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Objectives@#This study was conducted to investigate the relationship between personality and decision making in the group of young male depression patients. @*Methods@#Eighty-four male depression patients were subjected to the following test: Beck’s Depression Inventory-II (BDI-II), and Beck’s Anxiety Inventory (BAI), Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV), Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Personality Assessment Inventory (PAI), Temperament Character Inventory-Revised Short version (TCI-RS), Delay Discounting Task (DDT), Game of Dice Task (GDT). Pearson’s correlation analysis was used to determine the association between DDT and GDT performance results and self-report examination. Multiple linear regression models were conducted to figure out the causal relationship between risky choice of GDT and the variables suspected of having a linear relationship. The collected data was analyzed using SPSS 21. @*Results@#PAI mania, borderline features, dominance and novelty seeking of TCI-RS were positively correlated with the number of risky choices of GDT. Full Scale Intelligence Quotient, BDI-II, BAI score had no significant correlation with DDT and GDT. There was also no correlation between DDT and GDT. @*Conclusions@#The results suggest that risk taking decision is related to personality traits such as novelty seeking, while inter-temporal choice is not related to personality aspects. It could be inferred that two different decision-making processes take place independently at different brain regions.
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Objectives@#：A growing body of evidence links type 2 diabetes (T2D) with a neurodegenerative disease (ND) such as Alzheimer’s disease and Parkinson’s disease. The purpose of this study is to investigate the relationship between NDs and the development of T2D by comparing the incidence of T2D in a group of various NDs (ND group) and control group. @*Methods@#：A population-based 10-year follow-up study was conducted using the Korean National Health Information Database for 2002-2015. We used a retrospective cohort study design to investigate the association of ND with T2D occurrence. The study population included ND (n=8,814) and control (n=37,970) groups, all aged 60 years or over. The Kaplan-Meier method was used to estimate the risk of developing T2D as a function of time. Cox proportional hazards regression models were used to evaluate the relationship between ND and T2D. @*Results@#：T2D was developed in a significantly higher percentage of patients in the ND group (53.6%) than in the control group (44.7%). The ND group increased the risk of T2D (HR, 1.43; 95% CI, 1.38-1.47). About onethird of patients in both groups were additionally diagnosed with another ND before the occurrence of T2D during a 10-year follow-up period. When compared to those who did not have another ND during the follow-up period, the incidence of T2D in those who were additionally diagnosed with another ND was higher in both the ND and control groups. @*Conclusions@#：The ND group had about 1.4 times higher risk of developing T2D than the control group. Our results showed a positive association between ND and T2D.
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Objectives@#According to previous studies, cancer risk has decreased among patients with neurodegenerative disease (ND). However, some types of cancer are positively associated with ND.ND and cancer share common mechanisms of genetic and molecular abnormalities. The objective of this study was to evaluate the association between cancer and ND by comparing the incidence of cancer in the ND and control groups. @*Methods@#A population-based 10-year follow-up study was conducted using the Korean National Health Information Database for 2002–2015. The participants were 60-year-old or more, and they were divided into two groups, including ND (n=9324) and control (n=46683) groups. A multivariable Cox proportional hazards regression model was used to evaluate the hazard ratio and 95% confidence interval for determining cancer risk. @*Results@#About one-third of patients in both groups were diagnosed with ND before the occurrence of cancer during the 10-year follow-up. Cancer was developed in a significantly higher percentage of patients with ND (22.0%) than in the control group (18.4%). Compared to the control group, patients with ND had about 1.5-times higher risk of developing cancer. In the ND group, the incidence of cancer was increased when another ND was diagnosed during the 10-year follow-up. @*Conclusion@#Our results showed a positive association between ND and cancer. Thus, further replication study is needed to address the positive association between NDs and cancer, and it is also necessary to study the association between NDs and various types of cancer.
