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Han S, Kim SY, Jung YE, Kim W, Seo JS, Sohn I, Lee K, Lee JH, Chung SK, Lee SY, Hong JW, Yoon BH, Woo YS, Han C, Chang JG, Bahk WM, Song HR, Hong M. Patient's Perspective on Psychiatric Drugs: A Multicenter Survey-Based Study. Psychiatry Investig 2024; 21:28-36. [PMID: 38114066 PMCID: PMC10822732 DOI: 10.30773/pi.2023.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/17/2023] [Accepted: 09/15/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVE We aimed to identify the expectations and preferences for medication and medical decision-making in patients with major psychiatric disorders. METHODS A survey was conducted among patients with major psychiatric disorders who visited psychiatric outpatient clinics at 15 hospitals between 2016 and 2018 in Korea. The survey consisted of 12 questions about demographic variables and opinions on their expectations for medication, important medical decision-makers, and preferred drug type. The most preferred value in each category in the total population was identified, and differences in the preference ratio of each item among the disease groups were compared. RESULTS A total of 707 participants were surveyed. In the total population, patients reported high efficacy (44.01%±21.44%) as the main wish for medication, themselves (37.39%±22.57%) and a doctor (35.27%±22.88%) as the main decision makers, and tablet/capsule (36.16%±30.69%) as the preferred type of drug. In the depressive disorders group, the preference ratio of high efficacy was significantly lower, and the preference ratio of a small amount was significantly higher than that of the psychotic disorder and bipolar disorder groups. The preference ratio of a doctor as an important decision maker in the bipolar disorder group was higher compared to the other groups. CONCLUSION This study revealed the preference for medications and showed differences among patients with psychiatric disorders. Providing personalized medicine that considers a patient's preference for the drug may contribute to the improvement of drug compliance and outcomes.
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Affiliation(s)
- Seoyun Han
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | | | - Young-Eun Jung
- Department of Psychiatry, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea
| | - Won Kim
- Department of Psychiatry, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Inki Sohn
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| | - Kwanghun Lee
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Republic of Korea
| | - Jong Hun Lee
- Department of Psychiatry, College of Medicine, Daegu Catholic University, Daegu, Republic of Korea
| | - Sang-Keun Chung
- Department of Psychiatry, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Jung Wan Hong
- Department of Psychiatry, Iksan Hospital, Iksan, Republic of Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Changwoo Han
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Jhin Goo Chang
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hoo Rim Song
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Minha Hong
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
- UNC Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
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Woo YS, Hong JW, Shim SH, Sung HM, Seo JS, Park SY, Lee JG, Yoon BH, Bahk WM. Prevalence and Comorbidities of Adult Attention-deficit/hyperactivity Disorder in a Community Sample from Korea. Clin Psychopharmacol Neurosci 2023; 21:798-807. [PMID: 37859453 PMCID: PMC10591169 DOI: 10.9758/cpn.23.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 10/21/2023]
Abstract
Objective : Attention-deficit/hyperactivity disorder (ADHD) is prevalent in adults, and psychiatric comorbidities are common in adults with ADHD. We aimed to examine the prevalence of adult ADHD with several common psychiatric conditions in a community sample in Korea and the association between adult ADHD and risk of psychiatric comorbidities. Methods : This study used a cross-sectional survey design. We provided supplementary and optional self-report questionnaires, including the Korean version of the World Health Organization Adult ADHD Self-Report Scale (ASRS) short screening scale, Patient Health Questionnaire-9 for screening for depression, Alcohol Use Disorders Identification Test alcohol consumption questions, and the Korean version of the Mood Disorders Questionnaire, to Korean adults who visited one of six centers of a large private healthcare company for the National General Health Examination. Results : A total of 17,799 subjects included in this study, and 430 (2.4%) were positive on the ASRS screen. ADHD was significantly associated with the 19-30-year-old age group (odds ratio [OR] = 3.938), lower income (OR = 1.298), depression (OR = 11.563), and bipolar disorder (OR = 3.162). Conclusion : Adult ADHD was highly associated with depression and bipolar disorder, suggesting that clinicians should carefully evaluate and treat such psychiatric disorders in adults with ADHD symptoms.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Wan Hong
- Department of Psychiatry, Iksan Hospital, Iksan, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Hyung Mo Sung
- Department of Psychiatry, Soonchunhyang University Gumi Hospital, College of Medicine, Soonchunhyang University, Gumi, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
| | | | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Jeong JH, Bahk WM, Woo YS, Yoon BH, Lee JG, Kim W, Sohn I, Park SY, Shim SH, Seo JS, Choo ILH, Yang CM, Jung MH, Jon DI, Kim MD. Korean Medication Algorithm Project for Bipolar Disorder 2022: Comparisons with Other Treatment Guidelines. Clin Psychopharmacol Neurosci 2023; 21:32-48. [PMID: 36700310 PMCID: PMC9889890 DOI: 10.9758/cpn.2023.21.1.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 01/27/2023]
Abstract
The objective of this study was to compare recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2022 (KMAP-BP 2022) with other recently published guidelines for treating bipolar disorder. We reviewed a total of six recently published global treatment guidelines and compared treatment recommendation of the KMAP-BP 2022 with those of other guidelines. For initial treatment of mania, there were no significant differences across treatment guidelines. All guidelines recommended mood stabilizer (MS) or atypical antipsychotic (AAP) monotherapy or a combination of an MS with an AAP as a first-line treatment strategy in a same degree for mania. However, the KMAP-BP 2022 recommended MS + AAP combination therapy for psychotic mania, mixed mania and psychotic depression as treatment of choice. Aripiprazole, quetiapine and olanzapine were the first-line AAPs for nearly all phases of bipolar disorder across guidelines. Some guideline suggested olanzapine is a second-line options during maintenance treatment, related to concern about long-term tolerability. Most guidelines advocated newer AAPs (asenapine, cariprazine, long-acting injectable risperidone, and aripiprazole once monthly) as first-line treatment options for all phases while lamotrigine was recommended for depressive and maintenance phases. Lithium and valproic acid were commonly used as MSs in all phases of bipolar disorder. KMAP-BP 2022 guidelines were similar to other guidelines, reflecting current changes in prescription patterns for bipolar disorder based on accumulated research data. Strong preference for combination therapy was characteristic of KMAP-BP 2022, predominantly in the treatment of psychotic mania, mixed mania and psychotic depression.
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Affiliation(s)
- Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea,Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea,Address for correspondence: Won-Myong Bahk Department of Psychiatry, Yeuido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea, E-mail: , ORCID: https://orcid.org/0000-0002-0156-2510
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Won Kim
- Department of Psychiatry, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - InKi Sohn
- Department of Psychiatry, Keyo Hospital, Uiwang, Korea
| | | | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Korea
| | - IL Han Choo
- Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Korea
| | - Chan-Mo Yang
- Department of Psychiatry, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Myung Hun Jung
- Department of Psychiatry, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
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Jang SH, Bahk WM, Woo YS, Seo JS, Park YM, Kim W, Jeong JH, Shim SH, Lee JG, Jon DI, Min KJ. The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD): Changes in Preferred Treatment Strategies and Medications over 20 Years and Five Editions. J Clin Med 2023; 12:jcm12031146. [PMID: 36769798 PMCID: PMC9917906 DOI: 10.3390/jcm12031146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) is an expert consensus guideline for depressive disorder created in 2002, and since then, four revisions (2006, 2012, 2017, 2021) have been published. In this study, changes in the content of the KMAP-DD survey and recommendations for each period were examined. METHODS The development process of the KMAP-DD was composed of two stages. First, opinions from experts with abundant clinical experience were gathered through surveys. Next, a final guideline was prepared through discussion within the working committee regarding the suitability of the results with reference to recent clinical studies or other guidelines. RESULTS In mild depressive symptoms, antidepressant (AD) monotherapy was preferred, but when severe depression or when psychotic features were present, a combination of AD and atypical antipsychotics (AD + AAP) was preferred. AD monotherapy was preferred in most clinical subtypes. AD monotherapy was preferred for mild depressive symptoms, and AD + AAP was preferred for severe depression and depression with psychotic features in children, adolescents, and the elderly. CONCLUSIONS This study identified the changes in the KMAP-DD treatment strategies and drug preferences in each period over the past 20 years. This work is expected to aid clinicians in establishing effective treatment strategies.
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Affiliation(s)
- Seung-Ho Jang
- Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Correspondence:
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul 06974, Republic of Korea
| | - Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Republic of Korea
| | - Won Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University, Busan 48108, Republic of Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Kyung Joon Min
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul 06974, Republic of Korea
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Kim S, Kim SM, Kim DS, Han S, Hong JS, Seo JS. Level of Psychological and Somatic Symptoms Predict Perimenopausal Syndrome Severity Better Than Obstetric and Psychiatric History Do Among Korean Women. Psychiatry Investig 2023; 20:18-26. [PMID: 36721882 PMCID: PMC9890039 DOI: 10.30773/pi.2022.0249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/30/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Menopause symptoms can vary in type, duration, and severity. The purpose of this study was to investigate the key factors predicting severe symptoms among Korean perimenopausal women with various demographic data, obstetric and psychiatric histories, and menopausal symptoms screening scale scores. METHODS Data were collected from 1,060 women, and 4 latent classes were identified using latent profile analysis, with 6 major categories of menopausal complaints. Among the 4 classes, we selectively used data from the "all unimpaired" and "all impaired" groups. Menopause rating scale (MRS), sociodemographic, obstetric, and psychiatric factors were assessed, and hierarchical logistic regression analyses were conducted with the "all impaired" group as a dependent variable. RESULTS Marital status and scores on the psychological and somatic subscales of the MRS were statistically related to being in the "all impaired" group. Otherwise, family history of menopausal symptoms, menarche age, and history of other psychiatric disorders were not statistically significant predictors of being in the "all impaired" group. CONCLUSION The psychological and somatic subscales of the MRS predict the severity of perimenopausal syndrome better than obstetric and psychiatric history do among Korean perimenopausal women. Psychological and somatic symptoms as well as genitourinary symptoms in menopausal patients should be closely evaluated.
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Affiliation(s)
- Soyeon Kim
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Sun Mi Kim
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Da Seul Kim
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Seunga Han
- Department of Political Science, Vanderbilt University, Nashville, TN, USA
| | - Ji Sun Hong
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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Woo YS, Bahk WM, Jeong JH, Lee JG, Kim W, Sohn I, Park SY, Shim SH, Seo JS, Choo ILH, Yang CM, Jung MH, Jon DI, Kim MD, Yoon BH. Korean Medication Algorithm Project for Bipolar Disorder 2022, Fifth Revision: An Executive Summary. Clin Psychopharmacol Neurosci 2022; 20:747-761. [PMID: 36263649 PMCID: PMC9606436 DOI: 10.9758/cpn.2022.20.4.747] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 08/30/2023]
Abstract
OBJECTIVE We revised the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP), first published in 2002 and revised in 2006, 2010, 2014, and 2018, to reflect recent progress in the treatment of bipolar disorder. METHODS The questionnaires consisted of 56 items for adult patients and 7 items for child/adolescent patients, and were used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of bipolar disorder. The review committee included 87 Korean psychiatrists and 40 child and adolescent psychiatry experts. RESULTS For treatment of manic episodes, a combination of a mood stabilizer (MS) and atypical antipsychotics (AAP), or monotherapy with MS or AAP were recommended as first-line treatments. Combinations of MS and AAP, or AAP and lamotrigine (LMT) were recommended as first-line treatments for depressive episodes regardless of the severity. Monotherapy with MS, AAP, or LMT were also first-line treatments for mild to moderate depressive episodes. For mixed features, a combination of MS and AAP, or monotherapy with AAP or MS were recommended as first-line treatments, and a combination of AAP and LMT, or MS and LMT were the first-line treatments for depressive mixed state. CONCLUSION The recommendations of the KMAP-BP 2022 have changed from the previous version, to reflect the evolution of the social culture and healthcare system in Korea and recent evidence regarding pharmacotherapy of bipolar disorder. The KMAP-BP 2022 provides clinicians with a wealth of information regarding appropriate strategies to treat patients with bipolar disorder.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Won Kim
- Department of Psychiatry, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - InKi Sohn
- Department of Psychiatry, Keyo Hospital, Uiwang, Korea
| | | | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
| | - IL Han Choo
- Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Korea
| | - Chan-Mo Yang
- Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea
| | - Myung Hun Jung
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
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Lee SH, Shim CY, Kin DY, Seo JS, Iksung CHO, Ha JW, Hong GR. Determinants of exercise-induced pulmonary hypertension in rheumatic mitral stenosis: a study with exercise stress and speckle tracking echocardiography. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Backgrounds
Exercise stress echocardiography is helpful in assessing hemodynamic consequence of mitral stenosis (MS) and in guiding treatment. Exercised-induced pulmonary hypertension (PH) is result of severity of MS, but myocardial function of left ventricle and clinical factors can also have effect.
