The Effect of Depressive Symptoms in Elderly on General and Cancer Health Screening Participation

Objective@#In this study, we investigate the effect of depressive symptoms in elderly on general and cancer health screening participation using the large epidemiological study data in South Korea. @*Methods@#This study was conducted on 1,977 people who responded to a health examination questionnaire among 2,360 adults aged 60 or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) in 2020.Depressive symptoms were measured by the Patient Health Questionnaire-9 and classified as minimal (0-4), mild (5-9), and moderate and severe (10-27). To investigate the relationship between depressive symptoms and health screening participation, a multiple logistic regression model controlling covariates was used. @*Results@#Compared to the group with minimal depressive symptoms, the mild group did not show a significant difference (odd ratio [OR]=0.71, 95% confidence interval [95% CI]=0.45-1.13), but the moderate to severe group showed a significant negative relationship with general health screening participation (OR=0.59, 95% CI=0.35-0.99). There was a significant negative relation-ship between depressive symptoms and cancer health screening participation (mild group OR=0.77, 95% CI=0.48-1.23; moderate to severe group OR=0.50, 95% CI=0.28-0.87). @*Conclusion@#This study showed that people with depressive symptoms are less likely to get a general and cancer health screening. In order to promote health screening participation, policies that consider health behavior promotion programs and psychiatric interventions targeting moderate to severe depressive symptom groups are necessary.

Psychometric Properties of the Korean version of the Emotion Regulation Questionnaire (K-ERQ) in a Clinical Sample

Objective@#The Emotion Regulation Questionnaire (ERQ) is one of the widely used instruments to assess emotion regulation skills in many countries, including Korea. However, its psychometric properties have not been validated within this population. Also, the ERQ has increasingly been used in studies with psychiatric patients despite a general lack of validation in clinical settings. Therefore, the present study aimed to investigate the psychometric properties of the Korean version of the ERQ (K-ERQ) using a clinical sample in Korea. @*Methods@#One hundred and ninety-three psychiatric patients completed a packet of self-report measures, including K-ERQ, K-BDI-II, K-ASI-3, PCL-5-K, AUDIT-K. Confirmatory factor analysis (CFA) was administered to investigate the factor structure of the K-ERQ, and internal reliability and validity were examined. @*Results@#Results of the CFA supported the two-factor structure, but only after the removal of one item. The K-ERQ showed good internal consistency reliability, and its concurrent validity was also confirmed. Cognitive reappraisal was negatively correlated with depression and alcohol use disorder-related symptoms, and expressive suppression was positively correlated with depression, anxiety sensitivity, posttraumatic stress disorder (PTSD)-related symptoms and alcohol use disorder-related symptoms. Significant group differences were found in the use of emotion regulation strategies; patients with PTSD reported the higher level of cognitive reappraisal than patients with depressive disorders, bipolar disorders, and attention-deficit hyperactivity disorder. @*Conclusion@#The 9-itemed K-ERQ is a reliable and valid tool to assess the emotion regulation strategies in a Korean clinical sample. Our study also adds preliminary evidence on the usefulness of the ERQ in clinical settings.

The Effect of the Shift Work on Drinking and the Mediating Effect of Sleep / 정신신체의학

Objectives@#：Shift work has been known to cause various health problems by making it difficult for humans to adapt to their natural circadian rhythms. In particular, shift workers tend to complain of sleep difficulties associated with work schedules, and sometimes use alcohol as a self-medication to induce sleep. To date, no clear mechanism has been identified regarding the link between shift work and sleep, between shift work and drinking. This study aims to confirm the relationship between shift work and sleep, and to analyze whether the change in sleep caused by shift work causes drinking. @*Methods@#：This study included 11360 people (5704 men and 5656 women) among the Korean National Health and Nutrition Survey data in 2014, 2016 and 2018. The work type between 6am-6pm was defined as day work, and other work types were defined as shift work. Using logistic regression analysis, the relationship between shift work and sleep quality, shift work and high risk drinking, drinking amount at 1 time, drinking frequency were an-alyzed. In addition, we analyzed whether sleep mediates the relationship between shift work and drinking using mediated analysis. @*Results@#：Shift work showed a significant negative relationship with sleep quality in men and women (male OR=1.37, 95% CI 1.11-1.70, female OR=1.26, 95% CI=1.05-1.50). There was no significant relationship be-tween shift work and alcohol in the case of men, but in the case of women, there was a significant positive relation-ship between shift work and the number of alcohol consumption (OR=1.34, 95% CI=1.04-1.72). When mediation analysis was conducted, it was found that women's sleep quality partially mediated the relationship between shift work and the frequency of drinking. @*Conclusions@#：The results of this study suggest that shift work causes sleep difficulties, and in the case of women, drinking can be induced through the partial mediating effect of sleep. Considering that women are more likely to choose drinking as a coping method for sleep problems, more active interventions for female shift workers are needed.

