• 제목/요약/키워드: Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV)

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경도인지장애에서 우울증 유병률과 관련요인 (Prevalence and Associated Factors of Depression in Mild Cognitive Impairment)

  • 이준호;최영민;변민수;최효정;백혜원;손보경;이동영
    • 노인정신의학
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    • 제18권2호
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    • pp.86-91
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    • 2014
  • Objective : The aims of this study were to investigate the prevalence of co-morbid depression and related factors of depression in mild cognitive impairment (MCI) patients. Methods : Nine hundred and six MCI individuals were included in this study. Depression was defined as major and minor depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Depression-related demographic and clinical factors were also explored through multivariate logistic regression analysis. Results : In MCI patients, the prevalence of depression as defined according to the DSM-IV diagnostic criteria was 1.8% for major depressive disorder, 11.4% for minor depressive disorder, and overall 13.2% for both. Multivariate logistic regression showed that increased prevalence of overall depression was associated with female gender and non-amnestic subtype of MCI. Conclusion : Our findings based on a large number of MCI subjects who visited memory clinic indicated that more than ten percent of MCI patients have comorbid depression. In addition, female and non-amnestic subtype of MCI patients seems to be more vulnerable to depression.

Sex differences in QEEG in adolescents with conduct disorder and psychopathic traits

  • Calzada-Reyes, Ana;Alvarez-Amador, Alfredo;Galan-Garcia, Lidice;Valdes-Sosa, Mitchell
    • Annals of Clinical Neurophysiology
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    • 제21권1호
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    • pp.16-29
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    • 2019
  • Background: Sex influences is important to understand behavioral manifestations in a large number of neuropsychiatric disorders. We found electrophysiological differences specifically related to the influence of sex on psychopathic traits. Methods: The resting electroencephalography (EEG) activity and low-resolution brain electromagnetic tomography (LORETA) for the EEG spectral bands were evaluated in 38 teenagers with conduct disorder (CD). The 25 male and 13 female subjects had psychopathic traits as diagnosed using the Antisocial Process Screening Device. All of the included adolescents were assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. The visually inspected EEG characteristics and the use of frequency-domain quantitative analysis techniques are described. Results: Quantitative EEG (QEEG) analysis showed that the slow-wave activities in the right frontal and left central regions were higher and the alpha-band powers in the left central and bitemporal regions were lower in the male than the female psychopathic traits group. The current source density showed increases in paralimbic areas at 2.73 Hz and decreases in the frontoparietal area at 9.37 Hz in male psychopathics relative to female psychopathics. Conclusions: These findings indicate that QEEG analysis and techniques of source localization can reveal sex differences in brain electrical activity between teenagers with CD and psychopathic traits that are not obvious in visual inspections.

안정화된 만성 조현병 환자에서 강박장애 증상이 삶의 질에 미치는 영향 (Impact of Comorbid Obsessive Compulsive Symptoms on Quality of Life in Stable Patients with Chronic Schizophrenia)

  • 문정윤;강석훈;석정호;김찬형;김태용;최진희;소형석
    • 대한불안의학회지
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    • 제13권2호
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    • pp.141-147
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    • 2017
  • Objective : This study aimed to evaluate the relationship between comorbid obsessive compulsive disorder (OCD) and quality of life in stable patients with schizophrenia. Methods : We interviewed 162 symptom-stable inpatients who have been on a constant dose of antipsychotics for at least 3 months prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as evaluated using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Further, all clinical and demographic data were collected and evaluated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), Korean Modification of the Scale to Measure Subjective Well-Being under Neuroleptic Treatment (KmSWN) and Korean Version Quality of Life Scale (K-QOLS) were performed. Independent t-test and Chi-square test were used to compare groups and regression analysis was done to assess the relationship between the Y-BOCS and quality of life. Results : Schizophrenia patients with OCD showed significantly earlier onset of schizophrenia, more severe psychiatric symptoms and lower quality of life, compared to those without comorbid OCD. OCD might be associated with lower quality of life in schizophrenia. Conclusion : Schizophrenia patients with OCD showed lower quality of life than those without OCD. In the treatment for schizophrenia, evaluation of OCD might be needed to improve their quality of life and social function.

