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Objective@#To investigate the effects of long-acting injectable 3-monthly paliperidone palmitate on the clinical and social functioning of patients with schizophrenia. @*Methods@#This study enrolled patients with schizophrenia receiving long-acting injectable 1-monthly paliperidone palmitate for at least 4 months and who subsequently received 3-monthly paliperidone palmitate. Accordingly, 418 patients were followed up for 24 weeks. Their clinical symptoms and social functioning were measured using the Clinical Global Impression-Severity of Illness and Personal and Social Performance scales. @*Results@#The Personal and Social Performance total score was significantly higher after 3-monthly paliperidone palmitate treatment than at baseline (baseline vs. week 24: 54.3 ± 18.0 vs. 61.0 ± 14.5 [mean ± standard deviation]; p ＜ 0.001; Wilcoxon signed-rank test); the proportion of patients in the mildly ill group (scores 71−100) also increased significantly (baseline vs. week 24: 16.5% vs. 20.6%; p＜ 0.001; McNemar-Bowker test). The mean Clinical Global Impression-Severity of Illness score decreased significantly (baseline vs. week 24: 3.7 ± 1.0 vs. 3.4 ± 0.9; p＜ 0.001; Wilcoxon signed-rank test), as did the proportion of patients in the severely ill group (baseline vs. week 24: 4.1% vs. 2.1%; p ＜ 0.001; McNemar-Bowker test). @*Conclusion@#Continuous 3-monthly paliperidone palmitate treatment significantly enhances the personal and social performance of patients with schizophrenia and reduces the proportion of those with severe illness. These findings suggest that long-acting injectable antipsychotic administration at intervals longer than 1 month might improve the social functioning of and promote return to activities of daily living in patients with schizophrenia.
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Objective@#Successful transition to school is of great importance to children with autism spectrum disorder (ASD). The purpose of this study was to develop a school readiness inventory for Korean children with ASD, and demonstrate its content validity and reliability. @*Methods@#The Korean School Readiness Inventory (K-SRI) was developed to assess current levels of some fundamental skills needed for attending school for children with ASD. The K-SRI was comprised of four subscales and 16 test items: Self-help skills, Social and emotional development, School behavior, and Literacy and numeracy skills. For content validity, six experts rated the validity of the test items. Lawshe’s Content Validity Ratio (CVR) was calculated. For reliability, parents of 22 children with ASD entering school completed the KSRI twice. Cronbach’s alpha coefficient was calculated for internal consistency. The test–retest reliability was assessed using the intraclass correlation coefficient (ICC). @*Results@#All the items except two items in the literacy and numeracy skills did not show a CVR of 1. The two items were deleted resulting in a 14-item inventory. The Cronbach’s alpha coefficient of the K-SRI was 0.93, showing good internal consistency reliability. The test– retest reliability results showed ICC value of 0.93 (p<0.001), which indicates good stability. @*Conclusion@#A parent-rated, 14-item school readiness inventory for Korean children with ASD were developed and preliminary evidence of its content validity and reliability were demonstrated in this study. The present study provides a basis for future studies that would further help evaluate and promote school readiness of the children with ASD.
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Objective@#This study examined the factors influencing the mental health and stress of individuals during the coronavirus disease-2019 (COVID-19) pandemic. @*Methods@#A total of 600 participants were enrolled in this anonymous questionnaire survey that included questions on their demographic profiles and experiences related to the COVID-19 pandemic. The COVID-19 Stress Scale for Korean People (CSSK), Warwick– Edinburgh Mental Wellbeing Scale, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and Multidimensional Scale of Perceived Social Support were used. Data were analyzed using multiple regression to identify the factors affecting the total CSSK scores and the scores of each of the three CSSK subscales. @*Results@#Multiple regression analyses revealed that the severity of insomnia, sex, degree of income decline, occupation, religion, education level, marital status, residential status, level of social support, and degree of depression and anxiety had significant relationships with COVID-19-related stress. @*Conclusion@#We identified factors affecting stress and mental health in the general population during the COVID-19 pandemic. Our findings may be helpful in providing an individualized approach to managing the mental health of the public. We expect that the results of this study will be used to screen high-risk individuals vulnerable to stress and to establish policies related to the public health crisis.
