• 생물정신의학
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• 제23권4호
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• pp.140-147
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• 2016

Objectives To determine the relationship between the Alu insertion/deletion (I/D) polymorphism in the tissue-type plasminogen activator (tPA) gene and the clinical outcome of mirtazapine treatment in Korean major depressive disorder (MDD) patients. Methods We enrolled 422 patients in this study. Symptoms were evaluated using the 21-item Hamilton Depression Rating (HAMD-21) Scale. After 1, 2, 4, and 8 weeks of mirtazapine treatment, the association between the Alu I/D polymorphism in the tPA gene and remission/response outcomes were evaluated. Results The proportion of I/I homozygotes in responders was higher than that in non-responders, whereas the proportion of D/D homozygotes in responders was lower than that in non-responders at 8 weeks of treatment (p = 0.032, OR = 1.57). The percentage decline of HAMD-21 scores in I allele carriers was larger than that of D/D homozygotes at 2 and 8 weeks of treatment (p = 0.035 and 0.007, respectively). I allele carriers were associated with remission at 8 weeks of treatment (p = 0.047, OR = 2.2). Conclusions These results show that treatment response and remission to mirtazapine were associated with the Alu I/D polymorphism of the tPA gene. This suggests the Alu I/D polymorphism may be a potential genetic marker for the prediction of therapeutic response to mirtazapine treatment in patients with MDD.

• 대한불안의학회지
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• 제16권1호
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• pp.24-31
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• 2020

Objective : The purpose of our study was to investigate the relationship between job stress and depressive disorder among emotional laborers in a city. Methods : A total of 677 emotional laborers living in Jeonju-city participated in this study. The participants completed survey questions regarding demographic characteristics, job stress (using the Korean Occupational Stress Scale-24, KOSS-24), and depression (the Patient Health Questionnaire-9, PHQ-9). Logistic regression was performed to estimate the association between job stress and depression. Results : Our results indicated that 34.9% of the participants had a high risk of total job stress and 21.7% of participants had depression. In the multivariate logistic regression analysis, female sex (OR=1.66, 95% CI=1.01-2.72) and total job stress (OR=3.84, 95% CI=2.57-5.75) were significantly associated with depression after adjusting for confounding factors. Among the subscales of job stress, job demand (OR=3.06, 95% CI=1.99-4.72) and occupational climate (OR=1.88, 95% CI=1.19-2.97) were significantly associated with depression. But insufficient job control, interpersonal conflict, job insecurity, the organizational system and lack of rewards were not. Conclusion : Among the emotional laborers, job stress, particularly job demand and occupational climate, were major contributing factors associated with depression. Early screening and preventive strategies focusing on job stress could reduce the impact of depression in emotional laborers.

• 대한불안의학회지
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• 제16권1호
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• pp.32-40
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• 2020

Objective : The purpose of this study was to investigate the cognitive performance of major depressive disorder (MDD) in military service/conscription personnel who visited the psychiatric clinic for a medical certificate to consider the situation from the perspective of Korea's unique compulsory military system. We used the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) as the test for verifying the suitable level of cognitive functioning for military service and as the embedded measure with reflecting suboptimal effort. Methods : The study was conducted on 56 (28 males, age 19-34) in/out-patients admitted to the psychiatry department and diagnosed with MDD (DSM-IV). All participants completed a structured clinical interview (MINI-Plus), as well as self-report questionnaires related to demographics and severity of clinical symptoms. K-WAIS-IV was administered to each subject to assess cognitive characteristics. Results : Military group showed significantly lower processing speed index (PSI) score including subtests of symbol search (SS) and coding (CD) score, compared to the control group. There was no other significant differences in the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) scores including sub-tests comprised of the above indices, and Reliable Digit Span (RDS), Enhanced-RDS-Revised (E-RDS-R) between the study and control groups. Conclusion : This study was the first effort to verify the characteristics of Korea's military group with MDD and suggest the applicability of PSI and processing speed of K-WAIS-IV as an embedded performance index to test sub-optimal effort or low motivation beyond the purpose of testing cognitive deficits.

