• Title/Summary/Keyword: Depressive episode

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A case of patient who have depressive episode mixed with organic depressive disorder (기질성 우울장애가 혼재된 우울증 환자 1례)

  • Seo, Won-Hee;Moon, Ik-Ryol;Kim, Jeong-Keun;Bae, Kyeong-Yeon;Heo, Yoon-Kyoung;Park, Hyeong-Seon
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.2
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    • pp.199-206
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    • 2003
  • Objective : This is a case report of the patient diagnosed as the depressive episode mixed with organic depressive disorder. Method : We treat the patient with herbal medication and gave acupuncture treatment about 5 weeks, the symptom of the patient improved. The herbal medication and acupuncture treatment which we gave patient was based on Oriental medical diagnosis. Results : The patient had been taken the western medical treatment for 2 months, the symptom of the patient was not improved. But after the Oriental medical treatment, the patient is on the improving state. Conclusion : In the treatment of the depressive disorder which is mixed with organic depressive disorder, we found that the Herbal medication and Acupuncture based on correct 'Byonjung(辦證)' help the care of depressive episode which is mixed with organic depressive disorder.

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A Case Study on a Patient with Major Depressive Episode of Bipolar II Disorder Treated with a Combination of Interpersonal and Social Rhythm Therapy and Korean Medicine (제2형 양극성 장애의 주요우울 삽화에 대한 복합 한방 치료 사례보고: 대인관계 및 사회적 리듬 치료와 변증 치료를 중심으로)

  • Lee, Ji-Yoon;Kim, Ju-Yeon;Jeong, Jin-Hyung;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.3
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    • pp.213-223
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    • 2020
  • Objectives: To determine treatment effects of a combination of interpersonal and social rhythm therapy and Korean medicine for a patient with major depressive episode of bipolar II disorder. Methods: A patient was treated with Korean medicine (acupuncture, herbal medicine, etc.) and interpersonal and social rhythm therapy (IPSRT) for four months. Pattern identification for depressive mood and sleep associated symptoms was evaluated using Patient Health Questionnaire-9 (PHQ-9) and Social rhythm metric II-5 (SRM II-5). Results: At the end of the treatment, depression and delayed sleep symptoms were improved and social rhythm was recovered to the regular range. The patient acquired an insight to his interpersonal tensions and conflicts. Conclusions: Korean medicine in combination with interpersonal and social rhythm therapy can be used to treat patients with major depressive episode of bipolar II disorder. More cases are needed to develop guidelines for treating bipolar disorder.

A Case Report on Patient of Acute paralyic ileus with past history of mild depressive episode (급성 마비성 장폐색 환자 치험 1례)

  • Mok, Na-rae;An, Hun-Mo;Lee, Gi-Seung
    • Journal of Korean Medical Ki-Gong Academy
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    • v.13 no.1
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    • pp.19-35
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    • 2013
  • Objective : The purpose of this case is to report the improvement of a patient with acute paralytic ileus with past history of mild depressive episode after acupuncture therapy and herbal medicine. Methods : We treated the patient, who had acute abdominal pain and were diagnosed as paralytic ileus, with acupuncture, herbal medicine and manipulation therapy. We observed changes of chief symptoms and abdominal states. Results : We treated the patient who had severe abdominal pain, constipation and anorexia caused by acute paralytic ileus. For about one month of the treatment, we had the improvement of the symptoms. Conclusions : This study suggests that Conservative korean medical treatment might be useful for abdominal pain caused by acute paralytic ileus, and make a patient feel psychological stability.

