• Title/Summary/Keyword: depression insomnia

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Comparative Effectiveness of Adjunctive Aripiprazole versus Bupropion Uses to Selective Serotonin Reuptake Inhibitor on the Specific Symptom of Depression : A post-hoc, Multi-Center, Open-Label, Randomized Study (세로토닌 재흡수 억제제에 대한 아리피프라졸 및 부프로피온 부가요법의 우울증 세부증상에 대한 효과 비교 : 다기관, 개방표지, 무작위 연구)

  • Lee, Ga-Won;Lee, Kwang-Hun;Park, Young-Woo;Lee, Jong-hun;Koo, Bon-Hoon;Lee, Seung-Jae;Sung, Hyung-Mo;Cheon, Eun-Jin
    • Anxiety and mood
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    • v.13 no.2
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    • pp.66-73
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    • 2017
  • Objective : The purpose of this study was to examine the effects of adjunctive aripiprazole versus bupropion on specific symptoms of depression. Methods : Data were from 6-week, randomized, prospective, open-label multi-center study in 103 patients with major depressive disorders. Participants were randomized to receive aripiprazole (2.5-10 mg/day) or bupropion (150-300 mg/day) for 6 weeks. Change in four subscales of the 17-item Hamilton Depression Rating Scale (HAM-D17) that capture core depression symptoms was determined, and change in individual HAM-D17 items was also assessed. Changes in three composite subscales-anxiety, insomnia, and drive were also examined. Results : Within-group change in the four core subscales was large [effect size (ES)=1.30-1.47] and it was similar to that in the HAM-D17 total score. Differences between aripiprazole and bupropion were significant for each of the four core subscales and the HAM-D17 total score favored aripiprazole (p<0.001). On three composite scales, both treatments caused substantial changes in anxiety (within-group ES=1.10 (aripiprazole) vs. 1.00 (bupropion)], insomnia (ES=0.75 vs 0.50), and drive (ES=1.17 vs 1.15). Conclusion : This results suggested that both aripiprazole and bupropion adjunctive therapies with selective serotonin reuptake inhibitors resulted in significant and clinically meaningful changes in core symptom subscales for depression.

Cognitive Behavioral Therapy for Primary Insomnia: A Meta-analysis (만성 일차성 불면증 환자에게 적용한 인지행동중재의 효과: 메타분석)

  • Kim, Ji-Hyun;Oh, Pok-Ja
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.9
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    • pp.407-421
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    • 2016
  • This paper reports a meta-analysis of sixteen studies that evaluated the efficacy of cognitive behavioral therapy (CBT) for persistent primary insomnia. PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched between January 2015 and June 2015. The main search strategy involved the terms that indicate CBT-I (Cognitive Behavioral Therapy-Insomnia) and presence of insomnia. Methodological quality was assessed using Cochrane's Risk of Bias. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Sixteen clinical trials met the inclusion criteria, resulting in a total of 1503 participants. Stimulus control, sleep restriction, sleep hygiene education, and cognitive restructuring were the main treatment components. CBT-I was conducted for a mean of 5.4 weeks, 5.5 sessions, and an average of 90 minutes per session. The effects of CBT-i on total sleep time (d=-0.31), sleep onset latency (d=-0.29), awakening time after sleep onset (d=-0.55), sleep efficiency (d=-0.70), insomnia severity (d=-0.77) and sleep belief (d=-0.64) were significant. Overall, we found a range from small to moderate effect size. CBT-I also was effective for anxiety (d=-0.30) and depression (d=-0.35). The findings demonstrate that CBT-I interventions will lead to the improvement of both sleep quality and quantity in patients with insomnia.

