• Journal of agricultural medicine and community health
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• v.22 no.1
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• pp.49-59
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• 1997

Backgrounds : There has been many studies investigating the causes of farmers' syndrome. In some studies, psychologic stress is related to farmer's syndrome. And the diagnostic criteria of farmer's syndrome is similar to those of generalized anxiety disorder. So we carried out this study to investigate the psychiatric causes of farmers' syndrome. Methods : This study was done in some rural and urban areas of Kyoungsangnam Province, July, August, October and November of 1996. Those who came to free medical service and completed interview, medical examination and laboratory examination and 20-59 years old were 150 persons. And those who came to health center for health examination and completed only interview and 20-59 years old were 94 persons. The questionnaire was composed of sociodemographic factors, health risk factors, farmer's syndrome, work load, BEPSI(inventory to measure stress), Spielberger's state-trait anxiety inventory, self-rating depression scale. To examine statistical significance, we used X2-test, Mantel-Haenszel test for linear association, t-test, ANCOVA, correlation, multiple regression, logistic regression. Results : The prevalence of farmer's syndrome, adjusted for age and sex with population of Kyungsangnam Province of 1993 was 208 per 1,000(90 per 1,000 in men and 329 per 1,000 in women). In bivariate analysis, farmer's syndrome was significantly related to age, sex, job, income, smoking, alcohol drinking, work load, BEPSI, state anxiety, trait anxiety, depression, body mass index, Hwa-Byung, hypertension, anemia. However, when age and sex were adjusted, job was not significantly related to farmer's syndrome. The score of farmer's syndrome was significantly related to age, sex, work load, BEPSI, trait anxiety by multiple regression. Farmer's syndrome was significantly related to increasing age(odd ratio 1.079, 95% C.I. 1.060 - 1.099), sex(odds ratio of male 0.434, 95% C.I. 0.349 - 0.540), and BEPSI(odds ratio 1.231, 95% C.I. 1.148 - 1.320) by logistic regression. Results of logistic regression analysis of the component symptoms of farmer's syndrome were as follows. Shoulder stiffness was significantly related to increasing age, female sex and BEPSI. Lumbago was significantly related to increasing age, female sex and trait anxiety. Numb limbs and nocturia was significantly related to increasing age and female sex. Breathlessness was significantly related to work load, sleeplessness was significantly related to depression, dizziness was significantly related to job and state anxiety, and abdominal fullness was significantly related to female sex. Conclusion : Farmers' syndrome was related to work load, but was more related to psychiatric factors such as BEPSI and trait anxiety. And the occupation was not risk factor of farmers' syndrome in this study, so further study is needed to investigate the cause of farmers' syndrome.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.3-11
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• 2017

Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.

• Anxiety and mood
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• v.14 no.1
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• pp.44-52
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• 2018

Objective : The present study had examined the psychiatric symptoms and physical health consequences for the bereaved parents of the high school students who died in the 2014 Sewol ferry accident. Methods : Forty bereaved parents participated in the study. The authors administered self-report questionnaires about the parents' health behaviors and psychiatric symptoms. The authors also conducted laboratory tests to assess the parents' physical health at 18 and 30 months after the accident. Univariate descriptive statistics were performed to report the prevalence and severity of psychiatric symptoms and health-related behaviors. Paired t-test and Mcnemar test were performed to compare the 18-and 30-month findings. Correlation analysis between psychiatric symptoms and laboratory findings were performed to find a relationship between the two variables. Results : At 30 months after the accident, most of the bereaved parents still appeared to suffer from complicated grief (97.5%), post traumatic stress disorder (80%), insomnia (77.5%) and severe depression (62.5%) based on the scores on the Inventory of Complicated Grief (ICG), the PTSD Check List-5 (PCL-5), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire-9 (PHQ-9). One quarter of the bereaved parents reported high-risk drinking, and 47.5% reported increased drinking amount and frequency after the accident. In objective laboratory results, 55% of the bereaved parents were obese as defined by body mass index ${\geq}25$. The parents' mean low-density lipoprotein shows a significant increase over time (118.5 mg/dL at 18 months. vs. 132.5 mg/dL at 30 months. paired t-test t=-4.061, $$p{\leq_-}0.001$$). Total cholesterol and low-density lipoprotein at 30 months after the accident were in clinically borderline high range. In correlation analysis, triglyceride was positively correlated with ISI. Conclusion : The loss of children in the Sewol ferry accident, a disaster caused by human error, continued to have considerable impact on the victims' parents' mental and physical health 18 and 30 months after the accident. A longitudinal study following the parents' physical health would be necessary to investigate the long-term effects of this traumatic experience on physical health.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.1
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• pp.29-38
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• 2009

Objectives : This preliminary study evaluated the efficacy of two short-term programs for reducing depressive symptoms in female adolescents with depressive disorder. Methods : The participants were 23 middle school students who were randomly assigned to three groups : the cognitive-behavioral program group, the psycho education-program group and the no-intervention control group. Results : At postintervention, the students in cognitive-behavioral program group reported significantly lower levels of depressive symptoms, negative self-statement, automatic thought and psychiatric symptoms than did those in the no-intervention group and those in the psychoeducation-program group. Conclusion : The results suggest that the cognitive-behavioral program for female adolescent with depressive disorder was more effective in reducing depressive symptoms than the psychoeducation-program.

