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Objective@#It is essential to measure the effect of burnout on doctors because burnout can affect doctors’ mental health as well as the functioning of medical practice. This study aims to validate a Korean version of the single-item burnout measure (SIBM), which was developed to quickly measure the level of burnout among doctors. @*Methods@#Through an online survey, a self-report questionnaire was administered to 324 public health doctors in Korea. The Korean version of the SIBM was validated against the Maslach Burnout Inventory-General Survey (MBI-GS), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) screening tool, the Perceived Stress Scale (PSS), and the Vaccination Attitudes Examination (VAX) scale. Pearson correlation coefficients and analysis of variance (ANOVA) were used to determine the association between the SIBM and other scales. ANOVA was additionally used to determine the associations between the subscales of the MBI-GS and those of the SIBM. @*Results@#The correlation coefficient between the SIBM and the MBI-GS, PHQ-9, GAD-7, and PSS was positive (p<0.01), and the correlation coefficient between the SIBM and the VAX scale was not significant. Therefore, convergent and discriminant validity was verified. Exhaustion and cynicism, which were correlated with the SIBM, with r2=0.43 (p<0.01) and 0.48 (p<0.01), yielded R2 scores of 0.27 (p<0.01) and 0.20 (p<0.01) in ANOVA. @*Conclusion@#The Korean version of the SIBM is an appropriate screening tool for burnout. It can be evaluated in a short time, thereby enhancing continuous follow-up observations and response rates to burnout.
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Objective@#Cognitive functions have been shown to become impaired due to alcoholism. Recently, neuroinflammation gained attention for playing a role in the neurotoxic effect of alcohol. However, there is limited data on the relationship between alcohol and cognitive function, based on the mechanism of inflammation. This study examined whether the interaction between alcohol use and pro-inflammatory biomarkers is related to cognitive function in Korean male firefighters. @*Methods@#A total of 474 firefighters were assessed for alcohol-related problems using CAGE, cognitive functions, and pro-inflammatory biomarkers (CRP, IL-6, TNF-α). Sequential multiple regression analyses were conducted to determine if inflammatory markers moderate the relationship between alcohol use and cognitive function. @*Results@#Only a decreased attentional function was associated with the interaction of alcohol use and inflammatory markers, after controlling for age, sex, body mass index, lipid profiles, smoking, depression, fatigue, self-reported hypertension, diabetes, and musculoskeletal problems. @*Conclusion@#This study revealed that the interaction between alcohol use and inflammation is related to attentional function in Korean male firefighters. Additionally, this cross-sectional study suggests that diminishing attention, related to alcohol use, may be based on the mechanism of inflammation.
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Objective@#Written exposure therapy (WET) is exposure therapy for post-traumatic stress disorder (PTSD). Compared to evidencebased treatments for PTSD, WET requires only five sessions, has a shorter session time, and no between-session assignments. The current study examined the efficacy of WET among Korean patients with PTSD due to various traumatic events on PTSD symptoms, depressive symptoms, and global functioning levels. @*Methods@#The study recruited 41 patients with a current primary diagnosis of PTSD in psychiatric outpatient clinics. Assessments were conducted at baseline, and at 6, 12, and 24 weeks following the first treatment session. @*Results@#In total, 25 patients started WET. Findings showed a significant reduction in the rate of PTSD diagnosis and symptom severity scores. Fourteen of 23 (60.9%) patients at 6 weeks, 15 of 22 (68.2%) patients at 12 weeks, and 14 of 18 (77.8%) patients at 24 weeks no longer met the diagnosis of PTSD. Depressive symptoms and global function scores also improved after WET. The dropout rate was 8% (n=2). @*Conclusion@#This study suggests the feasibility of implementing WET among various types of patients with PTSD in Korea and other Asian countries.
