• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.4 no.1
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• pp.91-97
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• 1993

The objective of this paper was to determine the degree of diagnostic overlap. In a pilot study of 56 inpatients(mean age 12) with DSM-III-R axis I and/or II disorders, the degree of psychiatric comorbidity was examined. 64.3% had two or more diagnoses. The samples were divided into the following 9 groups 1) attention deficit hyperactivity disorder 2) conduct disorder 3) oppositional defiant disorder 4) schizophrenia 5) mood disorders 6) tie disorders 7) elimination disorders 8) mental retardation 9) personality disorders Substantial overlap(especially tic disorders, elimination disorders, disruptive behavior disorders) occured among inpatients Patients had about 2 DSM-III-R axis I & II diagnoses. Additional research with increased sample size is necessary to clarify its relationship with other psychiatric diagnoses.

• Anxiety and mood
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• v.3 no.2
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• pp.123-127
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• 2007

Objective : This study was conducted to evaluate the relation between symptoms and hippocampal volume in patients with posttraumatic stress disorder (PTSD). Methods : Eight patients with PTSD and five normal controls were enrolled in the present study. The severity of PTSD symptoms was measured using the clinician administered PTSD scale (CAPS), Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA). Magnetic resonance imaging (MRI) was used to measure hippocampal volume. Results : There were significant differences in the CAPS, HAMD, and HAMA scores between the PTSD patients and normal controls. The left and right hippocampal volumes were smaller in the PTSD patients than in the normal controls, but this difference was not statistically significant. The results showed that PTSD symptoms were not related to hippocampal volume. Conclusion : In this study, we could not identify a difference in hippocampal volume between normal controls and patients with PTSD at eight months after trauma. Future research with different subjects and a larger sample size is needed in order to confirm the difference in hippocampal volume.

• Anxiety and mood
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• v.9 no.2
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• pp.106-112
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• 2013

Objective : Several reports have found abnormal levels of androgen in post-traumatic stress disorder (PTSD) patients. This abnormality in androgen is hypothesized to due to chronic psychological stress effects on the hypothalamic-pituitary-gonadal (HPG) system. The present study was conducted to estimate serum testosterone levels in PTSD patients in comparison with normal subjects. Methods : Seventy-five male Korean veterans of the Vietnam War volunteered for the study, of which eleven were excluded because of incomplete psychological assessment. To measure basal serum testosterone, blood samples were collected between 8.00 and 9.30 a.m. The clinician administered PTSD scale (CAPS), the structured clinical interview for DSM-IV (SCID), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Rating Scale for Depression (HAM-D), Mini International Neuropsychiatric Interview Plus (Korean version of MINI-Plus), CES-K (Korean version of combat exposure scale). Results : The serum testosterone level of PTSD patients ($5.4{\pm}2.5ng/mL$) was higher than that of a control group ($3.1{\pm}1.7ng/mL$, p<0.001). Testosterone levels were significantly correlated with CAPS (r=.38, p<.01), HAM-A (r=.35, p<.01) and HAM-D (r=.28, p<.01) in all subjects. Conclusion : The results of the present study suggest that chronic psychological stress affects the HPG system.

• Anxiety and mood
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• v.9 no.2
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• pp.140-146
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• 2013

Objective : There have been few comprehensive studies on the analysis of 24-hour HRV of major depressive disorder (MDD). The purpose of this study was to compare the autonomic nerve system of patients with a MDD with healthy patients and to examine the physiologic and clinical effects of 24-hour HRV by analyzing whether the HRV demonstrates the level of depressive symptoms after improving the symptoms in patients with a MDD. Methods : The 24-hour HRV was measured in patient groups with a MDD (n=16) and control groups (n=16). The patients with a MDD received the follow up test for two months after the treatment. Results : There were significant differences among the indexes (SDNN, rMSSD, SDNN index, and pNN50) of time-domain analysis and the indexes (TP, VLF, LF, HF, and ULF) of frequency-domain analysis of HRV between patient and control groups. The means of RR, SDNN, SDANN, and TP increased after two month of the treatment, comparing them with before the treatment, but there were no statistical significance. Conclusion : The results of 24-hour HRV analysis indicated significant decrease of HRV indexes among MDD patients which may suggest decrease of parasympathetic nervous functions.

• Anxiety and mood
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• v.9 no.1
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• pp.19-24
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• 2013

Objectives: The objective of this study is to examine the association between the children's psychopathology and age, intellectual quotient, and parental psychopathology in children with post-traumatic stress disorder (PTSD). Methods: The emotional and behavioral problems of 35 children with PTSD (23 boys, 12 girls, mean age, $10.26{\pm}2.47$ years) were investigated by retrospective chart review. Their parents' anxiety and depression symptoms were also investigated. We examined the correlations between children's psychopathology and their parents' anxiety and depression symptoms, as well as their age and IQ. Results: There were positive correlations between maternal trait anxiety and depression, and children's emotional problems. State and trait anxiety of children with PTSD were positively correlated with age, and attention-deficit hyperactivity disorder symptoms were negatively correlated with age. Conclusion: Our results suggest that psychiatric manifestation of children who experienced trauma could differ according to the development stage, and the treatment of children with PTSD should involve parental education about the effect of maternal emotional states on children.

• Anxiety and mood
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• v.2 no.2
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• pp.94-100
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• 2006

Objective : This study was designed to examine the volumetric abnormality of orbitofrontal cortex (OFC) and its change after 2 years of pharmacotherapy in obsessive compulsive disorder (OCD) patients. Method : Volumetric magnetic resonance imaging studies were conducted in 15 OCD patients and 13 normal volunteers. For 2 years, all patients took at least one serotonin reuptake inhibitor and atypical antipsychotics were used as an augmentation therapy in most patients. The follow-up MRI studies were conducted after the pharmacotherapy and OFC volumes were measured by the manual region of interest method. Results : Bilateral OFC volumes of 15 OCD patients were significantly greater than those of the normal volunteers before the treatment. After 2 years of the treatment, significant decrease was observed in bilateral OFC volumes of OCD patients to the extent that left OFC volume of OCD patients was not different from that of the normal volunteers. Conclusion : This finding suggests that OFC is directly related to the pathophysiology of obsessive compulsive disorder.

