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PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES - (한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 -)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

Relationship between the Malocclusion and Caries Prevalence of Adolescents in Iksan (익산시 청소년의 부정교합과 치아우식 유병률 사이의 연관성)

  • Shin, Gayoung;Ra, Jiyoung;An, Soyoun;Song, Jihyun;Lee, Kwanghee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.207-217
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    • 2014
  • The purpose of the present study was to evaluate the relationship between the malocclusion and dental caries in adolescents with permanent dentition. The subjects of the study were 385 adolescents aged 12 to 15 years. Dental Aesthetic Index (DAI) and DMFT index were recorded as clinical indicators of malocclusion and dental caries. The mean Dental Aesthetic Index (DAI) score of the subjects was 12.42 and the mean DMFT index of the subjects was 2.89. Four students (1.04%) were included in the group of orthodontic treatment mandatory, which signifies the handicapping malocclusion. Moreover, the result of gender-specific analysis of the DAI components observed that the prevalence of midline diastema and mandibular overjet were significantly higher among boys (p < 0.05). In 7 components (missing teeth, incisal segment crowding, maxillary anterior irregularity, mandibular anterior irregularity, mandibular overjet, anterior openbite, antero-posterior molar relationship) among the 10 DAI components, abnormal groups showed significantly higher DMFT index than normal groups (p < 0.05). The subjects in the group of definite to handicapping malocclusion (DAI ${\geq}$ 26) showed significantly higher DMFT index than the subjects in the group of minor or no malocclusion (p < 0.01). In addition, the DAI score had significant positive linear correlation with the DMFT index (r = 0.584, p < 0.01). Consequently, the current findings suggested a positive relationship between the malocclusion and caries prevalence. And several specific types of malocclusion were supposed to be significantly correlated with dental caries.

"Liability of Air Carriers for Injuries Resulting from International Aviation Terrorism" (국제항공(國際航空)테러리즘으로 인한 여객손해(旅客損害)에 대한 운송인(運送人)의 책임(責任))

  • Choi, Wan-Sik
    • The Korean Journal of Air & Space Law and Policy
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    • v.1
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    • pp.47-85
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    • 1989
  • The Fundamental purpose of the Warsaw Convention was to establish uniform rules applicable to international air transportation. The emphasis on the benefits of uniformity was considered important in the beginning and continues to be important to the present. If the desire for uniformity is indeed the mortar which holds the Warsaw system together then it should be possible to agree on a worldwide liability limit. This liability limit would not be so unreasonable, that it would be impossible for nations to adhere to it. It would preclude any national supplemental compensation plan or Montreal Agreement type of requirement in any jurisdiction. The differentiation of liability limits by national requirement seems to be what is occurring. There is a plethora of mandated limits and Montreal Agreement type 'voluntary' limits. It is becoming difficult to find more than a few major States where an unmodified Warsaw Convention or Hague Protocol limitation is still in effect. If this is the real world in the 1980's, then let the treaty so reflect it. Upon reviewing the Warsaw Convention, its history and the several attempts to amend it, strengths become apparent. Hijackings of international flights have given rise to a number of lawsuits by passengers to recover damages for injuries suffered. This comment is concerned with the liability of an airline for injuries to its passengers resulting from aviation terrorism. In addition, analysis is focused on current airline security measures, particularly the pre-boarding screening system, and the duty of air carriers to prevent weapons from penetrating that system. An airline has a duty to exercise a high degree of care to protect its passengers from the threat of aviation terrorism. This duty would seemingly require the airline to exercise a high degree of care to prevent any passenger from smuggling a weapon or explosive device aboard its aircraft. In the case an unarmed hijacker who boards having no instrument in his possession with which to promote the hoax, a plaintiff-passenger would be hard-pressed to show that the airline was negligent in screening the hijacker prior to boarding. In light of the airline's duty to exercise a high degree of care to provide for the safety of all the passengers on board, an acquiescene to a hijacker's demands on the part of the air carrier could constitute a breach of duty only when it is clearly shown that the carrier's employees knew or plainly should have known that the hijacker was unarmed. A finding of willful misconduct on the part of an air carrier, which is a prerequisite to imposing unlimited liability, remains a question to be determined by a jury using the definition or standard of willful misconduct prevailing in the jurisdiction of the forum court. Through the willful misconduct provision of the Warsaw Convention, air carrier face the possibility of unlimited liability for failure to implement proper preventive precautions against terrorist. Courts, therefore, should broadly construe the willful misconduct provision of the Warsaw Convention in order to find unlimited liability for passenger injuries whenever air carrier security precautions are lacking. In this way, the courts can help ensure air carrier safety and prevention against terrorist attack. Air carriers, therefore, would have an incentive to increase, impose and maintain security precautions designed to thwart such potential terrorist attacks as in the case of Korean Air Lines Flight No.858 incident having a tremendous impact on the civil aviation community. The crash of a commercial airliner, with the attending tragic loss of life and massive destruction of property, always gives rise to shock and indignation. The general opinion is that the legal system could be sufficient, provided that the political will is there to use and apply it effectively. All agreed that the main responsibility for security has to be borne by the governments. I would like to remind all passengers that every discovery of the human spirit may be used for opposite ends; thus, aircraft can be used for air travel but also as targets of terrorism. A state that supports aviation terrorism is responsible for violation of International Aviation Law. Generally speaking, terrorism is a violation of international law. It violates the soverign rights of the states, and the human rights of the individuals. I think that aviation terrorism as becoming an ever more serious issue, has to be solved by internationally agreed and closely co-ordinated measures. We have to contribute more to the creation of a general consensus amongst all states about the need to combat the threat of aviation terrorism.