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Objective@#Cognitive functions have been shown to become impaired due to alcoholism. Recently, neuroinflammation gained attention for playing a role in the neurotoxic effect of alcohol. However, there is limited data on the relationship between alcohol and cognitive function, based on the mechanism of inflammation. This study examined whether the interaction between alcohol use and pro-inflammatory biomarkers is related to cognitive function in Korean male firefighters. @*Methods@#A total of 474 firefighters were assessed for alcohol-related problems using CAGE, cognitive functions, and pro-inflammatory biomarkers (CRP, IL-6, TNF-α). Sequential multiple regression analyses were conducted to determine if inflammatory markers moderate the relationship between alcohol use and cognitive function. @*Results@#Only a decreased attentional function was associated with the interaction of alcohol use and inflammatory markers, after controlling for age, sex, body mass index, lipid profiles, smoking, depression, fatigue, self-reported hypertension, diabetes, and musculoskeletal problems. @*Conclusion@#This study revealed that the interaction between alcohol use and inflammation is related to attentional function in Korean male firefighters. Additionally, this cross-sectional study suggests that diminishing attention, related to alcohol use, may be based on the mechanism of inflammation.
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Objective@#Written exposure therapy (WET) is exposure therapy for post-traumatic stress disorder (PTSD). Compared to evidencebased treatments for PTSD, WET requires only five sessions, has a shorter session time, and no between-session assignments. The current study examined the efficacy of WET among Korean patients with PTSD due to various traumatic events on PTSD symptoms, depressive symptoms, and global functioning levels. @*Methods@#The study recruited 41 patients with a current primary diagnosis of PTSD in psychiatric outpatient clinics. Assessments were conducted at baseline, and at 6, 12, and 24 weeks following the first treatment session. @*Results@#In total, 25 patients started WET. Findings showed a significant reduction in the rate of PTSD diagnosis and symptom severity scores. Fourteen of 23 (60.9%) patients at 6 weeks, 15 of 22 (68.2%) patients at 12 weeks, and 14 of 18 (77.8%) patients at 24 weeks no longer met the diagnosis of PTSD. Depressive symptoms and global function scores also improved after WET. The dropout rate was 8% (n=2). @*Conclusion@#This study suggests the feasibility of implementing WET among various types of patients with PTSD in Korea and other Asian countries.
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As of April 18, 2020, there have been a total of 10,653 confirmed cases and 232 deaths due to coronavirus disease 2019 (COVID-19) in Korea. The pathogen spread quickly, and the outbreak caused nationwide anxiety and shock. This study presented the anecdotal records that provided a detailed process of the multidisciplinary teamwork in mental health during the COVID-19 outbreak in the country. Psychosocial support is no less important than infection control during an epidemic, and collaboration and networking are at the core of disaster management. Thus, a multidisciplinary team of mental health professionals was immediately established and has collaborated effectively with its internal and external stakeholders for psychosocial support during the COVID-19 outbreak.
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Cognitive deficits due to posttraumatic stress disorder (PTSD) affect patients’ social and occupational functioning and lead to social costs. Thus, it is important to understand the nature and extent of PTSD-related neurocognitive deficits to clarify the mechanisms underlying cognitive changes, identify factors that interfere with treatment, and help interpret clinical profiles. This study reviewed recent studies on the relationships between PTSD and neurocognitive domains. The magnitude of the influence of PTSD differs across cognitive function domains. Also, the extent of the effect on any given domain may also differ according to the type of trauma experienced by the subject. In addition to its negative effects on cognitive functioning, PTSD was associated with increased response to threats or trauma-related stimuli, which compromised task performance. Although each PTSD symptom may have a different effect on each cognitive function, it was difficult to generalize the results. This study is significant in that our conclusions, which emerged through a review of studies regarding the relationship between PTSD and cognitive functioning, provide a theoretical basis for further research.
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Cognitive deficits due to posttraumatic stress disorder (PTSD) affect patients’ social and occupational functioning and lead to social costs. Thus, it is important to understand the nature and extent of PTSD-related neurocognitive deficits to clarify the mechanisms underlying cognitive changes, identify factors that interfere with treatment, and help interpret clinical profiles. This study reviewed recent studies on the relationships between PTSD and neurocognitive domains. The magnitude of the influence of PTSD differs across cognitive function domains. Also, the extent of the effect on any given domain may also differ according to the type of trauma experienced by the subject. In addition to its negative effects on cognitive functioning, PTSD was associated with increased response to threats or trauma-related stimuli, which compromised task performance. Although each PTSD symptom may have a different effect on each cognitive function, it was difficult to generalize the results. This study is significant in that our conclusions, which emerged through a review of studies regarding the relationship between PTSD and cognitive functioning, provide a theoretical basis for further research.