Purpose
We aimed to evaluate the associated factors with the pulmonary artery systolic pressure (PASP) in exercise stress echocardiography through 2D, Doppler, and speckle tracking imaging in patients with rheumatic MS.
Methods
A total of 164 patients with rheumatic MS underwent a graded, symptom-limited, supine bicycle exercise with echocardiography. After exclusion of patients who had very severe MS (valve area <1.0 cm2), a history of surgery or recent percutaneous mitral valvotomy, combined significant aortic valve dysfunction, left ventricular (LV) ejection fraction <50%, we analyzed 113 patients (77.6% female; mean age, 56±9 years). Echocardiographic parameters at rest, each stage (25 watt increment every 3 minutes), and peak exercise were obtained. Exercised induced PH was defined as present if PASP >60 mmHg at peak exercise. LV global longitudinal strain (LV-GLS) and left atrial (LA) strain were analyzed by software. The subjects were divided into 4 groups according to mean transmitral pressure gradient (MG) (15 mmHg) and PASP (60 mmHg) at peak exercise (Group 1, MG <15 mmHg and PASP <60 mmHg, n=29; Group 2, MG <15 mmHg and PASP ≥60 mmHg, n=9; Group 3, MG ≥15 mmHg and PASP <60 mmHg, n=23; Group 4, MG ≥15 mmHg and PASP ≥6 0mmHg, n=52).
Results
The mean mitral valve area was 1.30±0.23 cm2. PASP increased from 30.0±8.0 mmHg at rest to 61.0±14.8 mmHg at peak exercise, along with increase MG. 61 (53.9%) subjects had PASP>60 mmHg at peak exercise. Compared to group 1, group 2 had higher incidence of diabetes mellitus (DM) and significantly elevated PASP at baseline and impaired LV-GLS. However, there was no statical difference in LA strain between the two groups. In subjects with MG above 15 mmHg (Group 3 and 4), a similar trend was observed in occurrence of exercise-induced PH. On logistic multivariate regression, exercised induced PH was independently associated with female (HR: 5.35, 95% CI: 1.51–24.95; p=0.032), DM (HR: 10.05, 95% CI, 1.35–74.45; p=0.024), MG at peak exercise (HR: 1.17, 95% CI, 1.02–1.34; p=0.002), PASP at rest (HR: 1.17, 95% CI, 1.05–1.30; p=0.002), and LV-GLS (HR: 1.45, 95% CI, 1.09–1.91; p=0.009), but not with LA strain. The predictive value for exercised induced PH was highest when adding LV-GLS to the clinical factor (age, sex, DM) and echocardiographic parameters (Figure 1).
Conclusions
Exercised induced PH is affected by not only hemodynamic consequence of MS, but also myocardial function of left ventricle and clinical factors. Therefore, when determining the optimal timing of intervention based on exercise-induced PH in rheumatic MS patients, LV-GLS should be evaluated comprehensively along with MS characteristics.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): Yonsei University College of Medicine
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Affiliation(s)
- S H Lee
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - C Y Shim
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - D Y Kin
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - J S Seo
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - C H O Iksung
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - J W Ha
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - G R Hong
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
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Seo JC, Jon DI, Shim SH, Sung HM, Woo YS, Hong J, Park S, Seo JS, Bahk WM. Corrigendum: Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder Among Adults and Children/Adolescents in Korea. Clin Psychopharmacol Neurosci 2022; 20:402. [PMID: 35466112 PMCID: PMC9048005 DOI: 10.9758/cpn.2022.20.2.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Jeong-Cheol Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Korea
| | - Hyung-Mo Sung
- Department of Psychiatry, Soonchunhyang University Gumi Hospital, Soonchunhyang University, Gumi, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeongwan Hong
- Department of Psychiatry, Iksan Hospital, Iksan, Korea
| | | | - Jeong Seok Seo
- Department of Psychiatry, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Woo YS, Bahk WM, Seo JS, Park YM, Kim W, Jeong JH, Shim SH, Lee JG, Jang SH, Yang CM, Wang SM, Jung MH, Sung HM, Choo IH, Yoon BH, Lee SY, Jon DI, Min KJ. The Korean Medication Algorithm Project for Depressive Disorder 2021: Comparisons with Other Treatment Guidelines. Clin Psychopharmacol Neurosci 2022; 20:37-50. [PMID: 35078947 PMCID: PMC8813311 DOI: 10.9758/cpn.2022.20.1.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022]
Abstract
The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) first was published in 2002, and has been revised four times, in 2006, 2012, 2017, and 2021. In this review, we compared recommendations from the recently revised KMAP-DD 2021 to four global clinical practice guidelines (CPGs) for depression published after 2010. The recommendations from the KMAP-DD 2021 were similar to those from other CPGs, although there were some differences. The KMAP-DD 2021 reflected social culture and the healthcare system in Korea and recent evidence about pharmacotherapy for depression, as did other recently published evidence-based guidelines. Despite some intrinsic limitations as an expert consensus-based guideline, the KMAP-DD 2021 can be helpful for Korean psychiatrists making decisions in clinical settings by complementing previously published evidence-based guidelines, especially for some clinical situations lacking evidence from rigorously designed clinical trials.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Won Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Seung-Ho Jang
- Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea
| | - Chan-Mo Yang
- Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea
| | - Sheng-Min Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myung Hun Jung
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyung Mo Sung
- Department of Psychiatry, Soonchunhyang University Gumi Hospital, College of Medicine, Soonchunhyang University, Gumi, Korea
| | - Il Han Choo
- Department of Neuropsychiatry, College of Medicine, Chosun University, Department of Psychiatry, Chosun University Hospital, Gwangju, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kyung Joon Min
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
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10
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Seo JC, Jon DI, Shim SH, Sung HM, Woo YS, Hong J, Park S, Seo JS, Bahk WM. Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder Among Adults and Children/Adolescents in Korea. Clin Psychopharmacol Neurosci 2022; 20:126-134. [PMID: 35078955 PMCID: PMC8813326 DOI: 10.9758/cpn.2022.20.1.126] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/12/2021] [Accepted: 03/26/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This study investigated the prevalence and comorbidities of attention deficit hyperactivity disorder (ADHD) among adults and children/adolescents in Korea. METHODS This study used data from the Korea Health Insurance Review and Assessment Service collected from 2008 to 2018. Study participants comprised patients with at least one diagnosis of ADHD (International Statistical Classification of Diseases and Related Health Provisions, 10th revision code F90.0). Prevalence rates and psychiatric comorbidities were also analyzed. RESULTS We identified 878,996 patients diagnosed with ADHD between 2008 and 2018. The overall prevalence rate of diagnosed ADHD increased steeply from 127.1/100,000 in 2008 to 192.9/100,000 in 2018; it increased 1.47 times in children/adolescents (≤ 18 years) and 10.1 times in adults (> 18 years) during this period. Among adult and children/ adolescent ADHD patients, 61.84% (95% confidence interval [95% CI] 61.74-61.93) and 78.72% (95% CI 78.53- 78.91) had at least one psychiatric comorbidity, respectively. CONCLUSION Our results showed that the prevalence rate of diagnosed ADHD has increased in Korea; however, it is lower than the global average. Further studies are required to identify and treat vulnerable populations appropriately.
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Affiliation(s)
- Jeong-Cheol Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Korea
| | - Hyung-Mo Sung
- Department of Psychiatry, Soonchunhyang University Gumi Hospital, Soonchunhyang University, Gumi, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeongwan Hong
- Department of Psychiatry, Iksan Hospital, Iksan, Korea
| | | | - Jeong Seok Seo
- Department of Psychiatry, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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11
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Jang OJ, Chung YI, Lee JW, Kim HC, Seo JS. Emotional Distress of the COVID-19 Cluster Infection on Health Care Workers Working at a National Hospital in Korea. J Korean Med Sci 2021; 36:e324. [PMID: 34873887 PMCID: PMC8648606 DOI: 10.3346/jkms.2021.36.e324] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/01/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Frontline healthcare workers responding to coronavirus disease 2019 (COVID-19) inevitably face tremendous psychological burden. Thus, the present study aimed to identify the psychological impact and the factors contributing to the likely increase in emotional distress of healthcare workers. METHODS The participants include a total of 99 healthcare workers at Bugok National Hospital. Psychometric scales were used to assess emotional distress (12-item General Health Questionnaire; GHQ-12), depression symptoms (Patient Health Questionnaire-9; PHQ-9), and post-traumatic stress disorder-related symptoms (Impact of Events Scale-Revised; IES-R). A supplementary questionnaire was administered to investigate the experience of healthcare workers exposed to COVID-19-infected patients. Based on the results of GHQ-12 survey, participants were categorized into two groups: distress and non-distress. All the assessed scores were compared between the two groups. A logistic regression model was constructed to identify factors associated with emotional distress. RESULTS Emotional distress was reported by 45.3% (n = 45) of all participants. The emotionally distressed group was more likely to be female, manage close contacts, have higher scores on PHQ-9 and IES-R, feel increased professional risk, and report that proper infection control training was not provided. Female gender, managing close contacts, higher scores on PHQ-9, and a feeling that proper infection control training was not provided were associated with emotional distress in logistic regression. CONCLUSION Frontline healthcare workers face tremendous psychological burden during the COVID-19 pandemic. Therefore, appropriate psychological interventions should be provided to the HCWs engaged in the management of COVID-19-infected patients.
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Affiliation(s)
- Og-Jin Jang
- Department of Psychiatry, Bugok National Hospital, Changnyeong, Korea
| | - Young-In Chung
- Department of Psychiatry, Bugok National Hospital, Changnyeong, Korea
| | - Jae-Woon Lee
- Department of Psychiatry, Bugok National Hospital, Changnyeong, Korea
| | - Ho-Chan Kim
- Department of Psychiatry, Kosin University Gospel Hospital, Busan, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea.
