• Korean Journal of Biological Psychiatry
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• v.15 no.4
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• pp.303-309
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• 2008

Objectives : Some reports have suggested that 5-HT5A polymorphism allelic association was associated with depression, however, there has been no report about relationship between the 5-HT5A gene and antidepressant response. We conducted the association study of the 5-HT5A receptor gene polymorphisms (-19G/C,12A/T) and response to citalopram in Korean patients with major depressive disorder(MDD). Methods : A total of 106 patients with major depressive disorder were included in this study. The patient's symptoms were measured by 21-item Hamilton Depression Rating Scale(HAMD) at baseline, week 1, week 2, week 4 and week 8 during citalopram treatment. A Responder to citalopram was defined by 50% reduction of total HAMD scores. To analyze genetic polymorphisms, a polymerase chain reaction based method was used. Results : At week 8, responders were 62, non-responders were 44. No significant differences of genotypes or allelic association in 19G/C and 12A/T polymorphisms were observed between responsive and non-responsive patients. Conclusion : These results do not support the hypothesis that this polymorphism of the HT5A receptor gene is involved in the therapeutic response to citalopram.

• Journal of Oriental Neuropsychiatry
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• v.15 no.2
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• pp.45-51
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• 2004

Hwabyung is a Korean culture bound syndrome and translated as anger syndrome at DSM-IV. And it is caused by the suppression of anger and has characteristics of chest discomfort, burning up as physical symptoms, and mortification, chagrin as psychological symptoms. It is very common in the field of psychiatry in Korea with Major Depressive Disorder (MDD). * Objective : 95 patients with MDD or Hwabyung, who visited the department of psychiatry in Korea University Medical Center or oriental medical hospital of Kyunghee Medical Center from May 2003 to August 2003, were selected for the study to compare between Major Depressive Disorder and Hwabyung. * Methods : The Structured Clinical Interview Schedule for DSM-IV (SCID) and Hwa-Byung Diagnostic Interview Schedule (HBDIS) were conducted for diagnosis. And Symptom Check List-90-Revised (SCL-90-R) was carried out for comparison between MDD and Hwabyung. * Result : Among the 95 patients, MDD group was 23 persons, Hwabyung group was 36 persons, and MDD plus Hwabyung group was 36 persons and it occupied 37.9%. MDD plus Hwabyung group had higher scores than any other groups in the whole dimensions of SCL-90-R. Hwabyung group had higher scores than MDD group in somatization, anxiety, hostility, Global Severity Index(GSI) and positive symptom total (p<.05) of SCL-90-R, but two groups had no difference in obsessive-compulsive, interpersonal-sensitivity, depression, phobic anxiety, paranoid ideation, psychoticism, positive symptom distress index of SCL-90-R. * Conclusion : These result showed that Hwabyung is similar to MDD at the point of depression and psychoticism but more severe at somatization, anxiety and anger than MDD.

• Mood & Emotion
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• v.15 no.3
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• pp.117-122
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• 2017

Objectives : Early life stress (ELS) may have impact on functions of the autonomic nervous system. Heart rate variability (HRV) is a reliable psychophysiological marker for functions of the autonomic nervous system. The purpose of this study was to investigate characteristics of HRV associated with ELS in patients with major depressive disorder (MDD). Methods : We compared HRV measures of MDD patients with ELS and without ELS in a 5-minute resting-state electrocardiogram recoding. Forty subjects participated in the study (25 with ELS, 15 without ELS). The Mann-Whitney test was conducted to identify group differences. Results : We found significant group differences in standard deviation of the NN interval (SDNN) and total power (TP). SDNN was lower in the ELS group (M=38.80 ms, SD=13.05 ms) than in the Non-ELS group (M=53.53 ms, SD=19.47 ms). TP was lower in the ELS group ($M=7.07ms^2$, $SD=0.69ms^2$) than in the Non-ELS group ($M=7.72ms^2$, $SD=0.77ms^2$). Conclusion : ELS may have a negative impact on the autonomic nervous system function in patients with MDD. ELS and dysfunction of autonomic nervous system should be considered in treatment for patients with MDD.

• Anxiety and mood
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• v.17 no.2
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• pp.84-91
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• 2021

Objective : Mismatch negativity (MMN) is known to reflect several abnormalities of cognitive functioning. This study is aimed to investigate the differences in MMN among major depressive disorder (MDD) patients with or without suicidal ideation. Methods : Sixty-seven patients with MDD were recruited into this study. MMN was measured by a 64-channel electroencephalography (EEG) using oddball paradigm over the front-central area. Clinical characteristics were assessed using the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II), and the Beck Scale for Suicide ideation (SSI-BECK). Patients were divided into two groups, no suicidal ideation (N=12) and suicidal ideation (N=55), depending on the presence of suicide ideation in SSI-BECK questionnaires. Results : The MMN latencies were significantly longer in the MDD patients with suicidal ideation than in the MDD patents without suicidal ideation (p<0.05). The MMN amplitudes were not significantly different between the two groups. Conclusion : Suicidal ideation may be associated with longer MMN latencies, and it suggests that MMN may play a potential role in assessing the suicidal risk among MDD patients.

