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Diagnosis and Clinical Progress in a Case of Dementia with Lewy Bodies

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(1):60-68.

Dementia with Lewy bodies(DLB) is the second most common neurodegenerative disease. However, DLB might not be adequately diagnosed due to its variety of clinical symptoms. The authors present 65-year-old Mrs. A. who showed Parkinson's movement, cognitive decline, psychological symptoms, and autonomic dysfunction. According to the clinical features and biological markers in the recently revised DLB criteria, Mrs. A. was diagnosed with probable DLB. Differential diagnoses of delirium, Parkinson's dementia, and Alzheimer's dementia were discussed. Psychopharmacological treatments of antidepressants or anxiolytics caused intolerable side effects and showed little efficacy to Mrs. A. She experienced two episodes of hyponatremia during her one-year treatment. Recovery from neurological symptoms due to the first hyponatremia was time-consuming, and in the second, it was associated with changes in the level of consciousness despite relatively mild hyponatremia. A fall that occurred in the latter part of treatment triggered remarkable deterioration of DLB symptoms and daily life function. Prevention of falls is important for maintaining the quality of life of patients with DLB.
Accidental Falls ; Aged ; alpha-Synuclein ; Anti-Anxiety Agents ; Antidepressive Agents ; Biomarkers ; Consciousness ; Delirium ; Dementia ; Diagnosis ; Diagnosis, Differential ; Humans ; Hyponatremia ; Lewy Bodies ; Neurodegenerative Diseases ; Quality of Life

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The Effect of Adult ADHD Tendency on Psychological Characteristics in Young Male Adults with Depression

Hyeon Kyeong JEONG ; Yang Tae KIM

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(1):50-59.

OBJECTIVES: This study investigated psychological factors in patients with adult ADHD tendency and the relationship of adult ADHD tendency with depression and anxiety.METHODS: Ninety patients with depression(38 with adult ADHD and 52 with non-adult ADHD) were recruited in this study. All patients were subjected to the following tests : Korean Wechsler Adult Intelligence Scale-IV(K-WAIS-IV), Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale(ASRS-v1.1), Lee Ji-Yeon's adult ADHD scale, Beck's Depression Inventory II(BDI-II), Beck's Anxiety Inventory(BAI), and Temperament Character Inventory-Revised Short version(TCI-RS).RESULTS: The adult ADHD group had higher scores for BDI-II and BAI, novelty-seeking, harm-avoidance, and self-transcendence than the non-adult ADHD group. Conversely, the adult ADHD group showed lower scores for self-directedness and cooperativeness than the non-adult ADHD group. Depression scores were positively correlated with ASRS(r=0.524, p=0.000), Lee Ji-Yeon's adult ADHD scale(r=0.598, p=0.000), anxiety scores(r=0.650, p=0.000), novelty-seeking(r=0.411, p=0.000), harm-avoidance(r=0.517, p=0.000), and self-transcendence(r=0.234, p=0.026). However, they were negatively correlated with persistence(r=−0.231, p=0.029), and self-directedness(r=−0.594, p=0.000). Higher Lee Ji-Yeon's adult ADHD scale scores and lower self-directedness scores among TCI, resulted in higher depression scores. In addition, anxiety scores increased in parallel with the the Lee Ji-Yeon's adult ADHD scale and harm-avoidance TCI scores.CONCLUSION: In this study, we found a difference in the severity of depression and anxiety between the adult and non-adult ADHD groups. In addition, it was confirmed that the difference in temperament and character between the two groups was related to adult ADHD tendency and severity of depression and anxiety.
Adult ; Anxiety ; Depression ; Humans ; Intelligence ; Male ; Psychology ; Temperament

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Causes of Patient Mortality in Community Mental Health and Welfare Centers and Addiction Management Centers

Woo Young PARK ; Ji Eun HONG ; Soo Yeon WANG ; Jae Jeong SHIN ; Ju Yeon LEE ; Seon Young KIM ; Jae Min KIM ; JIL Seon SHIN ; Jin Sang YOON ; Sung Wan KIM

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(1):42-49.

