Neurobiological approach helps to resolve the mind-body dualism and develop new assessment and treatment approaches in psychiatry. However, it could be a problem to place too much emphasis on certain aspects of neurobiology, specifically structural neuroanatomy, because of the complexity or comorbidity of neuropsychiatric disorders. Developmental Coordination Disorder (DCD), for instance, is generally related to problems in motor skills and this movement disability is often related to perception. One account, two visual systems theory, relied on functional distinction in brain; ventral stream is responsible for visual recognition, and dorsal stream is responsible for the guidance of actions. However, Studies are now showing that shape perception is relevant to visually guided action, such as reaching-to-grasp an object. In this article, I reviewed fundamental findings of two-visual system theory and suggested problems of visually guided action to consider what shape perception implies for the two visual systems. Questions raised highlight possible limitations of adopting a structural neuroanatomical approach to account for perception and action effects, and by extent related psychiatric conditions such as DCD. In conclusion, neurobiological approach converging to neuropsychiatry, while useful, would be limited if it focuses too much on anatomical distinction.
Objectives: Symptoms of sleep apnea consisted of insomnia, excessive sleepiness during daytime, impaired cognitive functions and emotional disturbances. It was not so well known how these symptoms are correlated with various parameters of sleep and respiration, and what kind of psychophysiological processes are involved in development of these symptoms. Methods: In sixty patients with sleep apnea, sleep and respiration were studied by polysomnography of one night, also symptoms of sleep apnea were evaluated with the scales of insomnia, daytime sleepiness, emotional disturbance and cognitive impairment We studied correlations between apnea symptoms, and various parameters of sleep and respiration such as sleep efficiency, number severity of apnea, $O_2$ desaturation and number of snoring. Results: The result showing significant correlations are as follows. The patients with better sleep in insomnia scale showed more number of apnea, particularly more central type, and much more snoring in stage 3 sleep and mild desaturation of $O_2$. Excessive sleepiness during daytime correlated significantly with stage 1 sleep and its snoring, but correlated negatively with stage 2 sleep. However, no significant correlation was found with degree of $O_2$ desaturation. Emotional disturbance was more apparent in the patients with severe $O_2$ desaturation and smaller amounts of stage 4 sleep. Cognitive function was more impaired in cases of more REM sleep and less apnea. Conclusions: Symptoms of sleep apnea may occur through different causes and processes. The evaluation of apnea symptoms may be helpful to understand in some degree the condition of sleep and respiration during sleep in clinical setting.
Kim, Seok-Kwun;Moon, In-Sun;Kwon, Yong-Seok;Lee, Keun-Cheol
Archives of Plastic Surgery
/
v.36
no.4
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pp.437-444
/
2009
Purpose: Transgender is a disorder of gender identity, who have appropriate chromosomal, hormonal and anatomical characteristics corresponding to their sexual phenotype but feel strongly with respect to their sexual identity, that they belong to the opposite sex. There is a persistence discomfort and sense of inappropriateness about one's assigned sex in a person who has reached puberty. Transgender is a psychiatric problem, but surgical method provides more satisfactory adjustment for patients. In gender reassignment surgery for female to male transgender, mastectomy, nipple reduction, hysterectomy, oophorectomy and phalloplasty are included. And as the final operation, recommended for scrotoplasty and artificial testes insertion. So we investigated the necessity and method of scrotoplasty in the final operation of female to male transgender. Method: The authors have long term follow-up of 75 cases female to male transgender during January, 1991 to February, 2008. Among them, 13 cases were evaluated in this study. During phalloplasty, the labium major skin preserved. And this labium majoral skin flap was made for the neoscrotum. At least six months later, artificial testes were inserted in neoscrotum with local anesthesia. Middle sized (3 cm diameter) artificial testes(silicon gel or carving soft silicone implant) were used because of the limitation of the neoscrotum. We evaluated the questionnaire and interview about the postoperative satisfaction in configuration of reconstructed scrotum, and the necessity of operation, the postoperative psychosocioeconomic improvement and limitation of body exposure activities such as swimming, public bathing. Results: Based on this study, satisfaction of reconstructed scrotum after scrotoplasty was improved(92%). The necessity of scrotoplasty was in 92.3% and the postoperative psychosocioeconomic well - being improvement was 77% in answers. Less limitation of activities requiring body exposure was 54% in answers. Most of the patients were satisfied with the results of surgical operation inspite of the operative procedure had some postoperative complications. Conclusion: This study was reported that the scrotoplasty in female to male transgender is not only a conversion of external genitalia but also an improvement of psychosocial state. Most patients sincerely hope to this operation, so we improve our surgical method for more good results.
