• Korean Journal of Biological Psychiatry
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• v.18 no.4
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• pp.232-238
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• 2011

Objectives Optimized voxel based morphometry (VBM) has been increasingly applied to investigate differences in the brain morphology between a group of patients with mild cognitive impairment (MCI) and control subjects. Optimized VBM permits comparison of gray matter (GM) volume at voxel-level from the entire brain. The purpose of this study was to assess the regional GM volume change measured by optimized VBM in MCI subjects compared to controls. Methods Twenty patients with MCI and 20 control subjects with normal cognition were recruited for this study. We applied the optimized VBM protocol to the image data including study-specific template and the modulation of the data with the Jacobian determinants. GM volume differences between the MCI subjects and the control subjects and their correlations with the neuropsychological performances were investigated. Results Optimized VBM analysis revealed GM volume reduction in hippocampus, precentral gyrus, insula and parietal operculum in the MCI group compared to the control group (family wise error corrected p < 0.05). Korean version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) word list recall scores were significantly correlated with the GM volumes of hippocampus, precuneus and posterior cingulate in the MCI group (FWE corrected p < 0.05). Conclusions The results confirm previous findings of atrophic changes in medial temporal lobe and parietal lobe in the MCI group and suggest that these abnormalities may be related with cognitive decline and prognosis in patients with MCI.

• Korean Journal of Biological Psychiatry
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• v.21 no.2
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• pp.65-73
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• 2014

Objectives This study aimed to identify the differences and the profiles of cognitive deficits in remitted patients with schizophrenia and first-degree relatives of schizophrenic probands. Methods A total of 26 remitted states of schizophrenia patients were included in the study and the same number of unaffected first-degree relatives of schizophrenic probands and healthy controls were matched for age, sex, years of education. Cognitive function of all participants was measured by using the Digit span test, the Continuous performance test, the Rey auditory & visual learning test, the Complex figure test, the Verbal fluency test, the Wisconsin card sorting test and the Finger tapping test. The effects of subsyndromal symptomatology and general intelligence score were controlled. Results Schizophrenia patients' group showed more significant impairment than other groups in verbal memory (learning, immediate recall, delayed recall), visual memory (copy, immediate recall, delayed recall) and cognitive flexibility domains. The family group and the patient group commonly performed significantly worse than healthy controls in working memory and verbal fluency (category) tests. There were no differences in sustained attention, psychomotor performance. Conclusions Our research shows that the deficit in working memory and verbal fluency could be strong candidates of endophenotypic marker in schizophrenia.

• Korean Journal of Biological Psychiatry
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• v.14 no.2
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• pp.106-114
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• 2007

Objective : It is suggested that disturbance of dopaminergic system might be related to the possible mechanism of social phobia. The aim of this study was to investigate the possible association of DRD2 TaqI polymorphism and social phobia. Method : Fifty-one patients with social phobia and 200 comparison subjects were tested for DRD2 TaqI A polymorphism. The severity of social phobic symptoms was measured by self-report version of the Liebowitz Social Anxiety Scale(LSAS-SR) and Hamilton anxiety scale(HAM-A). Results : There was no signigicant difference in the genotype, allele frequency, A1 carrier frequency, and heterozygote frequency DRD2 TaqI A polymorphism between the social phobia patients and the control groups. However, we found significant decrease in somatic anxiety of the HAM-A in the patients having A2A2 homozygotes(p=0.014). In addition, patients having A1A2 heterozygotes showed more anxiety in two subscales (p=0.042 in anxiety, p=0.019 in performance) of the LSAS-SR. Conclusion : These results suggest that DRD2 A2 homozygote might have a protective role against somatic anxiety, and molecular heterosis of DRD2 TaqI A polymorphism might be related with more severe anxiety in social phobia.

