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1.
Clinical Psychopharmacology and Neuroscience ; : 243-253, 2021.
Artigo em Inglês | WPRIM | ID: wpr-897917

RESUMO

Objective@#Many patients with major depressive disorder (MDD) suffer from residual symptoms without achieving remission. However, pharmacologic options for residual symptoms of MDD have been limited. This study aimed to investigate benefit of aripiprazole augmentation in the treatment of residual symptoms in the patients with partially remitted MDD. @*Methods@#We retrospectively analyzed the 8-week medical records of the patients. The enrolled patients did respond to treatment of antidepressant but were not remitted. The range of 17-item Hamilton Depression Rating Scale (HAMD) total score of the subjects were 8 to 15 points. All patients were currently taking antidepressants when they started aripiprazole. The primary endpoint was the mean change of Clinically Useful Depression Outcome Scale (CUDOS).Secondary endpoint measures were HAMD, Clinical Global Impression-severity (CGI-S) scores, Patient Health Questionnaire-15 (PHQ-15), Beck Anxiety Inventory (BAI), Perceived Deficit Questionnaire-depression (PDQ-D), Sheehan Disability Scale (SDS) and General Health Questionnaire/Quality of Life-12 (GHQ/QL-12). @*Results@#A total of 134 medical records were analyzed. The changes of CUDOS, HAMD, CGI-S, BAI, PHQ-15, PDQ-D, SDS and GHQ/QL-12 from baseline to the endpoint were −7.93, −3.29, −0.80, −4.02, −2.05, −4.35, −4.77 and −2.82, respectively (all p < 0.001). At the endpoint, the newly remitted subjects rate by HAMD score criteria were approximately 46%. @*Conclusion@#Our preliminary findings have presented the effectiveness of aripiprazole augmentation for residual symptoms of partially remitted MDD patients in routine practice. This study assures subsequent well-controlled studies of the possibility of generalizing the above promising outcome in the future.

2.
Clinical Psychopharmacology and Neuroscience ; : 243-253, 2021.
Artigo em Inglês | WPRIM | ID: wpr-890213

RESUMO

Objective@#Many patients with major depressive disorder (MDD) suffer from residual symptoms without achieving remission. However, pharmacologic options for residual symptoms of MDD have been limited. This study aimed to investigate benefit of aripiprazole augmentation in the treatment of residual symptoms in the patients with partially remitted MDD. @*Methods@#We retrospectively analyzed the 8-week medical records of the patients. The enrolled patients did respond to treatment of antidepressant but were not remitted. The range of 17-item Hamilton Depression Rating Scale (HAMD) total score of the subjects were 8 to 15 points. All patients were currently taking antidepressants when they started aripiprazole. The primary endpoint was the mean change of Clinically Useful Depression Outcome Scale (CUDOS).Secondary endpoint measures were HAMD, Clinical Global Impression-severity (CGI-S) scores, Patient Health Questionnaire-15 (PHQ-15), Beck Anxiety Inventory (BAI), Perceived Deficit Questionnaire-depression (PDQ-D), Sheehan Disability Scale (SDS) and General Health Questionnaire/Quality of Life-12 (GHQ/QL-12). @*Results@#A total of 134 medical records were analyzed. The changes of CUDOS, HAMD, CGI-S, BAI, PHQ-15, PDQ-D, SDS and GHQ/QL-12 from baseline to the endpoint were −7.93, −3.29, −0.80, −4.02, −2.05, −4.35, −4.77 and −2.82, respectively (all p < 0.001). At the endpoint, the newly remitted subjects rate by HAMD score criteria were approximately 46%. @*Conclusion@#Our preliminary findings have presented the effectiveness of aripiprazole augmentation for residual symptoms of partially remitted MDD patients in routine practice. This study assures subsequent well-controlled studies of the possibility of generalizing the above promising outcome in the future.