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12
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Seo JS, Bahk WM, Woo YS, Park YM, Kim W, Jeong JH, Shim SH, Lee JG, Jang SH, Yang CM, Wang SM, Jung MH, Sung HM, Choo IH, Yoon BH, Lee SY, Jon DI, Min KJ. Korean Medication Algorithm for Depressive Disorder 2021, Fourth Revision: An Executive Summary. Clin Psychopharmacol Neurosci 2021; 19:751-772. [PMID: 34690130 PMCID: PMC8553538 DOI: 10.9758/cpn.2021.19.4.751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/11/2021] [Indexed: 12/19/2022]
Abstract
Objective In the 19 years since the Korean College of Neuropsychopharmacology and the Korean Society for Affective Disorders developed the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) in 2002, four revisions have been conducted. Methods To increase survey efficiency in this revision, to cover the general clinical practice, and to compare the results with previous KMAP-DD series, the overall structure of the questionnaire was maintained. The six sections of the questionnaire were as follows: 1) pharmacological treatment strategies for major depressive disorder (MDD) with/without psychotic features; 2) pharmacological treatment strategies for persistent depressive disorder and other depressive disorder subtypes; 3) consensus for treatment-resistant depression; 4) the choice of an antidepressant in the context of safety, adverse effects, and comorbid physical illnesses; 5) treatment strategies for special populations (children/adolescents, elderly, and women); and 6) non-pharmacological biological therapies. Recommended first-, second-, and third-line strategies were derived statistically. Results There has been little change in the four years since KMAP-DD 2017 due to the lack of newly introduced drug or treatment strategies. However, shortened waiting time between the initial and subsequent treatments, increased preference for atypical antipsychotics (AAPs), especially aripiprazole, and combination strategies with AAPs yield an active and somewhat aggressive treatment trend in Korea. Conclusion We expect KMAP-DD to provide clinicians with useful information about the specific strategies and medications appropriate for treating patients with MDD by bridging the gap between clinical real practice and the evidence-based world.
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Affiliation(s)
- Jeong Seok Seo
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Won Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Seung-Ho Jang
- Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea
| | - Chan-Mo Yang
- Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea
| | - Sheng-Min Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myung Hun Jung
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyung Mo Sung
- Department of Psychiatry, Soonchunhyang University Gumi Hospital, College of Medicine, Soonchunhyang University, Gumi, Korea
| | - Il Han Choo
- Department of Neuropsychiatry, College of Medicine, Chosun University, Gwangju, Korea.,Department of Psychiatry, Chosun University Hospital, Gwangju, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kyung Joon Min
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
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13
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Hwang DS, Seo JS, Choi HS. Skeletal stability after 2-jaw surgery via surgery-first approach in facial asymmetry patients using CBCT. Maxillofac Plast Reconstr Surg 2020; 42:11. [PMID: 32296663 PMCID: PMC7145879 DOI: 10.1186/s40902-020-00253-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/19/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The purpose of this study is to compare the skeletal stability of two-jaw surgery via surgery-first approach with conventional two-jaw surgery in facial asymmetry patients by measuring the skeletal changes after surgery from a three-dimensional analysis. From January 2010 to January 2014, 40 patients with facial asymmetry who underwent two-jaw surgery in Pusan National University Hospital were included in this study. They were classified into experimental group (n = 20) who underwent two-jaw surgery via surgery-first approach and control group (n = 20) who underwent conventional two-jaw surgery. After selection of 24 landmarks and the construction of horizontal and sagittal, coronal reference planes, changes in 10 linear measurements and 2 angular measurements were compared between the surgery-first approach and conventional groups in the preoperative, immediate postoperative, and postoperative periods. The paired t test and Student t test were used for statistical analysis. The mean and standard deviation of the measurement were calculated for the experimental and control groups. RESULTS The statistical analysis showed that changes in skeletal measurements were similar between the surgery-first approach and conventional groups, according to each period. However, U1-SRP measurement showed statistically significant changes in surgery-first approach groups at postsurgical change (T1 to T2). Also, the mean treatment duration in the treatment group was 15.9 ± 5.48 months whereas that in the control group was 32.9 ± 14.05 months. CONCLUSION In facial asymmetry patients, similar results were observed in the postoperative skeletal stability when 2-jaw surgery via surgery-first approach was compared with conventional 2-jaw surgery. However, significant lateral deviation of upper incisor midline was observed. In addition, a shorter average treatment duration was observed. To stabilize the unstable occlusion after surgery, increased wearing of the stent and proactive rubber guidance will be needed.
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Affiliation(s)
- Dae Seok Hwang
- Dental Research Institute, Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Pusan National University Dental Hospital, Dental Research Institute, Beomeori, Mulgeum, Yangsan, Kyoungsangnamdo 50612 South Korea
| | - Jeong Seok Seo
- Department of Dental Clinic, Bongseng Hospital, 401, Jungang-daero, Dong-gu, Busan South Korea
| | - Hong Seok Choi
- Department of Dental Clinic, Kosin University Hospital, 262, Gamcheon-ro, Seo-gu, Busan 49267 South Korea
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Yang CM, Hwang KS, Lee SY, Seo JS, Jang SH. Reliability and Validity of the Korean Version of Somatic Symptom Scale-8. Psychiatry Investig 2020; 17:814-821. [PMID: 32791820 PMCID: PMC7449834 DOI: 10.30773/pi.2020.0112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/05/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Somatic symptoms in psychiatry include underlying depression, anxiety, or other psychiatric disorders. This study aimed to conduct a validation study of a Korean version of the Somatic Symptom Scale-8 (K-SSS-8), and to utilize the K-SSS-8 effectively in clinical settings. METHODS For reliabilty, test-retest reliability and internal consistency were analyzed. For construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Known-group validity was verified, Jonckheere-Terpstra test (J-T statistic) were used. RESULTS Maternal Cronbach's alpha was 0.85 and r value of test-retest reliability was 0.777. In the EFA, 2-, 3- and 4-factor model showed cumulative percentile for variance of 60% or more. In the CFA, the 3-factor model was found to be the most appropriated and simplest (χ2=10.992, df=17, CFI=1.000, TLI=1.022, RMSEA=0.000). The verifying the difference in K-SSS-8 also showed significant difference. (J-T statistic=-2.510, p<0.05). CONCLUSION K-SSS-8 can be useful for exploring symptoms such as panic symptoms, physical pain, and physiological symptoms experienced by patients in a short time. In addition, the K-SSS-8 is expected to be very useful for determining the current severity by using the severity categories and for establish additionally required assessment plans for depression and anxiety symptoms.
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Affiliation(s)
- Chan-Mo Yang
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Kyu-Sic Hwang
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Seung-Ho Jang
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
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Lee SB, Chung S, Seo JS, Jung WM, Park IH. Socioeconomic resources and quality of life in alcohol use disorder patients: the mediating effects of social support and depression. Subst Abuse Treat Prev Policy 2020; 15:13. [PMID: 32066483 PMCID: PMC7027081 DOI: 10.1186/s13011-020-00258-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 02/10/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Quality of life (QoL) has recently attracted increased attention as a major indicator of the recovery from alcohol use disorder (AUD). This study investigated the mediating effects of social support and depression for the relationship between socioeconomic resources and QoL among people with AUD in South Korea. METHODS Patients across South Korea who had been diagnosed with AUD in the previous year (n = 404) and were registered at hospitals and addiction management centers were surveyed. The participants ranged in age from 19 to 65 years. Structural equation modeling was performed, using stable residence, income, stable employment, social support, depression, and QoL as predictors. Bootstrapping analysis was performed to test for mediating effects. RESULTS The socioeconomic resources income (β = .297, p < .001), stable employment (β = .131, p < .01), and stable residence (β = .091, p < .05) showed statistically significant and positive relationships with social support. However, none of these were significantly related to depression. Social support showed a significant and negative relationship with depression (β = -.172, p < .001). Income positively and directly influenced QoL (β = .148, p < .001). All three socioeconomic resources indirectly influenced depression through social support, which, in turn, influenced QoL. This suggests that socioeconomic resources directly influence QoL and indirectly influence it through social support. CONCLUSION These findings suggest that social support has an important role in improving the QoL of people with AUD. Furthermore, socioeconomic resources, such as having a stable residence, employment, and income, are necessary for recovery from alcohol addiction.
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Affiliation(s)
- Soo Bi Lee
- Department of Social Welfare, Chung-Ang University, 84 Heuksuk-Ro, Dongjak-Gu, Seoul, South Korea
| | - Sulki Chung
- Department of Social Welfare, Chung-Ang University, 84 Heuksuk-Ro, Dongjak-Gu, Seoul, South Korea.
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chung-ju, South Korea
| | - Won Mi Jung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Il Ho Park
- Department of Psychiatry and Behavioral Neurosciences, Catholic Kwandong University International Saint Mary's Hospital, Incheon, South Korea
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16
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Woo YS, Yoon BH, Song JH, Seo JS, Nam B, Lee K, Lee J, Jung YE, Kim MD, Lee JG, Wang SM, Kwon YJ, Bahk WM. Clinical correlates associated with the long-term response of bipolar disorder patients to lithium, valproate or lamotrigine: A retrospective study. PLoS One 2020; 15:e0227217. [PMID: 31923220 PMCID: PMC6953788 DOI: 10.1371/journal.pone.0227217] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/13/2019] [Indexed: 12/16/2022] Open
Abstract
Background Although mood stabilizers such as lithium (LIT), valproate (VAL), and lamotrigine (LMT) appear to be efficacious treatments for bipolar disorder (BD) in research settings, the long-term response to these mood stabilizers in clinical practice is highly variable among individuals. Thus, the present study examined the characteristics associated with good or insufficient responses to long-term treatment with LIT, VAL, or LMT for BD. Methods This study retrospectively analyzed the medical records of patients who visited an outpatient clinic with a diagnosis of BD I or II. Data from patients who were treated with one of three mood stabilizing medications (LIT, VAL, or LMT) for more than 6 months were selected, and the long-term treatment responses were evaluated using the Alda scale. For the purposes of this study, two response categories were formed: insufficient response (ISR), including non-response or poor response (Alda total score ≤ 6), and good response (GR; Alda total score ≥ 7). Results Of the 645 patients included in the present study, 172 were prescribed LIT, 320 were prescribed VAL, and 153 were prescribed LMT for at least 6 months. A binary logistic regression analysis revealed that a diagnosis of BD II (odds ratio [OR], 8.868; 95% confidence interval [CI], 1.123–70.046; p = 0.038), comorbid alcohol/substance use disorder (OR, 4.238; 95% CI, 1.154–15.566; p = 0.030), and a history of mixed episodes (OR, 4.363; 95% CI, 1.191–15.985; p = 0.026) were significant predictors of LIT-ISR. Additionally, a depressive-predominant polarity significantly predicted LMT-GR (OR, 8.586; 95% CI, 2.767–26.644; p < 0.001). Conclusion The present findings demonstrated that patients with a diagnosis of BD II, a comorbid alcohol/substance problem, or a history of mixed episodes were not likely to respond to LIT treatment. Additionally, LMT might be a better treatment choice for patients with a depressive-predominant polarity.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Jye-Heon Song
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Kwanghun Lee
- Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Jonghun Lee
- Department of Psychiatry, School of Medicine, Catholic University of Daegu, Daegu, Republic of Korea
| | - Young-Eun Jung
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Moon-Doo Kim
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, Paik Institute for Clinical Research, College of Medicine, Inje University, Busan, Republic of Korea
- Department of Health Science and Technology, Graduate School of Inje University, Busan, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Joon Kwon
- Department of Psychiatry, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail:
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17
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Park SJ, Park J, Lee MJ, Seo JS, Ahn JY, Cho JW. Time series analysis of delta neutrophil index as the predictor of sepsis in patients with acute poisoning. Hum Exp Toxicol 2019; 39:86-94. [PMID: 31558056 DOI: 10.1177/0960327119878244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Delta neutrophil index (DNI), which reflects the fraction of immature granulocytes, is used to detect infection and sepsis from noninfectious conditions, but few studies have evaluated in the early stage of acute poisoning. This retrospective observational study was performed on acute poisoning patients who visited to the emergency department (ED) and were consecutively admitted in intensive care units over 18-month period. The serial DNI, conventional inflammatory biomarkers, and culture results were obtained in the ED and after admission. The outcomes were the identification of sepsis, bacteremia, and 30-day mortality. Of 166 patients (mean age, 56.0 years) in this cohort, 59 (35.5%) had sepsis and 29 (17.5%) had bacteremia. Initial and peak DNI fractions 24 h after ED admission were strong independent predictors of sepsis development. Analysis of the area under the curve according to multiple receiver operating characteristics showed that DNI had a higher capability to predict sepsis than other parameters (0.815 for DNI, 0.700 for procalcitonin, 0.681 for C-reactive protein, and 0.741 for white blood cell). Using multivariable logistic regression analysis, it was found that DNI was an independent predictor of sepsis (95% confidence interval (CI) of odds: 1.03-1.18) and bacteremia (95% CI: 1.01-1.14). Therefore, initial and serial measurement of DNI may serve as useful risk predictor for development of sepsis or bacteremia in acute poisoning.
