• Sleep Medicine and Psychophysiology
• /
• v.28 no.2
• /
• pp.70-77
• /
• 2021

Objectives: Our study aims to investigate the clinical and polysomnographic variables associated with subjective sleep perception. Methods: Among the patients who underwent nocturnal polysomnography (PSG) at the Center for Sleep and Chronobiology of Seoul National University Hospital from May 2018 to July 2019, 109 diagnosed with insomnia disorder based on DSM-5 were recruited for the study, and their medical records were retrospectively analyzed. Self-report questionnaires about clinical characteristics including Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Epworth sleepiness scale (ESS) were completed. Subjective sleep quality was measured using variables of subjective total sleep time (subjective TST), subjective sleep onset latency (subjective SOL), subjective number of awakenings, morning feeling after awakening, and sleep discrepancy (subjective TST-objective TST) the morning after PSG. Pearson and Spearman correlation analyses were used to determine the factors associated with subjective sleep perception. Results: In patients with insomnia, subjective TST was negatively correlated with Wake After Sleep Onset (WASO) (p = 0.001) and N1 sleep (p = 0.039) parameters on polysomnography. Also, it was negatively correlated with PSQI (p < 0.001) and BDI (p = 0.014) scores. Sleep discrepancy was negatively correlated with PSQI score (p = 0.018). Morning feeling was negatively correlated with PSQI (p = 0.019) and BDI (p < 0.001) scores. Conclusion: Our results demonstrated that subjective sleep perception is associated with PSG variables (WASO and N1 sleep) and with PSQI and BDI scores. In clinical practice, it is helpful to assess and manage insomnia patients in consideration of objective sleep variables, subjective sleep quality, and depressed mood, which can influence subjective sleep perception.

• Journal of Oriental Neuropsychiatry
• /
• v.31 no.1
• /
• pp.1-12
• /
• 2020

Objectives: The purpose of this study was to evaluate the reliability and validity of the instrument on pattern identification for insomnia (PIT-Insomnia) and verify the correlation between PIT-Insomnia and psychological tests. Methods: Two evaluators examined the pattern identification of the participants who met insomnia disorder diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) and took the Insomnia Severity Index (ISI) score over 15 once manually and twice using the PIT-Insomnia to measure the inter-rater and test-retest reliability. We also conducted the following surveys: the Pittsburgh Sleep Quality Index (PSQI), the Korean version of Beck's depression inventory (K-BDI), the Korean version of the State-Trait Anxiety Inventory (STAI-K), the Korean Symptom checklist-95 (KSCL-95), and the EuroQol-5 dimension (EQ-5D), to measure concurrent validity and correlation between the PTI-Insomnia and psychological tests. Results: 1. The test-retest reliability analysis of the pattern identification results showed moderate agreement, and test-retest reliability analysis of each pattern identification score showed agreements from poor to moderate. 2. The inter-rater reliability analysis of the pattern identification results via manual showed slight agreement, when analysis was performed with calibration, the inter-rater reliability analysis of the pattern identification results via manual showed fair agreement. 3. The concordance analysis between results via manual and the PIT-Insomnia showed poor agreement, when the analysis was performed with calibration, concordance analysis showed fair agreement. 4. The concordance analysis between the PIT-Insomnia and the PSQI showed positive linear correlation. 5. The concordance analysis between the PIT-Insomnia and the PSQI, K-BDI, STAI-K, KSCL-95, and EQ-5D showed that non-interaction between the heart and kidney have positive linear correlation with the K-BDI, anxiety item of KSCL-95, dual deficiency of the heart-spleen have positive linear correlation with somatization item of KSCL-95, paranoia item of KSCL-95, heart deficiency with timidity have positive linear correlation with stress vulnerability item of KSCL-95, parania item of KSCL-95, phlegm-fire harassing the heart have positive linear correlation with K-BDI, paranoia item of KSCL-95, depressed liver qi transforming into fire have positive linear correlation with the anxiety item of KSCL-95, parania item of KSCL-95, all pattern identification have negative linear correlation with EQ-5D. Conclusions: The PIT-Insomnia has moderate agreement of reliability and reflects the severity of insomnia since it has some concurrent validity with the PSQI. There are some correlations between the PTI-Insomnia with specific psychological tests, so we could suggest it can be used appropriately in the clinical situation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.12 no.2
• /
• pp.192-217
• /
• 2001

