• Korean Journal of Biological Psychiatry
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• v.18 no.4
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• pp.210-216
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• 2011

Subsyndromal depression (SSD) is found to be more prevalent than major depressive disorder (MDD) and minor depressive disorder (MnDD). SSD is also associated with adverse clinical outcomes, increased risk of suicide, increased social dysfunction and disability, increased risk for future mood disorders, and increased uses of medical and mental health services. DSM-IV diagnostic criteria are not suitable for capturing SSD. Although there is no agreement on gold standard to define SSD so far, three definitions of SSD are available. First, SSD is defined as having two or more current depressive symptoms without core depressive symptoms (depressive mood or loss of interest) and with time threshold (most of the day and nearly every day over at least two weeks). Second, SSD is defined as having two or more current depressive symptoms with core depressive symptoms and without time threshold. Third, SSD is defined by using cutoff points of depression rating scales. SSD may represent a prodromal, residual, or interepisode symptomatic state in the course of MDD and MnDD. More than a half of SSD patients became any type of depressive disorders (SSD, MnDD and MDD) at 1 year. SSD may represent a discrete category of its own, without prior or consequent episodes of MDD. Considering clinical significance of SSD such as its high prevalence, significant psychosocial impairment and chronicity and serious outcomes, researchers and clinicians should be more vigilant in capturing and caring for patients with SSD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.1
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• pp.3-7
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• 2012

Objectives : The early onset of mood symptoms in bipolar disorder has been associated with poor outcomes in many studies. However, aspects of the clinical course of bipolar disorder in children and adolescents are controversial. The goal of this article is to review the clinical characteristics and longitudinal course of children and adolescents with bipolar disorders. Methods : Searches were conducted in MedLine, PsycINFO, KISS, and RISS using the terms phenomenology, clinical course, outcome, BPD, pediatric, children and adolescents. Twenty-one reports were selected : either original articles reporting symptoms and clinical characteristics of subjects (ages 5-18 years), or published articles in reviewed journals about bipolar disorder in children and adolescents. Results : Approximately 70% of subjects with bipolar disorder recovered from their index episode, and 50% had at least 1 syndromal recurrence, particularly depressive episodes. For 60% of the follow-up time, subjects had syndromal or subsyndromal symptoms with numerous changes in symptoms and shifts of polarity. Approximately 20% of BP-II subjects converted BP-I. Conclusion : Bipolar disorders in children and adolescents are characterized by episodic illness with subsyndromal and syndromal episodes with mainly depressive and mixed symptoms and rapid mood changes. Extensive follow-up time is needed to evaluate the continuity of bipolar disorder symptoms from childhood to adulthood.

• Korean Journal of Biological Psychiatry
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• v.15 no.2
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• pp.92-100
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• 2008

Objectives : The purpose of this study was to investigate 1) the neuropsychological deficits with major depressive disorder(MDD) in depressed state and 2) the changes of neuropsychological dysfunctions during depressed episodes and remitted periods in the MDD group. Methods : 12 patients with MDD and 70 normal controls who were diagnosed and classified by DSM-IV and SCID-IV interview participated in this study. The psychopathology was measured using the Hamilton rating scale for depression(HAM-D) and Brief Psychiatric Rating Scale(BPRS). The memory function, executive function, and sustained attention were measured by a trained psychologist using the Korean version of Memory Assessment Scale(K-MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone (COG) in Vienna Test System. After 6 weeks of treatment, we retested the cognitive tests in order to measure the cognitive functions in remitted states. Results : Patients with MDD achieved significantly lower score in sentence immediately recall, verbal memory score and total memory score of the K-MAS, total errors of the WCST, response time of Vigilance and response time at "Yes" response of Cognitrone than normal controls at baseline. After 6 weeks of medication, the psychiatric symptoms in the patient group were attenuated, and most of the neuropsychological functions including attention, memory, and frontal/executive function were improved except for response time of Cognitrone. Conclusions : This study provides evidence for distinct neuropsychological deficits in patients with MDD on their depressed states and remitted periods. The impairment on response time remains after remission, and this would be a trait marker of major depressive disorder.

