Spatial and Temporal Trends of Number of Deaths Attributable to Ambient PM(2.5) in the Korea

BACKGROUND: We aimed to evaluate the spatial and temporal trends of the health burden attributable to particulate matter less than 2.5 µm in diameter (PM2.5) in the metropolitan cities and provinces of the Korea. METHODS: We used modeled PM2.5 concentration data for the basic administrative levels, comprising the cities and the provinces of Korea, the corresponding annual population census data for each level, and the age and cause specific mortality data. We applied cause-specific integrated exposure-response functions to calculate the premature mortality attributable to ambient PM2.5 for four disease end points (ischemic heart disease [IHD], chronic obstructive pulmonary disease [COPD], lung cancer [LC], and cerebrovascular disease [stroke]) for the year 2015. Moreover, the temporal trends of the health burden from 2006 to 2015 were assessed. RESULTS: The annual average PM2.5 concentration for Korea was 24.4 μg/m3, and 11,924 premature deaths were attributable to PM2.5 exposure in 2015. By simulating the reduction in the annual mean values of PM2.5 to 10 µg/m3, about 8,539 premature deaths were preventable. There was spatial variation in mortality burden attributable to PM2.5 across the sub-national regions of Korea. In particular, the high burden was concentrated at Seoul and Gyeonggi province due to the high population density. However, decreasing trends were noted for most of the metropolitan cities and provinces of Korea since 2006. CONCLUSION: Our findings show that further actions to improve air quality in Korea would substantially improve the health burden due to particulate matter.

Reliability and Validity of the Korean Version of the Impaired Control Scale

OBJECTIVE: The aim of this study was to examine the reliability and validity of the Korean version of the Impaired Control Scale (K-ICS), a scale to screen patients with alcohol use disorder. METHODS: Participants were 173 inpatients with alcohol use disorder (AUD), and 174 normal controls (NC). Both AUD and NC groups completed the K-ICS as well as the Alcohol Dependence Scale (ADS), the Alcohol Abstinence Self-Efficacy Scale (AASES), the Brief Self-Control Scale (BSCS), and the Hospital Anxiety and Depression Scale (HAD). RESULTS: The internal consistencies of K-ICS were good in both AUD and NC. A good convergent validity was clearly shown by significant correlations with the ADS and the AASES, respectively. But the K-ICS had no or weak correlations with the BSCS and the HAD. The ROC curve analyses indicated that the optimal cut-off points of failed control (FC) and predicted control (PC) were estimated as >15 and >13, respectively. Hierarchical multiple regression analysis suggested that FC is a robust predictor of the severity of AUD. CONCLUSION: The K-ICS, especially FC subscale of it appears to be a valid and reliable measure of impaired control among both clinical and non-clinical sample.

Efficacy of the Life Goal-Focused Brief Intervention among Patients with Alcohol Use Disorder: A Preliminary Study

OBJECTIVE: The aim of this study was to examine the efficacy of the life goal-focused brief intervention, or the so-called the goal-focused self-regulation program (GFSRP), for patients with alcohol use disorder (AUD). METHODS: The GFSRP was developed as an 8-week group-program, which is based on a wide range of self-regulation theories, such as goal setting and implementation intentions. Patients with AUD (n=50) took part in the GFSRP and were compared to the control group (n=48). This study examined the changes in outcome measures from baseline to follow-up (12-week) in a mixed design. RESULTS: The GFSRP group had higher scores for the abstinence self-efficacy in negative affect situations than the control group at the post-test. In addition, it showed greater scores of optimisms compared to the control group. Furthermore, in the GFSRP group, there was no difference in intrinsic life goals from baseline to the 12-week follow-up, whereas the control group showed a significant decrease. CONCLUSION: The GFSRP could increase the abstinence self-efficacy and optimism among patients with AUD. Moreover, it might prevent loss of life-goals as core factors in self-regulation among patients with AUD.