Efficacy and Safety of Banhahubak-Tang for Depression Treatment: Study Protocol for a Randomized, Waitlist-Controlled Trial

  • Seung-Ho, Lee;Yunna, Kim;Dohyung, Kwon;Seung-Hun, Cho
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.4
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    • pp.389-400
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    • 2022
  • Objectives: Depression is a highly prevalent disease, and the market for antidepressant drugs continues to grow at a steady rate. Although current antidepressants are reported to be effective, because of their low remission rate and side effects, new antidepressants are needed. The use of Banhahubak-tang (BHT) to treat the symptoms of depression is supported by experimental evidence. The proposed study will evaluate the efficacy and safety of BHT in treating depression. Methods: A randomized, waitlist-controlled, parallel clinical trial will be conducted to assess the efficacy of BHT in depression. A total of 84 participants with depression will be randomized into the intervention group or waitlist-control group at a 1:1 ratio. Patients in the intervention group will be administered BHT three times a day for four weeks and followed up for four more weeks after therapy completion. Patients in the waitlist-control group will undergo the same intervention and follow-up after a four-week waiting period. The primary outcome is change in the Korean version of the Hamilton Depression Rating Scale (K-HDRS) scores for major depressive disorders after four weeks. The secondary outcomes include scores on the K-HDRS, Korean Symptom Check List 95 (KSCL-95), Insomnia Severity Index (ISI), State-Trait Anxiety Inventory-Korean version (STAI-K), State-Trait Anger Expression Inventory-Korean version (STAXI-K), and the Instrument on Pattern Identifications for Depression and EuroQol-5 Dimension (EQ-5D). Conclusions: This trial will provide high-quality clinical evidence of the efficacy and safety of BHT in the management of depression.

A Case Study of Ortho-Cellular Nutrition Therapy (OCNT) in a Patient with Hand Eczema (세포교정영양요법(OCNT)을 이용한 주부 습진 환자 사례 연구)

  • Jo, Jongbin
    • CELLMED
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    • v.13 no.1
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    • pp.6.1-6.3
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    • 2023
  • Objective: A case resport on the improvement of hand eczema through Ortho-Cellular Nutrition Therapy Methods: Two years of repeated improvement and worsening of hand eczema in a 68-year-old Korean woman resulted in pain and decreased quality of life. Results: After nutritional therapy, hand eczema improved. Conclusion: Nutritional therapy can help patients with chronic hand eczema improve inflammation, itching, depression, and insomnia.

Depression and marital intimacy level in parents of infants with sleep onset association disorder: a preliminary study on the effect of sleep education

  • Lee, Sihyoung;Rhie, Seonkyeong;Chae, Kyu Young
    • Clinical and Experimental Pediatrics
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    • v.56 no.5
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    • pp.211-217
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    • 2013
  • Purpose: Sleep onset association disorder (SOAD) is a form of behavioral insomnia observed in children that is caused by inappropriate sleep training. SOAD typically disturbs the sleep of not only infants and children but also their parents. We investigated levels of depression and marital intimacy among parents of infants with typical SOAD, to understand the influence of SOAD on family dynamics, as well as examine ways for improving depression and marital intimacy through behavioral training. Methods: Depression and marital intimacy were assessed using the Beck Depression Inventory (BDI) and Waring Intimacy Questionnaire (WIQ). These measures were administered to 65 parents of infants (n=50) diagnosed with SOAD. We conducted sleep education and behavioral training for the parents and compared levels of depression and marital intimacy after 2-6 weeks of training. Results: The 65 parents consisted of 50 mothers and 15 fathers. Depressive symptoms were higher among mothers than fathers (P=0.007). Marital intimacy was negatively correlated with depressive symptoms. Twenty-six parents were assessed again after sleep training. We found that mothers' depressive symptoms and marital intimacy improved post training. Conclusion: SOAD can be detrimental to both infants and parents, especially for parents who sleep with their infants. For instance, disruption of sleep patterns in such parents can reduce marital intimacy. However, behavioral modification is an effective treatment for infants with frequent nighttime waking, as well as for diminishing the depressive symptoms of sleep-deprived parents.