Clinical Characteristics of Non-Suicidal Self-Injury andSuicide Attempts among Psychiatric Patients in Korea:A Retrospective Chart Review

Objective@#Limited data exist on non-suicidal self-injury (NSSI) and suicide attempts among psychiatric patients in Korea. In this study,we investigated the clinical characteristics of patients who engaged in NSSI and/or suicide attempts. @*Methods@#We performed a retrospective medical chart review of patients with NSSI and/or suicide attempts at the psychiatric departmentof a university medical center in Seoul between 2017 and 2019. According to their history, patients were allocated to one of threegroups: NSSI only, suicide attempts only and NSSI and suicide attempts group. Groups were compared based on sociodemographic characteristicsand psychological assessments. @*Results@#Overall, 80 patients with NSSI and/or suicide attempts were evaluated. Patients with NSSI and suicide attempts were more likelyto be female than the other two groups. Patients with NSSI and suicide attempts were more likely to suffer from Cluster B personality disorderthan the other groups. And patients with NSSI and suicide attempts scored significantly higher on novelty-seeking in TCI and RC8,RC9 in MMPI-2. @*Conclusion@#Patients with NSSI and/or suicide attempts were more likely to be female, younger, and showed higher levels of psychologicaldisturbances. These findings highlight the importance of early detection and intervention for patients with NSSI.Psychiatry Investig 2020;17(4):320-330

Mediating Role of Anxiety and Depression in the Relationship between Posttraumatic Stress Symptoms and Illness Intrusiveness

BACKGROUND: Posttraumatic stress symptoms (PTSS) in patients with psychological trauma lead to poor health-related quality of life. Understanding of the relationships among PTSS, anxiety, depression, and illness intrusiveness will guide the development of efficient approaches to enhance subjective well-being in patients with psychological trauma. This study investigated whether anxiety and depression mediate the relationship between PTSS and illness intrusiveness in the hope of providing more comprehensive and effective trauma treatment. METHODS: Psychiatric outpatients who visited the trauma clinic of a university hospital (n = 260) participated in this study. Assessments were conducted for PTSS, anxiety, depression, and illness intrusiveness. Structural equation modeling and path analysis were performed to analyze the mediating effects of anxiety and depression on the relationship between PTSS and illness intrusiveness. RESULTS: PTSS had both direct and indirect exacerbating effects on illness intrusiveness. Anxiety exhibited the largest direct exacerbating effect on illness intrusiveness. The indirect effects of PTSS on illness intrusiveness through anxiety alone and through a depression-to-anxiety pathway were significant, but the indirect effect through depression alone was not. CONCLUSION: The findings demonstrate that anxiety, both independently and as part of an interrelated pathway with depression, partially mediates the relationship between PTSS and illness intrusiveness. Appropriate interventions and a comprehensive approach to alleviate anxiety and depression could mitigate the negative effects of PTSS on illness intrusiveness in patients with psychological trauma.

Add-on Eye Movement Desensitization and Reprocessing (EMDR) Therapy for Adults with Post-traumatic Stress Disorder Who Failed to Respond to Initial Antidepressant Pharmacotherapy

This study examined the add-on efficacy of eye movement desensitization and reprocessing (EMDR) therapy among adult civilians with post-traumatic stress disorder (PTSD) who continued to be symptomatic after more than 12 weeks of initial antidepressant treatment. Scores for the Clinician Administered PTSD Scale (CAPS) were rated pre- and post-EMDR and at a 6-month follow-up. After an average of six sessions of EMDR treatment, seven of 14 patients (50%) showed more than a 30% decrease in CAPS score and eight (57%) no longer met the criteria for PTSD. Our results indicate that EMDR could be successfully added after failure of initial pharmacotherapy for PTSD.