조현병 환자의 아동기 외상과 정신작용약물 사용 경향에 대한 예비 연구 (A Preliminary Study of Childhood Trauma and Patterns of Psychotropic Medication Use in Patients with Schizophrenia)

  • 김총기;김대호;이현지;김양석
    • 생물정신의학
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    • 제23권3호
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    • pp.116-121
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    • 2016
  • Objectives Experience of early childhood abuse elevates the risk of developing schizophrenia in later period of life, incidence of psychiatric comorbidity, symptomatic severity and complexity. In this context, we hypothesized that the pattern of psychotropic medication used would reflect this; those with childhood trauma will received more types and higher doses of psychotropic medication. Methods From our database of 102 outpatients diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) schizophrenia, we analyzed experiences of childhood trauma measured by the Childhood Trauma Questionnaire-Short Form and types and dose of prescribed psychotropic medication. Results We found significant positive correlations between child sexual abuse and the number of psychotropic medications (p = 0.029) and between child emotional neglect and the number of psychotropic medications other than antipsychotics (p = 0.045). Conclusions This preliminary study suggests that the pattern of psychotropic use may be affected by types of childhood trauma. Further studies will have to shed light on mediating factors such as symptoms or comorbid conditions that lead to prescription of certain psychotropic class.

뚜렛 증후군에 대한 중의학 임상연구 동향 (Review of Clinical Studies on Traditional Chinese Medicine for Tourette Syndrome)

  • 김종환;조희근;설재욱
    • 동의신경정신과학회지
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    • 제28권4호
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    • pp.303-318
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    • 2017
  • Objectives: To establish a base for further research by reviewing studies on traditional Chinese medicine treatment for Tourette Syndrome. This is the purpose of this study. Methods: Clinical studies involving the effects of traditional Chinese medicine treatment for Tourette Syndrome, published January 2010~June 2017, were obtained from CNKI, Pubmed. Selected Studies were evaluated by the Jadad Scale. Results: Among a total of 252 articles, 39 articles that meet the criteria were selected. 'Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV)' was most frequently used as diagnosis criteria. 'Yale Global Tic Severity Scale (YGTSS)' was primarily used for outcome measurements. Most of the studies showed effective results of traditional Chinese medicine therapy. However, the quality of a selected clinical studies was low. Conclusions: Despite several limitations, various studies to prove limited yet effective traditional Chinese medicine treatment on Tourette Syndrome provides much significance. Subsequent studies conducted by the complementary systematic review and well-designed clinical trials using the methodological quality will be needed to more firmly validate the effect of traditional Chinese medicine therapy.

도시지역 노인들의 치매유병률에 관한 단면조사연구 (Prevalence of Dementia in the Elderly of an Urban Community in Korea)

  • 나덕렬;연병길;강연욱;민경복;이수현;이상숙;이미라;표옥정;박찬병;김선민;배상수;김동현
    • Journal of Preventive Medicine and Public Health
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    • 제32권3호
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    • pp.306-316
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    • 1999
  • Objectives: In Korea, as in most countries, there will be a sharp increase in the number of dementia patients in the near future. However basic data on dementia prevalence, which is important in defining epidemiologic characteristics and in implementing preventive strategy, are limited. This study was conducted to estimate the prevalence rate of dementia in the urban elderly aged 65 or older in Kwangmyung, Korea. Methods: A two phase design was used for case finding and case identification. In phase I, a representative sample aged 65 or older was selected and interviewed by door-to-door survey with a Korean version of the Mini-Mental State Examination (K-MMSE). In phase II, Of the 946 subjects interviewed in phase 1,356 elderly were randomly selected disproportionately according to K-MMSE score. Of these elderly, 223 (61.5%) underwent standardized clinical evaluations, including psychiatric interview, neurological examination, and neuropsychological assessment. Dementia was diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The diagnosis of Alzheimer's disease (AD) was made by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and feinted Disorders Association(NINCDS-ADRDA) criteria and vascular dementia (VD) by DSM-IV. Results: The overall weighted prevalence rate of all dementia among Kwangmyung residents aged 65 or older was 12,8%(age-adjusted rate: 13,0%, 95% Confidence Interval[CI]: 10.6-15.3%). Women had much higher prevalence rate than men even when age was controlled(15.9%[95% CI 12.6-19.2%] vs 7.5%[95% CI 4.0-10.4%]), The rates of dementia were 5.2%, 12.2%, 17.0%, and 34.3% for the age groups of 65-69, 70-74, 75-79 and 80 and over, respectively. The rate of AD appeared to be slightly higher than that of VD(5.2% vs 4.8%), though not statistically significant. Most of the cases(69%) were mild dementia according to CDR(<1) in these subjects. Conclusions : These results showed that the prevalence rate of dementia among urban elderly in Korea appears to be higher than those of other Asian countries.