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The Effects of Total Sleep Deprivation on Anxiety, Mood, Sleepiness and Fatigue (전수면박탈이 정상인의 불안, 기분, 졸리움 및 피로도에 미치는 영향)

  • Lee, Heon-Jeong;Kim, Leen;Joe, Sook-Haeng;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
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    • v.6 no.1
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    • pp.76-84
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    • 1999
  • Objectives: A number of studies have shown that sleep deprivation results in reduced vigilance and increased negative affects such as tension, depression and anger. However there are few studies about effects of sleep deprivation on anxiety. The purpose of this study was to investigate the effects of 40 hour sleep deprivation on state anxiety, affects, sleepiness and fatigue. The authors also intended to study the effect of trait-anxiety on these psychological variables after sleep deprivation. Methods: Twenty nine subjects(22 men, 7 women, $24.59{\pm}1.35$ years of age) participated in this study. Subjects had no past history of psychiatric disorders and physical illnesses, and had normal sleep-waking cycle without current sleep disturbances. All of the subjects completed sleep dairy for two weeks to exclude some who suffered from chronic sleep deprivation or sleep disturbances. Subjects were instructed to get a normal sleep as usual at night before the study. After awakening, subjects remained awake for 40 hours under continuous surveillance. They completed State-Trait Anxiety Inventory, Index of General Affect, Stanford Sleepiness Scale and Fatigue Questionnaire every three hours, therefore they completed the scales 14 times totally. Subjects were dictated not to take caffeine, alcohol, or any medications on the day of the study. Heavy exercises and naps were restricted too. Results: Sleep deprivation resulted in increased state anxiety, negative general affects, and increased sleepiness and fatigue(p<.001). Dividing into high trait-anxiety group and low trait-anxiety group, there was significant sleep deprivation x traitanxiety interaction effect on general affect(p<.05). But, there was no significant sleep deprivation x trait-anxiety interaction effect on state-anxiety, sleepiness and fatigue. During sleep deprivation, the highest ratings of scales on anxiety, negative affect, sleepiness and fatigue occurred between 4 : 00AM and 7 : 00AM. Conclusions: These results show that sleep deprivation results in increased anxiety, mood state disturbance and increment of sleepiness and fatigue. These findings also suggest that trait-anxiety is a factor that influences the degree of worsening in general affect caused by sleep deprivation. During sleep deprivation, the rating curves of anxiety, affect, sleepiness and fatigue show rhythmicity that may be related to circadian rhythm.