The Relationship between Early Improvement of Subjective Symptom and Surgical Outcomes in Moderate to Severe Cubital Tunnel Syndrome / 대한정형외과학회잡지

PURPOSE: Moderate to severe cubital tunnel syndrome usually requires surgical treatment. Most surgical outcomes are evaluated 6 months after the procedure; however, subjective symptoms begin to show improvement much earlier. In this study, we explored whether patients who experience early improvement of subjective symptoms have different clinical characteristics and surgical outcomes than those without early improvement. MATERIALS AND METHODS: Between January 2012 and February 2015, 36 surgical cases of moderate- to severe-stage cubital tunnel syndrome (modified McGowan grade IIA, IIB, or III) were included. Nineteen patients (15 males and 4 females with a mean age of 54.3±12.0 years) reported subjective symptom improvements within 14 days postoperatively. Seventeen patients (15 males and 2 females with a mean age of 53.4±11.9 years) did not report any early symptom improvements. Clinical characteristics—hand dominance, sex, smoking history, type of surgery, age, symptom duration, elbow range of motion, grip strength, key pinch strength, 2 point discrimination, pain, quick disabilities of the arm, shoulder and hand (DASH) score, and modified McGowan grade—were analyzed retrospectively using a Mann-Whitney test or chi square test. Surgical outcomes were measured at postoperative 3 and 12 months using repeated-measures ANOVA, and Wilson and Krout criteria were analyzed using a chi-square test. RESULTS: There was a difference in key pinch strength (p<0.001) between the groups. At postoperative 12 months, Wilson and Krout criteria (p=0.029) were associated with early improvement of subjective symptoms. The subjects' quick DASH scores and grip strengths improved over time, but no difference was observed between the groups. CONCLUSION: After surgical treatments of moderate to severe cubital tunnel syndrome, patients who presented early improvement of subjective symptoms, compared with those who did not, had significantly higher preoperative key pinch strength and better surgical outcomes at postoperative 12 months.

Reliability and Validity of the Korean Version of the Lifetime Stressor Checklist-Revised in Psychiatric Outpatients with Anxiety or Depressive Disorders

PURPOSE: Traumatic events and adverse stressful experiences are major etiological factors in a wide variety of physical and mental disorders. Developing psychological instruments that can be easily administered and that have good psychometric properties have become an integral part for research and practice. This study investigated the reliability and validity of the Korean version of the Lifetime Stressor Checklist-Revised (LSC-R) in a consecutive sample of psychiatric outpatients. The LSC-R is a 30-item self-reporting questionnaire examining lifetime traumatic and non-traumatic stressors. MATERIALS AND METHODS: A final sample of 258 outpatients with anxiety or depressive disorders was recruited at the psychiatric department of a university-affiliated teaching hospital. Self-reported data included the Life Events Checklist (LEC), the Zung Self-Rating Depression and Anxiety Scales, and the Impact of Events Scale-Revised, in addition to the LSC-R. A convenience sample of 50 college students completed the LSC-R on two occasions separated by a three week-interval for test-retest reliability. RESULTS: Mean kappa for temporal stability was high (κ=0.651) and Cronbach alpha was moderate (α=0.724). Convergent validity was excellent with corresponding items on the LEC. Concurrent validity was good for symptoms of post-traumatic stress disorder, depression, and anxiety. An exploratory factor analysis revealed that 11 factors explained 64.3 % of the total variance. CONCLUSION: This study demonstrated good psychometric properties of the Korean version of the LSC-R, further supporting its use in clinical research and practice with a Korean speaking population.

