Hojun Lee

Major depressive disorder (MDD) is a heterogeneous condition with substantial variability in antidepressant treatment response. Identifying predictive biom

Objective Based on the neuroimmunological hypothesis of major depressive disorder (MDD), we analyzed the existing research to identify cytokine-related genes associated with MDD. Furthermore, we examined the cytokine alterations in patients with MDD as potential biomarkers for diagnosis and monitoring.Methods Differentially expressed genes (DEGs) related to MDD were identified using the GEO2R tool on public datasets, followed by functional enrichment analyses with Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathways. Protein-protein interaction (PPI) networks were constructed using Cytoscape to identify hub genes. Finally, blood samples from 20 patients with MDD and 10 healthy controls were analyzed using the Olink® Target 96 Inflammation panel with proximity extension assay (PEA) technology to identify potential protein biomarkers.Results Two GEO datasets related to MDD were analyzed to identify 66 common DEGs. Following the PPI analysis, 46 genes were identified. Functional enrichment analysis revealed that these genes were closely related to immune-related pathways. Subsequent blood sample analysis of patients with MDD and healthy controls confirmed that 18 cytokines related to 46 DEGs were significantly upregulated. Among the identified cytokines, oncostatin M (OSM) showed the highest receiver operating characteristic (ROC) performance (area under the curve [AUC]=0.96), followed by hepatocyte growth factor (HGF) (AUC=0.95), cluster of differentiation 6 (CD6) (AUC=0.90), and tumor necrosis factor superfamily 14 (TNFSF14) (AUC=0.90).Conclusion Our study confirms that neuroinflammation is an important pathophysiological aspect of MDD and that several related cytokines, such as OSM, HGF, CD6, and TNFSF14, may be potential biomarkers of MDD.

This study conducted an in-depth analysis of the psychological states of teachers during the first outbreak of coronavirus disease 2019 (COVID-19) using data on school mental health projects related to COVID-19 in Daegu from May to June 2020. The participants comprised 811 (34.9%) male and 1,511 (65.1%) female teachers in 1,041 (44.8%) middle and 1,281 (55.2%) high schools. After schools reopened, the most common causes of unbearable stress were unusual experiences, fear of infection, and negative emotions. Moreover, 41.5%/40.4% reported experiencing anxiety/depression, out of which 25.1%/23.6%, 10.0%/14.0%, and 6.4%/2.8% exhibited mild, moderate, and severe levels, respectively. The study identified the following influencing factors of anxiety: being female (OR: 1.52), years of employment (≤5 and <15; OR: 1.36; reference: <5), average monthly household income (≤3,000,000 and <5,000,000 [OR: 0.69], 5,000,000 ≤ [OR: 0.67]; reference ≤1,000,000 and <3,000,000 won), depression (OR: 19.14), posttraumatic stress symptoms (OR: 11.65), job stress (OR: 9.13), resilience (OR: 0.37), and subjective well-being (OR: 0.45). We identified the following factors for depression: being female (OR: 1.51), aged 40s (OR: 1.70; reference: 20s), average monthly household income (≤3,000,000 and <5,000,000 [OR: 0.75], ≤5,000,000 [OR: 0.66]; reference: ≤1,000,000 and <3,000,000 won), anxiety (OR: 19.14), posttraumatic stress symptoms (OR: 4.03), job stress (OR: 14.04), resilience (OR: 0.29), and subjective well-being (OR: 0.33). The findings suggest a necessity for specific, systematic measures and psychological support to teachers vulnerable to the impact of disasters, such as the COVID-19 pandemic, to cope with disasters and improve school adaptation.

Hyung Nam Park, Na Yeong Kong, Hee-Cheol Kim, Yang Tae Kim, Sung-Won Jung, and Hojun Lee. J Korean Acad Child Adolesc Psychiatry 2024;35:82-9. https://doi.org/10.5765/jkacap.230048

Children diagnosed with attention deficit hyperactivity disorder (ADHD) require early intervention and sustained treatment. This study used a game-based digital treatment planning NeuroWorld DTx to analyze the impact on attention and cognitive function in children with ADHD. Thirty children diagnosed with ADHD were recruited and subjected to a four-week NeuroWorld DTx digital treatment. To assess the impact of the digital therapeutic therapy on children’s attention, we used the comprehension attention test (CAT) and Korean ADHD Rating Scale (K-ARS). Clinical global impression (CGI) and the Korean-child behavior checklist (K-CBCL 6–18) were used to examine the degree of improvement in ADHD. After four weeks, significant differences in the sensitivity and response style indices were noted, as compared with the baseline in the CAT test; in the case of K-ARS and CGI, a moderate decrease in ADHD was confirmed. The study achieved better results for the “total behavior problems” belonging to the K-CBCL assessment. Game-based digital therapy intervention can be a treatment method that elicits interest and satisfaction in children with ADHD and can be used as an adjunct to drug therapy to improve the quality of life and strengthen attention in children with symptoms of ADHD.

