Prevalence and Correlates of DSM-IV Mental Disorders in South Korean Adults: The Korean Epidemiologic Catchment Area Study 2011

OBJECTIVE: The aim of this study was to estimate the prevalence and correlates of mental disorders in Korean adults. METHODS: Door to door household surveys were conducted with community residents aged 18-74 years from July 19, 2011, to November 16, 2011 (n=6,022, response rate 78.7%). The sample was drawn from 12 catchment areas using a multistage cluster method. Each subject was assessed using the Korean version of the World Health Organization Composite International Diagnostic Interview (CIDI) based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). RESULTS: Lifetime and 12-month prevalence estimates were as follows: alcohol use disorders, 13.4% and 4.4%, respectively; nicotine use disorders, 7.2% and 4.0%, respectively; anxiety disorders, 8.7% and 6.8%, respectively; and mood disorders, 7.5% and 3.6%, respectively. The prevalence rates of all types of DSM-IV mental disorders were 27.6% and 16.0%, respectively. Being female; young; divorced, separated, or widowed; and in a low-income group were associated with mood and anxiety disorders after adjustment for various demographic variables, whereas being male and young were associated with alcohol use disorders. Higher income was not correlated with alcohol use disorder as it had been in the 2001 survey. CONCLUSION: The rate of depressive disorders has increased since 2001 (the first national survey), whereas that of anxiety disorders has been relatively stable. The prevalence of nicotine and alcohol use disorders has decreased, and the male-to-female ratio of those with this diagnosis has also decreased.

Correlation between Tobacco Smoking and Mental Disorders Including Suicidal Tendencies / 신경정신의학

OBJECTIVES: In South Korea, there is limited information on nicotine dependence (ND) and its correlation with psychiatric disorders. Based on the National Epidemiologic Survey of Psychiatric Disorders in South Korea in 2006, we examined the relationship between the severity of tobacco smoking and mental disorders, paying specific attention to suicidal ideas, plans, and attempts. METHODS: A total of 6,510 adults underwent face-to-face interviews. The Korean version of the Composite International Diagnostic Interview (K-CIDI) was used to evaluate lifetime prevalence and correlates of mental disorders. According to the the severity of tobacco smoking, participants were grouped into never-smokers, ever-smokers, and ND. The frequencies of mental disorders and suicidal tendencies were analyzed among ND/ever-smokers. Multivariate logistic regression analysis was used to predict the odds ratios and significance levels among groups. RESULTS: Associations of ND with alcohol use disorder, mood disorder, anxiety disorder, pathological gambling, and suicidal tendencies were significant, even after controlling for demographic characteristics. Associations of most psychiatric disorders with smoking were stronger in females than in males. CONCLUSION: ND is highly associated with alcohol use disorder, mood and anxiety disorders, pathological gambling, and suicidal tendencies. Interventions are needed in order to prevent the development of ND from regular smoking.

The Psychometric Properties of Night Eating Questionnaire in Schizophrenic Outpatients / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the psychometric properties of the Night Eating Questionnaire (NEQ) as a measure of the night eating syndrome (NES) in a sample of outpatients with schizophrenia. METHODS: The behavioral and psychological symptoms of NES were assessed with the 14-item self-report questionnaire (NEQ). Body weight and height were measured to calculate the body mass index (BMI). Subjective estimates of depression, binge eating patterns, sleep quality and weight-related quality of life were evaluated using Beck's Depression Inventory (BDI), the Binge Eating Scale (BES), the Pittsburgh Sleep Quality Index (PSQI) and the Korean version of Obesity-related Quality of Life (KOQoL) Scale. RESULTS: Among 165 schizophrenic outpatients who completed the NEQ, 15 (9.1%) patients screened as having NES (total NEQ > or =25). The NEQ demonstrated high internal consistency (Cronbach's alpha=0.72), and the item-total correlations (r=0.29-0.75 ; p<0.001, respectively) were acceptable, except for morning anorexia. A principal components analysis revealed five factors (nocturnal ingestions, evening hyperphagia, mood/sleep, morning anorexia, and delayed morning meal), which explained 65.7% of the total variance. Although the NEQ total score was not correlated with BMI, age at onset, duration of illness, or use of atypical antipsychotics, it was significantly correlated with total scores on the BDI, BES, PSQI and KOQoL. Test-retest reliability was also good (r=0.74, p<0.001). CONCLUSION: Our results showed that the NEQ appears to be an efficient, valid measure of NES in outpatients with schizophrenia.