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Objectives@#：The purpose of this study was to investigate the effect of adult Attention-Deficit/Hyperactivity Disorder (ADHD) tendency on cognitive functions in the group of depression. @*Methods@#：117 male patients with depression (51 with adult ADHD and 66 with adult non-ADHD) were recruited in this study. All patients were subject to the following tests : Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV), Executive Intelligence Test, Rey-Kim memory test, Beck’s Depression Inventory II (BDI-II), and Beck’s Anxiety Inventory (BAI), Adult ADHD Self-Report Scale (ASRS), Lee Ji-Yeon’s adult ADHD scale. @*Results@#：Compared to the adult non-ADHD group, the adult ADHD group showed lower score in Rey-Kim memory test. Several test scores were negatively correlated with ASRS (free recall test trial 2 : r=-0.184, p=0.047, trial 3 : r=-0.277, p=0.002, trial 4 : r=-0.242, p=0.009, trial 5 : r=-0.264, p=0.004, delayed recall test : r=-0.187, p=0.044, recognition test : r=-0.209, p=0.024). No significant correlation was found between depression, anxiety and Rey-Kim memory test even though there is a meaningful correlation between adult ADHD tendency the severity of depression and anxiety. @*Conclusion@#：In this study, we found the adult ADHD with depression group has difficulties in retaining information and maintaining attention. Interestingly, it was proved the difference comes from ADHD tendency, not from the severity of depression or anxiety.
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Objective@#We evaluated the association between cancer and various neurodegenerative diseases (NDs), including Alzheimer’s disease (AD), Parkinson’s disease (PD), and circumscribed brain atrophy (CBA) and to evaluate the impact of ND on the development of cancer. @*Methods@#A population-based longitudinal study was conducted using the National Health Information Database for 2002-2015.A total of 9,365 ND patients (3,157 AD, 5,866 PD, 342 CBA) were included in the study, as were 46,818 matched controls. @*Results@#Various NDs were newly developed in control and ND groups during the 10-year follow-up periods. Newly developed ND cases were as follows: 33.0% in control, 35.3% in AD, 19.9% in PD, and 45.3% in CBA. Cancer developed in 22.6% of ND groups (20.5% AD, 23.6% PD, 24.3% CBA) and in 18.5% of control group. Cancer development was significantly higher in AD pa-tients with new ND cases (especially PD cases), compared to patients without new ND cases (22.8% vs. 19.3%, p=0.019). There were no differences in the frequencies of cancer development between patients with and without new ND cases in PD, CBA, and control groups. The adjusted hazard ratios for cancer in AD, PD, and CBA groups were 1.43, 1.55, and 1.58, respectively. @*Conclusion@#This study showed that various NDs are positively associated with development of cancer and suggests that newly developed PD in AD group during the follow-up period may influence the development of cancer that follows.
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Objective@#We evaluated the association between cancer and various neurodegenerative diseases (NDs), including Alzheimer’s disease (AD), Parkinson’s disease (PD), and circumscribed brain atrophy (CBA) and to evaluate the impact of ND on the development of cancer. @*Methods@#A population-based longitudinal study was conducted using the National Health Information Database for 2002-2015.A total of 9,365 ND patients (3,157 AD, 5,866 PD, 342 CBA) were included in the study, as were 46,818 matched controls. @*Results@#Various NDs were newly developed in control and ND groups during the 10-year follow-up periods. Newly developed ND cases were as follows: 33.0% in control, 35.3% in AD, 19.9% in PD, and 45.3% in CBA. Cancer developed in 22.6% of ND groups (20.5% AD, 23.6% PD, 24.3% CBA) and in 18.5% of control group. Cancer development was significantly higher in AD pa-tients with new ND cases (especially PD cases), compared to patients without new ND cases (22.8% vs. 19.3%, p=0.019). There were no differences in the frequencies of cancer development between patients with and without new ND cases in PD, CBA, and control groups. The adjusted hazard ratios for cancer in AD, PD, and CBA groups were 1.43, 1.55, and 1.58, respectively. @*Conclusion@#This study showed that various NDs are positively associated with development of cancer and suggests that newly developed PD in AD group during the follow-up period may influence the development of cancer that follows.
