1.Neuroprotection in Schizophrenia and Its Therapeutic Implications.
Psychiatry Investigation 2017;14(4):383-391
Schizophrenia is a chronic and debilitating mental disorder. The persisting negative and cognitive symptoms that are unresponsive to pharmacotherapy reveal the impairment of neuroprotective aspects of schizophrenia. In this review, of the several neuroprotective factors, we mainly focused on neuroinflammation, neurogenesis, and oxidative stress. We conducted a narrative and selective review. Neuroinflammation is mainly mediated by pro-inflammatory cytokines and microglia. Unlike peripheral inflammatory responses, neuroinflammation has a role in various neuronal activities such as neurotransmission neurogenesis. The cross-talk between neuroinflammation and neurogenesis usually has beneficial effects in the CNS under physiological conditions. However, uncontrolled and chronic neuroinflammation exert detrimental effects such as neuronal loss, inhibited neurogenesis, and excessive oxidative stress. Neurogenesis is also a major component of neuroprotection. Adult neurogenesis mainly occurs in the hippocampal region, which has an important role in memory formation and processing. Impaired neurogenesis and an ineffective response to antipsychotics may be thought to indicate a deteriorating course of schizophrenia. Oxidative stress and excessive dopaminergic neurotransmission may create a vicious cycle and consequently disturb NMDA receptor-mediated glutamatergic neurotransmission. Based on the current evidences, several neuroprotective therapeutic approaches have been reported to be efficacious for improving psychopathology, but further longitudinal and large-sample based studies are needed.
Adult
;
Antipsychotic Agents
;
Cytokines
;
Drug Therapy
;
Humans
;
Memory
;
Mental Disorders
;
Microglia
;
N-Methylaspartate
;
Neurobehavioral Manifestations
;
Neurogenesis
;
Neurons
;
Neuroprotection*
;
Oxidative Stress
;
Psychopathology
;
Schizophrenia*
;
Synaptic Transmission
2.Bipolar Disorder in the Elderly.
Journal of Korean Geriatric Psychiatry 2009;13(1):11-18
Growing body of evidence has suggested that bipolar disorder in the elderly is important issue of mental health care. While older bipolar patients show different clinical features and response to treatment compared to younger patients, there are few studies focused on the older bipolar patients. Authors reviewed clinical features and treatment issues for bipolar disorder in the elderly.
Aged
;
Bipolar Disorder
;
Humans
;
Mental Health
;
Mood Disorders
3.Borna Disease Virus Antibody and RNA from Peripheral Blood Mononuclear Cells of Race Horses and Jockeys in Korea.
Jin Won SONG ; Kyoung Sae NA ; Seong Ho TAE ; Yong Ku KIM
Psychiatry Investigation 2011;8(1):58-60
OBJECTIVE: During the last two decades, Borna disease virus (BDV) has received much attention as a possible zoonotic agent, particularly as a cause of psychiatric disease. Although several studies have shown that BDV is present in Asia, BDV has not been detected in Korea. This study was designed to further investigate the presence of BDV infection in Korea. METHODS: Blood samples were taken from 39 race horses and 48 jockeys. Antibody to BDV was detected by indirect immunofluorescence antibody test and RNA of BDV by real time reverse transcriptase PCR (rRT-PCR). RESULTS: No evidence of BDV was detected in either the horses or the jockeys group. CONCLUSION: Our results suggest that BDV infection may not be endemic in Korea. Further studies with novel diagnostic tools are required to clarify the prevalence of BDV infection in Korea.
Animals
;
Asia
;
Borna Disease
;
Borna disease virus
;
Continental Population Groups
;
Fluorescent Antibody Technique, Indirect
;
Horses
;
Humans
;
Korea
;
Prevalence
;
Reverse Transcriptase Polymerase Chain Reaction
;
RNA
4.Effect of Methylphenidate on Learning in Normal Population.
Kyoung Sae NA ; Soyoung Irene LEE
Journal of the Korean Academy of Child and Adolescent Psychiatry 2012;23(2):49-56
Methylphenidate is a widely used stimulant for treatment of attention-deficit hyperactivity disorder (ADHD). In addition to core symptoms of attention and behavioral symptoms, methylphenidate is even effective for executive functions. However, abuse and misuse of stimulants, including methylphenidate, for the purpose of cognitive enhancement is an issue of concern worldwide. Some prejudices and misunderstandings against methylphenidate are popular ; however, little attention has been given to the neuropsychiatric evidence of methylphenidate for enhancement of cognitive function among healthy populations. In this article, our aim was to conduct a review of previous studies investigating the effect of methylphenidate in healthy populations. Findings from several recent studies have demonstrated the effectiveness of methylphenidate for enhancement of cognitive function in healthy populations. The mechanisms of cognitive enhancement are thought to be associated with motivation and the reward circuit in the brain. However, when considering the risk to benefit, an official discussion of the use of methylphenidate among healthy members of the population would be premature. Instead, investigation of epidemiological studies of the prevalence of misuse of stimulants among healthy members of the population, particularly adolescents and college students, is needed. In addition, based on achievements reported in previous studies, investigation of the effect of an approach using non-pharmacological enhancing motivation, which will in turn result in increased cognitive function would be helpful.