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Affiliation(s)
- S J Park
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - J Park
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - M J Lee
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - J S Seo
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Seoul, Republic of Korea
| | - J Y Ahn
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - J W Cho
- Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Shim IH, Lee J, Kim MD, Jung YE, Min KJ, Kwon YJ, Kim JS, Lee K, Woo YS, Nam B, Seo JS, Lee JG, Jon DI, Sohn I, Park SY, Yoon BH, Bahk WM. The prevalence and diagnostic classification of mixed features in patients with major depressive episodes: A multicenter study based on the DSM-5. Int J Methods Psychiatr Res 2019; 28:e1773. [PMID: 30786322 PMCID: PMC6877217 DOI: 10.1002/mpr.1773] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/09/2019] [Accepted: 01/12/2019] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the prevalence of mixed features using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and to examine how patients with mixed states would be classified using the DSM-5. METHODS In total, 12 hospitals participated in this study, and data on the demographic characteristics and clinical diagnoses of patients treated between October 2013 and September 2016 were obtained. We reviewed the data for opposite-polarity symptoms according to the DSM-5 criteria and the research-based diagnostic criteria. RESULTS Of the 859 patients included in the final analysis, the prevalence of mixed features in patients with major depressive episodes based on the DSM-5 remained low. Patients with major depressive disorder were more likely to be classified as experiencing anxious distress and/or a cluster-B personality disorder in mixed state patients not diagnosed with DSM-5 mixed features, whereas more mixed state patients with bipolar disorder were diagnosed with mixed features using the DSM-5. CONCLUSIONS The prevalence of mixed features did not increase significantly when the DSM-5 was used, and patients with mixed states were more likely to be classified as having anxious distress and/or a cluster-B personality disorder in addition to mixed features.
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Affiliation(s)
- In Hee Shim
- Department of Psychiatry, Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Republic of Korea
| | - Jonghun Lee
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Moon-Doo Kim
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Young-Eun Jung
- Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Young-Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Republic of Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Republic of Korea
| | - Kwanghun Lee
- Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University and Paik Institute for Clinical Research, Department of Health Science and Technology, Graduate School of Inje University, Busan, Republic of Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Inki Sohn
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| | - Sung-Yong Park
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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19
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Jung YE, Kim MD, Bahk WM, Woo YS, Nam B, Seo JS, Jang SH, Sung HM, Shim IH, Yoon BH, Kim JS, Kwon YJ. Validation of the Korean Version of the Depression in Old Age Scale and Comparison with Other Depression Screening Questionnaires Used in Elderly Patients in Medical Settings. Clin Psychopharmacol Neurosci 2019; 17:369-376. [PMID: 31352703 PMCID: PMC6705099 DOI: 10.9758/cpn.2019.17.3.369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 02/27/2018] [Accepted: 03/02/2018] [Indexed: 11/18/2022]
Abstract
Objective The Depression in Old Age Scale (DIA-S) is a new screening tool for assessing depression in the elderly. The primary aims of this study were to describe the validation of the Korean version of the DIA-S (K-DIA-S) and to compare its validity with that of other depression screening questionnaires used in elderly outpatients in medical settings. Methods A total of 385 elderly outpatients completed the K-DIA-S and underwent the Mini International Neuropsychiatric Interview to diagnose depressive disorders. Other measures included the 15-item short form of the Geriatric Depression Scale (SGDS), the 9-item depression module of the Patient Health Questionnaire (PHQ-9), and the Montgomery–Asberg Depression Rating Scale (MADRS). Reliability and validity tests, an optimal cutoff point estimate, and receiver operating characteristic curve analysis were performed to investigate the diagnostic validity of the K-DIA-S. Areas under the curves (AUCs) for the K-DIA-S, SGDS, and PHQ-9 were compared statistically. Results The K-DIA-S showed good internal consistency and strong correlations with the SGDS (r = 0.853), PHQ-9 (r = 0.739), and MADRS (r = 0.772). The cut-off point of the K-DIA-S that can be recommended for screening depressive symptoms was a score of 4. For “any depressive disorder”, the AUC (standard error) for the K-DIA-S was 0.896 (0.015), which was significantly larger than that for the PHQ-9 (p = 0.033). Conclusion The present findings suggest that the K-DIA-S has good psychometric properties and is a valid and reliable tool for assessing depressive symptoms in elderly populations and medically ill patients.
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Affiliation(s)
- Young-Eun Jung
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Sae-Heon Jang
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea
| | - Hyung-Mo Sung
- Department of Psychiatry, Gumi CHA Medical Center, CHA University, Gumi, Korea
| | - In Hee Shim
- Department of Psychiatry, Cancer Center, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Young-Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
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Woo YS, Yoon BH, Jeon BH, Seo JS, Nam B, Lee SY, Jae YM, Jang SH, Eun HJ, Won SH, Lee K, Lee J, Bahk WM. Switching Antipsychotics to Blonanserin in Patients with Schizophrenia: An Open-label, Prospective, Multicenter Study. Clin Psychopharmacol Neurosci 2019; 17:423-431. [PMID: 31352709 PMCID: PMC6705098 DOI: 10.9758/cpn.2019.17.3.423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 12/26/2022]
Abstract
Objective This study was performed to investigate the efficacy and tolerability of blonanserin in schizophrenic patients who were previously treated with other antipsychotics but, due to insufficient response, were switched to blonanserin. Methods A total of 52 patients with schizophrenia who were unresponsive to treatment with antipsychotic monotherapy or combination therapy were recruited into this 12-week, open-label, prospective, multicenter study. Patients were switched to blonanserin from their existing antipsychotics over a maximum 2-week tapering-off period. Efficacy was primarily evaluated using the 18-item Brief Psychiatric Rating Scale (BPRS). Assessments were performed at baseline, and at weeks 1, 2, 4, 8, and 12. Results Switching to blonanserin resulted in a significant decrease in the mean total score on the BPRS from baseline (56.8 ± 9.4) to week 12 (42.1 ± 13.8, p < 0.001). The most common adverse events were extrapyramidal symptoms (n = 12, 23.1%), insomnia (n = 10, 19.2%), and emotional arousal (n = 6, 11.5%). Overweight or obese patients (body mass index ≥ 23 kg/m2, n = 33) who switched to blonanserin exhibited significant weight loss from 75.2 ± 9.3 kg at baseline to 73.5 ± 9.2 kg at week 12 (p = 0.006). The total cholesterol (baseline, 236.1 ± 47.6 mg/dl; endpoint [week 12], 209.9 ± 28.0 mg/dl; p = 0.005) and prolactin levels (baseline, 80.0 ± 85.2 ng/ml; endpoint [week 12], 63.2 ± 88.9 ng/ml; p = 0.003) were also significantly improved in patients with hypercholesterolemia or hyperprolactinemia. Conclusion The results of the present study suggest that switching to blonanserin may be an effective strategy for schizophrenic patients unresponsive to other antipsychotic treatments.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Bong-Hee Jeon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Beomwoo Nam
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, Wonkwang University School of Medicine, Iksan, Korea
| | - Young-Myo Jae
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea
| | - Sae-Heon Jang
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Korea
| | - Hun Jeong Eun
- Department of Neuropsychiatry, Presbyterian Medical Center-Jesus Hospital, Jeonju, Korea
| | - Seung-Hee Won
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kwanghun Lee
- Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Korea
| | - Jonghun Lee
- Department of Psychiatry, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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21
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Jeong JH, Bahk WM, Woo YS, Lee JG, Kim MD, Sohn I, Shim SH, Jon DI, Seo JS, Kim W, Song HR, Min KJ, Yoon BH. Korean Medication Algorithm for Bipolar Disorder 2018: Comparisons with Other Treatment Guidelines. Clin Psychopharmacol Neurosci 2019; 17:155-169. [PMID: 30905116 PMCID: PMC6478090 DOI: 10.9758/cpn.2019.17.2.155] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 12/29/2022]
Abstract
The objective of this study was to compare recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018) with other recently published guidelines for treating bipolar disorder. We reviewed a total of five recently published global treatment guidelines and compared treatment recommendation of the KMAP-BP 2018 with those of other guidelines. For initial treatment of mania, there were no significant differences across treatment guidelines. All guidelines recommended mood stabilizer (MS) or atypical antipsychotic (AAP) monotherapy or a combination of an MS with an AAP as a first-line treatment strategy for mania. However, the KMAP-BP 2018 did not prefer monotherapy with MS or AAP for psychotic mania. Quetiapine, olanzapine and aripiprazole were the first-line AAPs for nearly all phases of bipolar disorder across guidelines. Most guidelines advocated newer AAPs as first-line treatment options for all phases while lamotrigine was recommended for depressive and maintenance phases. Lithium and valproic acid were commonly used as MSs in all phases of bipolar disorder. As research evidence accumulated over time, recommendations of newer AAPs (such as asenapine, cariprazine, paliperidone, lurasidine, long-acting injectable risperidone and aripiprazole once monthly) became prominent. KMAP-BP 2018 guidelines were similar to other guidelines, reflecting current changes in prescription patterns for bipolar disorder based on accumulated research data. Strong preference for combination therapy was characteristic of KMAP-BP 2018, predominantly in the treatment of psychotic mania and severe depression. Further studies were needed to address several issues identified in our review.
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Affiliation(s)
- Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University and Paik Institute for Clinical Research, Department of Health Science and Technology, Graduate School of Inje Un.,Department of Health Science and Technology, Graduate School of Inje University, Busan, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - InKi Sohn
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Korea
| | - Duk-In Jon
- Department of Psychiatry, Sacred Heart Hospital, Hallym University, Anyang, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Won Kim
- Department of Psychiatry, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Hoo-Rim Song
- Department of Psychiatry, Myongji Hospital, Goyang, Korea
| | - Kyung Joon Min
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
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Lee SB, Chung S, Lee H, Seo JS. The Mutual Relationship Between Men's Drinking and Depression: A 4-Year Longitudinal Analysis. Alcohol Alcohol 2018; 53:597-602. [PMID: 29562310 DOI: 10.1093/alcalc/agy003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/18/2018] [Indexed: 11/14/2022] Open
Abstract
Aims The purpose of the current study was to examine the longitudinal reciprocal relationship between depression and drinking among male adults from the general population. Methods This study used a panel dataset from the Korean Welfare Panel (from 2011 to 2014). The subjects were 2511 male adults aged between 20 and 65 years. Based on the Korean Version of the Alcohol Use Disorders Identification Test (AUDIT-K) scores, 2191 subjects were categorized as the control group (AUDIT-K < 12) and 320 subjects were categorized as the problem drinking group (AUDIT-K ≥ 12). An autoregressive cross-lagged modelling analysis was performed to investigate the mutual relationship between problem drinking and depression measured consecutively over time. Results The results indicated that alcohol drinking and depression were stable over time. In the control group, there was no significant causal relationship between problem drinking and depression while in the problem drinking group, drinking in the previous year significantly influenced depression in the following second, third and fourth years. Conclusion This study compared normal versus problem drinkers and showed a 4-year mutual causal relationship between depression and drinking. No longitudinal interaction between drinking and depression occurred in normal drinkers, while drinking intensified depression over time in problem drinkers. Short summary This study found that problem drinking was a risk factor for development of depression. Therefore, more attention should be given to problem alcohol use in the general population and evaluation of past alcohol use history in patients with depressive disorders.
