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Objective@#North Korean defectors (NKDs) have experienced substantial difficulties during the migration and settlement in South Korea. They have a high prevalence of depression, post-traumatic stress disorder, and suicidal behaviors. The high prevalence of mental disorders among NKDs can lead to a high suicide rate. However, there are no suicide prevention programs for NKDs. This study aims to customize a suicide prevention program with content suitable for NKDs’ particular circumstances. @*Methods@#A multidisciplinary research team developed this program based on domestic and international gatekeeper training programs for suicide prevention and articles related to suicide prevention. @*Results@#We developed a multi-part gatekeeper training program, “Suicide CARE for NKDs.” In the “Introduction,” trainees learn about the need for the program and its importance. In “Careful observation,” trainees learn to recognize linguistic, behavioral, and situational signals of suicide risk. In “Active listening,” trainees learn how to ask about suicidal thoughts and to listen empathetically. In “Risk evaluation and expert referral,” trainees learn to evaluate suicide risk and to connect NKDs with institutes or services. @*Conclusion@#We expect this program to become useful for training gatekeepers to prevent suicide among NKD. A future follow-up study is needed to confirm the efficacy of the program.
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Objective@#We aimed to explore whether nursing professionals’ psychological states affect their grief response for a patient’s death in the coronavirus disease-2019 (COVID-19) inpatients’ ward. @*Methods@#Survey was conducted among frontline nursing professionals working in COVID-19 inpatients wards at three tertiary-level affiliated hospitals of the University of Ulsan during April 7–26, 2022. Participants’ information such as age, years of employment, or marital status were collected, and their responses to rating scales including Pandemic Grief Scale (PGS) for healthcare workers, Stress and Anxiety to Viral Epidemics-9 items (SAVE-9), Patient Health Questionnaire-9 (PHQ-9), Loneliness and Social Isolation Scale, and Insomnia Severity Scale (ISI) were collected. @*Results@#All 251 responses were analyzed. We observed that 34% reportedly suffered from depression. The linear regression analysis showed that a high PGS score was expected by high SAVE-9 (β=0.12, p=0.040), high PHQ-9 (β=0.25, p<0.001), high loneliness (β=0.17, p=0.006), and high ISI score (β=0.16, p=0.006, F=20.05, p<0.001). The mediation analysis showed that the depression of nursing professionals directly influenced their pandemic grief reaction, and their work-related stress and viral anxiety, insomnia severity, and loneliness partially mediated the association. @*Conclusion@#We confirm that frontline nursing professionals’ depression directly influenced their grief reaction, and their work-related stress and viral anxiety, insomnia severity, and loneliness partially mediated the association. We hope to establish a psychological and social support system for the mental health of nurses working in the COVID-19 wards.
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Objective@#This study aimed to explore the feasibility of cognitive-behavioral model hypochondriasis regarding coronavirus disease-2019 (COVID-19) among firefighters. In addition, we examined the possible role of their grief reaction and intolerance of uncertainty in the model of COVID-related hypochondriasis. @*Methods@#An anonymous online survey was done on October 27–28, 2022, among firefighters who witnessed people’s death. Demographic characteristics were collected, and their psychological states were assessed using rating scales such as the Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Fear of COVID-19 Scale (FCV-19S), Pandemic Grief Scale (PGS), and Intolerance of Uncertainty Scale–12 (IUS-12). @*Results@#Their OCS score was expected by the CRBS (β=0.30, p<0.001), FCV-19S (β=0.10, p<0.001), PGS (β=0.29, p<0.001), and IUS12 (β=0.04, p=0.024) (F=134.5, p<0.001). The COVID-related cognitive-behavioral model of hypochondriasis was feasible among firefighters who witnessed people’s death. Their pandemic grief reaction and intolerance of uncertainty directly influenced their preoccupation with coronavirus, and viral anxiety and coronavirus reassurance-seeking behavior mediated the relationship. @*Conclusion@#Firefighters’ viral anxiety and coronavirus reassurance-seeking behavior mediated the influence of pandemic grief reaction or intolerance of uncertainty on the preoccupation with coronavirus.
