Biomedical subjects

Il-Seon Shin

Publications and source records attributed to Il-Seon Shin.

At least 19 recordsLinked to original sources

PubMed2007

BDNF genotype potentially modifying the association between incident stroke and depression.

OBJECTIVE: To investigate the role of the brain-derived neurotrophic factor (BDNF) gene val66met polymorphism in the association between stroke and depression. METHOD: Five hundred community residents aged >65 years without stroke or depression at baseline were re-evaluated after 2 years. Disability (World Health Organization Disability Assessment Schedule, WHODAS II), cognitive function (Mini-Mental State Examination, MMSE), and BDNF genotype were also measured at baseline. RESULTS: The association between incident stroke and depression was strengthened progressively with increasing numbers of met alleles, and was only significant in subjects with the met/met genotype after adjustment for disability and cognitive function. CONCLUSION: The BDNF val66met polymorphism may modify the association between stroke and depression.

Aged↗

PubMed2006

Use of long-acting injectable risperidone before and throughout pregnancy in schizophrenia.

Data on the use of long-acting injectable (LAI) risperidone, the first atypical depot antipsychotic, during pregnancy are limited. A 35-year-old woman with schizophrenia was given LAI risperidone before and throughout her pregnancy. She gave birth to a female infant weighing 2230 g at 36 weeks and 6 days of pregnancy, following premature rupture of the membranes. The baby had no congenital malformation and was healthy 8 months postnatal. To our knowledge, this is the first reported use of LAI risperidone throughout an entire pregnancy. In this paper, we discuss the rationale and problems of LAI risperidone use in pregnancy, based on a literature review.

Adult↗

PubMed2006

Diagnostic validity of assessment scales for depression in patients with schizophrenia.

The aim of this study was to examine the diagnostic validity of four commonly used assessment scales for depression in schizophrenia. The study population consisted of 84 inpatients meeting the DSM-IV criteria for schizophrenia. Depression in the study subjects was defined by the DSM-IV criteria for major depressive episode. The Positive and Negative Syndrome Scale (PANSS) and the Simpson-Angus Rating Scale (SARS) were used to differentiate depression from the negative and extrapyramidal symptom-related depressive phenomena in schizophrenia. The following four depression scales were assessed for their diagnostic validity as measures of depressive disorder in schizophrenia: the Calgary Depression Scale for Schizophrenia (CDSS), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression (HAM-D), and the depression subscale of the PANSS (PANSS-D). Of 84 patients with schizophrenia, 32 were diagnosed as having comorbid depressive disorder. The areas under the Receiver Operating Characteristic (ROC) curves of the CDSS, HAM-D, PANSS-D, and BDI were 0.94, 0.89, 0.90, and 0.81, respectively. The area under the ROC curve of the CDSS was significantly greater than that of the BDI and tended to be more favorable than those for the HAM-D and the PANSS-D. Our study suggests that the CDSS may provide the best assessment for depression in patients with schizophrenia.

Adult↗

PubMed2006

Correlates of caregiver burden for Korean elders according to cognitive and functional status.

BACKGROUND: Caregiver strain was investigated in a community sample of Korean elders with cohabiting caregivers, and factors associated with this were compared between groups classified by cognitive and functional impairment. METHODS: The study sample consisted of 484 elders and their cohabiting caregivers resident in Kwangju, South Korea. Caregiver burden was measured by the Zarit Burden Interview. Data on the elders' socio-demographics (age, gender, education, and religion) and clinical characteristics (cognitive function (MMSE), activities of daily living (IADL), depressive symptoms, alcoholism, and physical illness), and caregivers' socio-demographic characteristics (age, gender, education, relation to elders, and current employment) and caregiving environments (living area, alternative caregiver, number of rooms, monthly income, and social network) were gathered. Participants were classified into those with (n=61) or without cognitive impairment. The second group was classified into those with (n=68) or without (n=355) functional impairment. RESULTS: Caregiver strain was significantly associated with cognitive impairment. In the group without cognitive impairment, caregiver strain was significantly associated with participant characteristics (IADL impairment, and symptoms of depression and alcoholism). In those with cognitive impairment, caregiver strain was associated with both participant status (depressive symptoms and IADL impairment) and caregiver characteristics (a child caregiver, lower social support, and urban environment). CONCLUSIONS: Individual mental and physical health characteristics predict caregiver strain regardless of cognitive impairment. Caregiver characteristics are most important in the presence of cognitive impairment.

Activities of Daily Living↗

PubMed2006

ALDH2 genotype-associated differences in the acute effects of alcohol on P300, psychomotor performance, and subjective response in healthy young Korean men: a double-blind placebo-controlled crossover study.

