Journal Detail Information

1

Cite

Share

Comparative Assessment of Clinical Efficacy between the Naive and the Switching Group to Donepezil: 12 Months Prospective Study.

Hyo Shin KANG ; Inn Sook AHN ; Ji Hae YUN ; Yu Jin MOON ; Tae Young HWANG ; Young Min LEE ; Hyeran KIM ; Jae Won CHUNG ; Doh Kwan KIM

Journal of Korean Geriatric Psychiatry.2010;14(2):111-117.

OBJECTIVES: The purpose of this study was to compare the efficacy between switching patients with Alzheimer's disease (AD) from galantamine or rivastigmine to donepezil because they were not responding adequately, and naive patients with AD who initiated therapy with donepezil. METHODS: A total of 108 patients were recruited for this 52-week study. The effect of donepezil on cognitive function was measured using Alzheimer's Disease Assessment Scale-cognitive subscale-preliminary Korean version (ADAS-cog-K). Patients' activities of daily living using Seoul-Activities of Daily Living (S-ADL) and the Seoul-Instrumental Activities of Daily Living (S-IADL);behavioral symptoms using the Korean version Neuropsychiatric Inventory (K-NPI) were measured at baseline, 13-weeks, 26-weeks, 39-weeks and 52-weeks. We defined the responsive patients to donepezil at those who showed a cognitive improvement or no change during the first six-month clinical trial. RESULTS: 86 naive patients and 22 switching patients were enrolled in the study. 74 patients completed the study and 34 discontinued their treatment before week 52. There was no significant difference between two patient groups in demographic data, baseline characteristics and dementia severity except duration of illness. The total ADAS-cog-K scores were not significantly different from baseline after 52 weeks of treatment in both groups. Both groups demonstrated deterioration of S-ADL and S-IADL at 52 weeks. The NPI scores did not significantly change in both groups. Based on the operational criteria, 61.6% of the naive group and 54.5% of the switching group were responders to donepezil. CONCLUSION: The switching group had similar levels of efficacy with the naive group who initiated therapy with donepezil. These results suggest that patients not responding adequately to rivastigmine or galantamine may improve or stabilize after switching to donepezil and prior medication does not effect donepezil's efficacy.

2

Cite

Share

Suicide in the Korean Elderly.

Jin Sook CHEON

Journal of Korean Geriatric Psychiatry.2006;10(1):14-19.

OBJECTIVES: The suicide rate has been increasing among the aged Koreans since 1990. However, there is few study on the epidemiology, causes, and strategies to help them. METHODS: The data were collected by the internet search for the journals and documents of studies on the suicide among aged Koreans from 1995 thru 2006. RESULTS: 1) The suicide rate (36.1 per 100,000) in the Korean elderly with age over 65 has been increasing over 50% since 1998, which estimated as 19.9 times of that in the general population. 2) The biopsychosocial factors possibly related to the elderly suicide in Korea are age, depression, bereavement, physical illness, elder abuse, poor economy and social support system. The poor economy, elder abuse and depression seemed to be the most influential. 3) The rate of the elderly suicide in Korea can be reduced with the active prevention by early detection and intervention of risk factors. CONCLUSION: The strategy including reduction of risk factors, regional welfare services and policy seems to be needed for the prevention of elderly suicide in Korea.
Aged* ; Bereavement ; Depression ; Elder Abuse ; Epidemiology ; Humans ; Internet ; Korea ; Risk Factors ; Suicide*

3

Cite

Share

A Korean Model of Dementia Management.

In Sung KIM

Journal of Korean Geriatric Psychiatry.2006;10(1):10-13.

No abstract available.
Dementia*

4

Cite

Share

Digital Silver for Well Ageing.

Dong Hee HAN

Journal of Korean Geriatric Psychiatry.2006;10(1):5-9.

No abstract available.
Silver*

5

Cite

Share

Symptom Patterns of Depressive Disorder in the Elderly Medical Inpatients: Focused on Major Depressive Disorder.

Jae Hyun KIM ; Hyo Jin KO ; Sang Cheol CHOI

Journal of Korean Geriatric Psychiatry.1999;3(2):174-183.

