• Title/Summary/Keyword: depressive disorder

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Comparison of Clinical Symptoms between Early and Late Onset Depression in Elderly Depressive Patients in Korea (한국의 노인우울증 환자에서 조발성 우울증과 만발성 우울증의 임상증상의 비교)

  • Park, Ki-Hong;Lee, Hwa-Young;Ham, Byung-Joo;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.17 no.3
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    • pp.145-152
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    • 2010
  • Objectives : Clinical differences between elderly patients with early and late onset depression have been described although these have been inconsistent. We aimed to compare differences of clinical symptoms using the 17 items Hamilton Rating Scale for Depression(HAM-D-17) between two groups. Methods : Data of 175 elderly patients with a diagnosis of major depressive disorder according to DSM-IV from January 2005 to November 2009 were collected. Seventy five patients were early onset depression and one hundred patients were late onset depression. Depressive symptoms were assessed by the 17-item Hamilton Rating Scale for depression. Results : There were some differences in HAM-D-17 scores between early and late onset depression. Early onset depression patients scored significantly higher in retardation(t = 2.41, p = 0.017) and somatic symptoms( general)(t = 2.37, p = 0.019) than late onset depression patients. Conclusion : We concluded that early onset depression patients have more severe psychomotor retardation and general somatic symptoms than late onset depression patients in Korea. Because of some limitations of this study, further investigations will be needed to validate this study results.

Bright Light Therapy in the Morning or at Mid-Day in the Treatment of Non-Seasonal Bipolar Depressive Episodes (LuBi): Study Protocol for a Dose Research Phase I / II Trial

  • Geoffroy, Pierre Alexis;El Abbassi, El Mountacer Billah;Maruani, Julia;Etain, Bruno;Lejoyeux, Michel;Amad, Ali;Courtet, Philippe;Dubertret, Caroline;Gorwood, Philip;Vaiva, Guillaume;Bellivier, Frank;Chevret, Sylvie
    • Psychiatry investigation
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    • v.15 no.12
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    • pp.1188-1202
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    • 2018
  • Objective This study protocol aims to determine, using a rigorous approach in patients with bipolar disorder (BD) and non-seasonal major depressive episode (MDE), the characteristics of bright light therapy (BLT) administration (duration, escalation, morning and mid-day exposures) depending on the tolerance (hypomanic symptoms). Methods Patients with BD I or II and treated by a mood stabilizer are eligible. After 1 week of placebo, patients are randomized between either morning or mid-day exposure for 10 weeks of active BLT with glasses using a dose escalation at 7.5, 10, 15, 30 and 45 minutes/day. A further follow-up visit is planned 6 months after inclusion. Patients will be included by cohorts of 3, with at least 3 days of delay between them, and 1 week between cohorts. If none meet a dose limiting toxicity (DLT; i.e hypomanic symptoms), the initiation dose of the next cohort will be increased. If one patient meet a DLT, an additionnal cohort will start at the same dose. If 2 or 3 patients meet a DLT, from the same cohort or from two cohorts at the same dose initiation, the maximum tolerated dose is defined. This dose escalation will also take into account DLTs observed during the intra-subject escalation on previous cohorts, with a "Target Ceiling Dose" defined if 2 DLTs occured at a dose. Discussion Using an innovative and more ergonomic device in the form of glasses, this study aims to better codify the use of BLT in BD to ensure a good initiation and tolerance.

Autonomic Neurocardiac Function in Patients with Major Depressive Disorder - Using a Heart Rate Variability Test Battery - (주요우울장애 환자에서의 자율신경심장기능 - Heart Rate Variability 검사를 사용하여 -)

  • Park, Young-Su;Lee, Kang-Joon;Kim, Hyun;Chung, Young-Cho
    • Sleep Medicine and Psychophysiology
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    • v.11 no.2
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    • pp.100-105
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    • 2004
  • Objectives: Major depression is associated with an increased risk of cardiovascular mortality. One possible explanation for this association is that major depression influences autonomic neurocardiac regulation. However, previous studies on the relationship between heart rate variability (HRV) and major depression have revealed conflicting results. The purpose of this study is to clarify that major depressive patients compared to healthy controls show a reduction in HRV as an expression of reduced modulation of vagal activity to the heart. Methods: According to DSM-IV, the time and frequency domain HRV indices (5-min resting study) of 30 patients with major depressive disorder were compared with those of 30 healthy controls. Standardized HRV tests enable quantitative estimation of autonomic nervous system function. Results: After controlling for age and gender, subjects with major depression showed a higher heart rate and significantly lower modulation of cardiovagal activity compared to controls. The total power (TP) band, very low frequency (VLF: 0.003-0.04 Hz) band, low frequency (LF: 0.04-0.15 Hz) band, and high frequency (HF: 0.15-0.4 Hz) band were significantly reduced in subjects with major depression compared to control subjects. Conclusion: Patients with major depression may suffer from functional disturbances in the interaction between the sympathetic and parasympathetic autonomic systems.

