Effect of Korean Red Ginseng in individuals exposed to high stress levels: a 6-week, double-blind, randomized, placebo-controlled trial

백지현,허정윤,Maurizio Fava,David Mischoulon,최관우,나은진,조하나,전홍진 고려인삼학회 2019 Journal of Ginseng Research Vol.43 No.3

Background: To investigate the neurobiological evidence supporting the adaptogenic effects of KoreanRed Ginseng in reducing the harmful consequences of stress using a double-blind, placebo-controlledtrial. Method: Sixty-three subjects with high stress levels were randomized to receive an orally administered,double-blind, 6-week treatment with Korean Red Ginseng (n ¼ 32) or placebo (n ¼ 31). All participantsunderwent a comprehensive psychological evaluation using Beck Depression Inventory and StressResponse Inventory, cognitive evaluation using the continuous performance test, biological evaluation bymeasuring blood levels of lipids, catecholamines, inflammation markers, and heart rate variability atbaseline and after 6 weeks. Results: At baseline, both groups showed no significant differences in age, sex, years of education, BeckDepression Inventory, and Stress Response Inventory. After 6 weeks, triglyceride levels were significantlyincreased within the normal limit in the Korean Red Ginseng group (F ¼ 4.11, p ¼ 0.048), and theepinephrine level was decreased in this group (F ¼ 4,35, p ¼ 0.043). The triglyceride increase wassignificantly associated with epinephrine decrease (B ¼ 0.087, p ¼ 0.041), suggesting that Korean RedGinseng may stabilize the sympathetic nervous system. In addition, we detected a significant group bytime effect in the visually controlled continuous performance test, suggesting positive effects of KoreanRed Ginseng on cognition. Conclusion: Korean Red Ginseng might help to stabilize the sympathetic nervous system and improvecognition in individuals with high stress.

Review of Suicide Prevention Programs: Massachusetts, United States, in Comparison with Seoul

백지현,박종익,안정훈,노성원,허정윤,Maurizio Fava,David Mischoulon,전홍진 대한신경정신의학회 2015 PSYCHIATRY INVESTIGATION Vol.12 No.3

Suicide is a tragedy that has massive impact on society. In order to prevent suicide, active government intervention is necessary. The suicide rate in Seoul is rapidly increasing and is more than five times higher than that in the state of Massachusetts (MA) during the last decade, especially in the elderly. The suicide prevention program of MA is one of the most effective suicide prevention programs in the United States. The program views suicide as a preventable public health problem, and emphasizes treatment of depression and de-stigmatization of mental health illnesses to prevent suicide. Also, through active collaboration with mental health professionals, they try to identify atrisk populations and help them to get medical interventions. The program also actively collaborates with the regional coalition program and the Samaritans in taking care of the elderly, and supports the elderly in feeling worthwhile after retirement by helping them to work for communities as volunteers. For its part, the Seoul suicide prevention program puts more emphasis on “life respect culture” and “emotional support to high risk individuals by regular visiting”. The annual budget of the Seoul suicide prevention program is one-quarter and that for mental health is about one-twentieth that of MA. Considering the high suicide rate and lower mental health service usage in Seoul, it is crucial to raise awareness of depression and decrease the stigma on mental illnesses. Furthermore, educational efforts with long-term investment in research on suicide are necessary.

Celebrity Suicides and Their Differential Influence on Suicides in the General Population: A National Population-Based Study in Korea

Woojae Myung,HongHee Won,Maurizio Fava,David Mischoulon,Albert Yeung,Dongsoo Lee,DohKwan Kim,HongJin Jeon 대한신경정신의학회 2015 PSYCHIATRY INVESTIGATION Vol.12 No.2

Objective-Although evidence suggests that there is an increase in suicide rates in the general population following celebrity suicide, the rates are heterogeneous across celebrities and countries. It is unclear which is the more vulnerable population according to the effect sizes of celebrity suicides to general population. Methods-All suicide victims in the general population verified by the Korea National Statistical Office and suicides of celebrity in South Korea were included for 7 years from 2005 to 2011. Effect sizes were estimated by comparing rates of suicide in the population one month before and after each celebrity suicide. The associations between suicide victims and celebrities were examined. Results-Among 94,845 suicide victims, 17,209 completed suicide within one month after 13 celebrity suicides. Multivariate logistic regression analyses revealed that suicide victims who died after celebrity suicide were significantly likely to be of age 20–39, female, and to die by hanging. These qualities were more strongly associated among those who followed celebrity suicide with intermediate and high effect sizes than lower. Younger suicide victims were significantly associated with higher effect size, female gender, white collar employment, unmarried status, higher education, death by hanging, and night-time death. Characteristics of celebrities were significantly associated with those of general population in hanging method and gender. Conclusion-Individuals who commit suicide after a celebrity suicide are likely to be younger, female, and prefer hanging as method of suicide, which are more strongly associated in higher effect sizes of celebrity suicide.

