• Anxiety and mood
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• v.15 no.1
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• pp.29-34
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• 2019

Objective : To determine predictors of posttraumatic stress disorder (PTSD) symptoms in burn injured patients and evaluate factors for identifying high risk group of PTSD. Methods : This study examined sixty one patients aged in the range of 19-65 years with burn injuries. All subjects completed self-assessment inventories about PTSD (The PTSD Check List for DSM-5. PCL-5), depression (Patient Health Questionnaire-9, PHQ-9), embitterment (Posttraumatic embitterment disorder self-rating scale, PTED scale) and meaning of life (Meaning in Life Questionnaire, MLQ). Stepwise multiple regression and ROC curve analysis were the tools used for analysis. Results : The results revealed higher depression, embitterment and lower presence of meaning in life predicted severe PTSD symptoms. ROC analysis indicated PTED scale and PHQ-9 were useful for discriminating high risk group of PTSD. Conclusion : The present study established that the need to consider embitterment, depression and meaning of life for alleviation and prevention of PTSD symptoms in burn patients.

• Anxiety and mood
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• v.2 no.1
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• pp.45-49
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• 2006

Puropse : Disturbances of dopaminergic system might be related to the possible mechanism of panic disorder. This study was aimed to examine the association of DRD2 Taq 1 polymorphism and panic disorder. Methods : One hundred and fourteen patients with panic disorder (62 male (54.4%), mean age $40.96{\pm}0.11$ years) and 200 comparison subjects (114 male (57.0%), mean age $35.57{\pm}8.81$ years)were tested for DRD2 TaqI A polymorphism. We excluded panic patients with comorbid alcohol related disorders, bipolar disorders, and any kinds of psychotic disorders because there have been some reports about association of these disease and DRD2 TaqI A polymorphism. Results : There was significant difference in the frequency of the genotype in DRD2 polymorphism between patients and controls (${\chi}^2$=6.09, df=2, p=0.048). The A1+ allele (A1A1 and A1A2) frequency analysis also showed significant association (${\chi}^2$=4.08, df=1, p=0.043). In addition, we observed a more strong and specific association between panic disorder and the A1+ allele of the DRD2 TaqI polymorphism for men (${\chi}^2$=4.71, df=1, p=0.03), but not for women (${\chi}^2$=0.45, df=1, p=0.50). Conclusion : These results in our Korean sample suggest that the DRD2 TaqI A polymorphism may be associated with panic disorder. Furthermore, we found sex-specific association of DRD2 A1 allele with panic disorder.

• Anxiety and mood
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• v.2 no.2
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• pp.108-114
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• 2006

Objectives : Only a few prospective studies of panic disorder are available. This study investigated naturalistic outcome of panic disorder patients at twelve months after the initial diagnosis. Methods : A total of 84 subjects were diagnosed with panic disorder by diagnostic interview, Structured Clinical Interview for DSM-IV (SCID-IV) and Anxiety Disorder Interview Schedule for DSM-IV (ADISIV). Among them, 80 subjects could be evaluated by means of Panic Disorder Severity Scale (PDSS) at follow-up interview after twelve months. Treatment continuation was also examined at follow-up interview. Results : At initial intake, 80 patients were classified into 22% with mild, 33% with moderate-to-marked, and 45% with severe symptoms on the basis of their PDSS total score. At twelve months, 20% of patients reached remission, 65% had mild and 15% had moderate-to-marked symptoms. Initial panic symptom severity, presence of agoraphobia, panic symptom duration before diagnosis, number of comorbid Axis I disorders were associated with significantly higher PDSS total score at twelve months. Forty six percent of total patients continued medication and 23% have stopped treatment by clinician's recommendation and 31% have selfdiscontinued their medication. At twelve months, all three groups were improved but self-discontinuation group had significantly higher PDSS total score. Conclusion : In the one-year naturalistic outcome study of panic disorder patients, high percentage of patients achieved remission or had mild symptoms.

• Anxiety and mood
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• v.4 no.2
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• pp.148-156
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• 2008

Objective : Although cognitive-behavior therapy (CBT) is effective in patients with panic disorder, its the-rapeutic mechanism of action in the brain remains unclear. This study was performed to investigate regional blood flow changes associated with successful completion of CBT in drug-naive patients with panic disorder. Method : The regional blood flow in 4 patients with panic disorder was compared to that in 11 healthy controls before and after a 12-week group CBT using $^{99m}Tc$-ECD SPECT imaging. Psychopathology was assessed using Panic Disorder Severity Scale. Data were analyzed using software for statistical parametric mapping (SPM2). Results : Before CBT, significantly decreased blood flow was found in the parietal and occipital area in panic patients than normal volunteers. In all the patients who showed remission after CBT, increased blood flow was detected in the right cingulate gyrus, left lingual gyrus, and left superior parietal lobule, whereas decreased blood flow was seen in the left inferior temporal gyrus. Conclusion : These results suggested that CBT is effective for panic disorder and change the activity of cingulate gyrus and left temporal gyrus, a part of the brain areas associated with fear in panic disorder.

