Failure to Detect Borna Disease Virus Antibody and RNA from Peripheral Blood Mononuclear Cells of Psychiatric Patients

나경세,태성호,송진원,김용구 대한신경정신의학회 2009 PSYCHIATRY INVESTIGATION Vol.6 No.4

Objective: Borna disease virus (BDV) is a highly neurotropic agent causing various neuropsychiatric symptoms in animals. Over the past two decades, it has been suggested that BDV might be associated with human psychiatric diseases. We aimed to investigate whether BDV is associated with psychiatric patients in Korea. Methods: We recruited 60 normal controls and 198 psychiatric patients (98 patients with depressive disorder, 60 with schizophrenia, and 40 with bipolar disorder). We used an indirect immunofluorescence antibody (IFA) test for the BDV antibody and a real-time reverse transcriptase polymerase chain reaction (rRT-PCR) assay for p24 and p40 RNA from peripheral blood mononuclear cells (PBMCs). Results: Neither the BDV antibody nor p24, p40 RNA was detected in controls and patients groups. Conclusion: Our results suggest that BDV might not be associated with psychiatric patients in Korea.

Venlafaxine에 의한 급성 독성 간염 1예

나경세,황희성,김신겸,이소영,정한용,Na, Kyeong-Sae,Hwang, Hee-Sung,Kim, Shin-Gyeom,Lee, So-Young-Irene,Jung, Han-Yong 대한생물정신의학회 2011 생물정신의학 Vol.18 No.3

Venlafaxine is among the most widely prescribed antidepressants. It is extensively metabolized to O-desmethylvenlafaxine via cytochrome P450 (CYP) 2D6. We report a case of acute toxic hepatitis resulting from venlafaxine in a 54-year-old woman with pain disorder. During venlafaxine treatment, laboratory tests revealed elevated liver enzymes with a maximum of 169 IU/L for aspartate transaminase (AST) and 166 IU/L for alanine transaminase (ALT). AST and ALT levels returned to normal after 6 days of discontinuation of venlafaxine. The patient was finally diagnosed with acute toxic hepatitis through liver biopsy. This case indicates the importance that clinicians should be aware of the hepatotoxicity of venlafaxine in practice.

A 52-Year-Old Woman Who Experienced a Myocardial Infarction during Treatment for Depression with Mirtazapine

나경세,Bun-Hee Lee,Yong-Ku Kim,한창수 대한정신약물학회 2006 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.4 No.1

Patients with depression and cardiovascular disease must be monitored carefully during pharmacotherapy because their depressive symptoms and/or antidepressant medications may have a negative impact on heart function. Mirtazapine is considered a safe and effective antidepressant drug used in the treatment of cardiovascular and other systemic diseases. This report, however, documents a case of myocardial infarction that appeared to be associated with mirtazapine administration

Mediating Effects of Cognitive Effort and Depression on Intelligence, Memory, and Executive Functions in Individuals with Mild Traumatic Brain Injury

나경세,정한용,이소영,김신겸 대한신경정신의학회 2014 PSYCHIATRY INVESTIGATION Vol.11 No.2

Objective Mild traumatic brain injury (mTBI) is frequently associated with psychiatric symptoms and cognitive dysfunction, as well as with the receipt of workers’ compensation, as many mTBIs occur due to work-related accidents. We hypothesized that depression and insufficient cognitive effort mediate the relationship between sociodemographic variables and cognitive dysfunction in mTBI. Methods A retrospective chart review study was conducted using 115 records of patients with mTBI. Cognitive effort was measured based on scores on the Rey 15-Item Test. Multivariate linear regression analysis was performed to examine factors predictive of cognitive functions. Path analysis was subsequently performed to investigate the mediating effects of depression and cognitive effort in relation to receipt of workers’ compensation and demographic variables. Results Fifteen of the 115 participants (13.0%) received failing scores on the Rey 15-Item Test, which indicated insufficient cognitive effort. Path analysis indicated that cognitive effort mediated the effects of age and workers’ compensation on cognitive functions. Conclusion Given the significant mediating effects of cognitive effort on cognitive performance, it is important to address patient motivation and encourage mTBI patients covered by workers’ compensation to perform tests with authentic effort.

Quetiapine 치료 중 발생한 무증상 갑상선 기능저하증 1례

나경세,김용구,Na, Kyeong-Sae,Kim, Yong-Ku 대한생물정신의학회 2007 생물정신의학 Vol.14 No.1

Quetiapine is an atypical antipsychotic drug with a benign side effect profile. However, recent studies have reported that thyroid dysfunction is associated with quetiapine treatment. The authors report a patient with DSM-IV bipolar I disorder who developed subclinical hypothyroidism during quetiapine treatment. The patient showed no significant clinical symptoms, but only abnormal thyroid function test findings including antithyroglobulin antibody. The abnormal thyroid function test findings were normalized after discontinuation of quetiapine. The subclinical hypothyroidism developed during quetiapine treatment may be associated with autoimmune process.