• Anxiety and mood
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• v.4 no.2
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• pp.121-126
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• 2008

Objective : The present study investigated gender differences in the symptoms of posttraumatic stress disorder (PTSD) among Korean PTSD patients from a multicenter sample. Methods : Data were collected from 18 psychiatric units of training hospitals nationwide. All the patients were interviewed by attending psychiatrists using a structured format for PTSD by DSM-IV diagnoses. Additionally the Davidson Trauma Scale was used to evaluate all self-reported symptomatology. Results : Forty-three patients with PTSD, 23 female and 20 male patients, were enrolled in this study. There were significant differences in the frequency and severity of avoidance symptoms, and severity of re-experience symptoms. The female patients reported a higher level of re-experience and avoidance symptoms than the male patients. Conclusion : The results of the present study were found to be consistent with previous studies on gender differences. Women were more susceptible to PTSD symptoms than men, especially exaggerated re-experience and chronic avoidance. Since all patients groups were enrolled from the hospital, this findings needs to be reexamined using community samples.

• Anxiety and mood
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• v.16 no.2
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• pp.83-90
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• 2020

Objective : Heart rate variability (HRV) is known to reflect autonomic nervous system activity. Individuals with posttraumatic stress disorder (PTSD) are reported to have lower HRVs. We attempted to find HRV indices with head up tilt position that reflect the symptoms well in order to evaluate PTSD symptoms. Methods : Sixty-seven patients with PTSD and 72 patients without PTSD were assessed using the PTSD Checklist for DSM-5 (PCL-5), the Beck Depression Inventory, the Beck Anxiety Inventory and the Pittsburgh Sleep Quality Index. HRV was measured in the head-up tilt position. We collected data regarding heart rate (HR), standard deviation of the NN intervals (SDNN), the square root of the mean squared differences of successive NN intervals (RMSSD), log low-frequency (LNLF) and log high-frequency (LNHF). Results : The value of LNHF was different according to presence or absence of PTSD after head-up tilt position. In the findings of the association between PTSD symptoms and HRV indices as based on head-up tilt, LNHF had a significant correlation with the total score of PCL-5. Conclusion : The reduction of the high-frequency component of HRVs in the PTSD group might reflect more PTSD symptoms.

• Anxiety and mood
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• v.16 no.2
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• pp.106-112
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• 2020

Objective : Social anxiety disorder (SAD) is characterized by fear of social threat and exhibits limbic hyper-reactivity toward social stimuli such as emotional faces. A previous study identified the uncinate fasciculus (UF) sub-tract as particularly related to facial memory. To explore the white matter tract relating to face-specific brain regions, we investigated the UF sub-tract in SAD. Methods : The diffusion tensor images of 22 patients with SAD and 20 healthy controls were analyzed with tractography. The UF sub-tract was delineated using the regions of interest of face patches in the anterior temporal lobe and the orbitofrontal cortex, and fractional anisotrophy (FA) and total number of streamlines (ST) were analyzed. We examined the group comparison of FA and ST of the UF sub-tract and correlations of FA and ST with the social anxiety symptoms such as the Liebowitz Social Anxiety Scale (LSAS), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS) and the Fear of Negative Evaluation scale (FNE) in SAD. Results : There were no group differences in FA and ST of the UF sub-tract. However, negative correlations were observed between ST of the right UF sub-tract and severity of social anxiety symptoms (LSAS, r_s=-0.480, p=0.024; SIAS, r_s=-0.580, p=0.005; SPS, r_s=-0.590, p=0.004; FNE, r_s=-0.675, p=0.001) in patients with SAD. Conclusion : Although patients with SAD did not show quantitative abnormalities in the UF sub-tact connecting face-specific brain regions, this structure seems to play a role in the symptom severity of SAD.

• Korean Journal of Biological Psychiatry
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• v.5 no.2
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• pp.227-234
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• 1998

Objective : Many evidences suggest that patients with bipolar disorder have functional abnormalities in their postreceptor signal transduction pathways, and mood stabilizing effect of lithium is exerted by modulating this dysfunctioning system. Carbamazepine, an antiepileptic agent, is also known to be effective in the treatment and prevention of bipolar disorder. But the precise mechanism of action of the drug is still poorly understood. This study was performed to elucidate the possible therapeutic mechanism of carbamazepine. Method : The effects of chronic carbamazepine administration on protein kinase A and protein kinase C activities in frontal cortex of rat brain after 2 weeks of drug administration were measured and compared with those of control subjects. Results : Mean(${\pm}SE$) value of activity(phosphate transfer ${\mu}mol/mg$ of $protein{\cdot}min$) of protein kinase A in control and test group was $0.249563{\pm}0.036$ and $0.539853{\pm}0.078$, and that of protein kinase C was $0.654817{\pm}0.053$ and $1.146205{\pm}0.052$ respectively, being increased in test group. And differences between the two groups were statistically significant for both enzymes(protein kinase A ; p<0.01, protein kinase C ; p<0.001). Conclusion : These results show that chronic carbamazepine administration increases protein kinase A and C activities, and concerning the possible mode of therapeutic action in bipolar disorder it is suggested that enhanced enzymes phosphorylate receptor-G-protein-effector complexes to dampen hyperfunctioning neuronal activity and thus stabilize the system.