Relationship between Depression and Glycated Hemoglobin: Analysis Based on the 2019 Korea National Health and Nutrition Examination Survey / 우울ㆍ조울병

Background@#The goal of this study is to investigate the relationship between depression and glycated hemoglobin in the general Korean population. @*Methods@#Adults aged 19 to 80 years were surveyed as part of the 2019 Korea National Health and Nutrition Examination Survey. A total of 4,831 people were chosen to complete the health questionnaire, provide their body mass index, and get a HbA1c blood test. The general characteristics of groups with high and low glycated hemoglobin were identified. To find out the correlation between depression diagnosis and the general population with high glycated hemoglobin, a chi-square test was carried out. A t-test was also used to compare the means of glycated hemoglobin between the groups diagnosed with and not diagnosed with depression. In analyzing the relationship between depression and glycated hemoglobin, analysis of covariance was performed by adjusting the effects for demographic factors. @*Results@#Sex, age, income level, education level, drinking, smoking, exercise, and body mass index are all factors that influence glycated hemoglobin. The mean glycated hemoglobin was high in the group diagnosed with depression. The relationship between depression and glycated hemoglobin could not be confirmed using logistic regression after controlling for confounding variables. @*Conclusion@#There was no significant correlation between depression and glycated hemoglobin in the general population of Korea based on the results of this study.

Neuromolecular Etiology of Bipolar Disorder: Possible Therapeutic Targets of Mood Stabilizers

Bipolar disorder is a mental illness that causes extreme mood swings and has a chronic course. However, the mechanism by which mood episodes with completely opposite characteristics appear repeatedly, or a mixture of symptoms appears, in patients with bipolar disorder remains unknown. Therefore, mood stabilizers are indicated only for single mood episodes, such as manic episodes and depressive episodes, and no true mood-stabilizing drugs effective for treating both manic and depressive episodes currently exist. Therefore, in this review, therapeutic targets that facilitate the development of mood stabilizers were examined by reviewing the current understanding of the neuromolecular etiology of bipolar disorder.

A Study on the Relationship among Obesity, Suicide Plans, and Suicide Attempts: The 2018 Korea National Health and Nutrition Examination Survey / 우울ㆍ조울병

Background@#This study explores the correlation among obesity, suicide plans, and suicide attempts in adults over 19 years of age in South Korea. @*Methods@#The study used data from adults who had participated in the 2018 Korea National Health and Nutrition Examination Survey. Obesity was defined as having a body mass index of ≥25 kg/m 2 . To identify differences between the characteristics of those who had reported suicide plans and attempts, a complex sample chi-square test was conducted. To analyze the effect of obesity on suicide plans and attempts, a logistic regression analysis was performed. @*Results@#There was no significant difference in the rate of suicide plans in one year between obese and non-obese groups; however, the rate of actual suicide attempts was significantly high in the obese group (p<0.050). After correcting for variables that were significantly different between the groups, obesity was found to have no significant effect on suicide plans but was linked to a significant increase in suicide attempts (odds ratio=3.355, p=0.008). @*Conclusion@#Obesity was found to have no effect on the suicide planning rate; however, the probability of a suicide attempt was high in obese adults.

Ciliogenesis is Not Directly Regulated by LRRK2 Kinase Activity in Neurons

Mutations in the Leucine-rich repeat kinase 2 (LRRK2 ) gene are the most prevalent cause of familial Parkinson’s disease (PD). The increase in LRRK2 kinase activity observed in the pathogenic G2019S mutation is important for PD development. Several studies have reported that increased LRRK2 kinase activity and treatment with LRRK2 kinase inhibitors decreased and increased ciliogenesis, respectively, in mouse embryonic fibroblasts (MEFs) and retinal pigment epithelium (RPE) cells. In contrast, treatment of SH-SY5Y dopaminergic neuronal cells with PD-causing chemicals increased ciliogenesis. Because these reports were somewhat contradictory, we tested the effect of LRRK2 kinase activity on ciliogenesis in neurons. In SH-SY5Y cells, LRRK2 inhibitor treatment slightly increased ciliogenesis, but serum starvation showed no increase. In rat primary neurons, LRRK2 inhibitor treatment repeatedly showed no significant change. Little difference was observed between primary cortical neurons prepared from wild-type (WT) and G2019S +/- mice. However, a significant increase in ciliogenesis was observed in G2019S +/- compared to WT human fibroblasts, and this pattern was maintained in neural stem cells (NSCs) differentiated from the induced pluripotent stem cells (iPSCs) prepared from the same WT/G2019S fibroblast pair. NSCs differentiated from G2019S and its gene-corrected WT counterpart iPSCs were also used to test ciliogenesis in an isogenic background. The results showed no significant difference between WT and G2019S regardless of kinase inhibitor treatment and B27-deprivation-mimicking serum starvation. These results suggest that LRRK2 kinase activity may be not a direct regulator of ciliogenesis and ciliogenesis varies depending upon the cell type or genetic background.

