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Comparison of Clinical Characteristics between Early-Onset and Late-Onset Panic Disorder : A Preliminary Study.

Min Kyoung KIM ; Kang Soo LEE ; Gyhye SUNG ; Sang Hyuk LEE

Journal of Korean Geriatric Psychiatry.2015;19(2):101-107.

OBJECTIVES: The objective of this study is to clarify the clinical characteristics of late-onset panic disorder (PD) compared to early-onset PD in symptoms frequency, severity, and quality of life. METHODS: 516 patients with PD were included in this study. Patients with PD onset at 60 or after were grouped (late-onset), and compared with the group with onset at 20 or earlier (early-onset). The following instruments were applied : Beck Depression Inventory, Beck Anxiety Inventory, Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, Anxiety Sensitivity Inventory-Revised, and Medical Outcomes Study 36-item Short-Form Health Survey. SPSS version 21.0 was used for statistical analysis. RESULTS: Late-onset PD was 4.84% of all PD patients, and the mean age was 64.68+/-4.36 years. Late-onset PD exhibited fewer panic symptoms and scored lower on most scales assessing clinical severity. However, the panic-related symptoms severity showed significant negative correlations with scores of quality of life, especially in physical functioning subscale, among the late-onset PD patients. CONCLUSION: These findings suggest that less severe panic symptoms may contribute to underdiagnosing PD in this elderly population. However, the panic-related symptoms severity plays an important role in quality of life among the late-onset PD patients. It suggests to implement specific strategies considering the age at onset in clinical approach among patients with PD.
Aged ; Anxiety ; Depression ; Health Surveys ; Humans ; Panic Disorder* ; Panic* ; Phobic Disorders ; Quality of Life ; Weights and Measures

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Reduced Cortical Thickness in Patients with Late Life Depression without Cerebral Vascular Disease.

Kang Yoon LEE ; Young Min LEE ; Je Min PARK ; Byung Dae LEE ; Eun Soo MOON ; Hee Jeong JEONG ; Young In CHUNG ; Ji Hoon KIM

Journal of Korean Geriatric Psychiatry.2015;19(2):97-100.

OBJECTIVES: The aim of this study is to compare cortical thickness in late life major depression patients without cerebral vascular disease (CVD) with that of non-depressed normal comparison subjects using magnetic resonance imaging (MRI). METHODS: Altogether, 47 subjects were finally recruited from the Memory impairment clinics of Pusan National University Hospital in Korea. All subjects (late life major depression patients without CVD : n=21, matched non-depressed normal comparison subjects : n=26) underwent 3-tesla MRI. RESULTS: Late life major depression patients without CVD showed reduced cortical thickness in left precuneus, left inferior temporal gyrus, and left cuneus compared with non-depressed normal comparison subjects. CONCLUSION: Our findings suggest that late life major depression without CVD is associated with reduced cortical thickness.
Busan ; Depression* ; Humans ; Korea ; Magnetic Resonance Imaging ; Memory ; Vascular Diseases*

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Efficacy of Cognitive Training in Community-Dwelling Elderly.

Na Lee BAE ; Kwang Hun LEE ; Kwan LEE ; Kyung Phil KWAK

Journal of Korean Geriatric Psychiatry.2015;19(2):91-96.

OBJECTIVES: This study was aimed to investigate the efficacy of cognitive training in community-dwelling elderly, and to support mental health care system for the elderly. METHODS: We investigated 1,994 and aged over 65 years elderly visiting senior center from April 2014 to July 2014. Their demographic data was investigated. Cognitive functions were evaluated by Korean Version of Mini Mental Status Examination for Dementia Screening (MMSE-DS) and Global Deterioration Scale. Quality of life was evaluated by Korean Quality of Life-Alzheimer's Disease (KQoL-AD) and depression by Short Korean Form of Geriatric Depression Scale. Before and after cognitive training, we analysed these data. RESULTS: MMSE-DS, KQoL-AD were significantly higher in score after the cogintive training than before of that (p<0.001). SGDS-K were significantly lower in score after the cognitive training than before of that (p<0.001). CONCLUSION: Cognitive training resulted in improvement in cognitive functions, quality of life and depression for communitydwelling elderly. These results suggest that future mental health care policy has to consider the importance of community-dwelling elderly.
Aged* ; Dementia ; Depression ; Humans ; Mass Screening ; Mental Health ; Quality of Life ; Senior Centers

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The Distribution of Depressive Symptoms among the Community-Dwelling Elderly.

