Factors Influencing on Internet Game Addiction among Adolescents* / 생물치료정신의학

Objectives@#：This study aimed to investigate the prevalence of internet game addiction and its association with environmental characteristics such as parent supervision, gaming hour (time spent on gaming) and attention-deficit hyperactivity disorder (ADHD) symptoms among middle school students. @*Methods@#：A total of 596 (416 males and 180 females) first grade middle-school students in Gwang-ju metropolitan city were included in this study. Subjects were asked to complete a self-reported questionnaire, including measures of the Internet Gaming Use-Elicited Symptom Screen (IGUESS), Attention deficit hyperactivity disorder (ADHD) symptom, environmental factor such as parent supervision, and game related factor like game hours. Internet Game addiction and non-addiction group were defined using IGUESS score of 10 as a cut-off. The data were analyzed using hierarchical regression analyses. @*Results@#：Internet Game addiction group was fifty-two subjects (8.7%). Male students were significantly higher than female students (OR 25.01). IGUESS score was statistically negatively correlated with parent attachment and parent supervision, while IGUESS score was positively correlated with time spent on gaming per day, the longest time spent on gaming per day and violent game and ADHD score. Among variables, IGUESS score showed the highest correlation with the longest time spent on gaming per day (r=0.373, p<0.01). Using hierarchical regression analyses, the longest time spent on gaming per day was also the highest predicting factor affecting internet game addiction among variables. @*Conclusion@#：Our findings indicate that parent supervision, parent attachment and game related characteristics such as gaming per day, the longest time spent on gaming per day and violent game and ADHD were associated with internet game addiction.

Distinct Neural Correlates of Executive Function by Amyloid Positivity and Associations with Clinical Progression in Mild Cognitive Impairment

PURPOSE: This study aimed to identify the neural basis of executive function (EF) in amnestic mild cognitive impairment (aMCI) according to beta-amyloid (Aβ) positivity. Furthermore, we explored if the identified brain areas could serve as predictors for clinical progression. MATERIALS AND METHODS: We included individuals with aMCI using data from [¹⁸F]-florbetapir-positron emission tomography (PET), fluorodeoxyglucose-PET, and EF scores, as well as follow-up clinical severity scores at 1 and 5 years from baseline from the Alzheimer's Disease Neuroimaging Initiative database. The correlations between EF score and regional cerebral glucose metabolism (rCMglc) were analyzed separately for aMCI with low Aβ burden (aMCI Aβ−, n=230) and aMCI with high Aβ burden (aMCI Aβ+, n=268). Multiple linear regression analysis was conducted to investigate the associations between rCMglc and clinical progression. RESULTS: Longitudinal courses differed between aMCI Aβ− and aMCI Aβ+ groups. On average, aMCI Aβ− subjects maintained their level of clinical severity, whereas aMCI Aβ+ subjects showed progression. EF impairment in aMCI Aβ− was related to the anterior cingulate cortex (ACC), whereas that in aMCI Aβ+ was related to Alzheimer's Disease-vulnerable brain regions. ACC and the posterior cingulate cortex were associated with clinical progression in aMCI Aβ− and aMCI Aβ+, respectively. CONCLUSION: Our findings suggest that although MCI subjects showed similar behavioral phenotypes at the time of diagnosis, EF and further progression were associated with different brain regions according to Aβ burden. Clarification of the etiologies and nature of EF impairment in aMCI are critical for disease prognosis and management.

The Prevalence and Psychosocial Correlates of Depressive Symptoms in Patients with Hypertension / 생물치료정신의학

OBJECTIVES: This study investigated the prevalence and psychosocial correlates of depressive symptoms in patients with hypertension.METHODS: The participants were 124 outpatients with hypertension who were treated at the Department of cardiology, Chosun University Hospital. Each subject was assessed concerning depressive symptom severity, state-trait anger, ego resilience, social conflict, and perceived stress using self-report questionnaires. A logistic regression model was constructed to examine the impact of psychosocial factors on depressive symptoms.RESULTS: A total of 37.1% of participants were identified as having depressive symptoms. Depressive symptoms were positively correlated with perceived stress, trait anger, social conflict, and state anger. On the other hand, ego resilience was negatively correlated with depressive symptoms. Further, perceived stress and state anger were related to a higher risk of depressive symptoms whereas ego resilience were associated with a lower risk of depressive symptoms.CONCLUSION: This study demonstrated a high prevalence of depressive symptoms in patients with hypertension. Moreover, several possible risk and protective psychosocial factors of depressive symptoms were determined. Especially, our findings suggest that improving ego resilience as well as lowering perceived stress and state anger would be important in the prevention and management of depression in patients with hypertension.