Ciliogenesis is Not Directly Regulated by LRRK2 Kinase Activity in Neurons

Mutations in the Leucine-rich repeat kinase 2 (LRRK2 ) gene are the most prevalent cause of familial Parkinson’s disease (PD). The increase in LRRK2 kinase activity observed in the pathogenic G2019S mutation is important for PD development. Several studies have reported that increased LRRK2 kinase activity and treatment with LRRK2 kinase inhibitors decreased and increased ciliogenesis, respectively, in mouse embryonic fibroblasts (MEFs) and retinal pigment epithelium (RPE) cells. In contrast, treatment of SH-SY5Y dopaminergic neuronal cells with PD-causing chemicals increased ciliogenesis. Because these reports were somewhat contradictory, we tested the effect of LRRK2 kinase activity on ciliogenesis in neurons. In SH-SY5Y cells, LRRK2 inhibitor treatment slightly increased ciliogenesis, but serum starvation showed no increase. In rat primary neurons, LRRK2 inhibitor treatment repeatedly showed no significant change. Little difference was observed between primary cortical neurons prepared from wild-type (WT) and G2019S +/- mice. However, a significant increase in ciliogenesis was observed in G2019S +/- compared to WT human fibroblasts, and this pattern was maintained in neural stem cells (NSCs) differentiated from the induced pluripotent stem cells (iPSCs) prepared from the same WT/G2019S fibroblast pair. NSCs differentiated from G2019S and its gene-corrected WT counterpart iPSCs were also used to test ciliogenesis in an isogenic background. The results showed no significant difference between WT and G2019S regardless of kinase inhibitor treatment and B27-deprivation-mimicking serum starvation. These results suggest that LRRK2 kinase activity may be not a direct regulator of ciliogenesis and ciliogenesis varies depending upon the cell type or genetic background.

Lack of Association between Metabolic Syndrome and Depression in Korean Adults: Analysis Based on the 2016 and 2018 Korean National Health and Nutrition Examination Surveys / 우울ㆍ조울병

Background@#This study aims to investigate the relationship between metabolic syndrome and depression in Korean adults using data from the 2016 and 2018 Korean National Health and Nutrition Examination Surveys (KNHANES). @*Methods@#The total number of participants in the 7th period 1st year (2016) and 3rd year (2018) surveys of KNHANES was 16142. This study was conducted with 10,722 subjects who met the diagnostic criteria for metabolic syndrome and responded to the Patient Health Questionnaire-9 (PHQ-9). Analysis of covariance was used to adjust the differences due to demographic factors, laboratory findings, and underlying diseases to understand the relationship between metabolic syndrome and PHQ-9 scores, if any. @*Results@#The prevalence of metabolic syndrome was determined to be 25.6% in this study. The PHQ-9 scores with and without metabolic syndrome were 2.56 and 2.48, respectively, and there was no significant difference when the confounding variable was corrected (p=0.406). According to the analysis of each PHQ-9 item and metabolic syndrome, the results were not significant. @*Conclusion@#In this cross-sectional study conducted in Korean adults, no significant correlation was found between metabolic syndrome and depression.