Unshik HA ; Duk In JON ; Hyun Ju HONG ; Myung Hun JUNG ; Mi Gyeong KIM ; Narei HONG

Journal of Korean Geriatric Psychiatry.2015;19(2):86-90.

OBJECTIVES: This study was to understand the characteristics of depressive symptoms among the community-dwelling elderly. METHODS: Through a community mental health mass screening program in senior society, 197 elderly were evaluated for depressive symptoms with Korean version of Short form Geriatric Depression Scale (SGDS-K). The subjects were grouped into normal or caution groups with a cut-off score of 6. The response rate and odds ratio were calculated and compared within each question. RESULTS: Although they had low total score, many subjects in normal group have the symptoms of the question 2, 13, 5, 10, 7, 4 (in order). Question 12, 6, 8, 4, 14, 3 (in order) showed higher odds ratio in caution group than normal group. Questions belonged to a factor 'general depressive mood' scored much higher odds ratio than the other. CONCLUSION: Even the elderly with low score in SGDS-K might complain of symptoms such as decreased level of energy, activities, interests, and memory. However the subjects with high score tend to report feeling more worthless, afraid, helpless, bored, hopeless, and empty. It can be helpful to know the distribution of depressive symptoms for providing careful mental health service to the elderly dwelling in the communities.
Aged* ; Community Mental Health Centers ; Depression* ; Geriatric Psychiatry ; Humans ; Mass Screening ; Memory ; Mental Health ; Mental Health Services ; Odds Ratio ; Psychiatric Status Rating Scales

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Influence of Depression on Working Memory Measured by Digit Backward Span in the Subjects with Mild Cognitive Impairment and Dementia.

Yang Ho ROH ; Min Jea KIM ; Chae Ri KIM ; Jin Wan PARK ; Yeon Jung LEE ; Sungil WOO ; Sang Woo HAHN ; Jaeuk HWANG

Journal of Korean Geriatric Psychiatry.2015;19(2):79-85.

OBJECTIVES: We aimed to explore the influence of depression on working memory in patients with mild cognitive impairment (MCI) and dementia. METHODS: Clinical and neuropsychological data of 43 subjects with mild cognitive impairment (MCI) (n=17) and dementia (n=26) who had visited Department of Psychiatry at Soonchunhyang University Seoul Hospital, were collected. The subjects were divided into depressed (n=18) and non-depressed (n=25) groups based on the Korean version of Short Geriatric Depression Scale. Two-way analysis of variance test was conducted to evaluate the influence of diagnosis (MCI and dementia), the presence of depression and their interaction on working memory which was measured by digit forward and backward span test. RESULTS: Among the patients with MCI, test score of digit backward span test in depressed group was significantly lower than in non-depressed group. However, among the patients with dementia, there was no significant difference in digit backward span test between depressed and non-depressed groups. CONCLUSION: This study suggests that the depression could deteriorate working memory measured by digit backward span test in patients with MCI, relative to in patients with dementia and it also implicates the diagnostic assessment for depression has clinically importance in patients with MCI.
Dementia* ; Depression* ; Diagnosis ; Humans ; Memory, Short-Term* ; Mild Cognitive Impairment* ; Seoul

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Extrapyramidal Signs and Impairment of Cognitive Subdomains in Mild Cognitive Impairment : A Clinical Research Center for Dementia of South Korea (CREDOS) Study.

Jin Hong PARK ; Woojae MYUNG ; Junbae CHOI ; Sangha KIM ; Hyo Shin KANG ; Duk L NA ; Seong Yoon KIM ; Jae Hong LEE ; Seol Heui HAN ; Seong Hye CHOI ; Sangyun KIM ; Doh Kwan KIM

Journal of Korean Geriatric Psychiatry.2015;19(2):72-78.

