한국형 우울장애 약물치료 알고리듬 2006 (Ⅲ) : 정신병적 양상을 동반한 주요우울삽화

김원,박원명,서정석,민경준,석정호,전덕인,전현태,이상열,송해철,홍진표,한국형 우울장애 약물치료 알고리듬 2006 연구그룹 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : Since the publication of Korean Medication Algorithm Project for Major DepressiveDisorder (KMAP-MD) in 2002, there has been a substantial need for a revision due to rapid progress in the pharmacological management of depressive disorder. We revised KMAP-MD 2002 and developed the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) 2006. Methods : We developed a questionniare for surveying the opinion of experts on pharmacotherapy of depressive disorder. The questionnaire consisted of 4 parts ; 1) treatment of non-psychotic depressive disorder, 2) treatment of psychotic de-pressive disorder, 3) treatment according to clinical subtypes and drugs choice considering adverse effects, and 4) treatment of depressive disorder in women. The questionnaire was completed by the review committee consisting of 101 experienced Korean psychiatrists. It is composed of 22 questions, and each question includes 54 sub-items. We classified the expert opinionto 3 categories (the first-line, the second-line, or the third-line) by χ²-test. Results : For depressive disorder with psychotic features, most reviewers prefer the combination of antidepressant and atypical antipsychotics. Electroconvulsive therapy and the combination of antidepressant and typical antipsychotics were the second-line treatment. Among antidepressants, venlafaxine was the most preferred, and SSRI and mirtazapine followed. Among atypical antipsychotics, quetiapine, risperidone and olanzapine were the most preferred, in this order. In patients who have no response to the first-line treatment, many reviewers recommended switching to another antidepressant or adding another atypical antipsychotics Conclusion : For severe depressive disorder with psychotic features, the combination of antidepressant and atypical antipsy-chotics was preferred for the first-line treatment. These results suggest that the medication strategies of depressive disorder are rapidly changing and reflects the recent studies and clinical experiences.

한국형 우울장애 약물치료 알고리듬 2006 (Ⅰ)

서정석,민경준,김원,석정호,박원명,송해철,이상열,전덕인,전현태,홍진표,한국형 우울장애 약물치료 알고리듬 2006 연구그룹 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.5

Objectives : Since the publication of Korean Medication Algorithm Project for Major depressive Disorder (KMAP-MD) in 2002, there has been a substantial need for a revision due to rapid progress in the pharmacological management for depressive disorder. We revised KMAP-MD to Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) in 2006. This paper is one of the following 4 papers consisting of Korean pharmacological algorithm for depressive disorder. Methods : The questionnaire consisted of 4 parts ; initial treatment of 1) non-psychotic depressive disorder, 2) psychotic depressive disorder, 3) treatment strategy for clinical subtypes and drug choice considering adverse effects, and 4) treatment for depressive disorder in women. It was composed of 22 questions, and each question had 54 sub-items. The questionnaire was completed by the review committee consisting of 101 experienced Korean psychiatrists. We classified the expert opinion to 3 categories (the first-line, the second-line, or the third-line). Results : For non-psychotic major depression, regardless ofthe severity of an episode, the antidepressant (AD) monotherapy was the optimal first-line treatment. SSRI, venlafaxine, and mirtazapine were the 1st-line AD. In case of a partial or no response to initial strategy, adding another AD was recommended. For psychotic major depression, combination of an AD and an atypical antipsychotic (AAP) was the treatment of choice. Among AAPs, quetiapine, rispendone, olanzapine were preferred. For non-responder to initial strategy, the next step was adding or changing AD before changing AAP. For women with premenstrual dysphoric syndrome or postpartum depression without psychotic features, AD monotherapty was a preferred strategy while for psychotic postpartum depression, combination of AD and AAP was recommended. Experts recommended various ADs according to adverse effect. Conclusion : These results suggest that the medication strategies for depressive disorder are rapidly changing and reflect the recent studies and clinical experiences.

The Development of the Korean Medication Algorithm for Major Depressive Disorder

MinSoo Lee,SeWon Lim,JiHyun Cha,SangKeun Chung,KwangSu Kim,Siegfried Kasper,the Executive Committee for the Korean Medication Algorithm Project for Major Depressive Disorder 대한신경정신의학회 2005 PSYCHIATRY INVESTIGATION Vol.2 No.2

