Clinical Significance of the Number of Depressive Symptoms in Major Depressive Disorder: Results from the CRESCEND Study

Park, Seon-Cheol,Sakong, Jeongkyu,Koo, Bon Hoon,Kim, Jae-Min,Jun, Tae-Youn,Lee, Min-Soo,Kim, Jung-Bum,Yim, Hyeon-Woo,Park, Yong Chon The Korean Academy of Medical Sciences 2016 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.31 No.4

<P>Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ<SUP>2</SUP> test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, <I>P</I> < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, <I>P</I> < 0.001), anxiety symptoms (F [4, 765] = 12.890, <I>P</I> < 0.001) and suicidal ideation (F [4, 653] = 6.970, <I>P</I> < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, <I>P</I> < 0.001), and quality of life (F [4, 656] = 11.975, <I>P</I> < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, <I>P</I> < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.</P>

Clinical Significance of the Number of Depressive Symptoms in Major Depressive Disorder: Results from the CRESCEND Study

박선철,사공정규,구본훈,김재민,전태연,이민수,김정범,임현우,박용천 대한의학회 2016 Journal of Korean medical science Vol.31 No.4

Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ2 test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, P < 0.001), anxiety symptoms (F [4, 765] = 12.890, P < 0.001), and suicidal ideation (F [4, 653] = 6.970, P < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, P < 0.001), and quality of life (F [4, 656] = 11.975, P < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, P < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.

분노증후군과 주요우울장애의 뇌파 연구

김가나,최민지,지상은,조성훈,Kim, Ka-Na,Choi, Min-Ji,Ji, Sang-Eun,Cho, Seung-Hun 대한한방신경정신과학회 2013 동의신경정신과학회지 Vol.24 No.suppl1

Objectives : We will discuss the differences on EEG results of Post-traumatic embitterment disorder (PTED) and Major depressive disorder (MDD). Methods : We measured EEG on 21 sites (Fp1, Fpz, Fp2, F7, F3, Fz, F4, F8, T3, C3, Cz, C4, T4, T5, P3, Pz, P4, T6, O1, Oz, O2) of PTED and MDD. Then, we compared the results. Results : There is a significant result of a beta band between PTED and MDD. Conclusions : We became aware of the differences on EEG results of PTED and MDD. This can be used as the basis of diagnosis.

결핍의 의식(deprivation cult)과 우울증: 코로나 이후 우울한 영혼 돌봄과 목회상담

하재성 한국목회상담학회 2023 목회와 상담 Vol.40 No.-

Contrary to previous common expectations or concerns, suicide rates did not increase in Korea during COVID-19. Interestingly enough, the worldwide pandemic did not bring about an outbreak of major depressive disorder (MDD) or suicides that medical professionals had warned of due to isolation, fear of infection or death. The result was the opposite: the suicidal rates had decreased, although the change was small. It is true that Korea has kept the disgraceful position of the highest suicidal rates among OECD countries for the many years, and the numbers have continued to grow. However, MDD seems to have maintained independence from the global pandemic, during which most were commonly afraid of the often deadly infection. MDD is not biologically inherited, but clinical observations may lead to a conclusion that it has much to do with the chronic deficiency of childhood attachment or emotional bonds to primary caregivers. The deficiency may come from a wider context of a sociocultural level beyond the individual one, which resonates with the deprivation cult, in other words, the spirit possession, that many women in different cultures are known to experience at a psycho-spiritual level. MDD is closely related to any kind of deficiency, from losses of both childhood attachment relationships outside and love objects inside. It does not come solely from common disasters outside, but with triggers at certain life stages, individual experiences of chronic emotional deficiency contribute largely to the outbreak of MDD. Pastoral counselors are expected to recognize those individualized deficiencies and, together with counselees, seek in hope for the proper expressions in the gospel, which may compensate for their long deprivations at the individual emotional and socio-spiritual levels. 전문가들의 우려와는 달리 코로나 시기에 한국에서 우울한 사람들의 자살률은 이전보다 더 낮았다. 이것은 코로나블루를 염려하던 전문가들의 예상과는 사뭇 다른 결과로서 세계적인 전염병이 우울증과 자살률에 특별한 영향을 미치지 않음을 보여준다. 물론 한국에서의 전연령별 우울증과 자살 발생 비율은 7년 전에 비해 계속 증가하고 있고 또 OECD 국가들보다 평균 두 배나 높은 수치여서 경계심이 필요하다. 세계적인 재난 가운데서도 우울증이 큰 변동 없이 지속성을 유지하는 것이 한편으로는 다행이면서도 다른 한편으로는 특별한 우려를 낳기도 한다. 왜냐하면 우울증이 팬데믹과 무관한 독립적 생존구조를 가지고 있기 때문이다. 우울증은 유전되지 않는다. 그러나 어릴 때부터 경험하는 만성적 공감 결핍은 한 인간의 안정적인 성장을 방해하고 장기적인 소진과 우울증을 일으킬 수 있다. 이것은 종교·인류학적 결핍증상이라 할 수 있는 ‘결핍의 의식’과 유사하며 정신·영적인 면에까지 영향을 미친다. 여기서 결핍의 의식이란 사회문화적 특권에서 배제되거나 박탈된 사람들이 비인격적인 상태에서 겪게 되는 비밀스런 통과의례를 가리킨다. 프로이트와 달리 DSM-V에서는 외적 대상의 상실조차 우울증과 연관되어 있다고 진단한다. 우울한 내담자들은 흔히 성장기 자원의 결핍을 겪은 경험자들로서 심신증을 겪으며 삶의 에너지의 고갈을 고통스럽게 느낀다. 청소년, 여성, 노년 등 다양한 계층의 우울증 양상을 살펴볼 때 성장기 결핍은 우울증 발생에 중요한 원인이며 작용을 한다. 다만 공동의 연대감이 작용하는 자연재해나 전쟁의 상황보다는 관계의 고립과 특권의 배제에서 비롯된 내면의 결핍에서 더 크게 발생한다. 목회상담자는 그리스도의 복음 안에서 이같은 개개인의 내적 결핍을 인지하고, 그것을 표현할 언어를 탐색함으로써 우울증의 오랜 시간의 정서적 결핍만 아니라 사회·영적 결핍을 보상하고 회복시키는 소망의 작업자들이다.