The Development of the Mission · Vision · Core Values for Korean NeuroPsychiatric Association / 신경정신의학

Awareness of public mental health has increased due to drastic changes in society, and issues concerning the rights of mentally ill patients have emerged. The Korean NeuroPsychiatric Association (KNPA) has examined the current environment and proposed directions for improvement of this field. As the step for the implementation of the development of the mission · vision · core values for KNPA, KNPA have gone on the effort to improve public mental health letting people realize of the work that KNPA have carried out and help members work together. The committee of special mission of KNPA began in 2016 and held its first meeting on March 25 with professional consultants. They researched and collected information, carried out interviews, surveys, analyzed various opinions, and examined information and materials throughout 7 meetings. The special members of KNPA submitted agendas to the board of directors on September 9th, and the provisional board committee debated and decided the final agendas on September 24th. They announced the mission · vision · core values for KNPA on October 28th at the great autumn congregation held in Kimdaejung Convention Center in Kwangju. The event has proved that all members of KNPA have cooperated for the rights and interest of the committee, and will lead the public mental health of our society. This will provide the basis for the better life of our society.

Inhibitory Activity of Cordyceps bassiana Extract on LPS-induced Inflammation in RAW 264.7 Cells by Suppressing NF-κB Activation

Cordyceps bassiana has long been used as an oriental medicine and reported to possess diverse biological activities. The fruiting bodies of Cordyceps bassiana was extracted with ethanol and then further fractionated with n-hexane, ethyl acetate, n-butanol and water. The butanol fraction from Cordyceps bassiana (CBBF) exhibited the most effective in anti-inflammatory activity in RAW 264.7 macrophages and the roles of CBBF on the anti-inflammation cascade in LPS-stimulated RAW 264.7 cells were studied. To investigate the mechanism by which CBBF inhibits NO, iNOS and COX-2, the activation of IκB and MAPKs in LPS-activated macrophage were examined. Our present results demonstrated that CBBF inhibits NO production and iNOS expression in LPS-stimulated RAW 264.7 macrophage cells, and these effects were mediated through the inhibition of IκB-α, JNK and p38 phosphorylation. Also, CBBF suppressed activation of MAPKs including p38 and SAPK/JNK. Furthermore, CBBF significantly suppressed LPS-induced intracellular ROS generation. Its inhibition on iNOS expression, together with its antioxidant activity, may support its anti-inflammatory activity. Thus Cordyceps bassiana can be used as a useful medicinal food or drug for further studies.

The Ratio of 2nd to 4th Digit Length in Korean Alcohol-dependent Patients

OBJECTIVE: The ratio of 2nd to 4th digit length (2D:4D) is a sexually dimorphic trait. Men have a relatively shorter second digit than fourth digit. This ratio is thought to be influenced by higher prenatal testosterone level or greater sensitivity to androgen. The purpose of this study is to investigate the relationship between alcohol dependence and 2D:4D in a Korean sample and whether 2D:4D can be a biologic marker in alcohol dependence. METHODS: In this study, we recruited 87 male patients with alcohol dependence from the alcohol center of one psychiatric hospital and 52 healthy male volunteers who were all employees in the same hospital as controls. We captured images of the right and left hands of patients and controls using a scanner and extracted data with a graphics program. We measured the 2D:4D of each hand and compared the alcohol dependence group with the control group. We analyzed these ratios using an independent-samples t-test. RESULTS: The mean 2D:4D of patients was 0.934 (right hand) and 0.942 (left hand), while the mean 2D:4D of controls was 0.956 (right hand) and 0.958 (left hand). Values for both hands were significantly lower for patients than controls (p<0.001, right hand; p=0.004, left hand). CONCLUSION: Patients who are alcohol dependent have a significantly lower 2D:4D than controls, similar to the results of previous studies, which suggest that a higher prenatal testosterone level in the gonadal period is related to alcoholism. Furthermore, 2D:4D is a possible predictive marker of alcohol dependence.

The Association Between Oxidative Stress and Depressive Symptom Scores in Elderly Population: A Repeated Panel Study / 예방의학회지

OBJECTIVES: Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population. METHODS: From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K) test for screening depression, and urinary malondialdehyde (MDA) levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores. RESULTS: A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42%) increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%). In bivariate analysis after an SGDS-K score ≥8 was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR) of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42). CONCLUSIONS: Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population.

