2.The Mediating Effect of Impulsivity on Resilience and Depressive Symptoms In Korean Conscripts
Dongyun LEE ; So Jin LEE ; Chul Soo PARK ; Bong Jo KIM ; Cheol Soon LEE ; Boseok CHA ; Ji Yeong SEO ; Jae Won CHOI
Psychiatry Investigation 2019;16(10):773-776
OBJECTIVE: Resilience and impulsivity have opposite effects on depression in stressful situations. This study aimed to investigate the association among resilience, impulsivity, and depression in young males. METHODS: The participants consisted of 429 conscripts who underwent military training over 5 weeks. The surveys included the Connors- Davidson Resilience Scale-Korean version, the Barratt Impulsiveness Scale-11-Revised, and the Center for Epidemiological Studies- Depression Scale. The surveys were administered both before and after training. RESULTS: When simultaneously considering impulsivity and resilience, resilience was not associated with depression. Impulsivity had a complete negative mediating effect on resilience and depressive symptoms. Impulsivity is a significant negative mediating factor for the protective effect of resilience on depression. CONCLUSION: This study recommends considering impulsivity when evaluating the protective role of resilience against depression.
Depression
;
Humans
;
Impulsive Behavior
;
Male
;
Military Personnel
;
Negotiating
3.Attention-Deficit/Hyperactivity Disorder Symptom Characteristics in Korean Elementary School Children: Comparison with US Population
Hyun Woo CHOI ; Chi Hyun CHOI ; Myung Ho LIM ; Ho Jang KWON ; Seung Jin YOO ; Ki Chung PAIK ; Kyoung Min KIM
Psychiatry Investigation 2019;16(6):425-432
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in elementary school children. The present study investigated the characteristics of ADHD in Korean elementary school children using the Korean version of the ADHD Rating Scale (K-ARS). The data was compared with those obtained from a comparable American population. METHODS: Participants included 29,914 elementary school children, aged 6–12 years, from a medium-sized city. The parents completed the home version of the K-ARS. The total and subscale-specific normative data and sex- and age-related mean score differences were analyzed. These data were compared with those obtained from the American population using independent t-tests. RESULTS: Mean total and subscale K-ARS scores were significantly higher among boys (vs. girls) and younger children aged equal to or less than 8 years old (vs. older children). Mean scores on the hyperactivity-impulsivity subscale were lower than those of American children, but similar to another Korean sample. CONCLUSION: Our data characterized ADHD symptoms in Korean children. However, further studies are needed to identify the cultural differences underlying ratings of ADHD symptom severity.
Child Psychiatry
;
Child
;
Cross-Cultural Comparison
;
Humans
;
Impulsive Behavior
;
Neurodevelopmental Disorders
;
Parents
4.Factors Associated with Suicidal Behavior of Psychiatric Inpatients
Honey KIM ; Ju Wan KIM ; Hee Ju KANG ; Seon Young KIM ; Ju Yeon LEE ; Jae Min KIM ; Il Seon SHIN ; Jin Sang YOON ; Sung Wan KIM
Journal of Korean Neuropsychiatric Association 2019;58(3):202-208
OBJECTIVES: This study examined the factors associated with suicidal behavior in psychiatric inpatients. METHODS: The medical records of 208 psychiatric inpatients were reviewed retrospectively. The factors related to suicide attempts and ideation at the time of admission, and during outpatient follow-up, were investigated. RESULTS: In total, 120 patients (57.7%) with a history of at least one suicide attempt, and 163 patients (78.4%) who reported active suicide ideation (e.g., a suicide plan or intention to commit suicide) at the time of admission were reviewed. Being unmarried or divorced, substance abuse, impulsivity, and a poor social support system were associated with a history of suicide attempts. The suicidal ideation group had significantly higher rates of coexisting depression, severe depressive symptoms, hopelessness, and impulsivity, as well as a lower incidence of moral objection to suicide and high religiosity. In total, 15 out of 193 patients (7.8%) who were followed-up at outpatient clinics attempted suicide after discharge. Patients who attempted suicide or reported suicidal ideation at the outpatient clinic after discharge were significantly more likely to have a history of previous suicide attempts, or have had active suicide ideation at the time of admission. Good social support and high responsibility to family were inversely associated with suicidal ideation as an outpatient. CONCLUSION: A history of suicide attempts and ideation at the time of hospital admission were the risk factors for future outpatient suicidal behavior. Further study is warranted to develop a checklist and assessment measures of the various risk and protective factors associated with suicidal behavior.