Gender Differences in Somatic Symptoms and Current Suicidal Risk in Outpatients with Major Depressive Disorder

전홍진,우종민,김효진,Maurizio Fava,David Mischoulon,조성진,장성만,박두흠,김종우,유익기,허정윤,홍진표 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.6

ObjectiveaaAlthough somatic symptoms are common complaints of patients with major depressive disorder (MDD), their associations with suicide are still unclear. MethodsaaA total of 811 MDD outpatients of aged between 18 to 64 years were enrolled nationwide in Korea with the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and the Depression and Somatic Symptom Scale (DSSS). ResultsaaOn stepwise regression analysis, current suicidality scores were most strongly associated with chest pain in men, and neck or shoulder pain in women. Severe chest pain was associated with higher current suicidality scores in men than in women, whereas severe neck or shoulder pain showed no significant differences between the genders. In conclusion, MDD patients of both sexes with suicidal ideation showed significantly more frequent and severe somatic symptoms than those without. Current suicidal risk was associated with chest pain in men, and neck or shoulder pain in women. ConclusionaaWe suggest that clinicians pay attention to patients’ somatic symptoms in real world practice.

Reduced Venous Blood Basophil Count and Anxious Depression in Patients with Major Depressive Disorder

백지현,Hee-Jin Kim,Maurizio Fava,David Mischoulon,George I Papakostas,Andrew Nierenberg,Jung-Yoon Heo,Hong Jin Jeon 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.3

ObjectiveaaAnxious depression has a distinct neurobiology, clinical course and treatment response from non-anxious depression. Role of inflammation in anxious depression has not been examined. As an exploratory study to characterize the role of inflammation on a development of anxious depression, we aimed to determine the relationship between white blood cell (WBC) subset counts and anxiety in individuals with major depressive disorder (MDD). MethodsaaA total of 709 patients who were newly diagnosed with MDD were recruited. Anxiety levels of participants were evaluated using the Anxiety/ Somatization subitem of the Hamilton Depression Rating Scale. The association between WBC subset fraction and anxiety was evaluated. ResultsaaBasophil and eosinophil sub-fractions showed significant negative correlations with HAM-D anxiety/somatization factor scores (basophils: r=-0.092, p=0.014 and eosinophils: r=-0.075, p=0.046). When an anxiety score (a sum of somatic and psychic anxiety) was entered as a dependent variable, only basophils showed significant negative association with the anxiety scores after adjusting for all other WBC subset counts and demographic factors (t=-2.57, p=0.010). ConclusionaaThis study showed that anxious depression had a decreased basophil subfraction, which might be associated with involvement of inflammation in development of anxious depression.

Comparisons of Subthreshold Versus Full Posttraumatic Stress Disorder Distinguished by Subjective Functional Impairment Among Train Drivers: A Population-Based Nationwide Study in South Korea

백지현,김지혜,김빛나,박승진,Maurizio Fava,David Mischoulon,이동수,전홍진 대한신경정신의학회 2017 PSYCHIATRY INVESTIGATION Vol.14 No.1

Objective: Subthreshold posttraumatic stress disorder (SPTSD), a condition that meets the full symptomatic criteria of posttraumatic stress disorder (PTSD) without subjective functional impairment, has yet to be fully investigated. In this study, we aimed to determine the prevalence and characteristics of SPTSD. Methods: The web-based survey including psychiatric diagnosis and experience of human error was conducted in actively working train drivers in South Korea. Results: Of the 4,634 subjects, 103 (2.23%) were categorized as full PTSD and 322 (6.96%) were categorized as having SPTSD. Individuals with full PTSD showed higher impulsivity and anxiety compared to those with SPTSD and those without PTSD, while those with SPTSD had more frequent clinically meaningful depression, posttraumatic stress, and alcohol and nicotine dependence and significant human error. Conclusion: Despite not qualifying as a subjective functional disability, SPTSD still had significant psychiatric symptoms. More clinical attentions need to be given to the diagnosis and treatment of SPTSD.

