OBJECTIVES: The purpose of this study is to get basic data to develop plan and strategy of com-munity mental health in Pohang city by identifying attitudes toward mentally ill in Pohang community. METHODS: The subjects of this study are the 491 persons aged between 20 and 59 who live in Pohang. Methods of selection for the subjects based on multistage stratified cluster sampling, i.e. by sex, by age, by place of residence("Up", "Myeon", "Dong"), and by ratio to total populations. Tool of the study is Community Attitudes to the Mentally Ill Inventory(CAMI). RESULTS: 1) The residents of Pohang community showed positive attitude in 'Benevolence' and 'Community mental health ideology' subscale and negative attitude in 'Authoritarianism' and 'Social restric-tiveness' subscale. Therefore community mental health project in Pohang city will be established and activated easily. 2) Aged group had more authoritative, social restrictive and less community mental health oriented attitude. 3) The lower educated group had more authoritative, social restrictive and less benevolent, community mental health oriented attitude. 4) The unmarried group had less authoritative, less social restrictive attitude. 5) The home-owners had more authoritative, more social restrictive attitude. 6) The opinion leaders had more authoritative and less community mental health oriented attitude. 7) The respondents whose family had used mental health services had less benevolent attitude. The respondents who themselves had used mental health services had more authoritative, less benevolent and community mental health oriented attitude. CONCLUSIONS: Therefore, it will be necessary to give public information and education for those who have negative attitude groups of aged, low educated, home-owners, opinion leaders and respondents who themselves or whose family had used mental health services. If resource could be made of persons of positive attitude groups of younger aged, highly educated and unmarried, community mental health project will be more efficient.
Surveys and Questionnaires ; Education ; Gyeongsangbuk-do* ; Humans ; Mental Health ; Mental Health Services ; Mentally Ill Persons* ; Single Person

The neurobiological basis of emotional recognition, processing and regulation has been extensively studied over the past years. Especially, posttraumatic stress disorder (PTSD) can be conceptualized as a dysfunction of fear circuit, thus, many studies focused on neural substrate of fear using functional neuroimaging. Neuroimaging studies of PTSD have suggested that the amygdala is hyperresponsive to fearful stimuli, which may be related to hyperarousal or reexperience symptoms of PTSD. The medial prefrontal cortex is hyporesponsive and fails to inhibit the amygdala. Researches also have acknowledged that abnormal activities in ventromedial prefrontal cortex and hippocampus might be associated with impairment of extinction of traumatic memory. Recent researches using facial emotional stimuli have suggested that PTSD involved not only dysfunction of fear circuit but also dysregulation of basic emotional processing. Despite the progress, many points are left which are yet to be clarified. Fear conditioning, contextualization, habituation and extinction should be investigated using novel paradigms that can explain the complexity of PTSD.
Amygdala ; Facial Expression ; Functional Neuroimaging ; Hippocampus ; Memory ; Neuroimaging ; Prefrontal Cortex ; Stress Disorders, Post-Traumatic

OBJECTIVE: Transcranial magnetic stimulation (TMS) is a new, noninvasive procedure of a localized pulsed magnetic field to the surface of the head to cause a depolarization of neurons in the brain cortex underneath. Knowledge of the neuroanatomic abnormalities of depression is serving as the background for TMS treatment in depression. Here we provide a summarized review of the therapeutic application of TMS in patients with depression. METHODS: We described the clinical and basic researches of TMS in depression and integrated the future direction using literature review and interview with experts. RESULTS: The field of TMS is beginning to address the issues of using TMS as a novel antidepressant. The ability to excite local areas of brain cortex has raised the possibility of the use of TMS as a novel therapeutic tool for depression. CONCLUSIONS: Many parameters, such as intensity, location, frequency, pulse width, intertrain interval, coil type, duration, numbers of sessions, and interval between sessions remain to be systematically explored. However TMS would be a relatively new and noninvasive method to investigate regional brain activity and to treat depression.
Brain ; Depression* ; Head ; Humans ; Magnetic Fields ; Neurons ; Transcranial Magnetic Stimulation*

OBJECTIVE: The present study aimed to evaluate the efficacy of low frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex (DLPFC) for the treatment of obsessive-compulsive disorder (OCD). METHODS: Twenty-seven patients with treatment resistant OCD were randomly assigned to 3 week either active (n=14) or sham (n=13) rTMS. The active rTMS parameters consisted of 1 Hz, 20-minute trains (1,200 pulses/day) at 100% of the resting motor threshold (MT). OCD symptoms, mood, and anxiety were assessed at baseline and every week throughout the treatment period. RESULTS: A repeated-measures analysis of variance (ANOVA) was used to evaluate changes on the Yale-Brown Obsessive Compulsive Scale (YBOCS). Our results revealed a significant reduction in YBOCS scores in the active group compared with the sham group after 3 weeks. Similarly, a repeated-measures ANOVA revealed significant effect of time and time×group interaction on scores on the Hamilton Depression Rating Scale and the Clinical Global Impression-Severity scale. There were no reports of any serious adverse effects following the active and sham rTMS treatments. CONCLUSION: LF rTMS over the right DLPFC appeared to be superior to sham rTMS for relieving OCD symptoms and depression in patients with treatment-resistant OCD. Further trials with larger sample sizes should be conducted to confirm the present findings.
Anxiety ; Depression ; Humans ; Obsessive-Compulsive Disorder* ; Prefrontal Cortex* ; Sample Size ; Transcranial Magnetic Stimulation*

