Lee, Neung-Se;Yoon, Bo-Hyun;Lee, Hyun Jae;Sea, Young-Hwa;Song, Je-Heon;Park, Suhee;Lee, Ji Seon
Korean Journal of Psychosomatic Medicine
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v.22
no.2
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pp.121-129
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2014
Objectives : This study was to assess the prevalence and its correlates of restless legs syndrome(RLS) in outpatients with bipolar disorder. Methods : A total of 100 clinical stabilized bipolar outpatients were examined. The presence of RLS and its severity were assessed using the International Restless Legs Sydrome Study Group(IRLSSG) diagnostic criteria. Beck's Depression Inventory(BDI), Spielberg's State Anxiety Inventory(STAI-X-1), Pittsburgh Sleep Quality Index(PSQI), Korean version Drug Attitude Inventory(KDAI-10), Subjective Well-Beings under Neuroleptic Treatment Scale-Short Form(SWN-K) and Barnes Akathisia Rating Scale(BARS) were used to evaluate the depressive symptomatology, level of anxiety, subjective quality of sleep, subjective feeling of well-being, drug attitude, presence of akathisia, respectively. Results : Of the 100 bipolar outpatients, 7(7%) were met to full criteria of IRLSSG and 36(36%) have at least one of the 4 IRLSSG criterion. Because of relatively small sample size, non-parametric analysis were done to compare the characteristics among 3 groups(full-RLS, 1 ${\geq}$positive RLS-symptom and Non-RLS). There were no significant differences in sex, age, and other sociodemographic and clinical data among 3 groups. BDI, STAI-X-1 and PSQI are tended to be impaired in RLS and 1 ${\geq}$positive RLS-symptom groups. Conclusions : This is the first preliminary study for studying the prevalence and its correlates of RLS in bipolar disorder. The results shows that relatively small proportion of RLS was present in bipolar disorder patients when compared to patients with schizophrenia. Same tendencies shown in schizophrenic patients were found that bipolar patients with RLS had more depressive symptoms, state anxiety and poor subjective sleep quality. Further systematic studies may be needed to find the characteristics of RLS in bipolar patients.
Introduction: This research was performed to contract the attitude of dietary restriction and the psychological problems such as depressive mood and perceived stress and to investigate the relationship of these and obesity in women who visited the obesity clinic. Methods: During May 2001, sociodemographic variables, physical characteristics, Three Factor Eating Questionnaire(TFEQ), Symptom Check List-90-R(SCL-90-R) and Perceived Stress Scale were assessed from 150 female who visited the obesity clinics which were located at downtown, Seoul and the Hospital of Ajou University, Medical College. Hamilton depression rating scale(HDRS) was estimated by author. And then 116 female cases who filled up the questionnaire faithfully were included. Results: Obese group more than Body Mass Index(BMI) $25.0kg/m^2$ was 50% of the total subjects. BMI was increased as the age goes up(p<0.001). The frequency of unmarried cases in the under normal weight group was high rate of 48.8% while it in the obese group was 13.8%(p<0.001). There was no significant difference in the rate of smoking and alcohol drinking among subjects by BMI. There was no significant difference of TFEQ among subjects by BMI and the percent of body fat. Factor 2(r=0.27, p<0.01) and Factor 3(r=0.24, p<0.01) were significantly correlated with Global Severity Index(GSI). Only the paranoia scale among each estimated mean value of T scores of SCL-90-R by BMI was the significant difference between the overweight group and the obese group(p<0.05). T scores of scales of SCL-90-R were less than 50, but T scores of the under normal weight group and the obese group were higher than overweight group. GSI was significantly correlated with HDRS(r=0.75, p<0.01) and Perceived Stress Scale(r=0.32, p<0.01). Depressive mood in the obese group was significantly higher than non-obese group that HDRS was compared to two groups by the percent of body fat(p<0.05). Perceived Stress Scale was no significant correlation with BMI and the percent of body fat. All of the subject were in trouble of high stress. Stress affected dietary restriction owing that perceived stress had a relation with Factor 2(r=0.29, p<0.01) and Factor 3(r=0.37, p<0.01). Also, it affected psychological characteristics owing that perceived stress had a relation with the depression scale, GSI and HDRS(r=0.33, r=0.32, r=0.34, p<0.01). Conclusion: Obese women have more psychological difficulties including depression and high perceived stress, which closely related with the attitude of dietary restriction. Psychiatric intervention and aggressive assessment of psychological problems will be needed to the people who visit the obesity clinic in the future.