Jeon, Hye-Yeon;Lee, Heon-Jeong;Kang, Seung-Gul;Kim, Leen
Sleep Medicine and Psychophysiology
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v.14
no.1
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pp.26-32
/
2007
Objectives: Angiotensin-converting enzyme (ACE) gene polymorphism has been reported to be associated with depression and therapeutic outcome in depression. The purpose of this study was to determine whether ACE gene polymorphism is associated with seasonal variation in mood and behavior in a young Korean college student sample. Methods: 297 young Korean medical students were recruited in this study. All subjects were free of major medical and psychiatric problems. They were genotyped for the ACE gene polymorphism and evaluated the seasonal variation in mood and behavior by the Seasonality Pattern Assessment Questionnaire (SPAQ). Results: Global Seasonality Score (GSS) of SPAQ between three genotypes were not different. However, comparison of the group that showed seasonality of mood and behavior during winter with the group that did not showed seasonality indicated significant difference in genotype distribution ($x^2=6.79$, p=0.034). The D allele non-carrier (ll genotype) frequency was significantly higher in winter seasonality group than non-seasonality group ($x^2=6.59$, p=0.010;odds ratio [OR]=2.27, 95% confidence interval [CI] 1.20-4.28). Conclusion: These results suggest that the ACE gene polymorphism is related to winter-type seasonality in a Korean population.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.22
no.4
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pp.262-270
/
2011
Objectives : The definition of a hidden youth is a young person who has completely withdrawn from society and shut himself or herself away for more than 3 months. Those pathologically-withdrawn youths have become a burden not only to society but also to the family. However, screening of these hidden youths cannot be done easily. This study focused on developing a primary effective screening tool for these hidden youths. Methods : The 42 participants of this study were parents of hidden youths that are between 8 to 25 years old. They were selected from from mental health centers and psychiatric clinics around Seoul and Gyeonggi Province. We also recruited 239 parents of middle and high school students in the Seoul metropolitan area for a control group. In order to decide the concurrent validity of this questionnaire, we used the Symptom Checklist-90-Revision, Children's Depression Inventory, Beck Depression Inven-tory, Social Anxiety Scale for Children-Revised, Social Anxiety and Distress Scale, Avoidant Personality Disorder Scale, and State-Trait Anxiety Inventory for Children. SPSS version 12.0 was used for statistical analysis. Results : Cronbach's alpha values, the reliability coefficient to represent internal consistency, were between 0.396 and 0.935, which showed relatively high internal consistency for this questionnaire. The test-retest coefficient was between 0.68 and 0.78, which was a statistically significant result. In a factor analysis, 4 factors such as avoidance, withdrawal, isolation, and apathy were extracted. In a concurrent validity test with SCL-90-R, the isolation factor showed a statistically-significant relationship with a phobic-anxiety sub-scale, and avoidance and withdrawal sub-scales were remarkably correlated with the interpersonal sensitivity sub-scale. Conclusion : Since the questionnaire for socially withdrawn youths has achieved statistically-satisfactory reliability and validity, it will be a useful method to screen for hidden youths in educational, community, and clinical settings.
Immune responses in the central nervous system (CNS) function as the host's defense system against pathogens and usually help with repair and regeneration. However, chronic and exaggerated neuroinflammation is detrimental and may create neuronal damage in many cases. The NOD-, LRR-, and pyrin domain―containing 3 (NLRP3) inflammasome, a kind of NOD-like receptor, is a cytosolic multiprotein complex that consists of sensors (NLRP3), adaptors (apoptosis-associated speck like protein containing a caspase recruitment domain, ASC) and effectors (caspase 1). It can detect a broad range of microbial pathogens along with foreign and host-derived danger signals, resulting in the assembly and activation of the NLRP3 inflammasome. Upon activation, NLRP3 inflammasome leads to caspase 1-dependent secretion of the pro-inflammatory cytokines IL-1β and IL-18, as well as to gasdermin D-mediated pyroptotic cell death. NLRP3 inflammasome is highly expressed in CNS-resident cell types, including microglia and astrocytes, and growing evidence suggests that NLRP3 inflammasome is a crucial player in the pathophysiology of several neuroinflammatory and psychiatric diseases, such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, stroke, traumatic brain injury, amyotrophic lateral sclerosis, and major depressive disorder. Thus, this review describes the molecular mechanisms of NLRP3 inflammasome activation and its crucial roles in the pathogenesis of neurological disorders.
Depression is a psychiatric disorder characterized by depressed mood, anhedonia, fatigue, and altered cognitive function, leading to a decline in daily functioning. In addition, depression is a serious and common mental illness not only in an individual's life but also in society, so it must be actively treated. Autophagy is involved in the pathophysiological mechanism of mental illness. According to a recent study, it is known that autophagy-induced apoptosis affects neuroplasticity and causes depression and that antidepressants regulate autophagy. Autophagy is a catabolic process that degradation and removes unnecessary organelles or proteins through a lysosome. And, it is essential for maintaining cellular homeostasis. Autophagy is activated in stress conditions, and depression is a stress-related disease. Stress causes damage to cellular homeostasis. Recently, although the role of autophagy mechanisms in neurons has been investigated, the autophagy of depression has not been fully studied. This review highlights the new evidence for the involvement of autophagy in the pathophysiological mechanisms and treatment of depression. To highlight the evidence, we present results from clinical and preclinical studies showing that autophagy is associated with depression. Understanding the relevance of autophagy to depression and the limitations of research suggest that autophagy regulation may provide a new direction for antidepressant development.