• Anxiety and mood
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• v.12 no.1
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• pp.1-6
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• 2016

Objective : This study was performed to confirm the hypothesis that the more one applies positive thinking, the less severe the symptoms of stress and the better the therapeutic responsein panic disorder and major depressive disorders. Methods : The study included 50 subjects with confirmed diagnoses of panic disorder or major depressive disorders. Positive thinking was assessed using Positive thinking scale. Beck Depression Inventory was used as a subjective measure for depression, and to ensure an objective measure for depression and anxiety, the Hamilton Depression and Hamilton Anxiety rating scales were implemented. Results : The positive thinking scale measured at the initial visit had shown a strong negative correlation with objective depression. Although patients with a high level of positive thinking had shown a tendency to respond better to the treatment, as compared with those with a lower level, the differences were not statistically significant. Conclusion : Positive thinking is likely to ameliorate major depressive disorder, panic disorder-induced depression, and anxiety. Nevertheless, it was not possible to confirm the effects of positive thinking on the patients' treatment responses.

• Anxiety and mood
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• v.7 no.1
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• pp.16-21
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• 2011

Objective : Depressive symptoms often coexist with other anxiety disorder symptoms. Furthermore, an anxiety disorder that is comorbid with a depressive disorder results in more severe symptoms and a poorer outcome prognosis. To understand the construct of depressive symptoms in anxiety disorder, this study investigated the factor structure of the Beck Depression Inventory among outpatients with anxiety disorders. Methods : All data were from psychiatric department outpatients at a university-affiliated hospital. We conducted a principal component analysis using data from 194 outpatients with DSM-IV anxiety disorders and calculated goodness-of-fit-indices. Results : Exploratory factor analysis revealed a four factor structure--Cognitive-affective symptoms (Factor 1), Somatic symptoms (Factor 2), Self-reproach (Factor 3), and Hypochondriasis/indecisiveness (Factor 4)--and a 57% total variance. This four-factor model demonstrated an acceptable level of model fit, and it fit better than did a three-factor solution from the literature on depressive disorder. Conclusion : This study's results suggest a difference in the construct of self-reported depressive symptoms in anxiety disorders. These findings also support a dimensional approach to studying anxiety and depression. Further studies may benefit from including comorbid depressive disorder and its influence on anxiety disorders.

• Journal of Korean Medical Science
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• v.33 no.46
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• pp.290.1-290.11
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• 2018

Background: The role of antidepressants (ADs) in bipolar disorder is long-standing controversial issue in psychiatry. Many clinicians have used ADs as a treatment for bipolar depression, and the selection of therapeutic agents is very diverse and inconsistent. This study aimed to examine recent AD prescription patterns for patients with bipolar disorder in Korea, using the nationwide, population-based data. Methods: This study utilized the Korean nationwide, whole population-based registry data of the year 2010, 2011, and 2013. All prescription data of the ADs, antipsychotics, and mood stabilizers of the sampled patients diagnosed with bipolar disorder (n = 2,022 [in 2010]; 2,038 [in 2011]; 2,626 [in 2013]) were analyzed for each year. Results: Annual prescription rate of ADs was 27.3%-33.6% in bipolar disorder, which was gradually increasing over the 3-year period. The combination pattern of ADs and antipsychotic drugs tended to increase over 3 years. The proportion of females and the prevalence of comorbid anxiety disorder were significantly higher in AD user group in all three years. Among individual ADs, escitalopram was prescribed most frequently, and fluoxetine and bupropion were prescribed to the next many patients. The mean duration of bipolar depressive episodes was 135.90-152.53 days, of which ADs were prescribed for 115.60-121.98 days. Conclusion: Our results show prescription rate of ADs in bipolar disorder was maintained at substantial level and increased in recent 3 years. More empirical data and evidence are needed to establish practical treatment consensuses.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.153-162
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• 2002

