OBJECTIVES : Whether bipolar II disorder (BP-II) is simply a milder form of bipolar I disorder (BP-I) or a valid diagnostic category that could be separated from BP-I, is an issue still under consideration. Investigations exploring differential clinical and biological features of the two conditions are needed to resolve the controversies. This study aimed to obtain a comprehensive view of differences in clinical course and symptoms characteristics between BP-I and BP-II. METHODS : 44 BP-I and 26 BP-II patients were assessed using the Diagnostic Interview for Genetic Studies (DIGS), Korean version. Demographic data, age at onset, number of (hypo) manic/ depressive episodes, the duration of illness, polarity at onset, seasonality, rapid cycling, atypical depression and symptom profiles of each episode were evaluated. RESULTS : BP-II patients experienced depressive episodes more frequently than BP-I patients after illness onset (U=240.5, p=0.008). More BP-II patients showed seasonality (34.9% vs. 61.5%) and a rapid cycling course (4.5% vs. 18.2%). When comparing symptom profiles of manic/hypomanic episodes, irritable mood, decreased sleep need, inattention, reckless behavior, arrogant/provocative attitude and frequent outbursts of anger were less encountered in BP-II patients. In depressive episodes, leaden paralysis and psychomotor agitation were more frequently observed in BP-II patients. There was no significant difference between the two groups in psychotic symptoms of depressive episode. CONCLUSION : BP-I and BP-II disorders showed differences in clinical courses and symptom profiles. BP-II disorder seems to be less severe than BP-I disorder with regard to the intensity of manic symptoms, but more severe with respect to frequencies of depressive episodes. These results provide additional evidence supporting the distinction of BP-I and BP-II as separate diagnos-tic categories that might have different genetic profiles and/or biological mechanisms.
Anger ; Depression ; Humans ; Irritable Mood ; Paralysis ; Psychomotor Agitation ; Seasons

OBJECTIVES : Whether bipolar II disorder (BP-II) is simply a milder form of bipolar I disorder (BP-I) or a valid diagnostic category that could be separated from BP-I, is an issue still under consideration. Investigations exploring differential clinical and biological features of the two conditions are needed to resolve the controversies. This study aimed to obtain a comprehensive view of differences in clinical course and symptoms characteristics between BP-I and BP-II. METHODS : 44 BP-I and 26 BP-II patients were assessed using the Diagnostic Interview for Genetic Studies (DIGS), Korean version. Demographic data, age at onset, number of (hypo) manic/ depressive episodes, the duration of illness, polarity at onset, seasonality, rapid cycling, atypical depression and symptom profiles of each episode were evaluated. RESULTS : BP-II patients experienced depressive episodes more frequently than BP-I patients after illness onset (U=240.5, p=0.008). More BP-II patients showed seasonality (34.9% vs. 61.5%) and a rapid cycling course (4.5% vs. 18.2%). When comparing symptom profiles of manic/hypomanic episodes, irritable mood, decreased sleep need, inattention, reckless behavior, arrogant/provocative attitude and frequent outbursts of anger were less encountered in BP-II patients. In depressive episodes, leaden paralysis and psychomotor agitation were more frequently observed in BP-II patients. There was no significant difference between the two groups in psychotic symptoms of depressive episode. CONCLUSION : BP-I and BP-II disorders showed differences in clinical courses and symptom profiles. BP-II disorder seems to be less severe than BP-I disorder with regard to the intensity of manic symptoms, but more severe with respect to frequencies of depressive episodes. These results provide additional evidence supporting the distinction of BP-I and BP-II as separate diagnos-tic categories that might have different genetic profiles and/or biological mechanisms.
Anger ; Depression ; Humans ; Irritable Mood ; Paralysis ; Psychomotor Agitation ; Seasons

The authors report a case of dexfromethorphan induced mood disorder with the review of literafures. The patient is a 19-year old female who had been taking dextromethorphan hydrobromide (trade name : romilar) for 14 month s to enjoy its pleasurable effects and to reduce anxiely. Acute intoxication symptoms of dextromethorphan hydrobromide were silly smiles, a euphoric feeling of floating and an optimistic mood. Tolerance developed and she had been taking 70 tablets (1050mg) ot maximum per day. Withdrawal symptoms were anxiely and its related symptoms and a craving for the drug. While taking 50 tagblets per day about 12 days prior to admission, she had developed leated and irritable mood. grandicstily and auditory hallucinations. These symptoms continued despite discontinuation of the drug after admission. the degree of elated and irritable patient's mood was prominent. flight of ideas was not so severe. However, there was prominent grandiosity and auditory hallucinations. She was treated with haloperidol and lithium and then showed gradual remission in 3weeks. If would necessary to explore any drug abuse history in psychiatric patients who are in their teens.
Adolescent ; Dextromethorphan* ; Female ; Hallucinations ; Haloperidol ; Humans ; Irritable Mood ; Lithium ; Mood Disorders* ; Substance Withdrawal Syndrome ; Substance-Related Disorders ; Tablets ; Young Adult