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OBJECTIVES@#Maternal depression has a detrimental effect on baby growth. Recent reports suggest that depressive symptoms are more likely to occur during pregnancy than in the postpartum period. In Korea, there are relatively few studies of depression during pregnancy compared to those related to postpartum depression. The purpose of this study is to identify factors associated with antenatal depression.@*METHODS@#The study included 143 pregnant women who had completed the Korean version of the Edinburgh Postnatal Depression Scale (K-EPDS), the Korea-Marital Satisfaction Inventory's global distress scale, the Rosenberg Self-Esteem Scale, and the Connor-Davidson Resilience Scale-2. Based on the K-EPDS scores, we divided the participants into two groups. Logistic regression was performed to identify factors associated with antenatal depression.@*RESULTS@#Thirty (21%) of the subjects were evaluated as being depressed, pregnant women. Pregnant women with high self-esteem and marital satisfaction were less likely to have depression. Similarly, those who are younger and those with an abortion history were more likely to have depression. Past psychiatric history and family history were not significantly different between the two groups.@*CONCLUSION@#Dissatisfaction with marriage, low self-esteem, younger age, and abortion history were closely related to the presence of antenatal depression. The results of this study can be used as baseline data for the development of family-based education programs and early antenatal depression policies.
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OBJECTIVES: Suicide is the most frequent cause of death among Korean adolescents, and adolescents who have experienced trauma have an increased risk of post-traumatic stress disorder (PTSD) symptoms, depression, and suicide attempts. However, resilience and self-esteem are protective factors. We examined the effects of resilience and self-esteem on the relationship among traumatic experiences, PTSD symptoms, depression, and suicidal ideation. METHODS: Middle-school students (n=403) completed questionnaires assessing traumatic experiences, PTSD symptoms, depression, suicidal ideation, resilience, and self-esteem. Path analysis was performed to investigate the mediating effects of PTSD symptoms, resilience, self-esteem, and depression on the relationship between trauma exposure and suicidal ideation. RESULTS: Traumatic experience was positively correlated with PTSD symptoms, depression, and suicidal ideation. PTSD symptoms and depression were positively correlated with suicidal ideation. The relationship between traumatic experiences and suicidal ideation was mediated by PTSD symptoms, which had both direct and indirect effects on suicidal ideation; the indirect effect was mediated by resilience, self-esteem, and depression. CONCLUSION: Korean adolescents who had experienced trauma were more likely to develop PTSD symptoms, increasing their risk of depression and suicidal ideation. However, self-esteem and resilience may help protect against depression and suicidal ideation. Our findings could inform suicide prevention initiatives.
Subject(s)
Adolescent , Humans , Cause of Death , Depression , Negotiating , Protective Factors , Stress Disorders, Post-Traumatic , Suicidal Ideation , SuicideABSTRACT
BACKGROUND: Resilient individuals have a comprehensive ability to adapt to various life circumstances. Psychological resilience predicts an individual’s physiological response to stress. The 10-item Connor-Davidson Resilience Scale (CD-RISC) is a widely used measure to quantify the level of self-perceived resilience. This study examined the psychometric properties of a Korean version of the 10-item Connor-Davidson Resilience Scale (10-item K-CD-RISC) on workers in Gumi, South Korea, exposed to hydrofluoric acid (HF). METHODS: The questionnaires included the 10-item K-CD-RISC and Beck Anxiety Inventor (BAI), the Impact of Event Scale-Revised-Korean version (IES-R-K), the Rosen-berg Self Esteem Scale (RSES), the Center for Epidemiologic Studies-Depression Scale (CES-D), and the Perceived Stress Scale (PSS). These were randomly distributed at 237 workplaces near the HF-spill site, in the Gumi 4 complex. The responses of 991 (67.3%) workers were analyzed. RESULTS: The exploratory factor analysis shown that a single-factor model was consistent with the original design of the 10-item CD-RISC. The scale also demonstrated good internal consistency (Cronbach’s alpha = 0.95). Scores on the scale reflected different levels of resilience with respect to personal factors (age, gender, marital status, and education and income levels) that are thought to be differentiated. Differences of resilience were also reflected by psychiatric symptoms (anxiety and depression). Moreover, the total score of scale positively correlated with RSES, whereas the IES-R-K, BAI, CES-D, and the PSS negatively correlated with the 10-item K-CD-RISC. CONCLUSIONS: The 10-item K-CD-RISC has good psychometric properties and is applicable for victims exposed to noxious chemical such as HF.
