Doo-Heum Park

Characteristics of Excessive Cellular Phone Use in Korean Adolescents

Abstract The objective of this study was to evaluate the possible psychological problems related to excessive cellular phone use in adolescents. Results from 595 participants showed that the potentially excessive user group had a tendency to identify themselves with their cellular phones and to have difficulties in controlling usage. They expressed more depressive symptoms, higher interpersonal anxiety, and lower self-esteem. A positive correlation was also observed between excessive cellular phone use and Internet addiction.

More Prominent Reactivity in Mood Than Activity and Sleep Induced by Differential Light Exposure Due to Seasonal and Local Differences

The aim of this study was to investigate how mood, work time, light exposure, activity, and sleep indices are affected by the differences of latitude and season in healthy volunteers. Twenty‐four subjects (38.92±11.32 yrs) in Rochester, Minnesota, USA (latitude 44°1′N) and 30 subjects (47.03±16.32 yrs) in San Diego, California, USA (latitude 32°43′N) completed a 1 yr protocol measuring daily logs including daily work time and sleep diary; the Center for Epidemiologic Studies Depression Scale (CES‐D); the eight‐item atypical subscore of the Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorder version (SIGH‐SAD); and actigraphic measures of light exposure and sleep for one‐week in each solstice of summer and winter. Higher scores of CES‐D (p=0.038) and the eight‐item atypical subscore of SIGH‐SAD (p=0.009), and longer indoor (p=0.001) and shorter outdoor (p=0.002) work times were observed during winter than summer only in Rochester, with no differences in San Diego. The mesor of light was decreased in both Rochester (p≤0.001) and San Diego (p=0.004) during winter compared to summer, with no differences in the mesors (24 h means) of activity and sleep. The eight‐item atypical subscore of SIGH‐SAD was significantly negatively correlated with the mesor of light (p=0.034). Sleep indices showed no significant differences between two locales or two seasons. A more prominent depressive mood in Rochester than San Diego during winter can be explained by decreased light exposure of healthy subjects in Rochester. Despite a significant difference of mood and light exposure between the two seasons in Rochester, there were no differences in activity or sleep. Therefore, mood might be more reactive than activity and sleep in the seasonal variation induced by differential light exposure.

The Effect of Aging and Severity of Sleep Apnea on Heart Rate Variability Indices in Obstructive Sleep Apnea Syndrome

Objective This study aims to analyze how much heart rate variability (HRV) indices discriminatively respond to age and severity of sleep apnea in the obstructive sleep apnea syndrome (OSAS). Methods 176 male OSAS patients were classified into four groups according to their age and apnea-hypopnea index (AHI). The HRV indices were compared via analysis of covariance (ANCOVA). In particular, the partial correlation method was performed to identify the most statistically significant HRV indices in the time and frequency domains. Stepwise multiple linear regressions were further executed to examine the effects of age, AHI, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and sleep parameters on the significant HRV indices. Results The partial correlation analysis yielded the NN50 count (defined as the number of adjacent R-wave to R-wave intervals differing by more than 50 ms) and low frequency/high frequency (LF/HF) ratio to be two most statistically significant HRV indices in both time and frequency domains. The two indices showed significant differences between the groups. The NN50 count was affected by age (p<0.001) and DBP (p=0.039), while the LF/HF ratio was affected by AHI (p<0.001), the amount of Stage 2 sleep (p=0.005), and age (p=0.021) in the order named in the regression analysis. Conclusion The NN50 count more sensitively responded to age than to AHI, suggesting that the index is mainly associated with an age-related parasympathetic system. On the contrary, the LF/HF ratio responded to AHI more sensitively than to age, suggesting that it is mainly associated with a sympathetic tone likely reflecting the severity of sleep apnea.

