OBJECTIVES: The prevalence of psychiatric disorders in homeless people is higher than the prevalence in a general population. With the increasing interests in homeless people after the economic crisis in Korea, psychiatrists started to investigate the prevalence of psychiatric disorders in homeless people. This study is to assess the prevalence of psychiatric disorders in homeless men living in a city shelter in Seoul and to compare these results with those of previous epiaemiological studies in Korea of homeless people and abroad. METHODS: Among 960 homeless men living in a city shelter in Seoul, 420 men were selected randomly from December 14 to December 29, 1999. Eight trained interviewer administered the Korean version of Composite International Diagnostic Interview (K-CIDI) to the subjects. The lifetime, one-year, and one-month prevalence of the psychiatric disorders in this study were compared to those of the previous studies of Korean general population and of homeless people abroad. RESULTS: The lifetime, one-year, and one-month prevalence of total psychiatric disorders were 71.7%, 49.8% and 45.0% respectively. The lifetime prevalence of nicotine dependence/withdrawal, alcohol use disorders (abuse/dependence), substance use disorders, major depressive disorder, psychotic disorders, and anxiety disorders were 31.0%, 58.6% (39.3%/19.3%), 3.1%, 11.7%, 2.4%, and 16.9% respectively. CONCLUSION: This study suggested that the prevalence of psychiatric disorders in homeless men is higher than the prevalence in general population, as the previous studies in Korea. The prevalence of alcohol use disorder was highest. The prevalence of non-alcohol substance use disorder and psychotic disorder were lower than the prevalence of these disorders in homeless people of other countries. These results suggest that there is a need to treat the psychiatric disorders, especially alcohol use disorder which is the major psychiatric problem in homeless men.
Anxiety Disorders ; Depressive Disorder, Major ; Epidemiology ; Humans ; Korea ; Male* ; Multiple Endocrine Neoplasia Type 1 ; Nicotine ; Prevalence* ; Psychiatry ; Psychotic Disorders ; Seoul ; Substance-Related Disorders

BACKGROUND: Clinicians broadly accept the Global Deterioration Scale (GDS) as a staging measure for dementia. The aim of this study is to test the inter-rater reliability and concurrent validity of the Korean version of GDS. METHODS: Participants included 34 subjects without dementia and 41 patients with Alzheimer's disease, in addition to 37 patients with vascular dementia. A rater, using a semi-structured clinical interview, interviewed the participants and their informed collateral sources. To obtain the concurrent validity, all participants received the Korean Mini-Mental State Examination (K-MMSE), the Korean version of Syndrome Kurz Test (K-SKT) and a 15-items abbreviated Korean-Boston Naming Test (K-BNT) on the same day. We also tested the inter-rater reliability among the four raters using a videotape design. RESULTS: The agreements of the overall GDS ratings by the four raters were high (kappa, 0.93-1.0). GDS correlated significantly with K-MMSE, K-SKT, and the abbreviated K-BNT and Clinical Dementia Rating scale. CONCLUSION: The Korean version of GDS may be a reliable and valid tool to be used as a staging measure for Korean patients with Alzheimer's disease as well as vascular dementia.
Alzheimer Disease ; Dementia ; Dementia, Vascular ; Humans ; Videotape Recording

BACKGROUND/AIMS: In chronic inflammatory conditions such as ulcerative colitis (UC), the migration of granulocytes and monocytes/macrophages from the circulation into the colonic mucosa is especially important in maintaining inflammation. The aim of this trial was to assess safety and efficacy of granulocyte and monocyte adsorption apheresis in patients with moderate-to-severe UC refractory to conventional drug therapies. METHODS: Twenty-seven patients with moderate (55.6%) to severe (44.4%) active UC refractory to conventional drug therapies who had no changes in their conventional therapy regimen in the past two weeks before the recruitment were enrolled in an open-label trial. Concomitant medications were allowed, and steroids were tapered down according to the clinical activity during the course. We used an adsorptive type extracorporeal column (Adacolumn(R); JIMRO, Takasaki, Japan), which selectively adsorb granulocytes and monocytes. Patients took five apheresis sessions, each with 60 minutes duration for 5 consecutive weeks. The primary efficacy variables were clinical disease activity, short inflammatory bowel disease questionnaire (SIBDQ), C-reactive protein (CRP), and endoscopic scores. These variables were scored at regular intervals, and analyzed at week 7 on an intention-to-treat (ITT) principles. RESULTS: At 7 weeks, 70.4% of patients showed overall improvement. Clinical disease activity (p<0.0001), endoscopic score (p<0.001), and the quality of life as assessed by SIBDQ (p<0.0001) were significantly improved after the therapy. In 56.3% of concomitant steroid users, tapering down or discontinuation of steroids was possible. Treatment was well tolerated, and no severe adverse events were observed. CONCLUSIONS: Adacolumn was very efficacious in patients with moderate-to-severe active UC refractory to conventional drug therapy, but further assessment is needed.
Adult ; Colitis, Ulcerative/*therapy ; English Abstract ; Female ; *Granulocytes ; Humans ; *Leukapheresis ; Male ; *Monocytes