From Bound Cells Comes a Sound Mind: The Role of Neuronal Growth Regulator 1 in Psychiatric Disorders

노경철,박정철,한정수,이성중 한국뇌신경과학회 2020 Experimental Neurobiology Vol.29 No.1

Cell-to-cell adhesion is important for maintenance of brain structure and function. Abnormal neuronal cell adhesion and loss of its connectivity are considered a main cause of psychiatric disorders such as major depressive disorder (MDD). Various cell adhesion molecules (CAMs) are involved in neuronal cell adhesions and thereby affect brain functions such as learning and memory, cognitive functions, and psychiatric functions. Compared with other CAMs, neuronal growth regulator 1 (Negr1) has a distinct functioning mechanism in terms of its cross-talk with cytokine receptor signaling. Negr1 is a member of the immunoglobulin LON (IgLON) family of proteins and is involved in neuronal outgrowth, dendritic arborization, and synapse formation. In humans, Negr1 is a risk gene for obesity based on a genome-wide association study. More recently, accumulating evidence supports that it also plays a critical role in psychiatric disorders. In this review, we discuss the recent findings on the role of Negr1 in MDD, focusing on its regulatory mechanism. We also provide evidence of putative involvement of Negr1 in other psychiatric disorders based on the novel behavioral phenotypes of Negr1 knockout mice.

항우울제 복용환자에 대한 한의치료와 M&L심리치료 활용 2례보고

황선혜 ( Seon-hye Hwang ),박아름 ( Areum Park ),송건의 ( Gun-eui Song ),임교민 ( Gyo-min Lim ),모민주 ( Min-ju Mo ),박세진 ( Se-jin Park ) 대한한방신경정신과학회 2017 동의신경정신과학회지 Vol.28 No.2

Objectives: The purpose of this study is to show that patients taking antidepressants significantly respond to Korean medical treatments and M&L psychotherapy. Methods: We treated two patients with Korean medical treatments (acupuncture, moxibustion and Herbal Medicine) and psychotherapy including M&L psychotherapy and Li-Gyeung-Byun-Qi therapy. The patients were diagnosed based on DSM-IV diagnostic criteria for MDD. Beck`s Depression Inventory (BDI), Beck`s Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI), Pittsburgh Sleep Quality Index (PSQI), and Visual Analogue Scale (VAS) were used to evaluate the patients. Results: The following observations were made after treatments: Case 1: the patient showed significant improvement in Beck`s Depression Inventory (BDI), Beck`s Anxiety Inventory (BAI), and Visual Analogue Scale (VAS). Case 2: the patient showed significant improvement in Beck`s Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Pittsburgh Sleep Quality Index (PSQI), and Visual Analogue Scale (VAS). Conclusions: These results suggest that Korean medical treatments and M&L psychotherapy might be effective for treating patients suffering from MDD.

Potential Relationship between Season of Birth and Clinical Characteristics in Major Depressive Disorder in Koreans: Results from the CRESCEND Study

박용천,박선철,사공정규,구본훈,김재민,전태연,이민수,김정범,임현우 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.3

We aimed to examine the potential relationship between season of birth (SOB) and clinical characteristics in Korean patients with unipolar non-psychotic major depressive disorder (MDD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, 891 MDD patients were divided into two groups, those born in spring/summer (n=457) and those born in autumn/winter (n=434). Measurement tools comprising the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Scale for Suicidal Ideation, Clinical Global Impression of severity, Social and OccupationFunctional Assessment Scale, WHO Quality of Life assessment instrument-abbreviated version, Alcohol Use Disorder IdentificationTest, and Temperament and Character Inventory were used to evaluate depression, anxiety, overall symptoms, suicidal ideation, global severity, social function, quality of life, drinking, and temperament and character, respectively. Using independentt-tests for continuous variables and χ2 tests for discrete variables, the clinical characteristics of the two groups were compared. MDD patients born in spring/summer were on average younger at onset of first depressive episode (t=2.084, p=0.038), had greater loss of concentration (χ2=4.589, p=0.032), and were more self-directed (t=2.256, p=0.025) than those born in autumn/winter. Clinically, there was a trend for the MDD patients born in spring/summer to display the contradictory characteristics of more severe clinical course and less illness burden; this may have been partly due to a paradoxical effect of the 5-HT system.

