OBJECTIVE: Previous studies reported the delayed recovery group after circadian rhythm disruption in mice showed higher quinpiroleinduced locomotor activity. This study aimed to compare not only Protein Kinase C (PKC) activities in frontal, striatal, hippocampus and cerebellum, but also relative PKC activity ratios among brain regions according to recovery of circadian rhythm. METHODS: The circadian rhythm disruption protocol was applied to eight-week-old twenty male Institute Cancer Research mice. The circadian rhythm recovery patterns were collected through motor activities measured by Mlog system. Depressive and manic proneness were examined by forced swim test and quinpirole-induced open field test respectively. Enzyme-linked immunosorbent assay was employed to measure PKC activities. RESULTS: The delayed recovery group presented greater locomotor activities than the early recovery group (p=0.033). The delayed recovery group had significantly lower frontal PKC activity than the other (p=0.041). The former showed lower frontal/cerebellar PKC activity ratio (p=0.047) but higher striatal/frontal (p=0.038) and hippocampal/frontal (p=0.007) PKC activities ratios than the latter. CONCLUSION: These findings support potential mechanism of delayed recovery after circadian disruption in bipolar animal model could be an alteration of relative PKC activities among mood regulation related brain regions. It is required to investigate the PKC downstream signaling related to the delayed recovery pattern.
Animals ; Bipolar Disorder* ; Brain ; Cerebellum ; Circadian Rhythm ; Enzyme-Linked Immunosorbent Assay ; Hippocampus ; Humans ; Male ; Mice* ; Models, Animal ; Motor Activity ; Protein Kinase C* ; Protein Kinases* ; Quinpirole

OBJECTIVE: The aim of the present study was to investigate differences in discontinuation time among antidepressants and total antidepressant discontinuation rate of patients with depression over a 6 month period in a naturalistic treatment setting. METHODS: We reviewed the medical records of 900 patients with major depressive disorder who were initially prescribed only one kind of antidepressant. The prescribed antidepressants and the reasons for discontinuation were surveyed at baseline and every 4 weeks during the 24 week study. We investigated the discontinuation rate and the mean time to discontinuation among six antidepressants groups. RESULTS: Mean and median overall discontinuation times were 13.8 and 12 weeks, respectively. Sertraline and escitalopram had longer discontinuation times than that of fluoxetine, and patients who used sertraline discontinued use significantly later than those taking mirtazapine. No differences in discontinuation rate were observed after 24 weeks among these antidepressants. About 73% of patients discontinued antidepressant treatment after 24 weeks. CONCLUSION: Sertraline and escitalopram tended to have longer mean times to discontinuation, although no difference in discontinuation rate was detected between antidepressants after 24 weeks. About three-quarters of patients discontinued antidepressant maintenance therapy after 24 weeks.
Antidepressive Agents* ; Citalopram ; Depression ; Depressive Disorder, Major* ; Fluoxetine ; Humans ; Medical Records ; Sertraline

BACKGROUND: Nicotine dependence and its severity are often determined by individuals’ psychosocial factors.This study purposed to analyze how Korean workers’ job stress is related with their nicotine dependence according to demographic and occupational characteristics in order to reduce smoking related to job stress and to establish objective indicators to be used in developing adequate smoking cessation strategies. METHODS: The subjects of this study were 4,639 workers who replied to the questionnaire survey. In addition, 1,948 current smokers were separated from non-smokers and ex-smokers, and the relationship between job stress and nicotine dependence was analyzed with the current smoker group. Nicotine dependence was tested using Fagerström’s Test of Nicotine Dependence, and stress was measured using a questionnaire on subjective stress felt by workers in their daily life and the short form of the Korean Occupational Stress Scale. RESULTS: The smoking rate was 54.1 % among men and 2.5 % among women. Nicotine dependence was significantly different according to interpersonal conflict, organization system and lack of reward (p < 0.05). As multivariate logistic analysis, job control, occupational climate and total stress score were statistical significant (p < 0.05). CONCLUSIONS: Job stress was found to be related with smoking status and nicotine dependence. Based on this result, it is suggested to enhance workers’ welfare for health promotion in workplace by improving their working environment in order to reduce job stress and consequently to decrease the smoking rate.
Climate ; Female ; Health Promotion ; Humans ; Male ; Nicotine* ; Reward ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Use Disorder*

