The Clinical Association between the Prevalence of Insomnia and Physical and Psychiatric Disorders in Two Areas of Gyeonggi Province of South Korea / 신경정신의학

OBJECTIVES: The purposes of this study are to examine the sociodemographic factors that increase the prevalence of insomnia, as well as to identify the relationship between the prevalence of insomnia and health conditions by navigating through the prevalence rates of insomnia in two different geographical regions with different socioeconomic structures. METHODS: A survey was conducted targeting 937 residents of Guri-si and Yangpyeong-gun in Gyeonggi Province, Korea. The Insomnia Severity Index was used to verify whether a respondent was experiencing insomnia. The Abbreviated Self-Rated Korean version of the Mini-International Neuropsychiatric Interview was used in diagnosis of mental diseases. Chi-square test was performed to determine the unique relationship between sociodemographic characteristics and the prevalence of insomnia. Multivariate logistic regression analysis was performed to examine the association of prevalence of insomnia with categorized relevant factors. RESULTS: The overall prevalence rate of insomnia for all respondents was 9.26%. The prevalence rate for Yangpyeong-gun was 11.75%, marking a significantly higher figure compared with the prevalence rate for Guri-si, which was 6.87%. Advanced age, female, other marital statuses than married, lower education, lower income, non-existence of private health insurance, and unemployment were risk factors for insomnia. The prevalence of insomnia showed strong association with physical and mental conditions, particularly with mental disorders, urologic diseases, and risk of injury from fall. CONCLUSION: The prevalence rates of insomnia in those two surveyed regions showed a meaningful difference even after controlling for sociodemographic characteristics. These findings suggest that such regional differences merits further attention and additional nationwide epidemiologic studies are needed.

Stressful Life Events and Depression in 60 Year Old Population of Gyeonggi Province : Social Support Can Act as Moderators?

OBJECTIVE: 60-year old Korean population has particular life experiences such as Korean War. With this life experience, we aimed to examine the moderating role of social support on the relationship between adverse life events and depressive symptoms in later life. METHODS: The total respondents were 639 people who were 60-year old dwelling in Yangpyung, Gyeonggi Province, South Korea. One to one interviews were conducted by experienced research assistants. RESULTS: Examining depression, 14.7% of total population showed 15 or higher geriatric depression scale-shortform-Korea score. 70% did report stressful life events as many as 13. Also, 31.6% of total participants were isolated or at high risk of isolation. Using hierarchical multiple regression models, the results showed that social support moderated the influence of the exposure to stressful life events on depression (R2=0.124, beta=-0.118, p<0.01). The moderating effect was greater in male (R2=0.118, beta=-1.36, p<0.01) than that of female (R2=0.113, beta=-0.115, p<0.01), which is apposite to our hypothesis. CONCLUSION: This finding suggests that social support play critical roles in the stress-outcome relationship among 60-years old population like it was suggested. Since most stressful events are inevitable, it is important to build sufficient social support networks.

Psychosocial, Physical, and Autonomic Correlates of Depression in Korean Adults: Results from a County-Based Depression Screening Study

OBJECTIVE: We aimed to investigate the prevalence and psychosocial and neurophysiological correlates of depression in a large county-based cohort of Korean adults. METHODS: We recruited 2355 adults from a rural county-based health promotion program. The following psychometric scales were used: the Center for Epidemiologic Studies Depression scale (CES-D) was used to assess depression, the General Health Questionnaire (GHQ) was used to evaluate stress, and the Medical Outcome Study Social Support Survey (MOS-SSS) was used to determine perceived social support. Heart rate variability (HRV) was used to assess neurophysiological properties. The psychosocial and neurophysiological variables of adults with depression (CES-D score > or =25) and without depression (CES-D score <25) were statistically compared. A logistic regression model was constructed to identify factors independently associated with depression. RESULTS: We estimated that 17.7% of the subjects had depression, which was associated with old age, being female, being single, less religious affiliation, high education, low body mass index (BMI), low levels of aerobic exercise, low social support, and a low HRV triangular index. The explanatory factors of depression included high education, less religious affiliation, low levels of current aerobic exercise, low BMI, and low social support. CONCLUSION: Given the relatively high prevalence of overall depression, subsyndromal depression should also be regarded as an important issue in screening. The independent factors associated with depression suggest that practical psychosocial intervention, including brief psychotherapy, aerobic exercise, and other self-help methods should be considered. In addition, the HRV results suggest that further depression screening accompanied by neurophysiological features would require fine methodological modifications with proactive efforts to prevent depressive symptoms.

