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        Prevalence and risk factors associated with depressive mood in Korean patients with fecal incontinence

        Daeho Shon,Sung Jin Kim,Eun-Jin Cheon,Sung Il Kang,Sohyun Kim 대한외과학회 2021 Annals of Surgical Treatment and Research(ASRT) Vol.101 No.3

        Purpose: The study was aimed at assessing the prevalence of depression in individuals with fecal incontinence (FI) and the relationship between the symptoms of depression and the severity of objective test parameters. Methods: Patients with FI for over 3 months were included in the study. The exclusion criteria were (1) diagnosis or treatment of the pelvic organ prolapse syndrome, (2) previous anorectal surgery, (3) inflammatory bowel disease, (4) previous diagnosis of psychiatric disorder, and (5) inability to read or understand the questionnaire themselves. The questionnaire included the Beck Depression Inventory-II (BDI-II) for measuring depression, and 142 patients were included for analysis. Results: Of the 142 patients, 34 were males and 108 were females, with a mean age of 67.8 years. The mean duration of FI symptoms was 38.36 months (range, 3–600 months). The mean Cleveland Clinic Incontinence Score and BDI-II were 11.96 ± 4.76 and 12.46 ± 9.84, respectively. The Cleveland Clinic Incontinence Score showed a positive correlation with the BDI-II score (P = 0.005). Of the 142 patients, 99 showed minimal to mild BDI-II scores, and 43 showed moderate-to-severe BDI-II scores. The multivariable logistic regression analysis showed that health insurance status was related to the depression in FI patients. Conclusion: Mood disorders related to FI are more affected by the severity of the subjective symptoms or the surrounding environment than the objective indicators derived from the test.

      • SSCISCIESCOPUS

        Associations of serotonergic genes with poststroke emotional incontinence

        Kim, Jae‐,Min,Stewart, Robert,Kang, Hee‐,Ju,Bae, Kyung‐,Yeol,Kim, Sung‐,Wan,Shin, Il‐,Seon,Kim, Joon‐,Tae,Park, Man‐,Seok,Cho, Ki‐,Hyun,Yoon, Jin‐ John Wiley Sons, Ltd 2012 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Vol.27 No.8

        <P><B>Objectives</B></P><P>Poststroke emotional incontinence (PSEI) has been associated with serotonergic dysfunction. Polymorphisms of serotonin transporter (5‐HTT) and serotonin 2a receptor (5‐HTR2a) genes may regulate serotonergic signaling at brain synapses, and this study was to investigate associations with PSEI in an East Asian population.</P><P><B>Methods</B></P><P>In 276 stroke cases, PSEI was diagnosed by Kim's criteria. Covariates included age, gender, education, history of depression or stroke, current depression, and stroke severity and location. Genotypes were ascertained for 5‐HTT gene‐linked promoter region (5‐HTTLPR), serotonin transporter intron 2 variable number tandem repeat, 5‐HTR2a 1438A/G, and 5‐HTR2a 102 T/C. Associations with PSEI were estimated by using logistic regression models, and gene–gene interactions were investigated by using the generalized multifactor dimensionality reduction method.</P><P><B>Results</B></P><P>PSEI was present in 37 (13.4%) patients. The 5‐HTT gene‐linked promoter region <I>s</I>/<I>s</I> genotype was independently associated with PSEI. No associations with STin2 VNTR and 5‐HTR2a genes were found, and no significant gene–gene interactions were identified.</P><P><B>Conclusions</B></P><P>Stroke patients with 5‐HTTLPR <I>s</I> allele had higher susceptibility to PSEI, which underlines the potential role of serotonergic pathways in its etiology. Copyright © 2011 John Wiley & Sons, Ltd.</P>

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        Differences in Therapeutic Responses and Factors Affecting Post-Stroke Depression at a Later Stage According to Baseline Depression

        Lee, Eun-Jae,Kim, Jong S.,Chang, Dae-Il,Park, Jong-Ho,Ahn, Seong Hwan,Cha, Jae-Kwan,Heo, Ji Hoe,Sohn, Sung-Il,Lee, Byung-Chul,Kim, Dong-Eog,Kim, Hahn Young,Kim, Seongheon,Kwon, Do-Young,Kim, Jei,Seo, Korean Stroke Society 2018 Journal of stroke Vol.20 No.2

        <P><B>Background and Purpose</B></P><P> The pathophysiology of post-stroke depression (PSD) is complex and may differ according to an individual’s mood immediately after stroke. Here, we compared the therapeutic response and clinical characteristics of PSD at a later stage between patients with and without depression immediately after stroke. </P><P><B>Methods</B></P><P> This study involved a <I>post hoc</I> analysis of data from EMOTION (ClinicalTrials.gov NCT01278498), a placebo-controlled, double-blind trial that examined the efficacy of escitalopram (10 mg/day) on PSD and other emotional disturbances among 478 patients with acute stroke. Participants were classified into the Baseline-Blue (patients with baseline depression at the time of randomization, defined per the Montgomery-Asberg Depression Rating Scale [MADRS] ≥8) or the Baseline-Pink groups (patients without baseline depression). We compared the efficacy of escitalopram and predictors of 3-month PSD (MADRS ≥8) between these groups. </P><P><B>Results</B></P><P> There were 203 Baseline-Pink and 275 Baseline-Blue patients. The efficacy of escitalopram in reducing PSD risk was more pronounced in the Baseline-Pink than in the Baseline-Blue group (<I>p</I> for interaction=0.058). Several risk factors differentially affected PSD development based on the presence of baseline depression (<I>p</I> for interaction <0.10). Cognitive dysfunction was an independent predictor of PSD in the Baseline-Blue, but not in the Baseline-Pink group, whereas the non-use of escitalopram and being female were more strongly associated with PSD in the Baseline-Pink group. </P><P><B>Conclusions</B></P><P> Responses to escitalopram and predictors of PSD 3 months following stroke differed based on the presence of baseline depression. Our data suggest that PSD pathophysiology is heterogeneous; therefore, different therapeutic strategies may be needed to prevent PSD emergence following stroke.</P>

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