Persistence of neuropsychiatric symptoms over six months in mild cognitive impairment in community-dwelling Korean elderly

BACKGROUND Several studies of patients with mild cognitive impairment (MCI) have revealed that this population, like people with dementia, have neuropsychiatric symptoms (NPS) as well as memory impairment. No study has reported on the natural history and course of NPS in MCI although this is important in terms of management. We aimed to determine the persistence of NPS over six months in participants with MCI. METHOD The Neuropsychiatric Inventory (NPI) was used to rate the severity of NPS in 241 consecutive referrals with MCI from a Korean clinic at baseline and in 220 patients at 6-month follow-up. We also collected information about the cognition and quality of life of patients and their caregivers. RESULTS Ninety-seven (44.1%) MCI participants who completed the 6-month follow-up exhibited at least one NPS at baseline; 60 (27.3%) were clinically significant NPS. Seventy (72.1%) of those with any symptom had at least one persistent NPS at 6-month follow-up, and 44 (73.3%) of those with clinically significant symptoms had at least one significant and persistent NPS at 6-month follow-up. Those with persistent symptoms had more severe baseline symptoms. Both patients and caregivers had a poorer quality of life when the patient had at least one clinically significant symptom. CONCLUSIONS NPS were highly persistent overall in older people with MCI. Persistence was predicted by having more severe symptoms at baseline. Clinically significant levels of NPS were associated with decreased quality of life. We conclude that clinicians should be aware that NPS symptoms in MCI usually persist.

Usefulness of Young's Internet Addiction Test for clinical populations

Abstract Background: Youngs Internet Addiction Test (IAT) is one of the most widely used scales for assessing Internet addiction. Aims: The purpose of the current study was to investigate the value of IAT for subjects clinically diagnosed with Internet addiction. Methods: A total of 52 subjects, whose chief complaint and most serious behavioral problem was Internet addiction, were enrolled at an Internet-addiction clinic associated with a university hospital. The IAT was administered to assess the existence and severity of Internet addiction. Subjects were classified according to the severity guidelines of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) and according to the duration of their Internet addiction. Results: The mean IAT score of our clinical subjects was 62.8 ± 18.2, which was below 70, the cut-off point indicating significant problems. The IAT detected only 42% of the clinical subjects as having significant problems with Internet addiction. No significant differences in IAT scores among those with mild, moderate and severe degrees of Internet addition were found, and no association between IAT scores and duration of illness was observed. Conclusions: IAT scores were not significant correlated with clinical severity and duration of illness in a clinical population. This instrument had limited clinical utility for evaluating the severity of Internet addiction. Considerable caution is required in interpretations of IAT scores.

Effectiveness of paliperidone extended-release for patients with schizophrenia: focus on subjective improvement.

This study assessed whether the subjective experience of patients with schizophrenia improved after switching from an oral antipsychotic to flexibly‐dosed paliperidone extended‐release.

Self-Reported Sleep Latency in Postmenopausal Women

The ain of this study was to access how self-reported sleep latency (SRSL) was affected by sleep habits, mood, and circadian rhythm in postmenopausal women. Subjects (n=384, 67.9±7.7 yr) completed sleep and mood questionnaires, sleep log and actigraphic data. The major urinary melatonin metabolite (6-sulphatoxymelatonin, aMT6s) was assayed in fractional urine specimens for two 24-hr intervals. Although SRSL (26.5±24.4 min) and actigraphic sleep latency (ASL; 27.8±20.0 min) were correlated (rs=0.361, p<0.001), the short SRSLs tended to be underestimated whereas the long SRSLs tended to be overestimated as compared to ASL. SRSL was positively correlated with the scales of insomnia, mood and hot flash, hypertension, use of anti-hypertensive drugs and the acrophase and the offset of aMT6s. SRSL was negatively correlated with the global assessment of functioning scale in DSM-IV (GAF scale), and light exposure and wrist activity. Multiple linear regression analysis showed that the best-fit model to predict SRSL was light exposure, GAF scale, and use of anti-hypertensive drugs. SRSL may be determined by psychophysiological factors as well as circadian rhythm function. Therapeutic approaches suggested for trouble falling asleep might include increased daylight exposure, improvements in general health, and modification of anti-hypertensive pharmacotherapy.