3.
Clinical Psychopharmacology and Neuroscience ; : 640-652, 2021.
Artigo em Inglês | WPRIM | ID: wpr-914078

RESUMO

Objective@#Subjective cognitive impairment (SCI) is associated with future cognitive decline. This study aimed to compare cortical thickness and local gyrification index (LGI) between individuals with SCI and normal control (NC) subjects. @*Methods@#Forty-seven participants (27 SCI and 20 NC) were recruited. All participants underwent brain magnetic resonance imaging scanning and were clinically assessed using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) battery of tests. We compared cortical thickness and LGI between the two groups and analyzed correlations between cortical thickness/LGI and scores on CERAD protocol subtests in the SCI group for region of interests with significant between-group differences. @*Results@#Cortical thickness reduction in the left entorhinal, superior temporal, insular, rostral middle frontal, precentral, superior frontal, and supramarginal regions, and right supramarginal, precentral, insular, postcentral, and posterior cingulate regions was observed in the SCI compared to the NC group. Cortical thickness in these regions correlated with scores of constructional praxis, word list memory, word list recall, constructional recall, trail making test A, and verbal fluency under the CERAD protocol. Significantly decreased gyrification was observed in the left lingual gyrus of the SCI group. In addition, gyrification of this region was positively associated with scores of constructional praxis. @*Conclusion@#Our results may provide an additional reference to the notion that SCI may be associated with future cognitive impairment. This study may help clinicians to assess individuals with SCI who may progress to mild cognitive impairment and Alzheimer’s dementia.

4.
Journal of Korean Geriatric Psychiatry ; : 1-9, 2020.
Artigo | WPRIM | ID: wpr-836004

RESUMO

Objective@#We investigated the frequency of depressive disorders in the elderly with normal cognition (NC), mild cognitive impairment (MCI) and dementia patients living in the community to find out the association between cognitive disorders and depressive disorders in the community dwelling elderly. @*Methods@#6,262 baseline study subjects from November 2010 through October 2012 were enrolled based on the Korean longitudinal study on cognitive aging and dementia which is the first nationwide multi-center population based prospective cohort study in Korea. Diagnosis of MCI, dementia, major depressive disorder (MDD), minor depressive disorder (mDD) and subsyndromal depression (SSD) was made by psychiatrists with expertise in dementia based on the appropriate diagnostic criteria. @*Results@#4,303 NC, 1,737 MCI, 222 dementia were enrolled. The frequency of MDD, mDD, SSD were highest in dementia and lowest in NC and showed significant difference among three groups. The odds ratio also increased significantly in MCI and dementia compared with NC showing highest odds ratio in dementia. @*Conclusion@#Our findings propose that MCI and dementia in the community dwelling elderly were significantly associated with various types of depressive disorders showing highest association tendency in dementia.

5.
Psychiatry Investigation ; : 21-28, 2020.
Artigo | WPRIM | ID: wpr-832519

RESUMO

Objective@#Cardiovascular diseases are representative risk factors for the onset of cognitive decline. The purpose of this study was to confirm the relationship between diastolic blood pressure and cognitive function in elderly people in Korea. @*Methods@#Data from subjects who were enrolled in the prospective Korean Longitudinal Study on Cognitive Aging and Dementia were used in this study. Data from 701 subjects whose diastolic blood pressure range did not change (≤79 mm Hg or ≥80 mm Hg) over 2 years were analyzed. To analyze the differences in cognitive function between the groups at the 2-year follow-up, an analysis of covariance was performed with covariates, which were significantly different between the two groups, and the baseline cognitive function. @*Results@#Significant differences were observed between the two groups, and the mean scores on the constructional praxis (η2=0.010) and word list recall tests (η2=0.018) in the diastolic blood pressure ≥80 mm Hg group were higher than those in the diastolic blood pressure ≤79 mm Hg group at the 2-year follow-up. @*Conclusion@#These results indicate that maintaining a DBP below 79 mm Hg presents a greater risk of cognitive decline in Korean elderly people.

6.
Psychiatry Investigation ; : 744-750, 2020.
Artigo | WPRIM | ID: wpr-832499

RESUMO

Objective@#This study estimated the incidence of driving-related adverse events and examined the association of cognitive function with the risk of future driving-related adverse events in the elderly Korean male population. @*Methods@#We analyzed 1,172 male drivers aged 60 years or older in the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD). Using the data from Korean National Police Agency, we classified the participants into three groups: safe driving (drove for 2 years after baseline without a traffic accident or repeated violations), driving cessation (stopped driving), and risky driving (one or more traffic accidents or repeated violations). We estimated the incidences of driving cessation and risky driving, and examined the effect of cognitive function on their risks. @*Results@#The incidence of driving cessation and risky driving in the Korean male drivers aged 60 years or older was 19.3 and 69.9 per 1,000 person-years respectively and increased in the late 80s. Drivers with better baseline Word List Memory Test scores showed less risky driving (OR=0.94, p=0.039). @*Conclusion@#Driving-related adverse events increased in late 80s, and better memory function was protective against these events.

