• Title/Summary/Keyword: somatic symptoms

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Comparison of the Bupropion versus Aripiprazole Adjunctive Therapy for the Treatment of Female Depression : Post-Hoc Analyses from a Randomized Prospective Open-Label Multi-Center Study (여성 우울증 환자에서 Aripiprazole과 Bupropion 부가요법의 우울증상 및 안전성에 대한 효과 비교 : 사후분석연구)

  • Keum, Mu-sung;Cheon, Eun-Jin;Lee, Kwang-Hun;Koo, Bon-Hoon;Lee, Young-Ji;Park, Young-Woo;Lee, Jong-hun;Lee, Seung-Jae;Sung, Hyung-Mo
    • Mood & Emotion
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    • v.16 no.3
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    • pp.140-151
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    • 2018
  • Objectives : The purpose of this study was to examine effects of adjunctive aripiprazole versus bupropion, on depressive symptoms of female depression. Methods : Sixty six female patients with major depressive disorders were enrolled from a six-week, randomized prospective open-label multi-center study. Participants were randomized to receive aripiprazole (2.5-10 mg/day) or bupropion (150-300 mg/day). Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale (HAM-D17), Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores, and Clinical Global Impression-Severity (CGI-S) were obtained at baseline and after one, two, four, and six weeks. Changes on individual items of HAM-D17 were assessed as well as on composite scales (anxiety, insomnia and drive), and on four core subscales that capture core depression symptoms. Results : Overall, both treatments improved depressive symptoms, without causing serious adverse events. There were significant differences in the HAM-D17 total score (p=0.046) and CGI-S (p=0.004), between aripiprazole and bupropion augmentation, favoring aripiprazole over bupropion. Aripiprazole revealed significantly greater effect size in depressed mood (p=0.006), retardation (p=0.005), anxiety psychic (p=0.032), and general somatic symptom (p=0.01). Conclusion : While both treatments were effective, results of this study suggested that aripiprazole may be preferable, in treating general and core symptoms of female depression.

The Clinical Report about the Stagnation Syndrome of Qi (기울증) Treated with Gyogam-dan plus Ganggi-tang (기울증을 교감단합항기탕으로 치료한 임상 1예)

  • 이진헌;조성은;우영민;김용호
    • The Journal of Korean Medicine
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    • v.22 no.4
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    • pp.171-176
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    • 2001
  • The Stagnation Syndrome of Qi is the depressed and suppressed mental state caused by anxiety, unaccomplished desire, maintained thought, and emotional problems, resulting in a concomitant physiological somatic dysfunction. Although blood test, urine test, EKG, and gastric endoscopy showed normal finding. a patient complained of a group of symptoms, so we considered it as an unidentified clinical syndrome. This syndrome could be interpreted as the disconnection of Fire (Heart) and Water (Kidney) in Oriental medicine, and treated with the therapeutic method of 'Ascending Water-Descending Fire'. After the application of Gyogam-dan and Ganggi-tang for 18 days, symptoms and signs improved.

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Questionnaire Survey of Nonherbal Therapy of Hwabyung in Professionals (화병의 비약물요법에 관한 전문가집단 설문 연구)

  • Lee, Seung-Gi;Choi, Woo-Jin;Kang, Hyung-Won;Koo, Byung-Soo;Kim, Geun-Woo;Lee, Jae-Hyuk
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.133-141
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    • 2009
  • Objectives : This study was performed to develop Hwabyung clinical guideline. Acupuncture, moxibustion, negative therapy and psychotherapy were selected, and herbal therapy was excluded in this study. Methods : 27 questions were composed to investigate nonherbal therapy of Hwabyung. They were answered by the experts. They are the professors of oriental neuropsychiatry in Korea. Results and Conclusions : Most experts use acupuncture mainly in treating Hwabyung. They think that acupuncture therapy is needed by all means. Moxibustion, negative therapy and psychotherapy are also utilized mainly or partially to treat Hwabyung, Moxibustion and negative therapy are usually done for somatic symptoms, and psychotherapy is for mental symptoms.

