• 생물치료정신의학
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• 제24권3호
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• pp.129-141
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• 2018

Suicide is a behavior that is intended to cause death by itself and requires medical treatment, resulting in suicidal attempt or completion. Suicide causes loss of life, damages the body, costs a lot of medical expenses, and causes families to fall into sorrow and suffering therefore this suicide is a huge loss to family and society. There have been attempts to reduce and prevent suicide by understanding the mechanism of suicide. The mechanism of suicide can be thought of as psychological mechanism and biological mechanism. In the past, if we considered the psychological and biological mechanisms separately, the development of neuroscience now connects and integrates these two. Psychological factors affect biological factors and biological temperaments also affect perception or thinking about the situation and increase psychological vulnerability. Distant factors in suicidal behavior-such as childhood adversity and family and genetic predisposition-increase the lifetime risk of suicide. They alter the response to stress and other processes through changes in gene expression and regulation of emotional and behavioral characteristics. Distant factors affect the biological system and consequently changes in these systems can increase the risk of suicide. In other words, the distal factor does not directly induce suicidal behavior but rather acts indirectly through developmental or mediating factors. These mediating factors are impulsive aggressive and anxious trait, and chronic use of substances. The mechanism of this disorder is the abnormality of the serotonin system and the abnormality of the lipid level. Proximal factors are associated with the onset of suicide events and include changes in the major neurotransmitter systems, inflammatory changes, and dysfunction of glial cells in the brain. A series of studies, including a variety of research methods and postmortem and in-vivo imaging studies, show the impairment of the serotonergic neurotransmitter system and hypothalamic-pituitary-adrenal axis stress response system for suicidal behavior. These disorders lead to suicidal behavior due to difficulty in cognitive control of mood, pessimism, reactive aggression, abnormality in problem solving abilities, excessive response to negative social signals, severe emotional distress, and cognitive dysregulation of suicidal ideation.

• 대한임상독성학회지
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• 제6권2호
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• pp.134-137
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• 2008

Methylene blue is the first choice for treating methemoglobinemia, any increase in normal methemoglobin levels. Methemoglobin is an abnormal hemoglobin in which the iron has been oxidized to the ferric(+3) state, making it incapable of oxygen transport. Methemoglobinemia most commonly results from exposure to oxidizing chemicals, but may also arise form genetic, dietary, or even idiopathic etiologies. Patients with low methemoglobin levels are asymptomatic, but high methemoglobin levels can lead to headaches or even death. Methylene blue, the first-line treatment for methemoglobinemia, can also produce hemolytic anemia. Jaundice or dark urine during methylene blue treatment may indicate hemolytic anemia. A 47-year-old female patient with a history of depressive mood disorder developed significant methemoglobinemia after ingesting a Propanil overdose. Twenty-two hours after ingestion, methemoglobin levels in the blood were 73.2%. She was treated with intravenous methylene blue in the therapeutic range (1 mg/kg every 4 h for 3days). The 2nd day after methylene blue use, methemoglobin levels in the blood were 33%, and the 5th day decreased to 10% with better general condition. The patient had hyperbilirubinemia after hemolytic anemia, but she recovered completely.

• 한국문헌정보학회지
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• 제53권4호
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• pp.171-187
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• 2019

본 연구는 소셜 네트워크 서비스인 페이스북에서 우울증 관련 게시물을 분석하여 그 안에서 주로 논의되는 주제를 파악하고자 한다. 구체적으로, 접근 용이성, 개방성 및 익명성 등의 특징을 지니는 페이스북이라는 온라인 커뮤니티에서 사용자들이 다소 민감한 정신적 질환인 우울증에 관하여 어떤 내용을 논의하는지 살펴보고자 한다. 본 연구를 위해 페이스북 데이터 수집에서부터 주제어 추출에 이르기까지의 전반적인 과정을 포함하는 자연어 처리 기반의 데이터 분석 프레임워크를 구현하였다. 구현한 프레임워크를 이용하여, 본 연구는 우울증을 논의하는 페이스북 최대 사용자 그룹에서 최근 1년간 작성한 885개의 게시물을 수집하여 분석하였다. 주제어 추출의 완성도와 정확도를 위해 자동화된 기법과 수동적인 접근법(불용어 제거, 주제어 개수 지정)을 결합하였으며, 이를 통해 주제를 다각도에서 분석하였다. 분석 결과, 사용자들은 우울증 일반, 인간관계, 기분 및 느낌, 우울증 증상, 자살, 의료 참고, 그리고 가족 등에 대한 논의를 주로 하는 것으로 파악되었다.