7.
Clinical Psychopharmacology and Neuroscience ; : 288-296, 2019.
Artigo em Inglês | WPRIM | ID: wpr-763528

RESUMO

OBJECTIVE: The purpose of this study was to examine post-hospitalization outpatient drug adherence in patients with severe psychiatric illness, including bipolar disorder and schizophrenia, and to investigate factors associated with drug adherence. METHODS: Eighty-one patients diagnosed with schizophrenia or bipolar disorder who were hospitalized due to aggravation of psychiatric symptoms were monitored. At hospitalization, we conducted clinical assessments such as the Clinical Global Impression-Severity, Drug Attitude Inventory, Contour Drawing Rating Scale, Multidimensional Scale of Perceived Social Support scale, and patients' demographic factors. We measured drug adherence using the Medication Event Monitoring System (MEMS), pill count, and patients' self-report upon out-patients visits, 4 and 24 weeks after discharge. RESULTS: The mean values of the various measures of adherence were as follows: MEMS (4 weeks) 84.8%, pill count (4 weeks) 94.6%, self-report (4 weeks) 92.6%, MEMS (24 weeks) 81.6%, pill count (24 weeks) 90.6%, and self-report (24 weeks) 93.6%. The adherence agreement between MEMS, pill count, and self-report was moderate (4 weeks intra-class correlation [ICC]=0.54, 24 weeks ICC=0.52). Non-adherence (MEMS ≤0.08) was observed in 26.4% of the patients at 4 weeks and 37.7% at 24 weeks. There was a negative correlation between drug adherence assessed 4 weeks after discharge and Contour Drawing Rating Scale difference score (r=−0.282, p<0.05). A positive correlation was found between drug adherence assessed 24 weeks after discharge and Drug Attitude Inventory (r=0.383, p<0.01). CONCLUSION: Patients' attitude towards their medication and their degree of physical dissatisfaction influenced post-hospitalization drug adherence in severe psychiatric patients.


Assuntos
Humanos , Transtorno Bipolar , Demografia , Monitoramento de Medicamentos , Hospitalização , Adesão à Medicação , Sistemas Microeletromecânicos , Pacientes Ambulatoriais , Esquizofrenia
8.
Sleep Medicine and Psychophysiology ; : 33-43, 2019.
Artigo em Coreano | WPRIM | ID: wpr-761379

RESUMO

OBJECTIVES: Bipolar disorder is characterized by repetitive relapses that result in psychosocial dysfunctions. The functioning of bipolar disorder patients is related to the severity of symptoms, quality of sleep, drug compliance, and social support. The purpose of this study was to investigate the association between sociodemographic and clinical factors and functional status in bipolar disorder patients. METHODS: A total of 52 bipolar disorder patients participated in the study. The following scales were utilized: Korean version of personal and social performance scale (K-PSP), Korean version of Hamilton rating scale for depression (K-HDRS), Korean version of young mania rating scale (K-YMRS), Korean version of pittsburgh sleep quality index (PSQI-K), Korean version of drug attitude inventory (K-DAI), mood disorders insight scale (MDIS), and multidimensional scale of perceived social support (MSPSS). RESULTS: The K-PSP score showed a negative relationship with K-HDRS score (r = −0.387, p = 0.005), but not with K-YMRS score (r = −0.205, p = 0.145). The K-PSP score showed a negative relationship with global PSQI-K score (r = −0.378, p = 0.005) and overall sleep quality (r = −0.353, p = 0.010). The K-PSP scores were positively associated with the KDAI score (r = 0.409, p = 0.003) and MSPSS score (r = 0.334, p = 0.015). The predictive factors for K-PSP were overall sleep quality and social support from family. CONCLUSION: Our study showed that depressive symptoms were related to overall function in bipolar disorder. Also, our study suggested that improving sleep quality is important in maintaining functional status. Appropriate social support and positive perception toward the drug may lead to the higher level of functioning. This study is meaningful in that the functional status of bipolar disorder patients is analyzed in a multivariate manner in relation to various variables in psychosocial aspects.


