• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.50-57
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• 2005

Objectives: This study was designed to evaluate the differences in clinical characteristics and severity of symptoms between panic patients with and without comorbid major depressive disorder, and to ascertain the differences in the function of the autonomic nerve system measured by heart rate variability (HRV). Methods: The subjects were 60 patients who have panic disorder without major depressive disorder and 19 patients who met DSMIV criteria for both panic disorder and major depressive disorder. First, they drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorder Inventory Schedule-Panic Attack & Agoraphobia (ADIS-P&A), Clinical Global Impression (CGI), Hamilton Rating Scale for Depression (HAM-D), Panic Disorder Severity Scale (PDSS) and Heart Rate Variability (HRV). For statistical analysis, we performed t-test to compare the scores of self reported scales and clinician’s rating scales in panic patients with comorbid major depressive disorder and those without major depressive disorder. ANCOVA was used to compare the variables of HRV, considering age as a covariate. Results: The subjective severities of depression and anxiety that comorbid patients complained of were higher than those of patients with only panic disorder. Futhermore, comorbid patients were more sensitive to anxiety and physical sensations, and they tend to be more negative in their thinking. The scores of clinician-rating scales such as CGI and PDSS were also higher in the comorbid patients. However, there were no significant differences in HRV variables between both groups, despite a tendency to low heart rate variability in the comorbid group. Conclusion: This study suggests that patients with panic disorder and comorbid major depressive disorder tend to complain of more symptoms and to be more sensitive to various symptoms than those with panic disorder without comorbid depression. However, in this study comorbid major depressive disorder did not have a significant impact on the HRV variables of patients with panic disorder.

• Child Health Nursing Research
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• v.24 no.3
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• pp.337-344
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• 2018

Purpose: The purpose of this study is to examine the association between each phase of the Life Transition Process (LTP) and depressive symptoms among parents of children with Autism Spectrum Disorder (ASD). Methods: Using a cross-sectional study design, data pertaining to LTP and depressive symptoms were collected from 285 parents of children with ASD (101 fathers and 184 mothers). Participants were recruited through the Autism Society of Korea and a counseling center for families of children with ASD. Results: Using a cut-off point of 5 or higher on the Beck Depression Inventory-Short Form, more than half of the parents (53.4%) were deemed depressed; these parents experienced moderate (27.4%) to severe (11.6%) levels of depressive symptoms. A hierarchical multiple regression using the socio-demographic characteristics of children and parents and each phase of the LTP as predictors, found that lower income (${\beta}=-.14$, p=.007) and greater scores for the wandering phase (${\beta}=.59$, p<.001) were significant predictors of greater levels of depressive symptoms. Conclusion: These findings confirm the association between LTP and depressive symptoms for parents of children with ASD, who were found to have a greater risk of depressive symptoms during wandering phase.

• Korean Journal of Biological Psychiatry
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• v.10 no.1
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• pp.70-79
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• 2003

Object : Currently, the alteration of cytokine system has been known to play an important role in regard to depressive symptom. We focused on the relationship between immunological parameters and clinical improvement in major depressive disorder. Method : Data were collected on 26 patients with major depressive disorder using a 8-week prospective follow-up design. After 8-week treatment period with fluoxetine, patients were classified into a response group and a non-response group according to their psychopathological outcome as evaluated by Hamilton Depression Rating Scale. The differences of the immunological parameters between pre-treatment phase and post-treatment phase were compared among patients. The difference of those was also compared within each phase among them. The relationship between socio-demographic variables, depression, cytokine, mononuclear cells was examined by correlation analysis. Multiple regression analyses were performed to explore the predictors of clinical improvement of major depressive disorder. Result : Pre-treatment levels of IL-$1{\beta}$ in the response group were significantly higher than those in the non-response group. Pre-treatment levels of IL-$1{\beta}$ of all patients and in the response group were positively correlated with pre-treatment monocyte counts. Patients with subsequent remission showed significantly lower IL-6 values at baseline than those with non-response. Post-treatment values of IL-6 did not differ significantly among the patients. The correlation test showed more frequent relations among cytokines and mononuclear cells in the response group than in the non-responder group. Especially, serum level of IL-6 in pre-treatment phase was only significantly correlated with HAMD score after 8-week treatement phase, while other cytokines and mononuclear cells were not. Pretreatment level of IL-6 was of paramount importance in predicting clinical improvement of depressive symptom. Conclusion : The immune system of major depressive disorder patients might dichotomize the patients into subsequent responders and non-responders. Immune system might be of great influence on the clinical improvement of major depressive disorder. The mode of interaction between depression and cellular immune function and the mediators responsible for the cytokine production need to be studied further.