목적 : 갱년기 여성은 내장비만의 위험이 높으며 또한 심리적 변화를 겪는 시기이다. 갱년기 여성의 복부지방, 내장지방, 피하지방 및 이와 관련된 단순비만지표, 간울증, 스트레스, 우울, 자존감 등을 조사하여 갱년기 건강의 위협이 되는 신체 심리 인자를 알아보고자 이 연구를 시행하였다. 방법 : 병원공고를 통해 체질량지수 $23kg/m^2$ 이상 비흡연자인 만 45세 이상 55세 이하의 폐경 전후의 갱년기 여성 환자를 모집하여 2007년 8월 20일부터 24일까지 47명이 모집되었으며 이중 체질량지수 $25kg/m^2$ 이상이면서 복부 전산화 단층촬영 상 내장지방이 $100cm^2$ 이상인 20명의 단순비만지표, 체성분검사, 혈액검사, 복부 전산화 단층촬영 및 한방비만변증 (간울) 및 스트레스, 우울, 자존감 설문검사 결과의 상관성을 분석하였다. 본 연구는 경희대학교 동서신의학병원의 임상연구심사위원회의 승인을 받았다. 결과 : 1. 갱년기 비만여성에서 복부지방 면적, 피하지방 면적은 체질량지수, 체지방률, 허리둘레/신장비 등의 단순비만지표와 유의한 상관성을 보인 반면 (p < 0.01), 내장지방 면적은 단순비만지표와 상관성을 보이지 않았다. 2. 내장지방 면적은 사회 재적응 평가척도 (${\gamma}=0.577$, p < 0.01)와 유의한 상관성이 있었고, 선형회귀분석에서 유의한 결과를 나타냈다. $VAT(cm^2)=116.1+0.101{\times}(SRRS\;score)$ (${\gamma}^2=0.332$) 3. 피하지방은 식이태도 점수와, 총복부지방은 식이태도 점수 및 갱년기지수 중 혈관운동증상과 상관성이 있었다. 4. 간울증은 스트레스 반응척도, 우울지수, 갱년기지수 및 그 하부항목 중 혈관운동, 정신, 운동, 소화, 전신증상과 양의 상관성을, 자존감척도와는 음의 상관성을 나타냈으며, 내장지방과 직접적인 상관성을 보이지 않았다. 결론 : 간울증은 높은 스트레스, 우울, 갱년기 증상 및 낮은 자존감과 관련되는 것으로 나타났다. 폐경전후 비만여성에서 내장지방 면적은 간울증과 유의한 상관성을 보이지 않았으나, 생활 스트레스 사건이 많을수록 높아지는 것으로 나타나 갱년기 여성 내장비만에서 스트레스에 대한 대처가 중요할 것으로 사료된다. 추후 임상적 연계성 및 설문 보완에 대한 연구가 필요하리라 생각된다.
