Dysfunctional Breathing in Anxiety and Depressive Disorder / 정신신체의학

Objectives@#：Although dysfunctional breathing is a common symptom in general population and affects qual-ities of life, it is still underdiagnosed. There are some studies of prevalence of it in astma, but few studies in anxiety and depressive disorders. The purposes of this study were to explore the prevalence of it in anxiety and depressive disorders, and to investigate whether anxiety and depressed mood influence it. @*Methods@#：135 patients diagnosed with anxiety or depressive disorders, and 124 controls were recruited. Ni-jmegen questionnaire was used to assess dysfunctional breathing, and Hospital anxiety depression scale was used. @*Results@#：The prevalence of dysfunctional breathing in anxiety or depressive disorders was higher than that in control. In the linear regression model, anxiety accounted for 59.6% of dysfunctional breathing, but depressed mood did not. With covariate adjusted for anxiety, scores of dysfunctional breathing in anxiety or depressive disorders were higher than in controls. @*Conclusions@#：Dysfunctional breathing in anxiety or depressive disorders is higher than that in control. Adjust-ing anxiety, its difference is still. Anxiety affects dysfunctional breathing, but depressed mood does not.

Clinical Usefulness of the Geriatric Depression Scale to Identify the Elderly at Risk of Suicide

Objective@#Population-based suicidal screening can be an important intervention method to reduce suicidal attempt rate in community. However, directly asking about suicidal behavior may be burdensome to non-mental health workers. This study aimed to evaluate the clinical usefulness of the Geriatric Depression Scale-15 (GDS-15) in identifying the elderly at risk of suicide in community. @*Methods@#Nine hundred forty-eight over 60 years of age participated in this study. All participants completed the GDS-15. A trained interviewer interviewed each participant for suicidality including suicidal ideation, plan, and prior attempt using the Structured Clinical Interview for DSM-IV. @*Results@#When the cut-off score of 10 in the GDS-15 was applied to identify the elderly at risk of suicide, the proportion of directly asking about suicidal behavior by non-mental health workers was reduced by 33.1%; however, 19.5% at risk of suicide were missed. When the cut-off was changed to 6, 100% at risk of suicide were covered by the GDS-15. @*Conclusion@#Screening for suicidality using GDS-15 is a promising way to reduce the proportion of directly asking about suicidal behavior by non-mental health workers among the high-risk suicidal elderly in a community setting.

Korean Medication Algorithm for Schizophrenia 2019, Second Revision: Treatment of Psychotic Symptoms

Objective@#In 2001, the Korean College of Neuropsychopharmacology and the Korean Society for Schizophrenia Research developed the Korean Medication Algorithm Project for Schizophrenia (KMAP-SPR 2001, revised 2006) through a consensus of expert opinion. The present study was carried out to support the second revision of the KMAP-SPR. @*Methods@#Based on clinical guidelines and studies on the treatment of psychotic symptoms in schizophrenia, the Executive committee completed a draft of KMAP-SPR 2019. To obtain an expert consensus, a Review committee of 100 Korean psychiatrists was formed and 69 responded to a 30-item questionnaire. Based on their responses, the KMAP-SPR 2019 was finalized. @*Results@#The revised schizophrenia algorithm now consists of 5 stages. At Stage 1, monotherapy with atypical antipsychotics was recommended by expert reviewers as the first-line strategy. At Stage 2, most reviewers recommended the use of typical or atypical antipsychotic drugs not used at Stage 1. At Stage 3, many reviewers agreed with the administration of clozapine. At Stage 4, a combination of clozapine and other agents such as antipsychotics, mood stabilizers, antidepressants, or electroconvulsive therapy was recommended. At Stage 5, most reviewers recommended combined treatment with an antipsychotic other than clozapine; and a mood stabilizer, antidepressant, or electroconvulsive therapy. At any stage, prescribing long-acting injectable antipsychotics at the discretion of the clinician was recommended. @*Conclusion@#Compared with previous versions, the KMAP-SPR 2019 now recommends using clozapine earlier in treatment-refractory schizophrenia. In addition, the use of long-acting injectable antipsychotics is now considered to be available at any stage.

