• Title/Summary/Keyword: Neuropsychiatric disorders

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Recent Advances in Diagnosis and Treatment of Alzheimer's Disease (알츠하이머병의 최신지견)

  • Lee, Jung Jae;Lee, Seok Bum
    • Korean Journal of Biological Psychiatry
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    • v.23 no.2
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    • pp.48-56
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    • 2016
  • Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.

Comparison of Suicide-Related Behaviors between Depressive Disorder Patients and Anxiety Disorder Patients (우울장애와 불안장애 환자들에서 자살관련 행동의 비교)

  • Shin, Ho-Chul;Lim, Se-Won;Oh, Kang-Seob
    • Anxiety and mood
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    • v.3 no.1
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    • pp.46-51
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    • 2007
  • Objectives : By comparing the prevalence rates of suicide-related behaviors (suicide ideation, plan and attempt) between depressive disorder and anxiety disorder patients, we tried to find the characteristics of suicide-related behaviors in these patients. Methods : Four hundred-three patients participated in the study and the prevalence rates of suicide-related behaviors were investigated using Korean version of Mini International Neuropsychiatric Interview plus. Pearson Chi-Square test was used to find the association between depressive or anxiety disorders and suiciderelated behaviors. Results : Statistically significant differences were found between depressive disorder group and anxiety disorder group in terms of suicide ideation ($X^2$=6.173, df=1, p=0.013) and suicide attempt ($X^2$=8.008, df=1, p=0.005). We also found that patients in depressive disorder group were more likely to have suicide ideation (Odds Ratio=2.049, 95% Confidence Interval=1.155-3.635), and attempt suicide (Odds Ratio=4.970, 95% Confidence Interval=1.466-16.845) than patients in anxiety disorder group. Conclusion : These findings suggest that suicide ideation and suicide attempt rates are higher in depressive disorders than in anxiety disorders.

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High-Resolution Microarrays for Mapping Promoter Binding sites and Copy Number Variation in the Human Genome

  • Albert Thomas
    • Proceedings of the Korean Society for Bioinformatics Conference
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    • 2006.02a
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    • pp.125-126
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    • 2006
  • NimbleGen has developed strategies to use its high-density oligonucleotide microarray platform (385,000 probes per array) to map both promoter binding sites and copy number variation at very high-resolution in the human genome. Here we describe a genome-wide map of active promoters determined by experimentally locating the sites of transcription imitation complex binding throughout the human genome using microarrays combined with chromatin immunoprecipitation. This map defines 10,567 active promoters corresponding to 6,763 known genes and at least 1,196 un-annotated transcriptional units. Microarray-based comparative genomic hybridisation (CGH) is animportant research tool for investigating chromosomal aberrations frequently associated with complex diseases such as cancer, neuropsychiatric disorders, and congenital developmental disorders. NimbleGen array CGH is an ultra-high resolution (0.5-50 Kb) oligo array platform that can be used to detect amplifications and deletions and map the associated breakpoints on the whole-genome level or with custom fine-tiling arrays. For whole-genome array CGH, probes are tiled through genic and intergenic regions with a median probe spacing of 6 Kb, which provides a comprehensive, unbiased analysis of the genome.

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Increased Frontal Gamma and Posterior Delta Powers as Potential Neurophysiological Correlates Differentiating Posttraumatic Stress Disorder from Anxiety Disorders

  • Moon, Sun-Young;Choi, Yoo Bin;Jung, Hee Kyung;Lee, Yoonji Irene;Choi, Soo-Hee
    • Psychiatry investigation
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    • v.15 no.11
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    • pp.1087-1093
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    • 2018
  • Objective Posttraumatic stress disorder (PTSD) is distinct from anxiety disorders in its etiology and clinical symptomatology, and was reclassified into trauma- and stressor-related disorders in DSM-5. This study aimed to find neurophysiological correlates differentiating PTSD from anxiety disorders using resting-state quantitative electroencephalography (qEEG). Methods Thirty-six patients with either PTSD or acute stress disorder and 79 patients with anxiety disorder were included in the analysis. qEEG data of absolute and relative powers and patients' medication status on the day of qEEG examination were obtained. Electrodes were grouped into frontal, central, and posterior regions to analyze for regional differences. General linear models were utilized to test for group differences in absolute and relative powers while controlling for medications. Results PTSD patients differed from those with anxiety disorders in overall absolute powers [F(5,327)=2.601, p=0.025]. Specifically, overall absolute delta powers [F(1,331)=4.363, p=0.037], and overall relative gamma powers [F(1,331)=3.965, p=0.047] were increased in PTSD group compared to anxiety disorder group. Post hoc analysis regarding brain regions showed that the increase in absolute delta powers were localized to the posterior region [F(1,107)=4.001, p=0.048]. Additionally, frontal absolute gamma powers [F(1,107)=4.138, p=0.044] were increased in PTSD group compared to anxiety disorder group. Conclusion Our study suggests increased overall absolute delta powers and relative gamma powers as potential markers that could differentiate PTSD from anxiety disorders. Moreover, increased frontal absolute gamma and posterior delta powers might pose as novel markers of PTSD, which may reflect its distinct symptomatology.

