• 대한불안의학회지
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• 제10권2호
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• pp.108-114
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• 2014

Objective : The correlation between age of onset and symptoms/severity of panic disorder has not yet been determined. The aim of this research is to determine the different clinical features of panic disorder according to the age of onset. Methods : Patients diagnosed with panic disorder were placed into two groups according to onset of age. The subjects were checked for 13 different panic symptoms presented in the DSM-IV. The investigation was also executed by severity, the anxiety sensitivity index, the scale for depression and anxiety. Results : The early onset group had significantly higher frequencies than the late onset group in the areas of "choking feeling" and "derealization or paresthesia". It was found that only "choking feeling" was statically significant as a risk factor of early onset panic disorder. Among the objective anxiety scale, the subscale of psychological anxiety was higher in the early onset group compared to the late onset group. Conclusion : "Choking feeling" was the only panic symptom that showed a significant difference in accordance with onset age. Earlier onset patients tend to experience a more frequent "choking feeling," which is related to respiratory symptoms. This could mean that earlier onset patients are more likely to have higher psychological anxiety.

• 대한불안의학회지
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• 제10권1호
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• pp.44-51
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• 2014

Objective : The amygdala has been considered to be a critical region in the pathophysiology of social anxiety disorder, but subregional connectivity pattern has not been examined yet despite lots of previous functional neuroimaging studies. Methods : Resting-state functional magnetic resonance imaging data was obtained in 19 patients with social anxiety disorder and 20 normal controls, and default mode functional connectivity with each of basolateral, centromedial and superficial areas of the amygdala was measured and compared between the two groups. Results : Differential amygdala-based networks between the two groups were distributed to all over the brain. In particular, however, a bias on the amygdala-cingulate pathway was observed in the superficial amygdala only. Connectivity strengths between the superficial amygdala and perigenual anterior cingulate cortex were correlated with scores of social interaction and avoidance. Conclusion : Our findings provide new insights into understanding of the intrinsic cognitive bias model of social anxiety disorder. An abnormality in superficial amygdala-anterior cingulate connectivity may influence on cognitive processing of socially-relevant information in social anxiety disorder.

• 대한불안의학회지
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• 제7권1호
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• pp.9-15
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• 2011

Objectives : We examined the reliability and validity of the Korean version of the Depression and Somatic Symptom Scale (DSSS) in Korean patients with depressive symptoms. Methods : Participants were 55 outpatients diagnosed with major depressive disorder, a depressive episode of bipolar I disorder, somatoform disorder, panic disorder, generalized anxiety disorder, or post-traumatic stress disorder according to the DSM-IV criteria. We assessed them using the Korean versions of the DSSS, Hamilton Depression Rating Scale (HDRS), and Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR). Results : The Korean version DSSS had a Cronbach's alpha of 0.90. Moreover, each item's correlation with the total score was statistically significant (r=0.24-0.71, p<0.01). The test-retest correlation coefficient (r=0.83, p<0.01) was relatively high, and the DSSS correlations with the HDRS and QIDS-SR were 0.77 and 0.74, respectively. Conclusion : These results demonstrate that the Korean version of the DSSS could be a reliable and valid tool for screening and assessing depressive patients. The Korean version of the DSSS will be a useful tool for screening both depressive and somatic symptoms in Korea.

• 대한불안의학회지
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• 제11권1호
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• pp.33-37
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• 2015

Objective : Impaired response inhibition has been suggested to play an important role in the pathophysiology of obsessive-compulsive disorder (OCD). The aim of this study was to evaluate the response inhibition in patients with OCD, by using the Go/NoGo paradigm, and to better understand its associations with clinical symptoms. Methods : The participants included 63 OCD patients and 80 healthy volunteers matched in age and sex. response inhibition was evaluated using computerized Go/NoGo task, in which their commission error rates, omission error rates, and mean response times were measured. The severity of clinical symptoms in the OCD patients was assessed using Montgomery-Asberg Depression Scale and Yale-Brown Obsessive Compulsive Scale. Result : OCD patients showed significantly impaired inhibition and higher omission errors rates despite their slower response time, compared to normal controls. Clinical symptoms were not correlated with commission errors and omission errors. Conclusion : The present results indicate that impairment in response inhibition may play a critical role in the pathophysiology of OCD as a trait. These findings suggest that deficit of response inhibition may contribute to developing and maintaining clinical symptoms such as compelling need to repeat certain actions in patients with OCD.

• 대한불안의학회지
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• 제5권2호
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• pp.133-138
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• 2009

Diagnosing post-traumatic stress disorder (PTSD) is challenging for several reasons: a lack of training in trauma assessment for most clinicians, underreporting and avoidance by patients, the overlapping of symptoms, and a high comorbidity with other mental disorders. Thus, a careful evaluation and differential diagnosis are essential for the treatment and management of this population. A concept of posttraumatic reaction in people with narcissistic vulnerability, called Trauma-Associated Narcissistic Symptoms (TANS) had appeared in the literature; this has not been, however, systemically investigated. This study examines three cases of TANS that developed after traumatic events such as traffic accidents and physical assault. TANS may mimic PTSD and can show similar features; however, a careful attention to the context and meaning of symptoms can help the clinicians in differentiating TANS from PTSD. Clinicians working with trauma and compensation evaluators should be on alert for this easily overlooked condition.

