The prevalence of obesity and overweight is increasing in mood disorder, and it is connected to an increased cardiovascular mortality. Because of them, treatment for obesity may be an essential part of mood disorder treatment. Similar to the general population, non-pharmacological treatment such as correction of life habits should be considered first of all. If this approaches are fail, pharmacological treatment for obesity would be required as next step. Any drug for obesity is not approved officially in mood disorder. So approved drugs in general population, and drugs supported by several studies are prescribed in clinical settings. Several treatment guidelines for mood disorder and studies support that orlistat, metformin, topiramate and bupropion is effective and safe.
Bupropion ; Drug Therapy* ; Metformin ; Mood Disorders* ; Mortality ; Obesity* ; Overweight ; Prevalence

Among the mood disorders in the elderly aged older than 65, dysthymia, major depression, and mania constitute the prototypes and depressed mood is the most frequent symptom. The mode of psychotherapy and psychosocial therapy for geriatric depression, which are similar throughout adulhood, include brief dynamic psychotherapy, interpersonal psychotherapy, psychoanalytic psychotherapy and psychoanalysis, supportive psychotherapy, cognitive therapy, family therapy, and group therapy. Psychotherapy alone is of value primarily in dysthymia and major depression. Short-term cognitive therapy, brief dynamic psychotherapy, and interpersonal psychothearapy have been found to be effective, without medications, in high-functioning elders suffering from major depression with minimal or no cognitive impairment. Cognitive-behavioral psychotherapy may be the treatment of choice in the depressed medically ill. Whatever technique is utilized, it is important to be aware of the dynamic issues that are prevalent in geriatric depression patients, as well as the transference and countertransferenc problems that may be aroused.
Aged ; Bipolar Disorder ; Cognitive Therapy ; Depression ; Family Therapy ; Humans ; Mood Disorders* ; Psychoanalysis ; Psychotherapy* ; Psychotherapy, Group

Among the mood disorders in the elderly aged older than 65, dysthymia, major depression, and mania constitute the prototypes and depressed mood is the most frequent symptom. The mode of psychotherapy and psychosocial therapy for geriatric depression, which are similar throughout adulhood, include brief dynamic psychotherapy, interpersonal psychotherapy, psychoanalytic psychotherapy and psychoanalysis, supportive psychotherapy, cognitive therapy, family therapy, and group therapy. Psychotherapy alone is of value primarily in dysthymia and major depression. Short-term cognitive therapy, brief dynamic psychotherapy, and interpersonal psychothearapy have been found to be effective, without medications, in high-functioning elders suffering from major depression with minimal or no cognitive impairment. Cognitive-behavioral psychotherapy may be the treatment of choice in the depressed medically ill. Whatever technique is utilized, it is important to be aware of the dynamic issues that are prevalent in geriatric depression patients, as well as the transference and countertransferenc problems that may be aroused.
Aged ; Bipolar Disorder ; Cognitive Therapy ; Depression ; Family Therapy ; Humans ; Mood Disorders* ; Psychoanalysis ; Psychotherapy* ; Psychotherapy, Group

This is the report of our clinical experience of 1365 cases of aneethesia for eelectroconvu lsive therapy at the Department of Anesthsiology, Maryknoll Hospital, during the period of March, 1989 to February, 1986. To prevent complications, suck as compressed fracture of the spine, and to improve doctor-patient relationship, softening electroconvulsive therapy is the preferred treatment for indicated cases.The results were as follows: 1) Diagnostic distribution of the patients treated by E.C,T. were schizophrenia 74.3%, affective disorder 15.0%, other psychosis 10.7$. 2) Average number of treatments given to a patient were average 6.7 times, for the entire group,7.8times for schizophrenia, 8.2 times for the patients with mania,5.5 times for the Patients with major depression, 5.6 times for the patients with the other psychosises. 3) Medication required was sufficient with half the dosage of uaual surgical procedu res ; ie, atropine sulfate 0.008 mg/kg, thiopental sodium 2.5 mg/kg, and succinylcholine 0.5 mg /kg. 4) Duration of apnea averaged 2 minutes 30 seconds, awakening averaged 10 minutes, and average duration per treatment was 15 min. 5) Few patients complained of discomfort or phobia, and less personnel and less effort were required. Complications and side effecta due to anesthesia were minimal.
Anesthesia ; Anesthesia, General* ; Apnea ; Atropine ; Depression ; Electroconvulsive Therapy* ; Humans ; Mood Disorders ; Phobic Disorders ; Psychotic Disorders ; Schizophrenia ; Spine ; Succinylcholine ; Thiopental