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Objective@#Subjective cognitive impairment (SCI) is associated with future cognitive decline. This study aimed to compare cortical thickness and local gyrification index (LGI) between individuals with SCI and normal control (NC) subjects. @*Methods@#Forty-seven participants (27 SCI and 20 NC) were recruited. All participants underwent brain magnetic resonance imaging scanning and were clinically assessed using the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) battery of tests. We compared cortical thickness and LGI between the two groups and analyzed correlations between cortical thickness/LGI and scores on CERAD protocol subtests in the SCI group for region of interests with significant between-group differences. @*Results@#Cortical thickness reduction in the left entorhinal, superior temporal, insular, rostral middle frontal, precentral, superior frontal, and supramarginal regions, and right supramarginal, precentral, insular, postcentral, and posterior cingulate regions was observed in the SCI compared to the NC group. Cortical thickness in these regions correlated with scores of constructional praxis, word list memory, word list recall, constructional recall, trail making test A, and verbal fluency under the CERAD protocol. Significantly decreased gyrification was observed in the left lingual gyrus of the SCI group. In addition, gyrification of this region was positively associated with scores of constructional praxis. @*Conclusion@#Our results may provide an additional reference to the notion that SCI may be associated with future cognitive impairment. This study may help clinicians to assess individuals with SCI who may progress to mild cognitive impairment and Alzheimer’s dementia.
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Objective@#This study aimed to investigate treatment effects of combination therapy of memantine and acetylcholinesterase inhibitors (AchEIs) compared with AchEIs alone on behavioral and psychological symptoms of dementia (BPSD) in patients with moderate Alzheimer’s dementia (AD). @*Methods@#This was a 12-week, double-blind, randomized, placebo-controlled trial. A total of 148 patients with moderate AD participated in this study. Mini-Mental State Examination, Neuropsychiatric Inventory (NPI), Clinician’s Interview-Based Impression of Change plus caregiver input, Gottfries–Bråne–Steen Scale, and Zarit Burden Interview were used as assessment scales. @*Results@#There were no significant differences in age, sex, or education between AChEIs alone and combination groups. The combination group showed significantly more improvement of NPI-disinhibition score (0.76±2.15) than the AChEIs alone group (-0.14±1.71) after 12 weeks. @*Conclusion@#Our findings suggest that the combination therapy of memantine and AchEIs might be a beneficial option for reducing disinhibition symptoms of patients with moderate AD compared with AchEIs alone. We believe that clinicians need to consider additional memantine treatment when patients with moderate AD complain disinhibition symptom. A larger clinical trial is needed to further determine the efficacy and advantages of such combination therapy of memantine and AchEIs for treating BPSD of patients with moderate AD.
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Objective@#This study aimed to investigate treatment effects of combination therapy of memantine and acetylcholinesterase inhibitors (AchEIs) compared with AchEIs alone on behavioral and psychological symptoms of dementia (BPSD) in patients with moderate Alzheimer’s dementia (AD). @*Methods@#This was a 12-week, double-blind, randomized, placebo-controlled trial. A total of 148 patients with moderate AD participated in this study. Mini-Mental State Examination, Neuropsychiatric Inventory (NPI), Clinician’s Interview-Based Impression of Change plus caregiver input, Gottfries–Bråne–Steen Scale, and Zarit Burden Interview were used as assessment scales. @*Results@#There were no significant differences in age, sex, or education between AChEIs alone and combination groups. The combination group showed significantly more improvement of NPI-disinhibition score (0.76±2.15) than the AChEIs alone group (-0.14±1.71) after 12 weeks. @*Conclusion@#Our findings suggest that the combination therapy of memantine and AchEIs might be a beneficial option for reducing disinhibition symptoms of patients with moderate AD compared with AchEIs alone. We believe that clinicians need to consider additional memantine treatment when patients with moderate AD complain disinhibition symptom. A larger clinical trial is needed to further determine the efficacy and advantages of such combination therapy of memantine and AchEIs for treating BPSD of patients with moderate AD.
