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Psychiatry Investigation

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Objective As the coronavirus (COVID-19) pandemic sweeps across the world, it is causing widespread concern, fear and stress, all of which are natural and normal reactions to the changing and uncertain situation that everyone finds themselves in.Methods In this general review, we examined the literature about the psychological effects of COVID-19 pandemia. In total 65 papers were reviewed using the Medline computer database. Only publications in English were selected.Results Children are likely to be experiencing worry, anxiety and fear and older people are also those with underlying health conditions, having been identified as more vulnerable to COVID-19, can be extremely frightening and very fear-inducing. China and several other countries took strict isolation measures. Medical staff and affiliated healthcare workers (staff) are under both physical and psychological pressure.Conclusion The COVID-19 pandemic is exceptional. Its effect will likely be imprinted on each individual involved. Extensive stressors will emerge or become worsened. Many medical staff workers will be harmfully psychologically affected.
Protagonist Role of Opioidergic System on Post-Traumatic Stress Disorder and Associated Pain
Protagonist Role of Opioidergic System on Post-Traumatic Stress Disorder and Associated Pain
Marjan Nikbakhtzadeh,Fatemeh Mohtashami Borzadaran,Elham Zamani,Mohammad Shabani
Psychiatry Investigation 제17권 제6호/ 2020
506-516 (11 pages)
의약학>정신과학
초록보기
Objective Post-traumatic stress disorder (PTSD) and chronic pain often co-occur. Studies have shown an interaction between pain and PTSD. In this narrative review, we aim to support conducting comprehensive studies by describing PTSD, pain and determining whether opioidergic system, its agonist and antagonist manipulation could positively or negatively affect PTSD symptoms and concurrent pain.Methods Term searches was done in Google Scholar, Scopus, ScienceDirect, Web of Science and PubMed databases as well as hand searching in key resource journals from 1979–2019.Results There are a lot of contradictions and disputes when endogenous opioidergic system and opioidergic antagonist system are studied in PTSD patients. Exogenous morphine administration in PTSD patients can decrease the symptoms of PTSD but it doesn’t have a pain reduction effect to an acceptable level. Beta-endorphin as an endogenous opioid is effective in pain reduction in the moment of events but after minutes to hours, the endorphins withdrawal syndrome leads to exaggerated intrusive thoughts and flashbacks of PTSD, which exacerbate the pain. It has also been shown that naloxone, as an opioidergic antagonist, can reduce or increase the PTSD symptoms and its associated pain.Conclusion Data suggest different roles of opioidergic system and their antagonist in pain control and mood in PTSD. However, further investigations need to be done in order to reveal the role of endogenous opioidergic system and opioidergic antagonist system as a mediator in PTSD patients suffering from acute or chronic pain.
Defining Subtypes in Children with Nail Biting: A Latent Profile Analysis of Personality
Defining Subtypes in Children with Nail Biting: A Latent Profile Analysis of Personality
Yunhye Oh,Jungwon Choi,Yul-Mai Song,Kyungun Jhung,Young-Ryeol Lee,Nam-Hee Yoo,Yeni Kim
Psychiatry Investigation 제17권 제6호/ 2020
517-525 (9 pages)
의약학>정신과학
초록보기
Objective This study aimed to examine personality profiles and behavioral problems of children with nail biting (NB) to gain insight into the developmental trajectory of pathological NB.Methods 681 elementary school students were divided into non NB (n=436), occasional NB (n=173) and frequent NB group (n=72) depending on the frequency of NB reported in Child Behavioral Checklist (CBCL). Children’s personality was assessed using the Junior Temperament and Character Inventory (JTCI), and behavioral problems were assessed using the CBCL. Latent Profile Analysis (LPA) was performed using JTCI profiles to classify personalities of the children with NB (belonging to frequent and occasional NB group, n=245).Results For subscale scores of CBCL, the total, internalizing, externalizing, anxious/depressed withdrawn/depressed, depression, thought, rule-breaking, and aggressive behavior problems, were most severe in the frequent NB group followed by occasional NB and non NB group. LPA of personality profile in children with NB revealed four classes (‘adaptiveness,’ ‘high reward dependence,’ ‘low self-directedness,’ and ‘maldaptiveness’). The four personality classes demonstrated significant group differences in all of the CBCL subscales. Children who showed low self-directedness and cooperativeness and high novelty seeking and harm avoidance personality profiles demonstrated highest tendency for problematic behavior irrespective of the frequency of NB.Conclusion Children with NB reported significantly more problematic behaviors compared to children without NB. Children with specific personality profile demonstrated higher tendency for problematic behavior irrespective of the frequency of NB. Therefore, accompanying personality profiles should be considered when assessing behavioral problems in children with NB.