Assuntos
Humanos , Transtorno Bipolar , Complacência (Medida de Distensibilidade) , Depressão , Transtornos do Humor , Recidiva , Pesos e Medidas
9.
Psychiatry Investigation ; : 532-538, 2019.
Artigo em Inglês | WPRIM | ID: wpr-760957

RESUMO

OBJECTIVE: This study aimed to examine the association between normal-but-low folate levels and cognitive function in the elderly population using a prospective cohort study. METHODS: We analyzed 3,910 participants whose serum folate levels were within the normal reference range (1.5–16.9 ng/mL) at baseline evaluation in the population-based prospective cohort study named the “Korean Longitudinal Study on Cognitive Aging and Dementia.” The association between baseline folate quartile categories and baseline cognitive disorders [mild cognitive impairment (MCI) or dementia] was examined using binary logistic regression analysis adjusting for confounding variables. The risks of incident MCI and dementia associated with the decline of serum folate level during a 4-year follow-up period were examined using multinomial logistic regression analysis. RESULTS: The lowest quartile group of serum folate (≥1.5, ≤5.9 ng/mL) showed a higher risk of cognitive disorders than did the highest quartile group at baseline evaluation (odds ratio 1.314, p=0.012). Over the 4 years of follow-up, the risk of incident dementia was 2.364 times higher among subjects whose serum folate levels declined from the 2nd–4th quartile group to the 1st quartile than among those for whom it did not (p=0.031). CONCLUSION: Normal-but-low serum folate levels were associated with the risk of cognitive disorders in the elderly population, and a decline to normal-but-low serum folate levels was associated with incident dementia. Maintaining serum folate concentration above 5.9 ng/mL may be beneficial for cognitive status.


Assuntos
Idoso , Humanos , Cognição , Transtornos Cognitivos , Envelhecimento Cognitivo , Estudos de Coortes , Demência , Ácido Fólico , Seguimentos , Modelos Logísticos , Estudos Longitudinais , Estudos Prospectivos , Valores de Referência
10.
Journal of the Korean Medical Association ; : 758-764, 2018.
Artigo em Coreano | WPRIM | ID: wpr-916089

RESUMO

Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors—donepezil, rivastigmine, galantamine—and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.

11.
Journal of the Korean Medical Association ; : 758-764, 2018.
Artigo em Coreano | WPRIM | ID: wpr-766468

RESUMO

Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors—donepezil, rivastigmine, galantamine—and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.


Assuntos
Humanos , Acetilcolinesterase , Atividades Cotidianas , Envelhecimento , Antidepressivos , Antipsicóticos , Inibidores da Colinesterase , Cognição , Demência , Tratamento Farmacológico , Estrogênios , Ácidos Graxos Ômega-3 , Ginkgo biloba , Glicerilfosforilcolina , Inibidores de Hidroximetilglutaril-CoA Redutases , Coreia (Geográfico) , Memantina , Memória , Programas Nacionais de Saúde , Saúde Pública , Rivastigmina , Vitamina E , Vitaminas
12.
Psychiatry Investigation ; : 767-774, 2018.
Artigo em Inglês | WPRIM | ID: wpr-716402

RESUMO

OBJECTIVE: Due to an unprecedented rate of population aging, South Korea is facing a dementia epidemic. For this reason, the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) was launched in 2009 with support from the Korean Health Industry Development Institute to investigate the epidemiology, biopsychosocial risk factors, and outcomes of dementia and dementia-related conditions. METHODS: The KLOSCAD is the first nationwide multi-center population-based prospective cohort study. In October 2010, 12,694 individuals were randomly sampled from residents aged 60 years or older who lived in 13 districts across South Korea. In the baseline assessment, which was conducted from November 2010 through October 2012, 6,818 (53.7%) individuals participated. Follow-up assessments have been conducted every two years, with the first follow-up assessment conducted between November 2012 and October 2014, and the second between November 2014 and October 2016. The third is now in progress, and will span from November 2016 to October 2018. Diagnosis of cognitive disorders, neuropsychological battery, behavioral and psychological symptoms of dementia, activities of daily living, physical and neurologic examination and laboratory tests, life styles, quality of life, and identification of death were evaluated in each assessment. RESULTS: The cumulative drop-out rate at the second follow-up assessment was 38.7%. Dementia and mild cognitive impairment were 5.0% and 27.0%, respectively. CONCLUSION: The KLOSCAD may provide strong scientific evidence for advancing the fight against dementia both in Korea and globally.