OBJECTIVE: Weight gain is a commonly encountered problem associated with atypical antipsychotics, especially olanzapine. To investigate the weight reducing effect of amantadine, we conducted an prospective open label study. METHODS: We started amantadine treatment in outpatients who had gained weight during olanzapine treatment (mean dose of 11.94 mg/day, mean weight gain of 6.33 kg). Data were collected at St. Mary's Hospital, College of Medicine, The Catholic University of Korea. The add-on treatment of amantadine was given at a mean dose of 161.9 mg/day with mean duration of administration for 110.2 day. Brief Psychiatric Rating Scale (BPRS), Extrapyramidal Symptom Scale were checked to evaluate the tolerability of amantadine. RESULTS: Before administration of amantadine, the mean dose of olanzapine was 11.94+/-4.58 mg and mean duration of administration was 123.1+/-174.6 days. Body weight and BMI during this period was significantly increased mean 6.33+/-4.45 kg (Z=-3.839, p<0.001), 4.94+/-0.75 (Z=-3.724, p<0.001) respectively. Amantadine was administered mean dose of 161.90+/-58.96 mg for mean 110.2+/-78.7 days. Body weight and BMI was decreased mean 0.96+/-3.44 kg, 0.71+/-2.7, respectively. There was no deterioration in psychiatric symptoms, as shown in BPRS score decrement and no adverse effects were reported. CONCLUSION: The present data suggests that amantadine does not significantly decrease weight gain experienced by some patients during olanzapine treatment and does not worse psychotic symptoms. Randomized placebo-controlled trial should be needed to confirm these findings.
Amantadine* ; Antipsychotic Agents ; Body Weight ; Brief Psychiatric Rating Scale ; Humans ; Korea ; Outpatients ; Prospective Studies ; Weight Gain*

OBJECTIVE: In recent years there has been an enormous increase of neuroscience research using the facial expressions of emotion. This has led to a need for ethnically specific facial expressions data, due to differences of facial emotion processing among different ethnicities. METHODS: Fifty professional actors were asked to pose with each of the following facial expressions in turn: happiness, sadness, fear, anger, disgust, surprise, and neutral. A total of 283 facial pictures of 40 actors were selected to be included in the validation study. Facial expression emotion identification was performed in a validation study by 104 healthy raters who provided emotion labeling, valence ratings, and arousal ratings. RESULTS: A total of 259 images of 37 actors were selected for inclusion in the Extended ChaeLee Korean Facial Expressions of Emotions tool, based on the analysis of results. In these images, the actors' mean age was 38+/-11.1 years (range 26-60 years), with 16 (43.2%) males and 21 (56.8%) females. The consistency varied by emotion type, showing the highest for happiness (95.5%) and the lowest for fear (49.0%). The mean scores for the valence ratings ranged from 4.0 (happiness) to 1.9 (sadness, anger, and disgust). The mean scores for the arousal ratings ranged from 3.7 (anger and fear) to 2.5 (neutral). CONCLUSION: We obtained facial expressions from individuals of Korean ethnicity and performed a study to validate them. Our results provide a tool for the affective neurosciences which could be used for the investigation of mechanisms of emotion processing in healthy individuals as well as in patients with various psychiatric disorders.
Anger ; Arousal ; Facial Expression ; Female ; Happiness ; Humans ; Male ; Neurosciences

OBJECTIVE: Although the diagnosis and treatment of cancer is associated with psychosocial distress, routine distress screening is difficult in hospitalized oncology settings. We developed a consecutive screening program for psychosocial distress to promote psychiatric treatment of cancer patients and evaluated the feasibility of our program by Distress Thermometer (DT) and Hospital Anxiety and Depression Scale (HADS). METHODS: Among 777 cancer inpatients recruited from the Catholic Comprehensive Institute of Seoul St. Mary's Hospital, 499 agreed to complete primary distress screening through DT. We conducted secondary distress screening through HADS in 229 patients who had high scores of DT. RESULTS: Of the 499 participants, 270 patients with low scores of DT were included in the distress education program. 229 patients with high scores of DT received secondary distress screening through HADS. Among 115 patients with low scores of HADS, 111 patients received distress management. Among 114 patients with high scores in the secondary distress screening, 38 patients received psychiatric consultation service whereas 76 patients refused psychiatric consultation. CONCLUSION: Using consecutive screening for psychosocial distress appeared to be feasible in an inpatient oncology setting. Nevertheless, the low participation rate of psychiatric consultation service in cancer patients with high distress level should be improved.
Anxiety ; Depression ; Diagnosis ; Education ; Hospitalization ; Humans ; Inpatients ; Mass Screening* ; Seoul ; Thermometers

