• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.408-414
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• 2022

In this review, we provide information about the etiology, risk factors, and clinical presentations of maltreatment to help clinicians better understand child abuse and neglect. Child maltreatment is a major global health challenge that can result in severe consequences. Abused and neglected children are likely to develop psychiatric disorders, such as major depressive disorder, anxiety disorder, and posttraumatic stress disorder. Understanding child maltreatment is expected to prevent and reduce victimization in children, adolescents, and their families.

• Journal of Preventive Medicine and Public Health
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• 제49권5호
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• pp.260-274
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• 2016

Objectives: Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population. Methods: From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K) test for screening depression, and urinary malondialdehyde (MDA) levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores. Results: A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42%) increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%). In bivariate analysis after an SGDS-K score ${\geq}8$ was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR) of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42). Conclusions: Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population.

• 정신신체의학
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• 제3권2호
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• pp.126-138
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• 1995

For investigating a disease specific psychological mechanism in various dermatological disorders, we tried to explore the difference in correlation among stress perception, locus of control as a coping strategy, depressive symptoms and pruritic symptoms in the patients with psychological pruritis and chronic urticaria. The subjects were composed of 32 patients with psychol-ogical pruritis and 67 patients with chronic urticaria(subject group), and 25 patients with organic pruritis and 59 patient with major depression(control group). Global assesment of recent stress scale(GARS), I-E locus of control scale, Beck Depression Inventory(BDI) and medical college of wisconsin center pain follow up questionnaire were used for assesement. The results were as follows: 1) There were a significant positive correlation between stress perception and depressive symptom in patients with psychological pruritis, chronic urticaria, and major depression but not hi organic pruritis. 2) In relationship between locus of control and depressive symptom, patients with psychological pruritis, organic pruritis, and major depression except chronic ruticaria showed a significant negative correlation. 3) For intensity and pattern of pruritis, there were positive relations with depressive symptom and stress perception only in patients with chronic urticaria. Above results indicate that stress perception and locus of contorl may play a significant role in the formation of psychological and dermatological symptoms in psychological pruitis and chronic urticaria. But the mechanisms of these processes are different in either disorder.

• 우울조울병
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• 제9권1호
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• pp.30-36
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• 2011

Purpose : Anxiety disorder and depressive disorder are often comorbid with each other, and the comorbidity is associated with poorer psychiatric outcome, resistance to treatment, increased risk for suicide, greater chance for recurrence. We aimed to investigate the comorbidity of anxiety disorder in Korea. Method : Subjects were total of 867 depressed patients recruited CRESCEND-K multicenter trial. We used SCID (Structured Clinical Interview for DSM - IV) to find comorbidity of anxiety disorders in depressed patient. Results : Of 867 patients, total 8.2% had anxiety disorder. Proportion of anxiety disorder Not Otherwise Specified was 3.5%, panic disorder was 1.7%, generalized anxiety disorder was 1.1%, post traumatic stress disorder was 0.9%, obsessive compulsive disorder was 0.6%, social phobia was 0.4%. Conclusion : In this study, anxiety disorder in depression were measured at a low comorbidity rate in compare to previous studies. Selection bias, use of antidepressants at registration, severity of depression symptoms, and point of SICD administration seems to have affected these results. It is probable that comorbidity evaluation would be more precise if shorter, structured interviews such as M. I.N.I.-Plus were used during first clinical interview for depression diagnosis.

• 디지털정책학회지
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• 1권1호
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• pp.1-5
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• 2022

본 연구의 목적은 마음 챙김에 기반한 인지치료가 불안장애 환자의 불안, 우울에 미치는 영향을 알아보기 위해 수행되었다. 본 연구는 24명의 불안장애 환자를 대상으로 하였으며, 인구사회학적 특성은 빈도, 평균과 표준편차으로 분석하였고 마음챙김 명상에 기반한 인지 치료 전후 불안과 우울은 Wilcoxon signed rank test를 이용하였다. 본 연구 결과 한국형 마음 챙김 명상에 기반한 인지치료는 불안과 우울을 유의하게 감소시킬 수 있었다(Z=-1.9, p=.06, Z=-2.9, p<.001). 본 연구 결과를 통하여 마음 챙김 명상을 불안장애 환자에게 적용하고 이들의 삶의 질을 향상시키는 방법을 모색하는 것이 필요하다고 할 수 있다.