OBJECTIVES: This study investigated the association between extrapyramidal signs (EPS) and five cognitive sub-domains in a large number of patients with mild cognitive impairment (MCI). METHODS: Our analyses considered 1,943 patients with MCI drawn from the nationwide Clinical Research of Dementia of South Korea study. EPS were defined as presence in patients with at least 1 of 11 operationally specified features. We assessed five cognitive sub-domains : attention, language, visuospatial function, memory, and frontal/executive function using the Seoul Neuropsychological Screening Battery-Dementia version. The associations of EPS with each cognitive sub-domain were analyzed with a multiple linear regression model after controlling for confounding factors : sex, age, education years, diabetes, hypertension, severity of global function, depressive symptoms, and white matter hyperintensities (WMH). RESULTS: 138 MCI patients (7.1%%) had EPS. This group had more global cognitive deterioration and severe WMH. MCI patients with EPS showed lower performance compared to those without EPS in 3 cognitive sub-domains: attention (p=0.05), visuospatial function (p=0.02), and frontal/executive function (p<0.0001). The language sub-domain and the memory sub-domain did not differ between the EPS positive and the EPS negative groups. CONCLUSION: EPS in MCI are associated with greater cognitive impairment in specific functional sub-domains rather than with global greater cognitive deterioration.
Cognition ; Dementia* ; Depression ; Education ; Humans ; Hypertension ; Korea* ; Linear Models ; Mass Screening ; Memory ; Mild Cognitive Impairment* ; Seoul

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Stressful Life Events and Depression in 60 Year Old Population of Gyeonggi Province : Social Support Can Act as Moderators?.

Ah Young PAIK ; Hyun YANG ; Mi Hyun PARK ; Jung Hyun NAM ; Dong Hoon OH

Journal of Korean Geriatric Psychiatry.2015;19(2):65-71.

OBJECTIVE: 60-year old Korean population has particular life experiences such as Korean War. With this life experience, we aimed to examine the moderating role of social support on the relationship between adverse life events and depressive symptoms in later life. METHODS: The total respondents were 639 people who were 60-year old dwelling in Yangpyung, Gyeonggi Province, South Korea. One to one interviews were conducted by experienced research assistants. RESULTS: Examining depression, 14.7% of total population showed 15 or higher geriatric depression scale-shortform-Korea score. 70% did report stressful life events as many as 13. Also, 31.6% of total participants were isolated or at high risk of isolation. Using hierarchical multiple regression models, the results showed that social support moderated the influence of the exposure to stressful life events on depression (R2=0.124, beta=-0.118, p<0.01). The moderating effect was greater in male (R2=0.118, beta=-1.36, p<0.01) than that of female (R2=0.113, beta=-0.115, p<0.01), which is apposite to our hypothesis. CONCLUSION: This finding suggests that social support play critical roles in the stress-outcome relationship among 60-years old population like it was suggested. Since most stressful events are inevitable, it is important to build sufficient social support networks.
Surveys and Questionnaires ; Depression* ; Female ; Gyeonggi-do* ; Humans ; Korea ; Korean War ; Life Change Events ; Male

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Cognitive Impairments in Clinically Stable Late-Life Depression : Relationship to Cardiovascular Risk : A Pilot Study.

Insun HWANG ; Seon Jin YIM ; Joon Noh LEE ; Yun Young SONG ; Kyungki HONG ; Moon Hwa HONG ; Hai Joo YOON ; Jooran EOM

Journal of Korean Geriatric Psychiatry.2015;19(2):55-64.