OBJECTIVES: Serious mental illnesses and substance use disorder have a high level of early mortality. This study aimed to identify the causes of their deaths among patients who had been under the care of community mental health and welfare centers and addiction management centers.METHODS: We collected information on deceased individuals, whose mortality was attributable to various causes of death, from 10 Community Mental Health Centers and Addiction Centers in Gwangju Metropolitan City. The primary variables collected included psychiatric diagnosis, cause of death, smoking habits, admission history, and several socio-demographic factors.RESULTS: A total of 214 deaths among service users were studies. In Community Mental Health Centers, 109 deaths were identified, with causes that may be itemized as follows : 27 suicides(24.8%), 56 physical illnesses( 51.4%), 14 accidents(12.8%), and 12 unknown causes(11.0%). Among the physical illnesses reported, cardiovascular illness and cancer were the most common causes of death. A history of frequent admission was common among those that had died by suicide(88.9%), compared with that observed among general service users(62.0%). In Addiction Centers, 105 deaths were identified, with causes that may be itemized as follows : 7 suicides(6.7%), 71 physical illnesses(68.3%), 7 accidents(6.7%), and 20 unknown causes(19.0%). Among the physical illnesses reported, sudden death, hepatic disorder, cancer, and cardiovascular disorder were the most common causes of death.CONCLUSION: Case managers should give due consideration to and carefully manage the physical health of individuals accessing mental health services via community mental health centers and addiction centers.
Case Management ; Cause of Death ; Community Mental Health Centers ; Death, Sudden ; Gwangju ; Humans ; Mental Disorders ; Mental Health Services ; Mental Health ; Mortality ; Smoke ; Smoking ; Substance-Related Disorders ; Suicide

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Impact of Body Dissatisfaction and Personality Characteristics on Smartphone Addiction

JiWook KANG ; Ik Seung CHEE

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(1):36-41.

OBJECTIVES: The purpose of this study was to investigate the effect of body dissatisfaction on Smartphone addiction and to determine the relative magnitudes of specific mediation effect of personality characteristics.METHODS: One hundred and fifteen young and healthy participants completed the Smartphone Addiction Scale, Body Dysmorphic Disorder Examination-Self Report, and NEO Five-Factor Inventory. By using Indirect SPSS macros, multiple-mediation analyses were performed.RESULTS: Body dissatisfaction had a significant total, direct and indirect effect on Smartphone addiction. Indirect effect of Body dissatisfaction on Smartphone addiction was significantly mediated via personality characteristics (Neuroticism, Conscientiousness, and Openness).CONCLUSION: These results suggest the importance of evaluating both patients' personality characteristics and body dissatisfaction for managing Smartphone addiction. Consequently, they will be useful in the prevention and treatment of Smartphone addiction.
Body Dysmorphic Disorders ; Healthy Volunteers ; Negotiating ; Smartphone

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The Association of Plasma Inflammatory Cytokines with Dementia and Mild Cognitive Impairment

Kyung Hoon SON ; Su Jeong SEONG ; Won Joon LEE ; Jae Yeon HWANG ; Jae Hyun HAN ; Yeong Ju JEON ; Chang Hwan HAN

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(1):28-35.

OBJECTIVES: The aim of this study was to investigate the association of plasma levels of inflammatory cytokines with dementia and mild cognitive impairment.METHODS: We compared serum levels of tumor necrosis factor-alpha(TNF-alpha), interleukin-6(IL-6), and insulin-like growth factor-1(IGF-I) in patients with dementia(n=8), mild cognitive impairment(MCI, n=15) and normal elderly (n=14). The diagnosis of dementia was made by the Diagnostic Statistical Manual of Mental Disorders-4th edition (DSM-IV). MCI was diagnosed based on the criteria of the National Institute of Aging and Alzheimer Association(NIA-AA) working group.RESULTS: When compared with normal controls, the levels of TNF-alpha and IL-6 were increased and level of IGF-I was decreased in MCI and dementia. Higher levels of TNF-alpha and IL-6 and lower level of IGF-I were also associated with increased age. However, when adjusted for age, the association between diagnosis and TNF-alpha, Il-6 and IGF-I was not significant.CONCLUSION: The difference in plasma levels of inflammatory cytokines in dementia and MCI may be associated with aging.
Aged ; Aging ; Cytokines ; Dementia ; Diagnosis ; Humans ; Insulin-Like Growth Factor I ; Interleukin-6 ; Mild Cognitive Impairment ; Necrosis ; Plasma ; Tumor Necrosis Factor-alpha

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Now and Future of Data Sharing : Brain Magnetic Resonance Imaging Repositories

Eun NAMGUNG ; Seunghee KIM ; Jaeuk HWANG

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(1):13-27.