Assuntos
Atividades Cotidianas , Envelhecimento , Envelhecimento Cognitivo , Estudos de Coortes , Demência , Diagnóstico , Epidemiologia , Seguimentos , Coreia (Geográfico) , Estilo de Vida , Estudos Longitudinais , Disfunção Cognitiva , Exame Neurológico , Estudos Prospectivos , Qualidade de Vida , Fatores de Risco
13.
Clinical Psychopharmacology and Neuroscience ; : 163-169, 2017.
Artigo em Inglês | WPRIM | ID: wpr-203965

RESUMO

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.


Assuntos
Humanos , Biomarcadores , Compensação e Reparação , Sulfato de Desidroepiandrosterona , Desidroepiandrosterona , Depressão , Transtorno Depressivo Maior , Diagnóstico Diferencial , Medicina Geral , Culpa , Neuroendocrinologia , Características da População , Regulação para Cima
14.
Psychiatry Investigation ; : 626-639, 2017.
Artigo em Inglês | WPRIM | ID: wpr-123492

RESUMO

OBJECTIVE: Although cognitive stimulation (CS) is one of the most popular non-pharmacological interventions for people with dementia, its efficacy is still debatable. We performed a meta-analysis of randomized controlled trials (RCTs) on the efficacy of CS in people with dementia. METHODS: Data sources were identified by searching PubMed, MEDLINE, Embase, psychINFO, and Cochrane Reviews Library. A total of 7,354 articles were identified, and of these, 30 RCTs were selected based on the selection criteria. Of these 30 RCTs, 14 were finally included in our meta-analysis [731 participants with dementia; 412 received CS (CS group) and 319 received usual care (control group)]. RESULTS: We found that the people with dementia had a moderate benefit from CS. The mean difference between the CS and control groups was 2.21 [95% CI (0.93, 3.49), Z=3.38, p=0.00007] in the Alzheimer's Disease Assessment Scale-Cognition and 1.41 [95% CI (0.98, 1.84), Z=6.39, p<0.00001] in the Mini-Mental State Examination. CS also improved quality of life in people with dementia [95% CI (0.72, 3.38), Z=3.02, p=0.003]. CONCLUSION: CS is effective for improving cognition and quality of life in people with dementia; however, its effects were small to moderate.


Assuntos
Doença de Alzheimer , Cognição , Demência , Armazenamento e Recuperação da Informação , Seleção de Pacientes , Qualidade de Vida
15.
Psychiatry Investigation ; : 647-655, 2017.
Artigo em Inglês | WPRIM | ID: wpr-123490

RESUMO

OBJECTIVE: To analyze the relationship between seizure threshold (ST) and psychotropic drugs in patients treated with ECT. METHODS: We examined clinical data from 43 patients. ST was titrated at each treatment session. We examined associations between ST and psychotropic drugs using multivariate correlation analyses. Data are presented as initial ST, the difference in ST between the first and 10th sessions (ΔST(10th)), and the mean difference in ST between the first and last sessions (mean ΔST(last)). RESULTS: Multivariate regression analyses showed associations between initial ST and the total chlorpromazine-equivalent dose of antipsychotics (β=0.363, p<0.05). The total fluoxetine-equivalent dose of antidepressants was associated with ΔST(10th) (β=0.486, p<0.01) and mean ΔST(last) (β=0.472, p<0.01). CONCLUSION: Our study elucidated possible effects of psychotropic drugs on ST shifts. Larger doses of antipsychotics were associated with higher initial ST, whereas higher doses of antidepressants were associated with stronger shifts in ST.


Assuntos
Humanos , Antidepressivos , Antipsicóticos , Eletroconvulsoterapia , Psicotrópicos , Convulsões
16.
Psychiatry Investigation ; : 50-57, 2016.
Artigo em Inglês | WPRIM | ID: wpr-108184