• 생물정신의학
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• 제14권2호
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• pp.91-98
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• 2007

임신 및 수유기 동안의 우울증의 치료에 관한 연구 실적을 고려했을 때 일반적인 우울증과는 구분하여 치료계획을 수립하는 것이 필요하다. 이에 저자들은 체계적인 검색을 통해 광범위하게 조사를 하였으나, 임신과 수유기 우울증 환자의 약물치료에 대한 근거는 아직까지 전체적으로 부족한 것으로 생각된다. 임신과 수유기 우울증의 치료는 그 시점과 개개인의 상황에 따라 최선의 의사결정을 해야 한다. 의사 결정은 위험과 이득에 관한 평가에 기초해서 이루어져야 하는데, 여기에는 약물치료의 위험과 우울증의 위험, 약물의 위험과 대체 치료의 위험, 그리고 정신치료의 효과가 지연되었을 때의 위험과 산모의 안전에 대한 위험 등을 모두 저울질 해보는 것이 포함된다. 또한 임신과 우울증 그리고 치료의 이득과 위험에 대해 산모와 보호자에게 충분히 상담을 해주고 동의를 구한 후에 치료가 이루어져야 한다. 증상을 조기에 발견하여 치료하는 것이 중요하고, 일단 치료가 시작되면 출산 후까지 지속적으로 재발 예방을 해야 한다. 각 치료법은 우울증의 정도에 따라 선택하는 것이 바람직한데, 경도에서 중등도 우울증의 경우 정신사회적 치료법과 더불어 광선치료와 같은 비약물학적 치료를 먼저 제공하고, 중등도에서 심한 정도의 우울증이나 재발 위험이 높은 우울증의 경우 정신사회적 치료와 약물치료를 함께 실시하도록 한다. 또한 자살의 위험성이 있는 우울증이거나 약물을 잘 견딜 수 없는 경우라면 전기충격요법을 활용할 수 있다. 약물을 선택할 때에는 정보에 기초하여 약을 선택하는 것이 바람직하고 용량도 치료 반응을 얻을 수 있는 가능한 최소한의 용량을 선택하도록 하며, 시기에 따라 약물의 용량을 조절해야 한다. 지난 10여 년간 선택적 세로토닌 재흡수 차단제의 임신과 수유기 동안의 안전성에 관한 연구 결과들이 발표되고 있고, 일차 치료제로써 선택되어지고 있다. 하지만 일반적으로 비교적 최근에 출시된 항우울제들은 임신이나 주산기 동안에 산모나 태아에게 미치는 영향에 대해 연구가 상대적으로 덜 이루어졌기 때문에 아직까지는 덜 권장되고 있다. 결론적으로, 임상의들은 임신과 수유기 동안의 우울증 치료 전략을 현재까지 수행된 연구 근거의 양과 수준을 감안하여 받아들여야 하고, 아직까지 명백한 결론을 이끌어 내기에는 부족하기 때문에 향후 관련 분야의 연구 결과들에 대해 예의 주시하여야 한다.

• 대한한방내과학회지
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• 제35권4호
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• pp.556-572
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• 2014

Objectives: The purpose of this study was 1. To investigate correlation of subjective stress with patient's prognosis 2. To observe the effect of Kami-shoyo-san on anxiety and depressive disorder. Methods: We investigated 3 cases of in-patients from traffic accidents. Patients were treated with Kami-shoyo-san. The Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used to assess anxiety and depression, respectively. We also used Qi stagnation test and Qi counterflow test according to Terasawa's criteria for diagnosis of anxiety and depression. Pain was evaluated by Numeric Rating Scale (NRS). Results: After treatment, the patient's symptoms improved considerably. Conclusions: 1. There were significant correlations between subjective stress and prognosis. 2. Kami-shoyo-san has good effect on anxiety and depressive disorder.