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Design and Implementation of the ChamCham and WordChain Play Robot for Reduction of Symptoms of Depressive Disorder Patient (우울증 진단 환자의 증상 완화를 위한 참참참, 끝말잇기 놀이 로봇 설계 및 구현)

  • Eom, Hyun-Young;Seo, Dong-Yoon;Lee, Gyeong-Min;Lee, Seong-Ung;Choi, Ji-Hwan;Lee, Kang-Hee
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.2
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    • pp.561-566
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    • 2020
  • We propose to design and to implement a recreational and end - of - play robot for symptom relief in patients with depression. The main symptom of depression is the loss of interest and interest in life. The depression diagnosis patient confirms the emotional analysis revealed by his / her robot through the robot, and performs the greeting or ending play. After analyzing the emotions in the expressions after the play, the function of the embodying robot is confirmed by receiving the report. A simple play can not completely cure a patient with a diagnosis of depression, but it can contribute to symptom relief through gradual use. The design of the play-by-play robot is using Q.bo One, an open-source robot that can interact with Thecorpora. Q.bo One's system captures a user's face, takes a picture, passes the value to the Azure server, and checks the emotional analysis before and after the play with the accumulated data.Play is implemented in Rasubian, the OS of Q.bo One, using the programming language Python and interacting with external sensors. The purpose of this paper is to help the symptom relief of depressive patients in a relatively short time with a play robot.

Cognitive Impairment and Decreased Quality of Life in Elderly Patients with Subsyndromal Depression (노인 아증후군적 우울증 환자의 인지기능 및 삶의 질 저하)

  • Ryu, Jae Sung;Kim, Moon Doo;Lee, Chang In;Park, Joon Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.20 no.2
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    • pp.45-53
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    • 2013
  • Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

Network Structure of Depressive Symptoms in General Population (일반 인구 집단의 우울증상 네트워크 구조)

  • Seon il, Park;Kyung Kyu, Lee;Seok Bum, Lee;Jung Jae, Lee;Kyoung Min, Kim;Hyu Seok, Jeong;Dohyun, Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.172-178
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    • 2022
  • Objectives : Although subclinical depression symptoms are associated with suicidal idea, most research have focused on clinical depression such as major depressive disorder or dysthymia. The aim of this study is to investigate network structure of depressive symptom and to reveal which symptoms are associated with suicidal ideation. Methods : We used part of data from the seventh Korea National Health and Nutrition Examination Survey. Participants were between 19 and 65 years of age (N=8,741). Network analysis with Isingfit model is used to reveal network structure of depressive symptoms and most central symptom and edges assessed by patient health questionnaire (PHQ-9). Results : The most two central symptoms were psychomotor activity and suicidal ideation. The strongest edge was psychomotor activity-suicidal ideation. Suicidal ideation also has strong association with depressive mood and worthlessness. Conclusions : These results suggest that psychomotor activity and suicidal ideation can serve as treatment target for subclinical depression and psychomotor activity, worthlessness and depressed mood may be important factor for early intervention of suicidal ideation.

Association between Type D Personality and the Somatic Symptom Complaints in Depressive Patients (우울증 환자에서 D형 인격과 신체 증상 호소와의 관련성)

  • Park, Wu-Ri;Jeong, Seong-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.18-26
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    • 2013
  • Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.

