• Journal of Korean Medical classics
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• v.35 no.4
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• pp.77-96
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• 2022

Objectives : This paper examines the medical treatise and treatment methods of Zhang Jiebin on the depressive pattern, for clinical application today. Methods : The Zazhengmo/Yuzheng chapter of the Jingyue Quanshu, related texts and annotations of the Huangdineijing, and related contents among the medical texts of the JinYuan masters were analyzed. Developmental process of the medical theories were compared and examined. Results : Zhang focused on the mechanism in which emotion affects Qi leading to a disease state, and categorized Yu[鬱, depressed state] into three: anger depression, contemplative depression and comprehensive depression. The concept of the Five Depressive Patterns and its treatment from the Huangdineijing·Suwen which was considered as excess pattern was expanded to include deficiency pattern based on comparison with annotations of Wangbing, Hwashou, and Wang Andao. Treatment methods centered on purging was also expanded to include tonifying to restore the damaged Jing Qi. The depressive patterns anger depression, contemplative depression and comprehensive depression were subdivided according to excess and deficiency, for which formulas such as Shenxiangsan, Shoupijian, Guipitang were suggested. As the depressive pattern is caused by emotions and thus the Heart, the Yiqingbianqi method that directly deals with emotions was suggested. Zhang adopted Zhu Zhenheng's opinion which expands the category of Yu, and in the perspective of excess/deficiency, it is most similar to that of Li Dongyuan. Conclusions : Before Zhang, the depressive pattern was discussed in terms of it being excess pattern. However, Zhang's discussion on depressive pattern based on anger depression, contemplative depression and comprehensive depression focuses on emotional stagnation while suggesting the possibility of deficient stagnation, expanding previous understanding. In terms of treatment, tonifying methods for deficiency pattern was added, while consideration of emotion itself became necessary in treatment.

• Korean Journal of Biological Psychiatry
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• v.28 no.2
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• pp.58-69
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• 2021

Objectives The aim of this study was to examine the association between the sleep pattern, chronotype (midpoint of sleep on free days) and the depressive symptoms in adults aged 19 years and over in Korea. This study also investigated the mediating effect of perceived usual stress (PUS) and self-rated health (SRH) on the association between chronotype and depressive symptoms. Methods Among the subjects of the 7th Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018, 16142 adults aged 19 or over responded to the survey and finally 8604 were analyzed according to the exclusion conditions. Logistic regression analysis was conducted to see the risk of depressive symptoms, suicidal ideation over sleep pattern, chronotype. Finally, mediation analysis was performed in order to clarify how PUS and SRH are associated to chronoytpe and depression. Results After controlling for potential covariates, weekly sleep duration < 5 hours, ≥ 10 hours was associated with depressive symptoms. And late bed time sleeping after am 1:00 and later midpoints of sleep was associated with a higher level of depressive symptoms. Additionally, the PUS and SRH between chronotype and depressive symptoms showed a serial multiple mediation effect. Conclusions Short or long sleep duration, late bed time and later midpoints of sleep on free days are associated with depressive symptoms. Furthermore, the mechanism between chronotype and depressive symptoms needs to be further clarified by identifying the serial multiple mediation effects of PUS and SRH.

• 한국노년학
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• v.34 no.2
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• pp.387-407
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• 2014

This study aims to identify the multiple trajectories of depressive symptoms and the characteristics of each trajectory group among the elderly. This study uses five waves of longitudinal data from the Korean Welfare Panel Study (KWPS, 2006-2010). Subjects were older adults aged 60 and over who had completed at least three waves between 2006 and 2010. A total of 4,181 respondents were analyzed. The latent growth mixture model and the multiple logistic regression model were mainly used for data analysis. The major findings were as follows: After controlling for the variables of gender, age, education, marital status, self-assessed health, and poverty, this study identified four different trajectory classes: stable low depressive symptoms (71.8%), high but decreased depressive symptoms (10.6%), moderate but increased depressive symptoms (7.9%), and an increased, then a decreased pattern of depressive symptoms (9.7%). The characteristics of theses trajectories as compared to previous studies were a lower percentage of 'stable low depressive symptoms', no 'persistently high depressive symptoms', and higher level of depressive symptoms. Also, the elderly in the stable low trajectory group had better health status, higher self-esteem and a good relationship with family members, having longer working periods, and more living in non-poverty. In addition, chronic health problems, loss of spouse, and household income differentiated the increased and then decreased pattern from the low stable pattern. Also, age and public pension differentiated the moderated but increased pattern from the low stable pattern. Based on the findings of this study, the researchers suggested political and practical implications for reducing depressive symptoms in later life.

• Korean Journal of Biological Psychiatry
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• v.9 no.2
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• pp.103-111
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• 2002

Neurocognitive research focusing on cognitive deficits in Depression has resulted in several important but yet potentially contradictory findings. Much literature documents the presence of significant neurocognitive impairments in depressive patients. Studies have shown that dysthymic disorder patients demonstrate a diffuse pattern of cognitive impairment which is frequently indistinguishable from that of focal braindamaged patients. Some reports have suggested that there is a focal pattern of deficit, such as anterior cingulate dysfunction, frontal lobe impairment, or dysfunction of the temporal-limbic cortex. The aim of this study is to evaluate the neurocognitive functions in dysthymic disorder patients, and to compare the functions with those of major depressive disorder patients. The subjects are 17 dysthymic disorder patients. And their neurocognitive functions are compared with those of 23 major depressive episode patients. Patients with a history of neurologic disease, alcohol dependence, substance abuse and mental retardation are excluded. They are assessed with a part of Vienna Test System which is computerized neurocognitive function tests and can evaluate attention, eductive ability, reproductive ability, visuoperceptual analysis, vigilance, visual immediate memory, the speed of information-processing, judgement, and fine motor coordinations. There are no other specific difference between two groups, except the result of cognitrone test. This study provides information about the neurocognitive functions and some difference between major depressive disorder patients and carefully diagnosed dysthymic disorder patients.

