• Korean Journal of Biological Psychiatry
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• v.7 no.2
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• pp.131-139
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• 2000

Even the pharmacotherapy is more effective than placebo for the treatment of depression, the outcome of pharmacoltherapy remains unsatisfactory for many patients. Apart from side effects, there are two major limitations of antidepressant therapy. One is the delayed onset of improvement and another is partial response. In order to address these clinical dilemmas, many psychiatrists more commonly employ add-on therapy. In past, the practice of using multiple drugs to enhance treatment response was called polypharamcy, and was disparaged as poor clinical practice. However, with improved understanding of how drugs affects the central nervous system and increased communication in journals and on computer networks about the relative merits of specific combinations, the scientific basis for the combining drugs is being defined. Indeed, the use of multiple medications as a stratege to enhance response has become both acceptable and widespread now a days. It is now referred to more positively as add-on therapy, co-medication, combination therapy, or drug augmentation. Thus, as the methods of practical strategies for treatment of depression, switching classes antidepressant drugs, combination therapy, augmentation strategies and brief treatment algorithm will be presented with items of considerations. However, when combination of drugs being tried, knowledges about the action of mechanism, pharamcokinetics, and pharmacodynamics are essential to cope with the possible adversive reactions and to get the appropriate responses for the treatment of depressive symptoms.

• Korean Journal of Biological Psychiatry
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• v.8 no.2
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• pp.226-232
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• 2001

The pharmacotherapy of depression has reduced morbidity and improved outcome for many depressive patients. A wide range of classical and new antidepressants are available for their treatment. However, 30-40% of all patients do not respond sufficiently to the initial treatment and present adverse effects. Pharmacogenetics studies the genetic basis of an individual's ability to respond to pharmacotherapy. Recently, some reports on serotonin transporter gene polymorphisms and their influence on the response to antidepressive therapy provide an interesting diagnostic tool in assessing the chances of response to antidepressants. We also investigated the relationship between serotonin transprter polymorphisms(5-HTTLPR) and the long-term effect of the antidepressant treatment. 128 depressive patients were enrolled into 2nd year study. The therapeutic response of each subset was not different at 8th, 16th week, but the subset with homozygote(l/l) of long variant showed a better therapeutic response to antidepressant than the heterozygote(l/s) of long and short variant, which showed a better therapeutic response than the subset with homozygote (s/s) of short variant at 1st year and 2nd year after the antidepressant treatment. This result shows that the serotonin transporter polymorphisms may be related to the long-term effect of antidepressant treatment. The potential for pharmacogenomics, the use of genetic information to guide pharmacotherapy and improve outcome by providing individualized treatment decisions, has gained increasing attention. pharmacogenomics will contribute to individualize drug choice by using genotype to predict positive clinical outcomes, adverse reactions, and levels of drug metabolism. Personalized medicine, the use of marker-assisted diagnosis and targeted therapies derived from an individual molecular profile, will impact the antidepressant therapy and this approach will replace the traditional trial-and-error practice of medicine.

• Journal of People, Plants, and Environment
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• v.21 no.6
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• pp.557-564
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• 2018

Along with the aging society, the prevalence of dementia is also increasing. Dementia causes short-term memory loss as well as difficulties of performing daily activities and gradually causes suffering of the patients and their family. In spite of various programs for prevention of dementia of older people are being implemented, there is a lack of developing natural-based program for physical and mental health promotion. Therefore, it is necessary to develop programs for the elderly living alone who are more vulnerable to dementia because of their social and economic isolation. The purpose of this study was to develop a natural-based program and investigate the effects of 10 weeks forest therapy program for dementia prevention to improve the psychological and physical health of the elderly living alone. The experimental subjects were 30 elderly (aged 65 or older) and 31 elderly participated in control group. The Stress response, depressive symptoms, weight, body mass index (BMI), fat mass and muscle mass were measured for pre and post test. The results showed that the experimental group showed subjective stress relief (t=5.249, p=.000), improvement in symptoms of depression (t=4.152, p=.000), and decreases in weight (t=2.686, p=.012), BMI (t=2.629, p=.014) and fat mass (t=2.918, p=.007) after the forest therapy program. The experimental group showed lower stress reactions(t=-7.185, p=.000) and less depressive symptoms (t=-5.303, p=.000) than control group after participating the program. These results suggest that periodic forest exposure can help having less stressful and depressive status than non-forest exposure and the forest therapy program can reduce participants' psychological and physical risk factors of dementia.