Direct vascular actions of quercetin in aorta from renal hypertensive rats

BACKGROUND: Chronic treatment with the dietary flavonoid quercetin is known to lower blood pressure and restore endothelial dysfunction in animal models of hypertension. This study investigated the direct effects of quercetin on vascular response in chronic 2-kidney, 1-clip (2K1C) renal hypertensive rats. The effects of antioxidant vitamin ascorbic acid on the vasoreactivity were also examined. METHODS: 2K1C renal hypertension was induced by clipping the left renal artery; age-matched rats that received sham treatment served as controls. Thoracic aortae were mounted in tissue baths for the measurement of isometric tension. RESULTS: Relaxant responses to acetylcholine were significantly attenuated in 2K1C rats in comparison with sham rats. Quercetin or ascorbic acid augmented acetylcholine-induced relaxation in 2K1C rats, whereas no significant differences were noted in sham rats. The relaxation response to sodium nitroprusside was comparable between 2K1C and sham rats, and sodium nitroprusside-induced relaxation was not altered by quercetin or ascorbic acid in either group. The contractile response to phenylephrine was significantly enhanced in 2K1C rats compared with sham rats. Phenylephrine-induced contraction was inhibited by pretreatment with quercetin or ascorbic acid in 2K1C rats, whereas neither chemical affected responses in sham rats. N(w)-nitro-L-arginine methyl ester markedly augmented the contractile response to phenylephrine in sham rats, whereas no significant differences were observed in 2K1C rats. Quercetin or ascorbic acid did not affect phenylephrine-induced contraction in the presence of N(w)-nitro-L-arginine methyl ester in either 2K1C or sham rats. CONCLUSION: Acute exposure to quercetin appears to improve endothelium-dependent relaxation and inhibit the contractile response, similar to the effect of ascorbic acid in 2K1C hypertension. These results partially explain the vascular beneficial effects of quercetin in renal hypertension.

Independent and Interactive Influences of the APOE Genotype and Beta-Amyloid Burden on Cognitive Function in Mild Cognitive Impairment

This study aimed to investigate the independent and interactive influences of apolipoprotein E (APOE) epsilon4 and beta-amyloid (Abeta) on multiple cognitive domains in a large group of cognitively normal (CN) individuals and patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Participants were included if clinical and cognitive assessments, amyloid imaging, and APOE genotype were all available from the Alzheimer's Disease Neuroimaging Initiative database (CN = 324, MCI = 502, AD = 182). Individuals with one or two copies of epsilon4 were designated as APOE epsilon4 carriers (epsilon4+); individuals with no epsilon4 were designated as APOE epsilon4 non-carriers (epsilon4-). Based on mean florbetapir standard uptake value ratios, participants were classified as Abeta burden-positive (Abeta+) or Abeta burden-negative (Abeta-). In MCI, APOE epsilon4 effects were predominantly observed on frontal executive function, with epsilon4+ participants exhibiting poorer performances; Abeta positivity had no influence on this effect. Abeta effects were observed on global cognition, memory, and visuospatial ability, with Abeta+ participants exhibiting poorer performances. Measures of frontal executive function were not influenced by Abeta. Interactive effects of APOE epsilon4+ and Abeta were observed on global cognition and verbal recognition memory. Abeta, not APOE epsilon4+, influenced clinical severity and functional status. The influences of APOE epsilon4+ and Abeta on cognitive function were minimal in CN and AD. In conclusion, we provide further evidence of both independent and interactive influences of APOE epsilon4+ and Abeta on cognitive function in MCI, with APOE epsilon4+ and Abeta showing dissociable effects on executive and non-executive functions, respectively.

