Circadian Rhythms and Depression in Adolescents: A Comparative Analysis of First Episode and Recurrent-Episode Groups.

Circadian rhythm disruptions are a hallmark feature of mood disorders. Patients experiencing acute depressive episodes report noticeable changes in their sleep-wake cycles. This research explains the association between depression and various circadian rhythm metrics, explicitly focusing on adolescents diagnosed with depressive disorders. Adolescence is a critical period marked by significant physiological and psychological changes, making it imperative to understand how mood disorders manifest during this phase. However, there have been minimal specific studies in pediatric populations to determine whether circadian rhythm changes differ between adolescents with first and multiple-recurrent depressive episodes. Our study involved a group of 61 adolescents aged between 13 and 18. We performed a cross-sectional study of a clinical population of patients presenting to a child and adolescent psychiatry clinic diagnosed with depression. Participants were asked to complete self-report evaluations using several tools: the Korean version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (K-BRIAN), the Korean Translation of Composite Scale to Measure Morningness-Eveningness (KtCS), and the Seasonal Pattern Assessment Questionnaire (SPAQ). Tools such as the Children's Depression Inventory (CDI), State-Trait Anxiety Inventory (STAI), and K-Mood Disorder Questionnaire (K-MDQ) were employed for the assessment of clinical characteristics of depression. Based on the frequency of their depressive episodes, participants were bifurcated into two distinct groups: those experiencing their first episode (n = 22, mean age: 15.09 ± 1.44 years) and those with recurrent episodes (n = 39, mean age: 15.95 ± 1.26 years). At first, the two groups' data revealed no significant differences regarding mood or circadian rhythm metrics (CDI: first episode 26.18 ± 10.54 and recurrent episode 25.90 ± 10.59, STAI-S: first episode 56.91 ± 12.12 and recurrent episode 57.49 ± 11.93, STAI-T: first episode 60.36 ± 11.63 and recurrent episode 59.09 ± 12.10, SPAQ-total: first episode 6.59 ± 4.86 and recurrent episode 6.77 ± 5.23, KtCS: first episode 30.32 ± 5.83 and recurrent episode 28.13 ± 7.36). However, we observed significant correlations between circadian rhythm disruptions and depression scales (CDI with SPAQ-weight (r = 0.26), KtCS (r = -0.48), K-BRIAN-sleep (r = 0.58), K-BRIAN-activity (r = 0.64), K-BRIAN-social (r = 0.71), and K-BRIAN-eating (r = 0.40)). These correlations were especially pronounced in the recurrent episode group, suggesting that with the progression and chronicity of depression, the relationship between circadian rhythms and depression becomes more intertwined and evident. In conclusion, especially in adolescents, as the severity and chronicity of depression increase, the interplay between circadian rhythms and mood disorders becomes more pronounced, warranting further research and clinical attention.

The Sewol Ferry Disaster: Experiences of a Community-Based Hospital in Ansan City.

The Sewol ferry disaster is one of the most tragic events in Korea's modern history. Among the 476 people on board, which included Danwon High School students (324) and teachers (14), 304 passengers died in the disaster (295 recovered corpses and 9 missing) and 172 survived. Of the rescued survivors, 72 were attending Danwon High School, located in Ansan City, and residing in a residence nearby. Because the students were young, emotionally susceptible adolescents, both the government and the parents requested the students be grouped together at a single hospital capable of appropriate psychiatric care. Korea University Ansan Hospital was the logical choice, as the only third-tier university-grade hospital with the necessary faculty and facilities within the residential area of the families of the students. We report the experiences and the lessons learned from the processes of preparing for and managing the surviving young students as a community-based hospital. (Disaster Med Public Health Preparedness. 2017;11:389-393).

Common MCL1 polymorphisms associated with risk of tuberculosis.