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Objective@#Subjective reports of patients with insomnia often show a discrepancy with their objective assessments of sleep. We aimed to assess subjective-objective sleep discrepancy in subjects with insomnia disorder as well as the psychological factors associated with the discrepancy. @*Methods@#This study is a secondary analysis of the baseline data of a randomized controlled study on 110 adults aged 18 years to 59 years with insomnia disorder. Subjective reports on sleep and the objective measures acquired by an overnight polysomnography were used to measure the sleep discrepancy. Smartphone Addiction Proneness Scale (SAPS), Center for Epidemiologic Studies Depression Scale (CES-D), beck anxiety inventory (BAI), and Global Assessment of Recent Stress (GARS) were used to evaluate the psychological factors associated with the sleep discrepancy. @*Results@#Mean total sleep time (TST) discrepancy of the participants was -81.65±97.41 minutes. Multivariable logistic regression analyses revealed that age (adjusted OR=1.07, 95% CI=1.01–1.13, p=0.027), years of education (adjusted OR=0.69, 95% CI=0.48–0.91, p=0.017), and smartphone addiction proneness (adjusted OR=1.14, 95% CI=1.04–1.27, p=0.008) were independent predictors of TST misperception. Mean sleep onset latency (SOL) discrepancy of the participants was 41.28±45.01 minutes. Only anxiety was an independent predictor of SOL misperception (adjusted OR=1.16, 95% CI=1.05–1.31, p=0.006). @*Conclusion@#The present study provides empirical evidence to increase our understanding of the various factors that are associated with subjective-objective sleep discrepancy. Screening insomnia patients with smartphone addiction proneness may help predict the potential discrepancy between the patients’ subjective reports and objective measures of sleep duration.
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Objective@#This study investigated the effect of suicide prevention education on attitudes toward suicide among police officers. @*Methods@#We used an anonymous questionnaire for 518 officers and surveyed the demographic profiles and examined attitudes toward suicide utilizing the Attitudes Towards Suicide Scale (ATTS) (1=totally agree, 5=totally disagree). Our study divided participants into two groups, based on whether or not they had received suicide prevention education, and examined the differences in attitudes toward suicide between the groups. @*Results@#Of the total population, 247 (47.7%) officers had received suicide prevention education. The education group thought suicide as a predictable matter, disagreeing significantly more with the ATTS factor ‘suicide is unpredictable’ (3.36 vs. 3.35; p=0.001) compared with the no education group. Also, the education group more perceived suicide as a cry for help and at the same time disagreed more with the notion ‘suicidal thoughts will never disappear’ (2.08 vs. 2.26; p=0.025, 3.2 vs. 3.05; p=0.035, respectively). @*Conclusion@#Officers with experience in suicide prevention education showed more positive attitude toward suicide and suicide prevention. These findings suggest a need to organize more opportunities of suicide prevention educations, such as making the training mandatory for police officers.
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Objective@#Young adults putting off marriage and having less children have become recent trends in many modern societies. Yet less is known about the psychological factors underlying the drastically low marriage and fertility rates. We hypothesized that childhood maltreatment experience may have a negative association with one’s marriage and childbearing intention. @*Methods@#A total of 1,004 college students (mean age of 20.8±2.3 years, 56.1% female) completed self-questionnaires including sociodemographic information, marriage and childbearing intention, Patient Health Questionnaire 9 (PHQ-9), and Childhood Trauma Questionnaire (CTQ). Multivariable logistic regression analyses were conducted to evaluate the effect of childhood trauma on marriage and childbearing intentions after controlling for sociodemographic variables and depression. @*Results@#29.7% had no intention to get married and 40.4% had no intention to have children in the future. The prevalence of physical, sexual, and emotional abuse was 33.1%, 18.5%, and 22.3%, respectively. Multivariable logistic regression analyses revealed that female (p<0.001), poor health status (p=0.001), and childhood emotional abuse (p=0.01) were independent predictors of no desire to get married. Female (p<0.001), poor health status (p<0.001), and childhood emotional abuse (p=0.038) were also predictors of no desire to have children. @*Conclusion@#Childhood emotional abuse may be the most damaging form among other types of childhood maltreatment because it can occur more pervasively and persist for a longer period, causing extensive damage to a child’s emotional, social and cognitive development. Raising awareness regarding the life-long consequences of childhood emotional abuse and the need to prevent and detect childhood emotional abuse should be emphasized.
