Association Between Sleep Pattern, Chronotype and Depressive Symptoms in Korean Adults

Objectives@#The aim of this study was to examine the association between the sleep pattern, chronotype (midpoint of sleep on free days) and the depressive symptoms in adults aged 19 years and over in Korea. This study also investigated the mediating effect of perceived usual stress (PUS) and self-rated health (SRH) on the association between chronotype and depressive symptoms. @*Methods@#Among the subjects of the 7th Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018, 16142 adults aged 19 or over responded to the survey and finally 8604 were analyzed according to the exclusion conditions. Logistic regression analysis was conducted to see the risk of depressive symptoms, suicidal ideation over sleep pattern, chronotype. Finally, mediation analysis was performed in order to clarify how PUS and SRH are associated to chronoytpe and depression. @*Results@#After controlling for potential covariates, weekly sleep duration < 5 hours, ≥ 10 hours was associated with depressive symptoms. And late bed time sleeping after am 1:00 and later midpoints of sleep was associated with a higher level of depressive symptoms. Additionally, the PUS and SRH between chronotype and depressive symptoms showed a serial multiple mediation effect. @*Conclusions@#Short or long sleep duration, late bed time and later midpoints of sleep on free days are associated with depressive symptoms. Furthermore, the mechanism between chronotype and depressive symptoms needs to be further clarified by identifying the serial multiple mediation effects of PUS and SRH.

Socio-Demographic and Clinical Variables Associated with Chronic Homelessness among the Street Homeless People / 신경정신의학

OBJECTIVES: This exploratory study was designed to estimate the socio-demographic characteristics, course of homelessness, adverse childhood experiences, and prevalence of mental disorders among the street homeless people in Seoul, Korea. In addition, we examined the associations between chronic homelessness and study variables. METHODS: The study subjects were 75 homeless people dwelling in the street around Seoul Station. Questionnaires related to socio-demographic data and the course of homelessness were provided to each subject. The subjects' Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) mental disorder diagnoses were made by using Mini International Neuropsychiatric Interview-Plus interviews. RESULTS: Most subjects exhibited chronic homelessness and the prevalence of DSM-IV mental disorders among the homeless subjects was higher than that among the Korean general population. There was a statistically significant association between chronic homelessness and adverse childhood experiences. Compared to those with no history of childhood adversity, homeless people with a history of childhood adversity had a younger age of first homeless episode and a higher prevalence of DSM-IV major mental disorders. The association between DSM-IV diagnosis and chronic homelessness was not significant, but the group with mental disorders had more prevalent re-housing and homeless recurrent histories. CONCLUSION: Street homeless people were often involved in chronic homelessness. Results of this study suggest that homeless people who were never married and had adverse childhood experiences were more vulnerable to chronic homelessness. In addition, we detected a possible relationship between the recurrence of homelessness and the presence of mental disorders.

The Effect of Subjective Physical and Mental Health on Cognitive Decline in the Elderly

OBJECTIVES: The aim of this study was to describe subjective physical and mental health assessed by the single item self-rated physical health (SRPH), and self-rated mental health (SRMH) had influence on the cognitive decline in community-dwelling elderly. METHODS: This study was based on the Suwon Project, a cohort comprising of non-random convenience samples of ethnic Koreans aged 60 years and above. 1,356 individuals were assessed at 2 time points 2 years apart for questionnaire which included demographic characteristics, medical history, Korean Mini-Mental State Examination (K-MMSE), Korean version of Geriatric Depression Scale (SGDS-K), SRPH, and SRMH. Multiple logistic regression was used to assess K-MMSE score change from the SRPH, and SRMH. RESULTS: At baseline, both SRPH (beta=0.18, p<0.01) and SRMH (beta=0.19, p<0.01) score positively associated with the K-MMSE score. At follow-up, subjects with baseline lower SRMH score had significantly greater decline in K-MMSE score (beta=0.09, p=0.007). However, baseline SRPH score showed no effect to follow up K-MMSE score before and after adjusting age, sex, education, number of chronic disease, SGDS-K, and baseline K-MMSE score (p=0.89). CONCLUSION: Brief and easily collected subjective mental health may predict the risk of cognitive decline, but subjective physical health may not.