Effect of Auricular Acupress Therapy on Insomnia of Cancer Patients : Randomized, Single Blinded, Placebo Controlled Trial (이압요법이 암환자의 불면증에 미치는 효능 : 무작위배정, 단일맹검, 위약대조군 연구)

  • Jung, In-Sook;Kim, Jung-Sun;Yoo, Hwa-Seung
    • Journal of Pharmacopuncture
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    • v.13 no.2
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    • pp.93-100
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    • 2010
  • Background: Auricular acupressure is one of the traditional health care treatments in oriental medicine. Approximately, 30~40% of the cancer patients have said to be suffering from insomnia and half of them having chronic and severe insomnia at the same time. Insomnia caused cancer patients feel more pain, fatigue, depression and anxiety and it sometimes let the power to have the best of cancer pull down. Objective: To investigate how effective the auricular acupressure treatment to cancer patients suffering from insomnia. Methods: We recruited participants from East-West Cancer Center of Daejeon University. Finally, of the people whose age range from 20 to 75, 12 patients who got less than 40 points from the score of Oh's sleeping score (OSS) were recruited. Single-blind, randomized pilot study was performed. The treatment group received auricular acupressure treatment (AAT) on active points and the control group had received sham acupressure treatment (SAT) for five times. Sleep parameters were checked by using OSS and numeric rating scale (NRS). We checked the scale everytime, both before and after treatment. We analyzed the data statistically by using independent T-test, paired T-test and analysis of variance (ANOVA) test. (p<0.05) Results: Twelve cancer patients participated in this pilot study and there was no significant difference between control and treatment group. Only 7 of them had completed the whole treatment process, 4 patients of AAT group and 3 participants of SAT. The OSS of AAT group had increased from $34.0{\pm}4.3$ to $39.5{\pm}3.1$ and that of SAT group had increased from $38.3{\pm}3.5$ to $40.0{\pm}0.0$. There was no significant difference between them. The NRS of AAT group had increased from $6.3{\pm}2.9$, $04.8{\pm}2.1$ and that of SAT group had increased from $7.0{\pm}1.0$ to $5.0{\pm}2.6$. No significant difference was observed between them. Conclusion: Although both groups did not show significant differences, most of the experimental participants showed increasing OSS and NRS after treatments. Significant participants' number will be needed in the next study.

Two Case Report of UL-syndrome(鬱症) Treated with Gamisoyosan(加味逍遙散) (가미소요산(加味逍遙散)으로 호전된 여성 울증 환자 치험 2례)

  • Je, Yun-Mo;Yoo, Dong-Youl
    • Journal of Haehwa Medicine
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    • v.19 no.2
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    • pp.187-193
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    • 2011
  • Purpose : This paper is aim to report the effects of Gamisoyosan(加味逍遙散) on the UL-syndrome(鬱症) Methods : This is two cases report of female patient suffering from headache, chest discomfort, heart burning, insomnia, dyspepsia, anorexia, fatigue and other symptoms due to chronic stress. 52 years old woman who diagnosed UL-syndrome(鬱症) was enrolled in this study. We gave her Gamisoyosan(加味逍遙散) 2 times, each for 3 weeks. During the treatments, we check changes of symptoms and HRSD. Results : After the oriental medical treatments, symptoms of UL-syndrome(鬱症) were decreased or disappeared. Conclusion : This clinical case indicate that Gamisoyosan(加味逍遙散) is effective in treatment of the depression disorder and symptoms of UL-syndrome(鬱症). More clinical data and studies are requested for the treatment of UL-syndrome(鬱症).

The Study on Korean Medical Pattern Differentiation of Sleep-Wake Disorders by DSM-V Classification (DSM-V 분류에 따른 수면-각성장애의 한의학적 변증 연구)

  • Na, Il Doo;Park, Mi Sun;Kim, Yeong Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.31 no.2
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    • pp.83-93
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    • 2017
  • This study covers pattern differentiation based on Korean medical references, research trend and modern clinical applications about Sleep-Wake disorders of Diagnostic and Statistical Manual of Mental Disorders(DSM-V) published by American Psychiatric Association. Insomnia disorder is mostly caused by yin deficiency of liver-kidney or liver qi depression and main patterns are heart-kidney non-interaction, deficiency-excess complex pattern containing phlegm-heat due to qi stagnation and blood stasis. Hypersomnolence disorder is more due to yang deficiency rather than yin deficiency and it's major pattern is spleen-kidney yang deficiency. Cataplexy is main feature in narcolepsy and corresponds to depressive psychosis or fainting in terms of Korean Medicine and narcolepsy is assumed to be relevant to liver wind. Breathing-related sleep disorders are related with phlegm-fluid retention brought on spleen deficiency with dampness encumbrance. Pattern of circadian rhythm sleep-wake disorders is combined with yin deficiency of liver-kidney or liver qi depression of insomnia disorder and spleen-kidney yang deficiency or dampness-phlegm of hypersomnolence disorder. Yin deficiency with effulgent fire brought on drugs or alcohol is one of main patterns of substance/medication-induced sleep disorder and combined patterns with yin deficiency of liver-kidney and blood stasis or dampness-phlegm-heat are mostly applied clinically. This study drew major and frequently applied patterns of sleep-wake disorders based on Koran medical literature and modern clinical applications. And that can be the groundwork for the task ahead like clinical practice guideline of sleep-wake disorders containing pattern differentiation, diagnosis and prescriptions.

