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

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

Adolescent ; Cerebellar Diseases ; diagnosis ; drug therapy ; etiology ; Cerebellum ; physiopathology ; Child ; Child, Preschool ; Cognition Disorders ; diagnosis ; drug therapy ; etiology ; Female ; Humans ; Infant ; Male ; Mood Disorders ; diagnosis ; drug therapy ; etiology

OBJECTIVE: To study the changes in metabolic markers and clinical outcome after treatment with different drug regimens in children with bipolar affective disorder. METHODS: A retrospective analysis was performed on the medical data of 220 children with bipolar affective disorder who attended the hospital from January 2017 to January 2020. According to the treatment method, 112 children treated with atypical antipsychotic drugs alone were enrolled as the control group, and 108 children treated with atypical antipsychotic drugs combined with mood stabilizer were enrolled as the study group. The two groups were compared in terms of baseline data, changes in related metabolic markers[fasting insulin (FIN), glycosylated hemoglobin (HbAlc), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] after treatment, incidence rate of metabolic syndrome, and clinical outcome. RESULTS: There were no significant differences in the baseline data including age, sex, and course of disease between the two groups ( CONCLUSIONS Atypical antipsychotic drugs combined with mood stabilizer in the treatment of bipolar disorder in children have little effect on the level of metabolic markers, and the curative effect is significant.
Antipsychotic Agents/therapeutic use* ; Biomarkers/blood* ; Bipolar Disorder/drug therapy* ; Child ; Cholesterol, HDL ; Humans ; Mood Disorders ; Retrospective Studies ; Triglycerides

Chemotherapeutic agents induce long-term side effects, including cognitive impairment and mood disorders, particularly in breast cancer survivors who have undergone chemotherapy. However, the precise mechanisms underpinning chemotherapy-induced hippocampal dysfunction remain unknown. In this study, we investigated the detrimental effects of chronic treatment with a combination of adriamycin and cyclophosphamide (AC) on the neuronal architecture and functions of the hippocampi of female C57BL/6 mice. After chronic AC administration, mice showed memory impairment (measured using a novel object recognition memory task) and depression-like behavior (measured using the tail suspension test and forced swim test). According to Golgi staining, chronic AC treatment significantly reduced the total dendritic length, ramification, and complexity as well as spine density and maturation in hippocampal neurons in a sub-region-specific manner. Additionally, the AC combination significantly reduced adult neurogenesis, the extent of the vascular network, and the levels of hippocampal angiogenesis-related factors. However, chronic AC treatment did not increase the levels of inflammation-related signals (microglial or astrocytic distribution, or the levels of pro-inflammatory cytokines or M1/M2 macrophage markers). Thus, chronic AC treatment changed the neuronal architecture of the adult hippocampus, possibly by reducing neurogenesis and the extent of the vasculature, independently of neuroinflammation. Such detrimental changes in micromorphometric parameters may explain the hippocampal dysfunction observed after cancer chemotherapy.
Adult ; Animals ; Breast Neoplasms ; Cognition Disorders ; Cyclophosphamide ; Cytokines ; Doxorubicin ; Drug Therapy ; Female ; Hindlimb Suspension ; Hippocampus ; Humans ; Macrophages ; Memory ; Mice* ; Mood Disorders ; Neurogenesis ; Neurons ; Spine ; Survivors

The authers reported one case of manic episode that occured after retirement in a 63 year old male patient. There was no psychiatric past history and family history. Also there was no abnormal finding on laboratory examination. This patient had received small doses of antidepressants anxiolytic and hypnotic (amitriptyline 10 mg, lorazepam 0.5 mg, triazolam 0.25 mg) to control insomnia since 3 months ago before admission. This patient showed manic symptoms such as grandious idea, expansive and irritable mood, increased psychomotor activity and insomnia after retirement. Pharmacotherapy (lithium and chloropromazine) supportive psychotherapy and family therapy were administered. Excessive motivation for work after retirement and small dose of antidepressant were suspected to trigger a manic episode in this elderly patient. We also reviewed literatures about pathophysiology of elderly manic disorder.
Aged* ; Antidepressive Agents ; Bipolar Disorder ; Drug Therapy ; Family Therapy ; Humans ; Irritable Mood ; Lorazepam ; Male ; Middle Aged ; Motivation ; Psychotherapy ; Retirement* ; Sleep Initiation and Maintenance Disorders ; Triazolam

