Cognitive models of panic disorder have emphasized cognitive distortions' roles in the maintenance and treatment of panic disorder (PD). However, the patient's difficulty with identifying and managing emotional experiences might contribute to an enduring vulnerability to panic attacks. Numerous researchers, employing emotion processing paradigms and neuroimaging techniques, have investigated the empirical evidence for poor emotion processing in PD. For years, researchers considered that abnormal emotion processing in PD might reflect a dysfunction of the frontal-temporal-limbic circuits. Although neuropsychological studies have not provided consistent results regarding this model, a few studies have tried to find the biological basis of dysfunctional emotion processing in PD. In this article, we examine the possibility of dysregulation of emotion processing in PD. Specifically we discuss the neural basis of emotion processing and the manner in which such neurocognitive impairments may help clarify PD's core symptoms.

Objectives : We examined the reliability and validity of the Korean version of the Depression and Somatic Symptom Scale (DSSS) in Korean patients with depressive symptoms. Methods : Participants were 55 outpatients diagnosed with major depressive disorder, a depressive episode of bipolar I disorder, somatoform disorder, panic disorder, generalized anxiety disorder, or post-traumatic stress disorder according to the DSM-IV criteria. We assessed them using the Korean versions of the DSSS, Hamilton Depression Rating Scale (HDRS), and Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR). Results : The Korean version DSSS had a Cronbach's alpha of 0.90. Moreover, each item's correlation with the total score was statistically significant (r=0.24-0.71, p<0.01). The test-retest correlation coefficient (r=0.83, p<0.01) was relatively high, and the DSSS correlations with the HDRS and QIDS-SR were 0.77 and 0.74, respectively. Conclusion : These results demonstrate that the Korean version of the DSSS could be a reliable and valid tool for screening and assessing depressive patients. The Korean version of the DSSS will be a useful tool for screening both depressive and somatic symptoms in Korea.

Objective : Depressive symptoms often coexist with other anxiety disorder symptoms. Furthermore, an anxiety disorder that is comorbid with a depressive disorder results in more severe symptoms and a poorer outcome prognosis. To understand the construct of depressive symptoms in anxiety disorder, this study investigated the factor structure of the Beck Depression Inventory among outpatients with anxiety disorders. Methods : All data were from psychiatric department outpatients at a university-affiliated hospital. We conducted a principal component analysis using data from 194 outpatients with DSM-IV anxiety disorders and calculated goodness-of-fit-indices. Results : Exploratory factor analysis revealed a four factor structure--Cognitive-affective symptoms (Factor 1), Somatic symptoms (Factor 2), Self-reproach (Factor 3), and Hypochondriasis/indecisiveness (Factor 4)--and a 57% total variance. This four-factor model demonstrated an acceptable level of model fit, and it fit better than did a three-factor solution from the literature on depressive disorder. Conclusion : This study's results suggest a difference in the construct of self-reported depressive symptoms in anxiety disorders. These findings also support a dimensional approach to studying anxiety and depression. Further studies may benefit from including comorbid depressive disorder and its influence on anxiety disorders.

Objective : Social anxiety disorder (SAD) has been characterized by a marked sense of anxiety provoked by exposure to one or more social situations. It has been well-known that the cultural characteristics of a society strongly affect the expression of SAD symptoms. The current study attempted to explore clinical and cultural characteristics of social anxiety symptoms in the Korean nonclinical population. Methods : 801 volunteers who participated in the national social anxiety screening day, which was held by Korean academy of anxiety disorders, were invited to complete the self-report version of Liebowitz social anxiety scale (LSAS-SR). A total of 691 participants completed the LSAS-SR and other information related to this study. Results : Social anxiety symptoms were reported by a great percentage of subjects, as displayed by the relatively high mean LSAS scores (44.58 ; SD=25.60). There were no significant differences in total LSAS score according to sex, education, or marital status. The three most fearful or avoided situations for participants, as measured by the percentage of subjects who had a score of more than 3 on each LSAS item were as follows: item 6 (acting, performing, or giving a talk in front of an audience ; 29.67% for fear and 22.72% for avoidance), item 16 (speaking up in a meeting ; 25.62% for fear and 21.56% for avoidance), and item 15 (being the center of attention; 13.89% for fear and 9.70% for avoidance). Conclusion : The Korean participants in this study demonstrated a high level of SAD symptoms. Our subjects reported that they were more likely to be fearful or avoid passive situations such as being the center of attention as compared with results from a study of western society which indicated that western people were more likely to be fearful or avoid active situations. These findings emphasize the importance of considering a patient's cultural background when evaluating SAD symptoms.

