Association between Obesity Indices and MMSE-K in Elderly / 신경정신의학

OBJECTIVES: The aim of this study was to investigate associations between obesity indices and cognitive functions using data from individuals older than 65 years in South Korea. METHODS: A total of 151 Koreans older than 65 years participated in this study voluntarily. Obesity was determined using body mass index (BMI) and waist-hip ratio (WHR). Cognitive function was evaluated using the Korean version of the Mini-Mental State Examination (MMSE-K). The participants were divided into four groups according to BMI : underweight (BMI or =25.0), and two groups according to WHR : normal (WHR or =0.8). Baseline characteristics were compared among different BMI or WHR subgroups. RESULTS: Older age and smoking habits showed an association with poor cognitive function. Among different BMI groups, the overweight group had the highest scores of MMSE-K ; the item scores for time and place orientation (4.48+/-0.770 and 4.80+/-0.500) and attention/calculation (4.00+/-1.258) as well as total score (25.88+/-2.877). Overweight in BMI showed an association with better cognitive function (OR(adjusted )=0.098, 95% confidence interval=0.017-0.577). CONCLUSION: In this study, the overweight group measured by BMI showed better cognitive function than other groups. Overweight in elderly might be acceptable in order to maintain cognitive performance. Further investigation regarding the underlying mechanism explaining the relationship between cognitive function and body weight will be needed.

The Effect of Environmental Tobacco Smoke Exposure and Glutathione S-Transferase Polymorphism on Childhood Behavioral Development during Mid-Pregnancy and Early Childhood / 신경정신의학

OBJECTIVES: The author investigated the relationship between the environmental tobacco smoke exposure during mid-pregnancy and early childhood and neurobehavioral outcomes of preschool children and if there is any effect of the genetic polymorphism of glutathione S-transferase (GST) M1 and T1 on this relationship. METHODS: The participants were the pregnant women (week 24-28) who visited the obstetrics and gynecology department (between 2001 and 2004). They had been evaluated for their sociodemographic data including direct and environmental tobacco smoke exposure history and the urine specimen had been sampled for the measurement of cotinine. The offsprings' urine specimen and blood sampling had been done and the socioeconomic data including the environmental tobacco smoke exposure history was evaluated at age 3. The cotinine level of urine specimen was measured and GST polymorphism was analyzed. The offsprings completed Korean-Childhood Behavioral Check List (K-CBCL) at age 4-5. RESULTS: The environmental tobacco smoke exposure during mid-pregnancy based on urine cotinine level has a significant association with increased total score and externalizing problem score of K-CBCL (p<0.05). The environmental tobacco smoke exposure based on urine cotinine level at age 3 is associated increased total score, externalizing problem score and internalizing problem score of K-CBCL with no statistical significance. The environmental tobacco smoke exposure after controlling for tobacco smoke exposure during pregnancy, however, is significantly associated with the increased externalizing problem scores (p=0.04). The environmental tobacco smoke exposure is associated with increased total score, externalizing problem score and internalizing problem score of K-CBCL with GSTM1 null type or GSTT1 null type at age 3 although there was no statistical significance. CONCLUSION: The environmental tobacco smoking exposure during pregnancy and at early childhood is associated with childhood behavioral problems. The clinical implication of this study is that it is important to avoid the environmental tobacco smoke exposure during pregnancy and early childhood and to monitor the possible emergence of behavioral problems of children.

A Study on Correlation between Anxiety Symptoms and Suicidal Ideation

OBJECTIVE: In South Korea, the number of deaths from suicide has increased in the last two decades, and suicide has become both a social and political problem. In this study, after controlling the variables influencing suicidal ideation, it was expected that it would be determined if anxiety symptoms are independently related to suicidal ideation. METHODS: Data were obtained from 327 psychiatric outpatients accomplished a self-reported questionnaire that included sociodemographic characteristics and clinical variables as well as self-rating scales for measuring the severity of one's anxiety, depression, and suicidal ideation. Logistic-regression analyses were used to determine the correlation between anxiety symptoms and significant suicidal ideation, adjusting for covariates. RESULTS: The patients with significant suicidal ideation were shown to be less educated, unemployed, never married, divorced, or separated by death, or living alone, and were shown to have a lower income, a drinking habit, a higher number of past suicide attempts, and more family members who committed suicide, than the patients without significant suicidal ideation. After adjusting the covariates influencing significant suicidal ideation, anxiety symptoms were associated with significant suicidal ideation. However, after adjusting for depressive symptoms, only the trait anxiety was associated with significant suicidal ideation. CONCLUSION: These findings suggest that anxiety symptoms are an independent risk factor for suicidal ideation. Clinicians may thus use anxiety symptoms for the screening examination when evaluating suicidal ideation and risk, and will have to actively evaluate and treat the anxiety symptoms of patients with suicidal tendencies.