• Korean Journal of Schizophrenia Research
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• v.23 no.1
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• pp.29-37
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• 2020

Objectives: This study aimed to investigate the characteristics of early maladaptive schemas and their associations with clinical symptoms in patients with schizophrenia. Methods: Forty-eight patients with schizophrenia, 49 patients with major depressive disorder, and 50 healthy controls completed the Young Schema Questionnaire and symptom measures including the Brief Psychiatric Rating Scale-Expanded (BPRS-E). Results: The schizophrenia group had significantly higher scores than the healthy controls and lower scores than the depression group in most schemas. Compared with healthy controls, the schizophrenia group exhibited higher scores in 10 schemas, i.e., mistrust, social isolation, failure, dependence, vulnerability to harm, enmeshment, insufficient self-control, subjugation, emotional inhibition, and negativity schemas (all p<0.001). Moreover, vulnerability to harm, enmeshment, subjugation, and negativity schemas were correlated with total scores of the BPRS-E (0.37≤r≤0.43, all p<0.05). Regarding the five BPRS domains, emotional deprivation schema showed significant relationships with negative (r=0.50, p=0.005) and disorganization (r=0.39, p=0.033) symptoms, while no schemas showed correlations with positive symptoms. Conclusion: These results suggest that most schemas in patients with schizophrenia pertain to impaired autonomy and performance as well as disconnection and rejection domains and may improve our understanding and the treatment of schizophrenia from a perspective of schema therapy focused on these domains.

• Journal of Oriental Neuropsychiatry
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• v.33 no.1
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• pp.79-111
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• 2022

Major depressive disorder (MDD) causes a persistent feeling of sadness and loss of interest. It can lead to emotional and physical problems. Treatments such as antidepressant and cognitive behavioral therapy for MDD have many limitations. Traditional East Asian Herbal Medicine (TEAM) is a representative modality of Complementary and Integrative Medicine (CIM) which can be used for MDD. However, no study has systematically reviewed the efficacy or safety of TEAM for MDD so far. Therefore, we performed a systematic review and meta-analysis to evaluate effectiveness and safety of TEAM as a monotherapy for MDD. We only included TEAM that could be used in context of clinical setting in Korean Medicine. Outcomes were the Hamilton Depression Rating Scale (HAMD) and total effective rate (TER). After comprehensive electronic search of 11 databases, we included 28 randomized controlled trials (RCTs) that compared HM as monotherapy with antidepressant for MDD. Meta-analysis showed that TEAM had significant benefits in reducing HAMD (MD=-0.40, 95% CI: -0.67 to -0.13, p=0.003, I²=85%) and improving TER (RR=1.06, 95% CI: 1.02 to 1.10, p=0.003, I²=0%). It also appeared to be safer than antidepressant in terms of adverse effects. Methods used for RCTs were poor and the quality of evidence was graded 'low' or 'moderate'. These findings indicate that the use of HM as a monotherapy might have potential benefits in MDD treatment as an alternative to antidepressant. However, considering the methodological quality of included RCTs, the clinical evidence is uncertain. Further well-designed RCTs are required to confirm these findings.

• Sleep Medicine and Psychophysiology
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• v.19 no.1
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• pp.42-46
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• 2012

Introduction: The objective of the present study was to investigate the defense style of insomnia patients and to grasp the differences in defense style between primary insomnia patients and insomnia patients with history of major depressive disorder. Methods: Forty three subjects with insomnia (11 subjects with primary insomnia and 32 subjects with major depressive disorder) and 138 control subjects participated in this study. To diagnose insomnia and major depressive disorder, interviews including structured clinical interview for DSM-IV (SCID-IV) were done. To assess the defense style, self-reported Korean version of Defense Style Questionnaire (K-DSQ) were completed by the participants. Results: Compared to normal controls, subjects with insomnia used more acting out (t=3.25, p<0.01), consumption (t=2.66, p<0.01), fantasy (t=3.51, p<0.001), resignation (t=5.42, p<0.001), suppression (t=3.28, p<0.01), projection (t=3.92, p<0.01), splitting (t=4.31, p<0.01), undoing (t=2.66, p<0.01), withdrawal (t=6.72, p<0.001) and isolation (t=3.80, p<0.001), and less omnipotence (t=4.08, p<0.001) and humor (t=3.20, p<0.01). Compared to normal controls, subjects with primary insomnia used more undoing and withdrawal. Compared to subjects with primary insomnia, subjects with insomnia with history of major depressive disorder used more resignation and withdrawal, and less humor. Conclusion: In the current study, there were differences in defenses between primary insomnia patients and insomnia patients with major depressive disorder history. To evaluate the pattern of defenses through the K-DSQ might provide important clues to differentiate these two conditions.