• Molecular & Cellular Toxicology
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• 제4권4호
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• pp.355-359
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• 2008

This study aimed to determine the relationship between the C825T polymorphism in the G-protein ${\beta}$3-subunit (GNB3) gene and the response to citalopram in a Korean population with major depressive disorder (MDD). Citalopram was administered for 8 weeks to the 84 MDD patients who completed this study. All subjects were examined using the Structured Clinical Interview for DSM-IV, and the severity of depression was assessed using the 21-item Hamilton Depression Rating (HAMD-21) scale. A main effect of an interaction of genotype with time on the decrease in the HAMD-21 score during the 8-week study period was not found. ANOVA revealed no significant effects of the GNB3 C825T polymorphism on the decrease in the HAMD-21 score at each time period. Although the C825T polymorphism of the GNB3 gene may affect the pathogenesis of MDD, our results do not support the hypothesis that this polymorphism is involved in the therapeutic response to citalopram in Korean patients with MDD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권3호
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• pp.149-158
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• 2015

Objectives : The objective of this study was to identify the risky behavior subtypes in adolescents with depression, and the relationship between those subtypes and suicide attempt. Methods : Ninety adolescents who met the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria for major depressive disorder, dysthymia, or depressive disorder not otherwise specified participated in the study. Participants were interviewed about suicidal attempts, non-suicidal self-injuries. Smoking, drinking behaviors, and searching for the word "suicide" on the internet, negative life events including bulling-bullied experiences, and history of abuse were also included with questionnaires. Results : The results of cluster analysis showed that four risky behaviors were divided into three clusters : non-risky type, characterized by few risky behaviors ; delinquency type, which was characterized by smoking and drinking ; non-suicidal self-injury type. In non-suicidal self-injury type, percentage of girls was higher and clinical symptoms were more severe than delinquency type. In addition, delinquency type members could be a bully, while non-suicidal self-injury type members could be abused by a family member. Logistic regression analysis showed that both risky behavior subtypes were significant predictors of suicide attempt. Conclusion : These results suggest that two types of risky behaviors of depressed adolescents have an effect on the suicide attempts independently. Then, the implications and limitations of the study were discussed and directions for future studies were suggested.

• 대한불안의학회지
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• 제14권2호
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• pp.99-105
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• 2018

Objective : The purpose of this study was to investigate effects of depression and anxiety on treatment response of social skills training in adolescents with autism spectrum disorders (ASD). Methods : A total of 107 teenagers that participated in the Program for the Education and Enrichment of Relational Skills (PEERS$^{(R)}$) between 2011 and 2015 were analyzed using linear regression. Outcome measures used were the Korean version of Social Responsiveness Scale (SRS), the Test of Adolescent Social Skills Knowledge-Revised (TASSK-R), and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS). Depression and anxiety were assessed by the Korean version of Child Depression Inventory (CDI), the Korean version of State and Trait Anxiety Inventory for Children (STAIC), and the Korean version of Child Behavior Checklist (K-CBCL). Results : As a result, depressive symptoms measured by CDI (p<0.05) and anxiety symptoms measured by STAIC (p<0.05) had significant influence on score change of social interaction domain of ADOS. It remained significant even after the baseline score was adjusted as covariates (p<0.05). Conclusion : We observed that pre-treatment anxiety and depressive symptoms of teenagers had significant effects on the treatment outcome of PEERS$^{(R)}$, especially in terms of face-to-face social interaction.

• The Korean Journal of Pain
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• 제35권1호
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• pp.86-96
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• 2022

Background: To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods: Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results: Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions: In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.