Achievement
;
Adolescent
;
Behavioral Symptoms
;
Brain
;
Executive Function
;
Humans
;
Learning
;
Methylphenidate
;
Motivation
;
Prejudice
;
Prevalence
;
Reward
5.A Survey on the Perception for the Disaster Mental Health Services among General Population.
Kyoung Sae NA ; Myung Soo LEE ; Jinhee HYUN ; Ilsung NAM
Journal of Korean Neuropsychiatric Association 2016;55(3):176-184
OBJECTIVES: Disasters exert substantial effects on the mental health of victims and bereaved populations. Thus, a systematic framework for preparing and providing psychosocial and mental health services is necessary. The current attitudes toward and knowledge of disaster mental health-related factors among the general population provides one component for development of the disaster mental health services framework. METHODS: The authors analyzed a web-based survey for disaster mental health-related factors among the general population. Responses for the knowledge and perception for the disaster mental health services were compared between people who experienced and did not experience disaster. RESULTS: One thousand and three people completed the questionnaire. One hundred and seventy (16.9%) people experienced more than one disaster. People who experienced a disaster were more disturbed by disaster broadcasting or reporting than people who had not. People who experienced a disaster gave disaster mental health services an average score 63.5. People who experienced a disaster perceived group psychotherapy and self-help meetings as less important than those who had not. The recognition of both community mental health center and disaster mental health center was higher in the experienced group than non-experienced. CONCLUSION: This study revealed that general satisfaction with the current disaster mental health service is low, particularly among people who have used disaster mental health services. A national mental health system for disaster victims should be established with consideration for efficiency, effectiveness and accessibility.
Disaster Victims
;
Disasters*
;
Health Policy
;
Mental Health Services*
;
Mental Health*
;
Psychotherapy, Group
;
Public Health
6.Prevalence and Correlates of Comorbid Posttraumatic Stress Disorder in Schizophrenia-Spectrum Disorder: A Systematic Review and Meta-Analysis
Anna SEONG ; Seo-Eun CHO ; Kyoung-Sae NA
Psychiatry Investigation 2023;20(6):483-492
Objective:
Schizophrenia-spectrum disorders and posttraumatic stress disorder (PTSD) share common clinical manifestations, genetic vulnerability, and environmental risk factors. We aimed to conduct a systematic review and meta-analysis of the comorbid prevalence of PTSD among schizophrenia-spectrum disorders.
Methods:
We performed a meta-analysis to identify possible contributing factors to the heterogeneity among these studies. We systematically searched electronic databases with no restrictions on language of articles.
Results:
We extracted 24 samples (18 for current prevalence and 6 for lifetime prevalence) from 22 studies and used a random effects model to estimate the pooled prevalence of PTSD among schizophrenia-spectrum disorders. The current and life prevalence of comorbid PTSD was 10.6% (95% confidence interval [CI]=6.3%–17.3%) and 13.0% (95% CI=5.3%–28.6%), respectively. Studies assessing psychotic experiences/involuntary admission reported the highest prevalence of comorbid PTSD (57.1%, 95% CI=43.6%–59.7%), whereas those assessing various anxiety disorders reported the lowest prevalence (1.1%, 95% CI=1.0%–5.5%). Heterogeneities of the subgroup analysis by similar objectives were largely homogeneous (I2=7.1–34.1). In the qualitative assessment, only two studies (9.1%) were evaluated as having a low risk of bias.
Conclusion
Our results showed that a careful approach with particular attention to assessing PTSD is essential to reliably estimate the prevalence of PTSD comorbid with schizophrenia-spectrum disorders. The reason for the wide discrepancy in the prevalence of comorbid PTSD among the four groups of studies should be addressed in future research.
7.Psychological Autopsy: Review and Considerations for Future Directions in Korea.