Prevalence and Correlates of Major Mental Disorders among Korean Adults : A 2006 National Epidemiologic Survey / 신경정신의학

OBJECTIVES : The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. METHODS : The Korean Epidemiologic Catchment Area study Replication (KECA-R) was conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target population included all eligible residents aged 18 to 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). RESULTS : A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nictotine use disorder, 9.0% and 6.0%;3) specific phobia, 3.8% and 3.4%;4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. CONCLUSION : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.

Prevalence, Correlates, and Comorbidity of 12-Month Tobacco Dependence among Ever-smokers in South Korea, During 1984-2001

The rate of dependence among ever-users of a drug indicates the risk of developing dependence once an individual has been exposed to the drug. This is the first study to investigate 12-month tobacco dependence (TD) among ever-smokers in a community-based population. Analyses were based on two national studies of representative samples aged 18-64 in 1984 (n=5,025) and in 2001 (n=6,275), conducted with household visits and face-to-face interviews. The rates of 12-month TD among ever-smokers in men showed no significant difference between 51.6% in 1984 and 50.6% in 2001. On the contrary, the rates in women significantly increased from 33.3% in 1984 to 52.8% in 2001. After adjusting for the sociodemographic variables, 'male gender' was significantly associated with 12-month TD among eversmokers in 1984, but not in 2001. 'Unmarried' was significantly associated in 2001 but not in 1984. 'Alcohol dependence' was the only psychiatric disorder associated with 12-month TD in both study years. In conclusion, 12-month TD was found in about 50% of ever-smokers, and gender differences between the rates of 12-month TD which was observed in 1984 disappeared in 2001. Individuals with 12-month TD showed higher comorbidity with alcohol dependence than ever-smokers without TD.

Korean Epidemiologic Catchment Area(KECA) Study for Psychiatric Disorderscc: Prevalence of Specific Psychiatric Disorders / 신경정신의학

OBJECTIVES: This study aims to estimate the prevalence of the DSM-IV psychiatric disorders in Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). METHODS: Subjects were selected by taking multi-stage, cluster samples of 7,867 adult household residents, 18 to 64 years of age, in ten catchment areas. Total 78 trained interviewers administered the K-CIDI to the selected respondents, from June 1 to November 30, 2001. RESULTS: Total 6,275 respondents completed the interview. Some 33.5% of respondents reported at least one lifetime disorder, 20.6% reported at least one-year disorder, and 16.7% reported at least one-month disorder. The most common lifetime disorders were alcohol abuse/dependence (17.24%), nicotine dependence/withdrawal (11.19%), specific phobia (5.16%), and major depressive disorder (4.25%). The lifetime prevalence of substance abuse/dependence (0.25%) and schizophrenia (0.16%) was very low. Nicotine and alcohol use disorder showed very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among female than male. CONCLUSION: The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in distributions of psychiatric disorders across the areas and times were observed.

A Study of Obstetric Complications and Minor Physical Anomalies in Sibling and Sporadic Schizophrenics / 신경정신의학

The authors hypothesized that sporadic schziophrenic patients had more chances of receiving environmental insults during the fetal neural development compared with familial schizophrenics. We tested our hypothesis by comparing obstetric complications(OCs), minor physical anomalies(MPAs) and other clinical features, and examining the correlation between OCs and MPAs in schziophrenic patients who had one or more sibling with schizophrenia(sibling group) and sporadic schizophrenics(sporadic group) and normal controls. OCs were evaluated by the scale of Lewis, and MPAs were measured by the Waldrop scale. There were no significant differences in OCs and MPAs between schizophrenic and control groups. Sporadic group had significantly higher fetal distress, total Waldrop score and Waldrop score for mouth than sibling group. And there was a tendency that the number of subjects having the Waldrop score over 4 points was greater in the sporadic group. No significant correlation was observed between OCs and MPAs. The scores of initial psychopathology and post-treatment functioning were much higher in the sporadic group, but the other clinical features showed no differences. Although male patients had more OCs than female patients in sibling group, no sex differences were observed as a whole. Our results suggest that, if the methodological weakness were complemented, OCs and MPAs would be useful tools in the search for the cause of schizophrenia.