• Clinical and Experimental Pediatrics
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• v.57 no.3
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• pp.153-156
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• 2014

Toxic epidermal necrolysis is an unpredictable and severe adverse drug reaction. In toxic epidermal necrolysis, epidermal damage appears to result from keratinocyte apoptosis. This condition is triggered by many factors, principally drugs such as antiepileptic medications, antibiotics (particularly sulfonamide), nonsteroidal anti-inflammatory drugs, allopurinol, and nevirapine. Lamotrigine has been reported potentially cause serious cutaneous reactions, and concomitant use of valproic acid with lamotrigine significantly increases this risk. We describe a case of an 11-year-old girl with tic and major depressive disorders who developed toxic epidermal necrolysis after treatment with lamotrigine, and who was diagnosed both clinically and pathologically. Children are more susceptible to lamotrigine-induced rash than adults, and risk of serious rash can be lessened by strict adherence to dosing guidelines. Unfortunately, in our case, the patient was administered a higher dose than the required regimen. Therefore, clinicians should strictly adhere to the dose regimen when using lamotrigine, especially in children.

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.766-779
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• 1999

The purpose of this study was to investigate the relationship between the burden on families who live with an elderly person suffering from senile dementia, and the degree of their depression. There were 400 participants in this study, staying in the Seoul and Kyonggi areas from August 1, 1997 to February 28, 1998. Among the group, 100 participants took care of their patient at home, and another 300 participants left 100 patient at a day-care center, 100 sanatorium for senile dementia(asylum for helpless elderly people), 100 an infirmary for elderly people. Eventually 242 subjects out of the 400 were selected for the data analysis. The Zarit (1980) tool was employed to measure the degree of burden and Zung's(1965) “Self-Rating Depression Scale” was employed for the data analysis. The data was analyzed, and the percentage, t-test, ANOVA and Person's Correlation Coefficient were calculated. The results are as follows : 1. The average degree of burden that care-giving families felt was 49.13, which is somewhat high. 2. The average degree of depression that care -giving families felt was 51.95, which is relatively high. 3. The degree of burden was directly affected by the relation with the patient(F＝2.48, P＜.05), and the socio-economic status of the family(F＝5.17, P＜.05). Its also affected by the patient's educational status(F＝2.17, P＜.05). 4. The degree of depression of the family was significantly dependent on sex(t＝-2.05, P＜.05), age (F＝2.99, P＜.05), the relationship with the patient(F＝3.65, P＜.01), socio-economic status (F＝7.74, P＜.001), occupation(t＝2.82, P＜.01), health status(F＝4.42, P＜.01), and the place of residence(F＝4.30, P＜.01), The patient characteristics was significantly dependent on his/her educational status(F＝3.85, P＜.01), the period of suffering from senile dementia(F＝2.47, P＜.05), and smoking habit(F＝6.17, P＜.001). 5. The relationship between the degree of burden and that of depression reads r＝0.43, which is statistically positive correlation in the high significant level. Upon analyzing the entire summation, most care-givers for elderly patients suffering from senile dementia lack time in caring for themselves. They also experience chronic fatigue and mental discomfort caused by the isolation from society, curtailment of certain activities, a sense of responsibility for their patients, and limits of their endurance in taking care of their patients over time. In conclusion, this study emphasizes the necessity for the following propositions : 1. In order to measure the degree of burden that Korean care-giving families undergo, a new tool must be developed on the basis of Korean culture. 2. An educational program based on the demands that care-giving families undergo must be developed, and its clinical effect also has to be examined.

