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Effectiveness and Safety of Traditional East Asian Herbal Medicine as Monotherapy for Major Depressive Disorder: A Systematic Review and Meta-Analysis (주요우울장애에 대한 한약 단독치료의 효과와 안전성: 체계적 문헌고찰 및 메타분석)

  • Seung, Hye-Bin;Kwon, Hui-Ju;Kim, Sang-Ho
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.1
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    • pp.79-111
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    • 2022
  • Major depressive disorder (MDD) causes a persistent feeling of sadness and loss of interest. It can lead to emotional and physical problems. Treatments such as antidepressant and cognitive behavioral therapy for MDD have many limitations. Traditional East Asian Herbal Medicine (TEAM) is a representative modality of Complementary and Integrative Medicine (CIM) which can be used for MDD. However, no study has systematically reviewed the efficacy or safety of TEAM for MDD so far. Therefore, we performed a systematic review and meta-analysis to evaluate effectiveness and safety of TEAM as a monotherapy for MDD. We only included TEAM that could be used in context of clinical setting in Korean Medicine. Outcomes were the Hamilton Depression Rating Scale (HAMD) and total effective rate (TER). After comprehensive electronic search of 11 databases, we included 28 randomized controlled trials (RCTs) that compared HM as monotherapy with antidepressant for MDD. Meta-analysis showed that TEAM had significant benefits in reducing HAMD (MD=-0.40, 95% CI: -0.67 to -0.13, p=0.003, I2=85%) and improving TER (RR=1.06, 95% CI: 1.02 to 1.10, p=0.003, I2=0%). It also appeared to be safer than antidepressant in terms of adverse effects. Methods used for RCTs were poor and the quality of evidence was graded 'low' or 'moderate'. These findings indicate that the use of HM as a monotherapy might have potential benefits in MDD treatment as an alternative to antidepressant. However, considering the methodological quality of included RCTs, the clinical evidence is uncertain. Further well-designed RCTs are required to confirm these findings.

Exercise Using Isokinetic Strength Training Equipment and Physical Function Improvement

  • Hyon-Min Tae;Su-Yeong Eom;Byoung-Kwon Lee;Dae-Sung Park
    • Physical Therapy Rehabilitation Science
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    • v.13 no.1
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    • pp.8-17
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    • 2024
  • Objective: This study aims to explore the relationship between isokinetic strength training and the enhancement of physical function in older adults. It also evaluates the effectiveness of isokinetic strength training equipment. Method: This study randomly divided twenty healthy adults into two groups.The experimental group engaged in isokinetic strength training for 30 minutes, three times a week, over a four-week period. In contrast, the control group did not participate in any exercise regimen. We assessed several outcome measures including physical functions (sit-to-stand test, flexibility, Timed Up and Go test), grip strength, balance, thigh circumference, the Korean version of the Patient Health Questionnaire-9 (PHQ-9), and the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Additionally, the experimental group's self-perceived improvement in lower limb condition was evaluated using the Global Rating of Change (GROC) scale. Results: The experimental group showed significant improvements compared to the control group in various aspects: reduced sit-to-stand test duration (7.00±2.05 seconds), increased flexibility (4.69±3.90 cm), improved grip strength (1.54±1.74 kg), increased thigh circumference (left: 1.29±1.19 cm, right: 1.19±1.27 cm), enhanced Timed Up and Go test performance (-1.47±0.86 seconds), better balance (eyes open stance: -8.08±4.03 cm, eyes closed stance: -0.27±0.13 cm/s), and a decrease in depression severity (-0.15±1.51 points). Furthermore, significant increases were observed in the experimental group's maximal isokinetic strength at 90°/s for both flexion (19.62±7.03 Nm) and extension (19.60±14.65 Nm) over the study period. Conclusion: The findings suggest that isokinetic strength training equipment can significantly enhance physical functions in seniors when incorporated into an exercise regimen.