Relationship between Social Activity and Cognitive Function in Korean Elderly

OBJECTIVES: Among non-pharmaceutical measures for preventing cognitive impairment, involving in social activities is known to be very effective. We tried to examine the correlation between social activity and cognitive function. METHODS: This study was based on the Suwon Project, a cohort comprising of non-random convenience samples of ethnic Koreans aged 60 years and above. All the subjects completed the study questionnaire which included demographic characteristics, current and past history of illnesses, drug history, Korean version of Mini Mental State Examination (K-MMSE), Korean version of Short Form Geriatric Depression Scale, and Beck Anxiety Inventory. We checked the time consumed in each 9 social activities through the checklist. RESULTS: On multiple logistic regression analysis, the total time spent in social activities wasinversely associated with the K-MMSE score after adjusting confounding variables like age, sex, education level, depression, anxiety and vascular risk factor (beta=-0.041, p=0.024). On the other hand, correlation was found between K-MMSE score and time spent in participating in religious party (beta=0.053, p=0.003) as well as time spent in elder's university (beta=0.040, p=0.025) after adjustingage, sex, education, depression, anxiety and vascular risk factor. CONCLUSION: Our results suggest that involving in quality social activities might be more effective in improving cognitive function than spending longer total time in any social activity.

A Study of Antidepressant and Mood Stabilizer's Effect on Phase of Peripheral Circadian Rhythm in Rat Fibroblast / 대한정신약물학회지

OBJECTIVE: Circadian rhythm is cyclic variations in biological activity, which is crucial for physiology in mammals and alterations in circadian rhythm may be related to mood disorders. However, the effect of mood disorder medications on peripheral tissue is less understood. In this study, we investigated whether treatment with antidepressants, antipsychotics, and mood stabilizers in rat fibroblast influenced circadian rhythm. METHODS: Lithium, bupropion, risperidone, lamotrigine, and paroxetine were used on cultured NIH3T3, peripheral rat fibroblast and we observed the periodic oscillation and rhythmicity of Per2, Bmal1 mRNA for 48 hours. RESULTS: We found that lithium has a dose-dependent effect on phase change of circadian rhythm and buproipion has a tendency to dampen the amplitude. Risperidone, lamotrigine, and paroxetine had no influence on circadian rhythm in NIH3T3 cell. CONCLUSION: These results suggest that lithium treatment may have an effect on circadian rhythm lengthening in peripheral fibroblast tissue.

Relationship between Physical Activity and Cognitive Function in the Elderly

BACKGROUND: Physical activity is considered an effective non-pharmaceutical preventive measure against cognitive impairment. This study was designed to investigate the correlation between physical activity and cognitive function. METHODS: Subjects were recruited from the Suwon Project, a cohort comprising a nonrandom convenience sample of ethnic Koreans aged 60 years or older. All participants completed study questionnaires which included questions about demographic characteristics, current and/or past medical history, and drug history. Cognitive functions were evaluated using the Korean version of Mini-Mental State Examination (K-MMSE), Korean version of Short Form Geriatric Depression Scale and Beck Anxiety Inventory. The total time spent to complete 10 physical activities was recorded on a daily basis. RESULTS: The total amount of time spent to execute 10 physical activities was 91.9+/-98.9 minutes per day. K-MMSE score was significantly associated with the duration of physical activity after adjustment for age, sex, educational level, depression, anxiety, and underlying diseases using multiple logistic regression analysis (beta=0.002, p<0.05). Categorizing physical activities into three groups by intensity yielded an interesting result; moderate intensity group demonstrated a direct correlation with cognitive function (beta=0.002, p<0.05). CONCLUSION: Although much remains to be elucidated, our results suggest that physical activity may be associated with cognitive function, after controlling for covariates.