Psychiatric Characteristics According to Tinnitus Severity

OBJECTIVES: The purpose of this study was to examine the psychiatric characteristics of outpatients with tinnitus. METHODS: A total of 88 subjects were included in this study. According to Tinnitus Handicap Inventory (THI) scores, the subjects were classified into two group ; a mild tinnitus symptoms (mild-tinnitus) group and a severe tinnitus symptoms (severe-tinnitus) group. A questionnaire was used for an assessment of demographic characteristics, and the THI, the Visual Analogue Scale (VAS) about tinnitus, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) are applied for evaluation of other clinical psychiatric characteristics. RESULTS: Higher THI scores were positively correlated with tinnitus course, the number of accompanying symptoms, and the VAS. BDI total scores, BDI factors, and BAI total scores were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. Also suicidal ideation, interpersonal problems, sleep problems, occupational impairment, and fatigue were significantly higher in the severe-tinnitus group than in the mild-tinnitus group. CONCLUSIONS: Tinnitus is a common disorder of hearing which is associated frequently with psychiatric problems. This study suggests that psychiatric interventions should be taken into consideration in the treatment of patients suffering from tinnitus.

Psychiatric Symptoms in Temporal Lobe Epilepsy with Left Mesial Hippocampal Sclerosis

A 16-year-old woman was referred to us for depression and persistent suicidal and homicidal ideation. From 2010, the patient visited a neurologist due to recurrent grand mal epilepsy, auditory and visual hallucinations, episodic memory loss, and persistent depression. Upon admission, it was revealed through clinical history taking that she had suffered from chronic bullying from same-sex peers and sexual abuse, twice, from an adult male in the neighborhood when she was 10 years old. A brain magnetic resonance imaging study showed left mesial hippocampal sclerosis. The patient exhibited improvement of her psychiatric symptoms after treatment with a combination of fluoxetine (30 mg) and aripiprazole (10 mg). Children and adolescents with epilepsy experience conflicts in the family, challenges at school, stigma, and psychosocial limitations or deprivations due to their comorbid psychiatric symptoms and hence, psychiatric evaluation and early intervention is important when treating these patients.

Electroconvulsive Therapy in a Case of Gender Dysphoria Patient with Severe Mood Dysregulation and Suicidal Ideation / 신경정신의학

Gender dysphoria is very rare, but has frequent psychiatric comorbidity. In addition, risk of suicide is higher in patients with gender dysphoria than for the general population. Treatment of gender dysphoria is not determined, and more aggressive treatment is required for patients with suicidal ideation. No case involving electroconvulsive therapy of a gender dysphoria patient has been reported in South Korea. We discuss a 24 year-old man given electroconvulsive therapy for gender dysphoria with severe mood dysregulation and suicidal ideation.

Violence Frequency by Sexual Assault Characteristics / 신경정신의학

OBJECTIVES: Sexual assaults are increasing in the world. They are frequently associated with violence of verbal or physical force and threat. The aim of this study is to investigate frequency of violence according to characteristics of sexual assault. METHODS: Eighty two female sexual assault victims were referred to the psychiatric clinic from Gwangju One-Stop Service Center between Sep. 4, 2006 and Dec. 31, 2012. We compared the frequency of violence, including verbal or physical force and threat according to characteristics of sexual assault : sexual assault type ; relationship with perpetrator ; time lag to visit one-stop center ; assault location. RESULTS: According to the results, 58.5% (n=48) of subjects had experienced violence before the sexual assaults. Compared to rape (50.9%), indecent (76.0%) showed more frequent violence ; and stranger assailant (81.8%) showed greater frequency of violence than acquaintance (50.0%). Victims who visited the One-stop center within 24 hours (76.7%) had greater exposure to violence than those who visited after 24 hours (48.1%). Regarding assault location, violence frequency was higher in other locations (65.7%) than in accommodations (26.7%). CONCLUSION: Our results suggest that frequency of violence before sexual assaults could be influenced by their characteristics.