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Affiliation(s)
- Soo Bi Lee
- Department of Social Welfare, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea
| | - Sulki Chung
- Department of Social Welfare, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea
| | - HaeKook Lee
- Department of Psychiatry, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, 271 Cheonbo-ro, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, 82 Gukwondae-ro, Chungju, Republic of Korea
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23
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Woo YS, Bahk WM, Lee JG, Jeong JH, Kim MD, Sohn I, Shim SH, Jon DI, Seo JS, Min KJ, Kim W, Song HR, Yoon BH. Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth Revision. Clin Psychopharmacol Neurosci 2018; 16:434-448. [PMID: 30466216 PMCID: PMC6245301 DOI: 10.9758/cpn.2018.16.4.434] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 05/15/2018] [Accepted: 05/16/2018] [Indexed: 12/12/2022]
Abstract
Objective The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP. Methods A 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts. Results The preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression. Conclusion The recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Goo Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine and Paik Institute for Clinical Research, Busan, Korea.,Department of Health Science and Technology, Graduate School of Inje University, Busan, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - InKi Sohn
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Korea
| | - Won Kim
- Department of Psychiatry, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Hoo-Rim Song
- Department of Psychiatry, Myongji Hospital, Goyang, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
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Seo JS, Bahk WM, Wang HR, Woo YS, Park YM, Jeong JH, Kim W, Shim SH, Lee JG, Jon DI, Min KJ. Korean Medication Algorithm for Depressive Disorders 2017: Third Revision. Clin Psychopharmacol Neurosci 2018; 16:67-87. [PMID: 29397669 PMCID: PMC5810446 DOI: 10.9758/cpn.2018.16.1.67] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 08/01/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE In 2002, the Korean Society for Affective Disorders developed the guidelines for the treatment of major depressive disorder (MDD), and revised it in 2006 and 2012. The third revision of these guidelines was undertaken to reflect advances in the field. METHODS Using a 44-item questionnaire, an expert consensus was obtained on pharmacological treatment strategies for MDD 1) without or 2) with psychotic features, 3) depression subtypes, 4) maintenance, 5) special populations, 6) the choice of an antidepressant (AD) regarding safety and adverse effects, and 7) non-pharmacological biological therapies. Recommended first, second, and third-line strategies were derived statistically. RESULTS AD monotherapy is recommended as the first-line strategy for non-psychotic depression in adults, children/adolescents, elderly adults, patient with persistent depressive disorder, and pregnant women or patients with postpartum depression or premenstrual dysphoric disorder. The combination of AD and atypical antipsychotics (AAP) was recommended for psychotic depression in adult, child/adolescent, postpartum depression, and mixed features or anxious distress. Most experts recommended stopping the ongoing initial AD and AAP after a certain period in patients with one or two depressive episodes. As an MDD treatment modality, 92% of experts are considering electroconvulsive therapy and 46.8% are applying it clinically, while 86% of experts are considering repetitive transcranial magnetic stimulation but only 31.6% are applying it clinically. CONCLUSION The pharmacological treatment strategy in 2017 is similar to that of Korean Medication Algorithm for Depressive Disorder 2012. The preference of AAPs was more increased.
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Affiliation(s)
- Jeong Seok Seo
- Department of Psychiatry, Konkuk University School of Medicine, Cheongju,
Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Hee Ryung Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang,
Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Won Kim
- Department of Psychiatry, Seoul Paik Hospital, Inje University College of Medicine, Seoul,
Korea
- Korea/Stress Research Institute, Inje University, Seoul,
Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan,
Korea
| | - Jung Goo Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan,
Korea
- Paik Institute for Clinical Research, Department of Health Science and Technology, Graduate School of Inje University, Busan,
Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang,
Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul,
Korea
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25
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Wang HR, Bahk WM, Seo JS, Woo YS, Park YM, Jeong JH, Kim W, Shim SH, Lee JG, Jon DI, Min KJ. Korean Medication Algorithm for Depressive Disorder: Comparisons with Other Treatment Guidelines. Clin Psychopharmacol Neurosci 2017; 15:199-209. [PMID: 28783928 PMCID: PMC5565074 DOI: 10.9758/cpn.2017.15.3.199] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 12/05/2016] [Accepted: 12/06/2016] [Indexed: 12/11/2022]
Abstract
In this review, we compared recommendations from the Korean Medication Algorithm Project for Depressive Disorder 2017 (KMAP-DD 2017) to other global treatment guidelines for depression. Six global treatment guidelines were reviewed; among the six, 4 were evidence-based guidelines, 1 was an expert consensus-based guideline, and 1 was an amalgamation of both evidence and expert consensus-based recommendations. The recommendations in the KMAP-DD 2017 were generally similar to those in other global treatment guidelines, although there were some differences between the guidelines. The KMAP-DD 2017 appeared to reflect current changes in the psychopharmacology of depression quite well, like other recently published evidence-based guidelines. As an expert consensus-based guideline, the KMAP-DD 2017 had some limitations. However, considering there are situations in which clinical evidence cannot be drawn from planned clinical trials, the KMAP-DD 2017 may be helpful for Korean psychiatrists making decisions in the clinical settings by complementing previously published evidence-based guidelines.
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Affiliation(s)
- Hee Ryung Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, Konkuk University School of Medicine, Chungju, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Min Park
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Won Kim
- Department of Psychiatry, Inje University Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea.,Stress Research Institute, Inje University, Seoul, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jung Goo Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.,Paik Institute for Clinical Research, Inje University, Busan, Korea.,Department of Health Science and Technology, Graduate School of Inje University, Busan, Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Korea
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Kim T, Kim JJ, Kim MY, Kim SK, Roh S, Seo JS. Erratum: A U-shaped Association between Body Mass Index and Psychological Distress on the Multiphasic Personality Inventory: Retrospective Cross-sectional Analysis of 19-year-old Men in Korea. J Korean Med Sci 2015; 30:1537. [PMID: 26396483 PMCID: PMC4575948 DOI: 10.3346/jkms.2015.30.10.1537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
[This corrects the article on p. 793 in vol. 30, PMID: 26028934.].
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Song HR, Bahk WM, Woo YS, Jeong JH, Kwon YJ, Seo JS, Kim W, Kim MD, Shin YC, Lee SY, Min KJ. Efficacy and Tolerability of Generic Mirtazapine (Mirtax) for Major Depressive Disorder: Multicenter, Open-label, Uncontrolled, Prospective Study. Clin Psychopharmacol Neurosci 2015; 13:144-9. [PMID: 26243840 PMCID: PMC4540031 DOI: 10.9758/cpn.2015.13.2.144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/17/2014] [Accepted: 12/22/2014] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Mirtax is a generic mirtazapine widely used since 2003. We conducted an open-label, uncontrolled 6-week study to evaluate the efficacy and safety of Mirtax for major depressive disorder (MDD). METHODS Ninety three MDD patients with the diagnosis of MDD and 17-item Hamilton Depression Rating Scale (HDRS) score ≥14 were recruited. The HDRS, Montgomery-Åsberg Depression Rating Scale (MADRS), and the Clinical Global Impressions-Severity Scale (CGI-S) were administered at baseline, 1, 2, 4 and 6 weeks. Response (≥50% decrease in the HDRS or MADRS score), remission (absolute HDRS score ≤7 or MADRS score ≤10) and CGI-I score ≤2 were also calculated. Adverse event (AE) frequency and severity, weight, blood pressure, and pulse rate were checked to assess safety. RESULTS The starting dosage was 11.5±6.4 mg/day, and the maintenance dosage was 23.1±9.4 mg/day. During 6 weeks, HDRS, MADRS and CGI-S scores decreased from 25.1±5.6 to 11.9±8.6 (mean change -13.1±8.3, p<0.001), from 30.2±6.3 to 13.73±10.40 (mean change -16.5±9.8, p<0.001), and from 5.0±0.8 to 2.5±1.3 (mean change -2.5±1.3, p<0.001), respectively. The percentages of responders, remitters by HDRS and patients with a CGI-I score ≤2 were 64.6%, 35.4% and 52.7%, respectively. Significant decreases in HDRS, MADRS and CGI-S scores were confirmed at week 1. The total rate of AEs was 32.3%; the most frequently reported AEs were sedation (4.3%) and constipation (4.3%). Weight was increased from 58.8±10.6 to 60.3±9.3 kg (mean change 0.7±1.7 kg, p=0.004). CONCLUSION This study, as the first clinical trial of generic mirtazapine, demonstrated the efficacy and tolerability of Mirtax for MDD using a single treatment design.
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Affiliation(s)
- Hoo Rim Song
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.,College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sup Woo
- College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Hyun Jeong
- College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Joon Kwon
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | | | - Won Kim
- Inje University Seoul Paik Hospital, Seoul, Korea
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Woo YS, Wang HR, Yoon BH, Lee SY, Lee KH, Seo JS, Bahk WM. Bioequivalence of Generic and Brand Name Clozapine in Korean Schizophrenic Patients: A Randomized, Two-Period, Crossover Study. Psychiatry Investig 2015; 12. [PMID: 26207129 PMCID: PMC4504918 DOI: 10.4306/pi.2015.12.3.356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Clozapine is the treatment of choice for refractory schizophrenia. The aim of this study was to compare the pharmacokinetics of the brand name (Clozaril) formulation and a generic formulation (Clzapine) of clozapine in Korean schizophrenic patients. METHODS A prospective, randomized, crossover study was conducted to evaluate the steady-state pharmacokinetic profiles of Clozaril and Clzapine. Schizophrenic patients were randomized to receive either the brand name or generic formulation (100 mg twice daily) for 10 days, followed by the other formulation for 10 days. Plasma samples were collected on the last day of each treatment period. RESULTS Twenty-two of 28 patients (78.6%) completed the study. The mean Cmax,ss values for Clzapine and Clozaril were 524.62 and 551.18 ng/mL, and the mean AUC0-12 values were 4479.90 hr·ng/mL and 4724.56 hr·ng/mL, respectively. The 90% CI values for the natural logarithmically transformed Cmax,ss and AUC0-12 ratios (Clzapine to Clozaril) after a single oral dose (100 mg) were 0.934 (0.849-1.028) and 0.936 (0.869-1.008), respectively. Five patients (20.8%) among 24 patients who took Clzapine reported 11 adverse events and six adverse events were reported by four patients (15.4%) among 26 who took Clozaril; there were no significant differences on physical examination or in vital signs, ECG, and laboratory tests between groups. CONCLUSION Generic clozapine (Clzapine) appears to be bioequivalent to brand name clozapine (Clozaril).