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Stress, Anxiety, and Depression of the Patients Who Complained of Functional upper Gut Symptoms (기능성 상부 위장관 증상을 호소하는 환자의 스트레스, 불안 및 우울)

  • Lee, Sang-Yeol;Shean, Sung-Hun;Choi, Suk-Chei
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.3-12
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    • 1998
  • Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.

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Factor Structure of the Beck Depression Inventory in Anxiety Disorder (불안 장애에서 벡우울척도의 요인구조)

  • Yang, Hyun-Joo;Kim, Dae-Ho;Jang, Eun-Young;Han, Chang-Woo;Park, Yong-Chon
    • 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.

Associations Between Heart Rate Variability and Symptom Severity in Patients With Somatic Symptom Disorder (신체 증상 장애 환자의 심박변이도와 증상 심각도의 연관성)

  • Eunhwan Kim;Hesun Kim;Jinsil Ham;Joonbeom Kim;Jooyoung Oh
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.108-117
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    • 2023
  • Objectives : Somatic symptom disorder (SSD) is characterized by the manifestation of a variety of physical symptoms, but little is known about differences in autonomic nervous system activity according to symptom severity, especially within patient groups. In this study, we examined differences in heart rate variability (HRV) across symptom severity in a group of SSD patients to analyze a representative marker of autonomic nervous system changes by symptoms severity. Methods : Medical records were retrospectively reviewed for patients who were diagnosed with SSD based on DSM-5 from September 18, 2020 to October 29, 2021. We applied inverse probability of treatment weighting (IPTW) methods to generate more homogeneous comparisons in HRV parameters by correcting for selection biases due to sociodemographic and clinical characteristic differences between groups. Results : There were statistically significant correlations between the somatic symptom severity and LF (nu), HF (nu), LF/HF, as well as SD1/SD2 and Alpha1/Alpha2. After IPTW estimation, the mild to moderate group was corrected to 27 (53.0%) and the severe group to 24 (47.0%), and homogeneity was achieved as the differences in demographic and clinical characteristics were not significant. The analysis of inverse probability weighted regression adjustment model showed that the severe group was associated with significantly lower RMSSD (β=-0.70, p=0.003) and pNN20 (β=-1.04, p=0.019) in the time domain and higher LF (nu) (β=0.29, p<0.001), lower HF (nu) (β=-0.29, p<0.001), higher LF/HF (β=1.41, p=0.001), and in the nonlinear domain, significant differences were tested for SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), and Alpha1/Alpha2 (ß=0.43, p=0.001). Conclusions : These results suggest that differences in HRV parameters by SSD severity were showed in the time, frequency and nonlinear domains, specific parameters demonstrating significantly higher sympathetic nerve activity and reduced ability of the parasympathetic nervous system in SSD patients with severe symptoms.

Prediction of Depression among Elderly with Mild Cognitive Impairment Living in the Community (경도인지장애 노인의 우울 예측 요인)

  • Shin, Kyung-Rim;Kang, Youn-Hee;Kim, Mi-Young;Jung, Duk-Yoo;Lee, Eliza
    • Korean Journal of Adult Nursing
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    • v.24 no.2
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    • pp.171-182
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    • 2012
  • Purpose: This study aimed to identify depression and its predictors among Korean community-dwelling elderly with mild cognitive impairment. Methods: Secondary data analyses of the data collected by the "Study on tailored integration program for reinforcing cognitive and physical function of the frail elderly. The study used data from one-to-one interviews using structured questionnaires. The subjects were 346 community-dwelling elderly who visited a healthcare center in Seoul, Korea. A descriptive correlational study design was utilized to explore depression and its predictors including physical factors and psychosocial factors among the elderly with mild cognitive impairment. Data were analyzed using t-test, Pearson's correlation, and hierarchical regression. Results: Mean score of depression was within normal limit $11.61{\pm}6.69$. Somatic symptoms, negative life events (severity), social support were shown as significant predictors of depression. The most influential predictor for depression was somatic symptoms (${\beta}$=.340, $p$ <.001). Conclusion: To prevent and relieve depression in the elderly with mild cognitive impairment, nursing intervention strategies which consider well-balanced physical and psychosocial aspects are needed. In particular, a specific nursing intervention strategy is required to improve physical health of the elderly with mild cognitive impairment.