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Background@#This study investigated the relationship between preoccupation with coronavirus disease 2019 (COVID-19), reassurance-seeking behavior, viral anxiety, intolerance of uncertainty, and adherence to physical distancing among frontline nursing professionals working in COVID-19 inpatient wards. Additionally, the study aimed to determine whether the commitment to physical distancing mediates the influence of intolerance of uncertainty on viral anxiety. @*Methods@#Frontline healthcare professionals working in the COVID-19 inpatient wards at three tertiary-level affiliated hospitals in Korea were surveyed between April 7 and 26, 2022.The survey included scales—such as the Obsession with COVID-19 Scale, Coronavirus Reassurance-Seeking Behaviors Scale, Fear of COVID-19 Scale, and Intolerance of Uncertainty Scale-12 and a questionnaire on adherence to physical distancing. A total of 256 responses were analyzed after excluding inappropriate or incomplete responses. @*Results@#Pearson’s correlation analysis found that age was significantly associated with the Obsession with COVID-19 Scale (r = −0.12, P < 0.05) and adherence to physical distancing (r = 0.27, P < 0.01). Linear regression analysis ascertained that age (β = −0.07, P = 0.002), Coronavirus Reassurance-Seeking Behaviors Scale (β = 0.35, P < 0.001), and Fear of COVID-19 Scale (β = 0.24, P < 0.001) were predictors of obsession with COVID-19 (Adjusted R 2 = 0.60, F = 78.1, P < 0.001). The indirect pathway by mediation analysis showed that reassurance-seeking and viral anxiety mediated the effect of intolerance of uncertainty on the preoccupation with COVID-19. @*Conclusion@#During the pandemic, there may be a strong association between reassuranceseeking behavior, viral anxiety, and a heightened preoccupation with COVID-19 among frontline healthcare workers. Thus, from the early stages of infectious disease, a psychological support team for medical staff responding to the disease should be established, and periodic evaluations should be conducted to identify high-risk groups.
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Background@#This longitudinal study examined risk factors for future suicidality among North Korean defectors (NKDs) living in South Korea. @*Methods@#The subjects were 300 NKDs registered with a regional adaptation center (the Hana Center) in South Korea. Face-to-face interviews were conducted using the North Korean version of the World Health Organization’s Composite International Diagnostic Interview to diagnose mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Subjects were also asked about sociodemographic and clinical factors at baseline. At follow-up after three years, the NKDs (n = 172 respondents) were asked to participate in an online survey, responding to self-questionnaires about suicidality. Logistic regression analyses were used to explore associations between baseline variables and future suicidality among NKDs. @*Results@#Thirty (17.4%) of the 172 survey respondents reported suicidality at follow-up. The presence of health problems over the past year, any prior suicidality at baseline, a higher score on a trauma-related scale, and a lower score on a resilience scale at baseline were associated with greater odds of suicidality at follow-up after adjusting for age, sex, and educational level. Of all mental disorder categories, major depressive disorder, dysthymia, agoraphobia, and social phobia were also associated with significantly increased odds of suicidality at follow-up after adjusting for age, sex, educational level, and prior suicidality at baseline. @*Conclusion@#Resilience, a previous history of suicidality, and the presence of lifetime depressive disorder and anxiety disorder should be given consideration in mental health support and suicide prevention in NKDs.