RESUMO

OBJECTIVE: A community survey was performed to investigate the factors and perspectives associated with happiness among the elderly in Korea (> or =60 years). METHODS: Eight hundred volunteers selected from participants in the Ansan Geriatric study (AGE study) were enrolled, and 706 completed the survey. The Happiness Questionnaire (HQ), which asks four questions about happiness, was administered. To explore the relationship between happiness and depression, the Geriatric Depression Scale (GDS) and the Beck Depression Inventory (BDI) also were administered. RESULTS: The participants' average level of happiness, determined using a 100-mm visual analogue scale (VAS) of the HQ, was 64.7+/-26.0. The happiest situations for most people were "getting together with family" (23.8%) and "living in peace with family members (well-being)" (13.2%). Frequent reasons for not being happy were "worsened health condition" (28.7% of the not-happy group), "economic problems of their own" (16.5%), and "economic problems of their children" (14.8%). The participants' choices regarding the essential conditions for happiness were "good health" (65.3%) and "being with family" (20.5%). The BDI and GDS scores were negatively related to the happiness score. A preliminary scale [Happy (Haeng-Bok, ) aging scale] based on the HQ for measuring the happiness level of the Korean elderly was suggested for follow-up studies. CONCLUSION: The most important factors determining the happiness of the community-dwelling elderly in Korea were good family relationships, economic stability, and good health. A higher depression score negatively impacted happiness among Korean elders. Further studies on the factors in their happiness are required.


Assuntos
Idoso , Humanos , Envelhecimento , Inquéritos e Questionários , Depressão , Relações Familiares , Seguimentos , Felicidade , Coreia (Geográfico) , Voluntários
17.
Korean Journal of Schizophrenia Research ; : 47-59, 2016.
Artigo em Coreano | WPRIM | ID: wpr-99450

RESUMO

OBJECTIVES: Schizophrenia is a chronic psychiatric disorder characterized by its debilitating course. It leads to personal and social dysfunctions, burdening patients and guardians heavily. Enhancing functional outcome is a major treatment goal, but pharmacotherapy alone is usually not enough. Hence, it is important to reveal clinical factors that can predict personal and social performance in schizophrenia patients. Analyze factors influencing personal and social performance in schizophrenia patients. METHODS: 66 schizophrenia patients from three University hospitals in Korea were enrolled, completing clinical scales between January 2008 and December 2009. 38 patients dropped out during follow up. 28 patients were included in the final study. Personal and social performance was measured using the Personal and Social Performance scale (PSP) since January 2015. Correlation and multiple regression analyses were performed to reveal associations between demographic and clinical factors and PSP. RESULTS: Correlation analyses resulted in statistically significant correlations between CGI-S (r=-0.646, p<0.01), PANSS (r=-0.419, p<0.05), KISP (r=-0.523, r<0.01), KmSWN (r=0.388, p<0.05), Trail making B (r=0.608, p<0.01), KDAI (r=0.608, p<0.01), and PSP. Stepwise multiple regression analyses showed significant models with CGI-S (β=-0.485, p<0.01), and KDAI (β=0.423, p<0.01). CONCLUSION: Our results show that attitude toward drugs and symptom severity affect a patient’s personal and social performance most prominently. We advise to focus on patient education to reinforce attitude toward drugs, and to concentrate on reducing symptom severity to enhance personal and social performance in schizophrenia patients.


Assuntos
Humanos , Tratamento Farmacológico , Seguimentos , Hospitais Universitários , Coreia (Geográfico) , Educação de Pacientes como Assunto , Esquizofrenia , Pesos e Medidas
18.
Psychiatry Investigation ; : 516-522, 2015.
Artigo em Inglês | WPRIM | ID: wpr-48248

RESUMO

OBJECTIVE: Comorbid depression is common in patients with Alzheimer's disease (AD). An increase in white matter lesions (WMLs) has been associated with depression in both elderly individuals with normal cognition and patients with Alzheimer's disease. We investigated whether the severity and location of WMLs influence the association between WMLs and comorbid depression in AD. METHODS: We enrolled 93 AD patients from Seoul National University Bundang Hospital. We administered both the Mini International Neuropsychiatric Inventory (MINI) and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K) clinical and neuropsychological battery. Subjects also underwent brain magnetic resonance imaging (MRI). We diagnosed AD according to the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association. We diagnosed depressive disorders according to the DSM-IV diagnostic criteria, and evaluated the severity of depressive symptoms using the Korean version of the Geriatric Depression Scale (GDS-K). We quantified the WML volumes from the brain MRI using a fully automated segmentation algorithm. RESULTS: The log of the WML volume in the frontal lobe was significantly associated with depressive disorders (odds ratio=1.905, 95% CI=1.027-3.533, p=0.041), but not with the severity of depressive symptoms as measured by the GDS-K. CONCLUSION: The WML volume in the frontal lobe conferred a risk of comorbid depressive disorders in AD, which implies that comorbid depression in AD may be attributed to vascular causes.