The Influence of Life Stress on the Severity of Depression and Somatic Symptoms in Depressive Women / 신경정신의학

OBJECTIVES: Stressful life events play the important role in depression. Somatic symptoms have also been closely linked to life stress. This study aimed to investigate the influence of life stress during four different life stages (childhood, adolescent, from 19 years to last year, the year prior to interview) on the severity of depression and somatic symptoms in depressive women. METHODS: Seventy women who had been diagnosed with major depressive disorder or dysthymic disorder according to the DSM-IV TR, and whose ages varied from 21 to 72 years (average age : 41 years), completed the Mooney Problem checklist, the Beck Depression Inventory (BDI), and Wittenborn`s somatic symptom scale. RESULTS: Life stressors which significantly influenced the severity of depression were difficulties with parents in the initial life stage, difficulties with other people in the third and fourth stages, and difficulties with social relationships in the fourth stage Further, somatic symptoms were influenced by health problem in the second period, difficulties with partners were prominent in the third stage, and difficulties with other people were noted in the fourth stage. The severity of depression showed a significantly positive correlation both with autonomic nervous system (p<0.001) and menopausal symptoms (p<0.001). After controlling for age, the severity of depression showed a significant positive correlation with stressors in the first stage (p<0.05), third stage (p<0.05), and fourth stage (p<0.01). Somatic symptom scores exhibited a significantly positive correlation with stressors in the second (p<0.05) and fourth stages (p<0.05). CONCLUSION: Current results suggested that the severity of depression and somatic symptoms were influenced by difficulties with other people in the fourth stage. The results of this study suggests that depression and somatic symptoms can be abbreviated by regulating excess stress.

Patient Characteristics in Cases of Misdiagnosed Delirium upon Psychiatric Consultation in a University Hospital: A Pilot Study / 신경정신의학

OBJECTIVES: The misdiagnosis of delirium may result in a delay of correct diagnosis and appropriate treatment of the delirium. Additionally, aggravation of physical illnesses can occur. The objective of this study was to investigate patient characteristics in cases of misdiagnosed delirium upon psychiatric consultation in a university hospital. METHODS: Subjects included patients with delirium among all who we had consulted over a 12 week span. Psychiatric diagnosis was made by two well-trained psychiatrists by means of the DSM-IV-TR. Cognitive function, level of delirium, and physical function were evaluated by the Korean version of Mini Mental Status Examination (MMSE-K), the Delirium Rating Scale-Revised-98 (DRS-R-98), the Clinical Global Impression-Severity (CGI-S), the Eastern Cooperative Oncology Group Performance Status (ECOG-PS), and the Global Assessment of Functioning Scale (GAF). In addition, we collected socio-demographic information, date of admission and consultation, present causes of consultation, and speculated psychiatric diagnoses made by referring physicians. RESULTS: Among 45 subjects with delirium, only 28 patients (62%) were diagnosed with delirium by referring physicians at the time of consultation. The remaining 17 patients (38%) had been diagnosed with other illnesses. The group of misdiagnosed patients tended to have a longer duration of formal education than those that had been correctly diagnosed. CONCLUSION: Early diagnosis and intervention of delirium can minimize subsequent problems related to delayed diagnosis. Therefore, it is vital to identify the factors related to misdiagnoses by referring physicians. This study showed that a longer duration of formal education is a contributing factor for the misdiagnosis of delirium. Longer education may cover up the typical symptoms of delirium. This can keep referring physicians from making a correct diagnosis. This study was a pilot study investigating diagnostic accuracy of delirium by referring physicians. Additional, well-controlled studies are warranted.

