• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.65-71
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• 2000

Objects : Aimed to test the hypothesis that neonatal testosterone exposure in female mice influences the development of testosterone-related pain inhibitory system and that testosterone administered in adulthood decreases the pain sensitivity. Methods : Thirty androgenized(testosterone propionate $100{\mu}g$ ip within 24 hrs after birth) adult female and twenty five control(normal saline $100{\mu}g$ ip within 24 hrs after birth) adult female mice were injected with testosterone propionate 1mg/kg/day for 3 consecutive days from 84th experimental days. Nociceptive sensitivity was measured before and after treatment of testosterone by tail flick latency on 84th and 86th experimental days. Results : 1) On the 84th experimental day, basal nociceptive sensitivity was significantly higher in the androgenized group($2.7{\pm}0.4$ sec) as compared to the control group($3.3{\pm}1.1$ sec). 2) Testosterone treatment on the 84th experimental day significantly lowered nociceptive sensitivity in both androgenized($5.2{\pm}0.9$ sec) and control groups($4.6{\pm}1.8$ sec). However the effect was significantly greater in the androgenized group. 3) Nociceptive sensitivity on 86th experimental day before administration of testosterone was significantly lower in the androgenized group($4.8{\pm}1.9$ sec) as compared to the control group($3.9{\pm}1.2$ sec). 4) Testosterone treatment on the 86th experimental day significantly lowered the nociceptive sensitivity in both groups, but the androgenized group($5.9{\pm}0.9$ sec) showed significantly lower post-treatment nociceptive sensitivity as compared to the control group($4.9{\pm}1.5$ sec). 5) Nociceptive sensitivity was decreased significantly after injection of testosterone once a day for two consecutive days in the androgenized group(${\Delta}2.1{\pm}1.0$ sec), but not in the control group(${\Delta}0.5{\pm}1.3$ sec). Conclusions : There may be a testosterone-related pain inhibitory system, the development of which is enhanced by exposure to testosterone in the neonatal period, and the activity of which is also mediated by testosterone in the later life.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.72-87
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• 2000

Objectives : This study was to provide normative data of Korean version of DSI(K-DSI), a sensitive measure of relatively minor stressors that could be administered daily. Methods : K-DSI was administered in 524 adults, age of 19 or over, daily for 1 week. On the seventh day, Becks Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), and Social Readjustment Rating Scale(SRRS) were also given to test the convergent validity. Analyses(ANOVA or t-test) were conducted to examine the potential effects of demographic variables on K-DSI score. Internal consistency for reliability and Pearson's corelation coefficient with BDI, STAI, SRRS for convergent validity were computed. Percentile scores were calculated for daily and weekly K-DSI Event, Impact and I/E Ratio scores. Results : K-DSI scores in women were higher than those in men. According to age and educational level, the younger and the higher educational level the normative groups were, the higher were K-DSI scores. Among the 5 categories of the inventory, the category of cognitive stressors was highest. Internal consistency of K-DSI(Cronbach's $\alpha$) was .99. Daily and Weekly events and impacts scores were significantly correlated with the scores of State-Trait Anxiety Inventory, Social Readjustment Rating Scale, and Beck Depression Inventory. 75 percentile scores of the daily/weekly Events, Impacts, and I/E ratio were 17/118 - 124, 57/368 - 389 and 3.48 - 3.49/3.47 - 3.48 respectively. And 95 percentile scores of daily/weekly Events, Impacts, and I/E ratio were 57/151- 161, 405/1038 - 1122, and 4.72 - 4.86/4.46 - 4.56 respectively. Conclusion : Reliability and validity of K-DSI were tested satisfactorily. Authors presented the normative data of K-DSI for Koreans. K-DSI could be a useful measure in clinical settings or researches to assess the minor stressors frequently experienced in everyday life.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.46-57
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• 2000