Validation of the Korean Version of the Depression in Old Age Scale and Comparison with Other Depression Screening Questionnaires Used in Elderly Patients in Medical Settings

OBJECTIVE: The Depression in Old Age Scale (DIA-S) is a new screening tool for assessing depression in the elderly. The primary aims of this study were to describe the validation of the Korean version of the DIA-S (K-DIA-S) and to compare its validity with that of other depression screening questionnaires used in elderly outpatients in medical settings. METHODS: A total of 385 elderly outpatients completed the K-DIA-S and underwent the Mini International Neuropsychiatric Interview to diagnose depressive disorders. Other measures included the 15-item short form of the Geriatric Depression Scale (SGDS), the 9-item depression module of the Patient Health Questionnaire (PHQ-9), and the Montgomery–Asberg Depression Rating Scale (MADRS). Reliability and validity tests, an optimal cutoff point estimate, and receiver operating characteristic curve analysis were performed to investigate the diagnostic validity of the K-DIA-S. Areas under the curves (AUCs) for the K-DIA-S, SGDS, and PHQ-9 were compared statistically. RESULTS: The K-DIA-S showed good internal consistency and strong correlations with the SGDS (r = 0.853), PHQ-9 (r = 0.739), and MADRS (r = 0.772). The cut-off point of the K-DIA-S that can be recommended for screening depressive symptoms was a score of 4. For “any depressive disorder”, the AUC (standard error) for the K-DIA-S was 0.896 (0.015), which was significantly larger than that for the PHQ-9 (p = 0.033). CONCLUSION: The present findings suggest that the K-DIA-S has good psychometric properties and is a valid and reliable tool for assessing depressive symptoms in elderly populations and medically ill patients.

Switching Antipsychotics to Blonanserin in Patients with Schizophrenia: An Open-label, Prospective, Multicenter Study

OBJECTIVE: This study was performed to investigate the efficacy and tolerability of blonanserin in schizophrenic patients who were previously treated with other antipsychotics but, due to insufficient response, were switched to blonanserin. METHODS: A total of 52 patients with schizophrenia who were unresponsive to treatment with antipsychotic monotherapy or combination therapy were recruited into this 12-week, open-label, prospective, multicenter study. Patients were switched to blonanserin from their existing antipsychotics over a maximum 2-week tapering-off period. Efficacy was primarily evaluated using the 18-item Brief Psychiatric Rating Scale (BPRS). Assessments were performed at baseline, and at weeks 1, 2, 4, 8, and 12. RESULTS: Switching to blonanserin resulted in a significant decrease in the mean total score on the BPRS from baseline (56.8 ± 9.4) to week 12 (42.1 ± 13.8, p < 0.001). The most common adverse events were extrapyramidal symptoms (n = 12, 23.1%), insomnia (n = 10, 19.2%), and emotional arousal (n = 6, 11.5%). Overweight or obese patients (body mass index ≥ 23 kg/m2, n = 33) who switched to blonanserin exhibited significant weight loss from 75.2 ± 9.3 kg at baseline to 73.5 ± 9.2 kg at week 12 (p = 0.006). The total cholesterol (baseline, 236.1 ± 47.6 mg/dl; endpoint [week 12], 209.9 ± 28.0 mg/dl; p = 0.005) and prolactin levels (baseline, 80.0 ± 85.2 ng/ml; endpoint [week 12], 63.2 ± 88.9 ng/ml; p = 0.003) were also significantly improved in patients with hypercholesterolemia or hyperprolactinemia. CONCLUSION: The results of the present study suggest that switching to blonanserin may be an effective strategy for schizophrenic patients unresponsive to other antipsychotic treatments.

Korean Treatment Guideline on Pharmacotherapy of Co-existing Symptoms and Antipsychotics-related Side Effects in Patients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The current study covers a secondary revision of the guidelines for the pharmacotherapy of schizophrenia issued by the Korean Medication Algorithm for Schizophrenia (KMAP-SCZ) 2001, specifically for co-existing symptoms and antipsychotics-related side-effects in schizophrenia patients. METHODS: An expert consensus regarding the strategies of pharmacotherapy for positive symptoms of schizophrenia, co-existing symptoms of schizophrenia, and side-effect of antipsychotics in patients with schizophrenia was retrieved by responses obtained using a 30-item questionnaire. RESULTS: For the co-existing symptoms, agitation could be treated with oral or intramuscular injection of benzodiazepine or antipsychotics; depressive symptoms with atypical antipsychotics and adjunctive use of antidepressant; obsessive-compulsive symptoms with selective serotonin reuptake inhibitors and antipsychotics other than clozapine and olanzapine; negative symptoms with atypical antipsychotics or antidepressants; higher risk of suicide with clozapine; comorbid substance abuse with use of naltrexone or bupropion/ varenicline, respectively. For the antipsychotics-related side effects, anticholinergics (extrapyramidal symptom), propranolol and benzodiazepine (akathisia), topiramate or metformin (weight gain), change of antipsychotics to aripiprazole (hyperprolactinemia and prolonged QTc) or clozapine (tardive dyskinesia) could be used. CONCLUSION: Updated pharmacotherapy strategies for co-existing symptoms and antipsychotics-related side effects in schizophrenia patients as presented in KMAP-SCZ 2019 could help effective clinical decision making of psychiatrists as a preferable option.

