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Objectives@#The effectiveness of drugs currently used in medication, which is important in the treatment of alcohol use disorders, is limited. Recently, ondansetron which acts as 5-HT3 receptor antagonist, has been studied and proved possibility as new medication for alcohol use disorder. Meanwhile, there are studies supporting that 5-HT1A receptors are related to addictive behavior. Considering those studies, we expect that vortioxetine, which acts as both 5-HT3 receptor antagonist and 5-HT1A receptor agonist, may be effective in treatment of alcohol use disorder. The purpose of this study is to examine the effect of vortioxetine on alcohol intake of C57BL/6 mice. @*Methods@#In this study C57BL/6 mice were randomly assigned to normal saline group, vortioxetine 10 mg/kg group and vortioxetine 1 mg/kg group. To study effect of vortioxetine on alcohol, water, food intake and body weight of mice, we administered each medication for 14 days. @*Results@#The overall alcohol intake was different between the three groups (PGroup=0.021), and alcohol intake in vortioxetine 10 mg/kg group was significantly lower than one in placebo group. Change across time points (PTime<0.001) and the interaction between group and time (PGroup×Time =0.016) were also significant. However, there were no significant differences between the three groups in water, food intake and body weight. @*Conclusions@#These results indicated that administration of high dose vortioxetine reduced alcohol intake of mice.Therefore, it is necessary to conduct clinical studies to examine the effectiveness of vortioxetine as a new treatment for alcohol use disorder.
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Objectives@#The purpose of the study was to classify the health and medical service affairs of local governments, and to analyze the proportions of non-matching fund by local governments and central government subsidies for local government health budget. @*Methods@#First of all, health affairs of local governments were classified to categories based on health-related laws and previous studies by review of the authors. In order to specify the scale of local government-led health affairs, we allocated 1,916 budget units into 6 main and 24 sub categories of the health and medical service affairs of local governments for the 2020 health budget of Jeju Special Self-Governing Province. For each categories, we compared the total amounts and the percentages of the 'central government subsidies', 'local government budget - matching fund', and 'local government budget -non-matching fund'. @*Results@#The total health budget of Jeju Special Self-Governing Province accounts for 1.2% of the total budget. Of the total health budget of Jeju Special Self-Governing Province, the proportion of central government subsidies was 39.6% and the proportions of local government budget-matching fund and non-matching fund were 33.8% and 26.6%, respectively. The proportions of non-matching fund by provincial and basic local governments were 37.3% and 19.9%, respectively. @*Conclusion@#In order for local governments to deal with the health problems of residents, it is necessary to secure and spend more local government budget(i.e., non-matching fund by local government) for health affairs in their administrative jurisdiction.
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Objectives@#Bipolar disorder has a high rate of recurrence, which can cause problems such as declines in cognitive and social functions. Lithium is the primary medication for preventing recurrence, but the medication compliance is poor owing to side effects that include diarrhea, tremor, polyuria, polydipsia, diabetes insipidus, increased creatinine level, and weight gain. Polyuria and polydipsia also cause voluntary discontinuation of the medication. However, no domestic and international studies have evaluated the direct correlation between lithium therapy and polydipsia in pediatric patients. Therefore, we assessed this relationship by evaluating urine osmolality changes after lithium administration in pediatric patients. @*Methods@#This study focused on patients admitted to the Department of Psychiatry, Pusan National University Yangsan Hospital. Patients had bipolar disorder types I or II and other specified bipolar disorders based on the DSM-5, criteria at discharge from December 1, 2018, to April 31, 2020. Urine osmolarity changes from admission to discharge in the patients who used lithium for the first time after admission were reviewed. @*Results@#For 47 patients, the change in osmolality was statistically significant (mean, 203.32±280.68; p<0.001) and significantly higher in those aged <14 years than in those aged ≥14 years (p=0.038). Antipsychotic use and sex-related differences did not affect urine osmolality. @*Conclusion@#The first-time users of lithium had significantly reduced urine osmolality at discharge. Considering the lithium effect on the kidneys, a prospective study to identify the relationship between lithium use and polydipsia is necessary.
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Objectives@#Bipolar disorder has a high rate of recurrence, which can cause problems such as declines in cognitive and social functions. Lithium is the primary medication for preventing recurrence, but the medication compliance is poor owing to side effects that include diarrhea, tremor, polyuria, polydipsia, diabetes insipidus, increased creatinine level, and weight gain. Polyuria and polydipsia also cause voluntary discontinuation of the medication. However, no domestic and international studies have evaluated the direct correlation between lithium therapy and polydipsia in pediatric patients. Therefore, we assessed this relationship by evaluating urine osmolality changes after lithium administration in pediatric patients. @*Methods@#This study focused on patients admitted to the Department of Psychiatry, Pusan National University Yangsan Hospital. Patients had bipolar disorder types I or II and other specified bipolar disorders based on the DSM-5, criteria at discharge from December 1, 2018, to April 31, 2020. Urine osmolarity changes from admission to discharge in the patients who used lithium for the first time after admission were reviewed. @*Results@#For 47 patients, the change in osmolality was statistically significant (mean, 203.32±280.68; p<0.001) and significantly higher in those aged <14 years than in those aged ≥14 years (p=0.038). Antipsychotic use and sex-related differences did not affect urine osmolality. @*Conclusion@#The first-time users of lithium had significantly reduced urine osmolality at discharge. Considering the lithium effect on the kidneys, a prospective study to identify the relationship between lithium use and polydipsia is necessary.