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Recently, nonsuicidal self-injury (NSSI) has been increasing considerably in school counseling. According to the Youth Counseling and Welfare Development Institute, the number of counseling support for NSSI adolescent in 2018 was more than three times higher than the previous year, and the average time when NSSI behavior first appeared was 12.43 years old. As such, adolesnect NSSI continues to increase in recent years, and the age is also gradually decreasing. Nevertheless, research on the motives and characteristics of NSSI among domestic adolescents is still insufficient. This may be attributed to the difficulty of conducting research because self-injury behavior is secretly performed. However, it is also true that this reality has another limitation in the school field, which urgently requires counseling intervention and prevention of students' mental health problems. In addition, counseling for self-injury in the school scene is the biggest cause of exhaustion for counselors because they are under very great stress to cope with repeated self-harm in the dual role of counselors and teachers in school situations. Therefore, this study examines the causes and characteristics of involuntary self-injury through previous research analysis, and examines various difficulties experienced as a school counselor, as well as the effective intervention method of non suicidal self-injury in school counseling.
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Objectives@#: The purpose of this study is to analyze Mental health literacy in General population. @*Methods@#: We analyze the National Mental Health Literacy and Attitude Survey Data in 2021. We investigate 2016 general population and evaluate sociodemographic characteristics, Mental health literacy and stigma. We utilize 4 Case vignette which consist of Major Depressive Disorder, Schizophrenia, Alcohol Use Disorder and Suicidal Ideation. @*Results@#: Schizophrenia (27.6%) have the lower disease recognition compare to Major Depressive Disorder (43.8%) and Alcohol Use Disorder (61.7%) (p<0.001). The stigma of Alcohol use disorder (52.8%) is highest and the stigma of Schizophrenia (47.2%) is the second highest (p<0.001). @*Conclusions@#: The education and overcoming the stigma in Mental health is needed in Schizophrenia and Alcohol Use Disorder.
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Objective@#The aims of this study were to explore the prevalence of and identify predictors of anxiety and depression related to coronavirus disease of 2019 (COVID-19) in South Korea. @*Methods@#The analysis is based on a quota survey design and a sampling frame that permitted recruitment of a national sample of 1,014 individuals between March 17–31, 2020. Several standardized measurements were used, including GAD-7, PHQ-9, COVID-19 related fear, restrictions in deaily life, as well as sociodemographic information and physical and psychosocial needs during the pandemic. Multiple logistic regression was conducted to analyze the influence of sociodemographic factors, fear, and physical/psychosocial needs on anxiety and depression. @*Results@#Significant numbers of the respondents were identifiable anxiety (19.0%) and depression group (17.5%), respectively. This indicates that the depression and anxiety prevalence rate after the COVID-19 is substantially high compared to the depression rate of 2.6% in 2020 and 2.8% in 2018 both reported in the Korea Community Health Survey and the anxiety rate of 5.7% reported in 2016 Survey of Mental Disorders in Korea. Multiple logistic regression results showed age, COVID-19 related fear, and the level of restrictions in daily as significant factors in understanding and predicting the anxiety group. Likfewise, the COVID-19 related fear, restrictions in daily life, and need for economic support were important predictors in predicting the depression group. @*Conclusion@#Findings on predictors for greater vulnerability to anxiety and depression has important implications for public mental health in the context of the COVID-19 pandemic.
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Objective@#North Korean refugee youths are at higher risk of developing a wide array of psychosocial sequelae, including increased impulsivity and problematic internet use. We aimed to identify reciprocal temporal relationships by performing autoregressive cross-lagged modeling and to examine how these relations differ by gender and adverse childhood experience. @*Methods@#We used the follow-up data of 108 North Korean refugee youths in South Korea over a 1-year period. The Barratt Impulsivity Scale-Brief and Young’s Internet Addiction Test were used to assess impulsivity and problematic internet use, respectively. @*Results@#Autoregressive effects were significant across all groups, indicating that impulsivity and problematic internet use were stable across time; however, prospective prediction of problematic internet use from impulsivity was not significant across all groups. Problematic internet use at baseline positively predicted impulsivity at after 1 year of follow up in only males and individuals with adverse childhood experience. @*Conclusion@#Our findings suggest that the negative effect of problematic internet use (i.e., increased impulsivity) among North Korean refugee youths may be more profound in males and those with adverse childhood experience. We present possible explanations for these findings and discuss the implications for targeted interventions.