Result of Multiphasic Personality Inventory among Myasthenia Gravis in Late Adolescence Visiting for Conscription Examination / 정신신체의학

OBJECTIVES@#The purpose of this study was to quantitatively assess the degree of myasthenia gravis (MG) affecting mental health through the results of multiphasic military personality inventory in late adolescence.@*METHODS@#We collected and analyzed the results of the military personality inventory for healthy controls and MG patients among the 19-year-old men who visited the Military Manpower Administration from February 2007 to January 2010. Military personality inventory invented for Korean military test has similar system to Minnesota multiphasic personality inventory.@*RESULTS@#Among validity scales, each score of faking good, faking bad and infrequency subscales showed no difference between healthy control and MG groups, respectively (t=−0.51, p=0.607 ; t=0.11, p=0.913 ; t=1.41, p=0.158). Among neurosis scales, the score of somatization subscale was higher (t=2.29, p=0.023) in MG group. Among psychopath scales, the score of schizophrenia subscale was lower in MG group (t=−2.38, p=0.018).@*CONCLUSIONS@#According to MPI results, we can confirm that MG patients in late adolescence may be more concerned with their somatic symptoms than the control group, and that they may be more likely to abide by the regulation and be conventional in their behavior than the control group.

Proper administration of psychostimulants

Psychostimulants are a broad class of sympathomimetic drugs that include drugs of abuse, such as illegal substances, as well as therapeutic drugs, such as methylphenidate and modafinil. The common effect of psychostimulants is to improve motivation, mood, movement, energy, wakefulness, arousal, anorexia and attention. Methylphenidate and modafinil are psychostimulants used in the treatment of attention deficit hyperactivity disorder and narcolepsy. They have also been found to be effective for treating certain cognitive disorders that result in secondary depression or profound apathy, obesity, cancer-related fatigue as well as in specific treatment-resistant depressions as an augmentation therapy with antidepressants. Psychostimulants are also used in an non-medical manner, such as cognitive and/or performance enhancers in healthy population. However, the most limiting adverse effect of psychostimulants is their vulnerability to psychological and physical dependence. Therefore, the abuse and misuse of stimulants, including methylphenidate and modafinil, for the purpose of neuroenhancement is an issue of concern throughout the world including Korea. Although several recent studies have reported on the cognitive and performance enhancement effects of methylphenidate and modafinil in healthy population, psychostimulants should be administered with discretion in the light of their potential adverse effects and the lacks of long-standing efficacy.

Impact of Eating-Alone on Depression in Korean Female Elderly : Findings from the Sixth and Seventh Korea National Health and Nutrition Examination Survey, 2014 and 2016 / 우울ㆍ조울병

OBJECTIVES: Despite the lack of domestic research, eating alone has been reported to be related to depression. We investigated correlation between eating alone, and depression, among women age 65 and older.METHODS: Among women registered in the Korea National Health and Nutrition Examination Survey data, 1,119 elderly in 2014, and 1,189 in 2016, were analyzed. Eating alone and the degree of depression were assessed, using a questionnaire and the Patient Health Questionnaire-9 respectively. The relationship between eating alone and depression, was analyzed using multilevel logistic regression.RESULTS: In 2014 data, eating alone had significant effect on depression, as the explanatory power is increased to 30.4% in a ‘three meals eating alone a day’ group (β=0.128, p < 0.05), when the eating alone parameter is added to demographic factors and health characteristics. In 2016, exploitation of ‘the frequency of eating alone’ variable led to increment of explanatory power to 22.3%, that was not statistically significant.CONCLUSION: The result of this study suggests that eating alone among women age 65 and older, was a risk factor of depression in 2014, and is becoming a new life pattern as a social and cultural phenomenon in 2016.

