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Schizophrenia-Like Psychosis and Dandy-Walker Variant Comorbidity: Case Report.

Selma BOZKURT ZINCIR ; Yigit KIVILCIM ; Filiz IZCI ; Umit Basar SEMIZ

Psychiatry Investigation.2014;11(1):102-104.

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

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Low-Dose Acetazolamide in the Treatment of Premenstrual Dysphoric Disorder: A Case Series.

Gabriele SANI ; Georgios D KOTZALIDIS ; Isabella PANACCIONE ; Alessio SIMONETTI ; Lavinia DE CHIARA ; Antonio DEL CASALE ; Elisa AMBROSI ; Flavia NAPOLETANO ; Delfina JANIRI ; Emanuela DANESE ; Nicoletta GIRARDI ; Chiara RAPINESI ; Daniele SERATA ; Giovanni MANFREDI ; Alexia E KOUKOPOULOS ; Gloria ANGELETTI ; Ferdinando NICOLETTI ; Paolo GIRARDI

Psychiatry Investigation.2014;11(1):95-101.

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

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Design and Methodology for the Korean Observational and Escitalopram Treatment Studies of Depression in Acute Coronary Syndrome: K-DEPACS and EsDEPACS.

Jae Min KIM ; Kyung Yeol BAE ; Hee Ju KANG ; Sung Wan KIM ; Il Seon SHIN ; Young Joon HONG ; Ju Han KIM ; Hee Young SHIN ; YoungKeun AHN ; Jong Keun KIM ; Myung Ho JEONG ; Jin Sang YOON

Psychiatry Investigation.2014;11(1):89-94.

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

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Serum Levels of Brain-Derived Neurotrophic Factor at 4 Weeks and Response to Treatment with SSRIs.

Reiji YOSHIMURA ; Taro KISHI ; Hikaru HORI ; Asuka KATSUKI ; Atsuko SUGITA-IKENOUCHI ; Wakako UMENE-NAKANO ; Kiyokazu ATAKE ; Nakao IWATA ; Jun NAKAMURA

Psychiatry Investigation.2014;11(1):84-88.

OBJECTIVE: It is important to predict a response to an antidepressant in early time after starting the antidepressant. We previously reported that serum brain-derived neurotrophic factor (BDNF) levels in responders to treatment with antidepressants were increased, whereas, those in nonresponders were not. Therefore, we hypothesized that the changes in serum levels of BDNF from baseline (T0) to 4 weeks (T4) after treatment with selective serotonin reuptake inhibitors (SSRIs) predict the response to the treatment at 8 weeks (T8) in depressed patients. To confirm the hypothesis, we measured serum BDNF at T0, T4, and T8 during the treatment with SSRIs (paroxetine, sertraline, and fluvoxamine). METHODS: One hundred fifty patients (M/F; 51/99, age; 50.4+/-15.1 years) met major depressive disorder (MDD) using by DSM-IV-TR enrolled in the present study. We measured serum BDNF concentrations at T0, T4, and T8 in patients with MDD treated with SSRIs. RESULTS: The changes in serum BDNF, age, sex, dose of SSRIs, and HAMD-17 score did not predict the response to SSRIs at T8. CONCLUSION: These results suggest that the changes in serum BDNF levels from T0 to T4 could not predict the subsequent responses to SSRIs at T8.
Antidepressive Agents ; Brain-Derived Neurotrophic Factor* ; Depression ; Depressive Disorder, Major ; Humans ; Serotonin Uptake Inhibitors ; Sertraline

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Association of VAMP-2 and Syntaxin 1A Genes with Adult Attention Deficit Hyperactivity Disorder.

Aye Nur Inci KENAR ; Ozlem Izci AY ; Hasan HERKEN ; Mehmet Emin ERDAL

Psychiatry Investigation.2014;11(1):76-83.

OBJECTIVE: The etiology of attention deficit hyperactivity disorder (ADHD) has not been entirely clarified yet. Structural and metabolic differences at the prefrontal striatal cerebellary system and the interaction of gene and environment are the main factors that thought to play roles in the etiology. Genetic investigations are performed especially about the dopamine pathways and receptors. In this study; it was aimed to investigate the association of the synaptobrevin-2 (VAMP-2) gene Ins/Del polymorphism and syntaxin 1A gene intron 7 polymorphism, which take place in encoding presynaptic protein, with adult ADHD. METHODS: One hundred thirty-nine patients, having ADHD aging between 18 and 60 years and 106 healthy people as controls were included into the study. DNA samples were extracted from whole blood and genetic analysis were performed. RESULTS: A significant difference was determined between ADHD and VAMP-2 Ins/Del polymorphism and syntaxin 1A intron 7 polymorphism according to the control group. These polymorphisms were found not to be associated with subtypes of ADHD. CONCLUSION: It is supposed that synaptic protein genes together with dopaminergic genes might have roles in the etiology of ADHD.
Adult* ; Aging ; Attention Deficit Disorder with Hyperactivity* ; DNA ; Dopamine ; Humans ; Introns ; Qa-SNARE Proteins* ; Syntaxin 1* ; Vesicle-Associated Membrane Protein 2*

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Neuropsychological and Behavioral Profiles in Attention-Deficit Hyperactivity Disorder Children of Parents with a History of Mood Disorders: A Pilot Study.

