Risk Factors for Serious Suicide Attempts with High Medical Severity.

OBJECTIVES: his study investigated the risk factors leading to serious suicide attempts with high medical severity. METHODS: Nine hundred and eighty-two patients who visited the emergency room after attempting suicide were divided into two groups: suicide attempters with high medical severity (25.3%) and those with low medical severity (74.7%). Demographic variables, clinical characteristics, and factors related to each suicide attempt were compared between the two groups. Multivariate logistic regression analysis was conducted to investigate risk factors for high medical severity in patients' current suicide attempts. RESULTS: The results show that suicide attempters with high medical severity had more severe depression and psychological disturbances such as agitation, intense emotions, and self-reproach. Suicide attempters with high medical severity also had more serious risk factors for suicide such as repetitive/intense/continuous thoughts of suicide, suicidal planning, and a stronger wish to die. School/work problems and physical illnesses were related to high medical severity with more lethal methods. Logistic regression demonstrated that school/work problems, total risk rating, severity of suicidal ideation, and agitation were risks for more serious suicide attempts, whereas more frequent lifetime suicide attempts were a protective factor. CONCLUSION: This study demonstrates that suicide attempters with high medical severity had more severe psychopathologies and risk factors related to suicidal behavior than those with low medical severity.

Effect of emotion regulation training in patients with panic disorder: Evidenced by heart rate variability measures.

OBJECTIVE: We aimed to examine the effect of emotion regulation training in patients with panic disorder (PD) by measuring heart rate variability (HRV). METHODS: Forty-eight patients with PD were randomly divided into emotion regulation group (n=25) and no-regulation group (n=23). Three five-minute ECG recordings were taken in the following states: 1) baseline, 2) while subjects viewed 15 aversive pictures (active stimulus), 3) resting state after aversive pictures (post-stimulus). The emotion regulation group briefly received acceptance technique training for five minutes before performing the experimental task. Spectral analysis measures included a high-frequency (HF; 0.15-0.4 HZ) component, a low-frequency (LF; 0.04-0.15Hz) component, and an LF/HF ratio. RESULTS: The mean change in LF/HF ratio from baseline to active stimulus was significantly lower in the emotion regulation group than in the no-regulation group (emotion regulation group, 0.13; no-regulation group, 2.31; t=-2.67; P<.05). CONCLUSION: This suggests that brief emotion acceptance training could decrease aversive stimulus-induced sympathetic hyperactivity in patients with PD.

Emotion-Induced Topological Changes in Functional Brain Networks.

In facial expression perception, a distributed network is activated according to stimulus context. We proposed that an interaction between brain activation and stimulus context in response to facial expressions could signify a pattern of interactivity across the whole brain network beyond the face processing network. Functional magnetic resonance imaging data were acquired for 19 young healthy subjects who were exposed to either emotionally neutral or negative facial expressions. We constructed group-wise functional brain networks for 12 face processing areas [bilateral inferior occipital gyri (IOG), fusiform gyri (FG), superior temporal sulci (STS), amygdalae (AMG), inferior frontal gyri (IFG), and orbitofrontal cortices (OFC)] and for 73 whole brain areas, based on partial correlation of mean activation across subjects. We compared the topological properties of the networks with respect to functional distance-based measures, global and local efficiency, between the two types of face stimulus. In both face processing and whole brain networks, global efficiency was lower and local efficiency was higher for negative faces relative to neutral faces, indicating that network topology differed according to stimulus context. Particularly in the face processing network, emotion-induced changes in network topology were attributable to interactions between core (bilateral IOG, FG, and STS) and extended (bilateral AMG, IFG, and OFC) systems. These results suggest that changes in brain activation patterns in response to emotional face stimuli could be revealed as changes in the topological properties of functional brain networks for the whole brain as well as for face processing areas.

Characteristic Risk Factors Associated with Planned versus Impulsive Suicide Attempters.

