The light therapy has been known to be effective to non-seasonal affective disorder as well as seasonal affective disorder. Although the mechanism of action of light therapy for depressive disorder has not been verified yet, its clinical application revealed similar effects like antidepressants and relatively smaller side effects. However, it is not common to apply the light therapy for treatment resistant depressive disorder. This case report indicates a robust efficacy of light therapy and its clinical usefulness, illustrating the complete remission in a treatment resistant patient with major depressive disorder after bright light therapy.
Antidepressive Agents ; Depressive Disorder ; Depressive Disorder, Major* ; Humans ; Mood Disorders ; Phototherapy* ; Seasonal Affective Disorder

Paraneoplastic limbic encephalitis associated with ovarian teratoma has variable clinical manifestations, including hallucination, abnormal behavior, amnesia, mental change, fever, chorea and dystonia, and often has antibodies to N-methyl-D-aspartate receptor (NMDAR), however cases without tumor or antibodies to NMDAR have also been reported. Here, we describe a 35-year-old female who was initially misdiagnosed as schizophrenia because she presented with acute onset of psychiatric symptoms, including visual hallucination, abnormal behavior, confusion, and memory impairment. Three days after admission, she developed high fever refractory to antibiotics. Brain MRI and examination of cerebrospinal fluid were normal. Computerized tomography of the pelvis showed an ovarian teratoma. The patient showed complete improvement after surgical removal of the ovarian teratoma and steroid therapy. We suggest that physicians should consider the possibility of paraneoplastic limbic encephalitis in patients who present with acute onset of psychiatric symptoms with high fever or movement disorder.
Adult ; Amnesia ; Anti-Bacterial Agents ; Antibodies ; Brain ; Cerebrospinal Fluid ; Chorea ; Dystonia ; Female ; Fever ; Hallucinations ; Humans ; Limbic Encephalitis* ; Magnetic Resonance Imaging ; Memory ; Movement Disorders ; N-Methylaspartate ; Pelvis ; Schizophrenia ; Teratoma

OBJECTIVES: This study examined the moderating effects of stress coping strategies on the relationship between occupational stress of national statistical office workers and mental health. METHODS: Subjects were 133 workers at a regional statistics office. Occupational stress, stress coping strategies, and mental health were examined using the Korean Occupational Stress Scale (KOSS), Ways of Coping Checklist, and The Symptom Check-List-90-R. Stress coping strategies were composed of problem-focused coping, social support coping, emotion-focused coping, and wishful thinking coping. RESULTS: Moderated regression indicated that the social support coping and emotion-focused coping style positively moderated the relationship between occupational stress and mental health in national statistical office workers. The social support coping style positively moderated the relationship between interpersonal conflict (KOSS subscale) and mental health in national statistical office workers. The emotion-focused coping style positively moderated the relationship between job insecurity (KOSS subscale) and mental health in national statistical office workers. The emotion-focused coping style negatively moderated the relationship between job demand (KOSS subscale) and mental health in national statistical office workers. CONCLUSION: The implications of this study included that negative results due to high occupational stress can be varied by use of suitable stress coping strategies.
Checklist ; Mental Health* ; Thinking

OBJECTIVES: This study was conducted to observe a longitudinal course of patients with schizophrenia enrolled in a community mental health center (CMHC) in Seoul, Korea, and to evaluate the clinical efficacy of case management provided for them. METHODS: Study subjects, including 50 patients in a case-managed group, and 34 patients in the control group, were enrolled from a CMHC and followed up for 36 months. Annual length of hospitalization was compared between two groups by t-tests and time until hospitalization by Kaplan-Meier survival analysis. RESULTS: For the first year of observation, there was no significant difference in annual length of hospitalization between two groups (3.4 weeks vs. 2.9 weeks), but annual length of hospitalization of the case-managed group became significantly shorter for the second (1.7 weeks vs. 7.2 weeks) and third year (1.4 weeks vs. 7.8 weeks). In Kaplan-Meier survival analysis, no difference in time until hospitalization was observed between two groups, but time until hospitalization more than 3 months was significantly shorter in the control group. CONCLUSION: At least two years of case management was required to reduce the length of hospitalization. Reduction in length of hospitalization was achieved by preventing long-term hospitalization.
Case Management* ; Community Mental Health Centers ; Community Mental Health Services ; Follow-Up Studies* ; Hospitalization ; Humans ; Korea ; Mental Health ; Prospective Studies* ; Schizophrenia* ; Seoul