Screening with the Korean Version of the Mood Disorder Questionnaire for Bipolar Disorders in Adolescents: Korean Validity and Reliability Study

OBJECTIVE: This study aimed to evaluate the validity and reliability of a Korean version of the Mood Disorder Questionnaire-Adolescent version (K-MDQ-A) as a screening instrument for bipolar disorders in adolescents. METHODS: One hundred two adolescents with bipolar disorders and their parents were recruited from November 2014 to November 2016 at 7 training hospitals. One hundred six controls were recruited from each middle school in two cities of South Korea. The parent version of the original MDQ-A was translated into Korean. The parents of all participants completed the K-MDQ-A. The diagnoses of bipolar disorders were determined based on the Korean version of K-SADS-PL. The test-retest reliability with a 10-month interval was investigated in 33 bipolar adolescents. RESULTS: K-MDQ-A yielded a sensitivity of 0.90 and a specificity of 0.92 when using a cut-off score of endorsement of 5 items, indicating that symptoms occurred in the same time period and caused moderate or serious problems. The internal consistency of the K-MDQ-A was good. The correlations between each item and the total score ranged from 0.40 to 0.76 and were all statistically significant. Factor analysis revealed 3 factors that explained 61.25% of the total variance. The mean total score was significantly higher in bipolar adolescents (7.29) than in controls (1.32). The Pearson correlation coefficient for the total test-retest score was 0.59 (p < 0.001). CONCLUSION: The K-MDQ-A completed by parents showed the excellent validity and reliability and may be a useful screening tool for adolescents with bipolar disorders attending in- and outpatient psychiatric clinics.

Proper administration of psychostimulants

Psychostimulants are a broad class of sympathomimetic drugs that include drugs of abuse, such as illegal substances, as well as therapeutic drugs, such as methylphenidate and modafinil. The common effect of psychostimulants is to improve motivation, mood, movement, energy, wakefulness, arousal, anorexia and attention. Methylphenidate and modafinil are psychostimulants used in the treatment of attention deficit hyperactivity disorder and narcolepsy. They have also been found to be effective for treating certain cognitive disorders that result in secondary depression or profound apathy, obesity, cancer-related fatigue as well as in specific treatment-resistant depressions as an augmentation therapy with antidepressants. Psychostimulants are also used in an non-medical manner, such as cognitive and/or performance enhancers in healthy population. However, the most limiting adverse effect of psychostimulants is their vulnerability to psychological and physical dependence. Therefore, the abuse and misuse of stimulants, including methylphenidate and modafinil, for the purpose of neuroenhancement is an issue of concern throughout the world including Korea. Although several recent studies have reported on the cognitive and performance enhancement effects of methylphenidate and modafinil in healthy population, psychostimulants should be administered with discretion in the light of their potential adverse effects and the lacks of long-standing efficacy.

The Influence of Urinary Incontinence and Depression in Elderly on the Quality of the Life / 정신신체의학

OBJECTIVES: Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. METHODS: A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. RESULTS: Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of ‘usual activity’, ‘anxiety’ and ‘visual analogue scale(VAS)’, whereas those with urinary incontinence, no depression showed lower QOL in ‘motility’, ‘usual activities’ and ‘pain’ domain. Statistically significant interaction effects of two diseases were observed in the domain of ‘VAS’, ‘self care’ and ‘anxiety’. CONCLUSIONS: Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.

Result of Multiphasic Personality Inventory among People with Scoliosis: Retrospective Cross-Sectional Analysis of Military Candidate in Korea / 신경정신의학

OBJECTIVES: The aim of this study was to identify the association between scoliosis and psychopathological effects using the Military Personality Inventory (MPI). METHODS: A retrospective cross-sectional study was conducted of 19-yr-old examinees admitted to the Military Manpower Administration in Korea from February 2007-January 2010. The authors compared the profiles of MPI of 3004 scoliosis cases with the profiles of MPI of 11920 normal controls. The scoliosis cases were classified into two groups according to severity, including mild to moderate, and severe. RESULTS: There was a significant difference between the two groups based on the validity scales. The neurosis scales, including anxiety, depression, somatization and personality disorder, were significantly different between the groups. Concerning the anxiety, depression and somatization subscales, the scores of the mild to moderate group and the severe group were higher than those of the control group. Regarding the personality disorder subscale, the mild to moderate group was higher than the control group. For the paranoid subscale, there was a significant difference between the groups and the mild to moderate group had a higher score than the control group. Furthermore, the partial eta square was 0.018, 0.019, and 0.018 for anxiety, depression, and somatization respectively, which suggests that scoliosis was significantly associated with symptoms of anxiety, depression, and somatization. CONCLUSION: Young men with scoliosis tended to have higher scores concerning the MPI than young men without scoliosis. In particular, the scores were higher for anxiety, depression, and somatization symptoms. This result shows that scoliosis may have psychopathological effects on young men.

