BACKGROUND: With the increase of interest in health promotion, doctor's role in health promotion has been progressively emphasized. Although there were many findings which showed that interventions by doctors can result in important changes in the health behaviors of patients, little was known about patients perception of doctor's intervention. Therefore, we attempted to find out about the factors related to patients interests in health behaviors (smoking, alcohol drinking, body weight, and exercise) and patient's perception of the need for doctor's intervention in changing these health behaviors. METHODS: The study subjects were patients who visited either two private clinics (265 patients) or the department of family medicine in a tertiary hospital(410 patients) located in Seoul. Questionnaires concerning demographic characteristics, patients interests, health behaviors, and their perception of the need for doctors intervention in changing health behaviors were administered to the study subjects between March 1997 and June 1997. We examined the factors which had significant relatianship with patient's interest and the perceptions of the need for doctor's intervention in health behaviors with multiple linear logistic regression analysis. The relationship between patients interests in health behavior and the perception of the need for doctor's intervention was evaluated with Spearman's correlation coefficients. RESULTS: Patient's interest and the perception of the need for doctors intervention in smoking was significantly higher in males, smokers, and private clinic patients. Patients interest in alcohol drinking was significantly higher in males, exsmokers, and drinkers. Patient's perception of the need for doctor's intervention in drinking was significantly higher in males, smokers, drinker's, and those who had chronic disease. Patient's interest in body weight control was significantly higher in females, exsmokers, tertiary hospital patients, and those who viewed themselves as obese. Patients perception of the need for doctor's intervention in body weight control was significantly higher in private clinic patients and those who viewed themselves as obese, and was significantly lower in those who recognized their body frame as normal. Patients interest in exercise was significantly higher in those who were older and who was exercising more than once a week. Patient's perception of the need for doctor's intervention in exercise was significantly higher among tertiary hospital patients. Significant relationship between patient's interest and the perception of the need for doctor's intervention in health behaviors, especially in smoking and drinking habit, was observed in private clinic patients as well as those in tertiary hospital. CONCLUSIONS: The degree of patients interest in health behaviors and their perception of the need for doctor's intervention in health promotion was significantly different according to the type of health behavior, the individual health habits, the demographic characteristics, and the type of medical center used by the patient. Therefore, doctors should pay more attention to providing interventions that affect the health behaviors of patients in consideration of these factors.
Alcohol Drinking ; Body Weight ; Chronic Disease ; Drinking ; Female ; Health Behavior ; Health Promotion ; Humans ; Logistic Models ; Male ; Seoul ; Smoke ; Smoking ; Tertiary Care Centers ; Surveys and Questionnaires

OBJECTIVE: The aim of this study was to evaluate the association between a variable number of tandem repeats polymorphism at the dopamine D4 receptor gene (DRD4) and the performance of children with attention deficit hyperactivity disorder (ADHD) in a continuous performance test (CPT). METHODS: This study included 72 ADHD children (mean age=9.39+/-2.05 years) who were recruited from one child psychiatric clinic. The omission errors, commission errors, reaction time and reaction standardization in the CPT were computed. The number of 48-base pairs tandem repeats in the exon III of DRD4 was analyzed in a blind manner. RESULTS: The homozygosity of the 4-repeat allele at DRD4 was significantly associated with fewer commission errors (t=2.364, df=28.685, p=0.025) and standard deviation of reaction time (t=2.351, df=24.648, p=0.027) even after adjusting for age. The results of analyses of CPT measured values among three groups showed that the group with higher frequency of the 4-repeat allele showed a lower mean score of commission errors (F=4.268, df=2, p=0.018). CONCLUSION: These results suggest a protective role of 4-repeat allele of the DRD4 polymorphisms on commission errors in the CPT in children with ADHD.
Alleles ; Attention Deficit Disorder with Hyperactivity ; Child ; Dopamine ; Exons ; Humans ; Minisatellite Repeats ; Reaction Time ; Receptors, Dopamine D4 ; Tandem Repeat Sequences

OBJECTIVES: This study was designed to assess the relationship between alcohol use and stress. METHODS: The study subjects were 1,261 people who drink among the 2,565 people who lived in Gangneung. We investigated the sociodemographic characteristics, Short Form-12 (SF-12), Global Assessment of Recent Stress (GARS) and Alcohol Use Disorder Identification Test (AUDIT). RESULTS: In Problem drinking group the GARS was significantly positively associated with the AUDIT (p=0.02). In Social drinking group sex (p<0.001) and age (p=0.02) is significantly associated with the AUDIT. CONCLUSION: This study showed the significantly positively association between stress and alcohol use. We think that the intervention and active management of the stress can prevent the alcohol problem.
Drinking ; Gangwon-do