OBJECTIVES: The objective of this study was to examine the and gender difference between metabolic syndrome and clinical psychiatric characteristics. METHODS: This study was conducted in local habitants who visited one community health service from July to August 2014. 318 local habitants who have not been diagnosed with psychiatric disorders were evaluated using Center for Epidemiological Studies-Depression Scale (CES-D), Reynold Suicidal Ideation Questionnaire (SIQ, Reynolds), Rosenberg Self-Esteem Scale (SES), Korean version of WHO Quality of Life Scale-Abbreviated Version (WHOQOL-BREF), and EuroQol-5 Dimension (EQ-5D). Differences in demographic characteristics of both gender were analyzed. RESULTS: In women, the group with metabolic syndrome showed significantly lower alcohol drinking frequency (p<0.001), educational level (p<0.001) compared to the group without syndrome. Women with metabolic syndrome had lower scores for physical health (p=0.002), environment (p=0.007) on WHOQOL-BREF than those without the syndrome. However, CES-D, EQ-5D, SIQ, Reynolds, and SES show no differences. Among men, no difference was observed in all scales. In addition, in women, logistic regression analysis showed that after adjusting for confounders, metabolic syndrome group had lower score for physical health (p=0.009), environment (p=0.042) on WHOQOL-BREF than the group without syndrome. CONCLUSION: Our study showed an association of metabolic syndrome with poor physical health, environment in women.
Adult* ; Alcohol Drinking ; Community Health Services* ; Depression ; Female ; Humans ; Logistic Models ; Male ; Mental Health* ; Quality of Life ; Suicidal Ideation ; Weights and Measures

OBJECTIVES: Obstructive sleep apnea (OSA) is classified as positional sleep apnea (POSA) and non-positional sleep apnea (NPOSA) according to apnea-hypopnea index (AHI) changed by sleep position. The aim of this study was to compare neurocognitive functions between two groups in the elderly Korean population. METHODS: Forty-four subjects in OSA patients with total AHI> or =5 participated as criteria for POSA (n=25) with 1) supine position AHI/non-supine position AHI> or =2 and 2) total AHI> or =5 or not (NPOSA, n=19). All participants completed clinical interview by physician and neurocognitive function assessments. Mann-Whitney U and chi-square test were performed for comparison of neurocognitive functions and sleep characteristics with polysomnography between two groups. RESULTS: No significant difference in demographic and clinical characteristics was observed between the two groups. However the NPOSA group showed more decline than the POSA group on the Boston naming test (p=0.034), digit span test (p=0.001), go-no-go test (p=0.042), and fist-edge-palm test (p=0.007). CONCLUSION: In this study NPOSA patients were found to have lower cognitive functions compared to POSA patients. A larger sample and long term follow-up study might be needed.
Aged* ; Follow-Up Studies ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Supine Position

OBJECTIVES: In this study, we performed a preliminary investigation for establishing guidelines for the usage of smartphones in children and adolescents. METHODS: From March 2014 to August 2014, 182 board-certified psychiatrists were asked to participate in the survey ; 121 participants completed the questionnaire. The questionnaire was developed by the authors, mainly the Public Relations Committee of the Korean Academy of Child and Adolescent Psychiatry. It evaluates psychiatrists' opinions on the use of smartphones in children and adolescents. In addition, psychiatrists' attitudes towards their own usage of smartphones were assessed in order to determine the impact on their opinion towards the children's usage. RESULTS: Psychiatrists have recommended various opinions as the appropriate age to own a smartphone for the first time. Mean age recommended by psychiatrists is grade 7.7. One-hundred participants (82.6%) agreed to the age limit to own a smartphone for the first time. In addition all participants agreed to the necessity of a time limit in children and adolescents. Psychiatrists (17.4%) who disagree on the age limit in children considered the smartphone more useful by themselves compared to psychiatrists who agreed on the age limit. CONCLUSION: Most psychiatrists have recommended that an appropriate limit for smartphone usage in children and adolescents is needed.
Adolescent Psychiatry ; Adolescent* ; Cellular Phone ; Child* ; Humans ; Psychiatry* ; Public Relations

OBJECTIVES: The aim of this study was to investigate the social withdrawal tendency in Korean adolescents using the Hikikomori Behavior Checklist and to compare the psychopathological differences between the high risk group of social withdrawal (HRSW) and the low risk group of social withdrawal (LRSW). METHODS: Participants included 300 high school students from Daegu, Korea. Each participant completed several questionnaires including the demographic questionnaire, Korean-Version of the Hikikomori Behavior Checklist (K-HBCL), the Parental Screening Questionnaire for Hidden Youth (HYQ), Beck Depression Inventory (BDI), Anxiety Sensitivity Inventory (ASI), Social Avoidance and Distress scale (SAD), the Scale for Fear of Negative Evaluation (FNE), and Maudsley Obsessive-Compulsive Inventory (MOCI). The subjects were divided into two groups, the HRSW and LRSW, depending on the mean value of their total HBCL score, and their BDI, ASI, SAD, FNE, and MOCI scores were compared between HRSW and LRSW. RESULTS: The scales affecting the high-risk group were BDI, ASI, and SAD. The total score of K-HBCL showed positive correlation with the total score of BDI, ASI, SAD, FNE, and MOCI. CONCLUSION: The socially withdrawn adolescents had more problematic issues of their psychopathology. Several emotional factors would be useful in assessing the high-risk group of socially withdrawn adolescents.
Adolescent* ; Anxiety ; Checklist ; Daegu ; Depression ; Humans ; Korea ; Mass Screening ; Parents ; Psychopathology ; Weights and Measures