OBJECTIVE: The present study aimed to investigate predictors for planned suicide attempters. METHODS: This study included 1,003 patients who attempted suicide and visited emergency department. They were divided into two groups, planned suicide attempters (SAs; n=133 [13.3%]) and impulsive SAs (n=870, [86.7%]), and the demographic variables, clinical characteristics, factors related to suicide, and psychiatric resources of the groups were compared. RESULTS: Major depressive disorder and substance use disorders were more common among planned SAs than among impulsive SAs. Additionally, the planned SAs were older, more likely to be divorced, separated or widowed, and more likely to have comorbid medical illnesses, severe depression, higher suicidality, and self-blaming tendencies than the impulsive SAs. Financial problems and physical illnesses were more common in planned SAs but interpersonal conflicts were more frequent in impulsive SAs. Planned SAs had fewer previous suicide attempts but these were more serious suicide attempts. The presence of the hope to die, a written will, and suicidal ideation of a repetitive, intense, and continuous nature were predictive of planned SAs. CONCLUSION: The present findings demonstrated that planned SAs had more severe psychopathology and medical illnesses than impulsive SAs. Therefore, screening for depression, substance use disorders, and suicidal plans among old and medically ill patients may be important for preventing suicide attempts.

Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program.

Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support.

Overactive Bladder Successfully Treated with Duloxetine in a Female Adolescent.

Overactive bladder (OAB) is defined as urgency, usually with frequency and nocturia, and with or without urge incontinence. Duloxetine, an antidepressant that inhibits reuptake of serotonin and norepinephrine, is indicated for the treatment of stress urinary incontinence in Europe. In this paper, we present a case of a 17-year-old female patient with OAB and depressive symptoms who was successfully treated with duloxetine. This case suggests duloxetine can be an option for patient with OAB, and it also highlights the need for further studies of duloxetine's use in the treatment of OAB.

Suicide Risk Assessments: Which Suicide Risk Factors Psychiatric Residents Consider Significant?

OBJECTIVE: Patients visiting the emergency department (ED) after a suicide attempt are generally assessed for suicide risk by psychiatric residents. Psychiatric residents' competence in evaluating the risk posed by the patients who attempted suicide is critical to preventing suicide. METHODS: We investigated factors considered important by psychiatric residents when evaluating suicide risk. This study included 140 patients admitted to the ED after attempting suicide. Psychiatric residents rated patients' severity of current and future suicide risk as low/moderate/high using the Brief Emergency Room Suicide Risk Assessment (BESRA). The association between each BESRA variable and level of suicide risk was analyzed. RESULTS: Many factors were commonly considered important in evaluating the severity of current and future suicide risk. However, the following factors were only associated with future suicide risk: female gender, having no religion, family psychiatric history, history of axis I disorders, having a will, harboring no regrets, and social isolation. CONCLUSION: Psychiatric residents use diverse factors when assessing suicide risk. Psychiatric residents might put more emphasis on non-modifiable demographic and clinical factors, concrete evidence showing suicide determination, and social isolation to assess the risk of future suicide.

Affective state-dependent changes in the brain functional network in major depressive disorder.

In major depressive disorder (MDD), as a network-level disease, the pathophysiology would be displayed to a wide extent over the brain. Moreover, the network-wide changes could be dependent on the context of affective processing. In this study, we sought affective state-dependent changes of the brain functional network by applying a graph-theoretical approach to functional magnetic resonance imaging data acquired in 13 patients with MDD and 12 healthy controls who were exposed to video clips inducing the negative, neutral or positive affective state. For each affective condition, a group-wise brain functional network was constructed based on partial correlation of mean activity across subjects between brain areas. Network parameters, global and local efficiencies, were measured from the brain functional network. Compared with controls', patients' brain functional network shifted to the regular network in the topological architecture, showing decreased global efficiency and increased local efficiency, during negative and neutral affective processing. Further, the shift to the regular network in patients was most evident during negative affective processing. MDD is proposed to provoke widespread changes across the whole brain in an affective state-dependent manner, specifically in the negative affective state.

Risk and protective factors predicting multiple suicide attempts.

