Test-retest reliability of health behavior items in the Community Health Survey in South Korea / 한국역학회지

OBJECTIVES: Responses to health-related items on the Community Health Survey (CHS) provide evidence that is used to develop community-based health policy. This study aimed to assess the test-retest reliability of selected health behavioral items on the CHS according to item category, response period, and response scale. METHODS: A sample of 159 men and women 20 to 69 years of age participated in a test-retest with an interval of 14 to 21 days. A total of 28 items relating to smoking, alcohol consumption, diet and weight control, and mental health were selected. We evaluated the test-retest reliability of the items using kappa statistics. RESULTS: Kappa values ranged from 0.44 to 0.93. Items concerning habits had higher kappa values (mean, 0.7; standard error, 0.05) than items concerning awareness or attitudes (p=0.012). The kappa value of items with two- to four-point scales was 0.63, which was higher than the value of 0.59 for items with scales involving five or more points, although this difference was not statistically significant. Different kappa values were observed for each reference period, but no statistically significant differences were noted. CONCLUSIONS: The test-retest reliability of the CHS items that we studied was associated with item category. Further study of the relationship between item category and reliability in domains other than health behaviors is required.

A Psychiatric Characteristics of the Alopecia Occured during Childhood and Adolescence / 신경정신의학

OBJECTIVES: There have been growing interests about alopecia occured during childhood and adolescence in clinical practice. The purpose of this paper is to explore the clinical characteristics of early onset alopecia in order to establish effective psychiatric intervention strategy. METHODS: The subjects were 31 early onset alopecia patients(14 males, 17 females) and 62 late onset control patients(26 males, 36 females). These patients had visited psychiatric outpatient clinic consulted from the department of dermatology, Yongsan hopital, Chung Ang University, Seoul, Korea, from January 1998 to june 1999. The sociodemographic data, clinical pattern of alopecia, psychiatic characteristics, comorbid physical illnesses and treatment variables were assesed. The data was statistically analyzed using chi-squre test and t-test through SPSSWIN 9.0V. RESULTS: 1) Early onset alopecia patients were more likely born in autum, had fewer siblings, and showed higher economical level of both patient and their parents than late onset patients. 2) Early onset alopecia patients were more likely to show diffuse hair loss, had more experienced past history of alopecia, more frequently had recurrence more than 3 times, were more severely damaged, had longer duration of hair loss had more loss of hairs on the vertex area at onset of alopecia, had more loss of hairs more than 2 areas, and had poorer prognosis such as no change or exacerbation in spite of treatment, spontaneous withdrawal of tratment and lack of efficacy to treatment than late onset patients. 3) Early onset alopecia patients were poorer in their adjustment in family life, or interpersonal relations, and more suffered from school stress such as changes of school life or test stress related with school entrance examination than late onset patients. 4) Early onset alopecia patients were more likely to show serious psychopathology such as increased rate of the anxiety disorders, of anxiety symptoms or depressive symptoms, and of personality disorders including the histrionic or the passive traits than late onset patients. 5) Early onset alopecia patients were more likely showed dermatitis including seborrheic dermatitis, and more significantly responding to the treatment with anti-anxiety drug, such as alprazolam, and dermatological therapies including polytar or tretinin than late onset patients. CONCLULSION: These findings suggest that dermatologists, as primary care physicians, are in unique position to recognize psychiatric comorbidity and to execute earlier intervention, in collaboration with psychiatrists, of early onset alopecia patients.