OBJECTS: Depressive symptoms are common in the elderly medical inpatients. But depressive disorders are considerably underdiagnosed and undertreated. Especially in major depressive disorder, patients show cognitive impairments and do not respond adequately to medical treatment. The goals of this study were to examine what are the patterns of depressive symptoms of major depressive disorders which differentiate from minor depressive disorders in the elderly medical inpatients. METHODS: A 4-month prospective study of 312 patients (65 years and older) was conducted in a general hospital. Depression was screened with Hamilton Depression Rating Scale and cognitive function was screened with Mini-Mental State Examination-K. The subjects were diagnosed according to DSM-IV for depression. And according to DSM-IV diagnosis, HDRS and MMSE-K subscales were analysed. RESULTS: In the 228 patients who were investigated, 16 (7%) patients were major depressive disorder, 53 (23%) were minor depressive disorder. Females were more depressed than males but there was no statistical significance. While the patients of major depressive disorder complained of depression and anxiety, the control subjects complained of loss of body weight, somatic symptoms and somatic anxiety, and the minor depressive disorders shows mixed symptoms of the two. The complaining frequency of the somatic symptoms and somatic anxiety were similar among the three groups. Significant differences were found among the three groups in terms of HDRS total scores. Among the three groups in terms of HDRS subscale scores all subscale scores except for the genital symptoms and body weight were significantly high in depressive disorders. Initial insomnia (p<0.01), middle insomnia (p<0.05), GI symptoms (p<0.01) and somatic symptomgeneral (p<0.05) were significantly different between the control subjects and the depressive disorder group. The subscales of terminal insomnia, agitation and loss of insight were significantly different between the minor depressives and major depressives (p<0.01), but no difference between the control subjects and the minor depressives. MMSE total scores were significantly correlated in major depressive disorders among the 3 groups. Comparing subscales of the three groups, significant correlation were found in time orientation, attention and calculation (p<0.05) and language (p<0.01). CONCLUSION: Major depressive disorder patients in elderly medical inpatients chiefly complained of depression and anxiety, but they also complained somatic symptoms. If elderly medical inpatients complain of agitation, terminal insomnia, cognitive impairment associated with depressive symptoms, consultants will pay attention for the major depressive disorders. This study suggests that further systematic study is necessary for the recognition of major depressive disorder in the elderly medical inpatients.
Aged* ; Anxiety ; Body Weight ; Consultants ; Depression ; Depressive Disorder* ; Depressive Disorder, Major* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Dihydroergotamine ; Female ; Hospitals, General ; Humans ; Inpatients* ; Male ; Prospective Studies ; Sleep Initiation and Maintenance Disorders

6

Cite

Share

Delirium and Death in Burn Patients under Intensive Care.

Guk Hee SUH ; Hyong Jik SHIN ; Bong Jin HAHM ; Seong Jin CHO ; Dong Woo LEE ; Ihn Geun CHOI ; Hyeon Gyun SON ; Byeong Kil YEON

Journal of Korean Geriatric Psychiatry.1999;3(2):165-173.

OBJECTIVE: This study was to estimate the prevalence of and identify the predisposing risk factors of delirium and to determine the effect of delirium on the prognosis, especially death in burn patients. METHOD: The study was completed by thorough examination of medical records, with additional confirmation, of the 245 patients who were admitted to the Burn ICU in Burn treatment center of Hangang Sacred Heart Hospital during last one year (Jan. 1. 1998-Dec. 31. 1998). Delirium was retrospectively diagnosed according to DSM-IV. Only when disturbance of consciousness and attention, cognitive dysfunction especially disorientation, or perceptual disturbance were observed, diagnosis of delirium were given. Final outcome such as death was discriminated through examination of medical records or question to those who knew the patient. RESULTS: One year prevalence of delirium in burn patients is 34.4%. Statistically significant predisposing risk factors of delirium were five;Age 65 and over (OR=45.51, 95% CI:6.07-341.11), burn size over 60% of total body surface (OR=6.48, 95% CI:3.16-13.28), current psychiatric disorder (OR=6.81, 95% CI:1.42-32.57), current medical disease (OR=3.00, 95% CI:1.40-6.45), alcohol abuse (OR=3.17, 95% CI:1.07-9.43) Statistically significant deathrelated risk factors were three;burn size over 60% of total body surface (OR=4.58, 95% CI:2.00-10.46), delirium (OR=2.94, 95% CI:1.25-6.94), current psychiatric disorder (OR=4.09, 95% CI:1.05-15.87). Aging is not the death-related factor in this study. CONCLUSION: Three factors, such as delirium, organic brain damage, and burn size over 60% of total body surface may predict higher risk of death in burn patients.
Aging ; Alcoholism ; Brain ; Burns* ; Consciousness ; Delirium* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart ; Humans ; Critical Care* ; Medical Records ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors

7

Cite

Share

Comparison Study of Quality of Life in Depressed, Demented and Normal Elderly.

Byeong Kil YEON ; Guk Hee SUH ; Seong Gon RYU ; Jong Woo LIM ; Hyeon Soog BANG ; Jee Yong SHIN ; Chang Hwan HAN

Journal of Korean Geriatric Psychiatry.1999;3(2):157-164.

The elderly people are often afflicted with chronic illnesses of which depression and dementia comprise substantial proportion. The authors tried to figure out the impact of depression and dementia on the quality of life of elderly. 1,300 community residents over 65 years of age were selected by random sampling. Using Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy, the authors selected 3 groups of subjects, namely dementia group (N=113), depression group (N=157), normal control group (N=289). The 3 groups of subjects were examined with General Health Questionnaire 12-Quality of Life, Geriatric Depression Scale, Mini-Mental State Exam-K, and Physical Self-Maintenance Scale. The results were compared between groups and the correlations of each scales were examined. The quality of life was lower in the older, female, lower educational groups. The quality of life was significantly lower in dementia group and depression group than in normal elderly group. The subjective quality of life of depressed elderly got lower with increasing severity of depression. Demented elderly had low quality of life but no correlation was found between subjective quality of life and severity of depression. The score of Mini-Mental State Exam-K was found to have significant correlation with the quality of life in demented group. The quality of life of normal elderly and those with dementia had significant correlation with Physical Self-Maintenance Scale. Conclusively, the quality of life was decreased in both normal elderly group and dementia group. The severity of depressive symptoms were correlated with the decrease of quality of life in depression group, whereas the degree of cognitive impairment had significant correlation with quality of life in dementia group. Therefore, the subjective quality of life must be considered in the treatment of the depression and dementia, and further study about the relation between psychopathology and the various aspects of living and the quality of life in the elderly is needed.
Aged* ; Chronic Disease ; Classification ; Dementia ; Depression ; Female ; Humans ; Psychopathology ; Quality of Life* ; Surveys and Questionnaires ; Weights and Measures

8

Cite

Share

Treatment of One Case of Elderly Manic Episode Developed after Retirement.

Baik Seok KEE ; Eung Jun LEE

Journal of Korean Geriatric Psychiatry.1997;1(1):112-116.

The authers reported one case of manic episode that occured after retirement in a 63 year old male patient. There was no psychiatric past history and family history. Also there was no abnormal finding on laboratory examination. This patient had received small doses of antidepressants anxiolytic and hypnotic (amitriptyline 10 mg, lorazepam 0.5 mg, triazolam 0.25 mg) to control insomnia since 3 months ago before admission. This patient showed manic symptoms such as grandious idea, expansive and irritable mood, increased psychomotor activity and insomnia after retirement. Pharmacotherapy (lithium and chloropromazine) supportive psychotherapy and family therapy were administered. Excessive motivation for work after retirement and small dose of antidepressant were suspected to trigger a manic episode in this elderly patient. We also reviewed literatures about pathophysiology of elderly manic disorder.
Aged* ; Antidepressive Agents ; Bipolar Disorder ; Drug Therapy ; Family Therapy ; Humans ; Irritable Mood ; Lorazepam ; Male ; Middle Aged ; Motivation ; Psychotherapy ; Retirement* ; Sleep Initiation and Maintenance Disorders ; Triazolam

9

Cite

Share

Depressive Symptoms in Elderly Patients with Physical Illness.

