OBJECTIVES: The aim of this study was to investigate associations between obesity indices and cognitive functions using data from individuals older than 65 years in South Korea. METHODS: A total of 151 Koreans older than 65 years participated in this study voluntarily. Obesity was determined using body mass index (BMI) and waist-hip ratio (WHR). Cognitive function was evaluated using the Korean version of the Mini-Mental State Examination (MMSE-K). The participants were divided into four groups according to BMI : underweight (BMI<18.5), normal (18.5< or =BMI<23.0), overweight (23.0< or =BMI<25.0), and obesity (BMI> or =25.0), and two groups according to WHR : normal (WHR<18.5) and abdominal obesity (WHR> or =0.8). Baseline characteristics were compared among different BMI or WHR subgroups. RESULTS: Older age and smoking habits showed an association with poor cognitive function. Among different BMI groups, the overweight group had the highest scores of MMSE-K ; the item scores for time and place orientation (4.48+/-0.770 and 4.80+/-0.500) and attention/calculation (4.00+/-1.258) as well as total score (25.88+/-2.877). Overweight in BMI showed an association with better cognitive function (OR(adjusted )=0.098, 95% confidence interval=0.017-0.577). CONCLUSION: In this study, the overweight group measured by BMI showed better cognitive function than other groups. Overweight in elderly might be acceptable in order to maintain cognitive performance. Further investigation regarding the underlying mechanism explaining the relationship between cognitive function and body weight will be needed.
Aged* ; Body Mass Index ; Body Weight ; Humans ; Obesity* ; Obesity, Abdominal ; Overweight ; Republic of Korea ; Smoke ; Smoking ; Thinness ; Waist-Hip Ratio

OBJECTIVE: In South Korea, the number of deaths from suicide has increased in the last two decades, and suicide has become both a social and political problem. In this study, after controlling the variables influencing suicidal ideation, it was expected that it would be determined if anxiety symptoms are independently related to suicidal ideation. METHODS: Data were obtained from 327 psychiatric outpatients accomplished a self-reported questionnaire that included sociodemographic characteristics and clinical variables as well as self-rating scales for measuring the severity of one's anxiety, depression, and suicidal ideation. Logistic-regression analyses were used to determine the correlation between anxiety symptoms and significant suicidal ideation, adjusting for covariates. RESULTS: The patients with significant suicidal ideation were shown to be less educated, unemployed, never married, divorced, or separated by death, or living alone, and were shown to have a lower income, a drinking habit, a higher number of past suicide attempts, and more family members who committed suicide, than the patients without significant suicidal ideation. After adjusting the covariates influencing significant suicidal ideation, anxiety symptoms were associated with significant suicidal ideation. However, after adjusting for depressive symptoms, only the trait anxiety was associated with significant suicidal ideation. CONCLUSION: These findings suggest that anxiety symptoms are an independent risk factor for suicidal ideation. Clinicians may thus use anxiety symptoms for the screening examination when evaluating suicidal ideation and risk, and will have to actively evaluate and treat the anxiety symptoms of patients with suicidal tendencies.
Anxiety ; Depression ; Divorce ; Drinking ; Humans ; Mass Screening ; Outpatients ; Surveys and Questionnaires ; Republic of Korea ; Risk Factors ; Single Person ; Suicidal Ideation ; Suicide ; Weights and Measures

