Purpose: Inhalant allergens are known as a major factor for respiratory allergic diseases. There are many differences in sensitization rates of inhalant allergens, depending on the environment and demographic factors. This study aimed to compare the cross-sectional differences in sensitivity patterns to inhalant allergen between children, adolescents, and adults. Methods: We analyzed the results of 449 patients with asthma or allergic rhinitis who underwent the inhalant allergen skin prick test at our university hospital in 2016. The subjects were classified 5 groups according to age: children ( ≤ 12 years), adolescents (13–17 years), young adults (18–30 years), middle adults (31–64 years), and elderly group ( ≥ 65 years). Positive responses skin prick test for allergens were defined as allergen-to-histamine wheal ratio ≥ 1. Results: The sensitization rate (SR) to house dust mites (HDM) was 52.1% on average, showing the highest SR in all groups, especially in children (64.2%). Children and adolescents showed high SRs to cockroach along with tree pollen, animal fur, and adults showed high SR to weed pollen along with them. Among the tree pollen, the SRs to oak, alder, birch, and beech were high in all groups; in children, the SR to plain and willow tended to be high, and in adults the SR to hazel was high. SRs to Timothy pollen (9.9%) and Alternaria (8.6%) tended to be higher in children than in the other groups. Conclusion Although HDM is still the major allergen in children and adults with respiratory allergy, our study suggests various differences in the sensitization pattern to inhalant allergens according to age even in the same area. Further studies are needed to explain these differences in sensitization patterns.

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

OBJECTIVE: Mild traumatic brain injury (mTBI) is frequently associated with psychiatric symptoms and cognitive dysfunction, as well as with the receipt of workers' compensation, as many mTBIs occur due to work-related accidents. We hypothesized that depression and insufficient cognitive effort mediate the relationship between sociodemographic variables and cognitive dysfunction in mTBI. METHODS: A retrospective chart review study was conducted using 115 records of patients with mTBI. Cognitive effort was measured based on scores on the Rey 15-Item Test. Multivariate linear regression analysis was performed to examine factors predictive of cognitive functions. Path analysis was subsequently performed to investigate the mediating effects of depression and cognitive effort in relation to receipt of workers' compensation and demographic variables. RESULTS: Fifteen of the 115 participants (13.0%) received failing scores on the Rey 15-Item Test, which indicated insufficient cognitive effort. Path analysis indicated that cognitive effort mediated the effects of age and workers' compensation on cognitive functions. CONCLUSION: Given the significant mediating effects of cognitive effort on cognitive performance, it is important to address patient motivation and encourage mTBI patients covered by workers' compensation to perform tests with authentic effort.
Brain Concussion ; Brain Injuries* ; Compensation and Redress ; Depression* ; Retrospective Studies ; Executive Function* ; Humans ; Intelligence* ; Linear Models ; Memory* ; Motivation ; Negotiating* ; Neuropsychological Tests ; Workers' Compensation

Depression and executive dysfunction are common neuropsychiatric sequelae of stroke. Patients with stroke are more predisposed to depression and executive dysfunction compared to patients with similar degree of physical disability. Both depression and executive dysfunction are also associated with poor prognosis such as high mortality and delayed recovery after stroke. Complex neurobiological and anatomical mechanisms are associated with the development of depression and executive dysfunction after stroke. Activation of pro-inflammatory cytokines is thought to be associated with onset of depression, whereas injuries in frontal-subcortical circuit are thought to be a link between depression and executive dysfunction. Early detection of depressive symptoms and both pharmacological and non-pharmacological treatment would be helpful. In this review paper, the authors investigated 1) biological and neuroanatomical substrate for poststroke depression and executive dysfunction, 2) the relationship and common etiopathology for poststroke depression and executive dysfunction, and 3) pharmacological and non-pharmacological treatment for poststroke depression. The contents of the paper are as follows : the prevalence, clinical manifestation, and biological etiology for poststroke depression, neuroanatomical abnormalities as a common etiological factor for depression and executive dysfunction, pharmacotherapy and non-pharmacological approach.
Aluminum Hydroxide ; Carbonates ; Cytokines ; Depression ; Humans ; Prevalence ; Prognosis ; Stroke

