While cognitive behavior therapy is considered to be the first-line therapy for adolescent depression, there are limited data on whether other psychotherapeutic techniques are also effective in treating adolescents with depression. This report suggests the potential application of eye movement desensitization and reprocessing (EMDR) for treatment of depressive disorder related, not to trauma, but to stressful life events. At present, EMDR has only been empirically validated for only trauma-related disorders such as posttraumatic stress disorder. Two teenagers with major depressive disorder (MDD) underwent three and seven sessions of EMDR aimed at memories of stressful life events. After treatment, their depressive symptoms decreased to the level of full remission, and the therapeutic gains were maintained after two and three months of follow up. The effectiveness of EMDR for depression is explained by the model of adaptive information processing. Given the powerful effects observed within a brief period of time, the authors suggest that further investigation of EMDR for depressive disorders is warranted.
Adolescent* ; Automatic Data Processing ; Cognitive Therapy ; Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Eye Movement Desensitization Reprocessing ; Eye Movements* ; Follow-Up Studies ; Humans ; Psychotherapy ; Stress Disorders, Post-Traumatic

OBJECTIVES: Psychiatric patients report higher rates of interpersonal trauma, and they present with more symptoms and behavioral problems. However, less is known about other anxiety disorders, except for posttraumatic stress disorder. In this study, we investigated symptomatic correlates of interpersonal trauma (i.e., physical or sexual assaults) in patients with heterogeneous anxiety disorders. METHODS: We surveyed a consecutive sample of 90 outpatients with DSM-IV anxiety disorders (panic disorder, generalized anxiety disorder, obsessive compulsive disorder, social phobia, anxiety disorder not otherwise specified) at the psychiatric department of a university-affiliated hospital. The questionnaire was comprised of the Symptom Checklist-90-Revised (SCL-90-R), Beck Depression Inventory, State and Trait Anxiety Inventory, and Impact of Events Scale-Revised. RESULTS: Patients with interpersonal trauma (n=51) demonstrated a significantly higher level of interpersonal sensitivity, paranoid ideation, and obsessive-compulsive subscale of the SCL-90-R. However, logistic regression analysis suggested that interpersonal sensitivity alone was suggested as the best fitting model. CONCLUSION: Anxiety disorder patients with interpersonal trauma demonstrated difficulty in domains of interpersonal relationship. Clinicians treating this population should consider this finding for better engagement and management.
Anxiety ; Anxiety Disorders ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Logistic Models ; Obsessive-Compulsive Disorder ; Outpatients ; Phobic Disorders ; Surveys and Questionnaires ; Stress Disorders, Post-Traumatic

Paruresis is a special type of non-generalized social phobia that involves fear and avoidance of urination in public restrooms. We administered eight 60-minute sessions of desensitization of triggers and urge reduction (DeTUR), an addiction protocol of eye movement desensitization and reprocessing (EMDR) therapy, to a 29-year old man with paruresis of 10 year duration. Because phobic avoidance is the hallmark of any anxiety disorder, we applied DeTUR targeting the urge to avoid each anxiety-provoking situation in succession. After treatment, the participant no longer met the requirements for a diagnosis of social anxiety disorder, and the self-reported symptoms of social anxiety had decreased to non-clinical levels; furthermore, these treatment gains were maintained at the one-year follow-up. Further clinical studies are needed to generalize this finding.
Anxiety ; Anxiety Disorders ; Diagnosis ; Eye Movements ; Follow-Up Studies ; Phobic Disorders ; Urination

OBJECTIVES: A growing body of literature supports the view that experiences of psychotic symptoms or involuntary admission may act as traumatic events which cause post-traumatic stress disorder (PTSD). Authors report three cases of postpsychotic (PP) PTSD developed in the course of schizophrenic illness. METHODS: Clinician-administered PTSD Scale (CAPS) and Positive and Negative Syndrome Scale for Schizophrenia (PANSS) were administered for evaluation of symptomatology. RESULTS: Two cases represented PP/PTSD caused by psychotic symptoms, especially auditory and visual hallucination, and one case by forced involuntary admissions. All three cases met DSM-IV diagnostic criteria of PTSD. The severity was mild in the range of 48 to 51 by CAPS. CONCLUSION: PP/PTSD developed during or soon after psychotic episodes and persisted for as long as nine years. Clinicians working with individuals with psychotic disorders should keep in mind that some portion of their patients may suffer from lingering posttraumatic effect of psychotic episode -related experiences.
Diagnostic and Statistical Manual of Mental Disorders ; Hallucinations ; Humans ; Psychotic Disorders ; Schizophrenia* ; Stress Disorders, Post-Traumatic*

