OBJECTIVE: This study aimed to investigate the effectiveness and safety of bupropion extended-release for the treatment of depressive disorder in children and adolescents. METHODS: This was a 12-week, retrospective chart review of bupropion, which included 127 youth (age, 15.3 ± 2.3 years; 66 boys) with depressive disorders (105 with major depressive disorder, 14 with dysthymia, 11 with adjustment disorder with depressed mood, and seven with depressive disorder not otherwise specified). Illness severity at baseline and at the 4th, 8th, and 12th weeks was retrospectively scored using the Clinical Global Impressions-Depression-Severity (CGI-Depression-S) and/or Clinical Global Impressions-Depression-Improvement (CGI-Depression-I). RESULTS: The mean dose of bupropion was 180.0 ± 52.6 (range, 75–300) mg/day and the mean duration 33.9 ± 53.1 (range, 7–295) weeks. The CGI-Depression-S scores were significantly decreased over 12 weeks (F = 132.125, p < 0.001, partial η² = 0.508). Fifty-eight subjects (45.7%) were determined to be responders at 12 weeks (defined by a CGI-Depression-I score ≤ 2). Forty-six patients (36.2%) discontinued bupropion before the 12 weeks (19 due to adverse events, 15 due to poor effectiveness, three due to referral to other clinics, and nine due to follow-up loss for unknown reasons). Overall, bupropion was well tolerated. The most common adverse event was irritability (n = 12, 9.4%), which resolved spontaneously in eight subjects or after drug discontinuation in four subjects. CONCLUSION: Our results provide preliminary evidence of the effectiveness and safety of bupropion in children and adolescents with depressive episodes. Large, prospective, placebo-controlled studies are needed to confirm these findings.
Adjustment Disorders ; Adolescent ; Bupropion ; Child ; Depressive Disorder ; Depressive Disorder, Major ; Drug-Related Side Effects and Adverse Reactions ; Follow-Up Studies ; Humans ; Prospective Studies ; Referral and Consultation ; Retrospective Studies ; Treatment Outcome

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by attention deficits, hyperactivity, and impulsivity. In the past, ADHD was considered to be limited to children and adolescents. However, ADHD has now been reconceptualized as a lifelong disorder, and two-thirds of ADHD patients continue to have core symptoms and dysfunction in adulthood. Currently, the public and clinicians’ interest in adult ADHD is rapidly increasing in Korea. In addition to interviews with patients for an adult ADHD diagnosis, interviews with family members, existing school records, and neuropsychological tests help clinicians to make a diagnosis. It is necessary to check whether the core symptoms of ADHD were expressed in childhood. Since adults’ symptom patterns differ from those of children, a self-report tool designed for adult ADHD is useful. The medications currently approved for ADHD in adults by the Ministry of Food and Drug Safety of Korea are long-acting methylphenidate and atomoxetine. Both methylphenidate and atomoxetine improve the core symptoms of ADHD as well as daily function. Methylphenidate and atomoxetine can be used safely as first-line treatments, and the overall adverse effects are tolerable. However, attention should be paid to possible cardiovascular adverse events and misuse. Bupropion, modafinil, alpha2-agonist, and tricyclic antidepressants can also be used off-label.

Objectives: Childhood adversity is a risk factor for anxiety symptoms, but it affects anxiety symptoms in attention-deficit/hyperactivity disorder (ADHD). The current study aimed to examine the association between childhood adversity and anxiety symptoms in participants with and without ADHD. Methods: Data were obtained from a school-based epidemiological study of 1017 randomly selected children and adolescents. The ADHD and non-ADHD groups were divided using the Diagnostic Interview Schedule for Children Predictive Scale (DPS). The DPS was also used to assess comorbidities such as anxiety and mood disorders. The childhood adversities were assessed using the Early Trauma Inventory Self Report-Short Form, and the anxiety symptoms were assessed using the Screen for Child Anxiety Related Disorders. Linear and logistic regression models were used to investigate the association between childhood adversity and anxiety in the ADHD and non-ADHD groups with adjustments for age and sex. Results: This study found that the ADHD group did not show any significant association between anxiety symptoms and childhood adversities, whereas the non-ADHD group always showed a significant association. In a subgroup analysis of the non-ADHD group, the normal group without any psychiatric disorders assessed with DPS demonstrated a statistically significant association between childhood adversities and anxiety symptoms. These results were consistent with the association between childhood adversities and anxiety disorders assessed using DPS, as shown by logistic regression. Conclusion The association between anxiety symptoms and childhood adversities statistically disappears in ADHD; ADHD may mask or block the association. Further longitudinal research is necessary to investigate this relationship.