MCL1 expression has been found to be up-regulated during infection with virulent Mycobacterium tuberculosis. We investigated the genetic polymorphisms in MCL1 as potential candidate gene for a host genetic study of clinical TB infection. We have sequenced exons and their boundaries of MCL1, including the 1.5 kb promoter region, to identify polymorphisms, and eight polymorphisms were identified. The genetic associations of polymorphisms in MCL1 with clinical TB patients (n=486) and normal controls (n=370) were analyzed. Using statistical analyses, one common promoter polymorphism (MCL1- 324C > A) which is absolutely linked with three other SNPs in the promoter and 3'UTR regions, were found to be significantly associated with increased risk of clinical TB disease. The frequency of the A-bearing genotype of -324C > A was higher in clinical TB patients than in normal controls (P=0.0008, OR= 1.68). Our findings suggest that polymorphisms in MCL1 might be one of genetic factors for the risk of clinical tuberculosis development.

BcSNPdb: bovine coding region single nucleotide polymorphisms located proximal to quantitative trait loci.

Bovine coding region single nucleotide polymorphisms located proximal to quantitative trait loci were identified to facilitate bovine QTL fine mapping research. A total of 692,763 bovine SNPs was extracted from 39,432 UniGene clusters, and 53,446 candidate SNPs were found to be a depth >3. In order to validate the in silico SNPs experimentally, 186 animals representing 14 breeds and 100 mixed breeds were analyzed. Genotyping of 40 randomly selected candidate SNPs revealed that 43% of these SNPs ranged in frequency from 0.009 to 0.498. To identify non-synonymous SNPs and to correct for possible frameshift errors in the ESTs at the predicted SNP positions, we designed a program that determines coding regions by protein-sequence referencing, and identified 17,735 nsSNPs. The SNPs and bovine quantitative traits loci informations were integrated into a bovine SNP data: BcSNPdb (http://snugenome.snu.ac.kr/BtcSNP/). Currently there are 43 different kinds of quantitative traits available. Thus, these SNPs would serve as valuable resources for exploiting genomic variation that influence economically and agriculturally important traits in cows.

Development of a Korean version of the Female Sexual Distress Scale.

INTRODUCTION: This article presents data based on the responses of more than 100 women who contributed to the development of a Korean version of the Female Sexual Distress Scale (FSDS). AIM: The FSDS was developed to measure sexually related personal distress in women. This article aims to test the usefulness and analyze factors of the 20-item version of the FSDS in a Korean female sample. METHODS: The original two-item FSDS was translated with cultural modifications. A total of 104 healthy, married women were recruited through a survey. A second survey was undertaken after 2 weeks for test-retest reliability. Validity, internal consistency reliability, and test-retest reliability were evaluated. An exploratory factor analysis was also performed. MAIN OUTCOME MEASURES: A Korean version of the FSDS. RESULTS: The test-retest coefficients of stability over a 2-week period was 0.99 (P < 0.01). The 20 items of the FSDS have good internal consistency, with an alpha of 0.96. The FSDS discriminated between women with and without sexually related distress (t = -7.34, P < 0.01). The optimal cut-off score was 20 (sensitivity 71.4%, specificity 92.2%). By principal axis factoring, the Korean version of the FSDS was found to consist of two factors. A 16-item FSDS had good internal consistency with an alpha of 0.97. The test-retest reliability was good (r = 0.99, P < 0.01). The items of the 16-item FSDS were somewhat different from the original 12-item FSDS. CONCLUSIONS: The Korean version of the FSDS (20-item) might be a useful tool for screening sexually distressed women in Korea. Instead of the 12-item version of the original FSDS, the 16-item FSDS was validated in this study. These results could reflect cultural differences between Eastern Asian and Western societies.

Long-term treatment with long-acting risperidone in Korean patients with schizophrenia.

OBJECTIVES: We evaluated the efficacy and safety of long-acting risperidone for 48-week period in Korean patients. METHODS: This was a non-randomized, open-label, single-centered, 48-week study. Each of the participants visited the hospital every 2 weeks, and injections were given at each visit. Complete evaluations were done on five occasions (baseline, 12, 24, 36, 48 weeks). We used Clinical Global Impression, Positive and Negative Syndrome Scale, Global Assessment of Functioning, Subjective Well-being under Neuroleptic treatment scale and Short-form-36 health survey. Drug attitude inventory and Drug Induced Extra-Pyramidal Symptoms Scale were also used. RESULTS: Forty patients were enrolled, and twenty-five patients completed this study. The therapeutic response rate was 36.1% in LOCF and 48% in completer's analysis. Scores on CGI, PANSS subscales and total were significantly decreased over 48-week period. Scores on other assessments did not show any significant changes over the period. At weeks 48, there was no significant difference in the changes of scores from baseline on self-rated assessments between the clinical improvement and non-improvement groups. CONCLUSIONS: Our study showed significant improvement of investigator-rated psychiatric symptoms in long-term follow-up using long-acting risperidone. Further researches would be required to find out the effects of the psychiatric symptom improvements on overall changes in perceived functioning and well-being.