Lee, Jung Eun;Lee, Jung-Hyun;Jung, Young-Chul;Park, Jun Young;Kee, Namkoong;Park, Dong Wha;Kim, Kyung Ran
Korean Journal of Psychosomatic Medicine
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v.23
no.1
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pp.3-11
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2015
Objectives:To determine the influence of parental behaviors on the onset and severity of eating disorders, this study compared aspects of perceived parental styles, according to eating disorder subtypes and age at onset in Korean women with eating disorders. Methods:One hundred and sixty-seven patients with eating disorders[Anorexia Nervosa (AN), N=49; Bulimia Nervosa(BN), N=118] were recruited for this study. Perceived parent behaviors were assessed with Parental Behavior Inventory(PBI) self-rating scale. The study subjects also completed the Eating Disorder Inventory -2 (EDI-2) to assess the severity of eating disorder symptoms. Results:In anorexia nervosa, early onset group(<16 years) reported low paternal affection and high paternal rational expression, low maternal interference than group with age at onset over 16 years. The severity of eating disorder symptoms was negatively associated with mother affection and rational expression in two subtypes of eating disorder(AN and BN). On stepwise regression analysis, paternal affection and maternal over-protection were associated with age of onset only in AN group and maternal affection was associated with the severity of symptoms in both groups of eating disorder. Conclusions:Considering the role of family function and perceived parental styles could help improve the management of eating disorders. These results emphasize the importance of fathers' role in the eating disorder on the age of onset, a relatively unexplored area of eating disorder research. Also, we investigated the importance of mothers' affection on the severity of symptoms.
Objectives: The purposes of this study were to investigate 1) the incidence of insomnia, 2) the clinical characteristics of the insomniacs, 3) the correlation of severity of insomnia with somatic complaints and psychological distresses, and 4) the beliefs and attitudes about sleep in patients with chronic renal failure on hemodialysis. Methods: The author evaluated 153 patients, receiving hemodialysis therapy at the four outpatients hemodialysis units in Pusan, Korea. The patients had completed a self-administered questionnaire package, which consisted of basic demographic findings, questions characterizing insomnia, Beck Depression Inventory(BDI), Spielburger's State-Trait Anxiety Inventory(STAI), and visual analogue scales measuring quantitatively the severity of the self-perceived psychological and somatic symptoms. And several laboratory data were collected. Diagnosis of insomnia was made in the base of insomnia criteria of DSM-IV and international classification of sleep disorders. Subjects were dichotomized into those who reported any characteristics of insomnia or those who had no insomnia during the preceding two weeks. Results: Insomnia was found in 100(65.4%) of 153 patients. No statistical differences were found between the patients with and without insomnia in terms of age, gender, education, marital status, mean duration of hemodialysis and all considered laboratory findings except serum albumin. The patients with insomnia had significantly higher BDI score and predialysis systolic blood pressure, and lower serum albumin as compared to non-insomnia group. Significant differences were found between two groups in terms of self-perceived distress such as sadness, anxiety, worry, pruritus, and dysfunction of daily life. The data showed statistically significant correlation between insomnia severity and some variables such as physical dysfunction, pruritus, bone pain, sadness, anxiety, worry, dysfunction of daily life and excessive daytime sleepiness. The patients with insomnia had significantly several dysfunctional beliefs and attitudes about sleep than those without insomnia. Conclusion: These results indicate that insomnia is very common in hemodialysis patients and likely contribute to the impaired quality of life experienced by many these patients. The author suggests that physical and psychological distresses would be reduced and the quality of life could be improved if their sleep disturbances are properly ameliorated in patients on hemodialysis.
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.
The purpose of this study was to investigate characteristics of victims, especially aggressive victims of dating violence, and examine how they constructed the dating relationship and their commitments in dating relationships. The participants were 526 female college students who had the experience of heterosexual dating relationships, whose ages ranged from 18 to 37 (M=20.10, SD=2.70). The psychological tests used in this research included the following: Straus' Conflict Tactics Scale, Foo and Margolin's Justification of Violence Scale, Korean Version of Gender-Role Scale, and Lee and Han's Relationship Measures. Results revealed that aggressive victims of dating violence were more likely to receive mild violence as well as severe violence from their dating partners than victims only, while women who were victim only experienced sexual harassments more than aggressive victims from their dating partners. Aggressive victims of dating violence had experienced fathers' domestic violence more than women who had not experienced dating violence. Victims of dating violence showed less negative attitude toward dating violence than women who had not experienced dating violence. Victims of dating violence showed stronger commitments in their dating relationships than women who had not experienced dating violence. The results of this study may provide valuable information for professionals who help victims of dating violence.
