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Objectives: Perinatal depression is prevalent and affects the physical and psychological well-being of both mothers and their offspring. Conventional antidepressants represent the most commonly used pharmacological treatments. However, concerns about safety during pregnancy and breastfeeding persist, alongside limitations such as delayed onset of action and suboptimal response rates. This review comprehensively examines biological treatment strategies for perinatal depression, with a focus on evidence for conventional antidepressants, novel neurosteroid-based therapies, emerging experimental treatments including oxytocin and perioperative esketamine, and neuromodulation methods. Mechanism: Conventional antidepressants modulate monoamine neurotransmission. Novel agents such as brexanolone, zuranolone, and esketamine act through neurosteroid modulation and N-methyl-D-aspartate (NMDA) receptor antagonism, producing rapid antidepressant effects. Oxytocin, a neuropeptide involved in social bonding and stress regulation, contributes to maternal mood regulation. Neuromodulation techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), target relevant brain circuits. Findings in Brief: Evidence indicates a slight increase in the risk of congenital malformations, particularly cardiovascular (CV) defects, and birth complications such as preterm birth or low birth weight associated with antidepressant use. However, absolute risks remain small and warrant cautious interpretation, as maternal depression itself is linked to adverse birth outcomes. Late pregnancy exposure to antidepressants may increase the risk of neonatal withdrawal symptoms or persistent pulmonary hypertension, but clinical guidelines do not recommend tapering treatment solely to prevent these outcomes. Brexanolone, zuranolone, and esketamine have emerged as rapid postpartum treatments, often used alongside standard antidepressants. Intranasal oxytocin and perioperative esketamine administered during cesarean section show promise, warranting further study. Neuromodulation techniques like rTMS and tDCS offer potential as adjuncts or alternatives. Conclusions: Biological treatments for perinatal depression are evolving rapidly. While conventional antidepressants remain the foundation of therapy, neurosteroids, esketamine, and oxytocin offer promising complementary options. Neuromodulation methods provide emerging alternatives. Ongoing research is essential to establish their safety and efficacy in perinatal populations and tailor personalized treatments that balance maternal and fetal-neonatal health.

BackgroundHeadache disorder is not only a common complaint but also a global burden. Pharmacotherapeutic and non-pharmacotherapeutic approaches have been developed for its treatment and prophylaxis. The present study included a systematic review of psychological treatments for primary headache disorder accessible in Korea.MethodsWe included English and Korean articles from EMBASE, MEDLINE, Cochrane library database, SCOPUS, ScienceDirect, Web of Science, CINAHL, PsycArticles and Korean database, KoreaMed and KMBASE which studied primary headache and medication-overuse headache. The primary efficacy measure was the number of headache days per month, while secondary efficacy measures were the number of headache attacks per week, headache index, treatment response rate, and migraine disability assessment. The meta-analysis was performed using R 3.5.1. to obtain pooled mean difference and pooled relative risk with 95% confidence interval (CI) for continuous data and dichotomous data, respectively.ResultsFrom 12,773 identified articles, 27 randomized clinical trials were identified. Primary outcome showed significant superiority of psychological treatments (pooled mean difference = − 0.70, 95% CI [− 1.22, − 0.18]). For the secondary outcomes, the number of headache attacks (pooled mean difference = − 1.15, 95% CI [− 1.63, − 0.67]), the headache index (pooled mean difference = − 0.92, 95% CI [− 1.40 to − 0.44]) and the treatment response rate (pooled relative risk = 3.13, 95% CI [2.24, 4.37]) demonstrated significant improvements in the psychological treatment group over the control group.ConclusionPsychological treatments for primary headache disorder reduced headache frequency and the headache index. Future research using standardized outcome measures and strategies for reducing bias is needed.

