Impact of COVID-19-Related Stress and Depression in Public Sector Workers / 정신신체의학

Objectives@#：The coronavirus disease 2019 (COVID-19) outbreak is a global medical crisis imposing particular burden on public sector employees. The aim of this study was to investigate the psychiatric distress among public sector workers amid the COVID-19 pandemic. @*Methods@#：We conducted a cross-sectional study with 531 public sector workers in Gwangmyung city who completed Korean versions of the Perceived Stress Scale (PSS), Patient Health Questionnaire-9 (PHQ-9), and Impact of Event Scale-Revised-Korean (IES-R-K). @*Results@#：The results revealed more than moderate levels of stress (85.2%), depressive symptoms (22.2%), and posttraumatic stress symptoms (38.8%). PSS total score was significantly correlated with PHQ-9, IES-R-K total scores as well as IES-R-K subscale scores. Total scores on the PSS, PHQ-9, and IES-R-K were all inversely correlated with age. @*Conclusions@#：COVID-19-related workers experience considerable stress and depressive symptoms, with self-rated stress correlating significantly with depression scores. Age may serve as a protective factor against oc-cupational stress and burnout. These findings highlight the need for adequate psychiatric screening and interven-tion for public sector workers.

Factors Affecting Admission Type in Patients with Schizophrenia Spectrum / 신경정신의학

OBJECTIVES: This study examined the admission type and its related factors among patients with psychotic disorders defined based on the revised mental health welfare law. METHODS: This study was conducted on a total of 100 patients diagnosed on the schizophrenia spectrum and other psychotic disorders. The admission type and sociodemographic characteristics were examined. Social support, psychopathology, excitement, insight, and social functioning were evaluated using the Social Support Scale, Positive and Negative Syndrome Scale (PANSS), PANSS excitement component, Brief Psychiatric Rating Scale, Global Assessment Functioning Scale, Strauss-Carpenter scale, Korean version of the Scale to Assess Unawareness of Mental Disorder, and Korean version of Beck Cognitive Insight Scale. RESULTS: The severity of psychotic symptoms, excitement, social functioning, and insight were significantly different between involuntary and voluntary admissions (p<0.05). Excitement and insight were found to be factors affecting the admission type (p<0.05). CONCLUSION: Excitement and insight were factors mainly accounting for the admission type in patients with psychotic disorder. This study could be helpful in improving clinical decision-making and community mental health care.

Temperament and Character Traits, Heart Rate Variability and Occupational Stress in New Nursing Employees / 신경정신의학

OBJECTIVES: Nursing is a job with high stress. This study investigated the relationship between temperament and character traits, heart rate variability, and the severity of occupational stress in new nursing employees. METHODS: Ninety-seven nurses newly employed in a Seoul Medical Center from April 2014 to September 2015 were included to the study. Before beginning employment, all subjects were asked to complete a sociodemographic questionnaire and Temperament and Character Inventory (TCI). After they were employed for a month, we administered a heart rate variability test and Korean Occupational Stress Scale (KOSS). RESULTS: Harm avoidance (r=0.334, p=0.001), self-transcendence (r=0.224, p=0.028) and KOSS scores were positively correlated. Self-directedness (r=-0.278, p=0.006) and cooperativeness (r=-0.263, p=0.009) were negatively correlated with KOSS scores. In multiple regression analyses, harm avoidance and cooperativeness were risk factors for severe occupational stress. Physical parameters of total power (r=0.303, p=0.003), very low frequency (VLF ; r=0.318, p=0.002), and standard deviation of the NN interval (r=0.220, p=0.030) were significantly associated with higher KOSS scores. In multiple regression analysis, VLF was significant correlated with KOSS scores. CONCLUSION: Individual factors, such as personality trait or autonomic function, may affect the occupational stress vulnerability on this study. Harm avoidance, cooperativeness in TCI parameters are associated with severity of the occupational stress.

Autosomal Dominant Type of Chronic Progressive External Ophthalmoplegia With Elevated Acetylcholine Receptor Binding Antibody

External ophthalmoplegia and ptosis are common manifestations of mitochondrial cytopathy, such as chronic progressive external ophthalmoplegia (CPEO). However, these symptoms and signs may also be presenting features of myasthenia gravis (MG). There are a few reports of CPEO with elevated acetylcholine receptor antibody (AchR-Ab). We report a case of AD-type CPEO with elevated acetylcholine receptor binding antibody. We confirmed a mutation on the SLC25A4 gene by molecular analysis.

Correlation between Hamstring Flexor Power Restoration and Functional Performance Test: 2-Year Follow-Up after ACL Reconstruction Using Hamstring Autograft

PURPOSE: To evaluate the restoration of the flexor power and the correlation between the flexor power and functional performance tests (FPTs) after anterior cruciate ligament (ACL) reconstruction with hamstring autograft. MATERIALS AND METHODS: Twenty-three men, who underwent ACL reconstruction with hamstring autograft, were evaluated using Lysholm, Subjective IKDC, Tegner activity score, isokinetic flexion and hyperflexion power test, and the FPTs at 1 and 2-year follow-up. We analyzed the mean change from 1 to 2 year and the correlation between both the flexion and hyperflexion power deficit with the FPTs at each follow-up. RESULTS: Mean age of the patients was 30.9 years (range, 19 to 44). Tegner activity score was significantly increased from 5.7 to 6.3 (p=.010). Hyperflexion power of the involved knee deficits significantly decreased at 2 year follow-up compared with 1 year (p<.001). There was a correlation between the flexor power deficit and the co-contraction, carioca, and involved one-legged hop test at each follow-up. However, no significant correlations were revealed between the hyperflexion power deficit and the FPTs. CONCLUSIONS: Hyperflexion power deficit after ACL reconstruction with the hamstring autograft decreased at 2 year follow-up compared to 1 year and does not affect the results of the FPTs.

Clinical Characteristics of Carpal Tunnel Syndrome in Patients With Diabetes

BACKGROUND: The clinical symptoms and signs of carpal tunnel syndrome (CTS) were investigated in patients with diabetes. METHODS: The nondominant hands of 105 consecutive patients with diabetes or CTS were divided into three groups: diabetic CTS, diabetic non-CTS, and nondiabetic CTS. The symptoms of CTS (pain, paresthesias, numbness, awakening, weakness, and clumsiness) were scored using the Global Symptom Score. The following signs of CTS were evaluated: Tinel's sign, Phalen's sign, thenar atrophy, and weakness of the abductor pollicis brevis (APB). The severity of the diabetic neuropathy was evaluated using the Michigan Diabetic Neuropathy Score. The score on the neuropathy scale, number of nerves involved, and the score for each CTS symptom and sign were compared among the groups. RESULTS: The duration of diabetes was longer (p=0.000) and diabetic polyneuropathy was more severe (p=0.014) in the diabetic CTS group than in the diabetic non-CTS group. The mean scores for pain and paresthesias were lower in the diabetic CTS group than in the nondiabetic CTS group (p=0.047 and p=0.049, respectively), whereas the mean scores for numbness and weakness did not differ significantly between these two groups (p=0.528 and p=0.638, respectively). In addition, APB weakness was more frequent whereas Phalen's sign was less frequent in the diabetic CTS group than in the nondiabetic CTS group (p=0.002 and p=0.02, respectively). CONCLUSIONS: Patients with diabetic CTS complained less of pain and paresthesias, but their intrinsic hand function did not differ significantly from that of patients with nondiabetic CTS.