Prevalence and Correlates of Depressive Symptoms in Korean Adults: Results of a 2009 Korean Community Health Survey

The aim of this study was to investigate the prevalence and correlates of depressive symptoms in the largest number of Korean individuals examined to date. We analyzed cross-sectional data collected from 229,595 Korean adults aged 19 yr and above who participated in a Korean Community Health Survey conducted in 2009. The Center for Epidemiologic Studies Depression Scale (CES-D) was used as the measurement tool for depressive symptoms (CES-D score over 16) and definite depression (CES-D score over 25). Multivariate logistic regression analysis was performed to identify associations between sociodemographic factors and depressive symptoms. The percentages of depressive symptoms and definite depression in the total study population were 11% (7.8% for men, 14.0% for women) and 3.7%, (2.4% for men, 5.0% for women), respectively. Female gender, older age, disrupted marital status, low education and income level, multigenerational household composition and metropolitan residence were associated with greater risk of depressive symptoms. The present study provides a valid prevalence and correlates of depressive symptoms, using the largest representative sample of the Korean general population to date. Various sociodemographic factors contribute to the prevalence and effects of depressive symptoms in Korea.

Difference of the Heart Rate Variability According to the Social Support Level in a County / 정신신체의학

OBJECTIVES: The present study takes part of the agricultural district cohort study of a certain county located in Gyeonggido and aims to investigate the difference of the heart rate variability(HRV) according to the social support level. METHODS: We used data from 1727 participants of a health promotion program who are older than 40 years old. A physical examination, as well as a one-to-one interview to obtain sociodemographic characteristics, was performed with each participant. In addition, the participants completed the Medical Outcomes Study-Social Support Survey(MOS-SSS) for their the social support level to be assessed, and their HRV were measured to evaluate their autonomic function. The entire group was divided in two groups according to its MOS-SSS points to facilitate the research. Those who were evaluated as the high 25%(432 persons) were denominated as high social support (HSS) group and those who were evaluated as the low 25%(425 persons) were denominated as poor social support(PSS) group. RESULTS: The two groups showed significant differences on the sociodemographic factor such as mean age and gender composition(p<0.05). Comparing the indices related to the HRV, the HSS group had the following values higher than the PSS group : SDNN(F=4.938, p=0.027), TP(F=8.088, p=0.005), VLF(F=6.220, p=0.013) LF (F=3.873, p=0.049). CONCLUSION: According to the research, the PSS group showed dysfunction on their autonomic nervous system comparing to the HSS group. The social support helps an individual overcome difficulties, helps the adaptation during the changes of circumstances and in stressful situations it serves like a buffer. Based on that, it's possible to define that a low social support level gave an impact on the autonomic function. Also, using the fact that the HRV can evaluate the autonomic function in an objective view, it was possible to visualize that it has a potential to be used as an assistant factor to evaluate the social support.

Prevalence of Main Psychiatric Disorders in Relation to Urbanization in Gyeonggi Province by Using the Korean Version of the Mini-International Neuropsychiatric Interview / 신경정신의학

OBJECTIVES: Epidemiological studies have supplied growing evidence of an association between the prevalence of psychiatric disorders and the urban/rural division. We investigated the prevalence and risk factors of the main psychiatric disorders in two areas of Gyeonggi Province of South Korean with different levels of urbanization. METHODS: A survey was conducted of the adult population (over 40 years of age) in Yangpyeong-gun (lower level of urbanization ; n=639) and Guri-si (higher level of urbanization ; n=335) in Gyeonggi Province. The Korean version of the Mini-International Neuropsychiatric Interview (K-MINI) was used as a structured psychiatric diagnostic interview instrument. Major depressive disorder (MDD), suicidality, alcohol dependence, alcohol abuse, generalized anxiety disorder (GAD), somatoform disorder, bipolar disorder, and schizophrenia were selected as the 8 main psychiatric problems. RESULTS: The prevalence of the 8 main psychiatric disorders in Guri-si (25.6%) was higher than those of Yangpyeong-gun (15.1%, p<0.05). In particular, the prevalence of MDD, suicidality, and GAD, which are thought to be strongly influenced by psychosocial factors, were significantly higher in Guri-si (p<0.05). CONCLUSION: A greater prevalence of almost all major psychiatric disorders is associated with higher levels of urbanization, exceptions being somatoform disorders and bipolar disorder. This urban.rural difference may be related to environmental risk factors.

