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Reliability and Validity of the Korean Version of the Childhood Trauma Questionnaire-Short Form for Psychiatric Outpatients.

Daeho KIM ; Seon Cheol PARK ; Hyunjoo YANG ; Dong Hoon OH

Psychiatry Investigation.2011;8(4):305-311.

OBJECTIVE: The Childhood Trauma Questionnaire (CTQ) is perhaps the most widely used and well-studied retrospective measure of childhood abuse or neglect. This study tested the initial reliability and validity of a Korean translation of the Childhood Trauma Questionnaire (CTQ-K) among non-psychotic psychiatric outpatients. METHODS: The CTQ-K was administered to a total of 163 non-psychotic psychiatric outpatients at a university-affiliated training hospital. Internal consistency, four-week test-retest reliability, and validity were calculated. A portion of the participants (n=65) also completed the Trauma Assessment Questionnaire (TAQ), the Impact of Events Scale-Revised, and the Dissociative Experiences Scale-Taxon. RESULTS: Four-week test-retest reliability was high (r=0.87) and internal consistency was good (Cronbach's alpha=0.88). Each type of childhood trauma was significantly correlated with the corresponding subscale of the TAQ, thus confirming its concurrent validity. In addition, the CTQ-K total score was positively related to post-traumatic symptoms and pathological dissociation, demonstrating the convergent validity of the scale. The CTQ-K was also negatively correlated with the competence and safety subscale of the TAQ, confirming discriminant validity. Additionally, we confirmed the factorial validity by identifying a five-factor structure that explained 64% of the total variance. CONCLUSION: Our study indicates that the CTQ-K is a measure of psychometric soundness that can be used to assess childhood abuse or neglect in Korean patients. It also supports the cross-cultural equivalence of the scale.
Child ; Child Abuse ; Dissociative Disorders ; Humans ; Mental Competency ; Outpatients ; Psychometrics ; Surveys and Questionnaires ; Reproducibility of Results ; Retrospective Studies

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Post-Traumatic Stress Disorder, Depression, and Heart-Rate Variability among North Korean Defectors.

Byoung A SONG ; So Young YOO ; Hee Young KANG ; Seong Hye BYEON ; Sang Ho SHIN ; Eun Jeong HWANG ; So Hee LEE

Psychiatry Investigation.2011;8(4):297-304.

OBJECTIVE: This study evaluated the symptoms of post-traumatic stress disorder (PTSD) among North Korean defectors and their level of suicidal ideation and the correlation between these and heart-rate variability (HRV) to explore the possibility of using HRV as an objective neurobiological index of signs of autonomic nervous system disorder. METHODS: A total of 32 North Korean defectors (nine men, 23 women) were selected as subjects, and their HRV was measured after they completed the Minnesota Multiphasic Personality Inventory-PTSD (MMPI-PTSD) scale and the Beck Depression Inventory (BDI). RESULTS: 1) Low-frequency (LF)/high-frequency (HF) ratios in the HRV index and MMPI-PTSD scores were correlated (r=0.419, p<0.05), as were BDI item 9 (suicidal ideation) and MMPI-PTSD scores (r=0.600, p<0.01). 2) A regression analysis of LF/HF ratios and MMPI-PTSD scores revealed an R-value of 13.8% (Adj. R2=0.138, F=4.695, p=0.041), and a regression analysis of BDI item 9 and MMPI-PTSD scores showed an R-value of 32.8% (Adj. R2=0.328, F=11.234, p=0.003). In other words, the LF/HF ratio (beta=0.419) and BDI item 9 (beta=0.600) appear to be risk factors in predicting MMPI-PTSD scores. CONCLUSION: The LF/HF ratio, a standard index of autonomic nervous system activity, can be used as an objective neurobiological index to analyze PTSD among North Korean defectors presenting with various mental and physical symptoms, and the approximate level of suicide -ideation can act as a predicting factor for PTSD.
Autonomic Nervous System ; Depression ; Humans ; Male ; Minnesota ; Risk Factors ; Stress Disorders, Post-Traumatic ; Suicidal Ideation ; Suicide

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Gamma Oscillation in Schizophrenia.

Yong Wook SHIN ; Brian F O'DONNELL ; Soyoung YOUN ; Jun Soo KWON

Psychiatry Investigation.2011;8(4):288-296.

Dysfunctional neural circuitry has been found to be involved in abnormalities of perception and cognition in patients with schizophrenia. Gamma oscillations are essential for integrating information within neural circuits and have therefore been associated with many perceptual and cognitive processes in healthy human subjects and animals. This review presents an overview of the neural basis of gamma oscillations and the abnormalities in the GABAergic interneuronal system thought to be responsible for gamma-range deficits in schizophrenia. We also review studies of gamma activity in sensory and cognitive processes, including auditory steady state response, attention, object representation, and working memory, in animals, healthy humans and patients with schizophrenia.
Animals ; Cognition ; Humans ; Interneurons ; Memory, Short-Term ; Schizophrenia

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Sundown Syndrome in Persons with Dementia: An Update.

