OBJECTIVES: The aim of this study was to investigate the gender differences of direct aggression and relational aggression in Korean elementary and middle school students. METHODS: Parents of 946 elementary school students(age 9.54±1.72 years, 485 boys, 461 girls) completed the Child Behavior Checklist(CBCL). Six-hundred-and-three middle school students(age 13.98±0.93 years, 301 boys, 302 girls) completed the Youth Self-Report(YSR). Independent t-test, chi-square test, and Fisher's exact test were used. RESULTS: Boys had significantly higher direct aggression scores than girls in elementary school students(p<0.001). There was no significance gender difference of relational aggression in elementary school students(p=0.235). In middle school students, boys had significantly higher direct aggression than girls(p=0.017), and girls had significantly higher relational aggression compared to the boys(p<0.001). CONCLUSION: Our results suggest the presence of gender differences in manifestation of aggression subtypes in Korean elementary and middle school students. These gender differences should be taken into account in prevention and intervention approaches of aggression in children and adolescents.
Adolescent* ; Aggression* ; Child Behavior ; Child* ; Female ; Humans ; Parents

OBJECTIVES: To investigate clinical and symptomatic differences among motoric subtypes of delirium. METHODS: A total of 256 patients referred to psychiatric consultation services for delirium due to general medical condition were assessed retrospectively. Motoric subtypes were determined according to Lipowski's criteria for hyperactive, hypoactive and mixed subtypes. All patients were evaluated according to Delirium Rating Scale-Revised-98(DRS-98-R) by trained psychiatrists to obtain symptomatic profiles of delirium. RESULTS: Hyperactive subtype were 50.8%(n=130), mixed 46.1%(n=118) and hypoactive 3.1%(n=8). Hyperactive patients were younger than mixed subtype(69.62±13.976 vs. 73.97±11.569, p=0.022) and received antipsychotics to manage symptoms of delirium more frequently(83.8% vs. 57.6%, p<0.001). Hyperactive patients had higher DRS-R-98 scores on both noncognitive(7.14±3.543 for hyperactive, 5.62±3.279 for mixed subtype) and cognitive subscales(10.00±3.574 for hyperactive, 6.38±2.875 for hypoactive, 7.43±3.771 for mixed subtype, p<0.001). CONCLUSION: We demonstrated that clinical and symptomatic profiles were different across motoric subtypes in delirium. Diagnostic and therapeutic approach should be made differently according to motoric subtypes of delirium and special attention is needed not to underestimate or delay treatment in specific motoric subtype of delirium.
Antipsychotic Agents ; Delirium* ; Humans ; Psychiatry ; Retrospective Studies

OBJECTIVES: The purpose of this study is to investigate the characteristics of drinking patterns and the prevalence of hazardous drinking and alcohol use disorder with the assessment of alcohol policy needs in community population of urban city in Korea. METHODS: Data was collected from 1,000 residents in a single urban city in Korea, from June 1 to July 31, 2011 by a questionnaire. As research tools, socio-demographic characteristics composed of variables based on study purpose, alcohol problems and alcohol use disorder state scales composed with Alcohol Use Disorder Identification Test(AUDIT) and Cut down, Annoyed, Guilty, Eye-opener(CAGE), and the assessment of alcohol policy needs in community population questions were used. RESULTS: The lifetime experience of alcohol drinking was 97.4%. For the frequency of drinking, 21.9% of population responded 2 to 4 times per weekly. 24.4% of male had one time or more high risk drinking, defined as having four or more drinks in a sitting, per week. 51.6% experienced the first time drinking of alcohol in adolescence. The lifetime prevalence of hazardous drinking and alcohol use disorder were 14.9% and 3.3%, respectively using AUDIT. Alcohol use disorder were 9.6% with the CAGE scale. Problem drinking were 8.4% in this study. They requested the program such as prevention education(57.2%), construction of liaison system to treatment facilities( 50.1%), alcohol counseling and intervention(41.7%), and rehabilitation program(39.8%). CONCLUSIONS: These results demonstrate that alcohol problem and alcohol use disorder were much prevalent, and these problem started in the earlier age. It is necessary to develop an effective alcohol prevention program or policy with considering the needs in community population.
Adolescent ; Alcohol Drinking ; Counseling ; Drinking ; Humans ; Korea ; Male ; Prevalence ; Questionnaires ; Weights and Measures

