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Trait Anxiety as a Mediator of the Association between Attention Deficit Hyperactivity Disorder Symptom Severity and Functional Impairment

  • Oh, Yunhye;Yoon, Hee Joon;Kim, Ji-Hae;Joung, Yoo Sook
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.407-414
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    • 2018
  • Objective: Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined. Methods: The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners' Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson's correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses. Results: Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales. Conclusion: Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.

The Correlation between Severity of Sleep Apnea, Sleep and Mood Related Scales, and Activity During Sleep in Obstructive Sleep Apnea Syndrome Patients (폐쇄성 수면무호흡증 환자에서 수면무호흡 정도, 수면 및 기분관련 척도, 수면중 활동도 간의 연관성)

  • Han, Kyu-Hee;Soh, Min-Ah;Ha, Jee-Hyun;Ryu, Seung-Ho;Yu, Jae-Hak;Park, Doo-Heum
    • Sleep Medicine and Psychophysiology
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    • v.18 no.2
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    • pp.76-81
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    • 2011
  • Objectives: This study aims to analyze the association between the severity of sleep apnea, sleep and mood related scales, and activity during sleep in obstructive sleep apnea syndrome (OSAS) patients. Methods: 176 drug-free male patients confirmed as OSAS (average age=$43{\pm}11$ years) were selected through nocturnal polysomnography (NPSG). OSAS was diagnosed with apnea-hypopnea index (AHI) >5, mean AHI was $39.6{\pm}26.0$. Sleep related scales were Stanford Sleepiness Scale (SSS), Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Index (PSQI) and Morningness-Eveningness Scale (MES). Mood related scales were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI) I, II and Profile of Mood States (POMS). NPSG was performed overnight with both wrist actigraphy (WATG). Parameters produced from WATG were total activity score, mean activity score and fragmentation index. We analyzed the correlation between each scale, AHI scored from NPSG and activity score analyzed from WATG. Results: ESS showed significant positive correlation with PSQI, BDI, BAI and STAI I, II, respectively (p<0.01). SSS showed significant positive correlation with PSQI and BAI (p<0.05, p<0.01). BAI showed significant positive correlation with total activity score, mean activity score and fragmentation index (p<0.05, p<0.01, p<0.05).Total activity score showed significant positive correlation with ESS and BAI, respectively (p<0.05). Fragmentation index showed significant positive correlation with ESS, PSQI and BAI (p<0.05, p<0.01, p<0.05). AHI, indicator of sleep apnea is showed no significant correlation with each sleep and mood related scale. Conclusion: The degree of daytime sleepiness tends to be associated with night sleep satisfaction, depression and anxiety, and the activity during sleep rather than the severity of sleep apnea.

Difference of Anxiety of Parents: before & after the VCUG (배뇨요도방광조영술 검사 전후 부모의 불안감에 대한 비교)

  • Lee, Na-Ra;Oh, Jung-Min;Yim, Hyung-Eun;Yang, Jae-Won;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.62-70
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    • 2010
  • Purpose : The voiding cystourethrogram (VCUG) is the investigation of choice in detecting the vesicoureteral reflux in urinary tract infections in children. As it is a potentially distressing and invasive test, most of the parents are so concerned about the child's stress. In this study, we compared the difference of the state of anxiety of parents before and after the VCUG. Methods : We divided 68 parents whose children underwent VCUG into 2 groups; who have given an explanation about VCUG in detail using pictures (group 1) Vs. who have given an oral explanation only (group 2). All the parents submitted the same questionnaire 2 times before and after the VCUG, which consisted of State-Trait-Anxiety-Inventory X-I (STAI-X-I) and visual analog scale (VAS) on the perception of worry, anxiety, confusion and pain. Results : Before VCUG, the perception of pain was higher in group 1 (P<0.05). After VCUG, the anxiety and confusion were significantly higher in group 2 than group 1 (P<0.05). In group 1, STAI-X-I scores, the perception of worry and anxiety were significantly decreased after the VCUG (P<0.05). In group 2, the confusion and pain were increased after VCUG (P<0.05). Conclusion : It showed that doctor's explanation on the procedure in advance may raise the perception of pain and the possibility of refusal by parents. But the STAI-X-I, worry, anxiety after VCUG were significantly decreased in group 1, while the confusion and pain were increased in group 2. Therefore we suggest that prior and sufficient explanation about invasive procedure like VCUG can be helpful in ameliorating the anxiety of the parents.