Objective : The purpose of this study is to identify and analyze the vocational rehabilitation evaluation tool for the mentally disabled. Methods : For literature search, the Pubmed database was used, and for the analysis, the development year, evaluation method, number of items, scale, and evaluation items were analyzed. In the analysis method, each evaluation item was divided into four categories: function, internal factor, environment, and mental symptom, and the evaluation elements of each evaluation tool were identified. Results : When searching Pubmed through search terms, 161 documents were retrieved. According to the selection method, Griffiths Work Behavior Scale (GWBS), Occupational Functioning Scale (OFS), Social and Occupational Functioning Assessment Scale (SOFAS), Work Ability Index (WAI), Work Behavior Inventory (WBI), Work Environment Impact Scale (WEIS), and Work and Social Adjustment Scale (WSAS) were screened. The evaluation items of all evaluation tools included job-related functional evaluation. According to the purpose of each evaluation tool, internal factors, environment, and mental symptoms were measured. Conclusion : Occupational skills are skills in which various functions such as physical, cognitive, social skills, and coping skills act in a complex way. Therefore, it is necessary to include the four factors analyzed in this study: function, internal factors, environment, and psychiatric symptoms.
Mi Kyoung Seo;Jung Goo Lee;Dae-Hyun Seog;Se Young Pyo;Won Hee Lee;Sung Woo Park
Journal of Life Science
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v.33
no.12
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pp.1062-1073
/
2023
Although depression is a common psychiatric disorder that negatively affects individuals and societies, its exact pathogenesis is not well understood. Stress is a major risk factor for depression and is known to increase susceptibility by triggering inflammation. Indeed, many preclinical and clinical studies have suggested a strong link between depression and inflammation. Depression is associated with increased levels of pro-inflammatory cytokines, such as interleukin (IL-)1β, IL-6, IL-12, tumor necrosis factor-α, and interferon-γ, and decreased levels of the anti-inflammatory IL-4, IL-10, and transforming growth factor-β. Administering pro-inflammatory cytokines causes depression-like behaviors in rodents. Conversely, administering anti-inflammatory drugs appears to ameliorate depressive symptoms. Although the importance of inflammation as a mediator of depression has been demonstrated, the mechanisms by which inflammation is activated in depression remain unclear. To address this issue, recent studies have focused on the importance of stress-induced sterile inflammation. Sterile inflammation refers to the activation of inflammatory processes due to physical and/or psychological stress in the absence of pathogens. Stress promotes the release of endogenous factors known as damage-associated molecular patterns (DAMPs), thereby triggering sterile inflammation. In turn, DAMPs are recognized by pattern recognition receptors, leading to the production of pro-inflammatory cytokines. Here, we review the role of DAMPs in depression based on preclinical and clinical evidence on the dysregulation of sterile inflammation.
Lee Young Sik;Jeon Chang Moo;Kim So Youn;Ko Bock Ja
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.16
no.2
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pp.231-238
/
2005
Objectives : This study was done to figure out the incidence of Korean adolescents with gender identity problem and homosexual tendency. Self esteem and sexual liberality were also checked to evaluate the relation with these problems. Method : Subjects were 1,748 adolescents (359 middle school boys, 452 middle school girls, 483 high school boys, and 454 high school girls). DSM-IV-TR gender identity disorder criteria, Kinsey's sexual orientation scale, Hudson's short form sexual liberality scale, and Halter's Self-perception profile for children were applied to them. Result : 1) $15\%$ of the middle school boys, $16.7\%$ of the high school boys, $39.4\%$ of the middle school girls, and $40.5\%$ high school girls showed gender identity problem. Incidence of mild problem was more frequent in girls, however severe problem that suggested gender identity disorder was more frequent in boys, especially in high school boys. 2) Gender identity problem group showed lower self esteem than no problem group, especially in the middle school boys (p=0.033) and high school girls (p=0.020). 3) $17\%$ of the middle school boys, $5.4\%$ of the high school boys, $17.7\%$ of the middle school girls, and $12\%$ of the high school girls showed homosexual tendency. The order of more vivid homosexual orientation incidence was as follows ; $3.3\%$ in the middle school girls, $3.1\%$ in the middle school boys, $2.1\%$ in the high school girls, and $1.7\%$ in the high school boys. 4) There was no difference in the score of sexual liberality according to homosexual tendency. In high school girl, self esteem score was lower in homosexual tendency group than that of heterosexual group (p=0.039). 5) Gender identity problem group showed higher incidence of homosexual tendency than that of gender identity formation group (p=0.001). 6) The incidence of sexual identity problem was not changed by age, but homosexual tendency was decreased with age, especially in boys. Conclusion : Adolescents with gender identity problem or homosexual tendency showed low self esteem. Therefore, more attention on systemic evaluation for early detection in school based mental health and psychiatric management for them are needed.
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