• Child Studies in Asia-Pacific Contexts
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• v.4 no.1
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• pp.27-45
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• 2014

The present study investigated the developmental pattern of Korean mothers' depressive symptoms from a week prior to birth through four months postpartum in a nationally represented survey sample in Korea, using a Latent Growth Curve model. Mother-reported four factors-maternal self-efficacy in parenting, father's participation in childcare, a number of hours mothers worked per week, child's emotional temperament-were examined as the predictors of depressive symptoms over time in the context of Korean culture. Effects of maternal depressive trajectories on their infants' developmental outcomes at the first year were also examined. Findings were as follows: First, mothers' reports of depressive symptoms decreased at the first month after birth and then increased again during the first 4 months postpartum. Second, mothers' perceived low spousal involvement in childcare, low parental self-efficacy, and their infants' difficult temperament at four-month old had significantly positive relations to the initial level of maternal depressive symptoms whereas the low spousal involvement in childcare and low maternal self-efficacy factors significantly predicted the changes of trajectories of maternal depressive symptoms. Third, the trajectories, in turn, predicted warm and responsive maternal parenting style at the fourth month. Subsequently, the parenting style had a significant longitudinal impact on the development of children's communication, problem-solving, and personal-social abilities. Based on these findings, awareness, preventive and interventional programs might be built to facilitate Korean mothers suffering severe postpartum depressive symptoms and further promote optimal early development of Korean children.

• Journal of Oriental Neuropsychiatry
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• v.31 no.3
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• pp.213-223
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• 2020

Objectives: To determine treatment effects of a combination of interpersonal and social rhythm therapy and Korean medicine for a patient with major depressive episode of bipolar II disorder. Methods: A patient was treated with Korean medicine (acupuncture, herbal medicine, etc.) and interpersonal and social rhythm therapy (IPSRT) for four months. Pattern identification for depressive mood and sleep associated symptoms was evaluated using Patient Health Questionnaire-9 (PHQ-9) and Social rhythm metric II-5 (SRM II-5). Results: At the end of the treatment, depression and delayed sleep symptoms were improved and social rhythm was recovered to the regular range. The patient acquired an insight to his interpersonal tensions and conflicts. Conclusions: Korean medicine in combination with interpersonal and social rhythm therapy can be used to treat patients with major depressive episode of bipolar II disorder. More cases are needed to develop guidelines for treating bipolar disorder.

• Korean Journal of Biological Psychiatry
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• v.13 no.3
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• pp.144-151
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• 2006

Objectives : Cognitive therapy is the most extensively researched psychological treatment for nonpsychotic unipolar outpatient depressive disorders. This review focused on the utility of this approach in severe or chronic depressive disorders, in relapse prevention and also on the potential benefits of combining cognitive therapy with medication. Methods : The author reviewed original studies and quantitative analyses on the effects of cognitive therapy, predictors of response, and neuroimaging studies of cognitive therapy in major depressive disorder. The sources used for the literature search were data bases : PubMed, EMBASE, CDSR on the internet, references in papers or books. Results : This review suggests that cognitive therapy is as effective as antidepressant medication in severe depressive disorders. And cognitive therapy can be an effective alternative to antidepressant medication. Patients benefited significantly more from combined cognitive therapy and antidepressant treatment than from either treatment alone. Most importantly, the addition of cognitive therapy to usual treatment appears to protect against future relapse in individuals known to be at high risk of repeated episodes of depression. In addition, subjects who received cognitive therapy showed significantly greater improvements in chronic depression than receiving antidepressant medication. Pooled data suggests that there is a significant relationship between the therapist's level of training or experience, the type of therapy used and patient outcome. Recent functional imaging studies examining brain changes following cognitive therapy report a variety of regional effects, but there is no consistent pattern across the few published studies. Conclusion : Cognitive therapy has proved beneficial in treating depressive patients. Despite empirical data supporting its efficacy, there are still problems in gaining access to cognitive therapy in clinical practice.

• Journal of Oriental Neuropsychiatry
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• v.31 no.2
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• pp.63-76
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• 2020

Objectives: The purpose of this study was to verify the clinical effects of herbal medicines on patients with depressive disorder. Methods: A prospective observational study on patients with depressive disorder was conducted. The patients were treated with herbal medicines for eight weeks. The Korean Hamilton Depression Rating Scale (K-HDRS) was evaluated as the primary outcome and the Korean Beck's Depression Inventory (K-BDI), Instrument on Pattern Identification for Depression, Korean Symptom Checklist-95 (KSCL-95), Insomnia Severity Index (ISI), Korean State-Trait Anxiety Inventory (STAI-K), Korean State-Trait Anger Expression Inventory (STAXI-K), EuroQol five-dimensional Questionnaire (EQ-5D), Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Heart Rate Variability (HRV) were measured as the secondary outcome. Adverse events were assessed for safety. Results: A total of 35 participants were observed for 12 weeks. The K-HDRS improved significantly in four, eight, and 12 weeks and the K-BDI showed significant differences in four, and eight weeks. There were no significant improvements in other evaluation scales. Gyejibongnyeong-hwan was the most frequently and continuously prescribed, showing significant improvements of K-HDRS after eight weeks of treatment. Conclusions: In our observational study, herbal medicine was effective for relieving the depression of patients with depressive disorder and Gyejibongnyeong-hwan showed the most significant effectiveness.

• Korean Journal of Psychosomatic Medicine
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• v.3 no.2
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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.

• 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.