• Psychiatry investigation
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• 제15권12호
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• pp.1115-1120
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• 2018

Objective The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) is a scale used to clinically evaluate disturbances in biological rhythm. In this study, we aimed to examine the reliability and validity of the Korean version of the BRIAN (K-BRIAN) in a Korean population. Methods A total of 181 participants, including 141 outpatients with bipolar disorder (BD; type I, 62; type II, 79) and 40 controls, were recruited. Construct validity was tested by comparing the mean K-BRIAN scores of the BD patients and control subjects. Concurrent validity was tested by evaluating the association between the K-BRIAN and the Morningness-Eveningness Questionnaire (MEQ). Results The mean K-BRIAN scores of the control subjects and patients with BD differed significantly (p<0.001). Particularly, the mean K-BRIAN score was considerably lower among control subjects (mean${\pm}$standard deviation=$35.00{\pm}8.88$) than among patients with BD type I ($41.19{\pm}12.10$) and type II ($50.18{\pm}13.73$). The Cronbach's alpha for the K-BRIAN was 0.914. The K-BRIAN was found to correlate with the MEQ (r=-0.45, p<0.001). Conclusion The findings affirm that the K-BRIAN has good construct validity and internal consistency. This suggests that the K-BRIAN can be used to assess biological rhythms in the Korean population, especially for patients with mood disorder.

• Psychiatry investigation
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• 제15권12호
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• pp.1188-1202
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• 2018

Objective This study protocol aims to determine, using a rigorous approach in patients with bipolar disorder (BD) and non-seasonal major depressive episode (MDE), the characteristics of bright light therapy (BLT) administration (duration, escalation, morning and mid-day exposures) depending on the tolerance (hypomanic symptoms). Methods Patients with BD I or II and treated by a mood stabilizer are eligible. After 1 week of placebo, patients are randomized between either morning or mid-day exposure for 10 weeks of active BLT with glasses using a dose escalation at 7.5, 10, 15, 30 and 45 minutes/day. A further follow-up visit is planned 6 months after inclusion. Patients will be included by cohorts of 3, with at least 3 days of delay between them, and 1 week between cohorts. If none meet a dose limiting toxicity (DLT; i.e hypomanic symptoms), the initiation dose of the next cohort will be increased. If one patient meet a DLT, an additionnal cohort will start at the same dose. If 2 or 3 patients meet a DLT, from the same cohort or from two cohorts at the same dose initiation, the maximum tolerated dose is defined. This dose escalation will also take into account DLTs observed during the intra-subject escalation on previous cohorts, with a "Target Ceiling Dose" defined if 2 DLTs occured at a dose. Discussion Using an innovative and more ergonomic device in the form of glasses, this study aims to better codify the use of BLT in BD to ensure a good initiation and tolerance.

• Molecules and Cells
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• 제25권1호
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• pp.7-19
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• 2008

Complexins play a critical role in the control of fast synchronous neurotransmitter release. They operate by binding to trimeric SNARE complexes consisting of the vesicle protein Synaptobrevin and the plasma membrane proteins Syntaxin and SNAP-25, which are key executors of membrane fusion reactions. SNARE complex binding by Complexins is thought to stabilize and clamp the SNARE complex in a highly fusogenic state, thereby providing a pool of readily releasable synaptic vesicles that can be released quickly and synchronously in response to an action potential and the concomitant increase in intra-synaptic $Ca^{2+}$ levels. Genetic elimination of Complexins from mammalian neurons causes a strong reduction in evoked neurotransmitter release, and altered Complexin expression levels with consequent deficits in synaptic transmission were suggested to contribute to the etiology or pathogenesis of schizophrenia, Huntington's disease, depression, bipolar disorder, Parkinson's disease, Alzheimer's disease, traumatic brain injury, Wernicke's encephalopathy, and fetal alcohol syndrome. In the present review I provide a summary of available data on the role of altered Complexin expression in brain diseases. On aggregate, the available information indicates that altered Complexin expression levels are unlikely to have a causal role in the etiology of the disorders that they have been implicated in, but that they may contribute to the corresponding symptoms.

• 생물정신의학
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• 제4권2호
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• pp.259-264
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• 1997

저자들은 1993년 5월 1일부터 1997년 4월 30일까지 한강성심병원 신경정신과 입원환자 중연성전기경련요법을 받은 60명을 대상으로 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 전기경련요법을 받은 환자 60명중 정신분열증이 51.7%, 주요우울증이 21.6%, 양극성 정동장애, 조증이 16.7%, 기타 10% 이었다. 2) 전기경련요법의 시행 횟수는 1인당 평균 12.2회(정신분열증 14.9회 : 주요우울장애 12.2회 : 양극성 정동장애 13.6회 : 기타 8.2회)이었다. 3) 치료의 대상이 되었던 증상은 정신분열증의 경우 피해망상, 환청, 주요우울장애는 정신운동지체, 우울기분, 그리고 자살사고 또는 시도, 양극성 정동장애에서는 파괴적 행동, 흥분상태 순이었다. 4) 전기경련요법에 사용된 약제로 atropine $0.0093mgkg^{-1}$, 마취제 pentothal $2.76mgkg^{-1}$, 근육이완제 succinylcholine $0.80mgkg^{-1}$을 사용하여 만족할 만한 효과를 얻을 수 있었다. 5) 전기경련요법시 사용된 마취제중 propofol은 pentothal에 비해 seizure duration을 낮추었다.