Nina KHACHIYANTS ; David TRINKLE ; Sang Joon SON ; Kye Y KIM

Psychiatry Investigation.2011;8(4):275-287.

"Sundowning" in demented individuals, as distinct clinical phenomena, is still open to debate in terms of clear definition, etiology, operationalized parameters, validity of clinical construct, and interventions. In general, sundown syndrome is characterized by the emergence or increment of neuropsychiatric symptoms such as agitation, confusion, anxiety, and aggressiveness in late afternoon, in the evening, or at night. Sundowning is highly prevalent among individuals with dementia. It is thought to be associated with impaired circadian rhythmicity, environmental and social factors, and impaired cognition. Neurophysiologically, it appears to be mediated by degeneration of the suprachiasmatic nucleus of the hypothalamus and decreased production of melatonin. A variety of treatment options have been found to be helpful to ameliorate the neuropsychiatric symptoms associated with this phenomenon: bright light therapy, melatonin, acetylcholinesterase inhibitors, N-methyl-d-aspartate receptor antagonists, antipsychotics, and behavioral modifications. To decrease the morbidity from this specific condition, improve patient's well being, lessen caregiver burden, and delay institutionalization, further attention needs to be given to development of clinically operational definition of sundown syndrome and investigations on etiology, risk factors, and effective treatment options.
Alzheimer Disease ; Antipsychotic Agents ; Anxiety ; Caregivers ; Cholinesterase Inhibitors ; Circadian Rhythm ; Cognition ; Dementia ; Dihydroergotamine ; Humans ; Hypothalamus ; Institutionalization ; Melatonin ; N-Methylaspartate ; Phototherapy ; Risk Factors ; Suprachiasmatic Nucleus

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Filicide: Needing Psychiatrists' Attention.

Chi Un PAE

Psychiatry Investigation.2014;11(2):214-215. doi:10.4306/pi.2014.11.2.214

No abstract available.

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Electroconvulsive Therapy on Severe Obsessive-Compulsive Disorder Comorbid Depressive Symptoms.

Xiaohui LIU ; Hong CUI ; Qiang WEI ; Ying WANG ; Keyong WANG ; Chen WANG ; Chunyan ZHU ; Xinhui XIE

Psychiatry Investigation.2014;11(2):210-213. doi:10.4306/pi.2014.11.2.210

Electroconvulsive therapy (ECT) is not currently used as a first-line treatment for obsessive-compulsive disorder (OCD). However, several related case reports have demonstrated that ECT seems to be effective for severe OCD, especially when first-line therapies have failed. In this study, we describe the courses, detailed parameters, effects, and follow-up information relating to three patients with severe OCD who were treated by modified bifrontal ECT after their first-line anti-OCD treatments pharmacotherapy, behavioral therapy, and cognitive behavioral therapy failed. The number of ECT procedures administered in each case is as follows: Case 1, eight; Case 2, three; and Case 3, four. In all three cases, the patients' depressive symptoms improved considerably after the ECT procedures. In addition, the condition of all three patients' OCD significantly improved and remained stable at regular follow-ups. ECT may play an effective role in treating severe OCD.
Cognitive Therapy ; Depression* ; Drug Therapy ; Electroconvulsive Therapy* ; Follow-Up Studies ; Humans ; Obsessive-Compulsive Disorder*

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A Case of Withdrawal Psychosis from Internet Addiction Disorder.

Ahyoung PAIK ; Daeyoung OH ; Daeho KIM

Psychiatry Investigation.2014;11(2):207-209. doi:10.4306/pi.2014.11.2.207

Similar to substance use disorder, patients with Internet addiction disorder (IAD) show excessive use, tolerance and withdrawal symptoms. We report a case of a patient with withdrawal psychosis who showed persecutory delusion and disorganized behaviors in addition to common withdrawal symptoms such as agitation and irritability. A 25-year-old male developed a full-blown psychotic episode within one day after discontinuing an Internet game that he had been playing for at least eight hours a day for two years. Upon admission, he had no abnormal brain imaging findings and laboratory tests. With antipsychotic medication (quetiapine up to 800 mg), his psychotic symptoms rapidly subsided and after four days of treatment, he no longer showed any signs of psychosis. This case report suggests that brief psychosis can develop during withdrawal from long-term excessive use of an Internet and the central pathology beneath the IAD is more likely a form of addiction than impulse control.
Adult ; Delusions ; Dihydroergotamine ; Humans ; Internet* ; Male ; Neuroimaging ; Pathology ; Psychotic Disorders* ; Substance Withdrawal Syndrome ; Substance-Related Disorders

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Acute-Withdrawal Restless Legs Syndrome Following Abrupt Cessation of Short-Term Tramadol.

