No abstract available.
Hospitals, Psychiatric* ; Humans ; Inpatients*

Attention is a phenomenon hard to define, but can be conceptualized as a mental function ranging from sustaining readiness to perceive stimuli to understanding the nature and value and selecting stimuli that are most relevant to the given situation. Manifestations of attention include vigilance, and focused, directed, selective, divided, and sustained attentions. While basic attentional tone is controlled by the interaction among reticular activating system, thalamus, and prefrontal cortex, direction and selection of attention is controlled by neural circuits of prefrontal, posterior parietal, and limbic cortex. It is expected that understanding of attention and its neural could provide answers to the relationship between pathophysiology and clinical symptoms of some major psychiatric disorders. More effort are required to develop tools to assess more detailed and various aspects of attention in Korea.
Attention ; Korea ; Prefrontal Cortex ; Rabeprazole ; Thalamus

No abstract available.
Carbamazepine* ; Haloperidol*

OBJECTIVE: This study was conducted to develop the computerized attention tests for Korean adults. It also aimed at evaluating the reliability and validity of these tests and providing their normative data. METHODS: Computerized versions of auditory & visual continuous performance tests (CPTs), controlled CPTs, and trail making test A & B were developed through several steps of preliminary applications and corrections. The test-retest reliabilities of each test was evaluated by the paired t-test and Pearson's correlation coefficient using the data from 27 normal persons. The validity of each test was evaluated by the Pearsons's correlation coefficient between the computerized test scores and the preexisting cognitive function tests using the data from 48 normal persons. The normative data were obtained from the 154 Korean adults, aged 20 to 50, whose educational levels were higher than high school graduate. RESULTS: There were no statistical differences between the means of the test and retest scores. High correlations were also observed between the tests and retest scores. The number of correct responses of the computerized CPTs were highly correlated with each other. They were also highly correlated with the scores of the pre-existing attentional measures. Trail making test scores were highly correlated with higher cortical functions such as IQ and hypothesis formation abilities. The CPTs scores were not affected by sex, educational level, and age. The performances for the visual CPTs were higher than those of auditory tests. Trial making test scores were influenced by educational level and age. The normative data and guidelines for interpretation were provided. CONCLUSION: Clinically applicable computerzied attention assessement tools with high reliability and validity were developed. The normative data for the Korean adults aged 20 to 50 were obtained and the guidelines for the interpretation were provided.
Adult* ; Humans ; Reproducibility of Results ; Trail Making Test

OBJECTIVES: This study was conducted to develop the computerized higher function assessment tools for Korea adults. It also aimed at evaluating the reliability and validity of these tests and providing their normative data. METHODS: Computerized versions of card sorting test, hypothesis formation test, color-word test, and finger tapping test were developed through several steps of preliminary applications and corrections. The test-retest reliability of each test was evaluated by the paired t-test and Pearson's correlation coefficient using the data from 27 normal subjects. The validity of each test was evaluated by the Pearsons's correlation coefficient between the computerized test scores and the pre-existing cognitive function tests using the data from 48 normal subjects. The normative data were obtained from the 150 Korean adults, age 20 to 50, whose educational levels were higher than high school graduate. RESULTS: There were no statistical differences between the means of the test and retest scores except hypothesis formation test, which showed marked practice effect. High correlations were also observed between the tests and the retest scores(r ranged from 0.543 to 0.905). The computerized higher cortical assessment tests scores were highly correlated with the scores of the pre-existing cognitive function tests, such as Standard Progressive Matrices. The scores of the card sorting test and the color-word test were not influenced by age, sex, and education level. However, the scores of the hypothesis formation were greatly influenced by the education level, and the scores of the finger tapping test were greatly influenced by sex. The normative data and guidelines for interpretation were provided. CONCLUSIONS: Clinically applicable computerized higher cortical function assessment tools with high reliability and validity were developed. The normative data for the Korean adults aged 20 to 50 were obtained and the guidelines for the interpretation were provided.
Adult* ; Education ; Fingers ; Humans ; Korea ; Reproducibility of Results

OBJECTIVE: Bipolar disorder patients often show excessive goal-directed and pleasure-seeking behavior during manic episodes and reduced hedonic capacity during depressive episodes, indicating that bipolar disorder might involve altered reward processing. As such, bipolar disorder subjects have been reported to show impaired reward learning in situations requiring integration of reinforcements over time. In this study, we examined characteristics of reward learning in euthymic patients with bipolar disorder using a probabilistic reward task. METHODS: We recruited 23 euthymic patients with bipolar disorder and 47 healthy subjects for the probabilistic reward task. This task is a reward-based paradigm to produce a response bias, in which correct identifications of two ambiguous stimuli are differently rewarded. The other dependent measures were the discriminability, hit rate and reaction time. RESULTS: Relative to comparison subjects, bipolar patients showed a reduced acquisition of response bias toward the more frequently rewarded stimulus (p<0.01). The overall reward learning was positively correlated with state and trait anxiety levels in bipolar patients (p<0.01). No significant differences of discriminability, hit rates, and reaction time were found between bipolar patients and controls. CONCLUSION: These findings suggest that euthymic patients with bipolar disorder may have deficits in reward learning related to anxiety.
Anxiety ; Bias (Epidemiology) ; Bipolar Disorder ; Humans ; Learning ; Reaction Time ; Reinforcement (Psychology) ; Reward