Object：This study was carried out to classify adolescents in runaway shelters by evaluating their psychopathology. And the ultimate purpose is to offer basic data for preventing adolescents‘ runaway and for diversifying runaway shelters suitable for the problem of individual adolescent. Method：128 adolescents who stay in the runaway shelters were asked to complete self-report qeustionnaires including basic sociodemographic data, Child Behavior Check List(CBCL), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revised(SCL-90-R). Korean Wechsler Adult Intelligence Scale(K-WAIS)[or Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children(KEDI-WISC)] and Bender-Gestalt test(BGT) were also done by clinical psychologists. Results：The most common age of the subjects were 15-year-old, and they dropped out their schools in the middle school most commonly. Mostly they were from middle class family and their parents' educational level were high school graduates. The first runaway episode was most common in the middleschool period, and their runaways were repeated. The most common frequency of runaways were more than 10 times. About 10% of them abused drugs and about 80% of them abused alcohol. One third of them had experiences of illegal problems and 10% of them engaged in sexual activity for money. 95 adolescents(83%) in CBCL, 42 adolescents(36%) in SCL-90-R, and 70 adolescents(69.3%) in MMPI showed clinical significance. In intelligence test, 22 adolescents(22%) were mentally retarded. In BGT, 35 adolescents(39.4%) manifested brain dysfunction signs. Conclusion：Runaway adolescents in the shelters have variable and severe psychopathology. Their psychopathology is classified as follows；The behavior disorder group, the mood disorder group with anxiety/depression, the somatic disorder group with somatic symptoms, and the psychosis group with possibility of severe psychopathology. Therefore it is very important to evaluate psychiatric problems of runaway adolescents, and specific therapeutic interventions according to their problems are required.

• Sleep Medicine and Psychophysiology
• /
• v.12 no.2
• /
• pp.111-116
• /
• 2005

Objectives: Although many reports have been written on seasonal variations in mood and behavior in foreign countries, few reports have dealt with Korean adolescents, except medical students. The goal of this study was to estimate the frequency of seasonal variations in mood and behavior among Korean high school students. Methods: A total of 656 high school students living in southeastern Seoul participated in this study. The subjects were investigated with the Korean translated version of the Seasonal Pattern Assessment Questionnaire (SPAQ), and their responses were evaluated for seasonal patterns in mood and behavior change according to Kasper's criteria to make SAD (seasonal affective disorder) or SSAD (subclinical seasonal affective disorder) diagnosis. Results: A total of 565 subjects completed the questionnaire and the responses (M：F=324：241) were collected and used for analysis. The mean age was 16.73 (SD=0.65) years, and mean global seasonality score 5.88 (SD=4.72). Of the respondents, 413 (73.1%) reported problems related with seasonal changes. Total prevalence rates were 13.6% for SAD, 10.8% for S-SAD. The estimated frequencies were 5.1% for summer SAD, 3.2% for summer S-SAD, 0.5% for winter SAD and 1.1% for winter S-SAD. The prevalence rate of summer SAD or S-SAD was higher than winter SAD or S-SAD. Conclusion: The subjects showed a higher prevalence rate of summer type than winter type in SAD or S-SAD. These results were similar to those of other studies carried out in East Asian countries. However, the unpleasant feelings resulting from high temperature and humidity in summer rather than depression may have influenced the results. Therefore, it is necessary to make new SAD criteria of the SPAQ suitable for East Asian countries.

