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

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.8 no.3
• /
• pp.302-313
• /
• 2001

Purpose: To identify characteristics of chronic fatigue, difference between the duration of fatigue and characteristics of chronic fatigue, and association between chronic fatigue and related factors in adults. Method: The subjects for this study were 180 adults who had experienced fatigue for over one month The measurement tools were the Revised Fatigue Scale by Chalder et al. (1993), the Visual Analogue Scale-energy developed by Lee et al. (1991), the BEPSI (Brief Encounter Psychosocial Instrument) by Frank & Zyzanski (1988), Zung's self rating depression scale (1965) and life style items including exercise sleep, drinking smoking and diet as developed by the researchers. Results : Those who complained of fatigue over six months experienced higher disturbances in their daily life compared to those who had suffered from fatigue less than six months. There were a significant correlation between severity of fatigue and depression (r=.46, p<.001), stress (r=.41, p<.001), and sleep (r=.20, p<.01) Statistically significant relationships were found between severity of fatigue and amount of exercise per week (F=3.79. p<.05) disturbed sleep (t=-2.66, p<.01), number of times awakened during the night (F=3.48, p<.05) types of drinking (F=2.65, p<.05), and diet regularity (F=5.83, p<.01). The construction of a multiple regression model revealed an adjusted $R^2$ of .27 with the depression score serving the major predictor variables for severity of fatigue. Men and people in the younger age group were more energetic than women and those in other age groups. Also married people experienced more fatigue than people who were single. divorced or separated. Conclusion: In nursing interventions for fatigue, medical personnel should consider sociodemographic characteristics of the clients, ways to reduce of stress and counter disturbances in daily life and develop strategies for a health promoting life style.

• Anxiety and mood
• /
• v.10 no.2
• /
• pp.128-136
• /
• 2014

Objective : This study aimed to examine impact of anxiety and demographic factors on relationship between severity of depressive symptom and quality of life and disability. Methods : One hundred ninety five patients who met DSM-IV-TR criteria for depressive disorder were enrolled. It includes "Hamilton Rating Scale for Depression (HRSD)", "State-Trait Anxiety Inventory-State (STAI-S)", "General Health Questionnaire/Quality of Life-12 (GHQ/QL-12)", and "Sheehan Disability Scale (SDS)". Correlation analysis was used to see the correlations of each variable. Hierarchical regression analysis was used to see mediating effect of anxiety in the relationship. Sobel test was used to verify mediating effect. Multiple regression analysis was used to see moderating effect of demographic factors in the relationship. Results : There was partial mediating effect of anxiety on the relationship between severity of depressive symptoms and decreased quality of life (z=-11.68, p<.001)/increased disability (z=10.42, p<.001). Only religion was found to be moderating effect on the relationship between depressive symptoms and decreased quality of life. Conclusion : Rapid relief of anxiety along with depressive symptom had important implications for the treatment of patients with depression.

• Anxiety and mood
• /
• v.12 no.1
• /
• pp.34-41
• /
• 2016

Objective : Emotional state and emotion regulation strategies are considered to be important factors influencing the pattern and severity of somatic pain. The aim of this study is to investigate the relationship between cognitive emotional regulation strategies and somatic pain in patients with depression and/or anxiety disorders. Methods : A total of 140 outpatients, diagnosed with depression and/or anxiety disorders according to DSM-IV-TR, were evaluated using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Numerical Rating Scale (NRS) for somatic pain. Pearson correlations and independent t-tests were performed to analyze the relationship between somatic pain, the severity of depression and/or anxiety and cognitive emotion regulation strategies. Results : The severity of pain was significantly correlated with depressive symptoms, but not with anxiety. Patients with somatic pain tend to use maladaptive cognitive emotion regulating strategies more frequently, especially rumination and catastrophizing. Conclusion : These findings suggest that somatic pain correlates with maladaptive cognitive emotional regulating strategies. Interventions which modulate these non-productive strategies, especially rumination and catastrophizing, would be a new approach for managing patients with depressive and/or anxiety disorders who are suffering from somatic pain.

