Decreased White Matter Structural Connectivity in Psychotropic Drug-Naïve Adolescent Patients with First Onset Major Depressive Disorder / 정신신체의학

OBJECTIVES: Recent neuroimaging studies focus on dysfunctions in connectivity between cognitive circuits and emotional circuits: anterior cingulate cortex that connects dorsolateral orbitofrontal cortex and prefrontal cortex to limbic system. Previous studies on pediatric depression using DTI have reported decreased neural connectivity in several brain regions, including the amygdala, anterior cingulate cortex, superior longitudinal fasciculus. We compared the neural connectivity of psychotropic drug naïve adolescent patients with a first onset of major depressive episode with healthy controls using DTI. METHODS: Adolescent psychotropic drug naïve patients(n=26, 10 men, 16 women; age range, 13–18 years) who visited the Korea University Guro Hospital and were diagnosed with first onset major depressive disorder were registered. Healthy controls(n=27, 5 males, 22 females; age range, 12–17 years) were recruited. Psychiatric interviews, complete psychometrics including IQ and HAM-D, MRI including diffusion weighted image acquisition were conducted prior to antidepressant administration to the patients. Fractional anisotropy(FA), radial, mean, and axial diffusivity were estimated using DTI. FMRIB Software Library-Tract Based Spatial Statistics was used for statistical analysis. RESULTS: We did not observe any significant difference in whole brain analysis. However, ROI analysis on right superior longitudinal fasciculus resulted in 3 clusters with significant decrease of FA in patients group. CONCLUSIONS: The patients with adolescent major depressive disorder showed statistically significant FA decrease in the DTI-based structure compared with healthy control. Therefore we suppose DTI can be used as a biomarker in psychotropic drug-naïve adolescent patients with first onset major depressive disorder.

Effect of systemic family dynamics, egma minnen bardndom on psychological traits and treatment efficacy of the first onset schizophrenia / 中华行为医学与脑科学杂志

[Abstrict] Objective To explore the effect of systemic family dynamics,egma minnen bardndom on the psychological traits,treatment efficacy of the first onset schizophrenia.Methods 53 schizophrenia patients with first onset were assessed by Self-rating Scale of Systemic Family Dynamics (SSFD),Egma Minnen Bardndom Uppforstran (EMBU),Neurotism Scale (Nf),Psychoticism (PSY),Paranoia Scale (Pa),Psychopathic Deviate Scale (Pd),Tolerance Scale(To) of MMPI-2,and lie Scale (L) was used to control assessment effectiveness.40 normal control cases were assessed by SSFD and EMBU.The scale scores between study group and control groupwere compared,and correlation and regression of study group were analyzed.Results Scores of family atmosphere,individuation,system logic of SSFD were higher in study group than those in control group (t=4.04,3.295,2.44,all P＜0.05),scores of emotional warmth and understand of EMBU in father and mother were lower in study group than those in control group (t=2.925,3.45,all P＜0.01),scores of refused and deny and punishment and stern of EMBU in father and mother were higher in study group than those in control group((t=4.715,4.971,4.331,4.067,all P＜0.01)).And correlation analysis showed that refused and deny of EMBU of father and mother,punishment and stern of EMBU of mother and PSY had significantly positive correlation(r=0.3378,0.4677,0.2895,all P＜0.05),refused and deny and punishment and stern of EMBU of father and mother and Pa had significantly negative correlation (r=-0.2913,-0.3254,-0.5003,-0.3242,all P＜0.05),punishment and stern and excessive interference of EMBU of father and Pd had significant positive correlation (r=0.3417,0.2958,all P＜0.05),PSY of MMPI-2 and treatment effect had significant negative correlation (r=-0.3194,P＜0.05).Regression analysis showed that psychoticism to forecast the poor treatment effect the rate was 10.2％,father and mother the refused and deny to forecast psychoticism high mark the rate respectively were 11.41％ and 21.87％,mother the severe punishment to forecast the psychoticism high mark the rate was 8.13％,Conclusion Father and mother the refused and deny,mother severe punishment have effects on psychological traits of the first onset schizophrenia,psychoticism of psychological traits has an affect on treatment efficacy,the psychoticism high mark presages the poor treatment efficacy.

Seasonsits of the First Onset in Schizophrenia and Mood Disorder: Mainly in Paranoid Schizophrenia and Bipolar I Disorder / 신경정신의학

This study aimed 1) at determining the seasonal pattern of the first onset and 2) at examining different demographic and clinical factors by the seasonality of first onset, for shizophrenia, mood disorder and subtypes of each diagnosis. Finally, the 52 subjects with paranoid schizophrenia were selected from all patients who fulfilled DSM-IV criteria far schizophrenia who had been admitted to the National Seoul Mental Hospital from March 1994 to February 1995. And the 44 subjects with bipolar I disorder were selected from all patients who fulfilled DSM-IV criteria for mood disorder who had been admitted to the hospital from March 1994 to February 1996. This study was done by reviewing the hospital records about season of the first outset, demographic factors(sex, age, occupation, educated period, religion, marital status, residence and socioeconomic status) and clinical factors(age at the first onset, duration of illness, family history, length of admission, frequency of admission and treatment result). The seasonal pattern of the first onset and the different demographic and clinical factors by the season of the first onset in paranoid shizophrenia and I disorder were analyzed. The results were as follows: 1) There was no significant seasonal variation of the first onset for paranoid schizophrenia. 2) There was a significant seasonal variation of the first onset with a maximum in spring for bipolar I disorder. 3) There was no significant seasonal variation of the first onset in case of bipolar I disorder that began with the manic episode. 4) There was nonsignificant seasonal tendency to peak in spring/summer in the case of the first manic episode for bipolar I disorder. 5) There were no significant differences in demographic and clinical factors by the season of the first onset for paranoid schizophrenia and bipolar I disorder.