Young Min PARK ; Hye Kyeong PARK ; Leen KIM ; Heon Jeong LEE ; Seung Gul KANG

Psychiatry Investigation.2014;11(2):204-206. doi:10.4306/pi.2014.11.2.204

We report a young man who had received tramadol for pain control and experienced an uncomfortable sensation in both legs immediately after tramadol withdrawal that worsened at rest and at night, and which could be relieved only by moving the legs. He suffered from insomnia and paced up and down in his house every night. Readministration of tramadol dramatically resolved his symptoms of restless legs syndrome (RLS), but they reappeared after tramadol withdrawal. Tramadol was therefore replaced with ropinirole, which was discontinued after several weeks, and there was no recurrence of his RLS symptoms. This patient appeared to have developed tramadol-withdrawal-induced RLS, and this case report emphasizes the importance of monitoring for withdrawal-type symptoms like RLS when tramadol intake is being stopped.
Humans ; Leg ; Recurrence ; Restless Legs Syndrome* ; Sensation ; Sleep Initiation and Maintenance Disorders ; Substance Withdrawal Syndrome ; Tramadol*

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Epistatic Interactions between CREB and CREM Variants in Affective Disorder.

Alberto CHIESA ; Agnese MARSANO ; Changsu HAN ; Soo Jung LEE ; Ashwin A PATKAR ; Chi Un PAE ; Alessandro SERRETTI

Psychiatry Investigation.2014;11(2):200-203. doi:10.4306/pi.2014.11.2.200

The aim of the present work is to investigate the existence of epistatic interactions possibly influencing psychotropic agents' response between rs6740584 within Cyclic adenosine monophosphate Response Element Binding (CREB) and rs12775799 within cAMP response element-modulator (CREM) variants in bipolar disorder (BD) and major depressive disorder (MDD). All BD and MDD patients were administered with the Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HAMD) at baseline and at endpoint, respectively. A multiple regression model was employed to investigate the existence of possible epistatic interactions between the two variants and diverse clinical factors including drug response in affective disorders. No significant epistatic interaction was observed between rs6740584 within CREB and rs12775799 within CREM on both symptom improvement and other clinical factors in affective disorders. Our preliminary results suggest that no epistatic interaction between rs6740584 within CREB and rs12775799 within CREM should exist on clinical improvement and clinical factors in affective disorders.
Adenosine Monophosphate ; Bipolar Disorder ; Depression ; Depressive Disorder, Major ; Humans ; Mood Disorders* ; Response Elements

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Genetic Role of BDNF Val66Met and 5-HTTLPR Polymorphisms on Depressive Disorder.

Kyu Young LEE ; Seong Hoon JEONG ; Se Hyun KIM ; Yong Min AHN ; Yong Sik KIM ; Hee Yeon JUNG ; Yang Weon BANG ; Eun Jeong JOO

Psychiatry Investigation.2014;11(2):192-199. doi:10.4306/pi.2014.11.2.192

OBJECTIVE: We investigated possible association between depressive disorders and BDNF Val66Met and 5-HTTLPR. Brain derived neurotrophic factor (BDNF) gene and serotonin transporter (SLC6A4) gene are promising candidate genes for depressive disorders. It has been suggested that BDNF promotes the survival and differentiation of serotonergic neurons and that serotonergic transmission exerts powerful control over BDNF gene expression. METHODS: Final analyses were performed on 186 patients with depressive disorders and 1032 controls. Val66Met polymorphism of BDNF gene and 5-HTTLPR polymorphism of serotonin transporter gene were genotyped and allele and genotypic associations on the diagnosis of depression and age at onset of depression were analyzed. RESULTS: The 5-HTTLPR was positively associated with depressive affected status in the total sample and in females (p=0.038 for allelewise, p=0.015 for genotype-wise associations), but, not in males. The BDNF Val66Met showed no association with depression. BDNF Val66Met and 5-HTTLPR alone were not associated with age at onset of depression. Additional analysis on the interaction between BDNF Val66Met and 5-HTTLPR found a significant association with age at onset of depression in the entire patient group. This association was also found in the female but not in the male patient group. None of the positive results survived Bonferroni correction for multiple testing. CONCLUSION: This result suggested that BDNF Val66Met and 5-HTTLPR may contribute to depressive disorders in a complex way and that the genetic effect could differ by gender. Further studies with large number of patients will be necessary.
Alleles ; Brain-Derived Neurotrophic Factor* ; Depression ; Depressive Disorder* ; Diagnosis ; Female ; Gene Expression ; Humans ; Male ; Polymorphism, Genetic ; Serotonergic Neurons ; Serotonin Plasma Membrane Transport Proteins

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