A Mixed-Methods Study Protocol for Soma Experiencing Motion Program (Soma e-motion Program): The Effectiveness of Contemplative Movement for Emotion Regulation

Somatics refers to body work and movement study that emphasize internal perception and experience. Recently, a new perspective has emerged that views somatics-based techniques as a kind of mindful movement. Somatic techniques as contemplative movement can improve emotional regulation ability through improvement of body awareness or interoception. Based on this background, the present study attempts to develop a somatics based program suitable for a group of clinical patients suffering from emotional dysregulation. This study plans to collect quantitative and qualitative data in order to clarify how interoception and the related emotional regulation ability change after the program. These findings will help to explore whether the somatics technique has potential as an emotion regulation program in the future. In addition, the results are expected to contribute to finding an alternative treatment modality for patients who have not achieved a sufficient effect with conventional psychotherapy.

A Mixed-Methods Study Protocol for Soma Experiencing Motion Program (Soma e-motion Program): The Effectiveness of Contemplative Movement for Emotion Regulation

Somatics refers to body work and movement study that emphasize internal perception and experience. Recently, a new perspective has emerged that views somatics-based techniques as a kind of mindful movement. Somatic techniques as contemplative movement can improve emotional regulation ability through improvement of body awareness or interoception. Based on this background, the present study attempts to develop a somatics based program suitable for a group of clinical patients suffering from emotional dysregulation. This study plans to collect quantitative and qualitative data in order to clarify how interoception and the related emotional regulation ability change after the program. These findings will help to explore whether the somatics technique has potential as an emotion regulation program in the future. In addition, the results are expected to contribute to finding an alternative treatment modality for patients who have not achieved a sufficient effect with conventional psychotherapy.

Transgenerational Transmission of Trauma: Psychiatric Evaluation of Offspring of Former “Comfort Women,” Survivors of the Japanese Military Sexual Slavery during World War II

“Comfort women” are survivors of sexual slavery by the Imperial Japanese Army during World War II, who endured extensive trauma including massive rape and physical torture. While previous studies have been focused on the trauma of the survivors themselves, the effects of the trauma on the offspring has never been evaluated before. In this article, we reviewed the first study on the offspring of former “comfort women” and aimed to detect the evidence of transgenerational transmission of trauma. In-depth psychiatric interviews and the Structured Clinical Interview for DSM-5 Axis I Disorders were conducted with six offspring of former “comfort women.” Among the six participants, five suffered from at least one psychiatric disorder including major depressive disorder, panic disorder, posttraumatic stress disorder, adjustment disorder, insomnia disorder, somatic symptom disorder, and alcohol use disorder. Participants showed similar shame and hyperarousal symptoms as their mothers regarding stimuli related to the “comfort woman” issue. Increased irritability, problems with aggression control, negative worldview, and low self-esteem were evident in the children of mothers with posttraumatic stress disorder. Finding evidence of transgenerational transmission of trauma in offspring of “comfort women” is important. Future studies should include more samples and adopt a more objective method.

Psychiatric Sequelae of Former “Comfort Women,” Survivors of the Japanese Military Sexual Slavery during World War II

“Comfort women” refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. “Comfort women” endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former “comfort women” currently alive in South Korea is introduced. The participants’ unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former “comfort women” after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former “comfort women” throughout their lives, and even to the present day.

Menopause and Cognitive Function : Hospitalized Female Patients with Depression

OBJECTIVES: Although forgetfulness is a common complaint among menopausal depressed women, there is still a debate about the relationship between memory impairment and menopause. The aim of this study is to examine whether menopause is related to cognitive decline among women with depressive disorders. We hypothesized that postmenopausal depressed women show generally poorer performance than premenopausal depressed women on various cognitive function tests. METHODS: With a retrospective chart review, we identified a total of 87 female patients (45 premenopausal patients and 42 postmenopausal patients) who were hospitalized with depressive disorders from 2000 to 2016. Demographic and clinical variables and cognitive test results were compared between two groups. RESULTS: ducation year is longer in premenopausal group than postmenopausal group whereas clinical characteristics (illness duration, recurrence, and symptom severity) and mean Intelligence Quotient (IQ) were similar between two groups. The postmenopausal group took longer time for Bender-Gestalt Test (BGT) recall, Trail Making Test (TMT)-A, and TMT-B than the premenopausal group. After controlling for age and education, significant difference was remained for BGT recall (p = 0.029). CONCLUSIONS: Postmenopausal state may be related with decline of visuospatial memory function, in particular, among depressed female patients. Other areas of cognitive function including complex attention, verbal memory, auditory memory, and working memory might be interpreted while considering age and education level.