OBJECTIVES: We compared the clinical presentations of manic and depressive episodes and the treatment response among children and adolescents with bipolar disorder (BD) types I and II and BD not otherwise specified (NOS). METHODS: The sample consisted of 66 patients, aged between 6 and 18 years, who were admitted for BD to a 20-bed child and adolescent psychiatric ward in a university hospital located in Seoul, Korea. RESULTS: Patients with BD type I were more likely to have lower intelligence quotients and exhibit violent behaviors during manic episodes than patients with BD type II or BD NOS and to show better treatment responses during manic episodes than patients with BD NOS. Patients with BD NOS were more likely to have an irritable mood rather than a euphoric mood during the manic phase than patients with BD type I or II and to exhibit violent behaviors during the depressive phase and chronic course than patients with BD type II. CONCLUSION: Pediatric BD patients are heterogeneous with respect to their clinical characteristics. Implications for the usefulness of the current diagnostic subtype categories should be investigated in future studies.
Adolescent ; Bipolar Disorder* ; Child ; Humans ; Inpatients* ; Intelligence ; Irritable Mood ; Korea ; Seoul

PURPOSE: Most studies of depression in adolescents, have been conducted in western countries. Accordingly, we took a survey in the city of Ansan to discover the actual state of depression in adolescents and found a solution. METHODS: Twelve questions of modified diagnostic criteria for DSM-IV(Diagonstic and Statistical Mannual of Mental Disorders, 4th ed.) major depressive disorder were filled out by 1,158 middle and high school students in Asan. The diagnosis of depression was made when more than six of 12 items were positive and the diagnosis of depressed mood, irritable mood, or loss of interest or pleasure was made when at least one of them was positive. RESULTS: There were 71 students(6.2%) who had major depression. Depressed mood was highly prevalent among Ansan teenagers(12.3%). Girls showed(20.8%) more symptoms than boys(16.7%). One hundred-five students(9.1%) thought seriously about attempting suicide. CONCLUSION: Depression and depressed moods are more highly prevalent among Ansan adolescents than American adolescents. So we point to the importance of broad screening of depression in this vulnerable population.
Adolescent* ; Chungcheongnam-do ; Depression* ; Depressive Disorder, Major ; Diagnosis ; Female ; Gyeonggi-do ; Humans ; Irritable Mood ; Mass Screening ; Mental Disorders ; Pleasure ; Suicide ; Vulnerable Populations

OBJECTIVE: To describe the sonographic (US) and clinical features of spontaneously reduced small bowel intussusception, and to discuss the management options for small bowel intussusception based on US findings with clinical correlation. MATERIALS AND METHODS: During a five years of period, 34 small bowel intussusceptions were diagnosed on US in 32 infants and children. The clinical presentations and imaging findings of the patients were reviewed. RESULTS: The clinical presentations included abdominal pain or irritability (n = 25), vomiting (n = 5), diarrhea (n = 3), bloody stool (n = 1), and abdominal distension (n = 1), in combination or alone. US showed multi-layered round masses of small (mean, 1.5+/-0.3 cm) diameters and with thin (mean, 3.5+/-1 mm) outer rims along the course of the small bowel. The mean length was 1.8+/-0.5 cm and peristalsis was seen on the video records. There were no visible lead points. The vascular flow signal appeared on color Doppler images in all 21 patients examined. Spontaneous reduction was confirmed by combinations of US (n = 28), small bowel series (n = 6), CT scan (n = 3), and surgical exploration (n = 2). All patients discharged with improved condition. CONCLUSION: Typical US findings of the transient small bowel intussusception included 1) small size without wall swelling, 2) short segment, 3) preserved wall motion, and 4) absence of the lead point. Conservative management with US monitoring rather than an immediate operation is recommended for those patient with typical transient small bowel intussusceptions. Atypical US findings or clinical deterioration of the patient with persistent intussusception warrant surgical exploration.
Abdomen/physiopathology ; Abdominal Pain/etiology ; Child ; Child, Preschool ; Diarrhea/etiology ; Female ; Humans ; Infant ; Intestine, Small/*ultrasonography ; Intussusception/*ultrasonography ; Irritable Mood ; Male ; Occult Blood ; Ultrasonography, Doppler, Color ; Vomiting/etiology