• The Korean Journal of Pain
• /
• v.32 no.2
• /
• pp.97-104
• /
• 2019

Background: This study was conducted to compare the effectiveness of low-dose ketamine versus ketorolac in pain control in patients with acute renal colic presenting to the emergency department (ED). Methods: This is a double-blind randomized clinical trial. The initial pain severity was assessed using the numerical rating scale (NRS). Then, ketamine or ketorolac was administered intravenously at a dose of 0.6 mg/kg and 30 mg respectively. The pain severity and adverse drug reactions were recorded 5, 15, 30, 60, and 120 min thereafter. Results: The data of 62 subjects in the ketamine group and 64 patients in the ketorolac group were analyzed. The mean age of the patients was $34.2{\pm}9.9$ and $37.9{\pm}10.6\;years$ in the ketamine and ketorolac group, respectively. There was no significant difference in the mean NRS scores at each time point, except for the 5 min, between the two groups. Despite a marked decrease in pain severity in the ketamine group from drug administration at the 5 min, a slight increase in pain was observed from the 5 min to the 15 min. The rate of adverse drug reactions, including dizziness (P = 0.001), agitation (P = 0.002), increased systolic blood pressure (> 140 mmHg), and diastolic blood pressure (> 90 mmHg) was higher in the ketamine group. Conclusions: Low dose ketamine is as effective as ketorolac in pain management in patients with renal colic presenting to the ED. However, it is associated with a higher rate of adverse drug reactions.

• The Korean Journal of Pain
• /
• v.36 no.1
• /
• pp.137-246
• /
• 2023

Background: To investigate the relationship between cutaneous allodynia (CA) and kinesiophobia, gastrointestinal system (GIS) symptom severity, physical activity, and disability, and to determine whether CA, pain, and disability were influencing factors for kinesiophobia, GIS symptoms, and physical activity in individuals with migraine. Methods: The study included 144 individuals with migraine. CA, kinesiophobia, GIS symptoms, physical activity level, and migraine-related disability were evaluated with the Allodynia Symptom Checklist, the Tampa Kinesiophobia Scale (TKS), the Gastrointestinal Symptom Rating Scale (GSRS), the International Physical Activity Questionnaire-7, and the Migraine Disability Assessment Scale (MIDAS), respectively. Results: The CA severity was only associated with TKS (r = 0.515; P < 0.001), GSRS-total (r = 0.336; P < 0.001), GSRS-abdominal pain (r = 0.323; P < 0.001), GSRS-indigestion (r = 0.257; P = 0.002), GSRS-constipation (r = 0.371; P < 0.001), and MIDAS scores (r = 0.178; P = 0.033). Attack frequency (P = 0.015), attack duration (P = 0.035) and presence of CA (P < 0.001) were risk factors for kinesiophobia. Attack frequency (P = 0.027) and presence of CA (P = 0.004) were risk factors for GIS symptoms. Conclusions: There was a relationship between the CA and kinesiophobia, GIS symptoms, and disability. CA and attack frequency were found to be risk factors for kinesiophobia and GIS symptoms. Migraine patients with CA should be assessed in terms of kinesiophobia, GIS, and disability. Lifestyle changes such as exercise and dietary changes and/or pharmacological treatment options for CA may increase success in migraine management.

• The Journal of Internal Korean Medicine
• /
• v.45 no.2
• /
• pp.131-139
• /
• 2024

In this case report, we describe the effects of Korean Medicine therapies, including Bunshimgi-eum, on a patient hospitalized with insomnia due to fibromyalgia in a Korean Medicine Hospital. We treated the patient with Bunshimgi-eum for 21 of 27 hospital days. Post-treatment, we used the Insomnia Severity Index (ISI) to measure the severity of insomnia. To determine the severity of multiple pain, including neck, low back, Lt. shoulder, Lt. elbow, Rt. knee, and hand, we used the Numerical Rating Scale (NRS). For evaluation of generic health status, we used the European Quality of Life-5 Dimensions (EQ-5D) scale. After the treatment, the patient's clinical symptoms improved, according to the ISI, NRS, and EQ-5D. The results of this case study suggest that Korean Medicine therapies, including Bunshimgi-eum, may have positive effects as a treatment for insomnia related to fibromyalgia.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.2
• /
• pp.204-214
• /
• 1999