Heat Shock Proteins as Molecular Chaperons in Neuropsychiatry (열충격 단백질의 신경정신의학적 의의와 중요성)

  • Oh, Dong-Hoon;Yang, Byung-Hwan;Choi, Joonho
    • Korean Journal of Biological Psychiatry
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    • v.14 no.4
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    • pp.221-231
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    • 2007
  • Recent researches have shown that important cellular-based autoprotective mechanisms are mediated by heat-shock proteins(HSPs), also called 'molecular chaperones'. HSPs as molecular chaperones are the primary cellular defense mechanism against damage to the proteome, initiating refolding of denatured proteins and regulating degradation after severe protein damage. HSPs also modulate multiple events within apoptotic pathways to help sustain cell survival following damaging stimuli. HSPs are induced by almost every type of stresses including physical and psychological stresses. Our nervous system in the brain are more vulnerable to stress and damage than any other tissues due to HSPs insufficiency. The normal function of HSPs is a key factor for endogenous stress adaptation of neural tissues. HSPs play an important role in the process of neurodevelopment, neurodegeneration, and neuroendocrine regulation. The altered function of HSPs would be associated with the development of several neuropsychiatric disorders. Therefore, an understanding of HSPs activities could help to improve autoprotective mechanism of our neural system. This paper will review the literature related to the significance of HSPs in neuropsychiatric field.

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Neuralgic Amyotrophy of the Lower Extremity in a Neuropsychiatric Patient: A Case Report (신경정신병 환자의 하지에서 발생한 신경통성 근위축증: 증례보고)

  • Moon, Won Sik;Mo, Sang Jun;Bae, Min Joon;Hwang, Ki Hun
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.124-129
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    • 2018
  • Neuralgic amyotrophy (NA) is an idiopathic disease characterized by muscular atrophy accompanied by neuralgia, where acute pain in the limb, mostly including the shoulders, leads to muscle weakeness and atrophy in the limb days to weeks after the onset of pain. Although its exact pathogenesis is unknown, genetic and nongenetic factors, such as infection, surgery, and trauma are suspected contributors. We report this case as we diagnosed NA of the right lower limb via enhanced MRI as well as EMG and have followed up the patient's prognosis and radiologic changes for one and a half years. In addition, the patient had been diagnosed with neuropsychiatric disorders, such as major depressive disorder and somatic symptom disorder.

Therapeutic Application of Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation in Depression (우울증에서 비침습적 두뇌 자극 치료 : 경두개 자기자극과 경두개 직류자극)

  • Chae, Jeong-Ho
    • Journal of Korean Neuropsychiatric Association
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    • v.57 no.2
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    • pp.119-132
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    • 2018
  • Despite the fact that pharmacotherapy depressive disorders have proven efficacy, a substantial number of patients are resistant to conventional management. As neuroscientific research about pathophysiology of depression have accumulated, repeated transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have emerged as an important mechanism-based treatment modality. This overview provides a review of therapeutic application of rTMS and tDCS in patients with depression. The clinical and basic studies of rTMS and tDCS in depression were reviewed and integrated using a literature review and interview with experts. rTMS is a noninvasive procedure of a localized pulsed magnetic field to the surface of the head to cause a depolarization of neurons in the brain cortex. tDCS has a mechanism of modulating cortical excitability in a polarity-specific manner without eliciting action potentials. rTMS and tDCS seem promising for treating depression. Although therapeutic parameters and further technical improvement remain to be systematically investigated, rTMS and tDCS would be a safe and effective intervention to treat depression.

Two Cases of Systemic Lupus Erythematosus with Cerebrovascular Involvement (뇌 혈관계를 침범한 전신성 홍반성 루푸스 2례)

  • Kim, Bong-Jun;Lee, Eun-Young;Hong, Young-Hoon;Park, Ki-Do;Song, Young-Doo;Lee, Choong-Ki;Shim, Young-Ran
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.371-380
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    • 1998
  • Systemic lupus erythematosus(SLE) is an autoimmune disease which may affect many different organs and disclose various clinical manifestations. Recently central nervous system(CNS) involvement has been recognized as an increasingly significant contributor to morbidity and mortality of SLE. The clinical manifestations of CNS-lupus are highly variable and range from mild cognitive dysfunction, movement disorder, headache, psychosis to life-threatening stroke and coma. Among the neuropsychiatric disorders encountered in patients with SLE, cerebrovascular disease has been a relatively rare complication. The diagnosis and management of CNS-lupus is difficult because of the lack of useful diagnostic methods. If cerebrovascular involvement is suspected, aggressive treatment such as high dose steroid, immunosuppressive therapy, plasma exchange may be required to reduce high mortality rate. We experienced 2 cases cerebrovascular dis eases occurring in SLE patients which presented with various neuropsychiatric manifestations. They were diagnosed as CNS-lupus by neuropsychiatric symptoms, brain MRI, and BEG, and showed good response to high dose steroid pulse therapy.