OBJECTIVES: The symptomatic and behavioral correlates of childhood trauma in schizophrenia are beginning to emerge in the literature. This study aimed to investigate whether the association between personality traits and schizophrenia with childhood abuse can be replicated in Koreans using the Multiphasic Minnesota Personality Inventory (MMPI). METHODS: Eighteen schizophrenias with childhood abuse and 24 schizophrenic comparisons without abuse history were recruited at the inpatient units of two general hospitals and the subjects completed the MMPI. RESULTS: Subjects with schizophrenia plus childhood history of abuse had less educational years (p<.001). After controlling the educational year as a covariate, abused schizophrenic patients had higher scores in the Schizotypal (p=.003), Dependent (p=.014), Passive-aggressive (p=.034), Borderline (p=.045) subscales. For the validity and clinical subscales, significant differences were found in the F scale (p=.036), Hypochondriasis (p=.042), Depression (p<.001), Hysteria (p=.002), Personality disorder (p=.001), Paranoia (p=.024), Psychasthenia (p=.001) and Schizophrenia (p=.006) subscales. CONCLUSION: Our findings suggest that childhood abuse in schizophrenia is associated with more complex features of personality characteristics rather than specific cluster B personality traits.
Adult* ; Child ; Child Abuse ; Depression ; Hospitals, General ; Humans ; Hypochondriasis ; Hysteria ; Inpatients ; Minnesota ; MMPI* ; Paranoid Disorders ; Personality Disorders ; Personality Inventory ; Schizophrenia* ; Sex Offenses*

OBJECTIVES: Delirium is commonly seen in clinical settings, and it can substantially influence the prognosis of patients. In this study, we investigated delirium with respect to its severity, classification and characteristics on each subtype. METHODS: Severity of delirium was examined in delirium patients, who were referred to the department of psychiatry in a general hospital for multidisciplinary treatment. After classification based on subtypes, factors influencing these aspects of delirium were examined. RESULTS: Among the 193 consultation-liaison patients referred to the department of psychiatry in a general hospital, 61 patients (31.6%) were diagnosed with delirium. Compared to patients in the non-delirium group, patients in the delirium group were older, had a shorter education period, and medical history of surgery. Among the delirium patients, the hyperactive subtype was found to be the most common (57.4%) and patients with the mixed subtype showed the highest severity score for delirium symptoms. In addition, the patient with the hypoactive subtype had a higher frequency of medical history of depression compared to those with the other subtypes. CONCLUSION: People with symptoms of hypoactive delirium can be misdiagnosed due to recurrence of depression, therefore, careful examination is required, particularly in patients with a history of depression.
Classification ; Delirium* ; Depression ; Education ; Hospitals, General ; Humans ; Prognosis ; Recurrence

OBJECTIVES: The aim of this study was to investigate the treatment effect and predictors of response of affect regulation group therapy (ARGT) delivered to a group of recently traumatized children. METHODS: A total of 464 school children, who had witnessed or confronted a tragic accident at school, were given a single-session of affect regulation group therapy, that which included psychoeducation and affect regulation elements from eye movement desensitization and reprocessing. Of 213 children whose with initial score of Subject Unit of Disturbance Scale (SUDS) score over 4, we compared pre- and post-treatment scores and performed conducted the responder vs. non-responder comparison. The pPost-traumatic disorder (PTSD) symptom scores measured by using Child Reaction to Traumatic Events Scale-Revised (CRTES-R), demographic variables, and clinical variables were considered. RESULTS: Affect regulation group therapy was effective for children who had experienced an acute traumatic event (t=16.3, p<0.001). Baseline SUDS score of for non-responder were was significantly higher (t=-2.89, p<0.001) and CRTES-R score approached a level of significance level (t=-1.72, p=0.09). However, results of logistic regression analysis identified showed that the pretreatment SUDS score was the only significant predictor of non-response. CONCLUSION: Affect regulation group therapy appeared to be effective for children who had undergone experienced an acute traumatic event. And in addition, the survivors' subjective distress was more important to treatment response than severity of PTSD symptoms severity.
Child* ; Eye Movement Desensitization Reprocessing ; Eye Movements ; Humans ; Logistic Models ; Psychotherapy, Group* ; Stress Disorders, Post-Traumatic ; Stress Disorders, Traumatic, Acute