Psychotic Disorder Induced by Appetite Suppressants, Phentermine or Phendimetrazine : A Case Series Study (식욕억제제 Phentermine, Phendimetrazine으로 유발된 정신병적 장애 증례군 연구)

  • Kwak, Sookyoung;Youn, Tak;Lee, Nam Young;Chung, In Won;Kim, Se Hyun
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.134-141
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    • 2017
  • Objectives A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. Methods A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. Results Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. Conclusions These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.

A Case of Panic Disorder Complained Enervation and Unstable Blood Pressure Improved by Herbal Medicine and Cognitive Behavioral Therapy (무력감과 불안정한 혈압을 호소하는 공황장애 환자에게 한방치료 및 인지행동치료를 병행하여 호전된 1례(例))

  • Seok, Seon-Hee;Yoo, Jong-Ho;Kim, Geun-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.3
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    • pp.193-207
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    • 2007
  • Panic disorder is one of the anxiety disorder, characterized by panic attacks which are discrete episodes of fear accompanied by somatic symptoms such as shortness of breath, palpitations, chest pain, choking, dizziness, trembling and/or faintness. We experienced a 41 year-old male who complained of sudden enervation, unstable blood pressure and anxiety about self's symptoms. We bad given herbal medicines aoh cognitive & behavioral therapy. Results from studies to date suggest the cognitive behavioral therapy(CBTl are useful for depression, anxiety disorder, phobia. He understood his symptom's meaning and tried to overcome fear related to symptoms through exposure training. We concluded that cognitive behavioral therapy can be very effective methods to treat panic disorder, because patient with panic disorder has maladaptive automatic thoughts, based on dysfunctional beliefs like "I'm too weak, I have some problem."

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Acute Pandysautonomic Neuropathy 2 Cases (급성 범자율신경장해성신경병증 (Acute Pandysautonomic Neuropathy) 2개증례)

  • Chun, Jong-Un;Lee, Yong-Seok;Nam, Hyunwoo;Park, Seong-Ho
    • Annals of Clinical Neurophysiology
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    • v.3 no.1
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    • pp.43-46
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    • 2001
  • Acute pandysautonomic neuropathy(APN) is an uncommon clinical entitiy involving vasomotor, sudomotor, pupilomotor, secretomotor and other autonomic systems. Both sympathetic or parasympathetic fibers are involved with relative preservation of somatic sensory and motor function. Although APN shares several clinical features with GBS, it is not clear whether APN is a subvariety of GBS. We report two young patients with APN. Patient 1 was a 18-year-old girl with recurrent fainting spells. Patient 2 was a 23-year-old man sufferring from unexplained nausea and vomiting. Both had a history of previous upper respiratory infection. They presented with gastroparesis, anhydrosis and orthostatic hypotension. Mild numbness and tingling sense was present, but motor power was intact. Neurologic examination showed bilateral tonic pupil, decreased pain and vibration sense, and absent tendon reflexes. Nerve conduction study indicated diffuse sensorimotor polyneuropathy. Nerve biopsy in patient 2 revealed axonal degeneration. After conservative management, gastrointestinal symptoms were improved in patient 2, however, patient 1 suffered from the symptoms lasting more than several months. These cases suggest that post-infectious dysautonomic symptoms in young patient may indicate the diagnosis of APN. Although the natural course is generally benign, accurate diagnosis and proper management may be mandatory for the better clinical outcome.

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