• Korean Journal of Biological Psychiatry
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• v.24 no.4
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• pp.225-234
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• 2017

Objectives Local gyrification reflects the early neural development of cortical connectivity, and is regarded as a potential neural endophenotype in psychiatric disorders. Several studies have suggested altered local gyrification in patients with bipolar I disorder (BD-I). The purpose of the present study was to investigate the alterations in the cortical gyrification of whole brain cortices in patients with BD-I. Methods Twenty-two patients with BD-I and age and sex-matched 22 healthy controls (HC) were included in this study. All participants underwent T1-weighted structural magnetic resonance imaging (MRI). The local gyrification index (LGI) of 66 cortical regions were analyzed using the FreeSurfer (Athinoula A. Martinos Center for Biomedical Imaging). One-way analysis of covariance (ANCOVA) was used to analyze the difference of LGI values between two groups adjusting for age and sex as covariates. Results The patients with BD-I showed significant hypogyria in the left pars opercularis (uncorrected-p = 0.049), the left rostral anterior cingulate gyrus (uncorrected-p = 0.012), the left caudal anterior cingulate gyrus (uncorrected-p = 0.033). However, these findings were not significant after applying the multiple comparison correction. Severity or duration of illness were not significantly correlated with LGI in the patients with BD-I. Conclusions Our results of lower LGI in the anterior cingulate cortex and the ventrolateral prefrontal cortex in the BD-I group implicate that altered cortical gyrification in neural circuits involved in emotion-processing may contribute to pathophysiology of BD-I.

• Korean Journal of Biological Psychiatry
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• v.6 no.2
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• pp.253-258
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• 1999

The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been known as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.3
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• pp.156-162
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• 2014

Objectives : The aim of this study was to estimate the prevalences of electroencephalographic (EEG) abnormalities and epilepsy in children and adolescents with autism spectrum disorder (ASD). In addition, we intended to identify demographic and clinical correlates of epilepsy in ASD. Methods : A total of 140 children and adolescents (age $7.3{\pm}4.8yrs$, 106 boys) with ASD underwent EEG from January 2010 to December 2013 at Asan Medical Center. Medical records were reviewed for demographic information, clinical characteristics, psychiatric diagnoses and comorbidities, EEG findings and neurological diagnoses. Results : The prevalences of EEG abnormalities and epilepsy in children and adolescents with ASD was 62.1% and 38.6%, respectively. In subjects with seizure-like movements, EEG abnormalities and epilepsy were more frequent than those without seizure-like movements (EEG abnormalities : 92.5% vs. 43.7%, p<.001 ; epilepsy : 90.6% vs. 5.7%, p<.001). ASD subjects who had epilepsy were older (p=.001), had lower full scale intelligence quotient (p<.001) and took more antipsychotics (p=.006) than those who did not. Conclusion : The prevalences of EEG abnormalities and epilepsy in our sample were similar to those from Western countries. Our results suggested a possible association of older age, lower intelligence quotient, and antipsychotics use with epilepsy in ASD. Conduct of further prospective study in a larger sample is needed.

• 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.

• Korean Journal of Biological Psychiatry
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• v.25 no.3
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• pp.79-87
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• 2018

Objectives Internet gaming disorder (IGD) is known to be related to stress and the serotonin-transporter-linked polymorphic region (5-HTTLPR) that is known to be associated with stress and has been studied to affect various psychiatric illness outbreaks. We tried to examine the relationship between stress, 5-HTTLPR and IGD. Methods A total of 59 participants with IGD, diagnosed according to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria and 67 normal controls (NC) were enrolled. The IGD group and the NC were compared using chisquare test and independent sample t-test, and logistic regression analysis was used to examine the relationship between stress, the 5-HTTLPR, and IGD. Results The mean scores for anxiety, impulsivity and stress were significantly higher in the IGD group than in the NC. In addition, there was a significant association between stress and IGD [odds ratio (OR) = 1.172, 95% confidence interval (CI) = 1.008-1.362]. Conclusions This study showed that stress would affect IGD. Therefore, the evaluation and management of stress should be included in the diagnosis and treatment of IGD.

• Journal of Oriental Neuropsychiatry
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• v.17 no.2
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• pp.159-165
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• 2006

Objective : It Is known that depression disorder has been related to chronic pains such as HIVD and physical harm. We propose that chronic cervical and lumbar herniations of intervertebral disc patients have emotional and psychiatric problems, therefore we compared it to Beck's Depression Inventory scores. Method : We divided them into two groups: The groups consisted of cervical and lumbar HIVD patients. We then requested them to fill out BDI research questionnaires, and evaluated patients according to the information and results. Result : The Beck's Depression Inventory mean score for the cervical - lumbar HIVD group was $14.00{\pm}5.80$, $10.83{\pm}$5.64 each. Higher Scores were recorded for cervical HIVD group than the lumbar HIVD group. Conclusion : There is statistical significance among two groups.(p<.05) however, the two groups' BDI score were lower than the defined boundary line of Depression disorder(16 points).