• Title/Summary/Keyword: depressive disorder

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Inflammasomes: Molecular Regulation and Implications for Metabolic and Cognitive Diseases

  • Choi, Alexander J.S.;Ryter, Stefan W.
    • Molecules and Cells
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    • v.37 no.6
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    • pp.441-448
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    • 2014
  • Inflammasomes are specialized signaling platforms critical for the regulation of innate immune and inflammatory responses. Various NLR family members (i.e., NLRP1, NLRP3, and IPAF) as well as the PYHIN family member AIM2 can form inflammasome complexes. These multiprotein complexes activate inflammatory caspases (i.e., caspase-1) which in turn catalyze the maturation of select pro-inflammatory cytokines, including interleukin (IL)-$1{\beta}$ and IL-18. Activation of the NLRP3 inflammasome typically requires two initiating signals. Toll-like receptor (TLR) and NOD-like receptor (NLR) agonists activate the transcription of pro-inflammatory cytokine genes through an NF-${\kappa}B$-dependent priming signal. Following exposure to extracellular ATP, stimulation of the P2X purinoreceptor-7 ($P2X_7R$), which results in $K^+$ efflux, is required as a second signal for NLRP3 inflammasome formation. Alternative models for NLRP3 activation involve lysosomal destabilization and phagocytic NADPH oxidase and /or mitochondria-dependent reactive oxygen species (ROS) production. In this review we examine regulatory mechanisms that activate the NLRP3 inflammasome pathway. Furthermore, we discuss the potential roles of NLRP3 in metabolic and cognitive diseases, including obesity, type 2 diabetes mellitus, Alzheimer's disease, and major depressive disorder. Novel therapeutics involving inflammasome activation may result in possible clinical applications in the near future.

A comparative study on physiopathology of depression by Korean medicine and conventional medicine (우울증의 병태생리에 관한 동서의학적 비교)

  • Oh, Hyeon-Muk;Kim, Seo-Woo;Oh, Young-Taeck;Son, Chang-Gue;Lee, Jin-Seok
    • Journal of Haehwa Medicine
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    • v.26 no.1
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    • pp.11-18
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    • 2017
  • Objective: This study aims to summarize recent findings of depression and compare the physiopathology of depression by conventional medicine and Korean medicine. Methods: A literature search of PubMed and Journal of Oriental Neuropsychiatry was conducted. This study analyzes the physiopathology of depression. Results: Despite difference of the viewpoints between conventional medicine and Korean medicine, etiology and symptoms of depression are similar. Recent findings of depression partly accord with Korean medicine theory. Conclusion: Physiopathology of depression has yet to be completely understood and current treatments remain ineffective in a large subset of patients. As the efficacy of Korean medicine against depression is demonstrating recently, understanding the viewpoints of Korean medicine will provide new perspectives and hints for further research and therapeutic development.

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Korean Clinical Practice Guideline for the Treatment of Depressive Disorder(II) (한국형 우울증 임상진료지침 개발(II))

  • Kang, Rhee-Hun;Kim, Soo-Young;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.219-225
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    • 2006
  • Depression has been causing huge direct and indirect losses to people's health because of its high prevalence, various clinical patterns, drug reaction and diverse courses different among individuals, but its treatment has not been systematic but dependent on individual clinicians' experience and knowledge. To correct this problem, it has been highly necessary to develop clinical guidelines defined as "systematically developed statements to assist practitioners' and patients' decisions about appropriate healthcare for specific clinical circumstances." Currently, countries throughout the world are making efforts to establish evidence-based guidelines among different levels of guidelines and to evaluate and test them. Although such efforts have been unsatisfactory in Korea because of several constraints including lack of high-quality RCT, the Korean Depression Clinical Practice Guideline has started to develop evidence-based guidelines, which are established through strictly designed processes. Thus, the present study purposed to review methods adopted in the development processes and to present the processes of developing the evidence-based guidelines clearly and transparently.