• 대한불안의학회지
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• 제2권1호
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• pp.22-27
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• 2006

Objectives : There is a paucity of data on the long-term course of obsessive-compulsive disorder (OCD) and chronological relationship between OC symptoms and their related symptoms such as anxiety and depression. The purpose of this study was to investigate the longitudinal course of OC symptoms as well as anxiety and depression which are believed to be associated with OC symptoms. Methods : Data for 155 patients with OCD who completed general evaluation for OCD were used. Forty four were excluded to minimize the effect of the different age of onset on the clinical course. One hundred eleven patients finally participated in the analysis. Cross-sectional correlations between each symptom as well as between such symptoms and the duration of illness were analyzed. Further correlation analysis was done within two groups that were divided by 7 years of the duration of illness. Results : There were significant correlations not only between the severity of OC symptoms and anxiety but also between anxiety and depressive symptom, regardless of the duration of illness. These correlations between such symptoms were also found within patients with the duration of illness below 7 years, whereas these were not within the group with the duration of illness above 8 years. Conclusion : Patients with OCD in this study shows the moderate to severe level of OC symptoms irrespective of the duration of illness. Our finding also suggests that the OC symptoms, especially obsessions are closely related to anxiety and depressive symptoms and these relationships might be pronounced in relatively early phase of the OCD after onset.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권4호
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• pp.251-257
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• 2015

Objectives : We compared the clinical presentations of manic and depressive episodes and the treatment response among children and adolescents with bipolar disorder (BD) types I and II and BD not otherwise specified (NOS). Methods : The sample consisted of 66 patients, aged between 6 and 18 years, who were admitted for BD to a 20-bed child and adolescent psychiatric ward in a university hospital located in Seoul, Korea. Results : Patients with BD type I were more likely to have lower intelligence quotients and exhibit violent behaviors during manic episodes than patients with BD type II or BD NOS and to show better treatment responses during manic episodes than patients with BD NOS. Patients with BD NOS were more likely to have an irritable mood rather than a euphoric mood during the manic phase than patients with BD type I or II and to exhibit violent behaviors during the depressive phase and chronic course than patients with BD type II. Conclusion : Pediatric BD patients are heterogeneous with respect to their clinical characteristics. Implications for the usefulness of the current diagnostic subtype categories should be investigated in future studies.

• 동의신경정신과학회지
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• 제34권4호
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• pp.349-358
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• 2023

Objectives: We used the 2019 Korea Health Panel Annual Data to analyze factors related to visits to Korean medicine (KM) outpatient clinics among patients with mood disorders in Korea. Methods: Individuals aged 19 years or older, with depressive or bipolar disorders, and with a record of using Western medicine (WM) and/or the KM medical service were included. The 266 subjects were classified into the WM group or the integrative medicine (IM) group. The Andersen healthcare utilization model was used to analyze factors that potentially influenced the subjects' healthcare utilization. Binomial logistic regression analysis was used to analyze factors influencing the use of IM medical services. Results: Among the subjects, 75.56% (n=201) were in the WM group, and 24.44% (n=65) were in the IM group. Statistically significant differences were observed in residential areas, total annual income, the presence of disability, and the level of pain/discomfort between the two groups. Regression analysis found that residential areas and pain/discomfort were factors related to the use of IM services. Specifically, reporting "a lot" of pain/discomfort compared to "no" pain/discomfort showed a significant positive relationship with the use of IM (odds ratio=4.57, 95% confidence interval=1.79 to 11.70). Conclusions: This study was the first to analyze the status of KM medical service use and related factors among patients with mood disorders in Korea. The finding that the presence of pain/discomfort was positively correlated with the use of KM services is potentially related to medically unexplained physical symptoms or somatization phenomena.