Comparing the Effects of Bupropion and Escitalopram on Excessive Internet Game Play in Patients with Major Depressive Disorder

OBJECTIVE: Several studies have suggested the efficacy of bupropion and escitalopram on reducing the excessive internet game play. We hypothesized that both bupropion and escitalopram would be effective on reducing the severity of depressive symptoms and internet gaming disorder (IGD) symptoms in patients with both major depressive disorder and IGD. However, the changes in brain connectivity between the default mode network (DMN) and the salience network were different between bupropion and escitalopram due to their different pharmacodynamics. METHODS: This study was designed as a 12-week double blind prospective trial. Thirty patients were recruited for this research (15 bupropion group+15 escitalopram group). To assess the differential functional connectivity (FC) between the hubs of the DMN and the salience network, we selected 12 regions from the automated anatomical labeling in PickAtals software. RESULTS: After drug treatment, the depressive symptoms and IGD symptoms in both groups were improved. Impulsivity and attentional symptoms in the bupropion group were significantly decreased, compared to the escitalopram group. After treatment, FC within only the DMN in escitalopram decreased while FC between DMN and salience network in bupropion group decreased. Bupropion was associated with significantly decreased FC within the salience network and between the salience network and the DMN, compared to escitalopram. CONCLUSION: Bupropion showed greater effects than escitalopram on reducing impulsivity and attentional symptoms. Decreased brain connectivity between the salience network and the DMN appears to be associated with improved excessive IGD symptoms and impulsivity in MDD patients with IGD.

Result of Multiphasic Personality Inventory on Pneumo- or Hemo-thorax : Retrospective Cross-Sectional Analysis of Military Candidate in Korea / 신경정신의학

OBJECTIVES: The aim of this study was to identify associations between pneumo- or hemo-thorax presence and psychological distress in young males by using the Military Multiphasic Personality Inventory (MPI) test. METHODS: A retrospective cross-sectional study was conducted on data from 19-year-old examinees that were admitted to the Military Manpower Administration in Korea between February 2009 and January 2010. A total of 1955 young males were enrolled in this study. Among them, a normal volunteer control group (n=1561) included individuals without a pneumo- or hemo-thorax. The pneumo- or hemo-thorax group (n=394) included individuals with a pneumo- or hemo-thorax. The latter group was divided into two subgroups : Group A (treated with conservative care or chest tube insertion, n=341) and Group B (treated with wedge resection, n=53). RESULTS: We compared each of three groups (Control group, Group A, Group B) by using covariance analysis. The somatization subscale score within the neurosis category was significantly higher in Group A (p<0.001) than in the Control group, and there was a tendency toward a higher somatization score in Group B than in the Control group (p=0.073). The other score categories (validity scale ; anxiety, depression, and personality disorder subscales for neurosis scale ; and psychopath scale) showed no significant differences among the three tested groups. CONCLUSION: Conservative care or chest tube insertion group was associated with higher somatization symptom scores than that in the control group. The wedge resection group had a tendency toward a higher somatization score than that in the control group. The result indicate that individuals with a history of pneumo- or hemo-thorax may be more concerned about their body shape and/or general condition than those without such a history. Supportive intervention and psychiatric education approaches may be useful in relieving somatic distress.

Efficacy and Tolerability of Paliperidone Extended-release in the Treatment of First-episode Psychosis: An Eight-week, Open-label, Multicenter Trial

OBJECTIVE: We investigated the efficacy and tolerability of paliperidone extended-release (ER) tablets in patients with first-episode psychosis (n=75). METHODS: This was an 8-week, open-label, multicenter trial. The primary outcome variable was scores on the Positive and Negative Syndrome Scale (PANSS); secondary measures included the Scale for the Assessment of Negative Symptoms (SANS), the Cognitive Assessment Interview (CAI), and the Global Assessment of Functioning (GAF). To assess safety, we measured drug-related adverse events, weight, lipid-related variables, and prolactin and administered the Simpson–Angus Rating Scale (SARS), the Abnormal Involuntary Movement Scale (AIMS), the Barnes Akathisia Scale (BAS), the Arizona Sexual Experiences Scale (ASEX), and the Udvalg for Kliniske Undersogelser side effect rating scale (UKU). RESULTS: The administration of paliperidone ER resulted in significant improvement in the PANSS, SANS, CAI, and GAF scores (p<0.001) over time. This improvement was evident as early as 1 week. The most frequent adverse events were akathisia, somnolence, anxiety, and sedation, which were well tolerated. Modest increases in weight and lipid profiles were also noted. Prolactin levels were substantially increased at the endpoint in both male and female patients. CONCLUSION: These results indicate that paliperidone ER is effective and is characterized by good tolerability in the treatment of positive and negative symptoms and cognitive functioning in first-episode psychosis.

