양극성 장애 환자에서 한국어판 Bipolar Spectrum Diagnostic Scale의 타당성 연구

왕희령,김상억,강시현,주연호,김창윤 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.6

본 연구는 한국어판 BSDS의 민감도와 특이도, 최적의 절단값을 조사하기 위해 시행되었다. SCID를 사용하여 DSM-IV에 의거하여 진단된 양극성 장애 및 주요우울장애 환자들을 대상으로 본 연구를 시행하였고, 가장 적절한 절단값은 10점, 이 때의 특이도, 민감도는 각각 0.85, 0.73 수준으로 나왔다. 본 연구 결과를 통해, 한국어판 BSDS는 양극성 장애에 선별에 있어서 높은 민감도와 특이도를 지닌 타당성 있는 자가보고형 선별도구임이 밝혀졌다. Objectives : Because bipolar spectrum disorders frequently go unrecognized in clinical practice, sensitive screening tools for bipolar spectrum disorders are much needed. This study was conducted to confirm the validity of the Korean version of the Bipolar Spectrum Diagnostic Scale (BSDS), which was originally designed by Ronald Pies. Methods : The BSDS, which was translated into Korean by the authors, was dministered to patients with known bipolar disorders (N=60) and unipolar depressive disorders (N=27). Using various cut-off scores, we calculated the sensitivities and specificities of the Korean version of the BSDS in order to determine the optimal cut-off score. Results : In this study,a cut-off score of 10 was shown to be optima1, with a sensitivity of 0.73 and a specificity of 0.85, although a cut-off score of 13 was proposed to be optima1 by the original authors of the BSDS. Conclusion : These results indicate that the Korean version of the BSDS is a valid screening tool for bipolar spectrum disorder.

소아 간질 아동 어머니의 양육 스트레스 및 부모효능감

박수빈,유한익,전정원,최순호,왕희령,김건우,김진용,고태성 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.6

Objectives : While parents who foster children with epilepsy would have considerable parenting diSiculties, the parenting stress and sense of competence have not been investigated. We investigated matemal parenting stress, Parenting satisfaction and sense of parenting competence in children with seizure disorders, and the associations with seizure-related variables. Methods : Mothers of 79 children with seizure disorders (41 boys, 38 girls ; mean age, 9.9±2.3 years) and 79 healthy comparison subjects matched for age and sex were recruited for this study. The Korean version of the Parenting Stress Index (K-PSI-SF) and the Parenting Sense of Competence (K-PSOC) were used to assess parenting stress, parenting satisfaction and parenting effcacy. Results : Mothers of children with seizure disorders showed higher scores on stress related to difficult child and child leaming and parenting anxiety compared to mothers of healthy children. In addition, scores on stress related to parental-child interaction and child leaming were significantly associated with parental economic status. Scores on stress from parental-child interaction was also correlated with seizure severity, and stress from child leaming was correlated with seizure type. Sense of parenting competence and anxiety scores were correlated with patemal educational status, respectively. Conclusion : These fndings suggest that mothers of children with epilepsy have greater parenting stress and anxiety and social and seizure-associated factors may affect the parenting stress and anxiety.

중추신경자극제를 사용할 수 없는 주의력결핍과잉행동장애 아동에서의 Modafinil 효과 : 예비 연구

유한익,김진용,박수진,전정원,왕희령,김붕년,홍진표,김성윤,김창윤 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6

Objectives : This study was aimed to examine the efficacy and safety of modafinil in psychostimulant-inapplicable children with attention deficit hyperactivity disorder (ADHD) due to insufficient treatment response or intolerable adverse effects. Methods : Fifteen children (8.8±1.8 years, 14 boys, total IQ 107.22±13.4) were recruited for this study. ADHD was confirmed by K-SADS-PL. The efficacy was assessed by ADHD rating scale (ADHDRS), Conner's parental rating scale-revised(CPRS-R), ADHDRS school version, clinical global impression (CGI) and computerized neurocognitive function test. Mean dose of modafnil was 250. 0±103.3 mg. Results : Total score (p=0.012) and hyperactive/impulsive score (p=0.021) of ADHDRS for investigator, as well as CPRS-R score (p<0.01) and CGI-severity score (p<0.01) were significantly reduced after 39.2±8.7 days of modafmil administration. Response time of word color test was also significantly decreased after medication. Decreased appetite (2 subjects), insomnia (2 subjects), irritability (1 subject) and alopecia (1 subject) were observed during this study period. Conclusion : Modafinil was effective and well-tolerated for the psychostimulant-inapplicable children with ADHD.