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Seropositivity and Serointensity of Toxoplasma gondii Antibodies and DNA among Patients with Schizophrenia

  • Omar, Ainsah;Bakar, Osman Che;Adam, Nor Fatini;Osman, Hakim;Osman, Arina;Suleiman, Ahmad Hatim;Manaf, Mohd Rizal Abdul;Selamat, Mohd Ikhsan
    • Parasites, Hosts and Diseases
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    • 제53권1호
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    • pp.29-34
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    • 2015
  • The aim of this cross sectional case control study was to examine the serofrequency and serointensity of Toxoplasma gondii (Tg) IgG, IgM, and DNA among patients with schizophrenia. A total of 101 patients with schizophrenia and 55 healthy controls from Sungai Buloh Hospital, Selangor, Malaysia and University Malaya Medical Center (UMMC) were included in this study. The diagnosis of schizophrenia was made based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The presence of Tg infection was examined using both indirect (ELISA) and direct (quantitative real-time PCR) detection methods by measuring Tg IgG and IgM and DNA, respectively. The serofrequency of Tg IgG antibodies (51.5%, 52/101) and DNA (32.67%, 33/101) among patients with schizophrenia was significantly higher than IgG (18.2%, 10/55) and DNA (3.64%, 2/55) of the controls (IgG, P=0.000, OD=4.8, CI=2.2-10.5; DNA, P=0.000, OD=12.9, CI=2.17-10.51). However, the Tg IgM antibody between patients with schizophrenia and controls was not significant (P>0.005). There was no significant difference (P>0.005) in both serointensity of Tg IgG and DNA between patients with schizophrenia and controls. These findings have further demonstrated the strong association between the active Tg infection and schizophrenia.

조기 발병 조현병과 성인기 발병 조현병의 임상적 특성의 비교 : 후향적 연구 (Comparison of Clinical Characteristics between Patients with Early-Onset and Adult-Onset Schizophrenia : A Retrospective Study)

  • 김평순;신재호;이창화
    • 생물정신의학
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    • 제20권4호
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    • pp.179-186
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    • 2013
  • Objectives This study is designed to compare the clinical characteristics of patients with early onset schizophrenia to those of adult onset schizophrenia patients in first episode. Methods Authors reviewed medical records of 16 early-onset schizophrenia patients and 22 adult-onset schizophrenia patients who had been admitted in the psychiatric ward and diagnosed as schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, fourth Edition (DSM-IV) at Eulji University Hospital during 2004-2008. Socio-demographic data and clinical characteristics such as duration between onset and active phase, number of significant positive and negative symptoms, positive and negative symptom scores of Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S) scores, duration from onset to admission, duration of admission, and equivalent dose of antipsychotics were reviewed. These clinical characteristics of early-onset group were compared to those of adult-onset group. Correlation between age of onset and other clinical characteristics was also analyzed. Results Early-onset group showed more insidious onset pattern and had longer duration of hospitalization than adult-onset group. Early onset group also exhibited more negative symptoms, higher negative symptom scores, and higher CGI-S scores than adult-onset group after treatment. However, there were no significant differences in family history of psychosis, positive symptom frequency at discharge and equivalent dose of antipsychotics between two groups. Conclusions This study revealed that patients with early-onset schizophrenia exhibited more insidious onset, more negative symptoms, and more severe symptoms than those with adult-onset schizophrenia after treatment.