뇌졸중에서 우울증과 실행기능부전에 대한 고찰

나경세,김신겸,이소영,정한용,Na, Kyoung-Sae,Kim, Shin-Gyeom,Lee, Soyoung Irene,Jung, Han-Yong 대한생물정신의학회 2012 생물정신의학 Vol.19 No.4

Depression and executive dysfunction are common neuropsychiatric sequelae of stroke. Patients with stroke are more predisposed to depression and executive dysfunction compared to patients with similar degree of physical disability. Both depression and executive dysfunction are also associated with poor prognosis such as high mortality and delayed recovery after stroke. Complex neurobiological and anatomical mechanisms are associated with the development of depression and executive dysfunction after stroke. Activation of pro-inflammatory cytokines is thought to be associated with onset of depression, whereas injuries in frontal-subcortical circuit are thought to be a link between depression and executive dysfunction. Early detection of depressive symptoms and both pharmacological and non-pharmacological treatment would be helpful. In this review paper, the authors investigated 1) biological and neuroanatomical substrate for poststroke depression and executive dysfunction, 2) the relationship and common etiopathology for poststroke depression and executive dysfunction, and 3) pharmacological and non-pharmacological treatment for poststroke depression. The contents of the paper are as follows : the prevalence, clinical manifestation, and biological etiology for poststroke depression, neuroanatomical abnormalities as a common etiological factor for depression and executive dysfunction, pharmacotherapy and non-pharmacological approach.

양극성 장애에서 발병 연령에 따른 증상 및 예후의 차이 : 전향적 1년 추적 연구

나경세,김용구 大韓神經精神醫學會 2007 신경정신의학 Vol.46 No.2

Objectives : There have been several studies demonstrating that age at onset is associated with clinical and functional outcome in bipolar disorder. The purpose ofthis study was to investigate whether age at onset would influence on the prognosis of patients with bipolar I disorder in a Korean sample. Methods : Thirty-one patients with bipolar I disorder (DSM-IV) were recruited. Age at onset was split at age 30 years into early onset (n=15) and late onset (n=16) groups. These patients were followed at 1 year to assess re-hospitalization, Psychiatric symptoms (Brief Psychiathc Rating Scale, Young Mania Rating Scale), and social functioning (Korean version of the Social Adjustment Scale II revised version : KSAS II-RV). The subgroups were compared by Mann-Whitney U test and chi-square test. Results : Early onset group had more psychotic symptoms at hospitalization (χ²=5.743, P=.029) and had more KSAS II-RV score aRer 1 year (U=49.000, P=.004). Other psychiatric symptoms except psychosis were not significantly different bet-ween early onset and late onset group. KSAS II-RV score was not significantly correlated with BPRS and YMRS score. Conclusion : Our data suggest that early onset group may have poorer social functioning than late onset group in bipolar I disorder.

심리부검 : 우리나라에서 향후 방향에 대한 검토 및 고찰

나경세,백종우,윤미경,김현수 대한신경정신의학회 2015 신경정신의학 Vol.54 No.1

Psychological autopsy is a systematic methodology for comprehensive investigation of psychiatric and behavioral factors assumed to be causative or related to death of the deceased. In many countries, psychological autopsy is considered the most direct and valuable tool for determining the relationship between risk factors and suicide. The case of Finland revealed that successful psychological autopsy studies could greatly contribute to the national suicide prevention strategy, which consequently reduced the national suicide rate. Despite the strengths of psychological autopsy for identifying risk factors of suicide and consequently preventing suicide, it has not been successful in Korea. Implementation of psychological autopsy has been inconsistent and sporadic across the provinces. In addition, standardization of psychological autopsy protocol and qualification of interviewers are needed. With all of these methodological issues in mind, conduct of as many psychological autopsies as possible is important in order to build an evidence-based suicide prevention strategy. For successful implementation of psychological autopsy in Korea, it is necessary to improve attitudes toward suicide and psychiatric conditions. Legal, administrative, and institutional support are also important. Finally, multidisciplinary approach based on the financial and legal support should be employed.

Association between Abacus Training and Improvement in Response Inhibition: A Case-control Study

나경세,이소영,박준호,정한용,Jung-Hee Ryu 대한정신약물학회 2015 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.13 No.2

Objective: The abacus, first used in Asian countries more than 800 years ago, enables efficient arithmetic calculation via visuospatial configuration. We investigated whether abacus-trained children performed better on cognitive tasks and demonstrated higher levels of arithmetic abilities compared to those without such training. Methods: We recruited 75 elementary school children (43 abacus-trained and 32 not so trained). Attention, memory, and arithmetic abilities were measured, and we compared the abacus with the control group. Results: Children who had learned to use an abacus committed fewer commission errors and showed better arithmetic ability than did controls. We found no significant differences between children with and without abacus training in other areas of attention. Conclusion: We speculate that abacus training improves response inhibition via neuroanatomical alterations of the areas that regulate such functions. Further studies are needed to confirm the association between abacus training and better response inhibition.

서방형 Bupropion을 과량복용한 후 발생한 일과성 정신병 1예

나경세,이소영,정한용 대한정신약물학회 2011 대한정신약물학회지 Vol.22 No.3

Bupropion is a unique antidepressant with enhancing both noradrenergic and dopaminergic neurotransmission without altering serotonergic system. Given its pharmacodynamics and structural similarity to amphetamine, the possibility of bupropionrelated psychosis has been reported. The authors describe a 22-year-old woman who presented psychotic symptoms after taking 10 tablets of sustained release bupropion (bupropion SR) 150 mg (total 1,500 mg) and lorazepam 0.5 mg (total 5 mg). Visual hallucinations developed at 17 hours after overdose, while paranoid ideation and aggressive behaviors developed at 24 hours after overdose. The psychotic symptoms remitted on the fifth day of antipsychotics treatment. She remained psychiatrically stable without any clinically significant symptoms during 3-month follow-up. This case raises issue about the possible relationship between bupropion overdose and transient psychosis.