• Korean Journal of Adult Nursing
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• v.26 no.1
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• pp.34-45
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• 2014

Purpose: The purpose of this study was to investigate the effect of laughter therapy and cognitive reinforcement program on self-efficacy, depression and cognitive functions of the elderly with mild cognitive impairments (MCI). Methods: The study design was a non-equivalent control group pre and posttest design. Thirty-six subjects over the age of 65 with a diagnosis of mild cognitive impairment were assigned either to a treatment or a comparison group. Data were collected from February 7 to March 27, 2012 in the dementia supporting center. An eight week treatment program that included laughter therapy coupled with a cognitive reinforcing program including hand exercise, laughter dance routine, laughter technic and cognitive training for attention, memory, orientation and execution skill. Results: MoCA-K (t=-6.86, p<.001) and Stroop test CW correct (t=-2.54, p=.008), self-efficacy (t=-3.62, p=.001) in the treatment group were significantly higher than those of the comparison group. Reported depression (t=2.29, p=.014), Stroop test CW error (U=53.50, p<.001) in the treatment group was significantly less than the comparison group. Conclusion: In this study, the treatment was effective in improving self-efficacy, cognitive function and reducing depression in the elderly with MCI.

• 한국노년학
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• v.40 no.3
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• pp.443-458
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• 2020

Aim: This study investigated the association between leisure activities and cognitive impairment in Korean community-dwelling older adults. Methods: Among participants of the 2017 National Survey of Older Koreans, 10,055 (male=4,277, female=5,778) were included in this cross-sectional study. To better identify the association between late-life cognition and leisure activities, individual leisure activities were categorized into 3 types including productive, consumptive, and unclassified activities. Multivariate logistic regression analysis was performed to assess the association between participation in leisure activities and cognitive impairment when controlling for possible covariates evidenced by previous studies. Results: Male participants were more likely to be cognitively impaired than female ones with significant differences in all the covariates. After controlling for confounding variables, involvement in productive leisure activities was found to be associated with cognitive function in both male and female groups, along with age, educational level, depressive symptoms, subjective hearing problems, and occupational status. Conclusion: Involvement in productive leisure activities might be associated with decreased risk of cognitive impairment in later life. Appropriate strategies to encourage older adults to participate in productive leisure activities should be established to help them maintain their cognitive function.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.176-184
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• 1997

Abnormal illness behavior in patients with somatoform disorders were known formed by their traditional disease concepts and somatization-prone socio-cultural factors. The authors evaluated the characteristics of abnormal illness behavior in patients with somatoform disorders(who had somatization) by using abnormal illness behavior questionnaire. Methods : 29 somatoform disorders(SD) and 57 disease controls were compared by clinical characteristics, severity of pain, state anxiety(by Spielberger's State & Trait Anxiety Inventory), depression(by Beck's Depression Inventory) and level of psychosocial stess(by DSM-III-R). The illness behavior was measured by illness Behavior Questionnaire(IBQ). Results SD group had longer period of somatic symptoms with less severity in pain. The degree of anxiety and depression were higher in SB compared with controls. However, the degree of psychosocial stress was almost same between both groups. In IBQ, SD showed higher scores in general hypochondriasis, disease conviction, and affective disturbance subscales compared to control group. Conclusion: High disease conviction and hypochondriacal nature revealed by IBQ seemed to be a role in making somatization by way of somatic focusing and hypervigilance. And those tended to lead patients visit hospital frequently and report various somatic complaints. Evaluating abnormal illness behavior in somatoform disorders would be not only helpful in understanding the natures of somatoform disorders but also useful differentiating SD with other psychiatric conditions.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.72-80
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• 2020

Objectives : The aim of this study was to compare the effect of Selective Serotonin Reuptake Inhibitor (SSRI) and Serotonin Norepinephrine Reuptake Inhibitor (SNRI) for mood symptoms, pain, and somatic symptoms in elderly depression patients with pain and somatic symptoms. Methods : This study is a prospective open-label study conducted by a single institution. A total of 43 subjects diagnosed with major depressive disorder under the DSM-5 diagnostic criteria participated in this study (average age: 72.53, 58.1% women). The subjects were classified as SSRI and SNRI groups. Depressive symptoms, pain, and somatic symptoms were evaluated by Korean version of the Hamilton Depression Rating Scale (K-HDRS), visual analogue scale (VAS) and Patient Health Questionnare-15 (PHQ-15) respectively at baseline and six weeks later. Two-way repeated-measure ANOVA was performed to analyze changes in the KHDRS, VAS, and PHQ-15 scores. Results : In the SSRI and SNRI groups, K-HDRS, VAS, and PHQ-15 all showed significant improvement after 6 weeks compared to each baseline values. There were no differences in therapeutic effect between the two groups. Conclusions : We found that SSRI and SNRI both improved somatic symptoms and pain in elderly depression patients. The results of this study are thought to help select antidepressants when administering medication to elderly depression patients who complain pain and somatic symptoms. Further research is needed on the longterm effects of the SSRI and SNRI.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.1
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• pp.32-39
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• 2012