• Anxiety and mood
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• v.10 no.1
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• pp.17-23
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• 2014

Objective : Panic disorders are frequently accompanied by major depressive disorder (MDD). There is insufficient information about which clinical factors in panic disorder are associated with comorbid MDD. The aim of this study is to identify clinical factors related with comorbid MDD in patients with panic disorder. Methods : Two experienced psychiatrists diagnosed panic disorder based on DSM-IV criteria. This diagnosis in the 275 subjects was confirmed again by Mini-International Neuropsychiatric Interview (MINI). Lifetime comorbid psychiatric diagnoses were examined by MINI. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Panic Disorder Severity Scale (PDSS) were used to assess the severity of depressive, anxiety and panic symptoms. Results : The result of MINI showed that 95 patients (34%) with panic disorder satisfied the diagnosis of MDD. Multivariate logistic regression model showed that comorbid generalized anxiety disorder (GAD) and the symptom of "fear of losing control or going crazy" were associated with MDD in patients with panic disorder. In female patients, the "chills or hot flushes" symptom was also associated with comorbid MDD. Conclusion : These results showed that coexisting GAD and certain symptoms of panic are associated with comorbid MDD.

• Journal of Preventive Medicine and Public Health
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• v.54 no.2
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• pp.110-118
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• 2021

Objectives: A growing number of people depend on flexible employment, characterized by outsider employment status and perceived job insecurity. This study investigated whether there was a synergistic effect of employment status (full-time vs. part-time) and perceived job insecurity on major depressive disorder. Methods: Data were derived from the 2012 Canadian Community Health Survey-Mental Health of 12 640 of Canada's labor force population, aged 20 to 74. By combining employment status with perceived job insecurity, we formed four employment categories: full-time secure, full-time insecure, part-time secure, and part-time insecure. Results: Results showed no synergistic health effect between employment status and perceived job insecurity. Regardless of employment status (full-time vs. part-time), insecure employment was significantly associated with a high risk of major depressive disorder. Analysis of the interaction between gender and four flexible employment status showed a gender-contingent effect on this link in only full-time insecure category. Men workers with full-time insecure jobs were more likely to experience major depressive disorders than their women counterparts. Conclusions: This study's findings imply that perceived job insecurity may be a critical factor for developing major depressive disorder, in both men and women workers.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.19 no.2
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• pp.112-119
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• 2008

Objectives : This study was conducted to examine whether there are qualitative differences in attention problem among children with various psychiatric disorders, including attention-deficit hyperactivity disorder (ADHD), depressive disorder, anxiety disorder, and tic disorder using clinical ADHD diagnostic system (ADS) T-scores. Methods : The subjects were 794 outpatient children aged from 5 to 15 years, including 540 children with ADHD, 95 children with depressive disorder, 86 children with anxiety disorder, and 73 children with tic disorder. Clinical T-scores on the ADS were calculated using the mean and standard deviations of four ADS variables for the ADHD group. Results : All four groups had T-scores on the ADS in the abnormal range. However, when comparing the clinical T-scores, the children with depressive and anxiety disorders performed better than the children with ADHD. We also found that although the four groups seemed to be similar in terms of clinical T-scores for omission and commission errors, there were significant differences in clinical T-scores for reaction time and the standard deviation of response time (RT) between the ADHD and other groups. Conclusions : We concluded that inattention and impulsivity might not be specific only to ADHD and that the clinical T-scores of RT and standard deviation of RT on the ADS could be used to discriminate between ADHD and other clinical groups.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.19 no.3
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• pp.175-181
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• 2008