• Korean Journal of Psychosomatic Medicine
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• v.10 no.2
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• pp.78-91
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• 2002

Objective : The purpose of this study was to develop the somatization rating scale (SRS), and then to use the scale in clinical pracitice. Methods: First, a preliminary survey was conducted for 109 healthy adults to obtain 40 response items. Second, a preliminary questionnaire was completed by 215 healthy subjects. Third, a comparison was made regarding somatization responses among 242 patients (71 with anxiety disorder. 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Results : Factor analysis yielded 5 subscales : cardiorespiratory and nervous responses, somatic sensitivity, gastrointestinal responses, general somatic responses, genitourinary, eye and muscular responses. Reliability was computed by administering the SRS to 62 healthy subjects during a 2-week interval. Test-retest reliability for 5 subscales and the total score was significantly high, ranging between .86-.94. Internal consistency was computed, and Cronbach's ${\alpha}$ for 5 subscales ranged between .72-.92, and .95 for the total score. Convergent validity was computed by correlating the 5 subscales and the total score with the total score of the global assessment of recent stress (GARS) scale, the perceived stress questionnaire (PSQ), and the symptom checklist-90-revised (SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the total score and the 5 subscale scores of the patient and control groups. Significant differences were found for 5 subscales and the total score. Only the depressive disorder group was siginificantly higher than control group in all the subscale scores and total scores of SRS among 4 patient groups. In somatic sensitivity, only depressive disorder patients were significantly higher than the normal controls, whereas in general somatic subscale, depressive disorder and somatoform disorder groups were significantly higher than the normal controls. In total scores of the SRS, female subjects were significantly higher than males. Conclusion : These results indicate that the SRS is highly reliable and valid, and that it can be utilized as an effective measure for research in stress- and somatization-related fields. The depressive disorder and somatoform disorder groups showed more widespread somatization than the anxiety and psychosomatic disorder groups.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.3
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• pp.141-146
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• 2010

This summary of literature during the past year reviews published studies relating to risk factors for depressive disorders in children and adolescents. Risk factors include environmental toxins, socio-environmental, and genetic factors. As depression has a complex, multifactorial causal mechanism, it is likely that the accumulation and/ or interaction among multiple risk factors lead to depression. Findings related to the result of toxin exposure have been difficult to interpret given that risk factors tend to interact and that higher mental functions are not easily measurable. However, some findings have been consistent. Clinical research data has also shown that the risk for negative outcomes may be modified both by genetic and environmental factors through a gene environment interplay mechanism.

• Korean Journal of Biological Psychiatry
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• v.25 no.3
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• pp.45-52
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• 2018

Objectives The objective of this study was to investigate the differences in sociodemographic and clinical characteristics, temperaments, and quality of life between panic disorder (PD) patients with and without major depressive disorder (PD+MDD and PD-MDD patients, respectively). Methods We compared 411 PD-MDD and 219 PD+MDD patients. All patients who were drug-free for at least 1 month were assessed at initial outpatient visits before the administration of medication. The following instruments were used for assessment: the NEO Personality Inventory-Neuroticism (NEO-N) ; the Temperament and Character Inventory-Harm Avoidance (TCI-HA) ; the State-Trait Anxiety Inventory (STAI) ; the Intolerance of Uncertainty Scale-Short (IUS); the Anxiety Sensitivity Index-Revised (ASI-R); the Beck Depression Inventory (BDI) ; the Beck Anxiety Inventory (BAI); the Penn State Worry Questionnaire (PSWQ) ; the Generalized Anxiety Disorder for 7 item (GAD-7) ; the Albany Panic and Phobia Questionnaire (APPQ) ; the Panic Disorder Severity Scale (PDSS) ; the Early Trauma Inventory Self Report-Short Form (ETISR-SF) ; the Scale for Suicidal Ideation (SSI) ; the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF) ; the Sheehan Disability Scale (SDS) ; and the Short Form health survey (SF-36). Results Compared to the PD-MDD patients, the PD+MDD patients were younger and more likely to be unmarried. They showed higher rates of unemployment, lower levels of education and income, younger age of onset, more previous suicide attempts, a greater incidence of agoraphobia, and more previous treatments. The PD+MDD patients showed significantly higher scores on the NEO-N, the TCI-HA, the STAI, the IUS, the ASI-R, the BDI, the BAI, the PSWQ, the GAD-7, the APPQ, the PDSS, the ETISR-SF, and the SSI. In addition, the PD+MDD patients showed significantly lower quality of life than did the PD-MDD patients. In contrast with previous studies, we observed no significant differences between the two groups in terms of gender, duration until treatment, and psychiatric comorbidities. Conclusions This study showed that the PD+MDD patients have more early trauma experiences, higher levels of anxiety-related temperaments, more severe panic and depressive symptoms, and lower quality of life than the PD-MDD patients.