Korean Medication Algorithm for Bipolar Disorder 2018 : Children and Adolescents (한국형 양극성 장애 약물치료 알고리듬 2018 : 소아/청소년)

  • Shim, Se-Hoon;Bahk, Won-Myong;Yoon, Bo-Hyun;Jon, Duk-In;Seo, Jeong Seok;Kim, Won;Lee, Jung Goo;Woo, Young Sup;Jeong, Jong-Hyun;Kim, Moon-Doo;Sohn, Inki;Song, Hoo-Rim;Min, Kyung Joon
    • Mood & Emotion
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    • v.16 no.3
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    • pp.109-122
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    • 2018
  • Objectives : The objective of this study was to revise the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) 2014: Children and Adolescents. Methods : We performed the survey, using a questionnaire comprising 22 questions according to each situation, in children and adolescents with bipolar disorder. Results : First-line pharmacotherapeutic strategies for manic episode in children with bipolar disorder were a combination of mood stabilizer (MS) and an atypical antipsychotics (AAP), monotherapy with an AAP, risperidone, and aripiprazole. Aripiprazole was selected as first-line medication for depressive episode in children with bipolar disorder, and aripiprazole, and risperidone were selected as first-line at high-risk children. First-line pharmacotherapeutic strategies for manic episode in adolescents were a combination of MS and an AAP, monotherapy with an AAP valproate, lithium, risperidone (Treatment of Choice, TOC), aripiprazole, and quetiapine. First-line pharmacotherapeutic strategies for depressive episode in adolescents, were a combination of an atypical antipsychotics and lamotrigine, valproate, aripiprazole (TOC), risperidone, and quetiapine. For depressive episodes in adolescents at high risk for bipolar disorder, valproate, aripiprazole (TOC), and risperidone were selected as first-line medication. Conclusion : We expect that the present KMAP-BP 2018-children and adolescents, is useful for clinicians to treat children and adolescents with bipolar disorder.

Platelet BDNF Level in Patients with Acute Bipolar Manic Episode : The Preliminary Study (급성 조증 환자에서 혈소판 BDNF 농도에 대한 예비 연구)

  • Choi, Kwang-Yeon;Kim, Yong-Ku;Lee, Bun-Hee
    • Korean Journal of Biological Psychiatry
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    • v.16 no.3
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    • pp.205-211
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    • 2009
  • Objectives : Serum and plasma BDNF levels have been shown to be decreased in patients with mood disorder such as major depressive disorder and bipolar disorder. We investigated whether platelet BDNF levels would be lower in patients with acute bipolar manic episode compared with those of normal controls. Methods : BDNF levels were examined in platelet-rich plasma(PRP) and platelet-poor plasma(PPP) in 20 healthy controls and 20 hospitalized patients who were diagnosed as bipolar I disorder, most recent episode manic using a Structured Clinical Interview for DSM-IV. And severity of manic symptoms was measured using Young Mania Rating Scale(YMRS). Platelet BDNF level was calculated by subtracting PPP BDNF from PRP BDNF level, and dividing the result by the total platelet count, and it was expressed as pg/$10^6$ platelet. Results : Platelet BDNF levels were significantly lower in patients with acute bipolar manic episode(4.55${\pm}$3.36pg/$10^6$ platelet) than in normal controls(6.84${\pm}$2.32pg/$10^6$ platelet)(p=0.008). However we failed to reveal the significant negative correlation between platelet BDNF levels and YMRS scores in patients with acute bipolar episode. Conclusion : Our finding suggests that there is a decrease in the platelet BDNF of patients with acute bipolar manic episode.

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The Application of Multi-State Model to the Bipolar Disorder Study (양극성 장애 환자의 기분 전환 현상 연구를 위한 다단계 모형의 적용)

  • Kim, Yang-Jin;Kang, Si-Hyun;Kim, Chang-Yoon
    • The Korean Journal of Applied Statistics
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    • v.20 no.3
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    • pp.449-458
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    • 2007
  • Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in person's mood, energy, and ability to function. Compared with manic episode, the depression episode causes more serious results such as restless, loss of interest or pleasure, or thoughts of death or suicide and the cure rate of depression episode is lower than that of manic episode. Furthermore, a long term use of antidepressants in bipolar patients may result in manic episode. Our interest is to investigate the effect of antidepressant on switch of moods of bipolar patients and to estimate the transition probabilities of switch between moods, depression and (hypo) manic. In this study, three approaches are applied in terms of multi state model. Parametric model is applied using left censoring data and nonparametric model is implemented under illness-death model with counting process. In order to estimate the effect of covariates, a multiplicative model is used. These all methods have similar results.