Subin PARK ; Kang E M HONG ; Young Hui YANG ; Jewook KANG ; Eun Jin PARK ; Kyooseob HA ; Mira PARK ; Hee Jeong YOO

Psychiatry Investigation.2014;11(1):65-75.

OBJECTIVE: We aimed to investigate the neurocognitive and behavioral endophenotypes of premorbid mood disorder. We compared intelligence, neuropsychological functioning, and behavioral problems among three groups: 1) a high-risk group [attention-deficit hyperactivity disorder (ADHD) children of parents with a history of a mood disorder], 2) a low-risk group (ADHD children of parents without a history of a mood disorder), and 3) normal comparison subjects. METHODS: We used the Korean Educational Development Institute Wechsler Intelligence Scale for Children-Revised (KEDI-WISC-R), the Stroop Color Word Interference Test (Stroop), the Wisconsin Card Sorting Test (WCST), and the Rey-Osterrieth Complex Figure Test (RCFT) as neurocognitive measures, and we used the Child Behavior Checklist (CBCL) as a behavioral measure. Performance on these neuropsychological tests and score on the CBCL of 18 high-risk children were compared to those of 20 low-risk children and 24 healthy children. We also assessed the children's current mood state and familial functioning to control for the confounding effects of these variables. RESULTS: Compared to low-risk and healthy children, high-risk children were impaired on the Picture Completion and Stroop Word subtest and showed higher scores on the CBCL subscales representing internalizing symptoms. These significant group differences persisted even after adjustment for the children's current mood state and familial functioning. CONCLUSION: Neuropsychological deficits in the offspring of parents with a mood disorder may be associated with the current mood state rather than with innate characteristics, while their internalizing symptoms may partially stem from innate characteristics that are endophenotypes of a premorbid mood disorder.
Attention Deficit Disorder with Hyperactivity ; Checklist ; Child Behavior ; Child* ; Endophenotypes ; Humans ; Intelligence ; Mood Disorders* ; Neuropsychological Tests ; Neuropsychology ; Parents* ; Pilot Projects* ; Wisconsin

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Cross-Cultural Adaptation, Reliability, and Validity of the Revised Korean Version of Ruminative Response Scale.

Seonyoung LEE ; Won KIM

Psychiatry Investigation.2014;11(1):59-64.

OBJECTIVE: Rumination is a negative coping strategy defined as repetitive and passive focusing on negative feelings such as depression. The Ruminative Response Scale (RRS) is a widely-used instrument to measure rumination, but there is continuing argument about the construct validity of the RRS, because of probable overlap between the measurement of depression and that of rumination. The RRS-Revised (RRS-R), which removed 12 items of the RRS, is suggested as a more valid instrument for measuring rumination. Therefore, we translated RRS-R into Korean and explored the reliability, validity and factor structure in patients with major depressive disorders. METHODS: Seventy-nine patients with major depressive disorder took the Korean version of RRS, RRS-R, State Trait Anxiety Inventory, Beck Depression Inventory and Penn State Worry Questionnaire. We performed exploratory factor analysis of RRS-R, and tested construct validity, internal reliability and test-retest reliability. RESULTS: The internal and test-retest reliability of RRS-R was high. Factor analysis revealed that RRS-R is composed of two factors. 'Brooding' factor explained 56.6% and 'Reflection' factor explained 12.5%. RRS-R, especially 'Brooding factor', was highly correlated with other clinical symptoms such as depression, anxiety and worry. CONCLUSION: In this study, we find out the RRS-R is more reliable and valid than the original RRS in Korean patients with depression because the RRS-R is free from the debate about the overlap of item with BDI. We also revealed that 'Brooding' is highly correlated with depressive symptoms. RRS-R may be a useful instrument to explore the implication of 'Brooding' in depression.
Anxiety ; Depression ; Depressive Disorder, Major ; Humans ; Surveys and Questionnaires

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Development of the Ubiquitous Spaced Retrieval-Based Memory Advancement and Rehabilitation Training Program.

Ji Won HAN ; Kyusoo OH ; Sooyoung YOO ; Eunhye KIM ; Ki Hwan AHN ; Yeon Joo SON ; Tae Hui KIM ; Yeon Kyung CHI ; Ki Woong KIM

Psychiatry Investigation.2014;11(1):52-58.

