Impact of Mental Disorders on Functional Disability: Effect of Non-Psychotic Common Mental Disorders on Work Loss Days / 신경정신의학

OBJECTIVES: This study was conducted to explore the relationship between non-psychotic, common mental disorders and work loss days, using data from 2001 KECA survey. METHODS: Six thousands and two hundred seventy-five community dwelling subjects, aged 18 years or older, were interviewed by using the Korean version of Composite International Diagnostic Interview (K-CIDI). Common mental disorders during last 12 months were assessed by work loss days of past month with questions from the WHO Disablement Assessment Scale version 2 (WHODAS-II). Main analysis was done by Linear and Logistic regressions to identify the association between mental disorders and work loss days. RESULTS: As expected, mental disorders were associated with substantial work loss days. Subjects with major depression had highest work loss days. Many common anxiety disorders like social phobia, specific phobia and posttraumatic stress disorder were also associated with high work loss days. CONCLUSION: Our results show that a number of common mental disorders might have substantial effect on job function, quality of life and, subsequently, social productivity. Therefore it seems that more attention for public mental health efforts is warranted.

Characteristics of Diagnostic Criteria for Depression in Korea / 신경정신의학

BACKGROUNDS: Many Korean epidemiologic studies reported lower prevalence rates of depression than those of Western countries. For the low prevalence, it is explained that there's something wrong in the direct application of diagnostic criteria of depression to Korean culture, i.e. categorical fallacy, or it may be truly low-prevalent. We will analyze diagnostic criteria for depression defined by Western. METHODS: Six thousand and two hundred seventy-five community dwelling subjects, aged 18-64 years were interviewed by using Korean version of Composite International Diagnostic Interview (K-CIDI). Diagnostic criteria for depression defined by DSM-IV were analyzed using the item response theory. RESULTS: We could not find any fallacies of diagnostic criteria for depression defined by DSM-IV when assessing depre-ssion among Koreans. Fatigue, concentration difficulties, and sleep disturbance appeared more frequently in mild depression, while psychomotor change, death/suicide, and worthlessness/guilt did not appear until severe depression. CONCLUSION: The diagnostic criteria for depression defined by DSM-IV are appropriate for the Koreans. There are different responding levels, i.e. threshold, of depressive criteria according to severities of depression. Koreans with depression are more likely to complain of appetite change, but less of worthless or guilty feelings than Western people.

Significance of Postoperative Peritoneal Drainage and Peritoneal Dialys is in Infants with congenital Heart Disease Who Underwent Open Heart Srugery

PURPOSE: We reviewed 5 years worth of experience with peritoneal drainage and dialysis in infants who underwent open heart surgery. The aim of this study was to investigate the effect of peritoneal drainage and peritoneal dialysis on fluid balance and several parameters of intensive care. METHODS: Six(10%) of 60 consecutive infants who underwent open heart surgery required peritoneal dialysis during peritoneal drainage. Simple peritoneal drainage was performed in the remaining 54 infants. The silicone rubber peritoneal dialysis catheter was inserted into the center of abdominal cavity just after operation, and subsequent peritoneal drainage was maintained during intensive care. RESULTS: Mean age of the study group was 0.48+/-0.21 years(M: F=32: 28). Early postoperative mortality amang the infants with congenital heart disease was 1.6%. Total amount of output was 7.0+/-2.28mL/kg/hr, urine output 5.14+/-2.9lmL/kg/hr, pleural fluid 0.80+/-0.5lmL/kg/hr, and peritoneal fluid 1.20+/-0.90mL/kg/hr. The ratio of output to intake(O/I) was 1.06. None of the complications required early termination of peritoneal drainage or peritoneal dialysis. Hemodynamics and pulmonary function were maintained steadily during postoperative intensive care. CONCLUSION: The early institution of peritoneal drainage and peritoneal dialysis in infants with congenital heart disease after cardiac operations not only removes fluid, thus easing fluid restriction, but may also improve cardiopulmonary function.

A Case of Mosaic Tetrapaloidy

Tetraploidy of human chromosome(92, XXYY) has been described very rarely. Liveborn infant with tetraploidy was reported in only 17 cases(complete 7 cases, mosaicism 10 cases) in the world, and no cases have been reported in Korea. The diploid-tetraploid mosaicism could arise during the early mitosis of the zygote. In one blastomeric cell, the chromosomes replicate but the cytoplasrn does not divide. We report a case of live infant with mosaic tetraploidy detected in lymphocyte(30%) and amniotic cell culture(25%), who presented with multiple congenital anomalies. A brief review of the literature is included.