BACKGROUND: The Clinical Dementia Rating (CDR) scale is broadly accepted by clinicians as a staging measure for dementia. The aim of this study was to test inter-rater reliability and concurrent validity of the Korean version of the CDR. METHODS: Participants included 34 persons without dementia and 41 patients with Alzheimer's disease, and 37 patients with vascular dementia. The participants and their informed collateral sources were interviewed by a rater using a semistructured clinical interview. To obtain concurrent validity, all the participants received K-MMSE, K-SKT (Syndrom Kurz Test), and a 15-items abbreviated K-BNT on the same day. We also tested inter-rater reliability among four raters using a videotape design. RESULTS: Agreements of the overall CDR ratings (kappa, 0.86-1.0) and Sum of Boxes of CDR (CDR-SB) (gamma, 0.89-1.0) by the four raters were high. Both global CDR and CDR-SB correlated significantly with K-MMSE, K-SKT and the abbreviated K-BNT. The Orientation and Memory box score correlated significantly with orientation and memory scores of K-MMSE. CONCLUSIONS: The Korean version of CDR appears to be a reliable and valid tool as a staging measure for Korean dementia patients.
Alzheimer Disease ; Dementia* ; Dementia, Vascular ; Humans ; Memory ; Videotape Recording

BACKGROUND/AIMS: This randomized, double-blind, phase III, multicenter trial was carried out to compare the efficacy and safety of revaprazan, a novel acid pump antagonist, with that of omeprazole in patients with more than one of gastric ulcers. METHODS: Two hundred and ninety two subjects were randomized to 4~8 weeks of treatment with either revaprazan 200 mg or omeprazole 20 mg. The primary efficacy parameter was the cumulative healing rate determined by endoscopy after 4 and 8 weeks of treatment, and the secondary efficacy parameter was an improvement rate of pain. RESULTS: The intention-to-treat analysis revealed revaprazan and omeprazole to have similar cumulative healing rates (93.0% and 89.6%, respectively; p=0.3038). The per-protocol analysis revealed revaprazan and omeprazole to also have similar cumulative healing rates (99.1% and 100%, respectively; p= 0.3229). In both analyses, there were no significant differences in an improvement rate of pain between the two groups. Both drugs were well tolerated. CONCLUSIONS: Revaprazan has similar efficacy to omeprazole in the treatment of patients with gastric ulcer with a once a day application of revaprazan 200 mg or omeprazole 20 mg over a 4 to 8-week period. In terms of safety, revaprazan was well tolerated.
Endoscopy ; Humans ; Omeprazole ; Stomach Ulcer*

BACKGROUND/AIMS: We performed a randomized, double-blind, phase III, multicenter trial to assess the comparative efficacy and safety of revaprazan, which is a novel acid pump antagonist in comparison with ranitidine for treating patients suffering with acute gastritis and acute aggravation of chronic gastritis. METHODS: Five hundred and twelve subjects were randomized to 2 weeks of treatment with either revaprazan 200 mg q.d. or ranitidine 150 mg b.i.d. The primary efficacy parameter was the estimated improvement rate according to endoscopy, and the secondary efficacy parameter was the improvement rate for the subjects' symptoms. RESULTS: The estimated improvement rates at 2 weeks (intention-to-treat analysis) were 79.9% with revaprazan and 60.5% with ranitidine; a significant difference was found between the two groups (p<0.0001). On the per-protocol analysis, the estimated improvement rates for revaprazan and ranitidine were 79.4% and 60.2%, respectively. There was a significant difference in the estimated improvement rates between the two groups (p<0.0001). On both analyses, there were no significant differences between the two groups for the improvement rates of the subjects' symptoms. Both drugs were well tolerated. CONCLUSIONS: The efficacy of revaprazan was higher than that of ranitidine for the estimated improvement rate according to endoscopy and also for the symptomatological improvement rate, and revaprazan was well tolerated by the subjects suffering with gastritis.
Endoscopy ; Gastritis* ; Humans ; Ranitidine

BACKGROUND/AIMS: To assess the comparative efficacy and safety of revaprazan, a novel acid pump antagonist, versus omeprazole in patients with duodenal ulcer, we performed a randomized, double-blind, phase III, multicenter trial. METHODS: Two hundred and twenty eight patients were randomized to 4 weeks of treatment with either revaprazan 200 mg or omeprazole 20 mg once daily. Primary efficacy parameter was complete ulcer healing by endoscopy, and secondary parameter was the improvement in the severity of daytime and nighttime pain. RESULTS: Healing rates at 4 weeks (intention-to-treat analysis) were 91.7% with revaprazan 200 mg and 91.3% with omeprazole 20 mg; there were no significant differences between two groups (p=0.9228). In per-protocol analysis, healing rates of revaprazan 200 mg and omeprazole 20 mg were 94.4% and 92.3%, respectively. There was no significant difference in healing rate between two groups (p=0.5666). There was no significant difference between two groups in improvement rates of daytime and nighttime pain. Both drugs were well tolerated. CONCLUSIONS: Revaprazan 200 mg was equivalent to omeprazole 20 mg for both ulcer healing and symptom relief, and was well tolerated in patients with duodenal ulcer.
Duodenal Ulcer* ; Endoscopy ; Humans ; Omeprazole ; Ulcer