• 대한불안의학회지
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• 제17권2호
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• pp.73-77
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• 2021

Objective : The Hoarding Rating Scale-Self-Report (HRS-SR) is a five-item scale that simply assesses the hoarding symptoms. We evaluated the factor structure, reliability, and validity of the Korean version of the HRS-SR (HRS-SR-K). Methods : A total of 144 individuals completed the self-administered questionnaires including HRS-SR-K, Obsessive-Compulsive Inventory-Revised-Korean version (OCI-R-K), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Psychometric properties of the HRS-SR-K were analyzed. Results : The Cronbach's α value for internal consistency of the HRS-SR-K was excellent (Cronbach's α=0.84). The construct validity was analyzed on the basis of principal component analysis and one-factor structure of the original scale was maintained. The HRS-SR-K total score and each item scores were more strongly correlated with the hoarding subscale score in OCI-R-K (convergent validity, r=0.71, p<0.01) than the corresponding scores of nonspecific depression or anxiety measures (discriminant validity). Conclusion : The HRS-SR-K is a simple and reliable self-report scale for examining the severity of hoarding symptoms.

• 대한불안의학회지
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• 제17권2호
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• pp.78-83
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• 2021

Objective : Current study investigated the association between internet addiction and suicidal attempts in psychiatric patients. Methods : Patients who visited emergency department or psychiatry outpatient unit of Chungnam National University Hospital from January 2020 to July 2021 were included in this study. Total of 192 participants, 96 suicidal attempt cases and 96 psychiatric control patients without history of suicidal attempt were matched by gender and baseline diagnosis. Depression and internet addiction were assessed by using Patient Health Questionnaire-9 (PHQ-9) and Young's Internet Addiction Test (IAT). Independent t-tests, and logistic regression analyses were conducted. Results : IAT scores were significantly higher in suicidal attempt case group (41.09±18.196 years) compared to psychiatric control patients without history of suicidal attempt (36.63±17.016 years) (p=0.040). Internet addiction (adjusted Odds Ratio [aOR]=2.049, 95% Confidence Interval [CI]=1.004-4.539, p=0.0493) was an independent risk factor for suicidal attempt in psychiatric patients after controlling age, gender, and sociodemographic factors, such as marital status, education level and employment status. Conclusion : This is the first study to investigate the relationship between internet addiction and suicidal attempt in psychiatric patients in Korea. Internet addiction is significantly associated with suicidal attempt in psychiatric patients, after adjusting sociodemographic variables. This study provides evidence to future studies to further investigate on causality of internet addiction and suicidality in psychiatric patients.

• 정신신체의학
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• 제29권2호
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• pp.199-206
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• 2021

Objectives : This study aimed to compare the characteristics of suicide attempts among Korean patients with mixed and non-mixed depression. Methods : Patients who visited the emergency room due to a suicide attempt and participated in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were included. Using the Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS), 111 patients were classified into the mixed depression (n=46) and non-mixed depression groups (n=65). The Koukopoulos Mixed Depression Rating Scale (KMDRS) score was calculated using the MADRS and YMRS scores. Suicide attempt characteristics were evaluated using the Columbia Suicidal Severity Rating Scale (C-SSRS) and Suicide Intent Scale (SIS). Results : In the mixed depression group, the reason item among the ideation intensity score of the C-SSRS was higher, and the deterrent item score was lower. Scores on the timing and suicide note items of the SIS were higher, and scores for overt communication items were lower in the mixed depression group. The KMDRS score was positively correlated with the C-SSRS ideation intensity and total SIS score. After adjusting for additional variables, the KMDRS scores had a significant effect on the C-SSRS ideation intensity and total SIS scores. Conclusions : The mixed depression group showed a difference in the intensity of suicidal ideation and suicidal intention compared to those in the non-mixed depression group. The overall suicidal ideation intensity and suicidal intention increased according to the degree of mixed depression.

• Psychiatry investigation
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• 제15권12호
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• pp.1188-1202
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• 2018