Serum Levels of Growth Factors in Alcohol-dependent Patients according to Comorbid Depressive Symptoms

OBJECTIVE: This study aims to reveal the relationship of depression with growth factors such as brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and insulin-like growth factor-1 (IGF-1) in inpatients diagnosed with alcohol dependence, and to identify candidate growth factors as biological markers to indicate the comorbid of alcohol dependence and depression. METHODS: This study examined demographic factors in 45 alcohol-dependent patients. The ADS (Korean version of the Alcohol Dependence Scale) and BDI (Korean version of Beck's Depression Inventory) were used. BDNF, NGF, and IGF-1 were measured through ELISA. RESULTS: The average drinking quantity and the ADS score were significantly more severe in alcohol-dependent patients with depression than in those without depression. Linearly comparing BDNF, NGF, and IGF-1 with BDI values, IGF-1 was the growth factor significantly correlated with BDI scores. BDI scores were significantly correlated with ADS scores. IGF-1 was significantly higher in alcohol-dependent patients with depression. Alcohol-dependent patients with depression had greater alcohol use and more severe ADS scores. BDNF and NGF showed no significant difference between alcohol-dependent patients with and without depression, but IGF-1 was significantly higher in those with than in those without depression. CONCLUSION: IGF-1 was found to be associated with depression in alcohol-dependent patients, suggesting that IGF-1 in alcohol-dependent patients could be an important biomarker to indicate whether alcohol-dependence is accompanied by depression.

Clinical Correlates of Subtype and Severity in Patients with Delirium / 신경정신의학

OBJECTIVES: Delirium is commonly seen in clinical settings, and it can substantially influence the prognosis of patients. In this study, we investigated delirium with respect to its severity, classification and characteristics on each subtype. METHODS: Severity of delirium was examined in delirium patients, who were referred to the department of psychiatry in a general hospital for multidisciplinary treatment. After classification based on subtypes, factors influencing these aspects of delirium were examined. RESULTS: Among the 193 consultation-liaison patients referred to the department of psychiatry in a general hospital, 61 patients (31.6%) were diagnosed with delirium. Compared to patients in the non-delirium group, patients in the delirium group were older, had a shorter education period, and medical history of surgery. Among the delirium patients, the hyperactive subtype was found to be the most common (57.4%) and patients with the mixed subtype showed the highest severity score for delirium symptoms. In addition, the patient with the hypoactive subtype had a higher frequency of medical history of depression compared to those with the other subtypes. CONCLUSION: People with symptoms of hypoactive delirium can be misdiagnosed due to recurrence of depression, therefore, careful examination is required, particularly in patients with a history of depression.

Posttraumatic Growth and Resilience: Assessment and Clinical Implications / 신경정신의학

Stress and trauma research has traditionally focused on the negative sequela of adversity. Recently, research has begun to focus on positive outcomes, specifically posttraumatic growth (PTG)-"positive change experienced as a result of the struggle with trauma"-which emphasizes the transformative potential of one's experiences with highly stressful events and circumstances. For evaluation of PTG, resilience is very important. Resilience refers to a person's ability to successfully adapt to acute stress, trauma or more chronic forms of adversity, maintaining psychological well-being. This article introduces several measurement scales for assessment of PTG and resilience. In addition, we suggest psychological techniques for facilitating PTG focusing on the relationship with adaptation after trauma. Finally, we discuss the applicability of a therapeutic approach for PTG in clinical practice. The systemic review of this article will provide further directions for PTG and resilience.

The Difference of the 2nd to 4th Digit Length Ratio betweenType I and Type II Alcoholism

OBJECTIVES: The second to fourth digit ratio (2D : 4D) is known to reflect testosterone level during intrauterine period. Testosterone is essential for masculinization of brain. Cloninger's type II alcoholism is characterized by early age at onset and largely limited to males. Compared with type I alcoholism, type II alcoholism is thought to be masculine. There is a possibility that the digit ratio of type II alcoholism is low compared with type I. We examined digit length ratio in Cloninger's type I and II alcoholism to understand the effects of intrauterine testosterone on the development of alcoholism. METHODS: The participants were 87 alcohol dependent patients. We divided two subtypes of patients by Irwin's symptom list, based on Cloninger's concept. We captured the images of both palms by the scanner and measured the lengths of digits by the graphic program. Then we analyzed the digit ratios by independent-sample t-test. RESULTS: The mean 2D : 4D of type I was 0.942 (right), 0.952 (left). The mean 2D : 4D of type II was 0.927 (right), 0.940 (left). In both hands, 2D : 4D of type II was significantly lower than type I. CONCLUSIONS: Type II alcoholism showed masculine type of digit length ratio compared with type I. It suggests the exposure of testosterone during intrauterine period might play an important role in determining the course and feature of alcoholism.