Objectives: ：We investigated relationship between sleep time and depression in the aged 65 years or older. Methods: ：This study was based on the data from seventh Korean National Health and Nutrition Examination Survey (KNHANES). 3,285 people aged 65 years or older were selected as the subjects of this research. The demographic characteristics, sleep time and Patient Health Questinnaire-9 (PHQ-9) were administered for each subjects. Depression was defined as above 10 points of PHQ-9. Results: ：All the demographic variables such as age, sex, education, household income, marital status, drinking and smoking except Body Mass Index (BMI) were correlated with the depression. When we corrected the variables, inadequate sleep time groups (less than 6 hours or more than 9 hours) tended to be depressed. Conclusions ：The study results showed the significant correlation between sleep time and depression in the aged 65 years or older. Adequate sleep time is important to prevent the depression of the aged.

OBJECTIVE: We examined the factors influencing subjective memory complaints among community dwelling elderly in urban area. METHODS: The subjects of this research were 160 community-dwelling elderly people without dementia and major depressive disorder. The questionnaires regarding the socio-demographic characteristics were conducted by each person. They include Korean version of Subjective Memory Complaints Questionnaires (SMCQ), Korean version of Short Geriatric Depression Scale (SGDS-K) and Korean version of Mini-Mental State Examination (K-MMSE). Subjective memory complaints were defined as above 4 points of SMCQ. RESULTS: 39.38% of the subjects had subjective memory complaints. There were significant associations between subjective memory complaints and SGDS-K (p < 0.001), physical illness (p=0.001), but there was no association with K-MMSE (p=0.383). CONCLUSION: There is a discrepancy between subjective memory complaints and actual cognitive impairments. This discrepancy suggests that the depressive disorders including minor depressive disorder and subsyndromal depression, might play a role in the subjective memory complaints rather than actual cognitive impairments in community-dwelling elderly people. Therefore, the treatments for the depressive disorders should be considered in dealing with the subjective memory complaints.
Aged* ; Cognition Disorders ; Dementia ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Humans ; Independent Living* ; Memory*

Objectives: ：The aim of this study was to determine how the efficacy and compliance of positive airway pressure (PAP) varies depending on the depressive symptom with obstructive sleep apnea (OSA). Methods: ：We collected data about baseline Apnea-Hyponea Index (AHI), sleep and mood state and demographic information from 125 obstructive sleep apnea patients prior to the start of positive airway pressure treatment. The Apnea-Hyponea Index and daytime sleepiness were examined as indicators of efficacy of positive airway pressure and daily average usage time and the utilization rate (%) for more than 4 hours were calculated as indicators of compliance of positive airway pressure at the time of 1, 3 or 9 months after the start of positive airway pressure. Repeated-measures ANOVA and linear mixed model (LMM) with adjusting age, body mass index and baseline Insomnia severity index were used for revealing any significant differences between groups over time passed. Results: ：This difference was confirmed at 9 months after starting positive airway pressure, between the two groups and the usage rate for more than 4 hours in depressive group was lower than that in non-depression group (56.2% vs. 67.5%). Conclusions ：We demonstrated that there would be a difference in the compliance of positive airway pressure among patients with obstructive sleep apnea according to depressive state. Therefore, we suggest evaluating depressive symptoms in patients with obstructive sleep apnea before starting positive airway pressure, to increase the compliance of the positive airway pressure, which is essential to maintain the efficacy of the positive airway pressure.

Background: This study aimed to investigate the relationship between exercise and depression based on responses to 2016 Korean National Health and Nutrition Examination Survey (KNHANES) and the Patient Health Questionairre-9 (PHQ-9). Specifically, this study examined which physical activities have the greatest effects in combating depression. Methods: This study was based on data from 2016 KNHANES and responses to the PHQ-9 questionnaire on physical activity. We selected 2,245 people of age >19 years, who completed the surveys. Physical activity variables included number of days of walking, duration of walking, days of strength training, and aerobic physical activity. These variables subdivided into aerobic and muscle strengthening activities and their effects on depression were examined. Results: All the variables, except duration of walking, were negatively correlated with the PHQ-9 scale scores. However, of the physical activity variables included in the hierarchical regression analysis, only the number of days of walking over 1 week had a statistically significant negative effect on the PHQ-9 scores. Conclusion For adults, aerobic activity (walking) had a greater effect on reducing depression than muscle strengthening activity. The frequency and consistency of walking had a greater impact than the duration of walks. These results suggest that regular walking is a better form of physical activity than strength training for its effect on mood and it assists in overcoming depression.

