Factors Related to Noncompliance in Screening and Tracking Mild Cognitive Impairment Patients in a Single Community

OBJECTIVE: We assessed the cumulative conversion rates (CCR) from minor cognitive impairment (MCI) to dementia among individuals who failed to participate in annual screening for dementia. Additionally, we analyzed the reasons for failing to receive follow-up screening in order to develop better strategies for improving follow-up screening rates. METHODS: We contacted MCI patients who had not visited the Dongdaemun-gu Center for Dementia for annual screening during the year following their registration. We compared the CCR from MCI to dementia in the following two groups: subjects registered as having MCI in the Dongdaemun-gu Center for Dementia database and subjects who failed to revisit the center, but who participated in a screening test for dementia after being contacted. The latter participants completed a questionnaire asking reasons for not previously visiting for follow-up screening. RESULTS: The final diagnoses of the 188 subjects who revisited the center only after contact were 19.1% normal, 64.9% MCI and 16.0% dementia. The final diagnoses of the 449 subjects in the Dongdaemun-gu Center for Dementia database were 25.6% normal, 46.1% MCI and 28.3% dementia. The CCR of the revisit-after-contact group was much lower than anticipated. The leading cause for noncompliance was “no need for tests” at 28.2%, followed by “other reasons” at 23.9%, and “I forgot the appointment date” at 19.7%. CONCLUSION: Considering the low dementia detection rate of the group who revisited only after contact and the reasons they gave for noncompliance, there appears to be a need for ongoing outreach and education regarding the course and prognosis of MCI.

Attitude toward Suicide and Personal Experiences of Suicide among Doctors and Health Care Workers in Korea / 신경정신의학

OBJECTIVES: The aim of this study was to investigate attitudes toward suicide and personal experiences with suicide among doctors and health care workers in Korea. METHODS: A total of 622 participants were included in this study and 617 participants completed a self-report questionnaire that included 31 items; 184 doctors and 433 health care workers. A questionnaire was used for assessment of demographic characteristics, attitude toward suicide, and personal experiences with suicide in doctors and health care workers. The collected data were evaluated using chi-square and binary logistic regression analyses. A probability level of p<0.05 was considered statistically significant. RESULTS: More permissive attitudes toward suicide showed an association with doctor group and non-religious group (p<0.05). Religious group and older age showed an association with a more negative attitude (p<0.05). The lifetime and one-year prevalence rates of suicidal ideation were 31.4% and 9.8%, respectively, in all participants. The lifetime prevalence of suicidal ideation was higher in the religious group (33.9%, p<0.05). Among all participants, 32.1% reported loss of a patient by suicide, and 29.9% reported contact with a patient at risk of suicide or with depression. In addition, 72.5% reported contact with a depressed patient. CONCLUSION: Attitudes toward suicide among doctors and health care workers were shown to differ significantly between age, gender, doctor group and health care worker group, religious group and non-religious group. The reported level of suicidal ideation among doctors and health care workers is worthy of concern. Research is needed for establishment of effective prevention strategies on the basis of our findings.