Internet-Based Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder in Korea

OBJECTIVE: Cognitive behavioral therapy (CBT) is regarded as one of the most effective intervention for obsessive-compulsive disorder (OCD). However, many patients remain untreated or inadequately treated due to time or geographical constraints. The purpose of this study was to develop an internet-based CBT (ICBT) for OCD, and to examine its efficacy in the Korean clinical setting. METHODS: The ICBT program ('COT') was developed from the same OCD manual in the standard CBT intervention. Twenty-seven participants of the total 42 patients completed all training sessions of the ICBT and the remainder (n=15) were classified as non-completers. Self-report measures of OCD, depression, anxiety, and work/social functioning, in addition to a neurocognitive test battery, were administered by face-to-face before and after treatment. RESULTS: The participants showed significant improvements in OCD and depressive symptoms, and in work/social functioning after ICBT completion. The presence of combined medication had no significant impact on treatment effect. The non-completers displayed more severe depressive and anxiety symptoms, and ICBT responders were younger and performed better in the Wisconsin Card Sorting Test. CONCLUSION: ICBT was found to be as effective for patients with moderate OC symptoms and little treatment experience. Considering the high accessibility and convenience of ICBT, it could be a helpful first treatment step for OCD patients when face-to-face treatment is unavailable. In the future a randomized controlled study will be necessary for verification and generalization of these results.

Korean Self-Report Version of the Yale-Brown Obsessive-Compulsive Scale: Factor Structure, Reliability, and Validity

OBJECTIVE: Although several self-report versions of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) have been developed and used widely, few psychometric studies have established the construct validity of this measure. Therefore, we developed Korean self-report version of the Y-BOCS and evaluated its factor structure, reliability, and validity. METHODS: A non-clinical student sample (n=206) and a clinical OCD sample (n=199) completed the Korean self-report version and other measures of obsessive-compulsive disorder (OCD), depression, and anxiety. RESULTS: Consistent with the originally proposed structure, confirmatory factor analyses supported a factor structure comprised of Obsessions and Compulsions factors in the Korean self-report version. Two subscale scores and the total score of the Korean self-report version showed good internal consistency and convergent validity, but relatively poor discriminant validity. Applying a cutoff score of 16, 84% of OCD patients and 93% of the non-clinical sample were classified correctly. CONCLUSION: Korean self-report version of the Y-BOCS is a psychometrically sound and valid measure for assessing OCD symptoms as compared with the clinician-administered version. The originally proposed division of OCD severity into obsessions and compulsions appears accurate in the Korean self-report version. The cutoff score for the Korean self-report version needs adjustment based on further researches.

The Lateralization and Localization of Memory and Neurocognitive Functioning in Patients with Temporal Lobe Epilepsy

PURPOSE: Material-specific memory deficits (laterality effects) are frequently observed in patients with temporal lobe epilepsy (TLE), and yet the different functional roles of temporal cortical vs. mesial structures remain unclear. This study aimed to examine the lateralization and localization of memory and other neurocognitive functioning in patients with TLE.METHODS: Sixty-nine patients with lesional TLE participated. Subjects were categorized in terms of lesion laterality (left, n=34; right, n=35) and intratemporal location (mesial, n=50; lateral, n=19). Neurocognitive tests, including verbal memory, visual memory, general intelligence, attention, working memory and executive function, were tested.RESULTS: Left TLE patients showed significantly higher visual than verbal memory capacity, whereas right TLE patients showed significantly better verbal than visual memory capacity. There were no differences between mesial TLE and lateral TLE groups on any other memory tasks. Mesial TLE patients showed significantly lower working memory and executive function compared with lateral TLE patients.CONCLUSIONS: Selective verbal or visual memory deficits that are dependent on side of seizure foci were apparent in this study. The different functional roles of temporal cortical vs. mesial structures in memory process (i.e. aquisition/working memory vs. long-term consolidation) were not clear, but rather mesial temporal lobe damage was found to be associated with working memory deficit. It may be explained in part by epileptogenic activity propagating from temporolateral to mesial structures and vice versa.

The Lateralization and Localization of Memory and Neurocognitive Functioning in Patients with Temporal Lobe Epilepsy / 대한간질학회지

PURPOSE: Material-specific memory deficits (laterality effects) are frequently observed in patients with temporal lobe epilepsy (TLE), and yet the different functional roles of temporal cortical vs. mesial structures remain unclear. This study aimed to examine the lateralization and localization of memory and other neurocognitive functioning in patients with TLE. METHODS: Sixty-nine patients with lesional TLE participated. Subjects were categorized in terms of lesion laterality (left, n=34; right, n=35) and intratemporal location (mesial, n=50; lateral, n=19). Neurocognitive tests, including verbal memory, visual memory, general intelligence, attention, working memory and executive function, were tested. RESULTS: Left TLE patients showed significantly higher visual than verbal memory capacity, whereas right TLE patients showed significantly better verbal than visual memory capacity. There were no differences between mesial TLE and lateral TLE groups on any other memory tasks. Mesial TLE patients showed significantly lower working memory and executive function compared with lateral TLE patients. CONCLUSIONS: Selective verbal or visual memory deficits that are dependent on side of seizure foci were apparent in this study. The different functional roles of temporal cortical vs. mesial structures in memory process (i.e. aquisition/working memory vs. long-term consolidation) were not clear, but rather mesial temporal lobe damage was found to be associated with working memory deficit. It may be explained in part by epileptogenic activity propagating from temporolateral to mesial structures and vice versa.