The Difference in Comorbidities and Behavioral Aspects between Internet Abuse and Internet Dependence in Korean Male Adolescents

OBJECTIVE: This study examined the differences in psychiatric comorbidities and behavioral aspects in accordance with the severity of Internet addiction in male adolescents. METHODS: One hundred and twenty-five adolescents from four middle and high schools in Seoul were enrolled in this study. The subjects were divided into non-addict, abuse, and dependence groups according to a diagnostic interview by psychiatrists. The psychiatric comorbidities and behavioral aspects of subjects were evaluated through psychiatric clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders (4th edition), the Children's Depression Inventory, the State-Trait Anxiety Inventory, the Internet Addiction Test, and a self-reported questionnaire about behavioral aspects. RESULTS: The psychiatric comorbidity distributions were significantly different in the abuse and dependence groups, particularly in terms of attention-deficit hyperactivity disorder and mood disorder items. The Children's Depression Inventory, the State-Trait Anxiety Inventory, and the Internet Addiction Test scores were also significantly different among the three groups. There were significant differences in 10 of the 20 items of the Internet Addiction Test between the non-addict, abuse, and dependence groups. There were significant differences in seven items between the non-addict and abuse groups, but no differences between subjects in the abuse and dependence groups. Significant differences were observed in three items between the abuse and dependence groups, but there were no significant differences between the non-addict and abuse groups. In terms of behavioral aspects, scores for abusive, sexual, and decreased social interest behaviors were highest in the dependence group, and lowest in the non-addict group. However, the behavioral aspects of decreased interpersonal relationships did not show this difference between groups. CONCLUSION: This study suggests that there are differences in psychiatric comorbidities and behavioral aspects between adolescent males with characteristics of Internet abuse and Internet dependence.

The Reliability and Validity of the Korean Version of Burden Assessment Scale (K-BAS) / 신경정신의학

OBJECTIVES: This study was conducted for evaluation of the reliability and validity of the Korean version of the Burden Assessment Scale (K-BAS). METHODS: A sample of 256 first-order relatives of schizophrenics completed the K-BAS and the data were analyzed for internal consistency and factor structure. In addition, a subset of participants (n=112) refilled the K-BAS after two weeks for test-retest reliability. To test for validity, the Family Burden Scale (FBS), Korean version of Drug Attitude Inventory-10 (KDAI-10), and Korean version of the Scale to Assess Unawareness of Mental Disorder (SUMD-K) were administered. RESULTS: The Cronbach's alpha coefficient of the K-BAS was high (0.91), which provided evidence for good internal consistency. The test-retest reliability of K-BAS was 0.86 (correlation coefficient, p<0.001). Convergent validity was examined through correlations between the K-BAS and the FBS (r=0.80, p<0.001). Divergent validity was examined through correlations between the K-BAS and KDAI-10 (r=-0.21, p=0.001), and between the K-BAS and SUMD-K (r=-0.02, p=0.796). Results of the factor analysis revealed a three-factor solution: activity limitation, social strain, and feelings of worry and guilt. CONCLUSION: These results suggest that the K-BAS had good psychometric properties and may be a useful instrument for evaluation of burden of families with schizophrenics.

Auditory and Visual P300 in ADHD Children with Higher and Lower IQ : Pilot Study

OBJECTIVES: Intellectual impairment in children with attention-deficit hyperactivity disorder (ADHD) is often associated with relatively severe cognitive dysfunction. This study was designed to investigate cognitive function using auditory and visual event-related potential P300 in children with ADHD with relatively higher and lower IQ. METHODS: A total of 20 children aged 6-12 years with DSM-IV-TR diagnosis of ADHD-combined type were recruited. For 10 children with lower IQ (100), auditory and visual P300 using oddball paradigm (target 0.2, standard 0.8, in probability) were employed. RESULTS: No significant differences were found in P300 amplitude and latency between ADHD children with higher and lower IQ in both modalities. However, auditory P300 amplitude in the right parietal area (P8 electrode) was negatively correlated with verbal IQ in ADHD subjects (R=-.50, p<.05). Visual P300 amplitude in the left parietal area (P3 electrode) was positively correlated with performance IQ in ADHD subjects (R=.57, p<.01). CONCLUSION: This study suggests intellectual impairment, as evidenced by lower IQ, could not be associated with cognitive dysfunction reflected in event-related potential P300 in ADHD children. However, cognitive function reflected in intellectual subcomponents and P300 might be processed in a stimulus modality-specific and asymmetric pattern.