A Case Report of Worsening Alzheimer's Disease Symptoms after COVID-19 Infection That Were Treated with Yigan-san-gami (COVID-19 감염 후 알츠하이머 치매증상의 악화에 대한 억간산 가미 치험 1례)

  • Hyo-jeong Lee;Sun-woo Kwon;Yi-jae Kwon;Jung-min Son;Choong-hyun Park;Ji-yoon Lee;Jung-eun Lee
    • The Journal of Internal Korean Medicine
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    • v.45 no.2
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    • pp.149-158
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    • 2024
  • Introduction: In this case report, we describe the clinical effectiveness of Yigan-san-gami in improving symptoms in a patient with worsening Alzheimer's dementia after COVID-19 infection. Case presentation: Symptoms of dementia worsened in a patient with Alzheimer's disease after COVID-19 infection. Western medicines were added following neurological consultation. However, there was no medicinal effect. The patient was treated with Korean medicine (Yigan-san-gami) three times a day. We used daily charts, the Korean Mini-Mental State Examination-2 (K-MMSE-2), Clinical Dementia Rating (CDR), and Short Version Geriatric Depression Scale (SGDS) to assess the patient's symptoms. Cognitive decline and behavioral and psychological symptoms of dementia (BPSD) improved following the treatment with Yigan-san-gami. Conclusion: The results suggest that Yigan-san-gami may be effective in improving symptoms of Alzheimer's disease that worsen after COVID-19 infection.

Standardization of Korean Version of Daily Stress Inventory(K-DSI) (한국어판 일상 생활 스트레스 척도(K-DSI)의 표준화 연구)

  • Joe, Sook-Haeng;Lee, Hyeon-Soo;Song, Hyun-Cheol;Kim, Seung-Hyun;Sub, Kwang-Yun;Sin, Dong-Kyun;Ko, Seung-Duk
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.72-87
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    • 2000
  • Objectives : This study was to provide normative data of Korean version of DSI(K-DSI), a sensitive measure of relatively minor stressors that could be administered daily. Methods : K-DSI was administered in 524 adults, age of 19 or over, daily for 1 week. On the seventh day, Becks Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), and Social Readjustment Rating Scale(SRRS) were also given to test the convergent validity. Analyses(ANOVA or t-test) were conducted to examine the potential effects of demographic variables on K-DSI score. Internal consistency for reliability and Pearson's corelation coefficient with BDI, STAI, SRRS for convergent validity were computed. Percentile scores were calculated for daily and weekly K-DSI Event, Impact and I/E Ratio scores. Results : K-DSI scores in women were higher than those in men. According to age and educational level, the younger and the higher educational level the normative groups were, the higher were K-DSI scores. Among the 5 categories of the inventory, the category of cognitive stressors was highest. Internal consistency of K-DSI(Cronbach's $\alpha$) was .99. Daily and Weekly events and impacts scores were significantly correlated with the scores of State-Trait Anxiety Inventory, Social Readjustment Rating Scale, and Beck Depression Inventory. 75 percentile scores of the daily/weekly Events, Impacts, and I/E ratio were 17/118 - 124, 57/368 - 389 and 3.48 - 3.49/3.47 - 3.48 respectively. And 95 percentile scores of daily/weekly Events, Impacts, and I/E ratio were 57/151- 161, 405/1038 - 1122, and 4.72 - 4.86/4.46 - 4.56 respectively. Conclusion : Reliability and validity of K-DSI were tested satisfactorily. Authors presented the normative data of K-DSI for Koreans. K-DSI could be a useful measure in clinical settings or researches to assess the minor stressors frequently experienced in everyday life.