The Associations of Coping Mechanism with Arterial Stiffness in Hwa-Byung Patients

OBJECTIVE: The goal of this study is to assess the relationship between stress coping mechanisms and the risk of atherosclerosis in patients with Hwa-Byung. METHODS: The Korean version of the Ways of Coping Checklist (WOCC) was administered to 50 patients with Hwa-Byung (49.1+/-10.1 years, 6 males). Brachial-ankle pulse wave velocity (baPWV) and serum cholesterol level were assessed in all participants. RESULTS: After controlling for age, sex, diagnosis of hypertension, Body Mass Index (BMI), and serum cholesterol level, the score of seeking social support in coping strategies was negatively correlated with right and left baPWV (r=-0.356, p=0.016; r=-0.373, p=0.012, respectively). In addition, the score of active coping mechanism was negatively correlated with both sides of baPWV (r=-0.383, p=0.009; r=-0.389, p=0.008, respectively). CONCLUSION: The seeking social support and active coping mechanism were inversely related to the severity of arterial stiffness in Hwa-Byung patients. Therefore, our result may suggest a possibility that coping strategies in Hwa-Byung patients are associated with the risk of atherosclerosis.

The Associations of Coping Mechanism with Arterial Stiffness in Hwa-Byung Patients

OBJECTIVE: The goal of this study is to assess the relationship between stress coping mechanisms and the risk of atherosclerosis in patients with Hwa-Byung. METHODS: The Korean version of the Ways of Coping Checklist (WOCC) was administered to 50 patients with Hwa-Byung (49.1+/-10.1 years, 6 males). Brachial-ankle pulse wave velocity (baPWV) and serum cholesterol level were assessed in all participants. RESULTS: After controlling for age, sex, diagnosis of hypertension, Body Mass Index (BMI), and serum cholesterol level, the score of seeking social support in coping strategies was negatively correlated with right and left baPWV (r=-0.356, p=0.016; r=-0.373, p=0.012, respectively). In addition, the score of active coping mechanism was negatively correlated with both sides of baPWV (r=-0.383, p=0.009; r=-0.389, p=0.008, respectively). CONCLUSION: The seeking social support and active coping mechanism were inversely related to the severity of arterial stiffness in Hwa-Byung patients. Therefore, our result may suggest a possibility that coping strategies in Hwa-Byung patients are associated with the risk of atherosclerosis.

A Case Report of Propofol Dependence in a Layman / 대한정신약물학회지

Propofol is a well-known ultra-short acting intravenous anesthetic agent for induction and maintenance of general anesthesia. Since its introduction into the market in the mid 1980s, this is the seventh report on propofol dependence in the literature. Of these, only two cases of propofol abuse have been previously reported in laypersons. We are reporting the case of a lay female who has dependence on propofol, and this is the first lay case in Asia.

Psychiatric Symptoms, Neurocognitive Function and Quality of Life according to Brain-MRI Findings in the Traumatic Brain Injury Patients / 신경정신의학

OBJECTIVES: This study was intended to compare psychiatric symptoms, neurocognitive function and quality of life between normal finding group and abnormal finding group on Brain-MRI. We investigated which variables were related to quality of life (QOL) in traumatic brain injury (TBI) patients. METHODS: Among thirty nine patients who had mild to moderate TBI, twenty two patients (57%) showed abnormal brain MRI findings correlated with their injury and 17 patients (43%) showed normal or nonspecific brain MRI findings. All patients completed Symptom check list-90-revised (SCL-90-R), Beck depression inventory (BDI), State-trait anxiety inventory (STAI), Korean version of the Smith Kline Beecham Quality of Life scale (KvSBQOL) and Marlowe-Crown Social Desirability Scale (MCSDS). Two psychiatrists assessed the patients using Hamilton rating scale for depression (HAMD), Hamilton anxiety scale (HAMA) and Functional assessment scale (FAS). In addition, Korean Wechsler Adult intelligence Scale (K-WAIS), Rey-Kim Memory Test (R-KMT) and Kims frontal-executive neuropsychological test (KF-ENT) were assessed. RESULTS: On FAS, the mean score was significantly lower in the abnormal finding on B-MRI group than the normal finding group (p=0.014). In the patients with abnormal MRI findings, the QOL scores significantly correlated with several subscales of SCL-90-R (obsessive-compulsive, depression, anxiety, global severity index and positive symptom total), FAS and memory quotient after controlling for MCSDS. However, in the patients with normal MRI findings, QOL scores significantly correlated with BDI and all subscales of SCL-90-R. When all pertinent variables were entered in stepwise regression analysis, depression (p<0.05) and interpersonal sensitivity (p<0.05) subscales of SCL-90-R explained 38.5% and 17.7% of the variance of the QOL score in patients with abnormal MRI findings. As for the patients with normal MRI findings, depression (p<0.05) subscale of SCL-90-R accounted for 54.2% of the variance of the QOL score. CONCLUSION: TBI patients who have persisting abnormal brain findings suffered from impaired daily functioning. Depression and interpersonal sensitivity explained 55% of the variance of the QOL together. In the patients with normal brain MRI findings, objective depression or anxiety did not correlate with QOL whereas subjective depressive symptom accounted for 54.2% of the variance of the QOL. This study suggests that subjective psychiatric symptoms including depression significantly correlated with the subjective QOL of TBI patients regardless of their brain MRI finding.

