• Title/Summary/Keyword: major depressive disorder

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Clinical Characteristics of Panic Disorder with Comorbid Major Depressive Disorder (주요우울장애를 동반한 공황장애 환자군의 임상적 특징)

  • Lee, Sun-Woo;Lee, Kang Soo;Lee, Sang-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.25 no.3
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    • pp.45-52
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    • 2018
  • Objectives The objective of this study was to investigate the differences in sociodemographic and clinical characteristics, temperaments, and quality of life between panic disorder (PD) patients with and without major depressive disorder (PD+MDD and PD-MDD patients, respectively). Methods We compared 411 PD-MDD and 219 PD+MDD patients. All patients who were drug-free for at least 1 month were assessed at initial outpatient visits before the administration of medication. The following instruments were used for assessment: the NEO Personality Inventory-Neuroticism (NEO-N) ; the Temperament and Character Inventory-Harm Avoidance (TCI-HA) ; the State-Trait Anxiety Inventory (STAI) ; the Intolerance of Uncertainty Scale-Short (IUS); the Anxiety Sensitivity Index-Revised (ASI-R); the Beck Depression Inventory (BDI) ; the Beck Anxiety Inventory (BAI); the Penn State Worry Questionnaire (PSWQ) ; the Generalized Anxiety Disorder for 7 item (GAD-7) ; the Albany Panic and Phobia Questionnaire (APPQ) ; the Panic Disorder Severity Scale (PDSS) ; the Early Trauma Inventory Self Report-Short Form (ETISR-SF) ; the Scale for Suicidal Ideation (SSI) ; the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF) ; the Sheehan Disability Scale (SDS) ; and the Short Form health survey (SF-36). Results Compared to the PD-MDD patients, the PD+MDD patients were younger and more likely to be unmarried. They showed higher rates of unemployment, lower levels of education and income, younger age of onset, more previous suicide attempts, a greater incidence of agoraphobia, and more previous treatments. The PD+MDD patients showed significantly higher scores on the NEO-N, the TCI-HA, the STAI, the IUS, the ASI-R, the BDI, the BAI, the PSWQ, the GAD-7, the APPQ, the PDSS, the ETISR-SF, and the SSI. In addition, the PD+MDD patients showed significantly lower quality of life than did the PD-MDD patients. In contrast with previous studies, we observed no significant differences between the two groups in terms of gender, duration until treatment, and psychiatric comorbidities. Conclusions This study showed that the PD+MDD patients have more early trauma experiences, higher levels of anxiety-related temperaments, more severe panic and depressive symptoms, and lower quality of life than the PD-MDD patients.

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Transcranial Direct Current Stimulation-Psychiatric Application and Its Current Status (경두개 직류 자극-정신과적 활용과 현황)

  • Kim, Pyungkyu;Kim, Dohyoung
    • Korean Journal of Biological Psychiatry
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    • v.24 no.4
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    • pp.175-187
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    • 2017
  • Transcranial direct current stimulation (TDCS) is a clinically safe and effective method of delivering weak electric current to modulate cortical activities. And based on the cumulating scientific evidences, the method is recommended to treat major depressive disorder (MDD) and other psychiatric disorders. In this paper, we review the development of TDCS in the rising field of neuromodulation. Then with suggested biochemical and physical mechanism of TDCS, we summarize the reported cases of using TDCS to alleviate major neuropsychiatric disorders. And, in particular, the treatment of MDD is highlighted as an illustrative example of using TDCS. We discuss here the therapeutic potentials of this method in psychiatry. And in closing remarks, we evaluate the current technical limitations and suggest the future directions of this method in both the clinical and research aspects.

Predictors of Cognitive Improvement during 12 Weeks of Antidepressant Treatment in Patients with Major Depressive Disorder

  • Lee, Jeong-Ok;Kim, Ju-Wan;Kang, Hee-Ju;Hong, Jin-Pyo;Kim, Jae-Min
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.461-468
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    • 2018
  • Objective: Cognitive disturbance is one of the major symptoms of depression and may be improved by treatment with antidepressants. This study aimed to investigate the predictors of cognitive improvement in patients with major depressive disorder (MDD) who were taking antidepressants. Methods: This study included 86 patients with MDD who completed 12 weeks of antidepressant monotherapy. Cognitive symptoms were assessed using the Perceived Deficits Questionnaire-Korean version (PDQ-K), which addresses four domains of cognitive functioning (attention/concentration, retrospective memory, prospective memory, and organization/planning) and was administered at study entry and at the 12-week end point. A variety of demographic, clinical, and treatment-related variables were evaluated as predictors of changes in total and domain scores. Results: All PDQ-K domains showed significant improvement after 12 weeks of antidepressant treatment. More severe initial depressive symptoms, fewer sick-leave days at study entry, and reduced use of concomitant anxiolytics/hypnotics during treatment were significantly associated with greater cognitive improvement. Conclusion: Cognitive symptoms are more responsive to antidepressant treatment in patients with severe MDD. Reduced use of anxiolytics and hypnotics could improve the cognitive functioning of patients with MDD taking antidepressants.