Kyoung Sae NA ; Jong Woo PAIK ; Mi Kyung YUN ; Hyun Soo KIM
Journal of Korean Neuropsychiatric Association 2015;54(1):40-48
Psychological autopsy is a systematic methodology for comprehensive investigation of psychiatric and behavioral factors assumed to be causative or related to death of the deceased. In many countries, psychological autopsy is considered the most direct and valuable tool for determining the relationship between risk factors and suicide. The case of Finland revealed that successful psychological autopsy studies could greatly contribute to the national suicide prevention strategy, which consequently reduced the national suicide rate. Despite the strengths of psychological autopsy for identifying risk factors of suicide and consequently preventing suicide, it has not been successful in Korea. Implementation of psychological autopsy has been inconsistent and sporadic across the provinces. In addition, standardization of psychological autopsy protocol and qualification of interviewers are needed. With all of these methodological issues in mind, conduct of as many psychological autopsies as possible is important in order to build an evidence-based suicide prevention strategy. For successful implementation of psychological autopsy in Korea, it is necessary to improve attitudes toward suicide and psychiatric conditions. Legal, administrative, and institutional support are also important. Finally, multidisciplinary approach based on the financial and legal support should be employed.
Autopsy*
;
Finland
;
Korea
;
Mental Health
;
Risk Factors
;
Suicide
8.Association between Abacus Training and Improvement in Response Inhibition: A Case-control Study.
Kyoung Sae NA ; Soyoung Irene LEE ; Jun Ho PARK ; Han Yong JUNG ; Jung Hee RYU
Clinical Psychopharmacology and Neuroscience 2015;13(2):163-167
OBJECTIVE: The abacus, first used in Asian countries more than 800 years ago, enables efficient arithmetic calculation via visuo-spatial configuration. We investigated whether abacus-trained children performed better on cognitive tasks and demonstrated higher levels of arithmetic abilities compared to those without such training. METHODS: We recruited 75 elementary school children (43 abacus-trained and 32 not so trained). Attention, memory, and arithmetic abilities were measured, and we compared the abacus with the control group. RESULTS: Children who had learned to use an abacus committed fewer commission errors and showed better arithmetic ability than did controls. We found no significant differences between children with and without abacus training in other areas of attention. CONCLUSION: We speculate that abacus training improves response inhibition via neuroanatomical alterations of the areas that regulate such functions. Further studies are needed to confirm the association between abacus training and better response inhibition.
Asian Continental Ancestry Group
;
Case-Control Studies*
;
Child
;
Cognitive Science
;
Humans
;
Mathematics
;
Memory
9.Informed Consent in Psychiatry.
Won Seok CHOI ; Kyoung Sae NA ; Kang Joon LEE ; Chae Keun OH ; Woong HAHM ; Han Yong JUNG
Journal of Korean Neuropsychiatric Association 2013;52(5):292-300
Informed consent is the procedure that respects the autonomy of patients ; doctors protect patients' choices and rights through informed consent. Competence and voluntariness are prerequisite for the informed consent. In recent years, the necessity of informed consent from the Psychiatric department has been raised. Regarding informed consent from the Psychiatric department, there is a need to consider from two perspectives : respect for the patient's decision-making ability and the psychiatrist's legal self-protection. In competence and voluntariness, psychiatric patients were excluded due to lack of decision-making ability and willingness. However, not all psychiatric patients were able to perform the given task. Therefore, informed consent is needed in the point of view regarding the decision-making ability of psychiatric patients. Psychotropic medications, particularly antipsychotics, can cause several side effects, including extrapyramidal syndrome and metabolic syndrome. Therefore, preannouncement of these patients for these side effects is needed. However, when the informed consent is only applied to psychiatric hospitals, it may increase prejudices and misconceptions about psychiatric medications and treatment. Therefore, the informed consent should first be considered carefully and thoughtfully.
Antipsychotic Agents
;
Hospitals, Psychiatric
;
Human Rights
;
Humans
;
Informed Consent*
;
Mental Competency
;
Prejudice
10.Alteration of Cognitive Function in Mild Traumatic Brain Injury Patients Grouped by Subjective Depression.
Heesung HWANG ; Kyoung Sae NA ; Shin Gyeom KIM ; Soyoung Irene LEE ; Han Yong JUNG
Journal of Korean Neuropsychiatric Association 2012;51(5):300-305
OBJECTIVES: To examine the association of subjective depressive symptoms and cognitive dysfunction in patients with mild traumatic brain injury (mTBI). METHODS: 36 patients with mTBI without structural abnormality in the brain imaging study were recruited. Participants were subdivided into two groups by a cutoff score of 70T in the Beck Depression Inventory (BDI). Cognitive functions including intelligence, memory, and executive function were significantly lower in the <70T group compared to the > or =70T group. In addition, BDI scores were negatively correlated with performances in most of the neuropsychological tests. RESULTS: Patients group who scored 70T or more in the BDI showed significantly lower scores in most items of the neuropsychological tests. CONCLUSION: High subjective depression is associated with low neuropsychological performance in mTBI.
Brain Injuries
;
Depression
;
Executive Function
;
Humans
;
Intelligence
;
Memory
;
Neuroimaging