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Restful Web Services Composition Using Semantic Ontology for Elderly Living Assistance Services

  • Fattah, Sheik Mohammad Mostakim;Chong, Ilyoung
    • Journal of Information Processing Systems
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    • v.14 no.4
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    • pp.1010-1032
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    • 2018
  • Recent advances in medical science have made people live longer, which has affected many aspects of life, such as caregiver burden, increasing cost of healthcare, increasing number of disabled and depressive disorder persons, and so on. Researchers are now focused on elderly living assistance services in smart home environments. In recent years, assisted living technologies have rapidly grown due to a faster growing aging society. Many smart devices are now interconnected within the home network environment and such a home setup supports collaborations between those devices based on the Internet of Things (IoT). One of the major challenges in providing elderly living assistance services is to consider each individual's requirements of different needs. In order to solve this, the virtualization of physical things, as well as the collaboration and composition of services provided by these physical things should be considered. In order to meet these challenges, Web of Objects (WoO) focuses on the implementation aspects of IoT to bring the assorted real world objects with the web applications. We proposed a semantic modelling technique for manual and semi-automated service composition. The aim of this work is to propose a framework to enable RESTful web services composition using semantic ontology for elderly living assistance services creation in WoO based smart home environment.

Communication at the End of Life

  • Onishi, Hideki
    • Journal of Hospice and Palliative Care
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    • v.24 no.3
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    • pp.135-143
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    • 2021
  • End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress, listening to and interacting with patients remains essential for understanding their psychological condition. The most important tool, though difficult to implement in practice, is end-of-life discussion (EOLD). EOLD has been shown to have positive effects on end-of-life treatment choices, achievement of patients' life goals, improvements in the quality of life of patients and their families, and the prevention of depression and complicated grief among bereaved family members. EOLD is not often undertaken in clinical practice, however, due to hesitancy among medical personnel and patients for various reasons. In order to conduct an EOLD, the patient's judgment, psychiatric illnesses such as delirium and depression, and psychological issues such as the side effects of psychotropic drugs, denial, and collusion must be evaluated. Open and honest conversation, treatment goal setting, the doctor's familiarity with the patient's background, and attentiveness when providing information are important elements for any dialogue. Meaning-centered psychotherapy was developed to alleviate the existential distress of cancer patients, and its application may promote EOLD. The future development of meaning-centered psychotherapy in practice and in research is expected to further promote EOLD.

A Review of the Korean Experimental Studies on the Antidepressant Effect of Herbal Medicines (한약의 항우울 효과에 대한 국내 실험연구 고찰)

  • Han, Da-Young;Kim, Sang-Ho;Chung, Dae-kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.2
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    • pp.71-88
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    • 2019
  • Objectives: The present study aims to review the antidepressant effect of herbal medicines reported in Korean local journals. Methods: We searched in electronic databases (Koreantk, KISS, OASIS, NDSL) for studies, published in Korean national journals, that assessed herbal medicine effect of depression model. The search term was 'depression' in the abstract or whole text. Depression model, herbal material, experimental results, mechanisms were extracted. Results: We included 43 articles in which 38 studies were in vitro experiments, and the rest 5 were in vivo experiments. The most common experiment subject model was a rat and the most widely used method to induce depression was Despair behavior test. 21 studies used simple herbal medicines, and 22 studies used complex herbal medication. Glycyrrhizae Radix was the most commonly used herbal material to improve depression model. The most common mechanisms of herbal medicine with antidepressant effect were inhibition of Monoamine activation mechanism and depression related neurohormone secretion. Conclusions: Herbal medicines may be a promising resource for treating depression.

Prevalence and Correlates of Symptoms of Post-Traumatic Stress Disorders in Korean Older Adults Exposed to Natural Disaster (자연재난 피해 노인의 외상 후 스트레스 장애(PTSD) 발생 관련 요인)