DEVELOPMENT OF KOREAN FORM OF CHILDREN'S YALE-BROWN OBSESSIVE-COMPULSIVE SCALE(CY-BOCS):A RELIABILITY AND VALIDITY STUDY (한국판 아동용 예일-브라운 강박 척도 ; 신뢰도와 타당도 연구)

  • Lee, Jeoung-Seop;Kang, Yun-Hyong;Cho, Seong-Jin;Suh, Dong-Hyuck;Hong, Kang-E;Chung, Sung-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.60-69
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    • 2000
  • Objective:This study was carried out to evaluate the reliability and validity of the Korean form of the Children's Yale-Brown Obsessive Compulsive Scale(CY-BOCS). Method:Forty-two children with obsessive-compulsive disorder(OCD)(31 boys and 11 girls, aged 7 to 18 years) were assessed with CY-BOCS. Interrater agreement was assessed by two raters in subsample(n=20). discriminant and convergent validity were assessed by comparing CY-BOCS scores to Clinical Global Impression-OCD(CGI-OCD), Leyton Obsessional Inventory-Child Version (LOI-CV), State-Trait Anxiety Inventory for Children(STAI-C), and Child Depression Inventory(CDI). Results:Internal consistency was high, measuring 0.86 for the 10 items and total score. The intraclass correlations for the CY-BOCS total, obsession, and compulsion scores were 0.94, 0.94, 0.84, suggesting excellent interrater agreement for subscale and total scores. The CY-BOCS total score showed highest correlation with CGI-OCD(r=0.88), and significant correlation with LOI-CV(r=0.51), Trait Anxiety score(r=0.43), and CDI scores(r=0.49), but it was not correlated with State-Anxiety score(r=0.25). Conclusion:The results of this study indicate that the Korean form of CY-BOCS is a reliable and valid scale for rating obsessive-compulsive symptom severity.

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Uncertainty, Medical Staff's Support, and Anxiety Perceived by Family Members with Patients Undergoing Surgery for Cancer (암환자가족이 지각하는 수술대기중 불안과 불확실성 및 의료인의 지지)

  • Shin, Sun-Mi;Lee, Eun-Nam;Kang, Ji-Yeon
    • Asian Oncology Nursing
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    • v.6 no.1
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    • pp.15-26
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    • 2006
  • Purpose: This study was to assess relationships among the uncertainty, medical staff's support, and anxiety perceived by family members with cancer patients while the family members were waiting for their patients undergoing surgery. Method: The data were collected from the family members of cancer patients who were undergoing surgery in D University Hospital at B city from February 1 to April 12, 2005. The used instruments were the State Anxiety Scale of Spielberger's(1975) STAI, Mishel's Uncertainty in Illness Scale (MUIS)(1981), and Relationship Questionnaires (Lee, 1978). The collected data was analyzed by using t-test, ANOVA, Pearson's coefficients, and stepwise multiple regression. Results: As the result, the most influential variable explaining anxiety of family members was uncertainty $({\ss}=0.37)$, followed by perceived illness state $({\ss}=-0.27)$. These two variables simultaneously explained 29.3% of the variance in anxiety. Conclusion: We suggest to develop a nursing intervention program to reduce the uncertainty through the medical staff's support and o test its effects.

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Effect of Korean Red Ginseng on Psychological Functions Patients with Severe Climacteric Syndromes : A Comprehensive Study from the Viewpoint of Traditional KAMPO-medicine and Western Medicine

  • Tode, Takehiko;Kikuchi, Yoshihiro
    • Journal of Ginseng Research
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    • v.27 no.3
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    • pp.110-114
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    • 2003
  • Objective; Antistress effect of Korean red ginseng (RG) on postmenopausal women with severe climacteric syndrome (CS) were evaluated from the viewpoint of traditional KAMPO-medicine and Western medicine. Methods; All patients with CS were treated with daily oral administration of 6g RG for 30 days. Nine patients with CS were evaluated with the use of diagnostic scores for KI-deficiency (deficiency of vital energy) and OKETSU (blood stagnation) syndrome from the viewpoint of KAMPO-medicine. In the same patients with CS, peripheral blood levels of ${\beta}$-endorphin and total plasminogen activator inhibitor-1 (t-PAI-1) were measured before and after treatment with RG. In another group, 12 patients with CS, psychological test using CMI, STAI and SDS were performed from the viewpoint of Western medicine. Stress related hormones, such as ACTH, cortisol and DHEA-S in those 12 patients with CS were also measured before and after treatment with RG. Results; KI-deficiency score and OKETSU score in patients with CS were significantly (p<0.001) higher than those in patients without CS. After treatment with RG, both scores were markedly (p<0.001) decreased compared to before treatment with RG. ${\beta}$-endorphin levels in patients with CS were significantly (p<0.05) higher than those in patients without CS. Total PAI-levels in patients with CS were increased before treatment with RG. No significant difference, however, were observed between patients with and without CS. After treatment with RG, both levels of ${\beta}$-endorphin and total PAI-1 in patients with CS were significantly (p<0.001 and p<0.05, respectively) decreased compared to before treatment with RG. CMI and STAI scores in patients with CS were significantly (p<0.05) higher than those in patients without CS. SDS scores in patients with CS were also markedly (p<0.00l) higher than in those without CS. After treatment with RG, all scores decreased within normal range. DHEA-S levels in patients with CS were about a half of those without CS. Consequently, cortisol/DHEA-S (C/D) ratio was significantly(p<0.001) higher in patients with CS than in those without CS. Although the decreased DHEA-S levels were not restored to the levels in patients without CS, the C/D ratio decreased significantly (p<0.05) after treatment with RG. Conclusion; Reinforcement of vital energy and improvement of stagnant blood circulations by oral administration of RG were elucidated from the viewpoint of traditional KAMPO-medicine. From the viewpoint of Western medicine, effect of RG on postmenopsusal women with CS seemed to be brought about in part by not only an improvement of psychoneuroendocrine dysfunctions but also an amelioration of blood coagulation systems.

