• Title/Summary/Keyword: Neuropsychiatric disorders

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Evaluation of Family Adaptability and Cohesion as Risk Factor of Postpartum Depression : Preliminary Study (산후우울증에서 위험인자로서의 가족응집성-적응력 평가 : 예비적 연구)

  • Kim, Bo-Rah;Suh, Shin-Young;Chang, Sung-Woon;Lee, Sang-Hyuk;Choi, Tae-Kyou;Kim, Yong-Woo;Cho, Sung-Joon;Yook, Keun-Young;Ryu, Mi;Kim, Myo-Jung;Kim, Keun-Hyang;Yook, Ki-Hwan
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.1
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    • pp.15-22
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    • 2009
  • Objectives : Prevalence of postpartum depressive disorders reaches approximately 10-15% of childbearing women. This preliminary study was intended to explore the relationships between postpartum depressive disorders and family adaptability and cohesion. Methods : Childbearing women(n=24) were assessed for risk factors for postpartum depression before and after childbirth prospectively. At gestational age between 36th and 40th week, the questionnaire about various factors before childbirth, Edinburgh postnatal depression scale(EPDS), Family adaptability-cohesion evaluation scale (FACES), and Beck anxiety inventory(BAI) were assessed. After childbirth, for the diagnosis of postpartum depressive disorders, a structured diagnostic interview according to MINI International Neuropsychiatric Interview was performed, furthermore, the questionnaire about various factors after childbirth, EPDS, and BAI were assessed at 4-6 weeks postpartum. Results : Among various factors and scales, family adaptability and cohesion, mood symptom and change during pregnancy were associated with postpartum depressive disorder in comparison with non-postpartum depressive disorder subjects. In addition, low family adaptability and cohesion and mood change during pregnancy were significantly associated factors with postpartum depressive disorder using logistic regression analysis. Conclusion : The results suggest the postpartum depressive disorder could be related with prenatal low family adaptability and cohesion. This preliminary study, however, includes only a few subjects, so that further large-sized study will be needed to replicate our results.

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

  • Lee, San;Oh, Seung-Taek;Ryu, So Yeon;Jun, Jin Yong;Lee, Kounseok;Lee, Eun;Park, Jin Young;Yi, Sang-Wook;Choi, Won-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.83-93
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    • 2016
  • Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.

Cognitive Impairment and Decreased Quality of Life in Elderly Patients with Subsyndromal Depression (노인 아증후군적 우울증 환자의 인지기능 및 삶의 질 저하)

  • Ryu, Jae Sung;Kim, Moon Doo;Lee, Chang In;Park, Joon Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.20 no.2
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    • pp.45-53
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    • 2013
  • Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation for Treatment of Depression and Latest Trends in TMS Techniques (반복 경두개자기자극술의 우울증 치료효과 및 최신동향에 대한 고찰)

  • Kim, Shin Tae;Kim, Hae Won;Kim, Se Joo;Kang, Jee In
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.95-109
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    • 2017
  • Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique which can change cortical excitability in targeted area by producing magnetic field pulses with an electromagnetic coil. rTMS treatment has been used to treat various neuropsychiatric disorders including depression. In this review, we evaluate the literature on rTMS for depression by assessing its efficacy on different subtypes of depression and different technical parameters. In particular, we focus on the results of randomized clinical trials and meta-analyses for depression after the US Food and Drug Administration approval in 2008, which acknowledged its efficacy and acceptability. We also review the new forms of rTMS therapy including deep TMS, theta-burst stimulation, and magnetic seizure therapy (MST) that have been under recent investigation. High frequency rTMS over left dorsolateral prefrontal cortex (DLPFC), low frequency rTMS over right DLPFC, or bilateral rTMS is shown to be effective and acceptable in treatment for patients with non-psychotic, unipolar depression either as monotherapy or adjuvant. Deep TMS, theta-burst stimulation and MST are promising new TMS techniques which warrant further research.

Development and Standardization of Modified Self-Assessment Manikin for Emotional Valence and Arousal Manikin (정서가 및 각성수준에 대한 자가 평가 마네킹 척도개발 및 표준화)