  • Cho, Myong Sun
    • Journal of Korean Public Health Nursing
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    • v.33 no.2
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    • pp.214-227
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    • 2019
  • Purpose: This study examined the socio-demographic factors, the disaster related factors, the physical health related factors and the psychological factors of older adults exposed to natural disaster and these factors may possibly cause the occurrence of PTSD. Methods: A cross-sectional study was designed using the secondary data from the 3rd Disaster Victims Panel Survey (2012-2017). The data from 1,397 disaster victims were analyzed using descriptive statistics and logistic regression analysis. Results: Compared with the younger adult disaster victims, the elderly were more likely to have symptoms of PTSD (15.0% vs. 12.1%). Factors such as the number of years since being exposed to the disaster, anxiety, depression and social adjustment were significantly associated with occurrence of PTSD for both older and younger adults. Female gender was the additional risk factors for the older adults, while marital status, income, having witnessed another person's injury or death, and having lost a home were associated with the occurrence of PTSD. Conclusion: The elderly were more likely to develop PTSD as compared with younger adults. More targeted post-disaster mental health services to the elderly with the symptoms of depressive, anxiety and impaired social adjustments, should be provided to improve their mental health.

Initial Impact of the COVID-19 Outbreak on ADHD Symptoms Among University Students in Japan

  • Toshinobu Takeda;Yui Tsuji;Reiko Akatsu;Tatsuya Nomura
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.2
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    • pp.69-75
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    • 2023
  • Objectives: The coronavirus disease 2019 pandemic and its associated societal responses are anticipated to have wide-ranging effects on youth development and mental health. Depression, anxiety, and attention deficit hyperactivity disorder (ADHD) are the three most common mental health problems among university students. Many factors that can threaten mental health during the outbreak affect these three conditions, as well as sleep conditions, in undergraduate students. Thus, determining how these abrupt changes in students' circumstances impact their mental health is very important from a public health perspective. Methods: We investigated the usual conditions and changes in ADHD symptoms during the outbreak, in relation to depressive and sleep-related symptoms among undergraduate students. A total of 252 students, primarily juniors, completed the online survey. Results: The results showed that 12% of the students exceeded the cut-off score of the ADHD questionnaire before the pandemic. Approximately 6%-21% of the university students, especially those with ADHD traits, rated their ADHD behaviors as worse during the outbreak than that before the outbreak. Conclusion: Female students and undergraduates with ADHD traits are more susceptible to experiencing further deterioration of ADHD (inattention) symptoms during the pandemic. In cases where it is difficult to intervene with ADHD symptoms, approaching circadian rhythm or depression will be of considerable clinical use.

A Conceptual Study of "Mai (脉)" in Gangpyeong-Shanghanlun Based on Comparative case analysis and Paleography (『강평상한론(康平傷寒論)』 맥(脉)에 관한 고찰: 임상 증례 분석 및 고문자학적 해석을 통하여)

  • Seong-hwan Cho;Hyun-yee Ha;Hyo-joong Yun;Jae-kyung Park;Joo Heo;Sung-jun Lee
    • 대한상한금궤의학회지
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    • v.15 no.1
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    • pp.1-52
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    • 2023
  • Objective : The objective of this study was to explore the meaning of Mai (脉) in the fifteen letters provisions of Gangpyeong-Shanghanlun through the comparative analysis of 10 cases and paleography. Methods : We have collected 10 cases that have been diagnosed and treated by Gangpyeong-Shanghanlun Mai (脉) provision. And then, comparative analysis has been done among those 10 cases. Based on result of case analysis, paleographic meaning of each Mai (脉) have been studied to redefine Gangpyeong-Shanghanlun Mai (脉)'s meaning. Results : After administration of Mai (脉) provision's herbal medicine, all 10 patients recovered their mobility problem and pain. From this result, we could fomulate the hypothesis that Mai (脉) in Gangpyeong-Shanghanlun could mean mobility problems. After through further paleography studies, we could elaborate each Mai (脉)'s clinical meaning and related diseases. Conclusions : Mai (脉) in Gangpyeong-Shanghanlun could mean mobility problems caused by various diseases, which include musculoskeletal pain, neuropathy, syncope, fatigue, developmental disability and major depressive disorder.

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Characteristics of Premenstrual Changes in Patients with Affective Disorder (정서장애 환자의 월경전기변화 특성)

  • Ko, Young-Hoon;Joe, Sook-Haeng;Suh, Kwang-Yun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.103-115
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    • 1999
  • Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

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