• 대한불안의학회지
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• 제20권1호
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• pp.8-16
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• 2024

Objective : The purpose of this study is to compare the signal obtained from the frontal 2-electrodes EEG with that obtained from the temporal, central, and parietal 2 electrodes. Methods : EEGs were recorded in a total of 67 patients with major depressive disorder (MDD), 104 patients with schizophrenia (SCZ), and 29 patients with Alzheimer's disease (AD). For each disease group, there were healthy controls (HC) that were paired accordingly (HC1=69, HC2=104, HC3=27). The following measurements were compared across electrodes: band power, alpha peak frequency (APF), APF power, alpha asymmetry (AA), and Kolmogorov complexity (KC). Results : Statistically significant differences were found in band power measured from frontal electrodes compared to electrodes placed in other locations. Specifically, the power of theta waves was measured higher in the temporal electorodes, alpha 1 and alpha 2 waves in the parietal, beta 1 and beta 2 in the central, and gamma waves in the temporal electrodes. Both SCZ and AD patients showed increased theta power in all electrodes. In SCZ patients, APF decreased in the central and temporal electrodes, but the APF power analysis showed no difference between the patients and controls. Additionally, AD patients exhibited increased AA in the central EEG, while SCZ patients showed decreased KC in the parietal and temporal electrodes. Conclusion : Depending on the electrode location, sensitive EEG frequencies differed. Compared with signals from other electrodes, frontal EEG in MDD patients revealed generally constant signal values, though the temporo-parieto-central electrodes appeared to be more reliable in SCZ and AD patients.

• 생물정신의학
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• 제4권2호
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• pp.259-264
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• 1997

저자들은 1993년 5월 1일부터 1997년 4월 30일까지 한강성심병원 신경정신과 입원환자 중연성전기경련요법을 받은 60명을 대상으로 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 전기경련요법을 받은 환자 60명중 정신분열증이 51.7%, 주요우울증이 21.6%, 양극성 정동장애, 조증이 16.7%, 기타 10% 이었다. 2) 전기경련요법의 시행 횟수는 1인당 평균 12.2회(정신분열증 14.9회 : 주요우울장애 12.2회 : 양극성 정동장애 13.6회 : 기타 8.2회)이었다. 3) 치료의 대상이 되었던 증상은 정신분열증의 경우 피해망상, 환청, 주요우울장애는 정신운동지체, 우울기분, 그리고 자살사고 또는 시도, 양극성 정동장애에서는 파괴적 행동, 흥분상태 순이었다. 4) 전기경련요법에 사용된 약제로 atropine $0.0093mgkg^{-1}$, 마취제 pentothal $2.76mgkg^{-1}$, 근육이완제 succinylcholine $0.80mgkg^{-1}$을 사용하여 만족할 만한 효과를 얻을 수 있었다. 5) 전기경련요법시 사용된 마취제중 propofol은 pentothal에 비해 seizure duration을 낮추었다.

• 동의생리병리학회지
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• 제31권2호
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• pp.83-93
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• 2017

This study covers pattern differentiation based on Korean medical references, research trend and modern clinical applications about Sleep-Wake disorders of Diagnostic and Statistical Manual of Mental Disorders(DSM-V) published by American Psychiatric Association. Insomnia disorder is mostly caused by yin deficiency of liver-kidney or liver qi depression and main patterns are heart-kidney non-interaction, deficiency-excess complex pattern containing phlegm-heat due to qi stagnation and blood stasis. Hypersomnolence disorder is more due to yang deficiency rather than yin deficiency and it's major pattern is spleen-kidney yang deficiency. Cataplexy is main feature in narcolepsy and corresponds to depressive psychosis or fainting in terms of Korean Medicine and narcolepsy is assumed to be relevant to liver wind. Breathing-related sleep disorders are related with phlegm-fluid retention brought on spleen deficiency with dampness encumbrance. Pattern of circadian rhythm sleep-wake disorders is combined with yin deficiency of liver-kidney or liver qi depression of insomnia disorder and spleen-kidney yang deficiency or dampness-phlegm of hypersomnolence disorder. Yin deficiency with effulgent fire brought on drugs or alcohol is one of main patterns of substance/medication-induced sleep disorder and combined patterns with yin deficiency of liver-kidney and blood stasis or dampness-phlegm-heat are mostly applied clinically. This study drew major and frequently applied patterns of sleep-wake disorders based on Koran medical literature and modern clinical applications. And that can be the groundwork for the task ahead like clinical practice guideline of sleep-wake disorders containing pattern differentiation, diagnosis and prescriptions.