OBJECTIVE: The purpose of this study was to test the hypothesis that cardiovascular risk is associated with cognitive impairments in clinically stable late-life depression. METHODS: A total of 59 clinically stable late-life depression patients over age 60 were enrolled in a cross-sectional study. Evaluation tools used in this study include Hamilton Rating Scale for Depression, Geriatric Depression Scale, State-Trait Anxiety Inventory, the Framingham general cardiovascular disease risk profile and the cognitive function battery designed for this study. Correlation analysis, analysis of variance and analysis of covariance were performed. RESULTS: Patients with higher cardiovascular risk performed significantly poorer in the domains of executive function and short-term or long-term memory. In models adjusted for age, sex, education, 10% higher cardiovascular risk was associated with poorer executive function. CONCLUSION: Our findings suggested that cardiovascular risk could be a significant factor associated with poor executive function in clinically stable late-life depression and the management which is necessary as a component of treatment planning. This pilot study provided good prospects for future studies to document this relationship on larger samples.
Anxiety ; Cardiovascular Diseases ; Cross-Sectional Studies ; Depression* ; Education ; Executive Function ; Humans ; Memory, Long-Term ; Pilot Projects*

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Follow-Up on Medication Adherence of Dementia Patients : After Diagnosed through the Nationwide Project for Early Detection of Dementia.

Ji Hyun ROH ; Won Hyoung KIM ; Ji Hyun KIM ; Jeong Seop LEE ; Chul Eung KIM ; Jae Nam BAE

Journal of Korean Geriatric Psychiatry.2015;19(2):47-54.

OBJECTIVE: This study examined medication adherence rate and associated factors with medication adherence in patients who had been diagnosed as having dementia through the nationwide project for early detection of dementia in South Korea. METHODS: This study enrolled a total of 131 patients, who were diagnosed as having dementia through utilization of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet at the Namgu Dementia Center in Incheon, from January 1, 2012 through December 31, 2012. Telephone interview was done with principal caregivers of dementia patients at least 18 months after they had been diagnosed. RESULTS: Out of 131 patients, 83 caregivers of patients completed telephone interview. 62 (72.9%) patients were currently being treated with antidementia drugs, and the proportion of patients being treated at the psychiatric clinic was 54.8%. Sociodemographic variables and clinical rating scales included in the study had no statistically significant effect on the medication adherence. The most common cause of nonadherence was a misconception of dementia diagnosis and treatment (28.6%). CONCLUSION: The major cause of nonadherence was a misconception of dementia diagnosis and treatment, therefore, education on misconception may enhance a patient's medication adherence. Sociodemographic variables and clinical rating scales included in the study had no statistically significant effect on the medication adherence.
Alzheimer Disease ; Caregivers ; Dementia* ; Diagnosis ; Early Diagnosis ; Education ; Follow-Up Studies* ; Humans ; Incheon ; Interviews as Topic ; Korea ; Medication Adherence* ; Weights and Measures

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Atypical Antipsychotics for Behavioral and Psychological Symptoms in Alzheimer's Dementia.

Myeong Il HAN ; Tae Young HWANG ; Jieun LEE

Journal of Korean Geriatric Psychiatry.2015;19(2):41-46.

In addition to cognitive and functional decline, various behavioral and psychological symptoms in dementia (BPSD) are manifested in the patients with Alzheimer's dementia (AD). Some of BPSD, especially psychosis, agitation, and aggression could be challenges to caregivers and clinicians. Atypical antipsychotic drugs (risperidone, olanzapine, quetiapine, and aripiprazole) are widely prescribed to manage complicated neuropsychiatric symptoms associated with AD. It is known that atypical antipsychotics (AAP) have modest and significant beneficial effects in the short term treatment of BPSD. However their safety of AAP has been concerned with potentially increased adverse events. This article reviewed the treatment outcomes and adverse effects of AAP when managing BPSD in the patients with AD. The effects of risperidone and aripiprazole are obvious on psychosis and aggression, but with small effect size. AAP could exacerbate cognitive decline, and it could increase the rate of cerebrovascular accidents and mortality rate in the patients with AD.
Aggression ; Alzheimer Disease ; Antipsychotic Agents* ; Behavioral Symptoms ; Caregivers ; Dementia* ; Dihydroergotamine ; Humans ; Mortality ; Psychotic Disorders ; Risperidone ; Stroke ; Aripiprazole ; Quetiapine Fumarate

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