Objectives : The purpose of the present study was to examine the effect of subacute treatment with the selective serotonin reuptake inhibitors(paroxetine and sertraline) on immobility in the forced swim test(FST) and on FST-induced changes in immune parameters of the mice. Methods : Authors applied a modified method of FST by Porsolt et al. Over 5 BALB/c mice were used for each group of experiments. To explore the changes in immune parameters by FST, authors investigated the production of anti-rat RBC antibody, concanavalin A(ConA)- or lipopolysaccharide(LPS)-stimulated splenocytes proliferation assay and cytokine gene expression. Results : Both paroxetine and sertraline decreased the duration of immobility in a dose-related manner. FST-performed mice showed a significant decrease in mitogenic responses of splenocytes and a slight increasing tendency in anti-rat RBC antibody response. All these responses were attenuated significantly by paroxetine and attenuated nearly nominal significance level by sertraline. The cytokine profiles of ConA-stimulated splenocytes from FST-performed mice showed stronger expression of IL-4 and weaker expression of IL-2 than control mice, and no changes in the expressions of IFN-$\gamma$ and lymphotoxin. IL-6 and IL-10 were not expressed in both group of mice. The pretreatment of paroxetine and sertraline attenuated the altered cytokine expressions in FST-performed mice to some extent. Some alterations of the expressions of IL-6 and IL-10 were observed in the mice which the selective serotonin reuptake inhibitors had been pretreated. Conclusion : The subacute treatment of paroxetine and sertraline attenuated the FST-induced behavioral and immune changes, and these serotonin reuptake inhibitors may exert some modulating effects on the immune system by the induction of cytokine gene expression, especially IL-6 and IL-10.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.112-119
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• 2008

Objectives : Premenstrual syndrome(PMS) is known to occur in more than 80% of reproductive women. Since PMS is closely related to changes in sex hormones, biological factors are suspected to be associated with the syndrome, but there have been no consistent reports regarding biological causes. In that sense, it is postulated that the occurrence of PMS is much dependent on the biological aspects, but that the severity or characteristics of the syndrome is more dependent on the psychological factors. Studies focusing on psychological factors are based on the theory that symptoms of PMS and previous psychologically traumatic events are closely related. If the theory is valid, it can be further postulated that symptom severity of PMS is associated with dissociative symptoms, since traumatic events are known to be related to dissociative symptoms. In this study, we tried to find out the association of PMS symptom severity with previous abuse history and dissociative symptoms. Methods : Subjects for the study were 377 nurses working in Seoul, Kyung-gi, and Kyung-book. 183 subjects who submitted valid data entered the study. The presence and the symptom severity of PMS were rated using Daily Records of Severity of Problems(DRSP) and Shortened Premenstrual Assessment Form(SPAF). Dissociative symptoms were evaluated with Dissociation Experience Scale Korean version(DES-K). Previous physical/verbal abuse, sexual abuse, and parental spouse abuse experience were rated with correspondent abuse scales. Results : Subjects were divided into 3 groups as No PMS group, mild to moderate PMS group, and severe PMS group according to SPAF total score. There was a statistically significant difference in DES-K total score among 3 groups($x^2=14.966$, df=2, p=0.001). Physical/verbal abuse scale($x^2=14.397$, df=2, p=0.001), sexual abuse scale($x^2=8.376$, df=2, p=0.015), and parental spouse abuse scale($x^2=9.322$, df=2, p=0.009) also revealed a significant difference among 3 groups. Symptom severity of PMS using SPAF total score showed a positive correlation both with degree of dissociative experience and previous abuse experience. There was a statistically significant difference in both dissociative experience and previous abuse experience among 3 groups. Conclusion : These results show that there can be a possible association among PMS symptoms, dissociative symptoms, and previous psychologically traumatic experience.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.103-111
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• 2008

