Design and Methods of a Prospective Smartphone App-Based Study for Digital Phenotyping of Mood and Anxiety Symptoms Mixed With Centralized and Decentralized Research Form: The Search Your Mind (S.Y.M., 心) Project

In this study, the Search Your Mind (S.Y.M., 心) project aimed to collect prospective digital phenotypic data centered on mood and anxiety symptoms across psychiatric disorders through a smartphone application (app) platform while using both centralized and decentralized research designs: the centralized research design is a hybrid of a general prospective observational study and a digital platform-based study, and it includes face-to-face research such as informed written consent, clinical evaluation, and blood sampling. It also includes digital phenotypic assessment through an application-based platform using wearable devices. Meanwhile, the decentralized research design is a non-face-to-face study in which anonymous participants agree to electronic informed consent forms on the app. It also exclusively uses an application-based platform to acquire individualized digital phenotypic data. We expect to collect clinical, biological, and digital phenotypic data centered on mood and anxiety symptoms, and we propose a possible model of centralized and decentralized research design.

Association between the IL10 rs1800896 Polymorphism and Tardive Dyskinesia in Schizophrenia

Objective@#Interleukin-10 (IL-10) is a major immunoregulatory cytokine and its gene plays a fundamental role in anti-inflammatory and immunosuppressive activity. This study aimed to examine the association between the IL10 gene promoter -1082G/A polymorphism (rs1800896) and tardive dyskinesia (TD) in schizophrenia. @*Methods@#Two hundred and eighty unrelated Korean schizophrenic patients participated in this study (105 TD and 175 non-TD patients). TD was diagnosed using the Research Diagnostic Criteria for TD and Abnormal Involuntary Movement Scale (AIMS). Genotyping was performed by RT-PCR and high-resolution melting curve analysis. @*Results@#The distributions of genotypic frequencies did not differ between patients with and without TD (χ2=4.33, p=0.115). However, allelic frequencies of the two groups were different (χ2=4.45, p=0.035); the A allele frequency was higher in TD. The total AIMS scores of the three genotypes were not different (F=1.33, p=0.266). However, the total AIMS scores of the A allele carrier and the A allele non-carrier were significantly different (t=5.79, p<0.001). Logistic regression analaysis showed that IL10 -1082G/A genotype significantly predicts presence of TD (p=0.045) after adjusting for covariates such as age and treatment duration. @*Conclusion@#This finding suggests that the A allele of rs1800896 may be associated with TD development following a low IL-10 function.

The Effect of Psychopathology on the Quality of Lifein Female Dermatological Outpatients / 생물치료정신의학

OBJECTIVES: The purpose of this study was to investigate the effect of psychopathology on the quality of life in dermatological outpatients.METHODS: A sample of 151 female dermatological outpatients was compared with a control group of 200 females. Symptom Check List-90-R(SCL-90-R) was used to screen for psychopathology and Skindex-29 for quality of life. We compared the scores of SCL-90-R and Skindex-29 between the two groups and examined the correlation between SCL-90-R and Skindex-29 in the patient group. We analysed the subscales of SCL-90-R that affect Skindex-29.RESULTS: There was statistically significant higher in the score of SCL-90-R in patient group than control group. In high score group of Skindex-29, the score of SCL-90-R was significantly higher than in low score group of Skindex-29. The correlation between SCL-90-R and Skindex-29 was positively correlated with moderate relationship on all subscales except paranoid ideation. Somatization and psychoticism of SCL-90-R were the factors affecting on the total score of Skindex-29.CONCLUSION: The results of this study suggest that psychological distress of the dermatological outpatients is more severe than control group, and somatization and psychoticism are suggested as predictors of the quality of life of dermatologic patients.

Dehydroepiandrosterone Sulfate Level Varies Nonlinearly with Symptom Severity in Major Depressive Disorder

OBJECTIVE: The pathophysiology of major depressive disorder (MDD) is still not well understood. Conflicting results for surrogate biomarkers in MDD have been reported, which might be a consequence of the heterogeneity of MDD patients. Therefore, we aim to investigate how the severity of depression and various symptom domains are related to the levels of dehydroepiandrosterone sulfate (DHEA-s) in MDD patients. METHODS: We recruited 117 subjects from a general practice. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Depressive symptoms were divided into three subdomains according to BDI items; somatic symptoms, guilt and failure, and mood and inhibition. RESULTS: In subjects with very-mild-to-moderate depression, the DHEA-s level increased as BDI score did. However, the DHEA-s levels in the subjects with severe depression were significantly lower than in subjects with moderate depression (p=0.003). DHEA-s level was correlated with the BDI subscore for guilt and failure in very-mild-to-moderate depression (r=0.365, p=0.006). CONCLUSION: The DHEA-s level appears to be indicative of MDD severity with respect to depressive symptoms, especially regarding guilt and failure. Our findings suggest that the upregulation of DHEA-s may be a part of a compensatory process in very-mild-to-moderate depression, and the failure of this compensation mechanism may underlie the development of severe depression.

Toward understanding the role of the neuron-specific BAF chromatin remodeling complex in memory formation

The long-term storage of memory requires the finely tuned coordination of intracellular signaling with the transcriptional, translational and epigenetic regulations of gene expression. Among the epigenetic mechanisms, however, we know relatively little about the involvement of chromatin remodeling-dependent control of gene expression in cognitive brain functions, compared with our knowledge of other such mechanisms (for example, histone modifications and DNA methylation). A few recent studies have implicated the Brm/Brg-associated factor (BAF) chromatin-remodeling complex, a mammalian homolog of the yeast Swi/Snf complex, in neuronal structural/functional plasticity and memory formation. The BAF complex was previously known to have a critical role in neurodevelopment, but these recent findings indicate that it also contributes to both cognitive functions in the adult brain and human mental disorders characterized by intellectual disability. In this review, we provide a brief overview of the BAF complexes, introduce recent research findings that link their functions to memory formation, and speculate on the yet-unknown molecular mechanisms that may be relevant to these processes.