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A Study on Factors Impacting on the Mental Health level of the Elderly People Living Alone (독거노인의 정신건강 수준과 영향요인)

  • Han, Hyekyung;Lee, Yu-Ri
    • 한국노년학
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    • v.29 no.3
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    • pp.805-822
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    • 2009
  • This study aims to investigate the mental health level of the elderly people living alone and examine the difference in mental health level by socio-demographic factors and analyze the factors impacting on mental health level. The study subjects were 131 elderly people living alone who lived in "G" city. Symptom Check List-90-Revision(SCL-90-R) was used to measure mental health level. The results of this study were as follows. First, the study subjects' mental health level(3.53, 5 rating scale) was very severe and this means the mental health level of elderly people living alone is more severe than the mental health level of general elderly people. The study subjects showed depression symptom most seriously and also had severe somatization symptom. Second, there was significant difference in mental health level by gender and education level among socio-demographic factors. Third, in the final regression model, statistically significant factors impacting on the mental health level of the elderly people living alone were life satisfaction, ADL, IADL, welfare service support, informal support, contact frequency with children, duration of living alone, subjective state of economy. And comprehensive(macro and micro) implications were recommended.

Relationship between Insomnia and Depression in Type 2 Diabetics (2형 당뇨병 환자에서 불면증과 우울 증상의 관련성)

  • Lee, Jin Hwan;Cheon, Jin Sook;Choi, Young Sik;Kim, Ho Chan;Oh, Byoung Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.50-59
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    • 2019
  • Objectives : Many of the patients with type 2 diabetes are associated with sleep problems, and the rate of insomnia is known to be higher in the general population. The aims of this study were to know the frequency and clnical characteristics of insomnia, and related variables to insomnia in patients diagnosed with type 2 diabetes. Methods : For 99 patients from 18 to 80 years of age (65 males and 34 females) with type 2 diabetes, interviews were performed. Total sleep time and sleep latency was evaluated. Insomnia was evaluated using the Korean Version of the Insomnia Severity Index (ISI-K). Severity of depressive symptoms were evaluted using the Korean version of the Hamilton Depression Scale (K-HDRM). According to the cutoff score of 15.5 on the ISI-K, subjects were divided into the group of type 2 diabetics with insomnia (N=34) and those without insomnia (N=65) at first, and then statistically analyzed. Results : TInsomnia could be found in 34.34% of type 2 diabetics. Type 2 diabetics with insomnia had significantly more single or divorced (respectively 11.8%, p<0.05), higher total scores of the K-HDRS ($11.76{\pm}5.52$, p<0.001), shorter total sleep time ($5.35{\pm}2.00hours$, p<0.001), and longer sleep latency ($50.29{\pm}33.80minutes$, p<0.001). The all item scores of the ISI-K in type 2 diabetics with insomnia were significantly higher than those in type 2 diabetics without insomnia, that is, total ($18.38{\pm}2.69$), A1 (Initial insomnia) ($2.97{\pm}0.76$), A2 (Middle insomnia) ($3.06{\pm}0.69$), A3 (Terminal insomnia) ($2.76{\pm}0.61$), B (Satisfaction) ($3.18{\pm}0.72$), C (Interference) ($2.09{\pm}0.97$), D (Noticeability) ($2.12{\pm}1.09$) and E (Distress) ($2.21{\pm}0.81$) (respectively p<0.001). Variables associated with insomnia in type 2 diabetics were as following. Age had significant negative correlation with A3 items of the ISI-K (${\beta}=-0.241$, p<0.05). Total scores of the K-HDRS had significant positive correlation, while total sleep time had significant negative correlation with all items of the ISI-K (respectively p<0.05). Sleep latency had significant positive correlation with total,, A1, B and E item scores of the ISI-K (respectively p<0.05). Conclusions : Insomnia was found in about 1/3 of type 2 diabetics. According to the presence of insomnia, clinical characteristics including sleep quality as well as quantity seemed to be different. Because depression seemed to be correlated with insomnia, clinicians should pay attention to early detection and intervention of depression among type 2 diabetics.