• 대한불안의학회지
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• 제7권1호
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• pp.9-15
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• 2011

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.

• 생물정신의학
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• 제22권2호
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• pp.29-33
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• 2015

The brain maintains homeostasis and normal microenvironment through dynamic interactions of neurons and neuroglial cells to perform the proper information processing and normal cognitive functions. Recent post-mortem investigations and animal model studies demonstrated that the various brain areas such as cerebral cortex, hippocampus and amygdala have abnormalities in neuroglial numbers and functions in subjects with mental illnesses including schizophrenia, dementia and mood disorders like major depression and bipolar disorder. These findings highlight the putative role and involvement of neuroglial cells in mental disorders. Herein I discuss the physiological roles of neuroglial cells such as astrocytes, oligodendrocytes, and microglia in maintaining normal brain functions and their abnormalities in relation to mental disorders. Finally, all these findings could serve as a useful starting point for potential therapeutic concept and drug development to cure unnatural behaviors and abnormal cognitive functions observed in mental disorders.

• 대한불안의학회지
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• 제6권2호
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• pp.119-124
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• 2010

Objective : The reliability and validity of the Korean version of the Patient Health Questionnaire-9 (PHQ- 9) was examined in Korean patients with depressive symptoms. Methods : Eighty six outpatients diagnosed as major depressive disorder or depressive episode of bipolar I disorder according to the DSM-IV criteria were assessed with the PHQ-9, Hamilton Depression Rating Scale (HDRS), the Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR), and the Center for Epidemiologic Studies Depression Scale (CES-D). Results : The Cronbach's alpha coefficient from the PHQ-9 was 0.81. And the correlations of each item with the total score were statistically significant (r=0.28-0.70, p<0.01). The test-retest correlation coefficient (r=0.89, p<0.01) was relatively high and correlations of the PHQ-9 with the HDRS, QIDS-SR and CES-D were 0.70, 0.81, and 0.81 respectively. Conclusion : These results demonstrated that the Korean version of PHQ-9 could be a reliable and valid tool for the screening and assessment of depressive patients. The Korean version of PHQ-9 will be a useful tool for screening depressive symptoms in Korea.

• 생물정신의학
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• 제8권1호
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• pp.167-174
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• 2001

A 54-year old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제9권1호
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• pp.34-46
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• 1998

이 연구는 최근 자녀양육에 있어서 관심이 커지고 있는 아버지의 양육태도를 측정하기 위한 척도를 개발하기 위하여 실시되었다. 연구자들은 국내외 선행연구에서 다양한 요인을 고려하여 총 57개 문항으로 이루어진 예비형 설문검사도구를 구성하였다. 구성된 설문을 서울과 부산에서 무작위 표집한 만 12세 이상의 자녀를 둔 정상가정의 어머니 126명에게 작성토록 하여 척도화 가능한 요인을 추출하고 그 신뢰도를 알아보았다. 그 결과‘능동적 참여’, ‘민주적 지도’, ‘적대’, ‘온정’, ‘교육열’의 5개 소척도를 얻을 수 있었으며 이들의 내적 일치도를 나타내는 Cronbach’s ${\alpha}$계수는 각각 .82, .78, .65, .78, .61이었다. 또한 상기 5개 소척도, 총 29문항으로 구성된 최종적인 설문검사도구의 변별타당도를 알아보기 위하여 국립서울정신병원에서 치료 중인 환자로 DSM-Ⅳ 기준에 의거하여 정신분열병과 제1형 양극성 장애로 진단받은 환자의 어머니를 각각 47명과 29명을 선정하였고, 대조군으로 만 18세 이상의 자녀를 둔 정상가정의 어머니 46명을 무작위 표집하였다. 변별타당도에서 ‘교육열’ 소척도를 제외한 소척도들은 정신분열병군 아버지와 대조군 아버지의 양육태도를 잘 구별하고 있었으며 특히‘적극적 참여’, ‘온정’ 소척도에서는 대조군과 나머지 두 군 모두를 잘 구별하고 있었다.

• The Korean Journal of Physiology and Pharmacology
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• 제21권1호
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• pp.125-131
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• 2017

Status epilepticus is the most common serious neurological condition triggered by abnormal electrical activity, leading to severe and widespread cell loss in the brain. Lithium has been one of the main drugs used for the treatment of bipolar disorder for decades, and its anticonvulsant and neuroprotective properties have been described in several neurological disease models. However, the therapeutic mechanisms underlying lithium's actions remain poorly understood. The muscarinic receptor agonist pilocarpine is used to induce status epilepticus, which is followed by hippocampal damage. The present study was designed to investigate the effects of lithium post-treatment on seizure susceptibility and hippocampal neuropathological changes following pilocarpine-induced status epilepticus. Status epilepticus was induced by administration of pilocarpine hydrochloride (320 mg/kg, i.p.) in C57BL/6 mice at 8 weeks of age. Lithium (80 mg/kg, i.p.) was administered 15 minutes after the pilocarpine injection. After the lithium injection, status epilepticus onset time and mortality were recorded. Lithium significantly delayed the onset time of status epilepticus and reduced mortality compared to the vehicle-treated group. Moreover, lithium effectively blocked pilocarpine-induced neuronal death in the hippocampus as estimated by cresyl violet and Fluoro-Jade B staining. However, lithium did not reduce glial activation following pilocarpine-induced status epilepticus. These results suggest that lithium has a neuroprotective effect and would be useful in the treatment of neurological disorders, in particular status epilepticus.