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

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

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 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*

OBJECTIVE: The ratio of 2nd to 4th digit length (2D:4D) is a sexually dimorphic trait. Men have a relatively shorter second digit than fourth digit. This ratio is thought to be influenced by higher prenatal testosterone level or greater sensitivity to androgen. The purpose of this study is to investigate the relationship between alcohol dependence and 2D:4D in a Korean sample and whether 2D:4D can be a biologic marker in alcohol dependence. METHODS: In this study, we recruited 87 male patients with alcohol dependence from the alcohol center of one psychiatric hospital and 52 healthy male volunteers who were all employees in the same hospital as controls. We captured images of the right and left hands of patients and controls using a scanner and extracted data with a graphics program. We measured the 2D:4D of each hand and compared the alcohol dependence group with the control group. We analyzed these ratios using an independent-samples t-test. RESULTS: The mean 2D:4D of patients was 0.934 (right hand) and 0.942 (left hand), while the mean 2D:4D of controls was 0.956 (right hand) and 0.958 (left hand). Values for both hands were significantly lower for patients than controls (p<0.001, right hand; p=0.004, left hand). CONCLUSION: Patients who are alcohol dependent have a significantly lower 2D:4D than controls, similar to the results of previous studies, which suggest that a higher prenatal testosterone level in the gonadal period is related to alcoholism. Furthermore, 2D:4D is a possible predictive marker of alcohol dependence.
Alcoholism ; Biomarkers ; Epigenesis, Genetic ; Gonads ; Hand ; Hospitals, Psychiatric ; Humans ; Male ; Testosterone ; Volunteers

OBJECTIVE: The Life Events Checklist is a brief screening instrument that is used for potentially traumatic events such as accidents, disasters, sexual or physical assaults, or combat-related exposures. The original English version was recently tested for reliability and validity and it showed good psychometric properties, and so its use is recommended for the assessment of trauma. METHODS: This study investigated the reliability and validity of a Life Events Checklist-Korean version in 157 consecutive psychiatric outpatients at a university-affiliated teaching hospital. The questionnaire also included the Impact of Events Scale-Revised (IES-R), the Beck Depression Inventory (BDI), and the State and Trait Anxiety Inventory (STAI). Correlation and principal component analyses were conducted. RESULTS: The four week test-retest reliability was good and the internal consistency was acceptable. In addition, the number of traumatic events was significantly correlated with the posttraumatic depressive and anxiety symptoms, which demonstrated the convergent validity of the scale. Additionally, exploratory factor analysis identified a six-factor structure that explained 57.2% of the total variance. CONCLUSION: These findings support the reliability and validity of the Life Events Checklist-Korean version.
Anxiety ; Checklist ; Depression ; Disasters ; Factor Analysis, Statistical ; Hospitals, Teaching ; Humans ; Life Change Events ; Mass Screening ; Outpatients ; Principal Component Analysis ; Psychometrics* ; Surveys and Questionnaires ; Reproducibility of Results

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

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*