OBJECTIVE: The Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program was developed by transforming the spaced retrieval-based memory training which consisted of 24 face-to-face sessions into a self-administered program with an iPAD app. The objective of this study was to evaluate the feasibility and efficacy of USMART in elderly subjects with mild cognitive impairment (MCI). METHODS: Feasibility was evaluated by checking the satisfaction of the participants with a 5-point Likert scale. The efficacy of the program on cognitive functions was evaluated by the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery before and after USMART. RESULTS: Among the 10 participants, 7 completed both pre- and post-USMART assessments. The overall satisfaction score was 8.0+/-1.0 out of 10. The mean Word List Memory Test (WLMT) scores significantly increased after USMART training after adjusting for age, educational levels, baseline Mini-Mental Status Examination scores, and the number of training sessions (pre-USMART, 16.0+/-4.1; post-USMART, 17.9+/-4.5; p=0.014, RM-ANOVA). The magnitude of the improvements in the WLMT scores significantly correlated with the number of training sessions during 4 weeks (r=0.793; p=0.033). CONCLUSION: USMART was effective in improving memory and was well tolerated by most participants with MCI, suggesting that it may be a convenient and cost-effective alternative for the cognitive rehabilitation of elderly subjects with cognitive impairments. Further studies with large numbers of participants are necessary to examine the relationship between the number of training sessions and the improvements in memory function.
Aged ; Alzheimer Disease ; Cognitive Therapy ; Computer User Training ; Dementia ; Education* ; Humans ; Learning ; Memory* ; Mild Cognitive Impairment ; Rehabilitation*

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Improvement of Screening Accuracy of Mini-Mental State Examination for Mild Cognitive Impairment and Non-Alzheimer's Disease Dementia by Supplementation of Verbal Fluency Performance.

Jee Wook KIM ; Dong Young LEE ; Eun Hyun SEO ; Bo Kyung SOHN ; Young Min CHOE ; Shin Gyeom KIM ; Shin Young PARK ; IL Han CHOO ; Jong Chul YOUN ; Jin Hyeong JHOO ; Ki Woong KIM ; Jong Inn WOO

Psychiatry Investigation.2014;11(1):44-51.

OBJECTIVE: This study aimed to investigate whether the supplementation of Verbal Fluency: Animal category test (VF) performance can improve the screening ability of Mini-Mental State Examination (MMSE) for mild cognitive impairment (MCI), dementia and their major subtypes. METHODS: Six hundred fifty-five cognitively normal (CN), 366 MCI [282 amnestic MCI (aMCI); 84 non-amnestic MCI (naMCI)] and 494 dementia [346 Alzheimer's disease (AD); and 148 non-Alzheimer's disease dementia (NAD)] individuals living in the community were included (all aged 50 years and older) in the study. RESULTS: The VF-supplemented MMSE (MMSE+VF) score had a significantly better screening ability for MCI, dementia and overall cognitive impairment (MCI plus dementia) than the MMSE raw score alone. MMSE+VF showed a significantly better ability than MMSE for both MCI subtypes, i.e., aMCI and naMCI. In the case of dementia subtypes, MMSE+VF was better than the MMSE alone for NAD screening, but not for AD screening. CONCLUSION: The results support the usefulness of VF-supplementation to improve the screening performance of MMSE for MCI and NAD.
Alzheimer Disease ; Animals ; Dementia* ; Mass Screening* ; Mild Cognitive Impairment* ; NAD

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A Normative Study of the Digit Span in an Educationally Diverse Elderly Population.

Hyo Jung CHOI ; Dong Young LEE ; Eun Hyun SEO ; Min Kyung JO ; Bo Kyung SOHN ; Young Min CHOE ; Min Soo BYUN ; Jee Wook KIM ; Shin Gyeom KIM ; Jong Choul YOON ; Jin Hyeong JHOO ; Ki Woong KIM ; Jong Inn WOO

Psychiatry Investigation.2014;11(1):39-43.

OBJECTIVE: The purpose of this study was to explore the effect of demographic variables on Digit Span test (DS) performance in an educationally diverse elderly population and to provide normative information. METHODS: The DS was administered to 784 community-dwelling volunteers aged 60-90 years with an educational history of from zero to 25 years of full-time education. People with serious neurological, medical and psychiatric disorders (including dementia) were excluded. RESULTS: Age, education and gender were found to be significantly associated with performance on the DS. Based on the results obtained, DS norms were stratified by age (2 strata), education (3 strata), and gender (2 strata). CONCLUSION: Our results on DS performance suggest that both attention and working memory are influenced by age, education and gender. The present study provides reasonably comprehensive normative information on the DS for an educationally diverse elderly population.
Age Factors ; Aged* ; Asian Continental Ancestry Group ; Education* ; Humans ; Memory, Short-Term ; Neuropsychological Tests ; Volunteers

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