This study compared demographical and clinical variables between first and multiple suicide attempters and investigated risk and protective factors predicting multiple attempts. 228 patients visiting emergency department after attempting suicide were divided into two groups: first attempter (n=148, 64.9%) and multiple attempter (n=80, 35.1%). Demographic variables, clinical characteristics, factors related with suicide behavior, and psychiatric resources between two groups were compared. Multivariate logistic regression analysis was conducted to investigate risk and protective factors predicting multiple attempts. The results showed that multiple attempters were younger, not married, more severe in psychopathology (e.g., psychiatric disorder, personality disorder, lower function, and suicide family history) and suicidality (e.g., repetitive/severe/continuous suicide ideation), and lower in psychiatric resources (e.g., interpersonal stress/conflict, conflicting interpersonal relationship, socially isolated, lower personal achievement, and lower ability to control emotion) than first attempters. Suicide ideation severity and conflicting interpersonal relationships predicted multiple suicide attempts, whereas past year's highest global functioning score and age over 45 protected against multiple suicide attempts. This study demonstrated that multiple suicide attempters have more severe clinical profile than first suicide attempters. Moreover, decreasing severity of suicide ideation, improving interpersonal relationships, and enhancing functioning level of suicide attempters might be important in preventing them from re-attempting suicide.

Psychometric properties of the Korean version of stanford acute stress reaction questionnaire.

The present study aimed to examine the psychometric properties of the Korean version of Stanford Acute Stress Reaction Questionnaire (SASRQ). A Korean version of the SASRQ was produced through forward translation, reconciliation, and back translation. A total of 100 healthy, non-clinical participants were selected through screening and clinical interview, and they each were given a set of questionnaires including SASRQ. Psychometric properties of SASRQ were then examined through statistical analyses. Full-scale and subscales of SASRQ yielded excellent internal consistency (Cronbach's alpha=0.98 and 0.78-0.95, respectively). Test-retest reliability at 2-week intervals was satisfactory, with coefficient r ranging between 0.47 and 0.71. Convergent validity was also demonstrated by strong correlations between SASRQ and other trauma-related questionnaires. Correlation with Social Desirability Scale, however, was not found to be significant; thus evidenced divergent validity. The Korean version of SASRQ appears to be a reliable and valid measurement tool for assessing symptoms of acute stress disorder. Including clinical samples for comparison with controls would be necessary in future studies.

Threat-induced autonomic dysregulation in panic disorder evidenced by heart rate variability measures.

OBJECTIVE: The objective was to compare autonomic response to threatening stimuli between patients with panic disorder (PD) and healthy volunteers by using 5-min recordings of heart rate variability (HRV). METHODS: Twenty-seven patients with PD and 20 healthy controls were recruited. The first 5-min measurement of HRV was conducted at resting state. HRV measurement during threatening stimuli was conducted while participants were viewing 15 threatening pictures. Spectral analyses measures included high-frequency (HF; 0.15-0.4 HZ) component, low-frequency (LF; 0.04-0.15 Hz) component and LF/HF ratio. RESULTS: There was no significant HRV difference between the two groups at the resting state. During threatening stimuli, the PD group had significantly higher LF power and LF/HF ratio and significantly lower HF power than the healthy controls (for all, P<.01). A two-way analysis of variance was employed to determine the effect of group (patient and control) and condition (threatening and resting) on all three HRV measures. The analysis showed a significant main effect of group (F=12.21; P<.01), condition (F=14.21; P<.001) and interaction effect between group and condition (F=4.83; P<.05) on LF/HF ratio. CONCLUSIONS: The findings from the present study suggest that patients with PD exhibit a sympathetic predominance when faced with threatening stimuli compared with normal control subjects.

Symptom severity of panic disorder associated with impairment in emotion processing of threat-related facial expressions.

AIM: To compare emotion recognition patterns between patients with panic disorder (PD) and healthy volunteers and to analyze the correlation between the degree of emotion recognition impairment and symptom severity in patients with PD. METHODS: Twenty-four patients with PD and 20 healthy controls were tested with a facial emotional expression recognition task involving four basic emotions (i.e. happiness, sadness, anger, and fear). Emotion recognition measures included the recognition threshold, response time, response time of correctly classified emotions (response time_crt), and recognition error. An average of all four emotions for each emotion recognition measure was compared between the two groups and then a comparison of recognition measures for each specific emotion was conducted. The correlations between severity of the State-Trait Anxiety Inventory, Beck Depression Inventory (BDI), and Panic Disorder Severity Scale with emotion recognition indices were also analyzed. RESULTS: Average recognition threshold was significantly higher in the PD group compared to the control group. In the PD group, there was a non-significant trend of increase in the emotion recognition threshold for fear and the response time for anger compared with the control group. In the correlation analysis, higher trait anxiety was associated with slower response time_crt for anger and a higher BDI score was associated with slower response times and response time_crt for happiness and anger. CONCLUSION: This study suggests that symptom severity of PD might be associated with impairment in emotion processing of threat-related facial expressions.