No borna disease virus-specific RNA detected in blood of race horses and jockeys.

BACKGROUND: Borna disease virus (BDV) predominantly infects horses and sheep, causing a broad range of behavioural disorders. It is controversial whether BDV infects humans and causes psychiatric disorders. OBJECTIVES: We searched for BDV-derived nucleic acids in blood of race horses and jockeys riding the horses. METHODS: We assayed for the BDV genome in RNA extracted from peripheral blood mononuclear cells (PBMC) of 39 race horses and 48 jockeys. Two polymerase chain reaction protocols [one-tube reverse transcription-polymerase chain reaction (RT-PCR) and two-step RT-PCR] were used to assay BDV p24 and p40 transcripts. RESULTS: The p24 and p40 viral nucleic acid sequences were not detected in the PBMC RNAs from any of the race horses or jockeys. CONCLUSIONS: These data do not support an epidemiological association between BDV infection, race horses and humans.

No association between the tryptophan hydroxylase gene polymorphism and major depressive disorders and antidepressant response in a Korean population.

The serotonergic neurotransmitter system has been implicated in major depressive disorder (MDD) and appears to be the target of a variety of antidepressants. Tryptophan hydroxylase (TPH) is the rate-limiting enzyme in serotonin biosynthesis, and selective serotonin re-uptake inhibitors exert their activity enhancing the general serotonergic tone. The goal of this study was to investigate whether the A218C polymorphism of the TPH gene is associated with MDD or antidepressant response. All patients were evaluated at the start and in the eighth week of using the 21-item Hamilton Depression Rating Scale. Genotyping was analyzed with polymerase chain reaction. There were no significant differences in genotypes and allele frequencies between the MDD patients (n = 93) and the control group (n = 127) and in the antidepressant response among TPH gene variants. Results suggest that the A218C polymorphism of the TPH gene does not play a major role in pathogenesis in MDD and does not serve as a modulator of antidepressant activity.

G-protein beta3 subunit C825T polymorphism tends to be associated with seasonal variation in young male college students.

This study investigated the relationship between G-protein beta(3) subunit (GNB3) C825T polymorphism and seasonal variation in 189 young male college students. The subjects were genotyped for C825T and were evaluated by the Seasonality Pattern Assessment Questionnaire. The Global Seasonality Score (GSS) between the three genotypes revealed a marginal difference. The heterozygotes showed significantly higher seasonal variations in GSS than the homozygotes. The prevalence of heterozygotes tended to be higher in seasonals compared with normal subjects, although it was not statistically significant. These results suggest that GNB3 C825T polymorphism tends to be related to seasonal variation in mood and behavior in the normal population.

High concentrations of plasma brain-derived neurotrophic factor in methamphetamine users.

Methamphetamine is a highly addictive drug that has a neurotoxic effect on the brain. A growing body of evidence suggests that brain-derived neurotrophic factor (BDNF) is associated with addictive behavior. The present study investigated the changes in plasma BDNF concentration that were induced by chronic methamphetamine use. Using an enzyme-linked immunosorbent assay (ELISA), we measured peripheral BDNF levels in methamphetamine users and in a control group. The plasma BDNF concentrations of methamphetamine users were significantly higher compared with those of controls (2536.3 pg/ml versus 1352.6 pg/ml). This finding suggests that BDNF plays some role in the neurotoxicity of methamphetamine.

Latency of auditory P300 correlates with self-control as measured by the Sixteen Personality Factor Questionnaire.