OBJECTIVE: Posttraumatic embitterment disorder (PTED) is characterized by states of “embitterment”, characteristically similar to “Hwa-byung”, which is a Korean culture-bound syndrome. The present study aimed to assess diagnostic relationships between PTED and Hwa-byung. METHODS: A total of 290 participants completed our survey. PTED and Hwa-byung were diagnosed using a diagnostic interview and scale. Scales for depression, suicide ideation, and anger were used for evaluation. Fisher's exact tests and Mann-Whitney U tests were performed to evaluate diagnostic overlap between PTED and Hwa-byung, and associations of scale scores for depression, suicide ideation, and anger between the PTED, Hwa-byung, and non-diagnosed groups. Associations of these scales between the depressive and non-depressive groups, and suicidal and non-suicidal groups were also evaluated. RESULTS: Among the participants, 1.7% of the sample fit the diagnostic criteria for PTED and 2.1% fit the criteria for Hwa-byung. No individual fit the criteria for both. Anger scores were significantly higher in the Hwa-byung group than in the non-diagnostic group. There were not any significant differences in anger scores between the PTED and non-diagnostic groups. Depression scores were significantly higher in the PTED than in the non-diagnostic groups. In contrast, no significant differences were observed between depression scores in the Hwa-byung and non-diagnostic groups. CONCLUSION: These results suggest that PTED may be a disorder category that is distinct from Hwa-byung.
Anger ; Asian Continental Ancestry Group ; Depression ; Ethnopsychology ; Humans ; Suicide ; Weights and Measures

OBJECTIVES: This study aims to test the validity of the Korean version of Mood Disorder Questionnaire (K-MDQ), a screening instrument for bipolar disorder. METHODS: A total of 238 subjects (126 DSM-IV bipolar outpatients and 112 controls without psychiatric history) completed the K-MDQ. RESULTS: The Cronbach's alpha, used to measure the internal consistency of the scale, was high (0.88). Principal component analysis with varimax rotation revealed three factors, which explained 59.5% of the variance. Individual item correlations with the total score were all statistically significant (p<0.001). The mean total score of the K-MDQ was 8.48 in bipolar disorder and 4.51 in non-clinical participants. A total K-MDQ score of 7 or more excluding further two questions was chosen as the optimal cutoff, as it provided good sensitivity (0.75) and specificity (0.69). CONCLUSION: The results of this study showed adequate validity of the K-MDQ, suggesting that this instrument is useful for screening of bipolar disorder.
Bipolar Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening ; Mood Disorders* ; Outpatients ; Principal Component Analysis ; Surveys and Questionnaires ; Sensitivity and Specificity

OBJECTIVES: This study aims to test the validity of the Korean version of Mood Disorder Questionnaire (K-MDQ), a screening instrument for bipolar disorder. METHODS: A total of 238 subjects (126 DSM-IV bipolar outpatients and 112 controls without psychiatric history) completed the K-MDQ. RESULTS: The Cronbach's alpha, used to measure the internal consistency of the scale, was high (0.88). Principal component analysis with varimax rotation revealed three factors, which explained 59.5% of the variance. Individual item correlations with the total score were all statistically significant (p<0.001). The mean total score of the K-MDQ was 8.48 in bipolar disorder and 4.51 in non-clinical participants. A total K-MDQ score of 7 or more excluding further two questions was chosen as the optimal cutoff, as it provided good sensitivity (0.75) and specificity (0.69). CONCLUSION: The results of this study showed adequate validity of the K-MDQ, suggesting that this instrument is useful for screening of bipolar disorder.
Bipolar Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening ; Mood Disorders* ; Outpatients ; Principal Component Analysis ; Surveys and Questionnaires ; Sensitivity and Specificity

OBJECTIVE: The purpose of this study was to examine the pharmacological treatment patterns in inpatients with bipolar disorder at a university hospital, and to establish appropriate clinical practice guideline in light of recent advances of pharmacotherapy of bipolar disorder. METHODS: A total of 454 first-admission cases with a diagnosis of bipolar disorder or schizoaffective disorder from 1990 to 2001 were analyzed with regard to the clinical characteristics and the use of mood stabilizers, antidepressants and antipsychotics. RESULTS: In manic, hypomanic, and mixed episodes, there has been a substantial increase in the use of valproate while the use of lithium has decreased. Antipsychotic drugs were prescribed as combination regimen in over 80% of total cases. In 44.6% of bipolar depression cases, mood stabilizers were not prescribed. In 70.7% of bipolar depression cases not receiving mood stabilizers, antidepressant monotherapy was utilized. The use of SSRIs and RIMA has increased, while a decrease was observed for TCA. There has been a tendency of the increased use of atypical antipsychotics. In particular, clozapine monotherapy has increased in mood stabilizer resistant cases. CONCLUSIONS: The results of the present study suggest that the prescription patterns have changed in general agreement with recent advances of pharmacotherapy of bipolar disorder during the past twelve years. However, there was clear tendency to use antipsychotics rather than other mood stabilizers as the combination regimen. Moreover, accurate diagnosis and careful reconsideration for pharmacological treatment strategies are required in bipolar depression, mixed states, and rapid cycling.
Antidepressive Agents ; Antipsychotic Agents ; Bipolar Disorder* ; Clozapine ; Diagnosis ; Drug Therapy* ; Humans ; Inpatients ; Lithium ; Prescriptions ; Psychotic Disorders ; Valproic Acid