Psychometric properties of the Korean version of the Interpersonal Sensitivity Measure (IPSM-K).

The aim of this study was to investigate the psychometric properties of a Korean version of Interpersonal Sensitivity Measure (IPSM). A Korean version of the IPSM (IPSM-K) was produced through forward translation, reconciliation, and back translation. A total of 338 healthy, non-clinical participants were selected through screening and clinical interview, and they each were given a set of questionnaires including IPSM-K. All subscales, as well as a full-scale IPSM-K showed satisfactory internal consistency (Cronbach's alpha=0.73-0.83 and 0.94, respectively). Test-retest reliability at 2-week intervals was significant, with coefficient r ranging between .80 and .94. In terms of convergent validity, IPSM-K showed the significant positive correlation with sociotropy and autonomy subscale of Personal Style Inventory-II, as well as with neuroticism subscale of Neuroticism Extraversion Openness-Personality Inventory. IPSM-K had no correlation with Social Desirability Scale, thus demonstrated divergent validity with social desirability. A factor analysis of the scale was conducted and five factors emerged (low self-confidence, interpersonal awareness, lack of assertiveness/separation anxiety, interpersonal vulnerability, and need for approval). This study demonstrated that IPSM-K could be useful in assessing interpersonal sensitivity in Korean population.

Characteristics of drug overdose in young suicide attempters.

OBJECTIVE: Few studies have focused on the characteristic features of drug overdose in children and adolescents who have attempted suicide in Korea. The present study examined the characteristics of drug overdose in children and adolescents who visited the emergency room following drug ingestion for a suicide attempt. METHODS: The medical records of 28 patients who were treated in the emergency room following a drug overdose from January 2008 to March 2011 were analyzed. Demographic and clinical variables related to the suicide attempts were examined. RESULTS: The mean age of the patients was 16.6±1.7 years (range 11-19 years), and 20 of the patients (71.4%) were female. Most of the patients (n=23, 82.1%) overdosed on a single drug; acetaminophen-containing analgesics were the most common (n=12, 42.9%). Depression was the most common psychiatric disorder (n=22, 78.6%), and interpersonal conflict was the most common precipitating factor of the suicide attempts (n=11, 39.3%). This was the first suicide attempt for approximately 80% of the patients. About one fourth of the patients (n=7, 25%) had follow-up visits at the psychiatric outpatient clinic. CONCLUSION: Early screening and psychiatric intervention for depression may be an important factor in preventing childhood and adolescent suicide attempts. Developing coping strategies to manage interpersonal conflicts may also be helpful. Moreover, policies restricting the amount and kind of drugs purchased by teenagers may be necessary to prevent drug overdose in this age group.

Elderly suicide attempters by self-poisoning in Korea.

BACKGROUND: Suicide is a major public health concern. The elderly have the highest rate of suicide and they make more lethal suicide attempts and have fewer psychiatric interventions than young people. Furthermore, they have old-age specific psychosocial difficulties. The present study investigated psychosocial risk factors and characteristics of an index suicide attempt of the elderly suicide attempters. METHODS: Subjects included 388 patients who were admitted to the emergency room following self-poisoning. Two age groups were defined: younger patients (aged less than 65 years) and older patients (aged over 65 years). Data including demographic factors, suicidal risk factors and information about the current suicide attempt were obtained from a retrospective chart review. RESULTS: The number of suicide attempters over the age of 65 years old was 57, and their mean age was 73.5 ± 7.5 years. The elderly patients had more underlying medical illnesses than the under-65 group (p < 0.001). Depression was the most common psychiatric diagnosis. Psychotropics were the most commonly ingested drugs in both groups, but the use of pesticides was more notable in the elderly. The elderly suicide attempters had higher risk-rating scores (p < 0.001) and lower rescue-rating scores (p = 0.014) than the under-65 group. Male-to-female ratio of the elderly group was nearly 1:1 unlike the under-65 group (p = 0.004). CONCLUSION: Elderly suicide attempters had different psychosocial stressors such as physical illness and more lethal suicide attempts. Our study suggests the need for development of specific preventive strategies and management guidelines for the elderly suicide attempters.