The MMPI Profile of Adult Schizophrenia with Childhood Physical or Sexual Abuse / 신경정신의학

OBJECTIVES: The symptomatic and behavioral correlates of childhood trauma in schizophrenia are beginning to emerge in the literature. This study aimed to investigate whether the association between personality traits and schizophrenia with childhood abuse can be replicated in Koreans using the Multiphasic Minnesota Personality Inventory (MMPI). METHODS: Eighteen schizophrenias with childhood abuse and 24 schizophrenic comparisons without abuse history were recruited at the inpatient units of two general hospitals and the subjects completed the MMPI. RESULTS: Subjects with schizophrenia plus childhood history of abuse had less educational years (p<.001). After controlling the educational year as a covariate, abused schizophrenic patients had higher scores in the Schizotypal (p=.003), Dependent (p=.014), Passive-aggressive (p=.034), Borderline (p=.045) subscales. For the validity and clinical subscales, significant differences were found in the F scale (p=.036), Hypochondriasis (p=.042), Depression (p<.001), Hysteria (p=.002), Personality disorder (p=.001), Paranoia (p=.024), Psychasthenia (p=.001) and Schizophrenia (p=.006) subscales. CONCLUSION: Our findings suggest that childhood abuse in schizophrenia is associated with more complex features of personality characteristics rather than specific cluster B personality traits.

The Therapeutic Factors Affecting Post-discharge Course of Schizophrenia Patients in a University Hospital

OBJECT: To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. METHODS: This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. RESULTS: We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. CONCLUSION: Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.

Association of TNFA Promoter Region Haplotype in Behcet's Disease

Although the etiology of Behcet's Disease (BD; MIM 109650) remains to be clearly elucidated, levels of tumor necrosis factor alpha (TNF-alpha) have been reported to be significantly elevated in BD patients, and TNF-alpha blockers have been demonstrated to exhibit some degree of therapeutic efficacy for a certain subset of BD sufferers. In this study, we have conducted an analysis of the TNFA haplotypes in the promoter response element that affect the binding affinity of specific transcription factors, in order to characterize their association with the clinical features of BD. Six polymorphisms in the promoter region of TNFA were genotyped in 254 BD patients and 344 control subjects, via the PCR-RFLP technique. TNFA -1031*C, -863*A and -308*G alleles were associated with an increased risk of BD (p=0.030, OR=1.4; p=0.008, OR=1.5; p=0.010, OR=1.8, respectively). The sole TNFA haplotype -1031C-863A-857C-376G-308G-238G, was associated with a 1.6 fold increase in the risk of BD, whereas the TNFA haplotype -1031T-863C-857C-376G-308A-238G was associated with a 0.6 decreased risk of BD. The TNFA -1031*C, -863*A, -857*C and -308*G alleles were significantly associated with BD. The findings of this study, collectively, indicate that TNFA haplotypes in the promoter response elements may exert significant influence on susceptibility to BD.

Prevalence of Traumatic Events and Posttraumatic Stress Disorder among Inpatients with Schizophrenia / 신경정신의학

OBJECTIVES: This study investigated the prevalence of traumatic events and posttraumatic stress disorder (PTSD) in an admission cohort of schizophrenic patients from two university affiliated psychiatric units in Korea. Differences in symptomatology between those with and without trauma were also assessed. METHODS: The consecutive sixty one inpatients (32 women and 29 men), who were diagnosed with schizophrenia by SCID-I, completed the Clinician-Administered PTSD Scale (CAPS), the Positive and Negative Syndrome Scale (PANSS), Symptom Checklist-90-Revised (SCL-90-R), Beck Depression Inventory, and State-Trait Anxiety Inventory. RESULTS: Forty patients (66%) had at least one traumatic event in their life time. The most common traumatic event was child physical abuse (34%), followed by accidents (21%), traumatic loss (18%), witnessing violence (15%), child sexual abuse (10%), natural disaster (8%), adult physical assaults (8%), adult sexual assaults (5%), and psychotic symptoms (5%). Only one patient (2%), however, was diagnosed with current PTSD. Patients with traumatic events compared to those without traumatic events demonstrated significantly higher scores on State anxiety scale (p=.006) and several subscales of SCL-90-R including paranoia, anxiety, phobia, interpersonal sensitivity, and degree of psychosis. No differences of sociodemographic and clinical background variables were found between the two groups. CONCLUSION: Low rate (2%) of current PTSD found in this study is comparable to North American literature reporting 10-46% of PTSD within the schizophrenic population. Absence of substance abuse or homelessness and low rate of sexual violence in these Korean patients may explain the discrepant rates. However, distinct symptom profiles of patients with trauma may suggest that PTSD diagnosis runs short of describing such patients. The results from this study imply that schizophrenia per se may not be associated with increased prevalence in current PTSD diagnosis.