Objective This study protocol aims to determine, using a rigorous approach in patients with bipolar disorder (BD) and non-seasonal major depressive episode (MDE), the characteristics of bright light therapy (BLT) administration (duration, escalation, morning and mid-day exposures) depending on the tolerance (hypomanic symptoms). Methods Patients with BD I or II and treated by a mood stabilizer are eligible. After 1 week of placebo, patients are randomized between either morning or mid-day exposure for 10 weeks of active BLT with glasses using a dose escalation at 7.5, 10, 15, 30 and 45 minutes/day. A further follow-up visit is planned 6 months after inclusion. Patients will be included by cohorts of 3, with at least 3 days of delay between them, and 1 week between cohorts. If none meet a dose limiting toxicity (DLT; i.e hypomanic symptoms), the initiation dose of the next cohort will be increased. If one patient meet a DLT, an additionnal cohort will start at the same dose. If 2 or 3 patients meet a DLT, from the same cohort or from two cohorts at the same dose initiation, the maximum tolerated dose is defined. This dose escalation will also take into account DLTs observed during the intra-subject escalation on previous cohorts, with a "Target Ceiling Dose" defined if 2 DLTs occured at a dose. Discussion Using an innovative and more ergonomic device in the form of glasses, this study aims to better codify the use of BLT in BD to ensure a good initiation and tolerance.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권4호
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• pp.168-177
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• 2019

Objectives: We examined the factor structure of the Adolescent version of the General Behavior Inventory (A-GBI) for Koreans. Methods: We retrospectively reviewed the medical records of 220 adolescents (age, 12-18 years) who completed the A-GBI through the Department of Psychiatry at Asan Medical Center, Seoul, Korea, from October 2011 to December 2018. Caregivers of the study participants completed the Parent version of the GBI (P-GBI) 10-item Mania Scale. The adolescents were evaluated based on the A-GBI, Children's Depression Inventory (CDI), and Revised-Children's Manifest Anxiety Scale (RCMAS). Subsequently, an exploratory factor analysis (EFA) using the maximum likelihood method with direct oblimin rotation and correlation analyses with other scales were performed. Results: The EFA identified a two-factor structure as having the best fit: factor I included depressive symptoms and factor II included hypomanic/biphasic symptoms. Factor I was very strongly correlated with the A-GBI depressive subscale (r=0.990, p<0.001) and strongly correlated with CDI (r=0.764, p<0.001) and RCMAS (r=0.666, p<0.001). Factor II was also very strongly correlated with the A-GBI hypomanic/biphasic subscale (r=0.877, p<0.001) and weakly correlated with CDI (r=0.274, p<0.001) and RCMAS (r=0.332, p<0.001). Conclusion: The above findings support a two-dimensional model of mood symptoms in Korean youth.

• 대한불안의학회지
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• 제15권2호
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• pp.68-76
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• 2019

Objective : The goal of this study was to investigate the characteristics of early maladaptive schemas (EMSs), and associated neurocognitive functions as seen in visitors for military designation process. Methods : This retrospective study included 111 males aged 18 to 24 years among three groups: 41 visitors for military designation process (VMD), 21 patients with obsessive-compulsive disorder (OCD), and 49 healthy subjects. We collected the results of the Young Schema Questionnaire, Symptom Checklist-90-Revised, three neurocognitive tests as well as their clinicodemographic data. We analyzed the differences in EMSs between these three groups, and the correlations among the identified EMSs and neurocognitive performances within the VMD group. Results : Compared with both the OCD and healthy groups, the evaluation of the VMD group showed significantly higher scores in mistrust/abuse (F=6.4, p=0.002), vulnerability to harm (F=6.6, p<0.0001) and negativity/pessimism schema (F=7.3, p<0.0001), even when controlling for depression scores and levels of education. These three schemas also exhibited significant negative correlations with the score of Stroop test with r ranging from -0.34 to -0.44. Conclusion : These findings suggest that people who are likely to have difficulties adjusting to living in a military life may have psychological vulnerabilities related to certain EMSs. Further studies are warranted to test the clinical potentials of these findings, such as a treatment target and a predictor factor.

• Biomolecules & Therapeutics
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• 제27권2호
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• pp.160-167
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• 2019

Depression is a major mood disorder. Abnormal expression of glial glutamate transporter-1 (GLT-1) is associated with depression. Schisantherin B (STB) is one bioactive of lignans isolated from Schisandra chinensis (Turcz.) Baill which has been commonly used as a traditional herbal medicine for thousands of years. This paper was designed to investigate the effects of STB on depressive mice induced by forced swimming test (FST). Additionally, we also assessed the impairment of FST on cognitive function in mice with different ages. FST and open field test (OFT) were used for assessing depressive symptoms, and Y-maze was used for evaluating cognition processes. Our study showed that STB acting as an antidepressant, which increased GLT-1 levels by promoting PI3K/AKT/mTOR pathway. Although the damage is reversible, short-term learning and memory impairment caused by FST test is more serious in the aged mice, and STB also exerts cognition improvement ability in the meanwhile. Our findings suggested that STB might be a promising therapeutic agent of depression by regulating the GLT-1 restoration as well as activating PI3K/AKT/mTOR pathway.