  • Kang, Eun-Ho;Choi, Jeong-Eun;Ham, Byung-Joo;Seok, Jeong-Ho;Lee, Kyoung-Uk;Kim, Won;Lee, Seung-Hwan;Lim, Hyun-Kook;Park, Young-Min;Yang, Jong-Chul;Ahn, Meekyung;Lee, Jae Seon;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.7 no.2
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    • pp.113-118
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    • 2011
  • Objectives : The Self-Assessment Manikin (SAM) developed by Bradley and Lang is a non-verbal pictorial assessment tool that measures human emotion and has been widely used. However, the pictures in SAM have not been easy for Korean subjects to understand or relate to. The authors developed a new manikin (Emotional Valence and Arousal Manikin, EVAS) modeling it after Korean faces while modifying and standardizing the SAM. Methods : Forty-one healthy subjects participated in this study. They were asked to rate the emotional valence and level of arousal using both the SAM and EVAS after being exposed to pictures of facial expressions for affective neurosciences-Korean version. The internal consistency of the EVAS and the correlation between EVAS and SAM were examined. Resuts : Internal consistencies of the valence using the EVAS were from 0.63 (surprise) to 0.82 (happiness) and those of the arousal were from 0.90 to 0.95. Correlation coefficients of the valence and arousal between the SAM and EVAS were from 0.61 (both surprise and disgust) to 0.84 (neutral) and from 0.82 (sadness) to 0.94 (fear), respectively. Conclusions : We developed a new manikin (the EVAS) for the Korean population modifying and standardizing the SAM. The EVAS demonstrated a good internal consistency and validity. As such, it can be used in the field of human emotion research.

Chronic Administration of Baicalein Decreases Depression-Like Behavior Induced by Repeated Restraint Stress in Rats

  • Lee, Bombi;Sur, Bongjun;Park, Jinhee;Kim, Sung-Hun;Kwon, Sunoh;Yeom, Mijung;Shim, Insop;Lee, Hyejung;Hahm, Dae-Hyun
    • The Korean Journal of Physiology and Pharmacology
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    • v.17 no.5
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    • pp.393-403
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    • 2013
  • Baicalein (BA), a plant-derived active flavonoid present in the root of Scutellaria baicalensis, has been widely used for the treatment of stress-related neuropsychiatric disorders including depression. Previous studies have demonstrated that repeated restraint stress disrupts the activity of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in depression. The behavioral and neurochemical basis of the BA effect on depression remain unclear. The present study used the forced swimming test (FST) and changes in brain neurotransmitter levels to confirm the impact of BA on repeated restraint stress-induced behavioral and neurochemical changes in rats. Male rats received 10, 20, or 40 mg/kg BA (i.p.) 30 min prior to daily exposure to repeated restraint stress (2 h/day) for 14 days. Activation of the HPA axis in response to repeated restraint stress was confirmed by measuring serum corticosterone levels and the expression of corticotrophin-releasing factor in the hypothalamus. Daily BA administration significantly decreased the duration of immobility in the FST, increased sucrose consumption, and restored the stress-related decreases in dopamine concentrations in the hippocampus to near normal levels. BA significantly inhibited the stress-induced decrease in neuronal tyrosine hydroxylase immunoreactivity in the ventral tegmental area and the expression of brain-derived neurotrophic factor (BDNF) mRNA in the hippocampus. Taken together, these findings indicate that administration of BA prior to the repeated restraint stress significantly improves helpless behaviors and depressive symptoms, possibly by preventing the decrease in dopamine and BDNF expression. Thus, BA may be a useful agent for the treatment or alleviation of the complex symptoms associated with depression.

Self-inflicted Tongue Ulceration in a Patient with Tourette Syndrome: A Case Report (뚜렛 증후군 환자에서 자해로 인한 혀 손상 : 증례 보고)

  • Lee, Kkotnim;Kim, Miae;Hwang, Inkyung;Park, Jihyun;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.3
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    • pp.327-333
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    • 2016
  • Tourette's syndrome is a chronic neuropsychiatric disorder characterized by the presence of vocal and multiple motor tics. Tics are defined as brief, intermittent, repetitive, unpredictable, purposeless, and stereotyped movements or sounds. Some patients experience physical pain from intense and complex tics. In addition, motor tics can result in self-injury which is a common feature of Tourette's syndrome. A 9-year-old boy was referred by the department of neuropsychiatry because of a severe tongue laceration. His parents reported that he had been biting his tongue irregularly for 2 months before referral and suffered from an intense burning sensation. The repeated biting resulted in ulcers on the tongue, which quickly worsened and led to progressive difficulty chewing and swallowing food. We offered to give him a two-piece removable appliance to limit tongue biting; it was made of soft silicone and fitted to both the maxillary and mandibular arches. As we emphasized that the device could help alleviate his pain, he agreed to accept it and adapted well. Just 3 weeks later, his tongue lesions had healed significantly.