Background : It was not uncommon authors as psychiatrists faced women patients with somatoform disorders who expresses their symptoms has been started after the poor adherence to 'Doing the month' practices (DMP). DMP is known as a traditional ritual for Korean postpartum women. Aims : This study is an cultural approach to explore the practices of Korean women during the postpartum period are related with the formation of somatoform disorders. Methods : 41 multipara women with somatoform disorders diagnosed by DSM-IV criteria and 91 healthy normal control were enrolled. Subjects were given scales of SOM scale of SCL-90R, Somatic Symptom Scale-Korean version, Korean 'Doing the month' practices Scale(40 items), Postpartum Sick Scale(14 items), Beck Depression Scale and State Anxiety Scale. Results : 1) The period of DMP less than one week were prevalent in the patients group(43.9%) compared to the control group(7.9%, p<0.01). 2) The period of DMP after the abortions showed no difference between two groups. 3) Subjective rate for their poor DMP was significantly high in the patients group(73.2%) compared to the control group(33.0%), and the patients group showed high score in Postpartum Sick Scale as well(4.1, 1.6 respectively). 4) Poor DM was negatively correlated with SOM scale of SCL-90R(correlation coefficient r=-0.47, p<0.01). Conclusion : Poor DMP may make a crucial role for their heath condition after the deliveries and which would be one of the major factors of the somatoform disorders in Korean women. And postpartum physical symptoms after the poor DMP could be last long enough to be diagnosed as somatoform disorders. By understanding the cultural nature of the somatization phenomena the doctor-patient relationship could be enhanced.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.95-102
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• 2008

Objectives : Diabetes patients suffer from severe stress in maintaining the diet therapy and exercise therapy as well as the disease itself, and this stress has bad effects on controlling the glucose level and causes high prevalence rate of depressive and anxiety disorders. These symptoms again have deleterious effects on blood glucose control. A lot of researches about the relationship between glycemic control and symptoms of depression and anxiety and about the positive effects of the treatments of depression and anxiety disorder on glycemic control in diabetic patients are being performed. In Korea, the research regarding the relationship between glycemic control and depression and anxiety symptoms are seldom performed. In this study, we tried to find out the correlation between the glycemic control and depressive symptom and anxiety symptom. Methods : The study included 65 patients(male 34, female 31) with Diabetes in outpatient clinic of the Department of Endocrinology in Dankook University Hospital. We used the HbA1c levels to check glycemic control through blood sample analysis and used Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI). Results : Among the 65 Diabetes patients, 21(32.30%) had mild depressive symptoms, and 6(9.23%) had moderate or severe depressive symptoms. The relation of HbA1c and BDI was not statistically significant, but was significant between HBA1c and BAI, (R=0.567, P<0.001). In the linear regression analysis, BAI had an effect on HbA1c($\beta=0.533$, T=5.012, P=0.00), but BDI, diabetes complications, diabetic morbid period and BMI had no effect on HbA1C. The relationship between HbA1c and BDI was not statistically significant, but the relationship between HbA1c and BAI was statistically significant(R=0.254, P<0.001). Conclusions : In this study, the rates of diabetic patients with depressive symptoms were higher, but those with anxiety symptoms were not higher than the general population. We could not find out significant relationship between depressive symptom and glycemic control, but found the significant relationship between the anxiety symptom and glycemic control in diabetic patients.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.19-29
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• 2010

Objectives：Authors hypothesized that bipolar tendency of non-psychiatric person would be associated with stress vulnerability. To test the hypothesis, we compared perceived stress level, Type A Behavioral Pattern (TABP) and unhealthy lifestyle between person with and without bipolar tendency. Methods：The study cohort consisted of 1987 subjects without past and current psychiatric history. In this study, bipolar tendency was determined by MDQ response which requires endorsement of at least 7 of the 13 "yes or no" questions. We compared the scores of Perceived Stress Scale, A/B lifestyle questionnaire, and unhealthy lifestyle(alcohol, smoking, lack of exercise, irregular meal) between MDQ positive and negative respondents. Results：We identified the bipolar tendency group determined by the MDQ positive response were 329 subjects(16.6%). The overall score of the bipolar tendency group was significantly high on the A/B lifestyle questionnaire compared to the non-bipolar tendency group(125.4 vs. 115.9, p<0.001), and the rate of the subjects defined as TABP was also significantly high(41.3% vs. 30.1%, p<0.001). In comparison of subjectively perceived stress level, the bipolar tendency group was observed to be significantly higher than the non-bipolar tendency group (18.5% vs. 16.5%, p<0.001). The bipolar tendency group was significantly higher than the non-bipolar tendency group on the rate of answering：'irregular eating habit' (20.1% vs. 14.3%, p=0.002), '4-or-more-times alcohol intake per week' (29.8% vs. 16.5%, p<0.001), 'currently smoking' (41.9% vs. 23.0%, p<0.001), '2-or-less-times physical exercises per week' (63.2% vs. 55.1%, p=0.007). Conclusion：By clinical diagnosis, even a person who does not meet the criteria of bipolar disorder has a high risk of stress-related behavioral pattern, and perceived stress when possessing bipolar tendencies such as the (hypo) maniac tendency or affective instability. Such individual has significantly higher risk of having unhealthy life-style such as smoking, drinking, irregular eating habit and lack of exercise compared to non-bipolar tendency group. Since these risk factors lead to increase the risk of obesity, metabolic syndrome, diabetes, and cardiovascular diseases, the individual with the bipolar tendency requires a more effort to manage stress and to maintain healthy lifestyle.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.146-156
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• 2016