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Eating Traits and General Psychopathology of Korean Males Who Show High Score on the Korean Version of Eating Attitudes Test-26 (한국판(韓國版) 식사태도(食事態度) 검사(檢査)-26에서 고득점(高得點)을 보인 한국(韓國) 일반(一般) 남성군(男性群)의 식사특성(食事特性)과 일반정신병리(一般精神病理))

  • Han, Ki-Seok;Lee, Young-Ho;Rhee, Min-Kyu;Park, Se-Hyun;Sohn, Chang-Ho;Chung, Young-Cho;Hong, Sung-Kook;Lee, Byung-Kwan;Chang, Phi-Lip;Yoon, A-Rhee
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.87-102
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    • 1999
  • Objectives : The purposes of this study were to estimate the prevalence rate of eating disorders in Korean males and to clarify their characteristics in sociodemograhic data, the eating traits, and general psychopathology through the comparison with those of female high scored group on the Korean version of Eating Attitudes Test-26(KEAT-26). Methods : Using a multi-stage questionnaire sampling method including area sampling, proportionated stratified sampling, and quota sampling, we surveyed a total of 4,400 Korean adults over 18 in a nationwide area(9 kus, 10 middle or small cities, and 17 kuns), obtaining usable responses on 3,896. Of the 3,062 subjects(1249 males and 1813 females) who were available for analysis, we ascertained 52 males and 208 females who had high score($\geq$ cutoff point 21) on the KEAT-26. Results : 1) The proportion of this high score group was 1.7% in male and 6.8% in female with a sex ratio(male versus female) of 1 : 4. 2) The mean age was higher in the male group than in the female group, although it was not statistically significant(p=0.0514). Mean Body Mass Index(BMI) of the male group was significantly higher than that of female group, and the number of male subjects with below 20 of BMI was also significantly lower than in the female group. 3) There were no significant difference in past history of physical illness between two groups. However, frequency of smoking and alcohol use, and mean amount of alcohol consumption per month were significantly higher in the male group than in the female group. There were no significant differences between the two groups on various socio-demographic correlates such as economic status, total duration of education, number of family, marital status, religious status, and area of residence, but the exception of being occupational status. 4) The 'Eating Habits Scale' score and score of 'preference for vegetables and fish, and dislike for sweet-tasting food' of the male group were significantly lower than those of the female group. Although there was no significant difference between the two groups in total scores of the KEAT-26, the mean score on 'pursuit of thinness' subscale was higher in the female group than in the male group, while scores of 'food preoccupation' and 'self-control' subscales were higher in the male group than in the female group. 5) Scores on 'psychoticism' was significantly higher in the male group than in the female group, although there were no significant differences between the two groups on 'locus of control for weight', 'depression' and 'hypochondriasis'. Conclusion : These results support a possibility of a high prevalence of eating disorders in Korean males. These results suggest that eating related characteristics of high scorer on the EAT are different by sex in spite of the same high score on the EAT, and also suggest that male patients with eating disorders have more serious personality pathology than female patients with eating disorders.

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Screening Tool for Anxiety Disorders: Development and Validation of the Korean Anxiety Screening Assessment

  • Kim, Yeseul;Park, Yeonsoo;Cho, Gyeongcheol;Park, Kiho;Kim, Shin-Hyang;Baik, Seung Yeon;Kim, Cho Long;Jung, Sooyun;Lee, Won-Hye;Choi, Younyoung;Lee, Seung-Hwan;Choi, Kee-Hong
    • Psychiatry investigation
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    • v.15 no.11
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    • pp.1053-1063
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    • 2018
  • Objective This study evaluated the psychometric properties of the Korean Anxiety Screening Assessment (K-ANX) developed for screening anxiety disorders. Methods Data from 613 participants were analyzed. The K-ANX was evaluated for reliability using Cronbach's alpha, item-total correlation, and test information curve, and for validity using focus group interviews, factor analysis, correlational analysis, and item characteristics based on item response theory (IRT). The diagnostic sensitivity and specificity of the K-ANX were compared with those of the Beck Anxiety Inventory (BAI) and Generalized Anxiety Disorder 7-item scale (GAD-7). Results The K-ANX showed excellent internal consistency (${\alpha}=0.97$) and item-total coefficients (0.92-0.97), and a one-factor structure was suggested. All items were highly correlated with the total scores of the BAI, GAD-7, and Penn State Worry Questionnaire. IRT analysis indicated the K-ANX was most informative as a screening tool for anxiety disorders at the range between 0.8 and 1.6 (i.e., top 21.2 to 5.5 percentiles). Higher sensitivity (0.795) and specificity (0.937) for identifying anxiety disorders were observed in the K-ANX compared to the BAI and GAD-7. Conclusion The K-ANX is a reliable and valid measure to screen anxiety disorders in a Korean sample, with greater sensitivity and specificity than current measures of anxiety symptoms.