Jun Su HAN ; Hyeon Soo LEE ; Seong Keun LEE ; In Kwa JUNG

Journal of Korean Geriatric Psychiatry.1997;1(1):100-111.

OBJECTIVES: This study aimed to evaluate the effects of severity of functional disability, caused by physical illness, on the depressive symptoms and depressive disorders of the elderly patients (above 65 year-old) with physical illness. METHOD: Complete medical and psychiatric evaluations were achieved on 138 patients, except the 12 patients, who were severely cognitively impaired (MMSE-K score;below 19), of the 150 elderly patients (above 65 year-old) with physical illness. Sociodemographic data and health characteristic data were systematically collected, and the severity of functional disability caused by physical illness was evaluated. Depression scales (KGDS, GDS, MADRS) on 138 elderly patients were executed. In addition, based on the 61 patients of the 65 elderly patients (above 65 years old) with physical illness, except 4 patients who were severely cognitively impaired (MMSE-K score;below 19), sociodemographic data and health characteristic data were collected. The clinical diagnosis by DSM-IV diagnostic criteria and KGDS on 61 elderly patients were performed, and their functional disability caused by physical illness was evaluated. RESULTS: The frequency of depressive symptoms showed 50.0%, 36.2%, and 35.5%, respectively in KGDS, GDS, and MADRS. The patients with severe functional disability caused by physical illness-compared with those with mild functional disability-had significantly higher score on the depression scales (KGDS, GDS, MADRS). The correlation between severity of functional disability caused by physical illness and depression scales was highly positive. Severity of functional disability caused by physical illness was the strongest contributor to the depression scales. In the additional study, 19.7% of patients were diagnosed as major depressive disorder, 18% of them as dysthymic disorder, and depressive disorder (major depressive disorder & dysthymic disorder) group-compared with nondepressive disorder group-showed significantly higher score on the FDRPT and KGDS. CONCLUSION: The frequency of depressive symptoms and depressive disorder in elderly patients with physical illness was higher, compared with those in general elderly people. Functional disability caused by physical illness most highly influenced on depressive symptoms. Thus, it is important to discriminate whether the elderly patients with physical illness have depressive symptoms or not. In addition, we assumed that KGDS was not only highly correlated with other depression scales (GDS, MADRS), but also had the high diagnostic power of dis-crimination for depressive symptoms and depressive disorder. This study suggested that KGDS was available in screening depression in the elderly patients with physical illness. It was necessary to study systematically the availability of KGDS in the future.
Aged* ; Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Dysthymic Disorder ; Humans ; Mass Screening ; Weights and Measures

10

Cite

Share

A Preliminary Study on the Risk Factors between Vascular Dementia and Alzheimer's Dementia.

Baik Seok KEE ; Jung Hyun YOON ; Sang Kook KIM

Journal of Korean Geriatric Psychiatry.1997;1(1):96-99.

The authers investigated risk factors between vascular dementia and Alzheimer's dementia patients admitted in Chung-Ang University Hospital and Inchen Eun Hea Hospital from October 1996 to Feburary 1997. Chart review was done and complete those were selected and final disgnoses of dementia for subjects (74) were made by DSM-IV and NINCDS-ADRDA criteria. Risk facters were studied between vascular dementia and Alzheimer's dementia. The results were as follows. 1) Alzheimer's dementia patients were 48 (male 16, female 32), mean age of those was 76.65 (+/-7.47) years and duration of education of those was 3.58 (+/-4.79) years. Vascular dementia patients were 26 (male 7, female 19), mean age and duration of education of those were 73.92 (+/-6.69) years and 5.04 (+/-5.27) years respectively. 2) With respect to risk factors , vascular dementia patients were more likely have a history of hypertension and general anesthesia. 3) We found no difference in history of COPD, diabetes mellitus, alcohol abuse, family history of dementia, closed head trauma and cigarette smoking.
Alcoholism ; Anesthesia, General ; Dementia* ; Dementia, Vascular* ; Diabetes Mellitus ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Female ; Head Injuries, Closed ; Humans ; Hypertension ; Pulmonary Disease, Chronic Obstructive ; Risk Factors* ; Smoking

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share