Acute Alcohol Responses and Personality Traits by Aldehyde Dehydrogenase 2 Genotype Variances in Patients with Alcohol Dependence

OBJECTIVES: The purpose of this study is to evaluate the pathophysiology of alcoholics by investigating the differences in frequency of Aldehyde Dehydrogenase 2(ALDH2) genotypes and ALDH2 alleles between patients with alcohol dependence and controls, and the differences of drinking and personality traits in Korean male alcoholics with ALDH2 genotype variances. METHODS: The authors selected 98 patients with alcohol dependence and 53 controls. Self-report questionnaires for acute reponses after alcohol ingestion, the AUI(Alcohol Use Inventory), and the NEO-PI-R(NEO Personality Inventory Revised) were given to all patients with alcohol dependence. ALDH2 genotypes were typed with Mbo II RFLP(Restriction Fragment Length Polymorphism) method in 53 controls and 98 patients with alcohol dependence. The authors divided alcoholic patients into two groups according to the presence of variant ALDH22 allele; normal ALDH2 alcoholics(N=87) and variant ALDH2 alcoholics(N=11). RESULTS: 1) The genotypic frequencies of subjects with ALDH21/1 were higher and those with ALDH21/2 and ALDH22/2 were lower in patients than in controls. 2) Alcohol dependence could be found in ALDH22/2 homozygote individuals. 3) Variant ALDH2 alcoholics had more family problems in the AUI than normal ALDH2 alcoholics. 4) Variant ALDH2 alcoholics experienced more flushing and cardiovascular responses after alcohol ingestion than normal ALDH2 alcoholics. 5) Variant ALDH2 alcoholics had less altruistic personality traits in the NEO-PI-R than normal ALDH2 alcoholics. 6) Variant ALDH2 alcoholics tended to have more tolerance to alcohol than normal ALDH2 alcoholics. CONCLUSION: Variant ALDH22 allele might play a protective role in the pathogenesis of alcohol dependence and there were several significant differences of drinking and personality traits in Korean male alcoholics with ALDH2 genotype variances.

Psychosocial Correlates of Duration of Untreated Psychosis in the First-Episode Schizophrenia / 신경정신의학

OBJECTIVES: This study investigated the psychosocial factors and clinical symptoms related to the duration of untreated psychosis (DUP) in 35 consecutive first-episode inpatients with schizophrenia. METHODS: Data from 35 schizophrenic patients were obtained from two general psychiatric inpatient units at a university medical center. These data included scores from Index of Social Position (ISP), Positive and Negative Syndrome Scale (PANSS) and Symptom Checklist-90-Revised (SCL-90-R) as well as socio-demographic informations. RESULTS: Among socio-demographic variables, lower social position (r=.610, p<.001), male sex (r=.407, p=.015), and grew up in rural area (r=.335, p=.045) were significantly correlated with DUP. The interpersonal sensitivity of SCL-90-R was the only symptomatic variable significantly correlated with DUP (r=.379, p=.027). However, after controlling interactive effects of the variables, only lower social position and interpersonal sensitivity remained significant. Lower social position was more influential on DUP than interpersonal sensitivity in the multiple regression model. CONCLUSION: Both social and symptomatic factors independently influenced DUP in schizophrenic patients. Lower social position defined by education and occupation of patients or caretakers may reflect barriers to psychiatric services or poor identification of mental illness. This together with patients' subjective distress in interpersonal interactions may delay the intervention of psychiatric services.