• Journal of Oral Medicine and Pain
• /
• v.33 no.4
• /
• pp.375-382
• /
• 2008

This study was a preliminary study to establish diagnostic criterias and treatment for Orofacial Movement Disorders. The 33 Orofacial Movement Disorder patients who were visited in the department of Oral Medicine from September, 2007 to December, 2007 were selected for this study. We analyzed the age, sex, systemic diseases, the diagnosis and the cause of the patients' chief complaints, the self-consciousness and the types of orofacial movements. The obtained results were as follows : 1. Female were predominant in orofacial movement disorders(81.82% vs 18.18%) and mean age was 78.78(56 to 87) years. 2. They almost had systemic diseases(81.82%). Hypertenstion was the most common disease(22.41%) and diabetes mellitus(17.24%), depression(8.62%), gastritis(8.62%) in turns. 3. In clinical manifestation, temporomandibular disorder was the most frequently complained symptom(33.33%), and soft tissue disease(21.57%), burning mouth syndrome(17.65%), orofacial movement itself(15.69%), diffuse orofacial pain(6명, 11.76%) in turns. 4. Most orofacial movement disorders are idiopathic(72.73%), and related to prosthetic treatment(24.24%), related to antidepressant medication(3.03%) in turns. 5. The jaw-closing type was the most common type of orofacial movement disorders, and lateral type(33.33%), jaw-opening types(16.67%) in turns. 6. There were more patients who did not conscious of their orofacial movements than those who did.(54.55% vs 45.45%). In conclusion, dentists must be consider the orofacial movement disorders in patients who have orofacial pain. Also, dentists should obtain a proper history and perform a clinical examination to avoid misdiagnosis and inappropriate, irreversible treatment.

• Journal of Yeungnam Medical Science
• /
• v.22 no.2
• /
• pp.150-165
• /
• 2005

Purpose: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. Materials and Methods: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. Results: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20(25.0%) for the BDI, 16(20.0%) for the ZDS, 18(22.5%) for the CDSS and 6(7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. Conclusion: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.

• Sleep Medicine and Psychophysiology
• /
• v.24 no.1
• /
• pp.46-54
• /
• 2017

Objectives: Domestic violence is related to many psychiatric diseases, such as depression, anxiety disorder, and PTSD. Heart rate variability (HRV) is an index of autonomic control of the heart and is related to cardiovascular and emotional disorders. Although there have been some studies on the effects of domestic violence on women's mental health, relatively little information is available on HRV in this population. The aim of this study is to investigate demographic data, psychological features, and HRV in female victims of domestic violence and difference between Korean and foreign female victims. Methods: A total of 210 female victims of domestic violence (166 Korean women and 44 foreign women) were recruited for this study. Psychological symptoms were measured using the Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Impact of Event Scale-Revised (IES-R). HRV measures were assessed by time-domain and frequency-domain analyses. Results: The mean score of HAM-A was 13.81, that of HAM-D was 12.92, and that of IES-R was 33.61 ; there were no significant differences between Korean and foreign women in these measures. In HRV time domain analyses, approximate entropy (ApEn) was significantly increased in foreign women compared to the Korean women. The square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) was significantly decreased in foreign women compared to Korean women. There were no significant differences in the other HRV variables between Korean and foreign women. Conclusion: Female victims of domestic violence in Korea are associated with depression, anxiety, and PTSD symptoms. The physiologic factors of a female victim's nationality could be related to higher ApEn and lower RMSSD in foreign female victims. These findings have important implications for future study to study the relationships among ethnic and environmental factors and HRV variables.

• Journal of Music and Human Behavior
• /
• v.4 no.2
• /
• pp.1-17
• /
• 2007

Huge growth in developmental level, new accomplishment, and The period of adolescents is not only the transition stage but also improvement of academic level. In this level of stage, adolescents have difficulties in development, so they show psychological abnormality such as stress and depression. They could develop mental disorder such as depression or anxiety if they do not overcome the abnormality. According to the situation of the insufficiency of the decent program for adolescents' mental health in the current society, we are strongly requested to develop the psycho-therapeutic program for them. Therefore, in this study, we examined the effect of the musical activities as blues music structure on the improvement of the Self-Efficacy in the female middle school students who have depressive tendencies as well as what they experienced through the activities. The 3 participants were selected out of 70 students in the first year at the "D" middle school in Seoul by being tested with Child Depression Inventory(CDI) and Self-Efficacy Scale(SES). The musical activities were built with 3 steps. Of which, the first one was the introduction to each other, the formation of rapport, and induction of their interests to the musical activities through blues. The second one was letting participants learn the blues music structure by practice and play assigned music(including improvisation) during later 5 sessions with different difficulties at each session. The third one was giving them opportunities to play a music out of the acquired ones during the session or creative music by their own, which results in maximizing musical activities and an acquired experience. As a result, first of all, the scores of CDI test of 3 participants in 10 time sessions showed slight changes, suggesting the negative correlation between CDI and SES even though changes were not big differences. Secondly, the scores of SES test of 3 subjects in 10 time sessions were all changed and especially preference for tasking was significant. Thirdly, the scores of SES for musical playing test of 3 participants in 10 time sessions were all changed and especially preference for musical tasking was significant shown. Finally, according to answers of 3 participants in 10 time sessions for the after questionnaire on musical activities, participants experienced affirmative self-confidence and positive emotion. Taken together, it was suggested that musical activities using blues music structure could be promising therapeutic intervention method.