Anxiety and Depression of The Korean Residents in China (중국 거주 조선인의 불안과 우울에 관한 실태)

  • SaKong, Jeong-Kyu;Cheung, Seung-Douk;Kim, Chang-Su;Kim, Cheol-Gu;Kim, Bong-Jin
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.275-287
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    • 1992
  • In order to survey the reality of anxiety and depression among the Koreans residing in China, a study was conducted between January and March of 1991, on the residents of Yun-Kil city, with subjects of 472 Koreans and 479 Chinese. The evaluation was based on the questionairs, named Combined self-rating anxiety depression scale(CADS), distributed among the subjects. ANOVA and t-test were applied for data processing. The results were as follows : There was not significant difference in the mean of total scores between the two groups. The scores of Koreans were $29.70{\pm}7.03$, while those of Chinese were $29.45{\pm}9.01$. The score of the CADS above 50(clinially significant level) was seen in 12(2.54%) Koreans and 21(4.38%) Chinese. The anxiety-depression scores relating to the items of indigestion and decreased appetite, sleep disturbance, apprehension, decreased libido were relatively high among the Koreans. The items appeared low in scores among the Koreans were faintness, fear, suicidal rumination, hopelessness, paresthesias. The highs among the Chinese were facial flushing, anxiousness, dissatisfaction, suicidal rumination. The items appeared low among the Chinese were fear, faintness, paresthesias, weight loss, suicidal rumination. In the comparison of evaluation by items between the two groups, the items placing the Koreans significantly higher over the Chinese are indigestion & decreased appetite, sleep disturbance, apprehension, decreased libido. The Chinese marked significantly higher in facial flushing, anxiousness, dissatisfaction, suicidal rumination. Those in the case of female (p<0.01 respectively), less than twenty years old (p<0.01 respectively), dissatisfied with family relationship(p<0.01 respectively), with past history of psychiatric hospitalization(Koreans p<0.01, Chinese p<0.05), pessimistic toward future, present, past self image(p<0.01 respectively) had significantly higher scores in both groups. In religion, neither group showed significant difference. In religion, neither group showed significant difference. In marital status, the Koreans showed a higher degree of divorce and separation and the Chinese in singleness(p<0.01 respectively). The Korean were higher in illiteracy and the Chinese had more college education(p<0.01 respectively). In place of growth, the Koreans showed not much difference in the areas while more Chinese grew up un large cities(p<0.01). More Koreans lived in the dormitory while the Chinese were engaged more in self-cooking(p<0.01 respectively). In pocket money per mouth, more Koreans were less than 1 dollar while the Chinese were between 7 and 10 dollars(p<0.01 respectively). There were no significant difference between two groups about religion.

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Relationship between Metabolic Syndrome and Cognitive Functions in Patients with Chronic Schizophrenia (만성 조현병 환자에서 대사증후군과 인지기능과의 연관성)

  • Kim, Kyung-Yoon;Kim, Shin-Kyum;Byun, Won-Tan;Lee, Duk-Ki;Jung, Bong-Joo;Park, Young-Min;Seo, Jae-Won
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.104-111
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    • 2014
  • Objectives : The aim of this study was to investigate the relationship between metabolic syndrome and cognitive functions among chronic schizophrenia patients. Methods : The survey participants were 105(40 metabolic syndrome and 65 non-metabolic syndrome) chronic schizophrenia patients at Yang-san Hospital. Each score of cognitive test(A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet, stroop test), Positive and Negative Syndrome Scale, Hamilton rating scale for Depression were assessed. Statistical analysis of the relationship between various tests of A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet and metabolic syndrome were performed using ANCOVA and logistic regression. Results : Schizophrenia patients with lower score on construction praxia were likely to be included in Metabolic syndrome group. However, there were no significant relationships in other tests between the two groups. Conclusions : This study found metabolic syndrome caused cognitive decline in chronic schizophrenia patients, especially Construction praxia. This study could be a basis to show metabolic syndrome has to be treated appropriately in schizophrenia patients and suggests the necessity of following longitudinal designed study.