OBJECTIVES: The author investigated the relationship between the environmental tobacco smoke exposure during mid-pregnancy and early childhood and neurobehavioral outcomes of preschool children and if there is any effect of the genetic polymorphism of glutathione S-transferase (GST) M1 and T1 on this relationship. METHODS: The participants were the pregnant women (week 24-28) who visited the obstetrics and gynecology department (between 2001 and 2004). They had been evaluated for their sociodemographic data including direct and environmental tobacco smoke exposure history and the urine specimen had been sampled for the measurement of cotinine. The offsprings' urine specimen and blood sampling had been done and the socioeconomic data including the environmental tobacco smoke exposure history was evaluated at age 3. The cotinine level of urine specimen was measured and GST polymorphism was analyzed. The offsprings completed Korean-Childhood Behavioral Check List (K-CBCL) at age 4-5. RESULTS: The environmental tobacco smoke exposure during mid-pregnancy based on urine cotinine level has a significant association with increased total score and externalizing problem score of K-CBCL (p<0.05). The environmental tobacco smoke exposure based on urine cotinine level at age 3 is associated increased total score, externalizing problem score and internalizing problem score of K-CBCL with no statistical significance. The environmental tobacco smoke exposure after controlling for tobacco smoke exposure during pregnancy, however, is significantly associated with the increased externalizing problem scores (p=0.04). The environmental tobacco smoke exposure is associated with increased total score, externalizing problem score and internalizing problem score of K-CBCL with GSTM1 null type or GSTT1 null type at age 3 although there was no statistical significance. CONCLUSION: The environmental tobacco smoking exposure during pregnancy and at early childhood is associated with childhood behavioral problems. The clinical implication of this study is that it is important to avoid the environmental tobacco smoke exposure during pregnancy and early childhood and to monitor the possible emergence of behavioral problems of children.
Child ; Child, Preschool ; Cotinine ; Female ; Glutathione ; Glutathione Transferase ; Gynecology ; Humans ; Obstetrics ; Organothiophosphorus Compounds ; Polymorphism, Genetic ; Pregnancy ; Pregnant Women ; Smoke ; Smoking ; Tobacco

OBJECTIVES: The misdiagnosis of delirium may result in a delay of correct diagnosis and appropriate treatment of the delirium. Additionally, aggravation of physical illnesses can occur. The objective of this study was to investigate patient characteristics in cases of misdiagnosed delirium upon psychiatric consultation in a university hospital. METHODS: Subjects included patients with delirium among all who we had consulted over a 12 week span. Psychiatric diagnosis was made by two well-trained psychiatrists by means of the DSM-IV-TR. Cognitive function, level of delirium, and physical function were evaluated by the Korean version of Mini Mental Status Examination (MMSE-K), the Delirium Rating Scale-Revised-98 (DRS-R-98), the Clinical Global Impression-Severity (CGI-S), the Eastern Cooperative Oncology Group Performance Status (ECOG-PS), and the Global Assessment of Functioning Scale (GAF). In addition, we collected socio-demographic information, date of admission and consultation, present causes of consultation, and speculated psychiatric diagnoses made by referring physicians. RESULTS: Among 45 subjects with delirium, only 28 patients (62%) were diagnosed with delirium by referring physicians at the time of consultation. The remaining 17 patients (38%) had been diagnosed with other illnesses. The group of misdiagnosed patients tended to have a longer duration of formal education than those that had been correctly diagnosed. CONCLUSION: Early diagnosis and intervention of delirium can minimize subsequent problems related to delayed diagnosis. Therefore, it is vital to identify the factors related to misdiagnoses by referring physicians. This study showed that a longer duration of formal education is a contributing factor for the misdiagnosis of delirium. Longer education may cover up the typical symptoms of delirium. This can keep referring physicians from making a correct diagnosis. This study was a pilot study investigating diagnostic accuracy of delirium by referring physicians. Additional, well-controlled studies are warranted.
Delayed Diagnosis ; Delirium ; Diagnostic Errors ; Early Diagnosis ; Humans ; Mental Disorders ; Pilot Projects ; Psychiatry

