Antidepressants are known to have no significant ability to cause addiction. However, a recent study showed many individuals with mood disorders self-medicated with antidepressants to relieve symptoms. We report here a male physician, diagnosed five years ago with major depressive disorder, with insomnia, anxiousness, and chest heaviness. He began self-medicating with 150 mg of venlafaxine daily, without any monitoring. During his most recent severe depressive episode, he was taking up to 1,500 mg of venlafaxine daily. Without this medication, he experienced discontinuation syndrome, which included severe anxiety, chest heaviness, and breathing difficulty, and which he judged as indicating a more severely depressed state. He also experienced overdose symptoms, such as hypertension and tachycardia. He attempted suicide with drugs that he possessed. In conclusion, careful monitoring is needed when treating patients with venlafaxine, because its discontinuation syndrome is similar to symptoms of major depressive disorder, and suicidality may result from an overdose.
Antidepressive Agents ; Anxiety ; Cyclohexanols ; Depressive Disorder, Major ; Humans ; Hypertension ; Male ; Mood Disorders ; Respiration ; Sleep Initiation and Maintenance Disorders ; Suicide, Attempted ; Tachycardia ; Thorax ; Venlafaxine Hydrochloride

The authors report a case of 5-Fluorouracil (5-FU) induced manic episode in an elderly female without any previous psychiatric history. The patient presented manic symptoms after 4th cycle of 5-FU chemotherapy after surgery of rectal cancer. After cessation of chemotherapy and administration of olanzapine and divalproex sodium, symptoms were subsided within 10 days.
Aged ; Benzodiazepines ; Colonic Neoplasms ; Female ; Fluorouracil ; Humans ; Rectal Neoplasms ; Valproic Acid

The concept of pervasive developmental disorders (PDD) and autism spectrum disorders (ASD) closely resemble each other. Both ICD-10 and DSM-IV use the term PDD. The authors surveyed the perception of PDD/ASD and attitudes toward terminology. The subjects of this study were 205 medical/social-welfare professionals working in fields relating to developmental disorders. Questionnaires were mailed to site investigators at the collaborating institutes. With regard to what the scope of ASD and PDD encompasses, the answers were almost equally divided among three views: ASD and PDD are the same, PDD is wider in scope and ASD is wider. The terms PDD and autism were used in slightly different ways depended upon the situation. Our results demonstrate that the parameters of PDD and ASD are unclear and that the terms related to PDD/ASD are often used differently. Further studies are required to develop more clear and reliable diagnostic criteria for PDD.
Academies and Institutes ; Asperger Syndrome ; Autistic Disorder ; Child ; Autism Spectrum Disorder ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; International Classification of Diseases ; Postal Service ; Surveys and Questionnaires ; Research Personnel

OBJECTIVE: Communication problems are a prevalent symptom of autism spectrum disorders (ASDs), which have a genetic background. Although several genome-wide studies on ASD have suggested a number of candidate genes, few studies have reported the association or linkage of specific endophenotypes to ASDs. METHODS: Forty-two Korean ASD patients who showed a language delay were enrolled in this study with their parents. We performed a genome-wide scan by using the Affymetrix SNP Array 5.0 platform to identify candidate genes responsible for language delay in ASDs. RESULTS: We detected candidate single-nucleotide polymorphisms (SNPs) in chromosome 11, rs11212733 (p-value=9.76x10(-6)) and rs7125479 (p-value=1.48x10(-4)), as a marker of language delay in ASD using the transmission disequilibrium test and multifactor dimensionality reduction test. CONCLUSION: Although our results suggest that several SNPs are associated with language delay in ASD, rs11212733 we were not able to observe any significant results after correction of multiple comparisons. This may imply that more samples may be required to identify genes associated with language delay in ASD.
Autistic Disorder ; Child ; Autism Spectrum Disorder ; Chromosomes, Human, Pair 11 ; Endophenotypes ; Genome-Wide Association Study ; Humans ; Language Development Disorders ; Multifactor Dimensionality Reduction ; Parents ; Polymorphism, Single Nucleotide

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

This study investigated the relationship between depression, somatization, anxiety, personality, and laryngopharyngeal reflux (LPR). We prospectively analyzed 231 patients with symptoms with LPR using the laryngopharyngeal reflux symptom index and the reflux finding score. Seventy nine (34.2%) patients were diagnosed with LPR. A significant correlation was detected between the presence of LPR and total scores on the Patient Health Questionnaire-9 (5.6±5.3 vs. 4.0±4.6, p=0.017) and the 7-item Generalized Anxiety Disorder Scale (4.3±4.9 vs. 3.0±4.5, p=0.041). LPR was significantly more frequent in those with depression than in those without (45.6% vs. 27.0%, p=0.004). A multivariate analysis confirmed a significant association between the presence of LPR and depression (odds ratio, 1.068; 95% confidence interval, 1.011–1.128; p=0.019). Our preliminary results suggest that patients with LPR may need to be carefully evaluated for depression.
Anxiety ; Anxiety Disorders ; Depression* ; Humans ; Laryngopharyngeal Reflux* ; Multivariate Analysis ; Prospective Studies ; Somatoform Disorders