Korean Clinical Practice Guideline for the Treatment of Depressive Disorders - The Present State and Future Direction of Development - (한국형 우울증 진료지침 개발 및 적용연구 - 우울증 진료지침 개발의 국내외 현황과 개발방향 -)

  • Lim, Se-Won;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.13 no.1
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    • pp.11-18
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    • 2006
  • Depressive disorder is one of well-known major public health problems in Korea. The socioeconomic burden of depression is growing bigger and bigger. Therefore, the Korean government decided to establish the clinical research center for depression for better care of patients with depression. One of the major task of the center is the development of Korean clinical practice guideline for depressive disorders. This guideline should reflect the clinical situation in Korea and meet Korean physicians' needs. In addition, it should be feasible and easy to use. We reviewed the present status of the guideline development in Korea and other countries, and introduces the scope, method, and goals of Korean clinical practice guideline for depression.

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Difference in Isoproterenol-Stimulated Cyclic AMP Levels of Lymphocytes between the Subgroups of Depressive Disorders (우울장애 아형간에 Isoproterenol 자극후 임파구 Cyclic AMP Levels의 차이)

  • Bahk, Won-Myong;Jeon, Yang-Whan;Kim, Kwang-Soo;Sung, Yang-Sook
    • Korean Journal of Biological Psychiatry
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    • v.3 no.1
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    • pp.46-50
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    • 1996
  • This study was designed to examine the basal cyclic AMP levels and the $10^{-5}mol/L$ isoproterenol-stimulated cyclic AMP levels of lymphocytes, by which ${\beta}$-adrenoceptor function was shown, between to normal controls and 17 drug free patients(8 major depresive patients and 9 dysthymic patients), who were diagnosed by DSM-III-R. The severity of depression was assessed by Hamilton Rating Scale for Depression (HDRS). Cyclic AMP levels were measured by radioimmunoassay(double antibody). The results were as follows ; 1) HDRS score was significantly higher in major depressive patients($41.8{\pm}4.6$) than in dysthymic patients($24.0{\pm}4.2$)(p<005). 2) There was no Significant difference in basal cyclic AMP levels among normal controls($3.9{\pm}1.7pmol/10^6cells/10min$), major depressive patients($2.1{\pm}0.5pmol/10^6cells/10min$), and dysthymic patients($3.9{\pm}1.8pmol/10^6cells/10min$). 3) There was significant difference in net cyclic AMP levels($10^{-5}mol/L$ isoproterenol-stimulated cyclic AMP levels minus basal cyclic AMP levels) among normal controls($16.5{\pm}6.0pmol/10^6cells/10min$), major depressive patients($3.0{\pm}1.4pmol/10^6cells/10min$), dysthymic patients($10.9{\pm}4.4pmol/10^6cells/10min$)(p <005). 4) The net cyclic AMP levels were significantly correlated with HDRS scores in major depressive patients(${\gamma}=-0.8^6$, p<0.05), but not in dysthymic patients(${\gamma}=0.43$, p=0.25). In conclusion, we suggested that the dysthymic disorder might differ from the molar depressive disorder not only in the severity of depressive symptoms but also in ${\beta}$-adrenergic responsiveness of lymphocytes, which was regarded as a biological marker of depressive disorder.

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N100 Amplitude Slopes in Major Depressive Disorder, Bipolar Disorder, Schizophrenia and Normal Controls (주요 우울 장애, 정신분열병, 양극성 장애 및 정상 대조군에서의 N100 진폭경사)