Antidepressant-Induced Sexual Dysfunction among Newer Antidepressants in a Naturalistic Setting.

OBJECTIVE: Antidepressants used to treat depression are frequently associated with sexual dysfunction. Sexual side effects affect the patient's quality of life and, in long-term treatment, can lead to non-compliance and relapse. However, studies covering many antidepressants with differing mechanisms of action were scarce. The present study assessed and compared the incidence of sexual dysfunction among different antidepressants in a naturalistic setting. METHODS: Participants were married patients diagnosed with depression, per DSM-IV diagnostic criteria, who had been taking antidepressants for more than 1 month. We assessed the participants via the Arizona Sexual Experiences Scale (ASEX), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI), and assessed their demographic variables, types and dosages of antidepressants, and duration of antidepressant use via their medical records. RESULTS: One hundred and one patients (46 male, 55 female, age 42.2+/-7 years) completed the instruments. Thirteen were taking fluoxetine (mean dose 21.3+/-8.5 mg/day), 24 were taking paroxetine (mean dose 20.4+/-7.2 mg/day), 20 taking citalopram (mean dose 22.1+/-6.5 mg/day), 22, venlafaxine (mean dose 115.7+/-53.2 mg/day) and 22, mirtazapine (mean dose 18+/-8.7 mg/day). Mean ages, sex ratios, and BDI and STAI scores did not differ significantly across antidepressants. A substantial number of participants (46.5%, n=47) experienced sexual dysfunction. The prevalence of sexual dysfunction differed across drugs: citalopram 60% (n=12), venlafaxine 54.5% (n=12), paroxetine 54.2% (n=13), fluoxetine 46.2% (n=6), and mirtazapine 18.2% (n=4). Regression analyses revealed the significant factors for sexual dysfunction were being female, total scores on the BDI and SAI, and type of antidepressant (F=4.92, p<0.0001). Of the antidepressants, the mirtarzapine group's total ASEX score was significantly lower than the scores of the citalopram, fluoxetine, and paroxetine groups. CONCLUSION: The incidence of sexual dysfunction was substantially high during antidepressant treatment. The incidence of sexual dysfunction differed among antidepressants having different mechanisms of action. Our study suggests the need for clinicians to consider the impact of pharmacotherapy on patients' sexual functioning in the course of treatment with antidepressants.

Deficits in facial emotion recognition in schizophrenia: a replication study with korean subjects.

OBJECTIVE: We investigated the deficit in the recognition of facial emotions in a sample of medicated, stable Korean patients with schizophrenia using Korean facial emotion pictures and examined whether the possible impairments would corroborate previous findings. METHODS: Fifty-five patients with schizophrenia and 62 healthy control subjects completed the Facial Affect Identification Test with a new set of 44 colored photographs of Korean faces including the six universal emotions as well as neutral faces. RESULTS: Korean patients with schizophrenia showed impairments in the recognition of sad, fearful, and angry faces [F(1,114)=6.26, p=0.014; F(1,114)=6.18, p=0.014; F(1,114)=9.28, p=0.003, respectively], but their accuracy was no different from that of controls in the recognition of happy emotions. Higher total and three subscale scores of the Positive and Negative Syndrome Scale (PANSS) correlated with worse performance on both angry and neutral faces. Correct responses on happy stimuli were negatively correlated with negative symptom scores of the PANSS. Patients with schizophrenia also exhibited different patterns of misidentification relative to normal controls. CONCLUSION: These findings were consistent with previous studies carried out with different ethnic groups, suggesting cross-cultural similarities in facial recognition impairment in schizophrenia.

The impact of executive function on emotion recognition and emotion experience in patients with schizophrenia.