• Korean Journal of Biological Psychiatry
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• v.17 no.4
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• pp.203-209
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• 2010

Objectives : Increasing evidence suggests the presence of neurobiological bases for temperamental characteristics in humans. Brain correlates of harm avoidance(HA) have been most extensively studied using functional and structural brain imaging methods due to its potential link with anxiety and depressive disorders. To date, however, we are not aware of any reports that have examined the potential relationship between HA levels and regional cortical thickness. The aim of the current study is to examine the cortical thickness which is associated with HA temperament in healthy young subjects. Methods : Twenty-eight young, healthy individuals(13 men and 15 women, mean age, $29.4{\pm}6.3$ years) were screened for eligibility and administered the Korean version of the Cloninger's Temperament and Character Inventory and underwent high-resolution structural magnetic resonance imaging scanning. Results : HA was associated with cortical thickness in the right superior frontal cortex and in the left parietal cortex, adjusted for age and sex and corrected for multiple comparisons using the permutation testing method. Conclusion : Individual temperamental differences in HA are associated with structural variations in specific areas of the brain. The fact that these brain regions are involved in top-down modulations of subcortical fear reactions adds functional significance to current findings.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.1
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• pp.61-74
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• 2004

Objectives：This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods：Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments；Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results：With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion：Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.

• Journal of Ginseng Research
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• v.3 no.1
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• pp.66-93
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• 1979

Panax ginseng C. A. Meyer, which has been known for more than EWO years. occupies a Particular prince in folk medicine as so called tonic remedy. The pharmacolgical investigations of ginseng, based on the scientific concepts and methodology, have been performed by many researchers through the past 50∼60 years at different parts of the world. The pharmacological action of Panax ginseng compiled from the numerous reports can be summarized as follows: 1. On central nervous system, the effect of Panax ginseng is timulatory in smaller doses and somewhat depressive in larger doses. From the psychopharmacological aspect, ginseng seems to increase the mental efficiency of man. 2. Ginseng has the effect tending to Protect organism from various physical and chemical stresses. 3. The growth and basal metabolic rates of experimental animals are stimulated by ginseng. Ginseng also prolongs the survival time of animals under adverse influences. 4. Increasing the physical and mental efficiency, ginseng postpones the onset of fatigue and increases the working capacities. 5. In the case of the intravenous administration of ginseng, a transitory and slight hypotensive effect is observed. These hypotensive effects seems to include that of a direct action and actions related to the release of histamine and/or serotonin by ginseng. 6. It is Presumed that ginseng lowers the elevated bleed ingar and cholesterol level. 7. Ginseng tends to increase the gastrointestinal motizity and tone 8. It is presumed that ginseng Promotes the iron metabolism and activates the hematopoietic factors. 9. Ginseng tends to stimulate the biosynthesis of nucleic acid and release of histamine and serotonin. 10. The toxicity end adverse reactions of ginseng appear to be nothing that warrants apprehension. 11. Anticancer erects of ginseng seem to be due to indirect action rather than direct action on cancer cell, by improving the host condition 12. Recent clinical trials of ginseng harts obtained sent good results, but Present trial is still limited in its range, so it is necessary to broaden the scope of trial covering many kinds of organs and diseases. From the above, although it appears that substantial advancements have been achieved in the studies on the Pharmacological actions of Panax ginseng there are many discrepancies noticed in the reported data. Furthermore the precise mechanisms of actions of ginseng are sometimes obscure, even unknown in other actions as the students stand now. The main reasons for this are considered to be that even though saponin has been identified at one of the active substances of ginseng, other components have not fully been identified and that the experimental approaches of the investigations varied with different researchers. Thus a thorough analysis of the chemical components and newer standardized concepts and metohds appear to be the pre-requisites for further study of the pharmacolgical effects and mechaisms of Panax ginseng.