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hee-Ryung Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Kwang Hun Lee
- Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Kim T, Kim JJ, Kim MY, Kim SK, Roh S, Seo JS. A U-shaped Association between Body Mass Index and Psychological Distress on the Multiphasic Personality Inventory: Retrospective Cross-sectional Analysis of 19-year-old Men in Korea. J Korean Med Sci 2015; 30:793-801. [PMID: 26028934 PMCID: PMC4444482 DOI: 10.3346/jkms.2015.30.6.793] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/23/2015] [Indexed: 11/20/2022] Open
Abstract
Objective personality tests, such as the Minnesota Multiphasic Personality Inventory (MMPI), might be more sensitive to reflect subclinical personality and be more state-dependent in an individual's lifetime, so they are good scales to predict the psychological distress regarding certain states. The aim of this study was to identify the specific pattern between body mass index (BMI) and psychological distress using the objective personality test. For this study, we investigated BMI and the Korean Military Multiphasic Personality Inventory (MPI). A retrospective cross-sectional study was conducted with 19-yr-old examinees who were admitted to the Military Manpower Administration in Korea from February 2007 to January 2010. Of 1,088,107 examinees, we enrolled 771,408 subjects who were psychologically apparent healthy possible-military-service groups. Afterwards, we reviewed and analyzed directly measured BMI and MPI results. In terms of the validity scales, the faking-good subscale showed an inverted U-shaped association, and faking-bad and infrequency subscales showed a U-shaped association with BMI groups. In terms of the neurosis scales, all clinical subscales (anxiety, depression, somatization, and personality disorder) also showed a U-shaped association with BMI groups. For the psychopath scales, the schizophrenia subscale showed a U-shaped association, and the paranoia subscale showed a near-positive correlation with BMI. In conclusion, a specific U-shaped pattern was observed between BMI and the MPI in 19-yr-old men in Korea. Underweight and obesity are related to psychological distress, so supportive advice and education are needed to them.
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Affiliation(s)
- Taehyun Kim
- Incheon-Gyeonggi Regional Military Manpower Administration, Suwon, Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung Jun Kim
- Incheon-Gyeonggi Regional Military Manpower Administration, Suwon, Korea
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Yeon Kim
- Incheon-Gyeonggi Regional Military Manpower Administration, Suwon, Korea
| | - Shin Kyoung Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Chungju, Korea
| | - Sungwon Roh
- Department of Mental Health Research, Seoul National University Hospital, Seoul, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, Konkuk University Chungju Hospital, Chungju, Korea
- Department of Psychiatry, School of Medicine, Konkuk University, Seoul, Korea
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Seok Seo J, Rim Song H, Bin Lee H, Park YM, Hong JW, Kim W, Wang HR, Lim ES, Jeong JH, Jon DI, Joon Min K, Sup Woo Y, Bahk WM. The Korean Medication Algorithm for Depressive Disorder: second revision. J Affect Disord 2015; 167:312-21. [PMID: 25010375 DOI: 10.1016/j.jad.2014.05.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 05/19/2014] [Accepted: 05/20/2014] [Indexed: 12/27/2022]
Abstract
AIM This study constitutes a revision of the guidelines for the treatment of major depressive disorder (MDD) issued by the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) 2006. In incorporates changes in the experts׳ consensus that occurred between 2006 and 2012 as well as information regarding newly developed and recently published clinical trials. METHODS Using a 44-item questionnaire, an expert consensus was obtained on pharmacological treatment strategies for (1) non-psychotic MDD, (2) psychotic MDD, (3) dysthymia and depression subtypes, (4) continuous and maintenance treatment, and (5) special populations; consensus was also obtained regarding (6) the choice of an antidepressant (AD) in the context of safety and adverse effects, and (7) non-pharmacological biological therapies. RESULTS AD monotherapy was recommended as the first-line strategy for nonpsychotic depression in adults, children and adolescents, elderly adults, and patients with postpartum depression or premenstrual dysphoric disorder. The combination of AD and atypical antipsychotics (AAP) was recommended for psychotic depression. The duration of the initial AD treatment for psychotic depression depends on the number of depressive episodes. Most experts recommended stopping the initial AD and AAP therapy after a certain period in patients with one or two depressive episodes. However, for those with three or more episodes, maintenance of the initial treatment was recommended for as long as possible. Monotherapy with various selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) was recommended for dysthymic disorder and melancholic type MDD. CONCLUSION The pharmacological treatment strategy of KMAP-DD 2012 is similar to that of KMAP-DD 2006; however, the preference for the first-line use of AAPs was stronger in 2012 than in 2006.
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Affiliation(s)
- Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea
| | - Hoo Rim Song
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hwang Bin Lee
- Department of Psychiatry, Seoul National Hospital, Seoul, Korea
| | - Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea
| | - Jeong-Wan Hong
- Department of Psychiatry, Namwon Sungil Mental Hospital, Namwon, Korea
| | - Won Kim
- Department of Psychiatry, Seoul Paik Hospital, School of Medicine, Inje University, Seoul, Korea/Stress Research Institute, Inje University, Seoul, Korea
| | - Hee-Ryung Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun-Sung Lim
- Department of Psychiatry, Shinsegae Hospital, KimJe, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Duk-In Jon
- Department of Psychiatry, Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Kyung Joon Min
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea.
| | - Young Sup Woo
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Abstract
The definition of a "good" psychiatrist has varied over the past decades due to changing roles of psychiatrists. Studies on the qualities of "good" psychiatrists have been completed in many countries. However, no such study has been undertaken in Korea. In Korea, recent growing interest in psychiatry demands the identification of qualities for a good psychiatrist. The purpose of this study was to define the qualities of a good psychiatrist in Korea, subsequently facilitating the improvement of psychiatric training programs. The questionnaire was based on a Singaporean survey with the permission from the original authors. Respondents were divided into patient group and psychiatrist group. The 40-item questionnaire contained items grouped into four themes: Professional, Personal Values, Academic Executive and Relationship. Of the four themes, both patient and psychiatrist groups considered Professional as the most important, whereas Academic Executive as the least important. The mean scores for all items of each theme in the patient group were higher than those in the psychiatrist group, reflecting higher expectations for good psychiatrist in the patient group. Patients emphasized Relationship more than psychiatrists did. It is concluded that a good psychiatrist in Korea can be defined as "a good communicator and listener with a professional manner, who respects confidentiality and has good doctor-patient relationships."
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Affiliation(s)
- Ji Hyun Kim
- Department of Psychiatry, School of Medicine, Konkuk Unversity, Chungju, Korea
| | - Phern-Chern Tor
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Joel King
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk Unversity, Chungju, Korea
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Jeong JH, Lee JG, Kim MD, Sohn I, Shim SH, Wang HR, Woo YS, Jon DI, Seo JS, Shin YC, Min KJ, Yoon BH, Bahk WM. Korean Medication Algorithm for Bipolar Disorder 2014: comparisons with other treatment guidelines. Neuropsychiatr Dis Treat 2015; 11:1561-71. [PMID: 26170669 PMCID: PMC4492647 DOI: 10.2147/ndt.s86552] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Our goal was to compare the recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2014 (KMAP-BP 2014) with other recently published guidelines for the treatment of bipolar disorder. We reviewed a total of four recently published global treatment guidelines and compared each treatment recommendation of the KMAP-BP 2014 with those in other guidelines. For the initial treatment of mania, there were no significant differences across treatment guidelines. All recommended mood stabilizer (MS) or atypical antipsychotic (AAP) monotherapy or the combination of an MS with an AAP as a first-line treatment strategy for mania. However, the KMAP-BP 2014 did not prefer monotherapy with MS or AAP for dysphoric/psychotic mania. Aripiprazole, olanzapine, quetiapine, and risperidone were the first-line AAPs in nearly all of the phases of bipolar disorder across the guidelines. Most guidelines advocated newer AAPs as first-line treatment options in all phases, and lamotrigine in depressive and maintenance phases. Lithium and valproic acid were commonly used as MSs in all phases of bipolar disorder. As research evidence accumulated over time, recommendations of newer AAPs - such as asenapine, paliperidone, lurasidone, and long-acting injectable risperidone - became prominent. This comparison identifies that the treatment recommendations of the KMAP-BP 2014 are similar to those of other treatment guidelines and reflect current changes in prescription patterns for bipolar disorder based on accumulated research data. Further studies are needed to address several issues identified in our review.
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Affiliation(s)
- Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Paik Institute for Clinical Research, Inje University, Busan, Korea ; Department of Health Science and Technology, Graduate School of Inje University, Busan, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - Inki Sohn
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Hee Ryung Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Duk-In Jon
- Department of Psychiatry, Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, Konkuk University Chungju Hospital, School of Medicine, Konkuk University, Chungju, Korea
| | - Young-Chul Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Woo YS, Lee JG, Jeong JH, Kim MD, Sohn I, Shim SH, Jon DI, Seo JS, Shin YC, Min KJ, Yoon BH, Bahk WM. Korean Medication Algorithm Project for Bipolar Disorder: third revision. Neuropsychiatr Dis Treat 2015; 11:493-506. [PMID: 25750530 PMCID: PMC4348143 DOI: 10.2147/ndt.s77838] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To constitute the third revision of the guidelines for the treatment of bipolar disorder issued by the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP 2014). METHODS A 56-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for the various phases of bipolar disorder and for special populations. The review committee included 110 Korean psychiatrists and 38 experts for child and adolescent psychiatry. Of the committee members, 64 general psychiatrists and 23 child and adolescent psychiatrists responded to the survey. RESULTS The treatment of choice (TOC) for euphoric, mixed, and psychotic mania was the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP); the TOC for acute mild depression was monotherapy with MS or AAP; and the TOC for moderate or severe depression was MS plus AAP/antidepressant. The first-line maintenance treatment following mania or depression was MS monotherapy or MS plus AAP; the first-line treatment after mania was AAP monotherapy; and the first-line treatment after depression was lamotrigine (LTG) monotherapy, LTG plus MS/AAP, or MS plus AAP plus LTG. The first-line treatment strategy for mania in children and adolescents was MS plus AAP or AAP monotherapy. For geriatric bipolar patients, the TOC for mania was AAP/MS monotherapy, and the TOC for depression was AAP plus MS or AAP monotherapy. CONCLUSION The expert consensus in the KMAP-BP 2014 differed from that in previous publications; most notably, the preference for AAP was increased in the treatment of acute mania, depression, and maintenance treatment. There was increased expert preference for the use of AAP and LTG. The major limitation of the present study is that it was based on the consensus of Korean experts rather than on experimental evidence.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jung Goo Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, South Korea ; Paik Institute for Clinical Research, Inje Univeristy, Busan, South Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Moon-Doo Kim
- Department of Psychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Inki Sohn
- Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, South Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, South Korea
| | - Duk-In Jon
- Department of Psychiatry, Sacred Heart Hospital, Hallym University, Anyang, South Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, South Korea
| | - Young-Chul Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Kyung Joon Min
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, South Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, South Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Seo JS, Jeon EJ, Jung SH, Park MA, Kim NY. Pharmacokinetics of amoxicillin trihydrate in cultured olive flounder (Paralichthys olivaceus). J Vet Pharmacol Ther 2014; 38:86-92. [PMID: 25229401 DOI: 10.1111/jvp.12155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 06/28/2014] [Indexed: 11/30/2022]
Abstract
The study was aimed at investigating the pharmacokinetics of amoxicillin trihydrate (AMOX) in olive flounder (Paralichthys olivaceus) following oral, intramuscular, and intravenous administration, using high-performance liquid chromatography following. The maximum plasma concentration (Cmax ), following oral administration of 40 and 80 mg/kg body weight (b.w.), AMOX was 1.14 (Tmax , 1.7 h) and 0.76 μg/mL (Tmax , 1.6 h), respectively. Intramuscular administration of 30 and 60 mg/kg of AMOX resulted in Cmax values of 4 and 4.3 μg/mL, respectively, with the corresponding Tmax values of 29 and 38 h. Intravenous administration of 6 mg/kg AMOX resulted in a Cmax of 9 μg/mL 2 h after administration. Following oral administration of 40 and 80 mg/kg AMOX, area under the curve (AUC) values were 52.257 and 41.219 μg/mL·h, respectively. Intramuscular 30 and 60 mg/kg doses resulted in AUC values of 370.274 and 453.655 μg/mL·h, respectively, while the AUC following intravenous administration was 86.274 μg/mL·h. AMOX bioavailability was calculated to be 9% and 3.6% following oral administration of 40 and 80 mg/kg, respectively, and the corresponding values following intramuscular administration were 86% and 53%. In conclusion, this study demonstrated high bioavailability of AMOX following oral administration in olive flounder.