• Korean Journal of Biological Psychiatry
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• v.25 no.2
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• pp.31-37
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• 2018

Objectives The aim of this study was to evaluate the psychopathological features such as depression and anxiety in schizophrenics with obsessive-compulsive symptoms (OCS) as well as the severity of OCS according to duration of schizophrenia. Methods We randomly selected sixty four inpatients with schizophrenia. We classified the patients into two groups (OCS group, non-OCS group) according to the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Clinical and demographic features were evaluated. To assess OCS, Y-BOCS were performed. The Korean version of the Positive and Negative Syndrome Scale(K-PANSS), the Brief Psychiatric Rating Scale (BPRS), the Korean version of the Calgary Depression Scale for Schizophrenia (K-CDSS), the Beck Anxiety Inventory (BAI) and the Satisfaction With Life Scale (SWLS) were conducted. Independent t-test and chi-square test were conducted to compare the two groups. Pearson correlation analysis was performed to examine the relationship between the duration of schizophrenia and the Y-BOCS score. Results The Y-BOCS, K-CDSS, and BAI scores were higher in the OCS group. There was a significant correlation between the duration of schizophrenia and the Y-BOCS score. Conclusions Anxiety and depression symptoms were severe in the OCS group. In addition, the results of this study indicate that the longer duration of schizophrenia, the more severe the OCS. Therefore, the evaluation of OCS in schizophrenics should be accompanied by treatment intervention.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.42-57
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• 2020

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

• Korean Journal of Biological Psychiatry
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• v.25 no.4
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• pp.110-117
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• 2018

Objectives This study aimed to investigate the relationship between depressive and anxiety symptoms and tardive dyskinesia (TD) and reveal the association of cognitive function and TD in patients with schizophrenia. Methods We recruited 30 schizophrenia patients with TD and 31 without TD from a national mental hospital in South Korea. To assess depressive and anxiety symptoms, the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI) were conducted. Using the five-factor structure of the BDI-II and BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety were assessed. Computerized neurocognitive function test (CNT) was performed to assess levels of cognitive functions. We compared the clinical characteristics, levels of cognitive functions, and depressive and anxiety symptoms between schizophrenia patients with TD and without TD. Chi-square test, Fisher's exact test, independent t-test and Mann Whitney U test were conducted to compare two groups. Pearson correlation analysis was conducted to evaluate relationships among the abnormal involuntary movement scale (AIMS), BDI-II, BAI, somatic anxiety, cognitive depression, somatic depression, subjective anxiety, and autonomic anxiety. Results The subjects with TD had significantly lower score on the cognitive depression than those without TD (t = -2.087, p = 0.041). There were significant correlations between the AIMS score and the BDI-II score (r = -0.386, p = 0.035) and between the AIMS score and cognitive depression score (r = - 0.385, p = 0.035). Conclusions Our findings suggest the inverse relationship between severities in TD and depression and support the assumption that there is an inverse relationship between the pathophysiology of TD and depression.

• Journal of the Korean society of biological therapies in psychiatry
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• v.24 no.3
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• pp.173-183
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• 2018

Objectives : The aim of study was to estimate the prevalence of poor sleep quality and depressive symptoms as well as to examine the moderating effect of positive psychology on the relationship between poor sleep quality and depressive symptoms among Korean university students. Methods : A total of 2,338(1,071 male and 1,267 female) university students at seven universities of four cities in Korea were randomly selected to participate in a survey. Data were collected by self-report questionnaires, including Pittsburgh Sleep Quality Index(PSQI), Beck Depression Inventory(BDI), Satisfaction with Life Scale(SWLS), Positive Psychotherapy Inventory(PPTI), and sociodemographic characteristics. Results : The prevalence was 44.8% for poor sleep quality and 14.4% for depressive symptoms among Korean university students. By moderated regression analysis, the results showed that poor sleep quality(${\beta}=0.453$, p<0.001) aggravated depressive symptoms of university students, and life satisfaction(${\beta}=-0.087$, p<0.001) and happiness(${\beta}=-0.145$, p<0.001) respectively buffered the negative effect of the poor sleep quality on depressive symptoms. Conclusion : This study showed very high prevalence of poor sleep quality and depressive symptoms among Korean university students. Overall, these findings demonstrates that positive psychology can be effective in the enhancement of subjective and psychological well-being and may help to reduce depressive symptom levels. In the context of public health, positive psychology can be used as preventive, easily accessible and non-stigmatizing tools.