OBJECTIVE: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous disorder with a bimodal pattern in age onset and treatment outcomes. This study attempted to ascertain the importance of the age factor for a better phenotypic precision. Therefore, the authors compared adult OCD patients with an early symptom onset to adult OCD patients with a later symptom onset. METHODS: One hundred sixty five patients with OCD were evaluated with semistructured interviews;79 with symptom onset before the age of 17 (early onset group) and 86 with symptom onset after the age of 17 (late onset group). The two groups were analyzed in terms of Y-BOCS (Yale-Brown Obsessive Compulsive Scale) scores and demographic data including clinical variables. RESULTS: Early onset group has more comorbidity of tic disorder and lesser of depression and anxiety disorder than late onset group. Early onset group showed more family history of tic disorder than late onset group. The treatment response to SSRI is relatively declined after 18 months of initiation in early onset group. CONCLUSION: The results indicate that age at onset may be an important factor in subtyping OCD. Early onset group may have more biological and familial tendency that might be differentiate the two groups.
Adult ; Age Factors ; Age of Onset ; Anxiety Disorders ; Comorbidity ; Depression ; Humans ; Obsessive-Compulsive Disorder* ; Tic Disorders

OBJECTIVES: It has been suggested that dopamine as well as serotonin were related to the pathophysiology of obsessive-compulsive disorder (OCD). Thus, many studies were performed to nivestigate brain regions and their association with dopamine in OCD patients. Recently, we have been able to monitor the density of the dopamine transporter (DAT) in the basal ganglia using I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane (I-123 IPT) SPECT, to evaluate the activity of the presynaptic dopamine function. In present study, we investigated the DAT density of the basal ganglia using I-123 IPT SPECT in patients with OCD. METHODS: Fifteen patients with OCD and nineteen normal control group were included in this study. We performed brain SPECT 2 hours after the intravenous administration of I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane (I-123 IPT) and carried out both quantitative and qualitative analyses using the SPECT, which were reconstructed for the assessment of the specific/nonspecific DAT binding ratio in basal ganglia. We then investigated the correlation between the severity of OCD symptoms assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the specific/nonspecific DAT binding ratio of basal ganglia. RESULTS: Patients with OCD showed a significantly increased specific/nonspecific DAT binding ratio in right basal ganglia compared with normal controls and did not show a significantly increased specific/nonspecific DAT binding ratio, and an increased tendency in the specific/nonspecific DAT binding ratio in left basal ganglia (Rt:Z=2.584, P=0.009, Lt:=1.873, P=0.060). We found no significant correlation between the total scores of the Y-BOCS and the specific/nonspecific DAT binding ratio of basal ganglia. CONCLUSIONS: The data of this study suggest that dopamine in basal ganglia plays an important role in fronto-subcortical circuit, which are already known as a site of the pathophysiological mechanism of OCD.
Administration, Intravenous ; Basal Ganglia* ; Brain ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Obsessive-Compulsive Disorder* ; Serotonin ; Tomography, Emission-Computed, Single-Photon*

Left atrial wall calcification is frequently observed in patients with rheumatic valvular heart disease. However, massive left atrial wall calcification, so called porcelain or coconut atrium, with left atrium thrombi is very rare. Here, we describe the case of a 67-year-old male patient with porcelain atrium, recurrent left atrial thrombi, and a spontaneous axillary hematoma after mitral valve replacement and surgical thrombectomy due to rheumatic valvular heart disease. The patient underwent two valvular surgeries 20 years prior; therefore, we determined not to perform additional surgeries because of a high risk of morbidity, mortality, and the recurrence of atrial thrombi. The patient has been maintained on daily warfarin as an anti-thrombic therapy for more than 5 years without major embolic complications.
Aged ; Cocos ; Dental Porcelain ; Heart Atria ; Heart Valve Diseases ; Hematoma ; Humans ; Male ; Mitral Valve ; Recurrence ; Thrombectomy ; Thrombosis ; Warfarin

OBJECTIVE: Some reports have shown the gender-related clinical differences in Obsessive-compulsive disorder (OCD), but no study has yet been done in Korea. The purpose of this study was to investigate the gender-related differences of clinical features in the obsessive-compulsive patients in Korea. METHODS: Two hundred forty nine patients with OCD were included in this study; 180 subjects were male and 69 subjects were female. The two groups were analyzed in terms of demographic data including clinical variable, Y-BOCS (Yale-Brown Obsessive Compulsive Scale) scores, clinical course and treatment response. RESULTS: We found the earlier age at onset of OC symptoms in males and the more frequent washing and somatization type in female. There were no gender difference in comorbidity, clinical course and the treatment response. CONCLUSION: We could observe some of the gender-related clinical differences in Korean OCD patients. The further studies would be required to evaluate the gender difference in the long-term clinical course and therapeutic response of Korean OCD patients.
Comorbidity ; Female ; Humans ; Korea ; Male ; Obsessive-Compulsive Disorder*