Screening for depression in males is important because their symptoms differ from those of females, ranging from indications of aggression to attempts at suicide. Men and women differ in their responses to job stress. There are no tools that have been verified, developed, or translated for screening male depression in Korea. Our team translated the Gotland Male Depression Scale (GMDS) into Korean. The Korean version of GMDS (K-GMDS) and Maslach Burnout Inventory-General Survey (MBI-GS) were administered to 277 office workers in one public institution. Gender differences in each scale score were measured along with the correlation between the K-GMDS and the MBI-GS. There was no significant difference in the K-GMDS score between males and females, whereas females scored significantly higher on the MBI-GS (p < .001). The correlation between the K-GMDS total score and the MBI total score (male: r = .702, p < .001, female: r = .375, p < .001) and MBI subscale scores were higher in males than females. Gender moderated the relationship between total K-GMDS and total MBI scores (p < .001). The Korean version of the GMDS is suitable for screening male depression symptoms in the workplace. The results of the K-GMDS demonstrated a strong correlation between depressive symptoms and work-related burnout among men. This study can be used as a basis for studying male depression symptoms in Korea, which has not been studied extensively. This will prove beneficial for work environments.

Although metabolic acid load has been associated with many well-known risk factors for mortality, its clinical implications are not yet clear. To evaluate the association between biomarkers of metabolic acid load, such as serum bicarbonate, serum anion gap and urine pH and mortality, we analyzed the health records of 31,590 adults who underwent a health screening between January 2001 and December 2010 and had an estimated glomerular filtration rate ⩾60 ml min(-1) per 1.73 m2. Urine pH was measured by a dipstick test performed on fast morning urine sample and categorized as acidic (urine pH ⩽5.5), neutral and alkaline (urine pH ⩾8.0). Using the Cox proportional hazard model, the adjusted hazard ratio (aHR) of all-cause mortality of the lowest quartile of serum bicarbonate was 1.460 (95% confidence interval (CI) 1.068-1.995) compared with the highest quartile, after a median follow-up of 93 months. The aHRs of cardiovascular and cancer mortality of the lowest quartile of serum bicarbonate were 2.647 (95% CI 1.148-6.103) and 1.604 (95% CI 1.024-2.513), respectively, compared with the highest quartile. Acidic and neutral urine pH were significantly associated with a higher all-cause mortality (aHR 2.550, 95% CI 1.316-4.935; aHR 2.376 95% CI 1.254-4.501, respectively), compared with an alkaline urine pH. In conclusion, higher metabolic acid load was associated with an increased all-cause and cardiovascular mortality in a healthy population. The association between metabolic acid load and mortality and the causality of the relationship need to be confirmed.

Purpose: This study used quantitative electroencephalography (QEEG) to investigate the characteristics of attention-deficit/hyper-activity disorder (ADHD) subtypes in children. Patients and Methods: There were 69 subjects (42 with ADHD and 27 neurotypical (NT)) in this study. A semi-structured interview was conducted with each participant for psychiatric diagnostic evaluation. We measured the absolute and relative power in 19 channels and analyzed QEEG using the following frequency ranges: delta (1-4 Hz), theta (4-8 Hz), alpha 1 (8-10 Hz), alpha 2 (10-12 Hz), beta 1 (12-15 Hz), beta 2 (15-20 Hz), beta 3 (20-30 Hz), and gamma (30-45 Hz). Group analyses and EEG noise preprocessing were conducted using iSyncBrain, a cloud-based, artificial intelligence EEG analysis platform. Analysis of covariance adjusted for IQ, age, and sex was used. Results: QEEG analysis revealed three ADHD subtypes, characterized by (A) elevated relative fast alpha and beta power, (B) elevated absolute slow frequency (delta and theta power), or (C) elevated absolute and relative beta power. A significant difference was found in the Korean ADHD Rating Scale (K-ARS) among the four groups (df=3, F=8.004, p<0.001); group C had the highest score (25.31 [+ or -]11.16), followed by group A (21.67[+ or -]13.18). The score of group B (12.64[+ or -]7.84) was similar to that of the NT group (11.07[+ or -]6.12) and did not reach the cut-off point of the K-ARS. In the Wender-Utah Rating Scale (WURS), group B score (55.82[+ or -]23.17) was significantly higher than the NT group score (42.81[+ or -]13.26). Conclusion: These results indicate that children with ADHD do not constitute a neurophysiologically homogenous group. Children with QEEG subtype B (elevated slow frequency) may be difficult to distinguish from normal children using the K-ARS, which is the most common screening tool for ADHD. Moreover, parents of children with this subtype may be less sensitive to observing ADHD symptoms. Keywords: attention-deficit/hyperactivity disorder, quantitative electroencephalography, subtype, clinical characteristics