The authers reported one case of manic episode that occured after retirement in a 63 year old male patient. There was no psychiatric past history and family history. Also there was no abnormal finding on laboratory examination. This patient had received small doses of antidepressants anxiolytic and hypnotic (amitriptyline 10 mg, lorazepam 0.5 mg, triazolam 0.25 mg) to control insomnia since 3 months ago before admission. This patient showed manic symptoms such as grandious idea, expansive and irritable mood, increased psychomotor activity and insomnia after retirement. Pharmacotherapy (lithium and chloropromazine) supportive psychotherapy and family therapy were administered. Excessive motivation for work after retirement and small dose of antidepressant were suspected to trigger a manic episode in this elderly patient. We also reviewed literatures about pathophysiology of elderly manic disorder.
Aged* ; Antidepressive Agents ; Bipolar Disorder ; Drug Therapy ; Family Therapy ; Humans ; Irritable Mood ; Lorazepam ; Male ; Middle Aged ; Motivation ; Psychotherapy ; Retirement* ; Sleep Initiation and Maintenance Disorders ; Triazolam

OBJECTIVETo set up a method of establishing the animal model of psychical erectile dysfunction with emotional stress.

METHODSAll thirty-six male rats with normal sexual function were divided into three groups, i. e. normal group, model group and demasculinized group randomly according to their weights. The rats in the model group were suspended upside down in midair over the water and irritated repeatedly. Two weeks later, the sexual abilities of all rats, i. e. the times of mounting and intromitting the estrus female rats, the latent period of mounting, intromission and ejaculation, were recorded, and the number of rats that had sexual activities was also counted. And the hemorheology indices of the rats were measured.

RESULTSCompared with the normal rats, the latency of mounting [(152.5 +/- 24.6) s vs (42.4 +/- 9.6) s] and intromission [(437.0 +/- 67.7) s vs (130.8 +/- 39.1) s] of the model rats were longer (P < 0.01), but the latency of ejaculation [(385.3 +/- 80.0) s vs (547.3 +/- 69.4) s] was shorter (P < 0.05) than that of the normal. There was no significant difference in the times of mounting between normal [(38.3 +/- 6.1) vices and model rats (38.5 +/- 5.4) vices], but the intromission times of model rats [(9.2 +/- 1.7) vices] was lower than that of the normal rats [(20.3 +/- 3.1) vices], P < 0.01. Compared with the normal rats, the sexual activity incidence of the model rats (mounting: 58.3%, intromission: 33.3%, ejaculation: 16.7%) was significant lower than that of the normal rats (100%) (P < 0.01). But there was no significant difference in the sexual ability between the model and the demasculinized rats (P > 0.05). The hemorheology indices, e. g. blood viscosity, hematocrit (Hct) and red cell aggregation (RCA), of the model rats was significant higher than that of the normal and demasculinized rats (P < 0.05), but there was no significant difference between the normal and demasculinized rats.

CONCLUSIONThe rat model of psychical erectile dysfunction can be made ideally with psychical stress.

Animals ; Behavior, Animal ; Disease Models, Animal ; Erectile Dysfunction ; physiopathology ; psychology ; Female ; Hemorheology ; Irritable Mood ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley

INTRODUCTIONThis study aimed to determine the sleep patterns and dysfunctions in children with learning problems in comparison against a local population-based sample.

MATERIALS AND METHODSParents of 200 children with learning problems and 372 parents of a local population-based sample of typically developing (TD) children were recruited to complete a questionnaire on their child's sleep patterns and sleep problems. The Children's Sleep Habits Questionnaire (CSHQ) is a validated parent-reported sleep screening questionnaire that contains 54 items identifying sleep behaviours in children.

RESULTSThe mean age of the sample was 4.2 years (SD: 1.4; range, 2 to 6 years). Sleep duration was similar between the 2 groups. The difference in mean CSHQ subscale scores between children with learning problems and TD children was significant for sleep-disordered breathing (1.3 vs 1.2,= 0.001). Among children with learning problems, 36.5% snored (vs 26.6% of TD children), 30.5% had noisy breathing (vs 18.8%), and 9.0% (vs 4.6%) experienced difficulty breathing 2 or more times a week. Children with learning problems woke up in a more irritable mood (= 0.01), had more difficulty in getting out of bed (<0.001), and took a longer time to be alert (<0.001). They exhibited fewer behaviours of daytime drowsiness (= 0.009). Among this group of children, 15.0% of parents reported that their child had a sleep problem compared to 9.0% in the TD group.

CONCLUSIONSleep breathing disorders and symptoms of morning sleepiness are more prevalent in children with learning problems. Symptoms of daytime lethargy are similar between the 2 groups. We suggest that a simple outpatient screening targeted at these problems be instituted in the initial workup of any child with learning difficulties.

Case-Control Studies ; Child ; Child, Preschool ; Comorbidity ; Female ; Humans ; Irritable Mood ; Learning Disorders ; epidemiology ; Male ; Prevalence ; Singapore ; epidemiology ; Sleep ; Sleep Apnea Syndromes ; epidemiology ; Sleep Hygiene ; Sleep Wake Disorders ; epidemiology ; Snoring ; epidemiology