There are many differences in the biological characteristics, clinical situations, and medical insurance systems between ethnic groups or countries. Consequently, there is a need for a specific Korean algorithm for the treatment of major depressive disorder. Therefore, the Korean society of depressive and bipolar disorder decided to develop the Korean Medication Algorithm for Major Depressive Disorder (KMA-MDD). The Korean Medication Algorithm Project for Major Depressive Disorder (KMAP-MDD) was designed with the goal of developing: 1) ideal algorithm, 2) Korean algorithm, 3) medication algorithm, 4) evidence-based and formal consensus algorithm. After collecting and reviewing many articles and reports by the evidence-based rule, we constructed a survey questionnaire designed to obtain the formal consensus of Korean experts. By employing panels of experts to review the collected evidences and survey results thoroughly, we used evidence based algorithm development as a component of the formal consensus development process. The KMA-MDD consists of two algorithms: one for major depressive disorder without psychotic features and the other for major depressive disorder with psychotic features. Clinical guidelines for the implementation of KMA-MDD were also developed. The KMA-MDD provides specific treatment strategies for each stage. The KMA-MDD is the first Korean algorithm for the treatment of major depressive disorder. It is based on evidence supporting the efficacy of each treatment modality and has obtained the consensus of Korean experts. We hope that the KMAMDD will be a good practical tool for clinicians who treat major depressive disorder in Korea.

한국형 우울장애 약물치료 알고리듬 (Ⅳ) : 우울장애의 아형 및 부작용에 따른 항우울제의 선택과 여성우울장애에서의 치료전략

전현태,이상열,김원,민경준,박원명,서정석,석정호,송해철,전덕인,홍진표,한국형 우울장애 약물치료 알고리듬 2006 연구그룹 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : In 2002, the Korean Medication Algorithm Project for Major depressive Disorder (KMAP-MD) was published, but there has been a need for a guideline about detailed issues of depressive disorder. We revised KMAP-MDD andreestablished Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) in 2006. Methods : A questionnaire had been developed by the executive committee for KMAP-DD. The review committee consisted of 101 experienced psychiatrists. From the total of 22 questions in the questionnaire, 7 questions were evaluated for these subjects . We classified the expert opinions to 3 categories according to its confidence interval; first, second and third line. Results : SSRI and venlafaxine were the first line antidepressants (AD) for atypical and melancholic depression. For dysthymic disorder and minor depressive disorder, SSRI was recommended as the first line medications. Only AD medications was a preferred initial strategy for treating premenstrual dysphoric disorder, mild to moderate and severe non-psychotic postpartum depression. In severe psychotic postpartum depression, combination therapy of AD and atypical antipsychotics was the treatment of choice. SSRI was preferred when considering sedation, anticholinergic and cardiovascular adverse effects. Also, experts recommended mirtazapine against gastrointestinal adverse effects and bupropion in avoiding sexual dysfunction. Conclusion : These results suggest that clinicians have to consider both clinical situations and drug adverse effects in the choice of antidepressant medications.

한국형 중독 치료지침서(Ⅲ) : 알코올 사용장애의 정신사회 치료

Korean Addiction Treatment Guidelines (III),Psychosocial Treatment of Alcohol Use Disorder 대한신경정신의학회 2014 신경정신의학 Vol.53 No.4

ObjectivesZZThe aim of this study is to develop guidelines for psychosocial treatment of alcohol use disorder. MethodsZZAccording to the ADAPTE manual, the Korean alcohol use disorder treatment guidelines were developed by the guideline development committee. Recommendations from foreign guidelines were evaluated regarding the applicability and acceptability to domestic circumstances. In addition, a survey from experts was conducted, along with a review of Korean literature. By these means, recommendations of psychosocial treatment for alcohol use disorder were established. ResultsZZThe main findings of the survey were as follows : 1) Although Group therapy was not recommended by foreign clinical guidelines, it was considered as a first-line treatment by Korean experts. 2) Among many psychosocial treatment programs, cognitive behavior therapy (CBT), coping skills training, 12-step facilitation, and Group therapy were commonly used programs in Korea. Finally, the following treatment methods were selected for recommendations : Group therapy, motivational enhancement treatment, CBT, behavioral self-management, alcoholic anonymous, 12-step facilitation, psychodynamic psychotherapy, psychoeducational intervention, continuous case management, and community residential rehabilitation program. ConclusionZZJust as in treatment of chronic diseases such as hypertension, continuity is important for management of alcohol use disorder. Therefore, not only pharmacological treatment but also psychosocial treatment should be provided comprehensively after treatment of acute withdrawal symptoms

Epidemiological Study of Hereditary Hemolytic Anemia in the Korean Pediatric Population during 1997–2016: a Nationwide Retrospective Cohort Study

심예지,정혜림,신희영,강형진,Jung Yoon Choi,하정옥,이제민,임영탁,양의진,백희조,최형수,유건희,박준은,김성구,김지윤,박은실,임호준,최희원,김순기,이재희,유은선,Park Hyeon Jin,Lee Jun Ah,Park Meerim,강현식,박지경,이나희,박상규,이영호,이성욱,Eun Jin Choi,공섬김,Red Blood Cell Disorder Wo 대한의학회 2020 Journal of Korean medical science Vol.35 No.33