Prevalence and Correlates of Sexual Assault in Psychiatric Patients / 신경정신의학

OBJECTIVES: The direct causal relationship between the experience of sexual assault and development of psychiatric disorder remains uncertain. However, studies consistently show that those with history of this horrendous event report a wide range of symptoms, higher level of distress, and various social and psychological problems. This study investigated the prevalence and associated risk factors in a cohort sample of 340 Korean psychiatric patients. METHODS: Data from consecutive 340 new patients were gathered at a psychiatric department of a university affiliated hospital. Participants completed Life Events Scale, Symptom Checklist-90-R, State-Trait Anxiety Inventory, Beck Depression Inventory, and Dissociative Experiences Scale. RESULTS: History of sexual assault was reported by 11.5% of respondents (women 18.6%;men 2.1%). Bivariate analysis revealed that women (p<.001), divorced or widowed and never been married (p<.05), unemployed and students or housewives (p<.05), monthly income more than 2 million Won (p<.05) were associated significantly with experience of sexual assault. All the scores from the scales but Beck Depression Inventory were significantly higher for the sexually assaulted. Multiple logistic regression analysis revealed that women were 12 times more likely to be sexually assaulted (Odds ratio=12.24, 95% CI=3.51-42.64). Other risk factors included younger age and interaction of post-traumatic stress disorder (PTSD) and Global Severity Index. CONCLUSION: This study supported the risk factors of sexual assaults identified in western literature. Clinicians can be alert for any history of sexual assault when younger women with PTSD present higher level of symptomatology.

Clinical Effectiveness of Urinary Human Chorionic Gonadotropin Related Protein (hCGRP) Quantification for Diagnosis of Ectopic Pregnancy

We detected pregnancy related new molecule, human chorionic gonadotropin related protein (hCGRP) in the urine of a pregnant women by using a monoclonal antibody against the human chorionic gonadotropin (hCG). This study examined the effectiveness of urinary hCGRP quantification in diagnosing ectopic pregnancy. This study included 40 normal pregnant women and 25 patients with ectopic pregnancy. Patients' serum and urinary intact whole hCG (i-hCG) and hCGRP concentrations were measured using sandwich ELISA and the ratio of hCGRP to i-hCG was calculated. Statistical analysis was performed using statistical package for social sciences (SPSS) 10.0. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the cut-off value to discriminate ectopic pregnancies from normal intrauterine pregnancies. Urinary hCGRP and hCGRP/i-hCG ratio in ectopic pregnancy group (14 +/- 6.6 ng/mL, 4.6 +/- 1.9%, respectively) were significantly lower than those of normal pregnancy group (149 +/- 10.2 ng/mL, 29.7 +/- 1.9%, respectively; p<0.001). Based on ROC curve analysis, a cut-off point of urinary hCGRP/i-hCG ratio <16.2% discriminated between ectopic pregnancy and normal pregnancy with a sensitivity, specificity, positive predictive value and negative predictive value of 92.0%, 90.0%, 32.6%, and 99.5%, respectively. Urinary hCGRP/i-hCG ratio measurement may be effective in diagnosing ectopic pregnancy.

A Study of Visual Event-Related Potential P300 in Schizophrenia

OBJECTIVE: Event-related potentials(ERPs) are electrical changes recorded at the surface of the scalp in response to stimulus presentation, and their latency and amplitude change according to cognitive processes. Through past studies of the auditory ERP in schizophrenia, the P300 has been reported to be statistically smaller and delayed in schizophrenia than comparison groups. However, studies of the visual ERP have not been systematically examined. The present study was designed to investigate the visual P300 in patients with schizophrenia and normal controls and to compare the pattern of P300 between them. METHODS: The subjects were composed of patients(N=22) with schizophrenia by DSM-IV and normal controls(N=22). The visual ERPs were measured by the visual continuous performance test. P300 amplitude and latency measured on 5 scalp electrodes(Fz, Cz, Pz, T7, T8) were compared between patients and controls. RESULTS: The P300 latencies measured on Fz, Cz, Pz, and T7 electrodes were significantly longer in patients than controls(p<0.05). The P300 amplitudes in patients were smaller than controls. However, the difference between them was not statistically significant. CONCLUSION: Analysis of the visual ERPs showed that the P300 latency is significantly delayed and the P300 amplitude is slightly smaller in patients than controls. These results are similar to established studies of the auditory P300 in schizophrenia.

The Association between the Psychosocial Well-being Status and Adverse Lipid Profiles in a Rural Korean Community / 예방의학회지

OBJECTIVES: To identify the psychosocial well-being status in a rural community, and examine the association between the psychosocial well-being status and adverse lipid profile. METHOD: In 2001, we surveyed 575 subjects in Yangpyoung, Kyounggido, including medical examination, fasting-blood sample and questionnaires for the psychosocial well-being status, socioeconomic position and behavioral risk factors. The logistic regression analysis was used to examine explanatory factors of the psychosocial well-being status, and association between the psychosocial well-being status and adverse lipid profiles. RESULT: The association between the psychosocial well-being status and adverse lipid profiles was not strong. The total cholesterol and triglyceridelevels were associated with psychosocial well-being. The adjusted odds ratio for moderate psychosocial well-being relating to total cholesterol was 1.90 (95%CI, 0.82-4.04), but that for triglyceride was 0.65 (95%CI, 0.36-1.21). The HDL-Cholesterol and LDL-Cholesterol level were not associated with the psychosocial well-being status. CONCLUSION: The total cholesterol and psychosocial well-being status were weakly associated, but the between the psychosocial well-being status and adverse lipid profiles were not consistent.