Relationship Between Metabolic Syndrome and Depression Using Patient Health Questionnaire-9 : 2016 Korea National Health and Nutrition Examination Survey Result Analysis / 우울ㆍ조울병

BACKGROUND: The purpose of this study was to investigate the relationship between metabolic syndrome and depressive symptoms by administering the nine-item depression module from the Patient Health Questionnaire-9 (PHQ-9) to participants from the general population of Korea.METHODS: In total, 8,150 adults participated in the 1st year of the 7th Korea National Health and Nutrition Examination Survey, which was conducted in 2016. Of them, 5,556 participants underwent tests pertaining to the criteria for metabolic syndrome and responded to PHQ-9; 2,594 respondents were excluded. Analysis of covariance was performed to analyze the relationship between the presence of metabolic syndrome and the PHQ-9 score after adjusting for the effects of demographic and hematologic characteristics and underlying diseases.RESULTS: The total PHQ-9 score (mean=2.98) was significantly higher in participants with metabolic syndrome than in those without it (mean=2.59) (p=0.002). Among the individual PHQ-9 items, changes in sleep, thoughts of suicide or self-harm, and depressive mood showed the greatest differences.CONCLUSION: The PHQ-9 scores in Korea were higher in adults with metabolic syndrome, suggesting an association between metabolic syndrome and depressive symptoms.

The Correlations among Depressive Symptoms, Cognitive Performance and Serum BDNF Levels in the Patients with Chronic Kidney Disease

OBJECTIVE: In the current study, we investigated whether there are relations among depressive symptoms, cognitive performance and serum BDNF levels in the patients with chronic kidney disease (CKD). METHODS: Sixty patients with CKD and 65 healthy controls participated. Depressive symptoms were evaluated with Beck depression inventory (BDI) and Hamilton Depression Rating Scale (HDRS). Mini-Mental State Examination included in the Korean version of the Consortium to Establish a Registry for Alzheimer’s disease (MMSE-KC) assessment packet was used for the evaluation of overall cognitive function. To assess memory function, the Korean version of the Hopkins Verbal Learning Test (K-HVLT) was used. BDNF levels were measured using an enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: The CKD patients showed more depressive symptoms when compared with controls. The depressive symptoms and cognitive function were not associated with serum BDNF levels in the CKD patients. CONCLUSION: In the current study, CKD patients had more depressive symptoms when compared controls. However, the serum BDNF levels of CKD patients were not associated with depressive symptoms and cognitive functions. These findings suggested that the serum BDNF levels may not be reflect the cognitive function and depressive mood state in the CKD patients.

Relationship between Suicidal Ideation and Plasma C-Reactive Protein Level in General Population : The Korean National Health and Nutrition Examination Survey / 우울ㆍ조울병

OBJECTIVES: The purpose of this study is to inquire into the relationship between the association of suicidal ideation and the plasma C-reactive protein level in the general population.METHODS: This study selected a total of 5,090 subjects who have responded to the survey item on suicidal ideation status, and received the plasma C-reactive protein test, as a research subject using the 2015 data of the National Health and Nutrition Survey. This study conducted a covariance analysis by correcting a potential influence of demographic and hematological factors. Besides, this study intended to define the cut-off value of the optimum plasma C-reactive protein level, which once identified can distinguish between a subject with and without suicidal ideation using the model of the decision tree.RESULTS: The Plasma C-reactive protein level of a subject having suicidal ideation was noted as being significantly higher than the one having no suicidal ideation in the covariance analysis (p=0.046). In addition, the proper cut-off value of the plasma C-reactive protein level between the subjects with and without suicidal ideation was found to be 1.30 mg/L (p=0.003).CONCLUSION: It is noted that the high plasma C-reactive protein level showed a significant correlation with individuals with noted suicidal ideation. In addition, this study has significance in that it presented that the plasma C-reactive protein concentration has the possibility as an accurate and significant marker of suicidal ideation in the general population.

Differential Effects of Olanzapine and Haloperidol on MK-801-induced Memory Impairment in Mice

OBJECTIVE: We investigated the differential effects of the antipsychotic drugs olanzapine and haloperidol on MK-801-induced memory impairment and neurogenesis in mice. METHODS: MK-801 (0.1 mg/kg) was administered 20 minutes prior to behavioral testing over 9 days. Beginning on the sixth day of MK-801 treatment, either olanzapine (0.05 mg/kg) or haloperidol (0.05 mg/kg) was administered 40 minutes prior to MK-801 for the final 4 days. Spatial memory performance was measured using a Morris water maze (MWM) test for 9 days (four trials/day). Immunohistochemistry with bromodeoxyuridine (BrdU) was used to identify newborn cells labeled in tissue sections from the dentate gyrus of the hippocampus. RESULTS: MK-801 administration over 9 days significantly impaired memory performance in the MWM test compared to untreated controls (p<0.05) and these deficits were blocked by treatment with olanzapine (p<0.05) but not haloperidol. The administration of MK-801 also resulted in a decrease in the number of BrdU-labeled cells in the dentate gyrus (28.6%; p<0.01), which was prevented by treatment with olanzapine (p<0.05) but not haloperidol. CONCLUSION: These results suggest that olanzapine has a protective effect against cognitive impairments induced by MK-801 in mice via the stimulating effects of neurogenesis.