Subject(s)
Humans , Anxiety , Education , Hydrofluoric Acid , Inventors , Korea , Marital Status , Psychometrics , Resilience, Psychological , Self Concept , Stress Disorders, Post-TraumaticABSTRACT
OBJECTIVE: The Center for Epidemiological Studies Depression Scale (CES-D) is designed to measure the current level of depressive symptomatology in the general population. However, no review has examined whether the scale is reliable and valid among children and adolescents in Korea. The purpose of this study was to test whether the Korean form of the CES-D is valid in adolescents. METHODS: Data were obtained from 1,884 adolescents attending grades 1–3 in Korean middle schools. Reliability was evaluated by internal consistency (Cronbach’s alpha). Concurrent validity was evaluated by a correlation analysis between the CES-D and other scales. Construct validity was evaluated by exploratory factor and confirmatory factor analyses. RESULTS: The internal consistency coefficient for the entire group was 0.88. The CES-D was positively correlated with scales that measure negative psychological constructs, such as the State Anxiety Inventory for Children, the Korean Social Anxiety Scale for Children and Adolescents, and the Reynold Suicidal Ideation Questionnaire, but it was negatively correlated with scales that measure positive psychological constructs, such as the Korean version of the Rosenberg Self-Esteem Scale and the Connor-Davidson Resilience Scale-2. The CES-D was examined by three-dimensional exploratory factor analysis, and the three-factor structure of the scale explained 53.165% of the total variance. The variance explained by factor I was 24.836%, that explained by factor II was 15.988%, and that explained by factor III was 12.341%. The construct validity of the CES-D was tested by confirmatory factor analysis, and we applied the entire group’s data using a three-factor hierarchical model. The fit index showed a level similar to those of other countries’ adolescent samples. CONCLUSION: The CES-D has high internal consistency and addresses psychological constructs similar to those addressed by other scales. The CES-D showed a three-factor structure in an exploratory factor analysis. The present findings suggest that the CES-D is a useful and reliable tool for measuring depression in Korean adolescents.
Subject(s)
Adolescent , Child , Humans , Adolescent Psychiatry , Anxiety , Depression , Epidemiologic Studies , Fibrinogen , Korea , Prothrombin , Psychometrics , Suicidal Ideation , Thromboplastin , Weights and MeasuresABSTRACT
The proteasome inhibitor, bortezomib, is ineffective against many solid tumors. Nutlin-3 is a potent antagonist of human homolog of murine double minute 2/p53 interaction exhibiting promising therapeutic anti-cancer activity. In this study, we show that treatment of various p53-defective bortezomib-resistant solid tumor cells with bortezomib plus nutlin-3 induces paraptosis, which is a cell death mode accompanied by dilation of the endoplasmic reticulum (ER) and mitochondria. Bortezomib alone did not markedly alter cellular morphology, and nutlin-3 alone induced only a transient mitochondrial dilation. However, bortezomib/nutlin-3 co-treatment triggered the progressive fusion of swollen ER and the formation of megamitochondria, leading to cell death. Mechanistically, proteasomal-impairment-induced ER stress, CHOP upregulation and disruption of Ca²⁺ homeostasis were found to be critically involved in the bortezomib/nutlin-3-induced dilation of the ER. Our results further suggest that mitochondrial unfolded protein stress may play an important role in the mitochondrial dilation observed during bortezomib/nutlin-3-induced cell death. Collectively, these findings suggest that bortezomib/nutlin-3 perturbs proteostasis, triggering ER/mitochondria stress and irrecoverable impairments in their structure and function, ultimately leading to paraptotic cell death.