Objectives: This study was conducted to compare the mothers' rearing attitude of ADHD children and that of children with depressive disorder. Methods: The participant consisted of 58 school-aged children diagnosed as ADHD, 14 children diagnosed as depressive disorder based on DSM-IV criteria. Normal control group consisted of 34 school-aged children who are free of any diagnosis of psychiatric disorders. Parental Acceptance-Rejection Questionnaire, Parenting Style Questionnaire, Children's Depression Inventory, Marital Satisfaction Scale, Beck's Depression Inventory were administered to all children and their mothers. Results: The parents of ADHD children showed more aggressive/hostile, neglecting/indifferent and less warm/affectionate parenting styles to their children than those of the depression and control groups. The depressive group perceived their parents as more rejecting than the control groups. Conclusion: The externalizing symptoms of ADHD might provoke parental distress and make it difficult for the parents to show positive rearing attitude toward their children. The depressive children might be more sensitive and perceptive to the negative sign of their parents' rearing attitude.

• Korean Journal of Biological Psychiatry
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• v.18 no.4
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• pp.189-196
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• 2011

Major depressive disorder is characterized by cellular and molecular alterations resulting in the depressive behavioral phenotypes. Preclinical and clinical studies have demonstrated the deficits, including cell atrophy and loss, in limbic and cortical regions of patients with depression, which is restored with antidepressants by reestablishing proper molecular changes. These findings have implicated the involvement of relevant intracellular signaling pathways in the pathogenetic and therapeutic mechanisms of depressive disorders. This review summarizes the current knowledge of the signal transduction mechanisms related to depressive disorders, including cyclic-AMP, mitogen-activated protein kinase, Akt, and protein translation initiation signaling cascades. Understanding molecular components of signaling pathways regulating neurobiology of depressive disorders may provide the novel targets for the development of more efficacious treatment modalities.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.376-382
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• 2018

We reviewed clinical studies investigating the pharmacological treatment of major depressive episodes (MDEs) with mixed features diagnosed according to the dimensional criteria (more than two or three [hypo]manic symptoms+principle depressive symptoms). We systematically reviewed published randomized controlled trials on the pharmacological treatment of MDEs with mixed features associated with mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). We searched the PubMed, Cochrane Library, and ClinicalTrials.gov databases through December 2017 with the following key word combinations linked with the word OR: (a) mixed or mixed state, mixed features, DMX, mixed depression; (b) depressive, major depressive, MDE, MDD, bipolar, bipolar depression; and (c) antidepressant, antipsychotic, mood stabilizer, anticonvulsant, treatment, medication, algorithm, guideline, pharmacological. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found few randomized trials on pharmacological treatments for MDEs with mixed features. Of the 36 articles assessed for eligibility, 11 investigated MDEs with mixed features in mood disorders: six assessed the efficacy of antipsychotic drugs (lurasidone and ziprasidone) in the acute phase of MDD with mixed features, although four of these were post hoc analyses based on large randomized controlled trials. Four studies compared antipsychotic drugs (olanzapine, lurasidone, and ziprasidone) with placebo, and one study assessed the efficacy of combination therapy (olanzapine+fluoxetine) in the acute phase of BD with mixed features. Pharmacological treatments for MDEs with mixed features have focused on antipsychotics, although evidence of their efficacy is lacking. Additional well-designed clinical trials are needed.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.650-657
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• 2017

Objective: This study was performed to report the effect of traditional Korean medicine as a treatment for laryngopharyngeal reflux (LPR) combined with depressive and anxiety disorder. Methods: We treated this patient with traditional Korean medicine and measured symptom severity using the reflux symptom index (RSI), Beck depression inventory (BDI), and Beck anxiety inventory (BAI). Results: After 3 weeks of treatment, most symptoms had decreased. The RSI score dropped from 21 to 8, BDI from 27 to 14, and BAI from 29 to 15. Conclusions: Traditional Korean medicine may be effective as a treatment for LPR combined with depressive and anxiety disorder, and a correlation may exist between LPR and psychological factors. However, more rigorous studies are required to identify exactly what treatment is most efficient for relieving LPR combined with depressive and anxiety disorder and whether LPR and psychological factors are clearly correlated.