Depressive Symptoms and Ways of Coping of Patients with Diabetes Mellitus: Compared with Rheumatoid Arthritis Patients and Healthy Subjects / 신경정신의학

OBJECTIVES: This study investigated how diabetes mellitus (DM) and depressive symptoms are related, and differed in terms of coping strategies. In addition, we compared those findings with rheumatoid arthritis (RA) patients. METHODS: 80 DM patients, 45 RA patients and 77 healthy subjects completed the Beck depression inventory (BDI) and the Korean version of the ways of coping checklist. RESULTS: BDI scores of depressed DM patients were significantly higher than healthy subjects (p<0.01) but not significantly with depressed RA patients. Both scores of active (p<0.01) and passive coping (p<0.05) in DM patients were significantly lower than healthy subjects (p<0.01), and the scores of wishful thinking of DM patients were significantly lower than RA patients (p<0.01). BDI scores of DM patients were significantly correlated with the number of complications and the scores of problem-focused coping (p<0.05). In the hierarchical regression analysis, even after controlling for clinical characteristics, coping strategies altogether could account for 31.0% of the variance of the depressive symptoms in DM patients significantly (p<0.01). CONCLUSION: DM patients showed significantly higher depression rate than healthy subjects but not than RA patients. In DM patients, insufficient coping strategies could explain substantial portions of depressive symptoms. Therefore, enhancing healthier coping strategies in addition to prevent medical complications might lessen depressive symptoms experienced by DM patients.

Depressive Symptoms and Ways of Coping of Patients with Diabetes Mellitus: Compared with Rheumatoid Arthritis Patients and Healthy Subjects / 신경정신의학

OBJECTIVES: This study investigated how diabetes mellitus (DM) and depressive symptoms are related, and differed in terms of coping strategies. In addition, we compared those findings with rheumatoid arthritis (RA) patients. METHODS: 80 DM patients, 45 RA patients and 77 healthy subjects completed the Beck depression inventory (BDI) and the Korean version of the ways of coping checklist. RESULTS: BDI scores of depressed DM patients were significantly higher than healthy subjects (p<0.01) but not significantly with depressed RA patients. Both scores of active (p<0.01) and passive coping (p<0.05) in DM patients were significantly lower than healthy subjects (p<0.01), and the scores of wishful thinking of DM patients were significantly lower than RA patients (p<0.01). BDI scores of DM patients were significantly correlated with the number of complications and the scores of problem-focused coping (p<0.05). In the hierarchical regression analysis, even after controlling for clinical characteristics, coping strategies altogether could account for 31.0% of the variance of the depressive symptoms in DM patients significantly (p<0.01). CONCLUSION: DM patients showed significantly higher depression rate than healthy subjects but not than RA patients. In DM patients, insufficient coping strategies could explain substantial portions of depressive symptoms. Therefore, enhancing healthier coping strategies in addition to prevent medical complications might lessen depressive symptoms experienced by DM patients.

Nocturanl Eating Behavior Associated with Zolpidem / 수면정신생리

OBJECTIVE: The authors would like to fine the relationship between zolpidem and nocturnal eating episodes in diverse psychiatric patients. METHOD: We evaluated case series of 6 patients who showed nocturnal eating episodes after takine zolpidem. RESULTS: We have experienced 6 cases who showed nocturnal eating behavior after taking zolpidem. They included 3 patients with schizoprenia, a patient with major depressive disorder, a patient with PTSD and a patient with bipolra I disorder. With reducing or discontiuation of of zolpidem, their nocturnal eating resolved. CONCLUSION: This finding strongly suggests the relationship between zolpidem and the nocturnal eating episode. Physicians should be aware that zolpidem might induce nocturnal eating behaviors.