Assuntos
Idoso , Humanos , Doença de Alzheimer , Encéfalo , Cognição , Transtornos da Comunicação , Depressão , Transtorno Depressivo , Manual Diagnóstico e Estatístico de Transtornos Mentais , Lobo Frontal , Imageamento por Ressonância Magnética , Seul , Acidente Vascular Cerebral
19.
Korean Journal of Psychosomatic Medicine ; : 57-65, 2015.
Artigo em Coreano | WPRIM | ID: wpr-63601

RESUMO

OBJECTIVES: Within the normal reproductive cycles of women, dramatic fluctuations of sexual hormones occur in the premenstrual and menopausal periods. In both periods, women are vulnerable to mood disturbances and show several somatic complaints. Based on these common clinical profiles and physiological changes, a relationship between vasomotor symptoms and the premenstrual syndrome has been suggested. However, attempts to establish such a link have yielded inconclusive results. The purpose of this study was to investigate the association between histories of premenstrual syndrome and menopausal vasomotor symptoms within different menopausal stages. METHODS: This cross-sectional study recruited Korean women aged 45-64 years who were perimenopausal and postmenopausal from 16 branch offices of the Korean Association of Health Promotion. All subjects completed self-report questionnaires that asked about a history of premenstrual syndromes, vasomotor symptoms, and several other variables. RESULTS: A total of 1054 participants(361 perimenopausal women and 693 postmenopausal women) completed the study. Severity of premenstrual symptoms significantly correlated with postmenopausal vasomotor symptoms, only in late perimenopausal(r=0.213, p=0.010) and early postmenopausal women(r=0.246, p<0.001). After adjusting for several factors related to vasomotor symptoms, a history of premenstrual syndrome was a significant predictor of moderate to very severe vasomotor symptoms in late perimenopausal(OR=5.197, p=0.005) and early postmenopausal women(OR=3.017, p=0.010). CONCLUSIONS: This study suggests that a history of premenstrual syndrome/premenstrual dysphoric disorder is differentially associated with vasomotor symptoms in the menopausal stage. Prospective studies with larger population are needed to confirm these findings.


Assuntos
Feminino , Humanos , Estudos Transversais , Promoção da Saúde , Menopausa , Síndrome Pré-Menstrual , Inquéritos e Questionários
20.
Psychiatry Investigation ; : 459-466, 2014.
Artigo em Inglês | WPRIM | ID: wpr-114486

RESUMO

OBJECTIVE: Switching antipsychotics is one useful therapeutic option when the treatment of schizophrenia encounters suboptimal efficacy and intolerability issues. This study aimed to investigate the efficacy and tolerability of cross-tapering switching to ziprasidone from other antipsychotics. METHODS: A total of 67 patients with schizophrenia or schizoaffective disorder were recruited in this 12-week, multicenter, non-comparative, open-label trial. Prior antipsychotics were allowed to be maintained for up to 4 weeks during the titration of ziprasidone. Efficacy was primarily measured using the 18-item Brief Psychotic Rating Scale (BPRS) at baseline, 4 weeks, 8 weeks, and 12 weeks. Efficacy was secondarily measured by the Clinical Global Impression-Severity (CGI-S) scale and the Global Assessment of Functioning (GAF) scale at each visit. Regarding the metabolic effects of switching to ziprasidone, weight, body mass index (BMI), waist-to-hip ratio (WHR), and lipid profile-including triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol levels-were measured at each follow-up visit. RESULTS: The BPRS scores were significantly improved at 12 weeks after switching to ziprasidone (F=5.96, df=2.11, p=0.003), whereas the CGI-S and GAF scores were not significantly changed. BMIs, WHRs, and TG levels were significantly decreased, with no significant changes in other lipid profiles. CONCLUSION: Cross-tapering switching to ziprasidone is effective for patients with schizophrenia spectrum disorders. Beyond the efficacy of the procedure, favorable metabolic profiles show that switching to ziprasidone may be helpful for maintenance therapy over an extended period.


Assuntos
Humanos , Antipsicóticos , Peso Corporal , Colesterol , Tratamento Farmacológico , Seguimentos , Lipoproteínas , Metaboloma , Transtornos Psicóticos , Esquizofrenia , Triglicerídeos , Relação Cintura-Quadril
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