• 대한불안의학회지
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• 제1권1호
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• pp.25-30
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• 2005

In the 40 years since the first benzodiazepine was brought into clinical use there has been a substantial growth in understanding the molecular basis of action of these drugs and the role of their receptors in anxiety disorders. Benzodiazepine receptors are present throughout the brain with the highest concentration in cortex, and it potentiate and prolong the synaptic action of the inhibitory neurotransmitter GABA. Central benzodiazepine receptors and $GABA_A$ receptors are part of the same macromolecular complex. Abnormalities of these $GABA_A$-benzodiazepine receptors as a result of drug challenge tests and neuroimaging studies may underlie some anxiety disorders. The role of $GABA_A$-benzodiazepine receptors in the action of benzodiazepine and as a factor in anxiety disorder, in both animal and humans including knock-out and knock in technique, may lead to new anxiolytics that have potentially significant therapeutic gains without unwanted side effects.

• 대한불안의학회지
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• 제6권1호
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• pp.31-36
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• 2010

Objective : Mismatch negativity (MMN) provides an electrophysiological index of an involuntary attention switching process. This study investigated MMN anomalies and their relationship to clinical variables in patients with obsessive-compulsive disorder (OCD). Methods : Study participants were 29 OCD patients and 24 normal controls. We used a 128-channel EEG to measure MMN during a passive oddball paradigm. Then we assessed the correlations between MMN amplitudes and clinical measures. Results : The OCD patients exhibited significantly greater MMN amplitude compared to the controls. Also, the right frontal lobe MMN amplitudes correlated significantly to the OCD patients' Yale-Brown Obsessive Compulsive Scale total scores (r=-0.520, p=0.005). Conclusion : These results suggest that MMN anomalies in OCD patients reflect a monitoring circuit dysfunction, raising the possibility that the OCD's pathophysiology includes glutamatergic dysfunction.

• 대한불안의학회지
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• 제6권1호
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• pp.3-9
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• 2010

Even experienced clinicians have difficulties in diagnosing posttraumatic stress disorder (PTSD) exactly, due to its diverse clinical features, which vary according to individuals, traumas, and various comorbid psychopathologies, and its related compensation issues. It is usually mandatory for clinicians and researchers to use screening and assessment tools when diagnosing and evaluating PTSD. To date, research has developed numerous PTSD screening and assessment tools ; therefore one of the cardinal issues is to select the best of the various tools, the one most suitable for the clinician's or researcher's purposes. This article reviews several currently-available subjective and objective instruments for the diagnosis and evaluation of PTSD and groups them according to whether they are Diagnostic and Statistical Manual for Mental Disorders-Correspondent Measures ; PTSD-Focused, Non-DSM-Correspondent Measures ; or Empirically Derived Measures. We present the instruments' psychometric properties and scoring methods and describe their merits and weak points, focusing on their practical usage.

• 대한불안의학회지
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• 제8권1호
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• pp.3-8
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• 2012

Patients with panic disoder (PD) show recollection of their first panic attack, which resembles a trauma that is perceived as an unexpected frightening and subjectively life-threatening event. Information-processing models suggest that anxiety disorders may be characterized by a memory bias for threat-related information. This paper reviews the previous researches that investigated the implicit and/or explicit biases in patients with panic disorder. Among the 17 studies, which addressed the explicit memory bias in PD patients, 11 (64.7%) were found to be explicit memory bias in PD patients. In regards to the implicit memory bias, 4 out of 9 studies (44.4%) were found to support the memory bias. The result shows that evidence of explicit memory bias in PD patients was supported by a number of previous researches. However, evidence of implicit memory bias seems less robust, thus, needs further research for replication. Also, development of new paradigms and applications of various methods will be needed in further researches on memory bias in PD patients.

• Journal of mucopolysaccharidosis and rare diseases
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• 제5권1호
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• pp.29-33
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• 2021

Prader-Willi Syndrome (PWS) is a neurodevelopmental genomic imprinting disorder involving a lack of gene expression from the paternal chromosome 15q11-q13 region. This is typically due to paternal 15q11-q13 deletions (in approximately 60% of cases), maternal uniparental disomy 15, or when both 15s are from the mother (about 35% of cases). An imprinting center controls the expression of imprinted genes in the chromosome 15q11-q13 region. PWS is a neurodevelopmental disorder characterized by mental retardation and distinct physical, behavioral, and psychiatric features. Characteristic behavioral disturbances in PWS include excessive interest in food, skin picking, difficulty with a change in routine, temper tantrums, obsessive and compulsive behaviors, and mood fluctuations. Individuals with PWS typically have intellectual disabilities (borderline to mild/moderate mental retardation) and exhibit a higher overall level of behavior disturbances compared to individuals with similar intellectual disabilities. This condition severely limits social adaptations and quality of life. Different factors have been linked to the intensity and form of these behavioral disturbances, but there is no consensus regarding the cause. Consequently, there is still controversy surrounding management strategies and there is a need for new data. PWS is a multisystem disorder. Family members, caregivers, physicians, dieticians, and speech-language pathologists all play an important role in the management and treatment of symptoms in an individual with PWS. Here we analyze behavioral problems in children and adults with PWS by age and review appropriate management and treatment strategies for these symptoms.