The reception, processing, and storage of information about experience define personality. The present study investigated the relationship between auditory event-related potentials (AERP) and personality traits. The AERP were recorded using a standard auditory oddball paradigm, and personality was evaluated by Cattell's Sixteen Personality Factor Questionnaire (16PF) in 20 healthy young male subjects. The P300 latency was found to be significantly associated with rule consciousness (factor G in the 16PF), perfectionism (factor Q3), and self-control (factor SC): it was negatively correlated with G score (r = -0.56, P = 0.01), Q3 score (r = -0.67, P = 0.001), and SC score (r = -0.65, P = 0.002). Moreover, the P300 amplitude and N100 amplitude were negatively correlated with reasoning (factor B; r = -0.46, P = 0.044; and r = -0.72, P = 0.002, respectively). These results indicate that the personality traits of self-control, perfectionism, high superego, and reasoning are related to information processing in the brain.

Treatment in risperidone-induced amenorrhoea.

Objective To find the optimal changes needed for resolution of amenorrhoea associated with risperidone. Method Between November 2001 and May 2002, 16 female outpatients who had taken risperidone for more than 3 months voluntarily reported amenorrhoea. Following each report of amenorrhoea, serum prolactin level was measured and treatment changes were undertaken. The menstrual cycles and clinical mental status of each patient were followed for the next 6 months. For nine of the 16 patients, the dose of risperidone was reduced. For the other seven patients, risperidone was switched to olanzapine or quetiapine. Results Fourteen of 16 patients had hyperprolactinemia. Two patients who had discontinuation of risperidone recovered from amenorrhoea and three of the risperidone-reduction patients resumed their periods. All subjects in the drug-switch patients recovered. The patients who recovered from amenorrhoea at a reduced dosage of risperidone took ≤3 mg/day. Two patients in the risperidone-reduction group dropped out. Conclusion Stopping risperidone (without starting any other antipsychotic) or switching to a prolactin-sparing antipsychotic is an effective strategy for resolution of amenorrhoea on risperidone, but that dose reduction is rarely effective either because amenorrhoea continues despite lower dose or because relapse of psychosis appears.

Th1, Th2 and Th3 cytokine alteration in schizophrenia.

BACKGROUND: Several studies have shown that there is an imbalance between T helper 1 (Th1) cytokines and T helper 2 (Th2) cytokines in patients with schizophrenia. The T helper 3 (Th3) cytokine, transforming growth factor beta-1 (TGF-beta1), has been shown to suppress the production of Th1 cytokines. Therefore it is hypothesized that it may play a role in schizophrenia by suppressing overactive Th1 system. METHODS: We recruited 88 schizophrenic patients and 88 matched controls. The basal plasma concentrations of IFN-gamma (Th1), IL-4 (Th2) and TGF-beta1 (Th3) were studied at the time the patients were admitted to the hospital and following 8 weeks of treatment with antipsychotics. RESULTS: The detection rate of plasma IFN-gamma and basal plasma TGF-beta1 level were significantly higher in schizophrenic patients than in controls whereas detection rate of plasma IL-4 was lower in patients. The ratio of Th1/Th2 cytokines (IFN-gamma/IL-4) was higher in schizophrenic patients. Following the neuroleptic treatment, the IFNgamma and TGF-beta1 levels returned to control values, and IL-4 concentration rose above the control value. CONCLUSION: Schizophrenic patients showed higher Th1/Th2 ratio which is attenuated by effective neuroleptic treatment. It is possible that TGF-beta1 plays a role in reducing the activity of Th1 cytokine.

A double-blind trial of risperidone and haloperidol for the treatment of delirium.

To compare the clinical efficacy of haloperidol and risperidone for the treatment of delirium, the authors performed a double-blind comparative study. Twenty-eight patients with delirium were recruited and randomly assigned to receive a flexible-dose regimen of haloperidol or risperidone over 7 days. The severity of delirium was assessed by using Memorial Delirium Assessment Scale scores. Scores for each group decreased significantly over the study period. However, no significant differences in mean Memorial Delirium Assessment Scale scores between groups were found. The group-by-time effect was not significant. In addition, there was no significant difference in the frequency of response to the drugs between the two groups. One patient in the haloperidol group experienced mild akathisia, but no other patients reported clinically significant side effects. These data show no significant difference in the efficacy or response rate between haloperidol and risperidone in the treatment of delirium.

Association between norepinephrine transporter gene polymorphism and major depression.