The Clinical Characteristics of Female Gamblers: Focusing on Casino Visitors / 신경정신의학

OBJECTIVES: Recently, the number of female gamblers has increased, therefore, the proportion of women is around one third of all the pathological gamblers. However, the majority of previous studies on pathological gambling have been performed with only male subjects and tended to generalize those results to females. The authors have investigated the gender differences in level 3 gambling in terms of characteristics of gambling and associated psychiatric symptoms. METHODS: 166 participants (104 males, 62 females) who came to a casino have been evaluated for their sociodemographic data and the characteristics of gambling. Participants completed the following self-reported questionnaires: The Korean Version of South Oaks Gambling Screen (KSOGS), The Korean Version of Zung Self-Rating Depression Scale (SDS), The Korean Version of Beck Anxiety Scale (BAI), The Korean Version of Barratt Impulsiveness Scale (BIS), The Korean Version of Behavioral Activation/Inhibition System Scale (K-BAS/BIS), CAGE (The CAGE Questionnare), The Korean Version of Eating Attitudes Test (KEAT). RESULTS: Female level 3 gamblers had significantly later age of onset for their gambling behavior than male. Female level 3 gamblers were significantly more depressed and male level 3 gamblers had more severe alcohol use problems. The proportion of the participants with more severe eating problems was significantly higher in female level 3 gamblers than their male counterparts. CONCLUSION: This study suggests the importance of considering the associated depressive symptoms and eating problems in female gamblers.

A Study on Depression, Anxiety and Quality of Life in Amenorrhea Schizophrenics Treated with Risperidone / 신경정신의학

OBJECTIVES: Amenorrhea, one of the most common side effects of neuroleptics, has known to be associated with prolactin elevation. Hyperprolactinemia seriously affects mental health causing depression, anxiety or hostility, while also affecting physical health causing amenorrhea, galactorrhea or sexual dysfunction. The possible correlation between risperidone-induced amenorrhea and depression, anxiety and quality of life was evaluated in a cross-sectional open study. METHODS: During a five-month period, WHO quality of life-BREF (WHOQOL), Beck depression inventory (BDI) and Statetrait anxiety inventory (STAI) were applied twice at two-month intervals for 30 patients with risperidone-induced amenorrhea and 22 patients without amenorrhea. RESULTS: Amenorrhea group had significantly higher scores in BDI and STAI-state, while showing lower scores in the quality of life than control group. The total BDI and STAI-state scores were more negatively correlated with WHOQOL score in amenorrhea group. CONCLUSION: Patients with risperidone-induced amenorrhea rated themselves significantly more depressed and more anxious, and a lower quality of life compared to the control group. Clinicians should be more active in evaluating and treating hyperprolactinemic side effects such as amenorrhea, galactorrhea, depression and anxiety.

Association between Schizophrenia and the Genetic Polymorphism of DRD3, DRD4 and HTR2A / 대한진단검사의학회지

BACKGROUND: Dopamine and serotonin receptors are candidate genes for the genetic study of schizophrenia because of their implication in the pathophysiology and etiology of schizophrenia (serotonine- dopamin hypothesis). A population-based association study was performed between schizophrenics and normal controls to identify the susceptibility genes. METHODS: A total of 145 schizophrenics and 242 normal controls were recruited. Ser9Gly polymorphism of DRD3, 12 bp repeat of DRD4, and 102T/C of HTR2A were selected as candidate polymorphism. The molecular techniques such as polymerase chain reaction (PCR)-restriction fragment length polymorphism and PCR-polyacrylamide gel electrophoresis were used. Chi-square analysis was performed to find any differences between two groups and logistic linear regression was tested to evaluate the interaction between three genes. RESULTS: There were no significant differences in allele frequencies and genotype frequencies of the three genetic polymorphism. Stratified by sex, the difference of DRD4 allele (P=0.065) and HTR2A allele (P=0.083) and genotype (P=0.054) was observed between male patients and controls; also noted was the difference of HTR2A genotype (P=0.080) between female patients and controls. Stratified by age of onset, the difference in the linear trend of DRD3 between early-onset patients and normal control (P=0.003) was observed. Stratified by family history, the difference in the linear trend of DRD4 (P=0.008) was also observed. Logistic linear regression with 90 patients who had early-onset phenotype (< or =20 year-old) or family history showed a significant result in interaction term (P=0.053). CONCLUSIONS: The finding that there were significant results only after stratification may imply a different genetic load on each subgroup of the disease. The interaction of genes between DRD3, DRD4, and HTR2A in a subgroup with supposedly high genetic background may support the serotonindopamine hypothesis. This, however, should be verified hereafter in large-scale studies.