Effect of Life-Style Factors on Bone Mineral Density in the Community: Based Survey

OBJECTIVE: This study is designed to evaluate the relationship between bone mineral density (BMD) and life-style factors such as physical activity, smoking, and alcohol consumption and to offer the information for the modification of life-style. METHOD: Eight hundred and sixty nine inhabitants (354 males and 515 females whose age was 55.0+/-13.9 years- old) were participated in this study. BMD was measured in the right calcaneus by quantitative ultrasound (Mark 6000(R), Medison). Amount of physical activity, smoking, and alcohol consumption were got through the closely designed interview. Independent sample T-test and simple regression were used for data analysis. RESULTS: Amount of physical activities were 2656.8+/-732.3 cal/day, smokers were 329 persons (37.9% of inhabitants), and amount of alcohol consumption were 26.2+/-53.3 g/day. Increasing the amount of physical activity, BMD showed significantly higher T-score (p<0.01). Increasing the amount of alcohol consumption, BMD showed significantly lower T-score (p<0.01). BMD in smokers appeared significantly lower T-score than non-smokers (p<0.01). CONCLUSION: Life-style factors significantly effect on bone mineral density. Therefore prevention of osteoporosis through maintenance or augmentation of BMD needs proper physical activity, cessation of smoking, and no heavy drinking.

A Prospective Multicenter Study on the Etiological Analysis of Community-Acquired Pneumonia in Adult Patients in Korea: Detection of Mycoplasma pneumoniae and Chlamydia pneumoniae Infections / 감염

BACKGROUND: The purpose of this study is to develop rapid and sensitive method to detect M. pneumoniae and C. pneumoniae. In addition, we prospectively investigate the prevalence of M. pneumoniae and C. pneumoniae infections in community-acquried pneumonia. METHODS: The nasopharyngeal aspirates were collected from July 1997 to April 2000. PCR or nested PCR techniques were used to detect causative agents. RFLP and nucleotide sequence analysis were performed to study molecular epidemiology. Furthermore, feasibility of one-step technique to detect two microorganisms was tested by use of multiplex PCR. RESULTS: Of 250 clinical specimens, 23 (9.2%) specimens were positive for M. pneumoniae and 33 (13.2%) for C. pneumoniae, including one dual-infected specimen. Most M. pneumoniae infection occurred during the colder months of the year. C. pneumoniae infection was predominently found between December to February. CONCLUSION: The result indicate that M. pneumoniae and C. pneumoniae infections are frequently found from patients with community-acquired pneumoniae.

Development and Evaluation of the Reliability and Validity of the VSSS-82 Korean Version for Measuring Satisfaction with Community-based Mental Health Services in Psychiatric Patients / 예방의학회지

OBJECTIVES: To develop a Korean version of VSSS-82 for measuring the multi-dimensional satisfaction with community-based mental health services in psychiatric patients and to investigate both the reliability and validity of the Korean version. METHODS: The VSSS-82 English version was translated and back-translated with some modification. Data from 68 psychosis patients using community-based mental health services in three Community Mental Health Centers (CMHCs) was collected through a personal interview survey regarding the satisfaction and suitability of service. Variability of satisfaction and internal consistency, discriminant validity, and concurrent validity of the VSSS-82 Korean version were evaluated. RESULTS: A higher number of dissatisfied subjects and significant pairwise differences for the dimensions were found. The Crohnbach's alpha coefficient, a measure of internal consistency, ranged from 0.56 (overall satisfaction) to 0.90 (skills and behavior) and significant differences in satisfaction was found in patients by the self-rated suitability of service. CONCLUSIONS: The VSSS-82 Korean version is a reliable and valid instrument for measuring multi-dimensional satisfaction with community-based mental health service.

Sequence Varation of 5(1) Nontranslating Region of Enterovirus Isolated from Patients with Aseptic Meningitis

No abstract available.