Korean Guidelines for the Pharmacological Treatment of Social Anxiety Disorder: Initial Treatment Strategies.

OBJECTIVE: The aim of the present study was to provide clinical consensus and evidence regarding initial treatment strategies for the pharmacological treatment of social anxiety disorder (SAD) in Korea. METHODS: We prepared a questionnaire to derive a consensus from clinicians regarding their preference for the pharmacological treatment of SAD in Korea. Data regarding medication regimens and psychotropic drugs used during initial treatment, the doses used, and the pharmacological treatment duration were obtained. Responses were obtained from 66 SAD experts, and their opinions were classified into three categories (first-line, second-line, third-line) using a chi-square analysis. RESULTS: Clinicians agreed upon first-line regimens for SAD involving monotherapy with selective serotonin reuptake inhibitors (SSRIs) or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine, or combined therapy using antidepressants with betablockers or benzodiazepines on a standing or as-needed basis. First-line psychotropic drug choices for initial treatment included the following: escitalopram, paroxetine, sertraline, venlafaxine, and propranolol. The medication dosage used by domestic clinicians was found to be comparable with foreign guidelines. Domestic clinicians tended to make treatment decisions in a shorter amount of time and preferred a similar duration of maintenance treatment for SAD when compared with foreign clinicians. CONCLUSION: This study may provide significant information for developing SAD pharmacotherapy guidelines in Korea, especially in the early stage of treatment.

The impacts of obesity on psychological well-being: a cross-sectional study about depressive mood and quality of life.

OBJECTIVES: The aim of this study was to assess whether individuals who visit clinics to ask medical help for obesity treatment depict comparable levels of depression, body dissatisfaction, eating psychopathology and lower quality of life. METHODS: This is a cross sectional study with 534 females who sought treatment for their obesity or overweight being recruited in seven clinical units in Seoul, Korea. The patients group was divided into two groups. The group 1 consisted of the patients with BMI >25 kg/m(2). The women who showed BMI < or =25 kg/m(2) among patients recruited for this study were classified as the group 2. The control group (group 3) was composed of 398 healthy females who have never tried to lose weight. RESULTS: We found that group 1 had higher frequency of more than moderate level of depression than group 2 and group 3 did. Both patients groups showed greater eating disordered attitudes and behaviors regardless of obese condition than the control group. Group 1 showed relatively lower level of quality of life than group 2 and group 3 in terms of the quality of life related to physical well-being. In addition, the control group reported higher quality of life in psychological health than both patients groups did. CONCLUSIONS: In conclusion, it is necessary for clinicians to make a careful evaluation of depressive tendency and eating disorders when obese women seek for medical help. The combination of medical treatment and psychological approach for obese women would result in higher quality of life.

Positive association of obesity with single nucleotide polymorphisms of syndecan 3 in the Korean population.

CONTEXT: Very recently the unforeseen role of syndecan 3 (SDC3), a family of membrane-bound heparin sulfate proteoglycans, in the regulation of energy balance has been discovered in the Sdc3 null female mice. OBJECTIVE: The objective of the study was to test the hypothesis that single nucleotide polymorphisms (SNPs) in SDC3 are associated with obesity in the Korean population. DESIGN/SETTING/SUBJECTS: We conducted a population-based cohort study consisting of 229 control and 245 study subjects and a second independent study consisting of 192 control and 115 study subjects. MAIN OUTCOME MEASUREMENT: Body mass index (BMI) was measured. RESULTS: First, Sdc3 mRNA expression in the brain of ob/ob mice was profoundly increased, compared with control mice. Next, all three nonsynonymous SNPs [T271I (rs2282440, C>T), D245N (rs4949184, C>T), and V150I (rs2491132, C>T)] in the SDC3 gene in control female subjects (BMI < 23, n = 229) and obese female subjects (BMI > 30, n = 245) were genotyped. We demonstrated the presence of clear ethnic differences in three nonsynonymous SDC3 SNPs among African-Americans, Chinese, Europeans, and Koreans. Of three SNPs in SDC3, rs4949184 was not associated with obesity and the other two SNPs (rs2282440 and rs2491132) were strongly associated with obesity (P < 0.0001), and the results were confirmed in the second independent study group. Haplotype analysis also revealed strong association with obesity (chi2 = 76.92, P < 0.000001). CONCLUSIONS: There are ethnic differences in the SDC3 polymorphisms, and the polymorphisms are strongly associated with obesity.

Melatonin enhances NADPH-diaphorase activities in the hypothalamus of maternally-separated rats.

Maternal separation or social isolation is a risk factor in the development of mammalian species affecting both physical and mental growth, and food intake regulation. Melatonin has been known to regulate body weight on various species including rodents. We investigated the effect of melatonin treatment on the expression of nitric oxide synthase, which may involved in food intake regulation, in the brain of maternally separated-rats using nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry. Melatonin (10 mg/kg i.p.) was injected to 14-day-old maternally-separated rats for 7 days. Maternally-separated rats with melatonin administration showed significantly higher staining intensities of NADPH-d-positive neurons in the paraventricular nucleus (PVN) and in lateral hypothalamic area (LHA) than maternally-separated without melatonin administration (P < 0.05). Body weight of melatonin treated rats significantly increased at the 6th and 7th day compared to that of rats without melatonin treatment (P < 0.05). These results indicate that melatonin may be associated with increase body weight via NOS in the hypothalamic areas in maternally-separated or socially isolated rats.