Objectives: Childhood adversity is a risk factor for anxiety symptoms, but it affects anxiety symptoms in attention-deficit/hyperactivity disorder (ADHD). The current study aimed to examine the association between childhood adversity and anxiety symptoms in participants with and without ADHD. Methods: Data were obtained from a school-based epidemiological study of 1017 randomly selected children and adolescents. The ADHD and non-ADHD groups were divided using the Diagnostic Interview Schedule for Children Predictive Scale (DPS). The DPS was also used to assess comorbidities such as anxiety and mood disorders. The childhood adversities were assessed using the Early Trauma Inventory Self Report-Short Form, and the anxiety symptoms were assessed using the Screen for Child Anxiety Related Disorders. Linear and logistic regression models were used to investigate the association between childhood adversity and anxiety in the ADHD and non-ADHD groups with adjustments for age and sex. Results: This study found that the ADHD group did not show any significant association between anxiety symptoms and childhood adversities, whereas the non-ADHD group always showed a significant association. In a subgroup analysis of the non-ADHD group, the normal group without any psychiatric disorders assessed with DPS demonstrated a statistically significant association between childhood adversities and anxiety symptoms. These results were consistent with the association between childhood adversities and anxiety disorders assessed using DPS, as shown by logistic regression. Conclusion The association between anxiety symptoms and childhood adversities statistically disappears in ADHD; ADHD may mask or block the association. Further longitudinal research is necessary to investigate this relationship.

OBJECTIVES: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. METHOD: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education-matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools-including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). RESULTS: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression (GDS> or =10) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. CONCLUSIONS: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.
Aged ; Alzheimer Disease ; Anxiety ; Depression ; Humans ; Memory ; Restless Legs Syndrome ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders ; Trail Making Test

Medical students’ career choices hold significant importance at both individual and national levels. Therefore, Chungnam National University College of Medicine aimed to systematize its revised career fair in 2022, basing its efforts on a career planning process model. Chungnam National University College of Medicine sought to formalize the design process by utilizing the ADDIE model (analysis design, development, implementation, evaluation model) in developing programs for the career fair program. Throughout the entire process, the student support center and student council actively collaborated, striving to incorporate students’ requests and opinions. They designed and developed a program for all stages of the career planning process. However, a new stage (“review & reflection”) was added to the existing 4-phase model, creating a transformed framework where this stage interacts with the original 4 phases. Each stage involved portfolios, career aptitude tests, career-related lectures, posters with introductory information about majors, and booths for each major. The revised career fair attracted double the expected participants (N=589). The program evaluation survey showed overall positive responses (N=135). Additionally, some factors in the Specialty Indecision Scale showed significant differences between before and after the career fair. The success of the newly developed career fair at Chungnam National University College of Medicine can be attributed to its systematic framework and the active involvement of students throughout the process. However, for aspects with long-term implications, such as “understand yourself” and “choose your specialty,” there may be a need for supplementary programs.

Objective: This study seeks to evaluate the association between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the severity of depression and anxiety in the Korean community during the period dominated by the Omicron variant. Methods: We used data from the 2022 Daejeon Mental Health Survey, involving data of 985 participants aged 19–69 years. The data collected included SARS-CoV-2 infection experience, days post-infection, and depression and anxiety symptoms evaluated using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder Questionnaire-7, respectively. Additionally, physical health, social activity status, and sociodemographic characteristics such as gender, age, marital status, educational level, and household income were collected. The association between SARS-CoV-2 infection and depression and anxiety were examined. Further analyses explored association between days post- infection and the severity of depression and anxiety. Results: There was no significant correlation between SARS-CoV-2 infection and depression and anxiety in the overall population. Notably, participants under 50 years of age exhibited a transient worsening of depression and anxiety, followed by a decrease in symptoms within 40 days. Participants aged 51 years and older showed no significant change in depression and anxiety. Conclusion This study discerned transient effects of Omicron variant infection on depression and anxiety, particularly in younger individuals. A prospective study encompassing a larger sample size is imperative to investigate the influence of SARS-CoV-2 infection on depression and anxiety.