Interim Report about The Effect of Bunsimgi-eum(Fenxinqiyin) on the Chest Discomfort of Hwa-byung's Major Symptom (화병 핵심증상 중 흉민에 대한 분심기음의 효능 : 무작위배정, 이중맹검, 위약대조군연구의 중간보고 - 피험자 특성을 중심으로)

  • Yim, Hyeon-Ju;Kim, Seok-Hwan;Lee, Sang-Ryong;Kang, Wee-Chang;Jung, In-Chul
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.3
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    • pp.169-188
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    • 2009
  • Objectives : The purpose of this research is to examine the effect of Bunsimgi-eum on the chest discomfort of Hwa-byung's major symptom. Methods : In this randomized, double blinded, placebo-controlled study, we planned to give Bunsimgi-eum or controlled medication for major symptoms of Hwa-byung. As preparatory research, 100 mm Visual Analogue Scale(VAS) for chest discomfort, the Hwa-byung' major symptom was measured as the 1st evaluative instrument, and Likert scale for major symptom of Hwa-byung, Korean State-Trait Anger Expression Inventory(STAXI-K), Korean State-Trait Anxiety Inventory(STAI-K), Korean Beck's Depression Inventory(BDI-K) and Heart Rate Variability(HRV) were also measured as the 2nd evaluative instrument at the before treatment. Results : Clinical characteristics-vital signs & demographic characteristics showed no significant difference between both groups. The characteristics of disease-chief complaint, pattern Identification, period, etiological factor, etc, also showed no significant difference between both groups. There were almost no Coincidence between pattern identification & weight of Hwa-byung's major symptoms. The results of Chest PA, EKG and clinicopathologic examination showed no significant difference between both groups. There were no significant difference between both groups in all valuation scales; 100 mm Visual Analogue Scale for chest discomfort, the Hwa-byung' major symptom was measured as the 1st evaluative instrument, and Likert scale for major symptom of Hwa-byung, STAXI-K, STAI-K, BDI-K and HRV. Conclusions : We considered that establishment of experimental group and controlled group was objective and worth conducting this research. And this methodology is expected to be applied to the subsequent research. And also, we hope to make up for this study through various study and discussion.

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Effect of Korean Red Ginseng on Psychological Functions in Patients with Severe Climacteric Syndromes: A Comprehensive Study from the Viewpoint of Traditional KAMPO-medicine and Western Medicine