Subject(s)
Humans , Bortezomib , Cell Death , Endoplasmic Reticulum , Homeostasis , Mitochondria , Proteasome Inhibitors , Up-RegulationABSTRACT
OBJECTIVES: The purpose of this study was to investigate the manner by which social anxiety symptoms, self-esteem, and depression influence suicidal ideation in adolescents. METHODS: This study involved 1320 middle school students. All participants completed several self-assessment questionnaires. Correlations among variables were assessed, and multiple regression analysis was performed to evaluate the relationships between variables and suicidal ideation. Finally, a structural equation model was used to determine the pathways by which the tested variables can influence suicidal ideation. RESULTS: Symptoms of social anxiety were positively correlated with depression and suicidal ideation, but were negatively correlated with self-esteem. Additionally, multiple regression analysis revealed that social anxiety symptoms, depression, and self-esteem were significantly related to suicidal ideation. The influence of social anxiety symptoms on suicidal ideation was associated with an increase in depression, whereas self-esteem acted as an intermediary between social anxiety symptoms and depression. CONCLUSION: The results of the present study demonstrate that social anxiety symptoms can directly increase depression and lower self-esteem, which in turn can increase the risk of suicidal ideation. Thus, it may be possible to prevent depression and ultimately lower the risk of suicide in adolescents by pursuing programs designed for the early detection of social anxiety symptoms and by using intervention programs that improve self-esteem.
Subject(s)
Adolescent , Humans , Anxiety , Depression , Self-Assessment , Suicidal Ideation , SuicideABSTRACT
OBJECTIVE: Second-generation antipsychotics have been repeatedly shown to be superior to placebo. However, the comparative efficacy among these drugs has not been systematically evaluated. In this study, we used Mixed Treatment Comparison (MTC) procedures to elucidate the comparative efficacy and tolerability of second-generation antipsychotics. METHODS: Seven antipsychotics were selected based on the availability of the relevant data. Data were gathered from a series of review article published by the Cochrane Collaboration. Six outcome measures were analyzed: 1) percentage of no clinically important response as defined by the original authors, 2) PANSS total score change from baseline to endpoint, 3) percentage of akathisia, 4) percentage of antiparkinson medication use, 5) percentage of total body weight increase more than 7%, and 6) percentage of drop-out due to any reasons. RESULTS: All the second-generation antipsychotics included in this study showed fairly similar efficacy but widely different tolerability. In terms of efficacy, amisulpride, clozapine and olanzapine were ranked higher than aripiprazole, quetiapine and ziprasidone. Clozapine and olanzapine were superior in terms of akathisia and extrapyramidal symptom risk, but, far more prone to induce clinically important weight gain. CONCLUSION: Using MTC methodology, we could line up the second generation antipsychotics according to their hierarchical superiority in terms of efficacy and tolerability. Though the wide overlap among the confidence intervals and the inconsistency between the direct and indirect comparison results may limit the validity of these results, it may still allow the important insights into the relative merits of the available drugs.
Subject(s)
Antipsychotic Agents , Body Weight , Clozapine , Cooperative Behavior , Outcome Assessment, Health Care , Psychomotor Agitation , Schizophrenia , Weight Gain , Quetiapine Fumarate , AripiprazoleABSTRACT
OBJECTIVE: We examined the relationship between chronotype and sleep disturbance, and assessed various factors that might be associated with sleep disturbance in Korean firefighters. METHODS: Self-administered questionnaires assessing chronotype, depression, alcohol use, posttraumatic stress disorder (PTSD), stress response and sleep quality were examined in 515 firefighters. RESULTS: Evening type firefighters more reported depression, alcohol use, PTSD, stress response and sleep disturbance. Also evening chronotype was the most significant risk factor for poor sleep quality (odds ratio [OR], 4.812; 95% confidence interval [CI], 2.448-9.459), even after controlling for all other variables (OR, 3.996; 95% CI, 1.806-8.841). CONCLUSION: Chronotype was the factor most strongly associated with sleep disturbance, and therefore should be considered an important variable in sleep quality, particularly in occupations involving stressful activities, such as firefighting.
Subject(s)
Humans , Depression , Firefighters , Occupations , Risk Factors , Sleep Initiation and Maintenance Disorders , Stress Disorders, Post-TraumaticABSTRACT
Phendimetrazine and related amphetamine-like compounds are used widely as appetite suppressants in Korea. We report on a patient who developed psychotic disorder and dependence while using phendimetrazine. A 25-year-old female with no psychiatric history began experiencing hallucination of bugs after using phendimetrazine for weight loss for five months. She was admitted and the drug was stopped. Three days later, her psychotic symptoms had subsided and she returned home. Two months after discharge, against medical advice, she returned to a clinic to obtain phendimetrazine for its anorectic effect. She continued using phendimetrazine because she had developed withdrawal symptoms and experienced cravings for it. Within two months of restarting the drug, she had developed paranoid delusions, auditory and olfactory hallucinations. She was readmitted, and was confirmed to have a dependence on phendimetrazine. This case provides a warning that amphetamine-related anorectics can cause psychotic disorder and dependence.