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A Relation between Clinical Characteristics of Cancer Patients on Radiotherapy and Psychiatric Disorders (방사선 치료중인 암환자의 임상적 특징과 정신과 장애의 관련성)

  • Kim, Ho-Chan;Moon, Chang-Woo;Park, Si-Sung
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.134-141
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    • 1999
  • Objects : Cancer patients receiving radiotherapy have many psychological problems. Those problems depend on clinical factors of cancer and the characteristics of patients. This study was designed to estimate the morbidity of psychiatric disorder and to investigate the relationship between psychiatric disorders and clinical variables. Methods : The subjects were 47 patients who had been treated by radiotherapy. Psychiatric disorder was diagnosed according to DSM-IV. The authors assessed the relation between psychiatric disorder and demographic features, clinical features of cancer such as site, duration, frequency of recurrence of cancer, and patients' awareness of disease and expectation of outcome of radiotherapy. Results : 21 patients(44.7%) had a psychiatric disorder. The most common psychiatric disorder were adjustment disorder(66.7%), and the next major depressive disorder(23.8%). There was a significant positive relationship between psychiatric disorder and recurrence of cancer, patients' expectation of poor outcome after radiotherapy. Psychiatric morbidity was significantly low in those who had no evidence of recurrence and who considered radiation treatment as curative. However, site and duration of cancer, patients' awareness about serious illness were not related with psychiatric disorder. Conclusion : Psychiatric disorders are common among cancer patients on radiotherapy. Further clinical attention and effective treatment of psychiatric complication in cancer patients are needed not only for reducing symptoms but for better adjustment.

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5-HT Transporter and Mood Disorder (세로토닌 수송체와 기분장애)

  • Lee, Min Soo
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.220-225
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    • 2001
  • As numbers of serotonin's function are so many, studies of serotonin are numerous nowadays. In the beginning, concentration of metabolites such as 5-HIAA was a key issue, but recent studies have been challenged for serotonin receptor genes and their relation to mood disoder. Serotonin transporter(5-HTT) gene is a strong candidate gene of mood disoder for following reason. Serotonin transporter is a key protein in the serotonin pathway as it regulate the concentration of serotonin in the synaptic clept and essential pathophysiology of depression is dysregulation of 5-HTT so that all antidepressants have effect of 5-HTT antagonist. The decrease of 5-HTT in the platelet and in brain of the depressive patients is much consistent results in the studies of the pathophysiology of mood disorder till now. By this, we will be able to develop simple and easy marker for diagnosis, type, and treatment monitoring of depression. Many psychiatrists have sought the independent genes in relation to depression or schizophrenia. Obviously, the hereditary vulnerability contributes to etiology of mood disorders, but it is difficult to discriminate the independent genes because of many environmental factors. Moreover, in the hereditarily complex diseases such as mood disorder, the only vulnerability of gene can not sufficiently explain the etiology. In the future, to exclude the role of the gene-environmental interaction, the methods such as gene transfer can be considered. In the opposite direction, by using the gene destruction method, the role of target genes can be examined. As yet the concept of the gene expression, neural plasticity, neurogenesis and etc, is the elementary stage. The development of this field will help to establish the treatment strategy of chronic and refractory mood disorders.

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Self-esteem and anxiety of obese children (비만 초등학생들의 자아존중감 및 불안에 대한 고찰)

  • Cho, Yu-Jeong;Kim, Eun-Joo;Cho, Jae-Heung;Jung, Won-Seok;Song, Mi-Yeon
    • Journal of Korean Medicine for Obesity Research
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    • v.10 no.2
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    • pp.27-39
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    • 2010
  • Objectives This study was performed to figure out relations of self-esteem, anxiety and the other factors related with obesity in obese children. Methods Forty-two children(21 boys and 21 girls) those who were diagnosed obesity have been recruited. To assess psychological factors, Self-esteem inventory(SEI), Revised Children's Manifest Anxiety Scale(RCMAS), International Physical Activity Questionnaires(IPAQ), Korean Eating Attitudes Test(KEAT-26) and Children's Depression Inventory(CDI) were administered. Behavioral characteristics were also analyzed. Results Self-esteem(SEI) had significant positive relationship with physical activity(IPAQ) and sleeping time. Self-esteem had significant negative relationship with anxiety(RCMAS), eating disorder(KEAT-26) and watching TV time. Anxiety had significant positive relationship with eating disorder(KEAT-26) and watching TV time, and negative relationship with physical activity(IPAQ) and sleeping time. All of participants seemed to be having depressive tendency. Conclusion Self-esteem and anxiety were significantly related. And eating disorder, physical activity, sleeping time and watching tv also affected to the self-esteem and anxiety of obese children.