• Investigative Magnetic Resonance Imaging
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• v.19 no.1
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• pp.10-18
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• 2015

Background and Purpose: The association between the low emotional regulation and the brain structural change of major depressive disorder (MDD) has been proposed, but the voxel-based morphometry (VBM) studies on female MDD are rare. The purpose of the present study was to show the regional volume changes of gray matter (GM) in female patients with MDD by optimized VBM. Methods: To control subjects homogeneity, twenty female MDD patients and age, sex matched 21 normal controls were included for the VBM analysis. To identify the change of regional gray matter volume (GMV), the optimized VBM was performed with T1 MRIs. The amounts of gray/white matter and intracranial cavity volumes (ICV) were measured. The analysis of covariance (ANCOVA) and partial correlation analyses covariate with age and ICV were applied for VBM. Results: The age and ICV distributions were similar between the two groups. In the ANCOVA, the total GMV of MDD was smaller than that of normal controls. In the VBM, regional GMV was relatively decreased in the limbic system (amygdalae, ambient gyri, hippocampi heads, subiculum, posterior parahippocampal gyri, pulvinar nuclei, dorsal posterior cingulate gyri, and left pregenual cingulate gyrus). The lingual gyri, short insular gyri, right fusiform gyrus, and right inferior frontal gyrus were also showed decreased regional GMV. Conclusion: The results of this study indicate that the female MDD is mainly associated with the structural deficits of the limbic system and limbic system related cortices, which were known to the center of emotions.

• Sleep Medicine and Psychophysiology
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• v.5 no.2
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• pp.202-209
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• 1998

Authors report the findings of nocturnal polysomnography and multiple sleep latency test(MSLT) before and after morning light treatment in a winter depressive patient with hypersomnia. On polysomnographic recordings, the sleep pattern of this case before light treatment was similar to that of narcolepsy exhibited, sleep onset REM period(SOREMP). After treatment, the shortened REM latency changed to normal condition, but, deep sleep percentage did not changed, and stage 4 sleep percentage was decreased. Depressive symptoms were improved on clinical interview with Hamilton Depressive Rating Scale. Sleep log showed shortened sleep latency and reduced sleep duration. These findings suggest that although light treatment could alter the sleep structure in seasonal affective disorder with hypersomnia, it does not necessarily imply that antidepressant response of light treatment is result of change of sleep structure.

• Journal of Oriental Neuropsychiatry
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• v.30 no.4
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• pp.371-383
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• 2019

Objectives: The purpose of this study was to review the research trends in the treatment of tai chi on depression. Methods: We searched articles in Pubmed and the China National Knowledge Infrastructure (CNKI) July 2009~June 2019. Selected studies were evaluated by the Jadad scale. Results: Fifteen controlled clinical trials were selected. The GDS (Geriatric Depression Scale) and SDS (Self-rating Depression Scale) were most frequently used as diagnostic criteria. The GDS was also the most commonly used outcome measurement. From the Jadad scale of 15 articles, the quality of the studies was low, overall. Conclusions: According to this study, it seems that tai chi treatment for depressive disorder is an effective and safe intervention. Thus, based on this study, more clinical research on diverse forms of treatments for depressive disorder should be performed in Korean medicine in the near future.

• Korean Journal of Biological Psychiatry
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• v.25 no.4
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• pp.89-100
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• 2018

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method that delivers 1-2 mA of current to the scalp. Several clinical studies have been conducted to confirm the therapeutic effect of major depressive disorder (MDD) patients with tDCS. Some studies have shown tDCS's antidepressant effect, while the others showed conflicting results in antidepressant effects. Our aim of this review is to understand the biological bases of tDCS's antidepressant effect and review the results of studies on tDCS's antidepressant effect. For the review and search process of MDD treatment using tDCS, the US National Library of Medicine search engine PubMed was used. In this review, we discuss the biological mechanism of tDCS's antidepressant effect and the existing published literature including meta-analysis, systematic review, control trial, open studies, and case reports of antidepressant effects and cognitive function improvement in patients with MDD are reviewed. We also discuss the appropriate tDCS protocol for MDD patients, factors predictive of response to tDCS treatment, the disadvantages of tDCS in MDD treatment, and side effects.