Ambulatory Care Facilities
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Checklist
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Depression
;
Divorce
;
Follow-Up Studies
;
Humans
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Impulsive Behavior
;
Incidence
;
Inpatients
;
Intention
;
Medical Records
;
Outpatients
;
Protective Factors
;
Retrospective Studies
;
Risk Factors
;
Single Person
;
Substance-Related Disorders
;
Suicidal Ideation
;
Suicide
;
Suicide, Attempted
5.The Impact of Impulsivity on Quality of Life in Early Drug-Naïve Parkinson's Disease Patients
Dong Woo RYU ; Joong Seok KIM ; Sang Won YOO ; Yoon Sang OH ; Kwang Soo LEE
Journal of Movement Disorders 2019;12(3):172-176
OBJECTIVE: Impulse control disorders (ICDs) in Parkinson's disease (PD) are mostly related to dopamine replacement therapy (DRT); however, drug-naïve PD patients have also frequently experienced impulsivity. This phenomenon makes clinicians hesitate treating patients with DRT. In this study, we assessed the effect of impulsivity on quality of life (QOL) in drug-naïve PD patients. METHODS: Two hundred three newly diagnosed, nonmedicated PD patients were enrolled, and they received structured clinical interviews, physical examinations and validated questionnaires to evaluate motor and nonmotor symptoms and QOL. Impulsivity was evaluated using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS). RESULTS: Thirty-eight patients (18.7%) had impulsivity with QUIP-RS scores ≥ 1 and 4 patients (2.0%) were diagnosed with combined ICDs. Motor and nonmotor symptoms were significantly correlated with the Parkinson's Disease Questionnaire-39 summary index. Female sex and QUIP-RS scores were also correlated with QOL in drug-naïve PD patients. CONCLUSION: The results of the present study showed that impulsivity negatively influences QOL in early drug-naïve PD patients. In addition, more severe motor and nonmotor symptoms were also associated with lower QOL. Such findings complicate treatment but provide valuable information for managing early PD.
Disruptive, Impulse Control, and Conduct Disorders
;
Dopamine
;
Female
;
Humans
;
Impulsive Behavior
;
Parkinson Disease
;
Physical Examination
;
Quality of Life
6.Pharmacotherapy for attention-deficit/hyperactivity disorder
Journal of the Korean Medical Association 2019;62(1):49-55
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder defined by impairing levels of inattention, disorganization, and/or hyperactivity-impulsivity. ADHD often persists into adulthood, with resultant impairments of social, academic and occupational functioning. ADHD is a very common disease during childhood and, the pooled overall prevalence of ADHD was found to be 5.29%. When screening for ADHD, clinicians should try to develop rapport with patients and their caregivers to increase the likelihood that they will follow the diagnostic process and treatment. The current drugs that have received Food and Drug Administration-approval for ADHD include stimulants (methylphenidate and dextroamphetamine) and non-stimulants (atomoxetine, guanfacine, and clonidine). Stimulants improve inattention, hyperactivity, and impulsivity in addition to decreasing disruptive behaviors and promoting academic achievement and the maintenance of appropriate friendships. In order to enhance drug compliance, the use of long-acting stimulants is increasing. Atomoxetine is a selective norepinephrine reuptake blocker, the effects of which may take 2 to 6 weeks to be noticeable. Furthermore, α2 agonists may help to improve behavioral side effects, tics, and sleep problems during stimulant or atomoxetine use. Common side effects of stimulants and atomoxetine include headache, stomachache, and loss of appetite. Routine electorcardiography before medication is not recommended unless there is a specific indication. Methylphenidate and atomoxetine are safe as first line therapies, and their side effects are well tolerated.