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A Study on the Legal Aspects of International Express Courier Business (현행 항공법상 상업서류 송달업의 문제점과 입법방향)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.26 no.2
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    • pp.125-147
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    • 2011
  • Considering a trend of logistics and transport industry in these days, it can be said that international express courier service is one of the most familiar transport type to the general public. Especially in Korea, due to development of electronic commercial transaction and the popularity of television home shopping, it can easily anticipated that express courier business will continuously grown in the future. However, the legal basis for international express courier is not properly set up so far. The only clause about this can be found on Korean Aviation Law said as 'commercial documents delivery business'. The origin of the commercial documents delivery business in Aviation Law is to make exception from public postal services which has been exclusive status as monopoly based on the Korean Postal Law. Basically, according to this regulation, all the private postal delivery is prohibited except some sort of commercial documents such as consignment notes, packing list, invoice etc. Thus, those documents could be delivered not only by public postal services but also by private courier company according to the Korean Postal Law. This waiver has probably come from under developing condition of Korean postal circumstances, however it should be revised according to the modernized business practice. Reflecting these revisions, the articles of Korean Postal Law adopted 'international express courier document' as the exception of postal service. Therefore, Korean Aviation Law also needs to be revised as Postal Law in due course. In addition to revision of Korean Aviation Law, some sort of new legislation is required to govern the private legal aspects such as legal liabilities, duties and rights of each parties on international express courier. This should be governed by 'law' not by 'terms and conditions' provided by business operators. Furthermore, to support and develop the current domestic logistics companies as international express courier company, it is required to regulate with the separate express courier law.

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A Study on UAV and The Issue of Law of War (무인항공기의 발전과 국제법적 쟁점)

  • Lee, Young-Jin
    • The Korean Journal of Air & Space Law and Policy
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    • v.26 no.2
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    • pp.3-39
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    • 2011
  • People may operate unmanned aerial vehicles (UAVs or drones) thousands of miles from the drone's location. Drones were first used (like balloons) for surveillance. By 2001, the United States began arming drones with missiles and using them to strike targets during combat in Afghanistan. By mid-2010, over forty states and other entities possessed drones, many with the capability of launching missiles and dropping bombs. Each new development in military weapons technology invites assessment of the relevant international law. This Insight surveys the international law applicable to the recent innovation of weaponizing drones. In determining what international law rules govern drone use, the most salient feature is not the fact that drones are unmanned. The fact drones carry no human operator may be the most important new technological breakthrough, but the key feature for international law purposes is the type of weaponry drones carry. Whether law enforcement rules govern drone use depends on the situation and not necessarily who is operating the drone. Battlefield weapons may also be lawfully used before an armed conflict in the following situations: when initiating self-defense under Article 51 of the United Nations Charter; when authorized by the UN Security Council; when a government seeks to suppress internal armed conflict; and, perhaps, when a state is invited to assist a government in suppressing internal armed conflict. The rules governing resort to force in self-defense are found in Article 51 of the UN Charter and a number of decisions by international courts and tribunals. Commentators continue to debate whether drone technology represents the next revolution in military affairs. Regardless of the answer to that question, drones have not created a revolution in legal affairs. The current rules governing battlefield launch vehicles are adequate for regulating resort to drones. More research must be undertaken, however, to understand the psychological effects of deploying unmanned vehicles and the effects on drone operators of sustained, close visual contact with the aftermath of drone attacks.