Can Atypical Antipsychotic Augmentation Reduce Subsequent Treatment Failure More Effectively Among Depressed Patients with a Higher Degree of Treatment Resistance? A Meta-Analysis of Randomized Controlled Trials

Wang, Hee Ryung,Woo, Young Sup,Ahn, Hyeong Sik,Ahn, Il Min,Kim, Hyun Jung,Bahk, Won-Myong Oxford University Press 2015 International Journal of Neuropsychopharmacology Vol.18 No.8

<P><B>Background:</B></P><P>Atypical antipsychotic augmentation was demonstrated to be efficacious in treatment-resistant depression (TRD) in previous meta-analyses. We investigate whether there are differences in the effect size of atypical antipsychotic augmentation in major depressive disorder according to the degree of treatment resistance.</P><P><B>Methods:</B></P><P>A comprehensive search of four databases identified 11 randomized controlled trials. The 11 trials, which included 3 341 participants, were pooled using a random-effects meta-analysis.</P><P><B>Results:</B></P><P>Atypical antipsychotic augmentation of antidepressant therapy showed superior efficacy compared to antidepressant monotherapy in TRD in terms of both response and remission rates (response, risk ratio [RR] = 1.38, 95% confidence interval [CI] = 1.25 to 1.53; remission, RR = 1.62, 95% CI = 1.42 to 1.85). In addition, regarding response rates in the TRD trials, atypical antipsychotic augmentation exhibited significantly different effect sizes according to the degree of treatment resistance (TRD 1: RR = 1.24; TRD 2: RR = 1.37; TRD 2–4: RR = 1.58). In non-TRD trials, atypical antipsychotic augmentation failed to show superior efficacy over antidepressant monotherapy in terms of remission rates (RR = 0.89; 95% CI = 0.69 to 1.14). Atypical antipsychotic augmentation of antidepressant therapy exhibits greater effect size in patients with a higher degree of treatment resistance.</P><P><B>Conclusions:</B></P><P>This finding strengthens the rationale for considering atypical antipsychotic augmentation among depressed patients with multiple previous treatment failures in clinical practice. The efficacy of atypical antipsychotic augmentation for non-TRD seems to be different from that for TRD and, thus, further studies of non-TRD populations are needed.</P>

The Influence of Current Mood States on Screening Accuracy of the Mood Disorder Questionnaire

Hee Ryung Wang,박원명,윤보현,Moon Doo Kim,Young-Eun Jung,Kyung Joon Min,홍정완,우영섭 대한정신약물학회 2020 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.18 No.1

Objective: In this study we investigated whether current mood states of patients with bipolar disorder have an influence on the screening accuracy of the Mood Disorder Questionnaire (MDQ). Methods: A total of 452 patients with mood disorder (including 192 with major depressive disorder and 260 with bipolar disorder completed the Korean version of the MDQ. Patients with bipolar disorder were subdivided into three groups (bipolar depressed only, bipolar euthymic only, bipolar manic/hypomanic only) according to current mood states. The screening accuracy of the MDQ including sensitivity, specificity and area under the curve (AUC) of receiver operating characteristic (ROC) curves were evaluated according to current mood states. Results: The optimal cutoff of MDQ was 5 in this study sample. Sensitivity and specificity were not significantly different according to current mood states. Significant differences in AUCs of four independent ROC curves were not found (ROC 1st curve included all bipolar patients; ROC 2nd curve included only bipolar depressed patients; ROC 3rd curve included only bipolar manic/hypomanic patients; ROC 4th curve included only bipolar euthymic patients). Conclusion: The study results showed that current mood states (either euthymic state, depressed or manic/hypomanic) did not significantly influence the screening accuracy of the MDQ suggesting that the MDQ could be a useful screening instrument for detecting bipolar disorder in clinical practice regardless of the current mood symptoms of subjects.

Korean Medication Algorithm for Depressive Disorder: Comparisons with Other Treatment Guidelines

Hee Ryung Wang,Won-Myong Bahk,Jeong Seok Seo,Young Sup Woo,Young-Min Park,Jong Hyun Jeong,Won Kim,Se-Hoon Shim,Jung Goo Lee,Duk-In Jon,Kyung Joon Min 대한정신약물학회 2017 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.15 No.3

In this review, we compared recommendations from the Korean Medication Algorithm Project for Depressive Disorder 2017 (KMAP-DD 2017) to other global treatment guidelines for depression. Six global treatment guidelines were reviewed; among the six, 4 were evidence-based guidelines, 1 was an expert consensus-based guideline, and 1 was an amalgamation of both evidence and expert consensus-based recommendations. The recommendations in the KMAP-DD 2017 were generally similar to those in other global treatment guidelines, although there were some differences between the guidelines. The KMAP-DD 2017 appeared to reflect current changes in the psychopharmacology of depression quite well, like other recently published evidence- based guidelines. As an expert consensus-based guideline, the KMAP-DD 2017 had some limitations. However, considering there are situations in which clinical evidence cannot be drawn from planned clinical trials, the KMAP-DD 2017 may be helpful for Korean psychiatrists making decisions in the clinical settings by complementing previously published evidence-based guidelines.