Appetite
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Atomoxetine Hydrochloride
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Attention Deficit Disorder with Hyperactivity
;
Caregivers
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Compliance
;
Drug Therapy
;
Friends
;
Guanfacine
;
Headache
;
Humans
;
Impulsive Behavior
;
Mass Screening
;
Methylphenidate
;
Neurodevelopmental Disorders
;
Norepinephrine
;
Prevalence
;
Problem Behavior
;
Tics
7.Recapitulation of Neuropsychiatric Behavioral Features in Mice Using Acute Low-dose MK-801 Administration
Darine Froy N MABUNGA ; Donghyun PARK ; Onjeon RYU ; Schley T VALENCIA ; Keremkleroo Jym L ADIL ; Seonmin KIM ; Kyoung Ja KWON ; Chan Young SHIN ; Se Jin JEON
Experimental Neurobiology 2019;28(6):697-708
Despite some innate limitations, animal models are a potent investigative tool when used to model specific symptoms of a disorder. For example, MK-801, an N-methyl-D-aspartate receptor antagonist, is used as a pharmacological tool to induce symptoms found in some neuropsychiatric disorders. However, a close examination of literature suggests that the application window of MK-801 doses is relatively narrow between individual behavioral paradigms, necessitating careful characterization of the evoked behavioral aberrations and the doses used to induce them. Moreover, variation in behaviors depending on the animal strain, gender of the subject, and the timing of administration is observed, making it difficult to compare the behavioral characteristics reported in different studies. We aim to characterize the behavioral aberrations induced by different doses of MK-801 in CD-1 mice and create a ready reference for future studies. We used CD-1 mice to recapitulate behavioral impairments resulting from acute administration of MK-801. In 0.1 mg kg⁻¹, we observed diminished spontaneous alteration during the Y-maze test, while 0.12 mg kg⁻¹ resulted in hyperlocomotion and social deficit. Mice treated with 0.2 and 0.3 mg kg⁻¹ of MK-801 demonstrated a decreased self-grooming. Finally, all doses significantly impaired cliff avoidance behaviors suggesting increased impulsivity. These results affirm that MK-801 can effectively model various symptoms of different neuropsychiatric disorders in a dose-dependent manner. The observed sensitivity against spatial-memory impairment and impulsive behaviors at low concentration of MK-801 suggest that MK801 may modulate cognitive function and impulsivity in even lower concentration before it can modulate other behavioral domains.
Animals
;
Avoidance Learning
;
Cognition
;
Dizocilpine Maleate
;
Impulsive Behavior
;
Mice
;
Models, Animal
;
N-Methylaspartate
8.Relationship of Probable Attention Deficit Hyperactivity Disorder with Severity of Psychopathology and Impulsivity in a Sample of Male Patients with Opioid Use Disorder
Cuneyt EVREN ; Izgi ALNIAK ; Vahap KARABULUT ; Turan CETIN ; Gokhan UMUT ; Ruken AGACHANLI ; Bilge EVREN
Psychiatry Investigation 2018;15(2):164-171
OBJECTIVE: The aim of the present study was to evaluate relationship of probable attention deficit hyperactivity disorder (ADHD) with severity of psychopathology and the effect of impulsivity on this relationship in a sample of male patients with opioid use disorder (OUD). METHODS: Participants included 234 patients (115 inpatients and 119 outpatients) with OUD. Participants were evaluated with the Adult ADHD Self-Report Scale (ASRS-v1.1), the Symptom Checklist-90-R (SCL-90-R) and the Short Form of Barratt Impulsiveness Scale (BIS-11-SF). RESULTS: Psychopathology and impulsivity scores were higher among those with the probable ADHD. ADHD scores were midly to moderately correlated with impulsivity and psychopathology scores. In logistic regression analyses, while severity of general psychopathology and impulsivity predicted probable ADHD in the first Model, in the second Model, among dimensions of psychopathology obsessive compulsive (OC) dimension, whereas among dimensions of impulsivity non-planning and motor impulsivity predicted probable ADHD. CONCLUSION: These findings suggest that probable ADHD is related with the severity of psychopathology, particularly OC dimension, while the severity of impulsivity may have an partial mediator (particularly non-planning and motor impulsivity) effect on this relationship among patients with OUD.
Adult
;
Attention Deficit Disorder with Hyperactivity
;
Humans
;
Impulsive Behavior
;
Inpatients
;
Logistic Models
;
Male
;
Psychopathology
9.Strategies of Using Antipsychotics in Patients with Bipolar Disorders.