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Privilege and Immunity of Information and Data from Aviation Safety Program in Unites States (미국 항공안전데이터 프로그램의 비공개 특권과 제재 면제에 관한 연구)

  • Moon, Joon-Jo
    • The Korean Journal of Air & Space Law and Policy
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    • v.23 no.2
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    • pp.137-172
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    • 2008
  • The earliest safety data programs, the FDR and CVR, were electronic reporting systems that generate data "automatically." The FDR program, originally instituted in 1958, had no publicly available restrictions for protections against sanctions by the FAA or an airline, although there are agreements and union contracts forbidding the use of FDR data for FAA enforcement actions. This FDR program still has the least formalized protections. With the advent of the CVR program in 1966, the precursor to the current FAR 91.25 was already in place, having been promulgated in 1964. It stated that the FAA would not use CVR data for enforcement actions. In 1982, Congress began restricting the disclosure of the CVR tape and transcripts. Congress added further clarification of the availability of discovery in civil litigation in 1994. Thus, the CVR data have more definitive protections in place than do FDR data. The ASRS was the first non-automatic reporting system; and built into its original design in 1975 was a promise of limited protection from enforcement sanctions. That promise was further codified in an FAR in 1979. As with the CVR, from its inception, the ASRS had some protections built in for the person who might have had a safety problem. However, the program did not (and to this day does not) explicitly deal with issues of use by airlines, litigants, or the public media, although it appears that airlines will either take a non-punitive stance if an ASRS report is filed, or the airline may ignore the fact that it has been filed at all. The FAA worked with several U.S. airlines in the early 1990s on developing ASAP programs, and the FAA issued an Advisory Circular about the program in 1997. From its inception, the ASAP program contained some FAA enforcement protections and company discipline protections, although some protection against litigation disclosure and public disclosure was not added until 2003, when FAA Order 8000.82 was promulgated, placing the program under the protections of FAR 193, which had been added in 2001. The FOQA program, when it was first instituted through a demonstration program in 1995, did not contain protections against sanctions. Now, however, the FAA cannot take enforcement action based on FOQA safety data, and an airline is limited to "corrective action" under the program. Union contracts can exclude FOQA from the realm of disciplinary action, although airline practice may be for airlines to require retraining if there is no contract in place forbidding it. The data is protected against disclosure for litigation and public media purposes by FAA Order 8000.81, issued in 2003, which placed FOQA under the protections of FAR 193. The figure on the next page shows when each program began, and when each statute, regulation, or order became effective for that program.

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International Liability for Damage Caused by Space Debris (우주잔해 손해에 대한 국제책임)

  • Kim, Dong-Uk
    • The Korean Journal of Air & Space Law and Policy
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    • v.23 no.2
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    • pp.173-205
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    • 2008
  • Space debris have frequently caused damage to space objects like satellites in orbits and sometimes have fallen on the earth. Such increase in space debris will lead to the high possibility of threatening space activities of mankind. However, it is not so easy for the damage caused both by identified and by unidentified space debris to be recovered since in the regime of the current international law, there is no legislation of prescribing the damage done by space debris. For overcoming the limitation it seems desirable that either the Liability Convention should partly be amended or new international law regime should be established. For instance, 'space debris' should be included in the new definition of 'space object' and the range of launching should also be defined clearly by making the concept of 'launching' somewhat more specified. Moreover, the subject of international liability for damage caused by space debris should be divided into two classes: the subject before and after registration. While in case of before-registration launch states should be held liable for any damage jointly or individually, in case of after-registration 'the state of registry' or 'owner' of the space debris should be. In the event of damage being caused elsewhere than on the surface of the earth to a space object of other State, 'fault-based liability' is currently applied. But it needs to be changed into 'absolutely liability'. In this paper, 'Liability Pool', 'Insurance', 'Market-Share Liability' are presented as aid devices of the damages resulting from unidentified space debris. They should be defined through the amendment of the Liability Convention or another international treaty. Some day there comes a time when our country shall possess many of the astronomical price of satellites. It means that we can't be free from the damage by the increasing number of space debris. Provided that our satellites are damaged by such space debris, it will do the satellites damage and cause impaired functioning or troubles in operation. As a result, if we are not paid for the damage by space debris, we will be confronted with tremendous economic loss because it is necessarily connected with the excess burden of taxation. Thus, an international agreement regarding the measures of the compensation for space debris damage must be made very soon.