BACKGROUND: This study investigated the acute effects of alcohol on neurophysiological and psychomotor functions and the subjective response in healthy young Korean men according to the mitochondrial aldehyde dehydrogenase (ALDH2) genotype. METHOD: A total of 24 males, half with ALDH2*1/*1 (active form) and the rest with ALDH2*1/*2 (inactive form), were selected through genotyping. In a double-blind placebo-controlled crossover design, each subject consumed either a 0.5 g/kg dose of alcohol or a placebo on two separate occasions, 1 week apart. The blood alcohol concentrations (BACs), P300 of event-related potential, psychomotor performance, and perceived feelings were assessed. RESULTS: Although the BACs were similar between the two groups, the effects of alcohol on P300 were greater overall in subjects with ALDH2*1/*2 than in subjects with ALDH2*1/*1. Psychomotor performance was more impaired after alcohol ingestion in subjects with ALDH2*1/*2 than in subjects with ALDH2*1/*1. The subjective response after alcohol ingestion was more negative in subjects with ALDH2*1/*2, compared to subjects with ALDH2*1/*1. CONCLUSIONS: These results suggest that the ALDH2 polymorphism is an important factor in determining the effects of alcohol on various psychobehavioral functions.

Adult↗

PubMed2006

Bullying and victimization behaviors in boys and girls at South Korean primary schools.

OBJECTIVE: To investigate the prevalence and correlates of bullying and victimization behaviors in boys and girls at South Korean primary schools. METHOD: In a cross-sectional survey, 1,344 fourth-grade primary school children completed a questionnaire on self-reported bullying and victimization behaviors, depression, anxiety, body image, coping strategies, and self-esteem as well as the self-report Strengths and Difficulties Questionnaire. Parents completed a questionnaire on demographic data, the General Health Questionnaire-12, and the Korean version of the Strengths and Difficulties Questionnaire. RESULTS: The prevalence of bullies, victims, and bullies/victims was 12.0%, 5.3%, and 7.2%, respectively. Boys were significantly more likely to be bullies and bullies/victims. In the multivariate analyses, bullying and victimization behaviors were associated with gender, greater than average height, higher depression, higher trait anxiety, lower self-esteem, and total difficulties of the Strengths and Difficulties Questionnaire. Differences in the associations were found between boys and girls. CONCLUSIONS: The authors found that bullying is common among South Korean primary school students and that bullying and victimization behaviors are related to various emotional, behavioral, and social problems; some gender-related differences are also evident.

Crime Victims↗

PubMed2006

A prospective study of changes in subjective memory complaints and onset of dementia in South Korea.

OBJECTIVE: Subjective memory complaints (SMCs) are associated with an increased incidence of dementia, but changes in SMCs have received little investigation. This study aimed to investigate the prospective association between change in self-reported memory and incident dementia in a community sample. METHOD: Korean residents aged 65+ without dementia were followed over a 2.4-year period (N = 686). SMCs were ascertained on both occasions using the Geriatric Mental State schedule. Incident dementia was ascertained at follow up, applying Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. RESULTS: Compared with those without SMCs on either occasion, dementia incidence was higher in those with persistent SMCs (present on both occasions) and transient SMCs (present at baseline but not follow up). There was no association with new onset of SMCs during follow up. The association with transient SMCs was weakened when those with cognitive impairment at baseline were excluded. CONCLUSIONS: Incident dementia is associated with memory complaints that persist or disappear but not with new complaints.

Aged↗

PubMed2006

Vascular risk factors and incident late-life depression in a Korean population.

BACKGROUND: Causal relationships between vascular factors and late-life depression are controversial. AIMS: To investigate prospective associations between risk factors for vascular disease and incidence of late-life depression. METHOD: Of 661 community participants aged 65 years or over, without depression at baseline, 521 (79%) were re-evaluated 2 years later. At baseline and follow-up, a diagnostic interview for depression was carried out and information on vascular status, disability and cognitive function was gathered. RESULTS: Pre-existing heart disease, incident stroke and lower baseline high-density lipoprotein cholesterol level were significantly associated with incidence of late-life depression, independently of disability and cognitive function. CONCLUSIONS: These results provide some support for a vascular aetiology of late-life depression. However, important risk factors for cerebrovascular disease such as hypertension and diabetes were not implicated, and the associations with lipid levels might still be explained by affective states earlier in life.

Aged↗

PubMed2005

Physical health, depression and cognitive function as correlates of disability in an older Korean population.