• Journal of the Korean society of biological therapies in psychiatry
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• v.24 no.3
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• pp.230-238
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• 2018

Objectives : Among adolescents, the proportion of daily smoking tends to increase with age, and does not return to the previous level. Therefore, we examined the factors associated with smoking frequency in a nationwide sample of Korean adolescents to help prevent the progression of smoking. Methods : Among 127,804 adolescents who participated in the 2016 and 2017 Korean Youth Risk Behavior Web-Based Survey, data from 7,781 adolescents who replied that they currently smoked were analyzed. According to the frequency of cigarette smoking, participants were classified into daily and non-daily smokers. Participants' socio-demographic characteristics, smoking behavior, and psychological problems including perceived stress, depressive mood, and suicidality were assessed. Results : There were 3,627(47.4%) daily smokers and 4,154(52.6%) non-daily smokers. Low parental educational level, and early smoking experience were positively associated with daily smoking. High academic achievement, and high socio-economic status were negatively associated with daily smoking. Daily smoking was positively associated with lower happiness, lower sleep satisfaction, and severe stress during the past 12 months. Factors affecting suicide attempts of smokers were sex, residential type, socioeconomic status, and early smoking experience. Conclusion : The results indicated that socially disadvantaged families, and smoking experience with young age influenced daily smoking among Korean adolescents. Daily smoking was associated with psychological problems including lower happiness, lower sleep satisfaction, and severe stress. Early smoking experience influenced suicidal attempts among Korean adolescent smokers. Early intervention for smoking cessation in this high-risk group may contribute to prevention of these psychiatric complications of smoking.

• Journal of the Korean society of biological therapies in psychiatry
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• v.24 no.3
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• pp.156-162
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• 2018

Objectives : This study aimed to investigate the relationship between the level of ego-resilience and depression, anxiety, conduct problems and self-esteem in a large sample of Korean adolescents. Methods : A total 4508(2036 males and 2472 females) middle and high school students in Gwang-ju metropolitan city were included in this study. Subjects were asked to complete a self-reported questionnaire, including Ego-Resilience(ER) scale, Beck Depression Inventory(BDI), Beck Anxiety Inventory(BAI), Self-Esteem Scale(SES), 15 items in Korean-Youth Self Report(K-YSR) to measure conduct problems and demographic variables. Subjects were classified into three high, intermediate and low ER group according to total ER scale scores. Results : Total ER scores was positively correlated with total SES scores and negatively correlated with total BDI, BAI, and conduct problem scores. Using analysis ANOVA(analysis and variance) and post hoc test, significant mean differences in BDI, BAI, SES and conduct problem scores were observed among the three groups. High ER group showed that SES scores were significantly higher and BDI, BAI and conduct problem scores were significantly lower than that observed in middle and lower ER group. Using multiple regression analysis, the results showed that depression, low self-esteem were significant factors affecting ego-resilience in adolescents. Conclusion : Our findings indicate that depression, anxiety, behavioral problem such as conduct problems and low self-esteem are associated with low ego-resilience.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.64-73
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• 2020

Suicidality is the most serious complication of mood disorders and psychosis; effective treatment should reduce suicide rates. The Organization for Economic Cooperation and Development age-standardized suicide rate in Korea was 22.6 in 2018, much higher compared to other countries worldwide. As mental and psychiatric problems are the main reasons for suicide attempts, accounting for 31.6% in 2018, targeting such problems should be the focus of efforts to reduce suicide rates. However, the ability of current pharmacotherapeutic and psychotherapeutic interventions to reduce suicide rates is limited due to their delayed effects. Therefore, electroconvulsive therapy (ECT) has been proposed as an alternative treatment. This approach is effective for treating most mental disorders associated with high suicide rates, including severe depression, bipolar disorder, and intractable psychotic disorders; ECT is also effective for Parkinson's disease, which has the highest suicide rate among all disorders in Korea. The acute, long-term, and prophylactic effects of ECT on suicidality have been reported in the literature, and treatment guidelines outside of Korea recommend that ECT be used at an early stage for rapid reduction of suicide rates, as opposed to being applied as a treatment of last resort. However, only ~0.092 of every 10000 members of the Korean general population received ECT in 2018; this is much lower than the average rate worldwide, of 2.2 per 10000. Elimination of obstacles to the use of ECT, early crisis intervention involving administration of ECT for rapid stabilization, and maintenance ECT to prevent recurrence should reduce suicide rates.