Relationship between Bronchodilator Response, Airway Hyperresponsiveness, and Exhaled Nitric Oxide Levels in Patients with Suspected Bronchial Asthma / 대한내과학회지

BACKGROUND/AIMS: Exhaled nitric oxide (NO) has been extensively investigated as a marker of airway inflammation in asthma, and fractional exhaled nitric oxide (FeNO) is recognized as a useful tool for its evaluation. The aim of this study was to investigate the relationships between FeNO levels and bronchodilator response (BDR), and between FeNO and mannitol-induced airway hyperresponsiveness (AHR), in patients with suspected asthma. METHODS: Clinical variables were collected from patients aged ≥ 13 years with suspected bronchial asthma and measured levels of FeNO. These levels were compared with patient values for forced expiratory volume in the first second (FEV1) and forced expiratory flow at 25 and 75% of the pulmonary volume (FEF(25-75%)) in bronchodilator response tests under control conditions, and during bronchial provocation with mannitol. Correlations and receiver operating characteristic (ROC) curves between FeNO levels and each test were assessed. RESULTS: A total of 259 patients were included in the analysis. The mean ages of the two test groups were 41.1 and 47.8 years, respectively. FeNO levels were strongly correlated with bronchodilator response (%) and with the mannitol dose producing a 15% fall in FEV1 (PD15). On the other hand, FeNO levels were only weakly correlated with FEF(25-75%). The optimal cut-off values for FeNO to predict a positive BDR and AHR were 38.5 and 29.5 parts per billion, respectively. CONCLUSIONS: This study suggests that FEV1 and FEF(25-75%) airway responses correlate with FeNO levels in patients with suspected bronchial asthma. FeNO levels may help to predict positive responses to BDR and AHR.

Predicting Autism Spectrum Disorder Using Blood-based Gene Expression Signatures and Machine Learning

OBJECTIVE: The aim of this study was to identify a transcriptomic signature that could be used to classify subjects with autism spectrum disorder (ASD) compared to controls on the basis of blood gene expression profiles. The gene expression profiles could ultimately be used as diagnostic biomarkers for ASD. METHODS: We used the published microarray data (GSE26415) from the Gene Expression Omnibus database, which included 21 young adults with ASD and 21 age- and sex-matched unaffected controls. Nineteen differentially expressed probes were identified from a training dataset (n=26, 13 ASD cases and 13 controls) using the limma package in R language (adjusted p value <0.05) and were further analyzed in a test dataset (n=16, 8 ASD cases and 8 controls) using machine learning algorithms. RESULTS: Hierarchical cluster analysis showed that subjects with ASD were relatively well-discriminated from controls. Based on the support vector machine and K-nearest neighbors analysis, validation of 19-DE probes with a test dataset resulted in an overall class prediction accuracy of 93.8% as well as a sensitivity and specificity of 100% and 87.5%, respectively. CONCLUSION: The results of our exploratory study suggest that the gene expression profiles identified from the peripheral blood samples of young adults with ASD can be used to identify a biological signature for ASD. Further study using a larger cohort and more homogeneous datasets is required to improve the diagnostic accuracy.

Recurrent Posterior Dislocation of the Elbow

The elbow joint is one of the most inherently stable articulations of the skeleton. Recurrent posterior dislocation of the elbow is a rare condition. We experienced a case of recurrent posterior dislocation of the elbow due to shallow trochlear notch and chronic radial head dislocation that was treated by transplantation of the biceps tendon to the coronoid process. We report on the case with a literature review.

Reliability and Validity of the Korean Version of the Symptom Checklist-Post-Traumatic Stress Disorder Scale

The Symptom Checklist - Post-Traumatic Stress Disorder Scale (SCL-PTSD), also known as Crime-Related PTSD Scale has been validated in survivors of interpersonal trauma in the general population. However, the psychometric properties have not been investigated in a clinical setting for patients with PTSD from diverse traumatic events. This study investigates the reliability and validity of the Korean version of the SCL-PTSD among 104 psychiatric outpatients with PTSD, caused by interpersonal (n = 50) or non-interpersonal trauma (n = 54). Self-report data of the SCL-PTSD, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Impact of Events Scale-Revised (IES-R) were gathered. The Korean version of the SCL-PTSD showed excellent internal consistency and moderate-to-good four-week temporal stability in both the interpersonal and non-interpersonal trauma groups. In comparison with other diagnostic groups, the scores of the SCL-PTSD were significantly higher compared to those of adjustment disorder, depression, other anxiety disorders, and schizophrenia, demonstrating its criteria-related validity. Convergent validity was confirmed because the scores of the SCL-PTSD were significantly correlated with BDI, SAI and TAI scores. Concurrent validity was demonstrated by significant correlation with the IES-R score. This study demonstrated the favorable psychometric prosperities of the Korean version of the SCL-PTSD, supporting its use in clinical research and practice.

