• 제목/요약/키워드: depressive disorder

검색결과 414건 처리시간 0.026초

Inflammasomes: Molecular Regulation and Implications for Metabolic and Cognitive Diseases

  • Choi, Alexander J.S.;Ryter, Stefan W.
    • Molecules and Cells
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    • 제37권6호
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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.

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

  • 오현묵;김서우;오영택;손창규;이진석
    • 혜화의학회지
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    • 제26권1호
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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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한국형 우울증 임상진료지침 개발(II) (Korean Clinical Practice Guideline for the Treatment of Depressive Disorder(II))

  • 강이헌;김수영;이민수
    • 생물정신의학
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    • 제13권4호
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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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    • 제14권4호
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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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    • 제24권3호
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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.

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

  • 한다영;김상호;정대규
    • 동의신경정신과학회지
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    • 제30권2호
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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.

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

  • 조명선
    • 한국보건간호학회지
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    • 제33권2호
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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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    • 제34권2호
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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.

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

  • 조성환;하현이;윤효중;박재경;허주;이성준
    • 대한상한금궤의학회지
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    • 제15권1호
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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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정서장애 환자의 월경전기변화 특성 (Characteristics of Premenstrual Changes in Patients with Affective Disorder)

  • 고영훈;조숙행;서광윤
    • 정신신체의학
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    • 제7권1호
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    • pp.103-115
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    • 1999
  • 연구목적 : 월경전기증후군에서 나타나는 증상 양상, 가족력, 높은 정서장애의 유병율은 이 질환의 정서장애와의 관련성을 시사해 주며 한편, 월경주기에 따른 정서장애 임상경과의 변화도 제시되고 있다. 본 연구는 정신과 외래 통원 치료를 받고 있는 정서장애 환자군과 대조군을 대상으로 하여 월경전기변화의 양상과 정도를 비교하고 일상 및 직업 생활에의 영향 및 환자군에서의 월경전기변화에 대한 가능성 있는 위험 요인들을 알아보고자 하였다. 방법 : 본 연구는 정신과 외래 통원 치료를 받고 있는 여성 정서장애 환자 80명과 정상 대조군 80명을 대상으로 하였다. 월경전기변화는 DSM-IV 월경전기불쾌기분장애의 진단기준 A를 세분화한 4점 척도의 16항목으로 구성된 자기 평가 형식의 설문지를 통해 후향적인 방법으로 평가되었다. 결과 : 1) 월경전기변화의 항목 중 한가지 이상에서 중등도 이상의 변화를 경험하는 월경전기변화군이 정서 장애 환자군은 32.6%. 대조군은 50%로 환자군에서 대상이 적었다. 2) 월경전기변화군에서 대조군은 기분 또는 행동 변화와 신체적인 변화를 호소하는 경우가 비슷한 분포로 나타났으나, 환자군은 기분 또는 행동 변화만을 호소하는 경우가 유의하게 많았다. 월경전기변화군에서 대조군은 신체적인 변화인 유방 통증의 빈도가 가장 높았던 반면 환자군에서는 기분이나 행동 변화인 피로감과 무기력의 빈도가 가장 높았다. 3) 대조군은 기분이나 행동 변화와 신체적인 변화가 많을수록 일상이나 사회 생활에 심한 장애를 경험하는 반면 환자군에서는 기분 또는 행동 변화만이 빈도가 높을수록 심한 일상이나 사회 생활의 장애를 경험하였다. 4) 환자군에서 월경전기변화군은 월경전기변화가 없는 군에 비해 월경통을 보고하는 경우가 유의하게 많았으며, 그 심각도는 월경전기변화의 빈도와 상관 관계를 나타내었다. 결론 : 정서 장애 환자군의 월경전기변화는 신체적 변화보다 기분 행동 변화가 두드러지는 특성을 보였다. 이들 환자군의 월경전기변화는 기존 질환의 월경전기악화 또는 기존 질환과 동반되는 월경전기증후군의 가능성을 제시해 준다. 또한, 환자군에서는 월경전기변화 특히 기분 또는 행동 변화의 빈도가 높을수록 심한 일상 생활의 장애를 경험하였다. 따라서, 정서장애 환자에서의 월경전기변화에 대한 정확한 평가와 이에 대한 적절한 치료 전략의 수립이 필요하리라 본다.

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