Objectives: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. Methods: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Results: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64). Conclusions: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.
Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.
Objectives: The purpose of this study was to investigate clinical trends of Traditional Chinese Medicine (TCM) on combined treatment of acupuncture and relaxation therapy. Methods: Clinical trials based on acupuncture and relaxation therapy searched and were selected from China National Knowledge Infrastructure (CNKI). In this study we selected clinical research articles using acupuncture and relaxation therapy as intervention. Studies were assessed by Risk of Bias (RoB) tool, and Jadad scale. Results: Eleven randomized controlled trials on combined treatment of acupuncture and relaxation therapy were selected, and these studies were published in China. Most studies have targeted psychiatric disorders such as insomnia and anxiety. Manual Acupuncture (MA) was the most used acupuncture treatment, and in five studies two or more relaxation therapies were used in parallel. Although the treatment result using acupuncture and relaxation therapy was superior, heterogeneity of the control group was high and it was difficult to estimate additional effects of relaxation therapy. Conclusions: Qualitative analysis revealed that the combination of acupuncture and relaxation was more effective than control in most studies. However, quality of most studies was low. Therefore, higher quality clinical research on combined treatment of acupuncture and relaxation therapy is required.
Objectives : This study aimed to understand the characteristics of the cases covered in the case studies on traditional Korean medicine (TKM) and furthermore, to provide basic information that can lead the discussion on 'what cases are worth reporting' in future case reports. Methods : Case reports on TKM were searched using the OASIS. The searched researches were analyzed according to the type of case, including information on disease/symptoms and intervention. Results : A total of 940 researches were searched. The most frequently reported type of case study was the report on the effectiveness of intervention. Case reports, which were only two cases in the 1970s, increased rapidly in the 2000s, and in particular, 314 cases within the last five years accounted for about 33% of the total literature. As for the number of studies by disease, the cases dealing with musculoskeletal diseases such as spine, shoulder and knee joint disorders were the most prevalent. Besides, there were many case reports related to cardiovascular, gynecological, cancer, psychiatric, and dermatological diseases. In a total of 51.9% of the included case reports, a combination of two or more Korean medical treatments such as acupuncture and herbal medicine was used at once, and western treatment was used with Korean medical treatment in 28.2% of the studies. The types of Korean medical treatments were varied, such as acupuncture, moxibustion, pharmacopuncture, electroacupuncture, Chuna, acupotomy, herbal medicine, external preparation, and psychotherapy. The main purpose of the publication of the included case reports was analyzed as a report of TKM treatment for rare diseases, or the application of TKM treatment to diseases or symptoms that are "uncommon in TKM treatment" even if it is not a rare disease. Conclusions : Case reports have the strength of generating new scientific hypotheses by detecting the basic needs and novelty of medicine. The current case studies of TKM do not seem to be sufficient to highlight these strengths. It is necessary to discuss which cases are reported as cases of patients worth publishing, and based on this, it is necessary to activate case studies of TKM by utilizing diagnostic tools and science technology.
Microarray technology allows the simultaneous analysis of gene expression patterns of thousands of genes, in a systematic fashion, under a similar set of experimental conditions, thus making the data highly comparable. In some cases arrays are used simply as a primary screen loading to downstream molecular characterization of individual gene candidates. In other cases, the goal of expression profiling is to begin to identify complex regulatory networks underlying developmental processes and disease states. Microarrays were originally used with ceil lines or other simple model systems. More recently, microarrays have been used in the analysis of more complex biological tissues including neural systems and the brain. The application of cDNA arrays in neuropsychiatry has lagged behind other fields for a number of reasons. These include a requirement for a large amount of input probe RNA In fluorescent-glass based array systems and the cellular complexity introduced by multicellular brain and neural tissues. An additional factor that impacts the general use of microarrays in neuropsychiatry is the lack of availability of sequenced clone sets from model systems. While human cDNA clones have been widely available, high qualify rat, mouse, and drosophilae, among others are just becoming widely available. A final factor in the application of cDNA microarrays in neuropsychiatry is cost of commercial arrays. As academic microarray facilitates become more commonplace custom made arrays will become more widely available at a lower cost allowing more widespread applications. in summary, microarray technology is rapidly having an impact on many areas of biomedical research. Radioisotope-nylon based microarrays offer alternatives that may in some cases be more sensitive, flexible, inexpensive, and universal as compared to other array formats, such as fluorescent-glass arrays. In some situations of limited RNA or exotic species, radioactive membrane microarrays may be the most practical experimental approach in studying psychiatric and neurodegenerative disorders, and other complex questions in the brain.
Objectives : An early age at onset of obsessive compulsive symptoms in family studies has been strongly associated with a more familial form of obsessive compulsive disorder (OCD). Further, many reports have suggested that early- and late- onset OCD represent separate subtypes of the disorder. The aim of this study was to investigate the associations between the glutamate receptor, the ionotropic, n-methyl-d-aspartate (NMDA) subunit 2B gene (GRIN2B) polymorphisms, and onset of OCD in the Korean population. Methods : We recruited 109 OCD patients and classified them into early- (age of onset <18 years) and late-onset groups (age of onset${\geq}$18). Genomic DNA was extracted from their blood after which the genotypes and allelic frequencies of the two GRIN2B polymorphisms (5072T/G and 5988T/C) were compared in the two groups. We also compared genetic data between child- (age of onset${\leq}$15) and adult-onset groups (age of onset${\geq}$19) using the same protocol. Results : There were no significant differences between the early- and late-onset groups with respect to genotype. Moreover, we could not find any differences in genotype frequencies between child and adult-onset groups. Conclusions : Our study suggested that GRIN2B polymorphisms (5072T/G and 5988T/C) do not affect the onset of OCD in Koreans. However, this finding has resulted from a preliminary study and thus, further study is required.