Prevalence and correlates of comorbid depression in a nonclinical online sample with DSM-5 internet gaming disorder

Wang, Hee Ryung,Cho, Hyun,Kim, Dai-Jin Elsevier 2018 Journal of affective disorders Vol.226 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>We investigated the prevalence and correlates of comorbid depression among patients with internet gaming disorder using the Internet Gaming Disorder scale (IGD-9) and the Patient Health Questionnaire-9 (PHQ-9) among nonclinical online survey respondents.</P> <P><B>Methods</B></P> <P>Korean adolescents and adults from 14 to 39 years of age were selected. We compared internet gaming use patterns and sociodemographic and clinical variables between patients with internet gaming disorder who had depression and those without depression.</P> <P><B>Results</B></P> <P>In 2016, 7200 people participated in an online survey. Respondents with internet gaming disorder that was comorbid with depression were older, more often female, had greater Internet Addiction Test total scores, Alcohol Use Disorder Identification Test total scores, Generalized Anxiety Disorder Scale-7 total scores, Fagerstrom Test for Nicotine Dependence total scores, and higher Dickman Dysfunctional Impulsivity Instrument dysfunctional subscale scores than those without depression. The binary logistic regression analysis revealed that female gender, problematic alcohol use, anxiety, and a past history of psychiatric counseling or treatment due to internet gaming use were significant predictors for comorbid depression among participants with internet gaming disorder.</P> <P><B>Conclusion</B></P> <P>Depression was a common comorbidity of internet gaming disorder. Internet gaming disorder with comorbid depression was related to more serious psychiatric phenomenology and a greater psychiatric burden.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Depression is a common comorbid condition among patients with IGD. </LI> <LI> The comorbid condition is associated with serious clinical phenomenology. </LI> <LI> Co-administration of IGD-9 and PHQ-9 is useful in screening comorbid condition. </LI> </UL> </P>

Predictors of a Shorter Time to Hospitalization in Patients with Bipolar Disorder: Medication during the Acute and Maintenance Phases and Other Clinical Factors

In Hee Shim,Young Sup Woo,Hee Ryung Wang,Won-Myong Bahk 대한정신약물학회 2017 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.15 No.3

Objective: The present study was conducted to compare the effects of pharmacological treatments during the acute and maintenance phases of mood episodes, sociodemographic, and clinical characteristics between a shorter time to hospitalization group (<12 months) and a longer time to hospitalization group (≥12 months). Methods: The discharge medication for the first hospitalization was considered the acute treatment and the medication used during the week prior to the second hospitalization at the outpatient clinic was considered the maintenance treatment. Additionally, the charts were reviewed to examine a variety of demographic and clinical characteristics. Results: Patients in the shorter time to hospitalization group were more likely to be unmarried and/or unemployed, have had a previous hospital admission for a mood episode, and have used antidepressant during the acute phase than those in the longer time to hospitalization group. Patients in the shorter time to hospitalization group were also less likely to use olanzapine, serotonin-norepinephrine reuptake inhibitors, or mood stabilizer monotherapy as a maintenance treatment than were patients in the longer time to hospitalization group. Conclusion: Predictors for shorter time to hospitalization were associated with number of previous hospital admissions for a mood episode, being unmarried and/or unemployed, and antidepressant use during the acute phase.

Orthosteric and allosteric action of the C5a receptor antagonists

Liu, Heng,Kim, Hee Ryung,Deepak, R. N. V. Krishna,Wang, Lei,Chung, Ka Young,Fan, Hao,Wei, Zhiyi,Zhang, Cheng Nature Publishing Group 2018 Nature Structural and Molecular Biology Vol. No.

Prevalence, correlates, comorbidities, and suicidal tendencies of premenstrual dysphoric disorder in a nationwide sample of Korean women.

Hong, Jin Pyo,Park, Subin,Wang, Hee-Ryung,Chang, Sung Man,Sohn, Jee Hoon,Jeon, Hong Jin,Lee, Hae Woo,Cho, Seong-Jin,Kim, Byung-Soo,Bae, Jae Nam,Cho, Maeng Je Springer International 2012 Social psychiatry and psychiatric epidemiology Vol.47 No.12

<P>We examined the prevalence, correlates, comorbidities, and suicidal tendencies of premenstrual dysphoric disorder (PMDD) according to the DSM-IV criteria in a nationwide sample of Korean women.</P>