The Clinical Association between the Prevalence of Insomnia and Physical and Psychiatric Disorders in Two Areas of Gyeonggi Province of South Korea / 신경정신의학

OBJECTIVES: The purposes of this study are to examine the sociodemographic factors that increase the prevalence of insomnia, as well as to identify the relationship between the prevalence of insomnia and health conditions by navigating through the prevalence rates of insomnia in two different geographical regions with different socioeconomic structures. METHODS: A survey was conducted targeting 937 residents of Guri-si and Yangpyeong-gun in Gyeonggi Province, Korea. The Insomnia Severity Index was used to verify whether a respondent was experiencing insomnia. The Abbreviated Self-Rated Korean version of the Mini-International Neuropsychiatric Interview was used in diagnosis of mental diseases. Chi-square test was performed to determine the unique relationship between sociodemographic characteristics and the prevalence of insomnia. Multivariate logistic regression analysis was performed to examine the association of prevalence of insomnia with categorized relevant factors. RESULTS: The overall prevalence rate of insomnia for all respondents was 9.26%. The prevalence rate for Yangpyeong-gun was 11.75%, marking a significantly higher figure compared with the prevalence rate for Guri-si, which was 6.87%. Advanced age, female, other marital statuses than married, lower education, lower income, non-existence of private health insurance, and unemployment were risk factors for insomnia. The prevalence of insomnia showed strong association with physical and mental conditions, particularly with mental disorders, urologic diseases, and risk of injury from fall. CONCLUSION: The prevalence rates of insomnia in those two surveyed regions showed a meaningful difference even after controlling for sociodemographic characteristics. These findings suggest that such regional differences merits further attention and additional nationwide epidemiologic studies are needed.

Profiling of Proteins Regulated by Venlafaxine during Neural Differentiation of Human Cells

OBJECTIVE: Antidepressants are known to positively influence several factors in patients with depressive disorders, resulting in increased neurogenesis and subsequent relief of depressive disorders. To study the effects of venlafaxine during neural differentiation at the cellular level, we looked at its effect on protein expression and regulation mechanisms during neural differentiation. METHODS: After exposing NCCIT cell-derived EBs to venlafaxine during differentiation (1 day and 7 days), changes in protein expression were analyzed by 2-DE and MALDI-TOF MS analysis. Gene levels of proteins regulated by venlafaxine were analyzed by real-time RT-PCR. RESULTS: Treatment with venlafaxine decreased expression of prolyl 4-hydroxylase (P4HB), ubiquitin-conjugating enzyme E2K (HIP2) and plastin 3 (T-plastin), and up-regulated expression of growth factor beta-3 (TGF-beta3), dihydropyrimidinase-like 3 (DPYSL3), and pyruvate kinase (PKM) after differentiation for 1 and 7 days. In cells exposed to venlafaxine, the mRNA expression patterns of HIP2 and PKM, which function as negative and positive regulators of differentiation and neuronal survival, respectively, were consistent with the observed changes in protein expression. CONCLUSION: Our findings may contribute to improve understanding of molecular mechanism of venlafaxine.

The Psychological Characteristics and Functional Magnetic Resonance Imaging Findings in Firefighters with Partial Posttraumatic Stress Disorder and the Effect of Treatment by Using Eye Movement Desensitization and Reprocessing / 신경정신의학