OBJECTIVES: Alzheimer's disease(AD) and mild cognitive impairment(MCI) affect several nervous structures involved with the autonomic nervous system. Association between neuropsychiatric deficits and heart rate variability has been observed. But cardiac autonomic function in AD has been scarcely studied and the results reported are conflicting. We investigated autonomic function in normal control, MCI, AD using heart rate variabil-ity(HRV) technique. METHODS: Time and frequency-domain variability of 5-min R-R interval series was comparatively evaluated in 26 normal control subjects, 22 MCI subjects and 34 AD subjects. Analysis of variance(ANOVA) was used to compare the differences across groups. Correlations between MMSE-KC and HRV components were performed using Pearson's correlation coefficient. RESULTS: No significant difference was observed among the groups in time, frequency-domain analysis of HRV (p>0.05). HRV were not found to be significantly correlated with the degree of cognitive impairment. CONCLUSIONS: There were no differences in HRV with MCI, AD subjects when compared with normal controls. Further investigation is required to use HRV technique as noninvasive parameters of MCI and AD.
Alzheimer Disease ; Autonomic Nervous System ; Heart ; Heart Rate ; Mild Cognitive Impairment

The pathophysiology of functional gastrointestinal disorder(FGID) is not completely understood, but the importance of the 'Brain-Gut Axis(BGA)' model in FGID is being increasingly recognized. The BGA model is a bidirectional, hard-wired and homeostatic relationship between the central nervous system(CNS) and the enteric nervous system(ENS) via neural, neurohormonal and neuroimmunological pathways. In addition, the BGA model would provide a rationale for the use of psychotropics on FGID. The authors experienced two cases in which duloxetine, a serotonin-norepinephrine reuptake inhibitor, was effective in relieving FGID symptoms as well as psychiatric symptoms such as depression and hypochondriacal anxiety. Therefore we discuss the vignettes from the perspective of BGA theory. Duloxetine showed efficacy in these two patients by reducing visceral hypersensivity (bottom-up regulation) and by relieving depression and anxiety(top-down regulation).
Anxiety ; Depression ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Thiophenes

OBJECTIVES: Perceived stress scale is a self-report inventory to estimate the degree of individual perceived stress in daily life. The aim of this study was to introduce this scale and test the reliability and validity of the Korean version of PSS. METHODS: The total of 154 female hospital workers were included in this study. The survey questionnaires were conducted for demographic information. All participants were required to complete PSS, Hamilton Anxiety scale and Beck Depression Inventory. Reliability and validity studies were conducted and internal consistency was examined. RESULTS: The mean score of the PSS reported in this sample was 20.69+/-4.56. The overall Cronbach's alpha was 0.819, and the test-retest reliability coefficient was 0.66. PSS had a significant positive correlation with the HAM-A(r=0.49, p<0.01), and the BDI(r=0.55, p<0.01). Factor analysis yielded 2 factors with eigenvalues of 3.924 and 2.608, accounting for 65 percent of variance. Factor 1 represented "stress" and factor 2 represented "control of stress". CONCLUSIONS: This study indicates that the PSS is appropriate for estimating the perceived stress levels. These results support the use of PSS in large sections of the population in Korea.
Accounting ; Anxiety ; Depression ; Female ; Humans ; Korea ; Questionnaires ; Reproducibility of Results

OBJECTIVES: The objective of this study is to measure and to compare the rate of depression, anxiety, self-esteem and the quality of life of the patients with chest pain. Based on the result of this study, the necessity of the psychiatric assessment and treatment of the patients with chest pain is emphasized. This study is a preliminary research for a larger scale investigation to be carried out in the future. METHODS: Thirty nine patients with chest pain who visited Cardiovascular Division of Dept. of Internal Medicine Pusan National University Hospital and fourty normal control group(NC) were included in this study. The patients were classified into typical chest pain group(TCP, N=19) and atypical chest pain group(ACP, N=20) based on the cause of the pain. The cause was determined by cardiac computed tomography, exercise stress test, coronary angiography, and questionaires by a cardiology specialist. The patients were assessed with Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), Rosenberg Self-Esteem Scale(RSES) and Korean version of the Smith Klein Beecham 'Quality of Life' scale(KvSBQOL). RESULTS: 1) When the risk factors of cardiac disease is compared, most of the factors(Hypertension, Diabetes, Hyperlipidemia, Cerebral infarction) did not differ significantly among the two chest pain groups, except for the family history, for which TCP group showed higher risk than ACP group did. 2) As for the self-report questionaires scores, BDI score, which indicates the rate of depression, of both ACP group and TCP group was significantly higher than that of NC group in BDI for depression. STAI score, which measures anxiety, was also significantly high in both groups. Especially, STAI score was significantly higher in ACP group than TCP group. 3) In the aspect of self-esteem and quality of life, ACP group scored significantly lower than TCP group and NC group. The scores for TCP group and NC group did not differ significantly. CONCLUSIONS: The patients with chest pain showed more depression and anxiety than normal control group, regardless of the cause of the pain. However, TCP group did not show significantly larger drop in self-esteem and quality of life than ACP group did. This result implies that early psychiatric assessment and treatment is needed for the patients with such chest pain, since it is highly likely that the pain would lead to lower quality of life of the patients.
Anxiety ; Cardiology ; Chest Pain ; Coronary Angiography ; Depression ; Exercise Test ; Heart Diseases ; Humans ; Hyperlipidemias ; Internal Medicine ; Quality of Life ; Risk Factors ; Specialization ; Thorax