Rearing Pattern of Mothers with Affective Disorder and Their Children's Behavior Problem / 신경정신의학

OBJECTIVES: This study is to compare psychopathology and their perceived parental rearing pattern of the children of mothers with major depression, bipolar disorder and those of normal control group. The correlation was also assessed between behavior problem and perceived parenting style. METHODS: The subjects were 30 children (age range 12-18) of mothers who met the DSM-IV criteria of major depressive disorder or bipolar I disorder and 30 children of normal mother group. All completed self-report questionnaires containing Child, adolescent Behavior Problem Checklist (K-CBCL), Youth Self Report (YSR) and Parental Bonding Instrument (PBI). RESULTS: 1) The mean score of the subscales of somatic complaints, anxious/depressed, internalizing problems in K-CBCL was significantly higher in the control subjects compared with that of the children of mothers with affective disorders (p<0.05). 2) In YSR, there was a tendency of increased behavior problems among the children of mothers with major depression compared with the control subjects. Compared with children of mothers with bipolar disorder, children of mothers with major depression had significantly more behavior problems (p<0.05). 3) Mothers with affective disorders tended to display less caring and fathers and mothers with affective disorders tended to display more overprotective parenting style than the control subjects. 4) There was positive correlation between paternal overprotection and behavior problems in the children of mothers with affective disorders. CONCLUSION: In summary, the author identified that the children of mothers with affective disorders have more behavior problems in social adjustment than normal control subjects. Parental rearing style is thought to have more negative influence on the children of mothers with affective disorders than normal control. It is surmised that less caring and more overprotective rearing style could influence behavior problems of their children.

Posttraumatic Stress Disorder Prevalence, Symptoms, Depressed Mood and Anxiety According to the Presence of Consciousness at the Time of Traumatic Accident / 신경정신의학

OBJECTIVES: This study investigated PTSD prevalence, symptoms, depressed mood and anxiety, comparing two groups of the patients in trauma; one who had experienced the loss of consciousness (group "A" here after) and the other group of patients who had not(group "B" here after). METHOD: Subjects were 120 patients(age18-66) who had received trauma(traffic accident, fall down) more than 1 month. Before they consisted of 56 patients who had experienced the loss of the consciousness(46.7%) and 64 who had not(53.3%). Men were 69 and women were 51. Clinician administered PTSD Scale, Beck Depression Inventory, State Trait Anxiety Inventory-I, II were administered. The factors such as sociodemographic variables, unconsciousness at the time of trauma, memory about traumatic accidents were considered. RESULT: Out of 120 subjects, 30 patients(25%) were diagnosed as PTSD: 17 from 56(30.4%) and 13 from 64(20.3%) were found in the group "A" and "B" respectively. Prevalence of PTSD was higher in the group "A". However, there was no significant difference between two groups(X2=1.607, p>0.05). The CAPS of group "A" showed significantly high frequency in the loss of interest, detachment, restricted affect, sleep difficulty, irritability/anger, concentration difficulty(p<0.05), while the group "B" scored high in intrusive recall and increased startle. The scores of BDI, STAI-I, II were significantly higher in the group "A"(t=-3.16, p<0.05)(t=-2.75, p<0.05, t=-3.38, p<0.05). CONCLUSION: PTSD was more frequent and depressed mood and anxiety appeared more often in the group who experienced the loss of consciousness. Thus the loss of the consciousness at the time of trauma prones of the aevelopment PTSD and to symptom of aepression and anxiety.