Background: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organism at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. Method: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. Results: 1. According to the criteria of pulmonary impairment with resting PFTs, $VO_2$max, and focal score of BDI were significantly low in the severe group(p<0.01). According to the criteria of $VO_2$max(ml/kg/min) and $VO_2$max(%), the parameters of resting PFTs, except $FEV_1$ were not significantly different between non-severe and severe(p>0.05). According to focal score($FEV_1$(%), FVC(%), MW(%), $FEV_1/FVC$, and $VO_2$max were significantly lower in the severe group(p<0.01). However, in the more severe dyspneic group(focal score<5), only $VO_2$max(ml/kg/min) and $VO_2$max(%) were low(p<0.01). $FEV_1$(%) was correlated with $VO_2$max(%)(r=0.52;p<0.01), but not predictive of exercise performance. The focal score had the correlation with max WR(%) (r=0.55;p<0.01). Sensitivity and specificity analysis were utilized to compare the different criteria used to evaluate the severity of pulmonary impairment, revealed that the classification would be different according to the criteria used. And focal score for dyspnea showed similar sensitivity and specificity. Conclusion : According to these result, resting PFTs were not superior to rating of dyspnea in prediction of exercise performance in patients with chronic pulmonary diseases and less correlative with focal score for dyspnea than $VO_2$max and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.

• Sleep Medicine and Psychophysiology
• /
• v.12 no.1
• /
• pp.50-57
• /
• 2005

Objectives: This study was designed to evaluate the differences in clinical characteristics and severity of symptoms between panic patients with and without comorbid major depressive disorder, and to ascertain the differences in the function of the autonomic nerve system measured by heart rate variability (HRV). Methods: The subjects were 60 patients who have panic disorder without major depressive disorder and 19 patients who met DSMIV criteria for both panic disorder and major depressive disorder. First, they drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorder Inventory Schedule-Panic Attack & Agoraphobia (ADIS-P&A), Clinical Global Impression (CGI), Hamilton Rating Scale for Depression (HAM-D), Panic Disorder Severity Scale (PDSS) and Heart Rate Variability (HRV). For statistical analysis, we performed t-test to compare the scores of self reported scales and clinician’s rating scales in panic patients with comorbid major depressive disorder and those without major depressive disorder. ANCOVA was used to compare the variables of HRV, considering age as a covariate. Results: The subjective severities of depression and anxiety that comorbid patients complained of were higher than those of patients with only panic disorder. Futhermore, comorbid patients were more sensitive to anxiety and physical sensations, and they tend to be more negative in their thinking. The scores of clinician-rating scales such as CGI and PDSS were also higher in the comorbid patients. However, there were no significant differences in HRV variables between both groups, despite a tendency to low heart rate variability in the comorbid group. Conclusion: This study suggests that patients with panic disorder and comorbid major depressive disorder tend to complain of more symptoms and to be more sensitive to various symptoms than those with panic disorder without comorbid depression. However, in this study comorbid major depressive disorder did not have a significant impact on the HRV variables of patients with panic disorder.

• Journal of The Korean Association For Science Education
• /
• v.32 no.1
• /
• pp.160-181
• /
• 2012

The purpose of this study is to understand raters' errors in rating performance assessments of science inquiry. For this, 60 middle school students performed scientific inquiry about sound propagation and 4 trained raters rated their activity sheets. Variance components estimation for the result of the generalizability analysis for the person, task, rater design, the variance components for rater, rater by person and rater by task are about 25%. Among 4 raters, 2 raters' severity is higher than the other two raters and their severities were stabilized. Four raters' rating agreed with each other in 51 cases among the 240 cases. Through the raters' conferences, the rater error types for 189 disagreed cases were identified as one of three types; different salience, severity, and overlooking. The error type 1, different salience, showed 38% of the disagreed cases. Salient task and salient assessment components are different among the raters. The error type 2, severity, showed 25% and the error type 3, overlooking showed 31%. The error type 2 seemed to have happened when the students responses were on the borders of two levels. Error type 3 seemed to have happened when raters overlooked some important part of students' responses because she or he immersed her or himself in one's own salience. To reduce the above rater errors, raters' conference in salience of task and assesment components are needed before performing the holistic scoring of complex tasks. Also raters need to recognize her/his severity and efforts to keep one's own severity. Multiple raters are needed to prevent the errors from being overlooked. The further studies in raters' tendencies and sources of different interpretations on the rubric are suggested.