Clinical Characteristics of Psychiatric Patients with Military Issues Using MMPI-2-RF / 정신신체의학

OBJECTIVES: The purpose of this study was to examine psychological characteristics of patients who visited psychiatric clinic for medical certificate for military service using MMPI-2-RF. We compared target group with general psychiatric patients with same age range. METHODS: A total of 165 male patients for medical certificate and 154 general psychiatric patients were collected from the Department of Psychiatry of three university hospitals. There were significant differences of age and educational level between two groups. We used independent t-test, ANCOVA, χ² test to examine differences between two groups. RESULTS: Medical certificate group scored higher on the validity scales, the Higher-Order(H-O) scales, the Restructured Clinical(RC) Scales, the Specific Problems(SP) Scales, and the Personality Psychopathology Five (PSY-5) Scales. Especially, EID, RC7, HLP, SFD, SAV, SHY, DSF, and INTR-r showed significant differences between two groups on all three statistical tests. CONCLUSIONS: The present study showed that psychiatric patients who received psychological evaluation for military service have significantly higher emotional distress, helplessness, lower self-confidence, and lower quality of interpersonal relationships. And the difference of validity scales between two groups could be related with psychological burden of compulsory military service in the study sample which causes elevation on scales of infrequent responses. MMPI-2-RF would be helpful instrument to assess these emotional and psychological characteristics.

Validation of the Mood and Anxiety Symptom Questionnaire in Korean Adolescents

OBJECTIVE: The tripartite model categorizes symptoms of depression and anxiety into three groups: 1) non-specific general distress that is shared between depression and anxiety, 2) depression-specific symptoms that include low positive affect and loss of interest, and 3) anxiety-specific symptoms that include somatic arousal. The Mood and Anxiety Symptoms Questionnaire (MASQ) was developed to measure these three factors of depression and anxiety. The purpose of the present study was to test the psychometric properties of the Korean version of the MASQ (K-MASQ) in adolescents. METHODS: Community-dwelling adolescents (n=933) were randomly assigned to two groups. Exploratory factor analysis and confirmatory factor analysis were conducted in each group to identify the factor structure of the K-MASQ. The reliability and validity of the K-MASQ were also evaluated. RESULTS: Our results support the three-factor structure of the K-MASQ in adolescents. However, we found that the specific items of each factor differed from those of the original MASQ. That is, the depression-specific factor was only related to low positive affect and not loss of interest, and the anxiety-specific factor included more items related to general somatic symptoms of anxiety. The reliability and validity of the K-MASQ were found to be satisfactory. CONCLUSION: The K-MASQ supports the tripartite model of depression and anxiety and has satisfactory reliability and validity among Korean adolescents. The K-MASQ can be used to distinguish unique symptoms of depression and anxiety in Korean adolescents.

A Validation Study of the Korean-Ruminative Response Scale in Korean Adolescents

OBJECTIVE: We aimed to evaluate the psychometric properties of Korean version of Ruminative Response Scale (K-RRS) for Korean adolescents. METHODS: A community sample of 1220 adolescents was recruited from middle schools and high schools. Exploratory factor analyses and confirmatory factor analyses were conducted, and additional analyses were performed to assess the reliability and validity of the K-RRS. RESULTS: An exploratory factor analysis of a sample of adolescents (n=550) yielded a three factor structure: 'depressive rumination', 'reflective pondering', and 'brooding'. Confirmatory factor analyses of another sample of adolescents (n=530) supported the three-factor model for the K-RRS. The K-RRS was found to have good internal consistency and construct validity. CONCLUSION: Our results suggest that K-RRS is a valid measurement to assess rumination in adolescents, as well as in adults.

Comparison of Emotional and Psychological Characteristics between Suicide Attempters and Non-Attempters in Depressed Patients : Using MMPI-2 Profiles / 정신신체의학

OBJECTIVES: To examine emotional and psychological characteristics associated with suicide attempts in depressed patients. METHODS: A sample of 37 inpatients diagnosed with major depressive disorder or depressive disorder NOS was divided into two groups : lifetime suicide attempters(N=15 ; 40.54%), non-attempters(N=22 ; 59.46%). Beck Depression Scale(BDI), Beck Anxiety Scale(BAI), Hamilton Depression Rating Scale(HDRS), Hamilton Anxiety Rating Scale(HARS), and MMPI-2 were used to evaluate symptoms severity and psychological characteristics. RESULTS: Suicide attempters scored higher on the BDI though there were no group differences on the HDRS and on the both anxiety scales. Also they showed higher scores on the F, Fb, Pa, RC1, DEP, HEA, PK, AAS among MMPI-2 subscales. Our findings suggest that suicide attempters among depressed patients undergo more severe subjective distress and difficulties in adjustment than non-attempters. Also they were more hostile to others and showed lower trust. Lastly, they showed more somatic complaints and substance related problems. CONCLUSION: The present study showed that suicide attempters among depressed patients have distinct emotional and psychological characteristics. MMPI-2 would be helpful to assess suicidal risk of depressed patients.