The Differences of Depression, Anxiety and Positive Thinking between Adult and Elderly Hemodialysis Patients (투석 환자에서 연령에 따른 우울, 불안 및 긍정사고의 차이)

  • Noh, Ki-Won;Ha, Juwon;Lim, Se-Won;Lee, Jae-Eun;Lee, Kyu-Beck;Kim, Hyang;Oh, Kang-Seob
    • Anxiety and mood
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    • v.9 no.1
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    • pp.38-44
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    • 2013
  • Objective : The end-stage renal disease patients who shared fear of death, functional impairment due to hemodialysis are vulnerable to depression, anxiety and other mental problems. It is possible that their psychiatric characteristics and related autonomic nervous functions have some differences depending on their age. We purpose to find the differences of psychiatric characteristics and related autonomic nervous functions between adult and elderly hemodialysis patients. Methods : Our subjects are end-stage renal disease hemodialysis patients composed of 39 adults (<65 years) and 24 seniors (${\geq}65$ years). Outcome measures included the 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale and Mini-International Neuropsychiatric Interview by clinician. And subjects fulfilled self-report scale, The Positive thinking scale and The Snaith-Hamilton Pleasure Scale. The autonomic nervous functions are measured by heart rate variability. Results : There are no significant differences in demographic factors between two groups. The 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale, The Snaith-Hamilton Pleasure Scale and autonomic nervous functions are also not different. But only positive thinking scale is higher in adult hemodialysis group than the elderly (F=5.395, p=0.024). Conclusion : This study compared depression, anxiety and autonomic nervous functions between adult and senior hemodialysis patients. There are no significant differences in psychiatric characteristics and autonomic nervous functions between two groups except positive thinking traits. Senior patients endured their chronic disease similar to adult patients did in spite of their old age. This result suggests that elderly's higher positive thinking traits affect their endurances about the negative situations.

Limitations of neurobiological approach convergent to neuropsychiatry: DCD and two visual systems theory (신경정신학에 융복합되는 신경생물학적 접근법의 한계점: 발달성 협응장애와 두 시각 이론에 관한 종설)

  • Lee, Young-Lim
    • Journal of Digital Convergence
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    • v.13 no.6
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    • pp.225-234
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    • 2015
  • Neurobiological approach helps to resolve the mind-body dualism and develop new assessment and treatment approaches in psychiatry. However, it could be a problem to place too much emphasis on certain aspects of neurobiology, specifically structural neuroanatomy, because of the complexity or comorbidity of neuropsychiatric disorders. Developmental Coordination Disorder (DCD), for instance, is generally related to problems in motor skills and this movement disability is often related to perception. One account, two visual systems theory, relied on functional distinction in brain; ventral stream is responsible for visual recognition, and dorsal stream is responsible for the guidance of actions. However, Studies are now showing that shape perception is relevant to visually guided action, such as reaching-to-grasp an object. In this article, I reviewed fundamental findings of two-visual system theory and suggested problems of visually guided action to consider what shape perception implies for the two visual systems. Questions raised highlight possible limitations of adopting a structural neuroanatomical approach to account for perception and action effects, and by extent related psychiatric conditions such as DCD. In conclusion, neurobiological approach converging to neuropsychiatry, while useful, would be limited if it focuses too much on anatomical distinction.

Pattern of Computer Game Play and Emotional and Behavioral Characteristics in Upper Grade Elementary School Children (초등학교 고학년 아동의 컴퓨터 게임 양상과 정서 및 행동 특성)

  • Lee, Ja-Yeong;Park, Tae-Won;Lee, Moon-Sook;Cho, Eun-Cheong;Chung, Young-Chul;Hwang, Ik-Keun;Yang, Jong-Chul;Chung, Sang-Keun;Jung, Ae-Ja;Eun, Hong-Bae
    • Anxiety and mood
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    • v.4 no.2
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    • pp.135-141
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    • 2008
  • Objective : The purpose of this study was to investigate the relationship between the pattern of computer game play and emotional and behavioral characteristics of 5th and 6th grade elementary school children in Jeonju city. Methods : Fifth and sixth graders from two elementary schools (N=413, M=214, F=199) were chosen to participate in this study. The participants completed self-report questionnaires designed by the authors, and were also evaluated based on a computer game addiction scale, state-trait anxiety inventory for children, children's depression inventory and Piers-Harris children's self-esteem scale. The parents of the participants determined the disruptive behavior rating scale of the participants. Results : Positive links were reported between the pattern of computer game play (years of computer game experience, average length of each computer game play session, average time spent on computer game play per day, and average frequency of computer game play per week) and scores of computer game addiction scale. In addition, significant correlation was found between the internalized problems of children (trait anxiety, state anxiety, depression, and self-esteem), and computer game addiction scale score, among both sexes (p<0.01). There were significant correlations between game addiction scale score and inattention (p<0.01) as well as total attention deficit hyperactivity disorder (ADHD) score (p<0.05) in girls. Conclusion : Our findings suggest that computer game addiction is related to symptoms of internalizing, particularly to the trait anxiety. Significant positive correlations between game addiction scale score and externalized behavioral problems were found only in girls.

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