Pediatric vertigo presents with complex etiologies, and its clinical diagnosis and management can be challenging due to children's limited ability to describe their symptoms. Recurrent vertigo episodes in children, who are at a critical stage of development, can readily lead to emotional disorders in both the children themselves and their guardians. This article reports a case of benign paroxysmal vertigo of childhood（BPVC） in a child who sought care from multiple providers. The child was found to have a patent foramen ovale（PFO） and mild emotional disorder. By analyzing challenges encountered during the diagnostic and management process in this case of recurrent pediatric vertigo, this study provides practical guidance for rational selection of diagnostic techniques and the comprehensive assessment of disease status in pediatric vertigo/dizziness.
Child ; Humans ; Affective Symptoms/complications* ; Foramen Ovale, Patent/complications* ; Vertigo/complications*

Going back to basics prior to mentioning the use of antipsychotics in patients with pain, the International Association for the Study of Pain (IASP) definition of pain can be summarized as an unpleasant experience, composed of sensory experience caused by actual tissue damage and/or emotional experience caused by potential tissue damage. Less used than antidepressants, antipsychotics have also been used for treating this unpleasant experience as adjuvant analgesics without sufficient evidence from research. Because recently developed atypical antipsychotics reduce the adverse reactions of extrapyramidal symptoms, such as acute dystonia, pseudo-parkinsonism, akathisia, and tardive dyskinesia caused by typical antipsychotics, they are expected to be used more frequently in various painful conditions, while increasing the risk of metabolic syndromes (weight gain, diabetes, and dyslipidemia). Various antipsychotics have different neurotransmitter receptor affinities for dopamine (D), 5-hydroxytryptamine (5-HT), adrenergic (α), histamine (H), and muscarinic (M) receptors. Atypical antipsychotics antagonize transient, weak D₂ receptor bindings with strong binding to the 5-HT(2A) receptor, while typical antipsychotics block long-lasting, tight D₂ receptor binding. On the contrary, antidepressants in the field of pain management also block the reuptake of similar receptors, mainly on the 5-HT and, next, on the norepinephrine, but rarely on the D receptors. Antipsychotics have been used for treating positive symptoms, such as delusion, hallucination, disorganized thought and behavior, perception disturbance, and inappropriate emotion, rather than the negative, cognitive, and affective symptoms of psychosis. Therefore, an antipsychotic may be prescribed in pain patients with positive symptoms of psychosis during or after controlling all sensory components.
Affective Symptoms ; Analgesics ; Antidepressive Agents ; Antipsychotic Agents ; Delusions ; Dopamine ; Drug-Related Side Effects and Adverse Reactions ; Dystonia ; Hallucinations ; Histamine ; Humans ; Movement Disorders ; Norepinephrine ; Pain Management ; Prolactin ; Psychomotor Agitation ; Psychotic Disorders ; Receptor, Serotonin, 5-HT2A ; Receptors, Neurotransmitter ; Serotonin ; Weight Gain

OBJECTIVES: This study investigated quality of life in Korean juvenile inmates with attention-deficit/hyperactivity disorder (ADHD) and the impact of behavioral and emotional problems on quality of life. METHODS: In total, 200 inmates were evaluated using the Korean version of the Mini-International Neuropsychiatric Interview (K-MINI) and the Korean version of the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (K-SADS-PL-K). We extracted the inmates with ADHD and evaluated their quality of life, behavioral problems, and emotional problems with the Pediatric Quality of Life Inventory (PedsQL) and the Korean Youth Self Report (K-YSR) scale. Descriptive statistics, Pearson correlation analysis, and multiple regression analysis were conducted. RESULTS: Among the 200 total inmates, 68 were diagnosed with ADHD by the K-SADS-PL-K. Most of the correlations between PedsQL scores and K-YSR items were significant. Multiple regression analysis showed that PedsQL could be predicted by affective problems (among the DSM-oriented scales of the K-YSR) and attention problems (among the syndrome scales of the K-YSR). CONCLUSION: Our results demonstrate that, among juvenile inmates with ADHD, quality of life was negatively correlated with most behavioral and emotional problems. Meanwhile, the significant influence of affective and attention problems on inmates' quality of life suggests the necessity of comprehensive treatments for this group.
Adolescent ; Affective Symptoms ; Attention Deficit Disorder with Hyperactivity ; Humans ; Mood Disorders ; Problem Behavior ; Quality of Life ; Self Report ; Weights and Measures