알코올의존으로 입원한 환자에서 나이와 성별에 따른 퍼센트 탄수화물-결핍트랜스페린과, 감마-글루타밀전이효소 변화 양상의 차이 (The Alteration of % Carbohydrate-Deficient Transferrin and Gamma-Glutamyl Transferase Levels of Alcohol-Dependent Inpatients according to Age and Sex)

  • 진교식;이중서;이병철;김지욱;최인근
    • 생물정신의학
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    • 제24권4호
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    • pp.219-224
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    • 2017
  • Objectives This study sought to investigate the relationship between age, sex and alterations in levels of % carbohydrate-deficient transferrin (%CDT) and gamma-glutamyl transferase (GGT) in patients admitted with alcohol dependence. Methods The study retrospectively enrolled 187 patients who were diagnosed with alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth edition (DSM-IV) and were admitted into a closed ward in Hallym University Hangang Sacred Heart Hospital from 2009 to 2012 and Hallym University Kangnam Sacred Heart Hospital from 2012 to 2017. Demographic factors (age, sex) and biochemical markers [%CDT, GGT, mean corpuscular volume (MCV), aspartate transferase (AST), alanine transferase (ALT)] were collected by reviewing medical records. Alterations in the levels of %CDT and GGT in different groups for each demographic factor were compared after correcting for confounding variables (age, initial %CDT, GGT, MCV, AST, ALT). Results Decreased %CDT and GGT were observed during the period of abstinence after admission. The normalization period for %CDT increased with age, while the normalization period for GGT was longer in female patients. Conclusions These results suggest that alcohol-dependent patients that vary in age have different alterations in %CDT, while different sexes have different alterations in GGT. Age and sex can be potential indicators of treatment response after abstinence in patients with alcohol dependence. Further studies are needed to evaluate the relationship between these factors with regards to physiological and hematological changes in alcohol dependence.

한국판 역학연구 우울척도 개정판(K-CESD-R)의 표준화 연구 (Validation of the Korean version of Center for Epidemiologic Studies Depression Scale-Revised(K-CESD-R))

  • 이산;오승택;류소연;전진용;이건석;이은;박진영;이상욱;최원정
    • 정신신체의학
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    • 제24권1호
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    • pp.83-93
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    • 2016
  • 연구목적 역학연구 우울척도 개정판은 우울 증상을 평가하는 데에 유용성이 입증된 척도로 알려져 있으며 '정신장애의 진단 및 통계 편람 제4판(DSM-IV)'에 기술되어 있는 주요우울장애의 주요한 우울 증상들을 포괄하고 있다. 이 연구에서는 한국판 역학연구 우울척도 개정판을 제작하여 척도의 신뢰도, 타당도와 특성을 평가하고자 하였다. 방 법 DSM-IV의 진단기준에 근거한 MINI를 사용하여 주요우울증, 기분부전증, 달리 분류되지 않는 우울장애로 진단된 48명의 환자군과 48명의 정상 대조군이 연구에 참여하였다. 연구 참여자들은 한국판 역학연구 우울척도 개정판, 몽고메리-아스버그 우울증 평가척도, 우울증 선별척도, 단축형 우울증상 평가 척도, 상태-특성 불안척도를 포함한 척도검사를 시행하여 교차 검증하였다. Cronbach's alpha 계수, Pearson 상관계수, 주성분 분석, Receiver Operating Characteristic(ROC) 곡선, 최적 절단점 산출을 위한 통계분석을 시행하였다. 결 과 한국판 역학연구 우울척도의 Cronbach's alpha 계수는 0.98이었으며, 한국판 역학연구 우울척도 개정판의 총점은 본 연구에서 시행하였던 다른 우울 및 불안척도의 점수와 높은 상관 관계를 보였다. 주성분 분석에서는 두 요인이 전체 분산의 76.29%를 설명하였으며, ROC 곡선을 이용하였을 때, 한국판 역학연구 우울척도 개정판의 최적 절단점은 13점이었다. 결 론 본 연구는 한국판 역학연구 우울척도 개정판의 표준화를 위한 첫 번째 연구로, 한국판 역학연구 우울척도는 우울 증상을 평가하는데 있어 신뢰성 있고, 타당한 척도임을 밝혔다. 또한 이 척도가 진료 및 역학 연구에서 유용한 선별검사 도구로 사용될 수 있을 것으로 기대한다.