No abstract available.
Myoclonus*

Acamprosate reduces the craving for alcohol by decreasing glutamate activity and increasing gamma-aminobutyric acid (GABA) action in patients with alcohol dependence. Acamprosate has tolerable side effects that include diarrhea, headache, dizziness and pruritus. In this study, we report acamprosate-induced extrapyramidal symptoms in an elderly patient with no history of neurologic disease. Severe extrapyramidal symptoms developed two days after the administration of acamprosate and improved over one week after the acamprosate was stopped. Extrapyramidal symptoms are commonly associated with dopamine receptor antagonists. However, there have been several reports of extrapyramidal symptoms occurring with drugs targeting other systems, including GABA, glutamate and serotonin. Acamprosate may decrease dopamine levels in the ventral tegmental area mediated by glutamatergic action and thus cause extrapyramidal symptoms. We suggest that acamprosate carries the risk of causing extrapyramidal symptoms.
Aged* ; Alcoholism* ; Diarrhea ; Dizziness ; Dopamine ; Dopamine Antagonists ; gamma-Aminobutyric Acid ; Glutamic Acid ; Headache ; Humans ; Pruritus ; Serotonin ; Ventral Tegmental Area

OBJECTIVES: The purpose of this study is to analyze a changing picture of the delusional types and contents in Korean adolescent psychotic patients during the last three decades. METHODS: The subjects were Korean adolescent psychotic patients with definite delusion who had been admitted to Kyungpook University Hospital and classified into three groups:the first group consisting of 39 patients from January 1, 1977 to December 12, 1978;the second group consisting of 41 patients from January 1, 1987 to December 12, 1988;the third group consisting of 44 patients from January 1, 1997 to December 12, 1998. RESULTS: 1) There was no significant difference in sex, age, religion, and parent distributions in three groups. The ratio of college or university graduates was increased in third group. As to birth order, the ratio of the eldest in third group was higher than that in the first two groups. 2) With respect to delusional type, persecutory delusion was the most common in the three groups. With regard to delusional content, delusion with friend theme was the most common and the frequency of it had been increasing. 3) In case of males, frequencies of reference delusion and delusion with friend theme had been increasing, whereas frequency of delusion with superpower theme decreasing. In case of females, frequencies of grandiose delusion and delusion with superpower theme had been increasing. 4) In case of 18-21 agers, frequencies of persecutory delusion and delusion with friend theme had been increasing. The type and content of delusion became diverse as age increased in the three groups. CONCLUSIONS: The results suggest that recent shifts in adolescent culture in Korea have had influence on the content of delusion in adolescent psychotic patients.
Adolescent* ; Birth Order ; Delusions* ; Female ; Friends ; Gyeongsangbuk-do ; Humans ; Korea ; Male ; Parents

OBJECTIVES: Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. METHODS: Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. RESULTS: Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p< 0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after di-agnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. CONCLUSIONS: We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.
Breast ; Breast Neoplasms* ; Delayed Diagnosis* ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Logistic Models ; Mammography ; Marriage* ; Mass Screening ; Mortality ; Psychology* ; Risk Factors ; Time-to-Treatment

OBJECTIVES: The purpose of this study is to evaluate the effects of attachment security, social support and health-related burden in the prediction of psychological distress and the mediation effects of social support and health-related burden in relationship between attachment security and psychological distress. METHODS: Finally, 161 patients were included for the analysis. Chi-square test and independent samples t-test were used for comparing differences between depressive/anxious group and non-depressive/non-anxious group. For evaluating the relationship among attachment security, social support, psychological distress and health-related burden, structural equation modeling analysis were performed. RESULTS: 40.7% and 32.0% of the patients have significant depressive symptoms and anxiety symptoms, respectively. In the analysis for testing the differences between groups who have psychological distress and who have not, there were no significant differences of sociodemographic factors and medical characteristics between groups, except for association between depressive symptoms and type of surgery (p = 0.01). Contrary to sociodemographic and medical characteristics, there were significant differences of health-related burden and two coping resources (attachment security and social support) between groups (all p < 0.01), except for the support from medical team in between anxious group and non-anxious group (p = 0.20). In the structural equation model analysis (Model fit : chi-square/df ratio = 0.8, root mean square error of approximation = 0.000, comparative fit index = 1.000, non-normed fit index =0.991), attachment security and social support emerged as an important predictor of psychopathology. CONCLUSIONS: Attachment security and social support are important factors affecting the psychological distress. We suggest that individual attachment style and the social support state must be considered to approach the newly diagnosed breast cancer patients with psychological distress.
Anxiety ; Breast Neoplasms* ; Depression ; Humans ; Negotiating ; Psychopathology ; Social Security