OBJECTIVE: This study was performed to elucidate relationships between alexithymia, suicide ideation and homocysteine levels in drug-naïve outpatients with major depressive disorder (MDD). METHODS: Sixty seven outpatients with MDD with melancholic features were evaluated by the means of the Hamilton Depression Rating Scale, the Toronto Alexithymia Scale (TAS–20), the Scale of Suicide Ideation, and homocysteine levels. RESULTS: Alexithymic subjects showed higher scores on all scales and higher homocysteine levels. Regression analysis shown higher homocysteine levels and TAS-20’ “Difficulty in Describing Feelings” dimension, in turn being associated with higher suicide ideation. CONCLUSION: In conclusion, alexithymic MDD outpatients may characterize for homocysteine dysregulation that may be linked to suicide ideation, regardless depression’ severity. However, study limitations are discussed and must be considered.
Affective Symptoms ; Depression ; Depressive Disorder, Major ; Homocysteine ; Humans ; Outpatients ; Suicidal Ideation ; Suicide ; Weights and Measures

PURPOSE: The purpose of this study was to examine the mediating effect of alexithmia on the relationship between attachment and depression in early adulthood. METHODS: A convenience sample of 260 young adults responded to the survey. The collected data were analyzed using descriptive statistics, independent t-test, Pearson's correlation coefficients, and path analyses using bootstrapping. RESULTS: The path analysis indicated that anxious attachment and alexithymia was positively related to depression, but there was not a significant relationship between avoidant attachment and depression. In a modified path model, alexithymia mediated the positive effects of anxious attachment and avoidant attachment on depression. CONCLUSION: Our study findings suggest that early adults who have insecure attachments are vulnerable to alexithymia and depression. Targeted interventions to improve emotional expressive ability may reduce depression in early adulthood.
Adult ; Affective Symptoms ; Depression ; Humans ; Negotiating ; Object Attachment ; Young Adult

OBJECTIVES: This study examined the functional disabilities of patients with chronic schizophrenia using WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and its related factors. METHODS: The subjects consisted of 86 patients with schizophrenia with more than 10 years' duration of illness and 40 healthy volunteers. The functional disabilities and psychopathology were evaluated using the WHODAS 2.0 and 18-items Brief Psychiatric Rating Scale (BPRS-18), respectively. This study analyzed the six sub-domains ('cognition', 'mobility', 'self-care', 'getting along', 'life activities', and 'participation') of WHODAS 2.0 and the four sub-scales ('positive symptoms', 'negative symptoms', 'affect', and 'resistance') of BPRS-18. RESULTS: Patients with chronic schizophrenia experienced severe functional disabilities across all six sub-domains of WHODAS 2.0 compared to healthy people. Hierarchical regression showed that 'negative symptoms' explained the disabilities in the WHODAS 2.0 sub-domains of 'cognition' (p<0.05), 'self-care' (p<0.05), 'getting along' (p<0.01), and 'life activities' (p<0.05). 'Positive symptoms' and 'affect' explained the disabilities in 'cognition' (p<0.01 and p<0.05, respectively) and 'participation' (p<0.05 and p<0.01, respectively). 'Resistance' was found to be a predictor of 'getting along' disabilities (p<0.01). CONCLUSION: Negative symptoms mainly accounted for the multiple domains of functional disabilities in the WHODAS 2.0 but residual positive and affective symptoms could also deteriorate the cognition and social participation of patients with chronic schizophrenia.
Affective Symptoms ; Appointments and Schedules ; Brief Psychiatric Rating Scale ; Cognition ; Disability Evaluation ; Global Health ; Healthy Volunteers ; Humans ; Psychopathology ; Schizophrenia ; Social Participation ; World Health Organization

Occlusal disharmony is frequently observed among edentulous patients. When artificial teeth come into contact, the unfavorable displacing force may lead to the discomfort, mucosal trauma, or even neuromuscular alterations and emotional disturbances. An optimal occlusal scheme is a critical factor for successful complete dentures. For this case, an edentulous patient with significant interarch size discrepancy due to mandibular prognathism contributing to inadequate function of dentures was treated with complete dentures. The posterior cross-bite tooth setup for compensating the abnormal jaw relations provided a stable and retentive complete denture prosthesis, which was considered adequate by both patient and dentist.
Affective Symptoms ; Dentists ; Denture Design ; Denture, Complete ; Dentures ; Humans ; Jaw ; Prognathism ; Prostheses and Implants ; Tooth ; Tooth, Artificial