Agoraphobia and Follicle-Stimulating Hormone Levels between Tamoxifen and Goserelin versus Tamoxifen Alone in Premenopausal Hormone Receptor-Positive Breast Cancer: A 12-Month Prospective Randomized Study

JungYoon Heo,Hawoo Yi,Maurizio Fava,David Mischoulon,Kiwon Kim,Sechang Yoon,HongJin Jeon,JeongEon Lee 대한신경정신의학회 2017 PSYCHIATRY INVESTIGATION Vol.14 No.4

Objective-Tamoxifen is an estrogen receptor antagonist used to prevent recurrence of breast cancer, which may provoke depression and anxiety and increase follicle-stimulating hormone (FSH) to patients. We compared anxiety and depression symptoms and FSH levels who received conventional tamoxifen alone and combination treatment of goserelin, a gonadotropin-releasing hormone (GnRH) analogue, with tamoxifen. Methods-Sixty-four premenopausal women with hormone receptor-positive early-stage breast cancer were included and were assigned randomly to receive either tamoxifen and goserelin combination or tamoxifen alone for 12 months. The participants were evaluated blindly using the Hamilton Depression and Anxiety Rating Scale, the Beck Depression Rating Scale, and the Albany Panic and Phobia Questionnaire (APPQ). Blood FSH levels were assessed at baseline, 6 and 12 months. Results-A significant time×group difference was detected in the agoraphobia trends subscale of the APPQ and in FSH levels. The combination group showed significantly less increases in agoraphobia subscale of APPQ and greater decreases in FSH level than those in the tamoxifen-alone group from baseline to 12 months of treatment. No significant differences for age, tumor grade, body mass index, or family history were found at baseline between the two groups. Conclusion-Our results suggest that the combination treatment of tamoxifen and goserelin resulted in less agoraphobia than tamoxifen alone in premenopausal women with breast cancer, which may associated with FSH suppression of goserelin.

Psychomotor symptoms and treatment outcomes of ziprasidone monotherapy in patients with major depressive disorder: a 12-week, randomized, double-blind, placebo-controlled, sequential parallel comparison trial.

Jeon, Hong Jin,Fava, Maurizio,Mischoulon, David,Baer, Lee,Clain, Alisabet,Doorley, James,DiPierro, Moneika,Cardoos, Amber,Papakostas, George I Clinical Neuroscience Publishers 2014 International clinical psychopharmacology Vol.29 No.6

<P>The aim of this study was to evaluate efficacy of ziprasidone monotherapy for major depressive disorder (MDD) with and without psychomotor symptoms. In accordance with the sequential parallel comparison design, 106 MDD patients (age 44.010.7 years; female, 43.4%) were recruited and a post-hoc analysis was carried out on 12-week double-blind treatment with either ziprasidone (40-160 mg/day) or placebo, divided into two phases of 6 weeks each to the assigned treatment sequences, drug/drug, placebo/placebo, and placebo/drug. Psychomotor symptoms were evaluated on the basis of the Mini-International Neuropsychiatric Interview at baseline. Efficacy assessments, on the basis of the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Quick Inventory of Depressive Symptomatology Scale, Self-Rated (QIDS-SR), were performed every week throughout the trial. In phase I, ziprasidone monotherapy produced significant improvement in patients with psychomotor symptoms compared with placebo on the basis of HDRS-17 (F=5.95, P=0.017) and QIDS-SR (F=5.26, P=0.025) scores, whereas no significant changes were found in HDRS-17 (F=2.32, P=0.15) and QIDS-SR (F=3.70, P=0.074) scores in patients without psychomotor symptoms. In phase II, ziprasidone monotherapy produced no significant differences compared with placebo. In the pooled analysis, ziprasidone monotherapy showed significance according to QIDS-SR (Z=2.00, P=0.046) and a trend toward statistical significance according to the HDRS-17 (Z=1.66, P=0.10) in patients with psychomotor symptoms. Ziprasidone monotherapy may produce significant improvement compared with placebo in MDD patients with psychomotor symptoms.</P>