The Quality of Life of Chronic Mental Patients according to Therapeutic Environment / 신경정신의학

OBJECTIVES: This study aimed to figure out the characteristics and differences of therapeutic environment by classifying into closed-ward inpatient, open-ward inpatient and community residence outpatient environment and comparing objective and subjective quality of life of each group. METHODS: The subjects consisted of 67 open-ward chronic inpatients, 58 closed -ward inpatients in the National Naju Mental Hospital and 85 outpatients living in Naju. We measured objective and subjective quality of life using semi-structural interview by Leman's quality of life scale and compared the 3 groups. We used one-way ANOVA and chi-square test to analyze the differences of the 3 groups. RESULTS: Open-ward inpatients who have autonomy and various community service program were more satisfied with their general life than the others. Community residence outpatients spent more money and less assaults experience but their leisure activities and social contact frequencies were lower than in the inpatients. Outpatients were less satisfied with their health, finances and leasure activities. Inpatients had more leisure activities and higher social contact frequency than outpatients. They were more satisfied with their finances despite of spending less the money monthly than the outpatients. They experienced violence and damage more often for the past one year and were more satisfied with their health. CONCLUSION: The quality of life reported by chronic mental patients differed according to the characteristics of therapeutic environment. The life-quality of open-ward inpatients were the highest among the 3 groups. It is necessary to serve various community service program so that we can improve the life-quality of community residence outpatients.

The Relation of Mood Disorder to Season of Birth / 신경정신의학

To examine the relation of mood disorder to season of birth, we analyzed the data of 156 male and female mood disorder patients who were admitted to or visited NaJu National Mental Hospital from March 1997 to June 1997. The results of this study were as follows: 1) There was a significant difference of birth season distribution in patients with mood disorder compared with that of geneal population. We suggest that birth seasonal factors have influence on onset of mood disorder. 2) High onset rate in spring was noted in patients with mood disorders. Winter-born patients had a significantly low onset rate in autumn, and autumn-born patients had a significantly low onset rate in winter. The results suggest that seasonal factors affecting onset of schizophrenia are associated with onset of mood disorder. Further studies should follow to find out concrete and objective relation of mood disorder to season of birth.

A Comparative Study on the Therapeutic Setting of the Open and the Closed Ward in Mental Hospital / 신경정신의학

OBJECTIVES: The treatment setting of mental hospital has a great influence on the outcome of treatment. The authors compared the characteristics of treatment setting of the open and the closed wards in a mental hospital and the attitudes of the staff and patients on each ward. METHODS: Total four wards two typical open wards and two typical closed wards were selected and each contained one male ward and one female ward. Ward Atmosphere Scale(WAS) was conducted to each and the mean scores of suscales of WAS were compared by using Student's t-test. RESULTS: 1) The closed ward was similar to the treatment setting of control-oriented program which stresses the stator control and the nile of ward and ignores the autonomy of patients and such a evaluation was perceived more by the patients than by the staff. 2) The open ward supported and encouraged the staff and patients and focused on solving the practical problems of the patients, and especially the staff perceived it as the treatment program the activated ward. 3) It was shown that the open ward was more therapeutic and while it focused on the autonomous problem solving, the closed ward pup enguasis on the protection of patients. In addition, the patients were more sensitive to the difference of setting between the two wards than the star. CONCLUSION: In conclusion, if various and realistic programs were offered to the patients in the ward, the open ward would be proposed as a desirable therapeutic form for the chronic psychiatric inpatients.

Therapeutic Factors Recognized by The Patient and The Therapist in Community Meeting / 신경정신의학

This research was conducted to investigate the responses of the patients and the therapists who attend the community meeting, to evaluate the therapeutic effects of community meeting as a group psychotherapy by applying short form scale of Yalom's Q-sort, to diagnose and complement the problems of the community meeting and to aim at activating the therapeutic function as the group psychotherapy The community meeting was held by 10 times during the stage of oscillation of the community and 26.7 patients group(+/-2.95) and 8.5 therapists group(+/-1.43) attended the every meeting. Consequently, both patients group and therapists group evaluate the community meeting as positive, and on the item which is helpful to them, while patient group responds it is 'mutual understanding and love' and 'self-understanding', therapist group does it is 'frank self-expression' and 'conversation'. On all items of group psychotherapy factors in the community meeting, the patients group evaluates it is more therapeutic in comparison with the therapists group, especially there is a significant difference in nine items such as 'altruism', 'group cohesiveness', 'interpersonal input', 'interpersonal output', 'identification', 'instillation of hope', 'family reenactment', 'self-understanding' and 'existential awareness'. In addition, on the therapeutic factor which is activated group psychotherapy factor in the community meeting, both patients and therapists respond that it is 'existential awareness' and 'universality', and they evaluate 'interpersonal output' as an non-activated therapeutic factor.