Summary：This study was designed to examine the effect of mother's depressive mood and parenting related attitude on parenting behavior, focusing on the cases having an ADHD child. Method：A total of 82 parents, 31 parents having children with ADHD and 51 normal, were involved in this study. The children of ADHD and normal group were 6-11 years old. ADHD group were diagnosed as attention-deficit hyperactivity disorder by psychiatric doctor and psychological evaluations using DSMIV criteria and the normal group were excluded by using Diagnostic Rating Scale-Parent, Teacher Form. The mothers of both group completed a series of questionnaire about mother's depressive mood and parenting-related attitude. To investigate the relationships between each variables, Student's t-test, correlation, stepwise regression, and hierarchical regression analysis were performed. Result：In correlation analysis, Mothers with an ADHD child were likely to report more coercive parenting behavior, more negative parenting-related attitudes, and depressive mood than normal group. In regression analysis, mother's parenting stress, dysfunctional thoughts, parenting competence, and depressive mood predicted coercive parenting behavior significantly, total explaining 50% of its variance, and especially depressive mood explained 29% of their coercive parenting behavior. These Results indicated that mother's depressive mood accounted for a substantial portion of coercive parenting behavior. Conclusion：These findings suggested that it is significantly important to reduce Mother's depressive mood through dealing with parenting sense of competence and dysfunctional thoughts, so, both parent education program and cognitive-behavioral therapeutic approach are needed to change parent's coercive parenting behavior. Finally, limitation of the present study and suggestions were discussed for further studies.

• Korean Journal of Psychosomatic Medicine
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• v.10 no.2
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• pp.154-165
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• 2002

Objectives : The purpose of this study was to identify characteristics of depression in cancer patients treated with chemotherapy. Methods : Subjects were 37 cancer inpatients of oncology in Yeungnam university hospital. BDI and ZDS were done and HDS was performed through semistructured interview. Results: 1) There were no significant differences of depression scale score according to sex, education, religion, marital status. 2) The mean scores of BDI, ZDS and HDS in 37 cancer patients were 18.27${\pm}$7.73, 36.51${\pm}$10.82, 15.14${\pm}$6.60, respectively. 3) HDS, ZDS scores were significantly higher in other cancer group receiving high dose chemotherapy. 4) Item score for depressed mood, diurnal variation(p<0.001), dissatisfaction(p<0.01), physical anxiety, decreased libido, sleep disturbance(p<0.05) were significantly higher in other cancer group than others. 5) Eight patients were diagnosed as having major depressive disorder, 11 as adjustment disorder, and 18 patients had no axis I diagnosis. 6) In major depressive disorder group, the score of the depressed mood item in ZDS was high (p<0.05). HDS item score for depressed mood, work difficulty, anxiey(p<0.001), psychomotor retardation(p<0.01) were significantly higher in major depressive disorder group. 7) In patients with adjustment disorder, ZDS item score of constipation(p<0.001), fatigue, anorexia (p<0.01), emptiness, sleep disturbance, dissatisfaction, weight loss(p<0.01) were high. HDS item score of hypochondriasis(p<0.01), agitation(p<0.01), fatigue, decreased libido(p<0.05) were significantly higher in adjustment disorder group. Conclusion : Some psychiatric disorders, such as adjustment disorder and major depressive disorder were common in the cancer patients in chemotherapy. Psychiatric intervention will increase compliance of cancer treatment and improve the quality of life. This study suggests that it would be important to consider the nature of somatic symptoms in diagnosing depression in cancer patients.

• Korean Journal of Biological Psychiatry
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• v.6 no.1
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• pp.125-134
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• 1999

The purposes of this study were to test the negative association between schizophrenia and rheumatoid arthritis(RA) and to clarify the role of prolactin and estrogen as protective factors in this association. The author compared the prevalence rate of RA between 561 patients with schizophrenia and 222 patients with mood disorder. For investigating the role of estrogen and prolactin, the author checked the plasma prolactin and estradiol level in 80 patients with paranoid schizophrenia and 77 patients with RA. The results were as follows. 1) Epidemiological data The prevalence rate of RA in the schizophrenic group was 0/561 and that of RA in the mood disorder group was 2/222. To compare these results between two groups, the author applied the Binomial test using the average prevalence rate of RA(0.8%) in the general population as a reference rate. The prevalence rate of RA in the schizophrenic group was significantly lower than that of RA in the general population. However, the prevalence rate of RA in the mood disorder group was not significantly different to that of RA in the general population. 2) Comparison of plasma prolactin and estradiol level between two groups The plasma level of prolactin in the schizophrenic group was significantly higher than that of prolactin in the RA group(p=0.000). However, the plasma level of estradiol in the schizophrenic group was significantly lower than that of estradiol in the RA group(p=0.017). These results were not consistent across gender. To contrast with the results in the female group, which were consistent with the results in the total subjects, for the male group, the plasma levels of prolactin and estradiol in the schizophrenic group were significantly higher than those of prolactin and estradiol in the RA group. These results support the results of previous studies which confirm the negative association between schizophrenia and RA. These results also suggest that the elevation of plasma prolactin level in the patients with schizophrenia has a antirheumatic effect while the elevation of plasma estradiol level in the patients with RA has a anti-schizophrenic effect, and that these effects act as a possible mechanism in the negative association between two disorders. However, these results suggest that this association is specific to female patients.