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Objective@#The study investigated the effects of severe human rights abuses in North Korean on Posttraumatic-stress disorder (PTSD) in North Korean Refugees (NKRs). @*Methods@#The study included 300 NKRs (245 females and 55 males) who completed self-report questionnaires that assessed PTSD, experiences of imprisonment, and exposure to inhumane treatment, by authorities in North Korea. A moderation analysis was conducted using a hierarchical multiple regression model to determine whether a moderation effect existed. In the next step, a post-hoc probing procedure of the moderation effect was performed using multiple regression models that included conditional moderator variables. @*Results@#The influence of the frequency of being imprisoned on PTSD varied as a function of recurrent exposure to inhumane treatment or punishment by authorities. Experiences of imprisonment were associated with PTSD only among those who were exposed to recurrent violence, such as beating or torture, by North Korean authorities. @*Conclusion@#The present findings highlight the significant effects of human rights violations, such as the inhumane treatment of prisoners in North Korea, on the PTSD of NKRs.
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Objective@#The aims of this study were to explore the prevalence of and identify predictors of anxiety and depression related to coronavirus disease of 2019 (COVID-19) in South Korea. @*Methods@#The analysis is based on a quota survey design and a sampling frame that permitted recruitment of a national sample of 1,014 individuals between March 17–31, 2020. Several standardized measurements were used, including GAD-7, PHQ-9, COVID-19 related fear, restrictions in deaily life, as well as sociodemographic information and physical and psychosocial needs during the pandemic. Multiple logistic regression was conducted to analyze the influence of sociodemographic factors, fear, and physical/psychosocial needs on anxiety and depression. @*Results@#Significant numbers of the respondents were identifiable anxiety (19.0%) and depression group (17.5%), respectively. This indicates that the depression and anxiety prevalence rate after the COVID-19 is substantially high compared to the depression rate of 2.6% in 2020 and 2.8% in 2018 both reported in the Korea Community Health Survey and the anxiety rate of 5.7% reported in 2016 Survey of Mental Disorders in Korea. Multiple logistic regression results showed age, COVID-19 related fear, and the level of restrictions in daily as significant factors in understanding and predicting the anxiety group. Likfewise, the COVID-19 related fear, restrictions in daily life, and need for economic support were important predictors in predicting the depression group. @*Conclusion@#Findings on predictors for greater vulnerability to anxiety and depression has important implications for public mental health in the context of the COVID-19 pandemic.
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Objective@#North Korean refugee youths are at higher risk of developing a wide array of psychosocial sequelae, including increased impulsivity and problematic internet use. We aimed to identify reciprocal temporal relationships by performing autoregressive cross-lagged modeling and to examine how these relations differ by gender and adverse childhood experience. @*Methods@#We used the follow-up data of 108 North Korean refugee youths in South Korea over a 1-year period. The Barratt Impulsivity Scale-Brief and Young’s Internet Addiction Test were used to assess impulsivity and problematic internet use, respectively. @*Results@#Autoregressive effects were significant across all groups, indicating that impulsivity and problematic internet use were stable across time; however, prospective prediction of problematic internet use from impulsivity was not significant across all groups. Problematic internet use at baseline positively predicted impulsivity at after 1 year of follow up in only males and individuals with adverse childhood experience. @*Conclusion@#Our findings suggest that the negative effect of problematic internet use (i.e., increased impulsivity) among North Korean refugee youths may be more profound in males and those with adverse childhood experience. We present possible explanations for these findings and discuss the implications for targeted interventions.