Over the past decade, practice of sharing brain magnetic resonance imaging (MRI) data is increasing given significance of reproducibility and transparency in human neuroscience. Larger multimodal brain MRI databases are needed for more robust research findings considering potential possibilities of large variability in human neuroscience. There are currently more than tens of thousands of shared brain MRI datasets across multiple conditions and hundreds of neuroimaging studies using multimodality through shared brain MRI data repositories. This article critically reviews aims, procedures, and current state of brain MRI data sharing. This review focuses on projects and research findings using structural and functional MRI open databases and is further divided into T1- and diffusion-weighted images for structural MRI as well as resting-state and task-based functional MRI. The challenges and directions are finally discussed. Advances in brain MRI data sharing will lead to more rapid progression in human neuroscience by fostering effective longitudinal, multi-site, multimodal neuroimaging research.
Brain ; Dataset ; Foster Home Care ; Humans ; Information Dissemination ; Magnetic Resonance Imaging ; Neuroimaging ; Neurosciences ; Transcutaneous Electric Nerve Stimulation

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Gender Differences in the Clinical Manifestation of Depression and Related Neurotransmitters

Seoyoung YOON ; Sung Man CHANG

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(1):5-12.

Depression is almost twice as prevalent in women than men. Atypical symptoms, somatic complaints, and comorbid anxiety disorders are more common in women, whereas suicide and comorbid substance use disorders are more common in men. Previous studies have also reported gender differences in the efficacy of and tolerability to specific classes of antidepressants. Various psychosocial and biological factors have been proposed to explain the gender differences in clinical characteristics of depression. The predominant theory of depression pathogenesis is the monoamine hypothesis, and consequently, monoamine neurotransmitters have been the primary target of antidepressants. In the first section of this review, study findings of clinical differences in depression by gender are summarized. Then, we provide an overview of the findings from human and rodent studies of gender differences in serotonin, norepinephrine, dopamine, and glutamate neurotransmitter systems. Total level, rate of synthesis, and receptor profiles of neurotransmitters seem to differ by gender in the euthymic state, depressed state, and in responses to stress or antidepressants. Furthermore, these neurotransmitters interact with gonadal hormones and the hypothalamic-pituitary-adrenal axis, systems that innately exhibit gender differences. Although most of the studies conducted so far are limited to animal models and results of the studies are heterogeneous, growing evidence suggests that gender differences exist in neurotransmitter systems, which possibly leads to gender differences in depression. More intensive studies in this field are needed to build gender-specific treatment strategies.
Antidepressive Agents ; Anxiety Disorders ; Biological Factors ; Depression ; Dopamine ; Female ; Glutamic Acid ; Gonadal Hormones ; Humans ; Male ; Models, Animal ; Neurotransmitter Agents ; Norepinephrine ; Rodentia ; Serotonin ; Substance-Related Disorders ; Suicide

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Augmentation of Aripiprazole versus Bupropion on Specific Symptoms of Depression in Older Adult Patients : A Post-Hoc, Multi-Center, Open-Label, Randomized Study

Sohye JO ; Eunjin CHEON ; Kwanghun LEE ; Bonhoon KOO ; Youngwoo PARK ; Jonghun LEE ; Seungjae LEE ; Hyungmo SUNG

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(2):138-151.

OBJECTIVES: The purpose of this study was to compare aripiprazole versus bupropion augmentation therapy in older adult patients with major depressive disorder unresponsive to selective serotonin reuptake inhibitors(SSRIs).METHODS: This is a post-hoc analysis of a 6-week, randomized prospective open-label multi-center study in thirty older adult patients with major depressive disorder. Participants were randomized to receive aripiprazole(N=16, 2.5–10mg/day) or bupropion(N=14, 150–300mg/day) for 6 weeks. Montgomery Asberg Depression Rating Scale (MADRS), 17-item Hamilton Depression Rating scale(HAM-D17), Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores, and Clinical Global Impression-Severity (CGI-S) were obtained at baseline and after one, two, four, and six weeks. Changes on individual items of HAM-D17 were assessed as well as on composite scales(anxiety, insomnia and drive), and on four core subscales that capture core depression symptoms.RESULTS: There was a significantly greater decrease in MADRS scores in aripiprazole group compared to bupropion group at 4(p<0.05) and 6(p<0.05) weeks. There were significantly higher response rate at week 4(p<0.05) and 6(p<0.05) and remission rate at week 6 in aripiprazole group compared to bupropion group. Individual HAM-D17 items showing significantly greater change with adjunctive aripiprazole than bupropion: insomnia, late(ES=0.81 vs. −0.24, p=0.043), psychomotor retardation(ES=1.30 vs. 0.66, p=0.024), general somatic symptoms(ES=1.24 vs. 0.00, p=0.01). On three composite scales, adjunctive aripiprazole was significantly more effective than bupropion with respect to mean change for drive(p=0.005).CONCLUSION: Results of this study suggested that aripiprazole augmentation have superior efficacy in treating general and core symptoms of depression in older adult patients. Aripiprazole augmentation is associated with greater improvement in specific symptoms of depression such as psychomotor retardation, general somatic symptoms and drive.
Adult ; Aripiprazole ; Bupropion ; Depression ; Depressive Disorder, Major ; Fatigue ; Humans ; Iowa ; Prospective Studies ; Serotonin ; Sleep Initiation and Maintenance Disorders ; Weights and Measures