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Affiliation(s)
- J S Seo
- Pathology Division, National Fisheries Research & Development Institute (NFRDI), Busan, Korea
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35
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Wang HR, Bahk WM, Park YM, Lee HB, Song HR, Jeong JH, Seo JS, Lim ES, Hong JW, Kim W, Jon DI, Hong JP, Woo YS, Min KJ. Korean medication algorithm for depressive disorder: comparisons with other treatment guidelines. Psychiatry Investig 2014; 11:1-11. [PMID: 24605117 PMCID: PMC3942544 DOI: 10.4306/pi.2014.11.1.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/19/2013] [Accepted: 04/25/2013] [Indexed: 01/10/2023] Open
Abstract
We aimed to compare the recommendations of the Korean Medication Algorithm Project for Depressive Disorder 2012 (KMAP-DD 2012) with other recently published treatment guidelines for depressive disorder. We reviewed a total of five recently published global treatment guidelines and compared each treatment recommendation of the KMAP-DD 2012 with those in other guidelines. For initial treatment recommendations, there were no significant major differences across guidelines. However, in the case of nonresponse or incomplete response to initial treatment, the second recommended treatment step varied across guidelines. For maintenance therapy, medication dose and duration differed among treatment guidelines. Further, there were several discrepancies in the recommendations for each subtype of depressive disorder across guidelines. For treatment in special populations, there were no significant differences in overall recommendations. This comparison identifies that, by and large, the treatment recommendations of the KMAP-DD 2012 are similar to those of other treatment guidelines and reflect current changes in prescription pattern for depression based on accumulated research data. Further studies will be needed to address several issues identified in our review.
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Affiliation(s)
- Hee Ryung Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Won-Myong Bahk
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Republic of Korea
| | - Hwang Bin Lee
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Hoo Rim Song
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea
| | | | - Jeong-Wan Hong
- Namwon Sungil Mental Hospital, Namwon, Republic of Korea
| | - Won Kim
- Department of Psychiatry, Stress Research Institute, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Republic of Korea
| | - Duk-In Jon
- Department of Psychiatry, College of Medicine, Hallym University, Anyang, Republic of Korea
| | - Jin-Pyo Hong
- Department of Psychiatry, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Young Sup Woo
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung Joon Min
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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Abstract
The purpose of this study was to find out whether the carpal indices measured on lateral radiographs with a slightly malpositioned wrist are the same as those measured in the true neutral position. Lateral radiographic views of 25 wrists were taken with 5° intervals from 20° of flexion to 20° of extension. Most carpal indices measured in the flexed or extended position were significantly different from the wrist in zero flexion-extension, except scapholunate angle at 5° of extension and scaphocapitate angle at 5° and 10° of flexion. Starting from the flexed position, there was an average of -4.0° change in radioscaphoid angle, -1.0° in scapholunate angle, -1.0° in scaphocapitate angle, +3.0° in radiolunate angle, and +2.0° in lunocapitate angle for each 5° of extension with linear trends. The results from this study suggest that even minimal degrees of flexion-extension can affect the measurements of carpal indices on lateral radiographs.
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Affiliation(s)
- K H Koh
- Department of Orthopaedic Surgery, Seoul Medical Center, Seoul, Republic of Korea
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Affiliation(s)
- Ji Hyun Kim
- Department of Psychiatry, School of Medicine, Konkuk Unversity, Chungju, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, School of Medicine, Konkuk Unversity, Chungju, Korea
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Seo JS, Jamieson K, Cosgrove V, Gwizdowski IS, Yang H, Sheehan DV, McElroy SL, Suppes T. Characteristics of responders and non-responders to risperidone monotherapy or placebo in co-occurring bipolar disorder and anxiety disorder. Eur Psychiatry 2011; 28:190-6. [PMID: 22130178 DOI: 10.1016/j.eurpsy.2011.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 08/12/2011] [Accepted: 08/13/2011] [Indexed: 10/27/2022] Open
Abstract
Clinical characteristics predicting response and remission to psychopharmacological treatment of bipolar disorder (BD) and co-occurring anxiety disorders have been understudied. We hypothesized that non-response to risperidone or placebo in individuals with co-occurring BD and anxiety symptoms would be associated with a more severe clinical course of BD, and certain demographic variables. This study was a secondary analysis of a randomized, double-blind, parallel, 8-week study comparing risperidone monotherapy and placebo in individuals with BD plus current panic disorder, current generalized anxiety disorder (GAD), or lifetime panic disorder (n=111) [31]. We compared clinical characteristics of responders (50% improvement on the Hamilton Anxiety Scale [HAM-A]) and non-responders as well as remitters (HAM-A<7) and non-remitters in risperidone treatment (n=54) and placebo (n=57) groups. For non-responders in the risperidone group, co-occurring lifetime panic disorder was significantly more common than for non-responders in the placebo group. Apart from this, no significant differences in course of illness or demographics were found either between or across groups for patients with BD and co-occurring anxiety symptoms receiving risperidone or placebo in this acute phase study.
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Affiliation(s)
- J S Seo
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, 3801, Miranda Avenue (151T), Palo Alto, CA 94304, USA
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Lee WJ, Chong S, Seo JS, Shim HJ. Transthoracic fine-needle aspiration biopsy of the lungs using a C-arm cone-beam CT system: diagnostic accuracy and post-procedural complications. Br J Radiol 2011; 85:e217-22. [PMID: 22010033 DOI: 10.1259/bjr/64727750] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The purpose of our study was to evaluate the diagnostic accuracy of transthoracic fine-needle aspiration biopsy (TFNAB) using a C-arm cone-beam CT (CBCT) system and to assess risk factors for immediate post-procedural complications in patients with lung lesions. METHODS From October 2007 to April 2009, 94 TFNAB procedures using a C-arm system were studied in 91 patients with pulmonary lesions a chest CT scans. We retrospectively reviewed the patients' radiological and histopathological findings. We evaluated the lesion size, lesion abutted to pleura and presence or absence of emphysema along the needle path, lesion depth, visibility of target lesion and patient's position. Pneumothorax and pulmonary haemorrhage were assessed after TFNAB. Overall diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were analysed. RESULTS In 94 TFNAB procedures, 58 lesions were malignant and 36 were benign. The sensitivity, specificity, PPV, NPV and overall diagnostic accuracy rate of TFNAB were 93.1%, 100%, 100%, 90% and 97.9%, respectively. Pneumothorax was developed in 24 procedures. None of the parameters showed significant impact on the frequency of the pneumothorax. Overall haemorrhage occurred in 43 procedures. The incidence of overall haemorrhage was higher in patients with smaller lesions, longer pleural distance and pleural abutted lesions (p<0.05). Differences in visibility at projection radiographs were statistically significant between patients with or without perilesional haemorrhage (p<0.05). CONCLUSION Transthoracic fine-needle aspiration biopsy using a C-arm CBCT system is feasible for imaging guidance of lung lesion and early detection of the procedural-related complications.
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Affiliation(s)
- W J Lee
- Department of Radiology, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul Republic of Korea
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Woo YS, Bahk WM, Jo SH, Yoon BH, Lee JG, Kim W, Jeong JH, Seo JS, Min KJ, Jon DI. Effect of initial ziprasidone dose on treatment outcome of korean patients with acute manic or mixed episodes. Psychiatry Investig 2011; 8:207-13. [PMID: 21994507 PMCID: PMC3182385 DOI: 10.4306/pi.2011.8.3.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 03/22/2011] [Accepted: 04/23/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We investigated the efficacy and tolerability of ziprasidone combined with divalproex to determine the relationship between the initial dose of ziprasidone and the treatment effect among Korean patients with acute bipolar manic or mixed disorders. METHODS This study was a 6-week, open-label, prospective investigation of Korean patients with an acute manic or mixed episode of bipolar disorder. Sixty-five patients were recruited. The patients were categorized based on the initial dose of ziprasidone as follows: low (20-79 mg/day) and standard (80 mg/day). Ziprasidone was given in combination with divalproex in flexible doses, according to the clinical response and tolerability. RESULTS The response and remission rates were significantly higher in the standard-dose group than the low-dose group. The combination of ziprasidone and divalproex was well-tolerated and adverse events were mostly mild with no statistically significant increase in body weight. CONCLUSION The results of this study showed that a standard starting dose of ziprasidone in combination with divalproex for bipolar disorder is more effective than a low starting dose.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Soo Hyun Jo
- Department of Psychiatry, Bugok National Hospital, Bugok, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Jung Goo Lee
- Department of Psychiatry, Haeundae Paik Hospital and Paik Institute for Clinical Research, Inje University, Busan, Korea
| | - Won Kim
- Department of Neuropsychiatry and Stress Research Institute, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Jeong Seok Seo
- Department of Neuropsychiatry, Konkuk University College of Medicine, Chungju Hospital, Chungju, Korea
| | - Kyung Joon Min
- Department of Neuropsychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Duk-In Jon
- Department of Psychiatry, College of Medicine, Hallym University, Anyang, Korea
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Hong BS, Kim TH, Seo JS, Kim TW, Moon SW. Comparison of Patient-centeredness Changes between Medical School Graduates and Medical Students after Psychiatric Clerkship. Korean J Med Educ 2009; 21:133-142. [PMID: 25813111 DOI: 10.3946/kjme.2009.21.2.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Accepted: 02/23/2009] [Indexed: 06/04/2023]
Abstract
PURPOSE The aim of this study was to compare patient-centeredness changes between medical school graduates and medical students after a psychiatric clinical clerkship. METHODS We focused on 40 medical school graduates. We received permission to use data from a 2006 study on patient-centeredness of 94 medical students. The following was repeated before and after clerkship: Minnesota Multiphasic Personality Inventory (MMPI), Meyers-Briggs type indicator (MBTI), Patient-practitioner Orientation Scale (PPOS) and Authoritarian Personality (AP) scale. RESULTS In the 2006 study on patient-centeredness of medical students, the AP scores were significantly lower than before clerkship and the PPOS scores were significantly higher than before clerkship. AP score changes were related to MBTI, correlated with MMPI subscales, but inversely correlated with PPOS changes. In this study, the change in PPOS scores was not significant after clerkship in case of medical school graduates. AP score changes inversely correlated with PPOS changes, but neither correlated with MMPI subscales or MBTI. CONCLUSION Considering previous findings, medical school graduates tend to be more patient-centered than medical students, but medical students can adopt a more patient-centered attitude than graduates through a psychiatric clinical clerkship.
