Moon-Soo Lee

Assessment of the Type D Personality Construct in the Korean Population: A Validation Study of the Korean DS14

This study aimed to develop a Korean version of the Type D Personality Scale-14 (DS14) and evaluate the psychiatric symptomatology of Korean cardiac patients with Type D personality. Healthy control (n = 954), patients with a coronary heart disease (n = 111) and patients with hypertension and no heart disease (n = 292) were recruited. All three groups completed DS14, the Eysenck Personality Questionnaire (EPQ), the state subscale of Spielberger State and Trait Anxiety Inventory (STAI-S), the Center for Epidemiologic Studies Short Depression Scale (CESD), and the General Health Questionnaire (GHQ). The Korean DS14 was internally consistent and stable over time. 27% of the subjects were classified as Type D. Type D individuals had significantly higher mean scores on the STAI-S, CESD, and GHQ compared to non-Type D subjects in each group. The Korean DS14 was a valid and reliable tool for identifying Type D personality. The general population and cardiovascular patients with Type D personality showed higher rate of depression, anxiety and psychological distress regarding their health. Therefore, identifying Type D personality is important in clinical research and practice in chronic medical disorders, especially cardiovascular disease, in Korea.

Trial of aripiprazole in the treatment of first-episode schizophrenia

Aims:  Aripiprazole is an atypical antipsychotic indicated for the treatment of adult patients with schizophrenia. It is effective and well tolerated in patients with schizophrenia or schizoaffective disorder. The aim of the present study was to investigate therapeutic efficacy and tolerability of aripiprazole in patients with first‐episode schizophrenia.

Association between tryptophan hydroxylase 2 polymorphism and anger-related personality traits among young Korean women.

Background/Aims: It has been suggested that the serotonergic systems are associated with anger and aggressive behaviors. We investigated the association between several single nucleotide polymorphisms in the serotonergic genes and anger-related personality traits. Methods: A total of 228 healthy female Korean women participated in this study. All subjects were assessed with the State-Trait Anger Expression Inventory (STAXI) and were genotyped for 3 polymorphisms: serotonin transporter (5-HTT) gene-linked polymorphic region (5-HTTLPR), tryptophan hydroxylase 1 (TPH1) A218C, and TPH2 G-703T. Results: The Anger Expression-Out (AX-Out) subscale scores of the STAXI differed significantly between the genotypes for the TPH2 G-703T polymorphism (F = 4.825, p = 0.009). G/G homozygous subjects scored significantly higher on the AX-Out subscale than those with the G/T genotype. However, no significant differences were observed in the relationships between the STAXI subscale scores of subjects with other polymorphisms. Conclusions: This study suggests that the TPH2 G-703T polymorphism might contribute to anger-related traits, especially to the expression of anger.

Internalizing Symptoms as Mediators of Lifetime Incidence of Trauma and Quality of Life among Out-of-School Youths

Objectives: The present study aimed to investigate the relationships among the lifetime incidence of trauma, internalizing symptoms, and quality of life (QoL) in out-of-school youths (OSYs). Methods: We recruited 50 OSYs in South Korea. Participants completed the following surveys: completed Lifetime Incidence of Traumatic Events for children, Youth Self Report, and The KIDSCREEN-27 QoL measure for children and adolescents. Mediation analysis was conducted to test the research hypotheses. Results: The mean lifetime incidence of traumatic events among OSYs was 3.27 (standard deviation, 2.41). Internalizing symptoms significantly mediated the lifetime incidence of trauma and QoL. OSYs with fewer internalizing symptoms exhibited a better QoL in the domain of psychological well-being, although their lifetime incidence of trauma was higher. Conclusion: The results of current study suggest that assessment and therapeutic intervention with regard to internalizing symptoms are needed to increase the QoL of OSYs.

Poster #M257 VARIABLES INFLUENCING SUBJECTIVE WELL-BEING IN PATIENTS WITH SCHIZOPHRENIA

Schizophrenia is often characterized by an alternation of deterioration and remission, adversely affecting the patients’ daily life, including their occupational and educational activities. In the past, the treatment of schizophrenia was focused on the reduction of positive symptoms. These days, due to the wide use of atypical antipsychotics, enhancement of the quality of life of patients has become more important, for instance, minimization of the side effects of the antipsychotics, alleviation of negative symptoms, depressive symptoms, and cognitive dysfunction. Although it is not easy to define the concept of quality of life in patients with schizophrenia, the recent studies have suggested that the multi-dimensional concept of subjective well-being is associated with the activities of daily life, including self-management and social roles, social support, treatments, and side effects of the antipsychotics. Subjective well-being in patients with schizophrenia is important because it is recognized as an important shift in the evaluation of treatment goals. Schizophrenia patients’ subjective well-being is an important index in evaluating the treatment course, and is being widely used in clinical settings. Subjective well-being is closely associated with the patients’ quality of life and is a predictive factor of complying with antipsychotics as well as of remission and recovery from symptoms. Various sociodemographic and clinical variables can affect Received: September 15, 2014 / Revised: September 25, 2014 Accepted: September 30, 2014 Address for correspondence: Seung-Hyun Kim, Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703, Korea Tel: 02-2626-3162, Fax: 852-1937 E-mail: gurokim@gmail.com Funding for this study was provided by CJ HealthCare. CJ HealthCare had no further role in the study design; in the collection, analysis or interpretation of data; in the writing of the manuscript; or in the decision to submit the paper for publication. Its contents are solely the responsibility of the authors. Variables Influencing Subjective Well-Being in Patients with Schizophrenia