OBJECTIVES: The objective of this study was to compare the Korean Personality Rating Scale for Children (K-PRC) profile between children with attention-deficit hyperactivity disorder (ADHD) and typically developing children. We also aimed to investigate the association of K-PRC and ADHD symptoms. METHODS: Ninety-nine youth (age 8.3+/-2.4 years, 72 boys) with ADHD and 84 controls (age 9.2+/-2.5 years, 43 boys) were recruited from the Department of Pediatric Psychiatry of the Asan Medical Center Children's Hospital. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The parents of the subjects completed the ADHD rating scale, and K-PRC. Independent t-tests, analysis of covariance, partial correlation analyses, and Mc Nemar test were used for analysis. RESULTS: Children and adolescents with ADHD showed higher K-PRC scores in verbal development, physical development, depression, delinquency, hyperactivity, family dysfunction and psychoticism. Delinquency and hyperactivity were significantly correlated with parent-rated ADHD rating scales and ADHD scores on K-SADS-PL. The hyperactive/impulsive and combined subtypes showed higher scores on hyperactivity and delinquency than the inattentive subtype, and the inattentive subtype showed higher scores on depression and social dysfunction of the K-PRC. CONCLUSION: Our results suggest that K-PRC could be used to comprehensively evaluate symptoms, combined psychopathologies, developmental delay and family dysfunction of children with ADHD.
Adolescent ; Child* ; Chungcheongnam-do ; Comorbidity ; Depression ; Diagnosis ; Humans ; Mood Disorders ; Parents ; Weights and Measures

OBJECTIVES: This study compared the demographic and clinical characteristics of police referrals with referrals from other sources to a psychiatric emergency department. METHODS: A retrospective cross-sectional study was conducted on the data from the psychiatric emergency department of Ulsan University Hospital from January 2014 to October 2017. The study sample consisted of 79 psychiatric patients who were referred by police, and the characteristics of this group were compared with those of 240 psychiatric patients who were referred by other sources. The collected data were analyzed using a chi-square, Fisher's exact test, and independent sample t-tests. RESULTS: Among the 1768 psychiatric emergency visits, 89 (5.0%) were referred by police, and among the 79 referrals by police chosen as the study group, there were 4(5.1%) cases of emergent psychiatric admission. These patients referred by police were more likely to be male and in a lower socio-economic status. Police referrals were more likely to exhibit violent behavior, be restrained, and more likely to visit after working hours. They were notified more rapidly to the psychiatric department, less notified to other departments, and visited the psychiatric outpatient clinics less after discharge from the emergency department. CONCLUSION: The study results highlight the importance of understanding the characteristics of psychiatric emergency patients referred by police and identifying the problems of the current psychiatric emergency services. Systems need to be developed that clarify the roles of police in psychiatric emergencies and facilitate collaboration between police and mental health institutions.
Ambulatory Care Facilities ; Cooperative Behavior ; Cross-Sectional Studies ; Emergencies ; Emergency Service, Hospital ; Emergency Services, Psychiatric ; Humans ; Male ; Mental Health ; Police ; Referral and Consultation ; Retrospective Studies ; Ulsan

OBJECTIVES: The molecular mechanisms underlying attention-deficit hyperactivity disorder (ADHD) remain unclear. Therefore, this study aimed to identify the genetic susceptibility loci for ADHD in Korean children with ADHD. We performed a case-control and a family-based genome-wide association study (GWAS), as well as genome-wide quantitative trait locus (QTL) analyses, for two symptom traits. METHODS: A total of 135 subjects (71 cases and 64 controls), for the case-control analysis, and 54 subjects (27 probands and 27 unaffected siblings), for the family-based analysis, were included. RESULTS: The genome-wide QTL analysis identified four single nucleotide polymorphisms (SNPs) (rs7684645 near APELA, rs12538843 near YAE1D1 and POU6F2, rs11074258 near MCTP2, and rs34396552 near CIDEA) that were significantly associated with the number of inattention symptoms in ADHD. These SNPs showed possible association with ADHD in the family-based GWAS, and with hyperactivity-impulsivity in genome-wide QTL analyses. Moreover, association signals in the family-based QTL analysis for the number of inattention symptoms were clustered near genes IL10, IL19, SCL5A9, and SKINTL. CONCLUSION: We have identified four QTLs with genome-wide significance and several promising candidates that could potentially be associated with ADHD (CXCR4, UPF1, SETD5, NALCN-AS1, ERC1, SOX2-OT, FGFR2, ANO4, and TBL1XR1). Further replication studies with larger sample sizes are needed.
Adolescent* ; Case-Control Studies ; Child ; Genetic Predisposition to Disease ; Genome-Wide Association Study ; Humans ; Interleukin-10 ; Polymorphism, Single Nucleotide ; Quantitative Trait Loci ; Sample Size