OBJECTIVE: The Modified Experiences in Close Relationships (ECR-M36) scale was developed for medically ill, older individuals in 2008 (Toronto, Canada, department of psychosocial oncology and palliative care, Princess Margaret Hospital). The scale has displayed satisfactory reliability and validity. This study aimed to test the reliability and validity of the Korean version of Modified Experiences in Close Relationships (K-ECR-M36) questionnaire in female patients with breast cancer. METHODS: A total of 199 post-operative breast cancer patients completed the K-ECR-M36 as well as other psychological measures including the Revised Adult Attachment Scale (RAAS), World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF), and Hospital Anxiety and Depression Scale (HADS). The reliability and validity of the K-ECR-M36 were evaluated. Explorative factor analysis was conducted to identify the factor structure of the K-ECR-M36. RESULTS: The K-ECR-M36 showed good internal consistency (Cronbach's alpha=0.87) and reasonable test-retest reliability (r=0.752, p<0.001). The total as well as avoidance and anxiety subscales demonstrated construct validity with the RAAS, the HADS, and the WHOQOL-BREF. Factor analysis revealed four-factor structure which was originally proposed by Brennan, Clark, and Shaver (1998). CONCLUSION: These findings support that the K-ECR-M36 has satisfactory reliability, validity and factor structure among patients with breast cancer.
Adult* ; Anxiety ; Breast Neoplasms ; Canada ; Depression ; Female ; Humans ; Palliative Care ; Quality of Life ; Reproducibility of Results* ; World Health Organization

OBJECTIVES: The aim of this study was to develop the Reciprocal Attachment Questionnaire-Korean version (RAQ-K). METHODS: The authors tested the reliability of dimensional and pattern scales of RAQ-K with Crohnbach's alpha, test-retest reliability and interscale correlation, and construct validity with factor analysis. The subjects were Korean undergraduate students: 234 males and 249 females in the medical and nursing schools of Kyungpook National University. RESULTS: The dimensional scale of RAQ-K proved to be reliable in terms of Crohnbach's alpha coefficient except Availability and Use subscales, test-retest reliability and interscale correlation. The pattern scales of RAQ-K were reliable. Both dimensional and pattern scales were valid with two factor orthogonal rotation. CONCLUSION: The authors found RAQ-K retained available psychometric properties. But further study with some consideration to develop RAQ-K is expected. This research should assess samples of various age groups or various kinds of patients after considering two subscales. The authors stress that it is very important to consider the cultural difference between the East and the West and characteristics of Korean culture in developing a Korean version of foreign scales.
Female ; Gyeongsangbuk-do ; Humans ; Male ; Psychometrics ; Surveys and Questionnaires* ; Reproducibility of Results* ; Schools, Nursing ; Weights and Measures