Endothelium-dependent vasodilation by ferulic acid in aorta from chronic renal hypertensive rats

BACKGROUND: Ferulic acid (FA) is a naturally occurring nutritional compound. Although it has been shown to have antihypertensive effects, its effects on vascular function have not been intensively established. The aim of this study was to assess the vasoreactivity of FA in chronic two-kidney, one-clip (2K1C) renal hypertensive rats. METHODS: Hypertension was induced in 2K1C rats by clipping the left renal artery and age-matched rats that received a sham treatment served as a control. Thoracic aortas were mounted in tissue baths to measure isometric tension. The effects of FA on vasodilatory responses were evaluated based on contractile responses induced by phenylephrine in the aortic rings obtained from both 2K1C and sham rats. Basal nitric oxide (NO) bioavailability in the aorta was determined by the contractile response induced by NO synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME). RESULTS: FA induced concentration-dependent relaxation responses which were greater in 2K1C hypertensive rats than in sham-clipped control rats. This relaxation induced by FA was partially blocked by the removal of endothelium or by pretreating with L-NAME. L-NAME-induced contractile responses were augmented by FA in 2K1C rats, while no significant differences were noted in sham rats. FA improved acetylcholine-induced endothelium-dependent vasodilation in 2K1C rats, but not in sham rats. The simultaneous addition of hydroxyhydroquinone significantly inhibited the increase in acetylcholine-induced vasodilation by FA. CONCLUSION: These results suggest that FA restores endothelial function by altering the bioavailability of NO in 2K1C hypertensive rats. The results explain, in part, the mechanism underlying the vascular effects of FA in chronic renal hypertension.

Distribution Patterns of Calbindin-D28K and NADPH-Diaphorase Positive Neurons in the Midbrain Periaqueductal Gray of the Rabbit / 신경정신의학

OBJECTIVES: We attempted to compartmentalize the periaqueductal gray (PAG) of the rabbit in terms of the different distribution patterns between NADPH-diaphorase (NADPHd)- and calbindin D28K (CB)-positive neurons. METHODS: Immunohistochemistry and immunofluorescent labelling for CB and histochemistry for NADPHd were carried out on coronally-sectioned midbrain slices of the rabbit. RESULTS: NADPHd-positive neurons were selectively localized in the dorsolateral (DL), the middle one-third of the lateral (L), the dorsal half of the ventrolateral (VLd) PAG, and the supraoculomotor cap nucleus (Su3C). Clusters of CB-immunoreactive perikarya marked the dorsal half of DL (DLd), Su3C, the ventral one-third of L, and the ventral half of the ventrolateral (VLv) PAG. Double labelling for NADPHd and CB revealed that two markers labelled different neuronal groups in DLd and Su3C subdivisions. CONCLUSION: The present data suggest that NADPHd and CB can be regarded as reliable neurochemical markers to reveal the longitudinally-columnar organization within the PAG and to subdivide each columnar area.

A Case of Schizophrenia with Periventricular Leukomalacia on Magnetic Resonance Imaging / 신경정신의학

Schizophrenia was once known as a functional psychosis, a disorder with no structural basis. However, nowadays research has identified and confirmed many structural abnormalities in schizophrenia. One prominent such feature is the combination of ventricular enlargement and decreased cerebral volume. Periventricular leukomalacia causes cerebral palsy, cognitive impairment, visual impairment, and seizures. Recent studies reveal that periventricular leukomalacia causes ventricular enlargement and many brain circuit disruptions. Ventricular enlargement caused by periventricular leukomalacia is the most common pathological marker of schizophrenia. In this study, we report a case with periventricular leukomalacia on MRI findings in a 28-year-old schizophrenia patient. This patient showed auditory hallucinations and somatic delusions. We highlight the structural abnormalities, especially periventricular leukomalacia, in this case of schizophrenia.

The Effect of Intern and Resident's Perspective of Death on the Attitude to Patient Care / 신경정신의학

OBJECTIVES: This study aimed to investigate the effect of intern and resident's perspective of death on the attitude to Patients care. METHODS: Participants were recruited from interns and residents working in Chosun University Hospital. The questionnaires on perspective of death and attitudes to patient care include i) the perspectives of death and degree of fear of death ii) the attitude of telling truth to dying patients iii) the attitude to the disease frequently associates with the thought of "living with it is worse than dying", and iv) the avoidant or acceptable attitude when they are treating patients with low chance of recovery thus facing death. RESULTS: Eighty-eight interns and residents participated in this survey. The most frequent reply on the perspective of death was "death is a part, and a process of life" (48.9%). This group also choose more those types of diseases in which they think "living is worse than dying if oneself get it" (p=0.014). This group also showed more avoidant inclination in treating patients with low chance of recovery and facing death compared with other groups (p=0.068). Paradoxically those people who answered that they have no fear to death showed significantly more avoidant behavior against the care of dying patients (p=0.050). CONCLUSION: This study showed that interns' and resident's perspectives of death affect their pattern of patients care, particularly with avoidant patterns against patients. This study suggests the importance of the medical education on thanatology that including the ethical and moral aspects of death.