Epigenetic Mechanisms of Early Adverse Experience in the Development of Depression / 대한정신약물학회지

Depression is a common mental illness with a high lifetime prevalence rate in the general population. However, the pathophysiology of depression is still poorly understood. Recent studies showed that environmental factors can affect gene expression by modifying epigenetic factors. Early life stress (ELS) is likely a risk factor of lifetime vulnerability to stress and development of depression. ELS or stressful lifetime can induce changes in gene expression through epigenetic mechanism, such as DNA methylation or histone modification. In this article, recent researches on the epigenetic mechanisms of depression will be discussed.

Antioxidant and Proliferative Activities of Bupleuri Radix Extract Against Serum Deprivation in SH-SY5Y Cells

OBJECTIVE: Bupleuri Radix (BR) is a major component of several Oriental herbal medicines used to treat stress and mental illness. There are evidences that antidepressant drugs modulate oxidative damage implicated in the pathophysiology of neuropsychiatric disorder, including depression. The aim of the present study was to investigate antioxidant and proliferative effects of BR against oxidative stress induced by serum deprivation in SH-SY5Y cells. METHODS: We examined the antioxidant effects of BR on a number of measures, including cell viability, formation of reactive oxygen species (ROS), superoxide dismutase (SOD) activity and levels of both Bcl-2 and Bax. We also investigated the effects of BR on cell proliferation using the bromodeoxyuridine (BrdU) assay, and used Western blot analysis to measure changes in expression of the cell cycle phase regulators. RESULTS: 1) Serum deprivation significantly induced the loss of cell viability, the formation of ROS, the reduction of SOD activity, down-regulation of Bcl-2 expression and up-regulation of Bax expression. However, BR extract reversed these effects in dose-dependent manner. 2) Serum deprivation significantly reduced cell proliferation. Western blot analysis revealed that serum deprivation significantly decreased cyclinD1 and phosphorylated retinoblastoma (pRb) expression, and increased p27 expression. On the other hand, BR dose dependently reversed these effects. CONCLUSION: This study suggests that aqueous extract of BR may exert potent antioxidant effects and also play an important role in regulating cell cycle progression during neurogenesis. These effects of BR may be a potentially important mechanism of antidepressant underlying the observed antioxidant and proliferative effects.

Understanding the Molecular Biology in the Pathogenesis of Depression / 대한정신약물학회지

Depression is a common psychiatric illness with a high lifetime prevalence in the general population. Serious problem, such as suicide is commonly occurring in the patients with depression. Till now, the monoamine hypothesis has been the most popular theory of pathogenesis for depression. However, the more specific pathophysiology of depression and cellular molecular mechanism underlying action of commercial antidepressant has not been clearly defined. Several recent studies demonstrated that neural plasticity, epigenetic and mammalian target of rapamycin signaling are promising answers to the pathophysiology of depression. In this article, current understanding of biology and molecular mechanisms of depression and new research on the pathophysiology of depression will be discussed.

A Study on Effects of Coercion by Family and Experts on the Recovery Attitude of the Persons with Mental Illness / 신경정신의학

OBJECTIVES: Based on the debate between paternalism and rights-driven view, to investigate the effects of coercion on the recovery attitudes of patients with mental illness. METHODS: The participants were 352 patients with schizophrenia (79.8%) and mood disorders (major depressive disorder 9.1%, bipolar 11.1%), who were in hospital or who were enrolled in a community mental health center or a social rehabilitation center. All were interviewed. Coercion was divided into family and experts, depending on coercer and was divided into positive and negative coercion such as persuasion, inducement, asked preference, threat, physical force and so on, depending on types of coercion. Recovery attitudes were subdivided into subjective clinical recovery attitudes and life recovery attitudes. RESULTS: When socio-demographic and disorder characteristics were controlled, positive coercion by family and experts had a significant effect on life recovery attitudes, and positive coercion by experts had a significant effect on subjective clinical recovery attitudes. The level of symptoms was found to be an important predictor of recovery attitudes. CONCLUSION: The findings of this study propose the important of the control of mental symptoms, more realistic training in family education, the secure of human rights protection guidelines applicable in the field and so on.