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Objective@#The study investigated the effects of severe human rights abuses in North Korean on Posttraumatic-stress disorder (PTSD) in North Korean Refugees (NKRs). @*Methods@#The study included 300 NKRs (245 females and 55 males) who completed self-report questionnaires that assessed PTSD, experiences of imprisonment, and exposure to inhumane treatment, by authorities in North Korea. A moderation analysis was conducted using a hierarchical multiple regression model to determine whether a moderation effect existed. In the next step, a post-hoc probing procedure of the moderation effect was performed using multiple regression models that included conditional moderator variables. @*Results@#The influence of the frequency of being imprisoned on PTSD varied as a function of recurrent exposure to inhumane treatment or punishment by authorities. Experiences of imprisonment were associated with PTSD only among those who were exposed to recurrent violence, such as beating or torture, by North Korean authorities. @*Conclusion@#The present findings highlight the significant effects of human rights violations, such as the inhumane treatment of prisoners in North Korea, on the PTSD of NKRs.
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Objectives@#：This study was designed to investigate the correlation between defense mechanism and posttraumatic stress disorder in burn patients. @*Methods@#：We recruit 40 burn patients and we evaluate sociodemographic characteristics, characteristics related to burn, korean version of Impact of Event Scale-Revised (IES-R), Korean Version of Center for epidemiologic studies depression scale (CES-D) and Ewha Defense Mechanisms Test (EDMT). Multiple regression analysis was performed to evaluate the correlation between EDMT score and IES-R score. @*Results@#：Factor 2 of EDMT which consists of Ego-expansion subjects was significantly correlate with IER-S score. In factor 2, Controlling (β=-0.299, p<0.05), Sublimation (β=-0.276, p<0.05) is significantly correlate with IER-S score. @*Conclusions@#：Some subjects of defense mechanism was significantly correlate with IES-R score. it might behelpful to understand defense mechanism for the posttraumatic stress disorder in burn patients.
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Objective@#Despite the growing need for psychological programs for North Korean refugees, most psychological interventions for these people lack a verification study that tests their effectiveness. This study aims to evaluate the effectiveness of cognitive behavioral therapy (CBT) in North Korean refugees. @*Methods@#Participants included 38 North Korean refugees, of whom 23 participated in simple relaxation and 15 participated in CBT. The Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D), State-Trait Anxiety Inventory-State (STAI-S), and Impact of Event Scale-Revised were used to evaluate symptoms pre- and post-intervention. @*Results@#Participants had a significant decrease in CES-D scores after treatment (p=0.037). The decrease in CES-D was larger in those who participated in the CBT compared to those in simple relaxation (p=0.023). The superior effects that CBT had on depressive symptoms over simple relaxation were particularly more prominent in those with severe depression (p=0.035). Participants with high levels of anxiety also showed significant decreases in STAI-S scores after treatment, regardless of which type of program they participated in (p=0.023). @*Conclusion@#This preliminary findings suggests that CBT is an effective psychiatric approach in treating depressive symptoms in North Korean refugees, especially for those with a higher degree of depressive symptom.
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No abstract available.
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OBJECTIVES: This study was designed to investigate the intrapsychic factors affecting the quality of life of patients with chronic schizophrenia. METHODS: Quality of life was measured using the World Health Organization Quality of Life Scale-Brief (WHOQOL-BREF) in 72 community-dwelling patients with schizophrenia. Demographic status, psychopathology, independent living skill, and insight were examined. Based on this, correlation analysis between each scale and multiple regression analysis was performed to examine the factors that can predict the quality of life. RESULTS: The illness duration was over 10 years in 79.2% of patients. The patients with 10–0 years of illness duration showed lower scores of quality of life than those with less than 10 years or more than 20 years. Anxiety/depressive symptom, hostile/suspiciousness were associated with quality of life scores. Among those, anxiety/depressive symptom was the strongest predictor of quality of life in patients with chronic schizophrenia. CONCLUSION: The management of anxiety and depressive symptoms should be implicated in the treatment of schizophrenic patients to improve the quality of life.