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Objectives@#：The purpose of this study is to evaluate the effect of a school-based social skills training program on the social decision-making of children and adolescents and to assess plan for effective school-based mental health services. @*Methods@#：It was performed school-based social skills training (n=46, 7 sessions) in elementary and middle school students. Evaluations were conducted before and after the application of the program using a ultimatum game and dictator game, in order to identify changes. @*Results@#：Before social skills training program (SSTP), the younger students showed higher acceptance rates of unfair offers than the older students in ultimatum game (UG) [at 9:1 offers 0.79±0.08>0.55±0.12 (p=0.001); at 8:2 offers 0.81±0.11>0.59±0.11 (p=0.001)]. the rejection rates of unfair offers in UG significantly increased after SSTP[at 9:1 offers 0.64±0.19→0.43±0.18 (p=0.001) ; at 8:2 offers 0.67±0.16→0.54±0.16 (p=0.046) ; at 7:3 offers 0.83± 0.20→0.65±0.12 (p=0.001)]. the rejection rates of unfair offers in UG significantly increased at happy and at neutral facial expression of proposers after SSTP[happy facial expression condition, at 9:1 offers 0.89±0.12→0.68±0.19 (p=0.001) ; at 8:2 offers 0.82±0.19→0.72±0.14 (p=0.001) ; at 7:3 offers 0.99±0.07→0.92±0.17 (p=0.040] [neutral facial expression condition, at 9:1 offers 0.71±0.20→0.54±0.13 (p=0.001) ; at 8:2 offers 0.61±0.18→0.52±0.06 (p=0.001) ; at 7:3 offers 0.91±0.13→0.83±0.12 (p=0.001)]. the amount of money offered as a proposer in dictator game significantly increased after SSTP [3989.1±1952.3→4742.5±371.1, (p=0.012)]. @*Conclusion@#：The social skills training program positively influences the social decision-making. The school-based social skills training program can be expected to have positive results in school-based mental health services. Future investigation is needed to validate the long term effects of this program.
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Major depressive disorder (MDD) and anxiety disorder (AD) are mental disorders with a high social burden. Since the discovery of neurogenesis, one effect of anti-depressant was revealed as increasing the neurogenesis of the dentate gyrus (DG). Thus, many researchers have speculated that neurogenesis may correlate with the pathogenesis of depression and anxiety disorders. It was reasonable to hypothesize that neurogenesis would be essential for the therapeutic mechanism. We call this new hypothesis the neurogenic theory. In this review, we investigated the validity and evidence of neurogenic theory through post-mortem studies and animal models. As a result, it seems to be a lack of strong evidence to claim that the defect of neurogenesis itself causes MDD and AD. However, neurogenesis seems to be essential, at least for improving depressive or anxiety behaviors. From the algorithmic perspective, we also discussed the pattern separation, suggested function of neurogenesis of the DG, in the relationship with the symptoms of mental disorder. We tried to show that it is appropriate to interpret the relationship between neurogenesis and mental disorder using the term “overgeneralization” rather than the theoretical term “pattern separation”.Overgeneralization was especially beneficial for interpreting the relationship between the defect of neurogenesis and post-traumatic stress syndrome (PTSD) among AD. It is necessary to further investigate the effect of neurogenesis in the treatment of mental illnesses such as MDD and AD including PTSD, and in the prognosis of patients.
ABSTRACT
Major depressive disorder (MDD) and anxiety disorder (AD) are mental disorders with a high social burden. Since the discovery of neurogenesis, one effect of anti-depressant was revealed as increasing the neurogenesis of the dentate gyrus (DG). Thus, many researchers have speculated that neurogenesis may correlate with the pathogenesis of depression and anxiety disorders. It was reasonable to hypothesize that neurogenesis would be essential for the therapeutic mechanism. We call this new hypothesis the neurogenic theory. In this review, we investigated the validity and evidence of neurogenic theory through post-mortem studies and animal models. As a result, it seems to be a lack of strong evidence to claim that the defect of neurogenesis itself causes MDD and AD. However, neurogenesis seems to be essential, at least for improving depressive or anxiety behaviors. From the algorithmic perspective, we also discussed the pattern separation, suggested function of neurogenesis of the DG, in the relationship with the symptoms of mental disorder. We tried to show that it is appropriate to interpret the relationship between neurogenesis and mental disorder using the term “overgeneralization” rather than the theoretical term “pattern separation”.Overgeneralization was especially beneficial for interpreting the relationship between the defect of neurogenesis and post-traumatic stress syndrome (PTSD) among AD. It is necessary to further investigate the effect of neurogenesis in the treatment of mental illnesses such as MDD and AD including PTSD, and in the prognosis of patients.
