• 생물정신의학
• /
• 제24권4호
• /
• pp.175-187
• /
• 2017

Transcranial direct current stimulation (TDCS) is a clinically safe and effective method of delivering weak electric current to modulate cortical activities. And based on the cumulating scientific evidences, the method is recommended to treat major depressive disorder (MDD) and other psychiatric disorders. In this paper, we review the development of TDCS in the rising field of neuromodulation. Then with suggested biochemical and physical mechanism of TDCS, we summarize the reported cases of using TDCS to alleviate major neuropsychiatric disorders. And, in particular, the treatment of MDD is highlighted as an illustrative example of using TDCS. We discuss here the therapeutic potentials of this method in psychiatry. And in closing remarks, we evaluate the current technical limitations and suggest the future directions of this method in both the clinical and research aspects.

• 정신신체의학
• /
• 제15권2호
• /
• pp.100-106
• /
• 2007

연구목적 : 본 연구는 주요 우울장애 환자들과 준임상적 우울증 환자들의 감정표현불능증 정도를 조사하기 위해 시행되었다. 방법 : 지역사회에 거주하는 386명(남/여=148/238, 평균 연령 : $43.0{\pm}13.9$, 연령 범위 : 19~79)이 연구에 참여했다. 구조화된 임상면담(Structured Clinical Inteview for DSM-IV, SCID)를 이용하여 주요 우울장애 및 기타 1축 정신질환을 진단했다. 우울증상를 평가하기 위해 역학연구센터 우울척도(the center for epidemiologic studies-depression scale, CES-D)를 자가 작성하게 했다. 감정표현불능증은 토론토 감정표현불능증 척도(Toronto alexithymia scale, TAS)로 평가했다. 주요 우울장애의 병력이 없는 이 중 SCID에서 경도 우울장애가 있거나, CES-D 점수가 16점 이상인 경우를 준임상적 우울증으로 정의했다. 주요 우울장애군, 준임상적 우울증군, 정상 대조군 세군으로 나누어 TAS 총점과 각 요인별 점수를 비교했다. 결과 : 전체 386명 중, 38명(9.8%)이 DSM-IV 주요 우울장애의 진단 기준에 부합하는 병력이 있었고, 57명(14.8%)이 준임상적 우울증군으로 분류되었다. 각 군간 TAS 총점($F_{2,383}=14.0$, p<0.01), 요인 1(감정인식의 장애) ($F_{2,383}=23.4$, p<0.01), 요인 2(감정표현의 장애)($F_{2,383}=7.8$, p<0.01)에 차이가 있었다. TAS 요인 3(외부지향적 사고)는 유의한 차이가 없었다($F_{2,383}=1.8$, p=0.16). 주요 우울장애군과 준임상적 우울증군은 모두 대조군에 비해 TAS 총점, 요인 1, 요인 2의 점수가 높았다(모두 p<0.01). 반면, 주요 우울장애군과 준임상적 우울증군은 TAS 총점 및 각 요인 점수에서 유의한 차이가 없었다. 결론 : 준임상적 우울증 환자는 우울증상이 없는 대조군에 비해 감정표현불능증이 더 심했다. 한편, 주요 우울장애와 준임상적 우울증은 감정표현불능증에서 유의한 차이가 없었다. 이러한 결과는 감정표현 불능증이 주요 우울장애 뿐아니라 준임상적 우울증과도 관계있음을 시사한다.