A Study on Effects of Coercion by Family and Experts on the Recovery Attitude of the Persons with Mental Illness / 신경정신의학

OBJECTIVES: Based on the debate between paternalism and rights-driven view, to investigate the effects of coercion on the recovery attitudes of patients with mental illness. METHODS: The participants were 352 patients with schizophrenia (79.8%) and mood disorders (major depressive disorder 9.1%, bipolar 11.1%), who were in hospital or who were enrolled in a community mental health center or a social rehabilitation center. All were interviewed. Coercion was divided into family and experts, depending on coercer and was divided into positive and negative coercion such as persuasion, inducement, asked preference, threat, physical force and so on, depending on types of coercion. Recovery attitudes were subdivided into subjective clinical recovery attitudes and life recovery attitudes. RESULTS: When socio-demographic and disorder characteristics were controlled, positive coercion by family and experts had a significant effect on life recovery attitudes, and positive coercion by experts had a significant effect on subjective clinical recovery attitudes. The level of symptoms was found to be an important predictor of recovery attitudes. CONCLUSION: The findings of this study propose the important of the control of mental symptoms, more realistic training in family education, the secure of human rights protection guidelines applicable in the field and so on.

A Study on Children's Mental Health of Mothers with Mental Illness / 신경정신의학

OBJECTIVES: This study aimed to identify risk factors and protective factors for the mental health problems of the children of mothers with mental illnesses. METHODS: We interviewed 136 mothers with mental illnesses, each of whom had at least one child under age 18, using a structured questionnaire to obtain sociodemographic data, clinical characteristics (diagnosis, chronicity, number of hospitalizations, symptom severity) and protective factors, such as social support and parental and marital cohesion. In addition, these mothers completed the Korean personality rating scale for their children, evaluating their children's mental health problems (behavioral, emotional, and developmental). RESULTS: High scores on measures of mental health problems in children correlated with significantly lower economic level, fewer social supports, lower marital and parental cohesion and more symptoms associated with the mother's mental illness. Using a decision tree analysis, we determined the important predictors were protective factors (parental cohesion, economic level, and social support), even though risk factors, such as mother's symptoms, were also important. CONCLUSION: This study proposes that for these children, preventive interventions that meet mothers' needs could minimize psychopathology in their children.

Effects of Structural and Functional Characteristics of Social Network on Social Adjustment in People With Mental Illness / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate effects of structural and functional characteristics of social network on social adjustment in people with mental illness. METHODS: 236 members of the people with mental illness who were enrolled in day hospital, community mental health center and social rehabilitation center participated in the survey. RESULTS: Of structural and functional characteristics of social network, the influenced factors on social adjustment were network size of professional, social support (family, friend and professional) and conflict with professional. When controlling socio-demographic and disorder characteristics, this regression model affected significantly on social adjustment but the power of influence reduced slightly. CONCLUSION: In order to improve the social adjustment of people with mental illness, it is necessary for social network to provide them with more emotional and social resources. Especially, it is important for mental health professionals to build active partnership with the people with mental illness as consumer. For people with mental illness, the economic stability through guaranteed income such as disability benefits, and occupational rehabilitation is very important.

A Comparison of Public's Stigma against the Mental Patients and Mental Patients' Perceived Stigma / 신경정신의학

OBJECTIVES: The purpose of this study is to compare public stigma against mental patients and mental patients' perceived stigma. METHODS: 549 members of general populations participated in the survey which included questions regarding prejudice and discrimination against mental mental patients, while 377 mental patients participated in the survey which included questions regarding perceived prejudice, experienced discrimination and a coping orientation to social stigma. RESULTS: The mental patients perceived prejudice more compared to public prejudice toward the mental patients. And they experienced discrimination less compared to public's practice of discrimination against mental patients. Also mental patients used passive-avoidance coping orientation against social stigma. CONCLUSION: This study concluded that consumer empowerment program for mental patients is just important as anti-stigma campaign.