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OBJECTIVES: This study investigated psychological factors in patients with adult ADHD tendency and the relationship of adult ADHD tendency with depression and anxiety.METHODS: Ninety patients with depression(38 with adult ADHD and 52 with non-adult ADHD) were recruited in this study. All patients were subjected to the following tests : Korean Wechsler Adult Intelligence Scale-IV(K-WAIS-IV), Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale(ASRS-v1.1), Lee Ji-Yeon's adult ADHD scale, Beck's Depression Inventory II(BDI-II), Beck's Anxiety Inventory(BAI), and Temperament Character Inventory-Revised Short version(TCI-RS).RESULTS: The adult ADHD group had higher scores for BDI-II and BAI, novelty-seeking, harm-avoidance, and self-transcendence than the non-adult ADHD group. Conversely, the adult ADHD group showed lower scores for self-directedness and cooperativeness than the non-adult ADHD group. Depression scores were positively correlated with ASRS(r=0.524, p=0.000), Lee Ji-Yeon's adult ADHD scale(r=0.598, p=0.000), anxiety scores(r=0.650, p=0.000), novelty-seeking(r=0.411, p=0.000), harm-avoidance(r=0.517, p=0.000), and self-transcendence(r=0.234, p=0.026). However, they were negatively correlated with persistence(r=−0.231, p=0.029), and self-directedness(r=−0.594, p=0.000). Higher Lee Ji-Yeon's adult ADHD scale scores and lower self-directedness scores among TCI, resulted in higher depression scores. In addition, anxiety scores increased in parallel with the the Lee Ji-Yeon's adult ADHD scale and harm-avoidance TCI scores.CONCLUSION: In this study, we found a difference in the severity of depression and anxiety between the adult and non-adult ADHD groups. In addition, it was confirmed that the difference in temperament and character between the two groups was related to adult ADHD tendency and severity of depression and anxiety.
Subject(s)
Adult , Humans , Male , Anxiety , Depression , Intelligence , Psychology , TemperamentABSTRACT
The Clinical Assessment Interview for Negative Symptoms (CAINS) was developed to overcome the limitations of existing instruments and reflect the current view of negative symptoms. The aim of the present study was to evaluate the reliability and validity of the Korean version of the Clinical Assessment Interview for Negative Symptoms (K-CAINS). Inpatients (n = 49) and outpatients (n = 70) with schizophrenia were recruited from three institutions. The confirmative factor analysis, test-retest reliability, inter-rater reliability, convergent validity, and discriminant validity were assessed. The study group consisted of 71 males (59.7%) and 48 females (40.3%). Their mean age was 42.15 years (SD = 12.2). The K-CAINS was confirmed to be divided into two subscales of 9 items related to "motivation/pleasure" and 4 items related to "expression" in concordance with the original version of the CAINS. The results showed that the K-CAINS had a good inter-rater reliability (ICC = 0.84-0.94), test-retest reliability (r = 0.90, P < 0.001). Convergent validity was proven by demonstrating a significant correlation with the Positive and Negative Syndrome Scale (PANSS) negative subscale, and the Scale for the Assessment of Negative Symptoms (SANS). Discriminant validity was proven by the lack of a significant correlation with the PANSS positive subscale, the Korean version of the Beck depression inventory (BDI), the Korean version of the Calgary depression scale for schizophrenia (K-CDSS), and the Modified Simpson Angus scale (MSAS). The K-CAINS could be a reliable and valid tool to assess the negative symptoms of Korean schizophrenia patients.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Asian People , Discriminant Analysis , Interviews as Topic , Psychiatric Status Rating Scales/standards , Republic of Korea , Schizophrenia/diagnosis , TranslatingABSTRACT