PURPOSE: This study was designed to investigate the effects of a network program to prevent obesity and improve dietary habits for patients taking antipsychotics or antidepressants. METHOD: Thirty-seven patients in two hospitals were assigned to a control group (21 patients) or an intervention group (16 patients). The intervention group was evaluated to analyze the effect of the network program for six weeks after the program. RESULT: There was a difference in the rate of increased body weight between the control group and the intervention group. Notably, the body weight of both groups before the intervention was significantly increased. However, after the intervention the body weight of the intervention group rarely increased, whereas, the body weight of the control group was significantly increased as expected. There was an observed difference in diet between the control group and the intervention group. After the intervention, caloric intake per day of the intervention group decreased. Also, the duration of the meal of the intervention group after the intervention was longer than before. CONCLUSION: The network program for preventing obesity and improving dietary habits of patients taking antipsychotics or antidepressants was effective. The study shows that a network program can be an important part of a nursing intervention in clinical practice.
Weight Gain/drug effects ; Schizophrenia/drug therapy ; Obesity/chemically induced/*prevention & control ; Mood Disorders/drug therapy ; Male ; Humans ; Female ; Energy Intake ; Diet, Reducing ; Antipsychotic Agents/*adverse effects ; Antidepressive Agents/*adverse effects ; Adult ; Adolescent

Anorexia nervosa, bulimia and other related eating disorders are a heterogenous group of psychiatric disorders whose prevalence rates reach 0.5-1.0% for anorexia nervosa and 1.0-3.0% for bulinmia nervosa. Anorexia nervosa is characterized by a refusal to maintain a minimally normal body weight and bulimia is characterized by repeated episodes of binge eating, misuse of laxatives. diuretics or other medications ; fasting and excessive exercise. A disturbance in perception of body shape and weight is an essential feature of both disorders. Patients with eating disorders may have numerous medical, hypothalamic endocrine, metabolic and nutritional abnormalities. There have been several conceptual models to explain the etiology of eating disorders These are socio-cultural, family pathological, individual psychodynamic, developmental psychobiologiccl, primary hypothalamic dysfunctional, cognitive-behavioral and affective disorder theories. Among these thoeries, this paper attempts to review the biological theory and pharmacotherapy in eating disorders. Specifically, this review deals with physiology of eating behavior, neurotransmitter regulation of appetite and eating bvehavior, disturbances in brcin neurotransmitter system, neuroendocrine findings in anorexia nervosa and bulimia nervosa. and finally pharmacotherapy. Based on this review, future directions for research are also sutggested.
Anorexia Nervosa ; Appetite ; Biology* ; Bulimia ; Bulimia Nervosa ; Disulfiram ; Diuretics ; Drug Therapy* ; Feeding and Eating Disorders* ; Eating* ; Fasting ; Feeding Behavior ; Humans ; Ideal Body Weight ; Laxatives ; Mood Disorders ; Neurosecretory Systems ; Neurotransmitter Agents ; Physiology ; Prevalence

OBJECTIVE: In 2002, the Korean Society for Affective Disorders developed the guidelines for the treatment of major depressive disorder (MDD), and revised it in 2006 and 2012. The third revision of these guidelines was undertaken to reflect advances in the field. METHODS: Using a 44-item questionnaire, an expert consensus was obtained on pharmacological treatment strategies for MDD 1) without or 2) with psychotic features, 3) depression subtypes, 4) maintenance, 5) special populations, 6) the choice of an antidepressant (AD) regarding safety and adverse effects, and 7) non-pharmacological biological therapies. Recommended first, second, and third-line strategies were derived statistically. RESULTS: AD monotherapy is recommended as the first-line strategy for non-psychotic depression in adults, children/adolescents, elderly adults, patient with persistent depressive disorder, and pregnant women or patients with postpartum depression or premenstrual dysphoric disorder. The combination of AD and atypical antipsychotics (AAP) was recommended for psychotic depression in adult, child/adolescent, postpartum depression, and mixed features or anxious distress. Most experts recommended stopping the ongoing initial AD and AAP after a certain period in patients with one or two depressive episodes. As an MDD treatment modality, 92% of experts are considering electroconvulsive therapy and 46.8% are applying it clinically, while 86% of experts are considering repetitive transcranial magnetic stimulation but only 31.6% are applying it clinically. CONCLUSION: The pharmacological treatment strategy in 2017 is similar to that of Korean Medication Algorithm for Depressive Disorder 2012. The preference of AAPs was more increased.
Adult ; Aged ; Antipsychotic Agents ; Biological Therapy ; Consensus ; Depression ; Depression, Postpartum ; Depressive Disorder ; Depressive Disorder, Major ; Drug Therapy ; Electroconvulsive Therapy ; Female ; Humans ; Mood Disorders ; Pregnant Women ; Premenstrual Dysphoric Disorder ; Transcranial Magnetic Stimulation