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OBJECTIVES: Haenyeo are Korean professional women breath-hold divers in Jeju island. The aim of this study was to investigate the clinical characteristics of depressed Haenyeo group, compared to non-Haenyeo depressed group. METHODS: This study included 75 Haenyeo and 340 non-Haenyeo with depressive disorders recruited from the Dementia Early Detection Program in Jeju island. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview. All patients completed the questionnaires, including the Subjective Memory Complaints Questionnaire (SMCQ), the Patient Health Questionnaire-15 (PHQ-15), and the Blessed dementia scale. Depression was evaluated by the Korean version of short form the Geriatric Depression Scale (K-SGDS) and cognition was assessed by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment packet. RESULTS: Although the mean scores of the K-SGDS were similar between Haenyeo and non-Haenyeo depressed groups, the Haenyeo group showed a higher mean score on the PSQ-15 (p < 0.001, ANCOVA adjusting for age, the K-SGDS and education). The Haenyeo group showed poorer performance on the Korean Version of Frontal Assessment Batter (p < 0.001), the Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet (p < 0.018), the word fluency test (p < 0.001), and the word list memory test (p = 0.012) in ANCOVA adjusting for age and education. The mean SMCQ score was higher in the Haenyeo depressed group than in the non-Haenyeo depressed group. CONCLUSIONS: The Haenyeo depressed group shows cognitive dysfunction, especially frontal lobe dysfunction, compared to the non-Haenyeo depressed group, indicating the Haenyeo depressed group may have more severe frontolimbic dysfunction due to chronic exposure to hypoxia. The Haenyeo depressed group suffers more somatic symptoms than the non-Haenyeo depressed group.
Subject(s)
Female , Humans , Alzheimer Disease , Hypoxia , Cognition , Dementia , Depression , Depressive Disorder , Education , Frontal Lobe , MemoryABSTRACT
OBJECTIVES: We developed the Korean version of Severe Mini-Mental Status Examination (SMMSE-K) which is a brief cognitive test for the severely demented patients. METHODS: The translation was carried out keeping the basic structure of the English version Severe Mini-Mental Status Examination (SMMSE). The SMMSE-K, Korean version of Mini Mental State Examination (MMSE-KC), and Clinical Dementia Rating (CDR) were administered to 84 Alzheimer's disease (AD) patients and 36 cognitively normal elderly subjects. For evaluating the reliability of the SMMSE-K, Cronbach alpha coefficient, inter-rater reliability, and test-retest reliability were examined. For confirming the validity of the SMMSE-K, the correlations of the SMMSE-K with MMSE-KC and CDR were examined, and factor analysis was performed using principal component analysis with Varimax rotation. RESULTS: SMMSE-K was found to have a high internal consistency (Cronbach alpha coefficient=0.906, p<0.01), inter-rater reliability (Pearson correlation coefficient=0.980, p<0.01) and test-retest reliability (Pearson correlation coefficient=0.940, p<0.01). Performances on the SMMSE-K and MMSE-KC were found to correlate significantly in the subjects with CDR of 2 (Pearson correlation coefficient=0.827, p<0.001) and 3 (Pearson correlation coefficient=0.929, p<0.001). In the subjects with CDR of 3, the MMSE-KC showed a floor effect (2.93+/-3.21), whereas the SMMSE-K did not (11.00+/-8.48). Exploratory factor analysis yielded two factors (automatic informational processing, controlled informational processing) accounting for 76.1% of the total variance. CONCLUSION: The SMMSE-K was found to be a reliable and valid test for assessing the cognition of severely demented patients.
Subject(s)
Aged , Humans , Accounting , Alzheimer Disease , Cognition , Dementia , Deoxycytidine , Floors and Floorcoverings , Principal Component Analysis , Reproducibility of ResultsABSTRACT
OBJECTIVES: We investigated the predictors of subjective memory complaints in the community-dwelling normal elderly. METHODS: This study was conducted as a part of Korean Longitudinal Study on Health and Aging (KLoSHA). 747 nondemented community-dwelling elderly aged 65 years or older were recruited. All participants underwent clinical evaluation for dementia and psychiatric disorder conformed to the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) Clinical Assessment Battery and Korean version of Mini-International Neuropsychiatric Interview, respectively. Word list recall test, frontal assessment battery, Mini Mental Status Examination (MMSE-KC) and Korean version of Geriatric depression scale (GDS-K) were administered to evaluate episodic memory, frontal function, global cognition and depression, respectively. Subjective memory complaint was defined in two different ways: worse than one's past (SMC-P) and worse than others of one's age (SMC-O). RESULTS: In highly educated elderly, minor depressive disorder (OR=7.23, 95% C.I.= 2.29-22.86) and frontal dysfunction (OR=2.48, 95% C.I.=1.29-4.77) significantly increased the risk of SMC-O. However, they did not influence the risk of SMC-P. In low educated elderly, both the minor depressive disorder and frontal dysfunction did not influence the risk of SMC-O as well as that of SMC-P. CONCLUSION: SMC-O can be a sensitive subjective recognition of mild depression and/or frontal dysfunction in highly educated normal elderly.