OBJECTIVES: Electroconvulsive therapy (ECT) has become useful in psychiatric practice. This study was conducted to describe the clinical practice of ECT, including indications, efficacy, and side effects, in patients treated with modified unilateral or bilateral ECT. METHODS: The clinical records of patients treated with ECT during the period of January 2002 to December 2013 were evaluated retrospectively. A total of 107 patients (83 unilateral and 24 bilateral) were included in the analysis. Diagnostic categories treated were schizophrenia (46.7%), major depression (42.1%), bipolar disorder (9.3%), and obsessive-compulsive disorder (1.9%). Right unilateral or bilateral ECT was administered with brief pulse stimulation using modified ECT. Severity of illness and clinical improvement were measured using the Clinical Global Impressions (CGI) Scale. RESULTS: A positive response to ECT was found in 56.1% according to response criteria of the CGI-Improvement (CGI-I) score of 1 or 2. Response rates (based on CGI-I < or =2) for schizophrenia, major depression, bipolar disorder, and obsessive-compulsive disorder were 48.0%, 62.2%, 70.0%, and 50.0%, respectively (p=0.42). Although unilateral and bilateral ECT did not differ in rates of response, bilateral ECT resulted in more rapid onset of improvement. Bilateral ECT showed association with more adverse side effects (unilateral 31.3% vs. bilateral 70.8%). CONCLUSION: ECT is a highly effective and safe therapeutic option in the treatment of psychiatric illness, particularly in major mood disorder and schizophrenia. The use of ECT in a university hospital psychiatric unit in South Korea reflects similar results to those described in the international literature.
Subject(s)
Humans , Bipolar Disorder , Depression , Depressive Disorder, Major , Electroconvulsive Therapy , Korea , Mood Disorders , Obsessive-Compulsive Disorder , Retrospective Studies , SchizophreniaABSTRACT
OBJECTIVES: Electroconvulsive therapy (ECT) has become useful in psychiatric practice. This study was conducted to describe the clinical practice of ECT, including indications, efficacy, and side effects, in patients treated with modified unilateral or bilateral ECT. METHODS: The clinical records of patients treated with ECT during the period of January 2002 to December 2013 were evaluated retrospectively. A total of 107 patients (83 unilateral and 24 bilateral) were included in the analysis. Diagnostic categories treated were schizophrenia (46.7%), major depression (42.1%), bipolar disorder (9.3%), and obsessive-compulsive disorder (1.9%). Right unilateral or bilateral ECT was administered with brief pulse stimulation using modified ECT. Severity of illness and clinical improvement were measured using the Clinical Global Impressions (CGI) Scale. RESULTS: A positive response to ECT was found in 56.1% according to response criteria of the CGI-Improvement (CGI-I) score of 1 or 2. Response rates (based on CGI-I < or =2) for schizophrenia, major depression, bipolar disorder, and obsessive-compulsive disorder were 48.0%, 62.2%, 70.0%, and 50.0%, respectively (p=0.42). Although unilateral and bilateral ECT did not differ in rates of response, bilateral ECT resulted in more rapid onset of improvement. Bilateral ECT showed association with more adverse side effects (unilateral 31.3% vs. bilateral 70.8%). CONCLUSION: ECT is a highly effective and safe therapeutic option in the treatment of psychiatric illness, particularly in major mood disorder and schizophrenia. The use of ECT in a university hospital psychiatric unit in South Korea reflects similar results to those described in the international literature.