OBJECTIVE: Electroconvulsive therapy (ECT) is used in the treatment of many psychiatric diseases and this therapy may be effective on antioxidant defence system. In this study, we aimed to evaluate the effects of ECT on oxidative stress. METHODS: Fourteen major depression, 11 schizophrenia and 8 bipolar affective disorder patients diagnosed and received ECT treatment, and 37 healthy volunteers enrolled in the study. ECT was applied to all patients. Before ECT, after the first and last ECTs, serum samples were obtained. Serum total antioxidant status (TAS), total oxidant status (TOS), and calculated oxidative stress index (OSI) were measured in patients before and after ECTs. RESULTS: TOS values before ECT were higher in major depression (p=0.005) and schizophrenia (p=0.001) groups compared to the control group. TAS values were lower in major depression (p=0.0001), schizophrenia (p=0.004), bipolar affective disorder (p=0.004) groups compared to the controls. Also OSI values were higher in major depression (p=0.0001), schizophrenia (p=0.001), bipolar affective disorder (p=0.009) groups compared to healthy group. After the last ECT, TOS values were significantly lower compared to TOS values before ECT in major depression (p=0.004) and schizophrenia patients (p=0.004). TAS values after the first ECT were higher compared to values before ECT in major depression patients (p=0.004). After last ECT, OSI values were significantly lower compared to before ECT in schizophrenia patients (p=0.006). CONCLUSION: As a result, it can be said that ECT did not increase oxidative stress. However, further studies with more patients are needed.
Depression ; Electroconvulsive Therapy* ; Healthy Volunteers ; Humans ; Mood Disorders ; Oxidative Stress ; Schizophrenia

Recurrent mood disorders show tendencies toward cycle acceleration over time-shorter and shorter well intervals belween successive episodes. On the other hand, clinical findings suggest that psychosocial stresses ore impl icated more prominently in early episodes of mood disorders, whereas less prominent stressors or conditioned behavioral factors are associated with the onset of later episodes. The dual models of behavioral sensitization and kindling may help to explain the pattern of apparent clinical course in th natural history of mood disorders and to link older psychoanclytic and neurobiologic concepts of illness evaluation. The unified approach suggests that psychosocial precipitants are involved in initial episodes, but later ones occur more autonomously : both the stresses and episodes themselves may leave behind changes in the individual's neurobiology by affecting gene expression. From the standpoint of treatment the dual models place a high premium on effective early pharmacologic interventions and their long term maintenance, and support the combination of psychotherapeutic and pharmacologic interventions, accepting the usefulness of psychodynamic or cognitive therapy.
Acceleration ; Cognitive Therapy ; Gene Expression ; Hand ; Mood Disorders* ; Natural History ; Neurobiology