Relationship Between Anxiety and Stroke Warning Signs in the Elderly

OBJECTIVES: We aimed to investigate the relationship between anxiety and stroke warning signs in the elderly. METHODS: Data obtained from 1,078 subjects (256 men and 822 women) aged above 65 years was analyzed from Suwon Project, which was a cohort comprising of nonrandom convenience samples. All the subjects completed the study questionnaire including their demographic characteristics, history of current and past illnesses, drug history, Korean version-Mini Mental State Examination (K-MMSE), SGDS-K (Korean version of the Geriatric Depression Scale-Short Form), BAI (Beck Anxiety Inventory). Stroke warning signs were defined as 5 stroke warning signs consistent with the American heart association public health message. RESULTS: There was significant relationship of anxiety and the number of stroke warning signs after adjusting age, sex, educational level and depression (beta=2.145, p<0.0001). On analysis of covariance, the interaction of the number of experienced stroke warning signs with sex on anxiety was observed after adjusting for the age, educational level, K-MMSE, and SGDS-K (p=0.011). CONCLUSION: These results suggest that there was significant relationship of anxiety and stroke the elderly.

Relationship between Mental Activity and Cognitive Function in Community-Dwelling Elderly

OBJECTIVES: The purpose of this study was to describe the status of mental activity participation in community-dwelling elderly and to evaluate the association between mental activity and cognitive function after adjustment for depression and anxiety. METHODS: This study was based on the Suwon Project, which was a cohort comprising of nonrandom convenience samples of ethnic Koreans aged 60 years and above. All the subjects completed the study questionnaire including their demographic characteristics, current and past illnesses history, drug history, Korean version-Mini Mental State Examination (K-MMSE), Korean version of Short Form Geriatric Depression Scale (SGDS-K), Beck Anxiety Inventory (BAI). We checked how many hours per day are used for each items of 11 mental activities through the checklist. RESULTS: Total time spent in 11 mental activities was 237.4+/-152.4 minutes per day. On multiple regression analysis, total time spent in 11 mental activities (MA-total), and time spent by watching television and reading book/newspaper showed statistically significant association with K-MMSE score after adjustment with age, sex, education, chronic medical illness, depression and anxiety. CONCLUSION: Our result suggested that mental activity may be associated with cognitive function in the elderly without cognitive impairment in the community after adjusting age, sex, education, chronic medical illness, depression and anxiety.

Characteristics of Internet Use in Relation to School Bullying / 신경정신의학

OBJECTIVES: The objective of this study was to evaluate the characteristics of internet use related to school bullying (victims, bully-victims, bullies) in adolescents. METHODS: A total of 10,013 middle and high school students in Gyeonggi-do were surveyed using demographic information, the Korea-Youth Self Report (K-YSR), and the Internet K-scale, Child Depression Inventory (CDI). All students were classified as victims, bully-victims, bullies, or control groups according to their bullying experience. A Chi-square test and one-way ANOVA were used to compare the four groups. RESULTS: The victims, bully-victims, and bullies groups showed significantly higher scores on the K-YSR and CDI than the control group. They also indicated significantly higher scores on the Internet K-scale than the control group. CONCLUSION: The victims, bully-victims, and bullies groups had significantly higher risk for internet addiction than those with no bullying experience. Though we cannot conclude that Internet addiction is a cause or consequence of bullying, clinicians must consider the possibility of internet addiction in cases of adolescents involved in bullying.

The Comparison Study of Temperament and Character in Subjects with Panic Disorder / 신경정신의학

OBJECTIVES: There were many studies assessed the relationship between Cloninger's Temperament and Character Inventory (TCI) and mood and anxiety disorders. This study investigated biogenetic temperament and character trait in panic disorder and assessed the correlation between the severity of panic disorder and TCI score. METHODS : The subjects were 31 patients who met DSM-IV criteria for panic disorder and 40 controls. All subjects completed Temperament and Character Inventory. The patients completed self-report version of panic disorder severity scale, extended anxiety sensitivity index, Albany Panic and phobia Questionnaire, Agoraphobic Cognition Questionnaire, Body Sensations Questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory. RESULTS : The panic disorder patients showed significantly high harm avoidance, reward dependence, and cooperativeness and low novelty seeking compared with healthy controls. The high harm avoidance had significant effects on the severity of panic symptoms. CONCLUSION : We suggest that high harm avoidance, reward dependence, and cooperativeness and low novelty seeking are biogenetic temperament and character pattern of panic disorder patients.