OBJECTIVE: We investigated the prevalence of obsessive compulsive disorder (OCD) among patients with schizophrenia, as well as the differences in psychotic symptoms and suicidality between schizophrenia patients with and without OCD. METHODS: Seventy-one subjects with the DSM-IV diagnosis of schizophrenia were evaluated by the Structured Clinical Interview for DSM-IV Axis I disorders, the Yale-Brown Obsessive-compulsive Scale and the Positive and Negative Syndrome Scale. RESULTS: There were 20 (28.2%) OCD patients with schizophrenia among the 71 subjects, and these 20 had significantly more severe negative and total psychotic symptoms than the 51 subjects without OCD, as evaluated with PANSS. The schizophrenia subjects with OCD had a significantly higher, recent suicidal attempt rate than those without OCD. CONCLUSION: The results of this study suggest the possibility that OCD symptoms in schizophrenia may be related to negative symptoms and that the OC symptoms may be related to the impulsivity expressed as suicidal attempts.
Axis, Cervical Vertebra ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Impulsive Behavior ; Obsessive-Compulsive Disorder ; Prevalence ; Schizophrenia

OBJECTIVE: The aim of this study was to describe and evaluate the clinical data and short-term treatment response in patients with obsessive-compulsive disorder (OCD) based on an outpatient setting. METHODS: A group of patients with OCD underwent mean 12-weeks treatment with selective serotonin reuptake inhibitors. The patients were divided into two groups according to treatment response, defined as a reduction of the Yale-Brown Obsessive Compulsive Scale total score >35% and CGI of 1 or 2. RESULTS: 1) Among the 249 patients, 24.1% had checking type and 23.7% washing type. Among these two types, 31.9% had mood disorder, 15.0% had anxiety disorder and 24.5% personality disorder as co-morbidity. One hundred fourteen patients (45.8%) responded to the treatment and 135 (54.2%) did not. The responders decreased Y-BOCS scores from 27.9+/-7.2 at baseline to 21.3+/-6.4 and 19.3+/-3.8 at post-treatment 8 and 12 weeks, respectively (repeated measure ANOVA, p=0.039). There were no differences among the treatment responses to serotonin reuptake inhibitors. CONCLUSION: About half of the OCD patients showed a response to pharmacological treatment using SSRI in the outpatient clinic setting for 12 weeks. Long-term and contrast studies of OCD may elucidate further clinical aspects of this disorder in the future.
Ambulatory Care Facilities ; Anxiety Disorders ; Comorbidity ; Humans ; Mood Disorders ; Obsessive-Compulsive Disorder* ; Outpatients ; Personality Disorders ; Serotonin Uptake Inhibitors

OBJECTIVES: The definite cause of obsessive-compulsive disorder (OCD) is still unknown. Evidences from familial, twin and segregation studies support the role of a genetic factor. There are also growing evidence indicating that OCD has specific neurochemical and neuroanatomical basis. Derived from the effectiveness of treatment with dopamine receptor blocker in certain part of OCD patients (eg. SSRI treatment-resistant OCD), several candidate genes related to dopamine dysregulation have been hypothesized to play an important role in the development of OCD. One of them is the Catechol-O-Methyltransferase (COMT) gene. The aim of this study was to investigate the association between COMT and OCD in Korean population. METHODS: 124 OCD patients and 170 normal controls participated in this study. Genomic DNA was extracted from their blood. The genotypes and allele frequencies of the COMT polymorphism between OCD group and control group were compared. We investigated the association between severity of OCD assessed by Yale-Brown obsessive compulsive symptom scale (YBOCS) and Hamilton depression rating scale (HDRS) scores and COMT polymorphism. RESULTS: In this case-control study, we could not find any association between COMT gene polymorphism and development of OCD. In OCD group, patients with H/H genotype had significantly higher scores for the HDRS than those with H/L or L/L genotype. CONCLUSION: In this study, there was no difference in genotype distributions of COMT between OCD and control groups. However, H/H genotype of COMT gene polymorphism might be related to depressive symptoms in OCD patients.
Case-Control Studies ; Catechol O-Methyltransferase* ; Depression ; DNA ; Dopamine ; Gene Frequency ; Genotype ; Humans ; Korea* ; Obsessive-Compulsive Disorder* ; Receptors, Dopamine