  • Tode Takehiko;Kikuchi Yoshihiro
    • Proceedings of the Ginseng society Conference
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    • 2002.10a
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    • pp.176-184
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    • 2002
  • Objective; Antistress effect of Korean red ginseng (RG) on postmenopausal women with severe climacteric syndrome (CS) were evaluated from the viewpoint of traditional KAMPO-medicine and Western medicine. Methods; All patients with CS were treated with daily oral administration of 6g RG for 30 days. Nine patients with CS were evaluated with the use of diagnostic scores for KI-deficiency (deficiency of vital energy) and OKETSU (blood stagnation) syndrome from the viewpoint of KAMPa-medicine. In the same patients with CS, peripheral blood levels of $\beta$-endorphin and total plasminogen activator inhibitor-1 (t-PAI-1) were measured before and after treatment with RG. In another group, 12 patients with CS, psychological test using CMI, STAI and SDS were performed from the viewpoint of Western medicine. Stress related hormones, such as ACTH, cortisol and DHEA-S in those 12 patients with CS were also measured before and after treatment with RG. Results; KI-deficiency score and OKETSU score in patients with CS were significantly (p<0.001) higher than those in patients without CS. After treatment with RG, both scores were markedly (p<0.001) decreased compared to before treatment with RG. ${\beta}-endorphin$ levels in patients with CS were significantly (p<0.05) higher than those in patients without CS. Total PAI-I levels in patients with CS were increased before treatment with RG. No significant difference, however, were observed between patients with and without CS. After treatment with RG, both levels of ${\beta}-endorphin$ and total PAI-l in patients with CS were significantly (p<0.01 and p<0.05, respectively) decreased compared to before treatment with RG. CMI and STAI scores in patients with CS were significantly (p<0.05) higher than those in patients without CS. SDS scores in patients with CS were also markedly (p<0.001) higher than in those without CS. After treatment with RG, all scores decreased within normal range. DHEA-S levels in patients with CS were about a half of those without CS. Consequently, cortisol/DHEA-S (C/D) ratio was significantly (p<0.001) higher in patients with CS than in those without CS. Although the decreased DHEA-S levels were not restored to the levels in patients without CS, the C/D ratio decreased significantly (p<0.05) after treatment with RG. Conclusion; Reinforcement of vital energy and improvement of stagnant blood circulations by oral administration of RG were elucidated from the viewpoint of traditional KAMPO-medicine. From the viewpoint of Western medicine, effect of RG on postmenopausal women with CS seemed to be brought about in part by not only an improvement of psychoneuroendocrine dysfunctions but also an amelioration of blood coagulation systems.

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A Preliminary Study on Emotion, Self-Esteem and Quality of Life in the Patients with Chest Pain (흉통 환자에서의 정서, 자존감 및 삶의 질에 대한 예비 연구)

  • Park, Sook Hyun;Jae, Young Myo;Lee, Dae Su;Jang, Saeheon;Choi, Jin Hyuk;Lee, Han Cheol
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.120-126
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    • 2012
  • Objectives : The objective of this study is to measure and to compare the rate of depression, anxiety, self-es-teem and the quality of life of the patients with chest pain. Based on the result of this study, the necessity of the psychiatric assessment and treatment of the patients with chest pain is emphasized. This study is a preliminary research for a larger scale investigation to be carried out in the future. Methods : Thirty nine patients with chest pain who visited Cardiovascular Division of Dept. of Internal Medicine Pusan National University Hospital and fourty normal control group(NC) were included in this study. The patients were classified into typical chest pain group(TCP, N=19) and atypical chest pain group(ACP, N=20) based on the cause of the pain. The cause was determined by cardiac computed tomography, exercise stress test, coronary angiography, and questionaires by a cardiology specialist. The patients were assessed with Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), Rosenberg Self-Esteem Scale(RSES) and Korean version of the Smith Klein Beecham 'Quality of Life' scale(KvSBQOL). Results : 1) When the risk factors of cardiac disease is compared, most of the factors(Hypertension, Diabetes, Hyperlipidemia, Cerebral infarction) did not differ significantly among the two chest pain groups, except for the family history, for which TCP group showed higher risk than ACP group did. 2) As for the self-report questionaires scores, BDI score, which indicates the rate of depression, of both ACP group and TCP group was significantly higher than that of NC group in BDI for depression. STAI score, which measures anxiety, was also significantly high in both groups. Especially, STAI score was significantly higher in ACP group than TCP group. 3) In the aspect of self-esteem and quality of life, ACP group scored significantly lower than TCP group and NC group. The scores for TCP group and NC group did not differ significantly. Conclusions : The patients with chest pain showed more depression and anxiety than normal control group, regardless of the cause of the pain. However, TCP group did not show significantly larger drop in self-esteem and quality of life than ACP group did. This result implies that early psychiatric assessment and treatment is needed for the patients with such chest pain, since it is highly likely that the pain would lead to lower quality of life of the patients.

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The effects of depression and anxiety on pain in ultrasonic scaling treatment (초음파스케일링 시 환자의 우울, 불안이 통증에 미치는 영향)

  • Hwang, Mi;Kim, Sook-Hyang;Lee, Kyeong-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.14 no.3
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    • pp.439-446
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    • 2014
  • Objectives : The purpose of the study is to investigate the correlation between the pain, depression, dental anxiety in the patients visiting to dental clinic for the ultrasonic scaling treatment. Methods : The study is a cross-sectional correlation study. A self-reported questionnaire was filled out by 254 patients having no history of mental illness in Seoul and Gyeonggido from December 12 to 20, 2013. The study instruments included modified Beck's Depression Inventory (BDI), STAI items by Spilberger, Humphis' Modified Dental Anxiety Survey(MDAS), and Visual Analogue Scale. Results : There existed correlation between the ultrasonic scaling pain, depression, dental anxiety, trait anxiety, and state anxiety. Dental anxiety was the most influencing factors on the pain. Conclusions : It is very important to reduce the anxiety in the patients more actively.