Small osteophytes are frequently encountered in the foot and ankle, and not to be confused with true osteochondromas, which are relatively uncommon in this region. Osteochondromas are the most common benign osseous neoplasm, occurs in the metaphysis of the long bone. It is rarely found in bones of the foot. Treatment of the osteochondroma is usually conservative, unless symptoms usually pain, are progressive rapid growth, and malignant transformation is suspected. We experienced a rare case of hallux rigidus with osteochondroma of the hallucal proximal phalanx which cause pain and corn of the plantar.
Animals ; Ankle ; Foot ; Hallux ; Hallux Rigidus ; Osteochondroma ; Osteophyte ; Zea mays

OBJECTIVES: Sound and light (SL) stimulation has been used as a method to induce some useful mental states in the fields of psychology and psychiatry. It is believed that sound and light entrainment device (SLED) has some specific effects through synchronization of EEG in patients who use it. Theta frequency is believed to stimulate deep relaxation and short term memory processing. This study was conducted to evaluate if 4-10Hz SL stimulation can induce relaxation and improve short term memory function. METHODS: Ten medical students with no medical or psychiatric problems participated in this study. Subjects were randomly divided into two groups. One group was applied with real SLED was applied to one group (R group) and pseudo SLED to the other group (P group). The two groups were exposed to SL stimulation with SLED 15 minutes a day for 5 days, and after two days rest the two groups were switched over. The Korea Wechsler Adult Intelligence Scale (K-WAIS), Academic Motivation Tests (AMT), Test Anxiety Scale (TAS), Korea Auditory Verbal Learning Test (K-AVLT), and digit span were used to evaluate short term memory. Spielberger's State-Trait anxiety inventory and heart rate variability (HRV) test were used to evaluate degree of relaxation. RESULTS: Compared with S group, R group showed a significant improvement in K-AVLT and digit span after a single application of SL stimulation. But 5-day long application did not reveal any differences between the two groups. A significant change in HRV was observed in 5-day long application of SL stimulation after being switched over to other SLED. CONCLUSION: This pilot study suggests that 4-10Hz SL stimulation has some positive influences on short term memory and relaxation.
Adult ; Anxiety ; Electroencephalography ; Heart Rate ; Humans ; Intelligence ; Korea ; Memory ; Memory, Short-Term* ; Motivation ; Pilot Projects* ; Psychology ; Relaxation ; Students, Medical ; Test Anxiety Scale ; Verbal Learning

BACKGROUND: Coagulase-negative staphylococci (CNS) has been considered as a major causative agent of nosocomial infections. A prompt and accurate detection of methicillin resistance (MR) in staphylococci is a current issue of clinical microbiology laboratories. This study was purposed to evaluate various methods for detecting MR from CNS. METHODS: We selected 78 CNS strains obtained from blood cultures from April 1999 through July 2001 including 20 strains of Staphylococcus epidermidis, 20 S. hominis (SHO), 19 S. capitis, 9 S. haemolyticus, 3 S. saccharolyticus, 1 S. saprophyticus (SAP), 2 S. warneri (SWA), 2 S. xylosus, 1 S. lugdunensis, and 1 S. auricularis. In addition, one SAP strain received from World Health Organization for proficiency tests was also studied. The following methods were compared to the mecA gene PCR: MicroScan PosCombo 12, oxacillin salt agar containing 6 microgram/mL (OSA-6) or 0.6 microgram/mL (OSA- 0.6) of oxacillin, oxacillin disk diffusion (ODD), and MRSA-Screen latex agglutination (LA) for detecting penicillin binding protein 2a. RESULTS: One SWA was failed in mecA-PCR and fifty-nine of 78 (75.6%) CNS were positive for mecA gene. The agreement rates, sensitivities, and specificities for each test were as follows: for MicroScan, 97.3%, 98.2%, 88.9%; for OSA-6 and OSA-0.6 at 24-h incubation, 79.5%, 74.6%, 94.7% and 79.5%, 72.9%, 100%, respectively, and at 48-h incubation, 91.0%, 91.5%, 89.5% and 91.0%, 96.6%, 73.7%, respectively; ODD, 84.6%, 84.7%, 84.2%; LA, 80.8%, 76.3%, 94.7%. One SHO and one SAP that were mecA-negative showed resistance in the MicroScan, ODD, and OSA. CONCLUSIONS: MicroScan appears a reliable method to detect MR in all species of CNS except SHO and SAP. ODD and LA were not appropriate in detecting MRCNS due to a low sensitivity. Although OSA-0.6 at 48-h incubation showed a high sensitivity, the low specificity may limit a routine use in clinical laboratory.
Agar ; Agglutination ; Cross Infection ; Diffusion ; Latex ; Methicillin Resistance ; Oxacillin ; Penicillin-Binding Proteins ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Staphylococcus epidermidis ; World Health Organization