A Study on the Knowledge and Attitudes Towards Radiation Therapy and Cancer / 대한방사선종양학회지

PURPOSE: To get the data for public information and education of medical students about radiation therapy (RT). MATERIALS AND METHODS: We evaluated the knowledge and attitudes towards the RT and cancer in the third grade medical students who did not receive a lecture before starting the poly-clinic education about radiation oncology in our medical school. We obtained a total of 142 answers from the students that completed the questionnaire. RESULTS: More than half of the third grade medical students answered 1 question correctly and 5 questions incorrectly among 6 questions about knowledge of RT. Incorrect answers were done about the frequency of RT, hair loss, the period of RT, re-RT, cost of RT. Fifty-six percent of students didn't wish to prolong the survival time from 1 year to 3 years with long courses of chemotherapy and RT. They had bad images about cancer of colorectum, lung, esophagus, liver, breast, cervix which consist of 56.3% of patients receiving RT. CONCLUSION: Public information about the basic points of RT should be considered. Also the students showed the pessimism about the anticancer treatments such as chemotherapy and RT, so the exact results and positive aspects of anticancer treatment should be educated more. Especially it is needed to inform the students and the public the positive aspects of RT in some cancers (colorectal, lung, esophageal, hepatic, breast, cervix cancers) which the students had bad images about.

The Relationship between Psychological Characteristics and Academic Achievement in Medical Students / 신경정신의학

OBJECTIVE: Several psychological characteristics of medical students were investigated, the relationhip between these characteristics and academic achievement was identified, and futhermore some significant predictors of their academic achievement were explored. METHOD: Subjects were a total of 489 medical students, 1st, 2nd, 3rd year in Chosun university as of in 1998. We administered self-report questionnaires including age, sex, grade failure, and transfer experience. And Beck Depression Inventory, Achievement Self-Discrepancy Scale, Self-Efficacy Scale, State-Trait Anxiety Inventory(state) Test Anxiety Scale, and the Inventory of Performance Anxiety were handed out to them on April 1998. After the semester, we examined the academic achievement according to grade point average. Pearson's correlations were calculated to explore the relationships between grade failure and other psychological variables, as well as the relationships between academic achievement and other psychological variables. The amount that academic achievement was explained by the psychological variables was obtained using multiple regression analysis. RESULT: 1)In 489 students, grade failure was 168(34.3%) non-failure was 321(65.7%) and transfer was 33(6.7%) 2)While G.P.A., performance anxiety, and self-efficacy, respectively, were negatively correlated with the failure, test anxiety was positively correlated with the grade failure. There were no statistically significant correlations between grade failure and depression, self-discrepancy, or state anxiety. 3)Academic achievement was positively correlated with both gender and self-efficacy, whereas it was negatively correlated with depression, self-discrepancy, test anxiety, and state anxiety, respectively. Female students were better than males in academic achievement. 4)The amount that age, gender, grade failure, transfer, depression, self-discrepancy, test anxiety, state anxiety, performance anxiety, and self-efficacy accounted for academic achievement was 10.86% totally. CONCLUSION: Gender, grade failure, and depression in medical students affected their academic achievement significantly.

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.

The Changing Patterns of Psychiatric Consultations at a General Hospital / 신경정신의학

We have studied the changing patterns of psychiatric consultation in a general hospital for 10 years . Results were as follows 1) The annual psychiatric consultation rate was 1.64%. 2) In age group, elderly patients above 60's had increasing tendency of consultation. 3) The referred patients from department of Internal medicine was the highest and ones from neurology department were increasing recently. 4) Most of the patients were consulted during the month of lune, f311owe4 by April, March and May. 5) The most frequent reason far their psychiatric consultation was psychiatric complaint without specific evidence of lab. data but physical problems. 6) In the psychiatric diagnoses of the consulted patients, organic mental disorders were the first, and depression was the second in order.

Psychiatric consultation at Chosun University Hospital / 신경정신의학

No abstract available.

A study for ego functions in patients with hypochondriasis / 신경정신의학

No abstract available.

Cognitive deficits of the schizophrenics / 신경정신의학

No abstract available.