Diagnosis and Psychological Assessment of Generalized Anxiety Disorder / 신경정신의학

Of the anxiety disorders which may be identified in a clinical setting, generalized anxiety disorder (GAD) has often been overlooked for several reasons : 1) its unremarkable place in the diagnostic hierarchy, 2) relationship to excessive anxiety and worry, and 3) comorbidity with other mental disorders which may take clinical precedence. However, clinicians should be attentive to the clinical signs leading to a diagnosis of GAD. This paper reviewed the availability of reliable assessment tools to help clinicians diagnose and assess GAD. First, diagnostic interview tools targeting GAD were introduced. Then, the tools for assessing worry (intensity/frequency/topic), factors associated with its maintenance (cognitive avoidance, intolerance of uncertainty), and tools for assessing generalized anxiety (severity/aspects), comorbid condition and differential diagnosis were reviewed. Lastly, cultural and developmental aspects related to GAD were addressed. The considerations included in this report were summarized in a flow chart and table that are practically useful in the diagnoses and assessment of GAD. Thus, this review provided guidelines for clinicians in the Korean psychiatric setting to enable appropriate diagnosis, assessment, and treatment of GAD.

1-Year Follow-Up of Mindfulness-Based Cognitive Therapy in Patients with Generalized Anxiety Disorder or Panic Disorder / 신경정신의학

OBJECTIVES: Mindfulness-base cognitive therapy (MBCT) has been used to treat patients with depression to prevent relapse. The purpose of this study was to examine the effectiveness of Mindfulness- Base Cognitive Therapy for patients who suffer with generalized anxiety disorder or panic disorder for 1 year. METHODS: 19 patients with generalized anxiety disorder or panic disorder were assigned to receive MBCT for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used at 0 weeks, 8 weeks and 1 year to assess the results. RESULTS: MBCT demonstrated significantly decreases on all the anxiety scale scores (HAM-A, p=0.00 ; BAI, p=0.00) and depressive scale scores (HAM-D, p=0.00 ; BDI, p=0.00). The patients who received 8-week of MBCT showed a higher remission rate (15/19, 78%) during the 1-year followup period. CONCLUSION: MBCT may be effective at relieving the anxiety and depressive symptoms of patients who suffer with generalized anxiety disorder or panic disorder for 1 year. However, further well-designed controlled trials are needed to assess the value of MBCT.

The Reliability and Validity of the Korean Adult Young ADHD Questionnaire-Self-Report(K-YAQ-S) and Young ADHD Questionnaire-Informant-Report(K-YAQ-I) / 신경정신의학

OBJECTIVES: The purpose of this study is to assess the psychometric properties and to investigate factor structure of the Korean version of the Young ADHD Questionnaire-Self-Report (K-YAQ-S) and the Young ADHD Questionnaire-Informant-Report (K-YAQ-I). METHODS: 269 normal college students completed the K-YAQ-S and the Lee Ji-Yeon's adult ADHD scale (1996). 213 informants of the subjects completed the K-YAQ-I. RESULTS: The K-YAQ-S and the K-YAQ-I had good internal consistency (Cronbach's =.957, .965). An ADHD symptomatology and emotional problem subscales of the K-YAQ-S showed strong correlation with the Lee Ji-Yeon's adult ADHD scale. The delinquency and social functioning subscales of the K-YAQ-S and all subscales of the K-YAQ-I correlated significantly but were relatively lower. An exploratory factor analysis showed that the K-YAQ-S revealed 4 factors (ADHD symptomatology, emotional problems, delinquency, social functioning) and the K-YAQ-I being composed of 3 factors (ADHD symptomatology/ aggressive behavior, emotional problem/social functioning, illegal act). CONCLUSION: These results suggest that the K-YAQ-S and the K-YAQ-I rating scale is a reliable and a valid test. These scales would be useful in diagnostic evaluation and in measuring the treatment effect for ADHD adult.

Psychological Characteristics and Changes after the Tattoo Removal

Tattooing has been practised since pre-Christian times, as an object of both fascination and revulsion. In the Present day, body tattoo has been a flourishing and contemporary teen issue. Adolescents have discovered tattoos as a means of self-expression. Due to the external characteristics of the tattoo however, a lot of researchers have shown their interest and done various researches. The examination of the psychological characteristics of the tattooed people revealed that a lot of people have psychological problems, the tattoos revealing the person's deviated image. As a result, several attempts have been made to try and correlate tattoos with the psychiatric diagnoses such as schizophrenia or personality disorder, or with adverse social circumstances such as poverty. The subject of tattoo removal is as old as the history of tattooing itself. Plastic surgeons have witnessed numerous tragic instances where a tattoo has caused hardship, including diminished employment prospects, even loss of love and affection from family and friends and, very commonly, loss of self-esteem. For this reason, the bearers of tattoo often consider the inevitable scarring left by tattoo removal as a preferable alternative. Past techniques of removing tattoos, using corrosive agents or skin graft, have been universally unsuccessful, or certainly less than satisfactory. But, currently laser therapy has been introduced into the market to remove tattoos. As a result, a lot of people have visited hospitals to get tattoos removed. In addition, many of those who had tried to hide the fact that they had tattoos, have been given the opportunity to express their feelings, and rate their psychological statements. This research enables to find the best approach to the person's psychiatric point of view, by objectively observing the person's psychological characteristics and psychological changes after the tattoo removal.