Objective : This study was performed to analyze the relationship between posttraumatic stress, coping style, and dissociation in Korean firefighters. Methods : Subjects included 193 male and 9 female firefighters in the metropolitan city of Daejeon. Their age ranged from 25 to 57 with an average of 39.17 (SD : 7.572) years. Their posttraumatic stress or traumatic experiences were assessed with the Korean Version of the Posttraumatic Stress Diagnostic Scale. Their coping style was categorized with the Korean version of the Ways of Coping Checklist. Their dissociation was assessed with the Korean version of Dissociative Experiences Scale. The data analysis included a correlation analysis and structural equation modeling. The modeling tested the validity of the model that posttraumatic stress had a direct effect on dissociation and coping style had an mediatory effect between stress and dissociation. Results : First, firefighters' posttraumatic stress or traumatic experiences had a direct effect on dissociation, a symptom of a mental disorder. Second, the firefighters employed passive styles to cope with their stress. This is explained that they had been exposed to their traumatic events repeatedly without being able to control it themselves. Third, coping style had no effect on the mediation between posttraumatic stress and dissociation. This is explained in terms of repeated exposure to the traumatic events. Conclusion : Based on the results, it is concluded that Korean firefighters' dissociation was not relieved by their coping effort but associated directly with their traumatic experiences. To decrease their dissociation, it is necessary to reduce the exposure to their traumatic events.

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.

Objective : This study aimed to investigate the prevalence of obsessive-compulsive disorder (OCD) in schizophrenia, and the relationship among OCD, severity of psychopathology, and social function in stable patients with chronic schizophrenia. Methods : We interviewed 138 symptom-stable inpatients who had been on a constant dose of antipsychotics for at least 1 month prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as investigated using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Further, all clinical and demographic data was investigated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), and the Korean Personal and Social Performance (K-PSP) were used. An independent ttest and Chi-square test were used to compare groups and a Pearson's correlation coefficient was used to assess the relationship between the Y-BOCS and other clinical rating scales. Results : The prevalence of OCD in schizophrenia patients was 18.1%. Patients with schizophrenia and OCD exhibited significantly earlier onset of schizophrenia, more severe psychiatric symptoms, and lower personal and social performance ability as compared to those without OCD. There was no significant relationship among Y-BOCS, K-PANSS, and K-PSP. Conclusion : We found that comorbid OCD was relatively more frequent in patients with schizophrenia. An investigation involving larger samples of schizophrenia patients with OCD with respect to social function and thus, the effect on quality of life is required.

본 연구는 주요우울증 환자군과 정상 대조군을 대상으로, 한국어판 Beck 우울설문지 2판(Beck Depression Inventory-II)에 대한 신뢰도와 타당도를 검증하여 실제적이고 표준화된 규준을 제시하고, 분할점(cut-off score)을 설정하여 우울증의 유무를 나타내는 기준을 마련하고자 하였다. 주요한 연구결과는 다음과 같다. 첫째, 한국판 BDI-II의 문항-총점 상관의 범위는 .51에서 .74이고, 전체 문항들이 .60 이상의 문항-총점 상관을 보여 한국어판 Beck 우울설문지 2판의 신뢰도가 '보통' 이상이라는 것이 검증되었다. 둘째, 집단별 BDI-II의 내적 일치도를 알아보기 위한 Cronbach' alpha 값은 .94 이상인 것으로 나타났다. 셋째, 주성분 분석 방식으로 요인을 추출하여 합치성을 검사한 결과 3개의 하위 요인이 추출되었고, 설명되는 변량은 총 47.3%였다. 넷째, 한국어판 BDI-II의 분할점수 산출을 위하여 ROC(Receiver operator characteristic) 분석을 실시한 결과 18점일 때 가장 높은 민감도와 특이도를 보인 것으로 나타났다. 따라서 본 연구결과를 바탕으로, 한국어판 BDI-II의 분할점은 18점으로 정하는 것이 타당할 것으로 여겨진다. 그러나 본 연구에서는 연구에 사용된 환자군이 우울증상을 가진 모든 정신질환자를 대상으로 한 것이 아니라 주요우울증 환자들만을 대상으로 하여 결과를 일반화 하는데 일부 제약이 따를 수 있을 것으로 판단되며, 증상의 중증도(severity)에 따라 군을 나눠 분할점을 산출하지는 못하여 추후에는 이를 고려한 추가적인 연구가 필요할 것이다.