Chang Su Han

T-helper types 1, 2, and 3 cytokine interactions in symptomatic manic patients.

It has been reported that the balance between T-helper type 1 (Th1) cytokines and T-helper type 2 (Th2) cytokines plays a role in psychiatric disorders such as bipolar disorder. The T-helper type 3 (Th3) cytokine, which transforming growth factor beta-1 (TGF-beta1), has been shown to modulate the production of Th1 and Th2 cytokines. However, the role of TGF-beta1 in bipolar disorder has not yet been explored. A total of 70 manic patients with bipolar disorder and 96 normal controls was recruited. The plasma levels of IFN-gamma, IL-4, and TGF-beta1 were studied at the time of admission and 8 weeks after mood stabilizer treatment. The detection rate and plasma concentrations of IFN-gamma and IL-4 and the IFN-gamma/TGF-beta1 and IL-4/TGF-beta1 ratios were significantly higher in patients than in controls, while the TGF-beta1 level was significantly lower. The TGF-beta1 level increased significantly after treatment and the IFN-gamma/TGF-beta1 and IL-4/TGF-beta1 ratios returned to control values. TGF-beta1 may play a role in the pathophysiology of bipolar disorder through the action of TGF-beta1 in modulating the IL-4/TGF-beta1 ratio.

Association between norepinephrine transporter gene polymorphism and major depression.

Noradrenergic and serotonergic abnormalities have long been implicated in patients with major depression. The novel selective norepinephrine reuptake inhibitor reboxetine has been shown to be at least as effective as imipramine, desipramine and fluoxetine in the treatment of major depression. It is suggested that the dysfunction of the norepinephrine transporter (NET) may be related to major depression. Although the transcriptional activity related to the NET gene expression is little known, it may be a good candidate gene for major depression. Therefore, we investigated whether the T-182C polymorphism of the NET gene is associated with major depression in a Korean sample of 112 major depression patients compared with 136 healthy controls. We found a significantly lower frequency in TT genotype in patients with major depression than in normal controls when the genotypes of T-182C polymorphism were classified into two groups: TT group versus TC + CC group (p = 0.019). This result suggests that the T-182C polymorphism in the NET gene might be associated with major depression.

Brain-derived neurotrophic factor gene polymorphisms and mirtazapine responses in Koreans with major depression

Brain-derived neurotrophic factor (BDNF) is a candidate molecule for influencing the clinical response to antidepressant treatment. The aims of this study were to determine the relationship between the Val66Met polymorphism in the BDNF gene and the response to mirtazapine in 243 Korean subjects with major depressive disorder (MDD). The reduction in the Hamilton Depression score over the 8-week treatment period was not influenced by BDNF V66M genotypes. A marginal effect of genotype on somatic anxiety score was observed at baseline (P = 0.047 in the dominant model). However, genotype–time interaction had no effect on somatic anxiety score after the 8-week a treatment period. Plasma BDNF levels tended to increase during mirtazapine treatment, although without statistical significance (P = 0.055). After 8 weeks of mirtazapine treatment, plasma BDNF levels were higher in Met allele homozygotes (1499.7 ± 370.6 ng/mL) than in Val allele carriers (649.7 ± 158.5 ng/mL, P = 0.049). Our results do not support the hypothesis that the Val66Met promoter polymorphism in the BDNF gene influences the therapeutic response to mirtazapine in Korean MDD patients. However, our data indicate that this polymorphism results in increased plasma BDNF after mirtazapine treatment.

No association between the tryptophan hydroxylase gene polymorphism and major depressive disorders and antidepressant response in a Korean population.

The serotonergic neurotransmitter system has been implicated in major depressive disorder (MDD) and appears to be the target of a variety of antidepressants. Tryptophan hydroxylase (TPH) is the rate-limiting enzyme in serotonin biosynthesis, and selective serotonin re-uptake inhibitors exert their activity enhancing the general serotonergic tone. The goal of this study was to investigate whether the A218C polymorphism of the TPH gene is associated with MDD or antidepressant response. All patients were evaluated at the start and in the eighth week of using the 21-item Hamilton Depression Rating Scale. Genotyping was analyzed with polymerase chain reaction. There were no significant differences in genotypes and allele frequencies between the MDD patients (n=93) and the control group (n=127) and in the antidepressant response among TPH gene variants. Results suggest that the A218C polymorphism of the TPH gene does not play a major role in pathogenesis in MDD and does not serve as a modulator of antidepressant activity.

G-Protein β3 Subunit C825T Polymorphism Tends to Be Associated with Seasonal Variation in Young Male College Students

This study investigated the relationship between G-protein β3 subunit (GNB3) C825T polymorphism and seasonal variation in 189 young male college students. The subjects were genotyped for C825T and were evaluated by the Seasonality Pattern Assessment Questionnaire. The Global Seasonality Score (GSS) between the three genotypes revealed a marginal difference. The heterozygotes showed significantly higher seasonal variations in GSS than the homozygotes. The prevalence of heterozygotes tended to be higher in seasonals compared with normal subjects, although it was not statistically significant. These results suggest that GNB3 C825T polymorphism tends to be related to seasonal variation in mood and behavior in the normal population.

Co-administration of sertraline and haloperidol.