BACKGROUND: The World Health Organisation Disability Assessment Schedule II (WHODAS II) measures functioning and disability in concordance with the bio-psycho-social model of the WHO's International Classification of Functioning, Disability, and Health. Our objectives were to investigate the independent associations of physical health, depression and cognitive function with WHODAS II disability in an older Korean population. METHODS: The WHODAS II was administered to a community sample of 1204 residents age 65 or over. Data on demographic characteristics (age, gender, living area, marital state, and religion), socio-economic state (education, type of accommodation, number of rooms, previous occupation, current employment, monthly income), social support, number of physical illness, depression (GMS), and cognitive function (MMSE) was gathered. A subsample (n = 746) received a clinical examination for dementia. RESULTS: Scores on the WHODAS II were significantly and independently associated with worse physical health, depression, and lower cognitive function. Associations with other factors were no longer apparent after adjustment for these. These associations persisted in the absence of dementia. In participants with dementia (n = 110), WHODAS II scores were principally associated with physical health and accommodation type. CONCLUSIONS: Level of disability, as measured by the WHODAS II, was principally associated with physical health, depression and cognitive function, rather than socio-demographic factors.

Aged↗

PubMed2005

Comparing effects of methylphenidate, sertraline and placebo on neuropsychiatric sequelae in patients with traumatic brain injury.

BACKGROUND: This study aimed to investigate the effects of methylphenidate and sertraline compared with placebo on various neuropsychiatric sequelae associated with traumatic brain injury (TBI). METHODS: This was a 4 week, double-blind, parallel-group trial. Thirty patients with mild to moderate degrees of TBI were randomly allocated to one of three treatment groups (n = 10 in each group) with matching age, gender and education, i.e. methylphenidate (starting at 5 mg/day and increasing to 20 mg/day in a week), sertraline (starting at 25 mg/day and increasing to 100 mg/day in a week) or placebo. At the baseline and at the 4 week endpoint, the following assessments were administered: subjective (Beck Depression Inventory) and objective (Hamilton Depression Rating Scale) measures of depression; Rivermead Postconcussion Symptoms Questionnaire for postconcussional symptoms; SmithKline Beecham Quality of Life Scale for quality of life; seven performance tests (Critical Flicker Fusion, Choice Reaction Time, Continuous Tracking, Mental Arithmetic, Short-Term memory, Digit Symbol Substitution and Mini-Mental State Examination); subjective measures of sleep (Leeds Sleep Evaluation Questionnaire) and daytime sleepiness (Epworth Sleepiness Scale). All adverse events during the study period were recorded and their relationships to the drugs were assessed. RESULTS: Neuropsychiatric sequelae seemed to take a natural recovery course in patients with traumatic brain injury. Methylphenidate had significant effects on depressive symptoms compared with the placebo, without hindering the natural recovery process of cognitive function. Although sertraline also had significant effects on depressive symptoms compared with the placebo, it did not improve many tests on cognitive performances. Daytime sleepiness was reduced by methylphenidate, while it was not by sertraline. CONCLUSIONS: Methylphenidate and sertraline had similar effects on depressive symptoms. However, methylphenidate seemed to be more beneficial in improving cognitive function and maintaining daytime alertness. Methylphenidate also offered a better tolerability than sertraline.

Adult↗

PubMed2005

Neuropsychiatric symptoms and quality of life in Alzheimer disease.

OBJECTIVE: Authors examined the impact of neuropsychiatric symptoms in Alzheimer disease (AD) patients' and caregivers' quality of life (QOL) and assessed the relationship of caregiver distress to neuropsychiatric symptoms and caregiver QOL. METHODS: Sixty-two patients with probable or possible AD and their caregivers participated. Neuropsychiatric symptoms of patients were assessed with the Neuropsychiatric Inventory (NPI). QOL of both patients and caregivers was assessed using the QOL-Alzheimer's Disease (QOL-AD) scale. Each patient and caregiver completed patient QOL ratings; caregivers also completed caregiver QOL assessments. RESULTS: Caregiver QOL-AD was negatively correlated with agitation/aggression, anxiety, disinhibition, irritability/lability, and total NPI score. Patient QOL on both patient and caregiver ratings was negatively correlated with depression. Patient-reported QOL-AD ratings at different levels of cognitive functioning were not correlated with caregiver-reported ratings. The lack of relationship between patient and caregiver assessments of patient QOL was evident in both mildly and moderately affected patients. Caregiver QOL was negatively correlated with distress related to agitation/aggression, disinhibition, irritability/lability, and total NPI distress. CONCLUSION: Neuropsychiatric symptoms of AD patients adversely affect both patient and caregiver QOL. These results suggest that identifying and treating neuropsychiatric symptoms in AD may improve both patient and caregiver QOL.