This study was attempted to investigate the discriminant validity of Korean version of Eating Attitude Test-26(KEAT-26) and to provide the sensitivity, specificity and efficiency according to cutting score, which may be useful to determine the optimal cutoff point on various purposes. The KEAT-26 was administered to 108 female patients with eating disorders, 179 female participants in body slimming center, 120 female athletic college students, 227 female college students, and 183 healthy normal women. Validity was tested by ANOVA and ROC curve analysis. The results revealed that the total score of the KEAT-26 showed a statistically significance between groups and that the score of the KEAT-26 of eating disorders group was significantly higher than that of the other groups in post hoc test. In comparison of the 4 subfactor score of the KEAT-26 between groups, significant differences in main effect within groups were found in all subfactors except factor IV. ROC curve analysis showed 80% of efficiency to discriminate eating disorders group from normal control group using cutoff score on maximum discriminant efficiency and 69% of efficiency to discriminate eating disorders group from high risk groups for eating disorders. Each cutoff score on maximum in efficiency was as follows ; 25 between eating disorders group and participants in body slimming center, 19 between eating disorders group and healthy normal woman, 23 between eating disorders group and athletic college students, 21 between eating disorders group and college students. Using 22(T score 65) of the KEAT-26 as the cutoff score, sensitivity was 54%, specificity was 84%, and overall efficiency was 80%. These results indicate that the KEAT-26 has a good discriminant validity in Korean population and also suggest that the KEAT-26 may be useful assessment tool to screen the disordered eating problems on clinical and epidemiological purposes.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.8
no.1
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pp.34-42
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1997
Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N=14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.
Objectives : Middle aged women with depression often experience hot flush symptoms. It is still unclear about the association between depression and hot flush symptoms. Therefore, we investigated hormonal profile, functional somatic symptoms, coping styles and attitude for menopause between depressed women with hot flush and those without hot flush. Methods : This study included 33 depressed patients with hot flush symptoms and 33 depressed patients without hot flush symptoms. Hot flush was confirmed through prospective daily symptom ratings for a week. Subjects' coping styles were assessed by the stress coping checklist. Somatic symptoms were assessed by the Patient Health Questionnaire-15(PHQ-15). Sex hormonal levels were assayed by a radioimmunoassay. The Brief World Health Organization Quality of Life Assessment Instrument(WHOQOL-BREF) was used to evaluate quality of life. Results : In coping style, depressed women with hot flush symptoms used less 'problem-centered coping'($13.15{\pm}3.17$) and 'search for social support'($11.83{\pm}2.84$) than those without hot flush symptoms($15.17{\pm}3.1$, p=0.028 ; $14.25{\pm}3.22$, p=0.009 ; respectively). Depressed women with hot flush symptoms showed more negative attitude toward post-menopause, but its statistical significance was marginally insufficient(p=0.059). We did not find any group differences in sex hormonal levels and somatic complaints assessed by the PHQ-15. The score of social relationship domain of WHOQOL-BREF was significantly lower in subjects with hot flush symptoms($8.62{\pm}2.04$) than subjects without hot flush symptoms($9.71{\pm}1.65$ ; p=0.044). Conclusions : Among middle aged women with depression, the manifestation of hot flush symptoms was associated with coping styles and attitude for menopausal transition. Hot flush symptoms in depressed women negatively influence quality of life, so clinicians actively perform therapeutic approach in case of depressed patients with hot flush symptoms. In case of depressed patients who present hot flushes, cognitive behavior therapy or stress management might be an effective treatment option in company with antidepressants or hormonal treatment. Later, longitudinal study will be needed to evaluate risk factor, cause and effect associated with hot flush and depression.
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