Environmental Risk Factors for Children and Adolescents Suffering from Depressive Disorder : Clinical Aspects

This summary of literature during the past year reviews published studies relating to risk factors for depressive dis-orders in children and adolescents. Risk factors include environmental toxins, socio-environmental, and genetic factors. As depression has a complex, multifactorial causal mechanism, it is likely that the accumulation and/ or interaction among multiple risk factors lead to depression. Findings related to the result of toxin exposure have been difficult to interpret given that risk factors tend to interact and that higher mental functions are not easily measurable. However, some findings have been consistent. Clinical research data has also shown that the risk for negative outcomes may be modified both by genetic and environmental factors through a gene environment interplay mechanism. KEY WORDS：Child·Adolescent·Toxin ·Risk Factor·Depressive Disorder·Gene·Environment.

P.2.d.004 The association of glucocorticoid receptor polymorphism with antidepressants treatment response in patients with major depressive disorder

Background: Cortisol and corticotropin-releasing hormone (CRH) affect the serotonin (5-HT) system. During the stress response, glucocorticoids (GCs) stimulate all these features of 5-HT transmission. Conversely, 5-HT transmission is impaired and noradrenergic transmission in the hippocampus is suppressed during chronic psychosocial stress and hypercortisolism, which is similar to the series of events evident during depression. Glucocorticoid receptor (GCCR), which is encoded by NR3C1 gene located in chromosome 5q31, has been known to be involved in the stress response. The GCCR polymorphisms affect GC sensitivity, which is associated with cortisol feedback effects. The degree of cortisol feedback is closely related to the development of depression and may also be affected by antidepressants. Therefore, we hypothesized that the GCCR polymorphisms are associated with the susceptibility to MDD and predict the response to treatment with antidepressants. Methods: Trained psychiatrists examined all of the subjects using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Korean version of the Diagnostic Interview for Genetic Studies (K-DIGS). The severity of depression was assessed using the 21-item Hamilton Depression Rating (HAMD21) scale. Only subjects with a minimum score of 18 on the HAMD21 scale were enrolled. During the treatment period in the study, all subjects took citalorpam or mirtazapine at a daily dose of 10−60mg or 15−60mg, respectively. Clinical symptoms were evaluated using the HAMD21 scale at baseline and after 1, 2, 4, and 8 weeks of treatment. The genotype frequencies were compared using logistic regression analysis, and betweengenotype differences in the decrease in the HAMD21 score were analyzed using a linear regression analysis in 257 Korean patients with MDD. Results: The proportion of patients with MDD possessing the G allele on +1830C>G was higher in responders (42.4%) than in non-responders (13.3%) to citalopram treatment at 4 weeks (P = 0.009, odd ratio = 6.42 (1.60–25.8). The reductions in the HAMD21 scores showed a trend to be larger in G allele carriers (73.47±11.26%) than those in patients with the CC genotype (51.68±3.92%) after 4 weeks of mirtazapine treatment (P = 0.087). In contrast, the reductions in the HAMD21 scores were smaller in G allele carriers (46.09±2.65%) than those in patients with the CC genotype (54.84±1.99%) after 4 weeks of mirtazapine treatment (P = 0.016). The patients having CC genotype showed better response to mirtazapine than to citalopram (62.0% vs 42.2%, P = 0.024, Table1), and the patients possessing G allele showed better response to citalorpam than to mirtazapine (77.8% vs 50.7%, P = 0.046, Table1). Conclusion: These results suggest that GCCR+1830C>G affects the outcome of antidepressant treatment in patients with MDD, and that this polymorphism may be a good genetic marker for choosing an appropriate antidepressant for individuals.

P03-159 Bupropion for smoking cessation in schizophrenia

Bupropion is a catecholamine reuptake inhibitor and also a potent noncompetitive ion channel site antagonist at the nicotinic acetylcholine receptor. Bupropion is indicated for use in combination with behavioral modification programs for smoking cessation. There have been a few studies about the effect of bupropion on smoking cessation in schizophrenia. Therefore, we aimed investigated the change of the symptomatology after smoking cessation with bupropion in the patients with schizophrenia. There were fifty-six patients with smoking in the psychiatric ward of Hapcheon Korea Hospital. Among them, thirty-nine inpatients meeting the DSM-IV criteria for schizophrenia were recruited. For 4 weeks, treatment team persuaded the patients to enter the program of smoking cessation. With the exception, if the patients did not agree the program, the patients were able to be transferred to another ward that smoking was permitted. All patients agreed to the program. Postive and Negative Symptom Scale (PANSS), Temperament and Character Inventory(TCI), State-Trait Anxiety Inventory(STAI), Fagerstrom Test for Nicotine Dependence(FTND) were evaluated at the beginning of the study and 12 weeks of Bupropion treatment. At 12 weeks after successful smoking cessation with bupropion, FTND scores were significantly decreased after smoking cessation. The scores of STAI and PANSS were not significantly changed. The subcale of TCI, Novelty Seeking showed decreasing tendency after smoking cessation, although there was no statistical significance(p=0.054). These results suggest that bupropion is an effective antidepressant on smoking cessation and does not aggravate the psychotic symptoms in schizophrenia. Further investigation with larger number of subjects is needed.