Insomnia, Anxiety, and Depression in Patients First Diagnosed With Female Cancer

Objective@#This study evaluated whether insomnia, anxiety, and depression differ by type of gynecological or breast cancer. @*Methods@#From September 7, 2011, to July 14, 2015, this study included 232 patients who were diagnosed with gynecological or breast cancer for the first time. The severity of insomnia, anxiety, and depression was measured with the National Cancer Center Psychological Symptom inventory (NCC-PSI), a self-reported scale, at the first outpatient visit after surgery. Multivariate logistic regression analyses were used to identify which diagnosis was associated with significant symptom levels. @*Results@#Patients with ovarian cancer and breast cancer reported more severe insomnia and problems with daily life compared with cervical cancer patients. Anxiety symptoms were more distressing among breast cancer patients than cervical cancer patients, and the degree of interference in daily life was severe. Finally, compared to those with cervical cancer, ovarian cancer and breast cancer patients reported more severe depression, and their daily life was disrupted more often than reported by cervical cancer patients. @*Conclusion@#Many female cancer patients are suffering distress but are not looking for specialized care. Psychiatric approach in the early stages of cancer diagnosis is needed and will require overcoming the stigmas of mental illness and cancer.

Insomnia, Anxiety, and Depression in Patients First Diagnosed With Female Cancer

Objective@#This study evaluated whether insomnia, anxiety, and depression differ by type of gynecological or breast cancer. @*Methods@#From September 7, 2011, to July 14, 2015, this study included 232 patients who were diagnosed with gynecological or breast cancer for the first time. The severity of insomnia, anxiety, and depression was measured with the National Cancer Center Psychological Symptom inventory (NCC-PSI), a self-reported scale, at the first outpatient visit after surgery. Multivariate logistic regression analyses were used to identify which diagnosis was associated with significant symptom levels. @*Results@#Patients with ovarian cancer and breast cancer reported more severe insomnia and problems with daily life compared with cervical cancer patients. Anxiety symptoms were more distressing among breast cancer patients than cervical cancer patients, and the degree of interference in daily life was severe. Finally, compared to those with cervical cancer, ovarian cancer and breast cancer patients reported more severe depression, and their daily life was disrupted more often than reported by cervical cancer patients. @*Conclusion@#Many female cancer patients are suffering distress but are not looking for specialized care. Psychiatric approach in the early stages of cancer diagnosis is needed and will require overcoming the stigmas of mental illness and cancer.

Treatment Strategy Based on Multimodal Management Outcome of Cavernous Sinus Dural Arteriovenous Fistula (CSDAVF) / 신경중재치료의학

PURPOSE: Angiographic finding including venous drainage pattern should be correlated to the presenting symptom pattern (SxP) in CSDAVF. We present outcome of CSDAVF management and suggest a strategy according to SxP and type of treatment based on our experience. MATERIALS AND METHODS: We evaluated SxP, angiographic type (proliferative, restrictive or late restrictive), mode of treatment (embolization, Gamma Knife Radiation (GKR) or conservative management), mode of embolization (transarterial or transvenous), and final clinical status (cure, improvement, aggravation or no change). Ninety consecutive patients were included from a prospective database. The mean follow-up was 17 months. We compared the outcomes according to SxP, angiographic type, mode of treatment, and embolization using the chi-square or Fisher's exact test. RESULTS: Ninety patients with 34 proliferative, 40 restrictive, and 16 late restrictive types of CSDAVF were treated by embolization (n = 63), GKR (n = 7), and conservative management (n = 20). Cure or improvement was 91% after embolization, 88% after conservative management, and 72% after GKR. Following embolization, 100% of 24 proliferative types, 87% of 30 restrictive types, and 90% of 10 late restrictive types were cured or improved. Cure or improvement after transvenous embolization was 98% (43/44) compared with 88% (15/17) after transarterial embolization (p = 0.003). CONCLUSION: Various factors of SxP, angiographic type, and mode of treatment should be considered in order to obtain a more favorable outcome for patients with CSDAVF. Embolization via venous approach tended to result in a more complete cure than that via arterial approach.

Acute Respiratory Distress Syndrome Induced by Adenovirus in an Otherwise Healthy Woman

Acute respiratory distress syndrome (ARDS) caused by adenovirus is a rare event in healthy adults, especially in non- military settings. Although treatment with intravenous ribavirin has been reported, supportive care, including mechanical ventilation, is known to be the main stay in the treatment of ARDS caused by adenovirus, with high-dose steroid treatment having rarely been reported. We report our experience with a 41-year-old, otherwise healthy, woman with ARDS, treated with high-dose steroid and mechanical ventilatory support.

A Normative Study of the Mini-Mental State Examination in the Korean Elderly / 신경정신의학

This study aimed to determine the variables significantly related to the MMSE in the Korean version of the CERAD assessment battery(MMSE-KC) and present the normative information of the test in the Korean elderly. The MMSE-KC was administered in a standardized manner to 618 healthy volunteers aged 60 to 90 who were recruited from 4 dementia clinics, 2 elderly welfare centers and 1 community population. The elderly with serious neurological, medical and psychiatric disorders including dementia and major depression were excluded through clinical evaluation using CERAD-K clinical assessment protocol. Univariate and multivariate analyses were performed to determine the variables significantly related to the MMSE-KC score. Age, educational level, and sex were found to have statistically significant effect on the test score. Based on this result, overlapping age normative table(60 to 74, 65 to 79, 70 to 84, and 75 to 90 years of age) with 3 educational strata(0 to 3 years, 4 to 6 years, and 7 years and more) separately for both male and female were developed. For resulting 24 normative units, 5 percentile, lower quartile, median, upper quartile, mean and standard deviation were calculated. The normative data from this study can be widely used as reference values to objectively interpret the MMSE-KC scores of the Korean elderly.