We used quantitative electroencephalography (EEG) spectral analysis to compare activity in the bilateral frontal, central, and occipital areas in nine patients with schizophrenia and ten healthy control subjects during standard nocturnal polysomnography. Patients with schizophrenia had longer sleep latency than controls. In N2 sleep, the patients had significantly lower 0.5–1 Hz power and higher theta power in the left frontal region, and higher beta power in the left occipital region than did control subjects. In N3 sleep, the patients with schizophrenia had significantly higher alpha power in the left occipital region than did controls. These findings show distinctive EEG sleep patterns in patients with schizophrenia, which may reflect brain dysfunction or medication effects.
Brain ; Electroencephalography* ; Humans ; Occipital Lobe ; Polysomnography ; Schizophrenia*

Dandy-Walker variant is a developmental malformation consisting of cerebellar hypoplasia and cystic dilatation of the fourth ventricle. Previous research has proposed a possible role for the cerebellum in cognition and in schizophrenia. In this paper we report a schizophrenia-like psychotic disorder in a 30 year-old woman with Dandy-Walker variant. The patient was treated with risperidone 6 mg/day, biperiden 4 mg/day and risperidone depot 50 mg injections fortnightly, and most of the symptoms were ameliorated within 2 months. The similar cognitive profile to populations with cerebellar pathology and rarity of the condition strongly suggests that there may be direct relationship between cerebellar pathology and appearence of psychotic symptoms.
Adult ; Biperiden ; Cerebellum ; Cognition ; Comorbidity* ; Dandy-Walker Syndrome* ; Dilatation ; Female ; Fourth Ventricle ; Humans ; Pathology ; Psychotic Disorders* ; Risperidone ; Schizophrenia

The treatment of premenstrual dysphoric disorder (PMDD) is far from satisfactory, as there is a high proportion of patients who do not respond to conventional treatment. The antidiuretic sulfonamide, acetazolamide, inhibits carbonic anhydrase and potentiates GABAergic transmission; the latter is putatively involved in PMDD. We therefore tried acetazolamide in a series of women with intractable PMDD. Here, we describe a series of eight women diagnosed with DSM-IV-TR PMDD, five of whom had comorbidity with a mood disorder and one with an anxiety disorder, who were resistant to treatment and responded with symptom disappearance after being added-on 125 mg/day acetazolamide for 7-10 days prior to menses each month. Patients were free from premenstrual symptoms at the 12-month follow-up. We suggest that acetazolamide may be used to improve symptoms of PMDD in cases not responding to other treatments. GABAergic mechanisms may be involved in counteracting PMDD symptoms.
Acetazolamide* ; Anxiety Disorders ; Carbonic Anhydrases ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Mood Disorders

Depression is common after acute coronary syndrome (ACS), adversely affecting cardiac course and prognosis. There have been only a few evidence-based treatment options for depression in ACS. Accordingly, we planned the Korean Depression in ACS (K-DEPACS) study, which investigated depressive disorders in patients with ACS using a naturalistic prospective design, and the Escitalopram for DEPACS (EsDEPACS) trial, which assessed the efficacy and safety of escitalopram for treating major or minor depression in patients with ACS. Participants in the K-DEPACS study were consecutively recruited from patients with ACS who were recently hospitalized at Chonnam National University Hospital, Gwangju, South Korea. Diagnoses were confirmed by coronary angiography from 2005. Data on depressive and cardiovascular characteristics were obtained at 2 weeks, 3 months, 12 months, and every 6 months thereafter following the index ACS admission. The K-DEPACS participants who met the DSM-IV criteria for major or minor depressive disorder were randomly assigned to groups in the 24-week, double-blind, placebo-controlled EsDEPACS trial beginning in 2007. The outcome of treatments for depressive and other psychiatric symptoms, issues related to safety, including general adversity, and cardiovascular factors were assessed. The K-DEPACS study can significantly contribute to research on the complex relationships between depression and ACS. The results of the EsDEPACS trial provide an additional treatment option for clinicians treating these patients.
Acute Coronary Syndrome* ; Citalopram* ; Coronary Angiography ; Depression* ; Depressive Disorder ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Gwangju ; Humans ; Jeollanam-do ; Observational Study ; Prognosis ; Prospective Studies ; Republic of Korea