Auditory and Visual P300 in ADHD Children with Higher and Lower IQ : Pilot Study

OBJECTIVES: Intellectual impairment in children with attention-deficit hyperactivity disorder (ADHD) is often associated with relatively severe cognitive dysfunction. This study was designed to investigate cognitive function using auditory and visual event-related potential P300 in children with ADHD with relatively higher and lower IQ. METHODS: A total of 20 children aged 6-12 years with DSM-IV-TR diagnosis of ADHD-combined type were recruited. For 10 children with lower IQ (100), auditory and visual P300 using oddball paradigm (target 0.2, standard 0.8, in probability) were employed. RESULTS: No significant differences were found in P300 amplitude and latency between ADHD children with higher and lower IQ in both modalities. However, auditory P300 amplitude in the right parietal area (P8 electrode) was negatively correlated with verbal IQ in ADHD subjects (R=-.50, p<.05). Visual P300 amplitude in the left parietal area (P3 electrode) was positively correlated with performance IQ in ADHD subjects (R=.57, p<.01). CONCLUSION: This study suggests intellectual impairment, as evidenced by lower IQ, could not be associated with cognitive dysfunction reflected in event-related potential P300 in ADHD children. However, cognitive function reflected in intellectual subcomponents and P300 might be processed in a stimulus modality-specific and asymmetric pattern.

Differences in Performance of ADHD Children on a Visual and Auditory Continuous Performance Test according to IQ

OBJECTIVE: Continuous performance tests (CPTs) are frequently used in clinical practice to assess the attentiveness of ADHD children. Although most CPTs do not categorize T scores by intelligence, there is great diversity of opinion regarding the interrelation between intelligence and CPT performance. This study aimed to determine if ADHD children with superior IQs would perform better than ADHD children with average IQs. Additionally, we aimed to examine the need for CPTs' to categorize according to IQ. METHODS: Participants were 326 outpatients, aged 5-15 years, diagnosed with ADHD. All participants completed the Wechsler Intelligence Scale for Children-Revised and a CPT. After excluding those who meet exclusion criteria, we had 266 patients for our analysis. RESULTS: The "Highly Intelligent Group" (HIG), patients with IQs 120 and above, performed superiorly to the "Normally Intelligent Group" (NIG) patients, with IQs between 70 and 120, with regard to omission and commission errors on the visual-auditory CPT, even after controlling for age and gender. The HIG had higher ratios of subjects with T scores <65 on the visual and auditory CPT variables than the NIG did. CONCLUSION: The results of this study suggest this CPT is not sensitive for discerning ADHD in children with superior IQs; thus, there is a need to standardize the variables based on IQ, as well as on age and gender. Moreover, clinicians need to pay attention to the effect of IQ in interpreting CPT scores; that is, a "normal" score does not rule out a diagnosis of ADHD.

The Reliability and Validity of World Health Organization Quality of Life Assessment Instrument (WHOQOL) in Patients with Breast Cancer: Physical Domain and Depression / 한국유방암학회지

PURPOSE: This study was designed to investigate the reliability and validity of the World Health Organization Quality of Life Assessment Instrument (WHOQOL) in patients with breast cancer according to depressive symptoms. METHODS: One-hundred seventeen patients with breast cancer who had undergone a radical operation were recruited. The 100 item-WHOQOL instrument and Hamilton Rating Scale for Depression were used to measure all the subjects. The five domain scores, except for the WHOQOL spiritual domain, were compared between patients with and without depressive symptoms, and then the reliability and validity of the five domains were calculated. RESULTS: Depressed patients with breast cancer had lower scores in all five domains of the WHOQOL than those who were not depressed in all five domains of WHOQOL [df=(1, 115), F=46.6, p<0.001]. Reliability and validity in the physical domain of depressed patients with breast cancer decreased markedly. CONCLUSION: WHOQOL is a valid and useful instrument for evaluating the quality of life in patients with breast cancer, but is limited in scoring of depressed patients with breast cancer, particularly in the physical domain. Therefore, quality of life must be interpreted with carefully hand in depressed patients with breast cancer.