• Korean Journal of Biological Psychiatry
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• v.18 no.4
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• pp.210-216
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• 2011

Subsyndromal depression (SSD) is found to be more prevalent than major depressive disorder (MDD) and minor depressive disorder (MnDD). SSD is also associated with adverse clinical outcomes, increased risk of suicide, increased social dysfunction and disability, increased risk for future mood disorders, and increased uses of medical and mental health services. DSM-IV diagnostic criteria are not suitable for capturing SSD. Although there is no agreement on gold standard to define SSD so far, three definitions of SSD are available. First, SSD is defined as having two or more current depressive symptoms without core depressive symptoms (depressive mood or loss of interest) and with time threshold (most of the day and nearly every day over at least two weeks). Second, SSD is defined as having two or more current depressive symptoms with core depressive symptoms and without time threshold. Third, SSD is defined by using cutoff points of depression rating scales. SSD may represent a prodromal, residual, or interepisode symptomatic state in the course of MDD and MnDD. More than a half of SSD patients became any type of depressive disorders (SSD, MnDD and MDD) at 1 year. SSD may represent a discrete category of its own, without prior or consequent episodes of MDD. Considering clinical significance of SSD such as its high prevalence, significant psychosocial impairment and chronicity and serious outcomes, researchers and clinicians should be more vigilant in capturing and caring for patients with SSD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.4
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• pp.99-105
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• 2022

Objectives: Suicide is the leading cause of death among adolescents in South Korea, and depression and personality profiles have been identified as significant risk factors for self-injurious behavior. This study examined the influence of depressive mood and temperament/character on self-injury in adolescents. Methods: A total of 116 adolescents (aged 12-18 years) with a primary diagnosis of major depressive disorder (MDD) and their parents were enrolled in this study. The participants were divided into three groups based on adolescent's self-injury frequency, and their Children's Depression Inventory (CDI), Youth Self-Report (YSR), and Temperament and Character Inventory (TCI) scores were compared. Finally, mediation analysis was conducted to investigate the relationship between suicidal ideation and self-injury. Results: Of study participants, 75.9% answered that they had suicidal ideation, and 55.2% answered that they had engaged in self-injurious behavior in the last six months. There were significant differences in CDI and suicidal ideation among the groups. After adjusting for age and sex, mediation analysis indicated that depressive mood mediated the relationship between suicidal ideation and self-injury. Conclusion: This study emphasizes the importance of evaluating and managing depressive mood severity in adolescents with MDD as these factors partially mediate the transition from suicidal ideation to self-injury.

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.102-108
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• 1996

This was an open trial to evaluate the efficacy and safety of moclobemide twice daily for treatment of Korean patients with major depressive disorder(DSM-III-R). The duration of the trial was 6 weeks with the initial dose of moclobemide being fixed lor the first two weeks at 300mg/day(150mg twice daily, each token after morning and evening meals). Thereafter, when necessary, the dose was allowed to increase to 600mg/day or decrease to 150mg/day according to the seventy of the depression and/or the tolerability of the drug. Hypnotics and/or sedatives from a benzodiazepine group could be concomitantly administered at usual dosage. Patients were assessed at baseline and at days 14, 28 and 42. Efficacy was primarily judged on the Hamilton Rating Scale for Depression(HAM-D) and Beck Depression Inventory(BDI). Patients had to score at least 17 respectively an both scales to enter the trial. Secondary efficacy parameters included Clinical Global Impression(CGI) for severity of illness and improvement. Safety and tolerability were judged on reported adverse events, vital signs and laboratory parameters. In addition, there was a series of questions and assessments for the psychiatrists and patients to complete at the end of the trial Twenty nine patients completing trial were included in the analysis of efficacy : of thirty one patients participating in the safety and tolerability analysis, those who withdraw voluntarily without particular reasons or violated the treatment schedule were not included. The efficacies as determined by HAM-D, BDI or CGI were found to be significant compared to baseline. The number of responders defined as patients with a total score of 10 or less or with a total score of 50% or less of the baseline score on HAM-D and BDI were 17(59%) and 18(62%) respectively. Regarding safety and tolerability, nine patients(29%) reported mild adverse events probably related to moclobemide : of these one patient dropped out because of poor tolerability : however, there were no appreciable changes in blood pressure, pulse rate, body weight or laboratory parameters for all patients over the trial period. Furthermore, the physicians' and patients' opinions at final evaluation showed that moclabemide has a good antidepressant effect as well as a favorable tolerability. In conclusion, a twice-daily dosage schedule with maclobemide is recommendable for the treatment of Korean patients with major depressive disorder since its efficacy and safety were demonstrated in this study.