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Effects of Total Sleep Deprivation on Fine Motor Performance (전수면박탈이 정상인의 미세운동수행 능력에 미치는 영향)

  • Lee, Heon-Jeong;Song, Hyung-Seok;Ham, Byung-Joo;Suh, Kwang-Yoon;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.8 no.2
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    • pp.129-137
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    • 2001
  • Objectives: The purpose of this study is to investigate the effects of 38-hour sleep deprivation on fine motor performance. The Motor Performance Series (MPS) in the Vienna Test System (computerized neurocognitive function tests) was used in this study. Methods: Twenty four subjects participated in this study. Subjects had no past history of psychiatric disorders and physical illness. Subjects had normal sleep-waking cycle without current sleep disturbances and were all right-handed (Annett's Hand Preference Questionnaire: above +9 points). To minimize the learning effects, familiarization with the Vienna Test System was performed one day before the study. Subjects were to get up at 6:00 in the morning after getting enough sleep according to his or her usual sleep-wake cycle. After awakening, subjects remained awake for 38 hours under continuous surveillance. During two consecutive study days, the subjects tested MPS at 7 AM and 7 PM each day, which means the MPS was done four times in total. During the experiment, anything that could affect the subjects' sleep such as coffee, tea, alcohol, a nap, tiring sports, and all medications were prohibited. Results: In MPS, the fine motor functions of both hands decreased after 38 hours of sleep deprivation. The decrement in motor performance was prominent in the dominant right hand. In the right hand, the total number of tapping was reduced (p<.005), and the number of misses (p<.05) and the length of misses (p<.05) of line tracking, the total length of inserting a short pin (p<.01), the total length of inserting a long pin (p<.05), and the number of misses in aiming (p<.05) increased. Such performance decrement was distinct in the morning sessions. Conclusions: These results suggest that fine motor performance decrement during sleep deprivation is predominant in the right hand, which exerts maximal motor function. The finding of decrement in motor function in tapping during sleep deprivation also suggested that the time required for exhaustion of muscles is shortened during sleep deprivation. More deterioration of motor performance was shown in the morning, which could be explained as circadian rhythm effects.

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Effect of Major Depressive Disorder and Insomnia on Somatization (주요 우울증과 불면증이 신체화 증상에 미치는 영향)

  • Jun, Jin Yong;Kim, Seog Ju;Lee, Yu-Jin;Cho, Seong-Jin
    • Sleep Medicine and Psychophysiology
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    • v.19 no.2
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    • pp.84-88
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    • 2012
  • Introduction: The objective of the present study was to investigate the independent effects of major depressive disorder (MDD) and insomnia on somatization, respectively. Methods: A total of 181 participants (73 males and 108 females ; mean age $41.59{\pm}8.92$) without serious medical problem were recruited from a community and a psychiatric clinic in Republic of Korea. Subjects were divided into 4 groups based on the Structured Clinical Interview for DSM-IV axis I disorder (SCID-IV) and sleep questionnaire : 1) normal controls (n=127), 2) primary insomnia (n=11), 3) MDD without insomnia (n=14), and 4) MDD with insomnia (n=29). All participants were requested to complete the somatization subscores of the Symptom Checklist-90-Revised (SCL-90-R). Results: There were significant between-group differences in somatization score (F=25.30, p<0.001). Subjects with both MDD and insomnia showed higher somatization score compared to normal control (p<0.001), subjects with primary insomnia (p=0.01), or MDD subjects without insomnia (p<0.001). Subjects with primary insomnia had higher somatization score than normal controls (p<0.01), while there was no significant difference between MDD subjects without insomnia and normal controls. In multiple regression, presence of insomnia predicted higher somatization score (beta=0.44, p<0.001), while there was only non-significant association between MDD and somatization (beta=0.14, p=0.08). Conclusion: In the current study, insomnia was associated with somatization independently from major depression. Subjects with primary insomnia showed higher somatization. Within MDD patients, presence of insomnia was related to higher somatization. Our finding suggests that insomnia may partly mediate the relationship between depression and somatization.