Neural Circuit and Mechanism of Fear Conditioning

Pavlovian fear conditioning has been extensively studied for the understanding of neurobiological basis of memory and emotion. Pavlovian fear conditioning is an associative memory which forms when conditioned stimulus (CS) is paired with unconditioned stimulus (US) once or repeatedly. This behavioral model is also important for the understanding of anxiety disorders such as posttraumatic stress disorder. Here we describe the neural circuitry involved in fear conditioning and the molecular mechanisms underlying fear memory formation. During consolidation some memories fade out but other memories become stable and concrete. Emotion plays an important role in determining which memories will survive. Memory becomes unstable and editable again immediately after retrieval. It opens the possibility for us of modulating the established fear memory. It provides us with very efficient tools to improve the efficacy of cognitive-behavior therapy and other exposure-based therapy treating anxiety disorders.

Association between Serotonin-Related Polymorphisms in 5HT2A, TPH1, TPH2 Genes and Bipolar Disorder in Korean Population

OBJECTIVE: The aim of the present study was to examine the association between serotonin-related gene polymorphisms and bipolar disorder in the Korean population. In addition, we sought to explore the relationship between the clinical characteristics of bipolar patients and serotonin-related gene polymorphisms. METHODS: Inpatients with bipolar disorder (n=103) and control subjects (n=86) were genotyped for 5HT2A 1438A/G, tryptophan hydroxylase 1 (TPH1) 218 A/C, and TPH2 703G/T. We divided patients with bipolar disorder into two groups according to the presence of psychotic symptoms. The severity of their symptoms was measured using the Young Mania Rating Scale (YMRS) and the Brief Psychiatric Rating Scale (BPRS). RESULTS: There were no significant differences in the genotype distributions or allelic frequencies in the three serotonergic polymorphisms between patients with bipolar disorder and normal controls. There were significant differences in genotype distributions and allele frequencies of the 5-HT2A -1438A/G polymorphism between the psychotic mania group and the non-psychotic mania group (genotype: chi-square=7.50, p=0.024; allele: chi-square=5.92, p=0.015). However, after Bonferroni correction this signifact difference disappeared. We did not find significant differences in the genotype distributions or allelic frequencies in the TPH1 218 A/C and TPH2 703G/T polymorphisms between the psychotic mania group and non-psychotic mania group. CONCLUSION: We failed to found the statistically significant association between three polymorphisms and bipolar disorder. However, there was a trend towards association between 5-HT2A -1438A/G polymorphism and psychotic symptom in bipolar disorder. Future research should seek to clarify this association.

Platelet BDNF Level in Patients with Acute Bipolar Manic Episode: The Preliminary Study

OBJECTIVES: Serum and plasma BDNF levels have been shown to be decreased in patients with mood disorder such as major depressive disorder and bipolar disorder. We investigated whether platelet BDNF levels would be lower in patients with acute bipolar manic episode compared with those of normal controls. METHODS: BDNF levels were examined in platelet-rich plasma(PRP) and platelet-poor plasma(PPP) in 20 healthy controls and 20 hospitalized patients who were diagnosed as bipolar I disorder, most recent episode manic using a Structured Clinical Interview for DSM-IV. And severity of manic symptoms was measured using Young Mania Rating Scale(YMRS). Platelet BDNF level was calculated by subtracting PPP BDNF from PRP BDNF level, and dividing the result by the total platelet count, and it was expressed as pg/10(6) platelet. RESULTS: Platelet BDNF levels were significantly lower in patients with acute bipolar manic episode(4.55+/-3.36pg/10(6) platelet) than in normal controls(6.84+/-2.32pg/10(6) platelet)(p=0.008). However we failed to reveal the significant negative correlation between platelet BDNF levels and YMRS scores in patients with acute bipolar episode. CONCLUSION: Our finding suggests that there is a decrease in the platelet BDNF of patients with acute bipolar manic episode.

The Psychosocial Factors Affecting Suicide Attempt / 신경정신의학

OBJECTIVES: A lots of studies have investigated the psychosocial characteristics of suicidal attempters in order to find efficient coping strategy and treatment intervention. The purpose of this study was to examine the psychosocial factors affecting the suicide attempt in psychiatric patients. METHODS: Two hundred eighty patients who attempted suicide and admitted in the emergency room in 3 university hospitals from December 2003 to May 2006 were recruited in this study. The patients were interviewed using Structured Clinical Interview for DSM-IV Axis I disorder (SCID-RV), Lethality of Suicide Attempt Ratings Scale (LSARS) and Risk-Rescue Rating system (RRR). RESULTS: The suicide attempters have psychosocial characteristics of female preponderance, age 20-39, high school in educational level, married in marriage condition, inoccupation, house makers in occupation. Most of attempters used the nonsevere methods such as drug ingestion or wrist cutting, and selected home as the place of attempt. The delay until discovery was less than 4 hours for most suicide attempters, and the rate of asking for help directly or dropping clues were high. Major depressive disorder was the most common psychiatric illness among attempters. Conclusions: The present study would be the early stage to explore the risk factor and protect factor of suicidal attempt. This study suggests that the closed observation to potential-suicidal attempter in daily life is critical to protect against the fatal results due to suicidal attempts.