Aged↗

PubMed2004

Lifetime urban/rural residence, social support and late-life depression in Korea.

BACKGROUND: Population ageing and rural-urban migration are accelerating in many non-Western nations. This study aimed to investigate: (i) the association between lifetime urban/rural residence and late-life depression in Korea and (ii) modification of associations between depression and social support by lifetime residence. METHODS: 1204 urban/rural residents aged 65+were interviewed and GMS-AGECAT diagnoses made. Previous areas of residence were recorded and social support deficits quantified. RESULTS: Depression was present in 9% and 21% of the rural and urban samples respectively. For the urban sample, depression was not associated with earlier urban/rural residence. Social support deficits were most strongly associated with depression in people with a lifetime rural residence, followed by urban residents with a rural birthplace. CONCLUSIONS: Prevalence rates of depression were increased in the urban sample regardless of previous urban/rural residence. Reduced social support was particularly strongly associated with depression in people with a rural upbringing.

Aged↗

PubMed2004

Assessment of association between mitochondrial aldehyde dehydrogenase polymorphism and Alzheimer's disease in an older Korean population.

BACKGROUND: The mutant allele of mitochondrial aldehyde dehydrogenase (ALDH2(*)2) was found to be associated with Alzheimer's disease (AD) in a Japanese sample, interacting with the apolipoprotein E epsilon 4 allele (Apo E4). OBJECTIVE: In a community Korean population we sought to investigate associations between ALDH2 genotypes and the following outcomes: cognitive impairment, previous cognitive decline, dementia and AD. METHODS: Six hundred ninety community residents aged 65 or over were assessed for demographic characteristics, drinking behaviour, cognitive function, clinical diagnoses of dementia and AD, physical health status, and genotype (ALDH2 and Apo E). RESULTS: There were no significant associations between the ALDH2(*)2 and any cognitive outcome, before or after adjustment for alcohol-related characteristics. These findings were consistent both in the non-drinkers and drinkers. Interaction between ALDH2 and Apo E was only found for one outcome (previous cognitive decline) at borderline levels of significance (P=0.058). CONCLUSIONS: Overall, these findings in a community population did not support a substantial role for ALDH2 genotype in the aetiology of dementia.

Acetaldehyde↗

PubMed2004

Vascular disease/risk and late-life depression in a Korean community population.

BACKGROUND: Associations between vascular risk factors and late-life depression are controversial. AIMS: To investigate the association between measures of vascular disease/risk and depression and confounding and effect modification by APOE genotype and cognitive function. METHOD: In a Korean community population aged 65+ (n=732), diagnosis of depression (Geriatric Mental State Schedule) and information on vascular status, disability, APOE genotype and cognitive function were obtained. RESULTS: Previous stroke and lower high-density lipoprotein cholesterol level (but neither hypertension nor diabetes) were significantly associated with depression (independently of disability and cognitive function). These associations were stronger in participants with borderline cognitive impairment, although not to a significant extent. CONCLUSIONS: Except for previous stroke and an atherogenic lipid profile, associations between depression and other common risk factors for cerebrovascular disease were not evident.

Aged↗

PubMed2004

Brain ferritin iron as a risk factor for age at onset in neurodegenerative diseases.

Tissue iron can promote oxidative damage. Brain iron increases with age and is abnormally elevated early in the disease process in several neurodegenerative disorders, including Alzheimer's disease (AD) and Parkinson's disease (PD). Higher iron levels in males may contribute to higher risk for younger-onset PD and recent studies have linked the presence of the hemochromatosis gene with a younger age at onset of AD. We examined whether age at onset of PD and AD was associated with increased brain ferritin iron. Ferritin iron can be measured with specificity in vivo with MRI utilizing the field-dependent relaxation rate increase (FDRI) method. FDRI was assessed in three basal ganglia regions (caudate, putamen, and globus pallidus) and frontal lobe white matter for younger- and older-onset male PD and AD patients and healthy controls. Significant increases in basal ganglia FDRI levels were observed in the younger-onset groups of both diseases compared to their respective control groups, but were absent in the older-onset patients. The results support the suggestion that elevated ferritin iron and its associated toxicity is a risk factor for age at onset of neurodegenerative diseases such as AD and PD. Clinical phenomena such as gender-associated risk of developing neurodegenerative diseases and the age at onset of such diseases may be associated with brain iron levels. In vivo MRI can measure and track brain ferritin iron levels and provides an opportunity to design therapeutic interventions that target high-risk populations early in the course of illness, possibly even before symptoms appear.

