difference in the comorbidity according to the scores from the stressful life event scale in the $L_A$ alleles (MH-${\chi}^2$ = 0.741, p = 0.399). In the results, alcohol-dependent individuals with $L_G$/S alleles had more comorbid depression than those with $L_A$ alleles when they had experienced severe stressful life events (MH-odds ratio = 2.699, p = 0.028). Conclusions : These results suggest that there is no direct relationship between triallelic serotonin transporter gene and depression in the alcohol dependent patients. But alcohol dependent individuals with the lower expressing alleles of the serotonin transporter gene were more susceptible to depression than those with the higher expressing alleles in response to stressful life events.

• Journal of Digital Convergence
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• v.13 no.6
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• pp.225-234
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• 2015

Neurobiological approach helps to resolve the mind-body dualism and develop new assessment and treatment approaches in psychiatry. However, it could be a problem to place too much emphasis on certain aspects of neurobiology, specifically structural neuroanatomy, because of the complexity or comorbidity of neuropsychiatric disorders. Developmental Coordination Disorder (DCD), for instance, is generally related to problems in motor skills and this movement disability is often related to perception. One account, two visual systems theory, relied on functional distinction in brain; ventral stream is responsible for visual recognition, and dorsal stream is responsible for the guidance of actions. However, Studies are now showing that shape perception is relevant to visually guided action, such as reaching-to-grasp an object. In this article, I reviewed fundamental findings of two-visual system theory and suggested problems of visually guided action to consider what shape perception implies for the two visual systems. Questions raised highlight possible limitations of adopting a structural neuroanatomical approach to account for perception and action effects, and by extent related psychiatric conditions such as DCD. In conclusion, neurobiological approach converging to neuropsychiatry, while useful, would be limited if it focuses too much on anatomical distinction.

• The Korean Society of Law and Medicine
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• v.19 no.1
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• pp.23-80
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• 2018

Since the 1960s, the United States' (U.S.) deinstitutionalization policy has reinstated people with mental illness into communities. Unfortunately, when untreated, some people with psychiatric disorders become homeless, and some commit serious crimes during a psychological crisis. Assisted Outpatient Treatment (AOT), also known as Kendra's Law in New York and Laura's Law in California, provides treatment, services and support to people with mental illness in the community. AOT has repeatedly been found effective and is recognized as an evidence-based practice. The response to the mental health crisis (crisis intervention) in the U.S. has also been successful in preventing worsening mental illness and related criminality and other issues. This paper provides an opportunity to create a platform from which to learn how to successfully apply the AOT and crisis intervention of the U.S. to South Korea within the cultural and societal context when establishing social services for people with mental illness in South Korea's communities.

• Journal of Yeungnam Medical Science
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• v.24 no.1
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• pp.1-10
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• 2007

The chronic fatigue immune dysfunction syndrome (abbreviated CFIDS or CFS) is a disorder characterized by debilitating fatigue(over 6 months.), along with cognitive, musculoskeletal, and sleep abnormalities. The etiology of this illness is unlikely to be a single agent. Findings to date suggest that physiological and psychological factors work together to predispose and perpetuate the illness. Diagnosis is made difficult by the nonspecific clinical findings and no available diagnostic testing. With no known cause or cure for the chronic fatigue and immune dysfunction syndrome, treatment is based on relieving symptoms and improving the quality of life of affected patients. There is emerging evidence that chronic fatigue syndrome may be familial. In the future, studies will examine the extent to which genetic and environmental factors play a role in the development of chronic fatigue syndrome. Most patients with CFS have psychiatric problems such as a generalized anxiety disorder, or major or minor depression, therefore, these mental health disorders may be correlated with the pathophysiology of the CFS. The treatment for CFS must be individualized, due to the heterogeneity of the CFS population. Also the treatment of CFS is built on a foundation of patient-physician relationship, respect and advocacy.