OBJECTIVES: Child abuse can affect mental and physical health of abused children. Accurate assessment of mental health of abused children is integral to providing proper treatment and preventing any further impact of childhood abuse on their future life. In this study, we investigated psychiatric illnesses among abused children. METHODS: Semi-structured interviews using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version were conducted for 61 abused children after obtaining consent from their guardians. We also assessed the relationship between the demographic data of these abused children and their diagnoses. RESULTS: Among the abused children, more than half had more than one psychiatric disorder. The most frequently diagnosed disorders were attention-deficit/hyperactivity disorder, posttraumatic stress disorder, depressive disorder, and oppositional defiant disorder. The incidence of posttraumatic stress disorder was higher in abused girls compared with abused boys. Abused children had a higher suicide risk than the general population. Among the parents of abused children, 50.8% had alcohol use disorders. CONCLUSION: Among the abused children, 50.8% had psychiatric disorders. Administration of intensive psychiatric treatment to abused children, and prevention of child abuse by education, treatment, and monitoring high-risk parents is imperative.
Attention Deficit and Disruptive Behavior Disorders ; Child Abuse ; Child* ; Depressive Disorder ; Diagnosis ; Education ; Female ; Humans ; Incidence ; Mental Disorders* ; Mental Health ; Mood Disorders ; Parents ; Stress Disorders, Post-Traumatic ; Suicide

OBJECTIVES: Fast change and confusion of the value system in society affect the identity formation of adolescents. So Adolescents' behavioral problems seem to be increasing yearly. It is known that the interpersonal group therapy is the most effective treatment modality among many group programs for adolescents with behavioral problems. Objectives of this study are as follows; first, evaluate therapeutic effects of the interpersonal group therapy for adolescents with behavioral problems second, examine the therapeutic factors; third, analyze the group process; fourth, orgamize the group therapy for adolescents with behavioral problems as an applicable treatment modality. The types of group therapy performed in this study are small, closed, homogeneous, outpatient, time limited, and adolescent group. METHODS: This study was carried out at one of the adolescents mental health services in Uiwang Mental Health Center, from April to June and from September to November in 2000. The subjects were 2nd grade students in K middle school with behavioral proplems. The experimental groups were composed of 4 groups including 2 male groups and 2 female groups (male 11, female 17), and the control groups matched the same conditions as the experimental groups (male 10, female 19). The group therapy was performed weekly in CA (club activity) time, and it took 60-70 minutes at one time. They met total 10 sessions including preparatory meeting and termination meeting. Before and after this program, self-rating scales (behavioral problems, aggression, and impulsivity) were applied for subjects, and the teacher rating scales (behavioral problems, aggression and impulsivity) were performed by teachers in charge. After each session, Yalom's 13 therapeutic factors scale was performed. At the last meeting, total assessment questionnaire was completed. RESULTS: The mean scores of all self-rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) than the control groups, but not significant statistically except the behavioral problem scale of female students. The mean scores of all teacher rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) in comparison with the control groups, all significant statistically. As faras the therapeutic factors are concerned; first, the mean scores of all therapeutic factors in female students were higher than in male students and the mean scores of all therapeutic factors in the later half sessions were higher than the former half sessions; second, catharsis and existential factor were high in all students and sessions; third, identification with therapist factor was high in all students and sessions; fourth, during the later half sessions, interpersonal input was relatively high in male students and socializing technique was relatively high in female students. Its for the total assessment questionnaires; 100% of male students and 88.2% of female students reported that they were helped by this group therapy; 100% of male students and 82.4% of female students reported that they would participate willingly if future opportunity of the same group therapy is given for them. CONCLUSION: Adolescents with behavioral problems who participated in this study showed the decrease of behavioral problems and the change of aggressive and impulsive attitudes in comparison with the control groups although they had some differences between male and female students. The group therapy with adolescents would be practiced more broadly and extensively though there are several accompanied problems including the difficulty of structuring, the deficit of motivation, and financial problem.
Adolescent* ; Aggression ; Catharsis ; Female ; Group Processes ; Gyeonggi-do ; Humans ; Male ; Mental Health ; Mental Health Services ; Motivation ; Outpatients ; Psychotherapy, Group* ; Surveys and Questionnaires ; Weights and Measures