Nocturia Improvement With Surgical Correction of Sleep Apnea

Purpose To evaluate changes in nocturia after surgical correction of obstructive sleep apnea (OSA). Methods A total of 66 patients were included in the present study. All had been diagnosed with OSA syndrome by polysomnography and underwent uvulopalatopharyngoplasty (UPPP). Preoperative and postoperative lower urinary tract symptoms (LUTS), quality of life (QoL), and nocturia episodes were evaluated using the International Prostate Symptom Score (IPSS) and overactive bladder symptom score (OABSS) questionnaires. Three months postoperatively, telephone interviews were performed to determine the success of surgery, current LUTS, and nocturia episodes. Patients were divided into surgical success and failure groups. Surgical success was defined as snoring decrease more than 50% based on the patient’s subjective judgment. Results The response rate was 56% and success rate was 73%. In all patients, nocturia episodes significantly decreased from 1.7±1.1 to 0.8±1.2 (P=0.002). Mean IPSS score, OABSS score, and QoL scores were also significantly improved. The success group showed a significant decrease in nocturia episodes, and total IPSS, OABSS, and QoL scores. However, the failure group did not show significant changes in all parameters. Conclusions OSA correction improved nocturia as well as other LUTS. These improvements were not observed in the failure group. This study shows that OSA is a cause of nocturia and that other LUTS and nocturia can be improved by surgical correction of OSA.

Comparison of Low Resolution Electromagnetic Tomography Imaging Between Subjects With Mild and Severe Obstructive Sleep Apnea Syndrome: A Preliminary Study

Objective The purpose of this study was to identify the regions of the brain associated with recurrent nocturnal chronic hypoxic episodes in patients with untreated obstructive sleep apnea syndrome (OSAS) using low-resolution electromagnetic tomography (LORETA) and quantitative electroencephalography (QEEG). Methods Nocturnal polysomnograph (NPSG) and subsequent morning electroencephalograph (EEG) were measured in 20 subjects with OSAS. Mild (n=10 ages 39.5±12.1 years) and severe (n=10 ages 41.7±13.6 years) right-handed male OSAS subjects were selected by interview and questionnaires including the NPSG, Beck Depression Inventory, Beck Anxiety Inventory, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index. The LORETA and QEEG were compared between the severe and mild OSAS groups by frequency bands (delta 1-3 Hz, theta 4-7 Hz, alpha 8-12 Hz, beta1 13-18 Hz, beta2 19-21 Hz, beta3 22-30 Hz, and total 1-30 Hz) made by spectral analysis during resting with the eyes closed. Results The LORETA analysis showed decreased alpha activity at the right posterior cingulate gyrus (Brodmann area 23) in cases with severe OSAS compared to mild OSAS (p<0.05). For the QEEG, the absolute power of the alpha activity (8-12 Hz) was decreased in P3 (p=0.047), PZ (p=0.039) and O2 (p=0.04) in cases with severe OSAS compared to mild OSAS cases. The LORETA and QEEG analyses had similar results with regard to band, activation and location. Conclusion The decreased activity of the alpha frequency in the right posterior cingulate gyrus, in patients with severe OSAS compared to those with mild OSAS, suggests that chronic repeated short-term hypoxia during sleep, in OSAS, could provoke cortical brain dysfunction associated with cognitive dysfunction such as memory and attention.

Onset of Manic Episode during Chemotherapy with 5-Fluorouracil

The authors report a case of 5-Fluorouracil (5-FU) induced manic episode in an elderly female without any previous psychiatric history. The patient presented manic symptoms after 4th cycle of 5-FU chemotherapy after surgery of rectal cancer. After cessation of chemotherapy and administration of olanzapine and divalproex sodium, symptoms were subsided within 10 days.