OBJECTIVES: Delirium is a disorder defined as a sudden disturbance in thinking, speaking, acting and sleep pattern due to altered level of consciousness and cognitive function. The objective of this study is to analyze characteristics and therapeutic methods of the delirious patients during the recent 5 years, and provide basic data for further studies and investigation regarding delirium in the occurrence and treatment. METHODS: We retrospectively reviewed medical records of 475 patients who were consulted for delirium in Kyunghee University Medical Center from January 2007 to December 2011. RESULTS: During the 5 years, among the 475 patients who were diagnosed as delirium, men were more common(61.7%). The most commonly consulted reason and cause were sleep disturbance(80.8%) and post-operational delirium(30.9%), respectively. The medication prescription percentage was 76.6% and was significantly increased year after year. Ratio of using antipsychotics were 76.4% among prescribed medication and the most frequently prescribed antipsychotic drug was quetiapine(46.8%). Other specialists commonly misdiagnosed delirium when the patient was previously diagnosed as dementia(6.8%). CONCLUSIONS: In our study, post-operational delirium was the most commonly referred reason and the percentage of medication prescription tended to increase. Patients with history of dementia were more easily misdiagnosed as diseases other than delirium. Our study suggests that we should evaluate symptoms, causes, reasons of consultation, management tendency of delirium. We should also closely observe changes in sleep patterns and establish the prevention strategies for post-operational delirium and therapeutic bases for pharmacotherapy.
Academic Medical Centers ; Antipsychotic Agents ; Consciousness Disorders ; Delirium ; Dementia ; Humans ; Male ; Medical Records ; Prescriptions ; Retrospective Studies ; Specialization ; Thinking

OBJECTIVES: We investigated the prevalence and composite score of the neuropsychiatric symptoms in patients with mild cognitive impairment(MCI), and dementia of Alzheimer's type(AD). The aim of this study is to analyze the correlation between the result of Korean Neuropsychiatric Inventory(K-NPI) and cognitive function. METHODS: A total of 163 patients diagnosed with MCI or AD was divided into three groups(55 MCI patients, 56 dementia patients with mild stage, and 52 dementia patients with moderate, severe stage). We examined neuropsychiatric symptoms by K-NPI and compared the prevalence and composite score of each subdomain in K-NPI among three groups. RESULTS: The most common symptoms in the MCI group were depression/dysphoria, sleep/night-time behavior, anxiety, and irritability/lability. In mild AD group, the most frequent disturbance was agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, and sleep/night-time behavior. In moderate to severe AD group, the most frequent disturbance was apathy/indifference, depression/dysphoria, agitation/aggression, and delusion. The frequencies of delusion, hallucination, agitation/aggression, apathy/indifference, aberrant motor behavior, appetite/eating change were statistically significant. The total NPI score showed a negative correlation with MMSE-KC and a positive correlation with GDS. CONCLUSIONS: Neuropsychiatric symptoms are common features of MCI and AD. These symptoms observed in MCI are similar to those of mild AD. Psychosis is most common in moderate to severe AD, leading to a faster rate of cognitive decline. Therefore, proper management according to the neuropsychiatric symptoms of MCI and three stages of dementia is needed.
Anxiety ; Delusions ; Dementia ; Hallucinations ; Humans ; Mild Cognitive Impairment ; Prevalence ; Psychotic Disorders

OBJECTIVES: This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. METHODS: For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale (NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). RESULTS: At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. CONCLUSIONS: More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.
Anxiety ; Appetite ; Depression ; Hand Strength ; Hostility ; Humans ; Muscles ; National Institutes of Health (U.S.) ; Neurologic Manifestations ; Stroke