Along with recent increased interest in the selective serotonin reuptake inhibitors, a number of studies has been undertaken to observe interactions with different drugs. When selective serotonin reuptake inhibitor was administered together with antipsychotics to schizophrenics showing depressive or obsessive symptoms and negative symptoms, meaningful results were observed. The objective of our research was to identify the changes in the concentration of plasma haloperidol when sertraline was administered to patients who already were being treated with haloperidol. Sixteen patients who did not respond to the traditional antipsychotics after 2 weeks of treatment with a certain dosage of haloperidol were administered with 50 mg of sertraline for a period of 2 weeks. The concentration changes between plasma haloperidol and the reduced haloperidol were observed using high‐powered liquid chromatography equipped with a UV detector. There was a significant increase (P< 0.01) in the concentration of haloperidol, the change being from 8.52 ± 4.22 to 10.91 ± 5.38 ng/mL. However, the change in the concentration of reduced haloperidol was from 7.41 ± 7.93 to 5.22 ± 6.10 ng/mL, showing a significant decrease. The concentrations of total plasma haloperidol showed no significant changes at all. In comparing the ratio of the reduced haloperidol and the haloperidol, the reduction ratio was down to 0.39 ± 0.27 from 0.94 ± 0.65 showing a significant decrease. There seems to be few studies done on interactions using serotonergic drugs together with antipsychotics in spite of their clinically applicable possibility. According to similar studies done in the past, co‐administering of such drugs not only increases the plasma concentration of antipsychotics, but it also results in clinical improvement of negative symptoms and aggravation of extrapyramidal symptoms. Changes in clinical symptoms and adverse effects were not observed in our study. However, we think these observations need to be included in upcoming larger scale studies.

Treatment in risperidone-induced amenorrhoea.

Objective To find the optimal changes needed for resolution of amenorrhoea associated with risperidone. Method Between November 2001 and May 2002, 16 female outpatients who had taken risperidone for more than 3 months voluntarily reported amenorrhoea. Following each report of amenorrhoea, serum prolactin level was measured and treatment changes were undertaken. The menstrual cycles and clinical mental status of each patient were followed for the next 6 months. For nine of the 16 patients, the dose of risperidone was reduced. For the other seven patients, risperidone was switched to olanzapine or quetiapine. Results Fourteen of 16 patients had hyperprolactinemia. Two patients who had discontinuation of risperidone recovered from amenorrhoea and three of the risperidone-reduction patients resumed their periods. All subjects in the drug-switch patients recovered. The patients who recovered from amenorrhoea at a reduced dosage of risperidone took ≤3 mg/day. Two patients in the risperidone-reduction group dropped out. Conclusion Stopping risperidone (without starting any other antipsychotic) or switching to a prolactin-sparing antipsychotic is an effective strategy for resolution of amenorrhoea on risperidone, but that dose reduction is rarely effective either because amenorrhoea continues despite lower dose or because relapse of psychosis appears.

Borna disease virus and deficit schizophrenia

Background: It is controversial whether Borna disease virus (BDV) infects humans and causes psychiatric disorders. Objectives: The relationship between BDV infection and schizophrenia with deficit syndrome was investigated. Study design: Using the Schedule for the Deficit Syndrome, 62 schizophrenic in-patients were selected from three psychiatric hospitals. RNA was extracted from peripheral blood mononuclear cells and analyzed using nested reverse transcriptase-polymerase chain reaction with primers to detect BDV p24 and p40. Results and conclusions: BDV transcripts were not detected in samples from any of the 62 schizophrenic patients. These data do not support an etiologic association between BDV infection and the deficit form of schizophrenia.

The Sewol Ferry Disaster: Experiences of a Community-Based Hospital in Ansan City.

The Sewol ferry disaster is one of the most tragic events in Koreas modern history. Among the 476 people on board, which included Danwon High School students (324) and teachers (14), 304 passengers died in the disaster (295 recovered corpses and 9 missing) and 172 survived. Of the rescued survivors, 72 were attending Danwon High School, located in Ansan City, and residing in a residence nearby. Because the students were young, emotionally susceptible adolescents, both the government and the parents requested the students be grouped together at a single hospital capable of appropriate psychiatric care. Korea University Ansan Hospital was the logical choice, as the only third-tier university-grade hospital with the necessary faculty and facilities within the residential area of the families of the students. We report the experiences and the lessons learned from the processes of preparing for and managing the surviving young students as a community-based hospital. (Disaster Med Public Health Preparedness. 2017;11:389-393).

Latency of auditory P300 correlates with self-control as measured by the Sixteen Personality Factor Questionnaire

Abstract  The reception, processing, and storage of information about experience define personality. The present study investigated the relationship between auditory event‐related potentials (AERP) and personality traits. The AERP were recorded using a standard auditory oddball paradigm, and personality was evaluated by Cattells Sixteen Personality Factor Questionnaire (16PF) in 20 healthy young male subjects. The P300 latency was found to be significantly associated with rule consciousness (factor G in the 16PF), perfectionism (factor Q3), and self‐control (factor SC): it was negatively correlated with G score (r =−0.56, P = 0.01), Q3 score (r =−0.67, P = 0.001), and SC score (r =−0.65, P = 0.002). Moreover, the P300 amplitude and N100 amplitude were negatively correlated with reasoning (factor B; r =−0.46, P = 0.044; and r = −0.72, P = 0.002, respectively). These results indicate that the personality traits of self‐control, perfectionism, high superego, and reasoning are related to information processing in the brain.