• Journal of Korean geriatric psychiatry
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• v.18 no.2
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• pp.86-91
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• 2014

Objective : The aims of this study were to investigate the prevalence of co-morbid depression and related factors of depression in mild cognitive impairment (MCI) patients. Methods : Nine hundred and six MCI individuals were included in this study. Depression was defined as major and minor depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Depression-related demographic and clinical factors were also explored through multivariate logistic regression analysis. Results : In MCI patients, the prevalence of depression as defined according to the DSM-IV diagnostic criteria was 1.8% for major depressive disorder, 11.4% for minor depressive disorder, and overall 13.2% for both. Multivariate logistic regression showed that increased prevalence of overall depression was associated with female gender and non-amnestic subtype of MCI. Conclusion : Our findings based on a large number of MCI subjects who visited memory clinic indicated that more than ten percent of MCI patients have comorbid depression. In addition, female and non-amnestic subtype of MCI patients seems to be more vulnerable to depression.

• Anxiety and mood
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• v.3 no.1
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• pp.32-40
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• 2007

Objectives : To investigate the validity of an abbreviated self-rated Korean version of MINI (Mini International Neuropsychiatric Interview) patient health survey which screening social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder. Methods : 115 subjects completed MINI and MINI patient health survey. The validity of MINI patient health survey was assessed by whether the results from MINI patient health survey were compatible with the results from MINI or not. The Cohen's kappa value, specificity, sensitivity, positive predictive value, and negative predictive value was calculated for this purpose. Results : The Kappa values of social anxiety disorder (0.60), panic disorder (0.49), generalized anxiety disorder (0.60) and major depressive disorder without other co-morbid disorder (0.59) were at least moderate in strength of agreement. Conclusion : The abbreviated self-rated Korean version of MINI patient health survey has the moderate to good validity in social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder without other co-morbid disorders. Our result suggests that this instrument might be useful for screening above 4 disorders if it is used under careful supervision of experienced clinicians.

• Mood & Emotion
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• v.15 no.2
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• pp.67-72
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• 2017

Objectives : Mindfulness meditation has recently become a major component in mainstream modern cognitive behavioral therapy. The purpose of this study was to examine effects of a mindfulness meditation program on positive resources of outpatients with depressive disorder and anxiety disorder. Methods : Participants were 55 psychiatric clinic outpatients. Participants received eight weekly sessions in a mindfulness meditation training program, that was approximately 90 minutes each. Measures included the Positive Resources Test (POREST), Acceptance and Action Questionnaire-16 (AAQ-16), Life Satisfaction Expectancy Scales (LSES), and Subjective Happiness Scale (SHS). Variables were measured at two time points : pre- and post-implementation (eight weeks later). Results : Paired t-test results of participants before and after the mindfulness meditation program revealed statistically significant improvement in positive resources (t=-5.847, p<.001), acceptance (t=-4.090, p<.001), life satisfaction expectancy (t=-3.892, p<.001), but not in subjective happiness. Conclusion : Results suggest mindfulness meditation may be effective to enhance positive resources, acceptance, and life satisfaction in outpatients with depressive disorder and anxiety disorder. Mindfulness meditation may be a factor in improving psychological well-being and positive psychological features in outpatients with depressive disorder and anxiety disorder.

• Anxiety and mood
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• v.9 no.1
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• pp.3-9
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• 2013

Intolerance of uncertainty (IU) is defined as the tendency to react negatively on an emotional, cognitive, and behavioral level to uncertain situations and events. However, this definition is somewhat categorical and does not explain the phenomenology of IU. Intolerance of uncertainty scale (IUS), the standard measure of IU, was considered to have two factors : 'unacceptability and avoidance of uncertainty' and 'uncertainty leading to the inability to act'. IU may be a cognitive vulnerability factor for clinical worry and generalized anxiety disorder (GAD). A number of moderators and mediators including cognitive avoidance, experiential avoidance and rumination influence the relationship between IU, worry, obsessive-compulsive symptoms, anxious and depressive symptoms. IU may be more strongly related to the symptoms of GAD than to symptoms of other anxiety disorders including obsessive-compulsive disorder (OCD), and major depressive disorder. IU may serve as an important transdiagnostic feature across anxiety and depressive disorders. Incorporating IU-specific treatment components into therapeutic protocols may result in pervasive benefits, and not only for those with GAD or OCD, but for people with any anxiety disorder or with depression.