• 생물정신의학
• /
• 제25권3호
• /
• pp.60-71
• /
• 2018

Objectives A growing body of evidence has suggested that morphologic changes in cerebellum may be implicated with pathophysiology of major depressive disorder (MDD). The aim of this study is to investigate a difference in the volume and cortical thickness of the specific region of cerebellum between patients with MDD and healthy controls (HC). Methods A total of 127 patients with MDD and 105 HC participated in this study and underwent T1-weighted structural magnetic resonance imaging. We analyzed volume and cortical thickness of each twelve cerebellum regions divided by left and right and the volume and cortical thickness of the whole cerebellum from T1-weigted image of participants. One-way analysis of covariance was used to investigate the volume and cortical thickness difference of total and specific regions between two groups adjusting for age, gender, medication, and total intracranial cavity volume. Results We found that the patients with MDD had significantly greater volume in the left cerebellum lobule III region [false discovery rate (FDR)-corrected p = 0.034] compared to HC. Also, our findings indicate that cortical thickness of left lobule VIIB (FDR-corrected p = 0.032) and lobule VIIIB (FDR-corrected p = 0.032) are significantly thinner in the patients with MDD compared with the HC. No significant volume and cortical thickness differences were observed in other sub-regions of the cerebellum. The volumes and cortical thickness of whole cerebellum between patients with MDD and HC did not differ significantly. Conclusions We observed the region-specific volume and cortical thickness difference in cerebellum between the patients with MDD and HC. The results of our study implicate that the information about structural alterations in cerebellum with further replicative studies might provide a stepping stone toward a specific marker to diagnose MDD.

• 생물정신의학
• /
• 제14권4호
• /
• pp.262-267
• /
• 2007

The serotonin 6(5-HT6) receptor gene is a candidate gene for influencing the clinical response to treatment with antidepressants. The purpose of this study was to determine the relationship between the C267T polymorphism in the 5-HT6 receptor gene and the treatment response to citalopram in a Korean population with major depressive disorder(MDD). Methods : Citalopram was administered for 8 weeks to the 90 patients who completed study. 21-item Hamilton depression rating scale(HAMD-21) was used as a outcome measure. Results : We found that the genotype, allele, and allele-carrier distributions did not differ significantly between MDD patients and normal controls. A main effect of an interaction of genotype with time on the decrease in the HAMD-21 score during the 8 weeks study period was not found. ANOVA revealed no significant effects of the C825T polymorphism on the decrease in the HAMD-21 score at each time period. Conclusions : These results suggest that the C267T polymorphism in the 5-HT6 receptor gene is not associated with the treatment response to citalopram.

• 대한불안의학회지
• /
• 제3권1호
• /
• pp.26-31
• /
• 2007

Object : This study was designed to assess the change of heart rate variability (HRV) during stimulation test among the patients with major depressive disorder. Methods : 15 patients with major depressive disorder (MDD) and 15 normal controls were enrolled in this study. We sequentially measured HRV at baseline, during cognitive stimuli and emotional stimuli. Results : There are significant differences between the two groups in HRV index, TINN on baseline state and under cognitive stimulus. Conclusion : Stimulation protocol using HRV can be useful in estimating autonomic nervous function.

• 생물정신의학
• /
• 제21권1호
• /
• pp.14-20
• /
• 2014

Objectives The current study investigated the putative relationship between chronotype and suicidality or bipolarity in patients with major depressive disorder (MDD). Method Nineteen outpatients who met the criteria for MDD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision were recruited for the current study. The subjects were divided into two subgroups based on their Basic Language Morningness (BALM) scores (dichotomized according to the median BALM score). The Loudness Dependence of Auditory Evoked Potentials (LDAEP) was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents. In addition, K-Mood Disorder Questionaire (K-MDQ), Beck Scale for Suicidal Ideation (BSS), Beck Hopelessness Scale (BHS), Barratt Impulsiveness Scale (BIS) were applied. Results The K-MDQ, BSS, BHS, BIS score was higher for the eveningness group than for the morningness group. However, the LDAEP, Hamilton Depression Rating Scale, Hamilton Anxiety Scale scores did not differ significantly between them. There were negative correlations between the total BALM score and the total K-MDQ, BSS, and BHS scores (r=-0.64 and p=0.0033, r=-0.61 and p=0.0055, and r=-0.72 and p=0.00056, respectively). Conclusions Depressed patients with eveningness are more vulnerable to the suicidality than those with morningness. Eveningness is also associated with bipolarity.