Subject(s)
Humans , Bipolar Disorder , Depression , Depressive Disorder, Major , Electroconvulsive Therapy , Korea , Mood Disorders , Obsessive-Compulsive Disorder , Retrospective Studies , SchizophreniaABSTRACT
OBJECTIVES: The aim of this study is to develop guideline for use in diagnosis of depression. METHODS: Development of this guideline was processed according to the ADAPTE manual, which was developed for adaptation of good clinical practice guidelines. Important key questions were determined, and a systematic review of clinical practice guidelines was performed. The contents of guidelines selected by comparison of the methodological quality and currency were evaluated with regard to the applicability and acceptability. Answers to key questions and clinical recommendations were established by peer review. RESULTS: There has been no evidence on strategies to improve the accuracy and rate of diagnosis of depression. The screening tools for depression were useful in diagnosis of depression in clinical practice. CONCLUSION: The results of this study may suggest the necessity of strategies to improve the validity and reliability of diagnosis of depression. In contrast, scales for screening depression can be useful in diagnosis of depression. This guideline did not include systematic reviews regarding useful scales for diagnosis of depression. In the future, amendment of this guideline might be needed in order to supplement limitations.
Subject(s)
Depression , Depressive Disorder , Diagnosis , Mass Screening , Methods , Peer Review , Reproducibility of Results , Weights and MeasuresABSTRACT
OBJECTIVES: The aim of this study is to develop guideline for evaluation of depression. METHODS: Development of this guideline was processed according to the ADAPTE manual, which was developed for adaptation of good clinical practice guidelines. Important key questions were determined, and a systematic review of clinical practice guidelines was performed. The contents of guidelines selected by comparison of the methodological quality and currency were evaluated with regard to the applicability and acceptability. Answers to key questions and clinical recommendations were established by peer review. RESULTS: Careful evaluations on the characteristics of depression, including subtype, severity, suicidality, and psychiatric and physical comorbidities were recommended because these factors can have an influence on course and prognosis in treatment of depression. CONCLUSION: The results of this study may contribute to the systematic evaluation of depression, based on clinical importance. However, this guideline did not include systematic reviews regarding useful scales for evaluation of depression. In the future, amendment of this guideline might be needed in order to supplement limitations.
Subject(s)
Comorbidity , Depression , Depressive Disorder , Diagnosis , Methods , Peer Review , Prognosis , Weights and MeasuresABSTRACT
PURPOSE: To assess proper soft tissue balancing of the varus arthritic knee between posterior oblique ligament (POL) release group and superficial medial collateral ligament (SMCL) release group. MATERIALS AND METHODS: This retrospective study was performed on 186 patients who underwent minimally invasive surgery (MIS) total knee arthroplasty (TKA) from January 2011 to December 2011. Eighty-three patients were in the group of SMCL release and 103 patients were in the POL release group. We intended to use a 10 mm polyethylene insert (PE) during TKA, and retrospectively compared the actual thickness of PE between POL release group and SMCL release group. RESULTS: The mean PE thickness was 10.59+/-1.3 mm (range, 8 to 15 mm) in POL group and 11.88+/-1.8 mm (range, 10 to 18 mm) in SMCL group (p=0.001). We found a significant difference in the mean PE thickness between POL release group and SMCL release group. CONCLUSIONS: POL and deep MCL releases in MIS-TKA would be beneficial for varus deformity correction in the osteoarthritic knee.
Subject(s)
Humans , Arthroplasty , Benzeneacetamides , Collateral Ligaments , Congenital Abnormalities , Knee , Ligaments , Piperidones , Polyethylene , Retrospective StudiesABSTRACT
PURPOSE: This study was conducted to investigate factors influencing suicidal ideation in people with mental disorder. METHODS: The subjects were 176 people with mental disorder from community mental health centers, social rehabilitation facilities, and university hospital psychiatric outpatient departments. The instruments used included a suicidal ideation questionnaire, a self-esteem scale, a spiritual well-being scale, a family support scale, and a professional support scale. Data were analyzed with t-test, one-way ANOVA, Pearson's correlation coefficient, and hierarchical regression analysis. RESULTS: Suicidal ideation was influenced by age, history of suicidal attempts, and existential spiritual well-being. This study shows that suicidal ideation has negative correlation with existential spiritual well-being, self-esteem, family support, and age. Existential spiritual well-being, history of suicidal attempts, and age accounted for 30% regarding suicidal ideation in people with mental disorder. CONCLUSION: The lower existential spiritual well-being and age, the higher suicidal ideation. And also suicidal ideation was higher in people who had attempted suicide than in those who had not. Based on the outcomes of this study, it is necessary to design an intervention program that emphasizes existential spiritual well-being in order to decrease suicidal ideation in young people with mental disorder.