Childhood Trauma, Parental Death, and Their Co-occurrence in Relation to Current Suicidality Risk in Adults: A Nationwide Community Sample of Korea

Jeon, Hong Jin,Lee, Christina,Fava, Maurizio,Mischoulon, David,Shim, Eun-Jung,Heo, Jung-Yoon,Choi, Hong,Park, Jae-Hyun by Lippincott Williams Wilkins 2014 The Journal of nervous and mental disease Vol.202 No.12

ABSTRACT: Although previous studies have suggested that childhood trauma and parental death are strongly associated with suicidality in adulthood, it is still unclear how these factors interact within the same population. A total of 1396 adults were recruited through nationwide multistage probability sampling in South Korea. Subjects were evaluated through face-to-face interviews using the Suicidality Module of the Mini-International Neuropsychiatric Interview and the Early Trauma Inventory Self Report-Short Form. Among the 1396 adults, the group that experienced both childhood trauma and parental death had the highest current suicidality risks (F = 12.16, p < 0.0001) and lifetime suicide attempt (&khgr; = 35.81, p < 0.0001) compared with the other groups, which were only childhood trauma, only parental death, and neither. Multivariate logistic regression analyses revealed that middle-to-high current suicidality risk and lifetime suicide attempt were significantly associated with concurrent childhood trauma and parental death (odds ratio, 3.64; 95% confidence interval, 1.99–6.65) as well as with only childhood trauma (odds ratio, 1.95; 95% confidence interval, 1.33–2.87), after adjusting for age, sex, education, marital status, household monthly income, and living area. Emotional abuse was the only type of childhood trauma significantly associated with higher current suicidality scores in those who experienced childhood parental death than in those who did not (F = 3.26, p = 0.041). Current suicidality risk and lifetime suicide attempt are associated with experiencing both parental death and trauma, especially emotional abuse, in childhood, whereas experiencing only childhood parental death is associated with neither.

Lifetime suicidal ideation and attempt in adults with full major depressive disorder versus sustained depressed mood

Yoo, Hye Jin,Hong, Jin Pyo,Cho, Maeng Je,Fava, Maurizio,Mischoulon, David,Heo, Jung-Yoon,Kim, Kiwon,Jeon, Hong Jin Elsevier 2016 Journal of affective disorders Vol.203 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Major depressive disorder (MDD) is a well-known risk factor for suicidality, but depressed mood has been used non-specifically to describe the emotional state. We sought to compare influence of MDD versus sustained depressed mood on suicidality.</P> <P><B>Methods</B></P> <P>A total of 12,532 adults, randomly selected through the one-person-<I>per</I>-household method, completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) and a questionnaire for lifetime suicidal ideation (LSI) and lifetime suicidal attempt (LSA).</P> <P><B>Results</B></P> <P>Of 12,361 adults, 565 were assessed as ‘sustained depressed mood group’ having depressed mood for more than two weeks without MDD (4.6%), and 810 adults were assessed as having full MDD (6.55%) which consisted of ‘MDD with depressed mood group’ (6.0%) and ‘MDD without depressed mood group’ (0.5%). The MDD with depressed mood group showed higher odds ratios for LSI and LSA than the sustained depressed mood group. Contrarily, no significant differences were found in LSI and LSA between the MDD group with and without depressed mood. MDD showed significant associations with LSI (AOR=2.83, 95%CI 2.12–3.78) and LSA (AOR=2.17, 95%CI 1.34–3.52), whereas sustained depressed mood showed significant associations with neither LSI nor LSA after adjusting for MDD and other psychiatric comorbidities. Interaction effect of sustained depressed mood with MDD was significant for LSI but not for LSA.</P> <P><B>Conclusions</B></P> <P>Sustained depressed mood was not related to LSI and LSA after adjusting for psychiatric comorbidities, whereas MDD was significantly associated with both LSI and LSA regardless of the presence of sustained depressed mood.</P> <P><B>Highlights</B></P> <P> <UL> <LI> We sought to compare the influence of major depressive disorder (MDD) versus only sustained depressed mood on suicidality. </LI> <LI> MDD showed significant association with lifetime suicidal ideation (LSI) and lifetime suicide attempt (LSA), whereas sustained depressed mood showed significant association with neither LSI nor LSA. </LI> <LI> Interaction effect of sustained depressed mood with MDD was significant only for LSI. </LI> </UL> </P>