Objective : Psychiatry in North Korea is believed to seem very different from psychiatry in South Korea. However, there is nearly no information regarding psychiatry in North Korea until now. Our study aimed to get information about North Korean psychiatry. Methods : Three North Korean defectors in South Korea, whose clinical experience as medical doctors in North Korea was over 10 years, were recruited. They underwent the semi-structured interview, content of which included the clinical experience with psychiatric patients, the details of psychiatry, the treatment of psychiatric patients, the stigma of mental illness, and the suicide, in North Korea. Results : In North Korea, psychiatric department was called as 49th(pronounced as Sahsip-gu-ho in Korean). Only patients with vivid psychotic symptoms came to psychiatric department. Non-psychotic depression or anxiety disorders usually were not dealt in psychiatry. The etiology of mental illness seemed to be confined to biological factors including genetic predisposition. Psychosocial or psychodynamic factors as etiology of mental illness appeared to be ignored. Psychiatry was apparently separated from political or ideological issues. The mainstay of psychiatric treatment is the inpatient admission and out-of-date therapy such as insulin coma therapy. Stigma over mental illness was common in North Korea. Suicide is considered as a betrayal to his/her nation, and has been reported to be very rare. Conclusion : The situation of psychiatry in North Korea is largely different from that of South Korea. Although some aspects of North Korean psychiatry are similar to psychiatry in former socialist countries, North Korean psychiatry is considered to have also its unique characteristics.

• Anxiety and mood
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• v.13 no.2
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• pp.53-59
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• 2017

Reliable and valid diagnostic screening tools in the primary care setting enable accurate estimation of depression in individuals at risk or in need of treatment, and provide patients with an opportunity to receive optimal treatments. Although there have been extensive studies on screening tools for depression used in domestic mental health settings, there is little consideration and lack of a thorough review of the diagnostic validity of screening tools. In the current review, we selected 13 representative screening tools for depression which were evaluated in a total of 19 validation studies conducted in Korea. We summarized DSM-5 target domains, diagnostic indices, sensitivity, specificity, cut-off scores, and diagnostic validity information for each tool. Finally, the depression measurement expert group was constituted to evaluate the current status of screening tools for depression, and their recommendations for a new screening tool were summarized. This study was conducted as part of the Mental Health Technology Development project to develop the Korean screening tool for depression (K-DEP).

• Sleep Medicine and Psychophysiology
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• v.19 no.1
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• pp.27-34
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• 2012

Objectives: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. Methods: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. Results: In serum lipid profile test, MDD group showed higher cholesterol ($197.68{\pm}42.94$ mg/dL vs. $176.85{\pm}34.68$ mg/dL, p=0.044), TG ($139.45{\pm}92.54$ mg/dL vs. $91.4{\pm}65.68$ mg/dL, p=0.018), LDL ($130.03{\pm}33.18$ vs. $106.62{\pm}27.08$, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant ($32.82{\pm}14.33$ ms vs. $40.36{\pm}21.40$ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group ($1.13{\pm}0.11$ vs. $0.91{\pm}0.18$, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). Conclusions: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.1
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• pp.40-60
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• 2004

Introduction：Research on attachment in view point of the developmental perspective which began in the 1940s progressed during several decades. Many investigators focused mother-child separation in early attachment studies, and moved to the relationship with childhood psychopathology. Recently attachment theory and research are moving forward along the intergenerational transmission of attachment patterns, and adolescents and adult mental disorders in the developmental perspectives. Methods：We surveyed the research papers through Medline search, attachment-related monographs, and review or original papers published in Korean journal. Results：Developmental attachment researches have demonstrated convincingly that insecure attachment in infancy is associated with attachment disorder; several childhood psychopatholgy, such as institutional care and adoption, aggression and behavioral problems, childhood anxiety disorders and depressive disorders, gender identity disorder and feeding disorder, and child abuse and maltreatment; peer relationship and social competency, and parental behaviors. Recently the methodological advances including the Adult Attachment Interview that systematically assesses the adults' recollections of the earlier parent-child relationship they experienced could move beyond attachment researcher's initial concern with infancy to consider attachment processes throughout the life span. We could find that the quality of attachment was associated with several mental disorders in adolescents and adults significantly. Conclusion：Attachment theory would have focused on more specific parent-child relationship than general parental behavior. Recent attachment theory underscores its evolutionary origins to promote development of infant and contribute to human survival in psychobiological bases. Advances in attachment research could unite interests in evolutional biology and developmental psychology in understanding early parent-child relationship, and apply to clinical issues concerning mental health throughout the life span.

• RED RIBBON
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• s.72
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• pp.9-11
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• 2006

후천성 면역 결핍 증후군(AIDS, Aquired Immune Deficiency Syndrome)과 사람 면역결핍 바이러스 (HIV, Human Immunodeficiency Virus)관련 질환은 1981년 처음 AIDS가 보고된 이래 전 세계적으로 인류의 건강을 위협하고 있는 공중보건학적 문제이다. 그동안 HIV/AIDS 관련 질환에 대한 치료들은 주로 감염 경로 차단 및 관련된 내과적 질환의 치료에 초점이 맞추어져 왔다. 그러나 AIDS 환자 본인뿐만 아니라 가족, 치료진들은 흔히 HIV 감염으로 인한 심리적인 어려움에서부터 HIV 전파 위험을 높이는 물질 오남용 문제, 우울증, 치매 같은 전형적인 정신과 질환 및 자살에 이르기 까지 다양한 종류의 정신건강 상의 문제들에 자주 직면한다. 이와 같은 신경정신과적 문제들은 치료 결과나 예후, 삶의 질 등에 영향을 미칠 수 있기 때문에 환자의 가족들은 AIDS로 인한 정신과적 질환이나 현상들에 대해 잘 이해하고 적절하게 대처할 필요가 있다.

• Journal of Yeungnam Medical Science
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• v.22 no.2
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• pp.150-165
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• 2005

Purpose: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. Materials and Methods: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. Results: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20(25.0%) for the BDI, 16(20.0%) for the ZDS, 18(22.5%) for the CDSS and 6(7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. Conclusion: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.