• 한국산림과학회지
• /
• 제98권1호
• /
• pp.26-32
• /
• 2009

현대 사회에는 도시 생활과 환경으로 인한 건강 문제가 증가하고 있는데 자연환경은 이러한 문제에 좋은 대안으로 대두되고 있다. 특히 숲과 나무는 예전부터 치유를 위한 공간으로 알려져 왔다. 주요우울장애는 매우 일반적이고 만성적인 질병으로 치료방법에는 약물치료와 다양한 심리치료가 포함되어 있다. 그러나 이러한 치료들은 환자들의 기능과 활동을 복귀시키는 것 보다는 기분 증상을 치료하는 것에 집중되어 있다. 본 연구에서는 우울증 환자들의 재활을 위한 산림활동 심리프로그램을 개발하였다. 본 연구에는 약물치료로 우울 증상은 개선되었으나 활동과 기능이 회복되지 못한 9명의 우울증 환자들이 참여하였다. 산림치유 프로그램은 4회기가 진행되었으며 매 회기마다 환자들의 우울증상과 심박변이도를 측정하였다. 4주간의 산림활동 심리프로그램 후 HRSD(Hamilton Rating Scale for Depression)로 측정된 우울감이 유의하게 감소하였으며, 건강관련 삶의 질을 측정하는 SF-36의 하위 척도의 점수가 상승하였고 심박통일성이 증가하였다. 본 예비적 연구 결과, 산림환경을 이용한 활동과 심리치료적 프로그램은 약물치료 중인 우울증 환자들의 기능회복과 재발방지에 긍정적인 역할을 할 가능성을 확인하였다.

• Molecular & Cellular Toxicology
• /
• 제4권4호
• /
• pp.355-359
• /
• 2008

This study aimed to determine the relationship between the C825T polymorphism in the G-protein ${\beta}$3-subunit (GNB3) gene and the response to citalopram in a Korean population with major depressive disorder (MDD). Citalopram was administered for 8 weeks to the 84 MDD patients who completed this study. All subjects were examined using the Structured Clinical Interview for DSM-IV, and the severity of depression was assessed using the 21-item Hamilton Depression Rating (HAMD-21) scale. A main effect of an interaction of genotype with time on the decrease in the HAMD-21 score during the 8-week study period was not found. ANOVA revealed no significant effects of the GNB3 C825T polymorphism on the decrease in the HAMD-21 score at each time period. Although the C825T polymorphism of the GNB3 gene may affect the pathogenesis of MDD, our results do not support the hypothesis that this polymorphism is involved in the therapeutic response to citalopram in Korean patients with MDD.

• Molecular & Cellular Toxicology
• /
• 제4권1호
• /
• pp.1-4
• /
• 2008

The 5-HTT gene is a candidate gene for influencing the clinical response to antidepressant treatment. The purpose of this gene study was to determine the relationship between serotonin transporter gene polymorphism at the SLC6A4 and the response to citalopram in a Korean population with major depressive disorder (MDD). Citalopram was administered for 8 weeks to the 80 patients who completed this study. The severity of depression was assessed with the 21-item Hamilton Depression Rating scale, and the 5-HTTLPR genotypes in the patients were determined using the polymerase chain reaction. Our result did not showed significant differences in, allele, and carrier distribution between the normal group and MDD patients. This study suggest that polymorphism of the 5HTT gene was not associated with citalopram response to MDD in the Korean population.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제33권4호
• /
• pp.99-105
• /
• 2022

Objectives: Suicide is the leading cause of death among adolescents in South Korea, and depression and personality profiles have been identified as significant risk factors for self-injurious behavior. This study examined the influence of depressive mood and temperament/character on self-injury in adolescents. Methods: A total of 116 adolescents (aged 12-18 years) with a primary diagnosis of major depressive disorder (MDD) and their parents were enrolled in this study. The participants were divided into three groups based on adolescent's self-injury frequency, and their Children's Depression Inventory (CDI), Youth Self-Report (YSR), and Temperament and Character Inventory (TCI) scores were compared. Finally, mediation analysis was conducted to investigate the relationship between suicidal ideation and self-injury. Results: Of study participants, 75.9% answered that they had suicidal ideation, and 55.2% answered that they had engaged in self-injurious behavior in the last six months. There were significant differences in CDI and suicidal ideation among the groups. After adjusting for age and sex, mediation analysis indicated that depressive mood mediated the relationship between suicidal ideation and self-injury. Conclusion: This study emphasizes the importance of evaluating and managing depressive mood severity in adolescents with MDD as these factors partially mediate the transition from suicidal ideation to self-injury.