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Affiliation(s)
- Bong Sik Hong
- Department of Psychiatry, Konkuk University College of Medicine, Chungju, Korea
| | - Tae Ho Kim
- Department of Psychiatry, Konkuk University College of Medicine, Chungju, Korea
| | - Jeong Seok Seo
- Department of Psychiatry, Konkuk University College of Medicine, Chungju, Korea
| | - Tong Wook Kim
- Department of Urology, Konkuk University College of Medicine, Chungju, Korea
| | - Seok Woo Moon
- Department of Psychiatry, Konkuk University College of Medicine, Chungju, Korea
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Park JH, Chang BU, Kim YJ, Seo JS, Choi SW, Yun JY. Determination of low (137)Cs concentration in seawater using ammonium 12-molybdophosphate adsorption and chemical separation method. J Environ Radioact 2008; 99:1815-1818. [PMID: 18799246 DOI: 10.1016/j.jenvrad.2008.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Revised: 04/23/2008] [Accepted: 07/23/2008] [Indexed: 05/26/2023]
Abstract
A new method has been developed for analyzing (137)Cs in a small volume of seawater. Ammonium 12-molybdophosphate (AMP) was used two times during pretreatment procedure. The first step was to adsorb (137)Cs in seawater samples into AMP in order to reduce sample volume, and the second was to remove (87)Rb, interference nuclide for beta counting. The AMP adsorbing (137)Cs was dissolved by sodium hydroxide solution, and then (137)Cs was finally formed to be cesium chloroplatinate precipitate by adding 10% hexachloroplatinic acid. The beta rays emitted from (137)Cs were measured with a low background gas-proportional alpha/beta counter. This method was applied to several seawater samples taken in the East Sea of Korea. Compared to the routinely used gamma-spectrometry method, this new AMP method was reliable and suitable for analyzing (137)Cs in deep seawater.
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Affiliation(s)
- J H Park
- Korea Institute of Nuclear Safety, Yuseong-gu, Daejeon, Republic of Korea.
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Chang BU, Koh SM, Kim YJ, Seo JS, Yoon YY, Row JW, Lee DM. Nationwide survey on the natural radionuclides in industrial raw minerals in South Korea. J Environ Radioact 2008; 99:455-60. [PMID: 17904704 DOI: 10.1016/j.jenvrad.2007.08.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2006] [Revised: 07/06/2007] [Accepted: 08/09/2007] [Indexed: 05/17/2023]
Abstract
A Nationwide survey on the natural radioactivity in industrial raw mineral commodities (17 kinds of domestic and 18 kinds of imported) that are representative minerals used in production and consumption in South Korea was conducted. The target industrial minerals can be categorized into two groups. The first group covers non-metallic and metallic raw minerals with low levels of radioactivity such as clay, silica sand, carbonates, bituminous and anthracite coal, iron ores, ilmenite, rutile, and phosphate ore. The other group comprises minerals with high levels of radioactivity including zircon and monazite. One hundred and sixty-four domestic and imported samples were analysed by gamma-ray spectroscopy using an HPGe detector. The (40)K content ranges from <0.00131 to 2.69Bq g(-1), and (226)Ra and (232)Th range over <0.0006 to 0.630 and <0.0008 to 0.474Bq g(-1), respectively. There was no anthropogenic radioactive signal in any of the samples.
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Affiliation(s)
- B U Chang
- Korea Institute of Nuclear Safety, Guseong-dong 19, Yuseong-gu, 305-338 Daejeon, Republic of Korea.
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Seo JS, Cho NY, Kim HR, Tsurumi T, Jang YS, Lee WK, Lee SK. Cell cycle arrest and lytic induction of EBV-transformed B lymphoblastoid cells by a histone deacetylase inhibitor, Trichostatin A. Oncol Rep 2008; 19:93-98. [PMID: 18097580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Latent infection of the Epstein-Barr virus (EBV) is strongly associated with the pathogenesis of several human tumor types. The restricted expression of the latent EBV antigens is critical for EBV-associated tumors to escape from immune surveillance. EBV lytic replication can be triggered by various treatments and the induced lytic genes cause strong cytotoxic T lymphocyte (CTL) responses. Histone acetylation or deacetylation is associated with chromatin remodeling and regulates gene expression. Histone deacetylase (HDAC) inhibitors affect cell cycle progression as well as gene expression in a wide variety of transformed cells. We examined whether an HDAC inhibitor, TSA, can affect cell cycle progression and induce EBV lytic replication in EBV-transformed lymphoblastoid cell lines (LCLs). TSA caused cell cycle arrest at low concentrations and induced apoptosis at higher (>300 nM) concentrations in the LCLs and EBV negative BJAB cells. To clarify the underlying mechanism of TSA-induced cell cycle arrest, expression of cell cycle regulatory factors was examined by RNase protection assay and Western blot analysis. Following TSA treatment, a reduced expression of cyclin D2 and an induction of p21 may have played an essential role for G1 arrest in LCLs, while p21 induction might have arrested BJAB cells in G1 phase. A Cdk inhibitor, p57, was increased by 300 nM TSA in both LCLs and BJAB cells, indicating its role in apoptosis. Moreover, immunofluorescene assay and Western blotting showed that TSA induced EBV lytic replication in LCL cells. These results suggest that TSA may exert an enhanced anti-tumor effect for EBV-associated tumors not only by inducing a cell cycle arrest and apoptosis, but also by triggering an EBV lytic cycle.
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Affiliation(s)
- J S Seo
- Research Institute of Immunobiology, Catholic University, Seoul 137-701, Japan
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Seo JS, Park TJ, Lee YM, Park HG, Yoon YD, Lee JS. Small heat shock protein 20 gene (Hsp20) of the intertidal copepod Tigriopus japonicus as a possible biomarker for exposure to endocrine disruptors. Bull Environ Contam Toxicol 2006; 76:566-72. [PMID: 16688536 DOI: 10.1007/s00128-006-0957-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Accepted: 02/17/2006] [Indexed: 05/09/2023]
Affiliation(s)
- J S Seo
- Department of Molecular and Environmental Bioscience, Graduate School, Hanyang University, Seoul, South Korea
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Seo JS, Lee SS, Kim SI, Ryu WH, Sa KH, Kim SU, Han SW, Nam EJ, Park JY, Lee WK, Kim SY, Kang YM. Influence of VEGF gene polymorphisms on the severity of ankylosing spondylitis. Rheumatology (Oxford) 2005; 44:1299-302. [PMID: 16014410 DOI: 10.1093/rheumatology/kei013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To investigate the role of polymorphisms of the vascular endothelial growth factor (VEGF) gene in susceptibility to ankylosing spondylitis (AS), and their relationship to clinical features and radiographic severity. METHODS This study included 157 patients with AS and 140 healthy unrelated controls. Polymorphisms of the VEGF gene were analysed by the polymerase chain reaction (PCR)-restriction fragment length polymorphism assay and amplification refractory mutation system-PCR. Haplotypes were reconstructed using the Bayesian algorithm. Radiographic severity was assessed by the Bath Ankylosing Spondylitis Radiological Index (BASRI). RESULTS The genotype frequencies of the polymorphisms were in Hardy-Weinberg equilibrium. The distributions of genotypes and alleles did not differ between AS patients and controls. Among the six haplotypes reconstructed based on the tight linkage disequilibrium at positions -2578, -1154 and -634 (pairwise linkage disequilibrium coefficient, r = 0.361-0.706), no haplotype was associated with susceptibility to AS. Clinical features were analysed for the four haplotypes (CGC, CGG, AAG, AGG) which were prevalent. In carriers of the AGG haplotype, the frequency of cervical spine involvement was significantly higher (P = 0.002, P(corr) = 0.036) and that of patients showing a BASRI score >6 was also higher (P = 0.025, P(corr) = 0.45). CONCLUSIONS This study demonstrates that polymorphisms of the VEGF gene may contribute to disease severity in AS.
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Affiliation(s)
- J S Seo
- Department of Internal Medicine, Kyungpook National University Hospital, Samduk 2-Ga, Junggu, Daegu 700-721, Republic of Korea
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Han SW, Kim GW, Seo JS, Kim SJ, Sa KH, Park JY, Lee J, Kim SY, Goronzy JJ, Weyand CM, Kang YM. VEGF gene polymorphisms and susceptibility to rheumatoid arthritis. Rheumatology (Oxford) 2004; 43:1173-7. [PMID: 15213335 DOI: 10.1093/rheumatology/keh281] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To investigate polymorphisms of the VEGF gene in patients with rheumatoid arthritis (RA), their relationship to clinical features and the radiographic progression of joint disease. METHODS One hundred and forty patients with RA and 149 healthy unrelated controls were recruited. We examined four polymorphisms of the VEGF gene which are reported to be associated with production of vascular endothelial growth factor (VEGF), using polymerase chain reaction (PCR) restriction fragment length polymorphism assay and amplification refractory mutation system (ARMS) PCR. Haplotypes were predicted by Bayesian algorithm using the Phase program. RESULTS All four polymorphisms were in Hardy-Weinberg equilibrium in both patients and controls. The frequency of the 936 T allele, which has been associated with lower production of VEGF, was significantly increased in RA patients compared with controls (22.7 vs 13.4%, P = 0.002). The frequencies of two haplotypes (CGCT and AAGT) which were predicted using the Phase program were significantly increased in RA patients compared with controls [33 vs 14%, odds ratio (OR) 2.636, 95% confidence interval (CI) 1.38-5.04 for CGCT; 17 vs 6%, OR 3.08, 95% CI 1.20-7.92 for AAGT]. The carriers of the susceptible haplotypes in RA patients had a younger age at disease onset but did not show a difference in the progression rate of radiographic joint destruction. CONCLUSIONS Our data suggest that the VEGF gene may play a role in the development of RA
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Affiliation(s)
- S W Han
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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Keum YS, Liu KH, Seo JS, Kim JH, Kim K, Kim YH, Kim PJ. Dissipation of foliar residues of diafenthiuron and its metabolites. Bull Environ Contam Toxicol 2002; 68:845-851. [PMID: 12012060 DOI: 10.1007/s00128-002-0032-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- Y S Keum
- School of Agricultural Biotechnology, Seoul National University, Seodundong 103, Suwon 441-744, Korea
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Seo JS, Liu KH, Chung KH, Shin JS, Kim JH. Bioconcentration and depuration of pyribenzoxim in common carp (Cyprinus carpio). Bull Environ Contam Toxicol 2002; 68:617-622. [PMID: 12068925 DOI: 10.1007/s001280299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- J S Seo
- School of Agricultural Biotechnology, Seoul National University, Suwon, Korea
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Lee SH, Kim M, Yoon BW, Kim YJ, Ma SJ, Roh JK, Lee JS, Seo JS. Targeted hsp70.1 disruption increases infarction volume after focal cerebral ischemia in mice. Stroke 2001; 32:2905-12. [PMID: 11739994 DOI: 10.1161/hs1201.099604] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Heat-shock proteins (HSPs) are highly conserved proteins that are induced by a variety of stresses. HSP70 is a 70-kDa HSP family known to have cytoprotective effects against various insults. The role of HSP70 in cerebral ischemia remains to be elucidated in vivo. METHODS To investigate the effect of reduced HSP70 levels on cerebral ischemia, focal cerebral ischemia by intraluminal occlusion of the middle cerebral artery was induced in hsp70.1 knockout mice. The expressions of hsp70.1 and hsp70.3 mRNAs and HSP70 protein were determined, and infarction volumes were measured and compared. RESULTS Northern blots confirmed the absence of hsp70.1 mRNA expression in the knockout mice. The mean infarction volume was significantly larger in hsp70.1 knockout mice (92.5+/-8.3 mm(3)) than in the wild-type mice (59.3+/-8.9 mm,(3) P<0.001). Western blots showed increased HSP70 expression in the ischemic hemisphere in both knockout and wild-type mice, but HSP70 expression levels in knockout mice were significantly lower than those in their wild-type littermates. Immunohistochemistry did not show any significant differences between the knockout and wild-type animals and showed increased HSP70 immunoreactivity in the ischemic hemisphere, with predominance in the cerebral cortex, especially in the penumbra. CONCLUSIONS Our results suggest that hsp70.1 plays an important role in the early protection of the brain, at least after acute focal cerebral ischemia in mice.
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Affiliation(s)
- S H Lee
- Department of Neurology, Seoul National University, Seoul, Korea.
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