OBJECTIVES: This study investigated the clinical characteristics and functional magnetic resonance imaging (fMRI) findings of firefighters suffering from partial posttraumatic stress disorder (partial PTSD). They were treated by eye movement desensitization and reprocessing (EMDR) and the treatment effect was evaluated. METHODS: A total of 116 firefighters were screened and 15 of them were diagnosed as partial PTSD. 1) We compared sociodemographic and psychological characteristics between the firefighter partial PTSD group and the firefighter control group. 2) Subjects in the firefighter partial PTSD group (n=10), firefighter control group (n=8), and general control group (n=12) underwent fMRI with traumatic, negative, positive, and neutral picture stimuli. We compared clinical characteristics and fMRI findings among these three groups. 3) Seven firefighters in the partial PTSD group were treated by EMDR and the treatment effect was evaluated according to psychological scales. RESULTS: In fMRI analysis, there was a left middle temporal/occipital activation in the order of the general control group, firefighter control group, than the firefighter partial PTSD group for the Traumatic-Baseline contrast. For the Negative-Baseline contrast, there was an increased left middle temporal/occipital activation in the general control group versus decreased activation in the firefighter control group and the firefighter partial PTSD group. All firefighters in the partial PTSD group treated by EMDR showed significant improvement of Clinician-Administered PTSD Scale scores. CONCLUSION: These results show high incidence rate of partial PTSD in firefighters. In addition, partial PTSD firefighters exhibited distinct clinical characteristics and fMRI findings and showed significant improvement by EMDR treatment.

NCAM140 and pCREB Expression after Tianeptine Treatment of SH-SY5Y Cells

OBJECTIVE: Antidepressants Modulate Neuronal Plasticity. Tianeptine, An Atypical Antidepressant, Might Be Involved In The Restoration Of Neuronal Plasticity; It Primarily Enhances The Synaptic Reuptake Of Serotonin. Ncam140 Is Involved In Neuronal Development Processes, Synaptogenesis And Synaptic Plasticity. We Investigated The Effect Of Tianeptine On The Expression Of Ncam140 And Its Downstream Signaling Molecule In The Human Neuroblastoma Cell Line Sh-sy5y. METHODS: NCAM protein expression was measured in human neuroblastoma SH-SY5Y cells that were cultivated in serum-free media and treated with 0, 10, or 20 microM tianeptine for 6, 24, or 72 hours. NCAM140 expression in the tianeptine treatment group was confirmed by Western blot, and quantified through measurement of band intensity by absorbance. CREB and pCREB expression was identified after treatment with 20 microM tianeptine for 6, 24, and 72 hours by Western blot. RESULTS: Compared to cells treated for 6 hours, cells treated with 0 or 10 microM tianeptine for 72 hours showed a significant increase in NCAM140 expression and cells treated with 20 microM tianeptine showed a significant increase after 24 and 72 hours. The pCREB level in cells treated with 20 microM tianeptine increased in time-dependent manner. CONCLUSION: Our findings indicated that the tianeptine antidepressant effect may occur by induction of NCAM140 expression and CREB phosphorylation.

Psychosocial, Physical, and Autonomic Correlates of Depression in Korean Adults: Results from a County-Based Depression Screening Study

OBJECTIVE: We aimed to investigate the prevalence and psychosocial and neurophysiological correlates of depression in a large county-based cohort of Korean adults. METHODS: We recruited 2355 adults from a rural county-based health promotion program. The following psychometric scales were used: the Center for Epidemiologic Studies Depression scale (CES-D) was used to assess depression, the General Health Questionnaire (GHQ) was used to evaluate stress, and the Medical Outcome Study Social Support Survey (MOS-SSS) was used to determine perceived social support. Heart rate variability (HRV) was used to assess neurophysiological properties. The psychosocial and neurophysiological variables of adults with depression (CES-D score > or =25) and without depression (CES-D score <25) were statistically compared. A logistic regression model was constructed to identify factors independently associated with depression. RESULTS: We estimated that 17.7% of the subjects had depression, which was associated with old age, being female, being single, less religious affiliation, high education, low body mass index (BMI), low levels of aerobic exercise, low social support, and a low HRV triangular index. The explanatory factors of depression included high education, less religious affiliation, low levels of current aerobic exercise, low BMI, and low social support. CONCLUSION: Given the relatively high prevalence of overall depression, subsyndromal depression should also be regarded as an important issue in screening. The independent factors associated with depression suggest that practical psychosocial intervention, including brief psychotherapy, aerobic exercise, and other self-help methods should be considered. In addition, the HRV results suggest that further depression screening accompanied by neurophysiological features would require fine methodological modifications with proactive efforts to prevent depressive symptoms.