Objectives : The purpose of this study was to assess the health-related quality of life (HRQoL) for patients with panic disorder using EQ-5D and EQ-VAS, and to examine the relationship between health-related quality of life and clinical outcomes following treatment. Methods : 29 patients with panic disorder were recruited from the Seoul Metropolitan area and 20 patients were followed up after two months of outpatient treatment. The Panic Disorder Severity Scale (PDSS) was used to assess the severity of the panic disorder and the changes in symptoms. HRQoL was assessed with EQ-5D and EQ-VAS at baseline and at two months of treatment. Results : All enrolled panic disorder patients showed significantly impairment of HRQoL in view of the subscales of EQ-5D, EQ-VAS index scores. The severity of PDSS was correlated the HRQoL in the panic patients. After treatment, the EQ-5D, EQ-VAS index scores showed significant improvement. Conclusion : Panic disorder patients suffer from lower HRQoL as well as from symptoms of the disorder. They showed clinical improvement and a restored HRQoL with treatment. These outcomes suggest using the EQ-5D, EQ-VAS such as the HRQoL in the assessment of patients with panic disorder is essential.
The purpose of this review was to investigate the neurophysiological and neuroimaging characteristics of patients with depression and anxiety reported in previous studies. A literature search was conducted using Medline and psychiatric textbooks. "Electroencephalography (EEG)", "Event Related Potentials (ERP)", "functional neuroimaging", "heart rate variability (HRV)" and "depression or anxiety" were used as key words. A physiological finding indicated that there was a higher degree of relativity with regards to prefrontal dysfunction in patients with depression. Right prefrontal lobe hyperactivity and left prefrontal hypoactivity were consistently observed, and abnormalities were observed in other regions (ACC, hippocampus, amygdala, etc.). Therefore, dysfunctions in these areas are related to depressive symptoms. In patients with anxiety disorder, each emotional condition showed specific activation patterns in different brain regions, such as the prefrontal cortex, occipital lobe, temporal lobe, hippocampus, and limbic system, including the amygdala. However, in the majority of patients with anxiety disorder, the degree of activation was higher in the right hemisphere than in the left hemisphere. The current data supports that there is a difference in brain dysfunction characteristics between depression and anxiety and that the different activations of various brain regions would play a significant role in the pathophysiology of depression and anxiety disorder.
Lee, Kyoung Eun;An, Ji Hyun;Kim, Da Eun;Moon, Carloyn Seungyoun;Hong, Jin Pyo
Anxiety and mood
/
v.14
no.2
/
pp.80-87
/
2018
Objective : The purpose of this study was to investigate prevalence and clinical characteristics of Post-traumatic Stress Disorder (PTSD) in North Korean defectors (NKD). Methods : The study population consisted of 300 NKDs registered in the multi-regional adaptation center (Hana Center), within three years of settling in South Korea. We conducted in-person interviews and a survey with each subject, based on the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) and various clinical scales. Results : Lifetime prevalence of PTSD in NKDs was 15.3%, approximately nine times higher than South Koreans (1.7%). Although experiencing broader type of traumas with higher rate than South Koreans, NKDs revealed lower odds of PTSD in most type of trauma (p<0.05). Conclusion : NKDs are at higher risk of experiencing different types of trauma than the general population in South Korea, and it is further validated that prevalence of PTSD is also higher. Careful evaluation for comorbid psychiatric symptoms and type of traumas prior to PTSD treatment for NKDs is necessary to facilitate more appropriate intervention for each subject, according to personal experience.
Oh, Se Young;Lim, Myung Ho;Jaung, Ji Suk;Lyu, Mi Kyung;Lim, Kyoung-Ok;Kim, Seon Kyung;Jang, Soyeong;Cha, Seung-Min;Choi, Jong Hyuk
Anxiety and mood
/
v.14
no.2
/
pp.112-119
/
2018
Objective : This study aims to identify personality characteristics in female homicide offenders by using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) test. Methods : This study retrospectively analyzed the mental appraisals and MMPI-2 scores of 54 women charged with homicide and 67 women charged with non-violent crimes, who were referred to National Forensic Hospital in Gongju city for psychiatric evaluation between January 2012 and March 2016. Results : Women charged with homicide scored significantly higher on Hs (p=0.018), D (p<0.001), Hy (p=0.002) and Pt (p=0.004) than the women charged with non-violent crimes. The women charged with homicide may have developed the following characteristics: hypochondriasis, depression, hysteria and psychasthenia. In multiple regression analyses, a final regression model including age of crime onset and depression was significant, explaining 16.5% of the variance in homicides committed by females. Conclusion : These findings suggest that personality characteristics in the female homicide offenders might be different compared to the non-violent crime offenders.
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