• Korean Journal of Psychosomatic Medicine
• /
• v.18 no.2
• /
• pp.82-93
• /
• 2010

Objectives : The purpose of this study was to explore attitude and belief about menopause and severity of menopausal symptoms according to menopausal status. This study conducted a cross-sectional assessment of the effects of depressive symptoms and the severity of trait anxiety on the severity of menopausal symptoms. Methods : Participants were all outpatients at the psychiatric outpatient clinic of Korea University Guro Hospital. All participants, aged 40 to 64, had depressive or anxiety disorders and were divided into the premenopause, perimenopause, premenopause, and postmenopause groups. Menopause Rating Scale(MRS) was used to measure the severity of menopausal symptoms. The attitude toward menopause was examined by a self-report questionnaire regarding menopause. Beck Depression Inventory(BDI) and State-Trait Anxiety Inventory(STAI) were used to assess depressive symptoms and anxiety. Results : The severity of menopausal symptoms was not different among the groups according to menopausal status. There was a significant correlation between a negative attitude toward menopause and the severity of menopausal symptoms. Patients with moderate to severe depressive symptoms and trait anxiety had more severe menopausal symptoms. Conclusion : Negative attitude toward menopause, depressive symptoms, and anxiety had a significantly negative impact on the severity of menopausal symptoms. The results of this study suggest that treatment to relieve depressive symptoms and anxiety and intervention to reduce negative attitude toward menopause are required. Further studies with larger sample size are needed to evaluate potentially effects of depressive symptoms and anxiety on severity of menopausal symptoms in middle-aged female psychiatric patients.

• Journal of Oral Medicine and Pain
• /
• v.37 no.4
• /
• pp.233-242
• /
• 2012

The purposes of this study were to compare psychological profiles, to investigate the differences in the clinical characteristics, and to compare treatment outcomes between myogenous pain and arthrogenous pain subgroups of temporomandibular disorder (TMD) based on Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD). Two hundred and fifty two patients diagnosed as TMD were divided into three groups based on the RDC/TMD axis I diagnostic guidelines; myogenous pain group, arthrogenous pain group, and mixed pain (both myogenous pain and arthrogenous pain) group. RDC/TMD history questionnaire was administered to each patient and depression, somatization, jaw disability, pain intensity, disability days, and graded chronic pain scale were analyzed. Bruxism, clenching, insomnia, headache, and unilateral chewing were assessed in a standardized TMD dysfunction questionnaire and the duration of onset, chronicity of pain, treatment period, the effectiveness of the treatment, and improvement of symptoms also analyzed. Myogenous pain group had higher depression (p=0.002), and somatization scales (p<0.001) than the arthrogenous pain group. Mixed pain group showed higher pain intensity (p=0.008), disability days (p<0.001), graded chronic pain scale (p=0.005), somatization (p<0.001), and depression scores (p=0.002) than the arthrogenous pain group. Jaw disability did not show any significant differences among the three groups (p=0.058). Arthrogenous pain group reported more limitation of mouth opening than myogenous pain group (p=0.007). Duration of onset showed that the arthrogenous pain group had lowest prevalence of chronicity among three groups (p=0.002). Mixed pain group patients showed lowest symptom improvements among three groups (p=0.007). Multiple linear regression analysis results showed that the treatment effectiveness was significantly associated with somatization score (${\beta}$=-0.251, p=0.03).