A Validation Study of the Korean -Version of the Montgomery- Asberg Depression Rating Scale / 신경정신의학

OBJECTIVES: The Montgomery-Asberg Depression Rating Scale (MADRS) has been reported as a valid tool for the assessment of depression because it is based on the core symptoms of depression. The aim of this study is to assess the reliability, validity and psychometric properties of the Korean version of the MADRS (K-MADRS). METHODS: One hundred seven patients, including in-patients and out-patients, diagnosed as major depressive disorder according to the DSM-IV criteria were enrolled in this study. They were assessed with K-MADRS, Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Clinical Global Impression (CGI) to examine cross-validation. Statistical analysis was done using calculation of Cronbach's alpha, Spearman Correlation Coefficient and Principal Components Analysis. RESULTS: The Cronbach's alpha coefficient of K-MADRS was 0.79. And the correlations of each item with total score were statistically significant (r=0.47-0.75, p<0.001). The inter-rater reliabilities of total score (r=0.89, p<0.001) and individual score (r=0.74-0.95, p=0.001) were high. The factor analysis revealed two factors. However, the first one accounted for 39% of variance, while the second one only for 11.1%. The total score of K-MADRS showed a significant correlation with those of HDRS, BDI and CGI (r=0.82, 0.47, 0.74, respectively, p=0.001). CONCLUSION: The K-MADRS showed good reliability and validity for the assessment of severity of depressive symptoms. And it demonstrated similar psychometric properties to previous studies. The K-MADRS is an useful instrument for assessing depressive symptoms in Korea.

The Relationship Between Obesity and Depressive Trends in Elementary School Children

PURPOSE: This study was designed to evaluate the relationship between obesity and depressive trends in elementary school children. METHODS: In 1999, we surveyed 2,091 elementary school children(1,079 boys and 1,012 girls) whose ages ranged from 10 to 12 years. Obesity was defined as an obesity index over 20 percent. The degree of depression was compared between the obese group and the normal body weight group according to Korean Children's Depression Inventory(CDI) of Kovacs and Beck. RESULTS: Among the subjects, 1,884(88.2%) formed the normal body weight group, 128(6.1%) formed mildly obese group, 98(4.7%) formed the moderately obese group and 21(1.0%) formed the severely obese group. The mean depression score in the obese group was significantly higher than that of the normal body weight group, and the more severely obese the more significantly the depression score increased. The depression score of the obese girls' group was higher than the obese boys' group. The depression score was significantly higher in the obese group who hate exercise and like computer games, than in the group who like exercise and don't play computer games. The depression score was significantly higher in the obese group who hate physical education than the group who like it. CONCLUSION: The depression score of the obese group was significantly higher than normal body weight group in elementary school children. Physicians should provide psychological support in the treatments of obese children.

The Effects of Achievement Self Discrepancy and Evaluative Threat Stress on Performance Anxiety / 신경정신의학

OBJECTIVES: The purpose of this study to examine if the levels of anxiety(emotional, cognitive, and behavioral measures) during performance are influenced by interaction of both achievement related self discrepancy(=psychological vulnerability variable) and evaluative threat stress(=stressor) based on vulnerabilitystress model in order to identify the mechanism of development of performance anxiety and furthermore to suggest psychological intervention strategies to reduce and prevent it effectively. METHOD: High and low self discrepancy subjects consisted of students from the upper(n=40) and lower 15%(n=40) on achievement related self discrepancy scale, respectively. They were randomly assigned to either evaluative threat condition or neutral condition, and then all subjects took intellective task(verbal reasoning test and digit symbol test). RESULTS: The results were as follows; 1) High self discrepancy subjects under evaluative threat reported significantly higher level of state anxiety during performance than low self discrepancy subjects under any condition and also experienced higher degreee of state anxiety with marginal significance than high self discrepancy subjects under neutral condition, whereas there were no significant effects on the anxiety level of group variable under neutral condition or of stress variable in low self discrepancy subjects. 2) High self discrepancy subjects reported more cognitive interference during performance than low self discrepancy subjects regardless of the level of stress. 3) High self discrepancy subjects performed marginally significantly more poorly in digit symbol test than low self discrepancy subjects regardless of the level of stress, whereas there were no significant effects on verbal reasoning test. CONCLUSION: The hypothesis that performance anxiety could be affected by achievement related self discrepancy and stress, and specially by interaction between self discrepancy and stress was relatively strongly supported by the results on emotional measure of performance anxiety. In addition, this hypothesis received partial support by the results on cognitive and behavioral measures. We might conclude that it is important to consider achievement-related self discrepancy and evaluative threat stress together to understand the mechanism of development of performance anxiety and to reduce or prevent this anxiety effectively.