Venlafaxine is among the most widely prescribed antidepressants. It is extensively metabolized to O-desmethylvenlafaxine via cytochrome P450 (CYP) 2D6. We report a case of acute toxic hepatitis resulting from venlafaxine in a 54-year-old woman with pain disorder. During venlafaxine treatment, laboratory tests revealed elevated liver enzymes with a maximum of 169 IU/L for aspartate transaminase (AST) and 166 IU/L for alanine transaminase (ALT). AST and ALT levels returned to normal after 6 days of discontinuation of venlafaxine. The patient was finally diagnosed with acute toxic hepatitis through liver biopsy. This case indicates the importance that clinicians should be aware of the hepatotoxicity of venlafaxine in practice.
Alanine Transaminase ; Antidepressive Agents ; Aspartate Aminotransferases ; Biopsy ; Cyclohexanols ; Cytochrome P-450 Enzyme System ; Drug Toxicity ; Drug-Induced Liver Injury ; Female ; Humans ; Liver ; Middle Aged ; Somatoform Disorders ; Desvenlafaxine Succinate ; Venlafaxine Hydrochloride

OBJECTIVES: The aim of this study was to develop the Korean version of the Warwick-Edinburgh Mental Well-being Scale (K-WEMWBS) and to examine its factorial structure, reliability, and convergent/discriminant validity. METHODS: In this study, the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), a self-rating measure for assessment of mental well-being, was translated into Korean. It was completed by 222 respondents, including 117 healthy subjects and 105 psychiatric patients from both inpatient and outpatient clinics at Soonchunhyang University Hospitals in Bucheon, Cheonan, and Seoul. RESULTS: The K-WEMWBS showed good content validity. Confirmatory factor analysis supported a single factor structure. The Cronbach's alpha value for the K-WEMWBS was 0.944, which demonstrated good internal consistency. Test-retest reliability at 2-8 weeks was high (0.789). The K-WEMWBS showed high correlations with mental health, positive affect, and quality of life scales. Moderate negative correlation was observed between the K-WEMWBS and the negative affect scale. Discriminant validity was partially identified. Statistically significant differences in scores were observed between the psychiatric patient group and the control group. CONCLUSION: The results of this study indicate that the K-WEMWBS is a reliable and valid instrument for assessment of mental well-being, particularly the positive aspects of mental health.
Ambulatory Care Facilities ; Chungcheongnam-do ; Surveys and Questionnaires ; Gyeonggi-do ; Hospitals, University ; Humans ; Inpatients ; Mental Health ; Quality of Life ; Seoul ; Weights and Measures

OBJECTIVES: The aim of this study was to analyze the environmental and familial variables associated with attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. METHODS: Children and adolescents aged 6-18 with in attention, hyperactivity, or impulsivity who visited the Department of Psychiatry at Soonchunhyang University Bucheon Hospital from April 2006 to April 2012, were interviewed for diagnosis of ADHD. Diagnostic and Statistical Manual of Mental Disorders, 4th edition symptom criteria for ADHD were assessed using a semi-structured interview, the schedule for affective disorders and schizophrenia for school-age children present and lifetime version (K-SADS-PL). Environmental and familial variables were obtained using questionnaires for parents. RESULTS: In total, 262 children and adolescents with ADHD (n=139) and control subjects (n=123) were recruited. In a multivariate logistic regression model, results of this study showed that maternal psychiatric problem during pregnancy, dystoia, forceps/vacuum use during delivery, and unplanned pregnancy were risk factors for ADHD. CONCLUSION: Findings of this study showed an association of some prenatal factors (such as unplanned pregnancy or maternal psychiatric problem during pregnancy) and some perinatal factors (dystocia and forceps/vacuum use during delivery) with increased risk of ADHD. The identified risk factors are environmental, and therefore potentially preventable. Conduct of further prospective studies is needed in order to clarify the potential role of these risk factors for ADHD.
Adolescent ; Aged ; Appointments and Schedules ; Child ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Logistic Models ; Mood Disorders ; Pregnancy ; Pregnancy, Unplanned ; Surveys and Questionnaires ; Risk Factors ; Schizophrenia