Mediation analysis of chronotype, sleep-related factors, and depressive symptoms among workers: a cross-sectional study

  • Seo Young Kim;Hyo Jeong Kim;Seong-Sik Cho;Min Young Park;Mo-Yeol Kang
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.47.1-47.14
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    • 2023
  • Background: This study aimed to examine the impact of chronotype on depressive symptoms and explore the mediating effects of sleep quality, pre-sleep cognitive arousal, and social jetlag in a sample of wage earners. Methods: A total of 3,917 waged workers were surveyed online in July 2022. Logistic regression and mediation analysis were used to assess the relationship between chronotype (morningness, intermediate, and eveningness) and depressive symptoms (Patient Health Questionnaire ≥ 5), and the mediating effects of Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Pre-Sleep Arousal Scale (PSAS). All analyses were adjusted for age, education level, income level, marital status, coffee consumption, alcohol consumption, physical activity, occupation, employment status, and working hours to calculate odds ratios (ORs). Results: The chronotypes of all the participants were divided into morningness (4.7%), intermediate (93.5%), and eveningness (1.8%). Multiple logistic regression analysis showed an increased risk of depression in the eveningness chronotype (OR: 2.96; 95% confidence interval [CI]: 1.51, 5.86). Regarding the mediation analysis, ISI mediated 28.44% (95% CI: 16.39-40.5), PSQI for 31.25% (95% CI: 19.36, 43.15), and PSAS-Cognitive Score (PSAS-C) for 23.58% (95% CI: 10.66, 36.50) of the association between chronotype and depressive symptoms. However, social jetlag did not significantly mediate this relationship. (percentage mediated = 0.75%, 95% CI: -3.88, 5.39) Conclusions: Evening chronotypes exhibit an increased risk of depressive symptoms, which ISI, PSQI, and PSAS-C partially mediated. This suggests that interventions to improve sleep quality and maintain adequate sleep habits may effectively prevent and treat depression in employees with an eveningness chronotype.

Psychosomatic Symptoms of Rotating Shift and Daytime Working Nurses in a General Hospital (일 병원의 순환교대근무와 주간고정근무 여성 간호사의 근무형태에 따른 정신신체 증상)

  • Kim, Byoung-Jo;Choi, Mal-Rye;Kim, Tae-Hyung;Kim, Hyeong-Wook;Eun, Hun-Jeong
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.79-86
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    • 2014
  • Objectives : Shift work disorder occurs when you have difficulties adjusting to a work schedule that takes place during a time which most people sleep. Some people may have diverse psychosomatic symptoms, such as sleep problems, depression, anxiety, and headaches even after the shift work schedule ends. The aims of this study are to compare difference of psychosomatic symptoms between rotating shift and daytime working nurse groups. Methods : Volunteer nurses working in a general hospital were recruited in a general hospital. We collected sociodemographic data. We used questionnaires for headache type, headache frequency, and VAS(Visual Analog Scale) for headache intensity, BDI(Beck depression Inventory) and GSAQ(Global Sleep Assessment Questionnaire). We used Mann-Whitney test and Chi-square test for hypothesis testing. Results : Data collected from 84 women nurses. Rotating shift(N=37) working nurses showed younger, more unmarried, and shorter work periods than daytime working nurses (N=47). Also rotating shift group showed more problems of headache, insomnia, excessive daytime sleepiness, depression and anxiety than daytime group. The above results were statistically significant. Conclusions : The rotating shift work women nurses produced more headache, insomnia, excessive daytime sleepiness, depression, and anxiety than daytime working ones.

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