주요우울증 환자에서 세로토닌 6(5-HT6) 수용체 C267T 다형성과 Citalopram 치료반응에 대한 연구

한상우,임세원,오강섭,강이헌,이민수,Hahn, Sang-Woo,Lim, Se-Won,Oh, Kang-Seob,Kang, Rhee-Hun,Lee, Min-Soo 대한생물정신의학회 2007 생물정신의학 Vol.14 No.4

The serotonin 6(5-HT6) receptor gene is a candidate gene for influencing the clinical response to treatment with antidepressants. The purpose of this study was to determine the relationship between the C267T polymorphism in the 5-HT6 receptor gene and the treatment response to citalopram in a Korean population with major depressive disorder(MDD). Methods : Citalopram was administered for 8 weeks to the 90 patients who completed study. 21-item Hamilton depression rating scale(HAMD-21) was used as a outcome measure. Results : We found that the genotype, allele, and allele-carrier distributions did not differ significantly between MDD patients and normal controls. A main effect of an interaction of genotype with time on the decrease in the HAMD-21 score during the 8 weeks study period was not found. ANOVA revealed no significant effects of the C825T polymorphism on the decrease in the HAMD-21 score at each time period. Conclusions : These results suggest that the C267T polymorphism in the 5-HT6 receptor gene is not associated with the treatment response to citalopram.

여성 우울장애 환자의 정확한 진단을 도울 수 있는 뇌파 특징을 이용한 머신러닝 기반 컴퓨터 보조 진단 시스템 개발

이지원(Ji-Won Lee),홍승용(Seung-Yong Hong),심미선(Miseon Shim),황한정(Han-Jeong Hwang) 한국정보기술학회 2021 Proceedings of KIIT Conference Vol.2021 No.11

본 연구에서는 신경생리학적인 특징을 잘 반영하는 뇌파 기반 생체지표를 이용하여 여성 주요우울장애의 진단을 도와줄 수 있는 기계학습 기반 컴퓨터 보조 진단 시스템을 개발하였다. 이를 위하여 안정상태 뇌파 기반의 서로 다른 세 개의 생체지표(주파수 스펙트럼 밀도, 위상 동기화 지수, 및 뇌-네트워크 인덱스)를 센서 및 신호원 수준에서 추출하여 특징으로 사용하였고, 분류를 위하여 서포트 벡터 머신 분류기와 leave-one-out 교차 검증을 사용하였다. 그 결과, 9개의 센서 수준의 주파수 스펙트럼 밀도 특징을 사용하였을 때 84.69%의 높은 진단 성능을 확인하였다. 앞으로 딥러닝 알고리즘을 적용하여 본 진단 시스템의 진단 성능 및 효율성을 향상시킬 예정이다. The aim of study is to develop a resting-state electroencephalography (EEG)-based computer-aided diagnosis (CAD) system for assisting accurate diagnosis of major depressive disorder (MDD) patients using machine-learning methods. To this end, we extracted three different types of features (power spectrum density, phase locking value, and network indices) in sensor- and source-level, respectively, using resting-state eyes-closed state EEG data. A support vector machine (SVM) classifier was used to differentiate 49 MDD patients and 49-matched healthy controls with leave-one-out cross-validation method. As a result, we achieved the best classification accuracy of 84.69 % using 9 sensor-level PSD features when differentiating MDD patients and healthy controls. In the future study, we will attempt to improve not only classification performances but also the efficiency the CAD system by applying deep-learning algorithms.

주요우울증환자의 정량적 뇌파특징 분석연구

정규희,이준석,이장한 한국임상심리학회 2008 Korean Journal of Clinical Psychology Vol.27 No.3

In an attempt to compare the brain activity between patients with major depressive disorder (MDD) and a normal control group, we analyzed the Quantitive Electroencephalography (QEEG) and we evaluated the possibility of QEEG as a useful clinical tool. The taditional measures of absolute and relative power and frequency, and the asymmetry measures were derived from the ranges of the delta, theta, alpha and beta frequencies. The asymmetry indexes were computed using two different formulas: the PCT index and the A index. The results showed the following. (1) The delta relative to power was increased and the alpha relative to power was decreased in the depressed patients, as compared to the controls. (2) The delta frequency was slower and the alpha frequency was faster in the depressed patients, as compared to the controls. (3) With the A index, the alpha and beta asymmetries were indicative of the left frontal and central hypoactivity, respectively, as was previously reported for MDD patients. However, theta asymmetry was also found in the PCT index, in addition to the alpha and beta asymmetries. Discriminant analysis correctly classified 82.6% and 87% of the patients (Ed note: check this.) when the A index and the PCT index were included, respectively. It was found that spectrally analyzed EEG could become a useful tool when diagnosing major depression and also for examining the basis of the symptoms.