Neurobiological Factors Associated with Suicidal Behavior

BunHee Lee,YongKu Kim 대한신경정신의학회 2006 PSYCHIATRY INVESTIGATION Vol.3 No.2

Suicide is a major public health issue and a significant cause of death worldwide. Many animal, postmortem, clinical, and genetic studies have produced results implicating at least 3 neurobiological systems in the pathogenesis of suicidal behavior: a deficiency in the serotonergic system, hyperactivity of the hypothalamic-pituitary-adrenal axis, and excess of norepinephrine release followed by norepinephrine deficiency. In addition, several studies have pointed to the involvement of the dopaminergic system, neurotrophic factors, cholesterol, and cytokines in the pathogenesis of suicidal behavior. However, more research will be required in order to confirm these associations. In the future, a greater understanding of suicidal behavior and its neurobiology may facilitate the detection of at-risk individuals, and contribute to the development of more effective interventions.

Resolution of Amisulpride associated Amenorrhea by Switching to Aripiprazole

BunHee Lee,YongKu Kim 대한신경정신의학회 2006 PSYCHIATRY INVESTIGATION Vol.3 No.1

Objective: To report a 4-case series in which amisulpride-induced symptomatic hyperprolactinemia was resolved by switching to aripiprazole. Case Reports: Four female patients developed symptomatic hyperprolactinemia such as amenorrhea and/or galactorrhea with elevated serum prolactin levels (113.7 230.0 ng/mL) after taking amisulpride (200-800 mg/day). To resolve the problem of symptomatic hyperprolactinemia, reducing the dosage of amisulpride was first tried, however this approach turned out to have no effect. Subsequently, all 4 patients were switched from amisulpride to aripiprazole (10 20 mg/day), upon which their regular menstrual cycles returned and galactorrhea improved, with the normalization of their serum prolactin levels (6.5 15.0 ng/mL) within 4 weeks after switching Conclusion: Switching to aripiprazole, a partial dopamine agonist, is an effective strategy for the resolution of antipsychotic-induced hyperprolactinemia and associated adverse effects.

Psychiatric Sequelae of Former “Comfort Women,” Survivors of the Japanese Military Sexual Slavery during World War II

Jeewon Lee,YoungSook Kwak,YoonJung Kim,EunJi Kim,EJin Park,Yunmi Shin,BunHee Lee,SoHee Lee,HeeYeon Jung,Inseon Lee,JungIm Hwang,Dongsik Kim,Soyoung Irene Lee 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.4

“Comfort women” refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. “Comfort women” endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former “comfort women” currently alive in South Korea is introduced. The participants’ unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former “comfort women” after all these years. This article highlights the fact that the trauma has affected the mental health and social functioning of former “comfort women” throughout their lives, and even to the present day.

Decreased Plasma Nitric Oxide Metabolite Levels in Schizophrenia

YongKu Kim,BunHee Lee,SunHwa Park 대한신경정신의학회 2006 PSYCHIATRY INVESTIGATION Vol.3 No.2

Background: Nitric oxide (NO) is synthesized by neuronal and endothelial NO synthase (NOS), and has multiple functions in brain circuits and plasticity, neuroprotection and neurotoxicity, and behavior. We evaluated plasma levels of NO metabolite in patients with schizophrenia. Method: Plasma levels of NO metabolites, nitrite and nitrate, were measured in 45 male schizophrenics and 45 male normal controls. The severity of schizophrenia and response to treatment were assessed with the positive and negative syndrome scale. Plasma NO metabolite levels were estimated by Griess method in plasma samples. Results: Plasma levels of the NO metabolites were significantly lower in schizophrenics than in normal controls (t = 2.841, df = 88, p = 0.006). There were no significant correlations between plasma NO metabolites and PANSS scores in schizophrenics. Conclusions: Our study suggests that decreased plasma NO metabolite level is associated with schizophrenia. This finding supports the hypothesis of a NO system reduction in schizophrenics.

Psychiatric Findings in Suspected and Confirmed Middle East Respiratory Syndrome Patients Quarantined in Hospital : A Retrospective Chart Analysis

HyunChung Kim,SoYoung Yoo,BunHee Lee,SoHee Lee,HyoungShik Shin 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.4

Objective-Little is known about the psychiatric complications or risk factors for depression in suspected or confirmed Middle East Respiratory Syndrome (MERS) patients quarantined in hospital. Methods-A retrospective chart review was performed of all the patients admitted to the acute MERS inpatient unit at the NMC during the 2015 outbreak. Results-30 (75%) were confirmed to be MERS-CoV positive among 40 admitted cases. Among the 24 MERS survivors, 17 (70.8%) exhibited psychiatric symptoms and 10 (41.7%) received a psychiatric diagnosis and medication during their hospital stay. Suspected MERS patients did not exhibit psychiatric symptoms or receive a psychiatric diagnosis. 27 suspected or confirmed MERS patients (age 41.15±18.64, male 37.0%) completed psychological assessments. A multiple linear regression analysis revealed that the Korean National Health and Nutrition Examination Survey-Short form and the Impact of Event Scale-Revised scores were significantly positively correlated with Patient Health Questionnaire-9 scores. Conclusion-Our findings indicate that the acute treatment of MERS-CoV infections in quarantine had a significant impact on the patients’ mental health. Furthermore, assessment of the risk factors for depression may identify vulnerable patients who require psychiatric care and attention during hospital quarantine.

Exploration of Biological Markers of Suicidal Behavior in Major Depressive Disorder

YongKu Kim,SungDoo Won,JiWon Hur,BunHee Lee,HwaYoung Lee,SeHoon Shim,SangWoo Han,SoHyun Choi 대한신경정신의학회 2007 PSYCHIATRY INVESTIGATION Vol.4 No.1

Objective-Most suicides occur in the context of depressive disorders. In this study, new candidate biological markers for suicide were explored. Methods-The suicidal subjects consisted of 48 depressed patients (18 males and 30 females) admitted to emergency rooms following suicide attempts. The levels of nitric oxide, brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), beta-nerve growth factor (β-NGF), and transforming growth factor-beta 1 (TGF-β1) were measured in the plasma of these 48 patients and 50 normal controls. The levels of tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), interleukin-2 (IL-2), interleukin-4 (IL-4), and interleukin-6 (IL-6) were measured in the culture supernatant after mitogen stimulation of whole blood from both groups. The lethality of the suicide attempt was measured using the Lethality Suicide Attempt Rating Scale (LSARS), and the Risk-Rescue Rating (RRR). Results-The suicidal depressed patients had significantly higher IL-6, TGF-β1, and nitric oxide (NO) levels compared with the normal controls after controlling for body mass. On the other hand, the BDNF, IL-2, IL-4 and IFN-γ levels were lower in the suicidal depressed patients than in the normal controls. The NO levels in the suicidal depressed patients were negatively significantly correlated with the LSARS and RRR scores. The IFN-γ levels in the suicidal depressed patients were positively correlated with the LSARS scores, but their TGF-β1 levels were negatively correlated with the LSARS scores. When the suicidal behaviors were divided into violent or nonviolent, the IL-6 and IFN-γ levels of the violent suicidal patients were significantly higher than those of the nonviolent suicidal patients. Conclusions-These results suggest that BDNF, NO, and cytokines could be useful as biological markers of suicidal behavior in major depression.