The Comparison of the Short-Term Prognosis According to the Polarity of First Episode in Children and Adolescent with Bipolar Disorder : A Single Center Study (소아 청소년 양극성장애 환아군에서의 첫 기분 삽화의 극성에 따른 단기 예후 비교 : 단일 기관 연구)

  • Kweon, Kukju;Park, Subin;Lee, Soo-Min;Kim, Jae-Won;Shin, Min-Sup;Yoo, Hee-Jeong;Cho, Soo-Churl;Kim, Bung-Nyun
    • Anxiety and mood
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    • v.9 no.2
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    • pp.101-105
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    • 2013
  • Objectives : This study was conducted to evaluate the association between first episode polarity of pediatric bipolar disorder and prognosis. Methods : We analyzed the clinical records of 66 inpatient subjects with DSM-IV defined pediatric bipolar disorder. The patients were split into 2 groups according to the polarity of the illness onset [depressive onset (DO) vs. manic/hypomanic/mixed onset (MO)]. Clinical feature and prognosis were compared between the two groups of patients. Results : In our sample, 68% of patients experienced a depressive onset. In DO patients, rates of suicidal attempt, episodic illness course and comorbid disruptive behavior disorder were higher than rates in MO patients. Conclusion : Findings from this study suggest that polarity of illness onset may be useful in predicting the prognosis of pediatric bipolar disorder.

Turning on the Left Side Electrode Changed Depressive State to Manic State in a Parkinson's Disease Patient Who Received Bilateral Subthalamic Nucleus Deep Brain Stimulation: A Case Report

  • Kinoshita, Makoto;Nakataki, Masahito;Morigaki, Ryoma;Sumitani, Satsuki;Goto, Satoshi;Kaji, Ryuji;Ohmori, Tetsuro
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.494-496
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    • 2018
  • No previous reports have described a case in which deep brain stimulation elicited an acute mood swing from a depressive to manic state simply by switching one side of the bilateral deep brain stimulation electrode on and off. The patient was a 68-year-old woman with a 10-year history of Parkinson's disease. She underwent bilateral subthalamic deep brain stimulation surgery. After undergoing surgery, the patient exhibited hyperthymia. She was scheduled for admission. On the first day of admission, it was clear that resting tremors in the right limbs had relapsed and her hyperthymia had reverted to depression. It was discovered that the left-side electrode of the deep brain stimulation device was found to be accidentally turned off. As soon as the electrode was turned on, motor impairment improved and her mood switched from depression to mania. The authors speculate that the lateral balance of stimulation plays an important role in mood regulation. The current report provides an intriguing insight into possible mechanisms of mood swing in mood disorders.

Bright Light Therapy in the Morning or at Mid-Day in the Treatment of Non-Seasonal Bipolar Depressive Episodes (LuBi): Study Protocol for a Dose Research Phase I / II Trial

  • Geoffroy, Pierre Alexis;El Abbassi, El Mountacer Billah;Maruani, Julia;Etain, Bruno;Lejoyeux, Michel;Amad, Ali;Courtet, Philippe;Dubertret, Caroline;Gorwood, Philip;Vaiva, Guillaume;Bellivier, Frank;Chevret, Sylvie
    • Psychiatry investigation
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    • v.15 no.12
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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.

Reliability and Validity of the Korean Version of the Patient Health Questionnaire-9 (PHQ-9) (한글판 우울증 선별도구(Patient Health Questionnaire-9, PHQ-9)의 신뢰도와 타당도)

  • Park, Seung-Jin;Choi, Hye-Ra;Choi, Ji-Hye;Kim, Kun-Woo;Hong, Jin-Pyo
    • Anxiety and mood
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    • v.6 no.2
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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.