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Validation Study of Behavior Problems Inventory-01 among Korean Children and Adolescents (한국판 문제행동 평가도구(Behavior Problems Inventory-01) 표준화 연구)

  • Choi, Miji;Kim, Yeni;Ban, Ji-Jeong;Hwang, Samuel Suk-Hyun;Kim, Bung-Nyun;Yang, Young-Hui
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.4
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    • pp.220-227
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    • 2017
  • Objectives: The purpose of this study was to examine the reliability and validity of the Korean version of the Behavior Problems Inventory (BPI-01) among children and adolescents aged between 3 and 18. Methods: The control group consisting of one hundred children and adolescents was recruited from schools and the patient group consisting of forty one children and adolescents with autism spectrum disorder were recruited from a hospital. We compared the measurements of both groups. To assess the concurrent validity of the BPI-01, we compared the problem behavior index of the Korean Scale of Independent Behavior-Revised (K-SIB-R) and, to assess the discriminant validity, we compared the Korean version of the Child Behavior Checklist (K-CBCL). The Cronbach's alpha of the BPI-01 was measured to assess its reliability. Correlation analyses between the BPI-01 and the other scale were carried out to examine the former's concurrent and discriminant validity. Results: The patient group showed a significantly higher score for all three subscales of the BPI than the control group. The Cronbach's alpha was 0.92 for the total severity score of the BPI and ranged between 0.67-0.89 for each subscale in the patient group. All subscales of the BPI-01's, i.e., self injurious behavior, stereotyped behavior and aggressive/destructive behavior, were significantly correlated with the corresponding subscales of the K-SIB-R. The BPI-01 generally did not demonstrate any significant correlation with emotional items such as anxiety/depression in the K-CBCL. Especially, the BPI-01's stereotyped behavior subscale showed little correlation with externalizing behaviors such as social problems and aggressive behaviors. Conclusion: This study found that the Korean version of BPI-01 is a reliable and valid behavior rating instrument for problem behavior in developmental disabilities among children and adolescents.

Effect of Auricular Acupress Therapy on Insomnia of Cancer Patients : Randomized, Single Blinded, Placebo Controlled Trial (이압요법이 암환자의 불면증에 미치는 효능 : 무작위배정, 단일맹검, 위약대조군 연구)

  • Jung, In-Sook;Kim, Jung-Sun;Yoo, Hwa-Seung
    • Journal of Pharmacopuncture
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    • v.13 no.2
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    • pp.93-100
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    • 2010
  • Background: Auricular acupressure is one of the traditional health care treatments in oriental medicine. Approximately, 30~40% of the cancer patients have said to be suffering from insomnia and half of them having chronic and severe insomnia at the same time. Insomnia caused cancer patients feel more pain, fatigue, depression and anxiety and it sometimes let the power to have the best of cancer pull down. Objective: To investigate how effective the auricular acupressure treatment to cancer patients suffering from insomnia. Methods: We recruited participants from East-West Cancer Center of Daejeon University. Finally, of the people whose age range from 20 to 75, 12 patients who got less than 40 points from the score of Oh's sleeping score (OSS) were recruited. Single-blind, randomized pilot study was performed. The treatment group received auricular acupressure treatment (AAT) on active points and the control group had received sham acupressure treatment (SAT) for five times. Sleep parameters were checked by using OSS and numeric rating scale (NRS). We checked the scale everytime, both before and after treatment. We analyzed the data statistically by using independent T-test, paired T-test and analysis of variance (ANOVA) test. (p<0.05) Results: Twelve cancer patients participated in this pilot study and there was no significant difference between control and treatment group. Only 7 of them had completed the whole treatment process, 4 patients of AAT group and 3 participants of SAT. The OSS of AAT group had increased from $34.0{\pm}4.3$ to $39.5{\pm}3.1$ and that of SAT group had increased from $38.3{\pm}3.5$ to $40.0{\pm}0.0$. There was no significant difference between them. The NRS of AAT group had increased from $6.3{\pm}2.9$, $04.8{\pm}2.1$ and that of SAT group had increased from $7.0{\pm}1.0$ to $5.0{\pm}2.6$. No significant difference was observed between them. Conclusion: Although both groups did not show significant differences, most of the experimental participants showed increasing OSS and NRS after treatments. Significant participants' number will be needed in the next study.