Auditory Event-Related Potentials P300 in Patients with Schizophrenia: Analysis by Reaction Time / 신경정신의학

OBJECTIVES: Using two stimuli, this study was designed to evaluate variations of P300 in relations to reaction time of pressing the button for target tones in patients with schizophrenia. METHODS: The auditory oddball paradigm was used for the patients (N=22) and normal controls (N=23). The two stimuli were composed of target (20%, 2000 Hz, 75 dB) tone and standard (80%, 1000 Hz, 75 dB) tone, with 2 sec inter-stimulus interval, 50 msec duration and 10 msec rise or fall time. In each subject, P300s were acquired for both fast reaction time (FRT) and slow reaction time (SRT) to target response. RESULTS: P300 amplitude in patients with schizophrenia was lower than controls across FRT and SRT (p0.8). In this study, even though the reaction time for the button pressing task might be faster in patients with schizophrenia (p<0.1), the P300 to FRT in patients with schizophrenia was lower than the P300 to SRT in controls (p<0.01). CONCLUSION: These results suggest that the lower P300 in patients with schizophrenia might be due to cognitive dysfunction and the patient's performance in reaction time for pressing buttons, both independently. Thus, P300 as well as reaction time may be used to further explore a variety of domains of cognitive function.

Natural Killer T Cells in Acute and Unmedicated Patients with Major Depressive Disorder / 신경정신의학

OBJECTIVES: To evaluate an association between depression and altered immunity, we examined peripheral T lymphocyte or natural killer (NK) cell measures plasma ACTH and cortisol using the flow cytometry in acute and unmedicated patients with major depressive disorder (MDD). METHODS: Forty-two patients with MDD from the outpatient clinic and forty normal controls from the hospital staff were recruited. We applied Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) for depressed subjects. Peripheral T lymphocyte or NK cell measures (CD3, CD4, CD8, or CD56) and plasma hormones (ACTH and cortisol) were obtained from all subjects. RESULTS: There were no statistical differences in CD3, CD4, CD8, or CD56 between the two subjects. The number of CD56 cells negatively correlated with HAM-D scores (r=-0.42, p<0.01), but did not correlate with HAM-A scores in patients with MDD. The number of CD56 cells showed strong negative correlation with CD4/CD8 (r=-0.47, p<0.01) in the control group, but not in the depressed group. Patients with MDD had higher cortisol level than controls within the normal range. CONCLUSION: The trait of immunological imbalance and HPA axis abnormality were shown in patients with MDD. Especially, the severity of depression, but not the anxiety, could be reflected as decreased number of CD56 (NK T) cells in acute and unmedicated state.

Quality of Life for Patients who had Breast Cancer Operations: The Validity and Availability for WHOQOL-BREF / 한국유방암학회지

PURPOSE: This study was designed to investigate the validity of the WHOQOL-BREF (Brief form of the World Health Organization Quality of Life Assessment Instrument) and explore the quality of life (QOL) of breast cancer patients who survived after an operation, using the Korean version of the WHOQOL-BREF. METHODS: Fifty (50) breast cancer patients after their operations and obtaining their informed consent were recruited. Hospital staff members served as the controls. The 100 item-WHOQOL instrument was employed for testing all the subjects. The scores of the WHOQOL-BREF, which is a short version (26 questions) of the WHOQOL, includes four domains (physical, psychological, social, and environmental), were compared with those of the WHOQOL. RESULTS: The scores of the WHOQOL-BREF were significantly correlated with those of the WHOQOL in all domains. The physical, psychological, and environmental domains were associated with a worse quality of life in patients with breast cancer. CONCLUSION: The WHOQOL-BREF is a valid and useful instrument for evaluating the quality of life in patients with breast cancer.

Event-Related Potential P3a and P3b using 3-Stimulus Auditory "Oddball" Paradigm in the Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions simultaneously, we examined patients with schizophrenia. METHODS: Fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). RESULTS: P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300 latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). CONCLUSION: These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.

Event-Related Potential P3a and P3b using 3-Stimulus Auditory "Oddball" Paradigm in the Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions simultaneously, we examined patients with schizophrenia. METHODS: Fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). RESULTS: P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300 latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). CONCLUSION: These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.

