• Title/Summary/Keyword: depression insomnia

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Association of Sleep Perception With Objective and Subjective Sleep Variables in Insomnia Patients (불면증 환자의 수면인식과 객관적, 주관적 수면변수의 연관성에 대한 연구)

  • Yoon, Gahui;Oh, Seong Min;Seo, Min Cheol;Lee, Mi Hyun;Yoon, So Young;Lee, Yu Jin
    • Sleep Medicine and Psychophysiology
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    • v.28 no.2
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    • pp.70-77
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    • 2021
  • Objectives: Our study aims to investigate the clinical and polysomnographic variables associated with subjective sleep perception. Methods: Among the patients who underwent nocturnal polysomnography (PSG) at the Center for Sleep and Chronobiology of Seoul National University Hospital from May 2018 to July 2019, 109 diagnosed with insomnia disorder based on DSM-5 were recruited for the study, and their medical records were retrospectively analyzed. Self-report questionnaires about clinical characteristics including Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Epworth sleepiness scale (ESS) were completed. Subjective sleep quality was measured using variables of subjective total sleep time (subjective TST), subjective sleep onset latency (subjective SOL), subjective number of awakenings, morning feeling after awakening, and sleep discrepancy (subjective TST-objective TST) the morning after PSG. Pearson and Spearman correlation analyses were used to determine the factors associated with subjective sleep perception. Results: In patients with insomnia, subjective TST was negatively correlated with Wake After Sleep Onset (WASO) (p = 0.001) and N1 sleep (p = 0.039) parameters on polysomnography. Also, it was negatively correlated with PSQI (p < 0.001) and BDI (p = 0.014) scores. Sleep discrepancy was negatively correlated with PSQI score (p = 0.018). Morning feeling was negatively correlated with PSQI (p = 0.019) and BDI (p < 0.001) scores. Conclusion: Our results demonstrated that subjective sleep perception is associated with PSG variables (WASO and N1 sleep) and with PSQI and BDI scores. In clinical practice, it is helpful to assess and manage insomnia patients in consideration of objective sleep variables, subjective sleep quality, and depressed mood, which can influence subjective sleep perception.

Correlation between Instrument on Pattern Identification for Depression and Psychological Tests by Statistical Analysis (통계적 분석을 통한 우울증 변증도구와 심리검사의 상관성 연구)

  • Kim, Hwan;Lee, Hun-Soo;Lee, Eun Jung;Park, Joon-Ho;Kang, Wee-Chang;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.3
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    • pp.131-146
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    • 2016
  • Objectives: This study was performed to determine the correlation between Instrument on Pattern Identification for Depression and Psychological tests by Pearson Correlation Coefficient and Regression analysis.Methods: Two assessors carried out the evaluation using the instrument on pattern identification for depression. They also performed the following psychological tests: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), State-Trait Anger Expression Inventory (STAXI), the Temperament and Character Inventory (TCI), Insomnia Severity Index (ISI_Total), Self-disclosure Inventory, subjective well-being Inventory, Health perception Inventory, and Personality Assessment Inventory (PAI). A total of 167 participants who got HAM-D score over 12 were targeted for the evaluation. Our research team carried out Pearson correlation coefficient analyses and regression analysis between pattern identification for depression and Psychological tests. We listed the results by descending order and interpreted the results.Results: Pearson correlation analysis revealed the following results: 1) Stagnation of Liver Gi was associated with BDI (0.60) and STAI (0.55); 2) Dual Deficiency of the Heart and Spleen was associated with BDI (0.60), ISI_Total (0.52), and STAI (0.42); 3) Relieving stagnation of Phlegm-Gi was associated with BDI (0.65), STAI (0.54), and Subjective well-being inventory (−0.52); 4) Gi-deficiency Mingled with sputum was associated with BDI (0.50), ISI_Total (0.40), and STAI (0.395); 5) Stagnant Gi transforming into fire was associated with BDI (0.56), STAI_TR (0.51), and Health perception Inventory (−0.458); 6) Yin-Deficiency with Effulgent Fire was associated with BDI (0.55), ISI_total (0.54), and STAI (0.41).Conclusions: Through correlation analysis between Instrument on Pattern Identification for Depression and Psychological tests, we could suggest a System for Oriental Medical Diagnosis for Depression.