Quality of Life, Suicide Ideation, and Depressive Symptoms in Industrial Injury Patients / 신경정신의학

OBJECTIVE: As the occupational and traffic accidents are increased, patients who are treated for complications of accidents have been increased in recent years. Accidents including industrial injury affect the physical state of the patients and make social, vocational, and economic prob-lems, so that they can affect the whole life of the patients. We performed this study to compare subjective evaluation of quality of life, depressive symptoms, and suicide ideation in both industrial injury patients and control subjects in order to know how industrial injury affect patients in psychiatric aspect. METHOD: The subjects were 169 inpatients who met the inclusion criteria of industrial injury patients and 166 healthy control subjects. All subjects were male and their age is from 19 to 60 years old. Demographic variables, quality of life, depressive symptom, suicide ideation were assessed in subjects. The types of injury and the duration of treatment were assessed in patients. The quality of life was measured using the Korean version of SmithKline Beecham 'Quality of Life' Scale(KvSBQOL), and the suicide ideation was measured using the Scale for Suicide Ideation(SSI), and the depressive symptom was measured using the Dpression scale of Patient Problem Questionaire(PPQ) which were devised from Primary Care Evaluation of Mental Disorder(PRIME-MD). RESULTS: 1) There were no significant differences in the general demographic variables between industrial injury patients and control subjects. 2) Scores of KvSBQOL were significantly lower, and SSI and Depression scale of PPQ were significantly higher in the industrial injury patients than control subjects(p<0.05). 3) In industrial injury patients, threre was a correlation between the age and the scores of KvSBQOL(p<0.01). The scores of KvSBQOL were lowest in older than 30's, highest in 10's-20's. No significant correlation was recognized between the age and the suicide ideation, the depressive symptoms. Threre was a correlation between the marital status and the scores of KvSBQOL(p<0.01). In unmarried, divorced or separated state, the scores of KvSBQOL were significantly lower than married state. There was a correlation between the duration of treatment and the scores of KvSBQOL, the suicide ideation. As the duration of treatment was longer, the scores of KvSBQOL were significantly lower(p<0.01), and the scores of SSI were significantly higher(p<0.01). 4) In industrial injury patients, there was a significant correlation between the type of injury and the scores of KvSBQOL, the suicide ideation, and the depressive symptoms. The scores of KvSBQOL were highest in the L-spine injury patients, lowest in the C-spine injury and multiple contusion patients(p<0.01). The scores of SSI were higher in the C-spine injury and multiple contusion patients, lowest in the L-spine injury patients(p<0.01). 5) In subjects, there was significant correlation between the scores of KvSBQOL, the scores of SSI, and the Depression scale of PPQ. CONCLUSION: Industrial injury patients feel bad about the quality of life and have more depression and suicide ideation. As a results, psychiatric intervention is needed for prevention of depression and suicide due to industrial injury.

Pseudoseizure due to Psychological Stressor

No abstract available.

A Study of Predictive Factors of Treatment Response to Sertraline in Patients with Obsessive-Compulsive Disorder / 신경정신의학

OBJECTIVES: The pharmacologic treatment of obsessive-compulsive disorder(OCD) with serotonergic antidepressant agents is well established in clinical psychiatry on the basis of serotonin hypothesis. Studies on predictive factors of treatment response to OCD are relatively scarce. The author compared the demographic factors, age of onset, length of illness, family history of mental illness, previous drug history for OCD, severity and type of symptoms between the drug responders and non-responders to find out the predicitive factors that may be related to treatment response. METHODS: The subjects were 31, both inpatients and outpatients who met the diagnostic criteria for OCD by DSM-IV and scored 20 or higher on the Yale-Brown Obsessive-Compulsive Scale(Y-BOCS) completed 12-week trial of sertraline. Y-BOCS, National Institute of Mental Health Obsessive-Compulsive Scale(NIMHOCS), Clinical Global Impression Scale(CGI) were scored to measure the changes of obsessive-compulsive symptoms, and Hamilton Anxiety Scale(HAM-A) was measured at each visit. RESULTS: 1) The responders, defined as achieving at least a 40% decrease in the Y-BOCS total score and more than a 2 point decrease in CGI score, were 17(54.8%), and non-responders were 14(45.2%). Responders tended to show later onset(p<0.1), and shorter duration of illness(p<0.05), and less previous drug therapy for OCD(p<0.05) than non-responders. There were no significant differences in family history of mental illness between the two groups. 2) The baseline Y-BOCS compulsive score was significantly lower in responders(p<0.05), although there was no significant difference in the baseline severity of other measures. 3) The obsession of contamination and washing behaviors were more frequent, but compulsive counting was not shown, in responders(p<0.05). The pathological doubt tended to be more common in nonresponders(p<0.1). CONCLUSIONS: In summary, the patients with shorter duration of illness, less prior drug therapy for OCD, and less severe compulsive behaviors, and the obsession of contamination and washing behaviors are expected to be better outcome with sertraline, whereas compulsive counting are the predictor of poor response.