Detection of Malingering Using Wechsler Adult Intelligence Scale-IV for Psychiatric Patients
Detection of Malingering Using Wechsler Adult Intelligence Scale-IV for Psychiatric Patients
An Kook On,Kyu-Sic Hwang,Seung-Ho Jang,Hye-Jin Lee,Min-Jung Soh,Chan-Mo Yang,Sang-Yeol Lee
Psychiatry Investigation 제17권 제6호/ 2020
526-532 (7 pages)
의약학>정신과학
초록보기
Objective Psychiatric patients sometimes show poor performance or exaggerated symptoms as malingering for secondary gain. The aim of this study was to introduce cut-off scores for detecting poor performance using Wechsler Adult Intelligence Scale (WAIS) in psychiatric patients.Methods Participants were 261 in- and out-patients who visited psychiatry department. They were classified into 4 group- 1) military service, 2) traumatic brain injury (TBI), 3) psychosis, 4) neurosis. A Digit Span subtest (called as Reliable Digit Span, RDS) of WAIS was used to detect malingering. This study considered a score of 10% base rate as RDS cut-off score.Results The RDS cut-off score was shown at 7 pts for military service group, at 3 pts for TBI group, at 6 pts for psychosis group, and at 6 pts for neurosis group.Conclusion This study first introduced RDS cut-off scores for malingering psychiatric patients in South Korea. In clinical practice, clinicians may be able to utilize the RDS cut-off scores for malingering-suspected patients. In particular, for patients with military service issues, 7 or less pts of RDS can be used for detecting and inferring their malingering.
The Prevalence and Incidence of Insomnia in Korea during 2005 to 2013
The Prevalence and Incidence of Insomnia in Korea during 2005 to 2013
Seockhoon Chung,Seung Woo Cho,Min-Woo Jo,Soyoung Youn,Jiho Lee,Chang Sun Sim
Psychiatry Investigation 제17권 제6호/ 2020
533-540 (8 pages)
의약학>정신과학
초록보기
Objective The aim of this study was to estimate the progress of insomnia prevalence and incidence over the past several years. Also, this study compared survival rates between individuals with and without insomnia.Methods The National Health Insurance Service-National Sample Cohort (NHIS-NSC) from 2002–2013 was used for this study. Prevalent cases of insomnia were defined using ICD-10 codes F51.0 or G47.0, or a prescription of sedatives. Cox’s proportional hazard analysis was conducted to compare survival rates between insomnia patients and people without insomnia.Results In 2013, there were 46,167 (5.78%) insomnia patients over 20 years old in this cohort. Insomnia was more common among women and the elderly. Annual incidence over the past several years remained steady but the prevalence increased. The survival of insomnia patients was lower than that of people without insomnia, and the hazard ratio for overall mortality was 1.702 (p<0.001).Conclusion This large-scale population-based cohort study provided current epidemiologic indicators of insomnia in the Korean general population.
Prevalence of DSM-IV Major Psychiatric Disorders among North Korean Defectors in South Korea
Prevalence of DSM-IV Major Psychiatric Disorders among North Korean Defectors in South Korea
Kyoung Eun Lee,Carolyn Seungyoun Moon,Ji Hyun An,Hyo Chul Lee,Da Eun Kim,Subin Park,Minji Lee,Hye In Chang,Jin Pyo Hong
Psychiatry Investigation 제17권 제6호/ 2020
541-546 (6 pages)
의약학>정신과학
초록보기
Objective The aim of this study was to estimate the prevalence of major psychiatric disorders among North Korean defectors (NKD) settled in South Korea.Methods The study population consisted of 294 North Korean defectors, aged 18 to 64 years settled in South Korea for 3 years or less. Between June 1, 2016 and October 31, 2016, face-to-face interviews were conducted using the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) to diagnose DSM-IV psychiatric disorders.Results The lifetime prevalence of any DSM-IV psychiatric disorders was 62.2% in NKD and 25.0% in the general Korean population. The prevalence of specific disorders in NKD and general Korean population was as follows: 22.3% and 4.9% for major depressive disorder (MDD), 12.2% and 1.4% for post-traumatic stress disorder (PTSD), 18.0% and 4.8% for nicotine dependence, and 14.5% and 11.2% for alcohol abuse. The incidence of every single psychiatric disorder varied in each country. For instance, the generalized anxiety disorder, specific phobia, and alcohol use disorder occurred more frequently in North Korea whereas PTSD was more prevalent in other countries.Conclusion The prevalence of psychiatric disorders among NKD was quite higher than in the general population of South Korea.