Subject(s)
Adult , Female , Humans , Appetite Depressants , Delusions , Hallucinations , Korea , Morpholines , Psychotic Disorders , Substance Withdrawal Syndrome , Weight LossABSTRACT
Basal autophagy plays a critical role in maintaining cellular homeostasis and genomic integrity by degrading aged or malfunctioning organelles and damaged or misfolded proteins. However, autophagy also plays a complicated role in tumorigenesis and treatment responsiveness. It can be tumor-suppressing during the early stages of tumorigenesis (i.e., it is an anti-tumor mechanism), as reduced autophagy is found in tumor cells and may be associated with malignant transformation. In this case, induction of autophagy would seem to be beneficial for cancer prevention. In established tumors, however, autophagy can be tumor-promoting (i.e., it is a pro-tumor mechanism), and cancer cells can use enhanced autophagy to survive under metabolic and therapeutic stress. The pharmacological and/or genetic inhibition of autophagy was recently shown to sensitize cancer cells to the lethal effects of various cancer therapies, including chemotherapy, radiotherapy and targeted therapies, suggesting that suppression of the autophagic pathway may represent a valuable sensitizing strategy for cancer treatments. In contrast, excessive stimulation of autophagy may also provide a therapeutic strategy for treating resistant cancer cells having high apoptotic thresholds. In order for us to develop successful autophagy-modulating strategies against cancer, we need to better understand how the roles of autophagy differ depending on the tumor stage, cell type and/or genetic factors, and we need to determine how specific pathways of autophagy are activated or inhibited by the various anti-cancer therapies.
Subject(s)
Humans , Anticarcinogenic Agents/therapeutic use , Autophagy/physiology , Cell Transformation, Neoplastic/drug effects , Neoplasms/drug therapyABSTRACT
Tardive blepharospam is characterized by repetitive, forceful, and sustained involuntary contractions of the orbicularis oculi. We report here one case of neuroleptic-induced tardive blepharospasm that developed during high-dose amisulpride treatment and was treated with clozapine. The patient was a 29-year-old man with a 6-year history of schizophrenia. After 33 months of amisulpride treatment (1200 mg/day), involuntary eye-blinking had developed. Following exclusion of all other possible etiopathological causes of the blepharospasm, we decided to switch the drug treatment from amisulpride to clozapine. On the fourteenth day of clozapine (250 mg/day) treatment, we observed significant improvements in eye-blinking and psychotic symptoms. Four months later, the eye-blinking had remitted completely. We suggest that amisulpride may cause blepharospasm and lead to an impaired ability to perform daily activities. Therefore, we recommend that clinicians regularly monitor involuntary movements in patients receiving antipsychotic treatment, especially when high doses of amisulpride are involved.
Subject(s)
Adult , Humans , Blepharospasm , Clozapine , Contracts , Dyskinesias , Organothiophosphorus Compounds , Schizophrenia , SulpirideABSTRACT
OBJECTIVE: This study was done to explore the relationship between circadian types, depressive mood, and sleep quality and to identify the mediating effect of depression between circadian types and sleep quality in shift work nurses. METHODS: Participants were 510 females selected by convenience sampling. Data were collected from October to November 2008 using the Composite Scale for Morningness, Beck Depression Inventory, and Pittsburgh Sleep Quality Index-Korean. The data were analyzed using descriptive statistics, Pearson correlation coefficients, logistic regression and multiple regression. RESULTS: There were significant relationships between sleep quality and circadian types(r=-0.160, p<0.001), and depressive mood (r=0.438, p<0.001). In addition, the circadian types was significantly correlated with depressive mood (r=-0.236, p<0.001). Depressive mood showed mediating effect between circadian types and sleep quality (beta=0.424, p<0.001). Evening type subjects showed higher scores in depressive mood and sleep quality than morning type ones. CONCLUSION: These results suggest that depression and circadian rhythm management in nurses with evening type would contribute to the prevention of sleep disturbance.