Objectives: ：Sexual dysfunction is common in both untreated and treated patients with schizophrenia and known as affecting the quality of life and drug compliance. The primary objective of this study is to estimate the prevalence of sexual dysfunction in Korean patients with schizophrenia treated with antipsychotic medications compared with healthy controls. Methods: ：Subjects were 75 patients who were recruited from outpatients with a diagnosis of schizophrenia or schizoaffective disorder according to DSM-IV-TR criteria, who had been stabilized on antipsychotic medications for more than three consecutive months. Control group consisted of 76 volunteers without history of any psychiatric disorder were excluded. We assessed for sexual dysfunction by the ASEX. Results: ：The prevalence of sexual dysfunction in the patient group was 57.33%, while that of the control group was 23.37%. Female gender and the use of antidepressants were best predictors of sexual dysfunction in patient group. Sexual difference at sexual drive observed in the control group diminished in the patient group. Conclusion ：The present study demonstrated a higher prevalence of sexual dysfunction in patient group than control. Clinicians should consider the differential sexual dysfunction effects of antipsychotics when prescribing medications.

BACKGROUND: Lesch types 2 (L2, anxiety model) and 3 (L3, depressive model) of alcoholism exhibit different responses to anti-craving agents, and most treatment guidelines provide differential treatment strategies for bipolar depression (DEP) and unipolar DEP. We compare the psychological characteristics of L2 and L3 alcoholism and between the unipolar and bipolar subgroups.METHODS: We reviewed medical records of patients who were diagnosed with alcohol use disorder using the DSM-5 diagnostic criteria and classified as L2 and L3 using Lesch Alcohol typology software. All patients completed self-report scales (Alcohol Use Disorders Identification Test [AUDIT], Beck Anxiety Inventory [BAI], Beck Depression Inventory-II [BDI-II], and Korean Symptom Checklist-95 [KSCL95]). The data were analyzed using descriptive statistics, the Wilcoxon Rank-Sum test, and ANOVA.RESULTS: Of the 43 patients, 23 were assigned L2, and 20 were assigned L3. The scores for the KSCL95 subscales fell generally in the increasing order of the L2-unipolar (L2U, n=10), L2-bipolar (L2B, n=13), L3-unipolar (L3U, n=11), and L3-bipolar (L3B, n=9) types. The L3B scores were greater than the L3U scores for most KSCL95 subscales, by contrast with the DEP and BAI scores.CONCLUSION: We found psychological differences between L2 and L3 and identified the unique psychological characteristics for each subgroup by polarity. The psychological characteristics of these subgroups of alcohol use disorder may help improve the treatment success rates through individualized treatment strategies.
Alcoholism ; Anxiety ; Bipolar Disorder ; Depression ; Depressive Disorder ; Humans ; Medical Records ; Weights and Measures

Objectives: ：Sexual dysfunction is common in both untreated and treated patients with schizophrenia and known as affecting the quality of life and drug compliance. The primary objective of this study is to estimate the prevalence of sexual dysfunction in Korean patients with schizophrenia treated with antipsychotic medications compared with healthy controls. Methods: ：Subjects were 75 patients who were recruited from outpatients with a diagnosis of schizophrenia or schizoaffective disorder according to DSM-IV-TR criteria, who had been stabilized on antipsychotic medications for more than three consecutive months. Control group consisted of 76 volunteers without history of any psychiatric disorder were excluded. We assessed for sexual dysfunction by the ASEX. Results: ：The prevalence of sexual dysfunction in the patient group was 57.33%, while that of the control group was 23.37%. Female gender and the use of antidepressants were best predictors of sexual dysfunction in patient group. Sexual difference at sexual drive observed in the control group diminished in the patient group. Conclusion ：The present study demonstrated a higher prevalence of sexual dysfunction in patient group than control. Clinicians should consider the differential sexual dysfunction effects of antipsychotics when prescribing medications.