• Korean Journal of Biological Psychiatry
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• v.18 no.4
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• pp.189-196
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• 2011

Major depressive disorder is characterized by cellular and molecular alterations resulting in the depressive behavioral phenotypes. Preclinical and clinical studies have demonstrated the deficits, including cell atrophy and loss, in limbic and cortical regions of patients with depression, which is restored with antidepressants by reestablishing proper molecular changes. These findings have implicated the involvement of relevant intracellular signaling pathways in the pathogenetic and therapeutic mechanisms of depressive disorders. This review summarizes the current knowledge of the signal transduction mechanisms related to depressive disorders, including cyclic-AMP, mitogen-activated protein kinase, Akt, and protein translation initiation signaling cascades. Understanding molecular components of signaling pathways regulating neurobiology of depressive disorders may provide the novel targets for the development of more efficacious treatment modalities.

• 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 Biological Psychiatry
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• v.12 no.1
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• pp.13-19
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• 2005

Objective:The purposes of this study were to investigate heart rate variability(HRV) in patients with generalized anxiety disorder(GAD) compared with major depressive disorder in Korea. Methods:Fifty-six GAD patients(20 male and 36 female) was classified into their comorbid psychiatric illness. Among them, Twenty-five patients(10 male and 15 female) who do not have any psychiatric comorbidity were compared with 30 major depressive disorder patients(12 male and 18 female). Clinical symptoms, HRV and MMPI were analysed between two group. Results:Comorbid psychiatric illnesses of GAD were ranked into no diagnosis(44.6%), MDD(32.1%), panic disorder(10.7%), social phobia(5.3%), PTSD(1.7%), OCD(1.7%), MDD+panic disorder(1.7%) and MDD+specific phobia(1.7%). GAD patients showed low functioning in HRV, but degree of decreasing HRV is not so severe compared with MDD patient. Balance of sympathetic and parasympathetic nerve tone is more severely impaired in GAD patients compared with MDD patient. The score of MMPI did not reveal any differences between two groups. Conclusions:The result showed that HRV can differenciate GAD and MDD patients. GAD patients could show decreased HRV functioning, less than MDD patients. But autonomic imbalance could be more severe in GAD than MDD patients.

• Korean Journal of Biological Psychiatry
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• v.22 no.4
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• pp.149-154
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• 2015

Mood disorder is a common psychiatric illness with a high lifetime prevalence in the general population. Many prescribed antidepressants modulate monoamine neurotransmitters including serotonin, norepinephrine and dopamine. There has been greater focus on the major excitatory neurotransmitter in the human brain, glutamate, in the pathophysiology and treatment of major depressive disorder (MDD). Recently, ketamine, an N-methyl-D-aspartate receptor antagonist, has received attention and has been investigated for clinical trials and neurobiological studies. In this article, we will review the clinical evidence for glutamatergic dysfunction in MDD, the progress with ketamine as a rapidly acting antidepressant, and other N-methyl-D-aspartate receptor antagonist for treatment-resistant depression.

• Anxiety and mood
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• v.7 no.1
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• pp.9-15
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• 2011

Objectives : We examined the reliability and validity of the Korean version of the Depression and Somatic Symptom Scale (DSSS) in Korean patients with depressive symptoms. Methods : Participants were 55 outpatients diagnosed with major depressive disorder, a depressive episode of bipolar I disorder, somatoform disorder, panic disorder, generalized anxiety disorder, or post-traumatic stress disorder according to the DSM-IV criteria. We assessed them using the Korean versions of the DSSS, Hamilton Depression Rating Scale (HDRS), and Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR). Results : The Korean version DSSS had a Cronbach's alpha of 0.90. Moreover, each item's correlation with the total score was statistically significant (r=0.24-0.71, p<0.01). The test-retest correlation coefficient (r=0.83, p<0.01) was relatively high, and the DSSS correlations with the HDRS and QIDS-SR were 0.77 and 0.74, respectively. Conclusion : These results demonstrate that the Korean version of the DSSS could be a reliable and valid tool for screening and assessing depressive patients. The Korean version of the DSSS will be a useful tool for screening both depressive and somatic symptoms in Korea.

• 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.