OBJECTIVETo observe the effect of Chinese medicine therapy combined with psychological intervention (combined therapy) on the clinical symptoms and levels of blood lipids and sex hormones of patients of peri-menopausal syndrome complicated with hyperlipidemia.

METHODSWith the use of a randomizing digital table method, 185 patients that fit the registration standard were randomly assigned to three groups. The 59 cases in Group A were treated with two Chinese patents, Kunbao Pill and Modified Xiaoyao Pill; the 63 in Group B received psychological intervention alone; and the 63 in Group C were treated with both (the combined therapy), with the treatment course for all six months. The items of observation included: (1) scoring by SCL-90 on eight factors and seven symptoms; (2) scoring on Chinese medicine symptoms by Kupermann scale, including anxiety and bad temper, scorching sense action with sweating, dizziness, tinnitus, soreness and weakness of the loin and knees, palpitation, insomnia, lassitude, weakness, and hyposexuality; (3) blood contents of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apoprotein AI (ApoAI) and B (ApoB); (4) levels of sex hormones, including estradiol (E(2)), progesterone (P), pituitary prolactin (PRL), follicular stimulating hormone (FSH), and), luteinzing hormone (LH) in some randomly selected patients; (5) adverse reaction; and (6) one-year follow-up study on long-term effect.

RESULTSA total of 21 patients (6, 8, and 7 cases in Groups A, B, and C, respectively) dropped out; the drop-out rate was insignificant among groups. (1) The markedly effective rates in Group A, B, and C were 26.42% (14/53), 18.18% (10/55), and 53.57% (30/56), respectively, and the total effective rates in them were 64.15% (34/53), 50.91% (28/55), and 87.50% (49/56), respectively, suggesting the therapeutic efficacy in Group C was significantly better than that in Groups A and B (P<0.01). (2) SCL-90 scoring showed that the total scores decreased significantly after treatment in Group C (P<0.01), but remained unchanged in Groups A and B (P>0.05). (3) Scoring on Chinese medicine symptoms showed the same results as shown by SCL-90 scoring in terms of total scores and individual symptoms, except that menstrual disorder and amenorrhea were unchanged in all three groups (P>0.05). (4) Levels of HDL-C, ApoAI, and E(2) increased and those of TG, TC, LDL-C, ApoB, FSH, and LH decreased after treatment in Group C, reaching near normal levels; similar trends of blood lipids were shown in Group A, but the level of sex hormones was unchanged. In Group B all the above-mentioned indices were unchanged (P>0.05). (5) A one-year follow-up study showed the markedly effective rate and the total effective rate in Group C were higher than those in the other two groups respectively (P<0.01). (6) No adverse reaction was found.

CONCLUSIONChinese medicine therapy combined with psychological intervention could not only improve the nervous symptoms, but also regulate the blood levels of lipids and sex hormones in patients of peri-menopausal syndrome complicated with hyperlipidemia.

Adult ; Anxiety ; complications ; drug therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Hot Flashes ; complications ; drug therapy ; Humans ; Hyperlipidemias ; complications ; therapy ; Medicine, Chinese Traditional ; Middle Aged ; Mood Disorders ; complications ; drug therapy ; Perimenopause ; drug effects ; psychology ; Psychotherapy ; methods ; Research Design ; Syndrome ; Treatment Outcome