OBJECTIVES: Stressful life events play the important role in depression. Somatic symptoms have also been closely linked to life stress. This study aimed to investigate the influence of life stress during four different life stages (childhood, adolescent, from 19 years to last year, the year prior to interview) on the severity of depression and somatic symptoms in depressive women. METHODS: Seventy women who had been diagnosed with major depressive disorder or dysthymic disorder according to the DSM-IV TR, and whose ages varied from 21 to 72 years (average age : 41 years), completed the Mooney Problem checklist, the Beck Depression Inventory (BDI), and Wittenborn`s somatic symptom scale. RESULTS: Life stressors which significantly influenced the severity of depression were difficulties with parents in the initial life stage, difficulties with other people in the third and fourth stages, and difficulties with social relationships in the fourth stage Further, somatic symptoms were influenced by health problem in the second period, difficulties with partners were prominent in the third stage, and difficulties with other people were noted in the fourth stage. The severity of depression showed a significantly positive correlation both with autonomic nervous system (p<0.001) and menopausal symptoms (p<0.001). After controlling for age, the severity of depression showed a significant positive correlation with stressors in the first stage (p<0.05), third stage (p<0.05), and fourth stage (p<0.01). Somatic symptom scores exhibited a significantly positive correlation with stressors in the second (p<0.05) and fourth stages (p<0.05). CONCLUSION: Current results suggested that the severity of depression and somatic symptoms were influenced by difficulties with other people in the fourth stage. The results of this study suggests that depression and somatic symptoms can be abbreviated by regulating excess stress.
Adolescent ; Autonomic Nervous System ; Checklist ; Depression ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Dysthymic Disorder ; Female ; Humans ; Parents ; Stress, Psychological

OBJECTIVE: The goal of this study is to assess the relationship between stress coping mechanisms and the risk of atherosclerosis in patients with Hwa-Byung. METHODS: The Korean version of the Ways of Coping Checklist (WOCC) was administered to 50 patients with Hwa-Byung (49.1+/-10.1 years, 6 males). Brachial-ankle pulse wave velocity (baPWV) and serum cholesterol level were assessed in all participants. RESULTS: After controlling for age, sex, diagnosis of hypertension, Body Mass Index (BMI), and serum cholesterol level, the score of seeking social support in coping strategies was negatively correlated with right and left baPWV (r=-0.356, p=0.016; r=-0.373, p=0.012, respectively). In addition, the score of active coping mechanism was negatively correlated with both sides of baPWV (r=-0.383, p=0.009; r=-0.389, p=0.008, respectively). CONCLUSION: The seeking social support and active coping mechanism were inversely related to the severity of arterial stiffness in Hwa-Byung patients. Therefore, our result may suggest a possibility that coping strategies in Hwa-Byung patients are associated with the risk of atherosclerosis.
Atherosclerosis ; Body Mass Index ; Checklist ; Cholesterol ; Humans ; Hypertension ; Pulse Wave Analysis ; Vascular Stiffness

OBJECTIVE: The goal of this study is to assess the relationship between stress coping mechanisms and the risk of atherosclerosis in patients with Hwa-Byung. METHODS: The Korean version of the Ways of Coping Checklist (WOCC) was administered to 50 patients with Hwa-Byung (49.1+/-10.1 years, 6 males). Brachial-ankle pulse wave velocity (baPWV) and serum cholesterol level were assessed in all participants. RESULTS: After controlling for age, sex, diagnosis of hypertension, Body Mass Index (BMI), and serum cholesterol level, the score of seeking social support in coping strategies was negatively correlated with right and left baPWV (r=-0.356, p=0.016; r=-0.373, p=0.012, respectively). In addition, the score of active coping mechanism was negatively correlated with both sides of baPWV (r=-0.383, p=0.009; r=-0.389, p=0.008, respectively). CONCLUSION: The seeking social support and active coping mechanism were inversely related to the severity of arterial stiffness in Hwa-Byung patients. Therefore, our result may suggest a possibility that coping strategies in Hwa-Byung patients are associated with the risk of atherosclerosis.
Atherosclerosis ; Body Mass Index ; Checklist ; Cholesterol ; Humans ; Hypertension ; Pulse Wave Analysis ; Vascular Stiffness

Propofol is a well-known ultra-short acting intravenous anesthetic agent for induction and maintenance of general anesthesia. Since its introduction into the market in the mid 1980s, this is the seventh report on propofol dependence in the literature. Of these, only two cases of propofol abuse have been previously reported in laypersons. We are reporting the case of a lay female who has dependence on propofol, and this is the first lay case in Asia.
Anesthesia, General ; Female ; Humans ; Propofol ; Substance-Related Disorders