This study aimed to evaluate the psychometric properties of the Korean version of the Clinically Useful Anxiety Outcome Scale (CUXOS) and to examine the current diagnostic comorbidity and differential severity of anxiety symptoms between major depressive disorder (MDD) and anxiety disorders. In total, 838 psychiatric outpatients were analyzed at their intake appointment. Diagnostic characteristics were examined using the structured clinical interview from the DSM-IV because the DSM5 was not available at the start of the study. The CUXOS score was measured and compared with that of 3 clinician rating scales and 4 self-report scales. The CUXOS showed excellent results for internal consistency (Cronbach's α = 0.90), test-retest reliability (r = 0.74), and discriminant and convergent validity. The CUXOS significantly discriminated between different levels of anxiety severity, and the measure was sensitive to change after treatment. Approximately 45% of patients with MDD were additionally diagnosed with anxiety disorders while 55% of patients with anxiety disorders additionally reported an MDD. There was a significant difference in CUXOS scores between diagnostic categories (MDD only, anxiety only, both disorders, and no MDD or anxiety disorder). The CUXOS scores differed significantly between all categories of depression (major, minor, and non-depression) except for the comparison between minor depression and non-depression groups. The Korean version of the CUXOS is a reliable and valid measure of the severity of anxiety symptoms. The use of the CUXOS could broaden the understanding of coexisting and differentiating characteristics of anxiety and depression.

Background: Hand function is an overall indicator of health and is often measured using grip strength. Hand-held dynamometry is the most common method of measuring grip strength. The purpose of this study was to determine the inter-rater and test-retest reliability, the reliability of one trial versus three trials, and the preliminary norms for a young adult population using the Baseline® Pneumatic Squeeze Bulb Dynamometer (30 psi). Methods: This study used a one-group methodological design. One hundred and three healthy adults (30 males and 73 females) were recruited. Six measurements were collected for each hand per participant. The data was analyzed using Intraclass Correlation Coefficients (ICC) two-way effects model (2,2) and paired-samples t-tests. Results: The ICC for inter-rater reliability ranged from 0.955 to 0.977. Conclusion: The results of this study suggest that the bulb dynamometer is a reliable tool to measure grip strength and should be further explored for reliable and valid use in diverse populations and as an alternative to the Jamar dynamometer.

ABSTRACTBackgroundPrevious studies suggest that there is a strong association between depression and cognitive decline, and that concurrent depressive symptoms in MCI patients could contribute to a difference in neurocognitive characteristics compared to MCI patients without depression. The authors tried to compare neurocognitive functions between MCI patients with and without depression by analyzing the results of neuropsychological tests. MethodsParticipants included 153 MCI patients. Based on the diagnosis of major depressive disorder, the participants were divided into two groups: depressed MCI (MCI/D+) versus non-depressed MCI (MCI/D−). The general cognitive and functional statuses of participants were evaluated. And a subset of various neuropsychological tests was presented to participants. Demographic and clinical data were analyzed using Student t-test or χ2 test. ResultsA total of 153 participants were divided into two groups: 94 MCI/D+ patients and 59 MCI/D− patients. Age, sex, and years of education were not significantly different between the two groups. There were no significant differences in general cognitive status between MCI/D+ and MCI/D− patients, but MCI/D+ participants showed significantly reduced performance in the six subtests (Contrasting Program, Go-no-go task, Fist-edge-palm task, Constructional Praxis, Memory Recall, TMT-A) compared with MCI/D− patients. ConclusionsThere were significantly greater deficits in neurocognitive functions including verbal memory, executive function, attention/processing speed, and visual memory in MCI/D+ participants compared to MCI/D−. Once the biological mechanism is identified, distinct approaches in treatment or prevention will be determined.