OBJECTIVE: This study investigated the impact of executive function on the performance of two different affective tasks, the Facial Affect Identification Task (FAIT) and the Iowa Gambling Task (IGT), in patients with schizophrenia. METHODS: Thirty-nine patients with schizophrenia and 33 healthy controls completed the FAIT and the IGT, followed by the Wisconsin Card Sorting Test (WCST) and the intelligence quotient (IQ) test. In addition to correlation analysis, regression analysis was used to determine the extent to which the performance of the WCST, in particular, perseverative error (PE), accounted for the variation in both the FAIT and the IGT. RESULTS: Relative to normal controls, patients with schizophrenia showed significant impairments in the IGT, the FAIT and the WCST even after controlling for IQ. While normal controls did not show any relationships between the WCST and two affective tasks, patients with schizophrenia showed that variables in the WCST correlated not only with the FAIT total correct score (r=-0.503, p=0.001 for PE) but also with the IGT net score (r=0.385, p=0.016 for PE). The PE score was a better predictor of the performance on the FAIT (R(2)=0.25) than that of the performance on the IGT (R(2)=0.15). CONCLUSION: Our findings imply that deficits in executive function in schizophrenia can affect performance on facial emotion recognition task more than performance on task based on emotion experience, that is, the feedback from the body. Therefore, more consideration is needed of the impact of executive function when interpreting the result of "conventional" facial affect recognition tests as opposed to interpreting the IGT.

Mirtazapine for patients with alcohol dependence and comorbid depressive disorders: a multicentre, open label study.

Major depressive disorder and alcohol dependence are common and serious mental illnesses. There is a great interest in discovering useful treatments for both mood symptoms and alcohol abuse in those patients with depressive disorders and comorbid alcohol dependence. The primary purpose of this study was to evaluate the effectiveness and tolerability of mirtazapine for the treatment of patients with alcohol dependence comorbid with a depressive disorder in an open label, naturalistic multicentre treatment setting. The 17-item Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS) and the Clinical Global Impression-Severity (CGI-S) scale were measured at baseline and at weeks 4 and 8 for the assessment of treatment effectiveness. Alcohol craving was measured using the Obsessive Compulsive Drinking Scale (OCDS) and the Visual Analog Scale for Craving (VAS). This study showed a statistically significant reduction of the scores on the HDRS (13.9+/-7.3, p<0.0001), HARS (10.8+/-7.2, p<0.0001) and the CGI-S (1.7+/-1.0, p<0.0001) from baseline to the endpoint (week 8). The OCDS and VAS scores were also decreased significantly by 42.3% and 53.2% (9.0+/-10.0, p<0.0001; 2.5+/-2.4, p<0.0001, respectively). The number of patients with a 50% reduction or more in the HDRS and HARS scores was 103 (72.0%) and 106 (74.1%) at the endpoint, respectively. Adverse events related to mirtazapine were observed in 10% or more of the patients in this study. In conclusion, the results from this naturalistic study suggest that the use of mirtazapine for the patients with alcohol dependence comorbid with depressive disorder is accompanied by clinical improvement in their mood and alcohol craving.

Concentration changes of methanol in blood samples during an experimentally induced alcohol hangover state.

A hangover is characterized by the unpleasant physical and mental symptoms that occur between 8 and 16 hours after drinking alcohol. After inducing experimental hangover in normal individuals, we measured the methanol concentration prior to and after alcohol consumption and we assessed the association between the hangover condition and the blood methanol level. A total of 18 normal adult males participated in this study. They did not have any previous histories of psychiatric or medical disorders. The blood ethanol concentration prior to the alcohol intake (2.26+/-2.08) was not significantly different from that 13 hours after the alcohol consumption (3.12+/-2.38). However, the difference of methanol concentration between the day of experiment (prior to the alcohol intake) and the next day (13 hours after the alcohol intake) was significant (2.62+/-1.33/l vs. 3.88+/-2.10/l, respectively). A significant positive correlation was observed between the changes of blood methanol concentration and hangover subjective scale score increment when covarying for the changes of blood ethanol level (r=0.498, p<0.05). This result suggests the possible correlation of methanol as well as its toxic metabolite to hangover.