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Objectives@#The aim of this study was to investigate elementary school teachers' knowledge and perception of attention-deficit/hyperactivity disorder (ADHD). Variables associated with the teacher's tendency to recommend treatment to parents of the ADHD children were also evaluated. @*Methods@#A total of 73 elementary-school teachers completed a self-questionnaire regarding their demographic characteristics, previous experience, and perception of ADHD children. Knowledge of the Attention Deficit Disorders Scale (KADDS) was used to examine the participants' level of knowledge of ADHD. Multivariable logistic regression analysis was performed to identify the variables associated with the participants' tendency to recommend treatment to parents of ADHD students. @*Results@#The average correct rate was 64.4% on the KADDS. 64 (87.7%) participants had a positive perception of medical treatments of ADHD, but only 41 (56.2%) participants reported that they would recommend treatment to parents of ADHD children. Teachers that were older and married were more likely to recommend treatment. The teacher's sense of efficacy was found to have a positive association with the tendency to recommend treatment to parents. @*Conclusion@#Educational programs and specific guidelines that can improve the knowledge of ADHD and self-efficacy as a teacher are needed for elementary school teachers. Teachers should understand that they have significant roles in the management of ADHD children.
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Objectives@#The aim of this study was to investigate elementary school teachers' knowledge and perception of attention-deficit/hyperactivity disorder (ADHD). Variables associated with the teacher's tendency to recommend treatment to parents of the ADHD children were also evaluated. @*Methods@#A total of 73 elementary-school teachers completed a self-questionnaire regarding their demographic characteristics, previous experience, and perception of ADHD children. Knowledge of the Attention Deficit Disorders Scale (KADDS) was used to examine the participants' level of knowledge of ADHD. Multivariable logistic regression analysis was performed to identify the variables associated with the participants' tendency to recommend treatment to parents of ADHD students. @*Results@#The average correct rate was 64.4% on the KADDS. 64 (87.7%) participants had a positive perception of medical treatments of ADHD, but only 41 (56.2%) participants reported that they would recommend treatment to parents of ADHD children. Teachers that were older and married were more likely to recommend treatment. The teacher's sense of efficacy was found to have a positive association with the tendency to recommend treatment to parents. @*Conclusion@#Educational programs and specific guidelines that can improve the knowledge of ADHD and self-efficacy as a teacher are needed for elementary school teachers. Teachers should understand that they have significant roles in the management of ADHD children.
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OBJECTIVES: Bipolar disorder is characterized by repetitive relapses that result in psychosocial dysfunctions. The functioning of bipolar disorder patients is related to the severity of symptoms, quality of sleep, drug compliance, and social support. The purpose of this study was to investigate the association between sociodemographic and clinical factors and functional status in bipolar disorder patients. METHODS: A total of 52 bipolar disorder patients participated in the study. The following scales were utilized: Korean version of personal and social performance scale (K-PSP), Korean version of Hamilton rating scale for depression (K-HDRS), Korean version of young mania rating scale (K-YMRS), Korean version of pittsburgh sleep quality index (PSQI-K), Korean version of drug attitude inventory (K-DAI), mood disorders insight scale (MDIS), and multidimensional scale of perceived social support (MSPSS). RESULTS: The K-PSP score showed a negative relationship with K-HDRS score (r = −0.387, p = 0.005), but not with K-YMRS score (r = −0.205, p = 0.145). The K-PSP score showed a negative relationship with global PSQI-K score (r = −0.378, p = 0.005) and overall sleep quality (r = −0.353, p = 0.010). The K-PSP scores were positively associated with the KDAI score (r = 0.409, p = 0.003) and MSPSS score (r = 0.334, p = 0.015). The predictive factors for K-PSP were overall sleep quality and social support from family. CONCLUSION: Our study showed that depressive symptoms were related to overall function in bipolar disorder. Also, our study suggested that improving sleep quality is important in maintaining functional status. Appropriate social support and positive perception toward the drug may lead to the higher level of functioning. This study is meaningful in that the functional status of bipolar disorder patients is analyzed in a multivariate manner in relation to various variables in psychosocial aspects.
