Temporal Changes of Psychosocial Status in Neuroblastoma Survivors Over Time / 신경정신의학

OBJECTIVES: The survival rate of all childhood cancers has been increasing, and latent effects on childhood cancer survivors have been gaining researchers' attention. It has been shown that childhood cancer survivors experience social maladaptation and a decreased quality of life. Although neuroblastoma is one of the most common solid cancers in childhood, there are few reports on psychosocial status in neuroblastoma survivors. The purpose of this study was to investigate temporal changes in psychosocial status in neuroblastoma survivors. METHODS: This study was conducted by undertaking retrospective chart reviews of neuroblastoma survivors that were treated between January 1997 and February 2016 at Samsung Medical Center, Seoul, Korea. Among the 54 survivors identified, data for 28 patients who underwent psychological evaluation before and after treatment completion were selected for further analysis. We compared intelligence score, Korea-Child Behavior Checklist (K-CBCL), and Korean Personality Rating Scale for Children (K-PRC) scores before and after treatment completion. Time derivatives for each variable were calculated to identify temporal changes in scores. RESULTS: After treatment completion, K-CBCL scores for total competence (t=−2.34, p=0.044), somatic complaints (t=−2.43, p=0.022), and thought problems (t=−3.03, p=0.006) were higher than the scores prior to treatment. Familial relationship in K-PRC was significantly improved after treatment (t=2.11, p=0.045). Time derivatives of the significant K-CBCL subscales, except for the withdrawal and externalizing symptom scores, showed a tendency to increase with time. CONCLUSION: Although familial relationship and social competence improved after treatment, the levels of somatic complaints and thought problems increased following neuroblastoma treatment.

Association between the Daytime Plasma Cortisol Level and Depression Component of Hamilton Depression Rating Scale in Korean Depression Clinic Outpatients / 신경정신의학

OBJECTIVES: There is evidence that Hypothalamic-Pituitary-Adrenocortical (HPA) system dysregulation plays a role in the pathophysiology of depression. However which psychiatric symptoms are related to HPA system dysregulation has not been studied well. The primary aim of this study was to investigate which symptom components of the Hamilton Depression Rating Scale (HAM-D) are related to HPA system dysregulation in Korean psychiatric outpatients. The secondary aim was to find other variables that have association with HAM-D components. METHODS: This study was a retrospective review of the charts of outpatients who first visited Samsung Medical Center Depression Clinic between July 2012 and October 2013. Among them those who checked the plasma cortisol level and HAM-D within one week of their first visit were selected. Fifty nine patients were selected. The HAM-D was divided into four components, including depression, anxiety, insomnia, and somatic components. Multiple regression of cortisol level was used for four subscales. RESULTS: Significant positive correlations were observed between the plasma cortisol level and depression component of HAM-D (beta=0.251, p=0.049). Age also showed negative correlation with the depression component of HAM-D (beta=-0.427, p=0.002). However anxiety, insomnia and somatic components of HAM-D did not show correlation with plasma cortisol level. CONCLUSION: Our study suggests that in Korean depression clinic outpatients, the depression component of HAM-D is related to plasma cortisol level.