Objectives: The purpose of this study was to investigate the association between body mass index (BMI) and body shape perception and depression. Methods: This study was based on data from 2016, 2018, and 2020 Korean National Health and Nutrition Examination Survey (KNHANES). The subjects were 7,302 adult female aged 19 to 65. We performed chi-square test with the RaoScott correction and Logistic regression analyses to examine the association among BMI, body shape perception, and depression. Results: All demographic variables such as age, household income, education, marital status, medical service satisfaction, body shape perception, medical conditions except drinking problem, smoking and physical activity were correlated with depression. The rate of depression decreased from underweight to normal weight and overweight, and increased from obesity to severe obesity (p<0.001). And people who perceived themselves thin or overweight had more depression than normal (p<0.001). Conclusions The results of this study suggest that appropriate body mass index and normal body shape perception have a positive effect on mental health.

OBJECTIVE: The aim of the present study was to investigate differences in discontinuation time among antidepressants and total antidepressant discontinuation rate of patients with depression over a 6 month period in a naturalistic treatment setting. METHODS: We reviewed the medical records of 900 patients with major depressive disorder who were initially prescribed only one kind of antidepressant. The prescribed antidepressants and the reasons for discontinuation were surveyed at baseline and every 4 weeks during the 24 week study. We investigated the discontinuation rate and the mean time to discontinuation among six antidepressants groups. RESULTS: Mean and median overall discontinuation times were 13.8 and 12 weeks, respectively. Sertraline and escitalopram had longer discontinuation times than that of fluoxetine, and patients who used sertraline discontinued use significantly later than those taking mirtazapine. No differences in discontinuation rate were observed after 24 weeks among these antidepressants. About 73% of patients discontinued antidepressant treatment after 24 weeks. CONCLUSION: Sertraline and escitalopram tended to have longer mean times to discontinuation, although no difference in discontinuation rate was detected between antidepressants after 24 weeks. About three-quarters of patients discontinued antidepressant maintenance therapy after 24 weeks.
Antidepressive Agents* ; Citalopram ; Depression ; Depressive Disorder, Major* ; Fluoxetine ; Humans ; Medical Records ; Sertraline

In addition to classical triad such as gait disturbance, urinary incontinence and dementia, parkinsonian extrapyramidal motor signs and neuropsychiatric symptoms can be observed in patients with normal pressure hydrocephalus (NPH). In our case, a 46 year old female patient showed extrapyramidal symptoms such as bradykinesia, rigidity and neuropsychiatric symptoms such as agitation, anxiety, restlessness and regressed behavior beside two(gait disturbance & urinary incontinence) symptoms of three classical triad. It was difficult to diagnose this patient as NPH from the beginning because of her relatively young age and previous psychiatric mediation history for controlling advanced anxiety and affective disorder. Antiparkinsonian agents and discontinuation of psychiatric medications did not work for this patient. Patient's brain computed tomographic finding showed enlarged ventricles. We suspected NPH and did empirical drainage of 30mL CSF. Finally, patient's pyramidal and neuropsychiatric symptoms as well as two of three classical triad of NPH were improved dramatically within several days. It is important to consider NPH as one of the differential diagnosis in patient with parkinsonian symptoms and various neuropsychiatric symptoms who did not respond to usual clinical management especially in case of ventricular enlargement in neuroimaging because of its treatable property by CSF shunt operation.
Antiparkinson Agents ; Anxiety* ; Bipolar Disorder* ; Brain ; Dementia ; Diagnosis, Differential ; Dihydroergotamine ; Drainage ; Female ; Gait* ; Humans ; Hydrocephalus, Normal Pressure* ; Hypokinesia* ; Mood Disorders ; Negotiating ; Neuroimaging ; Psychomotor Agitation ; Urinary Incontinence