OBJECTIVES: Restless legs syndrome (RLS) is a common sleep disorder in adults with diabetes. This study investigated the frequency of RLS and clinical correlations in children and adolescents with type 1 diabetes. METHODS: This study included 55 consecutive patients (21 males, age 12.6 +/- 3.4 years) with type I diabetes that were regularly treated at the Department of Pediatric Endocrinology. RLS was diagnosed by intensive interviews which also included the Epworth Sleepiness Scale (ESS) and International RLS Rating Scale (IRLSRS). Patients also received neurological examinations and laboratory tests for diabetes, iron metabolism and renal function. RESULTS: Thirteen patients (23.6%, 6 males) were compatible for the diagnostic criteria of RLS. None of the RLS patients showed abnormal findings in neurological evaluations and 7 patients had familial history of RLS. Demographic and laboratory findings were not different between the patients with or without RLS. The RLS group showed significantly increased ESS and IRLSRS scores. CONCLUSION: RLS was prevalent in children and adolescents with type I diabetes. The association between RLS and diabetes-related laboratory findings requires further investigation.
Adolescent* ; Adult ; Child* ; Endocrinology ; Humans ; Iron ; Male ; Metabolism ; Neurologic Examination ; Restless Legs Syndrome*

OBJECTIVES: Many patients diagnosed with cancer suffer from various psychiatric symptoms such as depression, anxiety and insomnia as well as cancer itself. Patients with cancer are more vulnerable to possible adverse events of psychotropic medications. Although antidepressants are widely used among cancer patients, there is little information about tolerability of antidepressants. This study was conducted to compare tolerability of antidepressants in cancer patients referred for psychiatric consultation. METHODS: The participants were cancer patients who had been referred to psychiatrist for their psychiatric symptoms. We retrospectively analyzed the data of patients diagnosed with cancer from 9 general hospitals in Korea. The discontinuation rate for a 6 months period after treatment initiation for three antidepressants(Escitalopram, Mirtazapine, Paroxetine) were compared. RESULTS: Antidepressants were prescribed for 96.3% of subjects and Escitalopram 150(47.2%), Mirtazapine 92 (28.9%) and Paroxetine 76(23.9%) were prescribed frequently in order There were no significant differences in discontinuation rates among the three antidepressants during the 6 month period after initiation of pharmacotherapy. But there was a difference in discontinuation rates between inpatients versus outpatients(p<0.0001). CONCLUSIONS: In a naturalistic setting for the antidepressant treatment for cancer patients, it seems that there are no differences in discontinuation rates among these three antidepressants. It is therefore essential that such interactions are carefully considered when treating patients of antidepressants who already have cancer.
Antidepressive Agents ; Anxiety ; Citalopram ; Depression ; Hospitals, General ; Humans ; Inpatients ; Korea ; Mianserin ; Paroxetine ; Psychiatry ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: Antidepressants are frequently used for treatment of psychological distress among cancer patients. The aim of this study is to investigate the characteristics of psychiatric consultations and antidepressant use for cancer patients. METHODS: Participants in the study included cancer patients who had been referred for psychiatric consultation. A total of 488 patients were recruited from nine general hospitals in Korea. Questionnaires based on medical records, including antidepressants prescribed, were investigated by psychiatrists. RESULTS: The most common psychiatric diagnosis of subjects was depressive disorders (72.4%), followed by anxiety disorders (13.0%), and adjustment disorders (7.3%). Antidepressants were prescribed for 96.3% of subjects and escitalopram, mirtazapine, and paroxetine were prescribed frequently, in order. Anxiolytics and hypnotics were used for 58.2% of the subjects, for which lorazepam and alprozolam were preferred. During the study period, 226 (46.8%) subjects discontinued treatment and the most common cause was improvement of symptoms (123, 54.4%). CONCLUSION: Our results showed a tendency of prescription of antidepressants and anxiolytics and common psychiatric problems in Korean cancer patients. We suppose that these data would be helpful to clinicians who manage psychiatric symptoms of cancer patients.
Adjustment Disorders ; Anti-Anxiety Agents ; Antidepressive Agents ; Anxiety Disorders ; Citalopram ; Depressive Disorder ; Hospitals, General ; Humans ; Hypnotics and Sedatives ; Korea ; Lorazepam ; Medical Records ; Mental Disorders ; Mianserin ; Paroxetine ; Prescriptions ; Surveys and Questionnaires ; Referral and Consultation