Age Factors↗

PubMed2003

Diagnosing dementia in a developing nation: an evaluation of the GMS-AGECAT algorithm in an older Korean population.

BACKGROUND: Numbers of older people are increasing rapidly in many developing nations and there is a pressing need for epidemiological studies of psychiatric morbidity, particularly dementia. Valid methods for case identification are an important first step. The Geriatric Mental State (GMS) is a widely used diagnostic instrument but has received little formal evaluation in developing nations. The objective of this study was to investigate the screening properties of GMS organic disorder with respect to clinically diagnosed dementia in an older Korean population, about half of whom have received no formal education. METHODS: 746 people aged 65+ in Kwangju, South Korea who were participants in a community survey of psychiatic morbidity, completed a GMS interview (with diagnoses assigned through the AGECAT computerised algorithm) and, independently, received a clinical assessment for dementia. RESULTS: GMS organic disorder was diagnosed in 262 participants (35%) and DSM-IV dementia in 110 (15%). Increased age, female gender and lower education independently predicted disagreement between the two diagnoses. In these groups, GMS sensitivity to a clinical diagnosis of dementia remained high but specificity was markedly reduced. CONCLUSIONS: Dementia may be overestimated in developing nations if the GMS-AGECAT diagnosis of organic disorder is used alone. The validity of other diagnoses, such as affective disorder, may also be affected if the hierarchical diagnostic algorithm is used (i.e. where the diagnosis of organic disorder affects the likelihood of other diagnoses).

Aged↗

PubMed2003

Differences in the behavioral and psychological symptoms between Alzheimer's disease and vascular dementia: are the different pharmacologic treatment strategies justifiable?

BACKGROUND: This study aimed (1) to compare the behavioral and psychological symptoms of dementia (BPSD) between patients with Alzheimer's disease (AD) and vascular dementia (VaD); (2) to investigate the differences in the correlates of BPSD between them; and (3) to suggest potential different pharmacological strategies in treating BPSD of either etiology. METHODS: In a study group of 135 patients with dementia (99 AD, 36 VaD), information on age, gender, education, age at onset and duration of dementia was collected. The severity of dementia was measured by the following assessment scales: Korean version of Mini-Mental State Examination (MMSE-K) for cognitive function; Blessed Dementia Scale (BDS) for functional activities of daily living (ADL); Barthel Index (BI) for physical ADL; and Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Scale (HAM-D) and Hamilton Anxiety Scale (HAM-A) for BPSD. The independent variables between the patients with AD and VaD were compared, and then the correlations of BPSD with other variables were estimated. RESULTS: HAM-D and HAM-A scores were higher in patients with VaD than in those with AD, while other variables demonstrated no statistical differences. BPRS score correlated with scores on MMSE-K, BDS and BI in AD, but only with BDS in VaD. The HAM-D score correlated with scores on BDS and BI in AD, but only with BDS in VaD. The HAM-A score was correlated with score on BDS in AD not in VaD. CONCLUSIONS: BPSD were more severe in the patients with VaD. However, BPSD correlated more prominently with cognitive or ADL impairments in patients with AD. Different treatment approaches to BPSD may be required according to the clinical differentiation of dementia type.

Aged↗

PubMed2003

Risperidone use in Korean patients with Alzheimer's disease: optimal dosage and effect on behavioural and psychological symptoms, cognitive function and activities of daily living.

BACKGROUND: This study aimed to investigate the effect of risperidone on the behavioural and psychological symptoms (BPS), cognitive function and activities of daily living (ADL) of Alzheimer's disease (AD). The optimal dose of risperidone in Korean patients with AD was determined with respect to both efficacy and safety profiles. METHODS: This was an 8 week prospective, open-labelled study with risperidone. The following efficacy measures were implemented: Behaviour Pathology in Alzheimer's Disease Rating Scale, Korean version for BPS; Korean version of mini-mental state examination for cognitive function; Barthel activities of daily living and blessed dementia rating scale for ADL; and global deterioration scale for global assessment of severity. Adverse events were recorded using the UKU side effect rating scale. RESULTS: Forty-eight patients completed the study. Risperidone was effective in reducing the BPS without affecting the cognitive and ADL domains of AD symptomatology. Risperidone dosages of 0.25 or 0.5 mg/day were most frequently administered and demonstrated the most favourable outcomes by efficacy and safety measures. Risperidone treatment was generally well tolerated, although extrapyramidal symptoms were noted in a dose-dependent manner. CONCLUSIONS: These results suggest that low dosages of risperidone are effective and favourable in reduction of the BPS for Korean patients with AD.

Activities of Daily Living↗