Comparison of the Bupropion versus Aripiprazole Adjunctive Therapy for the Treatment of Female Depression : Post-Hoc Analyses from a Randomized Prospective Open-Label Multi-Center Study (여성 우울증 환자에서 Aripiprazole과 Bupropion 부가요법의 우울증상 및 안전성에 대한 효과 비교 : 사후분석연구)

  • Keum, Mu-sung;Cheon, Eun-Jin;Lee, Kwang-Hun;Koo, Bon-Hoon;Lee, Young-Ji;Park, Young-Woo;Lee, Jong-hun;Lee, Seung-Jae;Sung, Hyung-Mo
    • Mood & Emotion
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    • v.16 no.3
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    • pp.140-151
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    • 2018
  • Objectives : The purpose of this study was to examine effects of adjunctive aripiprazole versus bupropion, on depressive symptoms of female depression. Methods : Sixty six female patients with major depressive disorders were enrolled from a six-week, randomized prospective open-label multi-center study. Participants were randomized to receive aripiprazole (2.5-10 mg/day) or bupropion (150-300 mg/day). Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale (HAM-D17), Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores, and Clinical Global Impression-Severity (CGI-S) were obtained at baseline and after one, two, four, and six weeks. Changes on individual items of HAM-D17 were assessed as well as on composite scales (anxiety, insomnia and drive), and on four core subscales that capture core depression symptoms. Results : Overall, both treatments improved depressive symptoms, without causing serious adverse events. There were significant differences in the HAM-D17 total score (p=0.046) and CGI-S (p=0.004), between aripiprazole and bupropion augmentation, favoring aripiprazole over bupropion. Aripiprazole revealed significantly greater effect size in depressed mood (p=0.006), retardation (p=0.005), anxiety psychic (p=0.032), and general somatic symptom (p=0.01). Conclusion : While both treatments were effective, results of this study suggested that aripiprazole may be preferable, in treating general and core symptoms of female depression.

Diurnal Variation and Sleep Pattern in Depressive Patients (우울증 환자의 주간기분변동과 수면 양상)

  • Park, Young-Min;Kim, Leen;Suh, Kwang-Yoon;Joe, Sook-Haeng;Kang, Seung-Gul;Yoon, Ho-Kyung
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.30-36
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    • 2001
  • Object: Diurnal variation is included in the diagnostic criteria of the major depressive disorder, melancholic specifier. But there has been controversy over whether diurnal variation is an unique depressive symptoms or a symptom related to a change of sleep patterns, or that of another mechanism, when the previous studies are reviewed. We investigated the existence of diurnal variation according to the subtype of depression and whether diurnal variation is charateristic of melancholic depression or not. We also compared sleep variables according to the existence of diurnal variation. Method: We examined diurnal variation, sleep patterns, severity of depression using the Visual Analogue Mood Scale, Pittsburgh Sleep Quality Index, and Hamilton Depression Rating Scale. Patients recorded their mood state on the Visual Analogue Mood Scale twice a day, morning and evening, for diurnal variation. We divided depressive patients into two groups,-diurnal variation group and nondiurnal variation group,-and compared the mood and sleep variables using SPSS. Results: The frequency of diurnal variation is not significantly different among the subtypes of depression. Significant differences between the diurnal variation group and the nondiurnal variation group existed in middle insomnia and sleep time (p<0.05). In melancholic type, al significant difference between the diurnal variation group and the nondiurnal variation group was noticed in PSQI total, sleep latency, sleep disturbances, daytime dysfunction as well as middle insomnia and sleep time (p<0.05). Conclusions: Diurnal variation existed in other types of depression as well as melancholic type. The results showed that diurnal variation was not a specific symptom of melancholic type, and existence of diurnal variation might be related to sleep patterns.

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Reflection of Pain in Cancer Patients Using a New Screening Tool for Psychological Distress

  • Oh, Seung-Taek;Lee, San;Lee, Hyeok;Chang, Myung Hee;Hong, Soojung;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.56-62
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    • 2017
  • Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

A Case of Sheehan's Syndrome Mimicking Psychotic Depression (정신병적 우울증 양상을 나타낸 Sheehan씨 증후군 1례)

  • Jeong, Jong-Hyun;Hong, Seung-Chul;Lee, Sung-Pil;Han, Jin-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.118-122
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    • 1997
  • We experienced a case of 51-year-old female patient who showed symptoms of persecutory delusion, auditory hallucination and hallucinatory behavior, severe insomnia, psychomotor retardation and social withdrawal, along with some clinical signs of the deficiency of various hormones those gradually progressed after massive postpartum vaginal bleeding 13 years ago. She was admitted to a psychiatric ward under the impression of psychotic depression. However careful history taking and evaluation of clinical feature gave rise to the possibility of underlying medical condition. Laboratory work-up revealed panhypopituitarism, hypoglycemia and hyponatremia. After replacement of thyroid hormone and cortisol for 1 week, her clinical symptoms including psychiatric symptoms were improved. Taken together, these findings were compatible with the diagnosis of Sheehan's syndrome. On reporting this case, we would like to emphasize again the importance of differential diagnosis of medical problems causing psychiatric symptoms those are easily neglected in the clinical approach toward psychiatric patients.