BACKGROUND AND PURPOSE: The pathophysiology of post-stroke depression (PSD) is complex and may differ according to an individual’s mood immediately after stroke. Here, we compared the therapeutic response and clinical characteristics of PSD at a later stage between patients with and without depression immediately after stroke. METHODS: This study involved a post hoc analysis of data from EMOTION (ClinicalTrials.gov NCT01278498), a placebo-controlled, double-blind trial that examined the efficacy of escitalopram (10 mg/day) on PSD and other emotional disturbances among 478 patients with acute stroke. Participants were classified into the Baseline-Blue (patients with baseline depression at the time of randomization, defined per the Montgomery-Asberg Depression Rating Scale [MADRS] ≥8) or the Baseline-Pink groups (patients without baseline depression). We compared the efficacy of escitalopram and predictors of 3-month PSD (MADRS ≥8) between these groups. RESULTS: There were 203 Baseline-Pink and 275 Baseline-Blue patients. The efficacy of escitalopram in reducing PSD risk was more pronounced in the Baseline-Pink than in the Baseline-Blue group (p for interaction=0.058). Several risk factors differentially affected PSD development based on the presence of baseline depression (p for interaction < 0.10). Cognitive dysfunction was an independent predictor of PSD in the Baseline-Blue, but not in the Baseline-Pink group, whereas the non-use of escitalopram and being female were more strongly associated with PSD in the Baseline-Pink group. CONCLUSIONS: Responses to escitalopram and predictors of PSD 3 months following stroke differed based on the presence of baseline depression. Our data suggest that PSD pathophysiology is heterogeneous; therefore, different therapeutic strategies may be needed to prevent PSD emergence following stroke.
Affective Symptoms ; Anger ; Citalopram ; Depression* ; Female ; Humans ; Random Allocation ; Risk Factors ; Stroke

PURPOSE: The present study was to examine the effect of a meditation-based exercise program on the motor and non-motor symptoms of Parkinson's disease (PD). METHODS: Sixty three PD patients who were recruited from a university hospital were randomly assigned to the experimental group (n = 33) and to the control group (n = 30). Participants completed an 8-week Mindfulness Meditation-based Complex Exercise Program (MMBCEP) that included 6 sessions. Before and after the intervention, the Six-Minute Walk Test (6MWT), elastic band pull, chair stand test, and 2.45-meter walk test were administered for the motor symptoms and the Korean Version of Geriatric Depression Scale, The State-Trait Anxiety Inventory (STAI), the Korean-Montreal Cognitive Assessment, Parkinson's Disease Sleep Scale (PDSS), Activities of Daily Living (ADL), and the Quality of Life of Patients with Parkinson's Disease (PDQL) were administered for non-motor symptoms. RESULTS: Significant improvements in the motor symptoms (i.e., muscle strength (lower and upper extremity), balance, and muscle endurance) and in the non-motor symptoms (i.e., anxiety, depression, cognitive functions, sleep disturbance, quality of life, and activities of daily living) were observed. CONCLUSIONS: MMBCEP, a complex exercise program-based on mindfulness meditation, is associated with increased motor symptoms, decreased emotional disturbances (anxiety and depression) and sleep disturbance, and improved cognitive functions, quality of life, and activities of daily living. Future research should test the effects of MMBCEP with more representative PD patients.
Activities of Daily Living ; Affective Symptoms ; Anxiety ; Cognition ; Depression ; Humans ; Meditation ; Mindfulness* ; Muscle Strength ; Parkinson Disease* ; Quality of Life*

According to the cognitive behavior theory and meta-cognitive theory of health anxiety, to examine the association between alexithymia, cognition factors or meta-cognition factors and health anxiety.
 Methods: A total of 1 164 medical students were investigated by the Short Health Anxiety Inventory, the Health Cognitions Questionnaire, the Meta-cognitions about Health Questionnaire and the Toronto Alexithymia Scale.
 Results: 1) Correlation analysis showed that alexithymia, dysfunctional beliefs, meta-cognition were significantly positively correlated with health anxiety (r=0.227-0.477, all P<0.01); 2) The results of structural equation model indicated that alexithymia could not exert effects on health anxiety directly (β=-0.05, 95% CI -0.123 to 0.021). The alexithymia could exert effects on health anxiety indirectly not only through dysfunctional beliefs (β=0.192, 95% CI 0.156 to 0.235), but also through the chain-mediated effect of dysfunctional beliefs and meta-cognitions (β=0.103, 95% CI 0.077 to 0.135). Dysfunctional beliefs fully mediated the relation between alexithymia and health anxiety (β=0.247, 95% CI 0.196 to 0.290).
 Conclusion: Alexithymia can affect health anxiety through the mediating effects of dysfunctional beliefs and meta-cognition.
Affective Symptoms ; complications ; Anxiety ; complications ; Culture ; Humans ; Metacognition ; Surveys and Questionnaires