Quality of Life in Patients with Stomach Cancer after a Curative Resection: The validity and availability of WHOQOL-BREF

PUPOSE: This study was designed to investigate the validity of WHOQOL-BREF (Brief form of the World Health Organization Quality of Life Assessment Instrument) and to explore quality of life (QOL) by using WHOQOL-BREF in patients with stomach cancer after a curative resection. MATERIALS AND METHODS: Fifty (50) patients with stomach cancer after a curative resection were recruited with informed consents. Age- and gender matched hospital staffs served as controls. The 100-item WHOQOL instrument was employed for the all subjects. The scores of the WHOQOL-BREF, which is a short version (26 questions) of the WHOQOL, and includes four domains (physical, psychological, social, and environmental), were compared with those of WHOQOL. RESULTS: The scores of the WHOQOL-BREF were significantly correlated with those of the WHOQOL in all domains. Two domains, physical and social, were associated with worse quality of life in patients with stomach cancer after a curative resection. CONCLUSION: The WHOQOL-BREF is a valid instrument that is useful for evaluating the quality of life in patients with stomach cancer.

A Preliminary Study on the Quality of Life for Patients Who Had Breast Cancer Operations / 한국유방암학회지

PURPOSE: This study was designed to explore the quality of life (QOL) for breast cancer patients who survived after operation by using the World Health Organization Quality of Life (WHOQOL) instrument-Korean version. METHODS: Fifty patients with breast cancer were recruited after their operations, and an informed consent was obtained from each of them. Hospital staff members served as the controls. The 100 item-WHOQOL instrument included questions on the physical, psychological, social, independence, environmental and spiritual domains, and it was employed for testing the all subjects. RESULTS: The physical, psychological, independence and social domains were shown to have a worsened quality of life for patients with breast cancer who survive after their operations. Quality of life in the physical and social domains were perceived as worse by patients having advanced stage tumor, with mastectomy. Patients with mastectomy who survived their cancer felt a worse quality of life in the psychological domain. The quality of life scores for patients having advanced stage tumor with mastectomy, during the early postoperative period (< or =2 years) was lower for the independence domain. Patients at middle postoperative period (2~5years) felt a better quality of life in spiritual domain. CONCLUSION: Not only is the objective medical success important to female breast cancer survivors, but the individual subjective perception of their condition is also important. The psychological status of these women needs to be considered when managing patients with breast cancer after their surgical operation. In this context, the WHOQOL reflects a measurement of a multi-dimensional state of well- being, and it could be a useful tool across a variety of cultural and value systems in the world.

A Case of Huntington's Disease with Generalized Seizure and Prominent Family History of the Disease / 신경정신의학

Huntington's disease(HD), an autosomal dominant disorder, is characterized by progressive involuntary choreiform movement, psychiatric symptoms, and dementia. We experienced a 44-year-old male HD patient with prominent family history of the disease who showed dementia and involuntary movements including chorea. The diagnosis was made by clinical symptoms, family history of the disease, and brain MRI findings to show bicaudate atrophy and diffuse cortical atrophy with marked ventricualr dilatation. Interestingly, the patient frequently exhibited generalized tonic-clonic seizures. The seizures first appeared about 3 to 4 years after the onset of HD and were controlled with valproic acid. To our knowledge, this may be the first case of lateonset HD accompanied by generalized seizures and we report this case with literature review.

A Topographic Study of Auditory Event-Related Potential P300 in Patients with Schizophrenia / 신경정신의학

OBJECTIVE: Results from various methodological modalities indicate laterality of brain function and information processing abnormalities in patients with schizophrenia. In neurophysiological field, there is particular interest in the P300 component of event related potentials, being recorded during discriminative information processing. A wide literatures documented reduction of P300 amplitudes in schizophrenic patients. The present study was designed to investigate the topographic pattern of amplitudes of P300 in the patients with schizophrenia. METHOD: The subjects were composed of patients (N=20) with schizophrenia by DSM-VI and normal controls (N=20). The Auditory event related potential P300 were measured by "oddball paradigm", which known as a standard method. P300 latency was determined by Global Field Power and amplitudes measured on 5 electrodes (Fz, Cz, Pz, T3, T4) were compared between controls and patients. RESULTS: There were reduction of P300 amplitudes on all 5 cortical areas in patients with schizophrenia compared with normal controls. There is no anterior to posterior effect but also left to right effect in the both groups. CONCLUSION: P300 amplitudes reduction without localization were founded in patients with schizophrenia.