Objectives : The aim of this study was to evaluate the associations between vasomotor symptoms and factors such as sociodemographics, health behaviors, medical condition, depression, stress, anxiety, attitude toward menopause, and quality of life. Methods : We conducted a cross-sectional study in peri- and post-menopausal women enrolled by the Korean Association of Health Promotion. Subjects submitted self-report questionnaires about vasomotor symptoms and other clinical symptoms. Associations between vasomotor symptoms and clinical variables were analyzed using stepwise multiple regression analyses. Results : 1951 women completed self-report questionnaires and 1022 women were enrolled in the study. The prevalence of vasomotor symptoms in peri- and post-menopausal women was 63.9%. Variables showing significant differences between subjects with vasomotor symptoms and subjects without them were score of Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, proportions of clinically significant depression(Beck Depression Inventory ${\geq}16$), Menopausal rating scale, attitude towards menopause, the 4 subscales of World Health Organization Quality of Life-BREF(Physical health, psychological, social relationships, environment), and a History of Premenstrual syndrome/Premenstrual dysphoric disorder. Stepwise multiple regression analyses indicated that Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, Menopausal Rating Scale, and the Psychological subscale of World Health Organization Quality of Life -BREF show associations with vasomotor symptoms. Conclusions : Menopausal vasomotor symptoms are associated with various psychological factors, especially with depression. Midlife women suffering vasomotor symptoms should therefore be screened for depression. Future prospective studies where clinical subjects are diagnosed using structured interviews, focusing on the causal relationship between depression and vasomotor symptoms are necessary.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.174-183
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• 2016

Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.191-199
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• 2016

Objectives : Despite the increased popularity of highly caffeinated beverages, there is little research examining psychiatric adverse effects. The purpose of this study was to investigate the relationships among pattern of highly caffeinated beverage intake and depressive symptom, suicidal ideation, suicidal plan, suicidal attempt in Korean adolescents. Methods : The data was obtained from the 2014 Korean Youth's Risk Behavior Web-based Study by Korea Centers for Disease Control & Prevention. All participants conducted web-based questionnaire survey. Chisquare test and multiple logistic regression analysis were performed to determine the association among highly caffeinated beverage intake pattern, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt adjusting for differences in age, gender, academic achievement, socioeconomic status. Results : A total of 71,638 participants were enrolled in this study. Depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more frequent in the group with presence of highly caffeinated beverage intake within 1 week than in non-drinker group(p<0.01). Highly caffeinated beverage intake was significantly associated with suicidal attempt(OR=1.99 ; 95% CI, 1.77-2.22). In addition, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more common in the group with heavy-drinker who exceed recommended daily intake dose of caffeine than in the group with light-drinker(p<0.01). Heavy drinking of caffeinated beverage was significantly associated with suicidal attempt(OR=4.05 ; 95% CI, 3.02-5.43). Conclusions : We found that highly caffeinated beverage intake was related to more frequent depressive symptom, suicidal ideation, plan, attempt in adolescents. Also, caffeine intake which exceed recommended daily intake dose identified the predictor of suicidal attempt. Our result suggested that clinicians need to be aware of the possible psychiatric adverse effects of highly caffeinated beverage in vulnerable population including young adolescents.