An Analysis of Psychiatric Characteristics of the Alopecia: A Comparative Study between Alopecia Areata and Alopecia Totalis / 신경정신의학

OBJECTIVES: The present study was performed to reveal correlations between the severity of the alopecia and their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment and to use them as basic materials for proper manaement and early prevention of the alopecia prone cases. METHODS: In order to analyze correlation between the severity of psychopathogy and the severity of hair losses, the subjects were divided into two subgroups as the 60 case of alopecia areata and the 33 cases of alopecia totalis with more severely affected loss of hairs, who had visited to the department of psychiatry after they were consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Korea, from January 1998 to December 1998. In data analysis, the subjects were statistically assesed by chi-squre test and T-test through SPSS-PC+ 8.0V. RESULTS: 1) Those with the more severely affected alopecia were more likely to visit to the department of dermatology in winter, and to show lower socioeconomical level in comparison to the alopecia areata. 2) Those with the more severely affected alopecia were more likely to show past history of alopecia, to recur frequently more than 3 times, to be damaged more severely, to have an younger mean age at onset of alopecia, to have longer total duration of hair loss than 2 years, to have longer recent duration of hair loss than 9 months, to have more loss of hairs on the vertex area at onset of alopecia, to have more loss of hairs in eyebrows, to have more loss of hairs more than 2 areas, to have more family history of alopecia in their parent, and to have poorer prognosis in comparison to those of the alopecia areata. 3) Psychosocial stress were positively correlated with the severity of loss of hairs. In the more severely affected alopecia group, their degree of stress were perceived higher. The more severely affected patients with alopecia , were poorer in their adjustment in family life,interpersonal relations or heterosexual relations, and suffered more from intrafamilial life changes in comparison to those of the alopecia areata group. 4) Those with the more severly affected alopecia were more likely to show serious psychopathology such as an increased rate of the depression, to complain more frequently with anxiety symptoms or depressive symptoms, to have personality disorders including the histrionic or the passive aggressive traits in comparison to the alopecia areata. 5) Those with the more severly affected alopecia were more likely to show neurotic MMPI code profiles such as histrionic or hypochondriacal trends. 6) Antianxiety drug such as alprazolam and drug therapies including tretinin,polytar or oral sorarens plus ultra-violet light A photochemotherapy were significantly more effective in the treatment of those with the more severly affected alopecia group. CONCLUSION: The most important factors in developing a psychopathologic reaction to the hair loss due to alopecia seems to be the presence of mental disorders including depression, the presence of stressful life events such as intrafamilial life changes, the presence of a significantly higher percentages of personality disorders such as the hysterical or the passive aggressive, and the presence of the psychosocial sequele and maladjustment in various life situations. From the above facts, the authors suggested that dermatologists acting as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for patients with alopecia with psychiatrists.

An Ecological Study on the Criminal Offences of Adolescent Students Reported on the Daily Newspapers in Korea / 신경정신의학

OBJECTIVES: The present study was performed to identify the socio-psychiatric aspects of adolescent criminal offences reported on daily newspapers and to use them as basic materials for prevention of adolescent criminal offences. METHODS: The author analysed 681 cases of adolescent criminal offenders, including 642 males and 39 females who reported on daily newspaper such as DongA Ilbo and Chung-Cheong Ilbo, aged from 12 through 21. In data analysis, the subjects were divided into two subgroups as the student(261 cases) and the non-student(420 cases). RESULTS: 1) The rate of student were more common in female and younger in their age group comparing with the non-student. Recently, the incidence of student's offences of all adolescent of offences were remarkably increased, while those of the non-student was Decreased. 2) Violence and theft or group offences were more common in the student, while felony or solitary offences were more frequently observed in the non-student. The more vulnerable time of criminal offences in the student were more in afternoon, while the non-student were more in midnight. 3) The psychological conflicts and the economical causes were the most ones in the student, while the curiosity, the personality problems and the heterosexual conflicts were more common in the lion-student. physical aggressions were more prominent ones in the student, compared with the instrumental aggression in the non-student. 4) The student committed offense more in the patterns of group offences with peers, younger in their age and were more often with their peer students, while the non-student committed offense more in the patterns of solitary crime, more prevalent with older aged jobless peers. 5) Most of the victims in the student were more abused to the intimate persons, and more younger students, while those in the non-student were more abused to the unknown persons and more older aged adolescents. CONCLUSION: In order to prevent and correct increasing trends of violence in school, nationwide guidance programs should be promptly applied through promotion of psychological wellbeing in family and school, proper guidance to peer relationship, and providing more opportunities for sound recreational activities in evening time to help dissipate the frustration of the adolescents.