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2-Nonadecanone Alleviates Depression through Inflammation Relief in SD Rat

  • Lee, Gil-Hyun;Hyun, Kyung-Yae
    • Biomedical Science Letters
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    • v.24 no.3
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    • pp.206-212
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    • 2018
  • Depression is a type of mood disorder characterized by hypochondriasis, decreased appetite, and insomnia. Depression is a disease that affects more than 100 million people worldwide. 2-Nonadecanone (NAC) is a bioactive substance that constitutes Fomes fomentarius, and NAC is expected to have an antidepressant effect. By using the forced swimming test (FST), we investigated the effects of treatment with NAC on immobility subacutely in rats after oral dosing once a day for 2 days. Serum levels of cytokine interleukin-1 beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) were determined by enzyme-linked immunosorbent assay (ELISA). Nuclear factor-2 (Nrf-2) and inducible nitric oxide synthases (iNOS) were analyzed by western blot method. NAC dose-dependently decreased immobility in the FST. NAC dosedependently decreased FST-induced increase of cytokine levels, as manifested by significantly stronger effects on $IL-1{\beta}$ and $TNF-{\alpha}$ levels at higher doses than the lowest dose of NAC. Western blot analysis showed that Nrf-2 was significantly lower in the NAC-treated group than in the disease-induced group. The iNOS results were also significantly lower in the NAC-treated group than in the other groups. Considering FST results, the antidepressant effect of NAC is effective. Considering the results of cytokine and protein expression, this anti-depressant effect may be related to the anti-inflammatory effect. Therefore, it can be said that the anti-inflammatory effect of NAC increases the antidepressant effect in the FST experiment.

The Literature Study of Ondamtng, Guibitang, Soyosan & Their Gagambang Recording in Dong-Eui-Bo-Gam ("동의보감(東醫寶鑑)"에 수록(收錄)된 온담탕(溫膽湯), 귀비탕(歸脾湯), 소요산(逍遙散) 및 그 가감방(加減方)에 대한 고찰(考察))

  • Seo, Seung-Ho;Jung, In-Chul;Lee, Sang-Ryong
    • Journal of Haehwa Medicine
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    • v.14 no.1
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    • pp.129-140
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    • 2005
  • 1. In Dong-Eui-Bo-Gam, Ondamtng & its Gagambang are applied for the sudden palpitation, epilepsy, the insomnia of exhaustion and an acute convulsion which are caused by the asthenia of heart and gall bladder(心膽虛怯). 2. In Dong-Eui-Bo-Gam, Guibitang & its Gagambang are applied for amnesia, amenorrhea, upper abdominal pain, the itching sign the pubic region, the hernia of the vulva which are caused by the asthenia of heart and spleen(心脾兩虛). 3. In Dong-Eui-Bo-Gam, Soyosan & its Gagambang are applied for epilepsy, the hemorrhage in time of coughing, the intermittent fever, metrorrhagia, various woman's diseases which are caused by the depression of vital energy of liver(肝氣鬱結).

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Sleep in Borderline Personality Disorder Individuals (경계성 인격 장애 환자의 수면)

  • Lee, So-Jin
    • Sleep Medicine and Psychophysiology
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    • v.19 no.2
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    • pp.59-62
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    • 2012
  • Borderline personality disorder (BPD) is characterized by identity and interpersonal problem, affective dysregulation and pervasive severe impulsivity. Although sleep disturbances are not primary symptoms of BPD, they are important aspects of this disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of BPD yet. Measured by nocturnal polysomnography, increased sleep latency as well as reduced total sleep time and sleep efficiency, and 'depression-like' REM abnormalities (i.e., reduced REM latency and increased REM density) are found in BPD patients. Co-morbid sleep disorders such as chronic insomnia, nightmare disorder or circadian rhythm sleep disorder associated with BPD have been reported. Clinicians should focus on the sleep complaints of BPD patients, and carefully manage such symptoms with sleep hygiene education, cognitive psychotherapy or light therapy.

The Case Study of a Patient with Ul-zeung who has treated by Hyun-chim therapy (현침요법을 통한 울증 치료 2례)

  • Yoon, Jong-Cheon;Jung, In-Chul;Lee, Sang-Yong
    • Journal of Haehwa Medicine
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    • v.16 no.2
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    • pp.289-294
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    • 2007
  • Hyun-chim Therapy was made for help the people who didn't learn breath training. The doctor acupuncture and treat 'Hyun-chi-sul' and it is a means by which patient can use 'universal Qi'. Ul-zeung comes from obstruction of qi by stress. The mind affect the body. The patient has depressed mood, irritable sign, chest discomfort, flank pain, angry stats and some strange feeling on the throat. In the case, two female patients, who complained of depression, insomnia, anxiety, palpitation, low energy, etc. We treated the patients with Hyun-chim Therapy. In result, the symptoms which they complained were improved.

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