OBJECTIVES: Catechol-O-methyltransferase (COMT) plays an important role in metabolizing catecholamines, including dopamine. Also, several single-nucleotide polymorphisms (SNPs) of the COMT gene are associated with schizophrenia. Therefore, this study aimed to find the association between COMT gene SNPs and schizophrenia in Koreans. METHODS: Participants were 366 schizophrenia patients and 359 normal controls. To identify the SNPs, we performed genetic analyses in 4 SNP regions, via SNP-ITTM assays. We compared allele, genotype, and haplotype frequencies between the two groups. Moreover, we built subgroups, based on onset age, and compared individual allele and genotype frequencies among these subgroups. RESULTS: In female patients, genotype frequencies showed a significant difference in rs2020917 among the 4 SNPs (p=0.0224), but haplotype frequencies showed no such difference among the 4 SNPs between patients and controls. We noted a significant difference in rs1544325 allele frequencies according to onset age. Also, in female patients, rs1544325 allele and genotype frequencies varied significantly according to onset age. CONCLUSION: This study found no genetic association between the COMT gene's 4 SNPs and schizophrenia in Koreans. However, our findings suggest genetic components for sex-specificity and onset age in Korean schizophrenics.
Age of Onset ; Alleles ; Catechol O-Methyltransferase ; Catecholamines ; Dopamine ; Female ; Gene Frequency ; Genotype ; Haplotypes ; Humans ; Polymorphism, Single Nucleotide ; Schizophrenia

OBJECTIVES: Common genetic SNPs in two genes, encoding catechol-O-methyltransferase (COMT) and methylenetetrahydrofolate reductase (MTHFR), which are interconnected with COMT gene regulation, have been reported to contribute to schizophrenia risk. In this study, we evaluated the association between functional polymorphisms in COMT and MTHFR and schizophrenia risk with a case-control study in a Korean population. METHODS: We performed a case-control study by genotyping analysis using 360 cases and 348 controls in Korean subjects to determine the association between functional polymorphisms in COMT and MTHFR and schizophrenia risk. RESULTS: Four functional SNPs in COMT (Val158Met and rs165599) and MTHFR (C677T and A1298C) were genotyped by primer extension assay. None of the genotype distributions for the four SNPs was significantly different between cases and controls. Stratified analysis did not show any significant gender difference for any polymorphism. In addition, we found no evidence of a gene-gene interaction in the analysis of combined genotypes. CONCLUSION: Our results suggest no significant association between the selected functional polymorphisms of COMT or MTHFR in Korean schizophrenia subjects. However, further studies are required to confirm our findings in a larger number of subjects.
Case-Control Studies ; Catechol O-Methyltransferase ; Genotype ; Methylenetetrahydrofolate Reductase (NADPH2) ; Polymorphism, Single Nucleotide ; Schizophrenia

OBJECTIVES: Delirium is a common postoperative complication in old adults associated with adverse events including functional decline, longer lengths of stay, and risk of institutionalization. The purpose of this study is to evaluate the incidence, preoperative, intraoperative, and postoperative risk factors of postoperative delirium in spine surgery. METHODS: Seventy-nine patients who underwent spine surgery were included. Preoperative assessments included current medical illness, number of comorbid problems, and the number of medications by past medical history, medical record, and interview with patients and caregivers. Intraoperative risk factors were evaluated. Laboratory data were checked preoperatively and postoperatively. The presence of delirium was determined by the Korean version of Delirium Rating Scale (K-DRS). RESULTS: Postoperative delirium was found in patients (7.6%). There was an association suggested between older age and postoperative delirium in spine surgery (p<0.05). An association was suggested between increasing numbers of medical conditions and postoperative delirium (p<0.05). Preoperative hemoglobin, hematocrit, sodium, potassium, calcium, albumin levels and postoperative hemoglobin and total protein levels were in the delirium group was significantly lower than those in control group (p<0.05). CONCLSION: This study showed that the postoperative delirium in spine surgery is not rare and several preoperative and postoperative factors are involved in the development of delirium. This pilot study is the first prospective trial in the area of postoperative delirium in spine surgery with a small sample size and short-term period, so further research with large sample size will be necessary.
Adult ; Aged ; Calcium ; Caregivers ; Delirium* ; Hematocrit ; Humans ; Incidence ; Institutionalization ; Medical Records ; Pilot Projects* ; Postoperative Complications ; Potassium ; Prospective Studies ; Risk Factors ; Sample Size ; Sodium ; Spine*

OBJECTIVES: To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale: SSS) for routinely assessing the quality of service in psychiatric ward inpatients. METHODS: A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and university hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. RESULTS: Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. CONCLUSION: SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring satisfaction of psychiatric inpatients in Korea.
Age of Onset ; Alcoholics ; Attitude of Health Personnel ; Education ; Employment ; Hospitalization ; Hospitals, General ; Hospitals, Psychiatric ; Hospitals, University ; Humans ; Inpatients* ; Korea ; Length of Stay ; Marital Status ; Mood Disorders ; Patient Satisfaction ; Principal Component Analysis ; Psychotic Disorders ; Surveys and Questionnaires ; Reproducibility of Results ; Somatoform Disorders