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Humans , Anxiety , Depression , Independent Living , Psychopathology , Quality of Life , Schizophrenia , World Health OrganizationABSTRACT
OBJECTIVES: Depression is a common mental illness and a major cause of suicide. Although serum lipids have been associated with depression and suicide, there has been much debate. In this study, we investigated the relationship between depression, suicide, and serum lipids in patients admitted with depressed mood. METHODS: A total of 134 subjects were divided into 86 non-suicide patients and 48 suicide attempters. The serum lipid levels and sub-scores of the Korean Symptom Checklist-95 (KSCL95) were compared. We also investigated the relationship between serum lipids and sub-scores of KSCL95 and investigated whether serum lipids were risk factors for suicide attempts. RESULTS: There was no difference in serum lipids between the two groups. Among the sub-items of KSCL95, obsession was higher in non-suicide group. Triglyceride showed positive correlations with anxiety, phobic anxiety, agoraphobia, schizophrenia, and self-regulation problem. High triglyceride was a risk factor for suicide attempts. CONCLUSIONS: Triglyceride is associated with depression, anxiety, and self - regulation, and high serum triglyceride levels may be a risk factor for suicide attempts.
Subject(s)
Humans , Agoraphobia , Anxiety , Cholesterol , Depression , Obsessive Behavior , Risk Factors , Schizophrenia , Self-Control , Suicide , TriglyceridesABSTRACT
OBJECTIVE: Despite the increasing number of North Korean defectors, research on their mental health conditions and suicidal thoughts and behaviors has not been conducted systematically. We examined the prevalence and risk factors of suicidal thoughts and behaviors in North Korean defectors. METHODS: This study focused on 300 North Korean defectors recruited from regional resettlement centers in South Korea. In-person interviews based on the North Korean version of the Composite International Diagnostic Interview were conducted to diagnose mental disorders and assess suicidal thoughts and behaviors. Logistic regression analyses were performed to evaluate the association between suicidal thoughts and behaviors and socio-demographic variables, and DSM-IV mental disorders. RESULTS: Lifetime prevalence of suicidal ideation, plans, and attempts were 28.3, 13.3, and 17.3%, respectively. Female sex (OR: 2.0, 95% CI: 1.0–3.9), presence of health problems in the past year (2.6, 95% CI: 1.4–4.6), and absence of both South Korean acquaintances (1.9, 95% CI: 1.0–3.4) and North Korean family (1.7, 95% CI: 1.0–2.9) were associated with higher odds of suicidal thoughts and behaviors, after adjusting for participant age, sex, and education. Presence of a mental disorder was associated with a significantly increased odd of suicide ideation, plan, and attempt. Of all mental disorder categories, agoraphobia had the strongest association with suicidal ideation (6.5, 95% CI: 2.0–21.6), plans (7.7, 95% CI: 2.5–23.2) and attempts (12.0, 95% CI: 3.5–40.8). CONCLUSION: Suicidal thoughts and behaviors among North Korean defectors are higher than the general population in South Korea, especially show high rates in transit countries. Further study should focus on the changes in suicidal thoughts and behaviors according to the settlement process and early prevention.
Subject(s)
Female , Humans , Agoraphobia , Diagnostic and Statistical Manual of Mental Disorders , Education , Friends , Korea , Logistic Models , Mental Disorders , Mental Health , Prevalence , Risk Factors , Suicidal Ideation , SuicideABSTRACT
BACKGROUND: The recent revision of South Korea's Mental Health Law emphasizes the role of the Mental Health Review Board. For this study, we examined the current status of continuing hospitalization judgement in Mental Health Review Board at the national level and aimed to determine the directions of improvement. METHODS: Using a qualitative case study as the research method, we interviewed 30 Mental Health Review Board members and analyzed the results. RESULTS: Each municipality had very different continuing hospitalization judgement methods. In our systematic review, which consisted of document inspection, we identified reliability problems due to limitations in Mental Health Review Board's operating systems, discharge orders, etc. Additionally, continuing hospitalization judgement needs to improve the objectivity, fairness, and effectiveness of their screening examinations. CONCLUSION: Based on the results of this study, we suggest policy proposals to improve these systems, such as standardizing examination processes, strengthening on-site inspections, increasing the independence and neutrality of judgment in Mental Health Review Board, building community mental health infrastructures, and establishing integrated management systems.