  • Yang, Eunkyoung;Lee, Seung-Hwan;Oh, Sunghee;Kim, Sangrae
    • Korean Journal of Biological Psychiatry
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    • v.16 no.3
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    • pp.181-189
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    • 2009
  • Objectives : N100 amplitude slope(the intensity dependence of the cortical auditory evoked potentials) is widely considered as an indirect indicator of central serotonergic neurotransmission. However, there are only a few studies about N100 amplitude slopes of major psychiatric disorders. In this study, we examined N100 amplitude slope differences among major depressive disorder(MDD), bipolar disorder(BD), schizophrenia (SCZ) and normal controls(NC). Methods : We measured the N100 amplitude slopes of 35 patients with MDD, 33 patients with BD, 27 patients with SCZ and 35 NC subjects. Amplitude differences from N1 to P2 at the five different sound intensities(55, 65, 75, 85 and 95dB) were examined at Cz electrode. The N100 amplitude slope was calculated as the linear regression of five N1/P2 peak-to-peak amplitudes across stimulus intensities. Results : BD patients showed significantly reduced N100 amplitude slope compared with NC(0.54${\pm}$0.70 vs. 0.96${\pm}$0.72, p=0.035). N100 amplitude slope of SCZ patients was significantly reduced compared with NC(0.50${\pm}$0.47 vs. 0.96${\pm}$0.72, p=0.027). N100 amplitude slope of BD patients was significantly lower than that of MDD patients(0.54${\pm}$0.70 vs. 0.94${\pm}$0.60, p=0.046). SCZ patients also showed significant reduction of N100 amplitude slope compared with MDD patients(0.50${\pm}$0.47 vs. 0.94${\pm}$0.60, p=0.036). There was no significant difference of N100 amplitude slope between MDD patients and NC(0.94${\pm}$0.60 vs. 0.96${\pm}$0.72, p=1.000). Conclusion : Interestingly, the N100 amplitude slopes of BD and SCZ were reduced compared to NC and MDD patients. Our results suggest the predictive use of N100 amplitude slope in making differential diagnoses of major psychiatric disorders. Clinical implications of N100 amplitude slope in major psychiatric disorders were discussed.

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CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 2000
  • The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

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EEG Classification for depression patients using decision tree and possibilistic support vector machines (뇌파의 의사 결정 트리 분석과 가능성 기반 서포트 벡터 머신 분석을 통한 우울증 환자의 분류)

  • Sim, Woo-Hyeon;Lee, Gi-Yeong;Chae, Jeong-Ho;Jeong, Jae-Seung;Lee, Do-Heon
    • Bioinformatics and Biosystems
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    • v.1 no.2
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    • pp.134-138
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    • 2006
  • Depression is the most common and widespread mood disorder. About 20% of the population might suffer a major, incapacitating episode of depression during their lifetime. This disorder can be classified into two types: major depressive disorders and bipolar disorder. Since pharmaceutical treatments are different according to types of depression disorders, correct and fast classification is quite critical for depression patients. Yet, classical statistical method, such as minnesota multiphasic personality inventory (MMPI), have some difficulties in applying to depression patients, because the patients suffer from concentration. We used electroencephalogram (EEG) analysis method fer classification of depression. We extracted nonlinearity of information flows between channels and estimated approximate entropy (ApEn) for the EEG at each channel. Using these attributes, we applied two types of data mining classification methods: decision tree and possibilistic support vector machines (PSVM). We found that decision tree showed 85.19% accuracy and PSVM exhibited 77.78% accuracy for classification of depression, 30 patients with major depressive disorder and 24 patients having bipolar disorder.

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Difference of Somatic Symptoms between Anxiety Disorder and Major Depressive Disorder and Their Domainal Association with Suicidal Idealization, Plan and Attempts (불안 장애와 주요우울장애에서 나타나는 신체 증상과 증상군에 따른 자살 사고, 계획, 행동과의 관계 고찰)

  • Ahn, Jun Seok;Kim, Eun young;Cho, Maeng Je;Hong, Jin Pyo;Hahm, Bong-Jin;Chung, In-Won;Ahn, Joon-Ho;Jeon, Hong Jin;Seong, Su Jeong;Lee, Dong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.174-183
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    • 2016
  • Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.

No Association between the 5-HT6 Receptor C267T Polymorphism and Response to Citalopram Treatment in Patient with Major Depressive Disorder (주요우울증 환자에서 세로토닌 6(5-HT6) 수용체 C267T 다형성과 Citalopram 치료반응에 대한 연구)

  • Hahn, Sang-Woo;Lim, Se-Won;Oh, Kang-Seob;Kang, Rhee-Hun;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.14 no.4
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    • pp.262-267
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    • 2007
  • The serotonin 6(5-HT6) receptor gene is a candidate gene for influencing the clinical response to treatment with antidepressants. The purpose of this study was to determine the relationship between the C267T polymorphism in the 5-HT6 receptor gene and the treatment response to citalopram in a Korean population with major depressive disorder(MDD). Methods : Citalopram was administered for 8 weeks to the 90 patients who completed study. 21-item Hamilton depression rating scale(HAMD-21) was used as a outcome measure. Results : We found that the genotype, allele, and allele-carrier distributions did not differ significantly between MDD patients and normal controls. A main effect of an interaction of genotype with time on the decrease in the HAMD-21 score during the 8 weeks study period was not found. ANOVA revealed no significant effects of the C825T polymorphism on the decrease in the HAMD-21 score at each time period. Conclusions : These results suggest that the C267T polymorphism in the 5-HT6 receptor gene is not associated with the treatment response to citalopram.

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