The Influence of Parental Behavior on Ego Resilience of Korean Middle School Student / 정신신체의학

OBJECTIVES: Parental behavior is related to personality development and ego resilience in the childhood. The objective of this study was to identify the influence of parental behavior on ego resilience in Korean middle school student. METHODS: Subjects were selected based on stratified multi-stage cluster sampling in Korea youth panel study 2013(Boy : N=1,075, Girl : N=1,033). We used Parental behavior inventory(PBI) to estimate parental behavior and the Ego resilience scale to estimate ego resilience. The data were statistically analyzed using a Pearson correlation analysis and regression analysis with the statistical package for the social sciences(SPSS). We considered differences to be significant when p<0.05. RESULTS: A regression analysis showed that rational explanation, affection, Interest and inconsistency of the parental behavior domains influence ego resilience. Also rational explanation, affection and Interest of the parental behavior domains showed a significant positive correlation with ego resilience(r=0.24, r=0.31, r=0.22, p<0.01). In contrast to early childhood studies, inconsistency showed no significant correlation. CONCLUSIONS: Adolescents who had taken more rational explanation, interest and affection from their parents were more likely to have higher ego resilience. However, inconsistency of parental behavior showed no correlation with ego resilience of adolescents, which means that they are affected by several other factors than parental behavior. This study would be a basic research that could be a help to psychosocial approach in pediatric psychiatry.

Elimination Rate and Pharmacokinetics of Alcohol in Korean Healthy Male Adults / 신경정신의학

OBJECTIVES: The objective of this study is to identify alcohol pharmacokinetics and to investigate the correlations between various factors for alcohol metabolism of healthy Korean males. METHODS: The 101 recruited volunteers were randomized into two groups as one group provided 0.35 mg/mL/kg and 0.7 mg/mL/kg, the other. Blood alcohol concentration was measured and analyzed in enzymatic methods eight times from drinking point. RESULTS: Alcohol elimination rate (beta) was found to be -0.0083%/h for low dose group and -0.0157%/h for the high dose group. The results indicate discrepancy in the legal criteria of alcohol elimination rate (-0.008%/h). The measured alcohol pharmacokinetic properties were following : mean time to reach maximum alcohol concentration in blood was 30 minutes, absorption rate was 0.0197%, maximum alcohol concentration in blood was 0.4930%, and Area under the curve was 59.25. Also, alcohol elimination was not affected by age, smoking, total body water, drinking capacity, body mass index, blood cholesterol, body fat, and body fat ratio. CONCLUSION: These results suggest that legal limitation could be adjusted in Korean males. Also the research should be extended including female and senior citizens for statistical significance of the research. These findings have contributed to our knowledge of the alcohol pharmacokinetics in Korean male.

A Field Study of the Conditions of the Elderly in Rural Community ; The Correlation between of Sleep Quality and Quality of Life / 신경정신의학

OBJECTIVES: This study aimed to investigate how sleep quality affects quality of life in the elderly of rural communities. METHODS: 877 elderly people aged 60 or over living in C towns participated in the study. They responded to the Pittsburgh Sleep Quality Index, EuroQol-5 dimension, Korean version of the short from of Geriatric Depression Scale, Mini-Mental State Examination for Dementia Screening and the presence of urinary incontinence. RESULTS: Most scores of the items of the quality of life index, except self-management, showed significant correlations with the total score of the sleep quality test. Statistically significant differences were found between the positives and the negatives of the sleep quality test in the scores of all the detailed items of the quality of life index. Among the detailed items of quality of sleep, subjective quality of sleep showed the highest correlation. CONCLUSION: The present study found that the subjective indicators such as subjective sleep quality and sleep disturbance affected quality of life in the rural lives of elderly people more than the objective indicators such as sleep durations or sleep latency periods. Based on the results of these studies, we concluded that a methodological approach and a management model to treating insomnia to improve the quality of life of the elderly would need to be developed and applied.