OBJECTIVES: This study was performed to review the change of research trends and to suggest the mode of future development in the field of Korean geriatric psychiatry by analyzing the titles of Korean medical articles associated with geriatric psychiatry. MATERIALS AND METHODS: Using medical literature searching site on the internet, the articles published between 1994 and 2003 associated with geriatric psychiatry were examined. The articles completed by non-psychiatric researchers were excluded from this analysis. The titles of articles examined were categorized according to the textbook's index of Korean geriatric psychiatry. Domestic materials published in international journals between 1994 and 2003 were also categorized using the same method. RESULTS: Overall, 283 articles were published in the domestic and international journals. The number of articles was abruptly increased after the year of first publishment of the official journal of Korean Association for Geriatric Psychiatry (Journal of Korean Geriatric Psychiatry, JKGP). The number of articles of domestic materials published in international journals was remarkably increased since 2001. The most frequent topic area in the journals was 'psychiatric disorders' area and the next was 'diagnosis and evaluation' area. In the topic of 'basic science' area, epidemiologic aspect was most frequently studied and was followed by genetic aspect. In the topic of 'diagnosis and evaluation' area, evaluation of neurocognitive function and psychiatric evaluation were more active than medical and neurological evaluations. In the topic of 'psychiatric disorder' area, dementia research was extremely active and mood disorder research was also active. In the topic of 'treatment' area, pharmacotherapy research was more active than psychotherapy research. Types of the JKGP articles published in 2003 were review articles in 52.6%, original articles in 31.6%, and case reports in 15.8%. CONCLUSION: The author suggests the followings through review of previous published articles:1) researches in various areas of psychiatric disorders and nationwide multi-center studies are needed, 2) research interests in sociocultural and psychological aspects as well as biological aspects are also needed, and 3) the proportion of original articles in the journal should be increased for quality improvement of the official journal of Korean Association for Geriatric Psychiatry.
Aged ; Dementia ; Drug Therapy ; Geriatric Psychiatry* ; Humans ; Internet ; Mood Disorders ; Psychotherapy ; Quality Improvement

OBJECTIVE: Electroconvulsive therapy (ECT) is the most effective treatment for mood disorders. Accumulating evidence has suggested the important role of circadian genes in mood disorders. However, the effects of ECT on circadian genes have not been systemically investigated. METHODS: We examined the expression and daily oscillation of major circadian genes in the rat frontal cortex after electroconvulsive seizure (ECS). RESULTS: Firstly, mRNA and protein level were investigated at 24 hr after single ECS (E1X) and repeated ECS treatements for 10 days (E10X), which showed more remarkable changes after E10X than E1X. mRNA expression of Rorα, Bmal1, Clock, Per1, and Cry1 was decreased, while Rev-erbα expression was increased at 24 hr after E10X compared to sham. The proteins showed similar pattern of changes. Next, the effects on oscillation and rhythm properties (mesor, amplitude, and acrophase) were examined, which also showed more prominent changes after E10X than E1X. After E10X, mesor of Rorα, Bmal1, and Cry1 was reduced, and that of Rev-erbα was increased. Five genes, Rev-erbα, Bmal1, Per1, Per2, and Cry2, showed earlier acrophase after E10X. CONCLUSION: The findings suggest that repeated ECS induces reduced expression and phase advance of major circadian genes in the in vivo rat frontal cortex.
Animals ; Circadian Rhythm ; Electroconvulsive Therapy ; Frontal Lobe* ; Mood Disorders ; Rats* ; RNA, Messenger ; Seizures*

Adult ; Female ; Humans ; Male ; Meniere Disease ; complications ; therapy ; Middle Aged ; Mood Disorders ; Treatment Outcome

OBJECTIVES: We aimed to examine whether mindfulness skills are mediating the improvements of depressive symptoms in patients with mood disorders who practiced Mindfulness-Based Cognitive Therapy (MBCT). METHODS: A total of 19 patients with mood disorder were included in this study. The participants were divided into two subgroups: a normal to mild depression group and a moderate depression group. The participants completed questionnaires to assess depressive symptoms, anxiety, quality of life, suicidal idea, and mindfulness skills which were measured by the Five Facets of Mindfulness Questionnaire (FFMQ) before and after MBCT course. RESULTS: The moderate depression group showed improvements through MBCT in depressive symptoms and suicidal idea, but not in anxiety and quality of life. The normal to mild depression group showed no significant change through MBCT. The improvement of depressive symptoms in the moderate depression group was predictable by improvements of the five facets of mindfulness, especially by ‘observe’ and ‘non-react’ components. CONCLUSIONS: This study showed that currently depressive patients with moderate severity but not with normal to mild severity benefit from MBCT in reducing depressive symptoms and suicidal idea. The improvement of depressive symptoms was mediated by improved mindfulness skills through MBCT.
Anxiety ; Cognitive Therapy* ; Depression* ; Humans ; Mindfulness* ; Mood Disorders* ; Negotiating ; Quality of Life