Objective Envy, as a stable personality trait, can affect individuals’ mental health. Specifically, previous studies have found that envy can lead to depression; however, the mechanism by which envy affects depression is still unclear. Therefore, based on the resilience framework, we used structural equation modeling to explore the mediating roles that social support and psychological resilience play between envy and depression.Methods Chinese college students (n=680) were recruited to complete four scales: the Dispositional Envy Scale (DES), the Symptom Checklist 90-Depression Subscale (SCL-90-DS), the Connor-Davidson Resilience Scale (CD-RISC), and the Perceived Social Support Scale (PSSS).Results The results confirmed that both social support and psychological resilience are significant mediators between envy and depression. Furthermore, social support plays a significant mediating role between envy and psychological resilience, and psychological resilience plays a significant mediating role between social support and depression. Specifically, the results indicated that envy not only directly increases the likelihood of developing depression, but also indirectly increases the likelihood of developing depression by affecting psychological resilience through negatively influencing social support.Conclusion This study provides a theoretical basis for enhancing psychological resilience and social support in order to ameliorate adverse effects of envy on depression.
Objective Excessive activation of defence modules leads to some dysfunctional outcomes, which can be broadly classified to defence activation disorders. Defence activation disorders have high mortality, low fertility, high prevalence and high heritability. In this study, agent-based simulation model is formulated for solving this evolutionary paradox.Methods The emotional system is considered as a superordinate cognitive module for grasping the average resource amount and the average diminishing returns of resources, based on the Marginal Value Theorem. Under the assumption, the evolutionary ecological model was proposed and analysed.Results Individuals utilising suboptimal strategies can be stably maintained in agent-based evolutionary simulation environments. Individuals were adapted to have different <i>d-values</i> according to the local niche. The simulation runs stably within the calibrated range of the variables for a long time. Agents establish locally optimal strategies based on their given <i>d-values</i>, and the relative proportion of subpopulation maintained stably in the heterogeneous habitat with the resource gradient.Conclusion This study verifies the evolutionary mechanism of defence activation disorders in computer-simulated environments by using agent-based modelling with the Marginal Value Theorem. Balancing selection appears to be a plausible evolutionary mechanism that makes the suboptimal levels of defence activation the evolutionarily stable strategies.
Objective Impaired serotonergic neurotransmission has been implicated in the pathogenesis of depression and schizophrenia. Blood platelets have been used for years as a peripheral model of neuronal serotonin dynamics. The objective was to investigate platelet count and serotonin concentration in patients with depression and schizophrenia, in an attempt to ascertain their clinical usefulness.Methods 953 participants were included in the study, 329 patients with depression, 339 patients with schizophrenia and 285 healthy controls. ELISA was used to assess platelet serotonin concentrations.Results There were no statistically significant differences among groups regarding age, total platelet count and serotonin concentration. Linear regression analyses revealed inverse correlations between platelet serotonin concentration and age of patients with depression and healthy individuals, as well as between platelet serotonin concentration and illness duration in patients with schizophrenia. In other words, longer illness duration in patients with schizophrenia, and higher age in patients with depression and healthy individuals was associated with lower platelet serotonin concentrations.Conclusion Platelet count and serotonin concentration did not prove to be of diagnostic value in differentiating patients and healthy individuals. However, illness duration in patients with schizophrenia may be associated with reduced concentrations of platelet serotonin.
Objective The association between benzodiazepine use and the risk of cognitive impairment or dementia has been controversial. Our study aims to detect this association through a case/non-case method using the Korea Institute of Drug Safety & Risk Management-Korea adverse event reporting system database (KIDS-KD) between 2007 and 2016.Methods Cases were adverse event (AE)-pairs with suspected cognitive impairment or dementia. 10 non-cases were matched to each case on age and sex. Exposure was defined as use of benzodiazepines, including long-, intermediate-, and short-acting benzodiazepine. We conducted multivariable logistic regression analyses to estimate reporting odds ratios (ROR) and 95% confidence intervals (CI).Results Of the 1,086,584 AE-pairs, 887 cases were suspected AE-pairs of cognitive impairment or dementia, and 775,444 non-cases were selected. Benzodiazepine use was associated with increased AE-pairs of cognitive impairment or dementia when assessed using those with certain, probable, and/or possible in causality assessments (ROR=2.69, 95% CI=1.66–4.38). Higher ROR estimates were shown in female (2.33, 1.48–3.67) and in those with polypharmacy (2.20, 1.35–3.57). Dementia safety profiles were inconsistent across individual benzodiazepine components.Conclusion These results suggest the potentially increased association between benzodiazepine use and cognitive impairment or dementia in female and those with polypharmacy. Inconsistent safety profiles of benzodiazepine components should be further investigated.