BackgroundsStudies to date detailing trajectories of depressive symptom dimensions in patients undergoing index electroconvulsive therapy (ECT) have been small in number; many studies have focused on the total score of the rating scale. This Study aimed to investigate the trajectories of depressive symptom dimensions and the time point when the difference in improvement of depressive symptom dimensions between the remitters and non-remitters appeared.MethodsA retrospective analysis was performed on 80 patients with major depressive disorder who underwent index ECT. The Hamilton Depression Rating Scale-17 was used, and each item was clustered into four dimensions (depression, anxiety, insomnia, and somatic symptoms). Dimensions were standardized to a T-score and assessed at five time points (pre-ECT, and after the third, sixth, ninth, and twelfth ECT session). The data were analyzed using the generalized estimating equations method.ResultsIn the total sample, the T-scores of all dimensions continued to reduce significantly until the sixth session. The reduction of the depression dimension T-score was prolonged until the ninth session. Significant differences in the amount of improvement between remitters and non-remitters appeared after the sixth session. The depression dimension showed a greater reduction in T-score than the other dimensions throughout the entire index ECT course.ConclusionsThe depression dimension improved more than other dimensions in patients undergoing ECT. It may be beneficial to administer at least six treatments to avoid early termination of ECT and relapse. Managing other depressive symptoms, such as insomnia, could play a significant role in improving therapeutic effect. Further studies examining depression symptoms using more accurate scales and specifying the neuronal circuits associated with each dimension are necessary.

Background: Attempts to use virtual reality (VR) as a treatment for various psychiatric disorders have been made recently, and many researchers have identified the effects of VR in psychiatric disorders. Studies have reported that VR therapy is effective in social anxiety disorder (SAD). However, there is no prior study on the neural correlates of VR therapy in patients with SAD. Objective: The aim of this study is to find the neural correlates of VR therapy by evaluating the treatment effectiveness of VR in patients with SAD using portable functional near-infrared spectroscopy (fNIRS). Methods: Patients with SAD (n=28) were provided with 6 sessions of VR treatment that was developed for exposure to social situations with a recording system of each participant’s self-introduction in VR. After each VR treatment session, the first-person view (video 1) and third-person view (video 2) clips of the participant’s self-introduction were automatically generated. The functional activities of prefrontal regions were measured by fNIRS while watching videos 1 and 2 with a cognitive task, before and after whole VR treatment sessions, and after the first session of VR treatment. We compared the data of fNIRS between patients with SAD and healthy controls (HCs; n=27). Results: We found that reduction in activities of the right frontopolar prefrontal cortex (FPPFC) in HCs was greater than in the SAD group at baseline (t=–2.01, P=.049). Comparing the frontal cortex activation before and after VR treatment sessions in the SAD group showed significant differences in activities of the FPPFC (right: t=–2.93, P<.001; left: t=–2.25, P=.03) and the orbitofrontal cortex (OFC) (right: t=–2.10, P=.045; left: t=–2.21, P=.04) while watching video 2. Conclusions: Activities of the FPPFC and OFC were associated with symptom reduction after VR treatment for SAD. Our study findings might provide a clue to understanding the mechanisms underlying VR treatment for SAD. Trial Registration: Clinical Research Information Service (CRIS) KCT0003854; https://tinyurl.com/559jp2kp

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Attempts to use virtual reality (VR) as a treatment for various psychiatric disorders have been made recently, and many researchers have identified the effects of VR in psychiatric disorders. Studies have reported that VR therapy is effective in social anxiety disorder (SAD). However, there is no prior study on the neural correlates of VR therapy in patients with SAD. Objective: The aim of this study is to find the neural correlates of VR therapy by evaluating the treatment effectiveness of VR in patients with SAD using portable functional near-infrared spectroscopy (fNIRS). Methods: Patients with SAD (n=28) were provided with 6 sessions of VR treatment that was developed for exposure to social situations with a recording system of each participant’s self-introduction in VR. After each VR treatment session, the first-person view (video 1) and third-person view (video 2) clips of the participant’s self-introduction were automatically generated. The functional activities of prefrontal regions were measured by fNIRS while watching videos 1 and 2 with a cognitive task, before and after whole VR treatment sessions, and after the first session of VR treatment. We compared the data of fNIRS between patients with SAD and healthy controls (HCs; n=27). Results: We found that reduction in activities of the right frontopolar prefrontal cortex (FPPFC) in HCs was greater than in the SAD group at baseline (t=–2.01, P=.049). Comparing the frontal cortex activation before and after VR treatment sessions in the SAD group showed significant differences in activities of the FPPFC (right: t=–2.93, P<.001; left: t=–2.25, P=.03) and the orbitofrontal cortex (OFC) (right: t=–2.10, P=.045; left: t=–2.21, P=.04) while watching video 2. Conclusions: Activities of the FPPFC and OFC were associated with symptom reduction after VR treatment for SAD. Our study findings might provide a clue to understanding the mechanisms underlying VR treatment for SAD. Clinical Trial: Clinical Research Information Service (CRIS) KCT0003854; https://tinyurl.com/559jp2kp