OBJECTIVE: This study is to suggest the plans for improving the quality of lives of the solitary old people by evaluating the effects of depression, social supports, and activity of daily living to the quality of life. METHODS: The subjects of this research were 329 elderly people who lived alone in Gangseo-gu, Seoul, Korea. They were recruited and underwent the questionnaire including their sociodemographic data, Activities of Daily Living/Instrumental Activities of Daily Living scale (ADL/IADL) and the Korean version of the Short Geriatric Depression Scale (SGDS-K). Statistical analyses including Pearson's correlation test, multiple regression were performed in this study. RESULTS: They were composed of 83.6% females and 16.4% males and almost age was between 70 and 84 years old. House welfare availability (p<0.05), subjective economic status (p<0.05), and SGDS-K score (p<0.01) had a negative correlation with Quality of life. Multiple regression analysis revealed that Quality of life correlates to SGDS-K score (p<0.05). CONCLUSION: The quality of life of elderly living alone was related with depression. Early detection and management for depression may need to be considered for quality of life of community dwelling elderly living alone.
Activities of Daily Living ; Aged* ; Depression* ; Female ; Humans ; Korea ; Male ; Quality of Life* ; Surveys and Questionnaires ; Seoul

OBJECTIVE: The purpose of this study was to examine the relationship between suicidal ideation and the associated with sociodemographic and clinical factors in community dwelling, elderly living alone in Korea. METHODS: A total of the 329 community-dwelling elderly aged 65 years or older who lived alone were recruited and they underwent the questionnaire including their sociodemographic data, Activities of Daily Living/Instrumental Activities of Daily Living scale (ADL/IADL) and the Korean version of the Short Geriatric Depression Scale (SGDS-K). Suicidal ideation was evaluated by using the "suicidal thought" item of the Beck Depression Inventory (BDI). RESULTS: According to the result of our sample of elderly living alone, 22.8% of the subjects reported their suicidal ideation. ADL/IADL score (p<0.01), subjective economic status (p<0.05), and subjective health status (p<0.05) had a negative correlation with suicidal ideation. SGDS-K score (p<0.05) had positive correlations with suicidal ideation. Multiple regression analysis revealed that suicidal ideation correlates to ADL/IADL score (p=0.025). CONCLUSION: This study exhibit that ADL/IADL is significantly associated with suicidal ideation.
Activities of Daily Living ; Aged* ; Depression ; Humans ; Korea ; Surveys and Questionnaires ; Suicidal Ideation* ; Suicide

A number of recent case reports and series indicate that obsessive compulsive disorder (OCD) can develop after traumatic experience as a comorbid conditon to post-traumatic stress disorder (PTSD). These descriptive studies consistently addressed that those patients respond poorly to treatments and had an unfavorable outcome. However, this conclusion was not supported by prospective follow up with objective measurement of symptomatology. This report presents three single trauma-related PTSD patients who developed full-blown OCD concurrently with or after the initiation of PTSD. These patients represent 10% of new PTSD outpatients at a PTSD clinic during one year period and 25% of PTSD patients who had been admitted. In all three cases compulsion seemed to distract or serve as avoidance to intrusive symptoms of PTSD. Despite Eye Movement Desensitization and Reprocessing (EMDR) and/or exposure therapy for PTSD together with at least two antidepressant trials for PTSD and OCD, at six month follow-up PTSD partially improved and OCD remained unchanged. This finding is consistent with previous reports from western literature.
Eye Movements ; Follow-Up Studies* ; Humans ; Implosive Therapy ; Obsessive-Compulsive Disorder* ; Outpatients ; Stress Disorders, Post-Traumatic