Noradrenergic and serotonergic abnormalities have long been implicated in patients with major depression. The novel selective norepinephrine reuptake inhibitor reboxetine has been shown to be at least as effective as imipramine, desipramine and fluoxetine in the treatment of major depression. It is suggested that the dysfunction of the norepinephrine transporter (NET) may be related to major depression. Although the transcriptional activity related to the NET gene expression is little known, it may be a good candidate gene for major depression. Therefore, we investigated whether the T-182C polymorphism of the NET gene is associated with major depression in a Korean sample of 112 major depression patients compared with 136 healthy controls. We found a significantly lower frequency in TT genotype in patients with major depression than in normal controls when the genotypes of T-182C polymorphism were classified into two groups: TT group versus TC + CC group (p = 0.019). This result suggests that the T-182C polymorphism in the NET gene might be associated with major depression.

T-helper types 1, 2, and 3 cytokine interactions in symptomatic manic patients.

It has been reported that the balance between T-helper type 1 (Th1) cytokines and T-helper type 2 (Th2) cytokines plays a role in psychiatric disorders such as bipolar disorder. The T-helper type 3 (Th3) cytokine, which transforming growth factor beta-1 (TGF-beta1), has been shown to modulate the production of Th1 and Th2 cytokines. However, the role of TGF-beta1 in bipolar disorder has not yet been explored. A total of 70 manic patients with bipolar disorder and 96 normal controls was recruited. The plasma levels of IFN-gamma, IL-4, and TGF-beta1 were studied at the time of admission and 8 weeks after mood stabilizer treatment. The detection rate and plasma concentrations of IFN-gamma and IL-4 and the IFN-gamma/TGF-beta1 and IL-4/TGF-beta1 ratios were significantly higher in patients than in controls, while the TGF-beta1 level was significantly lower. The TGF-beta1 level increased significantly after treatment and the IFN-gamma/TGF-beta1 and IL-4/TGF-beta1 ratios returned to control values. TGF-beta1 may play a role in the pathophysiology of bipolar disorder through the action of TGF-beta1 in modulating the IL-4/TGF-beta1 ratio.

Sexual function and psychological characteristics of penile paraffinoma.

AIM: To identify the sexual, emotional and psychological status of men who augmented their penis with mineral oil injection for their small penis. METHODS: Men who had penile paraffin were asked to answer the semi-structured questionnaire. The questionnaire was designed to assess the motivation, method of penile injection, changes in erectile function and satisfaction after penile injection. SCL (Symptom checklist)-90-R, STAI (State and Trait Anxiety Inventory) and Zung SDS (Self-rating depression scale) were also included in the questionnaire for psychological evaluation. RESULTS: A total of 357 men completed the questionnaire. The first-ranked motivation of the injection was recommendation by their acquaintances (48.9 %). The majority of the respondents had the procedure by non-medical person (78.0 %). Before injection, 17.2 % had a sense of inferiority in their penis and 32 % worried about their weak erectile function. After injection, 33.0 % have found relief from their sense of inferiority and 17.8 % wish to feel improvement in their erectile function. Most of the respondents (91 %) were not satisfied with their penis and 74 % of them replied that they want to remove the injected material. Only 15.6 % did not experience side effects. Most of the subjects have suffered from various side effects such as inflammation, skin necrosis, pain, etc. No evidence of psychiatric pathology was found in psychological evaluation. CONCLUSION: The motivations of mineral oil injection were recommendation by their acquaintances or desire to be more mannish. Most of them had suffered from various side effects and only a small number of them felt improvement in their sense of inferiority, in their penis and erectile function. Increased public awareness is needed for the prevention of this physically and psychologically debilitating problem.

Borna disease virus and deficit schizophrenia.

BACKGROUND: It is controversial whether Borna disease virus (BDV) infects humans and causes psychiatric disorders. OBJECTIVES: The relationship between BDV infection and schizophrenia with deficit syndrome was investigated. STUDY DESIGN: Using the Schedule for the Deficit Syndrome, 62 schizophrenic in-patients were selected from three psychiatric hospitals. RNA was extracted from peripheral blood mononuclear cells and analyzed using nested reverse transcriptase-polymerase chain reaction with primers to detect BDV p24 and p40. RESULTS AND CONCLUSIONS: BDV transcripts were not detected in samples from any of the 62 schizophrenic patients. These data do not support an etiologic association between BDV infection and the deficit form of schizophrenia.