Treatment Response of Affect Regulation Group Therapy for Recently Traumatized School Children / 신경정신의학

OBJECTIVES: The aim of this study was to investigate the treatment effect and predictors of response of affect regulation group therapy (ARGT) delivered to a group of recently traumatized children. METHODS: A total of 464 school children, who had witnessed or confronted a tragic accident at school, were given a single-session of affect regulation group therapy, that which included psychoeducation and affect regulation elements from eye movement desensitization and reprocessing. Of 213 children whose with initial score of Subject Unit of Disturbance Scale (SUDS) score over 4, we compared pre- and post-treatment scores and performed conducted the responder vs. non-responder comparison. The pPost-traumatic disorder (PTSD) symptom scores measured by using Child Reaction to Traumatic Events Scale-Revised (CRTES-R), demographic variables, and clinical variables were considered. RESULTS: Affect regulation group therapy was effective for children who had experienced an acute traumatic event (t=16.3, p<0.001). Baseline SUDS score of for non-responder were was significantly higher (t=-2.89, p<0.001) and CRTES-R score approached a level of significance level (t=-1.72, p=0.09). However, results of logistic regression analysis identified showed that the pretreatment SUDS score was the only significant predictor of non-response. CONCLUSION: Affect regulation group therapy appeared to be effective for children who had undergone experienced an acute traumatic event. And in addition, the survivors' subjective distress was more important to treatment response than severity of PTSD symptoms severity.

Cognitive Behavioral Therapy of Insomnia / 한양의대학술지

Cognitive behavioral therapy for insomnia (CBT-I) is a group of strategies which includes sleep restriction, stimulus control therapy, relaxation training, cognitive therapy, and various combinations of those methods. Growing evidence from controlled clinical trials indicates that the majority of patients (70 to 80%) with persistent insomnia respond to CBT, and approximately half of them achieve clinical remission. CBT-I produces significant improvements of sleep-onset latency, wake after sleep onset, sleep efficiency, and sleep quality. These benefits are paralleled by reductions of daytime fatigue, improvement in psychological symptoms, and decreased usage of hypnotics. Changes in sleep patterns are well maintained after completing therapy. Treatment outcomes have been documented primarily with prospective sleep diaries; studies using polysomnography and actigraphy have also supported these results. Considering the results of current peer-reviewed research, CBT-I should be the first-line therapy for persistent insomnia. Despite strong evidence supporting its efficacy and effectiveness, CBT-I remains under utilized by health care practitioners. Increased application of evidence-based CBT-I therapies and their extension into primary medical practices should be highly effective and should be recommended in the future for better clinical management of insomnia-related disorders.

Comparison of Neurite Outgrowth Induced by Erythropoietin (EPO) and Carbamylated Erythropoietin (CEPO) in Hippocampal Neural Progenitor Cells

A previous animal study has shown the effects of erythropoietin (EPO) and its non-erythropoietic carbamylated derivative (CEPO) on neurogenesis in the dentate gyrus. In the present study, we sought to investigate the effect of EPO on adult hippocampal neurogenesis, and to compare the ability of EPO and CEPO promoting dendrite elongation in cultured hippocampal neural progenitor cells. Two-month-old male BALB/c mice were given daily injections of EPO (5 U/g) for seven days and were sacrificed 12 hours after the final injection. Proliferation assays demonstrated that EPO treatment increased the density of bromodeoxyuridine (BrdU)-labeled cells in the subgranular zone (SGZ) compared to that in vehicle-treated controls. Functional differentiation studies using dissociated hippocampal cultures revealed that EPO treatment also increased the number of double-labeled BrdU/microtubule-associated protein 2 (MAP2) neurons compared to those in vehicle-treated controls. Both EPO and CEPO treatment significantly increased the length of neurites and spine density in MAP2(+) cells. In summary, these results provide evidences that EPO and CEPO promote adult hippocampal neurogenesis and neuronal differentiation. These suggest that EPO and CEPO could be a good candidate for treating neuropsychiatric disorders such as depression and anxiety associated with neuronal atrophy and reduced hippocampal neurogenesis.