OBJECTIVE: The Body Image Scale (BIS) developed in collaboration with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Study Group is a brief questionnaire for measuring body image concerns in patients with cancer. This study sought to assess the reliability and validity of the Korean version of the Body Image Scale (K-BIS). METHODS: The participants consisted of 155 postoperative breast cancer patients (56 breast conserving surgery, 56 mastectomy, and 43 oncoplastic surgery). Subjects were evaluated using the K-BIS, the Body-Esteem Scale for Adolescents and Adults (BESAA), the Rosenberg Self-Esteem Scale (RSES), the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). Test-retest reliability and internal consistency were examined as a measure of reliability and validity was evaluated by convergent validity, discriminant validity and factor analysis. RESULTS: Cronbach's alpha value was 0.943. The total score of the K-BIS was negatively correlated with the BESAA (r=0.301, p<0.001) and the body image facet in the WHOQOL-BREF (r=0.315, p<0.001). The total score of K-BIS positively correlated with the HADS (HAD-A: r=0.501, p<0.001, HAD-D: r=0.466, p<0.001). As for determining discriminant validity, scores were compared between the BCS subgroup, mastectomy subgroup, and oncoplastic surgery subgroup. Difference between the mastectomy subgroup and oncoplastic surgery subgroup was statistically significant (p=0.017). Factor analysis resulted in a single factor solution in three out of four anlyses, accounting for >59% variance. CONCLUSION: The K-BIS showed good reliability and validity for assessment of body image in Korean breast cancer patients.
Accounting ; Adolescent ; Adult ; Anxiety ; Body Image ; Breast ; Breast Neoplasms ; Cooperative Behavior ; Dapsone ; Depression ; Humans ; Mastectomy ; Mastectomy, Segmental ; Quality of Life ; Surveys and Questionnaires ; Reproducibility of Results ; World Health Organization

OBJECTIVE: To identify attachment insecurity as an associative factor with unresolved psychological distress 1 year after surgery in the early breast cancer (BC) population. METHODS: One-hundred fourteen participants completed the Hospital Anxiety and Depression Scale (HADS) and the Experiences in Close Relationship (ECR-M36) questionnaire within 1 week (baseline) and at 1-year post-surgery (follow-up). Participants were categorized into the distress and the non-distress groups based on a HADS-total score cut-off of 15. Logistic regression analysis revealed predictive factors of distress at follow-up. RESULTS: At baseline, 53 (46.5%) participants were found to be in the distress group. The degree of distress decreased over 1 year (p= 0.003); however, 43 (37.7%) showed significant remaining distress at follow-up. Baseline scores of the ECR-M36 avoidance [odds ratio (OR)=1.045, 95% confidence interval (CI)=1.002–1.090] and HADS-total (OR=1.138, 95% CI=1.043–1.241) were predictors of distress at follow-up. CONCLUSION: A substantial proportion of early BC patients suffer distress even one-year after surgery. Avoidant attachment appeared to be an influential factor on distress in early BC patients. Moreover, the finding that initial distress level could predict one at 1-year post-operation warrant a screening and management of distress along with BC treatment.
Anxiety ; Breast Neoplasms* ; Breast* ; Depression ; Follow-Up Studies* ; Humans ; Logistic Models ; Mass Screening

OBJECTIVES: The individual's ability to recognize and describe emotion in self and others is an important concept of many psychiatric disorders. The purpose of this study was to investigate emotional awareness deficits in patients with alcohol dependence. METHODS: 55 male inpatients with alcohol dependence and 28 male normal controls were evaluated by the Korean version of the Levels of Emotional Awareness Scale (LEAS-K), the Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K), the Openness Experience Inventory (OEI) and the Beck Depression Inventory (BDI). The LEAS-K is an objective measure to assess the ability to be aware of one's own or another's emotions and the TAS-20 is the most widely used subjective measure of alexithymia. Scores of these scales were compared between two groups using ANCOVA controlling age and BDI scores. RESULTS: The LEAS-K scores were significantly lower in alcohol-dependent patients than normal controls. The TAS-20K total scores, factor 1 (Difficulty to Identifying Feeling, DIF) and factor 3 (Externally Oriented Thinking, EOT) were significantly higher in alcohol-dependent patients than normal controls. In contrast to the LEAS-K, the TAS-20K scores correlated significantly with the BDI scores. CONCLUSION: Emotional awareness is impaired in alcohol-dependent patients and it may not be related with depressive mood. Additional studies are needed to explore the significance of alexithymia, especially impaired emotional awareness, and its relationship to depressive mood in patients with alcohol dependence.
Affective Symptoms ; Alcoholism ; Depression ; Humans ; Inpatients ; Male ; Thinking ; Weights and Measures