Journal of Korean Neuropsychiatric Association 2018;57(4):301-307
Bipolar disorder is a recurrent chronic condition and patients usually continue long-term medication from young age to prevent the recurrence of mood episodes. Antipsychotics play an important role in acute and maintenance treatment of bipolar disorder, even when patients experience no psychotic symptoms. Antipsychotics are also used in monotherapy and combination therapy involving mood stabilizers such as lithium or valproate. However, limited antipsychotics are currently approved by the US Food & Drug Administration ; 10 kinds of antipsychotics were approved for manic or mixed episodes, 3 for bipolar depression, and 5 for maintenance therapy. Before and after the use of antipsychotics, psychiatrists should carefully monitor baseline weight, pulse, blood pressure, fasting blood glucose or HbA1c, blood lipid profile, and electrocardiogram to evaluate QTc prolongation. During manic episodes or mixed features, antipsychotics rapidly control agitation, aggression, and impulsivity. Repetitive injections of typical antipsychotics are not implemented in bipolar patients as this practice is not evidence-based. However, long-acting injectable atypical antipsychotics are approved and feature support on maintenance therapy for bipolar patients. Although recent studies have shown the benefits of aripiprazole and olanzapine on rapid-cycling bipolar patients, few studies support the effectiveness of antipsychotics in suicide prevention. Moreover, while there is extensive evidence on the effectiveness of lithium in suicide or self-harm prevention. In conclusion, antipsychotics, especially aripiprazole, quetiapine, olanzapine, and risperidone, are effective to manage bipolar disorder in clinical settings. But weight gain and cardiac conductance should be carefully monitored before and during the use of antipsychotics.
Aggression
;
Antipsychotic Agents*
;
Aripiprazole
;
Bipolar Disorder*
;
Blood Glucose
;
Blood Pressure
;
Depression
;
Dihydroergotamine
;
Electrocardiography
;
Fasting
;
Humans
;
Impulsive Behavior
;
Lithium
;
Psychiatry
;
Quetiapine Fumarate
;
Recurrence
;
Risperidone
;
Suicide
;
Valproic Acid
;
Weight Gain
10.A Pilot Examination of Oxidative Stress in Trichotillomania.
Jon E GRANT ; Samuel R CHAMBERLAIN
Psychiatry Investigation 2018;15(12):1130-1134
OBJECTIVE: Trichotillomania is a relatively common illness whose neurobiology is poorly understood. One treatment for adult trichotillomania, n-acetyl cysteine (NAC), has antioxidative properties, as well as effects on central glutamatergic transmission. Preclinical models suggest that excessive oxidative stress may be involved in its pathophysiology. METHODS: Adults with trichotillomania provided a blood sample for analysis of compounds that may be influenced by oxidative stress [glutathione, angiotensin II, ferritin, iron, glucose, insulin and insulin growth factor 1 (IGF1), and hepcidin]. Participants were examined on symptom severity, disability, and impulsivity. The number of participants with out-of-reference range oxidative stress measures were compared against the null distribution. Correlations between oxidative stress markers and clinical measures were examined. RESULTS: Of 14 participants (mean age 31.2 years; 92.9% female), 35.7% (n=5) had total glutathione levels below the reference range (p= 0.041). Other oxidative stress measures did not have significant proportions outside the reference ranges. Lower levels of glutathione correlated significantly with higher motor impulsiveness (Barratt Impulsiveness Scale sub-score) (r=0.97, p=0.001). CONCLUSION: A third of patients with trichotillomania had low levels of glutathione, and lower levels of glutathione correlated significantly with higher motor impulsiveness. Because NAC is a precursor for cysteine, and cysteine is a rate limiting step for glutathione production, these results may shed light on the mechanisms through which NAC can have beneficial effects for impulsive symptoms. Confirmation of these results requires a suitable larger follow-up study, including an internal normative control group.
Adult
;
Angiotensin II
;
Cysteine
;
Ferritins
;
Follow-Up Studies
;
Glucose
;
Glutathione
;
Humans
;
Impulsive Behavior
;
Insulin
;
Iron
;
Neurobiology
;
Oxidative Stress*
;
Reference Values
;
Trichotillomania*

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