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Humans , Bipolar Disorder , Compliance , Depression , Mood Disorders , Recurrence , Weights and MeasuresABSTRACT
BACKGROUND: Smartphone addiction has recently been highlighted as a major health issue among adolescents. In this study, we assessed the degree of agreement between adolescents' and parents' ratings of adolescents' smartphone addiction. Additionally, we evaluated the psychosocial factors associated with adolescents' and parents' ratings of adolescents' smartphone addiction. METHODS: In total, 158 adolescents aged 12–19 years and their parents participated in this study. The adolescents completed the Smartphone Addiction Scale (SAS) and the Isolated Peer Relationship Inventory (IPRI). Their parents also completed the SAS (about their adolescents), SAS-Short Version (SAS-SV; about themselves), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). We used the paired t-test, McNemar test, and Pearson's correlation analyses. RESULTS: Percentage of risk users was higher in parents' ratings of adolescents' smartphone addiction than ratings of adolescents themselves. There was disagreement between the SAS and SAS-parent report total scores and subscale scores on positive anticipation, withdrawal, and cyberspace-oriented relationship. SAS scores were positively associated with average minutes of weekday/holiday smartphone use and scores on the IPRI and father's GAD-7 and PHQ-9 scores. Additionally, SAS-parent report scores showed positive associations with average minutes of weekday/holiday smartphone use and each parent's SAS-SV, GAD-7, and PHQ-9 scores. CONCLUSION: The results suggest that clinicians need to consider both adolescents' and parents' reports when assessing adolescents' smartphone addiction, and be aware of the possibility of under- or overestimation. Our results can not only be a reference in assessing adolescents' smartphone addiction, but also provide inspiration for future studies.
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Adolescent , Humans , Anxiety , Behavior, Addictive , Depression , Parents , Psychology , SmartphoneABSTRACT
Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors—donepezil, rivastigmine, galantamine—and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.
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Dementia is a clinical syndrome characterized by a cluster of symptoms and signs that manifest as difficulties in cognitive functions such as memory, psychological and psychiatric changes, and impairments in activities of daily living. As a result of worldwide trends of population aging, dementia has had a huge impact on public health in almost all countries. Disease modification therapies for dementia have not yet been developed. However, pharmacotherapy is essential in patients with dementia to combat delays in their cognitive and functional decline. In this article, we review the current pharmacotherapy for dementia. Three acetylcholinesterase inhibitors—donepezil, rivastigmine, galantamine—and memantine are the only medications that have been approved for the treatment of dementia. We present the indications, dose recommendations, side effects, and criteria for National Health Insurance coverage in Korea of these medications for dementia treatment. Although the Ministry of Food and Drug Safety in Korea has not approved any medications for managing the behavioral and psychological symptoms of dementia, some antipsychotics and antidepressants have been studied and used clinically for those purposes. Clinicians may consider vitamin E, Ginkgo biloba extract, choline alfoscerate, or omega-3 fatty acids as additional treatment options. Non-steroid anti-inflammatory drugs, estrogen hormone therapy, and statins are not generally recommended for dementia treatment. We believe that our findings will aid clinicians in the treatment of patients with cognitive decline.
Subject(s)
Humans , Acetylcholinesterase , Activities of Daily Living , Aging , Antidepressive Agents , Antipsychotic Agents , Cholinesterase Inhibitors , Cognition , Dementia , Drug Therapy , Estrogens , Fatty Acids, Omega-3 , Ginkgo biloba , Glycerylphosphorylcholine , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Korea , Memantine , Memory , National Health Programs , Public Health , Rivastigmine , Vitamin E , VitaminsABSTRACT
OBJECTIVES: Many patients with Alzheimer's disease have difficulty in taking their medicine by themselves and their poor drug adherence possibly results in aggravating various symptoms. The aim of this study was to assess the variables influencing drug adherence of Alzheimer's disease patients. METHODS: In a four-week period, 33 outpatients over 65 years old diagnosed with Alzheimer's disease were monitored. Drug adherences were assessed by the Medication Event Monitoring System (MEMS), the pill count, the clinician rating scale, and self-report. Agreements among adherence measures and the relationships between MEMS adherence and other clinical factors were assessed. RESULTS: The adherence rates for the MEMS, the pill count, the clinician rating scale and, self-report were 51.5%, 82.8%, 82.8%, and 87.9%. The Kappa coefficients were 0.382 (pill count vs. MEMS, clinician rating scale vs. MEMS) and 0.256 (self-report vs. MEMS). Males showed better adherence than females but the other clinical variables did not show significant differences between adherence group and non-adherence group. CONCLUSION: These findings suggest that clinicians should be concerned when assessing drug adherence in patients with Alzheimer's disease only by subjective reporting and pill counting since these methods may make patient's adherence underestimate. Clinicians should also take in mind that caregivers play an important role in improving adherence.