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The Mediating Effects of the Depression, Anxiety on the Relationship Between Temperament and Character and Maternal-Fetal Attachment in High-Risk Pregnant Women

Ho Young JAE ; In Sung CHUNG ; Sung Won JUNG

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(2):127-137.

OBJECTIVES: The objectives of this study were to investigate the correlations of the temperament and character, depression, anxiety, and maternal-fetal attachment and the mediating effects of the depression, anxiety on the relationship between temperament and character and maternal-fetal attachment.METHODS: A hundred and eleven high-risk pregnant women were recruited in this study. All subjects were administered a sociodemographic and obstetric questionnaire, Temperament and Character Inventory, Beck Depression Inventory-II, State Trait Anxiety Inventory-State, and Maternal-Fetal Attachment Scale.RESULTS: The results of this study were as follows. Higher scores on the reward dependence, persistence, cooperativeness, and self-transcendence scale were associated with higher scores on maternal-fetal attachment scale. Higher scores on the harm avoidance scale and lower scores on the self-directedness scale were associated with higher depression scores. Higher scores on the harm avoidance scale and lower scores on the persistence, self-directedness, and cooperativeness scale were associated with higher anxiety scores. Higher anxiety scores were associated with higher scores on maternal-fetal attachment scale. The anxiety was found to have a partial mediating effect on the relationship between persistence and the maternal-fetal attachment. It was also found to have a partial mediating effect on the relationship between cooperativeness and the maternal-fetal attachment.CONCLUSION: In this study, we found that the anxiety has partial mediating effect on the relationship between temperament and character and maternal-fetal attachment. Based on these findings, it is suggested that examining temperament and character and screening vulnerable pregnant women can help to prevent negative results for high-risk pregnant women.
Anxiety ; Depression ; Female ; Humans ; Mass Screening ; Negotiating ; Pregnancy, High-Risk ; Pregnant Women ; Reward ; Temperament

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A Comparative Study on the Anxiety, Depression, and Maternal-Fetal Attachment of High-Risk Pregnant Women and Normal Pregnant Women

Si Yeon KO ; Jin Gon BAE ; Sung Won JUNG

Journal of the Korean Society of Biological Therapies in Psychiatry.2019;25(2):117-126.

OBJECTIVES: In this study, we compared anxiety, depression, and maternal-fetal attachment between high-risk pregnant women and normal pregnant women, and investigated whether there was a correlation between anxiety, depression, and maternal-fetal attachment in each group.METHODS: Two hundred and eleven pregnant women(118 high-risk pregnant women, 93 normal pregnant women) were recruited. All subjects were administered a sociodemographic and obstetric questionnaire, Stait Trait Anxiety Inventory-State(STAI-S), Beck Depression Inventory- II(BDI-II), and Maternal-Fetal Attachment Scale(MFAS).RESULTS: Total score of STAI-S in high-risk pregnant women was 13.704 point higher than that in normal pregnant women(95% CI=10.449–16.959, p<0.001). Also, total BDI-II score in high-risk pregnant women was 5.325 higher than that in normal pregnant women(95% CI=1.850–3.711, p<0.001). There was no significant difference between total MFAS score of normal pregnant women and that of high-risk pregnant women(t=1.594, p=0.112). There was a significant positive correlation between anxiety and depression in both normal(r=0.529, p<0.001) and high-risk(r=0.582, p<0.001) groups. In normal pregnant women, there was a significant negative correlation between anxiety and maternal-fetal attachment(r=−0.284, p=0.006).CONCLUSION: High-risk pregnant women experienced more anxiety and depression than normal pregnant women, and the maternal-fetal attachment was not significantly different between the two groups. The higher the level of anxiety of the pregnant women, the lower the degree of maternal-fetal attachment. Psychological support for dealing with the emotional problems of high-risk pregnant women and promoting maternal-fetal attachment is needed.
Anxiety ; Depression ; Female ; Humans ; Pregnancy, High-Risk ; Pregnant Women

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