OBJECTIVES: The aim of this study is to investigate the proportion of dementia studies and the trends of the use of neuropsychological tests in dementia studies for the past 10 years. METHODS: The subjects of this study were 715 original articles published in Journal of Korean Neuropsychiatric Association and 72 original articles published in Journal of Korean Geriatric Psychiatry between January 1, 2000 and December 31, 2009. Among those, there were 78 articles of dementia study and 36 articles using the neuropsychological test used for the analysis. According to the published year, all articles were divided into two stages (between 2000-2004, between 2005-2009). The data were collected for what neuropsychological tests were used. RESULTS: The proportion of dementia studies increased from 8.2% to 12.4% and the proportion of dementia studies using the neuropsychological test decreased from 60.5% to 37.5%, when comparing the two stages. The use rate of screening tests, intelligence tests, and domain-specific cognitive tests decreased from 91.3% to 84.6%, 13.0% to 0%, 91.3% to 76.9% respectively, whereas the use rate of comprehensive assessment of dementia increased from 21.7% to 38.5%. CONCLUSION: These results show an increasing trend in dementia studies and decreasing rate of neuropsychological test use in Korea. However, the use rate of comprehensive assessment of dementia increased.
Dementia ; Geriatric Psychiatry ; Intelligence Tests ; Korea ; Mass Screening ; Neuropsychological Tests

OBJECTIVE: Switching antipsychotics is one useful therapeutic option when the treatment of schizophrenia encounters suboptimal efficacy and intolerability issues. This study aimed to investigate the efficacy and tolerability of cross-tapering switching to ziprasidone from other antipsychotics. METHODS: A total of 67 patients with schizophrenia or schizoaffective disorder were recruited in this 12-week, multicenter, non-comparative, open-label trial. Prior antipsychotics were allowed to be maintained for up to 4 weeks during the titration of ziprasidone. Efficacy was primarily measured using the 18-item Brief Psychotic Rating Scale (BPRS) at baseline, 4 weeks, 8 weeks, and 12 weeks. Efficacy was secondarily measured by the Clinical Global Impression-Severity (CGI-S) scale and the Global Assessment of Functioning (GAF) scale at each visit. Regarding the metabolic effects of switching to ziprasidone, weight, body mass index (BMI), waist-to-hip ratio (WHR), and lipid profile-including triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol levels-were measured at each follow-up visit. RESULTS: The BPRS scores were significantly improved at 12 weeks after switching to ziprasidone (F=5.96, df=2.11, p=0.003), whereas the CGI-S and GAF scores were not significantly changed. BMIs, WHRs, and TG levels were significantly decreased, with no significant changes in other lipid profiles. CONCLUSION: Cross-tapering switching to ziprasidone is effective for patients with schizophrenia spectrum disorders. Beyond the efficacy of the procedure, favorable metabolic profiles show that switching to ziprasidone may be helpful for maintenance therapy over an extended period.
Antipsychotic Agents ; Body Weight ; Cholesterol ; Drug Therapy ; Follow-Up Studies ; Humans ; Lipoproteins ; Metabolome ; Psychotic Disorders* ; Schizophrenia* ; Triglycerides ; Waist-Hip Ratio

The Clinical Research Center for Dementia of South Korea (CREDOS), a nation-wide clinical dementia research group, has prepared clinical practice guidelines (CPG) for dementia tailored to the Korean population. In this article, a summary of the CREDOS CPG is presented with the Korean and English version of full report included in the appendix. The CREDOS CPG in intended not only for psychiatrists and neurologists, but also internists, family physicians, and other primary care physicians involved in the prevention and early diagnosis of dementia. While our CPG for dementia mainly covers Alzheimer's disease (AD) and vascular dementia (VaD), it also includes mild cognitive impairment (MCI) and vascular MCI, which are currently known to be the preclinical stages of AD or VaD, respectively, with emphasis placed on early diagnosis. The CREDOS CPG aims to achieve the following goals by developing CPG for dementia: to establish evidence-based, objective and clear clinical standards for dementia; to improve the clinical decision-making process for patients with dementia; to provide scientific and systematic scales to aid in the work of dementia specialists; to suggest comprehensive and systematic healthcare services tailored to each dementia subtype. The CREDOS CPG focuses on diagnosis and evaluation of clinical practice available domestically, and provides useful concepts of dementia. Its emphasis is on etiologies and epidemiology, diagnostic criteria and evaluation, neuropsychological tests, behavioral and psychological symptoms, the activities of daily living, laboratory tests, and brain imaging.
Activities of Daily Living ; Alzheimer Disease ; Appendix ; Delivery of Health Care ; Dementia ; Dementia, Vascular ; Early Diagnosis ; Humans ; Mild Cognitive Impairment ; Neuroimaging ; Neuropsychological Tests ; Physicians, Family ; Physicians, Primary Care ; Psychiatry ; Republic of Korea ; Weights and Measures