OBJECTIVES: This study was intended to compare psychiatric symptoms, neurocognitive function and quality of life between normal finding group and abnormal finding group on Brain-MRI. We investigated which variables were related to quality of life (QOL) in traumatic brain injury (TBI) patients. METHODS: Among thirty nine patients who had mild to moderate TBI, twenty two patients (57%) showed abnormal brain MRI findings correlated with their injury and 17 patients (43%) showed normal or nonspecific brain MRI findings. All patients completed Symptom check list-90-revised (SCL-90-R), Beck depression inventory (BDI), State-trait anxiety inventory (STAI), Korean version of the Smith Kline Beecham Quality of Life scale (KvSBQOL) and Marlowe-Crown Social Desirability Scale (MCSDS). Two psychiatrists assessed the patients using Hamilton rating scale for depression (HAMD), Hamilton anxiety scale (HAMA) and Functional assessment scale (FAS). In addition, Korean Wechsler Adult intelligence Scale (K-WAIS), Rey-Kim Memory Test (R-KMT) and Kims frontal-executive neuropsychological test (KF-ENT) were assessed. RESULTS: On FAS, the mean score was significantly lower in the abnormal finding on B-MRI group than the normal finding group (p=0.014). In the patients with abnormal MRI findings, the QOL scores significantly correlated with several subscales of SCL-90-R (obsessive-compulsive, depression, anxiety, global severity index and positive symptom total), FAS and memory quotient after controlling for MCSDS. However, in the patients with normal MRI findings, QOL scores significantly correlated with BDI and all subscales of SCL-90-R. When all pertinent variables were entered in stepwise regression analysis, depression (p<0.05) and interpersonal sensitivity (p<0.05) subscales of SCL-90-R explained 38.5% and 17.7% of the variance of the QOL score in patients with abnormal MRI findings. As for the patients with normal MRI findings, depression (p<0.05) subscale of SCL-90-R accounted for 54.2% of the variance of the QOL score. CONCLUSION: TBI patients who have persisting abnormal brain findings suffered from impaired daily functioning. Depression and interpersonal sensitivity explained 55% of the variance of the QOL together. In the patients with normal brain MRI findings, objective depression or anxiety did not correlate with QOL whereas subjective depressive symptom accounted for 54.2% of the variance of the QOL. This study suggests that subjective psychiatric symptoms including depression significantly correlated with the subjective QOL of TBI patients regardless of their brain MRI finding.
Adult ; Anxiety ; Brain ; Brain Injuries* ; Depression ; Humans ; Intelligence ; Magnetic Resonance Imaging ; Memory ; Neuropsychological Tests ; Psychiatry ; Quality of Life* ; Social Desirability

OBJECTIVES: This study investigated how diabetes mellitus (DM) and depressive symptoms are related, and differed in terms of coping strategies. In addition, we compared those findings with rheumatoid arthritis (RA) patients. METHODS: 80 DM patients, 45 RA patients and 77 healthy subjects completed the Beck depression inventory (BDI) and the Korean version of the ways of coping checklist. RESULTS: BDI scores of depressed DM patients were significantly higher than healthy subjects (p<0.01) but not significantly with depressed RA patients. Both scores of active (p<0.01) and passive coping (p<0.05) in DM patients were significantly lower than healthy subjects (p<0.01), and the scores of wishful thinking of DM patients were significantly lower than RA patients (p<0.01). BDI scores of DM patients were significantly correlated with the number of complications and the scores of problem-focused coping (p<0.05). In the hierarchical regression analysis, even after controlling for clinical characteristics, coping strategies altogether could account for 31.0% of the variance of the depressive symptoms in DM patients significantly (p<0.01). CONCLUSION: DM patients showed significantly higher depression rate than healthy subjects but not than RA patients. In DM patients, insufficient coping strategies could explain substantial portions of depressive symptoms. Therefore, enhancing healthier coping strategies in addition to prevent medical complications might lessen depressive symptoms experienced by DM patients.
Arthritis, Rheumatoid* ; Checklist ; Depression* ; Diabetes Mellitus* ; Humans ; Thinking