Objective Observations of sex differences have led some scientists to doubt whether the neuroendocrine system is involved in attentiondeficit/hyperactivity disorder (ADHD) etiology. One of the interesting study subjects in this context is prenatal steroid hormone exposure. The aim of the present study was to replicate and extend previous work by addressing two research questions: 1) Are second-tofourth digit (2D:4D) ratios lower in ADHD than in controls? 2) Is there a correlation between 2D:4D ratios and symptoms of ADHD, aggression and intelligence scores in boys with ADHD?Methods The study included 100 treatment-naive male children diagnosed with ADHD and 55 healthy male children. We measured the ratios of 2D:4D and administered a Wechsler Intelligence Scale for Children-Revised to assess IQ scores, as well as behavioral rating scales, in children with ADHD and comparison individuals.Results We observed lower 2D:4D ratios in the right hand in ADHD in comparison to the control group. The left-hand ratios of 2D:4D, however, did not differ between ADHD and control groups. There were negative correlations between the left-hand 2D:4D ratios and the hyperactivity scores. However, no significant correlation was detected between right-hand 2D:4D ratios and the psychological questionnaire scores.Conclusion These results provide further evidence that fetal androgen exposure may contribute to the pathophysiology of ADHD, at least in boys.
Objective We aimed to compare cerebral beta-amyloid protein (Aβ) positivity rate and amyloid accumulation pattern on amyloid positron emission tomography (PET) between mild cognitive impairment (MCI) subtypes, i.e. amnestic mild cognitive impairment (aMCI) and non-amnestic mild cognitive impairment (naMCI).Methods The study participants were 34 naMCI patients and age-, sex- and education-matched 68 aMCI patients (1:2 ratio) who visited the Dementia and Age-Associated Cognitive Decline Clinic of the Seoul National University Hospital. All participants received comprehensive clinical and neuropsychological assessments and [<sup>18</sup>F] florbetaben PET.Results Aβ positivity rate of naMCI group (26.5%) was significantly lower than that of aMCI group (64.7%). Among Aβ positive individuals, there was no difference in Aβ accumulation pattern between naMCI and aMCI.Conclusion The findings suggest that MCI subtypes based on impaired cognitive domains have a differential association with brain Aβ deposition, a core pathology of AD. Amnestic subtype of MCI are more closely associated with cerebral Aβ deposition compared to nonamnestic subtype. In contrast, the pattern of amyloid deposition does not appear to have any difference between the subtypes.
Objective Disgust has been propounded as a potential etiological factor in certain sexual dysfunctions such as vaginismus. Studies reports that insular cortex is activated as a response to disgust. The present study aimed to investigate the predictive role of metabolites in insular cortex in response to group therapy among vaginismus patients.Methods Study sample consisted of 51 vaginismus patients attended an ambulatory group therapy, of whom 26 benefited from 8-week group therapy and 25 were unresponsive to group therapy. All of the patients underwent H magnetic resonance spectroscopy (H-MRS), and insular cortex N-acetyl aspartate (NAA), Creatinine (Cr), Glutamine (Gln), Glutathione (GSH), Choline (Cho), Myo-inositol (mIns), Glutamate (Glu) and Lactate (Lac) concentrations were compared between the groups.Results Comparing insular cortex metabolite concentrations between the groups, Cho was statistically significantly higher (p=0.005) but mIns was significantly lower (p=0.001) in the unresponsive to group therapy group.Conclusion MR spectroscopy findings of the present study indicated significant metabolic changes such as increased Cho/Cr ratio and decreased mIns/Cr ratio in the insular cortex of vaginismus patients who were unresponsive to group therapy. Our results support the studies suggesting that disgust is an important emotion in vaginismus patients and also that insula plays a role in the neurobiology of disgust.
Objective We aimed to explore the impact of moderate intensity exercise on the cortical thickness and subcortical volumes of preclinical Alzheimer’s disease (AD) patients.Methods Sixty-three preclinical AD patients with magnetic resonance imaging (MRI) and 18-florbetaben positron emission tomography (PET) data were enrolled in the study. Information on demographic characteristics, cognitive battery scores, self-reported exercise habits were attained. Structural magnetic resonance images were analyzed and processed using Freesurfer v6.0.Results Compared to Exercise group, Non-Exercise group demonstrated reduced cortical thickness in left parstriangularis, rostral middle frontal, entorhinal, superior frontal, lingual, superior parietal, lateral occipital, inferior parietal gyrus, temporal pole, precuneus, insula, fusiform gyrus, right precuneus, superiorparietal, lateral orbitofrontal, rostral middle frontal, medial orbitofrontal, superior frontal, lingual, middle temporal gyrus, insula, supramarginal, parahippocampal, paracentral gyrus. Volumes of right thalamus, caudate, putamen, pallidum, hippocampus, amygdala were also reduced in Non-Exercise group.Conclusion Moderate intensity exercise affects cortical and subcortical structures in preclinical AD patients. Thus, physical exercise has a potential to be an effective intervention to prevent future cognitive decline in those at high risk of AD.
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