Subject(s)
Humans , Community Mental Health Centers , Mental Disorders , Outpatients , Spirituality , Suicidal Ideation , Suicide, Attempted , Surveys and QuestionnairesABSTRACT
Pseudoaneurysm is extremely rare complication after ankle arthroscopy with standard anteromedial and anterolateral portals. We report a case of a pseudoaneurysm of the anterior tibial artery detected at 3 months after ankle arthroscopy in a 16-year-old male. He had sustained painful swelling of his right ankle after the arthroscopic surgery, and referred to our hospital with an MRI checked postoperatively. We failed to make the diagnosis of pseudoaneurysm with the postoperative MRI, thus the patient underwent another arthroscopy which revealed massive hemarthrosis within the joint. The diagnosis was confirmed with an angiography, and the vascular lesion was ligated.
Subject(s)
Animals , Humans , Male , Aneurysm, False , Angiography , Ankle , Arthroscopy , Hemarthrosis , Joints , Tibial ArteriesABSTRACT
Functional magnetic resonance imaging (fMRI) was used to assess the temporal response of neural activation in healthy subjects while they performed the Iowa Gambling Test (IGT), which utilizes decisions involving ambiguity and risk. The IGT was divided into five blocks of 20 trials; analysis showed that activity in the medial prefrontal cortex (mPFC) moves gradually from the dorsal to the ventral mPFC over the course of the IGT. These findings suggest that cognitive division of the mPFC, including the dorsal portion of the anterior cingulated cortex (ACC), plays a major role in ambiguous decision making and that the aspect of the IGT corresponding to risky decision making is associated with significant activity within the corticolimbic network strongly implicated in emotion and reinforcement. Our results also suggest that decisions made under ambiguity and decisions made under risk situations can be further divided into sub-phases based on the neural network involved.
Subject(s)
Decision Making , Gambling , Iowa , Magnetic Resonance Imaging , Prefrontal Cortex , Reinforcement, PsychologyABSTRACT
OBJECTIVE: We compared patients with chronic schizophrenia and normal controls with respect to decision-making ability. Measures were implemented to control for the participants' intelligence levels as well as to ensure to use of a moderate sample size. The goal of this study was to confirm inconsistent results from previous studies which had stemmed from too small of a sample size, highly variable performance of normal controls, and not controlling for intelligence as a confounding factor. METHODS: Fifty-two chronic stable schizophrenic inpatients and 55 healthy controls participated in the study. We controlled for intelligence by including subjects with intelligence quotient's (IQ) between 80 and 120, examining any differences in decision-making performance between groups on the Iowa Gambling Task (IGT). We also addressed several issues relating to performance on the IGT, such as working memory and clinical symptoms. RESULTS: Schizophrenic patients were found to perform poorly on the IGT relative to normal controls (F(1,105)=17.73, p<0.001); however, more importantly, they also displayed the slow yet profitable shift from disadvantageous decks to advantageous decks over time. We also found that when compared with healthy controls, schizophrenic patients showed a poorer performance on the Wisconsin Card Sorting Test (WCST)(t=-5.48, p<0.001 for perseverative error) which was not related to their performance on the IGT. CONCLUSION: Based on previous literature and the results of this study, impaired sensitivity to both reward and punishment might be a more plausible explanation for the poor performance on the IGT in the schizophrenic group. We speculated that this impairment seemed related more to the different responsiveness to the magnitude than to the frequency of punishment, and to the different interpretation of less informative verbal cues in the context of the reinforcing schedule.