Background: Hereditary hemolytic anemia (HHA) is a rare disease characterized by premature red blood cell (RBC) destruction due to intrinsic RBC defects. The RBC Disorder Working Party of the Korean Society of Hematology established and updated the standard operating procedure for making an accurate diagnosis of HHA since 2007. The aim of this study was to investigate a nationwide epidemiology of Korean HHA. Methods: We collected the data of a newly diagnosed pediatric HHA cohort (2007–2016) and compared this cohort's characteristics with those of a previously surveyed pediatric HHA cohort (1997–2006) in Korea. Each participant's information was retrospectively collected by a questionnaire survey. Results: A total of 369 children with HHA from 38 hospitals distributed in 16 of 17 districts of Korea were investigated. RBC membranopathies, hemoglobinopathies, RBC enzymopathies, and unknown etiologies accounted for 263 (71.3%), 59 (16.0%), 23 (6.2%), and 24 (6.5%) of the cases, respectively. Compared to the cohort from the previous decade, the proportions of hemoglobinopathies and RBC enzymopathies significantly increased (P < 0.001 and P = 0.008, respectively). Twenty-three of the 59 hemoglobinopathy patients had immigrant mothers, mostly from South-East Asia. Conclusion: In Korea, thalassemia traits have increased over the past 10 years, reflecting both increased awareness of this disease and increased international marriages. The enhanced recognition of RBC enzymopathies is due to advances in diagnostic technique; however, 6.5% of HHA patients still do not have a clear diagnosis. It is necessary to improve accessibility of diagnosing HHA.

Korean clinical practice guidelines for the diagnosis of hereditary hemolytic anemia

최희원,Sang Mee Hwang,Ye Jee Shim,Jae Min Lee,Hee Sue Park,Joon Hee Lee,Youngwon Nam,김남희,Hye Lim Jung,Hyoung Soo Choi,on behalf of Korean RBC Disorder Working Party 대한혈액학회 2022 Blood Research Vol.57 No.2

Although the prevalence of hereditary hemolytic anemia (HHA) is relatively low in Korea, it has been gradually increasing in recent decades due to increment in the proportions of hemoglobinopathies from immigrants of South East Asia, raising awareness of the disease among clinicians, and advances in diagnostic technology. As such, the red blood cell (RBC) Disorder Working Party (WP), previously called HHA WP, of the Korean Society of Hematology (KSH) developed the Korean Standard Operating Procedures (SOPs) for the diagnosis of HHA in 2007. These SOPs have been continuously revised and updated following advances in diagnostic technology [e.g., flow cytometric osmotic fragility test (FOFT) and eosin-5-maleimide (EMA) binding test], current methods for membrane protein or enzyme analysis [e.g., liquid chromatography-tandem mass spectrometry (LC-MS/MS), ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), high-performance liquid chromatography (HPLC)], and molecular genetic tests using next-generation sequencing (NGS). However, the diagnosis and treatment of HHA remain challenging as they require considerable experience and understanding of the disease. Therefore, in this new Korean Clinical Practice Guidelines for the Diagnosis of HHA, on behalf of the RBC Disorder WP of KSH, updated guidelines to approach patients suspected of HHA are summarized. NGS is proposed to perform prior to membrane protein or enzyme analysis by LC-MS/MS, UPLC-MS/MS or HPLC techniques due to the availability of gene testing in more laboratories in Korea. We hope that this guideline will be helpful for clinicians in making diagnostic decisions for patients with HHA in Korea.

Review of Cohort Studies for Mood Disorders

Hong Jin Jeon,Ji Hyun Baek,Yong Min Ahn,김세주,Tae Hyun Ha,Bo-Seok Cha,Eun Soo Moon,강희주,Vin Ryu,조철현,Jung-Yoon Heo,Ki-Won Kim,Heon-Jeong Lee,Mood Disorders Cohort Research Consortium 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.3

This paper aimed to review currently available cohort studies of subjects with mood disorders such as major depressive disorder (MDD) and bipolar disorder (BD). Using the PubMed and KoreaMed databases, we reviewed eight major cohort studies. Most studies recruited participants with MDD and BD separately, so direct comparison of factors associated with diagnostic changes was difficult. Regular and frequent follow-up evaluations utilizing objective mood ratings and standardized evaluation methods in a naturalistic fashion are necessary to determine detailed clinical courses of mood disorders. Further, biological samples should also be collected to incorporate clinical findings in the development of new diagnostic and therapeutic approaches. An innovative cohort study that can serve as a platform for translational research for treatment and prevention of mood disorders is critical in determining clinical, psychosocial, neurobiological and genetic factors associated with long-term courses and consequences of mood disorders in Korean patients.